Space–time pattern of hepatitis A in Spain, 1997–2007

Investigating the spatio-temporal variation of hepatitis A in Korea using a Bayesian model

Hepatitis A is a water-borne infectious disease that frequently occurs in unsanitary environments. However, paradoxically, those who have spent their infancy in a sanitary environment are more susceptible to hepatitis A because they do not have the opportunity to acquire natural immunity. In Korea, hepatitis A is prevalent because of the distribution of uncooked seafood, especially during hot and humid summers. In general, the transmission of hepatitis A is known to be dynamically affected by socioeconomic, environmental, and weather-related factors and is heterogeneous in time and space. In this study, we aimed to investigate the spatio-temporal variation of hepatitis A and the effects of socioeconomic and weather-related factors in Korea using a flexible spatio-temporal model. We propose a Bayesian Poisson regression model coupled with spatio-temporal variability to estimate the effects of risk factors. We used weekly hepatitis A incidence data across 250 districts in Korea from 2016 to 2019. We found spatial and temporal autocorrelations of hepatitis A indicating that the spatial distribution of hepatitis A varied dynamically over time. From the estimation results, we noticed that the districts with large proportions of males and foreigners correspond to higher incidences. The average temperature was positively correlated with the incidence, which is in agreement with other studies showing that the incidences in Korea are noticeable in spring and summer due to the increased outdoor activity and intake of stale seafood. To the best of our knowledge, this study is the first to suggest a spatio-temporal model for hepatitis A across the entirety of Korean. The proposed model could be useful for predicting, preventing, and controlling the spread of hepatitis A.

Acute hepatitis due to hepatitis A virus during the 2017 epidemic expansion in Asturias. Spain

INTRODUCTION

Since June 2016, there has been an increase in cases of acute hepatitis A (AHA) in several European countries, mainly affecting men who have sex with men (MSM). The aim was to know the characteristics of AHA diagnosed in recent months, comparing them with a previous series.

PATIENTS AND METHODS

All cases of AHA diagnosed in adults between November 2016 and December 2017 (G-I; n=108) were prospectively collected and compared with a series also prospectively collected between January 2004 and September 2016 (G-II; n=49), analysing clinical and epidemiological characteristics.

RESULTS

Compared with group II, in group I there was a greater proportion of males (95.4 vs. 81.6%; p=0.005), of MSM (63.9 vs. 22.4%; p<0.001), of cases with positive luetic serology (20.4 vs 2%; p=0.001) and of severe acute hepatitis (15 vs. 4%; p=0.043).

CONCLUSIONS

AHA diagnosed in recent months in our environment mainly affect MSM and have a more serious presentation with respect to what was observed in a historical series, highlighting the need to increase the vaccination rate against the hepatitis A virus.

Association between meteorological factors and hepatitis A in Spain 2010-2014

BACKGROUND

There is growing concern of how climate change could affect public health, due to the increase number of extreme climate events. Hence, the study of the role that climate events play on the distribution of waterborne diseases, like Hepatitis A, could be key for developing new prevention approaches.

OBJECTIVE

To investigate the association between climate factors and Hepatitis A in Spain between 2010 and 2014.

METHODS

Weekly Hepatitis A cases between 2010 and 2014 were obtained from the Spanish Epidemiology Surveillance Network. Climate variables (weekly cumulative rainfall, rainy days, storm days and snow days) were obtained from National Climatic Data Center (NOAA satellite and information Service of USA). Each municipality was assigned to the nearest weather station (N=73). A Mixed-Effects Poisson regression was performed to estimate Incidence Rate Ratios (IRR), including a time lag of 2, 3 and 4weeks (most probable incubation period for Hepatitis A).

RESULTS

Rainfall higher than 90th percentile (extreme precipitation) was associated with increased number of Hepatitis A cases 2weeks (IRR=1.24 CI 95%=1.09-1.40) and 4weeks after the event (IRR=1.15 CI 95%=1.01-1.30). An extra rainy day increased the risk of Hepatitis A two weeks after (IRR=1.03 CI 95%=1.01-1.05). We found higher risk of Hepatitis A two weeks after each extra storm day (IRR=1.06 CI 95%=1.00-1.12), and lower risk with 3 and 4weeks' lag (IRR=0.93 CI 95%=0.88-0.99 for lag3; IRR=0.94 CI 95%=0.88-0.99 for lag 4).

CONCLUSIONS

There is an increased risk of Hepatitis A 2weeks after water-related climate events. Including meteorological information in surveillance systems might improve to develop early prevention strategies for waterborne diseases.

Epidemiological and etiological characteristics of hand, foot, and mouth disease in Henan, China, 2008-2013

Hand, foot, and mouth disease (HFMD) is a common childhood illness caused by enteroviruses. HFMD outbreaks and reported cases have sharply increased in China since 2008. Epidemiological and clinical data of HFMD cases reported in Henan Province were collected from 2008 to 2013. Clinical specimens were obtained from a subset of these cases. Descriptive epidemiological methods were used to analyze the time, region and population distribution. The VP1 gene from EV71 and CA16 isolates was amplified, and the sequences were analyzed. 400,264 cases of HFMD were reported in this study, including 22,309 severe and 141 fatal cases. Incidence peaked between April and May. Laboratory confirmation was obtained for 27,692 (6.9%) cases; EV71, CA16, and other enteroviruses accounted for 59.5%, 14.1%, 26.4%, respectively. Phylogenetic analysis revealed that EV71 belonged to the C4a evolution branch of C4 sub-genotype and CA16 belonged to subtype B1a or B1b. The occurrence of HFMD in Henan was closely related to season, age and region distribution. Children under five were the most affected population. The major pathogens causing HFMD and their genotypes have not notably changed in Henan. The data strongly support the importance of EV71 vaccination in a high population density area such as Henan, China.

Spatial distribution and cluster analysis of a leishmaniasis outbreak in the south-western Madrid region, Spain, September 2009 to April 2013

Binary file ES_Abstracts_Final_ECDC.txt matches

Spatiotemporal analysis of infant measles using population attributable risk in Shandong province, 1999-2008

BACKGROUND

Reduction of measles incidence and mortality has been encouraging in China. However, it remains an important public health concern among infants. This study aimed to examine the space-time distribution pattern of infant measles occurrence for the period of 1999-2008 in Shandong, China.

METHODS AND FINDINGS

Measles cases among infants aged younger than 1 year were obtained from the national infectious diseases reporting information system. A spatiotemporal analysis using population attributable risk percent (PAR%) was used to distinguish between multiple geographic clusters of potential interest. The analysis detected 29 statistically significant space-time clusters with the most likely cluster in Zaozhuang City from 2006 to 2008. Of the 28 secondary clusters, 22 were found in 2008. The map of PAR%, relative risk (RR) and space-time cluster analysis indicated that the clusters were generally unchanged, and were found south-west and north-west of Shandong. The Lanshan District in Linyi had the highest PAR%, while highest RR was in the Yicheng District in Zaozhuang.

CONCLUSION

There were significant space-time clusters of infant measles in Shandong over the study period. PAR% is an effective way to analyze multiple clusters from their application like RR. Interrupting measles circulation and maintaining routine coverage over 95% may be the only effective strategy to achieve measles elimination.