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Liu SW, Li JX, Zou L, Liu XQ, Xu G, Xiong Y, Long ZE. Orthohantavirus infections in humans and rodents in the Yichun region, China, from 2016 to 2021. PLoS Negl Trop Dis 2023; 17:e0011540. [PMID: 37552670 PMCID: PMC10437993 DOI: 10.1371/journal.pntd.0011540] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2023] [Revised: 08/18/2023] [Accepted: 07/18/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND Rodents are the predominant natural hosts of orthohantavirus and the source of human infection, hemorrhagic fever with renal syndrome (HFRS) caused by orthohantavirus is a severe public health problem in the Yichun region, Jiangxi Province, China. However, little information is known about the infection of orthohantavirus in humans and rodents, and the genetic characteristics of the epidemic orthohantavirus in the region. METHODS The clinical data of HFRS cases in 2016-2021 was analyzed. Virus infection in rodents was analyzed by orthohantavirus antigen detection using immunofluorescent assay, and the species of orthohantaviruses in rodents and patients were identified by real-time RT-PCR and gene sequencing. The S and M segments of orthohantaviruses from rodents and patients were recovered and analyzed. RESULTS A total of 1,573 HFRS cases were reported in the Yichun region from 2016 to 2021, including 11 death cases. HFRS cases peaked twice each year: in winter from November to January and early summer from May to June. Farmers constituted the predominant population suffering from HFRS. The orthohantavirus antigen was identified in five species of rodents: Apodemus agrarius (A. agrarius), Rattus norvegicus (R. norvegicus), Sorex araneus, Rattus losea (R. losea), and Niviventer confucianus (N. confucianus). The real-time RT-PCR test and genetic analysis results showed that Hantaan orthohantavirus (HTNV), Seoul orthohantavirus (SEOV), and Dabieshan orthohantavirus (DBSV) were circulated in the rodents. HTNV, SEOV, and DBSV from the rodents were distantly related to other known orthohantaviruses and belonged to novel genetic lineages. SEOV and HTNV were found in HFRS patients, but 97.8% (90/92) of the infections were caused by HTNV. Winter and early summer peaks were both caused by HTNV. The HTNV sequences recovered from HFRS cases were closely related to those from A. agrarius. CONCLUSIONS In the Yichun region, the orthohantaviruses transmitted in rodents include HTNV, SEOV, and DBSV, which have obvious genetic characteristics and high genetic diversity. At the same time, this region is an HFRS mixed epidemic area dominated by HTNV, with two peaks every year, which deserves our high attention.
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Affiliation(s)
- Shi-Wen Liu
- College of Life Sciences, Nanchang Key Laboratory of Microbial Resources Exploitation & Utilization from Poyang Lake Wetland, Jiangxi Normal University, Nanchang, Jiangxi, China
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Jian-Xiong Li
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Long Zou
- College of Life Sciences, Nanchang Key Laboratory of Microbial Resources Exploitation & Utilization from Poyang Lake Wetland, Jiangxi Normal University, Nanchang, Jiangxi, China
| | - Xiao-Qing Liu
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Gang Xu
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Ying Xiong
- Laboratory of Viral Infectious Disease, Jiangxi Provincial Center for Disease Control and Prevention, Nanchang, Jiangxi, China
| | - Zhong-Er Long
- College of Life Sciences, Nanchang Key Laboratory of Microbial Resources Exploitation & Utilization from Poyang Lake Wetland, Jiangxi Normal University, Nanchang, Jiangxi, China
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Chen Y, Hou W, Dong J. Time series analyses based on the joint lagged effect analysis of pollution and meteorological factors of hemorrhagic fever with renal syndrome and the construction of prediction model. PLoS Negl Trop Dis 2023; 17:e0010806. [PMID: 37486953 PMCID: PMC10399869 DOI: 10.1371/journal.pntd.0010806] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Accepted: 06/26/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Hemorrhagic fever with renal syndrome (HFRS) is a rodent-related zoonotic disease induced by hantavirus. Previous studies have identified the influence of meteorological factors on the onset of HFRS, but few studies have focused on the stratified analysis of the lagged effects and interactions of pollution and meteorological factors on HFRS. METHODS We collected meteorological, contaminant and epidemiological data on cases of HFRS in Shenyang from 2005-2019. A seasonal autoregressive integrated moving average (SARIMA) model was used to predict the incidence of HFRS and compared with Holt-Winters three-parameter exponential smoothing model. A distributed lag nonlinear model (DLNM) with a maximum lag period of 16 weeks was applied to assess the lag, stratification and extreme effects of pollution and meteorological factors on HFRS cases, followed by a generalized additive model (GAM) to explore the interaction of SO2 and two other meteorological factors on HFRS cases. RESULTS The SARIMA monthly model has better fit and forecasting power than its own quarterly model and the Holt-Winters model, with an optimal model of (1,1,0) (2,1,0)12. Overall, environmental factors including humidity, wind speed and SO2 were correlated with the onset of HFRS and there was a non-linear exposure-lag-response association. Extremely high SO2 increased the risk of HFRS incidence, with the maximum RR values: 2.583 (95%CI:1.145,5.827). Extremely low windy and low SO2 played a significant protective role on HFRS infection, with the minimum RR values: 0.487 (95%CI:0.260,0.912) and 0.577 (95%CI:0.370,0.898), respectively. Interaction indicated that the risk of HFRS infection reached its highest when increasing daily SO2 and decreasing humidity. CONCLUSIONS The SARIMA model may help to enhance the forecast of monthly HFRS incidence based on a long-range dataset. Our study had shown that environmental factors such as humidity and SO2 have a delayed effect on the occurrence of HFRS and that the effect of humidity can be influenced by SO2 and wind speed. Public health professionals should take greater care in controlling HFRS in low humidity, low windy conditions and 2-3 days after SO2 levels above 200 μg/m3.
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Affiliation(s)
- Ye Chen
- Department of Infectious Disease, Shenyang Center for Disease Control and Prevention, Shenyang, PR China
| | - Weiming Hou
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, Peoples' Republic of China
| | - Jing Dong
- Department of Occupational and Environmental Health, School of Public Health, China Medical University, Shenyang, Peoples' Republic of China
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Prevalence of orthohantavirus in rodents: A systematic review and meta-analysis. Travel Med Infect Dis 2023; 51:102504. [PMID: 36402291 DOI: 10.1016/j.tmaid.2022.102504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 11/07/2022] [Accepted: 11/10/2022] [Indexed: 11/18/2022]
Abstract
INTRODUCTION Orthohantaviruses are zoonotic diseases transmitted mainly by rodents, particularly mice and rats, associated with multiple outbreaks in different continents. Despite its epidemiological relevance, there is a lack of systematic reviews and meta-analyses. OBJECTIVE To determine the combined global prevalence of Orthohantavirus infection in rodents. METHODS A systematic literature review was carried out in six databases (Web of Sciences, Scopus, PubMed, SciELO, Lilacs, Google Scholar) to evaluate the proportion of rodents infected with Orthohantavirus, defined by molecular and immunological techniques. The meta-analysis used a random effects model for the pooled prevalence and 95% confidence intervals (95%CI). Heterogeneity measures, Cochrane's Q, the I2 index and the tau-squared test were estimated. RESULTS A total of 35,706 rodents (229 studies) were evaluated for ELISA, in which 3360 were found positive, for seroprevalence of 4.9% (95%CI 4.3-5.4%) (τ2 = 0.001; Q = 4027.708; I2 = 94.339%, p < 0.001). For PCR (N = 8812, 91 studies) it was 3.2% (95%CI 2.5-3.9%) (τ2 = 0.001; Q = 397.483; I2 = 77.358%; p < 0.001). For IFA (N = 555, 7 studies) it was 18.8% (95%CI 9.4-28.2%) (τ2 = 0.011; Q = 51.239; I2 = 88.29%, p < 0.001). At the genus level, the studies evaluated Oligoryzomys (8.98%), Reithrodontomys (8.98%), Peromyscus (8.20%), Rattus (8.20%), and Akodon (6.64%). CONCLUSIONS The global prevalence of Orthohantavirus is worrisome, with an increase in its report in certain regions, including Latin America. In this context, rodents have a role as reservoirs. The data of the present meta-analysis showed considerable seroprevalences with great variations by years, countries and Orthohantavirus species.
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Zhang R, Zhang N, Liu Y, Liu T, Sun J, Ling F, Wang Z. Factors associated with hemorrhagic fever with renal syndrome based maximum entropy model in Zhejiang Province, China. Front Med (Lausanne) 2022; 9:967554. [PMID: 36275790 PMCID: PMC9579348 DOI: 10.3389/fmed.2022.967554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 09/21/2022] [Indexed: 12/03/2022] Open
Abstract
Background Hemorrhagic fever with renal syndrome (HFRS) is a serious public health problem in China. The geographic distribution has went throughout China, among which Zhejiang Province is an important epidemic area. Since 1963, more than 110,000 cases have been reported. Methods We collected the meteorological factors and socioeconomic indicators of Zhejiang Province, and constructed the HFRS ecological niche model of Zhejiang Province based on the algorithm of maximum entropy. Results Model AUC from 2009 to 2018, is 0.806–0.901. The high incidence of epidemics in Zhejiang Province is mainly concentrated in the eastern, western and central regions of Zhejiang Province. The contribution of digital elevation model ranged from 2009 to 2018 from 4.22 to 26.0%. The contribution of average temperature ranges from 6.26 to 19.65%, Gross Domestic Product contribution from 7.53 to 21.25%, and average land surface temperature contribution with the highest being 16.73% in 2011. In addition, the average contribution of DMSP/OLS, 20-8 precipitation and 8-20 precipitation were all in the range of 9%. All-day precipitation increases with the increase of rainfall, and the effect curve peaks at 1,250 mm, then decreases rapidly, and a small peak appears again at 1,500 mm. Average temperature response curve shows an inverted v-shape, where the incidence peaks at 17.8°C. The response curve of HFRS for GDP and DMSP/OLS shows a positive correlation. Conclusion The incidence of HFRS in Zhejiang Province peaked in areas where the average temperature was 17.8°C, which reminds that in the areas where temperature is suitable, personal protection should be taken when going out as to avoid contact with rodents. The impact of GDP and DMSP/OLS on HFRS is positively correlated. Most cities have good medical conditions, but we should consider whether there are under-diagnosed cases in economically underdeveloped areas.
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Affiliation(s)
- Rong Zhang
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Department of Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ning Zhang
- Puyan Street Community Health Service Center of Binjiang District, Hangzhou, Zhejiang, China
| | - Ying Liu
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Department of Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Tianxiao Liu
- School of Science and Technology, University of Tsukuba, Tsukuba, Japan
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Department of Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China,*Correspondence: Jimin Sun,
| | - Feng Ling
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Department of Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China,Feng Ling,
| | - Zhen Wang
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Department of Communicable Disease Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China,Zhen Wang,
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Koehler FC, Di Cristanziano V, Späth MR, Hoyer-Allo KJR, Wanken M, Müller RU, Burst V. OUP accepted manuscript. Clin Kidney J 2022; 15:1231-1252. [PMID: 35756741 PMCID: PMC9217627 DOI: 10.1093/ckj/sfac008] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Indexed: 01/18/2023] Open
Abstract
Hantavirus-induced diseases are emerging zoonoses with endemic appearances and frequent outbreaks in different parts of the world. In humans, hantaviral pathology is characterized by the disruption of the endothelial cell barrier followed by increased capillary permeability, thrombocytopenia due to platelet activation/depletion and an overactive immune response. Genetic vulnerability due to certain human leukocyte antigen haplotypes is associated with disease severity. Typically, two different hantavirus-caused clinical syndromes have been reported: hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). The primarily affected vascular beds differ in these two entities: renal medullary capillaries in HFRS caused by Old World hantaviruses and pulmonary capillaries in HCPS caused by New World hantaviruses. Disease severity in HFRS ranges from mild, e.g. Puumala virus-associated nephropathia epidemica, to moderate, e.g. Hantaan or Dobrava virus infections. HCPS leads to a severe acute respiratory distress syndrome with high mortality rates. Due to novel insights into organ tropism, hantavirus-associated pathophysiology and overlapping clinical features, HFRS and HCPS are believed to be interconnected syndromes frequently involving the kidneys. As there are no specific antiviral treatments or vaccines approved in Europe or the USA, only preventive measures and public awareness may minimize the risk of hantavirus infection. Treatment remains primarily supportive and, depending on disease severity, more invasive measures (e.g., renal replacement therapy, mechanical ventilation and extracorporeal membrane oxygenation) are needed.
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Affiliation(s)
- Felix C Koehler
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Veronica Di Cristanziano
- Institute of Virology, University of Cologne, Faculty of Medicine and University Hospital of Cologne, Cologne, Germany
| | - Martin R Späth
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - K Johanna R Hoyer-Allo
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Manuel Wanken
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
| | - Roman-Ulrich Müller
- Department II of Internal Medicine and Center for Molecular Medicine Cologne, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
- CECAD, University of Cologne, Faculty of Medicine and University Hospital Cologne, Cologne, Germany
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Zhang R, Mao Z, Yang J, Liu S, Liu Y, Qin S, Tian H, Guo S, Ren J, Shi X, Li X, Sun J, Ling F, Wang Z. The changing epidemiology of hemorrhagic fever with renal syndrome in Southeastern China during 1963-2020: A retrospective analysis of surveillance data. PLoS Negl Trop Dis 2021; 15:e0009673. [PMID: 34358248 PMCID: PMC8372920 DOI: 10.1371/journal.pntd.0009673] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 08/18/2021] [Accepted: 07/21/2021] [Indexed: 01/18/2023] Open
Abstract
Background Hemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease caused by hantavirus which was endemic Zhejiang Province, China. In this study, we aim to explore the changing epidemiology of HFRS in Zhejiang, identify high-risk areas and populations, and evaluate relevant policies and interventions to better improve HFRS control and prevention. Methods Surveillance data on HFRS during 1963–2020 in Zhejiang Province were extracted from Zhejiang Provincial Center for Disease Control and Prevention archives and the Chinese Notifiable Disease Reporting System. The changing epidemiological characteristics of HFRS including seasonal distribution, geographical distribution, and demographic features, were analyzed using joinpoint regression, autoregressive integrated moving average model, descriptive statistical methods, and Spatio-temporal cluster analysis. Results From 1963 to 2020, 114 071 HFRS cases and 1269 deaths were reported in Zhejiang Province. The incidence increased sharply from 1973 and peaked in 1986, then decreased steadily and maintained a stable incidence from 2004. HFRS cases were reported in all 11 prefecture-level cities of Zhejiang Province from 1963 to 2020. The joint region (Shengzhou, Xinchang, Tiantai, and surrounding areas), and Kaihua County are the most seriously affected regions throughout time. After 1990, the first HFRS incidence peak was in May-June, with another one from November to January. Most HFRS cases occurred in 21- (26.48%) and 30- years group (24.25%) from 1991 to 2004, but 41- (25.75%) and 51-years (23.30%) had the highest proportion from 2005 to 2020. Farmers accounted for most cases (78.10%), and cases are predominantly males with a male-to-female ratio of 2.6:1. It was found that the median time from onset to diagnosis was 6.5 days (IQR 3.75–10.42), and the time from diagnosis to disease report was significantly shortened after 2011. Conclusions We observed dynamic changes in the seasonal distribution, geographical distribution, and demographic features of HFRS, which should be well considered in the development of control and prevention strategies in future. Additional researches are warranted to elucidate the environmental, meteorological, and social factors associated with HFRS incidence in different decades. This study conducted a long-term and systematic study on the epidemiological characteristics of HFRS in Zhejiang Province from 1963 to 2020 through a combination of time and space analysis and epidemiology, aiming to analyze the distribution characteristics of HFRS and explore the high incidence of epidemics in Zhejiang Province Regional influence. From 1963 to 2020, all 11 prefecture-level cities in Zhejiang Province reported HFRS cases, and the morbidity and mortality rates decreased significantly. However, the geographical distribution of endemic areas has been expanding to eastern Zhejiang Province. Moreover, the age of high-risk groups increases over time. Although the incidence rate has declined in recent years, HFRS is still a huge threat to people’s health. As the incidence rate changes, some epidemiological characteristics have also changed. Comprehensive interventions should also be adjusted, including rodent control in endemic areas, health education, vaccination, and improved detection and diagnosis capabilities for HFRS epidemiological changes.
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Affiliation(s)
- Rong Zhang
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Zhiyuan Mao
- MPH department, college of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Jun Yang
- Institute for Environmental and Climate Research, Jinan University, Guangzhou, China
| | - Shelan Liu
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Ying Liu
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Shuwen Qin
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Huaiyu Tian
- State Key Laboratory of Remote Sensing Science, College of Global Change and Earth System Science, Beijing Normal University, Beijing, China
| | - Song Guo
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Jiangping Ren
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuguang Shi
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
| | - Xuan Li
- MPH department, college of Veterinary Medicine, Cornell University, Ithaca, New York, United States of America
| | - Jimin Sun
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- * E-mail: (JS); (FL); (ZW)
| | - Feng Ling
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- * E-mail: (JS); (FL); (ZW)
| | - Zhen Wang
- Key Laboratory of Vaccine, Prevention and Control of Infectious Disease of Zhejiang Province, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- * E-mail: (JS); (FL); (ZW)
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Sun W, Liu X, Li W, Mao Z, Sun J, Lu L. Effects and interaction of meteorological factors on hemorrhagic fever with renal syndrome incidence in Huludao City, northeastern China, 2007-2018. PLoS Negl Trop Dis 2021; 15:e0009217. [PMID: 33764984 PMCID: PMC7993601 DOI: 10.1371/journal.pntd.0009217] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 02/06/2021] [Indexed: 12/13/2022] Open
Abstract
Background Hemorrhagic fever with renal syndrome (HFRS), a rodent-borne disease, is a severe public health threat. Previous studies have discovered the influence of meteorological factors on HFRS incidence, while few studies have concentrated on the stratified analysis of delayed effects and interaction effects of meteorological factors on HFRS. Objective Huludao City is a representative area in north China that suffers from HFRS with primary transmission by Rattus norvegicus. This study aimed to evaluate the climate factors of lag, interaction, and stratified effects of meteorological factors on HFRS incidence in Huludao City. Methods Our researchers collected meteorological data and epidemiological data of HFRS cases in Huludao City during 2007–2018. First, a distributed lag nonlinear model (DLNM) for a maximum lag of 16 weeks was developed to assess the respective lag effect of temperature, precipitation, and humidity on HFRS incidence. We then constructed a generalized additive model (GAM) to explore the interaction effect between temperature and the other two meteorological factors on HFRS incidence and the stratified effect of meteorological factors. Results During the study period, 2751 cases of HFRS were reported in Huludao City. The incidence of HFRS showed a seasonal trend and peak times from February to May. Using the median WAT, median WTP, and median WARH as the reference, the results of DLNM showed that extremely high temperature (97.5th percentile of WAT) had significant associations with HFRS at lag week 15 (RR = 1.68, 95% CI: 1.04–2.74) and lag week 16 (RR = 2.80, 95% CI: 1.31–5.95). Under the extremely low temperature (2.5th percentile of WAT), the RRs of HFRS infection were significant at lag week 5 (RR = 1.28, 95% CI: 1.01–1.67) and lag 6 weeks (RR = 1.24, 95% CI: 1.01–1.57). The RRs of relative humidity were statistically significant at lag week 10 (RR = 1.19, 95% CI: 1.00–1.43) and lag week 11 (RR = 1.24, 95% CI: 1.02–1.50) under extremely high relative humidity (97.5th percentile of WARH); however, no statistically significance was observed under extremely low relative humidity (2.5th percentile of WARH). The RRs were significantly high when WAT was -10 degrees Celsius (RR = 1.34, 95% CI: 1.02–1.76), -9 degrees Celsius (1.37, 95% CI: 1.04–1.79), and -8 degrees Celsius (RR = 1.34, 95% CI: 1.03–1.75) at lag week 5 and more than 23 degrees Celsius after 15 weeks. Interaction and stratified analyses showed that the risk of HFRS infection reached its highest when both temperature and precipitation were at a high level. Conclusions Our study indicates that meteorological factors, including temperature and humidity, have delayed effects on the occurrence of HFRS in the study area, and the effect of temperature can be modified by humidity and precipitation. Public health professionals should pay more attention to HFRS control when the weather conditions of high temperature with more substantial precipitation and 15 weeks after the temperature is higher than 23 degrees Celsius. Climate change impacts vector-borne disease incidence by influencing vectors’ habitat and behaviors. As a rodent-borne disease, HFRS’s incidence rate fluctuates with the change of meteorological factors. In this study, we model the meteorological factors and time-series cases to explore the exposure-lag-response effect and interaction between meteorological factors on the risk of HFRS, respectively. The result showed there exist a lag effect between meteorological factors and the occurrence of HFRS and we find that a temperature higher than 23 Celsius degrees resulted in a significantly higher HFRS incidence after 15 weeks; a relative humidity higher than 93% led to a significantly higher incidence after 10 weeks. Also, a synergistic interaction between high temperature and high precipitation on HFRS risk was detected, this effect can be attributed to increased animal reproduction and food resources under this environment. This study provides a basis for in-depth evaluating the impact of meteorological factors and their interaction on HFRS.
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Affiliation(s)
- Wanwan Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xiaobo Liu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wen Li
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhiyuan Mao
- Cornell University, Ithaca, New York, United States of America
| | - Jimin Sun
- Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China
- * E-mail: (JMS); (LL)
| | - Liang Lu
- State Key Laboratory of Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Disease, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail: (JMS); (LL)
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Knust B, Brown S, de St Maurice A, Whitmer S, Koske SE, Ervin E, Patel K, Graziano J, Morales-Betoulle ME, House J, Cannon D, Kerins J, Holzbauer S, Austin C, Gibbons-Burgener S, Colton L, Dunn J, Zufan S, Choi MJ, Davis WR, Chiang CF, Manning CR, Roesch L, Shoemaker T, Purpura L, McQuiston J, Peterson D, Radcliffe R, Garvey A, Christel E, Morgan L, Scheftel J, Kazmierczak J, Klena JD, Nichol ST, Rollin PE. Seoul Virus Infection and Spread in United States Home-Based Ratteries: Rat and Human Testing Results From a Multistate Outbreak Investigation. J Infect Dis 2021; 222:1311-1319. [PMID: 32484879 DOI: 10.1093/infdis/jiaa307] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 05/31/2020] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND During 2017, a multistate outbreak investigation occurred after the confirmation of Seoul virus (SEOV) infections in people and pet rats. A total of 147 humans and 897 rats were tested. METHODS In addition to immunoglobulin (Ig)G and IgM serology and traditional reverse-transcription polymerase chain reaction (RT-PCR), novel quantitative RT-PCR primers/probe were developed, and whole genome sequencing was performed. RESULTS Seventeen people had SEOV IgM, indicating recent infection; 7 reported symptoms and 3 were hospitalized. All patients recovered. Thirty-one facilities in 11 US states had SEOV infection, and among those with ≥10 rats tested, rat IgG prevalence ranged 2%-70% and SEOV RT-PCR positivity ranged 0%-70%. Human laboratory-confirmed cases were significantly associated with rat IgG positivity and RT-PCR positivity (P = .03 and P = .006, respectively). Genomic sequencing identified >99.5% homology between SEOV sequences in this outbreak, and these were >99% identical to SEOV associated with previous pet rat infections in England, the Netherlands, and France. Frequent trade of rats between home-based ratteries contributed to transmission of SEOV between facilities. CONCLUSIONS Pet rat owners, breeders, and the healthcare and public health community should be aware and take steps to prevent SEOV transmission in pet rats and to humans. Biosecurity measures and diagnostic testing can prevent further infections.
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Affiliation(s)
- Barbara Knust
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Shelley Brown
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Shannon Whitmer
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sarah E Koske
- Wisconsin Department of Health Services, Madison, Wisconsin, USA
| | - Elizabeth Ervin
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Ketan Patel
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - James Graziano
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Jennifer House
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - Deborah Cannon
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Janna Kerins
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Chicago Department of Public Health, Chicago, Illinois, USA
| | | | - Connie Austin
- Illinois Department of Public Health, Springfield, Illinois, USA
| | | | - Leah Colton
- Colorado Department of Public Health and Environment, Denver, Colorado, USA
| | - John Dunn
- Tennessee Department of Health, Nashville, Tennessee, USA
| | - Sara Zufan
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Mary Joung Choi
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - William R Davis
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Cheng-Feng Chiang
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Craig R Manning
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Linda Roesch
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Trevor Shoemaker
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Lawrence Purpura
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jennifer McQuiston
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | | | - Rachel Radcliffe
- South Carolina Department of Health and Environmental Control, Columbia, South Carolina, USA
| | - Ann Garvey
- South Carolina Department of Health and Environmental Control, Columbia, South Carolina, USA
| | | | - Laura Morgan
- Manitowoc County Health Department, Manitowoc, Wisconsin, USA
| | - Joni Scheftel
- Minnesota Department of Health, St. Paul, Minnesota, USA
| | | | - John D Klena
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Stuart T Nichol
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Pierre E Rollin
- United States Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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9
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Spatiotemporal dynamics of hemorrhagic fever with renal syndrome in Jiangxi province, China. Sci Rep 2020; 10:14291. [PMID: 32868784 PMCID: PMC7458912 DOI: 10.1038/s41598-020-70761-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Accepted: 07/20/2020] [Indexed: 12/16/2022] Open
Abstract
Historically, Jiangxi province has had the largest HFRS burden in China. However, thus far, the comprehensive understanding of the spatiotemporal distributions of HFRS is limited in Jiangxi. In this study, seasonal decomposition analysis, spatial autocorrelation analysis, and space–time scan statistic analyses were performed to detect the spatiotemporal dynamics distribution of HFRS cases from 2005 to 2018 in Jiangxi at the county scale. The epidemic of HFRS showed the characteristic of bi-peak seasonality, the primary peak in winter (November to January) and the second peak in early summer (May to June), and the amplitude and the magnitude of HFRS outbreaks have been increasing. The results of global and local spatial autocorrelation analysis showed that the HFRS epidemic exhibited the characteristic of highly spatially heterogeneous, and Anyi, Fengxin, Yifeng, Shanggao, Jing’an and Gao’an county were hot spots areas. A most likely cluster, and two secondary likely clusters were detected in 14-years duration. The higher risk areas of the HFRS outbreak were mainly located in Jiangxi northern hilly state, spreading to Wuyi mountain hilly state as time advanced. This study provided valuable information for local public health authorities to design and implement effective measures for the control and prevention of HFRS.
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10
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Noack D, Goeijenbier M, Reusken CBEM, Koopmans MPG, Rockx BHG. Orthohantavirus Pathogenesis and Cell Tropism. Front Cell Infect Microbiol 2020; 10:399. [PMID: 32903721 PMCID: PMC7438779 DOI: 10.3389/fcimb.2020.00399] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Accepted: 06/29/2020] [Indexed: 12/20/2022] Open
Abstract
Orthohantaviruses are zoonotic viruses that are naturally maintained by persistent infection in specific reservoir species. Although these viruses mainly circulate among rodents worldwide, spill-over infection to humans occurs. Orthohantavirus infection in humans can result in two distinct clinical outcomes: hemorrhagic fever with renal syndrome (HFRS) and hantavirus cardiopulmonary syndrome (HCPS). While both syndromes develop following respiratory transmission and are associated with multi-organ failure and high mortality rates, little is known about the mechanisms that result in these distinct clinical outcomes. Therefore, it is important to identify which cell types and tissues play a role in the differential development of pathogenesis in humans. Here, we review current knowledge on cell tropism and its role in pathogenesis during orthohantavirus infection in humans and reservoir rodents. Orthohantaviruses predominantly infect microvascular endothelial cells (ECs) of a variety of organs (lungs, heart, kidney, liver, and spleen) in humans. However, in this review we demonstrate that other cell types (e.g., macrophages, dendritic cells, and tubular epithelium) are infected as well and may play a role in the early steps in pathogenesis. A key driver for pathogenesis is increased vascular permeability, which can be direct effect of viral infection in ECs or result of an imbalanced immune response in an attempt to clear the virus. Future studies should focus on the role of identifying how infection of organ-specific endothelial cells as well as other cell types contribute to pathogenesis.
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Affiliation(s)
- Danny Noack
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Marco Goeijenbier
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands.,Department of Internal Medicine, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Chantal B E M Reusken
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands.,Center for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, Netherlands
| | - Marion P G Koopmans
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
| | - Barry H G Rockx
- Department of Viroscience, Erasmus University Medical Center, Rotterdam, Netherlands
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11
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He J, Christakos G, Wu J, Jankowski P, Langousis A, Wang Y, Yin W, Zhang W. Probabilistic logic analysis of the highly heterogeneous spatiotemporal HFRS incidence distribution in Heilongjiang province (China) during 2005-2013. PLoS Negl Trop Dis 2019; 13:e0007091. [PMID: 30703095 PMCID: PMC6380603 DOI: 10.1371/journal.pntd.0007091] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2018] [Revised: 02/19/2019] [Accepted: 12/18/2018] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Hemorrhagic fever with renal syndrome (HFRS) is a zoonosis caused by hantavirus (belongs to Hantaviridae family). A large amount of HFRS cases occur in China, especially in the Heilongjiang Province, raising great concerns regarding public health. The distribution of these cases across space-time often exhibits highly heterogeneous characteristics. Hence, it is widely recognized that the improved mapping of heterogeneous HFRS distributions and the quantitative assessment of the space-time disease transition patterns can advance considerably the detection, prevention and control of epidemic outbreaks. METHODS A synthesis of space-time mapping and probabilistic logic is proposed to study the distribution of monthly HFRS population-standardized incidences in Heilongjiang province during the period 2005-2013. We introduce a class-dependent Bayesian maximum entropy (cd-BME) mapping method dividing the original dataset into discrete incidence classes that overcome data heterogeneity and skewness effects and can produce space-time HFRS incidence estimates together with their estimation accuracy. A ten-fold cross validation analysis is conducted to evaluate the performance of the proposed cd-BME implementation compared to the standard class-independent BME implementation. Incidence maps generated by cd-BME are used to study the spatiotemporal HFRS spread patterns. Further, the spatiotemporal dependence of HFRS incidences are measured in terms of probability logic indicators that link class-dependent HFRS incidences at different space-time points. These indicators convey useful complementary information regarding intraclass and interclass relationships, such as the change in HFRS transition probabilities between different incidence classes with increasing geographical distance and time separation. RESULTS Each HFRS class exhibited a distinct space-time variation structure in terms of its varying covariance parameters (shape, sill and correlation ranges). Given the heterogeneous features of the HFRS dataset, the cd-BME implementation demonstrated an improved ability to capture these features compared to the standard implementation (e.g., mean absolute error: 0.19 vs. 0.43 cases/105 capita) demonstrating a point outbreak character at high incidence levels and a non-point spread character at low levels. Intraclass HFRS variations were found to be considerably different than interclass HFRS variations. Certain incidence classes occurred frequently near one class but were rarely found adjacent to other classes. Different classes may share common boundaries or they may be surrounded completely by another class. The HFRS class 0-68.5% was the most dominant in the Heilongjiang province (covering more than 2/3 of the total area). The probabilities that certain incidence classes occur next to other classes were used to estimate the transitions between HFRS classes. Moreover, such probabilities described the dependency pattern of the space-time arrangement of HFRS patches occupied by the incidence classes. The HFRS transition probabilities also suggested the presence of both positive and negative relations among the main classes. The HFRS indicator plots offer complementary visualizations of the varying probabilities of transition between incidence classes, and so they describe the dependency pattern of the space-time arrangement of the HFRS patches occupied by the different classes. CONCLUSIONS The cd-BME method combined with probabilistic logic indicators offer an accurate and informative quantitative representation of the heterogeneous HFRS incidences in the space-time domain, and the results thus obtained can be interpreted readily. The same methodological combination could also be used in the spatiotemporal modeling and prediction of other epidemics under similar circumstances.
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Affiliation(s)
- Junyu He
- Ocean College, Zhejiang University, Zhoushan, China
| | - George Christakos
- Ocean College, Zhejiang University, Zhoushan, China
- Department of Geography, San Diego State University, San Diego, California, United States of America
- * E-mail: (GC); (WZ)
| | - Jiaping Wu
- Ocean College, Zhejiang University, Zhoushan, China
| | - Piotr Jankowski
- Department of Geography, San Diego State University, San Diego, California, United States of America
| | - Andreas Langousis
- Department of Civil Engineering, University of Patras, Patras, Greece
| | - Yong Wang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
| | - Wenwu Yin
- Division of Infectious Diseases, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wenyi Zhang
- Chinese PLA Center for Disease Control and Prevention, Beijing, China
- * E-mail: (GC); (WZ)
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12
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Blasdell K, Morand S, Henttonen H, Tran A, Buchy P. Hantavirus seropositivity in rodents in relation to habitat heterogeneity in human-shaped landscapes of Southeast Asia. Spat Spatiotemporal Epidemiol 2016; 17:27-35. [PMID: 27246270 DOI: 10.1016/j.sste.2016.04.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 02/08/2016] [Accepted: 04/06/2016] [Indexed: 01/01/2023]
Abstract
To establish how the conversion of natural habitats for agricultural purposes may impact the distribution of hantaviruses in Southeast Asia, we tested how habitat structure affects hantavirus infection prevalence of common murine rodents that inhabit human-dominated landscapes in this region. For this, we used geo-referenced data of rodents analysed for hantavirus infection and land cover maps produced for the seven study sites in Thailand, Cambodia and Lao PDR where they were collected. Rodents were tested by serological methods that detect several hantaviruses, including pathogenic ones. Rodents with a seropositive status were more likely to be found near to agriculture on steep land, and also in environments with a high proportion of agriculture on steep land. These results suggest that in Southeast Asia, hantaviruses, which are often associated with generalist rodent species with a preference for agricultural land, may benefit from land conversion to agriculture.
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Affiliation(s)
- Kim Blasdell
- Institut Pasteur in Cambodia, Virology Unit, 5 Monivong blvd, Phnom Penh, Cambodia; CSIRO Livestock Industries Biosecurity Flagship, Australian Animal Health Laboratory, 5 Portarlington Road, Geelong, VIC 3220, Australia
| | - Serge Morand
- CNRS-CIRAD AGIRs, Centre d'Infectiologie Christophe Mérieux du Laos, Vientiane, Lao Democratic People's Republic; Department of Helminthology, Faculty of Tropical Medicine, Mahidol University, 420/6 Ratchavithi Rd, Ratchathevi, Bangkok 10400, Thailand.
| | | | - Annelise Tran
- CIRAD, UMR TETIS, F-34093 Montpellier, France; CIRAD, UR AGIRs, Montpellier, France
| | - Philippe Buchy
- Institut Pasteur in Cambodia, Virology Unit, 5 Monivong blvd, Phnom Penh, Cambodia; GlaxoSmithKline Vaccines, Gateway West, 150 Beach Road, Singapore 189720, Singapore
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13
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Mattar S, Guzmán C, Figueiredo LT. Diagnosis of hantavirus infection in humans. Expert Rev Anti Infect Ther 2015; 13:939-46. [DOI: 10.1586/14787210.2015.1047825] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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14
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Transmission of haemorrhagic fever with renal syndrome in china and the role of climate factors: a review. Int J Infect Dis 2015; 33:212-8. [PMID: 25704595 DOI: 10.1016/j.ijid.2015.02.010] [Citation(s) in RCA: 41] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2014] [Accepted: 02/15/2015] [Indexed: 11/23/2022] Open
Abstract
Haemorrhagic fever with renal syndrome (HFRS) is a rodent-borne disease that poses a serious public health threat in China. HFRS is caused by hantaviruses, mainly Seoul virus in urban areas and Hantaan virus in agricultural areas. Although preventive measures including vaccination programs and rodent control measures have resulted in a decline in cases in recent years, there has been an increase in incidence in some areas and new endemic areas have emerged. This review summarises the recent literature relating to the effects of climatic factors on the incidence of HFRS in China and discusses future research directions. Temperature, precipitation and humidity affect crop yields, rodent breeding patterns and disease transmission, and these can be influenced by a changing climate. Detailed surveillance of infections caused by Hantaan and Seoul viruses and further research on the viral agents will aid in interpretation of spatiotemporal patterns and a better understanding of the environmental and ecological drivers of HFRS amid China's rapidly urbanising landscape and changing climate.
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15
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Wang CQ, Gao JH, Li M, Guo WP, Lu MQ, Wang W, Hu MX, Li MH, Yang J, Liang HJ, Tian XF, Holmes EC, Zhang YZ. Co-circulation of Hantaan, Kenkeme, and Khabarovsk Hantaviruses in Bolshoy Ussuriysky Island, China. Virus Res 2014; 191:51-8. [PMID: 25087879 DOI: 10.1016/j.virusres.2014.07.021] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Revised: 07/18/2014] [Accepted: 07/22/2014] [Indexed: 12/26/2022]
Abstract
Hemorrhagic fever with renal syndrome (HFRS) was first recognized in far eastern Asia in the 1930s, and has been highly prevalent in this region ever since. To reveal the molecular epidemiology of hantaviruses in this region, a total of 374 small mammals (eight species of rodents and one species of shrew) were captured in the Chinese part of the Bolshoy Ussuriysky Island (Heilongjiang Province). Hantavirus sequences were recovered from three striped field mice (Apodemus agrarius), 11 Maximowicz's voles (Microtus maximowiczii), and one flat-skulled shrew (Sorex roboratus). Genetic and phylogenetic analysis revealed the presence of three viruses: Hantaan virus (HTNV), Khabarovsk virus (KHAV), and Kenkeme virus (KKMV). HTNV sequences recovered from A. agrarius were closely related to those identified in Apodemus mice from the surrounding areas, while a new lineage of KHAV was present in M. maximowiczii. Additionally, while the viral sequences recovered from one flat-skulled shrew were most closely related to KKMV, their divergence to the prototype strain suggests that they represent a new viral subtype. Overall, these results suggest that Bolshoy Ussuriysky Island harbors considerable hantavirus diversity.
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Affiliation(s)
- Cai-Qiao Wang
- State Key Laboratory for Infectious Disease Prevention and Control, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, 102206 Beijing, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang Province, China; School of Basic Medical Sciences, Hebei United University, Tangshan 063000, PR China
| | - Jian-Hua Gao
- Heilong Entry-Exit Inspection and Quarantine Bureau, Harbin, Heilongjiang Province, China
| | - Ming Li
- Heilong Entry-Exit Inspection and Quarantine Bureau, Harbin, Heilongjiang Province, China
| | - Wen-Ping Guo
- State Key Laboratory for Infectious Disease Prevention and Control, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, 102206 Beijing, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang Province, China
| | - Ming-Qing Lu
- Heilong Entry-Exit Inspection and Quarantine Bureau, Harbin, Heilongjiang Province, China
| | - Wen Wang
- State Key Laboratory for Infectious Disease Prevention and Control, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, 102206 Beijing, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang Province, China
| | - Man-Xia Hu
- Heilong Entry-Exit Inspection and Quarantine Bureau, Harbin, Heilongjiang Province, China
| | - Ming-Hui Li
- State Key Laboratory for Infectious Disease Prevention and Control, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, 102206 Beijing, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang Province, China
| | - Jun Yang
- Heilong Entry-Exit Inspection and Quarantine Bureau, Harbin, Heilongjiang Province, China
| | - Hui-Jie Liang
- Heilong Entry-Exit Inspection and Quarantine Bureau, Harbin, Heilongjiang Province, China
| | - Xi-Feng Tian
- School of Basic Medical Sciences, Hebei United University, Tangshan 063000, PR China
| | - Edward C Holmes
- State Key Laboratory for Infectious Disease Prevention and Control, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, 102206 Beijing, China; Marie Bashir Institute for Infectious Diseases and Biosecurity, Charles Perkins Centre, School of Biological Sciences and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Yong-Zhen Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping Liuzi 5, 102206 Beijing, China; Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, Zhejiang Province, China.
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16
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Adams K, Jameson L, Meigh R, Brooks T. Hantavirus: an infectious cause of acute kidney injury in the UK. BMJ Case Rep 2014; 2014:bcr-2014-205529. [PMID: 25035452 DOI: 10.1136/bcr-2014-205529] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
We present a case of an undifferentiated febrile illness in a 59-year-old man from East Yorkshire. He was initially treated for leptospirosis due to the fact that he had farm exposure and the findings of acute kidney injury (AKI), thrombocytopenia and a raised alanine transferase (ALT) on his initial blood results. Serology tests later proved him to have had another rodent-borne illness: hantavirus. An investigation by Public Health England (formerly known as Health Protection Agency) (PHE) went on to prove the presence of the same serotype of hantavirus in rats caught on the patient's property. After an initial deterioration, the patient made a relatively uneventful recovery and all his blood tests returned to normal levels.
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Affiliation(s)
- Kate Adams
- Department of Infection, Castle Hill Hospital, Cottingham, East Yorkshire, UK
| | - Lisa Jameson
- Rare and Imported Pathogens Laboratory, Salisbury, Wiltshire, UK
| | - Rolf Meigh
- Department of Infection, Castle Hill Hospital, Cottingham, East Yorkshire, UK
| | - Tim Brooks
- Rare and Imported Pathogens Laboratory, Salisbury, Wiltshire, UK
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17
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Chen ZH, Qin XC, Song R, Shen Y, Chen XP, Wang W, Zhao YX, Zhang JS, He JR, Li MH, Zhao XH, Liu DW, Fu XK, Tian D, Li XW, Xu J, Plyusnin A, Holmes EC, Zhang YZ. Co-circulation of multiple hemorrhagic fever diseases with distinct clinical characteristics in Dandong, China. PLoS One 2014; 9:e89896. [PMID: 24587107 PMCID: PMC3937409 DOI: 10.1371/journal.pone.0089896] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Accepted: 01/29/2014] [Indexed: 12/14/2022] Open
Abstract
Hemorrhagic fevers (HF) caused by viruses and bacteria are a major public health problem in China and characterized by variable clinical manifestations, such that it is often difficult to achieve accurate diagnosis and treatment. The causes of HF in 85 patients admitted to Dandong hospital, China, between 2011–2012 were determined by serological and PCR tests. Of these, 34 patients were diagnosed with Huaiyangshan hemorrhagic fever (HYSHF), 34 with Hemorrhagic Fever with Renal Syndrome (HFRS), one with murine typhus, and one with scrub typhus. Etiologic agents could not be determined in the 15 remaining patients. Phylogenetic analyses of recovered bacterial and viral sequences revealed that the causative infectious agents were closely related to those described in other geographical regions. As these diseases have no distinctive clinical features in their early stage, only 13 patients were initially accurately diagnosed. The distinctive clinical features of HFRS and HYSHF developed during disease progression. Enlarged lymph nodes, cough, sputum, and diarrhea were more common in HYSHF patients, while more HFRS cases presented with headache, sore throat, oliguria, percussion pain kidney area, and petechiae. Additionally, HYSHF patients displayed significantly lower levels of white blood cells (WBC), higher levels of creations kinase (CK) and alanine aminotransferase (ALT), while HFRS patients presented with an elevation of blood urea nitrogen (BUN) and creatinine (CREA). These clinical features will assist in the accurate diagnosis of both HYSHF and HFRS. Overall, our data reveal the complexity of pathogens causing HFs in a single Chinese hospital, and highlight the need for accurate early diagnosis and a better understanding of their distinctive clinical features.
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Affiliation(s)
- Zhi-Hai Chen
- Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xin-Cheng Qin
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Rui Song
- Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yi Shen
- Department of Infectious Diseases, Dandong Infectious Hospital, Dandong, Liaoning Province, China
| | - Xiao-Ping Chen
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Wen Wang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Yong-Xiang Zhao
- Department of Infectious Diseases, Dandong Infectious Hospital, Dandong, Liaoning Province, China
| | - Jing-Shan Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Jin-Rong He
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ming-Hui Li
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Xue-Hua Zhao
- Department of Infectious Diseases, Dandong Infectious Hospital, Dandong, Liaoning Province, China
| | - De-Wei Liu
- Department of Infectious Diseases, Dandong Infectious Hospital, Dandong, Liaoning Province, China
| | - Xiao-Kang Fu
- Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Di Tian
- Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Xing-Wang Li
- Department of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Jianguo Xu
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Alexander Plyusnin
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- Department of Virology, Haartman Institute, University of Helsinki, Finland
| | - Edward C. Holmes
- Marie Bashir Institute for Infectious Diseases and Biosecurity, School of Biological Sciences and Sydney Medical School, The University of Sydney, Sydney, Australia
| | - Yong-Zhen Zhang
- State Key Laboratory for Infectious Disease Prevention and Control, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Department of Zoonoses, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
- * E-mail:
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18
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Ongoing spillover of Hantaan and Gou hantaviruses from rodents is associated with hemorrhagic fever with renal syndrome (HFRS) in China. PLoS Negl Trop Dis 2013; 7:e2484. [PMID: 24147168 PMCID: PMC3798614 DOI: 10.1371/journal.pntd.0002484] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2013] [Accepted: 09/06/2013] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Longquan City, Zhejiang province, China, has been seriously affected by hemorrhagic fever with renal syndrome (HFRS) since the first cases were registered in 1974. To understand the epidemiology and emergence of HFRS in Longquan, which may be indicative of large parts of rural China, we studied long-term incidence patterns and performed a molecular epidemiological investigation of the causative hantaviruses in human and rodent populations. METHOD/PRINCIPAL FINDINGS During 1974-2011, 1866 cases of HFRS were recorded in Longquan, including 20 deaths. In 2011, the incidence of HFRS remained high, with 19.61 cases/100,000 population, despite the onset of vaccination in 1997. During 1974-1998, HFRS cases in Longquan occurred mainly in winter, while in the past decade the peak of HFRS has shifted to the spring. Notably, the concurrent prevalence of rodent-borne hantaviruses in the region was also high. Phylogenetic analyses of viral sequences recovered from rodents in Longquan revealed the presence of novel genetic variants of Gou virus (GOUV) in Rattus sp. rats and Hantaan virus (HTNV) in the stripe field mice, respectively. Strikingly, viral sequences sampled from infected humans were very closely related to those from rodents. CONCLUSIONS/SIGNIFICANCE HFRS represents an important public health problem in Longquan even after years of preventive measures. Our data suggest that continual spillover of the novel genetic variant of GOUV and the new genetic lineage of HTNV are responsible for the high prevalence of HFRS in humans. In addition, this is the first report of GOUV associated with human HFRS cases, and our data suggest that GOUV is now the major cause of HFRS in this region.
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Noh JY, Cheong HJ, Song JY, Kim WJ, Song KJ, Klein TA, Lee SH, Yanagihara R, Song JW. Clinical and molecular epidemiological features of hemorrhagic fever with renal syndrome in Korea over a 10-year period. J Clin Virol 2013; 58:11-7. [PMID: 23871164 DOI: 10.1016/j.jcv.2013.06.027] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 05/25/2013] [Accepted: 06/14/2013] [Indexed: 11/16/2022]
Abstract
BACKGROUND Laboratory diagnosis of hemorrhagic fever with renal syndrome (HFRS), an infectious disease caused by rodent-borne hantaviruses in Asia and Europe, depends primarily on serological methods. Since the advent of such serodiagnostic tests, few reports are available about the clinical and molecular epidemiological features of HFRS. OBJECTIVES To investigate the epidemioclinical features of HFRS patients treated at a tertiary-care teaching hospital in Seoul over a 10-year period. STUDY DESIGN Medical records of HFRS patients, admitted to a tertiary-care teaching hospital during February 2002 to February 2012, were reviewed. Sera from patients were tested for Hantaan virus (HTNV) and Seoul virus (SEOV) RNA using RT-PCR. RESULTS Among 35 HFRS patients (mean age was 44.2±14.7 years), 29 were male (82.9%). Acute renal failure developed in 27 patients (77.1%), and 12 patients (34.3%) were admitted to the intensive care unit (ICU). Conjunctival injection (OR 10.32, 95% CI 1.09-97.77, P=.04) and initial serum albumin less than 3g/dL (OR 22.83, 95% CI 1.45-359.93, P=.03) were risk factors for ICU admission. Of 35 acute-phase sera, 11 (31.4%) were positive for HTNV RNA. None were positive for SEOV RNA. CONCLUSIONS HFRS was characterized by the clinical triad of fever, renal insufficiency and gastrointestinal symptoms. Conjunctival injection and serum albumin level were related to severity. A large-scale multi-center study is needed to enhance insights into epidemioclinical characteristics of HFRS in Korea.
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Affiliation(s)
- Ji Yun Noh
- Department of Microbiology, College of Medicine, Korea University, Seoul 136-705, Republic of Korea
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Sargianou M, Watson DC, Chra P, Papa A, Starakis I, Gogos C, Panos G. Hantavirus infections for the clinician: From case presentation to diagnosis and treatment. Crit Rev Microbiol 2012; 38:317-29. [DOI: 10.3109/1040841x.2012.673553] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
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