Korean Hemorrhagic Fever was recognized during the Korean War (1950-1953) and intensive studies have been done especially in early 1950's. However, the etiologic agent, vector, and reservoir are not known conclusively. The occurrence has two peak seasons in spring and autumn, and is not limited to military personnel in front lines but also civilians are attacked. Still the study is going on.
Diagnosis, Differential ; Hemorrhagic Fever with Renal Syndrome/epidemiology* ; Hemorrhagic Fever with Renal Syndrome/pathology ; Hemorrhagic Fever with Renal Syndrome/transmission ; Human ; Korea

China ; epidemiology ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Humans ; Population Surveillance

OBJECTIVETo study the incidence and spatiotemporal dynamic variation of hemorrhagic fever with renal syndrome (HFRS) in Shandong province.

METHODSAccording to surveillance data on HFRS epidemics and host animals, a 'contour area multifractal model' was estimated on the HFRS' incidence and multi-analysis model was applied to study spatiotemporal dynamic variation.

RESULTSThe process could be classified into 5 periods: 1st period (1974-1981) when HFRS was in completely natural focal state in Shandong, and the nature of focus was typical Apodemus type. 2nd period (1982-1986) indicated the process of expanding and merging of the Apodemus type focus in the southeastern part of Linyi district and the Rattus type focus was in the southern part of Jining city. 3rd period (1987-1990) indicated that through the expanding and merging of the two epidemic focuses,one mixed focus dominated by the Apodemus type had been formed in the hilly area of the southern and middle part of Shandong while another one dominated by the Rattus type in the Yellow River valley of the northwestern part of Shandong. 4th period (1991-1993) showed that the process of the spatial pattern of the mixed focus dominated by the Rattus type in Shandong. 5th period (1994-2004) referred to the spatial pattern of the mixed focus dominated by the Rattus became stabilized.

CONCLUSIONEvolution of the characteristics of HFRS focus in Shandong province experienced the following three processes: the simple Apodemus type and the simple Rattus type were seen separately to the mixed foci with the Apodemus type dominant and the Rattus dominant type coexisted and merged to the stable state of the mixed focus with Rattus as the dominant one.

China ; epidemiology ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Humans ; Incidence

OBJECTIVETo analyze the spatial distribution of hemorrhagic fever with renal syndrome (HFRS) in Haidian district, Beijing and to explore the geographical characteristics of HFRS in highly endemic areas.

METHODSAdministration boundary layer was established under the background of 1:100,000 map in the ArcInfo 8.1 software. The HFRS cases from 1997 to 2002 were positioned on the map. Highly endemic areas were identified by spatial cluster analysis using SaTScan 3.0 software. Distribution of HFRS cases was shown in different colors and contours by spatial analysis of geographic information system (GIS).

RESULTSSpatial Cluster Analysis of confirmed cases of HFRS identified in 1997 - 2002 in Haidian district showed that HFRS patients were not randomly distributed. The highly endemic areas were founded in Sujiatuo township, Yongfeng township, Shangzhuang township, Wenquan town and Bei'anhe township (relative risk = 4.43, P = 0.001). A thematic map of HFRS in haidian district was set up.

CONCLUSIONHFRS infections were not randomly distributed, since the distribution was related to geographic-environmental factors.

China ; epidemiology ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Humans ; Urban Health ; statistics & numerical data ; Urbanization

OBJECTIVETo take effective strategies and measures for the prevention and control of hemorrhagic fever with renal syndrome (HFRS) endemic areas by investigating its dynamic geographical boundaries in Shandong Province, China.

METHODSThe incidence of HFRS from 1982 to 2008 in Shandong Prvince, China, was detected with inverse distance weighting (IDW) interpolation based on geographical information system (GIS). Dynamic geographical boundaries of HFRS endemic areas in Shandong Province, China, were analyzed by geographical boundary analysis.

RESULTSThe HTN-type endemic areas of HFRS were located in Linyi City in phase 1 (1982-1986), the SEO-type endemic areas of HFRS were located in Jining City in phase 2 (1987-2003), and the endemic areas of HFRS in Jining City gradually disappeared and the endemic areas of HFRS with mixed-types of reservoir rodents were located in Linyi City in phase 3 (2004-2008). Meanwhile, new endemic areas emerged in the northwestern Shandong province, China.

CONCLUSIONThe SEO-type endemic areas of HFRS are located in western Shandong Province, China, and the HTN-type endemic areas of HFRS are located eastern Shandong Province, Chin, indicating that the endemic areas of HFRS should be vaccinated and rodents should be controlled.

China ; epidemiology ; Endemic Diseases ; Geography ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Humans ; Population Surveillance

Animals ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; virology ; Molecular Epidemiology ; Puumala virus ; genetics

OBJECTIVE: The Guanzhong Plain of Shaanxi Province is a severely afflicted hemorrhagic fever with renal syndrome (HFRS) epidemic area, while HFRS prevalence has decreased in most epidemic areas in China. Little information is available regarding the leading fine-scale influencing factors in this highly HFRS-concentrated area and the roles of natural environmental and socioeconomic factors. To investigate this, two regions in the Guanzhong Plain, that is, the Chang'an District and Hu County, with similar geographical environments, different levels of economic development, and high epidemic prevalence, were chosen as representative areas of the HFRS epidemic. METHODS: Maximum entropy models were constructed based on HFRS cases and fine-scale influencing factors, including meteorological, natural environmental, and socioeconomic factors, from 2014 to 2016. RESULTS: More than 95% of the HFRS cases in the study area were located in the northern plains, which has an altitude of less than 800 m, with topography contributed 84.1% of the impact on the spatial differentiation of the HFRS epidemic. In the northern plains, precipitation and population density jointly affected the spatial differentiation of the HFRS epidemic, with contribution rates of 60.7% and 28.0%, respectively. By comparing the influencing factors of the northern plains of Chang'an District and Hu County, we found that precipitation and the normalized difference vegetation index (NDVI) dominated the HFRS epidemic in the relatively developed Chang'an District, while land-use type, temperature, precipitation and population density dominated the HFRS epidemic in the relatively undeveloped Hu County. CONCLUSION Topography was the primary key factor for HFRS prevalence in the Chang'an District and Hu County, and the spatial differentiation of HFRS was dominated by precipitation and population density in the northern plains. Compared with the influencing factors of the relatively developed Chang'an District, the developing Hu County was more affected by socioeconomic factors. When formulating targeted HFRS epidemic prevention and control strategies in the targeted areas, it is crucial to consider the local economic development state and combine natural environmental factors, including the meteorological environment and vegetation coverage.
Humans ; Hemorrhagic Fever with Renal Syndrome/epidemiology* ; China/epidemiology* ; Epidemics ; Socioeconomic Factors ; Altitude

China ; epidemiology ; Epidemiologic Methods ; Geographic Information Systems ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; Humans ; Malaria ; epidemiology ; Schistosomiasis japonica ; epidemiology

BACKGROUNDHemorrhagic fever with renal syndrome (HFRS) is endemic in Junan county, Shandong Province, China. We conducted geographic information system (GIS)-based spatial analysis with the objective of estimating the spatial distribution of rodent populations and their hantavirus infection patterns, to describe the spatial relationships of hantavirus strains in small ecological areas and to identify key areas in endemic areas of HFRS for future public health planning and resource allocation.

METHODSRodent sampling was conducted in seven villages in Junan county from February 2006 to January 2007 using field epidemiological surveillance. Dynamics of hantavirus infection and population densities in rodents were investigated. Spatial statistical techniques including Ripley' L index and nearest neighbour hierarchical (NNH) clustering analysis were conducted to reveal the spatial structure of rodent populations in seven villages. Phylogenetic analysis and two-dimensional minimal spanning tree (2-D MST) models were employed to describe the spatial relationship of hantavirus strains.

RESULTSData showed that Mus musculus was the most common species in our study area, followed by Rattus norvegicus. Ripley's L index and NNH analysis showed that the spatial distribution of all captured rodents, Mus musculus and Rattus norvegicus in seven villages were clustered and there were hotspot areas of rodent distribution. The branches of 2-D MSTs had similar topologies to those of corresponding phylogenetic trees, and hantavirus strains exhibited obvious connective traces in seven villages.

CONCLUSIONSThese results contribute to the understanding of the spatial distribution of rodent populations and hantavirus infection patterns in small areas, and identify priority areas within the epidemic areas for the development of a better prevention strategy against hemorrhagic fever with renal syndrome in a small ecological area.

Animals ; Geographic Information Systems ; Hantavirus ; Hemorrhagic Fever with Renal Syndrome ; epidemiology ; virology ; Humans ; Rats ; Rodentia ; virology

BACKGROUND: Yeoncheon is an endemic region for hemorrhagic fever with renal syndrome (HFRS) and has been reporting HFRS cases intermittently in other seasons, including autumn. This study was conducted to determine whether a seasonal variation pattern of HFRS exists in Yeoncheon. MATERIALS AND METHODS: From 2002 to 2016, raw data of the number of patients with HFRS in Yeoncheon and nationwide was collected from the Korea Center for Disease Control and Prevention. On the basis of the raw data, the incidence per 100,000 population was calculated for each month of the year. The twelve months were divided into four quarters, and the proportion of the disease by each quarter was calculated. The effects of sex, age, quarter, and time on HFRS occurrence were analyzed by Poisson regression analysis. RESULTS: A total of 6,132 HFRS cases occurred nationwide, and 62 cases occurred in Yeoncheon. The incidence of the disease in Yeoncheon (9.07/100,000) was statistically higher than that nationwide (0.81/100,000). The quarterly incidence showed that occurrence proportion of HFRS was high in the third and fourth quarters (12.9%, 67.5%) nationwide, whereas it was relatively similar in all quarters in Yeoncheon (17.7%, 21.0%, 25.8%, 35.5%). The Poisson regression model showed that the relative risk of HFRS nationwide was 1.322 in the third quarter and 6.903 in the fourth quarter, but Yeoncheon had no risk increase by quarter. CONCLUSION: In this study, HFRS in Yeoncheon demonstrated no seasonal variation pattern compared to that in nationwide Korea, which may be considered a regional characteristic. Furthermore, in other regions where HFRS is endemic, like Yeoncheon, HFRS may arise regardless of seasonal variations.
Centers for Disease Control and Prevention (U.S.) ; Endemic Diseases ; Epidemiology ; Hemorrhagic Fever with Renal Syndrome* ; Humans ; Incidence ; Korea* ; Seasons*