Hemorrhagic fever with renal syndrome in Nanjing, China:long-term trends and epidemiological characteristics from 2015 to 2020 and the early warning threshold value
MA Tao1, ZHOU Qin-yi1, XU Qing1, WANG Jun-jun1, XING Guang-hong2, WANG Heng-xue1, ZHENG Ying3, HONG Lei1, ZHANG Shou-gang4
1. Department of Acute Infectious Disease Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing 210003, China; 2. Department of Disease Control and Prevention, Gaochun District Center for Disease Control and Prevention, Nanjing 211300, China; 3. Department of Scientific Research and Education Management, Nanjing Center for Disease Control and Prevention, Nanjing 210003, China; 4. Department of Disinfection and Vector Control, Nanjing Center for Disease Control and Prevention, Nanjing 210003, China
Abstract：This study aimed to understand the long-term trends and epidemic characteristics of hemorrhagic fever with renal syndrome (HFRS) in Nanjing, to explore prevention and control measures in key areas, predict the incidence in 2021, establish an early warning threshold value, and scientifically guide prevention and control strategies and measures. Descriptive epidemiology methods were used to examine the long-term trends in the reported incidence of HFRS from 1979 to 2020 in Nanjing and the epidemiological characteristics of HFRS from 2015 to 2020. Global spatial autocorrelation analysis and retrospective spatiotemporal rearrangement scans were used to assess HFRS spatial heterogeneity and spatial-temporal clustering in Nanjing. The early warning threshold value and the number of reported cases each month in 2021 were predicted on the basis of the moving median and Poisson distribution. The reported incidence rate of HFRS in Nanjing was 7.18/100 000 (436 cases) in 1982 and decreased to 2.00/10 million in the 1990s (except 1993). Since 2000, the reported incidence rates have all been within 0.60/10 million. From 2015 to 2020, 222 HFRS cases were reported; the median was 34 (21 to 53) cases. The median reported incidence rate was 2.55/100 000 (1.47/100 000 to 706/100 000), or 83.3% from December to the following June. During that time, March to June accounted for 52.7% of cases. Among all reported cases, men accounted for 64.9%. The median age was 51 (15 to 82) years, 68.9% were 45 years of age or older, and 33.8% were 60 years of age or older. Additionally, farmers accounted for 60.8% of cases, and homemakers and unemployed people accounted for 13%. In southern Nanjing, the number of reported cases was 105 in Gaochun District, 37 in Lishui District and 35 in Jiangning District, which accounted for 79.7% of cases in the city. Global spatial autocorrelation analysis showed that Moran’s I values were all positive (0.150-0.590), P<0.001. From 2016 to 2020, the cluster area was Gaochun District. In other years, the cluster areas were Gaochun District and Lishui District. All aggregation dates were distributed in the first half of the year (all P<0.001). Significantly, five blocks in northern and eastern Gaochun District and the town of Hefeng in northern Lishui District reported 76.1% cases in the two districts. The number of reported cases of HFRS in 2021 is projected to be 34 (95%CI:22-47), with a monthly forecast value of one to four cases and an early warning threshold value of four to nine cases from January to December. The HFRS epidemic has been controlled effectively in Nanjing since 1979. Forecasts indicate that the epidemic will remain stable, and an early warning threshold value was determined in 2021. Farmers and older people are the key affected groups. However, the incidence remains high in some areas in Gaochun District and Lishui District. Further research and continued intensification of comprehensive prevention and control measures are recommended.
马涛, 周沁易, 徐庆, 汪君君, 邢光红, 王恒学, 郑颖, 洪镭, 张守刚. 南京市肾综合征出血热长期趋势和2015—2020年流行特征及预警阈值[J]. 中国人兽共患病学报, 2021, 37(10): 916-922.
MA Tao, ZHOU Qin-yi, XU Qing, WANG Jun-jun, XING Guang-hong, WANG Heng-xue, ZHENG Ying, HONG Lei, ZHANG Shou-gang. Hemorrhagic fever with renal syndrome in Nanjing, China:long-term trends and epidemiological characteristics from 2015 to 2020 and the early warning threshold value. Chinese Journal of Zoonoses, 2021, 37(10): 916-922.
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2021, Vol. 37 
