HFRS heterogeneity in Northeastern China is influenced by ground temperature and precipitation (Preprint)

BACKGROUND Hemorrhagic fever with renal syndrome(HFRS) is a significant zoonotic disease mainly transmitted by rodents. However, the determinants of its spatial-temporal patterns in Northeast China remain unclear. OBJECTIVE This study aims to investigate the spatiotemporal dynamics, epidemiological characteristics of HFRS and detect the meteorological effect of the HFRS epidemic in Northeastern China. METHODS The HFRS cases of Northeastern China were collected from the Chinese Center for Disease Control and Prevention, and meteorological factors data were collected from the National Basic Geographic Information Center.Times series analyses, wavelet analysis and GeoDetector modeling were performed to identify the epidemiological characteristics, periodical fluctuation and meteorological effect of HFRS in Northeastern China. RESULTS A total of 52,655 HFRS cases were reported in Northeastern China from 2006 to 2020 and the age of HFRS patients was mainly between 30 and 59 years old; HFRS occurred most frequently in June and November and had a significant 4-6 months periodicity. The explanatory power of the meteorological factors to HFRS varies from 0.15 ≤ q ≤ 0.01. In Heilongjiang province, the temperature with a four-month lag, ground temperature with a four-month lag and pressure with a five-month lag had most explanatory power on HFRS. In Liaoning province, temperature with one month lag, ground temperature with one month lag, and wind speed with four months lag was found, but in Jilin province, the most important meteorological factors for HFRS were precipitation with six months lag, maximum evaporation with five months lag. The interaction analysis of meteorological factors mostly showed non-linear enhancement. CONCLUSIONS HFRS epidemic showed significant inequality in epidemic and meteorological effect in Northeastern China, and eastern prefectural-level cities presented a high risk of epidemic. This study quantifies the hysteresis effects of different meteorological factors and prompts us to focus on the influence of ground temperature and precipitation on HFRS transmission in future studies, which could assist local health authorities in developing HFRS-climate surveillance, prevention, and control strategies targeting high-risk populations in China.