Enlightenment to the prevention and control of hemorrhagic fever with renal syndrome in field training soldiers by analyzing spatial and temporal distribution in China from 2011 to 2020

  Objective  To analyze the spatial and temporal distribution of hemorrhagic fever with renal syndrome (HFRS) in China from 2011 to 2020, in order to provide the evidence for the prevention and control measures of HFRS.

  Methods  The data of HFRS was downloaded from the website of the Chinese Center for Disease Prevention and Control. The number of case was collected monthly every year. The season data was split according to spring and summer, autumn and winter. The circle distribution method was used to analyze the peak day and peak period of the HFRS, and the Join-point regression analysis method was used to evaluate the long-term trend and percentage change of the annual incidence of the disease (APC, 95%CI).The spatial distribution characteristics were analyzed in five directions, namely east, south, west, north and central, as well as the provinces under their jurisdiction.

  Results  The average incidence rate of HFRS in China from 2011 to 2020 was 0.831/100 000, and the average fatality rate was 0.695%. The trend of change in 10-year was not obvious.The APC (95%CI) during 2011−2017 and 2018−2020 was −1.47% ( −7.4%−4.8%), −13.04% (−48.1%−45.8%) (P>0.05). The incidence of HFRS showed the bimodal seasonal distribution, and there were obvious peak days and peak periods (P<0.01). The peak days of incidence in each year were different or not all the same (F_{spring and summer} =62.26, P<0.01; F_{autumn and winter} =30.49, P<0.01). The peak incidence in spring and summer was 11^th June, and the peak period was 10^th April-12^th August, and the peak of incidence in autumn and winter was 16^th December, and the peak period was 6^th November-26^th January. The largest number of cases in the five directions was the north, followed by the central, eastern, southern, and the least was the west. The number of HFRS cases in Shanxi province (14 766 cases) was the highest in the central direction, followed by Heilongjiang province (12 022 cases), Shandong province (10 585 cases) and Liaoning province (8 752 cases) in the northern direction.

  Conclusion  The incidence of HFRS in China existed northern and central high-incidence areas. Double-peak distribution characteristics was small peaks in spring and summer on 11^th June (April to August) and obvious peaks in autumn and winter on 16^th December (November to January), and the troops should pay attention to the high-incidence areas and done a good job in the prevention and control of HFRS around the peak periods.