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发表于 2007-9-23 03:52:48
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El Niño and Incidence of Hemorrhagic Fever With Renal Syndrome in China
http://jama.ama-assn.org/cgi/content/full/289/2/176
To the Editor: The El Niño-Southern Oscillation (ENSO) has been related to patterns of vector-borne diseases such as malaria.1 We studied the relationship between ENSO and hemorrhagic fever with renal syndrome (HFRS), a zoonosis caused by Hantaan or Hantaan-related virus, with characteristics of fever, hemorrhagic phenomena, kidney damage, and hypotension. Rodents, mostly mice, act as viral reservoirs and the source of infection. Although mice require moist soil, a large rainfall could have a negative impact on them by destroying their microenvironment.2 Cases of HFRS have been found in Asia, Africa, Europe, and America. China has the most cases in the world, with over 1 million between 1950 and 1995. Anhui province has among the highest incidences in China.3
Methods
Information on the annual incidence of HFRS in Anhui province and China over the periods 1970-1996 and 1970-1995, respectively, were retrieved from Chinese public health data.3 The ENSO can be assessed by the Southern Oscillation Index (SOI), the normalized atmospheric pressure difference between Darwin in Australia and Tahiti in the South Pacific. It affects most countries bordering on, or in, the Pacific and Indian Oceans, and accounts for up to 40% of temperature and rainfall in the Pacific.4 A positive index of the SOI means low pressure in Darwin and greater rainfall as well as a higher sea level, while a negative index indicates the opposite climate pattern. Annual SOI data were obtained from the Australian Bureau of Meteorology. We calculated Spearman correlation coefficients between the annual SOI and incidence of HFRS in Anhui Province and China as a whole.
Results
Figure 1 shows the annual incidence of HFRS and the respective annual SOIs. There was an inverse correlation between the SOI and the incidence of HFRS in China (Spearman r = -0.40, P<.05). This relationship was somewhat stronger in Anhui Province (Spearman r = -0.49, P<.05), perhaps because of its lower elevation.2, 5
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Figure. Southern Oscillation Index (SOI) and the Incidence of Hemorrhagic Fever With Renal Syndrome (HFRS) in China and Anhui Province
Comment
Earlier work2 on the relationship between rainfall, temperature, and the incidence of HFRS in China was constrained to a small area because it is generally not practical to form a single index at national or provincial levels from regionally based climatic data such as rainfall. However, using the SOI provides an alternative method to carry out such a study and prediction. This is biologically plausible, and consistent with our previous studies2, 5 and other observations.6 For instance, the incidence of HFRS in Anhui Province was 4.88/100 000 in 1980 across those regions with 400 to 800 mm of precipitation, while in the regions with precipitation of more than 800 mm, the incidence was only 0.43/100 000.6 Therefore, the SOI might be used as a predictor of HFRS for a larger geographic area, as an early warning system for future outbreaks.
Peng Bi, MBBS, PhD
Centre for Healthcare Related Infection Surveillance and Prevention
Princess Alexandra Hospital
Brisbane, Australia
Kevin A. Parton, BCom, MSc, PhD
Faculty of Rural Management
University of Sydney
Sydney, Australia
1. Bouma MJ, van der Kaay HJ. The El Nino Southern Oscillation and the historic malaria epidemics on the Indian subcontinent and Sri Lanka: an early warning system for future epidemics? Trop Med Int Health. 1996;1:86-96. FULL TEXT | ISI | PUBMED
2. Bi P, Tong S, Donald K, Parton K, Ni J. Climatic, reservoir and occupational variables and the transmission of haemorrhagic fever with renal syndrome in China. Int J Epidemiol. 2002;31:189-193. FREE FULL TEXT
3. Chen HX, Luo CW. The surveillance of haemorrhagic fever with renal syndrome in China, 1931-95. Chin J Vector Biol Control. 1996;7(suppl):1-26.
4. Nicholls N. El Nino Southern Oscillation and vector-borne disease. Lancet. 1993;342:1284-1285. FULL TEXT | ISI | PUBMED
5. Bi P, Wu XK, Zhang FZ, et al. Seasonal rainfall variability, the incidence of hemorrhagic fever with renal syndrome, and prediction of the disease in low-lying areas in China. Am J Epidemiol. 1998;148:276-281. FREE FULL TEXT
6. Wu XK. Epidemic haemorrhagic fever. In: Lian ZH, ed. Epidemiology. 3rd ed. Beijing, China: People's Medical Publishing House; 1994:244-256.
Letters Section Editor: Stephen J. Lurie, MD, PhD, Senior Editor.
JAMA. 2003;289:176-177. |
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