Health & Medicinearticle2026-10-10

Case-generating patterns of hemorrhagic fever with renal syndrome in Chinese mainland, 2006–2025: a national surveillance analysis

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Abstract

Hemorrhagic fever with renal syndrome (HFRS) shows marked spatiotemporal heterogeneity and frequent zero counts in Chinese mainland. We analysed monthly HFRS surveillance data from 352 cities during 2006–2025 using a zero-inflated time-series model incorporating meteorological, environmental, and policy-related covariates. Adjusted structural-zero, endemic, autoregressive, and neighbourhood component weights were used to identify city-level case-generating patterns. Among 84,480 city-month observations, 189,680 HFRS cases were reported and 61.80% had zero reported cases. Four model-derived patterns were identified. These patterns provided information complementary to incidence magnitude and may support differentiated local, cross-boundary, and One Health surveillance and prevention.

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View paper (DOI)Open access versionOpenAlexZenodo (CERN European Organization for Nuclear Research)Published 2026-10-10

Authors: Dong Jiawen, Tianren Lu, Bo Yang, Mengfan Zhu, Michael P. Ward, Haziq Jamil, Canjun Zheng, Yu-Jia Li, Zhijie Zhang

Institutions: The University of Sydney, Fudan University, Chinese Academy of Medical Sciences & Peking Union Medical College, Chinese Center For Disease Control and Prevention, King Abdullah University of Science and Technology, Center For Social Innovation