Yidan Li

Background: Although a vaccination campaign has been conducted since 2004, Japanese encephalitis (JE) is still a public health problem in Guizhou, one of the provinces with the highest incidence of JE in China. The aim of this study was to understand the spatiotemporal distribution of JE and its relationship with environmental factors in Guizhou Province in the post-vaccination era, 2004–2016. Methods: We collected data on human JE cases in Guizhou Province from 2004 to 2016 from the national infectious disease reporting system. A Poisson regression model was used to analyze the relationship between JE occurrence and environmental factors amongst counties. Results: Our results showed that the incidence and mortality of JE decreased after the initiation of vaccination. JE cases were mainly concentrated in preschool and school-age children and the number of cases in children over age 15 years was significantly decreased compared with the previous 10 years; the seasonality of JE before and after the use of vaccines was unchanged. JE incidence was positively associated with cultivated land and negatively associated with gross domestic product (GDP) per capita, vegetation coverage, and developed land. In areas with cultivated land coverage < 25%, vegetation coverage > 55%, and urban area coverage > 25%, the JE risk was lower. The highest JE incidence was among mid-level GDP areas and in moderately urbanized areas. Conclusions: This study assessed the relationship between incidence of JE and environmental factors in Guizhou Province. Our results highlight that the highest risk of JE transmission in the post-vaccination era is in mid-level developed areas.

After publication of the research paper

Striped field mice (Apodemus agrarius) are the main host for the Hantaan virus (HTNV), the cause of hemorrhagic fever with renal syndrome (HFRS) in central China. It has been shown that host population density is associated with pathogen dynamics and disease risk. Thus, a higher population density of A. agrarius in an area might indicate a higher risk for an HFRS outbreak. Here, we surveyed the A. agrarius population density between 2005 and 2012 on the Weihe Plain, Shaanxi Province, China, and used this monitoring data to examine the relationships between the dynamics of A. agrarius populations and environmental conditions of crop-land, represented by remote sensing based indicators. These included the normalized difference vegetation index, leaf area index, fraction of photosynthetically active radiation absorbed by vegetation, net photosynthesis (PsnNet), gross primary productivity, and land surface temperature. Structural equation modeling (SEM) was applied to detect the possible causal relationship between PsnNet, A. agrarius population density and HFRS risk. The results showed that A. agrarius was the most frequently captured species with a capture rate of 0.9 individuals per hundred trap-nights, during 96 months of trapping in the study area. The risk of HFRS was highly associated with the abundance of A. agrarius, with a 1–5-month lag. The breeding season of A. agrarius was also found to coincide with agricultural activity and seasons with high PsnNet. The SEM indicated that PsnNet had an indirect positive effect on HFRS incidence via rodents. In conclusion, the remote sensing-based environmental indicator, PsnNet, was highly correlated with HTNV reservoir population dynamics with a 3-month lag (r = 0.46, p < 0.01), and may serve as a predictor of potential HFRS outbreaks.