Environmental risk factors for haemorrhagic fever with renal syndrome in a French new epidemic area

• Published in: Epidemiology and infection Vol. 139; no. 6; pp. 867 - 874
• Main Authors: VIEL, J.-F., LEFEBVRE, A., MARIANNEAU, P., JOLY, D., GIRAUDOUX, P., UPEGUI, E., TORDO, N., HOEN, B.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01-06-2011; Cambridge University Press (CUP)
• Subjects: Adult; Arboviruses and human viruses associated with animals; Behavior; Biological and medical sciences; Cantons; Climate models; Disease; Disease Reservoirs - virology; Epidemics - statistics & numerical data; Female; France - epidemiology; Fundamental and applied biological sciences. Psychology; Geography; Hantaan virus; Hantavirus; Hantavirus infections; Hemorrhagic fever with renal syndrome; Hemorrhagic Fever with Renal Syndrome - epidemiology; Hemorrhagic Fever with Renal Syndrome - etiology; Humans; Incidence; Infections; Land cover; Life Sciences; Male; Microbiology; Puumala virus; Risk Factors; Rodents; Santé publique et épidémiologie; Seasons; Spacetime; Trees; Voles; Weather; France; Belgium; France, Franche-Comte; hantavirus infection; Bayesian regression; climate; haemorrhagic fever with renal syndrome (HFRS); cluster analysis; land cover; Myodes (Clethrionomys) glareolus; Puumala virus (PUUV); Infection; Epidemic; Hemorrhagic fever; Viral disease; Arbovirus disease; Risk factor; Environmental factor; Epidemiology
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268810002062

In France, haemorrhagic fever with renal syndrome (HFRS) is endemic along the Belgian border. However, this rodent-borne zoonosis caused by the Puumala virus has recently spread south to the Franche-Comté region. We investigated the space–time distribution of HFRS and evaluated the influence of environmental factors that drive the hantavirus reservoir abundance and/or the disease transmission in this area. A scan test clearly indicated space–time clustering, highlighting a single-year (2005) epidemic in the southern part of the region, preceded by a heat-wave 2 years earlier. A Bayesian regression approach showed an association between a variable reflecting biomass (normalized difference vegetation index) and HFRS incidence. The reasons why HFRS cases recently emerged remain largely unknown, and climate parameters alone do not reliably predict outbreaks. Concerted efforts that combine reservoir monitoring, surveillance, and investigation of human cases are warranted to better understand the epidemiological patterns of HFRS in this area.