{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:12:47Z","timestamp":1793124767675,"version":"4.5.0"},"reference-count":42,"publisher":"American Medical Association (AMA)","issue":"8","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Netw Open"],"abstract":"Importance<\/jats:title>Hemorrhagic fever with renal syndrome (HFRS), a neglected zoonotic disease, has received only short-term attention in postflood prevention and control initiatives, possibly because of a lack of evidence regarding the long-term association of flooding with HFRS.<\/jats:p><\/jats:sec>Objectives<\/jats:title>To quantify the association between severe floods and long-term incidence of HFRS in the Yangtze River basin and to examine the modifying role of geographical factors in this association.<\/jats:p><\/jats:sec>Design, Setting, and Participants<\/jats:title>This cross-sectional study collected data on HFRS cases between July 1, 2013, and June 30, 2019, from 58 cities in 4 provinces (Anhui, Hubei, Hunan, and Jiangxi) in the Yangtze River basin of China, with a breakpoint of flooding in July 2016, generating monthly data. The 3 years after July 2016 were defined as the postflood period, while the 3 years before the breakpoint were defined as the control period. Statistical analysis was performed from October to December 2023.<\/jats:p><\/jats:sec>Exposures<\/jats:title>City-level monthly flooding, elevation, ruggedness index, and closest distance from each city to the Yangtze River and its tributaries.<\/jats:p><\/jats:sec>Main Outcomes and Measures<\/jats:title>The primary outcomes were the number of city-level monthly HFRS cases and the number of type 1 (spring or summer) and type 2 (autumn or winter) HFRS cases.<\/jats:p><\/jats:sec>Results<\/jats:title>A total of 11\u202f745 patients with HFRS were reported during the study period: 5216 patients (mean [SD] age, 47.1 [16.2] years; 3737 men [71.6%]) in the control period and 6529 patients (mean [SD] age, 49.8 [15.8] years; 4672 men [71.6%]) in the postflood period. The pooled effects of interrupted time series analysis indicated a long-term association between flooding and HFRS incidence (odds ratio, 1.38; 95% CI, 1.13-1.68), with type 1 cases being at highest risk (odds ratio, 1.71; 95% CI, 1.40-2.09). The metaregression results indicated that elevation and ruggedness index were negatively associated with the risk of HFRS, while the distance to rivers interacted with these associations.<\/jats:p><\/jats:sec>Conclusions and Relevance<\/jats:title>This cross-sectional study of the long-term association between flooding and HFRS incidence, as well as the modification effects of geographical factors, suggests that severe floods were associated with an increased risk of HFRS within 3 years. This study provides evidence for the development of HFRS prevention and control strategies after floods.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamanetworkopen.2024.29682","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T17:51:30Z","timestamp":1724349090000},"page":"e2429682","source":"Crossref","is-referenced-by-count":13,"title":["The 2016 Severe Floods and Incidence of Hemorrhagic Fever With Renal Syndrome in the Yangtze River Basin"],"prefix":"10.1001","volume":"7","author":[{"given":"Haoqiang","family":"Ji","sequence":"first","affiliation":[{"name":"Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong Province, Jinan, People\u2019s Republic of China"},{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing, People\u2019s Republic of China"},{"name":"World Health Organization Collaborating Centre for Vector Surveillance and Management, Changping District, Beijing, People\u2019s Republic of China"},{"name":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong Province, Jinan, People\u2019s Republic of China"},{"name":"Shandong University Climate Change and Health Center, Shandong Province, Jinan, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ke","family":"Li","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing, People\u2019s Republic of China"},{"name":"World Health Organization Collaborating Centre for Vector Surveillance and Management, Changping District, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meng","family":"Shang","sequence":"additional","affiliation":[{"name":"Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong Province, Jinan, People\u2019s Republic of China"},{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing, People\u2019s Republic of China"},{"name":"World Health Organization Collaborating Centre for Vector Surveillance and Management, Changping District, Beijing, People\u2019s Republic of China"},{"name":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong Province, Jinan, People\u2019s Republic of China"},{"name":"Shandong University Climate Change and Health Center, Shandong Province, Jinan, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenxu","family":"Wang","sequence":"additional","affiliation":[{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing, People\u2019s Republic of China"},{"name":"World Health Organization Collaborating Centre for Vector Surveillance and Management, Changping District, Beijing, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Qiyong","family":"Liu","sequence":"additional","affiliation":[{"name":"Department of Vector Control, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong Province, Jinan, People\u2019s Republic of China"},{"name":"National Key Laboratory of Intelligent Tracking and Forecasting for Infectious Diseases, National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Changping District, Beijing, People\u2019s Republic of China"},{"name":"World Health Organization Collaborating Centre for Vector Surveillance and Management, Changping District, Beijing, People\u2019s Republic of China"},{"name":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Shandong Province, Jinan, People\u2019s Republic of China"},{"name":"Shandong University Climate Change and Health Center, Shandong Province, Jinan, People\u2019s Republic of China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","published-online":{"date-parts":[[2024,8,22]]},"reference":[{"issue":"9","key":"zoi240902r1","doi-asserted-by":"publisher","first-page":"e371","DOI":"10.1016\/S1473-3099(23)00128-7","article-title":"Hantavirus in humans: a review of clinical aspects and management.","volume":"23","author":"Vial","year":"2023","journal-title":"Lancet Infect Dis"},{"issue":"10","key":"zoi240902r2","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00774-6","article-title":"Hantavirus infections in Europe.","volume":"3","year":"2003","journal-title":"Lancet Infect Dis"},{"issue":"12","key":"zoi240902r3","doi-asserted-by":"publisher","first-page":"2325","DOI":"10.3201\/eid2512.181649","article-title":"Hemorrhagic fever with renal syndrome, Russia.","volume":"25","author":"Tkachenko","year":"2019","journal-title":"Emerg Infect Dis"},{"issue":"11","key":"zoi240902r4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0008786","article-title":"Hantavirus pulmonary syndrome outbreaks associated with climate variability in Northwestern Argentina, 1997-2017.","volume":"14","author":"Ferro","year":"2020","journal-title":"PLoS Negl Trop Dis"},{"key":"zoi240902r5","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ijid.2016.01.003","article-title":"Haemorrhagic fever with renal syndrome: literature review and distribution analysis in China.","volume":"43","author":"Zou","year":"2016","journal-title":"Int J Infect Dis"},{"key":"zoi240902r6","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2020.137564","article-title":"Interactions and marginal effects of meteorological factors on haemorrhagic fever with renal syndrome in different climate zones: evidence from 254 cities of China.","volume":"721","author":"Cao","year":"2020","journal-title":"Sci Total Environ"},{"key":"zoi240902r7","doi-asserted-by":"publisher","DOI":"10.3389\/fcimb.2020.584814","article-title":"Epidemic trend and molecular evolution of HV family in the main Hantavirus epidemic areas from 2004 to 2016, in P.R. China.","volume":"10","author":"Wang","year":"2021","journal-title":"Front Cell Infect Microbiol"},{"issue":"4","key":"zoi240902r8","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2312556121","article-title":"Spatiotemporal trends of hemorrhagic fever with renal syndrome (HFRS) in China under climate variation.","volume":"121","author":"Wang","year":"2024","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"12","key":"zoi240902r9","doi-asserted-by":"publisher","first-page":"e978","DOI":"10.1016\/S2468-2667(23)00245-1","article-title":"The 2023 China report of the Lancet Countdown on health and climate change: taking stock for a thriving future.","volume":"8","author":"Zhang","year":"2023","journal-title":"Lancet Public Health"},{"issue":"5","key":"zoi240902r10","doi-asserted-by":"publisher","first-page":"1022","DOI":"10.3390\/w11051022","article-title":"Analysis and projection of flood hazards over China.","volume":"11","author":"Liang","year":"2019","journal-title":"Water"},{"key":"zoi240902r11","doi-asserted-by":"publisher","first-page":"155","DOI":"10.1016\/j.eng.2020.11.002","article-title":"Ecological barrier deterioration driven by human activities poses fatal threats to public health due to emerging infectious diseases.","volume":"10","author":"Zhang","year":"2022","journal-title":"Engineering (Beijing)"},{"issue":"4","key":"zoi240902r12","doi-asserted-by":"publisher","first-page":"193","DOI":"10.1038\/s41579-021-00639-z","article-title":"Infectious disease in an era of global change.","volume":"20","author":"Baker","year":"2022","journal-title":"Nat Rev Microbiol"},{"issue":"5295","key":"zoi240902r13","doi-asserted-by":"publisher","first-page":"2025","DOI":"10.1126\/science.274.5295.2025","article-title":"Global climate and infectious disease: the cholera paradigm.","volume":"274","author":"Colwell","year":"1996","journal-title":"Science"},{"issue":"9","key":"zoi240902r14","doi-asserted-by":"publisher","first-page":"791","DOI":"10.1038\/s41558-022-01435-0","article-title":"Climate change exacerbates almost two-thirds of pathogenic diseases affecting humans.","volume":"12","year":"2022","journal-title":"Nat Clim Chang"},{"issue":"3","key":"zoi240902r15","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0005425","article-title":"Mechanism study on a plague outbreak driven by the construction of a large reservoir in southwest China (surveillance from 2000-2015).","volume":"11","author":"Wang","year":"2017","journal-title":"PLoS Negl Trop Dis"},{"key":"zoi240902r16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj-2023-075081","article-title":"Mortality risks associated with floods in 761 communities worldwide: time series study.","volume":"383","author":"Yang","year":"2023","journal-title":"BMJ"},{"issue":"3","key":"zoi240902r17","doi-asserted-by":"publisher","first-page":"453","DOI":"10.1111\/fec.2016.30.issue-3","article-title":"Floods and famine: climate-induced collapse of a tropical predator\u2013prey community.","volume":"30","author":"Ujvari","year":"2016","journal-title":"Funct Ecol"},{"issue":"9394","key":"zoi240902r18","doi-asserted-by":"publisher","first-page":"1481","DOI":"10.1016\/S0140-6736(03)14695-8","article-title":"El Ni\u00f1o and health.","volume":"362","author":"Kovats","year":"2003","journal-title":"Lancet"},{"key":"zoi240902r19","doi-asserted-by":"publisher","first-page":"1109","DOI":"10.1038\/nclimate2428","article-title":"Delays reducing waterborne and water-related infectious diseases in China under climate change.","volume":"4","author":"Hodges","year":"2014","journal-title":"Nat Clim Chang"},{"issue":"11","key":"zoi240902r20","doi-asserted-by":"publisher","DOI":"10.1641\/0006-3568(2002)052[0989:TEAEHO]2.0.CO;2","article-title":"The ecology and evolutionary history of an emergent disease: hantavirus pulmonary syndrome.","volume":"52","author":"Yates","year":"2002","journal-title":"Bioscience"},{"key":"zoi240902r21","doi-asserted-by":"publisher","first-page":"223","DOI":"10.1289\/ehp.109-1240669","article-title":"Climate variability and change in the United States: potential impacts on vector- and rodent-borne diseases.","volume":"109","author":"Gubler","year":"2001","journal-title":"Environ Health Perspect"},{"issue":"6","key":"zoi240902r22","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0002260","article-title":"Atmospheric moisture variability and transmission of hemorrhagic fever with renal syndrome in Changsha City, mainland China, 1991-2010.","volume":"7","author":"Xiao","year":"2013","journal-title":"PLoS Negl Trop Dis"},{"issue":"11","key":"zoi240902r23","first-page":"1012","article-title":"Spatial heterogeneity and influencing factors of HFRS epidemics in rural and urban areas: a study in Guanzhong Plain of Shaanxi Province, China.","volume":"35","author":"Zhu","year":"2022","journal-title":"Biomed Environ Sci"},{"issue":"1","key":"zoi240902r24","doi-asserted-by":"publisher","first-page":"20037","DOI":"10.1038\/s41598-022-23945-9","article-title":"Meteorological change and hemorrhagic fever with renal syndrome epidemic in China, 2004-2018.","volume":"12","author":"Luo","year":"2022","journal-title":"Sci Rep"},{"key":"zoi240902r25","doi-asserted-by":"publisher","first-page":"1249","DOI":"10.1016\/j.scitotenv.2018.04.407","article-title":"Impact of meteorological factors on hemorrhagic fever with renal syndrome in 19 cities in China, 2005-2014.","volume":"636","author":"Xiang","year":"2018","journal-title":"Sci Total Environ"},{"issue":"pt 2","key":"zoi240902r26","doi-asserted-by":"publisher","DOI":"10.1016\/j.scitotenv.2022.160339","article-title":"Dual seasonal pattern for hemorrhagic fever with renal syndrome and its potential determinants in China.","volume":"859","author":"Lv","year":"2023","journal-title":"Sci Total Environ"},{"issue":"4","key":"zoi240902r27","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1017\/S0950268812001434","article-title":"Association of haemorrhagic fever with renal syndrome and weather factors in Junan County, China: a case-crossover study.","volume":"141","author":"Liu","year":"2013","journal-title":"Epidemiol Infect"},{"key":"zoi240902r28","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268820002344","article-title":"Investigation on risk factors of haemorrhagic fever with renal syndrome (HFRS) in Xuancheng City in Anhui Province, mainland China.","volume":"148","author":"Wu","year":"2020","journal-title":"Epidemiol Infect"},{"issue":"11","key":"zoi240902r31","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pntd.0003344","article-title":"Spatiotemporal transmission dynamics of hemorrhagic fever with renal syndrome in China, 2005-2012.","volume":"8","author":"Zhang","year":"2014","journal-title":"PLoS Negl Trop Dis"},{"issue":"1","key":"zoi240902r33","first-page":"348","article-title":"Interrupted time series regression for the evaluation of public health interventions: a tutorial.","volume":"46","author":"Bernal","year":"2017","journal-title":"Int J Epidemiol"},{"key":"zoi240902r34","doi-asserted-by":"publisher","DOI":"10.5888\/pcd12.150187","article-title":"How do you know which health care effectiveness research you can trust? a guide to study design for the perplexed.","volume":"12","author":"Soumerai","year":"2015","journal-title":"Prev Chronic Dis"},{"issue":"1","key":"zoi240902r35","doi-asserted-by":"publisher","first-page":"87","DOI":"10.3201\/eid0501.990110","article-title":"Climatic and environmental patterns associated with hantavirus pulmonary syndrome, Four Corners region, United States.","volume":"5","author":"Engelthaler","year":"1999","journal-title":"Emerg Infect Dis"},{"issue":"8","key":"zoi240902r36","doi-asserted-by":"publisher","first-page":"2547","DOI":"10.1128\/AEM.02869-06","article-title":"Ex vivo stability of the rodent-borne Hantaan virus in comparison to that of arthropod-borne members of the Bunyaviridae family.","volume":"73","author":"Hardestam","year":"2007","journal-title":"Appl Environ Microbiol"},{"key":"zoi240902r37","doi-asserted-by":"publisher","first-page":"1063","DOI":"10.1038\/1951063a0","article-title":"Loss of infectivity on drying various viruses.","volume":"195","author":"Buckland","year":"1962","journal-title":"Nature"},{"key":"zoi240902r38","doi-asserted-by":"publisher","first-page":"212","DOI":"10.1016\/j.ijid.2015.02.010","article-title":"Transmission of haemorrhagic fever with renal syndrome in China and the role of climate factors: a review.","volume":"33","author":"Hansen","year":"2015","journal-title":"Int J Infect Dis"},{"issue":"25","key":"zoi240902r39","doi-asserted-by":"publisher","first-page":"10214","DOI":"10.1073\/pnas.1019486108","article-title":"Nonlinear effect of climate on plague during the third pandemic in China.","volume":"108","author":"Xu","year":"2011","journal-title":"Proc Natl Acad Sci U S A"},{"issue":"42","key":"zoi240902r40","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.2023691118","article-title":"Timing outweighs magnitude of rainfall in shaping population dynamics of a small mammal species in steppe grassland.","volume":"118","author":"Li","year":"2021","journal-title":"Proc Natl Acad Sci U S A"},{"key":"zoi240902r41","doi-asserted-by":"publisher","first-page":"801","DOI":"10.1016\/j.envint.2019.03.063","article-title":"The impact of the 2016 flood event in Anhui Province, China on infectious diarrhea disease: an interrupted time-series study.","volume":"127","author":"Zhang","year":"2019","journal-title":"Environ Int"},{"issue":"10415","key":"zoi240902r42","doi-asserted-by":"publisher","first-page":"1811","DOI":"10.1016\/S0140-6736(23)01664-1","article-title":"El Ni\u00f1o and health in an era of unprecedented climate change.","volume":"402","author":"Haines","year":"2023","journal-title":"Lancet"},{"key":"zoi240902r29"},{"key":"zoi240902r30","unstructured":"National Health Commission of the People\u2019s Republic of China. Diagnostic criteria for epidemic hemorrhagic fever. Published online 2021. Accessed September 6, 2023. https:\/\/www.chinacdc.cn\/tzgg\/qt\/202203\/t20220302_257301.html"},{"key":"zoi240902r32","unstructured":"Resource and Environment Science and Data Center of the Chinese Academy of Sciences. Accessed July 9, 2024. https:\/\/www.resdc.cn\/"}],"container-title":["JAMA Network Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/articlepdf\/2822717\/ji_2024_oi_240902_1723737979.4767.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T17:51:37Z","timestamp":1724349097000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamanetworkopen\/fullarticle\/2822717"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,8,22]]},"references-count":42,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2024,8,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamanetworkopen.2024.29682","relation":{},"ISSN":["2574-3805"],"issn-type":[{"value":"2574-3805","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,8,22]]}}}