{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T06:10:42Z","timestamp":1789193442360,"version":"build-2803163510"},"reference-count":35,"publisher":"Wiley","license":[{"start":{"date-parts":[[2023,9,20]],"date-time":"2023-09-20T00:00:00Z","timestamp":1695168000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Shandong Center for Disease Control and Prevention"},{"name":"National Meteorological Information Center of China"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Transboundary and Emerging Diseases"],"published-print":{"date-parts":[[2023,9,20]]},"abstract":"<jats:p>Hemorrhagic fever with renal syndrome (HFRS) is a climate-sensitive infectious disease. The effect of climatic drivers might predict and prevent HFRS, and understanding their relationship is urgently needed in the face of climate change. This study aimed to investigate the effect of meteorological factors on HFRS incidence. The random forest regression model, generalized additive model, and distributed lag nonlinear model (DLNM) were constructed to predict the importance, nonlinear trend and interaction effect, and exposure-lag effect of meteorological factors on HFRS incidence based on the data obtained in Shandong Province, China, 2013\u20132022. The most crucial meteorological factor was the weekly mean temperature. Interaction results showed that relative humidity affected HFRS incidence only under high or low-temperature conditions, and the effect of relative humidity with high and low pressure was the opposite. Using the median value as the reference, DLNM indicated that extremely low temperature had significant associations with HFRS at a lag of 3\u20135 weeks. Under extremely high temperatures, relative risks (RRs) became significantly high from a lag of 11 weeks, with the lowest value of 1.07 (95% CI: 1.00\u20131.13). RRs increased and then decreased with increasing mean temperature at lag 4 and 8 weeks, whereas at lag 12 and 16 weeks, the RRs gradually increased as the mean temperature climbed. This study demonstrates the complex relationship between meteorological factors and HFRS incidence. Our findings provide implications for the development of weather-based HFRS early warning systems.<\/jats:p>","DOI":"10.1155\/2023\/5572334","type":"journal-article","created":{"date-parts":[[2023,9,21]],"date-time":"2023-09-21T06:05:09Z","timestamp":1695276309000},"page":"1-9","source":"Crossref","is-referenced-by-count":9,"title":["Assessing the Relationship between Climate Variables and Hemorrhagic Fever with Renal Syndrome Transmission in Eastern China: A Multi-Cities Time Series Study"],"prefix":"10.1155","volume":"2023","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8315-3285","authenticated-orcid":true,"given":"Yao","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China"},{"name":"Department of Microbiological Laboratory Technology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-1934-9419","authenticated-orcid":true,"given":"Qing","family":"Duan","sequence":"additional","affiliation":[{"name":"Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan 250014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-5685-0092","authenticated-orcid":true,"given":"Bo","family":"Pang","sequence":"additional","affiliation":[{"name":"Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan 250014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0004-1111-1002","authenticated-orcid":true,"given":"Xueying","family":"Tian","sequence":"additional","affiliation":[{"name":"Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan 250014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-3840-1220","authenticated-orcid":true,"given":"Jing","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5850-1852","authenticated-orcid":true,"given":"Wei","family":"Ma","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5168-3193","authenticated-orcid":true,"given":"Zengqiang","family":"Kou","sequence":"additional","affiliation":[{"name":"Infection Disease Control of Institute, Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan 250014, China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7405-0404","authenticated-orcid":true,"given":"Hongling","family":"Wen","sequence":"additional","affiliation":[{"name":"Department of Microbiological Laboratory Technology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","reference":[{"issue":"2","key":"1","doi-asserted-by":"crossref","first-page":"95","DOI":"10.3201\/eid0302.970202","article-title":"Hantaviruses: a global disease problem","volume":"3","author":"C. 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