Animals; Europe/epidemiology; Humans; Arvicolinae/virology; Climate; Bayes Theorem; Hemorrhagic Fever with Renal Syndrome/epidemiology; Hemorrhagic Fever with Renal Syndrome/virology; Disease Outbreaks; Arvicolinae; Europe; Hemorrhagic Fever with Renal Syndrome; Public Health, Environmental and Occupational Health; Health, Toxicology and Mutagenesis
Abstract :
[en] Environmental factors, such as fluctuations of climatic conditions and land cover, play a pivotal role in driving infectious disease epidemics, particularly those originating from wildlife reservoirs. Orthohantavirus puumalaense, hosted by bank voles in Europe, is the causative agent of a form of hemorrhagic fever and renal syndrome called nephropathia epidemica. Despite two decades of consistent presence in western Europe, nephropathia epidemica outbreaks still pose challenges due to localized periodic occurrences and a lack of understanding of its environmental drivers.
OBJECTIVE: Our study aims to bridge this gap by investigating the specific ecological and climatic factors influencing nephropathia epidemica outbreaks in western Europe.
METHODS: We compiled monthly, serologically confirmed nephropathia epidemica case data obtained from public health authorities in Belgium, France, Germany, and the Netherlands for the period 2004-2012. Cases were georeferenced to the finest available administrative unit. We selected 28 covariates, including climatic variables, land cover, tree species distributions, and human population, and implemented a Bayesian spatiotemporal model using integrated nested Laplace approximation (INLA) with zero-inflated Poisson distribution, including fixed effects and spatial, temporal, and nonstructured random effects.
RESULTS: We identified key triggers for nephropathia epidemica outbreaks, particularly climate-mediated changes in all seasons up to 2 years before, favoring tree mast impacting bank vole abundance. Our findings revealed that while land-cover factors mostly determine hotspot locations, climatic fluctuation patterns rather tend to modulate outbreak intensity.
DISCUSSION: Crucially, our model allows for the generation of yearly maps showcasing nephropathia epidemica incidence and risk factors, aiding in public health preparedness against climate change-induced disease emergence. This work represents a significant step toward developing targeted forecasting tools for Orthohantavirus puumalaense outbreaks, offering valuable insights for epidemic control strategies.
Vincenti-Gonzalez, Maria Fernanda; Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Brussels, Belgium
Ghisbain, Guillaume ; Université de Mons - UMONS > Faculté des Sciences > Service de Zoologie ; Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Brussels, Belgium
Faber, Mirko; Department for Infectious Disease Epidemiology, Robert Koch-Institute, Berlin, Germany
Reusken, Chantal; Department Virology, Centre for Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, the Netherlands
Sauvage, Virginie; Université Paris Cité, Unité Environnement et Risques Infectieux, Centre National de Référence des Hantavirus, Institut Pasteur, Paris, France
Wint, William; Department of Biology, Environmental Research Group Oxford Ltd, Oxford, UK
Leirs, Herwig; Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium
Dellicour, Simon; Spatial Epidemiology Lab (SpELL), Université Libre de Bruxelles, Brussels, Belgium ; Laboratory for Clinical and Epidemiological Virology, Rega Institute, Department of Microbiology, Immunology and Transplantation, KU Leuven, Leuven, Belgium
Tersago, Katrien; Evolutionary Ecology Group, University of Antwerp, Antwerp, Belgium ; Epidemiology Unit, Scientific Institute of Public Health, Brussels, Belgium
Language :
English
Title :
Impact of Environmental Factors on the Distribution Patterns of Nephropathia Epidemica Cases in Western Europe.
Publication date :
May 2025
Journal title :
Environmental Health Perspectives
ISSN :
0091-6765
Publisher :
Public Health Services, US Dept of Health and Human Services, United States
We are grateful to two anonymous reviewers for their constructive and helpful comments, as well as to Markus Neteler, Els Ducheyne, Luigi Sedda, and David Rogers for their support in the initial phase of the project. We also acknowledge all persons involved in the data collection conducted by a) the Belgian network of sentinel laboratories and the service Epidemiology of Infectious Diseases at Sciensano, the National Public Health Institute of Belgium; b) Robert Koch Institute, Department for Infectious Disease Epidemiology in Germany; c) the Virology Department, Centre for Infectious Disease Control, National Institute for Public Health and the Environment in The Netherlands; and d) the Centre National de R\u00E9f\u00E9rence des Hantavirus, Unit\u00E9 de Environnement et Risques Infectieux at Institut Pasteur in France. D.E. acknowledges support from the European Union\u2019s Horizon 2020 research and innovation program under the Marie Sk\u0142odowska Curie grant agreement number 801505 and from the Fonds National de la Recherche Scientifique (F.R.S.-FNRS, Belgium). H.L., K.T., and W.W. acknowledge support from the EDENext project (Biology and control of vector-borne infections in Europe; EU grant FP7261504 EDENext). S.D. acknowledges support from the Fonds National de la Recherche Scientifique (F.R.S.-FNRS, Belgium; grant number F.4515.22) from the Research Foundation\u2014Flanders (Fonds voor Wetenschappelijk Onderzoek \u2014 Vlaanderen, FWO, Belgium; grant number G098321N) and from the European Union Horizon 2020 projects MOOD (grant agreement number 874850) and LEAPS (grant agreement number 101094685).
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