Xiaoxu Wu

Impact of global change on transmission of human infectious diseases

Global change, which refers to large-scale changes in the earth system and human society, has been changing the outbreak and transmission mode of many infectious diseases. Climate change affects infectious diseases directly and indirectly. Meteorological factors including temperature, precipitation, humidity and radiation influence infectious disease by modulating pathogen, host and transmission pathways. Meteorological disasters such as droughts and floods directly impact the outbreak and transmission of infectious diseases. Climate change indirectly impacts infectious diseases by altering the ecological system, including its underlying surface and vegetation distribution. In addition, anthropogenic activities are a driving force for climate change and an indirect forcing of infectious disease transmission. International travel and rural-urban migration are a root cause of infectious disease transmission. Rapid urbanization along with poor infrastructure and high disease risk in the rural-urban fringe has been changing the pattern of disease outbreaks and mortality. Land use changes, such as agricultural expansion and deforestation, have already changed the transmission of infectious disease. Accelerated air, road and rail transportation development may not only increase the transmission speed of outbreaks, but also enlarge the scope of transmission area. In addition, more frequent trade and other economic activities will also increase the potential risks of disease outbreaks and facilitate the spread of infectious diseases.

How environmental conditions impact mosquito ecology and Japanese encephalitis: An eco-epidemiological approach

Japanese encephalitis (JE) is one of the major vector-borne diseases in Southeast Asia and the Western Pacific region, posing a threat to human health. In rural and suburban areas, traditional rice farming and intensive pig breeding provide an ideal environment for both mosquito development and the transmission of JEV among human beings. Combining surveillance data for mosquito vectors, human JE cases, and environmental conditions in Changsha, China, 2004-2009, generalized threshold models were constructed to project the mosquito and JE dynamics. Temperature and rainfall were found to be closely associated with mosquito density at 1, and 4month lag, respectively. The two thresholds, maximum temperature of 22-23°C for mosquito development and minimum temperature of 25-26°C for JEV transmission, play key roles in the ecology of JEV. The model predicts that, in the upper regime, a 1g/m(3) increase in absolute humidity would on average increase human cases by 68-84%. A shift in mosquito species composition in 2007 was observed, and possibly caused by a drought. Effective predictive models could be used in risk management to provide early warnings for potential JE transmission.

Anthropogenically driven environmental changes shift the ecological dynamics of hemorrhagic fever with renal syndrome

Zoonoses are increasingly recognized as an important burden on global public health in the 21st century. High-resolution, long-term field studies are critical for assessing both the baseline and future risk scenarios in a world of rapid changes. We have used a three-decade-long field study on hantavirus, a rodent-borne zoonotic pathogen distributed worldwide, coupled with epidemiological data from an endemic area of China, and show that the shift in the ecological dynamics of Hantaan virus was closely linked to environmental fluctuations at the human-wildlife interface. We reveal that environmental forcing, especially rainfall and resource availability, exert important cascading effects on intra-annual variability in the wildlife reservoir dynamics, leading to epidemics that shift between stable and chaotic regimes. Our models demonstrate that bimodal seasonal epidemics result from a powerful seasonality in transmission, generated from interlocking cycles of agricultural phenology and rodent behavior driven by the rainy seasons.

Identification of weather variables sensitive to dysentery in disease-affected county of China

Climate change mainly refers to long-term change in weather variables, and it has significant impact on sustainability and spread of infectious diseases. Among three leading infectious diseases in China, dysentery is exclusively sensitive to climate change. Previous researches on weather variables and dysentery mainly focus on determining correlation between dysentery incidence and weather variables. However, the contribution of each variable to dysentery incidence has been rarely clarified. Therefore, we chose a typical county in epidemic of dysentery as the study area. Based on data of dysentery incidence, weather variables (monthly mean temperature, precipitation, wind speed, relative humidity, absolute humidity, maximum temperature, and minimum temperature) and lagged analysis, we used principal component analysis (PCA) and classification and regression trees (CART) to examine the relationships between the incidence of dysentery and weather variables. Principal component analysis showed that temperature, precipitation, and humidity played a key role in determining transmission of dysentery. We further selected weather variables including minimum temperature, precipitation, and relative humidity based on results of PCA, and used CART to clarify contributions of these three weather variables to dysentery incidence. We found when minimum temperature was at a high level, the high incidence of dysentery occurred if relative humidity or precipitation was at a high level. We compared our results with other studies on dysentery incidence and meteorological factors in areas both in China and abroad, and good agreement has been achieved. Yet, some differences remain for three reasons: not identifying all key weather variables, climate condition difference caused by local factors, and human factors that also affect dysentery incidence. This study hopes to shed light on potential early warnings for dysentery transmission as climate change occurs, and provide a theoretical basis for the control and prevention of dysentery.

Risk analysis of H5N1 highly pathogenic avian influenza in poultry at the Poyang Lake area, China

Migratory birds have been known to spread the highly pathogenic avian influenza virus (HPAIV) H5N1 over large distances. Moreover, previous studies have shown it to be widely circulated in live-bird markets. However, how live-bird markets in addition to wild birds affect the local persistence of avian influenza virus (AIV) remains uncertain. The abundance of fresh water and widely distributed wetlands make the Poyang lake area a suitable overwintering site for migratory birds. The intensive local poultry industry and poor biosecurity potentially increase the risk of interactions between the wild and domestic birds. These factors likely contributed to the spread and persistence of AIVs in the Poyang lake area in these years. Here, a cross-sectional survey together with sampling was conducted randomly in the Poyang lake area to investigate the local distribution of the H5N1 viruses. In total, 891 poultry isolates from 31 villages around the Poyang lake area were randomly sampled in poultry sectors and tested for the presence of avian influenza using RT-PCR assays. Environmental factors such as poultry density, road accessibility, and wild bird biodiversity together with breeding characteristics derived from these questionnaires were collected and utilized for risk analysis modelling. Our results revealed that distance to the nearest wetlands with a high number of birds and accessibility by road were the main risk factors for the occurrence HPAIV H5N1, suggesting that the high density of road networks may facilitate the transmission of this virus. Investigating the regional distribution characteristics of the virus is of great significance, therefore the general public would benefit from an early warning, prevention, and taking control measures in high-risk regions.

Decline in malaria incidence in a typical county of China: Role of climate variance and anti-malaria intervention measures

ABSTRACT Malaria is an important vector‐borne disease which is widespread in tropical and subtropical areas worldwide as well as in south China. Previous research has separately focused on the association between malaria incidence and meteorological variables or between malaria incidence and anti‐malaria intervention measures in China, especially in Yunnan Province. Therefore, a typical county, Tengchong County, in Yunnan Province with high malaria incidence was selected as the study area to investigate the integrated influence of climate variance and anti‐malaria intervention measures. Malaria incidence and meteorological variables were analyzed with a 2‐month lag. The variables include average monthly temperature, minimum temperature, maximum temperature, cumulative precipitation, wind speed, maximum wind speed, relative humidity and minimum relative humidity. First, the principal component analysis was introduced to investigate the relationship between malaria incidence and meteorological variables; classification and regression trees were used to clarify contributions of key meteorological variables to malaria incidence afterwards. Second, based on existing anti‐malaria intervention measures and above results, the integrated impact of climate variance and anti‐malaria interventions on interannual trends of malaria incidence was analyzed. High malaria incidence occurred under one of the two meteorological conditions: 1) high minimum temperature combined with high minimum relative humidity or both precipitation and minimum relative humidity above middle level; 2) middle minimum temperature combined with both precipitation and minimum relative humidity below middle levels. Moreover, the steep interannual decline of malaria incidence in Tengchong was determined by slight climate variance and persistent anti‐malaria intervention measures during malaria epidemics, predominantly by the latter. These findings will provide evidence data for developing malaria surveillance strategies in China. Graphical abstract Figure. No Caption available. HighlightsMalaria incidence shows a steeply interannual decline and an obvious seasonality.Malaria incidence highly correlates to temperature, precipitation and humidity.Two favorable climate conditions are determined for high incidence of malaria.There is good agreement between a decreasing malaria incidence and slightly declined climate variance in epidemic months.Malaria incidence is declined rapidly because of the persistent progress of anti‐malaria interventions.

Genetic evidence for avian influenza H5N1 viral transmission along the Black Sea-Mediterranean Flyway.

The current epidemic of highly pathogenic avian influenza H5N1 virus is considered to pose a significant threat to the health of wild and domestic avian species, and even to human beings. The Black Sea-Mediterranean Flyway is one of the most important epidemic areas of H5N1. However, the epidemic along this flyway has not been fully explored. To better understand the role of hosts in the spread and evolution of H5N1 virus along the flyway, a phylogeographic study was conducted using haemagglutinin (HA) gene sequences obtained during 2005-2013. To infer phylodynamic spread in time and space, we used a flexible Bayesian statistical framework and modelled viral spatial diffusion as a continuous-time Markov-chain process along time-measured genealogies. Our results revealed that H5N1 virus isolated from wild birds showed an increase in genetic variation of HA gene from 2005-2007. The mean genetic distance of viruses isolated from poultry reached its peak in 2010, and dropped in 2011, increasing again in 2012-2013. The reconstruction of virus circulation revealed a different viral-migration network of H5N1 virus by different hosts. Western Russia constituted a link in viral migration from Russia to Europe and Africa. Cross-species transmission of H5N1 viruses predominated in the migration network of the Black Sea-Mediterranean Flyway. This might be due to the migration of birds across long distances and interaction between local poultry and migratory birds. Additionally, the short-distance spread of H5N1 viruses among poultry followed local transportation networks. Such findings will aid in developing effective disease control and prevention strategies.