Meteorological factors are associated with hemorrhagic fever with renal syndrome in Jiaonan County, China, 2006–2011

This study examined the effect of meteorological factors on the occurrence of hemorrhagic fever with renal syndrome (HFRS) using a generalized additive model with penalized smoothing splines in Jiaonan, China, from 2006 to 2011. The dose–response relationship was first examined, and then the association between daily meteorological variables and HFRS occurrence was investigated according to the dose–response curves. There were two linear segments in the temperature–HFRS relationship curve. When daily temperature was lower than 17 °C, a positive association was found [with excessive risk (ER) for 1 °C increase on the current day being 2.56 %, 95 % confidence interval (CI): 0.36 % to 4.80 %]. An inverse association was found when daily temperature was higher than 17 °C [ER for 1 °C increase on the current day was −12.82 % (95 % CI: −17.51 % to −7.85 %)]. Inverse associations were observed for relative humidity [ER for 1 % increase on lag day 4 was −1.21 % (95 % CI: −1.63 % to −0.79 %)] and rainfall [ER for 1 mm increase on lag day 1 was −2.20 % (95 % CI: −3.56 % to −0.82 %)]. Meteorological factors might be important predictor of HFRS epidemics in Jiaonan County.