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January 8, 2003

El Niño and Incidence of Hemorrhagic Fever With Renal Syndrome in ChinaRESEARCH LETTER

JAMA. 2003;289(2):176-177. doi:10.1001/jama.289.2.176-d

To the Editor: The El Niño-Southern Oscillation (ENSO) has been related to patterns of vector-borne diseases such as malaria.1 We studied the relationship between ENSO and hemorrhagic fever with renal syndrome (HFRS), a zoonosis caused by Hantaan or Hantaan-related virus, with characteristics of fever, hemorrhagic phenomena, kidney damage, and hypotension. Rodents, mostly mice, act as viral reservoirs and the source of infection. Although mice require moist soil, a large rainfall could have a negative impact on them by destroying their microenvironment.2 Cases of HFRS have been found in Asia, Africa, Europe, and America. China has the most cases in the world, with over 1 million between 1950 and 1995. Anhui province has among the highest incidences in China.3