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Spatiotemporal Variation and Hotspot Detection of the Avian Influenza A(H7N9) Virus in China, 2013–2017

1,†, 2,3,†, 1,2,* and 2,3,4,*
College of Geoscience and Surveying Engineering, China University of Mining & Technology, Beijing 100083, China
State Key Laboratory of Resources and Environmental Information System, Institute of Geographical Sciences and Natural Resources Research, Chinese Academy of Sciences, Beijing 100101, China
College of Resources and Environment, University of Chinese Academy of Sciences, Beijing 100049, China
Key Laboratory of Carrying Capacity Assessment for Resource and Environment, Ministry of Land &Resources, Beijing 100101, China
Authors to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2019, 16(4), 648;
Received: 12 January 2019 / Revised: 9 February 2019 / Accepted: 19 February 2019 / Published: 22 February 2019
PDF [3341 KB, uploaded 22 February 2019]


This study aims to describe the spatial and temporal characteristics of human infections with H7N9 virus in China using data from 19 February 2013 to 30 September 2017 extracted from Centre for Health Protection of the Department of Health (CHP) and electronic databases managed by China’s Center for Disease Control (CDC) and provincial CDCs synthetically using the Geographic Information System (GIS) software ArcMap™ 10.2 and SaTScan. Based on the multiple analyses of the A(H7N9) epidemics, there was a strong seasonal pattern in A(H7N9) virus infection, with high activity in the first quarter of the year, especially in January, February, and April, and a gradual dying out in the third quarter. Spatial distribution analysis indicated that Eastern China contained the most severely affected areas, such as Zhejiang Province, and the distribution shifted from coastline areas to more inland areas over time. In addition, the cases exhibited local spatial aggregation, with high-risk areas most found in the southeast coastal regions of China. Shanghai, Jiangsu, Zhejiang, and Guangdong were the high-risk epidemic areas, which should arouse the attention of local governments. A strong cluster from 9 April 2017 to 24 June 2017 was also identified in Northern China, and there were many secondary clusters in Eastern and Southern China, especially in Zhejiang, Fujian, Jiangsu, and Guangdong Provinces. Our results suggested that the spatial-temporal clustering of H7N9 in China is fundamentally different, and is expected to contribute to accumulating knowledge on the changing temporal patterns and spatial dissemination during the fifth epidemic and provide data to enable adequate preparation against the next epidemic. View Full-Text
Keywords: H7N9; spatial-temporal characteristics; hotspot analysis; SaTScan H7N9; spatial-temporal characteristics; hotspot analysis; SaTScan

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Li, Z.; Fu, J.; Lin, G.; Jiang, D. Spatiotemporal Variation and Hotspot Detection of the Avian Influenza A(H7N9) Virus in China, 2013–2017. Int. J. Environ. Res. Public Health 2019, 16, 648.

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