Community Structure and the Epidemiology of Hantavirus in Southern Chile

描述（由申请人提供）：汉坦病毒感染是一个重大的全球公共卫生问题，可表现为病死率为12%的肾综合征出血热（HFRS）或病死率高达60%的汉坦病毒心肺综合征（HCPS）。由于疾病往往很严重，而且缺乏疫苗或专门的治疗方法，在流行地区实施有效的社区预防方案至关重要。作为一种啮齿动物传播的感染，其传播与职业接触、访问农村地区和家庭活动有关。然而，关于人类因素如何影响感染的信息仍然缺乏，具体而言，具体行为、风险感知、生活条件以及小规模景观组成如何影响感染。这一信息将加强目前的干预措施和控制前景。我们的研究计划的长期目标是阐明与人畜共患病的出现和维持相关的机制，以及最有效的控制方案。这项研究将作为NSF-EID赠款编号0913570的延伸，题为“拉丁美洲钩端螺旋体病的生态流行病学：了解社区内传播的动态”。本文提出的研究目的是提高对汉坦病毒发生的社会和生态因素综合影响的认识。该目标将通过以下具体目标来实现：1)确定和量化调节不同社区类型汉坦病毒地方性感染流行病学的社会生态因素；2)确定不同社区类型汉坦病毒感染空间格局的决定因素。拟议的研究将利用现有的国家科学基金会拨款所进行的广泛的实地工作和努力，包括从三种不同的社会生态社区的实地研究中收集样本和数据，并将量化人类感染的风险，同时考虑到每个家庭独特的环境和社会经济条件。预期结果包括全面了解传播风险的基本社会和环境驱动因素，并提高对家庭一级和非传统风险群体感染重要性的认识。这一信息对于推进汉坦病毒研究领域和促进风险行为改变至关重要。研究结果将在很大程度上适用于美国和其他国家的预防项目。该提案通过为控制一种对公众健康构成重大威胁的感染提供建议，从而有助于NIH的使命。

DESCRIPTION (provided by applicant): Hantavirus infection is a significant global public health problem that can manifest as hemorrhagic fever with renal syndrome (HFRS) with case-fatality rate of 12% or hantavirus cardiopulmonary syndrome (HCPS) with case-fatality rate of up to 60%. Due to the often severe disease and absence of vaccines or specific treatment, effective community-based prevention programs in endemic areas are critical. As a rodent-borne infection, transmission has been associated with occupational exposure, visiting rural areas, and domestic activities. However, information is still lacking on how the human element, specifically, how specific behaviors, perception of risk, and living conditions, as well as small-scale landscape composition influence infection. This information will enhance current interventions and prospects for control. The long term goal of our research program is to elucidate the mechanisms associated with the emergence and maintenance of zoonosis, as well as the most effective options for control. This research will be done as an extension of NSF-EID Grant No. 0913570 entitled "Eco-epidemiology of Leptospirosis in Latin America: Understanding the Dynamics of Transmission within a Community". The Objective of the study proposed here is to improve the knowledge on the combined effects of sociological and ecological factors on hantavirus occurrence. The Objective will be accomplished by pursuing the following Specific Aims: 1) To identify and quantify the socio-ecological elements that regulate the epidemiology of endemic hantavirus infection in different community types, and 2) To identify the determinants of spatial patterns of hantavirus infection in different community types. The proposed study will take advantage of the extensive field work and effort that is being done for the existing NSF grant including collection of samples and data from the field studies in three types of socio-ecologically distinct communities and will quantify the risk of human infection, while taking into consideration environmental and socio-economic conditions unique to each household. Expected outcomes include a comprehensive understanding of the fundamental sociological and environmental drivers of transmission risk and improved knowledge of the importance of infection at the household level and in non-traditional risk groups. This information is critical t advance the field of hantavirus research and promotion of risk behavioral change. Results will be largely applicable to prevention programs in the U.S. and other countries. This proposal contributes to the NIH mission by providing recommendations for control of an infection that presents a significant public health threat.