Analysis of the effects of different temperature levels in Changsha on human adenovirus infection
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摘要:
目的 探讨不同等级气温对人腺病毒(human adenoviruses, HAdV)感染情况的影响及其滞后效应。 方法 收集长沙市3家哨点医院2020年HAdV感染资料和同期气象资料，采用Spearman秩相关分析气象因素与HAdV感染病例数的相关性；将不同等级气温(日平均、日最高、日最低气温)＜P2.5和＞P97.5作为划定极低温和极高温的阈值，利用分布滞后非线性模型(distributed lag nonlinear model, DLNM)探讨不同等级气温对HAdV感染情况的影响和滞后效应。 结果 2020年，在长沙市41 624份标本中开展HAdV检测，检出阳性1 693份，检出率为4.07%，其中0~＜5岁婴幼儿占67.04%。Spearman秩相关分析结果显示，HAdV感染与日平均气温(rs=-0.121)、日最高气温(rs=-0.110)和日最低气温(rs=-0.119)存在弱相关(均P < 0.05)。在DLNM中，三维图和等高线图均显示，HAdV感染风险存在高温短期效应。极高温条件下，日平均和日最低气温对HAdV感染风险产生单日滞后效应；日平均与日最高气温的累积效应随滞后天数的增加逐渐上升，滞后21 d时，其相对风险分别上升至15.79(95% CI: 2.69~92.79)、11.81(95%CI: 2.26~61.68)；在滞后4 d时，日最低气温的累积效应最高(RR=6.78, 95% CI: 1.05~43.83)。 结论 婴幼儿是HAdV的易感人群，不同等级气温与HAdV感染情况存在相关性，且极高温条件可显著提高长沙市HAdV感染风险的单日和累积滞后效应。 Abstract:Objective The objective of this study was to examine the impact and lag effects of varying temperature levels on human adenovirus (HAdV) infection. Methods We collected information on HAdV infection in 2020 and meteorological data for the same period from three sentinel hospitals in Changsha. Spearman rank correlation was employed to analyze the relationship between meteorological factors and the number of HAdV infection cases. Different temperature levels, including daily average, daily maximum, and daily minimum, were categorized using thresholds below P2.5 and above P97.5 to define extremely low and high temperatures. The distributed lag nonlinear model (DLNM) was utilized to investigate the impact and lag effect of different temperature levels on HAdV infection. Results In 2020, a total of 41 624 specimens were examined in Changsha, with 1 693 yielding positive results for HAdV, resulting in a prevalence rate of 4.07%. Of these cases, infants and children aged 0-4 years comprised 67.04%. Spearman rank correlation analysis indicated that weak associations (all P < 0.05) between HAdV infection and daily average temperature (rs=-0.121), daily maximum temperature (rs=-0.110), and daily minimum temperature (rs=-0.119). The distributed lag nonlinear model (DLNM) showed that both three-dimensional plot (3-D plot) and contour plots revealed a noticeable short-term effect of high temperature on the risk of HAdV infection. Specifically, under extremely high temperature conditions, both daily average and daily minimum temperatures were found to exhibit a lagged impact on the risk of HAdV infection for a single day. Moreover, the cumulative effects of daily average and daily maximum temperatures displayed a gradual increase with longer lag periods. At a lag of 21 days, the relative risks rose to 15.79 (95% CI: 2.69-92.79) and 11.81 (95% CI: 2.26-61.68), respectively. Additionally, the cumulative effect of daily minimum temperature reached its peak at a lag of 4 days (RR=6.78, 95%CI: 1.05-43.83). Conclusions Infants and young children are particularly vulnerable to HAdV infection. The study findings reveal significant correlations between different temperature levels and the occurrence of HAdV infection. Moreover, the study highlights the significant immediate and cumulative lag effects of extreme temperatures on HAdV infection risk in Changsha. -
Key words:
- Temperature /
- Human adenovirus /
- Sentinel surveillance /
- Distribution lag nonlinear model
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图 1 2020年长沙市不同等级气温与人腺病毒感染的效应分布三维图
A: 日平均气温；B: 日最高气温；C: 日最低气温。
Figure 1. Three-dimensional plot of the distribution of effects of different temperature levels and human adenoviruses infection in Changsha in 2020
A: daily average temperature; B: daily maximum temperature; C: daily minimum temperature.
图 2 2020年长沙市不同等级气温对人腺病毒感染的效应分布等高线图
A: 日平均气温；B: 日最高气温；C: 日最低气温。
Figure 2. Contour plot of the distribution of effects of different temperature levels and human adenoviruses infection in Changsha in 2020
A: daily average temperature; B: daily maximum temperature; C: daily minimum temperature.
图 3 2020年长沙市不同等级气温下极端气温对人腺病毒感染风险的单日效应RR值(95% CI)
a: P < 0.05。
Figure 3. Single-day effects of extreme temperature on the risk of human adenoviruses infection under different temperature levels in Changsha in 2020, RR value (95% CI)
a: P < 0.05.
图 4 2020年长沙市不同等级气温下极端气温对人腺病毒感染风险的累积效应RR值(95% CI)
a: P < 0.05。
Figure 4. Cumulative effects of extreme temperature on the risk of human adenoviruses infection under different temperature levels in Changsha in 2020, RR value (95% CI)
a: P < 0.05.
表 1 2020年长沙市流行性感冒样病例检测人次数与人腺病毒感染情况
Table 1. Number of influenza-like cases tested and cases of human adenoviruses infection in Changsha in 2020
变量 Variables 检测人次数
Number of test persons感染病例数
Number of infection cases最小值
Min最大值
Max感染占比/%
Proportion of infections/%阳性率/%
Positive rate/%性别 Gender 男 Male 24 051 979 1 17 57.83 4.07 女 Female 17 573 714 1 14 42.17 4.06 年龄组/岁 Age group/years 0~ < 5 27 095 1 135 1 16 67.04 4.19 5~ < 25 8 549 371 1 9 21.91 4.40 25~ < 60 3 655 130 1 7 7.68 3.56 ≥60 2 325 57 1 2 3.37 2.45 季节 Season 春 Spring 8 002 302 1 9 17.84 3.77 夏 Summer 9 029 332 1 9 19.61 3.68 秋 Autumn 8 905 316 1 8 18.66 3.55 冬 Winter 15 688 743 1 26 43.89 4.74 合计 Total 41 624 1 693 1 26 100.00 4.06 
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表 2 2020年长沙市气象因素情况
Table 2. Meteorological factors in Changsha in 2020
变量 Variables 均数±标准差(x±s) 最小值
MinP2.5 P50 P97.5 最大值
Max日平均气温/℃ Daily average temperature/℃ 17.42±8.58 0.20 3.20 17.90 30.70 31.30 日最高气温/℃ Daily maximum temperature/℃ 21.54±9.47 2.60 4.95 22.90 35.28 37.00 日最低气温/℃ Daily minimum temperature/℃ 14.48±8.21 -3.80 0.08 14.50 26.85 28.20 相对湿度/% Relative humidity/% 79.07±13.81 43.00 51.18 82.00 98.82 100.00 平均气压/hPa Average air pressure/hPa 1 001.60±8.99 985.80 987.60 1 001.95 1 017.90 1 023.80 平均风速/(m·s-1) Average wind speed/ (m·s-1) 2.45±1.38 0.00 0.40 2.25 5.80 9.20 日照时数/h Sunshine hours/h 3.60±4.25 0.00 0.00 0.90 12.00 12.60 降水量/mm Precipitation/mm 4.03±9.55 0.00 0.00 0.00 39.10 55.60
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表 3 2020年长沙市人腺病毒感染与气象因素间Spearman分析
Table 3. Spearman analysis of human adenoviruses infection and meteorological factors in Changsha in 2020
变量 Variables 日平均气温/℃
Daily average temperature/℃日最高气温/℃
Daily maximum temperature/℃日最低气温/℃
Daily minimum temperature/℃相对湿度/%
Relative humidity/%降水量/mm
Precipitation/mm日照时数/h
Sunshine hours/h平均气压/hPa
Average air pressure/hPa平均风速/(m·s-1) Average wind
speed /(m·s-1)病例数/例
Number of cases/cases日平均气温/℃
Daily average temperature/℃1.000 日最高气温/℃
Daily maximum temperature/℃0.974 ① 1.000 日最低气温/℃
Daily minimum temperature/℃0.977 ① 0.918 ① 1.000 相对湿度/%
Relative humidity/%-0.157 ① 0.264 ① -0.016 1.000 降水量/mm
Precipitation/mm-0.117 ① 0.189 ① -0.012 0.711 ① 1.000 日照时数/h
Sunshine hours/h0.440 ① 0.565 ① 0.291 ① -0.685 ① -0.551 ① 1.000 平均气压/hPa
Average air pressure/hPa-0.900 ① 0.863 ① -0.905 ① -0.087 -0.069 -0.274 ① 1.000 平均风速/(m·s-1)
Average wind speed/ (m·s-1)-0.261 ① 0.283 ① -0.200 ① 0.085 0.008 -0.244 ① 0.257 ① 1.000 病例数
Number of cases-0.121 ① -0.110 ① -0.119 ① 0.067 0.035 -0.054 0.066 -0.039 1.000 注：① P < 0.05。
Note: ① P < 0.05.
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