title: Cluster of human infections with avian influenza A (H7N9) cases: a temporal and spatial analysis.
abstract: OBJECTIVE
  This study aims to describe the spatial and temporal characteristics of human infections with H7N9 virus in China using data from February 2013 to March 2014 from the websites of every province's Population and Family Planning Commission.
  
  
  METHODS
  A human infection with H7N9 virus dataset was summarized by county to analyze its spatial clustering, and by date of illness onset to analyze its space-time clustering using the ESRI® Geographic Information System (GIS) software ArcMap™ 10.1 and SatScan.
  
  
  RESULTS
  Based on active surveillance data, the distribution map of H7N9 cases shows that compared to the rest of China, the areas from near the Yangtze River delta (YRD) to farther south around the Pearl River delta (PRD) had the highest densities of H7N9 cases. The case data shows a strong space-time clustering in the areas on and near the YRD from 26 March to 18 April 2013 and a weak space-time clustering only in the areas on and near the PRD between 3 and 4 February 2014. However, for the rest of the study period, H7N9 cases were spatial-temporally randomly distributed.
  
  
  CONCLUSIONS
  Our results suggested that the spatial-temporal clustering of H7N9 in China between 2013 and 2014 is fundamentally different.
authors.affiliation: Beijing Center for Disease Prevention and Control (CDC), Beijing 100013, China. zps347@163.com.
authors.forename: Yi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Department of Earth and Environmental Sciences, Tulane University, New Orleans, LA 70118, USA. zshen@coastal.edu.
authors.forename: Zhixiong
authors.initials: Z
authors.lastname: Shen
authors.affiliation: Beijing Center for Disease Prevention and Control (CDC), Beijing 100013, China. ma_chun_na@126.com.
authors.forename: Chunna
authors.initials: C
authors.lastname: Ma
authors.affiliation: Maryland Institute for Applied Environmental Health, School of Public Health in University of Maryland, College Park, MD 20742, USA. cjiang89@umd.edu.
authors.forename: Chengsheng
authors.initials: C
authors.lastname: Jiang
authors.affiliation: School of Public Health & The Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada. cindy.feng@usask.ca.
authors.forename: Cindy
authors.initials: C
authors.lastname: Feng
authors.affiliation: Saw Swee Hock School of Public Health, National University of Singapore, Singapore. nivedita_shankar@nuhs.edu.sg.
authors.forename: Nivedita
authors.initials: N
authors.lastname: Shankar
authors.affiliation: Beijing Center for Disease Prevention and Control (CDC), Beijing 100013, China. yangpengcdc@163.com.
authors.forename: Peng
authors.initials: P
authors.lastname: Yang
authors.affiliation: School of Food Science, Guangdong Pharmaceutical University, Zhongshan 528458, China. wsun3@tulane.edu.
authors.forename: Wenjie
authors.initials: W
authors.lastname: Sun
authors.affiliation: Beijing Center for Disease Prevention and Control (CDC), Beijing 100013, China. bjcdcxm@126.com.
authors.forename: Quanyi
authors.initials: Q
authors.lastname: Wang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D005260:Female; D040362:Geographic Information Systems; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D064766:Influenza A Virus, H7N9 Subtype / Q000302:isolation & purification*; D007251:Influenza, Human / Q000453:epidemiology*; D008875:Middle Aged; D062206:Spatial Analysis; D055815:Young Adult