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Viral Infections and Vectors / Mosquito Borne Diseases and Control · Journal article
Zoonoses and Public Health · August 16, 2026
Reinforces what was already believed, rather than introducing something new.
This is a multilevel observational study of HCPS epidemiology in Chile that characterizes both ecological drivers of disease notification and individual risk factors for in-hospital mortality. The study confirms that older age, female sex, and indigenous affiliation increase mortality risk, and identifies forest fire activity as a novel ecological predictor of notification burden; the results are consistent with known HCPS epidemiology but do not establish causal mechanisms.
Ecological negative binomial mixed-effects model and individual-level logistic mixed-effects model. Ecological: all districts in Chile reporting HCPS cases 2005–2022. Individual: hospitalized HCPS patients in Chile 2010–2020.. n = 462. Chile.
Total 886 HCPS cases notified across 187 districts, averaging 49.2 cases per year over 2005–2022 Among 462 hospitalized patients (2010–2020), in-hospital case-fatality ratio was 19.7% Notifications positively associated with higher male population rates and greater burned area due to forest fires
No confidence intervals or p-values reported for individual-level mortality associations. Older age, female sex, and indigenous group affiliation significantly associated with higher in-hospital mortality risk
Clinicians should recognise that HCPS mortality is concentrated in older, female, and indigenous patients, warranting enhanced clinical vigilance and equitable access to care in these groups. Forest fire activity may serve as an actionable early warning signal for HCPS outbreak risk.
A rigorous multilevel observational study with large sample and mixed-effects models that confirms known epidemiological patterns of HCPS and identifies forest fire activity as a novel ecological risk factor, but does not test an intervention or establish causation.
As stated by the source record.
Quoted from the source exactly as published.
Clinicians should recognise that HCPS mortality is concentrated in older, female, and indigenous patients, warranting enhanced clinical vigilance and equitable access to care in these groups. Forest fire activity may serve as an actionable early warning signal for HCPS outbreak risk.
Graded across the dimensions that decide whether you should act, each from what the source actually supports. There is no single score, and where a dimension was not assessed it says so.
INTRODUCTION: Hantavirus cardiopulmonary syndrome (HCPS) is a severe zoonotic disease caused by Orthohantavirus andesense (Andes virus, ANDV), with significant public health burden in Chile. Despite decades of surveillance, knowledge gaps remain regarding the ecological drivers of notification burden and the individual-level determinants of in-hospital mortality among hospitalized patients. This study aimed to address both dimensions simultaneously, providing a multilevel characterization of HCPS epidemiology in Chile from 2005 to 2022. METHODS: Two complementary analyses were conducted. First, an ecological study examined district-level HCPS notifications (2005-2022) using a negative binomial mixed-effects model, with predictors including male population rate, urbanization proportion, population density, season and burned area due to forest fires during the most recent summer season. Second, an individual-level analysis of hospitalized HCPS patients (2010-2020) used a logistic mixed-effects model to identify correlates of in-hospital mortality among hospitalized patients, including age, sex, indigenous group affiliation, hospitalization duration and number of surgical interventions. RESULTS: A total of 886 HCPS cases were notified across 187 districts, averaging 49.2 cases per year. Notifications were positively associated with higher male population rates and greater burned area due to forest fires, and negatively associated with urbanization and population density. Among 462 hospitalized patients, the in-hospital case-fatality ratio was 19.7%. Older age, female sex and indigenous group affiliation were significantly associated with higher in-hospital mortality risk among hospitalized patients. Shorter hospitalization duration and greater number of surgical interventions, as correlates of clinical severity and complexity, were also associated with in-hospital mortality among hospitalized patients. CONCLUSIONS: HCPS notification burden in Chile is shaped by environmental and demographic factors, with forest fire activity representing a novel and actionable ecological risk indicator. In-hospital mortality among hospitalized patients is disproportionately concentrated in older, female, and indigenous populations, highlighting the need for targeted surveillance, equitable healthcare access and integrated One Health strategies to reduce the burden of HCPS in Chile.
Taken from the source record, never inferred. Follow any of these and new work involving them reaches your briefing.