Abstract / Summary
Hemorrhagic fever with renal syndrome (HFRS) shows marked spatiotemporal heterogeneity and frequent zero counts in Chinese mainland. We analysed monthly HFRS surveillance data from 352 cities during 2006–2025 using a zero-inflated time-series model incorporating meteorological, environmental, and policy-related covariates. Adjusted structural-zero, endemic, autoregressive, and neighbourhood component weights were used to identify city-level case-generating patterns. Among 84,480 city-month observations, 189,680 HFRS cases were reported and 61.80% had zero reported cases. Four model-derived patterns were identified. These patterns provided information complementary to incidence magnitude and may support differentiated local, cross-boundary, and One Health surveillance and prevention.