Abstract
First discovered in rural areas of middle-eastern China in 2009, severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonosis affecting hundreds of cases reported in China each year. Using the national surveillance data from 2010 to 2013, we conducted this retrospective epidemiological study and risk assessment of SFTS in China. We found that the incidence of SFTS and its epidemic areas are continuing to grow, but the case fatality rate (CFR) has steadily decreased. SFTS most commonly affected elderly farmers who acquired infection between May and July in middle-eastern China. However, other epidemiological characteristics such as incidence, sex ratio, CFR, and seasonality differ substantially across the affected provinces, which seem to be consistent with local agricultural activities and the seasonal abundance of ticks. Spatial scan statistics detected three hot spots of SFTS that accounted for 69.1% of SFTS cases in China. There was a strong association of SFTS incidence with temporal changes in the climate within the clusters. Multivariate modeling identified climate conditions, elevation, forest coverage, cattle density, and the presence of Haemaphysalis longicornis ticks as independent risk factors in the distribution of SFTS, based on which a predicted risk map of the disease was derived.
Highlights
First discovered in rural areas of middle-eastern China in 2009, severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonosis affecting hundreds of cases reported in China each year
We found that the incidence of SFTS and its epidemic areas are continuing to grow, but the case fatality rate (CFR) has steadily decreased
We provided the first comprehensive epidemiological description and risk assessment of the human SFTS virus (SFTSV) infections in China in recent years
Summary
First discovered in rural areas of middle-eastern China in 2009, severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne zoonosis affecting hundreds of cases reported in China each year. According to the surveillance data managed by the Chinese Center for Disease Control and Prevention, as of December 2013, SFTS cases had been reported in 14 provinces of China, and epidemic areas are seemingly expanding. In this report we examined these new data which were archived in the China Information System for Diseases Control and Prevention (CISDCP)[17] We conducted this retrospective study with three major objectives: (1) to provide an comprehensive epidemiological overview of human SFTS in China; (2) to investigate spatial, temporal, climate, and ecological risk factors for human SFTS cases; and (3) to map the potential risk distribution of SFTS in China
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