Abstract

Scrub typhus is an acute infectious disease in humans. A temporal, spatial and epidemiologic study was conducted to understand the characteristics of scrub typhus in Yunnan, to assist public health prevention and control measures. Based on the data on all cases reported in Yunnan during 2006–2017, we characterized the epidemiological features. Spatio-temporal patterns and Q-type cluster method were adopted to analyze the incidence of scrub typhus in Yunnan. In total, 27,838 scrub typhus cases were reported in Yunnan during 2006–2017. Of these, 49.53% (13,787) were male and 50.47% (14,051) were female (P > 0.05). Most patients were farmers (71.70%) (P < 0.05) and children aged 0–5 years (13.16%) (P < 0.01), which accounted for 84.86% of the total cases. An almost 20-fold increase in the number of patients was observed in 2017 (6,337 cases) compared to 2006 (307 cases). Baoshan and Lincang had the most cases accounting for 41.94%, while Diqing had the lowest incidence (only 3 cases). Sixteen municipalities infected were classified into three groups numbered in sequence. The incidence of scrub typhus in Yunnan is high and the annual incidence increased noticeably over time. Our results also indicate that surveillance and public education need to be focused on Baoshan, Lincang and Dehong.

Highlights

  • Scrub typhus is an acute infectious disease in humans

  • In China, scrub typhus was removed from the National Notifiable Disease Reported System since 1989

  • Research shows that chigger mites are the only vector of tsutsugamushi ­disease[21,22]

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Summary

Introduction

Scrub typhus is an acute infectious disease in humans. A temporal, spatial and epidemiologic study was conducted to understand the characteristics of scrub typhus in Yunnan, to assist public health prevention and control measures. 27,838 scrub typhus cases were reported in Yunnan during 2006–2017. Scrub typhus (tsutsugamushi disease) is an ancient infectious disease primarily endemic in several Asia–Pacific ­nations[1,2]. It is an infection caused by the pathogen Orientia tsutsugamushi, which can be transmitted occasionally to humans after being bitten by infected chigger mites (trombiculid mites)[3,4]. The number of reported cases of scrub typhus increased rapidly from 2006 to 2016, increasing by 15.4 times within 11 years. The increased incidence of tsutsugamushi disease in Yunnan offers an opportunity to enhance our understanding of the epidemiological trends of this re-emerging. The results from our study will provide authentic and reliable evidence for local health-care authorities to design strategies to alleviate the health effects of scrub typhus

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