Abstract
BackgroundScrub typhus, a serious public health problem in the Asia-Pacific area, is endemic in the “tsutsugamushi triangle” area. Scrub typhus has been widespread and has become a significant health concern in China. However, spatiotemporal patterns need to be investigated further.ObjectiveThis study aims to explore spatiotemporal patterns, diffusion characteristics and regional distribution differences of scrub typhus cases in mainland China from January 2006 to December 2017.MethodMonthly cases of scrub typhus reported at the county level during 2006–2017 were obtained. Time-series analyses, spatial distribution analyses, spatial diffusion analyses, spatial autocorrelation analyses and space-time scan statistic analyses were used to explore spatiotemporal characteristics of scrub typhus.ResultsA total of 121 251 scrub typhus cases were reported in 30 provinces (or municipalities) of mainland China during 2006–2017, which rose exponentially. There were seasonal characteristics from June to November for scrub typhus. Scrub typhus had been diffused from south, southwest, southeast and eastern coasts to center, north, northeast and northwest in mainland China. Scrub typhus occurrences were from point to surrounding regions, and from south to north every year. The peak periods of scrub typhus became longer and longer from north to southwest to south in mainland China. There existed a single peak in Southwest region and North region, respectively, but existed a bimodal peak for South region. Scrub typhus cases were clustered in Yunnan, Guangdong, Guangxi, Fujian and Anhui among June to November. The scrub typhus epidemics in Guangdong and Yunnan were the most serious.ConclusionsThe results in this study can be guide targeted public health interventions against scrub typhus at the county level.
Highlights
Scrub typhus, a bacterial zoonosis caused by Orientia tsutsugamushi (O. tsutsugamushi), is characterized by fever, typical eschar or ulcer at the bite site, rash, headache, myalgia, cough, generalized lymphadenopathy, hepatosplenomegaly, nausea, vomiting, and abdominal pain [1,2,3]
Scrub typhus is a bacterial zoonosis caused by Orientia tsutsugamushi and is popular in the Asia-Pacific area
A bacterial zoonosis caused by Orientia tsutsugamushi (O. tsutsugamushi), is characterized by fever, typical eschar or ulcer at the bite site, rash, headache, myalgia, cough, generalized lymphadenopathy, hepatosplenomegaly, nausea, vomiting, and abdominal pain [1,2,3]
Summary
A bacterial zoonosis caused by Orientia tsutsugamushi (O. tsutsugamushi), is characterized by fever, typical eschar or ulcer at the bite site, rash, headache, myalgia, cough, generalized lymphadenopathy, hepatosplenomegaly, nausea, vomiting, and abdominal pain [1,2,3]. A serious public health problem in the Asia-Pacific area [8], is endemic in the “tsutsugamushi triangle” area which includes Pakistan and Afghanistan in the west, far-eastern Russia and Japan in the north, and northern Australia in the south [9,10,11,12,13]. Until the 1980s, scrub typhus cases primarily occurred in the regions south of Yangtze River including Zhejiang and Yunnan [18,19]. Scrub typhus has been widespread and has become a significant health concern in China [22,23]. A serious public health problem in the Asia-Pacific area, is endemic in the “tsutsugamushi triangle” area. Scrub typhus has been widespread and has become a significant health concern in China.
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