Scrub Typhus, a Disease with Increasing Threat in Guangdong, China

Wu, De; Jing, Kou; Zhang, Huan; Qiong, Zhou Hui; Monagin, Corina; Min, Zhong; Huang, Ping; Wen, Ke Chang; Yan, Lin Jin

doi:10.1371/journal.pone.0113968

Cited by 23 publications

(18 citation statements)

References 16 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The reported incidence rates vary widely by region with the southern provinces more affected. Guangdong Province saw an increase in reported annual minimum incidence from 0.4/100,000 to 3.6/100,000 people from 2006 to 2013 (>8-fold), whereas in 2012 the provinces of Laiwu and Guangzhou City had annual incidences of 5.5/100,000 and 9.9/100,000 people, respectively [ 10 , 23 – 25 ].…”

Section: Resultsmentioning

confidence: 99%

Estimating the burden of scrub typhus: A systematic review

et al. 2017

View full text Add to dashboard Cite

BackgroundScrub typhus is a vector-borne zoonotic disease that can be life-threatening. There are no licensed vaccines, or vector control efforts in place. Despite increasing awareness in endemic regions, the public health burden and global distribution of scrub typhus remains poorly known.MethodsWe systematically reviewed all literature from public health records, fever studies and reports available on the Ovid MEDLINE, Embase Classic + Embase and EconLit databases, to estimate the burden of scrub typhus since the year 2000.FindingsIn prospective fever studies from Asia, scrub typhus is a leading cause of treatable non-malarial febrile illness. Sero-epidemiological data also suggest that Orientia tsutsugamushi infection is common across Asia, with seroprevalence ranging from 9.3%–27.9% (median 22.2% IQR 18.6–25.7). A substantial apparent rise in minimum disease incidence (median 4.6/100,000/10 years, highest in China with 11.2/100,000/10 years) was reported through passive national surveillance systems in South Korea, Japan, China, and Thailand. Case fatality risks from areas of reduced drug-susceptibility are reported at 12.2% and 13.6% for South India and northern Thailand, respectively. Mortality reports vary widely around a median mortality of 6.0% for untreated and 1.4% for treated scrub typhus. Limited evidence suggests high mortality in complicated scrub typhus with CNS involvement (13.6% mortality), multi-organ dysfunction (24.1%) and high pregnancy miscarriage rates with poor neonatal outcomes.InterpretationScrub typhus appears to be a truly neglected tropical disease mainly affecting rural populations, but increasingly also metropolitan areas. Rising minimum incidence rates have been reported over the past 8–10 years from countries with an established surveillance system. A wider distribution of scrub typhus beyond Asia is likely, based on reports from South America and Africa. Unfortunately, the quality and quantity of the available data on scrub typhus epidemiology is currently too limited for any economical, mathematical modeling or mapping approaches.

show abstract

Section: Resultsmentioning

confidence: 99%

Estimating the burden of scrub typhus: A systematic review

et al. 2017

View full text Add to dashboard Cite

show abstract

“…Scrub typhus was endemic in China for many decades. It was reported that 28 out of 34 provinces in China were affected by scrub typhus at some point [ 22 ]. Guangzhou was also affected by scrub typhus, our study showed that from 2006 to 2014, the number of reported cases per year increased from 261 to 735.…”

Section: Discussionmentioning

confidence: 99%

Climate variability, animal reservoir and transmission of scrub typhus in Southern China

Wei

Huang

et al. 2017

PLoS Negl Trop Dis

View full text Add to dashboard Cite

ObjectivesWe aimed to evaluate the relationships between climate variability, animal reservoirs and scrub typhus incidence in Southern China.MethodsWe obtained data on scrub typhus cases in Guangzhou every month from 2006 to 2014 from the Chinese communicable disease network. Time-series Poisson regression models and distributed lag nonlinear models (DLNM) were used to evaluate the relationship between risk factors and scrub typhus.ResultsWavelet analysis found the incidence of scrub typhus cycled with a period of approximately 8–12 months and long-term trends with a period of approximately 24–36 months. The DLNM model shows that relative humidity, rainfall, DTR, MEI and rodent density were associated with the incidence of scrub typhus.ConclusionsOur findings suggest that the incidence scrub typhus has two main temporal cycles. Determining the reason for this trend and how it can be used for disease control and prevention requires additional research. The transmission of scrub typhus is highly dependent on climate factors and rodent density, both of which should be considered in prevention and control strategies for scrub typhus.

show abstract

“…There existed a single peak in Southwest region and North region, respectively, but existed a bimodal peak for South region. Guangdong was with a bimodal peak in human cases typically occurring from May to November [44]. The annual rainfall rose from 800 mm to more, and the climate zone turned from the warm temperature zone to the sub-torrid zone to the torrid zone from north to southwest to south (Figs 8 and 9).…”

Section: Discussionmentioning

confidence: 99%

Spatio-temporal patterns of scrub typhus in mainland China, 2006-2017

et al. 2019

View full text Add to dashboard Cite

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.

show abstract

Scrub Typhus, a Disease with Increasing Threat in Guangdong, China

Cited by 23 publications

References 16 publications

Estimating the burden of scrub typhus: A systematic review

Estimating the burden of scrub typhus: A systematic review

Climate variability, animal reservoir and transmission of scrub typhus in Southern China

Spatio-temporal patterns of scrub typhus in mainland China, 2006-2017

Contact Info

Product

Resources

About