Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014

doi:10.1186/s12879-016-2153-3

. 2017 Jan 5;17(1):13.

doi: 10.1186/s12879-016-2153-3.

Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014

Ye Sun ^{1

2}, Yue-Hong Wei ³, Yang Yang ⁴, Yu Ma ³, Sake J de Vlas ⁵, Hong-Wu Yao ¹, Yong Huang ³, Mai-Juan Ma ¹, Kun Liu ¹, Xiao-Ning Li ³, Xin-Lou Li ¹, Wen-Hui Zhang ¹, Li-Qun Fang ⁶, Zhi-Cong Yang ⁷, Wu-Chun Cao ⁸

Affiliations

¹ The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
² Center for Disease Control and Prevention of Jinan Military Region, Shandong Province, Jinan, 250014, People's Republic of China.
³ Guangzhou Center for Disease Control and Prevention, Guangdong Province, Guangzhou, 510440, People's Republic of China.
⁴ Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 32311, Florida, USA.
⁵ Department of Public Health, Erasmus Medical Center, University Medical Center Rotterdam, 999025, Rotterdam, The Netherlands.
⁶ The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China. fanglq@bmi.ac.cn.
⁷ Guangzhou Center for Disease Control and Prevention, Guangdong Province, Guangzhou, 510440, People's Republic of China. yangzc@gzcdc.org.cn.
⁸ The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China. caowc@bmi.ac.cn.

PMID: 28056840
PMCID: PMC5216553
DOI: 10.1186/s12879-016-2153-3

Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014

Ye Sun et al. BMC Infect Dis. 2017.

. 2017 Jan 5;17(1):13.

doi: 10.1186/s12879-016-2153-3.

Authors

Ye Sun ^{1

2}, Yue-Hong Wei ³, Yang Yang ⁴, Yu Ma ³, Sake J de Vlas ⁵, Hong-Wu Yao ¹, Yong Huang ³, Mai-Juan Ma ¹, Kun Liu ¹, Xiao-Ning Li ³, Xin-Lou Li ¹, Wen-Hui Zhang ¹, Li-Qun Fang ⁶, Zhi-Cong Yang ⁷, Wu-Chun Cao ⁸

Affiliations

¹ The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China.
² Center for Disease Control and Prevention of Jinan Military Region, Shandong Province, Jinan, 250014, People's Republic of China.
³ Guangzhou Center for Disease Control and Prevention, Guangdong Province, Guangzhou, 510440, People's Republic of China.
⁴ Department of Biostatistics, College of Public Health and Health Professions, and Emerging Pathogens Institute, University of Florida, 32311, Florida, USA.
⁵ Department of Public Health, Erasmus Medical Center, University Medical Center Rotterdam, 999025, Rotterdam, The Netherlands.
⁶ The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China. fanglq@bmi.ac.cn.
⁷ Guangzhou Center for Disease Control and Prevention, Guangdong Province, Guangzhou, 510440, People's Republic of China. yangzc@gzcdc.org.cn.
⁸ The State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dong-Da Street, Fengtai District, Beijing, 100071, People's Republic of China. caowc@bmi.ac.cn.

PMID: 28056840
PMCID: PMC5216553
DOI: 10.1186/s12879-016-2153-3

Abstract

Background: In the last decade, scrub typhus (ST) has been emerging or re-emerging in some areas of Asia, including Guangzhou, one of the most affected endemic areas of ST in China.

Methods: Based on the data on all cases reported in Guangzhou from 2006 to 2014, we characterized the epidemiological features, and identified environmental determinants for the spatial distribution of ST using a panel negative binomial model.

Results: A total of 4821 scrub typhus cases were reported in Guangzhou during 2006-2014. The annual incidence increased noticeably and the increase was relatively high and rapid in rural townships and among elderly females. The majority of cases (86.8%) occurred during May-October, and farmers constituted the majority of the cases, accounting for 33.9% in urban and 61.6% in rural areas. The number of housekeeper patients had a rapid increment in both rural and urban areas during the study period. Atmospheric pressure and relative humidity with lags of 1 or 2 months, distributions of broadleaved forest and rural township were identified as determinants for the spatiotemporal distribution of scrub typhus.

Conclusion: Our results indicate that surveillance and public education need to be focused on the elderly farmers in rural areas covered with broadleaf forest in southern China.

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Figures

Fig. 1

Fig. 1

The spatial dynamic of scrub typhus in Guangzhou. a Spatial distribution of the locations of confirmed scrub typhus cases overlapped by the land cover, 2006―2014. b Average annual incidence of scrub typhus in township, 2006―2014

Fig. 2

Fig. 2

Heat map of monthly incidence of each township in Guangzhou, 2006―2014. Monthly incidences of all townships were shown in the heat map

Fig. 3

Fig. 3

Temporal distribution of monthly scrub typhus incidence for rural and urban areas separately. The bar charts in black and red represent the monthly incidence in rural and urban areas, and the black and red line represents the annual incidence of the scrub typhus in rural and urban areas in Guangzhou, 2006―2014

See this image and copyright information in PMC

References

1. Silpapojakul K. Scrub typhus in the Western Pacific region. Ann Acad Med Singapore. 1997;26(6):794–800. - PubMed
1. Walker DH. Scrub typhus - scientific neglect, ever-widening impact. N Engl J Med. 2016;375(10):913–915. doi: 10.1056/NEJMp1608499. - DOI - PubMed
1. Kelly DJ, Fuerst PA, Ching WM, Richards AL. Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi. Clin Infect Dis. 2009;48(Suppl 3):S203–230. doi: 10.1086/596576. - DOI - PubMed
1. Mathai E, Rolain JM, Verghese GM, Abraham OC, Mathai D, Mathai M, Raoult D. Outbreak of scrub typhus in southern India during the cooler months. Ann N Y Acad Sci. 2003;990:359–364. doi: 10.1111/j.1749-6632.2003.tb07391.x. - DOI - PubMed
1. Kweon SS, Choi JS, Lim HS, Kim JR, Kim KY, Ryu SY, Yoo HS, Park O. Rapid increase of scrub typhus, South Korea, 2001–2006. Emerg Infect Dis. 2009;15(7):1127–1129. doi: 10.3201/eid1507.080399. - DOI - PMC - PubMed

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[1] Silpapojakul K. Scrub typhus in the Western Pacific region. Ann Acad Med Singapore. 1997;26(6):794–800. - PubMed

[2] Silpapojakul K. Scrub typhus in the Western Pacific region. Ann Acad Med Singapore. 1997;26(6):794–800. - PubMed

[3] Walker DH. Scrub typhus - scientific neglect, ever-widening impact. N Engl J Med. 2016;375(10):913–915. doi: 10.1056/NEJMp1608499. - DOI - PubMed

[4] Walker DH. Scrub typhus - scientific neglect, ever-widening impact. N Engl J Med. 2016;375(10):913–915. doi: 10.1056/NEJMp1608499. - DOI - PubMed

[5] Kelly DJ, Fuerst PA, Ching WM, Richards AL. Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi. Clin Infect Dis. 2009;48(Suppl 3):S203–230. doi: 10.1086/596576. - DOI - PubMed

[6] Kelly DJ, Fuerst PA, Ching WM, Richards AL. Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia tsutsugamushi. Clin Infect Dis. 2009;48(Suppl 3):S203–230. doi: 10.1086/596576. - DOI - PubMed

[7] Mathai E, Rolain JM, Verghese GM, Abraham OC, Mathai D, Mathai M, Raoult D. Outbreak of scrub typhus in southern India during the cooler months. Ann N Y Acad Sci. 2003;990:359–364. doi: 10.1111/j.1749-6632.2003.tb07391.x. - DOI - PubMed

[8] Mathai E, Rolain JM, Verghese GM, Abraham OC, Mathai D, Mathai M, Raoult D. Outbreak of scrub typhus in southern India during the cooler months. Ann N Y Acad Sci. 2003;990:359–364. doi: 10.1111/j.1749-6632.2003.tb07391.x. - DOI - PubMed

[9] Kweon SS, Choi JS, Lim HS, Kim JR, Kim KY, Ryu SY, Yoo HS, Park O. Rapid increase of scrub typhus, South Korea, 2001–2006. Emerg Infect Dis. 2009;15(7):1127–1129. doi: 10.3201/eid1507.080399. - DOI - PMC - PubMed

[10] Kweon SS, Choi JS, Lim HS, Kim JR, Kim KY, Ryu SY, Yoo HS, Park O. Rapid increase of scrub typhus, South Korea, 2001–2006. Emerg Infect Dis. 2009;15(7):1127–1129. doi: 10.3201/eid1507.080399. - DOI - PMC - PubMed

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Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014

Affiliations

Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014

Authors

Affiliations

Abstract

Figures

References

MeSH terms

LinkOut - more resources

Full Text Sources

Other Literature Sources