Epidemiologic Changes of Scrub Typhus in China, 1952–2016

• Main Authors: Zhongjie Li, Hualei Xin, Junling Sun, Shengjie Lai, Lingjia Zeng, Canjun Zheng, Sarah E. Ray, Nicole Davis Weaver, Liping Wang, Jianxing Yu, Zijian Feng, Simon I. Hay, George F. Gao
• Format: Article
• Language: English
• Published: Centers for Disease Control and Prevention 2020-06-01
• Series: Emerging Infectious Diseases
• Subjects: scrub typhus; incidence; trends; seasons; China; surveillance
• Online Access: https://wwwnc.cdc.gov/eid/article/26/6/19-1168_article
• ISSN: 1080-6040; 1080-6059

Scrub typhus, a miteborne rickettsiosis, has emerged in many areas globally. We analyzed the incidence and spatial–temporal distribution of scrub typhus in China during 1952–1989 and 2006–2016 using national disease surveillance data. A total of 133,623 cases and 174 deaths were recorded. The average annual incidence was 0.13 cases/100,000 population during 1952–1989; incidence increased sharply from 0.09/100,000 population in 2006 to 1.60/100,000 population in 2016. The disease, historically endemic to southern China, has expanded to all the provinces across both rural and urban areas. We identified 3 distinct seasonal patterns nationwide; infections peaked in summer in the southwest, summer-autumn in the southeast, and autumn in the middle-east. Persons >40 years of age and in nonfarming occupations had a higher risk for death. The changing epidemiology of scrub typhus in China warrants an enhanced disease control and prevention program.