Skip to main content Accessibility help
×
Home

Epidemic characteristics and spatio-temporal patterns of scrub typhus during 2006–2013 in Tai'an, Northern China

  • L. ZHENG (a1), H.-L. YANG (a2), Z.-W. BI (a3), Z.-Q. KOU (a3), L.-Y. ZHANG (a1), A.-H. ZHANG (a2), L. YANG (a1) and Z.-T. ZHAO (a1)...

Summary

Tai'an, a famous cultural tourist district, is a new endemic foci of scrub typhus in northern China. Frequent reports of travel-acquired cases and absence of effective vaccine indicated a significant health problem of scrub typhus in Tai'an. Thus, descriptive epidemiological methods and spatial-temporal scan statistics were used to describe the epidemic characteristics and detect the significant clusters of the high incidence of scrub typhus at the town level in Tai'an. Results of descriptive epidemiological analysis showed a total of 490 cases were reported in Tai'an with the annual average incidence ranging from 0·48 to 2·27/100 000 during 2006–2013. Females, the elderly and farmers are the high-risk groups. Monthly changes of scrub typhus cases indicated an obvious epidemic period in autumn. Spatial-temporal distribution analysis, showed significant clusters of high incidence mainly located in eastern and northern Tai'an. Our study suggests that more effective, targeted measures for local residents should be implemented in the eastern and northern areas of Tai'an in autumn. Meanwhile, it may prove beneficial for health policy makers to advise travellers to take preventive measures in order to minimize the risk of infection of scrub typhus in Tai'an.

  • View HTML
    • Send article to Kindle

      To send this article to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about sending to your Kindle. Find out more about sending to your Kindle.

      Note you can select to send to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be sent to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

      Find out more about the Kindle Personal Document Service.

      Epidemic characteristics and spatio-temporal patterns of scrub typhus during 2006–2013 in Tai'an, Northern China
      Available formats
      ×

      Send article to Dropbox

      To send this article to your Dropbox account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Dropbox.

      Epidemic characteristics and spatio-temporal patterns of scrub typhus during 2006–2013 in Tai'an, Northern China
      Available formats
      ×

      Send article to Google Drive

      To send this article to your Google Drive account, please select one or more formats and confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your <service> account. Find out more about sending content to Google Drive.

      Epidemic characteristics and spatio-temporal patterns of scrub typhus during 2006–2013 in Tai'an, Northern China
      Available formats
      ×

Copyright

Corresponding author

* Author for correspondence: Professor Z.-T. Zhao, Department of Epidemiology and Health Statistics, School of Public Health, Shandong University, 44 Wenhuaxi Road, Jinan 250012, China. (Email: ztzhao@sdu.edu.cn)

References

Hide All
1. Liu, YX, et al. Clinical characteristics of the autumn-winter type scrub typhus cases in south of Shandong province, northern China. BMC Infectious Diseases 2009; 9: 82.
2. Zhang, M, et al. Scrub typhus: surveillance, clinical profile and diagnostic issues in Shandong, China. American Journal of Tropical Medicine and Hygiene 2012; 87: 10991104.
3. Sirisanthana, V, Puthanakit, T, Sirisanthana, T. Epidemiologic, clinical and laboratory features of scrub typhus in thirty Thai children. Pediatric Infectious Disease Journal 2003; 22: 341345.
4. Cracco, C, et al. Multiple organ failure complicating probable scrub typhus. Clinical Infectious Diseases 2000; 31: 191192.
5. Kim, DM, et al. Scrub typhus meningitis or meningoencephalitis. American Journal of Tropical Medicine and Hygiene 2013; 89: 12061211.
6. Lee, CS, et al. Risk factors leading to fatal outcome in scrub typhus patients. American Journal of Tropical Medicine and Hygiene 2009; 81: 484488.
7. Watt, G, Parola, P. Scrub typhus and tropical rickettsioses. Current Opinion in Infectious Diseases 2003; 16: 429436.
8. Zhang, M, Wang, XJ, Zhao, ZT. Current epidemic status and issues on prevention and control of scrub typhus [in Chinese]. Zhonghua liu xing bing xue za zhi 2011; 32: 419423.
9. Zhang, L, Bi, Z, Zhao, Z. Recent advances in molecular epidemiology of Orientia tsutsugamushi in China [in Chinese]. Zhonghua liu xing bing xue za zhi 2014; 35: 8892.
10. Wang, ZW, et al. Investigation of the first outbreak of scrub typhus in Feicheng. Disease Surveillance 2001; 8: 307308.
11. Ding, L, et al. Analysis of epidemic features of scrub typhus between year 2006 and 2010 in Shandong province, China [in Chinese]. Chinese Journal of Preventive Medicine 2012; 46: 338342.
12. Zhang, M, et al. Genetic variants of Orientia tsutsugamushi in domestic rodents, Northern China. Emerging Infectious Diseases 2013; 19: 11351137.
13. Yang, LP, et al. Comparative analysis of nucleotide sequences of Orientia tsutsugamushi in different epidemic areas of scrub typhus in Shandong, China. American Journal of Tropical Medicine and Hygiene 2008; 78: 968972.
14. Nachega, JB, et al. Travel-acquired scrub typhus: emphasis on the differential diagnosis, treatment, and prevention strategies. Journal of Travel Medicine 2007; 14: 352355.
15. Jensenius, M, Fournier, PE, Raoult, D. Rickettsioses and the international traveler. Clinical Infectious Diseases 2004; 39: 14931499.
16. Chattopadhyay, S, Richards, AL. Scrub typhus vaccines: past history and recent developments. Human Vaccines 2007; 3: 7380.
17. Peng., WW. Infectious Diseases, 6th edn. Beijing: People's Medical Publishing House, 2004, pp. 118121.
18. Kulldorff, M, et al. A space-time permutation scan statistic for disease outbreak detection. PLoS Medicine 2005; 2: e59.
19. Fang, L, et al. Spatial analysis of hemorrhagic fever with renal syndrome in China. BMC Infectious Diseases 2006; 6: 77.
20. SaTScan. User's Guide for version 9.1.1. (2011). (http://www.satscan.org/).
21. Bang, HA, Lee, MJ, Lee, WC. Comparative research on epidemiological aspects of tsutsugamushi disease (scrub typhus) between Korea and Japan. Japanese Journal of Infectious Diseases 2008; 61: 148150.
22. Kim, S, Kim, JS, Lee, H. Epidemiological characteristics of scrub typhus in Korea, 2009. Osong Public Health and Research Perspectives 2010; 1: 5560.
23. Wu, W, et al. Clusters of spatial, temporal, and space-time distribution of hemorrhagic fever with renal syndrome in Liaoning Province, Northeastern China. BMC Infectious Diseases 2011; 11: 229.
24. Wu, W, et al. GIS-based spatial, temporal, and space-time analysis of haemorrhagic fever with renal syndrome. Epidemiology and Infection 2009; 137: 17661775.
25. Onozuka, D, Hagihara, A. Geographic prediction of tuberculosis clusters in Fukuoka, Japan, using the space-time scan statistic. BMC Infectious Diseases 2007; 7: 26.
26. Amin, R, Burns, JJ. Clusters of adolescent and young adult thyroid cancer in Florida counties. BioMed Research International 2014; 2014: 832573.
27. Wei, Y, et al. Rapid increase of scrub typhus: an epidemiology and spatial-temporal cluster analysis in Guangzhou City, Southern China, 2006–2012. PLoS ONE 2014; 9: e101976.
28. Zhang, WY, et al. Scrub typhus in mainland China, 2006–2012: the need for targeted public health interventions. PLoS Neglected Tropical Diseases 2013; 7: e2493.
29. Kuo, CC, et al. Spatial analysis of scrub typhus infection and its association with environmental and socioeconomic factors in Taiwan. Acta Tropica 2011; 120: 5258.
30. Tsai, PJ, Yeh, HC. Scrub typhus islands in the Taiwan area and the association between scrub typhus disease and forest land use and farmer population density: geographically weighted regression. BMC Infectious Diseases 2013; 13: 191.
31. Traub, R, Wisseman, CL Jr. The ecology of chigger-borne rickettsiosis (scrub typhus). Journal of Medical Entomology 1974; 11: 237303.
32. Liu, YX, et al. Investigation on the vectors of scrub typhus in the foci of Shandong Province [in Chinese]. Modern Preventive Medicine 2004; 676: 678684.
33. Yang, LP, et al. Investigation on rodents' natural infection of Oientia tsutsugamushi in Tai'an area of Shandong, China [in Chinese]. Chinese Journal of Public Health 2008; 7: 877878.
34. Lyu, Y, et al. A case-control study of risk factors associated with scrub typhus infection in Beijing, China. PLoS ONE 2013; 8: e63668.

Keywords

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed