Skip to main content
Top
Published in: BMC Infectious Diseases 1/2017

Open Access 01-12-2017 | Research article

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

Authors: Ye Sun, Yue-Hong Wei, Yang Yang, Yu Ma, Sake J. de Vlas, Hong-Wu Yao, Yong Huang, Mai-Juan Ma, Kun Liu, Xiao-Ning Li, Xin-Lou Li, Wen-Hui Zhang, Li-Qun Fang, Zhi-Cong Yang, Wu-Chun Cao

Published in: BMC Infectious Diseases | Issue 1/2017

Login to get access

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.
Appendix
Available only for authorised users
Literature
1.
go back to reference Silpapojakul K. Scrub typhus in the Western Pacific region. Ann Acad Med Singapore. 1997;26(6):794–800.PubMed Silpapojakul K. Scrub typhus in the Western Pacific region. Ann Acad Med Singapore. 1997;26(6):794–800.PubMed
2.
go back to reference Walker DH. Scrub typhus - scientific neglect, ever-widening impact. N Engl J Med. 2016;375(10):913–5.CrossRefPubMed Walker DH. Scrub typhus - scientific neglect, ever-widening impact. N Engl J Med. 2016;375(10):913–5.CrossRefPubMed
3.
go back to reference 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.CrossRefPubMed 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.CrossRefPubMed
4.
go back to reference 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;990:359–64.CrossRefPubMed 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;990:359–64.CrossRefPubMed
5.
go back to reference 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):1127–9.CrossRefPubMedPubMedCentral 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):1127–9.CrossRefPubMedPubMedCentral
6.
go back to reference Phongmany S, Rolain JM, Phetsouvanh R, Blacksell SD, Soukkhaseum V, Rasachack B, Phiasakha K, Soukkhaseum S, Frichithavong K, Chu V, et al. Rickettsial infections and fever, Vientiane, Laos. Emerg Infect Dis. 2006;12(2):256–62.CrossRefPubMedPubMedCentral Phongmany S, Rolain JM, Phetsouvanh R, Blacksell SD, Soukkhaseum V, Rasachack B, Phiasakha K, Soukkhaseum S, Frichithavong K, Chu V, et al. Rickettsial infections and fever, Vientiane, Laos. Emerg Infect Dis. 2006;12(2):256–62.CrossRefPubMedPubMedCentral
7.
go back to reference Parola P, Blacksell SD, Phetsouvanh R, Phongmany S, Rolain JM, Day NP, Newton PN, Raoult D. Genotyping of Orientia tsutsugamushi from humans with scrub typhus, Laos. Emerg Infect Dis. 2008;14(9):1483–5.CrossRefPubMedPubMedCentral Parola P, Blacksell SD, Phetsouvanh R, Phongmany S, Rolain JM, Day NP, Newton PN, Raoult D. Genotyping of Orientia tsutsugamushi from humans with scrub typhus, Laos. Emerg Infect Dis. 2008;14(9):1483–5.CrossRefPubMedPubMedCentral
8.
go back to reference Watt G, Parola P. Scrub typhus and tropical rickettsioses. Curr Opin Infect Dis. 2003;16(5):429–36.CrossRefPubMed Watt G, Parola P. Scrub typhus and tropical rickettsioses. Curr Opin Infect Dis. 2003;16(5):429–36.CrossRefPubMed
9.
10.
go back to reference Wei Y, Huang Y, Luo L, Xiao X, Liu L, Yang Z. Rapid increase of scrub typhus: an epidemiology and spatial-temporal cluster analysis in Guangzhou City, Southern China, 2006–2012. PLoS One. 2014;9(7):e101976.CrossRefPubMedPubMedCentral Wei Y, Huang Y, Luo L, Xiao X, Liu L, Yang Z. Rapid increase of scrub typhus: an epidemiology and spatial-temporal cluster analysis in Guangzhou City, Southern China, 2006–2012. PLoS One. 2014;9(7):e101976.CrossRefPubMedPubMedCentral
11.
go back to reference Yang LP, Liu J, Wang XJ, Ma W, Jia CX, Jiang BF. Effects of meteorological factors on scrub typhus in a temperate region of China. Epidemiol Infect. 2014;142(10):2217–26.CrossRefPubMed Yang LP, Liu J, Wang XJ, Ma W, Jia CX, Jiang BF. Effects of meteorological factors on scrub typhus in a temperate region of China. Epidemiol Infect. 2014;142(10):2217–26.CrossRefPubMed
12.
go back to reference Traub R, Wisseman Jr CL. Ecological considerations in scrub typhus. 2. Vector species. Bull World Health Organ. 1968;39(2):219–30.PubMedPubMedCentral Traub R, Wisseman Jr CL. Ecological considerations in scrub typhus. 2. Vector species. Bull World Health Organ. 1968;39(2):219–30.PubMedPubMedCentral
13.
go back to reference Fang LQ, Wang LP, de Vlas SJ, Liang S, Tong SL, Li YL, Li YP, Qian Q, Yang H, Zhou MG, et al. Distribution and risk factors of 2009 pandemic influenza A (H1N1) in mainland China. Am J Epidemiol. 2012;175(9):890–7.CrossRefPubMedPubMedCentral Fang LQ, Wang LP, de Vlas SJ, Liang S, Tong SL, Li YL, Li YP, Qian Q, Yang H, Zhou MG, et al. Distribution and risk factors of 2009 pandemic influenza A (H1N1) in mainland China. Am J Epidemiol. 2012;175(9):890–7.CrossRefPubMedPubMedCentral
14.
go back to reference Rabe-Hesketh S, Everitt B. A handbook of statistical analyses using STATA (Third edition). New York: CRC Press; 2006. Rabe-Hesketh S, Everitt B. A handbook of statistical analyses using STATA (Third edition). New York: CRC Press; 2006.
15.
go back to reference Zhang WY, Wang LY, Ding F, Hu WB, Soares Magalhaes RJ, Sun HL, Liu YX, Liu QY, Huang LY, Clements AC et al. Scrub typhus in mainland China, 2006–2012: the need for targeted public health interventions. PLoS Negl Trop Dis. 2013, 7(12):e2493. Zhang WY, Wang LY, Ding F, Hu WB, Soares Magalhaes RJ, Sun HL, Liu YX, Liu QY, Huang LY, Clements AC et al. Scrub typhus in mainland China, 2006–2012: the need for targeted public health interventions. PLoS Negl Trop Dis. 2013, 7(12):e2493.
16.
go back to reference Park SW, Ha NY, Ryu B, Bang JH, Song H, Kim Y, Kim G, Oh MD, Cho NH, Lee JK. Urbanization of scrub typhus disease in South Korea. PLoS Negl Trop Dis. 2015;9(5):e0003814.CrossRefPubMedPubMedCentral Park SW, Ha NY, Ryu B, Bang JH, Song H, Kim Y, Kim G, Oh MD, Cho NH, Lee JK. Urbanization of scrub typhus disease in South Korea. PLoS Negl Trop Dis. 2015;9(5):e0003814.CrossRefPubMedPubMedCentral
17.
go back to reference Wei Y, Luo L, Jing Q, Li X, Huang Y, Xiao X, Liu L, Wu X, Yang Z. A city park as a potential epidemic site of scrub typhus: a case-control study of an outbreak in Guangzhou, China. Parasit Vectors. 2014;7:513.PubMedPubMedCentral Wei Y, Luo L, Jing Q, Li X, Huang Y, Xiao X, Liu L, Wu X, Yang Z. A city park as a potential epidemic site of scrub typhus: a case-control study of an outbreak in Guangzhou, China. Parasit Vectors. 2014;7:513.PubMedPubMedCentral
18.
go back to reference Xia T, Xin-wei W, Yue-hong W, Xin-cai X, Yong Z, Lei L, Jing Z, Fang-hua L. Genotype analysis of orientia tsutsugamushi isolated from humans in Guangzhou in 2012–2013. J Trop Med. 2014;14(11):1416–9 [in Chinese]. Xia T, Xin-wei W, Yue-hong W, Xin-cai X, Yong Z, Lei L, Jing Z, Fang-hua L. Genotype analysis of orientia tsutsugamushi isolated from humans in Guangzhou in 2012–2013. J Trop Med. 2014;14(11):1416–9 [in Chinese].
19.
go back to reference Kuo CC, Huang JL, Ko CY, Lee PF, Wang HC. Spatial analysis of scrub typhus infection and its association with environmental and socioeconomic factors in Taiwan. Acta Trop. 2011;120(1–2):52–8.CrossRefPubMed Kuo CC, Huang JL, Ko CY, Lee PF, Wang HC. Spatial analysis of scrub typhus infection and its association with environmental and socioeconomic factors in Taiwan. Acta Trop. 2011;120(1–2):52–8.CrossRefPubMed
20.
go back to reference Sharma PK, Ramakrishnan R, Hutin YJ, Barui AK, Manickam P, Kakkar M, Mittal V, Gupte MD. Scrub typhus in Darjeeling, India: opportunities for simple, practical prevention measures. Trans R Soc Trop Med Hyg. 2009;103(11):1153–8.CrossRefPubMed Sharma PK, Ramakrishnan R, Hutin YJ, Barui AK, Manickam P, Kakkar M, Mittal V, Gupte MD. Scrub typhus in Darjeeling, India: opportunities for simple, practical prevention measures. Trans R Soc Trop Med Hyg. 2009;103(11):1153–8.CrossRefPubMed
21.
go back to reference Wardrop NA, Kuo CC, Wang HC, Clements AC, Lee PF, Atkinson PM. Bayesian spatial modelling and the significance of agricultural land use to scrub typhus infection in Taiwan. Geospat Health. 2013;8(1):229–39.CrossRefPubMed Wardrop NA, Kuo CC, Wang HC, Clements AC, Lee PF, Atkinson PM. Bayesian spatial modelling and the significance of agricultural land use to scrub typhus infection in Taiwan. Geospat Health. 2013;8(1):229–39.CrossRefPubMed
22.
go back to reference Li T, Yang Z, Wang M. Scrub typhus rapidly increased in Guangzhou, southern China, 2007—2012. Rev Inst Med Trop Sao Paulo. 2013, 55:293–293. Li T, Yang Z, Wang M. Scrub typhus rapidly increased in Guangzhou, southern China, 2007—2012. Rev Inst Med Trop Sao Paulo. 2013, 55:293–293.
23.
go back to reference Clopton RE, Gold RE. Distribution and seasonal and diurnal activity patterns of Eutrombicula alfreddugesi (Acari: Trombiculidae) in a forest edge ecosystem. J Med Entomol. 1993;30(1):47–53.CrossRefPubMed Clopton RE, Gold RE. Distribution and seasonal and diurnal activity patterns of Eutrombicula alfreddugesi (Acari: Trombiculidae) in a forest edge ecosystem. J Med Entomol. 1993;30(1):47–53.CrossRefPubMed
24.
go back to reference Rubio AV, Simonetti JA. Ectoparasitism by Eutrombicula alfreddugesi larvae (Acari: Trombiculidae) on Liolaemus tenuis lizard in a Chilean fragmented temperate forest. J Parasitol. 2009;95(1):244–5.CrossRefPubMed Rubio AV, Simonetti JA. Ectoparasitism by Eutrombicula alfreddugesi larvae (Acari: Trombiculidae) on Liolaemus tenuis lizard in a Chilean fragmented temperate forest. J Parasitol. 2009;95(1):244–5.CrossRefPubMed
Metadata
Title
Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006―2014
Authors
Ye Sun
Yue-Hong Wei
Yang Yang
Yu Ma
Sake J. de Vlas
Hong-Wu Yao
Yong Huang
Mai-Juan Ma
Kun Liu
Xiao-Ning Li
Xin-Lou Li
Wen-Hui Zhang
Li-Qun Fang
Zhi-Cong Yang
Wu-Chun Cao
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Infectious Diseases / Issue 1/2017
Electronic ISSN: 1471-2334
DOI
https://doi.org/10.1186/s12879-016-2153-3

Other articles of this Issue 1/2017

BMC Infectious Diseases 1/2017 Go to the issue
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discuss last year's major advances in heart failure and cardiomyopathies.