title: Rapid Increase in Scrub Typhus Incidence in Mainland China, 2006-2014.
abstract: Scrub typhus is a vector-borne disease, which has recently reemerged in China. In this study, we describe the distribution and incidence of scrub typhus cases in China from 2006 to 2014 and quantify differences in scrub typhus cases with respect to sex, age, and occupation. The results of our study indicate that the annual incidence of scrub typhus has increased during the study period. The number of cases peaked in 2014, which was 12.8 times greater than the number of cases reported in 2006. Most (77.97%) of the cases were reported in five provinces (Guangdong, Yunnan, Anhui, Fujian, and Shandong). Our study also demonstrates that the incidence rate of scrub typhus was significantly higher in females compared to males (P < 0.001) and was highest in the 60-69 year age group, and that farmers had a higher incidence rate than nonfarmers (P < 0.001). Different seasonal trends were identified in the number of reported cases between the northern and southern provinces of China. These findings not only demonstrate that China has experienced a large increase in scrub typhus incidence, but also document an expansion in the geographic distribution throughout the country.
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Yi-Cheng
authors.initials: YC
authors.lastname: Wu
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Quan
authors.initials: Q
authors.lastname: Qian
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Ricardo J Soares
authors.initials: RJ
authors.lastname: Magalhaes
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Zhi-Hai
authors.initials: ZH
authors.lastname: Han
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Ubydul
authors.initials: U
authors.lastname: Haque
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Weppelmann
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Wen-Biao
authors.initials: WB
authors.lastname: Hu
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Yun-Xi
authors.initials: YX
authors.lastname: Liu
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China.
authors.forename: Yan-Song
authors.initials: YS
authors.lastname: Sun
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China zwy0419@126.com lishenlong@sohu.com.
authors.forename: Wen-Yi
authors.initials: WY
authors.lastname: Zhang
authors.affiliation: Institute of Disease Control and Prevention Academy of Military Medical Science, Beijing, People's Republic of China; School of Veterinary Science, Centre for Children's Health Research, University of Queensland, Brisbane, Australia; Navy General Hospital of People's Liberation Army, Beijing, People's Republic of China; Emerging Pathogens Institute, University of Florida, Gainesville, Florida; Department of Environmental and Global Health, College of Public Health and Health Professions, University of Florida, Gainesville, Florida; School of Public Health and Social Work, Queensland University of Technology, Brisbane, Australia; Chinese People's Liberation Army General Hospital, Beijing, People's Republic of China; Academy of Military Medical Science, Beijing, People's Republic of China zwy0419@126.com lishenlong@sohu.com.
authors.forename: Shen-Long
authors.initials: SL
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D012612:Scrub Typhus / Q000453:epidemiology*; D012621:Seasons; D013997:Time Factors; D055815:Young Adult