{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,24]],"date-time":"2025-12-24T18:06:23Z","timestamp":1766599583448},"reference-count":20,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"3","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,3,2]]},"abstract":"<jats:p>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 (<jats:italic>P<\/jats:italic> &lt; 0.001) and was highest in the 60\u201369 year age group, and that farmers had a higher incidence rate than nonfarmers (<jats:italic>P<\/jats:italic> &lt; 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.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0663","type":"journal-article","created":{"date-parts":[[2015,12,29]],"date-time":"2015-12-29T03:03:18Z","timestamp":1451358198000},"page":"532-536","source":"Crossref","is-referenced-by-count":36,"title":["Rapid Increase in Scrub Typhus Incidence in Mainland China, 2006\u20132014"],"prefix":"10.4269","volume":"94","author":[{"given":"Yi-Cheng","family":"Wu","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Quan","family":"Qian","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ricardo J. Soares","family":"Magalhaes","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhi-Hai","family":"Han","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ubydul","family":"Haque","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas A.","family":"Weppelmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Biao","family":"Hu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yun-Xi","family":"Liu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yan-Song","family":"Sun","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wen-Yi","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shen-Long","family":"Li","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2795","reference":[{"issue":"Suppl 3","key":"ref1","series-title":"Clin Infect Dis","first-page":"S203","article-title":"Scrub typhus: the geographic distribution of phenotypic and genotypic variants of Orientia 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Dis","first-page":"191","article-title":"Multiple organ failure complicating probable scrub typhus","volume":"31","author":"Cracco","year":"2000"},{"key":"ref7","series-title":"Emerg Infect Dis","first-page":"1127","article-title":"Rapid increase of scrub typhus, South Korea, 2001\u20132006","volume":"15","author":"Kweon","year":"2009"},{"key":"ref8","series-title":"PLoS One","first-page":"e46997","article-title":"New genotypes of Orientia tsutsugamushi isolated from humans in eastern Taiwan","volume":"7","author":"Yang","year":"2012"},{"key":"ref9","series-title":"Zhonghua Liu Xing Bing Xue Za Zhi","first-page":"419","article-title":"Current epidemic status and issues on prevention and control of scrub typhus [in Chinese]","volume":"32","author":"Zhang","year":"2011"},{"key":"ref10","series-title":"BMC Infect Dis","first-page":"139","article-title":"Meteorological factors and risk of scrub typhus in Guangzhou, southern China, 2006\u20132012","volume":"14","author":"Li","year":"2014"},{"key":"ref11","series-title":"PLoS Negl Trop Dis","first-page":"e2493","article-title":"Scrub typhus in mainland China, 2006\u20132012: the need for targeted public health interventions","volume":"7","author":"Zhang","year":"2013"},{"key":"ref12","series-title":"Chin J Prev Med","first-page":"338","article-title":"Analysis of epidemic features of scrub typhus between year 2006 and 2010 in Shandong Province, China","volume":"46","author":"Ding","year":"2012"},{"year":"2009","series-title":"Technical Guides for Prevention and Control of Scrub Typhus","author":"China Ministry of Health","key":"ref13"},{"key":"ref14","series-title":"Microbiol Immunol","first-page":"135","article-title":"Epidemiological characteristics of tsutsugamushi disease in Oita Prefecture, Japan: yearly and monthly occurrences of its infections and serotypes of its causative agent, Orientia tsutsugamushi, during 1984\u20132005","volume":"52","author":"Ogawa","year":"2008"},{"key":"ref15","series-title":"China Trop Med","first-page":"1278","article-title":"Current progress in research of tsutsugamushi disease in Yunnan Province in China","volume":"10","author":"Xuan","year":"2010"},{"key":"ref16","series-title":"J China Univ Min Technol (Soc Sci)","first-page":"44","article-title":"\u201cBalance\u201d between family and work\u2014invariability and variability of female status","volume":"10","author":"Zhang","year":"2008"},{"key":"ref17","series-title":"J Trop Dis Parasitol","first-page":"37","article-title":"Research on Rickettsia and epidemic situation of Rickettsia disease in China","volume":"3","author":"Zhang","year":"2005"},{"key":"ref18","series-title":"Infect Dis Info","first-page":"15","article-title":"Features and significance of tsutsugamushi disease outbreaks in the emerging epidemic focuses in Anhui Province","volume":"24","author":"Yu","year":"2011"},{"key":"ref19","series-title":"Chin J Vector Biol Control","first-page":"137","article-title":"Laboratory confirmation of scrub typhus outbreak in Pinggu District, Beijing","volume":"22","author":"Fu","year":"2011"},{"key":"ref20","series-title":"Chin J Vector Bio Control","first-page":"230","article-title":"The lab identification on tsutsugamushi disease for the first outbreak in Henan Province","volume":"18","author":"Xia","year":"2007"}],"container-title":["The American Society of Tropical Medicine and 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