{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T08:18:15Z","timestamp":1789892295421,"version":"4.0.1"},"reference-count":25,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"4","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2023,4,5]]},"abstract":"<jats:title>ABSTRACT.<\/jats:title>\n<jats:p>The worldwide spread of tick-borne diseases (TBDs) has become a public health concern. Therefore, this study aimed to clarify trends in the incidence of Japanese spotted fever (JSF), one of Japan\u2019s most prevalent TBDs. Weekly infectious disease reports were used to calculate the annual incidence rates (AIRs) of JSF. Data were stratified by age and sex, and joinpoint regression analysis was performed to estimate the annual percentage change (APC). AIR and APC were geographically compared among the 47 prefectures. A total of 3,453 JSF cases were observed from 2001 to 2020. The AIR per 100,000 population was 0.03 in 2001, which increased approximately 10-fold to 0.33 in 2020. The average APC (AAPC) during the study period was 12.3% (95% CI: 10.7\u201313.9). By age group, the incidence of JSF increased more rapidly among the older population: 11.5% (95% CI: 10.1\u201312.9) in those aged \u2265 65 years and 8.9% (95% CI: 6.4\u201311.5) in those aged &lt; 50 years. Although the AIR over the past two decades was higher in climatically warm regions located in southwestern Japan and on the Pacific coast, increases in the AAPC were notable in colder regions located in eastern Japan. The incidence of JSF continues to increase in Japan, especially among older populations and in eastern prefectures, where the disease has not been previously diagnosed.<\/jats:p>","DOI":"10.4269\/ajtmh.22-0487","type":"journal-article","created":{"date-parts":[[2023,2,6]],"date-time":"2023-02-06T15:35:50Z","timestamp":1675697750000},"page":"701-704","source":"Crossref","is-referenced-by-count":19,"title":["Trends in the Incidence of Japanese Spotted Fever in Japan: A Nationwide, Two-Decade Observational Study from 2001\u20132020"],"prefix":"10.4269","volume":"108","author":[{"given":"Yuki","family":"Otsuka","sequence":"first","affiliation":[{"name":"Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hideharu","family":"Hagiya","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shinnosuke","family":"Fukushima","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ko","family":"Harada","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan;"},{"name":"Department of Medicine, Icahn School of Medicine at Mount Sinai, Mount Sinai Beth Israel, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Toshihiro","family":"Koyama","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Biomedicine, Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences, Okayama University, Okayama, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fumio","family":"Otsuka","sequence":"additional","affiliation":[{"name":"Department of General Medicine, Dentistry and Pharmaceutical Sciences, Okayama University Graduate School of Medicine, Okayama, Japan;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2795","reference":[{"key":"b1","series-title":"QJM","first-page":"683","article-title":"Japanese spotted fever","volume":"113","author":"Nakanishi","year":"2020"},{"key":"b2","series-title":"Am J Trop Med Hyg","first-page":"466","article-title":"Important clinical features of Japanese spotted fever","volume":"99","author":"Noguchi","year":"2018"},{"key":"b3","series-title":"QJM","first-page":"741","article-title":"Japanese spotted fever","volume":"111","author":"Matsuura","year":"2018"},{"key":"b4","series-title":"Intern Med","first-page":"197","article-title":"Prediction of disseminated intravascular coagulation by 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warming","volume":"176","author":"Oliveira","year":"2017"},{"key":"b23","series-title":"Emerg Infect Dis","first-page":"1091","article-title":"Epidemiologic changes of scrub typhus in China, 1952\u20132016","volume":"26","author":"Li","year":"2020"},{"key":"b24","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"1333","article-title":"Mediterranean spotted fever in the elderly: a prospective cohort study","volume":"38","author":"Espejo","year":"2019"},{"key":"b25","series-title":"Clin Infect Dis","first-page":"e28","article-title":"African tick bite fever in elderly patients: 8 cases in French tourists returning from South Africa","volume":"47","author":"Roch","year":"2008"}],"container-title":["The American Journal of Tropical Medicine and 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