Are There Spatial and Temporal Correlations in the Incidence Distribution of Scrub Typhus in Korea?

Noh, Maengseok; Lee, Youngjo; Chu, Chaeshin; Gwack, Jin; Youn, Seung Ki; Huh, Sun

doi:10.1016/j.phrp.2013.01.002

Cited by 14 publications

(19 citation statements)

References 8 publications

(10 reference statements)

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“…In this study, our findings demonstrated the percentage of shrub, temperature and precipitation were risk factors associated to the spatiotemporal heterogeneity of scrub typhus notifications in China. A possible explanation is that temperature, precipitation, and shrub may affect the population dynamics and activity levels of chigger mites [ 7 , 33 ]. Previous studies also suggested the migration of infested rodents or chiggers may have led to the formation new natural foci in provinces of Shandong, Henan, and Beijing since the meteorological and vegetation cover conditions are similar in these areas [ 34 ].…”

Section: Discussionmentioning

confidence: 99%

Spatiotemporal Dynamics of Scrub Typhus Transmission in Mainland China, 2006-2014

Qian

Magalhães

et al. 2016

PLoS Negl Trop Dis

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BackgroundScrub typhus is endemic in the Asia-Pacific region including China, and the number of reported cases has increased dramatically in the past decade. However, the spatial-temporal dynamics and the potential risk factors in transmission of scrub typhus in mainland China have yet to be characterized.ObjectiveThis study aims to explore the spatiotemporal dynamics of reported scrub typhus cases in mainland China between January 2006 and December 2014, to detect the location of high risk spatiotemporal clusters of scrub typhus cases, and identify the potential risk factors affecting the re-emergence of the disease.MethodMonthly cases of scrub typhus reported at the county level between 2006 and 2014 were obtained from the Chinese Center for Diseases Control and Prevention. Time-series analyses, spatiotemporal cluster analyses, and spatial scan statistics were used to explore the characteristics of the scrub typhus incidence. To explore the association between scrub typhus incidence and environmental variables panel Poisson regression analysis was conducted.ResultsDuring the time period between 2006 and 2014 a total of 54,558 scrub typhus cases were reported in mainland China, which grew exponentially. The majority of cases were reported each year between July and November, with peak incidence during October every year. The spatiotemporal dynamics of scrub typhus varied over the study period with high-risk clusters identified in southwest, southern, and middle-eastern part of China. Scrub typhus incidence was positively correlated with the percentage of shrub and meteorological variables including temperature and precipitation.ConclusionsThe results of this study demonstrate areas in China that could be targeted with public health interventions to mitigate the growing threat of scrub typhus in the country.

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Section: Discussionmentioning

confidence: 99%

Spatiotemporal Dynamics of Scrub Typhus Transmission in Mainland China, 2006-2014

Qian

Magalhães

et al. 2016

PLoS Negl Trop Dis

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“…It is a burden to the communities in Asia-Pacific rim. 12 - 15 It also occur in the United States, Canada, and Europe, being imported by tourists returning from endemic regions. 16 …”

Section: Discussionmentioning

confidence: 99%

Scrub typhus associated hepatic dysfunctionand abdominal CT findings

Park¹,

Lee²,

Shim³

et al. 2015

Pak J Med Sci

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Objective:This retrospective study investigated abnormal hepatic dysfunction and abdominal computed tomography (CT) findings in scrub typhus.Methods:Three hundred forty nine adult patients were diagnosed with scrub typhus. Ninety four underwent abdominal CT. The CT images were reviewed by the attending radiologist. Patient data of history, symptoms, signs, and results of laboratory tests were collected from the electronic medical records.Results:In 349 patients with scrub typhus, elevation of aspartate aminotransferase (78.5%) and alanine aminotransferase (63.0%) were dominant compared to alkaline phosphatase (27.2%) and total bilirubin (16.1%). Abdominal CT findings of 94 patients were, in descending order of frequency, enlarged lymph node (53.2%), inhomogeneous enhancement of liver (47.9%), splenomegaly (46.8%), ascites (28.7%), low attenuation of periportal areas (27.7%), gallbladder wall thickening (17.0%), and splenic infarct (6.4%). Also, the level of aspartate aminotransferase tended to be elevated according to the number of CT findings (P= 0.028)Conclusions:We found that abdominal CT manifestations of scrub typhus with elevated aminotransferases were varied and not specific. However, knowledge of these findings may evoke the recognition of scrub typhus by clinicians in endemic areas.

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“…The use of improved diagnostic methods, increased medical investigations and awareness have recently contributed to greater recognition of scrub typhus in some countries, such as in Laos, India, southern China, South Korea, and Japan [ 8 ]. There is also evidence suggesting that a combination of climate change and expansion of humans into previously uninhabited areas may play a role in both re-emergence and apparent rising incidence of scrub typhus [ 9 – 11 ].…”

Section: Introductionmentioning

confidence: 99%

Estimating the burden of scrub typhus: A systematic review

et al. 2017

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BackgroundScrub typhus is a vector-borne zoonotic disease that can be life-threatening. There are no licensed vaccines, or vector control efforts in place. Despite increasing awareness in endemic regions, the public health burden and global distribution of scrub typhus remains poorly known.MethodsWe systematically reviewed all literature from public health records, fever studies and reports available on the Ovid MEDLINE, Embase Classic + Embase and EconLit databases, to estimate the burden of scrub typhus since the year 2000.FindingsIn prospective fever studies from Asia, scrub typhus is a leading cause of treatable non-malarial febrile illness. Sero-epidemiological data also suggest that Orientia tsutsugamushi infection is common across Asia, with seroprevalence ranging from 9.3%–27.9% (median 22.2% IQR 18.6–25.7). A substantial apparent rise in minimum disease incidence (median 4.6/100,000/10 years, highest in China with 11.2/100,000/10 years) was reported through passive national surveillance systems in South Korea, Japan, China, and Thailand. Case fatality risks from areas of reduced drug-susceptibility are reported at 12.2% and 13.6% for South India and northern Thailand, respectively. Mortality reports vary widely around a median mortality of 6.0% for untreated and 1.4% for treated scrub typhus. Limited evidence suggests high mortality in complicated scrub typhus with CNS involvement (13.6% mortality), multi-organ dysfunction (24.1%) and high pregnancy miscarriage rates with poor neonatal outcomes.InterpretationScrub typhus appears to be a truly neglected tropical disease mainly affecting rural populations, but increasingly also metropolitan areas. Rising minimum incidence rates have been reported over the past 8–10 years from countries with an established surveillance system. A wider distribution of scrub typhus beyond Asia is likely, based on reports from South America and Africa. Unfortunately, the quality and quantity of the available data on scrub typhus epidemiology is currently too limited for any economical, mathematical modeling or mapping approaches.

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Are There Spatial and Temporal Correlations in the Incidence Distribution of Scrub Typhus in Korea?

Cited by 14 publications

References 8 publications

Spatiotemporal Dynamics of Scrub Typhus Transmission in Mainland China, 2006-2014

Spatiotemporal Dynamics of Scrub Typhus Transmission in Mainland China, 2006-2014

Scrub typhus associated hepatic dysfunctionand abdominal CT findings

Estimating the burden of scrub typhus: A systematic review

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