Tsutsugamushi disease, also known as scrub typhus, is a zoonosis caused by Orientia tsutsugamushi, with rats as the main sources of infection and chigger mites as the only medium of transmission, and has no effective vaccines. Tsutsugamushi disease can be divided into summer, autumn and winter types according to seasons in China, while the summer type is characterized by strong virulence, typical and severe symptoms, high rates of misdiagnosis and mortality. The summer type of tsutsugamushi disease is distributed in the south of 31°N in China, with the epidemic time from June to August, and the cases are predominantly females, farmers and people at ages of over 40 years. Affected by natural environment, social and economic factors, the epidemic areas and the number of cases of summer type of tsutsugamushi disease are increasing continuously. Based on publications pertaining to the epidemiology of summer type of tsutsugamushi disease in China from 1960 to 2023, this review summarizes the mechanism of transmission, epidemiological characteristics and influencing factors, so as to provide the basis for prevention and control of summer type of tsutsugamushi disease in China.

Objective To investigate the knowledge, attitudes and practices (KAP) towards scrub typhus control and analyse the influencing factors among residents in Longling County, Yunnan Province in 2023, so as to provide insights into management of scrub typhus in the county. Methods Two townships were randomly sampled from Longling County, Baoshan City, Yunnan Province in July 2023, and 2 to 3 administrative villages were randomly selected from each township. Then, 20 to 40 households were randomly selected from each village, and 1 to 2 villagers were surveyed in each household. Residents’ KAP towards scrub typhus control was investigated, and factor affecting residents’ KAP towards scrub typhus control were identified with independent samples t test or analysis of variance (ANOVA) and multiple linear regression analysis. Results A total of 417 questionnaires were allocated, and 410 valid questionnaires were recovered, with an effective recovery rate of 98.32%. Of all respondents, 65.85% (270/410) heard of scrub typhus but were not familiar with it, and 12.68% (52/410) and 1.95% (8/410) were familiar and very familiar with it, respectively. Residents mainly acquired scrub typhus control knowledge via their relatives and friends. The knowledge, attitude, and behavior scores of the respondents with regard to scrub typhus were (34.14 ± 13.07), (55.04 ± 6.69), and (21.40 ± 5.61), respectively, and the total score for knowledge, belief, and behavior in relation to scrub typhus prevention and control was (110.57 ± 18.80). Univariate analysis revealed that age (F = 3.12, P < 0.05), education (F = 10.77, P < 0.05), occupation (F = 4.89, P < 0.05), frequency of outdoor activities (F = 3.61, P < 0.05), and type of place of residence (t = 1.33, P < 0.05) were the factors that influenced the participants’ scores for knowledge of the prevention and control of scrub typhus. Multiple linear regression analysis revealed that literacy level (β = 10.20 to 16.71, P < 0.05) and category of residence (β = −7.23, P < 0.05) were the factors that influenced residents’ current knowledge and trust behavior in relation to scrub typhus. Conclusions Place of residence and educational level are critical factors affecting scrub typhus control among residents in Longling County, Yunnan Province. Intensified health education pertaining to scrub typhus control and appropriate behavioral interventions are required among residents living in urban areas, with a low educational level and frequent outdoor activities.