Objective: To understand the epidemiological characteristics of tick-borne infectious diseases (TBID) and the risk factors of severe illness and death in Hubei Province from 2016 to 2021. Methods: Based on the incidence data of fever with thrombocytopenia syndrome (SFTS), tsutsugamushi disease, typhus and other TBID reported during 2016-2021, the epidemiological analysis was conducted. Field investigation results of TBID in areas with high incidence in 2021, logistic regression analysis of population characteristics, epidemiological history and other factors were used to explore the risk factors of severe and fatal cases. In the field vector investigation, free ticks and surface ticks of the host animals in the cases' home and surrounding grassland were monitored and detected. Results: A total of 3 826 TBID cases were reported in Hubei from 2016 to 2021, of which 71.30% (2 728/3 826) were SFTS, 13.04% (499/3 826) were tsutsugamushi disease and 15.66% (599/3 826) were typhus. A total of 44 cases died in 6 years; the fatality rate was 1.15% (44/3 826). In the peak seasons of incidence from May to July, the cases in people engaged in agriculture related work accounted for 84.61% (3 237/3 826). The incidence rate in women was higher than that in men, and the cases aged ≥50 years accounted for 81.02% of the total (3 100/3 826), and the incidence rate increased with age (P<0.001). The TBID cases were distributed in 86 counties and districts in 16 prefectures (municipality). The incidence rates of different areas had significant differences (P<0.05), and there was a certain spatial-temporal clustering and expasion. Bovis microplus and Haemaphysalis longicornis were captured in the field, and the positive rates in host animals and grassland ticks were 10.94% (7/64) and 40.00% (2/5), respectively. Univariate logistic regression analysis results showed that age ≥50 years and leukocyte <2.0×10⁹/L were risk factors for severe illness and death. Conclusions: The TBID reported in Hubei were mainly SFTS, tsutsugamushi disease and typhus. In order to reduce the incidence of TBID, it is necessary to strengthen the prevention and control in women aged ≥50 years and reduce field exposure and tick bites during the epidemic period.
Animals ; Female ; Typhus, Epidemic Louse-Borne ; Scrub Typhus/epidemiology* ; Severe Fever with Thrombocytopenia Syndrome ; Ticks ; Communicable Diseases ; Phlebovirus ; China/epidemiology* ; Tick-Borne Diseases/epidemiology*

Ticks are obligate, haematophagous arthropods that are distributed across the world, which may transmit more than 200 pathogens, including viruses, bacteria and parasites. A large number of tick species are widespread in China, and their transmitting tick-borne viral diseases pose a great threat to human health in endemic foci. This review describes the epidemiology of common, emerging and potentially pathogenic tick-borne viruses in China, and recommends the assessment of public health significance and pathogenicity of emerging tick-borne viruses using reverse microbial etiology, so as to provide insights into the management of emerging tick-borne diseases in China.
Animals ; Humans ; Tick-Borne Diseases/epidemiology* ; Ticks/microbiology* ; Viruses/genetics* ; Public Health ; China/epidemiology*

Objective: To summarize the clinical characteristics, diagnosis and treatment of forest encephalitis, and provide basis for revising relevant diagnostic criteria. Methods: From January to December 2020, the clinical characteristics, diagnosis and treatment of forest encephalitis cases in the data of China National Knowledge Infrastructure (CNKI) and Wanfang Chinese journals from 2009 to 2020 were retrospectively analyzed. The measurement data are expressed in Mean±SD, numbers, and the counting data of gender, region and occupation are expressed in numbers and composition ratio. Descriptive analysis of relevant data is carried out. Results: There were 1 153 confirmed cases of forest encephalitis reported in domestic literature, including 910 males and 243 females. Age: 16-78 years old; Cases were mainly distributed in Jilin Province, Inner Mongolia Autonomous Region and Heilongjiang Province. The cases included forest rangers (112/518), freelancers (104/518) and loggers (88/518). The common symptoms and signs were fever 81.2% (936/1153), headache 70.3% (811/1153), meninges irritation 29.0% (334/1153), vomiting 25.3% (292/1153), nausea 21.8% (251/1153), etc. Only 48.1% (555/1153) of the patients obtained positive pathogenic test results from blood and/or cerebrospinal fluid specimens. 42.1% (485/1153) had definite diagnosis grade, 354 cases were mild, 58 cases were moderate, and 73 cases were severe. Among 730 patients with forest encephalitis who received complete treatment, 511 cases were cured, 148 cases were improved, 48 cases were not cured, and 23 cases died. Conclusion: The epidemic of forest encephalitis has strict regional, seasonal and occupational characteristics. Early diagnosis and treatment can reduce the mortality and disability rate.
Male ; Female ; Humans ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Retrospective Studies ; Encephalitis, Tick-Borne ; Encephalitis/epidemiology* ; Headache ; Fever

Animals ; Ehrlichia/isolation & purification* ; Ehrlichiosis/veterinary* ; Prevalence ; Rodent Diseases/microbiology* ; Rodentia ; Species Specificity

OBJECTIVE: Tick-borne encephalitis virus (TBEV) is an emerging pathogen in Europe and North Asia that causes tick-borne encephalitis (TBE). A simple, rapid method for detecting TBEV RNA is needed to control this disease. METHODS: A reverse-transcription recombinase-aided amplification (RT-RAA) assay was developed. This assay can be completed in one closed tube at 39 °C within 30 minutes. The sensitivity and specificity of RT-RAA were validated using non-infectious synthetic RNA representing a fragment of the NS5 region of the wild-type (WT) TBEV genome and the Senzhang strain. Additionally, 10 batches of tick samples were used to evaluate the performance of the RT-RAA assay. RESULTS: The analytical limit of detection of the assay was 20 copies per reaction of the TBEV synthetic transcript and 3 plaque-forming units (pfu) per reaction of TBEV titers. With the specific assay, no signal due to other arboviruses was observed. Of the 10 batches of tick samples obtained from the Changbai Mountains of China, three were TBEV-positive, which was consistent with the results of the quantitative real-time PCR assay. CONCLUSION A rapid, highly sensitive, specific, and easy-to-use method was developed for the detection of the TBEV Far-Eastern subtype.
Encephalitis Viruses, Tick-Borne ; genetics ; isolation & purification ; Nucleic Acid Amplification Techniques ; RNA, Viral ; analysis

Because the case fatality rate (CFR) between Chinese and Korean patients with severe fever with thrombocytopenia syndrome is different, a comparison of the distribution of clinical manifestations shown at diagnosis in Chinese and Korean patients is needed. In contrast to Chinese patients between 2010 and 2013, Korean patients between 2013 and 2015 showed more cases of diarrhea (54.3% vs. 35.8%) and confusion (25.6% vs. 21.1%). These facts might delay the diagnosis in Korean patients and result in a higher CFR.
Asian Continental Ancestry Group ; Diagnosis ; Diarrhea ; Fever ; Humans ; Mortality ; Thrombocytopenia ; Tick-Borne Diseases

No abstract available.
Deer ; Farmers ; Lyme Disease ; Risk Factors ; Seroepidemiologic Studies

We report 17 patients with human granulocytic anaplasmosis between January 2015 and September 2018 at two tertiary university hospitals in Korea. Monthly incidence peaked in May and June. Among these patients, we identified three who were co-infected with scrub typhus, and one patient with hemorrhagic fever with renal syndrome.
Anaplasmosis ; Animals ; Coinfection ; Hemorrhagic Fever with Renal Syndrome ; Hospitals, University ; Humans ; Incidence ; Korea ; Scrub Typhus

BACKGROUND: Scrub typhus, severe fever with thrombocytopenia syndrome (SFTS) and human granulocytic anaplasmosis (HGA) are important arthropod-borne infectious diseases in Korea and share a common point that they are transmitted by arthropod bites mostly during outdoor activities and there are considerable overlaps of epidemiologic and clinical features at presentation. We investigated the co-infection of these infections. METHODS: The study subjects were patients with laboratory-confirmed scrub typhus who were enrolled retrospectively in 2006. SFTS virus (SFTSV) infection was confirmed by a reverse transcriptase polymerase chain reaction (PCR) to amplify partial L segment of SFTSV for molecular diagnosis. HGA was confirmed by a nested PCR to amplify 16S rRNA gene of Anaplasma phagocytophilum. Direct sequencing of the positive PCR products was performed. Clinical features of co-infected subjects were described. RESULTS: One-hundred sixty-seven patients with scrub typhus were included in the analysis. Co-infection of A. phagocytophilum was identified in 4.2% of scrub typhus patients (7/167). The route of co-infection was uncertain. The co-infected patients had not different clinical manifestations compared to the patients with scrub typhus only. All the study subjects were negative for SFTSV. CONCLUSION: We found retrospective molecular evidence of the co-infection of scrub typhus and HGA in Korea. HGA may be more prevalent than expected and need to be considered as an important differential diagnosis of febrile patients in Korea.
Anaplasma phagocytophilum ; Anaplasmosis ; Animals ; Arthropods ; Coinfection ; Communicable Diseases ; Diagnosis ; Diagnosis, Differential ; Fever ; Genes, rRNA ; Humans ; Korea ; Polymerase Chain Reaction ; Retrospective Studies ; Reverse Transcriptase Polymerase Chain Reaction ; Scrub Typhus ; Thrombocytopenia

OBJECTIVES: Jeju Province is well known as the region showing the highest incidence of severe fever with thrombocytopenia syndrome (SFTS) in South Korea. The aim of this study was to evaluate the epidemiological and clinical characteristics of SFTS patients in Jeju Province. METHODS: The primary data for this study were obtained from the Integrated Diseases and Health Control System of the Korea Centers for Disease Control and Prevention (KCDCIS). The selection criteria were confirmed cases of SFTS with a residence listed in Jeju Province at the time of diagnosis, reported to the KCDCIS between July 16, 2014 and November 30, 2018. RESULTS: Of 55 confirmed cases of SFTS, the case fatality rate was 10.9% (95% confidence interval [CI], 4.1 to 22.2). The most common presenting symptoms at diagnosis of severe fever, myalgia, and diarrhea had incidences of 83.6% (95% Cl, 71.2 to 92.2), 45.5% (95% Cl, 32.0 to 59.5), and 40.0% (95% CI, 27.0 to 54.1), respectively. CONCLUSIONS: Compared to SFTS patients nationwide in 2013-2015, the subjects of this study exhibited a lower case fatality rate and had a lower incidence of severe fever, myalgia, and confusion.
Bunyaviridae Infections ; Centers for Disease Control and Prevention (U.S.) ; Diagnosis ; Diarrhea ; Fever ; Humans ; Incidence ; Korea ; Mortality ; Myalgia ; Patient Selection ; Thrombocytopenia ; Tick-Borne Diseases