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      Analysis of epidemiological characteristics of four natural-focal diseases in Shandong Province, China in 2009-2017: A descriptive analysis

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          Abstract

          Background

          Natural-focal diseases are serious diseases that endanger human health. They threaten about 100 million people in Shandong Province, and cause illness in thousands of people each year. However, information on the epidemiological characteristics of natural-focal diseases in Shandong Province has been limited. The purpose of the study was to describe and analyze the epidemiological characteristics of natural-focal diseases in Shandong Province, 2009–2017.

          Methods

          We describe the incidence and distribution of four natural-focal diseases in Shandong Province using surveillance data from 2009–2017.

          Results

          From 2009–2017, 11123 cases of four natural-focal diseases including 257 deaths were reported in Shandong Province, China. The four natural-focal diseases were severe fever with thrombocytopenia syndrome (SFTS), human granulocytic anaplasmosis (HGA), typhus, and scrub typhus. The high-risk groups of the four diseases were farmers and the elderly. The incidence rate of scrub typhus was significantly higher in females. However, this difference was not seen in the other three diseases. The four diseases were mainly clustered in the middle-southern part of Shandong Province and the Shandong Peninsula. The annual incidence of SFTS and scrub typhus increased, typhus was relatively stable, and HGA declined. However, the range of SFTS expanded, while HGA shrunk, and typhus and scrub typhus were unchanged. The epidemic period of SFTS and HGA was from May to October, typhus was from October to November, and scrub typhus was from September to November. The fatality rates of SFTS, typhus, scrub typhus, and HGA were 9.19%, 0%, 0.01%, and 2.24%, respectively.

          Conclusions

          Our study described and analyzed the prevalence of natural-focal diseases in Shandong Province, and confirmed that age was closely related to the SFTS fatality rate. This study may help to improve the understanding of the prevalence of natural-focal diseases in Shandong Province in recent years and to better develop accurate prevention and control strategies for natural-focal diseases.

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          Haemaphysalis longicornis Ticks as Reservoir and Vector of Severe Fever with Thrombocytopenia Syndrome Virus in China

          Li-Mei Luo, Li Zhao, Hong-ling Wen … (2015)
          Transstadial and transovarial virus transmission occur among ticks, and transmission to mice can occur through a tick bite.
          Article 0 comments Cited 129 times – based on 0 reviews     Review now
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            A general overview of Mantel-Haenszel methods: applications and recent developments.

            J Landis, Gary G. Koch, S J Kuritz (1987)
            Article 0 comments Cited 70 times – based on 0 reviews     Review now
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              Nosocomial transmission of human granulocytic anaplasmosis in China.

              Daxin Ni, J Run, Kanglin Wan … (2008)
              Human granulocytic anaplasmosis (HGA) is an emerging tick-borne disease in China. A cluster of cases among health care workers and family members following exposure to a patient with fulminant disease consistent with HGA prompted investigation. To investigate the origin and transmission of apparent nosocomial cases of febrile illness in the Anhui Province. After exposure to an index patient whose fatal illness was characterized by fever and hemorrhage at a primary care hospital and regional tertiary care hospital's isolation ward, secondary cases with febrile illness who were suspected of being exposed were tested for antibodies against Anaplasma phagocytophilum and by polymerase chain reaction (PCR) and DNA sequencing for A. phagocytophilum DNA. Potential sources of exposure were investigated. Cases with serological or PCR evidence of HGA were compared with uninfected contacts to define the attack rate, relative risk of illness, and potential risks for exposure during the provision of care to the index patient. In a regional hospital of Anhui Province, China, between November 9 and 17, 2006, a cluster of 9 febrile patients with leukopenia, thrombocytopenia, and elevated serum aminotransferase levels were diagnosed with HGA by PCR for A. phagocytophilum DNA in peripheral blood and by seroconversion to A. phagocytophilum. No patients had tick bites. All 9 patients had contact with the index patient within 12 hours of her death from suspected fatal HGA while she experienced extensive hemorrhage and underwent endotracheal intubation. The attack rate was 32.1% vs 0% (P = .04) among contacts exposed at 50 cm or closer, 45% vs 0% (P = .001) among those exposed for more than 2 hours, 75% vs 0% (P < .001) among those reporting contact with blood secretions, and 87.5% vs 0% (P = .004) among those reporting contact with respiratory secretions from the index patient. We report the identification of HGA in China and likely nosocomial transmission of HGA from direct contact with blood or respiratory secretions.
              Article 0 comments Cited 62 times – based on 0 reviews     Review now
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                Author and article information

                Contributors
                Rui Chen: Role: Data curationRole: Formal analysisRole: MethodologyRole: SoftwareRole: Writing – original draft
                Zengqiang Kou: Role: Data curationRole: Formal analysisRole: ResourcesRole: SoftwareRole: Writing – original draft
                Liuchen Xu: Role: Data curationRole: Formal analysisRole: Methodology
                Jie Cao: Role: Data curationRole: Formal analysisRole: Project administration
                Ziwei Liu: Role: Data curationRole: Formal analysisRole: Methodology
                Xiaojing Wen: Role: Data curationRole: Formal analysisRole: Methodology
                Zhiyu Wang: Role: Data curationRole: Formal analysisRole: MethodologyRole: Project administration
                Hongling Wen:
                ORCID: http://orcid.org/0000-0001-7405-0404
                Role: ConceptualizationRole: Funding acquisitionRole: MethodologyRole: Project administrationRole: SupervisionRole: Writing – review & editing
                Isaac Chun-Hai Fung: Role: Editor
                Journal
                Journal ID (nlm-ta): PLoS One
                Journal ID (iso-abbrev): PLoS ONE
                Journal ID (publisher-id): plos
                Journal ID (pmc): plosone
                Title: PLoS ONE
                Publisher: Public Library of Science (San Francisco, CA USA )
                ISSN (Electronic): 1932-6203
                Publication date (Electronic): 27 August 2019
                Publication date Collection: 2019
                Volume: 14
                Issue: 8
                Electronic Location Identifier: e0221677
                Affiliations
                [1 ] Department of Microbiological Laboratory Technology, School of Public Health, Shandong University, Key laboratory for the prevention and control of infectious diseases (key laboratory of China’s “13th Five-Year”, Shandong University), Jinan, Shandong Province, China
                [2 ] Shandong Center for Disease Control and Prevention, Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control, Jinan, Shandong Province, China
                Georgia Southern University Jiann-Ping Hsu College of Public Health, UNITED STATES
                Author notes

                Competing Interests: The authors have declared that no competing interests exist.

                Author information
                http://orcid.org/0000-0001-7405-0404
                Article
                Publisher ID: PONE-D-19-22708
                DOI: 10.1371/journal.pone.0221677
                PMC ID: 6711524
                PubMed ID: 31454372
                SO-VID: dbd80aa5-9463-4364-80d0-2e08adea4ada
                Copyright © © 2019 Chen et al
                License:

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

                History
                Date received : 24 January 2019
                Date accepted : 13 August 2019
                Page count
                Figures: 6, Tables: 3, Pages: 19
                Funding
                This study was supported by Shandong Provincial Key Laboratory of Infectious Disease Prevention and Control (2017KEYLAB02) to HW. The funder had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Subject: Research Article
                Subject: Medicine and Health Sciences
                Subject: Infectious Diseases
                Subject: Bacterial Diseases
                Subject: Human Granulocytic Anaplasmosis
                Subject: Medicine and Health Sciences
                Subject: Infectious Diseases
                Subject: Bacterial Diseases
                Subject: Typhus
                Subject: Medicine and Health Sciences
                Subject: Infectious Diseases
                Subject: Bacterial Diseases
                Subject: Typhus
                Subject: Scrub Typhus
                Subject: People and Places
                Subject: Population Groupings
                Subject: Age Groups
                Subject: Biology and Life Sciences
                Subject: Population Biology
                Subject: Population Dynamics
                Subject: Geographic Distribution
                Subject: Biology and Life Sciences
                Subject: Population Biology
                Subject: Population Metrics
                Subject: Age Distribution
                Subject: People and Places
                Subject: Geographical Locations
                Subject: Asia
                Subject: China
                Subject: Medicine and Health Sciences
                Subject: Geriatrics
                Custom metadata
                Data Availability All relevant data are within the paper and its Supporting Information files.

                ScienceOpen disciplines: Uncategorized
                Data availability:
                ScienceOpen disciplines: Uncategorized

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