Sun Ruo-Xi, Lai Sheng-Jie, Yang Yang, Li Xin-Lou, Liu Kun, Yao Hong-Wu, Zhou Hang, Li Yu, Wang Li-Ping, Mu Di, Yin Wen-Wu, Fang Li-Qun, Yu Hong-Jie, Cao Wu-Chun
State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, People's Republic of China; Centre for Disease Control and Prevention of Fuyang, Anhui Province, People's Republic of China.
Division of Infectious Disease, Key Laboratory of Surveillance and Early-warning on Infectious Disease, Chinese Centre for Disease Control and Prevention, Beijing, People's Republic of China; Worldpop, Department of Geography and Environment, University of Southampton, Southampton, United Kingdom.
Ticks Tick Borne Dis. 2017 Jun;8(4):631-639. doi: 10.1016/j.ttbdis.2017.04.009. Epub 2017 Apr 17.
Tick-borne encephalitis (TBE) has become an increasing public health threat in recent years, ranging from Europe, through far-eastern Russia to Japan and northern China. However, the neglect of its expansion and scarce analyses of the dynamics have made the overall disease burden and the risk distribution of the disease being unclear in mainland China. In this study, we described epidemiological characteristics of 2117 reported human TBE cases from 2006 to 2013 in mainland China. About 99% of the cases were reported in forest areas of northeastern China, and 93% of reported infections occurred during May-July. Cases were primarily male (67%), mostly in 30-59 years among all age-gender groups. Farmers (31.6%), domestic workers (20.1%) and forest workers (17.9%) accounted for the majority of the patients, and the proportions of patients from farmers and domestic workers were increasing in recent years. The epidemiological features of TBE differed slightly across the affected regions. The distribution and features of the disease in three main endemic areas of mainland China were also summarized. Using the Boosted Regression Trees (BRT) model, we found that the presence of TBE was significantly associated with a composite meteorological index, altitude, the coverage of broad-leaved forest, the coverage of mixed broadleaf-conifer forest, and the distribution of Ixodes persulcatus (I. persulcatus) ticks. The model-predicted probability of presence of human TBE cases in mainland China was mapped at the county level. The spatial distribution of human TBE in China was largely driven by the distributions of forests and I. persulcatus ticks, altitude, and climate. Enhanced surveillance and intervention for human TBE in the high-risk regions, particularly on the forest areas in north-eastern China, is necessary to prevent human infections.
近年来,蜱传脑炎(TBE)对公共卫生构成的威胁日益增加,其范围涵盖欧洲、俄罗斯远东地区、日本及中国北方。然而,由于对其传播的忽视以及对动态变化的分析不足,中国大陆地区的整体疾病负担和疾病风险分布尚不明确。在本研究中,我们描述了2006年至2013年中国大陆地区报告的2117例人类TBE病例的流行病学特征。约99%的病例报告于中国东北地区的森林地区,93%的报告感染发生在5月至7月。病例以男性为主(67%),在所有年龄性别组中,主要集中在30至59岁。农民(31.6%)、家政服务人员(20.1%)和林业工人(17.9%)占患者的大多数,近年来农民和家政服务人员患者的比例呈上升趋势。TBE的流行病学特征在受影响地区略有不同。我们还总结了中国大陆三个主要流行地区该疾病的分布及特征。使用增强回归树(BRT)模型,我们发现TBE的存在与综合气象指数、海拔、阔叶林覆盖率、阔叶针叶混交林覆盖率以及全沟硬蜱(I. persulcatus)的分布显著相关。在县级层面绘制了中国大陆地区人类TBE病例存在的模型预测概率图。中国人类TBE的空间分布在很大程度上受森林、全沟硬蜱的分布、海拔和气候的驱动。为预防人类感染,有必要加强对高风险地区,特别是中国东北地区森林地区人类TBE的监测和干预。