Analysis of differences in characteristics of high-risk endemic areas for contracting Japanese spotted fever, Tsutsugamushi disease, and severe fever with thrombocytopenia syndrome

Ogawa, Takahisa; Tsuzuki, Shinya; Ohbe, Hiroyuki; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo; Kutsuna, Satoshi

doi:10.1093/OFID/OFAE025

Title

Analysis of differences in characteristics of high-risk endemic areas for contracting Japanese spotted fever, Tsutsugamushi disease, and severe fever with thrombocytopenia syndrome

Author

Ogawa, Takahisa

Tsuzuki, Shinya

Ohbe, Hiroyuki

Matsui, Hiroki

Fushimi, Kiyohide

Yasunaga, Hideo

Kutsuna, Satoshi

Abstract

Background Tick-borne infections, including tsutsugamushi disease, Japanese spotted fever, and severe fever with thrombocytopenia syndrome (SFTS), are prevalent in East Asia with varying geographic distribution and seasonality. This study aimed to investigate the differences in the characteristics among endemic areas for contracting each infection.Methods We conducted an ecologic study in Japan, using data from a nationwide inpatient database and publicly available geospatial data. We identified 4493 patients who were hospitalized for tick-borne infections between July 2010 and March 2021. Mixed-effects modified Poisson regression analysis was used to identify factors associated with a higher risk of contracting each tick-borne disease (Tsutsugamushi, Japanese spotted fever, and SFTS).Results Mixed-effects modified Poisson regression analysis revealed that environmental factors, such as temperature, sunlight duration, elevation, precipitation, and vegetation, were associated with the risk of contracting these diseases. Tsutsugamushi disease was positively associated with higher temperatures, farms, and forests, whereas Japanese spotted fever and SFTS were positively associated with higher solar radiation and forests.Conclusions Our findings from this ecologic study indicate that different environmental factors play a significant role in the risk of transmission of tick-borne infections. Understanding the differences can aid in identifying high-risk areas and developing public health strategies for infection prevention. Further research is needed to address causal relationships. This nationwide study of 4493 patients hospitalized for tick-borne infections explored environmental factors associated with the diseases. Tsutsugamushi disease was positively associated with higher temperatures, farms, and forests, whereas Japanese spotted fever and severe fever with thrombocytopenia syndrome were positively associated with higher solar radiation and forests.

Language

English

Source (journal)

Open Forum Infectious Diseases

Publication

2024

ISSN

2328-8957

DOI

10.1093/OFID/OFAE025

Volume/pages

11 :2 (2024) , p. 1-6