ArticleParasites & vectors2014
A city park as a potential epidemic site of scrub typhus: a case-control study of an outbreak in Guangzhou, China.
Article in Parasites & vectors, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.
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Who cites it
22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 32 citations in OpenAlex.
- Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: A systematic review and meta-analysis.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Pooled it
- Global seroprevalence of scrub typhus: a systematic review and meta-analysis.Scientific reports · 2024Pooled it
- Associations between meteorological factors and scrub typhus incidence: a systematic review and meta-analysis of linear and nonlinear dose-response relationships.Tropical medicine and health · 2025Article
- The Association Between Environmental Factors and Scrub Typhus: A Review.Tropical medicine and infectious disease · 2025Review
- Clinico-epidemiological and immunological characteristics of rickettsioses in a Sri Lankan patient cohort 2018-2023.BMC infectious diseases · 2025Article
- Spatiotemporal heterogeneity and long-term impact of meteorological, environmental, and socio-economic factors on scrub typhus in China from 2006 to 2018.BMC public health · 2024Article
- Epidemiologic changes of a longitudinal surveillance study spanning 51 years of scrub typhus in mainland China.Scientific reports · 2024Article
- Spatiotemporal epidemiology and risk factors of scrub typhus in Hainan Province, China, 2011-2020.One health (Amsterdam, Netherlands) · 2023Article
- Prevalence of and factors associated with scrub typhus exposure among the hill tribe population living in high incidence areas in Thailand: a cross-sectional study.BMC public health · 2023Article
- Epidemiological and clinical characteristics of scrub typhus in northern Fujian, China, from 2015 to 2019.BMC infectious diseases · 2023Article
- Epidemiological characteristics and spatiotemporal patterns of scrub typhus in Fujian province during 2012-2020.PLoS neglected tropical diseases · 2022Article
- The epidemiology, diagnosis and management of scrub typhus disease in China.Human vaccines & immunotherapeutics · 2021Article
- Ecological and behavioural risk factors of scrub typhus in central Vietnam: a case-control study.Infectious diseases of poverty · 2021Article
- A spatio-temporal analysis of scrub typhus and murine typhus in Laos; implications from changing landscapes and climate.PLoS neglected tropical diseases · 2021Article
- Epidemiological Characteristics of Rodents and Chiggers with Orientia Tsutsugamushi in the Republic of Korea.The Korean journal of parasitology · 2020Article
- The scrub typhus in mainland China: spatiotemporal expansion and risk prediction underpinned by complex factors.Emerging microbes & infections · 2019Article
- Outer Membrane Protein A Conservation amongTropical medicine and infectious disease · 2018Article
- A Review of Scrub Typhus (Orientia tsutsugamushi and Related Organisms): Then, Now, and Tomorrow.Tropical medicine and infectious disease · 2018Review
- A review of the global epidemiology of scrub typhus.PLoS neglected tropical diseases · 2017Review
- Rapid increase of scrub typhus incidence in Guangzhou, southern China, 2006-2014.BMC infectious diseases · 2017Article
Corrections and comments
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Authors and funding
9 authors at 2 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundScrub typhus is an important public health problem in China, especially in Guangzhou city. Typical outbreaks of scrub typhus have been previously reported in rural areas, affecting mainly farmers. We describe an atypical outbreak of the disease with case fatalities, from a park in Haizhu District, Guangzhou, that could turn out to be a potential scrub typhus epidemic site.
methodsFrom May 2012 to June 2012, a case-control study was conducted to identify source and risk factors of this outbreak. Reported cases of scrub typhus in Xiaogang Park were confirmed by Weil-Felix test or a nested polymerase chain reaction (NPCR). Controls were matched with their neighbors by gender and age. Multivariate conditional logistic regression was used to identify risk factors and protective factors.
resultsA total of 29 cases were confirmed by Weil-Felix test, including 4 deaths by both Weil-Felix test and NPCR. All patients presented with fever (100%), while 28 (96.6%) cases had eschars, 10 (34.5%) headache, 10 (34.5%) chills, 6 (20.7%) lymphadenopathy, 5 (17.2%) rash, 2 (6.9%) vomiting and 1 (3.5%) presented with conjunctival congestion. The proportion of cases with activity history in Xiaogang Park was much higher than the control group (72.4% vs 24.1%, P < 0.001), and morning exercise in park or field was also as a risk factor for scrub typhus (adjusted OR = 3.0, 95% CI: 1.1-8.2). Four factors were significantly associated with the risk of developing scrub typhus: sitting on the lawn (adjusted OR = 8.0, 95% CI: 1.4-44.5), close contact with rats (adjusted OR = 3.3, 95% CI: 1.2-9.6), sitting near the rat holes (OR = 6.8, 95% CI: 1.2-38.1) and wearing long-sleeved clothing when outside (adjusted OR = 0.3, 95% CI: 0.1-0.7).
conclusionsWe confirmed an atypical outbreak of scrub typhus in a park in Guangzhou city, which has the potential to develop into an important epidemic site. This public health risk should not be neglected and requires more attention from authorities.
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