[Spatio-temporal distribution of scrub typhus and related influencing factors in coastal beach area of Yancheng, China].

Objective In order to provide better programs on monitoring, early warning and prevention of Scrub Typhus in the coastal beach area, temporal-spatial distribution characteristics of scrub typhus were summarized. Relationships between temporal-spatial clustering of Scrub Typhus, meteorological factors, rodent distribution and the biological characteristics in coastal beach area of Yancheng city, were studied. Methods Reports on network-based Scrub Typhus epidemics and information on population, weather situation through monitoring those stations, from 2005 to 2014 were collected and processed, in the coastal beach area of Yancheng city. Distribution, density of the population concerned and seasonal fluctuation on rodents were monitored in coastal beach area, from April 2011 to December, 2013. Methods as descriptive statistics, space-time permutation scantistics, autocorrelation and Cross-correlation analysis etc, were used to analyze the temporal-spatial distribution of Scrub Typhus and correlation with rodent distribution, density fluctuation and meteorological indexes. Zero-inflated Pearson (ZIP) regression model was contributed according to the distribution of related data. All methods were calculated under Excel 2003, SPSS 16.0, Mapinfo 11.0, Satscan 9.0 and Stata/SE 10.0 softwares. Results (1) The incidence of Scrub Typhus was gradually increasing and the highest incidence of the year was seen in 2014, as 5.81/10 million. There was an autumn peak of Scrub typhus, with the highest incidence rate as 12.02/10 million in November. The incidence rate of Scrub typhus appeared high in Binhai, Dafeng and Xiangshui, with the average incidence rates appeared as 3.30/10 million, 3.21/10 million and 2.79/10 million, respectively. There were 12 towns with high incidence rates in the coastal beach area, with incidence rate showed between 4.41/10 and 10.03/10 million. (2) There were three incidence clusters of Scrub typhus seen in 25 towns, between October 2012 and November 2012 in Dongtai, Dafeng, Sheyang areas and 5 towns between October and November, 2014 in Xiangshui area, together with another 6 towns in November of 2006, in Binhai area. (3) Apodemus agrarius appeared the dominant species in the coastal area, with the constituent ratio as 89.19%. The rodent density appeared two peaks in winter and summer in 2011 and 2013. The winter peak was seen in January and the summer peak lasting for 5-8 months. Scrub Typhus was seen 10-11 months in a year and the incidence was increasing, parallel with the peak of the rodent density. The peak incidence of Scrub Typhus showed a temperature/rainfall-related peak. Rodent density, temperature, rainfalls were correlated with the incidence of Scrub Typhus, under the Cross correlation analysis. Rains, Mean minimum temperature of a 3-month lagging were directly correlated but the duration of sunshine and relative humidity were negatively correlated with the incidence of Scrub Typhus, under the Zero-inflated Pearson (ZIP) regression model. Conclusion Temporal-spatial clustering and factors as media creature and weather condition of Scrub Typhu were discovered, which provided evidence for effective measures on prevention and control of the disease. Key words: Scrub typhus; Temporal-spatial distribution; Seasonal fluctuation; Meteorologic factor; Coastal beach