Epidemiological characteristics of severe fever with thrombocytopenia syndrome and the relationship with meteorological factors in Jiangsu Province, China

Yuhao Tao¹Wendong Liu²Yin Wang³Shuyi Liang²Xiaochen Wang²Zhifeng Li²Wenxin Gu¹Xin Liu⁴Xinru Zeng¹Chang-jun Bao^1,2*

• ¹Nanjing Medical University, Nanjing, China
• ²Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China
• ³Yangzhou Center for Disease Control and Prevention, Yangzhou, China
• ⁴Nanjing University Medical School, Nanjing, China

Background: Severe Fever with Thrombocytopenia Syndrome (SFTS) has become a global public health concern in recent years. The main purpose of this study was to depict the epidemiological characteristics of SFTS in Jiangsu Province, China and evaluate the effects of meteorological factors on its dynamics.Methods: Joinpoint regression and spatial methods were used to explore the epidemiological trends of SFTS. Distributed Lag Non-linear Models (DLNM) were employed to evaluate the regional specific effects of meteorological factors on SFTS epidemics.Results: Between 2014 and 2023, a total of 914 SFTS cases were reported in Jiangsu Province, with an average annual incidence of 0.11 per 100,000 population and an overall case fatality rate of 7.44%. Cases aged 50-79 years accounted for 83.48% (763/914) of the total cases. Most affected individuals were farmers (69.14%, 632/914). Joinpoint regression analysis revealed an increasing trend in the incidence rate of SFTS, with an Annual Percent Change of 26.68% (P < 0.001). The incidence presented marked seasonality, with the peak occurring between May and July. Nanjing and Huai'an were the major endemic regions, together accounting for 79.32% of the total cases in the province. DLNM results showed an inverted "V"-shaped relationship between weekly average temperature and the risk of SFTS incidence in Nanjing and Huai'an, with temperature inflection points of 22.4°C and 19.2°C, respectively. In both cities, lower temperatures (Nanjing: 3.35, 8.77°C; Huai'an: 1.73, 7.15°C) were associated with a reduced risk of SFTS incidence, whereas higher temperatures (Nanjing: 24.32, 28.05°C; Huai'an: 23.89, 27.15°C) were associated with an increased risk. However, excessively high temperatures can also lead to a decrease in the incidence of SFTS. Targeted strategies and measures should be taken to prevent its spread.In conclusion, over the study period, SFTS incidence and geographic spread in Jiangsu Province showed an increasing trend. Temperature exerted a nonlinear impact on the incidence of SFTS, characterized by notable lag effects.