The underlying numerical data for Fig 3.

BackgroundScrub typhus, an overlooked vector-borne disease in mainland China, has shown shifting epidemiological patterns in recent decades, yet comprehensive assessments of its spatiotemporal trends and disease burden—including premature mortality quantified by years of potential life lost (YPLL)—remain limited. This study aimed to characterize the epidemiological trends, spatiotemporal patterns, and disease burden of scrub typhus in mainland China, with a focus on estimating YPLL.MethodsNationwide scrub typhus case data were extracted from the China Information System for Disease Control and Prevention (CISDCP). Time-series analysis, spatial autocorrelation analysis, and spatiotemporal clustering analysis (SaTScan) were performed, and years of potential life lost (YPLL) were calculated to explore the epidemiological characteristics and spatiotemporal patterns of the scrub typhus in China. Negative binomial regression analysis was used to explore the association between scrub typhus and environmental variables.ResultsThere were 283273 cases and 103 deaths reported. 2006–2023, the average yearly incidence was 1.14 cases per 100,000 people. From 0.10 per 100,000 population in 2006 to 2.37 per 100,000 population in 2023, the annual incidence rose dramatically. In 2023, there were 1,150 impacted counties, up from 226 in 2006. Yunnan (84795), Guangdong (70 013), Guangxi (30147), Anhui (20492) and Jiangsu (16760) were the top five provinces in terms of reported cases, accounting for 78.44% of all scrub typhus cases. The disease, which was endemic in southern China from 2006 to 2009, has spread to every province, particularly in northernmost and western of China. October has the highest seasonal index (2.53), followed by July and August. The majority of affected groups were women (52.90%), farmers (76.11%), and those between the ages of 40 and 59 (39.98%). The percentage of cases involving those 60 and older rose from 22.83% in 2006 to 37.90% in 2023. Spatial autocorrelation analyses showed a significant positive spatial correlation for scrub typhus incidence in all years except 2006–2011, showing a clustering distribution. The LISA cluster maps showed “high-high” clusters expanding in southern China, and “low-low” clusters were growing in northern areas. The results of negative binomial regression model revealed significant positive effects of temperature with a 1-month lag (IRR = 1.17, p ConclusionsBased on results, we recommend prioritizing surveillance and resource allocation to high-risk areas including Guangdong, Yunnan, Guangxi, and Fujian provinces, as well as emerging northern regions (e.g., Anhui, Shandong) exhibiting rapid geographic expansion. Health interventions should target farmers (particularly females) and adults aged ≥60 years in rural areas. Meanwhile, efforts should accelerate vaccine development for high-risk occupational groups. Vector control and prevention campaigns should be intensified during critical pre-peak windows: the outbreak peaked in October.背景 恙虫病（scrub typhus）是中国大陆地区一种被忽视的虫媒传染病，近数十年来其流行病学特征呈现动态变化，但目前针对其时空流行趋势与疾病负担——包括以潜在减寿年数（years of potential life lost, YPLL）量化的过早死亡负担——的全面评估仍较为有限。本研究旨在刻画中国大陆地区恙虫病的流行病学趋势、时空流行模式与疾病负担，重点估算潜在减寿年数。 方法 本研究从中国疾病预防控制信息系统（China Information System for Disease Control and Prevention, CISDCP）提取全国范围内的恙虫病病例数据。采用时间序列分析、空间自相关分析及时空聚类分析（SaTScan）方法，并计算潜在减寿年数（YPLL），以探究中国大陆地区恙虫病的流行病学特征与时空流行模式。采用负二项回归分析探讨恙虫病发病与环境变量之间的关联。 结果 本研究共报告恙虫病病例283273例，死亡103例。2006-2023年期间，年均发病率为1.14例/10万人。发病率从2006年的0.10例/10万人大幅攀升至2023年的2.37例/10万人。受疫情影响的县（市、区）数量从2006年的226个增至2023年的1150个。报告病例数排名前五的省份依次为云南省（84795例）、广东省（70013例）、广西壮族自治区（30147例）、安徽省（20492例）及江苏省（16760例），上述省份的病例数合计占全国总病例数的78.44%。2006-2009年，该病仅在我国南方地区呈地方性流行，此后已扩散至全国所有省份，尤其在我国北部与西部地区传播显著。季节指数峰值出现在10月（2.53），其次为7月与8月。感染者以女性（52.90%）、农民（76.11%）及40-59岁人群（39.98%）为主。60岁及以上病例占比从2006年的22.83%升至2023年的37.90%。空间自相关分析结果显示，除2006-2011年外，其余年份的恙虫病发病率均存在显著的正向空间相关性，呈现聚集性分布特征。LISA聚类地图显示，我国南方地区的“高-高”聚集区持续扩张，而北方地区的“低-低”聚集区范围逐步扩大。负二项回归模型结果表明，滞后1个月的气温对恙虫病发病存在显著正向影响（IRR=1.17，p 结论 基于本研究结果，建议优先针对广东、云南、广西及福建等高发地区，以及近期出现快速地理扩散的北方区域（如安徽、山东）强化监测工作与资源配置。健康干预措施应聚焦于农村地区的农民（尤其是女性农民）及60岁及以上成年人。同时，应加快针对高风险职业人群的疫苗研发进程。在疫情峰值前的关键窗口期（本次研究中疫情峰值出现在10月）需强化虫媒控制与预防宣传活动。