Objective To investigate the clinical manifestations and source of infection of the first case of Japanese spotted fever (JSF) in Yuhang District, Hangzhou, Zhejiang Province, China, so as to provide evidence for the prevention and control of JSF. Methods A individual case investigation was conducted, and the case was tested for pathogenic microorganisms using metagenomic next-generation sequencing (mNGS). Meanwhile, case search, epidemiological investigation, and vector surveillance were carried out. The clinical manifestations, diagnosis, and treatment of the case were analyzed to determine the source of infection. Results The case presented with fever, headache, generalized punctate erythema, and secondary coagulation disorder, septic shock, multiple organ failure, and acute respiratory distress syndrome. Clinical examinations showed decreased peripheral platelet count (lowest level: 14×109/L), increased white blood cell count (highest level: 23.33×109/L), elevated hypersensitive C-reactive protein (highest level: 200.50 mg/L), and increased D-dimer (highest level: 24 840 μg/L FEU). Rickettsia japonica was detected in bronchoalveolar lavage fluid and blood using mNGS, and the patient recovered after anti-infection and symptomatic treatment. No additional cases were identified in the case search. The patient had a history of multiple outdoor activities and suspected tick bites within one week before the onset of the disease. The density index of free-living ticks in the areas where the patient was active was 7.40 inds per flagged 100 meters, with the species being Haemaphysalis longicornis. Conclusions This is the first case of JSF in Yuhang District of Hangzhou, with the possible source of infection being local ticks. Considering the high density of free-living ticks in the areas where the case was active, it is necessary to strengthen the prevention and control of JSF and carry out case surveillance, tick control and prevention, and health education.
LI Sen, MENG Xiang-jie, SHOU Jun, WANG Li-fei
. Epidemiology of Japanese spotted fever in Yuhang District, Hangzhou, Zhejiang Province, China： A severe case report[J]. Chinese Journal of Vector Biology and Control, 2025
, 36(1)
: 81
-85
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DOI: 10.11853/j.issn.1003.8280.2025.01.015
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