From 2005 to 2024, China reported a total of 1,129,736 cases of VBDs (annual incidence rate of 4.13 per 100,000), with 6,096 deaths (Table 1). Scrub typhus accounted for the highest number of cases (318,258), followed by malaria (235,033), HFRS (207,850), and dengue (142,422). Tick-borne diseases exhibited the highest cumulative fatality rate (4.33%) during this period. Among individual diseases, plague had the highest case fatality rate (38.33%), followed by Japanese encephalitis (4.9%) and SFTS (4.79%). The mean age of all VBD cases was 43.85 years (SD: 20.04), with tick-borne disease cases having the highest mean age of 61.51 years (SD: 13.66). Males comprised a higher proportion of cases in all disease categories except tick-borne diseases. Across all VBD types, farmers represented a significantly higher proportion of cases compared to individuals in other occupations (Table 2, all P<0.05).
| Disease | Cases (No.) | Cumulative incidence (per 100,000) | Death (No.) | Fatality rate (%) |
| VBD | 1,129,736 | 82.60 | 6,096 | 0.54 |
| Mosquito-borne disease | 416,813 | 30.47 | 2,292 | 0.55 |
| Dengue | 142,422 | 10.41 | 14 | 0.01 |
| Malaria | 235,033 | 17.18 | 350 | 0.15 |
| Japanese encephalitis | 39,303 | 2.87 | 1,927 | 4.90 |
| Zika virus disease | 39 | − | 0 | 0.00 |
| Filariasis | 16 | − | 1 | 6.25 |
| Tick-borne disease | 38,241 | 2.80 | 1,656 | 4.33 |
| SFTS | 34,063 | 2.49 | 1,631 | 4.79 |
| Tick-borne encephalitis | 4,178 | 0.31 | 25 | 0.60 |
| Rodent-borne diseases | 217,579 | 15.91 | 2,001 | 0.92 |
| HFRS | 207,850 | 15.20 | 1,806 | 0.87 |
| Leptospirosis | 9,669 | 0.71 | 172 | 1.78 |
| Plague | 60 | − | 23 | 38.33 |
| Others | 457,103 | 33.42 | 147 | 0.03 |
| Scrub typhus | 318,258 | 23.27 | 108 | 0.03 |
| Schistosomias | 95,093 | 6.95 | 14 | 0.01 |
| Typhus group rickettsiosis | 37,673 | 2.75 | 6 | 0.02 |
| Leishmaniasis | 6,079 | 0.44 | 19 | 0.31 |
| Abbreviation: VBD=vector-borne disease; No.=number; HFRS=hemorrhagic fever with renal syndrome; SFTS=severe fever with thrombocytopenia syndrome. | ||||
Table 1.
The incidence and fatality of VBDs in China from 2005 to 2024.
| Characteristics | Mosquito-borne disease | Tick-borne disease | Rodent-borne diseases | Others | P |
| Age [mean (SD)] | 36.24 (20.02) | 61.51 (13.66) | 45.31 (15.80) | 48.61 (19.75) | <0.001 |
| Gender (%) | |||||
| Female | 152,948 (36.69) | 19,385 (50.69) | 56,169 (25.82) | 224,737 (49.17) | <0.001 |
| Male | 263,865 (63.31) | 18,856 (49.31) | 161,410 (74.18) | 232,366 (50.83) | |
| Occupation (%) | |||||
| Children | 33,522 (8.04) | 71 (0.19) | 884 (0.41) | 26,912 (5.89) | <0.001 |
| Service industry | 25,318 (6.07) | 187 (0.49) | 4,689 (2.16) | 4,240 (0.93) | |
| Farmer | 165,919 (39.81) | 29,944 (78.30) | 147,420 (67.75) | 339,774 (74.33) | |
| Unemployed | 33,686 (8.08) | 4,039 (10.56) | 16,332 (7.51) | 21,626 (4.73) | |
| Pupil | 51,199 (12.28) | 157 (0.41) | 9,734 (4.47) | 22,496 (4.92) | |
| Staff of public institutions | 12,364 (2.97) | 323 (0.84) | 5,845 (2.69) | 6,474 (1.42) | |
| Others | 94,805 (22.75) | 3,520 (9.20) | 32,675 (15.02) | 35,581 (7.78) | |
| Abbreviation: VBD=vector-borne disease; SD=standard deviation. | |||||
Table 2.
The Characteristics of cases with VBDs in China from 2005 to 2024.
Mosquito-borne diseases, primarily malaria (56.39%) and dengue (34.17%), are predominantly distributed in the southern regions of China (Figure 1). Tick-borne diseases, mainly SFTS (89.07%), are concentrated in Central and Eastern China. Rodent-borne diseases, predominantly HFRS (95.53%), are primarily found in Northeast China and along the middle and lower reaches of the Yangtze and Yellow Rivers. Other vector-borne diseases, chiefly scrub typhus (69.63%), are mainly distributed across Southwest and South China regions. Notably, dengue, scrub typhus, and SFTS have demonstrated annual increases in geographic spread, with reported cases expanding to 10.89, 12.37, and 7.07 more cities each year, respectively (
Spatial distribution of VBDs in China from 2005 to 2024. (A) VBDs; (B) Mosquito-borne diseases; (C) Tick-borne diseases; (D) Rodent-borne disease; (E) Other diseases.
Abbreviation: VBD=vector-borne disease; No.=number.
Map approval number: GS京(2025)0996号.
From 2005 to 2024, the incidence of VBDs in China has exhibited a fluctuating pattern with three distinct peaks occurring in 2006, 2014, and 2024 (P=0.721, Figures 2A and 2C). Mosquito-borne and rodent-borne diseases showed significant declining trends, while tick-borne diseases and other VBDs demonstrated significant increasing trends (all P<0.05). The first two peaks were primarily attributed to outbreaks of malaria and dengue, while the 2024 peak resulted mainly from increased scrub typhus and dengue cases. From 2004 to 2014, malaria and HFRS cases constituted a higher proportion of VBDs in China, whereas from 2014 to 2024, dengue, SFTS, and scrub typhus became more prevalent. Mann-Kendall trend analysis revealed that rodent-borne diseases (HFRS, leptospirosis), malaria, Japanese encephalitis, schistosomiasis, and typhus group rickettsiosis have shown significant declining trends, while SFTS, dengue, and scrub typhus have demonstrated significant increasing trends (all P<0.05). Additionally, VBDs exhibit distinct seasonal distribution patterns (Figure 2B and 2D). HFRS displays bimodal annual incidence peaks, dengue cases peak from June to October, and SFTS cases peak from May to August. Scrub typhus shows a higher proportion of cases from June to November.
The trends in incidence and seasonal characteristics of VBDs in Mainland China from 2005 to 2024. (A) Annual case distribution (%) of vector-borne diseases by disease; (B) Monthly case distribution (%) of vector-borne diseases by disease; (C) Annual reported cases of VBDs by vector category; (D) Monthly reported cases of vector-borne diseases by vector category.
Abbreviation: VBD=vector-borne disease; No.=number; HFRS=hemorrhagic fever with renal syndrome; SFTS=severe fever with thrombocytopenia syndrome.