Tick-Borne Infectious Diseases in China, 2003-2023

Tick-borne diseases (TBDs) pose a substantial threat to global public health, including China. This article systematically reviews the epidemiology of TBDs in Chinese mainland between 2003 and 2023. We retrieved and analyzed the incidence and distribution of notable bacterial, viral, and parasitic TBDs in China, and discussed their clinical characteristics, diagnostic approaches, and vectors. Severe fever with thrombocytopenia syndrome is the leading TBD in China, with cases rapidly increasing since its first report in 2009, and a high case fatality rate of 5%-33% in patients with severe disease. Other TBDs reported in China include spotted fever group rickettsiosis, human granulocytic anaplasmosis, Lyme borreliosis, babesiosis, and tick-borne encephalitis. Infections with emerging tick-borne pathogens, such as Yezo virus and Beiji nairovirus, have appeared very recently. Although evidence of human infection with Crimean-Congo hemorrhagic fever virus, Francisella tularensis, and Bartonella is currently unavailable, continuous monitoring of these pathogens remains necessary. This study enhances our understanding of TBDs, provides guidance for public health decision-making regarding important bacterial, viral, and parasitic TBDs, and offers new opportunities for TBD research in China.