Patterns in the Incidence of Scarlet Fever Among Children Aged 0–9 Years — China, 2010–2019

INTRODUCTION: This study investigates the patterns of scarlet fever among Chinese children aged 0–9 years from 2010 to 2019. The objective is to provide insights that may inform potential adjustments to China’s current prevention and control tactics for this illness. METHODS: The present study utilized data on the occurrence of scarlet fever in children from 2010 to 2019, sourced from the National Notifiable Disease Reporting System database, managed by the Chinese Center for Disease Control and Prevention. This research implemented SAS9.4 software to construct trajectory models representing the temporal incidence of scarlet fever, accounting for key variables such as sex, geographic region, urban versus rural dwellings, and various age brackets. RESULTS: From 2010 to 2019, a total of 554,695 scarlet fever cases were reported among children aged 0–9 years in the 31 mainland Chinese provincial-level administrative divisions, signifying a rate of 35.36 per 100,000 individuals. An inconsistent yet generally rising trend was observed, evidenced by a 3.17-fold increase in reported cases and a 3.02-fold escalation in incidence rate over this period. Examination of these trends revealed three distinctive developmental patterns for both males and females, with the lowest prevalence in the first trajectory and the highest in the third. The incidence was consistently higher among males than females in all trajectories. The urban and northern regions displayed equal or greater trajectory rates than their rural and southern counterparts, respectively. In terms of age groups, the lowest incidence was observed in the 0–1-year age group, while the highest was recorded in the 4–5 and 6–7-year age groups. CONCLUSIONS: Between 2010 and 2019, there was a marked increase in the incidence of scarlet fever among children in China. The disease predominantly impacts urban-dwelling children, ranging from 4 to 7 years old, in the northern regions of the country. The incidence is reported to be higher among boys compared to girls.