Hemorrhagic fever with renal syndrome (HFRS) is a statutory infectious disease of Class B, which has been widely prevalent in China and is posing a serious threat to the public health. For many years, under the leadership of the government and joint efforts of multiple sections to fully implement comprehensive prevention and control measures, HFRS has been effectively controlled, and the overall incidence has entered a period of fluctuations at low-level. However, the affected areas have continued to expand, and new foci of virus transmission are still emerging and the number of cases has been significantly increasing in some areas in certain years. This brings a new challenge to the prevention and control of HFRS. Further consolidating the achievements of prevention and control, reducing the incidence and mortality of HFRS still remain one of the most pressing challenges to be addressed by the current public health system. In order to provide references for the prevention and control of HFRS in China under the new situation, we attempt in this article to conduct a systematical analysis of the pathogenic characteristics, current epidemic situation as well as the strategies and measures for the prevention and control of HFRS in China.

Objective To analyze the epidemiological characteristics and predict the incidence trend of hemorrhagic fever with renal syndrome (HFRS) in Jilin Province for evidence in prevention and control of thin acute infections in 2024. Methods The incidence data of HFRS in Jilin Province from 2018 to 2023 were collected from the China Disease Prevention and Control Information System, and the monitoring data on the host animals in Jilin Province were also obtained. Then all data were analyzed using descriptive epidemiological method. An autoregressive integrated moving average (ARIMA) model was established, by which the number of cases of HFRS in Jilin Province from 2018 to 2023 was fitted to predict the incidence of HFRS in the next year. Results A total of 1 993 cases of HFRS were reported Jilin Province from 2018 to 2023, during which the number of cases (578 cases) and the incidence (2.13/100 000) were the highest in 2018, and then presented with overall downward trend. The number of cases (158 cases) and the incidence (0.67/100 000) were the lowest in 2023. Annual reported cases peaked at April to June (635 cases, 31.86%) and October to December (724 cases, 36.33%). Of the reported cases, 1 511 were males, and 482 females, with a male to female ration of 3.13∶1. The incidences were reported in all age groups, with the population aged 30-64 years being dominant (1 464 cases, 73.46%), and the farmers were most affected by occupational distribution (1 242 cases, 62.32%). The cases were reported in all cities (prefectures), and the top three regions in terms of the cumulative number of reported cases were Tonghua (440 cases, 22.08%), Baicheng (357 cases, 17.91%) and Yanbian (335 cases, 16.81%). The top three monitoring sites with the highest cumulative rat density in residential areas in spring were Hunchun City (5.26%), Lishu County (4.36%) and Shuangyang District (3.81%), and the top three monitoring sites with the highest cumulative rat density in the wild were Hunchun City (5.55%), Panshi City (4.00%) and Shuangyang District (3.47%). The top three monitoring sites with the highest cumulative rat density in residential areas in autumn were Hunchun City (4.43%), Shuangyang District (4.09%) and Fusong County (3.84%). The top three monitoring sites with the highest cumulative rat density in the wild were Hunchun City (6.84%), Shuangyang District (4.21%) and Panshi City (4.00%). The captured rodents were mainly Rattus norvegicus and Apodemus agrarius. The results of time series analysis showed that ARIMA (0,0,1) (0,1,1)₁₂ could better fit and predict the number of HFRS in Jilin Province (MAE=6.56, MRE=-0.16%). The average monthly number of incidence predicted in 2024 would be 7 cases. Conclusion The incidence of HFRS in Jilin Province is generally on a downward trend, the dominant rat species responsible for the transmission vectors are Rattus norvegicus and Apodemus agrarius. The monthly 2024 incidence is expected to be lower than the 2023. In the future, relevant health sections should continue to focus on monitoring and early warning of this acute infections.

Objective To analyze the epidemiological patterns of hemorrhagic fever with renal syndrome (HFRS) in Gansu Province, and investigate the primary risk factors affecting the incidence of HFRS among residents for reference in formulating targeted strategies and measures for prevention and control of this infection. Methods The relevant information of HFRS cases reported in Gansu Province from 2017 to 2022 was collected through the China Disease Prevention and Control Information System, and descriptive analysis was conducted on the temporal, regional and demographic distribution of HFRS cases. Furthermore, a case-control study was carried out on HFRS cases reported in Min County, Dingxi City from 2020 to 2022 to analyze the primary risk factors affecting the incidence of this acute zoonotic condition. Results In total, 747 cases of HFRS were reported in Gansu Province from 2017 to 2022, with an average annual incidence of 0.50 per 100 000 population. The highest incidence occurred in 2019, reaching 1.28 per 100 000 population. The reported cases were 469 (62.78%) for males, and 278 (37.22%) for females, with an average annual reported incidence of 0.61/100 000 and 0.38/100 000 population, respectively for each gender. In different age groups, the number of reported cases was the largest in population aged 45-59 years (296 cases, 39.63%), followed by those aged 30-44 years (184 cases, 24.63%). Farmers were the most involved in HFRS (487 cases, 65.19%), followed by herdsmen (133 cases, 17.81%). The incidence of HFRS was mainly concentrated in October to December (569 cases, 76.17%), with the peak occurring in November (262 cases, 35.07%). The reported cases were mainly in Xiahe County, Min County and Lingtai County, with a cumulative number of reported cases being 571 (76.44%). The results of the case-control study showed that the potential risks for HFRS were associated with absence of vaccination against HFRS (OR=5.99), presence of rat cavity in the house (OR=3.99), no wearing a mask when digging and organizing herbs (OR=10.45), intake of food contaminated by rodents (OR=5.49), contact with rodents or rodent feces (OR=11.64), and drinking unboiled water (OR=6.97). Conclusion From 2017 to 2022, the incidence of HFRS in Gansu Province showed a trend of first increasing and then decreasing, with a concentrated period and area of high incidence. For the areas of high incidence, preventive vaccination, health education and improvement of the living environment should be carried out in due course to strengthen residents' awareness of protection and guide them to develop better dietary and hygienic habits, so as to reduce the risk of the infection.

Objective To understand the incidence of hemorrhagic fever with renal syndrome (HFRS) and the infection status of rodent hosts in Heilongjiang Province for scientific basis in the development and adjustment of related prevention and control measures for HFRS. Methods The data on HFRS cases in Heilongjiang Province from 2018 to 2023 were collected through the China Disease Control and Prevention Information System, and data on vaccination and rodent host surveillance were obtained from Heilongjiang Provincial Center for Disease Control and Prevention. Then all data were analyzed regarding the temporal, regional and demographic distribution of HFRS, vaccination status, the infection rate in rodent hosts and the virulence index of rats. Results In total, 5 233 HFRS cases and 34 deaths were reported in Heilongjiang Province from 2018 to 2023, with annual reported incidence of 1.60/100 000 to 3.50/100 000, which showed a decreasing trend in general (χ²_trend=18.97, P<0.01). The average annual reported incidence was 2.47/100 000, and the average annual reported mortality was 0.02/100 000. The number of vaccine doses increased year by year in 2019-2022, with a slight decrease in 2023. Of the reported cases, 4 031 were males, and 1 202 females. The incidence was 3.79/100 000 and 1.14/100 000, respectively. The highest number of reported cases (1 386 cases) and incidence (3.54/100 000) were seen in population aged 50-59 years by age group, and farmers have the highest proportion of occupations (3 170 cases, 60.58%). The reported cases demonstrated a seasonal "bimodal" distribution, with the main peak occurring from October to December (2 628 cases, 50.22%) and the sub-peak appearing in May (471 cases, 9.00%). The top five regions with the highest incidence were involved in Shuangyashan City (5.68/100 000), Heihe City (5.54/100 000), Jixi City (4.76/100 000), Hegang City (4.40/100 000) and Jiamusi City (4.34/100 000). FlexScan spatial clustering scanning showed that Shuangyashan City, Heihe City, Jixi City, Hegang City, Jiamusi City, Mudanjiang City, Qiqihar City and Yichun City were classified as type A clustering area. Host monitoring showed that the density of mice was 7.12%. The average annual virus carrying rate, infection rate and virus carrying index of mice were 7.11%, 7.16% and 7.05, respectively. Conclusion The incidence rate of HFRS in Heilongjiang Province demonstrated a downward trend from 2018 to 2023, yet the situation of prevention and control still remains serious. In the future, there is still a need to strengthen the health education and preventive vaccination in the high-risk population, as well as to scale up and improve the monitoring of rodent hosts, so as to raise the monitoring and early-warning capacity for HFRS.

Objective To investigate the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Anhui Province for reference basis for prevention and treatment of this disease. Methods The data of HFRS cases reported in Anhui Province from 2019 to 2023 were collected through the China Disease Prevention and Control Information System, and analyzed by descriptive epidemiological method for identifying the epidemiological characteristics. Circular distribution method was used to analyze the seasonal characteristics. Monitoring sites in Anhui Province were selected to monitor the rodent vectors, and night-trap method was used to identify the rodent density. Hantavirus antigens were detected by direct immunofluorescence test. Results From 2019 to 2023, a total of 808 HFRS cases and 6 deaths were reported in Anhui Province, with an annual average incidence of 0.262 4/100 000. The case fatality rate was 0.74%. HFRS was reported in 16 cities and municipal administrations in Anhui Province from 2019 through 2023. The top 3 cities in terms of the number of incidence cases were Xuancheng City (227 cases), Chuzhou City (69 cases) and Lu’an City (69 cases), and Fuyang City (59 cases). The ratio of male cases to female cases was 3.17∶1. The infection was most seen in patients aged 50-59 years (27.97%), and in farmers by occupation (73.89%). The time of onset of HFRS cases in 2019-2023 was characterized by a spring/summer peak in April-June (31.31%，253/808) and a fall/winter peak in November-January of the following year (42.08%, 340/808). Circular distribution method analysis showed that the peak days of incidence in fall and winter (main peak) and spring and summer (sub-peak) were December 8 and May 14, respectively, and the peak periods were November 1-January 15 and April 4-June 25, respectively. Between 2019 and 2023, a total of 93 543 rat traps were placed in the 7 monitoring sites, and 2 623 rodents were captured. The average density was 2.80%. A total of 2 147 rodent lung specimens were tested, in which the positive antigens were detected in 66 specimens. The average virus carrying was 3.07% (66/2 147) for the rats. Conclusion There is an overall decreasing trend in the incidence of HFRS in Anhui Province from 2019 to 2023, yet the potential for HERS outbreaks still exists, and the time of incidence is obviously in seasonal fashion. The findings suggest that all preventive and control measures should be decided and implemented as early as possible before the peak period to effectively control the epidemic of HFRS.

Objective To investigate the effects of praziquantel (PZQ) on and its mechanisms in the proliferation, migration and apoptosis of hepatocellular carcinoma cells. Methods Hep3B human hepatoma cell lines and Hepa1-6 mouse hepatoma cell lines were cultured in vitro. Hep3B and Hepa1-6 cell lines were selected and divided into normal control group, PZQ treatment group, 5-HT_2B inhibitor group (RS127455 treatment group) and 5-HT_2B inhibitor group + PZQ treatment group (RS127445 + PZQ treatment group). Real-time quantitative fluorescent PCR (qRT-PCR) was performed to detect the relative expression of 5-HT_2B mRNA in Hep3B human hepatoma cell lines and Hepa1-6 mouse hepatoma cell lines, and CCK-8 method was used to detect the proliferation of HCC cells. Cell scratch assay, flow cytometry and western blot were used, respectively to determine the migration ability and apoptosis rate of hepatocellular carcinoma cells as well as the expression of apoptosis-related proteins of Bax and Bcl-2. Results The relative expression levels of 5-HT_2B receptor mRNA from Hep3B and Hepal-6 cell lines in normal control group and PZQ treatment group were 1.02±0.09 and 1.01±0.20, 1.36±0.16 and 1.66±0.16, respectively. The relative mRNA expression levels of 5-HT_2B receptor from Hep3B and Hepal-6 cell lines were increased after PZQ treatment (t=3.22, 5.07, both P<0.05). After 48 h of cell culture, the proliferation rates of the two cell lines in PZQ treatment group were (74.00±4.58) % and (77.00±5.29) %, which were lower than those in normal control group (t=9.88, 7.47, both P<0.01). After 72 h of cell culture, the proliferation rates of the two cell lines in PZQ treatment group were (71.00±6.08) % and (67.33±7.57) %, which were lower than those in normal control group (t=7.87, 6.00, both P<0.05) and RS127445+PZQ treatment group (t=5.48, 3.48, both P<0.05). The cell mobility of PZQ treatment group at 48 h was (52.91±3.15) % and (17.28±1.78) %, which was lower than that of normal control group (t=7.86, 13.46, both P<0.01). The cell mobility of the two cell lines was lower in the PZQ treatment group [(58.79±3.25) % and (22.29±5.87) %] than in the normal control group (t=11.65, 9.57, both P<0.05) and RS127445+PZQ treatment group at 72 h (t=3.13, 6.97, both P<0.05). The apoptosis rate of the two cell stains in PZQ treatment group at 72 h was (16.13±0.66) % and (20.70±2.85) %, which were higher than that of normal control group (t=27.82, 5.65, both P<0.01) and RS127445+PZQ treatment group (t=9.54, 4.10, both P<0.01). The relative protein levels of Bax in PZQ treatment group were 1.70±0.18 and 2.23±0.14, respectively, which were higher than those of normal control group (t=2.83, 7.89, both P<0.05) and RS127445+PZQ treatment group (t=9.40, 5.25, both P<0.05). The relative protein expression levels of Bcl-2 were 0.52±0.17 and 0.53±0.02, respectively, which were lower than those of normal control group (t=3.57, 8.39, both P<0.05) and RS127445+PZQ treatment group (t=12.09, 6.12, both P<0.05). Conclusion PZQ can affect the proliferation, migration and apoptosis of hepatocellular carcinoma cells through 5-HT_2B receptor.

Objective To investigate the environmental contamination status of Echinococcus eggs in Longbaotan area of Qinghai Province for evidence to formulate targeted measures in controlling echinococcosis. Methods From March to April 2023, we collected different types of environmental samples, including canine feces, animal hair, water, soil, grass and food, from the dog households, main streets in the villages and wild areas. PCR technology was used to detect Echinococcus eggs in the samples from different sources, and the detection rate of eggs was compared. ArcGIS software combined with ASTER GDEM elevation data was used to make the elevation map of sample distribution. Results A total of 400 environmental samples were harvested. The total detection rate of Echinococcus eggs was 13.50% (54/400). Of the samples obtained, 138 were canine feces, 75 animal hair, 13 water, 114 soil, 37 grass and 23 food, in which the detection rate of Echinococcus eggs was 30.43% (42/138), 5.33% (4/75), 15.38% (2/13), 5.26% (6/114), 0 (0/37) and 0 (0/23), respectively. Among 138 aliquots of canine faeces, the animals hosts were failed to be identified in the 19 aliquots of wild canine feces by PCR. Of the other 119 samples, the detection rates of Echinococcus egg in the feces of dog, Tibetan fox and red fox were 11.29% (7/62), 48.84% (21/43) and 50.00% (7/14), respectively, with significant difference (χ²=20.481, P<0.05). The egg detection rates of Echinococcus granulosus, E. multilocularis and E. shiquicus were 2.17% (3/138), 18.12% (25/138) and 16.67% (23/138), respectively, with significant difference (χ²=19.858, P<0.05). In the 75 animal hair samples, the detection rates of Echinococcus egg in dog hair and cow hair were 6.06% (4/66) and 0 (0/9), respectively, with no significant difference (P>0.05). Of the 13 water samples, the detection rates of Echinococcus egg in wild river and streams, village well water and stagnant water were 20.00% (2/10), 0 (0/2) and 0 (0/1), respectively, with no significant difference (P>0.05). Among the 114 soil samples, the detection rates of Echinococcus egg in dog households, main streets and fields were 15.00% (3/20), 15.00% (3/20) and 0 (0/74), respectively, with significant difference (P<0.05). The eggs detected in animal hair, water and soil samples were from E. granulosus. In terms of distribution of the eggs, the feces of canines detected with eggs was highly concentrated in areas near field roads, and there was no obvious concentration trend in the samples of eggs detected in other environments. Conclusion The environmental contamination of Echinococcus eggs in Longbaotan area is serious and widely distributed. Our findings suggest that it is necessary to continue to take prevention and control measures such as deworming of dogs (especially unleashed dogs) and wild infectious sources (foxes) to reduce the pollution of eggs and the transmission risk of echinococcosis.

Objective To investigate the epidemiological characteristics of hand, foot and mouth disease (HFMD) in the population aged 6 and above in Changsha, Hunan Province, for scientific basis in prevention and control of this infection. Methods The basic information of reported cases of HFMD in Changsha from 2013 to 2022 was obtained through the China Information System for Disease Control and Prevention, and the etiological monitoring data of hand-foot-mouth disease in each county (city, district) were collected. Descriptive epidemiological methods were used to analyze the temporal, regional and population distribution and pathogenic composition of the cases. Results A total of 14 889 cases of HFMD were reported in the population aged 6 and above from 2013 to 2022, which accounted for 5.04% of the total number of HFMD cases. No severe or fatal cases were reported. The average annual reported incidence was 19.54 per 100 000. The proportion of cases in this group showed an increasing trend in the total number of cases (χ²_trend=1 658.760, P<0.01). The annual peak of the disease occurred in April to July. Of the reported cases, 8 526 were males, and 6 363 females, with a sex ratio of 1.34∶1. The median age was 7 (6, 10) years old. Maximum age was 91 years old, and the proportion of 6-15 years old was 88.09% (13 116/14 889). The occupation distribution was mainly involved in students, accounting for 55.97% (8 334/14 889). The average annual reported incidence within the urban areas (Yuhua District, Kaifu District, Yuelu District, Furong District and Tianxin District) was 24.70/100 000, which was higher than that in the suburbs (Changsha County, Liuyang City, Ningxiang City and Wangcheng District; 12.75/100 000). Etiological monitoring showed that the positive rate of enterovirus in pathogenic specimens was 50.49% (156/309). The composition of enterovirus A71 (EV-A71), coxasckievirus A16 (CV-A16) and other enteroviruses was 5.77% (9/156), 37.18% (58/156) and 57.05% (89/156), respectively. Conclusion From 2013 to 2022, the proportion of HFMD cases in the population aged 6 and above in Changsha area showed an increasing trend, mainly other enteroviruses. Our findings suggest that attention should be paid to the prevention of HFMD in population aged 6 and above, strengthen the prevention and control measures of hand-foot-mouth disease in primary and secondary schools, and do a good job in monitoring other enterovirus typing.

Objective To investigate the relationship between severe fever with thrombocytopenia syndrome (SFTS) and meteorological factors in Chaohu City for scientific basis for prevention and control of SFTS. Methods Daily cases of SFTS in Chaohu area from 2013 to 2022 were retrieved from the China Information System for Disease Control and Prevention, and meteorological data during the same period were obtained through the Resources and Environmental Science Data Platform. The reference values were set based on the median of weekly average temperature (17.4℃), weekly average pressure (1 012.8 hPa), weekly sunshine duration (33.4 h) and the minimum weekly precipitation (0 mm). Then the distributed lag non-linear model (DLNM) was used to analyze the relationship between weekly SFTS cases and meteorological factors. Results In total, 231 cases of SFTS were reported in Chaohu area from 2013 through 2022. The annual incidence ranged from 0.63 per 100 000 to 5.78 per 100 000 population, with an average annual incidence at 2.93 per 100 000, and the overall trend of the annual incidence was on the rise (Z=3.04, P<0.01). Of the reported cases, 113 were males and 118 females, with average annual incidence being 2.90 per 100 000 and 2.97 per 100 000, respectively. By age group, the reported cases and incidence were the highest in population aged ≥60 years (175 cases, 10.54 per 100 000). The response curve of weekly SFTS incidence risk to weekly average temperature, weekly average pressure and sunshine duration was almost in inverted V-shape, and the response curve to weekly precipitation approximately presented half U-shape. The cumulative relative risk (CRR) of SFTS was the highest when the weekly average temperature was 22.4 ℃ [CRR=9.210, 95%CI: (0.832, 118.353)], and the risk of SFTS was increased when the weekly average temperature was 17.5-21.8 ℃ (P<0.05). When the weekly average pressure was 1 015.5 hPa, the CRR of SFTS was the highest [CRR=1.877, 95%CI: (0.649, 5.435)]. The risk of SFTS was decreased when weekly average pressure was 998.7-1 012.7 hPa and 1 022.1-1 031.5 hPa (P<0.05). The highest CRR of SFTS [CRR=1.024, 95%CI: (0.882, 1.188)] was seen at the sunshine duration being 31.0 h, and the risk of SFTS was decreased upon the sunshine duration being >39.3 h (P<0.05). The higher the weekly precipitation, the higher the risk of SFTS (P<0.05). Conclusions There is a nonlinear relationship between the cases of SFTS and meteorological factors. Suitable temperature and abundant precipitation are conducive to the occurrence of SFTS, yet high pressure and sunshine duration are unfavorable to the occurrence of SFTS.

Objective To understand the infection status and morphological identification of Anisakis in the marketed marine fish captured from the Bohai Strait and the Bohai Bay for evidence to plan the prevention and control measures for this parasite. Methods In the spring and winter of 2023, we obtained the marine fish that was caught from the Bohai Strait and the Bohai Bay sold in the coastal markets, and detected Anisakis infection status in the fish samples. Then the detected species were subjected to morphological analysis and intergeneric identification, and the differences in Anisakis infection among fish species, and internal parasitic site were also analyzed. Results In this study, no Anisakis nematodes were detected in the 91 fish samples of 7 species from the Bohai Bay. A total of 210 marine fish samples of 21 species from the Bohai Strait were investigated, in which Anisakis was detected in 48 samples of 11 species. The positive detection rate was 22.86%. A total of 1 370 Anisakis were detected, with an average infection intensity of 28.54 nematodes in individual fish. The top three detection rate for the 48 marine fish was Lophiiformes (100%, 14/14), Trichiurus lepturus (100%, 10/10), and Platycephalus indicus (80.00%, 8/10), and the top three fish species in terms of infection intensity were associated with Lophiiformes (69.00 larvae/fish), Trichiurus lepturus (24.70 larvae/fish) and Ditrema temmincki Bleeker (19.00 larvae/fish). The main parasitic sites of the fish found during physical examination were the intestine, mesentery, abdominal cavity, etc., and no infection was found in the cloaca. The correlation analysis showed that the body weight of Lophiiformes and Trichiurus lepturus were positively correlated with the infection of Anisakis (r=0.77, 0.67, respectively, all P<0.01). In total, 1 226 intact third stage larvae of Anisakis were obtained, and morphologically identified as Anisakis spp.(767 larvae) and Hysterothylacium spp.(459 larvae). Conclusion In current survey, no Anisakis was detected in the marine fish in the Bohai Bay, yet Anisakis infection is relatively serious in fish in the Bohai Strait, and these pathogenic nematodes are mainly involved in Anisakis spp. and Hysterothylacium spp. Our findings suggest that it is necessary to strengthen the health education on anisakiasis in local population in order to reduce the risk of this disease.

Objective To analyze the epidemiology, clinical pictures, diagnosis and treatment of acute Q fever in order to provide reference for the diagnosis and treatment of this entity. Methods Retrospective study was conducted on the 6 cases of acute Q fever diagnosed by metagenomics next-generation sequencing (mNGS) in Nantong Third People’s Hospital between May 2022 and August 2023. The data were collected and analyzed including the epidemiological history, past medical history, clinical manifestations, findings of laboratory tests, mNGS and imaging, diagnosis and treatment process and treatment outcome. Results All the 6 patients were males, aged 45-59 years. Four patients had a history of wild-fishing by the river many times, one had a history of fishing out the bird’s nests, and another one was living with sheep around his settlement before the disease onset. The onset occurred at any time throughout the year. The clinical manifestations were high fever in all patients (6/6), with remittent-fever being dominant (5/6). Other clinical pictures included weakness (6/6), chills (5/6), muscle pain (5/6), and poor appetite (4/6). Laboratory studies indicated decreased white blood cell (WBC) count in peripheral blood in 2 and decreased platelet count in 3 patients. Elevated levels of alanine aminotransferase, aspartate aminotransferase and lactate dehydrogenase were seen in all the 6 patients, and increased creatine kinase was observed in 4. All patients had notably increased levels of C-reactive protein, procalcitonin, ferritin and D-dimer, and three had mildly escalated erythrocyte sedimentation rate. Pneumonia was free in the 6 patients by chest CT detection, and no endocarditis was seen in the 5 patients undergone echocardiography. Coxiella burnetii (Cb) was detected by mNGS in the 6 patients, who were confirmed as acute Q fever. All patients were recovered and discharged after medication with doxycycline (2 cases) or doxycycline combined with moxifloxacin (4 cases). Conclusion The clinical manifestations, imaging and laboratory test results of acute Q fever are unspecific, and the epidemiological history appears inconclusive in some patients. mNGS can contribute to quick and definitive diagnosis in the suspected patients, and doxycycline and moxifloxacin are effective in treatment of this infection.