Objective To understand the epidemiological characteristics of epidemic hemorrhagic fever (EHF) in China from 2010 to 2024, establish a predictive model for incidence trends, and provide evidence for the improvement of disease prevention and control strategies.

Methods Descriptive epidemiological methods were used to analyze the three-dimensional distributions of EHF. Time series analysis on monthly surveillance data was performed by using software R 4.4.0, and the results were visualized. Global and local spatial autocorrelation analyses were conducted by using software Arcgis 10.8. The spatiotemporal clustering of EHF was detected by using software SatScan 10.0.

Results A total of 142 974 EHF cases were reported in China from 2010 to 2024, showing decreasing trends in both morbidity and mortality. The cases were distributed in all the provinces. Shaanxi, Heilongjiang, Shandong, and Liaoning were the provinces with high-incidence, with the reported cases accounting for 50.91% of the total. The annual distribution of the cases showed two peaks, one was during spring-summer (23.84%) and another one was during autumn-winter (42.51%). The cases were mainly distributed in age group 40-<60 years, the male to female ratio of the cases was 2.79∶1, and most cases were farmers (67.71%). Spatiotemporal analysis revealed clustering of EHF cases across the country, and 7 high-risk clusters were detected through spatiotemporal scanning. Predictions from the time series model indicated that the incidence of EHF would continue to decline in the future.

Conclusion In recent years, the overall incidence of EHF showed a downward trend in China, however, the incidence remained high in some areas. It is suggested to to strengthen the surveillance and health education in populations at high risk and in areas with high incidence.