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Objective To establish the risk index of early-warning on the human infections with avian influenza A (H7N9) virus. Methods The risk index (X) was calculated by using Principal Component Analysis based on the surveillance results (including the positive rates of environmental specimens and premises) during the period from April 2013 to March 2017 in Zhejiang Province. Then, the method of Classification and Regression Trees was used to establish the early-warning model for forewarning the epidemic situation of H7N9 human infections. Results The weights of two rates (the positive rates of specimens and premises) used to establish the risk index were 0.0545 and 0.0230 respectively. In the model of Classification and Regression Trees, risk index was divided into 4 grades: X ≤0.140, 0.140<X ≤0.757, 0.757<X ≤3.285 and X>3.285. Compared to the 1st grade, the risk ratios of the 2nd, 3rd and 4th grades were 7.4, 21.7 and 29.9 respectively. The accuracy, sensitivity and specificity of prediction were 86.1％ , 80.8％ and 87.3％ respectively, and the Kappa value was 0.592 . Conclusion The established risk index can be used to forewarn the H7N9 human infections, which is helpful for emergency preparedness and disease control.
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Objective To analyze the characteristics of school public health emergencies in Zhejiang Province, and to provide current suggestions for prevention and control. Methods A descriptive epidemiological analysis was conducted for the public health emergencies occurred in schools from 2014 to 2016 in Zhejiang Province. The data was derived from Emergency Public Reporting System. Results A total of 100 public health emergencies occurred in schools and 3 784 cases were reported during 2014-2016 in Zhejiang Province, meanwhile no death occurred. There were two peak seasons every year for the emergency report. Forty percent of the emergencies were reported during November to January of the following year, and 31.00 % were during April to May. The emergencies occurred on all the municipal districts when Ningbo accounted for 50.00%. The schools and kindergartens in rural area, town and urban area reported 37, 28 and 35 emergencies respectively. The main etiology of emergencies included varicella(37.00%), hand-foot-mouth disease(29.00%), norovirus(22.00%). The median duration of varicella outbreaks was 31.67d, which was longer than others. The scale of influenza and norovirus outbreaks were larger, and the median cases were 76 and 49 respectively. The time of emergencies detecting was significantly different between different detecting patterns. Conclusion The prevention and control of school emergencies was still urgently. There were still some deficiencies in the identification and active reporting of the epidemic, which need to be solved, while taking advantage of the surveillance system for sick absence. The future strategies should focused on reinforcing immunization and improving health habits to promote school health.
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Objective To explore the association between different visual display terminal use and physical symptoms among adults.Methods Hangzhou,Jiaxing,Huzhou,Jinhua and Quzhou City were selected,where residents aged 18 years old and above were investigated using Mitofsky-Waksberg two-stage sampling.Information of demography,different visual display terminal use,eye and musculoskeletal symptoms,eye disease and eye relax were collected.Backward stepwise logistic regression was used to explore the association between different visual display terminal use and the symptoms (P value for addition ＜ 0.05,P value for removal ＞ 0.1).Results Totally 350 adults responded to the investigation,with a response rate of 48.54％.Finally,333 respondents were included in the analysis,among which 120 reported eye symptoms (36.04％) and 71reported musculoskeletal symptoms (21.32％).More time of computer use at work(0.5-4 h:OR=2.006,95％ CI:1.021-3.943;4-6 h:OR=3.578,95％ CI:1.751-7.315;＞6 h:OR=4.874,95％ CI:1.897-12.521) and eye disease (OR =4.361,95％ CI:2.465-7.714) were significandy associated with higher odds ratios in eye symptoms.Similar pattern was seen for the association on time of computer use at work with musculoskeletal symptoms (0.5-4 h:OR =3.815,95 ％ CI:1.809-8.045;4-6 h:OR =4.974,95 ％ CI:2.281-10.845;＞ 6 h:OR =5.934,95％ CI:2.347-15.005).More time of watching TV on television (＞ 2 h:OR =2.051,95％CI:1.068-3.939) and women (OR =1.884,95％ CI:1.052-3.372) were also observed to be statistically associated with musculoskeletal symptoms.However,no statistical association was observed between the two symptoms and entertainment purpose use of computer/cell phone/pad/kindle (P ＞ 0.05).Conclusion Computer use at work was significantly associated with eye symptoms,especially for those having eye diseases.It was also statistically associated with musculoskeletal symptoms,especially for women.
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Objective To evaluate epidemiological capacity of infectious disease in institutions of disease control and prevention,and to improve the ability of infectious disease control and prevention. Methods Questionnaires of epidemiological capacity of infectious disease evaluation in institutions of disease control and prevention which contained surveillance analysis,emergency response,plan system and so on were used to evaluate epidemiological capacity of infectious disease in all of city,district or county level of center for disease control and prevention in Ningbo,Shaoxing, Quzhou.The degree of attainment for the ability or (and)resources was divided into vary bad,bad,average,and good. Descriptive epidemiological methods were used to perform analysis and evaluation.Results The capability for monitoring notifiable infectious diseases reaching to good was 1 9 (76.00%),greater than that in non -statutory communicable diseases 2 (8.00%). Twenty four (96.00%) institutions reported that the most important factor limiting the epidemiological capacity of infectious disease was lack of human resources,and 20 (80.00%)of institutions supported infectious disease epidemiology staff to publish articles in academic journals,but scientific research ability reaching to good was 3(1 2.00%).Training subordinate institution capacity reaching to good was 1 0(40.00%),with 2 (8.00%)reporting very bad.Most abilities were not significant across different regions,only significant in non -statutory communicable diseases surveillance (χ2 =7.04,P =0.03).Conclusion Institutions of disease control and prevention had a certain epidemiological capacity of infectious disease,and almost balance in different regions.For further enhancing the ability,it is necessary to increase the number of personnel,and to improve the ability of education and training.
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Objective To explore regional variations of basic public health services implementation in Zhejiang Province at prefectural,county and township level,respectively.To find key problems which obstacle the equalization of basic public health services in Zhejiang Province.Methods Descriptive analysis was made on surveillance data of basic public health services in Zhejiang Province,2014.Gini coefficient of key indicators was calculated at prefectural,county and township level,respectively.To the key indicator with higher Gini coefficient,Lorenz curve was plotted and Gini coefficient of each prefectural-level city was calculated.Results An increasing tendency from prefectural to township level was showed in Gini coefficient of all twenty-five analyzed indicators.The Gini coefficient at township level was 0.497 for the average financial fund per migrant person,and the highest prefectural -level cities were Taizhou (0.709 ),Lishui (0.838 ), Quzhou(0.918).The Gini coefficient at township level of other indicators were 0.314 and 0.235 for the children and elderly health management of traditional Chinese medicine,and lower than 0.05 for maternal &children health care, immunization,and coverage rate of electronic health record,and between 0.066 to 0.179 for health management of chronic disease and severe mental illness patients.Conclusion Average financial fund per migrant person and health management of traditional Chinese medicine are current major problems which obstacle the equalization of basic public health services in Zhejiang Province.
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Objective To explore the correlations between the scarlet fever and meteorological factors in Zhejiang Province. Methods The data which was been analyzed including month case of scarlet fever and meteorological factors from JAN 2005 to DEC 201 4,were analyzed for the degree and characteristic of the correlations between the scarlet fever and meteorological factors with generalized additive model(GAM).Results There were negative correlation between scarlet fever and meteorological factors including water vapor pressure and hours of sunshine.There were complex nonlinear correlations between scarlet fever and meteorological factors including precipitation,average barometric pressure,average wind speed and average temperature .The relationship between scarlet fever and meteorological factors including average barometric pressure,average wind speed and average temperature showed approximate quadratic function.The precipitation above 3 500(0.1 mm),average barometric pressure above 1 0 200(0.1 hPa)and under 1 0 050(0.1 hPa),average wind speed between 1 8.7 -23.6 (0.1 m/s)and average temperature between 1 00 -250 (0.1 ℃) were the suitable meteorological condition for scarlet fever.Conclusion There were complex nonlinear correlations between the scarlet fever and meteorological factors.Precipitation,average barometric pressure,average wind speed and average temperature may be associated with the incidence of scarlet fever.
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Objective To learn the present situation and influencing factors of job satisfaction and turnover intention among staff in primary health institutions in Jingning county,Zhejiang province. Methods Questionnaire investigation was conducted targeted to primary health workers in Jingning County. One hundred and ninety nine questionnaires were included in the analysis. One - way ANOVA and multivariable logistic regression were applied to analyze relative indicators. Results The mean score of general job satisfaction among primary health workers was 76. 39 ± 7. 28 in Jingning County. The two items with the lowest two scores of job satisfaction were compensation(2. 81 ± 0. 97)and advancement(3. 38 ± 0. 86),and the highest two were co - worker(4. 23 ± 0. 49)and moral value(4. 15 ± 0. 58). The percentage of turnover intention was 6. 75% in permanent workers and 36. 11% in temporary contract workers. Multivariable logistic regression showed that compensation was the main influencing factor associated with turnover intention(OR = 0. 33,95% CI:0. 19 -0. 58). Conclusion The primary health workers Jingning County are basically satisfied with their job,and low income and difficult promotion are the main problems at the moment. Increasing financial input,reforming income distribution mechanism and improving promotion channels are necessary to develop human resource in primary health institutions and to insure successful implementation of health care reform.
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Objective To study the function of X -1 2 -ARIMA model in analysis on incidence trend of typhoid. Methods Secular trend,seasonal periodicity and random fluctuations of the monthly morbidity data in Zhejiang province from 2005 to 201 3 were analyzed by X -1 2 -ARIMA model.Results The seasonal fluctuation showed a narrowing trend year by year during 2005 to 201 3.After September,2007,the incidence of typhoid showed a downward trend.After 2008,the annual peak of incidence changed from August to July.The irregular factor may well represent the outbreak. Conclusion The X -1 2 -ARIMA model showed clear secular trend and seasonal periodicity,and the random fluctuation was of great value.
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<p><b>OBJECTIVE</b>To assess the risk of local transmission of Dengue caused by introduced cases with semi-quantitative method in 2015 in Zhejiang Province.</p><p><b>METHODS</b>Risk indexes of local transmission of Dengue caused by introduced cases were reviewed. The weights of indexes were computed by analytic hierarchy process and further used to generate absolute risk values by multiplying indexes. Moreover, comprehensive indexes were computed to describe relative risk by combining analytic hierarchy process and TOPSIS methods.</p><p><b>RESULTS</b>Four primary indexes and 19 secondary indexes were identified for risk assessment of local transmission of Dengue. The indexes with maximum and minimum weight were the number of immigration from countries with Dengue patients (weight value: 0.0678) and density of population (weight value: 0.0371) respectively. All CR values, statistics for measuring consistency of score matrix, were less than 0.1 (minimum: 0.000, maximum: 0.0922, average: 0.0251). The absolute risk of Zhejiang Province was within the range of 0.397-0.504 (the full score was 1.0). The risk orders of 11 municipalities sorted by relative comprehensive indexes and absolute risk values methods were similar. The three highest municipalities were Hangzhou, Wenzhou and Ningbo and the ranges of absolute risk value were 0.387-0.494, 0.404-0.511 and 0.392-0.499 respectively.</p><p><b>CONCLUSION</b>The results provides scientific basis for preventing and controlling Dengue in Zhejiang Province. The indexes and weights may be used to assess risk of Dengue in future. In addition, the semi-quantitative method constructed in this study would be a significant reference for risk assessment of public health in emergencies.</p>
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Humans , China , Epidemiology , Dengue , Epidemiology , Risk AssessmentABSTRACT
<p><b>OBJECTIVE</b>To construct a forecasting model of influenza-like illness in Zhejiang Province.</p><p><b>METHODS</b>The number of influenza-like cases and related pathogens among outpatients and emergency patients were obtained from 11 sentinel hospitals in Zhejiang Province during 2012 to 2013 (total 104 weeks), and corresponding meteorological factors were also collected. The epidemiological characteristics of influenza during the period were then analyzed. Linear correlation and rank correlation analyses were conducted to explore the association between influenza-like illness and related factors. Optimal parameters were selected by cross validation. Support vector machine was used to construct the forecasting model of influenza-like illness in Zhejiang Province and verified by the historical data.</p><p><b>RESULTS</b>Correlation analysis indicated that 8 factors were associated with influenza-like illness occurred in one week. The results of cross validation showed that the optimal parameters were C=3, ε=0.009 and γ=0.4. The results of influenza-like illness forecasting model after verification revealed that support vector machine had the accuracy of 50.0% for prediction with the same level, while it reached 96.7% for prediction within the range of one level higher or lower.</p><p><b>CONCLUSION</b>Support vector machine is suitable for early warning of influenza-like illness.</p>
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Humans , China , Epidemiology , Forecasting , Influenza, Human , Epidemiology , Sentinel Surveillance , Support Vector MachineABSTRACT
Objective TostudytheinfluenceofmeteorologicalconditionschangingontheactivityintensityofinfluenzaA (H1 N1 )and to establish the prediction model of H1 N1 positive rate associated with meteorological factors.Methods TheinfluenzaA(H1N1)datafromAprilof2009toJanuaryof2011insentinelhospitalanddailymeteorologicaldatain the same period were collected,which were analyzed by Spearman correlation analysis.The prediction model was establishedusingChi-squaredautomaticinteractiondetector(CHAID).Results Weeklyaverageatmospheric pressure(r =0.50),highest atmospheric pressure (r =0.51 ),lowest atmospheric pressure (r =0.50),average temperature (r=-0.40),highest atmospheric temperature(r=-0.41),lowest atmospheric temperature(r=-0.39), precipitation(r=-0.23 )and average wind speed (r=-0.22 )were positively correlated with the activity intensity of H1N1(all P<0.05).Factors that affected H1N1 positive rate were lowest atmospheric pressure,average wind speed and precipitation(P<0.05 ).The prediction model of H1 N1 positive rate showed that the correct rate of prediction was 66.67%.Conclusion Lowestatmosphericpressure,averagewindspeedandprecipitationarecloselyassociatedwith the activity intensity of influenza A (H1 N1 ).CHAID method can be used to predict the H1 N1 epidemics.
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Objective To develop appropriate evaluation methods of local basic public health services which are suitable to county level and above.Methods Data on basic public health services of 1 1 cities in Zhejiang province in 201 2 was evaluated by different evaluation methods including weighted synthetic scored method,weighted synthetic index method, Weighted Technique for Order Preference by Similarity to Ideal Solution (Topsis ) and Weighted Rank -Sum Ratio (RSR).The consistency of evaluation results were tested by Kendall's coefficient of concordance W test.Combination evaluation was conducted to evaluate four single synthetic evaluation results through average method,weighted average combination evaluation method and hierarchical clustering analysis.Results Different synthetic evaluation methods had different evaluation results.However,in the order,the top two were all Hangzhou and Ningbo.Kendall's W test showed good consistence of four evaluation results.Rank of 1 1 cities were Hangzhou,Ningbo,Shaoxing,Jiaxing,Huzhou, Taizhou,Jinhua,Zhoushan,Lishui,Wenzhou and Quzhou based on combination evaluation value by average method, which was the same to the rank based on weighted average combination evaluation result.Eleven cities could be classified into four categories by hierarchical clustering analysis with statistical significance (P <0.01 ):Excellent (Hangzhou, Ningbo),Good (Huzhou,Jiaxing,Shaoxing),Middle (Zhoushan,Jinhua,Taizhou)and Poor (Wenzhou,Quzhou, Lishui).Conclusion These four synthetic evaluation methods used in this study are all suitable to county level and above in basic public health services evaluation.Various synthetic evaluation methods could be used in practice with combination evaluation of various evaluation results.Average method which is convenient and accurate is preferred when consistency of various synthetic evaluation results was testified.Hierarchical clustering analysis could be used for combination evaluation when no precise rank is needed.
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<p><b>OBJECTIVE</b>To understand the clinical and epidemiological characteristics of hand-foot-and-mouth disease (HFMD) deceased cases.</p><p><b>METHOD</b>Information of demographics, diagnosis and treatment, clinical symptoms and signs, laboratory test results, and epidemiological contact history of 72 HFMD cases who died between May 2008 and September 2011, in Zhejiang Province, were collected and analyzed.</p><p><b>RESULT</b>The average age of the 72 cases was 1.8 years, 45 were males, accounting for 62.5%, 63 (87.5%) of the cases were scattered children. Eighteen counties reported 2 or more deaths, accounting for 46.1% (18/39) among the counties where the deaths were reported. The deaths occurred mainly in April to August, the peak occurred in May and June. Fever (98.4%, 63/64) and rash (95.1%, 58/61) were the most common symptoms, but the rash was not obvious at the first diagnosis. Fever occurred before the rash (79.0%, 49/62), persisted for 4 days in average. Vomiting (71.9%, 46/64), dyspnea (65.6%, 42/64), cyanosis (53.1%, 34/64) and impaired consciousness (51.6%, 33/64) were often seen among the cases; 53.1% (34/64) cases went to see the doctor on the first day, but 82.5%(52/63)cases were misdiagnosed. Time to diagnosis of HFMD was in average 3 days. About 3 to 4 days after the onset, the disease deteriorated sharply, deaths occurred within 1 day after admission in 78.9%(45/57)of the deceased cases; 85.0% (34/40) cases had high white blood cells level, mainly neutrophils increased, the ratio of neutrophil was more than 70% in 55.6% (15/27) of cases. Enterovirus 71 (EV71) infection was found in 93.3% (56/60) cases, the deceased cases often died of pulmonary hemorrhage (42.9%, 21/49) and encephalitis (34.7%, 17/49). The sanitary conditions of the cases' family were poor (65.5%, 36/55), but 73.3% (33/45) cases had no exposure history.</p><p><b>CONCLUSION</b>The HFMD deceased cases were mostly younger aged boys, scattered children, nonlocal-residents, and had poor sanitation. They were often infected with EV71, had high fever but had no typical rash, no clear exposure history, they had increased leukocyte, and were often misdiagnosed. Three or 4 days after onset, the disease deteriorated abruptly, most cases died within 1 week after onset. To decrease the HFMD mortality, early detection of severe cases should be stressed, and relative measures should be taken. The guardian should be aware of having good sanitary situation and healthy habits.</p>
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Animals , Child, Preschool , Female , Humans , Infant , Male , China , Epidemiology , Disease Outbreaks , Enterovirus A, Human , Feces , Virology , Fever , Pathology , Hand, Foot and Mouth Disease , Epidemiology , Mortality , Pathology , Retrospective Studies , Sex DistributionABSTRACT
<p><b>OBJECTIVE</b>To analyze and evaluate the application of China Infectious Diseases Automated-alert and Response System(CIDARS)in Zhejiang province.</p><p><b>METHODS</b>Data through the monitoring program in 2012 was analyzed descriptively and compared with the incidence data in the same period as well information related to public health emergency events.</p><p><b>RESULTS</b>A total of 14 292 signals were generated on 28 kinds of infectious diseases in the system, in Zhejiang province. 100% of the signals had been responded and the median time to response was 0.81 hours. 123 signals (0.86%)were preliminarily verified as suspected outbreaks and 33 outbreaks were finally confirmed by further field investigation, with a positive ratio of 0.23% . Information related to regional distribution showed significant differences which reflecting a positive correlation between the numbers of diseases and the time of early-warning(r = 0. 97, P < 0.01). Distribution of information related to different types of diseases was also significantly different, showing a positive correlation between the prevalent strength of the disease and the amount of information in a specific area(r = 0.80, P < 0.01).</p><p><b>CONCLUSION</b>CIDARS had a good performance which could be used to assist the local public health institutions on early detection of possible outbreaks at the early stage. However, the effectiveness was different for different regions and diseases.</p>
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Humans , China , Epidemiology , Communicable Disease Control , Methods , Communicable Diseases , Epidemiology , Disease Outbreaks , Incidence , Population Surveillance , Methods , Public HealthABSTRACT
Objective To study a local hospital reported acute gastroenteritis in a boarding school on its source of infection, mode of transmission and risk factors of the infection. Methods A suspected case was defined as who had developed diarrhea (≥3 times/day) or vomiting among teachers or students of the school, during April 19-30, 2010. A confirmed case was from a probable case plus tested positive for norovirus in stool specimens by using RT-PCR. Stool specimens of cases and environmental specimens were collected for laboratory diagnosis. In a ease-control study, we compared exposures to sources of bottled water, consumption of bottled water, and hygienic habits of 220 probable or confirmed cases from April 21-23 in the peak of the outbreak, together with another 220 controls, with frequency-matched by school grade. Results 20.3% of the 1536 students but none of the teachers developed the disease. 98.6% of the cases (n=217) and 85.5% (n=188) of the controls had drunk bottled water in the classroom (ORM-H= 12.3,95%CI: 3.7-40.9). 47.9% (n= 104)of the cases and 41.5% (n=78)of the controls had drunk unboiled bottled water in classroom (ORM-H=3.8,95%CI: 1.5-9.6). 47.9% (n=104) of the cases and 48.4% (n=91) of the controls had drunk bottled mixed water (boiled and unboiled) in the classroom (ORM-H=2.8, 95%CI: 1.1-7.0).Stool specimens from 3 cases and one bottle of uncovered bottled water in classroom showed positive of having norovirus genotype Ⅱ. Coliforms was cultured much higher rates than standard deviations in the bottled water. The factory making the bottled water was not licensed or having strict disinfection facilities. Conclusion Bottled spring water contaminated by norovirus was responsible for this outbreak.
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<p><b>OBJECTIVE</b>To determine a dengue fever outbreak in Yiwu city, Zhejiang Province in 2009 and to trace the origin of the pathogen.</p><p><b>METHODS</b>The dengue virus IgM, IgG antibodies and viral nucleic acid were detected and virus was isolated using 40 serum samples from the suspected patients. The viral RNA of the isolated virus strains was extracted and the E gene was amplified by RT-PCR. The amplicons were sequenced and the phylogenetic and homological analyses were also constructed.</p><p><b>RESULTS</b>Among 40 serum samples from dengue fever suspected patients, 17 were positive from for dengue IgM (42.5%); 4 were IgG positive (10.0%); 34 samples were dengue virus RNA positive (85.0%), 28 dengue virus type 3 (D3) strains were isolated (70.0%). The complete coding region of envelope genes (E) from 13 D3 strains was all 1479 nt without any insertion or deletion, which encoded with 493 amino acids (aa). E gene from the 13 D3 strains from Zhejiang in 2009 (D3/ZJ/2009) was 100.0% identical. The strain from Saudi Arabia shared the highest similarity with the D3 strain, 99.3% and 100.0% of their E genes and deduced amino acids were identical, respectively, whereas they were 93.4% and 97.4% between D3/ZJ/2009 strain and its prototype strain (D3/H87/1956), and 93.6% and 97.4% between D3/ZJ/2009 and a D3 strain isolated in Guangxi Province in 1980. The phylogenetic tree of E genes also indicated that D3/ZJ/2009 had maximum similarity with the D3/Saudi Arabia/2004. They all belonged to the D3/GIII branch, which was originated from Indian Subcontinent.</p><p><b>CONCLUSION</b>The outbreak of dengue fever in Zhejiang in 2009 was caused by type 3 dengue virus III genotype. The virus was most likely originated from Saudi Arabia.</p>
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Adolescent , Adult , Aged, 80 and over , Female , Humans , Male , Middle Aged , China , Epidemiology , Dengue , Epidemiology , Virology , Dengue Virus , Classification , Genetics , Disease OutbreaksABSTRACT
<p><b>OBJECTIVE</b>To evaluate the epidemiological and serological efficacy after 10 years of vaccination against hemorrhagic fever with renal syndrome (HFRS) vaccines in Zhejiang province.</p><p><b>METHODS</b>One county was randomly chosen as the research unit with all the healthy people between 16 and 60 years old were equally divided into study and control groups. The study group was vaccinated. Immunofluorescent antibody assay was used to test specific IgG antibody and Mcro-CPE method was used to test the titer of neutralizing antibody.</p><p><b>RESULTS</b>Two weeks after the full-course immunization, the seroconversion rate became 100% (67/67, with 95% CI as 96.3%-100%) by immunofluorescent antibody test (IgG) and 44.4% (8/18 with 95% CI as 22.0%-69.0%) by neutralization test with GMT titers as 72.1 and 4.6 respectively. Booster immunization was provided one year later. Time span as two weeks prior to, one year, one and half years, two years, three years and five years after booster immunization, the rates of seroconversion on immunofluorescent antibody using IFAT method, were 28.6%, 83.3%, 75.0%, 53.1%, 22.6%, 10.0% and 55.0% respectively, and rates of seroconversion of neutralizing antibody by Mcro-CPE method were 14.8%, 55.6%, 35.0%, 31.3%, 26.0%, 10.0% and 50.0% respectively. Nine years after the reinforcement, the rates of seroconversion of immunofluorescent antibody by IFAT method was only 7.1%. The vaccinated group had no patient seen but the control group appeared 34 patients including 3 deaths. According to the ten-year observation, the vaccine seemed effective with the protection rate in population reached 100%.</p><p><b>CONCLUSION</b>HFRS vaccine was effective on epidemiological, social and economical efficacy.</p>
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Adolescent , Adult , Animals , Female , Humans , Male , Middle Aged , Rats , Young Adult , Hemorrhagic Fever with Renal Syndrome , Epidemiology , Allergy and Immunology , Immunization, Secondary , Methods , Vaccination , Methods , Viral Vaccines , Therapeutic UsesABSTRACT
<p><b>OBJECTIVE</b>To determine the risk factors involved in the typhoon episodes and to put forward and evaluate the intervention measures.</p><p><b>METHODS</b>We defined a confirmed injury case as: 'a person with fall,scalpel and stab, collision, drowning, injuries and trauma due to flying debris and building collapse, asphyxiation due to entrapment in collapsed buildings by typhoon from 0 am,August 12 to 6 pm, August 14 2004' and a death case as: 'a person with fall, scalpel and stab, collision, drowning, injuries and trauma due to flying debris and building collapse, asphyxiation due to entrapment in collapsed buildings by typhoon from 0 am, August 12 to 12 am, August 18 2004'. We investigated all hospitalized injured cases in ten hospitals and telephoned to those who were not hospitalized and the cases of death. We did case-control study with 1 pair versus 2 cases. 74 cases were selected in ten hospitals. The controls were neighbors of the controls matched by occupation, sex, village, and within 5 years of age without injury in this typhoon. We asked the cases and the controls on their alertness regarding typhoon and what actions taken when typhoon arrived.</p><p><b>RESULTS</b>There were 392 injury cases in all ten hospitals and 50 death cases. The attack rate of injury was 27.3 per 100 000. The fatal rate was 11.3% with the death rate 3.1 per 100 000. We investigated 209 injury cases and 31 death cases. The number of cases who were injured from 1 to 6 hours before typhoon landing accounted for 64.6% (155) of all cases. The peak of epidemic curve was 4 hours before the landing of typhoon. Data on the analysis of 74 cases and 148 controls revealed that 42% (31) of the cases were outside their homes before and during typhoon compared to 15% (22) of the controls (OR = 3.9, 95% CI: 1.9-7.7). Compared with 20% (30) control persons (OR = 17,95% CI: 4.2-68). 28% (21) cases did not receive the alert of typhoon before it arrived compared with 18% (27) control persons (OR = 3.3, 95% CI:1.3-8.6). 53% (39) of the cases did not pay attention to the alert of typhoon before typhoon arrived.</p><p><b>CONCLUSION</b>Staying outdoor, not receiving or did not take seriously about the alert of typhoon seemed to be the risk factors of injury by the typhoon episode, suggesting that the government should increase the emergency preparedness and to raise the awareness on risks associated with typhoon.</p>