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Objective To analyze the epidemiological characteristics of rabies in 1955-2016 and the third epidemic period in shaanxi province, and to provide scientific basis for prevention and control of rabies. Methods The historical epidemic data from 1853 to 2003, the rabies surveillance data from Chinese diesase prevention and control information system from 2004 to 2017, and the rabies patient case survey data from 2009 to 2017 were collected to conduct the analysis. Results From 1953 to 2017, there were three epidemics of human rabies in Shaanxi Province. In 2009-2017, 270 cases of rabies were reported, and rabies cases occurred every month. Cases were mainly concentrated in Guanzhong and southern Shaanxi, and occasional cases were reported in northern Shaanxi. The male-female ratio is 2.51 ∶〗1, and the occupational composition was dominated by farmers (84.4%). Injured dogs were mainly domesticated dogs, the ratio of domestic and stray dogs was 13.07 ∶〗1. The exposure level was mainly grade Ⅲ (84.23%). The wounds of 60% cases were not treated after the injury, and the rabies vaccination rate and immunoglobulin utilization rate were both low. Conclusions The public's awareness of the dangers of rabies was still insufficient, so that there was no standard treatment after canine bite, which causes disease. It is necessary to increase the publicity of rabies prevention and control knowledge. The focus should be placed on remote areas and rural areas, and the public should be advocated to take the initiative to use the reimbursement policy for medical treatment.
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Objective@#To understand the dynamics and epidemiological characteristics of hand, foot and mouth disease (HFMD) in Shaanxi province during 2009-2018 and provide evidence for prevention and control of HFMD.@*Methods@#Information on HFMD was collected from the Chinese Disease Prevention and Control Information System in Shaanxi Province during 2009-2018 and was analyzed by descriptive, dynamic geometric series averaging and circular distribution methods.@*Results@#The annual average incidence rate of HFMD was 140.04/100 000 in Shaanxi province during 2009-2018. The highest incidence rates were seen in age groups as 1-year olds (3 494.24/100 000), 2-year olds (2 734.79/100 000) and 3-year olds (2 608.58/100 000). The highest reported mortality rates appeared in: 1-year olds as 1.42/100 000, 2-year olds as 0.77/100 000) and 0-year olds (0.53/100 000). The incidence rate increased most rapidly in the 1-year olds and the 0-year olds groups. The top three incidence rates were reported in Xi’an (251.34/100 000), Weinan (161.21/100 000) and Xianyang (123.73/100 000) cities in Guanzhong area of Shaanxi province. In the whole province, incidence rate was on the rise, and the average increases of incidence rates were all greater than zero in these cities. The proportion of severe cases in most cities somehow declined. Results from the circular distribution method estimated that the peak incidence would appear in April 10-11 each year, and the high incidence season was from April to July. In 2018, the composition of enterviruses (EV) 71 was 26.47% (1 303/4 922). In 2014 to 2018, the proportion of Coxsackie virus A16 (Cox A16) was between 20.06%(753/3 753) and 23.08% (855/3 705). The proportions of other EVs increased from 6.09% (14/230) to 51.91% (2 555/4 922) during 2009-2018.@*Conclusions@#The overall incidence rate of HFMD was increasing, with high risk population appeared in children under 3 year olds, in Shaanxi province during 2009-2018. However, both mortality and fatality rates were declining, with severe cases also showing a downward trend in most of the areas. Composition of pathogens was changing over time.
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Objective To learn the diagnosis and treatment of brucellosis patients in Suide County of Shaanxi Province in 2015,and to provide a scientific basis for making accurate prevention and control measures.Methods All the cases diagnosed as brucellosis in Suide County from January 1 to December 31 in 2015 and lived in this county were retrospectively investigated by case questionnaire survey,including basic information,medical procedures,and epidemiological contacts.Descriptive statistical analysis was performed using SPSS 18.0 software.Results In 2015,75 cases of brucellosis were diagnosed in Suide County,75 questionnaires were distributed,with 53 completed questionnaires returned.The average age of respondents was (49 ± 14) years old,of which 84.9％ (45/53) were male and 94.3％ (50/53) were farmers,except one case was actively monitored by Suide County Centre for Disease Control and Prevention then treated,the rest of the patients were treated after the onset of the disease.Of the 52 patients,one patient was diagnosed after one visit,accounting for 25.0％ (13/52);one patient was diagnosed after at least 4 visits,accounting for 3.8％ (2/52).The cumulative diagnosis rate at provincial-level hospitals was 1/3 and that at disease prevention and control institutions was 92.7％ (51/55),there were no confirmed cases in municipal hospitals,county hospitals,township hospitals,village clinics and individual clinics.For the first reason to see a doctor,65.4％ (34/52) of the patients were fever or accompanied by sweating,fatigue,arthralgia and waist and leg pain.The medians from onset to treatment between the first diagnosis,and 2,3,4 visits were 15,18,27,45 days,respectively;the median from onset to diagnosis was 21 days,ranging from 2 to 182 days.Totally 84.9％ (45/53) patients had a history of exposure to animals,of which 97.8％ (44/45) had contacted the sheep.Conclusions The cases in Suide County are mainly adult male farmers,and the diagnosis rate at hospitals below municipal level is low.It is recommended to strengthen the health intervention of high-risk groups and improve the level of diagnosis and treatment of primary medical staff.
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Objective To investigate the ability in diagnosing and reporting brucellosis of primary medical personnel in Suide County of Shaanxi Province,and provide scientific basis for making prevention and control strategies.Methods Convenience sampling method was adopted in October 2016.A questionnaire survey was conducted among the county hospitals,township hospitals,village clinics and individual clinics in Suide County to collect information on the ability in diagnosing and reporting brucellosis of primary medical personnel.The specific content includes the basic information,the awareness of brucellosis diagnosis and reporting capabilities,the situation of brucellosis training,and the views about the diagnosis of brucellosis.SPSS 18.0 software was used to carry out descriptive statistical analysis.Results A total of 77 primary healthcare workers were surveyed.Their average age was (38 ± 9) years old,57.1％ (44/77) workers were undergraduates,and 53.2％ (41/77) were working in county hospitals.9.1％ (7/77) were completely aware of the major infectious diseases,29.9％ (23/77) were fully aware of the transmission mute,28.6％ (22/77) and 66.2％ (51/77) known the high risk population and the epidemiological history of brucellosis.Twenty-six percent (20/77) of the medical staff were thoroughly aware of the main clinical manifestations,68.8％ (53/77) were clearly aware of the clinical stage of brucellosis;24.7％ (19/77) could understand the specificity of the laboratory tests of brucellosis;44.2％ (34/77) had a strong ability in reporting brucellosis.71.4％ (55/77) of the medical staff received the training about the knowledge of brucellosis;49.4％ (38/77) thought that the clinical manifestation was the most difficult to grasp in the criteria about diagnosis of brucellosis.Conclusions The ability of diagnosis and reporting of brucellosis is weak in primary healthcare workers in Suide County,the epidemiology and clinical knowledge of brucellosis are not comprehensive.It is suggested to strengthen the understanding of brucellosis among medical staff,especially in primary healthcare workers.We should carry out the training of disease epidemiology and clinical knowledge of brucellosis and standardize patient management.