ABSTRACT
Objective To investigate the epidemic features and pathogen spectrum distribution of diarrhea cases in Minhang District of Shanghai City so as to provide scientific evidence for developing prevention and control measures. Methods Surveillance on diarrhea was conducted in sentinel hospitals in Minghang District from 2018 to 2020. According to the quantity of outpatients in the monitoring hospital, the stool samples were collected by systematic sampling method according to the fixed interval proportion in the case queue which met the requirements of the monitored cases, and the pathogenic composition and epidemiological characteristics were analyzed. Results Among the 721 samples detected , 307(42.58%) were pathogen positive, The main positive bacteria was Vibrio parahaemolyticus, which accounted for 36.11%(39/108) among all positive bacteria.The main positive virus was norovirus GII, which accounted for 24.43%(75/307) among all positive virus. Positive cases were detected among all age groups. 81 positive cases (26.38%) were detected among 31-40 years old, with the highest detection rate. There was no difference in the positive detection rate between genders(χ2= 1.95, P = 0.16). The positive cases showed two peaks during the season of winter and spring. The positive rate of bacteria was highest in the third quarter and positive rate of viruses was highest in the first quarter. The mixed infection rate of bacteria and viruses was highest in the second quarter. Conclusions Diarrhea cases in Minhang District of Shanghai from 2018 to 2020 is caused by a variety of pathogens and related seasonality is obvious in Minghang District, Shanghai City in 2018-2020. It is necessary to take specific prevention based on various pathogens to reduce the incidence of diarrhea.
ABSTRACT
ObjectiveThis study aimed to understand the epidemiological characteristics of hand-foot-mouth disease （HFMD） in Minhang District， Shanghai from 2009 to 2020， and provide a scientific basis for the prevention and control of HFMD. MethodsThe case information of HFMD was collected from the National Notifiable Infectious Diseases Reporting System of Chinese Center for Disease Control and Prevention. We used descriptive epidemiological methods to analyze the population characteristics， temporal and spatial distribution of HFMD， the pathogen composition of the case and its changing trend. ResultsFrom 2009 to 2020， a total of 66，198 cases of HFMD were reported in Minhang District， Shanghai， including 377 severe cases （severe case rate 0.57%） and 3 deaths （severs case fatality rate 0.80%）. There were more cases of HFMD in boys than in girls （1.5∶1）. HFMD patients aged under 5 years predominated， accounting for 88.91% of all cases. Majority of the cases （91.42%） were in scattered children （55.80%） and children in kindergartens （35.62%）. The incidence showed a cyclical trend， with low incidence years and high incidence years appearing alternately. The peak period was from April to July， and sometimes there were small peaks during October to December. A total of 12 years time-space scanning analysis revealed 3 clusters. The cluster centers were located in Wujing Town， Huacao Town and Xinzhuang Town， respectively. The proportion of EV71 in common cases was generally decreasing， and reduced to zero in 2019. The proportion of CoxA6 had increased year by year， and reached 75.00% in 2020. CoxA6 became the dominant pathogen in recent years. The number of severe cases had decreased year by year since 2010， and the dominant pathogen was EV71 （90.03% on average） in severe cases. ConclusionThe incidence of HFMD in Minhang District of Shanghai has a downward trend from 2014. The dominant pathogen changes from EV71 to CoxA6， and the dominant pathogen in severe cases is EV71. The discovered temporal and spatial clustering pattern is helpful for in-depth understanding of the distribution and epidemic trend of HFMD in Minhang District， and provides a scientific basis for epidemic prevention and control.