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Objective:To explore the lag effect and correlation between daily average temperature and the incidence of other infectious diarrhea in Hebei Province.Methods:The data of meteorological factors (including temperature and average daily temperature) and the daily incidence of other infectious diarrhea in Zhangjiakou City, Chengde City, Tangshan City, Qinhuangdao City, Baoding City, Langfang City, Cangzhou City, Shijiazhuang City, Hengshui City, Xingtai City, and Handan City in Hebei Province from 2017 to 2020 were collected. Eleven prefecture-level cities were divided into four regions, including east, north, middle and south regions. Distributed lag non-linear model was applied to examine the non-linear associations and the lag effect of daily mean temperature on daily incidence of other infectious diarrhea. Meanwhile, the cold and hot effects were used to estinuate the lag-response relationship on the incidence of other infectious diarrhea.Results:A total of 231 008 cases of other infectious diarrhea were reported in Hebei Province. The seasonal distribution was obvious, showing a bimodal distribution of large peaks in summer and small peaks in winter. An inverse S-shaped association between average daily temperature and cumulative risk ratio ( RR) of other infectious diarrhea was observed in Hebei Province. Both high temperature (higher than 27.50 ℃) and low temperature (less than 13.67 ℃) could increase the risk of other infectious diarrhea. When the temperature was lower than 13.00 ℃, the lag time and RR had a U-shaped association (lag four to seven days, 23 to 30 days). Meanwhile, when it was higher than 13.00 ℃, it had an inverted U-shaped association (lag 5 to 21 days). A comparison of four regions of Hebei Province showed that the lag time from south to north was extended from six days to 30 days at low temperature effects with temperature P5=-7.24 ℃. When the temperature getting hot ( P95=28.25 ℃), the risk occurred at lag 0 days, and the lag time gradually got short from north to south. Thus, the high temperature effect reached maximum quickly with a relative short duration. Conclusions:The inverse S-shaped non-linear association between daily average temperature and the incidence of other infectious diarrhea in Hebei Province is observed. Both low temperature and high temperature are associated with increased risk of other infectious diarrhea. But the impact of low temperature is more notable, which has a relative long duration.
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Objective@#To analyze the pathogenic spectrum of infectious diarrhea among children in Zhengzhou City in 2020, so as to provide insights into the management of childhood infectious diarrhea.@*Methods@#A total of 230 stool samples were collected from children with diarrhea in the Diarrhea Clinic of Zhengzhou Municipal Children's Hospital in 2020. Diarrheagenic Escherichia coli, Salmonella, Shigella, Vibrio parahaemolyticus, Campylobacter and Aeromonas were isolated. Salmonella was typed using pulsed-field gel electrophoresis ( PFGE ) and antimicrobial resistance was tested in Salmonella. The main types and drug resistance of pathogens were descriptively analyzed.@*Results@#The 230 children with diarrhea included 152 males and 78 females, with a male to female ratio of 1.95∶1. There were 173 cases at ages of 3 years and below ( 75.22% ), and 82 cases seen between June and August ( 35.65% ). A total of 71 pathogenic bacteria strains were isolated, with a detection rate of 30.87%. Salmonella was the most frequently isolated pathogen ( 35 strains, 15.22% prevalence ), following by diarrheagenic E. coli ( 20 strains, 8.70% ). Eleven serotypes of Salmonella were identified, which mainly included S. enteritidis and S. typhimurium. PFGE typing revealed 25 band patterns of Salmonella, with a similarity ranging from 11.85% to 100%. Salmonella were sensitive to imipenem, meropenem, polymyxin B and amikacin and highly resistant to streptomycin ( 85.71% ), ampicillin ( 80.00% ) and sulfaisoxazole ( 80.00% ). A 82.86% proportion of multi-drug resistance was detected in the 29 Salmonella strains. @*Conclusions@# A wide range of pathogenic bacteria were detected from the childhood infectious diarrhea in Zhengzhou City in 2020, which mainly included Salmonella and diarrheagenic E. coli. A high polymorphism level was seen in PFGE fingerprints of Salmonella, which presented high-level resistance to antimicrobial agents.
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Objective To investigate the etiology and epidemic characteristics of infectious diarrhea in children in Suzhou, and to provide a basis for accurate prevention and control. Methods Active surveillance of infectious diarrhea pathogens was carried out in a national sentinel surveillance hospital in Suzhou from 2018 to 2020. Epidemiological investigation was completed and stool samples were collected. All samples were detected and classified for 5 viruses and 6 types of bacteria. Results A total of 999 cases of infectious diarrhea were included, the detection rate of pathogen was 36.34%, virus was 31.41%, bacteria was 6.31%, and multi-pathogen mixed infection was 4.8%. The top three pathogens were rotavirus (17.92%), norovirus (12.51%) and Salmonella (3.4%). Both rotavirus diarrhea and norovirus diarrhea occurred most frequently in children aged 7-24 months, with peak incidence in winter and early spring. There was no obvious seasonal and age distribution of bacterial diarrhea. The multi-pathogen mixed infection was mainly virus-virus. G9[P]8 was the dominant genotype of rotavirus, while type 2 was the dominant type of norovirus in the cases of infectious diarrhea. Conclusion Infectious diarrhea in children under 5 years old in Suzhou area from 2018 to 2020 is mainly caused by viruses, among which rotavirus and norovirus are the dominant pathogens. Viral diarrhea has obvious population distribution and seasonal characteristics. The dominant pathogens of bacterial diarrhea are Salmonella and diarrheagenic Escherichia coli.
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Objective: To assess the antidiarrheal effects of Terfezia claveryi methanolic extract against Escherichia coli, Salmonella typhimurium, Shigella flexneri, and Giardia lamblia. Methods: Antibacterial effects of the Terfezia claveryi methanolic extract were carried out by determining the minimum inhibitory concentration (MIC) and minimum bactericidal concentration through micro broth dilution technique. Furthermore, reactive oxygen species production and protein leakage were evaluated. To evaluate the in vitro anti-giardial effects of Terfezia claveryi methanolic extract, Giardia lamblia WB (ATCC® 30957) trophozoites were treated with various concentrations of Terfezia claveryi methanolic extract for 10-360 min. In addition, the plasma membrane permeability of trophozoites treated with Terfezia claveryi methanolic extract was determined. The cytotoxicity effects of Terfezia claveryi methanolic extract against normal (HEK293T) and cancer (MCF-7) cells were also assessed using the MTT assay. Results: The MIC and minimum bactericidal concentration of Terfezia claveryi methanolic extract against bacterial strains were in the range of 0.52-1.04 and 1.04-2.08 mg/mL, respectively. The results revealed that reactive oxygen species production and protein leakage were significantly increased after the bacteria were treated with the Terfezia claveryi methanolic extract, especially at 1/3 and 1/2 MICs (P<0.001). Furthermore, Terfezia claveryi methanolic extract decreased the viability of Giardia lamblia trophozoites in a dose-dependent manner. Terfezia claveryi methanolic extract at 1, 2, and 4 mg/mL resulted in 100% mortality in Giardia lamblia trophozoites after 360, 240, and 120 min, respectively. Moreover, Terfezia claveryi methanolic extract altered the permeability of plasma membrane of Giardia lamblia trophozoites by increasing the concentration. MTT assay revealed that the 50% cytotoxic concentrations values for HEK293T and MCF-7 cells were 4.32 mg/mL and 6.40 mg/mL, respectively, indicating that Terfezia claveryi methanolic extract had greater cytotoxicity against cancer cells than normal cells. Conclusions: Terfezia claveryi methanolic extract had potent in vitro antibacterial and anti-parasitic effects on Escherichia coli, Salmonella typhimurium, Shigella flexneri, and Giardia lamblia by affecting cell membrane permeability and reactive oxygen species generation with no significant cytotoxicity on normal cells.
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Infectious diarrhea is an important public health problem, which has a significant impact on global disease burden. Under the background of climate change, rainstorms increase and floods occur frequently. Most studies show that the incidences of infectious diarrhea disease increase significantly after rainstorm and flood events. However, there is a lack of systematic summary on the path of rainstorm and flood events affecting the incidence of infectious diarrhea, including the key links and mechanisms underlying environmental-social interaction. This study comprehensively combed the literature from environmental factors, socio-economic and cultural factors, and population and individual susceptibility factors. The potential mechanisms of infectious diarrhea caused by rainstorm and flood events were discussed from the aspects of spreading of pathogens, affecting sanitation facilities and (or) drinking water treatment infrastructure, the regulatory role of individual and behavioral factors, and long-term effects. Based on the "pressure-state-response" model, a social driving process model of rainstorm and flood leading to incidence of infectious diarrhea was constructed. This model could provide reference for future quantitative modeling and other research directions. It is helpful to guide the public health departments to accurately identify factors affecting the incidence of infectious diarrhea after rainstorm and flood, so as to take targeted intervention measures.
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In order to meet the needs of prevention and control of intestinal infectious diseases， a comprehensive surveillance for diarrheal diseases has been innovated and explored in Shanghai since 2012. The surveillance has extensive distribution of sentinel hospitals， systematic sampling， multi-pathogen collection， and hospital information system （HIS） as the basis， which has achieved “One system for surveillance of multiple diseases and one sample for detection of multiple pathogens". Continual active surveillance for the whole population has been conducted， covering demography， clinical information， epidemiology， pathogen detection， and drug sensitivity test for diarrhea cases. The surveillance has obtained preliminary achievements as follows. First， diarrheal diseases and their periodic changes have been characterized， in which the most prevalent pathogen of diarrhea is determined to be norovirus in Shanghai. Second， some rare pathogens and serotypes have been identified that may provide clues to the sources of outbreaks. Third， it facilitates the information sharing between public health institutions and clinical institutions， and provides scientific evidence for clinical diagnosis and treatment. In the future， Shanghai diarrhea comprehensive surveillance will be improved for expanding range and depth of surveillance， artificial intelligence assisted diagnosis and treatment， early warning of outbreaks， prediction of epidemic trends， and application of new detection technologies.
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ObjectiveTo investigate the prevalence and epidemiological characteristics of norovirus in adult cases with infectious diarrhea in Putuo District of Shanghai， and provide scientific evidence for the prevention and control of infectious diarrhea caused by norovirus. MethodsFecal samples， clinical information and epidemiological data were collected from January 2013 through December 2019 in surveillance hospitals in Putuo District of Shanghai. Norovirus was examined by real-time fluorescent quantitative reverse transcription polymerase chain reaction （rRT-PCR）. ResultsIn 1 389 adult cases with infectious diarrhea， norovirus positive rate was 25.41%， which was significantly higher in male （27.16%） than female （23.89%）. Furthermore， in 353 cases positive for norovirus， GⅡ group was the most common （77.98%）.The positive rate was highest in the cases aged 30-44 years. Spring， autumn and winter were the seasons with higher incidence of norovirus （September to May）. The norovirus-infected cases had more nausea， vomiting， hyperactivity of bowel sounds， and watery stool， compared to the negative cases （P<0.05）. ConclusionThe detection rate of norovirus remains high in adult cases with infectious diarrhea in Putuo District of Shanghai， of which GII is predominant. Seasonality may be spring， autumn and winter. Therefore， it warrants the countermeasures， such as surveillance and health education， for prevention and control of norovirus in susceptible population during epidemic seasons.
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ObjectiveTo investigate the prevalence and epidemiological characteristics of norovirus in adult cases with infectious diarrhea in Putuo District of Shanghai， and provide scientific evidence for the prevention and control of infectious diarrhea caused by norovirus. MethodsFecal samples， clinical information and epidemiological data were collected from January 2013 through December 2019 in surveillance hospitals in Putuo District of Shanghai. Norovirus was examined by real-time fluorescent quantitative reverse transcription polymerase chain reaction （rRT-PCR）. ResultsIn 1 389 adult cases with infectious diarrhea， norovirus positive rate was 25.41%， which was significantly higher in male （27.16%） than female （23.89%）. Furthermore， in 353 cases positive for norovirus， GⅡ group was the most common （77.98%）.The positive rate was highest in the cases aged 30-44 years. Spring， autumn and winter were the seasons with higher incidence of norovirus （September to May）. The norovirus-infected cases had more nausea， vomiting， hyperactivity of bowel sounds， and watery stool， compared to the negative cases （P<0.05）. ConclusionThe detection rate of norovirus remains high in adult cases with infectious diarrhea in Putuo District of Shanghai， of which GII is predominant. Seasonality may be spring， autumn and winter. Therefore， it warrants the countermeasures， such as surveillance and health education， for prevention and control of norovirus in susceptible population during epidemic seasons.
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Objective To understand the epidemiological characteristics of norovirus infectious diarrhea in Pudong New Area of Shanghai, and to provide reference for prevention and control of diarrhea caused by norovirus. Methods Epidemiological data and stool samples from diarrhea cases of 15 hospitals in 2015-2019 years were collected. The two subtypes of norovirus G I and G II were detected by RT-PCR and analyzed. Results A total of 9 397 diarrhea samples were collected in 2015-2019 years, and 1 938 positive norovirus samples were detected, with a positive rate of 20.62%. The majority of serotypes were GII (88.60%). Diarrhea caused by norovirus occurs all year round, with high incidence season in 2-3and 10-12 months every year. There was no significant difference in the positive rate of norovirus between different sexes（χ2=2.611，P=0.106）. The positive rate of the 15-64 year old group was higher than that of the 0-14 year old group and the 65 year old and above group（χ2=153.634，P<0.001）. The highest positive rate was for cadres /worker/ business services / teachers / medical staff / drivers. The positive rate of norovirus in diarrhea cases with vomiting was significantly higher than that in patients without vomiting. Conclusions Diarrhea caused by norovirus is related to season, age and occupation. Because there is no effective antiviral drugs and vaccine prevention, continuous monitoring should be carried out and targeted preventive measures should be carried out according to epidemiological characteristics.
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Objective To investigate the relationship between clinical parameters related to acute bacterial dysentery and other infectious diarrhea in adults.Methods From April to October 2018,70 patients with clinical diagnosis of acute bacterial dysentery,180 patients with clinical diagnosis of infectious diarrhea and 399 patients with diarrhea to be examined were investigated retrospectively.The collected data included gender,age,time from onset to treatment,maximum body temperature,main symptoms,epidemiological history,blood routine,C-reactive protein and stool routine.Analysis of these clinical factors related to acute bacterial dysentery and other infectious diarrhea.Results A total of 70 patients with acute bacterial dysentery,180 patients with other infectious diarrhea and 399 patients with diarrhea of unknown origin were investigated.The positive rate of epidemiology in the three groups was statistically significant (P ＜0.05);the age of onset of bacterial dysentery was younger than that in patients with diarrhea of unknown orion (P＜O.05).Compared with the other two groups of patients,the onset to visit time was earlier,the number of vomiting was higher,the incidence of fever and tenesmus was higher,and the levels of white blood cells,neutrophils and C-reactive protein were significantly increased (P ＜ 0.05).Conclusions Patients with acute bacterial dysentery,other infectious diarrhea,and diarrhea of unknown origin have some differences in epidemiological history,age at onset,clinical manifestations,and laboratory tests.
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Objective@#To investigate the relationship between clinical parameters related to acute bacterial dysentery and other infectious diarrhea in adults.@*Methods@#From April to October 2018, 70 patients with clinical diagnosis of acute bacterial dysentery, 180 patients with clinical diagnosis of infectious diarrhea and 399 patients with diarrhea to be examined were investigated retrospectively. The collected data included gender, age, time from onset to treatment, maximum body temperature, main symptoms, epidemiological history, blood routine, C-reactive protein and stool routine. Analysis of these clinical factors related to acute bacterial dysentery and other infectious diarrhea.@*Results@#A total of 70 patients with acute bacterial dysentery, 180 patients with other infectious diarrhea and 399 patients with diarrhea of unknown origin were investigated. The positive rate of epidemiology in the three groups was statistically significant (P<0.05); the age of onset of bacterial dysentery was younger than that in patients with diarrhea of unknown origin (P<0.05). Compared with the other two groups of patients, the onset to visit time was earlier, the number of vomiting was higher, the incidence of fever and tenesmus was higher, and the levels of white blood cells, neutrophils and C-reactive protein were significantly increased (P<0.05).@*Conclusions@#Patients with acute bacterial dysentery, other infectious diarrhea, and diarrhea of unknown origin have some differences in epidemiological history, age at onset, clinical manifestations, and laboratory tests.
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Objective@#To analyze the epidemiological characteristics and its trends of other infectious diarrhea diseases in infants in Inner Mongolia Autonomous Region.@*Methods@#Statistical analysis was conducted on other infectious diarrhea cases of infants in Inner Mongolia Autonomous Region from China Information System for Disease Prevention and Control from 2005 to 2016. The main methods were descriptive epidemiology for population, area and time distribution of these registered cases in Inner Mongolia Autonomous Region. The trends were analyzed by the ratio of fixed base and ring base. Area map method was used for regional differences.@*Results@#From 2005 to 2016, 17 760 other infectious diarrhea diseases of infants were reported in Inner Mongolia Autonomous Region, accounting for 58% of the total reported cases. The cases number and incidence showed an overall upward trend. After 2011, the growth rate of case reports and incidences slowed down relatively. The peak of the incidence was in July and August (4 739 cases), accounting for 27% of cases of the whole year. Seventy-three point forty-four percent of the cases were located in Hulunbeier City (5 161 cases, 29.06%), Hohhot City (4 465 cases, 25.14%) and Baotou City (3 417 cases, 19.24%) . Except for Wuhai City, the remaining 11 cities showed increased incidence of other infectious diarrhea diseases in infants. The ratio of male to female was 1.55∶1, and the incidence in males was higher than that in females every year. Twelve-month-old (5 800 cases, 33%) had the greatest proportion. Clinical diagnosis (56.26%) and confirmed diagnosis (43.51%) were the main categories, but the rate of pathogen labeling was only 7.60%.@*Conclusions@#After 2011, the incidence of other infectious diarrhea diseases of infants in Inner Mongolia Autonomous Region have slowed down relatively. However, the incidence has significant time, region and population aggregation.
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Acute diarrhea (AD) is the increase in frequency and volume of bowel movements with decrease in their consistency that lasts less than 14 days. AD is a major public health problem and is still nowadays a cause of significant morbidity and mortality during childhood, especially in children with nutritional deficits. At a younger age, there is a greater susceptibility to diarrhea, which is more intense and more likely cause dehydration. The prevention and management of dehydration is the mainstay of treatment. The use of medications must be used with caution, analyzing individual cases and based on the best available evidence. We will analyze the subject with special emphasis on treatment according to scientific evidence.
La diarrea aguda (DA) se define como el aumento en la frecuencia y volumen de las deposiciones con disminución de la consistencia y que dura menos de 14 días. La DA es un gran problema de salud pública y es aún hoy en día una causa de importante morbimortalidad durante la infancia en especial en niños con déficits nutricionales. A menor edad hay mayor susceptibilidad de presentar diarrea, siendo ésta de mayor intensidad y con mayores posibilidades de producir deshidratación. La prevención y el manejo de la deshidratación es el pilar fundamental del tratamiento. El uso de medicamentos debe ser criterioso, analizando cada caso individual y basado en la mejor evidencia disponible. Analizaremos el tema con especial énfasis en el tratamiento según evidencia científica.
Subject(s)
Humans , Infant , Child, Preschool , Diarrhea/diagnosis , Diarrhea/drug therapy , Rehydration Solutions/therapeutic use , Acute Disease , Ondansetron/therapeutic use , Probiotics/therapeutic use , Dehydration/etiology , Diarrhea/etiology , Diarrhea/prevention & control , Anti-Bacterial Agents/therapeutic useABSTRACT
Objective To analyze the epidemiological characteristics and its trends of other infectious diarrhea diseases in infants in Inner Mongolia Autonomous Region.Methods Statistical analysis was conducted on other infectious diarrhea cases of infants in Inner Mongolia Autonomous Region from China Information System for Disease Prevention and Control from 2005 to 2016.The main methods were descriptive epidemiology for population,area and time distribution of these registered cases in Inner Mongolia Autonomous Region.The trends were analyzed by the ratio of fixed base and ring base.Area map method was used for regional differences.Results From 2005 to 2016,17 760 other infectious diarrhea diseases of infants were reported in Inner Mongolia Autonomous Region,accounting for 58％of the total reposed cases.The cases number and incidence showed an overall upward trend.After 2011,the growth rate of case reports and incidences slowed down relatively.The peak of the incidence was in July and August(4 739 cases),accounting for27％of cases of the whole year.Seventy-three point forty-four percent of the cases were located in Hulunbeier City(5 161 cases,29.06％),Hohhot City(4 465 cases,25.14％)and Baotou City(3 417 cases,19.24％).Except for Wuhai City.the remaining 11 cities showed increased incidence of other infectious diarrhea diseases in infants.The ratio of male to female was 1.55∶1,and the incidence in males was higher than that in females every year.Twelve-month-old(5 800 cases,33％)had the greatest proportion.Clinical diagnosis(56.26％)and confirmed diagnosis(43.51％)were the main categories,but the rate of pathogen labeling was only 7.60％.Conclusions After 2011,the incidence of other infectious diarrhea diseases of infants in Inner Mongolia Autonomous Region have slowed down relatively.However,the incidence has significant time,region and population aggregation.
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Diarrhea is one of the main disease types of illness and death in children in developing countries,and infectious diarrhea is especially harmful to children's health.A panel of multidisciplinary experts in management of infectious diarrhea in children and adults was convened in 2012.Panel participants included representatives from the Society for Healthcare Epidemiology of America (SHEA),Center for Disease Control and Prevention (CDC),and the Infectious Disease Society of America (IDSA) Standards and Practice Guidelines Committee (SPGC).In 2017,the panel issued a guideline for the diagnosis and treatment of infectious diarrhea,which was validated and recommended for the management of infectious diarrhea.Now,the part of the content on children in the guide was described.
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Objective@#To analyze the spatial-temporal characteristics of other infectious diarrhea (OID) in Jiangsu province from 2010 to 2017, and to provide evidence for setting up prevention and control programs of the disease.@*Methods@#Data was from the Chinese Center for Disease Control and Prevention and the Statistics Bureau of Jiangsu province. Descriptive methods were used to illustrate the epidemiological characteristics of OID from 2010 to 2017. Global autocorrelation statistics method (Moran’s I) was used to detect the spatial autocorrelation of OID, annually. Kulldorff M spatiotemporal scan statistics was used to analyze the spatial-temporal clustering of OID. ArcGIS 10.0 software, SaTScan 9.4 software and Excel 2017 software were also applied.@*Results@#A total of 126 341 OID cases were found in Jiangsu province from 2010 to 2017 with an average annual incidence as 19.96/100 000. Children under five accounted for 55.08% (69 590/126 341) of the total cases. Obvious seasonal backshift with the increasing trends of the OID was noticed. There appeared four areas with high incidence of OID in the whole province, including Wuxi, Suzhou, Yancheng and Xuzhou. OID showed positive spatial autocorrelation at the county level with higher Moran’s I from 0.19 to 0.33 (P<0.01). There appeared four positive clusters, all occurred in the high incidence period of OID, including the cluster area from the intersection areas of Changzhou and Wuxi (RR=7.61, LLR=2 605.80, P<0.01), respectively.@*Conclusion@#With the increasing trends and the seasonal backshift of OID cases, pathogen surveillance programs set for those scattered children under five, in clustered regions and epidemic seasons should be strengthened.
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Objective@#To study the lag effect of temperature and the source of heterogeneity on other infectious diarrhea (OID) in Zhejiang province, so as to identify related vulnerable populations at risk.@*Methods@#Data on OID and meteorology in Zhejiang province from 2014 to 2016 were collected. A two-stage model was conducted, including: 1) using the distributed lag non-linear model to estimate the city-specific lag effect of temperature on OID, 2) applying the multivariate Meta- analysis to pool the estimated city-specific effect, 3) using the multivariate Meta-regression to explore the sources of heterogeneity.@*Results@#There were 301 593 cases of OID in Zhejiang province during the study period. At the provincial level, temperature that corresponding to the lowest risk of OID was 16.7 ℃, and the temperature corresponding to the highest risk was 6.2℃ (RR=2.298, 95%CI: 1.527- 3.459). 16.7 ℃ was recognized as the reference temperature. P5 and P95 of the average daily temperature represented low and high temperature respectively. When the temperature was cold, the risk was delayed by 2 days, with the highest risk found on the 5th day (RR=1.057, 95%CI: 1.030-1.084) before decreasing to the 23rd day. When the temperature got hot, the risk of OID occurred on the first day (RR=1.081, 95%CI: 1.045-1.118) and gradually decreasing to the 8th day. Differences on heterogeneous sources related to the risks of OID in different regions, presented on urban latitude and the rate of ageing in the population.@*Conclusions@#Both high or low temperature could increase the risk of OID, with a lag effect noticed. Prevention program on OID should be focusing on populations living in the high latitude and the elderly population at the low temperature areas.
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Objective@#To investigate the epidemiologic characteristics of Norovirus among adult patients suffering from infectious diarrhea in Shanghai, so as to provide evidence for developing related strategies on prevention and control of the disease.@*Methods@#Diarrheal outpatients were monitored at the 'Intestinal clinic’ from 22 hospitals involved in the sentinel surveillance program in Shanghai. Information on demographic and epidemiologic features of the patients was collected while data and clinical, fecal specimens were collected and sent to the district CDC for Norovirus detection. Positive rates of Norovirus were also compared in various populations and seasons during 2013-2018. Multivariate logistic regression model was adopted to fit into the comparisons between non-Norovirus and Norovirus groups.@*Results@#19.28% of the 12 083 diarrheal cases were found to have carried the Norovirus, with GⅡgroup the most commonly identified genotype. Rates of detection was seen higher in males (20.78%) than in females (17.73%). 30-44 year-old were found having the highest positive rate (21.51%). The positive rates were found the highest (23.60%) in the year of 2015. All the above shown differences were statistically significant (P<0.05). Diarrheal patients affected with Norovirus would present watery stool (75.94%) and vomiting (35.84%). Data from the multivariate logistic analysis showed that factors as: being males, 30-44 years old, officials/clerks, in winter season and with histories of travelling etc., were related to higher risks on Norovirus infection.@*Conclusions@#Infectious diarrhea caused by Norovirus occurred all year round, with seasonal peaks seen in winter and spring, in Shanghai. Specific prevention and control measures should be taken on Norovirus- caused infectious diarrhea, according to the difference on age, gender and season.
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Objective@#To identify the etiology and source of infection in a diarrhea outbreak in Yunnan in May 2017 and to provide the evidence for formulating prevention and control measures.@*Methods@#Epidemiological investigation was carried out on the epidemic situation of diarrhea in the village of Lvchun County in Yunnan Province, the field sampling, laboratory testing and data analysis were also performed.@*Results@#Among the 44 patients, 11 of the 13 samples were positive for rotavirus nucleic acid in group A, and the positive rate was 84.62%. The survey showed that the water supply pipe was damaged and polluted by human and livestock manure and domestic sewage. The trend of the damaged water pipe was basically the same as the case distribution, and the rainfall was significantly related to the number of the disease.@*Conclusions@#This event was an outbreak of diarrhea caused by group A rotavirus. The direct pollution of drinking water caused by rainfall may be the risk factor of this outbreak. The health management of rural drinking water should be strengthened and the health knowledge and education of preventing intestinal infectious diseases should be promoted.