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ObjectiveTo present the exploration and application of a prospective follow-up research method for acute infectious disease surveillance based on natural community populations， using COVID-19 infection as an example， and to provide a reference for improving the infectious disease surveillance and early warning system. MethodsA multi-stage probability proportional sampling method was employed to sample residents from all communities of 16 administrative districts in Shanghai， with households as the units. A cohort for acute infectious diseases based on natural community populations was established. The baseline survey was conducted for all cohort subjects， and COVID-19 antigen test kits were distributed. From December 21， 2022 to September 30， 2023， prospective follow-up monitoring of COVID-19 antigen and nucleic acid was carried out on the study subjects on a weekly basis. The baseline characteristics and follow-up information of the cohort subjects were described. ResultsThe cohort for acute infectious diseases included a total of 12 881 subjects， comprising 6 098 males （47.3%） and 6 783 females （52.7%）. The baseline survey revealed that 35.2% （4 540/12 881） of the subjects had a history of COVID-19 infection. During the follow-up period from December 21， 2022 to September 30， 2023， the average incidence density in the cohort was 0.61/person-year， with a higher incidence density in females （0.63/person-year） compared to males （0.59/person-year）. Individuals aged 60 and above （0.64/person-year） and those with underlying health conditions （0.67/person-year） had a higher incidence density. Healthcare workers showed a notably higher incidence density （0.84/person-year） than that in other occupational groups. As of September 30， 2023， a total of 340 subjects in the cohort experienced secondary infections， with a median interval of 170 days between the first and second infections. ConclusionThis study applies cohort study method to acute infectious disease surveillance， providing crucial data support for estimating infection rates and forecasting alerts for acute infectious diseases in the community. This method can be promoted and applied as a new approach for acute infectious disease surveillance.
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ObjectiveTo conduct on-site epidemiological investigation， emergency response， tracing of infection source and analysis of a confirmed COVID-19 case of a foreign airline cargo service staff member in Shanghai’s international airport， aiming to provide reference for prevention of imported COVID-19 cases under regular prevention and control of COVID-19. MethodsA retrospective field epidemiological investigation was conducted to collect information of basic characteristics， illness onset， diagnosis， treatment， clinical manifestations， exposure history and risk factors within 14 days before onset， close contacts， close contacts of close contacts， and key places related to activity trajectories. Respiratory tract specimens of cases and contacts were collected for detection of SARS-CoV-2 by real time RT-PCR （rRT-PCR）. Emergency response， including infection source analysis and contact management， was conducted. ResultsThe case developed pharyngeal itch on July 28， 2021， and fever on the 30th， and went to the hospital for treatment twice on the 31st. Because his specimen was positive for SARS-CoV-2 by rRT-PCR on August 1， he was isolated and treated on August 2 and diagnosed as a confirmed case of COVID-19. The case was a foreign airline cargo service member at an international airport. The two regular nucleic acid screenings of him as a high-risk occupation on July 21 and 28 were negative. He did not leave Shanghai within 14 days before the onset of illness. During July 22nd and 23rd， he was repeatedly exposed during work to the high-risk environment that may have been contaminated by SARS-CoV-2 and had contact with the crew of foreign airlines， and the personal protection was not standardized. None of the 67 close contacts and 567 close contacts of close contacts in Shanghai showed symptoms during the 14-day medical quarantine， and the specimens of them were all negative for SARS-CoV-2 by rRT-PCR. The results of genome sequencing analysis showed that the genomic homology between the virus of the case and the one of recent domestic local epidemic and the recent imported cases was low， and the homology with the overseas Delta mutant strain was higher than that of the domestic Delta mutant strain. ConclusionThe situation of prevention of COVID-19 import is still serious. It is necessary to conduct regular nucleic acid screening for high-risk occupational groups， strengthen the diagnosis and reporting awareness of medical institutions， effectively implement the prevention and control measures for people， objects， and environment at international airports， and further enhance the public's awareness of personal protection.
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Objective@#To describe the spatial and temporal characteristics of human immunodeficiency virus/acquired immunodeficiency syndrome(HIV/AIDS) in permanent residents and migrants in Shanghai during 2005 to 2015 and provide suggestions for the HIV/AIDS prevention.@*Methods@#The data of HIV/AIDS was collected from the National HIV/AIDS Comprehensive Information Management System based on report date. The population data was collected from the statistical yearbook of Shanghai. Spatial analysis was conducted using the hotspots model in ArcGIS. SaTScan software was employed to determine the distribution of HIV clusters in space, time or both.@*Results@#During 2005 to 2015, a total of 13 498 cases of HIV/AIDS were reported in Shanghai. The prevalence of HIV increased from 0.025/105 (450 cases) to 0.093/105 (2 236 cases). The prevalence of AIDS increased from 0.002/105 (32 cases) to 0.028/105 (683 cases). Hotspot analysis showed that the hot spot of incidence of migrants had moved from Hongkou (2005) (Z=2.96, P=0.003) to Changning (2006-2015) (all Z>1.96, P<0.05); whereas the hot spot of incidence of permanent residents had moving from Jinshan (2005-2007) (all Z>2.58, P<0.01) to downtown area (2006-2015) (all Z>1.96, P<0.05). The spatial high clusters of HIV and AIDS were same, including Huangpu, Xuhui, Changning, Jingan, Putuo, Hongkou and Yangpu; The temporal high clusters of HIV cases among permanent residents were 2011 to 2015, and the spatial clusters were Huangpu, Xuhui, Changning, Jingan. The temporal high clusters of HIV cases among migrants were 2014 to 2015, and the spatial clusters was Xuhui, Changning, Jingan.@*Conclusion@#The total HIV/AIDS incidence in Shanghai was clustered in downtown area. The cluster of the incidence of the permanent residents had moving towards that of migrants, indicating the cluster area deserves a close surveillance.
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Objective To describe and analyze the epidemiologic and spatio-temporal characteristics of hepatitis E in China from 2004 to 2014.Methods Data on the incidence of hepatitis E in 31 provinces (municipality and autonomous region) from 2004 to 2014,were collected.Empirical Mode Decomposition (EMD) was applied to decompose the time-series data to accurately describe the trend of hepatitis E incidence.Mathematic model was used to estimate the annual change of incidence in each age group and the whole province.Software ArcGIS 10.1 and SaTScan 9.01 were used to analyze the spatio-temporal clusters.Results During 2004-2014,a total of 245 414 hepatitis E cases were reported in China.The overall incidence showed a slight increase (OR=1.05,95％CI:1.03-1.10).Incidence rates on hepatitis E were discovered different across the provinces,with significant increase appearing in the southern,central and northwestern areas.The highest increase was seen in the elderly,especially in the 65-69 and 70-74 year-olds.Results from the Local spatial autocorrelation analysis showed that the “high-high cluster” was moving from the north to the south and the “low-low cluster” disappeared as time went by.Data from Spatio-temporal scanning showed that there were five spatio-temporal clustering areas across the country.Conclusion The overall incidence of hepatitis E was on the rise from 2004 to 2014,in China,but with differences seen across the areas and age groups.
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Objective To describe and analyze the epidemiologic and spatio-temporal characteristics of hepatitis E in China from 2004 to 2014.Methods Data on the incidence of hepatitis E in 31 provinces (municipality and autonomous region) from 2004 to 2014,were collected.Empirical Mode Decomposition (EMD) was applied to decompose the time-series data to accurately describe the trend of hepatitis E incidence.Mathematic model was used to estimate the annual change of incidence in each age group and the whole province.Software ArcGIS 10.1 and SaTScan 9.01 were used to analyze the spatio-temporal clusters.Results During 2004-2014,a total of 245 414 hepatitis E cases were reported in China.The overall incidence showed a slight increase (OR=1.05,95％CI:1.03-1.10).Incidence rates on hepatitis E were discovered different across the provinces,with significant increase appearing in the southern,central and northwestern areas.The highest increase was seen in the elderly,especially in the 65-69 and 70-74 year-olds.Results from the Local spatial autocorrelation analysis showed that the “high-high cluster” was moving from the north to the south and the “low-low cluster” disappeared as time went by.Data from Spatio-temporal scanning showed that there were five spatio-temporal clustering areas across the country.Conclusion The overall incidence of hepatitis E was on the rise from 2004 to 2014,in China,but with differences seen across the areas and age groups.