Changes of class A and B communicable disease spectrum in Hangzhou, 1950–2018

ObjectiveTo understand the incidence characteristics and epidemic trends of class A and B communicable diseases in Hangzhou from 1950 to 2018, clarify the focus of the prevention and control of epidemics.

MethodsThe epidemic data of class A and B communicable diseases in Hangzhou from 1950 to 2018 were collected from the annual communicable disease reporting forms and "National Notifiable Disease Information Management System". A 10-year period division was used for the related analysis in different period from 1950 to 2018. The incidence trends and case-fatality of class A and B communicable diseases were assessed with χ² test. The spectrum and rank of class A and B communicable diseases in different periods were analyzed.

ResultsFrom 1950 to 2018, the average morbidity rate, average mortality rate and average case-fatality rate of communicable diseases in Class A and B showed a steady decline trend ( χ²_trend＝2 608 369.10, 32 135.20 and 5 953.34, P＜0.001). Compared with 1950–1959 period, the average morbidity rate, mortality rate, and case-fatality rate in 2010–2018 period declined by 89.68%, 98.21%, and 82.20% respectively. The incidences of respiratory infections, intestinal infectious diseases, insect vector-borne diseases, and natural focus infectious diseases in Hangzhou decreased significantly. The incidence rank of class A and B communicable diseases changed greatly in 7 periods. Gonorrhea, syphilis, and tuberculosis have become the diseases in top five diseases replacing measles, malaria, and whooping cough in early periods. HIV/AIDS was only began to report in the latest three periods, but the incidence showed an obvious and consistent increase.

ConclusionThe morbidity rates and mortality rates of class A and B communicable diseases decreased obviously in Hangzhou from 1950 to 2018. The disease spectrum has changed greatly. In the future, close attention should be paid to the prevention and control of sexually transmitted diseases, especially HIV/AIDS, tuberculosis, human infection with avian influenza A (H7N9) virus, and dengue fever etc.