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Articles in press have been peer-reviewed and accepted, which are not yet assigned to volumes/issues, but are citable by Digital Object Identifier (DOI).

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Identification and analysis of three correlated foodborne disease outbreaks caused by Vibrio parahaemolyticus in Shunyi, Beijing
Ying Li, Qing Zhang, Shuang Zhang, Yanchun Zhang, Hongbo Jing, Hongmei Ma, Bo Pang
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ObjectiveTo analyze three foodborne diseases outbreaks caused by Vibrio parahaemolyticu in Shunyi district of Beijing.MethodsThe epidemiological data, isolated pathogens from suspected contaminated food samples, environment samples and stool samples of diarrheal disease patient of three outbreaks were collected. Isolated V. parahaemolyticus strains were used for the molecular typing by  pulsed field gel electrophoresis(PFGE). The PFGE patterns were aligned analyzed by using China Pathogen Identification Net (PIN).ResultsFifteen V. parahaemolyticus strains(O3: K6, toxR+/tdh+/trh-)were isolated from 12 clinical samples of diarrhea patients and 3 suspected contaminated food samples. The PFGE patterns of the strains were divided into 2 closely related clusters. The patterns in each cluster shared 100% similarity, and the similarity of clusters between 2 patterns was 93.94%. These PFGE patterns of V. parahaemolyticus were not in the clusters detected in Shunyi from 2014 to 2017 according to China PIN.ConclusionThe 3 foodborne disease outbreaks caused by V. parahaemolyticus had common infection source. China PIN is a powerful tool for the detection and source tracing and correlation analysis of foodborne disease outbreaks.
Surveillance for death causes in residents in Yuyao, 2014－2017
Shanshan Shi, Yafeng Shi, Zhe Shao
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ObjectiveTo understand the epidemiological characteristics of deaths in residents in Yuyao, Zhejiang province, and provide scientific evidence for the prevention and control of injury.MethodsThe death surveillance data in residents in Yuyao from 2014 to 2017 were collected and the death causes were classified according to the International Classification of Diseases, 10th edition (ICD-10). The average mortality rate, standardized average mortality rate, potential years of life lost (PYLL), average years of life lost (AYLL) and the rate of PYLL were calculated.ResultsFrom 2014 to 2017, the average mortality rate was 739.95/100 000, and the standardized average mortality rate was 435.49/100 000. The average annual crude mortality rate was 832.53/100 000 and the standardized mortality rate was 484.60/100 000 for males. The average annual crude mortality rate was 649.51/100 000 and the standardized mortality rate was 386.28/100 000 for females. The overall mortality rate of males was higher than that of females (χ2＝381.589, P＜0.001); The first five death causes were malignant tumor (234.41/100 000), respiratory disease (136.09/100 000), cerebrovascular disease (99.82/100 000), heart disease (90.47/100 000) and injury (74.33/100 000). The death caused by the first 5 death causes accounted for 85.84% of the total. For the first 5 death causes, the PYLL was 79 305.00 person years, the average PYLL was 13.01 person years, and the rate of PYLL was 24.49‰. Injury caused greatest loss of life.ConclusionMalignant tumor was one of leading causes of deaths in Yuyao, causing great loss of life expectancy. The overall mortality rate of males was higher than that of females. Comprehensive disease control measures should be taken for different groups of people.
Survey of a brucellosis outbreak and risk factors in a dairy farm
Dan Wu, Wenzeng Zhang, Yuxin Ma, Yang Zheng, Hongxia Li, Guangyi Hu
Accepted Manuscript
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ObjectiveTo understand the causes of a brucellosis outbreak and associated risk factors in a dairy farm in 2017.MethodsAll the workers in the dairy farm were surveyed by using a self-administrated questionnaire in face to face interviews. For each worker, blood sample was collected for tube agglutination test.ResultsA total of 99 workers were surveyed. Twelve workers were positive in serological tube agglutination test, and the infection rate in milkers was highest (5/20, 25.00%). Nine brucellosis cases were confirmed. The cases were aged between 23 and 55 years, the main clinical symptoms were joint or muscle pain and fatigue without fever; and the antibody titers of 3 latent infection cases were all 1∶100++. Risk factors associated with brucellosis were contact with livestock apoblema（RR＝3.73, 95% CI: 1.07–7.27）, contact with sick cattle（RR＝4.07, 95% CI: 1.07–7.33）, vaccinating livestock（RR＝9.11, 95% CI: 1.37–21.22）, repeated use of gloves（RR＝5.09, 95% CI: 1.16–14.63）.ConclusionExposure to livestock apoblema, vaccinating livestock and repeated use of gloves might be main risk factors for brucellosis in the workers. It is necessary to strengthen the prevention and control of animal brucellosis epidemic and health education about brucellosis in occupational groups. Close attention should be paid to the supervision of milk production process.
Analysis on spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu, 2012–2017
Weimin Lyu, Kongfu Wei, Pinggui Wang, Yu'an Ma
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ObjectiveTo analyze the spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu province and provide evidence for the prevention and control of hepatitis B.MethodsThe incidence data of hepatitis B in Gannan from 2012 to 2017 was used to calculate the global Moran’s I and local G statistics and analyze its spatial-temporal distribution characteristics.ResultsThe incidence of hepatitis B showed spatial autocorrelation（P＜0.05）from 2012 to 2017, and local autocorrelation analysis indicated that the hot spots areas identified were mainly in some townships of Xiahe, Luqu. Maqu, Zhuoni and Hezuo, while the cold spots areas were mainly in some townships of Zhouqu, Diebu, Zhuoni, Lintan and Hezuo. Spatial-temporal analysis showed that the most likely clustering areas of incidence of hepatitis B were in some townships of Xiahe during 2012–2014 (RR＝3.50, LLR＝219.24, P＜0.001) and some townships in Luqu in 2016 (RR＝6.91, LLR＝198.61, P＜0.001）, followed by some townships of Lintan and Zhuoni during 2012–2013 (RR＝1.79, LLR＝70.41, P＜0.001).ConclusionThe incidence of hepatitis B showed spatial and spatial-temporal clustering in Gannan from 2012 to 2017. Targeted prevention and control measures should be taken according to the spatial distribution of the disease.
Epidemiology of viral hepatitis C in Qinghai, 2013−2017
Shicun Dong, Guanglan Pu, Weijun Wang, Ming Fan, Yulan Sun, Jiping Li, Yongcheng Ma, Yan Shi
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ObjectiveTo understand the epidemiological characteristics of viral hepatitis C in Qinghai province from 2013 to 2017.MethodsDescriptive epidemiological analysis was conducted by using the incidence data of hepatitis C collected from National Notifiable Disease Surveillance System.ResultsA total of 10 989 cases of hepatitis C were reported from 2013 to 2017. The annual reported incidence rate was 37.67/100 000, the male to female ratio of the cases was 1.18∶1. The cases were reported in all age groups, but the cases in age group 40- years accounted for 42.17%, and the disease mainly reported in Xining, Haidong and Yushu. The cases were mainly reported by medical institutions at provincial level, accounting for 69.53%. The disease occurred all the year round with no obvious seasonality.ConclusionThe incidence of hepatitis C was stable in Qinghai in recent years, but the incidence level was higher than other provinces. It is necessary to strengthen the prevention and control of hepatitis C.
Investigation on an outbreak of dengue serotype 1 virus in Xishuangbanna prefecture of Yunnan province, China, 2017
Jianhua Fan, Yun Feng, Jin Zhu, Hongbin Li, Yang Gao, Weiping Li, Yinghua Dao, Jing Zhang, Jianhong Zou, Junming Li, Yihanyu Rong, Hailin Zhang
Accepted Manuscript
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ObjectiveTo understand the epidemiologic, virologic and genetic characteristics of an outbreak of dengue fever in Xishuangbanna prefecture of Yunnan province in 2017.MethodsThe incidence data of dengue fever in Xishuangbanna were collected. The serum samples from acute patients were collected to detect the nucleic acid of dengue virus by RT-PCR assay. Coding regions of C/prM and E genes of dengue virus were amplified by RT-PCR and sequenced. The phylogenetic tree was constructed by Neighbor-Joining methods of MEGA 5.0 software.ResultsA total of 1 348 laboratory confirmed dengue fever cases were reported in Xishuangbanna in 2017, in which 1 231 were indigenous cases (91.32%), 117 were imported cases (8.68%). Imported cases from Laos and Myanmar were reported in Jinghong, Mengla and Menghai counties of Xishuangbanna, and indigenous cases occurred in Jinghong (1 030, 83.67%) and Mengla (201, 16.33%). The epidemic of dengue fever lasted from May to December. The majority of patients were aged 20－54 years, the youngest was 2 year-old and the oldest was 89 year-old. The male to female ratio of the cases was 1∶1.16. Phylogenetic analysis on nucleotide sequences of C/PrM of 48 virus strains obtained from the serum samples of dengue fever cases indicated that the 46 strains belonged to dengue virus serotype 1 (DENV-1), in which 33 from Jinghong, 10 from Mengla and 3 from Menghai and 2 strains belonged to dengue virus serotype 2 (DENV-2), in which 1 from Mengla and 1 from Menghai. The DENV-1 strains from imported cases of Laos shared high homology with the strains from indigenous cases. These DENV-1 strains from Xishuangbanna had closer geneticrelationship with the DENV-1 strains isolated from Ruili county of Dehong prefecture and Gengma county of Lincang prefecture of Yunnan and the countries of southeastern Asia in recent years.ConclusionsThe dengue fever epidemic occurred in Xishuangbanna in 2017 was mainly caused by DENV-1. The imported dengue fever cases from Laos were the main sources for the indigenous transmission of dengue fever in Xishuangbanna. It is necessary to strengthen control of the cross-border spread of dengue fever in this area.
Classification and regression tree model study on correlation between influenza epidemic and meteorological factors in different areas of Gansu
Xiaoting YANG, Dongpeng LIU, Jian HE, Faxiang GOU, Haixia LIU, Yunhe ZHENG, Kongfu WEI, Yao CHENG, Xinfeng LIU
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Objective To explore the influence of meteorological factors on the influenza epidemic intensity in Gansu province and provide scientific evidence for the improvement of timeliness of influenza prevention and control. Methods Three surveillance areas were selected, i.e. Baiyin, Tianshui and Jiuquan. The influenza surveillance data and meteorological data of the three areas were collected, and the lag time of various meteorological factors on the incidence of influenza was analyzed by cross correlation analysis. Classification and regression tree (CART) was used model to select the meteorological factors which had the greatest impact on the epidemic intensity. Results Meteorological factors correlation studies showed that temperature and humidity were negatively correlated with influenza epidemic intensity. The influenza epidemic intensity in Tianshui increased by 1.89 times when the 3 weeks moving average of maximum temperature was below 19.11℃; the influenza epidemic intensity in Jiuquan increased by 2.01 times when the 3 weeks moving average of average temperature was below 8.03℃; the influenza epidemic intensity of Baiyin increased by 2.24 times when the 3 weeks moving average of average temperature was below 8.68℃ and the 14 weeks moving average of relative humidity was below 61.04%. Conclusion Meteorological factors could affect the incidence of influenza, cold and dry weather would be suitable for the spread of influenza in population
Drug resistance detection and pulsed-field gel electrophoresis typing of Shigella sonnei isolated in case-based surveillance in Sichuan, 2007–2017
Gaopeng Lei, Hong Lyu, Yulan Huang, Weifeng Huang, Xiaorong Yang
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Objective To understand the drug resistance and pulsed-field gel electrophoresis (PFGE) patterns of Shigella sonnei strains isolated from sporadic diarrhea cases in surveillance in Sichuan province during 2007–2017. Methods A total 30 S. sonnei strains isolated from diarrhea patients were analyzed by PFGE and tested for minimal inhibitory concentration (MIC) of 14 antibiotics after the serological and biochemical identification. Results The antibiotic resistance test indicated all the isolates were only sensitive to cefoxitin, while 96.67% of the strains were multi-drug resistant. The resistance rates to azithromycin and ciprofloxacin were more than 10%. The resistance to 7 common antibiotics, including cefotaxime, reached more than 50%. PFGE typing showed that strains had 16 patterns and two predominant clusters which accounted for 80%, and other types accounted for 20%. A suspected outbreak caused by SCSN-1 and SCSN-3 from cluster I was detected respectively. Conclusion S. sonnei isolated in Sichuan from 2007 to 2017 had two predominant PFGE clusters and partial subtype showed clustering. The strains had high drug resistance, some of which showed resistance to common antibiotics used in the treatment of bacterial diarrhea, such as ciprofloxacin, azithromycin and cefotaxime.
Analysis on measles antibody level in healthy population in Dali Bai autonomous prefecture, Yunnan, 2012–2018
Yanjun Liu, Zuo He, Ran Xu, Fang Guan
Accepted Manuscript
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Objective To understand the measles antibody level in healthy population in Dali Bai autonomous prefecture of Yunnan province during 2012−2018 and provide scientific evidence for the elimination of measles. Methods Blood samples were collected annually from healthy populations in 8 age groups selected through stratified random sampling, a total of 28 459 blood samples were collected. Serum measles IgG was detected by using enzyme linked immunosorbent assay (ELISA). Results The differences in annual positive rate of measles IgG in healthy population were significant. The positive rate was lowest in 2016 (89.6%) and highest in 2013 (97.3%). The positive rate was ＞90% in other years. The differences in the positive rate were significant among different age groups (P＜0.05). The positive rate was lower in age groups 8−17 months and 25−34 years. There were significant differences in the positive rate and antibody geometric mean concentration (GMC) among people receiving different doses of measles containing vaccine (P＜0.05). The GMC was highest in people receiving 3 doses of measles vaccination (1 921.1 mIU/ml). Conclusion The immunity barrier has been basically formed in Dali, the possibility of measles outbreak is low, but close attention should be paid to the potential risk of measles in adults. It is necessary to conduct supplementary immunization activity in order to increase population antibody level and reduce the incidence of measles.
Spatial-temporal distribution characteristics of hand，foot and mouth disease in Jingzhou, Hubei, 2008–2017
Menglei Yao, Tian Liu, Li Wang, Shuqiong Huang, Jing Cai, Wenwen Yang, Ran Wu
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Objective To analyze the spatial-temporal distribution characteristics of hand foot and mouth disease (HFMD) in Jingzhou, Hubei province, from 2008 to 2017, and provide evidence for the prevention and control of HFMD. Methods The global and local autocorrelation analyses on the spatiotemporal clustering of the incidence data of HFMD at street/township scale in Jinzhou during this period were performed by using software ArcGIS 10, and the spatiotemporal clustering analysis on the incidence data of HFMD was performed by using software SaTScan 9.4. Results A total of 53 159 cases were reported in Jingzhou from 2008 to 2017, with an average annual incidence rate of 91.59/100 000. Spatial autocorrelation analysis showed that the incidence rate of HFMD had positive spatial correlation. The incidence rate of HFMD had obvious spatiotemporal clustering characteristics, the main clustering area was found in the central urban area of Jingzhou and adjacent counties and townships. Conclusion Understanding the spatial and temporal distribution and spatial clustering characteristics of the incidence data of HFMD at street/township scale in Jingzhou has important public health significance for the allocation of public health resources, effective prevention and control of HFMD.
Incidence trend and characteristics of cerebral infarction in residents in Tianjin, 2010－2016
Xiaodan Xue, Dezheng Wang, Ying Zhang, Wei Li, Chengfeng Shen, Shuo Pang, Guohong Jiang
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Objective To investigate the incidence trend and characteristics of cerebral infarction in residents in between 2010 and 2016, analyze the incidence differences in population with different characteristics, and provide evidence for the prevention and control of cerebral infarction. Methods The data of new cerebral infarction cases between 2010 and 2016 were collected from Tianjin Cerebral Infarction Surveillance System. The incidence of cerebral infarction and its distribution in different age groups, gender groups and urban or rural areas was analyzed. The population data based on the Sixth National Population Census in 2010 were used for standardized rate estimation. Difference among different groups was compared with χ2 test. The χtrend2 test was used to analyze the incidence trend with years and in different age groups. The change the incidence during this period and prediction of the incidence during 2017–2020 were analyzed by using Joinpoint software. Results The average age of initial cerebral infarction was 65.50 years, the smoking rate was 32.18%, and the recurrent rate was 34.01%. The incidence rate of cerebral infarction in Tianjin increased gradually from 2010 to 2016 with the crude incidence rate ranging from 379.70/100 000 to 583.64/100 000, and with the standardized incidence rate ranged from 212.40/100 000 to 291.52/100 000 (P＜0.000 1). The increase in rural area was more obvious. The incidence rate was consistently higher in male residents (the crude incidence: 450.17/100 000–698.82/100 000, the standardized incidence rate: 249.20/100 000–350.34/100 000) than in female residents (the crude incidence rate: 308.44/100 000–467.87/100 000, the standardized incidence rate: 174.48/100 000–232.85/100 000, allP＜0.001). And in all age groups, the incidences in men were higher than in women (P＜0.001). According to the prediction, the incidence of cerebral infarction in Tianjin will reach 808.58/100 000, and the standardized incidence of the disease will be 371.03/100 000 by 2020. Conclusions The incidence of cerebral infarction increased during the past 7 years. There was no turning point for decrease, and the increasing trend was more obvious in rural areas and in men. Attention should be paid to the disease and targeted interventions should be taken to reduce the incidence of cerebral infarction.
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CONTENTS IN BRIEF
2019, 34(3).
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2019, 34(3).
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National Data of Class A, B and C Communicable Diseases in February 2019
2019, 34(3): 189-189. DOI: 10.3784/j.issn.1003-9961.2019.03.001
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Summary of National Data of Class A, B and C Communicable Diseases in China, February 2019
2019, 34(3): 190-190. DOI: 10.3784/j.issn.1003-9961.2019.03.002
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Summary of global surveillance data of communicable diseases in February 2019
Hui Han, Bo Wu, Yajing Song, Meijuan Liu
2019, 34(3): 191-194. DOI: 10.3784/j.issn.1003-9961.2019.03.003
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In February 2019, a total of 46 kinds of communicable diseases were reported globally, affecting 63 countries or areas. The first five diseases in terms of number of countries or areas affected were dengue fever (33), measles (18), Chikungunya fever (9), cholera (6) and legionellosis (6). The first three diseases with high case fatality rates were Ebola hemorrhagic fever (62.7%), Middle East respiratory syndrome (34.7%) and Lassa fever (21.8%). The first five diseases with high death number were measles, cholera, Ebola hemorrhagic fever, Lassa fever and dengue fever. The epidemics of cholera, Ebola hemorrhagic fever, yellow fever, Lassa fever and measles mainly occurred in Africa, the epidemics of dengue fever, Middle East respiratory syndrome and measles mainly occurred in Asia, the epidemics of dengue fever and measles mainly occurred in America and the epidemics of measles mainly occurred in Europe.
Risk assessment of public health emergencies concerned in the mainland of China, March 2019
Ling Meng, Dayan Wang, Tao Chen, Miao Jin, Chao Ma, Dan Li, Zhiheng Hong, Wenxiao Tu, Nijuan Xiang, Guoqing Shi, Qun Li
2019, 34(3): 195-198. DOI: 10.3784/j.issn.1003-9961.2019.03.004
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ObjectiveTo assess the risks of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in March 2019.MethodsAn internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this meeting through video terminal.ResultsGenerally speaking, it is predicted that the incidence of public health emergencies would be higher in March than in February 2019, which might be dominated by the epidemics of varicella, seasonal influenza, mumps, other infectious diarrheal diseases and hand foot and mouth disease. The activity of seasonal influenza would continue to decrease, but clusters and outbreaks would still occur. The incidence peak of diarrhea epidemics caused by norovirus in schools might occur. The incidence of rubella would continue to increase. Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo would continue, however, the risk of spread to China is low.ConclusionClose attention should be paid to seasonal influenza, and general attention should be paid to norovirus caused diarrhea, rubella and EVD in the Democratic Republic of Congo.
本期特邀专题主持人——张周斌主任医师
2019, 34(3): 199-199.
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Deaths and death causes in residents of Shufu county of Xinjiang, 2017
Yan Li, Zhenxiang Xue, Hang Dong, Jun Yuan, Yuzhong Wang, Huazhang Liu, Ayxamgul·Bawudun, Guozhen Lin, Qiongying Yang, Yuanyuan Chen, Zhoubin Zhang, Zhicong Yang
2019, 34(3): 200-204. DOI: 10.3784/j.issn.1003-9961.2019.03.005
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ObjectiveTo understand the death pattern and causes in residents of Shufu county of Xinjiang, and provide scientific evidence for the development of comprehensive disease prevention measures.MethodsThe incidence data of deaths in local residents in Shufu in 2017 were collected to calculate the mortality rate and life expectancy, constituent ratio of death causes and potential years of life lost (PYLL). A sampling retrospective survey was conducted to understand the causes of deaths.ResultsA total of 1 623 death cases were reported in Shufu in 2017 and the mortality was 5.69 ‰, the standardized mortality rate was 6.90‰. The life expectancy was 71.40 years old (69.36 years old for males and 74.03 years old for females). The first 6 death causes were heart disease (20.09%), cerebrovascular disease (14.20%), communicable diseases/parasitosis (14.09%), injury (13.74%), cancer (11.66%) and respiratory diseases (7.62%), accounting for 81.41% of total death cases. Injury, cancer and perinatal diseases were the first 3 death causes with high PYLL, the rates of PYLL were 40.00%, 10.15%, 9.10%, respectively.ConclusionChronic and non-communicable diseases were the major causes of deaths in local residents in Shuhu, but communicable diseases, such as tuberculosis, also took a high proportion in constituent ratio of death causes. Injury was the main reason of early deaths in children and young adults. Comprehensive measures should be taken in disease prevention and control to improve people’s health and life expectancy.
Incidence of cardiocerebral vascular disease death and its influence on life expectancy in residents of Shufu county of Xinjiang, 2017
Qiongying Yang, Zhenxiang Xue, Yan Li, Hang Dong, Huazhang Liu, Yuzhong Wang, Bawudun Ayxamgul·, Dongmei Luo, Xin Yan, Zhuomin Wei, Yuanyuan Chen, Zhoubin Zhang, Zhicong Yang
2019, 34(3): 205-210. DOI: 10.3784/j.issn.1003-9961.2019.03.006
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ObjectiveTo analyze the incidence of cardiocerebral vascular disease death and its effects on life expectancy in residents of Shufu county of Xinjiang, and provide evidence for the prevention and control of cardiocerebral vascular disease.MethodsThe death data of the residents in Shufu in 2017 were obtained from multi-departments. Verbal Autopsy Scale was used to investigate the bereaved or the insider selected through multistage sampling, and the cardiocerebral vascular disease mortality rate, the death cause rank and the life expectancy without cardiocerebral vascular disease death were calculated.ResultsIn 2017, the crude mortality rate and standard mortality rate of cardiocerebral vascular disease were 195.00/100 000 and 253.30/100 000 respectively, the two rates were 219.43/100 000 and 290.28/100 000 respectively in males and 169.70/100 000 and 226.31/100 000 respectively in females. The mortality rate of cardiocerebral vascular disease increased with age, especially after the age of 65 years. The incidence of cardiocerebral vascular disease death had obvious seasonality, which reached the peaks in March-April and November-December. Other coronary heart disease (37.93%) and acute myocardial infarction (32.76%) were the leading death causes for cardiovascular disease, and hematencephalon (47.97%) and sequelae of cerebrovascular disease (25.20%) were the leading death causes for cerebrovascular diseases. After eliminating causes of cardiocerebral vascular disease death, the life expectancy increased from 71.40 years to 77.98 years in local residents. Life expectancy for eliminating causes of cardiocerebral vascular disease death in males and females increased by 5.84 years and 8.06 years, respectively.Conclusioncardiocerebral vascular disease was the leading cause of death in Shufu. It is important to develop prevention and control measures for high-risk groups to improve the life expectancy.
Causes of injury deaths in residents of Shufu county, Xinjiang, 2017
Yuanyuan Chen, Yan Li, Zhenxiang Xue, Nuermaimaiti Naizibanmu·, Xin Yan, Hang Dong, Qiongying Yang, Fanghua Liu, Zhuomin Wei, Huazhang Liu, Zhoubin Zhang, Zhicong Yang
2019, 34(3): 211-215. DOI: 10.3784/j.issn.1003-9961.2019.03.007
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ObjectiveTo analyze the characteristics of injury-related deaths in residents of Shufu county in Xinjiang and provide evidence for the development of strategies for injury prevention.MethodsThe incidence data of deaths in local residents in Shufu in 2017 were collected to calculate the mortality rate, constituent ratio of death causes and potential years of life lost (PYLL). A sampling retrospective survey was conducted to understand the causes of deaths. ResultsA total of 866 death cases were analyzed. The crude death rate of injury was 78.13/100 000, accounting for 13.74% of all deaths. The standardized injury death rate was 79.20/100 000. The crude death rate of injury was 107.13/100 000 in males and 48.10/100 000 in females respectively. The standardized injury death rate was 112.99/100 000 in males and 44.19/100 000 in females respectively. The years of potential life lost (YPLL) of injury was 3978 person years, accounting for 40.00% of all death cause YPLL. The first three leading causes of injury deaths were traffic accident, accidental fall and drowning. Injury was the first cause of death for people aged 1–44 years. Accidental drowning, drowning with unknown intention and traffic accident were the first three leading causes of injury deaths in age group 1–4 years. Accidental drowning was the leading cause of injury-related deaths in age group 5–14 years. Traffic accident, suicide and accidental fall were the first three leading causes of injury deaths for people aged 15–44 years. Traffic accident and accidental fall were the leading causes of injury deaths for people aged 45–64 years. Accidental fall, traffic accident and struck by falling objects were the first three leading causes of injury deaths for people aged ＞64 years.ConclusionThe death rate of injury and the potential years of life lost (YPLL) of injury in residents of Shufu were higher compared with other areas in China. Children and young adults were mainly affected. Injury death have led to a great loss of life expectancy and labor force and became a major public health problem in Shufu. It is necessary to develop targeted injury prevention and control measures for different age groups in Shufu.
Mortality of communicable disease in residents of Shufu county of Xinjiang, 2017
Hang Dong, Yan Li, Zhenxiang Xue, Huazhang Liu, Yuzhong Wang, Qiongying Yang, Nuermaimaiti Naizibanmu ·, Yuanyuan Chen, Zhoubin Zhang, Zhicong Yang
2019, 34(3): 216-220. DOI: 10.3784/j.issn.1003-9961.2019.03.008
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ObjectiveTo understand the mortality and category of communicable diseases in residents of Shufu county of Xinjiang in 2017, and provide evidence for the reasonable distribution of health resource.MethodsThe incidence data of deaths in local residents were obtained from related departments. Multistagesampling was conducted to select families for a household interview of bereaved family members or insiders by using " Death Cause Survey Scale”. The mortality rates of communicable diseases and the constituent ratio and rank of the death causes were calculated.ResultsThe crude mortality rate and the standardized mortality rate of communicable disease were 80.10/100 000 and 107.77/100 000, respectively, in Shufu in 2017, ranking third in all death causes. The crude mortality rate and the standardized mortality rate of pulmonary tuberculosis (TB) were 75.50/100 000 and 103.45/100 000 respectively, ranking first in all communicable diseases. In both men and women, the deaths caused by TB mainly occurred in the elderly aged ≥65 years with the mortality rate of 1 118.92/100 000, accounting for 82.61% of total TB deaths. The TB deaths mainly occurred in farmers and those with low education level and 82.61% of the TB deaths occurred at home. Autumn and winter were the high incidence seasons.ConclusionsThe mortality of communicable diseases in Xinjiang Shufu was serious. It is necessary to strengthen the prevention and control of TB by improving health education and timely detection/thorough treatment of TB cases.
Mortality of malignant tumors of residents in Shufu county of Xinjiang, 2017
Zhenxiang Xue, Fanghua Liu, Yan Li, Hang Dong, Bawudun Ayxamgul·, Dongmei Luo, Qiongying Yang, Yuanyuan Chen, Zhoubin Zhang, Zhicong Yang
2019, 34(3): 221-225. DOI: 10.3784/j.issn.1003-9961.2019.03.009
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ObjectiveTo understand the mortality of malignant tumors of residents in Shufu county of Xinjiang and provide evidence for the local prevention and control of malignant tumor.MethodsThe incidence data of deaths in local residents in Shufu in 2017 were collected to calculate the mortality rate and constituent ratio of death causes. A sampling retrospective survey was conducted to understand the causes of deaths. ResultsIn 2017, the mortality rate of malignant tumor was 66.31/100 000 and the standardized mortality rate was 82.05/100 000 in residents in Shufu. The first five malignant tumors were esophageal cancer (mortality rate: 16.41/100 000), accounting for 24.75% of the total, followed by gastric cancer, lung cancer, leukemia and liver cancer, accounting for 17.82%, 6.93%, 5.94% and 4.95% of the total respectively. Before the age of 30 years, the mortality rate of malignant tumor was low. After the age of 30 years, the mortality rate of malignant tumor increased with age, the peak was in age group 65–70 years, accounting for 21.78% of the total malignant tumor deaths. After the age of 70 years, the mortality rate of malignant tumor declined with age.ConclusionIn 2017, malignant tumor was the fifth cause of death in residents in Shufu; esophageal cancer was the first cause of death of malignant tumor. It is urgent to take effective measures to strengthen the prevention and control of malignant tumors to reduce the death rate of malignant tumors in Shufu.
Characteristics of patients with Creutzfeldt-Jakob disease in China, 2017
Jing Wang, Wei Zhou, Kang Xiao, Yuan Wang, Xiaoping Dong, Qi Shi
2019, 34(3): 226-231. DOI: 10.3784/j.issn.1003-9961.2019.03.010
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ObjectiveTo describe epidemiological and clinical characteristics of patients with Creutzfeldt-Jakob disease (CJD) patients in 12 provinces in China in 2017.MethodsThe clinical and epidemiological information of CJD patients obtained from China CJD surveillance network were analyzed. Brain tissue, blood and/or cerebral spinal fluid (CSF) specimens were collected from these patients. Immunohistochemistry study was applied to detect cerebral pathogen PrPSc, Western blot assay was conducted for detecting 14-3-3 protein in CSF, and PCR and sequencing were performed for analyzing the polymorphism of 129 and 219 amino acid and mutation of PRNP gene.ResultsA total of 1 definite CJD cases (0.20%), 224 probable CJD cases (44.44%) and 14 possible CJD cases (2.78%), 20 genetic CJD cases (3.97%), 10 fatal familial insomnia (FFI) cases (1.98%), and 3 GSS cases (0.60%) were identified. The cases occurred sporadically without clustering in time, place and population distributions. The median age of probable CJD patients was 62 years (33, 91 years old), the ratio of male to female was 1.06∶1. The median age of possible CJD patients was 65 years (40, 81 years old), the ratio of male to female was 1∶1. Rapidly progressive dementia was the major initial symptom. The probable CJD cases with more positive results in electroencephalogram (EEG), MRI and detection of 14-3-3 protein in CSF showed more typical clinical symptoms. Among 478 cases, 472 were M/M in allele 129, and 470 were E/E in allele 219. As of September 30, 2018, the analysis results of the survival time of probable sporadic CJD cases, genetic CJD cases, FFI cases and GSS cases in 2017 were consistent with the features of the reported clinical course of CJD worldwide.ConclusionCJD occurred sporadically in China in 2017. The time, place and population distributions, gender ratio and the average onset age of the CJD cases were consistent with the general characteristics of CJD cases in the world.
Molecular characteristics of Clostridium difficile infection in diarrhea inpatients in Fuyang district of Hangzhou, Zhejiang
Youping Huang, Xuhua Jin, Julian Ye, Yun Luo, Jun Li, Xiaojun Song, Chen Huang, Dazhi Jin
2019, 34(3): 232-236. DOI: 10.3784/j.issn.1003-9961.2019.03.011
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ObjectiveTo investigate current infection status of Clostridium difficile in hospitalized patients with diarrhea in Fuyang district of Hangzhou, Zhejiang province. Molecular characteristics of C. difficile isolates and risk factors of the patients were analyzed.MethodsA total of 228 stool samples were collected the diarrhea patients in our hospital from May 2017 to February 2018. C. difficile strains isolation and identification were performed by using anaerobic culture. The isolates were typed by multilocus sequence typing. The antibiotic resistance test was performed by using agar dilution assay. The clinical data were statistically analyzed.ResultsForty one strains of toxigenic C. difficile were isolated from 228 stool samples, in which 31 strains of C. difficile were from patients with hospital acquired diarrhea. The average age of the patients was 67.8 years, the patients were mainly from departments of gastroenterology (34.1%) and nephrology (19.5%). ST2, ST3 and ST54 were the major sequence types. All the isolates were sensitive to metronidazole, vancomycin, tetracycline, and piperacillin. The results of clinical data analysis showed that more diarrhea patients who were aged ＞60 years, had underlying diseases and used antibiotics within 8 weeks were infected with C. difficile（χ2＝4.229, 9.022, 5.767, P＝0.023, 0.001, 0.009）.ConclusionC. difficile infection mainly occurred in hospitalized diarrhea patients in Fuyang. Old age, underlying disease and antibiotic use within 8 weeks were the risk factors for C. difficile infection. This study indicated that C. difficile surveillance needs to be further strengthened in the prevention and control of nosocomial infection.
Plague epidemiology in natural plague foci in Yulong, Yunnan, 2005–2017
Zhengxiang Liu, Wenfeng Cai, Zongti Shao, Xingde Duan, Zihou Gao
2019, 34(3): 237-240. DOI: 10.3784/j.issn.1003-9961.2019.03.012
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ObjectiveTo understand of plague epidemic trend in Yulong natural plague foci in Lijiang prefecture of Yunnan province during 2005–2017 and provide evidence for the prevention and control of plague in Yulong plague foci.MethodsBy using descriptive epidemiological methods, we analyzed the time, population and area distributions and epidemic trend of animal and human plague in Yulong county and Gucheng district during this period.ResultsDuring 2005–2017, plague epidemic was very active in Yulong plague foci distributed in the Luzi village of Nanxi village committee of Huangshan township in Yulong county, and Mushu village of Houshan village committee of Qihe township in Gucheng district. The epidemic and incidence peak mainly occurred during April-May. In the past 13 years, 13 epidemic foci in 8 plague epidemics were found, and in a human plague epidemic occurred in 2005, five pneumonic plague cases were diagnosed, including 2 deaths.ConclusionSince the confirmation of Yulong plague foci, the plague epidemic in animals has been active and continuous. It is necessary to strengthen the surveillance for plague and make timely response to the animal epidemic to prevent the plague spread from animals to human.
Epidemiological and etiological characteristics of hand foot and mouth disease in Tongzhou district of Beijing, 2009−2017
Qiuhong Li, Zhiyong Gao, Hongjun Li, Yanna Yang, Lixin Chen, Ranran Zheng, Lu Xi
2019, 34(3): 241-245. DOI: 10.3784/j.issn.1003-9961.2019.03.013
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ObjectiveTo analyze the epidemiological and etiological characteristics of hand foot and mouth disease (HFMD) in Tongzhou district of Beijing from 2009 to 2017 and provide evidence for the prevention and control of HFMD.MethodsData of hand foot and mouth disease (HFMD) reports in Tongzhou district in recent 9 years were collected, and descriptive epidemiological methods were used to analyze the epidemiological and pathogenic data of HFMD.ResultsDuring the 9 years , 29 809 cases of HFMD disease were reported in Tongzhou district, with an average annual incidence of 276.04/100 000, showing a downward trend, the number of cases was high every other year. The incidence peak was from May－July. The western and northern regions have a high average annual incidence, and the top three are Majuqiao town, Liyuan town and Zhangjiawan town. The sex ratio of males and females was 1.45∶1, the cases were concentrated in the age group of 5 years old, accounting for 91.23%. In 2010, the highest proportion of serious illness case of illness, reaches 0.54%, then gradually decreased (χ2＝–6.864, P＜0.001). The composition of pathogens over the years is different (χ2＝285.149, P＜0.001), and the dominant strains are seasonally changing.ConclusionThe incidence and proportion of severe cases of HFMD showed decline trends in Tongzhou district, and the seasonal, age and area distributions of the cases were observed. The predominant pathogens varied with season and year. It is necessary to further strengthen HFMD surveillance, health education and etiological detection. Effective comprehensive HFMD prevention and control measures should be taken in key season, area and population during the epidemic season.
Investigation of vector and host infection of lyme disease in Jinghong, Yunnan
Cunjuan Duan, Ying Guo, Xuexia Hou, Shanshan Dong, Lin Zhang, Qin Hao, Peng Wang
2019, 34(3): 246-250. DOI: 10.3784/j.issn.1003-9961.2019.03.014
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ObjectiveTo understand the infection status and pathogenic characteristics of lyme disease in rats and ticks in Jinghong county of Yunnan province.MethodsIn March 2018, the specimens of ticks were collected from 7 villages in Jingne and Dadugang townships of Jinghong, and divided into two groups. The specimen in one group were used to culture Borrelia burgdorferi with BSK-Ⅱ medium and the specimen in another group were used to extract DNA for detection of carrier rate. The kidney and bladder specimens of rats were collected from 4 villages in Menghan, Mengyang, Gasa and Jingne townships to culture pathogens and extract DNA. The DNA samples were detected by real-time PCR for the recA gene. The positive samples of recA gene were detected by nested PCR for 5S–23S rRNA gene spacer, and the amplified products were sequenced and compared with sequence homology.ResultsA total of 724 Boophius microplus and 35 Rattus flavipectus were captured, but no B. burgdorferi strains were isolated from 524 ticks and 35 rats. Three of 200 ticks were positive for recA gene, while 35 rats were negative. The 5S–23S rRNA sequence homology analysis of the three positive specimens showed that they belonged to B. garinii.ConclusionThere was infection of B. garinii in ticks in Jinghong, and Boophius microplus might be the vector. Therefore, the surveillance in local population, host and vector should be strengthened.
Epidemiological characteristics of acute hepatitis B in Gansu, 2005–2016
Pinggui Wang, Lijie Zhang, Guomin Zhang, Jian He, Xiaoshu Zhang, Jing An
2019, 34(3): 251-253. DOI: 10.3784/j.issn.1003-9961.2019.02.015
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ObjectiveTo understand the epidemiological characteristics and changing trend of acute hepatitis B in Gansu province from 2005 to 2016, and provide evidence for the development of prevention and control measures in the future.MethodsThe incidence data of acute hepatitis B cases from 2005 to 2016 in Gansu province were obtained from the national disease prevention and control information system of China.ResultsFrom 2005 to 2016, the reported incidence rate of acute hepatitis B in Gansu Province showed a downward trend, which dropped from 17.7/100 000 in 2005 to 5.2/100 000 in 2016, a decline of 70.6%. In recent years, the reported incidence rates of acute hepatitis B in Gannan and Linxia prefectures (15.0/100 000 and 14.0/100 000 respectively) were significantly higher than those in other areas. Since 2005, the reported incidence rates of acute hepatitis B in all age groups had decreased. The incidence rate decreased by 88.8% in age group 5–14 years, by 80.4% in age group 15–29 years and by 66.0% in age group 30–59 years. The incidence peak occurred in older age groups. A total of 29 709 cases of acute hepatitis B were reported in Gansu from 2005 to 2016, in which 73.4% (21 825) were adults aged 15–49 years, only 7.3% (2 156) were children under 15 years old. The cases in farmers and students accounted for 53.1% and 15.8% respectively. The proportion of the cases in farmer increased year by year, reaching 76.8% in 2016. The reported incidence rate of acute hepatitis B in men was higher than that in women during this period.ConclusionThe reported incidence rate of acute hepatitis B in Gansu has decreased significantly, and the decline was more obvious in age group 5–29 years. Adults in rural areas are the key population in immunization program. It is suggested to conduct the evaluation of acute hepatitis B reporting accuracy in Gannan and Linxia prefectures.
Prevalence of HIV infection, syphilis and hepatitis C and related risk factors in drug users in Wuhan, 2009–2016
Jun Xu, Li Luo, Rong Hu, Lin Cao, Min Zhang, Xia Wang
2019, 34(3): 254-259. DOI: 10.3784/j.issn.1003-9961.2019.03.016
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ObjectiveTo understand the prevalence of HIV infection, syphilis and hepatitis C and related risk factors in drug users under sentinel surveillance in Wuhan during 2009–2016 and provide evidence for the improvement of HIV infection, syphilis and hepatitis C surveillance and behavior intervention in this population.MethodsA consecutive cross-sectional survey with uniformed questionnaire was conducted in drug uses selected in custody facilities and communities as well as urine morphine positive persons who visiting methadone maintenance treatment clinics in last month during the annual sentinel surveillance between April and June, and basic demographic information and blood samples were collected from them.ResultsA total of 6 408 drug users were included in the analysis. The prevalence rates of HIV infection, syphilis and hepatitis were 0.73% (low), 5.07% and 54.35% (high), respectively. The prevalence differed in drug users with different demographic characteristics. Multivariate analysis indicated that HIV infection related risk factors included living in other provinces originally (OR＝4.183, 95%CI: 1.670–10.476, P＝0.002), other ethnic group (OR＝7.754, 95%CI: 2.537–23.703, P＝0.000), syringe sharing (OR＝5.908, 95%CI: 2.906–12.009, P＝0.000) and being drug user in custody facility (OR＝2.468, 95%CI: 1.054–5.783, P＝0.038). Syphilis infection related risk factors included being female (OR＝2.705, 95%CI: 2.116–3.457, P＝0.000), injecting drug use (OR＝1.567, 95%CI: 1.133–2.165, P＝0.007) and being drug user in community (OR＝3.000, 95%CI: 2.265–3.973, P＝0.000). Hepatitis C virus infection related risk factors included being female (OR＝1.135, 95%CI: 1.151–1.583, P＝0.000), living in Hubei province (OR＝1.439, 95%CI: 1.208–1.713, P＝0.000), being traditional drug user or mixed drug user (OR＝3.643, 95%CI: 2.975–4.462, P＝0.000; OR＝3.454, 95%CI: 2.616–4.561, P＝0.000), injecting drug use (OR＝4.381, 95%CI: 3.777–5.082, P＝0.000) and being drug user in custody facility (OR＝2.075, 95%CI: 1.809–2.381, P＝0.000).ConclusionThe hepatitis C virus infection rate in drug users was high in Wuhan, and the proportion of new type drug users was in increase. It is necessary to continue the improvement of methadone maintenance treatment and further investigate the prevalence of HIV infection, syphilis and hepatitis C and influencing factors in drug users.
Investigation of casual sex behaviors in men who have sex with men in Taizhou, Zhejiang, 2013–2016
Ye Jiang, Haijiang Lin, Yuanyuan Xu, Shanling Wang, Xiaoxiao Chen
2019, 34(3): 260-264. DOI: 10.3784/j.issn.1003-9961.2019.03.017
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ObjectiveTo understand the prevalence of casual sex behavior and related factors in men who have sex with men (MSM) in Taizhou, Zhejiang province.MethodsFrom March 2013 to October 2016, MSM were recruited from MSM venues and through internet call. The information about the demography and sex behaviors of the MSM were collected by using questionnaire and HIV test was conducted for them.ResultsA total of 1 499 MSM were recruited, in whom 663 (44.23%) reported casual sex in past 6 years, their HIV positive rate was 14.78%. Compared with MSM reporting no casual sex, more MSM reporting casual sex were aged ＜25 years (27.15% vs. 20.93%, χ2＝7.906, P＝0.005), had both heterosexual and homosexual behaviors (44.80% vs. 32.54%, χ2＝23.602, P＜0.001), had more than two homosexual partners (96.53% vs. 86.84%, χ2＝42.930, P＜0.001), had more than two heterosexual partners (60.94% vs. 51.20%, χ2＝14.200, P＜0.001). Logistic regression analysis indicated that factors associated with casual sex behavior included age, sexual orientation, number of male sexual partners, frequency of condoms use in anal sex in recent 6 months, commercial sexual behavior.ConclusionThe prevalence of casual sex in MSM was high in Taizhou, and their complex behaviors would result in higher HIV infection and transmission risk. It is necessary to strengthen the intervention in MSM.
Effects of outdoor air fine particle (PM2.5) pollution on respiratory diseases in children in Jiangbei district of Ningbo
Yifeng Wu, Beibei Lu, Yujian Lu, Shaohua Gu, Aihong Wang, Yifu Zhou, Xiahong Zhang
2019, 34(3): 265-271. DOI: 10.3784/j.issn.1003-9961.2019.03.018
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ObjectiveTo evaluate the effect of outdoor air fine particle (PM2.5) on pediatric outpatient visits due to respiratory diseases in Jiangbei district of Ningbo.MethodsData of pediatric outpatient visits due to respiratory diseases in hospitals of Jiangbei district from 2014 to 2017 was collected, and the air pollution and meteorological data during the same period were collected too. The relative risk was calculated by using the distributed lag nonlinear model.ResultsA total of 984 941 pediatric outpatient visits due to respiratory diseases were recorded in Jiangbei district from 2014 to 2017. The effect of PM2.5 increased slowly at low concentration, but increased quickly at high concentration. The effect of PM2.5 at the same concentration decreased with the increase of lag days. The lag days of PM2.5 effects at different concentrations were different, and the longest could be 20 days. The effects of PM2.5 on boys and girls showed no difference, but the effects were different on age groups, the effects on 3 and 4–6 years old children were strongest. PM2.5 was more likely to cause acute upper respiratory tract infection before 10 lag days, but after 10 lag days, the effect on chronic lower respiratory diseases was stronger and longer.ConclusionThe rise of PM2.5 concentration would increase the pediatric outpatient visits due to respiratory diseases and has a lag effect. A PM2.5 concentration has different health hazards to children with different age, but there is no gender specific difference. PM2.5 is more likely to cause acute upper respiratory tract infection in early stage, but the effect on chronic lower respiratory tract disease is longer.
Application of difference-in-differences in public health
Shicheng Yu, Qiqi Wang, Manhui Zhang
2019, 34(3): 272-277. DOI: 10.3784/j.issn.1003-9961.2019.03.019
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Difference-in-differences (DID) is a statistical method specific to the nonequivalent group design (NEGD) and used to solve the problem of imbalance between the intervention group and control group in quasi-experimental study design. It can be used not only for dealing with the baseline difference between the two groups, but also for controlling the influence of confounding factors to effectively estimate the intervention effect. This paper summarizes the design principle and statistical method of DID, an example with a continuous variable as outcome (potential daily dose of formaldehyde, mg/d) is used to fit a general linear model, and the results are explained. With respect to the binary outcome, a logistic regression model is introduced to explain the statistical theory and parameters of DID. There are a bunch of quasi-experimental study designs with nonrandomized grouping in public health interventions. It is reasonable to handle this kind of data by using DID in order to achieve statistical effects similar to the randomized controlled trial (RCT). Difference-in-differences will be widely applied in the public health program evaluation with all-pervading technique of DID.
2018年9月世界卫生组织关于登革热疫苗的意见书
2019, 34(3): 278-284. DOI: 10.3784/j.issn.1003-9961.2019.03.020
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Abstract:
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