Gonorrhea poses a major public health challenge. This study analyzed the independent effects of age, period, and birth cohort on gonorrhea incidence in Eastern China to inform targeted interventions. Case data from Zhejiang Province (2005–2024) were obtained from the China Information System for Disease Control and Prevention. Age-Period-Cohort and Joinpoint regression models were used to evaluate trends and effects. A total of 347,868 gonorrhea cases were reported, with an average annual incidence of 31.87 per 100,000 and a male-to-female ratio of 3.66. Joinpoint analysis identified three distinct trends: a significant decrease during 2005–2012 (Annual Percentage Change=-10.56

The monitoring and identification of mosquito vectors are crucial for controlling the transmission of mosquito-borne diseases. Traditional mosquito morphological identification and surveillance methods, such as human landing catches, human-baited double net traps and BG-Sentinel mosquito traps, require a large amount of manpower but can only provide fragmented data. We utilized the MS-300, an internet-based vector mosquito monitor, to continuously capture and upload real-time data to cloud services across ten monitoring sites located in seven cities in Zhejiang Province, China from May to December 2023. A new multiplex PCR system was developed for amplifying the internal transcribed spacer 2 region, followed by employing both multiplex PCR and DNA barcoding techniques for detecting wild mosquitoes. A comprehensive monitoring of 9749 mosquitoes was conducted. The mosquito density gradually increased from May 2023, peaked around June 22nd, and then declined in a wave-like pattern. The mosquitoes have two peak activity times, the peak times may vary depending on different locations and seasons. The study showed the high specificity of a multiplex PCR system in distinguishing six mosquito species: Aedes albopictus, Aedes aegypti, Culex pipiens pallens, Armigeres subalbatus, Anopheles sinensis and Anopheles anthropophagus. Notably, the sensitivity of detecting An. anthropophagus reached an impressive 1fg/µL. With the exception of Ae. aegypti and An. anthropophagus, all four other mosquito species have been identified in Zhejiang Province, with Cx. p. pallens being the predominant population. The results were highly consistent with DNA barcoding technology. The MS-300 continuously and automatically monitors mosquito population density and activity, providing effective guidance for mosquito control based on the environment and reducing labor costs. Our newly established multiple PCR system enables precise identification of crucial vector mosquitoes, facilitating a comprehensive understanding of population structures across diverse regions for selecting effective control measures.

Background:Syphilis remains one of the serious public health challenges in China and worldwide. This study aims to assess the potential independent risks associated with age, period, and birth cohort for the reported incidence of syphilis in Eastern China. Methods:Data on all syphilis cases from 2005 to 2024 in Zhejiang Province in Eastern China were collected from the China Information System for Disease Control and Prevention. The Age-Period-Cohort (APC) model was used to analyze the effect coefficients, which were then converted into relative risks (RRs). Results:From 2005 to 2024, a total of 617,097 syphilis cases were reported in Zhejiang Province. The reported incidence of syphilis decreased by an average of -3.53% per year across all age groups (95% CI: -4.34, -2.70%). The age effect showed that the highest reported incidence was among individuals aged 20-24 years, with a relatively high rate also observed in those aged 60 years and above. The period effect indicated that compared with the reference group of 2010-2014 with the highest reported incidence risk, the risk in 2020-2024 was the lowest (RR = 0.48; 95% CI: 0.43, 0.54). The cohort effect shows that the risk decreased in later birth cohorts, with the highest reported incidence risk in the birth cohort of 1960-1964 (RR = 1.30; 95% CI: 1.08, 1.57) and the lowest risk in the birth cohort of 2020-2024 (RR = 0.00; 95% CI: 0.00, 0.18). Conclusion:The reported incidence of syphilis in Zhejiang Province has shown an overall downward trend. The implementation of national syphilis control programs has achieved significant results. There is a need to strengthen the management of late-stage syphilis among older adults and enhance syphilis prevention and control efforts among adolescents.

BACKGROUND:Hepatitis significantly increases the global disease burden and has become a major public health issue worldwide. China is a high-risk area for viral hepatitis, which is also a serious public health problem. METHODS:The scaling relationship between various types of hepatitis and population size was explained by a scaling law. Fixed-effects and random-effects meta-analyses were used to calculate a combined index of β based on the single-scale index from 2004 to 2023. Furthermore, the X11 process was employed to identify the structural components of the time series of various types of hepatitis. RESULTS:In the past 20 years, the proportion of patients with viral hepatitis in Zhejiang Province has changed significantly, and hepatitis B remains the main type of hepatitis, accounting for approximately 70% of all hepatitis cases. The proportion of hepatitis C and E cases has been increasing, whereas the proportion of hepatitis A cases has been decreasing since 2004 and has remained at a low level (approximately 3%) since 2010. The combined scaling exponents of hepatitis A, hepatitis B, hepatitis C, hepatitis E and unclassified hepatitis based on the random effects model were 0.88 (95% confidence interval(CI): 0.78 to 0.98), 0.78 (95% CI: 0.70 to 0.86), 1.18 (95% CI: 1.11 to 1.26), 0.91 (95% CI: 0.86 to 0.97) and 0.89 (95% CI: 0.79 to 1.00), respectively. CONCLUSION:In the past 20 years, the epidemic situation of hepatitis A, hepatitis B and unclassified hepatitis has shown a significant downward trend, whereas the proportions of hepatitis C and hepatitis E among those with viral hepatitis have increased annually. The combined scaling exponent and development trends of the five types of hepatitis show significant heterogeneity. Overall, hepatitis C exhibits superlinear characteristics, whereas other types of hepatitis exhibit sublinear characteristics. Different types of hepatitis exhibit distinct epidemic characteristics and require targeted prevention and control measures.

Introduction:This study presents empirical evidence from the implementation of an automated infectious disease warning system utilizing multi-source surveillance and multi-point triggers in Yuhang District, Hangzhou City, Zhejiang Province, so as to provide reference for more extensive practice of infectious disease surveillance and early warning in the future. Methods:The data were obtained from the Health Emergency Intelligent Control Platform of Yuhang District from January 1 to April 30, 2024, encompassing warning signal issuance and response documentation. Descriptive epidemiological method was used to analyze the early warning signals. Results:From January 1 to April 30, 2024, the Health Emergency Intelligent Control Platform in Yuhang District generated 4,598 valid warning signals, with a warning signal positive rate of 36.43%. The early warning system detected 71 infectious disease outbreaks reported through the Intelligent Control Platform, including 24 single-source early warning and 47 multi-source early warning. The sensitivity was 78.02%, demonstrating improved performance compared to existing infectious disease surveillance and warning systems. Conclusions:This represents the first domestic publication evaluating an automated multi-source surveillance and multi-point trigger warning system. By integrating and correlating multi-source data, the system can efficiently and accurately detect warning signals of infectious disease incidents, which has significant practical implications for early surveillance, warning, and management of infectious diseases.

BackgroundIn recent years, over-the-counter (OTC) drug sales have emerged as a novel indicator for symptom monitoring, attracting widespread attention in public health research globally. This study conducted weekly monitoring of five OTC drug categories related to fever respiratory system diagnostic cluster (FRSDC) — antitussive/expectorant drugs, cold medications, antibiotics, pungent and cool exterior-relieving agents, and influenza medicine — in Pinghu City, Zhejiang Province, from 2022 to 2024. Concurrently, weekly FRSDC cases from Pinghu First People’s Hospital were collected.MethodsSpearman correlation analysis was used to quantify associations between OTC sales and FRSDC cases, while decision tree models evaluated the reliability of OTC data for early prediction of FRSDC trends.ResultsResults showed significant positive correlations between all five OTC drugs and FRSDC cases, with synchronous seasonal peaks in winter and spring (Spearman’s correlation coefficients ranged from 0.36 to 0.80, all p value ≤ 0.0001). Even when OTC drug sales preceded FRSDC cases by one or two weeks, strong correlations persisted (Spearman’s correlation coefficients ranged from 0.28 to 0.79, p value ≤ 0.0001). Decision tree analysis revealed that combining antitussive/expectorant drugs and influenza medications effectively predicted FRSDC epidemics with 83.33% accuracy (adjusted p value < 0.05).ConclusionThese findings suggest that monitoring OTC drug sales may serve as a useful early warning indicator for FRSDC, potentially aiding public health response and resource planning.

Background:The emergence of advanced diagnostic techniques and improved disease surveillance have led to increased recognition of psittacosis cases in recent years. This study aimed to characterize the epidemiological patterns and spatiotemporal distribution of psittacosis in Zhejiang Province, China, and to identify high-risk clusters through predictive modeling. Methods:We conducted a comprehensive analysis of reported psittacosis cases in Zhejiang Province from January 2019 to June 2024. Demographic characteristics and seasonal trends were systematically analyzed. Spatial epidemiological methods, including spatiotemporal distribution mapping, spatial autocorrelation analysis, and Kriging interpolation, were employed to identify disease hotspots and predict risk areas. Results:During the study period, 315 psittacosis cases were reported, with an annual average incidence rate of 0.0914 per 100,000 population, showing a significant increasing trend. The geographic distribution of cases expanded over time. More cases were reported in winter. Cases demonstrated a male predominance (sex ratio 1.1:1) with a median age of 64 years. Occupational analysis revealed farmers as the most affected group (52.4%). Spatial analysis identified significant clustering (Moran's I = 0.5428, P < 0.001), with high-incidence areas concentrated in western and central regions. Kriging interpolation predicted the highest disease risk in western Zhejiang, followed by central, southwestern and parts of northern regions. Western and southwestern regions had high risks of cluster. Conclusions:Our findings demonstrate a concerning upward trend in psittacosis incidence with expanding geographic distribution in Zhejiang Province. The identification of high-risk clusters in western, central, and northern regions provides critical evidence for targeted public health interventions, including enhanced surveillance in agricultural communities and seasonal prevention campaigns during winter months.

Objective To describe the trends in the incidence of hand, foot and mouth disease (HFMD) before, during, and after China's Coronavirus Disease (COVID) control policies, and to interpret the influence on HFMD incidence at different control stages in Zhejiang Province.Methods We collected data on HFMD cases in Zhejiang between 2014 and 2023. We compared the constituent ratios of cases at different COVID control stages by sex, age, child groups, and pathogens and weekly seasonal indices to observe seasonal variations in the incidence of HFMD. An interrupted time-series segmented regression analysis was applied to estimate the influence on HFMD incidence at different control stages. Stratified and sensitivity analyses were conducted to validate the findings.Results A considerable proportion of cases occurred among children living separately. The proportions of children in kindergartens or nurseries and children aged 2-4 years were relatively low at the strict control stage compared to the other three stages. Enteroviruses other than enterovirus 71 and coxsackie virus A16 were the dominant HFMD pathogens, and the proportion showed an increasing trend. The usual spring-summer peak in HMFD incidence did not occur in 2020, and the periodicity of the biennial peak was disrupted for a year. The summer peak in 2023 was higher than that in the other years, and was delayed by 3 weeks. The trend changes in weekly HFMD cases during the strict control and regular control stages were - 15% (IRR: 0.85, 95% CI: 0.81-0.89) and 17% (IRR: 1.17, 95% CI: 1.12-1.23), respectively. However, the change was not statistically significant during the reopening stage (IRR: 1.41, 95% CI: 0.34-5.88). The expected number of cases increased by 1.12 times (95% CI: 243.17, 53.45%) during the reopening stage compared to what would have occurred if the zero-COVID policy had continued in 2023.Conclusion Non-pharmaceutical interventions (NPIs) for COVID-19 control can mitigate HFMD. However, after the dynamic zero-COVID policy ended, the HFMD incidence returned to historical levels. Strict NPIs such as traffic restrictions and kindergarten closures cannot be sustained long-term. NPIs such as improving personal hygiene for routine prevention are highly recommended.

BackgroundChina is one of the main epidemic areas of scrub typhus, and Zhejiang Province, which is located in the coastal area of southeastern China, is considered a key region of scrub typhus. However, there may be significant bias in the number of reported cases of scrub typhus, to the extent that its epidemiological patterns are not clearly understood. The purpose of this study was to estimate the possible incidence of scrub typhus and to identify the main driving components affecting the occurrence of scrub typhus at the county level.MethodsData on patients with scrub typhus diagnosed at medical institutions between January 2016 and December 2023 were collected from the China Disease Control and Prevention Information System (CDCPIS). The kriging interpolation method was used to estimate the possible incidence of scrub typhus. Additionally, a multivariate time series model was applied to identify the main driving components affecting the occurrence of scrub typhus in different regions.ResultsFrom January 2016 to September 2023, 2,678 cases of scrub typhus were reported in Zhejiang Province, including 1 case of reported death, with an overall case fatality rate of 0.04%. The seasonal characteristics of scrub typhus in Zhejiang Province followed an annual single peak model, and the months of peak onset in different cities were different. The estimated area with case occurrence was relatively wider. There were 41 counties in Zhejiang Province with an annual reported case count of less than 1, while from the estimated annual incidence, the number of counties with less than 1 case decreased to 21. The average annual number of cases in most regions fluctuated between 0 and 15. The numbers of cases in the central urban area of Hangzhou city, Jiaxin city and Huzhou city did not exceed 5. The estimated random effect variance parameters σλ2, σϕ2, and σν2 were 0.48, 1.03 and 3.48, respectively. The endemic component values of the top 10 counties were Shuichang, Cangnan, Chun’an, Xinchang, Pingyang, Xianju, Longquan, Dongyang, Yueqing and Qingyuan. The spatiotemporal component values of the top 10 counties were Pujiang, Anji, Pan’an, Dongyang, Jinyun, Ninghai, Yongjia, Xiaoshan, Yinwu and Shengzhou. The autoregressive component values of the top 10 counties were Lin’an, Cangnan, Chun’an, Yiwu, Pujiang, Longquan, Xinchang, Luqiao, Sanmen and Fuyang.ConclusionThe estimated incidence was higher than the current reported number of cases, and the possible impact area of the epidemic was also wider than the areas with reported cases. The main driving factors of the scrub typhus epidemic in Zhejiang included endemic components such as natural factors, but there was significant heterogeneity in the composition of driving factors in different regions. Some regions were driven by spatiotemporal spread across regions, and the time autoregressive effect in individual regions could not be ignored. These results that monitoring of cases, vectors, and pathogens of scrub typhus should be strengthened. Furthermore, each region should take targeted prevention and control measures based on the main driving factors of the local epidemic to improve the accuracy of prevention and control.

目的 分析自2022年3月以来浙江省本土新型冠状病毒感染(新冠)聚集性疫情流行病学特征.方法 收集2022年3月3日至5月8日浙江省本土新冠聚集性疫情的流行病学调查资料,采用描述性流行病学方法进行分析.结果 262起疫情波及11个市的71个县(市、区),累计报告确诊病例668例,无症状感染者866例.局部空间自相关分析显示,嘉善县、平湖市、海宁市、临平区、余杭区、拱墅区、上城区和婺城区存在热点聚集性.本次疫情由上海市输入并导致关联疫情占72.90％;50例以上规模疫情持续时间为7～15 d,10 d左右控制动态基本再生数(Rt)＜1.结论 本轮疫情主要发生在嘉兴市和杭州市,大部分是外省输入病例引起的关联疫情;疫情R,控制在1以下的时间越早,规模越小,疫情持续时间越短.

BackgroundSyphilis has caused epidemics for hundreds of years, and the global syphilis situation remains serious. The reported incidence rate of syphilis in Zhejiang Province has ranked first in the province in terms of notifiable infectious diseases for many years and is the highest in China. This study attempts to use the scaling law theory to study the relationship between population size and different types of syphilis epidemics, while also exploring the main driving factors affecting the incidence of syphilis in different regions.MethodsData on syphilis cases and affected populations at the county level were obtained from the China Disease Control and Prevention Information System. The scaling relationship between different stages of syphilis and population size was explained by scaling law. The trend of the incidence from 2016 to 2022 was tested by the joinpoint regression. The index of distance between indices of simulation and observation (DISO) was applied to evaluate the overall performance of joinpoint regression model. Furthermore, a multivariate time series model was employed to identify the main driving components that affected the occurrence of syphilis at the county level. The p value less than 0.05 or confidence interval (CI) does not include 0 represented statistical significance for all the tests.ResultsFrom 2016 to 2022, a total of 204,719 cases of syphilis were reported in Zhejiang Province, including 2 deaths, all of which were congenital syphilis. Latent syphilis accounted for 79.47% of total syphilis cases. The annual percent change (APCs) of all types of syphilis, including primary syphilis, secondary syphilis, tertiary syphilis, congenital syphilis and latent syphilis, were − 21.70% (p < 0.001, 95% CI: −26.70 to −16.30), −16.80% (p < 0.001, 95% CI: −20.30 to −13.30), −8.70% (p < 0.001, 95% CI: −11.30 to −6.00), −39.00% (p = 0.001, 95% CI: −49.30 to −26.60) and − 7.10% (p = 0.008, 95% CI: −11.20 to −2.80), respectively. The combined scaling exponents of primary syphilis, secondary syphilis, tertiary syphilis, congenital syphilis and latent syphilis based on the random effects model were 0.95 (95% CI: 0.88 to 1.01), 1.14 (95% CI: 1.12 to 1.16), 0.43 (95% CI: 0.37 to 0.49), 0.0264 (95% CI: −0.0047 to 0.0575) and 0.88 (95% CI: 0.82 to 0.93), respectively. The overall average effect values of the endemic component, spatiotemporal component and autoregressive component for all counties were 0.24, 0.035 and 0.72, respectively. The values of the autoregressive component for most counties were greater than 0.7. The endemic component of the top 10 counties with the highest values was greater than 0.34. Two counties with value of the spatiotemporal component higher than 0.1 were Xihu landscape county and Shengsi county. From 2016 to 2022, the endemic and autoregressive components of each county showed obvious seasonal changes.ConclusionThe scaling exponent had both temporal trend characteristics and significant heterogeneity in the association between each type of syphilis and population size. Primary syphilis and latent syphilis exhibited a linear pattern, secondary syphilis presented a superlinear pattern, and tertiary syphilis exhibited a sublinear pattern. This suggested that further prevention of infection and transmission among high-risk populations and improvement of diagnostic accuracy in underdeveloped areas is needed. The autoregressive components and the endemic components were the main driving factors that affected the occurrence of syphilis. Targeted prevention and control strategies must be developed based on the main driving modes of the epidemic in each county.

目的:分析浙江省学校肺结核单病例预警在传染病自动预警系统(简称"预警系统")中的应用效果.方法:从浙江省传染病自动预警系统产生的肺结核预警信息(包括预警信号数量、信号响应时间及响应结果等)和同期传染病报告管理系统中搜集2018年7月6日至2022年12月31日学校肺结核病例个案信息.以2021年2月24日为界点,比较预警对象调整前后预警系统的预警效果.结果:2018年7月6日至2022年12月31日,全省范围内预警系统共计发出35 418条学校肺结核预警信号,信号数居前3位的地市分别为宁波市(7531条,21.26％)、温州市(6786条,19.16％)和杭州市(5344条,15.09％).预警信号响应率为100.00％,及时响应率为97.60％(34 567/35 418),响应时间中位数(四分位数)[M(Q1,Q3]为1.19(0.30,5.83)h.其中5498条(15.52％)信号经初步判断为疑似信号,经现场调查核实,符合预警对象的学校肺结核患者4714例,预警信号阳性预测值为13.31％(4714/35 418).调整预警对象后,每日预警信号数减少了-60.24％[(11.43-28.75)/28.75],疑似信号率上升了25.29％[(18.43-14.71)/14.71];不同诊断结果的疑似信号率[18.43％(1424/7728)]较调整前[14.71％(4074/27 690)]明显提高,差异有统计学意义(x2=63.256,P=0.000),其中,调整前、后病原学阳性[分别为17.94％(615/3429)和 20.91％(586/2803)]和无病原学结果[12.81％(2316/18 086)和 14.80％(322/2175)]预警对象疑似信号率差异均有统计学意义(x2=8.560,P=0.003;x2=6.676,P=0.010).结论:浙江省肺结核单病例自动预警运行良好,可初步实现学校肺结核早期预警,通过调整预警对象可进一步提升预警应用效果.

BackgroundInfluenza infection causes a huge burden every year, affecting approximately 8% of adults and approximately 25% of children and resulting in approximately 400,000 respiratory deaths worldwide. However, based on the number of reported influenza cases, the actual prevalence of influenza may be greatly underestimated. The purpose of this study was to estimate the incidence rate of influenza and determine the true epidemiological characteristics of this virus.MethodsThe number of influenza cases and the prevalence of ILIs among outpatients in Zhejiang Province were obtained from the China Disease Control and Prevention Information System. Specimens were sampled from some cases and sent to laboratories for influenza nucleic acid testing. Random forest was used to establish an influenza estimation model based on the influenza-positive rate and the percentage of ILIs among outpatients. Furthermore, the moving epidemic method (MEM) was applied to calculate the epidemic threshold for different intensity levels. Joinpoint regression analysis was used to identify the annual change in influenza incidence. The seasonal trends of influenza were detected by wavelet analysis.ResultsFrom 2009 to 2021, a total of 990,016 influenza cases and 8 deaths were reported in Zhejiang Province. The numbers of estimated influenza cases from 2009 to 2018 were 743,449, 47,635, 89,026, 132,647, 69,218, 190,099, 204,606, 190,763, 267,168 and 364,809, respectively. The total number of estimated influenza cases is 12.11 times the number of reported cases. The APC of the estimated annual incidence rate was 23.33 (95% CI: 13.2 to 34.4) from 2011 to 2019, indicating a constant increasing trend. The intensity levels of the estimated incidence from the epidemic threshold to the very high-intensity threshold were 18.94 cases per 100,000, 24.14 cases per 100,000, 141.55 cases per 100,000, and 309.34 cases per 100,000, respectively. From the first week of 2009 to the 39th week of 2022, there were a total of 81 weeks of epidemics: the epidemic period reached a high intensity in 2 weeks, the epidemic period was at a moderate intensity in 75 weeks, and the epidemic period was at a low intensity in 2 weeks. The average power was significant on the 1-year scale, semiannual scale, and 115-week scale, and the average power of the first two cycles was significantly higher than that of the other cycles. In the period from the 20th week to the 35th week, the Pearson correlation coefficients between the time series of influenza onset and the positive rate of pathogens, including A(H3N2), A (H1N1)pdm2009, B(Victoria) and B(Yamagata), were − 0.089 (p = 0.021), 0.497 (p < 0.001), −0.062 (p = 0.109) and − 0.084 (p = 0.029), respectively. In the period from the 36th week of the first year to the 19th week of the next year, the Pearson correlation coefficients between the time series of influenza onset and the positive rate of pathogens, including A(H3N2), A (H1N1)pdm2009, B(Victoria) and B(Yamagata), were 0.516 (p < 0.001), 0.148 (p < 0.001), 0.292 (p < 0.001) and 0.271 (p < 0.001), respectively.ConclusionThe disease burden of influenza has been seriously underestimated in the past. An appropriate method for estimating the incidence rate of influenza may be to comprehensively consider the influenza-positive rate as well as the percentage of ILIs among outpatients. The intensity level of the estimated incidence from the epidemic threshold to the very high-intensity threshold was calculated, thus yielding a quantitative standard for judging the influenza prevalence level in the future. The incidence of influenza showed semi-annual peaks in Zhejiang Province, including a main peak from December to January of the next year followed by a peak in summer. Furthermore, the driving factors of the influenza peaks were preliminarily explored. While the peak in summer was mainly driven by pathogens of A(H3N2), the peak in winter was alternately driven by various pathogens. Our research suggests that the government urgently needs to address barriers to vaccination and actively promote vaccines through primary care providers.

目的 分析2021年12月浙江省三地Delta变异株新型冠状病毒肺炎(COVID-19)社区传播疫情流行特征.方法 收集中国疾病预防控制信息系统传染病监测系统中报告的本土病例及疾病预防控制中心流调报告信息,描述疫情流行特征,并估计潜伏期、代际间隔和动态再生数(Rt).结果 2021年12月4-27日,浙江省宁波、绍兴、杭州市累计报告COVID-19本土病例490例,均为确诊病例.宁波市报告74例,局限在镇海区蛟川街道,发病高峰为12月8-13日,疫情持续13 d,社会面清零用时6d.绍兴市报告387例,涉及上虞区(99.22％)和越城区(0.78％),发病高峰为12月12-16日,疫情持续21 d,社会面清零用时13 d.杭州市报告29例,涉及5个区,单日发病高峰在12月9日,疫情持续13 d,社会面清零用时4 d.三地病例男、女性别比为0.88∶1,年龄范围为2月龄至98岁,平均年龄为48.4岁,职业以工人(162例)、农民(113例)为主,临床分型以轻型(194例,39.59％)和普通型(291例,59.39％)为主,传播场所主要为家庭和密闭空间,密切接触者/次密切接触者排查和社区筛查是发现病例的主要方式.中位潜伏期为2.53(P25～P75:1.88～3.32)d,中位代际间隔为2.00(P25～P75:1.21～3.09)d.宁波、绍兴、杭州市的Rt在发现疫情后第10、12、11 d降到1以下.结论 本轮疫情传播迅速,家庭、菜场等密闭空间和人群聚集性活动场所的疫情传播风险较高,科学精准排查并有效管控高暴露风险人员有助于疫情的快速控制.

目的 利用手足口病百度指数和发病资料建立预测模型预测疱疹性咽峡炎的流行趋势,为分析监测资料有限或缺失的传染病疫情提供参考.方法 通过中国疾病预防控制信息系统收集浙江省2015年第1周至2021年第39周的手足口病发病资料,通过百度搜索收集同期手足口病和疱疹性咽峡炎的百度指数.采用小波分析法分析手足口病百度指数与其发病时间序列的关联特征;建立手足口病百度指数与其发病数的随机森林训练模型,采用平均百分比误差评价拟合效果,代入疱疹性咽峡炎百度指数预测同期流行趋势.结果 疱疹性咽峡炎百度指数和手足口病百度指数,手足口病百度指数和其发病数均显示出以26周和52周为周期的双峰型季节特征.手足口病百度指数和其发病时间序列相位差小于0.1周,建立的同期训练模型平均百分比误差为13.07％,手足口病预测发病数与实际报告发病数的一致性较好.预测疱疹性咽峡炎2015-2020年拟合发病数分别为28 822例、27 341例、28 422例、51 782例、52 457例和5 691例,2021年截至第39周发病数为48 702例.发病高峰与手足口病相似,主要在5-7月.结论 基于百度指数和手足口病发病资料建立的模型可用于预测疱疹性咽峡炎的流行趋势.

目的 分析2012-2021年浙江省学校突发公共卫生事件及相关信息,为学校公共卫生风险管理提供依据.方法 通过中国疾病预防控制信息系统突发公共卫生事件管理信息系统,收集2012-2021年浙江省学校和托幼机构突发公共卫生事件及相关信息资料,采用描述性流行病学方法分析事件的种类、时间、地区和学校类型分布,以及主要疾病罹患率变化趋势.结果 2012-2021年浙江省共报告学校突发公共卫生事件及相关信息1 284起,占突发公共卫生事件及相关信息总数的72.34％;报告病例40 562例,占突发公共卫生事件及相关信息病例总数的87.72％,无死亡病例报告.其中传染病类事件1 276起,占99.38％,以诺如病毒肠炎、水痘、流行性感冒(流感)、手足口病和流行性腮腺炎为主,分别报告649、281、181、94和22起,共占报告事件总数的95.56％.3-6月和11-12月为报告高峰,分别报告361和629起,占报告事件总数的28.12％和48.99％.全省11个市均有事件报告,其中杭州市最多,为507起.小学、幼儿园和中学报告事件数较多,分别为627、328和242起,共占报告事件总数的93.22％,均以城市学校为主.2012-2021年诺如病毒肠炎、水痘、流感、手足口病和流行性腮腺炎罹患率均无明显变化趋势.结论 2012-2021年浙江省学校突发公共卫生事件及相关信息主要疾病为诺如病毒肠炎、水痘、流感、手足口病和流行性腮腺炎,小学报告事件数最多.

Background Zhejiang, ranked in the top three in HFMD (hand, foot, and mouth disease) incidence, is located in the Yangtze River Delta region of southeast China. Since 2016, the EV71 vaccine has been promoted in Zhejiang Province. This study aimed to investigate the trend and seasonal variation characteristics of HFMD from 2010 to 2021 and estimate the reduction in enterovirus 71 infection after vaccine use. Methods The data on HFMD cases in Zhejiang Province from January 2010 to December 2021 were obtained from this network system. Individual information on cases and deaths was imported, and surveillance information, including demographic characteristics and temporal distributions, was computed by the system. The Joinpoint regression model was used to describe continuous changes in the incidence trend. The BSTS (Bayesian structural time-series models) model was used to estimate the monthly number of cases from 2017 to 2021 based on the observed monthly incidence during 2010-2016 by accounting for seasonality and long-term trends. The seasonal variation characteristics of HFMD pathogens were detected by wavelet analysis. Results From 2010 to 2021, the annual incidence rate fluctuated between 98.81 cases per 100,000 in 2020 and 435.63 cases per 100,000 in 2018, and 1711 severe HFMD cases and 106 fatal cases were reported in Zhejiang Province, China. The annual percent change (APC) in EV71 cases was -30.72% (95% CI: -45.10 to -12.50) from 2016 to 2021. The wavelet transform of total incidence and number of cases of the three pathogens all showed significant periodicity on the 1-year scale. The average 2-year scale periodicity was significant for the total incidence, EV71 cases and Cox A16 cases, but the other enterovirus cases showed significant periodicity on the 30-month scale. The 6-month scale periodicity was significant for the total incidence, EV71 case and Cox A16 case but not for the other enteroviruses case. The relative error percentage of the performance of the BSTS model was 0.3%. The estimated number of cases from 2017 to 2021 after the EV-A71 vaccines were used was 9422, and the reduction in the number of cases infected with the EV71 virus was 73.43% compared to 70.80% when the impact of the COVID-19 epidemic in 2020 was excluded. Conclusions Since 2010, the incidence of EV71 infections has shown an obvious downward trend. All types of viruses showed significant periodicity on the 1-year scale. The periodicity of the biennial peak is mainly related to EV71 and Cox A16 before 2017 and other enteroviruses since 2018. The half-year peak cycle of HFMD was mainly caused by EV71 and Cox A6 infection. The expected incidence will be 2.76 times(include the cases of 2020) and 2.43 times(exclude the cases of 2020) higher than the actual value assuming that the measures of vaccination are not taken. EV71 vaccines are very effective and should be administered in the age window between 5 months and 5 years.

目的 分析2020年浙江省法定传染病流行特征,为浙江省传染病防控工作提供依据.方法 通过中国疾病预防控制信息系统传染病监测系统收集2015-2020年浙江省法定传染病报告资料,采用描述流行病学方法分析2020年浙江省法定传染病发病及死亡情况,并与2015-2019年均值比较;分析新型冠状病毒肺炎、流行性感冒、其他感染性腹泻等传染病的流行特征.结果 2020年浙江省报告法定传染病30种,病例487271例,报告发病率为832.94/10万,死亡率为0.6154/10万,分别较2015-2019年均值下降7.05％和14.60％.甲、乙类传染病周发病率为1.24/10万～ 3.68/10万,第6-8周出现1个发病低谷;丙类传染病第1周发病率为154.19/10万,在第2-6周快速下降至4.83/10万,之后维持在较低水平.杭州市、金华市和宁波市发病率较高,分别为1412.62/10万、960.35/10万和921.25/10万;其中杭州市丙类传染病发病率为1248.80/10万,高于其他10个市.报告发病率较高的传染病有流行性感冒、其他感染性腹泻、手足口病、肺结核、梅毒和病毒性肝炎,分别为438.45/10万、140.29/10万、99.64/10万、41.92/10万、41.37/10万和30.48/10万;报告死亡率较高的传染病主要为艾滋病和肺结核,分别为0.4821/10万和0.1162/10万.报告新型冠状病毒肺炎确诊病例1306例,无症状感染者302例,死亡1例.结论 2020年浙江省法定传染病发病率较2015-2019年均值下降,肺结核、梅毒和乙肝仍然高发,新发的新型冠状病毒肺炎疫情波及范围广,部分呼吸道传染病和输入性传染病发病率较往年明显下降.

BackgroundZhejiang Province is one of the five provinces in China that had the highest incidence of novel coronavirus disease (COVID-19). Zhejiang, ranked fourth highest in COVID-19 incidence, is located in the Yangtze River Delta region of southeast China. This study was undertaken to identify the space-time characteristics of COVID-19 in Zhejiang.MethodsData on COVID-19 cases in Zhejiang Province from January to July 2020 were obtained from this network system. Individual information on cases and deaths was imported, and surveillance information, including demographic characteristics and geographic and temporal distributions, was computed by the system. The Knox test was used to identify possible space-time interactions to test whether cases that are close in distance were also close in time. Network analysis was performed to determine the relationship among the cases in a transmission community and to try to identify the key nodes.ResultsIn total, 1475 COVID-19 cases and 1 fatal case were reported from January to July 2020 in Zhejiang Province, China. Most of the cases occurred before February 15th, which accounted for 90.10%. The imported cases increased and became the main risk in Zhejiang Province after February 2020. The risk areas showed strong heterogeneity according to the Knox test. The areas at short distances within 1 kilometer and at brief periods within 5 days presented relatively high risk. The numbers of subcommunities for the four clusters were 12, 9, 6 and 4. There was obvious heterogeneity in the modularity of subcommunities. The maximum values of the node centrality for the four clusters were 2.9474, 4.3706, 4.1080 and 2.7500.ConclusionsCOVID-19 was brought under control over a short period in Zhejiang Province. Imported infections from outside of mainland China then became a new challenge. The effects of spatiotemporal interaction exhibited interval heterogeneity. The characteristics of transmission showed short range and short term risks. The importance to the cluster of each case was detected, and the key patients were identified. It is suggested that we should focus on key patients in complex conditions and in situations with limited control resources.

目的 探讨百度搜索指数与诺如病毒感染暴发疫情的关联性,用百度指数对暴发疫情进行预警.方法 收集浙江省2018年12月 2020年12月诺如病毒感染暴发疫情和百度指数数据,通过小波分析方法解析二者数据的周期性及关联性,通过随机森林方法探索预警阈值.结果 浙江省百度搜索指数和诺如病毒感染暴发疫情呈现相似的季节性特征,均在年内有两个周期性高峰;周百度搜索指数高峰领先诺如病毒感染暴发疫情高峰约2周;百度搜索指数在区间为685.60～770.20和＞1193.20时,滞后2周的诺如病毒感染暴发疫情数出现明显的增加.结论 百度搜索指数可以作为诺如病毒感染暴发疫情的早期预警指标,根据搜索指数最佳预警阈值/范围可以提早加强防控措施以遏制疫情高峰.