目的 分析南京市新冠感染疫情协查信息的特征,为优化协查信息系统功能、完善疫情处置流程提供参考.方法 利用《江苏省突发急性传染病接触者追踪管理系统》查询2021年1月1日—10月31日期间与南京市相关的新冠感染疫情协查信息,下载数据并做分析.结果 2021年1月1日—10月31日期间,南京市共处理协查信息函件16 239件,其中密切接触者函件7 464件,密切接触者的密切接触者函件7 633件,一般接触者函件1 142件.函件数量逐月缓慢上升,但7、8月份呈现突破性急剧增多.函件涉及全国除港澳台之外的31个省(自治区、直辖市).本省外市发南京协查的密接人员,当日管控率高于外省发南京协查的密接人员(80.15％vs.48.63％,X2=38.002,P＜0.05);次日管控率、延期管控率均低于外省发南京协查的密接人员(11.76％vs.38.70％,x2=31.967,P＜0.05;2.21％vs.10.27％,X2=8.488,P＜0.05).结论 有必要建立一套可供全国各省市区直接使用的、可实现协查信息实时传递的应用系统,进一步提升协查信息录入、传输、反馈的速率,为疫情防控赢得宝贵时间.各地应当持续做好能力储备,随时应对新冠感染突发疫情.

Objective To analyze the epidemiological characteristics of Public Health Emergencies（PHEs） in Nanjing from2004 to 2021, so as to provide a scientific evidence for targeted prevention and control measures in Nanjing city. Methods The data were collected and downloaded from National Public Health Emergency Reporting System and analyzed by descriptive method. Results From 2004 to 2021, a total of 302 PHEs were reported in Nanjing, of which more than 95%（287 PHEs） were infectious disease emergencies, including 106 cases of chickenpox, accounting for 35.10% of the total events, followed by infectious diarrhea, influenza, and mumps PHEs. Join-point analysis showed that there were three turning points, among which the increase from 2012 to 2019 was statistically significant（t=2.8, P=0.03）, September to October was the platform period for public health emergencies, and November to December was the peak months. No statistical difference was found in spatial autocorrelation analysis of public health emergencies in Nanjing（global Moran’s I =-0.03, Z =0.58, P =0.56）. There was a negative correlation between the proportion of ungraded events and the cumulative incidence of reported events（r=-0.768, P=0.04）. Public health emergencies mainly occurred in schools and kindergartens（217/302, 71.85%）. The types of infectious diseases involved in public health emergencies varied in different years and in schools. Conclusion The types of diseases in different years and stage vary greatly, and schools are the key places for prevention and control. Follow-up monitoring and analysis should be strengthened to keep track of the changes of the characteristics of public health emergencies in time.

目的 调查分析公众对长春长生疫苗事件的认知和看法,为类似事件处置提供参考.方法 通过问卷网平台自主填写问卷;采用x2检验进行率的比较,将单因素分析有统计学意义的自变量纳入模型,对结局变量进行多因素logistic回归分析.结果 受访者对疫苗事件的正确知晓率为59.3％,曾经通过微博或微信对事件信息进行点赞、评论或转发的受访人群显著高于未点赞、评论或转发组(P=0.003).公众对疫苗的生产厂家和批次、不良反应、有效期等信息更加关注.结论 今后出现类似事件时,相关部门应充分利用手机及互联网媒介,提高公众正确知晓率;应重视儿童监护人及文化程度较高人群,最大限度规避危机事件对疫苗接种工作的负面影响.

目的 分析南京市水痘突发公共卫生事件流行特征,揭示水痘疫情防控的关键环节,为疫情防控工作提供参考.方法 通过中国疾病预防控制信息系统收集2006-2020年南京市水痘突发公共卫生事件信息,使用描述性流行病学方法进行统计与分析.结果 2006-2020年间,南京市共报告104起水痘突发公共卫生事件,共计确诊患者3 255例,暴露人数132 109人,发病率为2.5％;事件数量呈现9月一次年1月主峰及3-6月次峰;小学(51.9％)、幼儿园(27.9％)的事件数占比最高,发病年龄以5～9岁组最多(56.0％);事件的持续时间(r=0.663,P＜0.001)及报告病例数(r=0.383,P＜0.001)均与事件的响应时间呈正相关.结论 水痘疫情防控应当重点关注冬季、小学及幼儿园、涉农区;建议加强水痘疫情监测,及时处置暴发疫情,做好学生及家长人群的健康教育,进一步完善适龄儿童水痘疫苗接种方案、提高水痘疫苗保护效果.

目的 研究新型冠状病毒肺炎疫情相关的网络舆情特征及公众诉求,为类似突发公共卫生事件的舆情引导及诉求回应提供参考.方法 使用新浪舆情通大数据平台收集网络舆情信息,依托研究单位的疫情咨询电话收集咨询信息,相关数据整理统计后以供分析.结果 舆情信息数量经历了酝酿期、暴发期、持续进展期;舆情信息主要来自于微博、客户端、微信和网站等;每周的星期五、每天的10～12时和22～24时产生的微博信息数量最多.咨询数量较多的话题主要为疫情的社区管理办法、隔离措施、防疫交通管制、核酸检测和出入境人员管理等.结论 舆情应对部门应充分利用公众关注度高的主流媒体、公众参与度高的关键时间段及时发布权威信息,积极应对负面信息,使公众及时调整生产、生活计划,积极配合防疫管控措施.

目的 分析南京市近年来突发公共卫生事件的流行病学特征,为今后突发公共卫生事件的预防、应对与处置提供参考.方法 在《突发公共卫生事件管理信息系统》中搜索南京市2006-2018年相关数据,进行流行病学描述与统计分析.结果 2006-2018年间共报告突发事件176起,其中重大事件1起,较大事件3起,一般事件108起,未分级事件64起;主要为传染病疫情事件,占总数的93.18％,前3位病种是水痘(34.15％)、流行性腮腺炎(14.63％)、诺如病毒感染性腹泻(12.20％);暴发数量呈现两个高峰:3-6月份(41.48％)、10-12月份(37.50％);学校及幼托机构是突发事件的主要发生场所(71.59％);传染病疫情事件、食物中毒事件、环境化学物中毒事件的报告时间中位数分别为4.04 d、6.34d、17.95 d,事件持续时间中位数分别为12.21 d、0.61 d、17.95 d.结论 肠道传染病和呼吸道传染病是南京市突发公共卫生事件的重点防控对象;应当进一步提高工作人员识别疫情的能力和及时报告的意识,在事件的早期阶段及时介入、科学处理,有效防止疫情的扩散和蔓延.

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">目的评价长春长生疫苗事件后公众预防接种意愿的变化及相关因素,为后续预防接种宣传提供参考,并为今后相关部门处理类似突发公共卫生事件提供思路。方法在江苏省南京市由专业人员设计问卷并网络发布,于2018年8月13—20日期间以"滚雪球"的方式线上招募受访志愿者完成在线答卷。≥18岁的网络用户共1 048人参加了问卷调查。问卷内容主要包括基本信息、事件认知情况、疫苗接种意愿等。网络平台自动收集答卷以供分析。采用logistic回归模型分析受访对象接种意愿的影响因素。结果受访对象中有30.7%（322/1 048）的人发生狂犬病疫苗接种犹豫,性别、文化程度、职业是接种犹豫发生率的影响因素（P &lt;0.05）。有32.2%（216/671）的儿童家长发生百白破疫苗接种犹豫,职业是接种犹豫发生率的唯一影响因素（P &lt;0.05）。相对于激烈的舆情走势及公众情绪,知晓该事件的人群发生接种犹豫的比例并未显著高于不知晓该事件的人群（P&gt; 0.05）。结论行政管理部门应当重视疫苗安全事件的应对,实施有效沟通、消除恐惧、扩大科学认知,重构公众对免疫规划工作的信任;应当发掘并利用高学历人群、医疗卫生行业人群向其他人群传播科学信息的能力,使突发公共卫生事件的处置取得事半功倍的效果。</span>

2019年湖北省主动监测到1起百日咳家庭聚集性疫情,及时开展流行病学调查和处置.调查发现感染可能来源于某母婴店,成人感染后引起了家庭内续发病例.建议加强对百日咳疫情的监测和应对、成人百日咳病例的调查和管理以及相关场所的卫生监管.

Objective: To understand the characteristics relating to the etiology and complications of hand, foot and mouth disease (HFMD) based on data from the pilot National Sentinel Surveillance (NSS) program so as to explore the feasibility, advantages and disadvantages of the NSS. Methods: Data were extracted from the NSS system, conducted in 11 provinces of China from November 2015 to October 2016. Characteristics regarding the etiology, complications of HFMD and factors related to the positive rates of HFMD specimens were analyzed under the logistic regression method by SPSS 20.0 software. Results: A total of 4 783 specimens were collected, including 3 390 from mild, 1 390 from severe and 3 from death cases. The overall positive rate was 81.43% (3 895/4 783). Other enteroviruses (non EV71/Cox A16 enteroviruses) appeared the major serotype (52.68%, 1 482/2 813) for mild infection of the disease while EV71 was for the severe cases (65.31%, 706/1 081). The serotype spectrum revealed by the pilot NSS was almost identical with the existing surveillance system. Other enteroviruses tended to infect younger children (χ(2)=130.17, P<0.001) than EV71 and Cox A16, in China. The multivariate logistic regression results showed that higher positive rate was associated with specimens which were collected from males, at children' hospitals, in peak seasons, timely and in stools. The positive rates presented downwarding trends with the extension of the onset-sampling interval (χ(2)=14.47, P<0.001 in stool specimen; χ(2)=31.99, P<0.001 in throat swab; χ(2)=24.26, P<0.001 in anal swab). Aseptic meningitis, non-brainstem encephalitis and brainstem encephalitis appeared the top three complications of both EV71-associated and other enteroviruses-associated severe HFMD cases. Conclusions: Factors as gender, season/place/timeliness of specimen collection, and types of hospital all appeared independently influenced the positive rates. NSS seemed feasible to be used as an alternative or supplement tool to the existing surveillance program in China.

目的 了解南京市2008-2017年手足口病的发病趋势和流行特征,为进一步制定手足口病预防策略和措施提供依据.方法 采用描述性流行病学方法分析手足口病病例和病原的分布特征.结果 2008-2017年南京市共报告手足口病157 698例,年均报告发病率为206.61/10万(94.06/10万～305.02/10万),累计报告死亡病例2例.2008-2013年报告发病率呈现升高趋势(t=3.481,P=0.025),2014年开始,发病率呈现隔年高发的周期性.2008-2017年累计报告重症病例2 307例,重症率为1.46％.手足口病发病呈现双峰模式,全年发病有2个高峰:4-7月(春夏高峰)和11-12月(秋冬高峰),男性发病率为258.78/10万,女性发病率为187.44/10万.实验室检测病例共计8 373例,病原学分型结果显示,普通病例病原构成中其他肠道病毒占比37.17％,CoxA16占比33.04％,EV71％占比29.78％.重症病例则以EV71病原为主,其次是其他肠道病毒,占比19.46％,CoxA16占比3.97％.结论 南京地区手足口病的流行具有明显的季节、地区、人群分布和病原构成特点,针对重点人群做好疾病防控将有利于手足口病的整体控制.

目的 了解2017年南京市腹泻病门诊医务人员对霍乱防治知识掌握情况,对开设腹泻门诊的态度,为制定腹泻病门诊设置和肠道传染病防控提供参考依据.方法 2017年4月17日-5月5日,从南京市辖区内设有腹泻病门诊的160家医疗机构中,问卷调查当天在岗的腹泻病门诊医生、护士、检验和管理人员,收集调查对象基本信息、霍乱防治相关知识及腹泻病门诊认知情况等信息,并对数据进行分析.结果 霍乱防治知识知晓率为47.5％(366/770),95％CI为43％～53％,8个问题的正确率为26.0％～97.4％.女性、不在编人员及年收入高者知晓率较高,三级和一级医疗机构的调查对象知晓率高于二级医疗机构.调查对象中91.0％持赞成开设腹泻病门诊,并对腹泻病门诊的建设提出了建议.结论 应继续加强腹泻病门诊相关医务人员霍乱防治知识培训,医务人员对本级医院开设腹泻病门诊多持支持态度,建议结合目前霍乱流行态势,及时进行资源优化,降低腹泻病门诊设置要求.

目的 对长春长生公司疫苗事件发生期间的网络舆情进行监测,并对舆情应对、风险沟通情况进行梳理与分析,为今后类似突发公共卫生事件的网络舆情处置提供参考.方法 以全网信息为研究范围,使用新浪舆情通系统对2018年7月7日-2018年9月10日期间的相关舆情信息进行监测,并对监测结果进行统计分析.结果 长生疫苗事件大致经历了酝酿期(7月15日-7月19日)、爆发期(7月20日-7月27日)、震荡期(7月28日-8月20日)、恢复期(8月21日-9月10日)4个阶段,呈现发展迅速、恢复缓慢的特点,其中爆发期的舆情信息数量达到最高峰.舆情信息来源主要包括微博类(88.02％)、微信类(3.77％)、客户端类(2.60％)、网站类(2.28％)、新闻类(1.42％)等,其中微博、微信在本次全部舆情信息中占比最高.网络舆情进展过程中,行政机关及时向公众披露信息,公布事件处置进展;专业机构积极开展补种续种工作,针对热点问题进行科学解答.结论 政府部门在处理此类突发公共卫生事件时已日趋成熟,能够及时疏导舆情、化解矛盾、促进事件平稳解决.公共卫生专业技术机构应当以网络为宣传主阵地,与自媒体、新闻网站、客户端等开展深度合作,继续做好知识宣传和健康教育,重构公众对疫苗产品的信任,巩固公众对免疫规划工作的信心.

目的 了解南京市肾综合征出血热(HFRS)的时间分布特征,为传染病的监测和防控提供依据.方法 应用集中度和圆形分布法,对HFRS的季节性进行分析.结果 2006-2016年南京市报告HFRS病例311例,年均发病率为0.38/10万.集中度M=0.50;圆形分布法计算平均角(α)=99.79°,平均角标准差S=84.46°(Z=35.40,P＜0.05).高峰点为4月11日(1月15日-7月5日).结论 南京市HFRS具有明显的季节性,发病高峰时点在4月中旬,高峰期为1月中旬到7月上旬.

目的 了解南京市5岁以下儿童家长对手足口病和EV71疫苗的认知,分析其影响因素,为EV71疫苗的市场应用提供基础数据.方法 采用多阶段抽样方法在南京市抽取300名儿童家长进行问卷调查,采用logistic回归分析手足口病认知的影响因素.结果 本研究调查300人,手足口病知识回答正确率为45.52％.高学历(OR=2.181,95％CI=1.344～3.538)、儿童年龄较大(OR=1.884,95％CI=1.171 ～3.030)是家长知识知晓的促进因素.300人中有25人知道已有上市EV71疫苗可以预防手足口病,电视、网络、社区宣传是前三大获知途径.300人中有162(54.00％)人愿意接种EV71疫苗.结论 应针对健康宣教薄弱环节,加大对低学历家长、低年龄儿童家长的宣传力度,并帮助居民树立对疫苗安全性的信心,以提升居民对手足口病的认知和EV71疫苗的接种意愿.

目的 了解南京市流感相关的网络舆情,探讨应对和风险沟通,为突发公共卫生事件的合理处置提供参考与帮助.方法 使用新浪舆情通系统对南京市2017年11月—2018年3月流感相关舆情进行监测,采用描述流行病学方法对监测资料进行分析.结果 南京市该时段流感舆情经历了酝酿期、暴发期、震荡期、恢复期.舆情信息来源主要包括微博、微信、网站、客户端、新闻、论坛等,其中微博、微信信息占比最高.结论 卫生行政部门、公共卫生专业技术部门、医疗机构以及主流媒体在舆情进展过程中主动进行了舆论引导和风险沟通,有效回应了公众意愿和诉求,引导了舆情平稳发展,促进了流感疫情的顺利处置.

了解2014～2017年南京地区诺如病毒胃肠炎暴发流行特征、变化规律和流行株特征,为疫情控制、疫苗研发提供科学依据.收集2014年9月至2017年8月南京地区12个区疾控上送85起疑似诺如病毒急性胃肠炎暴发样本,应用荧光定量PCR和一步法RT-PCR检测诺如病毒基因序列,测序后利用分子生物学软件对序列进行分析.其中66起诺如病毒检测阳性,暴发集中于幼儿园和小学,冬春季节高发.诺如病毒优势株在连续的几个流行季持续变化,由GⅡ.4/Sydney 2012转变为新型GⅡ.P17-GⅡ.17,再到GⅡ.P16-GⅡ.2.其中GⅡ.P16-GⅡ.2与全球2016～2017年参考株同源性达98.4％～99.5％.2014～2017年南京地区诺如病毒急性胃肠炎暴发的流行强度呈上升趋势.引起暴发的诺如病毒以GⅡ为主,含多种基因型,并存在重组株,优势基因型在连续的几个流行季持续改变.诺如病毒近几年不断变异,从而逃脱人群免疫,可能是其流行趋势上升的原因之一.

Objective To analyze the epidemiological characteristic of public health emergencies in Nanjing City so as to provide evidences for outlining prevention and control measures. Methods The information of public health emergencies was selected from Public Health Emergency Reporting System (the subsystem of Chinese Disease Prevention and Control Information System) reported from January 1, 2004 to December 31, 2014. Descriptive epidemiology method was used to analyze the three-dimensional distribution (population, time, district) and the epidemiological characteristics of public health emergencies in Nanjing from 2004 to 2014. Results A total of 105 public health emergencies were reported in Nanjing from 2004 to 2014, including 3 162 cases of illness and 9 deaths. Of all the events, there was 1 case at grade Ⅱ (0.95%), 1 at grade Ⅲ (0.95%), 52 at grade Ⅳ (49.52%), with 51 non-graded (48.57%) and no case at grade Ⅰ. The mayor type of events was infectious diseases (91.43%), which mainly included chickenpox (28.13%), mumps (25.00%), influenza A (H1N1) (15.63%)and influenza (13.54%). Peak months of public health emergencies appeared in March, June and December. As high as 63.81% (67/105) of the public health events took place in school. Conclusions Contagion events are the major type of public health emergencies in Nanjing from 2004 to 2014. Prevention and control of school infectious diseases during peak periods need to be particularly strengthened. Key words: Public health emergency; Epidemiology analysis; Descriptive study

Objective To analyze the epidemiological characteristics of hand foot mouth disease (HFMD) in Nanjing during 2011-2015,and to provide the basis for further work.Methods The data of all cases of hand foot mouth disease reported in Nanjing in recent five years were collected and analyzed by descriptive epidemiological methods.Results 90 920 HFMD cases were reported with incidence reaching 224.52/100 000,which showed a trend of the rising year by year (x2trend =463.217,P ＜ 0.001).1006 were diagnosed as severe cases,whose proportions in all the cases presented a trend of the declining year by year (P ＜0.001) and a downward trend with age (P ＜0.001).The two incidence peaks fell in early summer and early winter.The suburban districts had a higher morbidity,presenting a unique phenomenon of Ring distribution geographically.Children under 5 -year-old and male both had higher incidences.Of all cases,4970 were confirmed through laboratory testing.The common HFMD cases were mainly caused by CoxA16 and another enterovirus,while severe cases were mainly caused by EV71.Conclusion HFMD shows significant distribution features in terms of seasonal,regional,population and pathogen feature,etc in Nanjing.It's difficult to take current measures to reduce the incidence significantly.Prevention and control measures should be improved in key seasons,areas and populations,and the work will be facilitated by enhancing disease surveillance,vaccine development and application among others.

Objective The aim of this study was to investigate the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in Nanjing,China from 2010 to 2016,for developing the prevention and control strategy.Methods Descriptive epidemiological method was conducted to analyze epidemiological characteristics of the collected SFTS reported data of Nanjing from January 1,2010 to December 31,2016,through the National Notifiable Infectious Disease Surveillance System.The time,area,population distribution,and reporting medical institutions of SFTS cases were analyzed.Comparison between epidemiological characteristics between 2016 and the period from 2010 to 2015 was conducted.Results A total of 70 SFTS cases were reported in Nanjing during the period from 2010 to 2016.The average annual number was 10 (2-30) and the annual incidence was 0.14/100 000 (ranged from 0.05/100 000 to 0.36/100 000).The cases were reported from April to November and the incidence peaked in May to July (63％).The number of male cases accounted for 56％.The median age was 60 (ranged from 26 to 82),and the age distribution of both genders was the same (P=0.82).Farmers accounted for 63％ of the reported cases,followed by the people involved in housekeeping and job losing (20％).The case numbers reported in Lishui (39％),Jiangning (19％) and Pukou (14％) districts accounted for 71％.A family cluster outbreak was reported in 2010 and 3 cases were detected.The significant transmission factors might be blood,secretion or excretion.A total of 9 medical institutions in Nanjing reported SFTS cases,and 3 comprehensive medical institutions reported 84％ of the cases.The median time interval from onset to diagnosis was 10 d (0～30d).Conclusion The reported SFTS cases in Nanjing increased significantly in 2016,showing a same epidemiological feature with that from 2010 to 2015.Comprehensive measures should be taken for prevention and control.

Objective To analyze the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS) in Nanjing,2011-2016 and to explore the prevention and control strategy.Methods Descriptive epidemiological method was conducted to analyze epidemiological characteristics,clinical features,and exposure factors of the collected HFRS cases in Nanjing from January 1,2011 to December 31,2016.Results A total of 194 HFRS confirmed cases Were reported in Nanjing during the period of 2011 to 2016.The average annual number was 32 (ranged from 19 to45) and the annual incidence was 0.39/100 000 (ranged from 0.23/100 000 to 0.55/100 000).The incidence peaked twice annually and the value in spring (March to June) was higher than that in winter (December to January).The incidence of male was higher than that of female.The median age was 48 (ranged from 12 to 82),and farmer accounted for 57％ of the reported cases.The case reported in Gaochun District accounted for 45％.The global spatial autocorrelation analysis showed that there was a positive spatial correlation on the HFRS incidence (Morang I =0.17,P ＜0.05).The result from the space-time scan showed 2 space-time clustering areas,including Gaochun District (ranged from April 1,2012 to March 31,2015) and Jiangning District (ranged from January 1,2013 to March 31,2013).The annual average incidence in Gaochun District was 3.4/100 000 (ranged from 1.9/100 000 to 4.8/100 000),which was significantly higher than that in other areas in Nanjing.Most of the cases had the typical HFRS symptoms or signs of fever," three pain" or "three red",while the proportion of cases with a clear exposure history was very low.Conclusion The incidence of HFRS in Nanjing is stable.Comprehensive measures should be taken for prevention and control according to the epidemiological and etiological characteristics.