Objective:The temporal distribution characteristics of Salmonella-associated foodborne disease cases in China from 2014 to 2024 were examined to estimate the peak time point and epidemic period and to inform seasonal prevention efforts. Methods:Data on Salmonella-positive foodborne disease cases reported to the National Foodborne Disease Active Surveillance System during 2014-2024 were extracted. Circular distribution analysis was used to assess seasonal concentration and estimate peak timing, and Rayleigh's Z test was used to evaluate seasonal clustering. Results:Salmonella-associated foodborne disease showed clear seasonality, with a mean peak time point occurring on July 17 and a peak epidemic period spanning from May 17 to September 26. Conclusion:Salmonella-associated foodborne disease in China shows a clear seasonal concentration, with a peak occurring in summer. These findings support prioritizing enhanced food safety supervision, targeted inspections of high-risk food settings, and strengthened public risk communication from May to September to reduce preventable exposures during the identified high-risk period.

Nontyphoidal Salmonella (NTS) is the most commonly reported foodborne gastrointestinal infection and ranks among the top three causes of foodborne bacterial outbreaks in China. This study analyzed NTS data from the Foodborne Disease Surveillance System in China from 2013 to 2022 to summarize epidemiological features and assess reporting rate changes. We employed joinpoint regression model to calculate the annual percentage change in NTS reporting rate, sex reporting rate, as well as rural-urban reporting rate. We applied the Pearson correlation coefficient to evaluate the correlation of NTS reporting rate and the national per capita consumption of major foods and cases of COVID-19. During this period, 55,266 NTS cases were reported, with reporting rates increasing significantly (AAPC [CRR] = 21.89

Introduction:Vibrio parahaemolyticus (V. parahaemolyticus) is a common foodborne pathogen in coastal areas of China. Most epidemiological studies on V. parahaemolyticus have focused on foodborne disease outbreaks, with fewer studies based on long-term, continuous, and systematic sentinel surveillance. Methods:Data were collected from the national foodborne disease active surveillance program in 31 provincial-level administrative divisions (PLADs) in China from 2013 to 2022. V. parahaemolyticus-positive cases were collected for further analysis in this study. Results:From 2013 to 2022, the National Foodborne Disease Case Surveillance System identified 23,818 cases of V. parahaemolyticus foodborne infection in China. Patient ages ranged from 2 months to 100 years, with an average age of 38.41 years. These cases primarily occurred in coastal areas during summer. A new serotype, O10:K4, emerged in 2020 and has become the dominant serotype over O3:K6. Conclusions:V. parahaemolyticus infection is common in the eastern coastal areas of China and is strongly associated with aquatic food consumption. This study recommends that food regulatory authorities increase routine surveillance and inspection during high-risk periods and in high-risk areas. Authorities should also use social media platforms to conduct extensive public education campaigns on the prevention and control of V. parahaemolyticus-associated foodborne disease.

The problem of food-borne illnesses due to microbial contamination of infant and young children foods is usually of international concern， and the unique character of the infant and young child population requires special and strict food safety requirements for their own foods. This article reviews the progress of contamination with Salmonella and Cronobacter （Enterobacter sakazakii） of Enterobacteriaceae family in foods for infants and young children and its diseases risk at home and abroad in recent years， and also provides technical support for the revision of national standards for infant and young children foods and its manufacturing processes in China through the comparative analysis of domestic and international microbiological limits for infant and young children foods.

Objective To provide scientific basis for the prevention and control of foodborne diseases among the geriatrics in China's Mainland,the epidemiological characteristics of foodborne diseases was understood.Methods Information on acute gastroenteritis cases aged ≥65 years in China's Foodborne Disease Case Surveillance System from 2018 to 2022 was collected and analyzed.Results The overall prevelance of foodborne disease monitoring pathogens among the geriatrics in China was 9.15％(7 218/78 904,95％CI:8.95％,9.35％,with Salmonella spp.being the highest(4.90％,3 860/78 699,95％CI:4.75％,5.06％),Norovirus(2.07％,1 517/73 173,95％CI:1.97％,2.18％),Diarrheogenic E.coli(1.39％,1 015/72 763,95％CI:1.31％,1.48％),Vibrio parahaemolyticus(1.00％,782/78386,95％CI:0.93％,1.07％)and Shigella spp.(0.19％,147/78 611,95％CI:0.16％,0.22％).The prevelance of Salmonella spp.in male elderly was higher than that in female,while the prevelance of Vibrio parahaemolyticus in female was higher than that in male.The higher the age,the lower the prevelance was.Geriatrics with foodborne diseases had obvious seasonality.The prevelances of Salmonella spp.,Shigella spp.,Vibrio parahaemolyticus and diarrheogenic E.coli reach their peak in July and August,while Norovirus reaches its peak in February and March.The overall prevelance varies across different regions of the country,and the differences are statistically significant(x2=546.85,P＜0.001).The categories of suspicious exposed foods mainly include meat and meat products,grains and its products,vegetables and its products,etc,with households being the main place of consumption.Conclusion Salmonella spp.has the highest prevelance in active surveillance of acute gastroenteritis among the geriatrics in China's Mainland.The epidemiological characteristics of surveilled pathogens vary in different gender,age and regions,taking targeted measures should be formulated based on the corresponding distribution of characteristics to prevent foodborne diseases in geriatrics.

What is already known about this topic? Foodborne diseases, representing significant food safety and public health challenges globally, are not well- documented in terms of incidence, particularly for cases characterized by acute gastroenteritis (AGI) in China. What is added by this report? This study developed a pyramid model to estimate the incidence of five pathogens, stratified by gender and age. The estimated incidences per 100,000 people with 95% % uncertainty intervals (UI) UI ) are as follows: Norovirus, 3,188.28 (95% % UI : 2,518.03, 7,296.96); Salmonella spp., 1,295.59 (95% % UI : 1,002.62, 1,573.11); diarrheagenic E. coli (DEC), 782.62 (95% % UI : 651.19, 932.05); Vibrio parahaemolyticus , , 404.06 (95% % UI : 342.19, 468.93); and Shigella spp., 26.73 (95% % UI : 21.05, 33.46). What are the implications for public health practice? This study elucidates the incidence rates across various gender and age groups, thereby identifying priority populations for targeted preventive interventions aimed at reducing disease burden. These insights are crucial for the development of public health policies and management of food safety risks.

Objective To analyze the epidemiological characteristics of tetrodotoxin poisoning events in China from 2011 to 2020 and provide a scientific basis for precise measures to prevent and control tetrodotoxin poisoning.Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of tetrodotoxin poisoning incidents reported through the National Foodborne Disease Outbreak Monitoring System from 2011 to 2020.Results From 2011 to 2020,92 cases of tetrodotoxin poisoning reports were received through the National Foodborne Disease Outbreak Monitoring System;339 people were poisoned and 15 were dead,with a case fatality rate of 4.4％.Tetrodotoxin poisoning was mainly concentrated in the coastal areas of China.The food carriers of tetrodotoxin included pufferfish(71.7％,66/92),dried pufferfish(13.0％,12/92),Nassariidae(7.6％,7/92),horseshoe crabs(5.4％,5/92),and Acentrogobius nebulosus(2.2％,2/92).Each year,a high incidence of poisoning occurs from March to April.Conclusion To effectively prevent and control tetrodotoxin poisoning,it is necessary to establish a method for detecting tetrodotoxins in biological samples,improve the ability to identify the pathogenic factors of tetrodotoxin poisoning,strengthen the supervision and popularization of science in the circulation process,and change the dietary habits of people who eat wild pufferfish.

ObjectiveTo obtain the occurrence time and regional distribution characteristics， place of occurrence， high-risk food and risk factors， the epidemiological characteristics of foodborne disease outbreaks caused by Vibrio parahaemolyticus from 2010 to 2020 in China’s Mainland was analyzed.MethodsThe data of foodborne disease outbreaks caused by Vibrio parahaemolyticus were collected from China disease outbreak surveillance system from 2010 to 2020 were analyzed statistically.ResultsFrom 2010 to 2020， a total of 1 772 outbreaks of foodborne diseases caused by Vibrio parahaemolyticus were reported， with a total of 27 212 cases， 5 944 hospitalized cases and 2 deaths. The peak time was from July to September. The incidence in developed areas （28.8 cases/million people） was higher than that in underdeveloped areas （8.2 cases/million people）， and the incidence in coastal areas （31.7 cases/million people） was higher than that in inland areas （9.2 cases/million people）. The main causes were aquatic food （61.2%） and meat （25.3%）. Hotels and restaurants accounted for 49.6% of the total. The main contamination links were incomplete cooking of aquatic food and raw and cooked cross-contamination of ready-to-eat meat and vegetable food.ConclusionIn order to reduce the risk of foodborne diseases caused by Vibrio parahaemolyticus， it is important to strengthen the supervision of processing and storage of aquatic food and meat in catering service places.

Objective To study the epidemiological characteristics of foodborne disease outbreaks in China's Mainland in 2017.Methods The foodborne disease data collected by National Foodborne Disease Outbreaks Surveillance System were analyzed.Results A total of 5 142 foodborne disease outbreaks were reported in 30 provinces,which caused 34 981 illnesses and 158 deaths.Among these events,60.40％(3 106/5 142)were attributed to identifiable pathogens,with mushroom poisoning causing the highest number of events and fatalities,accounting for 45.40％(1 410/3 106)and 68.24％(101/148)respectively.Microbial factors were responsible for the highest number of cases,accounting for 51.29％(11 597/22 609).The majority of events occurred in catering service establishments,comprising 54.24％(2 789/5 142)of the total.Outbreaks in households accounted for 92.41％(146/158)of the reported deaths.Conclusion Catering service establishments are the primary sites for bacterial foodborne diseases such as Vibrio parahaemolyticus and Salmonella.The highest number of reported deaths from foodborne disease outbreaks in households was primarily due to the consumption of poisonous mushrooms.

Diarrheagenic Escherichia coli is one of the most prevalent foodborne pathogens and poses significant clinical challenges due to increasing rates of antibiotic resistance. In this study, 9,068 diarrheagenic E. coli isolates from sporadic diarrhea cases across 20 provinces of China from 2016 to 2022 were systematically analyzed to determine the prevalence and distribution of resistance. A total of 14 antibiotics were included in the antimicrobial resistance surveillance. Antimicrobial susceptibility testing indicated that the majority of the isolates (89.3

Background The true incidence of acute gastrointestinal illness in China is underrecognized by surveillance systems. The aims of this study were to estimate the incidence and prevalence of self-reported AGI in the community of China, and to investigate sociodemographic and epidemiological determinants of AGI. Methods We conducted a 12-months cross-sectional population-based survey in eight provinces of China during 2014–2015. The survey determined the prevalence and incidence of acute gastrointestinal illness (AGI) in the total permanent resident population in China according to the census of the population in 2010. The random multilevel population sample was stratified by geographic, population, and socioeconomic status. We used a recommended case definition of AGI, with diarrhea (three loose or watery stools) and/or any vomiting in a four-week recall. A face-to-face survey was conducted by selecting the member in the household with the most recent birthday. Results Among 56,704 sampled individuals, 948 (1,134 person-time) fulfilled the case definition; 98.5% reported diarrhea. This corresponds to 2.3% (95% CI:1.9%-2.8%) of an overall standardized four-week prevalence and 0.3 (95% CI: 0.23–0.34) episodes per person-year of annual adjusted incidence rate. There was no significant difference between males and females. The incidence rates were higher among urban residents, and in the spring and summer. In the whole study period, 50% of the cases sought medical care, of which 3.9% were hospitalized and 14.3% provided a biological sample for laboratory identification of the causative agent. Children aged 0–4 and young adults aged 15–24, people living in rural areas and people who traveled frequently had higher prevalence of AGI. Conclusion Results showed that AGI represents a substantial burden in China, and will contribute to the estimation of the global burden of AGI. Complemented with data on the etiologies of AGI, these estimates will form the basis to estimate the burden of foodborne diseases in China.

Objective Analy sis of the epidemiological and spatio-temporal clustering of aconite poisoning incidents in China from 2010 to 2020 was performed to provide a reference for the development of precise prevention and control measures and the construction of an early warning system.Methods Collection of reports of aconite poisoning incidents in surveillance data from 2010 to 2020 with descriptive analysis and spatio-temporal scan analysis was performed.Results From 2010 to 2020,a total of 380 outbreaks of aconite poisoning with 1 889 illnesses and 75 deaths were reported in China,with a case fatality rate of 3.97％(75/1 889).The highest number of outbreaks occurred from October to December with 787 cumulative illnesses,accounting for 41.66％(787/1 889)of all cases.More than 86.84％(330/380)of the outbreaks occurred in Yunnan Province and households accounted for 90.26％(343/380)of all outbreak locations.Improper processing resulting in 171 outbreaks,accounting for 45.00％(171/380).The results of the spatio-temporal scan showed a total of five agglomerative regions,including a category one agglomeration centered in Kunming,Yunnan Province,with an agglomeration period from June 2015 to November 2020,as well as four second-class aggregation areas,including 20 municipalities.Conclusion We should focus on prevention and control in areas with clusters of aconite poisoning,and publicize and popularize high-risk consumption methods to raise awareness on protection and reduce the occurrence of poisoning incidents before the arrival of the high months.

ObjectiveTo analyze the epidemiological characteristics of rural banquet foodborne disease outbreaks in China from 2010 to 2020 and provide a reference for formulating rural banquet foodborne disease prevention and control measures.MethodsData on foodborne disease outbreaks in rural banquet reported in the China Foodborne Disease Outbreak Surveillance System from 2010 to 2020 were statistically analyzed.ResultsFrom 2010 to 2020， a total of 1 421 foodborne disease outbreaks were reported in rural banquets， with 31 078 cases， 64 deaths， a fatality rate of 0.21%， and an average of 22 cases per outbreak. The overall incidence showed an upward trend. The top five provinces in China were Yunnan Province， Jiangsu Province， Hu’nan Province， Sichuan Province and Anhui Province， with 728 reports accounting for 51.23% （728/1 421）. The time distribution was mainly concentrated in the second and third quarters of the year. According to the analysis of pathogenic factors， pathogenic microorganisms， such as Vibrio parahaemolyticus and Salmonella， had the highest number of cases. The disease factor causing the highest number of deaths was methanol， followed by aconitine plants， toadstools， and toxic wild honey. Meat （livestock meat， poultry meat） and aquatic products such as crustaceans， mollusks and fish were the main causes of foodborne diseases.ConclusionBased on the high incidence areas， high incidence seasons， main pathogenic factors and causes of foodborne diseases in rural banquets in China， effective measures were implemented， focusing on monitoring and management to successfully prevent and control the occurrence of such diseases.

Salmonella is widely known as one of the most common foodborne pathogens, and antibiotics remain effective in clinical therapies against its infections. To guide better clinical antibiotic treatment, we analyzed the antimicrobial resistance (AMR) profiles of a nation-wide collection of 36,822 Salmonella isolates derived from sporadic diarrhea cases in China from 2014 to 2021. A panel of 15 antibiotics, including 10 critically important and 5 highly important antimicrobial agents for human medicine based on the WHO CIA List, was selected for AMR surveillance. Salmonella enterica serovar Typhimurium, Enteritidis, I 4,[5],12:i:-, London, and Stanley were turns to be the top five serotypes from human diarrhea cases in China. Antimicrobial susceptibility testing revealed that the majority of the isolates (87.2%) were resistant to at least one antimicrobial agent, and 66.5% were multidrug resistant (MDR). Salmonella isolates were found to be highly resistant to ampicillin (73.4%) while sensitive to imipenem (98.73%). Over the eight years, the isolates were demonstrated generally an increase in resistance to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, and azithromycin, but displayed varied resistance profiles in terms of serotypes. Stanley (0.66–27.18%) and Agona (0.78–45.30%) had lower resistance rates compared to Typhimurium (1.11–85.6%), Enteritidis (1.55–91.29%), and I 4,[5],12:i:- (1.02–94.28%). In conclusion, our results provide systematic data on the resistance characteristics of Salmonella isolates from human diarrhea cases in China. Furthermore, this data identifies priorities for the clinical treatments of antibiotics.

Introduction: Bacillus cereus (B. cereus) is a common gram-positive bacterium that contaminates starch-rich food and can cause outbreaks of foodborne diseases. This study describes the characteristics of outbreaks caused by B. cereus in China during 2010-2020 and explore the possible reasons for changes in the number of outbreaks over time. Results of this analysis can efficiently help guide and allocate public resources to prevent B. cereus-caused foodborne diseases.Methods: Descriptive statistical methods were used to analyze the data on B. cereus outbreaks in China during this period. The data were identified and reported at all levels in China through National Foodborne Disease Outbreak Surveillance System.Results: From 2010 to 2020, a total of 419 foodborne outbreaks prompted by B. cereus were reported in China, leading to 7,892 cases, 2,786 hospital admissions, and 5 fatalities. The bulk of the outbreaks were recorded in the summer, primarily between May and September. The most recurrent food vehicle was linked with rice or flour-based products, notably those made with rice or fried rice. School canteens bore the brunt of the B. cereus outbreaks. In multifactor outbreaks, food contamination was identified as the most common culprit; while in instances where only one factor contributed, improper storage was most frequently implicated.Conclusion: The prevalence of B. cereus outbreaks remained relatively consistent throughout the studied period. Understanding the types of foods, causative factors, and contributing elements leading to B. cereus outbreaks can help inform prevention strategies for foodborne illnesses. The majority of outbreaks were associated with rice-or flour-based foods in school canteens, suggesting contamination and improper storage during food preparation. Consequently, it is essential to prioritize continuous education for canteen staff on food safety, efficacious management, and proper practices. The implementation of comprehensive guidelines, encompassing multiple critical aspects, can potentially reduce the occurrence of B. cereus outbreaks.

Introduction:In terms of food preparation settings, catering service facilities have been identified as locations with the highest incidence of foodborne disease outbreaks in China. Since 2010, the China National Center for Food Safety Risk Assessment has established the Foodborne Disease Outbreak Surveillance System (FDOSS) to monitor foodborne disease outbreaks. Consequently, data from the FDOSS has provided a more accurate depiction of the epidemic characteristics of outbreaks within these facilities.Methods:From 2010 to 2020, the FDOSS gathered data related to the prevalence of outbreaks, cases, hospitalizations, and deaths linked to foodborne disease outbreaks in catering service facilities. This study examined the temporal and geographical distribution, pathogenic factors, and contributing variables of these outbreaks over the course of the decade.Results:From 2010 to 2020, China's catering service facilities reported 18,331 outbreaks, which resulted in 206,718 illnesses, 68,561 hospitalizations, and 201 deaths. The second and third quarters of the year accounted for 76.12% of the outbreaks and 72.93% of the cases. The primary pathogenic factors were pathogenic organisms, which caused 4,883 (26.64%) outbreaks, 94,047 (45.50%) cases, 32,170 (46.92%) hospitalizations, and 21 (10.45%) deaths. There were 5,607 (30.59%) outbreaks in restaurants, 2,876 (15.69%) outbreaks from street vendors, and 2,560 (13.97%) outbreaks in employee canteens in China.Conclusions:The implementation of relevant control methods, including health education and promotion, is critical for addressing foodborne diseases in catering service facilities. Regular food safety training sessions for restaurant personnel and managers are essential to ensuring the effective management of these health risks.

Invasive listeriosis is a rare but serious foodborne disease that causes maternal-neonatal, central nervous system, and bloodstream infections. The aim of this study was to assess the whole-genome sequencing (WGS)-based genetic diversity of clinical Listeria monocytogenes isolates over a 7-year period and prove the effect of WGS application in food vehicle investigation. A total of 360 isolates were recovered during 2013 and 2019 through the national listeriosis special surveillance program. Two hundred twenty-six isolates (62.8%) were associated with pregnancy. All isolates belonged to lineage I (214 isolates) or lineage II (146 isolates), with 4 serogroups (46.9% IIb, 39.7% IIa, 12.5% IVb, and 0.8% IIc). All isolates were in 25 clonal complexes (CCs) and 3 singletons, with CC87, CC8, and CC5 being the most common causes of human listeriosis. All clinical isolates were positive for Listeria pathogenicity island 1 (LIPI-1), LIPI-3 was present in 21.4% of isolates and LIPI-4 was detected in 29.2% of isolates. LIPI-4-positive isolates, including CC87, sequence type (ST)619, ST382, CC4, and CC2, have been shown to confer hypervirulence. Fifteen isolates harbored at least one antimicrobial encoding gene, including tet (M), mef (A), msr (D), and dfr (G). The sublineage designations were consistent with CC designations, and 215 distinct cgMLST types (CTs) were classified, the most abundant being CT58 and CT750. In summary, there is a high level of genetic diversity among the clinical isolates. WGS has strengthened listeriosis surveillance and will be implemented for other foodborne bacteria in the National Molecular Tracing Network for Foodborne Disease.

ObjectiveTo study the epidemiological characteristics of foodborne disease outbreaks in Chinese Mainland in 2018.MethodsThe 2018 annual foodborne disease data collected by National Foodborne Disease Outbreaks Surveillance System were analyzed by descriptive statistical analysis.ResultsA total of 6 537 foodborne disease outbreaks were reported in 31 provincial-level administrative divisions， which caused 41 750 illnesses and 135 deaths. The outbreak of foodborne diseases in families caused 80% of deaths， the number of events and deaths caused by poisonous mushroom was the largest， accounting for 25.13% and 37.78% respectively. The number of illnesses caused by microbial factors was the largest， accounting for 29.28%.ConclusionThe family is an important place caused the deaths of foodborne disease outbreaks， especially the eating habits with regional and local characteristics， such as wild mushrooms. Microbial foodborne disease are important food safety problems in China. Vibrio parahaemolyticus and Salmonella spp. are the most common foodborne microorganisms. Poisoning caused by metabolites of pathogenic bacteria （such as rice yeast acid） needs pay attention to.

National Molecular Tracing Network for Foodborne Disease Surveillance (TraNet) was launched in 2013, which is the only real-time whole-genome sequencing (WGS)-based subtyping network in China for effective foodborne disease surveillance. TraNet covers three levels of public health laboratories, national, provincial, and municipal. The TraNet national databases have a total of more than 54,000 entries representing seven common foodborne bacteria from humans, food, and environments. Raw sequence data are uploaded to TraNet by Data Delivery Center. Assembled sequence data, pulsed-field gel electrophoresis (PFGE) profiles, antibiotic resistance patterns, and epidemiological data are submitted to national pathogen-specific databases managed by China National Center for Food Safety Risk Assessment. PFGE patterns and WGS-based subtyping are compared for rapid differentiation of clusters of geographically diverse foodborne infections. WGS-based TraNet has played significant roles in improving foodborne disease surveillance in China for rapid outbreak investigation, source tracking, and cluster analysis of particular pathogens across the country.

Introduction: Mushroom poisoning was the leading cause of foodborne disease outbreaks and outbreak-associated deaths in China. Mushroom poisoning outbreak surveillance can provide insight into the epidemiological characteristics of mushroom poisonings and guide policymaking and health education to reduce illnesses and deaths. Methods: Foodborne Disease Outbreak Surveillance System was upgraded in 2011 to collect foodborne disease outbreaks in China. Mushroom poisoning outbreaks during 2010-2020 were selected to analyze geographical distribution, seasonal distribution, and setting of food preparation. Results: A total of 10,036 outbreaks, which resulted in 38,676 illnesses and 788 deaths, were reported in this period. Mushroom poisonings occurred all over the country, but with highest incidence in the southwest and central China. Overall, 84.6% outbreaks were associated with food prepared in households, followed by 8.7% in street stalls, and 2.5% in canteens. Mushroom poisoning outbreaks clearly exhibited seasonality, and the peak season was summer through autumn. Outbreaks occurring between May and October accounted for 94.1% of total outbreaks, 92.4% illnesses, and 97.2% deaths. Conclusions: Mushroom poisoning is a food safety issue of higher concern in China. Targeted health education is essential to reduce mushroom poisoning, especially in southwest China. Citizens are advised to not collect or eat wild mushrooms.