Objective: To learn the knowledge,attitude and practice（KAP）of primary healthcare workers on influenza vaccine and 23-valent pneumonia vaccine in Xiuzhou District of Jiaxing,and to provide basis for vaccination of influenza vaccine and 23-valent pneumonia vaccine. Methods: From November 2018 to January 2019,the primary healthcare workers from eight community health service centers in Xiuzhou District were selected by multi-staged random sampling method. A self-designed questionnaire was used to investigate the KAP of influenza vaccine and 23-valent pneumonia vaccine among primary healthcare workers. Logistic regression analysis was employed to select the influencing factors for vaccination and recommendation behaviors of primary healthcare workers. Results: Totally 105 healthcare workers（95.45%）completed the survey. Among them,86（81.90%）and 76（72.38%）workers believed influenza vaccine and 23-valent pneumonia vaccine effective;87（82.85%）and 88（83.81%）workers believed the two vaccines safe;82（78.10%）and 58（55.24%）workers knew the vaccination procedures;58（55.24%）and 34（32.38%）workers knew the key recommended population of vaccines;77（73.33%）workers knew that the vaccine costs could be paid by medical insurance. The vaccination rate of influenza or（and）pneumococcal vaccine among the respondents was 27.62%,and the recommendation rate was 46.67%. The results of multivariate logistic regression analysis showed that healthcare workers who were female（OR=7.250,95%CI：1.388-37.883）,believed the two vaccines effective（OR=4.390,95%CI：1.167-16.515）,believed the two vaccines safe（OR=11.977,95%CI：2.417-59.343）and knew the payment method of vaccine cost（OR=11.945,95%CI：2.924-48.793）were more likely to vaccinate;healthcare workers who majored in public health（OR=2.641,95%CI：1.338-5.214）,believed the two vaccines effective（OR=6.944,95%CI：1.655-29.134）,knew the key recommended population of vaccines（OR=4.380,95%CI：1.125-17.053）,had vaccinated the two vaccines（OR=7.902,95%CI：1.693-36.877）were more likely to recommend. Conclusion Primary healthcare workers in Xiuzhou District have less awareness of influenza vaccine and 23-valent pneumonia vaccine,then have lower vaccination rate（27.62%）and recommendation rate（46.67%）.

Objective: To investigate the coverage of rotavirus vaccination among children under five years in Xiuzhou District of Jiaxing City, so as to provide insights into rotaviral diarrhea control. Methods: The rotavirus vaccination data of children aged two months to five years were extracted from the vaccination clinics of eight township hospitals and community health service centers through the Zhejiang vaccination information system. The coverage of rotavirus vaccination was analyzed among children with different genders, ages, types of vaccines and doses of vaccination. Results: Totally 32 752 children were included, and the coverage of rotavirus vaccination was 47.09%. The coverage of rotavirus vaccination was significantly higher in boys than in girls ( 47.65% vs. 46.46%, P<0.05 ), and a higher vaccination rate was seen in children with local household registration than in those without ( 56.76% vs. 38.75%, P<0.05 ). The vaccination rates of monovalent and pentavalent rotavirus vaccines were 36.90% and 10.18%, respectively. Totally 26 982 doses of rotavirus vaccines were vaccinated, with a mean dose of ( 0.84±1.02 ) per capita, and the vaccination rates of one, two and three doses were 20.75%, 17.37% and 8.96%, respectively. The median age was 6.00 months ( interquartile range, 3.00 months ) among children vaccinated with the first dose. Conclusions The coverage of rotavirus vaccination and full-dose vaccination are low among children under five in Xiuzhou District, with monovalent rotavirus vaccines predominant. Intensified rotavirus vaccination is therefore recommended.

Objective The objective of this study was to investigate the epidemiological characteristics of disease caused by enterovirus type 71.Methods A total of 10 158 children aged between 6 and 35 months,were recruited from 7 sites where EV71 inactivated vaccine phase 3 clinical trial was carded out.All the subjects were followed up to one year to investigate the epidemiological characteristics of the disease caused by EV71.Results The accumulate incidence density of disease caused by EV71 was 15.17/1 000 person-year.Of all the cases,hand,foot and mouth disease (HFMD),herpangina,respiratory system diseases,digestive system diseases and other diseases accounted for 82.00％,2.67％,13.33％,1.33％ and 0.67％,respectively.The difference of the incidence density between boys and girls showed no statistical significance.Majority of the patients were between 12 and 23 months of age,which accounted for 58.67％ of the total patients.The differences of incidence density between different months of age were statistically significant (x2=7.789,P=0.020).The peak incidence density of disease caused by EV71 occurred from April to June.Nine cases showed severe symptoms or signs that accounted for 6.00％ of all the cases.All severe cases were identified as HFMD,of which 7 were boys and 2 were girls.The number of severe cases in different months of age appeared to be 1,7,and 1,all occurred between April and June.The median courses of HFMD cases and non-HFMD cases were 9 and 6 days,with difference statistically significant (Z=-4.000,P＜0.001).Median of excretion cycle for HFMD and non-HFMD cases were 9 and 11 days respectively.But with no statistically significant difference between the two.Conclusion Majority of the disease that caused by EV71 appeared as HFMD.Most of them were younger children and with seasonal variation.

Objective: To explore the reliability and validity of the Chinese Pediatric Quality of Life Inventory（PedsQL）in influenza children. Methods: From January 2017 to February 2018,we selected laboratory-diagnosed influenza cases and healthy children according to age and gender ratio by stratified random sampling and systematic sampling method. We employed Chinese version of PedsQL 4.0 to investigate their quality of life,used Cronbach's α to evaluate the reliability,and used Pearson correlation coefficient, t-test,confirmatory factor analysis（CFA）and ROC curve to evaluate the validity. Results: Totally 300 influenza cases and 300 healthy children were surveyed,with 294（98.00%）and 295（98.33%）valid questionnaires recovered. The general Cronbach's α was 0.89,and the Cronbach's α of each dimension ranged from 0.79 to 0.84. The Pearson correlation coefficients between the items and their belonged dimension ranged from 0.537 to 0.755,between the items and other dimension ranged from 0.203 to 0.384. The CFA resulted in RMSEA of 0.06,GFI of 0.88,AGFI of 0.90,CFI of 0.91 and NFI of 0.89. The scores in total and in all the dimensions in influenza cases were significantly different with those in healthy children（P<0.05）. Taking the scores in influenza cases as a golden standard,the area under the ROC curve was 0. 985（P<0.05）,the sensitivity was 0.92,and the specificity was 0.95. When the limit score was 82.18,the Youden index was the largest. Conclusion The Chinese version of PedsQL4.0 has good reliability and validity, which can be applied to quality of life assessment in children.

Objective: The objective of this study was to analyze the disease burden of influenza in schools and child care settings in rural areas of Hangzhou. Methods: Hospital visit influenza cases aged 3-17 years in hospitals that reported based on influenza surveillance system from 2016 to 2018 in Chun′an county, Hangzhou city were selected as study subjects and a total of 294 confirmed cases of influenza were selected using system sampling method. Questionnaires were designed to investigate the basic information and data on inpatients and outpatients among, health care and life quality, etc.. Direct and indirect economic burden and disability adjusted life year (DALY) were analyzed and compared among different age groups. Results: The mean age of investigated subjects was (8.88±3.92) years. A total of 143 (48.64%) investigated cases were male. In total of 283 (96.26%) cases were outpatients. The total economic burden was 124 743.95 CNY. The mean economic burden was 424.30 CNY per person. The mean direct and indirect economic burden was 361.33 and 62.97 CNY per person respectively. The difference of the mean direct, indirect and total economic burden per person between different age group was statistically significant (P<0.001). The 3-5 years age group showed the highest economic burden with the median value of direct, indirect and total economic burden per person being 276.24, 50.98 and 321.26 CNY, respectively, while the 12-17 years age group showed the lowest values with 175.30, 26.54, 201.79 CNY, respectively. The DALY of 294 influenza cases was 1.18, and the median of burden strength was 3.21 DALY/thousand. The difference of the burden of strength between different age group influenza case was statistically significant (P<0.001), of which the 12-17 years age group showed the highest value with 4.25 DALYs/thousand while the 3-5 years age group showed the lowest value with 2.60 DALY/thousand. Conclusion The disease burden of influenza was heavy in schools and kindergartens in rural areas of Hangzhou city, with the cases aged from 3 to 5 years showing higher economic burden and cases aged from 12 to 17 years showing greater burden strength.