Objective: To characterize the prevalence and genomic epidemiology of Vibrio parahaemolyticus from acute diarrheal patients in Shenzhen City from 2013 to 2021. Methods: Based on the Shenzhen Infectious Diarrhea Surveillance System, acute diarrheal patients were actively monitored in sentinel hospitals from 2013 to 2021. Whole-genome sequencing (WGS) of Vibrio parahaemolyticus isolates was performed, and the genomic population structure, serotypes, virulence genes and multilocus sequence typing were analyzed. Outbreak clusters from 2019 to 2021 were explored based on single-nucleotide polymorphism analysis. Results: A total of 48 623 acute diarrhea cases were monitored in 15 sentinel hospitals from 2013 to 2021, and 1 135 Vibrio parahaemolyticus strains were isolated, with a positive isolation rate of 2.3%. Qualified whole-genome sequencing data of 852 isolates were obtained. Eighty-nine serotypes, 21 known ST types and 5 new ST types were identified by sequence analysis, and 93.2% of strains were detected with toxin profile of tdh+trh-. 8 clonal groups (CGs) were captured, with CG3 as the absolute predominance, followed by CG189. The CG3 group was dominated by O3:K6 serotype and ST3 sequence type, while CG189 group was mainly O4:KUT, O4:K8 serotypes and ST189a and ST189 type. A total of 13 clusters were identified, containing 154 cases. About 30 outbreak clusters with 29 outbreak clusters caused by CG3 strains from 2019 to 2021. Conclusion: Vibrio parahaemolyticus is a major pathogen of acute infectious diarrhea in Shenzhen City, with diverse population structures. CG3 and CG189 have been prevalent and predominant in Shenzhen City for a long time. Scattered outbreaks and persistent sources of contamination ignored by traditional methods could be captured by WGS analysis. Tracing the source of epidemic clone groups and taking precise prevention and control measures are expected to significantly reduce the burden of diarrhea diseases caused by Vibrio parahaemolyticus infection in Shenzhen City.
Humans ; Vibrio parahaemolyticus/genetics* ; Diarrhea/epidemiology* ; Foodborne Diseases/epidemiology* ; Serogroup ; Genomics ; Dysentery ; Vibrio Infections/epidemiology* ; Serotyping

BACKGROUND: Although previous studies have shown that meteorological factors such as temperature are related to the incidence of bacillary dysentery (BD), researches about the non-linear and interaction effect among meteorological variables remain limited. The objective of this study was to analyze the effects of temperature and other meteorological variables on BD in Beijing-Tianjin-Hebei region, which is a high-risk area for BD distribution. METHODS: Our study was based on the daily-scale data of BD cases and meteorological variables from 2014 to 2019, using generalized additive model (GAM) to explore the relationship between meteorological variables and BD cases and distributed lag non-linear model (DLNM) to analyze the lag and cumulative effects. The interaction effects and stratified analysis were developed by the GAM. RESULTS: A total of 147,001 cases were reported from 2014 to 2019. The relationship between temperature and BD was approximately liner above 0 °C, but the turning point of total temperature effect was 10 °C. Results of DLNM indicated that the effect of high temperature was significant on lag 5d and lag 6d, and the lag effect showed that each 5 °C rise caused a 3% [Relative risk (RR) = 1.03, 95% Confidence interval (CI): 1.02-1.05] increase in BD cases. The cumulative BD cases delayed by 7 days increased by 31% for each 5 °C rise in temperature above 10 °C (RR = 1.31, 95% CI: 1.30-1.33). The interaction effects and stratified analysis manifested that the incidence of BD was highest in hot and humid climates. CONCLUSIONS This study suggests that temperature can significantly affect the incidence of BD, and its effect can be enhanced by humidity and precipitation, which means that the hot and humid environment positively increases the incidence of BD.
Beijing/epidemiology* ; China/epidemiology* ; Dysentery, Bacillary/epidemiology* ; Humans ; Humidity ; Temperature

Objective: To understand the epidemiological characteristics of notifiable infectious diseases reported in Beijing in 2021 under the influence of the novel coronavirus pneumonia epidemic prevention and control policy, and provide reference evidence for the prevention and control of notifiable infectious diseases. Methods: Descriptive epidemiological methods were used to analyze the morbidity of notifiable infectious diseases reported in Beijing in 2021, with software R 4.1.2 for data process and ArcGIS 10.8 for visualization. Results: The morbidity of notifiable infectious diseases in Beijing in 2021 was 290.51/100 000, a decrease of 43.29% compared with 2020 and a decrease of 71.45% compared with the average during 2017-2019. The top 5 reported diseases with high morbidity were other infectious diarrhea, influenza, hand foot and mouth disease, pulmonary tuberculosis and syphilis. From the perspective of transmission route, intestinal infectious diseases were the main diseases, accounting for 50.15% (31 898/63 601) of the total cases. From the perspective of pathogens, viral infectious diseases were the main diseases, accounting for 59.63% (25 259/42 356) of the total cases. The laboratory diagnosis rate of notifiable infectious diseases reported in Beijing increased from the average of 16.47% (36 289/220 371) during 2017-2019 to 35.36% (22 490/63 601) in 2021. The laboratory diagnosis rate of parasitic infectious diseases was 83.33%. The districts with high incidence of intestinal infectious diseases were Pinggu, Miyun and Fengtai; Natural foci and insect borne infectious diseases were mainly reported in Yanqing, Mentougou, Fangshan and Daxing. Conclusion: The morbidity of notifiable infectious diseases in Beijing in 2021 showed a decrease trend. The laboratory confirmation rate of reported notifiable infectious disease cases increased, and there were great differences in the laboratory confirmation rate among different diseases. It is very necessary to improve the laboratory confirmation rate of the cases. The diseases with different transmission routes showed different geographical distributions. It is necessary to conduct the targeted prevention and control of infectious diseases in different areas.
Beijing ; COVID-19 ; Communicable Diseases/epidemiology* ; Dysentery ; Humans ; Incidence

BACKGROUND: Understanding the association between floods and bacillary dysentery (BD) incidence is necessary for us to assess the health risk of extreme weather events. This study aims at exploring the association between floods and daily bacillary dysentery cases in main urban areas of Chongqing between 2005 and 2016 as well as evaluating the attributable risk from floods. METHODS: The association between floods and daily bacillary dysentery cases was evaluated by using distributed lag non-linear model, controlling for meteorological factors, long-term trend, seasonality, and day of week. The fraction and number of bacillary dysentery cases attributable to floods was calculated. Subgroup analyses were conducted to explore the association across age, gender, and occupation. RESULTS: After controlling the impact of temperature, precipitation, relative humidity, long-term trend, and seasonality, a significant lag effect of floods on bacillary dysentery cases was found at 0-day, 3-day, and 4-day lag, and the cumulative relative risk (CRR) over a 7-lag day period was 1.393 (95%CI 1.216-1.596). Male had higher risk than female. People under 5 years old and people aged 15-64 years old had significantly higher risk. Students, workers, and children had significantly higher risk. During the study period, based on 7-lag days, the attributable fraction of bacillary dysentery cases due to floods was 1.10% and the attributable number was 497 persons. CONCLUSIONS This study confirms that floods can increase the risk of bacillary dysentery incidence in main urban areas of Chongqing within an accurate time scale, the risk of bacillary dysentery caused by floods is still serious. The key population includes male, people under 5 years old, students, workers, and children. Considering the lag effect of floods on bacillary dysentery, the government and public health emergency departments should advance to the emergency health response in order to minimize the potential risk of floods on public.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Child, Preschool ; China/epidemiology* ; Cities ; Dysentery, Bacillary/epidemiology* ; Female ; Floods ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Retrospective Studies ; Young Adult

Objective: To analyze the pathogenic surveillance programs and related factors on bacillary dysentery in Beijing, 2008-2017, to provide evidence for the practices of diagnosis, treatment and prevention of the disease. Methods: Analysis was conducted on surveillance data of bacillary dysentery, collected from the surveillance areas of national bacillary dysentery in Beijing. Shigella positive rate of stool samples were used as the gold standard while detection rate of Shigella, diagnostic accordance rate and resistance were computed on data from the surveillance programs. Chi-square test was used to compare the rates and unconditional logistic regression was used to analyze the related factors of Shigella infection. Results: Both the reported incidence rate on bacillary dysentery and detection rate of Shigella in diarrhea patients showed significantly decreasing trend, from 2008 to 2017. The accordance rate of bacillary dysentery was only 7.80% (111/1 423). Shigella sonnei was the most frequently isolated strain (73.95%, 159/215) followed by Shigella flexnery. Results from the multivariate logistic regression of Shigella positive rate revealed that among those patients who were routine test of stool positive vs. routine test of stool positive (OR=1.863, 95%CI: 1.402-2.475), onset from July to October vs. other months'time (OR=7.271, 95%CI: 4.514-11.709) temperature ≥38 ℃vs. temperature <38 ℃(OR=4.516, 95%CI: 3.369-6.053) and age from 6 to 59 years old vs. other ages (OR=1.617, 95%CI: 1.085-2.410), presenting higher positive detection rates of Shigella from the stool tests. The resistant rates on ampicillin and nalidixic acid were 97.57% (201/206) and 94.90% (186/196), both higher than on other antibiotics. The resistant rates on ciprofloxacin (16.33%, 32/196), ofloxacin (9.57%, 11/115) and on amoxilin (15.05%, 31/206) were relatively low. The resistant rate appeared higher on Shigella flexnery than on Shigella sonnei. The proportion of strains with resistance on 3 more drugs, was 30.00%(21/70). Conclusions: The diagnostic accordance rate of bacillary dysentery in Beijing was low, with severe resistance of Shigella. Our findings suggested that clinicians should take multiple factors into account in their practices about epidemiological history, clinical symptom and testing results for diarrhea patients.
Adolescent ; Adult ; Anti-Bacterial Agents/therapeutic use* ; Beijing/epidemiology* ; Child ; China/epidemiology* ; Dysentery, Bacillary/prevention & control* ; Feces/microbiology* ; Humans ; Middle Aged ; Population Surveillance/methods* ; Sentinel Surveillance ; Shigella/isolation & purification* ; Shigella flexneri/isolation & purification* ; Shigella sonnei/isolation & purification* ; Young Adult

Objective: To analyze the spatial and temporal distributions of bacillary dysentery in Chongqing, Yichang and Enshi (the Three Gorges Area) from 2005 to 2016, and provide evidence for the disease prevention and control. Methods: The incidence data of bacillary dysentery in the Three Gorges Area during this period were collected from National Notifiable Infectious Disease Reporting System. The spatial-temporal scan statistic was conducted with software SaTScan 9.4 and bacillary dysentery clusters were visualized with software ArcGIS 10.3. Results: A total of 126 196 cases were reported in the Three Gorges Area during 2005-2016, with an average incidence rate of 29.67/100 000. The overall incidence was in a downward trend, with an average annual decline rate of 4.74%. Cases occurred all the year round but with an obvious seasonal increase between May and October. Among the reported cases, 44.71% (56 421/126 196) were children under 5-year-old, the cases in children outside child care settings accounted for 41.93% (52 918/126 196) of the total. The incidence rates in districts of Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Yubei, Chengkou of Chongqing and districts of Xiling and Wujiagang of Yichang city of Hubei province were high, ranging from 60.20/100 000 to 114.81/100 000. Spatial-temporal scan statistic for the spatial and temporal distributions of bacillary dysentery during this period revealed that the temporal distribution was during May-October, and there were 12 class Ⅰ clusters, 35 class Ⅱ clusters, and 9 clusters without statistical significance in counties with high incidence. All the class Ⅰ clusters were in urban area of Chongqing (Yuzhong, Dadukou, Jiangbei, Shapingba, Jiulongpo, Nanan, Beibei, Yubei, Banan) and surrounding counties, and the class Ⅱ clusters transformed from concentrated distribution to scattered distribution. Conclusions: Temporal and spatial cluster of bacillary dysentery incidence existed in the three gorges area during 2005-2016. It is necessary to strengthen the bacillary dysentery prevention and control in urban areas of Chongqing and Yichang.
Adolescent ; Adult ; Child ; Child, Preschool ; China/epidemiology* ; Cities ; Dysentery, Bacillary/epidemiology* ; Environment ; Female ; Humans ; Incidence ; Male ; Seasons ; Spatio-Temporal Analysis ; Young Adult

OBJECTIVE: To discuss the lag effects of daily average temperature on the daily cases of bacillary dysentery in Lanzhou city. METHODS: The data of daily cases of bacillary dysentery were collected during 2008 and 2015 in the city, and the meteorological data at the same period was integrated. The distributed lag non-linear model was used to analyze the relevance between daily average temperature and the daily cases of bacillary dysentery. RESULTS: The exposure response relationship between the daily temperature and the incidence of bacillary dysentery was "J" type, the lowest incidence temperature was 17 °C, and the effect of high temperature on different gender and age groups was higher than that of the intermediate effect. The effect of high temperature and intermediate effect on the male and female groups showed an acute effect, the effect of the day was the highest, followed by fluctuations in temperature, and the greater the impact on women. In different age groups, high temperature effect and the intermediate effect of bacterial dysentery in 0-3 years old groups were the biggest; the effects of high and intermediate temperature on people aged 0-3 and 19-64 year all showed acute effects, which were the maximum value at the day, then decreased volatility; and for people aged over 65 years, the day after the onset, decreases and then increases slowly. There were obviously increasing risks of bacillary dysentery both the high temperature (32 °C) and the middle temperature (26 °C) with respect to 17 °C. The accumulative effects were highest at lag14 days, and the RR (95%CI) values of middle temperature was 2.30 (1.53-3.13), 2.45 (1.65-3.30), 2.41 (1.59-3.28), 2.54 (1.40-3.79), 1.82 (0.41-3.43), 1.98 (1.11-2.93), and 1.73 (0.68-2.88) among the males, females, 0-3 years old, 4-11 years old, 12-18 years old, 19-64 years old and over 65 years old people, respectively; while the high temperature was 2.93 (1.38-4.69), 3.08 (1.48- 4.90), 3.26 (1.60-5.16), 3.12 (1.06-5.56), 1.94 (0.73-5.39), 2.31 (0.54-4.36), and 2.06 (0.02-4.51), respectively. CONCLUSION The high temperature may increase risks of bacillary dysentery, and the females and younger people were the sensitive population. Meteorological factors play an important role in the occurrence and development of bacillary dysentery in Lanzhou. The incidence of bacillary dysentery is affected by multiple meteorological factors, but the primary one is high temperature. The temperature has not a direct effect on the incidence of bacillary dysentery, but an indirect influence in different populations through the impacts of various aspects of the incidence of bacterial dysentery (residents living habits, communication channels and the habits of the susceptible population).
Adolescent ; Adult ; Aged ; Child ; Child, Preschool ; China/epidemiology* ; Cities ; Dysentery, Bacillary/epidemiology* ; Female ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Meteorological Concepts ; Middle Aged ; Temperature ; Young Adult

Objective: To understand the etiological characteristics of bacterial diarrhea in different areas, including large cities, mid-sized/small cities and rural area, in China. Methods: A cross-sectional surveillance was conducted in 17 provinces of China from 2010 to 2014. The acute diarrhea outpatients were selected from clinics or hospitals in large cities, mid-sized/small cities, including rural-urban fringe zones, and rural areas. The demographical and clinical characteristics of the patients were collected by using questionnaire, and stool samples were taken from them for laboratory detection of 17 kinds of bacteria. The differences in pathogen positive rates (PPR) and pathogen spectrum across the cases from three-type areas were compared. The different infection risk in different cases were analyzed with unconditional logistic regression model. Results: In our study, we enrolled 9 253 cases from large cities, 5 138 cases from rural areas and 13 683 cases from midsized/small cites. The pathogen with largest differences in infection rate across the three-type areas was Shigella (S.) flexneri (rural area: 5.81%, mid-sized/small city: 2.78%, large city: 0.46%), followed by Aeromonas (A.) hydrophila (rural area: 2.14%, mid-sized/small city: 0.96%, large city: 0.48%). Compared with cases in large cities, the cases in mid-sized/small cities and rural areas had higher infection risks for S. flexneri (mid-sized/small city: OR=6.481, 95%CI: 4.666-9.002, rural area: OR=11.304, 95%CI: 8.018-15.938) and A. hydrophila (mid-sized/small city: OR=1.992, 95%CI:1.401-2.832, rural area: OR=4.083, 95%CI: 2.833-5.884). The constituent ratio of diarrheagenic Escherichia coli and Salmonella increased with the urbanization development, while the ratios of Shigella and A. hydrophila had an opposite trend. S. sonnei (60.00%) was the predominant serogroup of Shigella in urban infections, while S. flexneri (77.37%) was the predominant serogroup in rural infections. Conclusion: The differences in pathogen spectrum of bacterial diarrhea were obvious across large cities, mid-sized/small cities and rural areas in China, especially the differences in the infection rates of S. flexneri and A. hydrophila.
Adolescent ; Adult ; Bacterial Infections/microbiology* ; Child ; China/epidemiology* ; Cross-Sectional Studies ; Diarrhea/microbiology* ; Dysentery/epidemiology* ; Escherichia coli/pathogenicity* ; Feces/virology* ; Female ; Humans ; Male ; Middle Aged ; Prevalence ; Rural Population ; Salmonella/pathogenicity* ; Shigella/pathogenicity* ; Suburban Population ; Urban Population

Objective: To analyze the distribution characteristics of bacillary dysentery in Beijing during 2004-2015 and evaluate the influence of meteorological factors on the temporal and spatial distribution of bacillary dysentery. Methods: The incidence data of bacterial dysentery and meteorological data in Beijing from 2004 to 2015 were collected. Descriptive epidemiological analysis was conducted to study the distribution characteristics of bacterial dysentery. Linear correlation analysis and multiple linear regression analysis were carried out to investigate the relationship between the incidence of bacillary dysentery and average precipitation, average air temperature, sunshine hours, average wind speed, average air pressure, gale and rain days. Results: A total of 280 704 cases of bacterial dysentery, including 36 deaths, were reported from 2004 to 2015 in Beijing, the average annual incidence was 130.15/100 000. The annual incidence peak was mainly between May and October, the cases occurred during this period accounted for 80.75% of the total, and the incidence was highest in age group 0 year. The population distribution showed that most cases were children outside child care settings and students, and the sex ratio of the cases was 1.22∶1. The reported incidence of bacillary dysentery was positively associated with average precipitation, average air temperature and rain days with the correlation coefficients of 0.931, 0.878 and 0.888, but it was negatively associated with the average pressure, the correlation coefficient was -0.820. Multiple linear regression equation for fitting analysis of bacillary dysentery and meteorological factors was Y=3.792+0.162X(1). Conclusion: The reported incidence of bacillary dysentery in Beijing was much higher than national level. The annual incidence peak was during July to August, and the average precipitation was an important meteorological factor influencing the incidence of bacillary dysentery.
Beijing/epidemiology* ; Child ; China/epidemiology* ; Dysentery, Bacillary/epidemiology* ; Humans ; Incidence ; Linear Models ; Meteorological Concepts ; Multivariate Analysis ; Regression Analysis ; Sex Ratio ; Temperature

Child ; Child, Preschool ; China ; epidemiology ; Cyclonic Storms ; Dysentery ; epidemiology ; Female ; Humans ; Male