ObjectiveTo investigate and analyze an outbreak of rotavirus infectious diarrhea in a prison in Chongqing Municipality, to provide a basis for adult rotavirus surveillance and prevention, and to explore the public health problems in special settings. MethodsA retrospective survey was conducted to collect and analyze data on individual cases with diarrheal disease on-site. The clinical characteristics, as well as the temporal, spatial and geographical distribution patterns of the epidemic were described. Multi-pathogen detection tests were conducted both on diarrhea cases and environmental samples, with viral genotyping performed on positive samples. A case-control analysis was performed to identify the causes of the outbreak, and an SEIR model was adopted to predict the outbreak trend and evaluate the effectiveness of interventions. ResultsA total of 65 cases were found among the inmates, with an attack rate of 2.03%. The predominant clinical manifestations included diarrhea (89.23%), watery stool (73.85%), and dehydration (18.46%). The epidemic curve indicated a “human-to-human” transmission pattern, with an average incubation period of 5‒6 days. The attack rates among chefs in the main canteen (80.00%, 8/10) and caterers (28.33%, 17/60) were significantly higher than those of other inmates （P<0.05）. Multi-pathogen polymerase chain reaction (PCR) testing detected positive for group A rotavirus, with the viral genotyping identified as G9P [8] strain. Factors such as unprotected "bare-handed" food distribution among cases with diarrhea (OR=9.512, 95%CI: 4.261‒21.234) and close contact with diarrhea cases (OR=3.656, 95%CI: 1.719‒7.778) were the possible cause of the outbreak. The SEIR model (r₀=5, α=0.3, β₁=0.08, β₂=0.04) was constructed using prison inmates as susceptible population, aiming at fitting the initial transmission trend of the outbreak, and the epidemic rate declined rapidly after intervention measures were implemented (r_t≈0). ConclusionThis rare rotavirus infection diarrhea outbreak among adults in confined settings suggests that the construction of public health prevention and control systems in prison may be overlooked. Cross infection during meal processing and distribution in the canteens of such settings is likely to be the cause of the outbreak. Given the potential neglect of public heath system construction in special settings, it is imperative to enhance the surveillance and monitoring of rotavirus and other intestinal multi-pathogens among adults, as well as the construction of public health prevention and control systems in these special settings.

Objective: To investigate the trends in incidence of HIV/AIDS in China from 1990 to 2019 and to examine the effect of age, period and cohort on the incidence of HIV/AIDS, so as to provide insights into the improvements of the HIV/AIDS control measures. Methods: Data pertaining to incidence of HIV/AIDS in China from 1990 to 2019 were extracted from the Global Burden of Disease Study 2019 (GBD 2019) datasets, and the trends in incidence of HIV/AIDS in China from 1990 to 2019 was analyzed with annual percentage change (APC) and average annual percentage change (AAPC) using a jointpoint regression model. The effects of age, period and cohort on the incidence of HIV/AIDS in China were examined with an age-period-cohort model. Results: The age-standardized incidence of HIV/AIDS appeared an overall tendency towards a rise in China from 1990 (0.80/105) to 2019 (2.21/105) (AAPC=3.209%, P<0.05), and the incidence of HIV/AIDS showed a tendency towards a rise from 1990 to 1997 (AAPC=9.044%, P<0.05) and from 1997 to 2003 (AAPC=17.598%, P<0.05), a decline from 2006 to 2014 (AAPC=-8.412%, P<0.05) and remained relatively stable from 2003 to 2006 and from 2014 to 2019 (both P>0.05). The incidence of HIV/AIDS appeared a tendency towards a rise with age, and peaked among patients at ages of 25 to 29 years (4.93/105) and 75 to 79 years (7.38/105). The risk of HIV/AIDS appeared a tendency towards a rise followed by a decline with time, and a reduced risk of HIV/AIDS was found from 1990 to 1994 (RR=0.297), from 1995 to 1999 (RR=0.523), from 2005 to 2009 (RR=0.737), from 2010 to 2014 (RR=0.412) and from 2015 to 2019 (RR=0.351) in relative to the period from 2000 to 2004. The risk of HIV/AIDS appeared a tendency towards a rise with the cohort, and a higher risk of HIV/AIDS was found in the 1930-1934 cohort (RR=1.880) and 2000-2004 cohort (RR=2.978) in relative to the 1955-1959 cohort. Conclusions The incidence of HIV/AIDS appeared a tendency towards a rise followed by a decline in China from 1990 to 2019, and remained at a low level since 2014. The adolescents and elderly were high-risk groups of HIV/AIDS. A variety of health education interventions and intensified active HIV/AIDS screening are recommended.