Objective:To understand the discovery of human brucellosis cases in new affected counties in Sichuan province, 2015-2017, and provide evidences for prevention and control of human brucellosis.Methods:The incidence data and outbreak data of human brucellosis in Sichuan were collected from Chinese Infectious Disease Surveillance Reporting System, and face to face interview, telephone interview and on-line survey were conducted to collect the case information, such as epidemiological characteristics, medical care seeking.Results:The incidence of human brucellosis in Sichuan has increased obviously since 2013, and 103 counties reported human brucellosis cases for the first time. A total of 23 cases of human brucellosis were investigated, and the common symptoms of the cases was fever, accounting for 91.30 % (21/23). The cases mainly sought medical care in hospitals under county-level for the first time, accounting for 73.91 % (17/23), and the misdiagnosis rate was 91.30 % at the first diagnosis (21/23). The median interval between onset and diagnosis was 52 days, and the longest one was 142 days. Only 4.35 % (1/23) cases knew human brucellosis, and when they contacted with suspected livestock, the use rate of protective clothing was 30.43 % (7/23), the use rate of gloves was 8.70 % (2/23), the use rate of mask was 4.35 % (1/23), and the rate of washing hands with disinfectant after contact with livestock was 4.35 % (1/23). Goat was suspected to be the infection source of all the cases, and 34.75 % (8/23) of the cases were from Gansu, Qinghai and other provinces. The overall awareness rate of human brucellosis in the doctors was 34.58 % (102/295), and the training rate was 58.31 % (172/295). Only 33.33 % (11/33) of the hospitals could perform laboratory diagnosis of human brucellosis and 34.78 % (8/23) of county CDCs could carry out laboratory test of human brucellosis. Conclusions:The prevention and control of human brucellosis is facing challenge in Sichuan. The misdiagnosis rate was very high in newly affected counties, and the diagnosis were delayed obviously. The awareness of human brucellosis was low in the cases, and their awareness of self-protection was poor. The awareness rate about human brucellosis in doctors was low and they need more training; the capacity of brucellosis laboratory diagnosis in hospitals and CDCs at county-level should be improved.

Objective:To explore the epidemiological characteristics of leptospirosis in Sichuan province from 2004 to 2018, and provide evidence for the prevention and control of leptospirosis.Methods:The descriptive epidemiology analysis was conducted based on the epidemic data of leptospirosis collected from the national notifiable infectious disease reporting information system (NNIDRIS) and sentinel surveillance system in 11 areas in Sichuan from 2004 to 2018. The ArcGIS 10.2 software was used for mapping. The SaTScan 9.1.1 software was used to analyze spatiotemporal scanning and characteristics of temporal-spatial clusters of leptospirosis.Results:A total of 2 834 cases of leptospirosis, including 41 deaths, were reported in Sichuan from 2004 to 2018, and the reported morbidity rate was 0.23/100 000 and the mortality rate was 0.003/100 000. It revealed that leptospirosis had an overall downward fluctuated trend. The incidence of leptospirosis had obvious seasonality, mainly from the last ten-day of August to the end of September, 1-2 weeks later after rice harvesting time. The reported cases were mainly males, the male to female ratio of the cases was 2.05∶1. The incidence was higher in age group 50-65 years. The majority of reported cases were farmers, accounting for 82.75% (2 345/2 834), followed by students, accounting for 12.74% (361/2 834). However, rare cases in students had been reported since 2011. In recent years, the high-incidence areas were alternating between Mabian, Muchuan counties along the Yangtze River and Yilong county located in the Jialing River basin. According to the spatial-temporal descriptive analyses by SaTScan, there were two clustering areas in the province where most cases occurred ( P<0.001). The average density of field rats in 11 sentinel surveillance areas was 5.44%(14 351/263 767), and the predominant field rats included Anourosorexsquamipes (69.07%), Apodemusagrarius (12.73%). Whatmore, the density of the Apodemusagrarius ranged from 4.60% to 0.19%, showing downward trend with the lowest level in 2018. The annual culture rate of Leptospira from rat kidney samples declined. During 2007-2018, the average positive rate of Leptospira antibodies in healthy people was 24.52%(3 271/13 339), and the predominant serogroup was Icterohaemorrhagiae. There was no replacement of Leptospira serogroup in recent years. Conclusions:The incidence of leptospirosis in Sichuan was extremely low during 2004-2018, and the incidence peak of leptospirosis occurred in rice harvesting period. The cases were mainly old farmers, and the high-risk areas were constantly alternating between the Yangtzi River and the Jialing River basin. Both the density and the carriage rate of Leptospira of Apodemusagrarius were low, and the predominant serogroup was Icterohaemorrhagiae. The average positive rate of leptospira antibodies in healthy people was very low.