This study investigated the infectious status and pathogen characteristics of Leptospira in rodents and the environment in Fujian province to provide data for the prevention and control of leptospirosis.A total of 723 rodents and 31 water samples were col-lected from 19 regions in Fujian Province during 2020-2023.The prevalent rodent species was Rattus losea(35.82%,259/723),which was followed by Rattus norvegicus(20.06%,145/723),Rattus tanezumi(19.64%,142/723),and Niviventer fulvescens(13.97%,101/723).A total of 144 positive samples of Leptospira spp.were detected in rodent kidney samples,accounting for 19.92%(144/723).The positivity rate of Leptospira spp.in wild rodents was higher than that in domestic rodents(χ2=8.48,P<0.05),and the positivity rate in adult rodents was higher than that in juvenile rodents(χ2=14.19,P<0.05).The positivity rates varied among rodent species(χ2=46.11,P<0.05),and differences in the positivity rates of Leptospira spp.were observed among regions(χ2=32.113,P<0.05).Ten strains were isolated from 440 rodent samples,and the isolation rate was 2.27%(10/440).Genospecies identification indi-cated that Leptospira borgpetersenii accounted for seven of the ten isolates,and L.interrogans accounted for three.MLST typing divided 10 isolates into three ST types:ST1,ST16,and ST143.5 isolates were isolated from 31 water samples,with an isolation rate of 16.13%,all of which were nonpathogenic L.tsangambouensis.Although pathogenic Leptospira spp.were not isolated from the water samples,the rodents in Fujian Province were generally infected with pathogenic Leptospira spp.Surveillance of the environment and ro-dents infected with Leptospira spp.should be strengthened.

To analyze the epidemiological characteristics of COVID-19 in Fujian Province from the 49th week of 2022 to the 5th week of 2023,after further optimization of China's COVID-19 prevention and control measures on December 7,2022(the 49th week of 2022),this study used multi-dimensional surveillance data to dynamically assess population infection levels and their changing trends.The aim of the study was to provide a scientific basis for early warning of epidemic risk,medical resource allocation,and evalu-ation of socio-economic impact.A multi-source data surveillance system was constructed,encompassing surveillance of fever clinics at medical institutions(weekly collection of visits,positive nucleic acid and antigen test results,inpatients,and severe cases in sec-ondary or above hospitals),population nucleic acid test monitoring(weekly person-times and positivity rates of single-tube tests from the provincial system),sentinel hospital monitoring(weekly proportion of influenza-like illness visits at 18 sentinel hospitals and re-lated viral testing data),and monitoring of novel coronavirus variants(weekly systematic collection of genomic sequences of local and imported cases).Line charts were plotted weekly,and time series analysis,molecular epidemiological methods,and an improved SEIAR model were used to simulate epidemic spread.During the study period,the COVID-19 epidemic in Fujian Province exhibited three distinct stages.In the infection peak stage(52nd week of 2022),the provincial fever clinic visits reached 606 893 person-times,and a 49.2%positivity rate in population single-tube nucleic acid tests and 63.8%positivity rate in sentinel hospital monitoring were observed.In the medical load peak stage(2nd week of 2023),274 460 inpatients and 28 487 severe cases were recorded.In the epidemic decline stage(4th to 5th weeks of 2023),fever clinic visits decreased by 96.3%with respect to the peak,the single-tube nucleic acid test positivity rate decreased to 6.3%,and the sentinel hospital COVID-19 nucleic acid test positivity rate was 6.4%.All 508 sequenced local cases were Omicron variants,predominantly BA.5.2 and its sub-lineages(67.4%).Among 56 imported se-quenced cases,BA.5.2 and its sub-lineages accounted for 50.0%,and 16.1%comprised nine variants of interest including XBB and BQ.The model predicted the infection peak in the 52nd week of 2022,whereas the hospitalization peak lagged by approximately 10.6 days.Multi-source data monitoring revealed a three-stage development of the COVID-19 epidemic in Fujian.The BA.5.2 strain was dominant during the epidemic.The combination of multi-source monitoring data and modeling provides important references for epi-demic prevention and control,and highlights the need to improve the monitoring system in follow-up.

This study investigated the infectious status and pathogen characteristics of Leptospira in rodents and the environment in Fujian province to provide data for the prevention and control of leptospirosis.A total of 723 rodents and 31 water samples were col-lected from 19 regions in Fujian Province during 2020-2023.The prevalent rodent species was Rattus losea(35.82%,259/723),which was followed by Rattus norvegicus(20.06%,145/723),Rattus tanezumi(19.64%,142/723),and Niviventer fulvescens(13.97%,101/723).A total of 144 positive samples of Leptospira spp.were detected in rodent kidney samples,accounting for 19.92%(144/723).The positivity rate of Leptospira spp.in wild rodents was higher than that in domestic rodents(χ2=8.48,P<0.05),and the positivity rate in adult rodents was higher than that in juvenile rodents(χ2=14.19,P<0.05).The positivity rates varied among rodent species(χ2=46.11,P<0.05),and differences in the positivity rates of Leptospira spp.were observed among regions(χ2=32.113,P<0.05).Ten strains were isolated from 440 rodent samples,and the isolation rate was 2.27%(10/440).Genospecies identification indi-cated that Leptospira borgpetersenii accounted for seven of the ten isolates,and L.interrogans accounted for three.MLST typing divided 10 isolates into three ST types:ST1,ST16,and ST143.5 isolates were isolated from 31 water samples,with an isolation rate of 16.13%,all of which were nonpathogenic L.tsangambouensis.Although pathogenic Leptospira spp.were not isolated from the water samples,the rodents in Fujian Province were generally infected with pathogenic Leptospira spp.Surveillance of the environment and ro-dents infected with Leptospira spp.should be strengthened.

To analyze the epidemiological characteristics of COVID-19 in Fujian Province from the 49th week of 2022 to the 5th week of 2023,after further optimization of China's COVID-19 prevention and control measures on December 7,2022(the 49th week of 2022),this study used multi-dimensional surveillance data to dynamically assess population infection levels and their changing trends.The aim of the study was to provide a scientific basis for early warning of epidemic risk,medical resource allocation,and evalu-ation of socio-economic impact.A multi-source data surveillance system was constructed,encompassing surveillance of fever clinics at medical institutions(weekly collection of visits,positive nucleic acid and antigen test results,inpatients,and severe cases in sec-ondary or above hospitals),population nucleic acid test monitoring(weekly person-times and positivity rates of single-tube tests from the provincial system),sentinel hospital monitoring(weekly proportion of influenza-like illness visits at 18 sentinel hospitals and re-lated viral testing data),and monitoring of novel coronavirus variants(weekly systematic collection of genomic sequences of local and imported cases).Line charts were plotted weekly,and time series analysis,molecular epidemiological methods,and an improved SEIAR model were used to simulate epidemic spread.During the study period,the COVID-19 epidemic in Fujian Province exhibited three distinct stages.In the infection peak stage(52nd week of 2022),the provincial fever clinic visits reached 606 893 person-times,and a 49.2%positivity rate in population single-tube nucleic acid tests and 63.8%positivity rate in sentinel hospital monitoring were observed.In the medical load peak stage(2nd week of 2023),274 460 inpatients and 28 487 severe cases were recorded.In the epidemic decline stage(4th to 5th weeks of 2023),fever clinic visits decreased by 96.3%with respect to the peak,the single-tube nucleic acid test positivity rate decreased to 6.3%,and the sentinel hospital COVID-19 nucleic acid test positivity rate was 6.4%.All 508 sequenced local cases were Omicron variants,predominantly BA.5.2 and its sub-lineages(67.4%).Among 56 imported se-quenced cases,BA.5.2 and its sub-lineages accounted for 50.0%,and 16.1%comprised nine variants of interest including XBB and BQ.The model predicted the infection peak in the 52nd week of 2022,whereas the hospitalization peak lagged by approximately 10.6 days.Multi-source data monitoring revealed a three-stage development of the COVID-19 epidemic in Fujian.The BA.5.2 strain was dominant during the epidemic.The combination of multi-source monitoring data and modeling provides important references for epi-demic prevention and control,and highlights the need to improve the monitoring system in follow-up.

Abstract: Objective To analyze the incidence trend and epidemiological characteristics of dengue fever in Fujian Province from 2009 to 2023, identify the high-incidence population and hotspot areas, and a scientific basis for formulating targeted prevention and control measures. Methods The surveillance data of dengue fever during 2009-2023 in Fujian Province were obtained from the National Disease Reporting Information System and analyzed using descriptive epidemiological methods, and the spatial autocorrelation analysis of dengue fever incidence at county/district levels was performed with ArcGlS 10.8. Results A total of 3 586 cases of dengue fever were reported in Fujian Province from 2009 to 2023, with an average annual incidence rate of 0.61/100 000, showing an overall increasing trend year by year (Z=18.35, P<0.001). Among them, there were 2 362 local cases and 1 224 imported cases, with a local/imported ratio of 1.93∶1 (2 362/1 224). The local cases were mainly distributed in Fuzhou, Putian, and Nanping, accounting for 87.81% (2 074/2 362). The imported cases were mainly distributed in Quanzhou, Fuzhou, and Xiamen, accounting for 72.55% (888/1 224). The local/imported ratio in Fuzhou, Nanping, and Putian was 6.20∶1 (1 557/251), 3.92∶1 (145/37), and 3.32∶1 (372/112), respectively, all significantly higher than the provincial average level. The spatial distribution of the local cases showed a clustered pattern, with 12 hotspots of incidence, all located in the counties and districts under the jurisdiction of Fuzhou. The onset of the disease had obvious seasonality: imported cases from other countries or regions mainly occurred from July to September (accounting for 45.73%, 519/1 135), imported cases from other provinces mainly occurred from August to November (accounting for 93.25%, 83/89), and local cases mainly occurred from August to October (accounting for 97.50%, 2 303/2 362). The gender ratio for local cases was 0.88∶1, and for imported cases, it was 3.04∶1. The average age of onset for local cases was 48 years old (Q1=32 years old, Q3=62 years old), while the average age for imported cases was 35 years old (Q1=28 years old, Q3=44 years old). Conclusions From 2009 to 2023, the dengue fever epidemic in Fujian Province showed a continuous upward trend, with spatiotemporal clustering of incidence. Therefore, prevention and control measures should be strengthened in key areas and populations during the high-incidence season.

Abstract: Objective To analyze the epidemiological characteristics of viral hepatitis E in Fujian Province from 2012-2021, and to provide scientific evidence for the prevention and control of hepatitis E in the future. Methods Descriptive epidemiological method was used to analyze hepatitis E cases in Fujian Province from 2012 to 2021. Results From 2012 to 2021, a total of 8 877 cases of hepatitis E were reported in Fujian Province from 2012-2021. The overall incidence rate showed a decreasing trend (χ2trend =458.14, P<0.001), with the lowest incidence rate of 1.32/100 000 in 2020 and an annual average incidence rate of 2.29/100 000 per year. The incidence was higher in winter and spring, with the months of March and April having the highest number of reported cases (2 146, 24.17%) and the fewest cases were reported in September (571, 6.43%). The difference in reported incidence rates between cities was statistically significant (χ2=1 877.75, P<0.01). The comprehensive experimental zone of Pingtan had the highest average reported incidence rate of 6.03/100 000, while Zhangzhou had the lowest at 0.94/100 000. The number of male cases was higher than the number of female cases, with a male to female ratio of 2.04∶1. The disease was most prevalent among middle-aged and elderly individuals, with the age group of 40-<65 years having the highest number of reported cases, accounting for 57.44% (5 099/8 877) of all cases. The age group of 50-<55 years had the highest reported incidence, with the number of reported cases increasing with age below 50 years, but decreasing with age over 50 years. As for occupational distribution, peasants had the highest proportion of the disease, accounting for 34.49% (3 062 cases) of the total cases. Conclusions The reported incidence rate of hepatitis E in Fujian showed a downward from 2012 to 2021. Due to the impact of COVID-19, incidence of the lowest was 2020, but it did not reflect the true situation of the disease, which may have affected trend of hepatitis E. In order to control and reduce the incidence of hepatitis E, efforts should be made to increase publicity and education on health knowledge and vaccination among key areas and populations, strengthen monitoring and diagnostic capability, and implement comprehensive prevention and control measures.

Objective: To elucidate the epidemiological and etiological features of a local outbreak of dengue fever (DF) in Taijiang district in Fuzhou, Fujian province in 2017, and speculate possible viral source based on phylogenetic analysis. Methods: The clinical and demographic data of cases were collected through field investigation and the outbreak was characterized epidemiologically by descriptive method. The patient′s serum were collected and the adult mosquitoes were captured by anti-mosquito double-net method for the laboratorial test and viral isolation. The viral isolates were typed by real-time fluorescent RT-PCR and their full length of viral envelope (E) genes were amplified by RT-PCR and sequenced. The E gene sequences obtained in this study, together with the reference sequences, were used for the phylogenetic analysis. Results: A total of 13 cases of autochthonous DF were confirmed in the outbreak. All cases presented obvious clinical manifestations and clustered spatially and temporally. The Breteau Index (BI) of mosquito larva density was the highest in epidemic foci of Xingang street and was relatively low in surrounding areas. Four DENV-1 strains, three from patients and one from the captured adult Aedes albopictus, were isolated and identified by real-time RT-PCR. Full length E gene sequences of the four isolates were completely identical and phylogenetic analysis showed that the isolates were genetically closest to the strain (GenBank No. KT825033) from Vietnam in 2014, rather than the DENV-1 strains found in Fujian previously. Conclusions The DF outbreak occurred in Fuzhou in 2017 was caused by DENV-1 which was imported possibly from somewhere outside of Fujian province and subsequently led to local DF transmission in human via the mosquito Aedes albopictus.

Objective To analyze the epidemiological characteristics and spatial distribution of human brucellosis in Fujian province during 2011-2016,and provide evidence for the prevention and control of the disease.Methods The surveillance data of human brucellosis in Fujian during 2011-2016 was analyzed with software R 3.3.1,ArcGIS 10.3.1,GeoDa 1.8.8 and SaTScan 9.4.3.Results During 2011-2016,a total of 319 human brucellosis cases were reported,the incidence increased year by year (F=11.838,P=0.026) with the annual incidence of 0.14/100 000.The male to female rate ratio of the incidence was 2.50 ∶ 1.Farmers and herdsmen accounted for 57.37％.The incidence was 0.40/100 000 in Zhangzhou and 0.32/100 000 in Nanping,which were higher than other areas.The number of affected counties (district) increased from 12 in 2011 to 28 in 2016,showing a significant increase (F=13.447,P=0.021).The Moran' s I of brucellosis in Fujian between January 2011 and December 2016 was 0.045,indicating the presence of a high value or low value clustering areas.Local spatial autocorrelation analysis showed that,high-high clustering area (hot spots) were distributed in Zhangpu,Longhai,Longwen,etc,while high-low clustering areas were distributed in Nan' an and Jiaocheng,etc.Temporal scanning showed that there were three clustering areas in areas with high incidence,the most possible clustering,occurring during January 1,2013-December 31,2015,covered 6 counties,including Yunxiao,Pinghe,Longhai,etc,and Zhangpu was the center,(RR =7.96,LLR=92.62,P＜0.001).Conclusions The epidemic of human brucellosis in Fujian is becoming serious,and has spread to general population and non-epidemic areas.It is necessary to strengthen the prevention and control of human brucellosis in areas at high risk.

In this study,we analyzed the data of hemorrhagic fever with renal syndrome (HFRS) and host animals monitoring in Zhangzhou City,Fujian Province,China,2006-2015,in order to find out the epidemic situation and risk factors,and provide a scientific basis for the prevention and control strategy.A total of 171 HFRS cases,including 1 death,were reported in Zhangzhou in this decade.The incidence rate of 0.352/105 showed an upward trend (xtrend2 =58.60,P＜0.01).And 70 villages and towns in 11 counties have affected,accounting for 56.00％ of the counties in Zhangzhou City.The cases were mainly reported in some towns of Huaan,Nanjing and Zhaoan countries.The cases mainly occurred in countryside,which reported 142 cases.The cases in farmers accounted for the highest proportion (79.58 ％),and pig farming staff accounting for 23.01％ in farmer cases.Most cases were reported in municipal hospitals (86.55 ％).The common clinical manifestations of those cases were fever,nausea,vomiting,backache,headache,pain,oliguria or anuria,eyelid edema and so on,with 72.67％ of thrombocytopenia and of 83.09 ％ proteinuria positive.Compared with the proportion (80.49 ％) of mice in patients' house from 2006 to 2010,that (45.83％) from 2011 to 2015 decreased obviously;however,the proportion of mice or mice droppings in workplaces were rising from 60.98％ to 73.33％.Mean rodent density was 6.40％ and total infection rate in rats was 7.42％.The main kind of rats with virus infection was Rattus norvegicus,carrying Seoul virus Ⅱ.Results of this study indicate that Zhangzhou is one of the foci of HFRS rodent,and the epidemic is rising in recent years,the overall in the highly distributed,while some counties showed a rising trend year by year.Thus,monitoring and control efforts in prone areas should be increased,and to carry out clinics training of HFRS in primary health care institutions.

OBJECTIVEA Dengue outbreak was reported in Dongfen town Jianou county, Fujian province on September 19, 2014. The goal of this project was to explore the role of syndromic surveillance program in the practice of early detection on disease outbreak through the case mentioned above.

METHODSThe authors retrospectively collected data related to Outpatient log and Pharmacy drug use in Dongfen township hospital through the electronic information system of the hospital from August to November, 2014. All the abnormal events were recorded, according to related data on fever and drug use. Description of fever, syndromic characteristics, correlation and Linear regression analyses were conducted, using the surveillance data on fever syndrome and drug use from the pharmacy.

RESULTSA total of 1 102 cases with fever and 2 437 fever-related clinic visits were reported which showing an increased number of 19.6, 10.2 times respectively, when compared to the same period of the previous year in which men accounted for 45.3% (499/1 102) and female accounted for 54.7% (603/1 102). Age groups presented an atypical type " M" type. 5 and 10 year olds groups formed the largest proportion, accounted for 11.5% (127/1 102) of the total number os the patients. The correlation coefficient ranged from 0.85 to 0.97 (P<0.05). Data from the syndromic surveillance program showed an " outbreak" was occured in August 23, 2014.

CONCLUSIONSCompared to routine surveillance program, the syndromic surveillance program could detect the appearence of an outbreak, a month or even more earlier. The role of syndromic surveillance program needs to be further explored.

Data Collection ; Dengue ; diagnosis ; epidemiology ; prevention & control ; Disease Outbreaks ; prevention & control ; Drug Prescriptions ; statistics & numerical data ; Drug Utilization ; statistics & numerical data ; trends ; Early Diagnosis ; Female ; Fever ; etiology ; Health Information Systems ; Humans ; Male ; Pharmacy Service, Hospital ; Population Surveillance ; methods ; Retrospective Studies