Objectives: Hand, foot and mouth disease (HFMD) is a widespread infectious disease that causes a significant disease burden on society. To achieve early intervention and to prevent outbreaks of disease, we propose a novel warning model that can accurately predict the incidence of HFMD. Methods: We propose a spatial-temporal graph convolutional network (STGCN) that combines spatial factors for surrounding cities with historical incidence over a certain time period to predict the future occurrence of HFMD in Guangdong and Shandong between 2011 and 2019. The 2011-2018 data served as the training and verification set, while data from 2019 served as the prediction set. Six important parameters were selected and verified in this model and the deviation was displayed by the root mean square error and the mean absolute error. Results: As the first application using a STGCN for disease forecasting, we succeeded in accurately predicting the incidence of HFMD over a 12-week period at the prefecture level, especially for cities of significant concern. Conclusions This model provides a novel approach for infectious disease prediction and may help health administrative departments implement effective control measures up to 3 months in advance, which may significantly reduce the morbidity associated with HFMD in the future.
China/epidemiology* ; Cities/epidemiology* ; Data Visualization ; Disease Outbreaks/statistics & numerical data* ; Forecasting/methods* ; Hand, Foot and Mouth Disease/prevention & control* ; Humans ; Incidence ; Neural Networks, Computer ; Reproducibility of Results ; Spatio-Temporal Analysis ; Time Factors

INTRODUCTION: We evaluated the impact of public health measures on paediatric emergency department attendances during the COVID-19 and severe acute respiratory syndrome (SARS) outbreaks in Singapore. METHODS: Between 1 January 2020 and 31 July 2020, we retrospectively reviewed paediatric emergency department attendances and admissions in a tertiary paediatric hospital in Singapore before and after a national lockdown to combat the spread of COVID-19 in Singapore. Hospital attendances and admissions were compared with data from a corresponding period in 2019 (1 January 2019 to 31 July 2019), as well as during and after the SARS outbreak (1 January 2003 to 31 December 2004). RESULTS: Compared with a corresponding non-outbreak period, emergency department attendances decreased in line with nationwide public health measures during the COVID-19 and SARS outbreaks (2020 and 2003 respectively), before increasing gradually following lifting of restrictions, albeit not to recorded levels before these outbreaks. During the COVID-19 outbreak, mean daily attendances decreased by 40%, from 458 per day in January-July 2019, to 274 per day in January-July 2020. The absolute number of hospital inpatient admissions decreased by 37% from January-July 2019 (19,629) to January-July 2020 (12,304). The proportion of emergency department attendances requiring admission remained similar: 20% in January-July 2019 and 21% in January-July 2020. CONCLUSION Nationwide public health measures in Singapore have had an impact on paediatric emergency department attendances and hospital inpatient admissions. Data from this study could inform planning and resource allocation for emergency departments in Singapore and internationally.
Adolescent ; COVID-19/prevention & control* ; Child ; Child, Preschool ; Disease Outbreaks ; Emergency Service, Hospital/trends* ; Facilities and Services Utilization/trends* ; Female ; Health Policy ; Humans ; Infant ; Infant, Newborn ; Male ; Patient Acceptance of Health Care/statistics & numerical data* ; Patient Admission/trends* ; Pediatrics ; Retrospective Studies ; Severe Acute Respiratory Syndrome/epidemiology* ; Singapore/epidemiology*

Objective: To analyze the reasons for the fluctuations in the percentage of outpatient or emergency visits for influenza-like illness (ILI) during the Spring Festival and National Day in 2014-2018 surveillance season. Methods: ILI surveillance data was collected during the period of Spring Festival and National Day in mainland China, and downloaded from Chinese Influenza Surveillance Information System, during the 2014-2018 surveillance season. Results: There was no significant difference noticed in the number of ILI reports in the festival week with weeks before or after in both the southern and northern provinces. The number of outpatient visits was much less than that of the week before and after, but the number of emergency visits was statistically significantly increased. Conclusion: In the holiday peak of ILI%, the major causes was the impact of holiday-off at sentinel hospitals, resulting in a large reduction in the number of outpatient visits in the consulting room during the festivals.
Adolescent ; Adult ; Biometry ; Child ; Child, Preschool ; China/epidemiology* ; Disease Outbreaks/prevention & control* ; Emergency Service, Hospital/statistics & numerical data* ; Holidays ; Hospitals ; Humans ; Influenza, Human/virology* ; Outpatients/statistics & numerical data* ; Population Surveillance ; Respiratory Syncytial Virus Infections/virology* ; Respiratory Syncytial Virus, Human/isolation & purification* ; Respiratory Tract Infections/virology* ; Seasons ; Young Adult

PURPOSE: The purpose of this study was to survey the current state of measles vaccination in university nursing students during a measles outbreak and to identify factors influencing nursing students' vaccination rate. METHODS: In 2014, this study used a self-administered questionnaire to survey 380 university nursing students. Factors influencing measles vaccination were identified through logistic regression analysis using variables between the vaccinated and nonvaccinated groups. RESULTS: Measles vaccination rate was 52.1%. The vaccination rate was significantly higher in juniors, seniors, and those who had heard about measles. In relation to health beliefs, the measles vaccination rate was higher when perceived benefits were high and perceived barriers were low. CONCLUSIONS: A systematic measles vaccination program targeting nursing students upon their entry to university is needed. In order to increase the measles vaccination rate, application of effective promotion campaigns and education programs is necessary.
Adult ; Disease Outbreaks/*prevention & control ; Female ; *Health Knowledge, Attitudes, Practice ; Humans ; Immunization Programs/*statistics & numerical data ; Male ; Measles/*prevention & control ; Republic of Korea ; Students, Nursing/*psychology ; Surveys and Questionnaires ; Universities ; Vaccination/*psychology ; Young Adult

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

Chickenpox ; prevention & control ; China ; Disease Outbreaks ; prevention & control ; Humans ; Schools ; Vaccination ; statistics & numerical data

No abstract available.
Coronavirus Infections/*diagnosis/epidemiology/*prevention & control ; Cross Infection/*diagnosis/epidemiology/*prevention & control ; Disease Outbreaks/prevention & control/*statistics & numerical data ; Global Health/*trends ; Humans ; Incidence ; Population Surveillance/methods ; Republic of Korea/epidemiology

PURPOSE: This study was to identify the current status of vaccination against the pandemic (H1N1) 2009 virus among university students from the fields of nursing and allied health from a local community and verify factors influencing vaccination. METHODS: The study included 227 students in the fields of nursing and allied health from a provincial university. Data were obtained from these participants between May 31 and June 11, 2010 by using self-report questionnaires. RESULTS: The rate of vaccination against the pandemic (H1N1) 2009 virus for these participants was 14.5%. No difference was observed in this regard between majors and school year. Factors that influence vaccination against this virus included previous vaccination against seasonal influenza and participants' attitudes toward general vaccination. CONCLUSION: The results suggest that for effective pandemic (H1N1) 2009 vaccination of university students from the fields of nursing and allied health, students who have not been vaccinated should be intensively managed. Developing a vaccination program that encourages a positive attitude toward vaccination is recommended.
Adult ; Attitude of Health Personnel ; Disease Outbreaks/prevention & control ; Female ; Humans ; Influenza A Virus, H1N1 Subtype/*immunology ; Influenza Vaccines/*immunology ; Influenza, Human/epidemiology/prevention & control ; Male ; Pandemics ; Questionnaires ; Students, Health Occupations/*psychology ; Students, Nursing/*psychology ; Vaccination/*statistics & numerical data ; Young Adult

INTRODUCTIONWe carried out an epidemiological review of cholera in Singapore to determine its trends and the factors contributing to its occurrence.

MATERIALS AND METHODSEpidemiological data of all notified cases of cholera maintained by the Communicable Diseases Division, Ministry of Health, for the period 1992 to 2007 were collated and analysed. Case-control studies were carried out in outbreaks to determine the source of infection and mode of transmission. Linear patterns in age and ethnic distribution of cholera cases were assessed using chi2 test for trend.

RESULTSThere were a total of 210 cholera cases reported between 1992 and 2007. The incidence of cholera declined from 17 cases in 1992 to 7 cases in 2007. About a quarter of the cases were imported from endemic countries in the region. Between 76% and 95% of the reported cases were local residents. Four elderly patients with comorbidities and who sought medical treatment late died, giving a case-fatality rate of 1.9%. Vibrio cholerae 01, biotype El Tor, serotype Ogawa, accounted for 83.8% of the cases. The vehicles of transmission identified in outbreaks included raw fi sh, undercooked seafood and iced drinks cross-contaminated with raw seafood.

CONCLUSIONWith the high standard of environmental hygiene and sanitation, a comprehensive epidemiological surveillance system and licensing and control of food establishments, cholera could not gain a foothold in Singapore despite it being situated in an endemic region. However, health education of the public on the importance of personal and food hygiene is of paramount importance in preventing foodborne outbreaks. Physicians should also maintain a high level of suspicion of cholera in patients presenting with severe gastroenteritis, especially those with a recent travel history to endemic countries.

Adolescent ; Child ; Child, Preschool ; Cholera ; microbiology ; mortality ; Disease Outbreaks ; statistics & numerical data ; Female ; Foodborne Diseases ; epidemiology ; prevention & control ; Humans ; Incidence ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Population Surveillance ; Singapore ; epidemiology ; Vibrio cholerae O1 ; isolation & purification ; Young Adult

INTRODUCTIONWe reviewed the epidemiology of hand, foot and mouth disease (HFMD) in Singapore after the 2000 epidemic caused by Enterovirus 71 (EV71), with particular reference to the cyclical pattern, predominant circulating enteroviruses and impact of prevention and control measures in preschool centres.

MATERIALS AND METHODSWe analysed the epidemiological data from all clinical cases and deaths of HFMD diagnosed by medical practitioners and notified to the Ministry of Health, as well as laboratory data on enteroviruses detected among HFMD patients maintained by the Department of Pathology, Singapore General Hospital, and the Microbiology Laboratory, KK Women's and Children's Hospital from 2001 to 2007.

RESULTSThe incidence rate was highest in the 0 to 4 years old age group, with males being predominant. Three deaths were reported between January and February 2001. Nationwide epidemics occurred periodically; the predominating circulating virus was Coxsackievirus A16 (CA16) in the 2002, 2005 and 2007 epidemics, and EV71 in the 2006 epidemic. During the epidemic years between 2005 and 2007, 2 peaks were observed. The number of institutional outbreaks had increased 10-fold from 167 in 2001 to 1723 in 2007, although most of these outbreaks were rapidly brought under control with an attack rate of less than 10%.

CONCLUSIONHFMD remains an important public health problem in Singapore with the annual incidence rate per 100,000 population increasing from 125.5 in 2001 to 435.9 in 2007, despite stringent measures taken in preschool centres to prevent the transmission of infection. A high degree of vigilance should be maintained over the disease situation, in particular, surveillance of EV 71 which continues to cause severe complications and deaths in the region.

Adolescent ; Adult ; Child ; Child, Preschool ; Communicable Disease Control ; methods ; Disease Outbreaks ; prevention & control ; statistics & numerical data ; Female ; Hand, Foot and Mouth Disease ; epidemiology ; prevention & control ; Humans ; Infant ; Infant, Newborn ; Male ; Middle Aged ; Retrospective Studies ; Singapore ; epidemiology ; Young Adult