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Sun CQ, Fu YQ, Ma X, Shen JR, Hu B, Zhang Q, Wang LK, Hu R, Chen JJ. Trends in temporal and spatial changes of Japanese encephalitis in Chinese mainland, 2004-2019: A population-based surveillance study. Travel Med Infect Dis 2024; 60:102724. [PMID: 38692338 DOI: 10.1016/j.tmaid.2024.102724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 03/23/2024] [Accepted: 04/28/2024] [Indexed: 05/03/2024]
Abstract
BACKGROUND Japanese encephalitis (JE) is a serious health concern in China, with approximately 80 % of global infections occurring in China. To develop effective prevention and control strategies, this study explored the epidemiological characteristics of JE in China based on spatiotemporal data, to understand the patterns and trends of JE incidence in different regions and time periods. METHOD The incidence and mortality rates of JE were extracted from the Public Health Data Center, the official website of the National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System from 2004 to 2019. Joinpoint regression was applied to examine the spatiotemporal patterns and annual percentage change in incidence and mortality of the JE. RESULTS From 2004 to 2019, a total of 43,569 cases of JE were diagnosed, including 2081 deaths. The annual incidence rate of JE decreased from 0.4171/100,000 in 2004 to 0.0298/100,000 in 2019, with an annual percentage change (APC) of -13.5 % (P < 0.001). The annual mortality rate of JE showed three stages of change, with inflection points in 2006 and 2014. The incidence and mortality rates of JE have declined in all provinces of China, and more cases were reported in 0-14 years of age, accounting for nearly 80 % of all patients. CONCLUSIONS The morbidity and mortality rates of JE in China are generally on a downward trend, and emphasis should be placed on strengthening disease surveillance in special areas and populations, popularizing vaccination, and increasing publicity.
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Affiliation(s)
- Chang-Qing Sun
- Department of College of Public Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China; School of Nursing and Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China.
| | - Yun-Qiang Fu
- Department of College of Public Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China.
| | - Xuan Ma
- Department of College of Public Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China
| | - Jun-Ru Shen
- Department of College of Public Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China
| | - Bo Hu
- School of Nursing and Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China
| | - Qiang Zhang
- School of Nursing and Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China
| | - Lian-Ke Wang
- School of Nursing and Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China
| | - Rui Hu
- Department of College of Public Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China
| | - Jia-Jun Chen
- Department of College of Public Health, Zhengzhou University, High-Tech Development Zone of States, Zhengzhou, 450001, PR China.
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Zheng P, Wen Z, Liu Y, Wang Q. The spatiotemporal distribution and prognostic factors of Japanese encephalitis in Shanxi Province, China, 2005-2022. Front Cell Infect Microbiol 2023; 13:1291816. [PMID: 38179427 PMCID: PMC10764619 DOI: 10.3389/fcimb.2023.1291816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Accepted: 12/04/2023] [Indexed: 01/06/2024] Open
Abstract
Japanese encephalitis (JE) is a naturally occurring localized disease caused by the Japanese encephalitis virus, which is spread by the Culex tritaeniorhynchus. China has a high rate of JE. Shanxi, located in North China, has a high prevalence of adult JE. Adult JE has more severe complications, mortality, and a higher disease burden, making it a public health issue. This retrospective study examined the dynamic epidemic changes, high-risk areas of JE, and clinical characteristics and prognostic factors of adult JE in Shanxi Province. The findings revealed that July to September was the primary epidemic season of JE and that JE cases were mainly in individuals over the age of 40. The incidence of JE from 2005 to 2022 demonstrated a positive spatial correlation with significant clustering characteristics, with high-incidence clusters in the south and southeast. Multivariate logistic regression analysis revealed that higher cerebrospinal fluid pressure, higher white blood cell counts, higher neutrophil percentage, deep coma, and lower albumin were independent factors for poor prognosis of adult JE. The developed risk prediction model holds great promise in early prognosis assessment of patients, providing a basis for clinical decision-making and early clinical intervention.
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Affiliation(s)
- Peiyu Zheng
- Department of Infectious Diseases, The First Hospital of Shanxi Medical University, Taiyuan, China
- Graduate School, Shanxi Medical University, Taiyuan, China
| | - Zhiying Wen
- Department of Infectious Diseases, The First Hospital of Shanxi Medical University, Taiyuan, China
- Graduate School, Shanxi Medical University, Taiyuan, China
| | - Yuan Liu
- Department of Infectious Disease Prevention and Control, Shanxi Provincial Center for Disease Control and Prevention, Taiyuan, China
| | - Qinying Wang
- Department of Infectious Diseases, The First Hospital of Shanxi Medical University, Taiyuan, China
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Shi T, Zhang X, Meng L, Li D, Jin N, Zhao X, Zheng H, Wang T, Li R, Ren X. Immediate and long-term changes in infectious diseases in China at the "First-level-response", "Normalized-control" and "Dynamic-COVID-zero" stages from 2020 to 2022: a multistage interrupted-time-series-analysis. BMC Public Health 2023; 23:1381. [PMID: 37464368 DOI: 10.1186/s12889-023-16318-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Accepted: 07/16/2023] [Indexed: 07/20/2023] Open
Abstract
BACKGROUND From January 2020 to December 2022, China implemented "First-level-response", "Normalized-control" and "Dynamic-COVID-zero" to block the COVID-19 epidemic; however, the immediate and long-term impact of three strategies on other infectious diseases and the difference in their impact is currently unknown. We aim to provide a more comprehensive understanding of the impact of non-pharmacological interventions (NPIs) on infectious diseases in China. METHODS We collected data on the monthly case count of infectious diseases in China from January 2015 to July 2022. After considering long-term trends using the Cox-Stuart test, we performed the two ratio Z tests to preliminary analyze the impact of three strategies on infectious diseases. Next, we used a multistage interrupted-time-series analysis fitted by the Poisson regression to evaluate and compare the immediate and long-term impact of three strategies on infectious diseases in China. RESULTS Compared to before COVID-19, the incidence of almost all infectious diseases decreased immediately at stages 1, 2, and 3; meanwhile, the slope in the incidence of many infectious diseases also decreased at the three stages. However, the slope in the incidence of all sexually transmitted diseases increased at stage 1, the slope in the incidence of all gastrointestinal infectious diseases increased at stage 2, and the slope in the incidence of some diseases such as pertussis, influenza, and brucellosis increased at stage 3. The immediate and long-term limiting effects of "Normalized-control" on respiratory-transmitted diseases were weaker than "First-level-response" and the long-term limiting effects of "Dynamic-COVID-zero" on pertussis, influenza, and hydatid disease were weaker than "Normalized-control". CONCLUSIONS Three COVID-19 control strategies in China have immediate and long-term limiting effects on many infectious diseases, but there are differences in their limiting effects. Evidence from this study shows that pertussis, influenza, brucellosis, and hydatid disease began to recover at stage 3, and relaxation of NPIs may lead to the resurgence of respiratory-transmitted diseases and vector-borne diseases.
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Affiliation(s)
- Tianshan Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaoshu Zhang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Lei Meng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Donghua Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Na Jin
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, Gansu, China
| | - Xin Zhao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Hongmiao Zheng
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Tingrong Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Rui Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China
| | - Xiaowei Ren
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, China.
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Zhang X, Jin N, Tu A, Dong M, Shi T, Ren X, Liu S, Zhao X, Liu J, Wu Z, Li Y, Wu D, Wang H, Wang H, Hu Y, Zhang B, Wang W, Meng L. Adults in Northwest China experienced the largest outbreak of Japanese encephalitis in history 10 years after the Japanese encephalitis vaccine was included in the national immunization program: A retrospective epidemiological study. J Med Virol 2023; 95:e28782. [PMID: 37212323 DOI: 10.1002/jmv.28782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/23/2023] [Accepted: 04/28/2023] [Indexed: 05/23/2023]
Abstract
Mainland China included Japanese encephalitis (JE) vaccine in the national immunization program in 2008 to control the JE epidemic. However, Gansu province in Western China experienced the largest JE outbreak since 1958 in 2018. We conducted a retrospective epidemiological study to explore the causes of this outbreak. We found that adults aged ≥20 years (especially those in rural areas) were the main JE cases in Gansu Province, with a significant increase in the JE incidence in older adults aged ≥60 years in 2017 and 2018. In addition, JE outbreaks in Gansu Province were mainly located in the southeastern region, while the temperature and precipitation in Gansu Province were gradually increasing in recent years, which made the JE epidemic areas in Gansu Province gradually spread to the western of Gansu Province. We also found that adults aged ≥20 years in Gansu Province had lower JE antibody positivity than children and infants, and the antibody positivity rate decreased with age. In the summer of 2017 and 2018, the density of mosquitoes (mainly the Culex tritaeniorhynchus) in Gansu Province was significantly higher than in other years, and the genotype of JEV was mainly Genotype-G1. Therefore, in the future JE control in Gansu Province, we need to strengthen JE vaccination for adults. Moreover, strengthening mosquito surveillance can provide early warning of JE outbreaks and the spread of epidemic areas in Gansu Province. At the same time, strengthening JE antibody surveillance is also necessary for JE control.
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Affiliation(s)
- Xiaoshu Zhang
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Na Jin
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Aixia Tu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Maoxing Dong
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Tianshan Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Xiaowei Ren
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, China
| | - Shuyu Liu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Xiaohong Zhao
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Jianfeng Liu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Zhao Wu
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
| | - Yixing Li
- Department of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Dan Wu
- Department of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huanyu Wang
- Department of Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Haijun Wang
- Department of Immunization Program, Longnan Center for Disease Control and Prevention, Longnan, China
| | - Yukun Hu
- Department of Immunization Program, Pingliang Center for Disease Control and Prevention, Pingliang, China
| | - Bin Zhang
- Department of Immunization Program, Tianshui Center for Disease Control and Prevention, Tianshui, China
| | - Wenjun Wang
- Department of Immunization Program, Qingyang Center for Disease Control and Prevention, Qingyang, China
| | - Lei Meng
- Department of Immunization Program, Gansu Provincial Center for Disease Control and Prevention, Lanzhou, China
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Song Q, Ma C, Hao L, Wang F, An Z, Yin Z, Wang H. Effects of Three Major Immunization Interventions on Measles Control - China, 1952-2021. China CDC Wkly 2023; 5:385-390. [PMID: 37197450 PMCID: PMC10184381 DOI: 10.46234/ccdcw2023.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 04/25/2023] [Indexed: 05/19/2023] Open
Affiliation(s)
- Quanwei Song
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Chao Ma
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Lixin Hao
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Fuzhen Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zhijie An
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Zundong Yin
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Huaqing Wang
- National Immunization Program, Chinese Center for Disease Control and Prevention, Beijing, China
- Huaqing Wang,
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Shi T, Zhao X, Zhang X, Meng L, Li D, Liu X, Zheng H, Yu D, Wang T, Li R, Li J, Shen X, Ren X. Immediate and long-term changes in the epidemiology, infection spectrum, and clinical characteristics of viral and bacterial respiratory infections in Western China after the COVID-19 outbreak: a modeling study. Arch Virol 2023; 168:120. [PMID: 36976267 PMCID: PMC10044131 DOI: 10.1007/s00705-023-05752-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 03/03/2023] [Indexed: 03/29/2023]
Abstract
BACKGROUND The impact of COVID-19 on the epidemiology, clinical characteristics, and infection spectrum of viral and bacterial respiratory infections in Western China is unknown. METHODS We conducted an interrupted time series analysis based on surveillance of acute respiratory infections (ARI) in Western China to supplement the available data. RESULTS The positive rates of influenza virus, Streptococcus pneumoniae, and viral and bacterial coinfections decreased, but parainfluenza virus, respiratory syncytial virus, human adenovirus, human rhinovirus, human bocavirus, non-typeable Haemophilus influenzae, Mycoplasma pneumoniae, and Chlamydia pneumoniae infections increased after the onset of the COVID-19 epidemic. The positive rate for viral infection in outpatients and children aged <5 years increased, but the positive rates of bacterial infection and viral and bacterial coinfections decreased, and the proportion patients with clinical symptoms of ARI decreased after the onset of the COVID-19 epidemic. Non-pharmacological interventions reduced the positive rates of viral and bacterial infections in the short term but did not have a long-term limiting effect. Moreover, the proportion of ARI patients with severe clinical symptoms (dyspnea and pleural effusion) increased in the short term after COVID-19, but in the long-term, it decreased. CONCLUSIONS The epidemiology, clinical characteristics, and infection spectrum of viral and bacterial infections in Western China have changed, and children will be a high-risk group for ARI after the COVID-19 epidemic. In addition, the reluctance of ARI patients with mild clinical symptoms to seek medical care after COVID-19 should be considered. In the post-COVID-19 era, we need to strengthen the surveillance of respiratory pathogens.
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Affiliation(s)
- Tianshan Shi
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xin Zhao
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xiaoshu Zhang
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, Gansu, China
| | - Lei Meng
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, Gansu, China
| | - Donghua Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xinfeng Liu
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, Gansu, China
| | - Hongmiao Zheng
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Deshan Yu
- Gansu Provincial Center for Disease Control and Prevention, Lanzhou, 730000, Gansu, China
| | - Tingrong Wang
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Rui Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Juansheng Li
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xiping Shen
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China
| | - Xiaowei Ren
- Institute of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, 730000, Gansu, China.
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