2017—2021年我国其他感染性腹泻突发公共卫生事件流行特征分析

Epidemiological characteristics of public health emergencies caused by other infectious diarrhea in China from 2017 to 2021

目的 了解近年来我国其他感染性腹泻突发公共卫生事件(简称其他感染性腹泻事件)的发生规律及流行病学特征,为该类事件的预警和有效控制提供科学依据。方法 采用描述性流行病学方法,对2017—2021年全国通过突发公共卫生事件报告管理信息系统报告的其他感染性腹泻事件的流行病学特征进行分析。结果 2017—2021年全国有28个省(自治区、直辖市)共报告其他感染性腹泻事件2 360起,累计报告病例90 689例,死亡病例5例。其他感染性腹泻事件的高发期是冬、春两季,分别在11—12月和3月呈现两个高峰。浙江、广东、江苏、重庆、福建、山东、安徽、广西、湖南和湖北等10个省份报告事件数和病例数较多。明确病原体的其他感染性腹泻事件共2 269起,其中病毒感染导致的事件占95.7%(2 171/2 269),细菌感染导致的事件占3.7%(84/2 269),病毒/细菌混合感染导致的事件占0.6%(14/2 269)。在所有明确病原体的其他感染性腹泻事件中,诺如病毒感染导致的占93.5%(2 122/2 269)。生活接触传播、食品污染和饮用水污染是其他感染性腹泻事件发生的主要原因,生活接触传播所致事件占比最高(51.0%,1 204/2 360)。托幼机构和学校是其他感染性腹泻发生的主要场所,共发生2 163起。结论 近年来我国其他感染性腹泻事件发生数呈上升趋势,主要病原为诺如病毒,托幼机构和学校是其发生的主要场所。今后应做好学校等重点场所的卫生监管和重点人群的健康宣教,加强食品安全和饮用水卫生管理,同时提高其他感染性腹泻流行病学调查和病原学诊断能力,提升事件监测报告水平,有效预防和控制该类事件的发生。

Objective To understand the occurrence and epidemiological characteristics of public health emergencies caused by other infectious diarrhea in China, so far as to provide evidence for early warning and effective control of such events. Methods The data on other infectious diarrhea were retrieved through National Report Management Information System of Public Health Emergency reported from 2017 to 2021, and analyzed for the epidemiological characteristics using descriptive epidemiology. Results In total, 2 360 other infectious diarrhea events were reported between 2017 and 2021 in 28 provinces(autonomous regions and municipalities directly under the central government), which involved 90 689 cases and 5 deaths. Other infectious diarrhea was highly prevalent in winter and spring season, and respectively peaked during November and December and following March. Most incidents and cases were reported in Zhejiang, Guangdong, Jiangsu, Chongqing, Fujian, Shandong, Anhui, Guangxi, Hunan and Hubei provinces. The pathogen responsible for other infectious diarrhea was clearly identified in 2 269 events, which accounted for 95.7%(2 171/2 269)of the events caused by virus infection. 3.7%(84/2 269) and 0.6%(14/2 269) were caused by bacterial infection and mixed virus/bacteria infection, respectively. Norovirus infection accounted for 93.5%(2 122/2 269) of all other infectious diarrhea with definite pathogens. Contact transmission via daily activities, intake of the contaminated food and drinking water were mainly responsible for other infectious diarrhea events, and the events caused by life-contact transmission account for the highest proportion(51.0%, 1 204/2 360). Schools as well as kindergartens, were the main places where other infectious diarrhea occurred, with a total of 2 163 cases reported. Conclusion Other infectious diarrhea events tends to be upward trend in China in recent years. The major pathogen is associated with norovirus, schools and kindergartens are the main places where it occurs. Implementation of health supervision in key places such as schools and health education for the key population, strengthening the management of food safety and drinking water hygiene,improving the epidemiological investigation and etiological diagnosis of other infectious diarrhea as well as the level of event monitoring report can effectively prevent and control the occurrence of such events.