Epidemiological Characteristics And Influencing Factors Of Yersiniosis In Lu’an City,Anhui Province

Objective To understand the epidemiological characteristics of yersiniosis in Lu’an area of Anhui Province,and to explore the influencing factors of yersiniosis.In this study,Lu’an City was selected as the case investigation area,monitored the diarrhea patients from 2013 to 2021,carried out a case-control study on yersinosis,analyzed the epidemic characteristics and influencing factors,and provide a reference basis for future scientific prevention and control.Methods The matched case-control study was conducted.The patients with yersiniosis admitted to the monitoring point clinics in Chengbei Township of Jin ’an District and Chengnan Town of Yu ’an District in Lu’an City from 2013 to 2021 were included as the case group,and all healthy family members(regardless of age)of matched cases were selected as the family control group.A total of 1:2 matched normal residents in the same village,gender,and age difference within 5 years were included in the community control group.The influencing factors and differences between the case group and the two control groups were analyzed and compared.A questionnaire survey and laboratory tests were conducted to collect demographic information,hand-washing and eating habits,living environment hygiene,poultry and livestock feeding,clinical features,detection of Yersinia enterocolitica and other data.SPSS 26.0 software was used for chi-square test,univariate and multivariate analysis,and conditional logistic regression analysis was used to analyze the possible independent influencing factors of the occurrence of the disease.Results A total of 2240 cases of diarrhea were detected at surveillance sites in the Lu’an area from 2013-2021,of which a total of 43 cases of Yersiniosis were reported,and the total detection rate of Yersinia enterocolitica in patients with diarrhea during the surveillance period was 1.92%.Among the reported cases,24 cases were male and 19 cases were female,with a sex ratio of 1.26: 1.The age distribution was 3-76 years old,with the highest percentage of people over 60 years old.The onset of yersiniosis was mainly concentrated in July and August.The clinical manifestations of yersiniosis were abdominal pain(76.74%),nausea and vomiting(27.91%),fever(20.93%),diarrhea ≤5times/d(55.81%),and fecal characteristics were mainly dilute stools(65.12%).The difference in detection rates between yersiniosis cases and diarrhea cases was different in terms of dilute stools(chi-square=4.134,P=0.042)and in terms of fever(chi-square=4.758,P=0.029),the detection rate of dilute stools and fever symptoms in yersinosis cases was higher.A total of 220 study subjects were investigated in this case-control study,including 43 cases in the case group,91 cases in the family control group,and 86 cases in the community control group.The results of univariate conditional logistic regression showed that compared with the family control group,the case group had statistically significant differences in the proportion of washing hands frequently before meals and after using the toilet,not washing hands after contact with poultry and livestock,eating raw vegetables and fruits,drinking unboiled water,and direct consumption of food in the refrigerator(P<0.05).There were significant differences between the case group and the community control group in the proportions of frequently washing hands before meals and after using the toilet,washing hands after going out and returning home,not washing hands after contact with poultry and livestock,eating raw vegetables and fruits,drinking unboiled water,direct consumption of food in the refrigerator,unclean refrigerator,raising pigs and chickens,poor living environment hygiene,and flies in the kitchen or restaurant in summer(P<0.05).There were significant differences between the case group and the control group in the proportion of frequently washing hands before meals and after using the toilet,not washing hands after contact with poultry and livestock,eating raw vegetables and fruits,drinking unboiled water,direct consumption of food in the refrigerator,unclean refrigerator,and the flies in the kitchen or restaurant in summer(P<0.05).The results of multivariate conditional logistic regression showed that compared with the family control group,the habit of drinking unboiled water(OR=6.721;95%CI: 1.765～25.588),and direct consumption of food in the refrigerator(OR=7.089;95%CI: 1.873～26.829)increased the risk of yersinia enterocolitica;Compared with the community control group: failure to wash hands after contact with poultry and livestock(OR=50.592;95%CI: 2.758～927.997),habit of eating raw vegetables and fruits(OR=5.340;95%CI:1.022 ～ 27.887),direct consumption of food in the refrigerator(OR=19.973;95%CI:2.118～188.336),and unclean refrigerator(OR=12.692;95%CI: 1.992～80.869)were risk factors for yersiniosis.Compared with the total control population,not washing hands after contact with poultry and livestock(OR=4.075;95%CI: 1.427～11.637),habit of drinking unboiled water(OR=4.153;95%CI: 1.331 ～ 12.957),habit of eating raw vegetables and fruits(OR=4.744;95%CI: 1.609～13.933),direct consumption of food in the refrigerator(OR=5.051;95%CI: 1.773～14.395)were independent risk factors for yersiniosis.Conclusions High detection rate of Yersinia enterocolitica in the Lu’an area and high incidence of yersiniosis in summer.Yersinosis patients showed higher symptoms of dilute stools and fever than other diarrhea patients.Poor hygiene practices such as the habit of drinking unboiled water,eating direct consumption of food in the refrigerator,not washing hands after contact with poultry and livestock,eating raw vegetables and fruits,and the unclean refrigerator increase the risk of yersiniosis.These findings to strengthen the surveillance and health education of the disease in key populations in the high incidence season,and improve the awareness of healthy diet and hygiene of local residents.