| BackgroundFoodborne diseases are one of the leading causes of morbidity and mortality worldwide and are a growing public health problem in both developing and developed countries.According to WHO,as many as 600 million people worldwide suffer from foodborne diseases each year,and nearly one in 10 people gets sick.Each year,foodborne diseases cause up to 420,000 deaths,including 125,000 children less than five years old.The situation in China is not optimistic either,with an average of one person in 6.5 suffering from foodborne diseases.Foodbome diseases not only seriously threaten human life and health,but also cause huge economic losses.It is estimated that the annual social burden caused by foodbome diseases in the United States is about 36 billion US dollars,and the annual economic burden caused by bacterial foodborne diseases in China is as high as 13.215 billion US dollars.With the globalization of economy,the increase of international travel and study abroad,environmental pollution and the change of people's living habits,the wide application of new food technology,epidemic range and incidences of known foodborne diseases are rising,unknown food safety problems appear constantly,and the resistance of pathogenic bacteria is emerging and growing.No matter in developed countries or developing countries,foodborne diseases are not effectively controlled and still a serious threat to people's health.The situation of prevention and control of foodborne diseases in China is also very serious.In order to effectively prevent and control foodborne diseases in Jining,this study investigated the epidemic characteristics of foodborne diseases in Jining from 2016 to 2017,so as to provide a scientific basis for the formulation of targeted prevention and control strategies.ObjectivesBased on the foodborne disease surveillance and foodborne disease outbreaks monitoring system built by Jining foodborne disease sentinel hospitals and the center for disease control and prevention,this study aimed to systematically analyze the sporadic cases and outbreak cases in Jining,to revealed the distribution characteristics and trend of foodborne diseases in Jining,to explore the high-risk food and the risk factors for foodborne diseases,so as to provide theoretical basis for targeted prevention and control strategies.We also aimed to unveil the epidemic trend of pathogens,offering guidance for foodborne disease treatment,prevention and control measures,and thus reducing the incidence of foodborne disease in Jining.Materials and methods1.Data collection(1)The cases of foodborne diseases admitted in 35 sentinel hospitals of foodborne diseases in Jining,cases admitted in sentinel hospitals of active surveillance,and outbreak incidents reported in 11 counties and urban areas were selected as the study subjects.(2)The foodborne disease surveillance system and foodborne disease outbreak surveillance system were used to collect and collate relevant information of the study subjects.2.Statistical analysisExcel 2007 was used to establish the database,and SPSS 20.0 was used to conduct statistical analysis.Ratio and composition ratio were used to describe cases,pathogens and outbreak events,and the indicators included time distribution,population distribution,suspicious exposed food.Chi-square test and the multivariate Logistic regression analysis were adopted to find factors related to the pathogen detection.P<0.05 was considered a statistical significance.Results1.From 2016 to 2017,a total of 17,770.cases of foodborne diseases were detected in 35 sentinel hospitals in Jining city.The incidence was mainly from May to September,and the ratio of male to female was 1:1.04.The 25-34 age group had the largest number,followed by the 0-5 age group.Rencheng District had the largest number,followed by Zoucheng City and Jiaxiang County.2.The suspected food exposure of foodborne disease cases were mainly fruits and their products(including preserved fruits and preserves),followed by meat and meat products,vegetables and their products.Suspicious eating places are mainly families,followed by restaurants(hotels)and street food.3.From 2016 to 2017,a total of 648 biological specimens were collected in the active surveillance hospitals,among which 182 were positive,with a detection rate of 28.09%.Among them,138 were norovirus and 54 were diarrhea Escherichia coli,with detection rates of 21.30%and 8.33%,respectively.The difference of pathogen detection rate was statistically significant(?2=43.14,P<0.001).4.The pathogen and the pathogenic Escherichia coli peaked in the third quarter,with the detection rate of 37.72%and 16.17%respectively(?2=11.25,P=0.010;?2=22.24,P<0.001).Detection of Norovirus was highest in the third quarter.The highest detection rates of pathogens and norovirus were 39,42%and 33.58%in the 45-65 age group(?2=17.67,P=0.003;?2=19.16,P=0.002).The highest detection rate was found in the age group of 45-65 years.The highest detection rates of pathogens,norovirus and epizocherichia coli in farmers and migrant workers were 38.54%,29.76%and 12.20%,respectively(?2=25.53,P=0.001;?2=19.12,P=0.014;?2=17.23,P=0.028).The highest detection rates of total pathogens and norovirus were 36.36%and 36.36%,respectively(?2=28.51,P=0.003;?2=24.22,P=0.012)5.The results of multivariate Logistic regression analysis on the factors affecting the pathogen detection showed that the pathogen was more easily detected in the third quarter(OR=2.043,95%CI:1.075-3.882).The occupations with higher risk were farmers and migrant workers(OR=5.039,95%CI:1.380-18.398),scattered and child-care workers(OR=29.972,95%CI:2.489-360.898),retired persons(OR=9.857,95%CI:2.136-45.492),aged 25-45(OR=2.952,95%CI:1.279-6.810)and 45-65(OR=4.673,95%CI:2.132-10.245),those who have eaten aquatic animals and their products(OR=6.690,95%CI:1.190-37.598),meat and meat products(OR=5.155,95%CI:1.082-4.558),fruits and their products(including preserved fruit and candied fruit)(OR=6.551,95%CI:1.435-29.912),grains and their products(containing starch and carbohydrate,baking and all kinds of staple food)(OR=6.230,95%CI:1.347-28.826),vegetables and their products(OR=5.634,95%CI:1.216-26.102)were more likely to detect pathogens.6.The results of multivariate Logistic regression analysis on the factors influencing the detection of norovirus showed that norovirus was more likely to be detected in the groups of scattered and young children(OR=19.658,95%CI:1.440-268396),those who were25-45 years old(OR=2.687,95%CI:1.095-6.592)and 45-65 years old(OR=4.054,95%CI:1.755-9.364),have eaten aquatic animals and their products(OR=8.384,95%CI:1.485-47.339),fruits and their products(including preserved fruit and candied fruit)(OR=4.815,95%CI:1.039-22.318),grains and their products(containing starch and carbohydrate,baking and various staple foods)(OR=5.065,95%CI:1.081-23.737).7.The results of logistic regression analysis showed that E.coli was not easily to be detected in the second quarter of the year(OR=0.228,95%CI:0.078-0.671);it was easier to be detected in the cases of farmers and migrant workers(OR=2.592,95%CI:1.219-5.511),scattered and kindergarten children(OR=7.727.95%CI:2.002-29.816).8.Outbreaks of foodborne diseases mainly occurred from May to September in Jining,accounting for 73.42%of the total number.The hospitalization rate in March and April was relatively high(66.67%,69.23%),and the difference in hospitalization rate in different months was statistically significant(?2=41.20,P<0.001).The incidence was mainly in families,with the largest number of events and the largest number of cases(51.90%,36.59%).The hospitalization rate was higher in street stalls and rural banquets(63.64%,57.50%).The difference in the hospitalization rate was statistically significant(?2=41.69,P<0.001).The number of events caused by chemical factors was the largest(15.19%).The highest number of cases was caused by microbial factors(20.30%),and the highest hospitalization rate was caused by toxic animals and plants and their toxins(100%)(?2=50.68,P<0.001).Among the food events that identified the cause,meat and meat products caused the largest number of events and the largest number of cases(18.99%,29.07%).The hospitalization rate caused by eating poisonous plant and canned food was higher(100%,100%).The difference in the hospitalization rate caused by eating different food was statistically significant(?2=68.95,P<0.001).Among the identified causative events,the number of outbreaks and the numtber of cases caused by improper food processing was the largest(13.92%,20.30%),and the hospitalization rate caused by accidental food misuse was the highest(66.67%).The difference in hospitalization rates caused by different causative factors was statistically significant(?2=70.40,P<0.001).Conclusions1.Foodborne diseases showed an obvious seasonal trend in lining city,with high incidence in summer and autumn,and the incidence is concentrated in 25-34 years old and 0-5 years old.Family was the place with high incidence.The main food with high incidence were fruit and its products,meat and meat products.2.The main pathogen of food-borne disease cases in lining was norovirus(mainly GII genotype),followed by diarrhea Escherichia coli(mainly EAEC).Norovirus is endemic throughout the year.It is more easily detected in the cases of scattered children,aged 25-45 years and 45-65 years,those who have eaten aquatic animals and their products,fruits and their products(including preserved fruits and preserves),grains and their products(containing starch,carbohydrate,baking and various staple foods)and other foods.Diarrhoeal Escherichia coli more easily to be detected in farmers,migrant workers,scattered and kindergarten children.3.Outbreaks of foodborne diseases mainly occurred in summer and autumn in Jining.The main pathogenic factors were meat and meat products.The main pathogenic factors were chemical factors,mainly nitrite and pesticide.The main causes of the outbreak were improper food processing,storage and misuse. |
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