Zhongjie Li

Chinese Center For Disease Control And Prevention, Peping, Beijing, China

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Publications (36)177.73 Total impact

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    ABSTRACT: Non-typhoidal Salmonella is a common cause of infectious diarrhea in humans. Antimicrobial-resistant Salmonella has become a global concern. Using laboratory-based surveillance system for Salmonella from September 2009 to December 2012 in Guangdong Province of China. The clinical information and samples of diarrhea patients were collected, according to the surveillance case definition. The lab tests were followed by standardized protocols, including sample isolation, isolates confirmation, serotyping, and antimicrobial susceptibility testing (AST). A total of 1,826 Salmonella isolates were identified from40,572 patients in 28 hospitals in11 prefectures. The isolates ratio was highest in autumn (38.8%, 708/1826) and lowest in winter (6.4%, 117/1826). Children aged <5 years were the group most affected by Salmonella in Guangdong Province accounting for 73% (1,329/1,826), of whom the infants (<1 year) were 81.5% (1084/1329) especially. A total of 108 serotypes were identified among the isolates. S. Typhimurium represented the most common serotype followed by serotype 4,5,12:i:-. S. Typhimurium was also the common serotype followed by S. Enteritidis among infants and children aged 1-3 years old. However, S. Enteritidis became the common serotype followed by S. Typhimurium among children aged 3-5 and >5 years. Resistance to at least one antimicrobial was found in 72% (1321/1,826) of the isolates. Resistance to at least three antimicrobials was found in 46% (850/1,826) of the isolates. Resistance to all 12 antimicrobials screened was observed in 8 isolates (0.44%, 8/1,826). The resistant prevalence to quinolones including nalidixic acid and ciprofloxacin was 61.9% (1131/1826), of which ciprofloxacin resistance rate was 8.05% (147/1826). The prevalence resistance to all three cephalosporin antimicrobials (cefepime, cefotaxime, and caftazidime) in <5 yr age group was accounted for 90% (89/99). Additional data and more refined methods can improve future surveillance. The invasive Salmonella isolates should also be included to the antibiotic resistance surveillance for clinical care or public health.
    BMC Infectious Diseases 12/2015; 15(1):784. DOI:10.1186/s12879-015-0784-4 · 2.61 Impact Factor
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    ABSTRACT: The objectives of the study were to identify dietary and medical risk factors for Vibrio parahaemolyticus (VP) infection in the coastal city Shenzhen in China. In April-October 2012, we conducted a case-control study in two hospitals in Shenzhen, China. Laboratory-confirmed VP cases (N = 83) were matched on age, sex, and other social factors to healthy controls (N = 249). Subjects were interviewed using a questionnaire on medical history; contact with seawater; clinical symptoms and outcome; travel history over the past week; and dietary history 3 days prior to onset. Laboratory tests were used to culture, serotype, and genotype VP strains. We used logistic regression to calculate the odds ratios for the association of VP infection with potential risk factors. In multivariate analysis, VP infection was associated with having pre-existing chronic disease (adjusted odds ratio [aOR], 6.0; 95% confidence interval [CI], 1.5-23.7), eating undercooked seafood (aOR, 8.0; 95% CI, 1.3-50.4), eating undercooked meat (aOR, 29.1; 95% CI, 3.0-278.2), eating food from a street food vendor (aOR, 7.6; 95% CI, 3.3-17.6), and eating vegetable salad (aOR, 12.1; 95% CI, 5.2-28.2). Eating raw (undercooked) seafood and meat is an important source of VP infection among the study population. Cross-contamination of VP in other food (e.g., vegetables and undercooked meat) likely plays a more important role. Intervention should be taken to lower the risks of cross-contamination with undercooked seafood/meat, especially targeted at people with low income, transient workers, and people with medical risk factors.
    Foodborne Pathogens and Disease 08/2015; DOI:10.1089/fpd.2015.1988 · 2.09 Impact Factor
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    ABSTRACT: During May-August 2013, a malaria outbreak comprising 874 persons in Shanglin County, China, was detected among 4,052 persons returning from overseas. Ghana was the predominant destination country, and 92.3% of malarial infections occurred in gold miners. Preventive measures should be enhanced for persons in high-risk occupations traveling to malaria-endemic countries.
    Emerging infectious diseases 05/2015; 21(5). DOI:10.3201/2105.141712 · 7.33 Impact Factor
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    ABSTRACT: Background Dengue has been a notifiable disease in China since 1 September 1989. Cases have been reported each year during the past 25 years of dramatic socio-economic changes in China, and reached a historical high in 2014. This study describes the changing epidemiology of dengue in China during this period, to identify high-risk areas and seasons and to inform dengue prevention and control activities. Methods We describe the incidence and distribution of dengue in mainland China using notifiable surveillance data from 1990-2014, which includes classification of imported and indigenous cases from 2005-2014. Results From 1990-2014, 69,321 cases of dengue including 11 deaths were reported in mainland China, equating to 2.2 cases per one million residents. The highest number was recorded in 2014 (47,056 cases). The number of provinces affected has increased, from a median of three provinces per year (range: 1 to 5 provinces) during 1990-2000 to a median of 14.5 provinces per year (range: 5 to 26 provinces) during 2001-2014. During 2005-2014, imported cases were reported almost every month and 28 provinces (90.3%) were affected. However, 99.8% of indigenous cases occurred between July and November. The regions reporting indigenous cases have expanded from the coastal provinces of southern China and provinces adjacent to Southeast Asia to the central part of China. Dengue virus serotypes 1, 2, 3, and 4 were all detected from 2009-2014. Conclusions In China, the area affected by dengue has expanded since 2000 and the incidence has increased steadily since 2012, for both imported and indigenous dengue. Surveillance and control strategies should be adjusted to account for these changes, and further research should explore the drivers of these trends.
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    ABSTRACT: Dengue has been a notifiable disease in China since 1 September 1989. Cases have been reported each year during the past 25 years of dramatic socio-economic changes in China, and reached a historical high in 2014. This study describes the changing epidemiology of dengue in China during this period, to identify high-risk areas and seasons and to inform dengue prevention and control activities. We describe the incidence and distribution of dengue in mainland China using notifiable surveillance data from 1990-2014, which includes classification of imported and indigenous cases from 2005-2014. From 1990-2014, 69,321 cases of dengue including 11 deaths were reported in mainland China, equating to 2.2 cases per one million residents. The highest number was recorded in 2014 (47,056 cases). The number of provinces affected has increased, from a median of three provinces per year (range: 1 to 5 provinces) during 1990-2000 to a median of 14.5 provinces per year (range: 5 to 26 provinces) during 2001-2014. During 2005-2014, imported cases were reported almost every month and 28 provinces (90.3%) were affected. However, 99.8% of indigenous cases occurred between July and November. The regions reporting indigenous cases have expanded from the coastal provinces of southern China and provinces adjacent to Southeast Asia to the central part of China. Dengue virus serotypes 1, 2, 3, and 4 were all detected from 2009-2014. In China, the area affected by dengue has expanded since 2000 and the incidence has increased steadily since 2012, for both imported and indigenous dengue. Surveillance and control strategies should be adjusted to account for these changes, and further research should explore the drivers of these trends. Please see related article: http://dx.doi.org/10.1186/s12916-015-0345-0.
    BMC Medicine 04/2015; 2015(13):100. DOI:10.1186/s12916-015-0336-1 · 7.28 Impact Factor
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    ABSTRACT: Diarrhea is a leading cause of morbidity and mortality for children, although sparse data is available on the etiology of diarrhea in China. This study was conducted to determine main causes that underlie childhood diarrhea and related diseases. Surveillance data for diarrhea was collected from 213 participating hospitals between 2009 and 2013. These stool specimens, from children aged 0-59 months, were then analyzed for a panel of etiological agents consisting of 5 viruses, 8 bacteria and 3 protozoa. The proportion of children who tested positive for each pathogen was calculated and seasonal patterns for major organisms were determined. Pathogens were identified in 44.6% of the 32,189 samples from children with diarrhea. The most commonly detected pathogens were rotavirus (29.7% of cases), norovirus (11.8%), Diarrheagenic Escherichia coli (DEC; 5.0%), adenovirus (4.8%), non-typhoidal Salmonella (NTS; 4.3%), and Shigella spp. (3.6%). A strong seasonal pattern was observed for these organisms, including rotavirus (winter), norovirus (autumn), and DEC, NTS, and Shigella (summer). A wide range of enteropathogens were detected in this five-year surveillance study; rotavirus and norovirus were most common among children under the age five. These findings should serve as robust evidence for public health entities when planning and developing national intervention programs in China. Copyright © 2015. Published by Elsevier Ltd.
    Journal of Infection 03/2015; 71(1). DOI:10.1016/j.jinf.2015.03.001 · 4.02 Impact Factor
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    ABSTRACT: To learn the characteristics of morbidity and mortality of notifiable diseases reported in China in 2013. Descriptive analysis method was used to analyze the morbidity and mortality of notifiable diseases in China in 2013, with Microsoft Excel 2010 and ArcGIS 10.0 used to develop statistical charts. In 2013, the morbidity of the nationwide notifiable diseases was 473.87/100 000, a decrease of 3% below the average of the recent 3 years, while the mortality was 1.23/100 000, an increase of 2% over the average of the recent 3 years. The rate of laboratory diagnosis of the reported cases was 38.4%. Top 5 diseases of the reported incidence were hand foot and mouth disease, other infectious diarrhea, hepatitis B, tuberculosis and syphilis. The death cases reported were mainly AIDS, tuberculosis and rabies. As classified by the transmission route analysis, intestinal infectious diseases accounted for 49% of the total incidence reported for the year, followed by the blood and sexually transmitted infectious diseases, respiratory infectious diseases, animal and vector borne infectious diseases. According to the pathogenic analysis, virus infectious diseases accounted for 68% of the total cases, higher than bacterial infectious diseases and animal-borne/vector-borne infectious diseases. In Shanghai, Zhejiang and Jiangsu, human infection with avian influenza A (H7N9) virus was emerging, as epidemic situation of measles, dengue fever and brucellosis were on the rise significantly nationwide, while the morbidity of infectious diseases decreased, namely pulmonary tuberculosis, hepatitis B among others. Morbidity of the top 5 provinces for notifiable infectious diseases were Hainan, Guangxi, Guangdong, Xinjiang and Zhejiang, respectively. The proportion of laboratory confirmed cases among totals was still low in 2013. The morbidity of the infectious diseases was higher in western provinces and parts of south-eastern province, the mortality was higher in western provinces. The emerging human infection with avian influenza A (H7N9) virus, and the high epidemic of measles, dengue fever and brucellosis in some areas had caught the society concerns.
    Zhonghua liu xing bing xue za zhi = Zhonghua liuxingbingxue zazhi 03/2015; 36(3):194-8.
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    Shuqing Zhao · Zhongjie Li · Sheng Zhou · Canjun Zheng · Huilai Ma
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    ABSTRACT: Visceral leishmaniasis (VL) remains an important public health problem in China. It is essential to elucidate the current epidemiological characteristics of VL for designing control policy. The data were obtained from China Disease Prevention and Control Information System from 2004 to 2012. Characteristics by major variables, such as age, gender, season and geography were analyzed using SPSS13.0. The incidence of VL in China remained at a lower level in recent years. The outbreak appeared in xinjiang kashgar region in 2008. A total of 3337 VL cases were reported in China from 2004 to 2012, 97.03% of cases were concentrated in Xinjiang, Gansu and Sichuan provinces. The cases under 5 year-old accounted for 59.21%. concentrated in 3 ~ 5 months each year and annual December to January of next year The ratio of males to females was 1.67:1(2088:1249). The lag time between symptom onset and diagnosis of VL appeared a marked decrease after 2008, and were shorter in endemic provinces of Xinjiang, Gansu and Sichuan than non-endemic provinces. The case fatality rate was 2.99% (10/3337) during the study period. The reported cases of VL were concentrated in Xinjiang, Gansu, Sichuan provinces in China, 2004-2012. The onset was given priority to children. The lag time between symptom onset and diagnosis of VL were difference among years and provinces. Therefore, prevention and control measures should be focused on improving awareness and capacities of diagnosis and treatment, targeting high-risk people in high-risk areas.
    Iranian Journal of Public Health 01/2015; 44(1):51-9. · 0.58 Impact Factor
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    ABSTRACT: A public health emergency of international concern regarding the 2014 West African Ebola epidemic was declared by the WorldHealth Organization on August 8, 2014, in view of its potential for further international spread. Based on historic traveller flightitinerary data between October and December 2013 from the International Air Transport Association, we assessed the potential risk ofEbola virus exportation from three West African Countries, Guinea, Liberia, and Sierra Leone, into China via commercial air travelbetween October 1, 2014 and December 31, 2014. We found 107,113 passengers departed from the three affected countries during thefourth quarter of 2013, with 3167 people (3.0%) arriving in mainland China after transfers at the international airports of eightcountries, including France, Belgium, and the U.A.E. The primary airports of entry into China for travelers from Guinea, Liberia, andSierra Leone are located in Beijing, Guangzhou, Shanghai, Hangzhou, Wuhan, Chongqing, and Dalian, whereas the main finaldestinations in China include Beijing, Guangzhou, Chongqing, Wuhan, Shanghai, Hangzhou, and Wenzhou. With the assumption thattravel behavior and mobility in the fourth quarter of 2014 will be the same as that of 2013, an average of 2235 international travellerswould need to be screened at the points of entry into China to capture one traveler with potential exposure to Ebola virus in the threeWest African countries. In total, our model projects only 0.54 travellers infected with Ebola virus departing the above three countriesentering China via commercial flights from October to December 2014 (0.35 infected travellers from Liberia, 0.16 from Sierra Leone,and 0.03 from Guinea). If the incidence of Ebola virus disease increases or the number of travellers to China decreases, the number oftravellers with Ebola virus infection would fluctuate accordingly. This study shows that the risk of Ebola imported from West Africa toChina via commercial air travel exists, although it is very low. China could support screening of departing international travellers fromWest Africa for the early detection of individuals with Ebola virus disease, screen high-risk traveller populations at the primary pointsof entry into China, and heighten surveillance in China's leading destination cities.
    Chinese Journal 12/2014; 59(36). DOI:10.1360/N972014-01201
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    ABSTRACT: Background In China, the national malaria elimination programme has been operating since 2010. This study aimed to explore the epidemiological changes in patterns of malaria in China from intensified control to elimination stages. Methods Data on nationwide malaria cases from 2004 to 2012 were extracted from the Chinese national malaria surveillance system. The secular trend, gender and age features, seasonality, and spatial distribution by Plasmodium species were analysed. Results In total, 238,443 malaria cases were reported, and the proportion of Plasmodium falciparum increased drastically from <10% before 2010 to 55.2% in 2012. From 2004 to 2006, malaria showed a significantly increasing trend and with the highest incidence peak in 2006 (4.6/100,000), while from 2007 onwards, malaria decreased sharply to only 0.18/100,000 in 2012. Males and young age groups became the predominantly affected population. The areas affected by Plasmodium vivax malaria shrunk, while areas affected by P. falciparum malaria expanded from 294 counties in 2004 to 600 counties in 2012. Conclusions This study demonstrated that malaria has decreased dramatically in the last five years, especially since the Chinese government launched a malaria elimination programme in 2010, and areas with reported falciparum malaria cases have expanded over recent years. These findings suggest that elimination efforts should be improved to meet these changes, so as to achieve the nationwide malaria elimination goal in China in 2020.
    Malaria Journal 11/2014; 13(1):419. DOI:10.1186/1475-2875-13-419 · 3.49 Impact Factor
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    ABSTRACT: Closure of live poultry markets was implemented in areas affected by the influenza virus A(H7N9) outbreak in China during winter, 2013-14. Our analysis showed that closing live poultry markets in the most affected cities of Guangdong and Zhejiang provinces was highly effective in reducing the risk for H7N9 infection in humans.
    Emerging infectious diseases 11/2014; 20(11):1891-4. DOI:10.3201/eid2011.140556 · 7.33 Impact Factor
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    ABSTRACT: Objective To evaluate the performance of China’s infectious disease automated alert and response system in the detection of outbreaks of hand, foot and mouth (HFM) disease. Methods We estimated size, duration and delay in reporting HFM disease outbreaks from cases notified between 1 May 2008 and 30 April 2010 and between 1 May 2010 and 30 April 2012, before and after automatic alert and response included HFM disease. Sensitivity, specificity and timeliness of detection of aberrations in the incidence of HFM disease outbreaks were estimated by comparing automated detections to observations of public health staff. Findings The alert and response system recorded 106 005 aberrations in the incidence of HFM disease between 1 May 2010 and 30 April 2012 – a mean of 5.6 aberrations per 100 days in each county that reported HFM disease. The response system had a sensitivity of 92.7% and a specificity of 95.0%. The mean delay between the reporting of the first case of an outbreak and detection of that outbreak by the response system was 2.1 days. Between the first and second study periods, the mean size of an HFM disease outbreak decreased from 19.4 to 15.8 cases and the mean interval between the onset and initial reporting of such an outbreak to the public health emergency reporting system decreased from 10.0 to 9.1 days. Conclusion The automated alert and response system shows good sensitivity in the detection of HFM disease outbreaks and appears to be relatively rapid. Continued use of this system should allow more effective prevention and limitation of such outbreaks in China.
    Bulletin of the World Health Organisation 09/2014; 92(9):656-63. DOI:10.2471/BLT.13.130666 · 5.11 Impact Factor
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    ABSTRACT: An outbreak detection and response system, using time series moving percentile method based on historical data, in China has been used for identifying dengue fever outbreaks since 2008. For dengue fever outbreaks reported from 2009 to 2012, this system achieved a sensitivity of 100%, a specificity of 99.8% and a median time to detection of 3 days, which indicated that the system was a useful decision tool for dengue fever control and risk-management programs in China.
    PLoS ONE 08/2014; 9(8):e106144. DOI:10.1371/journal.pone.0106144 · 3.23 Impact Factor
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    ABSTRACT: To investigate human exposure to live poultry and changes in risk perception and behavior after the April 2013 influenza A(H7N9) outbreak in China, we surveyed 2,504 urban residents in 5 cities and 1,227 rural residents in 4 provinces and found that perceived risk for influenza A(H7N9) was low. The highest rate of exposure to live poultry was reported in Guangzhou, where 47% of those surveyed reported visiting a live poultry market >1 times in the previous year. Most (77%) urban respondents reported that they visited live markets less often after influenza A(H7N9) cases were first identified in China in March 2013, but only 30% supported permanent closure of the markets to control the epidemic. In rural areas, 48% of respondents reported that they raised backyard poultry. Exposure to live commercial and private poultry is common in urban and rural China and remains a potential risk factor for human infection with novel influenza viruses.
    Emerging infectious diseases 08/2014; 20(8). DOI:10.3201/eid2008.131821 · 7.33 Impact Factor
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    ABSTRACT: Clostridium difficile is a well-known nosocomial infectious pathogen. Research on C. difficile infection has primarily focused on strains such as the hypervirulent PCR ribotype 027 (sequence type 1 [ST1]) emerging in Europe and North America. However, other new emerging ribotypes in some countries have attracted attention, such as PCR ribotype 17 (ST37) in Asia and Latin America. We collected 70 strains and sequenced their toxin genes, tcdA and tcdB. Multilocus sequence typing (MLST) was used to study their population structure. In addition, tcdA and/or tcdB sequences of 25 other isolates were obtained from GenBank. Single nucleotide polymorphisms (SNPs) were identified and analyzed. Phylogenetic analyses were performed to study toxin gene evolution. All tcdA and tcdB sequences were divided into 1 of 16 types (denoted A01 to -16 and B01 to -16, respectively). Hypervirulent strain RT027 is A13B12, and RT078 is A14B10, whereas the newly epidemic strain RT017 is A15B13. SNP analysis suggests the possibility of recombination in tcdB, perhaps through horizontal gene transfer. SNPs were also found in the sequences corresponding to the PCR primers widely used for toxin detection. Our study shows that ST037 shares a few genotypic features in its tcdA and tcdB genes with some known hypervirulent strains, indicating that they fall into a unique clade. Our findings can be used to map the relationships among C. difficile strains more finely than can be done with less sensitive methods, such as toxinotyping or even MLST, to reveal their inherent epidemiological characteristics.
    Journal of Clinical Microbiology 06/2014; 52(9). DOI:10.1128/JCM.03487-13 · 4.23 Impact Factor
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    ABSTRACT: Background Acute lower respiratory infections (ALRIs) are an important cause of acute illnesses and mortality worldwide and in China. However, a large-scale study on the prevalence of viral infections across multiple provinces and seasons has not been previously reported from China. Here, we aimed to identify the viral etiologies associated with ALRIs from 22 Chinese provinces. Methods and Findings Active surveillance for hospitalized ALRI patients in 108 sentinel hospitals in 24 provinces of China was conducted from January 2009-September 2013. We enrolled hospitalized all-age patients with ALRI, and collected respiratory specimens, blood or serum collected for diagnostic testing for respiratory syncytial virus (RSV), human influenza virus, adenoviruses (ADV), human parainfluenza virus (PIV), human metapneumovirus (hMPV), human coronavirus (hCoV) and human bocavirus (hBoV). We included 28,369 ALRI patients from 81 (of the 108) sentinel hospitals in 22 (of the 24) provinces, and 10,387 (36.6%) were positive for at least one etiology. The most frequently detected virus was RSV (9.9%), followed by influenza (6.6%), PIV (4.8%), ADV (3.4%), hBoV (1.9), hMPV (1.5%) and hCoV (1.4%). Co-detections were found in 7.2% of patients. RSV was the most common etiology (17.0%) in young children aged <2 years. Influenza viruses were the main cause of the ALRIs in adults and elderly. PIV, hBoV, hMPV and ADV infections were more frequent in children, while hCoV infection was distributed evenly in all-age. There were clear seasonal peaks for RSV, influenza, PIV, hBoV and hMPV infections. Conclusions Our findings could serve as robust evidence for public health authorities in drawing up further plans to prevent and control ALRIs associated with viral pathogens. RSV is common in young children and prevention measures could have large public health impact. Influenza was most common in adults and influenza vaccination should be implemented on a wider scale in China.
    PLoS ONE 06/2014; 9(6):e99419. DOI:10.1371/journal.pone.0099419 · 3.23 Impact Factor
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    ABSTRACT: To analyze the viral etiologies of hospitalized pneumonia patients aged less than five years in six provinces during 2009-2012, and to describe the seasonality of the detected viral etiologies.
  • Weizhong Yang · Yajia Lan · Zhongjie Li
    Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 04/2014; 48(4):244-7.
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    ABSTRACT: Providing evidences for further modification of China Infectious Diseases Automated-alert and Response System (CIDARS) via analyzing the outbreak detection performance of Moving Percentile Method (MPM) by optimizing thresholds in different provinces.
    Zhonghua yu fang yi xue za zhi [Chinese journal of preventive medicine] 04/2014; 48(4):265-9.
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    ABSTRACT: Objective For better application of spatial scan statistic method in early warning of infectious disease outbreak,we need to choose different parameters for spatial scan statistic method. Methods We took the cases and outbreaks of hand-foot-and-mouth disease( HFMD) and dysentery reported by Shandong and Hunan provinces in 2009 as data source. Taking sensitivity and positive prediction ratio as evaluation indices,w e compared the performance of thirty groups of parameters on these tw o diseases. Results For the dysentery cases in Hunan province,taking the sum of cases in four days w ith 1-rank coefficients,w e could get the best performance. For the hand-foot-and-mouth disease( HFMD) cases in Shandong province,taking the sum of cases in three days directly,w e could get the best performance. Conclusion When applying spatial scan statistic method in early w arning of infectious disease outbreak,w e ought to choose different parameters for different kinds of infectious disease in order to get the best results. In next steps,w e out to choose the best parameters based on the different incidence rates.

Publication Stats

337 Citations
177.73 Total Impact Points

Institutions

  • 2007–2015
    • Chinese Center For Disease Control And Prevention
      • • Institute for Viral Disease Control and Prevention
      • • Office for Disease Control and Emergence Response
      Peping, Beijing, China