Epidemiology and spatiotemporal analysis of acute hemorrhagic conjunctivitis in Zhejiang province, China, during 2004-2023

Abstract

Background Acute hemorrhagic conjunctivitis (AHC) has become a significant public health issue in Zhejiang province. However, the analysis of epidemiological characteristics and spatio-temporal aggregation of AHC in Zhejiang province has not been studied yet. Methods Information on sporadic cases and clustered epidemics data of AHC from 2004–2023 in Zhejiang province were obtained from the China Information System for Disease Control and Prevention. Global spatial autocorrelation and local spatial autocorrelation analyses were performed using ArcGIS 10.4 software and GeoDa 1.22 software, spatiotemporal hotspot area detection was carried out using SaTScan 10.1.3 software. Results Between 2004 and 2023, 52119 AHC cases were reported in Zhejiang province, resulting in an average incidence of 5.37 per 100000. No death cases occurred. The average age of all cases id 25.44 ± 4.37 years old, 16.70% individuals aged between 10–19 years old, August to October was the peak months in each year; students, farmers and kindergarten children were high incidence people. Positive spatial correlation of AHC in Zhejiang province were observed (Moran’I value between 0.075–0.173, P < 0.001), indicating spatial aggregation, mainly in southwest, central-western and eastern coasts counties in Zhejiang province. Spatiotemporal scanning detected one clusterⅠand one cluster Ⅱaggregation areas, with the clusterⅠaggregation area (RR = 212.44, LRR = 53739.20, P < 0.001) locating in northwestern Zhejiang province, comprising 30 counties, and an aggregation time from 1 September 2010 to 30 September 2010. Epidemiological analysis of 3 outbreaks caused by AHC found that the symptoms of the affected students were mainly conjunctival congestion, increased eye secretions, eye swelling, eye pain, photophobia and tearing, and the proportion of fever was relatively low. Conclusions Spatial and temporal aggregation of AHC is evident in Zhejiang province, with the incidence rate increased during August to October. It is important to take prevention and control measures such as monitoring, training and health educating in key population in high-incidence epidemic areas.