Epidemiology and spatiotemporal analysis of acute hemorrhagic conjunctivitis in Zhejiang province, China (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 patterns of AHC in Zhejiang province has not been studied yet.

Methods: Monthly cases of AHC from 2004 to 2023 reported at the county level in Zhejiang province were obtained from the China Information System for Disease Control and Prevention. Demographic features, yearly county incidence, global spatial autocorrelation, local spatial autocorrelation analyses, and temporal and space-time cluster analysis were performed to identify and visualize the spatiotemporal patterns of AHC cases in Zhejiang province. The epidemiological characteristics of AHC outbreaks in the same period in Zhejiang province were also compared.

Results: A total of 52,119 AHC cases were reported in Zhejiang province, yielding an average incidence rate of 5.37 per 100,000. No fatalities were reported. The average age of those affected was 25.44 ± 4.37 years, with the highest incidence (16.70%) among individuals aged between 10 and 19 years. Seasonal peaks occur from August to October each year. Students and farmers experienced the highest incidence rates of infection. Significant positive spatial correlations for AHC were observed in Zhejiang province in the years 2007 (Moran's I = 0.095, p = 0.039), 2009 (Moran's I = 0.075, p = 0.031), and 2011 (Moran's I = 0.173, p = 0.034), indicating spatial clustering. Spatiotemporal scanning identified two distinct clusters: Cluster 1 and Cluster 2. Cluster 1, characterized by a relative risk of 21.44 (p < 0.001), was located in northeastern Zhejiang province, comprising 30 counties, with an active period from 1st September 2010 to 30th September 2010. Compared to low-risk regions, high-risk counties exhibited a different demographic profile with a higher proportion of men, older people, and farmers. Among the affected students during outbreaks, the predominant symptoms were conjunctival congestion, increased eye secretions, eye swelling, eye pain, photophobia and tearing, while the incidence of fever was relatively low.

Conclusion: The results of this study demonstrate the spatiotemporal heterogeneity of AHC cases in Zhejiang province and underscore the necessity for targeted prevention and control measures in high-risk areas to mitigate transmission and occurrence.