From data to action: transforming listeriosis surveillance system in China informed by the European Union experience

Abstract

Objective

To identify priority targets for listeriosis surveillance in China by leveraging insights from the European Union (EU) surveillance system.

Methods

We conducted a systematic, macro-pattern comparison between integrated surveillance data from China and the EU. Given the substantial heterogeneity inherent in the Chinese data, a direct quantitative comparison between the two regions was unfeasible. Therefore, the analysis focused on identifying and contrasting broad epidemiological patterns. Particular attention was paid to patterns discernible from the EU data that could inform risk assessment in China, such as the identification of high-risk groups. To quantify one such key pattern within the EU dataset, the Cochran-Armitage trend test was used to assess the long-term trend in the proportion of cases aged 65 and above. A linear regression model was then applied to estimate the annual percentage change in this proportion over time.

Results

Most available data on listeriosis in China come from published literature. Consequently, the country lacks accurate disease burden statistics. Over the period 2007‒2023, the EU reported a cumulative total of 33,497 listeriosis cases. Both the demographic and serotype distributions showed clear predominance: individuals aged 65 and above constituted the largest proportion across all reported outcomes, while serotypes 4b, 4d and 4e together accounted for nearly 50% of cases. The EU has achieved full geographic and population coverage. In contrast, China’s surveillance remains fragmented and non-representative, with significant geographic and demographic gaps.

Conclusion

The experience of the EU provides critical clues for identifying high-risk populations and key serotypes. We should thoroughly analyze surveillance data from sentinel hospitals to systematically identify local high-risk groups (such as individuals aged 65 and above) and high-risk food categories. Building on this, we can progressively advance the development of a traceability system, expand surveillance coverage, and strengthen the refinement of relevant regulations and management frameworks.