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. 2012;7(2):e31076.
doi: 10.1371/journal.pone.0031076. Epub 2012 Feb 16.

Trends in notifiable infectious diseases in China: implications for surveillance and population health policy

Lei Zhang  1 , David P Wilson
Affiliations

Trends in notifiable infectious diseases in China: implications for surveillance and population health policy

Lei Zhang et al. PLoS One. 2012.

Abstract

This study aimed to analyse trends in notifiable infectious diseases in China, in their historical context. Both English and Chinese literature was searched and diseases were categorised according to the type of disease or transmission route. Temporal trends of morbidity and mortality rates were calculated for eight major infectious diseases types. Strong government commitment to public health responses and improvements in quality of life has led to the eradication or containment of a wide range of infectious diseases in China. The overall infectious diseases burden experienced a dramatic drop during 1975-1995, but since then, it reverted and maintained a gradual upward trend to date. Most notifiable diseases are contained at a low endemic level; however, local small-scale outbreaks remain common. Tuberculosis, as a bacterial infection, has re-emerged since the 1990s and has become prevalent in the country. Sexually transmitted infections are in a rapid, exponential growth phase, spreading from core groups to the general population. Together human immunodeficiency virus (HIV), they account for 39% of all death cases due to infectious diseases in China in 2008. Zoonotic infections, such as severe acute respiratory syndrome (SARS), rabies and influenza, pose constant threats to Chinese residents and remain the most deadly disease type among the infected individuals. Therefore, second-generation surveillance of behavioural risks or vectors associated with pathogen transmission should be scaled up. It is necessary to implement public health interventions that target HIV and relevant coinfections, address transmission associated with highly mobile populations, and reduce the risk of cross-species transmission of zoonotic pathogens.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. Temporal trend of morbidity and mortality rates, and their composition, of the eight major notifable infectious disease types in China.
Figure 2
Figure 2. Incidence of notified cases of infectious diseasesa in China by category of disease, 1975–2008.
See this image and copyright information in PMC

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