Epidemiological Characteristics of Notifiable Respiratory Infectious Diseases in Mainland China from 2010 to 2018

Abstract

Respiratory infectious diseases (RIDs) pose threats to people's health, some of which are serious public health problems. The aim of our study was to explore epidemic situations regarding notifiable RIDs and the epidemiological characteristics of the six most common RIDs in mainland China. We first collected the surveillance data of all 12 statutory notifiable RIDs for 31 provinces in mainland China that reported between 2010 and 2018, and then the six most prevalent RIDs were selected to analyze their temporal, seasonal, spatiotemporal and population distribution characteristics. From 2010 to 2018, there were 13,985,040 notifiable cases and 25,548 deaths from RIDs in mainland China. The incidence rate of RIDs increased from 109.85/100,000 in 2010 to 140.85/100,000 in 2018. The mortality from RIDs ranged from 0.18/100,000 to 0.24/100,000. The most common RIDs in class B were pulmonary tuberculosis (PTB), pertussis, and measles, while those in class C were seasonal influenza, mumps and rubella. From 2010 to 2018, the incidence rate of PTB and rubella decreased; however, pertussis and seasonal influenza increased, with irregular changes in measles and mumps. The mortality from PTB increased from 2015 to 2018, and the mortality from seasonal influenza changed irregularly. PTB was mainly prevalent among people over 15 years old, while the other five common RIDs mostly occurred among people younger than 15 years old. The incidence of the six common RIDs mostly occurred in winter and spring, and they were spatiotemporally clustered in different areas and periods. In conclusion, PTB, seasonal influenza and mumps remain as public health problems in China, suggesting that continuous government input, more precise interventions, and a high-tech digital/intelligent surveillance and warning system are required to rapidly identify emerging events and timely response.

Keywords: China; epidemiological characteristics; incidence; mortality; respiratory infectious diseases; seasonal distribution; spatiotemporal analysis; temporal distribution.

Figure 1

Age-specific incidence cases and rates of the six selected RIDs from 2010 to 2018. Note: (A) pulmonary tuberculosis; (B) pertussis; (C) measles; (D) seasonal influenza; (E) mumps; (F) rubella.

Figure 2

Age-specific mortality number and rates of pulmonary tuberculosis and seasonal influenza from 2010 to 2018. Note: (A) pulmonary tuberculosis; (B) seasonal influenza.

Figure 3

Temporal trends for incidence rates of the six selected RIDs from 2010 to 2018. Note: (A) pulmonary tuberculosis; (B) pertussis; (C) measles; (D) seasonal influenza; (E) mumps; (F) rubella. APC annual percentage change. CI confidence interval.

Figure 4

Temporal trends of mortalities for pulmonary tuberculosis and seasonal influenza from 2010 to 2018. Note: (A) pulmonary tuberculosis; (B) seasonal influenza. APC annual percentage change. CI confidence interval.

Figure 5

Seasonal decomposition of monthly incidence rates of the six selected RIDs. Note: (A) pulmonary tuberculosis; (B) pertussis; (C) measles; (D) seasonal influenza; (E) mumps; (F) rubella. Data represents the time series adjusted by seasonal components. Seasonal represents seasonality decomposed from time series. Trend represents the long-term progression and repeated but non-periodic fluctuations of series. Remainder represents residuals of the time series.

Figure 6

Spatiotemporal clustering of incidence rates for three RIDs of class B in 31 provinces of mainland China. Note: (A) pulmonary tuberculosis; (B) pertussis; (C) measles.

Figure 7

Spatiotemporal clustering of incidence rates for three class C RIDs in 31 provinces of mainland China. Note: (A) seasonal influenza; (B) mumps; (C) rubella.

Figure 8

Spatiotemporal clustering of mortalities for pulmonary tuberculosis and seasonal influenza in 31 provinces of mainland China. Note: (A) pulmonary tuberculosis; (B) seasonal influenza.