Background: Foodborne diseases are a growing public health problem and contribute significantly to the global burden of disease and mortality. Bacteria are the most common foodborne pathogens. We aimed to explore characteristics of bacterial foodborne disease outbreaks (FBDOs) in Zhejiang Province and to provide data support for foodborne disease prevention and control. Methods: Descriptive statistical methods were used to analyze the data reported by centers for disease control (CDCs) at all levels in Zhejiang Province through Foodborne Disease Outbreaks Surveillance System (FDOSS) during 2010–2020. Results: CDCs in Zhejiang Province reported 517 bacterial FBDOs in 11 years, resulting in 7031 cases, 911 hospitalizations, and 3 deaths. Vibrio parahaemolyticus had the highest number of outbreaks, accounting for 58.41% of the total bacterial outbreaks, followed by Salmonella (18.38%). In all settings, restaurants (37.14%), staff canteens (11.99%), and households (11.80%) were responsible for the large number of outbreaks. Aquatic products (42.08%), meat and meat products (23.56%), cereals (10.81%), and flour products (9.27%) were the most common single foods reported. Further analysis showed that the settings and food vehicles of outbreaks caused by different pathogens were different. Conclusions: Bacterial outbreaks are the most common type of FBDOs in Zhejiang Province. By analyzing the epidemiological characteristics of common pathogenic bacteria, we can identify the etiology, food, and setting that the government needs to focus on, and issue relevant targeted policies to reduce the number of FBDOs.

Cadmium (Cd) pollution of food safety is a prominent food safety concern worldwide. The concentration of Cd in six aquatic food categories collected from 2018 to 2022 was analyzed using inductively coupled plasma mass spectrometry, and the Cd exposure levels were calculated by combining the Cd concentration and food consumption data of 18913 urban and rural residents in Zhejiang Province in 2015–2016. The mean Cd concentration was 0.699 mg/kg and the mean Cd exposure of aquatic foods was 0.00951 mg/kg BW/month for the general population. Marine crustaceans were the largest Cd contributor, corresponding to 82.7%. The regional distribution results showed that the average Cd exposure levels of 11 cities did not exceed the provisional tolerable monthly intake (PTMI). According to the subgroups, the Cd mean exposure level of 2–3-year-old children was significantly higher than that of the other age groups but did not exceed the PTMI. Health risk classification assessment demonstrated that the final risk score was six, and the health risk level of Cd exposure in aquatic products in the Zhejiang population was medium. These results demonstrated that the risk of Cd exposure in certain food types or age groups should be given more concern.

Foodborne diseases are a growing public health problem worldwide, and chemical foodborne disease outbreaks (FBDOs) often have serious consequences. This study aimed to explore the epidemiological characteristics of chemical FBDOs in Zhejiang Province, China, and propose targeted prevention and control measures. Descriptive statistical methods were used to analyze chemical FBDO data collected from the Foodborne Disease Outbreaks Surveillance System in Zhejiang Province from 2011 to 2023. From 2011 to 2023, 74 chemical FBDOs were reported in Zhejiang Province, resulting in 461 cases, 209 hospitalizations, and one death. In contrast to other types of FBDOs, the percentage of hospitalized cases in chemical FBDOs was the highest (45.34%) (chi-square = 1047.9, p < 0.001). Outbreaks caused by nitrite accounted for the largest percentage (56.76%), followed by lead (17.57%). Outbreaks caused by nitrite occurred mainly in households (27), followed by restaurants (6), street stalls (5), and work canteens (3). Among all nitrite-related outbreaks, 59.52% (25/42) were caused by cooking food where it was used as a common seasoning, 26.19% (11/42) by eating pickled vegetables, 7.14% (3/42) by eating cooked meat products, and 4.76% (2/42) by eating grain products. Outbreaks caused by the misuse of nitrite in cooking mainly occurred in households (68%, 17/25), street stalls (16%, 4/25), work canteens (8%, 2/25), and restaurants (8%, 2/25). Outbreaks caused by eating pickled vegetables occurred mainly in households (90.91%, 10/11), and one outbreak occurred in a work canteen. Outbreaks caused by lead (n = 13) occurred in households, and liquor was involved in 12 outbreaks where they were caused by residents consuming yellow rice wine stored in tin pots. In view of the frequent outbreaks of chemical foodborne diseases in our province from 2011 to 2023, a variety of prevention and control measures were proposed based on the research results of the temporal and regional distribution, food and food establishments involved, and the etiological agents of the chemical FBDOs. However, the effectiveness of these recommendations needs to be further verified and studied. In general, public health institutions should further strengthen the surveillance and health education of the population. Individuals should store toxic chemicals, such as nitrates, pesticides, and rodenticides correctly to avoid poisoning by ingestion. In view of the chemical FBDOs caused by food in the catering and distribution links, relevant departments should strengthen targeted supervision.

Acute gastrointestinal illness (AGI) is a prevalent public health concern worldwide. This study investigated the magnitude, distribution and burden of self-reported AGI among residents of Zhejiang Province, China. A face-to-face household survey was conducted using a multi-stage stratified random sampling method in 10 counties in Zhejiang Province between July 2018 and June 2019. In total, 12,021 participants were recruited. The prevalence of AGI 28 days after standardization was 1.8% (95% confidence interval (CI), 1.6–2.1), with an incidence rate of 0.24 episodes of AGI per person-year and an estimated 14 million cases of AGI in Zhejiang Province. Univariate and multivariable analyses showed a higher AGI prevalence among people who performed housework and were unemployed in summer and autumn among respondents living in western or northern cities (p < 0.05). More than 50% of AGI cases were attributed to the consumption of contaminated food. The disease burden caused by AGI in Zhejiang Province was approximately 975 million Chinses yuan (CNY). These results indicated that the disease burden of AGI in Zhejiang Province should be addressed and highlights the need for an improved active surveillance system of foodborne diseases to assess the impact of AGI on society and health.

To understand the epidemiological characteristics and patterns of mushroom poisoning in Zhejiang Province from 2012 to 2023, and to overcome the limitations of previous descriptive studies in precise early warning and spatial identification, this study explored the feasibility of identifying spatial distribution characteristics and high-risk spatiotemporal clusters. First, descriptive epidemiological analysis was conducted on 2276 cases from the Foodborne Disease Case Surveillance System and 408 outbreaks from the Foodborne Disease Outbreak Surveillance System reported over the 12-year period to clarify the basic characteristics and trends of poisoning. Subsequently, spatial autocorrelation analysis (Moran’s I) was employed to reveal spatial dependence and clustering patterns. Finally, spatiotemporal scan statistics (SatScan) were used to precisely identify high-risk spatiotemporal clusters, systematically analyzing the spatiotemporal distribution and clustering patterns of mushroom poisoning cases. The results showed a distinct summer–autumn seasonal peak (June–October), attributed to the subtropical monsoon climate with high temperatures and abundant rainfall, which is conducive to mushroom growth. Farmers were the most affected population (47.93%), and homes were the primary poisoning locations (71.7%), reflecting widespread foraging habits and insufficient risk awareness in rural areas. Chlorophyllum molybdites (36.27%) and Russula japonica (10.05%) were the dominant poisoning mushroom species, with gastrointestinal symptoms being the predominant clinical manifestation (84.07%). Spatial analysis revealed significant spatiotemporal clustering of mushroom poisoning in Zhejiang Province. The global Moran’s I index showed significant positive autocorrelation in some years (p < 0.05), with local hotspots mainly distributed in western Zhejiang counties. This pattern is driven by a dual model of environmental suitability and behavioral risk, resulting from the high forest coverage and humid climate of the western Zhejiang mountainous areas providing suitable habitats, combined with long-standing foraging habits among local residents. Retrospective spatiotemporal scanning identified high-risk clusters for each year from 2018 to 2023, with the Lishui area in 2023 being the most significant cluster (Relative Risk (RR) = 15.44, Log-Likelihood Ratio (LLR) = 114.49). The results confirm that mushroom poisoning in Zhejiang Province exhibits a stable and identifiable spatiotemporal clustering pattern, providing a quantitative basis for precise health education and targeted prevention and control in high-risk counties of western Zhejiang during June–October, thereby shifting the approach from passive reporting to targeted intervention.

This article assesses per- and polyfluoroalkyl substances (PFAS) exposure levels, distribution, bioaccumulation characteristics, and health risks in freshwater fish from Zhejiang Province, China. A total of 240 market-sourced fish samples (covering carnivorous, omnivorous, and herbivorous species) collected between 2022 and 2024 were analyzed for 24 PFAS congeners, including four emerging alternatives. The results revealed widespread PFAS contamination, with a detection frequency of 77.5% and median total PFAS (Σ₂₄PFAS) concentration of 2.95 ng/g. Hexafluoropropylene oxide dimer acid (HFPO-DA), perfluorooctane sulfonate (PFOS), and perfluoroundecanoic acid (PFUnDA) were the most frequently detected congeners. PFOS exhibited the highest median concentrations in carnivorous and omnivorous fish, whereas PFUnDA was the dominant contaminant in filter-feeding and herbivorous fish. No significant difference in Σ₂₄PFAS concentrations was observed among fish with different feeding habits, but highly significant spatial variation was found. Long-chain PFAS concentrations were significantly higher than those of short-chain PFAS and emerging alternatives, with their proportion decreasing at lower trophic levels. The estimated daily intake of Σ₂₄PFAS and Σ₄PFAS for freshwater fish consumers averaged 0.14 and 0.042 ng/kg bw/day, respectively, with approximately 0.16% of the assessed individuals exceeding the recommended threshold. This study provides critical data to support food safety management and risk mitigation strategies.