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.

Background: Vibrio parahaemolyticus is one of the most common foodborne pathogens and poses a significant disease burden. The purpose of the study was to elucidate the epidemiological characteristics of Vibrio parahaemolyticus outbreaks in Zhejiang Province, and provide insights for the targeted prevention and control of foodborne diseases.Methods: Descriptive statistical methods were utilized to analyze the data on Vibrio parahaemolyticus outbreaks reported by all Centers for Disease Control and Prevention (CDCs) through Foodborne Disease Outbreaks Surveillance System (FDOSS) in Zhejiang Province from 2010 to 2022.Results: From 2010 to 2022, a total of 383 outbreaks caused by Vibrio parahaemolyticus were reported by 90 CDCs in 11 prefectures of Zhejiang Province, resulting in 4,382 illnesses, 326 hospitalizations and 1 death. The main symptoms of the outbreak-related cases were diarrhea (95.18%), abdominal pain (89.23%), nausea (55.64%), vomiting (50.57%), fever (24.21%), etc. The outbreaks occurring between July and September accounted for 77.54% of all outbreaks (297 out of 383). Outbreaks associated with restaurants accounted for the majority (57.96%, 222/383) of all outbreaks, followed by those linked to staff canteens (15.40%, 59/383) and rural banquets (11.23%, 43/383). 31.85% of all outbreaks were associated with the consumption of aquatic products, while ready-to-eat foods such as Chinese cold dishes and cooked meat products accounted for 12.53% of all outbreaks. Serotype O3:K6 (81.94%, 118/144) was the predominant serotype responsible for outbreaks from 2010 to 2020, while serotype O10:K4 (57.89%, 33/57) was the predominant serotype from 2021 to 2022.Conclusion: In-depth and comprehensive analysis of long-term surveillance data on Vibrio parahaemolyticus outbreaks is essential to gain insight into the epidemiological characteristics, identify long-term patterns and recent trends, and enable governments to prioritize interventions and develop targeted policies to mitigate such outbreaks.

Wild mushroom poisoning has been recognized as a global problem threatening human health. In this study, we aimed to explore characteristics of wild mushroom poisoning in Zhejiang province, China. From 2016 to 2018, 429 cases of wild mushroom poisoning were reported, and among them, there were 2 deaths and 84 hospitalizations, with the incidence of 0.2526 per 100,000 and the case fatality rate of 0.47%. Digestive symptoms were found in all cases. Systemic symptoms and signs, neurological symptoms, and urinary symptoms were found in 28.90% (124/429), 11.66% (50/429), and 4.90% (21/429) of the cases, respectively. The proportion of cases with incubation period <6 h was 85.78%, and those with ≥6 h accounted for 14.22%. The peak period of poisoning occurred from June to October annually. Quzhou (Moran’sI = 1.242,p < .05) and Lishui (Moran’sI = 0.759,p < .05) with mild climate, more mountains, and abundant rainfall were “hot spots” for the incidence of wild mushroom poisoning, showing a state of high‐incidence aggregation. Epidemiological analysis showed that there were seasonal, high‐incidence areas and high‐risk groups in wild mushroom poisoning. The government should give early warning to high‐incidence areas and strengthen publicity to high‐risk groups before wild mushrooms mature every summer and autumn. In addition, we recommend that ordinary people not pick wild mushrooms outdoors for consumption, because it is difficult to distinguish whether wild mushrooms are poisonous and do not buy wild mushrooms of unknown sources.

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.

With the increasing prevalence of metabolic syndrome (MS), there is a need to track and predict the development of MS. In this study, we established a Markov model to explore the natural history and predict the risk of MS. A total of 21,777 Chinese individuals who had at least two consecutive health check-ups between 2010 and 2015 were studied. MS was defined using the Chinese Diabetes Society criteria. Twelve metabolic abnormal states (the no component state, four isolated component states, six 2-component states, and the MS state) were contained in each Markov chain. The transition probability was the mean of five probabilities for the transition between any two states in 2 consecutive years. The dyslipidemia or overweight/obesity components were most likely to initiate the progress of MS in individuals aged 18–49. However, for individuals over 50 years old, the most likely initiating component of MS was dyslipidemia or hypertension. People who initially had dyslipidemia were most likely to develop the combined state of dyslipidemia with overweight/obesity before the age of 50, but after 50 years of age, the state of dyslipidemia merged with hypertension was the most common. Subjects (with the exception of males over 50 years of age who initially had an isolated state of hyperglycemia) who initially had an isolated state of overweight/obesity, hypertension, or hyperglycemia were most likely to develop a combination of one of these initial states with dyslipidemia. Males who initially had isolated hyperglycemia tended to develop hypertension after age 50. There was a greater chance for subjects who initially had an isolated hyperglycemia state or 2-component state that contained hyperglycemia to develop MS within 10 years compared to those who initially had other abnormal metabolic states. The occurrence of MS primarily began with overweight/obesity or dyslipidemia in people aged 18–49. However, for those over 50 years old, MS primarily initiated under the conditions of dyslipidemia or hypertension. When MS started under the conditions of overweight/obesity, hypertension or hyperglycemia, dyslipidemia tended to occur next. People who initially had isolated hyperglycemia or a 2-component state that contained hyperglycemia had a higher risk of developing MS than those with other initiating states.

Foodborne diseases are a growing public health concern worldwide and households are a common setting. This study aimed to explore the epidemiological characteristics of household foodborne disease outbreaks in Zhejiang Province and propose targeted prevention and control measures. Descriptive statistical methods were used to analyze household foodborne disease outbreak data collected from the Foodborne Disease Outbreaks Surveillance System in Zhejiang Province from 2010 to 2022. Household foodborne disease outbreaks showed an upward trend during the study period (Cox-Staurt trend test, p = 0.01563 < 0.05). These outbreaks mainly occurred from June to September, with 62.08% (352/567) of all reported outbreaks. The number of reported outbreaks varied in 11 prefectures, with a maximum of 100 and a minimum of only 7. Household foodborne disease outbreaks had a wide spectrum of etiologic factors. Mushroom toxins accounted for the largest proportion of all etiologies (43.39 %) and caused the highest proportion of hospitalization (54.18%) and death (78.26%). Such outbreaks are caused by accidently eating wild poisonous mushrooms. Bacterial infection (16.23%) was the second most common etiology, with Salmonella spp. and Vibrio parahaemolyticus being the primary pathogens. These outbreaks were caused by improper storage, improper processing or a combination of factors, and the foods involved were mainly aquatic animals, eggs and cooked meat. Other identified etiologies included plant toxins (9.52%), chemicals (7.23%), animal toxins (3.70%), and viruses (1.76%). Among the above-mentioned etiologies, mushroom toxins, bacteria, and animal toxins had seasonal characteristics. Analysis of regions and etiologies revealed that the proportion of various etiologies was different in 11 prefectures. Wild mushrooms (43.39%), aquatic animals (9.88%), and toxic plants (8.47%) were the top three foods involved in these outbreaks. The most common factors contributing to household foodborne disease outbreaks were inedibility and misuse (59.08%), followed by multiple factors (7.58%), improper storage (7.41%), and improper processing (7.41%). Household foodborne disease outbreaks were closely related to the lack of knowledge regarding foodborne disease prevention. Therefore, public health agencies should strengthen residents' surveillance and health education to improve food safety awareness and effectively reduce foodborne diseases in households. In addition, timely publicity and early warning by relevant government departments, the introduction of standards to control the contamination of pathogenic bacteria in raw materials, and strengthened supervision of the sale of substances that may cause health hazards, such as poisonous mushrooms and nitrites, will also help reduce such outbreaks.