Pathogens of patients with fever with rash syndrome in Gansu province, 2009 – 2019: a multiple correspondence analysis

Objective  To examine characteristics of pathogens identified among patients with fever and rash syndrome (RFIs) in Gansu province from 2009 to 2019, and to provide a reference for implementing targeted prevention measures and conducting pathogen surveillance. Methods Sentinel surveillance data on 5 822 RFIs cases reported in Gansu province from 2009 through 2019 were extracted from the Information Management System for Prevention and Treatment of AIDS and Viral Hepatitis and other Major Infectious Diseases. Multiple correspondence analysis was adopted to analyze characteristics of pathogens isolated from the RFIs patients. Results Enterovirus infection was confirmed in 1 653 (28.39%) of the all RFIs patients reported during the period and the number (proportion) of the patients confirmed with other pathogen infections were 548 (9.41%) for measles virus, 201 (3.45%) for rubella virus, and 495 cases (8.50%) for varicella-zoster virus, respectively. No pathogen infection was confirmed in 2 925 (50.24%) RFIs patients. The results of multiple correspondence analysis showed that enteroviruses infection was more frequently diagnosed in hospitalized cases in western and central Gansu province, during summer/autumn season, among scattered children aged ≤ 5 years and kindergarten children, among patients hospitalized in provincial and county-level hospitals; measles virus infection was more frequently confirmed among the patients in eastern and southern areas of Gansu province, during winter/spring season, in the adults (≥ 18 years) with some specific occupations, and among patients seeking medication at municipal hospitals; and more varicella-zoster virus and rubella virus infections were detected among the students aged 6 to 17 years. No pathogen infection was identified among the majority of the RFIs patients visiting doctors in outpatient/emergency departments. Conclusion The main pathogens inducing RFIs incidents in Gansu province from 2009 to 2019 include enterovirus, measles virus, varicella-zoster virus and rubella virus, and there were disparities in the detection rate of the pathogens among various populations, in different seasons and in various geographical areas.