{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,22]],"date-time":"2026-01-22T14:11:28Z","timestamp":1769091088803,"version":"3.49.0"},"reference-count":34,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T00:00:00Z","timestamp":1768953600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Objectives<\/jats:title>\n To analyze the epidemiological characteristics and estimate the incidence of infectious diarrhea in Beijing, China, 2015\u20132019.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n From January 2015 to December 2019, stool specimens and epidemiological data of diarrhea cases were collected from sentinel hospitals across all districts. Viral pathogens were detected by real time PCR or RT-PCR, including rotavirus, norovirus, astrovirus, adenovirus and sapovirus. Bacterial pathogens were detected using culture, biochemical and serological assays, including\n Vibrio cholerae<\/jats:italic>\n , Shigella,\n Salmonella typhi<\/jats:italic>\n and\n Salmonella paratyphi<\/jats:italic>\n , diarrheagenic\n Escherichia coli<\/jats:italic>\n (DEC), non-typhoidal Salmonella (NTS),\n Vibrio parahaemolyticus<\/jats:italic>\n , Campylobacter and other bacteria. Descriptive statistics and a Monte Carlo multiplier model were applied for analysis and incidence estimation.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n A total of 27,804 outpatients were included from 2015 to 2019. Among cases tested for viral pathogens (\n N<\/jats:italic>\n =\u202f9,351), norovirus (1,572\/9,351, 16.81%) was the most prevalent, followed by rotavirus (907\/9,351, 9.70%). Among those tested for bacterial pathogens (\n N<\/jats:italic>\n =\u202f20,741), diarrheagenic\n Escherichia coli<\/jats:italic>\n (DEC) (1,941\/20,741, 9.36%) was predominant, followed by non-typhoidal Salmonella (NTS) (4.55%) and\n Vibrio parahaemolyticus<\/jats:italic>\n (4.17%). Notably, enteroaggregative\n E. coli<\/jats:italic>\n (35.65%) was the predominant type of DEC identified in this study. The detection rates of viral pathogens were higher in winter and spring. Rotavirus was mainly identified in cases under 5\u202fyears of age, while norovirus was more common in cases aged 18\u201340\u202fyears old. Bacterial pathogens were mainly identified in cases aged 18\u201340\u202fyears old in summer. Estimated by the model, the average annual number of infectious diarrhea cases in Beijing from 2015 to 2019 was approximately 68,054 (95%CI: 49,917\u2013104,149). While the model result indicates the presence of significant hidden burden, but are constrained by inherent limitations in the modeling approach and monitoring design.\n <\/jats:p>\n <\/jats:sec>\n \n Conclusion<\/jats:title>\n Diarrhea remains a serious public health problem in Beijing, China. Norovirus, DEC, and rotavirus were the predominant pathogens among diarrhea outpatients in Beijing. Continuous surveillance is necessary for guiding prevention and control strategies.<\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1717990","type":"journal-article","created":{"date-parts":[[2026,1,21]],"date-time":"2026-01-21T06:51:10Z","timestamp":1768978270000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Epidemiological pattern and incidence estimation of infectious diarrhea before the COVID-19 pandemic: Beijing, China, 2015\u20132019"],"prefix":"10.3389","volume":"14","author":[{"given":"Ruihan","family":"Xu","sequence":"first","affiliation":[{"name":"School of Public Health, China Medical University","place":["Shenyang, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yi","family":"Tian","sequence":"additional","affiliation":[{"name":"General Administration of Customs (Beijing) International Travel Health Care Center","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lei","family":"Jia","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gemixi","family":"Dedema","sequence":"additional","affiliation":[{"name":"School of Public Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jueqiong","family":"Zhao","sequence":"additional","affiliation":[{"name":"Vanke School of Public Health, Tsinghua University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mei","family":"Qu","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Weihong","family":"Li","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bing","family":"Lv","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease 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on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control","place":["Beijing, China"]},{"name":"School of Public Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Zhiyong","family":"Gao","sequence":"additional","affiliation":[{"name":"School of Public Health, China Medical University","place":["Shenyang, China"]},{"name":"School of Public Health, Capital Medical University","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daitao","family":"Zhang","sequence":"additional","affiliation":[{"name":"School of Public Health, China Medical University","place":["Shenyang, China"]},{"name":"Beijing Key Laboratory of Surveillance, Early Warning and Pathogen Research on Emerging Infectious Diseases, Beijing Center for Disease Prevention and Control","place":["Beijing, China"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,21]]},"reference":[{"key":"ref1","article-title":"Diarrheal diseases","author":"Dattani","year":"2023"},{"key":"ref2","article-title":"Global health estimates: Leading causes of DALYs","year":"2020"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"92","DOI":"10.1186\/s12889-022-12515-3","article-title":"The burden of diarrhea, etiologies, and risk factors in India from 1990 to 2019: evidence from the global burden of disease study","volume":"22","author":"Behera","year":"2022","journal-title":"BMC Public Health"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"679853","DOI":"10.3389\/fpubh.2021.679853","article-title":"Epidemiological trends and hotspots of other infectious diarrhea (OID) in mainland China: a population-based surveillance study from 2004 to 2017","volume":"9","author":"Chen","year":"2021","journal-title":"Front Public 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