Therefore, this study aimed to explore Ku-0059436 the potential association between dysentery and floods based on a longitudinal analysis from 2004 to 2009 in Zhengzhou, Kaifeng and Xinxiang cities. Results will contribute to have a better understanding of the health impacts of floods and assist in developing national strategies to prevent and reduce the risk of infectious diseases with floods. Fig. 1 shows the geographic position

of the three cities in the north center of Henan Province, which are located in the middle reaches of the Yellow River. The similar geographic location determines these cities the characteristics of the warm temperate continental monsoon climate. Kaifeng is located between latitude 34°11′–35°01′N and longitude 113°52′–115°15′E with an annual average temperature from 13.7 to 15.8 °C and an annual average rainfall from 585.3 to 684.1 mm.19 Zhengzhou, the capital of Henan Province, is located NU7441 in vivo between latitude 34°16′–34°58′N and longitude 112°42′–114°14′E with

an annual average temperature from 13.7 to 14.2 °C and an average rainfall per year up and down in 640.9 mm.20 In addition, Xinxiang is located between latitude 34°55′–35°50′N and longitude 113°30′–115°30′E with an annual average temperature from 13.9 to 14.6 °C, and an annual average rainfall per year of 580–640 mm.21 The areas of Zhengzhou, Kaifeng and Xinxiang are 7446.2, 6444 and 8629 square kilometers, respectively. In 2009, the population of Zhengzhou was approximately 682 million, followed by 475 million in Kaifeng and 562 million in Xinxiang. Monthly

disease surveillance data on dysentery from January 2004 to December 2009 were obtained from the National Notifiable Disease Surveillance System (NDSS). The definition of dysentery from the NSDD is a group of the human diseases that are caused by Shigellae and protozoan parasite Entamoeba histolytica, which have fever, abdominal pain, tenesmus and bloody or mucus stool as the typical clinical presentation. BCKDHA In our study, all dysentery cases were defined based on the diagnostic criteria and principles of management for dysentery (GB 16002-1995) issued by Ministry of Health of the People’s Republic of China. 22 Only the cases confirmed clinically and by laboratory tests, including microscopic examination and biochemical identification, were included in our study. Information of cases included age, gender, occupation, address, name of disease, cases classification, date of onset, and date of death. The gastrointestinal diseases caused by intoxication and chemical factors were a type of food poisoning with non-communicable, which were not under the surveillance and notification in the NDSS of China. These gastrointestinal diseases were not included in our study. In China, dysentery is a statutory notifiable category B infectious disease.