Yi-Ying Tseng. This study was supported by National Science Council, Taiwan (NSC100-2314-B-758-001-MY3 and NSC102-2314-B-182A-044); Chang Gung Memorial Hospital, Taiwan (CMRPG 8B0642); Show Chwan Memorial Hospital, Taiwan (RA11028). “
“Due to climate change, floods are recognized as the most frequent and devastating type of natural disasters in the world.1 The number of global flood events doubled from 2001 to 2010. China frequently experiences natural disasters, of which flooding is the most serious.2 Yellow River Basin, the second large river in China, has unique river valley topography. OSI-744 cell line Climate change brought abundant rainfall and frequent storm

floods to the north central region of Henan Province, where the Yellow River meandered. Consequently, the persistent and heavy precipitation led to several floods in Zhengzhou, Kaifeng and Xinxiang cities-in the north center Henan Province between 2004 and 2009.3, 4, 5, 6 and 7 Floods are known to cause heavy physical damages during the initiation phase, GSK269962 but as floodwaters recede there are more threats to personal health and safety. Floods are associated with an increased risk for diarrheal diseases.8 Some studies have shown this effect that diarrheal diseases can increase in weeks or months after floods both in developing and developed countries. For example, Schwartz et al.

found that in all flood-associated diarrheal epidemics (1998–2004) cholera was a predominant cause compared to control period in Dhaka, Bangladesh.9 In a large study undertaken in Indonesia in 1992–1993, Regorafenib floods were identified as a significant risk factor for diarrheal illnesses caused by Salmonella enterica serotype Paratyphi A (paratyphoid fever). 10 A study from Germany revealed that contact with flood-water was significantly associated with onset diarrhea (OR = 5.8, 95% CI: 1.3–25.1). 11 In addition, an increased risk of gastroenteritis following the floods in 2000 has been reported in Lewes, England through a historical cohort study by Reacher et al. 12 Dysentery, including bacillary dysentery and amebic dysentery as diarrheal diseases, remains a

major public health problem in Henan Province. The incidence of dysentery each year ranged from 16.38 to 40.14 per 100,000 in Henan during 2004–2009,13 which was the second highest among the 39 species of notified infectious diseases. The health effects of floods may include increased mortality and morbidity from dysentery. Although some studies considering dysentery as a flood-related disease found that the rate of dysentery increased after floods,14, 15 and 16 there has been no research quantifying the effect of floods on dysentery to our knowledge. The evidence on the association between floods and dysentery is far from clear. Some studies also showed that after fully controlling for the difference with pre-flood rates and seasonality, there was no clear evidence of excesses found in dysentery risk during or after flooding.