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Multi respiratory pathogens detected in COVID-19 patients and their family members in Haidian district, Beijing
Liu Fangyao, Zhang Heng, Jiao Lijie, Liu Feng
, DOI: 10.3784/jbjc.202009230329
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  Objective  To analyze the infection status of common respiratory pathogens in coronavirus disease 2019 (COVID-19) patients and their family members in Haidian district of Beijing and compare the disease severity between the COVID-19 patients with co-infections and the COVID-19 patients only infected with SARS-CoV-2.  Methods  Multiplex PCR was used to detect the pathogen spectrum by using the respiratory tract samples of COVID-19 patients and their family members collected by the Haidian Center for Disease Control and Prevention during January-June, 2020. The differences in age and gender distributions and the severity of illness between the co-infection group and the non-co-infection group were compared.  Results  Parainfluenza virus, human metapneumovirus, NL63 coronavirus and Mycoplasma pneumoniae were detected in some samples of the COVID-19 patients, and respiratory syncytial virus, human metapneumovirus and NL63 coronavirus were detected in samples of some family members. There was no statistical differences between the co-infection group and the non-co-infection group in gender, age distributions and the severity of illness  Conclusion  Co-infections of SARS-CoV-2 and other respiratory pathogens were observed in the COVID-19 patients in Haidian district. There was a difference in pathogen spectrum detected in samples between the COVID-19 patients and their family members. No increased morbidity or mortality were observed in the COVID-19 patients co-infected with other respiratory pathogens. Application of multiplex PCR can provide more accurate evidence for the development of medical strategies.
Research progress of reclassification and virulence factors of Clostridioides difficile
Lin Shan, Song Xiaojun, Qu Pinghua, Jin Dazhi
, DOI: 10.3784/jbjc.202012250440
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Based on the research of phenotypic characteristics, chemical taxonomy and phylogeny, Clostridium difficile has been classified into the genus Clostridioides and renamed as Clostridioides difficile (C. difficile). In recent years, multi-drug resistant C. difficile infection has caused a significant increase in the number of antibiotic treatment failures and recurrent cases. At present, some European and American countries have established a complete surveillance systems and corresponding clinical diagnosis and treatment guidelines for C. difficile infection, but related works started late in our country. What's more, a large number of non-standardized antibiotic use, even abuse, still exist in clinical treatment in China, resulting in great challenges for the prevention, control, diagnosis and treatment of C. difficile infection. This study aimed to summarize the reclassification of C. difficile and the research progress of its virulence factors in order to provide reference to revise and standardize the name of Clostridioides difficile, promote domestic research of C. difficile and its pathogenic mechanism.
Epidemiological characteristics and research progress of Clostridioides difficile in China
Wu Yuan, Li Wenge, Jia Xiaoxi, Wang Yuanyuan, Zhang Wenzhu
, DOI: 10.3784/jbjc.202012210425
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Clostridioides difficile is recognized as the predominant pathogen for antimicrobial associated diarrhea and health care facility-associated infectious diarrhea, and is also listed as one of the urgent threat associated with antibiotics by Centers for Disease Control and Prevention of USA. In recent decades, studies on C. difficile and the rate of C. difficile infection increased dramatically. The aim of this study was to analyze the epidemiological characteristics of C. difficile infection and summarize research progress of C. difficile in China, which might help the further studies of C. difficile in China.
Detection of pathogens in clinically diagnosed cases of bacillary dysentery in Shunyi, Beijing
Yang Jie, Lyu Ziwei, Tan Dunfang, Ji Guoqiang, Li Ying, Zhang Maojun
, DOI: 10.3784/jbjc.202008310305
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  Objective  To analyze the composition and characteristics of pathogens of clinically diagnosed cases of bacillary dysentery in Shunyi, Beijing, and provide evidence for the effective prevention and control of bacillary dysentery.  Methods  A total of 44 clinical samples were collected from clinically diagnosed bacillary dysentery cases for the detections of Shigella, Campylobacter, Salmonella, Vibrio parahaemolyticus, Vibrio cholerae, Diarrhea Escherichia coli and Yersinia enterocolitica. Serotyping, molecular subtyping and virulence gene detection were performed for the pathogenic isolates.  Result  No Shigella and Yersinia enterocolitica were detected, and the positive rate was 30.00% (9/30) for Campylobacter, 18.18% (8/44) for Salmonella, 15.91% (7/44) for V. parahaemolyticus, 4.55% (2/44) for Diarrhea E. coli and 3.13% (1/32) for V. cholerae. Nine Campylobacter jejuni strains belonged to 9 STs; 8 Salmonella strains belonged to 4 serotypes and 7 PFGE patterns; 8 V. parahaemolyticus strains belonged to 4 serotypes and the virulence genes were tdh+/trh- and 1 V. cholerae strain belonged to non O1/O139 serotype and the virulence genes were ctx-/t3ss+.  Conclusion  The misdiagnosis rate of bacillary dysentery was high in Shunyi, to which close attention should be paid. The detection rate of pathogenic bacteria was high in clinically diagnosed cases of bacillary dysentery and the predominant pathogens were Campylobacter and Salmonella. The rapid differential diagnosis method between Shigella and other diarrhea pathogenic bacteria should be established and applied as soon as possible.
Optimization of isolation and culture method of Shigella spp. from stool samples
Wang Qifa, He Ziqiang, Li Yinmei, Hu Yongfeng, Jin Dong
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  Objective  To optimize the isolation method of Shigella spp. from stool samples.  Methods  A total of 129 stool samples were cultured with EC broth and Shigella enrichment broth. The ipaH gene was detected by PCR. Different selective media, including XLD medium, MAC medium, and SS medium, were used for the isolation of Shigella spp. The reference strains of Shigella spp. were used for simulated enrichment culture. Real-time PCR was used as detection method.  Results  The positive rate of EC broth enrichment samples with anaerobic condition was 38.76% and 34 ipaH gene positive strains were isolated (26.36%). The positive rate of Shigella enrichment broth samples with anaerobic condition was 55.81%, which was significantly higher than that of EC broth (P < 0.01), and 48 ipaH gene positive strains were isolated (37.21%). The isolation rate of Shigella spp. could be improved with other selective media such as MAC medium and SS medium except XLD medium. Anaerobic condition could increase the content of Shigella flexneri (Ct value decreased), but it had no obvious influence on Shigella sonnei.  Conclusion  Enrichment with 2-3 different selective culture media in combination with molecular biological method might be an effective way to improve the isolation rate of Shigella spp. in stool samples.
Molecular epidemiological characteristics and antibiotic resistance of multi-drug resistant Salmonella 14,[5]12:i:- in Guangdong
Huang Jingmin, Ke Bixia, Li Bosheng, He Dongmei, Liu Zhe, Li Zhencui, Deng Xiaoling
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  Objective  To study the characteristics of multi-drug resistance of Salmonella 1,4,[5],12:i:- and its genetic background in Guangdong province, and provide strong support for the drug resistance surveillance of this serotype and the early warning, prevention and control of foodborne disease outbreaks in Guangdong.  Methods  A total of 92 strains of Salmonella 1,4,[5],12:i:- collected from the sentinel hospitals for diarrhea pathogen surveillance in Guangdong province were included in the study. Minimal broth dilution method was used to detect the minimum inhibitory concentration of strains to 27 antibacterial agents. Whole-genome sequencing was applied to study the molecular characteristics associated with antibiotic resistance. Multilocus sequence typing (MLST) and whole-genome single nucleotide polymorphisms (wgSNPs) were conducted to analyze population structure of the isolates and evolutionary relationship between the isolates and global circulating strains.  Results  The multidrug resistance of Salmonella 1,4,[5],12:i:- was serious, with high resistance to tetracycline, ampicillin and sulfisoxazole, moderate resistance to aminoglycosides, cephalosporins, and high sensitivity to quinolones simultaneously. Resistance genes carried by the isolates were various. The drug resistance genes were consistent with overall drug-resistant phenotypes. The transmission of drug resistance genes mediated by mobile genetic elements such as IncHI2/IncHI2A, IncQ-type plasmids and insert sequences was the main mechanism of multidrug resistance of Salmonella 1,4,[5],12:i:-. MLST analysis showed that ST34 was the predominant clone of Salmonella 1,4,[5],12:i:- in Guangdong. Phylogenetic analysis found that the serotype population belonged to the same evolution branch with global circulating strain, which indicated a close genetic evolutionary relationship with international circulating clone.  Conclusion  The multidrug resistance patterns of Salmonella 1,4,[5],12:i:- varied in Guangdong, the drug resistance mechanism was complex, and acquired drug resistance was predominant. The multidrug resistant Salmonella 1,4,[5],12:i:- isolates in Guangdong showed a specific phylogenetic lineage. ST34 with a extensive antibiotic resistance pattern was predominant, which was consistent with the global trend.
Whole genome analysis on rotavirus isolated in outbreak in Ninghe district of Tianjin, 2020
Lei Yue, Zhuang Zhichao, Tian Hong, Dong Xinghua, Li Xiaoyan
, DOI: 10.3784/jbjc.202012020407
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  Objectives  To understand the whole genome characteristics of rotavirus A strains isolated from acute gastroenteritis cases in an outbreak in Ninghe district of Tianjin in 2020.  Methods  The viral nucleic acids of rotavirus isolated from positive stool samples collected in Ninghai were extracted for real-time PCR confirmation, the sequencing library were constructed following the instructions, the gene sequencing was conducted by the second generation sequencing method, and the sequencing data were analyzed by phylogenetic software, and 11 gene fragments full-genome sequences were analyzed by homology and phylogenetic analyses.  Results  Complete gene sequences of 4 strains of rotavirus were obtained successfully by the second generation sequencing method. All the strains shared >99% homology and showed the Wa-like constellation G9-P[8]-I1-R1-C1-M1-A1-N1-T1-E1-H1. Furthermore, phylogenetic analysis revealed that the VP7 genes belonged to lineage G9-VI and the VP4 sequences belonged to lineage P[8]-3. Amino acid substitutions were observed in the antigenic regions of the VP7 and VP4 gene. The nonstructural protein 4 (NSP4) genes contained multiple substitutions in antigenic sites I and II. The other NSP genes were conserved.  Conclusion  The study revealed that rotavirus G9-VI and P[8]-3 were the pathogens of this outbreak. The variations of the 4 strains were minor compared with the circulating strain. The continuous surveillance and analysis of the whole genomic constellation of circulating rotavirus strains needs to be strengthened to provide evidence for the prevention and control of rotavirus infection.
Analysis on HIV-1 infection, behavior and influencing factors in MSM in sentinel surveillance, Shanghai, 2012–2019
Wu Jian, Zhang Jiayu, Wang Xuting, Shu Weiping, Xu Yuan, Qin Xiaoyun, Ning Zhen
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  Objective  To investigate the infection status of human immunodeficiency virus-1 (HIV-1) and related behaviors in men who have sex with men (MSM) in Shanghai, identify the influencing factors, and provide evidence for HIV prevention and control.  Methods  Consecutive sentinel surveillance in MSM were conducted from 2012 to 2019. Blood samples were collected from the MSM and tested for HIV, syphilis and hepatitis C virus (HCV) antibodies. Logistics regression analysis was used to identify the influencing factors.  Results  A total of 3207 MSM were investigated from 2012 to 2019, they were mainly aged 25–34 years, unmarried and non-local population, and lived in Shanghai for more than 2 years. Most of them had education level college or above. The median of coverage rate of AIDS prevention service was 86.3%, and the median of awareness rate of AIDS related knowledge was 94.6%. The median of HIV antibody positive rate was 6.5%, which showed an overall upward trend (P<0.001). Up to 85.2% of MSM reported that they had anal homosexual behaviors in the past six months, among these MSM, 79.3% used condom at each anal sex. In the past six months, the proportions of condom use in homosexual, commercial homosexual and heterosexual behaviors all increased (P<0.05). Multivariate logistic regression analysis showed, education level of senior high school or lower (OR=1.506, 95% CI: 1.067–2.126, P=0.020), non-consistent condom use in anal sex (OR=1.379, 95% CI: 1.005–1.891, P=0.047), drug use (OR=3.688, 95% CI: 1.412–9.634, P=0.008) and syphilis status (OR=5.872, 95% CI: 3.784–9.111, P<0.001) were risk factors for HIV infection.  Conclusion  The positive rate of HIV antibody in MSM in Shanghai is still high, and HIV related risk behaviors are still common. It is necessary to further explore a comprehensive prevention and control intervention model to reduce the HIV infection in MSM.
Epidemiological and etiological characteristics of norovirus infection in children aged ≤5 years in Hubei, 2018–2019
Li Jing, Zhang Ting, Zou Wenjing, Cai Kun, Xu Junqiang
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  Objective  To understand the epidemiological and molecular characteristics of norovirus associated with acute diarrhea in infants and young children in Hubei province from 2018 to 2019.  Methods  A total of 922 stool samples from children aged ≤5 years with diarrhea were collected from viral diarrhea surveillance sentinel hospitals in Hubei Province from 2018 to 2019. The nucleic acids of norovirus GⅠ and GⅡ were detected by reverse transcription polymerase chain reactions. RT-PCR was used to amplify RNA polymerase and capsid region of the strain from norovirus positive samples and the PCR products were sequenced and genotyped.  Results  Among the 922 stool samples collected, 122 were norovirus positive (13.23%), in which 119 were norovirus GⅡ positive (97.54%) and 3 were norovirus GⅠ positive (2.46%). The difference in the infection rate between boys and girls was significant ( χ2=8.805, P=0.003). Children aged ≤5 years, especially the infants aged6 - 12 months, were the population with high incidence. Norovirus infection mainly occurred in winter and spring, there were two incidence peaks, and the higher one occurred during October-December. Norovirus GⅡ was predominant and recombination genotypes were mainly GⅡ.4 Sydney [P31](27.71%), GⅡ.2[P16](26.51%), GⅡ.3[P12](26.51%) and GⅡ.4 Sydney [P16](16.87%).  Conclusion  Multi genotypes and different recombination subtypes of norovirus were detected in children aged≤5 years with diarrhea in Hubei from 2018 to 2019. It is necessary to strengthen the surveillance for norovirus genotype and protect key population for the prevention and control of norovirus infection.
Investigation of Neisseria meningitidis in healthy population in Kashgar, Xinjiang, 2019
Chen Ziman, Xie Na, Xu Li, Wang Tongmin, He Lijuan, Zhu Bingqing, Gao Yuan, Shao Zhujun
, DOI: 10.3784/jbjc.202011250397
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  Objective   To investigate the carriage of Neisseria meningitides in the healthy population of Kashgar, Xinjiang.   Methods   In four counties in Kashgar prefecture, a total of 703 throat swabs were collected from healthy people in different age group selected by cluster random sampling. N. meningitides was isolated and identified by culture and real-time PCR. The serogroup of N. meningitides strain was determined by slide agglutination and real-time PCR. The laboratory results and epidemiological survey data were analyzed.   Results   In this study, a total of 91 N. meningitides strains were isolated with a carriage rate of 12.94%. The proportion of serogroup B, C, W, Y, E and non-groupable (NG) strains were 32.97% (30/91), 13.18% (12/91), 16.48% (15/91), 12.09% (11/91), 1.10% (1/91) and 24.17%(22/91), respectively. The N. meningitides carriage rate in healthy population were 27.27% (27/99) in age group 15–19 years, 15.00% (21/140) in age group ≥20 years, 14.20% (23/162) in age group 7–14 years, 9.18% (9/98) in age group 5–6 years, 4.90% (5/102) in age 3–4 years and 5.88% (6/102) in age group 0–2 years, respectively, the differences were significant ( χ2=45.725, P<0.05). A total of 185 throat swabs were positive in real-time PCR, and the difference in detection rates between culture and real-time PCR was significant ( χ2=153.589, P<0.05).   Conclusion   The N. meningitides carriage rate in healthy population in Kashgar was relatively high with age group 15–19 years having the highest carriage rate. The serogroups of N. meningitides strains isolated from the healthy population were complex. The application of real-time PCR in the carriage survey of N. meningitides in healthy population can increase the positive rate of the detection.
Functional Study on gene AL536_RS29525 of Vibrio fluvialis
Zhang Anran, Liu Xiaoshu, Huang Yuanming, Han Yu, Liu Ping, Li Jie, Kan Biao, Liang Weili
, DOI: 10.3784/jbjc.202101250043
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  Objective  To investigate the sequence characteristics of gene AL536_RS29525 located upstream of VflT6SS2 major cluster and downstream of paar gene of Vibrio fluvialis, its influence on VflT6SS2 secretion function and bactericidal activity as well as possible regulatory mechanism.  Methods  Muscle and GeneDoc softwares were used to compare and analyze AL536_RS29525 and homologs. Deletion mutant of AL536_RS29525 was constructed using suicide?plasmid based on the homologous recombination technology . Trans-complementation plasmid was constructed by cloning the coding sequence of AL536_RS29525 into plasmid pSRKTc, which was mobilized into the deletion mutant by conjugation. The expression and secretion of Hcp effector were analyzed by Western Blot. Standard bactericidal assay with E. coli as prey was used to measure the bactericidal ability of derivative strains. Luminescence activity of Lux based promoter fusion was used to test the promoter activities of VflT6SS2 major cluster and hcp orphan cluster in ΔAL536_RS29525 mutant strains and wild strains. Quantitative reverse transcription PCR (qRT-PCR) was used to detect the hcp (tssD2) and vipA (tssB2) mRNA level.  Results  The genomic structure and sequence of AL536_RS29525 homologs were conserved in Vibrio species. The deletion of AL536_RS29525 greatly decreased the expression and secretion of Hcp, and also significantly reduced the bactericidal ability. These defects can be restored by introducing the trans-complementation plasmid pSR-29525 into ΔAL536_RS29525 mutant. The mRNA expression levels of hcp (tssD2) and vipA (tssB2) of ∆AL536_RS29525 were lower than those of wild strains. However, the promoter activities of VflT6SS2 major cluster and hcp orphan were not significantly different between the mutant strains and wild strains.  Conclusion  AL536_RS29525 is an important component required for the expression and secretion of VflT6SS2 with a critical role in bactericidal activity of V. fluvialis.
Epidemiologic characteristics of measles and influencing factors in Baiyun district, Guangzhou, 2009–2019
Zhao Lixuan, Pang Zhiming, Lin Daner, Wang Zhiyun, Meng Yan, Lu Ruijun, Zhou Yong, Lu Jiahai
, DOI: 10.3784/jbjc.202012090413
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  Objective   To analyze the epidemiologic characteristics of measles and related influencing factors in Baiyun district of Guangzhou from 2009 to 2019 and provide evidence for measles prevention and control.   Methods   The measles surveillance system was used to carry out descriptive analysis on confirmed measles cases in Baiyun district from 2009 to 2019 and discuss the influencing factors.   Results   From 2009 to 2019, a total of 1430 confirmed measles cases were reported in Baiyun district, with an average annual incidence of 6.74/100,000, the cases mainly occurred during April – July, but the seasonality has been less obvious in recent years. The cases were mainly children aged < 2 years and adults aged 20–29 years. The cases were mainly distributed in population from other cities or provinces. The cases with 0 dose, 1 dose, ≥2 doses, and unknown immunization history of measles-containing vaccines (MCV) accounted for 61.73%, 7.26%, 17.46%, and 29.12%, respectively. The risk factors for measles in <18 years old group included being in floating population and medical treatment seeking history 7–21 days before onset (P < 0.05), and being on local population and history of MCV vaccination were the protective factors. Being in floating population was a risk factor for measles in people aged ≥18 years (P < 0.05).   Conclusion   Measles mainly occurred sporadically in Baiyun district, the incidence showed a single peak pattern and decline trend. Children aged <2 years and adults aged >20 years in floating population were the key populations in measles prevention and control. It is necessary to strengthen the active case finding in floating population, vaccination certificate check for the entrancement of private schools, active measles surveillance in medical institutions and encourage young migrant workers with unknown measles vaccination history to receive MCV, conduct accurate supplementary vaccination and take multiple measures to prevent periodic measles epidemic.
Spatiotemporal analysis on influenza in Hangzhou, Zhejiang, 2019–2020
Liu Muwen, Yang Xuhui, Wang Jing, Song Shujuan, Sun Zhou, Kao Qingjun
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  Objective   To analyze the temporal and spatial distribution of influenza epidemics in Hangzhou, and provide evidence for influenza prevention and control.   Methods   The influenza incidence data in Hangzhou during 2019–2020 were collected from “China Disease Prevention and Control Information System”, and the influenza outbreak data in Hangzhou during this period were derived from the epidemic response reports of Centers for Disease Control and Prevention in Hangzhou. Software ArcGIS 10.2 was used for global/local spatial autocorrelation analysis, and software SaTScan was used for spatiotemporal epidemiological analysis.   Results   A total of 264 410 influenza cases were reported in Hangzhou from January 1, 2019 to September 30, 2020, with an incidence rate of 269.98 per 10 000. The incidence peak was during December 2019 – January 2020 with cases accounting for 66.54% of the total. GSA Moran’s I value from the first quarter of 2019 to the first quarter of 2020 was positive and statistically significant (P<0.001). A total of 71 areas with high-high clustering were detected by local spatial association analysis, mainly located in the urban area and surrounding areas of Hangzhou. The spatiotemporal analysis showed that the class Ⅰ clustering areas were mainly located in the urban area and the surrounding areas of Hangzhou during December 15 2019 – January 25 2020, and the relative risk (RR) was 20.86, the log likelihood ratio (LLR) was 142 431.21 (P<0.001). The clustering areas detected by local spatial autocorrelation analysis and spatiotemporal analysis were similar to the actual outbreak distribution.   Conclusion   Temporal and spatial clustering of influenza incidence existed in Hangzhou during 2019–2020. Influenza prevention and control in the main urban areas and surrounding areas should be strengthened from November to January of the following year.
Estimation of excess number of diarrhea cases in intestinal disease outpatients in Beijing with adjusted Serfling regression model, 2012−2019
Liu Baiwei, Wang Yu, Tian Yi, Wang Xiaoli, Yan Hanqiu, Li Weihong, Shen Lingyu, Gao Zhiyong, Jia Lei, Wang Quanyi
, DOI: 10.3784/jbjc.202010220361
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  Objective   To estimate the excess number of diarrhea cases in intestinal disease outpatients in Beijing and analyze the characteristics of the excess cases.   Methods   The number of diarrhea cases diagnosed for the first time in 16 intestinal outpatient departments providing service all the year around in Beijing from 2012 to 2019 were collected to estimate the excess number of diarrhea cases with adjusted Serfling regression model.   Results   From 2012 to 2019, a total of 216 930 diarrhea cases were diagnosed for the first time in the 16 intestinal outpatient departments in Beijing, the age of the cases was mainly above 18 years. With adjusted Serfling regression model, 10 excess diarrhea epidemic periods were found, in which 28 135 excess cases occurred (95% CI: 13 423–42 847), accounting for 50.10% of the baseline level (95% CI: 23.90%–76.29%). The excess number of diarrhea cases diagnosed in the intestinal outpatient departments in spring, summer, autumn and winter were 2 673 (95% CI: 985–4 361), 11 564 (95% CI: 6 296–16 833), 2 570 (95% CI: 1 112–4 028) and 11 328 (95% CI: 5 030–17 626), respectively. The excess number of diarrhea cases in summer showed a decrease trend from 2012 to 2019 in Beijing ( χ2=5949.180, P<0.001), while the excess number of diarrhea cases in winter has been in increase since 2016.   Conclusion   Summer is the peak season of diarrhea diagnosis in Beijing, but in recent years, excess number of diarrhea cases increased obviously in winter. It is necessary to strengthen the surveillance for viral diarrhea in winter and adjust the corresponding prevention and control strategies.
Investigation of brucellosis epidemics in human and animals in Baoshan, Yunnan
Li Yanping, Ma Qiang, Huang Dongsheng, Zhao Ming, Ma Yunliang, Tang Xianyan
, DOI: 10.3784/jbjc.212101070013
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  Objective   To understand the characteristics of the brucellosis epidemics in human and animals in Baoshan prefecture of Yunnan province and provide scientific references for the prevention and control of brucellosis.   Methods   Descriptive epidemiological methods were used to analyze the investigation and response data of the two public health emergencies caused by brucellosis in Baoshan.   Results   Since 2017, two epidemics of brucellosis have been reported in Baoshan. In the first epidemic, a worker in a sika deer breeding farm showed fever with unknown reason and limb weakness, Brucella serological testing result was positive, and the antibody titer was 1∶400+. Brucella melitensis was detected by blood culture. Ten blood samples of sika deer were collected and tested by rose bengal plate agglutination test, the results showed that 2 samples were positive. The second epidemic was caused by infected beef cattle. In the response of the epidemic, 10 cattle attendants and 6 veterinarians were investigated. The blood samples of two persons were positive.   Conclusion   Two epidemics of brucellosis in Baoshan were effectively controlled through timely epidemiological investigation and managements. It is suggested to implement strict quarantine before the introduction of economic animals and strengthen the surveillance for brucellosis in staff and economic animals in breeding farms.
Comparison of the typing ability of the 6-site MLVA scheme and core genomic SNP scheme for Vibrio parahaemolyticus isolated in China
Zhang Jingshan, Zhao Wenxuan, Chen Meiling, Du Xiaoli, Zhao Lin, Wang Zijian, Xiao Wenjing, Zhang Weiwei, Zhao Hongqun, Li Jie, Diao Baowei, Kan Biao, Pang Bo
, DOI: 10.3784/jbjc.202111050373
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  Objective  To compare the ability of the whole-genome sequencing (WGS) SNP typing scheme with the multilocus tandem repeat analysis (MLVA) typing scheme for molecular typing of Vibrio parahaemolyticus isolated in China, and analyze the advantages and disadvantages of the two methods.  Methods  The MLVA scheme with six VNTR loci and the SNP scheme based on the whole genome sequence were used to analyze the molecular typing of 56 strains of Vibrio parahaemolyticus isolated in China, and evaluate the effects of these two methods with the isolates in China with quantitative indicators.  Results  Thirty-one MLVA types were obtained from 56 strains of V. parahaemolyticus by MLVA and the D value was 0.949. Thirty-three core genome SNP types were obtained in the same collection of strains by core genome SNP typing and the D value was 0.967. The discriminatory ability of the two typing methods is very close, and the typing results are highly consistent.  Conclusion  The 6-site MLVA typing scheme has similar typing capabilities to the typing scheme based on core genome SNP.
Epidemiological characteristics of measles outbreaks in international schools in Minhang district, Shanghai 2019
Chen Honghong, Zhang Liping, Su Hualin, Jin Baofang, Wang Ye
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  Objective   To analyze the epidemiological characteristics of a measles outbreak in international schools in Minhang district of Shanghai during May - June in 2019..   Method   An epidemiological investigation was conducted in all the suspected measles cases detected in the outbreak. Blood samples and throat swabs were collected from the cases to detect measles antibody and viral nucleic acid. Clinical and epidemiological characteristics of measles cases were discussed and described. Risk factors of measles transmission were assessed.   Results   A total of 18 suspected measles cases were reported in the outbreak, in which 12 were laboratory confirmed (66.67%). Three cases studied at Shanghai American School, 9 cases studied at the British International School Shanghai. In the 12 confirmed measles cases. 11 were with foreign nationality(91.67%). The peak time of measles outbreak was from May 28 to June 6, during which 9 cases were confirmed (75%). The age of the 12 cases ranged from 4 years to 15 years. Among them 1 had 3-dose measles-containing vaccine (MCV) immunization history (8.33%), 7 had 2-dose MCV immunization history (58.33%), 4 cases had 1-dose MCV immunization history (33.33%).   Conclusion   The investigation results suggested that the cause of the outbreak might be the common exposure to the index case during school sports meeting and Shanghai tennis club activity, indicating some students are susceptible to contracting measles infection in international schools. It is essential to strengthen joint prevention and control of infectious diseases in international schools according to local management requirement. It is strongly suggest that Shanghai education commission as well as Shanghai health department to formulate regulations and laws on vaccination certificate admission and supplementary vaccination in foreign students. Increasing the coverage rate of 2-doseMCV shots is an effective measure to prevent and control measles outbreak in schools.
Global yellow fever update, 2019
Gong Zhenyu, Gong Xunliang
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2019年全球霍乱流行概况
Gong Zhenyu
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Chinese reference list of core health indicators
, DOI: 10.3784/jbjc.202011300402
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Epidemiological characteristics of diarrhea pathogens and drug resistance of diarrhea-related bacteria in diarrheal patients in Miyun district, Beijing
Zhang Weiwei, Feng Baoli, Wang Jinlong, Han Yajun, He Guangxue
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  Objective  To understand the infection status of pathogenic bacteria and drug resistance characteristics in diarrhea patients in Miyun district, Beijing, and provide evidence for the prevention and treatment of infectious diarrhea.  Methods  The stool samples were collected from two sentinel hospitals in Miyun (Miyun District Hospital and Miyun Traditional Chinese Medicine Hospital) from 2014 to 2019. Pathogenic bacteria were identified by culture and isolation and drug resistances were analyzed. Diarrhea related viruses were also detected by real-time PCR.  Results  From 2014 to 2019, a total of 1 870 stool samples were collected. And 267 strains of bacteria (84 Salmonella strains, 52 Vibrio strains, 111 Escherichia coli strains, 10 Aeromonas strains, 8 Campylobacter strains, 2 Shigella strains) were isolated. And 314 samples were positive with viruses (204 with norovirus GII, 28 with norovirus GI, 61 with rotavirus, 17 with adenovirus, 4 with zaravirus). The highest positive rate was in age group <14 years (43.95%). The highest annual detection rate of diarrhea pathogens was in the third quarter, with an average positive rate of 40.26% in six years. The annual detection rate of diarrhea related viruses were higher in the first and fourth quarters, with an average positive rate of 18.86% and 23.63% respectively in six years. The drug resistance rates of Salmonella and diarrheagenic E. coli were 84.52% and 87.39% respectively. 36.90% of Salmonella strains and 36.94% of diarrheagenic E. coli strains were multidrug resistant.  Conclusion  In Miyun district, the composition of pathogens causing diarrhea tends to be diversified. Multidrug resistance of bacteria is serious. It is necessary to strengthen the pathogen surveillance, promote collaborations of multidisciplinary to response together, strengthen the management and rational use of drugs, and take effective measures to prevent and control the occurrence of drug resistance.
Clinical characteristics and drug resistance profile of 276 non-tuberculosis mycobacterium pulmonary disease patients
Niu Haijun, Li Yuanchun, Zhao Yanlin, Li Minghu
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  Objective  To investigate and analyze the clinical characteristics, pathogen species composition and drug sensitivity to first-line anti tuberculosis drugs of patients with non-tuberculosis mycobacterium (NTM) pulmonary disease from Nanyang, Henan province, and provide evidence to improve the diagnosis and treatment of NTM pulmonary disease.  Methods  A total of 276 patients with NTM pulmonary disease (all living in Nanyang) who visited the Sixth People's Hospital of Nanyang City from January 2015 to December 2019 were enrolled retrospectively. The baseline data, clinical symptoms, imaging manifestations and other information of the patients were collected, PCR reverse dot blot hybridization was used to identify NTM strains, and absolute concentration method was used for drug sensitivity test. SPSS18.0 was used for statistical analysis.  Results  From 2015 to 2019, the identification rates of NTM patients in suspected tuberculosis (TB) patients were 1.05%, 1.11%, 1.23%, 1.54% and 1.70%, respectively. Among the 276 NTM patients, men accounted for 61.59% (170/276), and the average age of the patients at onset was(51.21 ± 8.33)years. The main clinical manifestations were cough, expectoration, chest tightness, shortness of breath or anhelation. The most common imaging manifestations were pleural thickening (53.62%, 148/276), bronchiectasis (42.39%, 117/276) and cavity (40.58%, 112/276). Eight NTM strains were identified, and the top four strains were Mycobacterium intracellular (32.61%, 90 / 276), Mycobacterium Kansaii (23.91%, 66/276), Mycobacterium abscessus (21.38%, 59/276) and Mycobacterium avium (14.49%, 40/276). The drug resistance rates of the four major NTM to isoniazid, rifampicin, ethambutol, streptomycin, kanamycin and ofloxacin were 92.55% (236/255), 83.53% (213/255), 54.51% (139/255), 89.02% (227/255), 78.82% (201/255) and 64.31% (164/255), respectively. In NTM subspecies, M. aeruginosa was more likely to cause symptoms such as fever, chest tightness, shortness of breath or anhelation and imaging findings such as bronchiectasis and cavity compared with M. avium.  Conclusion  The identification rate of NTM pulmonary disease in Nanyang increased year by year. The clinical characteristics were similar to those of patients with pulmonary TB. Close attention should be paid to the patients with risk factors and complications in clinical practice, and the imaging manifestations and bacteriological characteristic should be differentiated. The common NTM strains had high resistance to the first-line anti TB drugs, so the treatment plan should be standardized.
Analysis on spread trend of anti-tuberculosis drug resistance, Liuzhou, Guangxi
Tan Shounan, Zheng Zhigang, Huang Baoyang, Qin Zhenhua, Tan Jinxue, Wei Wudi, Liang Bingyu, Liao Yanyan, Pan Peijiang, Jiang Junjun, Ye Li, Liang Hao
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  Objective  To understand the spread trend of drug resistant tuberculosis (DR TB) over time in Liuzhou City, Guangxi Zhuang Autonomous Region, and provide evidences to contain the spread and transmission of DR-TB.  Methods  Data from the DR TB surveillance network in Liuzhou were analyzed. The percentage of DR-TB cases among the newly registered TB cases and the average annual percentage change (APC) were calculated. The regression model was constructed with linear and binomial regression. The hypothesis testing of the average APC was conducted by using line/curve fitting approach.  Results  A total of 571 DR-TB cases were detected through the DR surveillance network in Liuzhou from 2014 to 2019, accounting for 2.14% (571/26691) of new registered TB cases. The number of DR-TB cases increased from 50 in 2014 to 189 in 2019, an increase of 2.60 times. Of those with drug resistant TB, 30.30% (173/571) were isoniazid resistant, 19.26% (110/571) were rifampin resistant, 29.25% (167/571) were multi-drug resistant (MDR), and 7.01% (40/571) were extensive drug resistant (XDR). In MDR TB cases, XDR TB cases accounted for 23.95%. From 2014 to 2019, the proportion of XDR-TB cases among newly registered TB cases increased from 0.15% to 0.17%. After 2016, the result of APC testing indicated that the total number of DR TB, isoniazid resistant TB cases and rifampin resistant TB were significant increased among new tuberculosis cases (P=0.031, P=0.018, P=0.043). Although the increasing trends of MDR TB and XDR TB cases were observed among new tuberculosis cases, the differences were not significant (PMDR TB=0.098, PXDR TB=0.484).  Conclusion  The average APCs of DR TB, isoniazid resistant TB and rifampin resistant TB cases significantly increased in Liuzhou overtime, but the difference in case increase over time between MDR TB and XDR TB had no significance. It is necessary to conduct consecutive surveillance to facilitate the development of evidence based prevention and control measures for DR TB and improve the prevention and control of TB and the spread of DR TB.
Epidemiology and awareness of brucellosis in populations at high risk in Hulunbuir, Inner Mongolia Autonomous Region, 2010-2019
Liu Dongyan, Wang Yong, Zhang Wenyang
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  Objective  To analyze the surveillance results of brucellosis in high-risk population in Hulunbuir, Inner Mongolia Autonomous Region from 2010 to 2019 and provide evidence for adjusting the brucellosis prevention and control strategy.  Methods  The stratified sampling surveillance in populations with direct exposures to livestock and its products was conducted in counties of Hulunbuir. Blood samples were taken from the individuals in these counties for preliminary screening by using rose bengal plate agglutination test (RBPT) and for confirmation by using serum agglutination test (SAT).The survey of brucellosis related knowledge awareness was carried out in the above-mentioned populations. The questionnaire included three parts: basic knowledge about brucellosis, risk factors and brucellosis prevention knowledge. Descriptive statistics were used to analyze the infection, incidence and knowledge of brucellosis among high-risk populations. The rate and composition ratio were compared with χ2 test, and P<0.05 was considered to indicate significance.  Results  From 2010 to 2019, a total of 162 539 blood samples were tested in Hulunbuir, in which 8 556 were positive (5.26%). Over time, the positive rate of blood test showed a downward trend. The difference was significant (χ2=448.824, P<0.05). The positive rate of blood test was 6.19% in pastoral areas, 6.10% in semi-agricultural and semi-pastoral areas, 5.68% in forest areas and 1.95% in cities. The differences among different areas were significant (χ2=792.139, P<0.05). As for age distribution, the positive persons were mainly young adults between 30 and 59 years old. The infected persons were engaged in breading industry (82.36%), other occupations (including workers, students, unemployed and others) (15.94%), and meat food processing, production, sales and transportation (1.69%). From 2010 to 2019, a total of 170 327 people were surveyed in Hulunbuir, in which 1 525 brucellosis cases were detected. The incidence rate was 0.90%. The incidence showed a fluctuating decreasing trend among different years with statistical significance (χ2=1 089.662, P<0.05). The awareness rate of brucellosis during 2014-2019 was continuously investigated with a total of 47,187 people being covered and 46,614 valid questionnaires being collected. The total awareness rate was 90.48%, and the total awareness rate showed an upward trend. The differences among years were significant (χ2=632.442, P<0.05). The awareness rate was 92.95% in cities, 90.48% in forest areas, 89.96% in pastoral areas and 88.47% in semi-agricultural and semi-pastoral areas. The differences were significant (χ2=122.780, P<0.05).  Conclusion  The prevention and control strategy for human brucellosis in Hulunbuir has achieved certain progress, but the situation is still serious. Therefore, it is necessary to carry out continuous surveillance for human brucellosis and conduct health education in populations at high risk.
Hot issues after marketing of COVID-19 vaccine
Ye Pengling, Wang Ming
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The pandemic of COVID-19 continues to spread worldwide, suggesting that the epidemic would continue in natural state. Although some progress has been achieved in the treatment of COVID-19, it is far from containing the spread of the epidemic. Therefore, human beings have pinned their hopes of controlling the COVID-19 epidemic on the development of vaccines. Currently, several COVID-19 vaccine products have been applied to immunize the population after completion of phase Ⅲ clinical trials. The safety, immunogenicity, efficacy, immunization procedures and response to virus mutations of different COVID-19 vaccines are the great concern of the public. The public and experts in the field are confused about the efficacy of vaccines due to the different evaluation indicators used by research and development institutions in publishing vaccine development and application information and the interpretation by media from different perspectives and calibers. This paper summarizes the published research data and discusses the hot issues in development and post-marketing application of COVID-19 vaccine.
Mental health status of staff and influencing factors in disease prevention and control system in Shanghai in the context of routine COVID-19 prevention and control
Xie Yanxin, Qi Hui, Pan Jie, Lu XiangHua, Hao Lipeng, Zhu Weiping
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  Objective  To investigate the mental status of staff in Shanghai's disease control and prevention centers (CDCs) and analyze the relevant factors in the context of routine prevention and control of COVID-19.  Methods  Stratified cluster sampling was used, a questionnaire survey of 538 staff members in 4 CDCs in Shanghai was conducted.  Results  The medium scores of depression, anxiety, interpersonal loneliness were 10, 7 and 4, respectively. Statistical difference in depression score was found among the staff with different education backgrounds, marital status, occupations, underlying diseases, units, work shifts. Statistical differences in anxiety and feeling loneliness scores were found among the staff with different education backgrounds, occupations, underlying diseases, units, work shifts. Multi-factor analysis showed that units, underlying disease, work shift, education background and long working time in the past 2 weeks were the main influencing factors for depression; units, underlying diseases, work shifts and long working time in the last 2 weeks were the main influencing factors for anxiety; units, work shifts were the main influencing factors for feeling loneliness.  Conclusion  The scores and influencing factors of depression, anxiety and feeling loneliness in the staff in CDCs in Shanghai were different. It is suggested that targeted measures should be taken to improve mental health status of the staff based on the investigation results.
An investigation of a botulism poisoning event in Urumqi, Xinjiang
Gulina Tuerdi  , Gao Pengya, Sun Hui, Sun Xihe, Li Xinyue, Lu Xuancheng, Liu Yang, Xu Xuefang
, DOI: 10.3784/jbjc.202009170320
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  Objective   To investigate the pathogenic factors and causes of a botulism poisoning event and provide evidence for the prevention and control of the similar events in the future.   Methods   Field epidemiological survey was conducted through consulting medical records, interviewing relevant doctors and household survey, Laboratory test was done after collecting case stool samples and residual food samples for the detection of Clostridium botulinum.   Results   Two poisoning cases were confirmed and admitted to hospital. After botulinum antitoxin A and B treatment, the symptoms were significantly alleviated. C. botulinum was isolated, which was identified as type A C. botulinum after detection of type A toxin gene by real time quantitative PCR. Type A botulinum toxin was detected in mouse experiments.   Conclusion   This poisoning event was caused by homemade tempeh contaminated by C. botulinum type A. It is recommended to strengthen health education about the prevention of contamination in food production and storage. Medical institutions should prepare emergency medicines for food poisoning. Antitoxin serum should be used for the treatment of botulism poisoning.
The Advisory Committee on Immunization Practices’ Updated Interim Recommendation for Allocation of COVID-19 Vaccine — United States, December 2020
Gong Zhenyu, Gong Xunliang
, DOI: 10.3784/jbjc.202012270443
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2021年1月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Diseases in January 2021
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《疾病监测》杂志稿约
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cover
2021-03期封面
2021, 36(3): 0-0.
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contents
contents
2021, 36(3): 1-3.
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Epidemic Bulletin
2021年2月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Diseases in February 2021
2021, 36(3): 195-195. DOI: 10.3784/jbjc.202103230103
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2021年2月中国甲乙病类传染病疫情动态概要
2021, 36(3): 196-197. DOI: 10.3784/jbjc.202103230125
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Summary of global surveillance data of infectious diseases in February 2021
Han Hui, Wu Bo, Li Haishan, Jia Jiaojiao
2021, 36(3): 198-200. DOI: 10.3784/jbjc.202103220141
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In February 2021, a total of 61 infectious diseases were reported globally, affecting 225 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were Corona virus disease 2019 (COVID-19, 225), dengue fever (32), measles (16), poliomyelitis (14) and cholera (8). The top five infectious diseases with highest case fatality rates were Ebola virus disease (44.0%), Middle East respiratory syndrome (36.3%), Rift valley fever (34.3%), Lassa fever (22.8%) and plague (6.0%). The top five infectious diseases with greatest number of deaths were COVID-19, Lassa fever, plague, Ebola virus disease and cholera. The prevalent infectious diseases in Asia were COVID-19 and dengue fever, the prevalent infectious diseases in Africa were COVID-19, Ebola virus disease, plague, cholera, yellow fever, Lassa fever and poliomyelitis, the prevalent infectious diseases in America were COVID-19 and dengue fever, the prevalent infectious disease in Europe was COVID-19.
Risk Assessment
Risk assessment of public health emergencies concerned in the mainland of China, March 2021
Meng Ling, Tu Wenxiao, Feng Yenan, Wang Fuzhen, Li Chao, Yang Lei, Jin Miao, Zhou Jing, Xiang Nijuan, Shi Guoqing
2021, 36(3): 201-203. DOI: 10.3784/jbjc.202103230148
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  Objective   To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in March 2021.   Methods   An internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this video conference.   Results   Generally speaking, it is predicted that the incidence of public health emergencies would be higher in March than February. The risk of imported cases and secondary infections of COVID-19 would continue to exist, but would be controllable. Sporadic cases of human infection with avian influenza might still occur. Enteritis due to norovirus would continue to increase, and clusters and outbreaks might still occur in schools and childcare facilities. Mushroom poisoning would begin to increase in southern provinces.   Conclusion   Special attention should be paid to COVID-19, and general attention should be paid to human infection with avian influenza, enteritis due to norovirus and mushroom poisoning.
Risk assessment of global COVID-19 pandemic in February 2021
Zhao Qing, Wu Jiewen, Fang Yuansheng, Yang Xinping, Liang Zuoru, Ji Hanran, Zhang Rongna, Pang Mingfan, Qi Xiaopeng
2021, 36(3): 204-208. DOI: 10.3784/jbjc.202103200133
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  Objective  To assess the global epidemic of COVID-19 in February 2021 and the risk of importation.  Methods  According to the daily COVID-19 data publicly released by Johns Hopkins University, combined with the policy stringency index published by the University of Oxford, an epidemiological description method was used to provide a comprehensive and timely assessment of the global epidemic risk through a general overview, a comprehensive assessment of the epidemic trends in WHO regions and key countries, as well as a comprehensive analysis of the epidemic and prevention and control policies in 14 land-bordering countries. The assessment results for each country are expressed as “countries of global concern” “countries of general concern in each WHO sub-region” and “neighboring countries of special concern”.  Results  Compared with the previous month, the number of confirmed cases decreased by 43.8% and deaths witnessed a 25.9% decline globally in February 2021. The European had the largest number of confirmed cases and deaths, followed by the Americas (North) and Americas (South), both of which need to be focused on. The time taken for every 10 million new confirmed cases globally showed an overall increasing trend, and the time taken for every 500, 000 new deaths remained unchange. Among the 14 land-bordering countries, the country that needs special attention is Russia.  Conclusion  The global COVID-19 pandemic is still spreading. Although the global growth rate of confirmed cases is showing an overall downward trend, it is necessary to continuously monitor the countries with global concern, and improve the communication mechanism between epidemic prevention entities, take timely and effective prevention and control measures against the epidemic.
Commentary
Carrying out wild animal microbial research for the response of new infectious diseases in the future
Qin Tian, Ruan Xiangdong, Duan Zhaojun, Cao Jianping, Liang Junrong, Yang Jing, Jiang Yan, Shi Mang, Shen Yujuan, Xu Jianguo
2021, 36(3): 209-213. DOI: 10.3784/jbjc.202101260044
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China is one of the countries with the richest species of wild animals in the world. The widely distributed wild animals of numerous species are the natural hosts or susceptible hosts of many infectious diseases. It is estimated that there are more than one million unknown types of viruses in China. In Qinghai-Tibet Plateau alone 10 000–30 000 unknown bacteria might exist in wild animals. There are no less than 600 000 species of animal-derived parasites, and about 2 million species of fungi worldwide. With the rapid development of China’s economy and globalization, contacts between humans and wild animals have become more frequent, increasing the probability of wild animal-derived pathogens infecting humans. The incidence of animal borne infectious diseases will become a “new normal” in the future. Therefore, research should be carried out on wild animal microbes and the prevention and control of emerging infectious diseases. In addition, we should establish an analysis framework and an evaluation technology system for the risk assessment and early warning of potential animal-derived emerging infectious diseases. These measures will not only increase our understanding of the background information of wild animal microbe communities, but more importantly, also enable in-depth analysis, discovery, early warning, and prediction of major new animal-borne infectious diseases that might occur in the future, and even help reduce the interval between discovery and response, minimize the impact and loss on society and economy, intervene the emergence or epidemics of diseases as soon as possible, and comprehensively improve the response and control capabilities for emerging and sudden infectious diseases.
The Subject of Health Measurement and Standardization
导 读
2021, 36(3): 214-214.
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Thoughts on design, measurement and evaluation system in public health
Qi Xiao, Yao Hongyan, Liu Jianjun, Yu Shicheng, Wang Qiqi
2021, 36(3): 215-218. DOI: 10.3784/jbjc.202011090374
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Public health is an action taken by society to protect and promote people’s health. Public health practice requires not only the participation of preventive medicine, but the joint participation of multiple disciplines other than medicine. Any public health practice requires design, measurement and evaluation (DME). This process must incorporate multidisciplinary principles and methods. At the same time, in order to facilitate comparison and application, the entire DME process needs to be standardized (Standardization), generally referred to as DMES (design, measurement, evaluation and standardization in public health, DMES). This article summarizes and rethinks the needs, concepts, research fields and content framework of DMES in the field of public health, which will provide references for the working ideas and methods of public health practices.
Progress in research of population health measurement and evaluation
Wang Wei, Li Zheng, Liu Junting, Xia Lanfang, Zhang Runhua, Chen Chen, Wang Lijie, Liang Ruiying, Zheng Wenjing, Qi Xiao, Yao Hongyan
2021, 36(3): 219-224. DOI: 10.3784/jbjc.202010270368
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With the transformation of disease spectrums and medical patterns, the scopes, contents, methods and metrics of health measurement and evaluation have also undergone profound changes. This review summarized and introduced the progress of research in health measurement and evaluation, from the aspects of development of population health theories, health measurement and evaluation theories, health measurement and evaluation metrics, and the application of big data in health measurement and evaluation, therefore, it could be able to provide robust evidence in the aspects of amplifying, improving and comparing the health information and developing health policies.
Health status of residents in Liaoning province, 2018
Shang Degao, Qin Yi, Yan Jianing, Tong Shuang, Wang Qiqi, Yu Shicheng, Yu Lianzheng
2021, 36(3): 225-228. DOI: 10.3784/jbjc.202101120016
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  Objective  To analyze the health status of residents in Liaoning province by using major health indicators and based on “The report of public health and population health status in Liaoning province”, and provide evidence for the timely adjustment of disease prevention and control in Liaoning.  Methods  The data about the causes of death, the incidence of malignant tumors and the incidence of communicable diseases in 2018, and the prevalence of hypertension and diabetes in 2016 in residents in Liaoning were collected for the analysis and description of the health status of local residents.  Results  The crude death rates were 944.30/100 000 and 786.76/100 000 in the residents in urban area and rural area in Liaoning, respectively. The crude incidence rate of malignant tumors in the urban residents was 407.15/100 000. The prevalence rates of hypertension and diabetes were 26.97% and 11.25% in the residents over 18 years old. The prevalence rate of hypertension was lower in the urban residents than in the rural residents, and it was higher in men than women. The prevalence rate of diabetes was higher in the urban residents than in the rural residents, and it was lower in men than in women. The reported incidence rate of communicable diseases was 312.95/100 000.   Conclusion  The prevention and control of chronic diseases and communicable diseases in residents in Liaoning can reach the goals of the action plan of “Healthy Liaoning 2030”.
A study of calculation of healthy life expectancy for residents in Henan, 2018
Kang Kai, Wang Bingyuan, Yu Shicheng, Di Xiujuan, Yang Wenjie, Wang Qiqi, Xuan Shuili, Li Shaofang, Han Zhiwei, Ma Shiwen, Feng Shixian, Fan Lei, Fan Junxing, Guo Wanshen
2021, 36(3): 229-234. DOI: 10.3784/jbjc.202011230394
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  Objective  To calculate healthy life expectancy for residents in Henan province in 2018 and provide evidence for the evaluation of healthy status of the residents.  Methods  Using available data from the death information registration management system of Henan, the 6th national health service survey and the age-specific years lived with disability rate of Henan from Global Burden of Disease Study 2019, the healthy life expectancy (self-perceived healthy life expectancy and disability-free life expectancy) and health-adjusted life expectancy for residents in Henan in 2018 were calculated.  Results  In 2018, the healthy life expectancy based on self-perceived health status of 0-year old residents in Henan was 70.26 years, 68.80 years for men and 71.87 years for women. In the 0-year group, the disability-free life expectancy was 71.55 years, 69.94 years for men and 73.27 years for women. Healthy adjusted life expectancy was 68.47 years for the 0-year group, 67.32 years for men and 69.85 years for women. The ratio of healthy life expectancy to life expectancy decreased with age in both men and women (all P value <0.001). Although women had higher healthy life expectancy and health-adjusted life expectancy than men in most age groups, the ratios of healthy life expectancy to life expectancy and health-adjusted life expectancy to life expectancy of women were always lower than that of men.  Conclusion  The healthy life expectancy of women was higher than that of men, but the quality of life of women was lower than that of men. In addition, health support and nursing care services for the elderly should be strengthened to improve the quality of life pf this population.
Interpretation for the group standard of the Chinese Reference List of Core Health Indicators
Wang Qiqi, Yu Shicheng, Hu Yuehua, Yao Hongyan
2021, 36(3): 235-238. DOI: 10.3784/jbjc.202101050007
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List of health indicators is an important tool for the evaluation of population health status, health service system performance, and basic reference for health policy-making. With an outline for the “Healthy China 2030” initiative, the population health evaluation has received widespread attention of the government and society. The group standard entitled Chinese Reference List of Core Health Indicators (T/CHAA 006-2019) written by experienced researchers from the Chinese Center for Disease Control and Prevention, universities, and institutes was issued, providing a framework and guideline for organizations in China to assess local population health. The aim of the group standard is to achieve the standardization of measurement indicators and improve the comparability of health status information across years and regions. This paper illustrates the background, current situation, compilation principle, main content, and application value, to provide a reference for the application and promotion of this group standard.
Standard Guide and Consensus
Chinese Reference List of Core Health Indicators(T/CHAA 006-2019)
2021, 36(3): 239-260. DOI: 10.3784/jbjc.202011300402
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Quality Evaluation of New Rural Cooperative Medical System
Building the standard operating procedure for improving health insurance data quality: Quality evaluation and improvement on the reimbursement records data of new rural cooperative medical system of a county in Henan province, 2013–2015
Liu Liqun, Liu Xiaoyan, Liu Yang, Wan Xia, Yang Gonghuan
2021, 36(3): 261-269. DOI: 10.3784/jbjc.202006120213
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  Objective   To assess and improve the quality of data of the new rural cooperative medical system (NRCMS) in a county in Henan province from 2013 to 2015, and provide evidence to build a standard operating procedure for improving medical insurance data quality and to improve data collection and collation in the future.   Methods   The research team checked the completeness and internal consistency of the raw data set, including missing, abnormal and extreme value checks, source comparison of same information, logical consistency check and so on, and made possible modifications on the data set in these respects. At the same time, the research team carried out structure rearrangement on the data set, especially coding on diagnoses, and formed a data dictionary. After that, the research team checked the external consistency of the improved data set by carrying out descriptive statistics and comparison on key variables such as diseases and costs.   Results   In the data set, 27.11% of the diagnosis records were "none", missing or unreadable codes. Other records showed the diagnoses of diseases in an unstructured text form. After manual rearrangement and coding, the research team formed a "diagnoses - standardized diagnoses - ICD-10 codes" dictionary. After transforming texts to ICD-10 codes, up to 96.00% of the records showed clear diagnoses of diseases. The logic consistence between diagnosis and gender or age reached 98.67%. All the records had cost and date information. Results of comparison showed that the cost information in this data set could be considered accurate. A few people had two or more hospital visits with time periods overlap, however, the percentage was very small (0.59%). Only 1 348 records (0.27%) had no demographic information or had abnormal or extreme demographic information, but sometimes, the gender or age information were not consistent with those extracted from the identification card numbers. From the above, the research team considered the data quality of the studied NRCMS data set was relatively high.   Conclusion   Medical insurance data is an important material for understanding population based disease prevalence and diseases related payments. It is necessary to carry out data quality evaluation and quality improvement following a standard operating procedure. A data dictionary could help improve the data filling, so that the diagnosis information filled could be normalized according to the international disease coding rules, which would facilitate the medical insurance data to play a more important role in population health estimation and help make the reasonable payment judgment of medical insurance expenses.
Infectious Disease Surveillance
Molecular subtyping of Listeria monocytogenes isolated from patients in Xicheng district, Beijing, 2015–2019
Huo Zhe, Zhang Xiaoai, Xu Jun, Cao Wei
2021, 36(3): 270-275. DOI: 10.3784/jbjc.202010170357
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  Objective  To study the serotype and molecular characteristics of Listeria monocytogenes isolated from patients in Xicheng district of Beijing from 2015 to 2019.  Methods  A total of 40 L. monocytogenes strains isolated from the patients from 2015 to 2019 were characterized by serotyping with multiplex PCR, pulsed field gel electrophoresis (PFGE) and multilocus sequence tying (MLST) analysis.  Results  In the 40 L. monocytogenes infection cases in this study, 14 were pregnancy related infection cases. 7 were neonatal infection cases, all were cured. In non-pregnancy related infection cases, 3 were fetal. In the 40 L. monocytogenes isolates, 3 serogroups were detected, in which 1/2a, 3a was predominant. The 40 strains were divided into 26 different PFGE types, GX6A16.BJ0003 was predominant (9 strains, 22.5%), and GX6A16.BJ0003 was detected in each year from 2015 to 2019, causing 2 deaths. The 2 cases associated with GX6A16.BJ0014 were all pregnancy related infections. The 40 strains were divided into 13 ST types based on MLST typing, the most common ST was ST8, ST87 and ST5.  Construction  The predominant serogroup of L. monocytogenes isolated from patients in Xicheng district was 1/2a, 3a from 2015 to 2019. GX6A16.BJ0003 and ST8 were the predominant PFGE type and sequence type, respectively. There was persistence of spread of L. monocytogenes of same clone in Xicheng district. It is necessary to pay close attention the surveillance for high-risk pulse types.
Studying of Rickettsiae carried by Ixodes persulcatus in Yakeshi city, Inner Mongolia
Lu Miao, Qin Xincheng
2021, 36(3): 276-279. DOI: 10.3784/jbjc.202010230364
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Abstract:
  Objective  To investigate the infection status of spotted fever group Rickettsiae and Anaplasma in ticks in the Greater Khingan Mountains area, Inner Mongolia.  Methods  Target genes of ticks collected in July, 2010 were amplified by using PCR and the positive DNA were send to sequence. The nucleotide sequences similarity was calculated with software MegAlign. Phylogenetic analysis was performed by using software phyML3.1.  Results  We collected 293 ticks in Alongshan mountain area, which belonged to Ixodes persulcatus indicated by morphological identification. The infection rates of spotted fever group Rickettsiae and Anaplasma in the ticks were separately 9.56% and 0. Nucleotide sequence analysis confirmed that the spotted fever group Rickettsiae carried by the ticks was Candidatus Rickettsia tarasevichiae, the homology between the sequences obtained from this study and known reference sequences from GenBank was 100.00% for rrs gene, and 99.80% for gltA gene.The amino acid homology was 100.00%. Phylogenetic analysis indicated that the Candidatus Rickettsia tarasevichiae detected in this study in Ixodes persulcatus in Yakeshthis belonged to the same genotype of the strains detected in Russia.   Conclusion  The pathogen Candidatus Rickettsia tarasevichiae was carried by Ixodes persulcatus in the Greater Khingan Mountains area, Inner Mongolia.
Comparative analysis of influenza A (H7N9) virus genomes in human infection cases in Gansu
Li Baodi, Li Hongyu, Zhang Hui, Xu Congshan, Wang Xueying, Zhao Zhe, Xiang Guofeng, Yu Aihong, Yu Deshan
2021, 36(3): 280-286. DOI: 10.3784/jbjc.202101080009
[Abstract](58) [FullText HTML](22) [PDF 5710KB](13) Peer reviewing opinions Related References Share
Abstract:
  Objective  To analyze the sequence of avian influenza A (H7N9) virus detected in human infection cases in Gansu, compare the genetic variation and molecular evolution characteristics of highly and low pathogenic H7N9 viruses, and provide scientific reference for the prevention and control of human infection with avian influenza virus.  Methods  The genomes of H7N9 virus found in Gansu since 2017 were compared, and the whole genome characteristics were analyzed by MEGA 7.0 and other software.  Results  The 6 cases of human infection with H7N9 virus had history of live poultry or environmental exposures, and 3 virus strains were isolated, i.e. GS/19545, GS/27151 and GS/23275. The HA and NA genes of GS/19545, GS/27151 and GS/23275 were all from the Yangtze River Delta Branch of Eurasia. The NP gene of GS/23275 was in the same evolutionary branch with the highly pathogenic H7N9 virus from Guangdong in 2017, forming another distinct branch differed with the low pathogenic strains of GS/19545 and GS/27151. The results showed that the PB2 gene of GS/23275 was closely related to the H9N2 virus isolated from poultry in Anhui in 2015. G186V and S138A mutations occurred in HA receptor binding sites of three H7N9 strains, 68–72 amino acid deletion occurred in NA protein stems, and the same amino acid mutation occurred in PA, PB1, PB2, M1, M2, NS1, NS2 proteins.  Conclusion  Some important molecular mutations occurred in the genome of H7N9 virus detected in human infection cases in Gansu, which might lead to increased virulence of avian influenza virus and potential interpersonal transmission. Strengthening the research and analysis on the genetic characteristics of avian influenza virus might facilitate the surveillance for the mutation of the virus at molecular level and carry out effective prevention and control of the epidemic.
Technology and Method
Study of screening of the minimum dataset for tuberculosis surveillance
Jin Zhiming, Guo Qing, Huang Fei, Ma Jiaqi
2021, 36(3): 287-291. DOI: 10.3784/jbjc.202101010421
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Abstract:
  Objective  Based on the status of Tuberculosis (TB) surveillance, the minimum dataset of TB surveillance was studied.  Methods  The contents of the minimum dataset for TB surveillance were determined by Delphi method.  Results  The dataset consisted of 70 data elements, including individual basic personal information, case report information, inspection and testing information, epidemiological investigation information, treatment and medication information and follow-up management information.  Conclusion  The minimum data set for TB surveillance is scientific and reasonable, which can be used to provide reference basis for standardizing TB surveillance data collection.
Review
Progress in application of metagenomics in studying common oral cavity chronic infectious diseases
Zhao Lilan, Wan Kanglin, Liu Zhiwen
2021, 36(3): 292-296. DOI: 10.3784/jbjc.202011170388
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Abstract:
The common chronic infectious diseases in oral cavity mainly include caries, pulp disease, periapical disease, periodontal disease, wisdom tooth pericoronitis and jaw osteomyelitis, etc. They are usually related to pathogenic bacteria, and the research on the etiology of these disease also focuses on the discovery of disease-related pathogenic bacteria. Due to the limitation of traditional culture technique, researchers had no comprehensive understanding of microorganisms, and believed that oral chronic infectious diseases were caused by a specific pathogenic microorganism. With the emergence and development of metagenomics and its sequencing technique, a large number of oral microorganisms has been discovered, which has broken the limitation of human knowledge and resulted in subsequent founding of oral microbial flora composition and change under different environment, healthy and pathogenic microorganism species, or special species in the disease development process and provided powerful evidence for the prevention and treatment of chronic oral cavity infectious diseases. In this article, we summarize the metagenomics technique and the progress in application of this technique in studying several common chronic oral cavity infectious diseases.

CN 11-2928/R

ISSN 1003-9961

Established in:1986 , Monthly

Responsible Institution:National Health Commission of the People's Republic of China

Sponsor: Editorial Board of Disease Surveillance,National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention

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