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Prevalence and distribution of echinococcosis in Tacheng, Xinjiang, 2005−2020
Yang Hanqi, Zhang Haiting, Maitijiang wumaier, Wang Shuo, Shi Guangzhong, He Haibo, Cheng Xia, Zhao Jiangshan
, DOI: 10.3784/jbjc.202112280663
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  Objective  To understand the prevalence and distribution of echinococcosis in Tacheng, Xinjiang Uygur autonomous region, from 2005 to 2020, and provide evidence for the local prevention and treatment of echinococcosis.   Methods  The data of echinococcosis cases reported in Tacheng from 2005 to 2020 were collected from national infectious disease reporting information management system. Excel 2007 and SPSS 17.0 were used to analyze the distribution of echinococcosis cases by area, age, gender and population.   Results  A total of 2 356 cases of echinococcosis were reported in Tacheng from 2005 to 2020. The average annual incidence was 14.39/100 000, and the highest incidence was 29.27/100 000 in 2017. There was a statistical difference in the quarter distribution of the cases (χ2=172.75, P<0.05), the number of reported cases in the first and fourth quarters was significantly higher than that in the second and third quarters; The gender ratio was about 1.09∶1, and there was no significant difference in gender distribution of the cases ( χ2=11.88, P>0.05). The age of the cases ranged from 2 to 90 years with an average age of 38 years. The cases in farmers and herdsmen (1416 cases) accounted for the highest proportion (60.10%). The cases were reported in Tacheng, Emin, Yumin, Toli, Wusu, Shawan, and Buxel. The annual average incidence in Toli was highest (45.80/100 000), where 436 cases were reported cumulatively, accounting for 18.51% of the total, the differences in incidence among different areas were significant (χ2=311.98, P<0.05). Among the reported cases, 2 163 (91.81%) were reported by hospitals.   Conclusion  The overall incidence of echinococcosis in Tacheng showed an increase trend from 2005 to 2020 although decline occurred after 2017. The echinococcosis cases were mainly distributed in young adults and adults engaged in agriculture and aquaculture in pastoral areas and semi-agricultural and semi-pastoral areas. In e prevention and control of echinococcosis, it is necessary to strengthen the health education about echinococcosis in key populations and adhere to the mode of integration of prevention and treatment for the early detection, diagnosis and treatment of echinococcosis.
Reporting quality of notifiable infectious diseases in medical institutions in Jiangxi, 2017−2021, an evaluation based on TOPSIS method
Hu Lingling, Fang Ji, Xiong Xiaoqing, Wang Xiaowen
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  Objective   To comprehensively evaluate the reporting quality of notifiable infectious diseases in Jiangxi province from 2017 to 2021, and explore evidence for the improvement of the reporting quality of infectious diseases.   Methods   Stratified cluster multistage sampling was used to collect the data of notifiable infectious disease reporting in medical and health institutions in Jiangxi from 2017 to 2021. Software SPSS 22.0 was used for data statistical analysis, TOPSIS method was used to comprehensively evaluate the reporting quality of notifiable infectious diseases.   Results   From 2017 to 2021, the reporting rate of notifiable infectious diseases in Jiangxi was 98.28%. The levels of medical institutions were divided into grade III, grade II, grade I and non-graded from high to low. The reporting quality of notifiable infectious diseases in medical institutions decreased with the grade decrease. The top three prefectures with high quality of infectious disease reporting in Jiangxi from 2017 to 2021 were Yingtan, Jingdezhen and Pingxiang. The quality of notifiable infectious disease reporting of medical institutions with hospital information system (HIS) was higher than that of medical institutions without HIS., and the quality of notifiable infectious disease reporting of medical institutions with infectious disease reporting management system was higher than that of those without such system.   Conclusion   The overall quality of notifiable infectious disease reporting of medical institutions in Jiangxi from 2017 to 2021 was high, but there were still problems such as underreporting, untimely reporting, incomplete and inaccurate reporting. The establishment of HIS system and the improvement of infectious disease reporting management of medical institutions can effectively improve the quality of infectious disease reporting.
Comparison of different methods for extracting Brucella DNA from anticoagulant cultured in blood culture bottle
Yang Xiaowen, Liu Jiayin, Zhang Yu, Fan Yu, Tian Guozhong, Zhao Hongyan, Piao Dongri, Jiang Hai
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  Objective   To compare the effects of different extraction methods of Brucella DNA in anticoagulant cultured in blood culture.   Methods   In this study, the quantitatively detected inactivated Brucella spp./genomic DNA gradient was added to the blood culture bottle containing anticoagulant. Then different methods were used to extract Brucella DNA. Finally, the real time PCR was used to detect the content.   Results   The results showed that the magnetic nanoparticles and lysis method could detect the inactivated bacterial solution added with 102 CFU/mL and 10−3 ng/μL genomic DNA. The centrifugal column method could not detect the inactivated bacterial solution added with 106 CFU/mL and 10 ng/μL genomic DNA without treatment of erythrocyte lysate. Only 104 CFU/mL inactivated bacterial solution and 1 ng/μL genomic DNA were detected after treatment with erythrocyte lysate.   Conclusion   The treatment of samples with erythrocyte lysate could increase the extraction amount of DNA. Among these methods, the extraction effect of lysis method was best, followed by magnetic nanoparticles method and centrifugal column method. This study provided a method as reference for the Brucella DNA extraction of blood cultures of suspected brucellosis samples, and also provided a new insight for improving the diagnosis rate of brucellosis.
Prevalence of myopia in primary and secondary school students in Baotou, Inner Mongolia, 2020
Jin Yanhui, Liu Xiaoling, Wang Yan, Feng Xiaodong
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  Objective  To understand the prevalence of myopia and its influencing factors in primary and secondary school students in Baotou and provide evidence for the development of myopia prevention and control strategies and targeted intervention measures.   Methods  A stratified cluster sampling method was used to select 8591 primary and secondary school students in Baotou to conduct the survey. The current myopia prevalence in Baotou students was analyzed by using descriptive epidemiological methods, and the risk factors and protective factors were identified using multivariate Logistic regression analysis.   Results  The overall prevalence rate of myopia in students in Baotou was 73.1%, and the prevalence rate was 57.6% in primary school students, 77.1% in junior high school students and 87.2% in senior high school students. The univariate and multivariate Logistic regression analyses showed that being girl, higher grade and out-of-school eye use (reading and writing for more than 2 hours a day averagely in a week, attending tutoring classes, attending tutoring classes for more than 2 hours in a week); short distance eye use (watching electronic screens for more than 2 hours, often or always watching electronic screens without turning on light in the evening, often lying on back or stomach to read book or watch computer screen, and reading books or watching electronic screens while walking or riding frequently, using eyes at short distance for more than 50 minutes); incorrect reading and writing posture, no correct reading and writing posture advice from teachers; less time spent outdoors during daytime and poor sleep were risk factors for myopia. Living in suburban area, adjusting the height of desks and chairs once a school year, doing eye exercises at school more than twice a day and outdoor break were protective factors for myopia.  Conclusion  It is necessary to make joint efforts by local government, families, schools and medical institutions to reduce the prevalence of myopia in students.
Epidemiological characteristics of pulmonary tuberculosis in elderly population in Inner Mongolia , 2016−2020
Lang Shengli, Xu Lijuan, Lu Aitao, Wang Cuixiu, Shi Ruiqing
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  Objective  To understand the epidemiological characteristics of pulmonary tuberculosis (TB) in the elderly population registered in Inner Mongolia autonomous region from 2016 to 2020 and provide evidence for the prevention and control of pulmonary TB in the elderly population in Inner Mongolia.  Methods  The information of pulmonary TB patients in the elderly population registered in Inner Mongolia from 2016 to 2020, including gender, age, occupation, source of patients, initial treatment and retreatment , were collected from “The Infectious Disease Surveillance System”, and the prevalence of pulmonary TB in the elderly was analyzed with software SPSS.  Results  From 2016 to 2020, a total of 15000 elderly patients with pulmonary TB were registered in Inner Mongolia, the average annual registration rate was 111.2/100000 (15000/13491000), which was significantly higher than the rate of 33.0/100000 (36934/11.782 million) in people under the age of 65 years (χ2=17740.4, P<0.001). Among the elderly patients with pulmonary TB, there were 9038 men and 5962 women. The ratio of male to female was 1.5∶1, which was lower than the ratio of 2.2∶1 in the population under 65 years old. The pulmonary TB patients in the elderly were mainly distributed in farmers, accounting for 67.8%, followed by house workers, the unemployed or jobless, accounting for 13.9%. The pulmonary TB cases in the elderly were mainly detected in medical care seeking due to symptoms, accounting for 34.0%, followed by followed up (31.1%). For initial treatment and retreatment, the initial treatment accounted for 89.2% and the retreatment accounted for 10.8%.  Conclusion  From 2018 to 2020, the registration rate of pulmonary TB cases in the elderly population in Inner Mongolia showed a downward trend, and the annual registration of elderly patients with pulmonary TB was higher than that in whole population. It is necessary to take targeted t measures in prevention and control of pulmonary TB in elderly population.
Early Evidence of the SARS-CoV-2 B.1.1.529(Omicron) Variant in Community Wastewater —United States, November-December 2021
Gong Zhenyu, Gong Xunliang
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Epidemiological characteristics of human brucellosis in Tongzhou district of Beijing from 2018−2020
Cui Yan, Li Hongjun, Zheng Ranran, Xi Lu, Yang Lili, Qiao Zhengyang, Yang Yanna
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  Objective   To analyze the epidemiological characteristics of human brucellosis in Tongzhou district of Beijing from 2018 to 2020, and explore the sources of human brucellosis infection, so as to provide data support for the prevention and treatment of human brucellosis in Tongzhou district.   Methods   Statistical analysis was conducted on epidemiological characteristics, sources of infection, protection, time interval from onset to diagnosis, etiological detection and clinical manifestations of reported brucellosis cases in Tongzhou district from 2018 to 2020. χ2 test were used to compare the incidence rate among different years and different genders, and P<0.05 was considered statistically significant.   Results   From 2018 to 2020, a total of 53 confirmed cases of brucellosis were reported in Tongzhou district, and the overall incidence declined by year. The incidence was high in spring and summer, with a peak from March to September. The incidence area was dominated by rural areas and urban-rural continuum. The incidence rate of male patients was 1.82/100 000, and that of female patients was 0.39/100 000, with statistical significance (χ2=21.67, P<0.001). The higher incidence occured in 40−69 years (79.19%), and the occupation distribution was mainly farmers. The main source of infection was contact with sheep, cattle and their products, and only 15.79% of the cases took effective protection in the process of feeding. 56.60% of the cases could be diagnosed within one month.   Conclusion   From 2018 to 2020, the overall incidence of human brucellosis in Tongzhou district showed a downward trend. The obvious seasonal and regional differences were observed. The morbidity were mainly males, farmers, and the highest age was 40−69 years old. The prevention and control measures should be taken according to the epidemiological characteristics.
Trend of diabetes mellitus related mortality in residents in Hangzhou, 2006−2020
Zhang Yan, Xu Jue, Fu Wen, Liu Bing
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  Objective   To analyze the mortality rate of diabetes melitus (DM) related death and its trend in residents in Hangzhou from 2006 to 2020, and to provide scientific basis for DM prevention and control.   Methods  Through the medical certificate of death in hospitals at county level and above and community health service centers,the monitoring data of the death mentioning DM in Hangzhou from 2006 to 2020 were collected. The crude motality rates, standardized mortality rates were calculated. The proportion from DM specified complications were analyzed. The annual percentage change (APC) was used to examine the changing trend of the mortality.   Results  The crude mortality rate and the standardized mortality rate of DM related death were 28.48/100 000 and 18.04/100 000 respectively in residents in Hangzhou from 2006 to 2020. The crude and standardized mortality rate from 2006 to 2020 showed increasing trends and the APC were 10.30% and 5.97% (P<0.001). The crude mortality rate was 27.71/100 000 in males,which was lower than 29.25/100 000 in females (χ2=21.608, P<0.001). The standardized mortality rate showed increasing trends in both males and females, the APC were 7.14% and 5.23%, respectively. The crude mortality rate of DM related death in Hangzhou increased gradually with age (χ2=60 754.086, P<0.001). The crude mortality rate in 45–54 years, 55–64 years and over 65 years groups showed upward trends (P<0.05). The standardized mortality rates were 20.66/10 000 in urban areas and 12.79/100 000 in rural areas (χ2=24 662.594, P<0.001), showing increasing trends, the APC were 6.08% and 6.61%, respectively. The proportions of specified complications including ketoacidosis, coma, renal complications, retinopathy, peripheral circulatory and multiple complications increased dramatically which collectively accounted for over 84.92% in the underlying death cause of DM.   Conclusion  The mortality of DM related death and proportions of DM complications in residents in Hangzhou increased from 2006 to 2020. More efforts are needed to reduce DM related death in rural residents, males and elderly population.
Study of norovirus infection and influencing factors in food practitioners in schools in Guangdong
Chen Xuguang, Chen Fengping, Yang Fen, Wang Hui, Jiao Liang, Wang Man, Chen Maoyu, Fang Ling, Li Jiansen, Li Hui, Zhang Meng
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  Objectives  To investigate the infection status of norovirus in food practitioners in schools in Guangdong province, and provide evidence for the prevention and control of norovirus infection outbreaks in schools.   Methods  A cross-sectional survey with convenient sampling method was conducted to collect the anal swabs of food practitioners in 9 schools within 1 week before the school open and 5-6 weeks after school open in spring and within 1 week before school open and 5-6 weeks after the school open in autumn in Guangzhou, Zhuhai, Zhongshan and Jiangmen, The norovirus nucleic acid was detected by real-time PCR, and the influencing factors of norovirus infection in food practitioners were identified by logistic regression analysis.   Results  A total of 1747 samples were collected. The positive rate of norovirus was 1.43% (n=25), and the attack rate of acute gastroenteritis was 1.26% (n=24). There was no differences in norovirus infection rate in food practitioners in different areas, in different types of schools, before and after school open, and with different types of work (P>0.05). Most infected persons (84.00%) were asymptomatic. The risk factors of norovirus infection were attending village banquet(OR=8.36, 95% : 2.27, 30.89)and norovirus infection in family(OR=10.94, 95% CI: 2.92, 40.96). The main risk factor of acute gastroenteritis was eating in restaurant (OR=4.88, 95%CI: 1.77, 13.51).   Conclusion  The incidence of norovirus infection in food practitioners of schools is generally low, and most infections are asymptomatic, but food and water might be contaminated in food processing, resulting norovirus infection epidemics in schools. It is necessary to strengthen the norovirus infection surveillance, health management and health education in food practitioners in schools.
Prevalence of type 2 diabetes and influencing factors in the elderly population aged ≥60 years in western Hainan
Lyu Jinfang, Li Wenxia, Li Meilan, Wang Yongyan, Guo Guilian
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  Objective   To investigate the prevalence and influencing factors of type 2 diabetes in the elderly population aged ≥60 years in the west of Hainan province and provide evidence for prevention and treatment of type 2 diabetes in the elderly.   Methods   Using the multi-stage cluster random sampling method, the elderly population aged ≥60 years in four counties in western Hainan were selected for the investigation. The information about their general characteristics and lifestyle were collected, and physical examination and laboratory testing were carried out for them. Univariate and multivariate Logistic regression analysis were used to analyze the related influencing factor of elderly type 2 diabetes in the elderly.   Results   A total of 12 582 subjects were included, and the prevalence rate of type 2 diabetes was 30.52% (3840/12582), with the highest prevalence rate of 32.24% (1 330/4 125) in those aged 70−79 years. The prevalence of type 2 diabetes in women (32.94%) was significantly higher than that in men (27.73%) (χ2=40.037, P<0.001). Multivariate Logistic regression analysis showed that overweight or obesity, family history of diabetes, hypertension, long term anxiety or tension, hyperuricemia and dyslipidemia were associated with a higher prevalence of type 2 diabetes in the elderly (P<0.05).   Conclusion   The prevalence of type 2 diabetes in the elderly in western Hainan is relatively high, and the controlling body mass index, blood pressure, uric acid and blood lipids is of great significance to the prevention and control of type 2 diabetes in the elderly.
Molecular characteristics of clinical isolates of Vibrio parahaemolyticus serogroup O4 in Hangzhou, Zhejiang, 2013−2018
Yu Hua, Zheng Wei, Chen Qi, Liu Xiaodong, Zheng Zhibei, Cao Feifei, Wang Haoqiu
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  Objective  To analyze molecular characteristics of Vibrio parahaemolyticus serogroup O4 in diarrhea patients in Hangzhou, Zhejiang province.   Methods  A total of 1 061 V. parahaemolyticus strains isolated from samples of diarrhea cases in Hangzhou from 2013 to 2018 were serotyped by serum agglutination, and 147 isolates of V. parahaemolyticus serogroup O4 were used to detect the virulence genes of thermostable direct hemolysin (tdh), thermostable hemolysin (trh), thermolabile hemolysin (tlh), toxRS/new genes by qPCR, and pulse-field gel electrophoresis (PFGE) was used.   Results  The serogroup O4 included O4: KUT (87.07%, 128/147), O4:K8 (10.20%, 15/147) and O4:K9 (2.72%, 4/147). The qPCR results showed that the virulence genes carried by the strains were all tdh+trh-tlh-toxR/new-. The PFGE patterns had two main clusters, PA (mainly isolates after 2016) and PB (isolates from 2013 to 2018), which contained 15 and 16 patterns respectively. All the O4:K8 strains belonged to PA cluster, and O4:K9 strains belonged to PB cluster.   Conclusion  There were two different O4: KUT clones in local food-borne isolates in Hangzhou in recent years. The O4: KUT strains of pattern PB have been detected since 2013. The O4: KUT strains of pattern PA, which were detected in 2016, have caused food-borne outbreaks since then and have the potential to become a local epidemic clone.
Analysis on life expectancy and cause-eliminated life expectancy in Pudong new district of Shanghai, 2005−2020
Zhou Yi, Hu Caixia, Chen Yichen, Chen Hanyi, Li Xiaopan, Sun Lianghong, Chen Hua, Qu Xiaobin, Wang Sen, Xiao Shaotan
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  Objective  To understand the life expectancy and cause-eliminated life expectancy of residents in Pudong new district of Shanghai during 2005−2020 and provide reference to the adjustment of health resource distribution.   Methods  Abridged life table and cause eliminated life table were used to calculate the life expectancy and cause-eliminated life expectancy of residents in Pudong, and temporal trend of life expectancy were evaluated by using software Join-point.   Results  The life expectancy of residents in Pudong was 84.76 years in 2020, and the life expectancy was 82.58 years in men and 87.01 years in women. The growth of life expectancy of residents in Pudong remained from 2005 to 2020, with an average annual increase of 0.25 years. In the past 16 years, the life expectancy loss caused by respiratory diseases and injury showed a downward trend, and the life expectancy loss decreased from 1.50 years and 1.01 years to 0.79 years and 0.70 years, respectively. The life expectancy loss caused by tumor kept stable. The life expectancy loss caused by circulatory diseases and endocrine nutritional and metabolic diseases showed an upward trend, and the life expectancy loss increased from 4.92 years and 0.38 years to 9.73 years and 0.68 years, respectively1. The rank of cause-eliminated life expectancy remained stable from 2005 to 2020, and the top 6 disease were circulatory diseases, tumor, respiratory diseases, injury/poisoning, endocrine nutritional and metabolic diseases and digestive system diseases.   Conclusion  The life expectancy in residents in Pudong increased steadily, which has reached leading levels of developed countries. Chronic and non-communicable disease was the main cause for the loss of life expectancy. There was an accelerating trend of loss of life expectancy caused by circulatory diseases and endocrine nutritional and metabolic diseases, and the loss of life expectancy caused by tumor remained at a high level. More effort should be made in the future prevention against these diseases.
Impact of non-pharmaceutical interventions on incidence of notifiable infectious disease in Jingzhou, Hubei
Liu Tian, Wu Yang, Chen Qi, Huang Jigui, Luo Man
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  Objective  To evaluate the impact of non-pharmaceutical interventions (NPIs) on the incidence of notifiable infectious disease in Jingzhou of Hubei province.   Methods  The weekly incidence of notifiable infectious disease in Jingzhou from December 29, 2014 (1st week in 2015) to January 3, 2021 (53rd week in 2020) was collected. The 1st week of 2015 to the 5th week of 2020 was used to fit a Bayesian structural time series (BSTS) model and predict the incidence of notifiable infectious disease from 6th to 53rd weeks in 2020. The incidence of notifiable infectious disease from 6th week to 53rd week in 2020 was compared with those during the same periods of 2015−2019 and the predicted value of the BSTS model in 2020, and the relative reduction (RR) was used to evaluate the impact of NPIs on the incidence of notifiable infectious disease. Disease types, gender, age groups, disease classification (class A, B and C; respiratory infectious diseases, intestinal infectious diseases, blood-borne and sexually transmitted infections, natural focal diseases), and periods (6th−18th week, 19th−24th week, 25th−53rd week) were used for subgroup analysis.   Results  A total of 18, 952 cases of 20 types of notifiable infectious diseases were reported in Jingzhou from 6th week to 53rd week in 2020, a decrease of 45.26% compared with the same periods during 2015− 2019. Based on the BSTS model, a decrease of 60.42% was than expected during 6th week−53rd week of 2020 (95% CI: 50.98%~69.66%). The notifiable infectious diseases in class A and B and in class C decreased by 36.63% (95% CI: 30.60%~43.19%) and 60.72% (95% CI: 33.97%~85.32%), respectively. The incidence of notifiable infectious disease during 6th week−18th week, 19th week−24th week, and 25th week−53rd week in 2020 decreased by 70.29% (95% CI: 56.88%~83.29%), 61.71% (95% CI: 45.34%~79.13%), 55.68 % (95% CI: 45.6%~67.29%) respectively. In terms of transmission routes, the incidence of respiratory infectious disease had the greatest decrease (RR=61.53%, 95% CI: 22.60%~100.87%), followed by intestinal infectious disease (RR=19.72%, 95% CI: 2.98%~35.29%). In terms of age, the largest decrease was found for people aged 15-64 years (RR=72.74%, 95% CI: 65.68%~80.1%), followed by children aged 0–14 years (RR=54.51%, 95% CI: 19.78%~87.15%). There was a positive correlation between the incidence of COVID-19 and the incidence decrease in different areas in 2020 (\begin{document}$ {r_s} $\end{document}=0.714, P=0.058). The top 5 diseases with the largest incidence decrease were rubella (999.77%, 95% CI: −2326.82%~4510.97%), influenza (68.93%, 95% CI: 91.76~117.10%), scarlet fever (88.59%, 95 % CI: 64.78%~112.12%), hand foot and mouth disease (86.09%, 95% CI: 77.46%~94.55%) and acute hemorrhagic conjunctivitis (78.54%, 95% CI: 28.11%~127.26%).   Conclusion  The NPIs against COVID-19 could significantly reduce the incidence of notifiable infectious disease in Jingzhou, and its effect had heterogeneity in terms of population, disease, time and space.
Characteristics of HIV infection diagnosis and treatment care continuum in Wenzhou, Zhejiang, 2019
Zhang Hemei, Gao Sihai, Li Jun, Su Dehua, Zhao Lina, Chen Xiangyan, Hu Wenxue, Lai Jiangyi, Chen Wanjun
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  Objective  To analyze the detection rate, previous CD4 detection rate, retention rate, registered antiviral therapy (ART) rate, ART maintenance rate, viral load suppression rate and related factors in HIV infection diagnosis and treatment care continuum in Wenzhou of Zhejiang province in 2019, and provide a insights into precise control of AIDS.   Methods  The case information of people living with human immunodeficiency virus/acquired immunodeficiency syndrome (PLWHA) in Wenzhou were collected, and the multivariate Logistic regression model was used to analyze the related factors.   Results  By the end of 2019, a total of 5 750 PLWHA (5082-6469) had been estimated to live in Wenzhou, and the detection rate was 76.2% (67.7-86.2%). Compared with the previous chain in the HIV infection diagnosis and treatment, the previous CD4 detection rate, retention rate and registered ART rate were 99.1%, 97.2%, and 98.9%, respectively. The ART maintenance rate was 91.5%, and the viral load suppression rate was 95.9%. Multivariate Logistic regression analysis showed that PLWHA in correctional places were more likely to loss retention in each chain, and the ORs were 0.23 (95% CI: 0.08-0.64), 0.32 (95% CI: 0.17-0.62), 0.33 (95% CI: 0.18-0.60), 0.33 (95% CI: 0.20-0.54) and 0.49 (95% CI: 0.31-0.78), respectively. Marriage/cohabitating was a protective factor for the retention in each chain, and the ORs were 4.45 (95% CI: 1.65-2.04), 2.50 (95% CI: 1.51-4.15), 2.29 (95% CI: 1.47-3.56), 2.49 (95% CI: 1.76-3.51) and 1.69 (95% CI: 1.29-2.22), respectively. The education levels of senior high school, technical secondary school and college or above were the protective factors for virus load suppression, and the ORs were 1.32 (95% CI: 1.05-1.66), 1.51(95% CI: 1.11-2.06) and 1.55 (95% CI: 1.12-2.15), respectively.   Conclusion  In 2019, the weak chain in HIV infection diagnosis and treatment in Wenzhou was the disease detection. It is necessary to strengthen the implementation of HIV testing strategies and measures and improve the willingness and service accessibility of high-risk and key groups for HIV testing.
Seasonal characteristics of hand foot and mouth disease in Yuyao, Zhejiang, 2012-2021
Shi Shanshan, Zhou Zhenyu
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  Objective  To analyze the seasonal characteristics of hand foot and mouth disease (HFMD) in Yuyao of Zhejiang province from 2012 to 2021 and provide evidence for the prevention, control and early warning of HFMD and development of HFMD immunization strategy in Yuyao .  Methods  The information of HFMD cases in Yuyao from 2012 to 2021 were collected China Disease Control and Prevention Information System for an analysis on seasonal distribution of HFMD in Yuyao by concentration and circular distribution methods.   Results  The average annual incidence rate of HFMD in Yuyao was 312.95/100 000, and the incidence was high every other year. The incidence rate in men (363.63/100 000) was higher than that in women (260.65/100 000). The cases were mainly distributed in children outside child care settings, accounting for 63.90%. The incidence of HFMD had seasonality (M=0.3031), the annual incidence was high from March 16 to September 11 (\begin{document}$ \overline \alpha $\end{document}=162.33°, S=88.53°, Z=3113.58, P<0.05) and peaked on June 14.   Conclusion  The incidence rate of HFMD in Yuyao is higher compared with some areas in China. The prevention and control of HFMD is a challenge. The incidence of HFMD has seasonality. It is necessary to be prepared for the comprehensive prevention and control of HFMD before the peak period to effectively reduce the incidence of the disease.
Risk assessment of global COVID-19 pandemic in May 2022
Zhang Rongna, Wu Jiewen, Ji Hanran, Pang Mingfan, Yang Xinping, Liang Zuoru, Fang Yuansheng, Li Jie, Zhao Qing, Qi Xiaopeng
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  Objective   To assess the global epidemic of Coronavirus disease 2019(COVID-19) in May 2022 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 neighbouring countries. The assessment results for each country are expressed as “countries of global concern”, “countries of the general concern in each WHO sub-region” and “neighbouring countries of special concern”.   Results  Compared with April 2022, the global monthly new confirmed cases dropped by 35.72%, and the global monthly new deaths dropped by 41.85%. Compared with April, except for the 111.80% increase in newly confirmed cases in the African region, and slightly increase in the Americas region (South) and Americas region (North), the new confirmed cases in May all declined, with the largest decline in the Southeast Asia region; And except for the 114.70% increase in new deaths in the Africa region, the number of new deaths decreased in all regions, ranging from 12.50% to 64.60%, with the largest decline in the Southeast Asia region.   Conclusion   The global daily newly confirmed cases and deaths showed an overall downward trend in May, but the epidemic situation in the African region is still aggravating, and the number of newly confirmed cases and deaths is still increasing, which should be paid special attention to, timely communicate and adjusted measures.
Risk assessment of public health emergencies concerned in the mainland of China, June 2022
Wang Xiaoye, Ma Yongsheng, Feng Yenan, Liu Qianqian, Li Dan, Li Jiandong, Wang Rui, Tu Wenxiao, Shi Guoqing, Xiang Nijuan
, DOI: 10.3784/jbjc.202206130254
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  Objective   To assess the risk of public health emergencies, including both indigenous and imported ones, which might occur in the mainland of China in June 2022.   Methods   An internet-based expert counselling was conducted to analyze the surveillance data of both public health emergencies and prioritized communicable diseases in China, as well as other information reported through different channels. Experts in each provincial center for disease control and prevention attended the video conference for risk assessment.   Results   Overall, the incidence of public health emergencies in June is predicted to be slightly lower than in May, while infectious disease accounting for the largest number. For COVID-19, the overall trend in China will be a steady decline, however, small fluctuations in some areas and provinces with new outbreaks reported will be expected. The incidence of severe fever with thrombocytopenia syndrome (SFTS) will continue to rise, and the number of reported cases may reach all-time high since the disease was discovered in China with most cases would be sporadic. Special attention should be paid to healthcare worker and the families of patient to avoid infection. Incidence of food poisoning would be high and the risk of death caused by poisonous mushroom poisoning raised. The global transmission risk of monkeypox is moderate. The risk of case imported and causing local spread in China should be concerned.   Conclusion   Special attention should be paid to COVID-19, general attention should be paid to severe fever with thrombocytopenia syndrome, food poisoning, and monkeypox.
2022年5月中国甲乙丙类传染病疫情动态概要
, DOI: 10.3784/jbjc.202206200272
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Application of a multiplex PCR assay for identification of Campylobacter fetus and subspecies differentiation in fecal samples from reptile animals
Hou Shuiping, Zhou Yong, He Peng, Tao Xia, Wang Anna, Hu Yushan, Wu Xinwei, Zhang Jing
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  Objective   To establish a multiplex polymerase chain reaction(PCR) method to differentiate C fetus subsp fetus(cff),C fetus subsp venerealis(cfv) and C fetus subsp testudinum(cft).   Method  The specific primers targetting C fetus,cfv and cft were designed and the reaction conditions were optimized. The multiplex PCR system was also evaluated by using 38 strains (including 18 Campylobacter fetus strains and 20 non-Campylobacter fetus strains) and further applied to 53 fecal samples from reptile animals.   Results  The multiplex PCR assay with 3 primer pairs could yield specific fragments: only one fragment of 359 bp for cff, two fragments of 359 bp and 156bp for cfv, two fragments of 359 bp and 266 bp for cft. The amplification conditions were also optimized and the extending temperature was 58 ℃. The optimal concentration of primers “MG3f and Cf359r”, “ISC2mf and ISC2mr”,“CoA266f and CoA266r” were 0.1 μM , 0.2 μM and 0.2 μM respectively. The sensitivity of the assay for detecting cff, cfv and cft was 0.40 ng/μL、0.39 ng/μL and 0.47 ng/μL respectively. The analytical specificity was 100% by examination of 18 Campylobacter fetus strains and 20 non-Campylobacter fetus strains. In 53 fecal samples from reptile animals, one was PCR postive for cft and the suspective colonies were also identified as cft.   Conclusion  The established multiplex PCR assay can differentiate three subspecies simutaneously and provide technical support for rapid identification, epidemiological investigation and tracing infection source.
Application of SARIMA model and Holt winters index smoothing method to predict incidence of pulmonary tuberculosis in Jiangsu
Guo Zaijin, Gong Hao, Zhou Luojing
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  Objective   To establish a seasonal auto regressive integrated moving average (SARIMA) model and a Holt-Winters exponential smoothing model for the prediction of the case number of tuberculosis (TB) in Jiangsu province and provide scientific reference for the prevention and control of TB in Jiangsu.   Methods   The SARIMA model and Holt-Winters exponential smoothing model were established by using the TB incidence data in Jiangsu from January 2016 to December 2020. The validation of the model used the TB incidence from January to December 2021 and evaluation of the models’ prediction effect used root-mean-square error (RMSE), mean absolute error (MAE) and mean absolute percentage error (MAPE).   Results   The best SARIMA model was (0,1,2) (0,1,0) 12, the RMSE was 229.52, MAE was 146.81 and MAPE was 6.33%, and the total relative error was 5.21%. For Holt winters additive model, the RMSE was 206.75, MAE was 156.45, MAPE was 6.63%, and the total relative error was 7.74%.   Conclusion   Both models can well fit the number of pulmonary TB, and the performance of SARIMA model was slightly better.
Species identification of non-tuberculous Mycobacteria from patients with pulmonary infection in Hainan
Zhong Yeteng, Chen Zhuolin, Wang Jieying, Lin Mingguan, Xu Yuni, Pei Hua
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  Objective   To identify the non-tuberculous Mycobacteria (NTM) detected in patients with pulmonary infection and discuss the types and population distribution of NTM pulmonary infection in Hainan province.   Methods   The respiratory tract samples of the patients with suspected pulmonary tuberculosis who visited the Second Affiliated Hospital of Hainan Medical College from July 2016 to June 2021 were collected for Mycobacteria culture, and the culture-positive samples were preliminarily identified by P-Nitrobenzoic acid (PNB)/2-Thiophenecarboxylic acid hydrazide (TCH) culture using DNA microarrays. Microarray technology was used to identify Mycobacterium species, and gene sequencing was used to further identify strains that could not be identified.   Results   A total of 8 507 respiratory tract samples from suspected pulmonary tuberculosis patients were collected during the study period. After excluding duplicated cases, 318 cases were preliminarily identified as NTM infection by PNB/TCH culture, and 315 cases were identified as NTM infection by DNA microarray chip technology and heat shock proteins 65(hsp65) gene sequencing. Among them, 308 patients had a single infection pattern, 6 had MTB+NTM infection and 1 had a mixed infection of two different NTMs. There were 128 strains of rapidly growing Mycobacteria (RGM), accounting for 40.5%, mainly Mycobacterium chelonae/abscessus (32.9%); and 188 strains of slow growing Mycobacteria (SGM), accounting for 59.5%, with Mycobacterium intracellulare as the main strain (39.6%). More infection occurred in women than in men, especially in middle-aged and elderly women, the male-to-female ratio of the cases was 0.79:1. The difference in age distribution of the cases between men and women was significant (z=2.200, P<0.05), and 91.1% of the cases were older than 40 years old.   Conclusion   In Hainan, NTM pulmonary infection was mainly caused by Mycobacterium chelonae/abscessus and Mycobacterium intracellulare, and the middle-aged and elderly women aged >40 years were the main populations affected by NTM.
Pathogen spectrum and epidemiological characteristics of viral diarrhea in Jiangsu
Chen Qiang, Qi Yuhua, Leng Hongying, Wu Yun, Guo Hongxiong
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  Objective  To investigate the pathogen spectrum and epidemiological characteristics of viral diarrhea cases in Jiangsu province from 2018 to 2019 and provide data support for the effective prevention and control and clinical treatment of infectious diarrhea.   Methods  Stool samples were collected from all diarrhea cases in sentinel hospitals in Jiangsu from November 2018 to October 2019 for viral nucleic acid detection, and the results were analyzed by χ2 test.   Results  In 2,486 diarrhea cases, 633 samples were positive in the viral nucleic acid test (25.46%). Norovirus and rotavirus were detected in 32.07% and 25.43% of all positive samples, respectively, accounting for more than half of the total. The highest incidence rate of infectious diarrhea was found in children under 5 years old (29.04%). The seasons with the highest positive rates were summer (28.59%) and autumn (28.59%). The virus positive rate in floating population (45.76%) was much higher than that in local residents (23.33%) (χ2=56.618, P<0.001).   Conclusion  It is suggested that preschool children should be regarded as the key population for the prevention and control of viral diarrhea, the prevention and control of viral diarrhea should be strengthened in summer and autumn, and the coverage of health education for floating population should be expanded.
Summary of global surveillance data of infectious diseases in May 2022
Han Hui, Wu Bo, Jia Jiaojiao, Song Yueqian
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In May 2022, a total of 66 infectious diseases were reported globally, affecting 233 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (233), monkeypox (36), dengue fever (31), measles (24) and cholera (11). The top five infectious diseases with highest case fatality rates were Ebola virus disease (100.0%), Middle East Respiratory Syndrome (34.4%), Crimean-Congo hemorrhagic fever (22.2%), Lassa fever (19.8%) and monkeypox (4.0%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, cholera, dengue fever and measles. The prevalent infectious diseases in Asia were COVID-19, dengue fever and cholera, the prevalent infectious diseases in Africa were COVID-19, Ebola virus disease, cholera, yellow fever, Lassa fever, malaria and monkeypox, the prevalent infectious diseases in America were COVID-19, dengue fever, chikungunya fever and Zika virus disease, the prevalent infectious disease in Europe were COVID-19, monkeypox and acute hepatitis of unknown aetiology.
2022年5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 May 2022
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Identification and tracing of norovirus GⅠ in epidemics of acute gastroenteritis in 6 schools in Xicheng district, Beijing, 2018−2019
Wang Yongquan, Cui Haiyang, Ji Yanli, Jin Bo, Li Weihong, Liu Baiwei, Sheng Lingyu, Gao Zhiyong, Yan Hanqiu
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  Objective  To analyze the genotype characteristics of norovirus GⅠ detected from the acute gastroenteritis epidemics in 6 schools in Xicheng district of Beijing from 2018 to 2019.   Methods  A total of 37 stool samples were collected from the acute gastroenteritis cases in the 6 schools during this period. Real-time fluorescent RT-PCR were used to detect the viral nucleic acids of norovirus G I/G II from the samples. The regions coding for RNA polymerase and capsid proteins VP1 of norovirus G I were amplified and sequenced in by RT-PCR. The successfully sequenced virus strains were preliminary identified and genotyped by using on-line Norovirus Typing Tool (Version 2.0). Software BioEdit7.0.9.0 was used for sequence alignment, and software MEGA 6.0 was used to construct phylogenetic tree.   Results  The acute gastroenteritis epidemics in 6 schools (18 S1−S4 and 19 S5−S6) were caused by norovirus. The positive rate of norovirus GⅠ nucleic acid was 83.78% (31/37), and no norovirus G II was detected. The phylogenetic analysis on polymerase and capsid proteins VP1 region showed that 4 strains from 1 epidemic and GⅠ.Pd and GⅠ. 3b reference strains were in the same branch, and 19 strains from 5 epidemics and GⅠ.Pb and GⅠ.6a reference strains were in the same branch, the similarity of each school strain was 100.0%. The results of bipartition type showed that 1 epidemic was caused by the recombinant strain of GⅠ.Pd-GⅠ.3b, The similarity between GⅠ.Pd-GⅠ.3b and GⅠ. 3[P13]/Hu/MT008455/2018/Shanghai/chi was 99.6%, and 5 epidemics were caused by the recombinant strain of GⅠ.Pb-GⅠ.6a, the similarity between GⅠ.Pb-GⅠ.6a and GⅠ. 6[P11]/Hu/MZ227264/2016/US was 98.1%.   Conclusion  The epidemics of norovirus-induced acute gastroenteritis occurred in 6 schools in Xicheng district of Beijing from 2018 to 2019 were caused by GⅠ.Pd-GⅠ.3b and GⅠ.Pb-GⅠ.6a recombinant strain. It is necessary to strengthen the molecular epidemiological surveillance for norovirus recombinant strains to provide evidence for the early warning and prediction of norovirus infection epidemics.
Investigation of a varicella outbreak and vaccination efficiency in a kindergarten in Nanjing, Jiangsu
Wang Junjun, Chen Yunhua, Xing Guanghong, Ma Tao, Ding Songning, He Min, Liu Huihui, Gu Runhui, Zhao Hongting, Peng Zhibin
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  Objective  To identify the risk factors for a varicella outbreak in a kindergarten in Nanjing, Jiangsu province, and evaluate the efficiency of varicella attenuated live vaccine (VarV) in the children.   Methods  Case definition was established and case finding was conducted. The demographic data, medical records, epidemiological history, immunization history of varicella and other data were collected from the cases. The distribution characteristics of cases and the differences in attack rate were explored. The immunization history of varicella and history of varicella were collected from children in classes with a high attack rate of varicella. A retrospective cohort study was used to analyze the differences in attack rate of varicella between vaccinated children and unvaccinated children, and the efficiency of VarV as well as the association between the time interval of the vaccination and efficiency of VarV were evaluated.   Results  A total of 61 cases of varicella were diagnosed. The attack rate of varicella was significantly higher in children (10.87%, 59/543) than in kindergarten staff (2.94%, 2/68) (χ2=4.22, P=0.040). The index case was a head teacher, who continued to work after the illness onset without reporting and was not detected by the routine health surveillance of kindergarten. The school perform no intervention measures after this teacher’s sick leave. This outbreak lasted for two months, resulting in 5 generations of the cases with a median generation interval of 15 days. The attack rates among different classes showed significant difference (χ2=256.98, P<0.001). Among 61 cases, 8 (13.11%) cases were breakthrough cases, who had received one-dose VarV. For these 8 breakthrough cases, the median time interval between vaccination and illness onset was 4.11 years. The results showed that VarV efficiency in this outbreak was 65% (95% CI: 24%~84%), and the vaccine efficiency decreased in the cases with the interval of more than 3 years between the first dose vaccination and this outbreak or illness onset.   Conclusion  This was a varicella outbreak in kindergarten with index case being a school staff. The potential risk factors for this outbreak included failure to identify and isolate case timely, inappropriate distribution of classrooms, low vaccination coverage, and long time after one-dose vaccination.
Research and analysis of infectious disease model based on individual behavior
Chen Tengfei, Long Hua, Shao Yubin, Du Qingzhi, Zhang Yanan, Song Xiaoxiao
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  Objective   In order to fully consider the impact of individual differences and personnel movement in population on the spread of infectious diseases, an infectious disease model based on individual behavior was established to reveal the dynamic characteristics of disease spread and evaluate the effectiveness of epidemic prevention and control measures.   Methods   The model was established based on individual subject, which gives different values to individual attributes to reflect the differences between individuals. The factors affecting the spread of infectious disease were introduced into the model in the form of parameters, and the individual state changes during the epidemic of infectious diseases were reflected by changing the individual attribute values.   Results   Through the setting and adjustment of relevant parameters, the result of the model was highly consistent with the epidemic trend. The model was validated by using the basic reproduction number of COVID-19 in Wuhan. On this basis, the impact of individual social activity on the development of epidemic was discussed, and the trend of infectious disease epidemic under different prevention and control measures was simulated.   Conclusion   The parameters in this model are flexible, which are suitable for the analysis on infectious diseases in various situations and can be used to evaluate the effectiveness of prevention and control measures to provide guidance for epidemic prevention and control.
Characterization of combined mutation of isoniazid and rifampicin resistance genes in Mycobacterium tuberculosis in Guangxi
Qin Yixiang, Lan Rushu, Qin Huifang, Ye Jing, Qin Xiaoling, Gan Li, Liu Gang, Xu Ruolan, Luo Dan
, DOI: 10.3784/jbjc.202112120636
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  Objective  To understand the combined mutation characteristics of isoniazid and rifampicin resistance genes of Mycobacterium tuberculosis in Guangxi and provide a basis for the molecular diagnosis and treatment of multidrug-resistant tuberculosis (MDR-TB).   Methods  A total of 49 MDR strains and 459 fully sensitive strains of M. tuberculosis collected from 30 designated TB treatment institutions in Guangxi during 2017–2018 were selected for whole genome sequencing.   Results  The consistent rate between the MDR phenotype and the combined mutation of genes was 71.43%. The single gene mutation rate and combined gene mutation rate were higher in the MDR strains than in the fully sensitive strains (χ2=5.753, P=0.016; χ2=284.034, P<0.001). The single gene mutation rates of katG and rpoB were higher in the MDR strains than in the fully sensitive strains (χ2=7.524, P=0.006; χ2=4.353, P=0.037). Combined mutations in katGrpoB genes were higher in the MDR strains than in the fully sensitive strains (χ2=279.956, P<0.001). Among the distribution of combined gene mutations, mutations at the katG315+rpoB450 and katG315+rpoB445 loci accounted for 40.82% (20/49), and the combined mutation rate of gene loci in both forms was higher in the MDR strains than in the fully sensitive strains (χ2=144.232, P<0.001; χ2=19.014, P<0.001).   Conclusion  Detection of combined mutations of resistance genes to isoniazid and rifampicin can be used as an important method for MDR screening in Guangxi. Isoniazid and rifampicin resistance gene mutations of M. tuberculosis in Guangxi were mainly caused by mutations at the loci of katG315, rpoB450 and rpoB445, while the gene combined mutations were mainly in the form of katGrpoB. Mutations at the katG315+rpoB450 and katG315+rpoB445 loci are the main molecular mechanisms of MDR in Guangxi.
Genetic characteristics of Coxsackievirus A16 isolated from hand foot and mouth disease cases in Qingdao in winter of 2019
Jiang Fachun, Zhao Chao, Dong Hongming, Jia Jing, Wang Xia, Wang Yanhai, Gao Chen, Han Jun
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  Objective  To investigate the etiological and genetic characteristics of hand foot and mouth disease (HFMD) cases in Women and Children Hospital and Central Hospital of Qingdao in the winter of 2019, and analyze the genetic evolution of coxsackievirus A16 (Cox A16).   Methods  After the collection of 104 throat swabs from hospitalized children with HFMD in Qingdao in the winter of 2019, enterovirus nucleic acid test was conducted by real-time fluorescent quantitative PCR (RT-qPCR), the positive samples were amplified with general typing primers of entrovirus. Blast alignment was conducted after sequence amplification. The full-length of Cox A16 VP1 gene was amplified by using semi-nested PCR with designed Cox A16 VP1 full length primers, and genetic analysis of nucleotides and amino acids was conducted by using DNAstar, and a phylogenetic tree was constructed by using MEGA software with reference sequences.   Results  In the 104 throat swabs from the hospitalized children with HFMD, 60 were positive for enterovirus, and the overall positive rate was 57.7%. The positive rate of Cox A16 was 30.8% (32/104), and the positive rate of Coxsackievirus A6 (CV A6) was 26.9% (28/104). After Cox A16 VP1 of 32 positive samples were amplified and sequenced, it was found that the nucleotide homology was 87.0%–100%, and the amino acid homology was 98.3%–100%. Phylogenetic analysis showed that 17 of the 32 Cox A16 strains belonged to Cox A16 B1a genotype, and the other 15 strains belonged to Cox A16 B1b genotype.   Conclusion  The pathogens that caused HFMD hospitalizations in Qingdao in the winter of 2019 included Cox A16, and Cox A16 types B1a and B1b spread at the same time.
Priority, difficulties and optimization ideas of infectious disease surveillance and early warning at present stage
Chen Wei, Ren Xiang, Geng Mengjie, Deng Yuan, Huang Shuo, Liu Caixiong, Wang Ruiyao, Chen Zhongming, Wang Liping
, DOI: 10.3784/jbjc.202203170107
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Application of α-Sutte model in epidemic prediction—based on software R
Liu Tian, Xie Cong, Yang Wenwen, Yao Menglei, Hou Qingbo, Huang Shuqiong
, DOI: 10.3784/jbjc.202109090486
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  Objective  To introduce the principle and method ofα-Sutte model, establish a α-Sutte model by using software R, compare the fitting and prediction effects of theα-Sutte model and multiple seasonal autoregressive integrated moving average model, SARIMA model and provides reference for the application of theα-Sutte model in epidemic prediction.   Methods  The daily cumulative number of reported cases of COVID-19 from India, the United States, Italy, Brazil, Russia, and South Africa from January 1, 2020 to July 16, 2021 were collected. Based on the time of the first reported case, the data reported by June 16, 2021 were used as training data, and the data reported from June 17, 2021 to July 16, 2021 were used as test data. According to the calculation formula of theα-Sutte model, the fitting and prediction functionα-Sutte() was written by software R. The training data was used to train theα-Sutte model and the SARIMA model. Two models were established to predict the number of daily reported cases of COVID-19 from June 17, 2021 to July 16, 2021. The fitted value was compared with the training data, the predicted value was compared with the test data, and the Mean Absolute Percentage Error (MAPE) was used to evaluate the model fitting and prediction effect.   Results  The optimal SARIMA models established by India, the United States, Italy, Brazil, Russia and South Africa were SARIMA(5, 2, 2) SARIMA(0, 2, 2), SARIMA(2, 2, 2), SARIMA(3, 2, 2), SARIMA(0, 2, 1) and SARIMA(4, 2, 3) respectively. The MAPE fitted by theα-Sutte and SARIMA models in India, the United States, Italy, Brazil, Russia, and South Africa were 1.32%, 1.34%, 0.89%, 1.65%, 0.99%, 0.99% and 1.51%, 1.59%, 0.89%, 1.67%, 1.03%, 1.13% respectively. The MAPE predicted by theα-Sutte and SARIMA models in 6 countries were 0.81%, 0.09%, 0.13%, 1.58%, 1.73%, 3.77% and 0.09%, 0.09%, 0.18%, 1.13%, 1.83%, 3.43% respectively.   Conclusion  The principle and modeling of theα-Sutte model are simple. Theα-Sutte model established by software R has high fitting and prediction accuracy, and it is worth to promote in disease surveillance.
Marburg Virus Disease: Epidemiology, Clinical Features, and Prevention
Du Shanshan, Deng Xuefei, Huang Xiaoxia, Li Jiandong
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  Objective  To summarize and analyze the epidemic characteristics, clinical manifestations, laboratory testing, prevention and control measures of Marburg virus disease.   Methods  The epidemic situation of Marburg virus disease was collected from PubMed database, Bing academic collection and information released by the World Health Organization. The complete sequence of virus genome with clear isolation time and region was screened, and the phylogenetic analysis was carried out to analyze the etiological characteristics.   Results  Marburg virus is one of the most lethal pathogens to human beings, and the areas threatened by Marburg virus are expanding. The understanding of the epidemic characteristics of Marburg virus mainly comes from three large-scale outbreaks. The genetic evolution of the virus has high stability. The difference between the two main clades is about 20%, and the difference of virus genome sequence within the clade is about 7%. However, the abundance and diversity of simultaneously circulating strains in natural hosts such as bats pose a challenge to nucleic acid based molecular diagnosis.   Conclusion  the epidemic situation and threaten of Marburg virus disease are underestimated, which should arouse attention to increase R & D investment in specific prevention and treatment measures.
Surveillance results and risk factors of neonatal birth defects in Haikou, Hainan province, 2016−2020
Wang Renyuan, Xu Li, Li Chao, Huang Ling, Zeng Liangying
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  Objective   To understand the incidence of neonatal birth defects and related risk factors in Haikou, Hainan province, from 2016 to 2020, and provide reference for the development of prevention measures.   Methods   A retrospective analysis was conducted by using the incidence data of neonatal birth defects in 31 860 newborns born in Hainan Maternal and Child Health Center and Haikou Maternal and Child Health Center from January 2016 to December 2020. The incidence of birth defects was statistically analyzed. Children with birth defects were divided into case group and healthy newborns matched with gender, age and birth time of the case group were selected as control group. The risk factors for birth defects were analyzed by multivariate Logistic stepwise regression analysis.   Results   A total of 419 cases of birth defects were detected in 31 860 neonates, and the incidence of birth defects was 1.32%. The first five birth defects were congenital heart disease, multi finger (toes), cleft lip and palate, neural tube defects and hypospadias. Multivariate logistic stepwise regression analysis showed year 2016−2017 (OR=2.903, 95% CI: 1.815−4.612), abnormal birth history (OR=2.518, 95% CI: 1.604−3.805), birth weight (OR=5.182, 95% CI: 3.627−8.519), alcohol consumption during pregnancy (OR=4.257, 95% CI: 3.106−6.115), smoking during pregnancy (OR=4.613, 95% CI: 3.327−7.185), virus infection in early pregnancy (OR=3.526, 95% CI: 2.413−5.114), pregnancy medication history (OR=8.903, 95% CI: 5.275−15.927), toxic substance exposure during pregnancy (OR=7.602, 95% CI: 4.713−13.165), malnutrition during pregnancy (OR=6.127, 95% CI: 3.952−11.864) and adverse mental stimulation during pregnancy (OR=2.308, 95% CI: 1.462−3.287) were risk factors for birth defects.   Conclusion   The incidence of neonatal birth defects was high in Haikou, and there were many risk factors affecting the incidence of neonatal birth defects. Health education during pregnancy should be strengthened to reduce the incidence of birth defects.
Application of FilmArray G Panel in the detection of diarrhea pathogens
Fan Lingfang, Zhang Jingyun, Sha Dan, Guan Hongxia
, DOI: 10.3784/jbjc.202104070187
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  Objective   To discuss the application value of the FilmArray GⅠ Panel in the detection of diarrhea pathogen.   Methods  152 fecal samplesfrom intestinal outpatients of Wuxi People's Hospital (including Children's Hospital) from January 2016 to September 2016 were collected. FilmArray GⅠ Panel and real-time PCR were used to detect samples, respectively, and the results of the two methods were compared.   Results  Total of 19 pathogens were detected by FilmArray GⅠ Panel, with a positive rate of 75.00% (114/152). Total of 17 pathogens were detected by real-time PCR detected, with a positive rate of 68.42% (104/152). The coincidence rate between the two methods was 67.76% (103/152).For adenovirus, Enteroinvasive E.coli(EIEC), Campylobacter and G. lambli, the coincidence rate was 100.00%.For Sapovirus, Enteroaggregative E.coli(EAEC), C. difficile, Salmonella and V. cholerae, the coincidence rates were 98.03%, 94.08%, 96.71%, 94.08% and 98.68%, and the consistency was moderate (Kappa values were 0.563, 0.546, 0.651, 0.610, 0.744). For Norovirus GⅠ/GⅡ, Rotavirus A, Enterotoxigenic E.coli(ETEC), Enteropathogenic E.coli(EPEC), P. shigelloides and V. parahaemolyticus, the coincidence rates were 98.03%, 99.34%, 97.37%, 92.76%, 99.34%, 98.68%, and the consistency was good (Kappa values were 0.892, 0.971, 0.890, 0.764, 0.944, 0.902). Using Chi-square tests, the detection rates of EAEC, ETEC, EPEC, C. difficile and Salmonella by FilmArray GⅠ Panel were higher than those by real-time PCR, and the difference was statistically significant (P<0.05).   Conclusion  Compared with real-time PCR, FilmArray detection has the characteristics of rapid, accurate and high throughput, which can be used for rapid detection of public health emergencies and rapid diagnosis of diarrheal diseases.
Bibliometric analysis of COVID-19 related literature, based on Web of Science Core Collection.
Zhang Rongna, Ji Hanran, Liang Zuoru, Pang Mingfan, Wu Jiewen, Yang Xinpin, Fang Yuansheng, Zhao Qing, Li Jie, Qi Xiaopeng
, DOI: 10.3784/jbjc.202204010130
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  Objective  This study conducted bibliometric analysis of COVID-19 related literature, to understand the research status of COVID-19, explore the latest progress and research trends in the field of COVID-19 research, and provide data support for the construction of a comprehensive and detail system based on COVID-19 literature.   Methods   Using Web of Science as the data source, using VOSviewer and CiteSpace as visualization tools, this study searched English literature related to COVID-19 published between January 2020 and January 2022, and analyzed the publication time, country, key words, institution and discipline category of the literature.   Results   A total of 158 413 articles or reviews related to COVID-19 were retrieved. The high-frequency keywords include Mental health, COVID-19 infection, Risk factors, Health-care and COVID-19 vaccine, etc., which mainly present 5 clusters. The four most influential subject categories are general internal medicine, public, environmental and occupational health, and infectious diseases. The organization with the most publications is Harvard Medical School, and the organization with the most citations is Huazhong University of Science and Technology. Among all countries, the United States and China are at the leading level in the number of publications, citations, and funding frequency. The National Natural Science Foundation of China has the highest funding frequency for COVID-19 research, four of the top ten funds are from China.   Conclusion   The research focus of COVID-19 has gradually expanded from public health and clinical medicine to social environment, economy, education and life, and its influence has gradually expanded. In addition, the specific classification of research fields and disciplines of COVID-19 literature needs to be further refined.
Research on transmission pattern of SARS-CoV-2
Zhang Xiangyu, Wang Lianhao, Wang Xuechun, Su Hexuan, Jia Zhongwei
[Abstract](56) [FullText HTML](34) [PDF 5722KB](23) [Peer reviewing opinions] Related References Share
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  Objective  Taking the three outbreaks caused by Delta variant (B.1.617.2) in Guangzhou, Guangdong Province, Nanjing, Jiangsu Province and Zhengzhou, Henan Province as examples, to explore different transmission pattern of SARS-CoV-2 epidemic and to provide basis for scientific prevention and control.   Methods  The research data was collected from the public data based on three related epidemics in Guangzhou, Nanjing and Zhengzhou reported by the national and local health commissions. Taking prefecture level city as the unit, according to the characteristics of infected cases movement, the epidemic transmission pattern was divided into jumping transmission and community transmission, and compared the two patterns of its characteristics.   Results   From May 21 to September 3, 2021, 1 494 infected cases were reported in the three epidemics, including 83 cases of jumping transmission infections and 1 411 cases of community transmission infections including 884 infected cases caused by jumping transmission. Jumping transmission spread to a total of 45 cities for 22 days. The average age of the infected population was 37.15 years old, and the proportion of asymptomatic was 26.51%. The duration of community transmission was 65 days, and the average age of the infected population was 45.21 years old, the proportion of asymptomatic in which was 8.65%. The age of infected population was lower than that of jumping transmission, the proportion of asymptomatic was higher, and these differences were significant (P<0.001).   Conclusion  The jumping transmission caused by population movement covered a wide range, with high proportion of young person and asymptomatic infected cases. Infections of community transmission were mainly middle-aged and elderly people. Therefore, it is suggested that differentiated control should be taken for different groups, such as strengthening the frequency of nucleic acid testing for mobile people and people in transportation hub, reducing gathering activities for community groups that reducing the frequency of contact can reduce the probability of infection.
Value of plasma NACAM/ABCA1 double-labeled exosomal Aβ42 and microRNA-388-5p in early diagnosis of Alzheimer's disease
Ling Sihai, Zhi Yang, Li Ying, Chen Xiali, Liu Chengeng
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  Objective   To detect the dual-labeled Aβ42 and miR-388-5p in exosomes of nerve cell adhesion molecule (NCAM) and ATP binding cassette transporter A1 (ABCA1), and analyze their potential value in the early diagnosis of Alzheimer's disease (AD).   Methods   The levels of plasma NCAM/ABCA1 exosomes Aβ42 and miR-388-5p of 67 cases of subjective cognitive decline (SCD), 63 cases of amnestic mild cognitive impairment (aMCI), 66 Alzheimer's disease cases with dementia (DAT), 60 healthy controls and 60 controls of vascular dementia (VaD) cases were detected, and the correlation between the indicators and the diagnostic power of each disease stage were analyzed.   Results  The plasma levels of NCAM/ABCA1 double-labeled exosomes Aβ42 in SCD, aMCI and DAT cases were significantly higher than those in controls of VaD cases and healthy controls (P<0.05). In plasma NCAM/ABCA1 of SCD, aMCI and DAT cases, the content of miR-388-5p in double-labeled exosomes was significantly lower than those of controls of VaD cases and healthy controls (P<0.05). The sensitivity and specificity of plasma NCAM/ABCA1 double-labeled exosomal Aβ42 for SCD, aMCI and DAT were higher than those of miR-388-5p.   Conclusion  This study suggests that Aβ42 and miR-388-5p in NCAM/ABCA1 double-labeled exosomes can be used as candidate markers for the diagnosis or early warning of aMCI and SCD, but longitudinal multicenter studies are still needed to further confirm the results.
Investigation of a cluster of COVID-19 cases imported through inbound air flight
Wang Hui, Zhang Zhizhong, Li Yongguang, Li Wanping, Long Jiali, Chen Zongqiu, Xie Chaojun, Luo Lei, Zhang Zhoubin
, DOI: 10.3784/jbjc.202107070386
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  Objective  To understand the epidemiological characteristics and explore source of infection of coronavirus disease 2019 (COVID-19) cases imported through an inbound air flight from Kenya to Guangzhou, China.   Methods  Using a standardized questionnaire, we collected information of the travelers’ demographic characteristics and illness before, during, and after the flight. We also collected data about the factors potentially associated with COVID-19 transmission during the flight by retrospective cohort study.   Results  There were 211 passengers and 14 crew members on the flight. A total of 31 COVID-19 patients were diagnosed among all passengers, in which 11 (35.48%) were symptomatic and 20 (64.52%) were asymptomatic. The attack rate was 14.69% (31/211). The cases were mainly the employees of GC Company. Retrospective cohort study suggested that high frequency of contact with foreigners or sharing rooms with COVID-19 cases in the Republic of Congo were risk factors for SARS-CoV-2 infection. The risk ratios were 6.250 for the passengers high frequency of contact with foreigners (95% CI: 1.095–35.682) and 11.500 for the passengers sharing rooms with COVID-19 cases (95% CI: 1.835–72.069) and.   Conclusion  The cases detected in this flight might be infected outside China, and the possibility of being infected due to the exposure in the flight was low. But it is still necessary to take effective personal protection in airplanes.
Role of dndC gene in DNA degeneration in pulsed-field gel electrophoresis and treatment method
Pu Ji, Zhou Juan, He Ziqiang, Xiong Yanwen, Jin Dong
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  Objective  To understand the carriage of dndC gene in Escherichia coli and E. fergusonii strains and the relationship between the dndC gene and the DNA degeneration phenotype, and explore the causes of DNA degeneration in pulsed-field gel electrophoresis (PFGE) and treatment methods.   Methods  A total of 450 E. coli and E. fergusonii strains were analyzed by PFGE. The primers were designed to detect and sequence the dndC gene. The phylogenetic tree was constructed based on the dndC genes obtained from this study and NCBI database to analyze the genotype of dndC gene and the distribution of dndC gene in different types of E. coli. Addition of thiourea and disinfection of electrophoresis equipment were used to study the treatment methods of DNA degeneration.   Results  There were 40 strains (8.89%) with the DNA degeneration phenotype by PFGE analysis and 33 strains of them were positive for dndC gene, accounting for 7.33% of 450 E. coli and E. fergusonii strains. The dndC genes of E. coli were divided into eight groups. There were positive strains carrying dndC gene in all eight types of E. coli strains, and the positive rates of dndC gene in eight types of E. coli strains were different. Addition of thiourea and disinfection of electrophoresis equipment could effectively improve the DNA degeneration phenotype.   Conclusion  The dndC gene can cause DNA degradation of E. coli and E. fergusonii in PFGE analysis. Addition of thiourea was an effective method to ease the DNA degradation caused by dndC.
Investigation of an outbreak of varicella in a district of Shenzhen and evaluation of control effect based on SEIR model
Chen Hongbiao, Gu Zihao, Zhou Xiaofeng, Luo Jingwei, Pen Weijun, Liu Lizhen
, DOI: 10.3784/jbjc.202108300473
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  Objective   To evaluate the effect of response measures of a varicella outbreak in a district in Shenzhen, and provide evidence for the control of varicella outbreak in the future.   Methods   The data of varicella outbreak in a school campus in Shenzhen were analyzed retrospectively, and the control effect was evaluated by using SEIR model of transmission dynamics.   Results   The outbreak involved 123 cases of varicella, with an attack rate of 3.40%. In the cases, 92 had history of varicella vaccination. The overall protection rate of varicella vaccine was 55.88%, the protection rate of only one dose of varicella vaccine was 55.20% , and the protection rate of two doses of varicella vaccine was 57.11% , there was a significant difference in attack rate between group of one dose, two doses and unvaccinated group (P<0.001) . There was no significant difference in attack rate between one dose group and two dose group (P>0.05). The SEIR model simulated that the school varicella outbreak duration for 180 days without intervention, 434 cases of varicella would occur, and the case number tend to be zero on day 101. In the fitted conditions of prompt isolation of the first case, isolation of all the cases, and timely emergency vaccination, 10, 92 and 31 cases of varicella would occur, the duration of the outbreak would be 0 day (the case number would be less than 1) , 87 days, and 35 days, respectively. In the fitted condition of four emergency varicella vaccinations in the school, 80 cases would occur, 43 cases less than actual number, and the outbreak would last for 72 days, 2 days less than actual duration, and compared with the situation under 90% vaccination rate, additional 49 cases would occur and the outbreak would last for another 41 days.   Conclusion   In the response of varicella outbreak, early detection of the first case, isolation of all the cases and timely emergency vaccination with high coverage are the key measures to control varicella outbreak.
Trends in diabetes disease burden in Inner Mongolia autonomous region, 1990−2019
Chen Wenjie, Qian Yonggang, Chu Di, Li Yanhong, Xia Yajuan
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  Objective   To understand the mortality and disease burden of diabetes in Inner Mongolia autonomous region during 1990–2019, and provide basic data support and theoretical basis for the development of diabetes prevention and control related policies.  Methods   Using data from the global burden of disease study 2019 (GBD 2019), we calculated crude mortality, standardized mortality, disability adjusted life year (DALY) rates, early life loss (YLL) rates, years lived with disability (YLD) rates in adults with diabetes in Inner Mongolia during 1990–2019, the annual percentage change (APC) was used to reflect changing trends of disease burden caused by diabetes.   Results   The mortality rate of diabetes increased from 3.58/100000 to 8.03/100000 in Inner Mongolia during 1990–2019, with an APC of 2.8%. The DALY rates increased from 2.90 per 1000 person years to 6.59 per 1000 person years with an APC of 3.0%. Whereas both the standardized mortality rate and standardized DALY rate declined first and then increased, but the standardized mortality rate and standardized DALY rate in men showed an increasing trend. And all the above trend changes were statistically significant (P<0.05). The number of deaths, mortality rate, and disease burden all increased with age and reached peaks in age group ≥70 years.   Conclusion   Inner Mongolia had a serious burden of diabetes, the burden of the disease and disability in men was most serious, and it is necessary to strengthen diabetes prevention and control and conduct targeted intervention in the elderly.
Population division and prevention and control situation of rabies virus in Hunan Province
Yang Xiaochen, Tao Xiaoyan, He Fangling, Wang Juan, Cai Liang, Dai Jiqiang, Zhu Wuyang
, DOI: 10.3784/jbjc.202111040574
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  Objective  To update the population types and evolutionary characteristics of rabies virus (RABV) circulating in Hunan Province, and to analyze and judge the situation of rabies epidemic prevention and control in Hunan Province.   Methods  The canine brain tissue specimens collected in Hunan Province from 2012 to 2017 were detected by direct immunofluorescence and reverse transcription polymerase chain reaction. The positive specimens were tested for the full sequence of N gene (1 353 bp) and sequence homology. Analyze and conduct phylogenetic analysis together with the representative strains of 7 RABV populations in China.   Results  The N gene nucleotide homology of the 25 newly tested RABV strains in Hunan Province was 91.9%–100%, and the amino acid homology was 83.6%–100%; the results of population division showed that 84% (21/25) of the virus strains are ChinaⅠgroup, 4 strains are China Ⅱgroup, China Ⅲ group and China V group prevalent in Hunan before 2010 have not been detected.   Conclusion  The type of rabies virus epidemic population in Hunan Province has not increased, and it is limited to the two main canine populations in China. Only by effectively strengthening dog management, especially the management and immunization of rural dogs, can the rabies epidemic in Hunan Province be further controlled.
Clinical and epidemiological characteristics of enterovirus D68 in cases with respiratory infection in Beijing, 2018−2019
Li Aihua, Gong Cheng, Li Maozhong, Luo Ming, Dong Mei, Wang Yiting, Wang Xue, Huang Fang
[Abstract](96) [FullText HTML](19) [PDF 1773KB](18) [Peer reviewing opinions] Related References Share
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  Objective  To analyze the clinical and epidemiological characteristics of enteroviruse-D68 (EV-D68) infection in patients with acute respiratory tract infection in Beijing from 2018 to 2019.   Methods  The epidemiological data and clinical samples were collected from respiratory infection patients in 35 sentinel hospitals in respiratory pathogen surveillance in Beijing. All the samples were subjected to EV and EV-D68 detections by real-time PCR. The VP1 gene sequences of EV-D68 positive samples were analyzed.   Results  Of 15 645 clinical samples from respiratory infection cases, 467 (2.98%) were EV positive and 22 (0.14%) were EV-D68 positive. Of the 22 EV-D68 infection cases, 11 were aged <18 years, 7 were aged 18−60 years and 4 were aged >60 years. Eight cases were diagnosed with upper respiratory tract infection and 14 cases were diagnosed with pneumonia, including two severe pneumonia cases. The main symptoms for EV-D68 infection cases were fever (18/22, 81.8%) and cough (15/22, 68.2%). Seven cases were detected in summer (June-August), 11 cases in autumn (September-November), 3 cases in winter (December-February) and 1 case in spring (March-May). Fourteen strains of 22 EV-D68 belonged to subclade B3 and D3, in which 8 strains belonged to subclade B3 and 1 strain blonged to subclade D3 in 2018, while 5 strains in 2019 belonged to subclade D3.   Conclusion  Respiratory tract infection caused by EV-D68 persisted in Beijing, mainly in summer and autumn. Subclade B3 and new subcalde D3 were the main pathogen subtypes.
Epidemiological and clinical characteristics of hospitalized children with group A rotavirus G9P[8]-caused diarrhea in China, 2011−2019
Wei Yuhang, Li Jingxin, Peng Rui, Wang Mengxuan, Sun Xiaoman, Zhang Qing, Wang Hong, Fan Jiaxin, Li Dandi, Duan Zhaojun
, DOI: 10.3784/jbjc.202111110589
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  Objective  To understand the epidemiological and clinical characteristics of hospitalized children with group A rotavirus G9P[8]-caused diarrhea in China from January 2011 to December 2019.   Methods  The data of viral diarrhea surveillance network in China from January 2011 to December 2019 were collected by using software EpiData 3.0, processed by using Excel 2010, and analyzed with software SPSS 26.0.   Results  From January 2011 to December 2019, a total of 47 386 samples of hospitalized children with acute gastroenteritis under 5 years old were collected by the viral diarrhea surveillance network in China. In the positive samples, the detection rate of group A rotavirus G9P [8] was 54.50% (8149/14952). The positive rate of group A rotavirus G9P [8] in girls was higher than in boys. The seasons with high incidence of group A rotavirus G9P [8] infection were autumn and winter. Compared with non-group A rotavirus G9P[8] infection, children with group A rotavirus G9P[8] infection usually had multi and serious symptoms or signs, such as fever (59.79%, 4872/8149), vomiting (53.87%, 4390/8149), diarrhea (92.93%, 7573/8149), respiratory symptoms (29.30%, 2388/8149), neurological symptoms (2.07%, 169/8149), rash, pneumonia and sepsis (8.21%, 669/8149) .   Conclusion  From January 2011 to December 2019, group A rotavirus G9P [8] gradually became the main predominant pathogen circulating in China. The seasonal incidence peak was during autumn-winter, and the symptoms of group A rotavirus G9P [8] infection were more severe. This study provided data support for rotavirus infection prevention and control and reference for the selection of rotavirus vaccine strain.
Epidemiological characteristics of scarlet fever cases in Yangpu district, Shanghai, 2015−2020
Chen Dan, Zhang Chen
, DOI: 10.3784/jbjc.202111120592
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  Objective   To understand the epidemiological characteristics of scarlet fever in Yangpu district, Shanghai, from 2015 to 2020, and provide theoretical basis for the prevention and control of scarlet fever.   Methods   Descriptive epidemiological method was used to describe and analyze the distributions of scarlet fever in Yangpu, and Ward cluster method was used to analyze the clinical symptoms and signs of scarlet fever.   Results   More scarlet fever cases occurred in boys than in girls. The age of the cases was 5−7 years and the cases aged 6 years had highest proportion (31.60%). The incidence level in central streets was higher than that in surrounding streets. The incidence level during 2015−2020 showed an upward trend followed by a downward trend, while the annual incidence had two peaks during May−June and during November−January. The cases could be divided into 3 groups according to the clinical symptoms and signs: more symptom group, less symptom group and non-symptom group, while the most common symptoms were systemic and oropharyngeal symptoms.   Conclusion   In recent years, the overall incidence level of scarlet fever in Yangpu showed an upward trend and then a downward trend. In the diagnosis, treatment and prevention and control of scarlet fever, special attention should be paid to school aged boys in late spring and early summer and in late autumn and early winter, while the differential diagnosis should be strengthened.
Epidemiological characteristics of pulmonary tuberculosis cases and incidence trend in Guiyang, 2010−2019
Yang Shengxiong, Pan Chunliu, Li Jun, Wang Junhua, Feng Jun, Yang Jun, Huang Yan, Chen Hong, Zhang Binbing, Mao Yongjia
, DOI: 10.3784/jbjc.202112090631
[Abstract](115) [FullText HTML](41) [PDF 1444KB](30) [Peer reviewing opinions] Related References Share
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  Objective  To understand the epidemiological characteristics of registered pulmonary tuberculosis (TB) cases from 2010 to 2019 and predict the incidence trend from 2011 to 2012 in Guiyang, and provide evidence for the local prevention and control of pulmonary TB.   Methods  Descriptive epidemiological methods were used to analyze the pulmonary TB incidence data in Guiyang from 2010 to 2019. The spatial kernel density map of pulmonary TB patients was drawn using ArcMap 10.2, and the GM (1, 1) model was established by MATLAB to predict the pulmonary TB incidence trend from 2021 to 2022.   Results  From 2010 to 2019, the pulmonary TB registration rate in Guiyang showed a downward trend (trend χ2=698.560, P<0.001). The ratio of male to female of TB cases was 1.72∶1. The age of the cases ranged from 20 years to 64 years. The proportion of pulmonary TB registration rates in age groups >50 , >65 and >80 years showed upward trends. The positive rate of etiological test was over 50% in 2019. Most cases were farmers, accounting for 60.84%. The annual incidence peak was during March - July, and the sub incidence peak has shifted from November to September since 2013. The area distribution was uneven, and the proportion of pulmonary TB registered in Guanshanhu, Kaiyang and Nanming districts (county) showed upward trends. GM (1, 1) model predicted that the registered case numbers of pulmonary TB in Guiyang in 2021 and 2022 would be 2881.946 and 2788.933, respectively.   Conclusion  The prevention and control of pulmonary TB in key population and key areas in Guiyang should be strengthened. The prediction effect of GM (1, 1) model is well, which is suitable for predicting the incidence trend of pulmonary TB in Guiyang.
Progress towards regional measles elimination – worldwide, 2000–2020
Gong Zhenyu, Gong Xunliang
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Drug sensitivity of 105 clinical isolates of Mycobacterium abscessus to 10 antibacterial drugs
Li Wenbin, Hu Peilei, Chen Zhongnan, Chen Zhenhua, Yi Songlin, Yu Yanyan, Guo Jingwei, Liu Binbin, Wang Qiaozhi, Wan Kanglin, Tan Yunhong, Tang Xiliang
, DOI: 10.3784/jbjc.202112110637
[Abstract](41) [FullText HTML](40) [PDF 1170KB](9) [Peer reviewing opinions] Related References Share
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  Objective   To analyze the drug sensitivity of clinical isolates of Mycobacterium abscessus (M. abscessus) to 10 kinds of antibiotics and to provide reference for the treatment of M. abscessus disease.   Methods  Clinical strains of M. abscessus isolated and identified in Hunan Chest Hospital from 2019 to 2020 were collected and microporous drug-sensitive plate minimum inhibitory concentration (MIC) test was performed for detecting the susceptibility of M. abscessus to 10 antibiotics including Sulfamethoxazole, Linezolid, Ciprofloxacin, Imipenem, Moxifloxacin, Cefoxitin, Amikacin, Clarithromycin, Tobramycin and Doxycycline (Doxycycline).   Results   A total of 105 clinical isolates of M. abscessus were collected. The results showed that M. abscessus was high sensitivity to Amikacin and Clarithromycin, accounted for 98.10% and 93.33% respectively. The sensitivity of M. abscessus to linezolid was 78.10%, while the sensitivity of the other drugs was less than 50%. M. abscessus had the strongest resistance to Doxycycline, of which the resistance rate was 84.76%. The drug resistance rates of Sulfamethoxazole, Ciprofloxacin and Imipenem were also high, which were 75.24%, 74.28% and 72.38%, respectively. 96.19% (101/105) of the strains were resistant to multiple antibiotics simultaneously.   Conclusion   M. abscessus has a high rate of resistance to antibiotics. Amikacin, Clarithromycin and Linezolid can be used as the best antibiotics for clinical treatment of M. abscessus disease. It is best to carry out precise anti-infection treatment under sensitivity test.
Epidemiological characteristics and spatiotemporal distribution of brucellosis in Shandong, 2016−2020
Ma Xiujun, Li Yan, Yu Xiaolin, Yu Jianmei, Li Meijia, Wang Zaixiang, Kou Zengqiang
, DOI: 10.3784/jbjc.202101190007
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  Objective  To analyze the epidemiological characteristics and spatial clustering of brucellosis in Shandong province from 2016 to 2020, and provide evidence for effective prevention and control of brucellosis.   Methods  Based on the surveillance data of brucellosis in Shandong from 2016 to 2020, global and local spatial autocorrelation analysis methods were used to analyze the incidence data of brucellosis in Shandong from 2016 to 2020 by using software ArcGIS 10.8.   Results  A total of 14 621 cases of human brucellosis were reported in Shandong from 2016 to 2020, with an average annual incidence of 293/100 000. There were 10 438 cases in men and 4 183 cases in women. The age of the cases was 40−59 years. The Moran's I index of the reported incidence of brucellosis in Shandong from 2016 to 2020 were 0.217, 0.154, 0.252, 0.290 and 0.315, respectively (P<0.001), suggesting spatial clustering. The results of local spatial autocorrelation showed that the “high-high” clusters were mainly in the northern and central Shandong, consistent with the high incidence areas. Low-low cluster areas were mainly in Qingdao, Yantai, Weihai and other eastern coastal areas and part of western Shandong.   Conclusion  The incidence of brucellosis in Shandong showed a decreasing trend from 2016 to 2020. There was a positive spatial correlation and obvious spatial clustering of brucellosis incidence in different areas. The high clustering areas were mainly distributed in the central and northern Shandong, where the prevention and control of brucellosis should be strengthened.
Awareness of AIDS related knowledge in rural residents aged ≥50 years in Liuzhou, 2015 and 2020
Zhang Sichen, Lan Jianguo, Wei Tao, Chu Qinshu, Wang Ting, Xie Changping, Fan Yinguang
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  Objective  To compare the awareness of AIDS related knowledge in rural residents aged ≥50 years in Liuzhou, Guangxi Zhuang autonomous region, between 2015 and 2020, and provide evidence for the development of health education plan and AIDS prevention and control in Liuzhou.   Methods  By a multi-stage stratified random sampling, rural residents aged ≥50 years in Liuzhou were selected to conduct questionnaire surveys of the awareness of AIDS related knowledge in 2015 and 2020. Multivariate Logistic regression analysis was used to identify the influencing factors for the awareness of AIDS related knowledge in local rural residents in 2020.   Results  In 2015 and 2020, a total of 1,298 and 1,373 rural residents in Liuzhou were selected, respectively. The awareness rates of AIDS related knowledge of them were 24.7% and 69.5% respectively. The main sources of AIDS related knowledge in 2020 were TV (60.6%), medical staff (43.2%), radio (41.4%) and newspapers (20.8%). Multivariate Logistic regression analysis in 2020 showed that the awareness rate of AIDS related knowledge was lower in the elderly (OR=0.516, 95% CI: 0.441~0.604). The individuals with monthly personal income of 1000~<2000 yuan (OR=1.674, 95% CI: 1.173~2.389), the married (OR=2.458, 95% CI: 1.715~3.523) and those who obtained AIDS related knowledge from free health education materials and Internet had higher awareness of AIDS related knowledge.   Conclusion  In 2020, the awareness of AIDS related knowledge in rural residents aged ≥50 years in Liuzhou significantly increased compared with 2015. However, it is still necessary to strengthen the health education about AIDS in the elderly, individuals with monthly income <1,000 yuan and the unmarried/divorced/widowed.
Analysis on premarital HIV screening results in Liangshan, Sichuan, 2014−2020
Liu Lunhao, Liu Li, Zhang Linglin, Yuan Fengsun, He Fang, Zhuoma Lacuo, Hu Ying, Feng Liao, Yu Gang
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  Objective  To understand the characteristics and trends of HIV infection in general population in Liangshan prefecture of Sichuan province by analyzing the results of local premarital HIV screening results during 2014−2020.   Methods  The premarital HIV screening data in 12 counties in Liangshan during 2015−2020 were collected for the analysis on the socio-demographic characteristics, transmission route and contact history related to risk behaviors of HIV tested positive individuals.   Results  During 2014−2020, the premarital HIV positive rate in men was higher than that in women; The HIV positive rate fluctuated between 1.49% and 1.99% in men and increased from 0.89% in 2014 to 1.34% in 2020 in women. The HIV positive rate in different areas varied greatly; The HIV positive people were mainly men, and the sex ratio of HIV positive men and HIV positive women decreased from 2.08 in 2014 to 1.36 in 2020; The age of HIV positive individuals ranged from 25 to 39 years, and the proportion of those aged less than 40 years decreased. The HIV positive individuals were mainly in ethnic group of Yi, accounting for 95.49%. The HIV positive individuals were mainly illiterate. The proportion of heterosexual transmission increased from 46.50% in 2014 to 62.98% in 2020, while the proportion of injecting drug use decreased from 53.39% in 2014 to 37.02% in 2020; Men accounted for 86.53% of HIV positive people infected by injecting drug use, and there were more women infected by heterosexual transmission, accounting for 58.61%; Heterosexual transmission was mainly caused by non-marital and non-commercial sexual contacts with the proportion increasing from 48.04% in 2014 to 72.87% in 2020, followed by marital sexual contact.   Conclusion  The prevalence of HIV/AIDS in the general population of Liangshan was high. The early HIV transmission pattern was characterized by injection drug use. Since the control of injecting drug use related HIV epidemic, the HIV transmission pattern has gradually changed from injection drug use to heterosexual contact, especially non-marital non-commercial heterosexual contact, across Liangshan. It is necessary to take targeted health education and intervention measures in Yi ethnic group.
Global yellow fever update, 2020
Gong Zhenyu, Gong Xunliang
, DOI: 10.3784/jbjc.202110170549
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Microtus fuscus plague natural foci surveillance results in Sichuan, 2013−2020
Wu Chaoxue, Song Yudan, Ma Xinya, Li Guangjun, Wang Limao, WeRongjie
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  Objective  To analyze the changing trends of the natural Microtus fuscus plague foci in Sichuan province and provide reference for the prevention and control of plague.   Methods  According to “National Plague Surveillance Protocol” and “Sichuan Province Plague Surveillance Protocol”, continuous surveillance for host animals, vectors and pathogens in the natural Microtus fuscus plague foci in Sichuan were conducted. Descriptive epidemiological method was used to analyze natural Microtus fuscus plague foci surveillance data in Sichuan from 2013 to 2020.   Results  From 2013 to 2020, a total of 5007 Microtus fuscus and 283 nocturnal mice were captured. The rodent density of Microtus fuscus ranged from113.14 to 123.81perhectare. The flea infection rate was58.46%, the average flea index was 0.95, and the nest flea infection rate was 100%, the nest flea index was70.03. The main fleas seized were Chrysosphaeria gracilis and Amphiprion. A total of 25 strains of Yersinia pestis were isolated and 13 positive serum samples were detected.   Conclusion  From 2013 to 2020, the status of host animals and fleas in the natural Microtus fuscus plague foci in Sichuan were relatively stable, the epidemic of plague among animals was active, and there was a risk of spread of the epidemics in animals to humans and wider spread of plague. It is necessary to continue the plague surveillance in season when Microtus fuscusactivities are frequent..
Investigation of a norovirus infection outbreak in a kindergarten and analysis on pathogen molecular epidemiological characteristics
Zhang Hui, Li Qian, Tang Hong, Liu Jifeng, Li Siyao, Li Yan
, DOI: 10.3784/jbjc.202109150508
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  Objective   To investigate the epidemiological characteristics and identify the cause of a norovirus infection outbreak in a kindergarten of Xi′an in 2021, and the pathogen was identified by molecular typing.   Methods   Active case finding was carried out according to the definition of suspected norovirus cases, and field hygienic survey was conducted. The clinical manifestations and the distribution of the cases were described with descriptive epidemiological method, and cohort-study was used to find out the cause of this outbreak. Anal swab samples were collected from typical cases for norovirus nucleic acid detection and gene sequencing.   Results   This norovirus outbreak lasted for 3 days, and a total of 31 cases were reported, all the cases were children, with an average attack rate of 14.16% (31/219). Among them, the cases aged 4-year-old accounted for the highest proportion (93.55%, 29/31), and the class 4 of grade 1 had the highest attack rate (40.00%, 12/30). The main clinical symptoms were vomiting (100.00%), diarrhea (12.90%) and abdominal pain (6.45%). No severe cases or deaths were reported. The epidemic curve showed that the outbreak was caused by one-time same source exposure. The cohort-study showed that the risk of close exposure to vomit was 3.98 times higher than that of long-distance exposure (RR=3.98, 95% CI:2.159–7.334). The positive rate of norovirus in case samples was 61.54% (8/13). Gene sequencing and type identification indicated that the pathogen was norovirus GⅡ.3[P12].   Conclusion   This outbreak was caused by the exposure to aerosols from vomit of the index case, and the pathogen was norovirus GⅡ.3[P12] . It is necessary to strengthen the training of staff in child care settings on norovirus prevention and control, especially on emergency disposal of excreta and vomit, to prevent such epidemics.
Molecular epidemiological investigation of Anaplasma in small mammals in Yunnan, 2019−2020
Bie Shuangshuang, Zhang Yi, Shao Zongti, Wang Fan, Pu Ennian, Yao Mingguo, Li Yuqiong, He Zhihai, Du Chunhong
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  Objective  To investigate the infection status of Anaplasma spp. in small mammals in Yunnan province, and provide scientific basis for the prevention and control of anaplasmosis.   Methods  From 2019 to 2020, small mammals were captured by snap traps and rat cages in 2 counties in the west of Yunnan and 5 counties in the north of Yunnan. After morphological identification, DNA was extracted from liver and spleen tissues of small mammals, and then the 660 bp target fragment of 16S rRNA gene of Anaplasma was amplified by semi-nested PCR. The positive amplicons was sequenced, and the recovered sequence was analyzed for homology and genetic evolution.   Results  A total of 1142 small mammals belonging to 39 species, 21 genera, 8 families, 3 orders were collected, and 21 samples from the small mammals were positive by PCR (1.84%). Among of the small mammals, 14 were infected with A. phagocytophilum, 6 were infected with A. ovis and 1 was infected with A. bovis. The positive small mammals belonging to 6 species, 3 genera, 2 families, 1 order. A. phagocytophilum was detected in R. brunneusculus, R. tanezumi and R. norvegicus in Menglian and Yuanmou counties. A. ovis were detected in R. brunneusculus, R. tanezumi, N .confucianus and E. miletus in Yuanmou county. A. bovis was detected in N. coxingi in Menglian county. Statistical analysis showed that there was a statistical difference in detection rate of Anaplasma in small mammals between Menglian county and Yuanmou county, and there was a statistical difference in detection rate of Anaplasma among small mammals, the detection rate was higher in N. coxingi and R. brunneusculus. No gender, age, habitat and altitude specific differences in detection arte of Anaplasma small mammals of Rodentia were observed.   Conclusion  Many kinds of rodents in Yunnan carry a variety of anaplasmosis pathogens that can cause disease in human and domestic animals. The various hosts are mainly distributed in some areas, where the prevention and control of anaplasmosis in local people and livestock should be strengthened.
Impact of COVID-19 epidemic on incidences of notifiable communicable diseases in Guangzhou, 2020
Zhou Qin, Li Hailin, Liu Yuan, Hu Wensui, Dong Zhiqiang, Liu Wei, Hou Jianrong, Yang Zhicong.
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  Objective  To analyze the impact of COVID-19 epidemic on the incidences of notifiable communicable diseases in Guangzhou in 2020.   Methods  The data from National Communicable Disease Reporting Information System were used for a descriptive analysis on the incidences of reported notifiable communicable diseases in Guangzhou at four periods of COVID-19 epidemic in 2020 (pre-response period: January 1–January 22; the first level response period: January 23–February 23; the second level response period: February 24–May 8; the third level response period: May 9–Dec 31). The result was compared with the average levels during the same periods of 2015–2019. Software R3.5.0 was used for statistical analysis.   Results  The reported incidence rates of notifiable communicable diseases in the four periods in Guangzhou in 2020 were 272.38/100 000, 51.16/100 000, 130.34/100 000 and 664.25/100 000, respectively. The incidence rate increased by 187.76% and decreased by 30.37%, 57.64% and 41.85%, respectively, compared with the average levels during the same periods of 2015–2019, especially the incidence rate of class C communicable diseases. The incidences of all kinds of communicable diseases in class A and B with different transmission routes decreased significantly after the start of the first level response, and decreased slowly in the second and third level response periods except natural focal diseases and vector-borne diseases, but the incidences of blood borne and sexual transmitted disease showed increases during the second and third response periods. The incidence rate of acute communicable diseases, such as influenza, decreased significantly after the start of the first level response and further decreased after the start of the second level response. However, the incidences of chronic communicable diseases, such as HIV/AIDS, syphilis and hepatitis B, showed decrease after the implementation of first level response, but showed less decrease during the second and third level response periods.   Conclusion  During the COVID-19 epidemic in Guangzhou in 2020, the incidences of reported notifiable communicable diseases decreased significantly, especially the incidences of acute communicable diseases, such as influenza, and such decreases could be found even in the late stage of the epidemic. The declines of the incidences of chronic communicable diseases were obvious in the early stage of the epidemic, but the incidences showed less decreases, became stable and increased slightly in the late stage of the epidemic.
Partial biological characteristics and genomic analysis of Vibrio cholerae typing phage VP2
Sun Huihui, Fan Yufeng, Li Zhenpeng, Zhao Shuo, Wang Xiaoxun, Pang Bo, Kan Biao
, DOI: 10.3784/jbjc.202105190282
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  Objective  This study aimed to further understand the genetic information of VP2 by analyzing the whole genome of Vibrio cholerae typing phage VP2, and analyzing the protein of mature particles in combination with biological characteristics.  Methods  The morphology of phage VP2 was observed under electron microscope, and some of its biological characteristics were determined. Online RAST (https://rast.nmpdr.org/) was used to predict and annotate the encoding genes of the phage VP2 genome, and the proteins in the mature VP2 particles were analyzed by mass spectrometry. Phage genome average nucleotide consistency (ANI, business, nucleotide identity) was analysis by pyani (https://github.com/widdowquinn/pyani).  Results  Phage VP2 was a typical 20-hedron short-tailed phage, the optimal MOI is 0.01. One step growth curve showed that incubation period is about 60 minutes, 60 minutes to 120 minutes for the outbreak period, after 120 minutes for the stable period. Forty-nine open reading frames (ORFs) were predicted. Protein spectrum analysis of mature VP2 particles showed that 34 proteins corresponded to the predicted genes. ANI cluster analysis showed that ANI was the highest in VP2 and vibro phage CJY.  Conclusion  The morphological and genomic characteristics of typing phage VP2 were identified, which laid a foundation for the further study of homologous phage and its interaction with Vibrio cholerae.
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.
Meeting of the WHO Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH), June 2020 Conclusions and advice—Gong Zhenyu(Selective Translation), Gong Xunliang(Reviser)
Gong Zhenyu, Gong Xunliang
, DOI: 10.3784/jbjc.2021
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Summary of global surveillance data of infectious diseases in May 2021
Han Hui, Wu Bo, Wu Hailei, Zhang Jin, Jia Jiaojiao
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In May 2021, a total of 67 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 (30), measles (29), poliomyelitis (15) and malaria (9). The top five infectious diseases with highest case fatality rates were Ebola virus disease (52.2%), Middle East respiratory syndrome (34.4%), lassa fever (20.3%), plague (6.0%) and Crimean-Congo hemorrhagic fever (5.3%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, measles, dengue fever 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 Rift valley fever, the prevalent infectious diseases in America were COVID-19 and dengue fever, the prevalent infectious disease in Europe was COVID-19.
Chinese reference list of core health indicators
, DOI: 10.3784/jbjc.202011300402
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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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《疾病监测》杂志稿约
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cover
cover
2022, 37(5).
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contents
contents
2022, 37(5): 1-3.
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Epidemic Bulletin
2022年4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 April 2022
2022, 37(5): 565-565. DOI: 10.3784/jbjc.202205160218
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2022年4月中国甲乙丙类传染病疫情动态概要
2022, 37(5): 566-567. DOI: 10.3784/jbjc.202205160217
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Summary of global surveillance data of infectious diseases in April 2022
Han Hui, Wu Bo, Jia Jiaojiao, Song Yueqian
2022, 37(5): 568-570. DOI: 10.3784/jbjc.202205230229
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In April 2022, a total of 69 infectious diseases were reported globally, affecting 232 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (232), dengue fever (29), measles (25), cholera (11) and leptospirosis (9). The top five infectious diseases with highest case fatality rates were Ebola virus disease (100.0%), Crimean-Congo hemorrhagic fever (40.0%), Middle East Respiratory Syndrome (34.4%), Lassa fever (19.3%) and monkeypox (5.3%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, dengue fever, cholera and measles. The prevalent infectious diseases in Asia were COVID-19 and dengue fever, the prevalent infectious diseases in Africa were COVID-19, Ebola virus disease, cholera, yellow fever, Lassa fever, malaria and measles, the prevalent infectious diseases in America were COVID-19, dengue fever, chikungunya fever and Zika virus disease, the prevalent infectious disease in Europe were COVID-19 and acute hepatitis of unknown aetiology.
Risk Assessment
Risk assessment of public health emergencies concerned in the mainland of China, May 2022
Wei Yinong, Yuan Yuan, Meng Ling, Tu Wenxiao, Xiang Nijuan, Shi Guoqing
2022, 37(5): 571-573. DOI: 10.3784/jbjc.202205130216
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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 May 2022.   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   It is expected that the overall situation of COVID-19 in China will continue to be stable and eased in May. Although the risk of the situation worsening may still exist. Considering the potential risks, it is still necessary to quicken local epidemic response, to optimize prevention and control measurement in time and to get fully prepared before the epidemic starts. It is also expected that toxic mushroom poisoning events will gradually increase since May. Acute and severe hepatitis of unknown origin in children are reported in U.K. and multiple other countries, whose further related surveillance and research progress need to be tracked.   Conclusion   Special attention should be paid to COVID-19. General attentions should be paid to toxic mushroom poisoning events.
Risk assessment of global COVID-19 pandemic in April 2022
Li Jie, Wu Jiewen, Pang Mingfan, Fang Yuansheng, Ji Hanran, Yang Xinping, Liang Zuoru, Zhang Rongna, Zhao Qing, Qi Xiaopeng
2022, 37(5): 574-578. DOI: 10.3784/jbjc.202205230235
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  Objective   To assess the global epidemic of Coronavirus disease 2019(COVID-19) in April 2022 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 neighbouring countries. The assessment results for each country are expressed as “countries of global concern”, “countries of the general concern in each WHO sub-region” and “neighbouring countries of special concern”.   Results  Compared with March 2022, the global monthly new confirmed cases dropped by 45.55%, and the global monthly new deaths dropped by 48.28%. Compared with March, except for the 18.4% increase in newly confirmed cases in the Americas (North) region, the new confirmed cases in April all declined, with a decline ranging from 35.3% to 65.6%, with the largest decline in the Eastern Mediterranean region; The number of new deaths decreased in all regions, ranging from 26.6% to 76.8%, with the largest decline in the Americas region (South).   Conclusion   The global daily newly confirmed cases and deaths showed an overall downward trend in April, but the epidemic situation in the Americas (North) region is still aggravating, and the number of newly confirmed cases and deaths is still increasing, which should be paid special attention to, timely communicate and adjusted measures.
Experiment Research
Evaluation of the probiotic properties of Bacteroides vulgatus Bv46
Qiao Lei, Xu Mingchao, Lin Xiaoying, Zhang Suping, Zhang Gui, Yang Jing, Sun Hui, Liu Liyun, Xu Jianguo
2022, 37(5): 579-584. DOI: 10.3784/jbjc.202202280075
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  Objective  To evaluate probiotic potential of Bacteroides vulgatus Bv46.   Methods  The Bv46 strain was tested on their tolerance to artificial gastric juices and bile salts. The Bv46 was assessed the hemolytic activity, antimicrobial susceptibility and gelatinase activity. Moreover, the probiotic properties of Bv46 were evaluated about auto-aggregation, hydrophobicity, adhesion to HT-29 cells, antimicrobial activity against pathogens, acid production and antioxidant properties.   Results  It was 59.55% and 63.76% to the survival rates of Bv46 isolated from healthy people in simulated gastric juice and 0.3% bile salts respectively. Bv46 showed no haemolytic and gelatinase activities, and were only resistant to ampicillin and penicillin G. Bv46 showed medium auto-aggregation ability, but high hydrophobicity and medium adhesion to HT-29 cells. Moreover, Bv46 inhibited the growth of pathogenic Escherichia coli and Salmonella typhimurium. Furthermore, Bv46 produced short-chain fatty acids, and had antioxidant effects.   Conclusion  The Bv46 is a potential probiotic.
Regulation of VfqI-VfqR Quorum sensing circuit on vgrG operon in VflT6SS orphan cluster of Vibrio fluvialis
Han Yu, Huang Yuanming, Cheng Qian, Li Jie, Diao Baowei, Liang Weili
2022, 37(5): 585-590. DOI: 10.3784/jbjc.202203180100
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  Objective  To explore the regulation of the vgrG operon in the VflT6SS2 orphan clusters by the Quorum sensing system VfqI-VfqR of Vibrio fluvialis.   Methods  Quantitative reverse transcription PCR was used to detect the relative expression of vgrG mRNA level in wild V. fluvialis strain and VfqI-VfqR system deletion mutant strains. Luminescence of promoter-lux fusion was measured to determine the vgrG promoter activity in wild V. fluvialis strain, derivative mutants and corresponding complemented strains. VfqR-overexpressed plasmid was introduced into Escherichia coli, the luminescence of vgrG promoter-lux fusion was compared to determine the direct effect of VfqR on vgrG operon activation.   Results  The vgrG mRNA and its promoter activity significantly decreased in the VfqI-VfqR deletion mutants compared with wild V. fluvialis strain. Furthermore, the vgrG promoter activity of ∆vfqR was restored either with trans-complemented plasmid or supplemented with exogenous 3-oxo-C10-HSL, C10-HSL or 3-oxo-C12-HSL AHL molecules. The effects of the three AHLs were similar. However, overexpression of VfqR combined with addition of AHLs had no effect on the promoter activity of vgrG in E. coli.   Conclusion  The VfqI-VfqR system is one of positive regulators of vgrG operator indirectly tuning the activation of its promoter.
Prediction and analysis of mobile gene elements in Vibrio fluvialis
Huang Yuanming, Li Zhenpeng, Cheng Qian, Han Yu, Liang Weili
2022, 37(5): 591-597. DOI: 10.3784/jbjc.202203180102
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  Objective  To evaluate the types and distribution of mobile gene elements (MGEs) in the genome of Vibrio fluvialis and investigate their significance for the adaptive evolution of V. fluvialis.   Methods  The publicly available genomes of 170 V. fluvialis strains were downloaded from NCBI SRA database, and MGEfinder was used to identify the MGEs in the genomes of V. fluvialis, and the diversity, insertion activity, distribution and virulence genes of MGEs were studied.   Results  A total of 1 227 MGEs were identified in 170 strains of V. fluvialis, including intact phage, questionable/incomplete phage, insertion element (IS element), group II intron, serine/tyrosine recombinase, containing CDS and TIR, coding gene sequences (CDS) and open reading frame-free sequences (No CDS). Among the 317 unique insertion clusters, 307 had low transposition activity, but the MGEs with high transposition activity were distributed more widely in V. fluvialis. The functions of coding genes carried by MGEs mainly involved gene duplication, duplication, repair, and gene transcription. The distribution of MGEs had no difference between environmental and clinical isolates of V. fluvialis. A variety of virulence factors were identified in four MGEs, including insertion elements, serine/tyrosine recombinase, containing CDS and TIR, and coding gene sequences, and the virulence factors carried by different MGEs were different.   Conclusion  V. fluvialis possess various types and functions of MGEs and exhibits adaptive evolutionary characteristics dominated by MGEs with high transposition activity.
Infectious Disease Surveillance
Characteristics of multiple infections of influenza in Beijing during 2017–2020 influenza seasons
Wang Chao, Gao Yanlin, Shi Yunping, Liu Yang, Hu Xiao, Xie Chunyan, Zhou Ying, Li Wei, Li Gang
2022, 37(5): 598-602. DOI: 10.3784/jbjc.202108230462
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  Objective  To analyze the proportion and epidemiological characteristics of multiple infections of influenza in Beijing during 2017−2020 influenza seasons.   Methods  The composition and distribution of multiple infection cases were analyzed by using the surveillance data of influenza in Beijing from 2017 to 2020.   Results  During 2017−2020 influenza seasons, 18637 multiple infections were reported (accounting for 4.13%), and the proportion of multiple infections in a single influenza season ranged from 0.10% to 0.93%. The trend of multiple infection cases was consistent with the change of the total number of influenza. There were five peaks of reinfection on the 120th, 285th,375th,450th and 725th day since the first infection. Univariate analysis found that there were significant differences in the proportion of multiple infections among gender, age groups, occupation and living districts. And the proportion of multiple infections was higher in male, 12 years old and below, nursery children, scattered children, healthcare providers and students, Chaoyang, Haidian, Changping, Xicheng and Tongzhou districts.   Conclusion  There were many multiple influenza infections in Beijing, and great differences in multiple infections could be found at different times, regions and populations.
Epidemiological and etiological characteristics of hand foot and mouth disease in Liuzhou, Guangxi, 2014−2018
Zhou Wanwan, Chen Weien, Liang Zhongfu, Yang Jun, Xie Yihong
2022, 37(5): 603-608. DOI: 10.3784/jbjc.202108160445
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  Objective  To understand the epidemiological and etiological characteristics of hand foot and mouth disease (HFMD) in Liuzhou, Guangxi, from 2014 to 2018, and provide evidences for the prevention and control of HFMD.   Methods  Descriptive and spatial analyses were used to analyze the epidemiological characteristics of HFMD in Liuzhou. Global and local spatial autocorrelation analysis was used to analyze the spatial clustering of HFMD. The trend surface analysis was used to evaluate the spatial distribution trend of HFMD, and the annual etiological test results of HFMD were analyzed.   Results  The annual average incidence rate of HFMD was 821.59/100 000 in Liuzhou from 2014 to 2018. Most cases were aged 0–5 years (95.90%), and 64.58% of them were children outside child care settings. The incidence rate and severe case number of HFMD showed decline trends from 2014 to 2018 (P<0.01), and the epidemic season was from April to July and September to November. EV71 and other enteroviruses were the main pathogens in 2014. Other enteroviruses were the main pathogens in 2015 and 2017 (>80%). Cox A16 was the main pathogen in 2016 and 2018, followed by other enteroviruses, and EV71 accounted for a relatively low proportion. There was spatial clustering with hot spots in the southern part of Liuzhou and cold spots in Rongshui Miao autonomous county. The high-incidence areas were in Liunan, Yufeng, Liubei, Chengzhong districts, and Labao, Luzhai, Luorong, Sandu, Jinde, Chengtuan, Shatang, Sipai and Guyi townships. The trend surface analysis showed that the incidence of HFMD increased gradually from north to south, and from east and west to central area.   Conclusion  HFMD mainly occurred in children under 5 years old in Liuzhou with the seasonal incidence peaks in summer and autumn, and had obviously spatial clustering distribution. The predominant pathogens were different in different years. It is necessary to further explore the risk factors in high-risk areas to provide scientific evidences for the development of HFMD prevention and control strategies and the allocation of public health resources.
Epidemiological characteristics of rabies in China, 2020
Liu Min, Liu Zhengran, Tao Xiaoyan, Zhu Wuyang
2022, 37(5): 609-612. DOI: 10.3784/jbjc.202109080483
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  Objective   To analyze the epidemiological characteristics of rabies in China in 2020 and provide scientific evidence for the development of prevention and control policies in the next stage.   Methods   The incidence data of rabies from National Notifiable Disease Reporting System (NNDRS) in 2020 and the national surveillance data were collected for a descriptive analysis.   Results   A total of 202 cases of rabies cases were reported in 21 provinces (municipalities and autonomous regions) in 2020, and the incidence rate decreased by 30.34% compared with 2019. The rabies cases were mainly distributed in the central and southern China, the cases reported in 4 provinces with high case number, i.e. Hunan (59 cases), Henan (27 cases), Sichuan (20 cases) and Jiangsu (17 cases), accounted for 60.89% of the total cases in China. The incidence was highest in August, and lowest in April. The majority of rabies cases were farmers, and the male-to-female ratio of cases was 1.93∶1, and the majority of the cases were middle-aged and elderly. The data of 85 cases were collected for case analysis. The results showed that dogs were the main animals attacking human (97%), nearly 60% of the dogs were domestic dogs, including the self-raised and neighbor-raised, and most of them caused human injuries through active attack and bite. Up to 65% of the cases had grade Ⅲ exposure, the upper limbs was the main exposure site, and 66% of the wounds were untreated; Eight patients with grade Ⅲ exposure were vaccinated (5 of them were injected with passive immune agents), but they died before completing the whole course of vaccination; The incubation period of most cases was less than one year.   Conclusion   The incidence of rabies continued to decrease significantly in 2020 based on the consecutive decline for 13 years, but the incidences in Hunan, Henan and other provinces were still higher, to which close attention needs to be paid. It is necessary to strengthen the management and immunization of dogs, especially rural dogs, and conduct the management of cats to maintain the achievements in the prevention and control of rabies.
Characterization of clinical isolates of Vibrio parahaemolyticus in HuZhou, Zhejiang, 2019−2020
Xu Deshun, Yan Wei, Ji Lei
2022, 37(5): 613-617. DOI: 10.3784/jbjc.202107050384
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  Objective  To understand the characteristics of Vibrio parahaemolyticus isolated from diarrhea patients in Huzhou, Zhejiang province, from 2019 to 2020.   Methods  A total of 109 strains of V. parahaemolyticus isolated from patients with diarrhea in Huzhou from 2019 to 2020 were collected for serological typing. Virulence genes were detected by fluorescence PCR. Drug resistance was detected by broth dilution method, and molecular typing was performed by pulsed-field gel electrophoresis (PFGE).   Results  The predominant serotype of the 109 clinical strains was O3∶K6 (72 strains). All the strains carried gene tlh, and only two of them carried trh. There were 108 strains which were divided into 72 PFGE types by Not Ⅰ enzyme, and the similarity coefficient between different types was 19.10%–100%. The antibiotic resistance test indicated that the isolates were highly resistant to sulfamethoxazole (63.30%), followed by ampicillin (49.54%).   Conclusion  Strengthening the continuous surveillance for V. parahaemolyticus in diarrhea patients can facilitate the risk assessment of foodborne illnesses caused by V. parahaemolyticus and provide reference for the prevention, control and clinical treatment of intestinal infection.
Analysis of sex ratio of newly reported people living with HIV/AIDS aged ≥50 years and infected through heterosexual contact in China, 2015−2019
Chen Fangfang, Ma Kaifang, Zhang Xiaoting, Ge Lin, Cai Chang, Qin Qianqian, Tang Houlin, Li Dongmin
2022, 37(5): 618-622. DOI: 10.3784/jbjc.202201250018
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  Objective  To understand sex ratio of newly reported people living with HIV/AIDS (PLWHA) aged ≥50 years and infected through heterosexual contact in China during 2015 and 2019.   Methods  The data of newly reported PLWHA aged ≥50 years and infected through heterosexual contact in China from 2015 to 2019 were collected from the China Information System for Disease Control and Prevention. Sex ratios of the PLWHA were analyzed in terms of diagnosis age and infection mode.   Results  From 2015 to 2019, the number of newly reported PLWHA aged ≥50 years and infected through heterosexual contact increased from 29 765 to 60 591. Among them, the proportion of those infected through sex with spouse/regular partners decreased from 12.7% to 10.6%, while the proportions of those infected through commercial and non-commercial casual sex remained at high levels (46.0% and 39.5% averagely). Τhe sex ratios of the PLWHA increased from 1.8 in 50−59 year age group to 2.5 in 60−69 year age group and 6.8 in ≥70 year age group. With the increase of diagnosis age, sex ratios of the PLWHA infected through commercial and non-commercial casual sex increased from 10.4 and 1.1 in 50−59 year age group to 58.7 (Z=38.31, P<0.001) and 3.4 (Z=51.49, P<0.001) in ≥70 year age group respectively, but the sex ratio of those infected through sex with spouse/regular sexual contact remained at 0.2−0.4.   Conclusion  In China, the differences in sex ratio existed in the reported PLWHA aged ≥50 years and infected through heterosexual contact in different age groups and infection mode groups. It is suggested to expand HIV testing, treatment and integrated behavioral intervention for high-risk populations, and utilize molecular epidemiology to explore HIV transmission chain in people aged ≥50 years to improve the efficiency of case detection.
Infection status and genetic characteristics of adenovirus in patients with acute exacerbation of chronic obstructive pulmonary disease
Chen Ping, Xu Yuanyou, Yang Yanqing, Du Haijun, Mei Guoyong, Xia Zhiqiang, Dong Hongming, Han Jun, Lu Guoyu
2022, 37(5): 623-628. DOI: 10.3784/jbjc.202112230655
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  Objective  To investigate the respiratory tract virus infection and the characteristics of adenovirus infection in patients with acute exacerbation of chronic obstructive pulmonary disease (AECOPD).   Methods  From November 2020 to April 2021, throat swabs from the severe patients with AECOPD in a class III hospital in Bengbu, Anhui province, were collected. Real-time fluorescent quantitative PCR (qPCR) was used to detect 16 common respiratory viruses, including adenovirus (ADV). The hexon genes of ADV were amplified followed with the phylogenetic analysis.   Results  The detection rate of respiratory viruses was 38.38% (109/284), and the detection rate of ADV was highest (27.81%, 79/284) in these AECOPD patients. ADV infection was mainly caused by subtype C1 virus, and there were multi subtypes such as B, C and D. Combined with clinical data, the AECOPD patients infected with ADV had a longer course of disease and poorer prognosis compared with the AECOPD patients without ADV infection.   Conclusion  Effective monitoring of respiratory virus infection in AECOPD patients should be carried out in clinical practice to improve the clinical diagnosis and treatment.
Investigation of incidence of febrile respiratory illness and related hospital visits in local residents aged 15 years or older in Shunyi district, Beijing, 2020
Liu Caixiong, Chen Wei, Zhang Wenzeng, Lin Shenghong, Huang Shuo, Deng Yuan, Zhang Cuihong, Zhang Lijie, Peng Zhibin, Wang Liping
2022, 37(5): 629-634. DOI: 10.3784/jbjc.202111230608
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  Objective  To understand the incidence of febrile respiratory illness (FRI) and relate4d hospital visits in local residents aged ≥15 years in Shunyi district, Beijing, in 2020.   Methods  The catchment area of Shunyi Hospital was used as the investigation area, and multi-stage sampling was conducted to select local residents aged ≥15 years for an online survey. The incidence rate of FRI and related hospital visit rate were calculated and adjusted according to the population composition in Shunyi. The differences in incidence rate and related hospital visit rate among the residents with different characteristics were compared. Univariate and multivariate logistic regression analyses were conducted to explore the factors influencing the hospital visits.   Results  A total of 2723 local residents aged ≥15 years in Shunyi were surveyed. In 2020, the self-reported incidence rate of FRI was 13.5% and then adjusted to 12.8%. There were significant differences in FRI incidence among the residents with different occupations, self-reported health status and history of underlying disease (P<0.05). Of the residents who reported FRI, 221 visited hospitals, the hospital visit rate was 60.2% and then adjusted to 57.7%. The multivariate Logistic regression study revealed that age, occupation, underlying disease and post-illness symptoms (chill and dry cough) were the main influencing factors of hospital visits   Conclusion  In the context of global COVID-19 pandemic and fighting against imported and reemerged COVID-19 in China, the incidence of FRI in the local residents in Shunyi was high and related hospital visit increased significantly. The results of this study can be used as reference for the disease burden evaluation, prevention and control of FRI.
Risk factors and clinical characteristics of macrolide resistance Moraxella catarrhalis pneumonia
Jiang Yan, Wang Jing, Qin Tian, Lian Xingxing, Tang Ruizhi, Lu Zhongxin, Xu Jianguo
2022, 37(5): 635-640. DOI: 10.3784/jbjc.202111230604
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  Objective  To explore the clinical characteristics and risk factors of macrolide resistance Moraxella catarrhalis (MRMC) pneumonia.   Methods  From January 2013 to January 2022, the information of 32 patients with MRMC pneumonia and 114 patients with macrolides sensitive Moraxella catarrhalis (MSMC) pneumonia were retrospectively analyzed.   Results  The patients with Moraxella catarrhalis pneumonia were mainly men (71.92%) and aged ≥65 years (67.12%). The incidence rate was high in winter and spring (64.38%). Multivariate logistic regression analysis showed that being woman (OR=2.77, 95% CI: 1.18–6.47) and the history of tuberculosis (OR=5.95, 95% CI: 1.31–31.57) were independent risk factors for MRMC pneumonia. The percentage of patients with fever (OR=2.87, 95% CI: 1.09–7.46), abnormal C-reactive protein (OR=2.65, 95% CI: 1.12–6.63), bronchitis (OR=4.00, 95% CI: 1.54–11.52), and emphysema (OR=5.73, 95% CI: 1.94–19.56) increased significantly in the MRMC group compared with the MSMC group.   Conclusion  Being woman and the history of tuberculosis were independent risk factors for MRMC pneumonia, and patients in the MRMC group had more severe symptoms, inflammation and pulmonary imaging manifestations, suggesting that attention should be paid to the clinical diagnosis and treatment of MRMC pneumonia.
Technology and Method
Culture and real time-PCR in detection of Helicobacter pylori in gastric antrum mucosal specimen
Yang Yaming, He Lihua, Yang Ningmin, Gong Yanan, Han Xiurui, Fan Ruyue, Xue Zhijing, Wei Yongyue, Zhang Jianzhong
2022, 37(5): 641-645. DOI: 10.3784/jbjc.202112020618
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  Objective   To evaluate the consistency of two diagnostic methods (isolation culture and real time-PCR) that are commonly used in detection of Helicobacter pylori (H. pylori) in gastric antrum mucosal specimen.   Methods  Four hospitals in Xiaoshan, Wenling, Cangnan, and Huzhou in Zhejiang province were selected. From November 16, 2020 to December 7, 2020, a total of 1 312 gastric antrum mucosal specimens were collected from the four hospitals and submitted to Zhiyuan Medical Laboratory in Hangzhou. Each specimen was processed in duplicate and subjected to H. pylori isolation and real time-PCR detection (cagH as target) in a parallel and double-blind manner. Pearson's χ2 test, Fisher's exact test, McNemar's paired χ2 test, independent-sample t-test, and other related statistical methods were used to analyze the consistency of the two methods and the differences among the four hospitals.   Results  The H. pylori positive rate of culture was 29.34% (385/1 312) and the H. pylori positive rate of real time-PCR was 28.51% (374/1 312), the difference was not significant (P=0.636). The positive rates of the two methods had no significant difference among the specimens from four hospitals respectively (P>0.05), and the Kappa values were 0.84, 0.89, 0.75, 0.91 and 0.85 in the specimens from Xiaoshan, Wenling, Cangnan, Huzhou hospitals and in all specimens, respectively. The sensitivity and specificity of the real time-PCR were 89.26% and 100.00%. Among the real time-PCR single positive samples, the range of Ct value was from 25.47 to 34.97, with a mean value of 30.90. There were 90% Ct values no more than 34.46 and the highest frequency group was the 29.00–30.00 group.   Conclusion  Both the cultural and real time-PCR could achieve high detection efficacy in the detection of H. pylori in clinical gastric antrum mucosal specimen. The results of both methods had good consistency, and each single method had good reliability. The content of H. pylori in specimen and specimen transportation method might have significant effects on results.
Development and application of loop-mediated isothermal amplification combined with nanoparticle-based lateral flow biosensor for rapid detection of Leptospira interrogans serogroup icterohaemorrhagiae
Wang Yi, Yang Xinggui, Liu Ying, Huang Junfei, Wang Ming, Ying Xia, Tan Qinqin, Hu Yong, Li Shijun
2022, 37(5): 646-651. DOI: 10.3784/jbjc.202108030429
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  Objective  To develop and evaluate a rapid detection assay for Leptospira interrogans serogroup icterohaemorrhagiae based on loop-mediated isothermal amplification (LAMP) combined with nanoparticle-based lateral flow biosensor (LFB).   Methods  The LAMP primers targeting the glycotransferase gene (gtf) in the O-antigen gene cluster of L.serogoup icterohaemorrhagiae were designed. After specific label of primers (FIP-FAM and LF-Biotin) and condition optimization, we evaluated the sensitivity, specificity and feasibility of gtf-LAMP-LFB assay. A total of 53 strains of Leptospira were identified by using LAMP-LFB assay, PCR and microscopic agglutination test (MAT), and the results were analyzed to evaluate the practicality of LAMP-LFB assay.   Results  Our data showed that the detection limit of the assay was 100 fg/μL for genomic DNA of reference strain of L. icterohaemorrhagiae (56601), and the specificity was 100% because there were no cross reactions with nucleic acids of other Leptospira serogroups and non-Leptospira strains. For the application examination, LAMP-LFB and MAT identification results were completely consistent, while the sensitivity of LAMP-LFB assay was higher than PCR. In addition, the color of CL and TL bands could be observed directly to determine the results by using LFB to detect LAMP amplicons.   Conclusion  The LAMP-LFB assay developed based on LAMP technique has high repeatability, sensitivity and specificity, which can be used for the rapid and accurate identification of the strains of L.interrogans serogroup icterohaemorrhagiae, and can be used as a potential screening and diagnosis tool for L.interrogans serogroup icterohaemorrhagiae.
Prediction of incidence of pulmonary tuberculosis in Zhejiang based on autoregressive integrated moving average model
Mao Rong, Wang Yuanhang, Ge Rui
2022, 37(5): 652-656. DOI: 10.3784/jbjc.202109240520
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  Objective   Autoregressive integrated moving average (ARIMA) model was used to predict the incidence of pulmonary tuberculosis (TB) in Zhejiang province to provides scientific basis for the precise prevention and control of pulmonary TB.   Methods  The monthly incidence rate of pulmonary TB in Zhejiang from January 2011 to August 2021 was collected. Software R (4.0.3) was used to build the ARIMA model based on the incidence rate of TB from 2011 to 2020. The model prediction was compared with the actual data from January to August in 2021 to select some optimal models.   Results  A total of new 374718 pulmonary TB cases were reported in Zhejiang from January 2011 to August 2021 was, showing a decrease trend. The incidence rate was relatively lower from December to February and relatively higher from March to May. The optimal model was ARIMA (2, 1, 0) (1, 1, 2)12. The mean relative error (MRE) between the predicted value and the actual value of the incidence of pulmonary TB in Zhejiang from January to August in 2021 fitted by this model was 8.87%. The values of AIC, BIC, RMSE and MAPE were 95.02, 111.05, 0.30, and 4.39, respectively.   Conclusion  The ARIMA (2, 1, 0) (1, 1, 2)12 model can fit and predict the incidence trend of pulmonary TB in Zhejiang, but it needs to be adjusted dynamically according to the actual situation to improve the prediction accuracy.
Establishment and evaluation of internal control of multiplex quantitative PCR for detection of Yersinia pestis
Li Bo, Cui Yan, An Jing, Guliayi·Baokaixi, Luo Yongjun, Wang Xinhui, Li Wei, Wang Xiaojun
2022, 37(5): 657-660. DOI: 10.3784/jbjc.202103230145
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  Objective  To establish an internal control of multiplex quantitative PCR for the detection of Yersinia pestis and evaluate its effect.   Methods  A multiplex quantitative PCR system was established using the YPO0393 gene of the chromosome of Y. pestis and caf1 gene of plasmid pMT1 as the target gene. The internal control was YPO0393. Specific primers and probes were designed. Detection was performed for DNA of the control, Y. pestis and field samples. The specificity, sensitivity and repeatability of this assay were evaluated.   Results  All the 8 DNA samples of Y. pestis at different concentrations showed significant S-curve amplification. The DNA of 12 controls showed no amplification curve, suggesting that the multiplex quantitative PCR was specific. The detection sensitivity of the multiplex quantitative PCR was 22.5×10−4 ng/μL, and the coefficient of variation ranged from 0.99 to 3.42 for the EV76 strain of Y. pestis, indicating good sensitivity and repeatability. In the 105 field samples, 6 were determined as positive by the multiplex quantitative PCR, which was consistent with routine PCR. Y. pestis was isolated from 4 positive field samples.   Conclusion  The multiplex quantitative PCR has high specificity, sensitivity and repeatability by using the YPO0393 gene as internal control, by which the false negative rate can be reduced. Therefore, this assay can be applied in the rapid detection of Yersinia pestis.
Drug Resistance Monitoring
Antibiotic resistance and multi-locus sequence typing of non-O157 Shiga toxin-producing Escherichia coli from livestock in Dongtai, Jiangsu
Han Yue, Han Ying, Liu Minqi, Dong Chen, Jin Hui
2022, 37(5): 661-667. DOI: 10.3784/jbjc.202112060625
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  Objective  To investigate and characterize the antibiotic resistance, antibiotic resistance genes, and multi-locus sequence typing (MLST) of non-O157 Shiga toxin-producing Escherichia coli (STEC) isolated from livestock in Jiangsu.   Methods  In May 2019, a total of 301 stool samples, including 231 sheep stool samples and 70 cattle stool samples, were collected in Dongtai of Jiangsu province for the isolation of non-O157 STEC. The modified micro broth method was used to determine the minimum inhibitory concentration (MIC) of 21 antibiotics to the isolates. The serotypes, antibiotic resistance genes and MLST of the isolates were analyzed by whole-genome sequencing (WGS).   Results  The drug sensitivity test showed that of the 68 non 157-STEC strains, 32 were at least resistant to one antibiotic. It was found that STEC showed the highest resistance rate to tetracycline (42.6%), followed by azithromycin (36.8%), trimethoprim-sulfamethoxazole (TMP/SMX) (35.3%), streptomycin (32.3%), chloramphenicol (30.9%) and ciprofloxacin (29.4%). A total of 25 AMR genes were identified. The majority of STEC isolates carried the antibiotic resistance genes associated with aminoglycoside (44.1%), TMP/SMX (44.1%), and tetracycline (42.6%). MLST showed that the isolates were divided into 13 sequence types (STs), among which ST43 (19.1%) and ST155 (16.2%) had higher proportions. The minimum spanning tree (MST) indicated that most STEC strains with the same serotypes were clustered together. Four STs of STEC strains, including ST25, ST40, ST43 and ST675, were clustered with HUSEC strains.   Conclusion  The antibiotic resistance of non-O157 STEC in livestock is complex, and there are multi-drug resistant strains. In addition, STEC strains in this area pose a potential threat to the population, and close attention needs to be paid to livestock, as an important host of non-O157 STEC.
Analysis on antibiotic resistance and staphylococcal chromosome cassette mec of 166 strains of Staphylococcus epidermidis isolating from early pregnancy cervical swabs
Wang Hengwei, Yang Lin, Hao Min, Shao Xifeng, Song Yanyan
2022, 37(5): 668-673. DOI: 10.3784/jbjc.202109010476
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  Objective  To analyze the antimicrobial resistance, distribution of resistance genes and staphylococcal chromosome cassette mec (SCCmec) typing in 166 strains of Staphylococcus epidermidis isolated from early pregnancy cervical swabs in Chaoyang district of Beijing during 2015–2017, and provide evidence for rational medication and infection prevention.   Methods  A retrospective analysis on antibiotic resistance of 166 strains of S. epidermidis isolated from early pregnancy cervical swabs in Chaoyang during 2015–2017 was conducted. K-B disk diffusion method was used to detect the susceptibility to cefoxitin. Microbroth dilution method was used to detect the susceptibility to 11 antibiotics. PCR was performed to detect drug resistance genes to erythromycin, quinolone, sulfa, aminoglycoside, macrolide and tetracycline and the genotypes and subtypes of all currently described SCCme. SPSS 22.0 was used for data analysis.   Results  The results showed that the sensitivity rate of 166 strains of S. epidermidis was 100% to vancomycin and 93.37% to daptomycin. The resistance rates to penicillin, oxacillin and erythromycin were above 90%, and the resistance rates to other antibiotics were different. For the 166 strains, the multi-drug resistance rate was 72.89%, the detection rate of mecA gene was 45.78%. The carriage rates of resistance genes norA1 (100%) and norA2 (95.78%) were highest, followed by msrA (71.08%). Among 76 strains of mecA gene-positive S. epidermidis, the major genotype was SCCmecⅢ (40.79%), followed by SCCmeⅤ (22.37%) .   Conclusion  The carrying rate of S. epidermidis in cervical swabs of healthy population was more than 50%, the detection rate of methicillin resistant S. epidermidis (MRSE) was 24.70%. It is necessary to trace back the typing and drug resistance of strain from cervical secretion of pregnant women. Long-term enhanced antibiotic supervision for multi-drug resistant strains is needed to reduce drug-resistant strains and reduce the risk for neonatal sepsis infection.
Death Cause Monitoring
Analysis on mortality and trend of breast cancer in women in Beijing, 2010–2020
Ma Jiaxin, Wei Zaihua, Su Jianting, Wang Ping, Du Jing, Wang Jing, Liu Qingping, Zhang Yiming, Wu Zhixin
2022, 37(5): 674-678. DOI: 10.3784/jbjc.202106100327
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  Objective   To analyze the mortality and trend of breast cancer in women with registered permanent residence in Beijing from 2010 to 2020, and provide scientific evidence for the prevention and control of breast cancer.   Methods   Based on the surveillance data of breast cancer deaths in women in Beijing from 2010 to 2020, the mortality rate, standardized mortality rate and years of premature death per 100 000 people (years of life lost, YLL rate) and other indicators were calculated, and the change in interval between onset and death of the patients and the proportion of the patients with secondary metastasis from 2010 to 2020 were analyzed. Software Joinpoint was used to analyze the trend of changes in the mortality rate and age-specific rate of breast cancer in the women in Beijing from 2010 to 2020.   Results   From 2010 to 2020, a total of 9 108 deaths of breast cancer occurred in the women with registered permanent residence in Beijing, and the crude death rate in 2020 was 14.43/100 000, an increase of 33.12% (average annual percent change, AAPC=3.10%, P<0.001) compared with 2010 (10.84/100 000), the age standardized mortality rate slowed a slighter increase (AAPC=1.10%, P=0.012). From 2010 to 2020, the median of age and the survival time from onset to death of the women who died of breast cancer in Beijing all showed an upward trends.   Conclusion   From 2010 to 2020, breast cancer was still the main cause of deaths from malignant tumors in women in Beijing, ranking fifth in malignant tumors. In recent years, the morbidity and mortality of breast cancer increased with year, but the survival time of women with breast cancer showed some increase, indicating that the prevention and treatment of breast cancer was effective in Beijing.
Mortality and years of life lost of pancreatic cancer in Huzhou, Zhejiang, 2013–2020
Ding Jingying, Yu Meihua
2022, 37(5): 679-683. DOI: 10.3784/jbjc.202105190408
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  Objective  To investigate the mortality and years of life lost of pancreatic cancer in Huzhou, Zhejiang province, from 2013 to 2020, and provide scientific evidence for the prevention and control of pancreatic cancer in the future.  Methods  The death surveillance data in Huzhou from 2013 to 2020 were collected from Zhejiang Chronic Disease Surveillance Information Management System (ICD-10 code C25.0–C25.9), the crude mortality, standardized mortality, potential years of life lost (PYLL), working potential years of life lost (WPYLL) were calculated to understand the death level of pancreatic cancer and its effect on population health, the annual percentage change (APC) was used to analyze the trend of pancreatic cancer death.  Results  From 2013 to 2020, a total of 2 455 deaths of pancreatic cancer were reported in Huzhou, accounting for 6.34% of all cancer deaths, the average age of the death cases was (70.45±10.95) years. The youngest was 27 years old and the oldest was 97 years old. The death component ratio of pancreatic cancer increased with time (P<0.05), and the average death age of women was higher than that of men (P<0.05). From 2013 to 2020, the crude mortality and the standardized mortality of pancreatic cancer in residents in Huzhou were 11.58/100 000 and 8.02/100 000. The crude mortality showed an upward trend (P<0.05), but the difference in standardized mortality of pancreatic cancer had no significant difference. The crude mortality of pancreatic cancer was 13.48/100 000 in men and 9.68/100 000 in women, and the difference was significant (P<0.05). Pancreatic cancer ranked fifth of death causes, but the ranking in women rose from fifth in 2013 to fourth in 2020. The crude mortality rate of pancreatic cancer increased with age (P<0.05). The deaths mainly occurred after the age of 45 years and peaked in age group 80-years. From 2013 to 2020, the mortality rate in the three groups (young, middle aged and old) of residents in Huzhou showed a significant increase. The mortality rate in the elderly group was highest, reaching 50.41/100 000. The PYLL and WPYLL caused by pancreatic cancer death were 10 002.50 and 3 903 person-years, the rates of PYLL and WPYLL were 0.52‰ and 0.20‰. The PYLL and WPYLL were higher in men than in women.  Conclusion  The mortality rate of pancreatic cancer in Huzhou showed an increasing trend from 2013 to 2020. The ranking of pancreatic cancer in death causes in women moved ahead, and the elderly and men were the high-risk groups, the mortality rate in women showed an upward trend, to which close attention needs to paid. It is necessary to strengthen the health education about healthy life style, rational diet, limited smoking and alcohol, moderate exercise for the primary prevention of pancreatic cancer.
Communicable Disease Reported Quality Evaluation
Sampling survey of under-registration of pulmonary tuberculosis and influencing factors in Hubei, 2019
Zeng Qiong, Zhang Yu, Hou Shuangyi, Da Qin, Lu Xingxing, Pi Qi, Yang Chengfeng, Zhang Mengxian, Zhou Liping
2022, 37(5): 684-688. DOI: 10.3784/jbjc.202109100491
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  Objective   To understand the under-registration of pulmonary tuberculosis (TB) and analyze the influencing factors and reasons in Hubei province in 2019.   Methods   A stratified random sampling method was used to select designated and non-designated tuberculosis medical institutions with tuberculosis diagnosis capabilities in counties and cities of Hubei to conduct a survey of registration of pulmonary TB cases and suspected pulmonary TB cases in 2019, and evaluate the status of the under-registration.   Results   The information of 21591 pulmonary TB cases were collected from 6 medical institutions, finally, the information of 3285 cases were analyzed. In 2019, the under-registration rate of pulmonary TB in Hubei was 10.23%. There were statistically significant differences in under- registration rate among the institutions with different nature (χ2=42.933, P<0.001), institutions of different types (χ2=6.747, P=0.009), cases with different diagnosis classification (χ2=18.266, P<0.001), areas with different epidemic situation (χ2=21.989, P<0.001) and hospitals with different outpatient visits (χ2=24.053, P<0.001). The risk for under-registration of pulmonary TB was higher at city level (compared with the county level, OR=2.27, 95%CI: 1.77−2.92) and in tuberculous pleurisy cases (compared with rifampicin-resistant tuberculosis cases, OR=6.71, 95 %CI: 1.90−23.74). Failure to follow up and one-off visits were the main reasons for the under-registration of pulmonary TB.   Conclusion   It is necessary to pay attention to the under-registration of pulmonary TB, improve the service capacity of the TB prevention and control system, and strengthen the standardized diagnosis and treatment of pulmonary TB in hospitals in Hubei.
Evaluation of Early Warning Effect
Evaluation of application of automatic early warning information system of infectious diseases in Jiangxi, 2015−2019
Fang Ji, Fu Weijie, Xiong Xiaoqing, Wang Xiaowen, Hu Lingling
2022, 37(5): 689-693. DOI: 10.3784/jbjc.202109160510
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  Objective   To understand the performance of the early warning system of infectious diseases in Jiangxi province from 2005 to 2019 and analyze the change characteristics of the automatic early warning information, and provide basis for further optimizing the early warning system and improving the efficiency of automatic early warning and monitoring of infectious diseases in Jiangxi.   Methods   Microsoft Excel 2010 was used to collect and classify the automatic early warning information data of infectious diseases in Jiangxi from 2015 to 2019, and SPSS 22.0 was used to statistically evaluate the application of early warning system and the quality of information reporting.   Results   From 2015 to 2019, a total of 43 697 early warning signals were released in Jiangxi. The proportion of suspected event reached peak during September-December, and the proportion of positive early warning signals reached peaks in September and December. The proportions of suspected event, positive early warning signals and proportion of public health emergencies were 7.41%, 0.78% and 40.46% respectively, Compared with 2008–2014, there were significant increases and there were significant differences in the proportion of suspected events (χ2=3 140.745, P<0.001), the proportion of positive early warning signals (χ2=305.895, P<0.001) and the proportion of public health emergencies (χ2=18.585, P<0.001); The top five diseases with the positive early warning signals were human infection with Streptococcus suis, human infection with avian influenza (H7N9) virus, dengue fever, cholera and unexplained pneumonia; The timely response rate of early warning signal and field investigation rate were 98.34% and 82.25% respectively, which increased significantly compared with 2008–2014. There were significant differences in the timely response rate of early warning signal (χ2=21 680.642, P<0.001) and field investigation rate (χ2=109.642, P<0.001).   Conclusion   The performance of automatic early warning information system of infectious diseases in Jiangxi is well, the early warning efficiency has been improved obviously, resulting in timely response. However, the overall proportions of positive early warning signal and early warning of public health emergency are still at low levels, suggesting that the early warning system of infectious disease needs to be further optimized.
Chronic Non-Communicable Disease Surveillance
Analysis on detections of benign and malignant thyroid nodules and risk factors in adult women in China
Zhang Ying, Ma Wei, Li Xiuwei, Wang Jianqiang, Wang Haiyan, Gu Yunyou, Xu Jing
2022, 37(5): 694-700. DOI: 10.3784/jbjc.202109240519
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  Objective   To understand the detections of benign and malignant thyroid nodules and related factors in adult women in China.   Methods   Women aged 18−60 years were selected randomly in Shandong, Henan, Hebei and Zhejiang provinces for dietary investigation, physical examination, tests of iodine in water, salt, urine and blood, and ultrasonic examination of thyroid gland. The detection of thyroid nodule and related factors were analyzed by descriptive study, univariate Logistic regression analysis and partial proportional odds model.   Results   A total of 2082 women were included in this study. The detection rates of non-nodule (TI-RADS grade 1), benign nodule (TI-RADS grade 2), possible benign nodule (TI-RADS grade 3), and suspected or highly suspected malignant nodule (TI-RADS grade 4 or 5) were 43.32%, 21.23%, 14.51% and 20.94%, respectively. The results of the partial proportional odds model showed that age, overweight and obesity, and thyroid disease history had significant effects on the thyroid nodule grading (P<0.05).   Conclusion   Older age, overweight and obesity, and thyroid disease history are the risk factors for thyroid nodule grading in adult women. It is necessary to conduct screening of thyroid nodules in the elderly, obese population and high-risk population with thyroid disease history.
Burden of Disease
Disease burden of falls in Inner Mongolia, 1990–2017
Chen Wenjie, Qian Yonggang, Kang Weiwei, Liu Huimin, Xi Yunfeng
2022, 37(5): 701-705. DOI: 10.3784/jbjc.202107260416
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  Objective   To analyze the disease burden of falls in Inner Mongolia from 1990 to 2017 and provide reference for the development of strategy of prevention and control of falls.   Methods   The number of deaths, mortality rate, years of life lost (YLL), years lived with disability (YLD), disability-adjusted life years (DALYs) of falls in Inner Mongolia during this period were from the results of the Global Burden of Disease study 2017 and standardized by using the 2017 global standard population. The gender and age specific disease burden of falls in Inner Mongolia during this period were described and the average annual percent change (AAPC) was used to reflect the change trend of disease burden of falls from 1990 to 2017.   Results   In 2017, the number of deaths , YLD, DALYs caused by falls in Inner Mongolia were 854, 36800 person years and 63400 person years respectively, which increased by 32.53%, 204.22% and 37.98% compared with 1990, however, the YLL fell by 21.46%; the standardized mortality rate decreased from 4.21/100 000 in 1990 to 3.23/100 000 in 2017, the AAPC was −1.00%, the standardized DALY rate decreased from 216.71/100 000 in 1990 to 208.10/100 000 in 2017, the AAPC was −0.40%, the standardized YLL rate decreased from 155.70/100 000 in 1990 to 97.53/100 000 in 2017, the AAPC was −2.00%, however, the standardized YLD rate showed an increase trend, the AAPC was 2.20%, all the above changes were statistically significant (P<0.05). The standardized mortality rate, the standardized YLL rate, the standardized YLD rate, the standardized DALY rate of falls were higher in men than in women. The mortality rate, YLL rate, and DALY rate declined first and then increased with age, the mortality rate, the YLL rate and the DALY rate was lowest in age group 5–14 years but highest in age group >70 years. Compared with 1990, the death number and disease burden of falls in age group 0–14 years showed decrease trends.   Conclusion  The standardized mortality rate and standardized DALY rate caused by falls showed decrease trends from 1990 to 2017, however, the burden of disability showed an increase trend. The elderly aged >70 years were the key population, it is necessary to take targeted prevention measures to reduce the death and disease burden of falls in this population.
Case Analysis
Epidemiological investigation of an acute gastroenteritis outbreak caused by norovirus in a primary school in Beijing, 2021
Zhang Wenzeng, Li Hongxia, Pi Hailun, Shi Jixin, Hu Guangyi, He Chao
2022, 37(5): 706-710. DOI: 10.3784/jbjc.202201260021
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  Objective   To analyze the epidemiological characteristics and identify the risk factors of an acute gastroenteritis outbreak caused by norovirus in a primary school in Beijing in 2021, suggest preventive measures and recommendations and evaluate the performance of the epidemic response.   Methods   Field epidemiology method were carried out. The clinical manifestations and the distribution of the cases were analyzed with descriptive epidemiological method, and a case-control study was conducted to find out the cause of this outbreak. Laboratory tests of enteroviruses and bacterial pathogens were performed by using anal swabs of the patients, food and environment samples.   Results   A total of 156 cases were identified, all of which were students, and the attack rate was 24.5% (156/638). The main clinical manifestations of the case were vomiting (98.1%), and no severe cases or deaths were reported. The epidemic curve suggested a point source exposure. Case distribution had obvious spatial clustering and the teaching building, floor and class specific differences in attack rate were significant (P<0.001); The attack rate was 33.1% (95/352) in boys and 26.2% (61/286) in girls, the difference was not significant (χ2=2.736, P=0.098). The results of a case-control study showed that close contact with patients' vomitus (≤1 m) was associated with illness (OR=12.14, 95% CI: 2.76−53.39). Norovirus GⅡ was detected in 57 anal swabs and 3 environmental smear samples.   Conclusion   It is an outbreak of acute gastroenteritis caused by norovirus GⅡ, and close contact with vomitus was the main risk factor. Failure in disposal of vomitus in time and delayed reporting of the epidemic were important reasons for this large-scale outbreak. It is suggested for schools to timely clean off vomitus in a standardized manner, strengthen disease surveillance and reporting as well as timely epidemic response to prevent the spread of the epidemic.
Overseas Dynamic
West Nile Virus and Other Domestic Nationally Notifiable Arboviral Diseases — United States, 2019
Gong Zhenyu, Gong Xunliang
2022, 37(5): 711-712. DOI: 10.3784/jbjc.202109110448
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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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