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Application of improved negative binomial regression model in early warning of peak time of varicella incidence in Dalian
Qingyu An, Wei Sun, Lin Zhu, Jun Wu
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.10.021
[Abstract](1646) [FullText HTML](360) [PDF 2591KB](10) [Peer reviewing opinions] Related References Cited By (0) Share
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ObjectiveTo evaluate the application of improved Poisson regression model or negative binomial regression model in the early warning of the peak time of varicella incidence in Dalian, Liaoning province.MethodsBased on the theory of Z-D phenomenon, the annual incidence data of varicella in Dalian from 2006 to 2014 were analyzed. Circular distribution method was used to calculate the incidence peak day and period. Considering over-dispersion might exist for data, Poisson regression model or negative binomial regression model were used to estimate the weekly baseline level of varicella. The sensitivity, detection time for early warning and false warning rate were used as evaluation indicators. Circular distribution method was used to select the appropriate warning threshold for reference standard to construct the early warning model of the peak time of varicella incidence in Dalian.ResultsFrom 2006 to 2014, a total of 26 427 varicella cases were reported in Dalian with annual incidence rate of 46.366 /100 000. The results of circular distribution method showed that there was seasonal characteristic of varicella incidence. The total concentration trend r value was 0.195 (P<0.010) between 2006 and 2014. The average annual incidence peak date was on 25 February, and the peak period lasted from 12 November to 10 June of the next year. Because the incidence data of varicella was over-dispersion, we established the baseline level of varicella by the improved negative binomial regression model. The Akaike information criterion (AIC) value was 418.854. Baseline level plus 20 cases in high incidence year and baseline level plus 10 cases in low incidence year were used as early warning threshold to accurately detect the time of varicella incidence. The sensitivity of early warning was 100%, the average detection time for early warning ranged from 1.50 to 4.67 weeks, and the false warning rate was 0%.ConclusionThe early warning model of varicella incidence peak time in Dalian based on improved negative binomial regression model has high sensitivity and appropriate detection time, which can provide scientific evidence for the prevention and control of varicella and other infectious diseases.
美国1938-2018年人类狂犬病暴露和死亡的趋势分析
Zhenyu Gong, Xunliang Gong
Accepted Manuscript
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Analysis on sentinel surveillance quality of influenza and influencing factors for influenza virus nucleic acid detection in Jingzhou, Hubei
Tian Liu, Xijun Weng, Lijie Zhang, Menglei Yao, Jigui Huang, Maoyi Chen, Jie Hu
Accepted Manuscript
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ObjectiveTo evaluate the surveillance quality of influenza and influencing factors for influenza virus nucleic acid detection in two influenza sentinel hospitals in Jingzhou of Hubei province, and provide evidence for the improvement of the quality of influenza surveillance.MethodsThe surveillance data of influenza-like illness (ILI) and pathogens from two influenza sentinel hospitals (hospital A and hospital B) in Jingzhou from 2010 to 2018 were collected from the China Influenza Surveillance Information System, ILI case proportion (ILI rate) and nucleic acid positive rate of ILI cases were used to evaluate the surveillance quality. Factors such as hospital, case sex, season, interval between onset and sampling, interval between sampling and detection were used as independent variables. Pathogen test result of ILI case was used as dependent variables, and the influencing factors was analyzed by two-category Logistic regression.ResultsThe ILI rates of hospital A and hospital B were 2.34% and 1.34%, respectively, and the difference was significant (χ2=3 096.26, P=0.000). The influenza virus nucleic acid positive rates of hospital A and hospital B were 13.63% and 14.84%, respectively, and the difference was significant (χ2=4.69, P=0.030). The change trends of ILI rate and nucleic acid positive rate of the two sentinel hospitals were consistent (rs=0.568, P=0.000; rs=0.824, P=0.000). Hospital A and Hospital B had consistent change trends of ILI rate and nucleic acid positive rate (rs=0.306, P=0.026; rs=0.477, P=0.000). Logistic regression results showed that sentinel hospital (OR=1.15, 95% CI: 1.05–1.26) and season (OR=3.19, 95% CI: 2.88–3.52) were associated with the positive rate of influenza virus nucleic acid detection. ConclusionThe overall performance of influenza sentinel surveillance was well in Jingzhou. There were differences in ILI rate and positive rate of influenza virus nucleic acid detection between two influenza sentinel hospitals. Sentinel hospital and season were the main factors affecting the positive rate of influenza virus nucleic acid detection.
Molecular characteristics of the first neonatal case of ST-4821 complex serogroup B meningococcal disease in Taizhou, 2019
Weiwei Shen, Lianhua Wang, Chunhua Qiu, Jianwei Lin, Xinping Pan, Pingping Yao
Accepted Manuscript
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ObjectiveTo understand the molecular epidemiological characteristics of the first neonatal case of ST-4821 complex serogroup B meningococcal disease in Taizhou.MethodsBlood and cerebrospinal fluid samples were collected from the patient and throat swabs were collected from 10 close contacts for pathogen isolation. Biochemical and serogroup identifications were conducted for suspected meningococcal isolates, and the isolate’s drug susceptibility test was conducted, and the strains were subjected to pulsed-field gel electrophoresis (PFGE) and multi-locus sequence typing (MLST).ResultsThree strains of Neisseria meningitidis were isolated from the patient's blood sample and two close contacts’ throat swabs. The strains from the patient and one close contact belonged to serogroup B, and one strain from another close contact had no serogroup identification results. The drug susceptibility test results showed that the three strains were sensitive to cefuroxime sodium, ceftriaxone, meropenem, not sensitive to minocycline, resistant to ciprofloxacin and cotrimoxazole, and intermediate to penicillin G and chloramphenicol. PFGE typing showed that the similarity of the three strains was 100%, which was probably from the same source. The MLST result indicated that three isolates were all ST-5664 strains, belonging to the highly pathogenic ST-4821 complex.ConclusionHighly pathogenic ST-4821 complex serogroup B Neisseria meningitidis spread in the healthy population of Taizhou, and has caused infection case, suggesting that the surveillance for its carrying status in healthy people and the molecular characteristics of the strains should be strengthened to provide laboratory support for the pathogen tracing and prevention and control of N. meningitides infection.
Etiological analysis of 1 case of a patient with Listeria monocytogenes infection
Huiru Feng, Jing Shi, Qian Chen, Xiuxia Wei, Hong Yu, Tao Yan, Zhaoe Wang, Meng Qin, Zhimin Zhang, Xiaogen Dong
Accepted Manuscript
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ObjectivesTo investigate the etiology and traceability of an infection case caused by Listeria monocytogenes.MethodsOn the basis of Field epidemiological investigation, samples of patient, foods, kitchen environmental appliances were collected for strain isolation and identification. Six pairs of virulence genes (prfA, plcB, hly, actA, iap, inlA) of positive strains were tested. The positive strains were analyzed by pulsed-field gel electrophoresis (PFGE) and multilocus-sequence typing (MLST) techniques. The homologous analysis was finally performed on the isolated strain.ResultsSix strains of Listeria monocytogenes were isolated, one from the case, two from the kitchen environmental kit, and three from the food of patient's family. In addition to the deletion of the virulence gene of the strain plcB detected by the two samples of the refrigerator inner wall and canned sweet corn, the other five virulence and all the virulence genes of other strains were all positive.. The isolated strains were all ST121 type, and the PFGE band type was 100% consistent.ConclusionThe reason for the prevalence of this patient was due to poor hygiene in the home kitchen and contamination of both food and the environment.
Summary of global surveillance data of infectious diseases in September 2019
Hui Han, Bo Wu, Yajing Song, Jiaojiao Jia
Accepted Manuscript
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In September 2019, a total of 62 infectious diseases were reported globally, affecting 86 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were dengue fever (36), measles (32), cholera (17), Chikungunya virus disease (10) and poliomyelitis (9). The top four infectious diseases with highest case fatality rates were Ebola virus disease (66.8%), Middle East respiratory syndrome (34.4%), Lassa fever (21.3%) and West Nile fever (9.3%). The top five infectious diseases with greatest number of deaths were measles, dengue fever, Ebola virus disease, cholera and West Nile fever. The prevalent infectious diseases in Africa were Ebola virus disease, cholera, yellow fever and Lassa fever, the prevalent infectious diseases in Asia were dengue fever and Middle East respiratory syndrome, the prevalent infectious diseases in America were dengue fever and measles, the prevalent infectious diseases in Europe were West Nile fever and measles.
Epidemiological characteristics of imported malaria in China, 2011–2016
Xiangbo Fan, Songwang Wang, Yingxin Pei, Xiaopeng Qi
Accepted Manuscript
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ObjectiveTo understannd the epidemiological characteristics of imported malaria in China during 2011—2016 and provide scientific evidence for the improvement of malaria surveillance and reaching the goal of elimination of malaria by 2020 in China.MethodsThe data of laboratory confirmed imported malaria cases from 2011 to 2016 were obtained from the Information System of Chinese Center for Disease Control and Prevention and analyzed with software SPSS and ArcGIS.ResultsA total 18 385 imported malaria cases, including 117 deaths, were reported in China during this period. Up to 94.87% of fatal cases were imported from Africa, and falciparum malaria accounted for 96.58%. The average interval between onset and diagnosis of falciparum malaria fatal cases (6.92 d) was longer than that of those who survived (4.93 d) (F=15.21, p <0.001). Imported cases were reported all the year round. The cases were mainly males (94.57%), aged 26—45 years (60.92%) and migrant workers (70.82%). The cases were mainly from Africa (72.98%) and Asia (24.87%, mainly from Myanmar). Africa imported cases were mainly from Ghana (16.70%), Angola (14.44%), Nigeria (11.58%), and Equatorial Guinea (10.79%). The proportion of Africa imported cases increased obviously from 48.71% in 2011 to 84.02% in 2016, in which 1333 cases were from Ghana in 2013. The imported areas were mainly detected in Yunnan (18.43%) and Guangxi (12.55%). The imported malaria cases were mainly falciparum malaria and vivax malaria in China. The proportion of vivax malaria decreased from 43.81% to 21.46%, while the proportions of falciparum malaria, quartan malaria and ovala malaria increased from 52.71%, 0.67% and 0.63% in 2011 to 65.25%, 2.15% and 10.47% in 2016, respectively.ConclusionThe annual proportion of falciparum malaria increased rapidly in imported malaria cases in China, which might be attributed to the increase of imported malaria cases from Africa. It is suggested take labor export population to malaria endemic areas as key surveillance population and improve falciparum malaria diagnosis to reduce malaria related death and prevent secondary transmission.
Application of exponential smoothing model in predicting incidence of scarlet fever in Shanghai
Dechuan Kong, Hao Pan, Yaxu Zheng, Chenyan Jiang, Ruobing Han, Huanyu Wu, Jian Chen
Accepted Manuscript
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ObjectiveTo explore the application of exponential smoothing model in the prediction of monthly incidence of scarlet fever in Shanghai.MethodsAccording to the time distribution of monthly reported incidence of scarlet fever in Shanghai from 2004 to 2017, Holt-winters exponential smoothing model was used to fit the incidence data of scarlet fever in Shanghai from 2004 to June 2017, and the optimal model was used to predict the incidence of scarlet fever in Shanghai from July to December 2017.ResultsThe fitting effect of Holt-winters additive exponential smoothing model of scarlet fever monthly reported incidence after natural logarithmic transformation was relatively optimal, the R2 was 0.884, and the standardized BIC value was −2.568. Its residual was a white noise sequence. The predicted value was basically consistent with the actual value, and the predicted accuracy for the period from July to October was better than that for the period from November to December in 2017.ConclusionThe exponential smoothing model can be used for the short term prediction of monthly incidence of scarlet fever in Shanghai,and the short-term prediction effect in four months is better.
Sentinel surveillance and whole genome evolution of influenza A (H1N1) pdm09 in Hunan, 2009–2018
Yiwei Huang, Siyu Zhang, Zhifei Zhan, Ge Zeng, Chaoyang Huang, Shixiong Hu, Wenchao Li, Hong Zhang, Lidong Gao
Accepted Manuscript
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ObjectiveTo analyze the sentinel surveillance results of influenza A (H1N1) pdm09 and understand the whole genome evolution or molecular characteristics of the virus strains isolated in Hunan province from 2009 to 2018.MethodsInfluenza surveillance was carried out in 23 sentinel hospitals in all 14 cities in the province. In every sentinel hospital, 5-20 throat swabs were collected from influenza-like illness (ILI) cases in outpatients every week for the nucleic acid test and/or isolation of influenza virus. The isolated strains were sequenced for whole genome, and the gene phylogenetic trees were constructed by using Bayesian method and BEAST software. The gene sequences of the strains were aligned with vaccine strain.ResultsDuring 2009—2018, a total of 190, 289 samples of ILI cases were collected in Hunan. Among them, 8014 were positive for influenza A (H1N1) pdm09 virus (4.21%). Seven epidemics were observed, the incidence peak was in 2009. The cases mainly occurred in age group 1-5 years, accounting for 25.13% of the total, and in age group 5-15 years, accounting for 32.83%. The male to female ratio of the cases was 1.23∶1. The whole genome of 60 strains of influenza A (H1N1) pdm09 virus from Hunan during 2009—2018 was analyzed. Compared with the vaccine strain, the homology of the whole genome sequence was between 97.2% and 99.9%. The Bayesian phylogenetic tree showed a step-like growth shape. It was estimated that the earliest public ancestor appeared in 2009.177, and the estimated average evolution rate was 2.695×10-3 substitutions/site/year. Bayesian skyline plot analysis showed that the population dynamics of influenza A (H1N1) pdm09 virus remained basically stable from 2009 to 2018. The surface protein selection pressure analysis showed that the values of dN/dS were 0.201 and 0.219. The main mutation sites of the HA molecules were L8M, S91R, S160G, S181T, A214T, and I312V. Two strains had the drug resistance mutation of H275Y in NA molecule.ConclusionDuring 2009-2018, the positive rate and proportion of influenza A (H1N1) pdm09 virus in Hunan varied with year. The incidence peak occurred in winter. The cases were mainly children and adolescents. The virus genes continued to evolve and the population dynamic was stable.
Epidemiological characteristics of Salmonella Enteritidis and Salmonella Typhimurium isolated from diarrhea patients in Shunyi, Beijing, 2013-2018
Guoqiang Ji, Ying Li, Hongmei Ma, Songjian Zhang
Accepted Manuscript
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ObjectiveTo analyze the epidemiological characteristics of Salmonella Enteritidis and Salmonella Typhimurium isolated from diarrhea patients in Shunyi district of Beijing during 2013-2018, and provide evidence for the effective prevention and control of diarrhea.MethodsIsolated Salmonella strains were from stool samples of diarrhea patients in surveillance project in Shunyi from 2013—2018. Serotyping and pulsed-field gel electrophoresis (PFGE) were conducted for the isolated strains of S. Enteritidis and S. Typhimurium, and χ2 test was conducted for the analyses on the population distribution and clinical symptoms of S. Enteritidis and S. Typhimurium infections.ResultsThe overall isolation rate of Salmonella was 5.63% (109/1936), and the constituent ratios of S. Enteritidis and S. Typhimurium were 32.73% (36/110) and 28.18% (31/110). The isolation rates of S. Enteritidis and S. Typhimurium were 1.85% and 1.60% respectively, the latter's fluctuation range was significantly larger than the former, and the isolation rates of the two pathogens showed an annual one fall but another one rise trend. Two detection peaks were found for S. Enteritidis, i.e. during April - May and during September - October, and three detection peaks of S. Typhimurium were in April, July and September. The isolation rate of S. Typhimurium was higher in the western part of Shunyi (2.49%) than in other parts of Shunyi. PFGE pattern of S. Enteritidis showed two banding clusters in a short time, and PFGE pattern of S. Typhimurium showed six banding clusters in a short time.ConclusionS. Enteritidis and S. Typhimurium spread had certain epidemiological characteristics in diarrhea cases in Shunyi, the serotype level analysis is more conducive to discover potential outbreaks, and the epidemiological investigation of " sporadic outbreaks” should be carried out to provide evidence for the effective prevention and control of Salmonella infection.
Spread and evolution of influenza A (H1N1) pdm09 virus in Hubei, 2015–2019
Bin Fang, Hui Xu, Xiao Yu, Xiang Li, Guojun Ye, Linlin Liu
Accepted Manuscript
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ObjectiveTo understand spread, phylogenetic characteristics, epitope and drug-resistance site of influenza A (H1N1) pdm09 virus in Hubei province during 2015—2019.MethodsThe spread period of the virus were divided according to the positive rate of influenza virus nucleic acid detection downloaded from influenza surveillance information system in China. Sequencing of 39 strains of influenza A (H1N1) pdm09 virus isolated from the positive samples in real-time fluorescence PCR in Hubei during 2015—2019 was conducted and 13 sequences of the strains isolated from Hubei were downloaded from global influenza database to analyze the distribution of phylogenetic clade, epitope and drug-resistant mutation sites by using bioinformatics software and simulate the structure of mutation sites by 3d modeling.ResultsThe annual spread of influenza A (H1N1) pdm09 virus lasted for 11-14 weeks in Hubei from 2015 to 2019, and the spread intensity increased year by year. Multiple branches of 6B.1A to 6B.1A7 evolved from 6B clade in phylogenetic tree of the HA and NA genes. Twelve epitope substitutions of HA and two drug-resistance sites of NA were detected, and there were obvious differences in D222G substitution virulence identifying marker and drug-resistance site I223V on homology in 3D modeling structure.ConclusionThe spread intensity and phylogenetic clade number of influenza A (H1N1) pdm09 virus increased In Hubei during 2015—2019. Sporadic virulence marker and drug-resistance site were detected for influenza A (H1N1) pdm09 virus. The results of this analysis can be used to improve the epidemiological research and genetic evolution surveillance of influenza virus in Hubei.
Diagnosis performance of brucellosis in China, 2013–2018
Shu Li, Qiulan Chen, Wenwu Yin, Yu Li, Di Mu, Zhongjie Li
Accepted Manuscript
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ObjectiveTo understand the diagnosis performance of brucellosis in China from 2013 to 2018, and provide reference for the improvement of the diagnosis quality of brucellosis.MethodsThe incidence data of brucellosis in China from 2013 to 2018 were collected from the infectious disease information management system of Chinese Center for Disease Control and Prevention. The diagnosis performance of brucellosis was described by analyzing the intervals between onset and diagnosis of brucellosis and the laboratory confirmation rates in different medical institutions and in northern and southern China.ResultsFrom 2013 to 2018, a total of 282 264 brucellosis cases were reported nationwide. Most cases were reported in northern China, accounting for 95.1% of the total. The cases reported by hospitals, CDCs and primary medical units accounted for 50.3%, 39.1% and 7.7% respectively. The proportion of the cases reported by hospitals increased gradually from 35.9% in 2013 to 62.5% in 2018. The median onset-diagnosis interval was 14 days, and 7.0% of the reported cases were diagnosed beyond acute phase (3 months). The median onset-diagnosis interval was shorter in southern China (11 days) than in northern China (14 days), and in hospitals and primary medical units (9 days, 11 days) than in CDCs and other medical units (20 days, 25 days). The overall laboratory conformation rate was 91.6% (92.0% in northern China and 84.4% in southern China). In northern China, the laboratory confirmation rate was only 88.8% in hospitals and 87.5% in primary medical units. The overall rate of non-local hospital visits was 48.0% (47.0% in northern China and 68.0% in southern China).ConclusionIn northern China, the brucellosis epidemic was serious from 2013 to 2018, but the laboratory diagnostic capacity was still inadequate, resulting in some delays in diagnosis. It is suggested to strengthen the building of laboratory diagnostic capacity of the medical institutions in northern China and improve the accessibility of diagnosis and treatment of brucellosis.
Evaluation of the clinical application of MALDI-TOF MS with directly smeared target in rapid identification of filamentous fungi
Gui Zhang, Liyun Wang, Mei Wang, Haitong Gu, Xinxin Lu
Accepted Manuscript
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ObjectiveTo evaluate the clinical application of matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) with directly smeared target (MS direct smear method) in the rapid identification of filamentous fungi.MethodsA study was performed on 133 strains of filamentous fungi cultured from clinical samples in Beijing Tongren Hospital affiliated to Capital Medical University from January 2010 to December 2017, these strains were identified by morphological observation, gene sequence analysis and MS direct smear method, respectively. The results were analyzed and compared. χ2 test was performed in the enumeration data analysis by using software SPSS 16.0.ResultsBased on the results of 133 strains of filamentous fungi identified by gene sequence analysis and morphological observation, the identification rates of species, complex and genera of the filamentous fungi strains by MS direct smear method were 64.66%, 79.70% and 96.24%, respectively, while the rates obtained by gene sequence analysis were 69.17%, 83.46% and 99.25%, respectively, and then the rates by morphological identification were 68.42%, 84.21% and 93.23%, respectively. Furthermore, there were no significant differences in the identification rates of the species, complexes and genera between MS direct smear method and latter two methods (χ2=0.611, 0.625, 2.728, respectively, and χ2=0.516, 0.915, 1.206, respectively, P>0.05). MS direct smear method identified 61.04%, 88.31% and 98.70% of the 77 strains of Aspergillus, respectively, at species, complex and genera levels, 64.29% and 92.86% of the 14 strains of Penicillium at species and genera levels, and 71.43% and 92.86% of 42 other filamentous fungi strains at species and genera levels. Five strains (3.76%, 5/133) were not identified due to the insufficient species of fungi in the database.ConclusionMALDI-TOF MS with directly smeared target can accurately identify clinical filamentous fungi with similar results to morphological observation and gene sequence analysis. It is a test which is rapid, easy and simple to handle for use in clinical practice.
Antibiotic resistance of 101 Legionella strains
shilin Xiao, Xueyang Jia, Xudong Nie, Tian Qin, Hongyu Ren
Accepted Manuscript
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ObjectiveTo investigate the drug resistance of Legionella from different sources and serotypes/groups.MethodsAntibiotic susceptibility tests of Legionella to erythromycin, rifampicin, levofloxacin, sulbactam, azithromycin, moxifloxacin and cefuroxime were carried out by using 101 Legionella strains, including 67 environmental isolates, 16 clinical isolates and 18 international reference strains, in 17 serotypes. ResultsOnly two of the strains showed no antibiotic resistance. The other 99 strains were resistant to seven antibiotics at different degrees. The resistance rate was 67.33% to cefuroxime (n=68), 8.91% to azithromycin (n=9), 7.92% to moxifloxacin (n=8), 5.94% to rifampicin (n=6), 4.95% to sulbactam (n=5), 2.97% to erythromycin (n=3), and 0.99% to levofloxacin (n=1). Among the 17 serotypes, 13 serotypes were found to be resistant to cefuroxime, and 4 serotypes were multi-drug resistant (≥ 2 antibiotics). The serotype of simultaneous resistant to sulbactam and cefuroxime was LP4; the serotype of simultaneous resistant to cefuroxime and moxifloxacin was LP5; the serotype of simultaneous resistant to erythromycin, sulbactam and cefuroxime was LP9; and the serotype of simultaneous resistant to erythromycin, azithromycin, levofloxacin, moxifloxacin, rifampicin, sulbactam and cefuroxime was LP1. The remaining 9 serotypes were only resistant to cefuroxime. In addition, two non-L. pneumophila serotypes (L. oakridgensi) were only resistant to azithromycin. LP3, L. feeleii and L. bozemanii were sensitive to all antibiotics. ConclusionErythromycin, a first-line antibiotic for legionellosis, could still be used as the first choice in clinical treatment. In addition, quinolone antibiotic levofloxacin can also be used as an alternative in the treatment of legionellosis. Cefuroxime, which is the most resistant drug, should be avoided to use in the treatment of legionellosis.
Evaluation of multiple locus variable-number tandem repeat analysis for subtyping of diarrheagenic Escherichia coli in Shenzhen
lei Wang, Qiongcheng Chen, Lulu Hu, Yaqun Qiu, Yiman Lin, Min Jiang, Yixiang Jiang, Xiaolu Shi, Qinghua Hu, Yinghui Li
Accepted Manuscript
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ObjectiveTo explore a better subtyping method for diarrheagenic Escherichia coli (DEC) through the comparison of multiple locus variable-number tandem repeat analysis (MLVA) and pulsed-field gel electrophoresis (PFGE).MethodsIn this study, variable-number tandem-repeat (VNTR) loci were screened for the use in MLVA for subtyping of DEC, the results were then compared with those of gold standard method-PFGE.ResultsAmong 58 DEC isolates, 43 PFGE patterns from three clusters (DI=0.965) and 42 MLVA subtypes from four clusters (DI=0.955) were obtained. The clustering of two outbreak strains showed highly consistent between the two methods.ConclusionAlthough there was no significant difference in discriminatory power betwee MLVA and PFGE, MLVA is a rapid, simple and high-throughput subtyping method, which are superior to PFGE and has great application value in disease surveillance and disease outbreak investigation.
Application of Excel to realize maximum spatial scanning scale screening of spatial scan statistics based on MCS-P
Tian Liu, Yang Wu, Yeqing Tong, Qi Chen, Li Qi, Menlei Yao, Jigui Huang, Shuqiong Huang
Accepted Manuscript
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ObjectiveTo evaluate the feasibility of application of Excel to realize the maximum spatial scanning scale screening of spatial scan statistics based on MCS-P.MethodsBased on the incidence data of hand foot and mouth disease (HFMD) in Hubei province in 2016, the parameters of the maximum spatial scan scale were set to 1%, 2%, 3%... 50% of the total population of Hubei. The parameter evaluation index MCS-P was calculated by Excel software. The optimal parameter was the largest MCS-P value, which was used to detect the spatial clustering of HFMD in Hubei in 2016.ResultsHFMD cases were reported in 102 counties (districts) in Hubei in 2016, with the incidence rates ranging from 17.92/100 000 to 898.69/100 000. When the maximum spatial scan scale was 3% of the total population of Hubei, MCS-P was 0.869, which was the maximum value in the results. Spatial clustering analysis was carried out with the optimal parameter. A total of 29 clusters were detected, which were distributed in 41 counties (districts) mainly in the northern and southeastern parts of Hubei.ConclusionExcel can be used to realize the maximum spatial scanning scale screening of spatial scan statistics based on MCS-P, which has some application value.
Analysis on drug resistance of pulmonary tuberculosis cases in Ningbo, Zhejiang, 2017
Tong Chen, Tianchi Yang, Xiang Lin, Sijia Wang, Guohua Ping, Yang Che, Lyu Lin, Mei Yu
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2019.09.020
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ObjectiveTo evaluate the levels and patterns of drug resistance in initially treated smear-negative pulmonary tuberculosis (TB) patients in Ningbo, and provide scientific evidence for the prevention and control of drug-resistant TB.MethodsSputum samples of 1 434 initially treated smear-negative pulmonary TB patients enrolled from March to December 2017 were isolated by liquid culture method. Strain identification and drug susceptibility tests were performed for all culture positive samples with proportion method.ResultsA total of 378 sputum samples from the 1 434 enrolled pulmonary TB patients were culture positive, in which 60 were non-tuberculosis mycobacterium positive. Eight six of 318 pulmonary TB cases were drug-resistant, the overall drug-resistance rate was 27.04%, with the highest resistance rate to isoniazid (17.92%, 57/86), and the lowest drug-resistance rate to rifampicin (5.35%, 17/86). The resistance rate to rifampicin in pulmonary TB patients with cavitation was significantly higher than that in those without cavitation (χ2=5.319, P<0.05).ConclusionThe drug resistance in initially treated smear-negative pulmonary TB cases was relatively severe in Ningbo. Further efforts should be made to expand drug susceptibility test coverage to find drug-resistant patients timely and improve the treatment and management of pulmonary TB cases.
Epidemiological survey of an infectious erythema outbreak in a school
Peinan Wei, Bing Chen, Taishun Wu, Yuan Li, Xiangbo Fan
Accepted Manuscript
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ObjectiveTo investigate the scale and pathogen of an unexplained rash outbreak in a school in Baoan district of Shenzhen, identify the risk factors and propose targeted prevention and control measures.MethodsOn April 4, 2018, the investigation and epidemic response was carried out in the school. The case definition was developed for case finding, standard epidemiological questionnaire was used for field survey, and the distribution characteristics of the cases were described. A retrospective cohort study was conducted to identify the risk factors, and blood samples were collected from the cases for pathogen antibody detection.ResultsA total of 12 cases were found, the attack rate was 11.9% (12/101). Four blood samples were collected, all were positive for human parvovirus B19 IgM and IgG antibody. According to the result of the retrospective cohort study, sitting next to the cases in class [RR=4.3 (1.2-14.9)] or playing chess with the cases [RR=5.7(1.3-24.7)] were the risk factors for the infection.ConclusionThis epidemic was an infectious erythema outbreak caused by human parvovirus B19. Close contact, such as sitting next to the case in class or playing chess with the case, was the risk factor for the infection.
Influence of two dose immunization schedule of varicella vaccine on epidemiological characteristics of varicella in Taizhou
Yafei Hu, Haijiang Lin, Wei Li
Accepted Manuscript
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ObjectiveTo understand the epidemiological characteristics of varicella in Taizhou after the implementation of two dose immunization schedule of varicella vaccine.MethodsThe incidence data of varicella in Taizhou from 2011 to 2017 were collected, the epidemiological characteristics of varicella cases were analyzed by descriptive epidemiology.ResultsA total of 16 895 cases of varicella were reported in Taizhou from 2011 to 2017 with an average annual reported incidence of 40.02/100 000. The highest incidence was 55.81/100 000 in 2015 and the lowest was 26.24/100 000 in 2011. The incidence of varicella increased from 2011 to 2015, and decreased during 2016–2017 after the implementation of two dose immunization schedule of varicella vaccine. The highest annual reported incidence was 103.77/100 000 in Tiantai county and the lowest was 17.46/100 000 in Yuhuan county. After the implementation of two dose immunization schedule of varicella vaccine, the vaccination rate increased, and there were no obvious changes in the sex ratio, seasonal distribution and age distribution of varicella cases. The incidence rate of increased in age group over 10 years and decreased in age group 0–9 years.ConclusionThe rising trend of varicella incidence in Taizhou was eased and the incidence in vaccinated population decreased after the implementation of two dose immunization schedule of varicella vaccine, but the proportion of varicella cases in non-vaccinated population aged ≥10 years increased. It is necessary to continue the two dose immunization schedule of varicella vaccine.
Epidemiological characteristics and temporal-spatial clustering analysis on severe fever with thrombocytopenia syndrome in Jinan, 2013–2018
Shang Gao, Xiaodong Zhao, Yaru Ren, Xiaolin Jiang, Caiyun Chang
Accepted Manuscript
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ObjectiveTo analyze the epidemiological characteristics and temporal-spatial clustering of severe fever with thrombocytopenia syndrome (SFTS) in Jinan of Shandong province, and provide scientific evidence for SFTS prevention and control.MethodsThe data of SFTS cases in Jinan during 2013–2018 were downloaded from National Notifiable Infectious Disease Reporting System of China, and comprehensive analysis on the epidemiological characteristics of SFTS was conducted by using descriptive epidemiological methods and spatial-temporal scan statistics method.ResultsA total of 385 SFTS cases, including 49 deaths, were reported in Jinan from 2013 to 2018. The average case fatality rate was 12.73%. The cases mainly occurred between April and October with the incidence peak in August. The cases over 50 years old accounted for 90.13% and farmers accounted for 90.91% of the total cases, respectively. The male-female ratio of the cases was 1.07∶1.The top three high-incidence areas were Zhangqiu, Licheng and Changqing, the cases in these areas accounted for 83.12% of the total. Spatial-temporal clustering analysis detected three clusters (one first-class cluster, two second-class clusters) and one suspected cluster with the characteristics of significant spatial-temporal clustering.ConclusionThe incidence of SFTS had spatial-temporal clustering in Jinan during 2013–2018. According to the spatial and temporal distribution and epidemiological characteristics of SFTS, prevention and control measures, such as health education, surveillance and staff training, should be carried out in key populations in areas with high incidences.
Progress in research of Orientia tsutsugamushi and its host and vector
Yunyan Luo, Jiaxiang Yin
Accepted Manuscript
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Orientia tsutsugamushi is a Gram-negative obligate intracellular bacterium and the causative agent of human scrub typhus, which is transmitted by mites. In recent years, with the rise of tourism and outdoor sports, human contact with mites has increased, and the possibility of scrub typhus outbreak exists. Orientia tsutsugamushi is the only pathogen of scrub typhus. Fully understanding of the morphological structure, genotype, pathogenic mechanism, host and vector of Orientia tsutsugamushi plays an important role in the prevention and control of scrub typhus and vaccine development. This paper summarizes the progress in research of Orientia tsutsugamushi and its host and vectors.
Correlation between atmospheric particulate matter pollution and number of patients admitted to hospital due to unstable angina in Taiyuan, Shanxi
Dianying Lu, Hai Jiang, Junfeng Zhang, Xiaofang Qiao, Jin Shang, Juanjuan He, Junni Wei
Accepted Manuscript
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ObjectiveTo investigate the effect of atmospheric particulate matter pollution on the number of patients admitted to hospital due to unstable angina (UA).MethodsThe number of hospitalized patients with UA from December 1, 2013 to August 31, 2016 was collected, as well as meteorological surveillance data during the same period. Based on the control of long-term trends, meteorological factors, holidays and the effects of the day of the week, a semi-parametric generalized additive model was constructed to analyze the relationship between atmospheric particulate matter (including PM10 and PM2.5) and the number of hospitalized patients with UA.ResultsAfter one day lag, as the PM10 increased by 10μg/m3, the number of UA patients admitted to hospital increased by 1.0%(95% CI: 0.6%-1.3%), and as the PM2.5 increased by 10μg/m3, the number of UA patients admitted to hospital increased by1.5%(95% CI: 0.9%-2.0%). Two pollutant models were constructed by using particulate matter (PM2.5 and PM10) and ozone (lag one day). The results of PM10 pollutant model was statistically significant after the substitution of O3, and the RR value increased (P<0.05). For PM2.5, the results were statistically significant after the substitution of O3, and the RR value increased (P<0.05).ConclusionAtmospheric particulate matter can cause an increase in the number of hospitalizations due to UA.
Prediction of rabies cases in China by using autoregressive moving average model
Yanrong Li, Liling Zhu, Wuyang Zhu, Xiaoyan Tao
Corrected proof
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ObjectiveTo predict the monthly incidence of rabies in the mainland of China by using autoregressive moving average model (ARIMA), and provide reference for the prevention and control of rabies in China.MethodsUsing SPSS 19.0 software, a time series model was established by using the monthly incidence data of rabies in China from January 2007 to December 2016, and the optimal model was validated by the monthly incidence data of rabies from January to December 2017. The optimal model was used to predict the incidence trend and case number of rabies in 2018.ResultsThe optimal model was ARIMA(0,1,1)(2,1,0)12, with a stationary R2=0.539, RMSE=17.653, Ljung-Box Q=8.932, P=0.881. In predicting the data for January-December 2017, the relative error of prediction was 1.55%. A total of 516 rabies cases occurred actually in 2017. It was predicted that the case number of rabies in China would drop to 398 in 2018.ConclusionThe ARIMA(0,1,1)(2,1,0)12 model can well fit the long-term trend and seasonal trend of rabies incidence, and the results of retrograde fitting and short-term prediction are ideal.
cover
2019, 34(9).
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contents
2019, 34(9).
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National Data of Class A, B and C Communicable Diseases in August 2019
2019, 34(9): 777-777. DOI: 10.3784/j.issn.1003-9961.2019.09.001
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Summary of National Data of Class A, B and C Communicable Diseases in China, August 2019
2019, 34(9): 778-778. DOI: 10.3784/j.issn.1003-9961.2019.09.002
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Summary of global surveillance data of infectious diseases in August 2019
Hui Han, Bo Wu, Yajing Song, Jiaojiao Jia
2019, 34(9): 779-781. DOI: 10.3784/j.issn.1003-9961.2019.09.003
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In August 2019, a total of 58 infectious diseases were reported globally, affecting 79 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were dengue fever (32), measles (30), cholera (10), West Nile fever (8) and poliomyelitis (8). The top four infectious diseases with highest case fatality rates were Ebola hemorrhagic fever (66.8%), Middle East respiratory syndrome (34.5%), Lassa fever (22.1%) and West Nile fever (9.2%). The top five infectious diseases with greatest number of deaths were dengue fever, Ebola hemorrhagic fever, measles, cholera and West Nile fever. The prevalent infectious diseases in Africa were Ebola hemorrhagic fever, plague, cholera, yellow fever and Lassa fever, the prevalent infectious diseases in Asia were Middle East respiratory syndrome and dengue fever, the prevalent infectious diseases in America were dengue fever and measles, the prevalent infectious diseases in Europe were West Nile fever and measles.
Risk assessment of public health emergencies concerned in the mainland of China, September 2019
Ling Meng, Xiaoxia Huang, Jiandong Li, Fengfeng Liu, Wei Li, Jianchun Wei, Maojun Zhang, Xiaoye Wang, Jinghuan Ren, Dan Li, Wenxiao Tu, Nijuan Xiang, Daxin Ni
2019, 34(9): 782-787. DOI: 10.3784/j.issn.1003-9961.2019.09.004
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ObjectiveTo assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in September 2019.MethodsAn 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 conference through video terminal.ResultsGenerally speaking, it is predicted that the incidence of public health emergencies would be slightly higher in September than in August 2019. It is the high incidence season of dengue fever in the area where Aedes exists, indigenous cases would continue to increase and local outbreaks would continue to occur or the risk of large scale outbreaks exits in grade Ⅰ provinces, in addition, the possibility of local transmission and outbreaks caused by imported cases exists in grade Ⅱ and grade Ⅲ provinces where imported case number and Aedes density are high. The autumn epidemic season of hand foot and mouth disease (HFMD) is coming. Sporadic cases of cholera might continue to occur. It is the high incidence season of anthrax, and anthrax is more likely to occur in the previous anthrax foci in western and northeastern China. Outbreaks of Guillain-Barre syndrome caused by Campylobacter jejuni infection might occur. The incidence of food poisoning would continue to be high. Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo would continue; however, the risk of its spread to China is low.ConclusionClose attention should be paid to dengue fever and HFMD, and general attention should be paid to cholera, anthrax, C. jejuni infection, Guillain-Barre syndrome, food poisoning and EVD in the Democratic Republic of Congo.
Introduction
2019, 34(9): 788-788.
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Etiological surveillance results of other infectious diarrhea in Zhuzhou, Hunan, 2015–2018
Qizhi Long, Li He, Shixiong Hu, Lidong Gao, Junhua Li
2019, 34(9): 789-794. DOI: 10.3784/j.issn.1003-9961.2019.09.005
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ObjectiveTo study the epidemiological characteristics and pathogen spectrum of other infectious diarrhea in Zhuzhou, Hunan province, from 2015 to 2018.MethodsThe relevant information were collected from diarrhea cases diagnosed in sentinel hospitals from May 2015 to November 2018. Stool samples were collected for the detection of intestinal pathogenic bacteria and viral nucleic acid detections.ResultsA total of 580 samples of diarrhea cases were collected and detected.Bacterial infection cases accounted for 30.17%, and the Salmonella was the major pathogen in bacterial infection, followed by Campylobacter jejuni and diarrheogenic Escherichia coli. Viral infection cases accounted for 37.07%, rotavirus A was the predominant pathogen in viral infection, followed by norovirus GⅡ. The detection rate of virus was higher than those of bacterium in all age groups. The cases were mainly children aged under 5 years old (82.59%, 479/580). The seasonality was obvious with detection peaks in autumn and winter. The main pathogen causing infectious diarrhea was Salmonella in summer. Most cases occurred in autumn were caused by norovirus, while most cases occurred in winter and spring were caused by rotavirus. The gender specific pathogen spectrums were similar. The detection rates in rural area (bacterium 31.63%, virus 41.83%) was higher than those in urban area (bacterium 29.88%, virus 36.09%).ConclusionThe viral infection rate was higher than bacterial infection rate in other infectious diarrhea cases in Zhuzhou, while rotavirus A, Salmonella, and norovirus GⅡwere the main pathogens causing other infectious diarrhea in Zhuzhou.
Etiological surveillance results of infectious diarrhea in Wuxi, Jiangsu, 2014–2018
Hongxia Guan, Dan Sha, Weihong Feng, Qianqian Qi, Yong Xiao
2019, 34(9): 795-799. DOI: 10.3784/j.issn.1003-9961.2019.09.006
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ObjectiveTo understand the pathogen spectrum and epidemiological characteristics of infectious diarrhea in Wuxi from 2014 to 2018.MethodsFrom January 2014 to December 2018, stool samples were collected from 3 408 outpatients with diarrhea in sentinel hospitals in Wuxi. Salmonella, Shigella, diarrheagenic Escherichia coli and Vibrio parahaemolyticus were isolated by conventional culture, and the nucleic acid of norovirus, rotavirus, enteric adenovirus, astrovirus and sapovirus were detected with real-time fluorescence quantitative PCR.ResultsA total of 946 positive samples, including 66 multi pathogen positive samples, were detected in 3 408 stool samples with the positive rate of 27.76%. Among the positive samples, 529 were bacteria positive with the positive rate of 15.52%. The isolation rate of diarrheagenic E. coli was highest (6.60%), followed by Salmonella (5.11%), V. parahaemolyticus (4.05%) and Shigella (0.32%). The diseases mainly occurred in summer. And among the positive samples, 460 were virus positive with the positive rate of 13.50%. The positive detection rates of norovirus (8.92%) and rotavirus (3.29%), which mainly spread in winter and spring, ranked 1-2. The positive rates of pathogens were different in different age groups. The infection rate of rotavirus in children under 5 years old was significantly higher than those in other age groups.ConclusionThe main pathogens causing infectious diarrhea were diarrheagenic E. coli, Salmonella, V. parahaemolyticus, norovirus and rotavirus in Wuxi from 2014 to 2018. Bacterial diarrhea dominated in summer and viral diarrhea dominated in winter and spring. For infants and young children under 5 years old and the elderly, it is necessary to take different control measures in different seasons.
Surveillance for pathogen spectrum of infectious diarrhea in Tongzhou district of Beijing, 2016–2018
Ping Zhang, Haoliang Yang, Bojun Zhen, Xiang Gao, Fengling Zhao, Jie Gao, Yang Zhang, Zhaohui Li, Duochun Wang, Jinglin Zhou
2019, 34(9): 800-804. DOI: 10.3784/j.issn.1003-9961.2019.09.007
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ObjectiveTo understand the bacterial pathogen spectrum of infectious diarrhea in Tongzhou district of Beijing from 2016 to 2018, and provide evidence for the prevention and control of bacterial infectious diarrhea.MethodsStool samples were collected from intestinal outpatient diarrhea patients of two sentinel hospitals of Tongzhou district for detection of related pathogenic bacteria. The molecular biology identification of Salmonella, Vibrio parahaemolyticus and diarrheagenic Escherichia coli was carried out according to serotype and virulence gene, and the epidemic characteristics were analyzed.ResultsA total of 298 strains of pathogenic bacteria were isolated from 1 269 stool samples with a detection rate of 23.48%. The detection rates of pathogenic bacteria in different age groups were statistically significant (χ2=33.584, P<0.001). Among the positive strains, diarrheagenic E. coli was predominant (140/298, 46.98%), mainly EAEC and ETEC, followed by V. parahaemolyticus (73/298, 24.50%) and Salmonella (58/298, 19.46%). The seasonality of bacteria spread was obvious, mainly in summer and autumn. The major Salmonella serotype were S. Enteritis and S. Typhimurium. The serotype of V. parahaemolyticus was mainly O3:K6.ConclusionFrom 2016 to 2018, pathogenic bacteria of infectious diarrhea in Tongzhou district were mainly diarrheagenic E. coli, V. parahaemolyticus and Salmonella were also the common pathogens of infectious diarrhea. It is necessary to strengthen the routine surveillance for pathogens of infectious diarrhea and health education in population at high risk, and risk factor investigation and prevention and control should be further strengthened.
Molecular characteristics and drug resistance of Aeromonas from environmental Sources in Ma'anshan, Anhui
Yonglu Wang, Zhenzhou Huang, Li Wang, Rong Wang, Hang Dai, Hongyan Cai, Xiaoli Du, Duochun Wang
2019, 34(9): 805-810. DOI: 10.3784/j.issn.1003-9961.2019.09.008
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ObjectiveTo understand the epidemiological characteristics, virulence gene characteristics and drug resistance of Aeromonas from environmental sources in Ma’anshan of Anhui province.MethodsFrom January to December, 2017, Aeromonas strains isolated from seawater products, packaged foods, domestic water, swimming pool water and food poisoning samples in Ma'anshan were detected. The species of Aeromonas were identified through housekeeping gene rpoD sequence analysis. PCR was used to detect six virulence genes (Fla, Elastase, hlyA, ast, act and ascF-G), the molecular types of the strains were detected by using pulsed-field gel electrophoresis (PFGE), and drug susceptibility test of the strains was also conducted.ResultsA total of 66 Aeromonas strains were isolated from 869 samples (7.6%), and the isolated rates were higher in rural domestic water, food poisoning samples and seafood products respectively. Sixty-six strains of Aeromonas belonged to seven species, mainly including A. veronii (24, 36.4%), A. hydrophila (13, 19.7%) and A. jandaei (13, 19.7%) respectively. 64 strains of Aeromonas (97.0%) carried one or more virulence genes, with the highest detection rate of Fla and act (53.1%), Fla was mainly detected in A. caviae (83.3%) and act was mainly detected in A. hydrophila (69.2%). Sixty six strains of Aeromonas were divided into 64 PFGE types, indicating the diversity of molecular biotypes. Drug susceptibility test showed that Aeromonas was sensitive to seven antibiotics including cefotetan, and partially sensitive to five antibiotics (1.5%–21.2%) such as cefazolin, and highly resistant to ampicillin and ampicillin/sulbactam (90.0%).ConclusionThe contamination of Aeromonas, which carries multiple virulence genes and has high resistances to several antibiotics, is severe in Ma'anshan. It is necessary to strengthen the surveillance for Aeromonas and its drug resistance.
Characteristics of phenotype and molecular type of Vibrio cholerae O1 in Beijing, 2018
Hanqiu Yan, Fu Li, Bing Lyu, Ying Huang, Xin Zhang, Lei Jia, Haijian Zhou, Mei Qu, Quanyi Wang
2019, 34(9): 811-816. DOI: 10.3784/j.issn.1003-9961.2019.09.009
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ObjectiveTo understand the characteristics of the phenotype and molecular type of Vibrio cholerae O1 in Beijing in 2018.MethodsThe strains of V. cholerae were isolated from cholera cases and external environments. Serotyping was performed for the strains with routine identification methods, and V. cholerae toxin gene were detected by using real-time PCR. The sensitivities of the strains to 21 kinds of antibiotics was conducted with micro-broth dilution method. Pulsed field gel electrophoresis (PFGE) with Xba Ⅰ and Not Ⅰ restriction enzymes was performed for the molecular typing of V. cholerae O1 strains.ResultsIn 29 V. cholerae O1 strains isolated, the proportions of non-toxin producing Ogawa strains, non-toxin producing Inaba strains and toxin producing Ogawa strains were 62.07% (18/29), 24.14% (7/29) and 13.79% (4/29) respectively. The resistance rate of the strains to cefazolin was highest (82.76%), all the strains were sensitivity to meropenem (100.00%). Twenty eight strains were drug resistant with 9 drug resistance types, the highest was resistant to 13 antibiotics; there were 13 resistance categories to 11 classes of antibiotics, the highest was resistant to 7 classes of antibiotics. Results from PFGE indicated that the 29 V. cholerae strains were classified into 16 molecular types.ConclusionV. cholerae O1 was mainly non-toxic in Beijing, and multi drug resistance of V. cholerae O1was severe. The results of PFGE molecular typing suggested that the attention should be paid to food safety, especially to strengthen the monitoring of aquatic products.
Isolation of two rare Shewanella spp. from specimens of patients in Liaocheng in 2016
Shengnan Liang, Xiangkun Jiang, Yinju Du, Pu Zhou, Li Liu, Lihong Cheng, Duochun Wang
2019, 34(9): 817-821. DOI: 10.3784/j.issn.1003-9961.2019.09.010
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ObjectiveTo identify the isolates of Shewanella spp. from two patient specimens in Liaocheng and explore the biochemical characteristics and drug susceptibility of the Shewanella spp.MethodsTwo specimens from the two patients and other 6 Shewanella spp. strains revived were cultured by using selective medium, and biochemical test, hemolytic test, salt-resistant and heat-resistant tests, drug-resistance test were conducted for the strains. API and VITEK 2 Compact, VITEK MS systems were used for the identification of the strains, 16S rRNA and gyrB sequence analyses were conducted.ResultsThe morphology and biochemical characteristics of 8 strains were consistent, the hemolytic state was different. The clinical identification system could only identified Shewanella algae and Shewanella putrefaciens. Two strains isolated from the patients were further identified as rare Shewanella haliotis and Shewanella upenei through 16S rRNA and gyrB gene sequence analyses.ConclusionIt was the first time to isolate rare Shewanella spp. from clinical cases in China. Further attention needs to be paid to clinical infection caused by Shewanella and the surveillance should be strengthened.
Spread and characteristics of Vibrio parahaemolyticus in Lishui, Zhejiang, 2014–2018
Xiuying Chen, Jianhua Mei, Shabin Chen, Fuming Liu, Xialiang Ye
2019, 34(9): 822-826. DOI: 10.3784/j.issn.1003-9961.2019.09.011
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ObjectiveTo investigate the spread, serotype, virulence gene and molecular typing characteristics of Vibrio parahaemolyticus in Lishui of Zhejiang province and provide evidence for the prevention of foodborne diseases.MethodsA total of 11420 stool samples of clinical diarrhea patients in foodborne disease surveillance and 497 food samples in food safety risk surveillance were collected in Lishui from 2014 to 2018 for the isolation and culture of V. parahaemolyticus, and the distribution characteristics of positive strains were analyzed. Serological typing, virulence gene detection and pulsed field gel electrophoresis (PFGE) for molecular typing were performed for the strains.ResultsA total of 296 strains of V. parahaemolyticus were isolated, in which 251 were from diarrhea patients and 45 were from foods. V. parahaemolyticus was mainly detected during July-September, The cases were mainly adults and most of them usually dined at home. O3∶K6 was the main serotype and tdh+trh-tlh+ was the virulence genotype detected in patients. O2 was the main serotype and tdh-trh-tlh+ was the virulence genotype detected in foods. Forty eight strains of V. parahaemolyticus could be classified into 42 PFGE banding patterns, and the banding pattern similarity values were from 6.16% to 100.00%.ConclusionIt is necessary to strengthen the health supervision for V. parahaemolyticus infection and health education about having a good dining habit and improving the household cooking process of aquatic products during July-September. The genetic similarity of the V. parahaemolyticus strains spreading in Lishui was low and polyclonal sources might exist. Serotype O3∶K6 was mainly detected in patients, and O2 was mainly in foods.
Epidemiologic and phylogenetic analysis on Rift Valley fever virus
Lijin Lai, Cui Shang, Yan Wei, Jiandong Li
2019, 34(9): 827-834. DOI: 10.3784/j.issn.1003-9961.2019.09.012
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ObjectiveTo analyze the genetic evolution and epidemiologic characteristics of Rift Valley fever virus (RVFV) since its discovery and the incidence and geographic distribution of Rift Valley fever (RVF) in the world, and provide evidence for the prevention and control of RVF.MethodsDescriptive epidemiological methods were used to collect and analyze the information about epidemic of RVF in the world; whole genomic sequences of viruses with clear isolation time and region were selected, and the BEAST 2 software packages was used for phylogenetic analysis, and the time and space distribution analysis were performed.ResultsBy 2018, RVF outbreaks had been reported in 22 countries, a total of 39 404 cases, including 2 323 deaths, had been reported in the world. Whole genomic sequences of 183 S fragments, 138 M fragments, and 135 L fragments of RVFV were selected. Phylogenetic analysis showed that RVFV S, M and L segments can be classified into seven lineages (A–G). Lineage A and B were the main lineages causing three pandemics. Cross border transmission of the virus is in increase, and an imported case from Angola to China was detected in 2016.ConclusionRVFV is widely distributed in Africa, but the severity of the virus spread is underestimated. In the context of increasing cross border transmission, it is necessary to strengthen the laboratory and epidemiologic surveillance for RVFV, information collection and release and improve political attention and public awareness for the prevention and control of the disease to protect people's health.
Surveillance results of avian influenza virus in external environment in Quzhou, Zhejiang, 2013–2018
Shiteng Huang, Ruijun Yang, Lei Lyu, Xufu Chen, Sheng Wan
2019, 34(9): 835-838. DOI: 10.3784/j.issn.1003-9961.2019.09.013
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ObjectiveTo understand the distribution of avian influenza virus in the external environment in Quzhou, Zhejiang province, from 2013 to 2018, and provide scientific evidence for the prevention and control of human infection with avian influenza virus.MethodsThe external environmental samples were collected from different surveillance sites of Quzhou for the nucleic acid detection of avian influenza viruses by using real-time RT-PCR during 2013–2018, and the results were used for statistical analysis.ResultsA total of 5 290 environmental samples were collected from 2013 to 2018, in which 1 809 were positive for avian influenza A virus (34.20%), The subtype identification showed that H9 and unspecific type were main subtypes, the positive rate were 44.50% and 29.13% respectively. The positive rate was highest in Kaihua county (54.85%) and lowest in Longyou county (17.25%). The detection rate in live poultry markets was highest (45.94%) in 5 types of places, and the detection rate in surface swabs of chopping boards for slaughtering or placing poultry products was highest (58.96%) in 6 types of samples. The positive rates were significantly higher during January-March (38.06%) and during October-December (37.23%). There were significant differences in time, area, place and sample type specific distributions of avian influenza viruses (all P<0.001).ConclusionThere were different subtypes and mixed types of avian influenza virus contamination in the environment in Quzhou. It is important to strengthen the surveillance for avian influenza virus in environment and take comprehensive prevention and control measures to reduce the risk of human infection with avian influenza virus.
Epidemiologic characteristics of dengue fever in foreigner population in China, 2005–2017
Yue Wu, Liping Wang, Liang Chen, Jichun Wang, Yu Qin, Yudan Song, Zhenjun Li, Guangxue He
2019, 34(9): 839-843. DOI: 10.3784/j.issn.1003-9961.2019.09.014
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ObjectiveTo understand the epidemiological characteristics of dengue fever in foreigner population in China between 2005 and 2017 and provide evidence for the improvement of dengue fever prevention and control.MethodsA descriptive epidemiologic study of dengue fever in the foreigner population in China from 2005 to 2017 was conducted by using data from National Notifiable Infectious Disease Reporting System to understand the demographic characteristics, temporal and spatial distributions of dengue fever cases in foreigners The epidemiologic characteristics of dengue fever in foreigners between Yunnan and other provinces were compared.ResultsFrom 2005 to 2017, a total of 2 106 cases of dengue fever were reported in foreigners in China, accounting for 3.08% of total dengue fever cases. The number of cases showed an ascending trend, with a peak in 2017. The areas reporting dengue fever cases in foreigners also expanded. Yunnan province had the highest number of the cases (1 751), accounting for 83.14% of the total, followed by Guangdong province (140 cases, 6.65%). Most dengue fever cases in foreigners in Yunnan were imported from Myanmar. The demographic characteristics, the sources of these dengue fever cases and the incidence trend between Yunnan and other provinces were different.ConclusionThe dengue fever cases in foreigners have great influence on dengue fever epidemics in China in recent years, especially in Yunnan. It is necessary to strengthen the cooperation with neighboring countries to improve the prevention and control of dengue fever, and conduct the surveillance, screening and treatment of dengue fever in foreigners in key areas.
Establishment of real-time PCR assays for rapid detection of Clostridium botulinum type A and B
Ying Huang, Yun Shi, Changyun Ye, Xuefang Xu
2019, 34(9): 844-848. DOI: 10.3784/j.issn.1003-9961.2019.09.015
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ObjectiveTo establish real-time PCR assays for the toxin gene detections of Clostridium botulinum type A and B, construct standard curves and evaluate the specificities, sensitivities and detection thresholds of the assays, and provide evidence for the rapid and accurate detection of C. botulinum.MethodsSpecific primers and probes were designed based on the sequences of toxin genes of C. botulinum type A and B. Real-time PCR assays were established with optimized reaction conditions. 25 other intestinal bacteria and common bacteria were used to test the specificities of the assays. Standard curve construction, fecal sample simulation and sensitivity measurement were achieved with recombinant plasmids containing toxin genes of C. botulinum type A and B.ResultsThe specificities of the real-time PCR assays were high. Specific amplification curves were observed in recombinant plasmids containing toxin genes of C. botulinum type A and B. No specific amplifications were found for the 25 other bacteria. The detection thresholds of toxin genes of C. botulinum type A and type B were 5.04×102 copy/μl and 6.91×102 copy/μl respectively according to the amplification curves. The detection thresholds of recombinant plasmids containing toxin genes of C. botulinum type A and B in artificial fecal samples were 1.71×103 copy/μl and 2.14×103 copy/μl respectively.ConclusionIn this study, real -time PCR assays for the toxin gens detections of C. botulinum type A and type B of China were established, which can be applied in the rapid detection of C. botulinum.
Progress in research of early diagnosis of blood-borne pathogens
Xiaoli Chen, Jinxing Lu, Xiaoping Chen
2019, 34(9): 849-854. DOI: 10.3784/j.issn.1003-9961.2019.09.016
[Abstract](4138) [FullText HTML](863) [PDF 885KB](7) Peer reviewing opinions Related References Cited By (0) Share
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Blood borne pathogen infection often occurs in hospitalized patients with high mortality rate, the early and rapid identification of pathogens and appropriate antimicrobial treatment are the key measures to reduce the mortality. Blood culture is the gold standard in the diagnosis of blood borne pathogen infection, blood culture, however, is not only time-consuming but also non-sensitive with low positive rate. Molecular biology method can greatly reduce diagnosis time, improve the sensitivity and specificity of diagnosis and provide reliable evidence for the rational clinical drug use and accurate treatment, which can greatly improve the patient's survival rate. This paper summarizes the progress in the research of molecular biology methods for the diagnosis of blood-borne pathogens, including nucleic acid hybridization technique, nucleic acid amplification technique, fluorescence real-time quantitative PCR, DNA microarray and matrix assisted laser desorption/ionizaton time of flight mass spectrometry(MALDI-TOF-MS).
Influence of daily mean temperature on incidence of hand foot and mouth disease in Jingzhou, Hubei, 2010–2017
Tian Liu, Xijun Weng, Lijie Zhang, Menglei Yao, Jigui Huang, Qinqin Xu, Yang Wu, Qi Chen, Yeqing Tong
2019, 34(9): 855-860. DOI: 10.3784/j.issn.1003-9961.2019.09.017
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ObjectiveTo discuss the 1ag effects of daily mean temperature on incidence of hand foot and mouth disease (HFMD) in Jingzhou of Hubei province.MethodsThe data of daily cases of HFMD in Jingzhou from 2010 to 2017 were collected, and local meteorological data during the same period were collected too. Spearman correlation test was used to analyze the relationship between the meteorological factors and the daily case number of HFMD, and the distributed lag non-linear model was used to analyze the relationship between the daily mean temperature and the daily case number of HFMD. The temperature of 18.18 ℃ was used as reference for the estimation of RRs at different temperature (P25, P50, P95). The delayed and cumulative effects of daily mean temperature on daily case number of HFMD were also assessed.ResultsA total of 48 591 cases were reported in Jingzhou from 2010 to 2017. The daily mean case number of HFMD was related to daily average temperature, daily precipitation, daily average pressure, daily relative humidity and wind speed. An inverse U-shaped relationship was found consistently between daily mean temperature and the daily case number of HFMD, and the maximum value of effect at 18.19 ℃ was 2.67 (95% CI: 2.12–3.37). When the temperature was set to 9.76 ℃ (P25), 18.35 ℃ (P50) and 30.96 ℃ (P95), the lag effect time of the significant positive influence (RR>1.00) on daily case number of HFMD was 6–19 d, 6–21 d and 0 d respectively. The lag effect was highest on lag 0–21 d, and the RR values of HFMD was 1.11(95% CI: 1.04–1.19), 1.56(95% CI: 1.31–1.86), 2.67, (95% CI: 2.12–3.37), 1.58 (95% CI: 1.19–2.10) for 5.17 ℃(P10), 9.76 ℃(P25), 18.35 ℃(P50) and 25.21 ℃(P95) respectively.ConclusionAverage temperature had significant influence on the risk of HFMD in Jingzhou. High temperature and low temperature could reduce the risk of HFMD, and the influence on the daily case number of HFMD was nonlinear and lagging.
Epidemiological investigation of a case of human infection with Streptococcus suis serotype 14
Songjian Xiao, Yi Zhou, Chudong Zhang, Yanmei Fang, Huitao Huang
2019, 34(9): 861-864. DOI: 10.3784/j.issn.1003-9961.2019.09.018
[Abstract](2051) [FullText HTML](573) [PDF 2277KB](22) Peer reviewing opinions Related References Cited By (0) Share
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In September 2018, a case of human infection with Streptococcus suis serotype 14 was reported in Zhuhai, Guangdong province. The patient and one co-exposed person showed clinical manifestations of meningitis, arthritis and permanent deafness. One week before illness they had no contacts with sick or dead pigs, but ate pork every day. According to the investigation, the patient might be infected due to damaged oral mucosa.
Multistate infestation with the exotic disease-vector tick Haemaphysalis longicornis — United States, August
2017-September 2018
Zhenyu Gong, Xunliang Gong
2019, 34(9): 865-866. DOI: 10.3784/j.issn.1003-9961.2019.09.019
[Abstract](1437) [FullText HTML](331) [PDF 1910KB](2) Peer reviewing opinions Related References Cited By (0) Share
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CN 11-2928/R

ISSN 1003-9961

Established in:1986 , Monthly

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

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

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