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2000-2017年世界各地区麻疹消除的进展趋势
Zhenyu Gong, Xunliang Gong
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.03.020
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Epidemiological characteristics of people living with HIV/AIDS before and after implementation of classified management
Hongbo Shi, Hang Hong, Hongjun Dong, Haibo Jiang, Xiaomin Gu
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.03.010
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ObjectiveTo understand the epidemiological characteristics of people living with HIV/AIDS before and after the implementation of classified management strategy in Ningbo, China.MethodsA the end of November 2017, a 1-year follow up was conducted in recruited HIV/AIDS who lived in Ningbo. Different management strategy was implemented in HIV/AIDS with different risk of transmission. The information about their socio-demographics, transmission risk, sex behavior, history of sexually transmitted diseases and antiretroviral therapy were analyzed.ResultsA total of 2 905 HIV/AIDS were included. After 1 year classified management, the proportion of HIV/AIDS with high transmission risk declined from 11.74% to 5.23% (χ2=66.786, P<0.05). The proportion of HIV/AIDS with high risk transmission significantly decrease (P<0.05) except those who were aged <20 years, with education level blow primary school and drug users (P>0.05). After classified management, the proportion of HIV/AIDS with sexual behaviors, with multi sex partners, using no condoms significantly decreased (P<0.05); the proportion of HIV/AIDS who were syphilis positive significantly decreased (P<0.05); the proportion of HIV/AIDS receiving no antiretroviral therapy and viral load ≥400 significantly decreased (P<0.05).ConclusionThrough the implementation of classified management strategy, the proportion of HIV/AIDS with high transmission risk in Ningbo significantly decreased, the prevalence of multi sex partners and sexual transmitted diseases in HIV/AIDS A with high transmission risk significantly decreased. In the future, it is necessary to further strengthen the follow up and anti-retroviral therapy in HIV/AIDS with high transmission risk in order to reduce the HIV transmission.
Methodological assessment and detection base line based prediction of Salmonella carriage level in catering and public service employees in Yulin
Xiaolu Pang, Guimin Gu, Yue Liu, Ming Luo, Fang Wang, Wen Liang, Mingliu Wang, Chunlei Shi, Xianming Shi, Yiwei Liu, Xuebin Xu
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.008
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ObjectiveTo predict the carriage level of Salmonella in catering and public service employees in Yulin in Guangxi based on the base line and methodological assessment of Salmonella detection process.MethodThe selective enrichment broth (SBG) and selective plates (CAS, XLD, DHL) were used to establish Salmonella screening techniques process. Statistical parameters were obtained through the detections of stock strains and 408 stool samples of the employees for the evaluation of the sensitivity, specificity and positive predictive value of different combination process (SBG+CAS/XLD/DHL) in the detection of Salmonella. The Salmonella carriage level in catering and public service employees in Yulin from 2014 to 2017 were adjusted and predicted according to the sensitivity of SBG-DHL in Salmonella isolation.ResultsReference stock strain detection showed that the sensitivity and specificity of CAS, XLD and DHL were 100.00% and 96.67%, 100.00% and 83.33%, 83.33% and 50.00%, respectively. A total of 22 Salmonella strains were isolated from 408 stool samples by using combined plates, the positive rate was 5.39%. The sensitivity and positive predictive rates were 95.45% and 89.23% for CAS, 86.36% and 27.72% for XLD, 68.18% and 16.15% for DHL, 100.00% and 29.27% for CAS+XLD, respectively. A Salmonella Rissen isolate with both hydrogen sulfide-negative and positive clones was isolated from an asymptomatic carrier by CAS and XLD. Through the calibration and prediction, the annual rate of Salmonella carriage was 3.35% in the employees from 2014 to 2017. Accordingly, we predicted that the Salmonella carriage rate was 3 350/100 000 in catering and public service employees in Yulin of Guangxi.ConclusionThe sensitivity and positive predictive rate of Salmonella detection can be used as the indicators for evaluation of detection quality and methodologies. Big data confirmed that the high Salmonella carriage arte was persistent in catering and public service employees in southern China. It is necessary to strengthen the screening of asymptomatic Salmonella carriers to reduce the recessive spread of food-borne pathogenic bacteria.
Effect of stachyose on colonization of Clostridium difficile and intestinal flora in intestinal tract of mice
Ying Kang, Xianping Li, Liqiong Song, Yuchun Xiao, Yuanming Huang, Zhihong Ren
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.017
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ObjectiveTo explore whether stachyose can effectively inhibit the colonization of Clostridium difficile in intestinal tract of mice and analyze the structural change of the intestinal flora using C. difficile infection mouse model.MethodsC57BL/6 female mice were randomly divided into three groups, one group did not receive any treatment (blank group), and the other two groups were daily administrated with stachyose (stachyose group) and phosphate buffered saline (PBS) (PBS group) respectively for 10 days after C. difficile infection. On day 10 after infection, the content of C. difficile in feces was measured with real-time polymerase chain reaction (PCR) and the variation of intestinal flora in mice in different groups was analyzed with 16S rRNA sequencing technique.ResultsOn day 10 after infection, stachyose significantly decreased the colonization of C. difficile in intestinal tract the mice infected with C. difficile. The 16S rRNA sequencing result showed that the ACE index of stachyose group was significantly higher than that of PBS group, but it did not return to normal level. At the phylum level, stachyose treatment resulted in a significant increase in the relative abundance of Bacteroidetes and Firmicutes and a significant decrease in the relative abundance of Proteobacteria in C. difficile-infected mice. At the species level, stachyose treatment resulted in a significant increase in the relative abundance of Parabacteroides goldsteinii, Blautia hansenii, Bacteroides thetaiotaomicron and a significant decrease in the relative abundance of Parasutterella excrementihominis, Parabacteroides distasonis.ConclusionStachyose treatment can effectively reduce the colonization of C. difficile, restore the richness of intestinal flora in intestinal tract of the mice in mice infected with C. difficile, especially the relative abundance of several bacteria, such as Bacteroides thetaiotaomicron and Parabacteroides goldsteinii.
Molecular etiologic investigation of gastroenteritis outbreaks caused by norovirus G in two schools in Lanzhou, 2018
Qian Kang, Jianhua Chen, Peng Wang, Huimin Zhang, Xueying Wang, Hui Zhang, Deshan Yu
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.019
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ObjectiveTo understand the molecular characteristics of norovirus-caused outbreaks of acute gastroenteritis in two schools in Lanzhou from May to June in 2018, and analyze the sources of norovirus infections.MethodsTwenty nine anal swabs and 4 surface swabs from the two outbreaks were detected for norovirus by real-time fluorescence quantitative RT-PCR. The RdRp and VP1 region genes of positive samples were sequenced and analyzed by NCBI and MEGA 6.0 software.ResultsThe outbreaks of gastroenteritis in two schools were caused by norovirus GⅠ. In the outbreak in school A from 28 May to 4 June, 50 cases occurred with an attack rate of 3.24%. In the outbreak in school B from 1 to 13 June, 35 cases occurred with an attack arte of 4.76%. The epidemiological investigation showed that the two outbreaks were related to small dining place and close contact. Thirteen out of 33 samples were positive for norovirus GⅠ nucleic acid. The gene sequencing and alignment results indicated that the first epidemic was caused by norovirus GⅠ.3 [P13], and the second one was caused by norovirus GⅠ.6 [P11]. Conclusion Two outbreaks of acute gastroenteritis in two schools in Chengguan district of Lanzhou were caused by norovirus GⅠ.3 [P13] and GⅠ.6 [P11] respectively. It is necessary to strengthen the surveillance for norovirus and the management of small dining places near middle and primary schools.
Laboratory detection for an acute gastroenteritis outbreak caused by norovirus and Staphylococcus aureus enterotoxins
Guoxin Zhen, Ying Li, Guoqiang Ji, Shuang Zhang, Yuanyuan Wang, Yanchun Zhang, Miao Wang, Hongbo Jing, Xiaochen Ma, Maojun Zhang
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.018
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ObjectiveTo analyze the laboratory detection results for an acute gastroenteritis outbreak.MethodsTaqMan real-time PCR was performed for the detections of norovirus and 8 major bacteria pathogens by using the original 6 vomit samples collected from patients. PCR for the enterotoxin (SE) genes of Staphylococcus aureus was performed by using the S. aureu strains cultured in enriched vomit samples. ELISA was performed for the detection of SEs of 5 S. aureu strains, and PCR was used for SE gene detection and spa typing.ResultsSix original vomit samples were collected in the outbreak. Among them, 5 were positive for norovirus and 2 were positive and nuc gene of S. aureus in real-time PCR. Five enriched vomit samples were positive for nuc gene, among them, 4 and 1 were positive for seb gene and sea gene, respectively. Five S. aureus isolates were obtained from 5 enriched vomit samples of the patients, and were divided into 3 spa types (t701, t437 and t4209). There was a difference in SE gene detection of S. aureu between PCR and ELISA.ConclusionLaboratory analysis indicated that this gastroenteritis outbreak may be caused by the infection of norovirus plus effect of SEs of S. aureu.
Expression of T lymphocyte surface markers in peripheral blood of patients with pulmonary disease
Qiuqiong Lyu, Hongmei Liu, Wenfang Xu, Qiong Wang, Yulan Chen, Liliang Wei
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.016
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ObjectivesTo observe the expression of T lymphocyte surface markers in peripheral blood of patients with pulmonary disease, and explore the pathogenesis of pulmonary disease from the level of cellular immunity.MethodsEighty four patients with pulmonary diseases receiving treatment in pneumology department of Shaoxing Hospital from January to December, 2016 were divided into tuberculosis (TB) group (34 cases), the lung cancer (LC) group (25 cases) and non-tuberculosis pneumonia (NTP) group (25 cases) according to the diagnosis, and a healthy control (HC) group (35 cases) was set up simultaneously. The percentages of CD3CD4, CD3CD8, CD3CD45RA/ CD45RO, CD3HLA-DR, CD8HLA-DR and CD4CD25 T cells in peripheral blood of all experimental groups were detected, and the results were statistically analyzed using t test.ResultsThe ratios of CD4/CD8 of TB group (1.01±0.48), LC group (1.17±0.39) and NTP group (1.35±0.55) were lower compared with HC group (1.48±0.52) (t=2.562, t=2.341, t=2.112, P<0.05). The percentages of CD3CD45RO cells in total T lymphocyte of TB group (65.20%±12.63%), LC group (56.70%±9.98%) and NTP group (55.90%±9.29%) were higher than that of HC group (49.60% ±11.52%, t=3.422, t=2.647, t=2.084, P<0.05), and that of TB group was higher than those of LC and NTP groups (t=2.153, t=3.112, P<0.05); The percentages of CD3HLA-DR cells of TB group (19.59%±7.01%) and LC group (21.70%±7.34%) in total T lymphocyte were higher than that of HC group (11.40%±5.33%, t=2.383, t=2.533, P<0.05); The percentage of CD8HLA-DRcells in total T lymphocyte was higher in TB group (11.26%±4.88%) than in HC group (7.10%±3.07%, t=2.244, P<0.05). The percentages of CD4CD25cells in total T lymphocyte increased in TB group (10.70%±3.06%) and LC group (10.40%±2.33%) compared with HC group (8.20%±2.79%, t=2.647, t=2.662, P<0.05). ConclusionThe expressions of surface markers of T lymphocytes in peripheral blood changed in patients with tuberculosis, lung cancer and pneumonia, especially in TB patients. For TB patients, it might be associated with the unique pathogenesis of tuberculosis.
Establishment of a nested polymerase chain reaction assay for detection of Brucella DNA
Guozhong Tian
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.015
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ObjectiveTo establish a nested polymerase chain reaction (PCR) assay with high sensitivity and specificity to detect Brucella DNA.MethodsThe bacteria DNA was extracted by using bacterial genome extraction kit. The DNA extraction from blood samples was conducted by using blood and other tissue genomic DNA extraction kit. The extracted DNA was pre-amplified by conventional PCR. The amplified PCR product was used again as the template for the second amplification by fluorescence quantitative PCR (nested PCR). The sensitivity and specificity for bacteria DNA extraction were tested. The relationship curve between Ct value and copy numbers of DNA was constructed. The DNA from blood samples was tested. The results were compared with conventional PCR and conventional fluorescence quantitative PCR.ResultsThe sensitivity of conventional PCR was 512 copies of Brucella DNA. The effective range of genomic DNA was 921.6 ng/μl–6.8 fg/μl for nested PCR. And the corresponding Ct value was 12.04–37.50. The index relationship was y=(e−0.695x)×1012, R2=0.998 6. The amplification efficiency of nested PCR was 2.28×109. The detection limit for nested PCR was 2 copy numbers of Brucella DNA. The sensitivity, specificity, positive predictive value and negative predictive value of nested PCR were 91.67%, 93.10%, 91.67% and 93.10%, respectively. Twenty five blood samples from a sheep farm were detected by nested PCR. The positive rate was 92.00% (23/25). The detection results of Brucella DNA were negative for 27 blood samples from healthy people (no Ct value).ConclusionThe nested PCR has high sensitivity and specificity, which is suitable to use for the detection of Brucella in blood samples.
Characteristics of pyrazinamide resistance in multidrug-resistant Mycobacterium tuberculosis and its correlation with second-line drug resistance
Yang Che, Tianchi Yang, Xiang Lin, Dingyi Bo
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.013
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ObjectiveTo investigate the characteristics of the resistance to pyrazinamide in multidrug-resistant (MDR) Mycobacterium tuberculosis(MTB) strains and its correlation with the second-line drug resistance in Ningbo.MethodsA total of 110 MDR-TB isolates selected in the drug resistance survey in Ningbo between 2015 and 2017 were used in the study. The conventional drug susceptibility test (1% ratio method) was used to detect the drug-resistant profiles of MDR-MTB against 5 second-line antibiotics (ofloxacin, levofloxacin, kanamycin, amikacin, capreomycin). BACTEC MGIT 960 PZA method was used to detect pyrazinamide resistance of 110 MDR-MTB isolates and gene sequencing was conducted to detect the mutation of pncA gene.ResultsAmong the 110 isolates of MDR-MTB, 65 were resistant to pyrazinamide (59.09%). pncA gene mutation occurred in 56 strains of MDR-MTB (50.91%). Among the 65 pyrazinamide resistant strains, pncA mutation was detected in 54 strains (83.08%). Among the 45 pyrazinamide sensitive strains, pncA mutation was detected in 2 strains (4.44%). The mutation rate of pncA was much higher in pyrazinamide resistant strains than in pyrazinamide sensitive strains, the difference was significant 2=65.787, P<0.001). There were 42 mutation types in pncA gene, and single base substitution was the main type (92.86%). The resistance to streptomycin, ethambutol, ofloxacin, levofloxacin and pre-extensive drug resistance (pre-XDR) were associated with pyrazinamide resistance in MDR-MTB strains.ConclusionMDR-MTB clinical isolates were resistant to pyrazinamide seriously, and the pyrazinamide resistance was associated with the resistances to second line antibiotics (ofloxacin, levofloxacin) and pre-XDR.
Surveillance results of first-line anti-tuberculosis drug resistance in tuberculosis patients in Lishui, Zhejiang, 2013–2018
Xiuying Chen, Lixia Xu, Fuming Liu, Jie Wu, Liyang Qiu, Pengfei Fan, Qiuhua Li
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.014
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ObjectiveTo understand the resistance of to the first-line anti TB drugs in tuberculosis (TB) patients in Lishui, Zhejiang province, and provide reference basis for TB prevention and control.MethodsThe Mycobacterium tuberculosis strains collected from 2013 to 2018 were identified and tested for the sensitivity to isoniazid, rifampicin, streptomycin and ethambutol.ResultsThe drug resistance of 1 883 strains of M. tuberculosis was detected, the strains were from 1 770 newly treated pulmonary TB cases and 113 retreated pulmonary TB cases. The overall drug resistance rate was 17.15% and the multidrug resistance rate was 5.74%. The drug resistance rate in newly treated pulmonary TB cases was 15.42% (273/1 770), lower than that in retreated TB cases (44.25%, 50/113). In newly treated pulmonary TB cases, the resistance rate to streptomycin was highest, followed by isoniazid, rifampicin and ethambutol. In retreated pulmonary TB cases, the resistance rate to isoniazid was highest, followed by rifampicin, streptomycin and ethambutol.ConclusionThe overall drug resistance rate and multidrug resistance rate in pulmonary TB cases in Lishui were lower than province and national baseline level and the level in last round surveillance in Lishui, but the multidrug resistance of TB was still serious.
Isolation of Yersinia pestis phage from Rattus norvegicus in Yunnan province and its epidemiological significance
Yue Yuan, Youhong Zhong, Haipeng Zhang, Chao Su, Lihua Yang, Fengyi Yang, Hesong Wu, Peng Wang
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.03.011
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ObjectiveTo investigate the status of plague phages in Rattus norvegicus, the host animal of plague in Yunnan province, and to explore its epidemiological significance.MethodsFrom 2015 to 2018, samples were taken from 25 sites in 10 counties and cities of Yunnan province to collect intestinal specimens of captured Rattus norvegicus. The Yersinia pestis phage was isolated from intestinal specimens by double plate method. The specific gene caf1 of Yersinia pestis was detected.ResultsTotally 344 copies of brown mouse were collected and 15 strains of Yersinia pestis phages were isolated from them, with a total isolation rate of 4.36%. From the sampling points, 10 spots were isolated from Yersinia pestis phages, with the highest isolation rates of Chunhe street and Yudai street in Hongta district of Yuxi city (28.57% and 16.67%). There was no significant difference between the sex, age and habitat of rats on the isolation of Yersinia pestis phages.The caf1 test of all specimens was negative. Four of the isolated bacteriophages are of the Myoviridae family.ConclusionThere are a certain number of Yersinia pestis phages in Rattus norvegicus in Yunnan province, and they are distributed in the historical epidemic area, the near historical epidemic area, the rekindling epidemic area and the current epidemic area. The carrying rate of Yersinia pestis phages in the historical epidemic area and urban Rattus norvegicus is higher, which microecological significance is worth further discussion.
Establishmentofareversetranscriptionrecombinase-mediatedamplificationassayforrapiddetectionofTahynavirus
Fan Li, Xiaofang Guo, Qikai Yin, Xinxin Shen, Shihong Fu, Songtao Xu, Wenwen Lei, Hongning Zhou, Xuejun Ma, Huanyu Wang
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.004
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ObjectiveTo establish a reverse transcription recombinase-mediated nucleic acid amplification (RAA) assay for the rapid detection of Tahyna virus nucleic acid.MethodsPrimers and probes were designed in the conserved region of S segment of Tahyna virus. The sensitivity of the new RAA assay was evaluated by constructing plasmids containing target gene fragments and cultured virus. The specificity of the assay were tested by seven viruses of flavivirus, alphavirus, Orthobunyavirus and Seadornavirus. Additionally, 30 batches of mosquito samples were used to evaluate the performance of the RT-RAA assay.ResultsThe limit detection of the assay was 100 copies per reaction for the constructed plasmid standard and 1 plaque-forming units (PFU) per reaction of Tahyna virus titers. There was no cross-reaction with other arboviruses.ConclusionA highly sensitive, specific, and easy-to-use assay was established for the rapid detection of Tahyna virus.
EstablishmentofTaqManRT-PCRfordetectionofKoutangovirus
Qikai Yin, Xiaojing Chen, Shihong Fu, Wenjing Liu, Fan Li, Wenwen Lei, Ying He, Songtao Xu, Guodong Liang, Kai Nie, Huanyu Wang
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.005
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ObjectiveTo establish a real-time quantitative TaqMan reverse transcription-polymerase chain reaction (RT-PCR) assay for the rapid detection of Koutango virus (KOUTV) in mosquito borne arbovirus surveillance.MethodsAll gene sequences of KOUTV were downloaded from GenBank for multiple sequence alignment. Specific primers and probes were designed for the highly conserved region of NS5 gene. The specificity of established TaqMan RT-PCR assay was evaluated with other 9 viruses from 5 families, and the stability of the assay was verified by parallel repeated experiments. Moreover, an absolute quantitative analysis model for the NS5 gene copy number of KOUTV was set up with in vitro transcribed RNA standards.ResultsThe established TaqMan RT-PCR assay has good specificity and sensitivity. No cross reaction with other arbovirus was observed and the sensitivity was 1.0×102 copies/reaction. The coefficients of variation of Ct values in repeated detection of same sample were all less than 1.5%. A total of 6 328 mosquito samples in 112 batches collected in Xinjiang were tested with the established assay and the results showed KOUTV negative in all samples.ConclusionA high specificity and sensitivity TaqMan RT-PCR assay for KOUTV was successfully established.
DetectionandmanagementofanimportedcaseofChikungunyafeverinHenan
Xingle Li, Xiangdong Jin, Jianmin Ma, Dongxiao Li, Ruijuan Fu, Haifeng Wang, Haimei Li, Jia Su, Xueyong Huang, Wanshen Guo
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.006
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ObjectiveTo understand the epidemiological and etiological characteristics of an imported Chikungunya fever case occurred in Huixian county of Henan province in August 2019 and provide evidence for the prevention and control of the further spread.MethodsThe serum samples of the case, person with co-exposure and contacts as well as mosquito samples were detected with real-time fluorescence quantitative RT-PCR and the virus isolation was conducted, E1 gene of the isolate was sequenced and analyzed by Clustal X and MEGA 7.0. Epidemiological investigation was conducted, and prevention and control measures were taken according to related technical guidelines.ResultsThe serum sample of the case was positive for nucleic acid of Chikungunya virus. The virus isolate (GenBank No. MN432879) belonged to ECSA genotype of Chikungunya virus. In E1 section, the isolate shared 100% nucleotide/amino acid homology of MN432879 with an imported strain (GenBank No. MG912993) in Zhejiang in 2017, and shared 99.4% nucleotide homology and 99.8% amino acid homology with an imported strain (GenBank No. MG925665) isolated in Henan. There was one case with co-exposure and three contacts, all of them showed no clinical manifestations of Chikungunya fever. The breteau index of the epidemic point declined from 9.5 in the first surveillance to 3.2 in the third surveillance and remained at a low level. Mosquito samples were negative for nucleic acid of Chikungunya virus.ConclusionThe imported Chikungunya fever case in Huixian county of Henan was caused by ECSA genotype Chikungunya virus, no further spread occurred in this area.
GeneticevolutionofavianinfluenzaA(H9N2)virusesfrompoultrymarketsinGuangzhou,2017–2019
Lan Cao, Kuibiao Li, Dan Xia, Yanhui Liu, Yiyun Chen, Jianyun Lu, Zhoubin Zhang, Biao Di
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2020.03.007
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ObjectiveTo analyze the characteristics of genetic evolution of avian influenza A (H9N2) virus strains isolated in Guangzhou and provide research data for the prevention and control of human infection with avian influenza virus.MethodsA total of 24 strains of H9N2 virus isolated from the samples collected in poultry markets in Guangzhou were randomly selected for sequencing. The genetic evolution characteristics of the strains were analyzed with bioinformatics software.ResultsThe nucleotide homology of all the strains ranged from 86.20% to 100.00%, and the evolutionary distance of nucleotide was 0.00–1.54. Genetic evolution analysis showed that all the strains clustered into same phylogenetic clades, and belonged to genotype G57. Molecular analysis showed that all the strains belonged to low pathogenic avian influenza viruses, and all strains had Q226L mutation in HA receptor binding sites, which suggested that these viruses can easily recognize the receptor of human. Most of the strains had mutations related to enhanced pathogenicity at the sites of HA-N166D, PB2-L89V/292V, PB1-I368V, L473V, PA-K356R, S409N, M1-N30D, T215A, NS1-P42S. All the strains were sensitive to neuraminidase inhibitors and resistant to alkylamines.ConclusionAvian influenza A (H9N2) viruses circulated in Guangzhou during 2017–2019 belonged to genotype G57, which had stable variation of enhanced binding ability to human receptor. Most of the strains had mutations of enhanced pathogenicity, which needed to be monitored continually.
Characteristics of Enterococcus hirae isolated from Tibetan gazelles in Qinghai-Tibet Plateau
Jiajia Meng, Kui Dong, Juan Zhou, Jing Yang, Jianguo Xu
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.03.012
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ObjectiveTo study the characteristics of Enterococcus hirae carried by Tibetan gazelles in Qinghai-Tibet Plateau.MethodsBacterial isolation, 16S rRNA and rpoA gene sequence analysis and whole genome analysis were conducted. K-B disk method was used for drug sensitivity test. COGs, SwissProt, CARD and VFDB databases were used for genome analysis. Software MUMmer and TreeBeST were used to construct the phylogenetic tree based on single nucleotide polymorphisms (SNP).ResultsTwo strains of E. hirae were isolated from 15 stool samples of Tibetan gazelles. The identification was supported by biochemical analysis, full-length 16S rRNA sequence analysis and whole genome analysis. Genomic analysis showed that the strains carried capsular polysaccharide gene cluster, which was recognized as virulence gene. Phylogenetic analysis based on SNPs indicated that two strains of E. hirae from Tibetan gazelle belonged to two clades, which were closer to animal strains, and the strains were sensitive to many commonly used antibiotics.ConclusionE. hirae isolated from Tibetan gazelles in Qinghai-Tibet Plateau carried capsular polysaccharide gene cluster, which was favorable for environment adaption. E. hirae strains showed sensitivity to multi-antibiotics. The study results indicated that YL69 has the potential to spread in humans.
2020年2月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Diseases in February 2020
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.03.001
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Summary of global surveillance data of infectious diseases in February 2020
Hui Han, Bo Wu, Jiaojiao Jia, Yajing Song
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.03.003
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In February 2020, a total of 61 infectious diseases were reported globally, affecting 82 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) (40), dengue fever(28), measles(13), legionellosis(8) and malaria(7).The top four infectious diseases with highest case fatality rates were Ebola virus disease (65.7%), Middle East respiratory syndrome(34.2%), Lassa fever(17.1%) and COVID-19(3.4%). The top five infectious diseases with greatest number of deaths were COVID-19, measles, dengue fever, Lassa fever and Ebola virus disease. The prevalent infectious diseases in Asia were COVID-19, Middle East respiratory syndrome and dengue fever, the prevalent infectious diseases in Africa were Ebola virus disease, cholera, yellow fever, Lassa fever and measles, the prevalent infectious diseases in America were dengue fever and COVID-19, the prevalent infectious diseases in Europe was COVID-19.
2020年2月中国甲乙丙类传染病疫情动态概要
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.03.002
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Epidemiological investigation of an outbreak of norovirus-caused gastroenteritis
Tong Su, Yingying Liu, Wenna Zhao, Qiuli Yu, Yun Xie, Shunxiang Qi, Qi Li
Accepted Manuscript
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ObjectiveTo study the epidemiological characteristics and identify the cause of an outbreak caused by norovirus infection in a school in Hebei province in 2018, and evaluate the performance of the epidemic response.MethodsField epidemiology method were used to collect basic information of an outbreak in a school in Hebei province in 2018 and retrospective questionnaire survey was conducted for all cases, followed by descriptive analysis of the outbreak. Risk factors related to the outbreak were explored through cross-sectional and case-control study. Meanwhile, laboratory tests of enteroviruses and bacterial pathogens were performed by using stool samples and anal swabs of the patients, food and water samples, and environment samples.ResultsThe outbreak lasted for 6 days, involving 55 cases. The cases mainly occurred in 16 classes, and the attack rate was 1.60%. Among the cases, 34 were males, and 21 were females, with the ratio of 1.62∶1. The age of the cases ranged from 6 years to 37 years, with the average age of 9.13 years. The main clinical symptoms were vomiting (92.73%, 51/55), diarrhea (65.45%, 36/55), which all disappeared within 1 or 2 days after onset. No death and server case occurred. Risk factor analysis showed that the differences in food intake and water drinking were not significant between class with high attack rate and class without case. A total of 19 samples of the cases were collected, in which 11 were positive for norovirus GⅡand 1 was positive for astrovirus. In addition, in 41 samples of food and water, no enterovirus was detected and the bacterial indexes were also within normal range.ConclusionThe outbreak was caused by norovirus GⅡ. Vomit aerosol transmission and person to person contact were main transmission routes in this outbreak. Untimely discovery and isolation of the first case, improper dispose of vomit and disinfection were the facilitating factors for the disease spread and outbreak.
Detection of common diarrhea-associated viruses in 142 stool samples collected from adult diarrhea patients in 1980s
Liu Yang, Yalong Xu, Jinsong Li, Zhaojun Duan, Chaofeng Ma
Accepted Manuscript
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ObjectiveTo understand the common diarrhea-associated viral pathogens in 142 stool samples collected from adult diarrhea patients in 1980s.MethodsPolymerase chain reaction was used to detect rotavirus, norovirus, enterovirus and astrovirus in 142 stool samples collected from adult diarrhea patients and stored in virus strain stock of National Institute for Viral Disease Prevention and Control, China CDC since 1980s, and the types of these viruses were determined through sequencing.ResultsAt least one virus was detected in 120 stool samples (84.51%, 120/142). The detection rate of rotavirus B was 42.96% (61/142), no rotavirus A and C were detected. The detection rate of norovirus was 0.70% (1/142). The detection rate of intestinal adenovirus was 4.23% (6/142), including two type 4 strains, two type 7 strains, one type 40 strain and one type 41 strain. The detection rate of astroviruses was 34.51% (49/142) and all the strains belonged to type 5. The detection rate of swine enterovirus was 1.41% (2/142). The detection rate of coxsackie virus was 0.70% (1/142). The detection rate of mixed infection was 24.65% (35/142). No poliovirus was detected.ConclusionRotavirus B was the main pathogen detected in stool samples collected from adult diarrhea patients in 1980s, and the rate of mixed infection with astrovirus was 21.13% (30/142), and the rotavirus B strains shared 94.67%–96.52% nucleotide sequence homology with standard strain of rotavirus in adult diarrhea patients. Other viruses showed similarities with viruses detected nowadays. Swine enterovirus was detected from the stool samples, which might be explained by sample contamination due to environment condition in 1980s.
Genetic characteristics of human adenovirus 4a causing an epidemic of febrile illness
Lin Zou, Ling Tong, Chong Zhang, Bojun Zhen, Lu Xi, Yanna Yang, Yanchun Wang, Hongjun Li, Tiegang Zhang, Xiang Gao, Guofeng Zhang
Accepted Manuscript
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ObjectiveTo understand the genetic characteristics of human adenovirus 4a causing an epidemic of febrile illness occurred in a primary school in Tongzhou district of Beijing in October, 2019.MethodsThe oropharyngeal swabs were collected from the febrile illness cases for the detections of 32 kinds of respiratory viruses and bacteria by real-time PCR. The Fiber, Hexon and Penton gene fragments were amplified and sequenced by PCR for adenovirus positive specimens. The Fiber, Hexon and Penton gene sequences were analyzed by BLAST in NCBI. A phylogenetic tree was constructed by using Fiber, Hexon and Penton gene sequences with software BioEidt7.2.5 and MEGA 6.06.ResultsThe oropharyngeal swabs of 6 febrile illness cases were all positive for adenovirus in real-time PCR. There were no other respiratory pathogens detected in the oropharyngeal swabs. Fiber, Hexon and Penton gene sequence alignment results indicated that the adenovirus strains from the 6 cases belonged to adenovirus 4a. The phylogenic tree analysis indicated that the adenoviruses isolated in this epidemic shared high homology with adenovirus 4a circulating in USA in recent years.ConclusionThis epidemic of febrile illness was caused by human adenovirus 4a.
contents
2020, 35(2).
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cover
2020, 35(2).
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National Data of Class A, B and C Communicable Diseases in January 2020
2020, 35(2): 93-93. DOI: 10.3784/j.issn.1003-9961.2020.02.001
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Summary of National Data of Class A, B and C Communicable Diseases in China, January 2020
2020, 35(2): 94-95. DOI: 10.3784/j.issn.1003-9961.2020.02.002
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Summary of global surveillance data of infectious diseases in January 2020
Hui Han, Bo Wu, Jiaojiao Jia, Yajing Song
2020, 35(2): 96-98. DOI: 10.3784/j.issn.1003-9961.2020.02.003
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In January 2020, a total of 65 infectious diseases were reported globally, affecting 52 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were dengue fever (22), measles (19), malaria (8), legionellosis (8) and cerebrospinal meningitis (8).The top three infectious diseases with highest case fatality rates were Ebola virus disease (65.5%), Middle East respiratory syndrome (34.3%) and Lassa fever (15.9%). The top five infectious diseases with greatest number of deaths were novel coronavirus disease 2019(COVID-19), measles, Lassa fever, dengue fever and Ebola virus disease. The prevalent infectious diseases in Africa were Ebola virus disease, cholera, yellow fever, Lassa fever and measles, the prevalent infectious diseases in Asia were COVID-19, Middle East respiratory syndrome and dengue fever, the prevalent infectious diseases in America was dengue fever.
Introduction
2020, 35(2): 99-99.
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Rabies exposure surveillance and analysis in Guangzhou, 2013–2017
Haiyan Chen, Conghui Xu, Wenfeng Ren, Jianmin Xu, Yuehong Wei, Shouyi Chen, Hao Zhang
2020, 35(2): 100-103. DOI: 10.3784/j.issn.1003-9961.2020.02.004
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ObjectiveTo understand the epidemiological characteristics of rabies in Guangzhou.MethodsThe surveillance data of rabies in Guangzhou from 2013 to 2017 were used for descriptive analysis.ResultsThe rabies exposure rates were 823.64/100 000, 822.86/100 000, 901.72/100 000, 988.30/100 000, and 1 187.20/100 000, respectively, in Guangzhou from 2013 to 2017, showing an increasing trend (P<0.05). Animal-related injuries in each year mainly occurred in summer and autumn (June-October), accounting for 45.17%–48.41% of the total cases. Dogs were responsible for most animal-related injuries, accounting for 65.53% of all the injuries. The proportions of degree Ⅱ and Ⅲ exposures ranged from 56.16% to 61.02% and from 28.61% to 31.38%, respectively, during 2013–2017. All the exposed persons received rabies vaccination. However, the annual passive immunization rate was relatively low during this period, which was only 15.06%, 6.91%, 7.30%, 5.38% and 7.06%, respectively.ConclusionA large number of people exposed to rabies in Guangzhou. The injection rate of rabies immunoglobulin was low in local degree Ⅲ exposure cases. It is suggested that the health education about rabies should be strengthened to increase the passive immunization rate and the joint prevention and control mechanism by multi departments should be established to strengthen dog management.
Sequence analysis on L gene of rabies virus isolated from wild Melogale moschata and domestic dogs in Zhejiang
Xiaoguang Wang, Yongliang Lei, Fuming Liu, Wuyang Zhu, Xiaoyan Tao
2020, 35(2): 104-109. DOI: 10.3784/j.issn.1003-9961.2020.02.005
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ObjectiveTo understand the L gene sequences of rabies virus isolated from wild Melogale moschata and domestic dogs and the mutation and genetic evolution characteristics of LP at the molecular level in Zhejiang.MethodsThe nucleic acid sequence of the L gene coding region was determined by using laboratory-positive rabies virus samples, and the sequences of nucleotide acid and amino acid of L gene were analyzed with software bioanalysis, and the encoded protein were aligned with 36 reference sequence encoding regions from GenBank.ResultsThe full-length nucleotide acid sequences of the L gene of rabies virus strains isolated from wild Melogale moschata (F02, F04) and domestic dogs (D01, D02) were obtained by sequencing and submitted to GenBank. The ORFs were all 6 387 bp, and all the encoding regions started with two consecutive codons ATG, encoding 2 128 amino acids. The short sequences of specific functions on the conserved domain of LP were almost completely conserved, and the sequence conservation between each domain was slightly poor. The polarity of most mutations did not change, and most of them were nonsense mutations. Phylogenetic analysis showed that the wild rabies strains isolated from Melogale moschata and domestic dogs in Zhejiang belong to the traditional rabies virus Asian lineage and belong to the same phylogenetic group of the widely spread rabies virus in China.ConclusionThe composition of the rabies virus L gene in Zhejiang is consistent with other traditional rabies viruses. The constructed phylogenetic tree has the same analytical effect as the N gene. The rabies virus from Melogale moschata still has the genetic characteristics of the native rabies virus. Domestic dog rabies virus might has same origin with rabies viruses in other host animals in China and might has cross transmission recently. Rabies viruses from different hosts have the evolution characteristics of population diversity and area specific spread characteristics.
Surveillance data of rabies in Chongqing, 2018
Kun Su, Hong Yin, Yafei Li, Han Zhao, Yu Xia, Yu Xiong, Juan Yi, Lin Yang, Li Qi, Wenge Tang, Qin Li
2020, 35(2): 110-113. DOI: 10.3784/j.issn.1003-9961.2020.02.006
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ObjectiveTo understand the epidemiological characteristics of rabies in Chongqing in 2018 and provide evidence for the control and prevention of rabies.MethodsThe incidence data of rabies in Chongqing in 2018 were collected from national infectious disease reporting information management system, the data of case exposure and prophylaxis from the rabies investigation database of Chongqing, and the data of dogs biting events from national public health emergency management information system. Descriptive epidemiological methods were applied to analyze the epidemiological characteristics of rabies cases.ResultsA total of 18 rabies cases were reported in Chongqing in 2018, with a reported incidence of 0.06/100 000. The majority of the cases were people over 60 years old (61.11%) and farmers (88.89%). All the cases were from rural areas of suburb counties and districts. Two geographic epidemic clusters were identified in six districts and counties in western Chongqing and three districts and counties in northeastern Chongqing. Up to 94.44% of rabies cases were victims of dog bites or scratch, and 61.11% of the cases exposed to stray dogs. None of these cases received standard prophylaxis after rabies exposure. Up to 88.89% of the dog biting events occurred in rural areas and 18.52% of the dog biting events affected more than 10 people.ConclusionThe incidence of rabies in Chongqing continued to decline in 2018 and the areas affected by the epidemic further decreased. The disease mainly occurred in rural areas of several districts and counties in western and northeastern Chongqing. The most rabies affected population was the people over 60 years in rural areas. The rabies cases were mainly caused by dog biting, and the proportion caused by stray dog biting increased further, and all the cases received no substandard post-exposure prophylaxis.
Factors affecting rabies virus neutralizing antibody level after vaccination
Yun Song, Pengcheng Yu, Xin Gao, Jiajia Liu, Yuan Xie, Hao Li, Wuyang Zhu
2020, 35(2): 114-117. DOI: 10.3784/j.issn.1003-9961.2020.02.007
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ObjectiveTo explore the factors affecting rabies virus neutralizing antibodies in vivo after rabies vaccination.MethodsSerum samples collected from the persons who received rabies vaccination from January to August 2018 were used in rapid fluorescent focus inhibition test (RFFIT) to detect rabies virus neutralizing antibody (RVNA) levels. Statistical analysis was performed by using SPSS 19.0 software.ResultsA total of 498 serum samples collected after full course rabies vaccination were tested. The RFFIT test results showed that the RVNA geometric mean titer (GMT) was 4.94 IU/ml, and the seropositive rate was 96.18% (479/498). The analysis on the antibody positive rate showed that there were statistical differences among groups with different post vaccination times (χ2=7.888, P=0.039). The antibody positive rate in 30–90 d group was higher than that in the 91–180 d group. The results of multivariate analysis showed that age and post vaccination time were important factors affecting RVNA level. Among them, the age was positively correlated with RVNA level, and the post vaccination time was negatively correlated with RVNA level. The post vaccination time had the largest impact on RVNA level, with an impact importance of 0.62.ConclusionRabies vaccination can produce a reliable immune effect. Age, days after vaccination and other factors have a certain effect on antibody positive rate and RVNA level. In addition to timely and standard post-exposure treatment after rabies exposure, serum antibody level should be regularly tested for populations at high-risk, immunocompromised individuals or people with immunosuppressive diseases. For those with RVNA titers less than 0.5 IU/ml after rabies vaccination, re-vaccination should be given to effectively prevent rabies.
Molecular epidemiology of rabies in Shandong province, 2010–2015
Jiajia Liu, Xiaomei Zhang, Muli Li, Qian Wang, Pengcheng Yu, Lin Duo, Hao Li, Xianjun Wang, Xiaoyan Tao, Shujun Ding, Wuyang Zhu
2020, 35(2): 118-122. DOI: 10.3784/j.issn.1003-9961.2020.02.008
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ObjectiveTo understand the genetic, evolution and spread characteristics of rabies virus in Shandong province.MethodsThe dog brain samples and human liquid samples (saliva, serum et al), collected during 2010–2015, were detected by using DFA or RT-PCR. The N gene of the rabies virus strains isolated from the positive samples were sequenced, and the results were used for phylogenetic analysis.ResultsAmong the 70 dog brain samples, 11 were positive; and among 21 human liquid samples, 2 were positive. The N genes (1 353 bp) were sequenced for all the rabies virus strains isolated from 13 positive samples and the phylogenetic tree was constructed based on the 26 N genes of Shandong strains and the reference strains in 7 lineages in China, which indicated that nearly 90% of the rabies strains from Shandong (collected during 2006–2015) belonged to China Ⅰ lineage, while the remaining 3 strains (collected during 2006–2008) belonged to China Ⅱ lineage. The rabies strains isolated from eastern and western Shandong were less diverse and shared similarity, but the strains isolated from Tai’an showed high diversity.ConclusionThe rabies strains isolated in Shandong province belonged to China Ⅰ and China Ⅱ lineages, and the spread of China Ⅰ lineage was responsible for the rabies incidence in Shandong in recent years.
Epidemiology of rabies and control suggestions in less developed Lyuliang mountain area between Shanxi and Shaanxi
Yaling Jin, Xiaoyan Tao, Hao Li
2020, 35(2): 123-125. DOI: 10.3784/j.issn.1003-9961.2020.02.009
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ObjectiveTo understand the epidemiological characteristics of rabies in impoverished Lyuliang mountain area between Shanxi and Shaanxi provinces, find out the problems in rabies prevention and control, and provide reasonable suggestions for the prevention, control and elimination of rabies.MethodsDescriptive epidemiological method is used to analyze the rabies surveillance data in Lyuliang mountain area from 2008 to 2018 collected from the Information Management System of Chinese Center for Disease Control and Prevention. Excel 2003 was used for data entry.ResultsFrom 2008 to 2018, a total of 23 rabies cases were reported in this area. The cases were distributed in 11 counties, the cases mainly occurred from May to November, and most cases were aged 45–65 years, and the male to female ratio of cases was 2.83∶1. The cases in farmers accounted for 86.96% of the total.ConclusionThe incidence of rabies showed obvious seasonal, area and population distribution characteristics in this area. Moreover, problems existed in local rabies surveillance system, local people had insufficient hazard awareness and heavy burden vaccination costs. Because farmer is populations at high risk for rabies, it is necessary to strengthen the rabies prevention and control in less developed areas for the better implementation of rabies elimination.
Application of moving epidemic method to study influenza epidemic intensity in winter and spring in Ningbo
Keqin Ding, Shaohua Gu, Xuying Lao, Yi Chen, Suli Jiao, Hongjun Dong, Bo Yi
2020, 35(2): 126-131. DOI: 10.3784/j.issn.1003-9961.2020.02.010
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ObjectiveTo use moving epidemic method (MEM) to study the epidemic intensity of seasonal influenza epidemic in Ningbo, establish influenza surveillance and early warning mechanism and provide evidence for the prevention and control of influenza.MethodsThe positive rates of virus detection in winter and spring influenza season in Ningbo from 2013 to 2018 (40th week to the 20th week next year) were used, the MEM model was established to analyze the epidemic intensity of the seasonal influenza epidemic in Ningbo from 2018 to 2019.ResultsIn the period of 2018–2019, the threshold of the initial influenza epidemic period in Ningbo was 22.68%, and the threshold of the late epidemic period was 23.32%. The initial epidemic period was from the 40th week of 2018 to the 1st week of 2019. In the 2nd week of 2019, the influenza incidence broke through the initial threshold and the epidemic intensity was low, and a medium epidemic intensity was recorded from the 3rd week. From the 8th week to the 9th week, the influenza epidemic intensity was high. The epidemic intensity gradually decreased to medium level from the 10th week to the 14th week and reached a low epidemic level from the 14th week to the 18th week. After the 19th week, it was the late epidemic period. The sensitivity of the MEM model was 80.04%, the specificity of the MEM model was 87.18%. The goodness of the model was good.ConclusionThe start time and intensity of influenza epidemic can be calculated by using the influenza early warning model established with MEM, and the model can be directly evaluated. This method provides a scientific basis for the early identification and early warning of influenza epidemic.
Epidemiologic characteristics of tuberculosis in Kashi, Xinjiang, 2017
maimaiti Hasilaitiayi·, wushouer Qimanguli·, yiming Gulimire·, Jing Wang, taiwaikuli Tunishaguli·, amuti Gulijiemilaimu·, Xin Hu
2020, 35(2): 132-135. DOI: 10.3784/j.issn.1003-9961.2020.02.011
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ObjectiveTo analyze the epidemiologic characteristics of tuberculosis (TB) in Kashi in Xinjiang in 2017 and provide scientific basis for TB prevention and control in this area.MethodsThrough National Special Reporting System for TB, the relevant data of TB patients in Kashi from 1 January to 31 December in 2017 were collected, and the time, place and population distributions of TB in Kashi were analyzed with descriptive epidemiology method.ResultsIn 2017, there were 14 678 registered TB patients in Kashi, mainly pulmonary TB (99.95%). Among pulmonary TB cases, smear positive TB cases accounted for 13.44%. In 2017, the case numbers and incidence rates of pulmonary TB and smear positive pulmonary TB decreased compared with the previous four years. There were 7 335 male cases and 7 343 female cases with the male to female ratio of 1∶1.001. The case number in age group 60–79 years was highest, accounting for 58.21%. Most cases were farmers (86.33%). The top three areas reporting high case numbers were Shache county (21.94%), Yingjisha county (13.88%) and Kashi city (10.28%). The incidence of TB was high in winter and spring.ConclusionIn 2017, the epidemic of TB in Kashi was still serious. It is still necessary to strengthen the implementation of TB prevention and control strategies, strengthen health education, improve the people’s awareness of TB and patients’ compliance of treatment, and realize the early detection and treatment of TB.
Incidence analysis of malaria in Shanxi, 2014–2018
Ping Tie, Ting Wang, Changfu Yan, Jingying Wang, Yuhua Zheng, Yongfei Bai, Hongxia Yang, Jing Chen
2020, 35(2): 136-139. DOI: 10.3784/j.issn.1003-9961.2020.02.012
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ObjectiveTo understand the epidemiological characteristics of imported malaria in Shanxi province, evaluate the sensitivity of the malaria surveillance system, and provide a scientific basis for the development of scientific and effective strategies and measures to prevent the spread of malaria, prevent or reduce malaria incifence and death.MethodsThe incidence data of imported malaria in Shanxi from 2014 to 2018 were analyzed. The blood samples were collected from the cases for blood film test of plasmodium.ResultsA total of 75 cases of malaria were reported, all of them were imported cases. There were 53 cases of falciparum malaria, 13 cases of vivax malaria, 5 cases of ovale malaria, 2 cases of quartan malaria and 2 cases of mixed infection. Most cases were males (94.67%, 71/75), and the cases aged 21–50 years accounted for 85.33% (64/75). The cases were mainly workers and farmers (54.67%, 41/75). Imported cases were reported all the year round, and there was no obvious incidence peak. The imported cases were mainly from Africa, accounting for 90.67%. The median intervals between onset and hospital visit and between hospital visit and diagnosis were 3 d and 2 d, respectively.ConclusionIn the past five years, malaria cases reported in Shanxi were all imported ones. Strengthening malaria surveillance in returnees from Africa and Southeast Asia, and timely detection and treatment of imported cases are critical for the implementation of malaria elimination in Shanxi.
Genetic characteristics and drug resistance of HIV strains isolated in Taiyuan, Shanxi, 2016–2017
Lin Mei, Mengze Gan, Jing Hu, Qiyu Zhao, Dequan Meng, Yi Feng, Hong Han, Yuhua Ruan, Ting Han, Yiming Shao, Hui Xing
2020, 35(2): 140-145. DOI: 10.3784/j.issn.1003-9961.2020.02.013
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ObjectiveTo understand the distribution of virus subtypes and the spread of drug-resistance of HIV isolated from untreated people living with HIV/AIDS (PLWHA) in Taiyuan, Shanxi province during 2016–2017.MethodsA survey was conducted in newly reported and untreated PLWHA in Taiyuan from August 2016 to December 2017. Blood samples were taken from them for the extraction of HIV nucleic acid RNA, the pol region sequences were obtained, and a phylogenetic tree was constructed for HIV subtype determination. Drug resistance was analyzed by using the Stanford University HIVdb Program library, and HIV-1 molecular network analysis was performed with software HyPhy 2.2.4 and software Cytoscape 3.6.1.ResultsA total of 227 pol region sequences were obtained from 251 newly reported and untreated PLWHA in Taiyuan. The study found that HIV-1 strains isolated in Taiyuan were predominated by subtype CRF01_AE, accounting for 52.0% (118/227), followed by CRF07_BC (32.6%, 74/227). The drug resistance rate of HIV-1 in the newly reported and untreated PLWHA was 5.3% (12/227), the resistance rate to non-nucleoside reverse transcriptase inhibitor (NNRTI) was 5.3% (12/227), and the resistance rate to nucleoside reverse transcriptase inhibitor (NRTI) was 1.3% (3/227), no protease inhibitor (PI) resistance was found. The molecular network access rate was 40.1% (91/227) according to the 1.5% gene distance threshold, and 12 clusters were found. The molecular network access rate was high in PLWHA infected with subtype CRF79_0107 (P=0.01).ConclusionMore than 80% of HIV-1 strains detected in Taiyuan belonged to subtype CRF01_AE and CRF07_BC, and the drug resistance rate to NNRTI was over 5%. The clustering transmission of infection of CRF79_0107 has been formed, so the investigation and intervention of this population need to be strengthened.
Evaluation of nested polymerase chain reaction in detection of pathogens in cerebrospinal fluid
Guozhong Tian
2020, 35(2): 146-150. DOI: 10.3784/j.issn.1003-9961.2020.02.014
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ObjectiveTo evaluate the feasibility of detecting pathogens in cerebrospinal fluid by nested polymerase chain reaction (PCR), and provide the reference for rapid and accurate diagnosis of diseases in clinical practice.MethodsA nested-PCR was designed by using the bacterial 16S rRNA gene sequences, including two PCR amplification processes by using two pairs primers. The bacterial DNA, which was extracted from cerebrospinal fluid, was amplified firstly by PCR using first pair primers. And the second PCR amplification was followed using the second pair primers. The DNA template was the first PCR amplification products. The products of the second PCR amplification were sequenced. The pathogen was determined by comparing and analyzing the sequences. The concentration of pure Brucella DNA was determined by DNA spectrophotometry. The sensitivity of nested-PCR was evaluated by using serial dilutions of DNA template. Two-fold serial dilutions were prepared from bacterial suspension.ResultsThe minimum detection limit of nested-PCR was about one copy number of DNA. The cerebrospinal fluid samples of clinical patients were detected by using nested-PCR. In 40 clinical cerebrospinal fluid samples, about 1 460 bp electrophoresis strips were detected in 37 samples. The sequencing results indicated that 7 cases were Neisseria meningitidis, 1 case was Pseudomonas alcaligenes infections, 22 cases were Pseudomonas poae infections. 2 cases were Stenotrophomonas maltophilia infections. 1 case was Streptococcus pneumoniae infection. 4 cases were unknown bacterial infections, and 3 cases had negative bacterial DNA detection results.ConclusionThe nested-PCR can be used in rapid detection of bacterial pathogens in cerebrospinal fluid with accurate results.
Establishment of a real-time fluorescence quantitative polymerase chain reaction assay for rapid detection of Salmonella in stool samples of humans and animals
Danni Chen, Yingying Han, Jie Li, Meiying Yan
2020, 35(2): 151-155. DOI: 10.3784/j.issn.1003-9961.2020.02.015
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ObjectiveTo rapidly detect and identify Salmonella and improve the response to the outbreaks of foodborne disease, we established a real-time fluorescence quantitative polymerase chain reaction (qPCR) assay. The specificity, sensitivity and detection limit of the assay were evaluated.MethodsFirstly, we screened some specific genes of Salmonella by using conventional PCR, then established a qPCR assay targeting one specific gene selected. The specificity, sensitivity and detection limit of the qPCR assay were evaluated by pure strains from different species of enterobacteria, Salmonella strains in different species and serotypes, and stool samples from humans and animals.ResultsOne specific gene, ttrA, was selected as the candidate gene for establishing PCR assay to detect Salmonella. The detection limit of the qPCR assay with purified DNA as template was 2 copies per reaction. The amplification results of qPCR assays were positive for all 1 100 Salmonella isolates of different species and serotypes, while the results were negative for all the strains of other enterobacteria. For 360 samples of stool enrichment, including 150 Salmonella culture positive human stool samples and 210 Salmonella culture positive animal stool samples, the qPCR detection results were all positive.ConclusionA qPCR assay based on a single gene to identify and detect Salmonella was established for the molecular detection and characterized by high specificity and high sensitivity. It can be used for the rapid detection and identification of Salmonella and the diagnosis of infectious diarrhea caused by Salmonella.
Correlation between climatic factors and incidence of melioidosis in Sanya, Hainan
Xiong Zhu, Lyufen He, Huihui Kuang, Huan Li, Sha Li, Hai Chen, Xiao Zheng, Licheng Wang, Rushou Chen
2020, 35(2): 156-161. DOI: 10.3784/j.issn.1003-9961.2020.02.016
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ObjectiveTo evaluate the influence of climatic factors on the incidence of melioidosis, and provide evidence for the prevention and control of melioidosis.MethodsThe average incidence data of melioidosis in Sanya of Hainan from 2013 to 2017 was analyzed, and univariate correlation analysis and multivariate stepwise regression analysis were performed on three research variables, i.e. precipitation, wind speed and air temperature, which might affect the incidence of melioidosis.ResultsIn this study, a total 123 patients with melioidosis were included in the analysis. The average age of the patients was 51.20 years, and those aged 41–60 years accounted for 53.66%. More cases occurred in males than in females, accounting for 81.30%. Sepsis occurred in 79 cases (64.23%) and pneumonia in 64 cases (52.03%). The incidence peak period was during July-October, and 66.67% of the cases occurred during this period. Univariate correlation analysis showed that the incidence of melioidosis was significantly correlated with mean precipitation and wind speed (r=0.765, P=0.004; r=0.614, P=0.034), and there was no significant correlation with air temperature (r=0.358, P=0.258). Multivariate stepwise regression analysis showed that the incidence of melioidosis was significantly correlated with mean precipitation and wind speed (P=0.001).ConclusionThe climate is an important factor affecting the incidence of melioidosis in Sanya, and the precipitation is positively correlated with the case number. When the wind speed is high, the spread of melioidosis is accelerated. The air temperature fluctuation in Sanya is small throughout the year, and has no significant correlation with the case number.
Epidemiological characteristics of public health emergencies caused by nosocomial infection in China, 2004–2017
Yunfei Zhang, Chao Li, Ruiqi Ren, Yali Wang, Juan Li, Jinxing Lu
2020, 35(2): 162-166. DOI: 10.3784/j.issn.1003-9961.2020.02.017
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ObjectiveTo understand the epidemiological characteristics of public health emergencies caused by nosocomial infection in China, and provide evidence for the prevention and control of public health emergencies caused by nosocomial infection.MethodsDescriptive analysis was conducted on the incidence of public health emergencies caused by nosocomial infection in China reported through national public health emergency management information system from 2004 to 2017.ResultsFrom 2004 to 2017, a total of 66 public health emergencies of infectious diseases caused by nosocomial infection were reported in China. A total of 2 340 cases were reported, including 485 medical staffs. The number of public health emergencies caused by nosocomial infection was higher in summer. The public health emergencies caused by influenza, norovirus infection and measles, the top three diseases, accounted for 71% (47/66) of the total. The top 3 departments in which public health emergencies caused by nosocomial infection were psychiatry, rehabilitation and internal medicine departments.ConclusionInfluenza, norovirus infection and other respiratory and intestinal infectious diseases were the main causes of nosocomial infections causing public health emergencies in China. Comprehensive prevention and control measures of nosocomial infection, including improving the management of nosocomial infection, strengthening the training on infectious disease prevention and control in medical staff and health education in people, and strengthening personal protection, are the key measures to reduce the incidence of public health emergency caused by nosocomial infection.
Epidemiological investigation of a brucellosis outbreak in a county in Guangdong
Lei Wang, Yao Yi, Xuguang Chen, Changyun Sun, Meng Zhang, Fengmei Zeng, Yufu Zeng, Dongliang He, Aiping Deng
2020, 35(2): 167-171. DOI: 10.3784/j.issn.1003-9961.2020.02.018
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ObjectiveTo investigate and verify a food-borne outbreak of brucellosis caused by drinking raw goat milk in a county of Guangdong province, and provide suggestions for the prevention and control of similar outbreaks.MethodsThe case finding was conducted through case investigation and hospital information system retrieval, the screening and confirmation of Brucella infection was conducted, and descriptive and analytical epidemiological methods were used to analysis.ResultsA total of 30 cases and 6 latent infection cases were found. The cases occurred during 10th July-18th August in 2019 in this outbreak represented a homologous infection source. The main clinical manifestations of the cases were fever (70.00%), muscle and joint pain (46.67%), fatigue (43.33%), etc. A total of 21 Brucella strains were isolated from the blood samples of the people surveyed, all the strains were B.melitensis type 3. According to the analysis, the only definite risk factor was drinking raw goat milk from H's farm compared with drinking no H's milk [RR=16.91 (2.38−119.96)] and compared with drinking boiled milk [RR=36.36 (5.07−260.58)]. Besides, the Brucella infection was related to goat milk drinking in a dose-response manner (χ2=4.437, P=0.035) and associated with drinking time.ConclusionThis was an outbreak of brucellosis caused by drinking raw goat milk contaminated by B. melitensis type 3.
Investigation of an outbreak of foodborne illness caused by norovirus G.17
Mingliang Wang, Wei Wang, Shuiying Yun, Yun Bai, Lijun Ren, Xiaoxiao Bai, Congwei Liu, Caoxin Bao, Lingyan Su, Xiaochen Ma
2020, 35(2): 172-176. DOI: 10.3784/j.issn.1003-9961.2020.02.019
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ObjectiveTo find out the cause and pathogenic factors of acute gastroenteritis occurred in a research institute in Beijing, 2018.MethodsThe clinical manifestations and the distribution of the patients were described with descriptive epidemiological method, and case control study was used to find out the suspected exposed meals and foods. Field hygiene survey was carried out. Samples from the cases and foods were collected for the PCR detection of norovirus, and partial gene sequencing of RNA-dependent RNA polymerase region was performed for the positive strains.ResultsA total of 107 cases were found with the main symptoms of diarrhea (100%), abdominal pain (79%), vomiting (74%) and nausea (68%). The results of the epidemiological investigation demonstrated that the lunch of March 21 (provided by a food delivery company) was the suspected meal, and sauce elbow was the suspected food, which might be cross-contaminated during the preparation and without effective heating before provision. Seventeen strains of norovirus GⅡ were detected from 26 anal swabs and stool samples. Polymerase region gene sequencing showed that 8 strains shared 100% consistent nucleotide sequence, and NCBI blast showed that the 8 strains shared 99% homology with the GⅡ.17 variant strain 41 621 reported in Guangzhou.ConclusionThe sauce elbow contaminated by norovirus was the main infection source of this outbreak of foodborne illness. It is suggested that we should strengthen the supervision and management of food production practices in catering industry for the prevention of recurrence of similar incidents.
Field investigation of a mumps outbreak and vaccination effect evaluation in a school in Anhui, 2018–2019
Jian Wang, Wei Qin, Jun Gu, Hui Yang, Xiangmei Meng, Yao Wang
2020, 35(2): 177-181. DOI: 10.3784/j.issn.1003-9961.2020.02.020
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ObjectiveTo understand the cause of a mumps outbreak and evaluate the vaccination effect (VE) of mumps-containing vaccine (MuCV) in a school in Anhui province during 2018–2019, and provide scientific basis for the improvement of immunization programs against mumps.MethodsDescriptive epidemiology method was used to analyze the cause and characteristics of this mumps outbreak. A retrospective cohort study was conducted to evaluate the vaccination effect of MuCV.ResultsA total of 78 mumps cases were identified during the outbreak, and the overall attack rate was 11.24% (78/694). The initial case had a history of a two-dose MuCV vaccination before the outbreak, and no standard isolation was performed for 42.31% of the cases. 91.03% cases were students in No.1 teaching building. The coverage of MuCV in students from No.1 and 2 teaching buildings were 90.25% and 68.38%, respectively. The incidence risk of student from No.1 teaching building was 3.71 times higher than that of students from No.2 teaching building (RR=3.71, 95% CI: 1.74–7.88). The protection rate of one-dose, two-dose and three-dose of MuCV were 30.94%, 32.69% and 100.00%, respectively. The longer the interval between onset and vaccination was, the higher the attack rate was. The difference was significant (χtrend2=24.472, P<0.001). The protection effect of MuCV decreased as time pass by, and the protection rate against mumps within 5 years after vaccination was 86.38% (95% CI: 40.29%–96.89%), but the difference in protective effect between vaccination group (>5 years) and non-vaccination group was not significant (RR=0.76, 95% CI: 0.41–1.41, P>0.05).ConclusionThe cases with a two-dose MuCV vaccination might be the infection source in this outbreak too. Non-standard management of the mumps cases in this school and waning immunity conferred by MuCV were likely contributors to this outbreak. Patients with two-dose of MuCV vaccination are still contagious. MuCV only provide effective protection against mumps within 5 years after vaccination. If the vaccination time is longer than 5 years, the protection effects of both one-dose and two-dose of MuCV are poor, however, three-dose of MuCV has better protection and immune persistence.
Application of semi-logarithmic line graph in epidemiological research
Yangxi Zhang
2020, 35(2): 182-183. DOI: 10.3784/j.issn.1003-9961.2020.02.021
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This paper introduces the structure and application of semi-logarithmic line chart, and studies the time distribution of novel coronavirus disease 2019 (COVID-19) epidemic in China by using semi-logarithmic line chart, and analyzes the change of epidemic speed of COVID-19. According to the analysis of the time distribution of COVID-19 patients in the late January 2020, the transmission speed of the COVID-19 patients was obviously decreased, the semi-logarithmic line was gradually flattened, and the daily link ratio (DLR) was close to one. Prevention and control measures are very effective. If the prevention and control during the return period of the Spring festival is proper, the epidemic is expected to gradually decline. The semi-logarithmic line graph is an important tool to study the law of epidemic fluctuation.
Responding to an outbreak of monkeypox using the one health approach——Nigeria, 2017–2018
Zhenyu Gong, Xunliang Gong
2020, 35(2): 184-184. DOI: 10.3784/j.issn.1003-9961.2020.02.022
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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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