Disease Surveillance

Interaction between PM_2.5 and air temperature on daily hospital visits of children due to respiratory disease in Changping district, Beijing

Jing Li, Huanxin Wang, Long Qu, Mingqiang Zhao, Yingjie Xing, Qiyong Liu

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.020

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ObjectiveTo understand the interaction between fine particulate matter with aerodynamic diameter ＜2.5 μm （PM_2.5） and air temperature on the daily hospital visits of children due to respiratory disease in Changping district of Beijing.MethodsThe data of daily hospital visits of children were collected from a hospital in Changping, and the relevant meteorological data and air pollution data, including PM_2.5, SO₂ and NO₂ concentrations, in Changping from 1^st of January 2014 to 31^st of December 2017 were also collected. Based on the distributed lag non-linear model （DLNM） with quasi-Poisson link, response surface model and stratified model were used to investigate the potential interactions between air pollution and air temperature on daily hospital visits of children due to respiratory disease.ResultsAt low, moderate, and high temperature layers stratified by the mean temperatures of 25th and 75th percentiles, a 10 μg/m³ increase of PM_2.5 concentration resulted in the relative risks of 1.003 （0.994,1.011）, 1.015 （1.007,1.023） and 1.039 （1.021,1.057）, respectively, for total hospital visits due to respiratory disease in children on lag 0-14 days. The adverse effect of PM_2.5 increased obviously under higher air temperature （P＜0.05）.ConclusionThere was an obvious interaction between PM_2.5 and high temperature on hospital visits due to respiratory disease in children, the adverse effect of PM_2.5 on hospital visits due to respiratory disease in children were more obvious when air temperature was high.

2019年4月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Disease in April 2019

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.001

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Establishment of multiple-locus variable number tandem repeat analysis assay for Vibrio parahaemolyticus isolated in China

Lin Zhao, Meiling Chen, Xin Lu, Jie Li, Hongqun Zhao, Biao Kan, Bo Pang

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2019.06.006

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ObjectiveTo establish a multiple-locus variable number tandem repeat analysis (MLVA) assay for Vibrio parahaemolyticus isolated in China.MethodsA total of 420 V. parahaemolyticus strains isolated from different areas in China were used. The 12 variable-number tandem-repeat (VNTR) loci were amplified by PCR and the amplicons were analyzed by capillary electrophoresis. The discriminatory power of different VNTR locus and combinations of VNTR loci were evaluated.ResultsThe amplification rates of the 12 VNTR loci of V. parahaemolyticus were different. Locus VP1-17 showed no polymorphism (Nei value＝0.00), locus VP2-03 showed low polymorphism (Nei valur＝0.10) and locus VP2-07 showed highest polymorphism. Locus VPTR7 could only be amplified in 71.90% of the test strains. The 420 V. parahaemolyticus strains could be divided into 311 MLVA types using the 6-locus(VP1-10, VPTR1, VPTR3, VPTR5, VPTR6, and VPTR8) .ConclusionThe established 6-locus MLVA scheme showed satisfactory discriminatory power and economic significance and thus is suitable for the molecular typing of V. parahaemolyticusstrains isolated in China.

Distribution and evolutionary characteristics of non-hemolytic mutant of El Tor biotype epidemic Vibrio cholerae in China

Yufeng Fan, Lin Zhao, Xin Lu, Xu Li, Huihui Sun, Jiazheng Wang, Ming Liu, Jie Li, Bo Pang, Biao Kan

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.005

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ObjectiveTo analyze the distribution and evolutionary characteristics of the non-hemolytic mutant of El Tor biotype strain of Vibrio cholerae O1 in China during the 7^th global cholera pandemic.MethodsToxigenic El Tor biotype strains of V. cholerae in different cholera pandemic periods since 1961 were selected for hemolytic phenotype test and whole genome sequencing. The temporal distribution of the non-hemolytic mutant was displayed. The sequence variation in hlyA gene was illustrated. ML tree was constructed based on the SNPs in the non-repetitive and non-recombinant genome regions of 230 El Tor biotype strains of V. cholerae O1 isolated in China since 1961. The distribution of the non-hemolytic mutants was mapped on the ML tree.ResultsDuring the 7^th cholera pandemic, there was an obvious sequence type conversion of the hemolysin gene hlyA in the strains detected in China after the first phase of pandemic. The non-hemolytic mutants emerged after the first phase of pandemic and became a common type in the 2^nd pandemic in 1970s. The non-hemolytic mutant dispersed in the 2^nd, 3^rd pandemic and the inter-pandemic periods. However, certain clones of non-hemolytic mutant spread for several years.ConclusionThe evolution of hlyA gene was independent of that of the whole genome in the 7^th cholera pandemic, which might be a random mutation. The results showed the role of hemolytic phenotype in the biotyping of epidemic strains.

2019年5月中国甲乙丙类传染病疫情动态概要

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.002

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Risk assessment of public health emergencies concerned in the mainland of China, June 2019

Wenxiao Tu, Di Mu, Fengfeng Liu, Yu Li, Jinghuan Ren, Yuan Yuan, Dan Li, Ling Meng, Nijuan Xiang, Yanping Zhang

Accepted Manuscript

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ObjectiveTo assess the risks of public health emergencies, both the indigenous ones and imported ones, which might occur in the mainland of China in June 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 the provincial centers for disease control and prevention attended this meeting through video conference.ResultsIt is expected that the number of public health emergencies reported in June will be lower than May, but still at a relative high level, which might be mainly the outbreaks of communicable diseases in schools, such as chickenpox, hand, foot and mouth disease (HMFD), mumps and rubella. The area where Aedes mosquitoes exist will gradually enter the high-risk season of dengue fever. The number of locally transmitted cases of dengue fever will continue to rise and small-scale local outbreaks might occur. HFMD cases will continue to increase and epidemic intensity will increase in most provinces of the country. The sporadic cases of human infection with Streptococcus suis infection may continue to increase, and people who engage in pork slaughtering and processing are at high risk of infection. Bacterial food poisoning in schools, catering service units and rural wedding banquets or funeral banquets will increase. Poisoning deaths caused by poisonous animal, plants and mushrooms will become the main death causes of food poisoning. The epidemic of Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) will continue, but the risk of its importation into China is low.ConclusionJune 2019, there is no special concern risk of public health emergency in the mainland China., major concern should be paid to the risk of dengue fever and HFMD epidemics, and general concern should be paid to the human infection with Streptococcus suis, food poisoning (including toxic mushroom poisoning) and EVD in the DRC.

Analysis on change trend of newborn birth weight in Yiwu, 2007—2018

Hongxing Jin, Xiamusiye Muyiduli, Xiaomei Liu, Xingfang Ying, Yu Shen, Shuojia Wang, Minjia Mo, Bule Shao, Yunxian Yu

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ObjectiveTo analyze the change trend of newborn birth weight in Yiwu, Zhejiang province, establish and revise the percentile curve of gestational age specific birth weight of newborns and compare it with different birth weight standards.MethodsThe data from the Yiwu Maternal and Child Health Information Platform were used to analyze the gestational age specific birth weight, rate of low birth weight and macrosomia in newborns. The LMS (least mean square) method was used to calculate the reference values for percentiles of gestational age specific birth weight. The GAMLSS model was used to draw the birth weight curve. The reference percentile value of the birth weight of this study was compared with domestic and foreign studies.ResultsA total of 68 358 newborns were included in this study. The average birth weights of baby boys and baby girls were 3 373 g and 3 257 g, respectively. The rates of preterm birth in baby boys and baby girls were 6.01% and 5.04%, respectively. The rate of preterm birth in baby boys was significantly higher than that in baby girls. The rates of low birth weight and macrosomia were 3.84% and 7.43%, respectively. The birth weight of baby boys at gestational age 33-41 weeks was significantly higher than that of baby girls at same gestational age. The birth weight increased with gestational age. The birth weight of baby boys was higher than 2015 national standard at gestational age 37-41 weeks and higher than the reference percentile value of INTERGROWTH-21^st study at gestational age 33-41 weeks. The birth weight of baby girls was higher than the 2015 national standard at gestational age 38-41 weeks and higher than the reference percentile value of INTERGROWTH-21^st study at gestational age 33, 35-41 weeks.ConclusionDuring 2007—2018, the birth weight of baby boys in Yiwu showed a decrease with year, and the birth weight of baby girls showed no obvious change. The gender specific birth weight curves of newborns were drawn.

Epidemiological characteristics of food poisoning in China, July-September, 2018

Jinghuan Ren, Xiaoye Wang, Xiaomin Wu, Rui Wang

Accepted Manuscript

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ObjectiveTo understand the epidemiological characteristics of food poisoning in the third quarter (July-September) in 2018 in China (excluding Hong Kong, Macao and Taiwan), and provide evidence for the early warning, prevention and control of food poisoning.MethodDescriptive epidemiological analysis was conducted by using the incidence data of food poisoning in China during July-September in 2018 collected from National Report Management Information System of Public Health Emergency.ResultsA total of 119 food poisoning events were reported in 23 provinces during this period, involving 3 488 cases and 27 deaths. Among them, 64 food poisoning events were grade IV and above, involving 2 643 cases and 27 deaths. The most frequent type of the reported events was bacterial food poisoning (42.02%), the involved cases accounted for 69.29% of the total. Fungal food poisoning caused highest death number of food poisoning, accounting for 55.56% of the total. The numbers of food poisoning events and related deaths occurred in families accounted for 32.77% and 92.59% of the total, respectively. The numbers of food poisoning cases occurred after catering accounted for 51.46% of the total.ConclusionBoth the numbers of food poisoning events and deaths declined, but the food poisoning cases increased during July-September in 2018 compared with the same period in 2017. It is necessary to strengthen the health supervision in key places, such as food service units, especially in school opening season, improve the management and guidance of food procurement, storage, and processing, and health education should be conducted to improve the public awareness of poisonous flora and fauna or poisonous mushroom, as well as knowledge of proper cooking and self and mutual-treatment after poisoning.

Epidemiologic investigation to the first cluster of fever cases caused by human bocavirus in Beijing, 2017

Xiaogen Dong, Zhimin Zhang, Meng Qin, Ruoxi Li, Huiru Feng, Baoyu Feng, Hong Yu, Xiuxia Wei, Zhaoe Wang, Jing Shi, Jianjun Zhang

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ObjectiveTo understand the etiologic and epidemiologic characteristics of a cluster of human bocavirus (HBoV) infection cases in Fengtai district of Beijing and the circulation and evolution of HBoV in Beijing, and provide scientific evidence for the prevention and control of HBoV infection.MethodsEpidemiologic investigation was performed for 13 children with fever, and 10 throat swabs were collected from them. The pathogens were identified by the multiplex combined real-time PCR detection kit for respiratory viruses. The HBoV VP1 gene region was specifically amplified and sequenced for the detected HBoV strains. The gene distance calculation and phylogenetic tree analysis were performed for the amplified sequences by using bioinformatics software DNAStar 7.1, Bioedit v7.0.9, and MEGA 6.0.6.ResultsThe clinical symptoms of the children were mainly fever and cough. All the children with fever were classmates. Three HBoV positive samples were detected in 10 throat swabs, and the 3 HBoV strains were classified into type 1 indicated by the gene distance and phylogenetic tree analysis. The nucleotide sequences of the 3 HBoV strains shared 100% homology and the 3 strains were highly homologous to Beijing strain 311-BJ07, suggesting that the outbreak may be related to the circulating HBoV-1 strain in Beijing.ConclusionThis cluster of fever cases was caused by HBoV-1 strain which are widespread in China. It suggested that HBoV-1 respiratory infection epidemic is serious. It is necessary to strengthen surveillance and research and develop effective HBoV-1 infection prevention and control measures.

Infection status and genotype characteristics of GⅠ norovirus in acute gastroenteritis cases in Huzhou, Zhejiang, 2017–2018

Lei Ji, Yongying Zhu, Liping Chen, Yuehua Shen, Xiaofang Wu, Deshun Xu

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ObjectiveTo understand the infection status and genotype characteristics of GⅠ norovirus in acute gastroenteritis cases in Huzhou, Zhejiang province.MethodsA total of 1 259 stool samples of acute gastroenteritis cases diagnosed in two sentinel hospitals in Huzhou from April 2017 to June 2018 were collected. The extracted viral RNA was subjected to GⅠ and GⅡ norovirus nucleic acid detections by using real-time quantitative reverse transcription polymerase chain reaction( RT-PCR). GⅠ positive samples were amplified and sequenced by RT-PCR in RdRp and VP1 regions. The genotyping of norovirus was confirmed by phylogenetic analysis and online typing tools.ResultsA total of 171 stool samples were norovirus nucleic acid positive, the positive rate was 13.58%. The positive rates of GⅡ and GI noroviruses were 11.83% (149/1 259) and 2.70% (34/1 259), respectively, GⅡ was the main genotype detected. GⅠ norovirus was mainly detected in the first half of 2018. The positive detection rate of GⅠ norovirus in each month from February to June 2018 was higher than the average detection rate of GⅠ during the surveillance period. The genotyping results showed that the GⅠ norovirus detected in 2018 included GⅠ.P4-GⅠ.5, GⅠ.P2-GⅠ.2, GⅠ.P1-GⅠ.1, GⅠ.Pd-GⅠ.3, GⅠ.P4-GⅠ.4 and GⅠ.P2-GⅠ.5, in which GⅠ.P4-GⅠ.5, GⅠ.P2-GⅠ.5 and GⅠ.Pd-GⅠ.3 recombinant norovirus were detected for the first time in Huzhou.ConclusionThe genotypes of GⅠ noroviruses circulating in Huzhou are diverse and the recombination phenomenon is obvious. It is necessary to strengthen the molecular epidemiological surveillance for GⅠ norovirus for the timely detection of variants or recombinant strains.

2018年美国俄勒冈州科罗拉多蜱传热病毒病调查

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Infection and etiological characteristics of Vibrio cholerae in diarrhea patients in Shunyi district of Beijing, 2015–2017

Mu He, Shuang Zhang, Yanchun Zhang, Yanbo Wang, Meijuan Zhu, Maojun Zhang, Ying Li

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ObjectiveTo understand the infection status and etiological characteristics of Vibrio cholerae in patients with food-borne diseases in Shunyi district of Beijing, and provide evidence for effective prevention, control and treatment of V. cholera infection.MethodsV. cholerae isolation and culture were conducted by using stool samples collected from diarrhea cases in surveillance from 2015 to 2017. PCR test of virulence genes, pulsed-field gel electrophoresis (PFGE), matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and antibiotic susceptibility analysis were carried out for the isolates of V. cholerae.ResultsA total of 1 105 diarrhea patients were surveyed in three years. The detection rate of V. cholerae was 0.54% (6/1 105). The detection results of cholera toxin genes ctxAB were negative. Serological typing indicated that all the strains were non-O1/O139. PCR indicated that 5 of the 6 V. cholerae strains were type III secretion system (T3SS) gene positive. The clustering results of PFGE were consistent with the clustering results of MALDI-TOF MS.ConclusionIt is necessary to attach importance to the infection and etiological surveillance of V. cholerae in food-borne disease surveillance system

Surveillance for public health emergencies caused by infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid in China, 2014–2016

Xijun Weng, Zhe Wang, Jinghuan Ren, Yang Zhang, Ling Yu, Rui Wang

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Objective To understand the epidemiological characteristics of the public health emergencies caused by infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid (hereinafter referred to as other infectious diarrheal diseases) in China.Methods Descriptive epidemiologic analysis was conducted by using the incidence data of other infectious diarrheal diseases in China from 2014 to 2016, which were collected from National Public Health Emergency Report Management Information System. The spatial auto-correlation analysis (Moran’s I and Getis G) were conducted for spatial statistical analyses on the incidences of other infectious diarrhea.Results A total of 332 other infectious diarrhea epidemics were reported in China from 2014 to 2016, involving 17 130 cases and without death. The annual incidence of other infectious diarrheal epidemic was high during November-March. Norovirus infection epidemic accounted for 86.14%. The causes of these incidents included exposure in daily life and food or drinking water contamination. All the provinces reporting the epidemics were in eastern China. Spatial autocorrelation analysis showed that the spatial clustering of other infectious diarrhea epidemics in China was obvious, and the " hot spots” were mainly in Guangdong, Guangxi and Fujian provinces. ConclusionNorovirus infection was the main cause of other infectious diarrhea epidemics in China. It is necessary to strengthen the health education in key population and surveillance in key places, such as schools, and improve food and drinking water safety supervision and management for the effective prevention and control of other infectious diarrheal diseases. In addition, it is suggested to strengthen the prevention and control in provinces where the " hot spots” clustered, such as Guangdong, Guangxi and Fujian, further explore the causes and mechanisms of obvious disease clustering and take effective prevention and control measures to reduce the incidence of other infectious diarrheal diseases.

Etiologic analysis on enterohemorrhagic Escherichia coli O157∶H7 from an infection case in Shanghai

Yuan Zhuang, Hongyou Chen, Yong Chen, Xi Zhang, Liping Gu, Wei Yu, Min Chen

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ObjectiveTo understand the etiologic characteristics of an infection case of enterohemorrhagic Escherichia coli (EHEC) O157∶H7 in June, 2016 in Shanghai.MethodsThe patient information was collected by epidemiological investigation. Two strains were isolated from case's stool samples and identified by biochemical analysis and serologic tests. Polymerase chain reaction was conducted to detect the virulence related genes and microdilution broth method was used to analyze the antibiotic resistance. Pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST) and single nucleotide polymorphisms (SNP) were conducted for further analysis on the strain's characteristics.ResultsNo suspected sources of infection were found by epidemiological investigation. The strains were confirmed to be EHEC O157∶H7 carrying eae and stx2, and they were sensitive to 16 kinds of antibiotics tested. Two strains were classified to ST11 while showed a new PFGE pattern. Compared with the reference strain, they showed more SNPs than the previously identified strains by core genome alignment.ConclusionNo EHEC O157∶H7 has been isolated from patient for about ten years in Shanghai since 2006. The virulence related genes, the antibiotic resistance and the ST type of the strains were confirmed in this study. They were more different from the previously identified strains according to the genome sequence alignment and PFGE results, further attention should be paid to it.

Etiologic surveillance for varicella in Beijing, 2017

Hongquan Li, Luodan Suo, Dan Zhao, Tiegang Zhang

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ObjectiveTo understand the types and predominant types of varicella- zoster virus (VZV) in Beijing, 2017, and provide evidence for the prevention and control of varicella.MethodsThe clinical vesicular fluid was collected from the varicella cases detected in outbreak in Beijing in 2017 for the identification of wild strains and vaccine strains of VZV with real-time PCR. The phylogenetic analysis on wild VZV in Beijing was performed based on the sequences of twenty-second open reading frame gene fragments (ORF).ResultsAmong the 316 vesicular fluid specimens from varicella cases, 271 were positive for VZV. All of these strains belonged to wild VZV strains. The gene fragments were obtained for 240 of 271 wild strains. They belonged to 3 serotypes, including 234 clade 2 strains (97.50%), 3 clade 1 strains (1.25%) and 3 clade 4 strains (1.25%). Clade 2 strains was distributed in all of 16 districts of Beijing, and clade 1 and clade 4 strains were distributed in Xicheng and Daxing districts, respectively.ConclusionThe varicella cases were mainly caused by clade 2 VZV in Beijing in 2017. It is necessary to strengthen the surveillance for new clade 1 and clade 4 VZV.

Epidemiological characteristics of food poisoning event in China, April-June, 2018

Xiaomin Wu, Jinghuan Ren, Xiaoye Wang, Zhe Wang, Rui Wang

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ObjectiveTo analysis epidemiological characteristics of food poisoning events in China during the second quarter (April-June) in 2018 (excluding Hong Kong, Macao and Taiwan) and provide evidence for the early warning, prevention and control of food poisoning.MethodsDescriptive epidemiological analysis was conducted by using the incidence data food poisoning in China during this period collected from National Report Management Information System of Public Health Emergency.ResultsA total of 80 food poisoning events were reported in 18 provinces during this period, involving 2 058 cases and 33 deaths. Among them, 44 food poisoning events were grade Ⅳ or above, involving 1 661 cases and 33 deaths. The first 5 provinces reporting high incidences of food poisoning events were Shandong, Yunnan, Sichuan, Guangdong and Guangxi. The most frequent type of event reported was bacterial food poisoning (65.91%), and the involved cases accounted for 68.08% of the total. Plant/Herbal toxins caused highest death number of food poisoning, accounting for 45.45% of the total. The food poisoning events and related deaths occurred in families accounted for 40.00% and 72.73% of the total, respectively. The food poisoning cases occurred after eating in canteen accounted for 53.98% of the total.ConclusionIt is suggested to strengthen the supervision in canteens and food service to ensure food hygiene in cooking, processing and storage in order to reduce the incidence of bacterial food poisoning events. It is necessary to conduct health education in public about prevention and self-treatment of plant, fungal and bacterial food poisoning which often occur in families and identification of poisonous plants or mushrooms through different channels, including internet, media and community promotion.

Genomic context of a Proteus mirabilis strain carrying both SGI1 and SXT/R391 resistance genomic islands

Tao Xiao, Binghuai Lu, Hang Dai, Hongyan Cai, Zhenzhou Huang, Duochun Wang

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ObjectiveTo characterize the gene structure and resistance genes of two resistance-related genomic islands (SGI1 and SXT/R391) of a Proteus mirabilis strain (CA151922) isolated from a patient.MethodsPolymerase chain reaction (PCR) was conducted to detect the specific integrase gene of SGI1 and SXT/R391, respectively. Second generation sequencing was performed for the strain CA151922. The contigs of SGI1 and SXT/R391 were extracted and assembled from the whole sequenced genomes against each reference. Online predicting and annotating open reading frames (ORFs) were conducted. Each sequence was used in a BLASTn stool to obtain high homology variants in public database. Non-redundant homologous gene set was identified by cd-hit, a cluster of homologous tree was built by using R 3.4.4. Resistance phenotype was detected with micro-broth dilution method.ResultsProteus mirabilis strain CA151922 carried two resistance-related genomic islands, i.e. SGI1 (SGI1-B) and SXT/R391 (ICEPmiJpn1). Compared with known variants of SGI1-B and ICEPmiJpn1, the sequence identity ranged from 97% to 99% and from 96% to 99%, respectively. Compared with each classic sequence, different resistance gene(s) were found, however, SGI1-B and ICEPmiJpn1 harbored different β-lactamase genes. Strain CA151922 was multi-drug resistant to eighteen antibiotics, only ampicillin and sulfonamides were related to the resistance genes on genomic islands, which suggested that resistance phenotype were not all encoded by genes at genomic island.ConclusionBoth SGI1 and SXT/R391 resistance-related genomic islands were identified for the first time in a strain of Proteus mirabilis, which increased the complexity and severity of drug resistance. Surveillance for resistance-related genomic islands in multi-drug resistant strains should be strengthened.

A Association of drug efflux pump gene Rv1456c, Rv1457c and Rv1458c expressions with drug resistance of Mycobacterium tuberculosis

Yang Che, Tianchi Yang, Guohua Ping, Lyu Lin

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ObjectiveTo explore the association between efflux pump gene Rv1456c, Rv1457c and Rv1458c expressions and phenotypic drug resistance of Mycobacterium tuberculosis.MethodsThe RNA of 102 strains of M. tuberculosis collected through drug resistance surveillance by Ningbo Prefectural Center for Disease Control and Prevention during 2017—2018 were extracted. The gene expression levels of Rv1456c, Rv1457c and Rv1458c were detected with real-time PCR and the data were analysed by using Mann-Whitney U test.ResultsThe medians and interquartile ranges of expressions of Rv1457c and Rv1458c in rifampicin resistant group ［0.507 (0.378–1.444), 1.842 (1.325–2.628)］, were higher than those in rifampicin sensitive group ［0.418 (0.357–0.618), 1.545 (1.189–2.065)］, the differences were significant (Z＝2.030, P＜0.05, Z＝2.108, P＜0.05). The medians and interquartile ranges of expressions of Rv1457c and Rv1458c in multidrug resistant group ［0.538 (0.419–1.490), 1.941 (1.471–2.659)］ were higher than those in non-multidrug resistant group ［0.415 (0.337–0.618), 1.533 (1.122–2.056)］, the differences were significant (Z＝2.865, P＜0.05, Z＝2.896, P＜0.05). There were significant difference in over-expression rates of gene Rv1456c and Rv1457c between isoniazid resistant group and isoniazid sensitive group (χ²＝4.858, P＜0.05, χ²＝6.789, P＜0.05). There was significant difference in over-expression rate of gene Rv1456c between rifampicin resistant group and rifampicin sensitive group (χ²＝8.424, P＜0.05). There was significant difference in over-expression rate of gene Rv1457c between streptomycin resistant group and streptomycin sensitive group (χ²＝4.545, P＜0.05). There were significant differences in over-expression rates of gene Rv1456c and Rv1457c between ethambutol resistant group and ethambutol sensitive group (χ²＝5.142, P＜0.05, χ²＝10.202, P＜0.05). ConclusionThe increases in expressions of ATP-binding cassette efflux pump gene Rv1457c and Rv1458c are associated with rifampicin resistance of M. tuberculosis.

Etiologic surveillance for infectious diarrhea in Mentougou district of Beijing, 2013-2017

Qiuyan Lyu, Longjian Li, Haitao Liu, Tian Chu, Xiangju Zhao

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ObjectiveTo understand the pathogen spectrum of infectious diarrhea in Mentougou district of Beijing and provide evidence for prevention and control of intestinal infectious diseases.MethodsStool samples were collected from the diarrhea patients receiving no antibiotic treatment in two large hospitals in Mentougou for the isolation, culture and identifications of Salmonella, Shigella, Vibrio parahaemolyticus and 5 kinds of diarrheagenic Escherichia coli (DEC). The patient data were analyzed with SPSS 20.0.ResultsA total of 1 672 stool samples were collected from diarrheal patients, and 270 strains of pathogenic bacteria were detected. The overall positive rate was 16.15%. Among these strains, 121 (7.24%) were DEC, 65 (3.89%) were V. parahaemolyticus, 58 (3.47%) were Salmonella, and 3 (0.18%) were Shigella. Enterotoxigenic E.coli (ETEC) was the most common pathogen in DEC (30.36%), and Salmonella Enteritidis was the most common pathogen in Salmonella (8.50%). In addition, the detection of pathogenic bacteria had obvious seasonality. The detection rate was highest between May and August. There was no significant difference in detection rate between men and women (χ²＝0.685, P＞0.05).ConclusionDEC was the main pathogen detected in stool samples of diarrhea patients in Mentougou, followed by V. parahaemolyticus and Salmonella. It is necessary to strengthen the surveillance for enteric pathogens, especially the pathogen spectrum of infectious diarrhea, for the prevention and control of infectious diarrhea.

Report of an imported measles outbreak caused by measles virus D8 in Shanghai, 2018

Chongshan Li, Zhi Li, Jing Wang, Jiayu Hu, Wei Tang, Yuying Yang, Yunyi Li, Yanji Yang, Xiaoxian Cui, Yulong Ye, Xi Zhang, Zhengan Yuan

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Abstract:
ObjectiveTo trace the source of an imported measles outbreak occurred in Shanghai in 2018, and analyze the molecular characteristics of the measles virus isolated.MethodsViral RNA was directly extracted from the throats swabs of the cases. The 676 nucleotides at COOH-terminal of nucleoprotein gene in measles virus were amplified by using one-step RT-PCR. The amplicons were sequenced by Sanger's to obtain the viral nucleotide sequences. Homology analysis was conducted to identify the viral genotype.ResultsThe cases in this outbreak came from a family, and 2 adult cases had a common outbound travel history within 21 days before the onset. The outbreak was caused by Measles virus D8.ConclusionBased on the results of epidemiologic investigation and laboratory tests, it was deduced that it was an imported measles outbreak caused by measles virus D8.

Transmission dynamic of influenza B virus Yamagata lineage and assessment of infection control measures in schools in Shenzhen

Jing Liang, Qiong Fang, Tianmu Chen, Jianming Zhong, Lin Cai, Li Cao, Baoni Lin, Dongting Wu

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Abstract:
ObjectiveTo analyze transmission dynamic of influenza B virus Yamagata lineage and assess the effects of vaccination and isolation measures for the outbreaks in schools in Shenzhen, 2017.MethodsThe susceptible-exposed-infectious/asymptomatic-removed (SEIAR) model was used to simulate the data from field investigation. Then the basic reproduction number (R₀) was calculated to evaluate the infectious ability of the virus. The SEIARV (vaccination) and SEIARQ (isolation) models were developed, then the cumulative incidence rate (TAR) and the duration of outbreak (DO) were calculated to evaluate the effectiveness of vaccination and isolation measures.ResultsAt the end of 2017, the R₀ of the B/Y influenza outbreak in Shenzhen was 5.97 (95% CI: 3.66−8.28); the epidemic would last for 52 days without any intervention and the TAR would be 99.57%. In the context of vaccination with inactivated influenza vaccine (IIV) before outbreak, when the vaccination rate was 30%, 50% and 70%, the TAR after vaccinations with IIV3 or IIV4 would be 80.51%/76.81%, 65.07%/58.48%, and 44.06%/33.77%. In the context of the emergent vaccination after outbreak, when the vaccination rate was 30%, 50%, and 70%, the TAR after vaccination with IIV3 or IIV4 was 85.94%/82.46%, 73.55%/67.03% and 57.90%/47.54%. In the context of combined intervention of vaccination and isolation before outbreak, when the vaccination rate is ≥50%, the TAR would be ＜1%. In the context of combined intervention of emergent vaccination and isolation after outbreak, when the vaccination rate is ≥50%, the TAR would be ＜5%.ConclusionInfluenza B virus Yamagata-lineage has a strong ability to spread in school outbreaks. In the context of vaccination with IIV3 or IIV4, high coverage combined with isolation is an effective prevention and control measure.

Subtypes and transmission characteristics of HIV-1 in men who have sex with men in Lishui, Zhejiang

Ling Ye, Xiaoguang Wang, Jiafeng Zhang, Xiuying Chen, Qin Fan, Bifeng Ye, Ying Cong, Xiaomeng Huang

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Abstract:
ObjectiveTo understand the subtypes and transmission characteristics of HIV-1 in men who have sex with men (MSM) in Lishui of Zhejiang province.MethodsBlood samples were collected from the newly-diagnosed HIV-1 infected MSM who received no antiviral therapy in Lishui during 2015–2018, pol gene was amplified and sequenced, the gene subtypes and transmission characteristics were analyzed by phylogenetic tree construction, at last mutations on drug resistance was analyzed with online software CPR 6.0.ResultsA total of 89 sequences were obtained successfully from 105 samples. The predominant subtypes were CRF01＿AE (49.4%, 44/89) and CRF07＿BC (37.1%, 33/89), others were B and CRF55_01B detected in 3 cases respectively and CRF08＿BC, CRF59_01B and URF(01_AE/BC) detected in 2 cases respectively. Eight transmission clusters were found, with the total clustered rate of 21.3% (19/89). Seven clusters of transmission were associated with the cases who lived in Liandu district (87.5%, 7/8). Three surveillance drug resistance mutations (M46I, V106A, K103N) were found respectively in three samples. The overall rate of transmitted drug resistance (TDR) was 3.4% (3/89).ConclusionThere were 7 HIV-1 subtypes in Lishui, HIV-1 genetic diversity showed complexity trend, and the cases in Liandu district might play a central role in the spread of HIV. It is necessary to strengthen the surveillance and targeted intervention for the cases associated with major transmission clusters. However, the prevalence of TDR was at a low level.

Analysis on duplication genes of toxigenic strains of Vibrio cholerae O1

Zhenpeng Li, Xin Lu, Bo Pang, Biao Kan

Accepted Manuscript

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Abstract:
ObjectiveGene duplication through paralogous gene evolution is an important way of prokaryotic genome evolution, while the characteristics of duplication genes in Vibrio cholerae genome are poorly understood. In this study, we analyzed the number, diversity of duplication genes and difference in duplication genes between two biotypes of toxigenic strains of V. cholerae O1.MethodsWe selected 300 strains of V. cholerae O1 of two biotypes causing the sixth and seventh pandemics. The numeric distribution and differential duplication genes between two biotypes were analyzed by using blastp and MCL; the diversity of duplication genes and genes of diversity difference were analyzed by measuring the average distance between any two sequences.ResultsThe results showed that the average number of homologous gene clusters per strain was 242.63, the average number of that was 244.85 for El Tor biotype strains, and 209.74 for classical biotype strains. El Tor biotype had more duplication homologous gene clusters than classical biotype. Thirteen homologous gene clusters with significant different copies numbers between El Tor biotype and classical biotype were screened out; their functions mainly include the anions, amino acids or other substances transport, localization and transmembrane transport. By analyzing the genetic diversity of homologous gene clusters with duplication genes, we found 50 homologous gene clusters with different diversity between the two biotypes, the biological processes they participate in mainly include anions, amino acids or other substances transport, localization and substrate-specific transmembrane transport activity, etc.ConclusionThe evolution of the duplication genes of V. cholerae has a certain functional tendency; the characterization of it could provide a new point for the understanding of the adaptive evolution of the genome, the diversity of strains and the differential evolution of the genomes of two biotypes.

Epidemiological survey of the first case of pregnant women infection with avian influenza A (H9N2) virus in Shenzhen

Feng Liu, Gang Li, Fengren Liu, Guolong Yu

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Abstract:
ObjectiveTo identify the possible infection source of the first case of pregnant woman infection with avian influenza A (H9N2) virus reported in Longgang district of Shenzhen and provide evidence for the prevention and control of human infection with H9N2 virus in the future.MethodsEpidemiological data of the case were collected systematically using field epidemiology method and the samples of case, close contacts and exposure environments were collected from 2017 to 2018. Influenza A virus was detected by using antigen test. The detection and subtyping of avian influenza virus were conducted with fluorescence quantitative PCR. The data was analyzed by using software Excel 2019.ResultsThe throat swabs of the case was detected to be H9N2 virus nucleic acid positive and the case was diagnosed as the first pregnant women infection with H9N2 virus in Shenzhen. Eight close contacts showed no influenza -like symptoms during the medical observation period, and the influenza antigen and avian influenza nucleic acid tests were all negative. In 2017, the daily environment surveillance results showed that the positive rate of H9 virus subtype was 14.49%, The H9 virus subtype positive samples accounted for 62.69% in total universal influenza A virus positive samples. A total of 103 environmental samples were collected in the epidemic, in which 15 were universal influenza A virus positive and 9 were influenza A virus subtype H9 positive.ConclusionThe infection source might be a pigeon farm, but the exposure to poultry products in daily life could not be exclude4d. Avian influenza virus contamination still exists in the environment of poultry markets in Shenzhen, suggesting that the population at high risk still might be exposed in epidemic season. It is necessary to pay attention to this problem.

Epidemiological and clinical characteristics of hospitalized influenza patients, Beijing, 2016–2018

Yi Zhang, Yang Pan, Jiachen Zhao, Daitao Zhang, Chunna Ma, Peng Yang, Quanyi Wang

Accepted Manuscript

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Abstract:
ObjectiveTo understand the epidemiologic and clinical characteristics of laboratory-confirmed influenza A and B cases in hospitalized patients with severe acute respiratory infection (SARI), and explore the association between illness severity and influenza type.MethodsDescriptive epidemiologic analysis was conducted on the data of laboratory-confirmed influenza cases detected through SARI sentinel surveillance in Beijing from August 2016 to July 2018. Influenza patients were regarded as severe cases if they needed invasive mechanical ventilation, or received ICU treatment, or died during hospitalization; or else they were regarded as mild cases. Multivariate logistic regression model was used to explore the association between type/subtype of influenza and illness severity.ResultsAmong 746 hospitalized influenza patients, 598 were infected with influenza A virus (80.2%) and 148 were infected with influenza B virus (19.8%). Six patients needed invasive mechanical ventilation (0.8%, 6/746), 17 patients needed intensive care (2.9%, 17/746) and 4 patients died during hospitalization (0.5%, 4/746). Influenza A patients had 1.3 times hider risk to have severe clinical course compared with influenza B patients (OR＝1.3, 95% CI: 0.4–4.7, P＝0.655). Compared with patients with influenza B/Yamagata virus infection, patients infected with influenza A(H1N1) pdm09 virus had 2.1 times higher risk to have severe clinical course (OR＝2.1, 95% CI: 0.5–8.5, P＝0.295).ConclusionThe hospitalized influenza patients were mostly young children and the elderly. Further studies are needed to confirm whether the clinical severity of influenza A is worse than that of influenza B.

Practice of management of auto-reporting of communicable diseases based on electronic medical records

Yuanyuan Kong, Guiling Gao, Qinghui Zhang, Xiaoqin Guo

Accepted Manuscript

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Abstract:
ObjectiveTo explore the data exchange and management mode of regional health information platform based on electronic medical records.MethodsBased on the regional health information platform, the information of communicable diseases were reported from medical institutions to the national infectious disease reporting system through 3 data exchange methods (intelligent reminding plug-in, standardized interface at background and page reporting).ResultsThe intelligent infectious diseases reporting system based on electronic medical record was completed through the pushing step by step. The trial operation results in October 2018 showed that the success rate and consistency rate of data reporting were all higher than 95.00%. The comparison of 728 communicable disease cases reporting between hospital information system and national direct reporting system indicated that the completeness rates and timeliness rates of two systems were all 100%, the accuracy rates were 99.31%, 97.39% respectively, the difference was significant (χ²＝8.304, P＝0.004). The medians of card filling time of the two systems were 1.23 min and 2.82 min respectively, the difference was significant (U＝186 809.500, P＝0.000).ConclusionThe intelligent model based on regional platform to exchange data with the national infectious disease reporting system has been established, which can greatly improves the efficiency of communicable disease reporting, reduce the workload of medical staff, realize data sharing and fill the gap in the domestic field.

Trend of cesarean section and influence factors in Zhoushan of Zhejiang, 2002–2018

Manxian Huang, Shuojia Wang, Muyiduli Xiamusiye, Minjia Mo, Bule Shao, Yu Shen, Shuting Si, Xing Xin, Yunxian Yu

Accepted Manuscript

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Abstract:
ObjectiveTo understand the trend of cesarean section (CS) in pregnant women in Zhoushan of Zhejiang province from 2002 to 2018, and analyze the potential influence factors.MethodsThe prenatal examination data and delivery information of pregnant women in Zhoushan during this period were collected by using local electronic medical record system. Multivariate logistic regression models were used to identify the influence factors for CS.ResultsThe study included 43 034 pregnant women from 2002 to 2018. The overall CS rate was 50.61%, and the rate began to decrease from 2013 and decreased to 40% in 2016. Older age at pregnancy (OR＝1.115, 95% CI: 1.106–1.123), higher pre-pregnancy BMI (OR＝1.080, 95% CI: 1.070–1.090), more than time pregnancy (OR＝1.199, 95% CI: 1.145–1.256), high-risk pregnancy (OR＝1.407, 95% CI: 1.317–1.504) and high fetal birth weight (OR＝1.730, 95% CI: 1.641–1.824), non-head delivery (OR＝7.620, 95% CI: 7.037–8.251) were the influence factors for CS. When stratified by year, higher educational level was the influence factor for CS before 2014.ConclusionThe average CS rate was relatively high in Zhoushan. Maternal age, pre-pregnancy BMI, gravidity, risk degree of pregnancy, fetal birth weight and position of the fetus were influence factors for CS.

Incidence of gestational diabetes mellitus and risk factors in Zhoushan Islands, Zhejiang

Liuyan Pu, Jinhua Wu, Wen Jiang, Manxian Huang, Li Chen, Bule Shao, Shuojia Wang, Wenyan Chen, Junfen Wang, Minjia Mo, Yunxian Yu

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Abstract:
ObjectiveTo understand the incidence of gestational diabetes mellitus (GDM) in pregnant women in Zhoushan, Zhejiang province, and identify its influencing factors.MethodsThe data of all the pregnant women underwent GDM screening in Zhoushan Maternal and Child Care Center from January 2014 to June 2018 were retrospectively analyzed in this study. Logistic regression models were used for the identification of the risk factors for GDM and GDM subtypes.ResultsA total of 10 802 pregnant women received GDM screening, the oral glucose tolerance test indicated that 1 489 pregnant women had GDM (13.78%). The proportions of different GDM subtypes (A, B and C) were 21.49%, 66.15% and 12.36%, respectively, in 1 489 GDM cases. The multivariate logistic regression analysis showed that older age, higher BMI during early pregnancy, higher blood glucose level during early pregnancy, higher heart rate during early pregnancy, higher albumin level during early pregnancy, screening in winter/spring and being primipara were the risk factors for GDM, while educational level was not associated with the risk for GDM. The multiple logistic regression analysis for different GDM subtype showed that higher BMI, higher blood glucose level during early pregnancy and screening in winter/spring were associated with increased risks for GDM subtype A. Older age, higher blood glucose level, higher heart rate and higher albumin level during early pregnancy, screening in winter/spring and higher educational level were associated with increased risk for GDM subtype B, while being multipara decreased the risk for GDM subtype B. Older age, higher BMI, higher heart rate and higher blood glucose level during early pregnancy, and screening in winter/spring were associated with increased risk for GDM subtype C, while higher educational level and being multipara decreased the risk for GDM subtype C.ConclusionThe incidence of GDM was high in Zhoushan. Older age, higher BMI, higher blood glucose level, higher heart rate and high albumin level during early pregnancy, screening in winter/spring increased the risk for GDM, respectively. It is important to avoid pregnancy at older age and control pre-pregnancy BMI and blood glucose level during early pregnancy to reduce the risk for GDM and improve the health of both mothers and infants.

Establishment of real-time PCR assays for rapid detection of Clostridium botulinum type A and B

Ying Huang, Yun Shi, Changyun Ye, Xuefang Xu

Accepted Manuscript

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Abstract:
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 were established, which can be applied in the rapid detection of C. botulinum.

Epidemiological characteristics of hepatitis C in Gansu, 2008–2017

Li Li, Bin Wang, Ailing Yu, Aixia Tu, Yadong Zhao

Accepted Manuscript

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Abstract:
ObjectiveTo analyzed the epidemiological characteristics of hepatitis C in Gansu province and provide scientific evidence for the improvement of prevention and control of hepatitis C.MethodsThe incidence data of hepatitis C in Gansu from 2008 to 2017 were collected for a descriptive epidemiological analysis. The statistical analysis was done with software SPSS 20.0 and the rate comparison was through χ² testResultsA total of 72 899 cases of hepatitis C were reported in Gansu during this period. The incidence rate of hepatitis C showed an increase trend from 20.92/100 000 to 29.71/100 000 (χ²＝1 330.472, P＜0.01) and reached peak of 34.93/100 000 in 2012. The male to female ratios of the cases were 1.08∶ 1 and 1.83∶ 1 respectively. The cumulative case number in age group 20–49 years accounted for 42.94% of the total, showing a decrease trend. The reported incidence rate in age group ≥50 years increased year by year (χ²＝1 342.154, P＜0.05), The proportion of the cases reported in women showed an increase trend. The cases in farmers accounted for 49.27% (35 919 cases) and increased with year. Hepatitis C occurred all the year round. The incidence rates ranged from 1/100 000 to 3/100 000. The incidence rates of hepatitis C in Wuwei and Lanzhou were higher than those in other areas.ConclusionThe overall incidence of hepatitis C in Gansu was in increase without obvious seasonality. The difference in incidences among different areas was significant, and the incidence rate increased with age. It is necessary to strengthen the surveillance for hepatitis C in key populations and areas.

Epidemiological and etiological characteristics of severe cases of hand foot and mouth disease in Zhongshan, Guangdong, 2013−2017

Enmiao Huang, Zifeng Yao, Wuyang Shi

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Abstract:
ObjectiveTo understand the epidemiology and etiological characteristics of severe cases of hand foot and mouth disease (HFMD) in Zhongshan of Guangdong province and provides evidence for the prevention and control of HFMD.MethodsCase investigation and laboratory test were conducted for the severe cases of HFMD reported in Zhongshan from 2013 to 2017. Data analysis was done by using Excel 2007 and SPSS 13.0 softwares.ResultsA total of 209 severe cases of HFMD were reported in Zhongshan, accounting for 0.25%（209/84 021） of total HFMD cases, with an annual average incidence of 1.31/100 000. The incidence peak was during March-July. The cases were mainly in 1–3 years old children outside child care settings, accounting for 73.68%（154/209）. The incidence in boys was higher than that in girls. All the 209 severe HFMD cases had skin rash, 95.22% of the cases had fever, and the main type of rash was herpes (71.29%). The time interval between onset and initial diagnosis was less than 3 days, accounting for 91.87% (192/209). Up to 63.64% of the cases (133/209) were correctly diagnosed with HFMD at the first visit. The differences in diagnostic accuracy of HFMD among hospitals at different levels were significant. The specimens of 203 severe HFMD cases were detected, the positive rate was 93.10% (189/203). The major pathogen was EV71 (58.13%), the detection peak time was during April-May.ConclusionThe incidence of severe HFMD had obvious time, population and area specific characteristics in Zhongshan. The major pathogen was EV71. It is necessary to take comprehensive measures and increase the vaccination coverage of EV71 inactivated vaccine to reduce the incidence of severe cases of HFMD.

Analysis on spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu, 2012–2017

Weimin Lyu, Kongfu Wei, Pinggui Wang, Yu'an Ma

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Abstract:
ObjectiveTo analyze the spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu province and provide evidence for the prevention and control of hepatitis B.MethodsThe incidence data of hepatitis B in Gannan from 2012 to 2017 was used to calculate the global Moran’s I and local G statistics and analyze its spatial-temporal distribution characteristics.ResultsThe incidence of hepatitis B showed spatial autocorrelation（P＜0.05）from 2012 to 2017, and local autocorrelation analysis indicated that the hot spots areas identified were mainly in some townships of Xiahe, Luqu. Maqu, Zhuoni and Hezuo, while the cold spots areas were mainly in some townships of Zhouqu, Diebu, Zhuoni, Lintan and Hezuo. Spatial-temporal analysis showed that the most likely clustering areas of incidence of hepatitis B were in some townships of Xiahe during 2012–2014 (RR＝3.50, LLR＝219.24, P＜0.001) and some townships in Luqu in 2016 (RR＝6.91, LLR＝198.61, P＜0.001）, followed by some townships of Lintan and Zhuoni during 2012–2013 (RR＝1.79, LLR＝70.41, P＜0.001).ConclusionThe incidence of hepatitis B showed spatial and spatial-temporal clustering in Gannan from 2012 to 2017. Targeted prevention and control measures should be taken according to the spatial distribution of the disease.

Epidemiology of viral hepatitis C in Qinghai, 2013−2017

Shicun Dong, Guanglan Pu, Weijun Wang, Ming Fan, Yulan Sun, Jiping Li, Yongcheng Ma, Yan Shi

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Abstract:
ObjectiveTo understand the epidemiological characteristics of viral hepatitis C in Qinghai province from 2013 to 2017.MethodsDescriptive epidemiological analysis was conducted by using the incidence data of hepatitis C collected from National Notifiable Disease Surveillance System.ResultsA total of 10 989 cases of hepatitis C were reported from 2013 to 2017. The annual reported incidence rate was 37.67/100 000, the male to female ratio of the cases was 1.18∶1. The cases were reported in all age groups, but the cases in age group 40- years accounted for 42.17%, and the disease mainly reported in Xining, Haidong and Yushu. The cases were mainly reported by medical institutions at provincial level, accounting for 69.53%. The disease occurred all the year round with no obvious seasonality.ConclusionThe incidence of hepatitis C was stable in Qinghai in recent years, but the incidence level was higher than other provinces. It is necessary to strengthen the prevention and control of hepatitis C.

Analysis on measles antibody level in healthy population in Dali Bai autonomous prefecture, Yunnan, 2012–2018

Yanjun Liu, Zuo He, Ran Xu, Fang Guan

Accepted Manuscript

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Abstract:
ObjectiveTo understand the measles antibody level in healthy population in Dali Bai autonomous prefecture of Yunnan province during 2012−2018 and provide scientific evidence for the elimination of measles.MethodsBlood samples were collected annually from healthy populations in 8 age groups selected through stratified random sampling, a total of 28 459 blood samples were collected. Serum measles IgG was detected by using enzyme linked immunosorbent assay (ELISA).ResultsThe differences in annual positive rate of measles IgG in healthy population were significant. The positive rate was lowest in 2016 (89.6%) and highest in 2013 (97.3%). The positive rate was ＞90% in other years. The differences in the positive rate were significant among different age groups (P＜0.05). The positive rate was lower in age groups 8−17 months and 25−34 years. There were significant differences in the positive rate and antibody geometric mean concentration (GMC) among people receiving different doses of measles containing vaccine (P＜0.05). The GMC was highest in people receiving 3 doses of measles vaccination (1 921.1 mIU/ml).ConclusionThe immunity barrier has been basically formed in Dali, the possibility of measles outbreak is low, but close attention should be paid to the potential risk of measles in adults. It is necessary to conduct supplementary immunization activity in order to increase population antibody level and reduce the incidence of measles.

Spatial-temporal distribution characteristics of hand, foot and mouth disease in Jingzhou, Hubei, 2008–2017

Menglei Yao, Tian Liu, Li Wang, Shuqiong Huang, Jing Cai, Wenwen Yang, Ran Wu

Accepted Manuscript

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Abstract:
ObjectiveTo analyze the spatial-temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Jingzhou, Hubei province, from 2008 to 2017, and provide evidence for the prevention and control of HFMD.MethodsThe global and local autocorrelation analyses on the spatiotemporal clustering of the incidence data of HFMD at street/township scale in Jinzhou during this period were performed by using software ArcGIS 10, and the spatiotemporal clustering analysis on the incidence data of HFMD was performed by using software SaTScan 9.4.ResultsA total of 53 159 cases were reported in Jingzhou from 2008 to 2017, with an average annual incidence rate of 91.59/100 000. Spatial autocorrelation analysis showed that the incidence rate of HFMD had positive spatial correlation. The incidence rate of HFMD had obvious spatiotemporal clustering characteristics, the main clustering area was found in the central urban area of Jingzhou and adjacent counties and townships.ConclusionUnderstanding the spatial and temporal distribution and spatial clustering characteristics of the incidence data of HFMD at street/township scale in Jingzhou has important public health significance for the allocation of public health resources, effective prevention and control of HFMD.