Disease Surveillance

Analysis on epidemic of pulmonary tuberculosis in minority ethnic areas included in health poverty alleviation project in four provinces in western China

Lijia Yang, Tao Li, Wei Chen

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ObjectiveTo analyze epidemic of pulmonary tuberculosis (TB) in minority ethnic areas included in a health poverty alleviation project in Qinghai, Sichuan, Yunnan and Gansu provinces in western China, and provide evidence for targeted pulmonary TB prevention and control.MethodsThe incidence data of pulmonary TB in the minority ethnic areas in 4 western provinces from 2011 to 2018 were collected from Infectious Disease Reporting System for a descriptive analysis to identify key areas and populations for the prevention and control of pulmonary TB.ResultsThe overall incidence rate of pulmonary TB in the minority ethnic areas in 4 western provinces increased gradually from 114.41 per 100 000 in 2011 to 140.90 per 100 000 in 2018, an increase of 23.16%. The highest incidence rate was reported in the minority ethnic area in Qinghai. In 2008, the incidence rate of pulmonary TB was higher in men than in women (166.43 per 100 000 versus 118.19 per 100 000). The case number in age group 15–24 years was highest (5 242 cases), accounting for 28.59%. The pulmonary TB incidence rates were 487.41 per 100 000 and 245.41 per 100 000, respectively, in 15–24 age group in minority ethnic areas in Qinghai and Sichuan and 451.96 per 100 000 and 314.26 per 100 000, respectively, in age group ≥65 years in minority ethnic areas in Qinghai and Gansu.ConclusionsThe pulmonary TB epidemic was very serious in the minority ethnic areas in 4 provinces in western China. Close attention should be paid to the prevention and control of pulmonary TB in these areas. In minority ethnic areas in Qinghai and Sichuan it is necessary to attach importance to pulmonary TB prevention and control in adolescents, while in the minority ethnic areas in Qinghai and Yunnan, the pulmonary TB prevention and control should be focused on the elderly.

Establishment and application of multilocus sequence typing for Vibrio metschnikovii

Zhenzhou Huang, Keyi Yu, Hang Dai, Hongyan Cai, Xiao Xu, Duochun Wang

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ObjectiveTo establish a multilocus sequence typing (MLST) assay for Vibrio metschnikovii, evaluate the molecular typing effect of the MLST assay, and perform MLST analysis on the collected V. metschnikovii strains.MethodsSeven housekeeping genes (ftsZ, gapA, mreB, gyrB, purM, recA, ropA) sequences in 17 V. metschnikovii strains were amplified with PCR by using self-designed specific primers. The gene polymorphism, neutral evolution and gene recombination were evaluated by using software DnaSP 6.12.03 and software Split tree 4.0, and corresponding sequence types (ST) were obtained based on the sequence differences among 7 housekeeping genes. The minimum spanning tree and clustering map were constructed for different ST types by using software BioNumerics 7.1, and clonal complexes (CCs) were calculated by using software eBURST 3.0.ResultsThe selected 7 housekeeping genes were suitable for MLST with sufficient allele loci, sequence differences and high resolving power. The split tree clustering of 7 housekeeping genes was consistent with all of V. metschnikovii strains, and the neutrality tests showed that 7 housekeeping genes were less subject to genetic drift during evolution. MLST divided 17 V. metschnikovii strains into 14 STs, and most of them (64.70 %) formed a single ST respectively, of which ST 007 was probably a potential predominant clonal complex. There was a relatively long genetic distance between these strains, and may have specific geographical distribution in vertical transmission.ConclusionThe MLST assay established in this study has great capability in analyzing the population structure and evolution relationship of V. metschnikovii.

Risk assessment of public health emergencies concerned in the mainland of China, January 2020

Fengbo Zhou, Dayan Wang, Jingxin Li, Zhe Wang, Yun Li, Wenxiao Tu, Nijuan Xiang, Guoqing Shi

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ObjectiveTo assess the risks of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in January 2020.MethodsAn internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this conference through video terminal.ResultsGenerally speaking, it is predicted that the incidence of public health emergencies reported in January 2020 would be lower than that in December 2019 and those during the same periods of previous three years, which might mainly be predominated by the epidemics of seasonal influenza, varicella, infectious diarrhea caused by norovirus and non-occupational carbon monoxide poisoning event. Dynamical risk assessment should be conducted according to the progress of investigations of etiology, clinical and epidemiological characteristics of the 2019 novel coronavirus infections occurred recently in Wuhan. The peak of seasonal influenza might occur at the end of January. The incidences of infectious diarrhea caused by norovirus and non-occupational carbon monoxide poisoning would still remain at high levels in January. In domestic vacation trips during the Spring Festival, travelers should pay attention to seasonal influenza, human infection with avian influenza virus, infectious diarrhea caused by norovirus, food poisoning and non-occupational carbon monoxide poisoning. While travelling abroad, Chinese travelers should pay attention to Ebola virus disease, cholera, dengue fever, yellow fever, Zika virus disease, Middle East respiratory syndrome, as well as food hygiene.ConclusionClose attention should be paid to the 2019 novel coronavirus infections occurred in Wuhan and seasonal influenza, general attention should be paid to infectious diarrhea caused by norovirus, non-occupational carbon monoxide poisoning and the Spring Festival travelling related health problems.

Culture, identification and related mechanism research of Proteus vulgaris KM-19

Qinmei Jia, Chuanlian Yang, Yanmei Huang

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ObjectiveTo analyze the biological characteristics, drug resistance mechanism and genomic characteristics of a beta hemolytic Proteus vulgaris (No.KM-19) strain isolated and identified from middle urinary culture deficient in migratory growth, and provide evidence for clinical rational use of antibiotics.MethodsThe strain was cultured and isolated by using conventional methods. Then, VITEK-2 Compact automatic microbiological analyzer was used for the strain identification and drug sensitivity test in vitro. The absence of flagella was observed by staining and semisolid dynamic test. The whole genome of the strain was sequenced by high-throughput sequencing. The sequence assembly, gene prediction and functional annotation were carried out with bioinformatics method, and gene clusters related to phenotypic mechanism and drug resistance mechanism of the strain were further explored.ResultsVITEK-2 Compact identified the strain as Proteus vulgaris. The whole genome sequencing results showed that 48 Contigs were obtained from genome assembly; the total length of the gene was 3 319 152 bp, and the average length was 904.89 bp, accounting for 85.50% of the total length of the genome; the genome had no repeat sequence and had 38% C+G content. This strain was most likely to be Proteus vulgaris, which also verified the accurate identification result of the VITEK-2 Compact. This Proteus vulgaris strain was resistant to the first and second generation of cephalosporin, ampicillin, furantoin, compound neostigmine and tigecycline, but is was sensitive to the other drugs. No flagellum structure was observed under oil microscope and semisolid dynamic test was negative. The comparison between the genome sequencing sequence and the VFDB database showed that the bacterial flagellar gene and related genes were not missing, but, in flagellar gene sequences, the Methyl-accepting chemotaxis protein Ⅲ/Ⅰ genes was found. Methyltransferase genes and hlyB genes were also found in the genome. In addition, the comparison between the genome sequence and the CARD database showed that there were OXY and CTX-M genes and active efflux pump genes.ConclusionThe main mechanism of no migrating growth of this strain might be the methylation of flagellar genes or related genes, which indicated that the bacteria wasunable to effectively express flagellin in vitro and lost the ability of migrating growth. The beta hemolytic phenotype might be due to the insertion of exogenous hemolysin gene (hlyB), which was expressed effectively the bacterial genome. The drug resistance in vitro was closely related to OXY and CTX-M genes and active efflux pump genes.

Genetic diversity of lipooligosaccharide core biosynthesis gene clusters in Campylobacter jejuni

Jiaqi Wang, Yixin Gu, Guilan Zhou, Hao Liang, Jianzhong Zhang, Maojun Zhang

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ObjectiveTo analyze the DNA sequence characteristics of the biosynthesis gene clusters in the lipooligosaccharide (LOS) core region of Campylobacter jejuni, and obtain the specific sequence features of the LOS types.MethodsA total of 132 whole genome sequences of C. jejuni were selected for analyzing. OrthoMCL software was used to obtain the homology of LOS core region biosynthesis gene clusters and specific sequence of the different LOS type. PCR assay was established targeting the specific sequences of specific types of the gene clusters. According to the specific primers and the size of the amplified products, the main types of LOS were identified.ResultsAmong the 132 strains, the DNA sequences of biosynthesis gene clusters in LOS core regions of 105 strains belonged to 14 previously identified types, and those of 27 strains belonged to 10 novel types according to DNA homology, i.e. CDC1- 10. There were a large number of polyA/T, polyG/C, insertion and deletion mutations of nucleobase in the sequences of the LOS core region biosynthesis gene clusters. Some mutations could lead to the amino acid mutations of the synthetase or transferase for the LOSs, affecting the antigenicity. The type A, B, C, and CDC8 of LOS specific DNA sequences of 50 C. jejuni strains were confirmed using the PCR assays developed in this study.ConclusionThe 10 novel LOS types are helpful for the accurate identification of C. jejuni and explaining the antigenic diversity of LOS. The DNA sequence of LOS core biosynthesis gene clusters of C. jejuni is highly variable, and there are a large number of poly-structures and DNA sequence mutations, which is the potential cause of LOS antigenic diversity. The PCR assay for LOS typing can be used to rapidly screen five specific LOS types, but more strains are still needed for the validation.

Summary of global surveillance data of infectious diseases in December 2019

Hui Han, Bo Wu, Yajing Song, Jiaojiao Jia

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.01.003

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In December 2019, a total of 64 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 measles(49), dengue fever(26),chikungunya fever(8), poliomyelitis(8) and cerebrospinal meningitis(8).The top four infectious diseases with highest case fatality rates were Ebola virus disease (66.0%), Middle East respiratory syndrome(34.4%), Lassa fever (20.8%) and plague (16.0%). The top five infectious diseases with greatest number of deaths were measles, malaria, dengue fever, cholera and Ebola virus disease. The prevalent infectious diseases in Africa were Ebola virus disease, plague, cholera, yellow fever, Lassa fever and measles, the prevalent infectious diseases in Asia were dengue fever and Middle East respiratory syndrome, the prevalent infectious diseases in America was dengue fever, the prevalent infectious diseases in Europe was measles.

Analysis on rabies exposure surveillance in Guangzhou, 2013–2017

Haiyan Chen, Conghui Xu, Wenfeng Ren, Jianmin Xu, Yuehong Wei, Shouyi Chen, Hao Zhang

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ObjectivesTo understand the epidemiological characteristics of rabies in Guangzhou.MethodsThe surveillance data of rabies in Guangzhou from 2013 to 2017 were used for descriptive analysisResultsThe rabies exposure rates were 823.64/100,000, 822.86/100,000, 901.72/100,000, 988.30/100,000, and 1 187.2/100,000, 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 rare was relatively low during this period, which was only 15.06%, 6.91%, 7.30%, 5.38% and 7.06%, respectively.ConclusionsA 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.

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

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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.

Infection status of Campylobacter and its etiologic characteristics in diarrhea patients in Nanshan district, Shenzhen

Min Liu, Changyan Ju, Yanping Ma, Yongxiang Duan, Muhua Yu, Maojun Zhang, Guoqing Wang

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ObjectiveTo understand the infection status of Campylobacter and its etiologic characteristics in diarrheal patients in autumn in Nanshan district of Shenzhen.MethodsThe stool samples were collected from local diarrheal patients during September-November in 2018. Campylobacter was isolated with new filtration method and the species identification was performed by real time PCR. Molecular sub-typing was carried out by using multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE). The minimum inhibitory concentrations (MICs) of 11 antibiotics to the isolates were obtained with agar dilution method. The genetic cluster analysis was performed by using minimum spanning tree analysis based on the sequence typing (ST) of the isolates.ResultsA total of 150 stool samples were collected from 150 diarrheal patients, including 74 men and 76 women. The age of the patients ranged from 1 year to 86 years. Eighteen Campylobacter strains were isolated from 150 stool samples. Among the 18 isolates, 14 (77.78%) were C. jejuni positive and 4 (22.22%) were C. coli positive. Fourteen C. jejuni isolates could be classified into 11 PFGE patterns and 8 STs, and ST-9763, a novel ST identified in this study, was the predominant STS (35.71%, 5/14). All of the tested isolates were resistant to tetracycline and completely sensitive to erythromycin, azithromycin, telithromycin, gentamicin, streptomycin and clindamycin. The minimum spanning tree analysis for 14 C. jejuni strains isolated in Nanshan showed no significant clustering characteristics, the strains were distributed in groups from different sources.ConclusionThe new filtration isolation method increased the isolation rate of Campylobacter in diarrheal patients. C. jejuni was the major species causing Campylobacter infection. The isolates in this study showed high drug resistances to tetracycline and quinolones. No significant genetic cluster was found in C. jejuni strains isolated in Nanshan district.

2019年12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 December 2019

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2019年12月中国甲乙丙类传染病疫情动态概要

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Epidemiologic characteristics and drug resistance of Campylobacter in Zhuzhou, Hunan, 2016–2018

Qizhi Long, Huayun Jia, Li He, Lan Wang, Shixiong Hu, Lidong Gao, Junhua Li

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ObjectiveTo understand the epidemiologic characteristics and drug resistance of Campylobacter in Zhuzhou of Hunan province.MethodsEpidemiologic investigation was conducted in diarrhea cases and children without diarrhea in Zhuzhou from July 2016 to June 2018, and their stool samples were collected. The stool samples were used for the isolation of Campylobacter. The isolated Campylobacter strains were tested for drug susceptibility.ResultsA total of 450 cases were surveyed. The detection rate of Campylobacter was 6.44% (29/450). The detection rate in children without diarrhea was 1.00% (1/100), and the detection rate in diarrhea cases was 8.00% (28/350). The clinical symptoms of Campylobacter infection were diarrhea, abdominal pain, mucus stool, and the stool microscopic examination results were mainly characterized by the detections of erythrocyte and leukocyte. The detection rate in age group 5– years was 19.44% (7/36). The infection cases were mainly students 17.65% (6/34). There was no significant difference in the detection rate between man and woman (χ²＝1.354, P＝0.245). The detection rate of Campylobacter was higher in spring and autumn than in summer and winter. In the 29 strains, 24 were Campylobacter jejuni and 5 were C. colon. In the 29 strains, 41.38% were multidrug resistant. The resistant rates to nalidixic acid, ciprofloxacin, tetracyvline were 96.15%, 88.46% and 76.92%, respectively.ConclusionCampylobacter has become one of the important pathogens causing diarrhea in Zhuzhou, and it showed serious drug resistance and multi-drug resistance, to which the monitoring and control measures should be strengthened.

Analysis on epidemiological characteristics of scarlet fever in Ordos, Inner Mongolia, 2009–2018

Yifan Zhao, Le Xu, Yuyang Wang, He Lin

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ObjectiveTo understand the incidence trend and epidemiological characteristics of scarlet fever in Ordos of Inner Mongolia, and provide evidence for the prevention and control of scarlet fever.MethodsDescriptive epidemiological analysis was conducted on the incidence data of scarlet fever in Ordos during 2009–2018.ResultsA total of 3 150 cases of scarlet fever were reported in Ordos during this period. The average annual morbidity rate was 16.50/100 000, and the morbidity rate was 1.58 times higher in boys than in girls. The incidence of scarlet fever had obvious seasonality, which peaked during May-July and October-January, respectively. The cases mainly occurred in age group 3–10 years, accounting for 94.16% of the total (2 966/3 150). The cases in children in child care settings (1 900 cases), students (889 cases) and children outside child care settings (336 cases) accounted for 60.32%, 28.22% and 10.67% of the total cases, respectively.ConclusionThe incidence of scarlet fever increased in Ordos during 2009–2018. The cases mainly occurred in late spring, early summer and winter. The incidence of scarlet fever was higher in boys than in girls.

Drug resistance of Campylobacter from livestock and poultry in Qingdao, Shandong, 2017–2018

Xiao Liu, Xing Li, Weishuai Zhai, Zhangqi Shen, Yang Wang, Dejun Liu

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ObjectiveTo investigate the spread and antimicrobial resistance of Campylobacter in poultry and livestock in Qingdao, Shandong during 2017—2018.MethodsWe collected cloaca, anal, caecum and meat samples of poultry and livestock in poultry/pig farms, slaughter houses, and rural produce markets in Qingdao for Campylobacter isolation. Species identification and antibiotic susceptibility test of the isolates were performed. RE-cmeABC and erm(B) genes were detected by using polymerase chain reaction (PCR).ResultsIn this study, 730 samples of livestock and poultry were collected in Qingdao from 2017 to 2018. A total of 235 strains (34.66%) of Campylobacter were isolated and identified, including 131 (55.74%) strains of Campylobacter jejuni and 104 (44.26%) strains of C. coli. Among these isolates, 147 (29.40%, 147/500) were detected in chickens, 80 (47.06%, 80/170) in ducks, 8 (13.33%, 8/60) in pigs, respectively. The results of antibiotic susceptibility test showed that C. coli was more resistant to erythromycin (92.31%), ciprofloxacin (100.00%), clindamycin (87.50%), florfenicol (53.85%), kanamycin (96.15%), gentamicin (92.31%) and tetracycline (99.04%), and C. jejuni was more resistant to ciprofloxacin (98.47%), florfenicol (61.83%), kanamycin (70.99%) and tetracycline (100.00%). PCR results indicated that 12 strains (5.11%) were positive for erm (B) gene and 125 strains (53.19%) were positive for RE-cmeABC gene.ConclusionThis study suggests that it is necessary to further monitor antibiotic resistance of Campylobacter and related mechanism in livestock and poultry in Qingdao to provide theoretical basis for the control of the spread of antibiotic resistant Campylobacter.

2019年全球中东呼吸综合征疫情概况

Zhenyu GONG, Xunliang GONG

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Analysis on duplicated reporting of hepatitis B in Suzhou, 2014–2018

Yang Yang, Cheng Liu, Liling Chen, Lianmei Jin, Huilai Ma, Huihui Liu

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ObjectiveTo understand the repeated reporting of hepatitis B in Suzhou from 2014 to 2018, provide data to support future research.MethodsThe data of hepatitis B cases in Suzhou from 2014 to 2018 were collected through National Notifiable Disease Reporting System, and repeated cases were identified to calculate the repetition rate.ResultsA total of 12 823 cases of hepatitis B were reported, in which 731 cases were duplicately reported, with a repetition rate of 5.70%. The repetition rate was 4.32% during 2014–2018, higher than annual repetition rate (1.44%). The area specific duplicated reporting constituent ratios ranged from 0.55% to 32.42%, and the repetition rates ranged from 1.46% to 11.2%. The rate of duplicated reporting in different age groups ranged from 3.59% to 6.40% (χ²＝21.518, P＝0.001), and was higher in high age groups than in low age group. Duplicated reporting occurred in medical institutions at provincial, prefectural, county and township levels, with the repetition rates ranging from 3.23% to 7.69% (χ²＝62.272, P＜0.001).ConclusionDuplicated reporting of hepatitis B existed in Suzhou, which might be explained by the limitation of National Notifiable Disease Reporting System and the loss, change and error in case’s basic information. Kunshan, Gusu and non-local institutions had greater impacts on duplicated reporting of hepatitis B in Suzhou, it is necessary to strengthen the check of the duplicated reporting in these areas. The duplicated reporting rate was higher in medical institutions at provincial and county levels than medical institutions at prefectural and township levels.

Analysis on an epidemic of mixed infection of norovirus GⅠ and GⅡ

Cairong Chen, Huifen Zhang, Hongbiao Liang

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ObjectiveTo investigate an epidemic of norovirus infection, identify the pathogen and transmission factors, and provide evidence for the response of similar epidemic.MethodsThe cases were searched, and case survey and field hygiene survey conducted. The risk factors were analyzed through case-control study. The stool samples were collected from the cases for norovirus nucleic acid detection with real time PCR.ResultsA total of 16 confirmed cases were found, the attack rate was 5.82% (16/275). The cases were all students, no teacher and school staff were affected. No severe case and death occurred. Acute illness was observed in the cases, the clinical manifestations included vomiting (100.0%), nausea (100.0%), abdominal pain (62.5%) and fever (25.0%); Thirteen norovirus positive samples were detected in 16 stool samples, i.e. 2 norovirus GⅠ and GⅡ mixed positive samples, 2 norovirus GⅠ positive samples, 9 norovirus GⅡ positive samples. Off-campus boarding (OR＝154, 95% CI: 19.82–1 196.45) and onlooking at vomiting sites were risk factors for the infection (OR＝143, 95% CI: 18.31–1 116.71).ConclusionThe epidemic was a norovirus caused infection cluster, which might be caused by aerosol transmission through the inhalation of vomit of the index case.

Spread and antibiotic resistance of Campylobacter of animal origin

Dejun Liu, Xiao Liu, Xing Li, Zhangqi Shen, Yang Wang

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Campylobacter spp. is an important foodborne zoonotic pathogen. In the past few years, the increased spread and antimicrobial resistance of Campylobacter resulted in highly concern from medical and veterinary fields. Europe, United States and China have all established the monitoring system of antibiotic resistance for Campylobacter from various origins. Meanwhile, amounts of studies have been carried out. Animal was one of the major sources of Campylobacter, so there is a potential risk for Campylobacter to infect humans via food chain. Herein, this paper summarizes the research progress of Campylobacter of animal origin for the better understanding of the spread and antibiotic resistance of Campylobacter in Europe, United States and China.

Analysis on deletion of reporting cards for viral hepatitis B in Tianjin, 2013–2018

Guoping Zhang, Zhaofei Wei, Haiyan He, Ying Zhao, Weishen Wu

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ObjectiveTo understand the reasons for the deletion of reporting cards for viral hepatitis B in Tianjin during 2013–2018, find out the existing problems and provide evidence for the standardized reporting of hepatitis B in the future.MethodsThe information about all hepatitis cases reported in Tianjin from January 1, 2013 to December 31, 2018 were collected from “Communicable Disease Information Reporting and Management System" for descriptive epidemiological analysis to understand the deletion rate of reporting cards for hepatitis B and the reasons and the deleted reasons’ distribution in different type hospitals, hepatitis B type classifications and institutions.ResultsThere were 17 983 reporting cards for hepatitis B, including 2 429 deleted reporting cards, in Tianjin during 2013–2018, the deletion rate was 13.51%. The repeated reporting was responsible for 47.06% in deleted reporting cards, followed by non-conformance with diagnostic criteria (30.34%), non-conformance with reporting standards (15.31%) and others (7.29%); The rates of repeated cards, non-conformance with reporting standard and non-conformance with the diagnostic criteria were significantly higher in unclassified hepatitis B cases than those in acute hepatitis B and chronic hepatitis B cases (P＜0.05); The rates of non-conformance with reporting standards and other reasons in hospitals were significantly higher than those in three types of CDC related institutions.ConclusionThe main reasons for the deletion of reporting cards for hepatitis B in Tianjin mainly included repeated reporting, non-conformance with reporting standards and non-conformance with diagnostic criteria. However there were a few reporting cards with unspecific deletion reasons. It is necessary to further standardize hepatitis B diagnosis reporting and the deletion reason filling to improve the quality of surveillance.

Surveillance and analysis of etiology characteristics of Campylobacter infection in adult diarrhea patients in Shunyi district of Beijing, 2016–2018

Ying Li, Qiaoling Jia, Guilan Zhou, Hongmei Ma, Yuanyuan Wang, Shuang Zhang, Yindong Li, Maojun Zhang

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ObjectiveTo understand the molecular type, antibiotic susceptibility and distribution characteristics of Campylobacter isolated from adult diarrhea patients in Shunyi district of Beijing, and provide evidence for the prevention and control of Campylobacter infection as well as related risk evaluation.MethodsStool samples were collected from the adult diarrhea patients in a surveillance project in Shunyi from 2016 to 2018. Campylobacter strains was isolated using filtration method and the species identification was carried out using Biochemical test and Real-time PCR. Multi-locus sequence typing (MLST) and pulsed-field gel electrophoresis (PFGE) were used for molecular sub-typing. The antibiotic susceptibility test was performed with agar dilution method.ResultsThe isolation rate of Campylobacter was 5.65% (17/301) in 2016, 10.51% (39/371) in 2017 and 7.75% (29/374) in 2018, respectively. A total of 87 strains of Campylobacter were isolated. Among them, 87.36% (76/87) were C. jejuni strains and 12.64% (11/87) were C. coli strains. All the C. jejuni isolates belonged to 55 STs and 11 C. coli isolates belonged to 9 STs. PFGE was performed for the isolates with same ST and the close isolation time in 6 clusters, and 5 PFGE patterns were observed. The antibiotic susceptibility tests indicated that 55.26% (42/76) of the C. jejuni isolates and 90.91% (10/11) of the C. coli isolates exhibited resistance to three or more types of antibiotics.ConclusionCampylobacter is an important pathogen causing diarrhea in adults in Shunyi of Beijing. The filtration method is an effective method for isolation of Campylobacter from stool samples. Multi-drug resistance in C. coli is serious in Campylobacter from patient stool sample in Shunyi, to which more attention should be paid in public health and clinical practices.

Etiological analysis of 1 case of a patient with Listeria monocytogenes infection

Huiru Feng, Jing Shi, Qian Chen, Xiuxia Wei, Hong Yu, Tao Yan, Zhaoe Wang, Meng Qin, Zhimin Zhang, Xiaogen Dong

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Abstract:
ObjectivesTo investigate the etiology and traceability of an infection case caused by Listeria monocytogenes.MethodsOn the basis of Field epidemiological investigation, samples of patient, foods, kitchen environmental appliances were collected for strain isolation and identification. Six pairs of virulence genes (prfA, plcB, hly, actA, iap, inlA) of positive strains were tested. The positive strains were analyzed by pulsed-field gel electrophoresis (PFGE) and multilocus-sequence typing (MLST) techniques. The homologous analysis was finally performed on the isolated strain.ResultsSix strains of Listeria monocytogenes were isolated, one from the case, two from the kitchen environmental kit, and three from the food of patient's family. In addition to the deletion of the virulence gene of the strain plcB detected by the two samples of the refrigerator inner wall and canned sweet corn, the other five virulence and all the virulence genes of other strains were all positive.. The isolated strains were all ST121 type, and the PFGE band type was 100% consistent.ConclusionThe reason for the prevalence of this patient was due to poor hygiene in the home kitchen and contamination of both food and the environment.

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

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[Abstract](42) [FullText HTML](22) [PDF 3029KB](1) [Peer reviewing opinions] Related References Cited By (0) Share

Abstract:
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.MethodThe positive rates of virus detection in winter and spring influenza season in Ningbo from 2013 to 2018 (40^th week to the 20^th week) were used, the MEM model was established to analyze the epidemic intensity of the seasonal influenza epidemic in Ningbo from 2018 to 2019.ResultIn 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 1^st week of 2019. In the 2^nd 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 3^rd week. From the 8^th week to the 9^th week, the influenza epidemic intensity was high. The epidemic intensity gradually decreased to medium level from the 10^th week to the 14^th week and reached a low epidemic level from the 14^th week to the 18^th week. After the 19^th 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.

Analysis on incidence of malaria in Shanxi, 2014–2018

Ping Tie, Ting Wang, Changfu Yan, Jingying Wang, Yuhua Zheng, Yongfei Bai, Hongxia Yang, Jing Chen

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Abstract:
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%). 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 days and 2 days, 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.

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

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[Abstract](65) [FullText HTML](25) [PDF 2457KB](1) [Peer reviewing opinions] Related References Cited By (0) Share

Abstract:
ObjectiveTo investigate and verify a food-borne outbreak of brucellosis caused by drinking raw goat’s milk in county in 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 for analysis.ResultsA total of 30 cases and 6 latent infection cases were found. The cases occurred during 10^th July-18^th August in 2019 in this outbreak with same 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 farm compared with drinking no His 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.

Detection and management of an imported case of Chikungunya fever in Henan

Xingle Li, Xiangdong Jin, Jianmin Ma, Dongxiao Li, Ruijuan Fu, Haifeng Wang, haimei Li, Jia Su, Xueyong Huang, Wanshen Guo

Accepted Manuscript

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Abstract:
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.

Establishment of a reverse transcription recombinase-mediated amplification assay for rapid detection of Tahyna virus

Fan Li, Xiaofang Guo, Qikai Yin, Xinxin Shen, Shihong Fu, Songtao Xu, Wenwen Lei, Hongning Zhou, Xuejun Ma, Huanyu Wang

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Abstract:
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 TAHV 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.

Investigation of an outbreak of foodborne illness caused by norovirus GⅡ.17

Mingliang Wang, Wei Wang, Shuiying Yun, Yun Bai, Lijun Ren, Xiaoxiao Bai, Congwei Liu, Caoxin Bao, Lingyan Su, Xiaochen Ma

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Abstract:
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 GⅡwere 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.

Antibiotic resistance characteristics of 527 Escherichia coli isolates from poultry meat

Xia Chen, Xiaofei Zhao, Jie Che, Yunfei Zhang, Min Yuan, Xuemei Bai, Juan Li

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[Abstract](103) [FullText HTML](40) [PDF 2154KB](3) [Peer reviewing opinions] Related References Cited By (0) Share

Abstract:
ObjectiveTo investigate and analyze the antibiotic resistance characteristics of Escherichia coli isolates from broilers.MethodsThe pre slaughter broilers were selected from 2 large poultry farms in Hebei province in March, 2017. A total of 273 of cloacal swabs of the poultry from five different parts of the henhouses were collected. Selective agar was chosen for E. coli preliminary isolation, and VITEK^®-2 Compact 60 was used for isolate identification and antibiotic susceptibility test. Extended-spectrum beta-lactamase (ESBL) producing characteristics of the isolates were analyzed simultaneously.ResultsA total of 527 non-repetitive E. coli isolates were identified, in which 475 isolates were ESBL-producing (90.13%). The E. coli isolates showed the highest carbapenem-sensitivity (99.43%), including ertapenem, meropenem and imipenem, and the highest amoxicillin-resistance (99.24%), followed by tetracycline (94.88%), ciprofloxacin (78.94%), piperacillin (78.37%), aztreonam (77.80%), and levofloxacin (70.40%). All of the E. coli isolates were resistant to at least one group of antimicrobial agents, except for one isolate. Multidrug resistance was detected in the tested E. coli isolates (98.10%). All of the multidrug resistant E. coli isolates were ESBL producing. The most prevalent multidrug resistant isolates were those resistant to 6 groups of antimicrobial agents (35.86%, 189/527). A total of 58 multidrug resistance spectrums were obtained. The proportion of the strains with multidrug resistance to penicillins, cephalosporins, aztreonam, aminoglycosides, flouroquinolones, tetracycline, sulfamethoxazole and trimethoprim was highest (15.40%) in antibiotic resistant E. coli isolates.ConclusionHigh prevalence of drug resistance and severe multidrug resistance were found in the tested E. coli isolates from broilers in Hebei. The multidrug resistance spectrums were complicated. It is necessary to strengthen the surveillance for E. coli of animal origin and continue the rational use of antibiotics.