Disease Surveillance

Epidemiology of global malaria and imported malaria in China

Hu Xuefeng, Wu Shuang, Weng Yunqi, Han Hui, Tian Lingling, Lyu Yongsheng, Xu Ruiping, Zhou Pengcheng, Wu Hailei

, DOI: 10.3784/jbjc.issn.1003-9961.202103150127

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Objective To investigate the epidemiological characteristics of global malaria and imported malaria in China, and provide scientific reference for the improvement of prevention and control measures of imported malaria at ports in China. Methods The global malaria reports from WHO and CNKI database literature were retrieved. The incidence data of global malaria during 2010–2019 and imported malaria in China during 2017–2019 were collected for descriptive analysis and statistical analysis. Results In terms of the risk for malaria and incidence of malaria, Africa had the most heavy burden of malaria in the world, and the malaria cases reported in Africa accounted for more than 90% of the global total. Africa was the main source region for the imported malaria cases in China, the imported malaria cases from Africa accounted for 87.81% of the total. Plasmodium falciparum was predominant Plasmodium species. Conclusion Africa is the key region for global malaria prevention and control. After the elimination of indigenous malaria cases, the imported malaria, especially falciparum malaria, from Africa, pose a serious threat to the elimination of malaria in China. In addition to the basic prevention and control measures, it is essential to strengthen health quarantine at ports, joint efforts, intervention for risk population and early warning to improve capacity to the response of imported malaria cases in China.

Molecular analysis on Vibrio parahaemolyticus strains isolated from patients in Nanjing, Jiangsu, 2016–2019

Wu Zhengyan, Dong Chen, Zhang Kangdi, Tan Zhongming, Zhu Yefei

, DOI: 10.3784/jbjc.202112160417

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Objective To understand the molecular characteristics of Vibrio parahaemolyticus strains in Nanjing, Jiangsu, and provide evidence for the prevention and control of human infection with V. parahaemolyticus. Methods Clinical isolates from diarrhea and food poisoning patients were collected from 2016 to 2019. Virulence genes of tlh, tdh, trh, toxRS/new and ORF8 were detected by polymerase chain reaction (PCR). Molecular types were analyzed by multilocus sequence typing (MLST). Results A total of 93 V. parahaemolyticus strains were collected. O3∶K6 was the predominant serotype (65 strains, 69.9%). Virulence genes screening revealed that all isolates carried tlh gene. 73 strains with tdh+trh-toxRS/new+ were classified as pandemic strains, and 5 non-pandemic strains with tdh-trh- were non-pathogenic strains. A total of 13 STs were detected, of which ST3 was predominant (68/93, 73.1%). Conclusion Molecular analysis on V. parahaemolyticus revealed that ST3 was predominant, and both the pandemic and non-pandemic strains were distributed in Nanjing.

Epidemiological characteristics of SARS-CoV-2 infection in Shayibake district, Urumqi, Xinjiang, July–August 2020

Yi Chunxia, Ma Yan, Yizaitiguli· mutila, Zhang Jinglei

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Objective To analyze the epidemiological characteristics of SARS-CoV-2 infection cases in Shayibake district of Urumqi of Xinjiang and provide scientific evidence for the prevention and control of COVID-19 epidemic. Methods A total of 122 cases of SARS-CoV-2 infection reported in Shayibake were studied. Descriptive investigations were conducted retrospectively to understand the age, gender and spatial/temporal distributions of the cases, the characteristics of clusters and the case detection ways. Results A total of 122 SARS-CoV-2 infection cases were reported in Shayibake. The reported infection rate was 16.30/100 000. The 122 cases included 106 confirmed cases (86.89%) and 16 asymptomatic cases (13.11%). The male to female ratio of the cases was 1∶1.35. The cases in Uyghur ethnic group accounted for 62.30% and the cases in Han ethnic group accounted for 35.25%. The age of the cases ranged from 3 months to 92 years. The median age was 33 years (the interquartile range: 15–49 years). The cases were found in all age groups. The confirmed cases were mainly aged under 60 years (93/106, 87.74%), and the asymptomatic cases were mainly aged under 40 years (15/16, 93.75%). The average age of the confirmed cases was higher than that of the asymptomatic cases (35 vs. 18 years, Z=−2.295, P<0.05). The majority of the cases were students (17.92%), followed by the elderly retirees, the unemployed, self-employed persons, and service personnel. There were 30 clusters with 88 cases (72.13%). Among them, 25 were family clusters (73 cases, 73/88, 82.95%). There were 2 clusters in neighborhood and work place (4 cases, 4/88, 4.55%) and 1 cluster in the same class (7 cases, 7/88, 7.95%). Family clusters accounted for high proportion. There were 26 cases reported in Changjiang community, accounting for highest proportion (21.31%). A total of 113 cases (92.62%) were detected through centralized isolation, mass screening and self-isolation. Most of the cases were found through active detection. The outbreak was effectively controlled within two weeks, the longest latency periods. Conclusion The epidemic of COVID-19 spread rapidly in Shayibake, mainly causing case clusters. The epidemic has been well controlled by effective prevention and control measures.

Analysis on seven virus detection results of 15 636 children with respiratory tract infection in Wuhan Children's Hospital, 2019

Chen Hongwei, Lu Xiaoxia, Li Ying, Du Qing, Huang Peiqi, Hu Ruohui

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Objective To analyze the epidemiologic characteristics of common respiratory virus infection in hospitalized children in Wuhan Children's Hospital from January to December 2019, and provide evidence for clinical diagnosis and treatment. Methods Nasopharyngeal swabs were collected from the hospitalized children with respiratory infection from January to December 2019. Seven respiratory virus antigens of parainfluenza virus type 1, type 2, type 3 (PIV1, 2, 3), influenza virus A, influenza virus B, adenovirus (ADV) and respiratory syncytial virus (RSV) were detected by direct immunofluorescence assay, and the general information of the children were collected and analyzed. Results A total of 15 636 nasopharyngeal swabs were collected from the hospitalized children with respiratory infection in Wuhan Children's Hospital in 2019, and the total positive rate was 27.26%. The positive rates of RSV, ADV, PIV 3, influenza virus B, influenza virus A, PIV 1 and PIV 2 were 8.58% (1 341/15 636), 8.06% (1 261/15 636), 6.47% (1 012/15 636), 1.27% (198/15 636), 1.20% (188/15 636), 1.15% (181/15 636), and 0.83% (129/15 636), respectively. The positive rate of RSV was highest. The overall positive rate of seven viruses in boys was higher than that in girls, and the difference was significant (χ²= 21.031, P<0.001). Among the seven viruses, only the positive rate of RSV in boys was higher than that in girls, and the difference was significant (χ²=12.442, P<0.001). There was no gender specific difference in the positive rate of other respiratory viruses (P > 0.05). In all age groups, the detection rates in age groups 6 months-1 year and < 6 months were 33.85% (717/2 118) and 31.68% (1 027/3 242), respectively, which were significantly higher than those of other age groups. But there was no significant difference between age group < 6 months and age group 6 months-1 year(χ²=2.760, P=0.097). The overall positive rate was highest in spring and lowest in autumn, but the detection rate of RSV was higher in winter and spring. The detection rates of PIV3 and ADV were higher in summer and autumn with obvious seasonality. There were 48 cases of co-infections, and the most common co-infection type was PIV3 plus RSV, accounting for 50% (24/48). Conclusion The overall positive rate of the seven viruses in children with respiratory tract infection in 2019 varied with gender, age and season in Wuhan, to which physicians should paid attention in clinical diagnosis.

Epidemiological characteristics and clinical severity of respiratory syncytial virus and influenza virus infections in hospitalized old patients with respiratory infection in Guiyang, 2016–2020

Zeng Qiangwu, Zhang Fengdan, An Shigang, Jiang Xiaoli, Li Furong

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Objective To describe the epidemiological characteristics of respiratory syncytial virus (RSV) infection in hospitalized old patients with respiratory tract infections, compare the differences of clinical characteristics and severity between respiratory syncytial virus (RSV) infection and influenza virus infection, and identify the risk factors of in-hospital-death of respiratory tract infection in the elderly. Methods The clinical data of 5131 hospitalized patients aged ≥60 years with respiratory tract infection in two hospitals from January 1, 2016 to December 31, 2020 were collected. We compared the differences in demographics, underlying disease, clinical symptom/sign, length of hospital stay and death during hospitalization in the elderly with RSV infection and influenza virus infection, and a multivariate Logistic regression model was used to identify the risk factors of deaths in the elderly with respiratory tract infection. Results Among the 5 131 hospitalized patients aged ≥60 years with respiratory tract infections, 104 were tested positive for RSV (2%) and 497 were tested positive for influenza virus (10%). During this period, 77% (80/104) of RSV infections and 63% (312/497) of influenza virus infections occurred during November - February, showing obvious seasonality. The differences in the median of age (73 years old vs. 74 years old, P=0.997), ICU admission proportion (7% vs. 6%, P=0.822) and in-hospital death rate (6% vs. 3%, P=0.233) were not significant between the old patients infected with RSV or influenza virus. Compared with the old patients infected with influenza virus, the old patients infected with RSV had longer hospitalization length median (14 d vs. 12 d, P=0.041) and lower proportion of fever at hospital admission (50% vs. 61%, P=0.048). Among the 5131 patients, 114 died during hospitalization (2%), including 6 deaths due to RDV infection (6%) and 15 deaths due to influenza virus infection (3%). The results of multivariate Logistic regression analysis showed that, after adjusting for gender and antibiotic usage before admission, age ≥80 years ［adjusted odds ratio (aOR)= 3.41, 95%CI=1.84～14.26］, underlying medical condition (aOR=2.34, 95%CI=1.12～4.91), interval between illness onset and diagnosis ≥7 days (aOR=8.94, 95% CI=1.60～29.99), blood oxygen saturation <90% (aOR=4.05, 95%CI=1.33～12.34) and RSV infection (aOR=5.38, 95%CI=1.65～17.51) were independent risk factors of death in the elderly with respiratory tract infection. Conclusion The study highlighted that RSV as an important infection increased the risk for death in the elderly hospitalized due to respiratory infection in Guiyang. Close attention needs to be paid to RSV infection in the elderly, and RSV infection surveillance, prevention and diagnosis need to be strengthened.

Molecular etiologic investigation of an acute gastroenteritis epidemic caused by multi genotype norovirus in a university in Gansu

Kang Qian, Wang Xueying, Lyu Caixia, Wang Peng, Zhang Huimin, Yu Deshan

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Objective To analyze the genetic characteristics of norovirus detected in an acute gastroenteritis epidemic in an university in Gansu province in September 2-10, 2020, and provide evidence for the prevention and control of viral diarrhea caused by norovirus. Methods A total of 232 stool samples were collected from the acute gastroenteritis cases with symptoms of vomiting and diarrhea in this epidemic. Real-time fluorescent PCR was used for preliminary screening and genome identification, and then reverse transcription polymerase chain reaction (RT-PCR) was used for positives sample amplification, and sequence determination of part of the polymerase region and capsid region was performed for the products with CT value less than 37, and software MEGA-X was used to construct a phylogenetic tree for genetic evolution analysis using the neighboring method. Results The rate of diarrhea was 92.55%, the rate of abdominal pain was 88.94%, the rate of vomiting was 87.66%, and the rate of nausea was 78.09% in this acute gastroenteritis epidemic. The epidemic in the university was caused by co-infection of norovirus GⅠ and GⅡ. The detection rate of norovirus in 232 stool samples was 77.59% (180/232), and the detection rate of GⅠ was 16.38% (38/232), the detection rate of GⅡ was 44.83% (104/232) and the co-infection rate of GⅠ and GⅡ was 16.38% (38/232). As of 18:00 on September 10, 2020, a total of 470 students had been diagnosed with acute gastroenteritis, most were mild cases, among them 33 were admitted in hospital for observation and treatment. Based on sequencing, the genotypes of norovirus causing the epidemic were GI.3［P10］, GⅠ.3［P13］, GI.5［P4］, GII.10［16］, GⅡ.17［P17］, GII.22［PNA5］and GIX.1［GII.P15］. Conclusion There were 7 genotypes of norovirus detected in the acute gastroenteritis epidemic in this university, the first three were GII.22［PNA5］, GⅠ.3［P13］, GIX.1［GII.P15］. It is necessary to further strengthen the surveillance level and genotype analysis of norovirus in Gansu.

Incidence trend and potential life loss of injury death in Huzhou, 2014–2020

Yu Meihua, Din Jingying

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Objective To study the morality and life loss of injury death in Huzhou, Zhejiang province, and provide scientific evidence for the prevention and control of injury. Methods The injury death data in residents in Huzhou from 2014 to 2020 were collected and the data were classified according to the international classification of diseases, 10^th edition(ICD-10); The mortality and death cause constituent were calculated, and the mortality trend was evaluated by using χ² test. The average years of life lost (AYLL) and potential years of life lost rate (PYLLR) were calculated, and the trend of AYLL and PYLLR were evaluated by using annual percent change (APC). Results The average mortality rate of injury was 69.82/100 000 in residents in Huzhou during 2014-2020, which showed a upward trend year by year(χ²_trend＝244.537, P＜0.001). The injury mortality was higher in males than in females(χ²＝233.771, P＜0.001). The first five injury death causes were accidental fall, traffic accident, shipping accident except motor vehicle, suicide, drowning. The mortality rates of deaths caused by accidental fall in entire population and drowning in females increased with year(χ²_trend＝474.799, P＜0.001, χ²_trend＝6.711, P＜0.05). Drowning was the major death cause in age group 0-14 years, traffic accident was the major death cause in age group 15-64 years and accidental fall was the major death cause in age group > 65 years. The average years of life lost by injury was 18.15 years, the potential years of life lost rate was 5.67‰, the first three leading injury related death causes were traffic accident, shipping accident except motor vehicle and suicide. Conclusion Injury has become one of major death causes in Huzhou, causing great loss of life expectancy, targeted prevention and control measures for traffic accident, accidental fall, drowning and other key injuries should be conducted to reduce the burden of injury effectively.

Investigation of economic burden caused by varicella in school aged children in Shenzhen

Wang Tieqiang, Zheng Qingming, Wu Yunjie, Yao Yunying, Kuang Cuiping, Li Xuemei

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Objective To understand the economic burden caused by varicella in school aged children in Shenzhen, compare the economic burden under different varicella immunization strategies and provide evidence for the development of targeted varicella prevention and control strategies. Methods A retrospective survey was conducted in 24 primary schools of Shenzhen where varicella outbreaks had been reported. Software SPSS 25.0 was used for analysis, the gender, age and case type specific direct cost, indirect cost and overall cost of varicella cases and the influence of their vaccination status on the economic burden were analyzed by non-parametric test (Kruskal Wallis test for multi-group comparison and Mann Whitney U test for pairwise comparison). Spearman rank correlation test was used to analyze the correlation between ordered variables (age, number of caregivers, number of care days) and the economic burden. Results A total of 515 cases of varicella were surveyed. The difference in economic burden between outpatients and inpatients of varicella was significant. Among the varicella cases surveyed, 426 were not hospitalized, and their average medical cost was 810.00 (400.00～1450.00) yuan, in which 260.00 (200.00～350.00) yuan was direct cost, and 500.00 (200.00～1100.00) yuan was indirect cost, and 23 varicella cases were hospitalized, and their average medical cost was 3020.00 (2050.00～3508.00) yuan, in which 1100.00 (1000.00～1340.00) yuan was direct cost, and 1900.00 (1200.00～2200.00) yuan was indirect cost. Spearman rank correlation test showed a positive correlation between the number of care days, number of caregivers and the medical cost of the varicella cases. There was no gender specific difference in medical cost. The difference in medical cost between the cases with different varicella vaccination status was significant. The medical cost was higher in the cases with 1 dose varicella vaccination than in the cases with 0 dose varicella vaccination. Conclusion The economic burden caused by varicella in school-aged children in Shenzhen was serious. Cases of varicella under different immunization strategy of varicella vaccine had different economic burden.

Analysis on density and seasonal fluctuation of flies in Wenzhou, Zhejiang, 2017–2020

Ni Qingxiang, Chen Shuai, Zhao Yanyu, Ling Ying

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Objective To monitor the density and seasonal fluctuation of flies in Wenzhou, Zhejiang province, and provide scientific evidence for fly control. Methods Cage traps were set up in the following four types of habitats: farm produce markets, catering external environment, greenbelts and residential areas. Results A total of 7197 flies, belonging to 4 families, 8 genera, and 13 species, were captured from 2017 to 2020. The predominant species were Musca domestica, Sarcophagidae, Musca sorbens, Lucilia sericata, Chrysomya megacephala and Lucilia cuprina. The annual density peak was during June - September. The highest density was 2.99 flies/cage in 2017, and the lowest population density was 1.93 flies/cage in 2018.In the four types of habitats, greenbelts had the highest fly diversity, where 13 species were found, and the highest fly density was found in farm produce markets with an average of 3.06 flies/cage. Conclusion The populations of calyptrate flies were abundant in Wenzhou. The predominant species, such as Musca domestica, Sarcophagidae, Musca sorbens, and Lucilia sericata, should be the focus of fly control. Primary control measures should be taken in farm produce markets and during June - September for the prevention and control of fly-transmitted diseases.

Comparison of insecticide resistance of Aedes albopictus before and after dengue fever epidemic in Ningbo, Zhejiang

Ma Min, Ma Xiao, Xu Ming, Chen Xiaoying, Yang Sijia

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Objective To investigate the resistance of Aedes albopictus to common insecticides before and after the dengue fever epidemic in Ningbo, Zhejiang province, and provide a scientific evidence for resistance management and dengue fever control. Methods Ae. albopictus larvae were collected in 10 counties (districts) in Ningbo before the epidemic of dengue fever in 2018 and after the epidemic in 2019. The collected larvae were reared for 1—2 generations in laboratory. The resistance of larvae and adults was determined by dipping method and contact method, respectively. Results The resistance ratios of Ae. albopictus larvae to deltamethrin, beta-cypermethrin, propoxur, dichlorvos and temephos were 45.43, 18.85, 4.81, 1.55 and 4.13 in 2018, respectively, and 82.00, 29.43, 7.14, 3.27 and 6.25 in 2019, respectively. Ae. albopictus adults exposed to 0.4% beta-cypermethrin, 0.1% deltamethrin, 3% permethrin, 0.05% propoxur and 0.5% malathion for 1 h, the death rates were 98.33%, 83.33%, 88.52%, 95.24% and 76.67% 24 h later in 2018, respectively, and 98.89%, 92.22%, 98.89%, 100.00% and 98.89% 24 h later in 2019, respectively. Conclusion Ae. albopictus larvae in Ningbo developed resistance to the tested insecticides, which was significantly higher than that before the dengue fever epidemic. While adult mosquitoes were relatively sensitive to the tested insecticides, and the resistance did not significantly increase. The insecticide resistance levels of larvae and adult mosquitoes were not consistent, so appropriate insecticide use strategies should be adopted for mosquito control according to the insecticide resistance of Ae. albopictus at different growth stage.

Investigation of natural infection of four pathogens in rodents in rural area of Taizhou, Zhejiang

Zhao Yishuang, Wu Yuyan, Zhou Haihui, Lin Jin, Zhu Guiwei, Chen Cairong

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Objective To understand the infection status of four pathogens in rodents in rural area of Taizhou, Zhejiang, and provide evidence for the prevention and control of rodent-borne infectious disease. Methods From September to December in 2020, rodents were captured by night trapping method in rural areas of Sanmen and Tiantai counties, Taizhou. The liver, spleen, lung and kidney of the rodents were collected aseptically after classification and identification. Hantavirus, new Bunia virus, Leptospira and Orientia tsutsugamushi were detected by real-time PCR. Results A total of 167 rodents of 7 species were captured in the two counties, and the overall capture rate was 6.13%. Among the rodents captured, Apodemus agrarius (84, 50.30%), Rattus losea (31, 18.56%) and Rattus norvegicus (25, 14.97%) were predominant. The composition of rodent species was similar among the two counties. In 167 tissue samples, 18 were positive for Leptospira (10.78%), 1 was positive for Hantavirus (0.6%), 2 were positive for Orientia tsutsugamushi (1.20%), but no new Bunia virus was detected. Leptospira was detected in Rattus norvegicus, Apodemus agrarius, Rattus flavipectus and Rattus losea, and the positive rates were 8.00%, 14.29%, 14.29% and 9.68% respectively. Hantavirus was only detected in Apodemus agrarius. Orientia tsutsugamushi was only detected in Rattus losea. No pathogens were detected in Rattus edwardsi, Mus musculus and Suneus murinus. Apodemus agrarius was co-infected with Leptospira and Hantavirus, and the rate of co-infection was 0.60%（1/167). Conclusion Rodents in rural area of Taizhou carried a variety of pathogens. The detection rate of pathogens in different rodents was different. It is necessary to strengthen the prevention and control of rodent-borne infectious disease to reduce the risk of human infection.

Evaluation and discussion of effect of “mosquito and fly-free village” establishment in Hongxi village, Jiashan, Zhejiang

Qi Yunpeng, Wang Jinna, Wu Yuyan, Fu Xiaofei, Li Yuefeng, Huang Jian, Gong Zhenyu

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Objective To evaluate and discuss the effect of vector control based on the establishment of “mosquito and fly-free village” in Hongxi village, Jiashan, Zhejiang province, and provide evidence for vector control in rural area. Methods Spot inspection and symposium were used to evaluate the organization/management and system establishment of the ‘mosquito and fly-free village’. Larval pipette method, spoon method, luring landing method, cage trapping method and visual observation were used to investigate the local mosquito and fly density. Questionnaire surveys were performed to investigate the knowledge awareness of the vector control methods and the satisfaction of the villagers. Results In the establishment of the‘mosquito and fly-free village’in Hongxi village, the organization/management of the villagers, work force performance and working system were perfect. The mosquito density from April to November 2019 were significantly lower than that during the same period in 2018, which reached the A control level of mosquito density in August, 2019. The adult fly density from April to November 2019 was significantly lower than that during the same period in 2018. According to the project standard, the fly density in Hongxi village reached the control level in October, 2019. The difference in knowledge awareness rate of the villagers in Hongxi village was significant before and after the establishment of ‘mosquito and fly-free village’ (χ²=44.843, P=0.000), and the knowledge awareness rate after the establishment of ‘mosquito and fly-free village’ was significantly higher than that in villagers of two control villages (χ²=55.264、43.215, P=0.000). The villagers’ satisfaction with the establishment of ‘mosquito and fly-free village’ was 92.26%, which reached the A-level. Conclusion The establishment of ‘mosquito and fly-free village’ can effectively reduce the mosquito and fly density and improve the living environment in rural areas. Further promotion is needed.

Drug resistance characteristics of Diarrheagenic Escherichia coli isolated from patients with diarrhea in Shunyi district of Beijing, 2013–2019

Wang Yuanyuan, Lin Fan, Wang Miao, Kang Ying, Li Ying, Ma Hongmei

, DOI: 10.3784/jbjc.issn.1003-9961.202102190075

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Objective To study the drug resistance characteristics of Diarrheagenic Escherichia coli (DEC) isolated from patients with diarrhea in two sentinel hospitals in Shunyi district of Beijing during 2013—2019. Method Stool samples of diarrhea patients were collected in the two sentinel hospitals during this period. Isolation, bacterial identification and PCR typing were conducted for DEC strains. Antimicrobial susceptibility tests were carried out using micro broth method to analyze the drug resistance characteristics of the isolated strains, including resistance rate, non-sensitive rate, multi-drug resistance rate and drug resistance spectrum. Result The detection rate of DEC in diarrhea patients was 9.53% (232/2434). The proportions of Enterotoxic Escherichia coli (ETEC), Enteropathogenic Escherichia coli (EPEC), and Enteroaggregative Escherichia coli (EAEC) were 56.47% (131/232), 27.16% (63/232) and 16.38% (38/232), respectively. The multi-drug resistance rates of DEC with 90 drug resistance spectrum, ETEC with 36 drug resistance spectrum, EPEC with 42 drug resistance spectrum, and EAEC with 23 drug resistance spectrum were 33.19% (77/232), 17.56% (23/131), 58.73% (37/63), 44.74% (17/38), respectively. Antibacterial drugs with resistance rate ≥30% included nudicacid (NAL) and ampicillin (AMP) for ETEC; AMP, tetracycline (TET), sulfamethoxazole tablets (SXT), sulfamethoxazole (Sul), NAL for EPEC; NAL, AMP, SXT, Sul, TET for EAEC. A comparison of the differences in the antimicrobial susceptibility tests during 2013—2016 and during 2017—2019 found that the resistance of ETEC to AMP, cefazolin (CFZ), TET, cefepime (FEP), aztreonam (AZM), and ampicillin/sulbactam (AMS) increased, while the resistance to Sul decreased; the resistance of EPEC to gentamicin (GEN) decreased; the resistance of EAEC to cefotaxime (CTX), GEN, and doxycycline (DOX) decreased. Conclusion Among the diarrhea cases in Shunyi, the intensity of DEC spread was high, and the spread and the drug resistances of ETEC, EPEC and EAEC had unique characteristics. The drug resistance was serious, to which close attention should be paid.

Analysis on characteristics of HIV-1 molecular transmission network and cluster in people aged ≥50 years in Shaoxing, Zhejiang

Yang Zuokai, Lu Qiaoling, Shan Xingren, Xu Shuhong, Cao Dongqing

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Objective To analyze the characteristics of HIV-1 molecular network in the people aged ≥50 years from July 2018 to June 2020 in Shaoxing, Zhejiang province, explore the risk factors associated with HIV-1 transmission network and provide evidence for the effective intervention. Methods A total of 147 samples of newly reported HIV-1 positive cases were consecutively collected, the POL gene fragments of HIV-1 were amplified by reverse transcription polymerase chain reaction (PCR) and nested PCR. The phylogenetic tree constructed to analyze the molecular transmission network for subtypes and different gene distances. The factors associated with the subjects entering network and characteristics of cluster were further analyzed. Results Four subtypes were found in the samples, CRF07_BC (76, 51.70%) were the major subtypes, followed by CRF_AE (36, 24.49%), CRF08_BC (33, 22.45%) and B (2, 1.36%). A total of 74 sequences entered the network, with an entry rate of 50.34%, forming 12 clusters with the number of individuals in the cluster ranging from 2 to 30. The analysis on the factors associated with entering network showed that those with lower education level and awareness rate of AIDS knowledge, paying no attention to AIDS topics, commercial sexual behavior without condoms and female sex workers with payment less than 50 yuan at each sex were more likely to be found in HIV-1 molecular networks. The results of multivariate logistics model analysis showed that female sex workers with payment less than 50 yuan more easily entered molecular network. CRF07_BC had the highest cluster proportion (30, 40.54%) and formed a large cluster with 30 cases, most of these cases lived in and near Chengnan Street of Yuecheng district and had commercial sex. CRF01_AE had a cluster of 7 cases, including 1 female sex worker, and these cases lived in and near Qixian Street of Keqiao district. There were twelve positive couples in all clusters, the family transmission were caused by male commercial sex. Conclusion The genotypes of HIV-1 in the people aged ≥50 years in Shaoxing have become complex, the risk factors associated with transmission network included lack of AIDS prevention knowledge and unprotected sex with lower grade female sex workers. The geographical distribution of cluster cases was obvious, in order to effectively control the spread of AIDS, more attention should be paid to intervention and HIV screening in areas with case clusters.

Surveillance for hemorrhagic fever with renal syndrome in Zhejiang, 2016–2020

Zhang Rong, Zhang Ning, Ling Feng, Gong Zhenyu, Liu Ying, Guo Song, Shi Xuguang, Ren Jiangping, Sun Jimin

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Objective To understand the epidemiological characteristics of hemorrhagic fever with renal syndrome (HFRS), the distribution, density and virus carriage of host animals in Zhejiang province, and provide scientific basis for the formulation of prevention and control measures. Methods The incidence data of HFRS in Zhejiang from 2016 to 2020 were collected for a descriptive epidemiological analysis to understand its time, place and population distributions. The host animals were investigated at 5 surveillance areas in Zhejiang, the capture rate was investigated by the night method, and rat-shaped animal lungs and blood were collected for the hantavirus antigen and antibody detections, and analysis on the distribution and virus carriage of rodents in Zhejiang were conducted. Results The annual reported case numbers and incidence rate of HFRS in Zhejiang were 349 and 0.62/100,000 in 2016, 353 and 0.63/100,000 in 2017, 327 and 0.59/100,000 in 2018, 369 and 0.63/100,000 in 2019, and 260 and 0.46/100,000 in 2020. From 2016 to 2020, a total of 14 068 rat traps were deployed in residential areas, and 622 rodents were captured, the capture rate was 4.42%, and a total of 31 875 rat traps were deployed in the field, and 2 112 rodents were captured, the capture rate was 6.63% in the 5 surveillance areas. The differences in rodent density in the filed among the 5 surveillance areas were significant (F=2.941, P=0.046). A total of 3 065 rodents were captured in the 5 surveillance areas. The predominant rodent species in the field was Apodemus agrarianus, (1830, 59.71%); the predominant rodent species in residential areas was Rattus norvegicus (330, 10.77%), the difference was significant (χ²=1675.401, P=0.000). A total of 3065 rodent serum samples were tested, and the antibody positive rate was 7.7% (236/3065), and a total of 3065 rodent lung specimens were tested, the antibody positive rate was 3.36% (103/3065), and the differences in rodent species which were antibody positive among the 5 surveillance areas were significant (χ²=235.762, P=0.000); and the differences in rodent species which were antigen positive among the 5 surveillance areas were significant (χ²=116.195, P=0.000). Conclusion The density and virus carrying rate of rodents were high in the areas with high incidence of HFRS in Zhejiang. It is necessary to take targeted prevention and control measures in key areas for the better prevention and control of HFRS.

Status of tick distribution and tick-borne pathogensin urban parks of Quzhou, Zhejaing

Cao Guoping, Zhan Bingdong, Zhong Jianyue, Yu Zhangyou, Zhang Jianmin, Chen Zhongbing, Yin Zhiying, Fang Chunfu

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Objective To understand the distribution and pathogen carriage of ticks in urban parks of Quzhou of Zhejiang province, and evaluate the transmission risk of tick-borne diseases in the urban parks. Methods From March to November during 2017−2019, a total of 18 urban parks in 6 counties (districts) of Quzhou were selected. The free ticks and parasitic ticks were collected by mannual lab-cloth flag method and animal surface collection method, and the tick species were identified. Borrelia burgdorferi, spotted fever group Rickettsia, Babesia microsatellite, Anaplasmosis/Eriksiella and severe fever with thrombocytopenia syndrome bunyavirus in ticks were detected by PCR. Results A total of 168 ticks were captured, and 41, 70 and 57 ticks were collected in spring, summer and autumn, respectively, the differences were not significant. All the 168 ticks were adult ticks, belonging to 7 species, 5 genera and 1 family. Dermacentor was predominant, accounting for 36.90%(62/168), followed by Haemaphysalis longicornis, accounting for 26.79%(45/168), Ixodes sinensis, accounting for 14.29%(24/168). There were 39 free ticks (23.21%) and 129 parasitic ticks (76.79%), in which 96 had rodents as host(74.42%), higher than other hosts. A total of 47 ticks were positive for five pathogens, and total positive rate was 27.98%, Among them, the positive rate of Borrelia burgdorferi was highest (13.10%), and the positive rate of Anaplasma/Eriksium was lowest(1.79%). Conclusion Dermacentor and H.longicornis were the main species of ticks captured in urban parks of Quzhou, carrying Borrelia burgdorferi, spotted fever group rickettsia, severe fever with thrombocytopenia syndrome bunyavirus and other pathogens, the risk of tick bite and infection exists for the public.

A pneumonia case caused by Neisseria meningitides serogroup Y ST-23 clonal complex

He qing, Zhang xingqiang, Lu xiaoling, Jing Qinlong, Shao Xiaoping, Liu Meizhen

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Objective To investigate the epidemiologic, etiologic and clinical characteristics of a meningococcal pneumonia case in Guangzhou. Methods Clinical diagnosis and epidemiological investigation data were collected, the Neisseria meningitides strains isolated by hospital were used for biochemical identification, latex agglutination, PCR, whole genome sequencing and drug susceptibility test in vitro. Results The patient had symptoms such as sore throat, fever, anhelation, mental fatigue, etc., but had no headache, nausea, disturbance of consciousness, meningitis irritation and petechia. Chest CT showed a pulmonary infection. The N. meningitides Y strain isolated from the pneumonia patient’s blood was identified as ST-1655, belonging to ST-23 clonal complex. The strain was sensitive to penicillin, cefotaxime, ceftriaxone, etc. Conclusion The meningococcal pneumonia was caused by N. meningitides Y ST-23 clonal complex, which was consistent with the imported strain isolated in Guangdong. We should keep vigilance to the ST-23 clonal complex. Further surveillance for other meningococcal disease is needed.

Etiological analysis on a bacillary dysentery outbreak caused by Shigella sonnei in Beijing

Lyv Bing, Tian Yi, Yang Yanna, Zhen Bojun, Jia Lei, Lin Changying, Zhang Xin, Huang Ying, Qu Mei

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Objective To investigate the etiologic and epidemiologic characteristics of an outbreak of bacillary dysentery caused by Shigella sonnei in a boarding school in Beijing, China. Methods Stool samples of the cases and cookers, water samples and environment smear samples were collected from 5^th to 20^th September, 2019 for pathogen isolation and identification. Drug susceptibility test, pulsed-field gel electrophoresis(PFGE), whole genome sequencing(WGS), multi-locus sequence type (MLST), drug resistance related gene and virulence gene detection were performed, and the phylogenetic tree was constructed by whole genome single nucleotide polymorphism(wgSNP). Results In this outbreak, 16 Shigella sonnei strains and 1 enterotoxigenic Escherichia coli(ETEC)strain were isolated. The antibiotic susceptibility testing revealed that 16 S. sonnei isolates were resistant to ampicillin, tetracycline, trimethoprim and sulphame-thoxazole, cephazoline, cefotaxime, gentamicin, nalidixic acid, azithromycin, doxycycline. Further tests confirmed these isolates to be extended-spectrum beta-lactamase (ESBLs) producing strains. MLST unfolded that all isolated S. sonnei strains in this outbreak belonged to ST152, a common epidemic sequence type in China. An insertion sequence was found in a S. sonnei strain and the ETEC strain, but not in other S. sonnei strains. Conclusion It was confirmed that the pathogen of this outbreak was S. sonnei. In addition to PFGE, WGS is necessary for epidemiological investigation.

Epidemiological characteristics of pulmonary tuberculosis in Heilongjiang, 2011–2020

Yu Yanling, Yan Xinglu, Wang Xin, Han Xue

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Objective To analyze the registration status and epidemiological characteristics of pulmonary tuberculosis (TB) in Heilongjiang province from 2011 to 2020 and provide evidence for the prevention and control of pulmonary TB. Methods The data of pulmonary TB patient registration in Heilongjiang during 2011–2020 were collected from China Information System for Disease Control and Prevention. The incidence of pulmonary TB during 2011–2020 was analyzed by descriptive method. Statistical analysis was conducted with Excel 2007 and SAS 9.4, and χ2 test was used to compare the rates. Results From 2011 to 2020, the reported case number and incidence of active pulmonary TB in the province decreased year by year, and the average annual decline rate was 1.59% with statistical difference（χ²=99.61, P<0.05）Most cases occurred in January and March, accounting for 20.4%. The average annual reported incidence was 102.6/100 000 in males and 93.5/100 000 in females, and the difference was significant（χ²=35428.61, P<0.05）. The cases were mainly aged between 20 and 69 years, and the cases in age group of 40—49 years accounted for the highest proportion. The cases in farmers accounted for the highest proportion (, 40%), followed by that in the jobless and unemployed (38.9%). The incidences in 13 prefectures showed decline trends, with an average annual decline of 8.53%. The rapid declines were found in Daxinganling, Mudanjiang and Shuangyashan. Conclusion The reported incidence of pulmonary TB in Heilongjiang decreased in recent ten years, indicating a great achievement in pulmonary TB prevention and control. Although more obvious decline in pulmonary TB incidence has been observed since 2015, it is still high compared with other areas in China.

Meeting of the WHO Strategic and Technical Advisory Group for Infectious Hazards (STAG-IH), June 2020 Conclusions and advice—Gong Zhenyu(Selective Translation), Gong Xunliang(Reviser)

Gong Zhenyu, Gong Xunliang

, DOI: 10.3784/jbjc.2021

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Abstract:
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Update on Excess Deaths Associated with the COVID-19 Pandemic—United States, January 26, 2020—February 27, 2021

Gong Zhenyu, Gong Xunliang

, DOI: 10.3784/jbjc.202105050244

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Abstract:
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Analysis on injury mortality in permanent residents in Hubei, 2019

Pan Jingju, Zhou Mengge, Zhang Lan, Tang Yumeng, Li Qian, He Tianjing

, DOI: 10.3784/jbjc.202103240154

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Objective Injury is a major public health problem worldwide, causing substantial burden of population health loss. It is crucial to analyze the mortality burden caused by injury in Hubei province for the prevention and control of injury. Methods The mortality data of injury in permanent residents in Hubei in 2019 were collected from the causes of death surveillance system in Hubei. Software SAS was used for statistical analysis, χ² test was done for various group comparisons, and ArcGis 10.2 was used for the spatial distribution of injury deaths. The 2010 national census data were used to calculate the standardized mortality rate (SMR). Results The injury mortality rate and standardized mortality rate in permanent residents in Hubei were 62.59/100 000 and 53.15/100 000, respectively, 77.07/100 000 and 69.19/100 000 in men and 47.65/100 000 and 37.22/100 000 in women. Falls, motor vehicle transport accident, and suicide were the top three causes of injury deaths. Men had a higher mortality rate compared with women in all cause-specific injury deaths (P<0.001) except homicide, and rural residents had higher mortality rate and standardized mortality rate (73.73/100 000 and 60.87/100 000) compared with urban residents (53.46/100 000 and 46.64/100 000 in all cause-specific injury deaths (P<0.001) except other transport accidents ( χ²=2.90, P=0.087) and homicide ( χ²=0.21, P=0.643). Children aged 5−14 years had lowest injury mortality rate (9.32/100 000), while people aged ≥ 65 years had highest injury mortality rate (265.13/100 000). The injury mortality rates were higher in Enshi, Jingmen, Shiyan, Xianning, Tianmen, Xiantao, and Jingzhou, while lower in Wuhan and Xiaogan. Conclusion The mortality of injury in Hubei is relatively high, especially the deaths caused by falls, motor vehicle transport accident, and suicide. The differences in injury mortality existed between men and women, and between urban area and rural area. It is necessary to take specific prevention and control measures in the prevention and control of injury.

Mental health status and influential factors of employees of Chinese enterprises in Ethiopia

Chen Shuo, Wang Xiaochun, Pang Mingfan, Qi Xiaopeng, Wang Lili

, DOI: 10.3784/jbjc.202104190202

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Objective To understand the mental health status and its influential factors of staff of Chinese enterprises in Ethiopia. Methods This study selected employees of Chinese enterprises still in Ethiopia to conduct the mental health questionnaire survey from June 27 to 28, 2020, and multiple linear stepwise regression model is performed to analyze the influential factors of the mental health. Results Among 671 employees, 38.75% had mental health problems. The anxiety and depression of the employees in the last 2 weeks was relatively prominent. The results of multivariate logistic regression analysis showed that the epidemic had an impact on the plan of returning home (OR=3.293, 95%CI: 1.897–5.714), employees worried about being in Africa and unable to take care of their family members in China (OR=2.329, 95%CI: 1.198–4.528), and the company did not take any measures (OR=4.697, 95%CI: 1.080–20.435) were risk factors of mental health. Employees had no physical symptoms in the past month (OR=0.305, 95%CI: 0.171–0.543), worked normally (OR=0.517, 95%CI: 0.322–0.831), the company guaranteed the necessities of life supply (OR=0.609, 95%CI: 0.371–1.000) and conducted COVID-19 knowledge promotion (OR=0.335, 95%CI: 0.183–0.614) were the protective factors of mental health. Conclusion The mental health status of employees of Chinese enterprises in Ethiopia is poor, and their mental health is affected by various factors. We should attach importance to their mental health and take various mental health interventions to reduce their anxiety and depression and other negative emotions.

Management of nosocomial infection of Clostridium difficile: surveillance, prevention and control

Xiao Yuanyuan, Li Chunhui

, DOI: 10.3784/jbjc.202101020001

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In recent years, the incidence of Clostridium difficile infection (CDI) has been in increase worldwide. Effective surveillance is the key to control the incidence and spread of CDI. The content of CDI surveillance mainly includes case definition, standardized diagnosis, CDI case source definition, CDI incidence and suggestions for CDI prevention and control. This review summarizes the pivotal components of effective CDI surveillance, and provides some practical prevention and control suggestions for the standardized surveillance and prevention and control of CDI in hospitals in China.

Epidemiological analysis on an upper respiratory tract infection outbreak caused by human coronavirus NL63 in Shenzhen, Guangdong, 2020

Wang Ying, Huang Yanfei, Wang Zhengduo, Dai Chuanwen

, DOI: 10.3784/jbjc.202101060012

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Objective To understand the epidemiological characteristics of an upper respiratory tract infection outbreak caused by human coronavirus NL63 (HCoV-NL63) and improve the prevention measures against coronavirus infection. Methods The field epidemiological investigation was carried out for an upper respiratory tract infection outbreak in Shenzhen, Guangdong, 2020. The descriptive epidemiology was used to analyze the epidemiological characteristics of the outbreak. Results A total of 43 upper respiratory tract infection cases were detected from 120 individuals under detention in 2 cells of a detention centers on 24^th–29^th August, 2020. The peak was during 27^th–29^th August. The attack rates in cell A and cell B were 55.0% (33/60) and 16.7% (10/60), respectively. The difference was significant. HCoV-NL63 was detected in all the 43 upper respiratory tract infection cases, and the infection rate was 35.8% (43/120). The infection rates in cell A and cell B were 51.7% (31/60) and 20.0% (12/60), respectively, and the difference was significant. The overall asymptomatic infection rate was 16.7% (20/120), which was 20.0% (12/60) in cell A and 13.3% (8/60) in cell B. The main symptoms were sore throat, cough and rhinorrhea. The attack rate and infection rate were highest in age group 50–59 years, but the differences had no significance among different age groups. Conclusion HCoV-NL63 is more likely to cause upper respiratory tract infection outbreaks in the unventilated and crowded places. The prevention measures are needed in these places against the human coronavirus, such as HCoV-NL63.

Design and implementation of data analysis platform of infectious disease syndromes and pathogen surveillance based on cloud computing technology

Zhao Jia, Su Xuemei, Ma Rui

, DOI: 10.3784/jbjc.202103010096

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Objective During the 11^th national five-year plan period, the information management system for infectious disease surveillance platform was established to provide information support for infectious disease surveillance. However, the system can not meet the new needs of information management after the operation for years, facing a series of challenges, such as the high sensitivity of data collection and complexity of users. Methods This paper expounds the design and implementation of infectious disease syndromes and pathogen surveillance information analysis platform from the aspects of business requirements, structure design, system deployment, etc. and evaluate the application of the platform. Results China CDC has established the cloud platform of infectious disease syndromes and pathogen surveillance information for the integration of existing system, newly established infectious disease syndromes and pathogen surveillance information analysis platform and pathogen genomics information platform to provide visualized statistical analysis results, which can improve the application value of the data. Conclusion The platform can control the access to resources effectively, ensure the authenticity and credibility of user's identity and improve the integration of resources to support scientific decision making.

Epidemiology of human parainfluenza virus infection in patients with acute respiratory tract infection in Beijing, 2015–2020

Xie Hui, Luo Ming, Huang Qi, Li Aihua, Wang Xue, Gong Cheng, Huang Fang

, DOI: 10.3784/jbjc.202104220219

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Objective To understand the epidemiological characteristics of human parainfluenza virus (HPIV) infection in patients with acute respiratory tract infections (ARIs) in Beijing, and provide support for the development of prevention and control strategies for respiratory infectious diseases. Methods The throat swabs, sputum, bronchoalveolar lavage fluid, tracheal aspirates and other pathogenic samples were collected from the patients with ARIs in 35 sentinel hospitals in Beijing from 2015 to 2020. Multiple real-time PCR was used to detect HPIV-1, HPIV-2, HPIV-3, HPIV-4 and other common respiratory tract viruses. The results were analyzed with SPSS 20.0 and χ² test was used to compare the rates between groups. Results During 2015–2020, the positive rate of HPIV was 3.90% (1622/41557). HPIV-3 was the mostly detected pathogen, accounting for 58.45%, followed by HPIV-1 (19.17%), HPIV-2 (12.70%) and HPIV-4 (10.79%). The positive rate of HPIV in 2020 (1.65%, 70/4 234) was significantly lower than that during 2015–2019 (4.52%, 1569/37 323). The HPIV infection arte showed a peak every other year. The infection peak of HPIV was from May to July. The incidence trend of HPIV-3 infection was the similar to other HPIVs. The positive rate of HPIV-1 during summer-autumn was higher than that in other seasons. There was no obvious seasonality of HPIV-2 infection. The positive rate of HPIV-4 in autumn was higher than that in other seasons. The positive rate of HPIV in men was lower than that in women. The positive rate in 0–5 years old group was highest (8.81%, 685/7 776), followed by 6–15 years old group (4.07%, 173/4 247), and ≥ 60 years old group (3.25%, 442/13 582). There was significant differences in the positive rate of HPIV-1 and HPIV-3 between upper and lower respiratory tract infection cases ( χ²=4.449, P=0.039; χ²=17.513, P<0.001). Conclusion HPIV is a common respiratory pathogens in Beijing. The main affecting population of HPIV infection is children under 15 years old. In 2020, the prevention and control of COVID-19 significantly reduced the incidence of HPIV infection.

Spatiotemporal distribution of norovirus infection outbreaks in Chengdu

Chen Heng, Cheng Yue, Wu Jialong, Meng Jiantong, Dai Yingxue, Du Changhui, Chen Zhenhua, Huang Weiwei, Su Liyuan, Liang Xian

, DOI: 10.3784/jbjc.202105080249

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Objective To analyze the spatiotemporal distribution of norovirus infection outbreaks in Chengdu with the geographic information system (GIS) and provide evidence for the prevention and control of norovirus infection. Methods A database of the outbreaks of norovirus infection in Chengdu from 2014 to 2019 was established. The concentration ratio and circular distribution method were used to analyze the temporal clustering of the epidemic, and the Moran’s I method was used to analyze spatial autocorrelation. Results The M value of norovirus outbreaks in Chengdu was 0.3927872, which showed the temporal clustering of norovirus infection with higher incidence in winter and the incidence peak during November - March. The incidence was higher in central urban area than in suburban area, with different “hot spot” or “cold spot” in different seasons. Conclusion There was obvious spatiotemporal clustering of norovirus infection outbreaks in Chengdu, suggesting that the prevention and control of norovirus infection should be strengthened in key area and period.

Seasonality, epidemiological characteristics and dynamic changes of influenza viruses subtypes/lineages in Guangdong, 2014–2020

Tan Xiaohua, Ye Meiyun, Zhuang Yali, Deng Aiping, Yang Yuwei, Zhang Yingtao, Kang Min

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Objective To explore the seasonality, epidemiological characteristics and dynamic changes of different subtypes/lineages of influenza viruses in Guangdong Province and provide evidences for precise prevention and control of influenza in Guangdong. Methods Data on weekly influenza pathogen surveillance from the week 36of 2014 to the week 35 of 2020 were collected in Guangdong. The moving epidemic method (MEM) was used to determine annual epidemic period, and characteristic of seasonality were analyzed. The epidemiologic characteristics and dynamic change of different subtypes/lineages of influenza viruses were compared and analyzed with χ² test. Results Influenza mainly occurred in winter, spring and summer in Guangdong. The incidence peaks mainly occurred in summer before and during 2016–2017 and in winter during and after 2017–2018. Based on data of the epidemic seasons from 2014–2015 to 2018–2019, the positive rate was lowest in age group 0–2 years, but increased with age and reached the peak in age group 7–18 years, then decreased. The distribution of the virus subtypes/lineages varied in different age groups, the proportion of influenza A virus was higher than influenza B virus. Influenza A (H1N1) pdm09 virus and influenza B virus (Yamagata lineage) were mainly detected in winter, influenza A (H3N2) virus in summer, and influenza B virus (Victoria lineage) in spring. Compared with results during before and during 2016–2017, the proportions of infections in age groups 7–18 years and 19–59 years increased, while the proportions of infections in other age groups decreased, and influenza A (H1N1) pdm09 virus and influenza B virus (Yamagata lineage) were mainly detected in winter, influenza A(H3N2) virus in spring, but influenza B virus (Victoria lineage) still in spring during and after 2017–2018. Conclusion From 2017–2018 to now, the annual incidence peak of influenza all occurred in winter. Different subtypes/lineages of influenza viruses had specific epidemiological characteristics and trends. It is necessary to continue to strengthen influenza pathogen surveillance for the precise evaluation of incidence trend and control of influenza.

Bibliometric analysis of diabetes Economics Evaluation Literature

Xiao Jun, Sun Jinfang, Zhou Zhichao, Shi Shuangqing, Zheng Jie, Li Guoxing

, DOI: 10.3784/jbjc.202103100110

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Objective To describe the current status of diabetes economics evaluation research through bibliometric analysis and provide information for medical researchers and policy makers. Method In the Web of Science platform, bibliometric analysis and visualization technologies with the DDA and Pajek's tools were used to analyze the publication year and journals, countries, core authors and research hotspots of the literatures of diabetes economics evaluation published since 1980. Result The earliest literature in this field was published in 1980 and the number of literatures has increased rapidly since 2002. Nearly 20% of the literatures on diabetes economics evaluation were published in the top 15 journals and 150 core authors were found in this field. The developed countries had outstanding performance on diabetes economics evaluation. The institutions with the highest number of publications were Harvard University and University of London. In the co-occurrence network constructed by keywords, there were 4 subject concepts: “Evaluation of Diabetes Economics”, “Diabetes Self-management and Drug Treatment”, “Diabetes Prevention and Early Warning”, “Diabetes Related Metabolic Diseases” and “Diabetes Screening Indicators”. Conclusion The research of diabetes economics evaluation has developed rapidly since 2000. There have been some specialized journals, core authors and research institutions with global influence in this field. The developed countries, such as the United States and the United Kingdom, play an important role in the international cooperation on diabetes economics evaluation., but there is still less focused research hotspots.

Trends of morbidity and mortality of hand foot and mouth disease in China, 2008–2017

Li Jialing, Wei Yujia, Dong Baiqing, Chen Minmei, Chen Min, Li Hai, Su Yongjian, Li Rongxiu

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Objective To analyze the trends of morbidity and mortality of hand foot and mouth disease (HFMD) in China from 2008 to 2017, and provide scientific evidence for the development of HFMD prevention and control strategies. Methods The morbidity and mortality data of HFMD in China during this period were collected from China Public Health Science Data Center and the demographic data were collected from National Bureau of Statistics. Software Excel 2016 was used to establish the morbidity and mortality database of HFMD reports. Software JoinPoint 4.9.0.0 was used for JoinPoint regression analysis to estimate the annual average percentage change (AAPC) of reported morbidity and mortality of HFMD in different age groups and in different provinces in China from 2008 to 2017, and analyze the changing trend of HFMD morbidity and mortality. Results A total of 18,183,889 cases of HFMD were reported from January 2008 to December 2017, the average annual reported morbidity was 134.75/100,000. A total of 3,632 deaths were reported, with an annual average reported mortality of 0.027/100,000. The morbidity and mortality were stable from 2008 to 2017 (P>0.05), but the mortality showed a decreasing trend from 2010 to 2017 (APC:-22.98%, 95%CI: −29.64% to −15.70%, P<0.05). The morbidity in 10 provinces (municipalities) showed an increasing trend (P<0.05), the morbidity in 4 provinces (municipalities) showed decreasing trend (P<0.05), the morbidity in 18 provinces (municipalities) remained stable, and the mortality showed decreasing trend in 5 provinces (P<0.05). The incidence of HFMD was high in children aged 0–7 years, and the highest morbidity was in children aged 1 year (3184.19/100000). The average annual morbidity of HFMD decreased with age (t=−2.97, P<0.05). The case fatality rate of HFMD in age group <20 years decreased with age (t=−3.18, P<0.05). The annual morbidity of HFMD in 14 age groups showed an increasing trend (P<0.05), and the annual morbidity of HFMD in 12 age groups remained stable (P>0.05). The mortality in age group 0–7 years remained stable (P>0.05). Conclusion The overall HFMD morbidity and mortality in China from 2008 to 2017 were relatively stable, but the mortality showed a decreasing trend from 2010 to 2017. The morbidity of HFMD showed increasing trend in Southern China, Southwestern China, Central China and Eastern China, but the morbidity of HFMD declined in northern China and northeastern China. The morbidity of HFMD was higher in children aged 0 to 7 years. It is suggested that HFMD prevention and control should be strengthened according to the change of HFMD epidemic in different areas to reduce the morbidity and mortality of HFMD.

Avian influenza virus in external environment in Akesu, Xinjiang, 2017–2020

Rong Xiaosu, Li Hu, Ma Ruijie, Jiang Wei, Jiang Qinli, Zhou Hongliang

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Objective To understand the distribution of avian influenza virus in external environment in Akesu of Xinjiang and provide evidence for the prevention and control of human infection with avian Influenza virus in Akesu. Methods Real time fluorescent quantitative RT-PCR was used to test the external environment samples in Akesu for the detection of avian influenza, and influenza A virus positive samples were further detected for H5, H7 and H9 subtypes. Software Excel and SPSS 25.0 were used to analyze the differences in distribution of avian influenza virus in different years, seasons, samples and surveillance sites. Results A total of 580 samples were collected in Akesu from 2017 to 2020, and the positive rate of influenza A virus was 34.14%, the positive rate of H9 subtype was 94.95%, H5 subtype was 1.51%, and H5 + H9 mixed subtype was 3.54%, but H7 subtype was not detected. The annual positive rate of avian influenza virus in the external environment reached peak in October (62.5%). Among the six types of samples, the positive rate of poultry drinking water was highest (48.28%), and the positive rate of sewage in poultry markets was lowest (22.08%). The environment of the live poultry markets was contaminated by H9 and H5 subtypes of avian influenza virus. Conclusion The surveillance results showed that the positive rate of avian influenza virus in the external environment of Akesu was high, mainly H9 subtype virus, and less H5 subtype virus. It is necessary to strengthen the surveillance for avian influenza virus in the external environment to understand the distribution of the virus in time and discover new subtypes of viruses for the early warning, prevention and control of human infection with avian influenza virus in Akesu.

Multiple locus variable-number tandem repeat analysis on Brucella isolated in Sichuan, 2015–2019

Li Wenbo, Zhou Hanhong, Yan Guodong, Hu Xinyue, Luo Chunhua, Tian Guozhong, Yang Xiaorong, Zeng Linzi, Liao Hongyu, Qi Teng, Jiang Hai

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Objective To understand the genotype of Brucella isolated in Sichuan Province and provide scientific evidence for the prevention and control of brucellosis. Methods A total of 33 Brucella isolates were genotyped by multiple locus variable-number tandem repeat analysis (MLVA)-16. MLVA-8 genotype was queried by online public database, and cluster analysis of MLVA-16 was performed with UPGMA using software Bio Numerics. Results The Brucella isolates were divided into 29 MLVA-16 genotypes with genetic similarity ranging from 74.6% to 100%. There were three MLVA-8 genotypes, including 42, 43 and 83, all of which originated from the Eastern Mediterranean group, and type 42 was predominant. The Simpson's index of MLVA-8 was 0.356, while that of MLVA-16 was 0.991. MLVA-16 can be used for local outbreak investigation and sporadic case surveillance. Conclusion Brucella melitensis was the main pathogen causing brucellosis in Sichuan, and type 42 (MLVA-8 genotype) was the predominant genotype, consistent with strains isolated in other areas in China, suggesting that there was a correlation in incidence of brucellosis between Sichuan and provinces in northern China. For the first time, Brucella strains isolated in Sichuan were classified by MLVA, and the database constructed by them would provide basic data support for the surveillance and molecular traceability of brucellosis.

Surveillance results of foodborne diseases in Huzhou, Zhejiang, 2018–2020

Wu Xiaofang, Xu Deshun, Ji Lei, Zha Yungfeng, Chen Liping

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Abstract:
Objective To discuss the infection status and epidemiological characteristics of foodborne diseases in Huzhou of Zhejiang province. Methods The Salmonella, Vibrio parahaemolyticus, diarrheogenic Escherichia coli strains from 6 sentinel hospitals (3 key surveillance points and 3 routine surveillance points) in Huzhou from 2018 to 2020 were used for serotyping and virulence gene detection;Real-time PCR was conducted for the nucleic acid detection of norovirus. Results A total of 6783 samples of diarrhea cases were detected, and 1373 were pathogen positive, with a detection rate of 20.24%.The detection rate of diarrheogenic Escherichia coli was 6.49%, mainly enteroaggregative E. coli and enterotoxigenic E. coli. The detection rate of V.parahaemolyticus was 5.31%, the main serotype was O3∶K6, and the main virulence genotype was tdh. The detection rate of Salmonella was 2.85%, with S. typhimurium as the main species. The positive rate of norovirus was 11.65%, and the genotype was mainly GII.2[P16].The incidence peak of pathogenic bacteria infection was in summer, and the incidence peak of norovirus infection was in winter and spring, and people aged 20—39 years were mostly affected. Conclusion The pathogens causing infectious diarrhea in Huzhou from 2018 to 2020 were norovirus, diarrheogenic E. coli, V. parahaemolyticus and Salmonella, and the infection incidence showed obvious seasonal and age distributions. The surveillance for foodborne pathogens should be strengthened to effectively prevent and control the incidence of foodborne diseases.

Analysis on rifampicin-resistant pulmonary tuberculosis patient screening and treatment in Inner Mongolia, 2015–2020

Lang Shengli, Xu Lijuan, Zhang jiwei, Wang Cuixiu

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Objective To understand the screening and treatment of rifampicin-resistant pulmonary tuberculosis (TB) patients in Inner Mongolia autonomous region from 2015 to 2020 and provide evidence for the development of local drug-resistant TB prevention and treatment strategies. Methods The medical records of TB patients and the data of rifampicin resistant pulmonary TB patient screening and treatment in Inner Mongolia from 2015 to 2020 were collected from "Tuberculosis Information Management System", the rate and composition ratio were used for descriptive statistical analysis. Results The screening rate of rifampicin resistance was 60.7% in new pathogenic positive pulmonary TB patients and 72.2% in high-risk group in Inner Mongolia during 2015-2020, and the rifampicin resistance screening rates increased year by year (χ²_trend=36625, p<0.0001; χ²_Trend=6465, p <0.0001); The detection rate of rifampicin resistance in pulmonary TB patients with different registration classification was 9.7%. The detection rate in new pathogenic positive pulmonary TB patients was 6.0%, and the detection rate in high-risk group was 22.3%, higher than that in new pathogenic positive pulmonary TB patients (χ²_trend=13293, p<0.0001). The detection rate was highest in the patients with failed treatment (50.0%); The rate of treatment of rifampicin-resistant patients was 66.1% in new pathogenic positive pulmonary TB patients and 70.9% in high-risk group, and the annual rate increased year by year (χ²_trend=928, p<0. 0001, trendχ²=1095, p<0. 0001). Conclusion The rate of rifampicin resistance screening and the rate of treatment in pathogenic positive TB patients in Inner Mongolia increased year by year.

Epidemiological characteristics of pulmonary tuberculosis in students in Jiangxi, 2011–2019

Peng Xiaomei, Liu Yueyuan, Huang Wenhui

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Objective To explore the epidemiological characteristics of pulmonary tuberculosis (TB) in students in Jiangxi, and provide evidence for the development of TB prevention and control measures in schools. Methods The incidence data of pulmonary TB in students in Jiangxi were collected from TB Management Information System and student demographic information were collected from Jiangxi Statistical Yearbook. Results From 2011 to 2019, the average registration rate of pulmonary TB in students in Jiangxi was 12.52/100 000, and the average registration rate of students with pathogenic positive TB was 3.41/100 000. Over the past nine years, the registration rate of pulmonary TB in students showed an upward trend (χ²₁=20.793, P<0.05). A total of 9 660 cases of pulmonary TB were registered in Jiangxi, and the male to female ratio of the cases was 1.76∶1. Most pulmonary TB cases were aged 15–19 years, and most cases occurred in the first and second quarter of a year. Referral was the most common way of case finding (4 406, 45.61%), and the proportion of case tracking increased year by year (χ²₁=67.844, P<0.001). Conclusion In the future, we should continue to strengthen the detection of TB in students, improve the TB screening for freshmen, make rapid response to sporadic cases, strengthen the etiological diagnosis, focus on high school and university students, pay attention to the epidemic in the first and second quarter of each year and strengthen the health education about TB prevention in students.

Eidemiological characteristics of pulmonary tuberculosis patients in Inner Mongolia, 2011–2020

Lang Shengli, Xu Lijuan, Wang Cuixiu

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Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (TB) patients in Inner Mongolia autonomous region from 2011—2020 and provide basis for formulating TB prevention and control measures. Methods The information about the gender, age, occupation, source and treatment of the pulmonary TB patients in Inner Mongolia from 2011 to 2020 were collected from "Infectious Disease Surveillance System". Results The average annual registration rate of pulmonary TB cases in Inner Mongolia was 47.4/100 000 (118 599/250 122 000) during 2010—2020. The annual registration rates in different leagues or cities ranged from 17.5/100 000 to 110.9/100 000, The average annual registration rate declined from 67.5/100 000 in 2011 to 35.4/100 000 in 2020. In the pulmonary TB patients, 79 090 were men, and 39 509 were women, the gender ratio was 2∶1. The cases were mainly distributed in age group 45～64 years, accounting for 39.7%. Most TB cases were farmers, accounting for 61.6%; The TB cases was mainly detected in outpatients, accounting for 42.5%. The initial treated patients accounted for 91.8%, and the retreated patients accounted for 8.2%. Conclusion The registration rate of pulmonary TB patients declined in Inner Mongolia during 2011—2020, and the registration rates varied obviously with areas, and prevention and control effort should be strengthened in areas with high incidence of pulmonary TB in Inner Mongolia.

Ten-year recurrence rate in pulmonary tuberculosis patients after successful treatment and influencing factors in Fujian

Dai Zhisong, Chen Kun, Lin Shufang, Zhou Yinfa, Zheng Kuicheng, Wei Shuzhen

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Objective To analyze the 10-year recurrence in pulmonary tuberculosis (TB) patients after successful treatment in Fujian province and provide evidence for TB prevention and control. Methods The data of pulmonary TB patients during 2010–2020 in Fujian were collected from China Disease Prevention and Control Information System. The 10-year recurrence rate were calculated, and the influencing factors were analyzed by a Cox proportional hazard regression model. Results Among the 18 367 cured pulmonary TB patients surveyed in Fujian, 219 relapsed within 10 years. The recurrence rate was 0.12/100 person-years and the median of recurrence interval was 47.40 months. Multivariate Cox proportional hazard regression analysis showed that being male (Hazard ratio, HR=1.87, 95% CI: 1.31～2.68), local registered residence (HR=1.60, 95% CI: 1.07～2.39), medical care seeking delay >14 days (HR =1.37, 95% CI: 1.03～1.82), first diagnosis in special TB hospital and other hospital (HR = 3.06, 95% CI: 2.13～4.39; HR = 1.66, 95% CI: 1.09～2.53), retreatment (HR=1.76, 95% CI: 1.17～2.65) were the major risk factors for the recurrence in the cured pulmonary TB patients. Conclusion The 10-year recurrence rate of pulmonary TB patients was 0.12/100 person-years in Fujian. Cured TB patients who were male, local residents, smear-positive, retreated patients and had medical care seeking delay >14 days and first diagnosis in special TB hospital or other hospital had higher risk for recurrence.

Epidemiological characteristics of brucellosis in Shaanxi, 2019 – 2020

Luo Boyan, Nie Shoumin, Sun Yangxin, Sun Jie, An Cuihong, Wang Wenjing, Fan Suoping

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Objective To understand the epidemiological characteristics and incidence trend of brucellosis in Shaanxi province from 2019 to 2020 and provide evidence for the targeted brucellosis prevention and control. Methods The incidence data of brucellosis cases and outbreaks in Shaanxi from 2019 to 2020 were collected for a descriptive epidemiological analysis to understand the population, area and time distributions of brucellosis cases in Shaanxi by using software SPSS25.0 and Arc GIS10.8. At the same time, the characteristics of outbreaks and risk of different infection routes were also analyzed. Results A total of 2 254 brucellosis cases were reported in Shaanxi from 2019 to 2020, with an annual incidence rate of 2.93/10 0 000. The cases were mainly reported from April to September, which were mainly distributed in Guanzhong and northern Shaanxi, and there was statistically significant difference in the annual incidence rate among Guanzhong, northern Shaanxi and southern Shaanxi (χ²=1338.771, P<0.001). Most patients were men, the difference in annual incidence rate between men and women had statistical significance (χ²=440.14, P<0.001), and most cases (71.25%) were aged 40–69 years. Farmers were mostly affected. A total of 27 outbreaks were reported during 2019–2020, involving 218 serum positive cases, including 175 cases and 43 latent infections. The small-scale outbreaks with 3–5 cases accounted for 51.85%. The places where the outbreaks occurred were mainly family farms (48.15%), the infection route of direct contact with skin and mucous membranes accounted for 44.44%. The differences in infection rate through direct contact with skin and mucous membrane, respiratory tract and digestive tract were significant (P < 0.001). The relative risk of brucellosis risk through direct contact with skin and mucous membrane, respiratory tract and digestive tract were 21.257 (95% CI: 13.621～33.183), 15.408 (95% CI: 8.927～26.600) and 15.895 (95% CI: 10.117～24.957) respectively. A total of 10 273 livestock were detected, in which 349 were killed in 27 outbreaks. A total of 69 Brucella strains were isolated and identified, which were mainly Br melitensis type 3. Conclusion It is necessary to adhere and improve the joint prevention and control mechanism, strengthen the quarantine of sick animal and improve people’s knowledge, attitude and practice of brucellosis prevention and control to prevent and control brucellosis in Shaanxi.

Laboratory diagnosis of a family cluster of pertussis in Shanxi

Yang Hongxia, Han Jiting, Guang Ming, Wang Hui, Gao Yuan

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Objective To analyze the epidemiologic and etiologic characteristics of the laboratory diagnosis of a family cluster of pertussis in Shanxi province and provide evidence to improve the clinical and laboratory diagnosis and detection of pertussis. Methods The incidence data of pertussis in a family were collected. The nasopharyngeal swabs of the patient (child) and the close contact (mother) were used for isolation, identification, nucleic acid detection of Bordetella pertussis, and the gene sequencing of the strains was conducted. Result The nasopharyngeal swabs of the child and his mother were positive for B. pertussis culture. The nasopharyngeal swab of the child was negative but the nasopharyngeal swab of his mother was positive in nucleic acid test. The MLST gene sequencing results showed that all the strains were ST-2, belonging to ST-2 complex. Cluster analysis was conducted with the genomes of 890 strains of B. pertussis download from NCBI database, and it was found that the MLST of the strains was closely related to the genetic evolution of 25 strains of B. pertussis. Conclusion The child and his mother were confirmed to be infected with B pertussis by laboratory tests, indicating a family cluster of pertussis. Laboratory testing can provide timely and accurate etiological information for the diagnosis of pertussis and the surveillance of pertussis epidemic.

Pulmonary tuberculosis diagnosing and reporting in different type of medical and health institutions in Beijing, 2019

Liu Yanfei, Li Tao, Du Xin, Gao Zhidong, He Xiaoxin, Chen Wei, Zhao Yanlin

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Objective To evaluate pulmonary tuberculosis (TB) distribution and reporting in different types of medical and health institutions in Beijing, and provide evidence for standardizing TB diagnosis and reporting in medical institutions. Methods Through National Special Reporting System for TB, the incidence data of pulmonary TB patients in Beijing in 2019 were collected and analyzed by descriptive epidemiology method. Results In 2019, a total of 25 566 TB cases were reported by 336 medical and health institutions in Beijing, of which 11 301 were confirmed TB cases, accounting for 44.20%. A total of 12 151 TB cases were reported by 21 designated medical institutions, accounting for 47.53%, and 13 415 TB cases were reported by 315 non-designated medical institutions, accounting for 52.47%. Among the designated medical institutions, Beijing Chest Hospital reported the most TB report cases (9 228 cases, 36.09%). Among the non-designated medical institutions, the Eighth Medical Center of PLA General Hospital reported the most TB cases (1 402 cases, 5.48%). A total of 15 721 TB cases were local residents in Beijing (61.49%) and 9 845 cases were not local residents in Beijing (38.51%). The TB cases in local residents were mainly reported by general hospitals (7 737 cases, 49.21%), and the TB cases in non-local residents were mainly reported by special hospitals (5 163 cases, 52.44%). The TB cases in non-local residents were mainly from the surrounding provinces of Beijing, such as Hebei (3 703 cases, 37.61%). The proportions of confirmed TB cases in designated and non-designated medical institutions were 58.76% and 31.02% respectively. The difference was significant (χ²=1 989.69, P<0.001). The proportions of the TB cases in local residents and non-local residents under registration management were 71.43% and 53.49%, respectively. The difference was significant (χ²=368.64, P<0.001). There were also differences in the proportion of TB cases in local residents under registration management among different districts (counties) in Beijing, which was highest in Mentougou district (94.16%) and lowest in Chaoyang district (40.29%). Conclusion More TB patients visited non-designated medical institutions, but the proportion of confirmed TB cases reported by them was lower than that reported by designated medical institutions. The reported TB cases were mainly local residents in Beijing, and the TB cases in non-local residents were mainly from Hebei. The registration management rate was higher in TB cases in local residents than in TB cases in non-local residents, and there were also differences in the registration management rate in TB cases in local residents among different districts (counties) in Beijing.

Epidemiological and evolutionary analysis on influenza A (H3N2) virus in Hubei, 2017–2020

Xie Mengsheng, Fang Bin, Huang Chengjing, Yu Tiantian, Han Shi, Chen Dan

, DOI: 10.3784/jbjc.

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Objective To investigate the epidemiological distribution and gene evolution of influenza A (H3N2) virus in Hubei province from 2017 to 2020. Methods Based on the influenza etiological surveillance data in Hubei, the epidemiological distribution of influenza A (H3N2) virus in Hubei during 2017–2020 was analyzed. A total of 38 strains of influenza A (H3N2) virus sent by the influenza surveillance network laboratories in Hubei during 2017–2020 were selected for gene sequencing according to the annual distribution and area distribution. The amino acid sequences of HA and NA were obtained and their antigens were analyzed, the changes of amino acid sites in clusters were analyzed, and gene evolution and 3D modeling analyses were conducted. Results There were three detection peaks of influenza A (H3N2) virus in Hubei from 2017 to 2020. The first peak was predominated by 3C. 2a1 virus cluster, the second peak was predominated by 3C.2a1b +T131K virus cluster and the third peak was predominated by 3C.2a1b +T135K virus cluster. 3C.2a1b +T131K virus cluster and 3C.2a1b +T135K virus cluster had 8 different amino acid mutation sites on 3 antigenic determinants of HA protein. There were significant differences among sites 50, 131, 135, 140 of 3C.2a1b +T131K virus cluster and 3C.2a1b +T135K virus cluster in the three-dimensional simulation structure diagram. Conclusion The cluster of influenza A (H3N2) virus in Hubei evolved continuously from 2017 to 2020. Enhancement of evolutionary surveillance and antigen mutation analysis of the recent cluster of 3C. 2a1b +T135K virus would improve the epidemiological and gene evolution surveillance of influenza viruses in Hubei.

Serotype distribution, molecular type, and antimicrobial resistance of Salmonella isolated in Haidian district of Beijing, 2016–2019

Bai Jing, Yin Kexin, Liu Wei

, DOI: 10.3784/jbjc.202102260088

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Objective To analyze the serotype distribution, PFGE pattern and the antimicrobial resistance of Salmonella isolated from Haidian district of Beijing, and understand the circulating characteristics and antimicrobial resistance of Salmonella in Haidian. Methods Serotyping, PFGE and antimicrobial resistance testing of 76 strains of Salmonella isolated in Haidian between 2016 and 2019 were conducted. Results The proportion of Salmonella enteritidis was highest (57.7%, 45/76). In the 76 Salmonella strains, 35 PFGE patterns were detected. The similarity between these patterns was 48.7%–100.0%, and 51 strains of Salmonella formed 4 clusters (type similarity ≥85%). The 76 strains of Salmonella were all sensitive to imipenem (100.0%, 76/7). The intermediary rate to levofloxacin was highest (80.3%, 61/76). The resistance rate to nalidixic was highest (68.4%, 52/76). The overall multi-drug resistance rate was 52.6% (40/76), showing 27 multi-drug resistance spectrums. Conclusion In the Salmonella strains isolated in Haidian from 2016 to 2019, the serotype and PFGE pattern showed high consistency, the strains with same serotype shared same or highly similar PFGE pattern and a strong association of antimicrobial resistance spectrums exited among the strains with same serotype and same PFGE pattern or in same cluster.

Analysis on epidemiologic characteristics of human brucellosis in Nanxun District of Huzhou, Zhejiang, 2012–2020

Yang Liping, Peng Caiwei

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Objective To analyze the epidemiologic characteristics of human brucellosis in Nanxun district of Huzhou, Zhejiang province, from 2012 to 2020, identify the main factors affecting the incidence of human brucellosis in Nanxun and provide evidence for the prevention and control of human brucellosis. Methods The incidence data of human brucellosis in Nanxun were collected for a descriptive epidemiologic analysis. Results A total of 86 cases of human brucellosis were reported in Nanxun from 2012 to 2020, without death, the incidence was lowest in 2016 (0.55/100 000) and the incidence was highest in 2020 (4.39/100 000), the annual reported incidence rate showed a fluctuant increase (trend X²=3.897, P=0.048). The incidence was higher in local areas, the cases were mainly men and farmers, occupational exposure was the main route of infection, but there was spread to general population. Conclusion The incidence of human brucellosis in Nanxun was in increase, the main reasons were that the occupational population took no protective measures, the sick sheep entered the market without quarantine, and sick sheep were raised with local sheep. It is still necessary to strengthen the joint prevention and control, focus on the prevention and control in occupational groups and at sheep source, expand the health education coverage and improve the awareness of the disease prevention in general population.

Incidence trend and epidemiological characteristics of pulmonary tuberculosis in Anhui, 2011–2020

Zhang Genyou, Liu Jie, Shi Sijiu, Li Hongmiao, Liu Ye, Liang Lu, Zhang Min

, DOI: 10.3784/jbjc.202106290371

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Objective To analyze the epidemiological characteristics of pulmonary tuberculosis (TB) in Anhui province from 2011 to 2020 and provide evidence for the development of TB control strategy in the 14^th Five-Year Plan period Methods By using descriptive epidemiology method, the population, space and time distributions and incidence trend of TB in Anhui 2011 to 2020 were analyzed based on the data from TB information management system. Results From 2011 to 2020, a total of 324 916 cases of pulmonary TB were registered in Anhui, the average annual registered incidence rate was 52.60/100 000, showing a significant decline trend (trend χ²=6411.398, P<0.001).The wide use of new diagnostic techniques during the 13^th Five-Year Plan period has improved the etiological positive detection of pulmonary TB, the difference in pulmonary TB detection between men and women was significant ( χ²=63397.998, P<0.001). The registered incidence rate increased with age, which was highest in age group ≥65 years (138.48/100 000). The majority of pulmonary TB cases were farmers (74.41%). The incidence of pulmonary TB peaked during March - May with obvious seasonality, and the cases were mainly distributed in Hefei (12.88%), Fuyang (11.92%) and Anqing (8.52%). The incidence were significantly higher in areas along the Yangtze River (Tongling, Chizhou, Ma’anshan, Anqing and Wuhu) than in other areas ( χ²=49.706, P<0.001). Conclusion TB control had achieved remarkable success in Anhui, but the case finding of pulmonary TB was affected by COVID-19 epidemic in 2020. It is necessary to strengthen the TB prevention and control in men, age group ≥65 years and farmers and in winter/spring and key areas in Anhui.

Spatiotemporal distribution of influenza temporal risk characteristics in Gansu

Liu Haixia, Yang Xiaoting, Zhang Hong, Liu Xinfeng

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Objective To understand the spatiotemporal distribution of influenza in Gansu province and evaluate the effects of influenza prevention and control measures. Methods The incidence data of influenza in 87 counties of Gansu from 2016 to 2020 were collected for spatial scanning analysis, and the temporal risk characteristic index (frequency index, duration index and intensity index) of influenza was analyzed by spatial autocorrelation method. Results A total of 46, 043 cases of influenza were reported in Gansu from 2016 to 2020, with an average annual incidence rate of 35.09/100, 000. The areas with high incidence of influenza in Gansu from 2016 to 2020 might be in Dingxi and Tianshui. The frequency index, duration index and intensity index of influenza were 0.58, 5.73 and 10.49 respectively. The global autocorrelation showed that the frequency index and intensity index had positive spatial autocorrelation, and local autocorrelation showed that the hot spots of frequency index and intensity index were mainly in Dingxi. Conclusion The incidence of influenza in Gansu showed spatiotemporal clustering. Dingxi was a high-risk area of influenza, and the prevention and control measures in different risk areas had different effects.

TOPSIS and RSR method based comprehensive evaluation of quality of influenza-like illness surveillance in China, 2013 - 2019

Gao Yige, Yang Lei, Chen Tao, Yang Jing, Shu Yuelong

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Objectives Technique for order preference by similarity to ideal solution (TOPSIS) and rank-sum ratio (RSR) were used to evaluate the quality of surveillance of influenza-like illness in sentinel hospitals and network laboratories in China. In addition, the applicability of TOPSIS and RSR in evaluating the quality of influenza surveillance was also discussed. Methods Indicators were selected according to the national influenza surveillance program for a comprehensive evaluation of the performance of sentinel hospitals (5 indicators) and network laboratories (6 indicators) in China from 2013 to 2019 by using TOPSIS and RSR. Results TOPSIS results showed that the first, median, and third quartiles of C values in sentinel hospitals and laboratories increased from 2013 to 2019. RSR results showed that the grading boundaries of sentinel hospitals and laboratories showed an overall increasing trend. Compared with 2013, the RSR grade increased in 188 sentinel hospitals, decreased in 99 sentinel hospitals and remained in 224 sentinel hospitals in 2019, and the RSR grade increased 113 laboratories, decreased in 76 laboratories and remained in 128 laboratories in 2019. Conclusion The overall surveillance quality of sentinel hospitals and network laboratories in China has been improved. The results of TOPSIS and RSR were objective and reliable, which could be applied in the quality evaluation of influenza-like illness surveillance.

Analysis on incidence trend and epidemiological characteristics of pulmonary tuberculosis in Foshan, 2010–2020

Wang Wei, Ye Yinong, Wu Zhilong, Zhong Qianhong, Chen Liang, Huang Fei, Du Fangfang, Cheng Shiming, Zhou Jie, Zhong Qiu

, DOI: 10.3748/jbjc.202104160205

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Objective To understand the incidence trend and epidemiological characteristics of tuberculosis (TB) in Foshan, Guangdong province, and provide evidence for the development of local TB prevention and control strategies. Methods We compared the incidence data of TB reported in Guangdong and Foshan from 2010 to 2020 collected from "China Information System for Disease Control and Prevention", and the age, gender and occupation specific changes in the incidence of TB were analyzed. Results From 2010 to 2020, the reported incidence of TB in Foshan had an average annual decline of about 9.28%, and an average annual decline rate of 7.03 per 100 000 (t=−12.68, P<0.0001), both decreased faster than those of Guangdong province. The gap in TB incidence levels among the counties and districts have gradually become smaller. The male to female ratio of the TB cases was 1∶0.40 (t=20.06, P<0.0001), and the cases decreased in younger age groups but increased in older age groups. The cases were mainly the jobless or unemployed, workers and farmers, accounting for about 65.38%. It is predicted that the TB incidence rate in Foshan would decrease to <10/100 000 by 2035 based on the decrease level in the past 10 years. Conclusion The incidence of TB declined rapidly in Foshan after taking a series of prevention and control measures. In the future, it is necessary to develop new TB prevention and control strategies, further increase investment, strengthen the TB prevention service system, improve people’s health and health insurance and promote the application of innovative technologies and smart tools according to the epidemiological characteristics of TB to improve TB prevention and control.

Drug resistance in tuberculosis patients in Jiamusi, Heilongjiang, 2017–2020

Liu Cuiyu, Li Suping, Pan Baoshan, Xing Hui, Liang Bohui, Rong Tianchang, Zhang Hui

, DOI: 10.3784/jbjc.202105130269

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Abstract:
Objective To understand the prevalence of drug resistance in tuberculosis (TB) patients in Jiamusi, Heilongjiang province, and provide reliable references for the prevention and control of TB. Methods Mycobacterium tuberculosis strains isolated from 575 TB cases collected by Jiamusi Tuberculosis Reference Laboratory from 2017 to 2020 were included in the study. Proportion method was used for the drug susceptibility test of the strains to isoniazid, rifampicin, ethambutol, streptomycin, ofloxacin and kanamycin. Results The overall drug resistance rate was 35.29% (198/561). The drug resistance rate of the strains from the previously untreated patients was 32.35% (143/442), and the drug resistance rate of the strains from the retreated patients was 46.22% (55/119). There was significant difference between the two groups in drug resistance rate ( χ²=7.893, P=0.005). The overall multi-drug resistance rate was 10.16% (57/561). The multi-drug resistance rate of the strains from the previously untreated patients was 7.92% (35/442), and the multi-drug resistance rate of the strains from the retreated patients was 18.49% (22/119). There was significant difference between the two groups in multi-drug resistance rate ( χ²=11.473, P=0.01).The drug resistance rates of the M. tuberculosis strains to 6 anti TB drugs were 22.82% to streptomycin (128/561), 19.25% to isoniazid (108/561), 15.69% to rifampicin (88/561), 6.77% to ofloxacin (38/561), 6.6% to ethambutol (37/561) and 2.14% to kanamycin (12/561). Conclusion The drug resistance in TB patients in Jiamusi was relatively serious, and the proportion of rifampicin resistant TB patients was relatively high. It is suggested that early detection and standardized treatment of TB patients with drug resistance should be strengthened to control the spread of drug resistant TB.

Factors associated with health care-seeking delay and treatment delay in tuberculosis patients in Shishou and Badong of Hubei

Lu Xingxing, Liu Xun, Li Tao, Ye Jianjun, Zhang Mengxian, Zhang Yu, Yang Chengfeng, Chen Wei, Zhou Liping

, DOI: 10.3784/jbjc.202104270229

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Abstract:
Objective To investigate the current status of health care-seeking delay and treatment delay of tuberculosis (TB) patients and the influencing factors in two counties of Hubei Province, and provide evidence for the early detection and early treatment of TB patients. Methods Cross-sectional survey was conducted through face to face interview and collection of patient's medical record information, outpatient and inpatient records of hospitals for univariate analysis and logistic regression analysis to identify the factors independently associated with the health care-seeking delay and treatment delay. Results The median of health care seeking delay was 7 days (IQR: 0–30), the risk factors associated with health care-seeking delay were cough or expectoration (OR=1.97, 95% CI: 1.04–3.75), distance to a health facility for the first health care seeking >20 km (OR=2.35, 95% CI: 1.36–4.06), but chest pain (OR=0.47, 95% CI: 0.25–0.89) was the protective factor for health care seeking delay. The median of treatment delay was 24 days (IQR: 13–54), the number of health care seeking and number of different medical institutions visited were independent factors for treatment delay (P<0.05), the higher the numbers, the higher the risk for treatment delay. The median of total delay was 56 days (IQR: 26–138), the total delay was positively associated with cough or expectoration (OR=2.37, 95% CI: 1.14–4.95), being smear positive (OR=2.07, 95% CI: 1.16–3.68), distance to nearest designated TB medical institution >30 km (OR=1.92, 95% CI: 1.04–3.55), the number of health care seeking (3–4 times: OR=2.50, 95% CI: 1.25–4.97, >4 times: OR=25.42, 95% CI: 5.19–124.44). Conclusion In this study, the total delay of TB patients was mainly caused by treatment delay. While taking measures to reduce health care seeking delay, it is still necessary to improve patient's health care seeking behavior, optimize patient access to medical institutions, improve the watchfulness and diagnosis level of TB of non-designated TB medical institutions and use molecular biology and other means for screening to reduce treatment delay of TB patients.

Influencing factors for delay of tuberculosis case finding in students in Jiaxing, Zhejiang, 2010–2019

Hu Jie, Gu Weiling, Wang Yuanhang, Chen Zhongwen, Du Zhequn, Shen Guochu, Xu Rongquan

, DOI: 10.3784/jbjc.202008050272

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Abstract:
Objective To investigate the delay of tuberculosis (TB) case finding in students in Jiaxing, Zhejiang province, and the influencing factors, and provide data support for health decision-making. Methods The information of TB cases in students in child care settings, primary schools, junior high schools, senior high schools and colleges were collected form National Tuberculosis Information System for statistical analysis. The risk factors for the TB case finding delay were analyzed by χ² test and multivariate Logistic regression model. Results A total of 443 TB cases were reported in students. The cases in boys accounted for 60.05% and the cases in college students accounted for 34.09%. In the reported TB cases, 55.40% had negative etiological test results. The median delay days of TB case finding in students was 16 days and the proportion of the cases with delayed finding was 30.70%. The risk factors of diagnostic delay were medical care seeking due to illness, referral, cavity, being etiological positive and severe TB. Conclusion It is necessary to promote the active TB case finding at school entrance and take systematic intervention measures to reduce TB case finding delay in schools.

Examination of close contacts of smear positive tuberculosis patients in Shaanxi, 2012–2020

Zhao Yan, Zhang Tianhua, Sun Xiaolu

[Abstract](21) [FullText HTML](12) [PDF 1968KB](5) [Peer reviewing opinions] Related References Share

Abstract:
Objective To analyze the examination of close contacts of smear positive pulmonary tuberculosis (TB) patients and the detection of pulmonary TB patients in Shaanxi province. Methods The performance of screening of 190 542 close contacts of newly registered smear positive pulmonary TB patients in Shaanxi from 2012 to 2020 was analyzed. The relevant information of the close contacts were collected and input into Excel database. SPSS21.0 was used for data analysis. Results The screening rate and examination rate of the close contacts of smear positive pulmonary TB patients in Shaanxi were 99.89% and 84.92%. The detection rate of TB patients and smear positive TB patients were 1.56% and 0.03%. The examination rate of close contacts, the annual detection rate of TB patients and the detection rate of smear positive TB patients showed an overall upward trend. The detection rate in family members, symptomatic patients were higher than that in non-family members and asymptomatic patients. The differences in the examination rate, detection rate of TB patients and detection rate of smear positive TB patients among all groups were significant. Conclusion It is important to conduct early detection of TB in close contacts of newly registered smear positive TB patients.

Treatment adherence and influencing factors of pulmonary tuberculosis patients in less developed areas of Chongqing

Yu Ya, Liao Wenping, Liu Ying, Wu Bo, Chen Wei

, DOI: 10.3784.jbjc.202105060233

[Abstract](135) [FullText HTML](41) [PDF 2170KB](14) [Peer reviewing opinions] Related References Share

Abstract:
Objective To investigate treatment adherence of pulmonary tuberculosis (TB) patients and identify its influencing factors in less developed areas of Chongqing and provide basis for the next step of developing relevant interventions. Methods A cross-sectional study was conducted in Qianjiang, Fengdu, Kaizhou and Wushan counties (districts) of Chongqing. A questionnaire was used to collect the information about social demographic characteristic, medication, living condition, medical expenditure, and family economic status of the active pulmonary TB patients registered from January 2019 to June 2020 in 4 designated TB hospitals in Chongqing. Analysis was conducted on the treatment adherence of the pulmonary TB patients, and influencing factors were identified by Logistic regression method. Results A total of 339 pulmonary TB patients were included in this study, in whom 51.9% had missed doses during the treatment, 34.2% missed over 10% of the total prescribed doses. The main reasons of missing dose were forgetting medicine taking (45.5%), economic hardship (34.1%), and intolerance to adverse drug reaction (27.8%). Aged 15−29 years, low total medical cost, living near designated TB hospital, having health insurance and assistance, social support and daily directly observed treatment (DOT) were the protective factors for the treatment adherence; however, low education level, adverse drug reactions, low family income, and inadequate health education about TB were the risk factors. Conclusion The treatment adherence rate of TB patients in less developed districts and counties of Chongqing is low. It is important to strengthen health education, encourage and support the TB patients to complete treatment, implement DOT, and improve health resource supply and economic conditions in the less developed areas to improve the TB treatment adherence of local pulmonary TB patients.

Comparison of subtyping methods for Salmonella enterica serotype Enteritidis strains isolated from outbreaks in Sichuan, 2008–2018

Xiao Tao, Lei Gaopeng, Huang Weifeng, Lyu Hong, Liu Li, Yang Xiaorong, He Shusen

[Abstract](51) [FullText HTML](15) [PDF 7306KB](4) [Peer reviewing opinions] Related References Share

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Objective To compare the molecular typing methods for the Salmonella Enteritidis strains isolated from the outbreaks in Sichuan province and provide evidence for the rapid and reliable source tracing of the outbreaks. Methods Pulse-field gel electrophoresis (PFGE), multilocus variable-number of tanden-repeat analysis (MLVA), clustered regularly interspaced short palindromic repeats (CRISPR), multilocus sequence typing (MLST) and whole genome sequencing-based Single Nucleotide Polymorphism (WGS-SNP) were used for the subtyping of S. Enteritidis strains isolated from the outbreaks in Sichuan from 2008 to 2018. Simpson Diversity Index (DI) was used as an indicator to compare the subtyping power of a single method and a combination of methods. Results When PFGE, MLVA, CRISPR, and MLST were used alone, the DI values were all lower than 0.9. The DI value of PFGE_XbaI and MLVA increased to above 0.9 when PFGE_XbaI and MLVA were used together. WGS-SNP had the highest DI value (0.971). Conclusion The most suitable method for the molecular subtyping of S. Enteritidis strains isolated from the outbreaks in Sichuan was WGS-SNP. In the absence of genome analysis capability, the PFGE_XbaI+MLVA method is recommended.

Spatial analysis on birth defects in Guangxi based on geographic information system

Peng Zhenren, Wei Jie, Chen Biyan, Huang Xiuning, Song Pengshu, Liang Lifang, Wei Hui, Qiu Xiaoxia, Liang Junrong, He Sheng

[Abstract](56) [FullText HTML](39) [PDF 34648KB](9) [Peer reviewing opinions] Related References Share

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Objective To understand the spatial distribution of the incidence of birth defects in Guangxi, and provide scientific evidences for the prevention and control of birth defects. Methods The spatial database of birth defects of Guangxi from 2016 to 2020 was established and used for the spatial analyses. The Kriging interpolation was used to plot the map of birth defects in Guangxi. And then the trend surface analysis, spatial autocorrelation analysis and hotspot analysis were conducted to understand the spatial distribution of the incidence of birth defects. Results The trend surface analysis showed that the incidence of birth defects increased first and then decreased from west to east and from north to south. The global spatial autocorrelation analysis showed that there was a positive spatial autocorrelation in the incidence of birth defects (Moran's I = 0.308, Z = 6.066, P < 0.001). The local spatial autocorrelation analysis indicated that the incidence of birth defects showed High-High and High-Low spatial clustering patterns (Z > 1.96, P < 0.05) in Guangxi. The hot spot analysis showed that the incidence of birth defects had both hot spots and cold spots (Z > 1.65, P < 0.10) in Guangxi. Conclusion The obvious spatial distribution of the incidence of birth defects was observed in Guangxi, and the incidences were high in some counties or districts. So, it is necessary to strengthen the prevention and control of birth defects in these areas

Analysis on epidemiologic characteristics and disease burden of infectious diarrhea in Jiangjin, Chongqing, 2016–2019

Liu Xun, Meng Qiuyu, Huang Kaixiong, Kang Jiming

[Abstract](65) [FullText HTML](15) [PDF 4159KB](16) [Peer reviewing opinions] Related References Share

Abstract:
Objective To analyze the epidemiiologic characteristics of infectious diarrhea in Jiangjin district, Chongqing, from 2016 to 2019, and provide scientific basis and support for infectious diarrhea prevention and control. Methods The incidence data of infectious diarrhoea in Jiangjin from 2016 to 2019 were collected from National Disease Control and Prevention Information System. The descriptive epidemiology method was used to analyze the characteristics of infectious diarrhoea. The disability adjusted life year (DALY) was estimated to evalaute the disease burden caused by infectious diarrhea in each year. The spatiotemporal scan statistic was used to explore the spatiotemporal clustering of cases, and ArcMap 10.2 was used to visualize the analysis results. Results From 2016 to 2019, a total of 4 670 cases of infectious diarrhoea were reported in Jiangjin, including 1 death, and the annual average incidence rate was 84.72/100 000. The male to female ratio of infectious diarrhea cases was 1.174: 1, and the incidence rate was highest in the age group <5 years (1128.69/100, 000). The cases in children outside child care settings accounted for the highest proportion (73.30%). The incidence peak was during November-March. Spatiotemporal scanning further found that the most likely clustering areas were 4 streets including Jijiang, Dingshan, Shuangfu and Degan (LLR=281.73, RR=4.44, P<0.01). The cases with definite etiological diagnosis accounted for 5.89%, most cases were rotavirus infections (87.91%). The years of life lost (YLL) due to infectious diarrhoea was 22.53 person-years, and the years lived with disability (YLD) was 9.42 person-years. Children aged <5 years were at high risk for infectious diarrhea with cumulative YLD of 7.21 person-years (76.54%). People aged >60 years old were also a risk group for infectious diarrhea with YLD of 0.82 person-years (8.70%). Conclusion The main urban area of Jiangjin should be regarded as the key area for the prevention and control of infectious diarrhea. The relevant departments should further improve the etiological diagnosis and take targeted measures to control the incidence and spread of infectious diarrhea in children aged <5 years and children outside child care settings according to the epidemilogic and etilogic characterisrics of infectious diarrhea.

Analysis on prevalence of myopia and related factors in primary school students in grade 4～6 in Ningbo.

Zhang Yan, Jiang Danjie, Gao Hua, Shi Bijun, Wu Feng, Wu Yiping

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Objective To investigate the prevalence of myopia and related factors in primary school students of grade 4～6 in Ningbo, and provide scientific evidence for the myopia prevention and behavior intervention in primary school students. Methods Through stratified cluster sampling, the questionnaire survey and myopia screening were conducted to describe the prevalence of myopia in the students selected. Unconditional logistic regression analysis was conducted to identify the related factors for myopia. Results The myopia prevalence rate in 1088 primary school students was 61.5%. The results of multivariate analysis showed that the myopia prevalence rate was associated with residence (OR=0.547, 95% CI: 0.417～0.717), grade (OR=2.188, 95% CI: 1.556～1.251), daily homework times (OR=0.498, 95% CI: 0.327～0.759), weekly cram school time (OR=1.358, 95% CI: 1.019～1.809), distance between eye and book (OR=0.732, 95% CI: 0.549～0.976) and parents' myopia (OR=2.233, 95% CI: 1.706～2.922). Conclusion Residence, grade, daily homework time, weekly cram school time, distance between eye and book, parents' myopia are the related factors for myopia in the primary school students of grade 4-6 in Ningbo. It is necessary to conduct targeted health education and behavior intervention to reduce the prevalence of myopia in primary school students.

Analysis on dietary status of elderly patients with ischemic stroke in China

Chen Jingyi, Li Yuqian, Jia Shanshan, Song Pengkun, Liu Zhen, Man Qingqing, Song Shuang, Li Cheng, Wang Jingzhong, Zhang Jian

[Abstract](67) [FullText HTML](21) [PDF 2256KB](10) [Peer reviewing opinions] Related References Share

Abstract:
Objective To investigate the awareness of Dietary Guidelines for Chinese Residents (2016) (hereinafter "dietary guidelines") and the dietary intake of patients in elderly patients with ischemic stroke in China, and provide evidence for dietary guidance and health management. Method The ischemic stroke patients aged ≥65 years were selected from the project of Chinese adult chronic disease and nutritional surveillance (2015), Questionnaire and semi-quantitative food frequency questionnaire (FFQ) were used to investigate the awareness rate of the dietary guidelines and the dietary nutrition status in the past year in the elderly patients with ischemic stroke and analyze the dietary status of the elderly patients with ischemic stroke in urban and rural areas. Results The awareness rate of the dietary guidelines in the elderly ischemic stroke patients was 12.47% in China, which was 18.75% in urban patients and 6.07% in rural patients. The awareness rate of dietary guidelines in urban patients was higher than that in rural patients (P<0.001). Among the patients who knew the dietary guidelines, the awareness rate of the recommended intake of edible salt was 67.47%, and the awareness rate of the recommended intake of edible oil was 30.12%. The awareness rate of the recommended intake of edible salt and edible oil in rural patients were lower than those in urban patients (P=0.021, P=0.046). The frequency of fresh vegetable intake of more than 3 times a day was 19.46% in the elderly patients with ischemic stroke, and 31.24% of the patients consumed fresh fruit more than once a day, 23.37% and 4.65% patients consumed milk and beans more than once a day, respectively. The intake of staple food in rural stroke patients was higher than the dietary guidelines recommended. Intakes of legumes, vegetables, fruits, and dairy products were inadequate according to the dietary guidelines, with the rural patients having lower intake compared with the urban patients (P<0.05). Conclusion The awareness rate of the dietary guidelines in elderly patients with ischemic stroke in China was low, and the awareness rate of dietary guidelines in urban patients was higher than in rural patients. In rural area, the proportion of over intake of staple food was relatively high, while the intake frequencies of vegetables, fruits, beans, aquatic products and dairy food were low, resulting in insufficient intakes of these foods, which was more obvious compared with urban area.

Analysis on oral health behavior and knowledge awareness of students aged 12-15 years in Hainan

Wang Yuanyuan, Xie Lili, Guo Dongmei, Guo Qiuyun, Quan Tao, Xie Qi, Bao Bocheng

[Abstract](56) [FullText HTML](45) [PDF 2011KB](6) [Peer reviewing opinions] Related References Share

Abstract:
Objective To understand the oral health behavior, knowledge awareness and attitude of students aged 12～15 years in Hainan province and provide reference for the targeted health education and prevention of oral diseases. Methods According to the program of the fourth national epidemiological survey of oral health, a total of 3479 students aged 12～15 years in Hainan were selected by an equal-sized stratified multistage randomly sampling. All of them were surveyed with questionnaires regarding oral health behaviors, knowledge awareness and attitude. The collected data were analyzed by descriptive statistics and χ² test. Results Among the students, 40.50% brushed their teeth twice a day or more, only 4.17% brushed their teeth with fluoride toothpaste and only 0.55% used flossed every day. The students who eat dessert and sweets, sweet drinks, sweetened milk and other foods once or more per day accounted for 39.15%, 27.48% and 28.08% respectively.; The awareness rates of oral disease related knowledge was less than 70%, the awareness rates of "fluoride is useful for protecting teeth" and "pits and fissure sealing can protect teeth" were 29.58% and 12.96%, respectively. For oral health concept, 61.54% of them agreed that "regular oral examination is very necessary” and more than 90% answered the other three questions correctly. In general, the oral health behavior, knowledge awareness and attitude of the urban students were better than those of the rural students, and the girl students had better oral health concept compared with boy students. Conclusion The 12～15 year old students in Hainan have poor oral health behaviors, poor diet habits, insufficient knowledge awareness of oral diseases, and it is necessary to improve their knowledge awareness of oral health. New targeted oral health intervention measures should be developed according to the urban-rural and gender specific differences in oral health behavior and knowledge awareness of students.

Analysis of influencing factors and Bayesian network model study of treatment outcome in tuberculosis patients in Qinghai

Liang Da, Zhao Xiaoyin, Shang Yue, Wang Zhaofen, Ma Binzhong

[Abstract](75) [FullText HTML](47) [PDF 2434KB](11) [Peer reviewing opinions] Related References Share

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Objective To analyze the influencing factors for treatment outcome in tuberculosis (TB) patients registered in Qinghai province from 2011 to 2019, infer the causal effect by establishing the Bayesian network model, and provide scientific evidence for the TB prevention and control in Qinghai. Methods The TB cases information registered in Qinghai from 2011 to 2019 were collected from the National Tuberculosis Management System for a descriptive analysis on the treatment outcomes of TB patients, and multivariate Logistic regression analysis was used to identify the factors affecting the treatment outcomes of TB patients. The influencing factors with statistical significance were used in the Bayesian network model for causal correlation and conditional probability inferences. Results There were 35 910 TB patients in Qinghai from 2011 to 2019, and 31 908 cases were treated successfully, with a success rate of 88.86%. The results of multivariate Logistic regression analysis showed that clinical consultation, referral, follow-up and diagnostic type were protective factors affecting the treatment outcomes in TB patients, while older age (≥ 55 years old), being farmers and herdsmen, being detected in health examination and other contact examination, severe disease, retreatment and non-full course management were the risk factors. The Bayesian network model concluded that the source of patients, disease severity and management mode had casual correlation with the treatment outcomes in TB patients. The mild TB patients who had sought medical care and received full cause supervision management had highest treatment success rate (95.63%) and the lowest probability of adverse outcome (4.37%). Conclusion Age, occupation, source of patients, diagnostic type, disease severity, treatment classification and management mode were the influencing factors of treatment outcomes in TB patients. The causal relationship and intensity between TB patient treatment outcome and influencing factors were revealed by establishing Bayesian network model. The model showed that the treatment success rate was highest in mild TB patients who sought medical care due to illness and received full-cause supervision management.

Data quality of acute stroke and myocardial infarction events registry in China, 2015–2019

Yan Liuxia, Chen Xiaorong, Qin Yu, Gong Weiwei, Shi Weiwei, Li Qian, He Yujin, Jing Wu

[Abstract](98) [FullText HTML](51) [PDF 3189KB](10) [Peer reviewing opinions] Related References Share

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Objective To evaluate the data quality of acute stroke and myocardial infarction (MI) events records in China. Methods Ten surveillance hospitals in Hebei, Jiangsu, Zhejiang, Hubei and Sichuan provinces were selected for this study. Stroke and MI event records reported between January 2015 and December 2019 were selected by quota sampling in each hospital. Data for stroke and MI event records were obtained from 'National Surveillance System for Chronic Disease, China Center for Disease Control and Prevention'. The completeness and accuracy of the event records were verified according to the electronic health records via a self-developed online quality assessment system. Results A total of 2184 acute stroke records were evaluated and data were 100.00% complete for the key variables. The consistency of key variables between the reported and the actual records were 79.21%-95.15%. A total of 2 062 acute stroke events were verified, the average positive predictive value was 94.41%, ranging from 93.07% to 96.14%. During 2015—2019, the accuracy of key variables of stroke reports significantly increased (P<0.001). A total of 699 acute MI event records were evaluated and all the data were completed. The consistency of key variables between the reported and the actual records were 75.1%—95.42%. A total of 668 acute MI events were verified, the average positive predictive value was 95.57%, ranging from 92.86% to 97.45%. During 2015—2019, the completeness of diagnostic criteria and the accuracy of key variables of acute MI reports significantly increased (P all <0.0001). Conclusion The completeness of stroke and MI events reports were high in China during 2015—2019, and the report accuracy gradually increased, yet false positive reports still existed. It is necessary to strengthen the standardized reporting of stroke and MI events

Summary of global surveillance data of infectious diseases in May 2021

Han Hui, Wu Bo, Wu Hailei, Zhang Jin, Jia Jiaojiao

[Abstract](96) [FullText HTML](42) [PDF 2049KB](8) [Peer reviewing opinions] Related References Share

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In May 2021, a total of 67 infectious diseases were reported globally, affecting 225 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were corona virus disease 2019(COVID-19, 225), dengue fever (30), measles (29), poliomyelitis (15) and malaria (9). The top five infectious diseases with highest case fatality rates were Ebola virus disease (52.2%), Middle East respiratory syndrome (34.4%), lassa fever (20.3%), plague (6.0%) and Crimean-Congo hemorrhagic fever (5.3%). The top five infectious diseases with greatest number of deaths were COVID-19, malaria, measles, dengue fever and cholera. The prevalent infectious diseases in Asia were COVID-19 and dengue fever, the prevalent infectious diseases in Africa were COVID-19, Ebola virus disease, plague, cholera, yellow fever, lassa fever and Rift valley fever, the prevalent infectious diseases in America were COVID-19 and dengue fever, the prevalent infectious disease in Europe was COVID-19.

Economic burden of 192 varicella cases in Taizhou

Hu Yafei, Li Chunxia, Lin Haijiang

[Abstract](71) [FullText HTML](55) [PDF 1926KB](10) [Peer reviewing opinions] Related References Share

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Objective To evaluate the economic burden of varicella cases with different vaccination status in Taizhou. Methods We selected varicella cases in 3 counties (dsitrict) with different economic levels in Taizhou for a questionnaire survey to collect the information about cases’ varicella vaccination status, economic burden and school absences. Results A total of 192 varicella cases were investigated. The cases with 0, 1 and 2 doses of varicella vaccination accounted for 44.79%, 46.88% and 8.33%. The average direct economic cost was 262.66 yuan RMB, the average school absence days was 7.50 days. The average indirect economic cost was 718.46 yuan RMB, 2.73 times higher than the direct economic cost. The cases who received vaccination had lower direct medical cost and less school absence days compared with those who received no vaccination (P<0.05). Conclusion The indirect economic cost of varicella cases in Taizhou was higher than the direct economic cost, and varicella vaccination can reduce school absence days. Varicella vaccination should be further promoted.

Characteristics of tuberculosis cases detected by large-scale active screening in the elderly in rural area of Quzhou, Zhejiang

Wang Wei, Hao Xiaogang, Zhu Ping

[Abstract](71) [FullText HTML](37) [PDF 940KB](14) [Peer reviewing opinions] Related References Share

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Objective To analyze the demographic and clinical characteristics of pulmonary tuberculosis (TB) cases detected through active screening in elderly population in rural area of Quzhou, Zhejiang province and discuss the prevention and control strategies of pulmonary TB. Methods In physical examination for rural residents, chest X-ray examinations were performed for elderly people aged 65 years and over in rural area of Quzhou. Descriptive epidemiological analyses were conducted for the pulmonary TB cases detected in the elderly in the active screening. Results A total of 186, 096 people were actively screened and 174 cases of active TB were detected, with a detection rate of 93.50/100, 000. Among elderly pulmonary TB cases, 66.67% were pathogenic positive, 30.46% showed cavities in the lungs on imaging examination, 42.53% had clinical symptoms of pulmonary TB, and 68.39% had no chest imaging in the past 5 years. There were significant differences in the detection rate of pulmonary TB and the age specific positive rates of the pathogen between men and women. Conclusion It is necessary to include chest X-ray examination in the basic elderly health management services in areas with high prevalence of pulmonary TB in the elderly. Active screening, can facilitate the early detection TB cases in elderly population to prevent further transmission.

Analysis on sequences of PRNP and amino acid of blue sheep on Qinghai-Tibet Plateau

Wu Jingxing, Gao Liping, Chen Dongdong, Xiao Kang, Wu Yuezhang, Dong Xiaoping, Shi Qi

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Objective To analyze the prion protein gene (PRNP) sequence of blue sheep and evaluate the susceptibility of blue sheep to scrapie. Methods The primers were designed according to the PRNP sequence of sheep published on GenBank, and then the PRNP sequence of blue sheep was amplified, sequenced, and compared with the PRNP sequence of 11 species of mammals published on GenBank. Results Gene sequencing results showed that the PRNP of blue sheep consists of 771 nucleotides and encodes 256 amino acids. Sequence analysis showed that the amino acid sequences of prion protein (PrP) in four blue sheep were completely homologous, and were consistent with those of wild-type sheep. In addition, the amino acid sequence of PrP in blue sheep showed high homology with goat (99.2%), reindeer (98%) and cattle (97.7%). Conclusion Four blue sheep enrolled in this study might be susceptible to scrapie as wild-type sheep, and have the potential to transmit scrapie between blue sheep and sheep.

Epidemiological characteristics and case investigation of rabies in Yunnan, 2015–2019

Yang Weihong, Jiang Han, Feng Yun, Wang Juan, Pan Hong

[Abstract](101) [FullText HTML](60) [PDF 1148KB](15) [Peer reviewing opinions] Related References Share

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Objective To analyze the epidemiological characteristics and morbidity and mortality of rabies in Yunnan province in recent five years, and provide scientific basis for the prevention and control of rabies in Yunnan. Methods The incidence data of rabies in Yunnan from 2015 to 2019 were collected, a database was established and a chart was drawn. Descriptive epidemiological methods were used to analyze these data. Results A total of 167 cases of rabies deaths were reported in Yunnan from 2015 to 2019, with an average annual incidence of 0.07/100, 000. The cases were mainly reported from June to August, the annual incidence peak of the disease usually occurred in same period. The male to female ratio of the cases was 2.21∶1, and the cases occurred in all age groups, mainly in middle-aged and elderly residents and children in rural area. Most cases were still mainly caused by dog bite. Among the cases, 148 had clear exposure time, the median incubation period was 73 days, and the median course of disease after onset was 3 days. Six cases were laboratory confirmed. Only 10 of the cases with exposure Ⅱ or above were vaccinated with rabies vaccine. Thirty one dead animals with rabies virus or being suspected to carry virus were treated innocuously. Conclusion The incidence of rabies in Yunnan decreased year by year, but the area affected expanded, the treatment after dog bite was not standardized, and the management of dogs in rural areas is not fully implemented. Therefore, rabies is still an important public health problem in Yunnan.

Effect of prevention and control measures of a norovirus infectious outbreak based on dynamic model

Yu Guolong, Chen Tianmu, Zhu Yuanzhao, Shi Rongjie, Liu Fengren, Ye Bili, Liu Feng, Lin Haiduan

[Abstract](98) [FullText HTML](70) [PDF 16104KB](48) [Peer reviewing opinions] Related References Share

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Objective To use a dynamic model to simulate the prevention and control effects of different interventions in the management of norovirus infection outbreaks, and explore the best prevention and control methods. Methods According to the natural history of norovirus infectious, a SEIAR model was establish to analyze the effects of isolation, class suspension and vomit disposal in a norovirus infection outbreak. Results Without intervention, the basic reproduction of this outbreak (R₀) of the epidemic would be 9.63 and the epidemic would lasted for 4 days. The population infection rate was 97.38%. If the isolation measures were taken, the later the measures were implemented, the more infections occurred, and the duration would has no obvious change. If the isolation started in the afternoon of the second day after the outbreak, the scale of the epidemic would be close to the scale of that without intervention, and the isolation measure would fail. If the class suspension was taken on the second day after the outbreak (the actual start of class suspension), the number of infections and the duration of the epidemic would close to the actual ones, if the class suspension started on the second day afternoon after the outbreak, the epidemic scale would be very close to that under no intervention, and the suspension would fail. Taking no disinfection measures had no influence on the epidemic scale. As the disinfection was strengthened, the number of infections decreased, When the disinfection effect reached more than 90%, there were nearly no cases reported. Conclusion When an outbreak of norovirus infectious occurred, the control effect would be better if prompt case isolation and class suspension are implemented, and the standardized disposal of case vomit is needed. The SEIAR model established in this study can be used to evaluate the effect of prevention and control measures such as isolation and class suspension.

Analysis on Coronavirus disease 2019 epidemic progress under routine prevention and control

Lei Jinzhi, Xu Chuang, Liu Shengqiang, Pei Yongzhen

[Abstract](196) [FullText HTML](72) [PDF 14260KB](81) [Peer reviewing opinions] Related References Share

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Objective To explore the routine prevention and control measures for COVID-19 by using an established computational model based on contact network and individual state changes, evaluate the epidemic progress in different status and provide theory evidence for the prevention and control of COVID-19. Methods The impacts of close contact isolation and secondary close contact isolation on the prevention and control of COVID-19 were evaluated based on an individual model. The dynamics of the epidemic in the context of sporadic cases, cluster, or continuous case importation under routine prevention and different control were studied through model simulation, respectively. Results Model simulations showed that the effect of the secondary close contacts isolation was best, which could greatly reduce the epidemic level compared with close contact isolation. According to model simulation, the proposed prevention and control strategy can effectively control the epidemic caused by sporadic cases, clusters, and continuous imported cases. Conclusion Based on the model simulation of epidemic progress under different status, the effect of COVID-19 epidemic prevention and control by routine measures was evaluated. Secondary close contact quarantine is necessary to control the disease spreading, and it is suggested to conduct early isolation of close contacts in the prevention and control of COVID-19.

HIV infection status and influencing factors in men who have sex with men receiving the first and non-first HIV testing in Taizhou, Zhejiang, 2016–2020

Mei Huijian, He Chunyan, Li Jing, Li Guixia, Wang Yanling, Xu Yuanyuan, Shen Weiwei, Weng Jian, Chen Xiaoxiao

[Abstract](84) [FullText HTML](47) [PDF 3092KB](10) [Peer reviewing opinions] Related References Share

Abstract:
Objective To understand the HIV infection status and the influencing factors in men who have sex with men (MSM) receiving the first and non-first HIV-test in Taizhou, Zhejiang province, from 2016 to 2020. Methods A cross-sectional study was conducted in MSM selected through through snowball sampling, health education and field recruitment in Taizhou during 2016—2020 according to the requirements of the national HIV sentinel surveillance protocol. Results A total of 1870 MSM with mean age of (34.99±13.39) years were surveyed and included in the analysis, in whom, 27.4% (505/1870) received the first HIV testing in this survey. The positive rates of HIV in the MSM receiving the first and non-first HIV testing were 13.7% and 8.4%, respectively, the difference was significant (χ²=11.40, P<0.001). Among MSM who received the first HIV testing, the HIV positive rate was lower in those with senor high school, secondary technical school and college and higher education levels than in those with junior high school or lower education levels (OR=0.46, 95% CI: 0.23～0.92, P=0.029;OR=0.37, 95% CI: 0.16～0.84, P=0.017) and in those without STD diagnoses than in those with STD diagnosis in last year STD (OR=0.29, 95% CI: 0.09～0.92, P=0.036), but the HIV positive rate was higher in samples from volunteer consulting and surveillance sites than in samples obtained at bars/dance clubs/tea rooms/clubs (OR=2.35, 95% CI: 1.21～4.56, P=0.011) and in MSM who received no HIV prevention services than in those who received HIV prevention services (OR=1.83, 95% CI: 1.07～3.11, P=0.026). Conclusion The risk of HIV infection was higher in MSM who received HIV testing for the first time in Taizhou. It is necessary to strengthen the HIV counseling and sentinel surveillance for MSM with lower education level and history of STDs.

Serological surveillance for avian influenza virus in environment and population with occupational exposure in Gansu, 2019–2020

Li Baodi, Li Hongyu, Xu Congshan, Zhang Hui, Wang Xueying, Zhao Zhe, Wang Peng, Yu Deshan

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Objective To understand the infection status of avian influenza virus in population with occupational exposure s in Gansu province from 2019 to 2020 and the contamination of avian influenza viruses in the environment of live poultry markets, and provide evidence for the prevention and control of human infection with avian influenza virus. Methods Environmental samples such as surface swabs of poultry cages and feces of poultry, were collected from live poultry markets in Gansu. Real-time fluorescent RT-PCR was used to detect nucleic acid of influenza A virus in the samples. The positive samples were then tested for nucleic acid of H5, H7 and H9 subtypes of avian influenza virus. At the same time, serum samples from population with occupational exposure to avian influenza virus were collected, and the hemagglutination inhibition (HI) method was used to detect the antibodies to avian influenza A (H5N6), (H7N9), and (H9N2) viruses. Results A total of 5, 225 environmental samples were collected from 2019 to 2020, in which 1, 069 were positive (20.46%); the predominant strains belong to subtype H9, and there were 14 mixed infections of subtype H7 and H9 viruses; the positive rate in Dingxi was highest (40.79%), followed by Tianshui (40.00%), Longnan (37.63%), Baiyin (31.05%) and Jiayuguan (26.35%). The positive rate of avian influenza virus was highest (46.16%) in poultry chopping board swabs (46.26%) and lowest in poultry drinking water samples (15.71%). The difference was significant (χ²=21.038, P<0.05). Seven serum H9 antibody positive samples were detected in 437 persons with occupational exposures. Conclusion Avian influenza virus contamination in the environment of live poultry markets in Gansu was mainly caused by subtype H9 virus, subtype H7 I was sporadically detected, and no subtype H5 virus was detected, and there was less latent H9N2 virus infection in the population with occupational exposures. Active surveillance should be strengthened to prevent the outbreak of human infection with avian influenza virus.

Application of fluorescence polarization assay in diagnosis of brucellosis

Liu Jiayin, Jiang Hai, Yang WenJie

[Abstract](85) [FullText HTML](55) [PDF 1933KB](12) [Peer reviewing opinions] Related References Share

Abstract:
Brucellosis is a widespread zoonotic disease and a serious public health problem in developingcountries. Rapid diagnosis and precise quarantine are the keys to the prevention and control of brucellosis. Fluorescence polarization assay (FPA) is a method approved by the World Organization for Animal Health (OIE) to detect animal brucellosis. In recent years, there have been reports of using this assay to detect human brucellosis. This article summarizes the principle of FPA, the progress in research of humans and animal brucellosis to provide a theoretical basis for the future development of FPA in China.

Detection of virulence of Pasteurella multocida isolates from wild rodents in Yunnan

Du Chunhong, Wang Peng, Yang Shan, He Lichun, Chen Chaonian, Liang Yun, Wang Anwei, Gao Zihou

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Objective To understand the virulence of Pasteurella multocida isolates from the wild rodents in a rodent epidemic in Simao of Yunnan province in 2016. Methods Two strains of P. multocida were isolated from dead wild rodents, which belonged to serotype A and F by molecular typing. Balb/C mice were inoculated with the two strains and their mixture (1∶1) by routine challenge test, and the median lethal dose (LD₅₀) of each group was calculated. Results The LD₅₀ of P. multocida serotype A, serotype F strains and their mixture to Balb/C mice were 1.1×10², 5.0×10⁶ and 5.8×10². By statistical analysis, the virulence of serotype A strain was strongest, and the virulence of serotype F strain was lower than that of serotype A strain and the mixture. Conclusion P. multocida serogroup A and F strains isolated in this rodent epidemic had strong virulence to Balb/C mice, especially serotype A strain, belonging to very virulent P. multocida.

Epidemiology of human brucellosis in Taiyuan, Shanxi, 2011–2020

Liu Jing, Wang Wanjin, Zhang Xiaojia, Zhao Yanhong

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Objective To analyze the prevalence of human brucellosis in Taiyuan, Shanxi province, from 2011 to 2020, and provide evidence for the effective prevention and control of human brucellosis. Method Descriptive statistical analysis was conducted for the local brucellosis cases in Taiyuan from 2011 to 2020 by using the data from "China Disease Prevention and Control Information System". Results The average annual incidence of brucellosis in Taiyuan from 2011 to 2020 was 2.6027/100 000 (1.24—4.51/100 000), with the highest incidence in 2014 (4.51/100 000); the annual peak of the incidence was during March - July; all the counties (cities, districts) reported cases, but the incidence rate in suburban counties (8.80/100 000) was higher than that in urban area (1.21/100 000) (χ²=1 432.21, P<0.001), but the proportion of the cases in urban areas was in increase, which was significantly higher during 2016—2020 (41.44%) than that during 2011—2015 (35.56%). The difference was significant (χ2=3.899, P=0.048). The male-to-female ratio of cases was 4.1∶1. The cases occurred in all the age groups (0—85 years), but the cases aged 20—60 years accounted for 69.22%, and the proportion of the cases aged ≥60 years increased during 2016—2020 (28.70%) compared with that during 2011—2015 (22.35%), the difference was significant (χ²=5.745, P=0.017). Most cases were farmers (69.13%), but the proportion showed a downward trend from 74.17% during 2011—2015 to 61.11% during 2016—2020, the difference was significant (χ²=21.205, P<0.001). Conclusion The incidence of human brucellosis in Taiyuan from 2011 to 2020 showed a fluctuation trend, and the cases mainly occurred in rural area, but the cases in urban area increased, and the proportion of the cases aged ≥60 years also increased, suggesting that it is necessary to conduct health education and take behavior intervention in urban population and in elder population.

Current status and development trend of botulinum antitoxin

Zhang Huajie, Yang Yingchao, Ma Xiao

, DOI: 10.3784/jbjc.202012300448

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Botulism is a rare, potentially fatal disease caused by botulinum toxin, a strongest biotoxin produced by Clostridium botulinum. Botulinum antitoxin is the only specific treatment for botulism. Early administration of botulinum antitoxin is essential for the therapeutic effect of botulism. At present, almost all the approved botulinum antitoxins are equine plasma derived products, which have the potential risk of adverse reactions, including allergic reactions. This paper summarizes the current status of production technique, quality control and clinical application of botulinum antitoxin both at home and abroad, and introduce the application prospect of botulinum antitoxin.

Discussion on prevention and control of COVID-19 epidemic in primary medical institutions

Zhang Yan, Li Jing, Zuo Bojun, Huang Xinling, Ma Wenbo

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Since late 2019, Coronavirus disease 2019(COVID-19)has rapidly spread across the world as a new infectious disease, Xinjiang autonomous region has also experienced three epidemic periods. The Epidemic Prevention Leading Group of Xinjiang and Xinjiang Production and Construction Corps established a special supervision group in time to conduct investigation and guide the performance of COVID-19 prevention and control in primary medical institutions, including pre-inspection and triage of fever cases, the use of protective equipment, hand hygiene, and environmental disinfection, to minimize the risk of nosocomial infection, effectively control the epidemic in Xinjiang, and restart the normal production and life.

Analysis on prevalence of myopia in school students in Yuyao, Zhejiang

Zhang Yi, Zhou Gaoxiang, Miao Chao, Shi Yafeng

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Objective To understand the prevalence of myopia in school students in Yuyao, Zhejiang province, and provide the scientific basis for further prevention and control of myopia in students. Methods A cross-sectional study of myopia was carried, all the students in Yuyao received visual acuity and refraction tests. Results A total 109088 students were surveyed by using questionnaire in Yuyao with 104 800 valid questionnaires returned. The prevalence rate of myopia in the students was 51.96%. The prevalence rate was significantly higher in girl students than in boy students (H=345, P<0.01). The prevalence rate in Han ethnic students was significantly higher than that in students in other ethnic groups(H=663, P<0.01). The prevalence rate was significantly lower in students in public schools than in students in private schools. The prevalence rate was significantly higher in urban students than in rural students(H=1182, P<0.01). Senior high students had highest prevalence rate of myopia, followed by vocational senior high school students, junior high school students and primary school students. With the increase of school age, the prevalence rate of myopia also increased significantly (r=0.90). In low school aged students (1～6 years), mild myopia was common, while in high school aged students (7～12 years), moderate and severe myopia were common. Conclusion The prevalence of myopia was higher in students in Yuyao, with a younger age and severity trend. In order to reduce the prevalence of myopia in students, it is necessary to take comprehensive intervention measures.

Pathogen spectrum in lower respiratory tracts of suspected case infected with SARS-CoV-2

Gu Lin, Song Yanyan, Zhang Shiyao, Hao Min, Li Li, Li Qian

[Abstract](244) [FullText HTML](114) [PDF 1998KB](28) [Peer reviewing opinions] Related References Share

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Objective To understand the pathogen spectrum in the lower respiratory tracts of 100 suspected cases infected with SARS-CoV-2 in Chaoyang district of Beijing from January to March, 2020. Methods A total of 28 kinds of respiratory pathogens were detected by real-time fluorescent quantitative polymerase chain reaction (PCR), including 14 viruses and 11 bacteria, as well as Mycoplasma pneumoniae, Chlamydia pneumoniae and fungi. Results The positive rate of nucleic acid of detected pathogens in 100 sputum samples of the suspected cases was 72.00% (72/100). The positive rate of SARS-CoV-2 was 15.00% (15/100). The positive rates of gram-negative bacteria, gram-positive bacteria, fungi, Mycoplasma pneumoniae and Chlamydia pneumoniae were 32.00% (32/100), 24.00% (24/100), 39.00% (39/100), 6.00% (6/100) and 3.00% (3/100), respectively. Influenza A virus, influenza B virus, adenovirus, respiratory syncytial virus and rhinovirus were also detected. A total of 13 samples were positive with both SARS-CoV-2 and other pathogens. Conclusion The pathogens detected in the lower respiratory tracts of 100 suspected cases infected with SARS-CoV-2 in Chaoyang from January to March in 2020 was diverse. Fungi, SARS-CoV-2, Staphylococcus aureus and Haemophilus influenzae were the main pathogens. S. aureus and fungi were the main co-infected pathogens detected in the lower respiratory tracts of suspected SARS-CoV-2 infection cases.

Comprehensive evaluation of quality of infectious disease information reporting system in Aksu, Xinjiang, 2016 - 2019

Zhou Quan, Luo Wenwei, Shen Xinxiu, Tuerhong ·musa, Xirenguli ·rusuli, Aikebaier ·aihemaiti

[Abstract](123) [FullText HTML](73) [PDF 1956KB](9) [Peer reviewing opinions] Related References Share

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Objective To understand the current status of infectious disease information report quality management in Aksu, find out the existing problems, and provide reference for improving the local information report quality of infectious disease. Methods The infectious disease report card data and field supervision table in Aksu from January 1, 2016 to December 31, 2019 were collected from the subsystem of infectious disease report information management of national information system of disease prevention and control system for the description epidemiological analysis. Trendχ² test was used to analyze the influencing the factors for the reporting timeliness, verifying timeliness, reporting card completeness and comprehensive evaluation index. Results From January 1, 2016 to December 31, 2019, the comprehensive evaluation index of infectious disease information report in Aksu ranked 3^rd among the 14 prefectures in Xinjiang. However, there were still some problems, such as the failure of timely reporting, the failure of timely verifying or the incomplete filling of valid ID number. Among them, the rate of non-timely reporting was on the rise, and the difference was significant (χ²_趋势=21.173, P<0.05). The failure rate of timely verification showed a downward trend, and the difference was significant (χ²_趋势=150.571, P<0.05). The incomplete rate of valid ID number filling showed a downward trend, and the difference was significant (χ²_趋势=270.824, P<0.05). The comprehensive evaluation index increased by 1.16%, 0.25% and 0.18% respectively, from 2016 to 2019. Conclusion The quality of infectious disease information report in Aksu was good, and the stabilities of reporting and verifying were good. However, there were reporting cards with poor reporting timeliness, incompleteness of valid ID number filling, and untimely verification, which were the important factors affecting the improvement of the comprehensive evaluation index.

Characteristics of second-line anti-tuberculosis drug resistance and gene mutation of multidrug-resistant Mycobacterium tuberculosis in Ningbo.

Che Yang, He Tianfeng, Lin Lyu, Ping Guohua

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Objective To analyze the characteristics of second-line anti-tuberculosis (TB) drugs resistance and gene mutation of multidrug-resistant (MDR) Mycobacterium tuberculosis isolated in Ningbo. Methods In 1597 M. tuberculosis isolates collected in the first drug resistance survey in Ningbo between 2018 and 2019, 133 MDR isolates, including 31 isolated from elderly group and 102 isolated from young and middle age group, were used in the study. All the isolates were detected using RD105 deletion-targeted multiplex PCR for Beijing genotype identification. Gene sequencing with PCR was conducted to detect the mutations of rrs, tlyA, eis, gidB, gyrA and gyrB genes. The conventional drug susceptibility test was used to detect the resistances to 5 second-line anti TB drugs (kanamycin, amikacin, capreomycin, ofloxacin, levofloxacin). Results The multidrug resistance rate of M. tuberculosis isolates was 8.33% (133/1597) in Ningbo. The resistance rates of 133 MDR M. tuberculosis isolates to kanamycin, amikacin, capreomycin, ofloxacin and levofloxacin were 7.52% (10/133), 6.01% (8/133), 3.01% (4/133), 30.08% (40/133) and 29.32% (39/133). The rates of pre-XDR and XDR of 133 MDR M. tuberculosis isolates were 28.57% (38/133) and 6.01% (8/133). The gene mutation rates of rrs, tlyA, eis, gidB, gyrA and gyrB of 133 MDR M. tuberculosis isolates were 6.77% (9/133), 7.52% (10/133), 1.50% (2/133), 3.76% (5/133), 34.59% (46/133) and 3.01% (4/133). There were 2 rrs mutations, 1 tlyA mutation, 2 eis mutations, 2 gidB mutations, 5 gyrA mutations and 4 gyrB mutations. Single base substitution was the main type. Conclusion The resistance of MDR M. tuberculosis to second-line anti-TB drugs was serious in Ningbo, especially the resistance to fluoroquinolone. It is necessary to strengthen the prevention and control of second-line anti TB drugs resistances of MDR M. tuberculosis.

Analysis on influenza-like illness and etiological surveillance in Zhenjiang, Jiangsu, 2013-2020

Sun Lina, Yuan Zhaohu, Liu Jin, Miao Chunhua

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Objective To understand the epidemiological and etiological characteristics of influenza-like illness (ILI) in Zhenjiang, Jiangsu province, during 2013—2020, and provide scientific basis for the prevention and control of influenza. Methods ILI surveillance system consisting of influenza surveillance sentinel hospitals and influenza laboratory network in Zhenjiang was used to collect the surveillance data of ILI cases and pathogens in Zhenjiang from 2013 to 2020 for a statistical analysis. Results A total of 207 252 ILI cases were reported by sentinel hospitals in Zhenjiang during 2013—2020, and the average ILI% during 2013—2020 was 3.50%, showing an increase trend (χ²_trend=30554.00, P<0.001). The ILI cases in age groups 0—4, 5—14, 15—24, 25—59 and ≥60 years accounted for 39.91%, 27.53%, 7.40%, 17.93%, 7.23% respectively. There were two peaks of ILI% in the same influenza surveillance year, December-February and June-September. A total of 25 318 ILI samples were tested in Zhenjiang during 2013—2020, in which 2 780 were influenza virus positive (10.98%). The detection rate of influenza A virus (7.08%) was higher than influenza B virus (3.90%). Influenza A (H1N1) virus was mainly detected during January-March, influenza A (H3N2) was mainly detected during July-December, influenza B virus Victoria lineage was mainly detected during April-June, and influenza B virus Yamagata lineage was mainly detected during January-March. There were two types of influenza virus epidemics, one was caused by single influenza virus, and another one was caused by multi influenza viruses. A total of 39 ILI outbreaks were reported during 2013—2019 in Zhenjiang, in which 37 occurred in schools and child care settings, no ILI outbreak was reported in 2020. During COVID-19 epidemic period in 2020, the ILI% (6.82%) was 125.08% higher than the average during 2013—2019 (3.03%), and the increase was highest in age group ≥60 years (176.61%). The positive rate of influenza virus was 52.21% in January, 11.20% in February, 0.37% in March, 0.00% in April-December in 2020, the positive rate in 2020 (5.37%) was 54.41% lower than the average during 2013—2019 (11.79%). Conclusion It is necessary to strengthen the prevention and control of influenza according to the epidemiological characteristics of ILI and influenza virus in Zhenjiang. The prevention and control measures for COVID-19 can be used for reference.

肉毒梭菌及其毒素分型方法概述

Yang Yingchao, Zhang Huajie, Ma Xiao

[Abstract](193) [FullText HTML](112) [PDF 12718KB](14) [Peer reviewing opinions] Related References Share

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Since Ermengem isolated and reported that the spore-forming Clostridium botulinum caused human poison in 1897, researchers found that there are 7 types of Clostridium botulinum in nature through serum neutralization methods. Subsequently, serological methods were also used to discover Clostridium botulinum that can produce bivalent toxins such as Ab, Ba, AB, Af and Bf. With the gradual maturity and improvement of gene sequencing technology, whole-genome sequencing by extracting Clostridium botulinum genomic DNA can not only identify the genetic composition of different serotypes of botulinum toxin, but also carry out typing studies at the nucleic acid or protein molecular level. Compared with serum neutralization methods, these newly emerging typing techniques and methods can not only solve the problems encountered in serological classification, but also quickly and accurately identify and track food or drug poisoning caused by Clostridium botulinum and the application of corresponding medications. In addition, different typing methods provide new tools and ideas for the identification and use of Clostridium botulinum strains and the development of new toxins.

An investigation of a botulism poisoning event in Urumqi, Xinjiang

Gulina Tuerdi , Gao Pengya, Sun Hui, Sun Xihe, Li Xinyue, Lu Xuancheng, Liu Yang, Xu Xuefang

, DOI: 10.3784/jbjc.202009170320

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Objective To investigate the pathogenic factors and causes of a botulism poisoning event and provide evidence for the prevention and control of the similar events in the future. Methods Field epidemiological survey was conducted through consulting medical records, interviewing relevant doctors and household survey, Laboratory test was done after collecting case stool samples and residual food samples for the detection of Clostridium botulinum. Results Two poisoning cases were confirmed and admitted to hospital. After botulinum antitoxin A and B treatment, the symptoms were significantly alleviated. C. botulinum was isolated, which was identified as type A C. botulinum after detection of type A toxin gene by real time quantitative PCR. Type A botulinum toxin was detected in mouse experiments. Conclusion This poisoning event was caused by homemade tempeh contaminated by C. botulinum type A. It is recommended to strengthen health education about the prevention of contamination in food production and storage. Medical institutions should prepare emergency medicines for food poisoning. Antitoxin serum should be used for the treatment of botulism poisoning.

Chinese reference list of core health indicators

, DOI: 10.3784/jbjc.202011300402

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Hot issues after marketing of COVID-19 vaccine

Ye Pengling, Wang Ming

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The pandemic of COVID-19 continues to spread worldwide, suggesting that the epidemic would continue in natural state. Although some progress has been achieved in the treatment of COVID-19, it is far from containing the spread of the epidemic. Therefore, human beings have pinned their hopes of controlling the COVID-19 epidemic on the development of vaccines. Currently, several COVID-19 vaccine products have been applied to immunize the population after completion of phase Ⅲ clinical trials. The safety, immunogenicity, efficacy, immunization procedures and response to virus mutations of different COVID-19 vaccines are the great concern of the public. The public and experts in the field are confused about the efficacy of vaccines due to the different evaluation indicators used by research and development institutions in publishing vaccine development and application information and the interpretation by media from different perspectives and calibers. This paper summarizes the published research data and discusses the hot issues in development and post-marketing application of COVID-19 vaccine.

The Advisory Committee on Immunization Practices’ Updated Interim Recommendation for Allocation of COVID-19 Vaccine — United States, December 2020

Gong Zhenyu, Gong Xunliang

, DOI: 10.3784/jbjc.202012270443

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《疾病监测》杂志稿约

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