疾病监测

Evaluation of communicable disease reporting based on three level intelligent platform in Ningbo

Keqin Ding, Liang Zhang, Bo Yi, Yi Chen, Hongjun Dong, Guozhang Xu

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.013

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Abstract:
Objective To evaluate the performance of communicable disease reporting based on a three level intelligent platform in Ningbo from March 28 to July 24 in 2017. Methods The communicable disease management information system and digital disease control platform of Ningbo were used to evaluate the performance of the intelligent platform communicable disease reporting in Ningbo. Results During this period, all the hospitals in Ningbo reported 24 497 communicable disease cards through the intelligent platform, 24 259 cards successfully transferred to national disease management information system, the successful rate was 99.03%. The average reporting time decreased by 3 minutes than before. From April to July, the timeliness reporting rate of communicable disease increased from 99.97% to 99.99%. ID number complete rate increased from 88.96% during the same period in 2016 to 99.95%. Comprehensive index increased from 97.79% in 2016 to 99.99%. The reporting consistent rate increased from 94.50% to 100%. Conclusion During the four-month operation, the performance of communicable diseases reporting based on the three level intelligent platform in Ningbo was well. Compared with the traditional model, the quality of communicable disease reporting has been greatly improved.

Epidemiological characteristics of rabies in pastoral areas in Yushu, Qinghai, 2013－2017

Sang Ga, Guilan Zhang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.10.0350

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Abstract:
Objective To analyze the monitoring data of rabies in the pastoral areas of Yushu prefecture, Qinghai province, from 2013 to 2017, discuss the epidemiological characteristics of rabies and provide evidence for the rabies prevention and control in pastoral areas. Methods The surveillance data of the rabies in Yushu from 2013 to 2017 were collected and analyzed and the information about dog biting were collected by using questionnaire. Results From 2013 to 2017, a total of 252 cases of dog biting were reported in Yushu, and 5 confirmed rabies cases occurred in 2 males and 3 females. Averagely, 63 dog biting cases occurred each year. The incidence was 1.98/100 000, and case fatality rate was 100%. The interval between onset and death was short (averagely 3–4 days). The incubation period was longer in cases with biting on lower limbs. The detection rates of rabies virus in human and wolf brain samples and cattle spinal marrow samples were all 100%. Of 5 rabies cases, 4 died within 1–7 days after exposure, and 1 died after 7 days of exposure. In addition, 5 cases of one dog biting multi people were reported, involving 16 persons and causing 5 deaths (4 deaths after street dog bite, 1 death after domestic dog bite). All the 11 persons who had grade Ⅱ exposure survived due to timely post exposure treatment. Dog biting mainly occurred during November–April. Conclusion From 2013 to 2017, the incidence of rabies in the pastoral areas of Yushu was in increase. The frequency of close contact between the wild host of rabies and livestock and human greatly increased. The poor management of dogs and low standard post exposure treatment rate were the main reasons for the increased incidence of rabies.

Incidence trend and characteristics of cerebral infarction in residents in Tianjin, 2010－2016

Xiaodan Xue, Dezheng Wang, Ying Zhang, Wei Li, Chengfeng Shen, Shuo Pang, Guohong Jiang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.10.0249

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Abstract:
Objective To investigate the incidence trend and characteristics of cerebral infarction in residents in between 2010 and 2016, analyze the incidence differences in population with different characteristics, and provide evidence for the prevention and control of cerebral infarction. Methods The data of new cerebral infarction cases between 2010 and 2016 were collected from Tianjin Cerebral Infarction Surveillance System. The incidence of cerebral infarction and its distribution in different age groups, gender groups and urban or rural areas was analyzed. The population data based on the Sixth National Population Census in 2010 were used for standardized rate estimation. Difference among different groups was compared with χ² test. The χ_trend² test was used to analyze the incidence trend with years and in different age groups. The change the incidence during this period and prediction of the incidence during 2017–2020 were analyzed by using Joinpoint software. Results The average age of initial cerebral infarction was 65.50 years, the smoking rate was 32.18%, and the recurrent rate was 34.01%. The incidence rate of cerebral infarction in Tianjin increased gradually from 2010 to 2016 with the crude incidence rate ranging from 379.70/100 000 to 583.64/100 000, and with the standardized incidence rate ranged from 212.40/100 000 to 291.52/100 000 (P＜0.000 1). The increase in rural area was more obvious. The incidence rate was consistently higher in male residents (the crude incidence: 450.17/100 000–698.82/100 000, the standardized incidence rate: 249.20/100 000–350.34/100 000) than in female residents (the crude incidence rate: 308.44/100 000–467.87/100 000, the standardized incidence rate: 174.48/100 000–232.85/100 000, allP＜0.001). And in all age groups, the incidences in men were higher than in women (P＜0.001). According to the prediction, the incidence of cerebral infarction in Tianjin will reach 808.58/100 000, and the standardized incidence of the disease will be 371.03/100 000 by 2020. Conclusions The incidence of cerebral infarction increased during the past 7 years. There was no turning point for decrease, and the increasing trend was more obvious in rural areas and in men. Attention should be paid to the disease and targeted interventions should be taken to reduce the incidence of cerebral infarction.

Surveillance for circulation and genetic evolution of avian influenza A (H7N9) virus in poultry markets in Guangzhou, 2014－2017

Lan Cao, Kuibiao Li, Yanhui Liu, Yiyun Chen, Jianyun Lu, Enjie Lu, Wenhui Liu, Dan Xia, Tiegang Li, Ming Wang, Biao Di, Zhicong Yang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.10.0274

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Abstract:
Objective To understand the circulation and gene evolution of avian influenza A (H7N9) virus in Guangzhou and provide research data for prevention and control of human infection with avian influenza A (H7N9) virus. Methods The samples were collected in poultry markets in Guangzhou during 2014–2017. Avian influenza A (H7N9) virus was detected by real-time RT-PCR, and the HA gene was plotted for phylogenetic tree. Results A total of 28 252 samples were detected, in which 888 were positive for H7N9 virus (3.14%). The circulation peak of H7N9 virus occurred during February–May. The highest detection rate was 13% in April. The nucleotide homology of HA gene was 88.6%–100%, and the amino acid homology was 92.0%–100%. The highly pathogenic avian influenza A (H7N9) virus has been detected in the environment in 2017. Evolutionary analysis revealed that the HA gene exhibited multiple evolutionary branching characteristics. In recent years, the virus HA gene has been localized, belonging to the Southern China branch. And we have detected the isolate belonging to other evolution branch from wild birds. Conclusion Avian influenza A (H7N9) virus continued to exist in Guangzhou during 2014–2017, and the virus mutated rapidly. It is necessary to strengthen the surveillance for avian influenza A (H7N9) virus in wild birds.

Distribution characteristics and drug resistance of Salmonella in outside environment and foodborne disease patients in Yuyao, 2014－2016

Jianqun Zhang, Shaojun Huang, Chao Miao, Shijie Yuan, Xuehui Luo

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.10.02018-0000

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Objective To understand the distribution characteristics and drug resistance of Salmonella in water, food and food borne disease patients after flood disaster in Yuyao, Zhejiang province, and provide scientific basis for clinical treatment and prevention of foodborne diseases. Methods Samples were collected from river water in the urban area, food and diarrhea patients in Yuyao, and then enrichment culture, isolation, biochemical identification, serotyping and drug susceptibility test were carried out. Results A total of 283 Salmonella strains were detected in Yuyao during 2014−2016, the detected strains belonged to 32 serotypes,S. Typhimurium was predominant (40.28%). Salmonella had high resistance rate to ampicillin (51.59%) and piperacillin (42.05%). It was found that 36 strains were multi-drug resistant. Conclusion The contamination rate of S almonella in outside environment was high in Yuyao, the detected Salmonella strains had multiple serotypes, high drug resistance rate and high multidrug resistance. S. Typhimurium was predominant. The distribution and drug resistance of Salmonellain river water, foods and foodborne disease patients after flood disaster had relevance and unique characteristics.

Analysis on infection source of the first case of human infection with avian influenza A (H7N9) virus in Daxing district of Beijing, 2017

Qiuling Li, Yanqing Gao, Wenjun Hou, Jinfeng Tang, Limin Zhou, Tianchi Zheng, Bofeng Wu, Dating Chen, Han Wang, Hongyan Cui, Jiangtao Han

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.10.0225

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Objective To understand the infection source of the first case of human infection with avian influenza A (H7N9) virus in Daxing district of Beijing in 2017, and provide scientific evidence for the prevention and control of human H7N9 virus infection. Methods Field epidemiological investigation and laboratory testing method were used to trace the possible source of infection. Results The exposure to live poultry of the case occurred one week before the onset of the disease. Throat swabs, deep cough sputum fluid, and serum samples of case were nucleic acid positive for H7N9 virus. H7N9 virus nucleic acid was detected in both live poultry and its environment. Seven other exposed individuals and close contacts were found to be nucleic acid negative. Sequencing analysis of hemagglutinin (HA) gene and neuraminidase (NA) gene showed no significant variation. Conclusion Live poultry exposure history was one of key risk factors of H7N9 virus infection. The source of infection was live poultry purchased from a floating market. The sequencing of the virus and the HA0 cleavage site of the virus indicated that the virus belongs to the virus of H7N9 Yangtze River Delta branch and is a low-pathogenic avian influenza virus.

Molecular epidemiology of rotavirus in infectious diarrhea patients in Taizhou, 2015−2016

Weiwei Shen, Ying Sheng, Jian Weng, Donghong Wang, Danhong Qiu, Congcong Li, Yaya Guan, Xiaoxiao Zhou, Haijiang Lin

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.10.000

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Objective To analyze the epidemiological characteristics of rotavirus infection and molecular characteristics of rotavirus in Taizhou, Zhejiang province. Methods Stool samples and information of patients with infectious diarrhea were collected from 2 sentinel hospitals in Taizhou from 2015–2016. The dual-fluorescence PCR was used to detect A/B group rotaviruses. The G/P genotyping and sequencing of all group A rotavirus-positive samples were performed. The homology and phylogenetic relationship of VP7 gene of major types were analyzed. Results Eighty-one strains of rotaviruses were detected in 1 589 diarrhea samples (5.10%), in which group A rotavirus accounted for 98.77% (80/81) and group B rotavirus accounted for 1.23% (1/81). The results showed the differences in incidence of rotavirus infection among age groups, seasons and occupations were significant, but there were no gender and living place specific significant differences. The group A rotavirus genotype mainly included G9P［8］(53.75%), G2P［4］(25.00%), G3P［8］ (11.25%), G1P［8］(2.50%), G4P［6］(2.50%). The study showed that G9P［8］ genotype was mainly G9-Ⅵsubtype according to the homology and evolutionary analysis of VP7 gene. The rotaviruses with same genotype were highly homogenous. Conclusion Rotavirus is a common pathogen causing diarrhea in Taizhou. Genotyping and evolution analysis showed the diversity and stability of group A rotavirus in this area. It is suggested to include G9 type rotavirus into vaccine strains, and conduct consecutive etiological surveillance in susceptible populations, especially young children.

Hypopsia surveillance in primary and middle school students in Zhejiang, 2017

Fang Gu, Yuanyuan Zhan, Ronghua Zhang, Jia Meng, yan Zou

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.018

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Objective To understand the epidemiological characteristics of hypopsia in primary and middle school students in Zhejiang province, and provide scientific evidence for the prevention and control of hypopsia. Methods Using stratified cluster sampling method, the eyesight of primary and middle school students in areas with different economic levels, urban and suburban areas of Zhejiang province was surveyed. GB/T 26343－2010 was used to detect the visual acuity of the naked eye. hypopsia was defined as baked eye vision ＜5.0. Software SPSS 17.0 was used for statistical analysis, χ² test was done for rate comparison and Goodman-Kruskal Gamma test was conducted for correlation analysis. Results A total of 8 343 primary and middle school students in Zhejiang were surveyed, the hypopsia rate was 73.53% and severe hypopsia rate was 47.03%. The primary school students, junior high school students and senior high school students with hypopsia accounted for 55.99%, 81.51% and 86.73%, the differences were statistically significant （χ²＝783.526, P＜0.001）. The hypopsia prevalence was higher in urban students, or in girls. Students with better economic conditions had the higher prevalence of hypopsia （χ²＝80.206, P＜0.001）. Conclusion The eyesight level of primary and middle school students in Zhejiang is much lower than national level. It is necessary to strengthen the prevention and control of hypopsia in students, the key populations are high grade students of primary schools and students of junior high school, especially girls as well as the boys in grade 9–10, who are prepared to enter a higher school.

A survey of deworming with praziquantel in domestic dogs infected with Echinococcus in Huanxian, Gansu

Zijing Liu, Ning Xiao, Lijie Zhang, Yu Feng, Pengfei Ge, Fan Li, Junrui Zhang, Ruixia Yan

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.015

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Objective To assess the performance of deworming with praziquantel in domestic dogs in the endemic area of echinococcosis in Huanxian county of Gansu province, identify the factors influencing the deworming in domestic dogs and further control the infectious source of echinococcosis. Methods Three townships were selected through stratified sampling in 12 townships in Huanxian according to the positive rate of Echinococcus antigen in dog feces (high, medium and low levels). One natural village was selected randomly from each selected township and all the dog owners in the selected villages were investigated. We collected the information about the frequency of praziquantel distribution, the feeding pattern of praziquantel and the attitude of dog owners to dog deworming by using standard questionnaire. Results Among 138 dog owners, only 30 (21.74%) gave their dogs monthly deworming during July 2016–June 2017. The proportion of monthly deworming was 8.51% (4/47) in the village praziquantel where praziquantel tables were distributed every 10 months, while it was 26.83% (11/41) in the village praziquantel where praziquantel tables were distributed every 6 months and 30.00%(15/50) in the village praziquantel where praziquantel tables were distributed every 4 months (trendχ² ＝5.8, P＜0.05). The main reasons for failing to monthly dog deworming included that the dog owners forgot to medicate (26.85%, 29/108), no praziquantel was supplied for dog owners (25.93%, 28/108) and dog owners misremembered the frequency of deworming (24.07%, 26/108). The swallowing rate of praziquantel tables in dogs was 75.00% (135/180). Conclusion The swallowing rate of praziquantel tables in dogs was high in Huanxian, while the proportion of monthly deworming by dog owners was not high enough. The main reasons included that the dog owners forgot to medicate or misremembered the frequency of deworming. It is suggested to increase the frequency of praziquantel distribution and remind the dog owners more frequently. Government should play a leading role in the control of echinococcosis by coordinating prevention efforts and set up a supervision mechanism to ensure the monthly deworming for every dog.

Epidemiological characteristics of tuberculosis in Yangquan, Shanxi, 2000–2017

Lihong Jing, Rien Cai, Yifei Feng, Yongbao Wang

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.008

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Objective To analyze the epidemiological characteristics of tuberculosis (TB) in Yangquan, Shanxi province, and provide scientific evidence for the development of TB prevention and control strategy. Methods Descriptive epidemiological analysis was conducted by using the incidence data of TB in Yangquan during 2000–2017. Results A total of 12 462 TB cases were reported in Yangquan from 2000 to 2017, the average annual incidence was 52.40/100 000. The lowest incidence was 32.02/100 000 in 2015, the highest incidence was 79.05/100 000 in 2005. The differences in annual incidence of TB were significant (χ²＝978.412, P＝0.000). Yuxian county had reported highest incidence since 2006, and the incidence showed an increasing trend in recent years. The differences in TB incidence among different counties were significant (χ²＝252.028, P＝0.000). There were 3 624 TB cases reported from March to June, accounting for 29.08%. The male to female ratio of the TB cases was 2.10∶1. Among the reported cases, 6 668 cases occurred in age group 20–49 years, accounting for 53.51%. 5 336 cases occurred in farmers, accounting for 42.82%, and 1 023 cases occurred in students, accounting for 8.21%. Conclusion The incidence of TB increased year by year in Yangquan during 2000–2005, and showed a marked decrease during 2005–2017. Farmers and students were the populations at high risk. It is necessary to improve the standardized management of TB cases and implement comprehensive TB prevention and control measures to effectively control the incidence and prevalence of TB.

Establishment and application of molecular quality control methods for standard strains for food inspection

Xiao Xu, Jichun Shi, Chune Wang, Li Liang, Kang Li, Wenyuan Sun, Cuiping Chen, Qiang Ye

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.011

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Objective The molecular quality control methods were established and applied for the standard strains of food inspection. Methods The different molecular methods, such as 16S rRNAgene sequence analysis, pulsed-field gel electrophoresis (PFGE), and multi locus sequence typing, were used for the molecular confirmation of the standard strains of food inspection used according to national food safety standards, and they were verified by the different batch strains. Results The results obtained after 16S rRNA gene sequence alignment were consistent with the genus of the strain and the 16S rRNA gene sequences of different batch standard strains were identical; Sequence typing (ST) type of the standard strains were identified and the ST of different batch isolates were identical. The research on the method of PulseNet was exploded on the strains without the standard method to obtain the suitable condition of restrictive endonuclease and electrophoresis parameters. The methods were then used to establish molecular fingerprints of standard strains. The PFGE profile similarity of different batches was 100%. Conclusion The molecular biology technology was applied on the quality control of the standard strains for the first time in this study. It hit the bottleneck of traditional quality control methods. The stability of the standard strains was assessed at the molecular level to ensure the stability and consistence of the standard strains in the food inspection process.

Analysis of prevalence of dyslipidemia and related risk factors in Uygur adults in Kashgar of South Xinjiang

Yaohui Li, Zhenxiang Xue, Wen Wang, Dongmei Luo, Xuelian Song, Tongmin Wang, Bawudun Ayxamgul·, Mamatiemin Munirzecz·, Nurmamat Nazibam·, Ziyan Zhou, Zhoubin Zhang

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.017

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To investigate the prevalence of dyslipidemia and related risk factors in Uygur adults in Kashgar of South Xinjiang. Methods Through cluster random sampling, Uygur adults aged ≥18 years were selected for analysis. Questionnaire survey, physical examination and laboratory detection were conducted for each participant. The population distribution of dyslipidemia was described, and risk factors were explored using non-conditional logistic regression analysis. Results Finally, 4 504 eligible participants were included in our analysis. The total prevalence of dyslipidemia was 50.84%, the prevalence of low high density lipoprotein cholesterol (HDL-C) was 46.65%, the prevalence of high triglyceride (TG) was 12.79%, the prevalence of high low density lipoprotein cholesterol (LDL-C) was 3.46% and the prevalence of high total cholesterol (TC) was 1.18%. The age-adjusted prevalence was 49.41%, 45.87%, 11.47%, 2.98% and 0.95%. The results of multivariable non-conditional logistic regression analysis showed that compared with females, males had 1.56 times higher risk of dyslipidemia (OR＝2.56, 95% CI: 2.22–2.95). Overweight (male:OR＝1.52, 95% CI:1.16–1.98; female:OR＝1.55, 95%CI:1.27–1.89), obesity (male:OR＝3.15, 95% CI:2.16–4.61; female:OR＝2.09, 95%CI:1.69–2.60), abdominal obesity (male:OR＝2.01, 95% CI:1.53–2.65; female:OR＝1.78, 95% CI:1.43–2.22）and diabetes in females (OR＝1.64, 95% CI:1.27–2.12) were the risk factors for dyslipidemia. Compared with the women with normal weight (BMI ＜24 kg/m²), the prevalence of dyslipidemia increased with the increase of BMI in both men and women (χ²＝384.69, P＜0.001). Overweight men (OR＝5.55, 95%CI: 4.03–7.63) and the obese men (OR＝11.77, 95% CI: 7.94–17.45) had higher risk for dyslipidemia (P _interaction ＝ 0.030), and the prevalence of low HDL-C also increased significantly (P_interaction＝0.039). Conclusion prevalence of dyslipidemia in Uygur adults in Kashgar was at relatively high level, especially low HDL-C. Synergic effect between BMI and gender had significant influence on prevalence of dyslipidemia and low HDL-C. More attention should be paid to overweight, obesity, and abdominal obesity, especially blood the lipid control in overweight and obese males.

2017－2018年流感季节美国流感活动以及2018－2019年流感季节流感疫苗的组成建议

Fuzhe Gong, Zhenyu Gong

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.021

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Abstract:
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Establishment and evaluation of high-throughput fluorescent PCR assay for identifying 16 kinds of Staphylococcus aureusenterotoxins

Le Zuo, Yinxiang Jiang, Xiaolu Shi, Yaqun Qiu, Yiman Lin, Min Jiang, Qinghua Hu

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.012

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Objective To establish a high-throughput fluorescent PCR assay (fluorescent probe melting curve method) for the identification of 16 kinds of Staphylococcus aureus enterotoxins. Methods Primers were designed according to S. aureus enterotoxin SEA-SEQ gene sequences with the different annealing temperature, and the PCR assay was established, then the limit detection, sensitivity, specificity and repeatability of the assay were evaluated by detecting 158 strains of food borne S. aureus in comparison with conventional PCR. Results The limit detection of the established PCR assay ranged from 0.80 ng/μl to 2.15 ng/μl. The specificity was 100.0%, no cross fluorescence signal was produced, and the coefficient of variation was lower than 1%. Compared with conventional PCR, the sensitivity and specificity of new PCR assay were 95.4% and 100.0%, the Kappa was 0.88. Conclusion The established PCR assay is rapid, accurate and specific and can be used to identify all the 16 kinds of enterotoxins of S. aureus.

Risk assessment of public health emergencies concerned in the mainland of China, September 2018

Ling Meng, Yu Li, Rui Wang, Xiaoye Wang, Hongjun Zhou, Jinghuan Ren, Dan Li, Zhiheng Hong, Wenxiao Tu, Guoqing Shi, Nijuan Xiang

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.003

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Objective To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in September 2018. Methods An internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this video conference. Results Generally speaking, it is predicted that the incidence of communicable diseases and public health emergencies would be higher in September than in August in 2018. The high incidence season of dengue fever would come, and the risk of its local transmission in southern provinces and flood-stricken areas would increase. It is still the high incidence season of food poisoning, and the risk in students and during the vacations of Mid-Autumn Festival and National Day would increase. Japanese encephalitis might still occur. The risks of communicable disease outbreaks such as hand, foot and mouth disease, varicella, mumps and influenza occurred in schools would increase. Disaster affected communities are at high risks of waterborne, foodborne and vector-borne diseases as well as other contagious communicable diseases. The risk of importation of Ebola virus disease from the Democratic Republic of Congo to the mainland of China is estimated to be low. Conclusion Close attention should be paid to dengue fever and food poisoning, and general attention should be paid to Japanese encephalitis, the public health risk caused by nature disaster such as flood, and Ebola virus disease in the Democratic Republic of Congo.

Clinical characteristics of brucellosis in acute phase in different age groups

Xiaochen Bai, Huihui Zeng, Bing Han, Chang Dou, Huali Sun, Meihua Song, Aibin Wang, Fang Qian, Yujiao Duan, Yanli Xu, Rui Song, Zhihai Chen, Rongmeng Jiang

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.09.009

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Objective To investigate the clinical characteristics of brucellosis in acute phase in different age groups. Methods The clinical data of 246 hospitalized brucellosis patients were retrospectively analyzed. The patients were divided into 5 groups: infant group (age 0–3 years), preschool group (age 3–7 years), adolescent group (age 7–18 years), young adult group (age 18–45 years) and middle age and elderly adult group (age 45–77 years). Results The differences in fatigue (P＝0.015), hidrosis (P＝0.048), lower back pain (P＜0.001) and hepatosplenomegaly (P＝0.013) among the acute brucellosis patients in different age groups were significant. The laboratory test results of white blood cell count (P＝0.001), neutrophil percentage (P＜0.001), lymphocyte count (P＜0.001), serum alanine transaminase (P＝0.024), aspartate aminotransferase (P＜0.001), ALB (P＜0.001), C-reactive protein (P＜0.001) and erythrocyte sedimentation rate (P＜0.001) also showed significant differences among the acute brucellosis patients in different age groups. Less children showed fatigue and hidrosis compared with the adults, but they were more susceptible to liver function damage and hepatosplenomegaly. While lower back pain mainly occurred in middle age and elderly adults, and C-reactive protein and erythrocyte sedimentation rate increased with age. Conclusion The clinical characteristics of acute brucellosis patients varied in different age groups. These characteristics should be taken into account in clinical diagnosis of brucellosis.

Evaluation of quality of measles surveillance in Wenzhou by using Rank-sum ratio, 2013–2016

Wancang Li, Jingjiao Wei, Lingping Chen, Xiaoyu Sun, Xiaochun Zheng, Zhigang Wang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.010

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ObjectiveTo conduct a synthetic evaluation of the quality of measles surveillance in Wenzhou of Zhejiang province from 2013 to 2016.MethodsRank-sum ratio (RSR) was used to evaluate 12 quality indicators of 3 categories in measles surveillance in Wenzhou during this period, the surveillance quality was evaluated according to rank-sum ratio size.ResultsAt county (district) level, Pingyang and Cangnan, Taishun, Yongjia and Wencheng, Longwan and Wencheng, Taishun were at higher rank in indicator quality of basic immune level, high probability of measles epidemic spread, measles surveillance and comprehensive evaluation, respectively. Ruian, Dongtou and Longwan, Lucheng, Lucheng and Longwan were at lower rank, respectively．ConclusionRSR method was flexible and simple, which has no specific requirements on samples, can eliminate the effects of comprehensive evaluation indexes of different dimension and has high applicable value in multiple indexes comprehensive evaluation of measles surveillance.

Isolation and identification of Zika virus in MRC-5 cell line

Xingle Li, Yi Li, Ruolin Wang, Jia Su, Kai Kang, Dacheng Guo, Bianli Xu, Xueyong Huang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.004

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Objective To culture, isolate and identify Zika virus in MRC-5 cell line. Methods MRC-5 cell line was used for Zika virus isolation from seminal fluid sample collected from a laboratory conformed Zika virus infection case, the cytopathic effect was observed, and the isolate was identified with real-time PCR. The Zika virus strain was sequenced and evolutionary analysis was conducted. Results The seminal fluid sample was cultured in MRC-5 cell line for three generations in blind passage. No obvious cytopathic effect was observed, but the real-time PCR result was positive. The Zika virus strain belonged to Asian genotype, which was named as Henan/001/2016 (GenBank No. MF593625). The strain was most close to Natal RGN strain genetically, the nucleotide homology and amino acid homology in E gene segment were 99.7% and 100% respectively. Conclusion MRC-5 cell line is suitable for the isolation and identification of Zika virus.

Molecular characteristics of two dominant serotypes Salmonella isolated in Zhuhai Guangdong

Yanmei Fang, Chunxiao Yang, Lirong Zhang, Bosheng Li, Quande Wei

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.005

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Abstract:
Objective To understand the antibiotic resistance and molecular characteristics of Salmonella typhimurium and Salmonella 1,4,［5］,12:i:– isolated in Zhuhai, Guangdong province, and provide reference data for molecular epidemiological investigation of food borne diseases. Methods Disk diffusion method was used for antibiotic susceptibility test. Pulsed-field gel electrophoresis (PFGE) and multiple loci variable number tandem repeat analysis (MLVA) were conducted for 121 strains of S. typhimurium and S. 1,4,［5］,12:i:– isolated from diarrhea patients in Zhuhai by using the protocols published on PulseNet International Network and European Food-borne Disease Surveillance Network. Results The antibiotic susceptibility test showed that 45 strains of S. typhimurium (45/51, 88.24%) and 51 strains of S. 1,4,［5］,12:i:– (51/70,72.86%) were multidrug resistant, the difference was significant (χ²＝4.256, P＝0.039). The antibiotics to which two serotypes strains' resistant rates were ＞50% were ampicillin, tetracycline, compound sulfamethizole and chloramphenicol. PFGE results indicated that the 121 isolates belonged to 88 types. There was no obvious clustering characteristics in two serotypes, but the types of S. typhimurium were more dispersed, the predominant 11 PT15 isolates had two serotypes. MLVA results indicated that STTR5 and STTR6 had highest repeat number (11 and 14), followed by STTR9 and STTR3. Up to 95.87% of the strains had no PCR amplification products. MLVA typing showed that there were 50 types. The predominant types were MT18 and MT10, which contained 23 and 11 isolates respectively, in two serotypes. Analysis with the minimum spanning tree (MST) found that 111 isolates (91.74%) were distributed in group I. Conclusion The multidrug resistant rates of two serotypes Salmonella in Zhuhai were high, their molecular types were diverse, but the type of S. typhimurium was more dispersed. They had similar genetic characteristics.

Analysis of distribution and drug resistance of bacteria in ICU and general wards of a teaching hospital

Lei Wang, Zixuan Yang, Haiquan Kang, Bing Gu

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.014

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Abstract:
A total of 12 307 strains of pathogenic bacteria firstly isolated form the patients in intensive care unit (ICU) and general wards in a hospital in 2016 were collected. The distribution of bacteria and their drug resistance were analyzed. Acinetobacter baumannii (25.50%) was the isolated pathogen ranking first in ICU, while Pseudomonas aeruginosa (16.68%) was the isolated pathogen ranking first in general wards. The antibiotic resistant rate of the pathogens from ICU was higher than that of the pathogens from general wards, and severe multi drug resistance was detected in the pathogen strains from ICU. It is necessary to standardize the antibiotic use strengthen the prevention of nosocomial infection to control the prevalence of drug resistance in ICU.

Field epidemiological investigation and control of a human adenovirus type 55 outbreak in a hospital

Yufang Yang, Xiuying Li, Xinjin Yang, Maoyu Chen, Jianhua Liang, Fengjuan Huang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.019

[Abstract](199) [FullText HTML](118) [PDF 1943KB](15) [peer reviewing opinions] Related References Cited By (0) Share

Abstract:
Objective To understand the epidemiological characteristics of an outbreak of human adenovirus type 55 infection in a class Ⅱ (A) hospital in Jiangmen, Guangdong province, in July, 2015, and provide evidence for the control of the epidemic. Methods The standard questionnaire was used for the field survey. The definition of case was established and the cases′ epidemiology characteristics were described. Throat swabs of the patients were collected and RT-PCR was conducted for pathogen detection. The comprehensive prevention and control were carried out based on the investigation results. Results A total of 43 cases were detected from 21 June to 8 July in 2016, no severe case or death occurred. Human adenovirus type 55 infection was confirmed by the results of throat swab testing. Infections mainly occurred in the department of neurosurgery (41 cases, 95.35%) and its attack rate was 24.12% (40/170). The spread of the infections was stopped by a series of prevention and control measures. Conclusion This outbreak was caused by the human adenovirus type 55. The infection was mainly transmitted by respiratory droplets spread and through close contacts. It is suggested to consider human adenovirus infection in clinical diagnosis of respiratory diseases to improve the diagnosis of respiratory infectious diseases.

2018年8月中国甲乙丙类传染病疫情动态概要

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.002

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Abstract:
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Study on change trend of blood pressure and related factors in 40 819 pregnant women in Zhoushan, Zhejiang

Liuyan Pu, Jinhua Wu, Manxian Huang, Yingying Shao, Minchao Li, Minjia Mo, Shuying Jiang, Muyiduli Xiamusiye, Bule Shao, Shuojia Wang, Yunxian Yu

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.016

[Abstract](205) [FullText HTML](76) [PDF 773KB](3) [peer reviewing opinions] Related References Cited By (0) Share

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Objective To describe and analyze the change trend of blood pressure and related factors in 40 819 pregnant women in Zhoushan of Zhejiang province. Methods The change trend of blood pressure in 40 819 pregnant women who had perinatal health care and delivery in Zhoushan Maternal and Child Health Care Center from January 2001 to December 2016 were described. The influence factors were analyzed by using multi factor generalized estimation equation. Results The average systolic blood pressure (SBP) and diastolic blood pressure (DBP) of pregnant women increased with gestational age. The higher the age of pregnant women and their body mass index (BMI) before pregnancy were, the higher the level of blood pressure during pregnancy was. The higher the pregnant women’s educational levels were, the higher the DBP of pregnant women were during pregnancy, but the effect on SBP was not significant. The birth history of pregnant women and the sex of the fetus had no significant influence on pregnant women’s blood pressure. The results of multivariate analysis showed that pre pregnancy BMI, maternal age, gestational age and educational level were related to SBP and DBP during pregnancy. Conclusion The age, BMI before pregnancy, gestational age and educational level of pregnant women were the main factors influencing the rise of blood pressure during pregnancy. Therefore, the monitoring and management of pregnant women’s blood pressure should be carried out throughout the pregnancy. For the weight management, special attention should be paid to the management of blood pressure in pregnant women who are overweight or obese before pregnancy and in older pregnant women.

Epidemiological characteristics of tuberculosis in Nanshan district of Shenzhen, 2005–2016

Tao Zhong, Shengyuan Liu, Guangxing Zhan, Guiyuan Han, Yao Huang, Juan He, Yuzheng Fan, Yarui Yang, Lijuan Wu

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.006

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Objective To understand the epidemiological characteristics of tuberculosis（TB） in Nanshan district of Shenzhen from 2005 to 2016. Methods Descriptive epidemiological analysis was conducted on the distribution of TB in local residents in Nanshan district during this period. The reported incidence rate of TB was analyzed by using software SPSS 13.0 and the incidence rate was compared with χ² test. Results The annual average reported incidence rate of TB was 85.72/100 000 in Nanshan district during this period. The annual average reported incidence rate of TB was 101.19/100 000 in males and 67.57/100 000 in females （χ²＝423.111, P＝0.000）. Patients were mainly young adults, and the incidence showed an increase in those aged ＞45 years. The TB cases were mainly distributed in workers, the jobless/unemployed and staff. The incidence in workers was in decline, but the incidence in staff was in increase. The seasonality of TB epidemic was obvious, the annual cases were mainly reported during March - May and in September. Conclusion After taking a variety of prevention and control measures, the reported incidence rate of TB showed a decline trend in Nanshan district from 2005 to 2016, and it declined to 52.86/100 000 in 2016. The TB epidemic was effectively controlled.

Surveillance for measles antibody level in healthy population in Changping district of Beijing, 2017

Tao Wang, Haihong Wang, Wenjuan Yi, Xinhai Yuan, Zonglong Zhu, Junying Yang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.007

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Objective To understand the measles antibody level in healthy population in Changping district of Beijing, discover the susceptible population and disease spread risk, and provide scientific evidence for measles elimination strategies. Methods Blood samples were collected from 300 healthy persons selected through simple random sampling in Changping for the detection of serum IgG against measles virus with enzyme linked immunosorbent assay (ELISA). Results The measles antibody positive rate was 82.22% in healthy population in Changping, and the geometric mean concentration (GMC) of the antibody was 1 109.59 mIU/ml. The difference in GMC was not significant between age group 1–4 years and age group 5–9 years (F＝0.734, P＞0.05). The differences in measles antibody positive rate and GMC between males and females and among the people with different household registration status and doses of measles vaccination had no significance. After the immunization of measles-containing vaccine (MCV), the differences in measles antibody positive rate and GMC among age groups ＜1 year, 1–4 years and 5–8 years were not significant. Conclusion The positive rate of measles antibody was at high level in healthy population in Changping, but it is still necessary to strengthen the MCV immunization in adults and other age groups at risk, especially in college students.

2018年8月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Disease in August 2018

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.001

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Cost estimation of hepatitis B vaccine immunization in obstetrics departments of hospitals in Beijing

Pei Gao, Dan Wang, Shiwen Shi, Min Lyu, Xuefeng Shi, Jiang Wu, Yiwei Guo, Xi Wang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.000

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Abstract:
Objective To estimate the cost of hepatitis B vaccine (HBV) immunization and its change pattern in the obstetrics departments of hospitals in Beijing, and provide data support for policy-making and evaluation of HBV immunization efficiency. Methods Data collection was conducted through field investigation and questionnaire survey. Database was established with ACCESS, and data were entered twice. Data analysis was performed with software SAS 9.4 and Excel 2016. Results From 1992 to 2013, the overall cost HBV immunization in obstetrics departments of hospitals in Beijing increased from 410 011.42 yuan to 4 344 244.00 yuan, with an annual growth rate of 11.90%; and the unit cost increased by 7 times, from 5.38 yuan to 37.25 yuan, with an annual growth rate of 9.65%. The cost of HBV immunization mainly originates from labor cost. Therefore, to some extent, the growth of overall cost of HBV immunization in hospitals is due to the increase of labor cost. Conclusion In the obstetrics departments of hospitals in Beijing, both the overall cost and the unit cost of HBV immunization showed an obvious increasing trend. The growth rate of unit cost was lower than that of total cost, and the growth of total cost mainly attributed to the increase of labor cost.

An investigation of foodborne disease caused by eating moringa oleifera seed in school

Jian Sun, Jinshui Zeng, Zhengxing Hu, Lijie Zhang, Xindong Zhang, Jialin Yu, Hao Li, Hua Jiang, Langwen Li, Yi Qiu

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.000

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A foodborne disease outbreak occurred in Shuitian Experimental School in Baoan District of Shenzhen in May 2017. The investigation found that Moringa oleifera seed, which was bought through the Internet, was the pathogenic food for this outbreak. It is important to strengthen the management of food safety in schools, and on the other hand, the management of online food sale should be strengthened too.

Epidemiological characteristics of public health emergencies in Guangzhou, 2007–2016

Xiaowei Ma, Jing Feng, Ruonan Zhen, Zhiwei Wang, Chaojun Xie, Jiandong Chen, Yongguang Li, Xinlong Liao, Xincai Xiao

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2018.09.000

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Objective To analyze the epidemiological characteristics of public health emergencies in Guangzhou, Guangdong province, and provide scientific evidence for the effective prevention and control of public health emergencies. Methods The incidence data of public health emergencies in Guangzhou from 2007 to 2016 were collected from " China Disease Reporting Information System” for a descriptive epidemiological analysis. Results A total of 920 public health emergencies were reported in Guangzhou during this period, involving 62 562 disease cases and 65 deaths. Unclassified events and communicable disease epidemics accounted for 83.04% and 93.04%, respectively. There was positive correlation between number of public health emergencies and local population density with the Spearman correlation coefficient of 0.198 (P＜0.05). Most public health emergencies occurred in schools, accounting for 74.41%. The median duration of epidemic was 11.08 d (ranging from 0 to 168.41 d), while the median interval between the onset of index case and online reporting was 6.32 d (ranging from 0 to 86.72 d). The correlation was positive with the Spearman correlation coefficient of 0.433 (P＜0.001). Conclusion The public health emergencies were mainly communicable disease epidemics in Guangzhou from 2007 to 2016, which mainly occurred in schools. The sooner report the epidemic, the shorter the epidemic duration was. Therefore, it is necessary to strengthen the surveillance for public health emergencies for the early reporting and early response to reduce the spread of related diseases.

Characteristics of vaccine-associated proteins of Neisseria meningitidis B and coverage of fHbp and NHBA candidate vaccines in Shanghai

Mingliang Chen, Genpeng Wu, Ping Yuan, Chi Zhang, Xi Zhang, Guoying Huang, Min Chen, Wei Zhu

Corrected proof , DOI: 10.3784/j.issn.1003-9961.2018.08.00x

[Abstract](182) [FullText HTML](82) [PDF 3415KB](8) [peer reviewing opinions] Related References Cited By (0) Share

Abstract:
Objective To characterize vaccine-associated proteins of Neisseria meningitidis B in Shanghai and provide evidence for the development of vaccine against N. meningitidis B. Methods During 2006–2013,N. meningitidis B isolates were collected in Shanghai. Recombinant proteins of fHbp and NHBA were constructed and expressed to prepare immunization sera for bactericidal antibody test. Results During 2006–2013, a total of 31N. meningitidis B isolates were collected, which showed 28 sequence types and 31 PFGE types. The fHbp sub-family B (63.64%, 7/11) was predominant in invasive isolates, while sub-family A (90.00%, 18/20) was predominant in healthy carriage isolates. Except the predominance of NadA-3 in NadA protein, no predominant variants of NHBA or PorA were found in N. meningitidis B isolates. ST-4821 complex (CC4821) was predominant in N. meningitidis B isolates, mainly including fHbp sub-family A variant 2.16 (54.55%, 6/11). In serum bactericidal assay, the antisera of fHbp sub-family A and B showed bactericidal activity to 60% and 100% of isolates with the same sub-family fHbp protein as the recombinant protein, respectively, while 20% of isolates with other sub-family fHbp protein. The antiserum of NHBA protein showed bactericidal activity to all the tested isolates. Conclusion CC4821 has become the predominant clonal complex in N. meningitidis B isolates from Shanghai. Varied vaccine-associated proteins in N. meningitidis isolates poses challenge to the development of vaccine against N. meningitidis B in China.

Epidemiological investigation of the first imported Chikungunya fever in Wenzhou, Zhejiang

Xianchuan Zhang, Chaorong Ni, Xiaoming Zhang, Qiongjiao Pan, Ling Li

Corrected proof , DOI: 10.3784/j.issn.1003–9961.2018.07.000

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Abstract:
On September 9, 2017, a businessman from Bangladesh was confirmed to be infected with Chikungunya fever virus by the Baiyun airport port inspection department of Guangzhou Entry-Exit Inspection and Quarantine Bureau. On the same day, the businessman arrived in Wenzhou and checked in a local hotel. It was the first confirmed Chikungunya fever case in Wenzhou. A series of prevention and control measures were taken timely by Wenzhou center for disease control and prevention to prevent the secondary ceases. It is necessary to strengthen disease surveillance capability and improve public health emergency response to prevent the possible outbreak of diseases.