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Articles in press have been peer-reviewed and accepted, which are not yet assigned to volumes/issues, but are citable by Digital Object Identifier (DOI).

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Distribution and drug susceptibility of pathogens causing bloodstream infections isolated in Sichuan Cancer Hospital, 2012–2016
Sujiao Ni, Xiaoyu Song, Pingyao Xu
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Objective To investigate the distribution and drug susceptibility of pathogens causing bloodstream infection isolated from blood samples of cancer patients in Sichuan Cancer Hospital from January 2012 to December 2016 and provide evidence for the rational use of antibiotics. Methods The drug susceptibility of the pathogen strains isolated from the cancer patients were analyzed with software WHONET 5.6 according to the breakpoints of Clinical and Laboratory Standards Institute in 2016. Results A total of 603 pathogen strains were isolated from blood samples of the cancer patients, including 165 gram positive cocci strains, 434 gram negative bacilli strains and 4 fungi strains, respectively. In the all cancer patients, the pathogen isolation rate was highest in cervical carcinoma patients, Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, coagulase negative Staphylococcus and Enterobacter cloacae were the most common pathogens isolated, accounting for 34.33%, 13.27%, 9.29%, 6.80% and 4.98%, respectively. Methicillin resistant strains accounted for 12.50% and 73.17%, respectively, in S. aureus and coagulase negative Staphylococcus isolates. The strains of Enterobacteriaceae were still highly sensitive to carbapenems, less than 5.00% of these strains were resistant to carbapenems. In contrast, Acinetobacter baumannii was highly resistant to carbapenems, and about 80.00% of A. baumannii strains were resistant to imipenem and meropenem, respectively. Conclusion Enterobacteriaceae was the main pathogens isolated from the blood samples of the cancer patients. Their drug susceptibilities varied. The resistance of A. baumannii to carbapenem was serious. Therefore, it is necessary to use antibiotics rationally according to the type of cancer and related drug susceptibility test results.
Relationship between wzy genes and serotype of Streptococcus suis
Jianping Wang, Pengcheng Du, Xuemei Bai, Han Zheng
Corrected proof
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Objective To study the relationship between serotype-specific wzy genes and serotype of Streptococcus suis and evaluate the feasibility of Whole-Genome Sequencing (WGS) -based serotyping strategy for the serotype-specific wzy genes. Methods Amino acid database of 54 wzy genes (1–31, 33, 1/2, NCL1-20 and Chz) for serotyping was established. All 767S. suis isolates available with WGS data and conventional serotype information were subjected to WGS-based serotyping by using the database. Results Among the 767 genomes, 1 of 54 wzy genes was detected in 765 genome sequences. The remaining 2 genomes carried a novel wzy gene, named as NCL21 in this study. WGS-based serotyping predicted serotype of 94.13% (722/767) genomes, consistent with conventional serotyping. Discrepancy of two methods was observed in 45 genomes. The cps sequences of these genomes were obviously different from those of the serotype reference strains indicated by conventional serotyping method. Conclusion WGS-based serotyping strategy for the serotype-specific wzy genes of S. suis is superior to conventional serotyping method.
Fluconazole susceptibility and multi locus sequence typing of Candida glabrata and Candida tropicalis Isolated from environment
Hao Zheng, Wenge Li, Wenpeng Gu, Xiaoping Chen, Jinxing Lu
Corrected proof
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Objective To understand the drug susceptibility and molecular epidemiological characteristics of Candida glabrata and Candida tropicalis strains isolated from leaves, barks and humus, compare the phylogenetic relationship between environmental isolates and clinical isolates and provide evidence for epidemiological investigation and effective control of invasive Candida infection. Methods A total of 200 environmental samples were collected in Yunnan province. The samples were inoculated on Sabouraud dextrose agar plate for Candida culture and isolation. The genomic DNA of the isolates was extracted, and the isolate species were identified through Internal Transcribed Spacer (ITS) region amplification and sequencing; Antifungal susceptibility testing was performed for each C. glabrata or C. tropicalis isolate by using broth micro dilution reference method; Multi locus sequence typing (MLST) was performed for the genotyping of the isolates. The phylogenetic relationship was analyzed by using eBURST V3 package. Results A total of 3 C. glabrata strains (1.5%) and 10 C. tropicalis strains (5.0%) were isolated from 200 environmental samples. All the isolates were sensitive to fluconazole. MLST indicated that ST3 was the only sequence type of C. glabrata. Among 10 C. tropicalis strains, 7 DSTs were identified by MLST, including 4 new DSTs (DST813–DST816). CC3 was the major clonal complex of environmentalC. glabrata strains. CC730 was the major clonal complex of environmental C. tropicalis strains. Conclusion The environmental isolates might share the same origin strain with clinical isolates. C. glabrata and C. tropicalis isolated from leaves, barks and humus might be the potential source of human infection, posing a serious health threaten to human health.
Epidemic and death case analysis on human infection with highly pathogenic avian influenza A (H7N9) virus in the mainland of China, 2016–2018
Chao Li, Ruiqi Ren, Dan Li, Yanping Zhang, Daxin Ni, Qun Li, Siyan Zhan, Lei Zhou
Accepted Manuscript
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Objective To analyze the epidemic and death cases of human infection with highly pathogenic avian influenza (HPAI) A (H7N9) virus in the mainland of China from 2016 to 2018, and provide evidences for reducing the severity and disease burden of human infection with highly pathogenic avian influenza virus. Methods Based on the existing surveillance data of human infection with HPAI A (H7N9) virus in China, descriptive epidemiological analysis was conducted on the time, area and population distributions of cases infected with HPAI A (H7N9) virus in China, and the epidemiologic and clinical characteristics of survival cases and death cases were compared. Results Since December 2016, a total of 32 cases of human infection with HPAI A (H7N9) virus, including 13 deaths, had been reported from 8 provinces in China. The case fatality rate was 40.63%, the difference was not significant compared with the cases infected with low pathogenic avian influenza A (H7N9) virus (37.98%) (χ2＝0.090, P＝0.763). The median age of the cases was 59 years, and the male to female ratio of the cases was 1.67∶1. Up to 81.25% of the cases were farmers. There were no significant differences in population, time and area distributions as well as key time interval in the course of disease, exposure history and underlying medical condition between the survival cases and the death cases. The results showed that acute respiratory distress syndrome, renal failure, cardiac failure and septic shock might be the risk factors resulting the deaths of the cases of HPAI A (H7N9) virus infection. Conclusion The case fatality rate of human infection with HAPI A (H7N9) virus in the mainland of China was relatively high during 2016–2018. The occurrence of specific clinical manifestations might predict the severe outcomes. It is necessary to strengthen the research and training on clinical diagnosis and treatment of human infection with highly pathogenic avian influenza virus in order to alleviate the severity of the disease.
Optimization of vancomycin resistant Enterococcus infection model in mice
Siyi Zhu, Xianping Li, Liqiong Song, Yuchun Xiao, Yuanming Huang, Qiongfang Chu, Zhihong Ren
Accepted Manuscript
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Objective To optimize the intestinal colonization model of vancomycin resistant Enterococcus (VRE) in mouse model, and evaluate the effect of antibiotic pretreatment and different infection dosages on the intestinal VRE colonization. Methods C57/6J mice were randomly divided into 3 pretreatment groups, which were mixed antibiotic pretreatment group, ampicillin and clindamycin pretreatment group and vancomycin pretreatment group. In mixed pretreatment antibiotic group, the mice were given mix antibiotic solution (kanamycin, gentamicin, colistin, metronidazole, vancomycin) on day 7 before infection; on day 2 before infection, vancomycin solution was given instead of the mixed antibiotic solution, and intraperitoneal injection of clindamycin was given on day 1 before infection. In ampicillin and clindamycin pretreatment group, the mice were given ampicillin solution on day 7 before infection, and intraperitoneal injection of clindamycin was given 1 day before infection. In vancomycin pretreatment group, vancomycin solution was given on day 7 before infection. On day 0, three groups of mice were infected with VRE. On day 3 after infection, vancomycin solution and ampicillin solution were changed to normal drinking water. The collected fecal live bacteria were counted within 2 weeks after infection, and changes of VRE colonization were observed. Results Three antibiotic-pretreated mouse models infected with VRE were successfully established, and VRE were successfully colonized on day 1 after infection. Within 1–9 days after infection, the VRE contents in feces of the three models was 105–108cfu/mg. Nine days after infection, the colonization of VRE in the three mouse groups showed downward trends, and the content of VRE in the mouse feces decreased to 103–105cfu/mg on the 15th day. And, we observed that two mice died in the ampicillin group on day 10 after infection. There was no significant difference in VRE colonization between high dosage group and low dosage group during the acute infection period in vancomycin pretreated mice. Conclusion The stability and simplicity of vancomycin-pretreated mouse model was superior to those of the other two antibiotic-pretreated mouse models. By the end of the experiment, VRE could successfully colonize in the intestinal tract of the mice for more than 15 days in vancomycin pretreatment group, and the VRE intestinal colonization model could be established steadily at the infection dosages ranging from 105 cfu to 107 cfu per mouse.
Epidemiological characteristics of typhoid and paratyphoid in China and its spatial temporal clustering analysis in five provinces of China, 2014
Bo Yang, Qiaohong Liao, Biao Kan, Meiying Yan
Accepted Manuscript
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Objective To understand the epidemiological characteristics of typhoid and paratyphoid fever in China and its spatial temporal clustering in five provinces of China in 2014. Methods Descriptive statistical analysis was conducted by using the incidence data of typhoid and paratyphoid collected from Disease Surveillance Information Reporting System in 2014. ArcGis 10.5 was used to show the geographic distribution of typhoid and paratyphoid cases. SaTScan statistics was used to identify spatial and temporal clustering areas of typhoid and paratyphoid in Yunnan, Guizhou, Hunan, Guangxi and Guangdong provinces. Results A total of 13 768 typhoid and paratyphoid cases were reported without death in 2014, the overall incidence rate was 1.02/100 000, a decline of 1.92% compared with 2013. There were 10 460 typhoid cases (75.97%) and 3 308 paratyphoid cases (24.03%), a decline of 2.44% and 3.10% respectively compared with 2013. The peak of incidence was in summer (June-September), accounting for 46.23% of the annual cases. Most cases were farmers, followed by students and children outside child care settings. Spatial clustering analysis of typhoid and paratyphoid fever in five provinces indicated the first and second class clustering areas were mainly distributed in bordering areas of these provinces. Conclusion The incidence of typhoid and paratyphoid decreased with year in China, but the prevention and control of typhoid and paratyphoid should not be neglected in provinces with high incidence. Close attention should be paid to the increased incidence of typhoid and paratyphoid and related factors in non-surveillance areas. It is necessary to take targeted prevention and control measures according to the risk factors identified. The case clustering was obvious in some neighboring provinces, suggesting the possible transmission across the province border.
Awareness of brucellosis related knowledge and prevalence of risk behaviors in farmers and herdsmen in Zuoyun, Shanxi
Mengjie Geng, Liping Wang, Lijie Zhang, Lingjia Zeng, Xiang Ren, Cuihong Zhang, Zhongjie Li
Accepted Manuscript
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Objective To understand the awareness of brucellosis related knowledge and the prevalence of risk behaviors in farmers and herdsmen in Zuoyun county of Shanxi province, and provide reference for public health education about brucellosis prevention and control. Methods Farmers and herdsmen were selected in Zuoyun through stratified two-staged sampling, A self-designed questionnaire was used to collect the information about their awareness of brucellosis related knowledge, prevalence of risk behavior and self-protection. The differences in the knowledge awareness and risk behavior prevalence between farmers or herdsmen who had suffered from brucellosis and those who had never suffered from brucellosis were analyzed with χ2 test. Results Among the 491 subjects surveyed, 70.47% knew that brucellosis will lead to muscle pain, 41.96% knew the fever symptom of brucellosis, 12.63% had no knowledge about the common symptoms of brucellosis. 82.06% believed the delivery of livestock might lead to the infection with brucella, 56.08% thought slaughtering livestock might lead to the infection, 41.65% believed eating undercooked beef and mutton might lead to the infection. When delivering the lambs, 77.17% of the subjects surveyed never wore masks, 64.84% never wore protective gloves; when dealing with livestock apoblema, 81.99% never wore masks, 72.04% never wore protective gloves. Although the local health department have conducted the health education of brucellosis knowledge, but 41.55% of the subjects surveyed answered receiving no health education about brucellosis. The differences in the correct answer rate among farmers and herdsmen with different education background were significant (χ2＝16.360, P＜0.05); the rate of drinking raw milk was 56.25% in those who had suffered from brucellosis and 43.75% in those who had never suffered from brucellosis, the difference were significant (χ2＝7.914, P＜0.05). Conclusion This survey indicated the local farmers and herdsmen had low awareness of brucellosis related knowledge, which was much lower than the expected, they usually took no protection measures in contacting livestock. It is necessary to strengthen the health education about brucellosis prevention and control in local farmers and herdsmen to improve their self-protection and reduce the prevalence of brucellosis.
Multi Locus Sequence Typing of Neisseria meningitidis in Jinan, Shandong
Xiaoying Shan, Aiying Bai, Zunyu Liu
Accepted Manuscript
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Objective To study the molecular epidemiology of Neisseria meningitidis isolated in Jinan of Shandong province from 2005 to 2018. Methods Multi locus sequence typing (MLST) was used to characterize the N. meningitidis, and the data were analyzed with BioNumerics software. Results A total of 130 N. meningitidis isolates were isolated in Jinan from 2005 to 2018, including serogroupA, B, C, W135, Y and non-groupable (NG) strains. The N.meningitidis strains were classified into to 37 sequence types (STs), in which 2 serogroup A strains were classified into 2 STs, belonging to clonal complex 5 and unknown clonal complex; 24 serogroup B strains were classified into 17 STs, belonging to clonal complex 4821, clonal complex 162 and unknown clonal complex; 39 serogroup C strains were classified into 8 STs, belonging to clonal complex 4821, clonal complex 32 and unknown clonal complex; 54 serogroup W135 strains were classified into 3 STs, belonging to clonal complex 11 and clonal complex 4821; 1 serogroup Y strain was ST-92, belonging to clonal complex 92; 10 of NG strains were classified into 8 STs, belonging to clonal complex 4821, clonal complex 198 and unknown clonal complex. Among the 108 strains with known clonal complex, 48.15% (52/108) belonged toclonal complex 11 and 45.37% (49/108) belonged to clonal complex 4821. Twenty-two strains of unknown clonal complex belonged to 18 STs, in which 15 strains were in serogroup B, belonging to 10 STs. Conclusion The STs of N. meningitidis in Jinan from 2005 to 2018 showed polymorphism and it was obvious in NG and serogroup B strains. Clonal complex 4821 and clonal complex 11 were two predominant clones. N. meningitidis serogroup B showed polyclonal trend in Jinan.
2017年非洲和美洲的黄热病疫情概况
Zhenyu Gong, Xunliang Gong
Accepted Manuscript
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Analysis on underreporting of brucellosis in Shanxi, 2015–2016
Ping Tie, Yuhua Zheng, Yongfei Bai, Buyun Cui, Jing Chen
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Objective To understand the underreporting of brucellosis in Shanxi province, find out the problemsin reporting of brucellosis in medical institutions, estimate the epidemic situationand provide the evidence for prevention and control of brucellosis. Methods According to the ‘National Survey Protocol forthe Underreporting of Notifiable Communicable Diseases’, we investigated the underreporting of brucellosis in residents and medical institutions in Shanxi. Results A total of 60 180 residents were investigated, and 103 cases of brucellosis were identified and the average annual incidence was 171.15/100 000. Among these cases, 45 were not reported, the underreporting rate was 43.69%, and 44 were failed to be diagnosed, the missed diagnosis rate was 42.72%. Seventy eight medical institutionswere investigated, and 542 cases of brucellosis were identified, in which 140 were not reported, and the rate of underreporting was 25.83%. One in the 402 reported cases of brucellosis was not reported in time. The timely reported rate was 99.75%. Conclusion The underreporting of brucellosis was severe in Shanxi; which might be due to the diagnosis and treatmentof brucellosis cases in different medical institutions and the ambiguity of the type ofbrucellosis which should be reported. So it is suggested to clarify the reporting type of brucellosis. The ability of diagnosis of medical institutions above county level should be improved in order to reduce the underreporting of brucellosis.
Investigation of Legionella contamination in soil
Jing Zhang, Xueyang Jia, Hongyu Ren, Jianguo Li, Tian Qin
Accepted Manuscript
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Objective To understand the contamination of Legionella in soil and the molecular type, sensitivity to antibiotics and intracellular growth ability of isolated strains. Methods A total of 123 soil samples from public places in Beijing were collected. Legionella in soil was detected by GVPC (Legionella selective medium) culture and quantitative real-time PCR detection. The intracellular growth ability of the Legionella isolates were tested by cell culture methods with mouse macrophage J774. The genotypes of the isolates were determined by pulsed-field gel electrophoresis. Antibiotic sensitivity detection of the isolates was conducted with E-test. Results Quantitative PCR assay detected Legionella in flower & bird market samples and reservoir samples in summer. The positive rates were 50.00% and 24.24% respectively. The plate culture method only detected Legionella in reservoir samples in summer. The positive rate was 6.06%. All the two Legionella strains isolated, TR1 and TR2, were L. pneumophila, and the serotypes were type 5 and type 8 respectively. All the two strains of L. pneumophila had high intracellular growth ability. PFGE typing showed two different band types. The drug sensitivity test showed that the two strains were sensitive to erythromycin, azithromycin, rifampicin, levofloxacin and moxifloxacin. TR1 showed resistance to cefuroxime, and TR2 was sensitive to cefuroxime. Conclusions Legionella pneumophila was detected in the soil of public places, and the isolates have higher intracellular growth ability, indicating the pathogenicity of the strains and suggesting the potential of causing legionellosis epidemic. Therefore, we should strengthen the monitoring of Legionella in public places.
Epidemiological characteristics of leprosy cases newly detected in Zhejiang during 2011−2017
Limei Wu, Qiang Yao, Yunliang Shen, Lijuan Fei, Wenming Kong, Yongfang Hu, Yanmin Wang
Accepted Manuscript
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Objective To understand the epidemiological characteristics of the leprosy cases newly detected in Zhejiang province from 2011 to 2017 and provide evidence for the development of control strategy. Methods The incidence data of leprosy in Zhejiang from 2011 to 2017 were collected from National Leprosy Prevention Management Information System for a descriptive and comparative analyses. Results A total of 145 leprosy cases were reported in Zhejiang during this period, including 94 cases in males and 51 cases in females. The average age the cases was 38.64±15.14, and 93.79% of the cases were detected through the examination at dermatology clinics. There were 20 cases with grade 2 disability, and the rate of early detection increased from 45.16% in 2011 to 86.67% in 2017. Except Zhoushan, leprosy cases were reported in all the prefectures of Zhejiang. The cases in local population accounted for 24.14% (35 cases), and the cases in floating population accounted for 75.86% (110 cases). Conclusion The newly detected leprosy case 4 number declined steadily in Zhejiang from 2011 to 2017. Most cases were detected in an early time. It is necessary to strengthen the early detection and standard management of the leprosy cases in floating population in Zhejiang.
Analysis on antibiotic use and drug resistance of Escherichia coli and Klebsiella pneumoniae in a hospital in Yunnan, 2013–2017
Yanmei Huang, Dexuan Li, Jian Wang, Peng Hua, Hongli Tan
Accepted Manuscript
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Objective To analyze the antibiotic use in recent years in our hospital, analyze its influence on the prevalence of drug resistance of Escherichia coli and Klebsiella pneumoniae and provide guidance for the reasonable clinical use of antibiotics and the control and decrease of bacterial drug-resistance. Methods The use frequency and use dose of antibiotics, and the drug resistance level of E. coli and K. pneumoniae isolated in our hospital from 2013 to 2017 were investigated. Results The antibiotic use dose (AUD) increased year by year from 2013 to 2015 and decreased in 2016 in our hospital. According to the analysis of defined daily dose (DDD), the drug resistant rate of E. coli was positively correlated with the use frequencies of ceftazidime and cefuroxime, but negatively correlated with the use frequencies of other antibiotics. While the drug resistance rate of K. pneumoniae was obviously positively correlated with the use frequencies of meropenem and levofloxacin (r＝0.980, P＝0.003 and r＝0.902, P＝0.036), and positively correlated with use frequencies of ceftazidime, cefepime, gentamicin and cefoperazone/sulbactam, but negatively correlated with use frequencies of cefuroxime, imipenem and piperacillin/tazobactam. Conclusion The use frequencies of commonly used antibiotics had certain relationship with the drug resistance of E. coli and K. pneumoniae, especially the relationship between the high frequency uses of meropenem and levofloxacin and the drug resistance of K. pneumoniae, to which close attention should be paid.
Infection status and drug resistance of Campylobacter in diarrhea patients in Shunyi district of Beijing,2017
Yuanyuan Wang, Ying Li, Shuang Zhang, Yanchun Zhang, Hongmei Ma, Maojun Zhang
Accepted Manuscript
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Objectives To understand the incidence of diarrhea caused by Campylobacter in Shunyi district of Beijing and explore the detection methods for Campylobacter and analyze the drug resistance characteristics of Campylobacter. Methods A total of 372 stool samples were collected from patients with diarrhea in two hospitals in Shunyi in 2017 for Campylobacter, Salmonella, Shigella, Escherichia coli and Vibrio parahaemolyticus isolation. The filter membrane method was used in the isolation of Campylobacter. The isolated Campylobacter strains were tested for drug sensitivity. Results Among 372 stool samples, a total of 39 strains of Campylobacter were isolated (10.48%), including 36 strains of C. jejuni (92.31%) and 3 strains of C. coli (7.69%). The positive rates of Salmonella, Shigella, E. coli and V. parahaemolyticus were 6.99%, 0.27%, 9.14%, and 12.63%, respectively. The clinical symptoms of 39 cases of Campylobacter infection were mainly diarrhea (watery stools), abdominal pain, nausea and dehydration. The detection rate of Campylobacter was higher in spring and autumn than in summer and winter, and the peak appeared in October. Campylobacter infection cases were mainly young and middle-aged adults aged 16 to 45 years; there was no significant difference in the detection rate between men and women (P＝0.698, χ2＝0.150). The infection cases were mainly distributed in students, people engaged in other occupations and in business services. Contaminated foods included vegetables, cereals and aquatic products. Three strains of C. coliwere only sensitive to chloramphenicol. The resistant rates of 36 C. jejuni isolates to quinolones, tetracyclines and chloramphenicol were high, including nalidixic acid (97.22%), ciprofloxacin (97.22%), tetracycline (86.11%), florfenicol (58.33%). Nineteen strains of C. jejuni (52.78%) were multi-drug resistant, and the multi-drug resistance spectrum was mainly quinolones-chloramphenicol-tetracyclines (47.37%, 9/19). Conclusions The proportion of diarrhea caused by Campylobacter was high in Shunyi. The isolated Campylobacter strains showed serious drug resistance, including multiple drug resistance, to which close attention should be paid.
Laboratory confirmation of 139 clinical diagnosed breakthrough mumps cases
Baojun Li, Yi Chen, Hong Zhao
Accepted Manuscript
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Objective To confirm the clinical diagnosis of breakthrough mumps cases and evaluate the validity of the clinical diagnosis and the sensitivities of laboratory methods. Methods For the clinical diagnosed mumps cases reported in Yinzhou district of Ningbo during 2015–2017, the serum IgM against mumps virus was detected with enzyme-linked immunosorbent assay (ELISA) and viral RNA extracted from strains isolated from throat swabs or oral fluids were detected by using reverse transcription-polymerase chain reaction (RT-PCR), the positive rate of samples collected in different time, the positive rates of breakthrough cases and cases without immunization history, and the positive rates of different type samples were compared. Results The positive rates of IgM were 36.37% (36/99) at 1–7 days after onset and 95.00% (19/20) at 8–30 days after onset, the difference was significant (Fisher’s exact test, P＜0.001). For the viral RNA detection, 6.47% (9/139) of breakthrough cases were positive, 16.67% (6/36) of unvaccinated cases were positive, the difference was not significant (χ2＝3.79, P＞0.05). The positive samples (throat swabs and oral fluids) were mainly collected within 2–3 days after onset. Only 1.39% (1/72) of throat swabs of breakthrough cases were positive, but 11.94% (8/67) of oral fluids of breakthrough cases were positive, the difference was significant（Fisher's exact test, P＝0.015) . Conclusion According to the results of IgM detection, we confirmed most clinically diagnosed breakthrough mumps cases, but the sensitivities of ELISA in detection of IgM and RT-PCR in detection of viral RNA were not high in acute phase (1–7 days). It is suggested to detect IgM 7 days later after onset for confirmation.
Establishment of back-propagation neural network using meteorological data and incidence data of hand, foot and mouth disease
Yingci Jiang, Ying Li
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Objective In order to analysis the relationship between meteorological factors and the incidence of hand, foot and mouth disease (HFMD), we used weekly meteorological data and the weekly incidence data of HFMD to establish and evaluate the back-propagation neural network (BPNN) model. Methods The incidence data of HFMD and meteorological data in Changning district of Shanghai from 2014 to 2017 were collected. Software SPSS 13.0 was used to analyze the relationship between the incidence HFMD and meteorological factors. The prediction model of BPNN was established with software Matlab 7.0. Mean error rate (MER) and determination coefficient (R2) were used to evaluate the fitting effect and the incidence data of HFMD in 2017 was used to verify the model. Results The weekly incidence of HFMD was positively correlated with the average temperature, the highest air temperature, the lowest air temperature, cumulative precipitation, relative humidity, minimum relative humidity, average wind speed (all P＜0.05), but negatively correlated with the mean air pressure of the same week (r＝ –0.527, P＜0.001). The weekly incidence of HFMD was positively correlated with the average air temperature, the highest air temperature, the lowest air temperature, cumulative precipitation, relative humidity, minimum relative humidity, average wind speed (all P＜0.05), but negatively correlated to the mean air pressure of the past week (r＝ –0.522, P＜0.001). The fitting effect using the meteorological data of the past week (MER＝19.0%, R2＝0.895) was slightly better than that using the data of same week (MER＝20.2%, R2＝0.894). Verified by meteorological data of 2017, the absolute error between the predicted value and actual value was between 0 and 9 and the average was 2.52. Conclusion The BPNN model established is suitable for the prediction of the incidence of HFMD in Changning.
Characteristics of injury caused by fall in the elderly aged ≥60 years in Guangzhou, 2016－2017
Weiquan Lin, Tingyuan Huang, Faju Qin, Yunou Yang, Jichuan， Shen
Accepted Manuscript
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Objective To understand the distribution characteristics of injury caused by fall in the elderly aged ≥60 years in Guangzhou, Guangdong province, during 2016−2017 and provide evidence for effective injury prevention and control in the elderly. Methods The data of injury cases seeking medical care for the first time were collected in 5 injury surveillance hospitals in Guangzhou from 2016 to 2017 for the analysis on the distribution characteristics of fall caused injury in the elderly aged ≥60 years. Results During 2016−2017, a total of 4 361 injury cases caused by fall in the elderly aged ≥60 years were reported by the 5 injury surveillance hospitals, accounting for 49.5% of the total injury cases in this group. Fall was the first leading cause of injury in this group. The men to women ratio of the injury cases was 0.60∶1. Injuries mainly occurred at home during leisure time. Most cases had mild and moderate injuries and left hospitals after treatment. The proportion of the injury caused by fall was slightly higher in March, July and November. With the increase of age, the proportion of fall caused injury cases increased gradually in older age group, the difference was significant (χ2＝1 220.807, P＜0.001). According to the gender and age group stratification, with the increase of age, the proportions of fracture cases, cases needing observation/hospitalization/referral and moderate injury cases increased. The people with lower degree of education had higher proportion of fall caused injuries (χ2＝85.667, P＜0.001). The injuries were mainly contusion/scratch or fracture (χ2＝3 095.215, P＜0.001) and the injury sites were mainly head or lower limb (χ2＝1 273.623, P＜0.001). Conclusion Fall is the major injury cause in the elderly in Guangzhou. It is necessary to take targeted prevention and intervention measures to reduce falls in the elderly.
Genetic characteristic analysis on 33 strains of rubella virus isolated in Chaoyang district of Beijing, 2012–2016
Yan Gao, Yang Jiao, Yusong Zhang, Shiyao Zhang, Lin Gu, Jianhong Zhao, Fang Wang, Lingli Sun
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Objective To identify the genotype and the genetic characteristics of rubella virus isolated from throat swabs of suspected rubella cases in Chaoyang district of Beijing during 2012–2016. Methods Vero /SLAM cells were used to isolate rubella viruses from throat swabs collected from rubella cases in rubella outbreak and sporadic cases in Chaoyang during this period. The fragments of E1 genes of the isolates were amplified by RT-PCR and then the PCR products were directly sequenced and analyzed. The phylogenetic tree based on the 739 nucleotide sequences of E1 genes were conducted using the rubella virus strains isolated in Chaoyang and 32 WHO reference strain sequences representing 13 genotypes, another phylogenetic tree was also conducted with the 33 rubella virus strains isolated in Chaoyang and 16 rubella virus strains isolated in other provinces in China for the multiple sequence comparison. Results A total of 33 strains of rubella virus strains were isolated, which belonged to two different genotypes, i.e. 1E (8 strains) and 2B (25 strains). The genotype 1E strains were detected during 2012–2013, and the genotype 2B strains were detected during 2012–2016. The intra and inter genetic distance of genotype 2B strains were less than those of genotype 1E strains. Conclusion Two genotypes of rubella virus (1E and 2B) were detected in Chaoyang during 2012–2016. The nucleotide sequence of genotype 2B strain was more stable and genotype 2B strain has gradually become predominant.
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
Corrected proof
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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 χtrend2 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.
Cost estimation of hepatitis B vaccine immunization in obstetrics departments of hospitals in Beijing, 1992–2013
Pei Gao, Dan Wang, Shiwen Shi, Min Lyu, Xuefeng Shi, Jiang Wu, Yiwei Guo, Xi Wang
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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 410 011.52 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.
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2018, 33(11).
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CONTENTS IN BRIEF
2018, 33(11).
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National Data of Class A, B and C Communicable Diseases in October 2018
2018, 33(11): 885-885. DOI: 10.3784/j.issn.1003-9961.2018.11.001
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Summary of National Data of Class A, B and C Communicable Diseases in China, October 2018
2018, 33(11): 886-886. DOI: 10.3784/j.issn.1003-9961.2018.11.002
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Risk assessment of public health emergencies concerned in the mainland of China, November 2018
Zhiheng Hong, Chao Li, Jing Yang, Miao Jin, Dan Li, Jinghuan Ren, Fan Ding, Ling Meng, Wenxiao Tu, Guoqing Shi, Nijuan Xiang
2018, 33(11): 887-890. DOI: 10.3784/j.issn.1003-9961.2018.11.003
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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 November 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 the provincial centers for disease control and prevention attended this meeting through video conference. Results Overall, it is predicted that the number of public health emergencies reported in November would increase compared with October, which might be mainly the epidemics of varicella, seasonal influenza, mumps, other infectious diarrheal diseases and hand foot and mouth disease. Sporadic cases of human infected with avian influenza virus might occur. The incidence of respiratory infections, such as seasonal influenza, would increase. The epidemic of Ebola virus disease in the Democratic Republic of Congo is still serious. The incidence of non-occupational carbon monoxide poisoning would become higher in November. Conclusion It is necessary to pay close attention to human infection with avian influenza virus and non-occupational carbon monoxide poisoning, and pay general attention to seasonal influenza, norovirus caused infectious diarrhea and Ebola virus disease in the Democratic Republic of Congo.
Cancer screening has a long way to go
Yan Li, Ming Wang
2018, 33(11): 891-896. DOI: 10.3784/j.issn.1003-9961.2018.11.004
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There is growing concern about cancer screening for its social and economic benefits. This paper summarizes the significance and existing problems of cancer screening in terms the current status & efficiency, screening methods, controversy and development trend, and to provide reference for selection and promotion of appropriate cancer screening strategy.
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
2018, 33(11): 897-901. DOI: 10.3784/j.issn.1003-9961.2018.11.005
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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.
Genotypic and epidemiological analysis of Orientale tsutsugamushi infection in Guangzhou, 2012–2016
Xia Tao, Jing Zhang, Yuehong Wei, Yong Zhou, Zhijun Bai, Xinwei Wu
2018, 33(11): 902-907. DOI: 10.3784/j.issn.1003-9961.2018.11.006
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Objective To analyze the genotypic and epidemiological characteristics of Orientia tsutsugamushi infection in Guangzhou from 2012 to 2016. Methods Whole blood samples were collected from the clinical diagnosed patients. 56kDa type-specific antigen gene segment of O. tsutsugamushi was amplified by using nested-polymerase chain reaction. Sequences were analyzed by alignment with GenBank and the phylogenetic tree was established by using software MGEA 5.0. Results A total of 220 samples were detected to be positive (24.3%) from 906 samples, including 138 strains of Karp, 29 strains of Kato, 39 strains of Gilliam, 13 strains of TA763 and 1 strains of uncertain genotype. Two incidence peaks were observed, one was during May - June and another one was during September - October. The cases mainly occurred in rural areas of Conghua and Zengcheng. Conclusion The incidence of scrub typhus in Guangzhou was in increase and the genotypes of O. tsutsugamushi showed diversity, but Karp was predominant. It is necessary to strengthen the molecular epidemiology surveillance for O. tsutsugamushi in Guangzhou.
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
2018, 33(11): 908-912. DOI: 10.3784/j.issn.1003-9961.2018.11.007
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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.
Subtype distribution and drug resistance of HIV-1 in HIV infected pregnant women in Guangzhou
Hao Wu, Kai Gao, Yali Zhang, Huifang Xu, Yanshan Cai, Zhigang Han, Caiyun Liang, Qingmei Li, Ming Wang
2018, 33(11): 913-918. DOI: 10.3784/j.issn.1003-9961.2018.11.008
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Objective To understand the subtype distribution and drug resistance of HIV-1 in HIV infected pregnant women in Guangzhou of Guangdong province. Methods Plasma samples from pregnant women who were positive for HIV-1 were collected during 2009–2014 for the amplification of protease (PR) and reverse transcriptase (RT) gene segments with nested reverse transcription polymerase chain reaction (nested-PCR). HIV subtypes were determined through phylogenetic analysis and the drug resistance mutation (DRM) was analyzed with HIV Drug Resistance Database of Stanford University. Results A total of 178 gene segments, including 10 from foreign cases, were successfully amplified. Significant difference in subtype distribution was observed between domestic cases and foreign cases (P＜0.001), the predominant subtypes were CRF01_AE (42.86%, 72/168) and CRF07_BC (31.55%, 53/168) in domestic cases and the predominant subtypes were C (30.00%, 3/10) and CRF01_AE (30.00%, 3/10) in foreign cases. The incidence rate of DRM was 12.36%.The upper low level resistant rates to any drug was 5.62% (10/178), and the resistant rates to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 2.81% (5/178), 1.12% (2/178) and 2.25% (4/178), respectively. Subtype C showed the highest DRM rate (50.00%, 3/6). DRMs were observed in 5 foreign cases and 3 cases were drug resistant. Six samples (3.37%) were predicted to be highly resistant to single class drug. No samples which were highly resistant to multi-class drugs were detected. Conclusion Twelve HIV-1 subtypes were detected in HIV infected pregnant women in Guangzhou, the predominant subtypes were CRF01_AE and CRF07_BC. The DRM rate and drug resistant rate were low, but the strains with high resistance to PIs or NRTIs or NNRTIs were observed and the foreign cases had higher DRM rate and drug resistant rate.
Thyroid volume of children aged 8−10 years in Guangzhou after reduction of iodine concentration in salt
Conghui Xu, Ming Wang, Shouyi Chen, Xiaoning Liu, Wenfeng Ren, Hao Zhang
2018, 33(11): 919-921. DOI: 10.3784/j.issn.1003-9961.2018.11.009
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Objective To understand the status of thyroid volume of children aged 8−10 years in Guangzhou after the reduction of iodine concentration in salt, and provide evidence for the evaluation of the performance of iodine deficiency disorder prevention and treatment and the development of the prevention and treatment measures. Methods A multi-stage stratified random sampling method was used to select the primary schools in the urban area, suburban area and outer suburbs of Guangzhou, and the children aged 8−10 years in each school selected were surveyed. Results The median of thyroid volume of children aged 8−10 years in Guangzhou was 3.53 ml. The thyroid volume varied in age groups and increased with age. The prevalence rate of endemic goiter was 3.92% in children aged 8−10 years in Guangzhou, the difference in the rate was not significant compared with that before the reduction of iodine concentration in salt. There were differences in the prevalence rate of endemic goiter among children in different age groups. Conclusion Overall, the thyroid volume of children aged 8−10 years in Guangzhou was in normal range. The prevalence rate of endemic goiter was low. The iodine nutrition of children was still in good status after the reduction of iodine concentration in salt.
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
2018, 33(11): 922-926. DOI: 10.3784/j.issn.1003-9961.2018.11.010
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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.
Survey of an epidemic of human infection with avian influenza A (H7N9) in Yunnan
Chunrui Luo, Xuehua Zhou, Xiaonan Zhao, Duo Li, Jienan Zhou, Deming Ning, Ruiqi Ren
2018, 33(11): 927-930. DOI: 10.3784/j.issn.1003-9961.2018.11.011
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Objective To understand the epidemiological characteristics of an epidemic of human infection with avian influenza A (H7N9) virus in Yunnan province and provide evidence for the prevention and control of human infection with avian influenza in the future. Methods A field epidemiological survey was conducted among patients and close contacts and in live-poultry markets. The samples collected from the patients and outdoor environment were detected and analyzed. Results During June-July 2017, five confirmed cases of human infection with avian influenza A (H7N9) virus were reported in Wenshan prefecture of Yunnan, including 2 cases detected in influenza like illness sentinel surveillance, 2 cases detected in unexplained pneumonia monitoring and 1 case detected in close contacts. Three cases were women and 2 cases were men. The median age was 37 years (4.5-55 years). Four cases had the exposures to live poultry before the onset. The average intervals between the onset and the first medical care seeking, diagnosis, admission hospital and antiviral treatment were 2, 3, 9 and 7 d respectively. All the cases were isolated and treated, and all the close contacts received medical observation, positive live poultry markets were closed. The epidemic was under control effectively. Conclusion The monitoring of unexplained pneumonia and influenza sentinel surveillance in medical institutions are the important means for the timely detection of human infection with avian influenza virus. Regular disinfection and closure of live-poultry markets are key measures to reduce the exposure opportunity.
Laboratory confirmation of Orientia tsutsugamushi (Kawasaki strain) first identified in Hebei province
Miao Lu, Chunyan Wang, Jianwei Shao, Zhumei Yu, Yongzhen Zhang
2018, 33(11): 931-935. DOI: 10.3784/j.issn.1003-9961.2018.11.012
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Objective To investigate the circulation of Orientia tsutsugamushi in Hebei province through the laboratory examination of a suspected scrub typhus case detected in Baoding of Hebei province on July 13, 2017. Methods The acute phase serum and convalescent phase serum of the case were collected at day 0 and day 14, respectively. The IgG titers of anti-O. tsutsugamushi in serum were analyzed by using indirect immunofluorescence assay (IFA). The genomic DNA was extracted using DNA extraction kit, and Rickettsiales was identified in this sample by amplifying the Rickettsiales 16S rRNA (rrs) and tsa56 genes. Phylogenetic trees were reconstructed using the maximum likelihood (ML) method implemented in PhyML to determine the genotype of the strain. Results The highest body temperature of the case with fever of unknown origin was 39℃. The detections for serum antibodies of 9 pathogens, including hantavirus, severe fever with thrombocytopenia syndrome virus, dengue virus, Anaplasma sp., Ehrlichiasp., Rickettsia sp., Salmonella typhi and Salmonella paratyphi and O. tsutsugamushi, were conducted, but only the result of O. tsutsugamushi detection was positive. The titers of IgG against O. tsutsugamushi was 1∶64 in the acute phase serum and 1∶256 in the convalescent phase serum. PCR amplification indicated that the rrs sequence from the strain from the case showed high similarity with O. tsutsugamushi(Kawasaki strain) (99.0%). Meanwhile, phylogenetic analysis of the rrs and tsa56 gene sequences revealed that the sequences from the case had a close relationship with Orientia tsutsugamushi(Kawasaki strain). Conclusion Orientia tsutsugamushi(Kawasaki strain) was identified for the first time in the laboratory in Heibei province.
Infection source of a neonatal sepsis case caused by Listeria monocytogenes
Ling Zhang, Xi Chen, Lijuan Luo, Yan Wang, Jie Zhang, Nianli Zou, Guodong Yan, Hong Wang, Qun Li
2018, 33(11): 936-939. DOI: 10.3784/j.issn.1003-9961.2018.11.013
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Objective To understand the etiological and epidemiological characteristics of a neonatal sepsis case caused by Listeria monocytogenes in Zigong of Sichuan and provide reference for listeria disease prevention and control. Methods The neonatal blood sample and maternal vaginal and vulva swabs were collected, and raw and ready-to eat food samples were collected from the open market near the home of the puerpera. Food samples in the refrigerator in home of the puerpera and environmental swabs of kitchen and bathroom were also collected. Meanwhile, self-designed questionnaire was used to conduct a face to face survey. L. monocytogenes strains isolated were used for serotyping. Multi locus sequence typing (MLST) and pulsed field gel electrophoresis (PFGE) were conducted to analyze the homology of strains. Results Seven strains of L. monocytogenes strains were isolated from samples of the neonate and the puerpera, 1 strain was isolated from the food sample. All the 8 strains belonged to serotype 1/2b, the sequence type was ST87 and the similarity of PFGE type was 100%. The perinatal listeriosis was caused by vertical transmission, the strains isolated from the puerpera and ready-to-eat meat were from the same contamination source. Conclusion Ready-to-eat meat products might be the important risk factor for the L. monocytogenes infection, it should be monitored in food safety risk surveillance project. The screening of L. monocytogenes should be an important part of antenatal examination.
Etiology of virus caused diarrhea in children aged ＜5 years in Wuhan, 2015
Jing Jin, Yecheng Zhang, Yingle Liu, Jianguo Wu
2018, 33(11): 940-944. DOI: 10.3784/j.issn.1003-9961.2018.11.014
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Objective To investigate the epidemiological characteristics of viral diarrhea in children under 5 years of age in Wuhan. Methods From January to December 2015, the clinical data of the diarrhea cases and fecal specimens were collected in Wuhan Children's Hospital. Enzyme linked immunosorbent assay (ELISA) was used to detect group A rotavirus, PCR was used to detect adenovirus, the reverse transcription PCR (RT-PCR) was used to detect norovirus, sapovirus, astrovirus, group B and group C rotavirus and nested PCR was used to detect GP genotypes of rotavirus. The molecular epidemiological characteristics of viral diarrhea in children aged ＜5 years was analyzed in Wuhan, 2015. Results The detection rate of the virus causing diarrhea showed that the main pathogen was still rotavirus, especially from September to November, rate of 50.3% in positive. The norovirus infection was higher during September-October, accounted for 40.9%. Adenovirus accounted for 2.0%, astrovirus accounted for about 1.8%, while no sapovirus, group B and group C rotavirus were detected. Viral diarrhea mainly occurred in children aged ＜2 years. Among rotavirus group A, G3P［8］ (37.4%) and G1P［8］ (17.9%) were the most common genotype. Conclusion The pathogen spectrum of children viral diarrhea in Wuhan was diverse. Rotavirus was the major pathogen causing viral diarrhea. G3P［8］ was the most common genotypes of rotavirus group A.
Progress in research of infectious disease surveillance and prediction based on Internet search engine
Sichao Huang, Kui Liu, Jianmin Jiang
2018, 33(11): 945-949. DOI: 10.3784/j.issn.1003-9961.2018.11.015
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Disease surveillance is one of the most important approaches for the prevention and control of infectious diseases. The application of Internet search engines along with the advance of internet has offered novel methods for infectious disease surveillance. This paper summarizes the progress in the research of infectious disease prediction byusing of Internet search engine both at home and abroad to supplement evidence for current surveillance system.
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
2018, 33(11): 950-954. DOI: 10.3784/j.issn.1003-9961.2018.11.016
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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 Salmonella 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.
Drug resistance of group A streptococcus and related factors in Beijing, 2016–2017
Daitao Zhang, Peng Yang, Yi Zhang, Chunna Ma, Guilan Lu, Yimeng Liu, Jiachen Zhao, Quanyi Wang, Xiaomin Peng
2018, 33(11): 955-958. DOI: 10.3784/j.issn.1003-9961.2018.11.017
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Objective To analyze the drug resistance characteristics of group A streptococcus and related factors in Beijing from 2016 to 2017. Methods The minimum inhibitory concentrations of 12 antibiotics to group A streptococcus isolated from 16 districts in Beijing from 2016 to 2017 were tested. Results A total of 243 group A streptococcus isolates were tested for drug resistance, and the sensitive rates of the isolates to cefotaxime, penicillin, meropenem and linezolid were 100%. The sensitive rates were 99.18% to cefepime and vancomycin, 97.53% to levofloxacin and 90.95% to ofloxacin. The sensitive rates to erythromycin, clindamycin and tetracycline were 1.65%, 2.06% and 2.88% respectively. Conclusion The drug resistance rates of group A streptococcus to macrolides, clindamycin and tetracycline remained at high level in Beijing, while group A streptococcus kept sensitive to penicillin, cephalosporins and quinolones. Penicillin is still the preferred choice for the treatment of group A streptococcus infection.
Iodine nutrition status in key populations in different areas of Xinjiang, 2017
Yuming Zhu, Ling Zhang, Qin Lin, Chenchen Wang, Jia Huang, Kai Pan, Dan Pu
2018, 33(11): 959-963. DOI: 10.3784/j.issn.1003-9961.2018.11.018
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Objective To analyze and evaluate the iodine nutrition status of 8–10 years old children and pregnant women and in areas with different water iodine contents in Xinjiang and provide evidence for appropriate iodine supplement. Methods Using stratified cluster random sampling method, 10 areas of investigation, i.e. Kumul, Tacheng, Fukang, Xinyuan, Tianshan district of Urumqi, Hotan, Altay, Shache, Xinhe and Bohu, were selected to carry out the testing of iodine content in drinking water. The urine and salt iodine content of 200 children aged 8–10 years and 100 pregnant women were detecteded at each survey site. The thyroid volumes of all children aged 8–10 years were detected by using B ultrasound examination. Results The water iodine contents in 10 areas of Xinjiang ranged from 1.81 to 21.43 g/L, the median was 3.40 (2.01–6.36) μg/L. Thyroid enlargement rate was 1.40%, The median of salt iodine content was 27.89 (25.12–30.54) mg/kg; The median of urine iodine level was 198.21 (132.90–272.03) μg/L in children aged 8–10 years and 153.10 (89.00–240.81) μg/L in pregnant women. There were area specific differences in urine iodine level between children aged 8–10 years and pregnant women. Conclusion The iodine content was low in the natural environment of Xinjiang. The concentration of iodine in drinking water will affect the iodine nutrition status of people, and more attention should be paid to the iodine nutrition status of pregnant women in the areas with water iodine concentration of ＜5 μg/L. The overall iodine nutrition status of children aged 8–10 years and pregnant women in the survey area was appropriate, but the risk of iodine insufficient exists in pregnant women in some areas. It is suggested to further strengthen the appropriate iodine supplement in key areas and key populations in Xinjiang.
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
2018, 33(11): 964-966. DOI: 10.3784/j.issn.1003-9961.2018.11.019
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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.
Investigation of brucellosis treatment effect and influencing factors in Qapqal Xibe autonomous county of Xinjiang
Arkin·obol, Ayxam·kiyom, Haiyan Wang, Penggao Chen, Ripkat·abulimit, Muhtar·hasan
2018, 33(11): 967-970. DOI: 10.3784/j.issn.1003-9961.2018.11.020
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Objective To investigate the current status of treatment of brucellosis in Qapqal Xibo autonomous county of Xinjiang, evaluate treatment effect and analyze the related factors, and provide reference for further comprehensive prevention and control of brucellosis. Methods The data were collected through the reviews of the survey results and clinical records as well as household interviews. The same criteria were used to classify the clinical type of brucellosis and evaluate the treatment effect. Results The cure rate of brucellosis in acute phase (74.48%) was significantly higher than that of brucellosis in chronic phase (23.81%), the difference was significant (χ2＝22.92, P＝0.01), The multivariate logistic regression analysis showed that the interval between onset and diagnosis（OR＝11.62, 95% CI: 2.11−64.32,OR＝7.54, 95%CI: 1.82−30.94, drug withdrawal (OR＝11.81, 95% CI: 3.82−36.35), treatment less than 6 weeks (OR＝4.34, 95% CI: 1.62−11.56), treatment in private clinic (OR＝10.39, 95% CI: 1.72−62.03), contacting livestock during treatment (OR＝3.82, 95% CI: 1.42−8.17), drinking raw milk during treatment (OR＝26.15, 95% CI: 1.93−344.07) were the potential factors influencing the treatment effect. Conclusion The treatment effect of brucellosis in Qapqal Xibe autonomous county is not satisfied. In the future, the priority of brucellosis diagnosis and treatment should be the regular follow up for non-hospitalized patients by primary health care providers to observe the treatment effect and supervise their medication according to the prescription and strengthen the patient's self-management for the increase of the cure rate of brucellosis.
Access to treatment for hepatitis B virus infection — Worldwide, 2016 
Fuzhe Gong, Zhenyu Gong
2018, 33(11): 971-972. DOI: 10.3784/j.issn.1003-9961.2018.11.021
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