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Interaction between PM2.5 and air temperature on daily hospital visits of children due to respiratory disease in Changping district, Beijing
Jing Li, Huanxin Wang, Long Qu, Mingqiang Zhao, Yingjie Xing, Qiyong Liu
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.020
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ObjectiveTo understand the interaction between fine particulate matter with aerodynamic diameter <2.5 μm (PM2.5) and air temperature on the daily hospital visits of children due to respiratory disease in Changping district of Beijing.MethodsThe data of daily hospital visits of children were collected from a hospital in Changping, and the relevant meteorological data and air pollution data, including PM2.5, SO2 and NO2 concentrations, in Changping from 1st of January 2014 to 31st of December 2017 were also collected. Based on the distributed lag non-linear model (DLNM) with quasi-Poisson link, response surface model and stratified model were used to investigate the potential interactions between air pollution and air temperature on daily hospital visits of children due to respiratory disease.ResultsAt low, moderate, and high temperature layers stratified by the mean temperatures of 25th and 75th percentiles, a 10 μg/m3 increase of PM2.5 concentration resulted in the relative risks of 1.003 (0.994,1.011), 1.015 (1.007,1.023) and 1.039 (1.021,1.057), respectively, for total hospital visits due to respiratory disease in children on lag 0-14 days. The adverse effect of PM2.5 increased obviously under higher air temperature (P<0.05).ConclusionThere was an obvious interaction between PM2.5 and high temperature on hospital visits due to respiratory disease in children, the adverse effect of PM2.5 on hospital visits due to respiratory disease in children were more obvious when air temperature was high.
2019年4月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Disease in April 2019
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.001
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Establishment of multiple-locus variable number tandem repeat analysis assay for Vibrio parahaemolyticus isolated in China
Lin Zhao, Meiling Chen, Xin Lu, Jie Li, Hongqun Zhao, Biao Kan, Bo Pang
Corrected proof , DOI: 10.3784/j.issn.1003-9961.2019.06.006
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ObjectiveTo establish a multiple-locus variable number tandem repeat analysis (MLVA) assay for Vibrio parahaemolyticus isolated in China.MethodsA total of 420 V. parahaemolyticus strains isolated from different areas in China were used. The 12 variable-number tandem-repeat (VNTR) loci were amplified by PCR and the amplicons were analyzed by capillary electrophoresis. The discriminatory power of different VNTR locus and combinations of VNTR loci were evaluated.ResultsThe amplification rates of the 12 VNTR loci of V. parahaemolyticus were different. Locus VP1-17 showed no polymorphism (Nei value=0.00), locus VP2-03 showed low polymorphism (Nei valur=0.10) and locus VP2-07 showed highest polymorphism. Locus VPTR7 could only be amplified in 71.90% of the test strains. The 420 V. parahaemolyticus strains could be divided into 311 MLVA types using the 6-locus(VP1-10, VPTR1, VPTR3, VPTR5, VPTR6, and VPTR8) .ConclusionThe established 6-locus MLVA scheme showed satisfactory discriminatory power and economic significance and thus is suitable for the molecular typing of V. parahaemolyticusstrains isolated in China.
Distribution and evolutionary characteristics of non-hemolytic mutant of El Tor biotype epidemic Vibrio cholerae in China
Yufeng Fan, Lin Zhao, Xin Lu, Xu Li, Huihui Sun, Jiazheng Wang, Ming Liu, Jie Li, Bo Pang, Biao Kan
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.005
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ObjectiveTo analyze the distribution and evolutionary characteristics of the non-hemolytic mutant of El Tor biotype strain of Vibrio cholerae O1 in China during the 7th global cholera pandemic.MethodsToxigenic El Tor biotype strains of V. cholerae in different cholera pandemic periods since 1961 were selected for hemolytic phenotype test and whole genome sequencing. The temporal distribution of the non-hemolytic mutant was displayed. The sequence variation in hlyA gene was illustrated. ML tree was constructed based on the SNPs in the non-repetitive and non-recombinant genome regions of 230 El Tor biotype strains of V. cholerae O1 isolated in China since 1961. The distribution of the non-hemolytic mutants was mapped on the ML tree.ResultsDuring the 7th cholera pandemic, there was an obvious sequence type conversion of the hemolysin gene hlyA in the strains detected in China after the first phase of pandemic. The non-hemolytic mutants emerged after the first phase of pandemic and became a common type in the 2nd pandemic in 1970s. The non-hemolytic mutant dispersed in the 2nd, 3rd pandemic and the inter-pandemic periods. However, certain clones of non-hemolytic mutant spread for several years.ConclusionThe evolution of hlyA gene was independent of that of the whole genome in the 7th cholera pandemic, which might be a random mutation. The results showed the role of hemolytic phenotype in the biotyping of epidemic strains.
2019年5月中国甲乙丙类传染病疫情动态概要
Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.06.002
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Risk assessment of public health emergencies concerned in the mainland of China, June 2019
Wenxiao Tu, Di Mu, Fengfeng Liu, Yu Li, Jinghuan Ren, Yuan Yuan, Dan Li, Ling Meng, Nijuan Xiang, Yanping Zhang
Accepted Manuscript
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ObjectiveTo assess the risks of public health emergencies, both the indigenous ones and imported ones, which might occur in the mainland of China in June 2019.MethodsAn internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all the provincial centers for disease control and prevention attended this meeting through video conference.ResultsIt is expected that the number of public health emergencies reported in June will be lower than May, but still at a relative high level, which might be mainly the outbreaks of communicable diseases in schools, such as chickenpox, hand, foot and mouth disease (HMFD), mumps and rubella. The area where Aedes mosquitoes exist will gradually enter the high-risk season of dengue fever. The number of locally transmitted cases of dengue fever will continue to rise and small-scale local outbreaks might occur. HFMD cases will continue to increase and epidemic intensity will increase in most provinces of the country. The sporadic cases of human infection with Streptococcus suis infection may continue to increase, and people who engage in pork slaughtering and processing are at high risk of infection. Bacterial food poisoning in schools, catering service units and rural wedding banquets or funeral banquets will increase. Poisoning deaths caused by poisonous animal, plants and mushrooms will become the main death causes of food poisoning. The epidemic of Ebola virus disease (EVD) in the Democratic Republic of the Congo (DRC) will continue, but the risk of its importation into China is low.ConclusionJune 2019, there is no special concern risk of public health emergency in the mainland China., major concern should be paid to the risk of dengue fever and HFMD epidemics, and general concern should be paid to the human infection with Streptococcus suis, food poisoning (including toxic mushroom poisoning) and EVD in the DRC.
Analysis on change trend of newborn birth weight in Yiwu, 2007—2018
Hongxing Jin, Xiamusiye Muyiduli, Xiaomei Liu, Xingfang Ying, Yu Shen, Shuojia Wang, Minjia Mo, Bule Shao, Yunxian Yu
Accepted Manuscript
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ObjectiveTo analyze the change trend of newborn birth weight in Yiwu, Zhejiang province, establish and revise the percentile curve of gestational age specific birth weight of newborns and compare it with different birth weight standards.MethodsThe data from the Yiwu Maternal and Child Health Information Platform were used to analyze the gestational age specific birth weight, rate of low birth weight and macrosomia in newborns. The LMS (least mean square) method was used to calculate the reference values for percentiles of gestational age specific birth weight. The GAMLSS model was used to draw the birth weight curve. The reference percentile value of the birth weight of this study was compared with domestic and foreign studies.ResultsA total of 68 358 newborns were included in this study. The average birth weights of baby boys and baby girls were 3 373 g and 3 257 g, respectively. The rates of preterm birth in baby boys and baby girls were 6.01% and 5.04%, respectively. The rate of preterm birth in baby boys was significantly higher than that in baby girls. The rates of low birth weight and macrosomia were 3.84% and 7.43%, respectively. The birth weight of baby boys at gestational age 33-41 weeks was significantly higher than that of baby girls at same gestational age. The birth weight increased with gestational age. The birth weight of baby boys was higher than 2015 national standard at gestational age 37-41 weeks and higher than the reference percentile value of INTERGROWTH-21st study at gestational age 33-41 weeks. The birth weight of baby girls was higher than the 2015 national standard at gestational age 38-41 weeks and higher than the reference percentile value of INTERGROWTH-21st study at gestational age 33, 35-41 weeks.ConclusionDuring 2007—2018, the birth weight of baby boys in Yiwu showed a decrease with year, and the birth weight of baby girls showed no obvious change. The gender specific birth weight curves of newborns were drawn.
Epidemiological characteristics of food poisoning in China, July-September, 2018
Jinghuan Ren, Xiaoye Wang, Xiaomin Wu, Rui Wang
Accepted Manuscript
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ObjectiveTo understand the epidemiological characteristics of food poisoning in the third quarter (July-September) in 2018 in China (excluding Hong Kong, Macao and Taiwan), and provide evidence for the early warning, prevention and control of food poisoning.MethodDescriptive epidemiological analysis was conducted by using the incidence data of food poisoning in China during July-September in 2018 collected from National Report Management Information System of Public Health Emergency.ResultsA total of 119 food poisoning events were reported in 23 provinces during this period, involving 3 488 cases and 27 deaths. Among them, 64 food poisoning events were grade IV and above, involving 2 643 cases and 27 deaths. The most frequent type of the reported events was bacterial food poisoning (42.02%), the involved cases accounted for 69.29% of the total. Fungal food poisoning caused highest death number of food poisoning, accounting for 55.56% of the total. The numbers of food poisoning events and related deaths occurred in families accounted for 32.77% and 92.59% of the total, respectively. The numbers of food poisoning cases occurred after catering accounted for 51.46% of the total.ConclusionBoth the numbers of food poisoning events and deaths declined, but the food poisoning cases increased during July-September in 2018 compared with the same period in 2017. It is necessary to strengthen the health supervision in key places, such as food service units, especially in school opening season, improve the management and guidance of food procurement, storage, and processing, and health education should be conducted to improve the public awareness of poisonous flora and fauna or poisonous mushroom, as well as knowledge of proper cooking and self and mutual-treatment after poisoning.
Epidemiologic investigation to the first cluster of fever cases caused by human bocavirus in Beijing, 2017
Xiaogen Dong, Zhimin Zhang, Meng Qin, Ruoxi Li, Huiru Feng, Baoyu Feng, Hong Yu, Xiuxia Wei, Zhaoe Wang, Jing Shi, Jianjun Zhang
Corrected proof
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ObjectiveTo understand the etiologic and epidemiologic characteristics of a cluster of human bocavirus (HBoV) infection cases in Fengtai district of Beijing and the circulation and evolution of HBoV in Beijing, and provide scientific evidence for the prevention and control of HBoV infection.MethodsEpidemiologic investigation was performed for 13 children with fever, and 10 throat swabs were collected from them. The pathogens were identified by the multiplex combined real-time PCR detection kit for respiratory viruses. The HBoV VP1 gene region was specifically amplified and sequenced for the detected HBoV strains. The gene distance calculation and phylogenetic tree analysis were performed for the amplified sequences by using bioinformatics software DNAStar 7.1, Bioedit v7.0.9, and MEGA 6.0.6.ResultsThe clinical symptoms of the children were mainly fever and cough. All the children with fever were classmates. Three HBoV positive samples were detected in 10 throat swabs, and the 3 HBoV strains were classified into type 1 indicated by the gene distance and phylogenetic tree analysis. The nucleotide sequences of the 3 HBoV strains shared 100% homology and the 3 strains were highly homologous to Beijing strain 311-BJ07, suggesting that the outbreak may be related to the circulating HBoV-1 strain in Beijing.ConclusionThis cluster of fever cases was caused by HBoV-1 strain which are widespread in China. It suggested that HBoV-1 respiratory infection epidemic is serious. It is necessary to strengthen surveillance and research and develop effective HBoV-1 infection prevention and control measures.
Infection status and genotype characteristics of G norovirus in acute gastroenteritis cases in Huzhou, Zhejiang, 2017–2018
Lei Ji, Yongying Zhu, Liping Chen, Yuehua Shen, Xiaofang Wu, Deshun Xu
Corrected proof
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ObjectiveTo understand the infection status and genotype characteristics of GⅠ norovirus in acute gastroenteritis cases in Huzhou, Zhejiang province.MethodsA total of 1 259 stool samples of acute gastroenteritis cases diagnosed in two sentinel hospitals in Huzhou from April 2017 to June 2018 were collected. The extracted viral RNA was subjected to GⅠ and GⅡ norovirus nucleic acid detections by using real-time quantitative reverse transcription polymerase chain reaction( RT-PCR). GⅠ positive samples were amplified and sequenced by RT-PCR in RdRp and VP1 regions. The genotyping of norovirus was confirmed by phylogenetic analysis and online typing tools.ResultsA total of 171 stool samples were norovirus nucleic acid positive, the positive rate was 13.58%. The positive rates of GⅡ and GI noroviruses were 11.83% (149/1 259) and 2.70% (34/1 259), respectively, GⅡ was the main genotype detected. GⅠ norovirus was mainly detected in the first half of 2018. The positive detection rate of GⅠ norovirus in each month from February to June 2018 was higher than the average detection rate of GⅠ during the surveillance period. The genotyping results showed that the GⅠ norovirus detected in 2018 included GⅠ.P4-GⅠ.5, GⅠ.P2-GⅠ.2, GⅠ.P1-GⅠ.1, GⅠ.Pd-GⅠ.3, GⅠ.P4-GⅠ.4 and GⅠ.P2-GⅠ.5, in which GⅠ.P4-GⅠ.5, GⅠ.P2-GⅠ.5 and GⅠ.Pd-GⅠ.3 recombinant norovirus were detected for the first time in Huzhou.ConclusionThe genotypes of GⅠ noroviruses circulating in Huzhou are diverse and the recombination phenomenon is obvious. It is necessary to strengthen the molecular epidemiological surveillance for GⅠ norovirus for the timely detection of variants or recombinant strains.
2018年美国俄勒冈州科罗拉多蜱传热病毒病调查
Accepted Manuscript
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Infection and etiological characteristics of Vibrio cholerae in diarrhea patients in Shunyi district of Beijing, 2015–2017
Mu He, Shuang Zhang, Yanchun Zhang, Yanbo Wang, Meijuan Zhu, Maojun Zhang, Ying Li
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ObjectiveTo understand the infection status and etiological characteristics of Vibrio cholerae in patients with food-borne diseases in Shunyi district of Beijing, and provide evidence for effective prevention, control and treatment of V. cholera infection.MethodsV. cholerae isolation and culture were conducted by using stool samples collected from diarrhea cases in surveillance from 2015 to 2017. PCR test of virulence genes, pulsed-field gel electrophoresis (PFGE), matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) and antibiotic susceptibility analysis were carried out for the isolates of V. cholerae.ResultsA total of 1 105 diarrhea patients were surveyed in three years. The detection rate of V. cholerae was 0.54% (6/1 105). The detection results of cholera toxin genes ctxAB were negative. Serological typing indicated that all the strains were non-O1/O139. PCR indicated that 5 of the 6 V. cholerae strains were type III secretion system (T3SS) gene positive. The clustering results of PFGE were consistent with the clustering results of MALDI-TOF MS.ConclusionIt is necessary to attach importance to the infection and etiological surveillance of V. cholerae in food-borne disease surveillance system
Surveillance for public health emergencies caused by infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid in China, 2014–2016
Xijun Weng, Zhe Wang, Jinghuan Ren, Yang Zhang, Ling Yu, Rui Wang
Corrected proof
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Objective To understand the epidemiological characteristics of the public health emergencies caused by infectious diarrhea other than cholera, dysentery, typhoid and paratyphoid (hereinafter referred to as other infectious diarrheal diseases) in China.Methods Descriptive epidemiologic analysis was conducted by using the incidence data of other infectious diarrheal diseases in China from 2014 to 2016, which were collected from National Public Health Emergency Report Management Information System. The spatial auto-correlation analysis (Moran’s I and Getis G) were conducted for spatial statistical analyses on the incidences of other infectious diarrhea.Results A total of 332 other infectious diarrhea epidemics were reported in China from 2014 to 2016, involving 17 130 cases and without death. The annual incidence of other infectious diarrheal epidemic was high during November-March. Norovirus infection epidemic accounted for 86.14%. The causes of these incidents included exposure in daily life and food or drinking water contamination. All the provinces reporting the epidemics were in eastern China. Spatial autocorrelation analysis showed that the spatial clustering of other infectious diarrhea epidemics in China was obvious, and the " hot spots” were mainly in Guangdong, Guangxi and Fujian provinces. ConclusionNorovirus infection was the main cause of other infectious diarrhea epidemics in China. It is necessary to strengthen the health education in key population and surveillance in key places, such as schools, and improve food and drinking water safety supervision and management for the effective prevention and control of other infectious diarrheal diseases. In addition, it is suggested to strengthen the prevention and control in provinces where the " hot spots” clustered, such as Guangdong, Guangxi and Fujian, further explore the causes and mechanisms of obvious disease clustering and take effective prevention and control measures to reduce the incidence of other infectious diarrheal diseases.
Etiologic analysis on enterohemorrhagic Escherichia coli O157∶H7 from an infection case in Shanghai
Yuan Zhuang, Hongyou Chen, Yong Chen, Xi Zhang, Liping Gu, Wei Yu, Min Chen
Corrected proof
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ObjectiveTo understand the etiologic characteristics of an infection case of enterohemorrhagic Escherichia coli (EHEC) O157∶H7 in June, 2016 in Shanghai.MethodsThe patient information was collected by epidemiological investigation. Two strains were isolated from case's stool samples and identified by biochemical analysis and serologic tests. Polymerase chain reaction was conducted to detect the virulence related genes and microdilution broth method was used to analyze the antibiotic resistance. Pulsed-field gel electrophoresis (PFGE), multi-locus sequence typing (MLST) and single nucleotide polymorphisms (SNP) were conducted for further analysis on the strain's characteristics.ResultsNo suspected sources of infection were found by epidemiological investigation. The strains were confirmed to be EHEC O157∶H7 carrying eae and stx2, and they were sensitive to 16 kinds of antibiotics tested. Two strains were classified to ST11 while showed a new PFGE pattern. Compared with the reference strain, they showed more SNPs than the previously identified strains by core genome alignment.ConclusionNo EHEC O157∶H7 has been isolated from patient for about ten years in Shanghai since 2006. The virulence related genes, the antibiotic resistance and the ST type of the strains were confirmed in this study. They were more different from the previously identified strains according to the genome sequence alignment and PFGE results, further attention should be paid to it.
Etiologic surveillance for varicella in Beijing, 2017
Hongquan Li, Luodan Suo, Dan Zhao, Tiegang Zhang
Corrected proof
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ObjectiveTo understand the types and predominant types of varicella- zoster virus (VZV) in Beijing, 2017, and provide evidence for the prevention and control of varicella.MethodsThe clinical vesicular fluid was collected from the varicella cases detected in outbreak in Beijing in 2017 for the identification of wild strains and vaccine strains of VZV with real-time PCR. The phylogenetic analysis on wild VZV in Beijing was performed based on the sequences of twenty-second open reading frame gene fragments (ORF).ResultsAmong the 316 vesicular fluid specimens from varicella cases, 271 were positive for VZV. All of these strains belonged to wild VZV strains. The gene fragments were obtained for 240 of 271 wild strains. They belonged to 3 serotypes, including 234 clade 2 strains (97.50%), 3 clade 1 strains (1.25%) and 3 clade 4 strains (1.25%). Clade 2 strains was distributed in all of 16 districts of Beijing, and clade 1 and clade 4 strains were distributed in Xicheng and Daxing districts, respectively.ConclusionThe varicella cases were mainly caused by clade 2 VZV in Beijing in 2017. It is necessary to strengthen the surveillance for new clade 1 and clade 4 VZV.
Epidemiological characteristics of food poisoning event in China, April-June, 2018
Xiaomin Wu, Jinghuan Ren, Xiaoye Wang, Zhe Wang, Rui Wang
Corrected proof
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ObjectiveTo analysis epidemiological characteristics of food poisoning events in China during the second quarter (April-June) in 2018 (excluding Hong Kong, Macao and Taiwan) and provide evidence for the early warning, prevention and control of food poisoning.MethodsDescriptive epidemiological analysis was conducted by using the incidence data food poisoning in China during this period collected from National Report Management Information System of Public Health Emergency.ResultsA total of 80 food poisoning events were reported in 18 provinces during this period, involving 2 058 cases and 33 deaths. Among them, 44 food poisoning events were grade Ⅳ or above, involving 1 661 cases and 33 deaths. The first 5 provinces reporting high incidences of food poisoning events were Shandong, Yunnan, Sichuan, Guangdong and Guangxi. The most frequent type of event reported was bacterial food poisoning (65.91%), and the involved cases accounted for 68.08% of the total. Plant/Herbal toxins caused highest death number of food poisoning, accounting for 45.45% of the total. The food poisoning events and related deaths occurred in families accounted for 40.00% and 72.73% of the total, respectively. The food poisoning cases occurred after eating in canteen accounted for 53.98% of the total.ConclusionIt is suggested to strengthen the supervision in canteens and food service to ensure food hygiene in cooking, processing and storage in order to reduce the incidence of bacterial food poisoning events. It is necessary to conduct health education in public about prevention and self-treatment of plant, fungal and bacterial food poisoning which often occur in families and identification of poisonous plants or mushrooms through different channels, including internet, media and community promotion.
Genomic context of a Proteus mirabilis strain carrying both SGI1 and SXT/R391 resistance genomic islands
Tao Xiao, Binghuai Lu, Hang Dai, Hongyan Cai, Zhenzhou Huang, Duochun Wang
Corrected proof
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ObjectiveTo characterize the gene structure and resistance genes of two resistance-related genomic islands (SGI1 and SXT/R391) of a Proteus mirabilis strain (CA151922) isolated from a patient.MethodsPolymerase chain reaction (PCR) was conducted to detect the specific integrase gene of SGI1 and SXT/R391, respectively. Second generation sequencing was performed for the strain CA151922. The contigs of SGI1 and SXT/R391 were extracted and assembled from the whole sequenced genomes against each reference. Online predicting and annotating open reading frames (ORFs) were conducted. Each sequence was used in a BLASTn stool to obtain high homology variants in public database. Non-redundant homologous gene set was identified by cd-hit, a cluster of homologous tree was built by using R 3.4.4. Resistance phenotype was detected with micro-broth dilution method.ResultsProteus mirabilis strain CA151922 carried two resistance-related genomic islands, i.e. SGI1 (SGI1-B) and SXT/R391 (ICEPmiJpn1). Compared with known variants of SGI1-B and ICEPmiJpn1, the sequence identity ranged from 97% to 99% and from 96% to 99%, respectively. Compared with each classic sequence, different resistance gene(s) were found, however, SGI1-B and ICEPmiJpn1 harbored different β-lactamase genes. Strain CA151922 was multi-drug resistant to eighteen antibiotics, only ampicillin and sulfonamides were related to the resistance genes on genomic islands, which suggested that resistance phenotype were not all encoded by genes at genomic island.ConclusionBoth SGI1 and SXT/R391 resistance-related genomic islands were identified for the first time in a strain of Proteus mirabilis, which increased the complexity and severity of drug resistance. Surveillance for resistance-related genomic islands in multi-drug resistant strains should be strengthened.
A Association of drug efflux pump gene Rv1456c, Rv1457c and Rv1458c expressions with drug resistance of Mycobacterium tuberculosis
Yang Che, Tianchi Yang, Guohua Ping, Lyu Lin
Corrected proof
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ObjectiveTo explore the association between efflux pump gene Rv1456c, Rv1457c and Rv1458c expressions and phenotypic drug resistance of Mycobacterium tuberculosis.MethodsThe RNA of 102 strains of M. tuberculosis collected through drug resistance surveillance by Ningbo Prefectural Center for Disease Control and Prevention during 2017—2018 were extracted. The gene expression levels of Rv1456c, Rv1457c and Rv1458c were detected with real-time PCR and the data were analysed by using Mann-Whitney U test.ResultsThe medians and interquartile ranges of expressions of Rv1457c and Rv1458c in rifampicin resistant group [0.507 (0.378–1.444), 1.842 (1.325–2.628)], were higher than those in rifampicin sensitive group [0.418 (0.357–0.618), 1.545 (1.189–2.065)], the differences were significant (Z=2.030, P<0.05, Z=2.108, P<0.05). The medians and interquartile ranges of expressions of Rv1457c and Rv1458c in multidrug resistant group [0.538 (0.419–1.490), 1.941 (1.471–2.659)] were higher than those in non-multidrug resistant group [0.415 (0.337–0.618), 1.533 (1.122–2.056)], the differences were significant (Z=2.865, P<0.05, Z=2.896, P<0.05). There were significant difference in over-expression rates of gene Rv1456c and Rv1457c between isoniazid resistant group and isoniazid sensitive group (χ2=4.858, P<0.05, χ2=6.789, P<0.05). There was significant difference in over-expression rate of gene Rv1456c between rifampicin resistant group and rifampicin sensitive group (χ2=8.424, P<0.05). There was significant difference in over-expression rate of gene Rv1457c between streptomycin resistant group and streptomycin sensitive group (χ2=4.545, P<0.05). There were significant differences in over-expression rates of gene Rv1456c and Rv1457c between ethambutol resistant group and ethambutol sensitive group (χ2=5.142, P<0.05, χ2=10.202, P<0.05). ConclusionThe increases in expressions of ATP-binding cassette efflux pump gene Rv1457c and Rv1458c are associated with rifampicin resistance of M. tuberculosis.
Etiologic surveillance for infectious diarrhea in Mentougou district of Beijing, 2013-2017
Qiuyan Lyu, Longjian Li, Haitao Liu, Tian Chu, Xiangju Zhao
Corrected proof
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ObjectiveTo understand the pathogen spectrum of infectious diarrhea in Mentougou district of Beijing and provide evidence for prevention and control of intestinal infectious diseases.MethodsStool samples were collected from the diarrhea patients receiving no antibiotic treatment in two large hospitals in Mentougou for the isolation, culture and identifications of Salmonella, Shigella, Vibrio parahaemolyticus and 5 kinds of diarrheagenic Escherichia coli (DEC). The patient data were analyzed with SPSS 20.0.ResultsA total of 1 672 stool samples were collected from diarrheal patients, and 270 strains of pathogenic bacteria were detected. The overall positive rate was 16.15%. Among these strains, 121 (7.24%) were DEC, 65 (3.89%) were V. parahaemolyticus, 58 (3.47%) were Salmonella, and 3 (0.18%) were Shigella. Enterotoxigenic E.coli (ETEC) was the most common pathogen in DEC (30.36%), and Salmonella Enteritidis was the most common pathogen in Salmonella (8.50%). In addition, the detection of pathogenic bacteria had obvious seasonality. The detection rate was highest between May and August. There was no significant difference in detection rate between men and women (χ2=0.685, P>0.05).ConclusionDEC was the main pathogen detected in stool samples of diarrhea patients in Mentougou, followed by V. parahaemolyticus and Salmonella. It is necessary to strengthen the surveillance for enteric pathogens, especially the pathogen spectrum of infectious diarrhea, for the prevention and control of infectious diarrhea.
Report of an imported measles outbreak caused by measles virus D8 in Shanghai, 2018
Chongshan Li, Zhi Li, Jing Wang, Jiayu Hu, Wei Tang, Yuying Yang, Yunyi Li, Yanji Yang, Xiaoxian Cui, Yulong Ye, Xi Zhang, Zhengan Yuan
Accepted Manuscript
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ObjectiveTo trace the source of an imported measles outbreak occurred in Shanghai in 2018, and analyze the molecular characteristics of the measles virus isolated.MethodsViral RNA was directly extracted from the throats swabs of the cases. The 676 nucleotides at COOH-terminal of nucleoprotein gene in measles virus were amplified by using one-step RT-PCR. The amplicons were sequenced by Sanger's to obtain the viral nucleotide sequences. Homology analysis was conducted to identify the viral genotype.ResultsThe cases in this outbreak came from a family, and 2 adult cases had a common outbound travel history within 21 days before the onset. The outbreak was caused by Measles virus D8.ConclusionBased on the results of epidemiologic investigation and laboratory tests, it was deduced that it was an imported measles outbreak caused by measles virus D8.
Transmission dynamic of influenza B virus Yamagata lineage and assessment of infection control measures in schools in Shenzhen
Jing Liang, Qiong Fang, Tianmu Chen, Jianming Zhong, Lin Cai, Li Cao, Baoni Lin, Dongting Wu
Corrected proof
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ObjectiveTo analyze transmission dynamic of influenza B virus Yamagata lineage and assess the effects of vaccination and isolation measures for the outbreaks in schools in Shenzhen, 2017.MethodsThe susceptible-exposed-infectious/asymptomatic-removed (SEIAR) model was used to simulate the data from field investigation. Then the basic reproduction number (R0) was calculated to evaluate the infectious ability of the virus. The SEIARV (vaccination) and SEIARQ (isolation) models were developed, then the cumulative incidence rate (TAR) and the duration of outbreak (DO) were calculated to evaluate the effectiveness of vaccination and isolation measures.ResultsAt the end of 2017, the R0 of the B/Y influenza outbreak in Shenzhen was 5.97 (95% CI: 3.66−8.28); the epidemic would last for 52 days without any intervention and the TAR would be 99.57%. In the context of vaccination with inactivated influenza vaccine (IIV) before outbreak, when the vaccination rate was 30%, 50% and 70%, the TAR after vaccinations with IIV3 or IIV4 would be 80.51%/76.81%, 65.07%/58.48%, and 44.06%/33.77%. In the context of the emergent vaccination after outbreak, when the vaccination rate was 30%, 50%, and 70%, the TAR after vaccination with IIV3 or IIV4 was 85.94%/82.46%, 73.55%/67.03% and 57.90%/47.54%. In the context of combined intervention of vaccination and isolation before outbreak, when the vaccination rate is ≥50%, the TAR would be <1%. In the context of combined intervention of emergent vaccination and isolation after outbreak, when the vaccination rate is ≥50%, the TAR would be <5%.ConclusionInfluenza B virus Yamagata-lineage has a strong ability to spread in school outbreaks. In the context of vaccination with IIV3 or IIV4, high coverage combined with isolation is an effective prevention and control measure.
Subtypes and transmission characteristics of HIV-1 in men who have sex with men in Lishui, Zhejiang
Ling Ye, Xiaoguang Wang, Jiafeng Zhang, Xiuying Chen, Qin Fan, Bifeng Ye, Ying Cong, Xiaomeng Huang
Corrected proof
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ObjectiveTo understand the subtypes and transmission characteristics of HIV-1 in men who have sex with men (MSM) in Lishui of Zhejiang province.MethodsBlood samples were collected from the newly-diagnosed HIV-1 infected MSM who received no antiviral therapy in Lishui during 2015–2018, pol gene was amplified and sequenced, the gene subtypes and transmission characteristics were analyzed by phylogenetic tree construction, at last mutations on drug resistance was analyzed with online software CPR 6.0.ResultsA total of 89 sequences were obtained successfully from 105 samples. The predominant subtypes were CRF01_AE (49.4%, 44/89) and CRF07_BC (37.1%, 33/89), others were B and CRF55_01B detected in 3 cases respectively and CRF08_BC, CRF59_01B and URF(01_AE/BC) detected in 2 cases respectively. Eight transmission clusters were found, with the total clustered rate of 21.3% (19/89). Seven clusters of transmission were associated with the cases who lived in Liandu district (87.5%, 7/8). Three surveillance drug resistance mutations (M46I, V106A, K103N) were found respectively in three samples. The overall rate of transmitted drug resistance (TDR) was 3.4% (3/89).ConclusionThere were 7 HIV-1 subtypes in Lishui, HIV-1 genetic diversity showed complexity trend, and the cases in Liandu district might play a central role in the spread of HIV. It is necessary to strengthen the surveillance and targeted intervention for the cases associated with major transmission clusters. However, the prevalence of TDR was at a low level.
Analysis on duplication genes of toxigenic strains of Vibrio cholerae O1
Zhenpeng Li, Xin Lu, Bo Pang, Biao Kan
Accepted Manuscript
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ObjectiveGene duplication through paralogous gene evolution is an important way of prokaryotic genome evolution, while the characteristics of duplication genes in Vibrio cholerae genome are poorly understood. In this study, we analyzed the number, diversity of duplication genes and difference in duplication genes between two biotypes of toxigenic strains of V. cholerae O1.MethodsWe selected 300 strains of V. cholerae O1 of two biotypes causing the sixth and seventh pandemics. The numeric distribution and differential duplication genes between two biotypes were analyzed by using blastp and MCL; the diversity of duplication genes and genes of diversity difference were analyzed by measuring the average distance between any two sequences.ResultsThe results showed that the average number of homologous gene clusters per strain was 242.63, the average number of that was 244.85 for El Tor biotype strains, and 209.74 for classical biotype strains. El Tor biotype had more duplication homologous gene clusters than classical biotype. Thirteen homologous gene clusters with significant different copies numbers between El Tor biotype and classical biotype were screened out; their functions mainly include the anions, amino acids or other substances transport, localization and transmembrane transport. By analyzing the genetic diversity of homologous gene clusters with duplication genes, we found 50 homologous gene clusters with different diversity between the two biotypes, the biological processes they participate in mainly include anions, amino acids or other substances transport, localization and substrate-specific transmembrane transport activity, etc.ConclusionThe evolution of the duplication genes of V. cholerae has a certain functional tendency; the characterization of it could provide a new point for the understanding of the adaptive evolution of the genome, the diversity of strains and the differential evolution of the genomes of two biotypes.
Epidemiological survey of the first case of pregnant women infection with avian influenza A (H9N2) virus in Shenzhen
Feng Liu, Gang Li, Fengren Liu, Guolong Yu
Corrected proof
[Abstract](282) [FullText HTML](97) [PDF 1843KB](11) [Peer reviewing opinions] Related References Cited By (0) Share
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ObjectiveTo identify the possible infection source of the first case of pregnant woman infection with avian influenza A (H9N2) virus reported in Longgang district of Shenzhen and provide evidence for the prevention and control of human infection with H9N2 virus in the future.MethodsEpidemiological data of the case were collected systematically using field epidemiology method and the samples of case, close contacts and exposure environments were collected from 2017 to 2018. Influenza A virus was detected by using antigen test. The detection and subtyping of avian influenza virus were conducted with fluorescence quantitative PCR. The data was analyzed by using software Excel 2019.ResultsThe throat swabs of the case was detected to be H9N2 virus nucleic acid positive and the case was diagnosed as the first pregnant women infection with H9N2 virus in Shenzhen. Eight close contacts showed no influenza -like symptoms during the medical observation period, and the influenza antigen and avian influenza nucleic acid tests were all negative. In 2017, the daily environment surveillance results showed that the positive rate of H9 virus subtype was 14.49%, The H9 virus subtype positive samples accounted for 62.69% in total universal influenza A virus positive samples. A total of 103 environmental samples were collected in the epidemic, in which 15 were universal influenza A virus positive and 9 were influenza A virus subtype H9 positive.ConclusionThe infection source might be a pigeon farm, but the exposure to poultry products in daily life could not be exclude4d. Avian influenza virus contamination still exists in the environment of poultry markets in Shenzhen, suggesting that the population at high risk still might be exposed in epidemic season. It is necessary to pay attention to this problem.
Epidemiological and clinical characteristics of hospitalized influenza patients, Beijing, 2016–2018
Yi Zhang, Yang Pan, Jiachen Zhao, Daitao Zhang, Chunna Ma, Peng Yang, Quanyi Wang
Accepted Manuscript
[Abstract](284) [FullText HTML](118) [PDF 2118KB](13) [Peer reviewing opinions] Related References Cited By (0) Share
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ObjectiveTo understand the epidemiologic and clinical characteristics of laboratory-confirmed influenza A and B cases in hospitalized patients with severe acute respiratory infection (SARI), and explore the association between illness severity and influenza type.MethodsDescriptive epidemiologic analysis was conducted on the data of laboratory-confirmed influenza cases detected through SARI sentinel surveillance in Beijing from August 2016 to July 2018. Influenza patients were regarded as severe cases if they needed invasive mechanical ventilation, or received ICU treatment, or died during hospitalization; or else they were regarded as mild cases. Multivariate logistic regression model was used to explore the association between type/subtype of influenza and illness severity.ResultsAmong 746 hospitalized influenza patients, 598 were infected with influenza A virus (80.2%) and 148 were infected with influenza B virus (19.8%). Six patients needed invasive mechanical ventilation (0.8%, 6/746), 17 patients needed intensive care (2.9%, 17/746) and 4 patients died during hospitalization (0.5%, 4/746). Influenza A patients had 1.3 times hider risk to have severe clinical course compared with influenza B patients (OR=1.3, 95% CI: 0.4–4.7, P=0.655). Compared with patients with influenza B/Yamagata virus infection, patients infected with influenza A(H1N1) pdm09 virus had 2.1 times higher risk to have severe clinical course (OR=2.1, 95% CI: 0.5–8.5, P=0.295).ConclusionThe hospitalized influenza patients were mostly young children and the elderly. Further studies are needed to confirm whether the clinical severity of influenza A is worse than that of influenza B.
Practice of management of auto-reporting of communicable diseases based on electronic medical records
Yuanyuan Kong, Guiling Gao, Qinghui Zhang, Xiaoqin Guo
Accepted Manuscript
[Abstract](262) [FullText HTML](105) [PDF 2483KB](5) [Peer reviewing opinions] Related References Cited By (0) Share
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ObjectiveTo explore the data exchange and management mode of regional health information platform based on electronic medical records.MethodsBased on the regional health information platform, the information of communicable diseases were reported from medical institutions to the national infectious disease reporting system through 3 data exchange methods (intelligent reminding plug-in, standardized interface at background and page reporting).ResultsThe intelligent infectious diseases reporting system based on electronic medical record was completed through the pushing step by step. The trial operation results in October 2018 showed that the success rate and consistency rate of data reporting were all higher than 95.00%. The comparison of 728 communicable disease cases reporting between hospital information system and national direct reporting system indicated that the completeness rates and timeliness rates of two systems were all 100%, the accuracy rates were 99.31%, 97.39% respectively, the difference was significant (χ2=8.304, P=0.004). The medians of card filling time of the two systems were 1.23 min and 2.82 min respectively, the difference was significant (U=186 809.500, P=0.000).ConclusionThe intelligent model based on regional platform to exchange data with the national infectious disease reporting system has been established, which can greatly improves the efficiency of communicable disease reporting, reduce the workload of medical staff, realize data sharing and fill the gap in the domestic field.
Trend of cesarean section and influence factors in Zhoushan of Zhejiang, 2002–2018
Manxian Huang, Shuojia Wang, Muyiduli Xiamusiye, Minjia Mo, Bule Shao, Yu Shen, Shuting Si, Xing Xin, Yunxian Yu
Accepted Manuscript
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ObjectiveTo understand the trend of cesarean section (CS) in pregnant women in Zhoushan of Zhejiang province from 2002 to 2018, and analyze the potential influence factors.MethodsThe prenatal examination data and delivery information of pregnant women in Zhoushan during this period were collected by using local electronic medical record system. Multivariate logistic regression models were used to identify the influence factors for CS.ResultsThe study included 43 034 pregnant women from 2002 to 2018. The overall CS rate was 50.61%, and the rate began to decrease from 2013 and decreased to 40% in 2016. Older age at pregnancy (OR=1.115, 95% CI: 1.106–1.123), higher pre-pregnancy BMI (OR=1.080, 95% CI: 1.070–1.090), more than time pregnancy (OR=1.199, 95% CI: 1.145–1.256), high-risk pregnancy (OR=1.407, 95% CI: 1.317–1.504) and high fetal birth weight (OR=1.730, 95% CI: 1.641–1.824), non-head delivery (OR=7.620, 95% CI: 7.037–8.251) were the influence factors for CS. When stratified by year, higher educational level was the influence factor for CS before 2014.ConclusionThe average CS rate was relatively high in Zhoushan. Maternal age, pre-pregnancy BMI, gravidity, risk degree of pregnancy, fetal birth weight and position of the fetus were influence factors for CS.
Incidence of gestational diabetes mellitus and risk factors in Zhoushan Islands, Zhejiang
Liuyan Pu, Jinhua Wu, Wen Jiang, Manxian Huang, Li Chen, Bule Shao, Shuojia Wang, Wenyan Chen, Junfen Wang, Minjia Mo, Yunxian Yu
Accepted Manuscript
[Abstract](253) [FullText HTML](102) [PDF 1777KB](5) [Peer reviewing opinions] Related References Cited By (0) Share
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ObjectiveTo understand the incidence of gestational diabetes mellitus (GDM) in pregnant women in Zhoushan, Zhejiang province, and identify its influencing factors.MethodsThe data of all the pregnant women underwent GDM screening in Zhoushan Maternal and Child Care Center from January 2014 to June 2018 were retrospectively analyzed in this study. Logistic regression models were used for the identification of the risk factors for GDM and GDM subtypes.ResultsA total of 10 802 pregnant women received GDM screening, the oral glucose tolerance test indicated that 1 489 pregnant women had GDM (13.78%). The proportions of different GDM subtypes (A, B and C) were 21.49%, 66.15% and 12.36%, respectively, in 1 489 GDM cases. The multivariate logistic regression analysis showed that older age, higher BMI during early pregnancy, higher blood glucose level during early pregnancy, higher heart rate during early pregnancy, higher albumin level during early pregnancy, screening in winter/spring and being primipara were the risk factors for GDM, while educational level was not associated with the risk for GDM. The multiple logistic regression analysis for different GDM subtype showed that higher BMI, higher blood glucose level during early pregnancy and screening in winter/spring were associated with increased risks for GDM subtype A. Older age, higher blood glucose level, higher heart rate and higher albumin level during early pregnancy, screening in winter/spring and higher educational level were associated with increased risk for GDM subtype B, while being multipara decreased the risk for GDM subtype B. Older age, higher BMI, higher heart rate and higher blood glucose level during early pregnancy, and screening in winter/spring were associated with increased risk for GDM subtype C, while higher educational level and being multipara decreased the risk for GDM subtype C.ConclusionThe incidence of GDM was high in Zhoushan. Older age, higher BMI, higher blood glucose level, higher heart rate and high albumin level during early pregnancy, screening in winter/spring increased the risk for GDM, respectively. It is important to avoid pregnancy at older age and control pre-pregnancy BMI and blood glucose level during early pregnancy to reduce the risk for GDM and improve the health of both mothers and infants.
Establishment of real-time PCR assays for rapid detection of Clostridium botulinum type A and B
Ying Huang, Yun Shi, Changyun Ye, Xuefang Xu
Accepted Manuscript
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ObjectiveTo establish real-time PCR assays for the toxin gene detections of Clostridium botulinum type A and B, construct standard curves and evaluate the specificities, sensitivities and detection thresholds of the assays, and provide evidence for the rapid and accurate detection of C. botulinum.MethodsSpecific primers and probes were designed based on the sequences of toxin genes of C. botulinum type A and B. Real-time PCR assays were established with optimized reaction conditions. 25 other intestinal bacteria and common bacteria were used to test the specificities of the assays. Standard curve construction, fecal sample simulation and sensitivity measurement were achieved with recombinant plasmids containing toxin genes of C. botulinum type A and B.ResultsThe specificities of the real-time PCR assays were high. Specific amplification curves were observed in recombinant plasmids containing toxin genes of C. botulinum type A and B. No specific amplifications were found for the 25 other bacteria. The detection thresholds of toxin genes of C. botulinum type A and type B were 5.04×102 copy/μl and 6.91×102 copy/μl respectively according to the amplification curves. The detection thresholds of recombinant plasmids containing toxin genes of C. botulinum type A and B in artificial fecal samples were 1.71×103 copy/μl and 2.14×103 copy/μl respectively.ConclusionIn this study, real -time PCR assays for the toxin gens detections of C. botulinum type A and type B were established, which can be applied in the rapid detection of C. botulinum.
Epidemiological characteristics of hepatitis C in Gansu, 2008–2017
Li Li, Bin Wang, Ailing Yu, Aixia Tu, Yadong Zhao
Accepted Manuscript
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ObjectiveTo analyzed the epidemiological characteristics of hepatitis C in Gansu province and provide scientific evidence for the improvement of prevention and control of hepatitis C.MethodsThe incidence data of hepatitis C in Gansu from 2008 to 2017 were collected for a descriptive epidemiological analysis. The statistical analysis was done with software SPSS 20.0 and the rate comparison was through χ2 testResultsA total of 72 899 cases of hepatitis C were reported in Gansu during this period. The incidence rate of hepatitis C showed an increase trend from 20.92/100 000 to 29.71/100 000 (χ2=1 330.472, P<0.01) and reached peak of 34.93/100 000 in 2012. The male to female ratios of the cases were 1.08∶ 1 and 1.83∶ 1 respectively. The cumulative case number in age group 20–49 years accounted for 42.94% of the total, showing a decrease trend. The reported incidence rate in age group ≥50 years increased year by year (χ2=1 342.154, P<0.05), The proportion of the cases reported in women showed an increase trend. The cases in farmers accounted for 49.27% (35 919 cases) and increased with year. Hepatitis C occurred all the year round. The incidence rates ranged from 1/100 000 to 3/100 000. The incidence rates of hepatitis C in Wuwei and Lanzhou were higher than those in other areas.ConclusionThe overall incidence of hepatitis C in Gansu was in increase without obvious seasonality. The difference in incidences among different areas was significant, and the incidence rate increased with age. It is necessary to strengthen the surveillance for hepatitis C in key populations and areas.
Epidemiological and etiological characteristics of severe cases of hand foot and mouth disease in Zhongshan, Guangdong, 2013−2017
Enmiao Huang, Zifeng Yao, Wuyang Shi
Accepted Manuscript
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ObjectiveTo understand the epidemiology and etiological characteristics of severe cases of hand foot and mouth disease (HFMD) in Zhongshan of Guangdong province and provides evidence for the prevention and control of HFMD.MethodsCase investigation and laboratory test were conducted for the severe cases of HFMD reported in Zhongshan from 2013 to 2017. Data analysis was done by using Excel 2007 and SPSS 13.0 softwares.ResultsA total of 209 severe cases of HFMD were reported in Zhongshan, accounting for 0.25%(209/84 021) of total HFMD cases, with an annual average incidence of 1.31/100 000. The incidence peak was during March-July. The cases were mainly in 1–3 years old children outside child care settings, accounting for 73.68%(154/209). The incidence in boys was higher than that in girls. All the 209 severe HFMD cases had skin rash, 95.22% of the cases had fever, and the main type of rash was herpes (71.29%). The time interval between onset and initial diagnosis was less than 3 days, accounting for 91.87% (192/209). Up to 63.64% of the cases (133/209) were correctly diagnosed with HFMD at the first visit. The differences in diagnostic accuracy of HFMD among hospitals at different levels were significant. The specimens of 203 severe HFMD cases were detected, the positive rate was 93.10% (189/203). The major pathogen was EV71 (58.13%), the detection peak time was during April-May.ConclusionThe incidence of severe HFMD had obvious time, population and area specific characteristics in Zhongshan. The major pathogen was EV71. It is necessary to take comprehensive measures and increase the vaccination coverage of EV71 inactivated vaccine to reduce the incidence of severe cases of HFMD.
Analysis on spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu, 2012–2017
Weimin Lyu, Kongfu Wei, Pinggui Wang, Yu'an Ma
Accepted Manuscript
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ObjectiveTo analyze the spatial-temporal distribution of hepatitis B in Gannan Tibetan autonomous prefecture of Gansu province and provide evidence for the prevention and control of hepatitis B.MethodsThe incidence data of hepatitis B in Gannan from 2012 to 2017 was used to calculate the global Moran’s I and local G statistics and analyze its spatial-temporal distribution characteristics.ResultsThe incidence of hepatitis B showed spatial autocorrelation(P<0.05)from 2012 to 2017, and local autocorrelation analysis indicated that the hot spots areas identified were mainly in some townships of Xiahe, Luqu. Maqu, Zhuoni and Hezuo, while the cold spots areas were mainly in some townships of Zhouqu, Diebu, Zhuoni, Lintan and Hezuo. Spatial-temporal analysis showed that the most likely clustering areas of incidence of hepatitis B were in some townships of Xiahe during 2012–2014 (RR=3.50, LLR=219.24, P<0.001) and some townships in Luqu in 2016 (RR=6.91, LLR=198.61, P<0.001), followed by some townships of Lintan and Zhuoni during 2012–2013 (RR=1.79, LLR=70.41, P<0.001).ConclusionThe incidence of hepatitis B showed spatial and spatial-temporal clustering in Gannan from 2012 to 2017. Targeted prevention and control measures should be taken according to the spatial distribution of the disease.
Epidemiology of viral hepatitis C in Qinghai, 2013−2017
Shicun Dong, Guanglan Pu, Weijun Wang, Ming Fan, Yulan Sun, Jiping Li, Yongcheng Ma, Yan Shi
Accepted Manuscript
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ObjectiveTo understand the epidemiological characteristics of viral hepatitis C in Qinghai province from 2013 to 2017.MethodsDescriptive epidemiological analysis was conducted by using the incidence data of hepatitis C collected from National Notifiable Disease Surveillance System.ResultsA total of 10 989 cases of hepatitis C were reported from 2013 to 2017. The annual reported incidence rate was 37.67/100 000, the male to female ratio of the cases was 1.18∶1. The cases were reported in all age groups, but the cases in age group 40- years accounted for 42.17%, and the disease mainly reported in Xining, Haidong and Yushu. The cases were mainly reported by medical institutions at provincial level, accounting for 69.53%. The disease occurred all the year round with no obvious seasonality.ConclusionThe incidence of hepatitis C was stable in Qinghai in recent years, but the incidence level was higher than other provinces. It is necessary to strengthen the prevention and control of hepatitis C.
Analysis on measles antibody level in healthy population in Dali Bai autonomous prefecture, Yunnan, 2012–2018
Yanjun Liu, Zuo He, Ran Xu, Fang Guan
Accepted Manuscript
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ObjectiveTo understand the measles antibody level in healthy population in Dali Bai autonomous prefecture of Yunnan province during 2012−2018 and provide scientific evidence for the elimination of measles.MethodsBlood samples were collected annually from healthy populations in 8 age groups selected through stratified random sampling, a total of 28 459 blood samples were collected. Serum measles IgG was detected by using enzyme linked immunosorbent assay (ELISA).ResultsThe differences in annual positive rate of measles IgG in healthy population were significant. The positive rate was lowest in 2016 (89.6%) and highest in 2013 (97.3%). The positive rate was >90% in other years. The differences in the positive rate were significant among different age groups (P<0.05). The positive rate was lower in age groups 8−17 months and 25−34 years. There were significant differences in the positive rate and antibody geometric mean concentration (GMC) among people receiving different doses of measles containing vaccine (P<0.05). The GMC was highest in people receiving 3 doses of measles vaccination (1 921.1 mIU/ml).ConclusionThe immunity barrier has been basically formed in Dali, the possibility of measles outbreak is low, but close attention should be paid to the potential risk of measles in adults. It is necessary to conduct supplementary immunization activity in order to increase population antibody level and reduce the incidence of measles.
Spatial-temporal distribution characteristics of hand, foot and mouth disease in Jingzhou, Hubei, 2008–2017
Menglei Yao, Tian Liu, Li Wang, Shuqiong Huang, Jing Cai, Wenwen Yang, Ran Wu
Accepted Manuscript
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ObjectiveTo analyze the spatial-temporal distribution characteristics of hand, foot and mouth disease (HFMD) in Jingzhou, Hubei province, from 2008 to 2017, and provide evidence for the prevention and control of HFMD.MethodsThe global and local autocorrelation analyses on the spatiotemporal clustering of the incidence data of HFMD at street/township scale in Jinzhou during this period were performed by using software ArcGIS 10, and the spatiotemporal clustering analysis on the incidence data of HFMD was performed by using software SaTScan 9.4.ResultsA total of 53 159 cases were reported in Jingzhou from 2008 to 2017, with an average annual incidence rate of 91.59/100 000. Spatial autocorrelation analysis showed that the incidence rate of HFMD had positive spatial correlation. The incidence rate of HFMD had obvious spatiotemporal clustering characteristics, the main clustering area was found in the central urban area of Jingzhou and adjacent counties and townships.ConclusionUnderstanding the spatial and temporal distribution and spatial clustering characteristics of the incidence data of HFMD at street/township scale in Jingzhou has important public health significance for the allocation of public health resources, effective prevention and control of HFMD.
2019-5-ml目录
2019, 34(5): 1-3.
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2019年4月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Disease in April 2019
2019, 34(5): 379-379. DOI: 10.3784/j.issn.1003-9961.2019.05.001
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2019年4月中国甲乙丙类传染病疫情动态概要
2019, 34(5): 380-380. DOI: 10.3784/j.issn.1003-9961.2019.05.002
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Summary of global surveillance data of communicable diseases in April 2019
Hui Han, Bo Wu, Yajing Song, Runqi Huang
2019, 34(5): 381-383. DOI: 10.3784/j.issn.1003-9961.2019.05.003
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In April 2019, a total of 48 infectious diseases were reported globally, affecting 82 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were measles (33), dengue fever (32), Chikungunya fever (15), cholera (10) and malaria (6). The top three infectious diseases with highest case fatality rates were Ebola hemorrhagic fever (65.8%), Middle East respiratory syndrome (34.4%) and Lassa fever (22.5%). The top five infectious diseases with greatest number of deaths were measles, Ebola hemorrhagic fever, cholera, dengue fever and Middle East respiratory syndrome. The prevalent infectious diseases in Africa were Ebola hemorrhagic fever, cholera, yellow fever, Lassa fever and measles, the prevalent infectious diseases in Asia were Middle East respiratory syndrome, dengue fever and cholera, the prevalent infectious diseases in America were dengue fever, measles and Chikungunya fever, the prevalent infectious disease in Europe was measles.
Risk assessment of public health emergencies concerned in the mainland of China, May 2019
Ling Meng, Fengfeng Liu, Di Mu, Xiaobo Liu, Chao Li, Dayan Wang, Rui Wang, Dan Li, Wenxiao Tu, Nijuan Xiang, Zhongjie Li
2019, 34(5): 384-388. DOI: 10.3784/j.issn.1003-9961.2019.05.004
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ObjectiveTo assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in May 2019.MethodsAn internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this meeting through video terminal.ResultsGenerally speaking, it is predicted that the incidence of public health emergencies would be higher in May than in April, 2019, which might be mainly the events of varicella, hand foot and mouth disease (HFMD), mumps and infectious diarrhea. The incidence of HFMD would gradually become higher to reach peak. Imported cases of dengue fever from other countries might still be found, and indigenous cases and small outbreaks of dengue fever might occur in high risk areas such as Guangdong, Zhejiang, Hainan, and Yunnan provinces. The activity of human infection with avian influenza virus would be low; however, the sporadic cases of human infections with avian influenza A (H7N9) virus and other subtype viruses of animal influenza might continue to occur. More food poisoning might occur, and the incidence of food poisoning caused by bacterial pathogens or poisonous mushrooms would increase. Ebola virus disease (EVD) outbreak in the Democratic Republic of Congo will continue; however, the risk of the spread to China is low.ConclusionClose attention should be paid to the incidence of HFMD, and general attention should be paid to dengue fever, human infection with avian influenza virus, food poisoning and EVD in Democratic Republic of Congo.
Mycoplasma pneumoniae detection in throat swabs and bronchoalveolar lavage fluid in children with mycoplasmal pneumonia by real-time PCR and culture
Jinrong Liu, Liyong Liu, Shunying Zhao, Hui Xu, Xiaolei Tang, Jianzhong Zhang, Fei Zhao
2019, 34(5): 389-393. DOI: 10.3784/j.issn.1003–9961.2019.05.005
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ObjectiveTo understand the performance of clinical nucleic acid detection, bacteria load detection and laboratory isolation/culture of Mycoplasma pneumoniae (MP) in throat swab and bronchoalveolar lavage fluid (BALF) samples and evaluate the significance of using throat swab in the nucleic acid detection and isolation/culture and whether the nucleic acid load of MP in throat swabs in children with MP pneumonia could predict the nucleic acid load of MP in BALF.MethodsTwenty-nine hospitalized children with MP pneumonia were enrolled, and throat swabs and BALF samples were collected from them, simultaneously. The quality of the specimens and nucleic acid extraction were controlled by human β-globin internal reference gene. Qualified specimens were used for quantitative detection of MP with real-time PCR, and the nucleic acid load was calculated. At the same time, culture was performed for all the specimens, and positive culture rate and the bacteria contamination rate of the two kinds of specimens were compared.ResultsThe positive rate of β-globin reference gene detection in all the specimens was 100%. The positive rate of real-time PCR detection in throat swabs and BALF samples were all 86.2% (25/29), and the quantitative range of MP nucleic acid was 3.2×102 copies/ml−1.8×107 copies/ml in the throat swabs and 6.8×102 copies/ml–5.4×108 copies/ml in BALF samples. The consistent rate of the detection results of two kinds of specimens was 93.1% (27/29). Ranking the MP load in BALF samples showed an increase trend, but no similar trend was found for positive throat swabs. The positive rate and contamination rate of throat swabs were 51.7% (15/29) and 51.7% (15/29), and these of BALF samples were 65.5% (19/29) and 6.9% (2/29), respectively.ConclusionThroat swab can be used as qualitative test specimen for MP real-time PCR, but it is not suitable for quantitative study, indicating that there was no significant correlation in MP load between throat swab and BALF. Compared with throat swab specimen, BALF has a higher positive culture rate and lower contamination rate, which makes it more suitable for MP isolation research.
Molecular typing of β-haemolytic group A Streptococcus isolates in Jinan of Shandong, 2012–2018
Aiying Bai, Lanzheng Liu, Zhengbin Chai, Zunyu Liu, Xiaoying Shan
2019, 34(5): 394-397. DOI: 10.3784/j.issn.1003-9961.2019.05.006
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ObjectiveTo analyze the emm genotypes of β-haemolytic group A Streptococcus (GAS) isolates in Jinan of Shandong province and provide data for etiologic surveillance for scarlet fever.MethodsGAS isolates were collected in Jinan from 2012 to 2018. The emm gene was amplified by PCR and the emm genotypes were obtained after the PCR products were sequenced and aligned.ResultsA total of 143 GAS strains were isoalted, belonging to 5 emm genotypes: emm12 (55.2%, 79/143), emm1 (42.0%, 60/143), and other three genotypes (2.8%, 4/143). Only 11 strains were isolated in 2015 and 2016, all belonged to emm12. Four emm genotypes were found in 116 isolates from patients, in which 97.4% were emm1 (46 strains) and emm12 (67 strains), and 2.6% were emm22 (1 strain) and emm75 (2 strains). The first 3 districts where the isolate numbers were high were Shizhong (85 strains), Huaiyin (35 starins) and Licheng (9 strains).ConclusionThe main emm genotypes of GAS were emm12 and emm1 in Jinan from 2012 to 2018 and emm1 was predominant in 2013 and 2014, while emm12 was predominant in other years.
Epidemiological characteristics of severe pneumonia cases in Nanchang, Jiangxi, 2013-2018
Fenglan He, Wen Xia, Xiansheng Ni, Guoyin Fan, Wentao Song, Junling Tu
2019, 34(5): 398-400. DOI: 10.3784/j.issn.1003-9961.2019.05.007
[Abstract](255) [FullText HTML](96) [PDF 1970KB](1) Peer reviewing opinions Related References Cited By (0) Share
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ObjectiveTo understand the epidemiological characteristics of severe pneumonia cases in Nanchang, Jiangxi province, and provide evidence for clinical prevention and treatment of severe pneumonia cases.MethodsThe respiratory samples and clinical data of severe pneumonia cases in Nanchang from April 2013 to March 2018 were collected for the etiological and epidemiological analyses.ResultsA total of 261 cases of severe pneumonia from 17 medical institutions in Nanchang were detected, in which 81 were detected to be positive for influenza virus nucleic acid (31.03%), including 43 cases of influenza A (H1N1) pdm09 virus infection, 13 cases of influenza A (H3N2) virus infection, 18 cases of human infection with avian influenza A (H7N9) virus, 3 cases of human infection with avian influenza A (H10N8) virus and 4 cases of influenza B virus infection. The cases mainly occurred in winter and spring (from December to May), and the male to female ratio of the cases was 1.69∶1. The youngest case was 1 month old and the oldest case was 95 years old. Twenty one cases of human infection with H7N9/H10N8 viruses were reported in Nanchang during the 5 years with the case fatality rate of 33.33%. Up to 90.48% of the cases (19/21) were detected through the surveillance for unexplained pneumonia. The median age of the cases was 69 years, most cases had underlying diseases and clear history of poultry contact.ConclusionThe major influenza virus causing severe pneumonia was influenza A (H1N1)pdm09 virus in Nanchang. It is necessary to conduct routine surveillance for the timely detection of novel influenza virus and better prevention and control of communicable diseases.
Herpangina cases of Beijing area detected in Beijing Children's Hospital, 2017
Xiaoxiao Liu, Hua Li, Yongquan Wang, Qingzheng Kong, Yanhong Huang, Junying Zhang, Haiyang Cui, Bo Jin
2019, 34(5): 401-405. DOI: 10.3784/j.issn.1003-9961.2019.05.008
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ObjectiveTo understand the epidemiological and etiological characteristics of herpangina of Beijing area detected in Beijing children's hospital and provide evidence for the prevention and control of pergangina.MethodsThe epidemiological and etiological data of herpangina cases were obtained from the surveillance hospital of Beijing area in 2017 for a descriptive epidemiological analysis.ResultsThe data of 6 922 herpangina cases who met the inclusion criteria were analyzed, the incidence peak of herpangina was from June to September. Up to 86.04% of herpangina cases were under 5 years old. The positive rate of pathogen surveillance was 53.42% (86/161), the positive rate of other enteroviruses was highest (54.65%), followed by coxsackievrius A6 (Cox A6) (32.56%), Cox A10(7/86, 8.14%), entervirus 71 (EV71)(3/86, 3.49%), Cox A16 (1/86, 1.16%). The highest pathogen detection rate was in July (76.92%), there were significant differences in pathogen detection rate among different months (χ2=29.98, P<0.05). Both the reported case number and pathogen detection rate were higher in summer and autumn, showing a positive correlation (rs=0.294, P<0.05).ConclusionThe incidence peak of herpangina occurred in summer and autumn, children under 5 years of age were susceptible, and the pathogens were mainly other enteroviruses and Cox A6, some pathogens (EV71, Cox A16, Cox A6) could cause hand foot and mouth disease (HFMD). Close attention should be paid to herpangina and the prevention and control of herpangina can refer to HFMD′s.
Tuberculosis register rate in Changping district, Beijing, 2010–2017
Weidong Xing, Luqin Wang, Li Wang, Zhen Yang, Zhiguo Zhang, Tao Li, Xin Du, Canyou Zhang, Jun Cheng, Fei Zhao, Shubo Ma
2019, 34(5): 406-410. DOI: 10.3784/j.issn.1003-9961.2019.05.009
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ObjectiveTo understand the current status of register and the epidemic trend of tuberculosis (TB) in Changping district of Beijing during 2010–2017.MethodsThe TB register data, population and economy data in Changping were collected from TB Information Management System and Beijing Statistical Yearbook, and the data were modeled and analyzed by constructing Probit regression model.ResultsBetween 2010 and 2017, a binomial relationship might existed between the year and the register rate of active pulmonary TB cases. After excluding the proportions of permanent population aged ≥65 years and permanent immigrant population, the Probit regression model was fitted with the annual square term, year and GDP as independent variables. The model fitted the data (Pearson's χ2=6.510, P=0.164; Logarithmic likelihood ratio χ2=6.613, P=0.158). The results of Probit regression model showed that the register rate of active TB cases was in a downward trend during 2010–2012 and in an upward trend during 2012–2017 (Wald χ2=1.994×107, P<0.001). The regression coefficient of GDP and the prevalence rate of active TB was −0.001 5, and the register rate of active TB cases decreased with the increase of GDP in Changping (Wald χ2=56.620, P<0.001) after adjusting for year variable. There was no significant difference between active pulmonary TB register rate and the proportion of permanent immigrant population in Changping. ConclusionThe register rate of active TB cases showed an increase trend in Changping after 2012, but the register rate declined slightly in 2017 compared with 2016, suggesting that the register rate of active TB would gradually become stable in Changping since 2017.
Epidemiological characteristics of scarlet fever in Guangdong province, 2005–2017
Xiaohua Tan, Meizhen Liu, Yuwei Yang, Baisheng Li, Min Kang
2019, 34(5): 411-416. DOI: 10.3784/j.issn.1003-9961.2019.05.010
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ObjectiveTo analyze the epidemiologic characteristics of scarlet fever from 2005 to 2017, in Guangdong, and provide evidence for prevention and control of scarlet fever.MethodsDescriptive epidemiologic analysis was conducted on the spatial, temporal and population distributions of scarlet fever cases reported through national infectious disease reporting and management system in Guangdong from 2005 to 2017. Joinpoint regression software was performed to obtain the average annual percentage changes (AAPC) of incident rates and analyze the incident trends. A total of 66 strains of beta-haemolyticgroup A Streptococcus pyogens (GAS) isolated in 2017 were analyzed through emm typing and antibiotic susceptibility test.ResultsA total of 20 157 scarlet fever cases were reported in Guangdong from 2005 to 2017, with the annual incidence rates of 1.46/100 000. More cases were reported in summer and winter. High incidences were reported in Pearl River Delta region, with the proportion of 95.79% to the total cases of the province. Most cases were children aged 3 to 7 years. The proportion of children in kindergarten is the highest, followed by scattered children and students. The incidence of scarlet fever in Guangdong was on the rise, and the AAPC was 26.4% (95%CI: 16.9%–36.7%). The most prevalent emm type of pathogenic bacteria was emm12 (65.12%), followed by emm1 (32.56%). The strains were all resistant to erythromycin, clindamycin and tetracycline, and the bacteria were all sensitive to pencillin, cefotaxime and levofloxacin.ConclusionThe incidence of scarlet fever in Guangdong was on the rise, but no obvious change were observed in the epidemiological patterns. The prevalent emm type of GAS was emm12 and emm1, and strains of GAS were sensitive to pencillin.
Epidemiologic characteristics of pertussis cases detected in Shanghai, 2017
Jia Ren, Jiayu Hu, Jing Wang, Zhi Li, Chongshan Li, Zhuoying Huang, Xiang Guo, Jianping Yang, Xiaodong Sun
2019, 34(5): 417-421. DOI: 10.3784/j.issn.1003-9961.2019.05.011
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ObjectiveTo understand the epidemiological characteristics of pertussis in Shanghai in 2017 and to provide evidence for the development of pertussis prevention and control measures.MethodsThe incidence data of pertussis in Shanghai in 2017 were collected from national notifiable diseases registry system (NNDRS) and district CDCs in Shanghai for a descriptive analysis.ResultsIn 2017, a total of 258 pertussis cases were reported by 6 sentinel hospitals in Shanghai. The incidence peak was during August-September. The cases in age groups <18 months and ≥20 years accounted for 50.00% and 41.47% respectively. The male to female ratio of the cases was 1∶1.28. The ratio of cases with local residence to cases without local residence was 1∶1.29. The cases were distributed in 75% of the districts in Shanghai. More than 50% cases aged 5 months - 14 years received at least 3 doses of pertussis-containing vaccines. The incidence rates of typical symptoms of vomiting, cyanosis or inspiratory stridor were all <30%. Among the close contacts with symptom of cough, the adults aged ≥20 years accounted for 71.88%. The positive rate of nasopharyngeal swab detection in PCR was 30.50%, while the positive rate of PT-IgG was 41.07%.ConclusionThe sensitivity of pertussis surveillance in Shanghai was greatly improved in 2017 due to the efforts of sentinel hospitals. Less cases showed typical symptoms of pertussis, a high proportion of cases had vaccination history. It is suggested revise the case definition of probable case of pertussis and improve the diagnosis of pertussis.
An outbreak of dengue fever in Gongshu district of Hangzhou, Zhejiang, 2017
Feifei Zhu, Hanyan Yuan, Zhimin Wang, Chenye Zhang
2019, 34(5): 422-426. DOI: 10.3784/j.issn.1003-9961.2019.05.012
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ObjectiveTo understand the cause of an outbreak of dengue fever occurred in Gongshu district of Hangzhu, Zhejiang province, in 2017, and provide evidence for the prevention and control of dengue fever in the future.MethodsEpidemiological survey was conducted through active search of dengue fever cases in hospitals and communities to describe the epidemiological characteristics of the cases and analyze the cause of the outbreak.ResultsA total of 327 cases were reported in this outbreak, most cases occurred from 21 August to 15 September and distributed in 4 communities along with the Beijing-Hangzhou Grand Canal. The cases were mainly the retired (123, 37.61%) and the jobless (76, 23.24%) and aged >50 years (61.16%). The average interval between onset and diagnosis was 5.20 days, and the interval was 3 days (2–5 d) in inpatient group and 5 days (3–7 d) in outpatient group, the difference was significant (Ζ=6.383, P<0.001).ConclusionThis outbreak, a local transmission of dengue fever, might be caused by imported or latent infection cases. It is suggested to improve the diagnosis and surveillance of dengue fever in hospitals at all levels and implement community responsibility protocol regularly for the timely detection and control of dengue fever epidemic in the future.
An outbreak of dengue serotype 1 virus in Xishuangbanna prefecture of Yunnan province, China, 2017
Jianhua Fan, Yun Feng, Jin Zhu, Hongbin Li, Yang Gao, Weiping Li, Yinghua Dao, Jing Zhang, Jianhong Zou, Junming Li, Yihanyu Rong, Hailin Zhang
2019, 34(5): 427-434. DOI: 10.3784/j.issn.1003-9961.2019.05.013
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ObjectiveTo understand the epidemiologic, virologic and genetic characteristics of an outbreak of dengue fever in Xishuangbanna prefecture of Yunnan province in 2017.MethodsThe incidence data of dengue fever in Xishuangbanna were collected. The serum samples from acute patients were collected to detect the nucleic acid of dengue virus by reverse transcription- polymerase chain reaction(RT-PCR) assay. Coding regions of C/prM and E genes of dengue virus were amplified by RT-PCR and sequenced. The phylogenetic tree was constructed by Neighbor-Joining methods of MEGA 5.0 software.ResultsA total of 1 348 laboratory confirmed dengue fever cases were reported in Xishuangbanna in 2017, in which 1 231 were indigenous cases (91.32%), 117 were imported cases (8.68%). Imported cases from Laos and Myanmar were reported in Jinghong, Mengla and Menghai counties of Xishuangbanna, and indigenous cases occurred in Jinghong (1 030, 83.67%) and Mengla (201, 16.33%). The epidemic of dengue fever lasted from May to December. The majority of patients were aged 20-54 years, the youngest was 2 year-old and the oldest was 89 year-old. The male to female ratio of the cases was 1∶1.16. Phylogenetic analysis on nucleotide sequences of C/PrM of 48 virus strains obtained from the serum samples of dengue fever cases indicated that the 46 strains belonged to dengue virus serotype 1 (DENV-1), in which 33 from Jinghong, 10 from Mengla and 3 from Menghai and 2 strains belonged to dengue virus serotype 2 (DENV-2), in which 1 from Mengla and 1 from Menghai. The DENV-1 strains from imported cases of Laos shared high homology with the strains from indigenous cases.These DENV-1 strains from Xishuangbanna had closer genetic relationship with the DENV-1 strains isolated from Ruili county of Dehong prefecture and Gengma county of Lincang prefecture of Yunnan and the countries of southeastern Asia in recent years.ConclusionThe dengue fever epidemic occurred in Xishuangbanna in 2017 was mainly caused by DENV-1. The imported dengue fever cases from Laos were the main sources for the indigenous transmission of dengue fever in Xishuangbanna. It is necessary to strengthen control of the cross-border spread of dengue fever in this area.
Gene polymorphism related with tuberculosis susceptibility in 364 Mongolian population
Lele Deng, Liqin Wei, Jinqi Hao, Qian Huang, Ruili Hou
2019, 34(5): 435-439. DOI: 10.3784/j.issn.1003-9961.2019.05.014
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ObjectiveTo explore the relationship between NRAMP1, Sp110 gene polymorphism and susceptibility to tuberculosis (TB) in inner Mongolia population.MethodsA case-control study was conducted, a total of 180 TB patients and 184 healthy controls were selected in inner Mongolia population. Polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) test was performed by using blood samples to detect the genotypes, and analyze the genotype frequency distribution in the case group and the control group. The relationship between genotype and environmental factors and TB susceptibility was analyzed with χ2 test and logistic regression.ResultsSingle factor χ2 analysis indicated that except body mass index (BMI) the other factors had balanced distribution between two groups, the gene polymorphisms of NRAMP1rs17235409, NRAMP1rs17235416 and Sp110rs3948464 loci were associated with the susceptibility to TB, the susceptibilities of mutated genotype GA+AA, TGTG/(-)+(-)/(-), and CC to TB were 1.784, 4.745 and 3.061 times higher than those of non-mutated genotype GG, TGTG/TGTG, TT. People with BMI<18.5, a risk factors for TB, had a 4.350 times higher risk for TB compared with those with BMI≥18.5.ConclusionThe gene polymorphisms of NRAMP1rs17235409, NRAMP1rs17235416 and Sp110rs3948464 loci is associated with the susceptibility to TB in inner Mongolia population.
Classification and regression tree model study on correlation between influenza epidemic and meteorological factors in different areas of Gansu, 2010 to 2016
Xiaoting Yang, Dongpeng Liu, Jian He, Faxiang Gou, Haixia Liu, Yunhe Zheng, Kongfu Wei, Yao Cheng, Xinfeng Liu
2019, 34(5): 440-445. DOI: 10.3784/j.issn.1003-9961.2019.05.015
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ObjectiveTo explore the influence of meteorological factors on the influenza epidemic intensity in Gansu province and provide scientific evidence for the improvement of timeliness of influenza prevention and control.MethodsThree surveillance areas were selected, i.e. Baiyin, Tianshui and Jiuquan. The influenza surveillance data and meteorological data of the three areas were collected, and the lag time of various meteorological factors on the incidence of influenza was analyzed by cross correlation analysis. Classification and regression tree (CART) was used model to select the meteorological factors which had the greatest impact on the epidemic intensity.ResultsMeteorological factors correlation studies showed that temperature and humidity were negatively correlated with influenza epidemic intensity. The influenza epidemic intensity in Tianshui increased by 1.89 times when the 3 weeks moving average of maximum temperature was below 19.11 ℃; the influenza epidemic intensity in Jiuquan increased by 2.01 times when the 3 weeks moving average of average temperature was below 8.03 ℃; the influenza epidemic intensity of Baiyin increased by 2.24 times when the 3 weeks moving average of average temperature was below 8.68 ℃ and the 14 weeks moving average of relative humidity was below 61.04%.ConclusionMeteorological factors could affect the incidence of influenza, cold and dry weather would be suitable for the spread of influenza in population.
Epidemiological characteristics of communicable disease related public health emergencies in schools (child care settings) in China, 2014–2016
Xijun Weng, Rui Wang, Xiaoye Wang, Na Li, Ling Yu, Yanping Zhang
2019, 34(5): 446-450. DOI: 10.3784/j.issn.1003-9961.2019.05.016
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ObjectiveTo understand the epidemiological characteristics of communicable disease related public health emergencies in schools (including child care settings) in China.MethodsThe incidence data of communicable disease related public health emergencies in schools in China from 2014 to 2016 were collected from public health emergency information system for a descriptive epidemiological analysis.ResultsA total of 3 491 communicable disease related public health emergencies occurred in schools were reported in China from 2014 to 2016, involving 116 682 cases and 16 deaths. The first 5 communicable diseases were varicella, hand foot and mouth disease (HFMD), influenza, mumps and other infectious diarrhea, the epidemics caused by these diseases accounted for 94.41% of the total. Two incidence peaks were reported, one was in spring and another one was in winter. Varicella was main respiratory infectious disease in spring and winter, HFMD was main intestinal infectious diseases in spring and other infectious diarrheal diseases mainly occurred in winter. The most commonly reported communicable diseases in child care settings, primary schools and middle schools were varicella, HFMD and influenza.ConclusionRespiratory infectious diseases are the main diseases reported in public health emergencies in schools in China. It is essential to conduct targeted disease prevention and control in different schools and in different seasons to reduce the incidence of communicable disease related public health emergencies in schools.
Application of real-time fluorescence quantitative PCR to detect DNA of Brucella
Guozhong Tian, Dongri Piao, Hongyan Zhao, Dianying Lu, Hai Jiang, Lijun Wang
2019, 34(5): 451-454. DOI: 10.3784/j.issn.1003-9961.2019.05.017
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ObjectiveTo understand the detection range of Brucella nucleic acid DNA concentration and the background Ct value of nucleic acid DNA in whole blood from healthy people by using fluorescence quantitative PCR.MethodsGenomic DNA extraction kits were used to extract nucleic acid DNA from pure Brucella, the blood samples of healthy people and clinical patients. Real-time fluorescence quantitative PCR was used to detect the nucleic acid DNA.ResultsThe average Ct value of 40 healthy blood samples was 37.0. The standard deviation was 1.9. The 95% range of Ct value was 33.0–38.8. The sensitivity of real-time fluorescence quantitative PCR was 6.7 fg in the light of double dilution of extracted Brucella nucleic acid DNA (56.2 ng–0.026 5 fg).ConclusionThe sensitivity of real-time fluorescence quantitative PCR to detect nucleic acid DNA from pure Brucella was equal to 2 genomic DNA copies.
Establishment of a recombinase polymerase amplification combining with lateral flow strip assay for rapid visual detection of Francisella tularensis
Yao Peng, Biao Kan, Lianxu Xia, Wei Li, Wen Zhang, Jinxing Lu, Aiping Qin
2019, 34(5): 455-459. DOI: 10.3784/j.issn.1003-9961.2019.05.018
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ObjectiveTo establish a rapid, sensitive and specific assay for detection of Francisella tularensis by recombinase polymerase amplification and lateral flow (LF-RPA) strip techniques.MethodsA primer-probe set targeting specific gene tul4 of F. tularensis for LF-RPA assay was designed and the parameters (temperature and time) for the assay were optimized. The sensitivity and specificity of the assay were evaluated.Field feasibility was explored by running the assay with Francisella -spiked blood samples.ResultsThe optimal temperature and time of the assay were at 40 ℃, and for 20 min. The limit of detection (LOD) of the LF-RPA assay on genomic DNA of F.tularensis was 20 fg/μl, similar to qPCR method targeting the same gene. No cross-reactions with 7 other non-F. tularensis bacteria species was observed,indicating the specificity of the LF-RPA assay. The LOD of the LF-RPA assay for detecting F. tularensis in simulated blood samples was about 460 CFU/ml.ConclusionThe newly developed assay is a simple, rapid, sensitive and specific method for the detection of F. tularensis with a potentiality of clinical diagnosis of tularemia and detection of Francisella at an outbreak field.
Surveillance for death causes in residents in Yuyao, Zhejiang, 2014–2017
Shanshan Shi, Yafeng Shi, Zhe Shao
2019, 34(5): 460-463. DOI: 10.3784/j.issn.1003-9961.2019.05.019
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ObjectiveTo understand the epidemiological characteristics of deaths in residents in Yuyao, Zhejiang province, and provide scientific evidence for the prevention and control of injury.MethodsThe death surveillance data in residents in Yuyao from 2014 to 2017 were collected and the death causes were classified according to the International Classification of Diseases, 10th edition (ICD-10). The average mortality rate, standardized average mortality rate, potential years of life lost (PYLL), average years of life lost (AYLL) and the rate of PYLL were calculated.ResultsFrom 2014 to 2017, the average mortality rate was 739.95/100 000, and the standardized average mortality rate was 435.49/100 000. The average annual crude mortality rate was 832.53/100 000 and the standardized mortality rate was 484.60/100 000 for males. The average annual crude mortality rate was 649.51/100 000 and the standardized mortality rate was 386.28/100 000 for females. The overall mortality rate of males was higher than that of females (χ2=381.589, P<0.001); The first five death causes were malignant tumor (234.41/100 000), respiratory disease (136.09/100 000), cerebrovascular disease (99.82/100 000), heart disease (90.47/100 000) and injury (74.33/100 000). The death caused by the first 5 death causes accounted for 85.84% of the total. For the first 5 death causes, the PYLL was 79 305.00 person years, the average PYLL was 13.01 person years, and the rate of PYLL was 26.49‰. Injury caused greatest loss of life.ConclusionMalignant tumor was one of leading causes of deaths in Yuyao, causing great loss of life expectancy. The overall mortality rate of males was higher than that of females. Comprehensive disease control measures should be taken for different groups of people.
Characteristics and death causes of perinatal death in floating population of Wenzhou, Zhejiang, 2007-2016
Ou Xiang
2019, 34(5): 464-467. DOI: 10.3784/j.issn.1003-9961.2019.05.020
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ObjectiveTo analyze the situation and causes of perinatal death in floating population in Wenzhou of Zhejiang province, and provide evidence for the reduction of perinatal mortality.MethodsThe surveillance data of perinatal deaths in Wenzhou and the reports of children and maternal health condition in floating population were collected from 2007 to 2016 for analysis of the incidence trend, characteristics and causes of perinatal deaths.ResultsThe perinatal mortality rate in floating population was significantly higher than that in local population (χ2=143.832, P<0.001). Moreover, it was noticed that the health care awareness and perinatal health care coverage in floating population were obviously lower than those in local population (χ2=538.904, P<0.001). The incidence of birth defect in perinatal death in floating population was obviously lower than that in local population (χ2=53.291, P<0.001). With the incidences of gestational hypertension related to dead fetus, stillbirth and neonatal death in flowing population was higher than that in local population (χ2=25.441, 15.104, 13.415, P<0.001). Besides, the incidence of placental abruption related with stillbirth and neonatal death in flowing population was higher than that in local population (χ2=65.146, P<0.001; χ2=7.657, P<0.01). The incidence of prolapse of cord in dead fetus in floating population was higher than that in local population (χ2=21.466, P<0.001). The incidence of premature birth/low birth weight related to perinatal death in floating population was higher than that in local population (χ2=147.932, P<0.001).ConclusionThe perinatal mortality rate in floating population showed a downward trend in the past 10 years. Therefore, it is necessary to strengthen health education, standardize pregnancy examination and improve high-risk management through multi sectoral cooperation to reduce perinatal death in floating population and improve population quality.
Application analysis of big data of duplicate reporting cards in National Notifiable Disease Report System, 2005–2017
Yanfei Li, Yewu Zhang, Xiaofeng Wang, Liping Wang
2019, 34(5): 468-472. DOI: 10.3784/j.issn.1003-9961.2019.05.021
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ObjectiveTo understand the current status of duplicate reporting cards in National Notifiable Disease Report System (NNDRS), analyze the causes of duplicate reporting and suggest solutions for the further standardization of reporting management and improvement of data quality.MethodsThe analyses on annual duplicate reporting cards, cumulative duplicate reporting cards and duplicate reporting cards beyond year of notifiable diseases in China from January 2005 to December 2017 were conducted by using Python and Jupyter notebook based on Hadoop and Spark big data analysis platform. And the results are displayed by using Python library matplotlib.ResultsDuring 2005–2017, the annual average rate of duplicate reporting cards was 7.65/10 000, and the cumulative number of duplicate reporting cards was 1 141 539 and the rate of cumulative reporting cards was 133.47/10 000. The first three diseases with high duplicate reporting card numbers were hepatitis B, hand foot and mouth disease and tuberculosis, accounting for 30.23%, 28.01% and 12.96% respectively of the total. In 2017, the rate of duplicate reporting cards was 11.19/10 000, the annual duplicate reporting card number was 8 497 and the cumulative duplicate reporting card number beyond year was 276 194.ConclusionThe data quality in NNDRS needs to be improved due to increased annual duplicate reporting cards beyond year and the rate of cumulative duplicate reporting cards. The duplicate reporting cards seriously influenced data analysis. It is necessary to take appropriate data management and analysis measure as soon as possible.
A brucellosis outbreak and risk factors in a dairy farm
Dan Wu, Wenzeng Zhang, Yuxin Ma, Yang Zheng, Hongxia Li, Guangyi Hu
2019, 34(5): 473-476. DOI: 10.3784/j.issn.1003-9961.2019.05.022
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ObjectiveTo understand the causes of a brucellosis outbreak and associated risk factors in a dairy farm in 2017.MethodsAll the workers in the dairy farm were surveyed by using a self-administrated questionnaire in face to face interviews. For each worker, blood sample was collected for tube agglutination test.ResultsA total of 99 workers were surveyed. Twelve workers were positive in serological tube agglutination test, and the infection rate in milkers was highest (5/20, 25.00%). Nine brucellosis cases were confirmed. The cases were aged between 23 and 55 years, the main clinical symptoms were joint or muscle pain and fatigue without fever; and the antibody titers of 3 latent infection cases were all 1∶100++. Risk factors associated with brucellosis were contact with livestock apoblema(RR=3.73, 95% CI: 1.07–7.27), contact with sick cattle(RR=4.07, 95% CI: 1.07–7.33), vaccinating livestock(RR=9.11, 95% CI: 1.37–21.22), repeated use of gloves(RR=5.09, 95% CI: 1.16–14.63).ConclusionExposure to livestock apoblema, vaccinating livestock and repeated use of gloves might be main risk factors for brucellosis in the workers. It is necessary to strengthen the prevention and control of animal brucellosis epidemic and health education about brucellosis in occupational groups. Close attention should be paid to the supervision of milk production process.
遵守“国际卫生条例”(2005)、在入境口岸通过全方位的风险告知措施阻止埃博拉病毒病的国际传播
2019, 34(5): 477-478. DOI: 10.3784/j.issn.1003-9961.2019.05.023
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CN 11-2928/R

ISSN 1003-9961

Established in:1986 , Monthly

Responsible Institution:National Health Commission of the People's Republic of China

Sponsor: Editorial Board of Disease Surveillance,National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention

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