Disease Surveillance

Epidemiological characteristics and spatial clustering of brucellosis in Guilin, Guangxi, 2017−2021

Xu Fanni, Qin Jinyong, Xiong Hao, Li Baoxiu, Long Hu

, DOI: 10.3784/jbjc.202303090097

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Objective To understand the epidemiological and spatial distribution characteristics of human brucellosis in Guilin, Guangxi Zhuang autonomous region, from 2017 to 2021, and provide the scientific basis for the development of brucellosis prevention and control strategy. Methods The incidence data of the human brucellosis in Guilin from 2017 to 2021 were collected for descriptive and statistical analyses with software spss25.0. Software ArcGIS 10.8 was used for cold and hot spot analysis, global spatial autocorrelation analysis and local spatial autocorrelation analysis. Results A total of 278 cases of human brucellosis were reported in Guilin from 2017 to 2021, and the annual incidence showed a downward trend. The cases occurred all the year round during this period, and the incidence peak was during March-July. The male to female ratio of the cases was 2.02∶1, and the cases were mainly aged 30−69 years, accounting for 89.93% (250/278) of the total. The epidemiological survey in 221 cases indicated that the top three populations affected were people engaged in sheep slaughtering and trading of sheep and sheep products (28.05%, 62/221), farmers (14.48%, 32/221) and the jobless and unemployed (14.03%, 31/221), followed by those with indirect contacts with sheep and sheep products (13.12%, 29/221) and those engaged in sheep breeding (4.52%, 10/221). The cases were reported in 17 counties (districts) in Guilin. The global spatial distribution analysis showed that the incidence of human brucellosis in Guilin showed spatial clustering during 2017−2021. The analysis on hot and cold spots indicated that the areas with high incidence were in main urban area, Lingui and Guanyang, and the annual spatial distribution showed a gradual diffusion trend from clustering to low clustering. Conclusion The incidence of human brucellosis showed a declining trend in Guilin from 2017 to 2021, and the human brucellosis cases occurred after contact with sheep still accounted for a high proportion, and the incidence in some urban areas was still high. It is necessary to continue the joint and targeted prevention and control of human brucellosis, strengthen the surveillance in key populations, standardize the management of livestock trading markets, and conduct health education in general and occupational populations to reduce the incidence of human brucellosis.

Etiological characteristics of a cholera epidemic in Tongzhou district, Beijing, 2022

Zhang Ping, Zou Lin, Gao Xiang, Yang Haoliang, Zhen Bojun, Li Weihong, Guo Xiaochen, Lin Changying, Li Renqing, Yan Hanqiu, Pang Bo

, DOI: 10.3784/jbjc.2021.000

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Objective To analyze the etiological characteristics of a cholera epidemic in Tongzhou district of Beijing in 2022 and make a comparison with previous cholera epidemics in Tongzhou. Methods The specific genes of Vibrio cholerae O1/O139 were detected by real-time PCR. At the same time, the strains were isolated, cultured and identified by conventional method. Eleven virulence genes of V. cholerae were detected by common PCR, and 12 kinds of drug sensitivity tests were carried out by minimal inhibitory concentration method. Not I restriction enzymes were used for pulsed field gel electrophoresis (PFGE) analysis and cluster analysis. Genetic analysis on strains was performed by whole genome sequencing. Results A total of 5 strains of non-virulence V. cholerae O1 serotype Ogawa were detected in this epidemic. All the strains carried ompU, toxR, tcpI, tcpA^EL, hlyA^EL, hlyA^CL and rtxC genes, but carried no ctxAB gene. The drug resistance of the 5 strains was consistent. All the strains were resistant to meropenem, cefotaxime, ceftazidime, streptomycin, ampicillin, and ampicillin/sulbactam. PFGE divided the strains into 6 types (Ⅰ- Ⅵ), and the strains causing this epidemic belonged to type Ⅱ. The comparison with the two strains of virulence V. cholerae O1 serotype Ogawa detected in previous local epidemic in 2011 indicated the similar PFGE pattern, the drug resistance was same, the virulence gene carriage was different, but both carried tcpA^EL gene. Genetic analysis showed that the strains in this epidemic belonged to new and emerging clonal group which was different from the strain causing the 7^th pandemic. Conclusion The predominant V. cholerae O1 strain in Tongzhou belonged to serotype Ogawa without toxin producing. PFGE patterns varied. The strains detected in this epidemic belonged to a newly emerged clone group. In cholera prevention and control in the future, attention should be paid to these strains and targeted strategies should be developed.

Molecular epidemiology of enteroviruses among herpangina patients in Shenzhen, China, 2017−2018

Chen Long, Yang Hong, Yao Xiangjie, Meng Jun, Zhang Hailong, Zhang Renli, He Yaqing

, DOI: 10.3784/jbjc.202204070136

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Objective The (sero) type distribution and molecular characteristics of enteroviruses (EV) associated with HA in Shenzhen were investigated to provide scientific basis for HA control and prevention. Methods A total of 314 clinical specimens from 157 HA patients, including 157 feces specimens and 157 throat swabs, were collected between 2017 and 2018. EV types were determined using real-time reverse transcription polymerase chain reaction (RT-PCR), RT nested PCR, and sequencing. VP1 sequences were analyzed using bioinformatics programs. Results Ten EV types were detected in 126 EV-positive HA patients (80.30%, 126/157). The most predominant pathogen was coxsackievirus A10 (CVA10) (19.70%, 31/157), followed by CVA4 (17.80%, 28/157), CVA6 (15.30%, 24/157) and CVA2 (10.80%, 17/157). Other pathogens detected included CVA5 (4.50%, 7/157), CVA16 (3.20%, 5/157), EV-A71 (1.30%, 2/157), CVA8 (0.60%, 1/157), CVB5 (0.60%, 1/157) and echovirus 11 (E11) (0.60%, 1/157). One patient co-infected CVA4 with CVA10. The predominant pathogens were CVA2 and CVA6 in 2017, but CVA10 and CVA4 became predominant in 2018. There was no statistically significant difference (χ²=0.0186, P=0.8916) between the pathogen detection rates of feces specimens and throat swabs. Molecular phylogeny based on the complete VP1 gene indicated that all CVA10 strains from this study were assigned to genotype C2 . All CVA4 strains except for one strain which was assigned to genotype C5 belonged to genotype C2. All CVA6 strains except for one strain which grouped in a previously uncharacterized clade were assigned to sub-genotype D3a. All CVA2 strains belonged to genotype D2. Conclusion Both feces specimens and throat swabs are suitable for EV RNA testing for HA. The main pathogens were CVA10, CVA4, CVA6 and CVA2 in HA patients from 2017 to 2018 in Shenzhen, China. A majority of strains belonged to the genotypes which were prevalent in China. And individual strain grouped in an uncommon genotype or clade.

Carriage and drug resistance of Salmonella in employees engaged in food and public place services in Yulin, Guangxi, 2022

Wu Yannong, Zhou Changyu, Mo Zongxin, Ling Zhisui, Wen Yujian, Xia Yinghua, Zhang Yaoping, Xie Lili, Luo Ming

, DOI: 10.3784/jbjc.202305240239

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Objective To understand the carriage, bacterial type distribution, and drug resistance of Salmonella in employees in the food and public place services in Yulin, Guangxi Zhuang Autonomous Region, and provide evidence for the development of local prevention and control plan for intestinal infectious diseases. Methods Salmonella isolation and serotyping were performed by using anal swabs collected from the employees; Drug susceptibility of the Salmonella strains to 28 antibiotics were tested by using micro broth dilution method. Results A total of 54588 samples were tested, and the detection rate of Salmonella was 1.85% (1012/54588). The detection rate was higher in summer and autumn than winter and spring. Two drug sensitive plates were randomly used for 1012 Salmonella strains (NMIC-413 drug sensitive plate for 905 Salmonella strains, and RUONMIC-801 drug sensitive plate for 107 Salmonella strains). Due to the difference of antibiotic types, statistical analysis could not be carried out, only analyze the results of 905 strains of NMIC-413 drug sensitive plates. The 1012 strains of Salmonella were divided into 56 serotypes. The first three serotypes were S. typhimurium (22.83%), S. lissenii (11.07%) and S. argonne (6.03%). The drug susceptibility test results of 905 strains showed that the drug resistance rate was 68.84%, and the resistance rate of strains to tetracycline was highest (59.34%), followed by that to chloramphenicol (49.28%) and trimethoprim/sulfamethoxazole (37.13%). The multidrug resistance rate was 40.55%. Conclusion The Salmonella carrying rate was high in the employees engaged in food and public place services in Yulin, and the serotypes of the Salmonella detected were complex. The detection rate of Salmonella varied with season, and the drug resistance level of the strains was high and multiple drug resistance was serious. It is necessary to strengthen the health surveillance for the early detection of Salmonella carriers and standardized medication.

Temporal-spatial epidemiological characteristics of malaria cases in Jiangsu province, 2012−2019

Hu Xuefeng, Chen Lin, Zhang Rong, Tian Lingling, Zhou Pengcheng, Shi Dan, Wu Hailei, Han Hui

, DOI: 10.3784/jbjc.202302190049

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Objective To analyze the temporal-spatial distribution characteristics of malaria cases in Jiangsu province from 2012 to 2019, to analyze the temporal-spatial clustering of malaria cases, in order to provide theoretical basis for prevention and control of imported cases. Methods The epidemic data of malaria cases in Jiangsu province was collected. The global and local spatial autocorrelation of malaria cases was carried out respectively by ArcGIS 10.2. The temporal-spatial clustering was analyzed by spatial-temporal scanning by SatScan 9.5. Results A total of 2333 malaria cases were reported in Jiangsu province from 2012 to 2019. 2329 (99.83%) cases were imported. 2317 (99.31%) cases were Chinese. 1939 (83.11%) cases were Chinese migrant workers. 2279 (97.85%) cases were imported from African. 43 (1.85%) cases were imported from south-east Asia. The top 5 cities were Nantong (350, 15.00%), Taizhou (277, 11.87%), Lianyungang (276, 11.83%), Yangzhou (268, 11.49%), Huai'an (258, 11.06%). There was a trend in spatial distribution. January-February and April-July were annual bimodal periods. Spatial autocorrelation analysis results showed that there was no obvious global spatial correlation from 2012 to 2019. But there were in hot areas and cold areas in local spatial autocorrelation analysis. Three high risk clustering areas were detected by year-by-year spatial-temporal scanning, involved in Huai’an, Lianyungang, Taizhou, Yangzhou, Nantong. Conclusions There is a certain level of spatial-temporal clustering in malaria cases in Jiangsu province from 2012 to 2019. The targeted measures should be taken to prevent and control the epidemic.

Epidemiological characteristics of public health emergencies caused by infectious diseases in Yunnan, 2015−2022

Chen Lihua, Zhang Rongbing, Li Rong, Zhao Jiang, Li Zeying, He Jibo

, DOI: 10.3784/jbjc.202305050200

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Objective To understand epidemiological characteristics of public health emergencies caused by infectious diseases in Yunnan province and provide reference for the prevention and control of infectious diseases. Methods The incidence data of public health emergencies caused by infections diseases in Yunnan from 2015 to 2022 were obtained from China Disease Prevention and Control Information System for a descriptive epidemiological analysis. Exponential model was used to predict the incidence of public health emergencies in Yunnan. Results From 2015 to 2022, a total of 1164 public health emergencies caused by infectious diseases were reported in Yunnan, including 1 Ⅲ-level emergency (0.086%), 861 Ⅳ-level emergencies (73.97%) and 302 non graded emergencies (25.95%). The main infection route was respiratory transmission, followed by intestinal transmission. The annual incidence peak was during October-December, and the sub peak was during May-June. The main places where public health emergencies occurred were schools and child care settings, and the main diseases were chickenpox and hand foot and mouth disease. It is predicted that 229 and 256 public health emergencies would occur in the following two years respectively. Conclusion In Yunnan, schools and child care settings are the key places for the prevention and control of public health emergencies caused by infectious diseases. It is necessary to strengthen the surveillance and early warning of respiratory and intestinal infectious disease epidemics in schools and child care settings for the timely detection, reporting, response and control of disease epidemics. At the same time, targeted vaccination and health education should be carried out during the seasons when infectious diseases usually occur.

Expert consensus on application of active mist ion in air disinfection of Mycobacterium

Wang Ruibai

, DOI: 10.3784/jbjc.202306030256

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The diseases caused by Mycobacteria include tuberculosis (TB), non-tuberculous mycobacterial diseases and leprosy, in which TB is the most serious and infectious one. TB is one of major global infectious diseases that seriously endanger human health and life and one of the major diseases in disease prevention and control in China. Through coughing, expectoration, sneezing, etc., the “droplet nucleus” carrying Mycobacterium tuberculosis is spread from infectious TB patients, causing infection in people nearby. Therefore, the prevention of airborne transmission of TB in health care institutions, public places, and even in families is one of the key measures in TB prevention and control. Active mist ions are charged groups with strong oxidation, including hydroxyl radicals, superoxide radicals, superoxide hydrogen radicals, etc. Under the package and protection of water molecules, they have better stability in air. Disinfection evaluation experiments have showed that active mist ion has good disinfection and sterilization effects on various bacteria and viruses, including Mycobacteria. The experts invited by Chinese Anti-tuberculosis Association, Zoonotic Tuberculosis Sub-association of Chinese Anti-tuberculosis Association and National Institute for Communicable Disease Control and Prevention, Chinese Center for Disease Control and Prevention have reached an consensus on the technical principle of active mist ion in air disinfection , composition of disinfection factors, disinfection effect and application in Mycobacterium disinfection through data inquiry, discussion and experimental research to provide technical guidance for the standardized application of active mist ion in air disinfection.

Species distribution and spread of non-tuberculous Mycobacteria in patients of Shaanxi Provincial Tuberculosis Prevention and Control Hospital, 2019−2021

Li Jing, Guo Le, Bai Guanghong, Wu Qianhong

, DOI: 10.3784/jbjc.202302170048

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Objective To understand the species distribution and spread of non-tuberculous Mycobacteria ( NTM ) in Shaanxi province and provide evidence for clinical diagnosis and prevention of the infections. Methods Retrospective analysis was conducted on the Mycobacterium nucleic acid positive respiratory tract samples collected in Shaanxi Provincial Tuberculosis Prevention and Control Hospital from July 2019 to December 2021. The detected NTM strains were identified by gene chip method and the composition ratio of different species was analyzed. The demographic data and clinical characteristics of the cases were analyzed by χ² test. Logistic regression analysis was used to evaluate the pathological damage degree of different NTMs in lungs based on the severity of lung lesions. Results The isolation rate of NTM was 3.5% (128/3646). A total of 7 species of NTM were detected, the first 3 were M. intracellular (36.7%, 47/128), M . chelonis/abscess (26.6%, 34/128), and M. Kansas (25.0%, 32/128). The difference in distribution ratio of different NTM infected patients was significant among different age group (χ²=25.727, P<0.001) and among people with different residence (χ²=15.227, P=0.002). Multivariate logistic regression analysis showed that M. chelonis/abscess caused milder lung pathologic damage compared with the other two species (OR=0.188, P=0.039). Conclusion The NTM detected in this study were mainly M. intracellular, M. chelonis/abscess and M. kansans, and different NTM caused different degrees of pathological damage in lungs.

Risk Assessment of Global COVID-19 Pandemic in August 2023

Zhao Qing, Wu Jiewen, Zhang Yichi, Ji Hanran, Pang Mingfan, Yang Xinping, Fang Yuansheng, Xue Xiuli, Sun Jing, Qi Xiaopeng

, DOI: 10.3784/jbjc.202309200493

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Objectives To assess the global epidemic of Coronavirus disease 2019 (COVID-19) in August 2023 and the risk of importation. Methods According to the daily COVID-19 data publicly released by World Health Organization, combined with the travel restrictions published by Sherpa, an epidemiological description method was used to provide a comprehensive and timely assessment of the global epidemic risk through a general overview, a comprehensive assessment of the epidemic trends in each continent and key countries, as well as a comprehensive analysis of the epidemic and travel requirements in 14 neighboring countries. Results Compared with the previous month, the number of confirmed cases and deaths globally increased 3.97% , while the number of deaths decreased by 45.8% in August 2023. Italy, the UK, Mexico, Greece, Portugal and Romania are the countries of global concern. Close attention should be paid to Israel in Asia, Saint Lucia in North America and Morocco in Africa. Special concern should be paid to Russia, India, Afghanistan, Nepal and Kyrgyzstan among the 14 land-boarding countries. Conclusion The global daily new confirmed cases showed a upward trend in August, while deaths cases showed a downward trend. It is necessary to continuously monitor countries with global concern and establish a communication mechanism with relevant agencies to exchange information and provide timely warnings.

Summary of global surveillance data of infectious diseases in August 2023

Han Hui, Wu Bo, Jia Jiaojiao, Song Yueqian

, DOI: 10.3784/jbjc.202309190492

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In August 2023, a total of 72 infectious diseases were reported globally, affecting 236 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (236), monkeypox (114), dengue fever (31), measles (31) and cholera (16). The top five infectious diseases with highest case fatality rates were Middle East respiratory syndrome (36.0%), Lassa fever (16.9%), Crimean-congo hemorrhagic fever (11.8%), meningitis (6.7%) and West Nile disease (6.1%). The top five infectious diseases with greatest number of deaths were COVID-19, dengue fever, cholera, measles and diphtheria. The prevalent infectious diseases in Asia were COVID-19, cholera, monkeypox, Crimean-congo hemorrhagic fever and dengue fever, the prevalent infectious diseases in Africa were COVID-19, cholera, monkeypox, Lassa fever, meningitis and poliomyelitis, the prevalent infectious diseases in America were COVID-19, dengue fever, chikungunya fever and monkeypox, the prevalent infectious disease in Europe was West Nile disease.

Ecological framework and transmission mechanism of communicable disease epidemics

Wang Weiwei, Chen Yusheng, Zhu Jianping, Zhu Miao

, DOI: 10.3784/jbjc.202212280554

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Objective To understand the ecological factors in the origin process and transmission of communicable diseases, explore the complex relationship among the occurrence, development and transmission paths of communicable diseases, and provide a systematic perspective for the effective prevention and control of communicable diseases. Methods Given the fact that a communicable disease epidemic results from complex ecological processes, the dynamic characteristics of the epidemic were summarized based on the viewpoint of system theory, and the interaction between the organism intrinsic factors and environment factors and social factors (biological and non-biological factors) were analyzed. Results From a balanced perspective of sustainable ecological development, a biological-natural-social ecosystem framework was constructed based on the biological characteristics of pathogen genetic metabolism, the characteristics of natural environment in which pathogens survive and evolve, and the characteristics of social environment by which pathogens spread. On this basis, the modeling of transmission of communicable diseases was conducted for the research of disease transmission mechanism, analysis on the transmission of communicable diseases under different conditions and evaluation of related control measures. Conclusion By clarifying the complex relationships in ecosystems resulting from biodiversity based on the construction of ecological framework, we can improve disease surveillance and response capabilities, provide scientific and feasible solutions for disease control and improve emergency management level.

Construction of combinatorial prediction model for infectious diseases based on software R

Liu Tian, Ruan Dexin, Hou Qingbo, Chen Hongying

, DOI: 10.3784/jbjc.202211090482

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Objective To construct a combinatorial prediction model for infectious diseases by using software R, and provide reference for disease surveillance. Methods The monthly incidence of hemorrhagic fever with renal syndrome (HFRS) in China, and in Jilin, Liaoning and Heilongjiang provinces from 2004 to 2017 were used as the training data to fit models, and the data from January to December 2018 were used to evaluate the prediction effect. Seasonal autoregressive integrated moving average (SARIMA), exponential smoothing (ETS), neural network autoregression (NNETAR), and exponential smoothing state space model (TBATS) were selected, and “forecastHybrid” package in software R was used to construct combinatorial models. Single models with the same weight was recorded as combinatorial model A; the combinatorial model with the weight of single models determined according to the fitting effect of the training data was recorded as combinatorial model B. Mean absolute percentage error (MAPE) and root mean square error (RMSE) were used to evaluate the fitting and prediction effects of the six models. The data from 2004 to 2011, 2004 to 2012, 2004 to 2013, 2004 to 2014, 2004 to 2015, 2004 to 2016 and 2004 to 2017 were selected as training sets to construct the models respectively, and predict the incidence from January to December in the following year for sensitivity analysis. The fitting of combinatorial model, and the rank of MAPE and RMSE predicted were calculated to evaluate the stability of model fitting and prediction effects. Results The MAPEs fitted by SARIMA, ETS, NNETAR, TBATS, combinatorial model A, and combinatorial model B in China, and in Jilin, Liaoning and Heilongjiang provinces were 11.81%, 9.75%, 11.50%, 9.71%, 8.09%, 8.06%; 29.63%, 15.39%, 23.04%, 14.60%, 16.33%, 16.29%;19.76%, 15.48%, 3.93%, 15.24%, 12.66%, 7.08%; 21.92%, 17.96%, 6.73%, 15.80%, 13.55%, 10.29% respectively. The predicted MAPEs of SARIMA, ETS, NNETAR, TBATS, combinatorial model A and combinatorial model B in China, and in Jilin, Liaoning and Heilongjiang provinces were 23.38%, 20.35%, 11.01%, 34.28%, 17.03%, 16.02%; 11.72%%, 14.26%, 24.32%, 14.16%, 11.93%, 11.92%; 28.09%, 27.57%, 29.19%, 27.32%, 26.91%, 26.49%; 23.72%, 33.28%, 28.96%, 33.785%, 25% 27.31% respectively. The RMSEs fitted by SARIMA, ETS, NNETAR, TBATS, combinatorial model A and combinatorial model B in China, and in Jilin, Liaoning and Heilongjiang provinces were 0.01, 0.01, 0.01, 0.01, 0.01, 0.01; 0.08, 0.08, 0.05, 0.08, 0.05, 0.05; 0.08, 0.07, 0.01, 0.07, 0.04, 0.02; 0.16, 0.16, 0.04, 0.15, 0.08, 0.06 respectively. The RMSEs predicted by SARIMA, ETS, NNETAR, TBATS, combinatorial model A and combinatorial model B in China, and in Jilin, Liaoning and Heilongjiang provinces were 0.02, 0.01, 0.02, 0.02, 0.01, 0.01; 0.03, 0.04, 0.07, 0.04 , 0.05, 0.05; 0.07, 0.05, 0.05, 0.05, 0.05, 0.05; 0.13, 0.14, 0.11, 0.14, 0.12, 0.12 respectively. The sensitivity analysis showed that the overall fitting effect of combinatorial model B ranked first, and combinatorial model A ranked 2–4. From the perspective of the prediction effect, the optimal effect of the combinatorial model in the two evaluation indicators ranked first or second. Conclusion The performance of fitting and prediction of the combinatorial model are better than that of the single model, and the combinatorial model with the model weights according to the fitting effect of the training data is the optimal model. The combinatorial model can be constructed by simple programming using software R, the application of the model is worthy to promote.

Discovery and confirmation of Altay Mountain plague focus in Xinjiang Uygur Autonomous Region

Wang Xinhui, Liu Ge, Guliayi Baokaixi, Wang Yumeng, Gui Youjun, Wang Xijiang, Wang Xiaojun, Luo Yongjun, Wang Shuo, Luo Tao, Yin Xiaoping, Wang Cheng, Li Wei, Li Bo

, DOI: 10.3784/jbjc.202301280011

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Objective To investigate and confirm the existence of natural focus of plague in Altay Mountain of Xinjiang Uygur Autonomous Region. Methods The plague focus investigation were carried out in Altay Mountain area, Qinghe, Fuhai, Altay, during 2021−2022. The experimental methods included bacteriological, serological, molecular biological identification assays in specimens (rodent organs, serum, heart infusion, vector parasitic fleas). In addition, biochemical type of Yersinia pestis isolates was identified. Results A total of 115 rodents, including dead ones, and 136 vector parasitic fleas were captured in Altay Mountains area. In the rodents, the predominant species were C. undulates and Marmota baibacina, accounting for 60.87% and 20.87%, respectively. In the parasitic fleas, the predominant species were Citellophilus tesquorum altaicus and Oropsylla silantiewi, accounting for 67.74% and 100.00%, respectively. A total of 86 serum samples, 21 samples of heart infusion of small mouse, 8 samples of dead rodent organ grinding fluid were tested through bacteriological, immunological methods, and 8 DNA samples extracted from dead rodent organ tissues were detected by real-time PCR. One F1 antibody positive serum sample of C. undulates was detected, the titer of indirect hemagglutination assay (IHA) was 1∶128 and the titer of ELISA was 1∶256. One positive sample of plague F1 antigen was detected in the grinding fluid of dead M. baibacina organ, the titer of reverse indirect hemagglutination assay (RIHA) was 1∶64, and titer of ELISA was 1∶128. Two positive samples of plague F1 antigen were detected in dead C. undulates organ grinding fluid, the titers of RIHA were 1∶512 and 1∶1 024; the titers of ELISA were 1∶2 048 and 1∶4 096 respectively. Plague special real-time PCR detected 2 positive samples in C. undulates organ tissues. Two strains of Y. pestis were isolated and corresponding biovars were identified as Antique type. Conclusion A new plague focus was identified in the Altay Mountain area of Xinjiang and the biochemical types belonged to Antique.

Estimated prevalence of syphilis in China based on Bayesian structural time series model

Zhang Zhen, Liu Xingyan, Li Yanyan, Xing Yingying, Wang Yongbin, Hu Bin

, DOI: 10.3784/jbjc.202211030474

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Objective To evaluate the performance of Bayesian structural time series (BSTS) model for estimating the prevalence of syphilis in China. Methods The incidence data of syphilis in China from January 2005 to August 2022 were collected. The trend and seasonal components in the syphilis monthly incidence data were analyzed by using software Eviews10. The model was constructed by using software RStudio, and in the model development, the incidence data from January 2005 to December 2021 were used as the training set to fit the BSTS model, whereas the incidence data from January to August 2022 were used as the test set to verify the prediction potential of the model. Subsequently, the prediction accuracy of BSTS model was compared with that of autoregressive integrated moving average (ARIMA) model. The test levels for all statistical analyses were designated as

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=0.05. Results Overall, the incidence of syphilis in China showed an upward trend and had a periodicity and seasonality with the trough during January-February and the peak during July-August. On the training and testing sets, the average absolute percentage error of BSTS model (4.95%, 5.73%) was lower than those of ARIMA model (5.44%, 6.52%). Also, it was found that the mean absolute error, root mean square error, and root mean square percentage error of BSTS model were lower than those of ARIMA model. The robustness test indicated the same result. The predicted total case number of syphilis was 719 600 (95%CI: 605 295–826 086) from September 2022 to December 2023 by BSTS model, with a monthly average of 44 975 cases (95%CI: 37 831–51 631). Conclusion In China, syphilis is a seasonal disease with high incidence. The BSTS model can be used for accurately assessing the incidence of syphilis and providing technical support for the accurate prevention and control of syphilis.

Analysis on tuberculin skin test results in 16795 freshmen in Ningbo, Zhejiang

Chen Tong, He Tianfeng, Yu Mei, Che Yang, Lin Xiang

, DOI: 10.3784/jbjc.202301180005

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Objective To obtain the latent infection and distribution characteristics of Mycobacterium tuberculosis in freshmen in senior high schools and boarding junior high schools in Ningbo by analyzing the tuberculin skin test results of some students, and provide evidence for the improvement of tuberculosis (TB) prevention and control strategies in schools. Methods TB symptom screening and purified protein derivative (PPD) test were conducted in 16,795 freshmen. The students with strong positive results of PPD were examined by chest X-ray, sputum smear and sputum culture. χ² test and Fisher's exact test were used to compare the differences in rates among different groups. Multivariate logistic regression analysis was used to identify the influencing factors of strong PPD positive reaction and tuberculosis infection risk. Results The positive rate of PPD tests in the freshmen in senior high schools and boarding junior high schools in Ningbo was 17.23%, the strong positive rate was 2.69% and the infection rate was 7.83%. Three active TB cases were found in this screening, and the incidence of TB was 17.86/100 000. The results of multivariate logistic regression analysis showed that gender, school type and age were the influencing factors for the risk of strong PPD positive action and infection in the freshmen. The risks for strong PPD positive reaction (OR=1.445, 95%CI: 1.197–1.745） and infection (OR=1.413, 95%CI: 1.262–1.582) in girls were higher than those in boys. The risks for strong PPD positive reaction (OR=1.535, 95%CI: 1.23–1.914) and infection (OR=1.525, 95%CI: 1.330–1.748) in freshmen in vocational middle schools were higher than those in freshmen in non-vocational middle schools. Compared with freshmen aged less than 13 years, those aged 14–15 years (OR=1.315, 95%CI: 1.037–1.666) and 16–17 years (OR=1.436, 95%CI: 1.115–1.851) were at a higher risk for strong PPD positive reaction, and the students aged 16–17 years (OR=1.195, 95%CI: 1.029–1.386) and ≥18 years (OR=2.009, 95%CI: 1.108–3.642) were at higher risk for infection. Conclusion PPD screening in freshmen can help identify infection sources as early as possible for the control of TB transmission, and find the key population in the prevention and control of TB and take targeted prevention measures in schools. Given the importance of PPD screening in TB prevention and control in schools, the PPD screening in freshmen is promoted to cover all the middle school students in Ningbo, especially the girl students, vocational middle school students, and the students in minor ethnic groups.

Epidemiological characteristics of hepatitis C in Suzhou, 2016−2022

Li Xiaoyin, Zhao Yanqiu, Cheng Xiaoqing, Wen Jiaxin, Feng Min, Zhou Weihua, Shan Xiangxiang, Shang Qingxiang

, DOI: 10.3784/jbjc.202304270188

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Objective To analyze the epidemiological characteristics of hepatitis C in Suzhou from 2016 to 2022, and provide evidence for the prevention and control of hepatitis C. Methods The incidence data of hepatitis C in Suzhou from 2016 to 2022 were collected for a descriptive epidemiological analysis on the distributions of hepatitis C cases in Suzhou. The differences in incidence of hepatitis C among different groups were compared with χ² test with P<0.05 indicating significant difference. Results From 2016 to 2022, a total of 2777 cases of hepatitis C were reported in Suzhou, with an incidence rate of 3.14/100 000, showing an increasing trend by year. Hepatitis C was reported all the year round with no obvious seasonality（M=0.100）. The incidence of hepatitis C was higher in main urban area than that in non-main urban area. The case number and incidence rate of hepatitis C were highest in Gusu district (540 cases, 8.11/100 000). The average annual incidence rate was higher in men (3.27/100 000) than in women (3.00/100 000), the difference was significant (χ²=4.832, P=0.028). The average annual incidence rate was higher in people aged 65– years (5.08/100 000) than in people aged 15–64 years (3.37/100 000), and the difference was significant (χ²=76.603, P<0.001). The cases were mainly the jobless or unemployed (33.71%), farmers (19.81%), workers (14.76%), people engaged in business services (13.90%) and retirees (12.71%). Conclusion From 2016 to 2022, the overall incidence of hepatitis C in Suzhou showed a rise trend. The incidence of hepatitis C showed no seasonality in Suzhou, but the differences in hepatitis C incidence among areas and populations were significant. The incidence of hepatitis C was high in Gusu district. It is necessary to standardize the reporting of hepatitis C in hospitals and strengthen case screening and health education in key populations in areas with high incidence of hepatitis C.

Analysis on trend of medical care seeking delay in pulmonary tuberculosis patients in floating population and influencing factors in Tongzhou district of Beijing, 2012−2021

Yang Chao, Wang Jing, Tang Guilin

, DOI: 10.3784/jbjc.202303300140

[Abstract](48) [FullText HTML](20) [PDF 2425KB](11) [Peer reviewing opinions] Related References Share

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Objective To analyze the medical care seeking delay in pulmonary tuberculosis (TB) patients in floating population and influencing factors in Tongzhou district of Beijing, and provide scientific evidence for reducing the medical care seeking delay in pulmonary TB patients, 2012−2021. Methods The information of pulmonary TB patients in floating population in Tongzhou from 2012 to 2021, including gender, age, ethnicity, occupation, case source, the result of etiological examination, treatment classification, complication, current address, onset date of, the date of the first medical case seeking and the date of registration, were collected from Tuberculosis Management Information Sub-system of China Information System for Disease Control and Prevention to analyze the distribution and trend of the medical care seeking delay. Univariate χ² test and multivariate Logistic regression analysis were conducted to identify the influencing factors. Results From 2012 to 2021, a total of 3202 cases of pulmonary TB patients in floating population were registered in Tongzhou. The male to female ratio of the patients was 1.75∶1. The patients were mainly aged 15–44 years (79.17%, 2535/3202). The median quartile of medical care seeking delay was 7 days (0, 32). The average medical care seeking delay rate was 38.63% (1237/3202). The median of health care seeking delay ranged from 10 days in 2012 to 2 days in 2021, showing a downward trend. The medical care seeking delay rate decreased from 43.33% (91/210) in 2012 to 33.07% (126/381) in 2021 (trend χ² =8.933, P=0.003). The majority of the patients with medical care seeking delay were men (62.33%, 771/1237). The composition ratio of the patients aged 25–44 years was highest (54.49%, 674/1237), the differences were significant among different age groups (trend χ²=21.644, P<0.001). Multivariate Logistic regression analysis showed that unknown occupation [odds ratio (OR) =2.351, 95% confidence interval (CI): 1.282–4.312］ and re-treatment (OR=1.457, 95%CI: 1.024–2.075) were risk factors for medical carte seeking delay. Being in minority ethnic group (OR=0.662, 95%CI: 0.515–0.85), being engaged in public/business service (OR=0.529, 95%CI: 0.385–0.726), being negative in etiological examination/unexamined (OR=0.637, 95%CI: 0.547–0.742) and being registered during 2020−2021 (OR=0.650, 95%CI: 0.539–0.784) were protective factors for medical care seeking delay. Conclusion The medical care seeking delay rate in pulmonary TB patients in floating population in Tongzhou showed a downward trend. The medical care seeking delay was related to ethnicity, occupation, the result of etiological examination, treatment classification and date of registration. It is necessary to take targeted intervention measures.

Reporting of notifiable communicable diseases in a grade 3A specialized hospital for cardiovascular disease, 2017−2022

Li Jiantao, Lin Xin, Yang Weixian

, DOI: 10.3784/jbjc.202303140102

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Objective To understand the status of the reporting and epidemiological characteristics of notifiable communicable diseases in a grade 3A specialized hospital for cardiovascular disease, and provide scientific evidence for the development of communicable disease and nosocomial infection control measures. Methods A descriptive study was conducted to statistically analyze the reporting rate, population distribution and transmission routes of notifiable communicable diseases reported directly online by Fuwai Hospital of Chinese Academy of Medical Sciences from 2017 to 2022. Results From 2017 to 2022, a total of 655 notifiable communicable diseases were reported om hospital, including 593 cases of class B diseases, 61 cases of class C diseases, and 1 case of other type disease. The total reporting rate showed a decreasing trend year by year, and the top three communicable diseases were recessive syphilis, pulmonary tuberculosis and other infectious diarrhea, mainly hematogenous borne and sexually transmitted diseases. Conclusion The results suggested that it is necessary to strengthen the prevention and control of syphilis and pulmonary tuberculosis in the hospital. At the same time, the hospital should pay more attention to emerging acute communicable diseases, such as monkey pox, and improve the ability of emergency response.

Association between central obesity and cardiometabolic diseases or cardiometabolic comorbidity in residents aged 35−75 years in Inner Mongolia

Xu Xiaoqian, Xia Yuan, Li Hailing, Zhang Nan, Cao Ning, Zhang Xingguang

, DOI: 10.3787/jbjc20230020

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Objective To analyze the association between central obesity and cardiometabolic diseases or cardiometabolic comorbidity in residents aged 35–75 years in Inner Mongolia autonomous region. Methods Residents aged 35–75 years recruited in “Early Screening and Comprehensive Intervention in Population at High Risk for Cardiovascular Diseases” in Inner Mongolia from September 2015 to June 2017 were selected for the study. Statistical analysis was performed by using software SPSS 25.0 and GraphPad Prism 5, mainly statistical description, χ² test and logistic regression analysis, to understand impact of central obesity on cardiometabolic diseases (hypertension, diabetes, dyslipidemia) and cardiometabolic comorbidity. Results The prevalence rate of central obesity was 66.5% (95%CI: 66.2%–66.7%), and the standardized rate was 64.6% in residents aged 35–75 years in Inner Mongolia. The proportions of persons with 0, 1, 2 and 3 cardiometabolic diseases were 28.8%, 40.5%, 23.8% and 6.9%, respectively. The results of logistic regression analysis showed that the risk for hypertension, diabetes, dyslipidemia and cardiometabolic comorbidity were 1.873 times and 3.093 times, 1.876 times and 2.764 times, 2.227 times and 3.412 times, 2.526 times and 4.419 times higher in people with mild central obesity and severe central obesity than in those without central obesity (all P<0.001). Conclusions Central obesity is a serious health problem in Inner Mongolia, and it is a risk factor for cardiometabolic diseases or cardiometabolic comorbidity, Therefore, we should strengthen the early screening of central obesity and conduct intervention.

《疾病监测》杂志稿约

[Abstract](249) [FullText HTML](106) [PDF 405KB](33) [Peer reviewing opinions] Related References Share

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《疾病监测》杂志稿约

[Abstract](366) [FullText HTML](152) [PDF 408KB](48) [Peer reviewing opinions] Related References Share

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Epidemiological characteristics of tuberculosis in Yunnan, 2010−2021

Dou Na, Dai Shiyuan, Chen Chuntao, He Feng, Luo Juan, Yang Yaqi, He Guozhong

, DOI: 10.3784/jbjc.202208150364

[Abstract](510) [FullText HTML](237) [PDF 7772KB](100) [Peer reviewing opinions] Related References Share

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Objective To analyze the epidemiological characteristics of tuberculosis (TB) in Yunnan province from 2010 to 2021 and provide reference for the prevention and treatment of TB in Yunnan. Methods The incidence data of TB in Yunnan from 2010 to 2021 were collected from Tuberculosis Surveillance Information System. Software Arcgis 10.7 was used for the visualization of the incidence of TB for a descriptive analysis on the epidemiological characteristics of TB in Yunnan. Results The incidence of TB fluctuated in Yunnan between 2010 and 2021 (χ²=858.570, P<0.001). A total of 333,846 TB cases were reported accumulatively with an annual average incidence rate of 57.58/100,000. In men, 224,397 TB cases were reported with an annual average incidence rate of 67.22%, while in women, 109,449 TB cases were reported with an annual average incidence rate of 32.78%. The male to female ratio of the cases was 2.05:1. In terms of temporal distribution, TB cases were mainly reported in during April-July. In terms of spatial distribution, the TB incidence rate was significantly higher in Nujiang prefecture than in other prefectures. In terms of age distribution, most TB cases were reported in people aged 15−70 years. In terms of occupation distribution, most cases were farmers (258,509, 77.43%), followed by students (19,454, 5.83%). Conclusions Men and farmers had become the main populations affected by TB in Yunnan, youth and middle-aged people accounted for high proportion in the TB cases. It is necessary to strengthen the prevention and treatment of TB at three levels, conduct active screening and organize follow up regularly.

《疾病监测》杂志稿约

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Development and Evaluation of the application effect of PCR assay for detection of Corynebacterium striatum

Qiu Xiaotong, Chen Dongke, Wang Xuebing, Zhou Haijian, Li Zhenjun

, DOI: 10.3784/jbjc.202109220515

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Objective To evaluate the application effect of a rapid PCR method for detecting Corynebacterium striatum (C. striatum) in clinical isolates and clinical sputum specimens. Methods A single PCR method for the detection of C. striatum was established using PCR primers Cst_1-F/Cst_1-R designed for the species-specific gene ftr1. The C. striatum reference strain ATCC6940, ATCC43751, 152 clinical isolates and 30 non-C. striatum strains was used to verify the effectiveness of this method. The resultof this PCR method was compared with that of 16S rRNA gene sequencing and MALDI-TOF MS.The specificity and sensitivity of this PCR method were evaluated. Finally, this PCR method was used to detect 88 clinical sputum specimens. Results The result of the PCR method was 100% consistent with that of 16S rRNA sequencing and MALDI-TOF MS in the identification of 152 C. striatum clinical isolates. There was no cross reaction in 30 non-C. striatum strains.The limit of detection was 1 ng template DNA per reaction.When applied this PCR method to detect clinical sputum specimens, the consistency of this method compared with sputum smear microscopy was 86.4% (76/88). Conclusion As a convenient, economic and effective method, the PCR assay in this study may replace 16S rRNA gene sequencing and MALDI-TOF MS for the clinical identification of C. striatum. Also, this assay has good application effect in the detection of C. striatum in clinical sputum specimens.

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

Gong Zhenyu, Gong Xunliang

, DOI: 10.3784/jbjc.2021

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Summary of global surveillance data of infectious diseases in May 2021

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

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

Chinese reference list of core health indicators

, DOI: 10.3784/jbjc.202011300402

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

Gong Zhenyu, Gong Xunliang

, DOI: 10.3784/jbjc.202012270443

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《疾病监测》杂志稿约

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