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

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Epidemiological characteristics of influenza in children during 2016–2020 and application of moving epidemic method in early warning in Zhoushan,
Shao Lingling, Zhang Liping
, DOI: 10.3784/jbjc.issn.1003-9961.2021.0000.0000
[Abstract](239) [FullText HTML](61) [PDF 4312KB](37) [Peer reviewing opinions] Related References Share
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  Objective  To analyze the epidemiological characteristics of influenza in children in Zhoushan during the influenza seasons from week 40, 2016 to week 13, 2020, calculate the epidemic thresholds and intensity thresholds of influenza in children based moving epidemic method (MEM) and suggest effective measures to prevent and control influenza in children in Zhoushan.  Methods  The incidence data of influenza-like Illness (ILI) in children were collected from the pediatric outpatient setting and emergency department of the sentinel hospital in Zhoushan. The number of children visiting outpatient and emergency department and the weekly proportion of ILI cases from week 40, 2016 to week 13, 2020 were calculated. Samples were collected from ILI cases for influenza virus detection and the weekly influenza positive rate (PR) was calculated. The proportion of ILI cases and PR were used as the surveillance indicators of the influenza activity level. The data were analyzed by using Excel 2007 and SPSS 23.0. Historical data of the weekly positive rates of influenza virus test during the influenza seasons from 2016 to 2019 were used (the influenza season is from the 40th week of the previous year to the 30th week of the following year) to establish a MEM model for the calculation of the pre-epidemic, post-epidemic thresholds and intensity thresholds of 2019–2020 influenza season.  Results  A total of 21241 cases of ILI in children were reported, in which 7184 cases were positive for influenza virus from week 40, 2016 to week 13, 2020. The weekly proportion of ILL cases and PR changed with the season of the year and the week of the month. The epidemic of influenza in children in Zhoushan mainly occurred in winter and spring. The pre-epidemic threshold and the post-epidemic threshold of the 2019–2020 influenza season calculated by MEM model was 22.62% and 28.37% respectively. The medium, high and extremely high epidemic intensity thresholds were 42.00%, 81.08% and 95.77% respectively.  Conclusion  Influenza in children in Zhoushan mainly occurred in winter and spring and influenza A and influenza B viruses co-circulated. The MEM model in this study has a good fitting effect and can be used for the early warning of influenza in children in Zhoushan.
Application of micro confocal Raman technique in classification and identification of bacteria
Gao Pengya, Su Yinghui, Sun Hui, Teng Zhongqiu, Wu Changde, Shi Yun, Yuan Hongfu,  Liu  yang, Xu Xuefang
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Raman spectroscopy can be used to identify and describe the characteristics of microorganisms.Compared with the traditional microorganism isolation and culture methods and molecular biology identification technique, Raman technique has the advantages of non-culture, rapidness and high efficiency. With the combination of Raman technique and molecular biology in the field of optics, microbial identification has become more efficient and rapid. Raman microspectroscopy, combined with stable isotope probe, fluorescence in situ hybridization and optical tweezers, provides an independent method for studying the function and physiology of non-culpable microorganisms in ecosystems. The microconfocal Raman technique has a great application prospect in the identification and classification of bacteria. In this paper, the basic knowledge of Raman spectroscopy and the research progress of microconfocal Raman technique in classification and identification of bacteria are described, and the advantages and disadvantages of this technique are summarized and evaluated, in order to provide reference for the applied microbiology research of Raman technique.
Analysis on current status of antibody detection kits for SARS-CoV-2
Luo Xuelian, Yan Meiying, Wu Yuan, Dai Yan, Cheng Yanpeng, Xu Jianguo
, DOI: 10.3784/jbjc.issn.1003-9961.2021.0000.0001
[Abstract](247) [FullText HTML](41) [PDF 1910KB](26) [Peer reviewing opinions] Related References Share
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Serological detection of specific antibody is an important method in the diagnosis of SARS-CoV-2 infection. However, numerous antibody detection kits for SARS-CoV-2 have been available within a short period, but their accuracy and effectiveness are uncertain. This paper summarizes the current status of antibody detection kits for SARS-CoV-2 developed both at home and abroad to provide reference on the use of antibody detection kits for SARS-CoV-2 by staffs in hospitals and CDCs.
Analysis on identification of Shewanella at species level based on16S rRNA and gyrB genes
Cai Hongyan, Fang Yujie, Yu Keyi, Huang Zhenzhou, Dai Hang, Wang Duochun
[Abstract](170) [FullText HTML](101) [PDF 3187KB](5) [Peer reviewing opinions] Related References Share
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  Objective   To establish an assay for the identification of Shewanella based on 16S rRNA and gyrB genes and compare the identification power of two genes.   Methods   Software DnaSP 6.0 was used to analyze the number and percentage of information bits, the nucleotide polymorphism, average G+C content, the ratio of non-synonymous mutation rate to synonymous mutation rate (Ka/Ks) and the Tajima test was used for 16S rRNA and gyrB genes of 54 Shewanella strains. Adjacency distance matrix method of software MEGA 6.06 was used to construct the phylogenetic tree 16S rRNA and gyrB genes of 90 tested strains and 54 type strains strains. The kimura’s 2-parameter model of MEGA 6.06 software was used to identify the species of 90 tested strains, then the genetic distance and sequence similarity of 16S rRNA and gyrB genes were calculated. The difference of identification power for the two genes was compared.   Results   The 16S rRNA sequences of Shewanella strains had a similarity range of 89.8%–100.0% (average 95.0%) and gyrB sequence similarity range was 73.2%–99.9% (average 80.8%). In the phylogenetic tree of 16S rRNA gene, S. marinintestina and S. sairae, S. livingstonensis and S. vesiculosa, showed almost identical evolutionary branches, but the gyrB gene could distinguish all strains at species level. 16S rRNA had a small range in intraspecific and interspecific similarities.   Conclusion   Compared with 16S rRNA gene, the phylogenetic tree of gyrB gene can identify Shewanella at species level more accurately.
Evaluation of implementation of “Diagnostic Criteria of Dengue Fever” (WS 216－2018)
Luo Min, Yi Yao, Zhang Yingtao, He Fan, Chen Xi, Kang Min, Song Tie
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  Objective  To evaluate the implementation of Diagnostic Criteria of Dengue Fever (WS 216-2018) and provide reference for the revision and better application of the criteria.  Methods  Using stratified random sampling, general hospitals, community health service centers, centers for disease control and prevention (CDCs) and customs in Guangdong, Zhejiang and Chongqing were selected to conduct questionnaire survey and field investigation. EpiData 3.1 was used to establish a database, and SPSS 22.0 was used for statistical analysis. Inter group differences were compared with χ2 test, analysis of variance and Kruskal-Wallis H test.  Results  A total of 61 medical institutions were surveyed, and 637 questionnaires were collected, in which 443 were from Guangdong (69.54%), 102 from Chongqing (16.01%) and 92 from Zhejiang (14.44%). The institutions were mainly general hospitals (86.66%) and the medical and health institutions at district or county level accounted for 56.51%. The total mastery rate of the criteria was 67.66%. The mastery rate in Guangdong (69.31%) was higher than that in Chongqing (66.36%) and Zhejiang (61.14%), and the mastery rate in general hospitals (67.02%) was lower than that in community health service centers (69.05%) and CDCs (74.43%). The awareness rate of the criteria through training was highest, reaching 76.61%. In clinicians surveyed, 25.84% used the criteria all the time, 28.50% often used it, 33.63% used it occasionally and 12.03% never used it. There were 73.45% and 64.25% of clinicians who could answer the questions about the tests to be conducted for suspected cases within five days and within seven days after onset. Only 42.48% of clinicians knew the dengue diagnostic tests to be provided in their hospitals. 96.55% of general hospitals could provide NS1 screening for dengue virus antigen. In the community health service centers surveyed, 87.50% in Guangdong could carry out NS1 screening, 2 in Zhejiang could provide NS1 screening, and all in Chongqing could not provide NS1 screening. Three CDCs surveyed in Chongqing and Zhejiang were all able to conduct nucleic acid testing for dengue virus. Among the 12 CDCs surveyed in Guangdong, 58.33% (7/12) were allowed to conduct nucleic acid testing, and the CDCs in non-Pearl River Delta area could not provide nucleic acid testing. In the process of implementation of the criteria, a good consistency was found in relevant regulation documents.  Conclusion  The mastery rate and use rate of the criteria were low in clinicians, it is necessary to further strengthen the training for the use promotion of the criteria.
Survival potential and infectiousness of 2019 novel coronavirus in environment
Huang Yuyuan, Zhang Sihui, Zhou Juan, Zhu Wentao, Huang Qianni, Yang Jing, Xu Jianguo
[Abstract](356) [FullText HTML](196) [PDF 2072KB](97) [Peer reviewing opinions] Related References Share
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Coronavirus disease 2019 (COVID-19) spreads rapidly and widely in the world, which is mainly transmitted through respiratory droplets and contact with contaminated media. In this study, 2019 novel coronavirus (2019-nCoV) was found to have a similar stability to severe acute respiratory syndrome coronavirus (SARS-CoV) by analyzing its survival time on different subject surfaces and main influencing factors in related research. 2019-nCoV can survive for several days at various subject surfaces or media at room temperature (stainless steel: 2 days, plastic: 3 days, glass: 4 days, etc.), and 2019-nCoV can persist for longer time at low temperature and low relative humidity, which has caused severe threat to public health and has posed severe challenges to the prevention and control of COVID-19. According to available data, 2019-nCoV has the characteristics of high infectiousness and high covertness, similar to influenza A virus. By understanding the survival potential and infectiousness of 2019-nCoV in environment, targeted disinfection and effective protection can be implemented to reduce the incidence of COVID-19.
Analysis on genetic characteristics of Arcobacter skirrowii based on whole genome sequence
Zhou Guilan, Wang Yuanyuan, Gu Yixin, Li Ying, Ju Changyan, Wang Jiaqi, Wang Hairui, Chen Xiaoli, Duan Yongxiang, Zhang Maojun
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  Objective  To understand the genetic characteristics of Arcobacter skirrowii from different sources and hosts and analyze their antibiotic resistance and virulence associated genes.  Methods  Bioinformatics software was used for the comparative analysis on the whole genome sequences of 8 A. skirrowii strains isolated in our laboratory and the whole genome sequences of 15 A. skirrowii strains from NCBI and PATRIC database.  Results  blaOXA-464 was the only identified antibiotic resistance gene in 3 A. skirrowii strains. All the strains contained immune invasion, evasion and motility-related virulence genes. Compared with the 10 virulence genes identified in other Arcobacter, the virulence genes, ciaB, tlyA, cj1349, pldA and mviN were found in all of the tested strains. iroE was identified only in two strains (CNAS12-1 and F28), no other 4 virulence genes were found. Type Ⅵ secretion system (T6SS) gene cluster was found in 21.7% (5/23) of the tested strains, which had differed genetic constitution and arrange compared with T6SS of other Arcobacter.  Conclusion  A. skirrowii showed high genetic diversity, and some strains might have potential drug resistance and pathogenic characteristics.
Epidemiological analysis on imported malaria in Tai'an, 2015–2019
Zhang Xinfeng, Hu Bin, Zhang Zhijun, Xu Yan, Kong Xiangli
[Abstract](516) [FullText HTML](226) [PDF 0KB](6) [Peer reviewing opinions] Related References Share
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  Objective  To analyze the epidemiological characteristics of imported malaria cases in Tai'an, Shandong province, from 2015 to 2019 for the prevention and control of malaria.  Methods  The incidence data malaria were collected through the Information Management System for Infectious Diseases Report of China and Parasitic Diseases Control and Prevention System, The surveillance and reported data of imported malaria were analyzed statistically.  Results  From 2015 to 2019, a total of 122 cases of imported malaria were reported in Tai'an, including 85 cases of falciparum malaria (69.67%, 85/122), 12 cases of vivax malaria (9.84%, 12/122). The disease onset showed no significant seasonal variations. Most imported malaria cases were distributed in age group 40-49 years (45.08%, 55/122). The diagnosis rate on the onset day was 35.25% (43/122). The imported malaria cases were mainly reported in three districts (90.16%, 110/112). The source countries mainly were in Africa and Asia (Pakistan).  Conclusion  The imported malaria cases in Tai'an had obvious area, type and source country specific distribution characteristics. Continued efforts are needed to strengthen the surveillance and management of imported malaria cases from some key countries to consolidate the achievement in malaria elimination.
Genetic characteristics of norovirus GⅡ.P7-GⅡ.6 isolated from acute gastroenteritis cases in Huzhou of Zhejiang, 2013–2019
Ji Lei, Liu Guangtao, Shen Yuehua, Zhu Yunfeng, Xu Deshun
[Abstract](774) [FullText HTML](188) [PDF 3707KB](8) [Peer reviewing opinions] Related References Share
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  Objective  To understand the genetic characteristics of norovirus GⅡ isolated from acute gastroenteritis cases in Huzhou in recent years, and provide reference for disease surveillance and prevention.  Methods  Fluorescence quantitative RT-PCR was used to detect norovirus nucleic acid in stool samples collected from 4 acute gastroenteritis outbreak in schools and child care settings from 2013 to 2019. RT-PCR was used to amplify the norovirus RNA polymerase and capsid genes of positive samples. The genotype of norovirus was confirmed by phylogenetic analysis and online typing tools.  Results  Four outbreaks of acute gastroenteritis occurred in December 2013, April and December 2014, and March 2019, respectively. A total of 28 samples were collected. Among the samples collected from 4 gastroenteritis outbreaks, 5, 4, 2 and 5 samples were positive for nucleic acid of norovirus GⅡ, and 1 strain from the positive samples was sequenced successfully in each outbreak. Online subtyping and phylogenetic analysis confirmed that the pathogens of the 4 outbreaks were all recombinant norovirus GⅡ.P7-GⅡ.6, but the evolutionary branches were different. The strains detected in 2013 belonged to GⅡ.P7-GⅡ.6c; the strains detected in 2014 belonged to GⅡ.P7-GⅡ.6b; the strains detected in 2019 belonged to GⅡ.P7-GⅡ.6a.  Conclusion  Recombinant norovirus GⅡ.P7-GⅡ.6 was the pathogen causing 4 outbreaks of acute gastroenteritis in Huzhou from 2013 to 2019, and there were differences in genetic evolutionary branches among the strains isolated in different years. Given the sustainable and wide spread of norovirus GⅡ.P7-GⅡ.6 worldwide, the surveillance for this type of recombinant norovirus should be further strengthened.
Epidemiological characteristics of mumps in Fengxian district of Shanghai
Hu Bin, Li Ruiping, Gao Caihong, Li Huitao
[Abstract](720) [FullText HTML](234) [PDF 3565KB](29) [Peer reviewing opinions] Related References Share
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  Objective  To analyze the epidemiological characteristics of mumps in Fengxian district of Shanghai from 2005 to 2019, and provide evidence for mumps prevention and control.  Methods  The incidence data of mumps in Fengxian from 2005 to 2019 were collected from national information system of disease prevention and control for a descriptive analysis.  Results  A total of 2900 mumps cases were reported in Fengxian from 2005 to 2019, the average annual incidence rate was 19.31/100 000. The annual case number ranged from 89 (2018) to 438 (2007), and annual incidence rates ranged from 8.26/100 000 (2018) to 54.78/100 000 (2009). The incidence was higher in males than in females. Most cases occurred in age group 5–9 years. The annual incidence peak occurred during April-July. More cases occurred in local population than in floating population, and more cases occurred in people without mumps containing vaccine (MuCV) immunization history or with unknown MuCV immunization history than in those with MuCV immunization history.  Conclusion  The overall incidence of mumps decreased in Fengxian from 2005 to 2019, but the incidence in children aged 5–9 years was still high. It is suggested to strengthen mumps surveillance and promote routine immunization in children for the prevention and control of mumps outbreak.
SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020
Gong Zhenyu, Gong Xunliang
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cover
cover
2020, 35(12): 0-0.
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contents
contents
2020, 35(12): 1-3.
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Epidemic Bulletin
2020年11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 Diseases in November 2020
2020, 35(12): 1059-1059. DOI: 10.3784/j.issn.1003-9961.2020.12.001
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2020年11月中国甲乙丙类传染病疫情动态概要
2020, 35(12): 1060-1061. DOI: 10.3784/j.issn.1003-9961.2020.12.002
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Summary of global surveillance data of infectious diseases in November 2020
Han Hui, Wu Bo, Li Haishan, Jia Jiaojiao
2020, 35(12): 1062-1064. DOI: 10.3784/j.issn.1003-9961.2020.12.003
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In November 2020, a total of 61 infectious diseases were reported globally, affecting 223 countries and regions.Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were COVID-19 (223), dengue fever (30), measles (13), zika virus disease (11) and poliomyelitis (11). The top five infectious diseases with highest case fatality rates were Ebola virus disease (42.3%), yellow fever (41.0%), Rift Valley fever (33.3%), Lassa fever (20.7%) and West Nile fever (11.1%). The top five infectious diseases with greatest number of deaths were COVID-19, yellow fever, dengue fever, cholera and Lassa fever.The prevalent infectious diseases were COVID-19 and dengue fever in Asia, COVID-19, Ebola virus disease, cholera, yellow fever, Rift Valley fever and Lassa fever in Africa, COVID-19 and dengue fever in America, COVID-19 and West Nile fever in Europe.
Risk Assessment
Risk assessment of public health emergencies concerned in the mainland of China, December 2020
Meng Ling, Tu Wenxiao, Song Yang, Xiang Nijuan, Shi Guoqing
2020, 35(12): 1065-1067. DOI: 10.3784/j.issn.1003-9961.2020.12.004
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  Objective  To assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in December 2020.  Methods  An internet based expert counsel was conducted to analyze the incidence data of public health emergencies reported both at home and abroad and 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 conference through video terminal.  Results  Generally speaking, it is predicted that the incidence of public health emergencies would be higher in December than November. At present, the global COVID-19 pandemic is still ongoing out of control. The risk of imported cases and secondary transmission of COVID-19 still exists in China, but it would be controllable.  Conclusion  Special attention should be paid to COVID-19.
COVID-19 Epidemic Prediction
Predictive analysis and countermeasures in response to COVID-19 epidemic in 2020–2021
Guo Deyin, Jiang Jiafu, Song Hongbin, Qin Tian, Li Zhenjun, Zhang Dingmei, Huang Senzhong, Shu Yuelong, Xu Jianqing, Jiang Shibo, Zheng Tao, Tian Huaiyu, Hao Rongzhang, Xu Jianguo
2020, 35(12): 1068-1072. DOI: 10.3784/j.issn.1003-9961.2020.12.005
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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a natural emerging virus, with rapid virus replication, wide cell tropism, and strong survival ability. Its epidemic characteristics are similar to those of influenza virus. Asymptomatic infections are widespread in a covert way, and the virus has adapted to human population, making it difficult to control the transmission. The global epidemic in 2020/2021 may further deteriorate before the SARS-CoV-2 vaccines are widely applied and show protective effectiveness, and China will still face the risk of continuous overseas multi-channel import and local outbreaks or recurrence of the epidemic. Therefore, it is necessary to carry out further surveillance about the prevalence and infection of SARS-CoV-2 in the population and the corresponding environment of the high-risk areas in China, and establish a national super mobile SARS-CoV-2 detection network laboratory for performing ultra-large-scale testing tasks; implement differentiated vaccination strategies and closely follow up and monitor the effectiveness and efficiency of vaccination; and continue to strengthen effective public health measures such as wearing masks, washing hands frequently, keeping social distances, opening windows frequently, and reducing gatherings. The coronavirus disease 2019 (COVID-19) epidemic warns us once again that the continuous emergence of new infectious diseases caused by unknown pathogens of wild animal origin has become the new normal status. It is necessary to systematically carry out unknown microbial discovery and reverse pathogenic etiology research in a prospective manner, and actively defend against emerging infectious diseases in the future.
Influenza Surveillance Subject
Introduction
2020, 35(12): 1073-1073.
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Antigenic and genetic characteristics of influenza B virus/Victoria lineage in Shanghai, 2018–2020
Zhao Xue, Teng Zheng, Fang Fanghao, Yuan Fang, Jiang Chenyan, Yuan Zhengan, Zhang Xi
2020, 35(12): 1074-1080. DOI: 10.3784/j.issn.1003-9961.2020.12.006
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  Objective  To analyze the antigenic and genetic characteristics and variation of influenza B virus /Victoria lineage in Shanghai during 2018–2020.  Methods  Hemagglutinin inhibition test was performed to analyze the antigenicity of 142 strains of influenza B virus/Victoria lineage isolated in Shanghai from April 2018 to March 2020, in which 63 strains were used for hemagglutinin and neuraminidase gene sequencing and analysis.  Results  V1A.3 was predominant clade in influenza B virus B/Victoria lineage circulating in Shanghai. A few circulating strains belonged to clade V1A.1 and clade V1A without deletion. Only 26.76% of the circulating virus strains were antigenically similar to the B/Colorado/06/2017 vaccine strain. Five amino acids loci had mutation in the HA protein sequence of clade V1A.3 compared with the B/Colorado/06/2017 vaccine strain, involving 4 important epitopes and receptors, such as 120 loop, 150 loop, 160 loop and 190 helix.  Conclusion  The majority of influenza B virus /Victoria lineage circulating in Shanghai did not match well with the vaccine strain B/Colorado/06/2017 recommended by WHO. It is necessary to further strengthen the surveillance for influenza virus variation to provide reliable data for the screening of influenza vaccine strain.
Correlation between seasonal influenza and meteorological factors: a systematic review
Guo Qian, Chen Tao, Zhou Luojing
2020, 35(12): 1081-1087. DOI: 10.3784/j.issn.1003-9961.2020.12.007
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  Objective  To explore the correlation between seasonal influenza activity level and meteorological factors.  Methods  A literature retrieval of papers about influenza activity and meteorological factors published by May 2019 in English electronic databases, such as Pubmed, Cochrane Library, OVID, EBSCO and Web of Science, was conducted. A total of 45 qualified literatures were included, including laboratory and epidemiological surveys. Research sites of epidemiological studies were stratified according to different climatic regions, and basic information, meteorological factors and statistical methods of the included literatures were extracted, classified and analyzed.  Results  Most epidemiological studies used some type of regression analysis. Influenza activity in temperate region was significantly associated with low temperature and low humidity. The correlation between influenza activity and temperature or humidity in subtropical and tropical regions were complex and inconsistent, and rainfall might increase the level of influenza activity in tropical region.  Conclusion  Environmental factors, such as cold and dry climate in temperate region and humid and rainy climate in tropical region, are closely related to influenza activity, but the information about the influence of meteorological factors, such as solar radiation, wind speed, and atmospheric pressure, on influenza activity is still limited.
Study of R0 of COVID-19 and pandemic influenza A (H1N1) 2009 based on systematic review
Chen Jiamin, Qiu Zengzhao, Zhong Shuyi, Wen Simin, Shu Yuelong
2020, 35(12): 1088-1099. DOI: 10.3784/j.issn.1003-9961.2020.12.008
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  Objective  The compare transmission efficiency of coronavirus disease 2019 (COVID-19) and influenza A (H1N1) pdm09 by a systematic review based on R0 calculation.  Methods  We conducted a literature retrieval by using the databases of CNKI, WanFang Data, VIP, PubMed, Embase, Web of Science, BioRxiv and MedRxiv for the research of COVID-19 and influenza A (H1N1) pdm09. Two reviewers independently screened the literatures, extracted and calculated related data and systematically compared the R0 of the two outbreaks.  Results  A total of 163 papers were included [54 about influenza A (H1N1) pdm09 and 109 about COVID-19]. The median R0 of COVID-19 [2.860 (IQR: 2.350−3.546)] was higher than that of influenza A (H1N1) pdm09 [1.508 (IQR: 1.336−1.836)] in the world. In China, the median R0 of COVID-19 was 2.930 (IQR: 2.215–3.453) and the median R0 of COVID-19 before implementing strict traffic control strategy in Wuhan [3.430 (IQR: 2.500−4.710)] was higher than that after the strict strategy [2.500 (IQR: 1.673−3.030)].  Conclusion  The transmission efficiency of COVID-19 is stronger than influenza A (H1N1) pdm09. The spread of COVID-19 in China has been controlled owe to the strict traffic control strategy.
Analysis on influenza vaccination status and influencing factors in medical workers in Chongqing
Gan Lin, Xiong Yu, Li Qin, Chen Tao, Tang Xiaojun
2020, 35(12): 1100-1104. DOI: 10.3784/j.issn.1003-9961.2020.12.009
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  Objective  To understand the status of influenza vaccination in medical workers in Chongqing, and identify the influencing factors.  Methods  A total of 1412 medical workers in 8 hospitals were investigated by stratified cluster random sampling, and univariate and multivariate analyses were conducted by χ2 test and logistic regression model.  Results  The influenza vaccination rate was 16.78% in medical staff in Chongqing from 2018 to 2019. The vaccination rate was higher in medical workers in influenza like illness related departments (22.61%) than in other departments (12.12%) (OR=2.030, 95% CI: 1.512–2.734). The influenza vaccination rate was 18.14% in those who has worked for 6–10 years (OR=1.504, 95% CI: 1.056–2.150), 21.29% in those who had worked for 11–15 years (OR=1.821, 95% CI: 1.182–2.783), and 19.74% in those who had worked for ≥ 16 years (OR=1.874, 95% CI: 1.229–2.840), all higher than that in those who had worked for ≤5 years.  Conclusion  The rate of influenza vaccination in medical workers in Chongqing was low, and lack of time was the main reason to hinder the vaccination. Working in influenza like illness department or not and working years were the main influencing factors for influenza vaccination in medical workers
Epidemiology and etiology of influenza in Hubei province, 2016–2019
Liu Linlin, Han Shi, Yu Xiao, Li Xiang, Ye Guojun, Fang Bin
2020, 35(12): 1105-1109. DOI: 10.3784/j.issn.1003-9961.2020.12.010
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  Objective  To understand the epidemiologic and etiologic characteristics of influenza in Hubei province from 2016 to 2019 and provide laboratory evidence for the prevention and control policy development and risk assessment of influenza in Hubei.  Methods  Combined with the results of etiologic surveillance and epidemiologic investigation of influenza network surveillance laboratory, the epidemiological analysis of influenza surveillance data in Hubei was carried out.  Results  The average proportion of influenza like illness (ILI) cases in Hubei during 2016–2019 was 2.90%. The ILI proportion was highest in 0–5-year-old group (61.83%), and lowest in people over 60 years old (3.69%). The average influenza virus positive rate in the annual sentinel surveillance during 2016–2019 was 14.06%. A total of 4991 strains of influenza viruses were isolated, and antigenic analysis was conducted for 565 strains. Influenza A (H1N1) pdm09 virus, seasonal influenza A (H3N2) virus and influenza B virus Victoria lineage circulated alternatively with seasons. During this period, a total of 343 outbreaks of ILI, mainly in winter and spring, were reported.  Conclusion  The annual circulation of influenza viruses showed peak in winter and spring, and sub-peak in summer in Hubei during 2016–2019, Different type influenza viruses circulated alternatively. Influenza epidemic is prone to occur in winter and spring.
Infectious Disease Surveillance
Detection of diarrheagenic Escherichia coli from diarrhea cases’ stool samples with combined molecular detection method
Liu Xiaolin, Wang Hui, Guo Kai, Qu Jianying, Wang Lijuan, Yu Weisen
2020, 35(12): 1110-1114. DOI: 10.3784/j.issn.1003-9961.2020.12.011
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  Objective  To retrospective investigate the infection status and genotype of diarrheagenic Escherichia coli(DEC)in diarrhea cases in Qingdao, Shandong with FilmArray gastrointestinal panel (FA GI) combining with real-time PCR, and the results were compared with traditional detection method to discuss the application of different detection method in diarrhea surveillance.  Methods  A total of 263 stool samples were collected from diarrhea cases by two hospitals in Qingdao. DEC strains were isolated by traditional culture method and submitted to Qingdao Municipal Center for Disease Control and Prevention for the identification by multiple real-time PCR, and at the same time DEC was detected directly from stool samples by FA GI combining with real-time PCR. Every five stool samples were mixed for one detection by FA GI. The positive results indicated that every sample needed to be detected again for DEC by real-time PCR.  Results  A total of 15 samples were DEC positive (5.7%) by traditional culture, in which 7, 4, 3, 1 were ETEC, EPEC, EAEC, EIEC positive, respectively. 35 DEC positive samples (13.3%) were detected with FA GI, in which 12, 12, 9, 2 were ETEC, EAEC, EPEC and EIEC positive, respectively. No sample was Shiga toxin-producing Escherichia coli (STEC) positive by both two methods. The virulence genes carriages in DEC indicated by two different methods were similar, i.e. pic in EAEC, estIb in ETEC and eae in EPEC.  Conclusion  The direct detection method of FA GI combining with real-time PCR can significantly improve the positive detection rate of DEC in stool samples from diarrhea cases due to its high sensitivity and specificity. This detection method can save both time and labor and can be used as supplementary investigation for routine surveillance for the better understanding of the prevalence and genotype distribution of DEC in diarrhea patients and strengthening of laboratory capability.
Legionella and its carriage of virulence genes detected in air condition cooling towers at public places in Quanzhou, Fujian, 2008–2019
Chen Mingchun, Liu Jianzhong, Chen Zhiyang, Chen Xiaoling
2020, 35(12): 1115-1119. DOI: 10.3784/j.issn.1003-9961.2020.12.012
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  Objective  To understand the contamination of Legionella in air condition cooling towers at public places in Quanzhou, Fujian province, from 2008 to 2019, and identify its carriage of virulence genes and pathogenicity and provide evidence for the prevention and control of Legionellosis.  Methods  The isolation, identification, genotyping and nucleic acid testing of Legionella from water samples collected from the air condition cooling towers at 31 public places in 12 counties of Quanzhou from 2008 to 2019 were conducted. PCR assay was used to detect 7 virulence genes of the isolated strains, including iraA, cpxR, cpxA, dotA, rpoB, icmC, icmD.  Results  A total of 569 water samples were collected from the air condition cooling towers during 2008–2019, in which 159 Legionella strains were isolated (27.94%). The majority of the Legionella strains were L. pneumophila (136, 23.90%), and the remaining included L. longbeachae, L. philliflora and L. dumoffii. The serotypes of L. pneumophila were 1, 3, 5, 6, 8 and 10, and serotype 1 was the predominant one (49, 30.82%). The consistent rate of the two methods was 88.40%, but the positive rate of quantitative real-time PCR was significantly higher than that of isolation. The difference was significant ( χ2=313.532, P<0.05). All the 136 L. pneumophila strains carried 7 virulence genes, while the virulence genes detection results of 82.61% of the non-L. pneumophila strains were negative.  Conclusion  Serious contamination of Legionella was found in the air condition cooling towers at public places in Quanzhou, and L. pneumophila was predominant and carried virulence genes. Timely cleaning and disinfection of air condition cooling towers are necessary to prevent the infection of Legionella.
Epidemiological characteristics of hepatitis B in Guangzhou, 2005–2018
Huang Yong, Wang Wen, Zhang Chunhuan, Xu Jianxiong, Zhang Zhoubin
2020, 35(12): 1120-1124. DOI: 10.3784/j.issn.1003-9961.2020.12.013
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  Objective  To analyze the epidemiological characteristics and trend of hepatitis B in Guangzhou during 2005–2018, and provide evidence for the effective prevention and control of hepatitis B.  Methods  The hepatitis B surveillance data in Guangzhou during the period were analyzed using descriptive epidemiological methods.  Results  From 2005 to 2018, a total of 285 648 hepatitis B cases were reported, and the annual incidence rate was 166.81/100 000. The annual average reported incidence rate of acute hepatitis B and chronic hepatitis B were 6.68/100 000 and 145.43/100 000, respectively. The incidence rate of hepatitis B in some non-central areas (Zengcheng, Conghua and Nansha) increased during 2012–2018 compared with that during 2005–2011. Acute hepatitis B mainly occurred in age group 15–44 years, while the chronic hepatitis B mainly occurred in age group 30–44 years. The reported incidence of chronic hepatitis B in age group >45 years was higher during 2012–2018 than during 2005–2011, but the reported incidence rate in other age groups decreased with varying degrees. The incidence rate was higher in men than in women.  Conclusion  It is necessary to pay attention to the epidemiological characteristics and trend of hepatitis B, strengthen the prevention and control of hepatitis B in adults, especially the high-risk groups, and accelerate the elimination process of viral hepatitis.
Surveillance of Parasitic Disease
Surveillance for echinococcosis in Pengyang county of Ningxia Hui Autonomous Region, 2011–2018
Liu Qirong, Wu Xianglin, Wen Rong
2020, 35(12): 1125-1128. DOI: 10.3784/j.issn.1003-9961.2020.12.014
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  Objective  To understand the changes of the surveillance data of echinococcosis in Pengyang county of Ningxia from 2011 to 2018 and evaluate the effects of integrated control measures.  Methods  The surveillance data of echinococcosis in population, domestic dogs, cattle and sheep in Pengyang during this period were recorded in the database. SPSS software was used for the data analysis and comparison.  Results  During this period, a total of 38 924 people were screened, in whom 91 echinococcosis patients were found, the prevalence rate was 0.23%, and the prevalence rate decreased year by year (trend χ2=72.680, P<0.05). A total of 8 352 blood samples of children aged 6–12 years were detected, in which 420 were seropositive, the infection rate in children was 5.03%, and the infection rate decreased year by year (trend χ2=11.537, P<0.05). A total of 6 246 stool samples of domestic dogs were detected, in which 110 were positive, the infection rate in dogs was 1.76%, and the infection rate decreased year by year (trend χ2=8.729, P<0.05). The prevalence rate of cattles was 1.05%; Prevalence rate of sheep was 1.95%. The prevalence rate in cattle decreased from 2.97% (6/202) in 2011 to 0 (0/286) in 2018 (trend χ2=6.178, P<0.05); The prevalence rate in sheep decreased from 4.13% (33/799) in 2011 to 0.28% (7/722) in 2018 (trend χ2=8.612, P<0.05).  Conclusion  The infection rate in domestic dogs and the prevalence rate in cattle and sheep significantly decreased, resulting in a lower risk of transmission of echinococcosis in human. The prevalence rate in population and the seropositive rate in children significantly decreased, indicating the effect of the project of transitional echinococcosis prevention and control.
Surveillance for COVID-19 related factors
Knowledge-attitude-practice survey of coronavirus disease 2019 in workers returning to work in Guangdong
Wang Lei, Peng Xin, Qu Yabin, Meng Ruilin, Kang Min, Chen Xuguang, Yang Fen
2020, 35(12): 1129-1135. DOI: 10.3784/j.issn.1003-9961.2020.12.015
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Abstract:
  Objective  To understand the knowledge, attitude and practice (KAP) towards coronavirus disease 2019 (COVID-19) in workers returning to work in Guangdong province and put forward some suggestions for the targeted prevention and control of COVID-19.  Methods  An online questionnaire survey in the occupation population selected through convenient sampling in Guangdong was conducted between 9 and 11, March, 2020. The results were analyzed one by one.  Results  A total of 3 266 valid questionnaires were collected, and the valid response rate was 99.15%. In terms of knowledge, the awareness rates of infection source, transmission route and clinical symptoms of COVID-19 as well as personal protective measures were 81.48%, 69.84%, 37.17% and 97.03%, respectively. Univariate analysis revealed that the factors influencing awareness of COVID-19 characteristics included concern extent about the epidemic, gender, age, education level, place of domicile, time of returning to work, post of duty, working age. The differences were significant (P<0.05). In terms of attitude, 88.52% of the respondents and their families highly concerned about COVID-19 epidemic, 91.95% of the respondents felt more fear or nervous than usual if fever, cough and other related symptoms occurred, and 94.55% might seek medical care if relevant symptoms occurred. The proportion of the people supporting the isolation of high-risk persons and the current prevention and control actions was 99.51%. In terms of practice, the rate of good behavior of individual was 90.72%. Logistic regression analysis showed that factors influencing personal protection behaviors included concern extent about the epidemic, gender, age and post of duty. Meanwhile, the rate of good behavior of employing units was 58.42%.  Conclusion  The awareness rate of COVID-19 related knowledge needs to be improved in workers returning to work in Guangdong, and the prevention and control measures were not fully implemented in some enterprises. It is suggested that comprehensive health education about COVID-19 needs to be continued in occupation population, and technical guidance for the epidemic prevention and control in enterprises should be carried out.
Vaccination
Status of influenza vaccination and recommendation intention to others and related factors in healthcare workers in community health service centers in Fengtai district, Beijing
Li Tian, Yang Rui, Tao Zhongfa, Zhang Yinan, Zhang Guoqin, Zhao Jing, Ma Huilai, Zhang Lijie, Wang Zhongzhan, Cai Jian, Feng Luzhao
2020, 35(12): 1136-1140. DOI: 10.3784/j.issn.1003-9961.2020.12.016
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  Objective  To understand the status of influenza vaccination and recommendation intention to others and related factors in healthcare workers in community health service centers in Fengtai district of Beijing, and provide evidence to increase the vaccination rate of influenza in this population.  Methods  All the healthcare workers of 23 community health service centers in Fengtai district of Beijing were surveyed by using a self-designed questionnaire and an interviews of 23 heads of public health section of community health service centers were conducted to collect the information about the awareness of influenza vaccine related knowledge, status of influenza vaccination during 2018–2019 and recommendation intention to others in health care workers as well as related policies. Unconditional multivariate logistic regression analysis was conducted to identify the related factors for influenza vaccination and recommendation intention to others.  Results  A total of 1359 valid questionnaires were returned, with an average response rate of 58.48% (1359/2324). The vaccination rate was adjusted to be 32.81%, and the vaccine recommendation rate was 79.76% (1084/1359). Department of public health, knowing the effectiveness of vaccines, knowing the time of vaccination, and knowing that healthcare workers are the key group to recommend vaccination to others in China, and the free supply of the vaccine were factors that are positively related to influenza vaccination. Older age, being doctor or nurse, history of influenza vaccination, awareness of influenza and influenza vaccine related knowledge were positive factors for influenza vaccine recommendations. In the health care workers interviewed, 78.26% (18/23) believed that the low influenza vaccination rate was due to non-free availability of the vaccine. Up to 91.30% (22/23) suggested to strengthen the health education about influenza and influenza vaccine to increase the vaccination rate.  Conclusion  The healthcare workers in community health service centers in Fengtai had a low rate of influenza vaccination and a high recommendation rate. Providing free vaccines for medical staff and targeted education are the key measures to increase the influenza vaccination rate in this population.
Death Surveillance
An epidemiological analysis on external causes of morbidity and mortality for hospitalized children in 22 grade Ⅲ (A) children’s hospitals
Wang Xinyu, Zeng Yueping, Song Fei, Tian Jian, Xu Xin, Feng Guoshuang
2020, 35(12): 1141-1145. DOI: 10.3784/j.issn.1003-9961.2020.12.017
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  Objective  To explore the distribution of external causes of morbidity and mortality in hospitalized children aged 0–14 years in China and provide reference basis for improving children's health and prevention of accidental injury in children.  Methods  According to the International Classification of Diseases, 10th edition (ICD-10) codes for external causes of morbidity and mortality, the patients aged 0–14 years hospitalized due to external causes in 22 grade III (A) children's hospitals in China from 2016 to 2018 were included, and the overall and age or gender specific proportions of external causes were calculated.  Results  A total of 122 284 cases met the inclusion criteria for analysis, of which 64.20% were boys and 35.98% were girls. Among all categories of external causes of morbidity and mortality, the top five were fall (39.43%), exposure to inanimate mechanical forces (20.34%), injuries to pedestrians in traffic accidents (10.66%), other accidental threats to respiration (10.01%), and exposure to hot and thermal substances (3.41%). There were slight differences in the ranks of external causes between boys and girls and in different age groups, but fall ranked first in all subgroups. On the whole, the absolute number of the cases due to external causes was higher in boys than in girls.  Conclusion  Through the analysis of a large sample, this study indicated that the major external causes of morbidity and mortality in children aged 0–14 years in China were fall, exposure to inanimate mechanical forces, injuries to pedestrians in traffic accidents, other accidental threats to respiration, and exposure to hot and thermal substances, to which close attention should be paid by all sectors of the society to prevent injury and decrease the morbidity and mortality due to external causes in children.
Drug Resistance Monitoring
Drug resistance and molecular types of Salmonella Enteritidis in Wuxi, Jiangsu, 2012–2018
Qi Qianqian, Sha Dan, Li Juan, Zhao Xiaofei, Zheng Dongyu, Guan Hongxia
2020, 35(12): 1146-1151. DOI: 10.3784/j.issn.1003-9961.2020.12.018
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  Objective   To investigate the antibiotic resistance and pulsed field gel-electrophoresis (PFGE) patterns of Salmonella Enteritidis strains detected in Wuxi, Jiangsu province, from 2012 to 2018.   Methods   A total of 110 strains of S. Enteritidis were isolated from diarrhea patients in outpatient departments of food-borne disease surveillance sentinel hospital, people receiving health examinations, food poisoning cases and environmental water samples in Wuxi from 2012 to 2018. Based on BD Phoenix automatic bacterial identification/susceptibility system test program and PulseNet China network laboratory standard method, we analyzed the drug susceptibilities and PFGE patterns of the 110 strains.   Results   The 110 strains of S. Enteritidis were sensitive to ciprofloxacin, ertapenem, imipenem, meropenem, azithromycin and ceftazidime/avibactam, but showed high resistance to nalidixic acid, ampicillin and ampicillin/sulbactam. Multidrug resistances were observed in 77 strains (70.00%), and the majority of them were resistant to 3 kinds of antibiotics (45.45%, 50/110). The 110 strains were divided into 39 PFGE patterns by Xba Ⅰ. Each pattern contained 1–31 strains. EN17, EN21 and EN24 were the main PFGE patterns.   Conclusion   S. Enteritidis strains isolated in Wuxi showed serious drug resistances, and close attention should be paid to its multidrug resistance. The PFGE patterns of the strains showed diversity and predominant patterns existed.
Traumatic Disease Surveillance
Analysis on factors influencing neurological outcome in patients with traumatic spinal cord injury
Zhang Jiaojiao, Qi Xiao, Yao Hongyan, Yu Shicheng, Yan Liang, Liu Jianjun
2020, 35(12): 1152-1157. DOI: 10.3784/j.issn.1003-9961.2020.12.019
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  Objective  To analyze the factors affecting the neurological outcome of inpatients with traumatic spinal cord injury (TSCI) in different hospitals, and explore the future prevention and treatment of TSCI.  Methods  Multistage stratified cluster sampling method was used to extract the medical record information of TSCI patients hospitalized in 69 grade Ⅲ hospitals from January 1 to December 31, 2018. Wilcoxon and Kruskal-Wallis H rank sum test was used to analyze the changes in injury grade of TSCI patients at discharge and admission according to American Spinal Injury Association (ASIA) injury classification; the two-level logistic random intercept model was used to analyze the influencing factorls of the changes in injury grade of TSCI patients according to ASIA injury classification in different hospitals.  Results  Among the 4404 TSCI patients, 1200 were in recovery group, accounting for 27.25%, and the difference in injury grade distribution at discharge and admission was significant. In the total variation of ASIA injury grade change, 24.12% was caused by hospital-level differences. In multivariate analysis, the grading improvement rate decreased by 0.90% for one-year increase of age. Compared with the lumbosacral segment. The grading improvement rates in the chest and neck segments were reduced by 28.90% and 21.50%, respectively. The grading improvement rate in patients with complete injury was 29.00% lower than that in patients with incomplete injury. The grading improvement rate in patients with fracture and dislocation was 33.50% lower than that in patients without these conditions. The grading improvement rate in patients with interval between injury and operation ≤3 days was 0.353 times higher than that in patients with the interval >3 days. The grading improvement rate in patients with rehabilitation training increased by 1.069 times. Compared with patients without surgery, the grading improvement rate in patients with decompression fixation increased by 1.565 times, and the rate in those with decompression fixation and fusion increased by 1.139 times.  Conclusion  The effect of TSCI inpatient treatment was poor; the differences in age, injury and treatment characteristics at different hospital levels were all related to the prognosis of TSCI, indicating that it is urgent to develop precise TSCI prevention strategies and establish a regional integration of “emergency-treatment-rehabilitation” platform.
Overseas Dynamic
Symptom Duration and Risk Factors for Delayed Return to Usual Health Among Outpatients with COVID-19 in a Multistate Health Care Systems Network — United States, March–June 2020
Gong Zhenyu, Gong Xunliang
2020, 35(12): 1158-1160. DOI: 10.3784/j.issn.1003-9961.2020.12.020
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Abstract:
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