Disease Surveillance

2019年7月中国甲乙丙类传染病疫情动态简介National Data of Class A, B and C Communicable Disease in July 2019

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2019.08.001

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Spread and characteristics of Vibrio parahaemolyticus in Lishui, Zhejiang, 2014–2018

Xiuying Chen, Jianhua Mei, Shabin Chen, Fuming Liu, Xialiang Ye

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ObjectiveTo investigate the spread, serotype, virulence gene and molecular typing characteristics of Vibrio parahaemolyticus in Lishui of Zhejiang province and provide evidence for the prevention of foodborne diseases.MethodsA total of 11420 stool samples of clinical diarrhea patients in foodborne disease surveillance and 497 food samples in food safety risk surveillance were collected in Lishui from 2014 to 2018 for the isolation and culture of V. parahaemolyticus, and the distribution characteristics of positive strains were analyzed. Serological typing, virulence gene detection and pulsed field gel electrophoresis (PFGE) for molecular typing were performed for the strains.ResultsA total of 296 strains of V. parahaemolyticus were isolated, in which 251 were from diarrhea patients and 45 were from foods. V. parahaemolyticus was mainly detected during July-September, The cases were mainly adults and most of them usually dined at home. O3:K6 was the main serotype and tdh+trh-tlh+ was the virulence genotype detected in patients. O2 was the main serotype and tdh-trh-tlh+ was the virulence genotype detected in foods. Forty eight strains of V. parahaemolyticus could be classified into 42 PFGE banding patterns, and the banding pattern similarity values were from 6.16% to 100%.ConclusionIt is necessary to strengthen the health supervision for V. parahaemolyticus infection and health education about having a good dining habit and improving the household cooking process of aquatic products during July-September. The genetic similarity of the V. parahaemolyticus strains spreading in Lishui was low and polyclonal sources might exist. Serotype O3:K6 was mainly detected in patients, and O2 was mainly in foods.

2019年7月中国甲乙丙类传染病疫情动态概要

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Analysis on sentinel surveillance quality of influenza and influencing factors for influenza virus nucleic acid detection in Jingzhou, Hubei

Tian Liu, Xijun Weng, Lijie Zhang, Menglei Yao, Jigui Huang, Maoyi Chen, Jie Hu

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ObjectiveTo evaluate the surveillance quality of influenza and influencing factors for influenza virus nucleic acid detection in two influenza sentinel hospitals in Jingzhou of Hubei province, and provide evidence for the improvement of the quality of influenza surveillance.MethodsThe surveillance data of influenza-like illness (ILI) and pathogens from two influenza sentinel hospitals (hospital A and hospital B) in Jingzhou from 2010 to 2018 were collected from the China Influenza Surveillance Information System,. ILI case proportion (ILI rate) and nucleic acid positive rate of ILI cases were used to evaluate the surveillance quality. Factors such as hospital, case sex, season, interval between onset and sampling, interval between sampling and detection were used as independent variables. Pathogen test result of ILI case was used as dependent variables, and the influencing factors was analyzed by two-category Logistic regression.ResultsThe ILI rates of hospital A and hospital B were 2.34% and 1.34%, respectively, and the difference was significant (χ²＝3096.26, P＝0.000). The influenza virus nucleic acid positive rates of hospital A and hospital B were 13.63% and 14.84%, respectively, and the difference was significant (χ²＝4.69, P＝0.030). The change trends of ILI rate and nucleic acid positive rate of the two sentinel hospitals were consistent (r_s＝0.568, P=0.000; r_s＝0.824, P＝0.000). Hospital A and Hospital B had consistent change trends of ILI rate and nucleic acid positive rate (r_s＝0.306, P＝0.026; r_s＝0.477, P＝0.000). Logistic regression results showed that sentinel hospital (OR＝1.15, 95% CI: 1.05 ~ 1.26) and season (OR＝3.19, 95% CI: 2.88 ~ 3.52) were associated with the positive rate of influenza virus nucleic acid detection. ConclusionThe overall performance of influenza sentinel surveillance was well in Jingzhou. There were differences in ILI rate and positive rate of influenza virus nucleic acid detection between two influenza sentinel hospitals. Sentinel hospital and season were the main factors affecting the positive rate of influenza virus nucleic acid detection.

Analysis on drug resistance of pulmonary tuberculosis cases in Ningbo, Zhejiang, 2017

Tong Chen, Tianchi Yang, Xiang Lin, Sijia Wang, Guohua Ping, Yang Che, Lyu Lin, Mei Yu

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ObjectiveTo evaluate the levels and patterns of drug resistance in initially treated smear-negative pulmonary tuberculosis (TB) patients in Ningbo, and provide scientific evidence for the prevention and control of drug-resistant TB.MethodsSputum samples of 1 434 initially treated smear-negative pulmonary TB patients enrolled from March to December 2017 were isolated by liquid culture method. Strain identification and drug susceptibility tests were performed for all culture positive samples with proportion method.ResultsA total of 387 sputum samples from the 1 434 enrolled pulmonary TB patients were culture positive, in which 60 were non-tuberculosis mycobacterium positive. Eight six of 327 pulmonary TB cases were drug-resistant, the overall drug-resistance rate was 27.04%, with the highest resistance rate to isoniazid (17.92%, 57/86), and the lowest drug-resistance rate to rifampicin (5.35%, 17/86). The resistance rate to rifampicin in pulmonary TB patients with cavitation was significantly higher than that in those without cavitation (χ²＝5.319, P＜0.05).ConclusionThe drug resistance in initially treated smear-negative pulmonary TB cases was relatively severe in Ningbo. Further efforts should be made to expand drug susceptibility test coverage to find drug-resistant patients timely and improve the treatment and management of pulmonary TB cases.

Analysis on molecular characteristics and drug resistance of Aeromonas from environmental Sources in Ma'anshan, Anhui

Yonglu Wang, Zhenzhou Huang, Li Wang, Rong Wang, Hang Dai, Hongyan Cai, Xiaoli Du, Duochun Wang

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ObjectiveTo understand the epidemiological characteristics, virulence gene characteristics and drug resistance of Aeromonas from environmental sources in Ma’anshan of Anhui province.MethodsFrom January to December, 2017, Aeromonas strains isolated from seawater products, packaged foods, domestic water, swimming pool water and food poisoning samples in Ma'anshan were detected. The species of Aeromonas were identified through housekeeping gene rpoD sequence analysis. PCR was used to detect six virulence genes (Fla, Elastase, hlyA, ast, act and ASCF-G), the molecular types of the strains were detected by using pulsed field gel electrophoresis (PFGE), and drug susceptibility test of the strains was also conducted.ResultsA total of 66 Aeromonas strains were isolated from 869 samples (7.6%), and the isolated rates were higher in rural domestic water, food poisoning samples and seafood products respectively. Sixty-six strains of Aeromonas belonged to seven species, mainly including A. veronii (24, 36.4%), A. hydrophila (13, 19.7%) and A. jandaei (13, 19.7%) respectively. 64 strains of Aeromonas (97.0%) carried one or more virulence genes, with the highest detection rate of Fla and act (53.1%), Fla was mainly detected in A. caviae (83.3%) and act was mainly detected in A. hydrophila (69.2%). Sixty six strains of Aeromonas were divided into 64 PFGE types, indicating the diversity of molecular biotypes. Drug susceptibility test showed that Aeromonas was sensitive to seven antibiotics including cefotetan, and partially sensitive to five antibiotics (1.5%–21.2%) such as cefazolin, and highly resistant to ampicillin and ampicillin/sulbactam (94.0%).ConclusionThe contamination of Aeromonas, which carries multiple virulence genes and has high resistances to several antibiotics, is severe in Maanshan. It is necessary to strengthen the surveillance for Aeromonas and its drug resistance.

Isolation of two rare Shewanella spp. from specimens of patients in Liaocheng

Shengnan Liang, Xiangkun Jiang, Yinju Du, Pu Zhou, Li Liu, Lihong Cheng, Duochun Wang

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ObjectiveTo identify the isolates of Shewanella spp. from two patient specimens in Liaocheng and explore the biochemical characteristics and drug susceptibility of the Shewanella spp.MethodsTwo specimens from the two patients and other 6 Shewanella spp. strains revived were cultured by using selective medium, and biochemical test, hemolytic test, salt-resistant and heat-resistant tests, drug-resistance test were conducted for the strains. API and VITEK 2 Compact, VITEK MS systems were used for the identification of the strains, 16S rRNA and gyrB sequence analyses were conducted.ResultsThe morphology and biochemical characteristics of 8 strains were consistent, the hemolytic state was different. The clinical identification system could only identified Shewanella putrefaciens and Shewanella algae. Two strains isolated from the patients were further identified as rare Shewanella haliotis and Shewanella upenei through 16S rRNA and gyrB gene sequence analyses.ConclusionIt was the first time to isolate rare Shewanella spp. from clinical cases in China. Further attention needs to be paid to clinical infection caused by Shewanella and the surveillance should be strengthened.

Analysis on surveillance for pathogen spectrum of infectious diarrhea in Tongzhou district of Beijing, 2016–2018

Ping Zhang, Haoliang Yang, Bojun Zhen, Xiang Gao, Fengling Zhao, Jie Gao, Yang Zhang, Zhaohui Li, Duochun Wang, Jinglin Zhou

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ObjectiveTo understand the bacterial pathogen spectrum of infectious diarrhea in Tongzhou district of Beijing from 2016 to 2018, and provide evidence for the prevention and control of bacterial infectious diarrhea.MethodsStool samples were collected from intestinal outpatient diarrhea patients of two sentinel hospitals of Tongzhou district for detection of related pathogenic bacteria. The molecular biology identification of Salmonella, Vibrio parahaemolyticus and diarrheagenic Escherichia coli was carried out according to serotype and virulence gene, and the epidemic characteristics were analyzed.ResultsA total of 298 strains of pathogenic bacteria were isolated from 1 269 stool samples with a detection rate of 23.48%. The detection rates of pathogenic bacteria in different age groups were statistically significant (χ²＝33.584, P＜0.001). Among the positive strains, diarrheagenic E. coli was predominant (140/298, 46.98%), mainly including EAEC and ETEC, followed by V. parahaemolyticus (73/298, 24.50%) and Salmonella (58/298, 19.46%). The seasonality of bacteria spread was obvious, mainly in summer and autumn. The major Salmonella serotype were S. Enteritis and S. Typhimurium. The serotype of V. parahaemolyticus was mainly O3:K6.ConclusionFrom 2016 to 2018, pathogenic bacteria of infectious diarrhea in Tongzhou district were mainly diarrheagenic E. coli, V. parahaemolyticus and Salmonella were also the common pathogens of infectious diarrhea. It is necessary to strengthen the routine surveillance for pathogens of infectious diarrhea and health education in population at high risk, and risk factor investigation and prevention and control should be further strengthened.

Characteristics of phenotype and molecular type of Vibrio cholerae O1 in Beijing, 2018

Hanqiu Yan, Fu Li, Bing Lyu, Ying Huang, Xin Zhang, Lei Jia, Haijian Zhou, Mei Qu, Quanyi Wang

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ObjectiveTo understand the characteristics of the phenotype and molecular type of Vibrio cholerae O1 in Beijing in 2018.MethodsThe strains of V. cholerae were isolated from cholera cases and external environments. Serotyping was performed for the strains with routine identification methods, and V. cholerae toxin gene were detected by using real-time PCR. The sensitivities of the strains to 21 kinds of antibiotics was conducted with micro-broth dilution method. Pulsed field gel electrophoresis (PFGE) with Xba Ⅰ and Not Ⅰ restriction enzymes was performed for the molecular typing of V. cholerae O1 strains.ResultsIn 29 V. cholerae O1 strains isolated, the proportions of non-toxin producing Ogawa strains, non-toxin producing Inaba strains and toxin producing Ogawa strains were 62.07% (18/29), 24.14% (7/29) and 13.79% (4/29) respectively. The resistance rate of the strains to cefazolin was highest (82.76%), all the strains were sensitivity to meropenem (100.00%). Twenty eight strains were drug resistant with 9 drug resistance types, the highest was resistant to 13 antibiotics; there were 13 resistance categories to 11 classes of antibiotics, the highest was resistant to 7 classes of antibiotics. Results from PFGE indicated that the 29 V. cholerae strains were classified into 16 molecular types.ConclusionV. cholerae O1 was mainly non-toxic in Beijing, and multi drug resistance of V. cholerae O1was severe. The results of PFGE molecular typing suggested that the attention should be paid to food safety, especially to strengthen the monitoring of aquatic products.

Correlation between atmospheric particulate matter pollution and number of patients admitted to hospital due to unstable angina in Taiyuan, Shanxi

Dianying Lu, Hai Jiang, Junfeng Zhang, Xiaofang Qiao, Jin Shang, Juanjuan He, Junni Wei

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ObjectiveTo investigate the effect of atmospheric particulate matter pollution on the number of patients admitted to hospital due to unstable angina (UA).MethodsThe number of hospitalized patients with UA from December 1, 2013 to August 31, 2016 was collected, as well as meteorological surveillance data during the same period. Based on the control of long-term trends, meteorological factors, holidays and the effects of the day of the week, a semi-parametric generalized additive model was constructed to analyze the relationship between atmospheric particulate matter (including PM₁₀ and PM_2.5) and the number of hospitalized patients with UA.ResultsAfter one day lag, as the PM₁₀ increased by 10μg/m³, the number of UA patients admitted to hospital increased by 1.0%（95% CI: 0.6%-1.3%）, and as the PM_2.5 increased by 10μg/m³, the number of UA patients admitted to hospital increased by1.5%（95% CI: 0.9%-2.0%). Two pollutant models were constructed by using particulate matter (PM_2.5 and PM₁₀) and ozone (lag one day). The results of PM₁₀ pollutant model was statistically significant after the substitution of O₃, and the RR value increased (P＜0.05). For PM_2.5, the results were statistically significant after the substitution of O₃, and the RR value increased (P＜0.05).ConclusionAtmospheric particulate matter can cause an increase in the number of hospitalizations due to UA.

2019年全球鼠疫疫情概况

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Summary of global surveillance data of infectious diseases in July 2019

Hui Han, Bo Wu, Yajing Song, Runqi Huang

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In July 2019, a total of 57 infectious diseases were reported globally, affecting 108 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were measles (56), dengue fever(32),Chikungunya fever(16),cholera(11) and malaria(7). The top three infectious diseases with highest case fatality rates were Ebola hemorrhagic fever (67.2%), Middle East respiratory syndrome (34.5%) and Lassa fever (22.5%). The top five infectious diseases with greatest number of deaths were Ebola hemorrhagic fever, dengue fever, cholera, measles and Lassa fever. The prevalent infectious diseases in Africa were Ebola hemorrhagic fever, cholera, yellow fever and Lassa fever, the prevalent infectious diseases in Asia were Middle East respiratory syndrome and dengue fever, the prevalent infectious diseases in America and Europe were dengue fever and measles.

Progress in research of Orientia tsutsugamushi and its host and vector

Yunyan Luo, Jiaxiang Yin

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Orientia tsutsugamushi is a Gram-negative obligate intracellular bacterium and the causative agent of human scrub typhus, which is transmitted by mites. In recent years, with the rise of tourism and outdoor sports, human contact with mites has increased, and the possibility of scrub typhus outbreak exists. Orientia tsutsugamushi is the only pathogen of scrub typhus. Fully understanding of the morphological structure, genotype, pathogenic mechanism, host and vector of Orientia tsutsugamushi plays an important role in the prevention and control of scrub typhus and vaccine development. This paper summarizes the progress in research of Orientia tsutsugamushi and its host and vectors.

Influence of two dose immunization schedule of varicella vaccine on epidemiological characteristics of varicella in Taizhou

Yafei Hu, Haijiang Lin, Wei Li

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ObjectiveTo understand the epidemiological characteristics of varicella in Taizhou after the implementation of two dose immunization schedule of varicella vaccine.MethodsThe incidence data of varicella in Taizhou from 2011 to 2017 were collected, the epidemiological characteristics of varicella cases were analyzed by descriptive epidemiology.ResultsA total of 16 895 cases of varicella were reported in Taizhou from 2011 to 2017 with an average annual reported incidence of 40.02/100 000. The highest incidence was 55.81/100 000 in 2015 and the lowest was 26.24/100 000 in 2011. The incidence of varicella increased from 2011 to 2015, and decreased during 2016-2017 after the implementation of two dose immunization schedule of varicella vaccine. The highest annual reported incidence was 103.77/100 000 in Tiantai county and the lowest was 17.46/100 000 in Yuhuan county. After the implementation of two dose immunization schedule of varicella vaccine, the vaccination rate increased, and there were no obvious changes in the sex ratio, seasonal distribution and age distribution of varicella cases. The incidence rate of increased in age group over 10 years and decreased in age group 0-9 years.ConclusionThe rising trend of varicella incidence in Taizhou was eased and the incidence in vaccinated population decreased after the implementation of two dose immunization schedule of varicella vaccine, but the proportion of varicella cases in non-vaccinated population aged ≥10 years increased. It is necessary to continue the two dose immunization schedule of varicella vaccine.

Influence of daily mean temperature on incidence of hand foot and mouth disease in Jingzhou, Hubei

Tian Liu, Xijun Weng, Lijie Zhang, Menlei Yao, Jigui Huang, Qinqin Xu, Yang Wu, Qi Chen, Yeqing Tong

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ObjectiveTo discuss the 1ag effects of daily mean temperature on incidence of hand foot and mouth disease (HFMD) in Jingzhou of Hubei province.MethodsThe data of daily cases of HFMD in Jingzhou from 2010 to 2017 were collected, and local meteorological data during the same period were collected too. Spearman correlation test was used to analyze the relationship between the meteorological factors and the daily case number of HFMD, and the distributed lag non-linear model was used to analyze the relationship between the daily mean temperature and the daily case number of HFMD. The temperature of 18.18 ℃ was used as reference for the estimation of RRs at different temperature (P₂₅, P₅₀, P₉₅). The delayed and cumulative effects of daily mean temperature on daily case number of HFMD were also assessed.ResultsA total of 48591 cases were reported in Jingzhou from 2010 to 2017. The daily mean case number of HFMD was related to daily average temperature, daily precipitation, daily average pressure, daily relative humidity and wind speed. An inverse U-shaped relationship was found consistently between daily mean temperature and the daily case number of HFMD, and the maximum value of effect at 18.19 ℃ was 2.67 (95% CI: 2.12 ~ 3.37). When the temperature was set to 9.76 ℃ (P₂₅), 18.35 ℃ (P₅₀) and 30.96 ℃ (P₉₅), the lag effect time of the significant positive influence (RR＞1.00) on daily case number of HFMD was 6 ~ 19 d, 6 ~ 21 d and 0 d respectively. The 1ag effect was highest on lag 0-14 d, and the RR values of HFMD was 1.11(95% CI: 1.04 ~ 1.19), 1.56(95% CI:1.31 ~ 1.86), 2.67, (95% CI: 2.12 ~ 3.37), 1.58 (95% CI: 1.19 ~ 2.10) for 5.17 ℃(P₁₀), 9.76 ℃(P₂₅), 18.35 ℃(P₅₀) and 25.21 ℃(P₉₅) respectively.ConclusionAverage temperature had significant influence on the risk of HFMD in Jingzhou. High temperature and low temperature could reduce the risk of HFMD, and the influence on the daily case number of HFMD was nonlinear and lagging.

Risk assessment of public health emergencies concerned in the mainland of China, August 2019

Wenxiao Tu, Di Mu, Zhaorui Chang, Xiaoye Wang, Jinghuan Ren, Dan Li, Yuan Yuan, Ling Meng, Nijuan Xiang, Zhongjie Li

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ObjectiveTo assess the risks of public health emergencies, both the indigenous ones and imported ones, which might occur in the mainland of China in August 2019.MethodsAn internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all the provincial centers for disease control and prevention attended this meeting through video terminal.ResultsIt is predicted that the number of public health emergencies reported in August would be similar to that in July, which would be at a low level of whole year. The local transmissions of dengue fever in Guangdong, Yunnan and other provinces would continue, and some of these transmissions might develop into larger scale outbreaks. Attention should be paid to the prevention and control of nosocomial outbreak of echovirus 11 in neonates, especially in premature infants. The incidences of food poisoning and heatstroke would be at the peaks of the year. The risks of waterborne, foodborne and vector-borne communicable diseases might increase after flood disasters predicted by meteorological department. The risk of bee stings will increase from August in some provinces. The epidemic of Ebola virus disease (EVD) in the Democratic Republic of Congo (DRC) will continue, but the risk of the spread to China is low.ConclusionIn August 2019, there is no special concern about risk of public health emergencies in the mainland of China. Close attention should be paid to the risk of local transmission of dengue fever, and general attention should be paid to the public health risks of echovirus infection cluster, food poisoning, heat stroke, flood related illness, bee stings and EVD in DRC.

Analysis on etiological surveillance results of other infectious diarrhea in Zhuzhou, Hunan, 2015–2018

Qizhi Long, Li He, Shixiong Hu, Lidong Gao, Junhua Li

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ObjectiveTo study the epidemiological characteristics and pathogen spectrum of other infectious diarrhea in Zhuzhou, Hunan province, from 2015 to 2018.MethodsThe relevant information were collected from diarrhea cases diagnosed in sentinel hospitals from May 2015 to November 2018. Stool samples were collected for the detection of intestinal pathogenic bacteria and viral nucleic acid detections.ResultsA total of 580 samples of diarrhea cases were collected and detected.Bacterial infection cases accounted for 30.17%, and the Salmonella was the major pathogen in bacterial infection, followed by Campylobacter jejuni and Diarrheogenic Escherichia coli. Viral infection cases accounted for 37.07%, rotavirus A was the predominant pathogen in viral infection, followed by norovirus GⅡ. The detection rate of virus was higher than those of bacterium in all age groups. The cases were mainly children aged under 5 years old (82.59%, 479/580). The seasonality was obvious with detection peaks in autumn and winter. The main pathogen causing infectious diarrhea was Salmonella in summer. Most cases occurred in autumn were caused by norovirus, while most cases occurred in winter and spring were caused by rotavirus. The gender specific pathogen spectrums were similar. The detection rates in rural area (bacterium 31.63%, virus 41.83%) was higher than those in urban area (bacterium 29.88%, virus 36.09%).ConclusionThe viral infection rate was higher than bacterial infection rate in other infectious diarrhea cases in Zhuzhou, while rotavirus A, Salmonella, and norovirus GⅡwere the main pathogens causing other infectious diarrhea in Zhuzhou.

Progress in research of early diagnosis of blood-borne pathogens

Xiaoli Chen, Xiaoping Chen, Jinxing Lu

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Blood borne pathogen infection often occurs in hospitalized patients with high mortality rate, the early and rapid identification of pathogens and appropriate antimicrobial treatment are the key measures to reduce the mortality. Blood culture is the gold standard in the diagnosis of blood borne pathogen infection, blood culture, however, is not only time-consuming but also non-sensitive with low positive rate. Molecular biology method can greatly reduce diagnosis time, improve the sensitivity and specificity of diagnosis and provide reliable evidence for the rational clinical drug use and accurate treatment, which can greatly improve the patient's survival rate. This paper summarizes the progress in the research of molecular biology methods for the diagnosis of blood-borne pathogens, including nucleic acid hybridization technique, nucleic acid amplification technique, fluorescence real-time quantitative PCR, DNA microarray and MALDI-TOF-MS.

Epidemiological characteristics of infectious diseases in children in child care settings in Huairou district of Beijing, 2008–2017

Juntao Chen, Liping Wang, Liwen Sun

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Objective To understand the epidemiological characteristics of infectious diseases reported in children in child care settings in Huairou district of Beijing from 2008 to 2017 and provide scientific evidence for the effective prevention and control of infectious diseases in children in child care settings and development of long-term prevention and control strategies of infectious diseases in child care settings. Methods Descriptive epidemiological method was used to analyze the incidence of infectious diseases in children in child care settings in Huairou from 2008 to 2017 by using the dada collected from Infectious Disease Reporting Information Management System and local CDC of Huairou. Results A total of 3 414 cases of 11 infectious diseases were reported in children in child care settings in Huairou from 2008 to 2017. The average annual reported incidence was 4 157.63/100 000, which was higher than the average level in China. No deaths caused by infectious diseases were reported. The annual reported incidence fluctuated, but the overall incidence showed a downward trend. The top five reported diseases were hand foot and mouth disease（HFMD）, influenza, other infectious diarrhea, varicella and mumps, accounting for 95.08% of the total reported cases. The first 3 townships reporting high incidences were Huairou, Beifang and Yanqi in urban-rural fringe. Conclusion Although the reported incidence of infectious diseases in child care settings in Huairou declined significantly in recent ten years, children in child care settings are still at high risk for infectious diseases. HFMD and influenza are the main infectious diseases affecting the health of children in child care settings. In urban-rural fringe with high incidence of infectious diseases, where the population structure is complex and more private child care settings exit, the supervision and health education about infectious disease prevention and control should be strengthened.

Spatial-temporal distribution characteristics of hemorrhagic fever with renal syndrome in Jingzhou, Hubei, 2005–2017

Menglei Yao, Tian Liu, Jigui Huang, Xiaopei Nie, Tianyan Li, yang Wu

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ObjectiveTo analyze the spatial and temporal distribution characteristics of hemorrhagic fever with renal syndrome (HFRS) in Jingzhou, Hubei province from 2005 to 2017 and provide reference for the development of HFRS prevention and control strategies.MethodsThe incidence data of HFRS were collected from Infectious Disease Reporting Information System in China, and the annual statistical analysis was conducted by using the data from March to next February. Spatial autocorrelation analysis and space-time scan statistics were applied to analyze the incidence of HFRS in Jingzhou from March 2005 to February 2018 to describe the spatial and temporal clustering characteristics.ResultsFrom 2005 to 2017, a total of 551 cases of HFRS were reported in Jingzhou. The annual incidence rate showed an increasing trend (r_s ＝0.901, P＜0.05). The incidence rate increased rapidly from 2016 to 2017. Spring and autumn-winter were the incidence peak seasons, and more than one subtypes of HFRS were detected in Jingzhou. The results of spatial and temporal scanning (upper limit of 15% population) showed that high incidence clustering areas were in the north of the Yangtze river from November 2011 to February 2018, including urban area of Shashi city, Jiangling and Jianli counties (29 streets and townships were involved). And 12 townships in Honghu city were added in the high risk clustering area list after December 2016.ConclusionFrom 2005 to 2017, a new round of HFRS epidemic with increasing incidence occurred in Jingzhou, the key prevention and control areas were Jiangling, Shashi, Jianli and Honghu.

Epidemiological investigation of a case of human infection with Streptococcus suis serotype 14

Songjian Xiao, Yi Zhou, Chudong Zhang, Yanmei Fang, Huitao Huang

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In September 2018, a case of human infection with Streptococcus suis serotype 14 was reported in Zhuhai, Guangdong province. The patient and one co-exposed person showed clinical manifestations of meningitis, arthritis and permanent deafness. One week before illness they had no contacts with sick or dead pigs, but ate pork every day. According to the investigation, the patient might be infected due to damaged oral mucosa.

An investigation of Norovirus gastroenteritis outbreak in a scenic spot caused by well water contamination

Shujun Ye, Qiucui Qin, Yu Huang, Zhi Li, Chunhua Lu

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From 25 September to October 1, 2017, an outbreak of Norovirus gastroenteritis occurred in Huangyao ancient town scenic spot in Hezhou of Guangxi zhuang autonomous region. A total of 104 cases were reported. The epidemiological investigation indicated that the outbreak was caused by well water contamination. After taking the measures such as stopping well water use, disinfection and case isolation, the outbreak was effectively controlled. It is suggested to improve sewage facilities, improve the management of drinking water and food hygiene and strengthen health education.

Epidemiological and etiological characteristics of hand-foot-mouth disease in reservoir and non-reservoir areas of three gorges area in China, 2009–2016

Han Li, Jing Zhang, Zhaorui Chang

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Objective To understand the epidemiological and pathogenic characteristics of hand-foot-mouth disease (HFMD) and influence factors in the reservoir area and non-reservoir area in three gorges area, and provide evidence for the development of prevention and control strategies of HFMD. Methods The HFMD surveillance data in these areas from 2009 to 2016 were collected from National Notifiable Infectious Disease Reporting Information System for a descriptive epidemiologic analysis, the results in reservoir area and non-reservoir area were compared. Results From 2009 to 2016, the average annual morbidity rate of HFMD was 145.66/100 000, the proportion of severe cases was 0.19%, and the reported case fatality rate was 0.045% in reservoir area. The average annual morbidity rate of HFMD was 78.42/100 000, the proportion of severe cases was 0.28%, and the reported fatality rate was 0.05% in non-reservoir area. The reported morbidity rate of HFMD in reservoir area was higher than that in non-reservoir area. The proportion of severe cases in reservoir area was lower than that in non-reservoir area (χ²＝28.732, P＜0.01). There was no significant difference in reported case fatality rate between reservoir area and non-reservoir area (χ²＝0.876, P＝0.349). The pathogen causing severe cases was mainly EV71 (79.17%) in reservoir area, while the pathogen causing severe cases were mainly EV71 (47.37%) and other enterovirus (35.34%) in non-reservoir area. Other enteroviruses (37.83%) were more common in mild cases in reservoir area, while EV71 (41.19%) was more common in mild cases in non-reservoir area too. Conclusion From 2009 to 2016, the reported morbidity rate of HFMD in reservoir area was higher than that in non-reservoir area in three gorges area, but the severe case rate in the reservoir area was lower than that in the non-reservoir area. The cases were mainly children aged ≤3 years in both reservoir and non-reservoir areas. There was difference in pathogen condtituent of HFMD between reservoir area and non-reservoir area. It is suggested that the prevention and control of HFMD should be focused on the pathogen changes, and EV71 vaccination and comprehensive measures should be taken to protect the population at high risk to reduce the overall incidence of HFMD in three gorges area.

Epidemiological characteristics and temporal-spatial clustering analysis on severe fever with thrombocytopenia syndrome in Jinan, 2013–2018

Shang Gao, Xiaodong Zhao, Yaru Ren, Xiaolin Jiang, Caiyun Chang

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Abstract:
ObjectiveTo analyze the epidemiological characteristics and temporal-spatial clustering of severe fever with thrombocytopenia syndrome (SFTS) in Jinan of Shandong province, and provide scientific evidence for SFTS prevention and control.MethodsThe data of SFTS cases in Jinan during 2013—2018 were downloaded from National Notifiable Infectious Disease Reporting System of China, and comprehensive analysis on the epidemiological characteristics of SFTS was conducted by using descriptive epidemiological methods and spatial-temporal scan statistics method.ResultsA total of 385 SFTS cases, including 49 deaths, were reported in Jinan from 2013 to 2018. The average case fatality rate was 12.73%.The cases mainly occurred between April and October with the incidence peak in August. The cases over 50 years old accounted for 90.13% and farmers accounted for 90.91% of the total cases, respectively. The male-female ratio of the cases was 1.07∶1.The top three high-incidence areas were Zhangqiu, Licheng and Changqing, the cases in these areas accounted for 83.12% of the total. Spatial-temporal clustering analysis detected three clusters (one first-class cluster, two second-class clusters) and one suspected cluster with the characteristics of significant spatial-temporal clustering.ConclusionThe incidence of SFTS had spatial-temporal clustering in Jinan during 2013—2018. According to the spatial and temporal distribution and epidemiological characteristics of SFTS, prevention and control measures, such as health education, surveillance and staff training, should be carried out in key populations in areas with high incidences.

Analysis on surveillance results of avian influenza virus in external environment in Quzhou, Zhejiang, 2013–2018

Shiteng Huang, Ruijun Yang, Lei Lyu, Xufu Chen, Sheng Wan

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Abstract:
ObjectiveTo understand the distribution of avian influenza virus in the external environment in Quzhou, Zhejiang province, from 2013 to 2018, and provide scientific evidence for the prevention and control of human infection with avian influenza virus.MethodThe external environmental samples were collected from different surveillance sites of Quzhou for the nucleic acid detection of avian influenza viruses by using real-time RT PCR during 2013—2018, and the results were used for statistical analysis.ResultsA total of 5290 environmental samples were collected from 2013 to 2018, in which 1809 were positive for avian influenza A virus (34.20%), The subtype identification showed that H9 and unspecific type were main subtypes, the positive rate were 44.50% and 29.13% respectively. The positive rate was highest in Kaihua county (54.85%) and lowest in Longyou county (17.25%).The detection rate in live poultry markets was highest (45.94%) in 5 types of places, and the detection rate in surface swabs of chopping boards for slaughtering or placing poultry products was highest (58.96%) in 6 types of samples. The positive rates were significantly higher during January-March (38.06%) and during October-December (37.23%). There were significant differences in time, area, place and sample type specific distributions of avian influenza viruses (all P＜0.001).ConclusionsThere were different subtypes and mixed types of avian influenza virus contamination in the environment in Quzhou. It is important to strengthen the surveillance for avian influenza virus in environment and take comprehensive prevention and control measures to reduce the risk of human infection with avian influenza virus.

Epidemiological characteristics of hand foot and mouth disease cases caused by enterovirus 71 in Guangzhou, 2013–2017

Chun Chen, Huaping Xie, Hui Wang, Jinmei Geng, Ying Lu, Dahu Wang, Meixia Li, Tiegang Li

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Abstract:
ObjectiveTo understand the epidemiological characteristics of hand foot and mouth disease (HFMD) cases caused by enterovirus 71 (EV71) in Guangzhou from 2013 to 2017.MethodsThe incidence data of HFMD cases caused by EV71 were collected from 5 sentinel hospitals in Guangzhou, including severe and fatal cases and outbreaks of HFMD, the estimation formula was defined, and χ² test was used for the data comparison.ResultsFrom 2013 to 2017, severe cases and fatal cases in Guangzhou accounted for 53.85% and 100.00%, respectively, in EV71 caused HFMD cases. The positive rate of EV71 in mild HFMD cases from sentinel hospitals was 12.21%. The highest estimated incidence rate of EV71 infection was in 2014 (134.36/100 000). The annual incidence peak was during April-June. The incidence was higher in age group below 5 years old, especially in children aged 1–3 years. However, severe and fatal cases mostly occurred in infants aged 0–1 year.ConclusionIn Guangzhou, EV71 was the most important pathogen causing severe and fatal cases of HFMD. Medical institutions should focus on the early identification and treatment of EV71 caused severe cases of HFMD, especially in children aged 1–3 years.

Analysis on etiological surveillance results of infectious diarrhea in Wuxi, Jiangsu, 2014–2018

Hongxia Guan, Dan Sha, Weihong Feng, Qianqian Qi, Yong Xiao

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ObjectiveTo understand the pathogen spectrum and epidemiological characteristics of infectious diarrhea in Wuxi from 2014 to 2018.MethodsFrom January 2014 to December 2018, stool samples were collected from 3 408 outpatients with diarrhea in sentinel hospitals in Wuxi. Salmonella, Shigella, Diarrheagenic Escherichia coli and Vibrio parahaemolyticus were isolated by conventional culture, and the nucleic acid of norovirus, rotavirus, enteric adenovirus, astrovirus and sapovirus were detected with real-time fluorescence quantitative PCR.ResultsA total of 946 positive samples, including 65 multi pathogen positive samples, were detected in 3 408 stool samples with the positive rate of 27.76%. Among the positive samples, 529 were bacteria positive with the positive rate of 15.52%. The isolation rate of Diarrheagenic E. coli was highest (6.60%), followed by Salmonella (5.11%), V. parahaemolyticus (4.05%) and Shigella (0.32%). The diseases mainly occurred in summer. And among the positive samples, 460 were virus positive with the positive rate of 13.50%. The positive detection rates of norovirus (8.92%) and rotavirus (3.29%), which mainly spread in winter and spring, ranked 1-2. The positive rates of pathogens were different in different age groups. The infection rate of rotavirus in children under 5 years old was significantly higher than those in other age groups.ConclusionThe main pathogens causing infectious diarrhea were Diarrheagenic E. coli, Salmonella, V. parahaemolyticus, norovirus and rotavirus in Wuxi from 2014 to 2018. Bacterial diarrhea dominated in summer and viral diarrhea dominated in winter and spring. For infants and young children under 5 years old and the elderly, it is necessary to take different control measures in different seasons.

Comparison of effectiveness of prevention and control measures for clusters and outbreaks of priority communicable diseases in Hubei, 2017

Danqin Huang, Xuesen Xing, Meihua Chen

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ObjectiveTo analyze the characteristics of cluster and outbreaks of major acute communicable diseases in Hubei province in 2017 and compare the effectiveness of different prevention and control measures.MethodsAn active surveillance system for clusters or outbreaks of communicable diseases in Hubei was established. Descriptive epidemiological analysis was conducted on the constituent and place distribution of cluster and outbreaks of communicable diseases in Hubei and compare the effectiveness of epidemic control measures by logistic regression analysis.ResultsA total of 1 128 clusters or outbreaks were detected in Hubei in 2017. In clusters, hand foot and mouth disease (HFMD) accounted for highest proportion (46.6%), and in outbreaks, influenza accounted for highest proportion (46.1%). Schools were the main places where the outbreak occurred (95.1%). Univariate Logistic regression analysis showed that the effective cluster control measures included school suspension (OR＝0.191, 95% CI: 0.116−0.314), environmental disinfection (OR＝0.505, 95% CI: 0.320−0.798) or health education (OR＝0.395, 95% CI: 0.230−0.679). Multivariate Logistic regression analysis showed that the effective outbreak control measures included school suspension (OR＝0.187, 95% CI: 0.111−0.314) or health education (OR＝0.439, 95% CI: 0.233−0.825).ConclusionThe priority acute communicable diseases detected in clusters or outbreaks in Hubei in 2017 were HFMD, varicella and mumps, which were mainly transmitted through respiratory tract and personal contact. The most effective control measures were school suspension or health education, which should be implemented as early as possible, and other prevention and control measures must also be implemented in parallel.

Prediction of rabies cases in China by using autoregressive moving average model

Yanrong Li, Liling Zhu, Wuyang Zhu, Xiaoyan Tao

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ObjectiveTo predict the monthly incidence of rabies in the mainland of China by using autoregressive moving average model (ARIMA), and provide reference for the prevention and control of rabies in China.MethodsUsing SPSS 19.0 software, a time series model was established by using the monthly incidence data of rabies in China from January 2007 to December 2016, and the optimal model was validated by the monthly incidence data of rabies from January to December 2017. The optimal model was used to predict the incidence trend and case number of rabies in 2018.ResultsThe optimal model was ARIMA(0,1,1)(2,1,0)₁₂, with a stationary R²＝0.539, RMSE＝17.653, Ljung-Box Q＝8.932, P＝0.881. In predicting the data for January-December 2017, the relative error of prediction was 1.55%. A total of 516 rabies cases occurred actually in 2017. It was predicted that the case number of rabies in China would drop to 398 in 2018.ConclusionThe ARIMA(0,1,1)(2,1,0)₁₂ model can well fit the long-term trend and seasonal trend of rabies incidence, and the results of retrograde fitting and short-term prediction are ideal.

Surveillance and drug resistance analysis of non-typhoid Salmonella in Yuyao, Zhejiang, 2014–2018

Shijie Yuan, Jianqun Zhang, Shaojun Huang

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Abstract:
ObjectiveTo understand the spread and drug resistance of non-typhoid Salmonella (NTS) in Yuyao, and provide scientific basis for clinical treatment and prevention of NTS infection.MethodsThe samples of diarrhea patients collected from sentinel hospitals were tested for bacterial enrichment (using selenite brilliant green), isolation, identification, serotyping and drug susceptibility testing from 2014 to 2018.ResultsA total of 299 NTS strains (12.85%) were detected from 2 327 samples of diarrhea patients, and 35 serotypes and 1 unspecified serotype were identified. The first four predominant serotypes were S. 4,5,12:i:-, S. typhimurium, S. Stanley and S. enteritidis. The detection rate of NTS was highest in summer (16.29%) and lowest in winter (2.33%). The infection cases in children aged ≤5 years accounted for 60.54% of the total. Drug susceptibility test showed that NTS had high resistance rates to penicillin and cephalosporin, low resistance rate to ciprofloxacin. And 111 strains were multidrug resistant. The resistance pattern of ACSSuT mainly existed in S.4,5,12:i:- and S. typhimurium strains.ConclusionThe predominant serotypes of NTS were S.4,5,12:i:- and S. typhimurium in Yuyao. Children aged ≤5 years were susceptible to NTS infection, suggesting that it is necessary to strengthen the surveillance in children aged ≤5 years. The multidrug resistance of NTS was serious. It is necessary to have a rational use of antibiotics in clinical practice.

Screening specific genes and virulence genes of Bacillus cereus for its rapid identification and detection

Huijuan Zhang, Enmin Zhang, Jinrong He, Wei Li, Jianchun Wei

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ObjectiveToscreen the specific genes and virulence genes of Bacillus cereus for its rapid identification and detection. MethodsA total of 329 B. cereus strains isolated from food and soil were used to evaluate the specificity of gyrB and groEL genes for the identification of B. cereus and investigate the distribution of virulence genes with PCR method. The appropriate genes were selected to develop a multiplex PCR assay for rapid detection of B. cereus. ResultsAmong the studied B. cereus and closely related Bacillus strains, gyrB gene was specific for B. cereus except for one B. thuringiensis strain, however, groEL gene was amplified in four species. The carrying rates of six virulence genes of nheA, entFM, bceT, hblC, cytK and ces were 84.19%, 79.64%, 49.24%, 47.72%, 47.11% and 1.52%, respectively. Six genes, gyrB, hblC, nheA, entFM, ces and cytK, were selected. Two multiplex PCR systems, including one duplex PCR (gyrB and cytK) and one quadruple PCR (nheA, hblC, entFM and ces), were optimized.ConclusionThe specific genes and virulence genes of B. cereus screened can be used in the detection of B. cereus in a comprehensive, specific, simple and effective way and have good potential in laboratory detection practice.

Analysis on hepatitis C virus infection status and risk behaviors of drug users in Anhui, 2010–2018

Yuelan Shen, Xiaoli Cheng, Hui Yao, Ping Ai, Xiang Wang, Hongbin Zhu, Xinping Ding, Qin Yue, Bin Su

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Abstract:
ObjectiveTo understand the hepatitis C virus (HCV) infection status and risk behavior characteristics of drug users in Anhui province, and provide evidence for the establishment of measures to prevent HCV infection in drug users.MethodsQuestionnaire survey and serological test were conducted for drug users in Anhui during 2010–2018, trend test was used to analyze the positive rate of HCV antibody and multivariate logistic regression analysis was done to identify the risk factors for HCV infection.ResultsA total of 18 925 drug users were investigated in Anhui from 2010 to 2018. The aanual positive rate of HCV antibody in drug users were 35.2%, 34.9%, 39.1%, 30.4%, 22.5%, 20.1%, 20.5%, 18.6% and 19.1% respectively (trend χ²＝458.635, P＜0.001). Multivariate logistic regression analysis showed that living in community (aOR＝1.310, 95% CI: 1.074−1.597), methadone treatment (aOR＝3.182, 95% CI: 1.434−7.062), 20− years old (aOR＝2.246, 95% CI: 1.134−4.450), 30− years old (aOR＝5.283, 95% CI: 2.669−10.458), 40− years old (aOR＝7.158, 95% CI: 3.565−14.375) and 50− years old (aOR＝3.125, 95% CI: 1.205-8.102), married (aOR＝1.708, 95% CI: 1.296−2.252), divorced or widowed (aOR＝1.818, 95% CI: 1.354−2.442), history of injecting drug use (aOR＝5.370, 95% CI: 4.239−6.804), seldom condom use in commercial sex in the past year (aOR＝1.254, 95% CI: 1.037−1.517) and never using condom (aOR＝1.282, 95% CI: 1.021−1.610) were high risk factors for HCV infection in drug users.ConclusionThe infection rate of HCV in the drug users in Anhui was high, but showed a downward trend. Therefore, effective measures should be taken to reduce the risk of HCV infection in drug users.

Analysis on serological surveillance results of brucellosis in key populations with occupational exposure in Haidian district, Beijing, 2014–2018

Lifei Shi, Kexin Yin, Lijie Jiao, Yanhang Zhao

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Objective To analysis the serological surveillance result of brucellosis in key populations with occupational exposure in Haidian district of Beijing from 2014 to 2018, understand the infection status of Brucella in key populations with occupational exposure and provide scientific evidence for the prevention and control of brucellosis. Methods In selected area of Haidian district, the breeders of cow or sheep and veterinaries were considered as the populations with occupational exposure to Brucella, The blood samples were collected from them for standard tube agglutination test（SAT） to detect the antibody to Brucella according to Diagnostic Criteria for Brucellosis（WS 269－2007）. Software SPSS 22.0 was used for statistical analysis and χ² test was used as the analysis method. Results A total of 243 serum samples were detected, and 7 serological positive cases without symptoms were detected, the positive rate was 2.88%, there was no significant difference among different years（in Fisher’s exact test, P＞0.05）. The serum positive rate in breeders was 3.03%; the serum positive rate in people who had contact with cow and sheep was 4.84%, the positive rate was 3.66% in people who had contact only with cow and 1.01% in people who had contact only with sheep. Conclusion The key populations with occupational exposure to Brucella were veterinaries and breeders in Haidian from 2014 to 2018. The main risk animals were cow and sheep. It is necessary to strengthen the health education about prevention and control brucellosis, immunize animals, conduct early detection of infection cases and monitor the epidemic trend for the effective prevention and treatment of brucellosis.

Etiology of paratyphoid A and B outbreaks

Yuxia Liu, Hongye Li, Bingquan Wang, Panlong Gong, Fanka Li

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ObjectiveTo understand the molecular biological characteristics of the pathogens detected in the paratyphoid A and B outbreaks occurred in a school of Xinjiang Production and Construction Corps in 2018, and provide evidence for the identification of the outbreaks.MethodsSeventeen strains were collected from patients in the hospital. The serological subtyping of 17 isolated strains was conducted. The antibiotic susceptibility test of the strains was done by using micro-broth dilution method. The pulsed-field gel electrophoresis (PFGE) patterns of the strains were analyzed with software BioNumerics 7.6.ResultsAmong the 17 strains, 12 were paratyphoid A strains with antigen 1,2,12∶a∶-, and 5 were paratyphoid B strains with antigen 1,4,12∶b∶1,2. All the strains were sensitive to 14 antibiotics. Cluster analysis of PFGE patterns showed that there were two patterns and the similarity of the two patterns was 59.4%. The same serotype had the same pattern type.ConclusionPFGE plays an important role in the investigation of typhoid and paratyphoid outbreaks.

Epidemiological characteristics of food poisoning in China, July-September, 2018

Jinghuan Ren, Xiaoye Wang, Xiaomin Wu, Rui Wang

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ObjectiveTo understand the epidemiological characteristics of food poisoning in the third quarter (July-September) in 2018 in China (excluding Hong Kong, Macao and Taiwan), and provide evidence for the early warning, prevention and control of food poisoning.MethodsDescriptive epidemiological analysis was conducted by using the incidence data of food poisoning in China during July-September in 2018 collected from National Report Management Information System of Public Health Emergency.ResultsA total of 119 food poisoning events were reported in 23 provinces during this period, involving 3 488 cases and 27 deaths. Among them, 64 food poisoning events were grade IV and above, involving 2 643 cases and 27 deaths. The most frequent type of the reported events was bacterial food poisoning (42.02%), the involved cases accounted for 69.29% of the total. Fungal food poisoning caused highest death number of food poisoning, accounting for 55.56% of the total. The numbers of food poisoning events and related deaths occurred in families accounted for 32.77% and 92.59% of the total, respectively. The numbers of food poisoning cases occurred after catering accounted for 51.46% of the total.ConclusionBoth the numbers of food poisoning events and deaths declined, but the food poisoning cases increased during July-September in 2018 compared with the same period in 2017. It is necessary to strengthen the health supervision in key places, such as food service units, especially in school opening season, improve the management and guidance of food procurement, storage, and processing, and health education should be conducted to improve the public awareness of poisonous flora and fauna or poisonous mushroom, as well as knowledge of proper cooking and self and mutual-treatment after poisoning.

Effect of cold treatment on biofilm formation ability of Listeria monocytogenes

Antuo Hu, Ping Wang, Caixia Zhang, Qiuhui Hu, Ying Chen

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Abstract:
ObjectiveTo study the effects of cold treatment on the biofilm formation ability of Listeria monocytogenes from different food sources and different serotypes, and provide evidence for the control of L. monocytogenes in food.MethodsThe biofilm formation ability of L. monocytogenes isolates under 37 ℃, 4 ℃ cold stress and 4 ℃ cold adaptation was determined by crystal violet staining, the analyses on gene sequence and the differences in expression levels of the biofilm formation related genes hpt, luxS and sigB of representative strains were carried out.ResultsAt 37 ℃, the biofilm formation ability of 1/2c serotype L. monocytogenes was stronger, and no strains with weak biofilm formation ability were observed. At 37 ℃, in the strong biofilm formation ability group (3 strains) and middle biofilm formation ability group (10 strains), 9 strains showed non-synonymous mutations in hpt gene. Under cold treatment conditions, among the 5 middle group strains, 1 strain showed high expression level of sigB gene, and 4 strains showed high expression level of hpt gene.ConclusionThe biofilm formation ability of L. monocytogenes is related to serotype. The 1/2c serotype strain has stronger biofilm formation ability at 37 ℃. hpt gene mutant strain has stronger biofilm formation ability at 37 ℃, cold treatment reduces the biofilm formation ability of pathogens but the overexpression of hpt and sigB genes enhances the biofilm formation ability of L. monocytogenes at 4 ℃.

Etiology of meningococcal meningitis cases in infants in Shanxi, 2017

Jiting Han, Hongxia Yang, Yang Wang, Tingting Yang, Qiuxiang Zhang, Suxia Yao, Ruie Hao, Bingqing Zhu

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ObjectiveTo analyze the etiologic characteristics of three meningococcal meningitis cases in infants in Shanxi province in 2017.MethodsEpidemiological data and clinical samples of suspected meningococcal meningitis cases were collected. Cerebrospinal fluid and blood specimens were used for the culture, isolation, identification of Neisseria meningitidis. Serogroup identification of N. meningitidis isolates were confirmed by slide agglutination test with serogroup B antiserum. Multi locus sequence typing (MLST) was used for molecular typing and E-test method was used for antimicrobial resistance test.ResultsThree meningococcal meningitis cases were aged 12 d, 5 months and 8 months, respectively, showing symptoms of purulent meningitis. Three N. meningitidis B strains were isolated, in which two belonged to ST-5664 (Clonal Complex 4821, CC4821) and one belonged to ST-5662 indicated by MLST. All the serogroup B isolates were resistant to ciprofloxacin, levofloxacin and sulfonamides.ConclusionThree meningococcal meningitis cases caused by N. meningitidis B occurred in Shanxi in 2017, the cases were all infants. It was the first time to isolate N. meningitidis B from case specimens in Shanxi, the major sequence type of the strains belonged to CC4821.

Subtypes and transmission characteristics of HIV-1 in men who have sex with men in Lishui, Zhejiang

Ling Ye, Xiaoguang Wang, Jiafeng Zhang, Xiuying Chen, Qin Fan, Bifeng Ye, Ying Cong, Xiaomeng Huang

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Abstract:
ObjectiveTo understand the subtypes and transmission characteristics of HIV-1 in men who have sex with men (MSM) in Lishui of Zhejiang province.MethodsBlood samples were collected from the newly-diagnosed HIV-1 infected MSM who received no antiviral therapy in Lishui during 2015–2018, pol gene was amplified and sequenced, the gene subtypes and transmission characteristics were analyzed by phylogenetic tree construction, at last mutations on drug resistance was analyzed with online software CPR 6.0.ResultsA total of 89 sequences were obtained successfully from 105 samples. The predominant subtypes were CRF01＿AE (49.4%, 44/89) and CRF07＿BC (37.1%, 33/89), others were B and CRF55_01B detected in 3 cases respectively and CRF08＿BC, CRF59_01B and URF(01_AE/BC) detected in 2 cases respectively. Eight transmission clusters were found, with the total clustered rate of 21.3% (19/89). Seven clusters of transmission were associated with the cases who lived in Liandu district (87.5%, 7/8). Three surveillance drug resistance mutations (M46I, V106A, K103N) were found respectively in three samples. The overall rate of transmitted drug resistance (TDR) was 3.4% (3/89).ConclusionThere were 7 HIV-1 subtypes in Lishui, HIV-1 genetic diversity showed complexity trend, and the cases in Liandu district might play a central role in the spread of HIV. It is necessary to strengthen the surveillance and targeted intervention for the cases associated with major transmission clusters. However, the prevalence of TDR was at a low level.

Establishment of real-time PCR assays for rapid detection of Clostridium botulinum type A and B

Ying Huang, Yun Shi, Changyun Ye, Xuefang Xu

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Abstract:
ObjectiveTo establish real-time PCR assays for the toxin gene detections of Clostridium botulinum type A and B, construct standard curves and evaluate the specificities, sensitivities and detection thresholds of the assays, and provide evidence for the rapid and accurate detection of C. botulinum.MethodsSpecific primers and probes were designed based on the sequences of toxin genes of C. botulinum type A and B. Real-time PCR assays were established with optimized reaction conditions. 25 other intestinal bacteria and common bacteria were used to test the specificities of the assays. Standard curve construction, fecal sample simulation and sensitivity measurement were achieved with recombinant plasmids containing toxin genes of C. botulinum type A and B.ResultsThe specificities of the real-time PCR assays were high. Specific amplification curves were observed in recombinant plasmids containing toxin genes of C. botulinum type A and B. No specific amplifications were found for the 25 other bacteria. The detection thresholds of toxin genes of C. botulinum type A and type B were 5.04×10² copy/μl and 6.91×10² copy/μl respectively according to the amplification curves. The detection thresholds of recombinant plasmids containing toxin genes of C. botulinum type A and B in artificial fecal samples were 1.71×10³ copy/μl and 2.14×10³ copy/μl respectively.ConclusionIn this study, real -time PCR assays for the toxin gens detections of C. botulinum type A and type B were established, which can be applied in the rapid detection of C. botulinum.