Disease Surveillance

Etiological and epidemiological characteristics of viral diarrhea in children under 5 years old in a sentinel hospital in Hangzhou, Zhejiang, 2012–2019

Xiaochun Shang, Huiqun Shuai, Xueqin Zhao, Xiaohong Zhou

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ObjectiveTo analyze the pathogenic spectrum and epidemiological characteristics of viral diarrhea in children under 5 years old in Hangzhou and its surrounding areas of Zhejiang province from 2012 to 2019 and provide evidence for the prevention and control of viral diarrhea.MethodsFrom 2012 to 2019, stool samples were collected from children aged <5 years with diarrhea in the outpatient and emergency department of Children's Hospital of Zhejiang University School of Medicine for the nucleic acid detections of norovirus (NV), rotavirus (RV), sapovirus (SAV), enteric adenovirus (EADV) and astrovirus (ASV) by real-time fluorescent quantitative PCR (quantitative real-time PCR). Statistical software SPSS 19.0 was used to analyze the results.ResultsA total of 1 350 stool samples were collected, in which 594 were positive for the viruses. The overall infection rate was 44.00%. A majority of the samples were single virus positive (84.51%, 502/594), while 14.31% and 1.18% of the samples were positive for two and three viruses, respectively. NV and RV co-infections accounted for 54.12%, (46/85). The infection rate of NV was highest (23.41%), followed by that of RV (19.11%). The detection rates of SAV, EADV and ASV were less than 5% (4.22%, 2.96% and 1.63%, respectively). There were significant differences in the virus detection rate among children with diarrhea among different age groups ( χ²=256.140, P<0.001). The age group 12-23-months had the highest detection rate (73.77%, 239/324), but the age group under 6-months had the lowest detection rate (17.18%, 73/425). There were significant differences in the detection rate of each virus among different age groups. The overall virus detection rate exhibited significant seasonal differences ( χ²=188.495, P<0.001), and peaked (70.31%, 225/320) in winter (i.e., December - February). The differences in the detection rates of NV, RV and SAV among different seasons were significant ( χ²=90.284, P<0.001; χ²=188.068, P<0.001; χ²=29.066, P<0.001), and the detection rate of NV peaked in autumn (September - November), while the detection rates of RV and SAV peaked in the winter. Between 2012 and 2019, the detection rate was higher in odd-numbered years than in previous even-numbered years, and the overall detection rate showed an upward trend (trend χ²=13.532, P<0.001). The annual changes in the detection rates of NV and ASV also showed upward trends (trend χ²=23.636, P<0.001; trend χ²=18.073, P=0.003). The changes in annual detection rates of RV, SAV and EADV were irregular (trend χ²=3.173, P=0.075; trend χ²=1.803, P=0.179; trend χ²=12.784, P=0.060).ConclusionThe main pathogens of viral diarrhea in children under 5 years old were NV and RV. The incidences of infections in infants and young children aged 12–35 months were high in autumn and winter. It is necessary to strengthen the prevention and control of viral diarrhea in autumn and winter.

Summary of global surveillance data of infectious diseases in August 2020

Hui Han, Bo Wu, Haishan Li, Jiaojiao Jia

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.09.003

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In August 2020, a total of 63 infectious diseases were reported globally, affecting 217 countries and regions. Except for influenza, the top five infectious diseases affecting greatest number of countries and regions were coronavirus disease 2019 (COVID-19, 217), dengue fever (32), measles (22), chikungunya fever (15) and poliomyelitis (13). The top five infectious diseases with highest case fatality rates were Ebola virus disease (43.1%), Lassa fever (20.9%), plague (18.7%), West Nile fever (8.2%) and COVID-19 (3.3%). The top five infectious diseases with greatest number of deaths were COVID-19, dengue fever, measles, cholera and Ebola virus disease.The prevalent infectious diseases in Asia were COVID-19 and dengue fever, the prevalent infectious diseases in Africa were COVID-19, Ebola virus disease, plague,cholera, yellow fever, Lassa fever and measles, the prevalent infectious diseases in America were COVID-19 and dengue fever, the prevalent infectious diseases in Europe were COVID-19, West Nile fever and measles.

Risk assessment of public health emergencies concerned in the mainland of China, September 2020

Ling Meng, Wenxiao Tu, Chao Li, Jingxin Li, Xiaoye Wang, Nijuan Xiang, Guoqing Shi

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.09.004

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ObjectiveTo assess the risk of public health emergencies, both the indigenous ones and the imported ones, which might occur in the mainland of China in September 2020.MethodsAn internet based expert counsel was conducted to analyze the surveillance data of public health emergencies and priority communicable diseases in China reported through different channels, and the experts in all provincial centers for disease control and prevention attended this conference through video terminal.ResultsGenerally speaking, it is predicted that the incidence of public health emergencies would be slightly higher in September than in August as school reopening season. At present, the global COVID-19 pandemic is still going on, and China has returned to be at the low risk. The risk of imported cases and secondary infections of COVID-19 would continue to exist, but it would be controllable. The possibility of sporadic cases, long-distance transmissions and imported cases of plague would not be ruled out. Outbreaks of norovirus infectious diarrhea might occur in schools and child care settings. The incidence of food poisoning would continue to be high. The risk of Ebola virus disease (EVD) spread from the Democratic Republic of Congo to China would be low.ConclusionSpecial attention should be paid to COVID-19, and general attention should be paid to plague, norovirus infectious diarrhea, food poisoning, and EVD in the Democratic Republic of Congo.

Development and prospect of the emergency response capacity for natural disaster of the CDC institutions

Zhe Wang, Rui Wang

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.09.005

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China is a country prone to natural disasters. The health effects caused by natural disaster have become a crucial public health problem. Since the Wenchuan earthquake in 2008, the public health emergency for natural disaster of the CDC institutions has made great progress, and the emergency response capacity is also rising. With more emphasis on emergency response of natural disaster for all the world, and the development of the public health emergency for natural disaster, thus propose the development direction and forecast about the emergency response capacity for natural disaster of the CDC institutions.

Advances in research on human respiratory syncytial virus

Qin Luo, Mei Dong, Fang Huang, Maozhong Li

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Human respiratory syncytial virus (HRSV) is a negative-sense and single-stranded RNA virus which belongs to the Pneumoviridae family, Orthopneumovirus genus. It is currently the leading cause of hospitalization in infants and children < 5 years of age. The infections of HRSV in adults, elderly and immunodeficiency patients are also increasingly recognized as a cause of severe respiratory disease. Unfortunately, no effective vaccine or treatment against HRSV is currently available. It has two subtype and multiple genotypes, which can result in different epidemiological feature. The aim of this review is to give a summary of HRSV etiology, epidemiology, vaccine and typing detection technique in order to better carry out HRSV epidemiological research. Also, this review can provides for the research of HRSV vaccine with important theoretical basis and provides reference for disease prevention and Surveillance.

Surveillance for illness-induced school absence in students of elementary and secondary schools in Hangzhou, 2013–2017

Li Hao, Bing Zhu, Wenying Shi, Hui Liu

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Objective To understand the epidemiological characteristics of illness induced school absence in students of elementary and secondary schools in Hangzhou during 2013–2017 and provide evidence for the development of effective intervention measures to reduce the rate of school absence due to illness in students. Methods The surveillance data of school absence due to illness in the students of elementary and secondary schools in Hangzhou during 2013–2017 were collected for statistical and descriptive analysis by using χ²test and Linear regression quadratic function to understand the epidemiological characteristics of the school absence and analyze the differences in gender distribution, stage of learning and district distribution. Results The overall rate of school absence due to illness was 23.21 per 10 000 during 2013–2017 and showed an increased tread (linear by linear association (P=0.010, F=100.035); The first disease causing school absence was influenza (54.45%); followed by other infectious diseases (9.90%); The absence rate was higher in primary school pupils (30.56 per 10000) than in middle school students (19.59 per 10000) ( χ²=5 299.071, P<0.001); The annual rate of school absence due to illness was highest in Xihu district (53.98 per 10000) and lowest in Xiaoshan district (7.49 per 10000). Conclusion Respiratory infectious diseases are the focus of disease prevention and control in schools. More attention should be paid to elementary schools. It is necessary to take targeted measures to reduce the school absence due to illness in students.

Comparison of Salmonella serotyping methods of slide agglutination and multiple fluorescence PCR serotyping kit

Xiaogen Dong, Tao Yan, Jing Shi, Meng Qin, Huiru Feng, Hong Yu, Zhaoe Wang, Zhimin Zhang, Zhenjiang Xin

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ObjectiveTo explore the applicability of the Salmonella serotyping kit in the surveillance of multiple intestinal pathogens, expand the laboratory's method for the serotyping of Salmonella, improve the laboratory capacity for the rapid and better response to diarrhea epidemic caused by Salmonella.MethodsUsing multiple fluorescence PCR serotyping kit and traditional slide agglutination test, the serotyping of 95 Salmonella strains was conducted, which were isolated from multiple intestinal pathogens surveillance in Fengtai district of Beijing from 2013 to 2018, and the results were compared.ResultsThe slide agglutination test result indicated that 95 strains of Salmonella belonged to 21 serotypes. The serotyping kit test indicated that 85 strains of Salmonella belonged to 17 serotypes, the remaining 10 strains were unspecified, including S. Goldcoast, S. London, S. Senftenberg, S. Thompson, S. Panama and S. Othmarsche. Among the 85 Salmonella strains, 83 shared same serotype in serotyping kit test and slide agglutination test, showing the consistent rate of 97.65%.ConclusionTraditional laboratory slide agglutination method has a good performance in the serotyping of Salmonella. The serotyping kit test has very high consistency with slide agglutination test, but the identification of uncommon serotypes of Salmonella needs to be improved. The combination of the two methods would improve the efficiency and accuracy of Salmonella serotyping.

Screening and treatment inclusion of multidrug resistant tuberculosis patients in Shaanxi,2015-2019

Yan Zhao, Tianhua Zhang, Xiaolu Sun, Xiao Zheng

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ObjectiveTo understand the detection and treatment inclusion of multidrug resistant tuberculosis (MDR TB) patients in Shaanxi province, and explore the MDR TB prevention and treatment strategies.MethodsDrug resistance information registered in Shaanxi from 2015 to 2019 were collected from the tuberculosis management information system of Chinese Center for Disease Control and Prevention. Descriptive epidemiological methods were used for the analysis. Enumeration data were expressed by case number, rate or constituent ratio. The intergroup rate was compared by χ²test, and P<0.05 was considered to be statistically significant.ResultsIn Shaanxi, the screening rate of MDR TB patients was 52.99%, the screening rate of multidrug resistance in new etiologic positive patients was 51.57%, and the screening rate of multidrug resistance in population at high risk was 62.25%. All the three rates began to show increasing trends year by year in 2017 (trend χ²=4 462.291, P<0.001, trend χ²=4 288.520, P<0.001, trend χ²=297.085, P<0.001). The detection rate of MDR TB patients was 8.39%. The multidrug resistance detection rate was highest in patients with TB recurrence (22.96%). The treatment inclusion rate of MDR TB patients was 72.73%. The total treatment inclusion rate of MDR TB patients and the treatment inclusion rate of new etiologic positive patients showed downward trends year by year（trend χ²＝8.788, P＝0.003; trend χ²＝12.806, P＜0.001）.ConclusionThe screening rate, detection rate and treatment inclusion rate of MDR TB patients were not high in Shaanxi. It is necessary to further improve the prevention, control and treatment of MDR TB.

Effects of antiviral therapy in 112 child AIDS cases in Nanyang, Henan

Jingyue Li

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Objective To understand the effects of antiviral therapy in children with AIDS in Nanyang, Henan province, and provide evidence for the standard treatment and management of AIDS in children. Methods A retrospective cohort study method was used to conduct a descriptive analysis on the main epidemiological characteristics, treatments, laboratory tests, and deaths of child AIDS cases included in the AIDS comprehensive prevention and treatment information system in Nanyang from 2011 to 2019 and evaluate the effects of antiviral therapy. Results In 112 child AIDS cases, 26 were fatal. The median of time from the beginning of the treatment to the observation end was 4.83 (1.67 to 6.86) years. The average age of cases at the beginning of treatment was (7.12±3.54) years. The CD4^＋T lymphocyte count of 1 year, 3 years and 5 years after treatment were significantly higher than the treatment baseline, the difference was significant (P<0.01), but the CD4 count showed a downward trend after more than 5 years of treatment, and there was no significant difference compared with the baseline (P>0.05). The viral load suppression ratios were 90.53%, 90.80%, 84.15%, 75.95%, and 67.50% in the 1^st, 3^rd, 5^th, 7^th, and 9^th years after treatment, respectively, showing a downward trend, and the difference in viral load suppression ratio was significant between the 7^th or 9^th years and the 1^st year (P<0.05). The causes of the deaths were as follows: AIDS-related disease (21 cases, 80.77%), and accidental death (5 cases, 19.23%). The average interval between diagnosis and death was (2.68 ± 2.46) years, and the death rate within 1 year of treatment was 46.75/100 person year. Conclusion Late diagnosis of AIDS in children was a prominent problem in Nanyang, and the mortality in the early stage of treatment was high. After more than 5 years of antiviral therapy, the virological and immunological effects had downward trends. Measures should be taken for the early detection and early treatment of HIV/AIDS in children.

Epidemiological characteristics of coronavirus disease 2019 outbreak in Garze Tibetan Autonomous Prefecture, Sichuan

Haijun Gao, Ting Zhang, Guangrong Xu, Ping Ye, Zhongxue Qin, Yongjun Duan

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Objective To understand the epidemiological characteristics of coronavirus disease 2019 (COVID-19) outbreak in Garze Tibetan Autonomous Prefecture of Sichuan province in 2020 and provide scientific evidence for the control of local epidemic and the prevention of imported epidemic. Methods Epidemiological survey and respiratory tract sample collection were conducted according to “Protocol of prevention and control of novel coronavirus 2019” and “Management protocol of suspected exposure (to) and close contact with COVID-19 cases (2rd edition)”. Real time RT-PCR was used for the nucleic acid detection of 2019-nCoV, and descriptive epidemiological analysis on cases’ characteristics, epidemic trend and influencing factors were conducted. Results A total of 682 close contacts of 54 COVID-19 cases were investigated, in which 39 confirmed cases and 3 asymptomatic cases were detected. As of February 28, 2020, a total of 96 COVID-19 cases, including 78 confirmed cases and 18 asymptomatic cases, had been reported in Garze Tibetan Autonomous Prefecture. The epidemic was caused by 5 imported cases who had sojourn history in Wuhan. Further spread of COVID-19 resulted from the gathering of 73 local confirmed cases and 18 asymptomatic cases. Conclusion A total of 96 COVID-19 cases were reported in the outbreak in Garze Tibetan Autonomous Prefecture. Household contact and religious ceremony（dharma assembly in temple and traditional funeral rites）were considered as the high-risk infection ways. Most asymptomatic cases were young or middle-aged adults. Strict isolation of close contacts, timely nucleic acid detection of 2019-nCoV for asymptomatic persons in close contacts and high-quality timely treatment for old-aged confirmed cases could effectively reduce the morbidity and mortality of COVID-19.

Progress in application of nucleic acid detection methods for Clostridium difficile

Xiaoxi Jia, Wenge Li, Yuanyuan Wang, Wenzhu Zhang, Yuan Wu, Jinxing Lu, Chaofeng Ma

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Clostridium difficile is an Anaerobic Gram-positive Bacillus that is found in the intestines of humans and animals. In recent years, because of abuse of antibiotics, the number of C. difficile infection has increased dramatically. As the increases of its morbidity and mortality, accurate diagnosis is important for the selection of the best treatment and preventive measures, so nucleic acid detection methods which are highly sensitive and specific, time-saving and labor-saving have been attracted more and more attention. This paper introduces and compares the applications of Food and Drug Administration (FDA)-approved and other classic laboratory-developed nucleic acid detection methods in the detection of C. difficile. provide a reference for the detection of C. difficile.

2020年8月中国甲乙丙类传染病疫情动态概要

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.09.002

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2020年8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 August 2020

Accepted Manuscript , DOI: 10.3784/j.issn.1003-9961.2020.09.001

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Epidemiology and control measures of nosocomial infection outbreaks in ICU in China

Ziqin Xu, Xueliang Zhang

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ObjectiveTo understand the epidemiological characteristics of outbreaks of nosocomial infection in intensive care units (ICUs) in hospitals in China and provide evidence for the prevention and control of nosocomial infection.MethodsThrough literature retrieval, the outbreaks of nosocomial infection in ICUs in hospitals in China reported from January 2010 to December 2018 were analyzed retrospectively. Excel was used for the statistical analyses on hospital grade, outbreak time and place, involved person, infection site, risk factor, pathogen, transmission route and susceptible population.ResultsA total of 45 outbreaks of nosocomial infection in ICUs were recorded, involving359 patients, in which 32 (70.11%) occurred in grade III (A) hospitals, 15 (33.33%) occurred in summer, 37 (82.23%) occurred in general ICUs and 35 (77.78%) had lower respiratory tract infections. Acinetobacter baumannii was major pathogen (28/43, 65.11%), followed by methicillin-resistant Staphylococcus aureus infection (11.63%, 5/43). In the pathogens, 93.02%(40/43)were multi-drug resistant. Most nosocomial infections were caused by indirect transmission, in which 21 were associated with contaminated medical devices, 16 with contaminated hands of medical staff, 15 with contamination of patient areas and 13 with contaminated medical textiles. The positive rate of conventional culture of environment samples was 10.76% (209/1943).ConclusionThe contact transmissions with multiple resources were dominant among the outbreaks of nosocomial infections in ICUs in China. It is necessary to pay close attention to multi-drug resistant pathogens and strengthen prevention and control of nosocomial infection outbreaks, and do not overly depend on the results of samples from environments.

HIV infection status and influencing factors in men who have sex with men in Taizhou, Zhejiang, 2016–2019

Mingming Gu, Qiang Cheng, yuanyuan Xu, Weiwei Shen, Haijiang Lin, Xiaoxiao Chen

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ObjectiveTo understand the infection status of human immunodeficiency virus (HIV) and related factors in men who have sex with men (MSM) in Taizhou, Zhejiang province, from 2016 to 2019.MethodsThe HIV infection status, AIDS related knowledge awareness and related behaviors in MSM in Taizhou were analyzed using the sentinel surveillance data from 2016 to 2019. Influencing factors of HIV infection were analyzed by multivariate Logistic analysis.ResultsA total of 1 740 MSM were investigated in Taizhou from 2016 to 2019, the overall awareness rate of AIDS related knowledge was 88.2%, showing an increase trend in the past four years (Z=2.205, P=0.028). The MSM who had homosexual anal sex in the past 6 months accounted for 79.0%, and among these MSM, 57.1% used condoms at each anal sex, the condom use rate increased over the 4 years (Z=2.742, P=0.006). The overall HIV antibody positive rate was 11.1%, and there was no significant difference in HIV antibody positive rate between 2016 and 2019 (Z=−1.481, P=0.138). Logistic regression analysis showed that homosexual anal sex, being from other provinces and syphilis status in the past 6 months were the risk factors for HIV infection, but education level of college or above, condom use at each homosexual anal sex in the past 6 months, heterosexual sex in the past 6 months and HIV intervention service were the protective factors for HIV infection (P<0.05).ConclusionThe HIV infection rate and the prevalence of related risk behaviors in MSM in Taizhou was still high from 2016 to 2019, and risk for syphilis existed. The intervention and management for HIV infection in MSM should be further strengthened.

Analysis on whole genome sequence of a norovirus GII.17 variant isolated in Huzhou

Liping Chen, Lei Ji, Xiaofang Wu, Deshun Xu

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ObjectiveTo analyze the gene sequence, phylogeny and evolution of a norovirus GII. 17 variant isolated in Huzhou, Zhejiang province and provide evidence for the study of genetic evolution of norovirus.MethodsAccording to the conserved sequence of GII.17 norovirus, three pairs of primers were designed to amplify three overlapping fragments covering the whole genome for the sequencing, phylogeny and evolution analyses of a norovirus GII. 17 strain isolated from an acute gastroenteritis cases.ResultsThe full length of genome of the norovirus GII.17 variant isolated from an acute gastroenteritis in March, 2015 in Huzhou (NS15217) was 7556 bp, encoding 3 ORFs, the length of ORF1 was 5 109 bp (5～5113 nt), the length of ORF2 was 1 623 bp (5094-6716 nt), and the length of ORF3 was 780 bp (6716-7495 nt), respectively. The strain was classified as GII.17 in both ORF1 and ORF2, and was most closely related to the LC037415.1/Hu/GII.17/Kawasaki308 strain and MG 692610 strain isolated in Huzhou. Compared with other strains selected, there were 106 variable residues across the VP1 domain. Among the 106 variable amino acids, 13 (12.3%) were observed in the shell domain and 30 (28.3%) in the P1domain; most of the substitutions and insertions were located in the P2 domain, accounting for 59.4% (63).ConclusionThe clade of the norovirus GII.17 variant isolated in Huzhou in 2015 belonged to cluster 3b. The understanding of its whole genome sequence could be helpful for the study of the genetic evolution of the virus and the development of rapid diagnostic reagents and vaccine.

First report of Salmonella Pomona infection in a young child associated with pet turtle exposure in Shanghai

Wenqing Wang, Hua Fang, Qiqi Cui, Chuchu Ye, Yanhua Gui, Jinghua Su, Lipeng Hao

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ObjectiveTo confirm the source of infection of a young child with diarrhea and fever by analyzing the pathogen isolated from samples of the child and pet turtle in his home.MethodsClinical information collection and epidemiological investigation were conducted based on informed consent. Samples from the patient and pet turtle (cloacal swab and body-surface swab), turtle tank water and other samples were collected for pathogen isolation and detection. Serotype identification, antimicrobial susceptibility and molecular typing were conducted for Salmonella isolates.ResultsSalmonella Pomona was isolated from the patient’s stool sample, pet turtle’s cloacal swab and body-surface swab and turtle tank water. All the isolates shared the same antibiotic resistant pattern (tetracyclines) and molecular subtyping pattern. Epidemiological and microbiological investigations suggested that pet turtle was the source of infection.ConclusionIt is the first report of S. Pomona infection in a young child associated with pet turtle exposure in Shanghai. Certain Salmonella serotype has dominant colonization in pet turtles. Young children are at high risk to behavioral and ecological infectious diseases. It is necessary to strengthen the prevention of the contamination of pathogen in pet turtle raising, improve case traceability and conduct public health education.

Continuation of Mosquito Surveillance and Control During Public Health Emergencies and Natural Disasters

Zhenyu Gong, Xunliang Gong

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Interpreting influenza surveillance data in the context of the COVID-19 pandemic

Zhenyu Gong, Xunliang Gong

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SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp — Georgia, June 2020

Zhenyu Gong, Xunliang Gong

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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

Zhenyu Gong, Xunliang Gong

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Molecular characteristics of norovirus in acute gastrointestinal illness, Tianjin, 2019

Yue Lei, Zhichao Zhuang, Hong Tian, Xiaoyan Li

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Objective To analyze the genetic characteristics of norovirus in Tianjin in 2019. Methods Stool samples from acute gastroenteritis patients in outbreaks and clusters of the disease or sporadic cases collected by all 16 district CDCs in Tianjin were detected with RT-PCR. The polymerase and capsid genes of the isolated strains were amplified. Phylogenetic tree was constructed for sequences analysis. Results A total of 1615 samples were detected by district-level CDCs, in which 97 were positive for norovirus (6.01%). The positive samples were detected all the year around except January. The positive rate was 1.11% for norovirus GⅠ and 5.02% for norovirus GⅡ respectively. The result of genotyping of both polymerase and capsid was as follow: GⅡ.2［P16］, GⅡ.4［P31］, GⅡP17［P17］, GⅠ.3［P13］, GⅡ.6［P7］, GⅠ.5［P4］, GⅡ.3［P12］, GⅠ.5［P12］, GⅠ.1［P1］ and GⅠ.2［P2］. The top three genetic recombination strains of norovirus detected in 13 cases of acute gastroenteritis in outbreaks and clusters of the disease were GⅡ.2［P16］ (30.77%, 4/13), GⅡ.4［P31］ (23.08%, 3/13) and GⅡ.17［P17］ (23.08%, 3/13). Conclusion The genotypes of norovirus was diverse in Tianjin. The coevolution and circulation of different genotypes continue, so it is necessary to further strengthen the surveillance and molecular typing of norovirus.

Diagnosis and report quality of hepatitis C in three medical institutions in Qingyang City

Junlong Meng, Dan Liu, Jincheng Li, Xiaohua sun, Yongfeng Jing, Liangliang Cui

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Objective To understand the difficulties and problems in the quality and management of hepatitis C monitoring reports in Qingyang City. Methods Three medical institutions were selected to check the data quality, and a questionnaire survey was conducted among the relevant staff. Results The positive rate of HCV RNA detection in institutions with detection ability was significantly higher than that in other two institutions (89.51%); The rate of missed report was 36.91%, the rate of missed report in outpatient cases (89.96%) was higher than that in inpatient cases (48.54%); The correct rate of diagnosis and classification was 69.44%, the correct rate of staging was 66.67%; The rate of knowledge about hepatitis C was 53.81%. Conclusion To improve the ability of nucleic acid detection in the laboratory of medical institutions, to increase the functions of information construction and early warning, to strengthen the training of new standards and knowledge of hepatitis C, to reduce the rate of missed reports of hepatitis C cases, to improve the rate of correct diagnosis and the rate of knowledge of hepatitis C.

Establishment and application of SEIAR model

Tian Liu, Zeyu Zhao, Menglei Yao, Jigui Huang, Fangsheng Mei, Tianmu Chen

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ObjectiveTo establish a SEIAR model by using software Berkeley Madonna and analyze the modeling steps and code.MethodsData on the onset time of an influenza outbreak in a city were collected. The Berkeley Madonna software was used to establish a non-intervention model (SEIAR0), a model for case isolation (SEIAR_I), a model for class suspension (SEIAR_C), and a model for comprehensive intervention (SEIAR_M). The cumulative attack rate (TAR) and duration of epidemics (DO) were used to compare the impact of interventions on outbreaks. The parameter β of the model was obtained by curve fitting, and other parameters were based on the same kind of research and sensitivity analysis on the stability of the result.ResultsThe influenza epidemic occurred on November 12, 2017, and the control measures for case isolation and class suspension were taken on November 17 and November 21 respectively. The optimal value of β was 0.00105, the TAR of the SEIAR0 model was 85.90%, and the DO was 49 days. SEIAR_M, SEIAR_I, and SEIAR_C decreased by 95.25%, 89.94%, and 73.32%, respectively, compared with SEIAR0. DO was 29 days, 78 days, and 39 days, respectively. The sensitivity analysis showed that the TAR was between 71.42% and 86.02% when the parameters changed.ConclusionThe SEIAR model established with Berkeley Madonna software is simple and easy to use, which is suitable for the evaluation of intervention effects.

Detection assay of Cryptococcus neoformans bloodstream infection based on recombined MBL- magnetic beads enrichment

Xiaoli Chen, Wenge Li, Hao Zheng, Xiaoping Chen, Jinxing Lu

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ObjectivesTo establish an assay based on recombined MBL protein-magnetic beads enrichment technique for the detection of Cryptococcus neoformans directly from whole blood, and provide guidance for clinical diagnosis of C. neoformans infection.MethodsWestern blot was used to detect the direct binding of recombined MBL protein (M1) to C. neoformans. M1-protein A beads were used to enrich C. neoformans with different concentration gradients in phosphate buffer saline (PBS)-simulated and rabbit blood-simulated samples, and the enrichment efficiencies were obtained. Three different assays of detecting C. neoformans in rabbit blood-simulated samples were compared., i.e. assay 1, M1-protein A enrichment followed by qPCR identification, assay 2, M1-protein A enrichment followed by culture and MS identification, assay 3, blood culture followed by MS identification (standard gold method).ResultsM1 protein could bind with standard and clinical strains of C. neoformans. The enrichment efficiency of M1-protein A magnetic beads in PBS-simulated samples with pathogens of 20 CFU/mL, 10 CFU/mL, 5 CFU/mL, and 1 CFU/mL was 71.65%, 72.40%, 62.70%, and 83.00% respectively, and in rabbit blood-simulated samples was 35.76%, 18.00%, 21.04%, and 23.30% respectively. Among the three assays of detecting C. neoformans., assay 1 needed the shortest time (4.25 h), and sensitivity was 10 CFU/mL. The sensitivity of assay 2 could reach ≤ 1 CFU/mL and needed a total time of 57 h. Although the sensitivity of assay 3 could also reach ≤ 1 CFU/mL, it lasted for 120 h.ConclusionCompared with standard blood culture, the detection assays with qPCR or MALDI-TOF MS based on M1-protein A beads enrichment need much less time, but still have high sensitivity and specificity.

Estimating the incidence of influenza in 2018-2019 season based on regional health big data platform

Yi Chen, Wei Ji, Xuying Lao, Qiaofang Li, Haibo Wang, Dongliang Zhang, Keqing Ding, Bo Yi

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ObjectiveTo estimate the actual case number and incidence rate of influenza in 2018-2019 season in Beilun district of Ningbo and evaluate the actual local incidence level of influenza.MethodsRetrospective analysis was adopted. Based on Ningbo regional health medical big data platform and influenza surveillance network platform and through the big data mining technology, all the records of acute upper respiratory tract infections in the district were obtained, and combined with the influenza nucleic acid positive rate, the case number and incidence rate of influenza in 2018—2019 season in Beilun were estimated.ResultsFrom October 2018 to September 2019, the estimated case number of influenza ranged from 27,683 to 115,123 approximately, and the estimated incidence rate of influenza ranged from 4.14% to 17.23% approximately in Beilun, significantly higher than the reported data. The incidence rate was highest in age group 0—4 years, ranging from 29.28% to 76.81%, and the incidence rate in age group 5—14 years ranged from 17.31% to 46.61%. The estimated case number of influenza was highly consistent with the incidence trend of reported cases with statistical significance (r_s1 =0.914, r_s2 =0.923, P<0.001).ConclusionThe local incidence rate of influenza was significantly higher than the reported one. Age groups <15 years and >60 years are key populations in the prevention and control of influenza. It is necessary to expand and increase the coverage of influenza vaccination in these two age groups.

A study on use of online sold fingertip blood HIV rapid test kits for self-testing

Duo Shan, Ran Xiong, Yanjun Shi, Jie Li, Ling Pan, Dong Xiao, Yiyun Hu

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ObjectiveTo understand the use of online sold fingertip blood HIV rapid test kits for self-testing and find its problems, provide evidence for the improvement of HIV self-testing.MethodsThrough WeChat group, QQ group, and Weibo in men who have sex with men (MSM), people who purchased and used online sold HIV fingertip blood test kits were recruited in the survey using a self-designed questionnaire. A qualitative interview was conducted in responsible persons of sales department in main domestic manufacturers of HIV rapid test kits.ResultsA total of 2752 people completed the questionnaires, the median of age was 27 years old (14–86 years old), Among these people, 1842 (66.9%) had education level of college or above, 1872 (68.0%) had full-time job, 1033 (37.5%) reported that the sellers provided post-test consulting services, while 66.0% reported that the consulting services failed to solve the problems. In the latest self-testing, 241 (8.8%) persons were HIV positive, and 1778 (64.6%) persons were negative. Among 733 with uncertain results, 74.2% (544/733) had problems in kits operation, 9.9% (73/733) had related errors due to the misunderstanding of instruction manual, and 12.6% (92/733) had problem with the results interpretation.ConclusionA number of HIV-infected people are not aware of their infection status, for whom HIV test can be promoted through internet. It is suggested to improve the consulting services, strengthen the management of HIV rapid test kits production and standardize the operation procedure of kits users to ensure the scientificity of HIV self-testing.

Characteristics of Persons Who Died with COVID-19 — United States, February 12–May 18, 2020

Zhenyu Gong, Xunliang Gong

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An outbreak of foodborne disease caused by Salmonella Isangi in Yuyao, Zhejiang, 2018

Jianqun Zhang, Jinjin Hu, Chengxi Sun, Chao Miao, Xinpeng Li

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Objective To investigate an outbreak of foodborne disease caused by Salmonella Isangi in Yuyao, Zhejiang province, in 2018, and analyze the biological and epidemiological characteristics, molecular typing and drug sensitivity characteristics of isolated pathogens. Methods Pathogenic bacteria were detected according to national standard in suspicious food samples. Salmonella was identified by systematic biochemical and serum typing methods. Drug sensitivity test was carried out with disk diffusion method. Pulse-field gel electrophoresis (PFGE) and whole genome sequencing (WGS) were used for molecular typing analysis. The patients' medical record analysis and follow-up were conducted in the epidemiological investigation. Results Three strains of Salmonella Isangi were isolated from 1 food sample (roast duck) and 2 patient stool samples. The isolates were resistant only to cotrimoxazole. PFGE band pattern was completely consistent. Multilocus sequence typing (MLST) showed that the strains belonged to ST216. wgMLST analysis showed that there was an allelic difference between two isolates from the patients. Furthermore, all of them carried 126 known virulence genes and a aminoglycoside antibiotic resistance gene aac(6)-Iaa. Conclusion It is confirmed that the outbreak of foodborne disease was caused by the consumption of roast duck contaminated by Salmonella Isangi ST216, which was first reported in Yuyao.

Investigation of concentrations of 6 elements in whole blood of children in Cixi, Zhejiang province, 2018–2019

Yidong Yu, Wei Feng, Songdao Ye

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Objective To understand the nutrition status of whole blood Six elements [lead (Pb), calcium (Ca), magnesium (Mg), iron (Fe), copper (Cu) and zinc (Zn)] in children in Cixi, Zhejiang province, and provide theoretical basis to guide trace and constant elements supplement in children. Methods A total of 7 508 children from January 2018 to October 2019 who visited preventive medicine clinic of Cixi Maternity and Child Health Care Center were surveyed, they were divided into four groups according to age, blood concentrations of Pb, Ca, Mg, Fe, Cu and Zn respectively, and the medical records of children diagnosed with trace element deficiency or excess were analyzed. Results The mean blood concentrations of Pb, Ca, Mg, Fe, Cu and Zn in children in all age groups were within the reference range, the differences in mean blood concentrations s of Ca, Mg, Fe, Cu and Zn showed significances among all age groups (P＜0.05), but the differences in Pb concentration showed no significance (P＞0.05). A total of 872 cases of Ca deficiency (11.61%), 448 cases of Zn deficiency (5.97%), 351 cases of Fe deficiency (4.68%), 94 cases of Pb excess (1.25%), 7 cases of Mg deficiency (0.09%) and 1 case of Cu deficiency (0.01%) were detected. The differences in Ca, Zn and Fe deficiency rates and Pb exceeding rate showed significances among all age groups (P＜0.05), but the differences in Mg and Cu deficiency rates had no significances (P＞0.05); The differences in Fe, Ca and Zn concentrations between children suffering from short stature, anorexia and acute upper respiratory infection and healthy children were significant (P＜0.05), but the differences in Pb concentration had no significance (P＞0.05). Conclusion The Zn, Ca and Fe deficiency rates and Pb exceeding rate were high in children in Cixi. The Fe, Ca and Zn concentrations were low in children suffering from short stature, anorexia and acute upper respiratory infection, so it is recommended to have appropriate supplement.

Probability and trend of premature death from major chronic diseases in Ya'an, Sichuan, 2015–2019

Yuqin Wei, Xiaoyu Wang, Li Ling

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ObjectiveTo analyze the mortality, premature death probability and its changing trend of four major chronic diseases (cardiovascular disease, malignant tumor, chronic respiratory disease and diabetes) in Ya'an, Sichuan province, from 2015 to 2019, and provide basic data for the decision-making and the development of comprehensive chronic disease prevention and control strategies.MethodsThe death data, population data and standardized population data in Ya'an from 2015 to 2019 were collected from national population death information register system, public security bureau information system and the population census in Sichuan (2010), respectively. Statistical software SPSS 19.0 was used to calculate the crude mortality rate, standardized mortality rate, death constituent ratio and premature death probability of the major chronic diseases in Ya'an from 2015 to 2019 and analyze their change trends.ResultsFrom 2015 to 2019, the crude mortality rate of the four major chronic diseases increased from 496.35/100 000 to 535.30/100 000. The percentage of (annual percent change, APC) was 1.91%, the difference was significant (P＝0.001). The standardized mortality rate of the four major chronic diseases increased from 372.48/100 000 to 393.87/100 000, the APC was 1.41%, the difference was not significant (P＝0.983). From 2015 to 2019, the premature death of the four major chronic diseases accounted for 22.38% of the total deaths, the probability of premature death decreased from 14.92% to 14.58%, APC was –0.57%, the difference was not significant (P＝0.066).ConclusionSince 2015, the crude death rate of the major chronic diseases has increased year by year in Ya'an, and the probability of premature death of the major chronic diseases has decreased slowly, but the situation of prevention and control is still challenging. Cardiovascular disease and malignant tumor are main causes of premature death in local residents. It is a priority to conduct the comprehensive intervention on the prevention and control of cardiovascular disease and malignant tumor.

Influence of community health management of hypertension on long-term trend of premature death caused by cardiovascular disease

Yongqin Hu, Rongrong Han, Aiqi Tang, Tiane Liu

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ObjectivesTo analyze the influence of community-based hypertension health management on long-term premature death caused by cardiovascular disease (CVD), and provide etiological clues for in-depth clinical empirical studies and epidemiological investigations.MethodsEcological trend study method was used to analyze the influence of community hypertension health management on premature CVD death in Yuhang district of Hangzhou, Zhejiang province from 2010 to 2019. The annual percentage change (APC) was used to evaluate the time trend of each statistical index, Spearman′s rank correlation coefficient was used to analyze the correlation.ResultsThe crude CVD mortality rate in the population of Yuhang was 164.67/100 000–236.52/100 000 during 2010–2019, showing a decrease of 71.85 per 100 000 (APC=−3.229, P=0.001); the premature mortality rate in age group 30–60 years was 33.06/100 000–79.69/100 000, showing a decrease of 40.01 per 100 000 (APC=−8.144, P<0.001). Premature CVD death accounted for approximately 15.57% of total deaths and contributed 14.31% of the decline to total deaths. The adult community hypertension management rate in Yuhang increased from 21.02% in 2010 to 67.02% in 2019 (APC=11.233, P<0.001). This upward trend was negatively associated with a downward trend of premature CVD death (r=−0.976, P<0.001).ConclusionThe adult community hypertension management rate increased with year in Yuhang, which has a good protective effect against the occurrence of premature death from CVD and shows good social and economic benefits by reducing the burdens of family and society.

Tuberculosis registration in schools in Inner Mongolia Autonomous Region, 2008-2018

Shengli Lang, Lijuan Xu, Cuixiu Wang

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ObjectiveTo understand the trend and characteristics of school tuberculosis (TB) epidemic in Inner Mongolia, and provide evidence for the formulation of school TB prevention and control policies.MethodsThe registered information of TB epidemic in students in Inner Mongolia from 2008 to 2018 were collected from National Infectious Disease Report Information Management System and analyzed by statistical software SPSS 20.0.ResultsIn 2018, a total of 517 students with TB were registered in Inner Mongolia, with registered incidence rate of 17.02/100 000, a decrease of 57.10% compared with 2008 (1 409 registered tuberculosis patients, with a registered incidence of 39.71/100 000). In the second quarter, the registering rate of TB patients was highest, with an average of 31.86%. The student cases accounted for 4.78% of the total TB patients. The case number of students in senior high school was highest (40.65%), and among these cases, the students in Han ethnic group accounted for 66.22%.ConclusionThe prevalence of TB in students in Inner Mongolia declined with year from 2008 to 2018. The number of reported patients in the second quarter was highest, the cases were mainly distributed in senior high school students with more cases in boys and in students in Han ethnic group. The registering rate of TB decreased in all ethnic groups, but the registering rate in Mongolia was higher. The prevention and control of school TB outbreak needs to be strengthened.

Impact of COVID-19 epidemic on AIDS prevention and control in Ningbo, Zhejiang

Haibo Jiang, Hongbo Shi, Hongwei Feng, Xiaomin Gu, Huailiang Li, Hang Hong

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ObjectiveTo describe the impact of coronavirus disease 2019 (COVID-19) epidemic for AIDS prevention and control work in Ningbo, Zhejiang province, and provide reference for the government and AIDS prevention and control departments to formulate response measures.MethodsThe data of COVID-19 epidemic from January to March 2020 and the information of AIDS case reporting, HIV antibody testing, high-risk interventions, antiretroviral therapy (ART), health education cloud platform and other relevant special surveys in past 10 years in Ningbo were collected from related platforms. Simple correlation, linear regression and spatial clustering analysis were used to analysis changes in AIDS prevention and control.ResultsFrom January to March 2020, the newly reported number of HIV/AIDS cases decreased by 36.36% compared with the same period in 2019. Voluntary counseling and testing, HIV testing in the entire population, and the number of people covered by high-risk interventions all declined significantly compared with the same period in 2019. The problems in obtaining medicines of 244 HIV/AIDS patients who were forced to stay in other provinces during January-March 2020 were solved. ART coverage increased by 6.03% compared with the same period in 2019.ConclusionThe COVID-19 epidemic had a severe impact on local AIDS prevention and control, such as HIV testing and high-risk intervention. AIDS case number declined significantly from January to March 2020. Although the problems of receiving medicines for HIV/AIDS patients who stayed in other provinces due to the epidemic had been solved, HIV counseling or testing and AIDS high-risk behavior interventions in key populations should be strengthened.

Epidemic characteristics of coronavirus disease 2019 in northwest and northeast border areas of China

Ye Zhao, Jinyuan Sun, Ling Yang, Yuyang Cai

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[Abstract](835) [FullText HTML](284) [PDF 5474KB](4) [Peer reviewing opinions] Related References Cited By (0) Share

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ObjectiveTo analyze the epidemic characteristics of coronavirus disease 2019 (COVID-19) in the northwest and northeast border areas of China (as of April 20, 2020) and provide scientific basis for prevention and control of COVID-19 epidemic situation.MethodsThe population density data of two areas were collected. The epidemic data of COVID-19, which were released by the National Health Commission and local governments, from January 23, 2020 to April 20, 2020 in cities of Xinjiang in northwestern China and in cities of Heilongjiang in northeastern China were used to analyze the infection rate in these areas. The trend analysis was carried out by using Joinpoint software according to the day percentage change (DPC).ResultsAs of April 20, 2020, a total of 989 confirmed cases had been reported in Xinjiang and Heilongjiang, i.e. 76 cases in Xinjiang and 913 cases in Heilongjiang, including 383 imported cases. The overall incidence of COVID-19 in Xinjiang showed normal trend, rising slowly at first (DPC=7.0%, P<0.05) and then declining rapidly (DPC=−12.0%, −64.2%, all P<0.05). The epidemic in Heilongjiang was relatively complex with two peaks. In the first peak, the incidence increased rapidly (DPC=20.1%, P<0.05), and then decreased slowly (DPC=−11.4%, −56.6%, all P<0.05). In the second peak, the incidence increased more rapidly (DPC=129.4%, P<0.05), then decreased slowly again (DPC=−10.1%, P<0.05).ConclusionThe epidemics of COVID-19 in the two areas were caused by imported cases. More imported cases may pose serious challenge to the prevention and control of COVID-19. However, if the prevention and control measures can be effectively implemented, the epidemic can be controlled in a short period of time, otherwise it is prone to spread.

Performance of methadone maintenance treatment in Zhejiang, 2008–2018

Weiyong Chen, Qiaoqin Ma, Xin Zhou, Tingting Jiang, Wanjun Chen, Lin Chen, Hui Wang, Jinlei Zheng

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Objective To analyze the performance of methadone maintenance treatment (MMT) in Zhejiang province from 2008 to 2018, found existing problems and provide evidence for the improvement of MMT in drug use control and HIV infection prevention. Methods MMT data in Zhejiang from 2008 to 2018 were collected from national MMT information management system and MMT clinic reports for a descriptive analysis with SPSS 21.0. Results A total of 105 MMT clinics were built from 2008 to 2018 which have provided treatment services for over 18000 persons. The highest number of treatment was 8060 in 2010. The lowest number of treatment was 3635 in 2018. The treatment dosage of MMT was between 39.91 mg/d and 43.83 mg/d. The positive conversion rate was between 0.07% and 0.08%. The annual treatment retention rate was between 60.17% and 84.37%, showing a gradual increasing trend. The number of persons who quitted the treatment began to exceed the number of new participants in 2011. The testing rates of HIV, HCV and syphilis were 0.19%–0.98%, 38.36%–62.24% and 4.36%–6.96% respectively, showing an increase trend with year. Conclusion MMT in Zhejiang had an obvious decrease in number of treatments, and the treatment dosage was low. It is necessary to improve the accessibility, quality of MMT service and clinic staff capability and reduce treatment dropping out for the better drug use control and HIV infection prevention.

Meta-analysis on prevalence of anemia in Zhejiang

Danting Su, Dong Zhao, Dan Han, Lichun Huang, Mengjie He, Yueqiang Fang, Ronghua Zhang

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ObjectiveTo understand the prevalence of anemia in Zhejiang province and provide evidences for the regular evaluation of anemia prevalence.MethodsA Meta-analysis was conducted by using the health surveillance or examination data in children and adolescents aged 6–17 years collected from maternal and child health care system and the health examination data and some electronic health records in adults aged 18–59 years and the elderly aged ≥60 years in 22 counties or districts in Zhejiang. Software Stata was used ti calculate the prevalence rate of anemia in different age groups. Sensitive analysis was also conducted.ResultsOverall, 8.00% of target population was covered in this study. The prevalence rate of anemia was 12.53% (95% CI: : 9.27%–15.79%) in Zhejiang. The prevalence were 7.62% (95% CI: 6.16%–9.07%), 11.41% (95% CI: 6.22%–16.60%), 11.19% (95% CI: 7.99%–14.40%), 19.49% (95% CI: 14.17%–24.81%) respectively in age groups >6 months, 6–17 years, 18–59 years and >60 years. The sensitive analysis indicated that after removal of data of 1–2 districts with smallest sample size prevalence the prevalence rates of anemia were 7.76% in age group ≥6 months (95% CI: 6.23%–9.29%), 11.35% in age group 6–17 years (95% CI: 5.29%–17.41%), 11.53% in age group 18–59 years (95% CI: 7.97%–15.08%) and 18.50% in age group ≥60 years (95% CI: 12.65%–24.35%), similar to the results before the removal.ConclusionMete-analysis can be used in the regular evaluation of anemia prevalence in population by using routine surveillance and report data in primary public health institutions. Anemia remains a mild public health problem in different populations in Zhejiang, but in the elderly population it has almost become a moderate public health problem. It is still necessary to expand the surveillance coverage of anemia in school aged children and adolescents.

Epidemiological characteristics of influenza viruses at subtypes/lineages level in Jiangsu, 2011–2019

Junjie Fu, Qigang Dai, Xiang Huo

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ObjectiveTo understand the differences in epidemiological characteristics of influenza viruses of different subtypes/lineages in Jiangsu province from 2011 to 2019 and provide evidences for the precise prevention and control of influenza.MethodsLaboratory-confirmed influenza cases reported in influenza surveillance system in Jiangsu from January 2011 to December 2019 were analyzed. The differences in distribution of categorical variable data were compared with χ² test, the risk factors were identified with Logistic regression analysis and odds ratios were calculated.ResultsThere were 26 934 confirmed influenza cases with subtype/lineage testing results in Jiangsu during this period. Influenza A (H3) virus accounted for the highest proportion (40.40%). The proportion of influenza subtypes/lineages differed significantly with year and area ( χ²=12448.182, P<0.001; χ²=180.333, P<0.001). The seasonal peaks were observed during December-January and August-September for A (H3) virus, during January-February for A (H1) virus and B-Y virus, during March-April for B-V virus. The proportion of influenza subtypes/lineages differed significantly among age groups and occupation groups ( χ²=13588.399, P<0.001; χ²=70.724, P<0.001). Multivariate logistic regression analysis showed that, after adjustment for areas and months, children aged <5 years were more likely to be infected with A (H1) virus. Older children aged 6–15 years had a significantly increased risk for the infection with B-V virus, while the elderly (more than 65 years) were prone to be infected with A (H3) virus and B-Y virus.ConclusionIn Jiangsu, influenza viruses of different subtypes/lineages circulated alternatively, they have different seasonality and infection risks. It is essential to analyze the epidemiological characteristics influenza viruses at subtypes/lineages level in time for the precise prevention and control of influenza.

刚果民主共和国埃博拉病毒病疫情的最新情况

Zhenyu Gong, Xunliang Gong

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Abstract:
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Diversity and drug resistance of Salmonella in river environment of Yuyao, Zhejiang, 2018–2019

Shaojun Huang, Xuehui Luo, Jiahui Zhu

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ObjectiveTo understand the distribution and pollution of Salmonella in rivers in Yuyao, Zhejaing province.MethodsThe water samples were collected from 12 surveillance sites in Yuyao from January 2018 to December 2019, and then enrichment, isolation, biochemical identification, serotyping, drug sensitivity test and detection of drug resistance genes were carried out.ResultsA total of 116 water samples containing Salmonella were detected in 192 river water samples, with a detection rate of 60.42%. The positive rate at Yaojiang bridge was highest (87.50%). A total of 177 Salmonella strains were detected in 116 positive water samples, which belonged to 25 serotypes, of which S.Typhimurium (16.38%), S. Derby (12.43%) and S.4,［5］,12:i:- (11.30%) ranked top three. The number of serotypes detected at Sanguantang of Yaojiang river was highest. In seasonal distribution of the detection, more serotypes were detected in spring. Thirty nine strains showed extensive sensitivity to 16 antibiotics tested, while other strains showed resistance to at least one antibiotic. The resistance rates to penicillin and tetracycline were higher, the resistance rates to ampicillin, piperacillin and tetracycline were 72.31%, 51.41% and 66.10%, respectively. Thirty four strains were multi-drug resistant to three or more antibiotics. The detection rates of β-lactam antibiotic resistance gene tem, oxa and ctx-M were 67.23%, 6.78% and 12.43% respectively. The detection rates of tetracycline resistance gene tetA, tetB and tetG were 55.37%, 15.25% and 7.9%, respectively.ConclusionThe detection rate of Salmonella in river environment of Yuyao was high, and the detected Salmonella strains had multi serotypes, serious drug resistance and complicated drug resistance mechanism. Therefore, it is suggested to pay close attention to the hazard of Salmonella from environmental sources in foodborne disease control.

Results of seroepidemiological survey of hepatitis B in healthy population in Zhejiang, 2018

Wen Shi, Yang Zhou, Chen Yuan, Rui Yan, Xuewen Tang, Hanqing He, Xuan Deng

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ObjectiveTo investigate the serum markers of hepatitis B virus in healthy population in Zhejiang province in 2018.MethodsA questionnaire survey was conducted among 0–59 years old people with local residence >6 months who were selected through multistage stratified cluster random sampling, in 11 prefectures (municipality) and Yiwu of Zhejiang, and 2 ml of venous blood was collected from each study subjects for the detections of hepatitis B virus related antigen and antibody.ResultsA total of 4 194 people were investigated, the positive rate of HBsAg was 4.58% (192/4 194), and the anti-HBs rate was 63.92% (2 681/4 194). The positive rate of HBsAg in populations aged 0–14, 15–29 and 30–59 years increased with age ( χ²= 85.228, P<0.001). The positive rate of anti-HBs decreased first and then increased ( χ²=110.413, P<0.001). The immunization rate of hepatitis B vaccine was 63.02% (2 643/4 194). The vaccination rates decreased with age ( χ²=2 229.121, P<0.001). The results of multivariate logistic analysis showed that gender and immunization history of hepatitis B vaccine were the main factors influencing the positive rate of HBsAg in adults. The positive rate of HBsAg was higher in men than in women (OR=1.404, 95%CI: 1.014–1.944). The positive rate of HBsAg was lower in patients with hepatitis B immunization history than in those without hepatitis B immunization history (OR=0.548, 95%CI: 0.371–0.810).ConclusionRemarkable achievements have been made in the prevention and control of hepatitis B in children in Zhejiang. It is beneficial for the prevention and control of hepatitis B in adults by increasing the immunization rate of hepatitis B vaccine and strengthening the detections of hepatitis B virus antigen and antibody in this population.

Study on HIV-1 subtypes and molecular cluster characteristics of middle-aged and elderly HIV/AIDS patients in Jiangshan, Zhejiang, 2014–2018

Xufu Chen, Jialing You, Jiafeng Zhang, Qin Fan, Jiaming Yao, Lei Lyu, Wei Wang, Ping Wang, Qi Wu

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Objective To understand the distribution of HIV subtypes and the characteristics of molecular transmission clusters of middle-aged and elderly HIV/AIDS patients in Jiangshan of Zhejiang province, and provide technical support for the analysis of HIV epidemic trends and the prevention and control of the epidemic. Methods Newly HIV-1 diagnosed middle aged and elderly HIV/AIDS patients in Jiangshan from 2014 to 2018 were enrolled in this molecular epidemiological study. Total viral RNA was extracted from plasma of 94 patients, including 3 female sex workers (FSWs). The pol genes were amplified with RT-PCR and nested PCR, and then the nucleic acid was sequenced. Software MEGA 6.0 was applied to construct Neighbor-Joining phylogenetic tree for subtype analysis. Software Cytoscape 3.6.0 was applied to construct HIV molecular clusters for sequences with a genetic distance ≤0.01. Results The success rate of sequence acquisition was 86.2% (81/94). The predominant subtype was CRF01_AE (93.8%, 76/81), followed by CRF07_BC in 3 cases (3.7%) and subtype B in 2 cases (2.5%). Three molecular transmission clusters consisting of subtype CRF01_AE were found. The total clustered rate was 84.0% (68/81). The large cluster contained 64 cases (including 1 positive FSW), and two small clusters were all composed of 2 cases. Conclusion The HIV subtype of middle- aged and elderly people in Jiangshan was mainly CRF01_AE. Transmission clusters that closely related to positive FSWs were found. Therefore, the case epidemiological investigation in the clusters should be strengthened in order to implement targeted public health intervention.