Intelligent fire information system based on 3D GIS

Background This work aims to build a comprehensive and effective fire emergency management system based on the Internet of Things(IoT)and achieve an actual intelligent fire rescue.A smart fire protection information system was designed based on the IoT.A detailed analysis was conducted on the problem of rescue vehicle scheduling and the evacuation of trapped persons in the process of fire rescue.Methods The intelligent fire visualization platform based on the three-dimensional(3D)Geographic Information Science(GIS)covers project overview,equipment status,equipment classification,equipment alarm information,alarm classification,alarm statistics,equipment account information,and other modules.The live video accessed through the visual interface can clearly identify the stage of the fire,which facilitates the arrangement of rescue equipment and personnel.The vehicle scheduling model in the system primarily used two objective functions to solve the Pareto Non-Dominated Solution Set Optimization:emergency rescue time and the number of vehicles.In addition,an evacuation path optimization method based on the Improved Ant Colony(IAC)algorithm was designed to realize the dynamic optimization of building fire evacuation paths.Results The experimental results indicate that all the values of detection signals were significantly larger in the smoldering fire scene at t=17s than the initial value.In addition,the probability of smoldering fire and the probability of open fire were relatively large according to the probability function of the corresponding fire situation,demonstrating that this model could detect fire.Conclusions The IAC algorithm reported here avoided the passages near the fire and spreading areas as much as possible and took the safety of the trapped persons as the premise when planning the evacuation route.Therefore,the IoT-based fire information system has important value for ensuring fire safety and carrying out emergency rescue and is worthy of popularization and application.

Sensor Scheduling Algorithm Target Tracking-Oriented

Target tracking is a challenging problem for wireless sensor networks because sensor nodes carry limited power recourses. Thus, scheduling of sensor nodes must focus on power conservation. It is possible to extend the lifetime of a network by dynamic clustering and duty cycling. Sensor Scheduling Algorithm Target Tracking-oriented is proposed in this paper. When the target occurs in the sensing filed, cluster and duty cycling algorithm is executed to scheduling sensor node to perform taking task. With the target moving, only one cluster is active, the other is in sleep state, which is efficient for conserving sensor nodes’ limited power. Using dynamic cluster and duty cycling technology can allocate efficiently sensor nodes’ limited energy and perform tasks coordinately.

Evolutionary Diversity of Coxsackievirus A6 Causing Severe Hand,Foot,and Mouth Disease—China,2012-2023

Introduction:Coxsackievirus A6(CVA6)has emerged as a significant pathogen responsible for severe cases of hand,foot,and mouth disease(HFMD).This study aims to delineate the demographic characteristics and analyze the viral evolution of severe HFMD associated with CVA6,thereby assisting in its surveillance and management.Methods:In this investigation,74 strains of CVA6 were isolated from samples collected from severe HFMD cases between 2012 and 2023.The VP1 gene sequences of CVA6 were amplified and analyzed to assess population historical dynamics and evolutionary characteristics using BEAST,DnaSP6,and PopART.Results:A significant portion(94.4%)of severe CVA6-associated HFMD cases(51 out of 54,with 20 lacking age information)were children under 5 years old.Among the 74 CVA6 strains analyzed,72 belonged to the D3a sub-genotype,while only two strains were D2 sub-genotype.The average genetic distance between VP1 sequences prior to 2015 was 0.027,which increased to 0.051 when compared to sequences post-2015.Historical population dynamics analysis indicated three significant population expansions of severe CVA6-associated HFMD during 2012-2013,2013-2014,and 2019-2020,resulting in the formation of 65 distinct haplotypes.Consistent with the MCC tree findings,transitioning between regional haplotypes required multiple base substitutions,showcasing an increase in population diversity during the evolutionary process(from 14 haplotypes in 2013 to 55 haplotypes over the subsequent decade).Conclusions:CVA6,associated with severe HFMD,is evolving and presents a risk of outbreak occurrence.Thus,enhanced surveillance of severe HFMD is imperative.

Thirty Years of Experience of Acute Flaccid Paralysis Surveillance for Polio — China, 1993–2022

Introduction:Detecting poliovirus infections proves to be highly challenging due to their asymptomatic nature and infectious potential,highlighting the crucial importance of effective detection methods in the context of polio eradication efforts.In many countries,including China,the primary approach for identifying polio outbreaks has been through acute flaccid paralysis(AFP)surveillance.In this study,we conducted an evaluation spanning three decades(1993–2022)to assess the effectiveness of AFP surveillance in China.Methods:Data on all AFP cases identified since 1993 and national-level AFP surveillance system quality indicators aligned with the World Health Organization(WHO)standards were collected for analysis.The quality indicators assess surveillance sensitivity,completeness,timeliness of detection notification,case investigation,and laboratory workup.Surveillance sensitivity is determined by the non-polio AFP(NPAFP)detection rate among children under 15 years of age.Results:Between 1993 and 2022,a total of 150,779 AFP cases were identified and reported.Within this pool,surveillance identified 95 cases of wild poliovirus(WPV)and 24 cases due to vaccinederived poliovirus.From 1995 onwards,the detection rate of NPAFP cases consistently adhered to the WHO and national standards of≥1 case per 100,000,falling between 1.38 and 2.76.Starting in 1997,all timeliness indicators consistently achieved the criteria of 80%,apart from the consistency in meeting standards set for the rate of positive specimens sent to the national laboratory.Conclusions:AFP surveillance has been instrumental in China’s accomplishment of maintaining a polio-free status.The ongoing adherence to key performance indicators,ensuring sensitivity and prompt specimen collection,demonstrates that AFP surveillance is proficient in detecting poliovirus in China.As we move into the post-eradication phase,AFP surveillance remains crucial for the sustained absence of polioviruses in the long term.

Analysis of the distribution characteristics of enterovirus types based on environmental surveillance from 2013 to 2021 in Fujian Province, China

Environmental surveillance (ES) is a useful approach for monitoring circulating viruses, including polioviruses (PVs) and non-polio enteroviruses (NPEVs). In this study, the results of nine years of ES from 2013 to 2021 at six sampling sites in three cities in Fujian Province, China, were summarized. It showed that the sewage samples contained abundant viruses, but the positive rate was affected by different sampling sites. From the 520 samples, 431 PVs, 1,713 NPEVs, and 281 human adenoviruses (HAdVs) were isolated. PV isolates had been markedly affected following the adjustment of the immunization strategy. All but one PV isolate were Sabin-like strains without wild PVs. One isolate was vaccine-derived PV type 3 with 10 variation points in theVP1 region. After May 2016, PV type 2 was no longer detected, and PV type 3 became a superior serotype. Of 1,713 NPEVs, 24 serotypes were identified, including echovirus11 (E11), E6, coxsackievirus B3 (CVB3), CVB5, E7, and E3 were the predominant serotypes (37.65%, 20.96%, 11.50%, 8.87%, 8.23%, and 7.06%, respectively). The temporal dynamic of the six common serotypes was inconsistent. E3 was frequently isolated, but the number of isolates was low, with no obvious peaks. E6, E7, and CVB3 exhibited periodic changes with a high peak every three to four years, and E11 only had one high peak lasting four years. Summer-fall peaks of the echoviruses and spring-winter peaks of CVB were observed in the monthly distribution of virus isolation. The infectious isolates of various serotypes of different species identified from the sewage samples showed that ES is an essential part of pathogen surveillance.

A comparative study on environmental surveillance of enterovirus:Using a two-phase separation method and a filtration method with a mixed cellulose ester(MCE)membrane

This study aimed to compare the sensitivity of two-phase separation and the filtration method using a mixed cellulose ester(MCE)membrane to detect enteroviruses in sewage samples.From December 2015 to July 2016,four domestic sewage samples(1 L/sample)were collected monthly from the Guangzhou Liede Sewage Treatment Plant,and each sewage sample was divided into two aliquots(500 mL).The sewage sample was concentrated using the two-phase separation and the filtration method using an MCE membrane,and the treated solutions were inoculated into cells for enterovirus isolation.Polymerase chain reaction amplification,VP1 sequencing,and enterovirus molecular typing were performed on the positive isolates.The detection rates of poliovirus(PV)and non-polio enterovirus(NPEV)obtained using the filtration method using an MCE membrane were higher than those using the two-phase separation method.McNemar's test showed that the detection rates of PV,NPEV,type 1 Sabin-like(SL1),type 2 Sabin-like(SL2),and type 3 Sabin-like(SL3)strain were not statistically significant(P>0.05).In Guangdong Province,China,the detection rates for PV and NPEV were 53.13%and 62.50%(20/32),respectively.Twenty-seven PVs were isolated,three highly variable strains of the type 1 vaccine,with seven nucleotide substitutions in the VP1 region,compared with the type 1 Sabin strains.Eighty-seven strains of NPEV were isolated and nine serotypes were identified,among which coxsackievirus B3(CVB3),echovirus 6(E6),and echovirus 11(E11)were the dominant strains.The filtration method using an MCE membrane is more sensitive than two-phase separation and can be used as a robust,sensitive,and cost-effective method to isolate enteroviruses from sewage.

Classification framework and semantic labeling for Big Earth Data

Big Earth Data refers to the multidimensional integration and association of scientific data,including geography,resources,environment,ecology,and biology.An effective data classification system and label management strategy are important foundations for long-term management of data resources.The objective of this study was to construct a classification system and realize multidimensional semantic data label management for the Big Earth Data Science Engineering Program(CASEarth).This study constructed two sets of classification and coding systems that realize classification by mapping each other;namely,the geosphere-level and Sustainable Development Goals(SDGs)indicator classifications.This technique was based on natural language processing technology and solved problems with subject-word segmentation,weight calculation,and dynamic matching.A prototype system for classification and label management was constructed based on existing CASEarth datasets of more than 1,100.Furthermore,we expect our study to provide the methodology and technical support for useroriented classification and label management services for Big Earth Data.

GeoGlue: feature matching with self-supervised geometric priors for high-resolution UAV images

We present GeoGlue,a novel method using high-resolution UAV imagery for accurate feature matching,which is normally challenging due to the complicated scenes.Current feature detection methods are performed without guidance of geometric priors(e.g.,geometric lines),lacking enough attention given to salient geometric features which are indispensable for accurate matching due to their stable existence across views.In this work,geometric lines arefirstly detected by a CNN-based geometry detector(GD)which is pre-trained in a self-supervised manner through automatically generated images.Then,geometric lines are naturally vectorized based on GD and thus non-significant features can be disregarded as judged by their disordered geometric morphology.A graph attention network(GAT)is utilized forfinal feature matching,spanning across the image pair with geometric priors informed by GD.Comprehensive experiments show that GeoGlue outperforms other state-of-the-art methods in feature-matching accuracy and performance stability,achieving pose estimation with maximum rotation and translation errors under 1%in challenging scenes from benchmark datasets,Tanks&Temples and ETH3D.This study also proposes thefirst self-supervised deep-learning model for curved line detection,generating geometric priors for matching so that more attention is put on prominent features and improving the visual effect of 3D reconstruction.

RepDDNet:a fast and accurate deforestation detection model with high-resolution remote sensing image

Forest is the largest carbon reservoir and carbon absorber on earth.Thus,mapping forest cover change accurately is of great significance to achieving the global carbon neutrality goal.Accurate forest change information could be acquired by deep learning methods using high-resolution remote sensing images.However,deforestation detection based on deep learning on a large-scale region with high-resolution images required huge computational resources.Therefore,there was an urgent need for a fast and accurate deforestation detection model.In this study,we proposed an interesting but effective re-parameterization deforestation detection model,named RepDDNet.Unlike other existing models designed for deforestation detection,the main feature of RepDDNet was its decoupling feature,which means that it allowed the multi-branch structure in the training stages to be converted into a plain structure in the inference stage,thus the computation efficiency can be significantly improved in the inference stage while maintaining the accuracy unchanged.A large-scale experiment was carried out in Ankang city with 2-meter high-resolution remote sensing images(the total area of it was over 20,000 square kilometers),and the result indicated that the model computation efficiency could be improved by nearly 30%compared with the model without re-parameterization.Additionally,compared with other lightweight models,RepDDNet also displayed a trade-off between accuracy and computation efficiency.

糖尿病患者索氏梭菌感染致中毒性休克综合征一例

目的探讨以中毒性休克综合征(TSS)为主要临床表现的糖尿病患者索氏梭菌感染诊治方法。方法分析1例以TSS为主要临床表现的糖尿病患者,血液培养样本应用基质辅助激光解吸飞行时间质谱(MALDI-TOF MS)快速鉴定后经基因组比对进一步确认为索氏梭菌,通过基因组学分析其引起的中毒性休克综合征和凝血障碍的致病基因。结果该患者有糖尿病病史4年,临床表现为中毒性休克综合征,白细胞总数和中性粒细胞数显著增高。厌氧血培养3 d报阳,厌氧环境下转种后形成扁平不规则菌落,MALDI-TOF MS联合16S rDNA序列检测确诊为索氏梭菌。通过基因组学分析索氏梭菌含有溶血素、磷脂酶C和神经氨酸酶基因,上述基因编码的产物可导致炎症和溶血反应。给予患者综合抗感染对症处理后疗效欠佳,病情恶化迅速,在确诊后半个月内死亡。结论MALDI-TOF MS快速鉴定和基因组学分析对索氏梭菌引起感染的诊断和治疗具有重要意义。厌氧菌分离培养后通过MALDI-TOF MS快速鉴定结合生物信息学分析为索氏梭菌诊治的关键。

Proteomic Analysis of Macrophages:A Potential Way to Identify Novel Proteins Associated with Activation of Macrophages for Tumor Cell Killing

One major mechanism through which macrophages effectively kill tumor cells requires cell to cell contact, indicating that certain molecules expressed on cell surface of activated macrophages may mediate the tumoricidal capability. Tumor necrosis factor （TNF） and nitric oxide （NO） are the two classical mediators of tumor cell death. However, evidence of discrepancy is accumulating indicating these known mediators do not appear to account for the broad and potent tumoricidal activity of macrophages. To obtain a full repertoire of tumoricidal activation-associated membrane proteins, we combined one-dimensional SDS-PAGE with capillary liquid chromatographytandem mass spectrometry （LC-MS/MS）. Using this technique, we identified 454 activated macrophage specifically expressed proteins with extremely high confidence, including most known activation markers of macrophages, such as NO synthase （iNOS）, Ym1, cyclooxygenase, etc. Membrane bound TNF-α was also identified on activated macrophages. However, it was also detected on thioglycolate elicited macrophages, indicating this molecule may not play a key role in conjugation-dependent tumor cell killing. In contrast, although NO has not been assigned as an effector molecule of conjugation-dependent tumoricidal pathway, iNOS was identified from membrane fraction of activated macrophages, suggesting NO may be involved in conjugation-dependent tumoricidal mechanism, because iNOS association with plasma membrane is ideally suited to deliver NO directly into the contacted tumor cells. This research provides not only new insights into macrophage conjugation-dependent tumoricidal mechanisms, but also a valuable data set of macrophage activation associated membrane proteins, thus providing better understanding of the functional mechanisms of macrophages in anti-tumor and other biological processes.

Surveillance, epidemiology, and pathogen spectrum of hand, foot, and mouth disease in mainland of China from 2008 to 2017

Hand,foot and mouth disease(HFMD)was reported in May 2,2008 to be the 38th legally notifiable disease in China's National Notifiable Disease Reporting and Surveillance System.In order to solve the infection,an extensive three-level HFMD surveillance laboratory network was established.In this study,the framework of that network is assessed and the incidence of HFMD in China from 2008 to 2017 is reported using a descriptive epidemiologic method.During these 10 years,a series of techniques have been widely applied in all the network laboratories.Using information and material obtained from the network,a virus bank and database containing 18,238 viruses were established.Nationally,18,184,834 HFMD cases,including 152,436 severe cases and 3633 fatal cases,were reported in mainland of China.The average annual incidence in the population was 133.99/100,000 people,with a maximum incidence of 205.06/100,000 people in 2014.The incidence and mortality rates of HFMD were the highest in children aged 1–2 years.The numbers of reported cases fluctuated,with a high incidence observed every 2 years.An overall increase in the number of reported cases was also observed throughout the study period.Despite this,the incidence of severe cases and the mortality rate have been decreasing.High-risk regions are located in southern,eastern,and central China.Two peaks of HFMD infection cases were observed annually except for Northeast China.Different proportions of enterovirus serotypes were observed during the studied years.The predominant enterovirus varies from year to year,but the disease severity is always closely related to the specific serotype.EV-A71 is the dominant serotype associated with severe and fatal cases,with constituent ratios of 70.03%and 92.23%,respectively.The studied highly sensitive and efficient surveillance network provides information that is critical for prevention and control of the disease.It is extremely necessary and important to continuously conduct extensive virological surveillance for HFMD.

Molecular analysis of Coxsackievirus A24 variant isolates from three outbreaks of acute hemorrhagic conjunctivitis in 1988,1994 and 2007 in Beijing,China

Coxsackievirus A24 variant(CVA24v)is a major pathogen that causes continued outbreaks and pandemics of acute hemorrhagic conjunctivitis(AHC).In China,the first confirmed outbreak of CVA24v-related AHC occurred in Beijing in 1988,followed by another two significant outbreaks respectively in 1994 and 2007,which coincides with the three-stage dynamic distribution of AHC in the world after 1970s.To illustrate the genetic characteristics of CVA24v in different periods,a total of 23 strains were isolated from those three outbreaks and the whole genome of those isolations were sequenced and analyzed.Compared with the prototype strain,the 23 strains shared four nucleotide deletions in the 5'UTR except the 0744 strain isolated in 2007.And at the 98th site,one nucleotide insertion was found in all the strains collected from 2007.From 1994 to 2007,amino acid polarity in the VP1 region at the 25th and the 32nd site were changed.Both the 3C and VP1 phylogenetic tree indicated that isolates from 1988 and 1994 belonged to Genotype III(GIII),and 2007 strains to Genotype IV(GIV).According to the Bayesian analysis based on complete genome sequence,the most recent common ancestors for the isolates in1988,1994 and 2007 were respectively estimated around October 1987,February 1993 and December 2004.The evolutionary rate of the CVA24v was estimated to be 7.45×10^(-3) substitutions/site/year.Our study indicated that the early epidemic of CVA24v in Chinese mainland was the GIII.Point mutations and amino acid changes in different genotypes of CVA24v may generate intensity differences of the AHC outbreak.CVA24v has been evolving constantly with a relatively rapid rate.

Detection and Initial Response to a Type 2 Vaccine-Derived Poliovirus—Sichuan Province,China,2019

What is already known about this topic?After the type 2 strain of the live,attenuated poliovirus vaccine was withdrawn globally in 2016,any identification of a type 2 poliovirus is a Public Health Emergency of International Concern.A vaccinederived type 2 poliovirus(VDPV2)was identified in Sichuan,prompting an urgent,comprehensive investigation and response.What is added by this report?Type 2 monovalent,live,attenuated oral poliovirus vaccine(mOPV2)is being used to respond to the numerous VDPV2 outbreaks seen around the world.In contrast,the response in Sichuan used Sabin strain inactivated poliovirus(sIPV)to stop circulation of the VDPV2.In the 6 months following the vaccination response,there have been no VDPV2s detected in Sichuan,despite extensive search.What are the implications for public health practices?Further search for the VDPV2 must continue in order to determine whether transmission has been stopped.The ongoing investigation and response to the Sichuan VDPV2 is providing evidence to the Global Polio Eradication Initiative on managing VDPV2 outbreaks.

Characteristics of HIV-1 Molecular Epidemiology in Suzhou,China,from 2009 to 2014

Human immunodeficiency virus（HIV）and acquired immunodeficiency syndrome（AIDS）remain major public health problems in China,where approximately 780,000people currently live with HIV,according to the 2012 China AIDS Response Progress Report.Suzhou was an early epidemic region in Jiangsu province and the current situation of HIV-1 prevalence is complicated.

Type I vaccine-derived polioviruses in China from 1995 to 2019

A nation-wide case surveillance was conducted in China since 1995 for the objective of identifying acute flaccid paralysis(AFP)in children so that potential wild polioviruses and vaccine-derived poliovirus(VDPV)could be identified on time.Two outbreaks associated with type I circulating VDPVs,eight native independent type I ambiguous VDPVs(aVDPV),and one imported aVDPV were identified during the AFP case surveillance in China from 1995 to 2019.The VP1 coding region of the Chinese type I VDPVs differed from the polio vaccine strain by 1.00%–3.75%(9–34 substitutions in 906 nucleotides).Most of the Chinese type I VDPV strains shared 4 amino acid substitutions in the neutralizing antigenic(NAg)sites:3 located at the BC loop,which formed the NAg site 1,and another at NAg site 3a.All of the Chinese type I VDPVs identified during the AFP case surveillance were young VDPVs,which indicated a limited viral replication resulted from the administration of the initiating oral polio vaccine(OPV)dose.VDPVs can emerge and spread in isolated communities with immunity gaps and the circulation ceases following a mass immunization with OPV.As such,high-quality surveillance permitted very early detection and response and it played a key role in stalling the widespread circulation of the emergent cVDPV strains in China.

Antibody Response to COVID-19 Virus--Heilongjiang Province and Gansu Province,China,2020

What is already known about this topic?Coronavirus disease 2019(COVID-19)has become a global pandemic,while the profile of antibody response against the COVID-19 virus has not been well clarified.What is added by this report?In this study,210 serum samples from 160 confirmed COVID-19 cases with different disease severities were recruited.The IgM,IgA,IgG,and neutralizing antibodies(NAb)against COVID-19 virus were determined.Our findings indicated that four antibodies could be detectable at low levels within 2 weeks of disease onset,then rapidly increasing and peaking from the 3^(rd) to 5^(th) Weeks.NAb decreased between 5^(th) and 9^(th) Weeks,and a higher IgM/IgA level was observed in the groups with mild/moderate severity within 2 weeks(p<0.05),while all 4 types of antibodies were higher in the group with severe/critical severity after 4 weeks(p<0.05).What are the implications for public health practice?Our study on the dynamics of serological antibody responses against COVID-19 virus among COVID-19 patients complements the recognition regarding the humoral immune response to COVID-19 virus infection.The findings will help in the interpretation of antibody detection results for COVID-19 patients and be beneficial for the evaluation of vaccination effects.

Epidemiological survey and genetic characterization of type 3 vaccine-derived poliovirus isolated from a patient with four doses of inactivated polio vaccine in Henan Province,China

Background:Vaccine-derived poliovirus(VDPV)is a potential threat to polio eradication because they can reintroduce into the general population and cause paralytic polio outbreaks,a phenomenon that has recently emerged as a prominent public health concern at the end of global polio eradication.This study aimed to describe the epidemiology and genetic characteristics of the frst VDPV identifed from a patient with acute faccid paralysis(AFP),with four doses of inactivated polio vaccine immunization in Henan Province,China in 2017.Methods:The patient was diagnosed with type 3 VDPV.Subsequently,a series of epidemiological approaches was implemented,including a retrospective search of AFP cases,rate of vaccination assessment,study of contacts,and supplementary immunization activities.Fecal samples were collected,viral isolation was performed,and the viral isolates were characterized using full-length genomic sequencing and bioinformatic analysis.Results:Phylogenetic analysis showed that the viral isolates from the patient were diferent from other reported genetic clusters of type 3 VDPV worldwide.They were identifed as a Sabin 3/Sabin 1 recombinant VDPV with a crossover site in the P2 region.Nucleotide substitutions,including U→C(472)and C→U(2493),have been identifed,both of which are frequently observed as reversion mutations in neurovirulent type 3 poliovirus.A unique aspect of this case is that the patient had been vaccinated with four doses of inactive polio vaccine,and the serum neutralizing antibody for Sabin types 1 and 3 were 1∶16 and 1∶512,respectively.Thus,the patient was speculated to have been infected with type 3 VDPV,and the virus continued to replicate and be excreted for at least 41 d.Conclusions:The existence of this kind of virus in human population is a serious risk and poses a severe challenge in maintaining a polio-free status in China.To the best of our knowledge,this is the frst report of VDPV identifed in the Henan province of China.Our results highlight the importance of maintaining a high-level vaccination rate and highly sensitive AFP case surveillance system in intercepting VDPV transmission.

New Simian Enterovirus 19(EV-A122) Strains in China Reveal Large-Scale Inter-Serotype Recombination between Simian EV-As

Dear Editor,The genus Enterovirus(EV),belonging to the family Picornaviridae,order Picornavirales,comprises 15 species:Enterovirus A–L and rhinovirus A–C(Zell et al.2017).Enterovirus A(EV-A)has 25 serotypes,including several pathogens,such as EV-A71,coxsackievirus A16(CV-A16),and CV-A6 that infect humans,as well as four serotypes(EV-A122,123,124,and 125)isolated from simians(Zell et al.2017).EV genomes share a similar structure with a length of 7.5 kb,and two open reading frames(ORFs)flanked by 5′-and 3′-untranslated regions(UTRs)in some EVs(Oberste et al.2013b;Zell et al.2017;Guo et al.2019;Lulla et al.2019).

Vaccine-Associated Paralytic Poliomyelitis--8 PLADs,China,October 2012–March 2014

Introduction:Poliomyelitis is a highly contagious,seasonal viral disease caused by any of three poliovirus(PV)serotypes(types 1,2,or 3).Oral poliovirus vaccine(OPV)on rare occasions causes vaccineassociated paralytic poliomyelitis(VAPP)in recipients of OPV and close contacts of recently vaccinated individuals.This study describes the epidemiology of VAPP when an all OPV schedule was used in the Expanded Program on Immunization(EPI).Methods:VAPP cases were identified using standardized diagnostic criteria from data reported by 8 provincial-level administrative divisions(PLADs)to the National Acute Flaccid Paralysis(AFP)Surveillance System in an 18-month period between October 2012 and March 2014.Results:During this period,28 VAPP cases were reported.Using the number of births as a denominator,the estimated incidence of VAPP was 2.47 cases per million births.Using the number of OPV doses administered through routine immunization,the VAPP incidence was 0.55 cases per million doses.Among vaccine-recipient VAPP cases,22(85%)were associated with the first dose of OPV;3 were associated with the second OPV dose.The relative risk of VAPP following the first dose compared with the second dose was 7.07.Conclusions and Implications for Public Health Practice:The per-dose and per-child incidences of VAPP were consistent with incidence estimates by the World Health Organization(WHO).The vast majority(85%)of VAPP in China was associated with the first dose of OPV in an all-OPV schedule.Because inactivated polio vaccine(IPV)is known to prevent VAPP from subsequent doses of OPV in immunocompetent children,this association provided strong evidence for using an IPV-first,sequential IPVOPV polio vaccination schedule in China during the globally-synchronized cessation of type 2 OPV and introduction of IPV in 2016.