Detection and Genetic Characterization of Rabies Virus from Human Patients

Saliva and blood were collected from two patients who had not received post exposure prophylaxis in the cities of Wenzhou and Xinning respectively. Both patients were confirmed as positive for rabies by detection of rabies virus specific nucleoprotein antibodies in the sera by Western Blot. However, rabies virus specific RNA was only identified in the saliva collected from the patient in Wenzhou. Furthermore, the isolate Zhejiang Wz0 (H) was obtained by inoculating one-day-old suckling mice. Both nucleoprotein (N) and glycoprotein (G) genes from the isolate were amplified by RT-PCR and sequenced. Phylogenetic analysis indicated that the isolate belonged to classic rabies virus, and shared a higher homology with the street viruses from dogs in the main endemic areas in China and the street virus from dogs in Indonesia than with other known strains. Further comparison of the deduced amino acid sequences between the isolate and the vaccine strains used in China showed that the virus had a higher level of homology with the vaccine strain CTN than with the other vaccine strains (3aG, PV, PM and ERA). In particular, amino acid residues substitutions located in antigenic site Ⅲ in the G protein, which could react with the neutralizing antibodies, were observed. These results suggested that the virus belonged to the classic rabies virus, and both N and G genes diverged from the current vaccine strains used in China at either the nucleotide or the amino acid level.

Two case of preoperative bridging therapy for patients undergoing non- cardiac surgery after coronary stent implantation

It has been reported that up to 12% of patients underwent non-cardiac surgery or invasive procedures within the first year after the coronary stent implantation. Premature dis- continuation of antiplatelet therapy is associated with a sig- nificant increase in mortality and major adverse cardiac events, in particular, stent thrombosis. Thus, postpone- ment of elective surgery is advocated during the first year after the coronary stent implantation.

Identifying the Risk of SARS-CoV-2 Infection and Environmental Monitoring in Airborne Infectious Isolation Rooms(AIIRs)

Healthcare workers(HCWs)are at high risk of occupational exposure to the new pandemic human coronavirus,SARSCoV-2,and are a source of nosocomial transmission in airborne infectious isolation rooms(AIIRs).Here,we performed comprehensive environmental contamination surveillance to evaluate the risk of viral transmission in AIIRs with 115 rooms in three buildings at the Shanghai Public Health Clinical Center,Shanghai,during the treatment of 334 patients infected with SARS-CoV-2.The results showed that the risk of airborne transmission of SARS-CoV-2 in AIIRs was low(1.62%,25/1544)due to the directional airflow and strong environmental hygiene procedures.However,we detected viral RNA on the surface of foot-operated openers and bathroom sinks in AIIRs(viral load:55.00–3154.50 copies/mL).This might be a source of contamination to connecting corridors and object surfaces through the footwear and gloves used by HCWs.The risk of infection was eliminated by the use of disposable footwear covers and the application of more effective environmental and personal hygiene measures.With the help of effective infection control procedures,none of 290 HCWs was infected when working in the AIIRs at this hospital.This study has provided information pertinent for infection control in AIIRs during the treatment of COVID-19 patients.

Hepatitis C Virus Infection Caused by Infrequent Exposure in China Should Be of Concern

Dear Editor,Hepatitis C Virus(HCV)infection is a huge public health problem globally,because it can lead to adverse long-term clinical outcomes.In China,the population has experienced a skyrocketing growth of HCV infections because of paid blood donations in the late 1980s to early 1990s(Lu et al.2013;Yin et al.2015).