Analysis of Epidemiological Characteristics of Varicella Before and After the Implementation of the Two-dose Varicella Vaccine Immunization Program in Banan District of Chongqing City

Objective:To explore the changes in the epidemiological characteristics of varicella before and after implementing the two-dose varicella vaccine(VarV)immunization program in the Banan District of Chongqing and to provide a reference for future epidemic prevention and control.Methods:The data of reported varicella cases in Banan District from 2014 to 2023 were collected and analyzed using the China Disease Prevention and Control Information System.Descriptive epidemiological methods were employed to assess the changes in the reported incidence of varicella before(2014-2018)and after(2019-2023)the implementation of the two-dose VarV immunization program.Results:The average annual reported incidence rate of varicella in Banan District from 2014 to 2023 was 81.53 per 100,000.From 2014 to 2018,the reported incidence rate showed an upward trend year by year(trend x2=223.96,P<0.05).However,the reported incidence rate decreased from 2019 to 2023(trend x?=189.51,P<0.05).Before and after the adjustment of the immunization program,the reported incidence rate for the 5-9 years old group was 774.62 per 100,000 and 476.98 per 100,000,respectively,with a statistically significant difference(x2=161.26,P<0.05).The onset of varicella showed a bimodal distribution,with peak incidence periods in May-June and October-December.From 2014 to 2023,a total of 155,181 doses of VarV were administered in Banan District.The estimated annual vaccination rate for the first varicella vaccine(VarV1)from 2019 to 2023 was 86.28%,and for the second dose(VarV2)was 59.18%.The primary vaccination targets were the 5-9-year-old group,accounting for 64.21%.Conclusion:After implementing the two-dose VarV immunization program in Banan District,the vaccination rate increased yearly,and the reported incidence of varicella showed a downward trend.The incidence rate of varicella in children aged 5-9 years reduced significantly,but the overall downward trend for the entire population was not as pronounced.Therefore,it is necessary to increase the vaccination rate of VarV2.

Epidemiological characteristics of varicella in Chongqing,China,2014-2021

Background:To analyze the epidemiological characteristics of varicella epidemics in Chongqing Municipality from 2014 to 2021,and to provide a scientific basis for the formulation of varicella prevention and control measures.Methods:Data on the incidence of varicella outbreaks and vaccination data in Chongqing from 2014 to 2021 were collected through the China Disease Control and Prevention Information System and statistically analyzed using descriptive epidemiological methods.Results:From 2014 to 2021,213,715 cases of varicella were reported in Chongqing Municipality,with an average annual incidence rate of 86.26/100,000,with a statistically significant difference(χ^(2)=24,972.069,P<0.001);varicella incidence is seasonal,with peaks in May/June and October/December each year,presenting a“double-peak distribution”.The average annual incidence rate of varicella in municipal districts was 90.74/100,000,which was higher than that of counties 69.62/100,000 and autonomous counties 84.04/100,000;the average annual incidence rate of varicella in males was 89.37/100,000,and in females,82.22/100,000,with the difference not being statistically significant;the age of onset of the disease was mainly in the group of people under 15 years of age,with a total of 190,021 cases reported(88.9%),with 5-9 years old(35.7%)as the high incidence age group.The incidence occupation was dominated by students in 133,733 cases(62.6%).Conclusion:The overall varicella epidemic in Chongqing is on the rise,and has obvious seasonal,regional and population distribution characteristics.The prevention and control of varicella epidemic should be strengthened,the publicity of varicella vaccine should be increased,and it is recommended that varicella vaccine should be included in the national immunization program.

Epidemiological Characteristics and Spatiotemporal Distribution Patterns of Human Norovirus Outbreaks in China, 2012–2018

Objective To clarify the epidemiological characteristics and spatial distribution patterns of human norovirus outbreaks in China, identify high-risk areas, and provide guidance for epidemic prevention and control.Methods This study analyzed 964 human norovirus outbreaks involving 50,548 cases in 26 provinces reported from 2012 to 2018. Epidemiological analysis and spatiotemporal scanning analysis were conducted to analyze the distribution of norovirus outbreaks in China.Results The outbreaks showed typical seasonality, with more outbreaks in winter and fewer in summer, and the total number of infected cases increased over time. Schools, especially middle schools and primary schools, are the most common settings of norovirus outbreaks, with the major transmission route being life contact. More outbreaks occurred in southeast coastal areas in China and showed significant spatial aggregation. The highly clustered areas of norovirus outbreaks have expanded northeast over time.Conclusion By identifying the epidemiological characteristics and high-risk areas of norovirus outbreaks, this study provides important scientific support for the development of preventive and control measures for norovirus outbreaks, which is conducive to the administrative management of high-risk settings and reduction of disease burden in susceptible areas.

Epidemiological characteristics of COVID-19 cases in a hotel Fangcang shelter hospital in Sanya

Objective:To analyze the epidemiological characteristics of COVID-19 cases(Omicron variant BA5.1.3)in a hotel Fangcang shelter hospital in Sanya,Hainan Province,and provide basis for optimizing epidemic prevention and control strategies.Methods:The epidemiological data of COVID-19 cases admitted to a hotel Fangcang shelter hospital in Sanya from August 10 to August 30 in 2022 were collected for descriptive epidemiological analysis.Results:By August 30,703 cases of COVID-19 had been treated in the hotel Fangcang shelter hospital.The epidemiological characteristics analysis showed that 328 cases were male,accounting for 46.7%,and 375 cases were female,accounting for 53.3%.The ratio of male to female was 0.87:1.The age range was 8 months to 85 years old,with a median of 37(20,49)years old.The majority of people aged 31-59 years old,accounting for 51.4%.Asymptomatic infection accounted for 39.8%,and mild infection accounted for 60.2%,the main clinical symptoms were cough 24.8%(105/423),fever 18.7%(79/423).8.8%of the infected people had a history of chronic basic diseases,and hypertension and diabetes were the most common.There were 416 infected patients discharged from hospital,and the median total hospital stay was 14(10,15)days.The proportion of people who did not receive COVID-19 vaccine was 10.1%,the proportion of people who completed one,two and three vaccination was 5.0%,36.3%and 48.6%respectively,and the proportion of people who completed two and three vaccinations among people ≥60 years old was only 10.1%and 8.8%.Conclusion:This strain was the novel coronavirus variant BA5.1.3,which was reported for the first time in China.It was more infectious and insidious,and generally susceptible to people of all ages.Therefore,it is necessary to strengthen personal prevention and control,and did a good job of external anti input and internal anti diffusion,and strengthen nucleic acid detection to realize timely detection and early treatment,and strengthen COVID-19 vaccination,to improve vaccination rate and reduce infection rate.

Epidemiological Characteristics and Risk Factors of the Pertussis in Infants < 12 Months of Age in Tianjin, China

The epidemiologic characteristics of 631 infant pertussis cases 〈 12 months, which accounted for 57.42% of the total cases, were analyzed by descriptive epidemiology in Tianjin, between 2010 and 2015. The incidence of infants was 104.66/100,000, which was 118 times higher than in other age groups （P 〈 0.001）. The primary type of pertussis simultaneously presented in households was adult-to-infant （70.51%）. The parents were identified as the source of infection in 80.18% of cases for infants. The positive rate of placental antibody transfer was 31.06% and 3.13% for 3-month-old infants. Infants presented the highest age-specific pertussis incidence. The most important reason was parents were the important sources of infection, and secondly the lower level of antibodies in neonates and the rapid waning of maternal antibody titer.

Epidemiological Characteristics of Notifiable Infectious Diseases among Foreign Cases in China,2004–2017

Objective We aimed to assess the features of notifiable infectious diseases found commonly in foreign nationals in China between 2004 and 2017 to improve public health policy and responses for infectious diseases.Methods We performed a descriptive study of notifiable infectious diseases among foreigners reported from 2004 to 2017 in China using data from the Chinese National Notifiable Infectious Disease Reporting System(NNIDRIS). Demographic, temporal-spatial distribution were described and analyzed.Results A total of 67,939 cases of 33 different infectious diseases were reported among foreigners.These diseases were seen in 31 provinces of China and originated from 146 countries of the world. The infectious diseases with the highest incidence number were human immunodeficiency virus(HIV) of18,713 cases, hepatitis B(6,461 cases), hand, foot, and mouth disease(6,327 cases). Yunnan province had the highest number of notifiable infectious diseases in foreigners. There were different trends of the major infectious diseases among foreign cases seen in China and varied among provinces.Conclusions This is the first description of the epidemiological characteristic of notifiable infectious diseases among foreigners in China from 2004 to 2017. These data can be used to better inform policymakers about national health priorities for future research and control strategies.

The Epidemiological Characteristics of Beijing Lineage Mycobacterium tuberculosis from a National Referral Center in China

Our study was to investigate the epidemiological characteristics of M.tuberculosis from a national tuberculosis referral center in China. All strains isolated from TB patients, were genotyped by the RD105 deletion, 8 and 51 SNP loci and VNTR. The high differentiation SNPs of modern Beijing strains were analyzed for protein function and structure. 413 M. tuberculosis were included. Of 379 Beijing lineage M. tuberculosis, ＇modern＇ and ＇ancient＇ strains respectively represented 85.5% （324/379） and 14.5% （55/379）. Rv2494 （V48A） and Rv0245 （Sl03F） were confirmed as high differentiation SNPs associated with modern strains. In a word, Modern Beijing lineage M.tuberculosis was dominant and the structural models suggested that modern sub-lineage may more easily survive in ＇extreme＇ host condition.

Epidemiological Characteristics of COVID-19 Confirmed Cases in Muscat Governorate, Sultanate of Oman

Introduction: The coronavirus disease 2019 (COVID-19) was declared as pandemic by WHO by March 11th. First case reported in Oman was on 24th February 2020 and later the country went through stages of epidemic progression. This study describes the sociodemographic and epidemiological characteristics of confirmed COVID-19 cases in Muscat governorate and related outcomes. Materials and Methods: This is a descriptive, exploratory analysis of all lab confirmed COVID 19 cases that were reported from 1st February to 31st May 2020. Data for the study was primarily extracted from notifications system established for surveillance (Tarassud). Secondary data sources were, contact listings and hospital medical records. Results: 11,648 initial cases of confirmed COVID-19 infections were included. The mean age was 35 years, 84.7% (N = 9862) were males, 25.9% (N = 3017) were Omanis, and 74.1% (N = 8631) were expatriates of which Indian origin were the majority (37%). Fever and cough were the most common presentations (46.3% and 29.5% respectively). Diabetes and hypertension were the most common comorbidities (4.9% and 4.6% respectively). Hospital admission was required for 7% (N = 811) of the total reported cases, out of them 171 cases (21%) were admitted to ICU, where 107 (13.2%) were ventilated. The case fatality rate (CFR) was 0.9%. 158 clusters containing 2949 contacts were identified from case records and categorised into 3 groups based on their exposure settings. The incubation period measured was 8 days (IQR 4.0 - 15.0) for workplace, 8 days (IQR 4 - 17) for dormitory and 4 days (IQR 2.0 - 7.0) for family groups. The secondary attack rate (SAR) estimated was 41.6% (95% CI: 0.34 - 0.48), 52% (95% CI: 0.40 - 0.63) and 33% (95% CI: 0.27 - 0.38) for workplace, dormitory and family groups, respectively. Conclusion: Results of this study, determine the transmission trend of COVID-19 in a country with high immigrant population. These findings could be utilised for further response planning in similar settings.

Epidemiological characteristics of 168 cases of COVID-19 in Hainan Island, tropical China: A descriptive study

Objective:To understand the epidemic characters of COVID-19 epidemic in Hainan province of tropical China and provid evidences for the prevention and control of the epidemic.Methods:Data on the COVID-19 epidemic collected from Health Commission of Hainan Province were analyzed by using the methods of retrospective descriptive epidemiology.Results:From January 22nd to February 21st,2020,COVID-19 was diagnosed in 168 confirmed cases(including 8 severe cases)in Hainan Province with the temporary fatality rate of 2.38%of 4 deaths,and 96 cases discharged from hospital,with the cure rate of 57.14%.The cases were distributed in altogether 15 cities and counties in Hainan Province,among which 121 cases were distributed in Sanya,Haikou,Danzhou and Wanning,accounting for 72.02%of the total number of cases.Cases in Sanya City were mainly found in Tianya district and Jiyang district,accounting for 69.81%of the total number of cases in Sanya.Cases in Haikou City were mainly found in Qiongshan district and Xiuying district,accounting for 72.5%of the total number of cases in Haikou.Among the patients,there were 81 males and 87 females,with a male-to-female ratio of 1.1;the youngest age was 3 months,the oldest was 79 years old,80%of the patients were in the age group of 30 to 69 years old,and the number of children and adolescents under 20 years old were relatively low.Conclusion:The daily number of new confirmed cases showed a gradual downward trend in Hainan province,and the epidemic situation was in transition from imported to local renewal,mainly in close contact between family members.With the increase of personnel mobility such as the resumption of work by enterprises and the return of migrant workers to the island,there is a risk of agglomeration epidemic.Prevention and control work in urban and rural areas should take a two-pronged approach.Amid preventing imported cases,more proactive measures should be taken to prevent and control the spread of local cases.

Epidemiological characteristics of tuberculosis incidence and its macro-influence factors in Chinese mainland during 2014-2021

Background Tuberculosis(TB)remains a pressing public health issue,posing a significant threat to individuals'well-being and lives.This study delves into the TB incidence in Chinese mainland during 2014-2021,aiming to gain deeper insights into their epidemiological characteristics and explore macro-level factors to enhance control and prevention.Methods TB incidence data in Chinese mainland from 2014 to 2021 were sourced from the National Notifiable Disease Reporting System(NNDRS).A two-stage distributed lag nonlinear model(DLNM)was constructed to evaluate the lag and non-linearity of daily average temperature(℃,Atemp),average relative humidity(%,ARH),average wind speed(m/s,AWS),sunshine duration(h,SD)and precipitation(mm,PRE)on the TB incidence.A spatial panel data model was used to assess the impact of demographic,medical and health resource,and economic factors on TB incidence.Results A total of 6,587,439 TB cases were reported in Chinese mainland during 2014-2021,with an average annual incidence rate of 59.17/100,000.The TB incidence decreased from 67.05/100,000 in 2014 to 46.40/100,000 in 2021,notably declining from 2018 to 2021(APC=-8.87%,95%CI:-11.97,-6.85%).TB incidence rates were higher among males,farmers,and individuals aged 65 years and older.Spatiotemporal analysis revealed a significant cluster in Xinjiang,Qinghai,and Xizang from March 2017 to June 2019(RR=3.94,P<0.001).From 2014 to 2021,the proportion of etiologically confirmed cases increased from 31.31%to 56.98%,and the time interval from TB onset to diagnosis shortened from 26 days(IQR:10-56 days)to 19 days(IQR:7-44 days).Specific meteorological conditions,including low temperature(<16.69℃),high relative humidity(>71.73%),low sunshine duration(<6.18 h)increased the risk of TB incidence,while extreme low wind speed(<2.79 m/s)decreased the risk.The spatial Durbin model showed positive associations between TB incidence rates and sex ratio(β=1.98),number of beds in medical and health institutions per 10,000 population(β=0.90),and total health expenses(β=0.55).There were negative associations between TB incidence rates and population(β=-1.14),population density(β=-0.19),urbanization rate(β=-0.62),number of medical and health institutions(β=-0.23),and number of health technicians per 10,000 population(β=-0.70).Conclusions Significant progress has been made in TB control and prevention in China,but challenges persist among some populations and areas.Varied relationships were observed between TB incidence and factors from meteorological,demographic,medical and health resource,and economic aspects.These findings underscore the importance of ongoing efforts to strengthen TB control and implement digital/intelligent surveillance for early risk detection and comprehensive interventions.

Epidemiological characteristics of ventilator-associated pneumonia in neurosurgery:A 10-year surveillance study in a Chinese tertiary hospital

Background Ventilator-associated pneumonia(VAP)is a significant and common health concern.The epidemiological landscape of VAP is poorly understood in neurosurgery patients.This study aimed to explore the epidemiology of VAP in this population and devise targeted surveillance,treatment,and control efforts.Methods A 10-year retrospective study spanning 2011 to 2020 was performed in a large Chinese tertiary hospital.Surveillance data was collected from neurosurgical patients and analyzed to map the demographic and clinical characteristics of VAP and describe the distribution and antimicrobial resistance profile of leading pathogens.Risk factors associated with the presence of VAP were explored using boosted regression tree(BRT)models.Results Three hundred ten VAP patients were identified.The 10-year incidence of VAP was 16.21 per 1000 ventilation days.All-cause mortality was 6.1%.The prevalence of gram-negative bacteria,fungi,and gram-positive bacteria among the 357 organisms isolated from VAP patients was 86.0%,7.6%,and 6.4%,respectively;most were multidrug-resistant organisms.Acinetobacter baumannii,Klebsiella pneumoniae,and Pseudomonas aeruginosa were the most common pathogens.The prevalence of carbapenem-resistant A.baumannii,P.aeruginosa,and K.pneumoniae was high and increased over time in the study period.The BRT models revealed that VAP was associated with number of days of ventilator use(relative contribution,47.84±7.25),Glasgow Coma Scale score(relative contribution,24.72±5.67),and tracheotomy(relative contribution,21.50±2.69).Conclusions Our findings provide a better understanding of the epidemiology of VAP and its risk factors in neurosurgery patients.

Epidemiological characteristics of seven notifable respiratory infectious diseases in the mainland of China:an analysis of national surveillance data from 2017 to 2021

Background Respiratory infectious diseases(RIDs)remain a pressing public health concern,posing a signifcant threat to the well-being and lives of individuals.This study delves into the incidence of seven primary RIDs dur‑ing the period 2017-2021,aiming to gain deeper insights into their epidemiological characteristics for the purpose of enhancing control and prevention strategies.Methods Data pertaining to seven notifable RIDs,namely,seasonal infuenza,pulmonary tuberculosis(PTB),mumps,scarlet fever,pertussis,rubella and measles,in the mainland of China between 2017 and 2021 were obtained from the National Notifable Disease Reporting System(NNDRS).Joinpoint regression software was utilized to analyze temporal trends,while SaTScan software with a Poisson probability model was used to assess seasonal and spatial patterns.Results A total of 11,963,886 cases of the seven RIDs were reported during 2017-2021,and yielding a fve-year aver‑age incidence rate of 170.73 per 100,000 individuals.Among these RIDs,seasonal infuenza exhibited the highest aver‑age incidence rate(94.14 per 100,000),followed by PTB(55.52 per 100,000),mumps(15.16 per 100,000),scarlet fever(4.02 per 100,000),pertussis(1.10 per 100,000),rubella(0.59 per 100,000),and measles(0.21 per 100,000).Males experi‑enced higher incidence rates across all seven RIDs.PTB incidence was notably elevated among farmers and individu‑als aged over 65,whereas the other RIDs primarily afected children and students under 15 years of age.The inci‑dences of PTB and measles exhibited a declining trend from 2017 to 2021(APC=−7.53%,P=0.009;APC=−40.87%,P=0.02),while the other fve RIDs peaked in 2019.Concerning seasonal and spatial distribution,the seven RIDs displayed distinct characteristics,with variations observed for the same RIDs across diferent regions.The proportion of laboratory-confrmed cases fuctuated among the seven RIDs from 2017 to 2021,with measles and rubella exhibit‑ing higher proportions and mumps and scarlet fever showing lower proportions.Conclusions The incidence of PTB and measles demonstrated a decrease in the mainland of China between 2017 and 2021,while the remaining fve RIDs reached a peak in 2019.Overall,RIDs continue to pose a signifcant public health challenge.Urgent action is required to bolster capacity-building eforts and enhance control and prevention strategies for RIDs,taking into account regional disparities and epidemiological nuances.With the rapid advancement of high-tech solutions,the development and efective implementation of a digital/intelligent RIDs control and pre‑vention system are imperative to facilitate precise surveillance,early warnings,and swift responses.

Epidemiological characteristics and disease burden of infectious mononucleosis in hospitalized children in China:A nationwide retrospective study

Epstein-Barr virus(EBV)is very common,with the infection rate in adults over 90%worldwide.Infectious mononucleosis(IM)is caused by primary infection with EBV.Most IM patients are generally considered to have a favorable prognosis,but a few patients will also develop complications.Children with severe symptoms will require hospitalization.However,the disease burden of children hospitalized with IM in China has been rarely described.In this study,we included the Face sheets of discharge medical records from 27 member children's hospitals of Futang Research Center of Pediatric Development from Jan 1st,2016 to Dec 31st,2020,and medical information such as gender,age,region,time of admission,length of stay and expenditure were extracted.There were 24,120 IM cases,which accounted for 0.42%(24,120/5,693,262)of all hospitalized cases during this period.The ratio of male to female was 1.48:1.Hospitalization for IM in the 4-6 years age group was the highest among inpatients of all age groups.Case numbers increased year by year between 2016 and 2020,and the monthly hospitalization was generally high from Jul to Sep but reduced from Jan to Feb per year.Bronchitis/pneumonia and hepatic dysfunction were two common complications in hospitalized IM patients.The median length of stay was 8 days,and the median cost of hospitalization was 970.59 US dollars.This study will help understand the epidemiological characteristics and disease burden of hospitalized children with IM in China.

Antimicrobial resistance and molecular epidemiological characteristics of clinical isolates of Staphylococcus aureus in Changsha area

Background Increasing prevalence of Staphylococcus aureus （S. aureus）, particularly methicillin-resistant S. aureus （MRSA） has been reported in China. In this study, we investigated the drug resistance characteristic, genetic background, and molecular epidemiological characteristic of S. aureus in Changsha. Methods Between January 2006 and December 2008, 293 clinical isolates of S. aureus were collected from 11 hospitals in Changsha and identified by the Vitek-2 system. All the isolates were verified as MRSA by PCR amplification of both femA and mecA genes. K-B disk method was used to test drug sensitivity of S. aureus to antibiotics. Pulsed-field gel electrophoresis （PFGE） was performed for genotypic and homologous analysis of 115 isolates randomly selected from the original 293 clinical S. aureus isolates. Results S. aureus was highly resistant to penicillin, ampicillin, erythromycin, and clindamycin with resistant rates of 96.6%, 96.6%, 77.1%, and 67.2% respectively. All the isolates were susceptible to tecoplanin, vancomycin, and linezolid. MRSA accounted for 64.8% （190/293） of all the S. aureus strains. The 115 S. aureus isolates were clustered into 39 PFGE types by PFGE typing, with 13 predominant patterns （designated types A to M） accounting for 89 isolates. The most prevalent PFGE type was type A （n=56, 48.7%） and 100.0% of type A strains were MRSA. PFGE type A included 13 subtypes, and the most prevalent subtype was subtype A1 （46.4%, 26/56）. Strains with PFGE type A were isolated from eight hospitals （8/11）, and both subtypes A1 and A4 strains were isolated in a university hospital. Conclusions Clinical isolates of S. aureus in Changsha were resistant to multiple traditional antibiotics. There was an outbreak of PFGE type A MRSA in this area and the A1 subtype was the predominant epidemic clone. Dissemination of the same clone was an important reason for the wide spread of MRSA.

Epidemiological characteristics of imported respiratory infectious diseases in China,2014-2018

Background:With the progress of globalization,international mobility increases,greatly facilitating cross-border transmission of respiratory infectious diseases(RIDs).This study aimed to analyze the epidemiological characteristics and factors influencing imported RIDs,with the goal of providing evidence to support adoption of high-tech,intel-ligent methods to early find imported RIDs and prevent their spread in China.Methods:We obtained data of imported RIDs cases from 2014 to 2018 from the Inbound Sentinel Network of Customs and the National Notifiable Diseases Reporting System in China.We analyzed spatial,temporal,and population distribution characteristics of the imported RIDs.We developed an index to describe seasonality.Pearson correlation coefficients were used to examine associations between independent variables and imported cases.Data analyses and visualizations were conducted with R software.Results:From a total of 1409265253 inbound travelers,31732(2.25/100000)imported RIDs cases were reported.RIDs cases were imported from 142 countries and five continents.The incidence of imported RIDs was nearly 5 times higher in 2018(2.81/100000)than in 2014(0.58/100000).Among foreigners,incidence rates were higher among males(5.32/100000),0–14-year-olds(15.15/100000),and cases originating in Oceania(11.10/100000).The vast majority(90.3%)of imported RIDs were influenza,with seasonality consistent with annual seasonality of influenza.The spatial distribution of imported RIDs was different between Chinese citizens and foreigners.Increases in inbound travel volume and the number of influenza cases in source countries were associated with the number of imported RIDs.Conclusions:Our study documented importation of RIDs into China from 142 countries.Inbound travel poses a significant risks bringing important RIDs to China.It is urgent to strengthen surveillance at customs of inbound travelers and establish an intelligent surveillance and early warning system to prevent importation of RIDs to China for preventing further spread within China.

Epidemiological and clinical characteristics of fifty-six cases of COVID-19 in Liaoning Province, China

BACKGROUND Pneumonia of uncertain cause has been reported in Wuhan,China since the beginning of early December 2019.In early January 2020,a novel strain ofβ-coronavirus was identified by the Chinese Center for Disease Control and Prevention from the pharyngeal swab specimens of patients,which was recently named severe acute respiratory syndrome coronavirus 2(SARS-CoV-2).There is evidence of human-to-human transmission and familial cluster outbreak of SARSCoV-2 infection.The World Health Organization(WHO)recently declared the SARS-CoV-2 epidemic a global health emergency.As of February 17,2020,71329 laboratory-confirmed cases(in 25 countries,including the United States and Germany)have been reported globally.Other than its rapid transmission,the epidemiological and clinical characteristics of coronavirus disease 2019(COVID-19)remain unclear.In December 2019,coronavirus disease(named COVID-19 by the WHO)associated with the SARS-CoV-2 emerged in Wuhan,China and spread quickly across the country.AIM To analyze the epidemiological and clinical characteristics of confirmed cases of this disease in Liaoning province,a Chinese region about 1800 km north of Wuhan.METHODS The clinical data of 56 laboratory-confirmed COVID-19 cases due to 2019-nCoV infection were analyzed.The cases originated from eight cities in Liaoning province.RESULTS The median age of the patients was 45 years,and 57.1%of them were male.No patient had been in direct contact with wild animals.Among them,23 patients(41.1%)had resided in or traveled to Wuhan,27 cases(48.2%)had been in contact with confirmed COVID-19 patients,5 cases(8.9%)had been in contact with confirmed patients with a contact history to COVID-19 patients,and 1 case(1.8%)had no apparent history of exposure.Fever(75.0%)and cough(60.7%)were the most common symptoms.The typical manifestations in lung computed tomography(CT)included ground-glass opacity and patchy shadows,with 67.8%of them being bilateral.Among the patients in the cohort,78.6%showed reduction in their lymphocyte counts,57.1%showed increases in their C-reactive protein levels,and 50.0%showed decreases in their blood albumin levels.Eleven patients(19.6%)were admitted to intensive care unit,2 patients(3.5%)progressed to acute respiratory distress syndrome,4 patients(7.1%)were equipped with non-invasive mechanical ventilation,and 1 patient(1.8)received extracorporeal membrane oxygenation support.There were 5 mild cases(5/56,8.9%),40 moderate cases(40/56,71.4%),10 severe cases(10/56,17.9%),and 1 critical case(1/56,1.8%).No deaths were reported.CONCLUSION SARS-CoV-2 can be transmitted among humans.Most COVID-19 patients show symptoms of fever,cough,lymphocyte reduction,and typical lung CT manifestations.Most are moderate cases.The seriousness of the disease(as indicated by blood oxygen saturation,respiratory rate,oxygenation index,blood lymphocyte count,and lesions shown in lung CT)is related to history of living in or traveling to Wuhan,underlying diseases,admittance to intensive care unit,and mechanical ventilation.

China stroke surveillance report 2021

Since 2015,stroke has become the leading cause of death and disability in China,posing a significant threat to the health of its citizens as a major chronic non-communicable disease.According to the China Stroke High-risk Population Screening and Intervention Program,an estimated 17.8 million[95%confidence interval(CI)17.6–18.0million]adults in China had experienced a stroke in 2020,with 3.4 million(95%CI 3.3–3.5 million)experiencing their first-ever stroke and another 2.3 million(95%CI 2.2–2.4 million)dying as a result.Additionally,approximately 12.5%(95%CI 12.4%–12.5%)of stroke survivors were left disabled,as defined by a modified Rankin Scale score greater than 1,equating to 2.2 million(95%CI 2.1–2.2 million)stroke-related disabilities in 2020.As the population ages and the prevalence of risk factors like diabetes,hypertension,and hyperlipidemia continues to rise and remains poorly controlled,the burden of stroke in China is also increasing.A large national epidemiological survey initiated by the China Hypertension League in 2017 showed that the prevalence of hypertension was 24.7%;the awareness,treatment,and control rates in hypertensive patients were:60.1%,42.5%,and 25.4%,respectively.A nationally representative sample of the Chinese mainland population showed that the weighted prevalence of total diabetes diagnosed by the American Diabetes Association criteria was 12.8%,suggesting there are 120 million adults with diabetes in China,and the awareness,treatment,and control rates in diabetic patients were:43.3%,49.0%,and 49.4%,respectively.The“Sixth National Health Service Statistical Survey Report in 2018”showed that the proportion of the obese population in China was 37.4%,an increase of 7.2 points from 2013.Data from 1599 hospitals in the Hospital Quality Monitoring System and Bigdata Observatory Platform for Stroke of China(BOSC)showed that a total of 3,418,432 stroke cases[mean age±standard error(SE)was(65.700±0.006)years,and 59.1%were male]were admitted during 2020.Of those,over 80.0%(81.9%)were ischemic stroke(IS),14.9%were intracerebral hemorrhage(ICH)strokes,and 3.1%were subarachnoid hemorrhage(SAH)strokes.The mean±SE of hospitalization expenditures was Chinese Yuan(CNY)(16,975.6±16.3),ranging from(13,310.1±12.8)in IS to(81,369.8±260.7)in SAH,and out-of-pocket expenses were(5788.9±8.6),ranging from(4449.0±6.6)in IS to(30,778.2±156.8)in SAH.It was estimated that the medical cost of hospitalization for stroke in 2020 was CNY 58.0 billion,of which the patient pays approximately CNY 19.8 billion.In-hospital death/discharge against medical advice rate was 9.2%(95%CI 9.2%–9.2%),ranging from 6.4%(95%CI 6.4%–6.5%)for IS to 21.8%(95%CI 21.8%–21.9%)for ICH.From 2019 to 2020,the information about 188,648 patients with acute IS receiving intravenous thrombolytic therapy(IVT),49,845 patients receiving mechanical thrombectomy(MT),and 14,087 patients receiving bridging(IVT+MT)were collected through BOSC.The incidence of intracranial hemorrhage during treatment was 3.2%(95%CI 3.2%–3.3%),7.7%(95%CI 7.5%–8.0%),and 12.9%(95%CI 12.3%–13.4%),respectively.And in-hospital death/discharge against medical advice rate was 8.9%(95%CI 8.8%–9.0%),16.5%(95%CI 16.2%–16.9%),and 16.8%(95%CI 16.2%–17.4%),respectively.A prospective nationwide hospital-based study was conducted at 231 stroke base hospitals(Level III)from 31 provinces in China through BOSC from January 2019to December 2020 and 136,282 stroke patients were included and finished 12-month follow-up.Of those,over 86.9%were IS,10.8%were ICH strokes,and 2.3%were SAH strokes.The disability rate[%(95%CI)]in survivors of stroke at 3-month and 12-month was 14.8%(95%CI 14.6%–15.0%)and 14.0%(95%CI 13.8%–14.2%),respectively.The mortality rate[%(95%CI)]of stroke at 3-month and 12-month was 4.2%(95%CI 4.1%–4.3%)and 8.5%(95%CI 8.4%–8.6%),respectively.The recurrence rate[%(95%CI)]of stroke at 3-month and 12-month was 3.6%(95%CI 3.5%–3.7%)and 5.6%(95%CI 5.4%–5.7%),respectively.The Healthy China 2030 Stroke Action Plan was launched as part of this review,and the above data provide valuable guidelines for future stroke prevention and treatment efforts in China.

Clinical landscape and treatment of acute non-variceal upper gastrointestinal bleeding:Insights from a high-volume center in Shaanxi,China

In this editorial we comment on the article by Wang et al,recently published on World Journal of Clinical Cases.Acute non-variceal upper gastrointestinal bleeding(ANVUGIB)represents a common and potentially serious gastroenterological emergency.Wang et al conducted a detailed study on the management of AN-VUGIB in a high-volume center in the Shaanxi region,China.Analyzing data from over 530 patients provided a comprehensive overview of clinical,epidemio-logical,and treatment characteristics.Results highlighted a younger patient population compared to European studies,with a higher prevalence of gastric and duodenal ulcers as the leading cause of bleeding.Endoscopic treatment is cur-rently the preferred therapeutic option,offering a variety of effective techniques.This study emphasizes the importance of implementing current guidelines in ANVUGIB management and highlights the crucial role of endoscopy in its management.

Epidemiological Analysis of Asymptomatic SARS-CoV-2 Novel Coronavirus Infection Cases in Yinchuan City of Ningxia

Objective:To analyze the epidemiological characteristics of asymptomatic SARS-CoV-2 novel coronavirus infection cases in Yinchuan City,Ningxia.Methods:Cases of asymptomatic SARSCoV-2 novel coronavirus infections discovered in Yinchuan City from February 2020 to April 2020 were taken as the research subjects,epidemiological and laboratory examination data were collected,and statistics and analysis were conducted.Results:Among the 10 cases of asymptomatic infection,6 were males and 4 were females,with an average age of(34.3±2.1)years;2 cases had a history of living in Hubei,8 cases had a history of close contact with confirmed cases;6 cases had no other underlying diseases while the other 4 cases were accompanied by one or more underlying diseases;6 cases were diagnosed as asymptomatic infection by serum-specific IgM antibody detection;4 cases were diagnosed as asymptomatic infection by throat swab testing;there were 4 cases with alanine base transferase level higher than the normal range,2 cases with aspartate aminotransferase level higher than the normal range,and 3 cases with D-dimer level out of the normal range.Conclusion:The asymptomatic SARS-CoV-2 novel coronavirus infection has certain clinical characteristics;it is infectious and has insidious characteristics.Even if medical observation is dismissed,monitoring is still needed to prevent the pandemic from rebounding.

Toward tuberculosis elimination by understanding epidemiologic characteristics and risk factors in Hainan Province, China

Background The disease burden of tuberculosis(TB)was heavy in Hainan Province,China,and the information on transmission patterns was limited with few studies.This atudy aims to further explore the epidemiological charac-teristics and influencing factors of TB in Hainan Province,and thereby contribute valuable scientific evidences for TB elimination in Hainan Province.Methods The TB notification data in Hainan Province from 2013 to 2022 were collected from the Chinese National Disease Control Information System Tuberculosis Surveillance System,along with socio-economic data.The spatial-temporal and population distributions were analyzed,and spatial autocorrelation analysis was conducted to explore TB notification rate clustering.In addition,the epidemiological characteristics of the cases among in-country migrants were described,and the delay pattern in seeking medical care was investigated.Finally,a geographically and tem-porally weighted regression(GTWR)model was adopted to analyze the relationship between TB notification rate and socio-economic indicators.The tailored control suggestions in different regions for TB elimination was provided by understanding epidemiological characteristics and risk factors obtained by GTWR.Results From 2013 to 2022,64,042 cases of TB were notified in Hainan Province.The estimated annual percent-age change of TB notification rate in Hainan Province from 2013 to 2020 was-6.88%[95%confidence interval(CI):-5.30%,-3.69%],with higher rates in central and southern regions.The majority of patients were males(76.33%)and farmers(67.80%).Cases among in-country migrants primarily originated from Sichuan(369 cases),Heilongjiang(267 cases),Hunan(236 cases),Guangdong(174 cases),and Guangxi(139 cases),accounting for 53%.The majority(98.83%)of TB cases were notified through passive case finding approaches,with delay in seeking care.The GTWR analysis showed that gross domestic product per capita,the number of medical institutions and health personnel per 10,oo0 people were main factors affecting the high TB notification rates in some regions in Hainan Province.Dif-ferent regional tailored measures such as more TB specialized hospitals were proposed based on the characteristics of each region.Conclusions The notification rate of TB in Hainan Province has been declining overall but still remained high in central and southern regions.Particular attention should be paid to the prevalence of TB among males,farmers,and outof-province migrant populations.The notification rate was also influenced by economic development and medical conditions,indicating the need of more TB specialized hospitals,active surveillance and other tailored prevention and control measures to promote the progress of TB elimination in Hainan Province.