Prevention and Control Strategies of Nosocomial Infection and Effectiveness Evaluation in a Tertiary Teaching Hospital during the Epidemic of COVID-19

Objective: To evaluate the role of prevention and control strategies for nosocomial infection in a tertiary teaching hospital during the sudden outbreak of Corona Virus Disease 2019 (COVID-19). Methods: The hospital initiated an emergency plan involving multi-departmental defense and control. It adopted a series of nosocomial infection prevention and control measures, including strengthening pre-examination and triage, optimizing the consultation process, improving the hospital’s architectural composition, implementing graded risk management, enhancing personal protection, and implementing staff training and supervision. Descriptive research was used to evaluate the short-term effects of these in-hospital prevention and control strategies. The analysis compared changes in related evaluation indicators between January 24, 2020 and February 12, 2020 (Chinese Lunar New Year’s Eve 2020 to lunar January 19) and the corresponding lunar period of the previous year. Results: Compared to the same period last year, the outpatient fever rate increased by 1.85-fold (P P Conclusion: The nosocomial infection prevention and control strategies implemented during this specific period improved the detection and control abilities for the COVID-19 source of infection and enhanced the compliance with measures. This likely contributed significantly to avoiding the occurrence of nosocomial infection.

Epidemiology and prevention of hepatitis B virus in China

Hepatitis B virus （HBV） infection is prevalent in China. Approximately 600 million people have ever been infected by HBV. About 130 million are HBV chronic carders and 30 million HB patients. Among them, 50% of HBV carriers are caused by carrier mothers to born infants. Around 300 000 people died of liver disease including liver cirrhosis and primary hepatocellular carcinoma each year and 50% of them died of primary hepatocellular carcinoma. HBV infection is not only the health problem but also becoming a social problem. HBV chronic carriers and patients have endured the great pressure from disease burden and social discrimination. According to the report of the national screening program of HBV released by the ministry of health in 2008, China has taken many effective measures to control the HBV infection, including vaccine immunization program, strengthening the management of blood sources and blood productions, prevention of nosocomial HBV infection, strengthening health education on HBV infection and safe injection techniques. The implementation of HB vaccine immunization program, which China officially introduced into the national immunization program since 1992, has dramatically reduced the incidence of HBV infection among infants and children. Integrated with other interventions, the rate of HBV infection decreased gradually. According to the survey of the national screening program of HBV in 2006, compared with the incidence of HBV in 1992, the incidence rate of HBsAg positive has decreased 26.36%, the number of children who have ever been infected by HBV decreased 80 million since 1992. However some problems are still existing. The solutions of low rate of vaccination in rural areas and migration population, lacking of practical measures on management of hepatitis B patients, the occurrence of health care acquired HBV infection, and low rate of vaccination among high risk groups have also been recommended.

Nucleos(t)ide analogs in the prevention of hepatitis B virus related hepatocellular carcinoma

Hepatocellular carcinoma(HCC) is among the most common cancer types and causes of cancer related mortality worldwide.Almost 50% of all HCC cases globally are attributable to chronic hepatitis B virus(HBV) infection.The incidence rates of HCC in untreated Asian subjects with HBV infection was estimated to be 0.2% in inactive carriers,0.6% for those with chronic hepatitis without cirrhosis,and 3.7% for those with compensated cirrhosis.In Western populations,HCC incidences are reported to be 0.02% in inactive carriers,0.3% in subjects with chronic hepatitis without cirrhosis,and 2.2% in subjects with compensated cirrhosis.Despite effective antiviral treatment options which are able to transform chronic hepatitis into an inactive carrier state,the risk of HCC cannot be fully ruled out to exclude those patients from surveillance.Newer nucleos(t)ide analogues(NAs) as entecavir and tenofovir are very potent in terms of sustained virological suppression which leads to improved liver histology.However,they do not have any influence on the ccc DNA or integrated DNA of HBV in the liver.Nonetheless,viral replication is the only modifiable component among the established risk factors for HBV-related HCC with the current treatment options.In this review,it was aimed to summarize cumulative evidence behind the concept of prevention of HBV related HCC by NAs,and to discuss remaining obstacles to eliminate the risk of HCC.

Research Progress and Prospect on Prevention and Control Measures of Sweet Potato Virus Disease

Sweet potato virus disease is a serious biological threat to sweet potato,which seriously affects the development of sweet potato industry in China.This paper gives a brief introduction to the main defensive measures of sweet potato virus disease,such as cutting of virus infection source,killing of viral transmission media,cultivation and application of virus-free sweet potato,use of antiviral agents,breeding of varieties with virus resistance,and mild strain cross protection,so as to provide some reference for this field.

Epidemiology of hepatitis C virus exposure in Egypt: Opportunities for prevention and evaluation

AIM: To critically evaluate the current epidemiology data on exposures, rather than infection, to hepatitis C virus(HCV) transmission and recommend epidemiologic strategies to fill gaps. METHODS: Standard methods for identifying and evaluating relevant epidemiologic literature and available data were used. RESULTS: There is a large body of literature on the epidemiology of HCV transmission in Egypt that collectively identifies ongoing iatrogenic exposures as the major driver for HCV transmission due to short comings in infection control and standard procedures. Additional epidemiologic studies on HCV transmission that requires the participation of human subject is unwarranted. Alternatively, very little literature was found on the epidemiology of exposure to HCV, infection control, and safe injection practices. The information that is available on patterns of HCV exposure shows high frequencies of inadequate infection control, problems in sterilization in health care facilities, low rates of hand washing, untrained personnel, lack of stated policies in facilities, HCV contamination of instruments and very large injection frequencies with low but very significant syringe and needle reuse. There is an important need to increase the number, size, and diversity of epidemiologic studies on HCV exposures, patterns of risk factors for infection, infection control, and safe injection practices. In addition to health care facilities evaluation, relevant knowledge attitude and practice studies are recommended. CONCLUSION: Epidemiologic methods on HCV ex-posure can be used to characterize the magnitude of exposures to HCV infection, target interventions to reduce exposures, and provide the best method for evaluating interventions by demonstrating the reduction of exposure to HCV infection.

Prevention of Avian Influenza Virus by Ultraviolet Radiation and Prediction of Outbreak by Satellite Parameters

The present study showed that avian influenza virus (AIV) occurred in the regions with rice and wheat productions under low ultraviolet (UV) radiation while there were negligible AIV outbreaks in the regions with a high rate of skin cancer due to extensive UV radiation. It is therefore proposed that having artificial UV radiation with poultry farmhouses is a simple solution to suppress AIV outbreaks. AIV outbreaks can be predicted a few months in advance by remote sensing satellite parameters such as Cosmos (minimum sunspot number, 10.7 cm solar flux, high UV radiation), Poles (CO2, O3 hole deterioration, hydroxyl layer temperature, ice-melting, chlorophyll or algae, krill, penguin, guillemot), and Continents (migratory birds, desert dust, low UV radiation, waters, fish, rice and wheat, climate). Since there was an abrupt 2% rise of global CO2 emissions in 2017, while the minimum sunspot number is simultaneously reached at the end of 2018, there can be an extensive UV radiation for mutant AIV in the Poles to have the highest degree of damage by AIV in regions such as U.S., East Asia, China, South Korea, Japan, west Africa, and Europe from November of 2018 till April of 2019.

Knowledge of Zika Virus Disease Prevention Methods, among Female Caregivers That Bring Babies for Immunization in a Teaching Hospital, Southeast Nigeria

Zika virus disease is a disease of public health importance and was declared a “Public Health Emergency of International Concern”, by the World Health Organization on February 1, 2016. It is mostly transmitted through the bite of Aedes aegypti and Aedes albopictus mosquitos. Transmission can also occur through blood transfusion and sexual intercourse. It could cause microcephaly and other neurological problems in newborns and adults, such as Guillain-Barre syndrome. It could also lead to abortion and stillbirth in pregnant women. Prevention methods are essentially targeted at transmission routes, which are mosquito bite, sexual intercourse, and blood transfusion. The study was of observational, descriptive, cross-sectional design, and conducted in a tertiary health institution in the Southeast geopolitical zone of Nigeria. Two hundred and fifty-six female caregivers participated in the study, with most of them being within the childbearing age group, and educated up to tertiary level. The objective was to assess the knowledge of Zika virus infection prevention methods, among female caregivers that bring babies for immunization in a Teaching Hospital, Southeast Nigeria. Out of the eight questions that sought to assess the knowledge level of the respondents, they scored 50% and above only in three, which were on prevention through protection against mosquito bite (60.5%), avoiding unnecessary blood transfusion in endemic areas (53.9%), and avoidance of oily meals not being a preventive measure (51.2%). Respondents in the childbearing age group, and those with higher educational qualifications, generally exhibited higher knowledge level than the other respondents. Scores on questions that sought to assess their knowledge on prevention aspects related to sexual behavior, and vaccination were poor. Sensitization, or awareness creation activities for persons in this study area, ought to be designed to address the observed gaps.

Diagnosis and Prevention of Duck Virus Enteritis

The characteristics of duck virus enteritis(DVE)are introduced from the aspects of pathogen,epidemiology,clinical symptoms,autopsy pathological changes,etc.,and clinical comprehensive diagnosis and laboratory diagnosis methods are given.The disease is distinguished from similar diseases including duck necrotic enteritis,duck candidiasis,duck hemorrhage,duck coccidiosis and duck vitamin A deficiency.Eventually,the prevention and treatment measures of the disease are put forward.

Study on Microsatellite Distribution in Complete Genomes of Tobacco Vein Clearing Virus

MATLAB software and optimal complete subgraph algorithm were used to extract and reveal the microsatellite distribution features in the complete genomes of the tobacco vein clearing virus （NC-003 378.1） from the NCBI database.The results showed that the repetitions number and their location of the N-base group has been extracted and displayed.The largest repetitions of N-base group in the complete genomes of the tobacco vein clearing virus was decreased as the exponential function with the increasing of N.The method used in this study could be applied to the extraction and revealing of the microsatellite distribution features in the complete genomes of other viruses,thereby provided a basis for the research of the structure and the law of function,inheritance and variation by the using of the microsatellite distribution features.

Control Effect of Bio-guide Wasp Virus Missile on Ostrinia furnacalis and Its Benefits for Maize Production in Nanchong City

In order to promote ＂green plant protection＂, reduce the administration dosage and residue of pesticides and control cost of environment pollution, and improve maize production, quality and agricultural ecological environment safety. In this study, the control effect and benefit of bio-guide wasp virus missile（BGWVM） on Ostrinia furnacalis in Nanchong City was investigated by using insect light traps and combined method of field investigation and experimental demonstration. According to the results, applying 30-37 pairs of BGWVM per hectare exhibited an average control efficiency of 78.0%, and the control cost was 139.50-172.50 CNY/hm2, which was reduced by 142.50-168.00 CNY/hm^2 compared with conventional chemical control. Average maize yield in BGWVM demonstration plot was 817.8 kg/hm2 higher and improved by 11.0% compared with blank control plot. The output value was improved by 1 799.16 CNY/hm^2 and the revenue increased by 1 941.66-1 967.16CNY/hm2. During 2003-2014, the cumulative demonstration and popularization area of BGWVM technique in Nanchong City had reached 24 507.33 hm^2, and the cumulative yield increment reached 20.042 1 million kg. BGWVM application improved total output value by 44.092 6 million CNY and saved control cost by 3.492 3-4.117 2 million CNY, thus increasing the revenue by 47.584 9-48.209 8 million CNY. BGWVM application reduced 551.41 t of 5% dimehypo GG or 12.87 t of 90%monosultap WP. In addition, BGWVM technique is simple to use, labor-saving and safe for human, animals, environment and crops, with significant economic, ecological and social benefits and without any side effect, which has become an ideal substitute for controlling O. furnacalis and reducing chemical pesticides in organic agriculture industry, modern agriculture industry, production of green and pollution-free agricultural products and IBM prevention and control demonstration gardens.

Prevention of hepatocellular carcinoma in chronic viral hepatitis B and C infection

Hepatocellular carcinoma(HCC)is a leading cause of cancer-related mortality worldwide,with the majority of cases associated with persistent infection from hepatitis B virus(HBV)or hepatitis C virus(HCV).Natural history studies have identified risk factors associated with HCC development among chronic HBV and HCV infection.High-risk infected individuals can now be identified by the usage of risk predictive scores.Vaccination plays a central role in the prevention of HBV-related HCC.Treatment of chronic HBV infection,especially by nucleoside analogue therapy,could also reduce the risk of HBV-related HCC.Concerning HCV infection,besides the advocation of universal precautions to reduce the rate of infection,pegylated interferon and ribavirin could also reduce the risk of HCV-related HCC among those achieving a sustained virologic response.Recently there has been mounting evidence on the role of chemopreventive agents in reducing HBV-and HCV-related HCC.The continued advances in the understanding of the molecular pathogenesis of HCC would hold promise in preventing this highly lethal cancer.

Global elimination of hepatitis C virus infection:Progresses and the remaining challenges

Today, with the introduction of interferon-free direct-acting antivirals and outstanding progresses in the prevention, diagnosis and treatment of hepatitis C virus(HCV) infection, the elimination of HCV infection seems more achievable. A further challenge is continued transmission of HCV infection in high-risk population specially injecting drug users(IDUs) as the major reservoir of HCV infection. Considering the fact that most of these infections remain undiagnosed, unidentified HCVinfected IDUs are potential sources for the rapid spread of HCV in the community. The continuous increase in the number of IDUs along with the rising prevalence of HCV infection among young IDUs is harbinger of a forthcoming public health dilemma, presenting a serious challenge to control transmission of HCV infection. Even the changes in HCV genotype distribution attributed to injecting drug use confirm this issue. These circumstances create a strong demand for timely diagnosis and proper treatment of HCV-infected patients through risk-based screening to mitigate the risk of HCV transmission in the IDUs community and, consequently, in the society. Meanwhile, raising general awareness of HCV infection, diagnosis and treatment through public education should be the core activity of any harm reduction intervention, as the root cause of failure in control of HCV infection has been lack of awareness among young drug takers. In addition, effective prevention, comprehensive screening programs with a specific focus on high-risk population, accessibility to the new anti-HCV treatment regimens and public education should be considered as the top priorities of any health policy decision to eliminate HCV infection.

Hepatitis C-related liver cirrhosis-strategies for the prevention of hepatic decompensation,hepatocarcinogenesis,and mortality

Liver cirrhosis (LC) is a critical stage of chronic liver disease, including that caused by hepatitis C virus (HCV). In the absence of antiviral therapy, 67%-91% of patients with HCV-related LC patients die of liver-related causes, including hepatocellular carcinoma (HCC) and liver failure. Among the therapeutic strategies used to prevent liver-related complications in these patients is standard therapy with pegylated interferon and ribavirin, which induces a sustained virological response (SVR) in 25% of HCV genotype 1-infected patients and in 69% of patients infected with genotypes 2 and 3. SVR in patients with HCV-related LC has been associated with reduced rates of hepatic decompensation, HCC, and mortality. More recently developed direct-acting antiviral agents have shown excellent antiviral efficacy, with preliminary data demonstrating that an interferon-free regimen that includes these direct-acting antiviral agents achieved SVR in more than 50% of patients with HCV genotype 1 LC. Branched-chain amino acid supplementation, improvement of insulin resistance, and the use of β-blockers for portal hypertension may also reduce liver-related complications. Here, we review advances in antiviral and adjunctive therapies for improved outcomes in patients with HCV-associated LC.

Thirty years of the human immunodeficiency virus epidemic and beyond

After more than 30 years of battling a global epidemic, the prospect of eliminating human immunodeficiency virus （HIV） as the most challenging infectious disease of the modern era is within our reach. Major scientific discoveries about the virus responsible for this immunodeficiency disease state, including its pathogenesis, transmission patterns and clinical course, have led to the development of potent antiretroviral drugs that offer great hopes in HIV treatment and prevention. Although these agents and many others still in development and testing are capable of effectively suppressing viral replication and survival, the medical management of HIV infection at the individual and the population levels remains challenging. Timely initiation of antiretroviral drugs, adherence to the appropriate therapeutic regimens, effective use of these agents in the pre and post-exposure prophylaxis contexts, treatment of comorbid conditions and addressin~ social and nsvcholo2ical factors involved in the care of individuals continue to be important considerations.

Prevention of hepatitis B reactivation in patients requiring chemotherapy and immunosuppressive therapy

Hepatitis B virus(HBV)reactivation can lead to severe acute hepatic failure and death in patients with HBV infection.HBV reactivation(HBVr)most commonly develops in patients undergoing cancer chemotherapy,especially B cell-depleting agent therapy such as rituximab and ofatumumab for hematological or solid organ malignancies and that receiving hematopoietic stem cell transplantation without antiviral prophylaxis.In addition,the potential consequences of HBVr is particularly a concern when patients are exposed to either immunosuppressive or biologic therapies for the management of rheumatologic diseases,inammatory bowel disease and dermatologic diseases.Thus,screening with HBV serological markers and prophylactic or pre-emptive antiviral treatment with nucleos(t)ide analogues should be considered in these patients to diminish the risk of HBVr.This review discusses the clinical manifestation,prognosis and management of HBVr,risk stratifications of cancer chemotherapy and immunosuppressive therapy and international guideline recommendations for the prevention of HBVr in patients with HBV infection and resolved hepatitis B.

Review of varicella-zoster virus infections in pregnant women and neonates

Even though varicella is rare in pregnancy, the disease can lead occasionally to disastrous illnesses for both the mother and her neonate. By contrast, normal zoster is not associated with special problems during pregnancy and peri- natal period. Pregnant women, who contract varicella, are at risk of varicella pneumonia which must be regarded as medical emergency. At any stage during pregnancy, chickenpox may cause intrauterine infection. The consequences for the fetus depend on the time of maternal disease. During the first two trimesters, maternal varicella may result in congenital varicella syndrome which may occur in nearly 2%. Typical symptoms are skin lesions in dermatomal distribution, neurological defects, eye diseases, and skeletal anomalies. Maternal infection near term is associated with a substantial risk of intrauterine acquired neonatal chickenpox in the neonate. If the mother develops varicella rash between day 4 (5) ante partum and day 2 post partum, generalized neonatal varicella leading to death in about 20% of the cases has to be expected. The present paper reviews the clinical consequences and the currently available concepts of prevention, diagnosis, and therapy of varicella-zoster virus infections during pregnancy.

Advances in treatment and prevention of hepatitis B

Chronic hepatitis B(CHB)continues to contribute to worldwide morbidity and mortality significantly.Scientists,clinicians,pharmaceutical companies,and health organizations have dedicated substantial Intellectual and monetary resources to finding a cure,increasing immunization rates,and reducing the global burden of CHB.National and international health-related organizations including the center for disease control,the national institute of health,the American Association for the study of liver disease(AASLD),The European association for the study of the Liver(EASL),The Asia Pacific association for the study of the Liver(APASL)and the world health organization release periodic recommendations for disease prevention and treatment.Our review of the most recent guidelines by EASL,AASLD,APASL,and Taiwan Association for the Study of the Liver revealed that an overwhelming majority of cited studies were published before 2018.We reviewed Hepatitis B-related literature published 2018 onwards to identify recent developments and current barriers that will likely direct future efforts towards eradicating hepatitis B.The breakthrough in our understanding of the hepatitis B virus life cycle and resulting drug development is encouraging with significant room for further progress.Data from high-risk populations,most vulnerable to the devastating effects of hepatitis B infection and reactivation remain sparse.Utilization of systems approach,optimization of experimental models,identification and validation of next-generation biomarkers,and precise modulation of the human immune response will be critical for future innovation.Within the foreseeable future,new treatments will likely complement conventional therapies rather than replace them.Most Importantly,pragmatic management of CHB related population health challenges must be prioritized to produce real-world results.

Baseline survey of pregnant women's knowledge of treatment to prevent mother- to-child human immunodeficiency virus transmission in a resource limited setting

Despite continuing advances in scientific knowledge about treatments to prevent mother-to-child(MTCT)of the human immune deficiency virus(HIV),there is a paucity of data on pregnant women’s knowledge of treatments to prevent MTCT of HIV in Aba,South Eastern Nigeria.We investigated pregnant women’s knowledge of the availability of treatments to prevent MTCT of HIV in the low resourced setting of Aba town in South Eastern Nigeria.A descriptive study involving 100 consecutive and consenting patients at the antenatal clinic of Abia State University Teaching Hospital(ABSUTH),Aba,South Eastern Nigeria over the period 1st November, 2007 to 30th November,2007.Using a structured questionnaire,the respondents’sociodemographic data were obtained as well as their knowledge of the availability of treatments to prevent mother to child HIV transmission in pregnant women and self-reported data on their having ever tested for HIV.Knowledge regarding availability of treatment to prevent mother to child transmission of HIV was good as 95%of the respondents were aware that such treatment was available.Knowledge that treatment is available to help someone infected by HIV to live longer was also good as 96% of the respondents were aware of the availability of such treatment.Seventy one percent of the respondents had ever tested for HIV.The levels of knowledge regarding the availability of treatment to prevent mother to child HIV transmission and to help someone infected with HIV are good.Thus, utilization of anti-retroviral prophylaxis amongst HIV infected pregnant women in this community would be expected to be high if the drugs were available.This will reduce the impact of HIV,especially in children.

Cancer prevention in patients with human immunodeficiency virus infection

Cancer is a leading cause of death in patients with human immunodeficiency virus(HIV) infection. With the advent of antiretroviral treatment, the risk of AIDS-defining cancers declined but the ageing of this population resulted in the emergence of other common cancers, particularly lung and hepatocellular cancer. Accordingly, screening programs similar to the general population should be implemented in patients with HIV infection. Vaccination against common oncogenic viruses is also essential. However, rates of cancer screening and vaccination against HPV and HBV are considerably low in this population, highlighting a pressing need to educate patients and healthcare professionals about the importance of cancer preventive measures in these vulnerable patients.

Obstetrical Surgery in the Context of Ebola Virus Disease (Ebola) in Guinea: Lessons Learned from 2 Cases

In this manuscript, the authors have studied obstetrical surgery in the context of Ebola virus disease in Guinea. No protocol recommends childbirth outside of Ebola treatment center, although it has no technical platform and no qualified providers in this area. These were unknown MVE cases in pregnant women/parturient women aged 25 and 40 years, with no education, who were confirmed in the RT-PCR test after surgical management. To fight Ebola virus transmission, traditional protection protocols must be strengthened. Training, supervision and monitoring of providers are key elements for the protection of staff in the event of an EVD outbreak. Improving working conditions and strengthening hand washing, usage of PPE/EPP, decontamination of equipment with 0.5% chlorine solution, hygiene of premises, immunization of personnel involved, are effective measures to combat EVD.