Expert consensus on One Health for establishing an enhanced and integrated surveillance system for key infectious diseases

China has been continuously improving its monitoring methods and strategies to address key infectious diseases(KIDs).After the severe acute respiratory syndrome epidemic in 2003,China established a comprehensive report-ing system for infectious diseases(IDs)and public health emergencies.The relatively lagging warning thresholds,limited warning information,and outdated warning technology are insufficient to meet the needs of comprehensive monitoring for modern KIDs.Strengthening early monitoring and warning capabilities to enhance the public health system has become a top priority,with increasing demand for early warning thresholds,information,and tech-niques,thanks to constant innovation and development in molecular biology,bioinformatics,artificial intelligence,and other identification and analysis technologies.A panel of 31 experts has recommended a fourth-generation comprehensive surveillance system targeting KIDs(41 notifiable diseases and emerging IDs).The aim of this surveil-lance system is to systematically monitor the epidemiology and causal pathogens of KIDs in hosts such as humans,animals,and vectors,along with associated environmental pathogens.By integrating factors influencing epidemic spread and risk assessment,the surveillance system can serve to detect,predict,and provide early warnings for the occurrence,development,variation,and spread of known or novel KIDs.Moreover,we recommend comprehensive ID monitoring based on the fourth-generation surveillance system,along with a data-integrated monitoring and early warning platform and a consortium pathogen detection technology system.This series of considerations is based on systematic and comprehensive monitoring across multiple sectors,dimensions,factors,and pathogens that is sup-ported by data integration and connectivity.This expert consensus will provides an opportunity for collaboration in various fields and relies on interdisciplinary application to enhance comprehensive monitoring,prediction,and early warning capabilities for the next generation of ID surveillance.This expert consensus will serve as a reference for ID prevention and control as well as other related activities.

The History of Controlling and Treating Infectious Diseases in Ancient China

Infectious diseases are the common enemies of mankind.In the course of historical development,they persistently threaten human health and safety.Even today,despite the developments in medical science,we cannot escape the fear and suffering caused by infectious diseases.Whether in ancient or modern times,the source of infection,route of transmission,and a susceptible population are the three key conditions for the prevalence and spread of infectious diseases.All factors closely related to these three conditions can affect the prevalence of infectious diseases.China is one of the cradles of world civilization.The ancient people accumulated a great deal of experience and lessons in the long struggle against infectious diseases.In the face of the current threat posed by widespread infectious disease,it is imperative to review and summarize ancient Chinese ideas and health policies on epidemic prevention and control to inspire contemporary efforts in the prevention and control of infectious disease.The combination of prevention-oriented epidemic prevention ideology and traditional medicine provides valuable insights,especially for impoverished and medically underserved regions.

Genetic and pathogenic characterization of new infectious bronchitis virus strains in the GVI-1 and GI-19 lineages isolated in central China

Avian infectious bronchitis(IB)is a highly contagious infectious disease caused by infectious bronchitis virus(IBV),which is prevalent in many countries worldwide and causes serious harm to the poultry industry.At present,many commercial IBV vaccines have been used for the prevention and control of IB;however,IB outbreaks occur frequently.In this study,two new strains of IBV,SX/2106 and SX/2204,were isolated from two flocks which were immunized with IBV H120 vaccine in central China.Phylogenetic and recombination analysis indicated that SX/2106,which was clustered into the GI-19 lineage,may be derived from recombination events of the GI-19 and GI-7 strains and the LDT3-A vaccine.Genetic analysis showed that SX/2204 belongs to the GVI-1 lineage,which may have originated from the recombination of the GI-13 and GVI-1 strains and the H120 vaccine.The virus cross-neutralization test showed that the antigenicity of SX/2106 and SX/2204 was different from H120.Animal experiments found that both SX/2106 and SX/2204 could replicate effectively in the lungs and kidneys of chickens and cause disease and death,and H120 immunization could not provide effective protection against the two IBV isolates.It is noteworthy that the pathogenicity of SX/2204 has significantly increased compared to the GVI-1 strains isolated previously,with a mortality rate up to 60%.Considering the continuous mutation and recombination of the IBV genome to produce new variant strains,it is important to continuously monitor epidemic strains and develop new vaccines for the prevention and control of IBV epidemics.

Bioactivities,Mechanisms,Production,and Potential Application of Bile Acids in Preventing and Treating Infectious Diseases

Infectious diseases are a global public health problem,with emerging and re-emerging infectious diseases on the rise worldwide.Therefore,their prevention and treatment are still major challenges.Bile acids are common metabolites in both hosts and microorganisms that play a significant role in controlling the metabolism of lipids,glucose,and energy.Bile acids have historically been utilized as first-line,valuable therapeutic agents for related metabolic and hepatobiliary diseases.Notably,bile acids are the major active ingredients of cow bezoar and bear bile,which are commonly used traditional Chinese medicines(TCMs)with the therapeutic effects of clearing heat,detoxification,and relieving wind and spasm.In recent years,the promising performance of bile acids against infectious diseases has attracted attention from the scientific community.This paper reviews for the first time the biological activities,possible mechanisms,production routes,and potential applications of bile acids in the treatment and prevention of infectious diseases.Compared with previous reviews,we comprehensively summarize existing studies on the use of bile acids against infectious diseases caused by pathogenic microorganisms that are leading causes of global morbidity and mortality.In addition,to ensure a stable supply of bile acids at affordable prices,it is necessary to clarify the biosynthesis of bile acids in vivo,which will assist scientists in elucidating the accumulation of bile acids and discovering how to engineer various bile acids by means of chemosynthesis,biosynthesis,and chemoenzymatic synthesis.Finally,we explore the current challenges in the field and recommend a development strategy for bile-acid-based drugs and the sustainable production of bile acids.The presented studies suggest that bile acids are potential novel therapeutic agents for managing infectious diseases and can be artificially synthesized in a sustainable way.

Identification of Early Warning Signals of Infectious Diseases in Hospitals by Integrating Clinical Treatment and Disease Prevention

The global incidence of infectious diseases has increased in recent years,posing a significant threat to human health.Hospitals typically serve as frontline institutions for detecting infectious diseases.However,accurately identifying warning signals of infectious diseases in a timely manner,especially emerging infectious diseases,can be challenging.Consequently,there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals.This paper examines the role of medical data in the early identification of infectious diseases,explores early warning technologies for infectious disease recognition,and assesses monitoring and early warning mechanisms for infectious diseases.We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems,in compliance with national strategies to integrate clinical treatment and disease prevention.Furthermore,hospitals should establish institution-specific,clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.

A surgical alternative of fusiform penetrating keratoplasty for the management of severe infectious keratitis

AIM:To describe the surgical procedure of fusiform penetrating keratoplasty(FPK)using multiple trephines of different sizes for treating patients with severe infectious keratitis.METHODS:Fourteen eyes underwent FPK,and 15 eyes received conventional penetrating keratoplasty(PK)were included in the study.The best-corrected visual acuity(BCVA),refractive outcomes,endothelial cell density,and postoperative complications were recorded.RESULTS:The FPK group was followed for an average of 15.3±2.1mo,whereas the PK group was followed for 16.1±1.9mo.The corneal ulcers were elliptical-shaped in all 14 eyes in the FPK group.The mean BCVA(logMAR,0.26±0.13)showed no statistically significant differences from that in the PK group(logMAR,0.21±0.12,P>0.05)at 1y after surgery.But the mean curvature,mean astigmatism,and mean spherical equivalent in the FPK group were lower than those in the PK group(P<0.05).Peripheral anterior synechia was observed in one patient in the FPK group,whereas 6 patients in the PK group.Suture loosening and neovascularization were observed in 4 and 5 eyes in the PK group,respectively.No graft immune rejection or elevation of intraocular pressure was observed in the two groups.CONCLUSION:For patients with elliptical-shaped corneas or corneal ulcers,FPK can avoid disrupting of corneal limbus,reduce the risk of postoperative complications,and can result in satisfactory visual quality.

Influencing factors and preventive measures of infectious complications after intestinal resection for Crohn’s disease

The incidence of Crohn’s disease(CD)has increased in recent years,with most patients requiring intestinal resection.Complications after intestinal resection for CD can lead to poor prognosis and recurrence,among which infectious complic-ations are the most common.This study aimed to investigate the common risk factors,including medications,preoperative nutritional status,surgery-related factors,microorganisms,lesion location and type,and so forth,causing infectious complications after intestinal resection for CD,and to propose corresponding preventive measures.The findings provided guidance for identifying suscept-ibility factors and the early intervention and prevention of infectious complic-ations after intestinal resection for CD in clinical practice.

Climate change and the emergence and exacerbation of infectious diseases:A review

Experts expressed severe concerns over the possibility of increasing burden of infectious diseases as the planet’s climate began to change years ago.There have been increased rates of climate-related catastrophes and as global temperatures rise,emergence of certain viruses has become a serious concern.Vectors are susceptible to changing temperatures as they exhibit innate responses to thermal stress to increase survivability.Climate change impacts virus reservoirs,increasing transmission rates of vectors.Vector-borne diseases have already witnessed increasing numbers compared to before.Certain non-endemic areas are encountering their first-ever infectious disease cases due to increasing temperatures.Tick-borne diseases are undergoing transformations provoking a heightened prevalence.Food-borne illnesses are expected to increase owing to warmer temperatures.It is important to recognize that climate change has a multivariable impact on the transmission of viruses.With climate change comes the potential of increasing interspecies interactions promoting jumps.These factors must be considered,and an informed strategy must be formulated.Adaptation and mitigation strategies are required to curb these diseases from spreading.Despite significant evidence that climate change affects infectious diseases,gaps in research exist.We conducted this review to identify the potential role climate change plays in the emergence of new viruses.

Research Advances in Infectious Mononucleosis Caused by Epstein-Barr Virus

Infectious mononucleosis (IM), primarily caused by the Epstein-Barr virus (EBV), manifests as the classic triad of fever, pharyngitis, and cervical lymphadenopathy. Severe cases may involve organ damage, most commonly affecting the liver. Diagnosis relies on a combination of clinical presentation and laboratory parameters, with commonly used indicators including EBV-specific antibodies, EBV-DNA load, and the ratio of atypical lymphocytes. Treatment primarily involves symptomatic supportive care, with a cautious approach to the routine use of antiviral medications. In recent years, significant research in traditional Chinese medicine has been conducted in China, showing promising advancements. This article provides a comprehensive review of EBV-induced infectious mononucleosis, offering insights for clinical diagnosis and treatment.

Compliance of Physicians with Standard Precautions of Handling Patients with Infectious Respiratory Disease

Background: Standard precautions (SPs) are the minimum infection prevention practices that aim to protect Health care workers (HCWs) including physicians and prevent them from transmitting the infections to their patients. Purpose: To assess the level of compliance of physicians with standard precautions of handling patients with infectious respiratory disease. Method: A cross sectional questionnaire-based study was conducted in two tertiary level hospitals named M Abdur Rahim Medical College and Hospital, Dinajpur, Bangladesh and Rajshahi Medical College and Hospital, Rajshahi, Bangladesh to assess the level of compliance of physicians with standard precautions. Purposive sampling technique was applied as per inclusion criteria and data was collected by face to face interview from 285 physicians. Statistical analysis of the results was done by SPSS and a p value less than 0.05 was considered as significant. Result: The study revealed that maximum physicians (76.5%) handling patients with infectious respiratory disease had a moderate level of compliance with standard precautions. 78.6% of the physicians had moderate level of awareness about standard precautions. Only 20.35% of the physicians had training on infection control. 94.4% of the respondents didn’t know the component of standard precaution and most of the physicians were not aware of the sequence of wearing and removing the different components of PPEs. Conclusion: The study result implies that with increased awareness, the compliance of the physicians with standard precautions increased. The main reasons of non-compliance with standard precautions were found to be lack of resources, lack of regular training and excess workload.

Emerging role of the gut microbiome in post-infectious irritable bowel syndrome:A literature review

Post-infectious irritable bowel syndrome(PI-IBS)is a particular type of IBS,with symptom onset after an acute episode of infectious gastroenteritis.Despite infectious disease resolution and clearance of the inciting pathogen agent,10%of patients will develop PI-IBS.In susceptible individuals,the exposure to pathogenic organisms leads to a marked shift in the gut microbiota with prolonged changes in host-microbiota interactions.These changes can affect the gut-brain axis and the visceral sensitivity,disrupting the intestinal barrier,altering neuromuscular function,triggering persistent low inflammation,and sustaining the onset of IBS symptoms.There is no specific treatment strategy for PI-IBS.Different drug classes can be used to treat PI-IBS similar to patients with IBS in general,guided by their clinical symptoms.This review summarizes the current evidence for microbial dysbiosis in PI-IBS and analyzes the available data regarding the role of the microbiome in mediating the central and peripheral dysfunctions that lead to IBS symptoms.It also discusses the current state of evidence on therapies targeting the microbiome in the management of PI-IBS.The results of microbial modulation strategies used in relieving IBS symptomatology are encouraging.Several studies on PI-IBS animal models reported promising results.However,published data that describe the efficacy and safety of microbial targeted therapy in PI-IBS patients are scarce.Future research is required.

Alzheimer’s disease risk after COVID-19:a view from the perspective of the infectious hypothesis of neurodegeneration

In light of the rising evidence of the association between viral and bacterial infections and neurodegeneration,we aimed at revisiting the infectious hypothesis of Alzheimer’s disease and analyzing the possible implications of COVID-19 neurological sequelae in long-term neurodegeneration.We wondered how SARS-CoV-2 could be related to the amyloid-βcascade and how it could lead to the pathological hallmarks of the disease.We also predict a paradigm change in clinical medicine,which now has a great opportunity to conduct prospective surveillance of cognitive sequelae and progression to dementia in people who suffered severe infections together with other risk factors for Alzheimer’s disease.

Characterisation and separation of infectious bursal disease virus-like particles using aqueous two-phase systems

Infectious bursal disease(IBD)causes considerable economic losses in the commercial poultry industry worldwide.The principal way to control IBD virus(IBDV),the causative agent of IBD,is still through vaccination programs.Virus-like particles(VLPs)are recognised as a safe and potent recombinant vaccine platform.This research work explores the characterisation and separation of infectious bursal disease virus-like particles(IBD-VLPs)from crude feedstock.Various characteristics were studied with highperformance size-exclusion chromatography(HP-SEC),sodium dodecyl sulphate–polyacrylamide gel electrophoresis(SDS-PAGE)and transmission electron microscopy(TEM)analyses.Subsequently,the separation of IBD-VLPs using polyethylene glycol(PEG)/sodium citrate-based aqueous two-phase systems(ATPSs)was conducted and optimised.Moreover,a scale-up study of the best ATPS constituted of 15%PEG 6000,11%sodium citrate and 10%crude feedstock was performed to compare the separation performance of IBD-VLPs with and without centrifugation-assisted.The results indicated that the optimised ATPS with centrifugation-assisted for both 5 g and 50 g systems showed good recovery of IBDVLPs of>97%in the interphase between the PEG-rich top and salt-rich bottom phases.These optimised systems also showed high removal efficiencies of impurities of>95%.The results demonstrated that aqueous two-phase extraction could be a promising technology for efficient VLPs separation.

美国《Emerging Infectious Diseases》2023年第8期有关人兽共患病论文摘译

P1506日本溃疡棒状杆菌感染的临床特点//Akihiko Yamamoto,Toru Hifumi,Manabu Ato,等,溃疡棒状杆菌是一种与白喉杆菌密切相关的细菌,一些溃疡杆菌菌株产生的毒素与白喉杆菌毒素相似。溃疡菌在环境中到处可见,被认为是对牲畜和野生动物最有害的病原体之一。

美国《Emerging Infectious Diseases》2023年第6期有关人兽共患病论文摘译

P1091神经莱姆病后持续症状与血液中IFN-α水平升高的相关性//Sergio A.Hernández,Katarina Ogrinc,Mi?a Korva,等神经莱姆病(LNB)患者尽管接受抗生素药物治疗,仍可能会经历持续的症状。本文对79例LNB患者的血清和脑脊液(CSF)中20种免疫介质进行为期1年的检测,来验证这些症状是否由适应性免疫反应异常引起。在研究初期,大多数介质高度集中在CSF感染的部位。

Hepatitis: A Case of Infectious and Autoimmune Hepatitis Occurring with Neurosyphilis

The liver is an organ that withstands a lot of insults due to various things such as infection, toxins and even our own immune system. There are injuries to the liver that are relatively common in medicine such as viral hepatitis caused by different strains of Hepatitis A-E, autoimmune hepatitis, and injury by drugs such as acetaminophen. However, syphilis causing hepatitis is not seen often and there are certain features that distinguish syphilitic hepatitis that should be reported more to distinguish its characteristic features.

Optimal Treatment Strategy for Infectious Diseases with Two Treatment Stages

In this paper, a disease transmission model with two treatment stages is proposed and analyzed. The results indicate that the basic reproduction number is a critical threshold for the prevalence of the disease. If the basic reproduction number is less than one, the disease free equilibrium is globally asymptotically stable. Otherwise, the endemic equilibrium is globally asymptotically stable. Therefore, besides the basic reproduction number, a new marker for characterizing the seriousness of the disease, named as dynamical final infective size, is proposed, which differs from traditional final size because the proposed model includes the natural birth and death. Finally, optimization strategies for limited medical resources are obtained from the perspectives of basic reproduction number and dynamical final infective size, and the real-world disease management scenarios are given based on these finding.

A Case of Infectious Mononucleosis Induced Jaundice Complicated by Possible Drug Induced Liver Injury (DILI)

In this case, a young female presented with non-specific features such as fever, sore throat, headache and fatigue. She went on to develop epigastric pain, darkening of urine and jaundice, with no resolution of prior symptoms. Physical and Laboratory tests confirmed the primary diagnosis of infectious mononucleosis, however, prior history of treatment with multiple drugs led to a diagnosis of DILI as a complication. Appropriate treatment with I.V. antibiotics, hepatoprotective agents, steroids as well as discontinuation of all potential hepatotoxic agents showed significant improvement in patients’ symptoms and overall condition.

Modellings of Infectious Diseases and Cancers under Wars and Pollution Impacts in Iraq with Reference to a Novel Mathematical Model and Literature Review

Microbial pathogens include bacteria, viruses, fungi, and parasites and together account for a significant percentage of acute and chronic human diseases. In addition to understanding the mechanisms by which various pathogens cause human disease, research in microbial pathogenesis also addresses mechanisms of antimicrobial resistance and the development of new antimicrobial agents and vaccines. Answering fundamental questions regarding host-microbe interactions requires an interdisciplinary approach, including microbiology, genomics, informatics, molecular and cellular biology, biochemistry, immunology, epidemiology, environment and interaction between host and microbe. Studies investigating the direct effects of pollutants on respiratory tract infections are very vast, but those interested in the role of a pre-existing disease and effects of the exposure on the response to secondary stresses are few. In an experimental study at concentrations of air pollutants found in urban environments, frank toxicological responses are rarely observed, however, exposure to secondary stress like the respiratory challenge with infectious bacteria can exacerbate the response of the experimental host. The models like experimental, mechanical, and mathematical are the most abstract, but they allow analysis and logical proofs in a way that other approaches do not permit. The present review is mostly concerned with these model representations particularly with a novel mathematical model explaining the interaction between pathogen and immunity including the equivalence point.

Genomic Sequencing and Molecular Characteristics of A Very Virulent Strain of Infectious Bursal Disease Virus Isolated in China

[Objective] The paper was to determine the genomic sequence of a very virulent strain of infectious bursal disease virus（IBDV）,and study its molecular characteristics.[Method] A very virulent strain（vvIBDV）（HLJ-0504） of infectious bursal disease virus（IBDV） with special characters was isolated in China and its genome was sequenced.[Result] Sequence analysis showed that segment A of HLJ-0504 was derived from vvIBDV,while segment B was from a distinct ancestor.The morbidity and mortality of HLJ-0504 was 100% and 86.7%to SPF chickens,respectively.[Conclusion] vvIBDV with distinct segment B were still circulating and the evolution of IBDV was diversified in China.Besides,it is hard to imagine that the virulence of IBDV is determined solely by segment A or B.