Vertically acquired hepatitis C virus infection:Correlates oftransmission and disease progression

The worldwide prevalence of hepatitis C virus(HCV)infection in children is 0.05%-0.4% in developed countries and 2%-5% in resource-limited settings, where inadequately tested blood products or un-sterile medical injections still remain important routes of infection. After the screening of blood donors, motherto-child transmission(MTCT) of HCV has become the leading cause of pediatric infection, at a rate of 5%. Maternal HIV co-infection is a significant risk factor for MTCT and anti-HIV therapy during pregnancy seemingly can reduce the transmission rate of both viruses. Conversely, a high maternal viral load is an important, but not preventable risk factor, because at present no anti-HCV treatment can be administered to pregnant women to block viral replication. Caution is needed in adopting obstetric procedures, such as amniocentesis or internal fetal monitoring, that can favor fetal exposure to HCV contaminated maternal blood, though evidence is lacking on the real risk of single obstetric practices. Mode of delivery and type of feeding do not represent significant risk factors for MTCT. Therefore, there is no reason to offer elective caesarean section or discourage breast-feeding to HCV infected parturients. Information on the natural history of vertical HCV infection is limited. The primary infection is asymptomatic in infants. At least one quarter of infected children shows a spontaneous viral clearance(SVC) that usually occurs within 6 years of life. IL-28 B polymorphims and genotype 3 infection have been associated with greater chances of SVC. In general, HCV progression is mild or moderate in children with chronic infection who grow regularly, though cases with marked liver fibrosis or hepatic failure have been described. Non-organ specific autoantibodies and cryoglobulins are frequently found in children with chronic infection, but autoimmune diseases or HCV associated extrahepatic manifestations are rare.

A prospective study of vertical transmission of hepatitis C virus

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Vertical transmission of hepatitis C virus: Current knowledge and perspectives

Hepatitis C virus(HCV) infection is a major global health issue.Infection by the HCV can cause acute and chronic liver diseases and may lead to cirrhosis,hepatocellular carcinoma or liver failure.The World Health Organization estimates that approximately 3% of the world population have been infected with HCVand the worldwide prevalence is between 1% and 8% in pregnant women and between 0.05% and 5% in children.Following the introduction of blood product screening,vertical transmission becomes the leading cause of childhood HCV infection.The prevalence of pediatric HCV infection varies from 0.05% to 0.36% in developed countries and between 1.8% and 5% in the developing world.All children born to women with antiHCV antibodies should be checked for HCV infection.Though universal screening is controversial,selective antenatal HCV screening on high-risk populations is highly recommended and should be tested probably.Multiple risk factors were shown to increase the possibility of HCV vertical transmission,including coinfections with human immunodeficiency virus,intravenous drug use and elevated maternal HCV viral load,while breastfeeding and HCV genotypes have been studied to have little impact.At present,no clinical intervention has been clearly studied and proved to reduce the HCV vertical transmission risk.Cesarean section should not be recommended as a procedure to prevent vertical transmission,however,breastfeeding is generally not forbidden.The high prevalence of global HCV infection necessitates renewed efforts in primary prevention,including vaccine development,as well as new approaches to reduce the burden of chronic liver disease.Future researches should focus on the interruption of vertical transmission,developments of HCV vaccine and directacting antivirals in infancy and early childhood.

Mouth shield to minimize airborne transmission risk of COVID-19 and other infectious diseases in the dental office

Transmission of coronavirus disease(COVID-19)and other infectious diseases is a significant risk during dental procedures because most dental interventions involve aerosols or droplets that could contaminate the surrounding environment.Current protection guidelines to address the high risk of droplets,aerosols,and airborne particle transmission of COVID-19 in the dental office recommend minimizing aerosol-generating procedures.In this paper,an innovative mouth shield is presented that should minimize water backsplash from the air-water syringe during dental treatment.The mouth shield can be added to the personal protective equipment to provide the dental team with extra protection.It can be made of different materials,is straightforward,inexpensive,and safe to fabricate,and is easy to use.

Transplacental transmission of dengue infection

We specifically addressed the persistent challenge of dengue in endemic regions,highlighting the potential seriousness of dengue infection through vertical trans-mission.Vertical dengue transmission has been well documented,particularly in hyper-endemic regions,including Ecuador.Herein,we present a neonate diagno-sed with congenital dengue and review similar cases from previously published reports.Although congenital dengue is commonly infected with severe serotypes of DENV(DENV-1 and DENV-2)infections,favorable outcomes are generally observed.

Vented Individual Patient(VIP)Hoods for the Control of Infectious Airborne Diseases in Healthcare Facilities

By providing a means of separating the airborne emissions of patients from the air breathed by healthcare workers(HCWs),vented individual patient(VIP)hoods,a form of local exhaust ventilation(LEV),offer a new approach to reduce hospital-acquired infection(HAI).Results from recent studies have demonstrated that,for typical patient-emitted aerosols,VIP hoods provide protection at least equivalent to that of an N95 mask.Unlike a mask,hood performance can be easily monitored and HCWs can be alerted to failure by alarms.The appropriate use of these relatively simple devices could both reduce the reliance on personal protective equipment(PPE)for infection control and provide a low-cost and energy-efficient form of protection for hospitals and clinics.Although the development and deployment of VIP hoods has been accelerated by the coronavirus disease 2019(COVID-19)pandemic,these devices are currently an immature technology.In this review,we describe the state of the art of VIP hoods and identify aspects in need of further development,both in terms of device design and the protocols associated with their use.The broader concept of individual patient hoods has the potential to be expanded beyond ventilation to the provision of clean conditions for individual patients and personalized control over other environmental factors such as temperature and humidity.

Machine learning enabled film pressure sensor to identify surface contacts:An application in surface transmission of infectious disease

The global prevalence of infectious diseases has emerged as a significant challenge in recent years.Surface transmission is a potential transmission route of most gastrointestinal and respiratory infectious diseases,which is related to surface touch behaviors.Manual observation,the traditional method of surface touching data collection,is characterized by limited accuracy and high labor costs.In this work,we proposed a methodology based on machine learning technologies aimed at obtaining high-accuracy and low-labor-cost surface touch behavioral data by means of sensor-based contact data.The touch sensing device,primarily utilizing a film pressure sensor and Arduino board,is designed to automatically detect and collect surface contact data,encompassing pressure,duration and position.To make certain the surface touch behavior and to describe the behavioral data more accurately,six classification algorithms(e.g.Support Vector Machine and Random Forest)have been trained and tested on an experimentally available dataset containing more than 500 surface contacts.The classification results reported the accuracy of above 85%for all the six classifiers and indicated that Random Forest performed best in identifying surface touch behaviors,with 91.8%accuracy,91.9%precision and 0.98 AUC.The study conclusively demonstrated the feasibility of identifying surface touch behaviors through film pressure sensor-based data,offering robust support for the calculation of viral load and exposure risk associated with surface transmission.

Stochastic Epidemic Model of Covid-19 via the Reservoir-People Transmission Network

The novel Coronavirus COVID-19 emerged in Wuhan,China in December 2019.COVID-19 has rapidly spread among human populations and other mammals.The outbreak of COVID-19 has become a global challenge.Mathematical models of epidemiological systems enable studying and predicting the potential spread of disease.Modeling and predicting the evolution of COVID-19 epidemics in near real-time is a scientific challenge,this requires a deep understanding of the dynamics of pandemics and the possibility that the diffusion process can be completely random.In this paper,we develop and analyze a model to simulate the Coronavirus transmission dynamics based on Reservoir-People transmission network.When faced with a potential outbreak,decision-makers need to be able to trust mathematical models for their decision-making processes.One of the most considerable characteristics of COVID-19 is its different behaviors in various countries and regions,or even in different individuals,which can be a sign of uncertain and accidental behavior in the disease outbreak.This trait reflects the existence of the capacity of transmitting perturbations across its domains.We construct a stochastic environment because of parameters random essence and introduce a stochastic version of theReservoir-Peoplemodel.Then we prove the uniqueness and existence of the solution on the stochastic model.Moreover,the equilibria of the system are considered.Also,we establish the extinction of the disease under some suitable conditions.Finally,some numerical simulation and comparison are carried out to validate the theoretical results and the possibility of comparability of the stochastic model with the deterministic model.

我国消除HBV母婴传播的实施案例与经验介绍

HBV母婴传播的减少是实现消除HBV的关键步骤。“乙肝母婴零传播工程”(“小贝壳”项目)于2015年7月在北京人民大会堂正式启动,是集科学防治和应用性研究于一体的公益项目,目的是通过移动医疗工具“小贝壳”手机应用软件对乙型肝炎孕妇进行规范化管理,以进一步减少甚至消除HBV母婴传播。目前,“小贝壳”项目已覆盖全国,为阻断HBV母婴传播提供了详细的实施策略、成功的实践经验及可靠的数据支持,对全球实现消除HBV母婴传播具有重要价值。本文详细介绍了4个典型案例的“小贝壳”项目实施策略及其成效,为进一步理解和阻断母婴传播提供了有力证据。

阻断HBV母婴传播:热点与难点

慢性HBV感染是我国最重要的公共卫生问题之一,HBV感染人群超过7000万,防控工作面临着严峻挑战。当前政府及社会各界正在加速推进“2030年实现消除病毒性肝炎对公众健康的威胁”的宏伟目标。母婴传播是HBV最主要的传播途径,因此,做好HBV母婴阻断是消除病毒性肝炎的关键一环。目前在该领域存在一些热点与难点问题亟需解决,包括妊娠期采用富马酸丙酚替诺福韦长期治疗的安全性、妊娠早期抗病毒治疗的安全性、无免疫球蛋白策略的有效性和HBV经生殖细胞传播的风险等,解决这些问题对进一步推进HBV母婴阻断工作,加快我国实现2030年目标的进程具有重要作用。

HBV母婴零传播——从争议到共识

母婴传播是HBV最主要的传播途径,预防HBV母婴传播是乙型肝炎防控的关键环节,也是2030年全球消除乙型肝炎的五大核心战略支柱之一。新生儿联合免疫和妊娠期的抗病毒干预是阻断母婴传播的关键措施,实施新生儿联合免疫和妊娠期抗病毒干预的综合策略能够加速实现消除母婴传播的目标。我国学者提出“乙型肝炎母婴零传播”的理念,并在全国范围开展了“乙肝母婴零传播工程”(“小贝壳”项目),旨在推动母婴阻断策略的实施,为我国消除病毒性肝炎打好基础。“小贝壳”项目为阻断乙型肝炎母婴传播提供了详细的实施策略、成功的实践经验及可靠的数据支持,凝聚了学术界对“乙型肝炎母婴零传播”的共识,对我国以及全球实现消除HBV母婴传播具有重要的参考价值。

餐饮空间呼吸道传染病传播风险分析:以新冠肺炎为例

为了解决餐饮空间内呼吸道传染病感染风险大、防控难的问题,基于视频分析人员近距离接触及表面触摸行为,同时考虑近距离空气、大飞沫、远距离空气和表面传播4种传播途径,建立餐饮空间内呼吸道传染病传播模型,并引入剂量-反应模型,对不同传播途径的贡献率进行计算。结果显示:在顾客、服务员与他人的交流中近距离交流分别占98.0%和80.3%,并且83.0%的交流持续时长不超过10 s;顾客、服务员双手超过85.4%的时间在触摸物体表面,服务员触摸公共表面次数占触摸所有物品次数的比重为59.6%,容易在餐厅内扩散病毒,而顾客触摸黏膜的概率约为服务员的6.8倍,更容易通过表面传播途径感染;远距离空气传播和近距离空气传播途径是新型冠状病毒在该餐饮空间的主要传播途径,相对贡献率分别为57.31%~65.44%和24.60%~40.56%,而表面传播与大飞沫传播途径的相对贡献率之和小于9.96%。

HBV母婴传播的分子病毒学机制

慢性HBV感染是全球公共卫生领域的重大威胁。在HBV中高流行地区,母婴传播仍然是慢性HBV感染的主要来源。随着新生儿乙型肝炎疫苗和乙型肝炎免疫球蛋白联合免疫的应用,HBV母婴传播率显著降低,但HBeAg阳性且高病毒载量母亲所生婴儿发生HBV母婴传播的风险仍然较高。尽管HBV高病毒载量孕妇在妊娠晚期接受抗病毒治疗可进一步降低HBV母婴传播的风险,但仍无法完全阻断母婴传播。深入了解HBV母婴传播的分子病毒学机制可为阻断HBV母婴传播提供明确思路,对HBV母婴传播的预防和管理具有重要意义。

2019—2021年某中医医院传染病报告分析与管理

目的分析某中医医院法定和其他重点监测传染病报告情况,为规范开展医院传染病报告和制定医院传染病报告管理策略提供参考。方法对2019—2021年某中医医院传染病报告数据进行描述性分析。结果2019—2021年某中医医院共报告法定和其他重点监测传染病6865例次,无甲类传染病报告,其中乙类传染病668例次(9.73%),丙类传染病5356例次(78.02%),其他重点监测传染病841例次(12.25%)。排名前5位的传染病分别是流行性感冒、水痘、梅毒、其他感染性腹泻病和肺结核,其中报告病例最多的流行性感冒,在报告时间上每年传染病报告例次数居首位的是第一季度。2019—2021年某中医医院法定和其他重点监测传染病报告例次数呈下降趋势。结论2019—2021年某中医医院法定和其他重点监测传染病报告以呼吸道传染病为主,应根据不同季节、疾病流行趋势,采取有针对性的传染病监测、防控策略。

基于传播动力学模型的超大型城市新发突发高致病性呼吸道传染病应对策略研究

目的探索中国超大型城市应对新发突发高致病性呼吸道传染病暴发时不同干预策略的效果,为有效应对新发突发呼吸道传染病提供决策依据。方法构建易感-潜伏-感染-移出(SEIR)传播动力学模型,参考既往多种新发呼吸道传染病的致病性和传染性参数,并将其进行组合。模拟低、中、高传染性的新发突发高致病性呼吸道传染病在中国1000万人口超大型城市暴发的场景下,比较实施不同非药物干预措施(NPIs)组合应对暴发后100 d内疫情的发展情况。结果高致病性新发呼吸道传染病暴发时,如果其传染性较低(R 0约为1.5),无需采取严格的NPIs就可以控制疫情。若其传染性为中等(R 0约为6),则需要根据其已有的感染规模采取不同强度的NPIs:在初始感染人数为50例时,采取中等强度的NPIs,100 d内可将感染及死亡比例控制在较低水平,病例所需住院床位控制在全国平均储备水平以下;但在已有感染规模超过100例时,则需要采取高强度的NPIs才能控制疫情发展。在其传染性极强(R 0约为10)的情况下,无论感染规模如何,应立即采取高强度NPIs才能有效控制疫情发展及感染、死亡规模。结论在面对新发高致病性呼吸道传染病暴发时,尽早根据其流行病学特征及感染规模采取合适的NPIs,才能最大限度降低其对人群健康的危害。

HPV经精子传播及其对早期胚胎发育的影响

人乳头瘤病毒(human papilloma virus,HPV)感染是全球常见的性传播疾病之一,与多种器官的肿瘤发生有关。近年来,HPV经生殖细胞传播及其对早期胚胎发育的潜在影响备受关注。研究表明,HPV感染可能影响男性精子质量,导致不育,同时可能干扰胚胎发育,增加自然流产的风险,并对辅助生殖技术的妊娠结局产生不良影响。综述HPV经精子传播及其对早期胚胎发育影响的研究进展,旨在深入理解HPV对生育健康的潜在威胁,并为临床实践和进一步研究提供参考。

具有垂直感染且带隔离项的SEIQR模型的稳定性分析

研究了一类含隔离者类且具有垂直感染的SEIQR传染病模型,得到了基本再生数。通过Lyapunov函数和LaSalle不变集原理证明了平衡点的全局渐近稳定性,最后运用数值模拟进一步说明了系统的稳定性态。

全球消除HBV母婴传播的进展与挑战

目前,全球89.8%的国家和地区有孕产妇乙型肝炎检测的政策。2022年,全球乙型肝炎疫苗出生接种率、第3剂接种率分别为45%、85%,约3%高病毒载量孕产妇接受了抗病毒治疗,5岁及以下儿童乙型肝炎表面抗原流行率约为0.7%。全球各国乙型肝炎母婴传播取得阶段性进展,但进展差异较大,且面临诸多挑战。全球各地乙型肝炎流行情况、疫苗接种情况、抗病毒药物获取情况不同,此外,实验室检测能力不足、感染孕产妇难以持续获得治疗干预等因素均对消除HBV母婴传播造成了阻碍。

妊娠期抗病毒治疗阻断HBV母婴传播的新进展

HBV母婴传播是导致我国慢性乙型肝炎疾病高负担的主要原因之一,阻断这一传播途径对消除乙型肝炎具有至关重要的战略意义。新生儿出生立即实施联合免疫接种是阻断HBV母婴传播的基本策略,但在高病毒血症母亲中仍有9%的母婴传播率。近年来,孕期抗病毒干预阻断母婴传播的研究取得了突破,对消除乙型肝炎母婴传播具有划时代意义。孕期抗病毒干预与婴儿出生后联合免疫接种的综合预防,已成为消除乙型肝炎母婴传播的关键策略。本文总结了妊娠期抗病毒干预阻断母婴传播的发展历程和最新进展,并归纳相关干预策略和适应证等,旨在为临床和公共卫生医生提供参考。

防控背景下城市轨道TOD对传染病传播影响分析

城市轨道交通TOD模式通过沿线大运量通勤和站区规模化服务,承载了人口的大规模流动和公共性聚集,理论上会以站区为核心,造成从沿线地区至更广泛辐射地区的传染病传播。然而,以2020年北京新发地新冠肺炎疫情为例,对北京主城区133个街道做有序Logistic回归分析发现,在传染病防控治理背景下,轨道交通TOD没有显著引起沿线街道传染病传播风险增加。其中,街道之间除常住人口规模外,多项资源条件的不平衡没有导致传染病传播风险分布的显著差异。进一步通过Spearman相关性分析发现,换乘站和区域站对传染病传播风险的升级影响仅表现在更远离轨道辐射的街道。分析结果一方面反映出彼时我国以北京为典型的城市疫情防控治理效果,另一方面也凸显了远离轨道辐射、人口活动具有内循环特征地区的防控挑战。