Frequency, Duration and Intensity of Dengue Fever Epidemic Risk in Townships in Pearl River Delta and Yunnan in China, 2013

Dengue fever （DF）, one of the neglected tropical diseases also known as breakbone fever, is a mosquito-borne disease common in the tropics and subtropics. Dengue fever is transmitted primarily by A.aegypti, resulting in infection with any of four distinct but closely related virus serotypes. The majority of infected people experience a self-limiting clinical course. A small proportion of cases develop into life-threatening Dengue Hemorrhagic Fever or Dengue Shock Syndrome.

Frequent Import and Multiple Sources of Dengue Fever have Changed the Epidemic Situation of the Disease in Fujian Province,China

Objective The aim of this study was to update the epidemic situation of dengue fever(DF) and provide new insights for the consideration of disease control in Fujian province,China.Methods Details about DF cases in Fujian reported during 2004–2017 were collected and analyzed.The envelope(E) genes of isolates of dengue virus(DENV) were sequenced for phylogenetic analysis.Results The number of imported DF cases had increased dramatically since 2013,and the source regions expanded from Southeast Asia to South Asia,America,Oceania,and Africa,as well as the surrounding provinces.This resulted in local outbreaks and indigenous cases of DF that occurred more frequently,with 10 of 13 local outbreaks and 85.9%(1,252/1,458) of indigenous cases reported in2013–2017.Compared with only two coastal cities before 2013,four coastal and one inland city in 2013–2017 experienced the local DF outbreaks.The phylogenetic analysis of E genes confirmed that the import of DENV,not only from abroad but also from the surrounding provinces,played an important role in dissemination and local outbreaks of DF in Fujian.Conclusions The frequent import of DF cases from not only abroad but also the surrounding provinces resulted in increased incidence,frequent local outbreaks,and expansion of distribution in Fujian in recent years.There is a need for urgent measures to improve disease control in this province.

Lipofuscin in brains of patients and mice with epidemic hemorrhagic fever

We have previously shown that the lipofuscin in the brain seems to have in-creased in amount in autopsy cases of epidemic hemorrhagic fever.The purpose of thisstudy was to testify if there is really such an increase.Lipfuscin in 10 sections from everybrain of 10 autopsy cases,stained with Sudan Ⅳ,Sudan black and H.E.,was carefully es-timated and found to be greatly increased as compared with the controls of the same agewithout brain disease.Animal experiment was also conducted on 15 sucking BALB/c miceby I.P.inoculation of 100 LD50（0.05ml）of strain Chen of hemorrhagic fever virus,andon 15 mice without inoculation as controls.No lipofuscin was detected in the controls.However,in the brains of experimental mice,lipofuscin was found to be markedly in-creased,especially in the necrotic cells.The findings suggest that the over-productionand deposition of lipofuscin may be a mild change caused by the virus and its related fac-tors,which might be enhanced by hypotension and shock.

Abnormalities of Cellular Immunoregulation in Patients with Epidemic Hemorrhagic Fever

In this report,a comparative study is made of the function test of spontaneousT suppressor cell（STs）and T Lymphocyte subsets in patients with epidemic hemorrha-gic fever（EHF）.It was found that in the early stages of the disease the activity of STs wasmarkedly lower than that of the controls,while the percentage of CD?+ cells increasedsignificantly,which led to the decrease and reciprocation of CD4/CD8 ratio,and that theactivity of STs was reversely related to the proportion of CD8+ cells on linear regressionanalysis,indicating that the CD8+ cells increased may mainly belong to cytotoxic T cells.It was also shown that the changes of STs function and CD4/CD8 ratio were related tothe abnormalities of serum C3 content and circulating immune complex.The results sug-gest that the disturbance of host cellular immunoregulation may play an important rolein the pathogenesis of EHF.

Study on Biologic Activity for Membrane of Normal Bone Marrow Cells with Infection of Epidemic Hemorrhagic Fever Virus

Using DPH fluorescence probe, the membrane of normal bone marrow cells with infection of epidemic hemorrhagic fever virus (EHFV) was labeled. The membrane lipid fluidity was obviously decreased from the membrane lipid fluorescence polarization. The membrane lipid fluidity of lympho- cyte, monocyte and neutrophilic granulocyte was dynamically observed. After culturing the cells for 1, 6, 24 and 72 h, it was found that all the membrane lipid fluidity of the infected cells was de- creased obviously with the longer the culturing time, the more obvious it. Compared with the normal control groups, there was a significant difference statistically (P<0. 05-0. 01). It was suggested that the decrease of the membrane lipid fluidity of normal bone marrow cell with infection of EHFV had correlation with the degree of virus invading and cellfunction injury.

A Universal Real-Time Fluorescence qPCR Method for Identifying Epidemic Strains of African Swine Fever Virus

Objective Establishing a highly sensitive real-time fluorescence quantitative PCR (qPCR) method for universal testing of epidemic African swine fever virus (ASFV) strains. Methods The ASFV p72 gene was targeted to design primer probes covering 24 p72 genotypes. The optimal amount of dimethylsulphoxide (DMSO) for qPCR amplification was determined, Various sensitivity and limit of detection (LOD) tests were performed, and clinical samples from China and imported goods were tested. Results The optimal primer-probe combination could specifically detect ASFV, 1.5% DMSO was optimal for qPCR, and LOD reached 3.2 copies/μL with good reproducibility (n = 20, p = 0.369). The method was employed to test 142 clinically suspected samples, of which 30 pig blood and 37 pig tissue samples were ASFV-positive. Moreover, the positive testing rate for ASFV was higher than for the standard qPCR method recommended by the Office International Des Epizooties (OIE), and for the commercially available kit. Thus, our method is superior for testing weakly positive samples with low virus titre, and epidemic strains present in imported goods. Conclusion Our method could be employed for universal testing of epidemic ASFV strains worldwide, ensuring wider coverage of hosts and ASFV strains/endemic strains, reducing false negatives, and benefitting early diagnosis.

STUDIES ON THE ENVIRONMENT STRUCTURE OF NATURAL NIDI AND EPIDEMIC AREAS OF HEMORRHAGIC FEVER WITH RENAL SYNDROME IN CHINA

The environment structure of natural nidi and epidemic areas of hemorrhagic fever with renal syndrome (HFRS) possesses characteristics of topography, hydrology, climate, soil, vegetation, and animals. The natural nidi and epidemic areas of HFRS are distributed mainly in plain and hilly regions under 500 meters above the sea level; in plentiful-water zones and transitional zones; in temperate zone and subtropical zone of the eastern monsoon region; in the abundant-aluminum soil region and the sial soil region; in the eastern China damp forest region (agricultural districts and northeast forest districts); in the eastern Asia dampness-prefering animal geographic region. Apodemus agrarius and Rattus norvegicus are the thriving animal population, predominant species or common species as well as the main reservoir hosts and sources of infection in the natural nidi and epidemic areas of HFRS.

Application of Conglutinin-ELISA for the detection of Circulating Immune Complexes in Sera of Patients with Epidemic Hemorrhagic Fever.

Conglutinin was extracted and purified from bovine’s sera and was used in ELISA for the detection of circulating immune complexes in the sera of patients suffering from epidemic hemorrhagic fever (EHF). The detected rates of circu-

The Yellow FeverPandemic and the Establishment of a Transatlantic Knowledge Network for Epidemic Prevention in the Late 18th and Early 19th Centuries

During the late 18th and early 19th centuries,a series of conflicts erupted in the Caribbean,leading to the spread of yellow fever to North America and Europe.This yellow fever epidemic was aggravated by war,migration,trade,and other human behaviors,resulting in a decadelong transatlantic pandemic.Groups of physicians in Europe and the United States established a transatlantic network focused on epidemic prevention,to investigate the pathology,causes,and treatments of yellow fever Subsequently,some consular officers were also concerned about the yellow fever epidemic,which led to the expansion of this network.The formation and expansion of the transatlantic knowledge network profoundly demonstrated the spirit of transnationalism and promotes progress in international public health.It sets a precedent for international health cooperation.However,this network was dominated by the so-called"white elite",with European and American countries holding the knowledge hegemony,it had a clear racist and colonialism feature.

Boosting Global Yellow Fever Vaccine Supply for Epidemic Preparedness: 3 Actions for China and the USA

Yellow fever(YF)is an acute disease caused by a flavivirus that infects the liver.It can cause jaundice,bleeding,kidney damage,and death.No antiviral therapy exists.A vaccine does exist,however,and fortunately confers lifelong immunity after a single dose(Monath et al.2016;WHO 2017a,b).

Pathological changes and viral antigen distribution in the lymphatic tissue of Patients with epidemic hemorrhagic fever

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Ophthalmic manifestations in seropositive dengue fever patients during epidemics caused by predominantly different dengue serotypes

Purpose:Dengue fever(DF)epidemics in Singapore in 2005–2006 and 2007 were caused predominantly by dengue virus serotypes 1(DENV-1)and 2(DENV-2)respectively.We investigated the prevalence of ophthalmic manifestations during these consecutive epidemics.Methods:Seropositive DF patients admitted to the hospital during two separate dengue epidemics were enrolled from June 2005 to December 2007.Demographic,ophthalmic,and laboratory data were collected.The primary outcome measures were differences in ophthalmic and laboratory features across the two epidemics.Factors associated with increased risk of developing various DF-related ophthalmic manifestations were the secondary outcome measures.Results:Of the 115 patients enrolled,109(94.7%;33 in 2005–2006 and 76 in 2007)completed the eye screening protocol.Majority of patients were Chinese(65,59.6%)and males(81,74.3%).The mean age was 40.8 years(range,18–87).Colour vision impairment(12 vs 14[36.4%vs 18.7%];P?0.04),cotton wool spots(10 vs 3[30.3%vs 3.9%];P<0.001),bleeding diathesis(7 vs 3[21.2%vs 3.9%];P?0.004)and abnormal liver function(mean alanine amino-transferase[150.2 U/L vs 68.28 U/L;P?0.001],mean aspartate amino-transferase[196.86 U/L vs 99.53 U/L;P?0.002],total protein[68.43 g/L vs 72.27 g/L;P?0.016],serum albumin[36.86 g/L vs 40.5 g/L;P?0.001])were noted more often in DF epidemics predominantly caused by DENV-1 compared to DENV-2.Conclusions:A higher prevalence of colour vision impairment,cotton wool spots,bleeding diathesis,and abnormal liver function was found in DF epidemics predominantly caused by DENV-1 compared to DENV-2.

Epidemic Hemorrhagic Fever in Hubei Frovince,The Peoples Repulic of China: A Clinical and Serological Study

Between July 1975 and April 1980, 71 patients were admitted to the 2ndAttached Hospital of Hubei Provincial Medical College in Wuchang withthe diagnosis of Epidemic Hemorrhagic Fever (EHF). The clinical courseamong these patients was similar to that described for patients with KoreanHemorrhagic Fever, Nephropathica Epidemica of Scandanavia and Hemor-rhagic Fever with Renal Syndrome of the U.S.S.R. The overall mortalitywas 11.2％. Sera obtaincd from some of these patients as well as frompatients admitted to the First Attached Hospital of Hubei Provincial Me-dical College were tested against an antigen associated with Korean He-morrhagic Fever and showed exceedingly high antibody titers. We concludethat EHF in Centfal China represents the same disease process as KoreanHemorrhagic Fever.

ASK THE DOC Fighting the dengue fever epidemic

For the past two months,Guangzhou has been hit by a dengue fever epidemic.At the time of writing this article,there have been over 30,000 cases of dengue fever in the greater Guangzhou area,with around 1,000 new cases daily.

Epidemic Characteristics and Spatio-Temporal Patterns of HFRS in Qingdao City,China,2010-2022

Objective This study investigated the epidemic characteristics and spatio-temporal dynamics of hemorrhagic fever with renal syndrome(HFRS)in Qingdao City,China.Methods Information was collected on HFRS cases in Qingdao City from 2010 to 2022.Descriptive epidemiologic,seasonal decomposition,spatial autocorrelation,and spatio-temporal cluster analyses were performed.Results A total of 2,220 patients with HFRS were reported over the study period,with an average annual incidence of 1.89/100,000 and a case fatality rate of 2.52%.The male:female ratio was 2.8:1.75.3%of patients were aged between 16 and 60 years old,75.3%of patients were farmers,and 11.6%had both“three red”and“three pain”symptoms.The HFRS epidemic showed two-peak seasonality:the primary fall-winter peak and the minor spring peak.The HFRS epidemic presented highly spatially heterogeneous,street/township-level hot spots that were mostly distributed in Huangdao,Pingdu,and Jiaozhou.The spatio-temporal cluster analysis revealed three cluster areas in Qingdao City that were located in the south of Huangdao District during the fall-winter peak.Conclusion The distribution of HFRS in Qingdao exhibited periodic,seasonal,and regional characteristics,with high spatial clustering heterogeneity.The typical symptoms of“three red”and“three pain”in patients with HFRS were not obvious.

论《广瘟疫论》透疫四法对吴又可透疫理念的继承与发挥

吴又可善用透法治疗疫病,对后世影响深远。清代名医戴天章在吴氏学说基础上撰成《广瘟疫论》,书中对通腑透邪、逐瘀泄热、开达膜原、滋养透邪透疫四法论述尤为深入,具有重要指导意义。本文深入剖析戴天章《广瘟疫论》透疫四法,主要包括开达膜原明辨表里,注重“孤邪”;通腑透邪力辟寒温,“三分”指征,细化治方;逐瘀泄热倡用“蓄血三焦辨证”;论广滋养透邪,增述“五变”,从中探寻其对吴又可透疫理念的继承与发挥,如疫邪在半表半里之时达原饮和柴胡剂之运用区分、开达膜原之“孤邪”加味法、通腑透邪六大用药手法、“厥阴蓄血”证治等,以期对现代临床提供助力。

Yellow Fever: A Re-Emerging Threat

Yellow fever (YF) is arguably one of the most notorious infectious diseases in the world. The disease is not only fatal to the human but also several primate species many of which are endangered by now. YF is caused by the yellow fever virus (YFV). While YFV was one of the most feared infectious diseases in the 18th and 19th century, the overall disease burden has been greatly reduced through an effective vector (mosquito) control and the development of the live-attenuated vaccine, YFV-17D. However, recent outbreaks in previously non-endemic areas have risen intense awareness among scientists and the public and remind us that YFV cannot be forgotten and containing it needs to remain a global health priority. Notably, the 11 imported yellow fever cases to China;hence the whole Asia-Pacific region, in 2016 alone, highlight that YFV may pose a threat to a large population which is intensified by increasing human migration and an extremely low vaccination rate. This paper assesses the possibility of a new round of epidemics of YFV, indicating that the virus should indeed be recognized as a re-emerging threat, and offers suggestions on how to prevent it. Stricter vaccine regulation and border check should be applied, as well as further research into alternative vaccines. More attention and efforts should be paid to fighting against the disease.

“An integrated system,three separated responsibilities”,a new fever clinic management model,in prevention and control of novel coronavirus pneumonia

BACKGROUND Since December 2019,there have been many new cases of coronavirus pneumonia in Wuhan,Hubei Province,which has gradually spread throughout the country.AIM To explore our hospital’s innovative management system to ensure the efficient operation of fever clinics during the epidemic,since controlling the spread of disease is an important way to prevent and control the epidemic.METHODS In total,200 outpatients with fever at our hospital between November 2019 and July 2020 were selected and allocated into two groups.RESULTS The fever clinic in our hospital operated smoothly,and infection with the novel coronavirus disease(COVID-19)has not been reported in our hospital.Additionally,we did not have any cases of missed diagnosis.The awareness regarding COVID-19 infection sources,transmission routes,early symptoms,and preventive measures was significantly higher in our fever clinic than in those of the pre-management group.CONCLUSION"An integrated system,three separate responsibilities"ensured the efficient functioning of our fever outpatient clinic and early screening of COVID-19 cases,which effectively curbed the transmission of COVID-19 and hence prevented COVID-19 pneumonia epidemic in our hospital,ultimately achieving the maximum effect of epidemic prevention and control.

Optimal design of culling compensation policy under the African swine fever——Based on simulations of typical pig farms in China

This paper aims to optimize the culling compensation policy from a micro perspective through scenario simulation.Based on an investigation of 273 pig farms in eight regions,four typical pig farms were constructed according to farm size and breeding mode,representing the swine producers in China.Besides,a decision objective function of pig farms facing suspected African swine fever(ASF)outbreaks was constructed.This study used a mathematical programming model to design and simulate scenarios based on compensation standards and local implementation levels,aiming to incentivize pig farms to report epidemics.The results show that the optimal decisions on epidemic reports differed among typical farms and by herd daily age.The results suggest the following adjustments for optimizing culling compensation policies:(1)to set culling compensation standards based on the market value and(2)to maintain a high level of epidemic surveillance capability in the animal husbandry and veterinary sector.

Acute Hemorrhagic Fever: Clinical, Epidemiological and Laboratory Aspects in São Toméand Príncipe

Background: In the last 6 months, cases of acute hemorrhagic fever (AHF) have been recorded in Sao Tome and Principe (STP). Objective: To identify the clinical, epidemiological and laboratory parameters associated with AHF cases found in patients hospitalized in STP. Methods: Descriptive and quantitative analysis of AHF cases hospitalized in STP in the period December 2021 to May 19, 2022 through the variables: demographic data;clinical data;laboratory data and clinical outcome. Results: Analyzed 18 of 22 AHF cases, 50% of them male, mean age 33.7 years, 85.7% residing in the 2 largest districts of the country, 66.7% rural workers, administrative near maritime areas, sailors and domestics. 66.7% were healthy individuals. ≥50% had a fever, asthenia/weakness, myalgia, headache, lethargy, nausea, vomiting, and diarrhea. 22.2% to 33.3% had retro-orbital pain, abdominal pain, decreased consciousness, dyspnea/hypoxia, and cough. In a smaller register (5.6% - 11.1%), exanthema, convulsion, arthralgia, low back pain, chills, and chest pain. Bleeding from the digestive tract was found in 72.2%, followed by vaginal (33.3%), urethral (27.8%), nasal (22.2%), and oral (16.7%). 50% had laboratory confirmation for dengue, and another 50% with suspected clinical diagnosis without laboratory confirmation of the etiologic agent. Despite hemorrhage, 66.7% of confirmed cases were hemodynamically non-severe, and 88.9% of suspected cases were severe. Coinfection with malaria is evidenced in 11.1% of cases. 72.2% recovered and 27.8% died (deaths in 55.5% of suspected cases). Case deaths were male (100%), resident foreigners (40%), tool store employees, sailors and students, healthy (80%), and residing in the largest district in the country (60%). All deaths were hospitalized in serious condition, 80% were hospitalized for hemorrhage and shock, with bleeding arising between day 4 - 5 of illness in 60% and hospitalization on day 5 of illness. 60% died within ≤24 hours of hospitalization. 80% died from shock and multi-organ dysfunction and 20% from respiratory failure. Deaths had thrombocytopenia (100%), renal dysfunction (100%) and significantly increased transaminases (100%), anemia (75%) and leukocytosis (66.7%). 20% had a radiological change of pulmonary infiltrates. Conclusion: Our data reveal the complexity of the pathogens causing AHF and suggest the possible presence of other human pathogens usually unknown in the Santomean geographical territory.