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.

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.

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.

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.

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.

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。

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。

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。

某传染病医院BIM暖通设计高共享度信息传递应用

传染病医院因功能多样,具有对通风、空调、压力梯度等精细化要求高的特点。某传染病医院项目机电管综复杂,全设计专业从方案阶段深化至精装修深度。为保质保量完成该项目,需保证专业设计信息能全面、准确、高效传递。而传统的设计方式在设计阶段及后期采购、施工、运维阶段因时空的不一致、人员更迭频繁,常常会顾此失彼。基于BIM三维协同管理的高共享度信息传递体系中,设计信息被赋值和结构化,精准、高效地传递于设计各专业之间及建筑全寿命周期中。本文以该项目实例展示了BIM暖通设计高共享度信息传递的具体应用,并分析了该体系的价值与未来展望,以供同行参考。

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.

Demographic and risk characteristics of healthcare workers infected with SARS-CoV-2 from two tertiary care hospitals in the United Arab Emirates

BACKGROUND Understanding the transmission dynamics of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection among healthcare workers(HCWs)and their social contacts is crucial to plan appropriate risk-reduction measures.AIM To analyze the socio-demographic risk factors and transmission of SARS-CoV-2 infection among HCWs in two tertiary care hospitals in Dubai,United Arab Emirates.METHODS The demographic and clinical characteristics were available for all HCWs in both facilities from the human resources department.A cross-sectional survey was conducted from January-April 2022 among HCWs who tested positive through Reverse Transcriptase Polymerase Chain Reaction of the nasopharyngeal swab for SARS-CoV-2 between March 2020 and August 2021 in two tertiary-level hospitals.The survey included questions on demographics,work profile,characteristics of coronavirus disease 2019(COVID-19),and infection among their household or co-workers.The survey also checked the knowledge and perception of participants on the infection prevention measures related to SARS-CoV-2.RESULTS Out of a total of 346 HCWs infected with SARS-CoV-2,286(82.7%)HCWs consented to participate in this study.From the sample population,150(52.5%)of participants were female,and a majority(230,80.4%)were frontline HCWs,including 121 nurses(121,42.4%).Only 48(16.8%)participants were fully vaccinated at the time of infection.Most infected HCWs(85%)were unaware of any unprotected exposure and were symptomatic at the time of testing(225,78.7%).Nearly half of the participants(140,49%)had co-infection among household,and nearly one-third(29.5%)had coinfection among three or more household.Another 108(37.8%)participants reported crossinfection among co-workers.The frontline HCWs were significantly more infected(25.1%vs 8.6%,P<0.001)compared to non-frontline HCWs.Another significant risk factor for a high infection rate was male sex(P<0.001).Among the infected frontline HCWs,a significantly higher proportion were male and shared accommodation with family(P<0.001).COVID-19 vaccination significantly reduced the infection rate(83.2%vs 16.8,P<0.001)among HCWs.Most participants(99.3%)were aware about importance of appropriate use of personal protective equipment.However,only 70%agreed with the efficacy of the COVID-19 vaccination in preventing an infection and severe disease.CONCLUSION The risk profiling of the HCWs infected with SARS-CoV-2 found that working at frontline and being male increase the rate of infection.COVID-19 vaccination can effectively reduce the rate of transmission of SARS-CoV-2 among HCWs.

基于中医疫病病因说探讨现代传染病的预防与治疗

与一般外感病不同,疫病有特殊的病因。历代医家在中医疫病病因方面提出了自己的见解,形成了特色的理论,产生了多种学说。其中最具有代表性的三种学说是“非时”说、“运气”说和“戾气”说,分别与现代传染病的三要素:易感人群、传播途径和传染源相关联。明确病因是中医辨证论治的基础,这三种学说及其体现的疫病防治原则和方法,如顾护正气、未病先防,扶正祛邪、三因制宜,表里双解、升降相因等,在当今传染病防治中依然有其合理性及重要的临床应用价值。因此,基于中医疫病病因说,正确理解、合理应用中医药防疫治疫的特色理论和方法,发挥中医药在现代传染病防治中的优势。

基于传染病动力模型的供水风险传递规律研究

针对跨流域调水工程供水风险传递规律不明确、风险动态管理效果不足等问题,以引汉济渭工程初期为例,识别风险因子并采用专家打分与突变系数法量化风险,基于传染病动力学创建供水风险传递模型,设置6种风险方案,揭示引汉济渭初期供水风险的传递规律。结果表明:产生供水风险的月份与风险源数量呈正相关;不考虑径流预报误差风险时,越早采取优化调度措施,出现供水风险的月份越少、恢复性越高;考虑径流预测误差时,采取优化调度措施对供水风险的控制效果不显著;风险的传递能力与风险数量不存在正相关,风险的破环性与风险源的数量呈正相关。研究成果对调水工程运行中供水风险防控、制定风险减控方案有重要意义。

传染病预防与控制在学校卫生管理中的应用价值

目的探讨和分析在学校卫生管理中加强传染病预防与控制的价值。方法通过搜索和查询疾病预防控制系统中突发公共卫生事件信息中子系统的方式获取2020年1月—2022年12月武夷山市中小学传染病的疾病类型、患病学生性别及学生年龄等相关资料,汇总和分析学校传染病预防与控制措施。结果2020年患有传染性疾病中小学生共计48例,水痘发生率最高,其次为手足口病及梅毒,2021年共计83例中小学生患传染性疾病,水痘发生率最高,其次为手足口病及肺结核,2022年患传染性疾病中小学生共计56例,水痘发生率最高,其次为梅毒及尖锐湿疣。2020年≥15岁学生传染性疾病发生率最高,2021年≥15岁学生传染性疾病发生率最高,其次为≥10~<15岁年龄段学生,2022年≥15岁学生传染性疾病发生率最高,其次为≥10~<15岁年龄段学生。结论学校存在较高的传染病发生和传播风险,以水痘、手足口病最为常见,学校必须采取有效的传染病预防与控制措施以最大程度地降低传染病发生率,不断提高卫生管理水平,有效切断传播途径,维护广大学生身心健康,推动教学秩序正常进行。

The transmission mechanism theory of disease dynamics:Its aims,assumptions and limitations

Most of the progress in the development of single scale mathematical and computational models for the study of infectious disease dynamics which now span over a century is build on a body of knowledge that has been developed to address particular single scale descriptions of infectious disease dynamics based on understanding disease transmission process.Although this single scale understanding of infectious disease dynamics is now founded on a body of knowledge with a long history,dating back to over a century now,that knowledge has not yet been formalized into a scientific theory.In this article,we formalize this accumulated body of knowledge into a scientific theory called the transmission mechanism theory of disease dynamics which states that at every scale of organization of an infectious disease system,disease dynamics is determined by transmission as the main dynamic disease process.Therefore,the transmission mechanism theory of disease dynamics can be seen as formalizing knowledge that has been inherent in the study of infectious disease dynamics using single scale mathematical and computational models for over a century now.The objective of this article is to summarize this existing knowledge about single scale modelling of infectious dynamics by means of a scientific theory called the transmission mechanism theory of disease dynamics and highlight its aims,assumptions and limitations.

Effects of a closed-loop system against SARS-CoV-2 at the Beijing 2022 Olympic Winter Games:a descriptive and modeling study

BACKGROUND:To assess the efficacy of the epidemic prevention measures of the“closed-loop”system adopted by the Beijing 2022 Olympic Winter Games(BOWG).METHODS:We retrospectively collected and analyzed information,including age,sex,nationality,vaccination status,date of diagnosis,and date of entry,from 280 SARS-CoV-2-positive individuals identified during the BOWG.A susceptibility-exposed-infectious-remove model was employed to evaluate the effectiveness of epidemic prevention strategies on controlling the spread of SARS-CoV-2 under different scenarios during the BOWG.RESULTS:Regarding SARS-CoV-2-positive cases,97.9%were imported,and 96.4%were asymptomatic.The median age was 37 years(range:29–47 years),and 73.9%were male,with the majority of cases being broadcasters and European attendees.Regarding vaccination status,93.5%were fully vaccinated,and six cases were considered to have been infected in the closed-loop system during the BOWG.Assuming that the BOWG adopted a semi-closed-loop management system,the cumulative number of confirmed cases would be 1,137 for quick quarantine measures(3 d later)implemented and 5,530 for delayed quarantine measures(9 d later)implemented.This modeling revealed that stringent pandemic prevention measures and closed-loop management effectively controlled the spread of SARS-CoV-2 during the BOWG.CONCLUSION:Imported cases are considered the main risk factor for SARS-CoV-2 transmission during mass gatherings,but a comprehensive closed-loop system could minimize transmission among attendees and general personnel.

HBV感染家庭聚集性传播的影响因素及远期结局情况分析

目的分析云南省HBV感染的家庭聚集性、传播危险因素及结局情况,为控制HBV家庭聚集性传播提供策略。方法选取2015年1月—2017年12月在昆明市第三人民医院确诊的HBsAg阳性患者,调查其家庭的人口学特征、实验室指标等。对HBsAg阳性者的家庭进行二项分布拟合优度χ^(2)检验并计算家庭聚集率。以单因素和多因素Logistic回归模型分析HBV传播及新发肝硬化或肝癌的影响因素。使用Kaplan-Meier法分析HBsAg阳性者肝硬化或肝癌的累积发生率,并采用Log-rank检验进行比较。结果共调查459户HBsAg阳性家庭,包括618例HBsAg阳性者和918例HBsAg阴性者,其中有107户≥2名家庭成员HBsAg阳性,家庭聚集率为23.31%(χ^(2)=95.393,P<0.001)。传播方式以母婴传播为主。多因素Logistic回归分析结果显示,性别(OR=0.397,95%CI:0.270~0.584,P<0.001)、民族(OR=1.655,95%CI:1.035~2.648,P=0.036)、月收入(OR=1.612,95%CI:1.094~2.375,P=0.016)、共用洁具(OR=2.789,95%CI:1.530~5.086,P<0.001)、基线肝硬化(OR=2.702,95%CI:1.404~5.203,P=0.003)、总胆固醇(OR=0.772,95%CI:0.657~0.908,P=0.002)和HBV DNA(OR=2.063,95%CI:1.753~2.428,P<0.001)是HBV家庭聚集性传播的独立影响因素。618例HBsAg阳性者平均随访4.80年,累积新发肝硬化或肝癌85例(13.75%);KaplanMeier法分析结果显示,HBV传播聚集性家庭的肝硬化或肝癌的累积发生率高于非聚集性家庭(χ^(2)=10.629,P<0.001)。以是否抗病毒治疗、是否为HBV聚集性传播家庭对618例HBsAg阳性患者进行分层分析,结果显示HBV传播聚集性家庭且未抗病毒治疗者的肝硬化或肝癌的累积发生率最高(32.50%),非HBV传播聚集性家庭且抗病毒治疗者的肝硬化或肝癌的累积发生率最低(3.33%)。结论HBsAg阳性者具有家庭聚集性,应加强其家庭成员的筛查、健康宣传教育和追踪观察。抗病毒治疗能有效降低聚集家庭内肝硬化和肝癌的发生率。