Surveillance for respiratory infectious diseases caused by 6 common viruses in a recruit training site in the Northern region of China

Background: Recruit training sites are places with a high incidence of respiratory infectious diseases. Effective surveillance for acute respiratory infectious diseases in a recruit training site is an important way to prevent disease outbreaks.Methods: Eight hundred recruits(722 males and 78 females) enlisted in autumn 2015 received a background survey within 24 h of settlement at the recruit training site, including their general personal information, vaccination history, mental status and clinical symptoms. Then, nasopharyngeal swabs of these recruits were collected to detect common respiratory pathogens [influenza virus type A, influenza virus type B, adenovirus(Adv), human respiratory syncytial virus, human bocavirus and human metapneumovirus] by PCR. In addition, fasting venous blood was collected in the morning for Adv Ig G antibody detection. During the three months of training, the recruits were monitored for symptoms of respiratory infection, and nasopharyngeal swabs were collected from those with an axillary temperature ≥38℃ and other respiratory symptoms within 4 h of symptom onset. Samples were further examined by PCR.Results: Among the 795 effective nasopharyngeal swab samples collected during survey, two cases of group C type 1 Adv were identified by PCR. During the 3 months of training, fever and respiratory symptoms occurred in 39 recruits(incidence rate of 4.9%) and 5 cases of Adv were detected(positive rate of 12.8%). Genotyping showed 3 cases of type 4 Adv and 2 of type 3 Adv. No type 7, 14 or 55 Adv was detected. The Adv-Ig G positive rate of recruits was 48.2%. Among the 5 Adv positive cases with fever and respiratory symptoms, 4 were Adv-Ig G positive.Conclusion: The pathogen carrier rate in recruits was low, and only group C Adv, which causes mild infection in humans, was detected. No respiratory outbreak was observed at the recruit training site, and sporadic cases were mainly caused by type 3 and type 4 Adv.

Epidemiological characteristics of seven notifable respiratory infectious diseases in the mainland of China:an analysis of national surveillance data from 2017 to 2021

Background Respiratory infectious diseases(RIDs)remain a pressing public health concern,posing a signifcant threat to the well-being and lives of individuals.This study delves into the incidence of seven primary RIDs dur‑ing the period 2017-2021,aiming to gain deeper insights into their epidemiological characteristics for the purpose of enhancing control and prevention strategies.Methods Data pertaining to seven notifable RIDs,namely,seasonal infuenza,pulmonary tuberculosis(PTB),mumps,scarlet fever,pertussis,rubella and measles,in the mainland of China between 2017 and 2021 were obtained from the National Notifable Disease Reporting System(NNDRS).Joinpoint regression software was utilized to analyze temporal trends,while SaTScan software with a Poisson probability model was used to assess seasonal and spatial patterns.Results A total of 11,963,886 cases of the seven RIDs were reported during 2017-2021,and yielding a fve-year aver‑age incidence rate of 170.73 per 100,000 individuals.Among these RIDs,seasonal infuenza exhibited the highest aver‑age incidence rate(94.14 per 100,000),followed by PTB(55.52 per 100,000),mumps(15.16 per 100,000),scarlet fever(4.02 per 100,000),pertussis(1.10 per 100,000),rubella(0.59 per 100,000),and measles(0.21 per 100,000).Males experi‑enced higher incidence rates across all seven RIDs.PTB incidence was notably elevated among farmers and individu‑als aged over 65,whereas the other RIDs primarily afected children and students under 15 years of age.The inci‑dences of PTB and measles exhibited a declining trend from 2017 to 2021(APC=−7.53%,P=0.009;APC=−40.87%,P=0.02),while the other fve RIDs peaked in 2019.Concerning seasonal and spatial distribution,the seven RIDs displayed distinct characteristics,with variations observed for the same RIDs across diferent regions.The proportion of laboratory-confrmed cases fuctuated among the seven RIDs from 2017 to 2021,with measles and rubella exhibit‑ing higher proportions and mumps and scarlet fever showing lower proportions.Conclusions The incidence of PTB and measles demonstrated a decrease in the mainland of China between 2017 and 2021,while the remaining fve RIDs reached a peak in 2019.Overall,RIDs continue to pose a signifcant public health challenge.Urgent action is required to bolster capacity-building eforts and enhance control and prevention strategies for RIDs,taking into account regional disparities and epidemiological nuances.With the rapid advancement of high-tech solutions,the development and efective implementation of a digital/intelligent RIDs control and pre‑vention system are imperative to facilitate precise surveillance,early warnings,and swift responses.

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.

Development of a negative pressure hood for isolation and transportation of individual patient with respiratory infectious disease

The frequent and sudden occurrence of both known and unknown infectious diseases can cause global social panic.If the source of infection can be effectively controlled in the early stages of an outbreak,the spread of infectious diseases can be prevented.In view of this situation,this study developed for infectious or suspected infectious patients a negative pressure isolation hood which effectively achieves direct individual isolation during the early stages of disease outbreak,and facilitates long-distance transport.The hood body is made of flexible transparent polyvinyl chloride(PVC)material,and the combination of the hood material is airtight.The unique inflatable column support structure and the design of the inflatable neck sleeve effectively ensure both stiffness and air tightness of the hood body.The electrical exhaust system maintains a stable negative pressure environment inside the hood,and polluted air inside the hood can be purified by a high efficiency filter.Test results showed that the internal noise of the hood was 68±1 dB(A),the air exhaust volume of the electric exhaust system was not<200 L/min,and the filtration efficiency of the filter to 0.3μm particles was>99.99%,indicating that the hood achieved effective isolation protection for patients with respiration infectious diseases.

Epidemiological characteristics of imported respiratory infectious diseases in China,2014-2018

Background:With the progress of globalization,international mobility increases,greatly facilitating cross-border transmission of respiratory infectious diseases(RIDs).This study aimed to analyze the epidemiological characteristics and factors influencing imported RIDs,with the goal of providing evidence to support adoption of high-tech,intel-ligent methods to early find imported RIDs and prevent their spread in China.Methods:We obtained data of imported RIDs cases from 2014 to 2018 from the Inbound Sentinel Network of Customs and the National Notifiable Diseases Reporting System in China.We analyzed spatial,temporal,and population distribution characteristics of the imported RIDs.We developed an index to describe seasonality.Pearson correlation coefficients were used to examine associations between independent variables and imported cases.Data analyses and visualizations were conducted with R software.Results:From a total of 1409265253 inbound travelers,31732(2.25/100000)imported RIDs cases were reported.RIDs cases were imported from 142 countries and five continents.The incidence of imported RIDs was nearly 5 times higher in 2018(2.81/100000)than in 2014(0.58/100000).Among foreigners,incidence rates were higher among males(5.32/100000),0–14-year-olds(15.15/100000),and cases originating in Oceania(11.10/100000).The vast majority(90.3%)of imported RIDs were influenza,with seasonality consistent with annual seasonality of influenza.The spatial distribution of imported RIDs was different between Chinese citizens and foreigners.Increases in inbound travel volume and the number of influenza cases in source countries were associated with the number of imported RIDs.Conclusions:Our study documented importation of RIDs into China from 142 countries.Inbound travel poses a significant risks bringing important RIDs to China.It is urgent to strengthen surveillance at customs of inbound travelers and establish an intelligent surveillance and early warning system to prevent importation of RIDs to China for preventing further spread within China.

Clinical status and its associated early warning per emerging infectious respiratory disease in China

In the past ten years, we had experienced a series of .emerging severe acute respiratory infections （SARI）.Some of them became serious public health emergent events, such as severe acute respiratory syndrome （SARS） and novel A/H7N9 avian influenza. Tracing back to 2003, SARS originated from Guangdong province and spread to 29 countries and regions until it was completely controlled. Out of 8 096 probable SARS cases world-wide, 774 patients died; the mortality was 9.6%.1 There were 5 327 patients with SARS in China, and 1 002 （19%） of them were health care workers （HCW）. Nearly all the HCW got hospital acquired infection since there was no efficient preventive and protective system.

Prematurity and the burden of influenza and respiratory syncytial virus disease

Background:Respiratory morbidity of former preterm infants and especially those with bronchopulmonary dysplasia(BPD)is high during infancy and early childhood.Data sources:We performed a review based on a literature search including EMBASE,MEDLINE,and CINAHL databases to identify all relevant papers published in the English and German literature on influenza and respiratory syncytial virus infection associated with preterm infant,prematurity,and BPD between 1980 and 2014.Results:Recurrent respiratory symptoms remain common at preschool age,school age and even into young adulthood.Acute viral respiratory tract infections due to different pathogens cause significant morbidity and necessitate rehospitalizations during the fi rst years of life.Infl uenza virus infection plays a minor role compared to respiratory syncytial virus(RSV)associated respiratory tract infection during infancy and early childhood.Nevertheless,particular morbidity to both viruses is high.Conclusions:The particular burden of both viral diseases in preterm infants is dominated by RSV and its associated rehospitalizations during the fi rst two years of life.Prophylactic measures include vaccination against influenza virus of family members and caregivers and active immunization starting at the age of 6 months,and monthly injections of palivizumab during the cold season to avoid severe RSV disease and its sequelae.

Detection of respiratory viruses and bacteria in children using a twenty-two target reverse-transcription real-time PCR(RT-qPCR)panel

Background:Rapid detection of the wide range of viruses and bacteria that cause respiratory infection in children is important for patient care and antibiotic stewardship.We therefore designed and evaluated a readyto-use 22 target respiratory infection reverse-transcription real-time polymerase chain reaction(RT-qPCR)panel to determine if this would improve detection of these agents at our pediatric hospital.Methods:RT-qPCR assays for twenty-two target organisms were dried-down in individual wells of 96 well plates and saved at room temperature.Targets included 18 respiratory viruses and 4 bacteria.After automated nucleic acid extraction of nasopharyngeal aspirate(NPA)samples,rapid qPCR was performed.RT-qPCR results were compared with those obtained by the testing methods used at our hospital laboratories.Results:One hundred fi fty-nine pediatric NPA samples were tested with the RT-qPCR panel.One or more respiratory pathogens were detected in 132/159(83%)samples.This was significantly higher than the detection rate of standard methods(94/159,59%)(P<0.001).This difference was mainly due to improved RT-qPCR detection of rhinoviruses,parainfl uenza viruses,bocavirus,and coronaviruses.The panel internal control assay performance remained stable at room temperature storage over a two-month testing period.Conclusions:The RT-qPCR panel was able to identify pathogens in a high proportion of respiratory samples.The panel detected more positive specimens than the methods in use at our hospital.The pre-made panel format was easy to use and rapid,with results available in approximately 90 minutes.We now plan to determine if use of this panel improves patient care and antibiotic stewardship.

Clinical characteristics and risk factors of severe respiratory syncytial virus-associated acute lower respiratory tract infections in hospitalized infants

Background:To investigate the clinical characteristics and analyze risk factors for severe respiratory syncytial virus(RSV)infection in hospitalized infants with acute lower respiratory tract infections(ALRIs).Methods:A retrospective review of the medical records of infants with RSV-associated ALRIs between March 1st,2011 and February 29th,2012 was conducted.Subjects were followed up over the phone or by outpatient visit six and twelve months after discharge.Results:Among 913 RSV-associated ALRIs infants,288(31.5%)had severe infections,which accounted for 4.2%of hospitalized children.The hospital RSV mortality rate was 1.0%.The proportions of cases with tachypnea,apnea,cyanosis,and fine rales were significantly higher in the severe ALRIs group(all P<0.001).Multivariate logistic regression showed that low-birth-weight[1.698(1.028-2.805)],age less than 3 months old[3.385(2.174-5.271)],congenital heart disease[1.667(1.149-2.418)],bronchopulmonary dysplasia[8.505(1.731-41.780)],and airway abnormalities[2.246(1.008-5.005)]were independent risk factors for severe ALRIs.The incidence of bronchitis,pneumonia and readmission in the severe group was significantly higher than that of the non-severe group during the one-year follow-up(all P<0.001).Conclusions:Younger age,low birth weight and underlying disease are associated with severe RSVassociated ALRIs.Furthermore,severe RSV infections may be associated with a higher frequency of subsequent bronchitis,pneumonia and re-hospitalization in the following year.