Ebola Virus Disease: General Characteristics, Thoughts, and Perspectives

In December 2013, a new round of Ebola virus disease （EVD） first occurred in a remote countryside of Guinea and then spread in Guinea, Liberia, Sierra Leone, and Nigeria of West Africa. EVD, caused by Ebolavirus and previously known as Ebola hemorrhagic fever, is an acute infectious disease with fatality rates up to 90%. As of August 22, 2014, the number of suspected and confirmed cases was 2615, causing 1427 deaths[I]. On August 8, 2014, World Health Organization announced the current outbreak in West Africa as an international public health emergency. The global epidemic tendency remains ambiguous to date. In recent years, China closely collaborates with West Africa in labor, business, overseas education, and also sends aid medical team there. Thus, the risk of importing the disease cannot be ignored. We conduct this literature review of epidemiology, pathogen, prophylaxis, and treatment to provide evidence for controlling the risk and carrying out effective interventions.

Dynamics of Rodent and Rodent-borne Disease during Construction of the Three Gorges Reservoir from 1997 to 2012

Objective To investigate the impact of impoundment and active public health interventions on rodent populations and rodent-borne diseases in the Three Gorges reservoir region from 1997 to 2012. Methods Surveillance data from 1997 to 2012 were extracted from the Public Health Surveillance System of The Three Gorges established in 1997. Temporal changes in the incidences of hemorrhagic fever with renal syndrome （HFRS） and leptospirosis, rodent density, pathogen-carrying rates, and their correlations were analyzed. Results The average indoor and outdoor rodent densities decreased overall from 1997 to 2012. The average densities decreased by 47.72% （from 4.38% to 2.29%） and 39.68% （from 4.41% to 2.66%）, respectively, after impoundment （2003-2012） compared with before impoundment （1997-2002）. The average annual incidence rates of HFRS and leptospirosis were 0.29/100,000 and 0.52/100,000, respectively, and decreased by 85.74% （from 0.68/100,000 to 0.10/100,000） and 95.73% （from 1.47/100,000 to 0.06S/100,000）, respectively, after impoundment compared with before impoundment. Incidences of HFRS and leptospirosis appear to be positively correlated with rodent density in the reservoir area. Conclusion This study demonstrated that rodent density and incidences of rodent-borne diseases decreased and were maintained at low levels during construction of the Three Gorges dam. Measures that reduce rodent population densities could be effective in controlling rodent-borne diseases during large-scale hydraulic engineering construction.

Non-pharmaceutical interventions for COVID-19 reduced the incidence of infectious diseases:a controlled interrupted time-series study

Background Non-pharmaceutical interventions(NPIs)have been implemented worldwide to suppress the spread of coronavirus disease 2019(COVID-19).However,few studies have evaluated the effect of NPIs on other infectious diseases and none has assessed the avoided disease burden associated with NPIs.We aimed to assess the effect of NPIs on the incidence of infectious diseases during the COVID-19 pandemic in 2020 and evaluate the health economic benefits related to the reduction in the incidence of infectious diseases.Methods Data on 10 notifiable infectious diseases across China during 2010–2020 were extracted from the China Information System for Disease Control and Prevention.A two-stage controlled interrupted time-series design with a quasi-Poisson regression model was used to examine the impact of NPIs on the incidence of infectious diseases.The analysis was first performed at the provincial-level administrative divisions(PLADs)level in China,then the PLAD-specific estimates were pooled using a random-effect meta-analysis.Results A total of 61,393,737 cases of 10 infectious diseases were identified.The implementation of NPIs was associated with 5.13 million(95%confidence interval[CI]3.45‒7.42)avoided cases and USD 1.77 billion(95%CI 1.18‒2.57)avoided hospital expenditures in 2020.There were 4.52 million(95%CI 3.00‒6.63)avoided cases for children and adolescents,corresponding to 88.2%of total avoided cases.The top leading cause of avoided burden attributable to NPIs was influenza[avoided percentage(AP):89.3%;95%CI 84.5‒92.6].Socioeconomic status and population density were effect modifiers.Conclusions NPIs for COVID-19 could effectively control the prevalence of infectious diseases,with patterns of risk varying by socioeconomic status.These findings have important implications for informing targeted strategies to prevent infectious diseases.

Screening Pathogenic Microorganism Standard Strains for Disinfection Efficacy Evaluation

Infectious diseases would always threaten human health,especially emerging infectious diseases(EIDs),such as the coronavirus disease-2019(COVID-19).In 2019,COVID-19 spread rapidly worldwide.On January 30,2020,World Health Organization(WHO)declared its outbreak a public health emergency of international concern.

Plastic Expander-Related Gordonia Sputi Infection: Case Report and Literature Review

Gordonia sputi 引起源于一台污染存在于的医药设备的稀罕细菌的感染。我们在一个女人报导手术后的塑料扩展脓肿的案例，与 G。由定序的 16S ribosomal RNA 的 sputi 鉴定。这份报告显示那 Gordonia spp。应该在引起塑料的有机体的表被包括植入感染。

Epidemiological Characteristics and Spatiotemporal Distribution Patterns of Human Norovirus Outbreaks in China, 2012–2018

Objective To clarify the epidemiological characteristics and spatial distribution patterns of human norovirus outbreaks in China, identify high-risk areas, and provide guidance for epidemic prevention and control.Methods This study analyzed 964 human norovirus outbreaks involving 50,548 cases in 26 provinces reported from 2012 to 2018. Epidemiological analysis and spatiotemporal scanning analysis were conducted to analyze the distribution of norovirus outbreaks in China.Results The outbreaks showed typical seasonality, with more outbreaks in winter and fewer in summer, and the total number of infected cases increased over time. Schools, especially middle schools and primary schools, are the most common settings of norovirus outbreaks, with the major transmission route being life contact. More outbreaks occurred in southeast coastal areas in China and showed significant spatial aggregation. The highly clustered areas of norovirus outbreaks have expanded northeast over time.Conclusion By identifying the epidemiological characteristics and high-risk areas of norovirus outbreaks, this study provides important scientific support for the development of preventive and control measures for norovirus outbreaks, which is conducive to the administrative management of high-risk settings and reduction of disease burden in susceptible areas.

Diagnostic performance of different specimens in detecting enterovirus A71 in children with hand,foot and mouth disease

Hand,foot and mouth disease(HFMD)is a major public health problem among children in the Asia-Pacific region.The optimal specimen for HFMD virological diagnosis remains unclear.Enterovirus A71(EV-A71)neutralizing antibody titres detected in paired sera were considered the reference standard for calculating the sensitivity,specificity,positive and negative predictive value of throat swabs,rectal swabs,stool,blood samples and cerebrospinal fluid(CSF)by RT-PCR or ELISA assay.In this study,clinical samples from 276 HFMD patients were collected for analysing the sensitivity of different kind of specimens.Our results showed that stool had the highest sensitivity(88%,95%CI:74%–96%)and agreement with the reference standard(91%).The order of diagnostic yield for EV-A71 infection was stool samplerectal swab>throat swab>blood sample>CSF sample,and using a combination of clinical samples improved sensitivity for enterovirus detection.The sensitivity of ELISA for IgM antibody detection in sterile-site specimens was significantly higher than that of RT-PCR(serum/plasma:62%vs.2%,CSF:47%vs.0%)(P<0.002).In conclusion,our results suggest that stool has the highest diagnostic yield for EV-A71-infected HFMD.If stool is unavailable,rectal swabs can be collected to achieve a similar diagnostic yield.Otherwise,throat swabs may be useful in detecting positive samples.Although IgM in blood or CSF is diagnostically accurate,it lacks sensitivity,missing 40%–50%of cases.The higher proportion of severe cases and shorter interval between onset and sampling contributed to the increase in congruency between clinical testing and the serological reference standard.

Neglected tropical diseases in the People’s Republic of China: progress towards elimination

Since the founding of the People's Republic of China in 1949,considerable progress has been made in the control and elimination of the country's initial set of 11 neglected tropical diseases.Indeed,elimination as a public health problem has been declared for lymphatic filariasis in 2007 and for trachoma in 2015.The remaining numbers of people affected by soil-transmitted helminth infection,clonorchiasis,taeniasis,and echinococcosis in 2015 were 29.1 million,6.0 million,366200,and 166100,respectively.In 2017,after more than 60 years of uninterrupted,multifaceted schistosomiasis control,has seen the number of cases dwindling from more than 10 million to 37600.Meanwhile,about 6000 dengue cases are reported,while the incidence of leishmaniasis,leprosy,and rabies are down at 600 or fewer per year.Sustained social and economic development,going hand-in-hand with improvement of water,sanitation,and hygiene provide the foundation for continued progress,while rigorous surveillance and specific public health responses will consolidate achievements and shape the elimination agenda.Targets for poverty elimination and strategic plans and intervention packages post-2020 are important opportunities for further control and elimination,when remaining challenges call for sustainable efforts.

Genetic Variation of Multiple Serotypes of Enteroviruses Associated with Hand, Foot and Mouth Disease in Southern China

Enteroviruses(EVs)species A are a major public health issue in the Asia–Pacific region and cause frequent epidemics of hand,foot and mouth disease(HFMD)in China.Mild infections are common in children;however,HFMD can also cause severe illness that affects the central nervous system.To molecularly characterize EVs,a prospective HFMD virological surveillance program was performed in China between 2013 and 2016.Throat swabs,rectal swabs and stool samples were collected from suspected HFMD patients at participating hospitals.EVs were detected using generic real-time and nested reverse transcription-polymerase chain reactions(RT-PCRs).Then,the complete VP1 regions of enterovirus A71(EV-A71),coxsackievirus A16(CVA16)and CVA6 were sequenced to analyze amino acid changes and construct a viral molecular phylogeny.Of the 2836 enrolled HFMD patients,2,517(89%)were EV positive.The most frequently detected EVs were CVA16(32.5%,819),CVA6(31.2%,785),and EV-A71(20.4%,514).The subgenogroups CVA16B1 b,CVA6D3 a and EV-A71C4 a were predominant in China and recombination was not observed in the VP1 region.Sequence analysis revealed amino acid variations at the 30,29 and 44 positions in the VP1 region of EV-A71,CVA16 and CVA6(compared to the respective prototype strains Br Cr,G10 and Gdula),respectively.Furthermore,in 21 of 24(87.5%)identified EV-A71 samples,a known amino acid substitution(D31 N)that may enhance neurovirulence was detected.Our study provides insights about the genetic characteristics of common HFMD-associated EVs.However,the emergence and virulence of the described mutations require further investigation.

Public Awareness and Mask Usage during the COVID-19 Epidemic:A Survey by China CDC New Media

An online survey conducted March 18–19,2020 on the official China CDC WeChat account platform was used to evaluate the effect of public education about masks usage during the new coronavirus disease 2019(COVID-19)epidemic.Chinese nationals older than 18 were eligible for the survey.The survey collected 5,761 questionnaires from the 31 provinces,municipalities,and autonomous regions of China's Mainland.99.7%and 97.2%of the respondents answered correctly that respiratory droplets and direct contact were the main transmission routes.73.3%of the respondents considered COVID-19 to be‘serious’or‘very serious’.

The Adverse Effect of the 2-1-1 Regimen for Rabies PEP in Preschool Children

Post-exposure prophylaxis（PEP） has proved to be the most important measure for rabies prevention and control. There is little information regarding adverse reactions to the Essen and 2-1-1 regimens in preschool children（aged 0-6）. We reexamined the outcomes of 1,109 preschool children who were vaccinated using SPEEDA under the Essen regimen between January 2011 and December 2012 and 1,267 preschool children under the 2-1-1 regimen between January 2013 and December 2014. We find that, in preschool children, the febrile reaction after the first 2-dose injection in the 2-1-1 regimen was significantly higher than that induced by the first 1-dose in the Essen procedure. Thus, we recommend that the Essen regimen should still be used for rabies PEP in preschool children.

Epidemic Characteristics,High-Risk Areas and Space-Time Clusters of Human Brucellosis—China,2020-2021

Introduction:Analyze the recent epidemiological and temporal-spatial characteristics of human brucellosis in China and provide information for adjusting strategies for brucellosis control.Methods:Human brucellosis data were obtained from the National Notifiable Disease Reporting System(NNDRS).A geographical information system(GIS)was used to visualize high-risk areas with annual incidence based on county(district)polygons.The space-time scan statistic(STSS)was applied to detect the space-time clusters of human brucellosis.Results:A total of 69,767 cases were reported from 2,083 counties in the mainland of China in 2021,a 47.7%increase from 2020(47,425).About 95.5%of the total cases were centralized in northern China and 31.8%in Inner Mongolia(IM).The number of counties with an incidence exceeding 100 per 100,000 was 34 in 2020 and 65 in 2021.From 2020 to 2021,24 space-time clusters were detected.The two primary clusters were located northeast of IM,including 109 counties.The secondary clusters affected 208 counties in 2020 and spread to 297 counties in 2021,the majority of which were located in the middle of IM,exhibiting a trend spreading west from IM to neighboring provincial-level administrative divisions(PLADs).Conclusions:From 2020 to 2021,the incidence of human brucellosis nationwide was exponential,demonstrating distinct spatiotemporal characteristics.Space-time clusters were located in IM and neighboring areas.Therefore,considerable efforts are required to curb this momentum.

Comparative study on epidemiological and etiological characteristics of patients with acute diarrhea with febrile or non-febrile symptoms in China

Background Acute diarrhea with fever can potentially represent a more severe form of the disease compared to non-febrile diarrhea. This study was to investigate the epidemiological characteristics and enteric pathogen composition of febrile-diarrheal patients, and to explore factors including pathogens associated with fever by age group.Methods A nationwide surveillance study of acute diarrheal patients of all ages was conducted in 217 sentinel hospitals from 31 provinces (autonomous regions or municipalities) in China between 2011 and 2020. Seventeen diarrhea-related pathogens, including seven viruses and ten bacteria, were investigated and their association with occurrence of fever symptoms was assessed using multivariate logistic analysis.Results A total of 146,296 patients with acute diarrhea (18.6% with fever) were tested. Th diarrheal children below 5 years had the highest frequency of fever (24.2%), and related to significantly higher prevalence of viral enteropathogens (40.2%) as compared with other age groups (P < 0.001). Within each age group, the febrile-diarrheal patients were associated with a significantly higher prevalence of bacterial pathogens than afebrile-diarrheal patients (allP < 0.01). There was discrepancy when each pathogen was compared, i.e., nontyphoidalSalmonella (NTS) was over-represented in febrile vs non-febrile patients of all age groups, while the febrile vs non-febrile difference for diarrheagenicEscherichia coli (DEC) was only significant for adult groups. The multivariate analysis revealed significant association between fever and infection with rotavirus A among children [odds ratio (OR) = 1.60], for DEC in adult groups (OR = 1.64), for NTS in both children (OR = 2.95) and adults (OR = 3.59).Conclusions There are significant discrepancy of the infected enteric pathogens in patients with acute diarrhea with fever between age groups, and it is valuable for priority detection of NTS and rotavirus A in patients with children < 5 years old and NTS and DEC in adult patients. The results may be useful in identifying dominant pathogen candidates for the application of diagnostic assays and prevention control.

First identification of kdr allele F1534S in VGSC gene and its association with resistance to pyrethroid insecticides in Aedes albopictus populations from Haikou City,Hainan Island,China

Background:Aedes albopictus is distributed widely in China,as a primary vector of Dengue fever and Chikungunya fever in south of China.Chemical insecticide control is one of the integrated programmes to prevent mosquito-borne diseases.Long-term applications of pyrethroids have resulted in the development of resistance in Ae.albopictus populations in China.However,the susceptibility of Ae.albopictus to pyrethroids in Hainan Island was unclear.Knockdown resistance(kdr),caused by point mutations in the VGSC gene,is one of the mechanisms that confer resistance to DDT and pyrethroids.This study was to investigate the resistance level of Ae.albopictus populations in Haikou City to three pyrethroid insecticides,and elucidate the relationship between the resistant phenotype and kdr mutations.Methods:The Aedes albopictus samples were collected in Xinbu Island(XI),Longtang Town(LT),Shishan Town(ST),Baishamen Park(BP),and Flower Market(FM)from Haikou City,Hainan Island,China.The larval susceptibility to deltamethrin,permethrin and beta-cypermethrin was tested by larval bioassays,and adult susceptibility to deltamethrin and DDT was determined by adult bioassays.The degree of resistance was determined by resistance ratio value(RR50>3)for larvae and by mortality for adult.The kdr alleles at codon 1534 of the VGSC gene were genotyped.The relationship between kdr genotypes and resistant phenotypes was analyzed by Chi-square test.Results:Out of five populations,assessed by larval bioassays,XI was susceptible to deltamethrin and permethrin;LT was susceptible to permethrin and beta-cypermethrin;and ST was susceptible to permithrin.FM and BP both were resistant to all of the three pyrethroids,and FM showed the highest degree of resistance,with RR50 values from 65.17 to 436.36.A total of 493 individuals from the larval bioassays were genotyped for kdr alleles.Five alleles were detected,including two wildtype alleles,TTC(F)(67.04%)and TTT(F)(0.41%),and three mutant alleles,TGC(C)(0.30%),TCC(S)(31.54%)and TTG(L)(0.71%).There was a clear correlation between mutant alleles(or F1534S)and resistant phenotypes(P<0.01).Conclusion:Two novel kdr mutant alleles F1534S and F1534L were detected in the pyrethroid resistant populations of Ae.albopictus in Haikou Hainan,China.For the first time,the mutant F1534S was associated with pyrethroid resistance in Ae.albopictus.

The economic burden of influenza-associated outpatient visits and hospitalizations in China: a retrospective survey

Background:The seasonal influenza vaccine coverage rate in China is only 1.9%.There is no information available on the economic burden of influenza-associated outpatient visits and hospitalizations at the national level,even though this kind of information is important for informing national-level immunization policy decision-making.Methods:A retrospective telephone survey was conducted in 2013/14 to estimate the direct and indirect costs of seasonal influenza-associated outpatient visits and hospitalizations from a societal perspective.Study participants were laboratory-confirmed cases registered in the National Influenza-like Illness Surveillance Network and Severe Acute Respiratory Infections Sentinel Surveillance Network in China in 2013.Patient-reported costs from the survey were validated by a review of hospital accounts for a small sample of the inpatients.Results:The study enrolled 529 outpatients(median age:eight years;interquartile range[IQR]:five to 20 years)and 254 inpatients(median age:four years;IQR:two to seven years).Among the outpatients,22.1%(117/529)had underlying diseases and among the inpatients,52.8%(134/254)had underlying diseases.The average total costs related to influenza-associated outpatient visits and inpatient visits were US$155(standard deviation,SD US$122)and US$1,511(SD US$1,465),respectively.Direct medical costs accounted for 45 and 69%of the total costs related to influenza-associated outpatient and inpatient visits,respectively.For influenza outpatients,the mean cost per episode in children aged below five years(US$196)was higher than that in other age groups(US$129–153).For influenza inpatients,the mean cost per episode in adults aged over 60 years(US$2,735)was much higher than that in those aged below 60 years(US$1,417–1,621).Patients with underlying medical conditions had higher costs per episode than patients without underlying medical conditions(outpatients:US$186 vs.US$146;inpatients:US$1,800 vs.US$1,189).In the baseline analysis,inpatients reported costs were 18%higher than those found in the accounts review(n=38).Conclusion:The economic burden of influenza-associated outpatient and inpatient visits in China is substantial,particularly for young children,the elderly,and patients with underlying medical conditions.More widespread influenza vaccination would likely alleviate the economic burden of patients.The actual impact and cost-effectiveness analysis of the influenza immunization program in China merits further investigation.

Comparative evaluation of the diagnosis, reporting and investigation of malaria cases in China, 2005–2014: transition from control to elimination for the national malaria programme

Background:The elimination of malaria requires high-quality surveillance data to enable rapid detection and response to individual cases.Evaluation of the performance of a national malaria surveillance system could identify shortcomings which,if addressed,will improve the surveillance program for malaria elimination.Methods:Case-level data for the period 2005–2014 were extracted from the China National Notifiable Infectious Disease Reporting Information System and Malaria Enhanced Surveillance Information System.The occurrence of cases,accuracy and timeliness of case diagnosis,reporting and investigation,were assessed and compared between the malaria control stage(2005–2010)and elimination stage(2011–2014)in China's Mainland.Results:A total of 210730 malaria cases were reported in China's Mainland in 2005–2014.The average annual incidence declined dramatically from 2.5 per 100000 people at the control stage to 0.2 per 100000 at the elimination stage,but the proportion of migrant cases increased from 9.8%to 41.0%.Since the initiation of the National Malaria Elimination Programme in 2010,the overall proportion of cases diagnosed by laboratory testing consistently improved,with the highest of 99.0%in 2014.However,this proportion was significantly lower in non-endemic provinces(79.0%)than that in endemic provinces(91.4%)during 2011–2014.The median interval from illness onset to diagnosis was 3 days at the elimination stage,with one day earlier than that at the control stage.Since 2011,more than 99%cases were reported within 1 day after being diagnosed,while the proportion of cases that were reported within one day after diagnosis was lowest in Tibet(37.5%).The predominant source of cases reporting shifted from town-level hospitals at the control stage(67.9%cases)to city-level hospitals and public health institutes at the eliminate stage(69.4%cases).The proportion of investigation within 3 days after case reporting has improved,from 74.6%in 2010 to 98.5%in 2014.Conclusions:The individual case-based malaria surveillance system in China operated well during the malaria elimination stage.This ensured that malaria cases could be diagnosed,reported and timely investigated at local level.However,domestic migrants and overseas populations,as well as cases in the historically malarial non-endemic areas and hard-to-reach area are new challenges in the surveillance for malaria elimination.

Challenges and needs for China to eliminate rabies

In China,rabies is a significant public health concern where dogs remain the main reservoir of disease transmission to humans;rabies-related mortality ranks second in the world.We compiled all published articles and official documents on rabies in China's Mainland to examine challenges and needs to eliminate rabies in the country.The Chinese authorities have identified rabies as a priority,recognized rabies control in dogs as key to control rabies in humans and required intersectoral collaborations.Efforts have been made to respond effectively to the latest re-emergence of rabies,which peaked in 2007 with>3,300 cases.Despite these outcomes and the increasing volume of publications and regulations in the recent years,our review points to some major information gaps to improve rabies control activities and envisage elimination program.An emphasis on laboratory or pathogen-associated and basic epidemiology research in the literature has contrasted with the absence of information to monitor various systems in humans and animals(e.g.quality of surveillance,response and post-exposure prophylaxis).Information is also lacking to appropriately inform policymakers(e.g.economic disease burden,impact of policies)and assist program managers(e.g.comprehensive and strategic guidance for cost-effective prevention and control activities,public education and dog population management).In conclusion,strategic planning is needed to provide a sense of direction,demonstrate feasibility of elimination in China,and develop a research agenda,addressing country’s operational needs and constraints.The planning should be a multisectoral effort.

Transmission and mortality risk assessment of severe fever with thrombocytopenia syndrome in China:results from 11-years’study

Background: The transmission and fatal risk of severe fever with thrombocytopenia syndrome (SFTS), an emerging infectious disease first discovered in China in 2009, still needed further quantification. This research aimed to analyze the SFTS clusters and assess the transmission and mortality risk for SFTS.Methods: Both epidemiological investigation and case reports regarding SFTS clusters in China during 2011-2021 were obtained from the Public Health Emergency Information Management System of the Chinese Center for Disease Control and Prevention Information System. The transmission risk was evaluated by using the secondary attack rate (SAR) and relative risk (RR). Mortality risk factors were analyzed using a logistic regression model.Results: There were 35 SFTS clusters during 2011-2021 involving 118 patients with a fatality rate of 22.0%. The number of clusters annually increased seasonally from April to September. The clusters mainly occurred in Anhui (16 clusters) and Shandong provinces (8 clusters). The SAR through contact with blood or bloody fluids was much higher than that through contact with non-bloody fluids (50.6% vs 3.0%;χ^(2) = 210.97,P < 0.05), with anRR of 16.61 [95% confidence interval (CI): 10.23-26.97]. There was a statistically significant difference in the SAR between exposure to the blood of a deceased person during burial preparation and exposure to the living patients’ blood (66.7% vs 34.5%;χ^(2)= 6.40,P < 0.05), with anRR of 1.93 (95%CI: 1.11-3.37). The mortality risk factors were a long interval from onset to diagnosis [odds ratio (OR)= 1.385), 95%CI: 1.083-1.772,P= 0.009) and advanced age (OR: 1.095, 95%CI: 1.031-1.163,P= 0.01).Conclusions: The SFTS clusters showed a high mortality rate and resulted in a high SAR. Contact with a bleeding corpse was associated with a higher infection risk, compared with contacting the blood from living patients. It is important to promote early detection and appropriate case management of patients with SFTS, as well as improved handling of their corpses, to prevent further transmission and mortality.

Global dynamic spatiotemporal pattern of seasonal influenza since 2009 influenza pandemic

Background:Understanding the global spatiotemporal pattern of seasonal influenza is essential for influenza control and prevention.Available data on the updated global spatiotemporal pattern of seasonal influenza are scarce.This study aimed to assess the spatiotemporal pattern of seasonal influenza after the 2009 influenza pandemic.Methods:Weekly influenza surveillance data in 86 countries from 2010 to 2017 were obtained from FluNet.First,the proportion of influenza A in total influenza viruses(PA)was calculated.Second,weekly numbers of influenza positive virus(A and B)were divided by the total number of samples processed to get weekly positive rates of influenza A(RWA)and influenza B(RWB).Third,the average positive rates of influenza A(RA)and influenza B(RB)for each country were calculated by averaging RWA,and RWB of 52 weeks.A Kruskal-Wallis test was conducted to examine if the year-to-year change in PA in all countries were significant,and a universal kriging method with linear semivariogram model was used to extrapolate RA and RB in all countries.Results:PA ranged from 0.43 in Zambia to 0.98 in Belarus,and PA in countries with higher income was greater than those countries with lower income.The spatial patterns of high RB were the highest in sub-Saharan Africa,Asia-Pacific region and South America.RWA peaked in early weeks in temperate countries,and the peak of RWB occurred a bit later.There were some temperate countries with non-distinct influenza seasonality(e.g.,Mauritius and Maldives)and some tropical/subtropical countries with distinct influenza seasonality(e.g.,Chile and South Africa).Conclusions:Influenza seasonality is not predictable in some temperate countries,and it is distinct in Chile,Argentina and South Africa,implying that the optimal timing for influenza vaccination needs to be chosen with caution in these unpredictable countries.

Assessment of malaria control consultation and service posts in Yunnan, P. R. China

Background:This paper seeks to assess the function of malaria control consultation and service posts(MCCSPs)that are located on the border areas of Yunnan province,P.R.China,as a strategy for eliminating malaria among the mobile and migrant population in these areas.Methods:A retrospective descriptive analytical study was conducted.Blood smear examinations conducted at all MCCSPs in Yunnan from 2008 to 2014 were analysed.A cross-sectional survey was conducted in 2014 to understand how the MCCSPs function and to elucidate the quality of the blood smear examinations that they conduct.Results:Out of the surveyed MCCSPs,66%(39/59),22%(13/59),and 12%(7/59)were attached to local township hospitals,village health clinics,and the county centre for disease control and prevention or private clinics,respectively.More than 64%(38/59)of the posts’staff were part-time workers from township hospitals and village health facilities.Less than 31%(18/59)of the posts’staff were full-time workers.A total of 35 positive malaria cases were reported from seven MCCSPs in 2014.Four MCCSPs were unable to perform their functions due to under staffing in 2014.There was a small fluctuation in blood smear examinations from January 2008 to June 2009,with two peaks during the period from July 2009 to October 2010.The number of blood smear examinations has been increasing since 2011.The yearly mean number of blood smear examinations in each post increased from 44 per month in 2011 to 109 per month in 2014,and the number of positive malaria cases detected by blood smear examinations has declined(χ^(2)=90.67,P=0.000).The percentage of people from Yingjiang county getting blood smear examinations increased between 2008 and 2014,while percentages of the mobile population including Myanmar people,people from other provinces,and people from other Yunnan counties getting blood smear examinations decreased.Conclusion:MCCSPs face challenges in the phase of malaria elimination in Yunnan,China.New case detection strategies should be designed for MCCSPs taking into account the current trends of migration.