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In recent years， with frequent outbreaks of infectious diseases around the world， the global public health is faced with many threats and challenges. An infectious diseases early warning system is an important means for prevention and control of infectious diseases. As an important part of the early warning system， the warning indicators is crucial for understanding the occurrence and development trend of infectious diseases， detecting abnormal situations timely and effectively， and issuing early warning and initiating emergency response. Based on the occurrence and development process of infectious diseases， this paper summarizes the research status of early warning indicators on infectious diseases， in order to provide reference for the development and improvement of the infectious diseases early warning system.
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ObjectiveTo understand the epidemic characteristics of notifiable infectious diseases （NIDs） other than coronavirus disease 2019 （COVID-19） in Shanghai in 2020， and to provide evidence for formulating infectious disease prevention and control strategies. MethodsData of NIDs reported in Shanghai from 2015 to 2020 were collected through the National Information System for Disease Control and Prevention. Descriptive epidemiological methods were used to analyze the incidence and prevalence characteristics of NIDs in Shanghai in 2020， and compared them with the average values of 2015 to 2019. ResultsA total of 45 574 cases of 23 kinds of NIDs were reported in Shanghai in 2020， except for COVID-19， with an incidence of 187.69/105， and a decrease rate of 50.58% compared with the average value of 2015 to 2019. The incidence of category B and C infectious diseases decreased by 38.07% and 57.47%， respectively （All P<0.001）. The top 3 reported infectious diseases with the highest incidence rate were influenza （64.58/105）， syphilis （39.09/105） and tuberculosis （24.90/105）. The incidence of most infectious diseases decreased compared with the average of 2015 to 2019， among which measles （97.15%）， rubella （88.81%）， pertussis （87.43%）， hand foot mouth disease （85.99%） and scarlet fever （79.84%） decreased significantly （all P<0.001）. In general， compared with the average from 2015 to 2019， respiratory infectious diseases declined most， followed by intestinal infectious diseases， insect-borne and natural focal infectious diseases， blood-borne and sexually transmitted diseases. Districts with higher incidence in 2020 were Fengxian District （310.23/105）， Xuhui District （271.93/105） and Hongkou District （254.38/105）. Respiratory infectious diseases in Fengxian District， intestinal infectious diseases in Jinshan District， blood-borne and sexually transmitted infectious diseases in Changning District， and insect-borne and natural focal infectious diseases in Yangpu District showed the highest incidence rate. Incidence of infectious diseases in 16 districts of Shanghai decreased with different degrees （all P<0.001）. Incidence of infectious diseases in males （209.44/105） was higher than that in females （164.89/105） （χ2=624.864， P<0.001）. Children aged 0-9 years had the highest incidence of respiratory and intestinal infectious diseases. People aged 70‒79 years and 20‒29 years had higher incidence of blood-borne and sexually transmitted infectious diseases， and people aged 20‒29 years had the highest incidence of insect-borne and natural focal infectious diseases. Majority of the patients were students （8 327 cases， 18.27%）， retired people （6 393 cases， 14.03%） and unemployed household workers （5 988 cases， 13.14%）. ConclusionUnder the COVID-19 prevention and control policies， the incidence of most NIDs in Shanghai decreased significantly in 2020.
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Objective@#To understand the epidemiological characteristics of product-related injuries among children in Changshan County from 2011 to 2017 and to provide evidence for targeted intervention. @*Methods@#The surveillance data of product-related injuries among children aged below 18 years from 2011 to 2017 was collected from three sentinel hospitals in Changshan County. The characteristics of product-related injuries among children were analyzed,especially those injuries caused by furniture,stationery and sporting goods,commodities and toys. @*Results@#A total of 5 111 product-related injury cases among children were reported,accounting for 13.49% of product-related injury cases of all age. There were 3 138 boys and 1 973 girls,accounting for 61.40% and 38.60%. There were 2 973 cases less than 10 years old,accounting for 58.17%. The main causes of product-related injuries were road traffic injury（49.46%）,blunt（16.02%）,stab/cut（12.39%）and fall（10.37%）. The main categories of products included transportation equipments（not including motor vehicles,36.83%）,motor vehicles（17.82%）,furniture（12.23%）,stationery and sporting goods（8.45%）,commodities（4.89%）and toys（3.25%）. Stab/cut（53.01%）was the main cause of commodities related injuries;blunt was the main cause of furniture,stationery and sporting goods and toys. The stationery and sporting goods related injuries occurred mainly in schools/public places（64.57%）and sports venues（18.48%）when engaging in sports（54.13%）;furniture,commodities and toys related injuries injured cases occurred at home when engaging in leisure activities. Commodities mainly resulted in sharp/bite/open wound（51.50%）;furniture,stationery and sporting goods and toys mainly resulted in bruises. Most cases were injured in head,slight and allowed home after treated.@*Conclusion@#The product-related injuries among children in Changshan County are more boys. The products mainly involve transportation equipments（not including motor vehicles）,motor vehicles,furniture,stationery and sporting goods,commodities and toys,with emphasis on the latter four categories in the prevention of product-related child injury.
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Objective To improve the understanding of cutaneous Mycobacterium haemophilum infection.Methods Clinical and laboratory data were collected from two patients with cutaneous Mycobacterium haemophilum infection.The clinical and histopathologic manifestations, etiology and treatment of cutaneous Mycobacterium haemophilum infection were analyzed.Results The two patients were both immunocompromised.Lesions, which occurred after trauma in both the patients, began as well-marginated subcutaneous nodules, and then gradually progressed into ulceration with crusting and abscess formation.Histopathological examination revealed epithelial cell granuloma or histiocytic infiltrate in the dermis, as well as focal necrosis and neutrophil abscesses.Acid-fast staining showed abundant bacilli in tissues.These bacilli only grew in iron-containing medium, and were finally identified as Mycobacterium haemophilum by PCR and sequencing.According to the result of antimicrobial sensitivity testing, both the patients were treated with rifampicin, clarithromycin and moxifloxacin.Three months later, the condition was improved in both of them.Conclusions Mycobacterium haemophilum infection occurs most frequently in immunocompromised populations after trauma, manifests as subcutaneous nodules and abscesses with histopathological changes consistent with infectious granuloma.Molecular biological approaches are reliable for the identification of Mycobacterium haemophilum.
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Objective To determine the extracellular enzymatic activity of common pathogens for onychomycosis, in the hope of finding virulence factors associated with the pathogenesis of onychomycosis. Methods Strains tested in this study included standard strains of common dermatophyte and non-dermatophyte fungi as well as clinical isolates of Trichophyton rubrum from patients with onychomycosis. All the tested strains were cultured in medium containing nail fragments at 25 ℃ for 10 to 21 days followed by the determination of the nail fragment-containing medium, a significant increase was observed in the activities of esterase, esterase lipase, N-acetyl-β-glucosaminidase and α-mannosidase in dermatophytes compared with non-dermatophytes (all P ＜ 0.05 ), as well as in the activity of N-acetyl-β-glucosaminidase in Trichophyton rubrum compared with the other tested species of fungi (all P ＜ 0.05). No significant difference was noted in the activity of extracellular enzymes, except for that of naphthol-AS-BI-phosphohydrolase, between the isolates of Trichophyton rubrum from patients with different ranges of scoring clinical index for onychomycosis (SCIO). Conclusions In specific conditions, the extracellular enzymatic activity of fungi isolated from patients with onychomycosis is associated with fungal species, and may have a certain influence on the manifestations of anychomycosis.
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Objective To analyze the clinical characteristics, mycology and therapeutics of 5 cases of cutaneous zygomycosis collected in recent 3 years. Methods A retrospective study was performed using clinical data on 5 cases of cutaneous zygomycosis collected in recent 3 years. Also, previous reports of this entity were reviewed. Results There were 1 male and 4 females among the 5 patients with cutaneous zygo-mycosis confirmed by mycology and/or pathology. The onset of age varied from 5 to 49 years, and course of disease from 7 months to 16 years. Of the 5 patients, 1 presented with superficial cutaneous zygomycosis, and the other 4 with gangrenous cutaneous zygomycosis; 3 had a history of trauma or surgery, 2 had no obvious inducements. Eruptions were located in the face of 2 patients and in the extremities of 3 patients. The isolate was identified as Rhizomucor variabilis in 3 cases, and species remained unclear in 2 cases. Four patients were treated by amphotericin B, and 1 by oral flueonazole as well as oral and injected itraconazole. Finally, 2 patients were healed, 1 was improved, 1 experienced no obvious improvement, and 1 died. Con-clusions Cutaneous zygomycosis is a rare severe devastating deep fungal infection. The first choice of drug is amphoteracin B for it. To improve the understanding of this disease may benefit the early diagnosis and therapy of it.