Evaluation on the implementation of malaria elimination measures in Huzhou City / 预防医学

Objective To analyze the situation of malaria epidemic and the course of prevention and control,and to summarize and promote the experience of malaria elimination. Methods The data of malaria prevention measures of different stages in Huzhou City from 1950 to 2015 were analyzed retrospectively. Results Huzhou City went through three serious malaria epidemics during the past 60 years:1954 to 1955,1962 to 1963 and early 1970. The highest incidence rate was 13 981. 76 / 1 00,000 in 1963. Since standard treatments(including anti - relapse treatment)were carried out and anti - mosquito facilities had improved,the average annual incidence rate in the 70 s declined gradually. From 1980 to 1989,Huzhou City set up 15 - 30 longitudinal monitoring stations which covered 70% villages and towns. In 1989,the City passed the fundamental evaluation of malaria eradication. The average annual incidence rate from 1990 to 2009 was 0. 37 / 1 000,000,and 48. 95% were imported cases. After 2010,Huzhou City had no local malaria case,and all cases reported were imported from 2010 to 2015. Conclusion A remarkable effects of the targeted control measures have been made at different stages in Huzhou City. In order to consolidate the achievements,we should strengthen the monitoring of floating population,timely and effective treatment of imported cases.

Clinical and epidemiological characteristics of the 6 confirmed human cases with novel influenza A (H7N9) virus infection in Zhejiang / 中华流行病学杂志

<p><b>OBJECTIVE</b>To explore the clinical spectrum, geographic location of human H7N9 avian influenza as well as the characteristics of population at high risk of infection, in order to develop strategies for the prevention and control of the infection. Clinical and epidemiological characteristics on the 6 confirmed human cases in Zhejiang were also analyzed.</p><p><b>METHODS</b>Real-time fluorescent quantitative PCR was used to test the nucleic acid of human H7N9 avian influenza infection, from pharyngeal swabs of the patients and their close contacts. Face to face interview and descriptive method were used to collect related clinical and epidemiological data. Statistical analysis was performed by SPSS 17.0.</p><p><b>RESULTS</b>Six confirmed cases were distributed in Hangzhou and Huzhou cities. The 6 confirmed human cases, including 5 males and 1 female were all confirmed with novel influenza A (H7N9) virus infection, with an average age as 60.83 years (with median as 64.50 years). Cough was the most common initial symptom to be noticed. The clinical manifestations would include fever, dizziness, pain of muscles, coughing, expectoration and short of breath. All the X-ray chest films showed severe pneumonia, and 5 of them having had other chronic diseases. None of the cases admitted to have had a history of exposure to ill/death avians. However, all of the cases had been frequently exposed to the agricultural-byproduct-trading-markets where the positive rate of novel influenza A (H7N9) virus in environmental specimens was up to 43.21%. 32 of the 375 close contacts (8.53%) to the 6 cases appeared abnormal symptoms, but no positive result related to novel influenza A (H7N9) virus nucleic acid was detected from their throat swabs.</p><p><b>CONCLUSION</b>Acute infection on the respiratory system seemed the main clinical manifestation. Elderly men, especially those with chronic diseases were under high risk of human infection with H7N9 avian influenza. The source of infection might be associated with the exposure to poultry. There was still lack of evidence to confirm the route of person to person transmission on H7N9 avian influenza.</p>

Rapidly detect and distinguish between norovirus G I and G II type with a pair of primers / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>The purpose of this study was to develop RT- PCR assay for Rapidly detect and distinguish between Norovirus genogroup I and genogroup II with a pair of primers.</p><p><b>METHODS</b>A pairs of primers specific to capsid prote in ORF2 gene of G I and G II Norovirus were dsigned according to the published complete genome sequence, with which the RNA of Norovirus was extracted and RT-PCR amplification. The sensitivity, specificity of the RT- PCR assay was estimated and apply it to the detection of Norovirus in clinical specimens.</p><p><b>RESULTS</b>The results showed that the assay possessed high specificity for Norovirus detection and without any evident cross-reaction with other viruses, including rotavirus, enteric adenovirus and hepatitis A virus. The detection limit of RT-PCR assay for Norovirus G I and G II were up to 100 pg/ml and 10 pg/ml respectively.</p><p><b>CONCLUSION</b>The RT- PCR assay provide rapid and sensitive detection of Norovirus G I and G II and should prove to be useful for Norovirus diagnosis in the outbreaks of acute gastroenteritis.</p>

A norovirus-borne outbreak caused by contaminated bottled spring water in a school, Zhejiang province / 中华流行病学杂志

Objective To study a local hospital reported acute gastroenteritis in a boarding school on its source of infection, mode of transmission and risk factors of the infection. Methods A suspected case was defined as who had developed diarrhea (≥3 times/day) or vomiting among teachers or students of the school, during April 19-30, 2010. A confirmed case was from a probable case plus tested positive for norovirus in stool specimens by using RT-PCR. Stool specimens of cases and environmental specimens were collected for laboratory diagnosis. In a ease-control study, we compared exposures to sources of bottled water, consumption of bottled water, and hygienic habits of 220 probable or confirmed cases from April 21-23 in the peak of the outbreak, together with another 220 controls, with frequency-matched by school grade. Results 20.3% of the 1536 students but none of the teachers developed the disease. 98.6% of the cases (n=217) and 85.5% (n=188) of the controls had drunk bottled water in the classroom (ORM-H= 12.3,95%CI: 3.7-40.9). 47.9% (n= 104)of the cases and 41.5% (n=78)of the controls had drunk unboiled bottled water in classroom (ORM-H=3.8,95%CI: 1.5-9.6). 47.9% (n=104) of the cases and 48.4% (n=91) of the controls had drunk bottled mixed water (boiled and unboiled) in the classroom (ORM-H=2.8, 95%CI: 1.1-7.0).Stool specimens from 3 cases and one bottle of uncovered bottled water in classroom showed positive of having norovirus genotype Ⅱ. Coliforms was cultured much higher rates than standard deviations in the bottled water. The factory making the bottled water was not licensed or having strict disinfection facilities. Conclusion Bottled spring water contaminated by norovirus was responsible for this outbreak.

Molecular characteristics of noroviruses causing outbreaks of acute gastroenteritis in Huzhou / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the molecular characteristics of Noroviruses causing outbreaks of acute gastroenteritis in Huzhou.</p><p><b>METHODS</b>From 2008 to 2010, total 119 fecal specimens collected from outbreaks of acute gastroenteritis were tested for Norovirus. Partial sequence of RNA dependent RNA polymerase (RdRp) of the positive samples were amplified by RT-PCR, then the PCR production were purified, sequenced and put into phylogenetic analysis.</p><p><b>RESULTS</b>50 of 119 specimens were positive for Norovirus by real-time RT-PCR. Out of those 50 Norovirus positive specimens, 9 were Norovirus Genogroup I (GI) positive, 35 were Norovirus Genogroup II (GII) positive, 6 was both Norovirus GI and GII positive. 12 PCR products for RdRp were selected for further studies on sequencing. Phylogenetic analysis revealed that the 5 GI norovirus isolates were belonged to genotype GI/2 and GI/3. Of the 7 GII norovirus isolates, 6 were belonged to genotype GII/4, 1 was belonged to genotype Glib.</p><p><b>CONCLUSION</b>Norovirus is a major cause of outbreaks of acute gastroenteritis in Huzhou and the epidemic strains of norovirus isolated from Huzhou had a high degree of genetic diversity.</p>

Epidemiological study and clinical analysis of 113 laboratory-confirmed cases with hand, foot and mouth disease / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To analyse the epidemiological and clinical characteristics of different pathogenesis type cases, severe and common cases of hand, foot and mouth disease.</p><p><b>METHODS</b>Descriptive epidemic method was used to analyse the epidemiological and clinical characteristics of laboratory-confirmed cases with hand,foot and mouth disease.</p><p><b>RESULTS</b>The epidemiological characteristics 113 cases were the same as epidemic situation at the same time in Anji county. Clinical characteristics were difference in different pathogenesis type cases, severe and common cases of hand, foot and mouth disease.</p><p><b>CONCLUSION</b>Prevention and control work taken should according to the characteristics of the disease, such as early identification of severe cases, handling and controlling over the outbreaks in order to reduce the severe cases and the death.</p>

An investigation and analysis on an outbreak of acute gastroenteritis caused by genogroup I and II norovirus / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the cause of an outbreak characterized by diarrhea and vomit in a middle school in Huzhou City.</p><p><b>METHODS</b>Comprehensive analysis was conducted based on field epidemiological study, clinical characteristics of the cases and laboratory test.</p><p><b>RESULTS</b>578 cases of acute gastroenteritis were found. The attack rate was 23.58%. The most frequently observed clinical symptoms were diarrhea, vomiting, abdominal pain and nausea. Some few had fever. Most cases had slight clinical symptom with a course from 1 to 3 days. The cases were distributed in every class, showing no phenomenon of clustering. Norovirus were detected in 11 out of 15 stool samples by using RT-PCR. 6 were genogroup II norovirus. 3 were genogroup I norovirus. enogroup I and II norovirus were detected at the same time in 2 stool samples (the same student with 2 tests). Case-control study showed that drinking unheated bottled water was risk factor (OR = 2.46, 95% CI = 1.19-5.23), and had a dose response relation with the disease (chi = 24.8 P < 0.01). The epidemic was controlled soon through isolating patients during treatment, providing boiled water, disinfecting and health education.</p><p><b>CONCLUSION</b>This was an infectious diarrhea outbreak caused by norovirus. The suspected transmission ways were drinking unheated bottled water and contact daily.</p>