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Objective To identify the epidemic characteristics and risk factors of an emerging infectious disease-severe fever with thrombocytopenia syndrome (SFTS) in Hubei province.Methods Active surveillance program on SFTS was set up in monitoring sites-hospitals,at the township level or above,in Suizhou,Huanggang and Wuhan from January to December,2010.Specific surveillance program on SFTS was launched across the province in hospitals above the county level.Cases that matched the definition of surveillance case were identified and reported to Centers for Disease Control and Prevention (CDCs).Cases were interviewed and their blood samples collected and detected using PCR and virus isolation.We also conducted serum antibody surveys among healthy population and livestock and surveillance on vector ticks in those high-epidemic areas.Results 188 cases that matched the definition of surveillance case and 21 deaths were reported in 11 cities,32 countries and 100 towns in 2010,with an incidence rate of 0.33/106.The fatality rate was 11.2％.Data showed that the patients were from hilly areas at the altitude elevated between 28-940 meters.The epidemic period was between April and December with the peak from May to September.The youngest case was an 11-year old,while the eldest was 81 with median age as 56-year old.95.3 ％ of the patients were farmers.All Patients did not have the history of traveling,two weeks before the onset of SFTS.93.6％ of the patients engaged in different kind of work which was associated with agriculture.52.8％ of the patients had been exposed to ticks.22.0％ of the patients had been bitten by ticks.Skin injury was found in 64.2％ of the patients.Samples from 129 cases (68.6％) were collected and detected,with 67.4％ of them (87 cases) showed positive by Real time-PCR for SFTS virus.An elevation in antibody titer by a factor of four or evidence of sero-conversion was observed in 11 patients; SFTS virus was isolated from 2 patients.The total antibody positive rates were 3.8％,55.0％ (6/11 ),36.7％ (2/3) and 80.0％ (4/5) respectively in healthy population,dogs,sheep and cows.Ticks from grass,cattle and sheep were detected positive by Real time-PCR.Conclusion Most cases of SFTS in Hubei were infected by SFTS virus,and cases of livestock were infected by SFTS virus.Ticks might serve as an important vector.Skin injury,exposure to tick bites seemed to be the risk factors.
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Objective Using simple quantitative methods to describe the seasonal distribution of rabies in different provinces of China and to analyze how it was influenced by geographical settings,to provide evidence for risk assessment and prediction of potential epidemics of rabies.Methods A total number of 17 800 clinical and laboratory confirmed rabies cases,reported by 29 provinces,from 2005 to 2011 and related data were collected from National Disease Reporting Information System.Data on related latitudes and longitudes of different provinces were obtained from the National Geographic Information Center.Excel 2003 was used to draw the national and provincial seasonal distribution curves while SPSS 18.0 was used to calculate parameters as P25,P50,P75,inter-quartile range Q and kurtosis so as analyze the linear correlation between P25,kurtosis and the latitude of different provinces respectively.Results The nation-wide incidence of rabies was low in February.The peaks fell in summer and autumn,especially in August.Seasonal distribution curves of P25,P50,P75,inter-quartile range (Q) and kurtosis were different among provinces.Compared to the low latitude areas,high latitude areas had higher P25,smaller Q and higher kurtosis.In 9 provinces where the annual reported number of cases more than 100,the related coefficients (r) between latitude and both P25,kurtosis were 0.9342 and 0.8528 respectively (P＜0.05).Conclusion There was a distinct seasonality of rabies occurrence in China which was correlated to the geographical settings which was more obvious in the higher latitude areas.
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Objective To analyze the surveillance data on hemorrhagic fever with renal syndrome (HFRS) including the epidemiological characteristics and trend of the disease,in 2010.Methods Descriptive methods were conducted to analyze the surveillance data in 2010 which were collected from the internet-based National Notifiable Disease Reporting System and 40 HFRS sentinels in China.Results There were 9526 cases of HFRS reported in 2010 in the country with an annual morbidity of 0.71/105,which was higher than that reported in 2009.And the case fatality rate in 2010 was 1.24％.During the year 2010,most cases were reported in spring and autumn-winter season,with November as the peak month.The proportion of cases reported in autumn-winter season was higher than that in spring.The number of cases reported in males was higher than that in females among all the age groups,and similar pattern of mortality could be seen in most of the age groups.The percentage of cases over 60 years old had increased in recent years.Farmers were still under the highest risk.Density and the virus-carrying rate of animal hosts,as well as the infection rate were relatively stable and similar to the previous findings.As to the prevailing species,Apodemus agrarius and Rattus norvegicus were still the most common and leading animal hosts.However,the dominant species in sentinel of Yunnan were Rattus flavipectus and Eothenomys miletus respectively,and a new hantavirus called LUXV was found,namely Eothenomys miletus.Conclusion HFRS cases were widely distributed in most provinces of China,but cases mainly focus on certain areas and present the nature of aggregation.The risk of outbreak could not be ruled out for variety of factors.Population characteristics and seasonal fluctuation had been changing.
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<p><b>OBJECTIVE</b>To understand the related factors of rabies epidemic and provide the basic data for rabies control and prevention in China by statistic and retrospective analysis of rabies surveillance data in 2010.</p><p><b>METHODS</b>We used descriptive epidemiology method and statistic analysis to analyze the epidemiological characteristics of rabies in 2010 of China.</p><p><b>RESULTS</b>2048 rabies cases were rabies cases were reported in 817 counties (districts) in 2010, which dropped 7.46% compares to 2009. The incidences in children and elder people were high; farmers are main occupation of the cases, the male to female ratio of the cases was 2.44:1. Children and older people are higher acquired rabies than other age population. 640 cases reported through national rabies sentinel surveillance system, 87.50% cases were caused by exposed to dogs, bite was the main exposure reason. The situation of deposing wounds was poor, and the use of vaccine was still low in individual cases, but in the rabies clinic cases under surveillance, the vaccine usage can reach 98%, the usage of immunoglobulin (RIG) or anti-serum for category III exposure in either group cases was not high.</p><p><b>CONCLUSION</b>The epidemic of the rabies in 2010 was eased, Out-patient post-exposure prophylaxis was in good station, but there are still lots of problem existed: post-exposure prophylaxis of individual case was not desirable yet.</p>
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Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , China , Epidemiology , Rabies , Epidemiology , Time FactorsABSTRACT
Objective To analyze the epidemiologic and surveillance data of hemorrhagic fever with renal syndrome (HERS) in China, from 2005 to 2008, to describe the epidemiology and trend of HERS. Methods Descriptive epidemiology were studied to analyze the surveillance data from 2005 to 2008, collected from both the internet-based national notifiable disease reporting system and 40 HFRS sentinel sites developed since 2005 in 40 counties around China. Results A total of 56 077 HERS cases and 692 deaths reported in China with case fatality rate as 1.23%. Morbidity and mortality had been annually decreasing since 2004. The top 7 provinces with HFRS cases were Heilongjiang, Lianning, Jilin, Shandong, Shaanxi, Hebei and Zhejiang, which had a total of 44 081 cases reported, accounting for 78.61% of the total number of cases, in the nation. More cases were reported in spring and autumn-winter season, with the peak in November. Cases reported in males were 3.13 times of the females and most cases seen in young and middle-aged farmers. The density and the virus carrying rate of animal hosts and the distribution of dominant species were relatively stable and similar to the previous findings. Apodemus agrarius and Rattus norvegicus were still the most common and predominant animal hosts. No genetic mutation of Hantavirus was detected in the surveillance program. Conclusion The continuous descending trend of the HERS epidemics could be related to the successful strategies on comprehensive prevention and control measures, as controlling the number of rodents and vectors, carrying out HERS vaccination campaign and health education by the local health care takers in the recent years. Implementation of the new national Expanded Program of Immunization on HFRS vaccine in high-risk areas may further reduce the epidemics. However,both the density and the virus carried rate among the host animals remain high in some areas, together with the emergence of new epidemic areas, all call for more attention to be paid on the disease.
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Objective To understand the situation of rabies exposure and self-management behaviors among primary school students from rabies epidemic areas in China. Methods This population-based investigation was conducted in Guizhou and Guangdong provinces which had been severe epidemic areas of rabies in China from January 2007 to May 2008. Primary schools from two prefectural, two county, four township and four village levels were selected in the 2 provinces.Students were sampled from each grade of the 12 schools to collect information on post-exposure prophylaxis. Results In the 2408 primary school students interviewed, 290 person/times exposure were found from 2007 to 2008. The self wound-treatment rates was 47.93%, with 16.55% of themwent to the clinic for care-seeking initiatively and 63.79% informed their parents or teachers. However 23.10% of the students did nothing after exposure. Students in Guangdong province had lower exposure rate and higher rate of good management behaviors than in Guizhou. No significant statistical difference was found between the self-management behaviors among male and female students or among different levels of primary schools. The proportion of disinfection on wounds with alcohol and seeking medical treatment in rabies clinic initiatively were both low in all grades of the students but the proportion of telling their parents or teachers about the exposure among children was high in all grades of students. Conclusion Some students after rabies exposure did not have any disposal in Guangdong and Guizhou provinces. Related education should be strengthened.
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Objective To provide scientific evidence for prevention and control program on dengue fever through analyzing the situation of dengue fever in China,from 2005 to 2007.Methods Data was collected from Internet-based National Notifiable Infectious Disease Reporting System,National Enhanced Dengue Fever Surveillance system and field investigation on dengue outbreaks,described and analyzed with descriptively and by SPSS statistical software.Results There was a total number of 1 623 dengue cases(including 1356 laboratory confirmed cases and 267 probable cases)and 1 death case reported in China from 2005 to 2007.Among the identified cases,151 were imported from foreign countries as the Southeast Asian countries,accounting for 9.3%,while the rest 1472 cases were reported from local infections,identified only in 9 cities from Guangdong and Fujian provinces.Data from the monitoring program on Aedes Mosquitoes indicated that:The indicators of BI from 84.6% of the sentinels were over 5,and BI from 72.2% of the sentinels were over 10.This index was especially at a higher level during summer in the southern areas of China.Aedes albopictus was found in all the sentinel sites while Aedes aegypti was only found in Hainan and in limited counties of Guangdong.No dengue virus was isolated from mosquito vectors collected from national sentinel sites, whereas positive results had been detected by PCR test in Guangdong province.Conclusion It was assumed that a sustainable local circulation of dengue virus had not yet been established successfully in Mainland China according to the surveillance data.However,more local outbreaks reported in Guangdong and Fujian with the wide distribution and high-level density of aedes mosquito,low antibody level in healthy population and the increasing number of imported dengue cases, there is a potential of Dengue outbreaks in southera China.An integrated mosquito vector monitoring and management system is needed in hish risk area to reduce the transmission of dengue fever.
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<p><b>OBJECTIVE</b>To evaluate the effectiveness of personal protective measures of health care workers (HCWs) against severe acute respiratory syndrome (SARS).</p><p><b>METHODS</b>A case-control study from ten hospitals in Guangdong, with 180 non-infected and 77 infected staff members that accessed the isolation unit every day, and participated in direct first aid for severe SARS patients. All participants were surveyed about how they were using personal protective equipment (PPE), protective drugs and hygiene habits when caring for patients with SARS. Statistical analysis was done with either chi(2) or Fisher's exact test for univariate analysis, whereas we used forward stepwise selection (Waldesian) for logistic regression.</p><p><b>RESULTS</b>Univariate analysis showed that mask, gown, gloves, goggles, footwear, "hand-washing and disinfecting", gargle, "membrane protection", "taking shower and changing clothing after work", "avoid from eating and drinking in ward", oseltamivir phospha tall had protective effects (P < 0.05), but stepwise logistic regression showed significant differences for mask (OR = 0.78, 95% CI: 0.60 - 0.99), goggles (OR = 0.20, 95% CI: 0.10 - 0.41) and footwear (OR = 0.58, 95% CI: 0.39 - 0.86). Analysis for linear trend in proportions showed that dose response relationship existed in mask, gown, gloves, goggles, footwear, gargle, "membrane protection" and "taking shower and changing dree after work" (P < 0.01). The attack rate of HCWs who were rescuing severe SARS patients without any PPE was 61.5% (16/26). It seemed that the more the protective measures were used, the higher the protective effect was (P < 0.001), and could reach 100% if mask, gown, gloves, goggles, footwear, "hand-washing and disinfecting" were all used at the same time.</p><p><b>CONCLUSIONS</b>Nosocomial infection of SARS can be prevented effectively by precautions against droplets and personal contact. HCWs must take strict protection according to the guidance of WHO or Chinese MOH and pay attention to personal hygiene.</p>
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Female , Humans , Male , China , Cross Infection , Health Occupations , Education , Logistic Models , Protective Devices , Classification , Severe Acute Respiratory Syndrome , Surveys and QuestionnairesABSTRACT
<p><b>OBJECTIVE</b>To analysis the risk factors influencing nosocomial infection of severe acute respiratory syndrome (SARS) in health-care workers and to evaluate effectiveness of its control and preventive measures in 13 key hospitals caring for SARS patients.</p><p><b>METHODS</b>Number of SARS patients, clinical conditions of them, its attack rate in health-care workers, and characteristics of hospitals, including their environment, isolating measures, etc. were investigated at the 13 hospital in Guangzhou to analyze the risk factors influencing nosocomial infection of SARS and its attack rates in health-care workers before and after implementation of preventive measures and to evaluate their effectiveness.</p><p><b>RESULTS</b>Totally, 841 patients with SARS were treated at the 13 hospitals in Guangzhou and 285 health-care workers caring for them infected nosocomially. Attack rate in health-care workers was higher at general hospitals, hospital accepting more cases in critical conditions and hospitals with poor precautious measures, and lower in hospitals with isolated wards or areas, or department of infection, specially caring for SARS patients, and those with effective intervention measures to prevent secondary infection.</p><p><b>CONCLUSION</b>Nosocomial infection of SARS in health-care workers was affected by clinical condition of SARS patients, characteristics and environment of hospitals and their personal protective measures adopted.</p>