Research progress in epidemiology and clinical characteristics of major tick-borne infectious diseases in Xinjiang / 中华临床感染病杂志

Ticks belong to arthropods and and the second largest vector of pathogens. Ticks can spread a variety of pathogens and cause diseases, threatening human health and livestock production. Although tick-borne diseases can be found almost in all regions in China, they are mainly distributed in Xinjiang, Inner Mongolia, Heilongjiang and other border areas. Tick-borne diseases in Xinjiang are rising year by year with a serious situations recently, and there are specific features in the distribution and characteristics of pathogens. This article reviews the etiology, epidemic status and clinical manifestations of major tick-borne infectious diseases in Xinjiang.

Research progress of infectious disease dynamics models / 预防医学

@#The management of emerging infectious diseases has always been given a high priority in public health. Identification of the epidemiological characteristics and transmission patterns of emerging infectious diseases is of great significance to contain the disease transmission and reduce the damages to public health and socioeconomic developments. Currently, infectious disease dynamics models are mainly established based on infectious disease surveillance data to predict the epidemiological patterns and trends of emerging infectious diseases; however, many model-based predictions fail to achieve the expected results due to the presence of multiple uncertain factors during the integrated management of infectious diseases. This review describes the basic principles and variables of common infectious disease dynamics models, including the susceptible-infected-recovered ( SIR ) model, susceptible-infected-removed-susceptible ( SIRS ) model, susceptible-exposed-infected-removed ( SEIR ) model and improved SEIR model, compares the advantages and disadvantages of these models, and summarizes the advances of the infectious disease dynamics models in the prediction of trends in incidence of emerging infectious diseases, so as to provide insights into the effective application of infectious disease dynamics models in the management of infectious diseases.

Emerging and re-emerging zoonoses is a persistent challenges for human health / 中国热带医学

@#Zoonoses are a class of infectious diseases that are transmitted from animals to humans. More than 200 known types of zoonoses have been reported across the world until now. Among 1 400 pathogens of human infectious diseases, approximately 61% are zoonotic origin, and 75% human emerging infectious diseases are zoonoses. These zoonoses pose a great threat to human and animal health and decrease livestock production. To effectively tackle the persistent challenges resulting from zoonoses, WHO collaborates with member governments, academia, non-governmental and charitable organizations, and regional and international partners to prevent and manage zoonotic threats and their public health, social and economic impacts. Although great success has been achieved in the management of zoonoses, there are still multiple challenges for zoonoses control in China due to environmental, climate, socioeconomic factors and antimicrobial resistance. Based on the One Health concept, the integration of modern biological, information, artificial intelligent and big data tools through multidisciplinary and multi-sectorial collaborations may facilitate the containment and elimination of zoonoses.

Role of public health emergencies integrated into curriculum ideological and political education of public health / 中华医学教育探索杂志

Aiming at the continuous advancement and deepening of curriculum ideological and political education in medical courses, taking the recent outbreak of public health emergency as an example, this paper expounds the feasibility of taking public health emergencies as typical cases of ideological and political education in public health courses in medical colleges from medical ethics, national spirit, policy guidelines, medical and health administrative system, social benefits and economic evaluation, scientific research collaboration, international cooperation and other aspects, in order to realize the simultaneous development of professional education and ideological and political education, and cultivate more high-quality medical talents with both merit and talent.

The situation and responses of emerging infectious diseases in China / 中华疾病控制杂志

Since the 1990s, emerging infectious diseases have been found in the world. After SARS in 2003, there have been several domestic and imported emerging infectious diseases in China, indicating a not optimistic situation. The associated and driven factors of occurrence or spreading of emerging infectious diseases come from biological, natural and social fields. Therefore, the world health organization and the international community focus on the establishment of effective regional and international monitoring and response systems. Although the emerging infectious diseases response capacity in China has been systematically improved since the SARS epidemic in 2003, there still has deficiencies on mechanism and system. Considering the current emerging infectious diseases situation and challenge, the key area or pathogens and the tasks of capacity building on surveillance, early warning and response need to be clarified and strengthened in China.

Neurologic manifestations in emerging arboviral diseases in Rio de Janeiro City, Brazil, 2015-2016

Abstract INTRODUCTION Dengue has affected Rio de Janeiro City since the 1980s. The sequential Zika and chikungunya virus introductions during 2015 aggravated the health scenario, with 97,241 cases of arboviral diseases reported in 2015-2016, some with neurological disorders. METHODS Arbovirus-related neurologic cases were descriptively analyzed, including neurological syndromes and laboratory results. RESULTS In total, 112 cases with non-congenital neurologic manifestations (Guillain-Barré syndrome, 64.3%; meningoencephalitis, 24.1%; acute demyelinating encephalomyelitis, 8%) were arbovirus-related; 43.7% were laboratory-confirmed, of which 57.1% were chikungunya-positive. CONCLUSIONS Emerging arbovirus infections brought opportunities to study atypical, severe manifestations. Surveillance responses optimized case identification and better clinical approaches.

Survey and Phylogenetic Analysis of Rodents and Important Rodent-Borne Zoonotic Pathogens in Gedu, Bhutan

Rodents are well-known reservoirs and vectors of many emerging and re-emerging infectious diseases, but little is known about their role in zoonotic disease transmission in Bhutan. In this study, a cross-sectional investigation of zoonotic disease pathogens in rodents was performed in Chukha district, Bhutan, where a high incidence of scrub typhus and cases of acute undifferentiated febrile illness had been reported in people during the preceding 4–6 months. Twelve rodents were trapped alive using wire-mesh traps. Following euthanasia, liver and kidney tissues were removed and tested using PCR for Orientia tsutsugamushi and other bacterial and rickettsial pathogens causing bartonellosis, borreliosis, human monocytic ehrlichiosis, human granulocytic anaplasmosis, leptospirosis, and rickettsiosis. A phylogenetic analysis was performed on all rodent species captured and pathogens detected. Four out of the 12 rodents (33.3%) tested positive by PCR for zoonotic pathogens. Anaplasma phagocytophilum, Bartonella grahamii, and B. queenslandensis were identified for the first time in Bhutan. Leptospira interrogans was also detected for the first time from rodents in Bhutan. The findings demonstrate the presence of these zoonotic pathogens in rodents in Bhutan, which may pose a risk of disease transmission to humans.

Psychological Effects on Medical Doctors from the Middle East Respiratory Syndrome (MERS) Outbreak : A Comparison of Whether They Worked at the MERS Occurred Hospital or Not, and Whether They Participated in MERS Diagnosis and Treatment / 신경정신의학

OBJECTIVES: The purpose of this study was to evaluate psychological effects of an outbreak of Middle East respiratory syndrome (MERS), a newly emerged infectious disease, on doctors. METHODS: After the MERS outbreak was over, we conducted an online survey of doctors who worked at the hospitals in which exposure to MERS cases had been confirmed or who were directly involved in MERS diagnosis and treatment. The Patient Health Questionnaires-9 (PHQ-9) and the Impact of Event Scale-Revised (IES-R) assessment methods were used to assess the severity of depressive and posttraumatic stress symptoms among the 64 doctors participating in the survey. RESULTS: The results of the survey indicate that 26.6% (n=17) of participants exhibited depressive symptoms and 7.8% (n=5) had post-traumatic stress symptoms. The doctors employed at hospitals with MERS cases had higher PHQ-9 and IES-R mean scores than those in doctors were not so employed. In contrast, there was no significant difference in those test scores between doctors who participated directly in MERS diagnosis and treatment and those doctors who did not. CONCLUSION: The survey demonstrated that 28.1% (n=18) of doctors involved in MERS care suffered from depressive or posttraumatic stress symptoms, even though the MERS infection was being controlled. Working at a hospital with MERS cases was the primary determinant of the adverse psychological outcomes among doctors ; however, direct participation in the diagnosis and care of MERS patients was not significantly related to such outcomes.

Practice and consideration on prevention and control of the emerging and imported infectious diseases / 上海预防医学

The health of human, animal and environment is under serious threat from the increasing emerging infectious diseases (EID).Through strengthening the three-level disease prevention network, expanding infectious disease surveillance system and multi-sectoral joint cooperation mechanism, the quick, effective and strong prevention and control system of emerging and imported infectious diseases has been established in Shanghai.Since 2013, through effective control of EIDs such as severe acute respiratory syndrome ( SARS), influenza A H1N1 and H7N9 avian influenza, as well as imported infectious diseases (IID) such as Ebola virus disease, middle east respirators syndrome(MERS), Zika virus disease and yellow fever, the surveillance and response capacity has been improved significantly, and the prevention and control system has been improved gradually.As an international megalopolis under globalization, Shanghai is faced with the challenges as follows: growing pressure to infectious diseases prevention and control, increasingly serious situation of EIDs and IIDs;prevention and control skills need to be improved and the current personnel cannot meet with the demands.In order to meet the challenges, infectious disease monitoring and early warning technology should be strengthened; the sensitivity of infectious disease surveillance and early-warning capacity should be improved; EID symptom complex monitoring system should be established; personnel training should be strengthened, domestic and international cooperation and exchange should be carried out;so as to safeguard public health security and public health in Shanghai.

Zika virus and its potential re-emergence in Malaysia

Zika virus (ZIKV) has re-emerged to cause explosive epidemics in the Pacific and Latin America, and appears to be associated with severe neurological complications including microcephaly in babies. ZIKV is transmitted to humans by Aedes mosquitoes, principally Ae. aegypti, and there is historical evidence of ZIKV circulation in Southeast Asia. It is therefore clear that Malaysia is at risk of similar outbreaks. Local and international guidelines are available for surveillance, diagnostics, and management of exposed and infected individuals. ZIKV is the latest arbovirus to have spread globally beyond its initial restricted niche, and is unlikely to be the last. Innovative new methods for surveillance and control of vectors are needed to target mosquito-borne diseases as a whole.

Avoiding student infection during a Middle East respiratory syndrome (MERS) outbreak: a single medical school experience / 한국의학교육

PURPOSE: In outbreaks of infectious disease, medical students are easily overlooked in the management of healthcare personnel protection although they serve in clinical clerkships in hospitals. In the early summer of 2015, Middle East respiratory syndrome (MERS) struck South Korea, and students of Sungkyunkwan University School of Medicine (SKKUSOM) were at risk of contracting the disease. The purpose of this report is to share SKKUSOM's experience against the MERS outbreak and provide suggestions for medical schools to consider in the face of similar challenges. METHODS: Through a process of reflection-on-action, we examined SKKUSOM's efforts to avoid student infection during the MERS outbreak and derived a few practical guidelines that medical schools can adopt to ensure student safety in outbreaks of infectious disease. RESULTS: The school leadership conducted ongoing risk assessment and developed contingency plans to balance student safety and continuity in medical education. They rearranged the clerkships to another hospital and offered distant lectures and tutorials. Five suggestions are extracted for medical schools to consider in infection outbreaks: instant cessation of clinical clerkships; rational decision making on a school closure; use of information technology; constant communication with hospitals; and open communication with faculty, staff, and students. CONCLUSION: Medical schools need to take the initiative and actively seek countermeasures against student infection. It is essential that medical schools keep constant communication with their index hospitals and the involved personnel. In order to assure student learning, medical schools may consider offering distant education with online technology.

Changes of Global Infectious Disease Governance in 2000s: Rise of Global Health Security and Transformation of Infectious Disease Control System in South Korea / 의사학

This paper focus upon the changes of global infectious disease governance in 2000s and the transformation of infectious disease control system in South Korea. Traditionally, infectious disease was globally governed by the quarantine regulated by the international conventions. When an infectious disease outbreak occurred in one country, each country prevented transmission of the disease through the standardized quarantine since the installation of international sanitary convention in 1892. Republic of Korea also organized the infectious disease control system with quarantine and disease report procedure after the establishment of government. Additionally, Korea National Health Institute(KNIH) was founded as research and training institute for infectious disease. However, traditional international health regulation system faced a serious challenge by the appearance of emerging and re-emerging infectious disease in 1990s. As a result, global infectious disease governance was rapidly changed under the demand to global disease surveillance and response. Moreover, global health security frame became important after 2001 bioterror and 2003 SARS outbreak. Consequently, international health regulation was fully revised in 2005, which included not only infectious disease but also public health emergency. The new international health regime was differently characterized in several aspects; reinforcement of global cooperation and surveillance, enlargement of the role of supranational and international agencies, and reorganization of national capacity. KNIH was reorganized with epidemic control and research since late 1990s. However, in 2004 Korea Center for Disease Control and Prevention(KCDC) was established as a disease control institution with combining quarantine and other functions after 2003 SARS outbreak. KCDC unified national function against infectious disease including prevention, protection, response and research, as a national representative in disease control. The establishment of KCDC can be understood as the adoption of new international health regulation system based upon SARS experience.

Emerging Infectious Disease and Safety of Blood Components / 대한수혈학회지

Recently, the emergency of Middle East Respiratory Syndrome in Korea raised public concern regarding emerging infectious disease (EID) and affected the strategy for blood safety. Although some cases of EID such as West Nile virus in the United States and hepatitis E virus in Japan emerged in a restricted area, the emergence can rapidly affect the situation in other countries in a globalized society with advancements in transportation and international exchange. Because the risk of transfusion-mediated infection may occur by the agent of EID which can be transmitted through blood, the strategy for safety must be considered for agents that were not tested in the stage of blood donor screening. We reviewed the characteristics of transfusion-transmissible EIDs raising concerns worldwide and the strategies which had been adopted.

Epidemiologic analysis on severe fever with thrombocytopenia syndrome in Hubei province, 2010 / 中华流行病学杂志

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.

Worms, slugs and humans: the medical and popular construction of an emerging infectious disease / Vermes, caramujos e humanos: as construções médica e popular de uma doença infecciosa emergente

The identification of the worm Angiostrongylus costaricensis parasitizing land snails and humans in Southern Brazil suggests under-diagnosis and under-notification of patients with abdominal angiostrongyliasis. This article analyzes how the concept of abdominal angiostrongyliasis was constructed in different ways in Costa Rica and Brazil and how these changes affected the understanding of its clinical and epidemiological diagnosis. The research shows that abdominal angiostrongyliasis is, de facto, a sociocultural construct, although the parasites and vectors are real. The analisys also shows the importance of an interdisciplinary approach for understanding disease.

A identificação do verme Angiostrongylus costaricensis em humanos e caramujos, no sul do Brasil, sugere a ocorrência de subdiagnóstico e subnotificação de pacientes com angiostrongilíase abdominal. O artigo analisa as diferentes construções do conceito de angiostrongilíase abdominal na Costa Rica e no Brasil e a influência dessas variações em seu diagnóstico clínico e epidemiológico. Demonstra que a angiostrongilíase abdominal é, de facto, um constructo sociocultural, embora parasitas e vetores sejam reais. Também destaca a importância da abordagem interdisciplinar para a compreensão da doença.

New Vaccine Technology for Control of Emerging and Reemerging Infectious Diseases / 한국역학회지

Although the development of vaccines has been one of the most important contributions of immunology to medicine and public health, and despite vaccination having been proven as the most effective and cheapest medical practice to prevent infectious diseases, infectious diseases still remain the main cause of human deaths and new infectious diseases continue to emerge. Furthermore, we face an unprecedented succession of new pathogens able to jump species barriers and infect humans, even as we continue to be frustrated in our efforts to control devastating diseases such as HIV, malaria and tuberculosis. Hence the need to develop new vaccines and improve existing vaccines. Other challenges for scientists include rapid identification and response to emerging diseases and successful intervention in re-emerging infectious diseases. Remarkable progress in molecular biology and biotechnology is making possible the development and improvement of new and old vaccines. Recombinant DNA technology, genetic attenuation of viral and bacterial pathogens and their use as vectors for heterologous proteins, naked DNA vaccines and peptide vaccines represent the most popular approaches hitherto adopted. Reverse genetics and reverse vaccinology are now used to investigate new vaccines. Genome-based reverse vaccinology is very useful and a major tool in vaccine development. The rapid identification of the genome sequence to new pathogens enables the speedy development of diagnostic tools as well as recombinant expression of targets for vaccine. Strengthening research and development in vaccines, including international cooperation, may be the most effective next step to control and prevent infectious diseases worldwide.

Trends of Bacterial Zoonoses in Humans in Korea

Out of 60 national communicable diseases in Korea, 23 are zoonoses, diseases transmissible from animals to humans. Among the bacterial zoonoses, plague, brucellosis, anthrax, Q fever, tularemia, glanders, and melioidosis are categorized as a high-level threat of bioterrorism and biowarfare in the world. In this paper, the trends of notifiable bacterial zoonoses recently occurring or recurring in Korea and other potential pathogens for bioterrorism or biowarfare are reviewed. Notifiable bacterial zoonoses recently occurring in Korea are enterohemorrhagic Escherichia coli (EHEC) infection, tetanus, tuberculosis, scrub typhus, leptospirosis, brucellosis, and anthrax. Other bacterial diseases recently emerging are tularemia, ehrlichiosis, and Q fever. However, no human case of plague, glanders, and melioidosis has been reported yet.