Global Epidemic of Ebola Virus Disease and the Importation Risk into China: An Assessment Based on the Risk Matrix Method / 生物医学与环境科学（英文）

OBJECTIVE@#To analyze the global epidemic status of the Ebola virus disease (EVD) and assess the importation risk into China.@*METHODS@#Data from World Health Organization reports were used. We described the global epidemic status of EVD from 1976-2021, and assessed and ranked the importation risk of EVD from the disease-outbreaking countries into China using the risk matrix and Borda count methods, respectively.@*RESULTS@#From 1976-2021, EVD mainly occurred in western and central Africa, with the highest cumulative number of cases (14,124 cases) in Sierra Leone, and the highest cumulative fatality rate (85%) in the Congo. Outbreaks of EVD have occurred in the Democratic Republic of the Congo and Guinea since 2018. The importation risk into China varies across countries with outbreaks of disease. The Democratic Republic of the Congo had an extremely high risk (23 Borda points), followed by Guinea and Liberia. Countries with a moderate importation risk were Nigeria, Uganda, Congo, Sierra Leone, Mali, and Gabon, while countries with a low importation risk included Sudan, Senegal, and Co

Characteristics of individuals positive for SARS-CoV-2 nucleic acid in a centralized isolation site for people entering China / 预防医学

Objective@#To analyze the characteristics of individuals positive for SARS-CoV-2 nucleic acid in a centralized isolation site for people entering China in Huzhou City of Zhejiang Province from December 18, 2021 to January 12, 2022, so as to provide insights into the prevention and control of overseas imported COVID-19. @*Methods@#The basic characteristics, nucleic acid detection and epidemiological investigations were collected from individuals positive for SARS-CoV-2 nucleic acid in a centralized isolation site for people entering China from December 18, 2021 to January 12, 2022, and the temporal distribution, population distribution, source of importation, and virus typing were descriptively analyzed.@*Results @#From December 18, 2021 to January 12, 2022, a total of 2 974 individuals in 19 flights were recorded in this centralized isolation site, and 33 cases were tested positive for SARS-CoV-2 nucleic acid, including 21 confirmed cases with common type, 9 confirmed cases with mild type, and 3 cases with asymptomatic infections. There were 11 cases with Omicron infections ( 33.33% ), 5 cases with Delta infections ( 15.15% ), and 17 cases with infection of unidentified types ( 51.52% ). The median interval ( interquartile range ) from the time of entry to the time of a positive test was 4.0 ( 7.0 ) days among all positive cases, 0 ( 4.0 ) day among cases with Omicron infections and 4.5 ( 8.5 ) days among cases with infections of Delta and unidentified types. The positive cases had a mean age of ( 36.97±8.58 ) years, and included 27 men (81.82%). There were 30 cases ( 90.91% ) receiving two and more doses of COVID-19 vaccines, and 7 cases ( 21.21% ) with a previous history of SARS-CoV-2 infections. There were 19 cases ( 57.58% ) from African countries, and 7 of 11 cases with Omicron infections were imported from African countries.@*Conclusion@#Omicron infection was predominant among individuals positive for SARS-CoV-2 nucleic acid in this centralized isolation site for people entering China from December 18, 2021 to January 12, 2022, with no severe cases detected, and most positive cases were imported from African countries.

Risk assessment of COVID-19 cases imported from aboard to Zhejiang Province / 预防医学

Objeetive@#To evaluate the imported risk of COVID-19 cases from aboard to Zhejiang Province,so as to provide reference for control strategies.@*Methods@#The epidemic data of COVID-19 in 9 foreign countries（US,UK,Italy,etc.）and Zhejiang Province were collected,as well as the number of entry persons. The imported risk values of COVID-19 cases to 90 counties（cities or districts）of Zhejiang Province and from the 9 countries during March 7th and 30th were calculated and normalized to the imported risk indexes. The imported risk indexes were classified into five levels from high to low according to percentiles. The imported risk of 90 counties（cities or districts）,the developing trend and the source were analyzed. @*Results @#A total of 39 confirmed cases and 24 asymptomatic cases were imported to Zhejiang Province untill March 30th. There were 10,13,22,21 and 24 counties（cities or districts）with high,medium high,medium,medium low and low imported risk,respectively. Qingtian had the highest imported risk（0.43）,followed by Ruian（0.32）and Wencheng（0.29）. The imported risks in 80（88.89%）counties（cities or districts）showed increased trend. The highest imported risk came from Italy（0.51）,followed by US（0.14）and Spain（0.11）. The imported risk in Wenzhou and Lishui mainly came from Italy and Spain,while that in the other areas mainly came from US,Germany and UK. @*Conclusions@#The risk of imported COVID-19 cases from aboard to Zhejiang Province showed an upward trend since March. The areas at high and medium high risk lay in southeast Zhejiang and the downtown of Hangzhou. The source of imported risk were maimly from Italy,US and Spain,but varied in counties.

Current status and transmission risks of oversea imported schistosomiasis in China / 中国血吸虫病防治杂志

With the acceleration of the process of global integration, China’s international exchanges and cooperation with other countries have been further increased. The personnel exchange has led to the frequent occurrence of imported schistosomiasis from abroad, which seriously endangers people’s health. This paper reviews the prevalence and transmission risks of oversea imported schistosomiasis, providing the reference for the entry and exit health quarantine and prevention and control of schistosomiasis in China.

Risk assessment of importation and local transmission of Ebola hemorrhagic fever in Jinhua / 预防医学

Objective @#To assess the risk of importation and local transmission of Ebola hemorrhagic fever（EHF）in Jinhua,and to provide reference for prevention policy making.@*Methods @#We collected the information of EHF cases,immigration data and EHF response capacity of Jinhua,then invited 18 experts from Jinhua Entry-Exit Inspection and Quarantine Bureau,Exit-Entry Administration Division of Public Security Bureau and Centers for Disease Control and Prevention in Jinhua. According to the risk assessment criteria recommended by World Health Organization,the risk of EHF importation and local transmission in Jinhua was assessed qualitatively by expert consultation,and the probability of local transmission after EHF importation was assessed quantitatively by compartment model.@*Results @#The results of expert consultation showed that the average scores of possibility and severity of EHF importation in Jinhua was 1.7 and 2.1,which was at low risk after substituted into the risk matrix. The risk of EHF importation in urban areas of Jinhua and Yiwu,where there were more African people,was higher than that in other counties or districts. The average scores of possibility and severity of local transmission was 1.9 and 3.1,which was at medium risk after substituted into the risk matrix. The results of compartment model analysis showed that the possibility of local transmission after the importation of EHF was related to the time interval between the onset of the epidemic and the effective isolation of the imported cases. When the interval was within 2 days,the risk of local transmission was low,but when it exceeded 4 days,the imported epidemic was easy to spread and lead to local transmission.@*Conclusion @#The EHF importation in Jinhua was at low risk;the local transmission caused by imported cases was at medium risk,but was less likely to cause large-scale transmission. Early identification of EHF cases was the key to reducing the risk of local transmission.

Operational Food Import Inspection Compared to International Standards at Checkpoints in Lao PDR / Lao Medical Journal

Background and Rational@#Open trades in Lao PDR leads to many imported goods. Lacking capacity with international standards for inspecting and validating the imported goods at border check point would harm consumers.@*Methodology@#A descriptive study was conducted to assess the opinions and practice towards the staff of food and drug administration at 16 check points in Lao PDR using self-administered questionnaire from March to June 2015.@*Result@#The detection and validation were done based on food categories, which included raw food, canned food and other prepared food. There are 5 steps of validation: 1) checking documents at the checking point; 2) checking food; 3) seizing food; 4) releasing food and 5) reporting. The staff reported that documents should include name of food, label, certificate of food quality, certificate of laboratory sample analysis, certificate of importation permission, invoice and packaging list. Meanwhile, checking food includes the random selection of product for screening tests, particularly raw food. The suspected contaminated food will be verified at the main laboratory. Then, the suspected contaminated food was seized until the result of the laboratory are available. The foods from those who had the history of contaminated food importation should be randomly tested. The contaminated foods were recorded as blacklisted in order to facilitate next importation in detecting and validating the quality of food. Any update regulations should inform to the importers. The food and drug administrators at checkpoints had a good practice based on Lao regulations. However, some materials need to be improved. The detection form needs to be separated according to the food categories. They need more test kits, random detection guidelines, guidelines for laboratory tests, guidelines for detecting high-risk contaminated food, tools and materials of inspection. Moreover, there is a need of short and long-term training on using detection tool kits, random selection and reporting system.@*Conclusion@#There are different methods of inspection of imported food at checking point of Lao PDR. The international checking point had better quality than the other one.

An investigation of a measles outbreak in Japan and Taiwan, China, March–May 2018

Objective@#To investigate a measles outbreak that spread to Japan and Taiwan, China during March–May 2018, exploring the characteristics of the super-spreading event.@*Methods@#A contact investigation of the index case and reconstruction of the epidemiological dynamics of measles transmission were conducted. Employing a mathematical model, the effective reproduction number was estimated for each generation of cases.@*Results and discussion@#A single index case gave rise to a total of 38 secondary cases, 33 in Japan and five in Taiwan, China. Subsequent chains of transmission were observed in highly vaccinated populations in both Japan and Taiwan, China. The effective reproduction number of the second generation was >1 for both Japan and Taiwan, China. In Japan, the reproduction number was estimated to be <1 during the third generation. Vaccination of susceptible individuals is essential to prevent secondary and tertiary transmission events.

Vulnerabilidade do SUS em relação à variação cambial: análise da dinâmica de importações de medicamentos e equipamentos de saúde entre 1996 e 2014 / SUS vulnerability regarding exchange rate variation: Analysis of the dynamics of drugs and health equipment import between 1996 and 2014

RESUMO Este artigo tem como objetivo verificar a vulnerabilidade do Sistema Único de Saúde ante a influência das variações cambiais sobre a dinâmica de importação de medicamentos e equipamentos médicos de 1996 a 2014. A hipótese que orientou o trabalho é que as condições externas e a política econômica, expressas nas taxas de câmbio, afetam a dinâmica de produção e inovação do Complexo Econômico-Industrial da Saúde. Conclui que a elasticidade da relação entre variação cambial e importação dos segmentos estudados foi relativizada no período, consideradas as mudanças ocorridas. Este resultado sugere a importância de desenhar modelos econômicos que incorporem essas variáveis.

ABSTRACT This article is aimed at determining the vulnerability of the Unified Health System when subject to the influence of exchange rates variations on the dynamics of drugs and medical equipment import from 1996 to 2014. The hypothesis that guided this work is that external conditions and economics policies expressed in exchange rates do affect the dynamics of both production and innovation of the Economic-Industrial Complex of Health. It comes to the conclusion that, considering changes that took place, the elasticity of the relationship between import and exchange rate of the segments analyzed herein was not so heavily affected over the period. This result suggests the importance of designing economic models that incorporate those variables.

Determinantes econômicos da demanda por importações de produtos farmoquímicos e farmacêuticos / Economic determinants of the demand for importation of pharmacochemical and pharmaceutical products / Determinantes económicos de la demanda de importaciones de productos farmoquímicos y farmacéuticos

Resumo: Este artigo analisa a relação entre a demanda por importações de produtos farmoquímicos e farmacêuticos e variáveis econômicas (taxa de câmbio, preço das importações e renda agregada), no Brasil, fazendo uso de dados mensais do período 1997-2014. Os principais resultados mostraram que aumentos na renda agregada e reduções nos preços das importações têm impacto positivo e significativo, respectivamente de forma elástica e inelástica, sobre as importações. A taxa de câmbio foi significativa apenas no modelo mais agregado. Portanto, a renda agregada se mostrou uma variável bastante robusta e com forte impacto sobre as importações dos produtos farmoquímicos e farmacêuticos. Considerando os argumentos explicitados na literatura de que o déficit no comércio internacional dessa indústria se relaciona com déficit em conhecimento e tecnologia, somando aos resultados encontrados neste trabalho, há indícios de que conforme o nível de atividade econômica cresce, ocorre maior demanda por esse tipo de produto, e, não havendo produção nacional suficiente, existe necessidade de importações, o que pode gerar pressões no déficit comercial desse segmento, representando dependência do Brasil a outros países.

Abstract: This article analyzes the relationship between the demand for importation of pharmacochemical and pharmaceutical products and economic variables (exchange rate, import prices, and aggregate income) in Brazil, using monthly data from 1997-2014. The main results showed that increases in aggregate income and price reductions in imports have a positive and significant impact (elastic and inelastic, respectively) on imports. Exchange rate was only significant in the more aggregate model. Thus, aggregate income was a robust variable with strong impact on the importation of pharmacochemical and pharmaceutical products. The arguments in the literature that this industry's international trade deficit is related to a deficit in knowledge and technology and the current study's results provide evidence that as economic activity grows, there is a greater demand for this type of product. Additionally, if domestic production is insufficient, there is a need for imports, which can generate pressure on the trade deficit in the industry and contribute to Brazil's dependence on other countries.

Resumen: Este artículo analiza la relación entre la demanda de importaciones de productos farmoquímicos y farmacéuticos y las variables económicas (tasa de cambio, precio de las importaciones y renta agregada), en Brasil, utilizando datos mensuales del período 1997-2014. Los principales resultados mostraron que los aumentos en la renta agregada y las reducciones en los precios de las importaciones tienen un impacto positivo y significativo, respectivamente, de forma elástica e inelástica sobre las importaciones. La tasa de cambio fue significativa sólo en el modelo más agregado. Por tanto, la renta agregada se mostró una variable bastante robusta y con un fuerte impacto sobre las importaciones de los productos farmoquímicos y farmacéuticos. Considerando los argumentos explicitados en la literatura, acerca de que el déficit en el comercio internacional de esa industria se relaciona con el déficit en conocimiento y tecnología, sumado a los resultados hallados en este trabajo, hay indicios de que conforme el nivel de actividad económica crece, se produce una mayor demanda por ese tipo de productos, y, sin existir producción nacional suficiente, hay una necesidad de importaciones, lo que puede generar presiones en el déficit comercial de este segmento, representando la dependencia de Brasil de otros países.

Research on China and the US drug importation registration management system / 中国药学杂志

OBJECTIVE: To provide the basis of improving drug importation registration management system of our country by studying domestic and foreign drug importation management system adequately. METHODS: Checked out and studied the laws associated with import drug of our country and United States with literature research and comparative analysis methods. RESULTS: To reform the drug importation registration management system of our country, related problems should be analyzed. Also the recommendations should be put forward, including the registration of foreign drug establishment, unified registration procedures and adopted DMF system. CONCLUSION: Based on national conditions, we must draw on the advantages of United States system selectively, to improve our system, ensure the quality of import drug lifecycle and protect public health.

Molecular epidemiology of measles virus infection in Shanghai in 2000–2012: the first appearance of genotype D8

Purpose: The purpose of this study was to identify measles virus in Shanghai in 2012 and study the genotype trend of measles virus epidemic strains during 2000–2012. Methods: Nose and throat swab specimens were collected from 34 suspected measles cases in Shanghai. Measles virus was isolated using Vero-SLAM cells (African green monkey kidney cells/lymphoid signal activating factor-transfected African green monkey kidney cells). The 450 bp of C terminus of the N gene and the entire hemagglutinin gene sequence was amplified using RT-PCR. Phylogenetic analysis was performed by comparing the seven measles strains in Shanghai with the reference strains for H1a, H1b and D8 genotypes, as well as the Chinese measles virus vaccine strain. Results: Seven measles viruses strains were isolated from the 34 throat swap specimens. Six strains were genotype H1a, which is the predominant strain in China and one strain was genotype D8, which is the first imported strain since 2000. All these seven strains maintained most of the glycosylation sites except subtype H1a, which lost one glycosylation site. Conclusion: Since 2000, measles virus strains in Shanghai are consistent with measles virus from other provinces in China with H1a being the predominant genotype. This study is also the first report of genotype D8 strain in Shanghai. All strains maintained their glycosylation sites except H1a that lost one glycosylation site. These strains could still be neutralized by the Chinese measles vaccine. We suggest that Shanghai Center for Disease Control laboratories should strengthen their approaches to monitor measles cases to prevent further spread of imported strains. .

Experiencia de importacao de equipamentos para pesquisa no ELSA-Brasil / La experiencia de importacion de equipos para investigacion en el ELSA-Brasil / Experience of importation of equipment for research in the ELSA-Brasil

OBJETIVO: Políticas de fomento à pesquisa em saúde foram estabelecidas na última década, avançando a produção científica nacional. Tal movimento não foi acompanhado do aperfeiçoamento do arcabouço legal-institucional, dificultando o desenvolvimento dos projetos de pesquisa. Isso inclusive no que tange às atividades de importação de equipamentos. O objetivo deste artigo foi analisar o processo de importação de equipamentos para o Estudo Longitudinal de Saúde do Adulto (ELSA-Brasil). MÉTODOS: Trata-se de estudo de caso, com dados coletados em documentos internos do ELSA-Brasil em cinco Centros de Investigação e respectivas fundações de apoio. Foram analisados documentos de importação de: velocidade de onda de pulso, bioimagem e retinografia. Adicionalmente, foram realizadas entrevistas não estruturadas com pesquisadores e informantes chave nas fundações. Os dados foram tratados e organizados em três etapas: administrativa-operacional, cambial e fiscal. Foram calculados os intervalos de duração dessas etapas de modo comparativo entre os centros. RESULTADOS: A necessidade de padronização dos equipamentos em estudo multicêntrico exigiu atuação conjunta de instituições executoras e fundações. Dos equipamentos analisados, a primeira etapa, a administrativa-operacional, teve duração variada (mínimo 8 e máximo de 101, com média de 55 dias), sendo mais demorada quando incluía pareceres jurídicos. A segunda etapa, a cambial, mais longa que a primeira, não apresentou entraves ao processo (mínimo 11 e máximo 381, média de 196 dias). A terceira etapa, a fiscal, foi a mais longa (mínimo 43 e máximo 388 dias, média de 215,5 dias), ...

OBJECTIVE: Policies that promote research in health were established in the last decade, developing the Brazilian scientific production. This development has not been accompanied by an improvement in the legal-institutional framework, thus hindering the development of research projects, including equipment importation activities. The present study aimed to analyze the equipment importation process for the Brazilian Longitudinal Study for Adult Health (ELSA-Brasil). METHODS: A case study was performed with data collected from internal ELSA-Brasil documents in five Investigation Centers and their respective supporting foundations. The following importation documents were analyzed: pulse wave velocity, bioimaging and retinography. Additionally, non-structured interviews with researchers and key informers were conducted in the foundations. Data were treated and organized into three stages: administrative-operational, exchange rate, and fiscal. Lengths of duration of these stages were calculated comparatively among centers. RESULTS: The need to standardize equipment in a multicenter study required a joint action of implementing institutions and foundations. Of all pieces of equipment analyzed, the first stage was administrative-operational, with a varying duration (minimum of eight, maximum of 101, and mean of 55 days) which was longer when legal opinions were included. The second stage was the exchange rate, which was longer than the former and did not pose any obstacles to the process (minimum of 11, maximum of 381, and mean of 196 days). The third stage was fiscal, which was the longest one (minimum of 43, maximum of 388, and mean of 215.5 days), due to the release of equipment without registration into the country. There were other factors that posed obstacles: inexperience of investigation centers and institutions in networking; inadequacy of the national legislation on scientific ...

A visão de distintos atores sobre o controle sanitário da importação de substâncias psicotrópicas no Brasil / The different point of view about the sanitary control of importation of psychotropic substances in Brazil

O objetivo deste artigo foi analisar a etapa da importação que integra o controle sanitário das substâncias psicotrópicas realizado pela área de portos, aeroportos e fronteiras da Agência Nacional de Vigilância Sanitária. Aqui, entenderam-se como substâncias psicotrópicas os insumos farmacêuticos ativos constantes da lista B1 da Portaria nº 344/98 e que necessitam da anuência da Anvisa para serem importados. Este estudo utilizou o método de entrevistas semiestruturadas com informantes-chave e observação participante. Os dados foram coletados e sistematizados por meio de análise de conteúdo, modalidade temática. Os resultados apontaram um controle bastante complexo que envolve um intenso processo burocrático. Os principais pontos críticos do processo identificados foram: a precariedade do sistema de informação; a carência em recursos humanos; a deficiência de apoio laboratorial e de infraestrutura dos recintos alfandegados. A página eletrônica da Anvisa e a legislação mostraram-se como pontos fortes, embora necessitem de aprimoramentos. Percebeu-se que, apesar do avanço, várias ações ainda precisam ser feitas para que o país tenha um sistema de controle sanitário eficiente sobre essas importações.

The purpose of this work is to analyze the process of importation, that is a part of the sanitary control of psychotropic substances, made by Brazilian National Health Surveillance Agency's ports, airports and borders. For this work, psychotropic substances are defined as active pharmaceutical raw materials present in the list B1 of Portaria nº 344/98; which need Anvisa's permission to be imported. For this purpose we used semistructured interviews with key informers and participant observation. The information were collected and systematized through the content analysis, thematic modality. The results show a very complex control which involves an intense bureaucratic process. The main identified critical points of the process were: the information system precariousness; the absence of human resources; deficiency of laboratorial support and infra-structure at customs. Anvisa's web page and the specific law are strong points of the process, but still needing improvements. We understood that despite of the progress made, there are many things to do for giving the country an efficient health control system to the importation of these substances.

Some opinions about the subject of importation together with the pharmaceutical domain

Importation together is one of essential measures in trying to stable drug ‘s price in the market, protect patients while also ensure requests about understanding property and freedom trade. Discuss about difficulties of Viet Nam in now importation together problem. Along with allow importation together, functional offices, which belong Health need combine well with different industry as market management, customs… to strengthen prevent manufacture unreal products, bad quality products and illegal imported products.

Discussion About Procurement Managerial Technique Standard for Medical Equipment Importation / 医疗卫生装备

Objective To discuss the procurement managerial technique standard for medical equipment importation.Methods The procurement managerial technique standard for medical equipment importation was studied from the aspects of flows for international bidding,declaration and operation as well as related specifications.Results The imported medical equipment according with the procurement managerial technique standard,gifted with a high cost performance,satisfied the requirements of the nation and the hospital.Conclusion The managerial technique standard can promote the procurement of imported medical equipment.