Epidemiological analysis on a family cluster of COVID-19 / 中华流行病学杂志

Objective@#To understand the possible transmission route of a family cluster of COVID-19 in Zhengzhou and the potential infectivity of COVID-19 in incubation period, and provide scientific evidence for the timely control of infectious source and curb the spread of the epidemic.@*Methods@#Epidemiological investigation was conducted for a family cluster of COVID-19 (8 cases) with descriptive epidemiological method, and respiratory tract samples of the cases were collected for the nucleic acid detection of 2019-nCoV by RT-PCR.@*Results@#Two primary cases, which occurred on 31 January and 1 February, 2020, respectively, had a common exposure history in Wuhan. The other six family members had onsets on 30 January, 31 January, 1 February (three cases) and 3 February, 2020.@*Conclusions@#In this family cluster of COVID-19, six family members were infected through common family exposure to the 2 primary cases. Five secondary cases had onsets earlier than or on the same day as the primary cases, indicating that COVID-19 is contagious in incubation period, and the home isolation in the early phase of the epidemic might lead to the risk of family cluster of COVID-19.

Analysis on the epidemiology and etiology characteristics of first imported Chikungunya fever case in Henan Province in 2017 / 中华预防医学杂志

To study the epidemiology and etiology characteristics of first imported Chikungunya fever case in Henan province, China, 2017. The patient was confirmed by Chikungunya virus (CHIKV) infected as CHIKV ribonucleotide was continuously detected in his serum specimens. BHK-21 cell line was used for virus isolation, the strain was named CHIKV/Henan001/2017. CHIKV/Henan001/2017 belonged to genotype ECSA. The highest ribonucleotide homology sequence of highly conserved region E1 with CHIKV/Henan001/2017 was hk02 strain (99.8%), who was an imported strain to Hong Kong, China, 2016. Epidemiological information and laboratory testing confirmed it was an imported Chikungunya fever case in Henan province, 2017. No secondary case has been reported.

Laboratory diagnosis and molecular tracing of dengue bordline cases in Henan Province, 2017 / 中华预防医学杂志

Objective@#To confirm the laboratory diagnosis of dengue bordline cases reported in Henan Province and trace its origin from molecular level in 2017.@*Methods@#The study samples were blood samples (3-5 ml), which came from 8 suspected cases of dengue fever reported in the 2017 direct reporting system of Henan provincial infectious disease monitoring network. Meanwhile, case investigation was conducted according to National dengue fever surveillance programme. Serum were separated from blood samples and tested for Dengue NS1 antigen, IgM & IgG antibodies, and dengue RNA. According to dengue diagnosis criteria, confirmed cases were identified by testing results. Samples carried dengue RNA performed for real-time PCR genotyping and amplification of E gene. Then, the amplicons were sequenced and homological and phylogenetic analyses were constructed.@*Results@#8 serum samples of suspected dengue cases were collected in Henan Province, 2017. Six of them were diagnosed as dengue confirmed cases. All the dengue confirmed cases belonged to outside imported cases, 5 of them were positive by dengue RNA testing. Genotyping results showed there were 1 DENV1 case, 2 DENV2 cases and 2 DENV3 cases. A DENV2 case and a DENV3 case of this study were traced its origin successfully. The sequence of Pakistan imported DENV2 case belongs to cosmopolitan genotype, which was the most consistent with Pakistan's DENV2 KJ010186 in 2013 (identity 99.0%). The sequence of Malaysia imported DENV3 case belongs to genotype I, which was the most consistent with Singapore's DENV3 KX224276 in 2014(identity 99.0%).@*Conclusion@#The laboratory diagnosis and molecular traceability of dengue cases in Henan Province in 2017 confirmed that all cases were imported and did not cause local epidemics.

Surveillance of avian influenza virus in poultry environment in Henan Province, 2013-2017 / 中华微生物学和免疫学杂志

Objective To monitor the environmental contamination with avian influenza virus (AIV) in Henan Province. Methods Environmental samples were collected every month from seven moni-toring sites in Henan from 2013 to 2017. Real-time RT-PCR method was performed to detect the nucleic acid of influenza A (Flu A), H5, H7 and H9 viruses in poultry environmental samples. Results A total of 2538 environmental samples were collected and 202 (7. 96％ ) of them were positive for Flu A nucleic acid, including 16 positive for H5 (0. 63％ ), eight positive for H7 (0. 32％ ) and 161 positive for H9 (6. 34％ ). The detection rate of Flu A increased dramatically from 2013 to 2017 except for a small fluctuation in 2015. However, H7 subtype AIV was detected only in 2015 and 2017. The highest detection rate of AIV was in February, followed by that in January. Among different environments, the highest detection rate of Flu A was in live poultry market, which was 13. 69％ , followed by that in poultry slaughtering plant (2. 58％ ) and poultry farm (0. 58％ ). The detection rates of Flu A in swab samples of poultry plucker and cutting board, stool specimens and poultry drinking water were 28. 57％ , 13. 76％ , 5. 70％ and 5. 26％ , respectively.Conclusion Contamination of H5 / H7 / H9 AIV did exist in poultry environment in Henan and was getting worse. Increasingly diversified sources and sale channels were the main causes of serious contamination of AIV. In order to effectively prevent and control human infection with AIV, live poultry in areas where human infection with AIV was confirmed should be blocked and banned to be sold to others areas.

Molecular epidemiological analysis of coxsackievirus A16 strains causing neurologic complications / 中华微生物学和免疫学杂志

Objective To analyze the VP1 sequences of coxsackievirus A16(CA16) causing neu-rologic complications. Methods Clinical samples and epidemiological information were collected from pa-tients with viral encephalitis. Coxsackievirus A16 in these samples were first detected with real time RT-PCR and then isolated. RT-PCR was performed to amplify VP1 sequences and the amplified products were se-quenced. DNAStar 5.0 and Mega 5 were used for sequence analysis. All data was analyzed with SPSS statis-tical software. Results Fifteen samples were collected from 12 patients with hand, foot and mouth disease (HFMD) complicated by neurologic complications. Eight patients had the symptoms of fever, skin rash, signs of meningeal irritation and neck rigidity. No typical cluster was associated with clinical features or the time of onset. Both pharyngeal/anal swab and serum samples were collected from three patients (patient′s number:01111,01169 and 01130). The two samples collected from both 01111 and 01130 patients shared 100% similarity in nucleotide and amino acid based on VP1 sequences,while those from 01169 patient dif-fered in only one base. The 15 CA16 isolates were highly similar in VP1 gene, sharing 94.5%-100% ho-mology in nucleotide sequences and 98.0%-100% homology in amino acid sequences. These 15 isolates showed 68.5%-70.5% identities in nucleotide sequences and 90.5%-91.9% identities in amino acid se-quences with the CA16 prototype strain G10. Phylogenetic analysis revealed that based upon VP1 sequences, all of the 15 CA16 isolates grouped into genotype B subtype 1b (B1b), which was further classified into three clusters. Conclusion All of the 15 CA16 isolates causing neurologic complications belonged to B1b sub-genotype. Understanding the molecular epidemiology of CA16 would be essential for controlling morbidi-ty rates of HFMD and vaccine research.

Stratified sampling survey of major human parasitic diseases in Henan province / 中华流行病学杂志

Objective To understand the prevalence of major human parasitic diseases and related factors in Henan province.Methods This stratified sampling survey was carried out according to the requirement of national survey protocol of major human parasitic diseases,2014-2015.The prevalence of soil-transmitted helminths infection,taeniasis and intestinal protozoiasis were surveyed in 104 sites selected from 35 counties (districts) and the prevalence of clonorchiasis was surveyed in 62 sites selected from 37 townships.In each survey spot,250 persons were surveyed.A total of 26 866 persons and 15 893 persons were surveyed.Modified Kato-Katz thick smear was used to detect the eggs of intestinal helminthes.Tube fecal culture was used to identify the species of hookworm.The Enterobius eggs were detected in children aged 3 to 6 years by using adhesive tape.The cyst and trophozoite of intestinal protozoa were examined with physiological saline direct smear method and iodine stain method.Results The overall infestation rate of intestinal parasites was 2.02％ in Henan,and the worm infection rate was higher than protozoa infection rate.Fourteen kinds of intestinal parasites were found,including nematode (5 species),trematode (2 species),and protozoan (7 species).The infection rate of Enterobius vermicularis was highest,and Qinba Mountain ecological area had the highest infestation rate of intestinal parasites in 4 ecological areas of Henan.There was no significant difference in intestinal parasite infection rote between males and females (x2=3.630,P=0.057),and the differences in intestinal parasite infection rate among different age groups had significance (x2=124.783,P=0.000 1).The infection rate reached the peak in age group ≤9 years and the major parasite was Enterobius vermicularis.Furthermore the overall human infection rate of parasite showed a downward trend with the increase of educational level of the people (x2=70.969,P=0.000 1),the differences had significance (x2=120.118,P=0.000 1).For different populations,the infection rate of intestinal parasites was highest among preschool children.The infection of intestinal helminth was mainly mild,only 2 severe cases were detected.The infection rate of Clonorchis sinensis in urban residents was only 0.006％.Logistic regression analysis showed that being preschool children (x2=15.765,P=0.000 1) and drinking well water (X2=45.589,P=0.000 1) were the risk factors for intestinal parasite infection,and annual income per capita of farmers was the protective factor against intestinal parasite infection.The infection rates of protozoa and intestinal parasites decreased sharply compared with the results of previous two surveys,and the rate of intestinal helminth infection also dropped sharply compared with the second survey.The numbers of protozoa,helminth and intestinal parasites detected in this survey were all less than the numbers found in the previous two surveys.Conclusions Compared the results of three surveys in Henan,the infection rate of protozoa and intestinal parasites showed a downward trend.The prevention and treatment of Enterobius vermicularis infection in children should be the key point of parasitic disease control in the future.

Stratified sampling survey of major human parasitic diseases in Henan province / 中华流行病学杂志

Objective To understand the prevalence of major human parasitic diseases and related factors in Henan province.Methods This stratified sampling survey was carried out according to the requirement of national survey protocol of major human parasitic diseases,2014-2015.The prevalence of soil-transmitted helminths infection,taeniasis and intestinal protozoiasis were surveyed in 104 sites selected from 35 counties (districts) and the prevalence of clonorchiasis was surveyed in 62 sites selected from 37 townships.In each survey spot,250 persons were surveyed.A total of 26 866 persons and 15 893 persons were surveyed.Modified Kato-Katz thick smear was used to detect the eggs of intestinal helminthes.Tube fecal culture was used to identify the species of hookworm.The Enterobius eggs were detected in children aged 3 to 6 years by using adhesive tape.The cyst and trophozoite of intestinal protozoa were examined with physiological saline direct smear method and iodine stain method.Results The overall infestation rate of intestinal parasites was 2.02％ in Henan,and the worm infection rate was higher than protozoa infection rate.Fourteen kinds of intestinal parasites were found,including nematode (5 species),trematode (2 species),and protozoan (7 species).The infection rate of Enterobius vermicularis was highest,and Qinba Mountain ecological area had the highest infestation rate of intestinal parasites in 4 ecological areas of Henan.There was no significant difference in intestinal parasite infection rote between males and females (x2=3.630,P=0.057),and the differences in intestinal parasite infection rate among different age groups had significance (x2=124.783,P=0.000 1).The infection rate reached the peak in age group ≤9 years and the major parasite was Enterobius vermicularis.Furthermore the overall human infection rate of parasite showed a downward trend with the increase of educational level of the people (x2=70.969,P=0.000 1),the differences had significance (x2=120.118,P=0.000 1).For different populations,the infection rate of intestinal parasites was highest among preschool children.The infection of intestinal helminth was mainly mild,only 2 severe cases were detected.The infection rate of Clonorchis sinensis in urban residents was only 0.006％.Logistic regression analysis showed that being preschool children (x2=15.765,P=0.000 1) and drinking well water (X2=45.589,P=0.000 1) were the risk factors for intestinal parasite infection,and annual income per capita of farmers was the protective factor against intestinal parasite infection.The infection rates of protozoa and intestinal parasites decreased sharply compared with the results of previous two surveys,and the rate of intestinal helminth infection also dropped sharply compared with the second survey.The numbers of protozoa,helminth and intestinal parasites detected in this survey were all less than the numbers found in the previous two surveys.Conclusions Compared the results of three surveys in Henan,the infection rate of protozoa and intestinal parasites showed a downward trend.The prevention and treatment of Enterobius vermicularis infection in children should be the key point of parasitic disease control in the future.

Human enterovirus infection status and clinical characteristics of 274 patients with viral encephalitis in Henan Province, 2011-2012 / 中华预防医学杂志

Objective@#To investigate human enterovirus (HEV) infection and clinical characteristics of viral encephalitis patients in Pingdingshan, Henan Province.@*Methods@#Cerebrospinal fluid specimens and epidemiological information were collected from 274 viral encephalitis patients in the departments of pediatrics and neurology in hospitals in Pingdingshan, Henan Province, from April 2011 to August 2012. Patients with bacterial infections were excluded from the study. Demographic information was collected by questionnaires and clinical information was mainly obtained from hospital examinations. Viral RNA was extracted using magnetic bead extraction. Real-time RT-PCR was then performed for HEV, CV-A16, and EV-A71 testing. SPSS statistical software was statistical analyses. Significant differences were determined using the chi-squared test (P<0.05).@*Results@#Among 274 cases of viral encephalitis, 180 cases (65.7%) were male and 94 cases were female (34.3%). The median age was 2.17 years. Approximately 61.3% (168) of patients were younger than 3 years of age. A total of 107 (39.1%), 2 (0.7%), and 42 (15.3%) cases were positive for HEV, CV-A16, and EV-A71, respectively. Eleven patients were younger than 6 months of age and one patient was co-infected with HEV and EV-A71. In the<3, 3-5, 6-15, and>15 years old age groups, HEV infections comprised 31.5% (53/168), 52.9% (18/34), 53.0% (35/66), and 16.7% (1/6) (χ2=13.10, P=0.003), respectively. The EV-A71 infection rates were 17.9% (30/168), 23.5% (8/34), 6.1% (4/66), and 0 (χ2=8.04, P=0.045), respectively. The other enterovirus (OEV) infection rates were 12.5% (21/168), 29.4% (10/34), 48.5% (32/66), and 16.7% (1/6) (χ2=35.19, P<0.001), respectively. The rate of vomiting in OEV and EV-A71 infected patients was 73% (44/60) and 26% (11/42), respectively, while the frequency of skin rash in OEV and EV-A71 infected patients was 32% (19/60) and 79% (33/42), respectively. Approximately 95% (99/104) of patients infected with HEV had a fever, and the breathing rhythm change rate was 19% (20/104), which was lower than that of patients without HEV infection (36.8% (60/163)) (χ2=9.35, P=0.002).@*Conclusion@#In Pingdingshan, HEV was a major causative agent of viral encephalitis and the rate of OEV infection was high, especially in children aged 3-15 years old. Fever was a common clinical symptom of patients infected with HEV. Patients infected with OEV primarily exhibited vomiting symptoms and EV-A71 infected patients showed skin rash.

Characteristics of molecular typing and drug resistance of 67 Salmonella paratyphi A isolated in Zhengzhou from 2013 to 2015 / 中华预防医学杂志

Objective@#To investigate the antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of S.paratyphi A strains in Zhengzhou city isolated from sentinel hospitals in 2013-2015.@*Methods@#According to Salmonella molecular typing and K-B drug susceptibility testing method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI2015), we analyzed drug sensitivity and PFGE molecular characteristics of 67 S.paratyphi A strains(11 strains in 2013, 7 strains in 2014, 49 strains in 2015) isolated from blood and stool samples in two sentinel hospitals of fever with rash syndrome surveillance system established in Zhengzhou city in 2013-2015.@*Results@#The results showed 67 strains of S.paratyphi A had different levels of resistance to 13 kinds of antibiotics, 65 strains were multi-drug resistant strains (97.0%), 5 isolates were resistant to 2-3 kinds of antibiotics (7.5%), 41 isolates were resistant to 5-8 kinds of antibiotics (61.2%),11 isolates were resistant to 9-10 kinds of antibiotics(16.4%),8 isolates were resistant to 11-12 kinds of antibiotics(11.9%). 67 strains of S.paratyphi A were divided into 10 molecular patterns(PTYA1-PTYA10) by digestion with XbaⅠ restriction endonuclease and pulsed field gel electrophoresis, each pattern contains 1-48 strains with similarity ranged from 94.31%-100%. PTYA3 contained 48 strains, which was predominant band type; PTYA1, 9 contained 6 strains; PTYA 2, 4, 5, 6, 7, 8, 10 contained 1 strains among them.@*Conclusion@#The status of drug resistance of clinical isolates of S.paratyphi A in Zhengzhou city was rather serious, PFGE patterns showed diversity and dominant characteristics. The PFGE patterns of partial strains and its corresponding anti-drug spectrum have certain relevance and cluster relationship.

Infection status, clinical symptoms and gene type transition of group A rotavirus in children, less than five years-of-age, with diarrhea in sentinel hospitals of Henan Province, China / 中华预防医学杂志

Objective@#To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China.@*Methods@#In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR. Epidemiological information (including demographic information such as age, sex and clinical symptoms) was also collected from the patients and analyzed.@*Results@#Group A rotavirus was detected in 30.9% (785/2 541) of diarrhea samples from children. The detection rate was higher in October (54.8%, 345/629) and lower in July (5%, 5/101) each year from 2008 to 2015. The group A rotavirus infection rate was higher in boys (30.6%, 451/1 476) than in girls (31.4%, 334/1 065) (χ2=0.18, P=0.664). Infection mainly occurred in 4-12 months old patients (61.3%, 481/785) (χ2=196.69, P<0.001), and the infection rate was lower in cities (26%, 258/992) compared with rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). G typing of 785 strains of group A rotavirus revealed the following types: G1 (13.5%, 106 strains), G2 (11.1%, 87 strains), G3 (29.7%, 233 strains), and G9 (57.5%, 451 strains); P typing revealed the predominance of P[4] (11.3%, 89 strains) and P[8] (84.7%, 665 strains); gene type combinations comprised mainly G9P[8], G2P[4], G3P[8], G1P[8], respectively accounted for 52.9% (415), 9.7% (76), 17.3% (136), 11.3% (89). Gene type combinations G1 [8] and G3P[8] have been decreasing in prevalence since 2008 and G9P[8] has become the dominant gene type of group A rotavirus in Henan province. Among the group A rotavirus infection samples, the male:female infection ratio was 1.4∶1 (451/334), with no significant difference in the infection rate (χ2=0.18, P=0.664); the infection rate was higher in 4- 12 months old patients (61.3%, 481/785), with a significant difference detected between age groups (χ2=196.69, P<0.001). The rate of detection was lower in cities (26.0%, 258/992) than in rural areas (34.0%, 527/1 549) (χ2=18.19, P<0.001). Clinical analysis revealed a body temperature of below 37 degrees in 75.7% of positive cases (594 patients), 37.0- 37.5 degrees in 17.2% of cases (135 patients), 37.6-38.0 degrees in 2.0% of cases (16 patients), and above 38 degrees in 5.1% of cases (40 patients), with most cases showing no fever or a mild fever. The frequency of episodes of diarrhea among the patients was 0- 3 times (21.1%, 166 cases), 4- 6 times (65.6%, 515 cases), 7- 9 times (8.0%, 63 cases), or 10- 15 times (5.2%, 41 cases), mainly showing mild and moderate diarrhea. Vomiting also varied in frequency among the patients from no vomiting (86.9%, 682 cases), 1-2 times (11.8%, 92 cases), 3 times (6.0%, 47 cases), and more than 3 times (0.4%, 3 cases). The occurrence of dehydration varied from no dehydration (86.9%, 682 cases), mild dehydration of 1%- 5% (12.1%, 95 cases), to severe dehydration of ≥5% (1.0%, 8 cases).@*Conclusion@#A higher infection rate of group A rotavirus was detected in children younger than five years of age with acute diarrhea in sentinel hospitals in Henan province, including part-mixed infection cases. A predominance of cases was detected in the autumn, and secondly the spring of each year. Gene type G9P[8] was most frequently isolated. The majority of patients displayed no fever, vomiting or dehydration. The cases with clinical symptoms of fever, diarrhea, vomiting and dehydration often showed mild disease.

Pathogenic analysis of rat infected hantavirus in Henan province, 2014-2016 / 天津医药

Objective To analyze the genotyping of hantavirus and investigate the pathogenic features of local rats in Henan province. Methods A total of 600 rats captured in Queshan county, Zhumadian city from 2014-2016 were chosen to find out the major species and density. Rat lung specimens were detected by RT-PCR using partial M and S segment primers, then sequencing and phylogenetic analysis based on M segment (2003-2302 nt) were performed to analyze gene subtype and evolution. Results In the field of Queshan county, major species were sewer rats and apodemus agrarius, and the average density of rats was 1.33%-1.83%. Sewer rats, mus musculus and apodemus agrarius were major species in the residential area, and the average density of rats was 1.36%-1.97%. Hantaviruses were detected by RT-PCR in three captured rats in 2014, and the species were mus musculus, cricetulus triton and sewer rats. Nucleotide homology similarity based M and S segment of three positive products was 100%. Phylogenetic analysis indicated the virus was belonged to S4 subgenotype of Seoul virus, which was similar with the strains in Korea and Hubei province, China. Conclusion The virus from rats in Queshan county, Henan province is seoul virus, S4 subgenotype. It is necessary to take the relevant prevention and control measures to prevent hemorrhagic fever of renal syndrome because of wide host range.

Comparison and evaluation of different assays in the diagnosis of severe fever with thrombocytopenia syndrome / 天津医药

Objective To evaluate different detection methods in the diagnosis of severe fever with thrombocytopenia syndrome (SFTS), and find the most quick and accurate one for the identification of new bunyavirus infection. Methods Real-time PCR and ELISA-IgM were used to detect serum samples of 158 patients with acute phase of SFTS, which were collected from the special monitoring system of SFTS in Henan Province in 2014. IgM and IgG antibodies were detected by ELISA in 109 acute and convalescent paired serum specimens. The differences of the positive rates were compared between the three methods, and the influence of the collected interval time on the detection results was analyzed. Results For 158 acute phase serum samples of SFTS patients, the positive rate detected by real-time PCR (76.58%) was higher than that of ELISA-IgM (47.47%), and the difference was statistically significant (χ2=34.13, P 0.05). In both the acute phase and convalescent phase, the positive rate of IgM was higher than that of IgG, and the difference was statistically significant (χ2=41.68 and 6.25, P<0.05). With the extension of collected interral time, the positive rates of IgM and IgG antibodies were both increased ( Z=6.42 and 10.08, P < 0.05). Conclusion Real-time PCR is the most sensitive method for the early diagnosis of the SFTS. ELISA-IgG is suitable for the detection of SFTS at recovery period. ELISA-IgM can be used as an assistant method to guide clinical diagnosis.

Establishment of response system to emergency parasitic disease affairs in China / 中国血吸虫病防治杂志

China's prevention and control of parasitic diseases has made remarkable achievements. However,the prevalence and transmission of parasitic diseases is impacted by the complicated natural and social factors of environment ,natural disas-ters,population movements,and so on. Therefore,there are still the risks of the outbreak of emergency parasitic diseases af-fairs,which may affect the control effectiveness of parasitic diseases and endanger the social stability seriously. In this article , we aim at the analysis of typical cases of emergency parasitic disease affairs and their impacts on public health security in China in recently years,and we also elaborate the disposal characteristics of emergency parasitic disease affairs,and propose the estab-lishment of response system to emergency parasitic disease affairs in China,including the organizational structure and response flow path,and in addition,point out that,in the future,we should strengthen the system construction and measures of the re-sponse system to emergency parasitic disease affairs,so as to control the risk and harm of parasitic disease spread as much as possible and to realize the early intervention and proper disposal of emergency parasitic disease affairs.

Characteristics of spatiotemporal distribution on severe fever with thrombocytopenia syndrome in Henan province / 中华流行病学杂志

Objective To explore the characteristics regarding temporal,spatial and spatiotemporal distribution on severe fever with thrombocytopenia syndrome (SFTS) in Henan province.Methods Surveillance data related to SFTS was collected in Henan province,from year 2014 to 2016.Descriptive method was used to analyze the distribution of SFTS.1.7.0 software related to the Public health geographic information system (PHGIS),was applied to draw the spatial distribution map of SFTS.Chi-square test was used to compare the different incidence rates.Results A total of 2 781 SFTS cases,including 34 deaths,were reported in Henan province from 2014 to 2016,with an average annual fatality rate as 1.22％.There were statistically significant differences for the incidence rates of SFTS between different years (P＜0.01).Cases were mainly concentrated from April to October,which accounted for 96.66％ of the total number,with the incidence peak seen in May.Incidence rates of SFTS in spring,summer,autumn were higher than that in winter.The cases were scattering around in 26 counties of 8 cities.Xinyang city reported 2 714 cases,accounting for 97.59％ of the total number of cases in the province.The average annual incidence rate in Xinyang city was 17.22 per 100 000,much higher than that for the whole Henan province (0.98 per 100 000),with statistically significant difference (P＜0.01).Six counties reported having death cases,that accounted for 23.08％ of the total number of counties,reported to have death cases.Two kinds of incidence patterns of SFTS were noticed in Henan province,with aggregation in some local regions or sporadic in individual counties.The number of counties with reporting cases increased annually.The epidemic area was expanding and gradually spreading from south to north areas of the province.Conclusions SFTS was characterized with both temporal and spatial clusters in Henan province.Effective prevention and control measures should be made in accordance with the spatiotemporal distribution and the trend on SFTS.

Characteristics of spatiotemporal distribution on severe fever with thrombocytopenia syndrome in Henan province / 中华流行病学杂志

Objective To explore the characteristics regarding temporal,spatial and spatiotemporal distribution on severe fever with thrombocytopenia syndrome (SFTS) in Henan province.Methods Surveillance data related to SFTS was collected in Henan province,from year 2014 to 2016.Descriptive method was used to analyze the distribution of SFTS.1.7.0 software related to the Public health geographic information system (PHGIS),was applied to draw the spatial distribution map of SFTS.Chi-square test was used to compare the different incidence rates.Results A total of 2 781 SFTS cases,including 34 deaths,were reported in Henan province from 2014 to 2016,with an average annual fatality rate as 1.22％.There were statistically significant differences for the incidence rates of SFTS between different years (P＜0.01).Cases were mainly concentrated from April to October,which accounted for 96.66％ of the total number,with the incidence peak seen in May.Incidence rates of SFTS in spring,summer,autumn were higher than that in winter.The cases were scattering around in 26 counties of 8 cities.Xinyang city reported 2 714 cases,accounting for 97.59％ of the total number of cases in the province.The average annual incidence rate in Xinyang city was 17.22 per 100 000,much higher than that for the whole Henan province (0.98 per 100 000),with statistically significant difference (P＜0.01).Six counties reported having death cases,that accounted for 23.08％ of the total number of counties,reported to have death cases.Two kinds of incidence patterns of SFTS were noticed in Henan province,with aggregation in some local regions or sporadic in individual counties.The number of counties with reporting cases increased annually.The epidemic area was expanding and gradually spreading from south to north areas of the province.Conclusions SFTS was characterized with both temporal and spatial clusters in Henan province.Effective prevention and control measures should be made in accordance with the spatiotemporal distribution and the trend on SFTS.

Characteristics of drug resistance and molecular type of Salmonella typhi and Salmonella paratyphi isolated in Henan province, 2009-2011 / 中华流行病学杂志

Objective To investigate the antibiotic resistance and pulsed field gel electrophoresis (PFGE) patterns of clinical isolates of Salmonella (S.) typhi and S.paratyphi in Henan province during 2009-2011.Methods According to molecular typing and Salmonella K-B drug susceptibility test method published by international PulseNet bacterial infectious disease monitoring network and USA Clinical and Laboratory Standards Institute (CLSI),the drug susceptibility and PFGE molecule characteristics of 78 S.typhi and S.paratyphi strains isolated from sentinel hospitals in Henan were analyzed.Results The 78 strains orS.typhi and S.paratyphi were resistant to 13 kinds of antibiotics,in which 62 were multidrug resistant (79.5％),4 were resistant to 2-3 kinds of antibiotics (5.1％),41 were resistant to 5-8 kinds of antibiotics (52.6％),14 were resistant to 9-10 kinds of antibiotics (17.9％),3 were resistant to 11-12 kinds of antibiotics (3.8％).The resistant rate to cephalosporins,quinolones and other 3 kinds of antibiotic showed an increase trends.Seventy two strains ofS.typhi and S.paratyphi could be divided 14 molecular patterns by digestion with Xba Ⅰ and PFGE,each pattem contains 1-47 strains which shared the similarity of 66.03％-100.00％.Conclusions The drug resistance of clinical isolates of S.typhi and S.paratyphi was serious in Henan.The PFGE patterns showed diversity,but the predominant patterns could be still found.The PFGE patterns of some strains were associated with their drug resistance.

Surveillance on the etiology and molecular epidemiology of Shigella sonnei isolated in Henan province from 2011 to 2014 / 中华流行病学杂志

Objective To detect and analyze the distribution of virulence factors,antimicrobial resistance and pulsed field gel electrophoresis (PFGE) patterns of Shigella sonnei,isolated in Henan province from 2011 to 2014.Methods Samples of diarrhea patients were collected and isolated with SS selective culture medium in 37 ℃ for 18-24 hours.All strains were identified under the Kligler iron agar/motility-indol-urea biochemical action and API20E biochemical system.Serological typing and prepared DNA template were carried out with thermal cracking method and multiplex PCR,to detect the virulence genes of Shigella sonnei.According to the molecular typing method and K-B drug susceptibility testing method published by the international PulseNet bacterial infectious disease monitoring network and USA clinical and Laboratory Standards Institute,antimicrobial susceptibility tests and PFGE molecular characteristics of these positive strains isolated from sentinel hospitals patients stool samples were analyzed.Results Among the 98 strains of Sonnei type Ⅰ and 118 strains of Sonnei type Ⅱ,all the strains carried carry different virulence genes including SHET-1B,SHET-2,ial,ipaH genes,with 4 kinds of virulence gene combination types.All the 216 strains of Shigella sonnei belonged to the multi-drug resistant strains,including 34 isolates resistant to 2-4 kinds of antibiotics (15.7％),147 isolates to 5-8 kinds of antibiotics (68.1％),24 to 9-10 kinds of antibiotics (11.1％),7 to 11 kinds of antibiotics (3.2％),and 4 to 13 kinds of antibiotics (1.9％).A total of 100 strains of Shigella sonnci were divided into 31 molecular patterns,digested by Xba Ⅰ and PFGE.Each pattern contained 1-13 strains with similarities ranged from 68.6％-100.0％.Conclusions All the Shigella sonnei strains carried virulence pathogenic factors,presenting serious status on drug resistance.PFGE fingerprinting patterns showed high polymorphism and dominant characteristics.PFGE patterns of partial strains and corresponding antidrug spectrum presented certain relevance and with same aggregation relationship.

Etiology study on severe cases caused by hand-foot-mouth disease in children from Henan province, 2014 / 中华流行病学杂志

<p><b>OBJECTIVE</b>To investigate the etiology of severe hand-foot-mouth disease (HFMD) in children in Henan province.</p><p><b>METHODS</b>A total of 244 HFMD cases admitted to a hospital in Zhengzhou from April to June of 2014 were recruited for research sampling, Real-time RT-PCR, virus isolation, VP1 sequencing and alignment methods were used to test the enterovirus-related etiology. SPSS 17.0 was used in performing statistical analysis.</p><p><b>RESULTS</b>There were 109 severe and 135 mild cases among all the 244 HFMD cases. The number of enterovirus positive stool samples was 229, with positive rate as 93.85%. EV71, Cox A16 and Cox A10 made up 83.84%, 5.68% and 8.30% of the enterovirus etiologicy, strains, respectively. EV71 infection caused 8 HFMD cases with heart-lung failure and 2 death, Cox A10 infection led to 1 HFMD case with heart-lung failure and death. There were statistically differences seen regarding the enterovirus infection rates between severe and the mild HFMD cases (χ(2)=5.312,P=0.021). Statistically significant difference was seen in the constituent ratio of EV71, Cox A16 and the others by Fisher' s exact test (P=0.048). There was statistically significant difference seen between the cardiorespiratory failure rate and the fatality rate by EV71 and Cox A10 infection (χ(2)=0.051,P=0.821; χ(2)=2.198,P=0.138). Cox A10 strains idenfied in Henan in 2014 belonged to genotype 6. The rates on homology of nucleotide and amino acid among the Cox A10 strains in Henan in 2014 were 94.3%-99.7% and 96.3%-100.0% respectively.</p><p><b>CONCLUSIONS</b>EV71 still remained the most common pathogen that causing severe HFMD in children, with the increasing Cox A10 percentage in the pathogens spectrum of HFMD infection. Cox A10 strains in Henan in 2014 belonged to genotype 6. Genotype 6 Cox A10 had appeared and widely distributed in Henan for long time, but not yet variated or reconstructed. Cox A10 infection could lead to cardio-respiratory failure thus called for the monitoring program on non-EV71 and non-Cox A16 enterovirus, especially Cox A10 to be strenthened.</p>

Distribution and molecular type of Salmonella from external environment in Henan province / 中华流行病学杂志

Objective To understand the distribution of Salmonella in external environment in Henan province,and explore the distribution of different serotypes of the Salmonella and their homology.Methods A total of 4 488 samples were collected form animal dung,meat products and kitchen utensils,and identified by biochemical tests and serotyped by serum agglutination reaction.The predominant serotypes were further typed by PFGE.Results A total of 324 Salmonella strains were detected in these samples,the detection rate was 7.21％.The 324 Salmonella isolates belonged to 39 serotypes,S.enteritidis (24.07％,78/324) and S.derby (20.37％,66/324) were predominant.Forty six strains ofS.enteritidis and 30 strains of S.derby were divided into 12 and 17 molecular patterns by digestion with Xba Ⅰ,while chicken and swine were the predominant animal hosts.Conclusions Serotyping of external environment Salmonella were phenotypically diverse and the serotype of Salmonella from different sources were different.The same clone was prevalent in same area.It is necessary to strengthen supervision and surveillance to ensure food safety.

Surveillance for viral diarrhea in sentinel hospitals in Henan province, 2013-2015 / 中华流行病学杂志

Objective To investigate the infection status of human rotavirus,calicivirus,astrovirus and enteric adenovirus in children aged ＜5 years in disease surveillance areas in Henan province from 2013 to 2015.Methods A total of 880 stool samples were collected from four sentinel hospitals and group A rotavirus was detected by ELISA and group A rotavirus G/P genotyping was performed with nested multiplex RT-PCR,while rotavirus (group B,C),calicivirus and astrovirus were detected by two-step multiplex RT-PCR and adenovirus were detected by PCR.The epidemiological data of positive cases were statistically analyzed.Results A total of 594 positive samples were detected,including 24 mixed infection samples,370 rotavirus positive samples (42.0％);162 calicivirus positive samples (18.4％);69 astrovirus positive samples (7.8％) and 17 enteric adenovirus positive samples (1.9％).The overall positive rate of four viruses was significantly higher in urban area than in rural area,but the positive rate of rotavirus was higher in males than in females and in younger age group than in older age group.G9P [8] was the major genotype of group A rotavirus,there were two seasonal infection peaks in autumn and spring.Norovirus Ⅱ was the predominant type of calicivirus and the infection peak was in spring.Viral diarrhea cases were distributed in different age groups,mainly in age groups 0-12 months (rotavirus) and 3-5 years (calicivirus).The main clinical symptoms included fever,diarrhea and vomiting.The etiological characteristics differed with gender and area.Conclusions The infection rate of diarrheal viruses was higher in young children ＜5 years old in disease surveillance areas.The epidemiological and clinical features varied with the type of pathogen.