Hospitalization burden of hand, foot and mouth disease in Anhua county of Hunan province, 2013-2016 / 中华流行病学杂志

Objective: To estimate the serotype and age-specific hospitalization burden associated with hand, foot and mouth disease (HFMD) in Anhua county of Hunan province, between October 2013 and September 2016. Methods: We collected hospitalization records of HFMD patients from 6 virological surveillance hospitals, and reimbursement records through new rural cooperative medical system from 23 township health centers to estimate the age-specific hospitalization burden of HFMD in Anhua. Combined with the results of virological surveillance, the serotype-specific hospitalization burden of HFMD in Anhua, was estimated. Results: During the three years, it was estimated that 3 541 clinical diagnosed HFMD cases, including 3 146 laboratory-confirmed HFMD cases, were hospitalized in Anhua, but only one was diaguosed as being severe. The estimated average hospitalization rate was 723/100 000(95%CI: 699/100 000-747/100 000) for clinical diagnosed HFMD and 642/100 000 (95%CI: 620/100 000-665/100 000) for laboratory-confirmed HFMD between October 2013 and September 2016. The cases caused by Cox A16 (208/100 000) and Cox A6 (202/100 000) had higher hospitalization rates compared with the cases caused by EV71 (130/100 000), Cox A10 (38/100 000) and other enterovirus (64/100 000), and the difference was statistically significant (P<0.001). HFMD-associated hospitalization rates peaked in children aged 1 year (3 845/100 000), and then decreased with age. Compared with the hospitalized HFMD caused by EV71 and Cox A16, Cox A6-associated hospitalizations mainly occurred in younger age groups (P<0.001). Conclusion: Our study revealed a substantial hospitalization burden associated with mild HFMD caused by EV71, Cox A16, Cox A6 and Cox A10, especially in young children, in Anhua.

Clinical characteristics and economic burden of influenza among children under 5 years old, in Suzhou, 2011-2017 / 中华流行病学杂志

Objective: To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou, China, 2011-2017. Methods: From March 2011 to February 2017, we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital. Through standard questionnaires and follow-up survey via telephone, we collected information regarding the demographic characteristics, medical history, clinical symptoms and both direct and indirect costs associated with influenza, of the patients. We then compared clinical characteristics and economic burden of influenza A/H1N1, A/H3N2, and B infections among children with ILI. Results: We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs. 791 (12.9%) of the swabs showed positive for influenza virus, including 88 (11.1%) subtype influenza A/H1N1, 288 (36.4%) subtype influenza A/H3N2, and 415(52.5%) type influenza B. The proportions of cough, rhinorrhea, wheezing, vomiting and convulsion in influenza-positive children were higher than those influenza-negative children. Except for the prevalence rates of cough (χ(2)=9.227, P=0.010), wheezing (χ(2)=7.273, P=0.026) and vomiting (χ(2)=8.163, P=0.017), other clinical symptoms appeared similar between the three viral subtypes. Among all the ILI children, the average total cost per episode of influenza was 688.4 Yuan (95%CI: 630.1-746.7) for influenza-negative children; 768.0 Yuan (95%CI: 686.8-849.3) for influenza-positive children and 738.3 Yuan (95%CI: 655.5-821.1) for influenza B. Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (χ(2)=7.237, P=0.028). Conclusion: Children infected influenza showed higher prevalence rates of cough, rhinorrhea, wheezing, vomiting and convulsion than those without influenza. Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.

Strategy for prevention and control of imported infectious disease / 中华流行病学杂志

The process of globalization increases the risk of global transmission of infectious diseases, resulting in pressure for country's prevention and control of imported infectious disease. Based on the risk assessment of disease importation and local transmission, a strategy that conducting importation prevention and routine prevention and control before the importation of disease and taking emergency control measures after the importation of disease was developed. In addition, it is important to take part in global infectious disease response action, aid the countries with outbreak or epidemic to actively decrease the risk of disease importation.

Dynamic Contrast-enhanced MRI in Identification and Diagnosis of Metastasis of Lung Cancer / 中国医学影像学杂志

Purpose To explore the application value of dynamic contrast enhanced MRI (DCE-MRI) in judging and diagnosing metastasis of lung cancer.Material and Methods Sixty-one metastatic spinal tumor patients received DCE-MRI and their images acquired after scanning were post-processed.Signal intensity-time curve,signal intensity amplification in rising period of the curve (Peak SE％),maximum ascending linear slope of the curve (Max Wash-in SE％) and descending slope of the curve (Wash-out SE％) and other semiquantitative parameters were acquired.Double chamber pharmacokinetics was adopted to analyze and obtain Ktrans,rate constant (Kep) and other quantitative parameters.CHAID method was taken to establish tree structure model to confirm optimal sorting parameter and identify optimal division.Results For the DCE-MRI scanning parameters for 61 metastatic spinal tumor patients,differences of Wash-out SE％ and Kep between lung cancer and other tumor spinal metastasis were statistically significant (P＜0.01),while differences of Peak SE％,Max Wash-in SE％ and Ktrans between the two were not statistically significant (P＞0.05).When Wash-out SE％＞-660.6％ and Max Wash-in SE％＞98.0％,original focus of about 94.7％ was possible to come from lung.When taking tree structure model set up in the study for identification,10-fold cross-validation indicated (29.5±5.8)％ error rate.Conclusion Taking DCE-MRI semi-quantitative and quantitative analysis parameters for identification and diagnosis of metastasis of lung cancer is feasible.It can provide reference evidence for source identification of spinal sarcoma and clinical treatment.

Aeromonas sobria infection in farmed mud loach [misgurnus mizolepis] in Korea, a bacteriological survey

A disease outbreak occurred in June 2012 among mud loach cultured on pond farms in Jangseong-gun, Jeollanam-do, Korea. Mortality rates reached up to 1.2% in the farm per day. Typical clinical signs were bleeding ulcer at the middle portion of head and haemorrhagic erosion of the operculum. Based on biochemical characteristics, the causative bacterium isolated from diseased fish was identified as Aeromonas sobria. The isolate expressed two haemolytic genes, aerolysin [sob] and haemolysin [asa1] genes. Histopathologically, liver showed hepatocellular vacuolar degeneration and congestion in sinusoids. The spleen exhibited necrotized splenocytes and haemorrhagic pulps. In the kidney, glomerular destruction, renal tubular necrosis and haemorrhage were observed. Experimental infection [infectious dose of 10[6], 10[7], and 10[8] cfu fish[-1]] of healthy mud loach with the isolate resulted in the development of clinical signs similar to those seen in the farm. By injection with an infectious dose of 10[6] cfu fish[-1], the mortality rate was 10.3% within 7 days post infection. A mortality rate of 60.9% was reached within 2 days when an infectious dose of 10[7] cfu fish[-1] was used. Otherwise, all fish died within 1 day when injected with 10[8] cfu fish[-1]. The results demonstrated that A. sobria is involved in the morbidity and mortality of the farmed mud loach