Dedicated to scientific research and public service: in memory of Su The Lung, a master of preventive medicine in China / 中华疾病控制杂志

Su Teh Lung(1906-1985), a famous public health scientist, medical educator and thinker, one of the founders of epidemiology in China. Through scientific experiments and field investigations, he first clarified the distribution law of Oncomelania hupensis comprehensively and proposed the method of eliminating Oncomelania hupensis, and his work has made outstanding contributions to the study of the causes and prevention of schistosomiasis in China. He advocated a comprehensive research of every link of epidemiological process with ecological research, attached importance to statistical methods and logical thinking, went deep into the field, combined with reality, and created theoretical system of epidemiology in China. He advocated truth, seek truth from facts, devoted all his life to the practice and research of epidemic prevention and control, which has a far-reaching impact on the development of preventive medicine in China and the world.

Evaluation on the immunization efficacy on the 23 years who had received plasma-derived HBV vaccine as newborns / 中华流行病学杂志

Objective To observe the long-term effect of plasma-derived HBV vaccine.Methods The effect of a plasma-derived HBV vaccine which was given to children born in 1986 in Huangpu district in Shanghai were followed up once every two years and testing for HBsAg,anti-HBs and anti-HBc was carried out.Compared to background results from cross-sectional survey of hepatitis B virus in 1984 and 1985 (as internal control) as well as finding of survey targeted in non-plasma-derived HBV vaccine of children born in the same time in the nearby area from results investigated in 1991 (as external control),positive rate was calculated to assess the effect of protection.Results The population immunized was followed up for 23 years and 5993 blood samples were collected.During the period of follow-up,the positive rate of anti-HBs decreased from 89.01％ to 18.77％ and the average level was 40.39％.The average positive rate of anti-HBc was 1.87％.The annual positive rate fluctuated around the average level.HBsAg positive rate remained less than 1.00％ (0.46％-0.98％),with an average of 0.62％ (37/5993).Ranges of positive efficacy were from 81.37％ to 95.78％ against background control and 72.76％ against external control.Conclusion The plasma-derived HBV vaccine showed a good long-term protective effect and there was no need for boosting the immunization 23 years later.

Evaluation on the immunization efficacy on the 23 years who had received plasma-derived HBV vaccine as newborns / 中华流行病学杂志

Objective To observe the long-term effect of plasma-derived HBV vaccine.Methods The effect of a plasma-derived HBV vaccine which was given to children born in 1986 in Huangpu district in Shanghai were followed up once every two years and testing for HBsAg,anti-HBs and anti-HBc was carried out.Compared to background results from cross-sectional survey of hepatitis B virus in 1984 and 1985 (as internal control) as well as finding of survey targeted in non-plasma-derived HBV vaccine of children born in the same time in the nearby area from results investigated in 1991 (as external control),positive rate was calculated to assess the effect of protection.Results The population immunized was followed up for 23 years and 5993 blood samples were collected.During the period of follow-up,the positive rate of anti-HBs decreased from 89.01％ to 18.77％ and the average level was 40.39％.The average positive rate of anti-HBc was 1.87％.The annual positive rate fluctuated around the average level.HBsAg positive rate remained less than 1.00％ (0.46％-0.98％),with an average of 0.62％ (37/5993).Ranges of positive efficacy were from 81.37％ to 95.78％ against background control and 72.76％ against external control.Conclusion The plasma-derived HBV vaccine showed a good long-term protective effect and there was no need for boosting the immunization 23 years later.

Valuation on the immunization efficacy on the 23 years who had received plasma-derived HBV vaccine as newborns / 中华流行病学杂志

<p><b>OBJECTIVE</b>To observe the long-term effect of plasma-derived HBV vaccine.</p><p><b>METHODS</b>The effect of a plasma-derived HBV vaccine which was given to children born in 1986 in Huangpu district in Shanghai were followed up once every two years and testing for HBsAg, anti-HBs and anti-HBc was carried out. Compared to background results from cross-sectional survey of hepatitis B virus in 1984 and 1985 (as internal control) as well as finding of survey targeted in non-plasma-derived HBV vaccine of children born in the same time in the nearby area from results investigated in 1991 (as external control), positive rate was calculated to assess the effect of protection.</p><p><b>RESULTS</b>The population immunized was followed up for 23 years and 5993 blood samples were collected. During the period of follow-up, the positive rate of anti-HBs decreased from 89.01% to 18.77% and the average level was 40.39%. The average positive rate of anti-HBc was 1.87%. The annual positive rate fluctuated around the average level. HBsAg positive rate remained less than 1.00% (0.46% - 0.98%), with an average of 0.62% (37/5993). Ranges of positive efficacy were from 81.37% to 95.78% against background control and 72.76% against external control.</p><p><b>CONCLUSION</b>The plasma-derived HBV vaccine showed a good long-term protective effect and there was no need for boosting the immunization 23 years later.</p>

The immunological effects of three doses of a live attenuated hepatitis A vaccine (H2 strain) in 8 years / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To observe the immunological effects of three doses of H2 strain live attenuated hepatitis A vaccine 8 years after the administration and to compare with that of one dose of the vaccine.</p><p><b>METHODS</b>In a country area, 110 children of 1 to 7 years old susceptible to HAV were screened and administered with one dose of the vaccine, as group B; Group A were 42 children from one of the villages and administered with 3 doses of the vaccine according to 0, 2, 6 month schedule. Blood samples were taken for the children 1, 2, 6, 7, 8, 12, 24, 36 and 96 months after the administrations respectively and detected for anti-HAV antibody.</p><p><b>RESULTS</b>For group B, the sero conversion rate of anti-HAV and GMC reached peak at 92.2% and 126.2 mIU/ml respectively, and then, began to drop with time; For group A, after 2 dose of the vaccine, the sero-conversion rate reached 100%, and the GMC reached peak of 2 739 mIU/ml one month after the third dose at 7 months. So that, group A has a better short-term immunological effects than that of group B. During 36 through 96 months, the anti-HAV positive rate in group B was 75%-71% and 80-89 mIU/ml respectively, and comparatively in group A were 100% and 918.2-480.6 mIU/ml respectively. The differences between group A and B were significantly important.</p><p><b>CONCLUSION</b>A 3-dose schedule administration of H2 strain live attenuated hepatitis A vaccine has better immunological effects than 1-dose schedule in 8years and further observations are needed.</p>

Early screening of cerebral palsy during infancy using 'Infant Motor Malfunction Profile' in the communities of two cities / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the prospective validity and predictive value of cerebral palsy during infancy, using 'Infant Motor Malfunction Profile'.</p><p><b>METHODS</b>Items of motor milestone in the profile was used as the first step to screen cerebral palsy on 8137 infants who were screened at 3, 6, 9, 12 months of age. The positive cases who had one of 7 developmental abnormal motor milestone items were examined using the items of primitive reflexes or postural reaction as the secondary step of cerebral palsy screening. The cases who had at least one abnormal item of primitive reflex or postural reaction received neurological examination by doctors to diagnose cerebral palsy.</p><p><b>RESULTS</b>According to our data, sensitivity, specificity, positive prospective value, positive and negative likelihood ratio of the profile in screening cerebral during infancy were 94.1%, 99.8%, 48.5%, 449.6 and 0.06, respectively.</p><p><b>CONCLUSION</b>The profile seemed to be an acceptable instrument for early identification of cerebral palsy.</p>

Efficacy of hepatitis B vaccination on hepatitis B prevention and on hepatocellular carcinoma / 中华流行病学杂志

<p><b>OBJECTIVE</b>To evaluate the efficacy of hepatitis B vaccination on hepatitis B prevention and on hepatocellular carcinoma.</p><p><b>METHODS</b>Birth cohort study, cross-sectional seroepidemiological survey, and surveillance of hepatitis B (HBV) and hepatocellular carcinoma were used to evaluate the efficacy of hepatitis B vaccination.</p><p><b>RESULTS</b>During the 14 years after hepatitis B vaccination, the HBsAg positive rates were found to be 0.7% - 2.9%, with an average of 1.5%, and the protective rates were 83.5% - 96.6%. Hepatitis B virus infection rates of children immunized with hepatitis B vaccine were 1.1% - 5.1%, with an average of 2.2% and the protective rates of 93.5% - 98.4%. 15 years after hepatitis B vaccination, the incidence of hepatitis B dropped from 3.27/10 000 to 0.17/10 000, a 94.8% decrease, in the group of 0 - 19 year-olds.</p><p><b>CONCLUSION</b>The universal infant hepatitis B vaccination has proved to be effective in reducing the incidence rate of acute hepatitis B as well as the mortality of hepatocellular carcinoma.</p>

Epidemiologic surveillance for bacterial meningitis in 140 000 children under 5 years of age in Nanning district, Guangxi province / 中华流行病学杂志

<p><b>OBJECTIVE</b>To characterize the incidence, epidemiologic features, etiologic agents and sequelae of bacterial meningitis in children under 5 years of age in Nanning, Guangxi.</p><p><b>METHODS</b>A population-based surveillance was conducted to evaluate children with signs and symptoms of meningitis. All hospitals, township health centers and village clinics in the surveillance area were structured to participate in the case referral and evaluation. Cerebrospinal fluid (CSF) and blood specimens were obtained and processed using standardized microbiologic methods.</p><p><b>RESULTS</b>During the 26-month surveillance period, among the children under 5 years old, a total of 1272 cases who met the screening criteria of meningitis were studied. 265 of 1272 cases were identified as clinically diagnosed meningitis, with an incidence rate of 86.36 per 100 000 population. The annual incidence rate under the 38 cases of confirmed bacterial meningitis appeared to be 12.38/100 000. Staphylococcus species accounted for the largest proportion of laboratory-confirmed bacterial meningitis, followed by E. coli and S. pneumoniae. The highest attack rate occurred in neonates < 1 month, followed by children aged 1 - 12 months in the confirmed patients. Meningitis caused by Sp and Hi mainly occurred in children aged 1 - 12 months. All cases of meningitis due to Hi and Sp were children aged 1 - 24 months. 13.16% and 0.00% of the cases survived with complications and sequelae, and the case-fatality rate was 18.42%. 40 bacterial isolates were identified from 1193 blood cultures and 23 from 1211 cerebrospinal fluid samples, but no Neisseria meningitidis was found.</p><p><b>CONCLUSION</b>Meningitis due to Hi was first confirmed in Guangxi with the incidence of 0.98 per 100 000 population. The annual incidence rate of confirmed bacterial meningitis was 12.38 per 100 000, which was considered an important public health problem in children. Staphylococci was the predominant pathogen in confirmed bacterial meningitis.</p>

Long-term efficacy of infant hepatitis B immunization program / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To evaluate the long-term efficacy of infant hepatitis B (HB) immunization program on preventing hepatitis B virus (HBV) infection, and to assess its impact on the incidence of HB in children.</p><p><b>METHODS</b>Since 1986, the universal HB vaccination for newborn babies with standard, pediatric dose had been launched without serologic prescreening of pregnant women for HBsAg, in a high endemic county of Long-An. A hepatitis surveillance system was set up to evaluate the possible impact on the incidence of hepatitis B. To serologically evaluate the effectiveness of the program, a stratified random sampling of 1000 children in 1987 birth cohorts, who received plasma-derived HB vaccine, was recruited for long-term follow up at the age of 1 to 13 years. A cross-sectional seroepidemiological survey was conducted in the county in 1985, before the program, and in 2001, for 1551 children born in 1996-2000 who were administered yeast recombinant HB vaccine.</p><p><b>RESULTS</b>During the 1 to 13 years after the program, the rates of HBsAg-positive were 0.7% to 2.9% with an average of 1.7% and the protective rates were 83.5% to 96.6%. HBV infection rates were 1.1% tp 5.1% with an average of 2.4% and the protective rates were 93.5% to 98.4%. For the population aged 1 to 4 years who were immunized with recombinant HB vaccine, HBsAg positive rates were 1.8% to 2.4% with an average of 2.0% and the protective rates were 78.4 to 85.2%. 14 years after the program, the cumulative incidence of acute hepatitis B in the children aged 1 to 14 years fell to 1.5 cases per 100,000 children, down 91.8% as compared with that in 1985 to 1987. However, the cumulative incidence of 14.4 cases per 100,000 population in unvaccinated children was not significantly different from that in the history controls. Acute hepatitis B children had not been reported, showing that the vaccination program was 100% protective in children.</p><p><b>CONCLUSION</b>The universal infant HB vaccination program in a hyperendemic area has proved to be effective in controlling HBV infection and decreasing the incidence of acute hepatitis B in children. Booster dose is unnecessary in 13 years after the immunization. The protective efficacy of yeast recombinant HB vaccine is similar to that of plasma-derived HB vaccine.</p>