Molecular epidemiological analysis of COVID-19 imported cases in Ruili from July to November, 2021

Objective To analyze the epidemiological and genomic characteristics of COVID-19 cases imported by land in Ruili, and to provide reference for border epidemic prevention and control in Yunnan Province. Methods We collected information about SARS-CoV-2 infected individuals from overseas land in Ruili, Yunnan from July to November, 2021. The epidemiological characteristics were statistically analyzed. The second-generation sequencing platform of Illumina was used to conduct high-through-put sequencing on the selected 40 positive samples and to analyze their genotyping and variation characteristics. Results During the study period,Ruili City reported 796 COVID-19 cases from abroad.The median age of COVID-19 cases was 28.5 years (Interquantile range 10, range 1–85). The gender ratio between men and women was 4.61 : 1, Most of these infected individuals engaged in business services, accounting for 49.75% (396/796) , 95.60% of COVID-19 cases were mild and moderate cases. The sequencing results of 34 cases can be divided into three clades according to Nextstrain typing method, including 24 cases belong to 21A(Delta) clade, 9 cases belong to 21I(Delta) clade and 1 case belongs to 20I (Alpha V1) clade. Conclusions The virus genotypes of the cases in this study were mainly divided into three branches and there were some differences among them, most of which were Delta mutants.We should continue to implement border control measures and continue to monitor the virus mutation of imported cases, so as to evaluate the threat of the mutant strain to the current situation of epidemic prevention and control in Yunnan Province. © 2023, Publication Centre of Anhui Medical University. All rights reserved.

Molecular epidemiological analysis of COVID-19 imported cases in Ruili from July to November, 2021.

Objective To analyze the epidemiological and genomic characteristics of COVID-19 cases imported by land in Ruili, and to provide reference for border epidemic prevention and control in Yunnan Province. Methods We collected information about SARS-CoV-2 infected individuals from overseas land in Ruili, Yunnan from July to November, 2021. The epidemiological characteristics were statistically analyzed. The second-generation sequencing platform of Illumina was used to conduct high-through-put sequencing on the selected 40 positive samples and to analyze their genotyping and variation characteristics. Results During the study period,Ruili City reported 796 COVID-19 cases from abroad.The median age of COVID-19 cases was 28.5 years (Interquantile range 10, range 1-85). The gender ratio between men and women was 4.61 : 1, Most of these infected individuals engaged in business services, accounting for 49.75% (396/796) , 95.60% of COVID-19 cases were mild and moderate cases. The sequencing results of 34 cases can be divided into three clades according to Nextstrain typing method, including 24 cases belong to 21A(Delta) clade, 9 cases belong to 21I(Delta) clade and 1 case belongs to 20I (Alpha V1) clade. Conclusions The virus genotypes of the cases in this study were mainly divided into three branches and there were some differences among them, most of which were Delta mutants.We should continue to implement border control measures and continue to monitor the virus mutation of imported cases, so as to evaluate the threat of the mutant strain to the current situation of epidemic prevention and control in Yunnan Province.Copyright © 2023, Publication Centre of Anhui Medical University. All rights reserved.

Clinical features, diagnosis, combined medical treatment, epidemiological characteristics, and therapy of 26 confirmed COVID-19 cases

Background: Clinical features, diagnosis, medical treatment, epidemiological characteristics, and the therapy of 26 confirmed cases were analyzed to provide a scientific basis for formulating epidemic prevention with control strategies and measures. Methods: An epidemiological survey, clinical features, treatment guidelines were conducted for 26 patients, who were diagnosed with Corona Virus Disease-19 (COVID-19) and have been treated in The General Hospital since Jan. 2020 according to China national guideline for COVID-19. Results: The ratio of males to females were 3.25∶1.22, (84.62%) were more than 18 years old. There were 20 (76.92%) cases suffering from fever, 14 (53.85%) cases with weakness, and 8 (30.77%) with dry cough. Progressive muscle relaxation (PMR) therapy could help COVID-19 patients overcome anxiety and sleep problems, which may give a boost in their mental strength to fight against this COVID-19 during their stay in the isolation ward. In this study, both the clinical results and quality of evidence showed that Ribavirin, Lopinavir/Ritonavir, Moxifloxacin and Arbidol Hydrochloride combination with supportive drugs are probably major effective treatments. In the present pandemic situation, frontline physicians;who treat patients in a medical setting and evaluate prophylaxis for COVID-19 high-risk environments formed by large quarantined and isolated populations, are facing a lot of challenges. Conclusion: Most cases were males. The aged people group were at higher risk of the disease. Half of the cases were caused by living together and close contact with a patient. Different combination drugs use for COVID-19 is clinically successfully effective in published literature, including this study. © 2020 The author (s).

Current status of hand-foot-and-mouth disease.

Hand-foot-and-mouth disease (HFMD) is a viral illness commonly seen in young children under 5 years of age, characterized by typical manifestations such as oral herpes and rashes on the hands and feet. These symptoms typically resolve spontaneously within a few days without complications. Over the past two decades, our understanding of HFMD has greatly improved and it has received significant attention. A variety of research studies, including epidemiological, animal, and in vitro studies, suggest that the disease may be associated with potentially fatal neurological complications. These findings reveal clinical, epidemiological, pathological, and etiological characteristics that are quite different from initial understandings of the illness. It is important to note that HFMD has been linked to severe cardiopulmonary complications, as well as severe neurological sequelae that can be observed during follow-up. At present, there is no specific pharmaceutical intervention for HFMD. An inactivated Enterovirus A71 (EV-A71) vaccine that has been approved by the China Food and Drug Administration (CFDA) has been shown to provide a high level of protection against EV-A71-related HFMD. However, the simultaneous circulation of multiple pathogens and the evolution of the molecular epidemiology of infectious agents make interventions based solely on a single agent comparatively inadequate. Enteroviruses are highly contagious and have a predilection for the nervous system, particularly in child populations, which contributes to the ongoing outbreak. Given the substantial impact of HFMD around the world, this Review synthesizes the current knowledge of the virology, epidemiology, pathogenesis, therapy, sequelae, and vaccine development of HFMD to improve clinical practices and public health efforts.

Analysis on epidemiological characteristics of public health emergencies of communicable diseases in Shenzhen from 2016 to 2020

Objective To analyze the epidemiological characteristics of surveillance results of public health emergencies of communicable diseases in Shenzhen from 2016 to 2020. Methods The data of public health emergencies in Shenzhen from 2016 to 2020 were derived from National Public Health Emergency Reporting Management Information System, the occurrence characteristics of epidemic outbreak were analyzed by disease types, regions and institution types, and SPSS 22. 0 was used for statistical analysis. Results The events of COVID-19 reported in 2020 were excluded,a total of 233 public health emergencies of for communicable diseases were reported, with 6 271 cases and 2 deaths were reported in Shenzhen from 2016 to 2020. The attack rate was 3. 87%, and the fatality rate was 0. 03%. The highest prevalence rate was 5. 20% in 2018. There were 164 clustered epidemic events, accounting for 70. 39% of the total information related to public health emergencies, involving 7 types of communicable diseases. Chicken pox (100 incidents,3 565 cases) and infectious diarrhea (41 incidents, 1 491 cases) were the found to be the most common diseases, accounting for 60. 98% and 25. 00% of the total clustered epidemic events, respectively. There were 78. 45% of the clustered events of respiratory communicable diseases occurred in primary schools, and 58. 33% of the clustered events events of intestinal diseases occurred in kindergartens. The difference was statistically significant in the composition ratio of the two kinds of communicable diseases in kindergartens, primary schools, middle schools, high schools, colleges and universities and other places. Conclusion A comprehensive prevention and control strategy should be adopted. The comprehensive control strategies should be formulated from aspects including the reduction of population susceptibility, implementing of early reporting and school suspension measures, monitoring of epidemic strains, and strengthening of personal hygiene protection habits for communicable diseases with high risk among different populations. © 2022, Editorial Department of Medical Pest Control. All rights reserved.

[Epidemiological characteristics of imported malaria in Zhengzhou City from 2016 to 2020].

OBJECTIVE: To analyze the epidemiological characteristics of reported imported malaria cases in Zhengzhou City from 2016 to 2020, so as to provide insights into the management of imported malaria in the city. METHODS: All data pertaining to cases with definitive diagnosis of malaria in Zhengzhou City from 2016 to 2020 were captured from the National Notifiable Disease Report System and the Information Management System for Parasitic Disease Control in China, including individual demographic data, and malaria onset, initial diagnosis and definitive diagnosis data. All data were descriptively analyzed. The duration from malaria onset to initial diagnosis, from initial diagnosis to definitive diagnosis and from onset to definitive diagnosis was compared among cases. In addition, the diagnoses of imported malaria cases in which definitive diagnosis was made were compared with the reexaminations by Zhengzhou Municipal Malaria Diagnosis Reference Laboratory. RESULTS: A total of 302 cases with definitive diagnosis of malaria were reported in Zhengzhou City from 2016 to 2020, and all were imported cases, with Plasmodium falciparum malaria as the predominant type (230 cases, 76.2%). There were 293 malaria cases imported from Africa (293 cases, 97.0%), which mainly included Nigeria (48 cases, 15.9%), Angola (40 cases, 13.2%), and the Democratic Republic of the Congo (29 cases, 9.6%). There was no obvious seasonality found in the date of malaria onset and time of reporting malaria. The ratio of male to female malaria cases was 49.3:1, and there were 103 cases (34.1%) with the current residency address in Zhengzhou City, 193 cases (63.9%) with the current residency address in other cities of Henan Province and 6 cases (2.0%) in other provinces of China. There were 271 cases (89.7%) seeking initial diagnosis in medical institutions, and the diagnostic accuracy of malaria was 56.6% (171/302) at initial diagnosis institutions. A total of 122 cases (40.4%) sought medical care on the day of malaria onset, and 252 cases (86.4%) within 3 days; however, only 22 cases (7.3%) were definitively diagnosed on the day of onset, and 162 cases (53.6%) diagnosed within 3 days. There were no significant differences between malaria cases seeking initial diagnosis at medical institutions and disease control and prevention institutions in terms of the duration from malaria onset to initial diagnosis (Z = -1.663, P > 0.05), from initial diagnosis to definitive diagnosis (Z = -0.413, P > 0.05) or from malaria onset to definitive diagnosis (Z = -0.838, P > 0.05). The median duration (interquartile range) from initial diagnosis to definitive diagnosis of malaria was 3.00 (2.00), 3.00 (6.00), 2.00 (4.00) d and 1.00 (1.00) d among cases seeking medical care at township-level and lower, county-, city- and province-level medical institutions, and the median duration from initial diagnosis to definitive diagnosis of malaria was significantly longer among cases seeking medical care at township-level and lower medical institutions than at city (Z = -3.286, P < 0.008 33) and province-level medical institutions (Z = -9.119, P < 0.008 33), while the median duration from initial diagnosis to definitive diagnosis [1.00 (3.00) d vs. 2.00 (4.00) d; Z = -4.099, P < 0.016] and from malaria onset to definitive diagnosis [3.00 (4.00) d vs. 4.00 (5.00) d; Z = -2.868, P < 0.016] among malaria cases with the current residency address in Zhengzhou City was both shorter than in other cities of Henan Province. The diagnostic accuracy was 89.1% (269/302) among malaria cases in which definitive diagnosis was made, and the accuracy of malaria reexaminations was 94.0% (284/302) in Zhengzhou Municipal Malaria Diagnosis Reference Laboratory. CONCLUSIONS: P. falciparum malaria was predominant among reported imported malaria cases in Zhengzhou City from 2016 to 2020, and these imported malaria cases were predominantly diagnosed at medical institutions; however, the diagnostic capability of malaria is poor in township-level and lower medical institutions. Strengthening the collaboration between medical institutions and disease control and prevention institutions and improving the diagnostic capability building at medical institutions are recommended to consolidate malaria elimination achivements.

Evaluating the Impact of Traveling on COVID-19 Prevalence and Predicting the New Confirmed Cases According to the Travel Rate Using Machine Learning: A Case Study in Iran

COVID-19 which has spread in Iran from February 19, 2020, infected 1, 550, 142 people and killed 59, 264 people until February 18, 2021. The immediate suggested solution to prevent the spread of this virus was to avoid traveling around. Unfortunately, on many occasions, this restriction was not enforced or respected by the citizens. Thus, the goal of this study was to evaluate the impact of traveling on the COVID-19 prevalence by measuring the correlation between traveling data and new confirmed cases of COVID-19 in Iran. The data consists of the daily traffic between Iran's provinces, air traffic, and daily COVID-19 new confirmed cases. In the first step, the importance analysis was used to determine the impact of different kinds of traveling on the COVID-19 spread. In the second step, KNN, Random Forest (RF), and Support Vector Regression (SVR) were used to predict the effect of traveling on the number of new COVID-19 cases. Although the available data was very coarse and there were no details of inner-cities commute, an R-squared of 0.89 and 0.86 on the train and test datasets was achieved respectively, showing a positive correlation between the number of travels between states and the new confirmed cases of COVID-19. It was also shown that there was an 8-day incubation period. Consequently, by considering this period the voting regressor model reached 0.92 and 0.98 R2 scores for test and train datasets respectively. The result confirms that one of the best ways to avoid the spread of the virus is limiting or eliminating traveling around. © 2021 IEEE.

Epidemiological characteristics of traumatic musculoskeletal injuries during the COVID-19 pandemic at a single tertiary hospital.

BACKGROUND: Musculoskeletal (MSK) injuries are common but can lead to devastating outcomes. During the COVID-19 pandemic in Saudi Arabia, it is thought that the burden of traumatic MSK injuries is minimized. OBJECTIVE: This study aimed to assess the epidemiological characteristics of traumatic MSK injuries during the lockdown period in Saudi Arabia. MATERIALS AND METHODS: This retrospective descriptive study included all patients who were admitted to the orthopedic department at a single tertiary hospital level 1 trauma center due to traumatic injuries from March 23 to June 21, 2020. RESULTS: The study included 92 patients. The majority were male (68.5%). The most common comorbidity was hypertension (30.4%). Falls were the most common mechanism of injury (47%). The most common sites to be fractured were the proximal femur (22.8%) followed by the distal tibia/fibula (14%). Skull fractures (12%), rib fractures (6.5%), and pneumothorax (6.5%) were the most common associated injuries. Age and the number of injuries were significant predictors of increased length of hospital stay. CONCLUSIONS: Major considerations for primary prevention must be taken into account during long periods of time with no direct patient interaction. Patient education is important to help avoid any burden that might be caused by otherwise preventable injuries. Further studies should be conducted to assess this phenomenon more in depth and to establish the appropriate method of educating patients on primary prevention.

The epidemiological characteristics of deaths with COVID-19 in the early stage of epidemic in Wuhan, China.

OBJECTIVES: To analyze the epidemiological characteristics of COVID-19 related deaths in Wuhan, China and comprehend the changing trends of this epidemic along with analyzing the prevention and control measures in Wuhan. METHODS: Through the China's Infectious Disease Information System, we collected information about COVID-19 associated deaths from December 15, 2019 to February 24, 2020 in Wuhan. We analyzed the patient's demographic characteristics, drew epidemiological curve and made geographic distribution maps of the death toll in each district over time, etc. ArcGIS was used to plot the numbers of daily deaths on maps. Statistical analyses were performed using SPSS and @Risk software. RESULTS: As of February 24, 2020, a total of 1833 deaths were included. Among the deaths with COVID-19, mild type accounted for the most (37.2%), followed by severe type (30.1%). The median age was 70.0 (inter quartile range: 63.0-79.0) years. Most of the deaths were distributed in 50-89 age group, whereas no deaths occurred in 0-9 age group. Additionally, the male to female ratio was 1.95:1. A total of 65.7% of the deaths in Wuhan combined with underlying diseases, and was more pronounced among males. Most of the underlying diseases included hypertension, diabetes and cardiovascular diseases. The peak of daily deaths appeared on February 14 and then declined. The median interval from symptom onset to diagnosis was 10.0 (6.0-14.0) days; the interval from onset to diagnosis gradually shortened. The median intervals from diagnosis to death and symptom onset to deaths were 6.0 (2.0-11.0), 17.0 (12.0-22.0) days, respectively. Most of the disease was centralized in central urban area with highest death rate in Jianghan District. CONCLUSION: COVID-19 poses a greater threat to the elderly people and men with more devastating effects, particularly in the presence of underlying diseases. The geographical distributions show that the epidemic in the central area of Wuhan is more serious than that in the surrounding areas. Analysis of deaths as of February 24 indicates that a tremendous improvement of COVID-19 epidemic in Wuhan has achieved by effective control measures taken by Wuhan Government.

[Epidemiological characteristics of COVID-19 in Wuchang district of Wuhan].

Objective: To analyzes epidemiological characteristics of COVID-19 and provide evidence for adjustment for COVID-19 prevention and control strategies. Methods: The data of COVID-19 cases in Wuchang district reported as of 19 March, 2020 were obtained from National Notifiable Disease Report System of Chinese Disease Prevention and Control Information System. The software's of Excel 2010, SPSSS 22.0, Arc GIS10.2 and Joinpoint regression program 4.8.0.0 were used for statistical analysis. Results: A total of 7547 COVID-19 cases had been reported as of 19 March, 2020 in Wuchang district, including 5 448 confirmed cases (72.19%), 2009 clinical diagnosed cases (26.62%) and 90 asymptomatic cases case (1.19%). The age of the cases was (56.65±16.25) years and age ranged from 2 days to 105 years among confirmed cases, 2634 were males (48.35%) and 2814 were females (51.65%), 2 492 were retirees (45.74%). A total of 545 health workers were infected with SARS-CoV-2 (7.22% of all cases) including 365 confirmed cases and 5 cases have died. A total of 430 cases of death were reported with case fatality rate of 7.89% (430/5 448), case fatality rate of males (10.9%, 266/2 634) was higher than that of females (5.82%, 164/2 814). The first phase of epidemic peak was from January 24 to January 26, the second phase of epidemic peak was from February 1 to February 5 and there was no one of new confirmed case in one day for the first time on March 18. The first four Streets with the highest incidence rates of confirmed cases were Huanghelou Street (1 043.77/100 000), Ziyang Street (627.97/100 000), Yangyuan Street (503.67/100 000) and Shuiguohu Street (486.02/100 000). Compared with females, aged ≤50 years and mild cases of clinical classification respectively, males (RR=0.690, 95%CI: 0.322-1.478), aged >50 years (RR=11.745, 95%CI: 6.878-20.058), severe cases (RR=2.317, 95%CI: 1.789-3.000) and critical cases of clinical classification (RR=10.794, 95%CI: 7.997-14.569), and gender time-dependent covariate (RR=1.392, 95%CI: 1.053-1.840) were major influencing factors of prognosis of COVID-19 confirmed cases. Conclusions: The gender, ages and occupation of distribution were wide among COVID-19 cases in Wuchang district. Males, aged >50 years, severe cases and critical cases of clinical classification were influencing factors of prognosis of COVID-19 confirmed cases. The standardized management of discharged cases, asymptomatic infected cases and close contact persons were main measures to reduce incidence rates of COVID-19 cases.

[Epidemiological characteristics of asymptomatic infection cases of COVID-19 in Guangdong province].

Objective: To analyze the epidemiological characteristics of the cases firstly reported as "asymptomatic infection of COVID-19" in Guangdong province. Methods: The follow-up observation method was used to continuously track and observe the cases firstly reported as "asymptomatic patients with COVID-19" in Guangdong province from January 14 to March 31, 2020. The epidemiological data of the cases were collected to analyze their epidemiological characteristics, outcome and influencing factors. Results: From January 14 to March 31, 2020, a total of 325 cases were firstly reported as "asymptomatic infections of COVID-19" in Guangdong province. The epidemic curve of asymptomatic infection cases was similar to that of confirmed cases, and it had two peaks. The first peak was from January 27 to February 5, and the second peak was from March 17 to March 26. Of the 325 cases, 184 (56.6%) were subsequently converted to confirmed cases. These cases were defined as incubation period asymptomatic infection cases. The age median of the cases was 40 years, and 93.5% (172/184) of the cases showed symptoms within 3 days after the first positive nucleic acid tests were conducted, and 141 (43.4%) of the 325 cases remained asymptomatic status until they were cured and discharged. They were inapparent infection cases, accounting for 8.6% (141/1 642) of those diagnosed with COVID-19 in Guangdong province during the same period. The age median of inapparent infection cases was 27 years. The median of the interval between the first positive nucleic acid test and discharge was 14 days. Up to 90.8% (138/141) of the inapparent infection cases were discharged for centralized medical observation within 28 days. The longest interval between the first positive nucleic acid test and the last positive nucleic acid test was 73 days. The positive rate of nucleic acid test was 0.3% in close contacts of inapparent infection cases and 2.2% in close contacts of incubation period asymptomatic infection cases. There were significant differences in age distribution and source of infection between incubation period asymptomatic infection cases and inapparent infection cases (P<0.05). Old age was the risk factor for the conversion of firstly reported asymptomatic infection cases to confirmed cases. Compared with the 0-19-year-old group, The patients aged 40-59 years and 60 years and above were more likely to become confirmed cases. The OR (95%CI) values were 2.730 (1.380-5.402) and 5.302 (2.199-12.783), and P values were 0.004 and 0.000, respectively. People being infected in China were more likely to become confirmed cases (OR=7.121, P=0.000). Conclusions: There were asymptomatic infection cases among patients diagnosed with COVID-19. The infectiousness of incubation period asymptomatic infection cases might be stronger than that of inapparent infection cases. The proportion of younger cases among asymptomatic infection cases was higher than that of the confirmed cases. Old age and domestic infection were the risk factors for the conversion of asymptomatic infection cases to confirmed cases, to which more attention should be paid. Further serological investigations are needed to provide a basis for the development of COVID-19 prevention and control strategies.

[Epidemiological characteristics of COVID-19 in Shaanxi province].

Objective: To understand the incidence trend and epidemiological characteristics of COVID-19 in Shaanxi province. Methods: The incidence data of COVID-19 reported in Shaanxi as of 22 February, 2020 were collected for an epidemiological descriptive analysis. Results: A total of 245 confirmed cases of COVID-19 were reported in Shaanxi. Most cases were mild (87.76%). As time passed, the areas where confirmed cases were reported continued to increase. The case number in Xi'an was highest, accounting for nearly half of the total reported cases in the province. The epidemic pattern in Shaanxi had gradually shifted from imported case pattern to local case pattern, and the transmission of local cases was mainly based on family cluster transmission. The confirmed cases from different sources had caused the secondary transmission in Shaanxi. After February 7, the number of reported cases began to fluctuate and decrease stably, indicating a decrease-to-zero period. Conclusions: At present, the overall epidemic of COVID-19 in Shaanxi has gradually been mitigated. However, considering the approaching of return to work and study and the increasing of imported cases from other countries, the prevention and control of COVIS-19 in Shaanxi will face new challenges.

[Epidemiological characteristics of COVID-19 in Gansu province].

Objective: To understand the epidemiological characteristics of COVID-19 cases in different epidemic stages in Gansu province. Methods: Epidemiological investigation was conducted to collect the information of confirmed COVID-19 cases, including demographic, epidemiological and clinical information. Results: As of 25 February 2020, a total of 91 confirmed COVID-19 cases had been reported in Gansu. The epidemic of COVID-19 in Gansu can be divided as three different stages, i.e. imported case stage, imported-case plus indigenous case stage, and indigenous case stage. A total of 63 cases were clustered cases (69.23%), 3 cases were medical staff infected with non-occupational exposure. The initial symptoms included fever (54.95%, 50/91), cough (52.75%, 48/91), or fatigue (28.57%, 26/91), the proportion of each symptom showed a decreasing trend along with the three epidemic stages, but only the differences in proportions of fever (trend χ2=2.20, P<0.05) and fatigue (trend χ2=3.18, P<0.05) among the three epidemic stages were statistically significant. The cases with critical severe symptoms accounted for 42.85% (6/14), 23.73% (14/59) and 16.67% (3/18), respectively, in three epidemic stages, showed a decreasing trend (H=6.45, P<0.05). Also, the incubation period prolonged along with the epidemic stage (F=51.65, P<0.01), but the intervals between disease onset and hospital visit (F=5.32, P<0.01), disease onset and diagnosis (F=5.25, P<0.01) became shorter along with the epidemic stage. Additionally, the basic reproduction number (R0) had decreased from 2.61 in imported case stage to 0.66 in indigenous case stage. Conclusions: The COVID-19 epidemic in Gansu was caused by the imported cases, and about 2/3 cases were clustered ones. No medical worker was observed to be infected by occupational exposure. With the progression of COVID-19 epidemic in Gansu, the change in initial symptom and incubation period suggests, the early screening cannot only depend on body temperature monitoring.