Post-pandemic American travelers' behavior given a chikungunya outbreak

Introduction: Mosquito-borne diseases have historically affected communities, especially in tropical areas where mosquitoes and illnesses are endemic. Globalization, climate change, and increased travel have created ideal conditions for outbreaks of mosquito-borne diseases that could threaten the American health system and place a burden on the national economy, especially in southern states. Methods: The study adopts a quantitative cross-sectional design with a retrospective survey carried out using the Pollfish platform in June 2022. The data were analyzed using descriptive statistics and hierarchical multiple regression to assess the three hypotheses: (H1) Chikungunya awareness is related to sociodemographic factors;(H2) Wearing long sleeves and pants is related to (a) Chikungunya awareness and (b) information-seeking behaviors, when controlling for sociodemographic variables;(H3) Use of insect repellents is related to (a) Chikungunya awareness and (b) information-seeking behaviors when controlling for sociodemographic variables. Results: The results highlight the relationships between chikungunya's awareness, information-seeking behavior, and willingness to engage in protective behaviors. 45.91% of the participants mentioned not having heard about chikungunya, and 67.07% of respondents had sought information about mosquito-borne illnesses in the past, 55.9% have looked at the U.S. State Department's website for mosquito-borne diseases, 38.32% have visited the U.S. CDC website for information specifically about chikungunya. Conclusions: The results of this study show that most American travelers are unaware of chikungunya and its mode of transmission. Travel could likely introduce the chikungunya virus to the United States. Despite increased health information-seeking behavior among U.S. residents after the Covid19 pandemic, Chikungunya awareness is low.

Imported malaria from land bordering countries in China: A challenge in preventing the reestablishment of malaria transmission.

OBJECTIVE: No indigenous malaria cases have been reported since 2017 in China, but a large number of imported cases are still reported every year, including those from the land bordering countries. To characterize their epidemiological profiles will provide evidence for the development of appropriate strategies to effectively address the challenges of border malaria in the post-elimination phase. METHODS: Individual-level data of imported malaria cases from the land bordering countries were collected from 2017 to 2021 in China via the web-based surveillance systems, and analyzed by SPSS, ArcGIS and WPS software, to explore their epidemiological profiles. RESULTS: A total of 1170 malaria cases imported into China from six of the fourteen land bordering countries were reported between 2017 and 2021 with a decline trend. Overall, cases were widely distributed in 31-97 counties from 11 to 21 provinces but mainly in Yunnan. Moreover, these imported cases were mainly infected with P. vivax (94.8%), and a total of 68 recurrent cases were reported in 6-14 counties from 4 to 8 provinces. In addition, nearly 57.1% of the total reported cases could seek healthcare within 2 days of getting sick, and 71.3% of the reported cases could be confirmed as malaria on the day they sought medical care. CONCLUSIONS: China still needs to attach great importance to the risk and challenge of the imported malaria from bordering countries particularly from Myanmar in preventing reestablishment of malaria transmission in the post-elimination phase. It is necessary not only to strengthen collaboration and cooperation with the bordering countries, but also coordinate multiple departments at home to improve malaria surveillance and response system and prevent the reestablishment of malaria transmission in China.

Investigation of imported malaria cases at a COVID-19 isolation point in Qingdao

The epidemiological data were collected from travellers who returned from Guinea on the 23rd of September, 2020 and were diagnosed with malaria at a C OVID -19 quarantine site in Qingdao, Shandong Province. The epidemiological characteristics, diagnosis and treatment of the cases and the epidemiology investigation and the rapid test screening results for other travellers on from the same flight and the interventions in reaction to the imported malaria cases were analyzed. The results showed that 4 out of 231 Guinean returned travellers had developed malaria symptoms, including chills and fever, during the isolation period. Rapid diagnostic test (RDT) indicated Plasmodium falciparum infection. Considering the patients ' travel history, clinical manifestations, and laboratory RDT test results, a confirmed diagnosis of imported P. falciparum malaria was made. The four malaria cases, who are male workers aged 29 to 55, were transferred to Jiaozhou People ' s Hospital for treatment. All four patients were administrated of artemether tablets upon diagnosis. One of the cases experienced severe malaria complications and were administrated with 12 doses (60 mg/dose) of artesunate intravenously for five days. The other three patients were treated with dihydroartemisinin and piperaquine phosphate tablets for one course of 8 tablets in 2 days (40 mg dihydroartemisinin and 320 mg piperaquine phosphate), respectively. Among the 231 returned travellers, 111 (48.1 %) had a history of malaria overseas. There were 23 positive cases detected by RDT, including the four symptomatic cases. The other 19 cases were asymptomatic. One of the asymptomatic cases became symptomatic three months later and was diagnosed as an imported P. malariae infection. Laboratory blood smear microscopic tests at the Jiaozhou City and Qingdao Municipal Center For Disease Control and Prevention showed negative results for the four malaria cases and the 19 RDT positive case. The samples from the four malaria cases were rechecked by the provincial reference laboratory of Shandong Institute of parasitic Disease. The results were negative for malaria infection by microscopic examination but positive for P. falciparum infection by nucleic acid test. It is suggested that during the routine control of COVID-19, the awareness of COVID-19 and malaria should be established among the returned travellers from high malaria-endemic areas. The health education "gate" should be moved forward to improve the treatment compliance for malaria cases and reduce the relapse or recrudescence caused by sub-optimal treatment.Copyright © 2022, Chin J Parasitol Parasit Dis. All rights reserved.

Epidemic characteristics analysis of COVID-19 cluster in Huizhou, Guangdong

Objective To analyze the epidemiological characteristics of COVID-19 cluster epidemic in Huizhou from January to February in 2020, and we provide experience and reference for the prevention and control of cluster epidemic. Methods Descriptive epidemiology was used to analyze the clusters of COVID-19 in Huizhou city. Results From January to February in 2020, a total of 19 COVID-19 cluster outbreaks were reported in Huizhou. The most common cluster outbreaks were in Huidong county (8 cases), Boluo county (3 cases) and Huiyang district (3 cases). There were 59 cases involved in 19 outbreaks, among which 46 were confirmed cases, and 13 were asymptomatic infected. The sex ratio of male to female was 0.84: 1, the age was 1-85 years old. The 19 cases of outbreaks were all caused by imported cases, among which 13 cases were imported from Wuhan (68.4%), 3 cases were imported from Hubei province except Wuhan (15.8%), and 3 cases were imported from other provinces and cities (15.8%). There were 13 cases (68.4%) in the first generation, and 6 cases (31.6%) in the second generation. Events exposed place were variety, including 3 (15.8%) simple family exposure, 13 (68.4%) joint exposure, exposure family, 1 (5.26%) of the joint exposure, family exposure, family dinners, 1 (5.26%) of the joint exposure, family exposure, exposure (hotel) exposed in public places, 1 (5.26%) of the collective unit (workplace) exposure. Conclusion All the COVID - 19 cluster outbreaks in Huizhou city were caused by imported cases, most of which occurred in the family and were caused by families living together and eating together. As the number of people returning to work, production and school increases, various prevention and control measures should be implemented in key areas, key populations and key places to prevent the outbreak from rebounding.Copyright © China Tropical Medicine 2021.

Epidemiological characteristics of four times of community transmission of COVID-19 in Hebei

Objective To analyze the epidemiological characteristics of community transmission of the coronavirus disease 2019 (COVID-19) caused by four imported cases in Hebei Province, and to provide a scientific basis for the prevention and control of the disease. Methods Descriptive epidemiological methods were used to analyze the epidemiological characteristics of four community-transmitted COVID-19 outbreaks reported in the China Disease Control and Prevention Information System from January 1, 2020 to December 31, 2021 in Hebei Province. Results From January 1, 2020 to December 31, 2021, four community-transmitted COVID-19 outbreaks caused by imported COVID-19 occurred in Hebei Province, respectively related of Hubei (Wuhan) Province, Beijing Xinfadi market, Overseas cases and Ejina banner of Inner Mongolia Autonomous Region. Total of 1 656 cases (1 420 confirmed cases and 236 asymptomatic cases) were reported, including 375 cases in phase A (From January 22 to April 16, 2020), and phase B (from June 14 to June 24, 2020) 27 cases were reported, with 1 116 cases reported in the third phase (Phase C, January 2 to February 14, 2021), and 138 cases reported in the fourth phase (Phase D, October 23 to November 14, 2021). The 1 656 cases were distributed in 104 counties of 11 districts (100.00%), accounting for 60.46% of the total number of counties in the province. There were 743 male cases and 913 female cases, with a male to female ratio of 0.81:1. The minimum age was 13 days, the maximum age was 94 years old, and the average age (median) was 40.3 years old. The incidence was 64.01% between 30 and 70 years old. Farmers and students accounted for 54.41% and 14.73% of the total cases respectively. Of the 1 420 confirmed cases, 312 were mild cases, accounting for 21.97%;Common type 1 095 cases (77.11%);There was 1 severe case and 12 critical cases, accounting for 0.07% and 0.85%, respectively. 7 patients died from 61.0 to 85.7 years old. The mean (median) time from onset to diagnosis was 1.9 days (0-31 days), and the mean (median) time of hospital stay was 15 days (1.5-56 days). Conclusions Four times in Hebei province COVID-19 outbreak in scale, duration, population, epidemic and type of input source, there are some certain difference, but there are some common characteristics, such as the outbreak occurs mainly during the legal holidays or after starting and spreading epidemic area is mainly in rural areas, aggregation epidemic is the main mode of transmission, etc. To this end, special efforts should be made to strengthen the management of people moving around during holidays, and strengthen the implementation of epidemic prevention and control measures in places with high concentration of people. To prevent the spread of the epidemic, we will step up surveillance in rural areas, farmers' markets, medical workers and other key areas and groups, and ensure early detection and timely response.Copyright © 2022 China Tropical Medicine. All rights reserved.

A pitfall of cognitive bias during the pandemic: Two cases of Plasmodium falciparum malaria coinfected or misdiagnosed with COVID-19.

We report two the cases of patients with imported Plasmodium falciparum malaria during the COVID-19 pandemic. One was coinfected with COVID-19 and the other was misdiagnosed with COVID-19; either way, the diagnosis of malaria was delayed. These cases suggest that physicians should beware of cognitive biases during pandemics and carefully evaluate febrile patients. Malaria should be considered in any febrile patient returning from a malaria-endemic area.

The patterns and driving forces of dengue invasions in China.

BACKGROUND: Global connectivity and environmental change pose continuous threats to dengue invasions from worldwide to China. However, the intrinsic relationship on introduction and outbreak risks of dengue driven by the landscape features are still unknown. This study aimed to map the patterns on source-sink relation of dengue cases and assess the driving forces for dengue invasions in China. METHODS: We identified the local and imported cases (2006-2020) and assembled the datasets on environmental conditions. The vector auto-regression model was applied to detect the cross-relations of source-sink patterns. We selected the major environmental drivers via the Boruta algorithm to assess the driving forces in dengue outbreak dynamics by applying generalized additive models. We reconstructed the internal connections among imported cases, local cases, and external environmental drivers using the structural equation modeling. RESULTS: From 2006 to 2020, 81,652 local dengue cases and 12,701 imported dengue cases in China were reported. The hotspots of dengue introductions and outbreaks were in southeast and southwest China, originating from South and Southeast Asia. Oversea-imported dengue cases, as the Granger-cause, were the initial driver of the dengue dynamic; the suitable local bio-socioecological environment is the fundamental factor for dengue epidemics. The Bio8 [odds ratio (OR) = 2.11, 95% confidence interval (CI): 1.67-2.68], Bio9 (OR = 291.62, 95% CI: 125.63-676.89), Bio15 (OR = 4.15, 95% CI: 3.30-5.24), normalized difference vegetation index in March (OR = 1.27, 95% CI: 1.06-1.51) and July (OR = 1.04, 95% CI: 1.00-1.07), and the imported cases are the major drivers of dengue local transmissions (OR = 4.79, 95% CI: 4.34-5.28). The intermediary effect of an index on population and economic development to local cases via the path of imported cases was detected in the dengue dynamic system. CONCLUSIONS: Dengue outbreaks in China are triggered by introductions of imported cases and boosted by landscape features and connectivity. Our research will contribute to developing nature-based solutions for dengue surveillance, mitigation, and control from a socio-ecological perspective based on invasion ecology theories to control and prevent future dengue invasion and localization.

Recent Advances in Imported Malaria Pathogenesis, Diagnosis, and Management.

Purpose of Review: Malaria is an important human parasitic disease affecting the population of tropical, subtropical regions as well as travelers to these areas.The purpose of this article is to provide clinicians practicing in non-endemic areas with a comprehensive overview of the recent data on microbiologic and pathophysiologic features of five Plasmodium parasites, clinical presentation of uncomplicated and severe cases, modern diagnostic methods, and treatment of malaria. Recent Findings: Employment of robust surveillance programs, rapid diagnostic tests, highly active artemisinin-based therapy, and the first malaria vaccine have led to decline in malaria incidence; however, emerging drug resistance, disruptions due to the COVID-19 pandemic, and other socio-economic factors have stalled the progress. Summary: Clinicians practicing in non-endemic areas such as the United States should consider a diagnosis of malaria in returning travelers presenting with fever, utilize rapid diagnostic tests if available at their practice locations in addition to microscopy, and timely initiate guideline-directed management as delays in treatment can lead to poor clinical outcomes.

An infectious disease model considering the impact of imported cases on internal spread of COVID-19

The coronavirus disease 2019(COVID-19) pandemic spreads across borders with the frequent global population movement. To explore the impact of the COVID-19 pandemic on China's domestic epidemic prevention and control, based on the classical infectious disease dynamics model this paper proposes an infectious disease model that considers oversea imported cases. The model can simulate three situations:national pandemic without imported cases, no domestic cases with only imported cases, and domestic cases with international travellers entering simultaneously. By calculating the peak case number and range of infection spread duration in these situations, as well as the amount of medical resources invested, the model has shown the different results of impact of entry type on the domestic pandemic and different pressures on medical resources. Finally, the paper suggests that testing measures should be taken according to the degree of pandemic risk and resource conditions, that strict prevention and control should be applied to the people not entering through customs, and closed-loop management to the people entering through customs, that entry quarantine measures and quarantine periods should be dynamically adjusted and international exchanges should be gradually resumed in the context of ensuring domestic and overseas epidemic prevention and control in advance, and that it is necessary to integrate medical resources, improve allocation efficiency, and relieve the pressure of resource occupation.

An imported case of ovale malaria in Xinjiang during the epidemic period of COVID-19.

On December 13, 2020, Yutian County People's hospital reported one imported malaria case in Hotan, Xinjiang. The patient had worked and lived in Yaounde, Cameroon, from January to September 2020. He was infected with malaria twice in March and May 2020. Antimalarial treatment was administrated by the team doctor for 2-3 days in each treatment. The treatment was stopped after the symptoms improved. The patient returned to China on September 16 and was hospitalized on December 13 due to a high fever of 39! and upper respiratory symptoms. Multiple detections of COVID-19 nucleic acid showed negative results. Peripheral blood from the patient was taken for Plasmodium rapid diagnostic test (RDT), which showed a positive result suggesting non Plasmodium falciparum infection. Ring stage P. ovale was found in the blood smear. Nested PCR showed positive for P. ovale. A diagnosis of imported ovale malaria was made. The patient was administrated with 4 dihydroartemisinin piperaquine tablets and 3 primaquine phosphate tablets daily. The malaria parasite test became negative after 8 days of treatment. The patient was followed up for 3 months after discharge and had no symptoms of chills or fever.Copyright © 2022, National Institute of Parasitic Diseases. All rights reserved.

Infectious disease Roundup 2022

This paper describes the epidemiology, prevalence, transmission, prevention and control of some infectious diseases in companion animals, livestock, wild animals and humans in Ontario, Canada, in 2022, including SARS-CoV-2;Echinococcus multilocularis, Leishmania spp. and SARS-CoV-2;antimicrobial stewardship resources;2 cases of rabid dogs imported from Iran (July 2021 and January 2022);prevalence of extended-spectrum beta-lactamase (ESBL)-producing Enterobacteriacea, Dirofilaria immitis, Brucella canis, canine parainfluenza and adeno- and herpes viruses in dogs recently imported from Asia;Paragonimus kellicotti lung flukes and Streptococcus equi subsp. zooepidemicus in dogs;African swine fever in pet pigs, backyard pigs and wild pigs and blastomycosis in dogs and humans.

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.

Analysis of the characteristics of imported COVID-19 cases in mainland China

Objective This study aimed to examine the epidemic characteristics of the COVID-19 imported cases entering mainland China from March 4, 2020 to October 31, 2021, so as to provide the reference for the prevention and control of imported epidemic at present. Methods Data were collected from the Daily Summary on the COVID-19 epidemic issued by the national/provincial health commission official website from March 4, 2020 to October 31, 2021, including " number of imported cases and existing imported cases and source country/territory and destination province for imported cases. Joinpoint regression was used to examine the time trends in the number of imported cases over time. Results From March 4, 2020 to November 3, 2021, the number of monthly newly imported cases and existing confirmed cases changed as a " W” shape. The imported cases came from 152 counties and territories in total, mainly from Myanmar, United States, Philippines and Russia (accounting for 27.6% of all imported cases). The number of imported cases mainly entered Shanghai, Guangdong, Yunnan, Sichuan, and Fujian, explaining 70.59% of total imported cases. Conclusions The great fluctuating change of imported cases in the mainland of China may be related to the change of global COVID-19 epidemic and domestic prevention and control policies. Considering the imbalanced distribution of source country/territory and destination province of imported cases, the government should take targeted measures in important source countries/terriories and destination provinces. Each province and municipality should modify its policy for preventing the imported epidemic dynamically according to the latest characteristic of source country/territory and virus mutation. © 2023, Publication Centre of Anhui Medical University. All rights reserved.

Assessing the impact of local context and priorities regarding domestic disease outbreaks and imported risk on early pandemic response: Cross-continental comparisons.

Introduction: Containment and closure policies are effective measures used in the early stages of a highly transmissible global pandemic such as COVID-19 to mitigate the spread and reduce transmissions. However, these policies can have negative impacts on the economy and personal freedom. Governments must carefully consider the necessity of increasing their stringency. Local contexts and priorities regarding domestic disease outbreaks and the risk of imported cases from other countries may vary among different countries, and could influence the decision to increase containment measures. Thus, this study aimed to differentiate the impacts of these affecting factors on the stringency of governmental containment measures through cross-continental comparisons. Methods: This study utilized a zero/one inflated beta (ZOIB) regression model to investigate how domestic epidemic, imported risk, and local context affect government responses to a pandemic. We used a country's weekly confirmed case and death numbers as a measure of its domestic threat. The imported risk was measured using a combination of weekly new cases in each country and the air passenger traffic between countries. Results: The findings indicate that domestic case numbers are a primary concern for governments when deciding to increase policy stringency. Countries with higher development levels tend to implement stricter policies as they can better handle the negative impacts. Additionally, there is an interaction between case numbers and development level, with countries at the second or third highest development level focusing more on domestic outbreaks than imported risks, while those at the highest level have similar concerns for both. Conclusions: We concluded that most countries adjust policies' stringency majorly based on the variation of domestic case number rather than the other pandemic factors and the countries with a high development level tend to implement strict policies since their socio-economical condition could afford such policies. These insights can aid policymakers in improving containment and closure policies for future pandemics.

First molecular documented case of a rarely reported parasite: Plasmodium knowlesi infection in Denmark in a traveller returning from Malaysian Borneo.

Plasmodium knowlesi has been reported as an emerging infection throughout the Southeast Asian region, especially in the Malaysian state of Sabah, where it accounts for the majority of the malaria cases reported. This is in contrast to Europe, where imported P. knowlesi is a rarely reported infection. We present a case of P. knowlesi infection in a Danish woman returning from a short trip to Malaysian Borneo. Microscopy of blood smears revealed 0.8% infected erythrocytes, but due to the atypical morphological presentation, a conclusive species identification was made by molecular methods. Plasmodium knowlesi is a potentially fatal infection and taking the increasing travel activity into consideration after the coronavirus disease 2019 (COVID-19) pandemic, P. knowlesi should be a differential diagnosis in patients with travel-associated illness returning from highly endemic Southeast Asian areas.

Epidemiological characteristics of overseas imported COVID-19 cases into China: A scoping literature review.

Previous studies investigating the characteristics of imported cases were mostly limited to a certain province/city or a specific sub-group during a certain period with a small sample size, which may not provide an overall picture of the characteristics of imported cases. In this scoping literature review, we comprehensively synthesized the epidemiological characteristics of overseas imported COVID-19 cases into China by retrieving six literature databases, with aims to provide implications for more targeted control, prevention, and medical treatment of this disease. After dropping duplicates and reviewing titles, abstracts, and full-texts, 50 articles were included in the review finally, including 26 (52%) articles in English and 24 (48%) articles in Chinese. According to the type of data sources, the 50 studies were divided into three categories: 13 (26%) articles using data sourced from the Chinese Infectious Diseases Online Reporting System, 15 (30%) articles using data from the websites of national/local health departments, and 22 (44%) articles using hospital admission data. Most of the overseas imported COVID-19 cases were young and middle-aged Chinese students and businessmen returning from the United States, Europe, and some neighboring countries. Airport routine health screening measures could not identify COVID-cases effectively, although scheduled multiple nucleic acid tests were required before boarding. Almost all imported cases were identified during the hotel quarantine period. Although a large proportion of imported cases were asymptomatic or with mild symptoms in the published literature, they may be due to participant selection bias. The exact proportion of asymptomatic cases may need to be further investigated especially through population-based large-scale studies.

Characteristics of post-Wuhan COVID-19 outbreaks in mainland China

Objective: To review the characteristic of Coronavirus disease 2019 (COVID-19) outbreaks in mainland China, particularly post-Wuhan outbreaks, and to help design effective responses in the foreseeable future. Method: The data regarding COVID-19 outbreaks between December 2019 and March 16, 2022 were obtained from China's publicly available databases. The data were analyzed using descriptive statistics. Five outbreak stages were defined according to distinct epidemiological characteristics across different time periods over the past two years. Result: Since the 2020 Wuhan outbreak, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) local infections were confirmed in 37 995 cases as of March 16, 2022. We identified 285 isolated outbreaks in unrelated people that occurred in four additional distinct stages, over 57% of which had been imported, such as imported infected travelers and fomite transmission. The basic reproduction number (R0) of original SARS-CoV-2 was about 2.79, while the Delta variant was about 5.08 and Omicron was 7.0 or greater, resulting in the disease being more contagious during the fourth (Delta) and fifth (Omicron) stages than previous stages. Conclusion: China has experienced various COVID-19 outbreaks of different levels since the start of the pandemic in Wuhan, and local transmission is mainly caused by imported sources. If the "dynamic COVID-zero" policy is not appropriately followed, it will be difficult to contain the spread in China from overseas and to cope with the Omicron variant.

Risk assessment of public health emergencies concerned in the mainland of China, January 2023

Objective: To assess the risk of public health emergencies occurring in the mainland of China or possibly imported from outside China in January 2023. Methods: Based on various data and departmental notification information on domestic and foreign public health emergencies reports and surveillance of key infectious diseases, the expert consultation method was used and experts from provincial (autonomous regions and municipalities directly under the central government) centers for disease prevention and control were invited to participate in the assessment by video conference. Results: The number of public health emergencies reported in January 2023 is expected to increase or be similar to that reported in December 2022. The COVID-19 rebound in the northern hemisphere is likely to continue in January 2023 due to immune escape of BQ, XBB and other possible emerging Omicron variants' subtypes. The increased migration of people in Chinese mainland during the Spring Festival in 2023 could increase the risk of the spread of the SARS-CoV-2 among uninfected people. The level of influenza virus activity is likely to increase in January, and influenza A is likely to dominate. January 2023 remains risky month for nonoccupational carbon monoxide poisoning. Conclusion: Special attention is given to COVID-19, and general attention is given to seasonal influenza and nonoccupational carbon monoxide poisoning.

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.

Retrospective Analysis of the Duration of Hospitalization of Imported Patients Infected with SARS-CoV-2 in Guangzhou, 2021

The pandemic of coronavirus disease 2019 is "not over,"in fact, the "dynamic clearing"policy for SARS-CoV-2 control and prevention in China has been firmly enforced. This study aimed to analyze the clinical symptoms and dynamic viral RNA changes in 2021 at Guangzhou Eighth People's Hospital. This study showed that 31.4% of the patients (695/2212) tested negative for viral RNA from admission to the final release from quarantine. Of all negative cases, 86.5% (601/695) remained in the hospital for no more than 5 days and were asymptomatic or mild. Among the remaining 402 patients who stayed for no more than 5 days, 76.4% (307/402) were viral RNA retest positive during the isolation stage. However, 96.4% of the peak viral RNA (296/307) was over Ct = 33 cycles during the isolation stage. © Wolters Kluwer Health, Inc. All rights reserved.