Epidemiological Features of Hepatitis C in China From 2015 to 2021: Insights From National Surveillance Data.

The COVID-19 pandemic overwhelmed national health care systems, not least in the context of hepatitis elimination. This study investigates the effects of the pandemic response on the incidence rate, mortality rate, and case fatality rate (CFR) for hepatitis C virus (HCV) cases in China. We extracted the number of hepatitis C cases and HCV-related deaths by month and year for 2015 to 2021 in China and applied two proportional tests to analyze changes in the average yearly incidence rates, mortality rates, and CFRs for 2015 to 2020. We used the autoregressive integrated moving average model to predict these three rates for 2020 based on 2015 to 2019 HCV data. The incidence of hepatitis C decreased by 7.11% and 1.42% (P < .001) in 2020 and 2021, respectively, compared with 2015 to 2019, while it increased by 6.13% (P < .001) in 2021 relative to 2020. The monthly observed incidence in 2020 was significantly lower (-26.07%) than predicted. Meanwhile, no differences in mortality rate or CFR were observed between 2021, 2020, and 2015 to 2019. Our findings suggest that nonpharmaceutical interventions and behavioral changes to mitigate COVID-19 could have reduced hepatitis C incidence and accelerated China's implementation of a plan to eliminate HCV infection.

Human respiratory syncytial virus subgroups A and B outbreak in a kindergarten in Zhejiang Province, China, 2023.

Background: In May-June 2023, an unprecedented outbreak of human respiratory syncytial virus (HRSV) infections occurred in a kindergarten, Zhejiang Province, China. National, provincial, and local public health officials investigated the cause of the outbreak and instituted actions to control its spread. Methods: We interviewed patients with the respiratory symptoms by questionnaire. Respiratory samples were screened for six respiratory pathogens by real-time quantitative polymerase chain reaction (RT-PCR). The confirmed cases were further sequenced of G gene to confirm the HRSV genotype. A phylogenetic tree was reconstructed by maximum likelihood method. Results: Of the 103 children in the kindergarten, 45 were classified as suspected cases, and 25 cases were confirmed by RT-PCR. All confirmed cases were identified from half of classes. 36% (9/25) were admitted to hospital, none died. The attack rate was 53.19%. The median ages of suspected and confirmed cases were 32.7 months and 35.8 months, respectively. Nine of 27 confirmed cases lived in one community. Only two-family clusters among 88 household contacts were HRSV positive. A total of 18 of the G gene were obtained from the confirmed cases. Phylogenetic analyses revealed that 16 of the sequences belonged to the HRSV B/BA9 genotype, and the other 2 sequences belonged to the HRSV A/ON1 genotype. The school were closed on June 9 and the outbreak ended on June 15. Conclusion: These findings suggest the need for an increased awareness of HRSV coinfections outbreak in the kindergarten, when HRSV resurges in the community after COVID-19 pandemic.

Corrigendum: Analysis of a super-transmission of SARS-CoV-2 omicron variant BA.5.2 in the outdoor night market.

[This corrects the article DOI: 10.3389/fpubh.2023.1153303.].

Analysis of a super-transmission of SARS-CoV-2 omicron variant BA.5.2 in the outdoor night market.

Introduction: The COVID-19 pandemic continues to ravage the world, and mutations of the SARS-CoV-2 continues. The new strain has become more transmissible. The role of aerosol transmission in the pandemic deserves great attention. Methods: In this observational study, we collected data from market customers and stallholders who had been exposed to the virus in the Qingkou night market on July 31 and were subsequently infected. We analyzed the possible infection zones of secondary cases and aerosol suspension time in ambient air. We described and analyzed the characteristics of the secondary cases and the transmission routes for customers. Results: The point source outbreak of COVID-19 in Qingkou night market contained a cluster of 131 secondary cases. In a less-enclosed place like the Qingkou night market, aerosols with BA.5.2 strain released by patients could suspend in ambient air up to 1 h 39 min and still be contagious. Conclusion: Aerosols with viruses can spread over a relatively long distance and stay in ambient air for a long time in a less enclosed space, but shorter than that under experimental conditions. Therefore, the aerosol suspension time must be considered when identifying and tracing close contact in outbreak investigations.

Case Report: A case of Chlamydia psittaci infection in an HIV patient.

Chlamydia psittaci is the pathogen of psittacosis and infects a wide range of birds and even humans. Human infection occurs most commonly in those with a history of contact with birds or poultry. We describe a case of psittacosis in a human immunodeficiency virus infected patient in Zhejiang Province for the first time. C. psittaci infection was confirmed by nested polymerase chain reaction (PCR) and Real-Time PCR. Phylogenetic analysis revealed that the sequences from the patient's samples clustered with genotype A in the same branch. Our study highlights the possibility of diagnosing psittacosis in patients with a chronic disease such as HIV-infected patients, and should increase awareness and surveillance of psittacosis in China.

Changing spatiotemporal patterns for hepatitis of unspecified aetiology in China, 2004-2021: a population-based surveillance study.

Objectives: As global efforts continue toward the target of eliminating viral hepatitis by 2030, the emergence of acute hepatitis of unspecified aetiology (HUA) remains a concern. This study assesses the overall trends and changes in spatiotemporal patterns in HUA in China from 2004 to 2021. Methods: We extracted the incidence and mortality rates of HUA from the Public Health Data Center, the official website of the National Health Commission of the People's Republic of China, and the National Notifiable Infectious Disease Surveillance System from 2004 to 2021. We used R software, ArcGIS, Moran's statistical analysis, and joinpoint regression to examine the spatiotemporal patterns and annual percentage change in incidence and mortality of the HUA across China. Results: From 2004 to 2021, a total of 707,559 cases of HUA have been diagnosed, including 636 deaths. The proportion of HUA in viral hepatitis gradually decreased from 7.55% in 2004 to 0.72% in 2021. The annual incidence of HUA decreased sharply from 6.6957 per 100,000 population in 2004 to 0.6302 per 100,000 population in 2021, with an average annual percentage change (APC) reduction of -13.1% (p < 0.001). The same result was seen in the mortality (APC, -22.14%, from 0.0089/100,000 in 2004 to 0.0002/100,000 in 2021, p < 0.001). All Chinese provinces saw a decline in incidence and mortality. Longitudinal analysis identified the age distribution in the incidence and mortality of HUA did not change and was highest in persons aged 15-59 years, accounting for 70% of all reported cases. During the COVID-19 pandemic, no significant increase was seen in pediatric HUA cases in China. Conclusion: China is experiencing an unprecedented decline in HUA, with the lowest incidence and mortality for 18 years. However, it is still important to sensitively monitor the overall trends of HUA and further improve HUA public health policy and practice in China.

Epidemiological features and trends in the mortality rates of 10 notifiable respiratory infectious diseases in China from 2004 to 2020: Based on national surveillance.

Objectives: The aim of this study is to describe, visualize, and compare the trends and epidemiological features of the mortality rates of 10 notifiable respiratory infectious diseases in China from 2004 to 2020. Setting: Data were obtained from the database of the National Infectious Disease Surveillance System (NIDSS) and reports released by the National and local Health Commissions from 2004 to 2020. Spearman correlations and Joinpoint regression models were used to quantify the temporal trends of RIDs by calculating annual percentage changes (APCs) in the rates of mortality. Results: The overall mortality rate of RIDs was stable across China from 2004 to 2020 (R = -0.38, P = 0.13), with an APC per year of -2.2% (95% CI: -4.6 to 0.3; P = 0.1000). However, the overall mortality rate of 10 RIDs in 2020 decreased by 31.80% (P = 0.006) compared to the previous 5 years before the COVID-19 pandemic. The highest mortality occurred in northwestern, western, and northern China. Tuberculosis was the leading cause of RID mortality, and mortality from tuberculosis was relatively stable throughout the 17 years (R = -0.36, P = 0.16), with an APC of -1.9% (95% CI -4.1 to 0.4, P = 0.1000). Seasonal influenza was the only disease for which mortality significantly increased (R = 0.73, P = 0.00089), with an APC of 29.70% (95% CI 16.60-44.40%; P = 0.0000). The highest yearly case fatality ratios (CFR) belong to avian influenza A H5N1 [687.5 per 1,000 (33/48)] and epidemic cerebrospinal meningitis [90.5748 per 1,000 (1,010/11,151)]. The age-specific CFR of 10 RIDs was highest among people over 85 years old [13.6551 per 1,000 (2,353/172,316)] and was lowest among children younger than 10 years, particularly in 5-year-old children [0.0552 per 1,000 (58/1,051,178)]. Conclusions: The mortality rates of 10 RIDs were relatively stable from 2004 to 2020 with significant differences among Chinese provinces and age groups. There was an increased mortality trend for seasonal influenza and concerted efforts are needed to reduce the mortality rate of seasonal influenza in the future.

Impact of the COVID-19 pandemic and the dynamic COVID-zero strategy on HIV incidence and mortality in China.

BACKGROUND: In response to the coronavirus disease 2019 (COVID-19) pandemic, the Chinese government implemented the dynamic COVID-zero strategy. We hypothesized that pandemic mitigation measures might have reduced the incidence, mortality rates, and case fatality ratios (CFRs) of the human immunodeficiency virus (HIV) in 2020-2022. METHOD: We collected HIV incidence and mortality data from the website of the National Health Commission of the People's Republic of China from January 2015 to December 2022. We compared the observed and predicted HIV values in 2020-2022 with those in 2015-2019 using a two-ratio Z-test. RESULTS: From January 1, 2015, to December 31, 2022, a total of 480,747 HIV incident cases were reported in mainland China, of which 60,906 (per year) and 58,739 (per year) were reported in 2015-2019 (pre-COVID-19 stage) and 2020-2022 (post-COVID-19 stage), respectively. The average yearly HIV incidence decreased by 5.2450% (from 4.4143 to 4.1827 per 100,000 people, p <  0.001) in 2020-2022 compared with that in 2015-2019. However, the average yearly HIV mortality rates and CFRs increased by 14.1076 and 20.4238%, respectively (all p <  0.001), in 2020-2022 compared with those in 2015-2019. During the emergency phase in January 2020 to April 2020, the monthly incidence was significantly lower (23.7158%) than that during the corresponding period in 2015-2019, while the incidence during the routine stage in May 2020-December 2022 increased by 27.4334%, (all p <  0.001). The observed incidence and mortality rates for HIV decreased by 16.55 and 18.1052% in 2020, by 25.1274 and 20.2136% in 2021, and by 39.7921 and 31.7535% in 2022, respectively, compared with the predicted values, (all p <  0.001). CONCLUSIONS: The findings suggest that China's dynamic COVID-zero strategy may have partly disrupted HIV transmission and further slowed down its growth. Without China's dynamic COVID-zero strategy, HIV incidence and deaths in the country would have likely remained high in 2020-2022. There is an urgent need to expand and improve HIV prevention, care, and treatment, as well as surveillance in the future.

Characteristics of the multiple replicon plasmid IncX1-X1 in multidrug-resistant Escherichia coli from Malayan pangolin (Manis javanica).

Potential zoonotic pathogens may be transmitted from wildlife to humans through the illegal wild meat trade, which has become a pressing issue. However, research on the antimicrobial resistance genes (ARGs) of Malayan pangolin (Manis javanica) intestinal bacteria is limited. Here, multidrug-resistant Escherichia coli M172-1 (ST354) isolated from Malayan pangolin feces in 2019 was found to be resistant to 13 antibiotics. BGWAS analysis revealed 4 plasmids, namely, pM172-1.1, pM172-1.2, pM172-1.3, and pM172-1.4, in the isolate. The pM172-1.2, pM172-1.3, and pM172-1.4 plasmids carried ARGs, namely, IncHI2-HI2A, IncX1-X1, and IncX1, respectively. pM172-1.3 and pM172-1.4 contained intact IntI1 integrons (Is26/IntI1/arr2/cmlA5/blaOXA-10 /ant(3″)-IIA/dfrA14/Is26). Notably, pM172-1.3 resulted from the fusion of 2 pM172-1.4 copies and carried many more ARGs. In addition to pM172-1.3 from the same host, other drug-resistant bacteria (E. coli M159-1 (ST48), E. coli S171-1 (ST206), and Klebsiella pneumoniae S174-1 (ST2354)) in the same Malayan pangolin fecal samples also carried 3 plasmids with 100% gene coverage of pM172-1.4 and 99.98% identity. Therefore, ARGs in IncX1 might spread in the intestinal flora of Malayan pangolin and between species via the illegal food chain, posing a potential threat to public health and safety.

Outbreak of acute respiratory disease caused by human adenovirus type 7 and human coronavirus-229E in Zhejiang Province, China.

In 2019, an outbreak of pharyngoconjunctival fever (PCF) occurred at a swimming center in Zhejiang Province, China. A total of 97 (13.55%) of the 716 amateur swimmers had illnesses, with 24 patients (24.74%) hospitalized in the pediatric ward. Human adenovirus serotype 7 (HAdV-7) was isolated from one concentrated water from the swimming pool, and 20 of 97 positive cases without liver damage. This outbreak led to a nosocomial outbreak in the pediatric ward, in which 1 nurse had a fever and was confirmed to be adenovirus positive. The hexon, fiber, and penton genes from 20 outbreak cases, 1 water sample, and 1 nurse had 100% homology. Furthermore, 2 cases admitted to the pediatric ward, 2 parents, and 1 doctor were confirmed to be human coronaviruses (HCoV-229E) positive. Finally, all outbreak cases had fully recovered, regardless of a single infection (adenovirus or HCoV-229E) or coinfection of these two viruses simultaneously. Thus, PCF and acute respiratory disease outbreaks in Zhejiang were caused by the completely homologous type 7 adenovirus and HCoV-229E, respectively. The swimming pool water contaminated with HAdV-7 was most likely the source of the PCF outbreak, whereas nosocomial transmission might be the source of HCoV-229E outbreak.

A cluster of two psittacosis cases among women farmers exposed to Chlamydia psittaci-infected domestic poultry in Zhejiang Province, China.

A cluster of Chlamydia psittaci (C. psittaci) cases was reported in Zhejiang Province, China, 2019. This study evaluates the extent of the outbreak and determines the source of infection. Real-time PCR and sequencing of the ompA gene of C. psittaci were performed to identify the cases, the domesticated poultry and close contacts. The index patient was a 76-year-old woman with chronic vertigo, and Case 2 was a 64-year-old female farmer with herpes zoster. Both women bought psittaci-infected chickens or ducks from the same mobile street vendor and raised them for 10 days and 23 days before fever onset. There were no direct contact between the two women. C. psittaci test was positive for the two patients, one sick chicken, three healthy ducks and the vendor's chicken cage. Phylogenetic analysis showed that all seven C. psittaci positive samples carried identical ompA genotype A of C. psittaci. Of all of the patients' 148 close contacts, none tested positive for C. psittaci, or developed acute respiratory symptoms. Both patients were discharged after a 4-week hospital stay. In conclusion, the source of this cluster was the poultry infected with C. psittaci, which occasionally cause infections in farmers, but inter-human transmission seems unlikely.

Epidemiological characteristics of influenza outbreaks in Zhejiang Province from 2013 to 2022 / 预防医学

Objective@#To investigate the epidemiological characteristics of influenza outbreaks in Zhejiang Province from 2013 to 2022, so as to provide insights into influenza prevention and control. @*Methods@#Data pertaining to influenza outbreaks reported in Zhejiang Province from 2013 to 2022 were collected from National Influenza Surveillance System in China, including time, region, cases and pathogen types of influenza outbreaks. The temporal, spatial and pathogen distribution of influenza outbreaks were analyzed using a descriptive epidemiological method. @*Results@#A total of 577 influenza outbreaks involving 448 698 individuals were reported in Zhejiang Province from 2013 to 2022, and the overall attack rate was 5.34% (23 974 cases), with no death reported. The lowest attack rate of influenza was 0.26%, and the highest was 80.00%, with a median attack rate of 10.89% (interquartile range, 24.26%). The outbreak had the shortest duration of 1.00 day, and the longest duration of 59.00 days, with a median duration of 9.00 (interquartile range, 11.00) days. There were 387 influenza outbreaks that occurred between November and January of the following year (67.07%), and the three highest numbers of outbreaks were reported in Hangzhou City (310 outbreaks), Wenzhou City (51 outbreaks) and Jinhua City (46 outbreaks). There were 395 outbreaks reported in urban regions (68.46%), 93 in counties and townships (16.12%) and 89 in rural regions (15.42%), and influenza outbreaks predominantly occurred in primary schools (487 outbreaks, 84.40%). In addition, the types of pathogens were alternately prevalent, with influenza B virus (241 outbreaks, 41.77%) and A/H3N2 virus (232 outbreaks, 40.21%) as predominant subtypes. @* Conclusions@#Influenza outbreaks mainly occurred in winter in Zhejiang Province from 2013 to 2022, and primary schools were main places of influenza outbreaks, while influenza B virus and A/H3N2 virus were predominant subtypes. It is necessary to reinforce the surveillance and report of influenza-like illness in schools and improve the coverage of influenza vaccination to prevent influenza outbreaks.

The clinical and virological features of two children's coinfections with human adenovirus type 7 and human coronavirus-229E virus.

Objective: Human adenovirus (HAdV) coinfection with other respiratory viruses is common, but adenovirus infection combined with human coronavirus-229E (HCoV-229E) is very rare. Study design and setting: Clinical manifestations, laboratory examinations, and disease severity were compared between three groups: one coinfected with HAdV-Ad7 and HCoV-229E, one infected only with adenovirus (mono-adenovirus), and one infected only with HCoV-229E (mono-HCoV-229E). Results: From July to August 2019, there were 24 hospitalized children: two were coinfected with HAdV-Ad7 and HCoV-229E, and 21 were infected with a single adenovirus infection. Finally, one 14-year-old boy presented with a high fever, but tested negative for HAdV-Ad7 and HCoV-229E. Additionally, three adult asymptotic cases with HCoV-229E were screened. No significant difference in age was found in the coinfection and mono-adenovirus groups (11 vs. 8 years, p = 0.332). Both groups had the same incubation period (2.5 vs. 3 days, p = 0.8302), fever duration (2.5 vs. 2.9 days, p = 0.5062), and length of hospital stay (7 vs. 6.76 days, p = 0.640). No obvious differences were found in viral loads between the coinfection and mono-adenovirus groups (25.4 vs. 23.7, p = 0.570), or in the coinfection and mono-HCoV-229E groups (32.9 vs. 30.06, p = 0.067). All cases recovered and were discharged from the hospital. Conclusion: HAdV-Ad7 and HCoV-229E coinfection in healthy children may not increase the clinical severity or prolong the clinical course. The specific interaction mechanism between the viruses requires further study.

Geographical patterns of Fejervarya limnocharis gut microbiota by latitude along mainland China's coastline.

The gut microbiota affects many aspects of host biology and plays key roles in the coevolutionary association with its host. Geographical gradients may play a certain role on gut microbiota variation in the natural environment. However, the distribution pattern of amphibian gut microbiota in the latitudinal gradient remains largely unexplored. Here, we sampled six natural populations of Fejervarya limnocharis along the eastern coastline of mainland China (spanning 20°-30° N = 1,300 km) using 16S rRNA amplicon sequencing to characterize the gut microbiota. First of all, a significant correlation between gut microbial diversity and latitude was observed in our research system. Second, we discovered that latitude influenced the composition of the gut microbiota of F. limnocharis. Finally, we detected that geographical distance could not determine gut microbiota composition in F. limnocharis. These results indicate that latitude can play an important role in shaping the gut microbial diversity of amphibian. Our study offers the first evidence that gut microbial diversity of amphibian presents a latitudinal pattern and highlights the need for increased numbers of individuals to be sampled during microbiome studies in wild populations along environmental gradients.

Comparison of clinical characteristics between COVID-19 and H7N9 fatal cases: An observational study.

Objective: The outbreak of COVID-19 in 2020 is reminiscent of the H7N9 outbreak in 2013, which poses a huge threat to human health. We aim to compare clinical features and survival factors in fatal cases of COVID-19 and H7N9. Methods: Data on confirmed COVID-19 and H7N9 fatal cases identified in mainland China were analyzed to compare demographic characteristics and clinical severity. Survival curves were estimated by the Kaplan-Meier method and compared using log-rank tests and a restricted mean survival time model. A Cox regression model was used to identify survival factors in fatal cases of COVID-19 and H7N9. Results: Similar demographic characteristics were observed in fatal cases of COVID-19 and H7N9. The proportion of fatal cases of H7N9 receiving antibiotics, antiviral drugs, and oxygen treatment was higher than that of COVID-19. The potential protective factors for fatal COVID-19 cases were receiving antibiotics (HR: 0.37, 95% CI: 0.22-0.61), oxygen treatment (HR: 0.66, 95% CI: 0.44-0.99), and corticosteroids (HR: 0.46, 95% CI: 0.35-0.62). In contrast, antiviral drugs (HR: 0.21, 95% CI: 0.08-0.56) and corticosteroids (HR: 0.45, 95% CI: 0.29-0.69) were the protective factors for H7N9 fatal cases. Conclusion: The proportion of males, those having one or more underlying medical condition, and older age was high in COVID-19 and H7N9 fatal cases. Offering antibiotics, oxygen treatment, and corticosteroids to COVID-19 cases extended the survival time. Continued global surveillance remains an essential component of pandemic preparedness.

The construction of Chinese indicator system on public health field investigation and short-term study hub: experience and implications.

BACKGROUND: The increasing of exchange activities among public health institutes and experts globally calls for a standardized operation to construct public health field investigation and short-term study hub (Field Study Hub). This can funcion as a platform to share experience in public health development in an accurate and comprehensive manner that would benefit global practices. This research aims to establish a supportive indicator system to guide the construction work. METHODS: Delphi method including two rounds of surveys were conducted among 82 senior public health experts. A structured questionnaire was designed to collect the opinions of the experts on the necessity of setting and feasibility of measurement for proposed 5 dimensions of 49 indicators and 7 additionally proposed ones. Percentage and score were used to describe the assessments, χ2 and t tests to compare differences, Kappa and Cronbach's alpha values to assess intra-rater and inter-rater reliabilities. Significance level α was 0.05. Bonferroni adjustment was used in the comparison of experts' judgment basis. RESULTS: The percentages of experts choosing "Very good" or "Good" for necessity and feasibility in rounds 1 and 2 were 73.1-97.6% (85.8% ± 7.5%), 64.6-93.9% (82.8% ± 6.7%), 73.8-100% (91.0% ± 6.2%) and 72.5-100% (89.2% ± 7.3%) respectively. The scores of necessity were higher than those of feasibility, and the differences in the dimensions of "Key experience", "Capacity for logistic support" and the total were statistically significant (t11 = 2.920, t12 = 3.035, t31 = 4.448, t32 = 2.664, tt1 = 3.794, tt2 = 3.007, P < 0.05). The fourteen most necessary indicators were identified. The judgment bases of "Theory" and "Experience" were higher than "Knowledge" and "Intuition" statistically significantly (round 2: χTK2 = 39.020, χEK2 = 67.692, χTI2 = 45.823, χEI2 = 76.515, P < 0.0125). The Kappa values exceeded 40 with the maximum as 75 and the Cronbach's alphas exceeded 0.8000 with the maximum as 0.9732. CONCLUSIONS: A set of 5 dimensions of 56 indicators with good necessity and feasibility were developed to technically support and well evaluate the construction of field study hub in public health institutions. This was of high significance because it tended to provide a preliminary baseline for the standardized practice in global health. Also, the present research might serve as a methodological reference for the development of other indicator sets.

Collateral Impact of COVID-19 Prevention Measures on Re-Emergence of Scarlet Fever and Pertussis in Mainland China and Hong Kong China.

The incidence of scarlet fever and pertussis has increased significantly in China in recent years. During the COVID-19 pandemic, stringent non-pharmaceutical intervention measures were widely adopted to contain the spread of the virus, which may also have essential collateral impacts on other infectious diseases, such as scarlet fever and pertussis. We compared the incidence data of scarlet fever and pertussis in Mainland China and Hong Kong from 2004 to 2021 before and after the COVID-19 pandemic. The results show that the incidence of both diseases decreased significantly in 2020-2021 compared to the after-re-emergence stage in these two locations. Specifically, in 2020, scarlet fever decreased by 73.13% and pertussis by 76.63% in Mainland China, and 83.70% and 76.10%, respectively, in Hong Kong. In the absence of COVID-19, the predicted incidence of both diseases was much higher than the actual incidence in Mainland China and Hong Kong in 2020-2021. This study demonstrates that non-pharmaceutical measures implemented during the COVID-19 pandemic can partially reduce scarlet fever and pertussis re-emergence in Mainland China and Hong Kong.

Comprehensive narrative review of real-world COVID-19 vaccines: viewpoints and opportunities.

Currently, people all over the world have been affected by coronavirus disease 2019 (COVID-19). Fighting against COVID-19 is the top priority for all the countries and nations. The development of a safe and effective COVID-19 vaccine is considered the optimal way of ending the pandemic. Three hundred and 44 vaccines were in development, with 149 undergoing clinical research and 35 authorized for emergency use as to March 15 of 2022. Many studies have shown the effective role of COVID-19 vaccines in preventing SARS-CoV-2 infections as well as serious and fatal COVID-19 cases. However, tough challenges have arisen regarding COVID-19 vaccines, including long-term immunity, emerging COVID-19 variants, and vaccine inequalities. A systematic review was performed of recent COVID-19 vaccine studies, with a focus on vaccine type, efficacy and effectiveness, and protection against SARS-CoV-2 variants, breakthrough infections, safety, deployment and vaccine strategies used in the real-world. Ultimately, there is a need to establish a unified evaluation standard of vaccine effectiveness, monitor vaccine safety and effectiveness, along with the virological characteristics of SARS-CoV-2 variants; and determine the most useful booster schedule. These aspects must be coordinated to ensure timely responses to beneficial or detrimental situations. In the future, global efforts should be directed toward effective and immediate vaccine allocations, improving vaccine coverage, SARS-CoV-2 new variants tracking, and vaccine booster development.

The impact of COVID-19 continuous containment and mitigation strategy on the epidemic of vector-borne diseases in China.

BACKGROUND: This study explored the effect of a continuous mitigation and containment strategy for coronavirus disease 2019 (COVID-19) on five vector-borne diseases (VBDs) in China from 2020 to 2021. METHODS: Data on VBDs from 2015 to 2021 were obtained from the National Health Commission of the People's Republic of China, and the actual trend in disease activity in 2020-2021 was compared with that in 2015-2019 using a two-ratio Z-test and two proportional tests. Similarly, the estimated trend in disease activity was compared with the actual trend in disease activity in 2020. RESULTS: There were 13,456 and 3684 average yearly cases of VBDs in 2015-2019 and 2020, respectively. This represents a decrease in the average yearly incidence of total VBDs of 72.95% in 2020, from 0.9753 per 100,000 population in 2015-2019 to 0.2638 per 100,000 population in 2020 (t = 75.17, P < 0.001). The observed morbidity rates of the overall VBDs were significantly lower than the predicted rates (47.04% reduction; t = 31.72, P < 0.001). The greatest decline was found in dengue, with a 77.13% reduction (observed rate vs predicted rate: 0.0574 vs. 0.2510 per 100,000; t = 41.42, P < 0.001). Similarly, the average yearly mortality rate of total VBDs decreased by 77.60%, from 0.0064 per 100,000 population in 2015-2019 to 0.0014 per 100,000 population in 2020 (t = 6.58, P < 0.001). A decreasing trend was also seen in the monthly incidence of total VBDs in 2021 compared to 2020 by 43.14% (t = 5.48, P < 0.001). CONCLUSIONS: The results of this study verify that the mobility and mortality rates of VBDs significantly decreased from 2015-2019 to 2020-2021, and that they are possibly associated to the continuous COVID-19 mitigation and contamination strategy implemented in China in 2020-2021.