The epidemiology of varicella and effectiveness of varicella vaccine in Ganyu, China: a long-term community surveillance study.

BACKGROUND: The real-world data of long-term protection under moderate vaccination coverage is limited. This study aimed to evaluate varicella epidemiology and the long-term effectiveness under moderate coverage levels in Ganyu District, Lianyungang City, Jiangsu Province. METHODS: This was a population-based, retrospective birth cohort study based on the immunization information system (IIS) and the National Notifiable Disease Surveillance System (NNDSS) in Ganyu District. Varicella cases reported from 2009 to 2020 were included to describe the epidemiology of varicella, and eleven-year consecutive birth cohorts (2008-2018) were included to estimate the vaccine effectiveness (VE) of varicella by Cox regression analysis. RESULTS: A total of 155,232 native children and 3,251 varicella cases were included. The vaccination coverage was moderate with 37.1%, correspondingly, the annual incidence of varicella infection increased 4.4-fold from 2009 to 2020. A shift of the varicella cases to older age groups was observed, with the peak proportion of cases shifting from 5-6 year-old to 7-8 year-old. The adjusted effectiveness of one dose of vaccine waned over time, and the adjusted VE decreased from 72.9% to 41.8% in the one-dose group. CONCLUSIONS: The insufficient vaccination coverage (37.1%) may have contributed in part to the rising annual incidence of varicella infection, and a shift of varicella cases to older age groups occurred. The effectiveness of one dose of varicella vaccine was moderate and waned over time. It is urgent to increase varicella vaccine coverage to 80% to reduce the incidence of varicella and prevent any potential shift in the age at infection in China.

The spatial-temporal distribution and etiological characteristics of hand-foot-and-mouth disease before and after EV­A71 vaccination in Kunming, China, 2017-2020.

After vaccination with enterovirus 71 (EV-A71), the prevalence of hand-foot-and-mouth disease (HFMD) remained high, and the spatial-temporal distribution of enteroviruses changed. Therefore, it is essential to define the temporal features, spatial distributions, and epidemiological and etiological characteristics of HFMD in Kunming. Between 2017 and 2020, a total of 36,540 children were diagnosed with HFMD in Kunming, including 32,754 children with enterovirus-positive clinical samples. Demographic, geographical, epidemiological and etiological data of the cases were acquired and analyzed. Other enteroviruses replaced EV-A71, and the incidence of EV-A71 decreased dramatically, whereas coxsackievirus A6 (CV-A6) and coxsackievirus A16 (CV-A16) had substantial outbreaks in 2018 and 2019, respectively. The major and minor peaks all extended for 2-4 months compared to before vaccination with the EV-A71 vaccine. From 2019 to 2020, CV-A6, as the predominant serotype, showed only a single peak. Although a high incidence of HFMD was observed in Guandu, Chenggong and Xishan, the annual incidence of different enterovirus serotypes was different in different regions. In 2017, other enteroviruses were most prevalent in Shilin. In 2018, CV-A16 and CV-A6 were most prevalent in Luquan and Shilin, respectively. In 2019, CV-A16 was most prevalent in Jinning. In 2020, CV-A6 and coxsackievirus A10 (CV-A10) were most prevalent in Luquan and Shilin, respectively. Meanwhile, the epidemic cycle of CV-A6 and CV-A16 was only 1 year, and CV-A10 and other enteroviruses were potential risk pathogens. The spatial and temporal distribution of HFMD varies at different scales, and the incidence of HFMD associated with different pathogens has obvious regional differences and seasonal trends. Therefore, research on multivalent combined vaccines is urgently needed, and proper preventive and protective measures could effectively control the incidence of HFMD-like diseases.

Type 2 congenital generalized lipodystrophy with a heterozygous missense NOTCH2 mutation.

Congenital generalized lipodystrophy (CGL) is a rare autosomal recessive disease with a prevalence of less than one in ten million. To our knowledge, ~500 cases, including 95% of BSCL2, have been reported in the literatures, but no types of CGL with NOTCH2 gene mutation has been described.

Antibacterial effect of Blumea balsamifera (L.) DC. essential oil against Staphylococcus aureus.

Staphylococcus aureus (S. aureus) is a common pathogenic bacteria in clinical environment, which can cause various diseases. Blumea balsamifera (L.) DC. as a traditional Chinese herb, its essential oil shows excellent bacteriostatic effect against S. aureus. To study the antibacterial effect of B. balsamifera (L.) DC. essential oil (BBO) against S. aureus, this study evaluated the effect of BBO on the permeability and integrity of cell membranes and on the total protein and nucleic acid content in S. aureus. Furthermore, proteomics was used to study the effect of BBO on the proteome of S. aureus. The results showed that BBO can destroy the permeability of the cell membrane, and inhibit the synthesis of bacterial nucleic acid and protein. Proteomics shows that BBO affects disorder of amino acid metabolism and affects the activity of various enzymes and the transport of substances. Taken together, these results indicated a substantial antibacterial effect of BBO on S. aureus.

Multispectral image analysis in Vogt-Koyanagi-Harada disease.

PURPOSE: To investigate fundus abnormalities in Vogt-Koyanagi-Harada (VKH) disease by a noninvasive tool, multispectral imaging (MSI). METHODS: A total of 77 patients with VKH and 163 healthy controls were enrolled between January and April 2015. The MSI findings were evaluated in combination with fundus fluorescein angiography (FFA), optical coherent tomography (OCT) and fundus photography (FP). Additionally, we compared extent of exposure of choroidal blood vessels between patients with VKH and healthy controls to evaluate retinal transmission function. RESULTS: A number of features could be recognized by MSI which included (i) general depigmentation, (ii) clumping of pigment and (iii) macular depigmentation and/or hyperpigmentation. The percentages of these three abnormalities discovered by MSI in 52 inactive VKH patients with a duration of more than 2 months in VKH were 67.3%, 75% and 84.6% respectively, which were all significantly higher than those detected by FFA, OCT or FP (p = 0.0398, p < 0.0001). Our study showed that MSI detected a higher percentages of these four abnormalities in patients with sunset glow fundus than in patients without this phenomenon (p = 0.0492, p < 0.0001). Additionally, at the same wavelength (590 nm), exposure of choroidal blood vessels in inactive patients was stronger than in healthy controls and active patients (p < 0.01, p < 0.001). CONCLUSION: Our results show that MSI is a sensitive noninvasive method to investigate the retinal pigment epithelium (RPE) in VKH disease. It is more likely to detect RPE abnormalities with MSI than when using FFA, OCT or FP. Retinal transmission function in inactive patients is stronger than that observed in active patients or healthy controls.

[An investigation of current situation of corneal donors action in Chongqing].

OBJECTIVE: To evaluate the current situation of corneal donors and possible way to improve the corneal donation program in the city of Chongqing. METHODS: (1) The 1,400 residents of Chongqing were randomly surveyed to understand their ideas and attitudes towards corneal donation and to evaluate the correlation between their knowledge and their participation in the program in May - December, 2001. (2) The sociology data of 1,278 registered donors in the Chongqing Eye Bank were analyzed from March 1999 to December 2001.(3) The social-medical data of 37 eye donors were analyzed from March 1999 to December 2001. RESULTS: (1) Results of the random survey: the response rate was 79.14% (1,108/1,400), 1,072 (76.57%) questionnaire met the criteria for further analysis.47.20% of 1,072 persons would like to be eye donors, 62.69% supported eye donation, 32.55% would only donate their cornea, but 90.49% did not register to be a donor at present. Of those surveyed, about 2/3 were not familiar with the Chongqing Eye Bank, most did not know how to become an eye donor, and 75.28% supported local legislation to regulate donation. (2) Data of 1,278 registered eye donors: 550 were males and 728 were females, 61.89% were 30 years old or younger, most were students, teachers, medical staff or white-collared workers in general, and more than half had a university level education. (3) Data of 37 eye donors: 25 were males and 12 were females, age range was 20 - 88 years old, the main causes of death were malignant tumors and cardio-cerebral vessel disorders, 59% had nine or less years of education while only 11% had a university level education, and nine were also cadaver donors. The clinical utilization rate of eyes was 73%. CONCLUSIONS: (1) There are a significant number of people who are willing to be eye donors. Education level and age do not affect their decision to become donors. (2) Only a small percentage of the mass are registered eye donors. (3) Legislation regarding eye donation should be enacted as soon as possible. (4) Corneal donations could be higher than those at present.