Clinical characteristics and risk factors of an outbreak with scrub typhus in previously unrecognized areas, Jiangsu province, China 2013.

Scrub typhus, caused by Orientia tsutsugamushi, has emerged recently in Jingjiang City, China where the disease had not been known to exist. We analyzed epidemiological data, clinical characteristics and risk factors of scrub typhus outbreak in Jingjiang City, 2013. The 271 clinically diagnosed patients were predominantly farmers 50 to 69 years old and the peak of onset was early to mid-November. For the 187 laboratory-confirmed cases, the major clinical manifestations of the patients were fever (100%), eschar (88.2%), rash (87.7%), chills (87.7%), and headache (66.8%). A community-based case-control study was carried out to investigate the risk factors of the scrub typhus outbreak. Bundling or moving waste straw (OR=9.0, 95%CI 4.6-17.8) and living at the edge of village (OR=0.6, 95%CI 0.4-0.9) posed the highest risks through single- and multi-variable conditional logistic regression. Phylogenetic analysis of the 56-kDa TSA gene showed that the new cluster (GB-C2) and the previously reported cluster (GB-C1) of O. tsutsugamushi were associated with this outbreak. These findings are useful for the establishment of a detailed control strategy for scrub typhus infection in previously unrecognized areas of Jiangsu Province, China.

[Evaluation of the "Jiangsu/WHO 100% condom use programme in China"].

OBJECTIVE: To evaluate the effect and to explore the feasible model of 100% condom use programme (100%CUP) under existing policy and law milieu, so as to provide information for the adjustment of HIV/AIDS policy and intervention strategies. METHODS: Information on knowledge, attitude and behavior of female sex workers (FSWs) in entertainment establishments were collected and followed by qualitative and quantitative analysis including: samples tested for Chlamydia; a repeated cross-investigation and the final evaluation on the effect of the programme. RESULTS: The reported rate of condom use at the last sex activity with clients increased from 74.9% to 92.2% while the rate of sexually transmitted disease (STD) prevalence droped from 25.1% to 14.1% after three year's intervention program. The number of condoms distributed increased from 50,000 per quarter of a year in 2001 to over 100,000 in 2003. The rates of awareness on the knowledge of STD/AIDS prevention increased obviously. CONCLUSION: The 100%CUP was proved to be feasible and effective in the pilot site, and should be expanded in entertainment establishments.