Polio infrastructure strengthened disease outbreak preparedness and response in the WHO African Region

IntroductionThe continuous deployments of polio resources, infrastructures and systems for responding to other disease outbreaks in many African countries has led to a number of lessons considered as best practice that need to be documented for strengthening preparedness and response activities in future outbreaks.MethodsWe reviewed and documented the influence of polio best practices in outbreak preparedness and response in Angola, Nigeria and Ethiopia. Data from relevant programmes of the WHO African Region were also analyzed to demonstrate clearly the relative contributions of PEI resources and infrastructure to effective disease outbreak preparedness and response.ResultsPolio resources including, human, financial, and logistic, tool and strategies have tremendously contributed to responding to diseases outbreaks across the African region. In Angola, Nigeria and Ethiopia, many disease epidemics including Marburg Hemorrhagic fever, Dengue fever, Ebola Virus Diseases (EVD), Measles, Anthrax and Shigella have been controlled using existing polio Eradication Initiatives resources. Polio staffs are usually deployed in occasions to supports outbreak response activities (coordination, surveillance, contact tracing, case investigation, finance, data management, etc.). Polio logistics such vehicles, laboratories were also used in the response activities to other infectious diseases. Many polio tools including micro planning, dashboard, guidelines, SOPs on preparedness and response have also benefited to other epidemic-prone diseases. The Countries’ preparedness and response plan to WPV importation as well as the Polio Emergency Operation Center models were successfully used to develop, strengthen and respond to many other diseases outbreak with the implication of partners and the strong leadership and ownership of governments. This review has important implications for WHO/AFRO initiative to strengthening and improving disease outbreak preparedness and responses in the African Region in respect to the international health regulations core capacities.     

烟台市区风疹爆发的流行病学调查

本文报告了1987年2~5月间烟台市区幼儿园、小学等集体机构发生的一起出疹性疾病。经调查和血清学检测证实为风疹。总罹患率为23.99%,有的班级高达83.33%。具有流行迅速、发病集中、临床表现较重等特征。其中一例于发疹后期并发脑炎死亡。     

一起阴囊皮炎爆发流行的调查与实验研究

本文报道了一起183例农民阴囊皮炎的爆发流行,发病率高达56.63%,不同的年龄、职业与发病率无显著差别,八月份为发病高峰。同时患有口角炎、舌炎并发症者占45.65%,取14例典型患者的阴囊鳞屑作真菌镜检,检出霉菌1例。85例患者经采用核黄素10mg,加复合维生素B10mg,每日两次连服七天进行试治,治愈率为96.47%(82/85),将19例患者与20例健康者对照,作4h尿中核黄素负荷试验比较,结果两者在统计学上具有显著性差别(u=2.11,P≤0.05)。经膳食营养调查,发现6~10月份核黄素供给不足47%。由此证明,发病与核黄素缺乏有关。     

神经外科ICU疑似耐碳青霉烯类肺炎克雷伯菌医院感染暴发调查与控制

目的对神经外科重症监护病房(ICU)一起疑似耐碳青霉烯类肺炎克雷伯菌(CRKP)医院感染暴发进行调查和控制,为多药耐药菌医院感染预防与控制提供参考。方法对2019年5月-6月华中科技大学同济医学院附属同济医院神经外科ICU的6例CRKP感染患者进行流行病学调查和环境卫生学监测,并采取针对性防控策略。结果共发生CRKP医院感染6例;其中5例的住院时间和床位存在重叠或相邻;6例患者的保洁人员为同一人;环境卫生学监测显示CRKP检出率为3.13%(2/64),分别从呼吸机和保洁人员手检出;患者检出的6株CRKP菌株和环境检出的2株CRKP菌株药敏结果基本一致。采取改进环境清洁消毒流程、严格执行手卫生、加强科室人员管理和全员医院感染防控培训及督导等针对性防控策略后,此次事件得到有效控制。结论神经外科ICU内环境清洁消毒不彻底以及医务人员手卫生执行不到位是导致此次疑似CRKP医院感染暴发的主要原因。及时识别并调查原因,采取针对性防控策略是有效控制医院感染暴发的关键。     

Projecting the impact of a two-dose COVID-19 vaccination campaign in Ontario,Canada

BackgroundA number of highly effective COVID-19 vaccines have been developed and approved for mass vaccination. We evaluated the impact of vaccination on COVID-19 outbreak and disease outcomes in Ontario, Canada.MethodsWe used an agent-based transmission model and parameterized it with COVID-19 characteristics, demographics of Ontario, and age-specific clinical outcomes. We implemented a two-dose vaccination program according to tested schedules in clinical trials for Pfizer-BioNTech and Moderna vaccines, prioritizing healthcare workers, individuals with comorbidities, and those aged 65 and older. Daily vaccination rate was parameterized based on vaccine administration data. Using estimates of vaccine efficacy, we projected the impact of vaccination on the overall attack rate, hospitalizations, and deaths. We further investigated the effect of increased daily contacts at different stages during vaccination campaigns on outbreak control.ResultsMaintaining non-pharmaceutical interventions (NPIs) with an average of 74% reduction in daily contacts, vaccination with Pfizer-BioNTech and Moderna vaccines was projected to reduce hospitalizations by 27.3% (95% CrI: 22.3% − 32.4%) and 27.0% (95% CrI: 21.9% − 32.6%), respectively, over a one-year time horizon. The largest benefits of vaccination were observed in preventing deaths with reductions of 31.5% (95% CrI: 22.5% − 39.7%) and 31.9% (95% CrI: 22.0% − 41.4%) for Pfizer-BioNTech and Moderna vaccines, respectively, compared to no vaccination. We found that an increase of only 10% in daily contacts at the end of lockdown, when vaccination coverage with only one dose was 6%, would trigger a surge in the outbreak. Early relaxation of population-wide measures could lead to a substantial increase in the number of infections, potentially reaching levels observed during the peak of the second wave in Ontario.ConclusionsVaccination can substantially mitigate ongoing COVID-19 outbreaks. Sustaining population-wide NPIs, to allow for a sufficient increase in population-level immunity through vaccination, is essential to prevent future outbreaks.     

Quantification of SARS-CoV-2 spike and nucleocapsid proteins using isotope dilution tandem mass spectrometry

The emergence and subsequent global outbreak of the novel coronavirus SARS-CoV-2 prompted our laboratory to launch efforts to develop methods for SARS-CoV-2 antigen detection and quantification. We present an isotope dilution mass spectrometry method (IDMS) for rapid and accurate quantification of the primary antigens, spike and nucleocapsid proteins. This IDMS method utilizes liquid chromatography-tandem mass spectrometry (LC-MS/MS) to analyze sample tryptic digests for detection and quantification of selected conserved peptides of SARS-CoV-2 spike and nucleocapsid proteins. The IDMS method has the necessary attributes to be successfully utilized for accurate quantification in SARS-CoV-2 protein-based vaccines and as targets of rapid diagnostic tests. Absolute quantification was achieved by quantifying and averaging 5 peptides for spike protein (3 peptides in the S1 subunit and 2 peptides in the S2 subunit) and 4 peptides for nucleocapsid protein. The overall relative standard deviation of the method was 3.67% for spike protein and 5.11% for nucleocapsid protein. IDMS offers speed (5 h total analysis time), sensitivity (LOQ; 10 fmol/µL) and precision for quantification of SARS-CoV-2 spike and nucleocapsid proteins.     

2008—2019年南宁市手足口病暴发疫情流行特征分析

目的 了解南宁市手足口病暴发疫情的流行病学特征,为手足口病暴发疫情防控工作提供科学依据。方法 收集整理2008—2019年间南宁市报告的手足口病暴发疫情处置资料进行分析。结果 2008—2019年南宁市累计报告手足口病暴发疫情104起,每年3—6月和9—10月是疫情高发期,城区报告疫情起数较多,占61.54%,但县区罹患率较高,为4.56%,91.35%的暴发疫情发生在托幼机构,病例以3～4岁儿童为主,占65.33%,病原体以EV71和Cox A16为主,分别占42.86%和32.47%。62.50%疫情为疾控机构通过疫情网检测发现,疫情发现时长中位数为12 d,疫情流行时长中位数为12 d,疫情罹患率中位数为4.93%。结论 近3年南宁市手足口病暴发疫情报告起数有下降趋势,托幼机构一直是手足口病暴发疫情重点场所。落实托幼机构保健医生的配备,加强托幼机构尤其是民办托幼机构手足口病防控知识培训,实现早发现早处置早停课,可有效控制手足口病暴发疫情的蔓延。     

黑龙江省2017—2020年流感样病例暴发疫情特征分析

目的 分析黑龙江省2017—2020年流感样病例暴发疫情流行特点及影响因素,为流感的防控提供科学依据。方法 收集“突发公共卫生事件报告管理信息系统”和“中国流感监测信息系统”报告的流感暴发疫情资料,对数据进行统计分析。结果 2017—2020监测年度黑龙江省共报告流感暴发疫情29起,累计报告发病数1 028例,报告时间主要集中在冬春季,12月份和4月份报告最多,占96.55%;场所分布主要以中小学校为主,占暴发疫情总数的93.10%;暴发疫情规模以10～29例居多,占暴发疫情总数的65.52%;病原学结果显示流感病毒流行株由A型（H3）转变为A型（新甲H1）,之后又为A型（H3）和B型（Victoria）共同流行。结论 黑龙江省流感暴发疫情冬春季高发,集中在中小学校,流感优势株变换频繁,应做好监测并及时控制疫情的发展。     

Effectiveness of typhoid conjugate vaccine in Zimbabwe used in response to an outbreak among children and young adults: A matched case control study

BackgroundZimbabwe suffers from regular outbreaks of typhoid fever (TF), worse since 2017. Most cases were in Harare and a vaccination campaign with Typhoid Conjugate Vaccine (TCV) was conducted in March 2019. The vaccine effectiveness (VE) was assessed against culture-confirmed S. Typhi in children six months to 15 years and in individuals six months to 45 years in Harare.MethodsA matched case-control study was conducted in three urban suburbs of Harare targeted by the TCV vaccination campaign. Suspected TF cases were enrolled prospectively in four health facilities and were matched to facility (1:1) and community (1:5) controls.FindingsOf 504 suspected cases from July 2019 to March 2020, 148 laboratory-confirmed TF cases and 153 controls confirmed-negative were identified. One hundred and five (47 aged six months to 15 years) cases were age, sex, and residence matched with 105 facility-based controls while 96 cases were matched 1:5 by age, sex, and immediate-neighbour with 229 community controls.The adjusted VE against confirmed TF was 75% (95%CI: 1–94, p = 0.049) compared to facility controls, and 84% (95%CI: 57–94, p < 0.001) compared to community controls in individuals six months to 15 years. The adjusted VE against confirmed TF was 46% (95%CI: 26–77, p = 0.153) compared to facility controls, and 67% (95%CI: 35–83, p = 0.002) compared to community controls six months to 45 years old.InterpretationThis study confirms that one vaccine dose of TCV is effective to control TF in children between six months and 15 years old in an African setting.     

Two outbreaks of typhoid fever related to the war in Bosnia and Herzegovina

Two outbreaks of typhoid fever caused by Salmonella typhi of the same phagotype (A, biotype II) and antibiotic susceptibility are reported. Both occurred during the war in Bosnia and Herzegovina. The first outbreak appeared among the refugees from the town of Jajce. The second outbreak appeared among the inhabitants in the village of Vidosi near Livno. This report describes main clinical, epidemioloigcal and laboratory findings for 22 patients treated in Split University Hospital, Croatia, in the period November 1992–January 1993. Possible epidemiological connections between those two outbreaks are discussed.