Influenza vaccine effectiveness to prevent influenza-related hospitalizations and serious outcomes in Canadian adults over the 2011/12 through 2013/14 influenza seasons: A pooled analysis from the Canadian Immunization Research Network (CIRN) Serious Outcomes Surveillance (SOS Network)

BackgroundOngoing assessment of influenza vaccine effectiveness (VE) is critical to inform public health policy. This study aimed to determine the VE of trivalent influenza vaccine (TIV) for preventing influenza-related hospitalizations and other serious outcomes over three consecutive influenza seasons.MethodsThe Serious Outcomes Surveillance (SOS) Network of the Canadian Immunization Research Network (CIRN) conducted active surveillance for influenza in adults ≥16 years (y) of age during the 2011/2012, 2012/2013 and 2013/2014 seasons in hospitals across Canada. A test-negative design was employed: cases were polymerase chain reaction (PCR)-positive for influenza; controls were PCR-negative for influenza and were matched to cases by date, admission site, and age (≥65 y or <65 y). All cases and controls had demographic and clinical characteristics (including influenza immunization status) obtained from the medical record. VE was estimated as 1-OR (odds ratio) in vaccinated vs. unvaccinated patients × 100%. The primary outcome was VE of TIV for preventing laboratory-confirmed influenza-related hospitalization; secondary outcomes included VE of TIV for preventing influenza-related intensive care unit (ICU) admission/mechanical ventilation, and influenza-related death.ResultsOverall, 3394 cases and 4560 controls were enrolled; 2078 (61.2%) cases and 2939 (64.5%) controls were ≥65 y. Overall matched, adjusted VE was 41.7% (95% Confidence Interval (CI): 34.4–48.3%); corresponding VE in adults ≥65 y was 39.3% (95% CI: 29.4–47.8%) and 48.0% (95% CI: 37.5–56.7%) in adults <65 y, respectively. VE for preventing influenza-related ICU admission/mechanical ventilation in all ages was 54.1% (95% CI: 39.8–65.0%); in adults ≥65 y, VE for preventing influenza-related death was 74.5% (95% CI: 44.0–88.4%).ConclusionsWhile effectiveness of TIV to prevent serious outcomes varies year to year, we demonstrate a statistically significant and clinically important TIV VE for preventing hospitalization and other serious outcomes over three seasons. Public health messaging should highlight the overall benefit of influenza vaccines over time while acknowledging year to year variability.ClinicalTrials.gov Identifier: NCT01517191.     

Assessing the safety of hepatitis B vaccination during pregnancy in the Vaccine Adverse Event Reporting System (VAERS), 1990–2016

BackgroundThe safety of hepatitis B vaccination during pregnancy has not been well studied.ObjectiveWe characterized adverse events (AEs) after hepatitis B vaccination of pregnant women reported to the Vaccine Adverse Event Reporting System (VAERS), a spontaneous reporting surveillance system.MethodsWe searched VAERS for AEs reports involving pregnant women who received hepatitis B vaccine from January 1, 1990–June 30, 2016. All reports and available medical records were reviewed by physicians. Observed AEs were compared to expected AEs and known rates of pregnancy outcomes to assess for any unexpected safety concern.ResultsWe found 192 reports involving pregnant women following hepatitis B vaccination of which 110 (57.3%) described AEs; 12 (6.3%) were classified as serious; one newborn death was identified in a severely premature delivery, and there were no maternal deaths. Eighty-two (42.7%) reports did not describe any AEs. Among pregnancies for which gestational age was reported, most women were vaccinated during the first trimester, 86/115 (74.7%). Among reports describing an AE, the most common pregnancy-specific outcomes included spontaneous abortion in 23 reports, preterm delivery in 7 reports, and elective termination in 5 reports. The most common non-pregnancy specific outcomes were general disorders and administration site conditions, such as injection site and systemic reactions, in 21 reports. Among 22 reports describing an AE among infants born to women vaccinated during pregnancy, 5 described major birth defects each affecting different organ systems.ConclusionOur analysis of VAERS reports involving hepatitis B vaccination during pregnancy did not identify any new or unexpected safety concerns.     

Why do we not want to recommend influenza vaccination to young children? A qualitative study of Australian parents and primary care providers

IntroductionInfluenza vaccination has been shown to be safe and effective against influenza and in the prevention of complicating secondary respiratory illnesses. However, its uptake in young children remains low. This study explored the views, attitudes and practices of parents and primary care providers (PCPs) on their knowledge and acceptance of influenza vaccination in children under 5.MethodsUsing a cross-sectional qualitative research design, we conducted 30 in-depth interviews with PCPs (i.e., general practitioners, practice nurses, maternal and child health nurses, and pharmacists) and five focus groups with parents (n = 50) between June 2014 and July 2015 in Melbourne, Australia. Data were thematically analysed.ResultsParents thought the vaccine could cause influenza, and influenza vaccination was not necessary for their children as they needed to build their own ‘immunity’. Parents said that they would consider vaccinating their children if recommended by their GP and if the influenza vaccine was part of the immunisation schedule. PCPs also expressed concerns regarding the efficacy of the vaccine as well as out-of-pocket costs incurred by families, and uncertainty regarding the mortality and morbidity of influenza in otherwise healthy children. However, they said they would recommend the vaccine to high-risk groups (e.g. children with chronic disease(s), and asthma).ConclusionDespite the established safety of influenza vaccines, barriers to uptake include concerns regarding the iatrogenic effects of vaccination, its administration schedule, and knowledge of influenza severity. Updated information on influenza and the efficacy of the vaccine, and incorporating influenza vaccination into the immunisation schedule may overcome some of these barriers to increase influenza vaccination in this vulnerable cohort.     

ST6型金黄色葡萄球菌食物中毒菌株的毒力因子分析

目的检测食物中毒优势型ST6型菌株的毒力基因特征,为食品安全风险评估、食源性病原菌的监测和致病性研究提供依据。方法选取深圳地区7次食物中毒收集的32株ST6型菌株进行全基因组测序,利用VFDB数据库进行毒力因子分析,并通过序列比对进行SEA亚型分析。结果第1-4起食物中毒ST6菌株携带的毒力因子谱完全相同;第5-7起食物中毒中,同一起食物中毒的暴发菌株携带的毒力因子一致,而非暴发菌株与暴发菌株携带的毒力因子不完全一致。在32株ST6型菌中,与粘附、酶和Ⅶ型分泌系统相关的毒力基因具有较高的携带率,α-溶血素(hly/hla)、β-溶血素(hlb)、δ-溶血素(hld)、γ-溶血素基因(hlgA、hlgB、hlgC)、肠毒素A基因(sea)和表皮剥脱毒素A基因(eta)的携带率均为100%,双组分白细胞毒素LukDE基因(lukD和lukE)的携带率为96.8%。所有菌株携带的肠毒素A均为SEA1亚型。结论32株ST6型食物中毒相关菌株携带多个毒力因子基因,以cna、sea、eta、lukD、lukE毒力基因携带率较高,编码的毒力因子可能对ST6型菌株的致病性产生影响。     

山东省聊城市婴幼儿食品、生物样品和环境标本中梭状芽孢杆菌的分离培养和鉴定

目的了解山东省聊城市0 ~ 1岁婴幼儿食品、生物样品及环境中梭状芽孢杆菌的污染水平,并对采集到的标本进行鉴定,为食品卫生监督管理部门采取相应措施减少梭状芽孢杆菌的污染提供相关依据。方法对采集的257份标本进行厌氧和微需氧培养,根据分离菌株的生长特性、革兰染色、普通显微镜下形态特征等表现特征,用16S rRNA基因克隆测序的方法对分离菌株进行鉴定。结果257份标本中检出梭状芽孢杆菌97株,检出率为37.74%,主要包括双酶梭菌38株、第三梭菌14株、生孢梭菌12株、酪酸梭菌11株、污泥梭菌9株。 97株梭状芽孢杆菌的标本分离自粪便50株、土壤28株、奶粉6株、配奶桌6株、乳头3株、配奶水2株、配奶人员手部2株。结论聊城市0 ~ 1岁婴幼儿食品、生物样品及环境中梭状芽孢杆菌的携带率高,其中双酶梭菌的检出率最高,其次为第三梭菌、生孢梭菌和酪酸梭菌。     

一株同时携带SGI1和SXT/R391耐药基因岛的奇异变形杆菌

目的分析1株人源奇异变形杆菌CA151922的2个耐药相关基因岛SGI1和SXT/R391的基因结构和耐药基因。方法聚合酶链式反应（PCR）检测SGI1和SXT/R391基因岛特异性整合酶基因,采用二代测序方法测定CA151922基因组。 分别以SGI1和SXT/R391基因岛的参考序列,从基因组序列中提取基因岛片段并组装。 在线预测并注释开放读码框（ORFs）。 基因岛的同源序列通过在线工具BLASTn获得,采用cd-hit获得非冗余的同源基因,利用R语言构建同源基因的聚类进化关系树。 利用微量肉汤稀释法进行耐药表型检测。结果奇异变形杆菌CA151922同时含有SGI1（SGI1-B）和SXT/R391（ICEPmiJpn1）2个耐药相关基因岛。 SGI1-B和ICEPmiJpn1与已知序列相似性分别为97% ~ 99%和96% ~ 99%。 SGI1-B和ICEPmiJpn1携带的耐药基因种类有所差异,但两者携带不同的编码β-内酰胺酶的基因。CA151922为多耐药菌株,耐药达18种,与基因岛耐药基因有关的耐药表型为氨苄西林和磺胺类药物,提示菌株耐药表型不完全由该耐药岛内的耐药基因决定。结论首次在奇异变形杆菌中发现,同时携带SGI1和SXT/R391耐药相关基因岛, 增加了菌株耐药的复杂性和严重性,提示应加强对多耐药菌株耐药相关基因岛的监测。     

2005-2017年我国外籍人群登革热的流行病学特征分析

目的描述和分析我国报告的外籍登革热病例的基本情况和时空分布特征,为登革热的防控提供参考。方法收集整理2005 — 2017年全国确诊报告的外籍登革热病例的基本信息,描述外籍登革热病例的人口学、时间和地理分布,并比较云南省与我国其他省份的登革热流行病学特征。结果2005 — 2017年,我国共报告外籍登革热病例2 106例,占全国累计报告登革热病例数的3.08%。 登革热发病随年度增加总体呈上升趋势,报告省份区域不断扩大。 云南省外籍病例最多（1 751例）,占全部病例数的83.14%。 其次为广东省（140例）,占6.65%。 外籍人群以输入性登革热为主,由缅甸经我国云南省入境。 云南省与我国其他省份登革热病例的人口学特征、流行趋势以及来源国等均有差异。结论近年来,外籍人群对我国,特别是云南省的登革热的流行存在一定影响。 应进一步加强同周边国家的合作,增强对登革热的防控,在重点地区有针对性地开展外籍登革热病例的监测、筛查和医疗救治工作。     

合肥市肉鸡沙门菌携带情况调查

目的了解合肥市养殖屠宰环节中肉鸡沙门菌的带菌率、血清型分布、抗生素耐药谱分布以及脉冲场凝胶电泳（PFGE）分子分型情况,为合肥市食品安全提供科学的基础数据,为进一步加强合肥市公共卫生安全提供科学依据。方法2010年7—9月对合肥市10家肉鸡养殖场和14家屠宰户分别采用肛拭法和胴体漂洗法采集45份肉鸡活体和45份肉鸡胴体标本,根据GB／T4789．4—2010对沙门菌进行分离、鉴定以及血清学分析;并采用PCR方法进行复核鉴定;对最终确定的阳性菌株使用临床实验室标准化协会（CLSI）推荐的纸片法进行药敏试验;同时采用PFGE方法确定其分子分型。结果在45份肉鸡活体样本中未检出沙门菌;45份肉鸡胴体样本中检出12株沙门菌,检出率为26．7％,经PCR复核检测,所分离的12株沙门菌对invA和hilA基因的携带率均为100％;12株沙门菌分为3种血清型,其中9株为印第安纳沙门菌,2株为鼠伤寒沙门菌,1株为肠炎沙门菌;12株沙门菌对实验中所采用的15种抗生素总耐药以及多重耐药菌株数均为10株;12株沙门菌共分出7种PFGE带型,9株印第安纳沙门菌共分离出5种不同的PFGE带型;同一血清型的沙门菌分子分型结果,基本位于同一大簇中;相同PFGE带型的菌株,耐药谱非常接近。结论合肥市肉鸡胴体沙门菌检出率高,沙门菌的血清型、药敏性以及基因型具有多样性特征,耐药现象严重,相同PFGE带型的菌株,耐药谱非常接近。     

弹状病毒的分类和进化

弹状病毒科病毒给人类健康、农业、畜牧业和渔业带来重大影响。不同属病毒之间在基因组结构、宿主范围、传播方式等方面性状各异。目前弹状病毒划分为9个属,但仍有不少新发现病毒有待分类。病毒的进化与媒介（宿主）、传播方式、生态环境等多种因素密切相关。     

多杀菌素Natular G30对海南省不同生境致倦库蚊的控制效果比较研究

目的 比较不同剂量多杀菌素Natular G30在生活污水与小型净水中对致倦库蚊海口种群的控制效果,为其在蚊虫控制中的应用提供依据.方法 用海南省海口市生活污水与小型净水中的致倦库蚊幼虫和水,在外环境以减退率为指标,分别测定Natular G30 10、20、40和80 mg/m2对蚊虫的控制效果.试验中,两次测量试验水体的水质pH值、温度、总固体含量、盐度、溶解氧含量.结果 生活污水的pH值、溶解氧含量分别为（9.62±0.43）、（12.79±3.01）mg/L,小型净水分别为（8.91±0.39）、（7.77±3.46）mg/L,二者差异有统计学意义（P＜0.05）.在生活污水中,多杀菌素有效浓度为10和20 mg/m2时,蚊虫控制持效时间为12d,40和80 mg/m2处理的则＞30 d;而在小型净水中,所有4个浓度均有超过30 d的持效期.两种水体所有剂量在第1天对1、2龄期幼虫的减退率即接近100％,3、4龄期幼虫在第3～7天出现100％减退,而蛹在第1天的减退率基本为负值.结论 多杀菌素Natular G30对致倦库蚊幼虫的控制效果具有高效、持久的特点;且对1、2龄幼虫的毒性高于对3、4龄幼虫的毒性,对蛹无明显的毒杀作用.因其在小型净水中的效果优于生活污水,使用时应根据水质调整剂量.