含扩增内对照的霍乱毒素基因ctx和不耐热肠毒素基因elt三重real-time PCR检测体系的建立

目的 建立一个含扩增内对照（IAC）的三重TaqMan real-time PCR体系,以检测霍乱毒素基因ctxA 和肠产毒性大肠埃希菌的不耐热肠毒素基因elt。方法 针对ctxA、elt 和IAC设计引物和探针,进行灵敏性和特异性分析,评价三重反应之间的互相影响。结果 该检测体系灵敏度为ctxA 每个反应94 拷贝,elt 每个反应79 拷贝,扩增效率分别为94.7%与98.1%。ctxA 与elt 拷贝数比例为1 ∶ 1～1 ∶ 10 时,二者均能良好扩增;elt 或ctxA 的量是IAC的100 倍以上时,IAC扩增受到抑制。结论 该检测体系具有良好的灵敏性和特异性,可以用于腹泻粪便中感染病原菌的检测,其中内对照检测可以提示粪便样本中是否存在PCR抑制因子。     

Discrete retinal input to the parabrachial complex of a new-world primate, the common marmoset (Callithrix jacchus)

Traditional retinal projections target three functionally complementary systems in the brain of mammals: the primary visual system, the visuomotor integration systems and the circadian timing system. In recent years, studies in several animals have been conducted to investigate the retinal projections to these three systems, despite some evidence of additional targets. The aim of this study was to disclose a previously unknown connection between the retina and the parabrachial complex of the common marmoset, by means of the intraocular injection of cholera toxin subunit b. A few labeled retinal fibers/terminals that are detected in the medial parabrachial portion of the marmoset brain show clear varicosities, suggesting terminal fields. Although the possible role of these projections remains unknown, they may provide a modulation of the cholinergic parabrachial neurons which project to the thalamic dorsal lateral geniculate nucleus.     

四川省首例霍乱0139病人流行病学调查报告

1999年7月10日,乐山市市中区发生了四川省首起0139霍乱疫情,此次疫情共发病1人,带菌者1人,疫情发生后,在各级领导的高度重视下,按照“早、小、严、突”的原则进行处理,使疫情很快被控制。现将疫情调查处理情况报告如下。     

《伤寒论·辨霍乱病脉证并治》浅析

分析<伤寒论·辨霍乱病脉证并治>篇的内存,在伤寒之类病中出现类似"霍乱"、以严重"吐利"为突出表现的病证,<伤寒论>将其冠以"崔乱病"之名.<伤寒论>撰用了"霍乱"之名,表明这类胃肠型伤寒之类病的特点,又有"霍乱"与伤寒的"雀乱病"鉴别诊断的意义.     

Immunogenicity of partial doses of live oral cholera vaccine CVD 103-HgR in children in the United States

In a phase 4, placebo-controlled, double-blind, multi-center study performed to assess the immunogenicity of a single oral dose of live, attenuated cholera vaccine, volunteers aged 2–17 years were randomized 6:1 to receive 1 × 10⁹ colony forming units of PXVX0200 or placebo. In the subset of subjects who consumed < 80 % of the vaccine dose, seroconversion rates were calculated and stratified by amount consumed. Of 468 subjects dosed, a subset of 33 (7 %) received < 80 % of the vaccine dose. SVA seroconversion occurred in 75.8 % of these subjects, including 100 % (7/7) of those who took 50–80 % and 69.2 % (18/26) of those who took < 50 %, versus 98.5 % of those who consumed 80 % or more. Vaccination with PXVX0200 produced an immune response in most children who received partial dosing. Since SVA seroconversion is a strong correlate of protection, PXVX0200 may protect against cholera infection in children who ingest only part of the vaccine dose.     

Coverage survey and lessons learned from a pre-emptive cholera vaccination campaign in urban and rural communities affected by landslides and floods in Freetown Sierra Leone

BackgroundOn 14 August 2017, massive landslides and floods hit Freetown (Sierra Leone). More than 1,000 people lost their lives while approximately 6,000 people were displaced. The areas most affected included parts of the town with challenged access to basic water and sanitation facilities, with communal water sources likely contaminated by the disaster. To avert a possible cholera outbreak following this emergency, the Ministry of Health and Sanitation (MoHS), supported by the World Health Organization (WHO) and international partners, including Médecins Sans Frontières (MSF) and UNICEF, launched a two-dose pre-emptive vaccination campaign using Euvichol™, an oral cholera vaccine (OCV).MethodsWe conducted a stratified cluster survey to estimate vaccination coverage during the OCV campaign and also monitor adverse events. The study population – subsequently stratified by age group and residence area type (urban/rural) – included all individuals aged 1 year or older, living in one of the 25 communities targeted for vaccination.ResultsIn total 3,115 households were visited, 7,189 individuals interviewed; 2,822 (39%) people in rural and 4,367 (61%) in urban areas. The two-dose vaccination coverage was 56% (95% confidence interval (CI): 51.0–61.5), 44% (95%CI: 35.2–53.0) in rural and 57% (95%CI: 51.6–62.8) in urban areas. Vaccination coverage with at least one dose was 82% (95%CI: 77.3–85.5), 61% (95%CI: 52.0–70.2) in rural and 83% (95%CI: 78.5–87.1) in urban areas.ConclusionsThe Freetown OCV campaign exemplified a timely public health intervention to prevent a cholera outbreak, even if coverage was lower than expected. We hypothesised that vaccination coverage in Freetown was sufficient in providing at least short-term immunity to the population. However, long-term interventions to ensure access to safe water and sanitation are needed.     

The interplay between WASH practices and vaccination with oral cholera vaccines in protecting against cholera in urban Bangladesh: Reanalysis of a cluster-randomized trial

The current global initiative to end Cholera by 2030 emphasizes the use of oral cholera vaccine (OCV) combined with feasible household Water-Sanitation-Hygiene (WASH) interventions. However, little is known about how improved WASH practices and behaviors and OCV interact to reduce the risk of cholera.We reanalyzed two arms of a cluster-randomized trial in urban Bangladesh, to evaluate the effectiveness of OCV given as a 2-dose regimen. One arm (30 clusters, n = 94,675) was randomized to vaccination of persons aged one year and older with OCV, and the other arm (30 clusters, n = 80,056) to no intervention. We evaluated the prevention of cholera by household WASH, classified at baseline using a previously validated rule, and OCV over 2 years of follow-up. When analyzed by assignment to OCV clusters rather than receipt of OCV, in comparison to persons living in “Not Better WASH” households in the control clusters, reduction of severe cholera (the primary outcome) was similar for persons in “Not Better WASH” households in vaccine clusters (46%, 95% CI:24,62), for persons in “Better WASH” households in the control clusters (48%, 95% CI:25,64), and for persons in “Better WASH” households in the vaccine clusters (48%, 95% CI:16,67). In contrast, when analyzed by actual receipt of a complete OCV regimen, , in comparison to persons in “Not Better WASH” households in the control clusters, protection against severe cholera increased steadily from 39% (95% CI:13,58) in residents of “Better WASH” households in the control clusters to 57% (95% CI:35,72) in vaccinated persons in “Not Better WASH” households to 63% (95% CI:21,83) in vaccinated persons in “Better WASH” households.This analysis suggests that improved household WASH and OCV received may interact to provide greater protection against cholera. However, the divergence between findings related to intent to vaccinate versus those pertaining to actual receipt of OCV underscores the need for further research on this topic.