The recombination hot spots and genetic diversity of the genomes of African swine fever viruses

The FilmArray^Ⓡ Meningitis/Encephalitis Panel detects the 14 most frequent pathogens causing meningitis and/or encephalitis. The use of FilmArray ME with non-validated samples is seldom published in the literature. We describe the case of a 3-year-old child, diagnosed with acute meningoencephalitis, in whom the FilmArray^Ⓡ ME technique successfully identified Neisseria meningitidis in both skin biopsy and whole blood samples.     

Are refugees arriving in Denmark an under-immunised group for measles? A cross-sectional serology study

BackgroundIn 2018, Europe faced the highest number of Measles cases in a decade. In Denmark, the childhood vaccination programme has a coverage of approximately 90%. To eliminate the disease, vaccine coverage needs to be above the herd immunity threshold of 95%. This can be even more difficult to obtain, when vaccination programmes break down due to war, natural disasters etc. and concern has been raised, that unvaccinated refugees could facilitate spread of measles when migrating.MethodsIn order to address this concern, we tested 513 newly arrived refugees and family reunified refugees aged between 0 and 70 years for measles IgG antibodies. The participants were tested as part of a general health assessment between May 2016 and October 2018. In the cohort, 50% were males and the majority came from Syria (55%).ResultsWe found that 85% of the total group of refugees had immunity against measles. The 15% lacking antibodies were evenly distributed between the various countries of origin. Moreover, we found immunity to increase with age, leaving young children most vulnerable to infection, 79.9% (<19 years) vs 89.1% (≥19 years). Interview questions on previous vaccinations did not correlate to serology.ConclusionRefugees have measles immunity slightly lower than the host population.     

Inverted U-Shaped Associations between Glycemic Indices and Serum Uric Acid Levels in the General Chinese Population: Findings from the China Cardiometabolic Disease and Cancer Cohort (4C) Study

Objective The relationship between serum uric acid(SUA)levels and glycemic indices,including plasma glucose(FPG),2-hour postload glucose(2 h-PG),and glycated hemoglobin(HbA1 c),remains inconclusive.We aimed to explore the associations between glycemic indices and SUA levels in the general Chinese population.Methods The current study was a cross-sectional analysis using the first follow-up survey data from The China Cardiometabolic Disease and Cancer Cohort Study.A total of 105,922 community-dwelling adults aged≥40 years underwent the oral glucose tolerance test and uric acid assessment.The nonlinear relationships between glycemic indices and SUA levels were explored using generalized additive models.Results A total of 30,941 men and 62,361 women were eligible for the current analysis.Generalized additive models verified the inverted U-shaped association between glycemic indices and SUA levels,but with different inflection points in men and women.The thresholds for FPG,2 h-PG,and HbA1 c for men and women were 6.5/8.0 mmol/L,11.0/14.0 mmol/L,and 6.1/6.5,respectively(SUA levels increased with increasing glycemic indices before the inflection points and then eventually decreased with further increases in the glycemic indices).Conclusion An inverted U-shaped association was observed between major glycemic indices and uric acid levels in both sexes,while the inflection points were reached earlier in men than in women.     

2010-2013年洛阳市境外输入性疟疾疫情分析

目的 目的 分析2010-2013年洛阳市境外输入性疟疾流行特征, 为该市疟疾防控提供依据。方法 方法 收集2010-2013 年洛阳市网络报告的疟疾疫情资料、 输入性疟疾病例个案调查及流行病学调查报告资料, 并进行统计分析。结果 结果 2010-2013年洛阳市报告输入性疟疾病例98例, 其中恶性疟 57例, 间日疟35例, 卵型疟4例, 三日疟2例, 均为实验室确 诊病例。98例输入性病例中, 71例来自非洲国家 （72.44%）, 27例来自东南亚国家 （27.55%）。发病人群主要为青壮年男 性, 发病时间无明显季节性; 从发病到就诊时间间隔中位数为6 d; 确诊单位主要为各级疾病预防控制机构 （78.57%）。结 结 论 论 洛阳市境外输入性疟疾疫情严峻, 需进一步强化医疗机构业务培训和多部门合作, 采取有效措施以降低其危害。     

Chinese guidelines for the diagnosis and treatment of hand,foot and mouth disease (2018 edition)

Background

Hand, foot, and mouth disease (HFMD) is a common infectious disease in childhood caused by an enterovirus (EV), and which is principally seen in children under 5 years of age. To promote diagnostic awareness and effective treatments, to further standardize and strengthen the clinical management and to reduce the mortality of HFMD, the guidelines for diagnosis and treatment have been developed.

Methods

National Health Commission of China assembled an expert committee for a revision of the guidelines. The committee included 33 members who are specialized in diagnosis and treatment of HFMD.

Results

Early recognition of severe cases is utmost important in diagnosis and treatment of patients with HFMD. The key to diagnosis and treatment of severe cases lies in the timely and accurate recognition of stages 2 and 3 of HFMD, in order to stop progression to stage 4. Clinicians should particularly pay attention to those EV-A71 cases in children aged less than 3 years, and those with disease duration less than 3 days. The following indicators should alert the clinician of possible deterioration and impending critical disease: (1) persistent hyperthermia; (2) involvement of nervous system; (3) worsening respiratory rate and rhythm; (4) circulatory dysfunction; (5) elevated peripheral WBC count; (6) elevated blood glucose and (7) elevated blood lactic acid. For treatment, most mild cases can be treated as outpatients. Patients should be isolated to avoid cross-infection. Intense treatment modalities should be given for those severe cases.

Conclusion

The guidelines can provide systematic guidance on the diagnosis and management of HFMD.

     

河南省60~76岁老年人代谢综合征的流行现状及影响因素

  目的  了解河南省60~76岁老年人代谢综合征的流行现状及其影响因素,为防控工作提供科学依据。  方法  数据来源于2015―2019年心血管病高危人群早期筛查与综合干预项目,选择年龄60~76岁的人群作为研究对象,利用调查问卷、体格检查和实验室检测的数据,采用χ2检验、Cochran-Armitage趋势χ2检验比较不同特征代谢综合征及各组分患病率的差异,采用多因素Logistic回归分析模型分析代谢综合征的影响因素。  结果  河南省60~76岁老年人代谢综合征的患病率为31.59%,女性高于男性(χ2 =369.65,P < 0.001),城市高于农村(χ2 =135.50,P < 0.001),高中以下高于高中及以上人群(χ2 =22.60,P < 0.001),不吸烟、不饮酒人群患病率高于吸烟、饮酒人群(均有P < 0.001)。高血压、高血糖、中心型肥胖患病率均较高,分别为65.14%、51.17%、47.01%,女性、高龄、城市、已婚、饮酒人群发生代谢综合征的风险高(均有P < 0.05)。  结论  河南省60~76岁老年人群代谢综合征患病率以及高血压、高血糖、中心型肥胖患病率较高,建议提高早期筛查力度和筛查范围,将关口进一步前移,筛出糖尿病前期和中心型肥胖前期的人群进行全面生活方式干预,对高血压、糖尿病人群进行生活方式和药物干预,利用健康讲座和同伴教育,提升老年人对慢性病的知晓率、治疗率和控制率。     

Risk factors for measles virus infection and susceptibility in persons aged 15 years and older in China: A multi-site case-control study, 2012–2013

IntroductionEndemic measles persists in China, despite >95% reported coverage of two measles-containing vaccine doses and nationwide campaign that vaccinated >100 million children in 2010. An increasing proportion of infections now occur among adults and there is concern that persistent susceptibility in adults is an obstacle to measles elimination in China. We performed a case-control study in six Chinese provinces between January 2012 to June 2013 to identify risk factors for measles virus infection and susceptibility among adults.MethodsPersons ≥15 years old with laboratory-confirmed measles were age and neighborhood matched with three controls. Controls had blood specimens collected to determine their measles IgG serostatus. We interviewed case-patients and controls about potential risk factors for measles virus infection and susceptibility. Unadjusted and adjusted matched odds ratios and 95% confidence intervals (CIs) were calculated via conditional logistic regression. We calculated attributable fractions for infection for risk factors that could be interpreted as causal.Results899 cases and 2498 controls were enrolled. Among controls, 165 (6.6%) were seronegative for measles IgG indicating persistent susceptibility to infection. In multivariable analysis, hospital visit and travel outside the prefecture in the prior 1–3 weeks were significant risk factors for measles virus infection. Occupation and reluctance to accept measles vaccination were significant risk factors for measles susceptibility. The calculated attributable fraction of measles cases from hospital visitation was 28.6% (95% CI: 20.6–38.8%).ConclusionsExposure to a healthcare facility was the largest risk factor for measles virus infection in adults in China. Improved adherence to hospital infection control practices could reduce risk of ongoing measles virus transmission and increase the likelihood of achieving and sustaining measles elimination in China. The use of control groups stratified by serological status identified distinct risk factors for measles virus infection and susceptibility among adults.     

Incidence and influencing factors of post-intensive care cognitive impairment

ObjectiveTo evaluate the incidence and risks factors of short-term post-intensive care (ICU) cognitive impairment.DesignProspective, observational study.SettingClosed university-affiliated intensive care unit.PatientsWe enrolled consecutive patients >18 yrs of age expected to be in intensive care unit for ≥24 hours.InterventionsNone.Measurements and main resultsThe score of Montreal Cognitive Assessment (MoCA) less than 26 was defined as cognitive impairment at hospital discharge and short-term post-ICU cognitive impairment was diagnosed in 185 of 409 assessed patients (45.2%). According to univariate analysis, age, years of education, occupation, past medical history, main ICU diagnosis, Acute Physiology and Chronic Evaluation Scoring System (APACHE II) score, Sequential Organ Failure Assessment (SOFA) score, Charlson comorbidity index, ICU length-of-stay (LOS), total hospital LOS, sedation, vasoactive agents, muscle relaxants, mechanical ventilation and duration of mechanical ventilation, constraints, early active mobilisation, hypoxemia, frequency and severity of delirium, blood pressure, rescue experience, and infection were significant predictors of post-ICU cognitive impairment. Multivariate analysis results showed that the frequency and severity of delirium, and advanced age were risk factors of post-ICU cognitive impairment; high years of education and early active mobilisation were protective factors.ConclusionsIncidence of post-ICU cognitive impairment is at a high level, which is similar to former researches’ results; the frequency and severity of delirium, and advanced age were risk factors of post-ICU cognitive impairment; high years of education and early active mobilisation were protective factors of post-ICU cognitive impairment.