北京市一起新型冠状病毒Omicron变异株聚集性疫情特征分析

目的 分析北京市海淀区一起新型冠状病毒肺炎聚集性疫情流行病学特征及传播链。方法 采用描述性流行病学方法分析疫情流行病学特征,应用现场调查和大数据技术分析传播链。结果 2022年4月27日至5月13日, 海淀区发生一起新型冠状病毒肺炎聚集性疫情,全基因组测序系Omicron变异株（BA.2.2进化分支）;涉及感染者38例,确诊病例34例,无症状感染者4例;临床分型以轻型（88.2%）为主,无重型、危重型和死亡病例;早期临床症状以咽部不适（50.0%）、咳嗽（29.4%）为主;17 d内传播7代,涉及3起社区聚集、2起单位聚集和8个家庭内传播;暴露方式以同住（47.6%）、同时空暴露（31.6%）为主;代间距M（Q₁,Q₃）为3（1,6）d;总续发率为1.5%（37/2 482）,其中家庭续发率为36.7%（18/49）。结论 本起Omicron变异株疫情临床症状轻,家庭、社区聚集性明显,疫情传播速度较快,同时空暴露感染风险较高,需利用信息化技术全面摸排密切接触者,以快制快,有效阻断疫情传播。     

北京市青少年乙型肝炎疫苗免疫效果观察

目的 评价青少年接种乙型肝炎(乙肝)疫苗后的流行病学效果。方法 收集接种人群历年的接种报告、现场调查该人群的乙肝血清学流行率以及疫苗接种情况,分析接种疫苗前、后历年来乙肝发病的疫情报告,采用放射免疫分析法测定乙肝表面抗原(HBsAg)、抗-HBs和抗-HBc,并与接种前期的检测结果进行比较。结果 青少年接种乙肝疫苗后,其乙肝发病率由接种前期的12.11/10万～16.89/10万降至1.78/10万～10.95/10万(X~2=10.71～60.45,P<0.01),HBsAg携带率由6.34％降至1.37％,下降约80.00％(X~2=14.16,P<0.01)。结论 青少年接种乙肝疫苗是预防和控制乙肝感染的有效手段。     

Molecular epidemiology of norovirus associated with gastroenteritis and emergence of norovirus GII.4 variant 2012 in Japanese pediatric patients

In late 2012, an outbreak of acute gastroenteritis due to norovirus variant Sydney_2012 occurred and have been reported from many counties. In this study, we described surveillance study of the incidence of norovirus infections among Japanese pediatric patients in association with gastroenteritis and investigated the antigenic change of the new variant Sydney_2012 circulated in Japanese populations. A total of 2381 fecal specimens collected from children with acute gastroenteritis in Hokkaido, Tokyo, Shizuoka, Kyoto, Osaka, and Saga from 2009 to 2013 were examined for norovirus and further analyzed molecularly. A high proportion (39.3%) of norovirus positive samples and several genotypes were detected. Norovirus GII.4 dominated over other genotypes (71.4%). The Den_Haag_2006b (43.2%) was detected as the predominant variant and co-circulated with New_Orleans_2009 (17.8%) until March 2012. Subsequently, they were displaced by Sydney_2012. The Sydney_2012 variant has been responsible for the majority of norovirus infections in 2012–2013 (85.7%). Although Sydney_2012 variant has a common ancestor with New_Orleans_2009 variant, analysis of P2 sub-domain showed a high level of diversity in comparison with other variants in four amino acid changes at the antigenic sites. The change in particular residue 393 of new variant may affect HBGA recognition. Analysis of noroviruses circulating in the past 4 years revealed a change of predominant variant of norovirus GII.4 in each epidemic season. The change of amino acid in putative epitopes may have led the virus escape from the existing herd immunity and explain the increase of new variant outbreaks.     

A systematic review of air pollution as a risk factor for cardiovascular disease in South Asia: Limited evidence from India and Pakistan

Cardiovascular diseases (CVD) are major contributors to mortality and morbidity in South Asia. Chronic exposure to air pollution is an important risk factor for cardiovascular diseases, although the majority of studies to date have been conducted in developed countries. Both indoor and outdoor air pollution are growing problems in developing countries in South Asia yet the impact on rising rates of CVD in these regions has largely been ignored. We aimed to assess the evidence available regarding air pollution effects on CVD and CVD risk factors in lower income countries in South Asia. A literature search was conducted in PubMed and Web of Science. Our inclusion criteria included peer-reviewed, original, empirical articles published in English between the years 1990 and 2012, conducted in the World Bank South Asia region (Afghanistan, Bangladesh, Bhutan, India, Maldives, Nepal, Pakistan and Sri Lanka). This resulted in 30 articles. Nine articles met our inclusion criteria and were assessed for this systematic review. Most of the studies were cross-sectional and examined measured particulate matter effects on CVD outcomes and indicators. We observed a bias as nearly all of the studies were from India. Hypertension and CVD deaths were positively associated with higher particulate matter levels. Biomarkers of oxidative stress such as increased levels of P-selection expressing platelets, depleted superoxide dismutase and reactive oxygen species generation as well as elevated levels of inflammatory-related C-reactive protein, interleukin-6 and interleukin-8 were also positively associated with biomass use or elevated particulate matter levels. An important outcome of this investigation was the evidence suggesting important air pollution effects regarding CVD risk in South Asia. However, too few studies have been conducted. There is as an urgent need for longer term investigations using robust measures of air pollution with different population groups that include a wider range of air pollutants and outcomes, including early indicators of CVD. These regions are facing burdens from increasing urbanization, air pollution and populations, generally weaker health infrastructure, aging populations and increased incidence of non-communicable diseases, included CVD. The extent to which the problem of air pollution and CVD will impact these countries will depend largely on the information available to inform policy and programs, which are still lacking, political will as well as social and economic development.     

2012年北京市大兴区法定传染病监测情况

目的通过了解北京市大兴区2012年法定传染病发生情况及流行特征,为制定防制对策和措施提供科学依据。方法采用描述流行病学方法对大兴区2012年法定传染病疫情监测资料进行统计分析。结果大兴区2012年共报告法定传染病20种7 690例,报告发病率为544.12/10万,较2011年上升9%;死亡12例,死亡率0.85/10万,比2011年下降27.56%。报告发病数居前5位的病种依次为手足口病、其他感染性腹泻、肺结核、痢疾、猩红热。结论对重点疾病、重点地区和重点人群进行干预,可减少传染病的危害,保障人民群众身体健康。     

我国不同地区猫和犬饲养及猫栉首蚤感染调查

目的了解我国部分地区猫、犬的饲养及其猫栉首蚤感染情况,为猫栉首蚤及其相关传染病的预防控制提供依据。方法采用入户调查法,在北京市、青岛市和云南省部分农村及城乡结合部调查猫、犬的养殖情况;用体表蚤、游离蚤、蚤卵调查和回顾调查等方法,调查家猫、流浪猫和家犬的猫栉首蚤感染率;用蚤卵调查法研究北京地区猫栉首蚤的季节发生规律。结果 (1)北京市郊区,64.52%～83.87%的农户养犬,平均0.84～1.87只/户,其中69.2%～86.8%的犬为散养;2.94%～6.45%的农户养猫,为散养。青岛市平度农村40.43%的农户养犬,平均0.50只/户,>36.5%的犬为散养。(2)北京市郊区和青岛市农村的猫,猫栉首蚤感染率为100%;而犬的蚤感染率仅为3.85%～19.15%,为人蚤和猫栉首蚤。(3)在北京市郊区,冬季猫栉首蚤产卵量依然较大。结论在我国农村和城乡结合部,家犬的养殖量较大,家猫的饲养很少,猫主要以流浪猫形式存在。流浪猫的猫栉首蚤发生普遍,且全年发生;应加强流浪猫的管理,关注猫栉首蚤及其相关人兽共患传染病的预防控制。     

手足口病患者不同标本肠道病毒检出率比较

实际工作中发现采集手足口病(HFMD)患儿的咽拭子、疱疹液等标本进行肠道病毒检测,结果存在不一致的现象,且患儿家长对咽拭子采集的依从率要远高于疱疹液采集,故有必要对两种标本采集方法进行比较,以指导实际工作.     

不同种类和剂量乙型肝炎疫苗成年人快速免疫效果观察

目的 探讨不同种类和剂量乙型肝炎（乙肝）疫苗（HepB）在成年人中的快速免疫效果。方法 在北京市朝阳区筛选≥ 20周岁、乙肝5项指标检测为阴性或单独核心抗体阳性者为接种对象,以社区为单位分成4组,按"0-1-2"免疫方案分别接种10、20 μg酒酿酵母乙肝疫苗（HepB-SCY）、20 μg中国仓鼠卵巢乙肝疫苗（HepB-CHO）、10 μg汉逊酵母乙肝疫苗（HepB-HPY）。全程接种1~2个月后采用化学发光法定量检测抗-HBs水平。结果 共有1 772名符合条件的研究对象完成疫苗接种和效果观察。平均年龄48.50岁,女性占62.75%。10、20 μg HepB-SCY组,20 μg HepB-CHO组和10 μg HepB-HPY组的抗-HBs阳转率和几何平均滴度（GMT）分别为79.49%、84.34%、82.50%、74.15%（P=0.005）和39.53、62.37、48.18、33.64 mIU/ml（P=0.025）;总体抗-HBs阳转率和GMT分别为79.01%和41.18 mIU/ml。4组研究对象抗-HBs水平均随年龄增长均呈下降趋势,组间抗-HBs的GMT的差异随年龄增大而缩小。logistic回归分析显示,控制了"是否单独核心抗体阳性"和"乙肝疫苗接种史"2个变量后,"接种疫苗种类和剂量"、"年龄"、"是否吸烟"均与抗-HBs有统计学关联。结论 "0-1-2"快速免疫方案中采用20 μg剂量仍能在中高年龄组人群中获得80%以上的阳转率,可作为"0-1-6"乙肝疫苗常规免疫程序的补充。