杨浦区水痘疫情特征分析及病例疫苗接种史调查

目的 掌握杨浦区水痘疫情特征,用发病资料评价疫苗流行病学免疫效果.方法 对2003-2005年发病资料进行描述分析,同时对所有病例进行疫苗接种史回顾性调查.结果 3年平均年发病率21.13/10万,暴发疫情中小学生占96.91%;发病时间和地区分布有集中趋势,年龄分布5～14岁组,占66.33%,94.75%病例无疫苗接种史.结论 水痘疫情呈上升趋势,0～4岁幼年组和年龄较大的在校学生均是水痘易感人群,疫情常在中小学校和幼托机构集体性单位频繁发生;病例疫苗接种率低.提高接种率是控制水痘发病的有效手段,当前应扩大疫苗接种年龄范围.     

2005-2009年成都市青白江区水痘流行特征分析

目的了解成都市青白江区水痘的流行病学特征,为有效控制水痘提供依据。方法对青白江区2005-2009年疾病监测信息报告系统上报的水痘病例进行描述性流行病学分析。结果 2005-2009年青白江区共报告水痘病例215例,水痘年均发病率为10.98/10万,发病率由2005年的1.25/10万逐年上升到2009年的36.21/10万。全年各月均有发病,以5-7月和10-12月较多,此6个月占全年总病例数的87.44%。以14岁及以下儿童、学生病例居多,占80.93%。病例集中在该区的大弯和红阳街道办事处。结论青白江区水痘疫情较严重,应进一步加强有关方面的宣教工作,切实落实学校卫生工作相关措施,根据条件开展水痘疫苗接种工作,确保水痘疫情的有效控制。     

2014─2016年甘肃省庆阳市水痘流行特征分析

目的分析2014─2016年甘肃省庆阳市水痘流行病学特征,为制定水痘预防控制策略提供参考依据。方法利用EXCEL 2007和SPSS 17.0软件,分析2014─2016年庆阳市各医疗机构通过疾病监测信息报告管理系统上报的水痘病例数据。结果 2014─2016年庆阳市共报告水痘病例1 361例,死亡1例,年均发病率20.39/10万;发病率最高为庆城县(40.66/10万)、最低为正宁县(9.13/10万),差异有统计学意义(χ~2=138.05,P<0.05);每年的5─7月(46.66%)和11月至次年1月(29.46%)发病较多,3个年度平均月发病趋势无明显变化(Cox-stuart检验,P>0.05);男女发病性别比1.24∶1,差异无统计学意义(χ~2=21.44,P>0.05);15岁以下儿童发病最多(1 174例)、占病例总数的86.26%,发病率以6岁~组最高(217.01/10万),差异有统计学意义(χ~2=1 634.07,P<0.05);学生最多633例、占病例总数的46.51%。结论甘肃省庆阳市水痘发病存在地区差异,冬季和春夏之交高发、集中在15岁以下、男性多于女性,应加强水痘防控知识的宣传力度,提高水痘疫苗接种率,从而降低水痘发病。     

2014—2018年高台县水痘疫情流行特征分析

目的了解甘肃省高台县水痘发病情况和流行特征,为制定科学的防控措施提供依据。方法从中国疾病预防控制信息系统中,按发病日期导出2014—2018年高台县水痘疫情资料,采用描述流行病学方法分析数据。结果2014—2018年高台县水痘共报告发病453例,无死亡病例,年平均报告发病率为57.34/10万,发病率呈逐年上升趋势;9个镇均有发病,发病率城关镇最高(115.63/10万)、占发病总数的33.55%;全年各月均有发病,发病高峰5—6月、9月—次年1月,各月报告发病率差异有统计学意义(χ~2=143.335,P<0.05);发病主要集中在3～15岁(383例、占84.55%),男性发病率高于女性,男女性别比为1.29∶1;以托幼儿童(34.44%)和学生为主要发病人群(48.34%)。结论加强部门协调沟通,重点加强托幼机构和学校水痘疫情监测,提高疫情处置有效性,针对性地开展健康教育,提高水痘疫苗二剂接种率,是高台县减少水痘发病的主要措施。     

2011—2022年新疆克拉玛依市克拉玛依区水痘流行病学特征分析

目的 分析2011—2022年新疆克拉玛依市克拉玛依区水痘流行病学特征,为制定符合克拉玛依区的水痘防控策略提供依据。方法 采用描述流行病学方法,对2011—2022年克拉玛依区的水痘报告病例数据进行统计分析。结果2011—2022年累计报告水痘病例4 277例,年发病率为29.60/10万～233.49/10万,平均为124.87/10万;每年各月均有水痘病例报告,月报告最高病例数为159例,发病总体呈4—6月（1 004例、占23.47%）和10月—次年1月（2 165例、占50.62%）双峰分布;学生报告病例数最多2 356例、占55.09%,其次为托幼儿童654例、占15.29%。结论 克拉玛依市克拉玛依区水痘发病呈现逐年下降;建议加强学校水痘疫情监测,将水痘疫苗接种纳入免疫规划疫苗范畴,以预防水痘在学校、托幼机构等集体单位的传播流行。     

2011—2015年北京市儿童流行性感冒流行特征分析

目的 了解北京市儿童2011—2015年流行性感冒(流感)的流行特征和流感病毒优势株的变化,为儿童流感的防控提供参考.方法 利用北京市儿童医院2011—2015年监测到的流感样病例(influenza like illness,ILI)及流感病原学监测数据,分析流感流行趋势和流感病毒的构成情况.结果 在7331597例门、急诊病例中监测到ILI 638623例,ILI占门、急诊就诊病例的8.71％,0～岁组所占比例最高,为69.56％;采集门诊ILI咽拭子标本5351例,其中流感病毒核酸阳性515例.各年份优势毒株构成不同,夏季也出现了ILI就诊的高峰.结论 2011—2015年各年份流感流行高峰出现在冬春季,小于5岁儿童是主要易感人群,建议夏季就诊高峰对儿童ILI开展多病原检测,从而可采取有针对性的预防及治疗措施.     

庆阳市某高中一起水痘暴发疫情流行病学调查及危险因素分析

目的 分析甘肃省庆阳市某高中一起水痘暴发疫情的流行特征及其危险因素,为制定有效防控水痘措施提供依据。方法 开展病例主动搜索和现场流行病学调查,以描述流行病学分析病例分布特征和罹患率差异,采用1∶2匹配病例对照研究分析危险因素。结果 本次疫情共持续2个月,全校师生共909人,发现病例83例(13例突破病例)、总罹患率9.13%;临床症状主要以透明样疱疹、斑疹、丘疹、发热、食欲减退为主,皮疹主要分布在头颈部(占74.70%)、胸部(占69.88%)、背部(占69.88%);罹患率学生(9.76%)高于老师(3.37%),差异有统计学意义(χ²=3.945,P<0.05);罹患率女生(15.17%)高于男生(4.02%),差异有统计学意义(χ²=28.901,P<0.01);罹患率高一年级(30.65%)高于高二年级(1.60%),差异有统计学意义(χ²=77.894,P<0.01);不同班级罹患率差异有统计学意义(χ²=53.112,P<0.01),高一5班罹患率高于其他班级,有...     

2015-2019年绵阳市涪城区手足口病流行特征分析

目的了解2015-2019年绵阳市涪城区手足口病流行及病原特征,为手足口病防治措施提供科学依据。方法采用描述流行病学方法,结合实验室RT-PCR检测结果,对2015-2019年绵阳市涪城区手足口病疫情资料进行统计分析,率的比较采用χ²检验。结果2015-2019年共报告手足口病病例6702例,实验室诊断2706例,无暴发疫情和死亡病例报告,重症14例,报告发病率为242.98/10万,重症率0.21%,不同年度发病差异有统计学意义(χ²=531.46,P<0.001)。时间分布以4-7月为主,发病3119例(46.54%),10-12月次之,发病2120例(31.63%);1~4岁发病5581例(占83.27%),发病率为5670.65/10万,不同年龄组发病率差异有统计学意义(χ²=147426.94,P<0.001);散居儿童发病3994例(59.59%),幼托儿童发病2448例(36.53%)。男性发病3954例(59.00%),发病率为287.09/10万,女性发病2748例(41.00%),发病率为198.99/10万,男性发病率高于女性(χ²=220.80,P<0.001);城区发病4504例,发病率为223.38/10万,乡村发病2198例,发病率为296.26/10万,乡镇发病率高于城区(χ²=110.84,P<0.001)。结论绵阳市涪城区手足口病发病年龄以5岁以下为主,散居儿童发病明显多于托幼儿童,男童发病率高于女童,建议涪城区继续加强手足口病的预防与控制工作,重视手足口病疫苗的接种。     

Very High Incidence of Type 1 Diabetes Among Children Aged Under 15 Years in Tlemcen,Northwest Algeria (2015-2018)

Objective:In Algeria, there is a lack of epidemiological data concerning childhood type 1 diabetes (T1D). The International Diabetes Federation estimated in 2019 that Algeria ranked 7th among countries with the highest prevalence of T1D. This study aimed to determine the incidence of T1D in children <15 years, living in Tlemcen in Northwest Algeria.Methods:A retrospective study using data from children (<15 years) who have been diagnosed with T1D in Tlemcen between 2015 and 2018, using the two-source capture–recapture method to estimate the completeness of ascertainment (%). Total average incidences, by sex, by onset age group, and by season of onset were calculated per 100,000 and per year.Results:During the study period, 437 new cases of T1D were registered, among them, 233 boys and 204 girls, with a sex ratio of 1.14. The average annual incidence rate of childhood T1D was 38.5/100,000 with a 95% confidence interval (CI): 35.20-41.79; boys: 40.51, 95% CI: 38.16-42.85; girls: 36.49, 95% CI: 34.17-38.80. Overall incidence rates in 2015, 2016, 2017 and 2018 were respectively 36.6 (95% CI: 33.72-39.48), 38.7 (95% CI: 35.43-41.97), 39.3 (95% CI: 35.97-42.62) and 39.5 (95% CI: 36.12-42.87)/100,000. Newly diagnosed children were more likely to present in winter and autumn. Ketoacidosis at diagnosis was diagnosed in 29.2%.Conclusion:The mean incidence of childhood T1D in Tlemcen was 38.5/100,000, this incidence is in the “extremely high” category of the World Health Organization DiaMond project classification of diabetes giving this region a very high risk.     

2005-2018年通江县扩大国家免疫规划实施前后风疹流行特征

目的了解通江县含风疹成分疫苗纳入扩大国家免疫规划实施前后风疹疫情变化情况及流行特征。方法通过《传染病报告信息管理系统》导出2005-2018年通江县风疹疫情资料,使用Excel 2016软件按扩大国家免疫规划实施前(2005-2008年)和实施后(2009-2018年)进行数据统计,采用描述流行病学分析疫情资料。率的比较使用SPSS 23.0软件进行χ2检验,检验水准α=0.05。结果2005-2018年通江县风疹年均发病率为3.43/10万。扩大国家免疫规划实施后年均发病率从实施前的10.87/10万降至0.54/10万;报告发病的乡镇比例从实施前的53.06%降至40.80%,病例均为散发,且实施前有病例报告的乡镇在实施后年均发病率降幅达20.96%~100.00%;男性年均发病率从实施前的12.08/10万降至0.54/10万,女性从实施前的9.61/10万降至0.53/10万。规划实施前以5~14岁儿童、学生发病为主(93.15%和91.78%),共发生5起中小学校风疹突发公共卫生事件;而实施后以0~4岁儿童、散居儿童发病为主(59.46%和48.65%)。规划实施前后均以春季和夏初发病为主(97.26%和64.86%)。结论通江县实施扩大国家免疫规划10年,风疹发病取得明显的控制效果,应进一步扎实开展扩大国家免疫规划和入托入学儿童预防接种证查验。     

山东省克山病病区与非病区1～15岁人群的心电图比较

为观察克山病发病区无自觉症状人群与非病区无自觉症状人群的心电图改变，以推断克山病发病区无自觉症状人群的整体心脏健康状况，随机检查了山东省克山病发病区2049人和非病区1595名无自觉症状1－15岁人群的心电图异常情况，结果表明两组人群的异常心电图改变项目不尽相同，但总的异常心电图检出率无明显差异，说明山东省克山病发病区人群与非病区人群的心脏健康状况基本接的。     

Serum Levels of Anti-Hepatitis B Surface Antibody Among Vaccinated Population Aged 1 to 18 Years in Ahvaz City Southwest of Iran

Background:

The duration of protection following primary series vaccination against hepatitis B is unknown in children and adolescents. It has been shown that the level of anti-hepatitis B surface antigen antibodies (anti HBs Ab) declines over years after vaccination.

Objectives:

The aim of this study was to estimate the long-term immunity against hepatitis B virus infection among children and adolescents who had received a complete hepatitis B vaccination series during infancy.

Patients and Methods:

In a cross-sectional study, the - anti-HBsAb levels of 840 vaccinated children and adolescents were determined by enzyme-linked immunosorbent assay.

Results:

Hepatitis B seroprotection rates (anti HBsAb ≥ 10 IU/L) among vaccinated children and adolescents aged 1 and 18 years were 90% and 48.9%, respectively. The declining trend of geometric mean titer of anti-HBsAb levels was observed as changed from 272.3 IU/L to 94.1 IU/L in 1 and 18-year-old population, respectively. A significant negative correlation was found between age and anti-HBsAb levels (r = - 0.220, P = 0.0001).

Conclusions:

The results showed a declining trend in anti-HBsAb titers over the time after vaccination against hepatitis B virus in our region. Further studies are warranted to establish the need for a booster dose in cases that are at risk of hepatitis B virus infection.     

High Incidence of SARS-CoV-2 Variant of Concern Breakthrough Infections Despite Residual Humoral and Cellular Immunity Induced by BNT162b2 Vaccination in Healthcare Workers: A Long-Term Follow-Up Study in Belgium

To mitigate the massive COVID-19 burden caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), several vaccination campaigns were initiated. We performed a single-center observational trial to monitor the mid- (3 months) and long-term (10 months) adaptive immune response and to document breakthrough infections (BTI) in healthcare workers (n = 84) upon BNT162b2 vaccination in a real-world setting. Firstly, serology was determined through immunoassays. Secondly, antibody functionality was analyzed via in vitro binding inhibition and pseudovirus neutralization and circulating receptor-binding domain (RBD)-specific B cells were assessed. Moreover, the induction of SARS-CoV-2-specific T cells was investigated by an interferon-γ release assay combined with flowcytometric profiling of activated CD4⁺ and CD8⁺ T cells. Within individuals that did not experience BTI (n = 62), vaccine-induced humoral and cellular immune responses were not correlated. Interestingly, waning over time was more pronounced within humoral compared to cellular immunity. In particular, 45 of these 62 subjects no longer displayed functional neutralization against the delta variant of concern (VoC) at long-term follow-up. Noteworthily, we reported a high incidence of symptomatic BTI cases (17.11%) caused by alpha and delta VoCs, although vaccine-induced immunity was only slightly reduced compared to subjects without BTI at mid-term follow-up.     

Comparison of Clinicopathologic Characteristics and Genetic Alterations Between Microsatellite Instability-Positive and Microsatellite Instability-Negative Sporadic Colorectal Carcinomas in Patients Younger than 40 Years Old

PURPOSE: Many studies have demonstrated that sporadic microsatellite instability–positive colorectal cancers share several clinicopathologic features with hereditary nonpolyposis colorectal cancers, including right-sided location, young age of onset, characteristic histomorphologic features, and a good prognosis. The aim of this study was to define distinct clinicopathologic features of sporadic microsatellite instability–positive colorectal cancers and to compare genotypic characteristics between microsatellite instability–positive and microsatellite instability–negative colorectal cancers in a young group. METHODS: We analyzed 61 cases of young patients (<40 years old) with colorectal cancers for microsatellite instability at five mononucleotide and three dinucleotide repeats, loss of heterozygosity at APC and DCC, and K-ras and p53 mutations. Microsatellite instability status was correlated with molecular genetic factors and clinicopathologic parameters. RESULTS: Microsatellite instability positivity was detected in 19 (31.1 percent) of 61 cases. Allelic alterations in TGFRII, BAX, and IGFIIR were observed exclusively in microsatellite instability–positive tumors (63.1, 26.3, and 26.3 percent, respectively). Microsatellite instability–positive tumors exhibited a lower frequency of the p53 mutation (10.5 percent) than microsatellite instability–negative tumors (47.6 percent; P < 0.05). However, microsatellite instability status was not associated with APC or DCC allelic deletion or with the K-ras mutation. Microsatellite instability–positive colorectal cancers exhibited a proclivity toward proximal location, expansive growth pattern, and large tumor size (P < 0.05). Microsatellite instability–positive colorectal cancers had lower preoperative serum carcinoembryonic antigen levels (P < 0.05), a less advanced stage at presentation (P < 0.05), and a tendency toward better prognosis (P = 0.051) than microsatellite instability–negative colorectal cancers. However, there was no difference between microsatellite instability–positive and microsatellite instability–negative colorectal cancers regarding gross features, tumor grade, and extracellular mucin production. CONCLUSION: These results suggest that sporadic microsatellite instability–positive colorectal cancers in young patients have different histomorphologic features from microsatellite instability–negative colorectal cancers and hereditary nonpolyposis colorectal cancers, some overlap of genetic alterations on multistep carcinogenesis with microsatellite instability–negative colorectal cancers, and a tendency for better prognosis.     

2015-2019年天津市输入性恶性疟病例血检指标与疟原虫感染度关系研究

目的　分析2015–2019年天津市输入性恶性疟病例血检指标与疟原虫感染度间的关系,为输入性恶性疟早期诊断提供参考。方法　收集2015–2019年天津市确诊的37例输入性恶性疟病例流行病学个案信息,回顾性分析病例流行病学基本情况及临床表现,分析恶性疟病例血检指标与疟原虫感染度间的关联性。结果　37例输入性恶性疟病例中,31例（83.8%）血小板（PLT）、16例（43.2%）红细胞（RBC）、16例（43.2%）血红蛋白（Hb）降低,23例（62.2%）中性粒细胞百分比（NEUT%）、32例（86.5%）总胆红素（TBIL）、29例（78.4%）天门冬氨酸氨基转移酶（AST）、28例（75.7%）丙氨酸氨基转移酶（ALT）、23例（62.2%）γ?谷氨酰转肽酶（GGT）升高。输入性恶性疟病人PLT、Hb与恶性疟原虫感染程度呈负相关（Goodman?Kruskal γ = -0.568、-0.521,P均< 0.05）,TBIL、NEUT%与恶性疟原虫感染度呈正相关（Goodman?Kruskal γ = 0.496、0.610,P均< 0.05）,ALT、AST、GGT、RBC与恶性疟原虫感染度无统计学关联（Goodman?Kruskal γ = 0.370、0.497、0.314、-0.434,P均> 0.05）。结论　PLT、Hb、TBIL、NEUT%可作为输入性恶性疟早期辅助诊断指标, PLT与TBIL似可作为诊断重症输入性恶性疟的参考指标。     

Characteristics of newly diagnosed type 1 diabetes in paediatric and adult population from Reims University Hospital,France from 1997 to 2019

French health insurance data showed that the incidence of type 1 diabetes mellitus (T1DM) in children increased over the years to 2015. The objective of our study was to assess the evolution of the number of incident cases of paediatric and adult type 1 diabetes in our institution, and to describe their clinical presentation and its evolution. All patients with T1DM managed at diagnosis at Reims University Hospital between 1997 and 2019 were included. The clinical and biological data were extracted from the Champagne-Ardenne Diabetes Network database. Included were 847 patients with a median age of 10.3 years. Diagnosis was established in 71% of cases before 15 years, 7.4% after 35 years. The number of newly diagnosed cases was 3.6-times higher in 2019 compared to 1997. Ketoacidosis, the frequency of which decreased with age (P < 0.0001), revealed diabetes in a total of 32% of cases and in 46% of children under 5 years. It was more severe in children than in adults (P = 0.03), and its frequency increased over the study period. Hypotrophy was found in 23% of children under 15 years of age, and was more pronounced before 5 years of age, with no improvement over time. We saw an increase in the frequency of obesity or overweight among adults. Our study showed an increase in incident cases of diabetes in our hospital that continued over time for both children and adults. Clinical features at diagnosis deteriorated during this period for those under 15 years of age with an increase in ketoacidosis frequency.