Polymorphism distribution of prion protein codon 117, 129 and 171 in Taiwan

Prion diseases compass transmissible spongiform neurodegenerative diseases from various causes, including the genetic and infectious ones. We investigated the prevalence of codon 117, 129 and 171 polymorphism in prion protein (PrP) in Taiwanese, mainly for the sake of the informative absence of this genetic distribution. Our subjects were 419 aged ones of Han ethic origin. We evaluated the PrP gene (PRNP) polymorphism by restriction fragment length polymorphism, after amplification of their genomic DNAs by polymerase chain reactions with specific primers, digested by restriction enzyme PvuII (for codon 117), NspI (for codon 129), and BbvI (for codon 171), respectively, and confirmed by nucleotide sequencing. All of the subjects were homozygotes at codon 117 (Ala/Ala, gca/gca) and 171 (Asn/Asn, aac/aac). There were no valine homozygotes (Val/Val) in our 419 subjects, and nine subjects (2.1%) showed methionine–valine heterozygosity (Mal/Val, atg/gtg). The methionine homozygotes (Met/Met) comprised the major population (97.9%), and the prevalence of distribution is different to that seen in Caucasians. The almost 100% conservation of the domain from codon 117 to 171 implies the warranty of PrP in cellular functions. The high prevalence of Met/Met alleles in Taiwan did not imply an increased risk of CJD, and the genetic susceptibility of CJD by codon 129 of PrP may be still elusive for the infectivity. K C Wang and V Wang have the same contribution to this work.     

合肥市传染病医院住院传染病病人疾病谱分析

目的 了解合肥市传染病医院7年来收治的传染病病人疾病谱的变化及趋势.方法 采用描述性流行病学的方法,对合肥市传染病医院2004-2010年传染病病案资料按疾病的构成、病种、主要传播途径、年龄等因素进行分析.结果 2004-2010年收治的传染病以乙类和丙类为主;疾病构成比呈波动性,主要受乙型肝炎、麻疹、甲型H1N1流感等收治病例影响.结论 卫生防疫机构及相关部门应将工作重点放在血源及性传播传染病上,同时加强呼吸道和肠道传染病的防治.     

Infectious diseases before and after German unification: trends in mortality and morbidity

After the fall of the Berlin Wall in 1989 the former communist countries of central and eastern Europe underwent substantial social and economic changes that had a major impact on health. The situation of the former German Democratic Republic was unique in that its existing institutions were replaced rapidly and it was quickly integrated economically with the West. This study describes recent trends in morbidity and mortality from infectious diseases in East and West Germany before and after unification using routine data from 1980 onwards. Substantial differences in morbidity and mortality resulting from infectious diseases were observed between East and West Germany. These seem to be the complex result of societal and health system differences in both parts of Germany before unification, differing population dynamics and health behaviours, and an increasing westernisation in the eastern part of Germany during recent years.     

Infectious diseases consult improves vaccination adherence in kidney transplant candidates

BackgroundVaccines prevent infections and avoid related complications. Low rates in immunocompromised patients are concerning due to increased morbidity. Vaccinations are less effective when administered post-transplant and should be administered prior. We describe pre-transplant vaccination rates among kidney or kidney-pancreas transplant recipients.MethodsRetrospective review including adults receiving kidney or kidney-pancreas allografts at Cleveland Clinic from October 2013 to October 2016. Pre-transplant vaccinations, serologies, and transplant data were collected.Results393 patients were included; median age was 53 years with most (46%) being Caucasian males. Influenza vaccination rate was 48%; receipt of at least one pneumococcal vaccine was 77%. Vaccination rates were higher among dialysis patients for pneumococcal, hepatitis B, and varicella vaccines; rates were also higher with infectious diseases consults.ConclusionsVaccination rates at our institution for kidney or kidney-pancreas transplant candidates are consistent with previous literature. Rates were higher for candidates with infectious diseases consults or receiving dialysis.     

Creutzfeldt-Jakob disease among libyan jews

The focus of CJD among Jews of Libyan origin has been recognized for two decades, but the reasons underlying it were unknown. Prevailing views suggested transmission from sheep infected with scrapie. However, recent data show that in fact CJD in this ethnic group is a genetically determined disease due to a point mutation on the codon 200 of the prion protein gene. The clinical characteristics of CJD in this group, and particularly the less common periodic activity in the EEG, are reviewed. New findings include peripheral neuropathy of the demyelinating type in two cases, presumably due to involvement of Schwann cells. The pathophysiology of the disease includes, presumably, a focal post-translational modification of the prion protein, (predisposed by the mutation). Later, the disease progresses through cell-to-cell transmission.     

2006-2010年扬州市邗江区传染病疫情资料分析

[目的]了解扬州市邗江区法定传染病的疫情动态与流行特征,为制定和完善传染病防治策略与措施提供科学依据。[方法]对邗江区2006～2010年法定传染病疫情资料进行分析。[结果]2006～2010年,全区累计报告法定传染病22种、8652例,年均发病率为358．44／10万,死亡6例,平均病死率为0．07％。其中,乙类传染病15种、5061例,丙类传染病7种、3591例。2006～2010年年均发病率（／10万）分别为272．39、295．65、342．53、472．03、425．30。年均发病率（／10万）,肺结核为76．89,梅毒为53．03,病毒性肝炎为41．97,痢疾为13．34,淋病为9．65,甲型HINI流感为6．26,麻疹为5．43,手足口病为109．91;城镇为604．94,农村为320．15;0～14岁为947．19,15～34岁为194．77,35～54岁为235．46,≥55岁为365．86;男性为428．01,女性为278．08。[结论]2006～2010年邗江区传染病发病率呈上升趋势,肺结核、梅毒、病毒性肝炎、淋病、手足口病是预防控制的重点传染病。     

Human prion disease and relative risk associated with chronic wasting disease

The transmission of the prion disease bovine spongiform encephalopathy (BSE) to humans raises concern about chronic wasting disease (CWD), a prion disease of deer and elk. In 7 Colorado counties with high CWD prevalence, 75% of state hunting licenses are issued locally, which suggests that residents consume most regionally harvested game. We used Colorado death certificate data from 1979 through 2001 to evaluate rates of death from the human prion disease Creutzfeldt-Jakob disease (CJD). The relative risk (RR) of CJD for CWD-endemic county residents was not significantly increased (RR 0.81, 95% confidence interval [CI] 0.40-1.63), and the rate of CJD did not increase over time (5-year RR 0.92, 95% CI 0.73-1.16). In Colorado, human prion disease resulting from CWD exposure is rare or nonexistent. However, given uncertainties about the incubation period, exposure, and clinical presentation, the possibility that the CWD agent might cause human disease cannot be eliminated.     

鹰潭市1957-2009年甲乙丙类传染病流行趋势分析

目的掌握鹰潭市自成立防疫机构以来法定甲乙丙类传染病的流行趋势,为制定传染病防控策略与措施提供科学依据。方法采用描述流行病学和COX-Stuart趋势检验方法进行资料分析。结果年均发病率、死亡率和病死率1957-2009年总体都呈下降趋势(均n=26,P<0.01),且近10年比50年代均下降85%以上,但2000年后又有所上升。呼吸道传染病年均发病率1997年后13年明显呈上升趋势(n=6,P>0.25),血源及性传染病年均发病率近20年总体呈上升趋势(n=10,P>0.25)。构成比分析:20世纪50~80年代呼吸道传染病最高>63.36%,90年代代之肠道传染病最高63.74%,近10年以肠道(36.65%)和呼吸道(34.94%)传染病为主,血源及性传染病已升至27.79%。发病谱分析:在前10位不重名的20个病种中,有65%的病种随年代顺位变迁处于下降及趋于下降趋势。结论鹰潭市甲乙丙类传染病53年总体呈下降趋势,但呼吸道和血源及性传染病近些年来呈上升趋势,它应是鹰潭市现阶段传染病防控工作的重点。     

2004～2009年吕梁市离石区传染病疫情资料分析

[目的]了解吕梁市离石区2004～2009年法定传染病疫情动态及流行特征,为制定和完善传染病防治策略与措施提供科学依据。[方法]对吕梁市离石区2004～2009年《疾病监测信息报告管理系统》中法定传染病报告资料进行分析。[结果]2004～2009年,全区累积报告法定传染病19种4 636例,年均发病率为308.18/10万,死亡5例(乙类传染病),死亡率为0.33/10万,病死率为0.29%。其中,乙类传染病15种4 122例,丙类传染病4种514例。各年发病率(/10万)分别为119.52、301.16、306.44、306.58、388.62、419.28。年均发病率(/10万),肺结核为111.88,乙型肝炎为73.99,淋病为9.44,梅毒为22.40,痢疾为19.01,麻疹为17.82;城镇为316.34,农村为297.90(P<0.05);0～14岁为185.41,15～34岁为346.41,35～54岁为382.95,55～64岁为188.78,≥65岁为221.27(P<0.01)。[结论]2004～2009年吕梁市离石区传染病发病率呈上升趋势,肺结核、乙肝、淋病、梅毒、痢疾为今后预防控制的重点。     

2006～2010年扬州市邗江区传染病疫情资料分析

[目的]了解扬州市邗江区法定传染病的疫情动态与流行特征,为制定和完善传染病防治策略与措施提供科学依据。[方法]对邗江区2006～2010年法定传染病疫情资料进行分析。[结果]2006～2010年,全区累计报告法定传染病22种、8652例,年均发病率为358.44/10万,死亡6例,平均病死率为0.07%。其中,乙类传染病15种、5061例,丙类传染病7种、3591例。2006～2010年年均发病率(/10万)分别为272.39、295.65、342.53、472.03、425.30。年均发病率(/10万),肺结核为76.89,梅毒为53.03,病毒性肝炎为41.97,痢疾为13.34,淋病为9.65,甲型H1N1流感为6.26,麻疹为5.43,手足口病为109.91;城镇为604.94,农村为320.15;0～14岁为947.19,15～34岁为194.77,35～54岁为235.46,≥55岁为365.86;男性为428.01,女性为278.08。[结论]2006～2010年邗江区传染病发病率呈上升趋势,肺结核、梅毒、病毒性肝炎、淋病、手足口病是预防控制的重点传染病。     

2007～2009年民和县法定传染病疫情资料分析

[目的]了解传染病发病情况,为制订预防控制措施提供参考依据。[方法]对2007～2009年民和县法定传染病疫情资料进行分析。[结果]2007～2009年累计报告18种4 253例传染病,年均发病率为361.72/10万;死亡10例,年均死亡率为0.77/10万,平均病死率为0.24%。年发病率,2007年为337.39/10万,2008年为359.23/10万,2009年为382.39/10万。年均发病率,血液及性传播传染病为181.62/10万,肠道传染病为72.19/10万,呼吸道传染病为106.88/10万,自然疫源及虫媒传染病为0.42/10万,其他传染病为0.51/10万;0～14岁为298.01/10万,15～24岁为275.10/10万,25～44岁为341.72/10万,45～64岁为560.43/10万,≥65岁为527.84/10万;城区为477.45/10万,农村为339.62/10万。3年累计,发病例数最多的传染病是乙型肝炎(1 980例)、肺结核(949例)、其他感染性腹泻病(344例)、痢疾(204)、甲型肝炎(162例)。[结论]2007～2009年民和县法定传染病发病率处于较高...     

深圳市宝安区1994～2004年法定传染病流行病学特征分析

目的探索深圳市宝安区主要法定报告传染病的流行趋势和流行病学特征,为制定法定传染病的防治策略和措施提供科学依据。方法采用描述性研究的方法对深圳市宝安区1994-2004年主要法定传染病的资料进行系统的统计分析。结果1994-2004年深圳市宝安区法定报告传染病发病率总体呈下降趋势,而死亡率呈先上升后下降的趋势,其中淋病、肺结核、肝炎、梅毒和痢疾的发病率较高。血源及性传播疾病的发病率最高,其他传染病（主要包括自然疫源性疾病及虫媒传播疾病）的发病率较低。结论1994-2004年深圳市宝安区法定报告传染病发病率总体呈逐年下降趋势,死亡率有所下降。目前防制的重点传染病为淋病、肺结核、病毒性肝炎、梅毒和痢疾。     

茂名市1950～1999年法定报告传染病流行动态分析

目的 探索茂名市传染病的发病趋势。方法 采用描述流行病学方法分析茂名市１９５０～１９９９年法定报告传染病的流行及发病趋势。结果 除鼠疫、黑热病外,其余法定传染病都有发生,年均发病率由５０年代的１９９６．０９／十万降低至９０年代的９４．５６／十万,死亡率由５０年代的８．１７／十万降至９０年代的０．６０／十万;５０年代以虫媒传染病（１３１９．９１／十万）为优势病种,６０～８０年代以呼吸道传染病（８６４．００／十万～４４２７．８８／十万）为优势病种,９０年代以肠道传染病（３５．２７／十万）为优势病种;居各年代首位的传染病为：５０年代疟疾,６０年代麻疹,７０～８０年代流感,９０年代肝炎;计免相关病种发病率下降明显,如麻疹由５０年代的４０９．９９／十万降至９０年代的５．１３／十万,脊灰从１９９４年起无病例报告,疟疾由５０年代的１３１９．７１／十万降至９０年代的４．３５／十万,肝炎发病率下降幅度不大;９０年代,肺结核、淋病和梅毒的发病率逐年上升,同时出现艾滋病新病种。结论 茂名市传染病发病总趋势是下降的。在继续抓好计划免疫的同时,应把肠道传染病、血源及性传播传染病作为今后防治重点。     

2009年聊城市法定传染病及重点传染病疫情分析

[目的]了解聊城市2009年法定传染病及重点传染病流行特征及其防治效果,为传染病的预防和控制提供科学依据。[方法]对聊城市2009年网络直报的传染病疫情资料进行分析。[结果]2009年法定传染病发病率为441.75/10万,死亡率为0.38/10万。发病率比2008年上升了90.56%。其中手足口病、病毒性肝炎,占法定传染病总发病数的75.23%。[结论]在今后的传染病的预防和控制中,手足口病、甲型流感、病毒性肝炎的防治是重点。     

2008年四川省甲乙类传染病流行病学分析

目的掌握四川省传染病发病动态,为制定防治措施和策略提供科学依据。方法利用《疾病监测信息报告管理系统》监测数据,收集、整理、分析资料,主要从三间分布探讨2008年法定传染病的流行病学特征,提示四川省传染病防控重点。结果2008年四川省无甲类传染病报告,共报告乙类传染病20种195935例,死亡794人;年报告发病率241.09/10万,死亡率0.98/10万,病死率0.41%。报告发病（发现）数居前5位的病种依次是：肺结核、乙肝、痢疾、梅毒、淋病,占总发病数的90.44%。报告发病率居前5位的地区依次是：阿坝州、攀枝花市、凉山州、遂宁市、甘孜州。全年传染病报告发病波动幅度小,以1月和3～7月较集中,其他月份略低。男女报告发病率性别比为1.79∶1,死亡率性别比为2.99∶1;乙类急性传染病报告发病率较高的年龄段为0～5岁、85岁及以上年龄组;职业以农民、学生、散居儿童、工人、家务及待业为主,其合计占发病总数的77.49%。结论传染病报告总发病率是自2004年网报工作开展以来首次较大幅度回落,发病率、死亡率、病死率均呈下降态势。四川省传染病防控工作主要以霍乱、艾滋病、血吸虫病、肺结核、乙肝等传染病为主;地区防控重点关注凉山州、成都市、南充市等;主要防控季节为春夏季;人群分布性别以男性为主,主要传染病为肺结核、乙肝等;年龄以0～5岁、85岁及以上组人群为主,0～5岁组主要疾病为痢疾、麻疹等,85岁及以上组人群主要疾病为痢疾、梅毒等;职业分布重点关注农民、学生和儿童,农民主要疾病为肺结核、乙肝;学生和儿童主要疾病为呼吸道传染病和肠道传染病。     

医院应建立健全传染病监测报告系统

目的提高法定传染病报告率和报告卡填写完好率. 方法完善各项规章制度和工作流程,严格法定传染病三级报告责任人追究制度;应用"军队医院信息管理系统" 提高传染病疫情报告的实效性和准确性;强化医务人员培训,专人负责传染病报告卡的收集、核查、上报工作,将传染病疫情报告纳入科室医疗质量管理范畴. 结果医院法定传染病报告率97.3%,传染病登记及报告卡填写完整率100%. 结论医院应建立健全传染病监测报告系统,依法实行传染病报告管理,提高法定传染病报告质量.     

Infectious diseases in primary care; managing the interface between the person and the community

Respiratory infections are still among the most common new diagnoses in primary care. The most frequent reason for encounter is acute cough. General practitioners have to make antibiotic prescribing decisions in a context of diagnostic uncertainty, patient preferences and antimicrobial resistance. There is a causal link between antimicrobial resistance and antibiotic prescribing in primary care. GRACE observational studies (www.grace-lrti.org), show that variation in clinical presentation does not explain the considerable variation in antibiotic prescribing in Europe for adults presenting in primary care with acute cough and that recovery is similar between those treated with any antibiotic, a particular antibiotic class, or no antibiotic. A GRACE randomized controlled trial (RCT) of the effect of antibiotics for acute cough has recruited more patients than all RCTs combined in the current Cochrane Review and will have the power to identify subgroups of patients who will (not) benefit from amoxicillin. Another multi-country GRACE RCT assessing the effect on antibiotic prescribing of largely web-based versions of successful interventions including a C-reactive protein point-of-care test, a communication skill training and an interactive patient booklet is awaited. Given potential long-term cost-effectiveness, the GRACE suite of observational and interventional studies are enhancing the evidence base for reducing diagnostic uncertainty and managing patient expectations in a patient-centred way to achieve greater evidence-based antibiotic prescribing that is likely to help containing antimicrobial resistance.     

2008年汶川大地震前后绵阳市涪城区甲乙类传染病疫情分析

[目的]掌握绵阳市涪城区地震前后法定传染病的流行特征,为政府和有关部门制定传染病预防控制措施提供参考依据。[方法]对涪城区地震前(2005～2007年)、地震后(2008～2010年)法定报告甲、乙类传染病疫情资料进行分析。[结果]2005～2010年涪城区累计报告甲、乙类法定传染病15种、13 518例,死亡15例,年均发病率为343.39/10万,病死率为0.11%。其中,地震前报告14种8 367例,死亡6例,年均发病率为430.55/10万;地震后累计报告13种5 151例,死亡9例,年均发病率为258.41/10万。呼吸道传染病年均发病率为135.93/10万,地震前为160.55/10万,地震后为111.92/10万(P<0.01);消化道传染病年均发病率为23.95/10万,地震前为25.88/10万,地震后为22.07/10万(P<0.01);虫媒及自然疫源传染病年均发病率为1.73/10万,地震前为2.83/10万,地震后为0.65/10万(P<0.01);血液及性传播传染病年均发病率为177.18/10万,地震前为235.06/10万,地震后为120.75/10万(P<0.01)。城区、农...     

Familial Creutzfeldt-Jakob disease in Finland: Epidemiological,clinical, pathological and molecular genetic studies

In 1974–1984 30 patients died with a diagnosis of Creutzfeldt-Jakob disease (CJD) in Finland (annual mortality rate of CJD 0.9 per million population for the years 1979–1984). Six of these patients (20%) were familial, all belonging to the same kindred. The pedigree now includes 15 affected members in four generations, and the occurrence of disease is consistent with an autosomal dominant mode of inheritance. The clinical features of CID in this family are in most respects typical of the familial disease described elsewhere. However, the mean age at onset is 47, periodic EEG activity has not been observed, and the mean duration of illness of 27.5 months is longer than usual for either familial or sporadic CJD. Neuropathological examination of brain biopsy and autopsy specimens revealed spongiform change without amyloid plaques, and brain tissue from one patient transmitted disease to a capuchin monkey. In an analysis of the histocompatibility antigens of the family, CJD was not linked with a single haplotype, but at least 12 out of 13 CJD patients shared the HLA antigen A28. Molecular genetic studies disclosed a new G-to-A mutation in codon 178 of the PRNP gene (resulting in a substitution of asparagine for aspartic acid) in the DNA of eight family members with CJD but not in any of ten currently healthy first degree relatives of the patients, or 86 controls. The codon 178 mutation thus seems to co-segregate with CJD in this family. Linkage analysis gave a LOD score value of 3.6.