The 2015–2016 influenza epidemic in Beijing,China: Unlike elsewhere,circulation of influenza A(H3N2) with moderate vaccine effectiveness

BackgroundWhile the 2015–2016 influenza season in the northern hemisphere was dominated by A(H1N1)pdm09 and B/Victoria viruses, in Beijing, China, there was also significant circulation of influenza A(H3N2) virus. In this report we estimate vaccine effectiveness (VE) against influenza A(H3N2) and other circulating viruses, and describe further characteristics of the 2015–2016 influenza season in Beijing.MethodsWe estimated VE of the 2015–2016 trivalent inactivated vaccine (TIV) against laboratory-confirmed influenza virus infection using the test-negative study design. The effect of prior vaccination on current VE was also examined.ResultsOf 11,000 eligible patients included in the study, 2969 (27.0%) were influenza positive. Vaccination coverage was 4.2% in both cases and controls. Adjusted VE against all influenza was 8% (95% CI: −16% to 27%): 18% (95% CI: −38% to 52%) for influenza A(H1N1)pdm09, 54% (95% CI: 16% to 74%) for influenza A(H3N2), and −8% (95% CI: −40% to 18%) for influenza B/Victoria. The overall VE for receipt of 2015–2016 vaccination only, 2014–2015 vaccination only, and vaccinations in both seasons was −15% (95% CI: −63% to 19%), −25% (95% CI: −78% to 13%), and 18% (95% CI: −11% to 40%), respectively.ConclusionsOverall the 2015–2016 TIV was protective against influenza infection in Beijing, with higher VE against the A(H3N2) viruses compared to A(H1N1)pdm09 and B viruses.     

Cost-effectiveness analysis of pertussis vaccination during pregnancy in Japan

BackgroundBoth re-emergence of pertussis outbreak among adolescents/adults and recent approval of the extended use of DTaP vaccine for boosting adolescents/adults against pertussis in Japan, have raised the possibility of using aP-containing vaccine in pregnant women to protect neonates and unvaccinated infants. There is a need, therefore, to evaluate the value for money of such possibility.MethodsWe evaluated the cost-effectiveness of conducting antepartum maternal vaccination (AMV) strategy in Japan. Considering the duration of vaccine effectiveness for infant (single year) and for mother (multiple years), the decision tree model and Markov model was adapted for infant and mother, respectively. Incremental cost-effectiveness ratio (ICER) compared with current no AMV strategy from societal perspective were calculated. The transition probabilities, utility weights to estimate quality-adjusted life year (QALY), and disease treatment costs were either calculated or extracted from literature. Costs per vaccination was assumed at ¥6000/US$54.5. Markov model for mothers with one-year cycle runs up to year four after vaccination, based on the waning of vaccine effectiveness. Infant who survived from pertussis was assumed to live until to his/her life expectancy.ResultsAMV strategy reduces disease treatment costs, while the reduction cannot offset the vaccination cost. Incremental QALYs were at 0.0002802, among them 79.5% were from infants, and others from mothers. ICER was ¥9,149,317/US$83,176 per QALY gained. One-way sensitivity analyses identified that the incidence rate and costs per shot were the two main key variables to impact the ICER.ConclusionWe found that vaccinating pregnant women with aP-containing vaccine to prevent neonatal and unvaccinated infants from pertussis-associated disease in Japan can be cost-effective from societal perspective, under the WHO-suggested “cost-effective” criteria (1 to 3 times of GDP). Pertussis is expected be designated as a notifiable disease in 2018, re-analysis should be conducted when straightforward incidence data is available.     

2017年7月全国突发公共卫生事件及需关注的传染病风险评估

目的 评估2017年7月国内外突发公共卫生事件及需要关注传染病的风险。方法 根据国内外突发公共卫生事件报告及重点传染病监测等各种资料和部门通报信息,采用专家会商法,并通过视频会议形式邀请省（直辖市、自治区）疾病预防控制中心专家参与评估。结果 根据既往监测数据,预计7月全国总体的突发公共卫生事件数和病例数将较6月下降,主要与学校放假、传染病暴发事件下降有关。东南亚国家登革热疫情高发,我国输入病例将持续增加,南方重点省份的本地传播风险将上升;而寨卡病毒病、基孔肯雅热等其他蚊媒传染病也存在输入性病例和输入后发生本地传播的风险。食物中毒事件将继续上升。7-8月也是毒蘑菇中毒事件高发期,且毒蘑菇中毒往往是引起食物中毒死亡的主要死因。洪涝灾区灾后发生的水源性、食源性、动物源性和接触性传染病风险将有所上升。人感染H7N9禽流感在7月将继续下降,但仍可能发现散发病例。7月持续高温潮湿天气,中暑病例易出现高峰。结论 预计2017年7月我国的突发公共卫生事件数相对较少;需重点关注登革热、寨卡病毒病、基孔肯雅热等蚊媒传染病,食物中毒以及自然灾害可能带来的传染病和突发公共卫生事件风险;一般关注人感染H7N9禽流感、霍乱和高温中暑。     

An outbreak of hepatitis E in an urban area of Bangladesh

We investigated an outbreak of jaundice in urban Bangladesh in 2010 to examine the cause and risk factors and assess the diagnostic utility of commercial assays. We classified municipal residents reporting jaundice during the preceding 4 weeks as probable hepatitis E cases and their neighbours without jaundice in the previous 6 months as probable controls. We tested the sera collected from probable cases and probable controls for IgM anti‐hepatitis E virus (HEV), and the IgM‐negative sera for IgG anti‐HEV using a commercial assay locally. We retested the IgM‐positive sera for both IgM and IgG anti‐HEV using another assay at the Centre for Disease Control and Prevention (CDC), USA. Probable cases positive for IgM anti‐HEV were confirmed cases; probable controls negative for both IgM and IgG anti‐HEV were confirmed controls. We explored the local water supply and sanitation infrastructure and tested for bacterial concentration of water samples. Probable cases were more likely than probable controls to drink tap water (adjusted odds ratio: 3.4; 95% CI: 1.2–9.2). Fifty‐eight percentage (36/62) of the case sera were IgM anti‐HEV positive; and 75% of the IgM‐positive samples were confirmed positive on retesting with another assay at CDC. Compared to confirmed controls, cases confirmed using either or both assays also identified drinking tap water as the risk factor. Two tap water samples had detectable thermotolerant coliforms. Research exploring decentralized water treatment technologies for sustainable safe water might prevent HEV transmission in resource‐poor cities. Detection of serological markers in a majority of probable cases implied that available diagnostic assays could adequately identify HEV infection during outbreaks.     

Bacterial associates of Hyalesthes obsoletus (Hemiptera: Cixiidae), the insect vector of bois noir disease,with a focus on cultivable bacteria

The planthopper Hyalesthes obsoletus (Hemiptera: Cixiidae) is an important vector of phytoplasma diseases in grapevine. In the current study, the bacterial community compositions of symbionts of this insect were examined. Two dominant bacterial lineages were identified by mass sequencing: the obligate symbiont Candidatus Sulcia, and a facultative symbiont that is closely related to Pectobacterium sp. and to BEV, a cultivable symbiont of another phytoplasma vector, the leafhopper Euscelidius variegatus. In addition, one bacterium was successfully isolated in this study – a member of the family Xanthomonadaceae that is most closely related to the genus Dyella. This Dyella-like bacterium (DLB) was detected by FISH analysis in H. obsoletus guts but not ovaries, and its prevalence in H. obsoletus increased during the fall, suggesting that it was acquired by the host through feeding. We found that DLB inhibits Spiroplasma melliferum, a cultivable relative of phytoplasma, suggesting that it is a potential candidate for biological control against phytoplasma in grapevines.     

2010年北京市海淀区手足口病流行病学分析

目的探讨2010年北京市海淀区手足口病的流行病学特征,为手足口病防控提供科学依据。方法对海淀区2010年手足口病病例建立数据库,进行统计学分析。结果 2010年,海淀区报告手足口病病例6 280例,发病率为230.63/10万;高发地区为流动人口较聚集的农村和城乡结合部地区;发病高峰为5-7月份;发病年龄主要集中在1-5岁,本地人口病例中托幼儿童较多,占发病人数的49.27%,外来人群病例中以散居儿童为主,占发病人数的62.11%;病原学监测以EV71为主,占47.92%;大部分手足口病例均会在发病当天或发病第2 d及时就诊,本地人群发病的就诊及时性要好于外地人群。结论 2010年北京市海淀区手足口病发病有明显的地区性、季节性及人群差异,预防控制策略应考虑手足口病的高危人群和季节性发病高峰。     

Recent progress towards understanding genetic variation in the Mycobacterium abscessus complex

Mycobacterium abscessus is an emerging cause of respiratory disease and soft tissue infections. Whole genome sequencing and other molecular approaches are enhancing our understanding of outbreaks, antibiotic resistance mechanisms, and virulence properties, and of the phylogeny of the M. abscessus complex. Infection models are providing further insights into factors such as colony phenotype that impact host-pathogen interactions. This paper reviews recent developments in our understanding of genetic variation in M. abscessus and the potential relevance for disease and treatment.