In recent years, tropical diseases in China have shown a trend of re-emergence and emergence, with a significantly elevated risk of local transmission of vector-borne infectious diseases such as dengue fever and chikungunya fever, posing a severe challenge to disease control and prevention. This article reviews the driving factors, epidemiological characteristics, and control challenges of ermerging and re-emerging tropical diseases in China. Studies suggest that climate change has expanded the distribution range of vectors, with vectors like Aedes albopictus continuously spreading northward; globalization has accelerated the cross-border transmission of pathogens, making imported cases a potential source of local outbreaks; rapid urbanization has created new suitable habitats for vectors; invasive alien species have introduced new pathogens and vectors; pesticide residues have led to increased vector resistance. Under the combined influence of these factors, a complex transmission network of tropical diseases has been formed, which has changed the disease spectrum and epidemiological pattern of tropical diseases in China and given rise to numerous ermerging and re-emerging tropical diseases with serious consequences. However, the current prevention and control system in China faces numerous challenges in addressing ermerging and re-emerging tropical diseases, such as insufficient monitoring coverage, limited early warning capacity, inefficient detection technology, and a reliance on singular control measures. In the future, it is necessary to build a comprehensive control system based on the "One Health" concept through scientific assessment of epidemiological trends, strengthen multi-sectoral collaboration, develop green and intelligent control technologies, and implement integrated prevention and control of multiple diseases simultaneously. Meanwhile, China should deepen participation in international health cooperation to jointly address the global challenges of emerging and re-emerging tropical diseases.
Neglected tropical diseases (NTDs) are typically prevalent in tropical and subtropical regions, predominantly affecting populations in the world's poorest areas, and have historically been overlooked due to a lack of attention and funding. In recent years, China has continuously advanced integrated prevention and control strategies at the national level, including strengthening surveillance and early warning systems, improving diagnostic and treatment capacities, and promoting vector control measures. These efforts have remarkably resulted in decreased incidence for multiple diseases and significant progress toward elimination for some diseases. Although China has made remarkable progress in the prevention and control of these diseases, significant regional disparities and increasing risks of imported cases remain, particularly in the context of climate change and rapid urbanization. The emerging and re-emerging infectious disease threats have compounded existing burdens, placing additional pressure on China's public health system. This paper summarizes recent achievements, current status, and existing challenges in China's efforts to combat NTDs. It further proposes the continued implementation of integrated prevention and control strategies, reinforcement of cross-border joint prevention and control mechanisms, and promotion of international cooperation to advance the sustainable control and eventual elimination of NTDs in China.
Visceral leishmaniasis (VL) was once one of the five major parasitic diseases posing a serious threat to public health in China. Through dedicated control efforts, the disease had been basically eliminated in most endemic areas by the early 1980s. However, since the 21st century, a rapid resurgence of mountain-type zoonotic visceral leishmaniasis has occurred in central and western China, with numerous historically endemic counties experiencing re-emergence and a continuous geographical expansion of the epidemic area, currently spanning seven provinces/municipalities: Gansu, Sichuan, Shaanxi, Shanxi, Henan, Hebei, and Beijing. This article systematically reviews the current epidemiological characteristics, spatiotemporal distribution, and monitoring status of vector sandflies and reservoir hosts (dogs). It analyzes the drivers of the resurgence under the combined effects of global climate change, ecological environmental shifts, and social factors. Existing control measures focusing on case management, reservoir host and vector control, along with their associated challenges, are summarized. To advance sustainable control and elimination, recommendations are proposed, including strengthening integrated research, promoting the translation of technologies into practice, and establishing a multi-sectoral collaborative governance network.
Babesiosis is an emerging tick-borne parasitic disease caused by Babesia species. In recent years, increased global human mobility has led to the continued reporting of imported babesiosis cases across Asia, Europe, Africa, and Oceania, highlighting its significance as a cross-border public health challenge. China reported two confirmed imported cases in 2023, underscoring the transition of this disease from a theoretical concern to a tangible domestic health threat. The current risk of importation primarily stems from travel exposure in endemic areas through activities such as outdoor excursions, direct or indirect contact with ticks from these regions, and the heightened susceptibility of elderly and immunocompromised individuals, who are more prone to severe disease progression. Furthermore, the clinical presentation of babesiosis including symptoms like fever and hemolytic anemia，closely resembles that of malaria and other illnesses, often leading to misdiagnosis or delayed diagnosis and consequently postponing critical treatment. To effectively mitigate the risks of transnational spread, it is essential to enhance prevention and control mechanisms by strengthening port health quarantine and border surveillance, improving clinicians' ability to recognize the disease, and raising public awareness especially among travelers to endemic regions about personal protective measures. Deepening international collaboration is also crucial to collectively establish a robust "One Health"-based prevention and control network that integrates human, animal, and environmental health.
Alongshan virus (ALSV) is a newly identified segmented RNA virus classified under the genus Jingmen virus of the family Flaviviridae. Since first discovered in Heilongjiang Province, China, in 2017, ALSV has been reported in seven countries across East Asia and Europe. It has emerged as a tick-borne pathogen capable of cross-regional spread, presenting a potential threat to public health. The clinical presentation of ALSV infection closely mimics that of other tick-borne illnesses, which contributes to frequent underdiagnosis and misdiagnosis. Consequently, the true incidence of infection is likely underestimated. The viral nucleic acid has been detected in several tick species such as Ixodes persulcatus, Ixodes ricinus, Dermacentor reticulatus, Dermacentor nuttalli, and Haemaphysalis concinna. Nevertheless, key aspects of its ecology-including geographic distribution, vector range, and host spectrum-require further investigation. This article systematically reviews the etiology, clinical features, diagnostic approaches, and epidemiological characteristics of ALSV, with the goal of providing a scientific foundation for its surveillance, diagnosis, prevention, and control.
Objective To analyze the epidemiological characteristics and challenges in the control and prevention of imported schistosomiasis cases in China, providing scientific evidence for schistosomiasis control and prevention during the transition from transmission interruption to elimination. Methods Data were obtained from the China Disease Control and Prevention Information System (National Notifiable Disease Reporting System). All imported schistosomiasis cases reported nationwide between January 1, 2015, and December 31, 2024 were included. Variables such as source country, reporting province, Schistosoma species, and demographic characteristics were analyzed descriptively. Results From 2015 to 2024, a total of 32 imported schistosomiasis cases were reported in China, with 2-6 cases annually, the proportion of reported in spring was 46.9% (15/32). The mean age was (36.66±10.41) years, and males accounted for 93.8% of all cases. The occupations were mainly laborers (31.3%) and students (25.0%). Cases originated from 16 countries, of which 27 cases (84.4%) were from sub-Saharan Africa; the major source countries were Nigeria (n=5), Angola (n=4), Zimbabwe (n=3), Equatorial Guinea (n=3), and Sudan (n=3). Most cases were reported in endemic provinces (24 cases, 75.0%), mainly in Zhejiang and Jiangsu. By species, infections were predominantly by Schistosoma haematobium (56.3%) and S. mansoni (18.8%); two cases were caused by S. intercalatum. Nine cases had follow-up data, and all were cured after praziquantel treatment. Conclusion Imported schistosomiasis in China shows concentrated sources of infection abroad, distinct occupational patterns, and partial overlap between domestic reporting locations and endemic areas. Although the number of cases remains sporadically reported, potential risk of re-transmission exists. Strengthened health management for cross-border populations, enhanced clinical recognition and laboratory capacity, and improved surveillance are essential to consolidate achievements in transmission interruption and prevent re-emergence.
After the founding of the People's Republic of China, years of active prevention and control efforts have enabled the country to reduce annual malaria cases from 30 million to zero indigenous infections, and China was certified as malaria-free by the World Health Organization (WHO) in 2021. However, in the border areas of Myanmar adjacent to Yunnan Province of China, the number of malaria cases was only 2 583 in 2019 but surged to 34 171 in 2024, representing a staggering increase rate of 1 222.92%. The high incidence of malaria in Myanmar has imposed a heavy disease burden, posing severe challenges to the prevention of malaria importation and re-transmission in China, especially in the China-Myanmar border areas of Yunnan. To address the risk of cross-border malaria retransmission, China has innovatively initiated and implemented the "3+1" border prevention and control strategy in its border areas. This strategy has successfully blocked the risk of cross-border malaria transmission at the frontier, providing critical safeguards for China to sustain its malaria elimination achievements. Furthermore, it has offered China's solutions and reference cases for other countries grappling with cross-border malaria transmission issues, which holds substantial public health significance.
Objective To investigate the bacterial diversity and prevalence of common tick-borne pathogens in ticks parasitizing water buffaloes in Anfu County, Ji'an City, Jiangxi Province, China. Methods A total of 104 ticks were collected from water buffaloes in Xiatanyuan Village, Yangmen Township, Anfu County, Jiangxi Province. Species identification was performed using morphological and molecular biological methods. DNA from 46 randomly selected ticks was subjected to high-throughput sequencing of the 16S rDNA V3-V4 region to analyze bacterial diversity, and species composition was calculated and analyzed for each sample. Additionally, polymerase chain reaction (PCR) was used to screen all 104 ticks for six major tick-borne pathogens: Borrelia burgdorferi, Borrelia miyamotoi, Coxiella burnetii, Anaplasma phagocytophilum, Ehrlichia chaffeensis, and spotted fever group rickettsiae (SFGR). Positive amplicons were sequenced and phylogenetic trees were constructed. Results All 104 engorged female ticks were identified as Rhipicephalus microplus. High-throughput sequencing of the 16S rDNA V3-V4 region revealed that the dominant bacterial phyla were Bacillota (mean relative abundance:61.24%) and Pseudomonadota (38.43%), with Aeromonas hydrophila (31.60%) being the predominant species. Several pathogenic bacteria were detected: Coxiella burnetii (positive rate 23.91%), Anaplasma phagocytophilum (17.39%), Klebsiella pneumoniae (15.22%), Acinetobacter lwoffii (10.87%), and Rickettsia conorii (2.17%). PCR results showed that 14 ticks carried tick-borne pathogens: Borrelia theileri (6.73%), SFGR (2.88%), Borrelia burgdorferi (0.96%), Borrelia miyamotoi (0.96%), Coxiella burnetii (0.96%), and Anaplasma phagocytophilum (0.96%). Both methods indicated co-infections with multiple pathogenic bacteria in the ticks. Conclusions Rhipicephalus microplus parasitizing water buffaloes in Anfu County, Jiangxi Province, harbors a highly diverse bacterial community, including multiple pathogenic and opportunistic bacteria, indicating potential public health risks. Systematic investigation and monitoring of tick-borne diseases in this region should be strengthened to provide a scientific basis for targeted prevention and control.
Objective To investigate the genetic diversity and evolutionary dynamics of Venezuelan equine encephalitis virus (VEEV), with emphasis on lineage evolution, key mutations, and recombination events, and provide a scientific basis for control and prevention strategies. Methods A total of 196 complete VEEV genomes were retrieved from GenBank for alignment and curation. A maxium likelihood phylogenetic tree was constructed, and Bayesian methods were used to estimate lineage-specific substitution rates and times to the most recent common ancestor (tMRCA). Selection pressure on structural proteins and recombination in nonstructural regions were also assessed. Results Phylogenetic analysis showed that, VEEV sequences clustered into five major lineages with clear geographic patterns. The ⅠC, ⅠD, and ⅠE lineages were included in the evolutionary dynamics analysis, with ⅠD exhibiting the highest and ⅠC the lowest substitution rate, likely due to differences in ecological or host-related pressures. Different base substitution rates in various branches and the time of the most recent common ancestor support multiple evolutionary paths of the virus. Structural proteins were under strong purifying selection, with two sites under positive selection. A hypervariable region in nonstructural protein nsp3 coincided with a detected recombination event, suggesting a potential recombination hotspot. Conclusion VEEV shows independent evolutionary trajectories across lineages. Variation in substitution rates and the presence of positively selected sites reflect viral adaptation. These findings provide genomic insights valuable for improving VEEV detection, vaccine development, and outbreak preparedness.
Objective To investigate the ectoparasite infection status of Rousettus leschenaultii in Yunnan Province, analyze the infection levels and potential influencing factors, and provide a foundation for subsequent studies on bat ectoparasites and pathogen surveillance. Methods R. leschenaultii specimens were captured using mist nets at two sampling sites in Yunnan Province in July 2022 and August 2023. Ectoparasites from all captured bats were collected and identified. Descriptive analyses were conducted to determine the prevalence of infection, mean abundance, and overall mean intensity. A generalized linear model was applied to evaluate the effects of host sex, body size (measured by forearm length), and sampling site on ectoparasite load. Results Among the 61 captured bats (31 females and 30 males), 56 were infected with ectoparasites, resulting in a prevalence of 91.80%. Ectoparasite infection in R. leschenaultii was widespread, with a mean abundance of 5.29 parasites per bat and a total mean intensity of 17.78 parasites per bat. A total of 323 ectoparasites were collected, belonging to five families (Spinturnicidae, Trombiculidae, Argasidae, Ischnopsyllidae, and Nycteribiidae) and encompassing six genera and six species. Argas vespertilionis and Eucampsipoda hyrtlii were identified as the dominant species. Generalized linear model analysis indicated no significant correlation between ectoparasite load and host sex or forearm length (P>0.05), whereas sampling site had a significant effect. Conclusion The survey across two sites in Yunnan revealed a high ectoparasite infection rate of 91.80% in R. leschenaultii, with ticks and bat flies as the dominant ectoparasites. Infection levels varied significantly among sampling sites, while host sex and body size showed no significant influence. This study provides valuable supplementary data on bat ectoparasites in China and offers important reference values for monitoring and preventing related zoonotic diseases.
Objective To investigate the reparative effects and underlying mechanisms of vanillic acid on myocardial hypertrophy-induced injury in C57BL/6J mice and HL-1 cardiomyocytes induced by angiotensin Ⅱ (Ang Ⅱ). Methods C57BL/6J mice （female） and HL-1 mouse cardiomyocyte cell line were randomly assigned to four experimental groups: control, Ang Ⅱ, vanillic acid, and vanillic acid+AngⅡ, with appropriate interventions administered accordingly. In the in vivo study, cardiac hypertrophy was evaluated by heart weight-to-body weight ratio (HW/BW) and heart weight-to-tibia length ratio (HW/TL); cardiac hemodynamic function were assessed via echocardiography; the degree of myocardial tissue and cell hypertrophy and fibrosis, were analyzed using hematoxylin-eosin (HE) staining, Masson's trichrome staining, and wheat germ agglutinin (WGA) staining; immunohistochemical analysis was performed to determine the expression levels of Kelch-like ECH-associated protein 1 (Keap1), nuclear factor erythroid 2-related factor 2 (Nrf2), and NADPH oxidase 4 (NOX4) in myocardial tissues of each group. In the in vitro study, the optimal non-cytotoxic concentration of vanillic acid for HL-1 cells was determined using the cell counting kit-8 (CCK-8) assay; cellular morphology and size were assessed by phalloidin staining; protein expression levels of Keap1, Nrf2, and NOX4 were quantified by Western blot analysis. Results In vivo findings demonstrated that, compared with the control and vanillic acid groups, the Ang Ⅱ group exhibited significant myocardial hypertrophy, interstitial fibrosis, and cardiomyocyte enlargement (P<0.05), increased interventricular septal thickness at end-systole (P<0.05), reduced left ventricular ejection fraction (P<0.05), and upregulated expression of Keap1, Nrf2, and NOX4 (P<0.05). These pathological changes were significantly attenuated following vanillic acid treatment (P<0.05). In vitro results showed that, compared with the control and vanillic acid groups, AngⅡ treatment led to a marked increase in cardiomyocyte cross-sectional area (P<0.05), and elevated expression of Nrf2, Keap1 and NOX4 (P<0.05), both of which were reversed by vanillic acid co-treatment. Conclusion Vanillic acid ameliorates cardiac dysfunction and suppresses myocardial hypertrophy, through modulation of the Keap1/Nrf2 signaling pathway.
Objective To analyze the differences in hepatitis B seroepidemiology in Hainan Province across the years 2014, 2020, and 2023, and to explore the changing trends in seroprevalence among individuals aged 1-<30 years at two surveillance sites over the past decade, thereby providing reference data for the further optimization of regional hepatitis B prevention and control strategies. Methods In 2014 and 2020, a two-stage cluster random sampling method was used, while in 2023, a two-stage unequal probability cluster random sampling method was employed. All surveys were conducted among the resident population aged 1-<30 years in Ding'an County and Meilan District of Haikou City, Hainan Province, for hepatitis B seroepidemiological investigation. Descriptive epidemiological methods were used to compare and analyze the positivity rates of hepatitis B surface antigen (HBsAg), hepatitis B surface antibody (anti-HBs), and hepatitis B core antibody (anti-HBc). Results The HBsAg positivity rate among individuals aged 1-<30 years decreased from 3.75% (95%CI: 2.44%-5.72%) in 2014 to 2.34% (95%CI: 1.50%-3.63%) in 2020, and further to 0.64% (95%CI: 0.33%-1.26%) in 2023 (Z=-4.70, P<0.001). Among these, the rate remained consistently below 0.65% in the 1-<10 age group, while the largest decrease (8.10 percentage points) occurred in the 20-<30 age group. The anti-HBs positivity rate decreased from 60.04% (95%CI: 55.82%-64.11%) in 2014 to 47.10% (95%CI: 43.69%-50.54%) in 2020, further to 36.94% (95%CI: 34.31%-39.65%) in 2023 (Z=-9.08, P<0.001). This downward trend was most pronounced among the 5-<20 age group, while positivity rates remained relatively stable in other age cohorts. The anti-HBc positivity rates decreased from 9.76% (95%CI: 7.52%-12.57%) in 2014 to 6.41% (95%CI: 4.92%-8.31%) in 2020, further to 1.84% (95%CI: 1.23%-2.75%) in 2023 (Z=-7.45, P<0.001). Decreases were observed across all age groups, with the largest reduction (23.82 percentage points) occurring among those aged 20-<30 years. No statistically significant gender differences were found for any of the three indicators across the three surveys (all P>0.05). The gap in HBsAg positivity rates between the two regions narrowed over time, but anti-HBs positivity rates in Ding'an County remained consistently lower than those in Meilan District of Haikou City (all P<0.05). Conclusions Under hepatitis B vaccination policies, the level of hepatitis B virus infection among individuals aged 1-<30 years at two surveillance sites in Hainan Province has decreased from intermediate to low endemicity; a relatively large decline in anti-HBs levels was observed among those aged 5-<20 years.
Objective To analyze the epidemic characteristics and hemagglutinin (HA) gene variations of influenza B virus (IBV) in Guizhou Province from 2022 to 2024, aiming to provide a basis for optimizing the local influenza prevention and control strategies. Methods A total of 76 976 samples were collected from patients with influenza-like illness (ILI) at 13 sentinel hospitals for influenza surveillance in Guizhou Province from January 2022 to December 2024. Influenza B virus nucleic acid was confirmed by real-time fluorescence quantitative polymerase chain reaction (qPCR), and virus isolation was performed using MDCK cells. Fifty-two isolates of influenza B virus were selected for sequencing. Phylogenetic trees were constructed using bioinformatics software, and their molecular evolutionary characteristics were analyzed. Results A total of 2 893 cases of influenza B were detected, with a detection rate of 3.76% (2 893/76 976), all of which belonged to the Victoria subtype. The detection rate varied significantly by year (P<0.001), peaking in 2022 (6.75%), and also by age group and season (P<0.001 for both). There was no significant difference between genders (P=0.222). The highest detection rates were observed in the 15-<60 age group (5.38%) and during winter (10.21%), followed by spring (4.51%). Phylogenetic analysis showed that the HA gene sequences of all 52 isolates were highly homologous and clustered within the V1A.3 subclade, alongside the B/Austria/1359417/2021 vaccine strain. Eight amino acid mutations occurred in the key antigenic epitope regions (120-loop, 150-loop, 190-helix) of the HA protein. Forty-nine of the isolates shared 10 conserved potential N-glycosylation sites with the vaccine strain. Conclusion Influenza B in Guizhou Province shows a winter-spring epidemic pattern, with young and middle-aged adults as the key population for prevention and control. The V1A.3 clade of the B/Victoria subtype is the predominant strain. While the HA gene of circulating viruses showed good homology to the contemporary vaccine strain, the presence of site mutations in key antigenic determinant regions highlights the need for dynamic monitoring and timely update of vaccine components.
Objective The purpose of this study is to systematically analyze the molecular evolutionary characteristics of influenza A (H3N2) epidemic strains in Changsha from 2019 to 2024, reveal the genetic variation patterns, and provide a scientific basis for the precise prevention and control of influenza and the selection of vaccine strains in Changsha. Methods Sixteen H3N2 influenza strains isolated from national sentinel surveillance in Changsha from January 2019 to December 2024 were selected as representative strains. The full-length gene fragments of hemagglutinin (HA) and neuraminidase (NA) of the virus were amplified by RT-PCR, and complete gene sequences were obtained by next-generation sequencing (NGS) technology. Megalign software was used for sequence homology analysis, and the Clustal W method of MEGA 11.0 software was used for multiple sequence alignment and amino acid mutation site analysis. Phylogenetic trees of HA and NA genes were constructed by the neighbor-joining (N-J) method (Bootstrap=1 000). Results The HA protein of all 16 Changsha H3N2 isolates belonged to the 3C.2a evolutionary branch. In 2019, two sub-branches, 3C.2a1b.1b and 3C.2a1b.2, diverged, which gradually evolved into the 3C.2a1b.2a.2a branch after 2022. All strains from 2023 and 2024 belonged to the 3C.2a1b.2a.2a.3a.1 evolutionary branch. Homology analysis showed that the HA and NA genes of the 2019 H3N2 epidemic strains had the lowest similarity with the vaccine strain, while the 2024 strains showed the highest similarity. Significant variations occurred at key sites of the HA protein, including N190D and Y195F in the receptor binding site (RBS) region, as well as antigenic drift mutations such as T135K, H156S, N158K, and other antigenic drifts in the antigenic epitope region. The newly emerged NYTY glycosylation motif of the 2022 strains may lead to decreased hemagglutination ability. The catalytic center of the NA protein in all isolates was highly conserved, and no neuraminidase inhibitor resistance mutations such as E119V/R292K were detected. Conclusion From 2019 to 2024, H3N2 influenza virus strains in Changsha City continuously underwent antigenic drift and genetic evolution, forming a new dominant epidemic evolutionary branch, 3C.2a1b.2a.2a.3a.1. Multiple amino acid site mutations in the antigenic determinants and RBS regions of the HA protein have altered receptor binding characteristics and viral antigenicity, highlighting the need for timely updates to the influenza vaccine. No drug-resistant mutations were found in the NA protein, suggesting continued sensitivity to neuraminidase inhibitors and other antiviral drugs.
Objective This study aimed to optimize the laboratory rearing method for Oncomelania hupensis robertsoni (the Dianchuan subspecies snail) artificially infected with Schistosoma japonicum, thereby providing a theoretical foundation for establishing a standardized laboratory system for rearing S. japonicum-infected snails. Methods A total of 240 uninfected snails, screened via the cercarial shedding method, were individually infected with S. japonicum miracidia at a miracidium-to-snail ratio of 5∶1. Under identical environmental conditions, four rearing methods were applied in parallel: the mud pot method, the sponge and straw paper method, the enamel tray with straw paper and coarse soil method, and the enamel tray with straw paper and fine soil method. Dead snails were removed and recorded weekly to calculate the mortality rate in each group. After 60 days post-infection, infected snails were identified using the cercarial shedding method, which was conducted weekly for nine consecutive weeks. Snails that did not shed cercariae were dissected and examined microscopically at 120 days post-infection; if cercariae were present, these snails were classified as infected and included in the infection rate analysis. Identified infected snails were maintained using their original rearing methods, and cercarial shedding was performed every 10 days for a total of five shedding events. Results After 120 days of rearing, the cumulative mortality rates for the mud pot method, sponge and straw paper method, enamel tray with straw paper and coarse soil method, and enamel tray with straw paper and fine soil method were 40.00%, 41.67%, 25.00%, and 36.67%, respectively. The corresponding cumulative infection rates were 31.67%, 30.00%, 41.70%, and 43.33%, respectively. The average numbers of shed S. japonicum cercariae were 1 169, 615, 412, and 1 022, respectively. The time required for one person to prepare and replace one set of rearing materials was approximately 25 minutes for the mud pot method, 12 minutes for the sponge and straw paper method, 10 minutes for the enamel tray with straw paper and coarse soil method, and 12 minutes for the enamel tray with straw paper and fine soil method. Statistical analysis revealed no significant differences in snail mortality rate (χ2=4.442, P>0.05) or infection rate (χ2=3.589, P>0.05) among the methods. However, significant differences were observed in the average number of shed cercariae (F=6.875, P<0.05) and the workload required (F=117.195, P<0.05). Conclusion Considering the snail mortality rate, average number of shed cercariae, and rearing workload comprehensively, the enamel tray with straw paper and fine soil method is the most suitable approach for laboratory rearing of artificially infected Oncomelania hupensis robertsoni.
Objective To investigate the epidemiological characteristics of two local cases of severe fever with thrombocytopenia syndrome (SFTS) in Changsha, analyze the molecular genetic characteristics of Dabie bandavirus (DBV), and we provide a scientific basis for local epidemic surveillance and prevention and control. Methods Blood samples from two SFTS cases and their close contacts, as well as serum samples from animals and tick specimens collected from the surrounding living environment of the cases, were collected. DBV nucleic acid was detected using quantitative reverse transcription-polymerase chain reaction (RT-PCR). Positive samples were subjected to whole-genome sequencing using the Illumina platform, and sequence assembly was performed using CLC Genomics Workbench 25.0 software. Sequences with high similarity to those in this study were downloaded from the GenBank database. Bioinformatics software such as DNA STAR and MEGA7 were used to analyze gene sequence homology, amino acid variations, and construction of phylogenetic trees. Results The DBV nucleic acids of the two Changsha cases were both positive. The nucleotide homology of their L, M, and S gene fragments exceeded 99.8%. The homology with the reference sequences in the GenBank database was 95.9%-99.6% (L gene), 93.7%-99.8% (M gene), and 95.6%-99.8% (S gene) respectively. Among these, the homology with the Shandong strain QD04 was the highest (99.6%-99.8%). Phylogenetic analysis indicated that the L, M, and S genes of the two case samples all belonged to genotype B. Amino acid analysis identified specific mutation sites in the GPs protein (GPs-501T, 662P, 962S), which might be associated with viral pathogenicity. Conclusion Two local epidemic DBV strains in Changsha are highly homologous to the Shandong strain, but have unique amino acid variations, which may affect the transmission characteristics of the virus. It is necessary to strengthen surveillance of tick vectors and animal hosts as well as research on multi-route transmission mechanisms.
Objective To investigate the clinical isolates of Corynebacterium striatum obtained from patients exhibiting infections caused by this bacterium at Shanxi Bethune Hospital, and to summarize their epidemiological and molecular characteristics, thereby providing a reference for clinical anti-infection treatment strategies. Methods Clinical isolates of Corynebacterium striatum were collected from patients diagnosed with infections caused by this bacterium at Shanxi Bethune Hospital between February 2021 and December 2023. All isolates underwent antimicrobial susceptibility testing, while whole-genome sequencing was performed specifically on bloodstream infection isolates, followed by genetic analysis. Results A total of 487 isolates of Corynebacterium striatum were isolated from clinical specimens. The infections were primarily localized to the lungs (408/487, 83.78%), with the highest prevalence observed in neurology and neurosurgery departments (266/487, 54.62%). Antimicrobial susceptibility testing revealed that all isolates exhibited resistance to penicillin, meropenem, ceftriaxone, and ciprofloxacin, but remained susceptible to vancomycin and linezolid. Partial isolates demonstrated susceptibility to tetracycline, clindamycin, gentamicin, and erythromycin, with susceptibility rates of 34.50%, 7.19%, 36.34%, and 16.43%, respectively. Whole-genome sequencing and genomic analysis of 12 bloodstream infection strains identified 11 antimicrobial resistance genes. All isolates carried the ermX gene, and 10 of them harbored more than five resistance genes simultaneously. Additionally, virulence genes spa and srt were detected in these isolates. Phylogenetic analysis demonstrated diversity in sequence types (STs) among the 12 Corynebacterium striatum isolates; however, identical STs were identified across different clinical departments. Conclusion All Corynebacterium striatum isolates were multidrug-resistant, with vancomycin and linezolid retaining robust antibacterial activity, and genomic analysis confirmed the presence of multiple resistance genes. Enhanced screening and infection control measures for Corynebacterium striatum are essential for preventing nosocomial transmission and optimizing antimicrobial therapy.
Objective To analyze the epidemiological characteristics and influencing factors of treatment outcomes of patients with pulmonary tuberculosis with diabetes mellitus (TB-DM) in Guizhou Province from 2017 to 2023, and to provide a reference for scientific formulation for the control and prevention strategies of co-morbidities. Methods The information data of pulmonary tuberculosis patients registered in Guizhou Province from 2017 to 2023 were collected from Tuberculosis Information Management System under National Health Insurance Disease Control Information System. The prevalence of TB-DM patients was analyzed using descriptive epidemiological methods, and the influencing factors of treatment outcomes were analyzed using binary logistic regression. Results From 2017 to 2023, a total of 7 892 TB-DM patients were registered in Guizhou Province, with an average registration rate of 2.94/100 000. The registration rate showed an increasing trend year by year, with an average annual increase of 28.84% (95%CI: 22.16%-35.87%, t=12.36, P<0.001); the proportion of TB-DM patients among pulmonary tuberculosis population was 3.14%, increasing from 1.24% in 2017 to 6.35% in 2023, showing an increasing trend (χ2trend=2 841.53, P<0.001). The proportion of males, 45-<65 years old, the proportion of farmers, positive etiological examinations, referrals for diagnosis, primary treatment patients, and secondary pulmonary tuberculosis in TB-DM patients were all higher than those in non-TB-DM patients, and the differences were statistically significant (P<0.05). The successful treatment rate of TB-DM patients in the province was 91.95%, and adverse outcome incidence was 8.05%. The adverse outcomes were mainly adverse reactions (3.34%) and treatment failure (2.49%). The results of multivariate logistic regression analysis showed that age≥65 years (OR=1.47, 95%CI: 1.17-1.85) and retreatment (OR=1.78, 95%CI: 1.14~2.78) were risk factors for adverse outcomes in TB-DM patients. Conclusion The number and proportion of registered TB-DM patients showed an upward trend in Guizhou Province from 2017 to 2023, and the incidence of adverse outcomes was high. We should focus on elderly people aged 65 and above, as well as patients with co-morbidities who have been retreated, and further do a good job in tuberculosis and diabetes mellitus bidirectional screening.
Objective To analyze the etiological characteristics of an outbreak of febrile respiratory infectious diseases associated with a school swimming pool in Hainan Province, China, in 2022, and to provide a scientific basis for the prevention and control of related infectious diseases. Methods An epidemiological investigation was conducted for this outbreak. Nasopharyngeal swab specimens were collected from cases, followed by nucleic acid testing for human adenovirus (HAdV) and virus isolation. Preliminary genotyping was performed by amplifying the Loop2 region of the hexon gene, and full-length sequencing of the penton base, hexon, and fiber genes was carried out. Sequence alignment, phylogenetic analysis, and homogeneity analysis were performed by comparing the sequences with prototype strains of various HAdV types. Results A total of 125 cases were reported during the outbreak, with ages ranging from 3 to 13 years (mean age: 9.1 years). The main clinical symptoms included fever (100.0%), sore throat or pharyngeal discomfort (59.2%), and cough (40.0%). Among 61 nasopharyngeal swab specimens, 35 tested positive for HAdV nucleic acid (positive rate: 57.4%), and 18 viral strains were successfully isolated. Genotyping revealed that the Loop2 region of the hexon gene in all isolated viral strains showed the highest homology with HAdV-3, but combined analysis of the three genes confirmed them as the recombinant type HAdV-114 (P7H3F3). The isolates shared 100.0% genomic sequence identity. Compared with the prototype strain of HAdV-114 (GenBank accession number: OR853835), the isolates' penton base gene contained a 3-base (CCT) insertion, resulting in an additional proline at amino acid position 20. The fiber gene presented an A214G missense mutation (N72D), while the hexon gene sequence was identical to the prototype. Conclusion The outbreak was caused by recombinant HAdV-114 strain, which exhibited high homology with the prototype strain. This study provides important scientific data for the surveillance, detection, and prevention of HAdV outbreaks associated with swimming pools.
Objective To analyze the disease burden of dengue fever in China and ASEAN from 1990 to 2021 and predict its future trend, to provide a reference for implementing effective dengue fever prevention and control measures. Methods Based on Global Burden of Disease (GBD) data from 1990 to 2021, the age-standardized rates of prevalence, incidence, mortality, and disability-adjusted life years (DALYs) for dengue fever in China and ASEAN were collected and analyzed. The Joinpoint regression model was employed to calculate the annual percent change (APC) and average annual percent change (AAPC) for these indicators. The autoregressive integrated moving average (ARIMA) model was used to predict the disease burden of dengue fever from 2022 to 2036. Results From 1990 to 2021, the age-standardized incidence and prevalence of dengue fever in China showed an upward trend, with AAPC being 5.59% and 5.57%, respectively (all P<0.05). The age-standardized mortality and DALYs rates exhibited a declining trend, and AAPC of -6.14% and -5.87%, respectively (both P<0.05). In ASEAN, the age-standardized incidence, prevalence, and mortality rates of dengue fever all showed an upward trend, with AAPC being 1.39%, 1.38%, and 0.77%, respectively (all P<0.05), while the age-standardized DALYs rate showed a non-significant trend with an AAPC of 0.41% (P>0.05). The ARIMA model predicted that from 2022 to 2036, the age-standardized incidence and prevalence rates in both China and ASEAN would show upward trends, while the age-standardized mortality and DALYs rates would show downward trends. It is estimated that by 2036, the age-standardized incidence rate and age-standardized prevalence rate of dengue fever in China will increase to 3.74/100 000 and 0.22/100 000 respectively, while the age-standardized mortality rate and age-standardized DALYs rate will decrease to 0.000 2/100 000 and 0.04/100 000, respectively. In ASEAN, by 2036, the age-standardized incidence rate and age-standardized prevalence rate of dengue fever will increase to 1 373.43/100 000 and 83.38/100 000, respectively, while the age-standardized mortality rate and age-standardized DALYs rate will decrease to 0.77/100 000 and 46.94/100 000, respectively. Conclusion From 1990 to 2021, the incidence and morbidity burden of dengue fever continued to increase in both China and ASEAN. While China experienced a declining trend in dengue fever mortality and DALYs burden, ASEAN showed an upward trend. It is predicted that the burden of incidence and prevalence in China and ASEAN will continue to increase from 2022 to 2036, but the disease burden of disability and death will decrease. It is recommended that China engage in joint prevention and control with ASEAN, focusing on the control of cases imported from ASEAN, strengthening protection for key populations such as the elderly and children, and reducing the disease burden on patients and society.
Objective Investigate the detection rate of hyperuricemia (HUA) among the personnel stationed on Xisha Islands, analyze the correlation as well as influencing factors between HUA and various biochemical indicators, so as to provide a scientific basis for the prevention and treatment of HUA. Methods A cross-sectional study method was adopted using the laboratory data from the physical examination (n=2 100) of the personnel stationed on the islands at the People's Hospital of Sansha City in Xisha Islands. Statistical analysis was carried out on biochemical test indicators. The differences in biochemical test indicators between the HUA group (n=724) and the control group (n=1 376) were compared. Pearson correlation analysis and logistic regression model were used to analyze the independent risk factors for HUA. Results The total detection rate of HUA was 34.48%. The uric acid (UA) level in the HUA group was significantly higher than that in the control group, and the difference was statistically significant (P<0.05). The levels of CR, BUN, ALT, AST, TBIL, ALB, TC, TG, and LDL-C in the HUA group were all higher than those in the control group (P<0.05), and the HDL-C level in the HUA group was lower than that in the control group, with a statistically significant difference (P<0.05). Pearson correlation analysis showed that the uric acid (UA) level was positively correlated with CR, BUN, ALT, AST, TBIL, ALB, TC, TG, and LDL-C, while HDL-C was negatively correlated with the UA level. Logistic regression model analysis showed that CR, ALT, AST, TBIL, ALB, TC, TG, and LDL-C were independent risk factors for the occurrence of HUA, while HDL-C was a protective factor for the occurrence of HUA. Binary logistic regression analysis showed that abnormal renal function, abnormal transaminase, and hyperlipidemia were risk factors for the occurrence of HUA. Conclusion The detection rate of HUA among the personnel stationed on Xisha Islands is relatively high. There is a significant correlation between abnormal renal function indicators, abnormal transaminase indicators, hyperlipidemia, and HUA. It is recommended to establish a regular monitoring mechanism for this group, and implement lifestyle intervention and drug prevention strategies for those with abnormal metabolic indicators.
Objective To investigate the composition of fly populations and the characteristics of enteric pathogen spectrum carried by flies in a large urban village in Pudong New Area, Shanghai, and to assess the potential role of flies in the transmission of intestinal infectious diseases, to provide a reference for formulating targeted control and prevention measures. Methods From June to October 2024, 18 sampling sites were set up in Taiping Village, Kangqiao Town, Pudong New Area. Flies were collected outdoors using trap cages and indoors using sticky traps. Captured flies were morphologically identified, and real-time fluorescent quantitative RT-PCR was used to detect 31 enteric pathogens (including viruses, bacteria, and parasites). The incidence of diarrhea among residents and related factors were collected through questionnaires. Data were processed using descriptive statistics, chi-square test, and Pearson correlation analysis. Results A total of 214 flies were captured, with Sarcophagidae (60.75%), Anthomyiidae (17.29%), and Lucilia sericata (13.55%) being the dominant species. Thirteen enteric pathogens were detected in flies, including 8 bacteria, 3 viruses, and 2 parasites, with Cryptosporidium having the highest detection rate (51.68%). Green belts and residential outdoor environments were the primary habitats where pathogens were detected in flies. Sarcophagidae carried the highest variety of pathogens, while Chrysomyia megacephala only carried two parasites: Cryptosporidium and Blastocystis hominis. The incidence of diarrhea among the population was 6.86% (58/845), and the detection rate was significantly positively correlated with the diarrhea rate (P<0.05). Conclusions The fly populations are highly diverse in the urban village environment of Pudong New Area, and can carry multiple enteric pathogens, posing a relatively high transmission risk for Cryptosporidium, Sapovirus, and diarrheagenic E. coli. The temporal trend is relatively consistent with the detection rate of fly-borne pathogens in July and August. The results of correlation analysis show that the detection rates of sapovirus, Blastocystis hominis, EPEC and O157 increased. It is recommended to enhance environmental management in urban villages, implement integrated fly control measures, and strengthen health education among residents to reduce the risk of intestinal infectious diseases.
Objective To explore the CT features of early asymptomatic active pulmonary tuberculosis (APT) and provide reference for early clinical diagnosis. Methods One hundred early asymptomatic APT patients diagnosed at the outpatient department of Anti-TB Institute of Shantou, Guangdong Province, from January to December 2024, were selected and underwent chest CT examination to analyze CT features, including lesion location, morphology, density, accompanying signs, and quantity. Results The lesions were predominantly in the right lung (46 cases, 46.0%), Morphologically, nodules were most common (68 cases, 68.0%), followed by ground glass opacities (59 cases, 59.0%). Solid density was the primary density type (41 cases, 41.0%), Pleural thickening was the most common accompanying sign (42 cases, 42.0%). Multiple lesions were observed in 73 cases (73.0%), with 2-3 lesions accounting for 41.00%. The proportions of ground glass opacities (79.0%) and pure ground glass density (32.3%) in the bacterial negative group (n=62) were higher than those in the bacterial positive group (n=38) at 26.3% and 10.53%, respectively. The proportion of cavities in the bacterial positive group (26.3%) was higher than that in the bacterial negative group (3.2%), and the differences were statistically significant (χ2=27.070, 6.100,9.810, P<0.05). After 6 months of treatment, the proportion of ground glass opacities, nodules, and other signs significantly decreased with statistical significance (χ2=74.641, 70.702, P<0.05), while calcified lesions showed no significant change (P>0.05). Conclusions The CT signs of early asymptomatic APT have certain characteristics, with lesions predominantly in the right lung, characterized mainly by nodules, ground glass opacities, and multiple lesions. Solid density is common, often accompanied by pleural thickening. Significant differences exist in the proportion of ground glass opacities and cavities between patients with bacterial negative and bacterial positive conditions. Except for calcifications, the prevalence of abnormal signs decreases significantly after standardized treatment. Combining these CT features with imaging differences between bacterial negative and bacterial positive cases can aid in early diagnosis and efficacy evaluation of APT, and demonstrating high clinical value.
To investigate and analyze a poisoning incident occurred in a County, Qiannan Prefecture, Guizhou Province, which resulted in one death due to a family consumed self-picked Lepiota brunneoincarnata（L. brunneoincarnata）, thereby providing a significant reference in investigations and treatments of acute liver injury induced by poisonous mushrooms for future. Epidemiological investigation methods were used to investigate the poisoning incident in a County, Qiannan Prefecture in June 2024. Blood biochemical indicators were combined to identify the suspected food. Liquid chromatography-tandem mass spectrometry (LC-MS/MS) was employed for the qualitative and quantitative detection of toxins in mushroom samples collected from the site and in the patient's blood. The initial clinical manifestations of the patients poisoned in this incident were gastrointestinal symptoms. Liver function indicators showed no significant changes on the day of poisoning. On the third day after poisoning, the levels of alanine aminotransferase (ALT) and aspartate aminotransferase (AST) increased sharply, subsequently leading to multiple organ failure and ultimately death despite rescue efforts. Based on morphological and molecular biological identification of the mushroom samples, the species involved in this incident was identified as L. brunneoincarnata. The causative toxins were amatoxins, with the contents of α-amanitin and β-amanitin measured at 398.70 mg/kg and 293.35 mg/kg, respectively. This is the first reported case of L. brunneoincarnata poisoning in Guizhou. Notably, the mushrooms were collected from a leisure park with high visitors flow. This report provide important reference value for the prevention and clinical management of similar poisoning incidents.
