[Surveillance of adverse events following immunization in Henan Province, China between 2010-2011].

OBJECTIVE: To analyze the epidemiological features of adverse events following immunization (AEFI) in Henan Province, China and to evaluate the safety of vaccines currently used in Henan. METHODS: The AEFI cases reported in Henan from January 1, 2010 to December 31, 2011 were collected through the China Surveillance System of Information on National Immunization Program. The descriptive method was used for epidemiological analysis. RESULTS: A total of 2415 cases of AEFI were reported in Henan from January 1, 2010 to December 31, 2011, and 1238 (51.26%) of them were found in Zhengzhou, Luoyang, and Jiaozuo cities. The male-to-female ratio was 1.32:1. Seven hundred and ninety-nine (33.08%) of these cases were less than one year old. Measles vaccine and DPT vaccine (against diphtheria, pertussis, and tetanus) were the main causes of AEFI, contributing to 61.24% of cases; the incidence rates of AEFI among people receiving measles and DPT vaccines were 30.3/105 and 5.0/105, respectively. 1528 cases (63.27%) developed AEFI after the first dose of vaccination. Inflammation and allergic symptoms were the predominant adverse effects caused by the top 5 vaccines AEFI-causing vaccines, and the clinical manifestations were significantly different among AEFI cases caused by different vaccines (χ2=304.5, P<0.001). Among the 2415 AEFI cases, 1946 (80.58%) had common adverse reaction, 348 (14.41%) had rare adverse reaction, 98 (4.06%) had coupling disease, 13 (0.51%) had psychogenic reaction, and 10 (0.41%) had reaction for unknown reasons. The prognosis of most AEFI cases was good, with a cure rate as high as 90.64%. CONCLUSIONS: AEFI occurs mostly in young children and after the first dose of vaccination. This should be brought to the attention of vaccination service personnel and the children's parents.

[Sero-prevalence and associated risk factors on hepatitis C in Maqiao township, Henan province of China].

OBJECTIVE: To describe the prevalence and risk factors of hepatitis C virus (HCV) occurred in Henan province, at the end of 2011. METHODS: Five villages round Maqiao township, including 5187 residents, were selected for the study. Five-milliliter-blood was drawn from every one of the interviewee. Clinical data including age, gender and anti-HCV antibody was recorded. Patients with positive antibodies against HCV were tested for HCV RNA. RESULTS: A total number of 5187 people from five villages were studied, with age span from 1 to 97. The average age was 48 years and the sex ratio was 1:1.34. The anti-HCV result showed that the prevalence was 2.27%, with 1-9 age group the lowest (1.55%) and the ≥ 50 year-olds the highest (4.93%). Different villages seemed to have significant differences on the prevalence of HCV, with the highest as 8.68% and the lowest as 0.55%. Under risk factors analysis and distance-infection rates linear regression analysis, data showed that the prevalence might have correlated to the behavior of a certain family-run clinic. RESULTS: from multivariate analysis indicated that factors as intravenous dropping, intravenous injection and the use of surgery/endoscope were associated with the HCV infection in this village. CONCLUSION: Although the public health care system had been developed for more than ten years, iatrogenic infection was yet responsible for the infection of HCV patients in the rural areas of China that called for further attention paid to the system.

[Studies on heredity rule of the first genealogy regarding fatal familial insomnia in Henan province].

OBJECTIVE: To investigate the epidemiological, genealogic characteristic, familial history of the families with fatal familial insomnia, its clinical and pathological features as well as the heredity rule of related genes. METHODS: 135 familial members of 7 eras were studied. Vein blood samples from patients as well as from some familial members were collected. PRNP gene was studied with PCR, its serial was determined and then authenticated with Nsp I . Brain tissue was obtained for neuropathological test and PrP(Sc) test with Western blot method. RESULTS: Clinical symptoms of the 2 diagnosed cases were typical. 11 familial members died of similar neural disease. 32 samples of their familial members, codon at D178N of PRNP of 11 members was mutated, with mutation rate as 34.38% while D129N showed as methionine. Brain tissue of both probands denaturalized into spongiform and the nerve fiber was absent but PrP(Sc) protein was identified. CONCLUSION: Genealogy was described in the family with fatal familial insomnia since the patients had typical clinical symptoms and pathological characteristics. It seemed necessary to confirm cases of fatal familial insomnia and their genealogy with epidemiological data and to investigate its gene characteristics as well as with neuropathological and Western blot tests.

[Surveillance and control of Japanese encephalitis in Henan province, 1950 - 2008].

OBJECTIVE: To analyze the characteristics and trend of Japanese encephalitis (JE) in Henan province. METHODS: Adopting descriptive epidemiological method to analyze the data on the epidemic situation of JE from 1950 to 2008, and on mosquitoes and host animals at disease surveillance points. The host serum JE IgG antibody was detected by ELISA. Data was analyzed using SPSS 12.0 and Excel 2003 software. RESULTS: The incidence of JE in Henan province had a fluctuant downward trend. Peak of the incidence fell in July to September, accounting for 88.09% of total cases. The scope of geographical distribution was increasing from northern to southern parts of the province. Cases mainly concentrated in the southern and south-eastern parts of the province. 0 - 14 year-old group had the highest incidence (81.95%). In Luoyang city, there was a significant increase in children at 15-years or older (58.93%). Most patients were farmers (42.33%). The positive-times for half of the antibodies of JE in piglets of the surveillance sentinels were different, which might be the reason for the different levels for the incidence rates. The proportion of different kinds of mosquitoes were also different in surveillance sentinel sites, and the time for the density peak of the mosquitoes was in accordance with the incidence peak of JE. CONCLUSION: To develop control strategies, evidence should be based on the characteristics of geographical variance, age, occupation differences, data related to monitoring on animal host and media mosquitoes of JE incidence in Henan province.

[Complete genome sequencing of enterovirus 71 (EV71) HENAN08 strain isolated in Henan province].

OBJECTIVE: To sequence the whole-genome of enterovirus 71 (EV71) srtain isolated from patient with hand, foot and mouth in Henan province in 2008. METHODS: Eight overlapping clones covering the whole viral genome were obtained by RT-PCR and the sequences were determined by Sanger dideoxg-mediated chain termination method. RESULTS: Data it showed that the full length of enterovirus 71 (EV71) HENAN08 genome (not including Poly A tail) is 7405 bp. No deletion or insertion was detected in the coding region. There were several deletions and insertions in 5'UTR and 3'UTR regions. In P1 region, HENAN08 strain shared high homology with AnhuiFY08 strain, Zhejiang08 strain and SHZH strains (SHZH98, SHZH03) but low homology with Cox. A16. In P2 and P3 regions, HENAN08 strain shared higher nucleotide homology with Cox. A16 (81.7% and 83.7%) than that with BrCr and TW2086 strains. The phylogenetic analysis based on P1 region demonstrates that HENAN08 strain had the nearest genetic relationship with AnhuiFY and Zhejiang strains (isolated in 2008). CONCLUSION: The HENAN08 strain might belong to the same genogroup with AnhuiFY08 and Zhejiang08 strains as C4 gene subtypes.

[Epidemiology of pediatric HIV infection in six provinces of China].

OBJECTIVE: To investigate the epidemiology of pediatric human immunodeficiency virus (HIV) infection in six provinces of China. METHODS: A cross-sectional study was conducted in six provinces with the highest HIV prevalence. Surveys on demographics and HIV-related questions (transmission modes, time of diagnosis, clinical stage, laboratory test) were distributed to clinicians in these provinces. Descriptive and bivariate analyses were performed on the completed surveys. RESULTS: Survey results of 650 children [405 males and 245 females; average age: (7.9 +/- 3.2) years] were eligible for analysis. The interval between possible transmission and diagnosis was (7.1 +/- 3.2) years. The location distribution was as follows: 570 cases (87.7%) in Henan Province, 23 cases (3.5%) in Guangxi Province, 21 cases (3.2%) in Yunnan Province, 19 cases (2.9%) in Hubei Province, 10 cases (1.5%) in Anhui Province, and 7 cases (1.1%) in Shanxi Province. Transmission routes included mother-to-child transmission (75.1%), blood transfusion/ plasma donation (15.7 %), and injecting drug use (IDU, 0.5%). Former plasma donation (FPD) was the main transmission route in some provinces (Henan, Shanxi, Hubei, and Anhui), while IDU was the main transmission route in other provinces (Guangxi and Yunnan). The average age in the FPD provinces was significantly higher than that in IDU provinces [(8.1 +/- 3.2) vs. (5.4 +/- 2.2) years, P <0.001]. Among 178 patients in all six provinces who required treatment (on the basis of CD4 count or WHO staging), 133 (74.7%) did not receive treatment and 45 (25.3%) received antiretroviral therapy. CONCLUSION: Mother-to-child transmission is the main transmission mode in pediatric patients. Efforts should be made to strengthen the diagnosis and treatment of pediatric HIV/AIDS patients.

[Study on the authenticity of parents' memory on their children's immunization status].

OBJECTIVE: To evaluate the authenticity of the parents' memory on their children's immunization status. METHODS: Two counties and 1 district in each of the 18 prefectures were selected, and parents of the children 1 - 2 years old, residents in counties or floating in district, were studied on the authenticity of their memory regarding their children's immunization status. RESULTS: The rates of inoculation with all the four expanded programme on immunization (EPI) vaccines were 89.7% in the whole province, and 77.9% among floating children. The authenticity of the reply from parents on their children, inoculation status with vaccines was above 96%. However, less than 50% of the parents could remember what specific vaccines that their children had received. The authenticity of parents' memory was higher in the parents with high school or college education than those who were illiterates or only having had elementary school education. Mothers had better memory than the fathers. Of the children whose parents could not remember the vaccination status, 97% of them had been inoculated. CONCLUSION: The definite answer of parents to children's immunization status had high creditability, especially when the mothers having had more schooling. Those children whose parents failed to remember whether vaccination had been received should not be ranked as unimmuned.