Risk factors associated with food consumption and food-handling habits for sporadic listeriosis: a case-control study in China from 2013 to 2022.

The prevalence of listeriosis in China has been increasing in recent years. Listeriosis primarily spreads through contaminated food. However, the resilient causative organism, Listeria monocytogenes, and its extended incubation period pose challenges in identifying risk factors associated with food consumption and food-handling habits. This study aimed to identify the risk factors associated with food consumption and food-handling habits for listeriosis in China. A matched case-control study (1:1 ratio) was conducted, which enrolled all eligible cases of listeriosis between 1 January 2013 and 31 December 2022 in China. Basic information and possible risk factors associated with food consumption and food-handling habits were collected. Overall, 359 patients were enrolled, including 208 perinatal and 151 non-perinatal cases. Univariate and multivariable logistic analyzes were performed for the perinatal group. For the perinatal and non-perinatal groups, ice cream and Chinese cold dishes were the high-risk foods for listeriosis (odds ratio (OR) 2.09 95% confidence interval (CI): 1.23-3.55; OR 3.17 95% CI: 1.29-7.81), respectively; consumption of leftovers and pet ownership were the high-risk food-handling habits (OR 1.92 95% CI: 1.03-3.59; OR 3.00 95% CI: 1.11-8.11), respectively. In both groups, separation of raw and cooked foods was a protective factor (OR 0.27 95% CI: 0.14-0.51; OR 0.35 95% CI: 0.14-0.89), while refrigerator cleaning reduced the infection risk by 64.94-70.41% only in the perinatal group. The identification of high-risk foods and food-handling habits for listeriosis is important for improving food safety guidelines for vulnerable populations.

Epidemiological Evaluation of Bacillus cereus-Induced Foodborne Outbreaks - China, 2010-2020.

Introduction: Bacillus cereus (B. cereus) is a common gram-positive bacterium that contaminates starch-rich food and can cause outbreaks of foodborne diseases. This study describes the characteristics of outbreaks caused by B. cereus in China during 2010-2020 and explore the possible reasons for changes in the number of outbreaks over time. Results of this analysis can efficiently help guide and allocate public resources to prevent B. cereus-caused foodborne diseases. Methods: Descriptive statistical methods were used to analyze the data on B. cereus outbreaks in China during this period. The data were identified and reported at all levels in China through National Foodborne Disease Outbreak Surveillance System. Results: From 2010 to 2020, a total of 419 foodborne outbreaks prompted by B. cereus were reported in China, leading to 7,892 cases, 2,786 hospital admissions, and 5 fatalities. The bulk of the outbreaks were recorded in the summer, primarily between May and September. The most recurrent food vehicle was linked with rice or flour-based products, notably those made with rice or fried rice. School canteens bore the brunt of the B. cereus outbreaks. In multifactor outbreaks, food contamination was identified as the most common culprit; while in instances where only one factor contributed, improper storage was most frequently implicated. Conclusion: The prevalence of B. cereus outbreaks remained relatively consistent throughout the studied period. Understanding the types of foods, causative factors, and contributing elements leading to B. cereus outbreaks can help inform prevention strategies for foodborne illnesses. The majority of outbreaks were associated with rice- or flour-based foods in school canteens, suggesting contamination and improper storage during food preparation. Consequently, it is essential to prioritize continuous education for canteen staff on food safety, efficacious management, and proper practices. The implementation of comprehensive guidelines, encompassing multiple critical aspects, can potentially reduce the occurrence of B. cereus outbreaks.

Attribution Analysis of Household Foodborne Disease Outbreaks in China, 2010-2020.

Foodborne diseases have become a serious public health problem worldwide, and foodborne disease outbreaks have placed a heavy disease burden on China. Foodborne disease outbreaks occur most frequently among families in China. The objectives of this study were to analyze the cause of household foodborne disease outbreaks in China from 2010 to 2020 and to identify where preventive measures could be targeted. All data were obtained from the China Foodborne Disease Surveillance System Report. A total of 17,985 outbreaks, which resulted in 73,252 illnesses, 38,829 hospitalizations, and 1269 deaths, were reported in this period. Most household outbreaks of foodborne diseases occurred in May-October, and the highest number occurred in July (3620 outbreaks, 20%). The province with the highest number of outbreaks was Yunnan Province (4829 outbreaks), followed by Hunan Province (2264 outbreaks). The attribution analysis revealed that fungi (mainly poisonous mushrooms) were the most implicated food category, with 8873 (49.3%) cases. The second was poisonous plants and their products, with 1552 (8.6%) cases. Fungi were the primary etiologic agent, with 31,125 illnesses, accounting for 42.5% of the incidents. Inedibility and misuse (9423 outbreaks), unknown origin (2505 outbreaks), and improper processing (2365 outbreaks) were the main contributing factors causing outbreaks of foodborne diseases. The results show that southwest China was a high-risk area for household foodborne diseases. Therefore, public health institutions should strengthen supervision and food safety education of residents to reduce the outbreaks of household foodborne diseases.

Epidemiological Features of Foodborne Disease Outbreaks in Catering Service Facilities - China, 2010-2020.

Introduction: In terms of food preparation settings, catering service facilities have been identified as locations with the highest incidence of foodborne disease outbreaks in China. Since 2010, the China National Center for Food Safety Risk Assessment has established the Foodborne Disease Outbreak Surveillance System (FDOSS) to monitor foodborne disease outbreaks. Consequently, data from the FDOSS has provided a more accurate depiction of the epidemic characteristics of outbreaks within these facilities. Methods: From 2010 to 2020, the FDOSS gathered data related to the prevalence of outbreaks, cases, hospitalizations, and deaths linked to foodborne disease outbreaks in catering service facilities. This study examined the temporal and geographical distribution, pathogenic factors, and contributing variables of these outbreaks over the course of the decade. Results: From 2010 to 2020, China's catering service facilities reported 18,331 outbreaks, which resulted in 206,718 illnesses, 68,561 hospitalizations, and 201 deaths. The second and third quarters of the year accounted for 76.12% of the outbreaks and 72.93% of the cases. The primary pathogenic factors were pathogenic organisms, which caused 4,883 (26.64%) outbreaks, 94,047 (45.50%) cases, 32,170 (46.92%) hospitalizations, and 21 (10.45%) deaths. There were 5,607 (30.59%) outbreaks in restaurants, 2,876 (15.69%) outbreaks from street vendors, and 2,560 (13.97%) outbreaks in employee canteens in China. Conclusions: The implementation of relevant control methods, including health education and promotion, is critical for addressing foodborne diseases in catering service facilities. Regular food safety training sessions for restaurant personnel and managers are essential to ensuring the effective management of these health risks.

Prevalence and distribution of acute gastrointestinal illness in the community of China: a population-based face-to-face survey, 2014-2015.

BACKGROUND: The true incidence of acute gastrointestinal illness in China is underrecognized by surveillance systems. The aims of this study were to estimate the incidence and prevalence of self-reported AGI in the community of China, and to investigate sociodemographic and epidemiological determinants of AGI. METHODS: We conducted a 12-months cross-sectional population-based survey in eight provinces of China during 2014-2015. The survey determined the prevalence and incidence of acute gastrointestinal illness (AGI) in the total permanent resident population in China according to the census of the population in 2010. The random multilevel population sample was stratified by geographic, population, and socioeconomic status. We used a recommended case definition of AGI, with diarrhea (three loose or watery stools) and/or any vomiting in a four-week recall. A face-to-face survey was conducted by selecting the member in the household with the most recent birthday. RESULTS: Among 56,704 sampled individuals, 948 (1,134 person-time) fulfilled the case definition; 98.5% reported diarrhea. This corresponds to 2.3% (95% CI:1.9%-2.8%) of an overall standardized four-week prevalence and 0.3 (95% CI: 0.23-0.34) episodes per person-year of annual adjusted incidence rate. There was no significant difference between males and females. The incidence rates were higher among urban residents, and in the spring and summer. In the whole study period, 50% of the cases sought medical care, of which 3.9% were hospitalized and 14.3% provided a biological sample for laboratory identification of the causative agent. Children aged 0-4 and young adults aged 15-24, people living in rural areas and people who traveled frequently had higher prevalence of AGI. CONCLUSION: Results showed that AGI represents a substantial burden in China, and will contribute to the estimation of the global burden of AGI. Complemented with data on the etiologies of AGI, these estimates will form the basis to estimate the burden of foodborne diseases in China.

Whole-Genome Sequencing-Based Characterization of Clinical Listeria monocytogenes Isolates in China, 2013-2019.

Invasive listeriosis is a rare but serious foodborne disease that causes maternal-neonatal, central nervous system, and bloodstream infections. The aim of this study was to assess the whole-genome sequencing (WGS)-based genetic diversity of clinical Listeria monocytogenes isolates over a 7-year period and prove the effect of WGS application in food vehicle investigation. A total of 360 isolates were recovered during 2013 and 2019 through the national listeriosis special surveillance program. Two hundred twenty-six isolates (62.8%) were associated with pregnancy. All isolates belonged to lineage I (214 isolates) or lineage II (146 isolates), with 4 serogroups (46.9% IIb, 39.7% IIa, 12.5% IVb, and 0.8% IIc). All isolates were in 25 clonal complexes (CCs) and 3 singletons, with CC87, CC8, and CC5 being the most common causes of human listeriosis. All clinical isolates were positive for Listeria pathogenicity island 1 (LIPI-1), LIPI-3 was present in 21.4% of isolates and LIPI-4 was detected in 29.2% of isolates. LIPI-4-positive isolates, including CC87, sequence type (ST)619, ST382, CC4, and CC2, have been shown to confer hypervirulence. Fifteen isolates harbored at least one antimicrobial encoding gene, including tet (M), mef (A), msr (D), and dfr (G). The sublineage designations were consistent with CC designations, and 215 distinct cgMLST types (CTs) were classified, the most abundant being CT58 and CT750. In summary, there is a high level of genetic diversity among the clinical isolates. WGS has strengthened listeriosis surveillance and will be implemented for other foodborne bacteria in the National Molecular Tracing Network for Foodborne Disease.

[Development of PCR rapid detection method for Listeria monocytogenes in oysters].

OBJECTIVE: To develop a polymerase chain reaction(PCR) method for rapid detection of Listeria monocytogenes in oysters without pre-enrichment. METHODS: The combination of ß-cyclodextrin and bentonite-coated activated carbon was used to remove PCR inhibitors from oyster samples, and the target gene inlB was used for the PCR subsequently. The specificity, sensitivity, and application of the developed method were verified, and the stability and application of the reagents stored under cryopreservation conditions were evaluated. RESULTS: The specificity of the developed PCR method was 100% for the detection of 130 target bacterial strains and 63 non-target bacterial strains. The method reduced the time required for Listeria monocytogenes detection to 4 h without pre-enrichment, and the detection limit was 10 CFU/25 g. The method was consistent with the conventional culture method on the detection rate and viable bacteria detection rate of Listeria monocytogenes in natural oyster samples(the coincidence rate was 100%). Additionally, the reagents could be used normally after storing at-20 ℃ for at least one year. CONCLUSION: The PCR method developed in this study has high specificity and sensitivity, and can be used for rapid, accurate detection of Listeria monocytogenes in oysters.

Nanomechanical Profiling of Aß42 Oligomer-Induced Biological Changes in Single Hippocampus Neurons.

Understanding how Aß42 oligomers induce changes in neurons from a mechanobiological perspective has important implications in neuronal dysfunction relevant to neurodegenerative diseases. However, it remains challenging to profile the mechanical responses of neurons and correlate the mechanical signatures to the biological properties of neurons given the structural complexity of cells. Here, we quantitatively investigate the nanomechanical properties of primary hippocampus neurons upon exposure to Aß42 oligomers at the single neuron level by using atomic force microscopy (AFM). We develop a method termed heterogeneity-load-unload nanomechanics (HLUN), which exploits the AFM force spectra in the whole loading-unloading cycle, allowing comprehensive profiling of the mechanical properties of living neurons. We extract four key nanomechanical parameters, including the apparent Young's modulus, cell spring constant, normalized hysteresis, and adhesion work, that serve as the nanomechanical signatures of neurons treated with Aß42 oligomers. These parameters are well-correlated with neuronal height increase, cortical actin filament strengthening, and calcium concentration elevation. Thus, we establish an HLUN method-based AFM nanomechanical analysis tool for single neuron study and build an effective correlation between the nanomechanical profile of the single neurons and the biological effects triggered by Aß42 oligomers. Our finding provides useful information on the dysfunction of neurons from the mechanobiological perspective.

Epidemiology of foodborne bongkrekic acid poisoning outbreaks in China, 2010 to 2020.

Foodborne bongkrekic acid (BA) poisoning is a fatal foodborne disease in China. From 2010-2020, a total of 19 BA poisoning outbreaks were reported to the China National Foodborne Disease Outbreak Surveillance System. These outbreaks involved 146 illnesses, 139 hospitalizations, and 43 deaths, with a case-fatality rate of 29.5%. Approximately 73.3% of the outbreaks occurred in South and Southwest China. Homemade fermented corn flour products, tremella, and sweet potato flour and corn flour products (jelly) caused more early outbreaks, and novel vehicles (wet rice noodles and Auricularia auricula) were associated with later outbreaks in the study period. Outbreaks most frequently occurred at home (79.0%) and in restaurants (21.0%). The prohibition of traditional processed homemade fermented corn flour products and improvement in bongkrekic acid poisoning case identification and early treatment have resulted in a reduction in the case-fatality rate.

Distribution and Transmission of Colistin Resistance Genes mcr-1 and mcr-3 among Nontyphoidal Salmonella Isolates in China from 2011 to 2020.

Mobile colistin resistance (mcr) genes are present mainly in plasmids and can disseminate clonally or horizontally via either plasmids or insertion sequences in different genomic locations among the Enterobacteriaceae. A nationwide large-scale study on mcr prevalence and transmission in nontyphoidal Salmonella isolates is still lacking. Here, we identified 140 mcr-positive Salmonella isolates out of 7,106 isolates from 29 provinces in China from 2011 to 2020. We aligned short reads to putative plasmids from long-read hybrid assemblies and predicted the plasmid backbones of non-long-read sequencing isolates to elucidate mcr transmission patterns. The mcr-1 and mcr-3 genes are transmitted on similar high-risk clones (sequence type 34 [ST34]) but through plasmids of various replicon types. Furthermore, the ban on colistin use in food animals can lead to a decrease in the mcr-positive Salmonella prevalence among diarrheal patients, related mainly to IncHI2A_IncHI2 plasmids. We provide a framework for plasmid data incorporation into genomic surveillance systems, contributing to a better understanding of mcr spread and transmission. IMPORTANCE Nontyphoidal Salmonella is one of four major causative agents of diarrheal diseases globally, with most cases of salmonellosis being mild. Antimicrobial treatments are required for cases of life-threatening infections, and colistin is one of the last-line antibiotics for the treatment of multidrug-resistant Salmonella infections. However, the efficacy of colistin has been compromised by the emergence of various mcr genes. To elucidate the transmission of mcr genes in Salmonella isolates, our study analyzed 7,106 Salmonella strains from 29 provinces in China from 2011 to 2020. The results showed that mcr genes are transmitted on similar high-risk clones (ST34) but through plasmids of various replicon types. In addition, our data illustrated that the ban on the use of colistin in food animals led to a significant decrease in mcr-positive isolates. Our findings offer an essential step toward a more comprehensive understanding of the spread and transmission of mcr genes.

Attribution Analysis of Foodborne Disease Outbreaks Related to Meat and Meat Products in China, 2002-2017.

This study aimed to understand the epidemiological characteristics of foodborne disease outbreaks related to meat and meat products in China from 2002 to 2017. Data collected from the National Foodborne Diseases Surveillance System and searched databases were analyzed. From 2002 to 2017, China reported 2815 outbreaks caused by foodborne diseases related to meat and meat products, resulting in 52,122 illnesses and 25,361 hospitalizations, and 96 deaths. Outbreaks were markedly seasonal and concentrated from May to September, accounting for 66.93%. Outbreaks were concentrated mainly in China's eastern coastal and southern regions. Unidimensional attribution analysis revealed that livestock meat was the most commonly implicated food category causing the outbreaks, accounting for 28.67%. Bacteria were the most common pathogenic cause of outbreaks, accounting for 51.94%. Clostridium botulinum was the most common pathogenic cause of death, accounting for 34.38%. Improper processing was the most common contributing factor, accounting for 27.89%. Households were the most common food preparation location causing the outbreak, accounting for 34.39%. Two-dimensional and multidimensional attribution analysis found that Salmonella contamination occurred in different locations and regions, mainly caused by various contributing factors and improper processing. Nitrite poisoning is caused by improper processing in households in East China. Bacterial causes were the commonest agents associated with foodborne diseases related to meat and meat products, and improving the safety and quality of meat and meat product should be a priority.

Epidemiological Analysis of Foodborne Botulism Outbreaks - China, 2004-2020.

Introduction: Foodborne botulism is a rare, potentially fatal illness resulting from the ingestion of foods contaminated with preformed botulinum neurotoxin types A, B, E, or F, produced by Clostridium botulinum. The descriptive epidemiology of foodborne botulism outbreaks in China during 2004-2020 was performed to inform public health response strategies. Methods: Data from 22 of 31 provincial-level administrative divisions (PLADs) of the National Foodborne Disease Outbreaks Surveillance System during 2004-2020 and Embase, China National Knowledge Infrastructure (CNKI), Wanfang Data, and Chinese Science and Technique Journals (CQVIP) from January 2004 to December 2020 to identify indexed publications in the Chinese literature using the following search terms "botulism," or "botulinum toxin," or "Clostridium botulinum." The number and proportion of outbreaks, illnesses, and deaths by PLAD, food types, and contributing factors were calculated. Results: During 2004-2020, a total of 80 foodborne botulism outbreaks occurred in China, involving 386 illnesses and 55 deaths; most outbreaks were reported between June and August, with a sharp peak in January; 22 out of 31 PLADs reported foodborne botulism outbreaks, Xinjiang reported the largest number of outbreaks (20), followed by Qinghai (13); the most commonly implicated foods were home-prepared traditional processed stinky tofu and dried beef, accounting for 51.25% events. Improper processing and improper storage in contributing factors accounted for 77.50% outbreaks. Initial misdiagnosis occurred in 27.50% of cases. Conclusions: Outbreaks of foodborne botulism had a high case-fatality rate. Targeted food safety and popularization education to farmers and herdsmen in Xinjiang and Qinghai related to botulism prevention should be carried out, and timely outbreak investigation and hospital surge capacity should be improved.

Mechanically Induced Highly Efficient Hydrogen Evolution from Water over Piezoelectric SnSe nanosheets.

Piezoelectric nanomaterials open new avenues in driving green catalysis processes (e.g., H2 evolution from water) through harvesting mechanical energy, but their catalytic efficiency is still limited. The predicted enormous piezoelectricity for 2D SnSe, together with its high charge mobility and excellent flexibility, renders it an ideal candidate for stimulating piezocatalysis redox reactions. In this work, few-layer piezoelectric SnSe nanosheets (NSs) are utilized for mechanically induced H2 evolution from water. The finite elemental method simulation demonstrates an unprecedent maximal piezoelectric potential of 44.1 V for a single SnSe NS under a pressure of 100 MPa. A record-breaking piezocurrent density of 0.3 mA cm-2 is obtained for SnSe NSs-based electrode under ultrasonic excitation (100 W, 45 kHz), which is about three orders of magnitude greater than that of reported piezocatalysts. Moreover, an exceptional H2 production rate of 948.4 µmol g-1 h-1 is achieved over the SnSe NSs without any cocatalyst, far exceeding most of the reported piezocatalysts and competitive with the current photocatalysis technology. The findings not only enrich the potential piezocatalysis materials, but also provide useful guidance toward high-efficiency mechanically driven chemical reactions such as H2 evolution from water.

Population genomics of the food-borne pathogen Vibrio fluvialis reveals lineage associated pathogenicity-related genetic elements.

Vibrio fluvialis is a food-borne pathogen with epidemic potential that causes cholera-like acute gastroenteritis and sometimes extraintestinal infections in humans. However, research on its genetic diversity and pathogenicity-related genetic elements based on whole genome sequences is lacking. In this study, we collected and sequenced 130 strains of V. fluvialis from 14 provinces of China, and also determined the susceptibility of 35 of the strains to 30 different antibiotics. Combined with 52 publicly available V. fluvialis genomes, we inferred the population structure and investigated the characteristics of pathogenicity-related factors. The V. fluvialis strains exhibited high levels of homologous recombination and were assigned to two major populations, VflPop1 and VflPop2, according to the different compositions of their gene pools. VflPop2 was subdivided into groups 2.1 and 2.2. Except for VflPop2.2, which consisted only of Asian strains, the strains in VflPop1 and VflPop2.1 were distributed in the Americas, Asia and Europe. Analysis of the pathogenicity potential of V. fluvialis showed that most of the identified virulence-related genes or gene clusters showed high prevalence in V. fluvialis, except for three mobile genetic elements: pBD146, ICEVflInd1 and MGIVflInd1, which were scattered in only a few strains. A total of 21 antimicrobial resistance genes were identified in the genomes of the 182 strains analysed in this study, and 19 (90%) of them were exclusively present in VflPop2. Notably, the tetracycline resistance-related gene tet(35) was present in 150 (95%) of the strains in VflPop2, and in only one (4%) strain in VflPop1, indicating it was population-specific. In total, 91% of the 35 selected strains showed resistance to cefazolin, indicating V. fluvialis has a high resistance rate to cefazolin. Among the 15 genomes that carried the previously reported drug resistance-related plasmid pBD146, 11 (73%) showed resistance to trimethoprim-sulfamethoxazole, which we inferred was related to the presence of the dfr6 gene in the plasmid. On the basis of the population genomics analysis, the genetic diversity, population structure and distribution of pathogenicity-related factors of V. fluvialis were delineated in this study. The results will provide further clues regarding the evolution and pathogenic mechanisms of V. fluvialis, and improve our knowledge for the prevention and control of this pathogen.

Characteristics of Settings and Etiologic Agents of Foodborne Disease Outbreaks - China, 2020.

INTRODUCTION: Foodborne diseases are a growing public health problem and have caused a large burden of disease in China. This study analyzed epidemiological characteristics of foodborne diseases in China in 2020 to provide a scientific basis for prevention and control measures. METHODS: Data were collected from 30 of 31 provincial-level administrative divisions (PLADs) in the mainland of China, excluding Xizang (Tibet) Autonomous Region, via the National Foodborne Disease Outbreaks Surveillance System. The number and proportion of outbreaks, illnesses, hospitalizations, deaths by setting, pathogen-food category pairs and etiology were calculated. RESULTS: In 2020, 7,073 foodborne disease outbreaks were reported, resulting in 37,454 illnesses and 143 deaths. Among the identified pathogens, microbial pathogens were the most common confirmed etiology, accounting for 41.7% of illnesses. Poisonous mushrooms caused the largest proportion of outbreaks (58.0%) and deaths (57.6%). For venues where foodborne disease outbreaks occur, household had the highest number of outbreaks (4,140) and deaths (128), and catering service locations caused the largest proportion of illnesses (59.9%). Outbreaks occurring between June and September accounted for 62.8% of total outbreaks. CONCLUSIONS: Foodborne disease outbreaks mainly occurred in households. Microbial pathogens remained the top cause of outbreak-associated illnesses. Poisonous mushrooms were ranked the top cause of deaths in private homes in China. The supervision and management of food safety and health education should be strengthened to reduce the burden of foodborne diseases. Publicity should be increased to reduce the incidence of mushroom poisonings in families, and supervision and management of food should be strengthened to reduce microbial contamination.

Mushroom Poisoning Outbreaks - China, 2010-2020.

Introduction: Mushroom poisoning was the leading cause of foodborne disease outbreaks and outbreak-associated deaths in China. Mushroom poisoning outbreak surveillance can provide insight into the epidemiological characteristics of mushroom poisonings and guide policymaking and health education to reduce illnesses and deaths.Methods: Foodborne Disease Outbreak Surveillance System was upgraded in 2011 to collect foodborne disease outbreaks in China. Mushroom poisoning outbreaks during 2010-2020 were selected to analyze geographical distribution, seasonal distribution, and setting of food preparation.Results: A total of 10,036 outbreaks, which resulted in 38,676 illnesses and 788 deaths, were reported in this period. Mushroom poisonings occurred all over the country, but with highest incidence in the southwest and central China. Overall, 84.6% outbreaks were associated with food prepared in households, followed by 8.7% in street stalls, and 2.5% in canteens. Mushroom poisoning outbreaks clearly exhibited seasonality, and the peak season was summer through autumn. Outbreaks occurring between May and October accounted for 94.1% of total outbreaks, 92.4% illnesses, and 97.2% deaths.Conclusions: Mushroom poisoning is a food safety issue of higher concern in China. Targeted health education is essential to reduce mushroom poisoning, especially in southwest China. Citizens are advised to not collect or eat wild mushrooms.

Prevalence of Antimicrobial Resistant of Vibrio parahaemolyticus Isolated from Diarrheal Patients - Six PLADs, China, 2016-2020.

WHAT IS ALREADY KNOWN ON THIS TOPIC?: Vibrio parahaemolyticus (V. parahaemolyticus) is frequently resistant to common antimicrobials such as ampicillin and generally highly susceptible to most clinically used antimicrobials. WHAT IS ADDED BY THIS REPORT?: V. parahaemolyticus were highly resistant to cefazolin and ampicillin: 94.4% and 37.0%, respectively. However, it was below 3% resistance to all 10 other antimicrobials including clinically relevant agents and even imipenem. The overall levels of antimicrobial resistance and multidrug resistance were 95.1% and 3.3%, respectively. The distribution of antimicrobial resistance and the multidrug resistance had regional, temporal, sexual, and isolated source strain variation. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: This study provides data on drug resistance of V. parahaemolyticus in Chinese clinical settings, which will help develop a public health strategy.

Foodborne Disease Risk Prediction Using Multigraph Structural Long Short-term Memory Networks: Algorithm Design and Validation Study.

BACKGROUND: Foodborne disease is a common threat to human health worldwide, leading to millions of deaths every year. Thus, the accurate prediction foodborne disease risk is very urgent and of great importance for public health management. OBJECTIVE: We aimed to design a spatial-temporal risk prediction model suitable for predicting foodborne disease risks in various regions, to provide guidance for the prevention and control of foodborne diseases. METHODS: We designed a novel end-to-end framework to predict foodborne disease risk by using a multigraph structural long short-term memory neural network, which can utilize an encoder-decoder to achieve multistep prediction. In particular, to capture multiple spatial correlations, we divided regions by administrative area and constructed adjacent graphs with metrics that included region proximity, historical data similarity, regional function similarity, and exposure food similarity. We also integrated an attention mechanism in both spatial and temporal dimensions, as well as external factors, to refine prediction accuracy. We validated our model with a long-term real-world foodborne disease data set, comprising data from 2015 to 2019 from multiple provinces in China. RESULTS: Our model can achieve F1 scores of 0.822, 0.679, 0.709, and 0.720 for single-month forecasts for the provinces of Beijing, Zhejiang, Shanxi and Hebei, respectively, and the highest F1 score was 20% higher than the best results of the other models. The experimental results clearly demonstrated that our approach can outperform other state-of-the-art models, with a margin. CONCLUSIONS: The spatial-temporal risk prediction model can take into account the spatial-temporal characteristics of foodborne disease data and accurately determine future disease spatial-temporal risks, thereby providing support for the prevention and risk assessment of foodborne disease.

Application of Whole-Genome Sequencing in the National Molecular Tracing Network for Foodborne Disease Surveillance in China.

National Molecular Tracing Network for Foodborne Disease Surveillance (TraNet) was launched in 2013, which is the only real-time whole-genome sequencing (WGS)-based subtyping network in China for effective foodborne disease surveillance. TraNet covers three levels of public health laboratories, national, provincial, and municipal. The TraNet national databases have a total of more than 54,000 entries representing seven common foodborne bacteria from humans, food, and environments. Raw sequence data are uploaded to TraNet by Data Delivery Center. Assembled sequence data, pulsed-field gel electrophoresis (PFGE) profiles, antibiotic resistance patterns, and epidemiological data are submitted to national pathogen-specific databases managed by China National Center for Food Safety Risk Assessment. PFGE patterns and WGS-based subtyping are compared for rapid differentiation of clusters of geographically diverse foodborne infections. WGS-based TraNet has played significant roles in improving foodborne disease surveillance in China for rapid outbreak investigation, source tracking, and cluster analysis of particular pathogens across the country.