Serological Survey of Zika Virus in Humans and Animals in Dejiang Prefecture, Guizhou Province, China.

OBJECTIVE: The current outbreak of Zika virus (ZIKV) poses a severe threat to human health. Two ZIKV strains were isolated from mosquitoes collected from the Dejiang prefecture in China in 2016, which was the first isolation of ZIKV in nature in China. METHODS: In this study, serum samples were collected from 366 healthy individuals and 104 animals from Dejiang prefecture in 2017, and the plaque reduction neutralization test (PRNT) was used to evaluate the seroprevalence of ZIKV. RESULTS: None of the 366 residents from whom the samples were collected were seropositive for ZIKV. None of the 11 pigs from whom the samples were collected were seropositive for ZIKV, while 1 of 63 (1.59%) chickens and 2 of 30 (6.67%) sheep were seropositive for ZIKV. CONCLUSION: The extremely low seropositivity rate of ZIKV antibodies in animals in the Dejiang prefecture, Guizhou province in this study indicates that ZIKV can infect animals; however, there is a low risk of ZIKV circulating in the local population.

Fat-to-muscle Ratio: A New Anthropometric Indicator for Predicting Metabolic Syndrome in the Han and Bouyei Populations from Guizhou Province, China.

OBJECTIVE: To investigate the prevalence and possible factors influencing metabolic syndrome in people from Guizhou Province and to explore the predictive value of the fat-to-muscle ratio in diagnosing metabolic syndrome. METHODS: A multistage stratified sampling method was used in this cross-sectional study of 20-80 years old Han and Bouyei populations from Guizhou Province, southwestern China, from October-December 2012. The study included 4,553 cases of metabolic syndrome, that was defined according to 2005 International Diabetes Federation criteria. The receiver operating characteristic curve was used for determining the sensitivity, specificity, and predictive ability of the fat-to-muscle ratio for the diagnosis of metabolic syndrome. RESULTS: The age-standardized prevalence of metabolic syndrome was 11.38% (men: 9.76%; women: 12.72%) for Han and 4.78% (men: 4.43%; women: 5.30%) for Bouyei populations. In Guizhou Province, the cut-off value for the men fat-to-muscle ratio was 0.34, the area under the curve was 0.95, and the sensitivity and specificity were 0.94 and 0.85, respectively. The cut-off value for the women fat-to-muscle ratio was 0.55, the area under the curve was 0.91, and the sensitivity and specificity were 0.93 and 0.79, respectively. CONCLUSION: The fat-to-muscle ratio is highly predictive of metabolic syndrome in Guizhou Province, and a useful reference indicator.

[Identification and genetic characteristics on the bacteria isolate from a case of human Brucellosis in Guizhou province].

OBJECTIVE: A suspected Brucella (B.) strain(GZZA), isolated from a case of anti-Brucella antibody positive patient was identified and its' genetic characteristics was analyzed, to provide etiologic basis for the confirmation of patient in Guizhou province. METHODS: Conventional methods and polymerase chain reaction(PCR)were used to identify the bacteria strain, with genetic characteristics analyzed by MLVA-16. RESULTS: The bacteria strain was identified as B. melitensis biovar 3 under the conventional and PCR methods. Results from the MLVA-16 analysis indicated that the bacteria strain was closely clustered with B. melitensis biovar 3, and differences of repeated numbers at VNTR loci bruce42, bruce04, bruce09 and bruce16 were also displayed. CONCLUSION: Both traditional and molecular methods to identify one bacteria strain isolated from the human patient as B. melitensis biovar 3 and the genetic characteristics of the strain was closely related to that of B. melitensis biovar 3. Differences of repeated numbers at part of VNTR loci were also showed. The results of this study provided etiologic evidences for the confirmation of Brucella infection of the patient, also providing scientific basis for the control and prevention of Brucellosis in Guizhou province.

[Fever monitoring program in areas with high incidence of typhoid and paratyphoid fever in Guizhou province].

OBJECTIVE: To understand the incidence rates of both typhoid fever and paratyphoid fever in the high prevalent areas of Guizhou province so as to provide evidence for the development of programs on comprehensive intervention and effectiveness evaluation. METHODS: Six townships in Pingba county were selected as intervention areas while six townships in Kaiyang county were taken as control. All hospitals and clinics were classified into A, B and C types according to its level and the capacity of the blood culture. Surveillance on typhoid and paratyphoid fever was conducted based on all population and all hospitals, clinics and county CDCs among the patients with unknown fever. RESULTS: In the surveillance area in those two counties, there were 12 944 blood samples from patients with unknown fever which have been tested and cultured. Among them, 200 strains of Salmonella including 16 typhoid strains, 184 paratyphoid A strains were identified, with the total positive rate as 1.55%. The positive rate before the intervention program was higher than the after. The detection rate was 1.91% in the type A hospitals. 39 strains of Salmonella have been cultured from 2039 samples which accounting for 19.50% (39/200) of the total strains. 4315 blood samples were cultured at the 'Class B' sites which isolated 82 strains of Salmonella, accounting for 41.00% (82/200), with a detection rate as 1.90%. 6590 samples were cultured at the 'Class C' sites, which identified 79 strains of Salmonella, accounting for 39.50% (79/200), with a detection rate as 1.20%. The detection rate was much higher before the use of antibiotics than after using them (P < 0.05). The annual peak time of positive detection was in spring and fall. The outbreaks or epidemics often appeared in the same places, with farmers, students as the high-risk populations. Symptoms of both typhoid and paratyphoid fever were not typical. CONCLUSION: Typhoid and paratyphoid monitoring programs which covered primary health care institutions in the high incidence area seemed to be effective in reflecting the pictures as well as the burden of both typhoid and paratyphoid.

[Analysis on molecular epidemiological features of enterovirus type 71 in Guizhou Province, 2008-2011].

To study the genotype and molecular epidemiological features of enterovirus type 71 (EV71) in Guizhou Province. The hand-foot-mouth disease(HFMD) patients since 2008 in Guizhou Province were surveyed. EV71 RNA positive samples, including mild cases, death cases and cases of serious conditions, were used for subsequent cell culture and sequencing of VP1 complete gene. Genotypes were compared between domestic and foreign epidemic strains. The results showed that the main pathogenwas EV71 subtype C4a in 2008, 2009 and 2011. The nucleotide homology was 95. 3 - 99. 7% among 109 sequenced strains isolated in Guizhou Province. Guizhou strains were more similar to the representative strains from neighbor Province or City, including Shandong, Shanghai, Nanjing, Jilin and Ningbo. There was no distinct sequence difference among the isolates from either of death, mild case or case of serious condition at the nucleotide and amino acid levels. The diversity of nucleotide sequence of isolates was less within same region and year than those trans-regional strains or strains in different year.

[Genotype features of norovirus associated with acute gastroenteritis through sentinel surveillance in Guizhou Province, 2011].

To study the genotype of Norovirus associated with acute gastroenteritis in Guizhou Province 2011, the patients' fecal specimens were collected from the Guizhou Province People's Hospital in the period of May to December 2011. Noroviruses in specimens were detected by a real-time reverse transcription polymerase chain reaction (Real-time RT-PCR). VP1 genes of norovirus-positive strains were then cloned and sequenced. Out of 70 clinical samples, the positive rates for norovirus G I (1 strain) and G II (34 strains) were 1.43% and 48.57, respectively. The VP1 sequencing results of seven norovirus G II showed thatthree strains were genotype G II . 4 and four strains were genotype G II . 3 Those genotype GIL . 4 strains were new variants (GII . 4 2011),closest to GII . 4 2006b variant. One amino acid appeared back mutation. Those genotype G II . 3 strains were divided into 2 gene clusters. One cluster was closest to Korean strain (HM635118) and Shanghai strain(GU991355). One cluster was closest to Japaness strain (AB629943) and 2007 Indian strain (EU921389), Four amino acids appeared back mutations.

Molecular typing of Leptospira interrogans strains isolated from Rattus tanezumi in Guizhou Province, Southwest of China.

OBJECTIVE: To identify and type three leptospires isolated from Rattus tanezumi in Guizhou Province by using three molecular techniques (PFGE, MLVA, and MLST), reveal the molecular characteristic of causative agents of local leptospirosis and evaluate these three molecular methods based on their detection resolution and efficiency. METHODS: Three Leptospira strains were isolated from the kidney of Rattus tanezumi and cultured with EMJH medium. PFGE, MLVA, and MLST assays were applied to type the three strains isolated from Rattus tanezumi in Guizhou Province. RESULTS: PFGE, MLVA, and MLST typing showed that the three leptospiral isolates matched with leptospiral serogroup Icterohaemorrhagiae serovar Lai. The findings of the genotyping methods were consistent. MLVA and MLST defined genotypes, whereas PFGE allowed the recognition of additional subgroups within the genotypes, and the findings of molecular typing were also consistent with those of traditional techniques. CONCLUSION: Three leptospiral isolates from Guizhou Province matched with leptospiral serogroup Icterohaemorrhagiae serovar Lai, and PFGE, MLVA, and MLST, as reliable molecular techniques for identifying and typing of Leptospira interrogans, would contribute to the active surveillance, outbreak investigation and source tracking for leptospirosis in Guizhou Province.

[Analysis of the genetic differences in the nucleoprotein between rabies virus and its vaccine strains in Guizhou province from year 2005 to 2010].

OBJECTIVE: This study was to explore the differences in the nucleoprotein gene between rabies virus (RABV) and its vaccine strains in Guizhou province from year 2005 to 2010. METHODS: Samples from 4 rabies patients and cerebral tissue samples of 28 rabies infected dogs were collected from different districts in Guizhou province between year 2005 and 2010. Direct Immunofluorescence Assay (DFA) and RT-nested PCR assay were applied to detect the overall length of N gene sequence. Meanwhile, based on the comparison between the homology and phylogenetic tree, the differences in N gene sequence between the prevalent RABV and the RABV vaccine strains collected from NCBI database in these years. RESULTS: According to DFA and RT-nested PCR assay, the antigen and nucleic acid of the 21 dogs and 4 human samples were both confirmed positive; whose full length of N gene sequences were both 1353 bp. The homological analysis showed that the 25 strains of RABV virus and the RABV type I virus stored by GenBank database shared a high homology in N gene nucleotide and amino acid sequences, which were 89%-100% and 98%-100%, respectively. Besides, the homology between the 25 strains of RABV virus and its vaccines in nucleotide and amino acid sequences were separately 86%-95% and 96%-100%. The N gene of vaccines for livestock shared the highest homology with HEP-Flury strain in the nucleotide and amino acid, which were 88%-89% and 98%-99%, respectively. The vaccines for human use showed its greatest homology with the CTN strain in nucleotide (86%-100%) and amino acid (96%-100%). The phylogenetic tree analysis indicated that the 25 strains of RABV virus, RABV type I virus and the CTN vaccine strains constituted one individual cluster, which was least different from the CTN vaccine for human use. CONCLUSION: The prevalent RABV virus, the vaccine HEP-Flury for livestock and the vaccine CTN for human use were found to be highly similar in N gene expression in Guizhou province from 2005 to 2010.

[Analysis on nucleoprotein gene sequence of 25 rabies virus isolates in Guizhou Province, China].

To analyze 25 nucleoprotein gene (N gene) sequences of rabies viruses circulating in Guizhou province during 2005-2010, China, and to explore the epidemic characteristics and the probable mutant of rabies in Guizhou Province. Rabies virus RNA in human brain tissues, human saliva, and domestic dog brain tissues derived from different prefectures of Guizhou Province were detected with RT-nested PCR, and the amplified products were then sequenced. Bioinformatics software was used to determine the genetic characteristics of these rabies viruses. The sequences of N gene of 25 Guizhou provincial isolates were identical with homogeny between 97.5% - 99.3% and 98.4% - 99.8% at nucleotide and deduced amino acid level, respectively, while the identities between them and isolated strains from other province of China were 88% - 99.1% and 88% - 99.7%. There were several amino acid substitutions in the nucleoprotein of 25 Guizhou isolates compared with the known genotype 1 isolates. The analysis of phylogenetic tree of 25 Guizhou isolates was demonstrated to be genetically divided into two groups, indicating that the virus presented a unique characteristics in geographic distribution and in a time dependent-manner. And phylogenetic tree of 25 Guizhou isolates and 7 genotype 1 strains isolated from other Province of China was also divided into two groups, which were further composed of several subgroups, respectively. From these observations, the rabies viruses derived from Guizhou province were still genotype 1. These isolates of rabies virus were diverged from the strains isolated from other provinces in both gene sequences and deduced amino acid sequences, and these divergences were characterized in geographic distribution and in a time-dependent manner.

[Self-management behaviors among children after exposure to rabies in two severe rabies epidemic areas of China].

OBJECTIVE: To understand the situation of rabies exposure and self-management behaviors among primary school students from rabies epidemic areas in China. METHODS: This population-based investigation was conducted in Guizhou and Guangdong provinces which had been severe epidemic areas of rabies in China from January 2007 to May 2008. Primary schools from two prefectural, two county, four township and four village levels were selected in the 2 provinces. Students were sampled from each grade of the 12 schools to collect information on post-exposure prophylaxis. RESULTS: In the 2408 primary school students interviewed, 290 person/times exposure were found from 2007 to 2008. The self wound-treatment rates was 47.93%, with 16.55% of them went to the clinic for care-seeking initiatively and 63.79% informed their parents or teachers. However 23.10% of the students did nothing after exposure. Students in Guangdong province had lower exposure rate and higher rate of good management behaviors than in Guizhou. No significant statistical difference was found between the self-management behaviors among male and female students or among different levels of primary schools. The proportion of disinfection on wounds with alcohol and seeking medical treatment in rabies clinic initiatively were both low in all grades of the students but the proportion of telling their parents or teachers about the exposure among children was high in all grades of students. CONCLUSION: Some students after rabies exposure did not have any disposal in Guangdong and Guizhou provinces. Related education should be strengthened.

[Study on the status of infection and distribution of rabies virus in China].

OBJECTIVE: To investigate the status of infection and distribution of rabies virus (RV) in different epidemic areas in China. METHODS: Brain specimens from animals and suspected patients were collected at the districts of high-, medium- and low incidence rates of human rabies and detected by both direct Immunofluorescence assay (DFA) and RT-PCR. RESULTS: 254 of 3007 specimens of dog brains showed RV positive by DFA (positive rate of 8.4%). Among these 254 samples, 78 showed positive (positive rate of 30.7%) by RT-PCR. 93 specimens from dogs and cats that had attacked human beings, 63 of them showed positive by DFA (positive rate of 67.7%) and all of them were also positive by RT-PCR. In addition, RV could also be detected in Apodemus agrarius, ferret badger, and suspected patients specimens from the districts under survey. There was no statistical difference between the infection rates of RV in different provinces and regions with different incidence of rabies. CONCLUSION: There might be a relatively high infection rate of RV among the domestic dogs/cats in the endemic areas in China. Wild animals might have been infected with RV in the districts under survey.

Epidemiological investigations of human rabies in China.

BACKGROUND: The epidemic of rabies showed a rising trend in China in recent years. To identify the potential factors involved in the emergence, we investigated and analyzed the status and characteristics of human rabies between 1996 and 2008. Moreover, the status of rabies infection and vaccination in dogs, and prophylaxis of humans after rabies exposure were analyzed. METHODS: Human rabies data in China between 1996 and 2008 collected from the annual reports of Chinese Center for Disease Control and Prevention (China CDC) were analyzed. To investigate the status of dogs and postexposure prophylaxis (PEP) of humans, brain specimens of domestic dogs were collected and detected, and the demographic details, exposure status and PEP of rabies patients were obtained in 2005 and 2006 in Guangxi, Hunan and Guizhou provinces. RESULTS: The results showed 19,806 human rabies cases were reported in China from 1996 to 2008, with an average of 1,524 cases each year, and the incidence almost was rising rapidly, with the peak in 2007 (3,300 cases). It was notable that nearly 50% of the total rabies cases nationwide were reported in Guangxi, Hunan and Guizhou provinces. In these three provinces, the rabies infection rate in dogs was 2.3%, and 60% investigated cities had a dog vaccination rate of below 70%; among the 315 recorded human cases, 66.3% did not receive any PEP at all, 27.6% received inadequate PEP, and only 6.0% received a full regime of PEP. CONCLUSIONS: In recent years, rabies is reemerging and becoming a major public-health problem in China. Our analysis showed that unsuccessful control of dog rabies and inadequate PEP of patients were the main factors leading to the high incidence of human rabies in China, then there are following suggestions: (1) Strict control of free-ranging dogs and mandatory rabies vaccination should be enforced. (2)Establishing national animal rabies surveillance network is imperative. (3) PEP should be decided to initiate or withhold according to postmortem diagnosis of the biting animal. (4) The cost of PEP should be decreased or free, especially in rural areas. (5)Education of the public and health care staff should be enhanced.

Molecular epidemiology of rabies in Southern People's Republic of China.

In recent years, the number of human rabies cases in the People's Republic of China has increased during severe epidemics in 3 southern provinces (Guizhou, Guangxi, and Hunan). To analyze the causes of the high incidence of human rabies in this region, during 2005-2007, we collected 2,887 brain specimens from apparently healthy domestic dogs used for meat consumption in restaurants, 4 specimens from suspected rabid dogs, and 3 from humans with rabies in the 3 provinces. Partial nucleoprotein gene sequences were obtained from rabies-positive specimens. Phylogenetic relationships and distribution of viruses were determined. We infer that the spread of rabies viruses from high-incidence regions, particularly by long-distance movement or transprovincial translocation of dogs caused by human-related activities, may be 1 cause of the recent massive human rabies epidemics in southern China.

[Survey and anslysis of infection rate of dog rabies in the regions with high incidence of human rabies].

OBJECTIVE: To investigate the situation of dog rabies and analyze it's relationship with human rabies. METHODS: In Guizhou, Guangxi and Hunan provinces which suffered from rabies most heavily, one or two cities were selected respectively from regions with high-, middle-, low-incidence rate of human rabies as investigation spots where Dogs' brain specimens were collected and detected with both direct immunofluorescence assay (IFA) and RT-PCR. RESULTS: A total of 2887 specimens were collected and 66 of these were positive for IFA and RT-PCR. Therefore, the rate of positive specimens was 2.3%. However, there was not a close relationship in the incidence rate of dog rabies and human rabies. CONCLUSION: Dog's infection situation of rabies contributed to the severe epidemic of human rabies.

[Characterization of rabies virus phosphoprotein in high prevalence provinces of China].

OBJECTIVE: Characterization of rabies virus phosphoprotein through analyzation of genetic variations about rabies virus phosphoproteins in high-incidence regions in China. METHODS: The nucleotide sequence of the P gene of Guangxi, Guizhou and Hunan provinces positive sample's were sequenced, and the P region's similarity and phylogenetic analyses were completed by using softer wares. RESULTS: The similarity of P region's nucleotide sequence is 82.1%-100%, while, the similarity of amino acid sequence is 87.5%-100%. A little variation in phosphoprotein cannot influence its biological functions. CONCLUSION: All rabies viruses isolated from Guangxi, Guizhou and Hunan provinces belong to genotype 1 and share same phylogenesis and same genome characteristic; Virus distribution presents unique Characterization; Some virus isolates from Hunan province and Thailand may come from the same virus.

Novel genospecies of Borrelia burgdorferi sensu lato from rodents and ticks in southwestern China.

By using multilocus sequence analysis, five Borrelia valaisiana-related strains isolated from rodents and ticks in southwestern China were eventually classified as a new genospecies of B. burgdorferi sensu lato rather than B. valaisiana. The finding explained the differences in transmission cycle and phenotype between B. valaisiana strains from Europe and B. valaisiana-related strains from eastern Asia.

Molecular diversity and phylogeny of Hantaan virus in Guizhou, China: evidence for Guizhou as a radiation center of the present Hantaan virus.

To gain further insight into the molecular epidemiology of Hantaan virus (HTNV) in Guizhou, China, rodents were captured in this region in 2004 and 2005. In addition, serum samples were collected from four patients. Ten hantaviruses were isolated successfully in cell culture from four humans, two Apodemus agrarius, three Rattus norvegicus and one Rattus nitidus. The nucleotide sequences for their small (S), medium (M) and partial large (L) segments were determined. Phylogenetic analysis of the S and M segment sequences revealed that all of these isolates belong to the species HTNV, suggesting a spillover of HTNV from A. agrarius to Rattus rats. All available isolates from Guizhou were divided into four distinct groups either in the S segment tree or in the M segment tree. The clustering pattern of these isolates in the S segment tree was not in agreement with that in the M or L segment tree, showing that genetic reassortment between HTNV had occurred naturally. Analysis of the S segment sequences from available HTNV strains indicated that they formed three clades. The first clade, which comprised only viruses from Guizhou, was the outgroup of clades II and III. The viruses in the second clade were found in Guizhou and mainly in the far-east Asian region, including China. However, the viruses in the third clade were found in most areas of China, including Guizhou, in which haemorrhagic fever with renal syndrome (HFRS) is endemic. Our results reveal that the highest genetic diversity of HTNV is in a limited geographical region of Guizhou, and suggest that Guizhou might be a radiation centre of the present form of HTNV.

Investigation of the role of healthy dogs as potential carriers of rabies virus.

To investigate whether healthy animals are potential carriers of rabies virus in China, 153 domestic dogs were collected from a rabies enzootic area, Anlong county in Guizhou Province, and monitored for 6 months. Initially, findings of rabies virus antigen in the saliva of 15 dogs by an enzyme-linked immunosorbent assay (ELISA) test suggested they might be carriers. These 15 dogs were kept under observation for 6 months. None of the dogs showed any clinical signs of rabies during the observation period. Moreover, using the ELISA test alone, detection of rabies virus antigen in saliva of some animals was not consistent during the observation period. However, none of the saliva samples collected either at the time of acquisition or during the observation period was found to be positive for rabies virus RNA by reverse transcriptase-polymerase chain reaction (RT-PCR). Furthermore, neither viral antigen nor viral RNA was detected in the brain samples collected at the time of euthanasia. These results do not provide support for the contention that healthy dogs act as carriers in rabies. Caution is urged when preliminary and nondefinitive tests, such as ELISA, are used to infer clinical status related to rabies.