First Case Report of Cystic Echinococcosis Caused by G7 Genotype Echinococcus intermedius Confirmed by Genetic Sequencing - Southern China, December 2023.

What is already known about this topic?: Echinococcosis exhibits a global distribution. In China, the primary endemic area is the northwest region. In December 2023, we documented a case of echinococcosis in an individual lacking any travel or residential history in endemic regions. What is added by this report?: This is the first laboratory-confirmed case of hepatic echinococcosis reported in Guangdong Province, associated with the G7 genotype of Echinococcus granulosus (E. granulosus). The most probable mode of transmission is a local infection resulting from E. granulosus introduced from endemic regions. What are the implications for public health practice?: As the circulation of agricultural products increases, it is essential to enhance the quarantine and management of livestock from epidemic areas to prevent and control the spread of echinococcosis to non-epidemic regions.

Developing a geographical-meteorological indicator system and evaluating prediction models for alveolar echinococcosis in China.

BACKGROUND: Geographical and meteorological factors have been reported to influence the prevalence of echinococcosis, but there's a lack of indicator system and model. OBJECTIVE: To provide further insight into the impact of geographical and meteorological factors on AE prevalence and establish a theoretical basis for prevention and control. METHODS: Principal component and regression analysis were used to screen and establish a three-level indicator system. Relative weights were examined to determine the impact of each indicator, and five mathematical models were compared to identify the best predictive model for AE epidemic levels. RESULTS: By analyzing the data downloaded from the China Meteorological Data Service Center and Geospatial Data Cloud, we established the KCBIS, including 50 basic indicators which could be directly obtained online, 15 characteristic indicators which were linear combination of the basic indicators and showed a linear relationship with AE epidemic, and 8 key indicators which were characteristic indicators with a clearer relationships and fewer mixed effects. The relative weight analysis revealed that monthly precipitation, monthly cold days, the difference between negative and positive temperature anomalies, basic air temperature conditions, altitude, the difference between positive and negative atmospheric pressure anomalies, monthy extremely hot days, and monthly fresh breeze days were correlated with the natural logarithm of AE prevalence, with sequential decreases in their relative weights. The multinomial logistic regression model was the best predictor at epidemic levels 1, 3, 5, and 6, whereas the CART model was the best predictor at epidemic levels 2, 4, and 5.

Investigation on the Management for Patients with Echinococcosis Treated with Albendazole - Three PLADs, China, 2019.

What is already known about this topic?: In China, patients with echinococcosis receive complimentary healthcare services, such as medical treatment, diagnostic examinations, and follow-up care. Despite this, no studies have been conducted to assess the quality of patient management to date. What is added by this report?: This study reviewed the medical records of 899 patients who underwent albendazole treatment across 10 endemic counties. Out of 634 evaluable patient files, the proportion of patients with a ratio of actual follow-up and reexamination times to theoretical follow-up and reexamination times ≥0.8 were both low (21.92% and 23.19%, respectively). What are the implications for public health practices?: This study identified weaknesses and specific issues in patient management and proposed feasible recommendations to enhance patient file documentation, follow-up, and reexamination.

Epidemiological characteristics and risk factors for cystic and alveolar echinococcosis in China: an analysis of a national population-based field survey.

BACKGROUND: Human cystic and alveolar echinococcosis are neglected tropical diseases that WHO has prioritized for control in recent years. Both diseases impose substantial burdens on public health and the socio-economy in China. In this study, which is based on the national echinococcosis survey from 2012 to 2016, we aim to describe the spatial prevalence and demographic characteristics of cystic and alveolar echinococcosis infections in humans and assess the impact of environmental, biological and social factors on both types of the disease. METHODS: We computed the sex-, age group-, occupation- and education level-specific prevalences of cystic and alveolar echinococcosis at national and sub-national levels. We mapped the geographical distribution of echinococcosis prevalence at the province, city and county levels. Finally, by analyzing the county-level echinococcosis cases combined with a range of associated environmental, biological and social factors, we identified and quantified the potential risk factors for echinococcosis using a generalized linear model. RESULTS: A total of 1,150,723 residents were selected and included in the national echinococcosis survey between 2012 and 2016, of whom 4161 and 1055 tested positive for cystic and alveolar echinococcosis, respectively. Female gender, older age, occupation at herdsman, occupation as religious worker and illiteracy were identified as risk factors for both types of echinococcosis. The prevalence of echinococcosis was found to vary geographically, with areas of high endemicity observed in the Tibetan Plateau region. Cystic echinococcosis prevalence was positively correlated with cattle density, cattle prevalence, dog density, dog prevalence, number of livestock slaughtered, elevation and grass area, and negatively associated with temperature and gross domestic product (GDP). Alveolar echinococcosis prevalence was positively correlated with precipitation, level of awareness, elevation, rodent density and rodent prevalence, and negatively correlated with forest area, temperature and GDP. Our results also implied that drinking water sources are significantly associated with both diseases. CONCLUSIONS: The results of this study provide a comprehensive understanding of geographical patterns, demographic characteristics and risk factors of cystic and alveolar echinococcosis in China. This important information will contribute towards developing targeted prevention measures and controlling diseases from the public health perspective.

The First Detection of Echinococcus Granulosus DNA in Residents' Hands, Dogs' Hair, and Soil in Highly Endemic Region of Echinococcosis - Naqu City, Xizang Autonomous Region, China, 2020.

What is already known about this topic?: Echinococcosis is a serious zoonotic parasitic disease that predominantly infects humans; domestic animals like cattle or sheep; as well as wild animals such as small rodents. To date, there is a lack of comprehensive information about all potential environmental transmission routes for Echinococcus. What is added by this report?: This study assesses the importance of under-researched environmental factors for the transmission of Echinococcus. It concludes that hand hygiene is an important factor in the robust environmental transmission of Echinococcus granulosus. What are the implications for public health practice?: This study suggests that residents are at risk of catching echinococcosis through hand-oral transmission routes. Health education given to local residents is thus a key intervention, as well as avoiding close contact with dogs and ensuring proper hand-washing practices are followed.

Epidemiological Trends of Coronavirus Disease 2019 in Sierra Leone From March 2020 to October 2021.

Coronavirus disease 2019 (COVID-19), a serious public health challenge the world over, has led to significant health concerns in Sierra Leone. In the present study, epidemic indices, such as the number of cases, positivity rate, reproduction rate (R0), case fatality rate (CFR), age, and sex, were used to characterize the epidemiological trends of COVID-19. As of October 31, 2021, a total of 6,398 cases and 121 related deaths had been confirmed. The total number of COVID-19 reverse transcription polymerase chain reaction (RT-PCR) tests conducted to October 31, 2021, was 249,534, and the average positivity rate was 2.56%. Three waves of COVID-19 were recorded, occurring during weeks 15-46 in 2020 (2,369 cases), week 47 in 2020 to week 16 in 2021 (1,665 cases), and weeks 17-43 in 2021 (2,364 cases), respectively. Remarkably, there was no increase in the numbers of confirmed COVID-19 cases despite rising test numbers throughout the three waves. Moreover, three high R0 values were observed before each wave. The number of positive cases significantly correlated with positive numbers of international arrivals (P < 0.01), deaths (P < 0.01), and the positivity rate of tested samples (P < 0.01). Moreover, all of the deaths occurred during the peak of the three waves. Our results indicate that there was a low level of COVID-19 epidemic in Sierra Leone and that COVID-19's introduction led to local transmission. It is vital to fight against the spread of SARS-CoV-2 from the source of origin by strengthening testing and management of people entering the country. Our findings will provide important clues for expanding sample screening and will contribute to the reasonable allocation of medical resources.

Knockdown resistance mutations distribution and characteristics of Aedes albopictus field populations within eleven dengue local epidemic provinces in China.

Background: Aedes albopictus, commonly known as the tiger mosquito, has attracted global attention because its bite can transmit several viruses, such as dengue virus. With the absence of an effective therapy and vaccine, mosquito control is the sole method for dengue fever control. However, Ae. albopictus has developed resistance to most insecticides, especially pyrethroids. Many scholars have conducted thorough research for the target-site of pyrethroids. The main target-site is the voltage-gated sodium channel gene (VGSC) whose mutation causes knockdown resistance (kdr). The spatial distribution of three locus kdr mutations in Ae. albopictus has not been comprehensively analyzed nationwide in China. In addition, the relationship between the frequency of kdr mutations and dengue fever has not yet been explored. Methods: A total of 2,241 Ae. albopictus samples from 49 populations from 11 provinces of mainland China were collected in 2020 and analyzed for mutations in the VGSC gene. DNAstar 7.1. Seqman and Mega-X were used to compare the sequences and read the peak map to confirm the genotypes and alleles of each mutation. ArcGIS 10.6 software was used to make interpolation and extract meteorological data of collection sites and to conduct spatial autocorrelation analysis. R 4.1.2 software was used to conduct a chi-square test for kdr mutations and dengue area and to analyze the correlation between meteorological factors and kdr mutations. Results: The overall frequencies of mutant alleles at 1016G, 1532T, and 1534S/C/L were 13.19%, 4.89%, and 46.90%, respectively. Mutations at the three loci were found at 89.80% (44/49), 44.90% (22/49), and 97.96% (48/49) of the field populations. At each of the loci V1016 and I1532, only one allele was detected, which was GGA(G) and ACC(T), respectively. Five mutant alleles were found at codon 1534: TCC/S (33.49%), TGC/C (11.96%), TTG/L (0.60%), CTC/L (0.49%), and TTA/L (0.58%). In total, 31 triple-locus genotype combinations were found, and the single locus mutation was the most common. We also found firstly triple-locus mutant individuals, whose genotypes were V/G+I/T+F/S and V/G+I/T+S/S. The 1016 and 1532 mutation rates were significantly negatively related to the annual average temperature (AAT), but the 1534 mutation rate was significantly positively related to AAT. The 1532 mutation rate was significantly positively related to the 1016 mutation rate but negatively related to the 1534 mutation rate. A relationship was observed between the 1534 codon mutation rate and dengue epidemic areas in this study. Furthermore, spatial autocorrelation analysis results showed that the mutation rates of different codons in different geographical areas had spatial aggregation and positive spatial correlation. Conclusion: This study showed that the multiple kdr mutations at codon 1016, 1532 and 1534 of Ae. albopictus were found in most areas of China. Two novel triple-locus genotype combinations, V/G+I/T+F/S and V/G+I/T+S/S, were detected in this study. In addition, the relationship between mosquito resistance and dengue fever outbreak should be further explored, especially considering the insecticide-usage history in different areas. The characteristic of spatial aggregation of VGSC gene mutation rates reminds us to notice the gene exchange and similarity of insecticide usage in the adjacent areas. The use of pyrethroids should be restricted to delay resistance development. New-type insecticides should be developed to adjust the changes in the resistance spectrum. Our study provides abundant data on the Ae. albopictus kdr gene mutation in China; these findings will be useful for the correlation analysis of molecular mechanism of insecticide resistance.

Geographical Detector-based influence factors analysis for Echinococcosis prevalence in Tibet, China.

Echinococcosis, caused by genus Echinococcus, is the most pathogenic zoonotic parasitic disease in the world. In Tibet of the People's Republic of China, echinococcosis refers principally to two types of severe zoonosis, cystic echinococcosis (CE) and alveolar echinococcosis (AE), which place a serious burden on public health and economy in the local community. However, research on the spatial epidemiology of echinococcosis remains inadequate in Tibet, China. Based on the recorded human echinococcosis data, maps of the spatial distribution of human CE and AE prevalence in Tibet were produced at city level and county level respectively, which show that the prevalence of echinococcosis in northern and western Tibet was much higher than that in other regions. We employ a geographical detector to explore the influencing factors for causing CE and AE while sorting information on the maps of disease prevalence and environment factors (e.g. terrain, population, and yak population). The results of our analysis showed that biological factors have the most impact on the prevalence of echinococcosis, of which the yak population contributes the most for CE, while the dog population contributes the most for AE. In addition, the interaction between various factors, as we found out, might further explain the disease prevalence, which indicated that the echinococcosis prevalence is not simply affected by one single factor, but by multiple factors that are correlated with each other complicatedly. Our results will provide an important reference for the evaluation of the echinococcosis risk, control projects, and prevention programs in Tibet.

Factors influencing the spatial distribution of cystic echinococcosis in Tibet, China.

Cystic echinococcosis (CE), which is caused by Echinococcus granulosus, is a worldwide helminthozoonosis that is highly endemic in the Tibet Autonomous Region of China and has important public health and economic impacts. However, the spatial epidemiological characteristics of CE in Tibet are still unclear. Based on recorded human CE cases and the use of a geographic information system, the spatial distribution patterns of CE prevalence at three different scales were analyzed. In addition, a spatial agglomeration map of CE prevalence was generated based on cold/hot spot analysis. By combining maps of environmental and biological covariates with information about known human CE cases, the links between CE prevalence and relevant covariates were explored, revealing that the annual average precipitation, elevation, water accessibility and animal population (dog and yak) were associated with the prevalence of CE at the significance level of P < 0.05. Our results provide a novel insight and better understanding of the current situation of and the factors influencing CE in Tibet, which can help public health authorities develop disease prevention and control strategies.

Contribution to the echinococcosis control programme in China by NIPD-CTDR.

As a zoonotic parasitosis caused by the parasitism of Echinococcus larvae, echinococcosis imposes serious disease and economic burdens on human beings and society, and is thus a global public health issue. Its complex life history, wide distribution, the combined influence of various epidemic factors, coupled with the unique natural environment, customs, and religious beliefs in endemic areas, pose a huge challenge to the national echinococcosis control programme in China. Accurate early detection and confirmation of diagnosis of echinococcosis, the use of effective drugs, real-time surveillance of the infection status of populations and various hosts, controlling the source of infection, and blocking the route of transmission are of enormous significance for control. In this paper, the work by NIPD-CTDR on the prevention and control of echinococcosis in China is reviewed, with a view to providing reference for the further promotion of the national echinococcosis control programme.

National Alveolar Echinococcosis Distribution - China, 2012-2016.

What is already known about this topic? Both alveolar echinococcosis (AE) and cystic echinococcosis are endemic in China, among which alveolar echinococcosis has a very high mortality rate. What is added by this report? The survey results showed the prevalence and scope of AE in China and identified high-risk groups including children, monks, herdsmen and illiterate people. At the same time, all the cases found in the survey (more than 90% of the patients did not go to the hospital for diagnosis and treatment before survey) were promptly diagnosed and treated. What are the implications for public health practice? This study provides information for the development of a plan for AE prevention and control and for the implementation of interventions targeted to high-risk populations.

Epidemiological survey of echinococcosis in Tibet Autonomous Region of China.

BACKGROUND: The echinococcosis is prevalent in 10 provinces /autonomous region in western and northern China. Epidemiological survey of echinococcosis in China in 2012 showed the average prevalence of four counties in Tibet Autonomous Region (TAR) is 4.23%, much higher than the average prevalence in China (0.24%). It is important to understand the transmission risks and the prevalence of echinococcosis in human and animals in TAR. METHODS: A stratified and proportionate sampling method was used to select samples in TAR. The selected residents were examined by B-ultrasonography diagnostic, and the faeces of dogs were tested for the canine coproantigen against Echinococcus spp. using enzyme-linked immunosorbent assay. The internal organs of slaughtered domestic animals were examined by visual examination and palpation. The awareness of the prevention and control of echinococcosis among of residents and students was investigated using questionnaire. All data were inputted using double entry in the Epi Info database, with error correction by double-entry comparison, the statistical analysis of all data was processed using SPSS 21.0, and the map was mapped using ArcGIS 10.1, the data was tested by Chi-square test and Cochran-Armitage trend test. RESULTS: A total of 80 384 people, 7564 faeces of dogs, and 2103 internal organs of slaughtered domestic animals were examined. The prevalence of echinococcosis in humans in TAR was 1.66%, the positive rate in females (1.92%) was significantly higher than that in males (1.41%), (χ2 = 30.31, P < 0.01), the positive rate of echinococcosis was positively associated with age (χ2trend = 423.95, P < 0.01), and the occupational populations with high positive rates of echinococcosis were herdsmen (3.66%) and monks (3.48%). The average positive rate of Echinococcus coproantigen in TAR was 7.30%. The positive rate of echinococcosis in livestock for the whole region was 11.84%. The average awareness rate of echinococcosis across the region was 33.39%. CONCLUSIONS: A high prevalence of echinococcosis is found across the TAR, representing a very serious concern to human health. Efforts should be made to develop an action plan for echinococcosis prevention and control as soon as possible, so as to control the endemic of echinococcosis and reduce the medical burden on the population.

Characterization of Co-Cultivation of Cyanobacteria on Growth, Productions of Polysaccharides and Extracellular Proteins, Nitrogenase Activity, and Photosynthetic Activity.

Cyanobacteria as biofertilizers are benefit to reduce the use of chemical fertilizers and reestablish the ecological system in soil. In general, several strains of cyanobacteria were involved in the biofertilizers. The co-cultivation of cyanobacteria were characterized on growth profile, production of polysaccharides and extracellular proteins, nitrogenase activity, and photosynthetic activity for three selected N2-fixing cyanobacteria, Anabaena cylindrica (B1611 and F243) and Nostoc sp. (F280). After eight-day culture, the highest dry weights were obtained in F280 pure culture and co-cultivation of B1611 and F280. Higher production of extracellular proteins and cell-bonding polysaccharides (CPS) were observed in co-cultivations compared with pure culture. The highest released polysaccharides (RPS) contents were obtained in pure culture of F280 and co-cultivation of F280 and F243. Galactose and glucose were major components of CPS and RPS in all samples. Trehalose was a specific component of RPS in F280 pure culture. Based on the monosaccharide contents of CPS and RPS, F280 was the dominant species in the related treatments of co-cultivation. The nitrogenase activities in all treatments exhibited a sharp rise at the late stage while a significant decrease existed when three cyanobacteria strains were mixed. Photosynthetic activities for all treatments were determined with rapid light curve, and the related parameters were estimated.

Strain improvement of Chlorella sp. for phenol biodegradation by adaptive laboratory evolution.

Microalgae are highly efficient photosynthesis cell factories for CO2 capture, biofuel productions and wastewater treatment. Phenol is a typical environmental contaminant. Microalgae normally have a low tolerance for, and a low degradation rate to, high concentration of phenol. Adaptive laboratory evolution was performed for phenolic wastewater treatment by Chlorella sp. The resulting strain was obtained after 31 cycles (about 95d) under 500mg/L phenol as environmental stress. It could grow under 500mg/L and 700mg/L phenol without significant inhibition. The maximal biomass concentrations of the resulting strain at day 8 were 3.40g/L under 500mg/L phenol and 2.70g/L under 700mg/L phenol, respectively. They were more than two times of those of the original strain. In addition, 500mg/L phenol was fully removed by the resulting strain in 7d when the initial cell density was 0.6g/L.