Evaluation of the Therapeutic Effect of Bi-Maxillary Osteotomy Using the Stress Distribution on the Temporomandibular Joint When Doing Anterior Teeth Occlusion.

The purpose of this study was to investigate how sagittal split ramus osteotomy (SSRO) and Le Fort 1 osteotomy affected the stress distribution of the temporomandibular joint (TMJ) during an anterior teeth bite using the three-dimensional (3D) finite element (FE) method. Fourteen orthognathic surgery patients were examined with mandibular prognathism, facial asymmetry, and mandibular retraction. They underwent Le Fort 1 osteotomy in conjunction with SSRO. In addition, ten asymptomatic subjects were recruited as the control group. The 3D models of the mandible, disc, and maxilla were reconstructed according to cone-beam computed tomography (CBCT). Contact was used to simulate the interaction of the disc-condyle, disc-temporal bone, and upper-lower dentition. Muscle forces and boundary conditions corresponding to the anterior occlusions were applied on the models. The stresses on the articular disc and condyle in the pre-operative group were significantly higher than normal. The contact stress and minimum principal stress in TMJ for patients with temporomandibular disorder (TMD) were abnormally higher. The peak stresses of the TMJ of the patients under anterior occlusions decreased after bimaxillary osteotomy. No postoperative TMD symptoms were found. Maxillofacial deformity led to excessive stress on the TMJ. Bimaxillary osteotomy can partially improve the stress distributions of the TMJ and relieve the symptoms of TMD.

Outbreak of macrolide-resistant mycoplasma pneumoniae in a primary school in Beijing, China in 2018.

BACKGROUND: On 7th June, 2018, a primary school in Beijing, China notified Shunyi CDC of an outbreak of acute respiratory disease characterized by fever and cough among students and resulting in nine hospitalization cases during the preceding 2 weeks. We started an investigation to identify the etiologic agent, find additional cases, develop and implement control measures. METHODS: We defined probable cases as students, teachers and other staffs in the school developed fever (T ≥ 37.5 °C) with cough or sore throat; or a diagnosis of pneumonia during May 1-June 31, 2018. Confirmed cases were probable cases with Mycoplasma pneumoniae detected in oropharyngeal (OP) swabs by quantitative real-time polymerase chain reaction (qPCR). We searched case by reviewing school absenteeism records and interviewing students, teachers and staff in this school. Oropharyngeal swabs were collected from symptomatic students. Two qPCR) assay, a duplex qPCR assay, and sequencing were performed to determine the pathogen, genotype and macrolide resistance at the gene level, respectively. RESULTS: From May 1st to June 31st, 2018, we identified 55 cases (36 probable and 19 confirmed), of whom 25 (45%) were hospitalized for complications. All cases were students, none of the teachers and other staffs in the school were with similar symptoms. The attack rate (AR) was 3.9% (55/1398) for all students. The cases were mainly male (58%), with an age range of 7-8 years (median: 7 years). 72% (18/25) of inpatients had radiograph findings consistent with pneumonia, and some cases were hospitalized for up to 4 weeks. Pathogen detection results indicated that Mycoplasma pneumonia (M. pneumoniae) P1 type 1 was the causative agent in this outbreak, and the strain harbored one point mutation of A to G at position 2063. CONCLUSIONS: The infections by macrolide-resistant M. pneumoniae are not always mild and pneumonia was common and M. pneumoniae could causes serious complications which require long-term hospitalization. In the future infectious disease prevention and control practice, M. pneumoniae should be paid more attention. It is necessary to establish and improve the pathogen and drug resistance surveillance system in order to prevent and control such mutated strains of M. pneumoniae from causing future outbreaks or epidemics in China.

Lyme Borreliosis-associated Risk Factors in Residents of Beijing Suburbs: a Preliminary Case-control Study.

A population-based case-control study was conducted to evaluate the relative factors in the environments, agricultural works, outdoor activities, and the effectiveness of Lyme borreliosis (LB)- associated personal protective measures in Beijing. Thirty-four cases and 272 controls were personally interviewed by well-trained interviewers. Venous blood samples were taken from each subject. Sowing or harvesting in summer (OR=2.571, 95% CI: 1.109-5.962), living in house with weeding in the yard (OR=2.247, 95% CI: 1.062-4.755), and residence at the plain area (OR=2.630, 95% CI: 1.050-6.588) were the independent relative factors for seropositive LB. Wearing long pants and clothes with cuffs was the only protective behavior against tick bite (OR=0.186, 95% CI: 0.041-0.846). The findings showed that local farmers were easily infected with LB and almost no protective measure was taken against LB infection. Infection with LB was easier in residents of plain regions. Pets raising and outdoor activities were not the risk factors for infection with LB. Further studies are needed to fully understand the risk of infection with LB in China.

[Analysis on the whole genome of the influenza H1N1 virus of the mild and severe cases in Beijing in 2009].

OBJECTIVE: To explore the characteristics of the whole genome of the influenza H1N1 virus of the mild and severe cases in Beijing. METHODS: A total of 21 samples of throat swabs were collected from surveillance-designated hospitals between June and December in 2009, including 10 severe cases (4 death cases) and 11 mild cases. RNA of the virus were extracted,and the amplified primers of the whole genome were designed.Reverse transcription and PCR were performed to the RNA and then the PCR product was sequenced by software to analyze the evolution of the viral genes and the variation of the amino acids. RESULTS: Compared with the reference vaccine strain A/California/07/2009 (H1N1), the genetic nucleotide homology in the eight segments of the pandemic H1N1 virus in Beijing in 2009 was higher than 99%, without significant variation. Among them,the genetic distance of hemagglutinin (HA), neuraminidase (NA) and nucleoprotein (NP) was comparatively far, separately 0.0050, 0.0040 and 0.0040.The gene of HA, P83S, the gene of NA, N248D, the gene of polymerase (PA), P224S and the gene of NP, V100I and L122Q were found to mutate in all the samples. Genes of HA, NA, NP, PA, PB 2 and nonstructural protein (NS1) in severe cases showed obviously clustered evolution. The mutation of gene S128P and S203T of HA, gene R269R and D547E of PA, gene T588I of PB 2 and gene I123V of NS mainly happened in severe cases, separately counting 6, 9, 6, 7, 9 and 6 cases. The relevance between the mutation happened in S203T of HA, R269K and D547E of PA and the severeness of the cases showed statistical significance (P < 0.05). The mutations of HA gene were mainly on the Ca and Cb antigene domains. No drug resistant mutation was found on NA gene but happened on matrix protein 2 (M2 gene). None of the mutations were found on the virulence related genes. CONCLUSION: A high homology was found between the pandemic H1N1 virus in Beijing in 2009 and the reference vaccine strain A/California/07/2009(H1N1). Mutational sites related with the severe and fatal cases were found, but not the virulence related mutation.

[The genetic features of drug resistance to group A streptococcus and macrolides antibiotics among pediatric patients in Beijing 2012].

OBJECTIVE: To investigate the genetic features of drug resistance to group A streptococcus(GAS) and macrolides antibiotics among pediatric patients in Beijing 2012. METHODS: A total of 199 strains of GAS were collected from 36 hospitals in Beijing between May and July, 2012. All strains were isolated from oropharyngeal swabs. The minimum inhibitory concentrations (MICs) of ten antibiotics (penicillin, ampicillin, erythromycin, clindamycin, tetracycline, levofloxacin, tigecycline, vancomycin, linezolid and streptogramin) were detected by VITEK-2 compact with GPS-67 test kit. The genes encoding macrolides resistance (ermA, ermB and mefA ) were amplified and tested by PCR. The macrolides resistant phenotype of group A streptococcus was detected by double disc test (D-test). RESULTS: Among 199 strains of GAS collected in this study, 101(50.8%) were from suburbs and the other 98(49.2%) were from urban areas. 111(55.8%) strains were collected from scarlet fever patients while the other 88(44.2%) were from oropharyngeal infection cases. All the strains were sensitive to penicillin and ampicillin, and the percentage of resistance to erythromycin, clindamycin and tetracycline were 96.5% (192/199), 95.5% (190/199) and 92.0% (183/199), respectively. All strains were susceptible to levofloxacin, tigecycline, vancomycin, linezolid and streptogramin. The rates of resistance to erythromycin, clindamycin and tetracycline were different in different districts, however, the difference in it between ages and clinical diagnosis did not show statistical significance (P > 0.05) . The detected rate of drug resistance gene ermB was 98.5% (196/199). The gene ermA was only detected out in 5 strains and the gene mefA was not detected out. 199 strains showed A macrolides resistant phenotype cMLS, while the phenotype iMLS was not found in this study. CONCLUSION: This study demonstrates the high level of clindamycin resistance in group A streptococcus collected from children in Beijing, 2012. The macrolides resistance of group A streptococcus was highly prevalent in Beijing, and the dominant phenotype was cMLS mediated by gene ermB.

[Analysis of status and influence factors of health literacy related to infectious diseases in residents of Beijing].

OBJECTIVE: To assess the status and associated influence factors of health literacy relating to infectious diseases in Beijing. METHODS: A multi-stage stratified sampling method was carried out to select the sample population in Beijing, which were adults aged over 18 years. The questionnaire survey was used to collect the information of adult health literacy relating to infectious diseases, and the answers were scored. Logistic regression model was used to analyze the influence factors of health literacy relating to infectious diseases. RESULTS: The samples were 13 287 people, and the valid questionnaires were 13 001. In the study, 9.9% of the respondents were classified with enough health literacy relating to infectious diseases, and the low level of health literacy was observed among the respondents living in rural area (6.6%), elderly aged over 60 years (6.4%), poor-educated people (0.8%), farmers (4.5%), workers (4.3%), house-holders and people waiting for employment (4.5%). Multiple Logistic analyses indicated that age, educational status, occupation, self-reported health status, and regions (urban or rural area) were the influence factors associated with the level of health literacy. CONCLUSION: The residents living in Beijing were considered to be with low level of health literacy relating to infectious diseases, and more measures should be taken to improve it.

[Application of EARS in early-warning of influenza pandemic in Beijing].

OBJECTIVE: To illustrate the efficiency of cumulative sum (CUSUM) in pre-warning of the influenza peak in Beijing. METHODS: CUSUM was used to analyze the data of influenza like illness (ILI), and the results of the influenza laboratory surveillance was regarded as the gold standard to judge the approaching of the influenza peak. RESULTS: The surveillance was launched in 421 hospitals in Beijing during the 2009 to 2010 influenza season, while the influenza laboratory surveillance was launched by 7 collaborative laboratories. From Jun. 2009 to Apr. 2010, the average ILI percentage in the 421 hospitals was 2.56%. In the study, 19 262 pharyngeal swab samples were collected from the ILI cases in 11 hospitals and 5 045 of them were tested positive for the influenza virus, with the novel swine-origin influenza A H1N1 virus dominating. After analyzing of the ILI surveillance data with CUSUM, it was found that the ILI surveillance in Beijing could make a satisfactory early warning for the approaching of the influenza peak referring to the gold standard based on the influenza laboratory results. CONCLUSION: It could give the prediction and early warning for the influenza peak efficiently and precisely, by using CUSUM to analyze the influenza surveillance data of Beijing.

[Study on types of M protein gene in group A streptococcus isolated from children in Beijing, 2011].

OBJECTIVE: To explore the distribution characteristics of the types of M protein gene (emm) in group A streptococcus (GAS) isolated from children in Beijing in the year 2011. METHODS: During May to July in 2011, a total of 3315 patients who were diagnosed scarlet fever or pharyngeal infection by doctors in pediatric outpatient and emergency units of 36 hospitals, were selected as subjects. Their throat swab samples were collected and isolated the strains of GAS. Gene emm was then amplified and sequenced by PCR method, and the differences in types of gene emm between different populations and diseases were compared. RESULTS: A total of 633 strains of GAS were isolated from the 3315 throat swab samples, 610 strains out of which were gene emm positive and were recruited in the study. Out of the 610 recruited strains, 448 (73.4%) were isolated from scarlet fever patients, the other 162 (26.6%) were isolated from pharyngeal infection patients; 397 (65.1%) were from urban, the other 213 (34.9%) were from suburb; 240 (39.4%) were from patients aging between 1 - 5 years old, the other 369(60.6%) were from patients aging 6 - 18 years old. A total of 8 types of gene emm (scarlet fever: 6 types, pharyngeal infection: 4 types) and 21 subtypes of gene emn (scarlet fever: 16 subtypes, pharyngeal infection: 10 subtypes) were identified. Three new subtypes were found in the study, naming emm1.63, emm12.62 and st5144.20. Among them, emm1.63 was found both in scarlet fever and pharyngeal infection patients, while emm12.62 and st5144. 20 were only found in pharyngeal infection patients. Among all the types of gene-emm, emm12 accounted for the highest percentage as 80.5% (491/610) and then followed by emm1 (18.0% (110/610)). Among all the subtypes, the dominant subtype was emm12.00, accounting for 69.0% (421/610), following by emm1.00 (16.9% (103/610)) and emm12.19 (6.1% (37/610)). All the above types and subtypes of gene emm were the most prevalent strains in scarlet fever patients and pharyngeal infection patients. Significant differences in the distribution of prevalent strains were observed among various aging patients and regions. The constituent ratios of emm1, emm1.00 and emm12.19 were higher in patients from suburb (emm1: 22.1% (47/213), emm1.00: 19.2% (40/213), emm12.19: 8.0% (17/213)) than those in urban areas (emm1: 15.9% (63/397), emm1.00: 15.6% (62/397), emm12.19: 5.0% (20/397)). The difference showed statistical significance (P < 0.05). The constituent ratio of emm1.00 was higher among patients aging 6-18 years old (19.2% (71/369)) than those aging 1 - 5 years old (13.3% (32/240)). The difference also showed statistical significance (χ(2) = 8.45, P < 0.05). CONCLUSION: Among the types of gene emm in GAS isolated from children in Beijing in year 2011, the most prevalent two were emm12 and emm1, and the most prevalent emm subtypes were emm12.00, emm1.00 and emm12.19. A significant difference in their distribution between various aging patients and isolated places can be obviously found.

[Prevalence of hepatitis B in Chaoyang district, Beijing in 2010].

OBJECTIVE: To study the prevalence of hepatitis B infections and carrier status among general population in Chaoyang district, Beijing in 2010. METHODS: From May to December 2010, 14 491 subjects over 12 months old were selected by multistage random cluster sampling method from residents in Chaoyang district, Beijing. Five millilitre venous blood specimens were collected from these subjects to test hepatitis B virus antigens and antibodies. Status of hepatitis B infections were analyzed in different age, sex and registered permanent residence groups. RESULTS: The overall positive rate of surface antigen (HBsAg) was 2.66% (383/14 410). The lowest rate of 0.56% (9/1603) was found in the 1 to 14 years old group and the 35 to 44 years old group had the highest rate of 4.27% (92/2154). The rate in subjects younger than 24 years old was 1.03% (31/2986). The overall positive rate of surface antibody (anti-HBs) was 40.21% (5798/14 421). The highest positive rate of anti-HBs (80.59%, 407/505) was found in the 1 to 4 years old group. The overall positive rate of core antibody (anti-HBc) was 30.26% (4364/14 424). The overall hepatitis B virus infection rate was 30.32% (4364/14 393). For male and female groups, the positive rates of HBsAg were 2.93% (179/6108) and 2.44% (202/8287) respectively (χ² = 3.32, P > 0.05); anti-HBs were 41.93% (2563/6113) and 38.96% (3231/8293) respectively (χ² = 12.88, P < 0.01); and anti-HBc were 31.39% (1919/6114) and 29.39% (2438/8295) respectively (χ² = 6.65, P = 0.01). For local residents group and mobile population group, the positive rates of HBsAg were 2.46% (283/11 510) and 3.60% (98/2719) respectively (χ² = 11.08, P < 0.01); anti-HBs were 37.11% (4293/11 568) and 53.07% (1445/2723) respectively (χ² = 233.51, P < 0.01); and anti-HBc were 30.83% (3567/11 570), and 28.41% (774/2724) respectively (χ² = 6.08, P < 0.05). CONCLUSION: The positive rate of HBsAg in population younger than 24 years old has reached a relatively low level. The mobile population has significantly higher positive rate of HBsAg than local residents, indicating the need for enhancing prevention and control measures for hepatitis B for the mobile population and local residents over 25 years old.

[Multilocus variable-number tandem-repeat analysis for molecular subtypes of Shigella isolates in Beijing].

OBJECTIVE: Selecting variable-number tandem-repeat (VNTR) loci for different serogroups of Shigella spp to explore and establish multilocus variable-number tandem-repeat analysis (MLVA) method, in order to study the molecular characteristic of the isolated strains. METHODS: Of the Shigella strains found by dysentery surveillance in Beijing from 2001 to 2009, 180 strains were selected for this study, according to the number and serotypes of the surveillant strains, at the ratio of 15%; including 50 strains of Shigella sonnei and 130 strains of Shigella flexneri. After screening the polymorphism of the 18 VNTR loci, 10 VNTR loci (sh1-sh10) were retained and constructed three groups of multi-PCR methods to detect all he 180 strains and analyze MLVA molecular subtypes using capillary segments. RESULTS: A range of 2 to 11 alleles were found on the 10 VNTR loci among the 180 Shigella strains, with a diversity index value between 0.158 and 0.766. The 10 loci showed diversity in different serogroups, such as only one allele found in sh6 of Shigella flexneri, sh2 and sh3 of Shigella sonnei individually. The isolated 180 strains were divided into 84 MLVA subtypes, with a resolution ratio D value at 0.967 (95%CI: 0.956 - 0.978). The 130 strains of Shigella flexneri were divided into 63 subtypes, named as TF001-TF063; among which TF001, TF002 and TF 005 were the dominant subtypes, accounting to 17, 16 and 15 strains respectively. The 50 strains of Shigella sonnei were divided into 21 subtypes, named as TS001-TS021; among which TS002 (14 strains) and TS001 (7 strains) were the dominant subtypes. CONCLUSION: MLVA subtyping method including 10 VNTR loci was preliminarily developed. The MLVA cluster analysis revealed that the subtypes of Shigella strains isolated in Beijing were diverse, and suggested the possibility of multiple-clone source.

Symptomatic and Asymptomatic SARS-CoV-2 Infection and Follow-up of Neutralizing Antibody Levels.

Objective: To investigate neutralizing antibody levels in symptomatic and asymptomatic patients with coronavirus disease 2019 (COVID-19) at 6 and 10 months after disease onset. Methods: Blood samples were collected at three different time points from 27 asymptomatic individuals and 69 symptomatic patients infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Virus-neutralizing antibody titers against SARS-CoV-2 in both groups were measured and statistically analyzed. Results: The symptomatic and asymptomatic groups had higher neutralizing antibodies at 3 months and 1-2 months post polymerase chain reaction confirmation, respectively. However, neutralizing antibodies in both groups dropped significantly to lower levels at 6 months post-PCR confirmation. Conclusion: Continued monitoring of symptomatic and asymptomatic individuals with COVID-19 is key to controlling the infection.

Serologic survey of pandemic influenza A (H1N1 2009) in Beijing, China.

OBJECTIVE: To examine the frequency and distribution of antibodies against pandemic influenza A (H1N1 2009) [H1N1] in populations in Beijing and elucidate influencing factors. METHODS: In January 2010, a randomized serologic survey of pandemic influenza A (H1N1 2009) was carried out. Six districts that were randomly selected with a total of 4601 participants involved in the survey have their antibody level tested by hemagglutination inhibition assay. RESULTS: Among the 4601 participants, the overall seropositive rate for pandemic influenza A (H1N1 2009) antibodies was 31.7%. The seropositivity prevalence in participants who received the pandemic H1N1 vaccination was 60.9%. Only 53.1% of the pandemic influenza A (H1N1 2009) seropositive individuals who had not received the vaccination experienced respiratory tract infection symptoms. Multivariate logistic regression revealed that factors such as age, occupation, dwelling type, whether the participant's family included students in school, and the vaccination history with pandemic influenza A (H1N1 2009) were associated with antibody titers (p<0.05). CONCLUSIONS: Our data indicated that almost 30.0% of the residents had appropriate antibody titers against pandemic influenza A (H1N1 2009) in Beijing, and these titers may provide an immune barrier.

[The coverage rate and obstructive factors of influenza vaccine inoculation among residents aged above 18 years in Beijing from 2007 to 2010].

OBJECTIVE: To assess the coverage rate and obstructive factors of influenza vaccine inoculation among residents aged above 18 years in Beijing from 2007 to 2010. METHODS: A total of 13 287 residents were recruited from six districts in Beijing. Information included demographic data, whether or not got vaccinated from 2007 to 2010, and the reasons for non-vaccination were collected using the questionnaires. RESULTS: A total of 13 002 copies of questionnaires were valid and retrieved. The coverage rates of influenza vaccine inoculation among Beijing residents aged above 18 years between year 2007 and 2010 were 14.2% (1850/13 001), 18.0% (2345/13 002), 23.4% (3036/13 002) and 18.6% (2416/13 002), respectively. The 4-year adherent inoculation rate was 9.1% (1186/13 001). The coverage rates in the subjects aged over 60 years, less educated, medical-practitioner or retired were relative higher, with the 4-year adherent inoculation rate at 24.4% (614/2521), 24.4% (94/386), 14.6% (47/323) and 19.0% (386/2036). The factors induced non-vaccination among residents included "I don't think I am very likely to catch the flu" (51.2%, 6002/11 722), "I have no spare time to get vaccinated" (18.3%, 2145/11 722), "The influenza vaccination is too expensive" (15.8%, 1852/11 722), "I am afraid of the side-effects" (15.2%, 1782/11 722), "I don't believe the vaccine is effective enough" (12.9%, 1512/11 722), "I don't think influenza is a serious disease" (10.1%, 1184/11 722), "I have the specific contraindications" (7.3%, 856/11 722), and "I have never heard influenza vaccination before" (5.2%, 610/11 722). With regard to the reasons for non-vaccination, significant differences were found among subjects with different educated levels, different ages and different occupations. The proportion of thoughts "I don't think I am very likely to catch the flu" among the residents in five educational levels (illiterates or semi-illiterates, primary school, junior middle school, senior middle school and college or above) were 28.6% (83/289), 39.8% (473/1188), 49.1% (1642/3341), 50.7% (1719/3392) and 51.3% (1794/3501) respectively, with a significant statistical difference (χ(2) = 98.33, P < 0.01). CONCLUSION: The coverage rates of influenza vaccine inoculation were low among residents aged above 18 years from 2007 to 2010 in Beijing. The main reasons for non-vaccination included lack of information about risk in influenza infection and its severity to health, and anxiety about vaccine safety and effectiveness.

[Epidemiological characteristics and molecular typing of Salmonella in Beijing from 2008 to 2009].

OBJECTIVE: To study the epidemiological characteristics and molecular phenotypes of Salmonella by pulsed-field gel electrophoresis (PFGE) in Beijing from 2008 to 2009. METHODS: A total of one hundred thirty-seven isolates recovered from the WHO Global Salmonella Surveillance system and entero clinic surveillance system were identified by biochemical tests and serotyping. The related epidemiological informations were also analyzed. The isolates were further typed by PFGE. RESULTS: The prevalence of Salmonella from 2008 to 2009 showed obvious seasonal character. High incidence occurred from June to September, and 64.1% (84/131) isolates were recovered in this period. Patients of 18 - 40 year-old were 46.1% (58/128) and 80 patients were male and 40 patients were female with the ratio of 1.57:1. These 137 Salmonella isolates belonged to 20 serotypes, including Enteritidis (46.7%, 64/137) and Typhimurium (17.5%, 24/137) as the dominant serotype. In total, 71 PFGE profiles were identified. Four PFGE patterns of S. Enteritidis isolates (JEGX01.CN0001, JEGX01.CN0003, JEGX01.CN0002, JEGX01.CN0019) and S. Typhimurium pattern of JPXX01.CN0001 were dominant patterns. CONCLUSION: The prevalence of Salmonella from 2008 to 2009 showed distribution characteristics of sex, age and seasons. The numerous PFGE patterns of Salmonella showed diversity of these isolates and different clones existed in Beijing.

[Epidemiological characteristics of infection for close contacts of pandemic (H1N1) 2009 in Beijing].

OBJECTIVE: To examine the epidemiological characteristics of infection for close contacts of pandemic (H1N1) 2009 and to provide scientific evidence for preparedness and response for the next pandemic. METHODS: A total of 613 index cases with clear information of close contacts and their 7099 close contacts, determined between May 16 and September 15, 2009, were included in this study. Based on data of epidemiological investigation, sampling and test of index cases and close contacts, the characteristics of infection for close contacts were described. RESULTS: 56.8% (348/613) of the index cases were male, and 43.2% (265/613) were female, and the median age was 20 years (range: 1 - 75 years). 49.6% (3518/7099) of the close contacts were male, and 49.5% (3514/7099) were female, but the sex information of 0.9% (67/7099) could not be recorded. The median age of the close contacts was 27 years (range: 0 - 99 years). 2.4% (167/7099) of close contacts were infected. The attack rates decreased with increasing age of close contacts (χ()2 = 27.87, P < 0.001), and were significantly different between various contact patterns of close contacts (χ()2 = 109.76, P < 0.001). 14.4% of the infected close contacts were asymptomatic. For close contacts with symptomatic infection, virus could be shed 4.5 days before illness onset, and the median generation time was 2.4 days. CONCLUSION: The attack rate of close contacts was very low; and the attack rates were different between various ages and contact patterns of close contacts. In this series 14% of cases with pandemic (H1N1) 2009 were asymptomatic. The symptomatic cases might have infectivity 1 day earlier before illness onset.

[A case-control study of the transmission of pandemic influenza A (H1N1) virus in families].

OBJECTIVE: To explore the characteristics of transmission of pandemic influenza A/H1N1, and to analyze the possible factors of influencing transmission in families and to provide scientific evidence for formulating strategies of H1N1 prevention and control. METHODS: A 1:2 matched case-control study was conducted. The case was defined as a household with 2 or more cases and the control was defined as that with 1 case. Face-to-face interview with questionnaire was used to collect information of work and family life of the study participants. Conditional logistic regression was used to analyze the data. RESULTS: Univariate analysis showed that factors such as education level of the secondary case, the number of family members, per capita living space, flu-like symptom, insulation of case, ventilation, hand-washing, and influenza A/H1N1 vaccine immunization were all associated with infection of influenza A/H1N1. Results of multivariate logistic regression analysis showed that variables such as education level of secondary case (OR = 0.42), insulation of case (OR = 3.29), ventilation, (OR = 0.28), hand-washing (OR = 0.71), influenza A/H1N1 vaccine immunization (OR = 0.05) were all correlated to infection of influenza A/H1N1. CONCLUSIONS: Factors such as vaccine, insulation, ventilation, and hand-washing can help persons in protection from infection of influenza A/H1N1, suggesting the importance of good hygienic habit and immunization with influenza A/H1N1 vaccine.

[Comparisons of epidemiological and clinical characteristics in children with hand-foot-mouth disease caused by Enterovirus 71 and Coxackievirus A16].

OBJECTIVE: To compare the differences of epidemiological and clinical characteristics in children with hand-foot-mouth disease (HFMD) caused by Coxsackievirus A16 (CA16) and Enterovirus 71 (EV71). METHODS: The samples of vesicle fluid and throat swabs of 108 children with HFMD were collected and detected for enterovirus by RT-PCR. The clinical data of children with EV71 and CA16 infection were retrospectively reviewed and compared. RESULTS: The total positive rate of enterovirus was 97.2% (105/108). Of the 105 cases, 56 cases were positive for EV71 (51.9%), 39 cases were positive for CA16 (36.1%), 2 cases were positive for other enterovirus (1.9%), and 8 cases were co-infected by EV71 and CA16 (7.4%). There were no significant differences in age and sex between EV71 and CV16 infected cases. The univariate analysis showed that the incidences of herpes of mouth, erythra of knees, and nose running in children infected by CA16 were higher than in those infected by EV71. The multivariate logistic regression analysis showed that the HFMD children who had erythra of knees had higher probability of CA16 infection. CONCLUSIONS: EV71 should be considered as the pathogen in children with HFMD who have no herpes of mouth, erythra of knees, and nose running.

Coronavirus disease 2019 outbreak in Beijing's Xinfadi Market, China: a modeling study to inform future resurgence response.

BACKGROUND: A local coronavirus disease 2019 (COVID-19) case confirmed on June 11, 2020 triggered an outbreak in Beijing, China after 56 consecutive days without a newly confirmed case. Non-pharmaceutical interventions (NPIs) were used to contain the source in Xinfadi (XFD) market. To rapidly control the outbreak, both traditional and newly introduced NPIs including large-scale management of high-risk populations and expanded severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) PCR-based screening in the general population were conducted in Beijing. We aimed to assess the effectiveness of the response to the COVID-19 outbreak in Beijing's XFD market and inform future response efforts of resurgence across regions. METHODS: A modified susceptible-exposed-infectious-recovered (SEIR) model was developed and applied to evaluate a range of different scenarios from the public health perspective. Two outcomes were measured: magnitude of transmission (i.e., number of cases in the outbreak) and endpoint of transmission (i.e., date of containment). The outcomes of scenario evaluations were presented relative to the reality case (i.e., 368 cases in 34 days) with 95% Confidence Interval (CI). RESULTS: Our results indicated that a 3 to 14 day delay in the identification of XFD as the infection source and initiation of NPIs would have caused a 3 to 28-fold increase in total case number (31-77 day delay in containment). A failure to implement the quarantine scheme employed in the XFD outbreak for defined key population would have caused a fivefold greater number of cases (73 day delay in containment). Similarly, failure to implement the quarantine plan executed in the XFD outbreak for close contacts would have caused twofold greater transmission (44 day delay in containment). Finally, failure to implement expanded nucleic acid screening in the general population would have yielded 1.6-fold greater transmission and a 32 day delay to containment. CONCLUSIONS: This study informs new evidence that in form the selection of NPI to use as countermeasures in response to a COVID-19 outbreak and optimal timing of their implementation. The evidence provided by this study should inform responses to future outbreaks of COVID-19 and future infectious disease outbreak preparedness efforts in China and elsewhere.

[Prevalence of fecal incontinence among adult women in Beijing district].

OBJECTIVE: To investigate the prevalence of fecal incontinence (FI) among adult women in Beijing area, and to analysis risk factors associated with FI. METHODS: A stratified multiple-cluster systemic method was used to recruit women ≥ 20 years old in 6 districts of Beijing. A self-administrated questionnaire was used to collect information about FI and possible risk factors. RESULTS: There were three thousand and 58 women participated in the survey, the average age was (48 ± 16) years (range 20-79 years). The prevalence of FI was 1.28% (39/3058), which was related to age. There were five factors entered the logistic regress model, which were included age ≥ 40 years old (OR = 3.3, 95%CI: 1.7-6.8), urinary incontinence (OR = 3.0, 95%CI: 1.5-6.1), vaginal delivery (OR = 2.4, 95%CI: 1.2-4.9), household per capita income ≤ 2000 RMB per month (OR = 3.3, 95%CI: 1.6-6.5), and feeling fatigue (OR = 3.0, 95%CI: 1.5-5.8). CONCLUSION: Prevalence of FI is low among adult women in Beijing area, while risk factors associated with FI are complicated and further studies are necessary to be conducted.

[Pandemic influenza A (H1N1) virus infection factors among healthcare workers - a case-control study].

OBJECTIVE: To explore factors related to pandemic influenza A (H1N1) virus infection among healthcare workers. METHODS: H1N1 influenza confirmed cases of health workers in hospital of Beijing from Aug 30th 2009 to Jan 31st 2010 were included. A 1:4 matched case-control study was conducted with 54 healthcare workers who were infected by influenza A(H1N1) virus and 216 matched controls who were not infected. Face-to-face interview with questionnaires was used to collect information of work and family aspects of the study participants. Conditional logistic regression was used to analyze the H1N1 infection factors. RESULTS: The age was 29.6 ± 7.4 years old and male subjects accounted for 17.4% (47/270). There were 5.6% (3/54) and 34.4% (74/216) of the cases get the influenza A (H1N1) vaccine immunization separately in the case group and control group. Among 18.5% (10/54) and 40.1% (88/216) of the cases and controls used high protection level masks during the epidemic. Besides, 33 (61.1%)and 161 (74.5%) cases lengthening the time of mask wearing separately. There were 13 (24.1%) and 85 (39.4%) cases using disposable tissue to clean hands in the case group and control group, 24 (44.4%) and 46 (21.3%) cases feel they were much easier to get infected in respiratory disease than others based on experience in the case and control group. Univariate analysis showed that factors such as using disposable tissue to clean hands (OR = 0.15, 95%CI = 0.04 - 0.57), lengthening the time of mask wearing (OR = 0.43, 95%CI = 0.20 - 0.92), using high protection level masks (OR = 0.26, 95%CI = 0.11 - 0.58), getting influenza A (H1N1) vaccine immunization (OR = 0.04, 95%CI = 0.01 - 0.32), much easier to get infected in respiratory disease than others based on experience (OR = 2.85, 95%CI = 1.44 - 5.62), were all associated with influenza A (H1N1) infection. Results of multivariate logistic regression analysis showed that variables such as history of influenza A (H1N1) virus immunization (OR = 0.18, 95%CI = 0.06 - 0.51), using high protection level masks (OR = 0.05, 95%CI = 0.01 - 0.35), much easier to get infected in respiratory disease than others based on experience (OR = 3.69, 95%CI = 1.58 - 8.63) were all correlated to influenza A (H1N1) infection. CONCLUSIONS: Factors such as history of influenza A (H1N1) vaccine immunization, using high protection level masks and improving respiratory health can protect healthcare workers from infection of influenza A (H1N1).