Norovirus outbreaks in Fengtai District, Beijing, China, 2014.

Norovirus (NoV) is the most common cause of non-bacterial acute gastroenteritis (AGE) outbreaks worldwide. Eight NoV outbreaks in the Fengtai District of Beijing City, China, were identified in 2014. Samples were collected from the eight outbreaks, and 73 out of 119 samples from cases and 10 out of 59 samples from the close contacts were positive for NoVs. The genotypes were determined by sequencing analysis. Six different GII genotypes, including GII.2, 4, 6, 7, 8, 14, and 17 were found, and GII.4 was not the local major epidemic genotype in the present study. Enhanced strain surveillance is necessary for future NoV epidemics.

[Correlates of Fatigue in Patients with Neuromyelitis Optica].

OBJECTIVES: To determine clinical characteristics associated with fatigue in patients with neuromyelitis optica (NMO). METHODS: A questionnaire survey was conducted in NMO patients, measuring fatigue using the fatigue impact scale (FIS). RESULTS: A total of 64 NMO patients (mean age: 50.0 years; male/female: 3/61) completed the survey: 71.9% were NMO-IgG seropositive and 43 (67.2%) received immunosuppressive treatments. The patients obtained a global FIS score of 64.8±36.1, with 13.2±8.5, 20.6±11.6 and 31.0±18.7 for the cognitive, physical and social dimensions, respectively. No significant differences were found in global FIS scores ( P=0.294 9), and cognitive ( P=0.467 1), physical ( P=0.472 2) and social ( P=0.212 6) dimensional scores between those with and without immunosuppressive treatments. Age, sex, serum NMO-IgG, duration of disease and annual relapse rates were neither correlated with global FIS scores ( P>0.05), nor with the three dimensional scores ( P>0.05). The Expanded Disability Status Scale score was positively associated with global FIS scores ( P=0.000 5)and cognitive( P=0.018 7), physical( P=0.000 4) and social ( P=0.000 5)dimensional scores. The frequency of attack was also positively correlated with cognitive dimensional scores ( P=0.007 9). CONCLUSIONS: Disability is associated with cognitive, physical and social dimensions of fatigue. High frequency of attack is positively correlated with the cognitive dimension of fatigues.

Association of GTF2IRD1-GTF2I polymorphisms with neuromyelitis optica spectrum disorders in Han Chinese patients.

Variants at the GTF2I repeat domain containing 1 (GTF2IRD1)-GTF2I locus are associated with primary Sjögren's syndrome, systemic lupus erythematosus, and rheumatoid arthritis. Numerous studies have indicated that this susceptibility locus is shared by multiple autoimmune diseases. However, until now there were no studies of the correlation between GTF2IRD1-GTF2I polymorphisms and neuromyelitis optica spectrum disorders (NMOSD). This case control study assessed this association by recruiting 305 participants with neuromyelitis optica spectrum disorders and 487 healthy controls at the Department of Neurology, from September 2014 to April 2017. Peripheral blood was collected, DNA extracteds and the genetic association between GTF2IRD1-GTF2I polymorphisms and neuromyelitis optica spectrum disorders in the Chinese Han population was analyzed by genotyping. We found that the T allele of rs117026326 was associated with an increased risk of neuromyelitis optica spectrum disorders (odds ratio (OR) = 1.364, 95% confidence interval (CI) 1.019-1.828; P = 0.037). This association persisted after stratification analysis for aquaporin-4 immunoglobulin G antibodies (AQP4-IgG) positivity (OR = 1.397, 95% CI 1.021-1.912; P = 0.036) and stratification according to coexisting autoimmune diseases (OR = 1.446, 95% CI 1.072-1.952; P = 0.015). Furthermore, the CC genotype of rs73366469 was frequent in AQP4-IgG-seropositive patients (OR = 3.15, 95% CI 1.183-8.393, P = 0.022). In conclusion, the T allele of rs117026326 was associated with susceptibility to neuromyelitis optica spectrum disorders, and the CC genotype of rs73366469 conferred susceptibility to AQP4-IgG-seropositivity in Han Chinese patients. The protocol was approved by the Ethics Committee of West China Hospital of Sichuan University, China (approval number: 2016-31) on March 2, 2016.

Muscle damage in patients with neuromyelitis optica spectrum disorder.

OBJECTIVE: Increasing evidence has shown that skeletal muscle damage plays a role in neuromyelitis optica spectrum disorder (NMOSD). The objective of this study was to compare the serum creatine kinase (sCK) levels in NMOSD patients with different clinical statuses. METHODS: In the observational study, levels of sCK were measured during the acute and stable phases for patients with NMOSD and healthy controls (HCs). RESULTS: We enrolled 168 patients with NMOSD (female:male ratio, 153:15; age: 43.9 ± 13.1 years) in the acute phase, and blood samples were collected from 85 of the patients with NMOSD during both acute and stable phases to determine the sCK levels. The mean log sCK levels of the patients with NMOSD in the acute phase were higher (4.51 ± 1.17, n = 85) than those of the patients with NMOSD in the stable phase (3.85 ± 0.81, n = 85, p = 0.000). Furthermore, the log sCK levels of the patients with NMOSD in the stable phase were lower than those of the HCs (4.31 ± 0.39, n = 200, p = 0.000). In patients with sCK levels within the normal limits, these differences were also observed (p < 0.05). In the multivariable linear regression model performed for the patients with NMOSD in the acute phase, it suggested that a higher estimated glomerular filtration rate (p = 0.026), patients with the core clinical characteristics of optic neuritis (p = 0.005), and serum anti-SSA positivity (p = 0.019) predicted lower log sCK levels. CONCLUSIONS: Muscle damage occurs in patients with NMOSD and is aggravated during the acute phase.

A Waterborne Gastroenteritis Outbreak Caused by Norovirus GII.17 in a Hotel, Hebei, China, December 2014.

Norovirus (NoV) is responsible for an estimated 90 % of all epidemic nonbacterial outbreaks of gastroenteritis worldwide. Waterborne outbreaks of NoV are commonly reported. A novel GII.17 NoV strain emerged as a major cause of gastroenteritis outbreaks in China during the winter of 2014/2015. During this time, an outbreak of gastroenteritis occurred at a hotel in a ski park in Hebei Province, China. Epidemiological investigations indicated that one water well, which had only recently been in use, was the probable source. GII.17 NoV was detected by real-time reverse-transcription polymerase chain reaction from samples taken from cases, from concentrated water samples from water well, and from the nearby sewage settling tank. Nucleotide sequences of NoV extracted from clinical and water specimens were genetically identical and had 99 % homology with Beijing/CHN/2015. All epidemiological data indicated that GII.17 NoV was responsible for this outbreak. This is the first reported laboratory-confirmed waterborne outbreak caused by GII.17 NoV genotype in China. Strengthening management of well drinking water and systematica monitoring of NoV is essential for preventing future outbreaks.

Outbreak of hand, foot, and mouth disease caused by coxsackievirus A6 in a Juku in Fengtai District, Beijing, China, 2015.

An outbreak of hand, foot, and mouth disease (HFMD) that occurred in a Juku in Fengtai District, Beijing, China, in 2015 was monitored by the China Information System for Disease Control and Prevention. Epidemiological investigation showed that 11 cases occurred from two classes in the preschool art training department in the Juku. Coxsackievirus A6 (CV-A6) was identified as the causative pathogen of the outbreak via sequences analysis of products of real-time reverse-transcription polymerase chain reaction (RT-PCR) and nested RT-PCR. Phylogenetic analysis showed that CV-A6 strains isolated in this study clustered with epidemic strains isolated in China since 2013. The outbreak ended quickly with effective measures. This event indicates that continuous surveillance of HFMD etiological agents other than enterovirus 71 and coxsackievirus A16 is necessary.