Population-based surveillance for bacterial meningitis in China, September 2006-December 2009.

During September 2006-December 2009, we conducted active population and sentinel laboratory-based surveillance for bacterial meningitis pathogens, including Streptococcus pneumoniae, Neisseria meningitidis, and Haemophilus influenzae type b, in 4 China prefectures. We identified 7,876 acute meningitis and encephalitis syndrome cases, including 6,388 among prefecture residents. A total of 833 resident cases from sentinel hospitals met the World Health Organization case definition for probable bacterial meningitis; 339 of these cases were among children <5 years of age. Laboratory testing confirmed bacterial meningitis in 74 of 3,391 tested cases. The estimated annual incidence (per 100,000 population) of probable bacterial meningitis ranged from 1.84 to 2.93 for the entire population and from 6.95 to 22.30 for children <5 years old. Active surveillance with laboratory confirmation has provided a population-based estimate of the number of probable bacterial meningitis cases in China, but more complete laboratory testing is needed to better define the epidemiology of the disease in this country.

A case-control study of risk factors for HIV-negative children with cryptococcal meningitis in Shi Jiazhuang, China.

BACKGROUND: Although cryptococcal meningitis (CM) is an emerging disease worldwide, there have been few studies of the characteristics and risk factors of CM in children. METHODS: We used data collected from May 2007 through April 2012 in the Acute Meningitis-Encephalitis Syndrome Surveillance project in Shi Jiazhuang, China to describe the epidemiologic, clinical, and laboratory findings in children with CM. Furthermore, a matched case-control study was used to determine risk factors of CM. RESULTS: Overall 23 HIV-negative children with CM (median age: 10.91 years; range: 5 months-17 years) were enrolled in our study. The average annual incidence of CM was 0.43/100,000 with a fatality rate of 1.7%. Most patients were males (60.87%) and rural children (73.91%). Common clinical symptoms included increased intracranial pressure, such as headaches (78.3%), nausea (60.9%), altered mental status (56.5%), vomiting (52.2%), and seizures (43.5%), and frequent laboratory findings consisted of blood leukocytosis (87.0%), decreased CSF glucose (87.0%), pleocytosis (82.6%), increased intracranial pressure (73.9%) and elevated CSF proteins (65.2%). Epidemiologic, clinical, and laboratory findings were similar between patients with and without underlying diseases. Multivariate logistic regression analysis showed that children who had contact with birds/bird droppings or saprophytes were more likely to be infected than those without such contact (odds ratio(OR) =11.82; 95% confidence interval (CI), 2.21-62.24; P = 0.004). Patients with an interval of ≥20 days from onset to admission were at high risk for CM (OR= 5.31; 95%CI, 1.58-17.89; P = 0.007). CONCLUSIONS: Our findings show that CM is an uncommon disease with a high mortality rate in children. Although additional studies are needed to find effective prevention and treatments for CM, clinicians should consider CM as a potential cause for pediatric meningitis in children, particularly boys from rural areas, who had contact with birds/bird droppings or saprophytes and in children who did not receive prompt medical attention.

Epidemiological Investigation of an Inhalational Anthrax Patient Traveling for Medical Treatment in Beijing Municipality, China, August 2021.

What is already known about this topic?: Inhalational anthrax, also known as pulmonary anthrax, is an infectious disease caused by Bacillus anthracis . The patients are usually infected by inhaling aerosolized B. anthracis spores from dead animals or animal products. Compared to cutaneous anthrax, inhalational anthrax is rare and deadly and few cases in China were reported. What is added by this report?: This report covers all information of clinical features, laboratory testing, and epidemiological characteristics as well as exposure history of a recent primary inhalational anthrax patient who was seeking medical treatment in Beijing Municipality in August 2021. New laboratory techniques, including second-generation sequencing, polymerase chain reaction, and rapid test for serum antibody, played an important role in the process. What are the implications for public health practice?: The information provided in this report, including the correct sample type, epidemiological investigation details, and application of the new diagnostic criteria of anthrax, could assist public health professionals in dealing with anthrax epidemics.

A COVID-19 Outbreak - Nangong City, Hebei Province, China, January 2021.

WHAT IS KNOWN ABOUT THIS TOPIC?: Coronavirus disease 2019 (COVID-19) is widespread globally. In China, COVID-19 has been well controlled and has appeared only in importation-related cases. Local epidemics occur sporadically in China and have been contained relatively quickly. WHAT IS ADDED BY THIS REPORT?: Epidemiological investigation with genome sequence traceability analysis showed that the first case of COVID-19 in Nangong City acquired infection from a confirmed case from Shijiazhuang City; infection subsequently led to 76 local cases. All cases were associated with the index case, and most were located in Fenggong Street and did not spread outside of Nangong City. The main routes of transmission were family clusters, intra-unit transmission, and nosocomial transmission. WHAT ARE THE IMPLICATIONS FOR PUBLIC HEALTH PRACTICE?: This study highlights new techniques for rapidly tracing cases and identifying COVID-19 transmission chains. The different epidemiological characteristics in Nangong City, from the earliest stages of the outbreak, suggest that allocation of health sources for prevention and treatment were reasonable. Preventing transmission within medical institutions and isolation facilities and strengthening management in the community should be priorities for COVID-19 control during a city lockdown.

Revisiting Stress Majorization as a Unified Framework for Interactive Constrained Graph Visualization.

We present an improved stress majorization method that incorporates various constraints, including directional constraints without the necessity of solving a constraint optimization problem. This is achieved by reformulating the stress function to impose constraints on both the edge vectors and lengths instead of just on the edge lengths (node distances). This is a unified framework for both constrained and unconstrained graph visualizations, where we can model most existing layout constraints, as well as develop new ones such as the star shapes and cluster separation constraints within stress majorization. This improvement also allows us to parallelize computation with an efficient GPU conjugant gradient solver, which yields fast and stable solutions, even for large graphs. As a result, we allow the constraint-based exploration of large graphs with 10K nodes - an approach which previous methods cannot support.

Structure-aware Fisheye Views for Efficient Large Graph Exploration.

Traditional fisheye views for exploring large graphs introduce substantial distortions that often lead to a decreased readability of paths and other interesting structures. To overcome these problems, we propose a framework for structure-aware fisheye views. Using edge orientations as constraints for graph layout optimization allows us not only to reduce spatial and temporal distortions during fisheye zooms, but also to improve the readability of the graph structure. Furthermore, the framework enables us to optimize fisheye lenses towards specific tasks and design a family of new lenses: polyfocal, cluster, and path lenses. A GPU implementation lets us process large graphs with up to 15,000 nodes at interactive rates. A comprehensive evaluation, a user study, and two case studies demonstrate that our structure-aware fisheye views improve layout readability and user performance.

CC4821 serogroup W meningococcal disease in China.

Neisseria meningitidis is a major public health concern worldwide, including China. A few cases of serogroup W meningococcal disease have been reported in southeast China in recent years. Thus far, invasive disease due to W isolates has involved sequence type 11. We report two cases of N. meningitidis infection caused by CC4821 serogroup W strains.