Identification and control of a poliomyelitis outbreak in Xinjiang, China.

BACKGROUND: The last case of infection with wild-type poliovirus indigenous to China was reported in 1994, and China was certified as a poliomyelitis-free region in 2000. In 2011, an outbreak of infection with imported wild-type poliovirus occurred in the province of Xinjiang. METHODS: We conducted an investigation to guide the response to the outbreak, performed sequence analysis of the poliovirus type 1 capsid protein VP1 to determine the source, and carried out serologic and coverage surveys to assess the risk of viral propagation. Surveillance for acute flaccid paralysis was intensified to enhance case ascertainment. RESULTS: Between July 3 and October 9, 2011, investigators identified 21 cases of infection with wild-type poliovirus and 23 clinically compatible cases in southern Xinjiang. Wild-type poliovirus type 1 was isolated from 14 of 673 contacts of patients with acute flaccid paralysis (2.1%) and from 13 of 491 healthy persons who were not in contact with affected persons (2.6%). Sequence analysis implicated an imported wild-type poliovirus that originated in Pakistan as the cause of the outbreak. A public health emergency was declared in Xinjiang after the outbreak was confirmed. Surveillance for acute flaccid paralysis was enhanced, with daily reporting from all public and private hospitals. Five rounds of vaccination with live, attenuated oral poliovirus vaccine (OPV) were conducted among children and adults, and 43 million doses of OPV were administered. Trivalent OPV was used in three rounds, and monovalent OPV type 1 was used in two rounds. The outbreak was stopped 1.5 months after laboratory confirmation of the index case. CONCLUSIONS: The 2011 outbreak in China showed that poliomyelitis-free countries remain at risk for outbreaks while the poliovirus circulates anywhere in the world. Global eradication of poliomyelitis will benefit all countries, even those that are currently free of poliomyelitis.

An outbreak following importation of wild poliovirus in Xinjiang Uyghur Autonomous Region, China, 2011.

BACKGROUND: After more than 10 years without a case of wild poliovirus (WPV) in China, an outbreak occurred in 2011 in Xinjiang Uyghur Autonomous Region. METHODS: Acute flaccid paralysis (AFP) case surveillance was strengthened with epidemiological investigations and specimen collection and serological surveys were conducted among hospitalized patients. RESULTS: There were 21 WPV cases and 23 clinical compatible polio cases reported. WPV was isolated from 14 contacts of AFP cases and 13 in the healthy population. Incidence of WPV and clinical compatible polio cases were both highest among children <1 years, however, 24/44 (54.5%) polio cases were reported among adults aged 15-39 years. CONCLUSIONS: High coverage of routine immunization should be maintained among children until WPV transmission is globally eradicated. Expansion of AFP case surveillance and use of serologic surveys to estimate population immunity should be conducted rapidly to guide preparedness and response planning for future WPV outbreaks.

Evolutionary genetics of genotype H1 measles viruses in China from 1993 to 2012.

Virologic surveillance is a critical component of measles management. One of the criteria for verification of elimination of endemic measles is genetic analysis of wild-type viruses to demonstrate lack of an indigenous genotype. Measles is yet to be eliminated in China, and genotype H1 has been detected continuously since virologic surveillance was initiated in 1993. Virologic surveillance has been very active in China, providing a unique opportunity to conduct a detailed study of the evolution of a single, endemic genotype over a timespan of nearly two decades. Phylogenetic analysis performed on the 450 nt coding sequence for the C-terminal 150 amino acids of the nucleoprotein (N-450), fusion (F) gene and haemagglutinin (H) gene confirmed the continued circulation of genotype H1 viruses for 19 years. No evidence of selective pressure for the H protein was found. The substitution rates ranged from 0.75×10(-3) substitutions site(-1) year(-1) for H to 1.65×10(-3) substitutions site(-1) year(-1) for N-450. The time of most recent common ancestor (TMRCA) for genotype H1 was estimated as approximately 1985 (95 % highest probability density, 1979-1989). Finally, the overall diversity of measles sequences from China decreased from 2005 to 2012, coincident with a substantial decrease in measles cases. The results suggest that detailed evolutionary analyses should facilitate the documentation of eventual measles elimination in China. Moreover, the molecular approaches used in this study can be applied in other countries approaching measles elimination.

Enhanced surveillance of acute flaccid paralysis following importation of wild poliovirus in Xinjiang Uygur Autonomous Region, China.

BACKGROUND: After being polio free for more than 10 years, an outbreak occurred in China in 2011 in Xinjiang Uygur Autonomous Region (Xinjiang) following the importation of wild poliovirus (WPV) originating from neighboring Pakistan. METHODS: To strengthen acute flaccid paralysis (AFP) surveillance in Xinjiang, "zero case daily reporting" and retrospective searching of AFP cases were initiated after the confirmation of the WPV outbreak. To pinpoint all the polio cases in time, AFP surveillance system was expanded to include persons of all ages in the entire population in Xinjiang. RESULTS: Totally, 578 AFP cases were reported in 2011 in Xinjiang, including 21 WPV cases, 23 clinical compatible polio cases and 534 non-polio AFP cases. Of the 44 polio cases, 27 (61.4%) cases were reported among adults aged 15-53 years. Strengthening AFP surveillance resulted in an increase in the number of non-polio AFP cases in 2011 (148 children < 15 years) compared with 76 cases < 15 years in 2010. The AFP surveillance system in Xinjiang was sensitive enough to detect polio cases, with the AFP incidence of 3.28/100,000 among children < 15 years of age. CONCLUSIONS: Incorporating adult cases into the AFP surveillance system is of potential value to understand the overall characteristics of the epidemic and to guide emergency responses, especially in countries facing WPV outbreak following long-term polio free status. The AFP surveillance system in Xinjiang was satisfactory despite limitations in biological sample collection.

Heavy grazing reduces soil bacterial diversity by increasing soil pH in a semi-arid steppe.

Background: In a context of long-term highly intensive grazing in grassland ecosystems, a better understanding of how quickly belowground biodiversity responds to grazing is required, especially for soil microbial diversity. Methods: In this study, we conducted a grazing experiment which included the CK (no grazing with a fenced enclosure undisturbed by livestock), light and heavy grazing treatments in a desert steppe in Inner Mongolia, China. Microbial diversity and soil chemical properties (i.e., pH value, organic carbon, inorganic nitrogen (IN, NH4+-N and NO3--N), total carbon, nitrogen, phosphorus, and available phosphorus content) both in rhizosphere and non-rhizosphere soils were analyzed to explore the responses of microbial diversity to grazing intensity and the underlying mechanisms. Results: The results showed that heavy grazing only deceased bacterial diversity in the non-rhizosphere soil, but had no any significant effects on fungal diversity regardless of rhizosphere or non-rhizosphere soils. Bacterial diversity in the rhizosphere soil was higher than that of non-rhizosphere soil only in the heavy grazing treatment. Also, heavy grazing significantly increased soil pH value but deceased NH4+-N and available phosphorus in the non-rhizosphere soil. Spearman correlation analysis showed that soil pH value was significantly negatively correlated with the bacterial diversity in the non-rhizosphere soil. Combined, our results suggest that heavy grazing decreased soil bacterial diversity in the non-rhizosphere soil by increasing soil pH value, which may be due to the accumulation of dung and urine from livestock. Our results highlight that soil pH value may be the main factor driving soil microbial diversity in grazing ecosystems, and these results can provide scientific basis for grassland management and ecological restoration in arid and semi-arid area.

An asynchronous response fluorescence sensor combines machine learning theory to qualitatively and quantitatively detect tetracyclines.

Excess use of tetracyclines poses significant health risks arising from animal-derived foods, meaning simple and sensitive methods to detect tetracyclines would be beneficial given current laboratory methods are complex and expensive. Herein, we describe an asynchronous response fluorescence sensor constructed based on Zn-based metal-organic framework and Ru(bpy)32+ (denoted as Ru@Zn-BTEC) for the qualitative and quantitative detection of tetracyclines in foods. Under excitation at 365 nm, the sensor emitted red fluorescence at 609 nm. When tetracyclines were present, these molecules aggregated in the Ru@Zn-BTEC framework, causing green fluorescence emission at 528 nm. The developed sensing system accurately distinguished the different categories of tetracyclines with a classifier accuracy of 94 %. The Ru@Zn-BTEC sensor demonstrated a detection limit of 0.012 µM and satisfactory recovery (87.81 %-113.84 %) for tetracyclines in food samples. This work provides a pathway for constructing asynchronous response fluorescence sensors for food analysis.

A MOF-on-MOF heterostructure ratiometric/colorimetric dual-mode fluorescence sensor based on support vector machine for detecting tetracyclines in animal-derived foods.

The misuse of tetracyclines in livestock production poses significant health risks. Thus, establishing convenient detection methods to replace complex laboratory tests for food safety is crucial. In this study, a heterostructure Zn-BTC/IRMOF-3 (denoted as ZBI) asynchronous response fluorescence sensor was developed for the qualitative and quantitative detection of tetracyclines in foods. The ZBI solution exhibited blue fluorescence under UV excitation; upon the introduction of tetracyclines, ZBI selectively recognized the tetracycline molecules through electron transfer, π-π stacking, and chelation, resulting in blue fluorescence quenching and green fluorescence enhancement. The ZBI sensor for tetracycline detection achieved recovery rates ranging from 93.91 to 111.91% in food samples, with a detection limit of as low as 0.086 µmol/L. Lastly, a portable sensing device using support vector classifier was constructed for detecting tetracyclines in real-life scenarios. Our findings introduce a new approach for fabricating fluorescence sensors and offer a novel method for detecting tetracyclines.

Joint multi-site domain adaptation and multi-modality feature selection for the diagnosis of psychiatric disorders.

Identifying biomarkers for computer-aided diagnosis (CAD) is crucial for early intervention of psychiatric disorders. Multi-site data have been utilized to increase the sample size and improve statistical power, while multi-modality classification offers significant advantages over traditional single-modality based approaches for diagnosing psychiatric disorders. However, inter-site heterogeneity and intra-modality heterogeneity present challenges to multi-site and multi-modality based classification. In this paper, brain functional and structural networks (BFNs/BSNs) from multiple sites were constructed to establish a joint multi-site multi-modality framework for psychiatric diagnosis. To do this we developed a hypergraph based multi-source domain adaptation (HMSDA) which allowed us to transform source domain subjects into a target domain. A local ordinal structure based multi-task feature selection (LOSMFS) approach was developed by integrating the transformed functional and structural connections (FCs/SCs). The effectiveness of our method was validated by evaluating diagnosis of both schizophrenia (SZ) and autism spectrum disorder (ASD). The proposed method obtained accuracies of 92.2 %±2.22 % and 84.8 %±2.68 % for the diagnosis of SZ and ASD, respectively. We also compared with 6 DA, 10 multi-modality feature selection, and 8 multi-site and multi-modality methods. Results showed the proposed HMSDA+LOSMFS effectively integrated multi-site and multi-modality data to enhance psychiatric diagnosis and identify disorder-specific diagnostic brain connections.

Identifying psychosis subtypes use individualized covariance structural differential networks and multi-site clustering.

BACKGROUND: Similarities among schizophrenia (SZ), schizoaffective disorder (SAD) and bipolar disorder (BP) including clinical phenotypes, brain alterations and risk genes, make it challenging to perform reliable separation among them. However, previous subtype identification that transcend traditional diagnostic boundaries were based on group-level neuroimaging features, ignoring individual-level inferences. METHODS: 455 psychoses (178 SZs, 134 SADs and 143 BPs), their first-degree relatives (N = 453) and healthy controls (HCs, N = 220) were collected from Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP I) consortium. Individualized covariance structural differential networks (ICSDNs) were constructed for each patient and multi-site clustering was used to identify psychosis subtypes. Group differences between subtypes in clinical phenotypes and voxel-wise fractional amplitude of low frequency fluctuation (fALFF) were calculated, as well as between the corresponding relatives. RESULTS: Two psychosis subtypes were identified with increased whole brain structural covariance, with decreased connectivity between amygdala-hippocampus and temporal-occipital cortex in subtype I (S-I) compared to subtype II (S-II), which was replicated under different clustering methods, number of edges and across datasets (B-SNIP II) and different brain atlases. S-I had higher emotional-related symptoms than S-II and showed significant fALFF decrease in temporal and occipital cortex, while S-II was more similar to HC. This pattern was consistently validated on relatives of S-I and S-II in both fALFF and clinical symptoms. CONCLUSIONS: These findings reconcile categorical and dimensional perspectives of psychosis neurobiological heterogeneity, indicating that relatives of S-I might have greater predisposition in developing psychosis, while relatives of S-II are more likely to be healthy. This study contributes to the development of neuroimaging informed diagnostic classifications within psychosis spectrum.

Amino-functionalized Al-MOF modulated TpTt-COF with dual-emission for fluorescent and optosmart detecting tetracycline in food samples.

Tetracycline residues in animal-derived food pose serious harm to human health, making it demanded to develop simple and sensitive method for detecting tetracycline. Herein, a dual-emission synchronous response fluorescence probe is reported based on amino-functionalized Al-MOF modulated TpTt-COF (donate as NMT). NMT exhibits excellent dual-emission at 455 and 575 nm under single excitation. Tetracycline is sensitively detected through quenching the dual-emission of NMT. NMT specifically recognizes tetracycline through intermolecular hydrogen bonding between -OH/-NH2 of tetracycline and deprotonated O-/-NH-/CN of NMT. A calibration curve is built between the fluorescence ratio and the tetracycline concentration with a detection limit of 0.014 µmol/L. NMT is employed to detect tetracycline in milk, pork and chicken, and displays satisfactory recoveries of 94.39-105.67%, respectively. The optosmart sensor based on NMT and smartphone has been constructed for visually detecting tetracycline. This method provides routes to construct MOF-COF fluorescence probes and has good prospects in food analysis.

Molecular Evolution of Human Parainfluenza Virus Type 2 Based on Hemagglutinin-Neuraminidase Gene.

To understand the molecular evolution of human parainfluenza virus type 2 (HPIV2), 21 Hemagglutinin-Neuraminidase (HN) gene sequences covering seven Chinese provinces in 2011 and 2017 to 2021 were combined with 90 published HN sequences worldwide for phylogenetic analysis. The result showed that global HPIV2 could be classified into two distinct clusters (I and II), five lineages (IA to IIE), and four sublineages (IB1 and 2, and IIE1 and 2). The minimum genetic distances between different clusters and lineages were 0.049 and 0.014, respectively. In the last decade, one lineage (IID) and three sublineages (IB1, IB2, and IIE1) have been cocirculating in China, with the sublineages IB2 and IIE1 dominating, while sublineages IB1 and IIE1 are dominant globally. In addition, the spread of HPIV2 had relative spatial clustering, and sublineage IB2 has only been detected in China thus far. The overall evolution rate of HPIV2 was relatively low, on the order of 10-4 substitutions/site/year, except for sublineage IB2 at 10-3 substitutions/site/year. Furthermore, human-animal transmission was observed, suggesting that the HPIV2 might have jumped out of animal reservoirs in approximately 1922, the predicted time of a common ancestor. The entire HN protein was under purifying/negative selection, and the specific amino acid changes and two novel N-glycosylation sites (N316 and N517) in sublineages IB1, IB2, and IIE1 were mostly located in the globular head region of the HN protein. In this study, preliminary evolutionary characteristics of HPIV2 based on the HN gene were obtained, increasing the recognition of the evolution and adaptation of HPIV2. IMPORTANCE The phylogenetic analysis showed that global HPIV2 could be classified into two distinct clusters (I and II) and five lineages (IA to IIE) with at least 0.049 and 0.014 genetic distances between clusters and lineages, respectively. Furthermore, lineages IB and IIE could be further divided into two sublineages (IB1-2 and IIE1-2). All China sequences belong to one lineage and three sublineages (IB1, IB2, IID, and IIE1), among which sublineages IB2 and IIE1 are predominant and cocirculating in China, while sublineages IB1 and IIE1 are dominant globally. The overall evolution rate of HPIV2 is on the order of 10-4 substitutions/site/year, with the highest rate of 2.18 × 10-3 for sublineage IB2. The entire HN protein is under purifying/negative selection, and the specific amino acid substitutions and two novel N-glycosylation sites (N316 and N517) in sublineages IB1, IB2, and IIE1 are mostly located in the globular head region of the HN protein.

Integration and Segregation of Dynamic Functional Connectivity States for Mild Cognitive Impairment Revealed by Graph Theory Indicators.

Mild cognitive impairment (MCI) is an intermediate stage between normal aging and dementia. Researchers tend to discuss its early state (early MCI, eMCI) due to its high conversion rate of dementia and poor treatment effect in the middle and late stages. Currently, the research on the disease evolution of the brain functional networks of patients with MCI has gradually become a research hotspot. In this study, we compare the differences in dynamic functional connectivity among eMCI, late MCI (lMCI), and normal control (NC) groups, and their graph theory indicators reveal the integration and segregation of functional connectivity states. Firstly, dynamic functional network windows were constructed based on the sliding time window method, and then these window samples were clustered by k-means to extract the functional connectivity states. The differences in the three groups were compared by analyzing the graph theory indicators, such as the participation coefficient, module degree distribution, clustering coefficient, global efficiency, and local efficiency, which distinguish the functional connectivity states. The results reveal that the NC group has the strongest integration and segregation, followed by the eMCI group, and the lMCI group has the weakest integration and segregation. We conclude that with the aggravation of MCI, the integration and segregation of dynamic functional connectivity states tend to decline. The results also reflect that the lMCI group has significantly more brain functional connections in some states, such as IPL.L-MTG.R and DCG.R-SMG.L, than the eMCI group, while the lMCI group has significantly less OLF.L-SPG.L than the NC group.

Constructing Dynamic Brain Functional Networks via Hyper-Graph Manifold Regularization for Mild Cognitive Impairment Classification.

Brain functional networks (BFNs) constructed via manifold regularization (MR) have emerged as a powerful tool in finding new biomarkers for brain disease diagnosis. However, they only describe the pair-wise relationship between two brain regions, and cannot describe the functional interaction between multiple brain regions, or the high-order relationship, well. To solve this issue, we propose a method to construct dynamic BFNs (DBFNs) via hyper-graph MR (HMR) and employ it to classify mild cognitive impairment (MCI) subjects. First, we construct DBFNs via Pearson's correlation (PC) method and remodel the PC method as an optimization model. Then, we use k-nearest neighbor (KNN) algorithm to construct the hyper-graph and obtain the hyper-graph manifold regularizer based on the hyper-graph. We introduce the hyper-graph manifold regularizer and the L1-norm regularizer into the PC-based optimization model to optimize DBFNs and obtain the final sparse DBFNs (SDBFNs). Finally, we conduct classification experiments to classify MCI subjects from normal subjects to verify the effectiveness of our method. Experimental results show that the proposed method achieves better classification performance compared with other state-of-the-art methods, and the classification accuracy (ACC), the sensitivity (SEN), the specificity (SPE), and the area under the curve (AUC) reach 82.4946 ± 0.2827%, 77.2473 ± 0.5747%, 87.7419 ± 0.2286%, and 0.9021 ± 0.0007, respectively. This method expands the MR method and DBFNs with more biological significance. It can effectively improve the classification performance of DBFNs for MCI, and has certain reference value for the research and auxiliary diagnosis of Alzheimer's disease (AD).

An aseptic meningitis outbreak caused by echovirus 6 in Anhui province, China.

An outbreak of aseptic meningitis (AM) occurred in Jinzhai County in Anhui province from April to July in 2005. Totally, 97 children aged 3-15 years were hospitalized. To identify the etiologic agent, 77 cerebrospinal fluid specimens (CSF) and 5 fecal specimens were collected from the patients and cultured by human rhabdomyosarcoma (RD) cell line. Thirty isolates of human echovirus 6 (E6) from 27 CSF and 3 fecal specimens were confirmed by neutralization assay and sequencing analysis of the VP1 gene. The homology of VP1 gene among Anhui isolates was 99.7-100.0% and it indicated that this AM outbreak probable caused by a single transmission link of E6. Phylogenetic analysis based on all the available complete VP1 sequences indicated that E6 could be divided into clusters A, B, and C with at least 15% diversity between clusters and the C cluster could be further divided into C1, C2, C3, and C4. The Anhui isolates most resembled a 2005 strain from Russia (25465 Tambov) and belong to C4. This is the first report that E6 was responsible for an outbreak of AM in China. J. Med. Virol. 82:441-445, 2010. (c) 2010 Wiley-Liss, Inc.

Retrospective seroepidemiology indicated that human enterovirus 71 and coxsackievirus A16 circulated wildly in central and southern China before large-scale outbreaks from 2008.

BACKGROUND: Large nationwide outbreaks of hand, foot, and mouth disease (HFMD) occurred in China from 2008; most of the cases were in children under 5 years. This study aims to identify the situation of natural human enterovirus 71 (HEV71) and coxsackievirus A16 (CVA16) infections in children before 2008 in China. RESULTS: Retrospective seroepidemiologic studies of HEV71 and CVA16 were performed with 900 serum samples collected from children ≤5 years of age in 2005. The samples were collected from 6 different geographical areas (Anhui, Guangdong, Hunan, Xinjiang, Yunnan, and Heilongjiang provinces) in mainland China. Of the 900 samples, 288 were positive for HEV71; the total positive rate was 32.0% and the geometric mean titer (GMT) was 1:8.5. Guangdong (43.7% and 1:10.8), Xinjiang (45.4% and 1:11.1), and Yunnan (43.4% and 1:12.0) provinces had relatively high rates of infection, while Heilongjiang province (8.1% and 1:4.9) had the lowest rate of infection. On the other hand, 390 samples were positive for CVA16; the total positive rate was 43.4% and the GMT was 1:9.5. Anhui (62.2% and 1:16.0) and Hunan (61.1% and 1:23.1) had relatively high rates, while Heilongjiang (8.0% and 1:4.6) had the lowest rate. Although there is a geographical difference in HEV71 and CVA16 infections, low neutralizing antibody positive rate and titer of both viruses were found in all 6 provinces. CONCLUSIONS: This report confirmed that HEV71 and CVA16 had wildly circulated in a couple provinces in China before the large-scale outbreaks from 2008. This finding also suggests that public health measures to control the spread of HEV71 and CVA16 should be devised according to the different regional characteristics.

Genetic characterization of wild-type measles viruses isolated in China, 2006-2007.

Molecular characterization of wild-type measles viruses in China during 1995-2004 demonstrated that genotype H1 was endemic and widely distributed throughout the country. H1-associated cases and outbreaks caused a resurgence of measles beginning in 2005. A total of 210,094 measles cases and 101 deaths were reported by National Notifiable Diseases Reporting System (NNDRS) and Chinese Measles Laboratory Network (LabNet) from 2006 to 2007, and the incidences of measles were 6.8/100,000 population and 7.2/100,000 population in 2006 and 2007, respectively. Five hundred and sixty-five wild-type measles viruses were isolated from 24 of 31 provinces in mainland China during 2006 and 2007, and all of the wild type virus isolates belonged to cluster 1 of genotype H1. These results indicated that H1-cluster 1 viruses were the predominant viruses circulating in China from 2006 to 2007. This study contributes to previous efforts to generate critical baseline data about circulating wild-type measles viruses in China that will allow molecular epidemiologic studies to help measure the progress made toward China's goal of measles elimination by 2012.

Constructing Dynamic Functional Networks via Weighted Regularization and Tensor Low-Rank Approximation for Early Mild Cognitive Impairment Classification.

Brain functional networks constructed via regularization has been widely used in early mild cognitive impairment (eMCI) classification. However, few methods can properly reflect the similarities and differences of functional connections among different people. Most methods ignore some topological attributes, such as connection strength, which may delete strong functional connections in brain functional networks. To overcome these limitations, we propose a novel method to construct dynamic functional networks (DFN) based on weighted regularization (WR) and tensor low-rank approximation (TLA), and apply it to identify eMCI subjects from normal subjects. First, we introduce the WR term into the DFN construction and obtain WR-based DFNs (WRDFN). Then, we combine the WRDFNs of all subjects into a third-order tensor for TLA processing, and obtain the DFN based on WR and TLA (WRTDFN) of each subject in the tensor. We calculate the weighted-graph local clustering coefficient of each region in each WRTDFN as the effective feature, and use the t-test for feature selection. Finally, we train a linear support vector machine (SVM) classifier to classify the WRTDFNs of all subjects. Experimental results demonstrate that the proposed method can obtain DFNs with the scale-free property, and that the classification accuracy (ACC), the sensitivity (SEN), the specificity (SPE), and the area under curve (AUC) reach 87.0662% ± 0.3202%, 83.4363% ± 0.5076%, 90.6961% ± 0.3250% and 0.9431 ± 0.0023, respectively. We also achieve the best classification results compared with other comparable methods. This work can effectively improve the classification performance of DFNs constructed by existing methods for eMCI and has certain reference value for the early diagnosis of Alzheimer's disease (AD).

Outbreak of acute respiratory disease in China caused by B2 species of adenovirus type 11.

An outbreak of acute respiratory tract infection occurred in Shanxi Province, China, from March to April 2006. Of the 254 patients affected by this outbreak, 247 patients were students of a senior high school; 1 of these patients died during the outbreak. Serological tests and blood culture revealed no evidence of bacterial infection. The results of direct reverse transcription-PCR or PCR performed with clinical specimens collected from the patients, including the sole patient who died, were positive for human adenoviruses (HAdVs) but negative for influenza virus, measles virus, rubella virus, mumps virus, parainfluenza virus, respiratory syncytial virus, and human enteroviruses. These findings were confirmed by enzyme-linked immunosorbent assay for HAdV immunoglobulin A, the conventional neutralization test, and viral isolation and identification. Sequencing of the entire hexon gene revealed that HdAV type 11a (HAdV-11a) belonging to the B2 species of HAdV was the etiological agent responsible for the outbreak. However, both the analysis of the phylogenetic relationship and the similarity plot indicated that the sequence of the 3' end of the hexon gene outside the hypervariable regions the HAdV-11a strain isolated in this outbreak may be a recombinant with the sequence of the HAdV-14 strain of species B2. Although isolates of HAdV species B2 seldom cause respiratory infections, they may pose a new global challenge with regard to acute respiratory diseases; this possibility cannot be overlooked and should be carefully considered. Hence, the need to establish and improve both epidemiological and virological surveillance of HAdV infections in China should be emphasized.

Measles resurgence associated with continued circulation of genotype H1 viruses in China, 2005.

Measles morbidity and mortality decreased significantly after measles vaccine was introduced into China in 1965. From 1995 to 2004, average annual measles incidence decreased to 5.6 cases per 100,000 population following the establishment of a national two-dose regimen. Molecular characterization of wild-type measles viruses demonstrated that genotype H1 was endemic and widely distributed throughout the country in China during 1995-2004. A total of 124,865 cases and 55 deaths were reported from the National Notifiable Diseases Reporting System (NNDRS) in 2005, which represented a 69.05% increase compared with 2004. Over 16,000 serum samples obtained from 914 measles outbreaks and the measles IgM positive rate was 81%. 213 wild-type measles viruses were isolated from 18 of 31 provinces in China during 2005, and all of the isolates belonged to genotype H1. The ranges of the nucleotide sequence and predicted amino acid sequence homologies of the 213 genotype H1 strains were 93.4%-100% and 90.0%-100%, respectively. H1-associated cases and outbreaks caused the measles resurgence in China in 2005. H1 genotype has the most inner variation within genotype, it could be divided into 2 clusters, and cluster 1 viruses were predominant in China throughout 2005.

Molecular characterization of measles viruses in China: Circulation dynamics of the endemic H1 genotype from 2011 to 2017.

Due to the Expanded Program on Immunization (EPI) and supplementary immunization activities (SIAs) in China, the incidence of measles in China has decreased extensively. The incidence reached its lowest levels in contemporary history in 2012 and 2017, with incidence rates of 4.6 and 4.3 per million population, respectively. However, more than 147,000 measles cases were reported from 2013 to 2016. Furthermore, the proportions of cases in infants < 8 months and adults have been increasing since 2013, representing a considerable challenge for measles elimination in China. A total of 14,868 measles viruses were isolated from confirmed measles cases from 2011 to 2017, of which 14,631 were identified as the predominant endemic genotype, H1; 87 were identified as genotype A viruses that were vaccine associated strains; and 150 were identified as non-H1 genotype viruses. The non-H1 genotype viruses included 62 D8 viruses, 70 D9 viruses, 3 D11 viruses, 14 B3 viruses, and 1 G3 virus, which were identified as imported or import-related viruses that caused sporadic cases or small outbreaks. Most of the transmission chains detected during the period 2011-2012 were interrupted and were followed by many new transmission chains of unknown origin that spread, causing a large measles resurgence in China during 2013-2016. After 4 years of measles resurgence and continuous implementation of the routine immunization program and SIAs, the population immunity reached a sufficiently high level to interrupt most of the transmission chains; only a few strains survived, which continued to be sporadically detected in China in 2017. In the present study, the results from the combined epidemiological and molecular virological data demonstrated the great progress towards measles elimination in China by the further analysis of circulation dynamics for the endemic H1 genotype measles virus from 2011 to 2017. And this study accumulated critical baseline data on circulating wild-type measles viruses in China and provides comprehensive information to the world. These comprehensive baseline data provide evidence to support measles elimination in the future, not only in China but also in other countries worldwide. In addition, the information will be very useful to other countries for tracing their sources of measles cases and for identifying transmission links, which can help prevent potential measles outbreaks.