Sequence analysis of HA and NA genes of human infected H9N2 avian influenza virus in Yunnan province, 2019 / 中国热带医学

@#Abstract: Objective To investigate the molecular characteristics of the H9N2 avian influenza virus (AIV) causing human infection in Yunnan Province in 2019, and to provide the scientific basis for the prevention and control of avian influenza in Yunnan Province. Methods Influenza virus typing was performed by real-time RT-PCR in two influenza-like illness samples, and the Illumina Miseq high-throughput sequencer was used to determine the viral genome sequence. HA and NA gene sequence alignment and phylogenetic tree construction were performed using Mega7.0 software. Results Real-time RT-PCR results showed that two influenza-like illness samples were positive for H9N2 subtype. The full length of HA and NA were obtained by genomic sequencing. Sequence system evolution analysis showed that the HA and NA of the two AIVs in Yunnan Province were in the same evolutionary clade as A/Chicken/Zhejiang/HJ/2007 and belonged to the G57 type. The HA nucleotide and amino acid homology of the two AIVs were 93.92% and 95.00%, respectively, and the NA nucleotide and amino acid homology was 93.31% and 82.03%, respectively. The nucleotide (amino acid) homology of HA was 92.29%-96.94% (93.77%-98.43%) and 92.84%-94.92% (94.18%-96.23%), respectively, and NA nucleotide homology (amino acid) were 91.81%-97.60% (77.82%-94.83%), 94.38%-97.22% (85.47%-94.55%), respectively, compared with that of human infected H9N2 epidemic strains obtained in China from 2015 to 2020. Both AIVs HA protein cleavage site sequences were PSRSSR↓GLF, which was in line with the characteristics of low pathogenic influenza. The analysis of HA protein receptor binding site showed that amino acids at positions 109, 161, 163, 191, 202, 203 and 234 were consistent with the reference strains, while amino acids at position 198 were mutated to T. N166D and 168N mutations were also found in HA protein, and both AIVs had 7 potential glycosylation sites. Analysis of the erythrocyte binding site of NA gene found that there were amino acid mutations at positions 369, 402, 403, and 432, and amino acid deletion at positions 63-65 was found in the NA genes. There were 4 and 5 potential glycosylation sites in the two AIVs, respectively, and no drug resistance site mutations were found. Conclusions　The receptor binding sites, erythrocyte binding sites and glycosylation sites of HA and NA genes of H9N2 AIV in Yunnan Province have different degrees of variation, and monitoring and prevention and control should be strengthened.

Bird flu in Nepal

Avian flu also known as bird flu is caused by deadly virus H5N1 which initially was found in birds and wild animals, however, later it was found in human beings causing severe respiratory related problems. This review article was performed to understand the epidemiology of outbreaks of H5N1 in different districts of Nepal. First outbreak of strain H5N1 was reported in 2009. Consequently, highest number of outbreaks i.e. 201 was noted in the year 2013. Till date only one human case was identified by NPHL which was later confirmed by genetic laboratory in Japan in collaborating with WHO.

Detection of Pseudorabies Virus Antibodies in Human Encephalitis Cases / 生物医学与环境科学（英文）

Pseudorabies virus (PRV), a veterinary pathogen that infects domestic animals as well as wild animals such as wild boar and feral swine, was recently reported to infect human and led to endophthalmitis and encephalitis. A retrospective seroepidemiologic survey was conducted using 1,335 serum samples collected from patients with encephalitis and ELISA positive rates were 12.16%, 14.25%, and 6.52% in 2012, 2013, and 2017, respectively. The virus neutralizing antibody titers of positive samples correlated well with ELISA results. The pseudorabies virus antibody positive rate of patients with encephalitis were higher than that of healthy people in 2017. The above results suggest that some undefined human encephalitis cases may be caused by PRV infection.

First report of Myxobolus (Cnidaria: Myxozoa) spores in human feces in Brazil / Primeiro relato de esporos de Myxobolus (Cnidaria: Myxozoa) em fezes humanas no Brasil

Most species of Myxobolus (Cnidaria: Myxozoa) infect freshwater and marine fish, and cause sporozoosis. Passage of myxozoan parasites into human feces has been described occasionally. We examined fecal samples from 97 dwellers of a riverine community in Amazonas State (Brazil), which revealed Myxobolus sp. in 13 (13%) samples. The discovery probably does not represent true parasitism as the myxospores - most likely ingested through the consumption of infected fish - were eliminated unchanged after passing through the gastrointestinal tract. This discovery represents the first report of this myxosporean in human fecal samples in Brazil. (AU)

A maioria das espécies de Myxobolus (Cnidaria: Myxozoa) infecta principalmente peixes de água doce e marinhos, nos quais produz esporozoose. A passagem de parasitos mixozoários em fezes humanas tem sido ocasionalmente descrita. Nós examinamos amostras fecais de 97 moradores de uma comunidade ribeirinha no estado do Amazonas e identificamos Myxobolus sp. em 13 (13%) delas. O achado provavelmente não representa um parasitismo verdadeiro, uma vez que os mixosporos − mais provavelmente ingeridos ao consumir peixes infectados − foram eliminados inalterados após a passagem pelo trato gastrointestinal. O achado representa o primeiro relato deste mixosporídeo em amostras fecais humanas no Brasil.(AU)

Analysis on spatial epidemiological characteristics of human infection with avian influenza A(H7N9) virus in Fujian Province / 中华疾病控制杂志

Objective The aim is to analyze the spatial epidemiological characteristics for human infection with avian influenza H7N9 in Fujian Province, so as to provide scientific evidence for developing and adjusting related control strategies. Methods The epidemiological data of human infection with H7N9 avian influenza in Fujian Province, from 2013 to 2017 was analyzed by SAS 9.2, ArcGIS 10.3 and SaTScan 9.4 software.Results There were a total of 108 cases and 28 deaths reported in Fujian Province, up to December 31, 2017. The case fatality rate was 25.93%.96.30% of cases were sporadic. There were more incidences in winters and springs, more incidences in rural areas. The global spatial autocorrelation and high/low clustering analysis indicated that clusters at the county level were in the shore areas (Z=3.74, P<0.001; Z=5.26, P<0.001). The cities of Changle, Fuqing, Jinjiang and Siming were the high-high clustered areas and local hot-points. There were two clusters, from December 2014 to March 2015, the most likely cluster regions was centered around Zhangpu County with a radius of 63.04 km (RR=4.72, LLR=11.41, P<0.001). The secondary cluster regions was centered around Fuqing City with a radius of 81.98 km (RR=4.07, LLR=7.96, P=0.037). Conclusions Human infection with avian influenza H7N9 in Fujian Province is spatially and temporally clustered. The measures of prevention and control should be focused on high incidence seasons and key regions, and the surveillance of etiology should be strengthened.

Study on the source of human infection with H9N2 influenza virus from live poultry markets in Changsha / 中华疾病控制杂志

Objective To explore the source of human infection H9N2 avian influenza virus (AIV). Methods Environmental AIV nucleic acid monitoring was conducted for live poultry markets in Changsha city from 2014 to 2015, and data of human infection H9N2 subtype AIV cases worldwide were collected. Phylogenetic trees of hemagglutinin(HA), neuraminidase(NA)and non-structural protein(NS)genes from human infection H9N2 subtype AIV, the live poultry markets environmental H9N2 subtype AIV and partial avian H9N2 subtype AIV were constructed using the MEGA 6.06 software, respectively. Results In 2014-2015, H9 subtype AIV had the highest nucleic acid positive rate (44.76%) in the live poultry markets environment of Changsha city, and the pollution was serious. A total of 27 cases of human infection with H9N2 subtype AIV had been reported worldwide, and most of these patients recovered after treatments.Epidemiological survey showed that 59.26% (16/27) of cases had a clear history of exposure to poultry or live poultry markets. The phylogenetic trees of HA, NA and NS genes showed that the human infection H9N2 subtype AIV isolates isolated from Hunan and Guangdong were closely related to the H9N2 subtype AIV isolated from the live poultry markets environment in Hunan and Guangdong provinces from 2013 to 2016. The nucleotide similarity was as high as 97%-99%. Conclusion Live poultry market is one of the sources of human infection with H9N2 influenza virus.

Design and application of bundle treatment plan in the early stage for severe human infection by avian influenza H7N9 / 中华危重病急救医学

Objective To design bundle treatment plan in the early stage for severe human infection by avian influenza H7N9, and explore its clinical efficacy and application value. Methods Fifteen patients with severe human infection by avian influenza H7N9 in Guizhou Province from December 29th, 2016 to June 7th, 2017 were enrolled. Patients admitted from March 6th, 2017 to June 7th, 2017 served as a prospective observation period (bundle treatment group), and those from December 29th, 2016 to March 5th, 2017 were selected as a historical control period (conventional treatment group). Conventional treatment group was given conventional treatment such as isolation, anti-virus, symptomatic treatment, and traditional Chinese medicine and so on. Bundle treatment group was given bundle treatment on the basis of conventional treatment, including isolation, anti-virus, respiratory support, restrictive fluid management, immunotherapy, inhibition of inflammation, antibiotic therapy, nutritional support, prevention of hospital acquired infection (HAP), individual sedation, continuous blood purification (CBP) for acute kidney injury (AKI) and severe acute respiratory distress syndrome (ARDS) patients, and intensive care. A cluster of bundle treatment team was set up to ensure that all measures carried out smoothly. The gender, age, onset to diagnosis time, acute physiology and chronic health evaluationⅡ(APACHEⅡ) score, oxygenation index (PaO2/FiO2) at admission, the length of intensive care unit (ICU) stay, total hospitalization time and prognosis of the two groups were observed. Correlation analysis between bundle therapy and prognosis was analyzed by Spearman correlation analysis. Receiver operating characteristic (ROC) curve was drawn, and the clinical value of bundle treatment was analyzed. Results There was no significant difference in gender, age, onset to diagnosis time, APACHEⅡscore, PaO2/FiO2, the length of ICU stay, or total hospitalization time between bundle treatment group (n = 9) and conventional treatment group (n = 6), but the death patients in the bundle treatment group was significantly fewer than those in conventional treatment group (cases:2 vs. 5, χ2= 3.225, P = 0.041). Correlation analysis showed that there was a significant correlation between the mortality and whether received bundle treatment or not in patients who infected by avian influenza H7N9 (r = -0.875, P = 0.018). ROC curve analysis showed that the area under the ROC curve (AUC) of non-bundle treatment for predicting the death in patients with severe human infection by avian influenza H7N9 was 0.938, 95% confidence interval (95%CI) was 0.795-1.000, the sensitivity was 88.88%, and the specificity was 98.62%. Conclusions Early bundle therapy has a significant effect on severe human infection by avian influenza H7N9, which can improve the prognosis and reduce the mortality of patients. It is worthy for clinical application.

Investigation and analysis on the first case of human infected with avian influenza (H5N6) in Anhui Province / 中国人兽共患病学报

We analyzed epidemiological and clinical characteristics of the case of human infected with avian influenza (H5N6) in Anhui Province and provided evidences for drawing up the prevention and control measures.We did an epidemiolog ical investigation on the case,close contacts and infection source of the infected case;relevant specimens were collected and tested in laboratories.The data gathered were analyzed with descriptive epidemiology method.The first case of human infected with avian influenza (H5N6) in Anhui was a single case and did not showed signs of human-to-human transmission.The early clinical manifestations and signs was lack of specificity.This case had definite contact with sick/dead poultry one week before the onset of the disease.Two environmental specimen of live poultry market which was the source of sick/dead poultry had been detected and the results were H5N6 positive.This case was a local infection case and contacting with sick/dead poultry was the source of infection,while there was no evidence of human to human transmission.

Epidemiology of human infection with avian influenza A(H7N9) virus in China, 2013-2017 / 中华流行病学杂志

Objective To understand the epidemiological characteristics of human infection with avian influenza A (H7N9) virus in China,and provide evidence for the prevention and control of human infection with H7N9 virus.Methods The published incidence data of human infection with H7N9 virus in China from March 2013 to April 2017 were collected.Excel 2007 software was used to perform the analysis.The characteristics of distribution of the disease,exposure history,cluster of the disease were described.Results By the end of April 2017,a total of 1 416 cases of human infection with H7N9 virus were confirmed in China,including 559 deaths,the case fatality rate was 39.5％.In 2016,the case number was lowest (127 cases),with the highest fatality rate (57.5％).The first three provinces with high case numbers were Zhejiang,Guangdong and Jiangsu.The median age of the cases was 55 years and the male to female ratio was 2.3 ∶ 1.Up to 66％ of cases had clear live poultry exposure history before illness onset,31％ of cases had unknown exposure history and only 3％ of the cases had no live poultry exposure history.There were 35 household clusters (5 in 2013,9 in 2014,6 in 2015,5 in 2016,10 in 2017),which involved 72 cases,accounting for 5％ of the total cases.Conclusions The epidemic of human infection with H7N9 virus in China during 2013-2017 had obvious seasonality and spatial distribution.There was limited family clustering.Infection cases were mostly related to poultry contact.

Epidemiology of human infection with avian influenza A(H7N9) virus in China, 2013-2017 / 中华流行病学杂志

Objective To understand the epidemiological characteristics of human infection with avian influenza A (H7N9) virus in China,and provide evidence for the prevention and control of human infection with H7N9 virus.Methods The published incidence data of human infection with H7N9 virus in China from March 2013 to April 2017 were collected.Excel 2007 software was used to perform the analysis.The characteristics of distribution of the disease,exposure history,cluster of the disease were described.Results By the end of April 2017,a total of 1 416 cases of human infection with H7N9 virus were confirmed in China,including 559 deaths,the case fatality rate was 39.5％.In 2016,the case number was lowest (127 cases),with the highest fatality rate (57.5％).The first three provinces with high case numbers were Zhejiang,Guangdong and Jiangsu.The median age of the cases was 55 years and the male to female ratio was 2.3 ∶ 1.Up to 66％ of cases had clear live poultry exposure history before illness onset,31％ of cases had unknown exposure history and only 3％ of the cases had no live poultry exposure history.There were 35 household clusters (5 in 2013,9 in 2014,6 in 2015,5 in 2016,10 in 2017),which involved 72 cases,accounting for 5％ of the total cases.Conclusions The epidemic of human infection with H7N9 virus in China during 2013-2017 had obvious seasonality and spatial distribution.There was limited family clustering.Infection cases were mostly related to poultry contact.

An Overview of Fish-borne Nematodiases among Returned Travelers for Recent 25 Years– Unexpected Diseases Sometimes Far Away from the Origin

Along with globalization of traveling and trading, fish-borne nematodiases seems to be increasing in number. However, apart from occasional and sporadic case reports or mini-reviews of particular diseases in particular countries, an overview of fish-borne nematodiasis among travelers have never been performed. In this review, we gathered fish-borne nematodiasis among travelers for recent 25 years by an extensive global literature survey using appropriate keywords, e.g. travelers diseases, human infection, anisakiasis, gnathostomiasis, capillariasis, sushi, sashimi, ceviche, Gnathostoma, Pseudoterranova, Anisakis, Capillaria, etc., as well as various combinations of these key words. The Internet search engines PubMed, Medline, Google and Googler Scholar were used as much as possible, and the references of every paper were checked in order to identify useful and reliable publications. The results showed unexpectedly high incidence of gnathostomiasis and low incidence of anisakidosis. The different incidence values of the infection with several fish-borne zoonotic nematode species are discussed, as well as some epidemiological aspects of the infections. The difficulties of differential diagnosis in non-endemic countries are emphasized. It is concluded that travelers must avoid risky behaviors which can lead to infection and that physicians and health authorities must advice travelers on the risks of eating behaviors during travel.

Genomic characterization of avian influenza A(H7N9) virus in Zhaoqing, China, 2014-2016 / 中国人兽共患病学报

We analyzed genetic evolution characteristics of avian influenza A (H7N9) virus isolated in Zhaoqing,China,2014-2016.Nucleic acid were extracted and sequenced from 17 samples of H7N9 positive cases in Zhaoqing.Genetic characteristics of homology and important amino acid sites were analyzed by using BioEdit5.0 and MEGA6.0.The evolutionary trees were constructed by Neighbor-Joining and the referenced sequences were downloaded from GenBank,Eight nucleic acid fragments from 7 strains of H7N9 viruses were successfully generated.The highest homology was found in HA gene with A/chicken/Dongguan/695/2014(H7N9),and NA gene with A/chicken/Dongguan/1075/2014(H7N9).The internal genes were high homology with avian H7N9 and H9N2 virus from Dongguan and Shenzhen in Guangdong,China.The HA and NA genes were directly evolved in the Pearl River Delta evolution branch with the H7N9 sequences from the cities of Dongguan,Guangzhou and Shenzhen,while the sequences from the provinces of Anhui,Zhejiang,and Jiangsu were in the Yangtze River Delta evolution branch.There were 2 alkaline amino acids in cleavage site of HA,2 mutations (G186V and Q226L) in the crucial sites related with the receptor of HA protein,1 mutation (E627K) in PB2 protein,and 1 drug resistance mutation (S31N) in M2 protein.And no evidence of neuraminidase resistance in NA protein was found.In conclusion,the H7N9 virus for human infection in Zhaoqing may originate from avian H7N9 and H9N2 viruses,which circulated in the Pearl River Delta region of Guangdong from 2013 to 2014.The mutations of G186V,Q226L and E627 K might be related with high susceptibility to human beings.

A caseof the severe human infection by avian influenza H7N9 was rescued successfully by the sepsis bundle / 中华危重病急救医学

One confirmed diagnosiscase of severe human infection by avian influenza H7N9 admitted to intensive care unit (ICU) of the Second Affiliated Hospital of Guizhou Medical University on January 12th, 2017 was reported. The patient was treated with the sepsis bundle, and recovered finally, including a series of comprehensive treatments, such as respiratory support, circulation support, antiviral, anti-inflammation, immunization enhancement, critical nursing, fluid management, nutritional support and treatment of complications. The critical patient was admitted on January 27th, and the treatment was successful. It has important significance to rescue the severe human infection from avian influenza H7N9 by the sepsis bundle.

Epidemiological characteristics of human infection with avian influenza A(H7N9) virus in Xiaoshan, China, 2013-2016 / 中国人兽共患病学报

To analyze the epidemiological characteristics of human infection with avian influenza A(H7N9) virus from 2013 to 2016 in Xiaoshan,China,we collected the epidemiological data of human A(H7N9) cases as well as the results of environmental monitoring and analyzed it by case study,descriptive epidemiological method,and statistical analysis.Results showed that a total of 22 cases were confirmed,including 12 deaths.All the cases occurred in winter and spring,and most of them had been exposed to live poultry,and with the underlying condition of chronic diseases.Chi-square test showed that the ratio of cases with chronic diseases in death group was higher (P=0.01).The environmental monitoring result showed there were distinctive seasonal differences of positive rate with peaks in winter and spring and nadirs in autumn and summer.Positive rates for the samples from external environmental monitoring were consistent with the distribution of the case onset.Due to rise of environmental monitoring positive rate,we should be alert to the occurrence of new cases,especially in rural areas where live poultry fairs still exist and among people with occupational exposure.We should further improve ability to prevent and control this disease.

An analysis on the clinical and epidemiological characteristics of 15 cases of human infection with avian influenza A (H7 N9)virus in Jiaxing City / 预防医学

Objective To analyze the clinical and epidemiological characteristics of human avian influenza A (H7N9 ) epidemic in Jiaxing City,and to provide scientific basis for the control and prevention of the disease.Methods The epidemiological and clinical information of 15 cases of human infection with avian influenza A (H7N9)reported from April, 2013 to May,2015 were collected.Sample of patients and external environmental samples of suspected exposure were collected and detected by real-time PCR.The epidemic distribution and clinical characteristics were analyzed.Results Fifteen cases of human infection with H7N9 were confirmed from April,2013 to May,2015,including 11 cases of death (77.33%).The confirmed cases mostly reported in winter and spring,and 9 confirmed cases were over 60 years,and male case proportion was higher than women (1.5∶1 ).Most of cases (66.67%)were sporadic and occurred in rural areas,but no epidemiological association was observed among the cases.Fever (100%),cough (66.67%),and wheezing and tightness in chest (33.33%)were common initial symptoms.The chest imaging examination of patients showed ground glass opacity and patchy consolidation,and 7 cases had simple pleural effusion.Twelve of confirmed cases had other chronic diseases.Eleven cases of death had appeared multiple medical comorbidities,such as respiratory failure (6/1 1 ),pulmonary embolism (4/1 1 ),multiple systemic organ failure (3/1 1 ),and heart cerebrovascular embolization (2/11).Twelve cases had been exposed to the live poultry markets where the positive rate of novel influenza A (H7N9) virus in environmental specimens was 7.69%(25/325).One of the 252 close contacts to confirmed cases appeared mild flu-like symptoms.No positive result related to novel influenza A (H7N9)virus nucleic acid was detected from each close contact's throat swabs.Conclusion Human infections with avian influenza A (H7N9)virus showed obvious seasonal distribution in Jiaxing.Elderly men,especially those with chronic diseases were the high risk people of human infection with H7N9 avian influenza.The infection might be associated with the exposure to live birds.Standard management of live poultry markets is the key measure in preventing and controlling H7N9 virus infection among population.

An Improved PCR-RFLP Assay for Detection and Genotyping of Asymptomatic Giardia lamblia Infection in a Resource-Poor Setting

Laboratory workers, in resource-poor countries, still consider PCR detection of Giardia lamblia more costly and more time-consuming than the classical parasitological techniques. Based on 2 published primers, an in-house one-round touchdown PCR-RFLP assay was developed. The assay was validated with an internal amplification control included in reactions. Performance of the assay was assessed with DNA samples of various purities, 91 control fecal samples with various parasite load, and 472 samples of unknown results. Two cysts per reaction were enough for PCR detection by the assay with exhibited specificity (Sp) and sensitivity (Se) of 100% and 93%, respectively. Taking a published small subunit rRNA reference PCR test results (6%; 29/472) as a nominated gold standard, G. lamblia was identified in 5.9% (28/472), 5.2%, (25/472), and 3.6% (17/472) by PCR assay, RIDA® Quick Giardia antigen detection test (R-Biopharm, Darmstadt, Germany), and iodine-stained smear microscopy, respectively. The percent agreements (kappa values) of 99.7% (0.745), 98.9% (0.900), and 97.7% (0.981) were exhibited between the assay results and that of the reference PCR, immunoassay, and microscopy, respectively. Restriction digestion of the 28 Giardia-positive samples revealed genotype A pattern in 12 and genotype B profile in 16 samples. The PCR assay with the described format and exhibited performance has a great potential to be adopted in basic clinical laboratories as a detection tool for G. lamblia especially in asymptomatic infections. This potential is increased more in particular situations where identification of the parasite genotype represents a major requirement as in epidemiological studies and infection outbreaks.

Retrospective analysis of human avian influenza A (H10N8) virus infection in Jiangxi province / 中华流行病学杂志

Objective To analyze and discuss the source and epidemic disposition of human infection with avian influenza A(H10N8)virus. Methods Epidemiological surveys were used to collect related data and RT-PCR was applied to detect the specimens collected from cases,close contacts related exposure to live poultry markets. Data were analyzed descriptively. Results Three cases were discovered by surveillance on patients with severe pneumonia,two of the three died,but one in the hospital with the course over 6 months. All the three cases had histories of exposure to live poultry or related markets. Lower respiratory tract gargle aspirate samples of 3 patients were detected by Nanchang Municipal Center for Disease Control and Prevention (CDC) and Jiangxi Provincial CDC,and the results showed the influenza 2009pdmH1,H3,H5,H7,H9 subtypes negative. Specimen of patient 1 and 2 was positive for influenza A universal primers. Specimen of patient 3 was positive for H10N8 detected by Chinese National Influenza Center. All 33 close contacts of the patients were negative for H10N8 virus. Positive rate of the total poultry environmental specimens collected from the cases exposure markets was 5.19%. No new cases were found,after the prevention and control messages were implemented. Conclusion Three cases of H10N8 avian influenza virus infection province might be associated with exposure to live poultry market in Jiangxi.

Retrospective analysis of human avian influenza A (H10N8) virus infection in Jiangxi province / 中华流行病学杂志

Objective To analyze and discuss the source and epidemic disposition of human infection with avian influenza A(H10N8)virus. Methods Epidemiological surveys were used to collect related data and RT-PCR was applied to detect the specimens collected from cases,close contacts related exposure to live poultry markets. Data were analyzed descriptively. Results Three cases were discovered by surveillance on patients with severe pneumonia,two of the three died,but one in the hospital with the course over 6 months. All the three cases had histories of exposure to live poultry or related markets. Lower respiratory tract gargle aspirate samples of 3 patients were detected by Nanchang Municipal Center for Disease Control and Prevention (CDC) and Jiangxi Provincial CDC,and the results showed the influenza 2009pdmH1,H3,H5,H7,H9 subtypes negative. Specimen of patient 1 and 2 was positive for influenza A universal primers. Specimen of patient 3 was positive for H10N8 detected by Chinese National Influenza Center. All 33 close contacts of the patients were negative for H10N8 virus. Positive rate of the total poultry environmental specimens collected from the cases exposure markets was 5.19%. No new cases were found,after the prevention and control messages were implemented. Conclusion Three cases of H10N8 avian influenza virus infection province might be associated with exposure to live poultry market in Jiangxi.

Spatial aggregation of 438 human infections with avian influenza A (H7N9) in the mainland of China / 中华流行病学杂志

Objective To investigate the spatial distribution and growing trend of 438 human infection with the H7N9 avian influenza virus in mainland China,and to provide evidence for developing scientific prevention and control strategies.Methods 438 human infection with the avian influenza A (H7N9) cases from February 2013 to May 2014 in mainland China were studied and data collected to establish a database for the development of geographic information system.Trend surface analysis and spatial autocorrelation analysis were used to study the spatial distribution.Descriptive epidemiological method was utilized to analyze the demographic characteristic.Results From June 2013 to May 2014,cases had an overall national increase,but significantly decreasing in Shanghai.A trend surface was established for human infection with avian influenza A (H7N9) in the mainland of China,showing that the incidence was increasing obviously from north to south and the line slope declined from west to east.Distribution pattern of the cases varied within different time series and regional levels.The overall Moran' s I coefficient of the provincial level from February to May in 2013 and the coefficient of the city level from June 2013 to May 2014 were 0.144 718 and 0.117 468,respectively,with the differences statistically significant (P＜0.05).According to the analysis of the local autocorrelation and hot spot,northern Zhejiang and southern Guangdong showed high spatial clusters of human infection with avian influenza A(H7N9) (Z＞2.58).Conclusion From February 2013 to May 2014,the spatial correlation at the provincial level decreased.However,the spatial correlation and the numbers of hot spots at the city level were both increasing.Effective measures should be taken accordingly,following the distributive characteristics.

Four Human Cases of Acanthotrema felis (Digenea: Heterophyidae) Infection in Korea

Acanthotrema felis is an intestinal trematode of cats originally reported from the Republic of Korea. Only 1 human case infected with a single adult worm has been previously recorded. In the present study, we report 4 human cases infected with a total of 10 worms recovered after anthelmintic treatment and purging. All 4 patients reside in coastal areas of Jeollanam-do, Korea, and have consumed brackish water fish including the gobies, Acanthogobius flavimanus. The worms averaged 0.47 mm in length and 0.27 mm in width, and had 3 sclerites on the ventrogenital sac; 1 was short and thumb-like, another was long and blunt-ended, and the 3rd was long and broad-tipped. They were identified as A. felis Sohn, Han, & Chai, 2003. Surveys on coastal areas to detect further human cases infected with A. felis are required.