Seroepidemiology of pertussis in the east of China: Estimates of incidence of infection in adolescents and adults pre- and post-COVID-19.

Introduction: The dramatic decrease in the number of reported cases of pertussis during COVID-19 pandemic has been underestimated. The objective was to compare the estimated incidence rate of pertussis in populations pre- and post-COVID-19 pandemic by analyzing the anti-pertussis toxin (anti-PT) IgG and anti-filamentous hemagglutininant (anti-FHA) IgG antibodies in healthy Chinese population from 2018 to 2021. Methods: All serum samples (N = 1,000) were collected from healthy population (aged ≥ 15 years) who attended an annual monitoring project of antibody levels in Jiangsu province in 2018-2021 were measured by ELISA. Results: The positive rates of anti-PT IgG and anti-FHA IgG antibodies were 11.4% (114/1,000) and 20.2% (202/1,000) (≥40 IU/ml), the GMC were 17.25 (95% CI: 15.49-19.03) IU/mL and 24.94 (95% CI: 22.73-27.16) IU/mL in the study population, respectively. The percentage of participants with anti-PT IgG antibodies higher than 40 IU/mL was 5.20% (11/212) in 2018, 5.5% (19/348) in 2019, 21.2% (46/217) in 2020 and 17.0% (38/223) in 2021, respectively. The non-detectable rate (<5 IU/mL) of anti-PT IgG antibodies was 16.9, 17.7, 28.1, and 37.3% in 2018, 2019, 2020, and 2021, respectively. We assumed that the infection occurred within 58.6 days, and based on the overall proportion (2.9%) of individuals with anti-PT IgG antibody ≥100 IU/ml, the incidence rate (/100) was estimated by the formula to be 18.08 (95% CI: 12.40-26.11). In addition, the estimated incidence of Post-COVID-19 was higher than that of Pre-COVID-19 (36.33/100 vs. 12.84/100), and the difference was statistically significant (p < 0.05). Conclusions: Our results suggest a high rate of under-reporting of pertussis in Jiangsu Province both pre- and post-COVID-19 pandemic, and there are a large number of adults of childbearing age who are susceptible to pertussis. It seems imperative that vaccination of adolescents and adults should be considered for inclusion in vaccination programs.

Pooled Sampling is an Efficient and Economical Strategy for SARS-CoV-2 Detection in Low-Prevalence Areas.

BACKGROUND: Corona virus disease 2019 (COVID-19) is a severe acute respiratory disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Different pooling testing strategies have been applied for the detection of SARS-CoV-2. However, the discrepancies among different pooling strategies are still to be explored. METHODS: The aim of this study was to evaluate the two pooling strategies of collecting respiratory specimens for the detection of SARS-CoV-2 RNA. Two groups of five-sample pools were prepared to evaluate the impact of sample pooling and pooled sampling on test sensitivity, respectively. Viral RNA of coronavirus was extracted with the automation system. The N and ORF1ab genes of SARS-CoV-2 RNA were detected with real-time reverse-transcription PCR. The turnaround time of SARS-CoV-2 testing was analyzed before and after the implement of pooled sampling. RESULTS: The pooled sampling displayed advantages in assay sensitivity over the sample pooling. The implementation of pooled sampling significantly shortened the turnaround time of SARS-CoV-2 testing. CONCLUSIONS: The pooled sampling is an efficient and economical strategy for SARS-CoV-2 detection during the periods of high screening demand in low-prevalence areas.

Association Between Passive Smoking and Health Among Chinese Nurses: A Cross-Sectional Study.

This study aimed to investigate the association between passive smoking and physical and psychological health in Chinese nurses. Participants of this cross-sectional study comprised 2,484 non-smoking nurses. Passive smoking and demographic information were assessed using a self-administered questionnaire. Physical, psychological, and overall health status of nurses were measured using the Cornell Medical Index (CMI) health questionnaire. Multivariate-adjusted odds ratio (OR) and 95% confidence interval (CI) for nurses' health were estimated by exposure to passive smoking using unconditional logistic regression models. A total of 1,219 nurses (49.07%) were exposed to passive smoking. Of these, 609 (24.52%), 160 (6.44%), and 587 (23.63%) nurses had poorer physical, mental, and overall health, respectively. After adjusting for other confounding factors, compared with the non-passive smoking group, passive smoking was associated with poor physical (OR = 1.51, 95% CI: 1.25-1.83), mental (OR = 1.48, 95% CI: 1.07-2.07), and overall (OR = 1.58, 95% CI: 1.30-1.93) health of nurses, respectively. We also carried out subgroup analyses stratified by age, department, and professional title, which showed that most findings supported the main results. This study demonstrated that exposure to passive smoking was a risk factor for overall decreased physical and mental health status among Chinese nurses.

Impact of non-pharmaceutical interventions on the incidences of vaccine-preventable diseases during the COVID-19 pandemic in the eastern of China.

BACKGROUND: In response to the coronavirus disease 2019 (COVID-19) pandemic, many countries have implemented mitigating non-pharmaceutical interventions. We investigated the impact of these interventions and changes in public behavior on the incidences of selected vaccine-preventable diseases (VPDs) during the COVID-19 pandemic in the eastern of China. METHODS: From routine monitoring data collected in the capital of eastern China's Jiangsu Province, we extracted and analyzed the incidences of influenza; hand, foot and mouth disease (HFMD); varicella; mumps; pertussis; and hepatitis B. We also investigated the changes in public behavior during the COVID-19 pandemic through telephone interviews and questionnaire surveys. RESULTS: Compared with the baseline (2017-2019), the incidences of all VPDs except influenza declined significantly in 2020 (HFMD decreased by 79.92%, varicella decreased by 7.71%, mumps decreased by 2.03%, pertussis decreased by 78.91%, and hepatitis B decreased by 0.31%). The reduction in reported cases in children (0-14 years) was greater than that in adults, and pertussis had the largest reduction (approximately 80%) in children. Influenza peaks in winter; in the three years before the COVID-19 pandemic, Influenza rates took an average of 10 weeks to recede to their lowest levels after the Spring Festival, while in 2020, this took only 1 week. A total of 366 outbreaks with 20,205 cases were reported during the COVID-19 pandemic. Among the participants in the study, 94.2% of the interviewees avoided going to high-risk areas, 82.4% avoided going to crowded places, 92.9% wore masks when going out,88.4% washed their hands frequently, and 67.9% maintained social distance. CONCLUSIONS: Our study showed significant reductions in the incidences of VPDs after the implementation of a series of non-pharmaceutical interventions during the COVID-19 pandemic.