Ruxolitinib plus standard of care in severe hospitalized adults with severe fever with thrombocytopenia syndrome (SFTS): an exploratory, single-arm trial.

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) is an emerging tick-borne infectious disease, and its morbidity and mortality are increasing. At present, there is no specific therapy available. An exacerbated IFN-I response and cytokine storm are related to the mortality of patients with SFTS. Ruxolitinib is a Janus kinase (JAK) 1/2 inhibitor that can block proinflammatory cytokines and inhibit the type I IFN pathway. We aimed to explore the use of ruxolitinib plus standard of care for severe SFTS. METHODS: We conducted a prospective, single-arm study of severe SFTS. We recruited participants aged 18 years or older who were admitted to the hospital with laboratory-confirmed severe SFTS and whose clinical score exceeded 8 points within 6 days of symptom onset. Participants received oral ruxolitinib (10 mg twice a day) for up to 10 days. The primary endpoint was 28-day overall survival. The secondary endpoints included the proportion of participants who needed intensive care unit (ICU) admission, total cost, changes in neurologic symptoms and clinical laboratory parameters, and adverse events (AEs) within 28 days. A historical control group (HC group, n = 26) who met the upper criteria for inclusion and hospitalized from April 1, 2021, to September 16, 2022, was selected and 1:1 matched for baseline characteristics by propensity score matching. RESULTS: Between Sep 16, 2022, and Sep 16, 2023, 26 participants were recruited into the ruxolitinib treatment group (RUX group). The 28-day overall mortality was 7.7% in the RUX group and 46.2% in the HC group (P = 0.0017). There was a significantly lower proportion of ICU admissions (15.4% vs 65.4%, p < 0.001) and total hospitalization cost in the RUX group. Substantial improvements in neurologic symptoms, platelet counts, hyperferritinemia, and an absolute decrease in the serum SFTS viral load were observed in all surviving participants. Treatment-related adverse events were developed in 6 patients (23.2%) and worsened in 8 patients (30.8%), and no treatment-related serious adverse events were reported. CONCLUSIONS: Our findings indicate that ruxolitinib has the potential to increase the likelihood of survival as well as reduce the proportion of ICU hospitalization and being tolerated in severe SFTS. Further trials are needed. TRAIL REGISTRATION: ChiCTR2200063759, September 16, 2022.

Engineering Fluorine-rich Double Protective Layer on Zn Anode for Highly Reversible Aqueous Zinc-ion Batteries.

The high thermodynamic instability and side reactions of Zn-metal anode (ZMA), especially at high current densities, greatly impede the commercialization of aqueous zinc-ion batteries (AZIBs). Herein, a fluorine-rich double protective layer strategy is proposed to obtain the high reversibility of AZIBs through the introduction of a versatile tetradecafluorononane-1,9-diol (TDFND) additive in aqueous electrolyte. TDFND molecule with large adsorption energy (-1.51 eV) preferentially absorbs on the Zn anode surface to form a Zn(OR)2 - (R=-CH2 -(CF2 )7 -CH2 -) cross-linking complex network, which balances space electric field and controls the Zn2+ ion flux, thus enabling the uniform and compact deposition of Zn (002) crystal planes. Meanwhile, TDFND with low Lowest unoccupied molecular orbital (LUMO, 0.10 eV) energy level is priorly decomposed to regulate the interfacial chemistry of ZMA by building a ZnF2 -rich solid electrode/electrolyte interface (SEI) layer. It is found that a 14 nm-thick SEI layer delivers excellent structural integrity to suppress parasitic reactions by blocking the direct contact of active water and ZMA. Consequently, the Zn electrode exhibits a superior cycling life over 430 h at 10 mA cm-2 and a high average Coulombic efficiency of 99.8 % at 5 mA cm-2 . Furthermore, a 68 mAh pouch cell delivers 80.3 % capacity retention for 1000 cycles.

Delayed Diagnosis of Acute Q Fever, China.

We report a patient in China with fever of unknown origin who visited 3 hospitals in 3 weeks and was finally given a diagnosis of acute Q fever, determined by metagenomics next-generation sequencing. Our results indicate that physicians are unfamiliar with Q fever and the disease is neglected in China.

Entanglement Added to Cross-Linked Chains Enables Tough Gelatin-Based Hydrogel for Zn Metal Batteries.

Currently, it is still challenging to develop a hydrogel electrolyte matrix that can successfully achieve a harmonious combination of mechanical strength, ionic conductivity, and interfacial adaptability. Herein, a multi-networked hydrogel electrolyte with a high entanglement effect based on gelatin/oxidized dextran/methacrylic anhydride, denoted as ODGelMA is constructed. Attribute to the Schiff base network formulation of ─RC═N─, oxidized dextran integrated gelatin chains induce a dense hydrophilic conformation group. Furthermore, addition of methacrylic anhydride through a grafting process, the entangled hydrogel achieves impressive mechanical features (6.8 MPa tensile strength) and high ionic conductivity (3.68 mS cm-1 at 20 °C). The ODGelMA electrolyte regulates the zinc electrode by circumventing dendrite growth, and showcases an adaptable framework reservoir to accelerate the Zn2+ desolvation process. Benefiting from the entanglement effect, the Zn anode achieves an outstanding average Coulombic efficiency (CE) of 99.8% over 500 cycles and cycling stability of 900 h at 5 mA cm-2 and 2.5 mAh cm-2. The Zn||I2 full cell yields an ultra-long cycling stability of 10 000 cycles with a capacity retention of 92.4% at 5 C. Furthermore, a 60 mAh single-layer pouch cell maintains a stable work of 350 cycles.

Epidemiological characteristics and spatio-temporal aggregation of severe fever with thrombocytopenia syndrome in Jinan City, China, 2018-2022.

BACKGROUND: Severe fever with thrombocytopenia syndrome (SFTS) has become a significant public health issue in Jinan City. However, the analysis of epidemiological characteristics and spatio-temporal clustering of SFTS in Jinan has not been studied yet. METHODS: SFTS data from 2018-2022 in Jinan City were obtained from the China Information System for Disease Control and Prevention. Global spatial autocorrelation and local spatial autocorrelation analyses were performed using ArcGIS 10.2 software, and spatiotemporal hotspot area detection was carried out using SatScan 9.6 software. RESULTS: Between 2018 and 2022, 680 SFTS cases were reported in Jinan City, resulting in 53 deaths and an average case fatality rate of 7.8%. 99.0% of cases occurred between April and October, 91.9% individuals were over 50 years old, and 87.79% were primarily farmers. A positive spatial correlation of SFTS in Jinan was observed (Moran's I value between 0.135-0.197, P<0.001), indicating spatial aggregation, primarily in Licheng, Zhangqiu, Laiwu, and Gangcheng districts in southeastern Jinan. Spatiotemporal scanning detected one class I and two class II aggregation areas, with the class I aggregation area (RR = 5.66, LLR = 192.547, P<0.001) locating in southeastern Jinan City, comprising 31 towns/streets, and an aggregation time from 13 May 2020 to 13 October 2022. CONCLUSION: Spatial and temporal aggregation of SFTS is evident in Jinan. Based on the spatial and temporal distribution and epidemiological characteristics, prevention and control measures such as public education, monitoring, and training should target key populations in high-incidence epidemic areas.

Nonepitaxial Electrodeposition of (002)-Textured Zn Anode on Textureless Substrates for Dendrite-Free and Hydrogen Evolution-Suppressed Zn Batteries.

Nontoxic and safe aqueous Zn batteries are largely restricted by the detrimental dendrite growth and hydrogen evolution of Zn metal anode. The (002)-textured Zn electrodeposition, demonstrated as an effective approach for solving these issues, is nevertheless achieved mainly by epitaxial or hetero-epitaxial deposition of Zn on pre-textured substrates. Herein, the electrodeposition of (002)-textured and compact Zn on textureless substrates (commercial Zn, Cu, and Ti foils) at a medium-high galvanostatic current density is reported. According to the systematic investigations on Zn nucleation and growth behaviors, this is ascribed to two reasons: i) the promoted nonepitaxial nucleation of fine horizontal (002) nuclei at increased overpotential and ii) the competitive growth advantages of (002)-orientated nuclei. The resulting freestanding (002)-textured Zn film exhibits significantly suppressed hydrogen evolution and prolonged Zn plating-stripping cycling life, achieving over 2100 mAh cm-2 cumulative capacity under a current density of 10 mA cm-2 and a high depth of discharge (DOD) of 45.5%. Therefore, this study provides both fundamental and practical insights into long-life Zn metal batteries.

The presence of foci of Rickettsia conorii infection in China.

China is not considered as an endemic area of Rickettsia conorii, so there is no routine clinical way to diagnose this infection. This study aims to determine whether 2 febrile patients who had a tick bite in East China were indeed infected with R. conorii. The citrate synthase gene (gltA) was amplified with universal rickettsial primers by real-time fluorescent PCR from the patients' blood samples. Nested PCR was used to amplify the outer membrane protein A gene (ompA) for positive specimens. PCR products were further identified and analyzed through nucleic acid sequencing. Positive amplification of the gltA and ompA genes was found in both patients. The nucleotide sequences (303 bp) of the ompA gene of the 2 patients had high homology (99%) with the R. conorii Indian tick typhus strain in GenBank. A more than 4-fold increase in IgG against R. conorii provided supportive evidence of SFG Rickettsia infection. And the rapid recovery after doxycycline treatment also supported a rickettsial cause for the disease. Physicians in East China should be aware of human infections with R. conorii. PCR-based diagnostic methods offer a rapid and precise way to diagnose rickettsiosis, improving patient identification and management.

Hollow Ni3Se4 with High Tap Density as a Carbon-Free Sulfur Immobilizer to Realize High Volumetric and Gravimetric Capacity for Lithium-Sulfur Batteries.

Despite that the practical gravimetric energy density of lithium sulfur batteries has exceeded that of the traditional lithium-ion battery, the volumetric energy density still pales due to the low density of carbonaceous materials. Herein, hollow polar nickel selenide (Ni3Se4) with various architectures was designed and employed as a carbon-free sulfur immobilizer. Among them, hollow sea urchins like Ni3Se4 with high porosity (0.39 cm3 g-1) and large specific surface area (82.7 m2 g-1) exhibit abundant adsorptive and electrocatalytic sites, which pledge excellent electrochemical performances of the Li-S battery. Correspondingly, the Ni3Se4-based sulfur electrode presents excellent rate endurability (581 mAh g-1-composite at 2.0 C) and superior cycle stability (ultralow fading rate of 0.042% per cycle during the 1000 cycles at 1.0 C). More importantly, thanks to the higher tap density (Ni3Se4/S: 1.57 g cm-3 vs super P/S: 0.7 g cm-3), the volumetric specific capacity of Ni3Se4-based cathodes is as high as 1699 mAh cm-3-composite at 0.1 C, which is almost 2.8 times that of the carbonaceous electrode. Hence, rational transition metal selenide architecture design with synergistic function of good conductivity, well-defined catalyst and adsorption, as well as high tap density provide a promising route toward high gravimetric and volumetric energy density of Li-S batteries.

Suppressing the Exacerbated Hydrogen Evolution of Porous Zn Anode with an Artificial Solid-Electrolyte Interphase Layer.

Rechargeable Zn batteries are widely studied as aqueous, safe, and environmentally friendly alternatives to Li-ion batteries. The 3D porous Zn anode has been extensively reported for suppressing Zn dendrite growth and accelerating the electrode kinetics. However, we demonstrate herein that the undesirable hydrogen evolution reaction (HER) is also exacerbated for porous Zn electrode. Therefore, a polytetrafluoroethylene (PTFE) coating is further applied on the porous Zn serving as the artificial solid-electrolyte interphase (SEI), which is demonstrated to effectively inhibit the hydrogen evolution and maintain the Zn plating kinetics. By utilizing the synergistic effects of the porous morphology and artificial SEI layer, better performances are obtained over porous Zn or bare Zn foil, including dendrite-free Zn plating/stripping up to 2000 h at 2 mA cm-2 and extended cycling in the Zn||V2O5 cell. This work suggests two complementary strategies for achieving simultaneously dendrite-free and side-reaction-suppressed Zn batteries.

Self-Healing Solid Polymer Electrolyte for Room-Temperature Solid-State Lithium Metal Batteries.

Poor room-temperature ionic conductivities and narrow electrochemical stable windows severely hinder the application of conventional poly(ethylene oxide)-based (PEO-based) solid polymer electrolytes (SPEs) for high-energy-density lithium metal batteries (LMBs). Herein, we designed and synthesized a PEO-based self-healing solid polymer electrolyte (SHSPE) via dynamically cross-linked imine bonds for safe, flexible solid LMBs. The constructed dynamic networks endow this SPE with fascinating intrinsic self-healing ability and excellent mechanical properties (extensibility > 500% and stress >130 kPa). More importantly, this SHSPE exhibits ultrahigh ionic conductivity (7.48 × 10-4 S cm-1 at 25 °C) and wide ESW (5.0 V vs Li/Li+). As a result, Li||Li symmetrical cells with the SHSPE showed reliable stability in a >1200 h cycling test under room temperature. The assembled Li|SHSPE|LiFePO4 cell maintained a discharge capacity of 126.4 mAh g-1 after 300 cycles (0.1C, 27 °C). This work highlights a promising strategy for next-generation room-temperature solid-state LMBs.

Ultra-stretchable and healable hydrogel-based triboelectric nanogenerators for energy harvesting and self-powered sensing.

The next-generation multifunctional soft electronic devices require the development of energy devices possessing comparable functions. In this work, an ultra-stretchable and healable hydrogel-based triboelectric nanogenerator (TENG) is prepared for mechanical energy harvesting and self-powered sensing. An ionic conductive hydrogel was developed with graphene oxide and Laponite. as the physical cross-linking points, exhibiting high stretchability (∼1356%) and healable capability. When using the hydrogel as the electrode, the TENG can operate normally at 900% tensile strain, while the electrical output of the TENG can fully recover to the initial value after healing the damage. This hydrogel-based TENG is demonstrated to power wearable electronics, and is used as a self-powered sensor for human motion monitoring and pressure sensing. Our work shows opportunities for multifunctional power sources and potential applications in wearable electronics.

Wearable Antifreezing Fiber-Shaped Zn/PANI Batteries with Suppressed Zn Dendrites and Operation in Sweat Electrolytes.

Fiber-shaped Zn batteries are promising candidates for wearable electronics owing to their high energy and low cost, but further studies are still required to address the issues related to detrimental Zn dendrite growth and limited low-temperature performances. Here, we report an antifreeze, long-life, and dendrite-free fiber-shaped Zn battery using both nanoporous Zn and polyaniline (PANI) electrodeposited on carbon nanofibers (CFs) as the cathode and anode, respectively. The fiber-shaped Zn anode achieves stable plating/stripping for 1000 mAh cm-2 accumulative capacity with low polarization (30 mV) at a current density of 2 mA cm-2. The dendrite-free Zn electrodes also enable the stable cycling of the fiber battery with 75.1% capacity retention after 1000 cycles. With an antifreeze agent added in the gel electrolyte, the fiber battery maintains excellent performance at temperatures as low as -30 °C. Lastly, by utilizing the doping/dedoping mechanism of Cl- in the PANI electrode, we achieve, for the first time, a Zn battery using human sweat as a harmless electrolyte. Our work provides a long-life and antifreeze fiber-shaped battery that is highly promising for future wearable energy storage devices.

Textile Triboelectric Nanogenerators Simultaneously Harvesting Multiple "High-Entropy" Kinetic Energies.

Distributed renewable kinetic energies are ubiquitous but with irregular amplitudes and frequencies, which, as one category of "high-entropy" energies, are crucial for next-generation self-powered electronics. Herein, we present a flexible waterproof dual-mode textile triboelectric nanogenerator (TENG), which can simultaneously scavenge multiple "high-entropy" kinetic energies, including human motions, raindrops, and winds. A freestanding-mode textile TENG (F-TENG) and a contact-separation-mode textile TENG (CS-TENG) are integrated together. The structure parameters of the textile TENG are optimized to improve the output performances. The raindrop can generate a voltage of up to ∼4.3 V and a current of about ∼6 µA, while human motion can generate a voltage of over 120 V and a peak power density of ∼500 mW m-2. The scavenged electrical energies can be stored in capacitors for powering small electronics. Therefore, we demonstrated a facile preparation of a TENG-based energy textile that is highly promising for kinetic energy harvesting and self-powered electronics.

Revisiting the positive roles of liquid polysulfides in alkali metal-sulfur electrochemistry: from electrolyte additives to active catholyte.

Polysulfide dissolution and shuttling in liquid organic electrolytes are considered as the most challenging detrimental effects of an Li-S cell, which is one of the most promising next-generation high-energy-density batteries. Therefore, considerable efforts have been devoted to confining solid sulfur or sulfide so as to avoid the formation and diffusion of dissolved polysulfides. However, the positive roles played by the liquid polysulfides in Li-S electrochemistry should not be overlooked. Polysulfide dissolution can promote the cell kinetics and sulfur utilization; as electrolyte additives, polysulfides can help stabilize the Li metal anode, redistribute the active mass in the cathode and act as extra back-up active sulfur sources. After being applied directly as active catholytes, a novel Li-polysulfide redox flow battery (Li-PS RFB) and an Li-polysulfide battery (Li-PS battery) have been developed. This review revisited these beneficial effects of polysulfides and provided a summary of the recent progress on Li-PS RFB and Li-PS batteries, especially with a more comprehensive emphasis on the latter. Furthermore, dissolved polysulfides applied as active catholytes in Na-S and K-S systems and as catholytes or anolytes in aqueous batteries were also briefly discussed. Hopefully, the Li-S electrochemistry can be better understood so as to overcome challenging issues in the way of the practical commercialization of the Li-S batteries.

Rubella outbreak and outbreak management in a school setting, China, 2014.

BACKGROUND: An active response to a rubella outbreak may interrupt disease transmission, and outbreak response immunization (ORI) can increase immunity among persons who might otherwise not be protected. On March 17, 2014, a rubella outbreak was reported in a middle school in Guangzhou city, China. We conducted an investigation to assess impact of a policy of exclusion of cases from school and of ORI. METHODS: Active surveillance was used to find cases of rubella. Investigators interviewed teachers and reviewed the absentee records to determine implementation details of school exclusion. ORI was recommended on 2 occasions during the outbreak, one small-scale and one large-scale. Laboratory confirmation tests included serum IgM and IgG measurements to distinguish between acute infection and immunity. A serological survey in 4 classes was used to determine immunity status and identify symptomatic and asymptomatic cases. RESULTS: From February 17 to May 23, 2014, 162 rubella cases (24 laboratory-confirmed and 138 epidemiologically linked) were detected among 1,621 students. Cases ultimately occurred in 27 classes (72.97%) across 37 classes. In 11 classes in which exclusion from school was delayed by 1 or more days, the secondary attack rate was 12.30%, compared with 2.35% in 15 classes with immediate exclusion. ORI increased vaccine coverage from 25.83 % to 86.92%, and the final case of the epidemic was reported one month later. A serological survey of 91 students in 4 classes identified 15 cases, 6 of which were asymptomatic. CONCLUSIONS: The outbreak happened in school with low rubella-containing vaccination coverage. Exclusion from school upon rash/fever onset was associated with lowering the secondary attack rate, but school exclusion alone was not able to stop this outbreak - a large ORI was needed. Assuring complete vaccination upon entry to school is likely to be necessary to ensure coverage is above the herd immunity threshold and prevent outbreaks from happening.

Coverage estimates and patterns of inactivated poliovirus vaccine (IPV) use prior to and during the polio eradication endgame, Jinan City, China, 2010-2015.

BACKGROUND: Use of inactivated poliovirus vaccine (IPV) in Jinan during the polio eradication endgame has not been previously documented. Two IPV-containing vaccines were made available as an option for Jinan parents in 2009. We describe coverage levels and patterns of use of IPV over time using data from the Jinan Childhood Immunization Information Management System (JNCIIMS). METHODS: Children born between January 2010 and December 2014 who were registered in JNCIIMS were included in this study. Vaccination records were obtained from JNCIIMS on April 30, 2015. JNCIIMS distinguishes among available poliovirus vaccines; doses administered data were used to describe IPV usage over time. We identified the polio vaccination sequences used by children in the 2012 and 2013 birth cohorts. Coverage estimates were analyzed by birth cohort and migration status. We developed 3 categories for analysis: "resident child," "migrant child" and "other child" according to migration status. RESULTS: In total, 12,354 (11.7%) IPV, 5,893(5.6%) DTP-IPV-Hib vaccine and 87,054(82.7%) OPV doses were administered to children in the 2010 to 2014 birth cohorts. The proportion of children using an IPV-only schedule increased each year, consistent with the introduction of IPV that is called for by the Polio Eradication Endgame Strategic Plan 2013-2018. During this time, 4.7% children used a schedule containing both IPV and oral poliovirus vaccine (OPV). In the 2012 to 2013 birth cohorts, 14.4% children used an IPV-only schedule; 5.7% children used a sequential schedule, and 79.9% used OPV-only schedule. Use of IPV only schedules was higher among migrant children than among resident children. Among those sequential schedule using both IPV and OPV, 87.2% children used IPV for the first dose and 12.8% used OPV for the first dose. CONCLUSIONS: JNCIIMS provided a mechanism for tracking IPV and OPV vaccination patterns, and showed areas in need of improvement. Ensuring appropriately sequenced IPV and OPV supports reduction of risk of vaccine associated paralytic polio.

Risk Factors for Influenza A(H7N9) Disease in China, a Matched Case Control Study, October 2014 to April 2015.

Background. Human infections with avian influenza A(H7N9) virus have been associated with exposure to poultry and live poultry markets (LPMs). We conducted a case-control study to identify additional and more specific risk factors. Methods. Cases were laboratory-confirmed A(H7N9) infections in persons in China reported from October 1, 2014 to April 30, 2015. Poultry workers, those with insufficient data, and those refusing participation were excluded. We matched up to 4 controls per case by sex, age, and residential community. Using conditional logistic regression, we examined associations between A(H7N9) infection and potential risk factors. Results. Eighty-five cases and 334 controls were enrolled with similar demographic characteristics. Increased risk of A(H7N9) infection was associated with the following: visiting LPMs (adjusted odds ratio [aOR], 6.3; 95% confidence interval [CI], 2.6-15.3), direct contact with live poultry in LPMs (aOR, 4.1; 95% CI, 1.1-15.6), stopping at a live poultry stall when visiting LPMs (aOR, 2.7; 95% CI, 1.1-6.9), raising backyard poultry at home (aOR, 7.7; 95% CI, 2.0-30.5), direct contact with backyard poultry (aOR, 4.9; 95% CI, 1.1-22.1), and having ≥1 chronic disease (aOR, 3.1; 95% CI, 1.5-6.5). Conclusions. Our study identified raising backyard poultry at home as a risk factor for illness with A(H7N9), suggesting the need for enhanced avian influenza surveillance in rural areas.

Effectiveness of Rubella vaccine in a rubella outbreak in Guangzhou city, China, 2014.

BACKGROUND: WHO recommends the use of rubella-containing vaccine (RCVs) to prevent rubella and congenital rubella syndrome (CRS). Most licensed rubella vaccines in use globally are based on RA27/3 strains and have estimated vaccine effectiveness (VE) rates of 95-100%. In contrast, China uses a BRD-II strain-based rubella vaccine. Few field studies have been conducted that estimate VE of China's RCV. On March 17, 2014, a rubella outbreak was reported in a middle school in Guangzhou city, China. We conducted an investigation to understand reasons for the outbreak, and we used that investigation to estimate vaccine effectiveness of China's rubella vaccine. METHODS: To identify cases, investigators reviewed records kept by the school doctor and absentee records kept by teachers. Self-administered questionnaires were sent to parents of all students to collect information about the students' symptoms, the results of any physician consultation, and disease history. We obtained demographic information and illness information for all students in the school; vaccination status was determined by inspection of official, parent-held vaccination records. A retrospective cohort study was conducted in 13 classes that had secondary cases of rubella. Using the secondary attack rates, we evaluated VE by the number of RCV doses received and age at vaccination. RESULTS: During the period February 17-May 23, 2014, 162 students (50 suspected cases, 88 probable cases, 24 confirmed cases) were diagnosed with rubella, yielding an overall attack rate of 10% (162/1621). Cases occurred in 27 classes (73%) of 37 classrooms. Secondary cases occurred in 13 classes (35%) of 37 classrooms. A total of 1130 students (69.7%) have vaccination certificates; 419 (37%) students were record-confirmed to have received RCV. For those vaccinated using BRD-II strain vaccine, vaccine effectiveness (VE) was 94% (95%CI: 75-98). VE for measles, mumps, and rubella (MMR) vaccine which is based on either BRD-II or RA27/3 strain was 89% (95%CI: 56-97). VE of a single dose of domestic monovalent rubella vaccine that used BRD-II strain vaccine was 93% (95%CI: 73-98). VE for those who received the vaccine between 1 and 2 years of age was 95% (95% CI: 67-99) while the VE was 100% for those vaccinated after 2 years of age. VE among those who received RCV <12 years ago was 100% while VE among those who received RCV ≥12 years ago was 92% (95%CI: 70-98). CONCLUSIONS: The rubella vaccines used in China that are based on the BRD-II rubella vaccine strain have VE of 94%, which is similar to the more commonly used RA27/3-based RCVs. Low vaccination coverage contributed to this outbreak; early reporting of an outbreak is necessary for effective outbreak response immunization.