Detecting influenza and emerging avian influenza virus by influenza and pneumonia surveillance systems in a large city in China, 2005 to 2016.

BACKGROUND: Detecting avian influenza virus has become an important public health strategy for controlling the emerging infectious disease. METHODS: The HIS (hospital information system) modified influenza surveillance system (ISS) and a newly built pneumonia surveillance system (PSS) were used to monitor the influenza viruses in Changsha City, China. The ISS was used to monitor outpatients in two sentinel hospitals and to detect mild influenza and avian influenza cases, and PSS was used to monitor inpatients in 49 hospitals and to detect severe and death influenza cases. RESULTS: From 2005 to 2016, there were 3,551,917 outpatients monitored by the ISS system, among whom 126,076 were influenza-like illness (ILI) cases, with the ILI proportion (ILI%) of 3.55%. After the HIS was used, the reported incident cases of ILI and ILI% were increased significantly. From March, 2009 to September, 2016, there were 5,491,560 inpatient cases monitored by the PSS system, among which 362,743 were pneumonia cases, with a proportion of 6.61%. Among pneumonia cases, about 10.55% (38,260/362,743) of cases were severe or death cases. The pneumonia incidence increased each year in the city. Among 15 avian influenza cases reported from January, 2005 to September, 2016, there were 26.7% (4/15) mild cases detected by the HIS-modified ISS system, while 60.0% (9/15) were severe or death cases detected by the PSS system. Two H5N1 severe cases were missed by the ISS system in January, 2009 when the PSS system was not available. CONCLUSIONS: The HIS was able to improve the efficiency of the ISS for monitoring ILI and emerging avian influenza virus. However, the efficiency of the system needs to be verified in a wider area for a longer time span in China.

Evidence-Based interventions of Norovirus outbreaks in China.

BACKGROUND: In resource-limited settings where laboratory capacity is limited and response strategy is non-specific, delayed or inappropriate intervention against outbreaks of Norovirus (NoV) are common. Here we report interventions of two norovirus outbreaks, which highlight the importance of evidence-based modeling and assessment to identify infection sources and formulate effective response strategies. METHODS: Spatiotemporal scanning, mathematical and random walk modeling predicted the modes of transmission in the two incidents, which were supported by laboratory results and intervention outcomes. RESULTS: Simulation results indicated that contaminated water was 14 to 500 fold more infectious than infected individuals. Asymptomatic individuals were not effective transmitters. School closure for up to a week still could not contain the outbreak unless the duration was extended to 10 or more days. The total attack rates (TARs) for waterborne NoV outbreaks reported in China (n = 3, median = 4.37) were significantly (p < 0.05) lower than worldwide (n = 14, median = 41.34). The low TARs are likely due to the high number of the affected population. CONCLUSIONS: We found that school closure alone could not contain Norovirus outbreaks. Overlooked personal hygiene may serve as a hotbed for infectious disease transmission. Our results reveal that evidence-based investigations can facilitate timely interventions of Norovirus transmission.

Integrative Analysis of Fruit Quality and Anthocyanin Accumulation of Plum cv. 'Cuihongli' (Prunus salicina Lindl.) and Its Bud Mutation.

Fruit color is one of the quality indicators to judge the freshness of a plum. The coloring process of plum skin is valuable for research due to the high nutritional quality of anthocyanins found in plums. 'Cuihongli' (CHL) and its precocious mutant variety 'Cuihongli Red' (CHR) were used to analyze the changes of fruit quality and anthocyanin biosynthesis during plum development. The results showed that, during the development of the two plums, the total soluble solid and soluble sugar contents were highest at the mature stage, as the titratable acid trended gradually downward as the fruits of the two cultivars matured, and the CHR fruit showed higher sugar content and lower acid content. In addition, the skin of CHR turned red in color earlier than CHL. Compared with CHL, the skin of CHR had higher anthocyanin concentrations, higher activities of phenylalanine ammonia-lyase (PAL), chalcone isomerase (CHI), dihydroflavonol-4-reductase (DFR), and UDPglucose: flavonoid-3-O-glucosyltransferase (UFGT), and higher transcript levels of genes associated with anthocyanin production. In the flesh of the two cultivars, no anthocyanin content was detected. Taken together, these results suggest that the mutation exerted a major effect on anthocyanin accumulation via modification of the level of transcription; thus, CHR advances the ripening period of 'Cuihongli' plum and improves the fruit quality.

[Application of capture-mark-recapture method on evaluating the abilities of birth defects surveillance systems].

OBJECTIVE: To evaluate the abilities of population-based birth defects surveillance system (PBBDSS) and hospital-based birth defects surveillance system(HBBDSS). METHODS: We used capture-mark-recapture method(CMR) to analyze the data of the two kinds of birth defects surveillance systems from 1 Oct. 2006 to 31 Dec. 2006 in a county of Hunan province. Data from PBBDSS were defined as the first source and data from HBBDSS were defined as the second source. RESULTS: 49 and 28 birth defect cases were found from PBBDSS and from HBBDSS respectively. Among these cases, 20 were marked. With the method of CMR, the estimated birth defects cases were 68 (95% CI: 56-70). The coincident rates of PBBDSS and HBBDSS were 72.1% and 41.2%, while the total coincident rates was 83.8% and the coincident rates from different sources was 57.1%. The unreported rates of PBBDSS and HBBDSS were 27.9% and 58.8%. CONCLUSION: Not only the HBBDSS but also the PBBDSS appeared to have had high unreported rates, suggesting that we could use CMR to adjust the rate of birth defects from the birth defects surveillance data.