Plague, caused by Yersinia pestis, is a class A infectious disease in China. In order to address the practical requirements of plague prevention and control, this study conducted a systematic analysis based on the national surveillance data from 2010 to 2024.

Data on human and animal plague epidemics were collected from the National Plague Prevention and Control Management Information System and analyzed using descriptive epidemiological methods.

As of 2024, 12 types of natural plague foci have been identified in China. Between 2010 and 2024, 33 human plague cases and 14 deaths were reported nationwide. Geographically, cases were concentrated in Inner Mongolia (15, 45.5%), Xizang (8, 24.2%), and Gansu (6, 18.2%). By focus type, cases originated primarily from Marmota himalayana (16, 48.5%), Meriones unguiculatus (15, 45.5%), and Rattus flavipectus (2, 6.1%). Pneumonic plague was most common (15, 45.5%), followed by bubonic (10, 30.3%), septicemic (7, 21.2%), and intestinal plague (1, 3.0%). Animal plague epidemics persisted nationwide, with active outbreaks in foci of M. himalayana, Marmota baibacina, Spermophilus undulatus, and Meriones unguiculatus. Bacterial isolation positivity rates in animals and insects were 0.05%–0.13% and 0.04%–0.11%, respectively, while Indirect Hemagglutination Assay (IHA) and Reverse Indirect Hemagglutination Assay (RIHA) positivity rates were 0.08%–0.25% and 0.09%–2.18%, respectively. Currently, Polymerase Chain Reaction (PCR) testing has been implemented in some regions, with positivity rates of 0.80% in animals and 1.59% in insects in 2024.

The current plague epidemic situation in China is characterized by “sporadic human cases, active animal epidemics in some foci.” It is recommended to strengthen targeted surveillance, promote PCR-based screening, and enhance cross-provincial coordination.

Coxsackievirus A4 (CVA4) causes several diseases, including hand, foot, and mouth disease (HFMD) and herpangina. This study analyzed CVA4 isolates collected between 1996 and 2024 from the Xizang Autonomous Region to elucidate the phylogenetic characteristics and epidemiological patterns of this virus in high-altitude regions.

VP1 coding region sequences of CVA4 were obtained through virus isolation and Sanger sequencing. MEGA software was used to construct a maximum likelihood phylogenetic tree based on the VP1 region. The BEAST toolkit was used to generate a maximum clade credibility tree and perform phylogeographic analysis.

From 2018 onwards, the prevalence of CVA4 among healthy carriers increased significantly, accounting for 62.12% of all detections. Genotyping revealed that most isolates belonged to genotype C, while the remainder were classified as D2. As the dominant genotype, genotype C has spread outward from Xigaze and Lhasa since 2011, leading to multiple asymptomatic infections in Shannan (2020), Xigaze and Lhasa (2023), and Ngari Prefecture (2024).

Transmission of CVA4 genotype C among healthy children in high-altitude areas suggests strong environmental adaptability, highlighting the need to strengthen enterovirus surveillance and control, including targeted monitoring of CVA4, in these regions.

Given the proportion of undiagnosed human immunodeficiency virus (HIV) cases and regional disparities in Fujian Province, achieving the 2030 targets to end acquired immunodeficiency syndrome (AIDS) remains uncertain.

HIV transmission in Fujian has stabilized through treatment and viral suppression, achieving the “95-95-95” targets; however, a diagnostic gap persists (86.30%). Transmissibility recently increased (R_eff=1.03), with males and adults aged 20–70 years as the primary high-risk populations, threatening elimination goals.

Improving diagnostic coverage is essential for epidemic elimination. Targeted screening and self-testing must be intensified among key populations, particularly middle-aged and older adults, while maintaining treatment achievements to prevent resurgence.

In China, patients with human immunodeficiency virus are diagnosed at the CDC and then referred to hospitals for antiretroviral therapy (ART), but treatment delays persist. Previous studies have reported overall delay in time from diagnosis to ART initiation without identifying where delays occur.

A Nanjing cohort study showed that hospital delays were almost eliminated with integrase strand transfer inhibitor (INSTI)-based regimens: 87.9% of patients initiated ART within 7 days of their first hospital visit. However, the main bottleneck remains CDC referral, as 49.8% of patients attended the hospital within 7 days of HIV confirmation.

Shortening the CDC-to-hospital interval via stronger linkage and equitable INSTI access is critical for achieving rapid ART.

Current HIV-1 subtype classification tools often rely on time-consuming alignment, whereas new non-alignment methods typically target single genes. China lacks a model for specifically predicting the non-B subtype strains prevalent domestically.

We developed a fast alignment-free method (SCCFV-RDA) for building multigene models. It achieved over 99.85% accuracy in classifying an international dataset and 99.7% accuracy in classifying Chinese pol gene data and showed superior recall for key circulating recombinant form subtypes.

This tool provides accurate and efficient computational support for the precise molecular surveillance of HIV-1 in China, thereby facilitating the formulation of targeted prevention and control strategies.