Trends and Age-Period-Cohort Effect on Acute Hepatitis B Incidence — China, 2005–2021
This study analyzed long-term trends in the incidence of acute hepatitis B (AHB) in China, focusing on age, period, and cohort effects on incidence. Data on AHB from 2005 to 2021 were extracted from the National Notifiable Disease Reporting System (NNDRS) of China for analysis. Incidences of AHB were calculated by gender and age group using population denominators from the 2000, 2010, and 2020 censuses. Joinpoint regression was employed to evaluate trends, and an age-period-cohort (APC) model was used to assess the age, period, and cohort effects. The annual average incidence of reported AHB in children aged 14 years and below in low, intermediate, and high endemic areas decreased from 1.65, 2.33, and 2.56 per 100,000 in 2005–2010 to 0.56, 0.58, and 0.48 per 100,000 in the 2016–2021 period. The 15–39-year age group in high endemic areas exhibited the most significant decline in incidence, dropping from 23.14 per 100,000 in 2005 to 4.59 per 100,000 in 2021 among males, and from 10.62 per 100,000 to 3.21 per 100,000 among females. APC analysis indicated decreasing age, period, and cohort effects for reported AHB incidence in each endemic area, except for a slight upward trend in the 15–19-year age group and in the cohort born between 1951–1955. This study demonstrated a rapid decline in AHB incidence across various endemic areas since 2005. Children aged 14 years and below exhibited very low AHB incidences, while the incidence among individuals over 15 years was higher. To further reduce AHB incidence, hepatitis B vaccine (HepB) coverage should be enhanced among adolescents and adults.
急性乙型病毒性肝炎发病趋势的年龄-时期-队列分析 — 中国，2005–2021年
本研究分析了中国急性乙型病毒性肝炎的长期趋势，探讨了年龄、时期和队列效应对发病趋势的影响。2005–2021年急性乙肝报告发病数来自中国法定传染病报告系统，采用2000、2010和2020年全国人口普查数据计算年龄和性别发病率。通过Joinpoint回归和年龄-时期-队列（APC）模型分析急性乙肝的发病趋势及其年龄、时期和队列效应。结果显示，低、中、高流行地区14岁及以下儿童的急性乙肝年平均报告发病率分别从2005–2010年的1.65/10万、2.33/10万和2.56/10万下降至2016–2021年的0.56/10万、0.58/10万和0.48/10万。高流行地区15–39岁人群的急性乙肝报告发病率下降幅度最大，男性从2005年的23.14/10万降至2021年的4.59/10万，女性从2005年的10.62/10万降至2021年的3.21/10万。APC模型分析显示，年龄、时期和队列效应均呈现下降趋势，但15–19岁组的年龄效应和1951–1955年的队列效应有小幅上升。本研究表明，自2005年以来，不同流行地区的急性乙肝发病率均快速下降。14岁及以下儿童的急性乙肝发病率已降至非常低的水平。然而，15岁及以上人群的急性乙肝发病率仍较高。为了进一步降低这一人群的急性乙肝发病率，需要在青春期儿童和成年人中提高乙肝疫苗的接种率。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.164


The Prevalence of Rickettsial and Rickettsial-Like Diseases in Patients with Undifferentiated Febrile Illness — Hainan Province, China, 2018–2021
Rickettsial and Rickettsial-like diseases, resulting from obligate intracellular Gram-negative bacteria, pose a growing public health threat in China. To assess the current prevalence of these diseases on Hainan Island, a study was conducted on 9 bacterial pathogens found in patients with undifferentiated febrile illness (UFI) treated in Haikou between 2018 and 2021 using a TaqMan Polymerase Chain Reaction (PCR) array. Blood samples (n=503) were collected from patients with UFI between 2018 and 2021. The samples were screened for Rickettsia spp., Orientia tsutsugamushi (O. tsutsugamushi), Anaplasma phagocytophilum (A. phagocytophilum), Ehrlichia chaffeensis, Coxiella burnetii, Chlamydia psittaci, Brucella spp., Burkholderia pseudomallei, and Borrelia burgdorferi using a TaqMan PCR array. Positive samples [with a cycle threshold (Ct)<35] underwent confirmation through nested PCR, sequencing, and phylogenetic analysis. O. tsutsugamushi and A. phagocytophilum were detected in the patients at positive rates of 14.51% (73/503) and 5.57% (28/503), respectively. Coinfection of O. tsutsugamushi and A. phagocytophilum was identified in scrub typhus (ST) positive populations from Hainan (10.96%, 8/73), Guangxi (61.54%, 8/13), and Yunnan (5.36%, 3/56) provincial-level administrative divisions (PLADs) of China. An increased prevalence rate of ST and a decreased prevalence of rickettsioses were observed in patients with UFI in Hainan compared to a decade ago. The coinfectionof O. tsutsugamushi and A. phagocytophilum poses a current public health threat in China.
不明原因发热患者中立克次体与类立克次体疾病的流行 — 中国海南省，2018-2021
立克次体与类立克次体疾病为胞内革兰氏阴性菌。本研究应用Taqman PCR技术对海南 2018–2021 年间收集的不明原因发热患者血液样本中 9 种致病菌的感染情况进行筛查。研究采集了海南 2018–2021 年间不明原因发热患者血液样本共503份。应用Taqman PCR技术筛查的病原体包括立克次氏体、恙虫病东方体、嗜吞噬细胞无形体、查菲埃里克体、贝氏柯克斯体、鹦鹉热衣原体、布鲁氏杆菌、类鼻疽伯克霍尔德菌和伯氏疏螺旋体菌。对筛查阳性（Ct<35）的样本应用巢式 PCR 反应进行进一步验证，并基于巣氏 PCR 产物测序结果进行遗传进化分析。结果发现恙虫病东方体与嗜吞噬细胞无形体的阳性率分别为14.51%（73/503）和5.57%（28/503）。本研究在恙虫病东方体阳性人群中检测到同时感染嗜吞噬细胞无形体的个体，阳性率分别为：海南（10.96%、8/73）、广西（61.54%、8/13）和云南（5.36%、3/56）。海南地区不明原因发热患者中恙虫病东方体的感染率近10年间上升，立克次氏体感染率降低。恙虫病东方体与嗜吞噬细胞无形体的共感染情况对中国的公共卫生带来了日益严重的威胁。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.165


Developing a Research Network of Early Warning Systems for Infectious Diseases Transmission Between China and Australia
This article offers a thorough review of current Early Warning Systems (EWS) and advocates for establishing a unified Research Network for EWS in infectious diseases between China and Australia. We propose that future research should focus on improving infectious disease surveillance by integrating data from both countries to enhance predictive models and intervention strategies. The article highlights the need for standardized data formats and terminologies, improved surveillance capabilities, and the development of robust spatiotemporal predictive models. It concludes by examining the potential benefits and challenges of this collaborative approach and its implications for global infectious disease surveillance. This is particularly relevant to the ongoing project, Early Warning Systems for Infectious Diseases between China and Australia (NetEWAC), which aims to use seasonal influenza as a case study to analyze influenza trends, peak activities, and potential inter-hemispheric transmission patterns. The project seeks to integrate data from both hemispheres to improve outbreak predictions and develop a spatiotemporal predictive modeling system for seasonal influenza transmission based on socio-environmental factors.
建立中国和澳大利亚之间传染病传播预警系统研究网络
本文对当前的预警系统（EWS）进行了全面梳理，并倡导在中国和澳大利亚之间建立一个统一的传染病预警系统研究网络。我们建议未来的研究应侧重于通过整合两国的数据来改善传染病监测，以增强预测模型和干预策略。文章强调了标准化数据格式和术语、改进监测能力以及开发强大的时空预测模型的必要性。结论部分探讨了这种协作方法的潜在利益和挑战及其对全球传染病监测的影响。这对于正在进行的“中国和澳大利亚之间的传染病预警系统”（NetEWAC）项目尤其重要，该项目旨在以季节性流感为案例，分析流感趋势、活动高峰和潜在的跨半球传播模式。该项目力求整合两半球的数据，以改善疫情预测，并基于社会环境因素开发季节性流感传播的时空预测建模系统。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.166


A New Approach Refined Probabilistic Health Risk Assessment of Shaoguan Smelter Based on Microenvironment — Guangdong Province, China, 2021
This study introduces a novel method for developing an advanced exposure conceptual model tailored for health risk assessment, focusing on microenvironments. The research was conducted at a major smelter in China to assess the health risks associated with trace metals (TMs) pollutants in the facility and the surrounding soil. Deterministic risk assessment indicated that Cobalt, cadmium, antimony, manganese, arsenic, plumbum, and mercury (Co, Cd, Sb, Mn, As, Pb, and Hg) necessitated further evaluation through probabilistic risk assessment to assess potential health risks to residents. The 95% quantile concentrations of other TMs were found to be within acceptable health risk limits. For the probabilistic risk assessment, exposure parameters such as body weight, respiration rate, and exposure duration were collected using a questionnaire. This targeted assessment of the residential microenvironment revealed it as the site of the highest carcinogenic (CR) and non-carcinogenic risks (NCR), with values ranging from 2.84×10-5 to 6.7×10-5 and 1.59 to 5.57, respectively. The primary contaminants posing the greatest health risks in residential and industrial areas have been identified as As, Pb, and Mn. The probabilistic health risk model, which focuses on microenvironmental factors, yields more precise results and offers a valuable tool for managing soil health risks.
新方法评估韶关冶炼厂基于微环境的精细化概率健康风险 — 中国广东省，2021年
本研究介绍了一种用于针对微环境的健康风险评估的高级暴露概念模型新方法。研究在中国某大型冶炼厂进行，评估该厂区及周围土壤中微量金属(TMs)污染物的健康风险。确定性风险评估结果表明，钴、镉、锑、锰、砷、铅和汞(Co、Cd、Sb、Mn、As、Pb和Hg)需要通过概率风险评估来进一步评估居民潜在的健康风险，其他痕量金属污染物在95%分位数浓度下计算的健康风险在可接受的范围内。对于概率风险评估，使用调查问卷收集暴露参数，如体重、呼吸速率和暴露时间。本次对居住区微环境的概率性评估结果发现，该微环境是致癌风险(CR)和非致癌风险(NCR)最高的微环境，其值分别为2.84×10-5–6.7×10-5和1.59–5.57。居民区和工业区微环境中对健康风险最大的污染物为As、Pb和Mn。基于微环境因概率健康风险评估模型可以计算出更精确的结果，并为土壤健康风险管理提供了一个有价值的工具。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.167


Integrated Approaches of Prevention and Medicine for Dealing with Central Nervous System Brucellosis: A Case from a Non-Epidemic Area — China, 2023
Researchers report a rare case of central nervous system (CNS) brucellosis in Jinan, China, likely contracted from consuming contaminated meat. The patient experienced headaches, vomiting, seizures, and altered consciousness. Diagnosis was confirmed by isolating Brucella bacteria from cerebrospinal fluid. Prompt communication between the Jinan CDC and Qilu Hospital, facilitated by an innovative integrated healthcare system, allowed for timely diagnosis and treatment. The patient recovered fully after receiving antibiotics for several months. This case highlights the importance of collaboration between public health and clinical institutions in managing infectious diseases effectively, and the potential for such integrated systems to improve patient outcomes, particularly for rare conditions like CNS brucellosis.
医防融合新机制应用于中枢神经系统布鲁菌病的处置：来自非流行地区的病例报告 — 中国，2023年
中国山东省济南市报告了一例罕见的中枢神经系统布鲁菌病，患者可能是因食用受污染的肉类而感染。该病例主要症状为头痛、呕吐、癫痫发作和意识改变，经脑脊液培养查到布鲁菌而明确诊断。确诊后济南市疾控中心和山东大学齐鲁医院迅速沟通协调，通过医防融合新机制及时诊断并治疗患者。应用抗菌药几个月后患者完全康复。这一案例凸显了公共卫生部门和临床机构在管理感染病方面有机协作的重要性，以及医防融合新机制改善患者预后的潜力，特别是对改善中枢神经系统布鲁菌病等罕见疾病患者预后尤为重要。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2024.168