Comparative Analysis of Epidemiologicaland Clinical Characteristics Between Mpox Cases with and Without HIV — China, 2023

Yichen Jin^1,2; Qianqian Qin^1,2; Chao Li^3,4;Houlin Tang^1,2; Dapeng Zhang¹; Wenqing Bai^3,4;Fangfang Chen^1,2; Peilong Li^1,2; Pairidai Duolaitiniyazi^4,5;Ruiqi Ren^3,4; Dan Li^3,4; Nijuan Xiang^3,4; GuoqingShi^3,4; Fan Lyu^1,2,#; Qun Li^3,4,#

1. National Center for AIDS/STD Control andPrevention, Chinese Center for Disease Control and Prevention, Beijing, China;

2. National Key Laboratory of IntelligentTracking and Forecasting for Infectious Diseases, National Center for AIDS/STDControl and Prevention, Chinese Center for Disease Control and Prevention,Beijing, China;

3. National Key Laboratory of IntelligentTracking and Forecasting for Infectious Diseases, Chinese Center for DiseaseControl and Prevention, Beijing, China;

4. Chinese Center for Disease Control andPrevention, Beijing, China;

5. Qira Center for Disease Control andPrevention, Hotan area, Xinjiang Uygur Autonomous Region, China.

# Corresponding authors: FanLyu, fanlv@chinaaids.cn; Qun Li, liqun@chinacdc.cn.

Thisstudy aimed to analyze the epidemiological characteristics and clinicalsymptoms of mpox cases with and without human immunodeficiency virus (HIV)reported in China in 2023, providing evidence for coordinated prevention andcontrol strategies for both infections. All confirmed mpox cases reported in2023 were extracted from China's Information System for Disease Control andPrevention. Data were collected from the surveillance system andepidemiological investigations. Statistical analyses were performed using SPSS 24.0, with group comparisons conducted using ttests and chi-square tests. Among 1,712 confirmed mpox cases in China during2023, 802 (46.8%) were people with human immunodeficiency virus (PWH). Of the1,702 male cases, 97.3% of PWH and 91.1% of those without HIV self-identifiedas men who have sex with men (MSM). Age distribution showed 79.4% of PWH and87.6% of those without HIV were under 40 years old, while 64.2% of PWH and71.3% of those without HIV were reported from eastern regions. Cardinalsymptoms at diagnosis occurred at similar rates between those with and withoutHIV, including rash (90.9% vs 93.4%), fever (52.5% vs 53.8%), andlymphadenopathy (23.8% vs 25.4%). Among coinfected cases, individuals diagnosedwith HIV after mpox or within one year before mpox demonstrated higher rates ofimmunodeficiency and lower rates of HIV viral suppression. Male mpox cases withHIV were more likely to be MSM, older, and reported from central and westernregions compared to those without HIV. No significant differences were observedin cardinal symptom occurrence between groups. These findings emphasize theimportance of implementing integrated prevention strategies targeting both HIVand mpox, particularly among key populations.

合并与未合并艾滋病病毒感染的猴痘病例流行病学和临床特征对比分析— 中国， 2023年

金怡晨^1,2；秦倩倩^1,2；李超^3,4；汤后林^1,2；张大鹏¹；白文清^3,4；陈方方^1,2；李培龙^1,2；排日代·多来提尼亚孜^4,5；任睿琦^3,4；黎丹^3,4；向妮娟^3,4；施国庆^3,4；吕繁^1,2,#；李群^3,4,#

1. 中国疾病预防控制中心性病艾滋病预防控制中心，北京，中国；

2. 传染病溯源预警与智能决策全国重点实验室,中国疾病预防控制中心性病艾滋病预防控制中心，北京，中国；

3. 传染病溯源预警与智能决策全国重点实验室,中国疾病预防控制中心，北京，中国；

4. 中国疾病预防控制中心，北京，中国；

5. 新疆维吾尔自治区和田地区策勒县疾病预防控制中心，和田地区，新疆维吾尔自治区，中国。

^# 通信作者:吕繁，fanlv@chinaaids.cn；李群，liqun@chinacdc.cn。

本研究旨在分析2023年中国报告的合并与未合并艾滋病病毒（HIV）感染的猴痘病例的流行病学特征及临床症状，为两种传染病的协同防控策略提供依据。以中国疾病预防控制信息系统中2023 年报告的全部猴痘确诊病例作为研究对象，提取监测系统及流行病学调查中相关数据。使用 SPSS 24.0 软件进行统计学分析，组间比较采用t检验和卡方检验。2023年中国1712例猴痘确诊病例中，802例（46.8%）为 HIV感染者。1702 例男性病例中，HIV感染者和非感染者中分别有 97.3%和91.1%自我认定为男性同性性行为者（MSM）。HIV感染者和非感染者中分别有79.4%和 87.6% 年龄在 40 岁以下，东部地区报告病例数分别占 HIV 感染者的 64.2% 和非感染者的 71.3%。 HIV 感染者和非感染者确诊时出现的主要症状比例相近，包括皮疹（90.9% vs 93.4%）、发热（52.5% vs 53.8%）及淋巴结肿大（23.8% vs 25.4%）。在合并感染病例中，猴痘确诊后或确诊前 1 年内诊断 HIV 感染的个体免疫缺陷发生率更高，HIV 病毒抑制率更低。与未感染HIV的男性猴痘病例相比，感染HIV的男性猴痘病例更可能为MSM,年龄更大,中西部地区占比较高。两组主要症状发生率无显著差异。本研究结果提示采取针对HIV和猴痘综合预防策略的重要性，尤其是在重点人群中。

For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.037

Epidemiological Characteristics of HumanRespiratory Syncytial Virus in Children with Acute Respiratory Infection — Shijiazhuang City, Hebei Province,China, 2021–2023

Yan Li¹;Guangyue Han¹; Caixiao Jiang¹; Wenhao Zhou²; MinghaoGeng¹; Nana Guo¹; Wentao Wu¹; Yamei Wei¹;Lanfen Liu¹; Xu Han¹; Guofan Li¹; Shangze Liu¹;Zhihuai Xing¹; Qi Li^1,#

1.Hebei Provincial Center for DiseaseControl and Prevention, Shijiazhuang City, Hebei Province, China;

2.Peking University People's Hospital,Beijing, China.

#Corresponding author:Qi Li, kepeichu@hebmail.gov.cn.

Human respiratory syncytial virus (HRSV) isthe predominant respiratory pathogen causing acute respiratory tract infection(ARTI). Globally, HRSV infection represents the leading cause of acuterespiratory morbidity and hospitalization in children under 2 years of age.HRSV infection continues to pose a significant public health challengeworldwide. Through epidemiological surveillance of HRSV in children with ARTI,we can elucidate its incidence patterns and epidemic characteristics to informevidence-based prevention and control strategies. We collected upper and lowerrespiratory tract specimens and clinical data from children under 14 years ofage with ARTI. HRSV was detected using Real-time PCR to analyze its incidenceand epidemic characteristics. Among 1,440 specimens, the overall HRSV detectionrate was 7.8% (HRSVA and HRSVB detection rates were 4.0% and 3.8%,respectively). Detection rates peaked in spring (12.2%), followed by winter(10.3%), with the lowest rates in autumn (2.8%) (P<0.05). HRSV-B was the dominant subtype throughout 2021, whileHRSV-A predominated during 2022 and the first half of 2023. Detection rateswere significantly higher in children under 5 years compared to older children,with lower respiratory tract infections in the 0–2 years age group showingnotably higher detection rates (18.1%) than upper respiratory tract infections(8.1%) (P<0.05). HRSV exhibitedconsistent circulation among children with ARTI in the Shijiazhuang area from2021 to 2023, characterized by winter and spring outbreaks and alternatingpredominance of subtypes A and B. Infections predominantly affected childrenunder 5 years of age.

急性呼吸道感染患儿中呼吸道合胞病毒流行特征分析 — 石家庄市，河北省，中国，2021–2023年

李岩¹；韩光跃¹；姜彩肖¹；周文昊²；耿明浩¹；郭娜娜¹；吴文韬¹；魏亚梅¹；刘兰芬¹；韩旭¹；李国繁¹；刘尚泽¹；邢直槐¹；李琦^1，#

1.河北省疾病预防控制中心，石家庄市，河北省，中国；

2.北京大学人民医院，北京，中国。

^#通信作者：李琦, kepeichu@hebmail.gov.cn。

了解石家庄地区急性呼吸道感染患儿中呼吸道合胞病毒(HRSV)的感染现状及流行特征，为HRSV的防控提供科学依据。收集14岁以下ARTI患儿的上、下呼吸道感染病例标本及病例个案资料，采用Real-time PCR技术检测HRSV，分析其发病现状及流行特征。1,440份标本中HRSV的检出率为7.8%(HRSVA和HRSVB检出率分别为4.0%和3.8%)，春季检出率最高(12.2%)，冬季次之(10.3%)，秋季最低(2.8%) (P<0.05)。2021年流行的优势亚型为HRSV-B，2022年及2023年上半年流行的优势亚型为HRSV-A。5岁以下年龄组的检出率显著高于5岁以上组，0–2岁组患儿中下呼吸道标本(18.1%)的检出率显著高于上呼吸道标本的检出率(8.1%) (P<0.05)。2021–2023年石家庄地区呼吸道感染患儿中存在HRSV流行，呈冬春季流行特征，存在A-B亚型交替流行的特点，感染以5岁以下儿童为主。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.038

Variations in Prevalence andCharacteristics of Rotavirus Diarrhea Among Outpatients — Shanghai Municipality, China, 2017–2023

Xiaohuan Gong^1,2,&; XiaozhouKuang^3,&; Yaxu Zheng^4,&; Sheng Lin¹; WenjiaXiao¹; Min Chen³; Jian Chen¹; Zheng Teng^3,#;Hao Pan^1,#

1. Division of Infectious Disease Controland Prevention, Shanghai Municipal Center of Disease Control and Prevention,Shanghai, China;

2. Department of Epidemiology, School ofPublic Health, Fudan University, Shanghai, China;

3. Division of Microbiology Detection,Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China;

4. Shanghai Academy of Preventive Medicine,Shanghai, China.

&Joint first authors.

# Corresponding author: Hao Pan,panhao@scdc.sh.cn; Zheng Teng, tengzheng@scdc.sh.cn.

This study investigated temporal changes inrotavirus group A (RVA) prevalence, epidemiological characteristics, andgenotype distribution patterns among diarrhea outpatients in ShanghaiMunicipality, China. We conducted prospective active surveillance of diarrhealdisease in pediatric and adult outpatients in Shanghai. Stool specimens wereanalyzed for five viral and twelve bacterial pathogens. Real-time reversetranscription polymerase chain reaction (rRT-PCR) was employed for RVAdetection, followed by genotyping of RVA-positive samples through partialamplification of VP7 and VP4genes. The study analyzed 2,331 diarrhea cases in children aged 0-14years and 8,418 cases in individuals aged ≥15 years between January 2017 andDecember 2023. Overall RVA positivity rates decreased significantly from 7.43%in 2017 to 1.19% in 2023 (P=0.0243).The most pronounced decline occurred in children aged 2-5 years, whereRVA-positive rates fell from 13.08% to 1.72%. Adults aged ≥30 years also showeda substantial reduction. Among RVA-positive pediatric cases (≤14 years), theproportion of cases aged 6-14 years increased from 2.33% to 18.18%. WhileG9P[8] remained the predominant strain, its prevalence decreased from 77.78% to31.25%, concurrent with the emergence of G8P[8] strains. RVA prevalence hasshown a marked decline since 2018-2019, accompanied by a shift in agedistribution toward older children. The diminishingdominance of G9P[8] strains coincided with the emergence of G8P[8] strains.Continued epidemiological and genetic surveillance of rotavirus diarrhea,coupled with real-world effectiveness evaluations of domestic vaccines,remains crucial for optimizing rotavirus immunization strategies.

轮状病毒腹泻门诊病例的流行情况及特征的变化 — 上海直辖市，中国，2017–2023年

宫霄欢^1,2,&, 匡小舟^3,&, 郑雅旭^4,&, 林声¹, 肖文佳¹, 陈敏³, 陈健¹, 滕峥^3,#, 潘浩^1,#

1.传染病防治所，上海市疾病预防控制中心，上海，中国；

2.流行病学教研室，公共卫生学院，复旦大学，上海，中国；

3.病原生物检定所，上海市疾病预防控制中心，上海，中国；

4.上海市预防医学研究院，上海，中国。

^&共同第一作者。

^#通信作者:潘浩，panhao@scdc.sh.cn；滕峥，tengzheng@scdc.sh.cn。

本研究旨在调查2017至2023年上海地区腹泻门诊患者中RVA的流行情况、流行病学特征及基因型分布的变化。在上海对成人和儿童门诊腹泻患者进行前瞻性主动监测。对粪便样本检测五种病毒和十二种细菌。采用实时反转录聚合酶链反应（rRT-PCR）检测RVA，并对RVA阳性样本进行VP7和VP4基因的部分扩增以进行基因分型。2017年1月至2023年12月期间，分析了2,331例0-14岁和8,418例≥15岁腹泻病例。总RVA阳性率从2017年的7.43%显著下降至2023年的1.19%（P=0.0243）。2-5岁儿童RVA阳性率降幅最为明显，从2017年的13.08%降至2023年的1.72%。≥30岁成人阳性率也有所下降。在≤14岁RVA阳性病例中，6-14岁年龄组的病例比例从2.33%上升至18.18%。随着G9P[8]株占比从77.78%下降至31.25%（仍为优势株），G8P[8]株开始出现。自2018-2019年以来，RVA的流行强度有所下降，年龄分布向较大儿童转移。随着G9P[8]株的优势地位有所减弱，同时G8P[8]株开始出现。持续对轮状病毒腹泻开展流行病学和基因型监测，以及评估多种国产疫苗的真实世界疫苗效果，对于优化轮状病毒免疫策略至关重要。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.039

Evaluation of the Factors Influencingthe Survival Times of Chinese Patients with Probable Creutzfeldt-Jacob Disease — China, 2020–2022

WeiweiZhang¹; Yuan Wang¹; Ruhan A¹; Donglin Liang¹;Kang Xiao¹; Donghua Zhou¹; Xiaoxi Jia¹; BingXu¹; Rundong Cao¹; Cao Chen¹; Xiaoping Dong^1,2,3,4,#;Qi Shi^1,#

1. NationalKey-Laboratory of Intelligent Tracking and Forecasting for Infectious Disease,NHC Key Laboratory of Medical Virology and Viral Diseases, National Institutefor Viral Disease Control and Prevention, Chinese Center for Disease Controland Prevention, Beijing, China;

2. Centerfor Biosafety Mega-Science, Chinese Academy of Sciences, Wuhan City, Hubei Province, China;

3. ChinaAcademy of Chinese Medical Sciences, Beijing, China;

4. Shanghai Institute of Infectious Disease andBiosafety, Shanghai, China.

^# Corresponding author: Qi Shi,shiqi@ivdc.chinacdc.cn; Xiaoping Dong, dongxp@chinacdc.cn.

Theclinical durations of sporadic Creutzfeldt-Jacob disease (sCJD) patientstypically do not exceed 2 years, though considerable variation exists. Thefactors influencing survival among Chinese sCJD patients remain incompletelycharacterized. We analyzed the potential elements associated with survivalusing the data of 300 probable sCJD cases from 2020 to 2022 by China NationalSurveillance for CJD. The associations of 31 factors in 7 categories withsurvival were estimated by univariate analysis of Kaplan-Meier and multivariateregression analysis of Cox proportional hazard model. Statistical assaysfigured out that the patients >65 year-old at onset, having pyramidal orextrapyramidal dysfunction, recording high signal in caudate/putamen on magneticresonance imaging (MRI), and not receiving nasal feeding were closelyassociated with short survival. In the subgroup analysis of £65 y and>65 y at onset-age, nasal feeding was the contributor to prolonged survivalfor both groups. MRI high signal of caudate/putamen in the younger group andpyramidal or extrapyramidal dysfunction in older group seemed to be moreassociated with poor survival separately. The data indicate the onset-age andnasal feeding are the most crucial factors influencing on the prognosis forChinese sCJD patients, establishing an evidence base for developing andimplementing targeted intervention strategies.

疑似克雅病患者生存时间影响因素的评估 — 中国，2020–2022年

张卫卫¹；王远¹；阿如罕¹；梁冬林¹；肖康¹；周冬花¹；贾筱溪¹；徐冰¹；曹润冬¹；陈操¹；董小平^1,2,3,4,#；石琦^1,#

1. 传染病溯源预警与智能决策全国重点实验室，国家卫生健康委员会医学病毒和病毒病重点实验室，中国疾病预防控制中心病毒病预防控制所，北京，中国；

2. 中国科学院生物安全大科学中心，武汉市，湖北省，中国；

3. 中国中医科学院，北京，中国；

4. 上海市重大传染病与生物安全研究院，上海，中国。

^#通信作者：石琦，shiqi@ivdc.chinacdc.cn；董小平，dongxp@chinacdc.cn。

散发型克雅病（sporadicCreutzfeldt-Jacob disease，sCJD）患者的临床病程通常不超过2年，且表现出显著的差异性。目前，影响中国sCJD患者生存时间的因素尚未得到明确。

我们使用中国国家CJD监测系统2020至2022年的300例疑似sCJD病例数据，分析了影响生存时间潜在因素。通过Kaplan-Meier单因素分析和Cox比例风险回归模型的多因素分析，评估了7个类别中31个因素与患者生存时间的关联。统计分析显示，发病年龄大于65岁的患者、出现锥体/锥体外系功能异常、磁共振成像（magnetic resonance imagine，MRI）中出现尾状核/壳核高信号以及未接受鼻饲的患者与短生存期密切相关。在发病年龄（£65岁和>65岁）的亚组分析中，鼻饲是延长两组患者生存期的有利因素。在年轻组中，尾状核/壳核的MRI高信号和在老年组中锥体或锥体外功能异常与较差的生存率相关。数据表明，发病年龄和鼻饲是影响中国sCJD患者预后最重要的因素，为制定和实施针对性干预策略提供了证据基础。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.040

An Imported Yellow Fever Adverse EventsFollowing Immunization Case Identified by Targeted Next-Generation Sequencing — Guangdong Province, China, October2024

Xin Zhang^1,&; Zhe Liu^2,&; Jieling Wang¹;Jianhua Huang¹; Shen Huang¹; Biao Di³; JiandongLi⁴; Qiqi Tan¹; Xiaolu Shi⁵; Min Kang¹;Baisheng Li^1,#

1.Guangdong Provincial Center forDisease Control and Prevention, Guangzhou City, GuangdongProvince, China;

2. Guangdong Provincial Institute of Public Health, Guangzhou City,Guangdong Province, China;

3. Guangzhou Center for Disease Control and Prevention, GuangzhouCity, Guangdong Province, China;

4. Chinese Center for Disease Control and Prevention, Beijing, China;

5. Shenzhen Center for Disease Control and Prevention, ShenzhenCity, Guangdong Province, China.

& Joint first authors.

^# Corresponding authors: Baisheng Li, sjkzx_wjs@gd.gov.cn.

Vaccination stands as the most effectivepreventive measure against Yellow fever (YF). However, the YF vaccinationassociated Adverse Events following Immunization (AEFI) cases occuroccasionally. The Guangdong Provincial Center for Disease Control andPrevention utilized Targeted Next-Generation Sequencing (tNGS) to determinewhether the imported suspected YF case was infected by the wild-type YF virus strainor had experienced an AEFI. tNGS analysis successfully yielded a 10.2 kb viralgenomic sequence. Subsequent in - depth analysis revealed high similarity tothe YF vaccine strain 17D-213 and classified thesequence within the West Africa II genotype, clustering with the 17D vaccinestrain. This case represented YF AEFI. The implementation of tNGS technologyenables more precise and expeditious pathogen sequencing, providing criticalevidence for accurate disease diagnosis and informed public health interventions.

通过靶向二代测序技术鉴定一例输入性黄热病疑似预防接种异常反应事件— 广东省，中国，2024年10月

张欣^1,&，刘哲^2,&，王介玲¹，黄健华¹，黄莘¹，狄飙³，李建东⁴，谈琦琪¹，石小璐⁵，康敏¹，李柏生^1,#

1.广东省疾病预防控制中心，广州市，广东省，中国；

2.广东省公共卫生研究院，广州市，广东省，中国；

3.广州市疾病预防控制中心，广州市，广东省，中国；

4.中国疾病预防控制中心，北京市，中国；

5. 深圳市疾病预防控制中心，深圳市，广东省，中国。

^&共同第一作者。

^# 通信作者：李柏生，sjkzx_wjs@gd.gov.cn。

接种疫苗是预防黄热病(Yellow fever, YF)的最有效措施，但疑似预防接种异常反应事件(AdverseEvents following Immunization, AEFI)时有发生。广东省疾病预防控制中心采用靶向二代测序（Targeted Next-Generation Sequencing, tNGS）技术对一例输入性黄热疑似病例展开鉴别。成功获得10.2kb长的病毒基因组序列，其与黄热病疫苗株17D-213相似度极高，并同属于西非II型基因型分支。该病例属于黄热病疑似预防接种异常反应。tNGS技术可实现更精准、快速的病原体测序，助力疾病防控。

For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.041