An investigation on pathogens was performed on 219 consecutive adult inpatients with community-acquired pneumonia (CAP) from November 2008 to August 2009 in Hebei Province.Sputum samples from all patients in acute phase were collected for multiplex polymerase chain reaction (PCR) detection. Pathogens were identified in 125 patients. Streptococcus pneumoniae was the most common pathogen isolated in 75 cases (60％) ; influenza A virus was the most common virus isolated in 32 cases (26％) ; and mixed infection were found in 31 patients (25％). Streptococcus pneumoniae species were more frequent among patients aged ≤30 and 51 -70; Haemophilus influenzae species were more frequent among patients with coexisting disease; the percent of Mycoplasma pneumoniae species infections in the lowrisk groups( Ⅰ - Ⅱ ) was higher than patients in the high-risk groups ( Ⅲ - V ).The percent of virus pneumoniae species infections in patients with coexisting disease trended to higher than patients without coexisting disease,but the difference was not statistically significant ( P ＞ 0.05 ).The results indicate that Streptococcus pneumoniae remains the major bacteria,Viruses are frequently detected in CAP with influenza A virus being the most common one; and mixed infection should not be ignored.The age and underlying diseases are important factors influencing the distribution of pathogens.

N)compared with B/HongKong/330/2001.Conclusions H1,H3 and B virus were circulated in Hebei from 2005 to 2006.Recent viruses were changing in genetic characteristics,while influenza B viruses varied more obviously.

Objective To understand the genetic characterization of HA1 gene of influenza A H3N2 viruses circulated in recent years in Hebei.Methods Viral RNAs of 25 H3N2 strains were extracted and amplified by Reverse Transcription Polymerase Chain Reaction (RT-PCR).The products of PCR were purified and sequenced,and the sequences were analyzed though biometic software.Results Several amino acid substitutions located in antigenic sites or receptor binding sites were found more in the isolates than the current vaccine virus or the isolates from previous year.Amino acid substitution was found in 3,140,142,144,145,158,159,189,192,193,198,204,225,226 and 227 positions in the isolates during 2003-2008,more amino acid substitutions took place in antigenic determinant A,B and receptor binding site (RBS).New phylogenetic branches appeared continuously during 2003-2008.The H3N2 strains of the same year almost clustered in the same group on the phylogenetic tree.Conclusions Amino acid substitutions continuously occurred in the HA1 genes in influenza A H3N2 viruses isolated in Hebei from 2003 to 2008,it is meaningful to pay close attention to the HA1 variation in order to prevent and control influenza.

Objective To investigate the viral etiology and the epidemilogy of acute upper respiratory tract infection in Hebei Province from 2013 to 2015,providing scientific basis for diagnosis,prevention and control of the respiratory tract infection.Methods l 551 throat swab samples of the acute upper respiratory infection patients from four hospitals in Hebei Province were collected,Multiplex real-time PCR was used to detect 15 kinds of respiratory tract viruses for all specimens after nucleic acids extraction.Results Totally 714 positive samples were obtained from 1 551 samples,with a positive rate of 46.03％.Human rhinovirus(186,11.99％)was detected as the most common viral species,followed by human parainfluenza 3(167,10.77％),respiratory syncytial virus (122,7.87％),adenovirus (108,6.96％),influenza B virus (56,3.61％),human metapneumovirus(40,2.58％),influenza A virus(39,2.51％),human boca virus (38,2.45％),human parainfluenza 1 (35,2.26％),human coronavirus-229E/NL63 (33,2.13％),human enterovirus (32,2.06％),human parainfluenza 4(31,2.00％),human coronavirus-OC43 (30,1.93％),and human parainfluenza 2(11,0.71％).176 cases (11.35％) were detected as co-infection.The infection rate(56.07％) of under 5 years old group was higher than that of other groups.Conclusions The predominant respiratory viruses,who are responsible for acute upper respiratory tract infections in Hebei Province,are HRV,PIV3,RSV,ADV and IFV.Each virus possess the specific epidemiological feature.

Objective: To understand epidemiological characteristics of the pathogens and evolution of the genotype associated with infectious diarrhea epidemic caused by norovirus in Hebei Province. Methods: A total of 8 infectious diarrhea outbreaks caused by norovirus were reported from Jan 2015 to Dec 2016, of which epidemic treatment materials and specimens were collected at the same time. Norovirus nucleic acid was detected by using real-time PCR, and the partial ORF2 of the all positive specimens were amplified by RT-PCR and sequenced. Phylogenetic tree was constructed by using Mega5.2 based on partial ORF2 sequences of norovirus to perform phylogenetic analysis. Results: A total of 8 norovirus outbreaks, involving 265 cases who were mainly for residential inhabitents, children and students, were reported during this period, and the overall attack rate ranged from 0.70% to 8.13%. The overall positive detection rate of norovirus was 66.25%. The PCR products were sequenced, and sequencing result were obtained for 28 samples, which included GⅠ.3, GⅡ.2, GⅡ.4, GⅡ.13 and GⅡ.17. Conclusions Multiple genotypes of infectious diarrhea outbreaks caused by norovirus were found in Hebei province.

0.05).The concentration of IL-6 in sputum of multi-virus infection group(122.51?39.86)ng/L was higher than in single virus infection group(65.30?34.92)ng/L.The concentration of IL-6 in sputum of bacteria-virus mixed infection group(120.31?46.62)ng/L was higher than in bacteria or virus single infection group(83.61?47.83)ng/L.Conclusion Streptococcus pneumonia and influenza virus A infection are important factors in AECOPD at early stage.Virus infection would prolong recovery time,increase inflammation of the airway and even induce bacteria infection.Therefore,we should pay more attention to the virus infection in COPD patients,especially A-type influenza virus.

Objective:To explore the lag effect and correlation between daily average temperature and the incidence of other infectious diarrhea in Hebei Province.Methods:The data of meteorological factors (including temperature and average daily temperature) and the daily incidence of other infectious diarrhea in Zhangjiakou City, Chengde City, Tangshan City, Qinhuangdao City, Baoding City, Langfang City, Cangzhou City, Shijiazhuang City, Hengshui City, Xingtai City, and Handan City in Hebei Province from 2017 to 2020 were collected. Eleven prefecture-level cities were divided into four regions, including east, north, middle and south regions. Distributed lag non-linear model was applied to examine the non-linear associations and the lag effect of daily mean temperature on daily incidence of other infectious diarrhea. Meanwhile, the cold and hot effects were used to estinuate the lag-response relationship on the incidence of other infectious diarrhea.Results:A total of 231 008 cases of other infectious diarrhea were reported in Hebei Province. The seasonal distribution was obvious, showing a bimodal distribution of large peaks in summer and small peaks in winter. An inverse S-shaped association between average daily temperature and cumulative risk ratio ( RR) of other infectious diarrhea was observed in Hebei Province. Both high temperature (higher than 27.50 ℃) and low temperature (less than 13.67 ℃) could increase the risk of other infectious diarrhea. When the temperature was lower than 13.00 ℃, the lag time and RR had a U-shaped association (lag four to seven days, 23 to 30 days). Meanwhile, when it was higher than 13.00 ℃, it had an inverted U-shaped association (lag 5 to 21 days). A comparison of four regions of Hebei Province showed that the lag time from south to north was extended from six days to 30 days at low temperature effects with temperature P5=-7.24 ℃. When the temperature getting hot ( P95=28.25 ℃), the risk occurred at lag 0 days, and the lag time gradually got short from north to south. Thus, the high temperature effect reached maximum quickly with a relative short duration. Conclusions:The inverse S-shaped non-linear association between daily average temperature and the incidence of other infectious diarrhea in Hebei Province is observed. Both low temperature and high temperature are associated with increased risk of other infectious diarrhea. But the impact of low temperature is more notable, which has a relative long duration.

Objective: To explore the spatial-temporal distribution and epidemic characteristics of hemorrhagic fever with renal syndrome (HFRS) in Hebei province from 2005 to 2016. Methods: Records of HFRS cases reported from each county in Hebei during January 2005 to December 2016 were collected from National Notifiable Disease Surveillance System (NNDSS). Global and local spatial association statistics were used to measure the spatial autocorrelation and software GeoDa 1.2.0. Software SaTScan 9.4.1 was used to analyze spatiotemporal clusters. Software ArcGIS 10.2 was used to visualize the yearly scan results. Results: In Hebei province, a total of 8 437 human HFRS cases reported from 170 counties with an annual incidence rate of 0.99/100 000 population during 2005-2016. The peak incidence season was spring. Global spatial autocorrelation analysis on the incidence of HFRS at county-level showed that the value of Moran’s I were all above 0 (P<0.05), indicating that the significant spatial cluster. The result of local indicators on spatial association (LISA) analysis revealed that identified hot spots were mainly in northeastern area, while cold spots were found in some counties of central and southern areas. Spatial-temporal scan detected that the primary cluster of HFRS incidence was mainly distributed in Qinhuangdao city and Tangshan city, including 11 counties (city/district): Beidaihe district, Haigang district, Funing district, Shanhaiguan district, Changli county, Lulong county and Qinglong Manchu autonomous county in Qinhuangdao city, and Qian’an city, Laoting county, Luanzhou city and Luannan county in Tangshan city (RR=39.64, P<0.001), during January-July in 2005. Conclusions There were significant spatial-temporal cluster of HFRS in Hebei from 2005 to 2016. The cluster areas of HFRS were mainly in northeastern Hebei, it is necessary to strengthen the prevention and control programs of HFRS in these areas.

Objective: To analyze the epidemiological characteristics of severe and deceased cases of hand, foot and mouth disease (HFMD) in Hebei province, so as to provide reference for prevention and control of the disease. Methods: Severe and deceased HFMD cases reported from the National Disease Surveillance Information Management System and the laboratory testing result in Hebei province from 2010 to 2016 were analyzed. Descriptive epidemiological method involving the distribution of population, area, time and pathogeny were used for the analysis. Results: From 2010 to 2016, 3 803 severe HFMD cases and 162 deceased cases were reported in Hebei province, and the ratio of severe cases among all HFMD patients was 0.75%. A chi-square test showed that the incidence of severe HFMD between males and females was significantly different (χ²=239.37, P<0.001), and scattered children were the main patient. Infants less than six months of age had the highest ratio of severe HFMD cases, the group of one-year-old and younger children had the highest proportion of severe HFMD cases. The severe ratio and severe incidence of Xingtai, Langfang and Hengshui were the top three prefectures having the highest proportions of severe cases. The number of severe cases fluctuated over the past 7years, but showed a downward trend. The constituent ratios of EV-A71 in severe cases and deaths were 79.25% and 92.66%, respectively. Conclusions Severe HFMD epidemics showed a declining trend in Hebei province. EV-A71 is still the main pathogen of both severe and fatal cases. It is necessary to strengthen the prophylactic and therapeutic measures for the young children (< 2 years).