Objective: To investigate the infection pattern and etiological characteristics of a case of human infection with highly pathogenic avian influenza A (H7N9) virus and provide evidence for the prevention and control of human infection with highly pathogenic avian influenza virus. Methods: Epidemiological investigation was conducted to explore the case's exposure history, infection route and disease progression. Samples collected from the patient, environments and poultry were tested by using real time reverse transcriptase-polymerase chain reaction (RT-PCR). Virus isolation, genome sequencing and phylogenetic analysis were conducted for positive samples. Results: The case had no live poultry contact history, but had a history of pulled chicken processing without taking protection measure in an unventilated kitchen before the onset. Samples collected from the patient's lower respiratory tract, the remaining frozen chicken meat and the live poultry market were all influenza A (H7N9) virus positive. The isolated viruses from these positive samples were highly homogenous. An insertion which lead to the addition of multiple basic amino acid residues (PEVPKRKRTAR/GL) was found at the HA cleavage site, suggesting that this virus might be highly pathogenic. Conclusions: Live poultry processing without protection measure is an important infection mode of "poultry to human" transmission of avian influenza viruses. Due to the limitation of protection measures in live poultry markets in Guangzhou, it is necessary to promote the standardized large scale poultry farming, the complete restriction of live poultry sales and centralized poultry slaughtering as well as ice fresh sale.
Animals ; Chickens ; China ; Commerce ; Humans ; Influenza A Virus, H7N9 Subtype/pathogenicity* ; Influenza in Birds/virology* ; Influenza, Human/virology* ; Phylogeny ; Poultry/virology* ; Real-Time Polymerase Chain Reaction ; Zoonoses

OBJECTIVE This study aimed to determine the relationship between individual allergens with current wheezing and bronchial hyperresponsiveness (BHR) in schoolchildren from three chinese cities: Beijing, Guangzhou and Hong Kong. METHODS Community-based random samples of 10-yr-old schoolchildren from the 3 cities were recruited for study using the International Study of Asthma and Allergies in Childhood (ISAAC) Phase II protocol. The subjects were studied by parental questionnaires (n = 10,902), skin-prick tests (n = 3478), and methacholine challenge tests (n = 608). RESULTS The highest prevalence rates of wheezing in the past 12 months (Beijing, 3.8%; Guangzhou, 3.4%; Hong Kong, 5.8%) and atopy (Beijing, 23.9%; Guangzhou, 30.8%; Hong Kong, 41.2%, defined as having Allergens ; classification ; immunology ; Asthma ; etiology ; immunology ; Bronchial Hyperreactivity ; etiology ; immunology ; Child ; China ; Hong Kong ; Humans ; Risk Factors ; Skin Tests ; Surveys and Questionnaires

Purinergic P2Y Receptor Antagonists ; Consensus ; Cardiovascular System ; Cardiology ; Asia

Objective: To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province, and provide evidence for the improvement of antiretroviral therapy strategy. Methods: A case-control study was designed with 1∶2 matching on case and control groups. Household and face-to-face interview were conducted in October, 2015. All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong. The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases. Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL). Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing. Subjects who were confirmed resistant to with secondary drug, were selected as case group, the rest subjects with non-secondary drug resistance would form the control group. EpiData 3.1 software and SPSS 22.0 software were used to establish a database. Related influencing factors were analyzed with non- conditional stepwise logistic regression model. Results: A total of 288 cases were enrolled, including 103 in the case and 185 cases in the control groups, with average age as (37.62±1.06) years and (37.90±0.74) years old, respectively. Most of them were male, married/cohabitant, with education level of junior/senior high school or below and under Han nationality. Results from the multivariate logistic regression model showed that ORs (95%CI) of receiving antiretroviral therapy for 1-3 years, or more than 3 years were equal to 8.80 (3.69-21.00), 3.00 (1.20-7.53), compared with receiving antiretroviral therapy less than one year, respectively. OR (95%CI) of Among the PLWHA that with missing rate above 25.0% on medication, the OR appeared as 15.41(4.59-51.71), compared with not missing medication. OR (95%CI) among those who took the medicine themselves was 0.22 (0.07-0.74). Conclusions: Factors as duration of treatment, missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance. Other factors as duration on antiretroviral therapy longer than 1 year, missing rate above 25.0% on medication, were related to the risk on secondary drug resistance. However, if the medicine was taken by oneself, it served as a protective factor for secondary drug resistance. It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.
Adult ; Anti-HIV Agents ; Antiretroviral Therapy, Highly Active ; Case-Control Studies ; Drug Resistance ; HIV/isolation & purification* ; HIV Infections/drug therapy* ; Humans ; Infant ; Logistic Models ; Male

Objective: To explore the effects of both pre-gestational BMI and gestational weight gain (GWG) on the birth weight of neonates. Methods: A total of 5 395 pregnant women were selected from the Southwest areas of China (Sichuan/Yunnan/Guizhou) and were divided into groups as pre-gestational underweight, normal weight, overweight and obesity, according to the WHO Recommendation on BMI Classification. Guidelines on Pregnancy weight were adopted from the Institute of Medicine to confirm the accuracy of GWG. Multinomial logistic regression model was used to assess the associations between pregestational BMI and GWG, on the birth weight of the neonates. Results: After adjusting for related confounders, low pre-gestational BMI appeared as a risk factor for SGA (OR=1.91, 95%CI: 1.47-2.50), and was also associated with the decreased risk of LGA (OR=0.55, 95%CI: 0.47-0.66). Inadequate GWG was both associated with the increased risk of delivering SGA (OR=1.57, 95%CI: 1.21-2.03) and the decreased risk of LGA (OR=0.48, 95%CI: 0.41-0.57). Pre-gestational overweight/obesity (OR=1.85, 95%CI: 1.58-2.17) and excessive GWG (OR=1.87, 95%CI: 1.67- 2.11) were both positively associated with the risks on LGA. Data from the stratified analysis indicated that inadequate GWG was positively associated with the risk of SGA among underweight or normal weight women (all P<0.05), but not with those overweight/obese women. Conclusions: Pre-gestational BMI and GWG were important influencing factors on the birth weight of neonates. Health education programs for pregnant women should be intensified and gestational weight gain should also be reasonably under control.
Adult ; Birth Weight ; Body Mass Index ; China ; Female ; Gestational Weight Gain ; Humans ; Infant, Newborn ; Obesity ; Overweight ; Pregnancy ; Pregnancy Outcome ; Prospective Studies ; Weight Gain

Objective: To understand the clinical characteristics and economic burden of influenza-like illness (ILI) children aged 0-59 months in the outpatient settings in Suzhou, China, 2011-2017. Methods: From March 2011 to February 2017, we conducted a prospective surveillance program on ILI for children aged less than 5 years at Soochow University Affiliated Children's Hospital. Through standard questionnaires and follow-up survey via telephone, we collected information regarding the demographic characteristics, medical history, clinical symptoms and both direct and indirect costs associated with influenza, of the patients. We then compared clinical characteristics and economic burden of influenza A/H1N1, A/H3N2, and B infections among children with ILI. Results: We enrolled 6 310 patients with ILI from March 2011 to February 2017 and collected all their throat swabs. 791 (12.9%) of the swabs showed positive for influenza virus, including 88 (11.1%) subtype influenza A/H1N1, 288 (36.4%) subtype influenza A/H3N2, and 415(52.5%) type influenza B. The proportions of cough, rhinorrhea, wheezing, vomiting and convulsion in influenza-positive children were higher than those influenza-negative children. Except for the prevalence rates of cough (χ(2)=9.227, P=0.010), wheezing (χ(2)=7.273, P=0.026) and vomiting (χ(2)=8.163, P=0.017), other clinical symptoms appeared similar between the three viral subtypes. Among all the ILI children, the average total cost per episode of influenza was 688.4 Yuan (95%CI: 630.1-746.7) for influenza-negative children; 768.0 Yuan (95%CI: 686.8-849.3) for influenza-positive children and 738.3 Yuan (95%CI: 655.5-821.1) for influenza B. Children with influenza A/H1N1 spent much more than those with influenza A/H3N2 or influenza B in the total cost (χ(2)=7.237, P=0.028). Conclusion: Children infected influenza showed higher prevalence rates of cough, rhinorrhea, wheezing, vomiting and convulsion than those without influenza. Influenza A/H1N1 subtype caused heavier economic burden than the other two influenza subtypes.
Ambulatory Care/statistics & numerical data* ; Child ; Child, Preschool ; China/epidemiology* ; Cost of Illness ; Cough/virology* ; Female ; Fever/virology* ; Humans ; Infant ; Infant, Newborn ; Influenza A Virus, H1N1 Subtype ; Influenza A Virus, H3N2 Subtype ; Influenza, Human/epidemiology* ; Outpatient Clinics, Hospital/statistics & numerical data* ; Outpatients/statistics & numerical data* ; Prospective Studies ; Socioeconomic Factors ; Surveys and Questionnaires ; Virus Diseases

Objective: To explore the association between nuclear factor kappa-light-chain-enhancer of activated genetic polymorphisms in B cells (NF-κB) and the HCV susceptibility, among the Chinese population. Methods: A total of 1 679 participants were enrolled; including 503 drug users and 1 176 other participants at risk under the exposure for blood. By using the logistic regression analysis, related risk factors for HCV infection among subjects were analyzed. Two NF-κB pathway variants, NF-κB1 rs72696119 and REL rs13031237 were then genotyped by TaqMan assay method. Logistic regression analysis was performed to analyze the association between gene polymorphisms and the susceptibility on HCV. Results: Among the drug users, women (OR=0.408, 95%CI: 0.308-0.767) appeared to be associated with the decreased risk for HCV infection, while factors as drug injection (OR=8.817, 95%CI: 5.577-13.937) and the duration of drug-intake >5.5 years (OR=2.891, 95%CI: 1.824-4.583) were associated with the increased risk for HCV infection. Among the participants who had been exposed to blood, women (OR=3.431, 95%CI: 2.360-4.988) were associated with the increased risk for HCV infection, while the levels of education beyond elementary school (OR=0.613, 95%CI: 0.429-0.876) were associated with the decreased risk for HCV infection. Compared to the reference NF-κB1 rs72696119 CC genotype, the carriage of GG genotype was associated with an increased risk of susceptibility on HCV (OR=1.412, 95%CI: 1.035-1.927) among the total study population. Results from the interaction analysis showed that there was no interactive effects appeared between rs72696119 and route of infection, or between rs72696119 and gender among the total population under study (all P>0.05). Conclusion: NF-κB1 polymorphism rs72696119 and related factors seemed associated with the susceptibility to HCV infection among high-risk Chinese populations.
Asian People/genetics* ; B-Lymphocytes ; Case-Control Studies ; China/epidemiology* ; Female ; Genetic Predisposition to Disease ; Hepatitis C/genetics* ; Humans ; Male ; Middle Aged ; NF-kappa B/genetics* ; Polymorphism, Single Nucleotide

Objective: To understand the epidemiological and molecular characteristics of a norovirus- borne outbreak caused by GⅡ.4 Sydney 2012 in a university of Guangzhou to provide evidence for the prevention and control strategy on norovirus-caused epidemics. Methods: A self-designed questionnaire was used to collect clinical information from the patients as well as other data related to the epidemic. Pathogen detections were performed through anal swab specimens from the patients, kitchen workers and samples from the environment. Positive samples were further sequenced for phylogenetic analysis. A case-control study was employed to identify the risk factors related to this outbreak. Results: A total of 226 cases of norovirus-borne infection were identified between September 17 and 21, 2017, including 223 students, with an attack rate of 0.73% (223/30 711), and 3 kitchen workers. Students staying in the A dormitory area had the highest attack rate (1.73%, 164/9 459). No clustering was found in different colleges or classes. Results from the case-control study revealed that people who ate at the canteen in A dormitory area during September 18 to 20 was at risk for the onset of illness (OR=10.75, 95%CI: 5.56-20.79). The highest risk was related to the dinner on September 18. Another significant risk factor (OR=3.65, 95%CI: 1.92-6.94) was close personal contact in the same room of the dorm. The 3 norovirus infected kitchen workers were all from the canteen in A dormitory area where the positive rate of norovirus identified in kitchen workers was 26.67% (12/45). Positive samples were sequenced and sub-typed with results showing that the GⅡ.4 Sydney 2012 variant and the nucleotide sequences of cases and kitchen workers were 100% identical. Conclusions: The outbreak was caused by norovirus GⅡ.4 Sydney 2012 variant at campus. Similar outbreaks had been seen since 2013, with the routes of transmission most likely due to food-borne or personal contact.
Adolescent ; Adult ; Caliciviridae Infections/epidemiology* ; Case-Control Studies ; China/epidemiology* ; Disease Outbreaks ; Female ; Foodborne Diseases/virology* ; Gastroenteritis/virology* ; Humans ; Male ; Norovirus/isolation & purification* ; Phylogeny ; Surveys and Questionnaires

Animals ; Mice ; Colon ; Histological Techniques