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Molecular epidemiology analysis of Brucella in ticks in Xinjiang Uygur Autonomous Region

Mengmeng JIANG ; Meihua YANG ; Ruixia SONG ; Yuanzhi WANG ; Jinliang SHENG

Chinese Journal of Endemiology.2019;38(12):947-950. doi:10.3760/cma.j.issn.2095-4255.2019.12.001

Objective: To carry out a investigation on molecular epidemiological features of tick-borne Brucella in Xinjiang Uygur Autonomous Region (Xinjiang), and to provide a scientific basis for formulation of effective preventive and control measures. Methods: In 2016-2018, parasitic ticks (including engorged females) were collected on the body surface of livestock in 10 counties (cities) along the border of Xinjiang. The free-living ticks were collected by flagging method in Alashankou. The engorged female was placed in a breathable insect tube for spawning, each egg batch was divided into two parts: one part was tick eggs, while the second part was allowed further larval development. All ticks were identified by molecular biology (16S rRNA) identification. Tick DNA was extracted, PCR was performed based on Brucella omp22 and IS711, and amplification products were sequenced and analyzed by BLAST. Results: A total of 1 084 ticks were collected in 11 counties (cities), of them 747 were parasitic ticks (including 34 engorged females) and 337 were free-living ticks. Based on 16S rRNA identification, 1 084 ticks belonged to 4 genera and 5 species, and the proportions of Dermacentor nuttalli, Dermacentor marginatus, Haemaphysalis punctata, Hyalomma asiaticum and Rhipicephalus turanicus were 29.43% (319/1 084), 16.51% (179/1 084), 10.42%(113/1 084), 37.27% (404/1 084), and 6.37% (69/1 084), respectively. A total of 214 Brucella-positive nucleic acid samples were detected, the positive rate was 19.74%. The parasitic ticks' positive rate was 25.30% (189/747), and the free-living ticks' positive rate was 7.42% (25/337), parasitic ticks' positive rate was higher than that of free-living ticks (χ²=46.873, P < 0.05). Two Brucella melitensis nucleic acid samples were detected in 34 "engorged females-tick eggs" developmental stage, and one Brucella melitensis nucleic acid sample was detected in 22 "tick eggs-larvae" developmental stage. Conclusions Brucella is widely distributed in parasitic ticks and free-living ticks in Xinjiang border areas, and the parasitic ticks' positive rate is obviously higher than that of free-living ticks. The Brucella melitensis has potential transovarian transmission and transstadial transmission in ticks. In the prevention and control of livestock brucellosis, the work of killing ticks should be strengthened, including parasitic ticks on the body surface and free-living ticks in the environment.

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Comparison of bone resorption-related cytokines in acute and chronic brucellosis

Lihong HAN ; Fan SHU ; Yi HOU ; Shuyi MA

Chinese Journal of Endemiology.2019;38(12):951-954. doi:10.3760/cma.j.issn.2095-4255.2019.12.002

Objective: To observe interleukin-6 (IL-6), interleukin-17 (IL-17), and tumor necrosis factor-α (TNF-α) levels in acute and chronic brucellosis before and after antibiotics treatment in order to assess the bone resorption. Methods: Using group design, 36 acute and 36 chronic brucellosis before antibiotics treatment, and 36 acute and 36 chronic brucellosis after antibiotics treatment from the Endemic Disease Prevention and Control Center of Ulanqab City were selected as the research subjects, with 25 local healthy persons as the healthy control group from January to April 2017. Enzyme linked immunosorbent assay (ELISA) method was used to determine the serum levels of IL-6, IL-17, and TNF-α in acute brucellosis, chronic brucellosis and control groups before and after antibiotics treatment. Results: The means of IL-6 [(23.19 ± 2.51), (21.93 ± 2.27), (14.52 ± 2.08) ng/L], IL-17 [(23.55 ± 2.24), (21.43 ± 2.44), (13.69 ± 1.85) ng/L], and TNF-α [(478.97 ± 47.11), (434.67 ± 42.11), (290.19 ± 34.67) ng/L] were significantly different in the acute brucellosis, chronic brucellosis and control groups before antibiotics treatment (F= 113.91, 152.88, 153.49, P < 0.01); compared to control group, the levels of IL-6, IL-17, and TNF-α in acute brucellosis and chronic brucellosis groups were significantly increased before antibiotics treatment (P < 0.05); the levels of IL-6, IL-17, and TNF-α in acute brucellosis group were significantly increased compared to those of chronic brucellosis group before antibiotics treatment (P < 0.05). The means of IL-6 [(17.83 ± 2.31), (18.45 ± 2.15), (14.52 ± 2.08) ng/L], IL-17 [(17.58 ± 2.21), (18.56 ± 2.29), (13.69 ± 1.85) ng/L], and TNF-α [(370.73 ± 41.04), (375.46 ± 44.61), (290.19 ± 34.67) ng/L] were significantly different in the acute brucellosis, chronic brucellosis and control groups after antibiotics treatment (F=25.94, 39.96, 38.30, P < 0.01); compared to the control group, the levels of IL-6, IL-17, and TNF-α in acute brucellosis and chronic brucellosis groups were significantly increased after antibiotics treatment (P < 0.05); the levels of IL-6, IL-17, and TNF-α in acute brucellosis group were not significantly different compared to those of the chronic brucellosis group after antibiotics treatment (P > 0.05). Conclusions This study shows that before antibiotics treatment, the bone resorption-related cytokines IL-6, IL-17, and TNF-α of acute brucellosis are higher than those of chronic brucellosis. Antibiotic treatment can significantly reduce their levels and may affect bone resorption in patients with brucellosis.

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Correlation analysis of inflammatory factor expression and pain degree in patients with Kashin-Beck disease after total knee arthroplasty

Zhan WANG ; Yuxin SONG ; Yaowen QIAN

Chinese Journal of Endemiology.2019;38(12):955-958. doi:10.3760/cma.j.issn.2095-4255.2019.12.003

Objective: To explore the relationship between the expression of inflammatory factors and the degree of pain in patients with Kashin-Beck disease after total knee arthroplasty. Methods: Forty-nine patients with Kashin-Beck disease and 55 patients with knee osteoarthritis who underwent total knee arthroplasty in the Department of Orthopaedics, Gansu Provincial People's Hospital from January 2016 to December 2018, were selected, as the Kashin-Beck disease group and osteoarthritis group, respectively, and 50 healthy subjects who underwent healthy physical examination at the same time were selected as the control group. At the 7th day after operation, 3 ml of fasting venous blood was collected from all subjects. The expression levels of interleukin (IL)-6, tumor necrosis factor (TNF)-α, and C-reactive protein (CRP) were measured by enzyme-linked immunosorbent assay (ELISA); the visual analogue score (VAS) and knee society score (KSS) were used to compare the pain degree and knee function of each group; correlation analysis between postoperative inflammatory factor levels and VAS, KSS scores in patients with Kashin-Beck disease were studied. Results: The expressions of IL-6 [(78.17 ± 13.28), (60.28 ± 9.92), (9.65 ± 3.12) ng/L], TNF-α [(126.67 ± 15.83), (105.29 ± 12.76), (21.09 ± 5.82) ng/L] and CRP [(11.23 ± 3.41), (8.31 ± 2.54), (2.14 ± 1.01) mg/L] in Kashin-Beck disease group, osteoarthritis group and control group were significantly different (F=12.397, 19.982, 9.167, P < 0.05); and the VAS scores [(5.21 ± 1.44), (2.98 ± 1.03), (0.61 ± 0.22) points], and KSS scores [(60.15 ± 8.91), (72.91 ± 9.19), (93.92 ± 5.73) points] between the three groups were statistically different (F=21.092, 16.743, P < 0.05). The correlation analysis showed that IL-6, TNF-α, and CRP levels were positively correlated with VAS scores in patients with Kashin-Beck disease (r=0.517, 0.498, 0.522, P < 0.05), and negatively correlated with KSS scores (r=-0.509,-0.514, -0.487, P < 0.05). Conclusion After total knee arthroplasty for patients with Kashin-Beck disease, the expression levels of inflammatory factors IL-6, TNF-α and CRP are higher, and they are associated with postoperative pain and knee function recovery.

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Epidemiological and clinical characteristics of human brucellosis in Huai'an of Jiangsu Province, 2013-2018

Zheng ZHANG ; Qiang GAO ; Qi SU ; Wenyi ZHANG ; Jinliu HU ; Weizhong ZHOU

Chinese Journal of Endemiology.2019;38(12):959-962. doi:10.3760/cma.j.issn.2095-4255.2019.12.004

Objective: To understand the epidemiological and clinical characteristics of human brucellosis in Huai'an of Jiangsu Province, and to provide evidence for the formulation of prevention and control measures. Methods: Relevant data was collect through "Infectious Disease Report Information Management System". Descriptive epidemiology (population distribution, time distribution, regional distribution) and clinical characteristics analysis of brucellosis were conducted in Huai'an City from 2013 to 2018. Results: Totally 704 cases of brucellosis had been reported in Jiangsu Province, with an average annual incidence of 0.146 7/100 000, among which 32 cases (4.55%) had been reported in Huai'an, with an average annual incidence of 0.110 0/100 000 from 2013 to 2018. The annual outcomes (incidence rates) were 2 (0.041 6/100 000), 4 (0.083 4/100 000), 6 (0.124 7/100 000), 6 (0.123 2/100 000), 8 (0.163 6/100 000) and 6 (0.122 1/100 000), respectively. Most of the cases were males (20 cases, 62.5%), and aged mainly focused from 40-< 60 years old (20 cases, 62.5%). The occupation was mainly farmers (21 cases, 65.6%). The contact with animals was mainly sheep, and the contact mode was feeding and slaughtering. The cases mainly occurred from March to September (26 cases), and all districts had cases except Hongze. The main clinical manifestations were fever, fatigue, hyperhidrosis and arthromyalgia, with 30 cases (93.8%), 28 cases (87.5%), 25 cases (78.1%) and 22 cases (68.8%), respectively. Some cases showed enlargement of liver, spleen, lymph nodes and testis. Conclusions The incidence of brucellosis in Huai'an City is on the rise, and the characteristics of population distribution, time distribution and regional distribution are obvious. The clinical features are mainly fever, fatigue, and hyperhidrosis. We should strengthen the monitoring of brucellosis, carry out health education for high-risk groups, and reduce the occurrence of brucellosis.

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Epidemiological characteristics of human brucellosis in Laiwu City of Shandong Province, 2011-2017

Guoying NING ; Tao WANG ; Jinping ZHANG ; Yan LIU ; Chunyan LI

Chinese Journal of Endemiology.2019;38(12):963-966. doi:10.3760/cma.j.issn.2095-4255.2019.12.005

Objective: To analyze the epidemiological trend and characteristics of human brucellosis in Laiwu City of Shandong Province, and to provide a scientific basis for improving prevention and control strategies and measures. Methods: The information on the outbreaks of brucellsis in Laiwu City from 2011 to 2017 collected from the "Infectious Disease Reporting Information Management System" in the "China Information System of Disease Prevention and Control", and a retrospective analysis method was used to descriptive statistical analysis of the three distributions (time distribution, regional distribution, population distribution) and transmission route of brucellosis cases. Results: A total of 146 cases of brucellosis were reported from 2011 to 2017. The incidence of brucellosis increased from 0.23/100 000 in 2011 to 2.98/100 000 in 2017, showing an increasing trend year by year (χ²_trend=55.56, P < 0.05); the scope of outbreak was expanding, and the epidemic area was spread from 2 towns (streets) in 2011 to 17 towns (streets) in 2017. There were cases of brucellosis in the whole year, the onset time was mainly concentrated in April and May; the gender of the patients was mainly male, and the male-female ratio was 2.84: 1.00 (108:38); the onset age was mainly concentrated in 30-70 years old; the occupational distribution was dominated by farmers. The transmission route was mainly direct contact infection of occupational population, accounting for 78.77% (115/146); followed by food-borne infection, accounting for 13.70% (20/146). Conclusions The outbreak of brucellosis in Laiwu City is on the rise and the scope of the epidemic area is expanding, occupation is dominated by farmers, the transmission route is mainly direct contact. The health education and awareness of self-protection for related occupational population should be strengthened.

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Monitoring results of coal-burning-borne endemic fluorosis in Hubei Province from 2012 to 2017

Xin DAI ; Yimin DUAN ; Peisheng XIONG ; Suhua ZHOU ; Biyun ZHANG

Chinese Journal of Endemiology.2019;38(12):967-970. doi:10.3760/cma.j.issn.2095-4255.2019.12.006

Objective: To understand the prevention and control of coal-burning-borne endemic fluorosis in Hubei Province, and to evaluate the effects of prevention and control measures on coal-burning-borne endemic fluorosis. Methods: According to the requirements of national "Coal-burning-borne Endemic Fluorosis Monitoring Program", 9 fixed monitoring villages and 15 non-fixed villages in Jianshi, Badong and Zhuxi were selected as the monitoring sites every year from 2012 to 2017, 10 households were selected in each village to carry out the dynamic monitoring of the usage of stove and health behavior related to the corn and pepper for human consumption. At the same time, the monitoring survey of children's dental fluorosis and urinary fluoride were carried out. Results: From 2012 to 2017, the residents of the monitoring villages mainly used the improved stoves, the usage rates of the improved stove were all > 96%. There were statistically significant differences in the qualified rate and correct usage rate of the improved stove between each year (fixed monitoring villages: χ²= 48.71, 63.72, P < 0.05; non-fixed monitoring villages: χ²= 74.02, 84.80, P < 0.05). The correct usage rates of the improved stove were all 100.00% from 2015 to 2017. There were statistically significant differences in the correct rate of drying, keeping and washing eating corn and pepper between each year (fixed monitoring villages: χ²= 10.18, 10.41, 4.99, 15.71, 4.67, 6.80, P < 0.05; non-fixed monitoring villages: χ²= 6.22, 6.23, 18.86, 49.90, 23.88, 6.42, P < 0.05). From 2015 to 2017, all the rest rates were 100.00% except for the washing rate of pepper before eating. It showed a significant decline of dental fluorosis detection rate in 8 to 12 years old children annually (χ²=251.89, P < 0.05), from 33.57% (330/983) of 2012 to 10.26% (111/1 082) of 2017. The geometric means of urinary fluoride of children were 0.62, 0.60, 0.54, 0.53, 0.54 and 0.47 mg/L, respectively. There was statistically significant difference between each year (H=56.91, P < 0.05). Conclusions The prevention and control measures on coal-burning-borne endemic fluorosis of the 3 monitoring counties are implemented well in Hubei Province. Health behavior and life style are gradually formed, and the general condition gets better obviously.

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Analysis of monitoring results of drinking-water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018

Yijun LIU ; Na CUI ; Zhiwei GUO ; Zili CHANG ; Xiaojuan YANG ; Yajuan XIA

Chinese Journal of Endemiology.2019;38(12):971-974. doi:10.3760/cma.j.issn.2095-4255.2019.12.007

Objective: To understand the epidemic situation and control effect of drinking-water type endemic arsenism in Inner Mongolia Autonomous Region from 2009 to 2018, and provide a basis for further development and improvement of prevention and control strategies. Methods: In 2009-2018, 38 diseased villages were selected from 8 cities in Inner Mongolia Autonomous Region as fixed monitoring sites to investigate the water improvement situation of the village and the operation of the water improvement project, and to detect the arsenic content of the water; physical examinations were carried out on all the resident populations who were exposed or previously exposed to high levels of arsenic water in the monitoring villages, and the changes in the condition of arsenic poisoning patients were observed; 30 adult urine samples were collected from each monitoring village to detect urinary arsenic levels. Results: The water improvement rate of the 38 monitoring villages increased from 84.21% (32/38) in 2009 to 100.00% (38/38) in 2013, and continued to maintain; the normal operation rate of water improvement project increased from 64.29% (9/14) in 2009 to 100.00% (18/18) in 2016, and continued to maintain; the qualified rate of water arsenic content of water improvement project increased from 64.29% (9/14) in 2009 to 88.89% (16/18) in 2018; the proportion of qualified project covered population increased from 47.79% (4 846/10 140) in 2009 to 84.35% (5 370/6 366) in 2018. In 2009-2018 the detection rate of arsenic poisoning in the water arsenic content qualified village was 9.17% (3 968/43 276), and the detection rate in the unchanged water and water arsenic exceeded villages was 7.48% (805/10 759); there was no new case for ten consecutive years. There were significant differences in urinary arsenic levels of the water arsenic content qualified villages, the unchanged water and water arsenic exceeded villages between different years (H=424.04, 100.35, P < 0.05); the urinary arsenic level of water arsenic content qualified villagers was lower than that of the unchanged water and water arsenic exceeded villages in the same year (P < 0.05). Conclusions During the 10-year monitoring period, the prevalence of arsenic poisoning has been effectively controlled. The water improvement rate and the normal operation rate of the project remain in good condition, but the qualified rate of water arsenic still should to be improved.

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Investigation of urinary iodine levels of 8 to 10 years old children in Linhai City of Zhejiang Province from 2016 to 2018

Qing YANG ; Mingyuan FANG ; Caijiao HUANG ; Xiansong HE ; Yang CAO

Chinese Journal of Endemiology.2019;38(12):975-977. doi:10.3760/cma.j.issn.2095-4255.2019.12.008

Objective: To investigate the iodine nutritional status of 8 to 10 years old school children in Linhai City, and to provide a theoretical basis for prevention and treatment of iodine deficiency. Methods: From 2016 to 2018, in the townships and sub-district offices under the jurisdiction of Linhai City, one town (street) was selected according to its geographical distribution in the east, west, south, north, and middle five directions, and one central primary school was selected in each town (street). In each central primary school, 40 children aged 8 to 10 years were selected, 5 to 10 ml of urine samples were collected, and urinary iodine level was determined by arsenic cerium catalytic spectrophotometry. Results: A total of 620 urine samples were detected in children, and the median urinary iodine was 172.5 μg/L. In 2016, 200 samples were tested, the median urinary iodine was 191.5 μg/L, 14.00% (28/200) for < 100 μg/L, and 20.00% (40/200) for ≥300 μg/L; in 2017, 210 samples were tested, the median urinary iodine was 174.5 μg/L, 18.10% (38/210) for < 100 μg/L, 11.90% (25/210) for ≥300 μg/L; in 2018, 210 samples were tested, the median urinary iodine was 149.0 μg/L, 24.29% (51/210) for < 100 μg/L, and 9.05% (19/210) for ≥300 μg/L. The differences in urinary iodine concentration between the three years were statistically significant (H=20.831, P < 0.05). A total of 310 boys were tested urinary iodine level, with a median of 147.5 μg/L, and 310 girls were tested with a median of 119.5 μg/L. The difference in urinary iodine concentration between boys and girls was statistically significant (Z=2.766, P < 0.05). Conclusion The iodine nutritional level of 8 to 10 years old school children in Linhai City is within the appropriate range (100-199 μg/L), but the monitoring of urinary iodine should continue.

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Evaluation of iodine nutritional status of children and pregnant women in non-high iodine areas of Xuchang City

Yan WANG ; Ning WU ; Jinhua PENG ; Yanyan YANG ; Xiaolu ZHANG ; Xiaoli LI

Chinese Journal of Endemiology.2019;38(12):978-981. doi:10.3760/cma.j.issn.2095-4255.2019.12.009

Objective: To evaluate the iodine nutritional status of children and pregnant women in non-high iodine areas with different water iodide levels that supplied with standard iodized salt. Methods: In 2016-2018, after excluding high iodine towns, in each county 5 townships were selected according to the east, west, south, north, and middle orientation. If the township was concentrated in water supply, 1 sample of peripheral water was collected; If the water supply was dispersed, collected 10 water well samples in each village to test the water iodine content. And 40 children aged 8-10 years and 20 pregnant women were extracted to collect urine samples and household salt samples, and iodine of urine and salt samples were tested. Children's thyroid volume was examined by B-mode ultrasound. The differences of urinary iodine and child goiter rates among children and pregnant women in different water iodine content areas were analyzed. Results: A total of 1 282 water samples were collected from 30 townships in Xuchang City, and the median water iodine range of townships was 0.80-94.70 μg/L. A total of 1 258 children aged 8-10 years were investigated, and the median salt iodine content of children homes was 26.8 mg/kg, ranging from 0 to 60.9 mg/kg; the median urinary iodine level of children was 211.5 μg/L, and the range was 8.3-833.6 μg/L; 39 children with goiter were examined, and the children's goiter rate was 3.10%. A total of 616 pregnant women were investigated, and the median salt iodine content of pregnant women's homes was 26.9 mg/kg, ranging from 0 to 88.0 mg/kg; the median urinary iodine level of pregnant women was 182.2 μg/L, ranging from 9.7 to 609.6 μg/L. In the areas of the median water iodine 0-< 10, 10-< 50 and 50-100 μg/L, the median urinary iodine of 8-10 years old children were 202.6, 204.0, 320.5 μg/L, respectively, the difference between the three was statistically significant (H=79.89, P < 0.01). And the area of 50-100 μg/L was significantly higher than 0-< 10.0, 10-< 50 μg/L areas (P < 0.01); the children's goiter rate of the three areas was 1.58% (10/634), 4.40% (22/500) and 5.65% (7/124), respectively; the median urinary iodine of pregnant women of the three areas respectively was 177.0, 180.9 and 238.0 μg/L, and the 50-100 μg/L areas was higher than 0-< 10, 10- < 50 μg/L areas(P < 0.01). Conclusion The current standard iodized salt in non-high iodine areas in Xuchang City is basically suitable for most children and pregnant women with iodine nutrition, but the iodine nutrition of children with water iodine greater than 50 μg/L is excessive.

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Preliminary comparative analysis of epidemic characteristics of hemorrhagic fever with renal syndrome in Jingzhou City in different periods from 2009 to 2018

Tian LIU ; Menglei YAO ; Jigui HUANG ; Zhuo TANG ; Li LIU ; Yang WU ; Tianyan LI

Chinese Journal of Endemiology.2019;38(12):982-987. doi:10.3760/cma.j.issn.2095-4255.2019.12.010

Objective: To analyze the changes of the characteristics of Hemorrhagic fever with renal syndrome (HFRS) in Jingzhou City in different periods. Methods: According to the HFRS epidemic data of Jingzhou City in 2009-2018, based on the incidence rate, the HFRS epidemic situation in Jingzhou City was divided into three periods: 2009-2012 (low), 2013-2016 (middle), and 2017-2018 (high). Descriptive epidemiological methods, standard deviation ellipse and spatio-temporal scanning analysis were used to analyze the time, region, population distribution and temporal and spatial trends of HFRS epidemic in the three periods. Results: The incidence of HFRS in Jingzhou City in the three periods was seasonal and bimodal. The peak incidence included spring and summer peaks (May-July) and autumn-winter peaks (January, November-December). The HFRS cases in Jingzhou City were concentrated in Jianli County, Jiangling County and Honghu City in the three periods. The incidence rates were 0.48/100 000, 1.98/100 000, 0.84/100 000, 0.89/100 000, 1.88/100 000, 1.20/100 000; 4.82/100 000, 13.37/100 000, and 4.58/100 000. The incidence of HFRS in males was higher than that in females in the three periods (χ²=43.38, P < 0.05); the occupations of HFRS in the three periods were mainly farmers, which were 56.26%(69/122), 69.61% (126/181), 74.94% (293/391), respectively. In 116 farmers, growing rice [48.28% (56/116)] and shrimp rice [27.59% (32/116)] were mostly. From the age point of view, the incidence rate in 2009-2017 was 55 to 64 years old; the incidence rate of 2018 was 60 to 69 years old. The results of standard deviation ellipse analysis showed that the expansion trend of HFRS epidemic areas in Jingzhou City was not obvious, and the center of gravity was located in Jianli County or Jiangling County. Spatio-temporal scans revealed that the first-class spatial-temporal clustering areas in the three periods were 2 towns and villages in Jiangling County, and the gathering time was from December 7, 2010 to January 2, 2011; in some townships in Jiangling County and Shacheng District, the gathering time was from December 7, 2016 to February 28, 2017; some townships in Jiangling County and surrounding counties, gathered from April 27, 2018 to July 16, 2018. Conclusions The HFRS epidemic season in Jingzhou City in different periods is basically the same; the high-incidence areas are basically the same, but there are local fluctuations; the population is mainly male farmers, and the age of high-incidence has shifted back. We should adapt to local conditions and formulate scientific and reasonable comprehensive prevention and control measures.

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