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Construction and strategies of disease prevention and control system in the new era in Shanghai

Chun-feng WU ; Ping ZU ; Yong CHEN ; Fei-long HE ; Ye LU ; Jian CHEN ; Xiao-yan HUANG ; Chen FU

Shanghai Journal of Preventive Medicine.2021;33(2):97-. doi:10.19428/j.cnki.sjpm.2021.20740

After the epidemic of novel Coronavirus Disease 2019(COVID-19), construction of disease prevention and control has become a top priority. As a pioneer in the recovery of global economy and society, Shanghai should play a fundamental role in building a comprehensive system of public health and advanced disease prevention and control in the new era. In this article, we systematically categorize the requirements for the construction of disease prevention and control system in the new era, identify the weakness and challenges during and after the epidemic, and then make suggestions. It is proposed that we should utilize the important window period of the"14th Five-Year Plan", with the"Healthy China"strategy and municipal"20 Tasks for Public Health Construction"as the starting point, to make substantial contribution to the functional orientation, investment of resources, capacity building, operational mechanism and team building, which may provide scientific evidence for the reform and development of disease prevention and control system.

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Result analysis of the 2019 national assessment of individual dose monitoring capability in Chongming District, Shanghai

Yue-hua DING ; Ji-ying MA

Shanghai Journal of Preventive Medicine.2021;33(2):102-. doi:10.19428/j.cnki.sjpm.2021.20169

Objective In 2019, Laboratory of Shanghai Chongming Center for Disease Control and Prevention participated in national assessment of individual dose monitoring capability. By analyzing the results, this report summarizes the experience and shortcomings that will help improve the individual dose monitoring capability of the laboratory. Methods According to the requirements of the national assessment scheme for individual dose monitoring capacity in 2019, the assessment process and results were sorted out and analyzed one by one. Results The single group performance deviations(P_i values)between the measured values and references of the five groups were -0.04, -0.07, -0.05, -0.04 and -0.06, respectively. The overall bias(B value)of all groups was 0.003. According to the judgment standards, both the single group performance and overall performance were all qualified. Conclusion The individual dose monitoring system of the laboratory meets the requirements of the relevant national standards. The individual dose monitoring capability can be further improved by strengthening the quality control of the relevant procedures of the assessment.

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Assessment of energy discrimination dosimeter in monitoring personal dose

Xue-xin WEN ; Ai-jun QIAN

Shanghai Journal of Preventive Medicine.2021;33(2):106-. doi:10.19428/j.cnki.sjpm.2021.19983

Objective To evaluate the performance of energy discriminating dosimeter and compare the impact of the assessment results. Methods CTLD-J4000 energy discriminating dosimeter was irradiated with different energy photons, and the differences covered by the dosimeters were used. Density filtering materials have different filtering effects on photons, and the ratio curve of the readings to the photon energy was fitted to identify the photon energy. Results The coincidence between the non-filter/light filter of the CTLD-J4000 energy discrimination dosimeter and the manufacturer's reference value was better than that of the non-filter/re-filter. The latter had higher deviation values at 48 keV(12.8%)and 83 keV(15.5%), respectively. Using the average scale factor, the maximum energy response deviation was 23.5%. Conclusion Using a discriminating dosimeter can better identify the ray energy, thereby reducing the energy response error caused by using the average scale factor.

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Occupational health monitoring status of medical radiation workers in Qinzhou City, Guangxi

Xiao-lan LAO ; Xian-ying HUANG

Shanghai Journal of Preventive Medicine.2021;33(2):109-. doi:10.19428/j.cnki.sjpm.2021.20225

Objective To understand the situation of occupational health monitoring status of medical radiation workers in radiation diagnosis and treatment institutions, to provide reference for the evaluation of radiation protection measures as well as for the health supervision/inspection agencies, and to maximize the protection of occupational health rights of medical workers in radiation diagnosis and treatment. Methods Questionnaires were distributed then collected in the radiation diagnosis and treatment institutions in Qinzhou. The data were analyzed afterwards. Results A total of 850 medical radiation workers were recruited from 101 institutions that had obtained the radiation diagnosis and treatment license in Qinzhou. Among them, the physical examination rate of radiation diagnosis and treatment staff was 96.94%, the personal dosimeter monitoring rate was 93.41%, the training rate of radiation protection and legal knowledge was 94.12%, and the monitoring rate of equipment performance stability was 51.49%. Conclusion The occupational health monitoring of radiation workers in high-level institutions relatively meets the standard, and the management of occupational health monitoring in township hospitals, private hospitals and dental clinics is not satisfactory. The monitoring rate of radiation equipment performance in the whole city is generally low. Health supervision and law enforcement departments should strengthen law enforcement, urge the institutions to conduct radiation occupational health monitoring in an orderly manner according to law, and protect the health rights/interests of radiation diagnosis and treatment workers to the maximum extent.

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Radiational dose detection for natural uranium container port

Jin-gui WU ; Hong-wei YU ; Chuan-xi TANG ; Sheng-jie ZHANG

Shanghai Journal of Preventive Medicine.2021;33(2):112-. doi:10.19428/j.cnki.sjpm.2021.20392

Objective To determine the level of radiation dose in port workplace for loading and unloading natural uranium ore containers, and to provide a basis for occupational health management of the operators. Methods Workplace investigation was conducted to understand the loading and unloading process of natural uranium ore containers, operation time and frequency, etc. A radiation dose rate meter was used to detect the radiation dose rate at 5 cm from the outer surface of 168 natural uranium ore containers. At the same time, we selected one container and detected the level of dose rate at 5-200 cm away from each side surface of the 5 container surfaces except for the bottom side. Results The dose rate level at 5 cm at outer surface of 168 containers ranged from 27 μSv/h to 44 μSv/h, and the average dose rate level was 35.6 μSv/h. The average dose rate levels at 5, 30, 50, 100 and 200 cm were 21.3, 14.6, 11.3, 7.1 and 3.5 μSv/h, respectively. In normal operation, the personal exposure dose of port worker were estimated to be less than 580 μSv/a. Conclusion In normal operation, the dose rate level at any workplace on the outer surface of natural uranium ore container is far below the national standard limit.

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Influenza surveillance in Huzhou during 2011-2017

Yan LIU ; Jian-yong SHEN ; Dong WEN ; Guang-tao LIU

Shanghai Journal of Preventive Medicine.2021;33(2):115-. doi:10.19428/j.cnki.sjpm.2021.19290

Objective The influenza monitoring results in Huzhou city were analyzed to understand the characteristics of influenza pandemic and to provide a scientific basis for prevention and control of influenza. Methods The influenza-like cases(ILI)were collected from two sentinel hospitals in Huzhou according to the protocol of The National Influenza Surveillance Program. Pharynx swab samples of the ILI were taken randomly for the test of influenza virus. Results Among 5 322 788 patients who went to the sentinel hospitals in Huzhou from 2011 to 2017, 185 010 were ILI. The percentage of ILI was 3.48% and there was a slowly rising trend in ILI% of month from 2011 to 2017(trend χ² = 2 970.93, P < 0.001). Winter /spring and summer seasons marked the peaks in influenza epidemics. Patients were mostly children under 14 years old(accounting for 89.1%). In a total of 11 490 throat swabs collected from ILI, 1 975 were tested to be positive for influenza virus(positive rate 17.19%). These included A type H3N2, 1 008; A type H1N1, 350; B type, 614(160 Victoria type, 238 Yamagata, 216 unclarified B type), and 3 mixed type. The correlation between positive rate of influenza nucleic acid test and ILI% is statistically significant(r = 0.40, P < 0.001). Conclusion The incidence peaks of influenza in Huzhou are mainly in the winter /spring and summer periods. The influenza is mainly occurs in young people under 14 years old and the main type virus is A(H3N2). The prevalence of influenza B and H1N1 occurs at intervals. There is a positive correlation between influenza activity and ILI%.

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Epidemiological analysis of syphilis from 2009 to 2018 in Qingpu District, Shanghai

Yan-fen LI ; Chun-yu XIA ; Dan-hua LI

Shanghai Journal of Preventive Medicine.2021;33(2):120-. doi:10.19428/j.cnki.sjpm.2021.19675

Objective To understand the epidemiological features of syphilis in Qingpu District for developing control strategies. Methods The data of syphilis cases(2009-2018)were collected and analyzed. Results The reported syphilis incidence decreased from 27.17/10⁵ in 2009 to 24.69/10⁵ in 2018. The ratio of secondary syphilis declined from 64.98% in 2009 to 57.14% in 2018, while that of latent syphilis increased from 23.74% in 2009 to 32.89% in 2018. The incidence of syphilis was higher in males than in females, and the average male/female ratio increased from 1.01:1 in 2009 to 1.51:1 in 2018. The incidence of syphilis was the highest in the age group of 20-59 years, but the constituent ratio increased in the aged group(≥ 60 year). The cases were mainly in the local household register, but the composition ratio showed a downward trend from 81.71% in 2009 to 59.14% in 2018. The main source of cases was STD outpatients. It decreased from 89.11% in 2009 to 46.51% in 2018, and the proportion of inpatients and other outpatients increased from 8.56% in 2009 to 50.49% in 2018. Conclusion The incidence of syphilis shows a decreasing trend. The incidence of reported secondary syphilis has decreased in general but increased rapidly in older patients. More measures are urgently in need to control epidemic syphilis effectively.

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Epidemiological investigation and follow-up study of indeterminate HIV antibody test results in Jiading, Shanghai

Jia-xing WANG ; Fang-lan YIN ; Yong ZHANG ; Pei-song ZHONG

Shanghai Journal of Preventive Medicine.2021;33(2):124-. doi:10.19428/j.cnki.sjpm.2021.19149

Objective To investigate the rate and the population distribution of subjects with indeterminate result of HIV antibody test and to understand the relationships between the western blot(WB)banding patterns and HIV infection through follow-up reexamination. Methods Samples with indeterminate results of HIV antibody test were collected by Jiading Center for Disease Control and Prevention from 2013 to 2017. They were used for analysis of the source, the distribution of Western blotting band pattern and the follow-up results. Results Among 698 samples required to be re-tested for confirmation of HIV infection, 151(21.63%)showed indeterminate WB test results. There were 18 types of WB band in 151 HIV antibody-indeterminate samples. The most common band types, accounting for 79.47%, were p24, gp160, and gp160p24. One hundred(among 151)subjects were followed up and the success follow-up rate was 50.00%. Among them, 28(56.00%)samples were still with indeterminate results of HIV antibody, 11(22.00% turned to be negative and 11(22.00%)turned to positive. The follow-up confirmatory tests showed that 67.86% of the samples with p24 band were still with indeterminate results and 40.00% of the samples with gp160 band became HIV antibody-negative. The samples with one of the three band patterns of gp160gp120p24, gp160p24p17 and gp160gp120p66p51 all became HIV antibody-positive. Conclusion The detection rate of indeterminate HIV antibody results varies in different populations. Positive conversion rates with different WB band patterns are different. Follow-up of the populations with specific WB band patterns should be strengthened to detect HIV infection cases as early as possible.

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Identification of the bacteria strain and its antibiotic resistance in an epidemic of cholera

Xiao-hong ZHOU ; Pei-hua XU ; Yan-jing NI ; Jian CHI ; Xiao-wei ZHU

Shanghai Journal of Preventive Medicine.2021;33(2):128-. doi:10.19428/j.cnki.sjpm.2021.19226

Objective The present study was conducted to identify the Vibrio cholera type and to analyze its antibiotic resistance in an epidemic of cholera in Haiyan County in 2018, which would provide the references for prevention and control of cholera. Methods Stool samples of the patient and his close contacts as well as the food and environmental samples were collected for identification of the type of Vibrio cholerae and the toxin gene. The resistance of identified Vibrio cholerae to 20 different common antibiotics were tested. Results A total of 176 samples were collected, including 101 stool samples from the case and his close contacts, 35 environmental samples and 40 food samples. Among those samples, only one strain of V. cholerae, O139, was isolated from the patient's first feces sample. It was detected as a toxin gene of ctxA positive by real-time fluorescence PCR. Antibiotic resistance test showed that the strain was sensitive to norfloxacin, levofloxacin, ciprofloxacin, cefotaxime, cephalothin, ampicillin, and amoxicillin. It was 100% resistant to tetracycline, doxycycline, neomycin, kanamycin, streptomycin, and rifampicin. Conclusion V. cholerae O139 strain with ctxA is detected in an epidemic of cholera. Norfloxacin, levofluoxacin and some other antibiotics could be used for clinical treatment and prevention. It should pay attention to this strain of V. cholera regarding the multiple drug resistance and the change of antibiotic resistance.

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Detection of measles virus infection and proliferation by real-time quantitative PCR

Ran XU ; Lin-ya ZHANG ; Wen-zhen YANG ; Wei ZHU

Shanghai Journal of Preventive Medicine.2021;33(2):132-. doi:10.19428/j.cnki.sjpm.2021.19441

Objective A SYBR-Green real-time quantitative PCR(RT-qPCR)method was set up to detect the infection and proliferation of measles virus, which could be useful in virus titer determination. Methods In this project, we used a 405 bp fragment of the N gene of measles virus as a target sequence and constructed a plasmid to establish the standard curve in absolute quantitative experiment. We then used this method to obtain the proliferation curve of measles virus and to detect the virus proliferation at different MOI. Results There was a linear relationship between the virus copy number and the titer of the measles virus reference at the range of 6 to 2 lgCCID₅₀/mL, with a correlation coefficient (r) of 0.991(P < 0.01). Based on the analysis of virus proliferation curve, measles virus mainly proliferated intracellularly within 48 h after its entering the cell. There was no detected increase in viral RNA level in the first 24 h, suggesting the virus was in a silent period in the cell. After 24 h, the virus expanded in large numbers and entered the exponential growth phase. The intracellular viral RNA level reached the plateau phase after its peak at 96 h. The virus secreted to the outside of the cell entered the exponential growth phase starting from 48 h, peaked at 144 h, then followed by plateau phase. Conclusion A SYBR-Green RT-qPCR method is established and used to monitor virus proliferation. Our result is helpful in understanding of the proliferation and secretion of measles virus in cells and provides experimental basis for detection of live attenuated virus titers.

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