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Isolation and identification of a severe acute respiratory syndrome coronavirus 2 strain in feces from COVID-19 patients in Shanghai

Yanqiu ZHOU ; Xiaoxian CUI ; Jiabin MOU ; Fanghao FANG ; Zheng TENG ; Huanyu WU ; Min CHEN ; Xi ZHANG

Shanghai Journal of Preventive Medicine.2022;34(12):1173-1179. doi:10.19428/j.cnki.sjpm.2022.22266

ObjectiveTo isolate and study the biological characteristics of severe acute respiratory syndrome coronavirus 2 （SARS-CoV-2） from feces of coronavirus disease 2019 （COVID-19） patients. MethodsVero E6 cells were used for virus isolation and the isolated strains were tested by nucleic acid test， immunofluorescence test， virulence test and whole genome sequencing. 50% tissue culture infective dose （TCID₅₀） was calculated after the cell cultures of each generation were collected ResultsEight fecal specimens were inoculated with Vero E6 cells after treatment and cultured for 48 h. One specimen showed obvious cytopathic effect on Vero E6 cells. One SARS-CoV-2 out of 8 fecal samples from COVID-19 patients were isolated， and separation rate was 12.5%. The TCID₅₀ of P1， P2 and P3 were 10^4.0/0.2 mL， 10^4.5/0.2 mL and 10^4.75/0.2 mL， respectively. Only one of the 8 stool samples had SARS-CoV-2 virus replication and amplification， and the Ct value of the nucleic acid detection was about 10. The sequence of the isolation was more than 99.99% homologous with that of Wuhan-Hu-1（GenBank MN908947）. ConclusionThe SARS-CoV-2 strain is isolated from the fecal samples of COVID-19 cases and is confirmed by genomic sequencing and immunofluorescence test， which indicates the presence of live virus in feces of COVID-19 cases.

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Clinical characteristics of 151 COVID-19 cases in a designated hospital in a district of Shanghai， 2022

Wen ZHU ; Hai ZHOU ; Xiaoqing SHUAI ; Lei CHENG ; Chao WENG

Shanghai Journal of Preventive Medicine.2022;34(12):1180-1187. doi:10.19428/j.cnki.sjpm.2022.22263

ObjectiveTo analyze the clinical characteristics of 151 local COVID-19 patients in Shanghai， 2022. MethodsThe clinical data of 151 COVID-19 patients admitted to a district-level designated hospital in Shanghai from April 13 to May 10， 2022 were reviewed， and their clinical manifestations， laboratory tests， lung imaging， treatment and outcomes were analyzed. ResultsThe 151 patients ranged from 3 to 97 years old， with a median age of 72 years. Most of them were clustered cases in the communities and families. The main clinical types were mild （95 cases， 62.9%） and general （47 cases， 31.1%）. Most of the 9 severe/critical patients （6.0%） were elderly and complicated with multiple comorbidities. The proportion of people who had not been vaccinated was as high as 66.9%， and the proportion of those among severe/critically ill patients who had not been vaccinated was even higher. The most common first symptoms were expectoration in 71 cases （47.0%）， fever in 51 cases （33.8%） and dry cough in 30 cases （19.9%）. The counts of white blood cells and neutrophils in mild or general group were mostly normal or decreased， and in the severe/critical group increased significantly （P<0.001）. Increase of troponin， D-dimer， creatinine， and myoglobin； and decrease of lymphocytes in severe/critical group were more common than the other clinical types （P<0.05）. The proportions of use of antibiotics， antiviral drugs， thymalfasin and heparin in severe/critical and general patients were significantly higher than those in mild patients （P<0.05）. Among the cured and discharged patients （138 cases， 91.4%）， the median number of days for COVID-19 viral nucleic acid to turn negative after treatment was 12 days. The negative conversion days of mild patients were significantly shorter than those of general patients and severe/critical patients （P<0.01）. Four （2.6%） death patients were all over 80 years old， unvaccinated， combined with multiple comorbidities， and eventually died of those serious comorbidities. ConclusionCOVID-19 patients at the district-level designated hospital are mainly clustered cases， and the proportion of patients who do not receive COVID-19 vaccine is high. Most of the hospitalized patients are mild， but advanced age， multiple underlying diseases， and lack of vaccination are high-risk factors for developing severe disease. Early assessment and comprehensive treatment are the key to improve prognosis.

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Investigation and management of an anaphylactic shock case after inoculation with COVID-19 vaccine

Yingxia LI ; Wenyan TAN ; Chenghua LI ; Jianxiong LI

Shanghai Journal of Preventive Medicine.2022;34(12):1188-1191. doi:10.19428/j.cnki.sjpm.2022.22075

Anaphylactic shock is a serious and rare adverse reaction， which can be life-threatening if not treated in time. COVID-19 vaccine is a newly marketed vaccine， and people pay high attention to its adverse reactions. This report summarized the investigation and management process of a case of anaphylactic shock after inoculation with COVID-19 vaccine， in order to provide reference for standardizing the diagnosis and management of anaphylactic shock after vaccination.

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China-Russia cooperation mechanism for pandemic prevention and control in the post-pandemic era

Lizhi E ; Hongbo CHEN

Shanghai Journal of Preventive Medicine.2022;34(12):1192-1196. doi:10.19428/j.cnki.sjpm.2022.22558

Since the outbreak of COVID-19， the governments of China and Russia have strengthened their responsibilities and actively implemented border control measures. Simultaneously， good results have been achieved in the prevention and control of the pandemic in both countries. After we entered the phase of regular pandemic prevention and control， exported cases are still an important factor that should not be neglected. We need to build a mechanism to strengthen the cooperation between China and Russia in pandemic prevention and control. The article proposes building effective systems for pandemic surveillance and early warning， medical resources sharing， health department meetings， information sharing， joint prevention， academic exchanges， and personnel training.

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Association between obesity phenotype and hypertension in middle-aged and elderly adults in China： a cohort study

Yongfeng HU ; Qiang LI ; Liping LIU ; Qiqiang HE ; Gaolei LU

Shanghai Journal of Preventive Medicine.2022;34(12):1197-1200. doi:10.19428/j.cnki.sjpm.2022.22258

ObjectiveTo investigate the association between obesity phenotype and the occurrence of hypertension in middle-aged and elderly adults in China. MethodsData were obtained from the China Health and Retirement Longitudinal Study （CHARLS） in 2011 and 2015. Participants who completed two visits with ≥45 years old age at baseline were enrolled. Obesity phenotype was defined as the following four groups according to weight and metabolic status：metabolically healthy non-overweight/obesity （MHNO）， metabolically healthy overweight/obesity （MHO）， metabolically abnormal non-overweight/obesity （MANO）， and metabolically abnormal overweight/obesity （MAO）. Cox proportional risk regression model was used to analyze the relationship between obesity phenotype and the incidence of hypertension. ResultsA total of3 781 subjects with 1 775（46.95%） males and mean age of （57.76±8.57） years were included in this study. When the metabolically normal non-overweight/obese group （MHNO） was regarded as the reference group， the risk of developing hypertension was significantly increased （P<0.01） in MHO， MANO， and MAO with HRs of 1.35（1.11‒1.63）， 1.51（1.15‒1.97）， and 2.00（1.68‒2.38） respectively.ConclusionBoth MHO phenotype and MAO/MANO are significantly associated with the occurrence of hypertension in middle-aged and elderly adults.

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Epidemiological analysis on death cases of pneumoconiosis during 1959‒2019 in Chongming District of Shanghai

Jinxiang WANG ; Jiying MA ; Wendi MA ; Feng YANG ; Jing QU

Shanghai Journal of Preventive Medicine.2022;34(12):1201-1206. doi:10.19428/j.cnki.sjpm.2022.22185

ObjectiveTo study the epidemiological characteristics of deaths due to pneumoconiosis and its complications in order to improve the prevention and management of pneumoconiosis. MethodsThe pneumoconiosis deaths who died during 1959‒2019 in Chongming District of Shanghai were investigated and analyzed retrospectively by the descriptive epidemiological methods. The correlation of the age of onset and the course of disease was analyzed by Spearman rank correlation，as well as the duration of dust exposure and the course of disease in pneumoconiosis patients. ResultsFrom 1959 to 2019， there were 226 pneumoconiosis deaths， 223 males （98.67%）. The mortality of silicosis was the highest （82.07%）. The age of onset of pneumoconiosis was negatively correlated with the course of disease （r_s=-0.596，P<0.001）.There was no correlation between the duration of dust exposure and the course of disease in pneumoconiosis patients （r_s=-0.107，P=0.109）.There were statistically significant differences in mortality among groups in different types and stages of pneumoconiosis（χ²=59.250，27.666，both P<0.05）. The mortality increased with the increase of stage of pneumoconiosis. The mortality of pneumoconiosis was significantly different in 1959‒1979， 1980‒1989， 1990‒1999， 2000‒2009 and 2010‒2019 （χ²=29.750， P<0.05）. The top three causes of death in pneumoconiosis cases were respiratory diseases， malignant tumor and cardiovascular and cerebrovascular diseases.ConclusionIt is suggested to further strengthen the health monitoring and management of pneumoconiosis patients，control lung and chronic respiratory diseases to delay the life expectancy and improve quality of life of pneumoconiosis patients.

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Analysis on mortality and premature death rates of four major chronic diseases in Taizhou， Zhejiang 2011‒2018

Dongju QIAO ; Liangyou WANG ; Xueping LOU ; Wenjie CHAI ; Chaonan JIA ; Zizhu LI ; Yingyan GUO ; Xiaoxiao CHEN

Shanghai Journal of Preventive Medicine.2022;34(12):1207-1213. doi:10.19428/j.cnki.sjpm.2022.22174

ObjectiveTo analyze the characteristics of death and premature death of 4 major chronic diseases （cardiovascular and cerebrovascular diseases， malignant tumors， chronic respiratory diseases and diabetes） in Taizhou City from 2011 to 2018，and provide data basis for the government to formulate chronic disease prevention planning. MethodsThe death data of household registration residents in Taizhou City from 2011 to 2018 were derived from the Chronic Disease Surveillance Information Management System in Zhejiang Province. The death toll ratio of chronic diseases， the mortality rate of chronic diseases， the probability of premature death of chronic diseases were analyzed. The standardization rate was calculated six times in 2010. Population composition of the census. The Joinpoint Regression Program 4.2 software was used for calculating annual percent change （APC） and its statistical test results. ResultsFrom 2011 to 2018， there were 231 724 chronic disease deaths in Taizhou City， with a mortality rate of 486.52/10⁵ and a standardized mortality rate of 381.55/10⁵. The proportion of chronic disease deaths to total deaths was 79.89%， of which males were higher than females and rural areas were higher than urban areas.From 2011 to 2018， the standardized mortality and early death probability of cardiovascular and cerebrovascular diseases， malignant tumors and chronic respiratory diseases in Taizhou showed a downward trend （P<0.05）， the standardized mortality of diabetes （P=0.46） and the early death probability （P=0.22） did not decline， and the mortality of all age groups of the above four types of chronic diseases in rural areas was higher than that in urban areas. The mortality of the four types of chronic diseases from high to low are cardiovascular and cerebrovascular diseases， malignant tumors， chronic respiratory diseases and diabetes， and the mortality tends to increase with age. From 2011 to 2018， the probability of premature death from four types of chronic diseases in Taizhou City showed a downward trend， from 13.49% in 2011 to 10.49% in 2018， with an average annual decrease of 2.97%. The difference was statistically significant （t=‒5.83，P<0.05）. ConclusionChronic disease death is the main cause of death in Taizhou City. In order to reduce the mortality rate of chronic diseases， effective prevention and control measures for chronic diseases should be carried out， especially the prevention and control of diabetes and male chronic diseases.

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Analysis of cerebrovascular disease between 1996 and 2021 in Minhang District of Shanghai

Linli CHEN ; Lijing CHEN ; Jingyi NI ; Shuili XUAN ; Wei LIU ; Xiuhong TIAN ; Yiqin GU ; Ruonan HUANG ; Weibing WANG

Shanghai Journal of Preventive Medicine.2022;34(12):1214-1218. doi:10.19428/j.cnki.sjpm.2022.22330

ObjectiveTo analyze the changing trend of cerebrovascular disease burden in Minhang District of Shanghai from 1996 to 2021， and to provide scientific evidence for government to formulate targeted cerebrovascular disease prevention and control strategies. MethodsMortality， years of life lost（YLL）， years of lived with disability（YLD） and disability⁃adjusted life years（DALY） were used to evaluate the burden of cerebrovascular diseases in Minhang District. Joinpoint linear regression was used to analyze the trend of disease burden. ResultsFrom 1996 to 2021， the YLL rate of cerebrovascular diseases in Minhang District showed a downward trend （whole population： APC=-1.69%， t=-6.9， P<0.05）， The YLD rate of cerebrovascular diseases showed a slow upward trend （whole population： APC=1.17%， t=3.5， P<0.05）， The DALY rate of cerebrovascular diseases showed a downward trend， and fluctuated since 2003 （whole population： APC= -1.43%， t=-5.6， P<0.05）. The YLL rate of cerebrovascular diseases in men was higher than that in women， and the YLD rate of cerebrovascular diseases in women was higher than that in men. After 2014， the DALY of cerebrovascular diseases in men was higher than that in women. With the increase of age， the burden of cerebrovascular diseases increased， and the burden of disease increased significantly in the age group above 70. ConclusionThe burden of cerebrovascular diseases in Minhang District is at a high level， and there are differences in age， gender and other aspects. Measures such as screening， intervention and rehabilitation need to be improved to reduce disability and premature death caused by cerebrovascular diseases and to reduce the burden of cerebrovascular diseases on individuals， families and society.

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Analysis of late detection of HIV/AIDS cases aged 50 years and above in Jilin Province

Yan HU ; Jixiang FAN ; Baihong QIU ; Lining HUANG ; Zixuan LI ; Na LI ; Dan WU

Shanghai Journal of Preventive Medicine.2022;34(12):1219-1223. doi:10.19428/j.cnki.sjpm.2022.22614

ObjectiveTo investigate the late detection of HIV/AIDS cases in the elderly in Jilin Province and analyze its influencing factors， to provide theoretical basis for improving their life quality. MethodsThe first CD4 values of HIV/AIDS patients aged 50 years and above living in Jilin Province were used to estimate late detection， and the influencing factors of late detection in elderly cases were analyzed. ResultsThe average CD4 cell count of newly reported HIV/AIDS cases aged 50 and above in Jilin Province from 1996 to 2021 was （230.55±191.97）， the low value group accounted for the largest proportion （50.8%）， and the late detection rate was 59.3% （1397/2325）. The late detection cases were mainly from sexual transmission （46.8% for same-sex and 48.2% for heterosexual contact）. From the perspective of sample sources， most of the late detection patients were diagnosed while testing for other illnesses， followed by testing and consulting. In terms of contact history， the late detection of cases of men who have sex with men was higher. The binary logistic regression analysis showed that gender， marriage， sample source and report year were the factors affecting the late detection of AIDS. The late detection rate of males was higher， and cases of married couples were more likely to be late detection. With the increase of report year， the late detection rate decreased， and testing and counseling could effectively reduce the late detection rate of AIDS. ConclusionThe CD4 cell count in the first detection of HIV/AIDS in the elderly in Jilin Province is low， and the late detection rate of male cases is high. In recent years， the expansion of voluntary counseling and testing in Jilin Province has effectively reduced the late detection rate of HIV/AIDS. At the same time， sex education should be strengthened for the elderly， healthy marital relationships should be advocated and more attention should be paid to the mental health of the elderly.

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Field epidemiological investigation of a varicella outbreak in a school of Nanxun District， Huzhou

Caiwei PENG ; Liping YANG ; Binhui LIU

Shanghai Journal of Preventive Medicine.2022;34(12):1224-1228. doi:10.19428/j.cnki.sjpm.2022.20839

ObjectiveTo determine the epidemiological characteristics and transmission factors of a varicella outbreak in a school in Nanxun District of Huzhou City， and assess the effect of prevention and control measures， which may provide scientific evidence for improvement in the response to varicella outbreak. MethodsData were collected by field epidemiological survey and analyzed by descriptive epidemiology. Statistical analysis was performed by SPSS 22.0 software. ResultsA total of 80 varicella cases were identified in this outbreak， which lasted 68 days. There were four peaks of incidence， involving 21 classes. The total incidence rate was determined to be 4.14%. Before the public health intervention， some cases were not isolated in time， which led to the initial spread in the class. After the mid-term examination， the outbreak further spread to multiple classes. Breakthrough varicella cases accounted for 48.75% of all the cases in the outbreak， among which 94.87% had been vaccinated for more than five years. However， there was no significant difference in the incidence of fever and rash between the breakthrough cases and non-breakthrough cases（P>0.05）. ConclusionTimely report， prompt response， and strict implementation of prevention and control measures remain crucial for effective containment of varicella outbreak.

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