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 understand the epidemiological characteristics of influenza in Hebei Province from 2018 to 2019, and to analyze the characteristics and variation of hemagglutinin(HA) gene of influenza B-Victoria(BV) strains.Methods:Throat swab specimens of influenza-like cases within 3 days of fever were collected from 28 sentinel hospitals in Hebei province, meanwhile, The surveillance data was collected by the Chinese National Influenza Surveillance Network from April 2018 to March 2019, Throat swab specimens were collected from patients with influenza-like symptoms in sentinel hospitals, and tested by RT-PCR and virus isolation. 14 influenza B-Victoria strains from different regions were selected to sequence HA gene, Phylogenetic tree and the molecular characteristics were analyzed by DNASTAR 7.0 and Mega-X software.Results:From 2018 to 2019, A total of 99 266 cases of influenza-like illness (ILI) were detected from 4 689 103 cases by 28 influenza sentinel hospitals in Hebei Province, the visit percentage of ILI was 2.12%. During the period, 18 730 samples were detected, and 2 752(14.69%) samples were positive tested by RT-PCR, the peak was in the third week of 2019(44.92%), In the early stage of epidemic season, Influenza A(H1N1)pdm09 virus was the main type, while BV virus was the main type in the late stage. HA gene sequence analysis showed that the 14 BV viruses belonged to 162-164 amino acid deletion strains, the amino acid homology between HA sequences was 97.16%-100.00%, and 97.16%-98.95% compared with the vaccine strain B/Colorado/06/2017 recommended by WHO. Compared with the vaccine strains, 14 strains involved 11 amino acid site mutations.Conclusion:Influenza was prevalent in winter and spring in Hebei province from 2018 to 2019, Multiple mutations in antigenic sites of BV viruses might be related to the outbreaks.

Objective:To understand the epidemic characteristics of influenza A (H1N1)pdm09 and hemagglutinin (HA) gene mutations in Hebei province from 2017 to 2020, in order to provide scientific basis for the prevention and control of influenza.Methods:The analysis was conducted on the data of Hebei province, which was down loaded from the Chinese National Influenza Surveillance Network from April 2017 to March 2020, and 37 influenza A (H1N1)pdm09 strains were selected for sequencing and evolutionary analysis of HA gene.Results:A total of 57 670 throat swabs from influenza like illness (ILI) patients in Hebei province were detected, and 8 569 samples were positive for the viral nucleic acid, with the positive rate of 14.86%, influenza A (H1N1)pdm09 accounted for 40.52% (3 472/8 569). The cases were detected throughout the whole 11 regions of Hebei province. All age groups were infected by influenza A (H1N1) virus, and the highest detection rate was in the 25- year age group, the peak detection rate was in winter and spring seasons. The HA genes of 37 strains of influenza A (H1N1) virus belong to 6B.1 branch, and the amino acid homology is from 97.31% to 100.00%. S74R, S164T, S183P and I295V were the major amino acid variation sites in 2017-2018 influenza season. S183P, H126Y, N129D, T185I, L233I and N260D were the major amino acid variation sites of epidemic strains in 2018-2019 influenza season. The variation sites of D187A and Q189E of epidemic strains were found in 2019-2020 influenza season.Conclusions:The prevalence of influenza A(H1N1) pdm09 in Hebei province has an obvious seasonality. The HA gene and its encoded amino acid have been mutating gradually. The strains which were isolated recently were clustered with the 2020-2021 season northern hemisphere vaccine strain A/Guangdong-Maonan/SWL1536/2019.

Objective:To understand the influence and lag effect of meteorological factors on the incidence of hand, foot and mouth disease (HFMD) in Shijiazhuang.Methods:The daily incidence data of HFMD in Shijiazhuang during 2017-2019 were collected from Chinese Information System for Disease Control and Prevention. The hourly meteorological data were collected form meteorological stations of Shijiazhuang of Chinese meteorological data network. The distributed lag nonlinear model was built for statistical analysis by software R 3.6.2.Results:When the daily average temperature was 15-26 ℃, the risk of incidence of HFMD increased at lag 3-6 days. However, the risk was highest when the temperature was 25 ℃ at lag 3 days ( RR=1.03,95% CI:1.00-1.06). When the daily average relative humidity was more than 80%, the risk of incidence of HFMD increased at lag 5-18 days. However, the risk was highest at lag 9 days ( RR=1.04, 95% CI: 1.02-1.06).When the daily average air pressure ranged from 999 hPa to 1 007 hPa, the risk of incidence of HFMD increased at lag 5-8 days. However, the risk was highest at lag 6 days ( RR=1.01, 95% CI: 1.00-1.02).When the daily average precipitation ranged from 15 to 32 mm, the risk of incidence of HFMD increased at lag 3-18 days. However, the risk was highest at lag 6 days ( RR=1.11, 95% CI: 1.02-1.19). Conclusions:Meteorological factors increased the risk of incidence of HFMD such as higher daily average temperature (15-26 ℃), higher daily average humidity (>80%), lower daily average air pressure (999-1 007 hPa) and higher daily average precipitation (15-32 mm) in Shijiazhuang during 2017-2019. They were all correlated with the incidence of HFMD with certain lag days. It is suggested to use these meteorological indicators for the early warning of HFMD.

Objective:To understand the epidemiological characteristics of influenza in Hebei Province from 2018 to 2019, and to analyze the characteristics and variation of hemagglutinin(HA) gene of influenza B-Victoria(BV) strains.Methods:Throat swab specimens of influenza-like cases within 3 days of fever were collected from 28 sentinel hospitals in Hebei province, meanwhile, The surveillance data was collected by the Chinese National Influenza Surveillance Network from April 2018 to March 2019, Throat swab specimens were collected from patients with influenza-like symptoms in sentinel hospitals, and tested by RT-PCR and virus isolation. 14 influenza B-Victoria strains from different regions were selected to sequence HA gene, Phylogenetic tree and the molecular characteristics were analyzed by DNASTAR 7.0 and Mega-X software.Results:From 2018 to 2019, A total of 99 266 cases of influenza-like illness (ILI) were detected from 4 689 103 cases by 28 influenza sentinel hospitals in Hebei Province, the visit percentage of ILI was 2.12%. During the period, 18 730 samples were detected, and 2 752(14.69%) samples were positive tested by RT-PCR, the peak was in the third week of 2019(44.92%), In the early stage of epidemic season, Influenza A(H1N1)pdm09 virus was the main type, while BV virus was the main type in the late stage. HA gene sequence analysis showed that the 14 BV viruses belonged to 162-164 amino acid deletion strains, the amino acid homology between HA sequences was 97.16%-100.00%, and 97.16%-98.95% compared with the vaccine strain B/Colorado/06/2017 recommended by WHO. Compared with the vaccine strains, 14 strains involved 11 amino acid site mutations.Conclusion:Influenza was prevalent in winter and spring in Hebei province from 2018 to 2019, Multiple mutations in antigenic sites of BV viruses might be related to the outbreaks.

Dengue viruses(DENV) are seriously affected by cell autophagy in intracellular replication,transmission between host,and the pathogenic mechanism.Here,the latest research progress of complex interplay between DENV and cell autophagy were reviewed in this paper.Autophagy,a cellular procedural protein degradation pathway generally possessed by all eukaryotes plays a key role in response to outside pressure and maintaining cellular homeostasis.This catabolic pathway also promotes cell survival against the invasion of pathogens such as various viruses.However,autophagy plays an opposite role in the replication of DENV.Autophagy not only provides a replication site for viruses to replicate,but also provides a source of energy for this process.Cell autophagy also participates in the pathogenesis of some DENV infection.In short,autophagy contributes to the replication of DENV.

Objective:To understand the epidemiological characteristics of cases with severe and fatal hand, foot, and mouth disease (HFMD) caused by other enterovirus in Hebei province, 2013-2017. Genetic characteristics of the main pathogen cosackie virus A6 (CoxA6) were also analyzed to further clarifying the characteristics and rules of genetic evolution on this virus.Methods:Descriptive epidemiological methods were used to analyze the distribution of severe and fatal cases with HFMD caused by other enterovirus in Hebei, 2013-2017. The VP1 sequences of CoxA6 were phylogenetically analyzed, using the Mega 5.2 software package.Results:A total of 86 severe and fatal cases with HFMD caused by other enterovirus were reported, accounting for 1.12%, comparing to all the HFMD caused by other enterovirus. Cases began to rise in April, and peaked in May-July. 65.12% of the cases occurred in children between 1 and 5 years old. The sex ratio between male and female was 1.39∶1. A total of 93.02% of the cases were children outside the child care settings. A total of 39 positive strains were identified, with positive isolation rate as 45.35%. Phylogenetic analysis on the VP1 sequences of CoxA6 strains in this study revealed that CoxA6 strains belonged to sub-genotypes D3a and D3b.Conclusions:Severe and fatal HFMD cases that caused by other enterovirus in Hebei province was with seasonal feature, consistent with the overall trend of this disease, 2013-2017. No new evolutionary branch appeared in the CoxA6 strain.

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).

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.