Since 2007, the annual incidence of human rabies in China has been continuously decreasing, and China has entered the critical stage of eliminating human rabies. China will prioritize the control of rabies among dogs as the primary task for human rabies prevention and control, and implement surveillance and containment strategies, while also focusing on improving the standardization of post-exposure prophylaxis (PEP) for rabies. The sufficient production capacity of rabies immune preparations in China provides good biological product guarantee conditions for rabies prevention and control. However, dog management issues are prominent in China, not only affecting canine immunization, but also leading to a high number of canine injuries, resulting in huge costs for human rabies PEP. China lags behind in developing cheaper and more efficient rabies vaccines, which can help more rabies-exposed individuals obtain PEP. There are no insurmountable technical barriers in rabies prevention and control in China, and the prospect of achieving the elimination of human rabies by 2030 in China is promising.

Objective:To analyze the epidemiological characteristics of rabies in China from 2007 to 2023, and to provide reference evidence for tailoring strategies to facilitate the elimination of rabies in the country.Methods:Case data from 2007 to 2023 were obtained from China′s National Notifiable Infectious Disease Reporting Information System, and the spatial, temporal, and demographic features of cases were analyzed.Results:From 2007 to 2023, a total of 18 751 human rabies cases were reported in China, with an average annual incidence rate of 0.08 per 100 000. The average annual percentage change (AAPC) in incidence rate was -18.58% (95% CI: -21.32% to -15.75%, P<0.05), with three significant turning points in 2011, 2018, and 2021. Based on the trend of the epidemic, Chinese provinces can be roughly divided into five categories. The geographical range affected by rabies has decreased from 23 provinces and 984 counties (districts) in 2007 to 17 provinces and 101 counties (districts) in 2023. Since 2019, the high-incidence counties (districts) have been mainly concentrated in the southwestern part of Hunan, the southern part of Henan, and the western part of Anhui. Fourteen provinces have reported no cases for at least two consecutive years. Males (70.24%) and farmers (72.18%) were the main affected groups, and the proportion of cases aged 65 and above increased from 17.43% in 2007 to 36.07% in 2023. Conclusions:The incidence of rabies in China has changed from endemic in many areas to sporadic, with the remaining endemic regions mainly located in parts of the middle and lower reaches of the Yangtze River. The main vulnerable groups are middle-aged and elderly farmers. The current prevention and control measures can effectively curb the transmission of rabies, but the decline of cases has slowed down recently.

Non-neonatal tetanus is an acute, specific, toxic disease in patients over 28 days of age, characterized by continuous rigidity and paroxysmal spasms of the skeletal muscles throughout the body caused by the intrusion of Clostridium tetani through skin or mucosal membrane into the body and reproducing in anaerobic environments to produce exotoxins. The mortality rate of severe patients is close to 100% without medical intervention. Even with aggressive comprehensive treatment, the global mortality rate remains at 30%-50%, making it a potentially fatal disease. In order to standardize the diagnosis, treatment and prevention of non-neonatal tetanus, based on "Regulation for Diagnosis and Treatment of Non-neonatal Tetanus (2019 Edition)", experts have revised this regulation according to clinical practice and recent research progress in this field to guide medical institutions in the prevention and control of non-neonatal tetanus. This article interprets the key points and basis for updating the 2024 edition regulation to guide clinical implementation and application.

Patients with severe trauma require an extremely timely treatment and transfusion plays an irreplaceable role in the emergency treatment of such patients. An increasing number of evidence-based medicinal evidences and clinical practices suggest that patients with severe traumatic bleeding benefit from early transfusion of low-titer group O whole blood or hemostatic resuscitation with red blood cells, plasma and platelet of a balanced ratio. However, the current domestic mode of blood supply cannot fully meet the requirements of timely and effective blood transfusion for emergency treatment of patients with severe trauma in clinical practice. In order to solve the key problems in blood supply and blood transfusion strategies for emergency treatment of severe trauma, Branch of Clinical Transfusion Medicine of Chinese Medical Association, Group for Trauma Emergency Care and Multiple Injuries of Trauma Branch of Chinese Medical Association, Young Scholar Group of Disaster Medicine Branch of Chinese Medical Association organized domestic experts of blood transfusion medicine and trauma treatment to jointly formulate Chinese expert consensus on blood support mode and blood transfusion strategies for emergency treatment of severe trauma patients ( version 2024). Based on the evidence-based medical evidence and Delphi method of expert consultation and voting, 10 recommendations were put forward from two aspects of blood support mode and transfusion strategies, aiming to provide a reference for transfusion resuscitation in the emergency treatment of severe trauma and further improve the success rate of treatment of patients with severe trauma.

The purified Vero cell rabies vaccine (PVRV) has been used in rabies prevention for more than 40 years. A comprehensive review of the relevant researches on PVRV in rabies prevention at local and overseas in recent years shows that in the simplified Zagreb immunization program, PVRV has the similar immunogenicity and safety as in the standard Essen program. PVRV, purified chicken embryo cell rabies vaccine (PCECV) and human diploid cell rabies vaccine (HDCV) have similar immunogenicity and safety. PVRV also has good immunogenicity and safety in special populations such as those with diseases. The combined vaccination of PVRV and acellular diphtheria, tetanus, pertussis and inactivated poliomyelitis combined vaccine (DTP-IPV) or others did not find immune interference, which provided feasibility for children to vaccinate against rabies at the same time of vaccinating with planned vaccines. The combination of PVRV and equine rabies immunoglobulin can also achieve better prevention effect. PVRV plays an important role in the prevention of rabies, and its wide application will make a positive contribution to achieving the goal of eliminating rabies transmitted from dogs to humans by 2030 proposed by World Health Organization (WHO).

Rabies is one of the important zoonotic infectious diseases, with a mortality rate of almost 100%. Rabies is a vaccine preventable disease, and proper rabies exposure prophylaxis can effectively prevent the occurrence of human rabies. In recent years, there has been significant progress in clinical research on the rabies exposure prophylaxis both domestically and internationally. World Health Organization (WHO) released the Rabies Vaccine: WHO Position Paper-April 2018. In order to guide medical institutions of all levels in rabies exposure prophylaxis, the National Administration of Disease Prevention and Control, in conjunction with the National Health Commission of the People's Republic of China, organized the Rabies Vaccine Working Group of the National Immunization Program Technical Working Group and invited experts to revise and issue the National Regulation for the Rabies Exposure Prophylaxis (2023 Edition). This article compares the National Regulation for the Rabies Exposure Prophylaxis (2009 Edition) and interprets the updated key points and supporting basis of the new version of the guidelines to guide clinical application and implementation.

Objective:To analyze the epidemiological characteristics of severe fever with thrombocytopenia syndrome (SFTS) in China from 2011 to 2021, and provide evidence for the prevention and control of SFTS.Methods:The incidence data of SFTS were collected from the National Disease Reporting Information System of Chinese Center for Disease Control and Prevention for a descriptive epidemiological analysis and Cochran-Armitage trend test was used to evaluate the association between age and the morbidity rate and case fatality rate (CFR) of SFTS.Results:From 2011 to 2021, a total of 18 902 laboratory confirmed cases of SFTS, including 966 deaths, were reported in 533 counties (districts) of 154 prefecture-level cities in 27 provinces. The annual average morbidity rate was 0.125/100 000, and the annual average CFR was 5.11%. From 2011 to 2021 the overall morbidity rate of SFTS was in increase with an average annual percentage change (AAPC) of 14.80% ( P=0.001). Most cases (99.23%) occurred in 7 provinces, including Shandong, Henan, Anhui, Hubei, Liaoning, Zhejiang and Jiangsu, with 70.28% of the cases in 11 prefecture-level cities. The average annual CFRs in the 7 provinces varied greatly from 1.30% to 11.27%. In 2011, SFTS cases were reported in 108 counties (districts) of 51 prefecture-level cities in 13 provinces, but SFTS cases were reported in 277 counties (districts) of 88 prefecture-level cities in 19 provinces in 2021, the disease spread from central area to the northeast and from the west and the south. SFTS mainly occurred in summer and autumn in both southern and northern China, and 96.63% of the cases were reported from April to October, and the incidence peak was during May-June. The cases mainly occurred in age group 50-74 years (69.46%), and the deaths mainly occurred in age group ≥60 years (79.71%). Both the morbidity rate and the CFR increased with age. The morbidity rate increased from 0.040/100 000 in age group 0-4 years to 4.480/100 000 in age group ≥80 years in males ( χ2=13 185.21, P<0.001) and from 0.038/100 000 in age group 0-4 years to 3.318/100 000 in age group ≥80 years in females ( χ2=12 939.83, P<0.001); the CFR increased from 0.70% in age group 30-34 years to 11.58% in age group ≥80 years in males ( χ2=115.70, P<0.001) and from 1.56% in age group 35-39 years to 8.98% in age group ≥80 years in females ( χ2=103.42, P<0.001). Conclusion:From 2011 to 2021, the incidence of SFTS increased in China, and the spread and obvious spatiotemporal distribution of SFTS were observed. The reported CFR varied greatly with area, and both the morbidity and mortality risk were high in the elderly.

Objective:To understand the epidemiological characteristics of rabies in China from 2007 to 2018, and to provide reference information for formulating strategies to eliminate rabies.Methods:The incidence data were obtained from the national notifiable communicable disease reporting information system in China to analyze the spatial, population and time distribution of human rabies cases.Results:From 2007 to 2018, 17 848 cases of human rabies were reported nationwide. 57% of the cases were reported in 6 provinces, including Guangxi, Guangdong, Guizhou, Hunan, Henan and Sichuan. A total of 37 counties reported more than 50 cases. The number of reported cases decreased from 3 300 in 2007 to 422 in 2018, with an average annual decline rate of 7%. The number of districts and counties involved decreased from 984 in 2007 to 308 in 2018. The population aged 35-75 years accounted for 67%, followed by the population aged 0-15 years (17%). Farmers accounted for 70% of the total number of cases, followed by students (11%) and scattered children (6%).Conclusions:China′s human rabies epidemic has changed from a regional epidemic to a multi-regional spread.

In December 2019, novel coronavirus pneumonia epidemic occurred in Wuhan, Hubei Province, and spread rapidly across the country. In the early stages of the epidemic, China adopted the containment strategy and implemented a series of core measures around this strategic point, including social mobilization, strengthening case isolation and close contacts tracking management, blocking epidemic areas and traffic control to reduce personnel movements and increase social distance, environmental measures and personal protection, with a view to controlling the epidemic as soon as possible in limited areas such as Wuhan. This article summarizes the background, key points and core measures in the country and provinces. It sent prospects for future prevention and control strategies.

Objective:To analyze the epidemiological characteristics of outbreaks of dengue fever in China from 2015 to 2018, and provide evidence for the prevention and control of dengue fever.Methods:We extracted the incidence data of dengue fever from China Disease Prevention and Control Information System, Public Health Emergency Reporting Management Information System and Vector Biological Monitoring System, and explored the epidemiological characteristics of the outbreaks in the past four years. Excel 2010 software and SPSS 20.0 software were used for data processing and analysis, ArcGIS 10.5 software was used for mapping.Results:A total of 111 outbreaks of dengue fever were reported nationwide from 2015 to 2018, involving 12 490 cases, accounting for 73.7% of the total cases in China. These outbreaks occurred in 85 counties and districts of 4 provinces, namely Guangdong (77 outbreaks), Yunnan (14 outbreaks), Zhejiang (8 outbreaks) and Fujian (8 outbreaks). The outbreaks occurred during May-November. Small-scale outbreaks with no more than 10 cases ended within 30 days (28/34, 82.4%) and larger-scale outbreaks lasted for several months. Dengue virus type 1 and type 2 were the main epidemic pathogens of dengue fever outbreaks in China. The outbreaks mainly occurred in areas with high population density and poor sanitary environment. There were significant differences in the age and occupational composition of the cases in the main outbreak provinces.Conclusions:Outbreaks of dengue fever can been seen in more areas in China, even in high latitudes areas. The epidemiologic characteristics of the outbreaks were different among provinces, showing as port type, rural type and urban type. Each province should adjust the control strategies accordingly.