湖北省某中学因面条引起诺如病毒感染性腹泻暴发

目的分析湖北省某中学一起诺如病毒感染性腹泻暴发疫情的流行病学因素,为制定防控措施提供依据。方法采用现场流行病学的方法,对病例进行调查,运用描述性流行病学方法、病例对照方法对暴发疫情数据和各种因素进行分析。结果疫情涉及91例疑似病例和2名隐性感染者,罹患率为33.8%(91/269)。4名厨工中,2名为隐性感染者。首发病例为八(2)班学生,发病日期为2017年2月15日7∶30。69.2%(63/91)的病例在2月15日8∶00～24∶00发病,发病时间中位数为2月15日16∶00。病例对照研究结果提示,进食2月14日早餐热干面发病风险增加[比值比(OR)=9.93,95%置信区间(95%CI)为1.17～84.04]。结论此次事件为一起由诺如病毒引起的感染性腹泻暴发疫情,在诺如病毒感染性腹泻高发季节,应继续加强对学校诺如病毒感染性腹泻疫情监测,积极开展健康教育,有效预防诺如病毒感染性腹泻暴发疫情的发生。     

The economic value of quarantine is higher at lower case prevalence,with quarantine justified at lower risk of infection

Some infectious diseases, such as COVID-19 or the influenza pandemic of 1918, are so harmful that they justify broad-scale social distancing. Targeted quarantine can reduce the amount of indiscriminate social distancing needed to control transmission. Finding the optimal balance between targeted versus broad-scale policies can be operationalized by minimizing the total amount of social isolation needed to achieve a target reproductive number. Optimality is achieved by quarantining on the basis of a risk threshold that depends strongly on current disease prevalence, suggesting that very different disease control policies should be used at different times or places. Aggressive quarantine is warranted given low disease prevalence, while populations with a higher base rate of infection should rely more on social distancing by all. The total value of a quarantine policy rises as case counts fall, is relatively insensitive to vaccination unless the vaccinated are exempt from distancing policies, and is substantially increased by the availability of modestly more information about individual risk of infectiousness.     

Quantification of bovine leukemia virus proviral DNA using a low-cost real-time polymerase chain reaction

The detection of bovine leukemia virus (BLV) proviral DNA is an important tool to address whether an animal is infected with BLV. Compared with serological assays, real-time PCR accounts for greater sensitivity and can serve as a confirmatory test for the clarification of inconclusive or discordant serological test results. However, the high cost related to real-time PCR assays has limited their systematic inclusion in BLV surveillance and eradication programs. The aim of the present study was to validate a low-cost quantitative real-time PCR. Interestingly, by using SYBR Green detection dye, we were able to reduce the cost of a single reaction by a factor of 5 compared with most common assays based on the use of fluorogenic probes (i.e., TaqMan technology). This approach allowed a highly sensitive and specific detection and quantification of BLV proviral DNA from purified peripheral blood leukocytes and a milk matrix. Due to its simplicity and low cost, our in-house BLV SYBR quantitative real-time PCR might be used either as a screening or as a confirmatory test in BLV control programs.     

从一起疑似产气荚膜梭菌食源性疾病暴发调查反思实验室依赖的病因筛查思路

目的调查一起急性胃肠炎暴发的原因,并对当前基层疾病预防控制机构在食源性疾病暴发流行病学调查中有关样品和标本采集后,致病因子的筛查思路进行了分析探讨。方法制定病例定义,开展病例搜索和个案调查,采用描述性流行病学方法分析事件特征;开展病例对照研究探讨危险因素和现场卫生学调查追溯原因。采集病例标本和环境样品进行致病菌分离。结果共搜索病例43例,临床表现主要以腹泻(100.0%,43/43)、腹痛(93.0%,40/43)、恶心(32.6%,14/43)等为主。流行曲线符合点源暴发模式,可疑餐次为2013年9月12日午餐,病例对照研究结果提示烧鸭为可疑食物(OR=4.0,95%CI为1.04~15.23)。共采集各类样品和标本36份,在13份病例肛拭子中分离培养出产气荚膜梭菌5份,阳性率为38.5%。结论该事件为一起疑似产气荚膜梭菌食源性疾病暴发,可能危险因素为烧鸭烤熟后在室温下长时间(约5~6 h)缓慢冷却后受污染,且未经重新加热直接进食所致。建议加强对餐饮机构厨师的监督管理,防止类似事件再次发生。基层流行病学调查人员应摒弃"实验室依赖"的惯性思维,加强对各种致病因子"症状流行病学"知识的归纳总结,以降低在各种食源性疾病暴发中,因不熟悉疾病临床特征而导致的误判和漏检。     

Campylobacter: An overview of cases,occurrence in food,contamination sources,and antimicrobial resistance in Brazil

Campylobacter has been the most prevalent microorganism associated with foodborne gastroenteritis in developed countries in the last years. The consumption of contaminated chicken meat is the main source of campylobacteriosis in humans. However, in developing countries, Campylobacter has not been recognized as a food safety problem. Here, we provide an overview of studies focusing on occurrence of Campylobacter in Brazilian chicken processing chain, epidemiological data, contamination sources, antimicrobial resistance and fields where more studies are needed. Over the past 15 years, only five foodborne outbreaks involving 37 cases of campylobacteriosis were reported in Brazil. However, the occurrence of Campylobacter in samples of carcasses and chicken products was about 32.7%, and the microbial load ranged from <0.30 to 5.15 log10 CFU. This pathogen was also found in feces, caecum, intestine and cloaca of chicken (50.9%), chicken litter (65.4%), and water (13.7%). The most prevalent species identified in the studies were C. jejuni (80%) and C. coli (19.6%). In addition, high antimicrobial resistance rates were noted for cephalosporins (98.5–100%), quinolones (84.5%), and fluoroquinolones (77.6–82.8%). This review demonstrates that Campylobacter seems to be an important pathogen in the chicken processing chain and, consequently, for public health in Brazil.     

Predicting undetected infections during the 2007 foot-and-mouth disease outbreak

Active disease surveillance during epidemics is of utmost importance in detecting and eliminating new cases quickly, and targeting such surveillance to high-risk individuals is considered more efficient than applying a random strategy. Contact tracing has been used as a form of at-risk targeting, and a variety of mathematical models have indicated that it is likely to be highly efficient. However, for fast-moving epidemics, resource constraints limit the ability of the authorities to perform, and follow up, contact tracing effectively. As an alternative, we present a novel real-time Bayesian statistical methodology to determine currently undetected (occult) infections. For the UK foot-and-mouth disease (FMD) epidemic of 2007, we use real-time epidemic data synthesized with previous knowledge of FMD outbreaks in the UK to predict which premises might have been infected, but remained undetected, at any point during the outbreak. This provides both a framework for targeting surveillance in the face of limited resources and an indicator of the current severity and spatial extent of the epidemic. We anticipate that this methodology will be of substantial benefit in future outbreaks, providing a compromise between targeted manual surveillance and random or spatially targeted strategies.     

An 8-year longitudinal study of the natural history of threshold, subthreshold, and partial eating disorders from a community sample of adolescents.

The authors examined the natural history of threshold, subthreshold, and partial eating disorders in a community sample of 496 adolescent girls who completed annual diagnostic interviews over an 8-year period. Lifetime prevalence by age 20 years was 0.6% and 0.6% for threshold and subthreshold anorexia nervosa (AN), 1.6% and 6.1% for threshold and subthreshold bulimia nervosa (BN), 1.0% and 4.6% for threshold and subthreshold binge-eating disorder (BED), and 4.4% for purging disorder (PD). Overall, 12% of adolescents experienced some form of eating disorder. Subthreshold BN and BED and threshold PD were associated with elevated treatment, impairment, and distress. Peak age of onset was 17–18 years for BN and BED and 18–20 years for PD. Average episode duration in months was 3.9 for BN and BED and 5.1 for PD. One-year recovery rates ranged from 91% to 96%. Relapse rates were 41% for BN, 33% for BED, and 5% for PD. For BN and BED, subthreshold cases often progressed to threshold cases and diagnostic crossover was most likely for these disorders. Results suggest that subthreshold eating disorders are more prevalent than threshold eating disorders and are associated with marked impairment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

奶粉中阪崎克罗诺杆菌耐干燥性与MLST分型的研究

为了解奶粉中阪崎克罗诺杆菌耐干燥性及多位点序列分型(multilocus sequence typing,MLST)间的关系,对实验室保存的35株阪崎克罗诺杆菌进行干燥试验,并采用MLST对所有菌株进行分子遗传学分析。经过6 d干燥试验处理,结果显示,35株阪崎克罗诺杆菌中,耐干燥能力较强的IQCC10409(1号)、IQCC10455(6号)和110609-3(31号)菌株失活率分别为63.73 %、56.94 %和44.43 %,其中31号菌株耐干燥能力最强,它们分别属于ST73、ST73和ST23型。MLST分析表明,全部菌株共分成16个不同的序列型(sequence type,ST),其中,属于ST1型(20号、24号、27号、28号、33号)和ST4型(4号、6号、7号、9号、11号)的菌株较多,分别有5株菌。结果表明阪崎克罗诺杆菌基因多样性程度较高,而耐干燥性较强的菌株主要集中于ST73和ST4型,另外还发现,即使相同ST型的菌株,其耐干燥能力也不定相同。     

食用小麦后运动诱发过敏反应的研究进展

食用小麦后运动诱发的过敏反应(WDEIA)是一种罕见的,但可能是严重的由IgE介导的食物过敏.单独摄入小麦并不会引起任何症状.然而,当摄入小麦后伴随运动、服用非甾体抗炎药、摄入乙醇时,将引发瘙痒、荨麻疹、血管性水肿、呼吸困难、低血压等过敏反应症状,严重者可致过敏性休克.为避免严重过敏反应,及时准确诊断尤为重要.然而由于...