The incidence of scarlet fever has increased dramatically in recent years in Chongqing, China, but there has no effective method to forecast it. This study aimed to develop a forecasting model of the incidence of scarlet fever using a seasonal autoregressive integrated moving average (SARIMA) model. Monthly scarlet fever data between 2011 and 2019 in Chongqing, China were retrieved from the Notifiable Infectious Disease Surveillance System. From 2011 to 2019, a total of 5073 scarlet fever cases were reported in Chongqing, the male-to-female ratio was 1.44:1, children aged 3-9 years old accounted for 81.86% of the cases, while 42.70 and 42.58% of the reported cases were students and kindergarten children, respectively. The data from 2011 to 2018 were used to fit a SARIMA model and data in 2019 were used to validate the model. The normalised Bayesian information criterion (BIC), the coefficient of determination (R2) and the root mean squared error (RMSE) were used to evaluate the goodness-of-fit of the fitted model. The optimal SARIMA model was identified as (3, 1, 3) (3, 1, 0)12. The RMSE and mean absolute per cent error (MAPE) were used to assess the accuracy of the model. The RMSE and MAPE of the predicted values were 19.40 and 0.25 respectively, indicating that the predicted values matched the observed values reasonably well. Taken together, the SARIMA model could be employed to forecast scarlet fever incidence trend, providing support for scarlet fever control and prevention.
So far, Google Trend data have been used for influenza surveillance in many European and American countries; however, there are few attempts to apply the low-cost surveillance method in Asian developing countries. To investigate the correlation between the search trends and the influenza activity in Asia, we examined the Google query data of four Asian developing countries.
Abstract Background The coronavirus disease 2019 (COVID-19) epidemic has been largely controlled in China, to the point where case fatality rate (CFR) data can be comprehensively evaluated. Methods Data on confirmed patients, with a final outcome reported as of 29 March 2020, were obtained from official websites and other internet sources. The hospitalized CFR (HCFR) was estimated, epidemiological features described, and risk factors for a fatal outcome identified. Results The overall HCFR in China was estimated to be 4.6% (95% CI 4.5–4.8%, P < 0.001). It increased with age and was higher in males than females. Although the highest HCFR observed was in male patients ≥70 years old, the relative risks for death outcome by sex varied across age groups, and the greatest HCFR risk ratio for males vs. females was shown in the age group of 50–60 years, higher than age groups of 60–70 and ≥ 70 years. Differential age/sex HCFR patterns across geographical regions were found: the age effect on HCFR was greater in other provinces outside Hubei than in Wuhan. An effect of longer interval from symptom onset to admission was only observed outside Hubei, not in Wuhan. By performing multivariate analysis and survival analysis, the higher HCFR was associated with older age (both P < 0.001), and male sex (both P < 0.001). Only in regions outside Hubei, longer interval from symptom onset to admission, were associated with higher HCFR. Conclusions This up-to-date and comprehensive picture of COVID-19 HCFR and its drivers will help healthcare givers target limited medical resources to patients with high risk of fatality.
The monthly distribution of human rabies cases in Chongqing from 2007 to 2016. Table S2. Comparison of the population distribution of human cases with that of the local population in Chongqing. Table S3. The interval of exposure and treatment time for PEP. Table S4. The proportion of cases that sought medical treatment. Table S5. The proportion of cases with exposure on head/neck. Table S6. PEP ambulant clinic conditions in Chongqing, 2016. (XLSX 20Â kb)
According to the global framework of eliminating human rabies, China is responding to achieve the target of zero human death from dog-mediated rabies by 2030. Chongqing is the largest municipality directly under central government in China. We described the epidemiological characteristics and post-exposure prophylaxis (PEP) of human rabies in this area, in order to provide a reliable epidemiology basis for further control and prevention of human rabies. The most updated epidemiological data for human rabies cases from 2007 to 2016 in Chongqing were collected from the National Disease Reporting Information System. A standardized questionnaire was applied to the human rabies cases or family members of cases as proxy to investigate the PEP situation. A total of 809 fatal human rabies cases were reported in Chongqing from 2007 to 2016. There was a trend of gradual annual decline about number of cases from 2007 to 2013, followed by stable levels until 2016. Rabies was mostly reported in summer and autumn; a majority of cases were noted in farmers (71.8%), especially in males (65.3%). The cases aged 35–74 and 5–14 years old accounted for 83.8% of all the cases. We collected information of 548 human rabies cases’ rabies exposure and PEP situation. Of those, 95.8% of human rabies cases were victims of dog bites or scratch, and 53.3% of these dogs were identified as stray dogs. Only 4.0% of the domestic dogs were reported to have been vaccinated previously. After exposure, 87.8% of the 548 human rabies cases did not seek any medical services. Further investigation showed that none of the 548 cases received timely and properly standardized PEP. Human rabies remains a major public health problem in Chongqing, China. Dogs are the main reservoir and source of human rabies infection. Unsuccessful control of canine rabies and inadequate PEP of cases might be the main factors leading to the serious human rabies epidemic in this area. An integrated “One Health” approach should be encouraged and strengthened in this area; with combined effort it would be possible to achieve the elimination of human rabies in the expected date.
The prevention of infectious diseases is a global health priority area. The early detection of possible epidemics is the first and important defense line against infectious diseases. However, conventional surveillance systems, e.g., the Centers for Disease Control and Prevention (CDC), rely on clinical data. The CDC publishes the surveillance results weeks after epidemic outbreaks. To improve the early detection of epidemic outbreaks, we designed a syndromic surveillance system to predict the epidemic trends based on disease-related Google search volume. Specifically, we first represented the epidemic trend with multiple alert levels to reduce the noise level. Then, we predicted the epidemic alert levels using a continuous density HMM, which incorporated the intrinsic characteristic of the disease transmission for alert level estimation. Respective models are built to monitor both national and regional epidemic alert levels of the U.S. The proposed system can provide real-time surveillance results, which are weeks before the CDC's reports. This paper focusses on monitoring the infectious disease in the U.S., however, we believe similar approach may be used to monitor epidemics for the developing countries as well.
Abstract Background: Feline herpesvirus-1 (FHV-1) is a most common virus that cause viral rhinotracheitis and ocular diseases in domestic cats and wild felids. As other alpha-herpesviruses, acute FHV-1 infection is responsible for severe upper respiratory tract and ocular disease, followed by lifelong latency that persist the limited virus in sensory neuronal cells. While latency reactivation can result in recrudescence, leading sever ocular lesions. Hence, FHV-1 infection in cats can be considered as a good natural host model to study alpha-herpesvirus pathogenesis. Results: In this study, the FHV-1 CH-B was isolated from nasal discharge collected from a British shorthair cat in China, and was further identified via transmission electron microscopy (TEM) observation, indirect immunofluorescence assay (IFA) and genome analysis. Experimental infection of domestic cats with different dose of isolate CH-B, ranging from 10 4 to 10 7 TCID 50 , showed that cats inoculated with 10 5 TCID 50 not only showed typical upper respiratory track and ocular symptoms, but also could copy the progress of disease development. Therefore, the FHV-1 infection model was established by intranasally inoculated with 10 5 TCID 50 of FHV-1 isolate CH-B. Infected cats began to show clinical signs at days 5 post inoculated (dpi), developed severe upper respiratory tract and ocular symptoms at 10-15 dpi, began to recover at 20 dpi, and recovered almost completely by 25 dpi. During acute infection period, virus mainly replicates in turbinate, conjunctiva, cornea and sensory neuronal cells, while virus only persists in trigeminal ganglia (TG) at lifelong latency. Viremia and viral infections in lungs do not appear in FHV-1 CH-B infected cats, with only one exception. We also demonstrate that FHV-1 CH-B infection can induce severe inflammatory responses and lung, trachea, and tonsils tissues damage in cats. In addition, we found that FHV-1 infected cats can shed virus via nasal and ocular discharge, resulting FHV-1 infection in in-contact cats. Conclusions : This natural host model of FHV-1 infection will be valuable for the screen and assessment of antiviral drugs and vaccines, as well as the studies of the pathogenesis of alpha-herpesvirus infection in animals and humans.
BackgroundBefore effective vaccines become widely available, sufficient understanding of the impacts of climate, human movement and non-pharmaceutical interventions on the transmissibility of COVID-19 is needed but still lacking.MethodsWe collected by crowdsourcing a database of 11 003 COVID-19 cases from 305 cities outside Hubei Province from December 31, 2019 to April 27, 2020. We estimated the daily effective reproduction numbers (Rt) of COVID-19 in 41 cities where the crowdsourced case data are comparable to the official surveillance data. The impacts of meteorological variables, human movement indices and nonpharmaceutical emergency responses on Rt were evaluated with generalized estimation equation models.FindingsThe median Rt was 0•46 (IQR: 0•37–0•87) in the northern cities, higher than 0•20 (IQR: 0•09–0•52) in the southern cities (p=0•004). A higher local transmissibility of COVID-19 was associated with a low temperature, a relative humidity near 70–75%, and higher intracity and intercity human movement. An increase in temperature from 0℃ to 20℃ would reduce Rt by 30% (95 CI 10–46%). A further increase to 30℃ would result in another 17% (95% CI 5–27%) reduction. An increase in relative humidity from 40% to 75% would raise the transmissibility by 47% (95% CI 9–97%), but a further increase to 90% would reduce the transmissibility by 12% (95% CI 4–19%). The decrease in intracity human movement as a part of the highest-level emergency response in China reduced the transmissibility by 36% (95% CI 27–44%), compared to 5% (95% CI 1–9%) for restricting intercity transport. Other nonpharmaceutical interventions further reduced Rt by 39% (95% CI 31–47%).InterpretationClimate can affect the transmission of COVID-19 where effective interventions are implemented. Restrictions on intracity human movement may be needed in places where other nonpharmaceutical interventions are unable to mitigate local transmission.FundingChina Mega-Project on Infectious Disease Prevention; U.S. National Institutes of Health and National Science Foundation.
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