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Sun Q.,Research Base of Key Laboratory of Surveillance and Early warning on Infectious Disease in China CDC
BMC public health | Year: 2014

BACKGROUND: More than 200 students and teachers at a boarding school in Shanghai developed acute gastroenteritis in December, 2012. The transmission mode remained largely unknown. An immediate epidemiological investigation was conducted to identify it.METHODS: Using a retrospective cohort design, we investigated demographic characteristics, school environment, and previous contacts with people who had diarrhea and/or vomiting, drinking water conditions, recalls of food consumption in the school cafeteria, hand-washing habits and eating habits. Rectal swabs of the new cases and food handlers as well as water and food samples were collected to test potential bacteria and viruses. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).RESULTS: A total of 278 cases developed gastrointestinal symptoms in this outbreak, and the overall attack rate was 13.9%. The main symptoms included vomiting (50.0%), abdominal cramps (40.3%), nausea (27.0%), diarrhea (6.8%) and fever (6.8%). Twenty rectal swab samples were detected as Norovirus-positive, including 11 from student cases and 9 from asymptomatic food handlers (non-cases). Among environmental surface samples from the kitchen, 8 samples were also detected as Norovirus-positive. The genotypes of viral strains were the same (GII) in patients, asymptomatic food handlers and environmental surfaces. Other samples, including rectal swabs, water samples and food samples were negative for any bacteria and other tested viruses. Asymptomatic food handlers may have contaminated the cooked food during the food preparation.CONCLUSION: The study detected that the outbreak was caused by Norovirus and should be controlled by thorough disinfection and excluding asymptomatic food handlers from food preparation. Early identification of the predominant mode of transmission in this outbreak was necessary to prevent new cases. Furthermore, good hygiene practices such as regular hand washing and efficient daily disinfection should be promoted to prevent such infection and outbreaks.


Ding G.,Shanghai JiaoTong University | Ding G.,Tongji University | Yu J.,Shanghai JiaoTong University | Cui C.,Research Base of Key Laboratory of Surveillance and Early warning on Infectious Disease in China CDC | And 5 more authors.
Environmental Research | Year: 2015

The use of polybrominated diphenyl ethers (PBDEs) has been dramatically increasing over the last two decades in China. Animal studies suggest that prenatal exposure to PBDEs may result in neurodevelopmental deficits. Two hundred thirty-two participating mothers were recruited from a prospective birth cohort in rural northern China between September 2010 and February 2012. We analyzed 232 cord blood specimens for selected PBDE congeners and examined their association with children's developmental quotients (DQs) at 12 (n=192) and 24 (n=149) months of age based on the Gesell Developmental Schedules (motor, adaptive, language, and social domains). There were no substantial differences by demographic characteristics among the three time points: baseline, 12 and 24 months of age. Median cord blood levels of PBDE congeners 47, 99, 100, and 153 were 3.71, 6.70, 2.63, and 2.19. ng/g lipid, respectively. At 12 months of age, neither the individual nor total (the sum of BDEs 47, 99, 100, and 153) congener levels were associated with any of the four domain DQs. However, at 24 months of age, a 10-fold increase in BDE-99 levels was associated with a 2.16-point decrease [95% confidence interval (CI): -4.52, -0.20] in language domain DQs and a 10-fold increase in BDE-47 levels was associated with a 1.89-point decrease (95% CI: -3.75, -0.03) in social domain DQs. Prenatal exposure to PBDEs was associated with lower DQs in young children. The results contribute to the growing evidence that PBDEs could act as developmental neurotoxicants, and the findings have implications for children's environmental health in China. © 2015 Elsevier Inc.


PubMed | Research Base of Key Laboratory of Surveillance and Early Warning on Infectious Disease in China CDC and Shanghai Pudong New Area Center for Disease Control and Prevention
Type: Journal Article | Journal: PloS one | Year: 2015

Clinical and etiological characteristics of influenza-like illness (ILI) in outpatients is poorly understood in the southern temperate region of China. We conducted laboratory-based surveillance of viral etiology for ILI outpatients in Shanghai from January 2011 to December 2013.Clinical and epidemiological data from ILI outpatients, both children and adults, were collected. A total of 1970 nasopharyngeal swabs were collected and tested for 12 respiratory viruses using multiplex RT-PCR, and the data were analyzed anonymously.All 12 respiratory viruses were detected in the specimens. At least one virus was detected in 32.4% of 1970 specimens analyzed, with 1.1% showing co-infections. The most frequently detected agents were influenza A (11.7%), influenza B (9.6%), and rhinoviruses (3.1%).Other viruses were present at a frequency less than 3.0%. We observed a winter peak in the detection rate in ILI patients during 3 years of surveillance and a summer peak in 2012. HCoV, HADV, and HMPV were detected more frequently in children than in adults. Patients infected with influenza virus experienced higher temperatures, more coughs, running noses, headaches and fatigue than patients infected with other viruses and virus-free patients (p<0.001).The spectrum, seasonality, age distribution and clinical associations of respiratory virus infections in children and adults with influenza-like illness were analyzed in this study for the first time. To a certain extent, the findings can provide baseline data for evaluating the burden of respiratory virus infection in children and adults in Shanghai. It will also provide clinicians with helpful information about the etiological patterns of outpatients presenting with complaints of acute respiratory syndrome, but further studies should be conducted, and longer-term laboratory-based surveillance would give a better picture of the etiology of ILI.


PubMed | Research Base of Key Laboratory of Surveillance and Early warning on Infectious Disease in China CDC
Type: | Journal: BMC public health | Year: 2014

More than 200 students and teachers at a boarding school in Shanghai developed acute gastroenteritis in December, 2012. The transmission mode remained largely unknown. An immediate epidemiological investigation was conducted to identify it.Using a retrospective cohort design, we investigated demographic characteristics, school environment, and previous contacts with people who had diarrhea and/or vomiting, drinking water conditions, recalls of food consumption in the school cafeteria, hand-washing habits and eating habits. Rectal swabs of the new cases and food handlers as well as water and food samples were collected to test potential bacteria and viruses. Norovirus was detected by real-time reverse transcription-polymerase chain reaction (RT-PCR).A total of 278 cases developed gastrointestinal symptoms in this outbreak, and the overall attack rate was 13.9%. The main symptoms included vomiting (50.0%), abdominal cramps (40.3%), nausea (27.0%), diarrhea (6.8%) and fever (6.8%). Twenty rectal swab samples were detected as Norovirus-positive, including 11 from student cases and 9 from asymptomatic food handlers (non-cases). Among environmental surface samples from the kitchen, 8 samples were also detected as Norovirus-positive. The genotypes of viral strains were the same (GII) in patients, asymptomatic food handlers and environmental surfaces. Other samples, including rectal swabs, water samples and food samples were negative for any bacteria and other tested viruses. Asymptomatic food handlers may have contaminated the cooked food during the food preparation.The study detected that the outbreak was caused by Norovirus and should be controlled by thorough disinfection and excluding asymptomatic food handlers from food preparation. Early identification of the predominant mode of transmission in this outbreak was necessary to prevent new cases. Furthermore, good hygiene practices such as regular hand washing and efficient daily disinfection should be promoted to prevent such infection and outbreaks.


PubMed | Research Base of Key Laboratory of Surveillance and Early warning on Infectious Disease in China CDC, University of Sichuan, McGill University and Centers for Disease Control and Prevention
Type: | Journal: BMC research notes | Year: 2016

Syndromic surveillance has been widely used for the early warning of infectious disease outbreaks, especially in mass gatherings, but the collection of electronic data on symptoms in hospitals is one of the fundamental challenges that must be overcome during operating a syndromic surveillance system. The objective of our study is to describe and evaluate the implementation of a symptom-clicking-module (SCM) as a part of the enhanced hospital-based syndromic surveillance during the 41st World Exposition in Shanghai, China, 2010.The SCM, including 25 targeted symptoms, was embedded in the sentinels Hospital Information Systems (HIS). The clinicians used SCM to record these information of all the visiting patients, and data were collated and transmitted automatically in daily batches. The symptoms were categorized into seven targeted syndromes using pre-defined criteria, and statistical algorithms were applied to detect temporal aberrations in the data series.SCM was deployed successfully in each sentinel hospital and was operated during the 184-day surveillance period. A total of 1,730,797 patient encounters were recorded by SCM, and 6.1% (105,352 visits) met the criteria of the seven targeted syndromes. Acute respiratory and gastrointestinal syndromes were reported most frequently, accounted for 92.1% of reports in all syndromes, and the aggregated time-series presented an obvious day-of-week variation over the study period. In total, 191 aberration signals were triggered, and none of them were identified as outbreaks after verification and field investigation.SCM has acted as a practical tool for recording symptoms in the hospital-based enhanced syndromic surveillance system during the 41st World Exposition in Shanghai, in the context of without a preexisting electronic tool to collect syndromic data in the HIS of the sentinel hospitals.


PubMed | Fudan University, Research Base of Key Laboratory of Surveillance and Early warning on Infectious Disease in China CDC, University of Sichuan, Centers for Disease Control and Prevention and Peking Union Medical College
Type: | Journal: Journal of medical virology | Year: 2016

Acute respiratory infections (ARIs), with viral pathogens as the major contributors, are the most common illnesses worldwide, and increase the morbidity and mortality among the elderly population. The clinical and pathological features of elderly people with ARIs need to be identified for disease intervention. From January 1

Loading Research Base of Key Laboratory of Surveillance and Early warning on Infectious Disease in China CDC collaborators
Loading Research Base of Key Laboratory of Surveillance and Early warning on Infectious Disease in China CDC collaborators