ABSTRACT: Outbreaks of hand, foot, and mouth disease (HFMD) in central China have caused public health concerns since 2007. It is of particular public health significance to update epidemiology of HFMD in port cities.
To investigate epidemical, etiological and clinical characteristics of HFMD in Ningbo, China, from 2008 to 2011.
From May 2008 to December 2011, a total of 37,404 HFMD cases including 196 severe and 12 fatal cases were investigated. Human enteroviruses from 2360 cases were determined by real-time RT-PCR. The VP1 gene of EV71 from 78 cases and CA16 from 21 cases, the VP4 gene from 28 cases, and full-length genomes of 10 isolates were analyzed. Neutralizing antibodies were evaluated in 258 healthy subjects. Parameters associated with severe HFMD were evaluated.
Annual incidence of HFMD was 3066.8/100,000 in the population of ≤5 years. EV71 C4a, CA16 B1, and other enteroviruses accounted for 63.7%, 24.0% and 12.3%, respectively. The genomes of EV71 from fatal and non-fatal cases were nearly identical. The positive rates of neutralizing antibody to EV71 increased from 13.5% to 67.6% in 1- to 5-year healthy groups. The neutralizing antibody to CA16 B1 isolate was negative. EV71, exposure history and certain early manifestations including fever, vomiting, limb exanthema and peripheral neutrophil ratio were significantly associated with HFMD severity.
HFMD mainly caused by EV71 C4a and CA16 B1 is seriously epidemic in Ningbo. Future emphasis should be paid on EV71 immuno-prophylaxis and early identification of severe cases upon the etiological and clinical characteristics.
Journal of clinical virology: the official publication of the Pan American Society for Clinical Virology 05/2012; 54(4):342-8. · 3.12 Impact Factor
ABSTRACT: To determine the etiological cause of a food-borne outbreak of scarlet fever in adults.
Swabs from the throats of the patients and asymptomatic control were cultured on blood agar plates individually. Biochemical identification of all isolates was performed with a VITEX automated system. Antibiotic susceptibility was examined by using the Kirby-Bauer disc diffusion method. emm gene and extracellular pyrogenic exotoxins of each isolate were amplified by using polymerase chain reaction and subjected to DNA sequencing. Sequence differences between the isolated and the highly similar reference sequences were compared on BLAST. Bioinformatics was used to predict protein structures.
Beta-haemolytic group A streptococci (GAS) emm75 were identified from 10 of 13 available patients. The isolates were susceptible to penicillin, ampicillin, vancomycin, cefatriaxone, ofloxacin, linezolid and quinupristin. All of the isolates carried pyrogenic exotoxin A (speA) and cysteine protease (speB). Isolated speA was phylogenetically different from 30 highly similar references on BLAST. Differences in the primary sequence of the deduced protein were 14.37-20.12% between the speA and each of 11 references. Secondary protein structure of the speA was different from the references at the N-terminal.
GAS emm75 encoding altered speA was responsible for the food-borne outbreak of scarlet fever in adults.
The Journal of infection 05/2008; 56(4):261-7. · 4.13 Impact Factor
ABSTRACT: Autochthonous dengue infections have not been reported in Ningbo, People's Republic of China since 1929. In August-October 2004, an outbreak of dengue fever was confirmed in Xiaolin, Cixi, Ningbo. Of 83 cases reported, 68 were laboratory confirmed. Fifty-three percent (34 of 64) of the cases had IgM antibodies to dengue virus. Dengue virus serotype-1 was isolated from two cases. The outbreak was linked to a traveler who returned from Thailand. Phylogenetic analysis showed that the Ningbo isolate was closely associated to strains from Thailand. Prevalence of dengue-specific IgG in asymptomatic residents was significantly higher in the epidemic-stricken area than in a control area. High density of Aedes albopictus, which resulted from waterlogging caused by Typhoon Rananim and lifestyle of local residents, was responsible for rapid spread of the virus. Eradication of mosquito infestation might interrupt transmission. This outbreak underscores the importance of maintaining surveillance and control of potential vectors for the control of emerging infectious diseases.
The American journal of tropical medicine and hygiene 07/2007; 76(6):1182-8. · 2.59 Impact Factor