Summary What is already known about this topic?Trainees in the China Field Epidemiology Training Program(CFETP)constitute a vital workforce in addressing global public health emergencies.Developing intercultural commu...Summary What is already known about this topic?Trainees in the China Field Epidemiology Training Program(CFETP)constitute a vital workforce in addressing global public health emergencies.Developing intercultural communication competence is essential for their future participation in international public health efforts.However,within China’s existing public health training system,this aspect has not yet received adequate attention or been systematically strengthened.展开更多
Background: The investigation of an occupational outbreak, once the index case has been identified, triggers a stress situation to epidemiologists. Modelling occupational outbreaks will be useful to guide the field in...Background: The investigation of an occupational outbreak, once the index case has been identified, triggers a stress situation to epidemiologists. Modelling occupational outbreaks will be useful to guide the field investigation. Objective: To identify standard pathways for occupational epidemic outbreaks. Methods: In-depth critical appraisal of 57 occupational outbreaks. Standard pathways of occupational outbreaks were identified by analysing the similarity between out-breaks. The model’s accuracy and homogeneity were established through Fisher’s exact test and the Kappa Index. Results: The analysis allowed synthesizing the occupational outbreaks variability in 4 pathways. 92.98% of the analysed outbreaks could be allocated to one of those 4 types. The theoretical patterns showed a good adjustment with the analysed out-breaks: Type I (Kappa = 0.94 - 0.60), Type II (Kappa = 1.00), Type III (Kappa = 1.00 - 0.68) and Type IV (Kappa = 0.94 - 0.87). The probability of a given outbreak fitting with its three components in any of the theoretical pathways was 0.83. Conclusions: The incorporation of those pathways to the field occupational epidemiology will allow: 1) to provide early guidance to epidemiological, clinical and environmental studies focused on specific hypothesis of causality;2) to anticipate preventive measures;3) to contribute to an earlier and more efficient outbreak resolution.展开更多
Introduction:On November 27,2024,an active pulmonary tuberculosis case(pathogen positive)was identified in a senior high school in Guigang City,Guangxi Zhuang Autonomous Region,China.Methods:A comprehensive field epid...Introduction:On November 27,2024,an active pulmonary tuberculosis case(pathogen positive)was identified in a senior high school in Guigang City,Guangxi Zhuang Autonomous Region,China.Methods:A comprehensive field epidemiological investigation was conducted to identify close contacts.Close contacts underwent detailed interviews regarding their exposure history and symptoms,followed by diagnostic testing including the recombinant M.tuberculosis fusion protein test or interferon-γrelease assay,along with chest X-ray or CT imaging.Suspected cases were subjected to comprehensive laboratory evaluation,including sputum smear microscopy,sputum culture,and molecular biological testing.Drug susceptibility testing and genomic sequencing analysis were performed on culture-positive strains.Epidemiological associations were systematically assessed.Results:Screening encompassed 957 close contacts(919 from the senior high school and 38 from the index case’s junior high school class).Among these contacts,18 active pulmonary tuberculosis cases(16 epidemiologically linked and 2 sporadic),12 suspected cases,and 36 latent tuberculosis infections were identified.Four M.tuberculosis strains were successfully isolated from epidemiologically associated cases(including the index case,his junior high school classmate,high school deskmate,and current teacher).Genomic sequencing revealed that all strains exhibited isoniazid resistance and demonstrated high genetic homology(with<6 single nucleotide polymorphisms,SNPs).The index case had exhibited symptoms including cough and expectoration during junior high school;however,no abnormalities were detected during the physical examination upon senior high school enrollment.Additionally,routine daily health screenings conducted during morning and afternoon periods yielded consistently normal results.The investigation revealed that the index case had significant family contact history,with his father,two uncles,grandfather,and grandmother diagnosed with active pulmonary tuberculosis between 2019 and 2025,three of whom had confirmed isoniazid-resistant tuberculosis.Conclusion:This outbreak represented a tuberculosis cluster resulting from household transmission that subsequently spread across different school grades and classes.The delayed identification of the index case,attributable to multiple systemic factors,constituted the primary driver of disease dissemination.These findings underscore the critical importance of screening close contacts,particularly those who are teachers or students within affected families.展开更多
Background:In this study,we present a case of Japanese spotted fever(JSF)caused by Rickettsia japonica and use this case to investigate the process of diagnosing and reintegrating traceability of infectious diseases v...Background:In this study,we present a case of Japanese spotted fever(JSF)caused by Rickettsia japonica and use this case to investigate the process of diagnosing and reintegrating traceability of infectious diseases via metagenomic next-generation sequencing(mNGS).Methods:From data relating to epidemiological history,clinical and laboratory examinations,and mNGS se-quencing,a diagnosis of severe JSF was concluded.Results:A detailed field epidemiological investigation discovered parasitic Haemaphysalis longicornis from a host animal(dog)in the domicile of the patient,within which R.japonica was detected,along with a diverse array of other potentially pathogenic microorganisms that could cause other infectious diseases.Conclusion:The mNGS provided an efficient method to diagnose JSF infection.This methodology could also be applied to field epidemiological investigations to establish the traceability of infectious diseases.展开更多
基金Supported by funds from African countries to enhance their public health capacitybuilding projects[No.OPP1161303(GAT/16/303)].
文摘Summary What is already known about this topic?Trainees in the China Field Epidemiology Training Program(CFETP)constitute a vital workforce in addressing global public health emergencies.Developing intercultural communication competence is essential for their future participation in international public health efforts.However,within China’s existing public health training system,this aspect has not yet received adequate attention or been systematically strengthened.
文摘Background: The investigation of an occupational outbreak, once the index case has been identified, triggers a stress situation to epidemiologists. Modelling occupational outbreaks will be useful to guide the field investigation. Objective: To identify standard pathways for occupational epidemic outbreaks. Methods: In-depth critical appraisal of 57 occupational outbreaks. Standard pathways of occupational outbreaks were identified by analysing the similarity between out-breaks. The model’s accuracy and homogeneity were established through Fisher’s exact test and the Kappa Index. Results: The analysis allowed synthesizing the occupational outbreaks variability in 4 pathways. 92.98% of the analysed outbreaks could be allocated to one of those 4 types. The theoretical patterns showed a good adjustment with the analysed out-breaks: Type I (Kappa = 0.94 - 0.60), Type II (Kappa = 1.00), Type III (Kappa = 1.00 - 0.68) and Type IV (Kappa = 0.94 - 0.87). The probability of a given outbreak fitting with its three components in any of the theoretical pathways was 0.83. Conclusions: The incorporation of those pathways to the field occupational epidemiology will allow: 1) to provide early guidance to epidemiological, clinical and environmental studies focused on specific hypothesis of causality;2) to anticipate preventive measures;3) to contribute to an earlier and more efficient outbreak resolution.
基金Supported by the National Key R&D Program of China(2022YFC2305204)the Guangxi Medical and Health Key Discipline Construction Project(2022-06-21).
文摘Introduction:On November 27,2024,an active pulmonary tuberculosis case(pathogen positive)was identified in a senior high school in Guigang City,Guangxi Zhuang Autonomous Region,China.Methods:A comprehensive field epidemiological investigation was conducted to identify close contacts.Close contacts underwent detailed interviews regarding their exposure history and symptoms,followed by diagnostic testing including the recombinant M.tuberculosis fusion protein test or interferon-γrelease assay,along with chest X-ray or CT imaging.Suspected cases were subjected to comprehensive laboratory evaluation,including sputum smear microscopy,sputum culture,and molecular biological testing.Drug susceptibility testing and genomic sequencing analysis were performed on culture-positive strains.Epidemiological associations were systematically assessed.Results:Screening encompassed 957 close contacts(919 from the senior high school and 38 from the index case’s junior high school class).Among these contacts,18 active pulmonary tuberculosis cases(16 epidemiologically linked and 2 sporadic),12 suspected cases,and 36 latent tuberculosis infections were identified.Four M.tuberculosis strains were successfully isolated from epidemiologically associated cases(including the index case,his junior high school classmate,high school deskmate,and current teacher).Genomic sequencing revealed that all strains exhibited isoniazid resistance and demonstrated high genetic homology(with<6 single nucleotide polymorphisms,SNPs).The index case had exhibited symptoms including cough and expectoration during junior high school;however,no abnormalities were detected during the physical examination upon senior high school enrollment.Additionally,routine daily health screenings conducted during morning and afternoon periods yielded consistently normal results.The investigation revealed that the index case had significant family contact history,with his father,two uncles,grandfather,and grandmother diagnosed with active pulmonary tuberculosis between 2019 and 2025,three of whom had confirmed isoniazid-resistant tuberculosis.Conclusion:This outbreak represented a tuberculosis cluster resulting from household transmission that subsequently spread across different school grades and classes.The delayed identification of the index case,attributable to multiple systemic factors,constituted the primary driver of disease dissemination.These findings underscore the critical importance of screening close contacts,particularly those who are teachers or students within affected families.
基金supported by the National Natural Science Foundation of China(82273689)Key Research and Development Program of Shaanxi(2024SF-YBXM-289).
文摘Background:In this study,we present a case of Japanese spotted fever(JSF)caused by Rickettsia japonica and use this case to investigate the process of diagnosing and reintegrating traceability of infectious diseases via metagenomic next-generation sequencing(mNGS).Methods:From data relating to epidemiological history,clinical and laboratory examinations,and mNGS se-quencing,a diagnosis of severe JSF was concluded.Results:A detailed field epidemiological investigation discovered parasitic Haemaphysalis longicornis from a host animal(dog)in the domicile of the patient,within which R.japonica was detected,along with a diverse array of other potentially pathogenic microorganisms that could cause other infectious diseases.Conclusion:The mNGS provided an efficient method to diagnose JSF infection.This methodology could also be applied to field epidemiological investigations to establish the traceability of infectious diseases.
