Objective To analyze the epidemiological characteristics of fatal cases of scrub typhus in China for a reference for scientific prevention and control of this mite-borne disease. Methods Fatal cases of scrub typhus registered in China from 2006 to 2025 were obtained from the Chinese Disease Prevention and Control Information System. Descriptive epidemiology was used to analyze the characteristics of temporal, regional, and population distribution of fatal scrub typhus cases, as well as the time intervals among onset, diagnosis, and death. Results From 2006 to 2025, a total of 359 017 scrub typhus cases and 114 fatal cases were reported in China, with an average annual case fatality rate of 0.03%. Deaths were reported every year except in 2006 and 2009. Scrub typhus deaths were concentrated between May and November, accounting for 98.25% (112/114) of the total deaths. The fatal cases were distributed across 11 provinces (autonomous regions), 46 prefecture-level cities, and 77 counties (cities, districts). Among the provinces (autonomous regions), Guangdong (55 deaths), Yunnan (28 deaths), Fujian (11 deaths), and Guangxi (10 deaths) added up to 91.23% (104/114) of all deaths. The prefecture-level cities with relatively higher number of fatal cases comprised Guangzhou City (17 deaths), Foshan City (7 deaths), and Heyuan City (6 deaths) in Guangdong Province, and Chuxiong Yi Autonomous Prefecture (10 deaths) and Lincang City (5 deaths) in Yunnan Province. Of the fatal cases, 65 were in males and 49 in females, with a gender ratio of 1.33∶1. The age group of 50-79 years contributed to 67.54% (77/114) of the total deaths. In terms of occupation distribution, 75.44% (86/114) of the deaths were in farmer, retiree, housekeeper and the unemployed. The median time interval from infection onset to confirmed diagnosis for fatal cases was 7 (3, 11) days, and the median time interval from onset to death was 7 (3, 10) days. A total of 30 cases were diagnosed only after death (26.32%), while 54 cases (47.37%) died on the day of definitive diagnosis. Conclusion The number of reported cases of scrub typhus in China presents an increasing trend, and deaths have been yearly reported since 2010. The fatal cases exhibit distinct seasonal and spatial clustering characteristics. It is recommended to enhance case surveillance, early diagnosis, standardized treatment, and health education on prevention and control of scrub typhus in high-incidence seasons, key regions and populations at high risks.

Objective To understand the endemic trend of reported pulmonary tuberculosis (TB) among students and teachers in Xinjiang Uygur Autonomous Region. Methods The incidence data on TB among students and teachers reported in Xinjiang from 2005 to 2024 were obtained from the Chinese Disease Prevention and Control Information System. Descriptive epidemiology was used to analyze the epidemiological characteristics, and the Joinpoint regression model was applied to analyze the changes trends of incidence. Results From 2005 to 2024, a total of 35 101 cases of TB among students and teachers were reported across the region, among whom 27 225 were associated with students, and 7 876 with teachers. The average annual reported incidence rate was 30.98/100 000 for students, and 130.52/100 000 for teachers. From 2005 to 2024, the overall reported incidence rate of TB among students showed an overall downward trend (AAPC=-5.80%, 95% CI: -7.70% to -4.80%, t=-7.84, P<0.05), and the proportion of reported cases in the total population presented an upward trend in 2016-2024（APC=11.54%，95%CI：4.70%~29.60%，t=1.81，P<0.05）. The overall reported incidence rate of teacher TB showed a downward trend (AAPC=-12.50%, 95% CI: -16.60% to -10.40%, t=-7.90, P<0.05), and the proportion of reported cases in the total population tended to decline correspondingly (AAPC= -8.78%, 95% CI: -10.50% to -7.50%, t=-14.10, P<0.05). Among different regions, the incidence hotspots of TB among students were mainly concentrated in Northern Xinjiang, with Tacheng Prefecture recording the highest average annual reported incidence rate across Xinjiang at 76.77/100 000. For teachers, TB incidence hotspots were predominantly in Southern Xinjiang, and Kashgar Prefecture had the highest average annual reported incidence rate in Xinjiang, standing at 257.85/100 000. Conclusion From 2005 to 2024, the reported incidence rate of TB among students and teachers in Xinjiang showed a downward trend in general. However, in recent years, the proportion of students among all TB cases tended to rise. In the future, TB monitoring, screening, and standardized management should be strengthened in the targeted areas to reduce the occurrence of TB in schools.

Objective To analyze the epidemiological characteristics of tuberculosis among students in Guangxi and their cross-regional medical consultations for a reference in implementing effective prevention and control measures. Methods The incidence of tuberculosis reported among the whole population and students in Guangxi were obtained from 2020 to 2024 through the Chinese Disease Prevention and Control Information System, and analyzed for the trends in tuberculosis incidence among students, epidemiological characteristics, and the proportion of patients seeking medical treatment outside their home region. Results From 2020 to 2024, a total of 7 683 cases of tuberculosis among students were reported in Guangxi, with an average annual incidence rate of 13.60 per 100 000. The annual incidence rate showed a fluctuating downward trend, decreasing from 16.78 per 100 000 in 2020 to 11.94 per 100 000 in 2024. By temporal distribution, two epidemic peaks, namely September-October (20.53%, 1 577/7 683) and December-January of the following year (22.05%, 1 694/7 683) were observed. In terms of demographic distribution, there were 3 909 male cases (50.88%) and 3 774 female cases (49.12%). Cases aged 16-18 years occupied the largest proportion of incidence (46.53%, 3 575/7 683). The city with the highest number of reported cases and the highest reported incidence rate was Nanning (1 052 cases) and Baise (26.43 per 100 000), respectively. Among students studying outside Guangxi, the majority chose to return to their places of origin for medical treatment (79.33%, 353/445), and those who were studying within Guangxi, 39.42% (2 814/7 139) underwent medical treatment in local area, 35.19% (2 512/7 139) sought cross-district treatment within the city, and 25.40% (1 813/7 139) sought treatment in other cities. Conclusion The overall incidence of tuberculosis among students in Guangxi exhibits a fluctuating downward trend, with an uneven regional distribution of cases and a notable trend of cross-regional medical visits. These findings suggest that it is necessary to strengthen routine monitoring and active screening of the cases, particularly the targeted measures shall be prioritized for high school students aged 16-18 years. In addition, prevention and control measures should be optimized according to regional differences in epidemic, and health management for students who move frequently should be enhanced to effectively curb the spread of tuberculosis on school campuses.

Objective To analyze the influencing factors of medical consultation and diagnosis delay among pulmonary tuberculosis patients aged 65 years and above in Chongqing for evidences for the prevention and treatment of the elderly pulmonary tuberculosis. Methods Medical record data of pulmonary tuberculosis patients aged 65 years and above in Chongqing were obtained from 2020 to 2024 through the Chinese Disease Prevention and Control Information System. Joinpoint regression model was used for temporal trend analysis. Chi-square test and multivariate logistic regression were applied to analyze the influencing factors of delayed medical visit and diagnosis. Results A total of 21 910 pulmonary tuberculosis patients aged 65 years and over in Chongqing area were included in this study from 2020 to 2024. Among these subjects, 16 504 had medical consultation delay, with a delay rate of 75.33%, and 2 555 had diagnosis delay, with a delay rate of 11.66%. Joinpoint regression analysis showed that the overall medical visit delay rate presented no significant temporal trend from 2020 to 2024 (APC=1.99%, 95%CI: -2.26% to 6.82%, P>0.05). The diagnosis delay rate showed an overall trend by rising first and then declining, which increased rapidly from 2020 to 2022 (APC=14.54%, 95%CI: 10.36% to 19.39%, P<0.001), and decreased significantly from 2022 to 2024 (APC=-6.96%, 95%CI: -10.62% to -3.48%, P<0.001). Multivariate logistic regression analysis indicated that female gender (OR=1.11, 95%CI: 1.03 to 1.20) and non-key population (OR=1.11, 95%CI: 1.03 to 1.19) were associated with a higher risk of medical consultation delay, whereas aged ≥80 years (OR=0.88, 95%CI: 0.80 to 0.96), non-farmer occupation (OR=0.71, 95%CI: 0.67 to 0.76) and retreated cases (OR=0.80, 95%CI: 0.73 to 0.88) were linked to a lower risk of medical consultation delay. Higher risks of diagnosis delay were found in ethnic minorities (OR=4.65, 95%CI: 3.59 to 6.02), non-local household registration (OR=1.80, 95%CI: 1.47 to 2.20), non-farmer occupation (OR=1.63, 95%CI: 1.49 to 1.78) and retreatment cases (OR=1.54, 95%CI: 1.36 to 1.73). In contrast, female gender (OR=0.88, 95%CI: 0.80 to 0.98), age groups of 70-74 years (OR=0.88, 95%CI: 0.79 to 0.97), 75-79 years (OR=0.88, 95%CI: 0.79 to 0.99) and ≥80 years (OR=0.81, 95%CI: 0.71 to 0.93), as well as positive etiological testing results (OR=0.77, 95%CI: 0.70 to 0.85) corresponded to a lower risk of delayed diagnosis. Conclusion The rates of medical visit and diagnosis delay remain relatively higher among the elderly patients with pulmonary tuberculosis in Chongqing area. Female gender and non-key population are prone to delayed medical consultation, and diagnosis delay is more seen in non-local household registration, ethnic minorities, non-farmers and retreated patients. These findings suggest that targeted health education and active screening should be strengthened for the above high-risk groups in following tasks. Meanwhile, medical institutions shall improve their diagnosis and treatment capacity as well as service accessibility to realize early detection and early diagnosis of pulmonary tuberculosis in the older population of our area.

Objective To understand the surveillance results at the tuberculosis drug resistance surveillance sites in Chongqing area for a reference for following prevention and control of drug-resistant tuberculosis. Methods The surveillance data were collected from 2013 to 2024 from the two national-level tuberculosis drug resistance surveillance sites in Fengdu County and Fengjie County of Chongqing, and analyzed regarding the drug resistance patterns, categories and spectrums of six common anti-tuberculosis drugs: isoniazid (INH), rifampicin (RFP), streptomycin (Sm), ethambutol (EMB), ofloxacin (Ofx) and kanamycin (Km) among the patients with etiologically confirmed positive tuberculosis. The Joinpoint regression model was used to analyze the trends in drug resistance. Results A total of 2 144 tuberculosis patients were included in the study. The overall drug resistance rate was 19.96% (428/2 144), and the multidrug resistance rate accounted for 4.34% (93/2 144). The rate of drug resistance and multidrug resistance were significantly higher in retreated patients than in primary treated patients (34.88% vs. 17.92%, 14.73% vs. 2.92%; χ²= 40.869, 76.316, respectively; both P<0.05). Patients with a history of dust exposure or pneumoconiosis exhibited a higher drug resistance rate than those without such history (30.00% vs. 19.15%, χ²=10.903, P<0.05). The resistance rate for the six drugs ranking from high to low was Sm (9.98%, 214/2 144), INH (9.75%, 209/2 144), Ofx (6.11%, 131/2 144), RFP (5.64%, 121/2 144), EMB (2.75%, 59/2 144), and Km (2.10%, 45/2 144). In terms of drug resistance spectrum, the most prevalent drug resistance profile was mono-resistance to Ofx (3.78%, 81/2 144). From 2013 to 2024, the multidrug resistance rate exhibited a decreasing trend (AAPC=-6.581, P<0.05), yet the resistance rates of Km and Ofx showed an upward trend (AAPC=13.934 and 11.862, respectively; both P<0.05). The overall drug resistance, multidrug resistance rates, pre-extensively drug resistance rates and the resistance rates to INH, RFP, EMB and Ofx at the surveillance site in Fengjie County were all significantly higher than those at the site of Fengdu County (χ²=9.822, 13.035, 12.191, 6.811, 7.349, 12.650 and 23.102, respectively; all P<0.05). Conclusion The drug resistance situation of tuberculosis in Chongqing remains severe. Among them, single resistance to Ofx is the most common, and the drug resistance rate of second-line anti-tuberculosis drugs shows an upward trend. The risk of drug resistance is higher in retreated patients as well as those exposed to dust or with a history of pneumoconiosis. In the future, it is necessary to strengthen the screening of drug resistance to second-line anti-tuberculosis drugs, and enhance the monitoring and standardized diagnosis and treatment management of drug resistance in the key populations.

Objective To understand the effectiveness of empirical mode decomposition-seasonal autoregressive integrated moving average (EMD-SARIMA) model in predicting pulmonary tuberculosis (TB) incidence trend in the Xinjiang Production and Construction Corps. Methods Monthly reported TB incidence data in the Xinjiang Production and Construction Corps were retrieved and analyzed from January 2010 to December 2024. Data from 2010 to 2023 were included in the training set to establish EMD-SARIMA model, and those from 2024 were used in the validation set to evaluate the predictive performance of the models. Finally, the forecasting performance was compared with that of the single SARIMA model. Results From 2010 to 2024, a total of 26 143 TB cases were reported, with an average annual incidence rate of 58.42 per 100 000 population. The incidence peaked in 2011 (88.30 per 100 000 population) and was the lowest in 2022 (38.19 per 100 000 population), showing an overall downward trend. The original signal was able to be decomposed into five intrinsic mode function (IMF) components and one trend term. The optimal SARIMA model for each component derived from the EMD decomposition was identified based on the lowest Akaike Information Criterion, and the residuals of all these models satisfied the white noise test (all P>0.05). The final prediction results of EMD-SARIMA model were obtained by summing the forecasts of each component. The EMD-SARIMA model achieved lower prediction errors, with its MSE, MAE, RMSE, and MAPE values all being lower than those of the single SARIMA model (0.283 vs. 0.745, 0.473 vs. 0.775, 0.532 vs. 0.863, and 13.587% vs. 21.115%). Conclusion EMD-SARIMA model can more accurately predict the tuberculosis incidence trend in the Xinjiang Production and Construction Corps and has better application value compared to the single SARIMA model.

Objective To analyze the epidemiological characteristics and changing trends of typhoid and paratyphoid fever incidence in provinces and cities at prefecture level in China from 2005 to 2024 for evidences to formulate region-specific prevention and control strategies and measures for typhoid and paratyphoid fever. Methods Case data of typhoid and paratyphoid fever from 2005 to 2024 were retrieved from the Chinese Information System for Disease Control and Prevention. Descriptive epidemiology was used to analyze the epidemiological characteristics, and the Joinpoint regression model was applied to observe the trends in incidence rates. Results A total of 263 767 cases of typhoid and paratyphoid fever were reported nationwide in China from 2005 to 2024, with an average annual incidence rate of 0.97 per 100 000 population. The annual reported incidence rate showed a declining trend over the years, decreasing from 2.69 per 100 000 to 0.33 per 100 000. The seasonal indices were all greater than 1 from May to October, during which the reported cases accounted for 63.87% of the total cases (168 474/263 767). The number of reported cases was 141 813 in males and 121 954 in females, with average annual incidence rates of 1.02 per 100 000 and 0.92 per 100 000, respectively. The proportion of reported cases was the highest in the age group of 35-59 years (29.26%, 77 191/263 767), and maximal incidence rate was seen in the age group under 3 years (2.57 per 100 000). By occupational distribution, farmers were the dominant group (36.09%, 95 206/263 767). By regional distribution, Yunnan Province reported the largest number of cases (n= 72 679). The top three prefecture-level cities in terms of reported case number were Honghe Hani and Yi Autonomous Prefecture (n=11 896) and Kunming City (n= 11 863) in Yunnan Province, and Guilin City (n=11 133) in Guangxi Zhuang Autonomous Region. In terms of incidence trends, the national reported incidence rate showed an overall downward trend (AMPC=-0.67%, 95%CI: -1.03% to -0.31%, t=-3.64, P<0.05). Analysis based on provincial data revealed that the reported incidence rate tended to be a downward trend in 10 provinces, with AMPC values ranging from -1.77% to -0.29% (all P<0.05), whereas the overall trend in the rest of the provinces showed no statistical significance. Observation at the prefecture-level cities indicated that the reported incidence rate decreased in 140 cities, with the AAPC ranging from -2.15% to -50.68% (all P<0.05), and another 15 cities showed an upward trend (AAPC: 4.41% to 16.90%, all P<0.05). Among provinces with a declining incidence trend, 54.47% (67/123) of their prefectural-level cities showed a downward trend and 1.63% (2/123) presented an upward trend. In provinces with no significant temporal trend, 34.93% (73/209) of their subordinate cities exhibited a declining trend and 6.22% (13/209) showed an increasing trend. Conclusion The national overall incidence rate of typhoid and paratyphoid fever declined from 2005 to 2024. However, the incidence trends varied distinctly with changing magnitudes across provinces and prefecture-level cities. Within some provinces, the trends in certain prefectural-level cities were inconsistent with the provincial trend. These findings suggest that differentiated prevention and control strategies should be formulated according to local conditions, and precise interventions should be implemented in key areas and during critical time periods to achieve more efficient control of typhoid and paratyphoid fever.

Objective To understand the composition and seasonal fluctuation trend of fly density in Shanghai area for a basis for scientific prevention and control of flies. Methods According to the vector surveillance protocol of Shanghai, we conducted an ecological monitoring of flies at various surveillance sites in Shanghai area from March to November during 2023-2024. The surveys were carried out in four types of habitats at each monitoring site, including farmers’markets, external environments of catering establishments, residential quarters, and large greenbelts. The flies were captured in the selected habitats by cage trapping, identified for the species and counted. Finally, the fly species composition and its density were analyzed and compared. Results A total of 2 430 traps were deployed, and 3 892 flies were captured during 2023-2024. The annual mean density was 1.54 flies/cage. The fly density was 1.65 per trap in 2023 and 1.43 per trap in 2024, which showed no significant difference (t=1.282, P>0.05). Fourteen fly species were identified, with Muscina stabulans (15.08%, 587/3 892), Chrysomya megacephala (13.36%, 520/3 892), and Boettcherisca peregrina (13.00%, 506/3 892) being the top three by count. However, B. peregrina (0.23 flies/cage), C. megacephala (0.22 flies/cage), and M. stabulans (0.20 flies/cage) ranked highest by density. Species composition varied seasonally, except for M. stabulans and B. peregrina being active during the entire monitoring period. In spring, the dominant species was Aldrichina grahami (24.08%, 202/839), while C. megacephala (16.15%, 493/3,053) was more prevailing in summer and autumn. The fly density fluctuation in Shanghai area between 2023 and 2024 exhibited a unimodal pattern, peaking from June to August, with statistical differences among different months in each year (χ²=46.498, 37.311, all P<0.001). Among different habitats, large green belts (1 505 flies, 38.67%) and farmers’ markets (1 032 flies, 26.52%) accounted for the majority of captured flies. The farmers’ markets had the highest average fly density (2.03 flies/cage), followed by large green belts (1.51 flies/cage), external environments of catering establishments (1.45 flies/cage), and residential quarters (1.22 flies/cage). Conclusion M. stabulans and B. peregrina are predominant fly species in Shanghai area. The fly density peaks in summer and agricultural trade fairs shall be the key sites for fly control. Our findings suggest that integrated fly control in the key sites should be persistently strengthened during active fly seasons.

Objective To observe the effect and dynamic change trend of Schistosoma japonicum egg excretory-secretory antigen (ESA) on the proportion of regulatory T cells (Tregs) in the spleen of mice, and to preliminarily investigate its immunomodulatory effect on the mice. Methods A rabbit model of Schistosoma japonicum infection was established, and then the eggs were isolated and purified from the liver tissues to prepare ESA of Schistosoma japonicum. Forty SPF-grade male Kunming mice were randomly divided into an experimental group and a control group (n=20 in each group). Mice in the experimental group were treated with Schistosoma japonicum ESA, and those in the control group were intervened with PBS for 4 consecutive weeks. Before immunization and at 4, 8 and 12 weeks after immunization, flow cytometry was used to detect the percentage of CD4⁺CD25⁺Foxp3⁺Tregs in CD4⁺T cells in the spleen of mice. The immune response was evaluated in combination with changes in body weight and spleen index of the mice. Results At 8 and 12 weeks after ESA immunization, the body weight of mice was generally lower in the experimental group than in the control group [(40.18 g±0.56 g, 41.71 g±0.54 g) vs. (42.18 g±0.26 g, 44.71 g±0.69 g), respectively]. The difference was statistically significant (t=7.116, 7.661, both P<0.01). At 4, 8, and 12 weeks following immunization, the spleen indexes of mice in the experimental group were higher than those in the control group [(3.80 mg/g±0.04 mg/g, 4.16 mg/g±0.02 mg/g, 4.31 mg/g±0.03 mg/g) vs. (3.57 mg/g± 0.01 mg/g, 3.58 mg/g±0.01 mg/g, 3.59 mg/g±0.02 mg/g), respectively], and the difference was statistically significant (t=-11.309, -58.881, -48.882, all P<0.01). Meanwhile, the proportions of Tregs in CD4⁺T cells in the spleen of mice in the experimental group at 4, 8, and 12 weeks after immunization were 20.15%±1.01%, 24.92%±1.06% and 30.29%±1.06%, respectively, which were higher than those in the control group at the corresponding time points (14.27%±0.66%, 15.40%±0.86% and 16.56%±0.86%), with significant statistical differences (t=-10.343, -15.637, -22.494, respectively, all P<0.01). Moreover, the proportion gradually increased with the extension of immunization time. Conclusion ESA can induce the differentiation of CD4⁺T cells into Tregs in the spleen of mice, and this effect is positively correlated with the duration of immune intervention.

This article reports one case of iliac artery aneurysm and abdominal aortic dissecting aneurysm secondary to Brucella infection. The patient visited the hospital due to recurrent fever and lower abdominal pain. Contrast-enhanced computed tomography revealed an abdominal aortic pseudoaneurysm with bilateral iliac artery involvement. The patient subsequently underwent endovascular aneurysm repair (EVAR) and iliac artery stenting. Following perioperative prophylactic antimicrobial therapy, the patient’s body temperature temporarily recovered to normal, yet fever and abdominal pain recurred after discharge. Further epidemiological inquiry demonstrated that the patient was a sheep farmer. The Rose Bengal plate test (RBPT) was positive, with a titer of 1∶200 by the serum agglutination test (SAT). The blood culture detected Brucella melitensis biovar 3, thereby confirming the diagnosis of brucellosis-associated infected aneurysm. After triple-antibiotic therapy with doxycycline, rifampicin, and levofloxacin, the patient improved clinically and was discharged. The patient then continued outpatient oral treatment with doxycycline and rifampicin, and the outcome was favorable during follow-up. The clinical data of this case were retrospectively analyzed, with related literatures reviewed to summarize the clinical characteristics, diagnostic approaches, and therapeutic strategies of this condition, with an attempt to enhance clinical understanding of the disease.

Objective To analyze the implementation of HIV antibody screening at HIV-screening laboratories in Zhengzhou City for a scientific basis for further facilitating local HIV/AIDS prevention and control. Methods Annual HIV antibody screening data from 2020 to 2024 for HIV-screening laboratories in Zhengzhou were obtained from the National AIDS Testing Laboratory Information Management System, and the number of screening tests, the number of reactive results and positivity rate were analyzed. Serum blind sample test results were obtained from the AIDS confirmation laboratory of Zhengzhou Center for Disease Control and Prevention, and the occurrence of unacceptable blind sample results was analyzed as well. Results The number of medical and health institutions with HIV-screening laboratories in Zhengzhou increased from 106 in 2020 to 159 in 2024. Among public institutions, the number of HIV-screening laboratories was the most at general hospitals, and among non-public institutions, at specialized hospitals. Public general hospitals had the highest cumulative number of screening tests (6.349 1 million person-times), and third-party medical laboratories had the lowest (397.7 thousand person-times). The annual number of screening tests in both public and non-public specialized hospitals showed significant increasing trends (β=4.07, 0.83; t=3.35, 4.58; both P<0.05). The number of reactive results was maximal in public general hospitals (4 260 person-times), and the lowest in non-public traditional Chinese medicine hospitals (207 person-times). The highest reactive rate was observed in third-party medical laboratories (2.73‰), and the lowest in non-public traditional Chinese medicine hospitals (0.43‰). The annual trend in the reactive rate of third-party medical laboratories showed a downward trend (AAPC=-44.84%, 95% CI: -66.34% to -9.60%, t= -3.83, P<0.05). Among laboratories with unacceptable blind sample results, the annual average number and proportion were both higher in non-public institutions than in public institutions (6.8 vs. 4.4 laboratories, 11.71% vs. 6.39%). Among different types of institutions, non-public specialized hospitals had the highest annual average number and proportion (4.2 laboratories, 14.63%). Conclusion The HIV-screening laboratory network in Zhengzhou City has been scaling up in recent years, and hospitals have played a pivotal role in case detection. Non-public institutions, especially specialized hospitals, must continuously strengthen relevant technical training and quality control to ensure the quality of testing results.