Objective To analyze the correlation of hand,foot and mouth disease（HFMD）incidence risk indicators（including the incidence rate,the proportion of severe cases,the positive rate of EV71 and the case fatality rate）with meteorological factors in Hunan Province from 2011 to 2018,to build a prediction model,and to carry out the research and application of early warning and grading standards for the incidence risk of HFMD．Methods The data were processed by z-score standardization.Analytic hierarchy process and expert scoring method were used to determine the weights of HFMD incidence risk indicators,and the weighted superposition model was applied to obtaining the value of early warning level of HFMD incidence risk.Using K-means clustering method,the early warning level of HFMD incidence risk was divided into four categories:red,orange,yellow and blue.The early warning classification standard for HFMD incidence risk in Hunan was constructed．Results As for the multiple stepwise regression prediction model constructed by the incidence rate,the proportion of severe cases,the positive rate of EV71,the case fatality rate and meteorological factors,R2was between 0.019 and 0.119,and F value between 7.213 and 37.598.The weights of effects of the incidence rate,the proportion of severe cases,the positive rate of EV71 and the case fatality rate on the grades of HFMD incidence risk were 0.56,0.26,0.12 and 0.06,respectively.The maximum eigenvector（λmax）was 4.118,the consistency index（CI）0.040,the consistency ratio（CR）0.044,andCR＜0.1.The cluster centers of early warning grades of HFMD incidence risk were-0.3288,0.3258,1.4141 and 4.0639,respectively.The three thresholds were-0.002,0.880 and2.750,respectively．Conclusion The multiple stepwise regression prediction model constructed by HFMD incidence risk indicators （including the incidence rate,the proportion of severe cases,the positive rate of EV71 and the case fatality rate） and meteorological factors in Hunan Province in 2011-2017 passed the significance test.The prediction model was valid,and the weights of HFMD incidence risk indicators were effective.The early warning classification standard for HFMD incidence risk in Hunan Province was verified based on the HFMD incidence data in Hunan Province in 2017-2018,and it was found that the predicted early warning level fitted well with the actual situation.The constructed early warning classification standard for HFMD incidence risk in Hunan Province has good application value.

Background: Great concerns have been raised on SARS-CoV-2 impact on men's andrological well-being, and many studies have attempted to determine whether SARS-CoV-2 is present in the semen and till now the data are unclear and somehow ambiguous. However, these studies used quantitative real-time (qRT) PCR, which is not sufficiently sensitive to detect nucleic acids in clinical samples with a low viral load.Methods: The clinical performance of various nucleic acid detection methods (qRT-PCR, OSN-qRT-PCR, cd-PCR, and CBPH) was assessed for SARS-CoV-2 using 236 clinical samples from laboratory-confirmed COVID-19 cases. Then, the presence of SARS-CoV-2 in the semen of 12 recovering patients was investigated using qRT-PCR, OSNqRT-PCR, cd-PCR, and CBPH in parallel using 24 paired semen, blood, throat swab, and urine samples.Results: The sensitivity and specificity along with AUC of CBPH was markedly higher than the other 3methods. Although qRT-PCR, OSN-qRT-PCR and cdPCR detected no SARS-CoV-2 RNA in throat swab, blood, urine, and semen samples of the 12 patients, CBPH detected the presence of SARS-CoV-2 genome fragments in semen samples, but not in paired urine samples, of 3 of 12 patients. The existing SARS-CoV-2 genome fragments were metabolized over time. Conclusions: Both OSN-qRT-PCR and cdPCR had better performance than qRT-PCR, and CBPH had the highest diagnostic performance in detecting SARS-CoV-2, which contributed the most improvement to the determination of the critical value in gray area samples with low vrial load, which then provides a rational screening strategy for studying the clearance of coronavirus in the semen over time in patients recovering from COVID-19. Although the presence of SARS-CoV-2 fragments in the semen was demonstrated by CBPH, COVID-19 is unlikely to be sexually transmitted from male partners for at least 3 months after hospital discharge.

Background: Tuberculosis (TB) is a public health problem worldwide, and the influence of meteorological and air pollutants on the incidence of tuberculosis have been attracting interest from researchers. It is of great importance to use machine learning to build a prediction model of tuberculosis incidence influenced by meteorological and air pollutants for timely and applicable measures of both prevention and control. Methods: The data of daily TB notifications, meteorological factors and air pollutants in Changde City, Hunan Province ranging from 2010 to 2021 were collected. Spearman rank correlation analysis was conducted to analyze the correlation between the daily TB notifications and the meteorological factors or air pollutants. Based on the correlation analysis results, machine learning methods, including support vector regression, random forest regression and a BP neural network model, were utilized to construct the incidence prediction model of tuberculosis. RMSE, MAE and MAPE were performed to evaluate the constructed model for selecting the best prediction model. Results: (1) From the year 2010 to 2021, the overall incidence of tuberculosis in Changde City showed a downward trend. (2) The daily TB notifications was positively correlated with average temperature (r = 0.231), maximum temperature (r = 0.194), minimum temperature (r = 0.165), sunshine duration (r = 0.329), PM2.5 (r = 0.097), PM10 (r = 0.215) and O3 (r = 0.084) (p < 0.05). However, there was a significant negative correlation between the daily TB notifications and mean air pressure (r = −0.119), precipitation (r = −0.063), relative humidity (r = −0.084), CO (r = −0.038) and SO2 (r = −0.034) (p < 0.05). (3) The random forest regression model had the best fitting effect, while the BP neural network model exhibited the best prediction. (4) The validation set of the BP neural network model, including average daily temperature, sunshine hours and PM10, showed the lowest root mean square error, mean absolute error and mean absolute percentage error, followed by support vector regression. Conclusions: The prediction trend of the BP neural network model, including average daily temperature, sunshine hours and PM10, successfully mimics the actual incidence, and the peak incidence highly coincides with the actual aggregation time, with a high accuracy and a minimum error. Taken together, these data suggest that the BP neural network model can predict the incidence trend of tuberculosis in Changde City.

Since the epidemic of the severe acute respiratory syndrome coronavirus 2 (SARS-COV-2), many governments have used reverse transcription polymerase chain reaction (RT-PCR) to detect the virus. However, there are fewer measures of CT values information based on RT-PCR results, and the relationship between CT values and factors from consecutive tests is not clear enough. So in this study, we analyzed the connection between CT values and the factors based on cohort data from Delta variant of SARS-CoV-2 in Hunan Province. Previous studies have showed that the mean age of the cases was 33.34 years (+/- 18.72 years), with a female predominance (55.03%, n = 71), and the greatest proportion of clinical symptoms were of the common type (60.47%, n = 78). There were statistical differences between the N and ORF1ab genes in the CT values for the cases. Based on the analysis of the association between CT values and the factors, the lowest CT values were obtained for the unvacci-nated, older and clinically symptomatic group at 3-10 days, the maximum peak of viral load occurred. Therefore, it is recommended to use patient information to focus on older, clinically symptomatic, unvaccinated patients and to intervene promptly upon admission.(c) 2023 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

The Omicron variant is the dominant strain circulating globally, and studies have shown that Omicron cases have milder symptoms than Delta cases. This study aimed to analyze the factors that affect the clinical severity of Omicron and Delta variants, evaluate and compare the effectiveness of COVID-19 vaccines with different technological platforms, and assess the vaccine effectiveness against different variants. We retrospectively collected the basic information of all local COVID-19 cases reported by Hunan Province to the National Notifiable Infectious Disease Reporting System from January 2021 to February 2023, including gender, age, clinical severity, and COVID-19 vaccination history. From 1 January 2021 to 28 February 2023, Hunan Province reported a total of 60,668 local COVID-19 cases, of which, 134 were infected with the Delta variant and 60,534 were infected with the Omicron variant. The results showed that infection with the Omicron variant (adjusted OR (aOR): 0.21, 95% CI: 0.14–0.31), getting vaccinated (booster immunization vs. unvaccinated aOR: 0.30, 95% CI: 0.23–0.39) and being female (aOR: 0.82, 95% CI: 0.79–0.85) were protective factors for pneumonia, while old age (≥60 years vs. <3 years aOR: 4.58, 95% CI: 3.36–6.22) was a risk factor for pneumonia. Being vaccinated (booster immunization vs. unvaccinated aOR: 0.11, 95% CI: 0.09–0.15) and female (aOR: 0.54, 95% CI: 0.50–0.59) were protective factors for severe cases, while older age (≥60 years vs. < 3 years aOR: 4.95, 95% CI: 1.83–13.39) was a risk factor for severe cases. The three types of vaccines had protective effects on both pneumonia and severe cases, and the protective effect on severe cases was better than that on pneumonia. The recombinant subunit vaccine booster immunization had the best protective effect on pneumonia and severe cases, with ORs of 0.29 (95% CI: 0.2–0.44) and 0.06 (95% CI: 0.02–0.17), respectively. The risk of pneumonia from Omicron variant infection was lower than that from Delta. Chinese-produced vaccines had protective effects on both pneumonia and severe cases, with recombinant subunit vaccines having the best protective effect on pneumonia and severe pneumonia cases. Booster immunization should be advocated in COVID-19 pandemic-related control and prevention policies, especially for the elderly, and booster immunization should be accelerated.

Objective To understand the infection status of brucellosis in key population and the epidemic regularity of brucellosis in Hunan Province from 2017 to 2021, and to provide scientific evidence for formulating brucellosis prevention and control strategies. Methods The epidemiological characteristics of brucellosis cases reported in Hunan Province from 2017 to 2021 were descriptively analyzed. Results A total of 960 brucellosis cases were reported in Hunan Province during 2017-2021, with an average incidence rate of 0.28/100,000. Cases were mainly distributed in Yongzhou City, Chenzhou City, Huaihua City, Shaoyang City and Changsha City, accounting for 59.48% of the total cases. The number of reported cases showed a fluctuating upward trend, with the incidence rate rising from 0.26/100,000 in 2017 to 0.36/100,000 in 2021. The peak of brucellosis incidence was mainly from April to July. Cases were reported in all age groups, ranging from 8 days old to 90 years old. Most cases were reported in the group aged 50-＜60 years, with 322 cases（accounting for 33.54%）. There were 679 male cases and 281 female ones, with a male-to-female ratio of 2.42:1. Farmers accounted for the highest proportion of occupation（64.06%）. Conclusion The number and incidence rate of human brucellosis cases reported in Hunan Province in 2017-2021 were on the rise, and the high incidence region was in the southwest of Hunan Province. It is suggested that medical institutions should establish a multi-department joint prevention and control mechanism and form a flexible and efficient mechanism for joint prevention and control of brucellosis.

Background: The current outbreak of novel coronavirus disease 2019 has caused a serious disease burden worldwide. Vaccines are an important factor to sustain the epidemic. Although with a relatively high-vaccination worldwide, the decay of vaccine efficacy and the arising of new variants lead us to the challenge of maintaining a sufficient immune barrier to protect the population.Method: A case-contact tracking data in Hunan, China, is used to estimate the contact pattern of cases for scenarios including school, workspace, etc, rather than ordinary sus-ceptible population. Based on the estimated vaccine coverage and efficacy, a multi-group vaccinated-exposed-presymptomatic-symptomatic-asymptomatic-removed model (VEFIAR) with 8 age groups, with each partitioned into 4 vaccination status groups is developed. The optimal dose-wise vaccinating strategy is optimized based on the currently estimated immunity barrier of coverage and efficacy, using the greedy algorithm that minimizes the cumulative cases, population size of hospitalization and fatality respectively a certain future interval. Parameters of Delta and Omicron variants are used respectively the optimization.Results: The estimated contact matrices of cases showed a concentration on middle ages, and has compatible magnitudes compared to estimations from contact surveys in other studies. The VEFIAR model is numerically stable. The optimal controled vaccination strat-egy requires immediate vaccination on the un-vaccinated high-contact population of age 30-39 to reduce the cumulative cases, and is stable with different basic reproduction numbers (R0). As for minimizing hospitalization and fatality, the optimized strategy requires vaccination on the un-vaccinated of both aged 30-39 of high contact frequency and the vulnerable older. Conclusion: The objective of reducing transmission requires vaccination in age groups of the highest contact frequency, with more priority for un-vaccinated than un-fully or fully vaccinated. The objective of reducing total hospitalization and fatality requires not only to reduce transmission but also to protect the vulnerable older. The priority changes by vaccination progress. For any region, if the local contact pattern is available, then with the vaccination coverage, efficacy, and disease characteristics of relative risks in heterogeneous populations, the optimal dose-wise vaccinating process will be obtained and gives hints for decision-making.(c) 2023 The Authors. Publishing services by Elsevier B.V. on behalf of KeAi Communications Co. Ltd. This is an open access article under the CC BY license (http:// creativecommons.org/licenses/by/4.0/).

What is already known about this topic? Little is known about the epidemiology, natural history, and transmission patterns of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Delta variant. Monitoring the evolution of viral fitness of SARS-CoV-2 in the host population is key for preparedness and response planning. What is added by this report? We analyzed a successfully contained local outbreak of Delta that took place in Hunan, China, and provided estimates of time-to-key event periods, infectiousness over time, and risk factors for SARS-CoV-2 infection and transmission for a still poorly understood variant. What are the implications for public health practice? Our findings simultaneously shed light on both the characteristics of the Delta variant, by identifying key age groups, risk factors, and transmission pathways, and planning a future response effort against SARS-CoV-2.

Enterovirus A71 (EV-A71)-related hand, foot, and mouth disease (HFMD) imposes a substantial clinical burden in the Asia Pacific region. To inform policy on the introduction of the EV-A71 vaccine into the National Immunization Programme, we investigated the seroepidemiological characteristics of EV-A71 in two prospective cohorts of children in southern China conducted between 2013 and 2018. Our results show that maternal antibody titres declined rapidly in neonates, with over half becoming susceptible to EV-A71 at 1 month of age. Between 6 months and 2 years of age, over 80% of study participants were susceptible, while one third remained susceptible at 5 years old. The highest incidence of EV-A71 infections was observed in children aged 5-6 months. Our findings support EV-A71 vaccination before 6 months for birth cohorts in southern China, potentially with a one-time catch-up vaccination for children 6 months-5 years old. More regionally representative longitudinal seroepidemiological studies are needed to further validate these findings.

目的 分析长沙市气象因素与手足口病发病的关联及其滞后效应.方法 收集2016-2019年长沙市手足口病日发病数据及同期气象数据,对其进行关联性分析,采用分布滞后非线性模型分析气象因素对手足口病发病的滞后效应.结果 2016-2019年长沙市共报告手足口病122788例,年平均发病率为395.09/10万,4～7月和11～12月是每年手足口病发病高峰期.以中位数18.2℃为参考值,日均气温在28.5℃时对手足口病发病的总体效应最高(RR=2.70,95％CI:2.04～3.58),低温(P5=3.2℃)情况下滞后2d时RR最大,为1.19(95％CI:1.09～1.30),高温(P95=30.7℃)情况下滞后0d时RR最大,为1.14(95％CI:1.04～1.26).以中位数1002.10hPa为参考值,日均气压在991hPa时对手足口病发病的总体效应最高(RR=2.35,95％CI:1.84～3.02),低压(P5=988.7hPa)情况下滞后5d时RR最大,为1.10(95％CI:1.06～1.13),高压(P95=1015.8hPa)情况下滞后2d时RR最大,为1.10(95％CI:1.05～1.16).结论 日均气温、日均气压与手足口病发病呈非线性关系,并存在明显的滞后效应,高温、低压对手足口病发病的影响更为显著.

目的 分析2011-2020年湖南省伤寒、副伤寒流行特征和菌株耐药情况,为做好伤寒、副伤寒防控工作提供依据.方法 收集2011-2020年湖南省伤寒、副伤寒监测数据,采用描述性流行病学方法分析三间分布特征,对各市州分离上送的67株伤寒、副伤寒沙门菌采用梅里埃VITEK2 Compact全自动细菌鉴定及药敏分析系统进行细菌鉴定和药敏分析.结果 10年间湖南省共报告伤寒、副伤寒病例9 888例,死亡0例,年均发病率1.47/10万.发病人群以农民、散居儿童、学生为主,5-9月为高发季节,主要集中在湘南和湘西地区.2011-2020年湖南省共报告4起伤寒、副伤寒暴发疫情,暴发场所均为学校,传播途径均为水型传播.67株伤寒、副伤寒菌对头孢他啶、氨曲南和厄他培南100％敏感;对哌拉西林/他唑巴坦、头孢吡肟和复方新诺明敏感率为98.5％;对氨苄西林/舒巴坦敏感率为97.0％;对头孢唑林、头孢替坦、阿米卡星、庆大霉素和妥布霉素敏感性较低(＜10％).55.3％菌株对三类及以上抗生素耐药,发现1株同时对8种抗生素耐药.结论 湖南省伤寒、副伤寒发病呈持续低发状态,局部地区存在暴发.菌株多重耐药现象严重,应加强疫情及耐药监测.

目的 分析87起由密切接触导致的新型冠状病毒肺炎聚集性疫情的序列间隔,为制定防控策略和措施提供依据.方法 收集2020年1-2月湖南省报告的新型冠状病毒肺炎聚集性疫情病例资料,根据原发病例与续发病例的发病时间,采用中位数方法估算序列间隔,采用秩和检验比较不同代际关系、原发病例不同发病-隔离时间段的序列间隔的差异,描述2起序列间隔为负值的聚集性疫情详细信息.结果 新型冠状病毒肺炎中位序列间隔6d,四分位数为7d;不同代际关系的序列间隔差异无统计学意义;原发病例发病-隔离间隔时间段为11d及以上、6～10d的中位序列间隔分别为10、8d,均长于原发病例发病-隔离时间段为0～5d的中位序列间隔4d(P＜0.05);病例最早在发病前7d即具有传播能力.结论 新型冠状病毒肺炎序列间隔比严重急性呼吸道综合征、中东呼吸综合征短,有效传播速度更快;及早对原发病例进行隔离与治疗,序列间隔将缩短,流行初期的研究反映干预前实际传播速度;新型冠状病毒肺炎病例在发病时即具有较强的传染性;部分代际传播发生在原发病例发病前,建议有条件地区可将适当延长病例发病前的调查及密切接触者判定的时间范围.

Abstract Evaluations of the pandemic to endemic phase are a great concern, especially in Zero-COVID-19 countries. Herein, we developed a mathematical model to simulate future scenarios for the variants of concern (VOCs) in the condition of several immune barriers and controlling measures. The results demonstrated that the Omicron variant would lead to 592.0 (mean ± standard deviation (SD): 433.9–750.0) million symptomatic, 24.3 (mean ± SD: 17.4–312.8) million hospital admission, 9.6 (mean ± SD:7.0–12.3) million ICU admission, and 5.4 (mean ± SD:3.7–7.5) million death cases after simulation with 1,000 days. At the endemic phase, there were nearly 500 death cases per day attributed to reinfection (66% [range: 62–70%]), infection from birth (18% [range: 16–21%]), and infection from migration (16% [range: 14–17%]). Actively treating more than 80% of cases could effectively reduce disease severity and death rates. It is feasible to transmit pandemic to endemic with Omicron variant and other milder VOCs. We recommend that the successful transition strategy is to improve medical resource allocation and enhance the prevention and control capabilities of health agencies.

The strong suppression of Aedes albopictus on two Guangzhou islands in China has been successfully achieved by releasing males with an artificial triple- Wolbachia infection. However, it requires the use of radiation to sterilize residual females to prevent population replacement. To develop a highly effective tool for dengue control, we tested a standalone incompatible insect technique (IIT) to control A. albopictus in the urban area of Changsha, an inland city where dengue recently emerged. Male mosquitoes were produced in a mass rearing facility in Guangzhou and transported over 670 km under low temperature to the release site. After a once-per-week release with high numbers of males (phase I) and a subsequent twice-per-week release with low numbers of males (phase II), the average numbers of hatched eggs and female adults collected weekly per trap were reduced by 97% and 85%, respectively. The population suppression caused a 94% decrease in mosquito biting at the release site compared to the control site. Remarkably, this strong suppression was achieved using only 28% of the number of males released in a previous trial. Despite the lack of irradiation to sterilize residual females, no triple-infected mosquitoes were detected in the field post release based on the monitoring of adult and larval A. albopictus populations for two years, indicating that population replacement was prevented. Our results support the feasibility of implementing a standalone IIT for dengue control in urban areas.

目的 分析2019-2020年湖南省手足口病的监测数据,掌握手足口病流行特征及病原变化情况,为手足口病防控策略的制定提供依据.方法 对中国疾病预防控制信息系统中2019-2020年湖南省手足口病监测资料进行描述性流行病学分析,应用实时荧光聚合酶链式反应检测手足口病临床诊断病例标本中的肠道病毒71型(EV71)、柯萨奇病毒A组16型(CVA16)和其他肠道病毒.结果 2019年湖南省共上报手足口病病例97 110例,发病率为140.76/10万;2020年报告手足口病病例114 400例,发病率为165.35/10万;2020年发病数较2019年上升15.1％,发病率较2019年上升14.9％;两年手足口病发病呈现单峰流行,2019年顶峰发生在6月,2020年则在10月达到顶峰;发病率较高的地区主要为湘中和湘西地区(如长沙市、湘西自治州与湘潭市);主要发病人群为5岁以下的散居儿童,男女比为1.27:1;2019年湖南省共报告手足口病聚集性疫情168起,2020年共报告276起,2020年较2019年增加64.3％,两年合计报告444起,其中发生在幼托机构的有200起,占44.9％,发生在社区的有244起,占55.1％;两年共采集标本12 398份,阳性标本7 222份,总阳性率为58.2％;阳性样本中EV71型39份(0.5％)、CVA16型874份(12.1％)、其他肠道病毒型6 306份(87.3％),在其他肠道病毒中,检测到CA6型159份(2.5％)、CA10型14份(0.2％)、CA4型10份(0.2％)和未分型6 123份(97.1％),其他肠道病毒中未分型病毒成为湖南省2019-2020年的优势型别;不同年份(x2=486.38,P＜0.001)、地区(x2=229.89,P＜0.001)和年龄(x2=128.44,P＜0.001)手足口病病原谱构成差异有统计学意义,2019年与2020年不同病例类型手足口病病原谱构成差异无统计学意义(x2=4.56,P＞0.05;x2=2.36,P＞0.05).结论2019-2020年湖南省手足口病的流行具有明显季节性和区域性,5岁以下儿童是手足口病防控的重点人群,病原谱中其他肠道病毒构成比最高,需重点加强散居儿童的健康教育及病原学监测工作,及时掌握手足口病病原谱变化情况.

The current outbreak of novel coronavirus disease 2019 (COVID-19) is already causing a serious disease burden worldwide, this paper analyzed data of a delta variant Covid-19 outbreak in Hunan, China, and proposed an optimal dose-wise dynamical vaccinating process based on local contact pattern and vaccine coverage that minimize the accumulative cases in a certain future time interval. The optimized result requires an immediate vaccination to that none vaccinated at age group 30 to 39, which is coherent to the prevailing strategies. The dose-wise optimal vaccinating process can be directive for countries or regions where vaccines are not abundant. We recommend that vaccination should be further intensified to increase the coverage of booster shots, thus effectively reducing the spread of COVID-19.

目的 分析2016—2020年湖南省手足口病时空聚集性特点,为手足口病疫情防控提供科学依据.方法 在中国疾病预防控制信息系统收集2016—2020年湖南省手足口病数据,以县区为单位采用ArcGIS 10.2软件对手足口病发病数据进行空间自相关分析,采用SaTScan 9.7软件对手足口病发病数据进行时空聚集性分析.结果 2016—2020年湖南省累计报告手足口病714157例,年均发病率208.36/10万.全局空间自相关显示,2016—2020年湖南省手足口病在县区尺度上存在空间正相关.局部空间自相关显示,热点区域主要集中在湘中偏北、湘中部偏东和湘西地区.时空扫描分析探测到一类聚集区(RR=6.65,P<0.001)覆盖湘北、湘中34个县区,主要分布在岳阳市、长沙市、株洲市、益阳市和湘潭市,聚集时间为2018年5月至2018年6月;二类聚集区(RR=3.02,P<0.001)覆盖大湘西地区及湘中、湘西南40个县区,聚集时间为2016年4月至2016年6月.结论 湖南省手足口病的发病有季节性和地区高发特点,应结合时空聚集性特点,指导手足口病防控工作.

Objectives: To data, no patients with obvious epidemiological relationship co-infected with SARS-CoV-2 and other pathogens have been reported. Here, we investigated 10 patients caused by co-infection with SARS-CoV-2 and human adenovirus (HAdV), resulting in third-generation transmission. Materials and Methods: From Jan 15, 2020, we enrolled 10 patients with pneumonia in Hunan Province, China. Epidemiological, clinical, and laboratory investigation results from these patients were analyzed. An epidemiological investigation was performed to assess whether patient infections were linked using conventional methods and metagenomic sequencing. Results: The presence of co-infection with SARS-CoV-2 and HAdV was determined via RT-PCR and metagenomic sequencing. Phylogenetic analysis revealed that SARS-CoV-2 and HAdV genomes clustered together, with similar genetic relationships. The first patient likely became co-infected during meetings or travel in Wuhan. The patient transmitted the virus via dinners and meetings, which resulted in four second-generation cases. Then, a second-generation case transmitted the virus to her family members or relatives via presymptomatic transmission. Conclusions: This study described an example of co-infection with SARS-CoV-2 and HAdV in pneumonia patients, which caused third-generation cases and inter-regional transmission via meetings, household interactions, and dinner parties. We also observed the persistent and presymptomatic transmission of co-infection, which has the potential to make the continued control of the COVID-19 pandemic challenging. Continuous surveillance is needed to monitor the prevalence, infectivity, transmissibility, and pathogenicity of SARS-CoV-2 co-infection with other pathogens to evaluate its real risk.

RESEARCH QUESTION:What are the risks associated with cryopreserved semen collected during and after the coronavirus disease 2019 (COVID-19) pandemic wave in Wuhan, China?DESIGN:Retrospective cohort study involving young adult men who were qualified sperm donors at the Hunan Province Human Sperm Bank (China) during the pandemic wave (1 January 2020 to 30 January 2020) and after the wave and return to work (7 April 2020 to 30 May 30 2020). One hundred paired semen and blood specimens from 100 donors were included. One-step single-tube nested quantitative real-time polymerase chain reaction (OSN-qRT-PCR) was used to detect SARS-CoV-2. Moreover, to control the unacceptable risk of false-negative results, a second round of screening was performed with pooled RNA from negative semen samples using crystal digital PCR (cd-PCR).RESULTS:For individual blood and semen samples, the target genes, namely the nucleocapsid protein (N) and open reading frame (ORF-1ab) genes, tested negative in all of the 100 paired samples. Further, as per cd-PCR results, there were >20,000 droplets per well in the RNA for each combined sample and no positive droplets were present for either of the aforementioned target genes. A total of 100 paired semen and blood samples from these two groups tested negative for SARS-CoV-2.CONCLUSIONS:Cryopreserved semen at the Hunan Province Human Sperm Bank during and after the COVID-19 pandemic wave was free of SARS-CoV-2 and was judged safe for external use in the future.

目的 掌握湖南省肾综合征出血热病例的流行特征和临床特点,为防治工作提供参考依据.方法 采用描述性流行病学方法分析2009-2019年湖南省肾综合征出血热病例临床和流行病学特征以及宿主动物监测情况.结果 2009-2019年湖南省共报告肾综合征出血热病例7001例,年均报告发病率为0.95/10万.患者以男性青壮年农民为主,各市州病例发病日期距离就诊日期中位数集中在3～5 d,就诊日期距离诊断日期中位数集中在0～2 d.病例症状以轻型、中型为主(82.45％).临床症状和体征以发热(93.49％)、乏力(91.57％)、起病急(85.39％)等多见.相关暴露因素中,主要有鼠或鼠排泄物接触史.2009-2019年各监测点平均鼠密度为3.22％,室内鼠密度3.47％高于野外(1.77％,x2=648.794,P=0.000).鼠肺标本HFRS总抗原阳性率1.75％,4个监测点HFRS的抗原阳性率差异有统计学意义(x2=29.445,P=0.000),双峰县鼠病毒携带率最高,邵东县鼠病毒携带率最低.结论 近年来湖南省出血热疫情出现上升趋势,汉城型和汉滩型混合分布,患者临床表现不典型,就诊不够及时,需要加强健康教育工作,提高民众自我保护和及时就诊意识.