BACKGROUND/OBJECTIVES:This prospective cohort study assessed the impact of seasonal influenza during pregnancy on fetal and infant health outcomes. METHODS:Pregnant women with laboratory-confirmed influenza were matched (1:4) by age and pregnancy loss history with women without influenza from annual cohorts in Suzhou, China, during 2015-2018. Participants underwent twice-weekly follow-up for influenza illness, and medical records were linked to ascertain outcomes. Multivariable regression models were used to estimate associations. RESULTS:We included 441 pregnant women with influenza and 1764 without it. Four (0.9%) in the influenza group had late pregnancy loss, whereas one (0.1%) in the non-influenza group did. Influenza was associated with late pregnancy loss (adjusted hazard ratio [aHR] 31.1, 95% Confidence Interval [CI]: 1.3-756.8, p = 0.035). Four (0.9%) in the influenza group experienced early pregnancy loss, while five (0.3%) in the non-influenza group did. Influenza was not significantly associated with early pregnancy loss (aHR 2.1, 95% CI: 0.4-10.4, p = 0.374). By 8 months of age, infants born to 198 of the 441 mothers (44.9%) in the influenza group met the criteria for the program-defined child health monitoring indicator, compared with infants born to 650 of the 1764 mothers (36.8%) in the non-influenza group. Overweight/obesity was the largest contributor: 142 (32.2%) versus 470 (26.6%). Maternal influenza was associated with higher odds of meeting program-defined child health monitoring indicator in offspring (adjusted odds ratio [aOR] 1.4, 95% CI: 1.1-1.8, p = 0.006), with a significant contribution from overweight/obesity (aOR 1.3, 95% CI: 1.0-1.7, p = 0.045). CONCLUSIONS:In this cohort, influenza during pregnancy was associated with an increased risk of late pregnancy loss and program-defined child health monitoring indicator in offspring, particularly overweight/obesity. Because the observed association with pregnancy loss was based on a small number of events and had a wide confidence interval, it should be interpreted cautiously and confirmed in larger studies. These findings are consistent with current recommendations supporting influenza vaccination during pregnancy to protect maternal and infant health.

During this 2025/26 Northern Hemisphere influenza season, the predominant influenza A(H3N2) subclade K virus has binding site mutations and postvaccine sera reduced inhibition, raising concerns about antigenic differences with available vaccines. During November 2025– January 2026, 8,455 patients with influenza-like illness (ILI) and 4,479 patients with severe acute respiratory illness (SARI) were identified through 25 sentinel surveillance hospitals in Suzhou City, Jiangsu Province, China. Among enrolled ILI and SARI patients, 4,032 (47.7%) and 697 (15.6%) were influenza positive by RT-PCR, respectively. Of all influenza positives, four were influenza B Victoria and three were influenza A(H1N1)pdm09; all remaining positives were influenza A(H3N2). Among gene sequenced viruses isolated from 44 randomly-selected positive samples during the study period, 95% were influenza A(H3N2) subclade K. Generalized linear regression models indicated Northern Hemisphere 2025/26 influenza vaccines, including A/Croatia/10136RV/2023 (H3N2)-like viruses, reduced risk for influenza-associated outpatient visits by approximately one-half during the November 2025–January 2026 subclade K dominant months. We did not observe statistical significance, although the point estimate suggested a possible one-fifth reduction in influenza-associated hospitalizations. Increasing seasonal influenza vaccine coverage could relieve stress on the medical system during respiratory disease season.

Background: Health departments disseminate health education related to influenza to the public through various media in China. We examined knowledge, attitudes, and practices regarding influenza and the influenza vaccine (KAP-flu) over time among pregnant women (PW) compared to non-PW. Methods: A cross-sectional survey was conducted in Suzhou, China in 2013 and 2023. We included and interviewed PW seeking prenatal care and excluded PW there for non-routine visits. The comparison group was drawn from non-PW seeking physical examinations at the same facilities. Stratified cluster sampling was used to enroll participants from the various levels of prenatal-care facilities. Results: In 2013, we surveyed 1673 PW and 401 non-PW, and in 2023, we surveyed 2195 PW and 1171 non-PW. The proportion of PW who had ever heard of the influenza vaccine showed no significant change, at 56% in 2013 and 57% in 2023; by contrast, there was a significant increase among non-PW (55% to 78%). The proportion of pregnant participants who knew when to get vaccinated dropped from 14% to 12%, in contrast to the increase among non-PW (6% to 20%). The proportion of PW who believed that the influenza vaccine is effective dropped from 91% in 2013 to 76% in 2023, in contrast to the stable value among non-PW (84% to 82%). In 2023, pregnant participants exhibited lower levels of knowledge about both influenza disease and the influenza vaccine, along with less positive attitudes toward the effectiveness and safety of the vaccine. They also showed lower willingness to vaccinate and lower vaccination rates compared to non-pregnant participants. Concerning KAP-flu among PW, less than half recognized that influenza is different from a common cold; fewer than one in five understood the timing and frequency of vaccination or the policy prioritizing PW for influenza vaccination; vaccination coverage remained below 2% over time. Conclusions: PW had concerning gaps in knowledge and attitudes regarding influenza and the influenza vaccine compared to non-PW in Suzhou, China. Specific actions targeting PW, such as initiatives leveraging the maternal and child healthcare system, are warranted to reduce the gaps.

Objective:To explore the influencing factors of seasonal influenza among pregnant woman in Suzhou from 2015 to 2018.Methods:Based on the data of the influenza follow-up cohort of pregnant women in Suzhou from 2015 to 2018, the basic and clinical characteristics of the cohort were described, and the influencing factors of laboratory-confirmed influenza cases in pregnant women were analyzed by unconditional logistic regression.Results:A total of 19 006 pregnant women were recruited, in whom 479 cases of influenza were laboratory confirmed. Influenza A (H3N2) (42.8%) was the main sub-type. In pregnant women with exposure risk in influenza season, unconditional univariate logistic analysis showed that pregnant women or their husbands had registered permanent residence in Suzhou, pregnant women worked as childminder or nanny, had more than 2 permanent residents in the family except themselves, had medical insurance in Suzhou, had fertility insurance in Suzhou, were in the third trimester at the time of enrollment, had cough in the past month, were pregnant for the first time, had children, before and after pregnancy, spent more time outdoors than before, wore masks more often than before and had changed the frequency of gathering were all related to influenza virus infection in pregnant women. Among them, the first pregnancy, increasing the time of outdoor activity, increasing the frequency of wearing masks, and changing the frequency of gathering were important protective factors. Unconditional multivariate logistic regression analysis showed that the number of permanent residents at home was >2 (a OR=1.24, 95% CI: 1.01-1.52) and being in the third trimester, (a OR=1.56, 95% CI: 1.26-1.91) were the risk factors for maternal infection with influenza virus. Conclusion:Pregnant women with a large number of permanent residents and late pregnancy should pay attention to preventing seasonal influenza.

Objective:To understand the reinfection rate of 2019-nCoV in the previously infected population in Suzhou and compare the illness severity and prognosis of the reinfection cases with the first-time infection cases.Methods:A questionnaire survey was conducted in the persons with previous 2019-nCoV infection reported in Suzhou from January 22, 2020 to November 8, 2022 to collect the information about the incidence of reinfection of 2019-nCoV in this population from December 8, 2022 to January 18, 2023. The persons who were infected with 2019-nCoV for the first time were selected by marching the residence, age and gender at ratio of 1∶2 from 2019-nCoV infection community follow-up cohort of Suzhou. By χ2 test, the clinical symptoms and prognosis of the reinfection case and the first-time infection cases were compared. Results:The reinfection rate of 2019-nCoV was 13.01% (147/1 130) in Suzhou. No reinfection was found within 1-6 months after the first-time infection, the rate of reinfection was 10.59% (95/897) in those with interval of 7-12 months between the reinfection and the first-time infection and 45.61% (52/114) in those with the interval ≥24 months. The lowest reinfection rate was 9.09% (1/11) in those who had completed 4 doses of 2019-nCoV vaccination. The main symptoms of the reinfection cases were similar to those of the first-time infection cases. Except for dry cough, nausea/poor appetite and other symptoms, there were significant differences in other clinical symptoms between the two groups ( P<0.05). In the reinfection cases, fever had shorter duration with lower body temperature. The hospital visit rate in the reinfection cases was 4.08% (6/147), lower than that in the cases with the first-time infection (11.56%, 34/294). The time for negative nucleic acid (antigen) test result and recovery from illness after the reinfection were shorter than those after the first-time infection. Conclusions:Reinfection occurred in some people who had been infected with 2019-nCoV. The interval between the reinfection and the first-time infection and the completion of the 4 doses of booster vaccination were the factors influencing the reinfection rate. The hospital visit rate in the reinfection cases was lower than that in the cases with the first-time infection. The reinfection had similar symptoms and shorter illness duration compared with the first-time infection.

Background: We estimated symptomatic and asymptomatic influenza infection frequency in community -dwelling unvaccinated pregnant persons to inform risk communication. Methods: We collected residue sera from multiple antenatal-care blood draws during October 2016-April 2017. We determined influenza infection as seroconversion with >= 4-fold rise in antibody titers between any two serum samples by improved hemagglutinin-inhibition assay including ether-treated B antigens. The serology data were linked to the results of nuclei acid testing (rRT-PCR) based on acute respiratory illness (ARI) surveillance. Results: Among all participants, 43 %(602/1384) demonstrated serology and/or rRT-PCR evidenced infec-tion, and 44 %(265/602) of all infections were asymptomatic. ARI-associated rRT-PCR testing identified only 10 %(61/602) of total infections. Only 1 %(5/420) of the B Victoria cases reported ARI and had a rRT-PCR positive result, compared with 33 %(54/165) of the H3N2 cases. Among influenza ARI cases with multiple serum samples, 19 %(11/58) had seroconversion to a different subtype prior to the illness. Conclusions: The incidence of influenza B infection in unvaccinated pregnant persons is under-estimated substantially. Non-pharmaceutical intervention may have suboptimal effectiveness in preventing influ-enza B transmission due to the less clinical manifestation compared to influenza A. The findings support maternal influenza vaccination to protect pregnant persons and reduce consequent household transmission. (c) 2022 The Authors. Published by Elsevier Ltd.

Background: Data on influenza incidence during pregnancy in China are limited. Methods: From October 2015–September 2018, we conducted active surveillance for acute respiratory illness (ARI) among women during pregnancy. Nurses conducted twice weekly phone and text message follow-up upon enrollment until delivery to identify new episodes of ARI. Nasal and throat swabs were collected ≤10 days from illness onset to detect influenza. Results: In total, we enrolled 18,724 pregnant women median aged 28yo, 37% in first trimester, 48% in second trimester and 15% in third trimester, with 7 self-reported vaccination during pregnancy. In the 18-week epidemic period during October 2015–September 2016, influenza incidence was 0.7/100 person-months (95% CI:0.5–0.9). In the 29-week epidemic during October 2016–September 2017, influenza incidence was 1.0/100 person-months (95% CI:0.8–1.2). In the 11-week epidemic period during October 2017–September 2018, influenza incidence was 2.1/100 person-months (95% CI:1.9–2.4). Influenza incidence was similar by trimester. More than half of the total influenza illnesses had no elevated temperature and cough. Most influenza-associated ARIs were mild, and <5.1% required hospitalization. Conclusions: Influenza illness in all trimesters of pregnancy was common. These data may help inform decisions regarding the use of influenza vaccine to prevent influenza during pregnancy.

目的 了解苏州市住院肺炎病例的病原谱和流行动态,为呼吸道传染病的防治提供参考.方法 利用苏州市呼吸道传染病综合监测项目,选取2018年4月—2020年3月期间苏州市264例住院肺炎病例进行11种常见呼吸道病原体RT-PCR检测,描述病原谱和流行动态.结果 264例住院肺炎病例共检出阳性标本134份,阳性率50.8％,其中33份(占24.6％)为混合感染.检出率居前3的病原体为肺炎链球菌(14.0％)、呼吸道合胞病毒(8.7％)及流感嗜血杆菌(7.2％).呼吸道合胞病毒、鼻病毒、人偏肺病毒、单纯疱疹病毒、流感嗜血杆菌、肺炎支原体的检出率在不同年龄组间差异均有统计学意义(P＜0.05).肺炎链球菌、呼吸道合胞病毒、流感病毒以及人偏肺病毒在冬春季(11月—次年4月)更易检出,冬春季检出占比分别为64.9％、91.3％、76.9％、90.9％.结论 肺炎链球菌是苏州市住院肺炎病例中最常见的病原体,同时也是混合感染中最常见的病原体.各类病原体在人群和季节分布上有所不同,应针对重点人群、重点病原体采取更有针对性的防控措施.

目的 了解苏州市新型冠状病毒肺炎(COVID-19)聚集性疫情的流行病学特征,探索其传播力.方法 收集2020年1-3月苏州市传播链明确的COVID-19聚集性疫情,收集聚集性疫情病例的基本信息,使用伽马分布拟合病例代际间隔时间(Tg),使用SEIR模型计算基本再生数(R0).结果 25起聚集性疫情中,16起来源于湖北疫区,23起是家庭聚集性疫情,包含48例确诊病例,12例核酸阳性的无症状感染者.25起聚集性疫情病例代际间隔时间为2～18 d,平均(7.09±4.31)d;估算苏州市新冠肺炎感染的R0为2.62(95％CI:2.22～3.06).结论 COVID-19聚集性疫情主要在家庭内聚集传播,早期传播力和重症急性呼吸综合征(SARS)、中东呼吸综合征(MERS)相当,应采取严格的防控措施阻断其流行.

目的 了解苏州市相城区某幼儿园1起由札如病毒引起的聚集性疫情.方法 运用描述性流行病学方法,分析聚集性疫情流行病学特征.采集病例肛拭子、呕吐物和粪便以及环境样本,进行可疑病原体PCR核酸和致病菌检测.结果 2019年9月1-6日,通过病例搜索共发现病例16例,确诊病例8例,临床诊断病例8例.临床症状以呕吐为主(16例,占100.00％).发病至痊愈间隔平均为2.50d,就诊组为2.12d,未就诊组为2.88 d,差异无统计学意义(t=-1.33,P=0.21).发病时间主要集中在9月5日16:00-9月6日10:00,呈现点源传播方式,病例全部分布在小三班,罹患率为40.00％(16/40).病例样本核酸检测诺如病毒、轮状病毒、星状病毒均为阴性,札如病毒阳性9份,阳性率50.00％,确诊病例8例,其1例肛拭子和粪便均为札如病毒阳性.环境样本检测诺如病毒、沙门菌和志贺菌均为阴性.结论 本次疫情是一起札如病毒引起的胃肠炎聚集性疫情,教室内接触可能是主要传播途径.

Respiratory syncytial virus (RSV) causes serious lower respiratory tract infections and there are currently no safer or more effective drugs available. It is important to find novel medications for RSV infection. A series of steroidal pyridines were synthesized for screening and evaluation of their antiviral activity and investigation of their antiviral mechanism of action. Compound 3l had the highest antiviral activity, with a half-maximal effective concentration (EC50) of 3.13 mu M. Compound 3l was explored for its effects in vitro on RSV 2 h before infection (pretreatment), at the time of infection (competition), and 2 h after infection (postinfection). Toll-like receptor (TLR)-3, retinoic acid-inducible gene (RIG)-I, interleukin (IL)-6, and interferon (IFN)-beta were suppressed at the cellular level. Mouse lung tissue was subjected to hematoxylin and eosin (HE) staining and immunohistochemistry, which showed that RSV antigen and M gene expression could be reduced by compound 3l. Decreased expression of TLR-3, RIG-I, IL-6, IFN-beta, and IL-10 was also found in vivo. The results indicated that compound 3l exerted its antiviral effects mainly through inhibition of viral replication and downregulation of inflammatory factors.

Influenza A virus is a highly variable and contagious respiratory pathogen that can cause annual epidemics and it poses an enormous threat to public health. Therefore, there is an urgent need for a new generation of antiviral drugs to combat the emergence of drug-resistant strains of the influenza virus. A novel series of butene lactone derivatives were screened and the compound 3D was selected, as it exhibited in vitro potential antiviral activity against A/Weiss/43 H1N1 virus with low toxicity. In addition, 3D dose-dependently inhibited the viral replication, expression of viral mRNA and viral proteins. 3D exerted a suppressive effect on A/Virginia/ATCC2/2009 H1N1 and A/California/2/2014 H3N2 in vitro. The time-of-addition analysis indicated that 3D suppressed H1N1 in the early stage of its life cycle. A/Weiss/43 H1N1-induced apoptosis in A549 cells was reduced by 3D via the mitochondrial apoptosis pathway. 3D could decrease the production of H1N1-induced pro-inflammatory cytokines that are induced by H1N1 in vitro and in vivo. The administration of 3D reduced lung lesions and virus load in vivo. These results suggest that 3D, which is a butene lactone derivative, is a promising agent for the treatment of influenza A virus infection.

目的 分析苏州市2018-2020年疱疹性咽峡炎的流行特征和病原学的分布及变化趋势,为疱疹性咽峡炎的防控提供科学依据.方法 收集在苏州监测医院就诊的疱疹性咽峡炎病例的基本信息和病原学信息.采用实时荧光-PCR方法进行病毒核酸检测,并对结果信息进行描述分析.结果 2018年5月至2020年6月共采集疱疹性咽峡炎病例标本1092例,监测期内无重症和死亡病例,标本阳性率为48％(529/1092),主要病原类型为CoxA6(34.03％),Cox A16(20.60％),其他肠道病毒(44.42％);阳性标本中,≤6岁儿童占95.7％,男性标本阳性率稍高于女性;6-9月标本阳性率较高,3月最低,不同月份阳性率差异有统计学意义.监测期内,共发生疱疹性咽峡炎聚集性疫情19起(2020年0起),总发病人数113,发病高峰期集中在每年的4-6月和9-11月,以3、4岁学龄儿童为主;2018和2019年疫情的主要病原分别为CoxA6和EV71.结论 苏州疱疹性咽峡炎的易感人群是≤6岁以下的儿童,好发于夏秋季,主要的致病原为CoxA6、CoxA16和其他肠道病毒.疱疹性咽峡炎的主要病原体和手足口病相同,且优势毒株不断转变,应加强监测,建议依照手足口病的管理办法进行防控.

ObjectiveTo understand the hospital preference in terms of area and grade for treatment in hepatitis B cases in Suzhou from 2014 to 2018 and provide evidence for the rational allocation of medical resources in the prevention and treatment of hepatitis B in Suzhou. MethodsThe data of the confirmed hepatitis B cases with current address in Suzhou from 2014 to 2018 were collected from the National Notifiable Infectious Disease Reporting Information system (NNDRS), and the data were collated and analyzed by Excel 2013. The medical care seeking flow of the hepatitis B cases in Suzhou was drawn by using the circlize package of R software (version 3.6.1). The Sankey diagram of the medical care seeking flow and hospital grade was generated with the networkD3 package of software R, and the extra-area medical care seeking map of the hepatitis B cases was produced with software ArcGIS 10.3. ResultsIn hepatitis B cases in Suzhou, 9.74% sought medical cares in hospitals in other cities. 64.24% sought medical cares in local hospitals of the districts or counties. The hospitals in Gusu district were the preference of hepatitis B cases in urban area of Suzhou. The hepatitis B cases in 4 outer counties of Suzhou were more likely to see doctors in hospitals in Shanghai. Up to 73.48% (3 370/4 586) of the hospitals for extra-area medical care seeking belonged to grade Ⅲ (A), while the proportion of grade Ⅲ (A) hospitals for local medical care seeking was 15.67% (1 291/8 237) (OR＝14.91, 95% CI: 13.65–16.29). ConclusionHepatitis B patients in Suzhou were mainly treated by local hospitals of districts or counties where they lived, while the patients seeking extra-area treatment mainly went to the grade Ⅲ (A) hospitals in Gusu district of Suzhou and in Shanghai.

目的 了解某幼儿园一起流感暴发疫情的流行特征,探讨暴发原因,为其防控提供科学依据.方法 现场进行流行病学调查并采样检测,对不同人群的罹患率进行卡方检验.结果 此次疫情共持续7日,累计发病21例,教师罹患率为20.59％、学生罹患率为3.90％,人群罹患率差异有统计学意义(x2=17.10,P＜0.01);病例主要症状为咳嗽(95.24％)、发热(85.71％);4例病例咽拭子标本经检测均为甲型H1N1阳性;全园师生近一年来均无流感疫苗接种史;教师病例中仅2例具有就诊史.结论 根据流行病学调查、临床症状及实验室检测结果,综合判断此次疫情为一起甲型H1N1流感病毒引起的暴发疫情.教师在幼儿园流感疫情蔓延中的作用不容忽视,应加强对患病教师的隔离治疗.

目的 分析苏州市新型冠状病毒肺炎(COVID-19)已出院确诊病例疾病病程及实验室检测情况.方法 根据国家疾病预防控制信息系统报告的病例个案信息,结合流行病学调查报告信息对截止2020年2月26日苏州市59例已出院确诊病例的病程天数的影响因素进行logistic回归分析;对病例在医疗机构采集的病原学标本的实验室检测结果进行描述分析.结果 年龄≥43岁或有湖北省等疫区旅居史的病例病程较长(≥23 d)的可能性分别是年龄＜43岁或无外出史密切接触发病者的4.05倍(P＜0.05,95％CI为1.23～13.36)和5.55倍(P＜0.05,95％CI为1.14～27.15);病程11天内的病原学标本检出以阳性结果为主,第12天后以阴性结果为主.结论 疫区旅居史和年龄偏大是COVID-19病程的主要影响因素,提示密切接触者的及时隔离观察和加强对中老年人群的疾病防控健康宣教非常重要.从实验室检测结果看,COVID-19病例治疗效果可能从病程的12天开始显现.

A series of butene lactones were synthesized and these compounds were tested for anti-respiratory syncytial virus (RSV) activity in vitro. Three compounds exhibited an antiviral effect, the highest of which was compound 6b3 with an effective concentration 50% of 6.35 μM. The effects of 6b3 were then evaluated in vivo and a significant reduction in the lung index caused by RSV was detected. Reduced inflammatory infiltration and necrosis of the lungs were revealed by histopathology and gross pathology. Activation of an early immune response by 6b3 was also observed by cytokine analysis via a real-time polymerase chain reaction. These results indicated that 6b3 has an anti-RSV effect both in vitro and in vivo, and is a possible candidate compound for the development of an anti-RSV drug in the future.

The annual deaths associated with influenza is estimated to be between 290 000 and 650 000,which caused substantial burden to the society.Children have the highest incidence of influenza among all age groups,which can cause overloaded medical visits and a significant increase of hospitalization risk.The severe economic burden includes not only the direct medical costs due to outpatients and hospitalization,but also the indirect burden of school absence of children and work absence of their family members.Annual vaccination is the best measure to prevent influenza,however,influenza vaccination coverage among children in China is very low,and influenza vaccination has not yet been included in the National Immunization Program.Now,the disease burden of influenza and the vaccine usage in children in China were reviewed,and in order to provide evidence for influenza control and prevention.

目的 通过百度搜索指数探讨2017-2018年冬春季节流行性感冒(流感)舆情特点及原因,探讨科学、可行的流感健康传播策略.方法 选取2014年1月1日至2018年4月30日流感相关关键词百度搜索指数及报告的全国流感发病数据,分析百度搜索指数与流感发病数之间的相关性,以及2017年10月至2018年4月“流感”关键词百度指数需求分布表,探讨流感舆情特点及原因.结果2014-2018年百度搜索指数与报告的流感发病具有正相关性(rs=0.60,P＜0.000 1),两者的高峰及持续时间较为一致,百度搜索指数中利用“流感+感冒+咳嗽”的关键词组合与流感发病数的相关性(rs=0.57,P＜0.000 1)最好.结论基于搜索引擎的舆情监测可作为流感舆情特征分析及健康传播手段的有效参考及补充.

Influenza viruses (IV) cause substantial morbidity and mortality through routine seasonal spread and epidemics. A novel series of butenolides were discovered to be able to inhibit influenza H1N1 activity in vitro, and the SAR for anti-influenza activity was investigated. By optimization of the hit compound, compound 37 was obtained with an EC50 of 6.7 μM against influenza A virus H1N1 as an inhibitor of NA and with low cytotoxicity on MDCK cells. Also, it can inhibit the expression of the influenza A virus gene in the lung of SPF KM mice to show antivirus activity in vivo. These results suggested that compound 37 could inhibit the influenza A virus H1N1 via targeting NA.