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Coxsackievirus A16 (CV‐A16) is a significant etiologic agent of hand, foot, and mouth disease (HFMD) and herpangina (HA), with the capacity to progress to severe complications, including encephalitis, aseptic meningitis, acute flaccid paralysis, myocarditis, and other critical conditions. Beijing's epidemiological surveillance system, established in 2008, encompasses 29 hospitals and 16 district disease control centers. From 2019 to 2021, the circulation of CV‐A16 was characterized by the co‐circulation of B1a and B1b clades. Multiple cases of HFMD linked to clade B1c has not been reported in Beijing until 2022. This study enrolled 400 HFMD and 493 HA cases. Employing real‐time RT‐PCR, 368 enterovirus‐positive cases were identified, with 180 selected for sequencing. CV‐A16 was detected in 18.89% (34/180) of the cases, second only to CV‐A6, identified in 63.33% (114/180). Full‐length VP1 gene sequences were successfully amplified and sequenced in 22 cases, revealing the presence of clades B1a, B1b, and B1c in 14, 3, and 5 cases, respectively. A cluster of five B1c clade cases occurred between June 29 and July 17, 2022, within a 7‐km diameter region in Shunyi District. Phylogenetic analysis of five complete VP1 gene sequences and two full‐genome sequences revealed close clustering with the 2018 Indian strain (GenBank accession: MH780757.1) within the B1c India branch, with NCBI BLAST results showing over 98% similarity. Comparative sequence analysis identified three unique amino acid variations (P3S, V25A, and I235V). The 2022 Shunyi District HFMD cases represent the first instances of spatiotemporally correlated CV‐A16 B1c clade infections in Beijing, underscoring the necessity for heightened surveillance of B1c clade CV‐A16 in HFMD and HA in this region. [ABSTRACT FROM AUTHOR]

Coxsackievirus A16 (CV‐A16) is a significant pathogen responsible for causing hand foot and mouth disease (HFMD) and herpangina (HA). This study aimed to investigate the recent evolution and spread of CV‐A16 by monitoring HFMD and HA cases in 29 hospitals across 16 districts in Beijing from 2019 to 2021. The first five cases of HFMD and the first five cases of HA each month in each hospital were included in the study. Real‐time reverse transcription polymerase chain reaction was used to identify CV‐A16, CV‐A6, and EV‐A71. From each district, two to four CV‐A16 positive samples with a relatively long sampling time interval every month were selected for sequencing. A total of 3344 HFMD cases and 2704 HA cases were enrolled in this study, with 76.0% (2541/3344) of HFMD and 45.4% (1227/2704) of HA cases confirmed to be infected by enterovirus. Among the EV‐positive samples, CV‐A16 virus was detected in 33.61% (854/2541) of HFMD cases and 13.4% (165/1227) of HA cases, with the predominant cluster being B1a. Both B1a and B1b had a co‐circulation of local and imported strains, with different origin time (1993 vs. 1995), different global distribution (14 countries vs. 10 countries), and different transmission centers but mainly distributed in the southern and eastern regions of Beijing. Strengthening surveillance of HFMD in southern and eastern regions will improve the prevention and control efficiency of enterovirus infections. [ABSTRACT FROM AUTHOR]

Background: Between mid‐January and early February, provinces of mainland China outside the epicentre in Hubei province were on high alert for importations and transmission of COVID‐19. Many properties of COVID‐19 infection and transmission were still not yet established. Methods: We collated and analysed data on 449 of the earliest COVID‐19 cases detected outside Hubei province to make inferences about transmission dynamics and severity of infection. We analysed 64 clusters to make inferences on serial interval and potential role of pre‐symptomatic transmission. Results: We estimated an epidemic doubling time of 5.3 days (95% confidence interval (CI): 4.3, 6.7) and a median incubation period of 4.6 days (95% CI: 4.0, 5.2). We estimated a serial interval distribution with mean 5.7 days (95% CI: 4.7, 6.8) and standard deviation 3.5 days, and effective reproductive number was 1.98 (95% CI: 1.68, 2.35). We estimated that 32/80 (40%) of transmission events were likely to have occurred prior to symptoms onset in primary cases. Secondary cases in clusters had less severe illness on average than cluster primary cases. Conclusions: The majority of transmissions are occurring around illness onset in an infected person, and pre‐symptomatic transmission does play a role. Detection of milder infections among the secondary cases may be more reflective of true disease severity. [ABSTRACT FROM AUTHOR]

What Is Already Known About This Topic?: Current research regarding hand, foot, and mouth disease (HFMD) has primarily concentrated on the economic impacts, drawing from retrospective or sentinel hospital-based data. This approach often overlooks cases that were either not consulted or were misdiagnosed., What Is Added by This Report?: This research systematically examined the iceberg phenomenon of HFMD and its economic implications in Beijing. Our findings indicate that each confirmed case represents 9.1 actual infections, imposing financial burdens of 25.58 United States dollars (USD) per unconsulted individual, 265.75 USD per misdiagnosed individual, 366.50 USD per individual with mild cases, and 2355.89 USD per individual with severe cases. The annual economic losses attributed to HFMD in the area range from 7.03 million USD to 13.31 million USD., What Are the Implications for Public Health Practice?: This study offers insight into the actual prevalence of HFMD in Beijing, as well as conducting an economic burden analysis on a per-case, per-category basis. This could facilitate a cost-effectiveness analysis of prevention and control strategies for HFMD., Competing Interests: No conflicts of interest., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2023.)

What Is Already Known About This Topic?: China has repeatedly contained multiple severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) outbreaks through a comprehensive set of targeted non-pharmaceutical interventions (NPIs). However, the effectiveness of such NPIs has not been systematically assessed., What Is Added by This Report?: A multilayer deployment of case isolation, contact tracing, targeted community lockdowns, and mobility restrictions could potentially contain outbreaks caused by the SARS-CoV-2 ancestral strain, without the requirement of city-wide lockdowns. Mass testing could further aid in the efficacy and speed of containment., What Are the Implications for Public Health Practice?: Pursuing containment in a timely fashion at the beginning of the pandemic, before the virus had the opportunity to spread and undergo extensive adaptive evolution, could help in averting an overall pandemic disease burden and be socioeconomically cost-effective., Competing Interests: The findings and conclusions in this study are those of the authors and do not necessarily represent the official position of the funding agencies, the National Institutes of Health, or the U.S. Department of Health and Human Services., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2023.)

What Is Already Known on This Topic?: The norovirus has often caused outbreaks in schools and kindergartens, but minimal research has been performed on environmental contamination during norovirus outbreaks in schools and kindergartens., What Is Added by This Report?: This report conveys the norovirus detection rates and viral loads in different environmental sites in 45 norovirus outbreaks in Beijing Municipality from October to December 2020., What Are the Implications for Public Health Practice?: The evidence presented here can instruct professionals and the public to sample and disinfect key locations of the environment purposefully when responding to norovirus outbreaks., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2021.)

What is already known about this topic?, Annual morbidity analysis reports that summarized trends and changing epidemiology for notifiable diseases were published in 2013 and 2015 (1,2)., What is added by this report?, In 2018, the morbidity of national notifiable diseases was 559.41 per 100,000 population, an increase of 12.88% compared with the average rate between 2015-2017. The five notifiable diseases with the highest reported morbidity were hand, foot, and mouth disease (HFMD), infectious diarrhea, hepatitis B, tuberculosis, and influenza. The five regions with the highest reported morbidity of infectious diseases were Zhejiang Province, Guangxi Autonomous Region, Guangdong Province, Beijing Municipality, and Xinjiang Autonomous Region., What are the implications for public health practice?, Evidence on notifiable disease morbidity trends and changing epidemiology should help disease control and prevention agencies and medical institutions direct their response and prevention efforts. In addition, this report demonstrates the continued need for surveillance systems and high-quality data to identify focal points for disease control., Competing Interests: Conflict of interest statement: The authors who have taken part in this study declared that they do not have any other potential conflicts of interest., (Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2019.)

On the basis of H 2 O 2 -mediated growth of gold nanoparticle (AuNPs), a novel plasmonic enzyme-linked immunosorbent assay (pELISA) was developed with a polyclonal antibody for the ultrasensitive simultaneous naked-eye detection of tetrabromobisphenol A bis(2-hydroxyetyl) ether (TBBPA DHEE) and tetrabromobisphenol A mono(hydroxyethyl) ether (TBBPA MHEE), one of the major derivatives and byproducts of tetrabromobisphenol A (TBBPA), respectively. In this modified indirect competitive pELISA, glucose oxidase (GOx) played an important role leading to the growth of AuNPs through a reaction between GOx and glucose to produce hydrogen peroxide (H 2 O 2 ). In addition, further signal amplification was achieved via a large number of GOx molecules, which were immobilized on silica nanoparticles carrying poly brushes (SiO 2 @PAA) to increase the enzyme load, and the whole complex was conjugated on the second antibody. Under the optimized conditions, 10 -3 μg/L TBBPA DHEE can be distinguished via the observation of a colored solution, and the limit of detection (LOD) of the method using a microplate reader reaches 3.3 × 10 -4 μg/L. In contrast, the sensitivity of the method was 3 orders of magnitude higher than that using conventional colorimetric ELISA with the same antibody. Furthermore, the proposed approach showed good repeatability and reliability after a recovery test fortified with a variety of targets was performed (recoveries, 78.00-102.79%; coefficient of variation (CV), 4.38-9.87%). To our knowledge, this is the first case in which pELISA was applied for the detection of small molecules via the production of H 2 O 2 from GOx and glucose. The method will be widely used for the investigation of TBBPA DHEE and TBBPA MHEE in real environments.