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Background: While parents were traditionally the main reservoir for infant pertussis, transmission sources may have shifted with China's multi-child policy. Our study aimed to investigate the household transmission patterns and clinical characteristics of pertussis in infants. Methods: We investigated infant pertussis patients (aged ≤ 6 months) diagnosed at a hospital (Children's Hospital of Zhejiang University School of Medicine) from 1 January to 1 May 2024. The laboratory diagnosis of pertussis was confirmed through bacterial culture. We collected basic and clinical information and conducted a telephone survey to investigate the transmission patterns within their households. Results: A total of 275 infant pertussis cases were identified, including 162 (58.9%) infants aged ≤ 3 months. A total of 188 households completed the transmission pattern survey, of which 121 households had two or more children. The clinical characteristic analysis indicated that infants aged ≤ 3 months had more severe disease, with higher proportion of paroxysmal cyanosis (12.4% vs. 3.5%), elevated leukocyte count (13.3 vs. 9.8 × 109/L), and prolonged hospital stay (10.0 vs. 5.5 days) (all P < 0.05). The household survey revealed significant differences in the distributions of first and source cases between single-child and multi-child households (P < 0.001). In multi-child households, the primary sources of pertussis transmission to infants were siblings aged 3–12 years, accounting for 46.4% of cases, while adults accounted for 32.1%. Conclusions: This study highlights the growing involvement of older children in the spread of pertussis, with siblings emerging as the main sources of pertussis transmission to infants in multi-child households. Optimization of pertussis vaccination tactics is advised to protect infants better. [ABSTRACT FROM AUTHOR]

Background: The resurgence of pertussis in China underscores the urgency of active surveillance to complement the passive surveillance system. Methods: Active surveillance for pertussis was conducted from 1 June 2021 to 31 May 2022, at Yiwu, Zhejiang province of China. Patients with suspected pertussis were further confirmed as pertussis cases by PCR and culture. The incidence rate of pertussis in the community was estimated. Results: The overall estimated incidence of pertussis was 108.3 per 100,000 (95% CrI: 91.7–126.4). Children aged 4–5 years had the highest incidence (1154.3 per 100,000 [95% CrI: 817.4–1553.5]), followed by infants aged 1 year (836.1 per 100,000 [95% CrI: 434.0–1308.8]). Infants aged 0–4 months had the highest hospitalization rate among the pertussis patients (>50.0%). Although the incidence was low in elderly aged ≥ 60 years, the hospitalization rate was rather high (6.7%). Conclusion: Active surveillance in this study revealed a higher burden of pertussis in Yiwu, China, compared to passive surveillance. Children aged 4–5 years are the dominant population group at risk of pertussis. Infants aged ≤ 4 months are the most vulnerable pertussis patients that require hospitalization treatment. Our results highlight the urgency of large-scale active surveillance of pertussis in China. [ABSTRACT FROM AUTHOR]

Background: Measles and rubella are vaccine-preventable diseases targeted for elimination in most World Health Organization regions, and China is considered to have momentum towards measles elimination. Therefore, this study aimed to assess the population immunity levels against measles and rubella in Zhejiang Province in China in order to provide valuable insights for informing future public health measures and contributing to the ongoing global campaign against these diseases. Materials and methods: A cross-sectional serological survey was conducted in 2022. A total of 2740 blood samples were collected from healthy individuals spanning the age range of 0–59 years, representing diverse demographic strata across 11 prefectures in Zhejiang Province in China. The sera were tested for measles and rubella IgG antibodies to determine positivity rates and geometric mean concentrations (GMCs). Results: The overall positivity rate for the measles IgG antibody was 85.3%, with a GMC of 588.30 mIU/mL. The positivity rate for the rubella IgG antibody was 70.9%, and the GMC was 35.30 IU/mL. Measles IgG antibody positivity rates across the 0–11 months, 12–23 months, 24–35 months, 3–5 years, 6–9 years, 10–14 years, 15–19 years, 20–29 years, and 30–59 years age groups were 63.1%, 92.5%, 97.0%, 94.0%, 85.8%, 77.3%, 86.9%, 84.9%, and 88.7%, respectively (trend χ2 = 118.34, p < 0.001). Correspondingly, rubella antibody positivity rates for these same age brackets were 55.9%, 87.9%, 94.7%, 88.2%, 69.9%, 54.2%, 72.6%, 67.5%, and 74.3% (trend χ2 = 199.18, p < 0.001). Both univariate and multivariate analyses consistently demonstrated that age, immunization history, and differing economic levels were significant factors contributing to variations in antibody levels. Conclusions: The seroprevalence of measles and rubella was lower than that required for herd immunity. Periodic vaccination campaigns should be launched to increase immunity. [ABSTRACT FROM AUTHOR]

Introduction: Restrictive eligibility criteria in cancer drug trials result in low enrollment rates and limited population diversity. Relaxed eligibility criteria (REC) based on solid evidence is becoming necessary for stakeholders worldwide. However, the absence of high‐quality, favorable evidence remains a major challenge. This study presents a protocol to quantitatively evaluate the impact of relaxing eligibility criteria in common non‐small cell lung cancer (NSCLC) protocols in China, on the risk–benefit profile. This involves a detailed explanation of the rationale, framework, and design of REC. Methods: To evaluate our REC in NSCLC drug trials, we will first construct a structured, cross‐dimensional real‐world NSCLC database using deep learning methods. We will then establish randomized virtual cohorts and perform benefit–risk assessment using Monte Carlo simulation and propensity matching. Shapley value will be utilized to quantitatively measure the effect of the change of each eligibility criterion on patient volume, clinical efficacy and safety. Discussion: This study is one of the few that focuses on the problem of overly stringent eligibility criteria cancer drug clinical trials, providing quantitative evaluation of the effect of relaxing each NSCLC eligibility criterion. This study will not only provide scientific evidence for the rational design of population inclusion in lung cancer clinical trials, but also establish a data governance system, as well as a REC evaluation framework that can be generalized to other cancer studies. [ABSTRACT FROM AUTHOR]