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BACKGROUND: Hong Kong enforced stringent travel restrictions during the COVID-19 pandemic. Understanding the characteristics of imported COVID-19 cases is important for establishing evidence-based control measures. METHODS: Retrospective cohort study summarising the characteristics of imported cases detected in Hong Kong between 13 November 2020 and 31 January 2022, when compulsory quarantine was implemented. FINDINGS: A total of 2269 imported COVID-19 cases aged 0-85 years were identified, of which 48.6 % detected on arrival. A shorter median delay from arrival to isolation was observed in Delta and Omicron cases (3 days) than in ancestral strain and other variants cases (12 days; p

Abstract Background Dengue fever (DF) has emerged as a significant public health concern in China. The spatiotemporal patterns and underlying influencing its spread, however, remain elusive. This study aims to identify the factors driving these variations and to assess the city-level risk of DF epidemics in China. Methods We analyzed the frequency, intensity, and distribution of DF cases in China from 2003 to 2022 and evaluated 11 natural and socioeconomic factors as potential drivers. Using the random forest (RF) model, we assessed the contributions of these factors to local DF epidemics and predicted the corresponding city-level risk. Results Between 2003 and 2022, there was a notable correlation between local and imported DF epidemics in case numbers (r = 0.41, P

Objective To analyze the epidemiological characteristics of dengue fever in Guangzhou and provide a scientific basis for dengue fever prevention and control. Methods The data of dengue cases in Guangzhou, Guangdong Province reported between 2019 and 2023, were retrieved from the China Disease Prevention and Control Information System. Cross-sectional analysis was used to describe the temporal, spatial, and demographic distribution, and analyze the epidemiological characteristics. Results A total of 3 518 cases of dengue fever were reported in Guangzhou from 2019 to 2023, including 3 101 local cases (88.15%) and 417 imported cases (11.85%). The annual average incidence rate ranged from 0.09 to 17.59 per 100 000 population. Imported dengue fever cases were reported in all months, with the peak reported from May to November (374 cases, 89.69%). Local cases were first reported in May and the last in December, with the highest incidence from August to November (2 960 cases, 95.45%). The cases were reported in all 11 administrative districts; the top three were Baiyun District, Yuexiu District, and Liwan District. Male and female cases accounted for 53.52% and 46.48%, respectively; the age group mainly concentrated between 20-<60 years (2 547 cases, 72.40%). The top three occupations were business services (784 cases), housework and unemployment (738 cases), and retirees (596 cases). The average time from onset to diagnosis for local cases was 4.06 days, and 4.60 days for imported cases. The overseas imported cases mainly came from Southeast Asia 88.10%(311/353), with the most being imported from Cambodia. Cases imported from other provinces mainly came from Yunnan Province, and cases imported from other cities within the province mainly came from Foshan City. Conclusions In recent years, the incidence of dengue fever in Guangzhou has remained at a high level, with obvious imported and seasonal characteristics. Relevant departments should pay attention to key populations and take effective measures to reduce the density of mosquito vectors, and strictly prevent the spread of dengue fever. [ABSTRACT FROM AUTHOR]

Background: Dengue fever (DF) has emerged as a significant public health concern in China. The spatiotemporal patterns and underlying influencing its spread, however, remain elusive. This study aims to identify the factors driving these variations and to assess the city-level risk of DF epidemics in China. Methods: We analyzed the frequency, intensity, and distribution of DF cases in China from 2003 to 2022 and evaluated 11 natural and socioeconomic factors as potential drivers. Using the random forest (RF) model, we assessed the contributions of these factors to local DF epidemics and predicted the corresponding city-level risk. Results: Between 2003 and 2022, there was a notable correlation between local and imported DF epidemics in case numbers (r = 0.41, P < 0.01) and affected cities (r = 0.79, P < 0.01). With the increase in the frequency and intensity of imported epidemics, local epidemics have become more severe. Their occurrence has increased from five to eight months per year, with case numbers spanning from 14 to 6641 per month. The spatial distribution of city-level DF epidemics aligns with the geographical divisions defined by the Huhuanyong Line (Hu Line) and Qin Mountain-Huai River Line (Q-H Line) and matched well with the city-level time windows for either mosquito vector activity (83.59%) or DF transmission (95.74%). The RF models achieved a high performance (AUC = 0.92) when considering the time windows. Importantly, they identified imported cases as the primary influencing factor, contributing significantly (24.82%) to local DF epidemics at the city level in the eastern region of the Hu Line (E–H region). Moreover, imported cases were found to have a linear promoting impact on local epidemics, while five climatic and six socioeconomic factors exhibited nonlinear effects (promoting or inhibiting) with varying inflection values. Additionally, this model demonstrated outstanding accuracy (hitting ratio = 95.56%) in predicting the city-level risks of local epidemics in China. Conclusions: China is experiencing an increasing occurrence of sporadic local DF epidemics driven by an unavoidably higher frequency and intensity of imported DF epidemics. This research offers valuable insights for health authorities to strengthen their intervention capabilities against this disease. [ABSTRACT FROM AUTHOR]

Cutaneous leishmaniasis (CL) is often considered a ‘great imitator’ and is the most common form of leishmaniasis. The Leishmania species responsible for CL varies among countries, as these species exhibit specific distribution patterns. The increased mobility of people across countries has resulted in the imported incidences of leishmaniasis caused by non-endemic species of Leishmania. During 2023, we confirmed three CL cases caused by L. major from Kerala, India, and upon detailed investigation, these were identified to be imported from the Middle East and Kazakhstan regions. This is the first report of CL caused by L. major from Kerala. The lesion morphology, detection of anti-rK 39 antibody and Leishmania parasite DNA from the blood samples were the unique observations of these cases. Kerala, being an emerging endemic zone of visceral leishmaniasis (VL) and CL, the imported incidences of leishmaniasis by non-endemic species can pose a significant threat, potentially initiating new transmission cycles of leishmaniasis caused by non-endemic species. [ABSTRACT FROM AUTHOR]

Background: Hong Kong enforced stringent travel restrictions during the COVID-19 pandemic. Understanding the characteristics of imported COVID-19 cases is important for establishing evidence-based control measures. Methods: Retrospective cohort study summarising the characteristics of imported cases detected in Hong Kong between 13 November 2020 and 31 January 2022, when compulsory quarantine was implemented. Findings: A total of 2269 imported COVID-19 cases aged 0–85 years were identified, of which 48.6 % detected on arrival. A shorter median delay from arrival to isolation was observed in Delta and Omicron cases (3 days) than in ancestral strain and other variants cases (12 days; p

We report an imported Crimean-Congo hemorrhagic fever case in Senegal. The patient received PCR confirmation of virus infection 10 days after symptom onset. We identified 46 patient contacts in Senegal; 87.7% were healthcare professionals. Strengthening border crossing and community surveillance systems can help reduce the risks of infectious disease transmission.

Abstract Background Plasmodium malariae was always neglected compared with P. falciparum and P. vivax. In the present study, we aimed to describe the epidemiology of reported cases infected with P. malariae in the past decade to raise awareness of the potential threat of this malaria parasite in China. Methods Individual data of malaria cases infected with P. malariae reported in China in the past decade were collected via the China Information System for Disease Control and Prevention and Parasitic Diseases Information Reporting Management System, to explore their epidemiological characteristics. Pearson Chi-square tests or Fisher’s Exact Test was used in the statistical analysis. Results From 2013 to 2022, a total of 581 P. malariae cases were reported in China, and mainly concentrated in 20–59 years old group (P

ObjectiveTo characterize the prevalence and epidemic situation of imported malaria cases in Songjiang District of Shanghai from 2013 to 2022， and to provide evidence for malaria prevention and control.MethodsRelated data were collected and analyzed， including malaria cases， blood testing of febrile patients， and mosquito surveillance in Songjiang from 2013 to 2022.ResultsA total of 13 002 febrile patients in Songjiang were tested for plasmodium parasites from 2013 to 2022， among which 18 malaria cases were confirmed， including 17 cases of falciparum malaria and 1 case of ovale malaria. Moreover， a total of 36 malaria cases were notified in Songjiang through the National Notifiable Disease Reporting System from 2013 to 2022， including cases reported from Songjiang District and other districts or provinces with physical addresses in Songjiang. Of them， there were 31 cases of falciparum malaria， 2 cases of vivax malaria， 2 cases of ovale malaria and 1 case of quartan malaria. The gender ratio of male to female cases was 17∶1， and the majority was young and middle aged. In addition， 35 cases were imported from Africa and 1 case from southeast Asia； 34 cases were migrant workers， and 2 cases were travellers abroad； 17 cases were found and reported in Songjiang， 15 cases were reported from other districts of Shanghai， and 4 cases were reported from other provinces； 27 cases were treated in Shanghai， 3 cases were treated in other provinces and 6 cases were treated with self-provided antimalarial drugs. Mosquito surveillance in Songjiang showed that density of Anopheles sinensis was extremely low.ConclusionNo indigenous malaria case has been notified in Songjiang since 2008. Malaria surveillance on migrant workers remains the focus of malaria prevention and control. Furthermore， achievement of malaria elimination in Songjiang should be continually enhanced to avoid potential further transmission of imported malaria.

Background: Plasmodium malariae was always neglected compared with P. falciparum and P. vivax. In the present study, we aimed to describe the epidemiology of reported cases infected with P. malariae in the past decade to raise awareness of the potential threat of this malaria parasite in China. Methods: Individual data of malaria cases infected with P. malariae reported in China in the past decade were collected via the China Information System for Disease Control and Prevention and Parasitic Diseases Information Reporting Management System, to explore their epidemiological characteristics. Pearson Chi-square tests or Fisher's Exact Test was used in the statistical analysis. Results: From 2013 to 2022, a total of 581 P. malariae cases were reported in China, and mainly concentrated in 20–59 years old group (P < 0.001), and there was no significant trend in the number of cases reported per month. Moreover, four kinds of P. malariae cases were classified, including 567 imported cases from 41 countries in 8 regions and distributed in 27 provinces (autonomous regions, municipalities) in China, six indigenous cases in a small outbreak in Hainan, seven recurrent cases in Guangdong and Shanghai, and one induced case in Shanghai, respectively. In addition, only 379 cases (65.2%) were diagnosed as malaria on the first visit (P < 0.001), and 413 cases (71.1%) were further confirmed as P. malariae cases (P = 0.002). Meanwhile, most cases sought healthcare first in the health facilities at the county and prefectural levels, but only 76.7% (161/210) and 73.7% (146/198) cases were diagnosed as malaria, and the accuracy of confirmed diagnosis as malaria cases infected with P. malariae was only 77.2% (156/202) and 69.9% (167/239) in these health facilities respectively. Conclusions: Even though malaria cases infected with P. malariae didn't account for a high proportion of reported malaria cases nationwide, the threat posed by widely distributed imported cases, a small number of indigenous cases, recurrent cases and induced case cannot be ignored in China. Therefore, it is necessary to raise awareness and improve the surveillance and response to the non-falciparum species such as P. malariae, and prevent the reestablishment of malaria transmission after elimination. [ABSTRACT FROM AUTHOR]

Abstract Background Global connectivity and environmental change pose continuous threats to dengue invasions from worldwide to China. However, the intrinsic relationship on introduction and outbreak risks of dengue driven by the landscape features are still unknown. This study aimed to map the patterns on source-sink relation of dengue cases and assess the driving forces for dengue invasions in China. Methods We identified the local and imported cases (2006–2020) and assembled the datasets on environmental conditions. The vector auto-regression model was applied to detect the cross-relations of source-sink patterns. We selected the major environmental drivers via the Boruta algorithm to assess the driving forces in dengue outbreak dynamics by applying generalized additive models. We reconstructed the internal connections among imported cases, local cases, and external environmental drivers using the structural equation modeling. Results From 2006 to 2020, 81,652 local dengue cases and 12,701 imported dengue cases in China were reported. The hotspots of dengue introductions and outbreaks were in southeast and southwest China, originating from South and Southeast Asia. Oversea-imported dengue cases, as the Granger-cause, were the initial driver of the dengue dynamic; the suitable local bio-socioecological environment is the fundamental factor for dengue epidemics. The Bio8 [odds ratio (OR) = 2.11, 95% confidence interval (CI): 1.67–2.68], Bio9 (OR = 291.62, 95% CI: 125.63–676.89), Bio15 (OR = 4.15, 95% CI: 3.30–5.24), normalized difference vegetation index in March (OR = 1.27, 95% CI: 1.06–1.51) and July (OR = 1.04, 95% CI: 1.00–1.07), and the imported cases are the major drivers of dengue local transmissions (OR = 4.79, 95% CI: 4.34–5.28). The intermediary effect of an index on population and economic development to local cases via the path of imported cases was detected in the dengue dynamic system. Conclusions Dengue outbreaks in China are triggered by introductions of imported cases and boosted by landscape features and connectivity. Our research will contribute to developing nature-based solutions for dengue surveillance, mitigation, and control from a socio-ecological perspective based on invasion ecology theories to control and prevent future dengue invasion and localization. Graphical Abstract

ObjectiveTo estimate the optimal quarantine period for inbound travelers and identify key risk factors to provide scientific reference for emerging infectious diseases.MethodsA parametric survival analysis model was used to calculate the time interval between entry and first positive nucleic acid test of imported cases in Guangzhou, to identify the influencing factors. And the COVID-19 epidemic risk prediction model based on multiple risk factors among inbound travelers was constructed.ResultsThe approximate 95th percentile of the time interval was 14 days. Multivariate analysis found that the mean time interval for inbound travelers in entry/exit high-risk occupations was 29% shorter (OR 0.29, 95% CI 0.18–0.46, p

Background: Global connectivity and environmental change pose continuous threats to dengue invasions from worldwide to China. However, the intrinsic relationship on introduction and outbreak risks of dengue driven by the landscape features are still unknown. This study aimed to map the patterns on source-sink relation of dengue cases and assess the driving forces for dengue invasions in China. Methods: We identified the local and imported cases (2006–2020) and assembled the datasets on environmental conditions. The vector auto-regression model was applied to detect the cross-relations of source-sink patterns. We selected the major environmental drivers via the Boruta algorithm to assess the driving forces in dengue outbreak dynamics by applying generalized additive models. We reconstructed the internal connections among imported cases, local cases, and external environmental drivers using the structural equation modeling. Results: From 2006 to 2020, 81,652 local dengue cases and 12,701 imported dengue cases in China were reported. The hotspots of dengue introductions and outbreaks were in southeast and southwest China, originating from South and Southeast Asia. Oversea-imported dengue cases, as the Granger-cause, were the initial driver of the dengue dynamic; the suitable local bio-socioecological environment is the fundamental factor for dengue epidemics. The Bio8 [odds ratio (OR) = 2.11, 95% confidence interval (CI): 1.67–2.68], Bio9 (OR = 291.62, 95% CI: 125.63–676.89), Bio15 (OR = 4.15, 95% CI: 3.30–5.24), normalized difference vegetation index in March (OR = 1.27, 95% CI: 1.06–1.51) and July (OR = 1.04, 95% CI: 1.00–1.07), and the imported cases are the major drivers of dengue local transmissions (OR = 4.79, 95% CI: 4.34–5.28). The intermediary effect of an index on population and economic development to local cases via the path of imported cases was detected in the dengue dynamic system. Conclusions: Dengue outbreaks in China are triggered by introductions of imported cases and boosted by landscape features and connectivity. Our research will contribute to developing nature-based solutions for dengue surveillance, mitigation, and control from a socio-ecological perspective based on invasion ecology theories to control and prevent future dengue invasion and localization. [ABSTRACT FROM AUTHOR]

The study aimed to determine the trends in the manifestations and severity over the epidemic course of imported COVID-19 cases, with comparison to native cases. The clinical characteristics of imported and native Chinese COVID-19 cases included in the study were assessed and compared. The association was analyzed using Mann-Whitney U test for categorical variables, Kruskal-Wallis H test for continuous variables, and Spearman's correlation test for disease severity. A total of 247 imported patients were enrolled, with an average age of 29 years, and 41.3% were female. The imported patients were younger than the native patients (29 vs 47 years) and included a lower proportion of fever (44.1%), chills (5.3%), fatigue (10.1%), leukopenia (14.6%), lymphopenia (39.3%), elevated C-reactive protein (CRP) (7.3%), elevated D-dimer (16.3%), and pneumonia (65.6%). Among patients with moderate severity, imported cases had a lower proportion of fever (44.2%), dyspnea (8.3%), and increased CRP (7.7%) than native cases. COVID-19 infection was less severe in imported cases than that in native cases.

Abstract Background The goal of this study was to understand the epidemiological characteristics of imported malaria in Shanghai specifically during the epidemic period of novel corona-virus pneumonia (COVID-19), to provide a reference for preventing the transmission of imported malaria after this disease had been previously eliminated. Methods The data of malaria cases reported in Shanghai from 2020 to 2021 were obtained from the China Information System for Disease Control and Prevention (CISDCP) and the Information System for Parasitic Disease Control and Prevention (ISPDCP). The characteristics of demographic and epidemiological distribution, travel-related information, diagnosis information, regions of infection acquisition and disposal information of epidemic situation were analysed with descriptive statistics. Results A total of 112 cases of malaria were reported in Shanghai from January 2020 to December 2021. There were 18 cases and 94 cases in 2020 and 2021, respectively, reaching the lowest and highest levels in the past 10 years. The incidence of malaria associated with seasons had an increasing trend (χ2 = 81.143, P

Abstract Background Following initiation of China’s National Malaria Elimination Action Plan (NMEAP) in 2010, the ‘1-3-7’ approach was developed and rolled out in China to facilitate the malaria elimination programme and accelerate malaria elimination. This study aims to summarize and condense these experiences through a retrospective analysis in Jiangsu Province, which could be adapted and applied in other malaria elimination settings worldwide. Methods A retrospective analysis of imported malaria cases into China identified through an improved surveillance and response system in Jiangsu Province was carried out for the period of 2001–2020. To improve the malaria surveillance and response system, Centers for Diseases Control and Prevention from the prefectures and counties in Jiangsu province conducted population-level health education to improve healthcare seeking behavior, strengthened capacity of health facilities to improve performance of malaria diagnosis and treatment, and raised the capacity of public health providers to improve implementation of the ‘1-3-7’ approach. Categorical variables were carried out by Chi square tests with Fisher’s exact correction. Results From 2001 to 2020, a total of 9,879 malaria cases were reported in Jiangsu Province. Since 2012, no indigenous malaria cases have been reported in Jiangsu Province. However, in recent years, there has been a substantial increase of imported falciparum malaria cases. Between 2012 and 2020, an estimated 61.57 million individuals have benefited from population-level health education in Jiangsu Province. For healthcare-seeking services among the 2,423 imported malaria cases, 687 (28.4%) and 1,104 (45.6%) cases visited hospitals on the first day and the second day from symptom onset, respectively. A total of 1,502 (61.9%) cases were diagnosed on the first day at medical facilities. Jiangsu Province achieved 100%, 99.4% and 98.3% completion rate in terms of case detection and notification (within one day), case investigation (within three days) and foci response and disposition (within seven days), respectively. The improved surveillance and response system in Jiangsu Province plays an important role in preventing the re-introduction of malaria and maintaining the malaria-free status. Conclusions Jiangsu Province has maintained its malaria-free status since 2012. The continuous improvement of a surveillance and response system plays an important role in the early detection and rapid response of potential malaria-related outbreaks in Jiangsu, China, and has important lessons for other malaria eliminating settings. Remaining vigilant in the detection of imported malaria cases and maintaining an active surveillance and response system is critical to sustain the success of malaria elimination. Graphic Abstract

Abstract Background Overseas imported dengue fever is an important factor in local outbreaks of this disease in the mainland of China. To better prevent and control such local outbreaks, the epidemiological characteristics and temporal-spatial distribution of overseas imported dengue fever cases in provincial-level administrative divisions (PLADs) where dengue fever is outbreak in the mainland of China were explored. Methods Using the Chinese National Notifiable Infectious Disease Reporting Information System (CNNDS), we identified overseas imported dengue fever cases in dengue fever outbreak areas in the mainland of China from 2005 to 2019 to draw the epidemic curve and population characteristic distribution of overseas imported cases in each PLAD. Based on spatial autocorrelation analysis of ArcGIS 10.5 and temporal-spatial scanning analysis of SaTScan 9.5, we analyzed the temporal-spatial distribution of overseas imported dengue fever in dengue fever outbreak areas in the mainland of China. Results A total of 11,407 imported cases, mainly from Southeast Asia, were recorded from 2005 to 2019 in these 13 PLADs. Of which 62.1% were imported into Yunnan and Guangdong Provinces. Among the imported cases, there were more males than females, mainly from the 21–50 age group. The hot spots were concentrated in parts of Yunnan, Guangdong and Fujian Provinces. We found the cluster of infected areas were expanding northward. Conclusions Based on the analysis of overseas imported dengue cases in 13 PLADs of the mainland of China from 2005 to 2019, we obtained the epidemiological characteristics and spatial distribution of imported dengue cases. Border controls need to pay attention to key population sectors, such as 21–50 years old men and education of key populations on dengue prevention. There is a need to improve the awareness of the prevention and control of imported cases in border areas. At the same time, northern regions cannot relax their vigilance. Graphical Abstract

The importation of COVID‐19 cases in China is due to the returning of Chinese citizens abroad, where the majority of cases stand. This study aimed to evaluate the risk of importing COVID‐19 into the Sichuan Province of China and conduct a short‐term risk prediction assessment and analysis. Data on COVID‐19 cases in each country and Sichuan were collected, as well as visitors to Sichuan, population, area, and medical resources in each city in Sichuan province. According to different control strategies of entry aviation and quarantine control, we built models of epidemic transmission to estimate the risk for imported COVID‐19 cases in 21 cities of Sichuan. Within 140 days of the policy change's implementation, the number of susceptible, infected, and recovered people in all cities followed the same pattern over time: (1) the number of susceptible people declined slowly at first, then accelerated to reach a stable value; (2) the number of infections gradually increased to a peak, then decreased; and (3) the number of recovered patients gradually increased to a stable value. Under the four different scenarios, there were no significant differences between the risk peaks because the social distance did not change. However, the peak time would be delayed due to the implementation of flight control and nucleic acid detection measures. The improvement of foreign epidemics (reduction of attenuation factors) all delayed the arrival of the peak risk value in Chengdu by about 20 days; however, the size of the peak value did not change significantly. The improvement of nucleic acid detection accuracy delayed the arrival of the peak risk value in Chengdu, but the size of the peak value did not change significantly. Therefore, flight control and the improvement of nucleic acid detection accuracy and overseas epidemic situations have positively affected the prevention and control of the epidemic in Sichuan. [ABSTRACT FROM AUTHOR]

A 40-year-old female traveler developed a cutaneous lesion 7 days after arriving in Senegal. The lesion gradually expanded, forming two erythematous rings with a central red area and a clearance between the rings. The patient had no fever or systemic symptoms but recalled multiple mosquito bites. Laboratory tests showed no abnormalities, and Lyme disease was considered but ruled out. Fungal cultures revealed the presence of Microsporum audouinii, a dermatophyte known for causing tinea corporis. The patient was treated with itraconazole orally and miconazole cream, and the lesion resolved after 4 weeks. [Extracted from the article]

Dengue fever is the most common arboviral infection worldwide. Its epidemiology in Africa is not yet fully understood due to the lack of awareness, the presence of other dengue‐like febrile diseases, and insufficient laboratory capabilities. This paper reports on the import of dengue virus serotype 2 case from Côte d'Ivoire to Senegal in West Africa. Phylogenetic analysis based on full‐length genome sequence revealed that the isolate clustered with strains of cosmopolitan genotypes from the Burkina Faso outbreak in 2016 and those from the ongoing dengue fever outbreak in Côte d'Ivoire. This suggests a possible spread of strains from the Burkina Faso outbreak to other West African countries including Côte d'Ivoire and Senegal. [ABSTRACT FROM AUTHOR]

Objective To compare the clinical features of Omicron and Delta cases, so as to provide scientific basis for the prevention and treatment of COVID-19. Methods The case-control study method was used to retrospectively analyze the clinical data of the Omicron cases admitted to the designated hospital for the treatment of COVID-19 in Xi’an from December 2021 to January 2022. and the Delta cases admitted during the same period were used as the control group. The demographic data, epidemiological history, vaccination status, clinical characteristics, laboratory tests, nucleic acid and antibody levels, and outcomes of patients in the two groups were collected and compared. Results A total of 21 patients were included in the study, 5 were Omicron patients and 16 were Delta cases. The mean age of the patients in the two groups were（38.20±15.07） and（37.69±10.39） years, respectively. The time interval between the last vaccination and the diagnosis was（145.40±77.92） days and （159.00±99.74）days,respectively.For the initial symptoms, the patients with Omicron were mainly characterized by throat discomfort（3,60%）,cough and sputum（2,40%）,and the patients with Delta were mainly characterized by throat discomfort（5,31.25%）,fatigue（5,31.25%）,cough and sputum（4,25%）.On admission, laboratory tests showed that 60% of Omicron patients had low lymphocytes and elevated erythrocyte sedimentation rate,and50% of patients in the delta group had elevated hemoglobin. The Ct values of ORFlab gene, N gene and E gene with Omicron were lower than those with Delta. And the difference of E gene between the two groups was statistically significant （t=-2.711,P=0.024）.IgG antibody levels increased in both groups. The time for nucleic acid to turn negative with Omicron was（28.20±5.89）days,and it was（18.50±7.73）days with Delta, and the difference between the groups was statistically significant （t=2.565,P=0.019）.The length of hospitalization with Omicron was（30.60±4.88）days,and that with Delta was（22.13±7.81）days,and the difference was statistically significant （t=2.270,P=0.035）.Conclusions The initial symptoms of Omicron patients are mainly throat discomfort, cough and sputum. The clinical manifestations are generally mild. The nucleic acid test Ct value is lower. The time for nucleic acid to turn negative and the time for hospitalization are longer, and the potential infectiousness is stronger. Those eligible for vaccination should complete the full course of vaccination and booster vaccination as soon as possible. At the same time,the management of “early detection, early reporting, early isolation, and early treatment” should be implemented. [ABSTRACT FROM AUTHOR]

Background: The goal of this study was to understand the epidemiological characteristics of imported malaria in Shanghai specifically during the epidemic period of novel corona-virus pneumonia (COVID-19), to provide a reference for preventing the transmission of imported malaria after this disease had been previously eliminated. Methods: The data of malaria cases reported in Shanghai from 2020 to 2021 were obtained from the China Information System for Disease Control and Prevention (CISDCP) and the Information System for Parasitic Disease Control and Prevention (ISPDCP). The characteristics of demographic and epidemiological distribution, travel-related information, diagnosis information, regions of infection acquisition and disposal information of epidemic situation were analysed with descriptive statistics. Results: A total of 112 cases of malaria were reported in Shanghai from January 2020 to December 2021. There were 18 cases and 94 cases in 2020 and 2021, respectively, reaching the lowest and highest levels in the past 10 years. The incidence of malaria associated with seasons had an increasing trend (χ2 = 81.143, P < 0.05). These cases included Plasmodium falciparum (97, 86.61%), Plasmodium vivax (4, 3.57%), Plasmodium ovale (8, 7.14%) and Plasmodium malariae (3, 2.68%). The median age of patients with malaria was 38.0 years, the majority of these individuals were males (109, 97.32%), and most of them were labour personnel (93, 83.04%). Of the reported cases, 8 of these individuals (7.14%) reported experiencing malaria symptoms before their arrival in China after their stay overseas; 97 of these individuals (86.61%) reported experiencing symptoms within 14 days after their initial arrival from overseas; 15 of these individuals (13.39%) were diagnosed with 'severe malaria'; and 4 of these individuals (3.57%) were also diagnosed with COVID-19. All cases were imported from Africa, and there were no indigenous cases and deaths. Conclusion: Due to the impact of COVID-19, the number of imported malaria cases in Shanghai had greatly increased; however, prevention and control measures for imported malaria could be implemented to prevent re-transmission of this condition. Considering that the number of individuals returning from overseas labour is likely to increase in the next few years, it is necessary to strengthen the surveillance of imported malaria and to review the protocol for potential epidemic situations. Together, these measures could support the maintation of free-malaria status in Shanghai. [ABSTRACT FROM AUTHOR]

Abstract Background The COVID-19 pandemic has elicited imposition of some form of travel restrictions by almost all countries in the world. Most restrictions currently persist, although some have been gradually eased. It remains unclear if the trade-off from the unprecedented disruption to air travel was well worth for pandemic containment. Method A comparative analysis was conducted on Singapore, Taiwan, Hong Kong and South Korea’s COVID-19 response. Data on COVID-19 cases, travel-related and community interventions, socio-economic profile were consolidated. Trends on imported and local cases were analyzed using computations of moving averages, rate of change, particularly in response to distinct waves of travel-related interventions due to the outbreak in China, South Korea, Iran & Italy, and Europe. Results South Korea’s travel restrictions were observed to be consistently more lagged in terms of timeliness and magnitude, with their first wave of travel restrictions on flights departing from China implemented 34 days after the outbreak in Wuhan, compared to 22–26 days taken by Singapore, Taiwan and Hong Kong. South Korea’s restrictions against all countries came after 91 days, compared to 78–80 days for the other three countries. The rate of change of imported cases fell by 1.08–1.43 across all four countries following the first wave of travel restrictions on departures from China, and by 0.22–0.52 in all countries except South Korea in the fifth wave against all international travellers. Delayed rate of change of local cases resulting from travel restrictions imposed by the four countries with intrinsic importation risk, were not observed. Conclusions Travel restriction was effective in preventing COVID-19 case importation in early outbreak phase, but may still be limited in preventing general local transmission. The impact of travel restrictions, regardless of promptness, in containing epidemics likely also depends on the effectiveness of local surveillance and non-pharmaceutical interventions concurrently implemented.

Abstract Background The coronavirus disease 2019 (COVID-19) pandemic continues to expand. Herein, we report the epidemiological and clinical features of 478 patients with confirmed COVID-19 from a multicenter study conducted in four cities in China excluding Wuhan. Methods A total of 478 patients transferred by emergency medical services to designated hospitals in four major cities in China (Beijing, Chongqing, Jinan, and Nanning) were enrolled. We compared the characteristics of imported and indigenous cases and calculated the frequencies of fatal, severe, mild, and asymptomatic disease. The results were used to generate a pyramid of COVID-19 severity. Results The mean age of patients with COVID-19 was 46.9 years and 49.8% were male. The most common symptoms at onset were fever (69.7%), cough (47.5%), fatigue (24.5%), dyspnea (8.4%), and headache (7.9%). Most cases (313, 65.5%) were indigenous, while 165 (34.5%) were imported. Imported cases dominated during the early stages of the pandemic, but decreased from 1 February 2020 as indigenous cases rose sharply. Compared with indigenous cases, imported cases differed significantly in terms of sex (P = 0.002), severity of disease (P = 0.006), occurrence of fever (P

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Background: Following initiation of China's National Malaria Elimination Action Plan (NMEAP) in 2010, the '1-3-7' approach was developed and rolled out in China to facilitate the malaria elimination programme and accelerate malaria elimination. This study aims to summarize and condense these experiences through a retrospective analysis in Jiangsu Province, which could be adapted and applied in other malaria elimination settings worldwide. Methods: A retrospective analysis of imported malaria cases into China identified through an improved surveillance and response system in Jiangsu Province was carried out for the period of 2001–2020. To improve the malaria surveillance and response system, Centers for Diseases Control and Prevention from the prefectures and counties in Jiangsu province conducted population-level health education to improve healthcare seeking behavior, strengthened capacity of health facilities to improve performance of malaria diagnosis and treatment, and raised the capacity of public health providers to improve implementation of the '1-3-7' approach. Categorical variables were carried out by Chi square tests with Fisher's exact correction. Results: From 2001 to 2020, a total of 9,879 malaria cases were reported in Jiangsu Province. Since 2012, no indigenous malaria cases have been reported in Jiangsu Province. However, in recent years, there has been a substantial increase of imported falciparum malaria cases. Between 2012 and 2020, an estimated 61.57 million individuals have benefited from population-level health education in Jiangsu Province. For healthcare-seeking services among the 2,423 imported malaria cases, 687 (28.4%) and 1,104 (45.6%) cases visited hospitals on the first day and the second day from symptom onset, respectively. A total of 1,502 (61.9%) cases were diagnosed on the first day at medical facilities. Jiangsu Province achieved 100%, 99.4% and 98.3% completion rate in terms of case detection and notification (within one day), case investigation (within three days) and foci response and disposition (within seven days), respectively. The improved surveillance and response system in Jiangsu Province plays an important role in preventing the re-introduction of malaria and maintaining the malaria-free status. Conclusions: Jiangsu Province has maintained its malaria-free status since 2012. The continuous improvement of a surveillance and response system plays an important role in the early detection and rapid response of potential malaria-related outbreaks in Jiangsu, China, and has important lessons for other malaria eliminating settings. Remaining vigilant in the detection of imported malaria cases and maintaining an active surveillance and response system is critical to sustain the success of malaria elimination. [ABSTRACT FROM AUTHOR]

Background: Overseas imported dengue fever is an important factor in local outbreaks of this disease in the mainland of China. To better prevent and control such local outbreaks, the epidemiological characteristics and temporal-spatial distribution of overseas imported dengue fever cases in provincial-level administrative divisions (PLADs) where dengue fever is outbreak in the mainland of China were explored. Methods: Using the Chinese National Notifiable Infectious Disease Reporting Information System (CNNDS), we identified overseas imported dengue fever cases in dengue fever outbreak areas in the mainland of China from 2005 to 2019 to draw the epidemic curve and population characteristic distribution of overseas imported cases in each PLAD. Based on spatial autocorrelation analysis of ArcGIS 10.5 and temporal-spatial scanning analysis of SaTScan 9.5, we analyzed the temporal-spatial distribution of overseas imported dengue fever in dengue fever outbreak areas in the mainland of China. Results: A total of 11,407 imported cases, mainly from Southeast Asia, were recorded from 2005 to 2019 in these 13 PLADs. Of which 62.1% were imported into Yunnan and Guangdong Provinces. Among the imported cases, there were more males than females, mainly from the 21–50 age group. The hot spots were concentrated in parts of Yunnan, Guangdong and Fujian Provinces. We found the cluster of infected areas were expanding northward. Conclusions: Based on the analysis of overseas imported dengue cases in 13 PLADs of the mainland of China from 2005 to 2019, we obtained the epidemiological characteristics and spatial distribution of imported dengue cases. Border controls need to pay attention to key population sectors, such as 21–50 years old men and education of key populations on dengue prevention. There is a need to improve the awareness of the prevention and control of imported cases in border areas. At the same time, northern regions cannot relax their vigilance. [ABSTRACT FROM AUTHOR]

Background: The coronavirus disease of 2019 (COVID-19) pandemic shocked the world, overwhelming the health systems of even high-income countries. Predictably, the situation has elicited social and medical responses from the public and governments, respectively. Nigeria recorded an imported case from Italy on February 27, 2020. Hence, this paper assesses the early socio-medical response to COVID-19 in Nigeria in the first 100 days after the index case. The paper employs analytical methods and collates data from various media reports and official sources. Findings: The incidence of COVID-19 grew steadily in Nigeria, moving from an imported case and elitist pattern to community transmission. The case fatality stood at 2.8%. The country recorded an upsurge (52% of total cases) in the transmission of COVID-19 during the short period the lockdown was relaxed. This paper presents a concise response framework to highlight some specific multisectoral responses to the pandemic. A combination of social and medical responses to a large extent helped Nigeria curtail the spread of the virus. Conclusion: The potential of overwhelming COVID-19 is still imminent in Nigeria as the country is attempting to hurriedly open the economy, which could sacrifice public health gains for temporary economic gains.

This study aimed to observe the initial trend of imported COVID-19 cases in South Korea since the beginning of the outbreak. All imported cases were classified into 5 regions (China, Asia, Europe, Africa, and America) according to travel history and potential exposure to the COVID-19. The list of countries for which confirmed cases had a travel history (single visit, multiple visits) and presented, were used to estimate the potential “exposure countries” of confirmed cases. For better understanding of the overall imported cases, time differences (day) among 3 major steps (symptom onset, entry to South Korea, laboratory confirmation) were measured based on available data. From the first importation of a COVID-19 case on January 20th, a total of 171 imported cases have been officially reported in South Korea as of March 23rd 2020. The overall trend of importation has significantly changed during this period. Importation of confirmed cases were initially from China, and subsequently from other Asian countries. After that, importation from Europe rapidly increased, with importation from America also increasing. One hundred fifteen (81%) were confirmed within 7 days of symptom onset. One Hundred forty three (84.1%) imported cases were confirmed within a week after entry into South Korea. One hundred seven imported cases (75.9%) developed symptoms within 5 days before or after, entry to South Korea. Streamlined processes of detection, subsequent testing, isolation, and treatment by public health authority, was key in minimizing the risk of secondary transmission.

This paper reports the diagnosis and treatment of the first imported case of schistosomiasis haematobia in Xihu District of Hangzhou. The patient was an international student from Zimbabwe, and experienced repeated gross hematuria without obvious motivation. Cystoscopy displayed bladder masses, and a large number of fresh or calcified parasite eggs were found in pathological sections. In addition, urine microscopy identified Schistosoma haematobium eggs. The case was therefore definitively diagnosed as overseas imported case of imported schistosomiasis haematobia. Another case of schistosomiasis mansoni was identified among international students in the same school with the patient above by indirect haemagglutination test and urine and stool etiology examination. It is recommended to intensify health education and monitoring among overseas floating populations and improve the diagnostic skills of overseas imported schistosomiasis among professionals working in medical and disease control and prevention institutions, in order to prevent misdiagnosis and mistreatment.

Histoplasmosis is caused by Histoplasma capsulatum and is prevalent in areas of the world where H. capsulatum is endemic. We herein report a patient diagnosed with HIV-1 who developed histoplasmosis from a non-H. capsulatum endemic area who experienced severe hemophagocytic syndrome due to a delayed diagnosis. The patient's symptoms emerged four years after residing in regions with a high histoplasmosis prevalence. The unrestricted administration of antifungal medication for oral candidiasis delayed the diagnosis because it improved the patient's condition. This case underscores the importance of prudent antifungal drug use in undiagnosed disseminated conditions and evaluating the travel history going back several years to facilitate a diagnosis.

Travelers play a role in triggering epidemics of imported dengue fever because they can carry the virus to other countries during the incubation period. If a traveler carrying dengue virus visits open green space and is bitten by mosquitoes, a local outbreak can ensue. In the present study, we aimed to understand the movement patterns of international travelers in Tokyo using mobile phone data, with the goal of identifying geographical foci of dengue transmission. We analyzed datasets based on mobile phone access to WiFi systems and measured the spatial distribution of international visitors in Tokyo on two specific dates (one weekday in July 2017 and another weekday in August 2017). Mobile phone users were classified by nationality into three groups according to risk of dengue transmission. Sixteen national parks were selected based on their involvement in a 2014 dengue outbreak and abundance of Aedes mosquitoes. We found that not all national parks were visited by international travelers and that visits to cemeteries were very infrequent. We also found that travelers from countries with high dengue prevalence were less likely to visit national parks compared with travelers from dengue-free countries. Travelers from countries with sporadic dengue cases and countries with regional transmission tended to visit common destinations. By contrast, the travel footprints of visitors from countries with continuous dengue transmission were focused on non-green spaces. Entomological surveillance in Tokyo has been restricted to national parks since the 2014 dengue outbreak. However, our results indicate that areas subject to surveillance should include both public and private green spaces near tourist sites. [ABSTRACT FROM AUTHOR]

Copyright of Croatian Journal of Infection / Infektoloski Glasnik is the property of Croatian Society for Infectious Diseases and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Background There is a global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Information on viral genomics is crucial for understanding global dispersion and for providing insight into viral pathogenicity and transmission. Here, we characterized the SARS-CoV-2 genomes isolated from five travelers who returned to Taiwan from the United States of America (USA) between March and April 2020. Methods Haplotype network analysis was performed using genome-wide single-nucleotide variations to trace potential infection routes. To determine the genetic variations and evolutionary trajectory of the isolates, the genomes of isolates were compared to those of global virus strains from GISAID. Pharyngeal specimens were confirmed to be SARS-CoV-2-positive by RT-PCR. Direct whole-genome sequencing was performed, and viral assemblies were subsequently uploaded to GISAID. Comparative genome sequence and single-nucleotide variation analyses were performed. Results The D614G mutation was identified in imported cases, which separated into two clusters related to viruses originally detected in the USA. Our findings highlight the risk of spreading SARS-CoV-2 variants through air travel and the need for continued genomic tracing for the epidemiological investigation and surveillance of SARS-CoV-2 using viral genomic data. Conclusions Continuous genomic surveillance is warranted to trace virus circulation and evolution in different global settings during future outbreaks.

Background: The COVID-19 pandemic has elicited imposition of some form of travel restrictions by almost all countries in the world. Most restrictions currently persist, although some have been gradually eased. It remains unclear if the trade-off from the unprecedented disruption to air travel was well worth for pandemic containment.Method: A comparative analysis was conducted on Singapore, Taiwan, Hong Kong and South Korea's COVID-19 response. Data on COVID-19 cases, travel-related and community interventions, socio-economic profile were consolidated. Trends on imported and local cases were analyzed using computations of moving averages, rate of change, particularly in response to distinct waves of travel-related interventions due to the outbreak in China, South Korea, Iran & Italy, and Europe.Results: South Korea's travel restrictions were observed to be consistently more lagged in terms of timeliness and magnitude, with their first wave of travel restrictions on flights departing from China implemented 34 days after the outbreak in Wuhan, compared to 22-26 days taken by Singapore, Taiwan and Hong Kong. South Korea's restrictions against all countries came after 91 days, compared to 78-80 days for the other three countries. The rate of change of imported cases fell by 1.08-1.43 across all four countries following the first wave of travel restrictions on departures from China, and by 0.22-0.52 in all countries except South Korea in the fifth wave against all international travellers. Delayed rate of change of local cases resulting from travel restrictions imposed by the four countries with intrinsic importation risk, were not observed.Conclusions: Travel restriction was effective in preventing COVID-19 case importation in early outbreak phase, but may still be limited in preventing general local transmission. The impact of travel restrictions, regardless of promptness, in containing epidemics likely also depends on the effectiveness of local surveillance and non-pharmaceutical interventions concurrently implemented. [ABSTRACT FROM AUTHOR]

Objective To analyze the epidemiological characteristics of imported malaria in Xinjiang from 2016 to 2020, scientifically evaluate the level of malaria monitoring and early warning ability in Xinjiang, and we provide scientific basis for the adjustment and formulation of monitoring strategies after malaria elimination in Xinjiang. Methods We collected the case information of malaria cases reported in Xinjiang from 2016 to 2020 from the National Infectious Disease Monitoring System and Parasite Prevention and Control Information Management System. The epidemiological study was used to describe the incidence, source of infection and three distribution of cases, and to analyze the diagnosis of imported malaria cases and the time interval from onset to diagnosis. Results Totally 32 cases of imported malaria were reported, including 20 cases of falciparum malaria (62.5%), 7 cases of vivax malaria (21.9%), 3 cases of ovalbumine (9.4%), 1 case of quartan malaria (3.1%), and 1 case of mixed infection of ovalbumine and falciparum malaria (3.1%). The cases were mainly young men working in Africa. There were 8 cities (prefectures and municipals) and 12 districts and counties with case reports, including 10 cases of High Tech Zone, 7 cases of Changji City, 4 cases of Shaibak District, 2 cases in Huocheng county and Tianshan District respectively, and 78.1% of all cases reported by 5 districts and counties. 90.6% of the cases reported were diagnosed by medical institutions, and the cases diagnosed by disease control institutions accounted for a relatively small (9.4%). 20 cases (62.5%) were reported by medical institutions at the autonomous region level, 3 cases (9.4%) were reported by cities (prefectures and municipals) medical institutions, 9 cases (28.1%) were reported by medical institutions at county level and below, and no death cases were reported. Conclusion Malaria in Xinjiang is mainly imported from Africa, and health education of risk population should be continued, management and monitoring of migrating population should be strengthened, diagnosis and treatment ability of medical institutions should be improved, and re-spread in overseas input prevention and control work will be emphasized. [ABSTRACT FROM AUTHOR]

Abstract Background Chikungunya virus (CHIKV) is a widespread mosquito-borne virus representing a serious challenge to public health. The largest outbreak in the Middle-East was recorded in 2016–2017 in Pakistan. Sistan and Baluchistan Province of Iran shares a wide border with Pakistan; accordingly, introduction of CHIKV from Pakistan to Iran seems to be probable. The current study is aimed at investigating CHIKV infection in Sistan and Baluchistan Province. Methods Between April 2017 and June 2018, a total of 159 serum samples of CHIK suspected cases from 10 cities of Sistan and Baluchistan Province were tested by molecular and serological assays. Samples obtained up to 4 days after onset of illness were tested by real time PCR (n = 8). Samples collected 5–10 days after disease onset were subjected to ELISA, as well as real time PCR tests (n = 72). Samples obtained after the 10th day of disease onset were tested by only ELISA (n = 79). Phylogenetic analysis of real time PCR positive samples was carried out by sequencing of a 1014-bp region of Envelope 1 gene (E1 gene). Chi-square and independent t tests were used to evaluate the association between variables and CHIKV infection. Results In total, 40 (25.1%) out of 159 samples tested positive either by real time PCR or ELISA tests.Out of 151 samples serologically analyzed, 19 (12.6%) and 28 (18.6%) cases were positive for anti-CHIKV IgM and anti-CHIKV IgG antibodies, respectively. Of 80 samples tested by real time PCR, CHIKV RNA was detected in 11 (13.7%) sera, all of them had recent travel history to Pakistan. Additionally, phylogenetic analysis of 5 samples indicated their similarity with recent isolates of Pakistan outbreak 2016–2017 belonging to Indian Ocean sub-lineage of ECSA genotype. A significant correlation between abroad travel history and CHIKV infection was observed (P

Abstract Background Zanzibar has maintained malaria prevalence below 1% for the past decade, yet elimination remains elusive despite high coverage of core vector control interventions. As part of a study investigating the magnitude and drivers of residual transmission in Zanzibar, qualitative methods were utilized to better understand night time activities and sleeping patterns, individual and community-level risk perceptions, and malaria prevention practices. Methods A total of 62 in-depth interviews were conducted with community members and local leaders across six sites on Unguja Island, Zanzibar. Twenty semi-structured community observations of night-time activities and special events were conducted to complement interview findings. Data were transcribed verbatim, coded, and analysed using a thematic approach. Results Participants reported high levels of ITN use, but noted gaps in protection, particularly when outdoors or away from home. Routine household and community activities were common in evenings before bed and early mornings, while livelihood activities and special events lasted all or most of the night. Gender variation was reported, with men routinely spending more time away from home than women and children. Outdoor sleeping was reported during special events, such as weddings, funerals, and religious ceremonies. Participants described having difficulty preventing mosquito bites while outdoors, travelling, or away from home, and perceived higher risk of malaria infection during these times. Travel and migration emerged as a crucial issue and participants viewed seasonal workers coming from mainland Tanzania as more likely to have a malaria infection and less likely to be connected to prevention and treatment services in Zanzibar. Some community leaders reported taking the initiative to register seasonal workers coming into their community and linking them to testing and treatment services. Conclusions Targeting malaria interventions effectively is critical and should be informed by a clear understanding of relevant human behaviour. These findings highlight malaria prevention gaps in Zanzibar, and the importance of identifying new approaches to complement current interventions and accelerate the final phases of malaria elimination. Development and deployment of complementary interventions should consider human behaviour, including gender norms, that can influence exposure to malaria vectors and prevention practices. Expansion of community-level programmes targeting travellers and seasonal workers should also be explored.

Background: Overseas imported cases of COVID-19 continue to increase in China, so we conducted this study to review the epidemiological characteristics of these patients.Methods: From February 26 to April 4, 2020, the imported cases from abroad were enrolled in this study. The effect of prevention countermeasures in curbing the spread of COVID-19 was assessed in this study. Moreover, we defined incubation period and confirmed time as from the date of leaving the epicenter to date of symptom onset and date of final diagnosed, respectively, and the interval of symptom onset to final diagnosed time was defined as diagnostic time. Categorical variables were summarized as numbers and percentages, and the difference among the variables were analyzed.Results: For 670 cases imported from abroad, 555 were Chinese and 115 were foreigners. Apparently, confirmed cases had significantly decreased after China was compelled to temporarily suspend the entry of foreign passport holders with valid visas or residence permits; 6 days after implement of controlled measures, the daily new confirmed cases were reduced to 13 cases. Moreover, about 84.3% of patients (166/197) presented symptoms 1 week after leaving the epicenter, and notably seven patients (3.6%) had symptoms 2 weeks after leaving the epicenter. The median incubation period was 3.0 days (inter quartile range, 1.0 to 6.0), the 95th percentile was 11.6 days. Additionally, most of cases (92.9%) were detected positively of nucleic acid after symptom onset with 4 days, the median diagnostic time was 2.0 days (interquartile range, 1.0 to 3.0), and the 95th percentile of the distribution was 5.0 days. Finally, about 5.8% of patients were healthy carriers, and the median confirmed time of asymptomatic patients was 4.0 days (interquartile range, 2.0 to 9.0). The following variables might be associated with confirmed time: symptom type (P = 0.005), exported regions (P < 0.001), and symptom onset time (P < 0.001).Conclusions: The prevention countermeasures for imported cases implemented by the Chinese government played an indispensable role in curbing the spread of COVID-19; the time of departure from epicenter could provide an estimate of the incubation period; and a confirmed time, 2-week quarantine period might need to be prolonged, while asymptomatic patients should be closely monitored.

Brucellosis is a zoonotic disease caused by Brucella spp. and a major concern for livestock. Most human cases are caused by B. melitensis and clinical presentation is usually a mild febrile illness. However, treatment failure is frequent and more severe complications can occur. In Austria, every human brucellosis is investigated to determine whether it was imported from endemic areas or is the sign of an undetected autochthonous transmission. For this study, 21 B. melitensis strains isolated in Austria between 2005 and 2019 were collected, 17 strains from 15 different patients and four strains from cattle. Whole genome sequencing combined with core-genome MLST analysis was used to characterize these strains. A cluster of seven isolates from 2018 (three human and four cattle isolates) was identified, with fewer than two allelic differences. They corresponded to the only Austrian B. melitensis outbreak that happened over the past 15 years. The other 12 Austrian brucellosis cases were single cases, and geographical origins were available for 8/12. Genomic data was used to locate probable geographical origins and compared with the results of the epidemiological investigations. Austrian strains were compared with 67 published B. melitensis sequences available on NCBI. The result of genomic analysis matched for 7/8 cases with documented conclusion of the epidemiological investigation. Genome analysis also pointed to the geographical origin for three of the four cases with missing epidemiological data. Strains from six cases were grouped together (

Objective This paper analyzed 11 cases of severe malaria in Jiangsu Province, summarized the causes of severe malaria, evaluated the effect of diagnosis and treatment, and provided scientific basis for formulating feasible treatment measures of severe malaria. Methods The case information, epidemiological investigation reports and inpatient medical records of 11 severe malaria cases in Jiangsu Province in 2019 were collected from the Infectious Disease Report Information Management System and Parasitic Disease Prevention and Control Information Management System. The onset time, clinical manifestations, diagnosis process and treatment of severe malaria cases were summarized and analyzed. Results Totally 11 cases of severe malaria, including 10 cases of falciparum malaria, and 1 case of ovale malaria, were all imported cases from abroad. The shortest time of living abroad was 22 days, and the longest was 1 070 days. Four cases had malaria while abroad. All of the 10 severe cases of falciparum malaria developed within one month after they returned to China, and three of them became ill on the day they returned home. One severe case of Plasmodium ovale began onset 134 days after returning home. The average time from onset to treatment was 2.5 days, and the average interval time from visit to diagnosis was 1.81 days. There were 3 cases of coma or shock, 3 cases of severe anemia, 4 cases of acute renal failure, and 1 case of acute respiratory distress syndrome. 1 case of Plasmodium ovale had severe anemia due to spontaneous rupture of spleen. Except one case of ovale malaria was treated with dihydroartemisinin piperaquine tablets plus primaquine tablets, the other 10 severe falciparum malaria cases were treated with artesunate injection for antimalarial treatment, and all of them were cured and discharged from hospital after receiving antimalarial treatment. 11 cases of severe cases, the shortest length of stay was 9 days, the longest was 40 days, with an average of 22.64 days; the minimum hospitalization cost was 9 270 yuan, the maximum was 177 174 yuan, with an average of 81 520.76 yuan. Conclusion It is necessary to strengthen multi department cooperation to improve patients' awareness of timely treatment, strengthen the professional knowledge and professional training of medical staff, find and treat imported malaria cases as soon as possible, so as to prevent severe malaria caused by delayed diagnosis. [ABSTRACT FROM AUTHOR]

Background: Hong Kong enforced stringent travel restrictions during the COVID-19 pandemic. Understanding the characteristics of imported COVID-19 cases is important for establishing evidence-based control measures., Methods: Retrospective cohort study summarising the characteristics of imported cases detected in Hong Kong between 13 November 2020 and 31 January 2022, when compulsory quarantine was implemented., Findings: A total of 2269 imported COVID-19 cases aged 0-85 years were identified, of which 48.6 % detected on arrival. A shorter median delay from arrival to isolation was observed in Delta and Omicron cases (3 days) than in ancestral strain and other variants cases (12 days; p < 0.001). Lower Ct values at isolation were observed in Omicron cases than in ancestral strain or other variants cases. No Omicron cases were detected beyond 14 days after arrival. Cases detected after 14 days of quarantine (n=58, 2.6 %) were more likely asymptomatic at isolation and had higher Ct value during isolation, some of them indicating re-positivity or post-arrival infections., Conclusions: Testing inbound travellers at arrival and during quarantine can detect imported cases early, but may not prevent all COVID-19 introductions into the community. Public health measures should be adapted in response to the emergence of SARS-CoV-2 variants based on evidence from ongoing surveillance., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: BJC consults for AstraZeneca, Fosun Pharma, GlaxoSmithKline, Moderna, Pfizer, Roche, and Sanofi Pasteur. SGS has served (unpaid) on advisory boards for Sanofi and Seqirus. The authors report no other potential conflicts of interest., (© 2024 Published by Elsevier Ltd on behalf of The Royal Society for Public Health.)

Cystic echinococcosis, a zoonotic disease that poses a significant threat to human health and animal husbandry development, is prevalent across the world and predominantly occurs in agricultural and pastoral regions. However, cystic echinococcosis cases are rare in non-endemic areas, which is likely to cause misdiagnosis or missing diagnosis, resulting in delay in treatment. This report presents an overseas imported cystic echinococcosis case misdiagnosed as pulmonary and hepatic cysts, so as to provide insights into diagnosis and treatment of cystic echinococcosis in non-endemic areas.

We report an imported Crimean-Congo hemorrhagic fever case in Senegal. The patient received PCR confirmation of virus infection 10 days after symptom onset. We identified 46 patient contacts in Senegal; 87.7% were healthcare professionals. Strengthening border crossing and community surveillance systems can help reduce the risks of infectious disease transmission.

Japan has reported 26 cases of coronavirus disease 2019 (COVID-19) linked to cruise tours on the River Nile in Egypt between March 5 and 15, 2020. Here, we characterized the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome of isolates from 10 travelers who returned from Egypt and from patients possibly associated with these travelers. We performed haplotype network analysis of SARS-CoV-2 isolates using genome-wide single-nucleotide variations. Our analysis identified two potential Egypt-related clusters from these imported cases, and these clusters were related to globally detected viruses in different countries.

Background. Imported cases of measles from other countries are recorded annually in the Republic of Belarus. The aim of the study is to present the epidemiological and clinical features of the complications of sanitary and epidemic situation (measles outbreak) on the example of one district of the Grodno region in the spring of 2018. Material and methods. The material for the study was medical documentation. Methods of etiological verification were ELISA and PCR. The materials were processed using the statistical package of the Microsoft Excel computer program. Summary. In the period from 20.02.2018 to 15.03.2018 in the Grodno region there was a complication of the sanitary and epidemic situation of measles with the number of sick 37 people, including 16 children under 18 years. The cause of the measles outbreak in the Volkovysk district was the introduction of the measles virus (a strain of B3 Dublin, probably from EU countries, the source is not established) and its prevalence among people with insufficient tension of immunity. The first case of the disease was registered in an unvaccinated child (due to parents' refusal). Localization of the outbreak of measles and prevention of its further spread in the Grodno region was achieved due to the timely diagnosis of the first measles case and promptly conducted organizational and sanitary and anti-epidemic measures.

Seoul hantavirus–associated hemorrhagic fever with renal syndrome cases are rare outside Asia and have not yet been found in Germany. We report clinical and molecular evidence for a Seoul virus infection in a patient in Germany. The infection was most likely acquired during a stay in Sulawesi, Indonesia.