Background: Although the association between meteorological factors and influenza was numerously documented, the results are inconsistent, requiring a meta-analysis for synthesis. A recent analysis of the association between influenza and meteorological factors was conducted in Wuxi, China.Methods: Meteorological data and laboratory-confirmed influenza cases from 2014 to 2019 were collected in Wuxi. The exposure-response relationship was analyzed using a generalized additive model. Then we performed subgroup analysis based on age and gender. Finally, meta-analysis was utilized to aggregate the total influence of meteorological factors on influenza.Results: A total of 5,306 influenza cases were reported. Seven influenza peaks, observed every winter to spring and only one summer (2015), were noted. For a unit increase in weekly average pressure, temperature, wind speed, relative humidity, precipitation, and sunshine duration, the risk of influenza increased by 7.37%, decreased by 8.39%, decreased by 33.83%, increased by 6.44% when relative humidity was >68.86%, increased by 19.91% when precipitation was ≤ 6.13 mm, and decreased by 11.41% when sunshine duration was ≤ 6.30 h, respectively. No significant gender differences were observed. The impacts of air pressure, temperature, precipitation, and sunshine duration on children aged 3–14 were greater than on other age groups. Compared with the meta-analysis, the pooled effect of ambient temperature was consistent. In subgroup and meta-regression analysis, significant differences were found in the children group.Conclusion: This study provides further insight into the effects of meteorological factors on influenza incidence, especially the impact on children, helping enhance the level of influenza monitoring and early warning research.

Outbreaks/epidemics caused by coxsackievirus A6 (CVA6) have been reported continuously since 2008. However, outbreaks of ocular conjunctival hemorrhage caused by CVA6 in adults in a collective unit have not been reported. Methods. The epidemiological investigations were carried out according to the monitoring program, and the clinical data were collected from the treated hospitals. The nasopharyngeal swab specimens were collected to extract the total nucleic acid (DNA/RNA). The pathogen was determined using nucleic acid detection kits for 22 respiratory pathogens. The VP1 gene of this pathogen was amplified and sequenced. Sequence alignment and analysis were performed using BioEdit 7.0. The gene phylogenetic tree was constructed with MEGA4.0. Results. The factory emerged patients in succession from February 14 and reached the peak on the 18th. A total of 19 workers had symptoms in this factory up to March 31, 2019, giving an attack rate of 8.26. The main symptoms were rash, ocular conjunctival hemorrhage, fever, and sore throat. The laboratory results showed that coxsackievirus A6 was the main pathogen causing this outbreak. The risk of taking a bath in the bathroom was 7.37 times higher than that of not taking a bath (95 confidence interval (CI): 1.6732.79). Conclusion. This manuscript further enriched the infection-related information of CVA6, which was helpful to better identify and deal with the epidemic in the future.

: The study investigated the genotypic changes and epidemiologic features of norovirus outbreaks and factors influencing the attack rate and outbreak duration in Wuxi from 2014 to 2018. Norovirus outbreaks, monitored through surveillance system, were investigated. The norovirus-positive specimens from outbreaks were collected and genotyped using a dual polymerase-capsid genotyping protocol based on a one-step polymerase chain reaction (PCR) amplicon. The genotypes were analyzed by Norovirus Typing Tool Version 2.0. A total of 74 norovirus outbreaks were reported in Wuxi from 2014 to 2018. Most (93.2%) norovirus outbreaks were caused by GII genotypes. The predominant norovirus genotypes in outbreaks have changed from GII.17 (20.3%) in 2014–2015 to GII.P16/GII.2 (40.5%) in 2017–2018. GII.P16/GII.2 in 2017–2018 season were more prevalent than GII.17 in 2014–2015 season (χ² = 4.741, P = 0.029). 56.7% of the outbreaks occurred in primary schools. The re-outbreak rate was 16.2%. 66.7% of re-outbreaks were caused by norovirus variants different from previous genotypes. Outbreaks in nonprimary school settings (odds ratio [OR]: 4.007; 95% CI: 1.247–12.876) and those leading to temporary school or institution closure (OR: 20.510; 95% CI: 1.806–232.937) were reported with a higher attack rate. The outbreaks in primary schools (OR: 4.248; 95% CI: 1.211–14.903), re-outbreaks (OR: 6.433; 95% CI: 1.103–37.534) and longer report timing (OR: 8.380; 95% CI: 2.259–31.089) declared a significantly longer duration. It is of great importance that the monitoring of norovirus outbreaks for the emergence of novel strains, along with responsive prevention and control intervention should be strengthened in adults and school-age population, especially in primary students and preschool children.

In 2016, an outbreak of paratyphoid fever occurred in 40 cases at Qingyang town, in China. A case-control study was carried out to determine the source of this outbreak. Case-control study was conducted to identify the risk factors of this outbreak. The cases were identified as patients with isolation of S. Paratyphi, controls were confirmed cases’ healthy classmates, colleagues or neighbors and matched by age (±5 y) and gender. Pulsed-field gel electrophoresis was performed to source tracking. Totally, 40 cases were reported: 24 cases were students, and 20 (20/24) of them were Qingyang High School students. For the case-control study, consuming Chinese egg pancakes was detected as a risk factor (OR1:1 = 5.000; 95% CI: 1.710-14.640), and hand-washing before meals was protective behavior compared with seldom hand-washing (OR1:1 = 23.256; 95% CI: 2.451-200.000). S. Paratyphi was cultured from a well water sample used for washing contents of the pancakes. Isolates from well water and paratyphoid cases showed the same PFGE patterns. Contaminated well water and Chinese egg pancakes were likely source and vehicle of this outbreak. Health education, especially handwashing, and food safety supervision should be promoted particularly in schools.

Background: Outbreaks/epidemic caused by Coxsackievirus A6 have been reported continuously since 2008. However, outbreaks caused by Coxsackievirus A6 infection in adults of a collective unit have not been reported. Methods: The nasopharyngeal swab specimens were collected to extract the total nucleic acid (DNA/RNA). The pathogen was determined using 22 respiratory pathogen nucleic acid detection kits. The VP1 gene of this pathogen was amplified and sequenced. Sequence alignment and analysis were performed using Bioedit. The gene phylogenetic tree was constructed with MEGA software. Results: The factory emerged patients in succession from the February 14 and reached the peak on the 18th. The main symptoms were rash, ocular conjunctival hemorrhage, fever and sore throat. A total of 19 workers had symptoms in this factory up to March 31, 2019, giving an attack rate of 8.26%. The laboratory results showed that Coxsackievirus A6 was the enterovirus type causing this outbreak. The risk of illness was 7.37 times higher taking bath in bathroom than that of not taking bath (95% CI 1.67, 32.79). Conclusions: Epidemiologic and molecular data indicated Coxsackievirus A6 as the etiology of this outbreak of adults in a collective unit, a risk factor for the spread was taking bath in the bathroom of the factory.

Norovirus (NoV) is a common pathogen that can cause infectious diarrhea. This study aimed to determine the prevalence, clinical features, and genotypes of NoV-associated diarrhea in Wuxi, China. A total of 4,416 stool samples were collected from patients with diarrhea at enteric disease clinics of sentinel hospitals in Wuxi from February 1, 2013 to December 31, 2020. Univariate and Akaike information criterion stepwise logistic regression were used to identify differences as integrated within a clinical setting (NoV positive [+] versus NoV negative [–], NoV+ versus rotavirus [RV]+, NoV+ versus bacteria+, genogroup [G] I and GII genotypes). Norovirus was detected in 9.85% of stool samples, which was greater than other tested pathogens. Excluding coinfection of NoV and other viruses or bacteria, patients infected with NoV had a lower chance of acquiring the virus in summer (P < 0.001; odds ratio [OR], 0.257; 95% CI, 0.189–0.36) when compared with patients without NoV. Patients with diarrhea infected with NoV featured nausea and vomiting (P < 0.001; OR, 2.297, 95% CI, 1.85–2.86) and loose stools (P = 0.006; OR, 2.247; 95% CI, 1.30–4.10), but less abdominal cramping (P = 0.001; OR, 0.676; 95% CI, 0.54–0.84). Patients infected with RV (P < 0.001; OR, 0.413; 95% CI, 0.25–0.68) or bacteria (P < 0.001; OR, 0.422; 95% CI, 0.26–0.67) were more vulnerable to fever than those infected with NoV. A total of 379 GII strains were detected concomitant with 48 GI strains, and there was a seasonal difference between the GI and GII genotypes. Strengthening pathogen detection for infectious diarrhea was helpful for understanding the epidemiological characteristics of infections with NoV and, potentially, for preventing disease outbreaks.