Table of Content

25 October 2025, Volume 37 Issue 5

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Strategies and practices for joint prevention and control of cross⁃border infectious diseases between Guangxi Zhuang Autonomous Region, China and Vietnam

CAI Jianfeng, MENG Jun, HU Liping, JIANG Zhihua, LAN Guanghua

2025, 37(5):  451-454, 493. 

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This article discusses the important role and practical experience of Guangxi Zhuang Autonomous Region as a bridgehead between China and the Association of Southeast Asian Nations (ASEAN) in the joint prevention and control of cross⁃border infectious diseases between China and Vietnam. The cross⁃border transmission of infectious diseases has been effectively managed in Guangxi Zhuang Autonomous Region through a package of strategies, including government leadership, construction of the joint prevention and control mechanism, establishment of dialogue platforms, collaboration of scientific researches, and personnel exchange and training; however, there are still challenges. Further deepening of collaboration is required to meet future needs for infectious disease prevention and control.

Global epidemiology and control strategies of Chikungunya virus: a review

RONG Heng, DING Yuhan, NING Shuo, GE Yiyue, CUI Lunbiao

2025, 37(5):  455-464. 

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Chikungunya virus (CHIKV), which is primarily transmitted by Aedes aegypti and Ae. albopictus, has recently rapidly spread across the world, which poses a huge threat to public health. Chikungunya fever (CHIKF), caused by CHIKV infection, typically manifests as acute febrile illness with severe polyarthralgia that may persist for months to years. A few severe CHIKF cases may be accompanied by serious neurological complications, even resulting in death. The accelerating global expansion of CHIKV is closely associated with genetic variations of the virus, and mutated genes in CHIKV may augment the virus adaptability to Aedes vectors and transmission efficiency. Currently, the diagnosis of the CHIKV infection primarily relies on molecular and serological assays; however, there are still multiple challenges for early and differential diagnosis of CHIKV infections due to co⁃infections with arboviruses and nonspecific early symptoms. The first prophylactic vaccine for CHIKF has been recently approved in the United States; however, the large⁃scale application still awaits further validations. More importantly, there are no licensed antiviral therapies against CHIKV until now. This review describes the structure and pathogenesis of CHIKV, summarizes the latest epidemiology and advances in the diagnosis of CHIKV infections, and depicts the current status and prospects of antiviral agents and vaccine development, so as to inform evidence⁃based prevention and control strategies. 

Regulation of natural killer cell subtypes and functions by programmed cell death protein 1 and its receptor at the maternal⁃fetal interface in mice infected with Toxoplasma gondii during the second trimester

SUN Jiayue, BAI Qiuhua, CHEN Xiaodan, LÜ Jiayin, HE Shanshan, TANG Lili, LIAO Dejun, LIU Dengyu, FU Xiaoyin

2025, 37(5):  465-474. 

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Objective　To investigate the regulatory role of the programmed cell death protein 1 (PD⁃1) and its ligand programmed cell death protein ligand 1 (PD⁃L1) signaling on the subtypes and functions of natural killer (NK) cells at the maternal⁃fetal interface during the second trimester in mice following Toxoplasma gondii infection during the first trimester. Methods　Twelve 6⁃ to 8⁃week⁃old female mice of the C57BL/6J strain were divided into a control group and an infection group, of 6 mice in each group. On the 6.5th day of pregnancy (Gd6.5), each pregnant mouse in the infection group was intraperitoneally injected with 150 tachyzoites of the Toxoplasma gondii PRU strain, while mice in the control group were injected with an equal volume of physiological saline. On the 12.5th day of pregnancy (Gd12.5), uterus and placenta tissues were sampled from pregnant mice for pathological observations, and the mRNA expression levels of PD⁃1, PD⁃L1, and tumor necrosis factor⁃α (TNF⁃α) were quantified in uterus and placenta tissues. The PD⁃1 and DX5 expression was measured on NK cells at the maternal⁃fetal interface using flow cytometry. In addition, the in vitro JEG⁃3 trophoblast cells and NK⁃92MI cells co⁃culture system was established as the control group, and the addition of T. gondii tachyzoites in the co⁃culture system served as the infection group. The PD⁃1, PD⁃L1, and DX5 mRNA expression was quantified in cells using real⁃time fluorescence quantitative reverse transcription PCR (RT⁃qPCR) assay, and the TNF⁃α concentration was measured in the cell culture supernatant using enzyme⁃linked immunosorbent assay (ELISA). Results　On Gd12.5, clear and intact cellular structures of placental decidual tissues were seen in pregnant mice in the control group, with no remarkable abnormal changes found in the uterine columnar epithelial cells, and inflammatory cell infiltration and blood stasis at varying degrees were found in uterine and placental tissues from pregnant mice in the infection group. The relative PD⁃1, PD⁃L1, and TNF⁃α mRNA expression was (1.004 ± 0.004), (1.001 ± 0.001), and (1.001 ± 0.001) in uterine tissues from pregnant mice in the control group and (2.480 ± 0.720), (3.355 ± 0.920), and (2.391 ± 0.073) in the infection group, respectively. The relative PD⁃1, PD⁃L1, and TNF⁃α mRNA expression was (1.007 ± 0.010), (1.006 ± 0.006), and (1.001 ± 0.001) in the uterine tissues in the control group and (6.948 ± 1.918), (3.225 ± 1.034), and (1.536 ± 0.150) in the infection group, respectively. The relative PD⁃1, PD⁃L1, and TNF⁃α mRNA expression was higher in both the uterine (t = 3.55, 4.43 and 33.02, all P values < 0.05) and placental tissues (t = 5.36, 3.72 and 6.18, all P values < 0.05) in the infection group than in the control group. Flow cytometry showed that the proportions of PD⁃1+ NK cells, PD⁃1+ DX5+ NK cells, and DX5+ NK cells were (12.200 ± 1.082)%, (9.373 ± 7.728)%, and (44.000 ± 4.095)% in uterine tissues from pregnant mice in the control group, and (21.733 ± 1.630)%, (18.767 ± 1.242)%, and (73.367 ± 0.611)% in the infection group, respectively. The proportions of PD⁃1+ NK cells, PD⁃1+ DX5+  NK cells, and DX5+ NK cells were (1.100 ± 0.510)%, (2.277 ± 1.337)%, and (96.167 ± 2.831)% in placental tissues from mice in the control group, and (26.867 ± 9.722)%, (23.433 ± 6.983)%, and (82.467 ± 2.248)% in the infection group, respectively. The proportions of PD⁃1+ NK cells (t = 8.45, P < 0.05) and DX5+ NK cells (t = 12.29, P < 0.05) were higher in uterine tissues from pregnant mice in the infection group than in the control group, and no significant difference was seen in the proportion of PD⁃1+DX5+ NK cells (Z = -1.09, P > 0.05). The proportions of PD⁃1+ NK cells (t = 4.58, P < 0.05) and PD⁃1+ DX5+ NK cells (t = 5.15, P < 0.05) were higher in placental tissues from pregnant mice in the infection group than in the control group, while the proportion of DX5+ NK cells was lower in the infection group than in the control group (t = -6.56, P < 0.05). RT⁃qPCR assay revealed that the relative PD⁃1, PD⁃L1, and DX5 mRNA expression was (1.010 ± 0.005), (1.002 ± 0.003), and (1.001 ± 0.001) in the JEG⁃3 cells and NK92MI cells co⁃culture system and (3.638 ± 1.258), (0.397 ± 0.158), and (4.267 ± 1.750) in the control group, and ELISA measured that the TNF⁃α concentration was higher in the cell culture supernatant in the infection group [(22.056 ± 3.205) pg/mL] than in the control group [(12.441 ± 0.001) pg/mL] (t = 5.20, P < 0.05). The PD⁃1(t = 3.62, P < 0.05) and DX5 mRNA expression (t = 3.23, P < 0.05) was higher in the infection group than in the control group, and the PD⁃L1 mRNA expression was lower in the infection group than in the control group (t = -6.63, P < 0.05). Conclusions　Following T. gondii infection, both PD⁃L1 expression and PD⁃1 expression on DX5+ NK cells at the maternal⁃fetal interface are upregulated in mice during the second trimester; however, the proportion of DX5+ NK cells decreases. These findings suggest that PD⁃1/PD⁃L1 signaling may suppress NK cell functions by modulating DX5+ NK cell subsets.

Prevalence of Schistosoma japonicum infections in wild rodents in key areas during the elimination phase

LÜ Chao, XU Xiaojuan, LI Jiajia, FENG Ting, ZHU Hai, LI Yifeng, XU Ling, FENG Zhihong, JIANG Huiwen, ZOU Xiaoqing, WEI Wenjun, QIN Zhiqiang, HONG Yang, ZHANG Shiqing, XU Jing

2025, 37(5):  475-481, 523. 

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Objective　To investigate the prevalence of Schistosoma japonicum infections in wild rodents in schistosomiasis⁃endemic areas of China, so as to provide insights into formulation of technical guidelines for monitoring of and the precise control strategy for S. japonicum infections in wild rodents during the elimination phase. Methods　Two administrative villages where schistosomiasis was historically highly prevalent were selected each from Dongzhi County, Anhui Province, and Duchang County, Jiangxi Province as study villages. Wild rodents were captured from study villages with baited traps or cages at night in June and September, 2021. The number of rodents captured was recorded, and the rodent species was characterized based on morphological characteristics. Liver tissues were sampled from captured rodents for macroscopical observation of the presence of egg granulomas, and S. japonicum infection was detected simultaneously using liver tissue homogenate microscopy, examinations of mesenteric tissues for parasites, and modified Kato⁃Katz thick smear technique (Kato⁃Katz technique). A positive S. japonicum infection was defined as detection of S. japonicum eggs or adult worms by any of these methods. The rate of wild rodent capture and prevalence of S. japonicum infections in wild rodents were compared in different study villages and at different time periods, and the detection of S. japonicum infections in wild rodents was compared by different assays. Results The overall rate of wild rodent capture was 8.28% (237/2 861) in Dongzhi County, and the wild rodent capture rates were 9.24% (133/1 439) and 7.31% (104/1 422) in two study villages ([χ2] = 3.503, P = 0.061), and were 8.59% (121/1 409) and 7.99% (116/1 452) in June and September, 2021, respectively ([χ2] = 0.337, P = 0.561). The overall rate of wild rodent capture was 3.72% (77/2 072) in Duchang County, and the wild rodent capture rates were 6.91% (67/970) and 0.91% (10/1 102) in two study villages ([χ2] = 51.901, P < 0.001), and were 4.13% (39/945) and 3.37% (38/1 127) in June and September, 2021, respectively ([χ2] = 0.815, P = 0.365). Rattus norvegicus was the predominant rodent species captured in both counties, accounting for 70.04% (166/237) of all captured wild rodents in Dongzhi County and 88.31% (68/77) in Duchang County. No S. japonicum infection was detected in wild rodents captured in Duchang County. Nevertheless, the overall prevalence of S. japonicum infections was 51.05% (121/237) in wild rodents captured in Dongzhi County, with prevalence rates of 50.38% (67/133) and 51.92% (54/104) in two study villages ([χ2] = 0.098, P = 0.755), and 54.31% (63/116) and 47.93% (58/121) in September and June, 2021, respectively ([χ2] = 0.964, P = 0.326). Of 237 wild rodents captured in Dongzhi County, there were 140 (59.07%) rodents with visible hepatic egg granulomas, 117 (49.47%) tested positive for S. japonicum eggs by liver tissue homogenate microscopy, 34 (14.35%) tested positive for S. japonicum eggs with Kato⁃Katz technique; however, no adult S. japonicum worms were detected in mesenteric tissues. In addition, hepatic egg granulomas were found in all wild rodents tested positive for S. japonicum eggs with liver tissue homogenate microscopy.  Conclusions　The rate of wild rodent capture and prevalence of S. japonicum infection in wild rodents vary greatly in schistosomiasis⁃endemic areas of China, and the prevalence of S. japonicum infection is slightly higher in wild rodents captured in autumn than in summer. Liver tissue is recommended as the preferred sample for surveillance of S. japonicum infection in wild rodents, and a combination of macroscopical observation of hepatic egg granulomas and liver tissue homogenate microscopy may be a standard method for surveillance of S. japonicum infection in wild rodents.  

Antibacterial activity of the antifungal peptide Mt6⁃21DLeu derived from Musca domestica against Acinetobacter baumannii and the underlying mechanisms

HUA Xuan, QIU Tong, WANG Xuyuan, TANG Renxian, KONG Delong

2025, 37(5):  482-493. 

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Objective　To investigate the antibacterial activity of the antifungal peptide Mt6⁃21DLeu derived from Musca domestica against Acinetobacter baumannii (AB) and unravel its underlying mechanisms, so as to provide insights into development of novel agents against AB. Methods　The minimum inhibitory concentrations (MICs) of Mt6⁃21DLeu, M. domestica⁃derived antifungal peptide⁃1 (MAF⁃1A), and polymyxin B were determined against Staphylococcus aureus, Bacillus subtilis, Escherichia coli, Klebsiella pneumoniae, Pseudomonas aeruginosa and AB using the broth microdilution assay, and the antibacterial activity of Mt6⁃21DLeu and polymyxin B was dynamically assessed against AB over 24 hours with time⁃kill curves. The inhibitory effects of Mt6⁃21DLeu and polymyxin B on biofilm formation in AB at concentrations of 1/4 × MIC, 1/2 × MIC and MIC, and the eradication effects of Mt6⁃21DLeu and polymyxin B on mature biofilms in AB at concentrations of MIC, 2 × MIC, and 4 × MIC were evaluated using crystal violet staining. Structural changes in the cell membrane of AB were observed 3 hours post⁃exposure to Mt6⁃21DLeu at concentrations of MIC and 2 × MIC using scanning electron microscopy, and alterations in the cell membrane permeability of AB were analyzed 3 hours post⁃treatment with Mt6⁃21DLeu at concentrations of MIC and 2 × MIC by means of fluorescence microscopy and propidium iodide (PI) staining. Intracellular reactive oxygen species (ROS) levels in AB were measured 3 hours post⁃treatment with Mt6⁃21DLeu at concentrations of MIC, 2 × MIC, and 4 × MIC using flow cytometry. The survival of Caenorhabditis elegans exposed to Mt6⁃21DLeu at concentrations of MIC, 2 × MIC, and 4 × MIC was monitored for 7 consecutive days, and survival curves were plotted to evaluate the in vivo toxicity of Mt6⁃21DLeu. In addition, C. elegans infected with AB and treated with Mt6⁃21DLeu at a concentration of 4 × MIC served as the treatment group, and uninfected C. elegans served as the control group, while infected but untreated C. elegans served as the infection group. The in vivo antibacterial efficacy of Mt6⁃21DLeu at a concentration of 4 × MIC was evaluated by comparing the survival curves and bacterial load among the three groups.  Results　The MICs of MAF⁃1A were all >128 μg/mL against S. aureus, B. subtilis, E. coli, K. pneumoniae, P. aeruginosa, and AB. In contrast, the MICs of Mt6⁃21DLeu were >128, 32, 8, 8, 16, and 4 μg/mL against these strains, respectively, and the MIC of Mt6⁃21DLeu against AB was close to that of polymyxin B (2 μg/mL). Time⁃kill curve analysis showed that both Mt6⁃21DLeu at concentrations of MIC and 2 × MIC and polymyxin B at a concentration of MIC inhibited AB growth over the 24⁃hour study period. The biofilm biomass in AB was (52.38 ± 6.92)%, (40.88 ± 9.17)% and (14.77 ± 6.00)% post⁃exposure with Mt6⁃21DLeu at concentrations of 1/4 × MIC, 1/2 × MIC and MIC, (61.58 ± 7.35)%, (47.42 ± 5.51)% and (20.85 ± 10.48)% post⁃treatment with polymyxin B at concentrations of 1/4 × MIC, 1/2 × MIC and MIC, and (100.00 ± 15.92)% in the control group (only bacterial suspension), respectively (F = 68.38, P < 0.001), and pairwise comparisons indicated that Mt6⁃21DLeu and polymyxin B at all concentrations significantly inhibited biofilm formation as compared to the control group (all P values < 0.001). The mature biofilm biomass in AB was (73.44 ± 11.41)%, (72.56 ± 13.08)% and (49.65 ± 9.23)% post⁃exposure to Mt6⁃21DLeu at concentrations of MIC, 2 × MIC, and 4 × MIC, (84.38 ± 8.6)%, (72.31 ± 9.63)% and (58.85 ± 4.96)% post⁃treatment with polymyxin B at concentrations of MIC, 2 × MIC, and 4 × MIC, and (100.00 ± 6.36)% in the control group (F = 35.63, P < 0.001), and pairwise comparisons revealed that Mt6⁃21DLeu at all concentrations significantly eradicated biofilm biomass (all P values < 0.05); however, polymyxin B showed no clear⁃cut eradication effect at a concentration of MIC (P > 0.05). Scanning electron microscopy revealed pore formation and content leakage in the cell membrane of AB 3 hours post⁃treatment with Mt6⁃21DLeu at concentrations of MIC and 2 × MIC. Fluorescence microscopy showed that the proportions of PI⁃stained AB were (24.79 ± 11.51)% and (68.44 ± 15.80)% post⁃treatment with Mt6⁃21DLeu at concentrations of MIC and 2 × MIC, and (0.96 ± 0.94)% in the phosphate⁃buffered saline (PBS) treatment group (F = 105.90, P < 0.001), with the highest proportion of PI⁃stained AB seen post⁃treatment with Mt6⁃21DLeu at a concentration of 2 × MIC  (P < 0.05). Flow cytometry revealed that the relative intracellular ROS levels in AB were (652.00 ± 141.90), (694.33 ± 14.19), and (974.33 ± 160.02) 3 hours post⁃treatment with Mt6⁃21DLeu at concentrations of MIC, 2 × MIC and 4 × MIC, and (403.67 ± 86.56) in the PBS treatment group, respectively (F = 12.27, P < 0.05), with the highest intracellular ROS level measured following treatment with Mt6⁃21DLeu at a concentration of 4 × MIC (P < 0.05). Survival curve analysis revealed that Mt6⁃21DLeu posed no impact on C. elegans survival at concentrations of MIC ([χ2] = 0.02, P > 0.05), 2 × MIC ([χ2] = 0.06, P > 0.05) or 4 × MIC ([χ2] = 0.16, P > 0.05), and there was a significant difference in the survival period of C. elegans among the control group, the infection group, and the treatment group ([χ2] = 82.66, P < 0.05), with a significantly longer survival period in the treatment group than in the infection group ([χ2] = 45.00, P < 0.05). In addition, the log⁃transformed bacterial colony counts in C. elegans were (0.00 ± 0.00), (5.46 ± 0.03), and (3.91 ± 0.47) CFU/mL in the control group, the infection group, and the treatment group, respectively (F = 324.80, P < 0.001), and the log⁃transformed bacterial colony counts in C. elegans were significantly lower in the treatment group than in the infection group (P < 0.05). Conclusions　Mt6⁃21DLeu exerts potent antibacterial effects through disrupting the cell membrane integrity of AB and promoting intracellular ROS accumulation in AB, and exhibits promising potential for treatment of AB infections both in vivo and in vitro, which may serve as a candidate drug molecule against multidrug⁃resistant AB infections.

Ownership of insecticide⁃treated nets in African countries from 2010 to 2023

TAO Man, HE Jiaxin, LIU Xinliang, CHEN Chen, DING Wei, LI Hao

2025, 37(5):  494-505, 529. 

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Objective　To analyze the situation of insecticide⁃treated nets (ITNs) ownership in malaria⁃endemic African countries from 2010 to 2023, so as to provide insights into China's deeper participation in malaria control in Africa. Methods　The study period from 2010 to 2023 was divided into three phases: the baseline phase (from 2010 to 2015), the middle phase (from 2016 to 2019), and the final phase (from 2020 to 2023), a total of 11 African countries with at least one Demographic and Health Survey (DHS) in each phase were included. Data pertaining to ITNs in 33 surveys of the above 11 African counties from 2010 to 2023 were captured from the DHS database, and the proportions of sources of ITNs and ITN ownership in each phase (number of ITNs ownership per person, overall ownership rate, and ownership rate per two residents) were calculated. The differences in numbers of ITNs per person between urban and rural areas and specified by socioeconomic status were analyzed. Results　The proportions of ITNs from distribution campaigns were 60.24% to 94.01% and 50.46% to 85.04% in 11 African countries in the middle and final phases, respectively. The median numbers (interquartile range) of INTs ownership per person were 0.22 (0.50), 0.33 (0.50) and 0.33 (0.50) in the baseline, middle, and final phases, and the overall ownership rates [95% confidence interval(CI)] were 59.77% (59.50%, 60.05%), 70.32% (70.06%, 70.57%), and 69.21% (68.95%, 69.47%), while the ownership rates per two residents were 26.91% (26.66%, 27.16%), 38.07% (37.80%, 38.34%), and 36.56% (36.29%, 36.84%), respectively. The number of ITNs per person showed a significant increase followed by a significant decrease in 7 countries during all three phases (H = 102.518 to 2 327.440, Z = -48.886 to -4.653, all P < 0.05 after Bonferroni correction). In 33 surveys, there were 31 (Z = -26.719 to -2.472, P < 0.05) and 28 surveys (Z = -27.316 to -4.068, P < 0.001) with significant differences in numbers of ITNs ownership per person between households in urban and rural areas and with different socioeconomic status, including 20 surveys with a significantly higher number of ITNs ownership per person in households in rural areas than in urban areas, and 17 surveys with a significantly higher number of ITNs ownership per person among the poorest households than among the richest households. Conclusions　There are substantial disparities in ITNs ownership in 11 African countries. Intensified cooperation on malaria prevention and control measures, such as ITNs, is recommended between China and African countries to build a global community of health for all.

Economic burden of echinococcosis patients in endemic areas of western China: a meta⁃analysis

YIN Zhe, SHI Guangzhong, RENA Wusiman, KAISAIER Tuerxunjiang, MA Weiqian, ADILI Simayi, ZHAO Jiangshan

2025, 37(5):  506-516. 

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Objective　To systematically evaluate the economic burden of echinococcosis patients in western China using meta⁃analysis, so as to provide insights into formulation of effective echinococcosis control strategies and optimization of medical resource allocation. Methods　Articles pertaining to the economic burden of echinococcosis patients in western China were retrieved in  international and Chinese databases, including PubMed, Web of Science, CNKI, Wanfang Data, and VIP Chinese Science and Technology Periodicals Full⁃Text Database. Studies were screened according to inclusion and exclusion criteria, and the basic characteristics of included articles, characteristics of included studies, and echinococcosis patients' economic burden were extracted.  A meta⁃analysis was performed using the software R package. The pooled effect size and heterogeneity were examined using a random effects model, and subgroup analyses were conducted. Results　A total of 13 articles were enrolled, including 12 Chinese publications and one English publication, and all were retrospective studies. Included studies covered 4 western provinces (autonomous regions) of China, including Ningxia Hui Autonomous Region, Xinjiang Uygur Autonomous Region, Sichuan Province, and Qinghai Province, which involved 11 282 echinococcosis patients, and the study period spanned from 2006 to 2023. Meta⁃analysis showed that the pooled direct medical costs of echinococcosis patients were 24 730 [95% confidence interval (CI): (13 040, 36 430)] Yuan in endemic areas of western China, appearing a significant heterogeneity (I2 = 79.95%, P < 0.01). Subgroup analyses showed the pooled direct medical costs of 9 090 [95% CI: (-4 970, 23 150)] Yuan for echinococcosis patients in Ningxia Hui Autonomous Region and 18 140 [95% CI: (8 440, 27 840)] Yuan in Xinjiang Uygur Autonomous Region, and pooled direct medical costs of 9 470 [95% CI: (-1 850, 20 790)] Yuan for cystic echinococcosis patients prior to 2007 and 15 270 [95% CI: (560, 24 030)] Yuan after 2007, respectively. There were high heterogeneities in the pooled direct medical costs for echinococcosis patients in terms of date of publication (I2 = 82.05%, P < 0.001), treatment modality (I2 = 83.28%, P < 0.001) and type of echinococcosis (I2 = 72.63%, P < 0.001). In addition, the pooled indirect medical costs and direct non⁃medical costs were 5 670 Yuan and 4 000 Yuan for echinococcosis patients in western regions of China, respectively. Conclusions　Echinococcosis patients suffer from a high economic burden in endemic areas of western China, and there are disparities in the direct medical costs for echinococcosis patients depending on disease type, study areas and study period.

Epidemiological characteristics of dengue fever in Shenzhen City in 2024

WAN Jia, NIU Cong, LIU Wei, LIN Liangqiang, YANG Fan, LÜ Ziquan, ZHANG Zhen, FENG Tiejian, LU Jianhua, KONG Dongfeng

2025, 37(5):  517-523. 

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Objective　To investigate the epidemiological characteristics of dengue fever in Shenzhen City in 2024, so as to provide insights into formulation of the preventive and control measures for dengue fever.  Methods　The epidemiological data of dengue cases reported in Shenzhen City in 2024 were extracted from the China Disease Prevention and Control Information System and field epidemiological survey data of dengue fever in Shenzhen City, and the temporal, regional and population distributions of dengue fever cases, source of acquire dengue virus infections, disease diagnosis and treatment and outbreaks were analyzed. The dengue virus nucleic acid was tested and the serotypes of dengue virus were characterized using real⁃time quantitative reverse transcription PCR (RT⁃qPCR) assay, and the dengue virus gene was sequenced using next⁃generation sequencing (NGS). In addition, the surveillance on the density of Aedes albopictus was performed using Breteau index (BI) and mosquito oviposition index (MOI).  Results　A total of 1 735 dengue fever cases were reported in Shenzhen City in 2024, including 952 local cases and 783 imported cases. Most imported dengue fever cases acquired infections from eight cities of Foshan, Guangzhou, Zhongshan, Jiangmen, Dongguan, Zhaoqing, Huizhou, and Zhuhai in the Pearl River Delta region (664 cases, 84.8% of total imported cases) into Baoan, Longgang, and Nanshan districts. The epidemic exhibited an early onset and rapid progression, peaking during the period between September and November (1 632 cases, 94.1% of total cases), and dengue fever cases were distributed across 73 subdistricts in 10 districts, with most cases reported in densely populated central and western regions. The dengue fever cases had a male⁃to⁃female ratio of 1.9 ∶ 1, and a median age of 37 (21) years, with a higher median age among local cases than among imported cases [40 (20) years vs. 33(15) years; Z = -10.303, P < 0.05]. Housework, unemployment, workers, and business service were predominant occupations (1 405 cases, 81.0% of total cases), and there was a significant difference in the constituent ratio of occupations between local and imported cases ([χ2] = 92.3, P < 0.05). Among the 1 735 dengue fever cases, the median duration from onset to definitive diagnosis was 3.3 (2.9) days, and 1 686 cases (97.2%) were identified in healthcare facilities, with a low rate of hospitalization and isolation seen in 1 701 inpatients with available epidemiological data (485 cases, 28.5% of total inpatients). A total of 29 outbreaks of dengue fever occurred in Shenzhen City across 2024, which primarily in construction sites (27 outbreaks, 93.1% of total). Dengue virus typeⅠwas the dominant serotype causing dengue fever in Shenzhen City in 2024. Sequencing showed that the genomes of dengue virus from multiple dengue fever cases in Shenzhen City shared a high sequence homology with those from cities neighboring Shenzhen City, and there might be intra⁃city transmission of dengue virus among multiple construction sites in Shenzhen City. The Aedes albopictus density was significantly higher in Shenzhen City in 2024 than in 2023, peaking from May to September. The annual MOI values ranged from 0.9 to 14.0, and the BI values ranged from 0.6 to 6.0. Conclusions　The overall epidemic of dengue fever was severe in Shenzhen City in 2024, which was greatly affected by case importation from neighboring cities, construction sites⁃centered local transmission, and the effectives of routine mosquito vector control was not satisfactory. Integrated dengue fever control measures should be implemented, focusing on regional joint prevention and control mechanisms, capacity building for mosquito vector control, addressing challenges in epidemic containment at construction sites, and strengthening case detection and management systems.

Epidemiological characteristics of cross⁃county imported dengue fever cases within Yunnan Province in 2023

TANG Yerong, ZHOU Hongning, WU Chao, WEI Chun, ZHAO Xiaotao, WANG Xuefei, GUO Xiaolian, JIANG Jinyong

2025, 37(5):  524-529. 

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Objective　To investigate the epidemiological characteristics of cross⁃county imported dengue fever cases within Yunnan province in 2023, so as to provide insights into formulation of preventive and control measures for intra⁃provincial spread of dengue fever.  Methods　All data pertaining cross⁃county imported dengue fever cases within Yunnan Province in 2023 were collected, and the temporal, regional and population distributions of the cases were descriptively analyzed.  Results　A total of  1 664 intra⁃provincial cross⁃county imported dengue fever cases were reported in 95 counties (cities, districts) cross 16 profectures (cities) in Yunnan Province in 2023, accounting for 12.34% of total cases in the province. Cross⁃county imported dengue fever cases were predominantly reported during the period between August and October (1 516 cases, 91.11% of total cases), and peaked in September (659 cases), with a single⁃day peak on October 8 (36 cases). During the period from September 4 to 10, five counties (cities) with local dengue fever epidemics, including Jinghong City of Xishuangbanna Dai Autonomous Prefecture, Gengma Dai and Wa Autonomous County of Lincang City, Ruili City of Dehong Dai and Jingpo Autonomous Prefecture, Mengla County of Xishuangbanna Dai Autonomous Prefecture, and Zhenkang County of Lincang City, exported 165 cross⁃county imported dengue fever cases to the rest of the province. Among the 1 644 intra⁃provincial cross⁃county imported dengue fever cases, the male to female ratio was 1.40∶1, and 1 329 cases were at ages of 15 to 55 years (79.87%), with farmers as the predominant occupation (886 cases, 53.25%). The top 5 counties (cities/districts) reporting the highest number of intra⁃provincial cross⁃county imported dengue fever cases included Simao District (266 cases) and Lancang Lahu Autonomous County (118 cases) of Pu'er City, Mengla County (91 cases) and Menghai County (91 cases) of Xishuangbanna Dai Autonomous Prefecture, and Mangshi City (73 cases) of Dehong Dai and Jingpo Autonomous Prefecture, which accounting for 38.40% of total imported cases. These intra⁃provincial cross⁃county imported dengue fever cases originated from 7 counties (cities/districts) in 4 prefectures (cities), including 1 261 cases (76.70%) from Jinghong City of Xishuangbanna Dai Autonomous Prefecture, 224 cases (13.63%) from Ruili City of Dehong Dai and Jingpo Autonomous Prefecture, 103 cases (6.27%) from Gengma Dai and Wa Autonomous County of Lincang City, 31 cases (1.89%) from Mengla County of Xishuangbanna Dai Autonomous Prefecture, 30 cases (1.82%) from Zhenkang County of Lincang City, 10 cases (0.61%) from Cangyuan Wa Autonomous County of Lincang City, and 5 cases (0.30%) from Mohan⁃Boten Economic Cooperation Zone of Kunming City. In addition, local dengue fever epidemics following intra⁃provincial cross⁃county importation of dengue fevers cases in Simao District, Jinggu Dai and Yi Autonomous County, Mangshi City, Longchuan County, and Cangyuan Wa Autonomous County. Conclusions　Farmers and students are high⁃risk populations for intra⁃provincial cross⁃county imported dengue fever cases in Yunnan Province, and health education pertaining personal protection against dengue fever should be strengthened among these high⁃risk populations by governments at all levels. There is a high risk of local outbreak of dengue fever following continuous introduction of intra⁃provincial cross⁃county imported cases. Standardized management of intra⁃provincial cross⁃county imported dengue fever cases should be reinforced to reduce the risk of local epidemics.

Single⁃molecule, real⁃time sequencing of ceftazidime⁃avibactam⁃resistant Pseudomonas aeruginosa and the mechanism of resistance to ceftazidime⁃avibactam

WAN Li, LIU Weiqi, ZHOU Yangyang, WENG Hang, CAI Xingwang, MAO Chengye

2025, 37(5):  530-536, 548. 

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Objective　To perform single⁃molecule, real⁃time sequencing of ceftazidime⁃avibactam (CAZ⁃AVI)⁃resistant Pseudomonas aeruginosa and to investigate the mechanism underlying ceftazidime⁃avibactam resistance in P. aeruginosa.  Methods    The susceptibility of 89 P. aeruginosa isolates randomly sampled from clinical specimens in Sanming First Hospital Affiliated to Fujian Medical University from November 2021 through July 2023 to common antimicrobial agents was tested, and the minimum inhibitory concentration (MIC) of CAZ⁃AVI was determined against P. aeruginosa with a broth microdilution assay, with CAZ⁃AVI MICs of 8 mg/L and lower defined as susceptible and 16 mg/L and higher as resistant. The expression of drug⁃resistant genes ampC, oxa⁃488, oprD, mexA, oxa⁃10, oxa⁃14, vim and tem was quantified in P. aeruginosa using a real⁃time quantitative reverse transcription PCR (qPCR) assay. CAZ⁃AVI⁃susceptible and ⁃resistant P. aeruginosa isolates from the same case were selected for PacBio single⁃molecule, real⁃time sequencing, and sequencing results were subjected to genome structure and Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) functional annotations.  Results　The 89 P. aeruginosa isolates showed a relatively high level of resistance to meropenem (75.28%) and imipenem (74.16%) and the highest susceptibility to amikacin (91.01%). There were 49 CAZ⁃AVI⁃resistant P. aeruginosa isolates and 40 susceptible isolates. qPCR assay detected lower oprD gene expression in CAZ⁃AVI⁃resistant P. aeruginosa isolates [0.104 (2.385)] than in susceptible isolates [0.551 (17.885)] (Z = -2.958, P < 0.01), and there were no significant differences between CAZ⁃AVI⁃susceptible and ⁃resistant P. aeruginosa isolates in terms of ampC, oxa⁃488, mexA or tem gene expression (all P values > 0.05), while oxa⁃10, oxa⁃14 and vim gene was expressed in few P. aeruginosa isolates. There were 1 729, 3 936, 3 737 and 3 955 genes in CAZ⁃AVI⁃resistant P. aeruginosa isolates PA⁃762 and PA⁃M174 and susceptible isolates PA⁃885 and PA⁃808 that were annotated to GO terms, with the highest numbers of genes enriched in the molecular function of catalytic activity, high numbers of genes enriched in biological processes of metabolic process, single⁃organism process and cellular process, and high numbers of genes enriched in cellular components of cell and cell membranes. There were 1 803, 4 084, 3 915 and 4 066 genes in the PA⁃762, PA⁃M174, PA⁃885 and PA⁃808 isolates enriched in the KEGG signaling pathway, and the majority of genes were enriched in four primary signaling pathways of metabolism, genetic information processing, environmental information processing and cellular process, with the highest number of genes associated with metabolic pathways. Both CAZ⁃AVI⁃resistant P. aeruginosa isolates PA⁃762 and PA⁃M174 carried multiple efflux pumps systems, including MexAB⁃OprM, MexCD⁃OprJ, MexEF⁃OprN and MexXY⁃OprM. Single nucleotide substitution was found at position 169 in the DNA sequence of the PA⁃762 isolate, leading to substitution of serine for glycine at position 57 in the protein sequence, and there are deletions of two bases at positions 307 and 308 in the DNA sequence of the PA⁃M174 isolate, leading to substitution of threonine for arginine at position 103 in the protein sequence.  Conclusion　Mutation or downregulation of oprD gene may lead to CAZ⁃AVI resistance in P. aeruginosa.

Teaching practice of the problem⁃based hands⁃on inquiry⁃based comprehensive experiment of blood⁃borne protozoa infections and diagnosis

ZHOU Xia, LI Yuanyuan, HE Yan, WANG Lei

2025, 37(5):  537-541. 

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Cultivating and inspiring students' interests in performing experiments and improving students' diagnostic skills and scientific research capability for infectious diseases like malaria are critical to comprehensive experimental teaching of morphology. Consequently, Soochow University initiated a problem⁃based hands⁃on inquiry⁃based comprehensive experiment program of blood⁃borne protozoa infections and diagnosis, which took students in the "5 + 3" integrated program of clinical medicine as the teaching targets, and it consisted of three parts: pre⁃class, in⁃class, and post⁃class. Before the experimental curriculum, students learned the theoretical knowledge and the process of modeling Plasmodium berghei and Babesia microti infections in mice through online course and virtual simulation experiments, and during the experimental curriculum, students performed exploratory experiments on differential diagnosis of P. berghei and B. microti infections with pathogenic and serological tests. After the experimental curriculum, students performed molecular biological testing and extracurricular scientific research project training through open experiments. A questionnaire survey was conducted among 99 students in the "5 + 3" integrated training program of clinical medicine in batch 2021, and a total of 93 valid questionnaires were retrieved, with a questionnaire recovery rate of 93.94%. Questionnaire survey showed that 70.97% (66/93), 70.97% (66/93), 77.42% (72/93), 70.97% (66/93), and 83.87% (78/93) of the students strongly agreed with the five statements in the questionnaire respectively, namely "high interest in learning during the experiment", "reasonable experimental content settings and good classroom atmosphere", "teachers were good at guiding students' practice and thinking", "students were the main body of the classroom during the experiment" and "Comprehensive experiments had better teaching effects than traditional verification experiments", indicating that the problem⁃based hands⁃on inquiry⁃based comprehensive experiment teaching has enhanced students' learning interest, spirit of inquiry, innovative thinking, and teamwork ability. 

Tips for schistosomiasis prevention and control during the flood season

CAO Chunli, CHEN Lin

2025, 37(5):  542-544, 560. 

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Flood disasters frequently occur in schistosomiasis⁃endemic regions of China during the flood season, which causes a high risk of schistosomiasis transmission. Therefore, it is particularly crucial to control schistosomiasis transmission during the flood season. Based on field schistosomiasis control needs, this article proposes scientifical and operational countermeasures during three phases of pre⁃flood preparation, response to flood disasters, and post⁃flood management, and emphasizes multi⁃faceted interventions as responses to the risk of Oncomelania hupensis spread and schistosomiasis transmission caused by flood disasters, including information collection, risk assessment, material reserve, health education, Oncomelania hupensis control, cercariae elimination, personal protection, and preventive treatment, so as to provide insights into schistosomiasis prevention and control during the flood season.

Challenges and countermeasures for soil⁃transmitted and food⁃borne parasitic diseases surveillance in low⁃endemicity areas

MAO Fanzhen, LIU Yaobao, CAO Jun

2025, 37(5):  545-548. 

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As a global public health concern, parasitic diseases have been a great threat to human health for a long period of time. Following decades of integrated control efforts, the incidence of soil⁃transmitted and food⁃borne parasitic diseases has been remarkable reduced in most endemic foci of China, and is now low across the country. However, there are still multiple factors affecting the transmission of soil⁃transmitted and food⁃borne parasitic diseases, which pose multiple challenges to parasitic diseases surveillance in the new era. This article analyzed the current status and challenges of soil⁃transmitted and food⁃borne parasitic diseases surveillance in Jiangsu Province, a low⁃endemicity area, and proposed countermeasures to tackle the challenges, so as to provide insights into key parasitic diseases surveillance in the new era.

Epidemiological characteristics of dengue fever in Guangzhou City in 2024

DAI Bofeng, LIU Wenhui, ZHEN Ruonan, ZHANG Wei, LU Ying, LIU Yanhui

2025, 37(5):  549-554. 

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Objective　To investigate the epidemiological characteristics and effectiveness of emergency responses to epidemic foci in Guangzhou City in 2024, so as to optimization of the dengue fever control strategy in Guangzhou City. Methods　All data pertaining to dengue fever cases in Guangzhou City in 2024 were collected from the National Notifiable Infectious Disease Surveillance Information Reporting System. The temporal, spatial and population distributions of dengue fever cases and sources of infections were descriptively analyzed, and the effectiveness of emergency responses to epidemic foci of dengue fever was evaluated through standard space index (SSI), the interval from disease onset to case reporting and the percentage of isolation in hospital.  Results　A total of 3 656 dengue fever cases were reported in Guangzhou City in 2024, including 3 102 local cases and 554 imported cases. Of all cases, 67.86% (2 481 cases) occurred at ages of 20 to 59 years, and the three most common occupations included housework/unemployment (793 cases, 21.69%), business servants (744 cases, 20.35%) and retirees (669 cases, 18.30%). The peak of dengue fever epidemics was concentrated during the period from the 39th to the 45th weeks in 2024, when a total of 2 317 local cases were reported, accounting for 74.69% of all local cases in 2024. Dengue fever cases were reported across all 11 districts in Guangzhou City in 2024, with local cases concentrated in Baiyun District (754 cases, 24.31%), Liwan District (398 cases, 12.83%), Panyu District (365 cases, 11.77%), Haizhu District (332 cases, 10.70%) and Tianhe District (328 cases, 10.57%). Imported dengue fever cases were predominantly domestically imported (492 cases, 88.81%), with the majority imported from Foshan City (377 cases), and overseas imported cases were predominantly imported from southeastern Asian countries. The mean proportion of case isolation in hospital was 9.16% (284/3 102), and the mean interval from disease onset to case reporting was (3.99 ± 2.70) days, while the percentages of mosquito density meeting the required standard were 61.68% (462/749) and 66.32% (126/190) on the 4th and 7th day of emergency responses to epidemic foci, respectively. Conclusions　The prevention and control cycle of dengue fever in Guangzhou in 2024 took longer than in previous years, with a larger scale of the epidemic. Although some progress has been made in epidemic management, there are still problems such as unsustainable mosquito vector control and low hospitalization isolation rates for cases. Further optimization of control measures in mosquito vector control, case monitoring and management is required to improve the effectiveness of dengue fever control measures.

Epidemiological characteristics and control measures of dengue fever in Zhongshan City in 2024

WANG Man, LUO Le, CHEN Xueqin, SHI Wuyang, CHEN Chuying, MAI Yongqiang

2025, 37(5):  555-560. 

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Objective　To investigate the epidemiological characteristics and control measures of dengue fever in Zhongshan City in 2024, so as to provide insights into optimization of dengue fever control strategies in the city. Methods　Data pertaining to dengue fever cases in Zhongshan City in 2024 were collected from the Infectious Disease Reporting System of China Disease Prevention and Control Information System, and the epidemiological characteristics of the cases were analyzed using a descriptive statistical method. The density of Aedes albopictus mosquito was monitored across all 23 townships (subdistricts) using Breteau index (BI) and mosquito ovitrap index (MOI) at midmonth each month from March to December 2024. In addition, the climatic characteristics, case reporting patterns, and corresponding control measures were analyzed during different phases of dengue fever epidemics in Zhongshan in 2024. Furthermore, real⁃time quantitative reverse transcription PCR (RT⁃qPCR) assay was employed to serotype the dengue virus among local dengue fever cases with unknown sources of infections. The dengue virus envelope (E) gene was sequenced using Sanger sequencing among dengue fever cases without apparent epidemiological links. A phylogenetic tree was constructed using the neighbor⁃joining method to infer major transmission chains during the dengue fever epidemics.  Results　A total of 952 dengue fever cases were reported in Zhongshan City in 2024, including 879 local cases, 57 domestically imported cases from other regions, and 16 overseas imported cases, representing the largest outbreak in nearly two decades. The first local dengue fever case was reported on July 5, and the last one was detected on December 19, with all townships and subdistricts affected. Mosquito monitoring data indicated that both MOI and BI rose rapidly from March to May, and then remained at high levels with fluctuations, and began to decline in October. The dengue fever epidemic was categorized into five distinct phases in Zhongshan, including non⁃epidemic, pre⁃epidemic, early⁃epidemic, peak, and receding stages. During the pre⁃epidemic and early⁃epidemic phases, key measures included enhancing sensitivity of case detection, implementing isolation and treatment of hospitalized cases, and carrying out standardized vector control measures in affected communities. In the peak phase, the strategy shifted towards targeted mosquito control in key communities and clinical rescue and treatment emphasized on “preventing severe cases and deaths”. Among 481 local cases with unknown sources of infections, RT⁃qPCR assay revealed that 68.8% (331/481) were infected with dengue virus typeⅠ and 31.2% (150/481) with type Ⅱ among local dengue fever cases in Zhongshan City in 2024. Phylogenetic analysis revealed two major transmission chains: one originating from imported cases within Guangdong Province around Zhongshan City, and another from cases imported from Malaysia. Late detection of local dengue fever cases contributed to widespread community outbreaks.  Conclusions　The 2024 dengue fever epidemic in Zhongshan City was of considerable scale, which was primarily driven by imported cases from overseas and surrounding regions, leading to local community outbreaks. The epidemic began in early July, increased rapidly during August and September, peaked in October, and subsequently declined, with a trend consistent with the average pattern observed in previous high⁃incidence years. By implementing differentiated control measures tailored to each phase of the epidemic, the local transmission of dengue fever was successfully contained in Zhongshan in 2024. 

Advances in the mechanisms underlying the contributions of thymocyte selection⁃associated high mobility group box group to pathogen infections: a review

WANG Yuanfeng, YING Tingting, WU Junru, HONG Yuna, GUO Haorui, WANG Mingyue, YANG Zhenke, WANG Shuai

2025, 37(5):  561-568. 

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Thymocyte selection⁃associated high mobility group box group (TOX), a member of the high mobility group protein superfamily, plays an important role in T cell development, functional maintenance, and exhaustion. It has been recently found that TOX exerts critical immunoregulatory functions during pathogen infections, and TOX expression is strongly associated with the intensity and tolerance of host immune responses. This review systematically summarizes the structural and functional features of TOX and focuses on its expression dynamics, mechanisms of action, and immunomodulatory effects during viral, bacterial, and parasitic infections, which provides a theoretical support to better understanding of the role of TOX in infectious diseases and provides new insights into development of potential immunotherapeutic strategies targeting TOX.