Characteristics of SARS-CoV-2 transmission in a medium-sized city with traditional communities during the early COVID-19 epidemic in China

The nationwide COVID-19 epidemic ended in 2020, a few months after its outbreak in Wuhan, China at the end of 2019. Most COVID-19 cases occurred in Hubei Province, with a few local outbreaks in other provinces of China. A few studies have reported the early SARS-CoV-2 epidemics in several large cities or provinces of China. However, information regarding the early epidemics in small and medium-sized cities, where there are still traditionally large families and community culture is more strongly maintained and thus, transmission profiles may differ, is limited. In this study, we characterized 60 newly sequenced SARS-CoV-2 genomes from Anyang as a representative of small and medium-sized Chinese cities, compared them with more than 400 reference genomes from the early outbreak, and studied the SARS-CoV-2 transmission profiles. Genomic epidemiology revealed multiple SARS-CoV-2 introductions in Anyang and a large-scale expansion of the epidemic because of the large family size. Moreover, our study revealed two transmission patterns in a single outbreak, which were attributed to different social activities. We observed the complete dynamic process of single-nucleotide polymorphism development during community transmission and found that intrahost variant analysis was an effective approach to studying cluster infections. In summary, our study provided new SARS-CoV-2 transmission profiles representative of small and medium-sized Chinese cities as well as information on the evolution of SARS-CoV-2 strains during the early COVID-19 epidemic in China.     

Evaluation of the probability of the infection of medical personnel with Crimean-Congo hemorrhagic fever virus in cases of introduction of the infective agent to a non-endemic territory of Russia

The data on the secondary cases of infection with Crimean-Congo hemorrhagic fever (CHF) virus during the period of 1960 - 2002 have been analyzed and the probability of the infection of medical personnel with this virus has been evaluated. The data obtained in this study may be used in the development of the mathematical model of CHF epidemics (outbreaks), taking into account not only the transmission of the infective agent, but also hospital infection, as well as for calculating the number medical personnel, necessary for the liquidation of CHF epidemics (outbreaks).     

"Winged sponges": houseflies as carriers of typhoid fever in 19th- and early 20th-century military camps

Typhoid fever was the scourge of 19th- and early 20th-century armies. During the Spanish-American War (1898) and the Anglo-Boer War (1899- 1902), typhoid killed more soldiers than enemy bullets. Walter Reed and his coworkers investigated the cause of the typhoid epidemics in the U.S. Army camps and concluded that, next to human contact, the housefly (Musca domestica) was the most active agent in the spread of the disease. British medical officers in South Africa, facing even worse typhoid epidemics, reached the same conclusion. The experiences of the American and British armies finally convinced the medical profession and public health authorities that these insects conveyed typhoid. The housefly was now seen as a health menace. Military and civilian sanitarians waged fly-eradication campaigns that prevented the housefly's access to breeding places (especially human excrement), and that protected food and drink from contamination. Currently, M. domestica is recognized as the mechanical vector of a wide variety of viral, bacterial, and protozoal pathogens. Fly control is still an important public health measure in the 21st century, especially in developing countries.     

Ideas of heredity,reproduction and eugenics in Britain, 1800–1875

In this paper I begin by arguing that there are significant intellectual and normative continuities between pre-Victorian hereditarianism and later Victorian eugenical ideologies. Notions of mental heredity and of the dangers of transmitting hereditary ‘taints’ were already serious concerns among medical practitioners and laymen in the early nineteenth century. I then show how the Victorian period witnessed an increasing tendency for these traditional concerns about hereditary transmission and the integrity of bloodlines to be projected onto the level of national health. Tracing the gradual emergence of eugenical thought, I also highlight some of the more fundamental social, political and intellectual factors that promoted this predilection for extrapolating from the individual lineage to the nation and race. In doing so I argue that fully fledged eugenical thought was always unlikely to emerge prior to the early Victorian period. However, I am also able to show that Francis Galton's 1865 eugenical proposals were far from innovative and that identifying him as the ‘father’ of the eugenics movement is highly misleading.     

The poliomyelitis story: a scientific hegira

There is evidence that paralytic poliomyelitis occurred in ancient times, but it was not recognized as a distinct disease until the eighteenth century and did not come into prominence until the late nineteenth century when epidemics began to appear. Outbreaks of increasing size were reported first in the Scandinavian countries, then in the United States and elsewhere, to the surprise and consternation of the medical profession. Poliovirus was first isolated in 1908, but many years of intensive research were required before the epidemiology and pathogenesis of the disease were sufficiently understood to allow preventive measures to be devised. The road to eventual success was complicated by controversies, setbacks, and tragedies, played out and influenced by many powerful personalities. Today there are two effective vaccines. The disease has been virtually eliminated in countries where they have been used extensively, yet in the developing areas of the world recent "lameness surveys" indicate that the incidence of paralytic poliomyelitis is as high as it was during the peak years in the United States in the early 1950s. The challenge now is to use the available vaccines to extend control to the developing countries and eventually to achieve elimination of the disease worldwide.     

What's so special about Osler?

Sir William Osler was an outstanding figure in American and British Medicine during the early years of this century. Over fifty years after his death, his name is still remembered and honored, whereas other leaders who were equally important in the eyes of their contemporaries have been relegated to the realm of history. This brief review attempts to discover what special qualities have kept Osler''s memory vivid. No single characteristic of his skill, science, or personality seems in itself to explain his continuing reputation. Rather, a combination of his eminence in several different medical schools, his presence at a time of revolution in medical teaching and thought, his authorship of one of the most successful medical textbooks, and an enthusiastic claque of ex-students and colleagues seem to have combined to maintain his memory as a leader of medicine.     

Enteroviruses in the XX and XXI centuries

The modern view of the role of enteroviruses in the eradication of poliomyelitis is presented. Enteroviruses were discovered in the XX century. In the 1950s they caused great epidemics of poliomyelitis and serous meningitis in many countries of the world. The introduction of oral poliomyelitis vaccine (OPV) into medical practice made it possible to eliminate the epidemics of poliomyelitis in a short time. Poliomyelitis morbidity was reduced to sporadic cases and in a number of regions disappeared. OPV produced non-specific influence also on the epidemics of serous meningitis, as well as on a case incidence. The eradication of poliomyelitis viruses and the cessation of immunization with OPV will not result in eradication of paralytic diseases. Paralytogenic viruses of 20 serotypes circulate in nature, and some of these viruses are capable of causing the outbreaks of severe paralytic diseases. The authors propose either to retain immunization with OVP as tour immunizations with monovaccine of type 2, or to create new live enterovirus vaccines on the basis of avirulent enterovirus strains.     

Phylodynamics of HIV-1 subtype B among the men-having-sex-with-men (MSM) population in Hong Kong

The men-having-sex-with-men (MSM) population has become one of the major risk groups for HIV-1 infection in the Asia Pacific countries. Hong Kong is located in the centre of Asia and the transmission history of HIV-1 subtype B transmission among MSM remained unclear. The aim of this study was to investigate the transmission dynamics of HIV-1 subtype B virus in the Hong Kong MSM population. Samples of 125 HIV-1 subtype B infected MSM patients were recruited in this study. Through this study, the subtype B epidemic in the Hong Kong MSM population was identified spreading mainly among local Chinese who caught infection locally. On the other hand, HIV-1 subtype B infected Caucasian MSM caught infection mainly outside Hong Kong. The Bayesian phylogenetic analysis also indicated that 3 separate subtype B epidemics with divergence dates in the 1990s had occurred. The first and latest epidemics were comparatively small-scaled; spreading among the local Chinese MSM while sauna-visiting was found to be the major sex partner sourcing reservoir for the first subtype B epidemic. However, the second epidemic was spread in a large-scale among local Chinese MSM with a number of them having sourced their sex partners through the internet. The epidemic virus was estimated to have a divergence date in 1987 and the infected population in Hong Kong had a logistic growth throughout the past 20 years. Our study elucidated the evolutionary and demographic history of HIV-1 subtype B virus in Hong Kong MSM population. The understanding of transmission and growth model of the subtype B epidemic provides more information on the HIV-1 transmission among MSM population in other Asia Pacific high-income countries.     

新型冠状病毒肺炎对野生动物疫病立法执法与管理的启迪

进入21世纪以来, 中国爆发了SARS与新型冠状病毒肺炎两场重大传染病。研究表明这两场传染病的疫源可能是蝙蝠, 也可能还有其他中间宿主动物, 人们纷纷要求立法禁止食用野生动物。事实上, 国家已经立法禁止食用受法律保护的和非法来源的野生动物, 市场调查也未发现有蝙蝠出售。那么, SARS病毒与新型冠状病毒是如何从野生动物传到人类的? 我们应当从这两场疫病中吸取哪些教训? 除了全面禁止非法食用野生动物外, 笔者建议: (1)完善野生动物疫病立法, 填补立法空缺。修订现有法律关于野生动物疫病自然疫源地建设项目的管理条款。(2)设立常设机构, 覆盖野生动物疫病调查监测、人与野生动物接触界面检疫监管、易感人群免疫、法律与科学知识普及和疾病防治整个流行病环节, 实现野生动物疫病的早预防、早发现、早治疗, 切实保证社会公共卫生安全。(3)建立野生动物疫病的防控机制, 定期鉴别携带病原的野生动物, 加强对蝙蝠的监测, 发布野生动物疫源疫病控制红线, 加强野生动物疫病执法和预防管理。(4)完善动物生产管理、动物产品及其销售市场的检疫程序。改革人们现场宰杀动物、追求食用鲜活动物食品的习惯。     

Stochastic eco-epidemiological model of dengue disease transmission by Aedes aegypti mosquito

We present a stochastic dynamical model for the transmission of dengue that takes into account seasonal and spatial dynamics of the vector Aedes aegypti. It describes disease dynamics triggered by the arrival of infected people in a city. We show that the probability of an epidemic outbreak depends on seasonal variation in temperature and on the availability of breeding sites. We also show that the arrival date of an infected human in a susceptible population dramatically affects the distribution of the final size of epidemics and that early outbreaks have a low probability. However, early outbreaks are likely to produce large epidemics because they have a longer time to evolve before the winter extinction of vectors. Our model could be used to estimate the risk and final size of epidemic outbreaks in regions with seasonal climatic variations.     

The cholera: The epidemics and their social-demographic features in Southern Italy

Cholera, as it was regarding each infective disease of which nobody knew its aetiologic agent or, in any way, if its agent was present really, was for the Calabrian people an unknown enemy that nobody knew anything about either its behaviour or the modality of its penetration into the human body. During many years characterized by a medical methodological obscurantism, Calabrian people lived, during the different choleric epidemics, on a daily life based upon the ignorance, and the pseudo-treatments, and pseudo-physicians. During the cholera epidemics, not only the people groped in the dark, but also the governmental authorities were confused because were subdivided into those who supported the theory of the epidemics spread and those who supported the theory of the contagion spread. It must be emphasized that from the XX century, when the pathologies due to natural agents were reduced and were substituted with those due to humans, cholera influenced very much the demography and the social-cultural features of the Southern Italy.     

The discovery of Angiostrongylus cantonensis as a cause of human eosinophilic meningitis

The theoretical and subsequent confirmation in 1961 of the rat lungworm, Angiostrongylus cantonensis, as the causative agent o f eosinophilic meningitis is one o f the remarkable parasitological findings of the twentieth century. Here, Joseph Alicato briefly summarizes the early history and his epidemiological studies on the relationship between the parasite and the epidemics o f encephalitis that swept through Oceania after the Second World War.     

以兽类为例探讨我国陆生野生动物疫病监管中面临的问题与对策

近年来, 新型冠状病毒、SARS病毒和鼠疫等新发和再发性动物源疫病多是由兽类及其媒介携带的病原生物直接或间接感染而引发的, 不仅对人类健康和生态系统平衡造成了重大威胁, 而且威胁全球公共卫生安全、粮食安全和生物安全。结合我国重要陆生兽类疫源疫病发生的新情况和新特点, 本文重点总结了我国以陆生野生及非野生兽类(家畜为主)为重点的24种重要人兽共患病的监管情况, 并对这些疫源疫病的监管空缺进行了分析。由于病原生物的种类多及其感染传播方式多样, 我国人间和动物间疫情呈现多发态势, 新发和再发疫病防控面临严峻挑战。从目前情况来看, 我国重要野生动物疫源疫病呈现为多部门、多层监管的局面。全球化贸易剧增、非法猎杀、非法交易、违法违规养殖、滥食野生动物陋习、检疫环节失察等导致了当前我国野生动物疫源疫病的传染源头和传播链错综复杂, 加剧了人类与野生动物所携带的病原接触、感染和传播的风险。极端气候或灾害事件频发以及对新发再发传染病的认知不足导致难以从源头做好疫病防控。针对上述问题, 本文提出了从源头加强基础研究和全链条监管来积极防范陆生野生动物疫病疫情的对策和建议。     

Mosquitoes and transmission of malaria parasites – not just vectors

The regional malaria epidemics of the early 1900s provided the basis for much of our current understanding of malaria epidemiology. Colonel Gill, an eminent malariologist of that time, suggested that the explosive nature of the regional epidemics was due to a sudden increased infectiousness of the adult population. His pertinent observations underlying this suggestion have, however, gone unheeded. Here, the literature on Plasmodium seasonal behaviour is reviewed and three historical data sets, concerning seasonal transmission of Plasmodium falciparum, are examined. It is proposed that the dramatic seasonal increase in the density of uninfected mosquito bites results in an increased infectiousness of the human reservoir of infection and, therefore, plays a key role in "kick-starting" malaria parasite transmission.     

The Excitations and Suppressions of the Times: Locating the Emotions in the Liver in Modern Chinese Medicine

This paper explores how doctors of Chinese medicine have borrowed from a long history of scholarship on the problem of “constraint” to develop treatments for modern emotion-related disorders, such as depression. I argue that this combining of medical practices was made possible by a complex sequence of events. First, doctors in the 1920 and 1930s were engaged in a critical reexamination of the entire corpus of Chinese medical knowledge. Spurred by the encounter with European imperialism, the sudden rise of Japan as a new power in East Asia, and the political struggles to establish a Chinese nation state, these scholars were among the first to speculate on the possible relationship between Chinese medicine and Western medicine. Second, in the 1950 and 1960s, doctors like other intellectuals were focused on national reunification and institution building. They rejected some of the experimental claims of their predecessors to focus on identifying the key characteristics of Chinese medicine, such as the methodology of “pattern recognition and treatment determination bianzheng lunzhi.” The flexibility of the new bianzheng lunzhi paradigm allowed doctors to quietly adopt innovations from their early twentieth century counterparts that they ostensibly rejected, ultimately paving the way for contemporary treatments of depression.     

Smallpox: A Retrospect

Smallpox has been known as a disease of man since the earliest times. However, its severity increased greatly during the eighteenth century, stimulating physicians and others to find methods of protection against it. Variolation (the inoculation of smallpox material into the skin) was tried, and for a while found general approval, although its practice was not without danger. In 1796, Edward Jenner began his investigations into the use of cow-pox material (vaccination) as a prophylactic against smallpox, and later showed that vaccination could confer protection. Although vaccination centres were first set up in Canada early in the nineteenth century, the disease on occasion assumed epidemic proportions, such as occurred in Montreal in 1885. Sporadic outbreaks have occurred since then, including the recent case in Toronto. From the public health point of view, maintenance of a high level of immunity to smallpox throughout the general population is necessary if serious epidemics are to be avoided.     

Modeling polio as a disease of development

Poliomyelitis is a disease which began to appear in epidemic proportions in the late 19th century, paradoxically, just at the time when living conditions and developments in health were transforming enormously for the better. We present a simple age-class model that explains this "disease of development" as a threshold phenomenon. Epidemics arise when improved conditions in hygiene are able to reduce disease transmission of polio amongst children below a critical threshold level. This generates a large susceptible adult population in which, under appropriate conditions, epidemics can propagate. The polio model is analysed in terms of its bifurcation properties and in terms of its non-equilibrium outbreak dynamics.     

Use of Hangeul Twitter to Track and Predict Human Influenza Infection

Influenza epidemics arise through the accumulation of viral genetic changes. The emergence of new virus strains coincides with a higher level of influenza-like illness (ILI), which is seen as a peak of a normal season. Monitoring the spread of an epidemic influenza in populations is a difficult and important task. Twitter is a free social networking service whose messages can improve the accuracy of forecasting models by providing early warnings of influenza outbreaks. In this study, we have examined the use of information embedded in the Hangeul Twitter stream to detect rapidly evolving public awareness or concern with respect to influenza transmission and developed regression models that can track levels of actual disease activity and predict influenza epidemics in the real world. Our prediction model using a delay mode provides not only a real-time assessment of the current influenza epidemic activity but also a significant improvement in prediction performance at the initial phase of ILI peak when prediction is of most importance.     

Review. The changing face of kuru: a personal perspective

The epidemic of kuru is now known to have been transmitted among the Fore by ritual consumption of infected organs from deceased relatives. As cannibalism was suppressed by government patrol officers during the 1950s, most transmission had ceased by 1957, when the kuru research programme first commenced. As predicted in the 1960s, the epidemic has waned, with progressive ageing of kuru-affected cohorts over the years to 2007. The few cases seen in the twenty-first century, with the longest incubation periods, were almost certainly exposed as children prior to 1960. Although the research programme had almost no role in bringing the kuru epidemic to an end, it did provide important knowledge that was to help the wider world in controlling the later epidemics of iatrogenic and variant Creutzfeldt-Jakob disease and bovine spongiform encephalopathy.     

Storytelling, statistics and hereditary thought: the narrative support of early statistics

This paper's main contention is that some basically methodological developments in science which are apparently distant and unrelated can be seen as part of a sequential story. Focusing on general inferential and epistemological matters, the paper links occurrences separated by both in time and space, by formal and representational issues rather than social or disciplinary links. It focuses on a few limited aspects of several cognitive practices in medical and biological contexts separated by geography, disciplines and decades, but connected by long term transdisciplinary representational and inferential structures and constraints. The paper intends to show a given set of knowledge claims based on organizing statistically empirical data can be seen to have been underpinned by a previous, more familiar, and probably more natural, narrative handling of similar evidence. To achieve that this paper moves from medicine in France in the late eighteenth and early nineteenth century to the second half of the nineteenth century in England among gentleman naturalists, following its subject: the shift from narrative depiction of hereditary transmission of physical peculiarities to posterior statistical articulations of the same phenomena. Some early defenders of heredity as an important (if not the most important) causal presence in the understanding of life adopted singular narratives, in the form of case stories from medical and natural history traditions, to flesh out a special kind of causality peculiar to heredity. This work tries to reconstruct historically the rationale that drove the use of such narratives. It then shows that when this rationale was methodologically challenged, its basic narrative and probabilistic underpinings were transferred to the statistical quantificational tools that took their place.