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1.  Novel Variants of Clade 2.3.4 Highly Pathogenic Avian Influenza A(H5N1) Viruses, China 
Emerging Infectious Diseases  2013;19(12):2021-2024.
We characterized 7 highly pathogenic avian influenza A(H5N1) viruses isolated from poultry in China during 2009–2012 and found that they belong to clade 2.3.4 but do not fit within the 3 defined subclades. Antigenic drift in subtype H5N1 variants may reduce the efficacy of vaccines designed to control these viruses in poultry.
doi:10.3201/eid1912.130340
PMCID: PMC3840869  PMID: 24274396
influenza; avian influenza virus; clade 2.3.4; China; clade; influenza virus; flu; H5; H5N1; highly pathogenic; viruses; avian; AIV; phylogeny; chickens; birds; HPAI
2.  Risk Perceptions for Avian Influenza Virus Infection among Poultry Workers, China  
Emerging Infectious Diseases  2013;19(2):313-316.
To determine risk for avian influenza virus infection, we conducted serologic surveillance for H5 and H9 subtypes among poultry workers in Beijing, China, 2009–2010, and assessed workers’ understanding of avian influenza. We found that poultry workers had considerable risk for infection with H9 subtypes. Increasing their knowledge could prevent future infections.
doi:10.3201/eid1902.120251
PMCID: PMC3563274  PMID: 23343592
Avian influenza; influenza; viruses; poultry workers; serologic survey; knowledge; attitudes; practices
3.  Human Streptococcus suis Outbreak, Sichuan, China 
Emerging Infectious Diseases  2006;12(6):914-920.
Streptococcus suis outbreak was associated with exposure to sick or dead pigs.
From mid-July to the end of August 2005, a total of 215 cases of human Streptococcus suis infections, 66 of which were laboratory confirmed, were reported in Sichuan, China. All infections occurred in backyard farmers who were directly exposed to infection during the slaughtering process of pigs that had died of unknown causes or been killed for food because they were ill. Sixty-one (28%) of the farmers had streptococcal toxic shock syndrome; 38 (62%) of them died. The other illnesses reported were sepsis (24%) and meningitis (48%) or both. All isolates tested positive for genes for tuf, species-specific 16S rRNA, cps2J, mrp, ef, and sly. A single strain of S. suis caused the outbreak, as shown by the identification of a single ribotype. The high death ratio was of concern; prohibiting backyard slaughtering ended the outbreak.
doi:10.3201/eid1206.051194
PMCID: PMC3373052  PMID: 16707046
Keywords: Streptococcus suis; streptococcal toxic shock syndrome; outbreak; zoonoses; research
4.  SARS-CoV Infection in a Restaurant from Palm Civet 
Emerging Infectious Diseases  2005;11(12):1860-1865.
Contact with food animals was associated with SARS-CoV infection in the People’s Republic of China.
Epidemiologic investigations showed that 2 of 4 patients with severe acute respiratory syndrome (SARS) identified in the winter of 2003–2004 were a waitress at a restaurant in Guangzhou, China, that served palm civets as food and a customer who ate in the restaurant a short distance from animal cages. All 6 palm civets at the restaurant were positive for SARS-associated coronavirus (SARS-CoV). Partial spike (S) gene sequences of SARS-CoV from the 2 patients were identical to 4 of 5 S gene viral sequences from palm civets. Phylogenetic analysis showed that SARS-CoV from palm civets in the restaurant was most closely related to animal isolates. SARS cases at the restaurant were the result of recent interspecies transfer from the putative palm civet reservoir, and not the result of continued circulation of SARS-CoV in the human population.
doi:10.3201/eid1112.041293
PMCID: PMC3367621  PMID: 16485471
Severe acute respiratory syndrome; coronavirus; palm civet; research
5.  Subclinical Highly Pathogenic Avian Influenza Virus Infection among Vaccinated Chickens, China 
Emerging Infectious Diseases  2014;20(12):2152-2154.
Subclinical infection of vaccinated chickens with a highly pathogenic avian influenza A(H5N2) virus was identified through routine surveillance in China. Investigation suggested that the virus has evolved into multiple genotypes. To better control transmission of the virus, we recommend a strengthened program of education, biosecurity, rapid diagnostics, surveillance, and elimination of infected poultry.
doi:10.3201/eid2012.140733
PMCID: PMC4257838  PMID: 25418710
Influenza; type A; subtype H5; H5N2; avian influenza virus; pathogenicity; epidemiology; vaccine-escape; variant; zoonosis; poultry; viruses; subclinical; silent infection; HPAI; highly pathogenic avian influenza; vaccine; China
6.  Nosocomial Neonatal Legionellosis Associated with Water in Infant Formula, Taiwan 
Emerging Infectious Diseases  2014;20(11):1921-1924.
We report 2 cases of neonatal Legionella infection associated with aspiration of contaminated water used in hospitals to make infant formula. The molecular profiles of Legionella strains isolated from samples from the infants and from water dispensers were indistinguishable. Our report highlights the need to consider nosocomial legionellosis among neonates who have respiratory symptoms.
doi:10.3201/eid2011.140542
PMCID: PMC4214307  PMID: 25340315
water; infant formula; Legionella; neonatal legionellosis; neonate; nosocomial infection; Taiwan; bacteria
7.  Asymptomatic, Mild, and Severe Influenza A(H7N9) Virus Infection in Humans, Guangzhou, China 
Emerging Infectious Diseases  2014;20(9):1535-1540.
doi:10.3201/eid2009.140424
PMCID: PMC4178418  PMID: 25148539
avian influenza; influenza; influenza A(H7N9); H7N9; surveillance; person-to-person transmission; asymptomatic infection; viruses; respiratory infections; human; China
8.  Early Public Response to Influenza A(H7N9) Virus, Guangzhou, China, May 30–June 7, 2013 
Emerging Infectious Diseases  2014;20(7):1238-1240.
doi:10.3201/eid2007.131155
PMCID: PMC4073867  PMID: 24964006
public; influenza; influenza virus; influenza A(H7N9) virus; subtype H7N9; live poultry markets; China; Guangzhou; behaviors; attitudes; urban; semirural; viruses; chickens
9.  Porcine Epidemic Diarrhea Virus Variants with High Pathogenicity, China 
Emerging Infectious Diseases  2013;19(12):2048-2049.
doi:10.3201/eid1912.121088
PMCID: PMC3840889  PMID: 24274832
Porcine epidemic diarrhea virus; variants; animal infection experiment; viruses; China; pigs
10.  Seoul Virus in Rats (Rattus norvegicus), Hyesan, North Korea, 2009–2011 
Emerging Infectious Diseases  2013;19(11):1895-1896.
doi:10.3201/eid1911.130207
PMCID: PMC3837658  PMID: 24229532
Seoul virus; Rattus norvegicus; Hyesan; North Korea; viruses; hantavirus
11.  Avian Metapneumovirus Subgroup C Infection in Chickens, China 
Emerging Infectious Diseases  2013;19(7):1092-1094.
Avian metapneumovirus causes acute respiratory tract infection and reductions in egg production in various avian species. We isolated and characterized an increasingly prevalent avian metapneumovirus subgroup C strain from meat-type commercial chickens with severe respiratory signs in China. Culling of infected flocks could lead to economic consequences.
doi:10.3201/eid1907.121126
PMCID: PMC3903454  PMID: 23763901
Avian metapneumovirus subgroup C; Pneumovirinae; Paramyxoviridae; viruses; chickens; M gene sequencing; pathogenesis; China
12.  Human Papillomavirus Genital Infections among Men, China, 2007–2009 
Emerging Infectious Diseases  2013;19(6):992-995.
To determine prevalence of genital human papillomavirus (HPV) infection among men in rural China, we analyzed genital swab specimens. Among 2,236 male residents of rural Henan Province, HPV infection prevalence was 17.5%. The most common oncogenic and nononcogenic types were HPV-16 and HPV-3, respectively. Infection was associated with younger age and multiple sex partners.
doi:10.3201/eid1906.111597
PMCID: PMC3713808  PMID: 23735236
HPV; men; China; viruses; genital infection; human papillomavirus
13.  Coxsackievirus B3, Shandong Province, China, 1990–2010 
Emerging Infectious Diseases  2012;18(11):1865-1867.
To determine the cause of a 2008 outbreak of aseptic meningitis in Shandong Province, China, we analyzed samples from outbreak patients and coxsackievirus B3 samples collected during 1990–2010 surveillance. The cause of the outbreak was coxsackievirus B3, genogroup D. Frequent travel might increase importation of other coxsackievirus B3 genogroups.
doi:10.3201/eid1811.120090
PMCID: PMC3559141  PMID: 23092737
coxsackievirus B3; aseptic meningitis; acute flaccid paralysis; phylogenetic analysis; viruses; China
14.  Human Infection with Candidatus Neoehrlichia mikurensis, China 
Emerging Infectious Diseases  2012;18(10):1636-1639.
To identify Candidatus Neoehrlichia mikurensis infection in northeastern China, we tested blood samples from 622 febrile patients. We identified in 7 infected patients and natural foci for this bacterium. Field surveys showed that 1.6% of ticks and 3.8% of rodents collected from residences of patients were also infected.
doi:10.3201/eid1810.120594
PMCID: PMC3471638  PMID: 23017728
Candidatus Neoehrlichia mikurensis; bacteria; human infection; ticks; rodents; vector-borne infections; China
15.  Rickettsia raoultii–like Bacteria in Dermacentor spp. Ticks, Tibet, China 
Emerging Infectious Diseases  2012;18(9):1532-1534.
doi:10.3201/eid1809.120644
PMCID: PMC3437703  PMID: 22931966
rickettsia; Rickettsia raoultii; R. raoultii–like bacteria; Candidatus Rickettsia tibetani; bacteria; spotted fever group; ticks; Dermacentor everestianus; Dermacentor niveus; Tibet; China
16.  Murine Typhus in Drug Detoxification Facility, Yunnan Province, China, 2010 
Emerging Infectious Diseases  2012;18(8):1388-1390.
doi:10.3201/eid1808.120060
PMCID: PMC3414037  PMID: 22840682
Murine typhus; Rickettsia typhi; outbreak; China–Myanmar border; People’s Republic of China; typhus; Rickettsia; vector-borne infections
17.  Pandemic (H1N1) 2009 among Quarantined Close Contacts, Beijing, People’s Republic of China 
Emerging Infectious Diseases  2011;17(10):1824-1830.
The attack rate was low, and having contact with an ill household member and younger age were the major risk factors.
We estimated the attack rate of pandemic (H1N1) 2009 and assessed risk factors for infection among close contacts quarantined in Beijing, People’s Republic of China. The first 613 confirmed cases detected between May 16 and September 15, 2009, were investigated; 7,099 close contacts were located and quarantined. The attack rate of confirmed infection in close contacts was 2.4% overall, ranging from 0.9% among aircraft passengers to >5% among household members. Risk factors for infection among close contacts were younger age, being a household member of an index case-patient, exposure during the index case-patient’s symptomatic phase, and longer exposure. Among close contacts with positive test results at the start of quarantine, 17.2% had subclinical infection. Having contact with a household member and younger age were the major risk factors for acquiring pandemic (H1N1) 2009 influenza virus infection. One person in 6 with confirmed pandemic (H1N1) 2009 was asymptomatic.
doi:10.3201/eid1710.101344
PMCID: PMC3310645  PMID: 22000351
influenza; pandemic; close contact; attack rate; quarantine; viruses; China; pandemic (H1N1) 2009; research
18.  Novel Reassortant Highly Pathogenic Avian Influenza (H5N5) Viruses in Domestic Ducks, China 
Emerging Infectious Diseases  2011;17(6):1060-1063.
In China, domestic ducks and wild birds often share the same water, in which influenza viruses replicate preferentially. Isolation of 2 novel reassortant highly pathogenic avian influenza (H5N5) viruses from apparently healthy domestic ducks highlights the role of these ducks as reassortment vessels. Such new subtypes of influenza viruses may pose a pandemic threat.
doi:10.3201/eid1706.101406
PMCID: PMC3358203  PMID: 21749770
H5N5; highly pathogenic avian influenza; reassortant; domestic ducks; viruses; influenza; China; dispatch
19.  Fatal Avian Influenza (H5N1) Infection in Human, China 
Emerging Infectious Diseases  2010;16(11):1799-1801.
doi:10.3201/eid1611.090212
PMCID: PMC3294501  PMID: 21029551
Viruses; avian influenza; influenza-like illnesses; respiratory infections; poultry; H5N1; China; letter
20.  Anaplasma phagocytophilum from Rodents and Sheep, China 
Emerging Infectious Diseases  2010;16(5):764-768.
Three strains were isolated and characterized.
To characterize the strains of Anaplasma phagocytophilum in wild and domestic animals in China, we isolated the organism from rodents and sheep in northeastern China. We isolated 3 strains (2 from rodents and 1 from sick sheep) through propagation in BALB/c mice and then cell culture in HL60 cells. The 3 isolates were identified by Wright-Giemsa staining, immunofluorescence, and electronic microscopy and were characterized by sequence analyses of the 16S rRNA gene, partial citrate synthase gene, major surface protein 4 gene, and heat shock protein gene. The multiple sequences of the 3 isolates were identical to each other but different from all known strains from other countries. The public health and veterinary relevance of the isolates deserves further investigation.
doi:10.3201/eid1605.091293
PMCID: PMC2953994  PMID: 20409364
Anaplasma phagocytophilum; isolation; rodents; sheep; China; rickettsia; research
21.  Multiple Origins of Foot-and-Mouth Disease Virus Serotype Asia 1 Outbreaks, 2003–2007 
Emerging Infectious Diseases  2009;15(7):1046-1051.
Viruses in 6 genetic groups have caused recent outbreaks in Asia.
We investigated the molecular epidemiology of foot-and-mouth disease virus (FMDV) serotype Asia 1, which caused outbreaks of disease in Asia during 2003–2007. Since 2004, the region affected by outbreaks of this serotype has increased from disease-endemic countries in southern Asia (Afghanistan, India, Iran, Nepal, Pakistan) northward to encompass Kyrgyzstan, Tajikistan, Uzbekistan, several regions of the People’s Republic of China, Mongolia, Eastern Russia, and North Korea. Phylogenetic analysis of complete virus capsid protein 1 (VP1) gene sequences demonstrated that the FMDV isolates responsible for these outbreaks belonged to 6 groups within the Asia 1 serotype. Some contemporary strains were genetically closely related to isolates collected historically from the region as far back as 25 years ago. Our analyses also indicated that some viruses have spread large distances between countries in Asia within a short time.
doi:10.3201/eid1507.081621
PMCID: PMC2744236  PMID: 19624919
Picornaviridae; Aphthovirus; foot-and-mouth disease virus; serotype Asia 1; surveillance; epidemiology; phylogeny; sequencing data; viruses; research
22.  Peste des Petits Ruminants Virus in Tibet, China 
Emerging Infectious Diseases  2009;15(2):299-301.
Serologic and molecular evidence indicates that peste des petits ruminants virus (PPRV) infection has emerged in goats and sheep in the Ngari region of southwestern Tibet, People’s Republic of China. Phylogenetic analysis confirms that the PPRV strain from Tibet is classified as lineage 4 and is closely related to viruses currently circulating in neighboring countries of southern Asia.
doi:10.3201/eid1502.080817
PMCID: PMC2657621  PMID: 19193278
Peste des petits ruminants virus; prevalence; ruminants; Tibet; China; dispatch
23.  Spatial Analysis of Tuberculosis Cases in Migrants and Permanent Residents, Beijing, 2000–2006 
Emerging Infectious Diseases  2008;14(9):1413-1419.
Population fluctuation is a risk factor for TB in Beijing.
To determine the role of the migrant population in the transmission of tuberculosis (TB), we investigated the distribution and magnitude of TB in permanent residents and migrant populations of Beijing, People’s Republic of China, from 2000 through 2006. An exploratory spatial data analysis was applied to detect the “hot spots” of TB among the 2 populations. Results, using the data obtained from 2004–2006, showed that people who migrated from the western, middle, and eastern zones of China had a significantly higher risk of having TB than did permanent residents. These findings indicate that population fluctuations have affected the rate of TB prevalence in Beijing, and interventions to control TB should include the migrant population.
doi:10.3201/1409.071543
PMCID: PMC2603090  PMID: 18760008
pulmonary tuberculosis; migrant population; spatial analysis; Extra Poisson model; research
24.  SARS-associated Coronavirus Transmitted from Human to Pig 
Emerging Infectious Diseases  2005;11(3):446-448.
Severe acute respiratory syndrome–associated
coronavirus (SARS-CoV) was isolated from a pig during a survey for possible routes of viral transmission after a SARS epidemic. Sequence and epidemiology analyses suggested that the pig was infected by a SARS-CoV of human origin.
doi:10.3201/eid1103.040824
PMCID: PMC3298239  PMID: 15757562
25.  Anti–SARS-CoV Immunoglobulin G in Healthcare Workers, Guangzhou, China 
Emerging Infectious Diseases  2005;11(1):89-94.
Low level of immunity for SARS-CoV among well healthcare workers reinforces the need for infection control measures in hospitals to prevent epidemics.
To determine the prevalence of inapparent infection with severe acute respiratory syndrome (SARS) among healthcare workers, we performed a serosurvey to test for immunoglobulin (Ig) G antibodies to the SARS coronavirus (SARS-CoV) among 1,147 healthcare workers in 3 hospitals that admitted SARS patients in mid-May 2003. Among them were 90 healthcare workers with SARS. As a reference group, 709 healthcare workers who worked in 2 hospitals that never admitted any SARS patients were similarly tested. The seroprevalence rate was 88.9% (80/90) for healthcare workers with SARS and 1.4% (15/1,057) for healthcare workers who were apparently healthy. The seroprevalence in the reference group was 0.4% (3/709). These findings suggest that inapparent infection is uncommon. Low level of immunity among unaffected healthcare workers reinforces the need for adequate personal protection and other infection control measures in hospitals to prevent future epidemics.
doi:10.3201/eid1101.040138
PMCID: PMC3294349  PMID: 15705328
SARS; Seroprevalence; Healthcare workers; China; research

Results 1-25 (155)