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Transmissibility of an emerging infectious disease is a key factor for determining transmission dynamics in a population. The basic reproductive number, [R.sub.0], indicates the average number of new cases resulting [...]

Scrub typhus is a life-threatening disease caused by Orientia tsutsugamushi, an obligate intracellular bacterium transmitted by the larvae of trombiculid mites (1). Only biting larvae of Asian scrub typhus chiggers [...]

Objective To ascertain the trends and burden of malaria in China and the costs of interventions for 2011-2015. Methods We analysed the spatiotemporal and demographic features of locally transmitted and imported malaria cases using disaggregated surveillance data on malaria from 2011 to 2015, covering the range of dominant malaria vectors in China. The total and mean costs for malaria elimination were calculated by funding sources, interventions and population at risk. Findings A total of 17 745 malaria cases, including 123 deaths (0.7%), were reported in mainland China, with 15 840 (89%) being imported cases, mainly from Africa and south-east Asia. Almost all counties of China (2855/2858) had achieved their elimination goals by 2015, and locally transmitted cases dropped from 1469 cases in 2011 to 43 cases in 2015, mainly occurring in the regions bordering Myanmar where Anopheles minimus and An. dims are the dominant vector species. A total of United States dollars (US$) 134.6 million was spent in efforts to eliminate malaria during 2011-2015, with US$ 57.2 million (43%) from the Global Fund to Fight AIDS, Tuberculosis and Malaria and US$ 77.3 million (57%) from the Chinese central government. The mean annual investment (US$ 27 million) per person at risk (574 million) was US$ 0.05 (standard deviation: 0.03). Conclusion The locally transmitted malaria burden in China has decreased. The key challenge is to address the remaining local transmission, as well as to reduce imported cases from Africa and south-east Asia. Continued efforts and appropriate levels of investment are needed in the 2016-2020 period to achieve elimination. Objectif Determiner Involution et la charge du paludisme en Chine ainsi que les couts des interventions visant son ellmination, pour la periode de 2011 a 2015. Methodes Nous avons analyse les caracteristiques spatio-temporelles et demographiques des cas de transmission locale et d'importation du paludisme, en utllisant des donnees de surveillance desagregees sur le paludisme couvrant les principaux vecteurs en Chine sur la periode de 2011 a 2015. Les couts totaux et moyens des efforts domination du paludisme ont ete calcules pour chaque source de financement, chaque type d'Intervention et en fonction de la population exposee. Resultats Un total de 17 745 cas de paludisme, dont 123 mortels (0,7%), a ete recense en Chine continentale, avec 15 840 cas importes (89%), essentiellement depuis l'Afrique et l'Asie du Sud-Est. Pratiquement tous les comtes de Chine (2855/2858) ont atteint leurs objectifs vers lelimination du paludisme en 2015, et les cas de transmission locale ont chute de 1469 cas en 2011 a 43 cas en 2015, survenus prindpalement dans les regions bordant le Myanmar, oU les especes Anopheles minimus et An. dirus sont les principaux vecteurs. Au total, 134,6 millions de dollars des Etats-Unis (USD) ont ete depenses dans les efforts d'elimination du paludisme entre 2011 et 2015, dont 57,2 millions d'USD (43%) en provenance du Fonds mondial de lutte contre le sida, la tuberculose et le paludisme et 77,3 millions d'USD (57%) en provenance du gouvernement central chinois. L'investissement annuel moyen (27 millions d'USD) par personne exposee (574 millions) a ete de 0,05 USD (ecart type: 0,03). Conclusion La charge des cas de transmission locale du paludisme en Chine a dimlnue. Le principal defi consiste desormais a lutter contre la transmission locale residuelle et a reduire les cas Importes depuis l'Afrique et l'Asie du Sud-Est. Des efforts continus et des niveaux d'investissement appropries sont necessaires sur la periode 2016-2020 pour atteindre l'objectif d'elimination du paludisme. Objetivo Determinar las tendencias y la carga de paludismo en China y los costes de las intervenciones entre 2011 y 2015. Metodos Se analizaron las caracteristicas espacio-temporales y demograficas de los casos de paludismo importado y transmitido localmente utilizando datos de seguimiento desglosados sobre el paludismo entre 2011 y 2015, y se cubrio la gama de vectores del paludismo dominantes en China. Se calcularon los costes totales y medios para la eliminacion del paludismo teniendo en cuenta las fuentes de financiacion, las intervenciones y la poblacion en riesgo. Resultados En China continental se registro un total de 17 745 casos de paludismo, incluyendo 123 muertes (0,7%), de los cuales 15 840 (89%) fueron casos importados, principalmente de Africa y el sudeste asiatico. Casi todos los condados de China (2 855/2 858) habian logrado sus objetivos de eliminacion para 2015, y los casos transmitidos localmente descendieron de 1 469 casos en 2011 a 43 casos en 2015, principalmente en las regiones fronterizas con Myanmar, donde Anopheles minimusy An. dirus son las especies de vectores dominantes. Se gasto un total de 134,6 millones de dolares estadounidenses (USD) en el esfuerzo por eliminar el paludismo durante el periodo 2011-2015. De este dinero, 57,2 millones de USD (un 43%) provinieron del Fondo Mundial de lucha contra el sida, la tuberculosisy la malaria y 77,3 millones de USD (un 57%) del gobierno central chino. La inversion anual media (27 millones de USD) por persona en riesgo (574 millones) fue de 0,05 USD (desviacion estandar: 0,03). Conclusion La carga de paludismo transmitido localmente en China ha disminuido. El reto principal es poner remedio a los casos transmitidos localmente que quedan, ademas de reducir los casos de importacion de la infeccion desde Africa y el sudeste asiatico. Durante el periodo 2016-2020, se necesitan esfuerzos continuos y niveles de inversion adecuados para lograr su eliminacion., Introduction Malaria remains a public health issue, with an estimated 214 million cases and 438000 deaths globally in 2015. (1,2) Historically, malaria has been widespread in China, with 24 malaria-endemic [...]

Malaria is a potentially deadly disease caused by infection with Plasmodium spp. parasites, which are transmitted to humans through bites from infected Anopheles spp. mosquitoes. As part of global malaria [...]

Background Hand, foot, and mouth disease (HFMD) is a common childhood illness caused by serotypes of the Enterovirus A species in the genus Enterovirus of the Picornaviridae family. The disease has had a substantial burden throughout East and Southeast Asia over the past 15 y. China reported 9 million cases of HFMD between 2008 and 2013, with the two serotypes Enterovirus A71 (EV-A71) and Coxsackievirus A16 (CV-A16) being responsible for the majority of these cases. Three recent phase 3 clinical trials showed that inactivated monovalent EV-A71 vaccines manufactured in China were highly efficacious against HFMD associated with EV-A71, but offered no protection against HFMD caused by CV-A16. To better inform vaccination policy, we used mathematical models to evaluate the effect of prospective vaccination against EV-A71-associated HFMD and the potential risk of serotype replacement by CV-A16. We also extended the model to address the co-circulation, and implications for vaccination, of additional non-EV-A71, non-CV-A16 serotypes of enterovirus. Methods and Findings Weekly reports of HFMD incidence from 31 provinces in Mainland China from 1 January 2009 to 31 December 2013 were used to fit multi-serotype time series susceptible-infected-recovered (TSIR) epidemic models. We obtained good model fit for the two-serotype TSIR with cross-protection, capturing the seasonality and geographic heterogeneity of province-level transmission, with strong correlation between the observed and simulated epidemic series. The national estimate of the basic reproduction number, [R.sub.0], weighted by provincial population size, was 26.63 for EV-A71 (interquartile range [IQR]: 23.14, 30.40) and 27.13 for CV-A16 (IQR: 23.15,31.34), with considerable variation between provinces (however, predictions about the overall impact of vaccination were robust to this variation). EV-A71 incidence was projected to decrease monotonically with higher coverage rates of EV-A71 vaccination. Across provinces, CV-A16 incidence in the post-EV-A71-vaccination period remained either comparable to or only slightly increased from levels prior to vaccination. The duration and strength of cross-protection following infection with EV-A71 or CV-A16 was estimated to be 9.95 wk (95% confidence interval [CI]: 3.31, 23.40) in 68% of the population (95% CI: 37%, 96%). Our predictions are limited by the necessarily short and under-sampled time series and the possible circulation of unidentified serotypes, but, nonetheless, sensitivity analyses indicate that our results are robust in predicting that the vaccine should drastically reduce incidence of EV-A71 without a substantial competitive release of CV-A16. Conclusions The ability of our models to capture the observed epidemic cycles suggests that herd immunity is driving the epidemic dynamics caused by the multiple serotypes of enterovirus. Our results predict that the EV-A71 and CV-A16 serotypes provide a temporary immunizing effect against each other. Achieving high coverage rates of EV-A71 vaccination would be necessary to eliminate the ongoing transmission of EV-A71, but serotype replacement by CV-A16 following EV-A71 vaccination is likely to be transient and minor compared to the corresponding reduction in the burden of EV-A71-associated HFMD. Therefore, a mass EV-A71 vaccination program of infants and young children should provide significant benefits in terms of a reduction in overall HFMD burden., Introduction Hand, foot, and mouth disease (HFMD) is a common childhood illness caused by serotypes of the Enterovirus A species in the genus Enterovirus of the Picornaviridae family [1,2]. HFMD [...]