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The studies of prions and prion disease usually need many special platforms and techniques that differ from those for classical microbes. Search of new biomarkers and establishment of new methods for the diagnosis of human prion diseases are priorities in the field of prion study.

This report briefly described the establishment and implementation of national surveillance for human prion disease (PrD) in China. Reported cases came from Chinese surveillance network for PrD. Immunohistochemistry, Western blot, enzyme-linked immunosorbent assay (ELISA), Polymerase Chain Reaction (PCR), and real-time quaking-induced conversion (RT-QuIC) tests were used for the samples of brain, cerebrospinal fluid (CSF), and blood. Diagnosis standard for the PrDs is based on the National Commission of Health (WS/T 562-2017). The study summarized major epidemiological, clinical and laboratory features of more than 2,100 diagnosed different types of Chinese PrD cases. Sporadic Creutzfeldt-Jacob disease (sCJD) is the predominant type of PrD (88.7%). 19 different genotypes of genetic PrDs (gPrDs) were identified, accounting for about 11.3% of all PrDs, revealing ethno-relationships. No iatrogenic CJD (iCJD) and variant CJD (vCJD) was identified. The characteristics of different types of sCJD in China showed similar features as those reported globally, but gPrDs showed an obvious ethno-relationship.

Unlike infectious diseases caused by conventional microbes, there are no detectable specific humoral or cellular immunoresponses to prion infection. However, extensive and active gliosis is observable in affected brain regions along with significant deposits of scrapie-like prion protein (PrP

An outbreak of coronavirus disease 2019 (COVID-19) of Omicron BA.2 emerged in Jilin City since March 3, 2022, which involved in 27,036 cases by April 12. The vaccination program with inactivated COVID-19 vaccines has been implemented since the beginning of 2021.The incidences of moderate, severe, and critical cases in the whole population of the group of 0+1 dose were 1.82-, 9.49-, and 3.85-fold higher than those in the group of 2 doses, and 5.03-, 44.47-, and ∞-fold higher than those received 3 doses vaccination. For the population ≥60 years, the incidences of moderate, severe, and critical cases in the group of 0+1 dose were 29.92, 9.62, and 4.27 per 100,000, showing 4.13-, 43.72-, and 4.85-fold higher than 2 doses, as well as 13.28-, 22.37-, and ∞-fold higher than 3 doses.The incidences of each type of COVID-19 in the population who were fully vaccinated or booster vaccinated in Jilin City were significantly lower than those who were unvaccinated and/or partially vaccinated. Booster vaccination with homologous inactivated vaccines induces stronger protectiveness for COVID-19 caused by variant of concern (VOC) Omicron.

What is already known about this topic? Healthcare workers are at high risk of acquiring COVID-19 from occupational exposure to COVID-19 virus during their daily medical service work. Excellent infection prevention and control measures and adequate personal protective equipment (PPE) are essential to reduce the risk of hospital-acquired COVID-19. What is added by this report? On March 17, 2021, a female healthcare professional who already received both doses of the COVID-19 vaccination and was working in the isolation area of a designated COVID-19 hospital was diagnosed with COVID-19 in Xi’an city. Her exposure likely occurred five days before illness onset when she obtained nasopharyngeal and oropharyngeal swabs from the two imported cases that were identified as belonging to the B.1.1.7 lineage, the variant first detected in the United Kingdom. What are the implications for public health practices? Since the healthcare worker had been fully vaccinated and had mild symptomatology, it is considered a mild breakthrough infection. All vaccines are associated with breakthrough infections. In addition to rigorous adherence to infection prevention and control measures, use of adequate PPE, and using good clinical practices, the potential role of chronic upper respiratory infection in acquiring COVID-19 during medical procedures deserves further consideration.

What is already known on this topic? Cases of histoplasmosis have been reported in every continent except Antarctica but are fairly rare in China. High prevalence of histoplasmosis has been observed in Central America, Caribbean, and South America. Infections of Histoplasma are acquired through a respiratory route, particularly inhalation of aerosols from disturbed soils enriched with excreta from birds and bats. These infections are most common in persons involved with removing soil, visiting caves, cleaning old houses, or felling trees, etc. What is added by this report? This is the first report of cluster infections of Histoplasmaamong overseas Chinese workers. A strong dose-dependent association of illness onset and disease severity with the exposure intensity to the soils and wastes possibly contaminated by the Histoplasmahas been proposed. Long labor times, repeated entering of contaminated tunnels, working in high-dust environments are likely to result in earlier illness onsets, more severe clinical courses, and even fatal outcomes. More importantly, none of the patients used reliable personal protection equipment (PPE), such as common masks while working, that would prevent the inhalation of more Histoplasmaspores. What are the implications for public health practice? The epidemiological findings of this outbreak investigation highlight a probable risk of infection with Histoplasma when entering without PPE into the environment with bats living around, such as caves or mines. Effective education and communication might be needed among residents and travelers. This outbreak expands our knowledge of the control and prevention of fungal disease in China.