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Objectives Beginning in June 2017, numerous dengue virus (DENV) infections occurred in the Jining City of Shandong Province, formerly a dengue-free region in East China. We sought to describe the clinical and epidemiological features of this outbreak. Methods We reviewed the clinical records and epidemiological data regarding a case series of patients diagnosed with DENV in Jining City, from June 30 to September 14, 2017. Diagnosis was confirmed by molecular method, culture, or rapid diagnostic tests. Sequencing of the DENV envelope gene or the whole viral genome was performed for 11 patients. Additionally, neutralizing antibodies against DENV was measured among patients and residents from their same villages. Results Data from 150 patients were evaluated in this outbreak. None were diagnosed with dengue hemorrhagic fever or dengue shock syndrome. The patients’ ages ranged between 2–88 years (median 51 years, [IQR=37.5–64.3]), and 100 (66.7%) were female. Epidemiological analyses implicated a man who had visited Saudi Arabia as the likely source of the outbreak. Phylogenetic studies identified DENV serotype 1. Most of the patients demonstrated increases of neutralizing antibody titers one year after infection compared with titers three months after infection. The residents living in dengue-affected villages had a significant higher seroprevalence of 21.2% (95%CI 16.9-25.5) than residents (3.2%, 95%CI-0.36-6.7) living in a non-dengue-affected village. Conclusions This report documents the first dengue outbreak in Shandong Province, China, in more than 60 years. It underscores the need for medical providers to record patients’ travel histories and to consider dengue in their differential diagnoses.

Background: Haemaphysalis longicornis, a vector of various diseases with medical and veterinary importance, is native to eastern Asia, and recently invaded the United States as an emerging disease threat. Methods: We collected multi-source data from field survey, reference book, literature search and related websites. Geographic distribution of H. longicornis and its infected agents was mapped by geographical information system techniques. Hosts of H. longicornis and infection rates of H. longicornis-borne agents were estimated by meta-analysis. Ecological niche model was used to predict potential distribution of H. longicornis around the world. Findings: H. longicornis was broadly distributed in ten countries, predominantly in eastern Asia, the United States, and countries in the southwest Pacific Ocean. The tick was known to feed on a variety of domestic and wild animals. Nearly 60 agents, including spotted fever group rickettsiae, Anaplasmataceae family, Borrelia burgdorferi sensu lato, Babesia, Theileria, Francisella, Bartonella, Coxiella, Hepatozoon, Toxoplasma, and viruses were detected in H. longicornis, over half of which were pathogenic to humans. H. longicornis-borne agents were mainly reported in eastern Asia. The predictive modeling revealed that H. longicornis might infest more extensive regions, unexpectedly in Europe, South America, and Africa. Interpretation: H. longicornis is widely distributed in the world, and infected with various pathogens. Authorities and health care workers should be aware of the threat of the tick species to public health and veterinary medicine. Expanding surveillance and further investigations should be enhanced. Funding Statement: This study was supported by the Natural Science Foundation of China (81621005) and National Key Research and Development Program of China (2019YFC1200505). Declaration of Interests: The authors declare no competing interests. Ethics Approval Statement: Not required.

Background: The ongoing outbreak of COVID-19 is challenging the Chinese public health response system We aim to understand the epidemic dynamics and underlying

The ongoing pandemic of 2019 novel coronavirus disease (COVID-19) is challenging global public health response system. We aim to identify the risk factors for the transmission of COVID-19 using data on mainland China. We estimated attack rate (AR) at county level. Logistic regression was used to explore the role of transportation in the nationwide spread. Generalized additive model and stratified linear mixed-effects model were developed to identify the effects of multiple meteorological factors on local transmission. The ARs in affected counties ranged from 0.6 to 9750.4 per million persons, with a median of 8.8. The counties being intersected by railways, freeways, national highways or having airports had significantly higher risk for COVID-19 with adjusted odds ratios (ORs) of 1.40 (p = 0.001), 2.07 (p

Background: Severe fever with thrombocytopenia syndrome (SFTS) is a newly emerging infectious disease, which has a substantial burden in eastern Asia and an increasingly global concern. Differences in infectious diseases between male and female individuals are an important public health problem. Methods: We used the database containing all reported SFTS cases in mainland China, and conducted systematic evaluation of gender differences in incidence and fatality in relation to age, temporal and spatial distribution, residence location and some clinical factors. Findings: A total of 15234 SFTS cases were reported during 2010-2018. Female individuals had significantly higher average annual incidence rate (AAIR) with a RR of 1·21 (95% CI 1·17-1·25; p˂0·0001), but significantly lower case fatality rate (CFR) with an OR of 0·74 (95% CI 0·63-0.85; p