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Background: In June 2019, a patient presented with persistent fever and multiple organ dysfunction after a tick bite at a wetland park in Inner Mongolia. Next-generation sequencing in this patient revealed an infection with a previously unknown orthonairovirus, which we designated Wetland virus (WELV)., Methods: We conducted active hospital-based surveillance to determine the prevalence of WELV infection among febrile patients with a history of tick bites. Epidemiologic investigation was performed. The virus was isolated, and its infectivity and pathogenicity were investigated in animal models., Results: WELV is a member of the orthonairovirus genus in the Nairoviridae family and is most closely related to the tickborne Hazara orthonairovirus genogroup. Acute WELV infection was identified in 17 patients from Inner Mongolia, Heilongjiang, Jilin, and Liaoning, China, by means of reverse-transcriptase-polymerase-chain-reaction assay. These patients presented with nonspecific symptoms, including fever, dizziness, headache, malaise, myalgia, arthritis, and back pain and less frequently with petechiae and localized lymphadenopathy. One patient had neurologic symptoms. Common laboratory findings were leukopenia, thrombocytopenia, and elevated d-dimer and lactate dehydrogenase levels. Serologic assessment of convalescent-stage samples obtained from 8 patients showed WELV-specific antibody titers that were 4 times as high as those in acute-phase samples. WELV RNA was detected in five tick species and in sheep, horses, pigs, and Transbaikal zokors ( Myospalax psilurus ) sampled in northeastern China. The virus that was isolated from the index patient and ticks showed cytopathic effects in human umbilical-vein endothelial cells. Intraperitoneal injection of the virus resulted in lethal infections in BALB/c, C57BL/6, and Kunming mice. The Haemaphysalis concinna tick is a possible vector that can transovarially transmit WELV., Conclusions: A newly discovered orthonairovirus was identified and shown to be associated with human febrile illnesses in northeastern China. (Funded by the National Natural Science Foundation of China and the Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences.)., (Copyright © 2024 Massachusetts Medical Society.)

Soil nematodes are a crucial component of belowground ecosystems. Soil nematode ecology, the studies of community distribution, structural composition, ecological functions, and interaction mechanisms with environment, has always been a hot spot in soil biology research. We systematically elaborated soil nematodes' high diversity and various diet, their advantages as bioindicator and model organisms, and their roles in biological control, ecological functions and soil health. Then, we reviewed the research progress of soil nematode ecology in China, including molecular biology identification methods, responses to global changes, food web structure and function, aboveground and belowground diversity relationship, and large-scale diversity pattern. We put forward the development trend of soil nematology, focusing on the high-throughput sequencing technology in nematode identification and quantification, the necessity of establishing a universal analysis platform to promote soil nematode research, and the importance of strengthening large-scale soil nematode survey.

In this study, we explored the thickness influence of undecomposed litter layer and semi-decomposed litter layer on the natural regeneration in an artificial pure forest of Larix principis-rupprechtii in the forest area of Guandi Mountain. We divided the litter into an undecomposed layer and a semi-decomposed layer, which was further divided into eight groups based on the thickness. The results showed that when the thickness of undecomposed layer was 0.32-0.83 cm, and that of semi-decomposed layer was 0.18-0.89 cm, the regeneration index was larger (≥0.15), and the regeneration was better. When the thickness of undecomposed layer was more than 1.1 cm and that of semi-decomposed layer was more than 0.5 cm, the regeneration index was smaller (≤0.07), and the rege-neration of understory was worse. Results of redundancy analysis showed that the undecomposed layer thickness of litter had a high and stable explanatory ability for natural regeneration, with a contribution rate of 38.7%, while the semi-decomposed layer thickness had no significant effect on natural regeneration. Structural equation modeling revealed that the thickness of undecomposed layer of litter increased the mechanical resistance to seed germination which had a negative direct effect on natural regeneration (-0.617), and a positive indirect effect on natural rege-neration by influencing the content of alkali-hydrolyzed nitrogen and available phosphorus (+0.178). The combined effects (-0.439) showed an inhibitory effect on the natural regeneration. In conclusion, the thickness of undecomposed layer of litter under L. principis-rupprechtii was most closely related to natural regeneration, and the thickness of semi-decomposed layer had a minimal effect on natural regeneration.

In this study, we analyzed the vertical distribution characteristics of root biomass density, root length density, root surface area density in monoculture and mixture of Pinus tabuliformis and Robinia pseudoacacia plantations in Caijiachuan small watershed of Jixian County, Shanxi. We examined their relationships with soil physical and chemical properties in different stand types. The results showed that the total root biomass density of P. tabuliformis and R. pseudoacacia in mixture was more than 75% higher than that in monoculture. Root system of P. tabuli-formis mainly distributed in shallow layer (0-40 cm), while that of R. pseudoacacia was deeper (40-80 cm). Fine roots were predominant in different diameter classes. Length density and surface area density of fine roots were in the order of R. pseudoacacia in mixture > P. tabuliformis in mixture > R. pseudoacacia stand > P. tabuliformis stand. Root biomass density of fine roots was in the order of P. tabuliformis in mixture ＞ R. pseudoacacia in mixture ＞ P. tabuliformis stand ＞ R. pseudoacacia stand. In vertical profile, the total root and fine root biomass, root length and root surface area density of P. tabuliformis stand, R. pseudoacacia stand, P. tabuliformis in mixture and R. pseudoacacia in mixture showed a rule of decreasing with the increases of soil depth. Under different stand types, fine root length density, root biomass density and total root length density were positively correlated with soil total nitrogen, soil organic carbon, and soil water contents. Total root surface area density was significantly positively correlated with soil organic carbon, soil water content, and soil total nitrogen. The distribution of roots in pure and mixed stands of P. tabuliformis and R. pseudoacacia showed different patterns. Compared with the pure stand, the mixed stand had higher root biomass, soil nutrient contents, and soil water content.

We analyzed the impacts of thinning intensity on the natural regeneration of Larix principis-rupprechtii in Shanxi Pangquangou Nature Reserve, with an experiment of five thinning intensities (5%, 25%, 45%, 65% and 85%). We constructed a structural equation model of thinning intensity-understory habitat-natural regeneration by using correlation analysis. The results showed that the regeneration index of moderate thinning (45%) and intensive thinning (85%) stand land was significantly higher than that of other thinning intensities. The constructed structural equation model had good adaptability. The effects of thinning intensity on each factor were as follows: soil alkali-hydrolyzable (-0.564) > regeneration index (0.548) > soil bulk density (-0.462) > average height of seed tree (-0.348) > herb coverage (-0.343) > soil organic matter (0.173) > undecomposed litter layer thickness (-0.146) > total soil nitrogen (0.110). Thinning intensity had a positive impact on the regeneration index, which was mainly through adjusting height of the seed tree, accelerating litter decomposition, improving soil physical and chemical properties, and thus indirectly promoting the natural regeneration of L. principis-rupprechtii . Tending thinning could effectively improve the survival environment of regeneration seedlings. From the perspective of natural regeneration of L. principis-rupprechtii , moderate thinning (45%) and intensive thinning (85%) were more reasonable in the follow-up forest management.

Background: Salvianolate, a common drug for stabilizing heart disease and Angina Pectoris, is considered to be off-label for preventing venous thromboembolism (VTE) or anticoagulation at present. However, many clinical studies have showed that salvianolate can effectively inhibit the deep-vein thrombosis (DVT) incidence, and prevent VTE of perioperative patients in the real world in China., Objective: This analysis aimed to evaluate the effectiveness and safety of salvianolate in preventing VTE in perioperative patients., Methods: Databases of PubMed, Cochrane Library, Embase, CNKI, Wanfang and VIP were searched until July 2019. Literature retrieval, data extraction and quality assessment were independently completed by two researchers and checked with each other. Review Manager 5.2 software was applied for meta-analysis., Results: A total of 429 studies were retrieved, including 11 randomized controlled trials (RCTs) with a total of 1149 subjects. Compared with low molecular weight heparin (LMWH) group alone, salvianolate combined LMWH group had lower DVT incidence in preventing perioperative thrombosis (2.75% and 14.23%, OR: 0.21, 95% CI:[0.08,0.53]; P = .0009). The incidence of adverse reactions of experimental group was similar to that of control group (1.79% and 2.31%, OR: 0.65, 95% CI:[0.18,2.35]. P = .51). Compared with the control group, D-dimer level (D-D), platelet count (PLT), fibrinogen (FIB), whole blood high shear viscosity (WBHSV), and whole blood low shear viscosity (WBLSV) were all significantly decreased (P < .01), and prothrombin time (PT) was significantly increased (P < .05)., Conclusion: Salvianolate combined LMWH has better effectiveness and the same safety in preventing venous thromboembolism in perioperative patients. However, due to the small number of included literatures, large sample studies are still needed to further verify this conclusion., Competing Interests: Conflict of interest statement: The author(s) declare no conflict of interest., (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)

Objective: To analyze the epidemiological characteristics of the cases firstly reported as "asymptomatic infection of COVID-19" in Guangdong province. Methods: The follow-up observation method was used to continuously track and observe the cases firstly reported as "asymptomatic patients with COVID-19" in Guangdong province from January 14 to March 31, 2020. The epidemiological data of the cases were collected to analyze their epidemiological characteristics, outcome and influencing factors. Results: From January 14 to March 31, 2020, a total of 325 cases were firstly reported as "asymptomatic infections of COVID-19" in Guangdong province. The epidemic curve of asymptomatic infection cases was similar to that of confirmed cases, and it had two peaks. The first peak was from January 27 to February 5, and the second peak was from March 17 to March 26. Of the 325 cases, 184 (56.6%) were subsequently converted to confirmed cases. These cases were defined as incubation period asymptomatic infection cases. The age median of the cases was 40 years, and 93.5% (172/184) of the cases showed symptoms within 3 days after the first positive nucleic acid tests were conducted, and 141 (43.4%) of the 325 cases remained asymptomatic status until they were cured and discharged. They were inapparent infection cases, accounting for 8.6% (141/1 642) of those diagnosed with COVID-19 in Guangdong province during the same period. The age median of inapparent infection cases was 27 years. The median of the interval between the first positive nucleic acid test and discharge was 14 days. Up to 90.8% (138/141) of the inapparent infection cases were discharged for centralized medical observation within 28 days. The longest interval between the first positive nucleic acid test and the last positive nucleic acid test was 73 days. The positive rate of nucleic acid test was 0.3% in close contacts of inapparent infection cases and 2.2% in close contacts of incubation period asymptomatic infection cases. There were significant differences in age distribution and source of infection between incubation period asymptomatic infection cases and inapparent infection cases ( P <0.05). Old age was the risk factor for the conversion of firstly reported asymptomatic infection cases to confirmed cases. Compared with the 0-19-year-old group, The patients aged 40-59 years and 60 years and above were more likely to become confirmed cases. The OR (95 %CI ) values were 2.730 (1.380-5.402) and 5.302 (2.199-12.783), and P values were 0.004 and 0.000, respectively. People being infected in China were more likely to become confirmed cases ( OR =7.121, P =0.000). Conclusions: There were asymptomatic infection cases among patients diagnosed with COVID-19. The infectiousness of incubation period asymptomatic infection cases might be stronger than that of inapparent infection cases. The proportion of younger cases among asymptomatic infection cases was higher than that of the confirmed cases. Old age and domestic infection were the risk factors for the conversion of asymptomatic infection cases to confirmed cases, to which more attention should be paid. Further serological investigations are needed to provide a basis for the development of COVID-19 prevention and control strategies.

Objective: To understand the current practice of preoperative bowel preparation in elective colorectal surgery in China. Methods: A cross-sectional questionnaire survey was conducted through wechat. The content of the questionnaire survey included professional title of the participants, the hospital class, dietary preparation and protocol, oral laxatives and specific types, oral antibiotics, gastric intubation, and mechanical enema before elective colorectal surgery. A stratified analysis based on hospital class was conducted to understand their current practice of preoperative bowel preparation in elective colorectal surgery. Result: A total of 600 questionnaires were issued, and 516 (86.00%) questionnaires of participants from different hospitals, engaged in colorectal surgery or general surgeons were recovered, of which 366 were from tertiary hospitals (70.93%) and 150 from secondary hospitals (29.07%). For diet preparation, the proportions of right hemicolic, left hemicolic and rectal surgery were 81.59% (421/516), 84.88% (438/516) and 84.88% (438/516) respectively. The average time of preoperative dietary preparation was 2.03 days. The study showed that 85.85% (443/516) of surgeons chose oral laxatives for bowel preparation in all colorectal surgery, while only 4.26% (22/516) of surgeons did not choose oral laxatives. For mechanical enema, the proportions of right hemicolic, left hemicolic and rectal surgery were 19.19% (99/516), 30.04% (155/516) and 32.75% (169/516) respectively. Preoperative oral antibiotics was used by 34.69% (179/516) of the respondents. 94.38% (487/516) of participants were satisfied with bowel preparation, and 55.43% (286/516) of participants believed that preoperative bowel preparation was well tolerated. In terms of preoperative oral laxatives, there was no statistically significant difference between different levels of hospitals [secondary hospitals vs. tertiary hospitals: 90.00% (135/150) vs. 84.15% (308/366), χ(2)=2.995, P =0.084]. Compared with the tertiary hospitals, the surgeons in the secondary hospitals accounted for higher proportions in diet preparation [87.33% (131/150) vs. 76.78% (281/366), χ(2)=7.369, P =0.007], gastric intubation [54.00% (81/150) vs. 36.33% (133/366), χ(2)=13.672, P <0.001], preoperative oral antibiotics [58.67% (88/150) vs. 24.86% (91/366), χ(2)=12.259, P <0.001] and enema [28.67% (43/150) vs. 15.30% (56/366), χ(2)=53.661, P <0.001]. Conclusion: Although the preoperative bowel preparation practice in elective colorectal surgery for most of surgeons in China is basically the same as the current international protocol, the proportions of mechanical enema and gastric intubation before surgery are still relatively high.

The emergence and dissemination of carbapenem-resistant Escherichia coli (E. coli) strains is a main risk for global public health, but little is known of carbapenemase producing E. coli in Henan, China. The study was undertaken to investigate the prevalence and mechanism of carbapenem-resistant E. coli strains in a hospital in Xinxiang, Henan, China, 2014. A total of 5 carbapenemase-producing E. coli strains were screened from 1014 isolates. We found that they were all resistant to meropenem and imipenem. Amikacin showed the best sensitivity, with gentamicin coming up next. The positive rate of bla NDM was 80% (4/5). The sequencing results showed that two isolates belonged to bla NDM-1 whereas other 2 isolates carried the bla NDM-5. Other carbapenemase genes including bla IMP , bla VIM , bla KPC and bla OXA-48 were not detected. The bla CTX-M-15, bla TEM-1, sul2, aad, and aac(6")-Ib-cr were also detected. MLST analysis showed that NDM-producing E. coli were sporadic. Conjugation test indicated bla NDM was the principal resistance mechanism of carbapenem-resistant E. coli in the hospital, Henan, China.NDM was the principal resistance mechanism of carbapenem-resistant E. coli in the hospital, Henan, China., (Copyright © 2017. Published by Elsevier Ltd.)

Objectives: Frequent outbreaks of dengue are considered to be associated with an increased risk for endemicity of the disease. The occurrence of a large number of indigenous dengue cases in consecutive years indicates the possibility of a changing dengue epidemic pattern in Guangdong, China., Methods: To have a clear understanding of the current dengue epidemic, a retrospective study of epidemiological profile, serological response, and virological features of dengue infections from 2005-2011 was conducted. Case data were collected from the National Notifiable Infectious Diseases Reporting Network. Serum samples were collected and prepared for serological verification and etiological confirmation. Incidence, temporal and spatial distribution, and the clinical manifestation of dengue infections were analyzed. Pearson's Chi-Square test was used to compare incidences between different age groups. A seroprevalence survey was implemented in local healthy inhabitants to obtain the overall positive rate for the specific immunoglobulin (Ig) G antibody against dengue virus (DENV)., Results: The overall annual incidence rate was 1.87/100000. A significant difference was found in age-specific incidence (Pearson's Chi-Square value 498.008, P<0.001). Children under 5 years of age had the lowest incidence of 0.28/100000. The vast majority of cases presented with a mild manifestation typical to dengue fever. The overall seroprevalence of dengue IgG antibody in local populations was 2.43% (range 0.28%-5.42%). DENV-1 was the predominant serotype in circulation through the years, while all 4 serotypes were identified in indigenous patients from different outbreak localities since 2009., Conclusions: A gradual change in the epidemic pattern of dengue infection has been observed in recent years in Guangdong. With the endemic nature of dengue infections, the transition from a monotypic to a multitypic circulation of dengue virus in the last several years will have an important bearing on the prevention and control of dengue in the province and in the neighboring districts.

Objective: To investigate the natural infection of Angiostrongylus cantonensis in Guangdong Province, and to provide the scientific evidence for control measures., Methods: The investigation was carried out in 56 villages of 28 towns of 28 counties/districts in East Guangdong, West Guangdong, the mountain area of North Guangdong and Peal River Delta of the Province from 2005 to 2010. The rodents were captured with live trap and the species identified. Angiostrongylus cantonensis adult worms were collected from the hearts and lungs of rodents, examined, counted and the sex of worms identified., Results: The rodents were captured from 2005 to 2010, belonged to 2 orders, 2 families (subfamily), 4 genera and 10 species. Seven species of the rodents were found infected with Angiostrongylus cantonensis in all 28 counties/districts. Totally 5 820 rats were examined and 496 infected ones were identified, with a mean infection rate of 8.52%. The infection rate of rodents was highest in the Peal River Delta, reaching 9.8% (205/2084) (chi2=15.25, P<0.01). Rattus norvegicus had the highest infection rate of 16.9% (310/1 835) (chi2=240.91, P<0.01). The mean intensity of infection was 6.1 worms/rat. 1 125 female and 1064 male worms were found respectively (chi2=1.75, P>0.05)., Conclusion: Natural infection of Angiostrongylus cantonensis in rodents has been found in all the 56 villages selected from the 4 regions of Guangdong Province.

Toxicity of commercial cypermethrin on the growth of three marine microalgal species, Skeletonema costatum (Bacillariophyceae), Scrippsiella trochoidea (Dinophyceae) and Chattonella marina (Raphidophyceae) was separately investigated by 96 h and 24 d growth tests. The growth was stimulated at low concentrations and inhibited under high concentrations; however, overcompensation was observed at the late period of exposure under high concentrations in 24 d growth tests. The highest stimulation rates were obtained at concentration of 5 microg/L. The 24 h SC10 values were 0.91, 4.17 and 20.4 microg/L for S. costatum, S. trochoidea and C. marina, respectively. The 96 h IC50 values were 75.3, 227 and 114 microg/L for the three species, respectively. Results suggest that cypermethrin level used for sea lice controlling exert a stimulative effect on phytoplankton growth, and might result in the succession of phytoplankton community structure due to different sensitivity of species., (Copyright (c) 2010 Elsevier Inc. All rights reserved.)

Objective: To analyze the epidemiological characteristics of imported cases of dengue fever in Guangdong province (GD) and in Hong Kong (HK) during 2004-2006 to provide evidence for further cooperation in the prevention and control programs on dengue fever in the two places., Methods: Descriptive statistical analysis was performed on data obtained from dengue fever surveillance and reporting network in GD and from Centre for Health Protection, Department of Health, HK., Results: Both from GD and HK 44 and 93 imported cases of Dengue fever were reported during 2004-2006. Most patients from GD acquired their infection from Singapore (13 cases), Indonesia (9 cases) or Cambodia (6 cases) while patients in HK mainly were imported from Indonesia (31 cases), the Philippines (16 cases) and Thailand (15 cases). The peak seasons of the two places were both from July to September. During the non-peak season period, the number of cases in Hong Kong was higher than that in Guangdong. Male/ female ratio was 1.2:1 in GD and 1.1:1 in HK. Age of patients in GD appeared to range from 6-80 years, with 63.6% (28/44) of them aged 20-39 years. 40.9% (18/44) of the cases were engaged in business, services, housework or unemployed. Those cases in HK were between 10-72 years of age, with 63.6% (28/ 44) of them aged 20-39 years while 47.3% (44/93) of the patients were with the occupation of business, services and industry. More cases in GD had a onset of disease before entering the border (27:17) than the cases in HK (35:57). The average time interval between onset and diagnosis were 7 and 9 days for GD and HK respectively., Conclusion: Frequent travel between Southeast Asia in summer among the working class appeared to be the main factor, causing imported cases of dengue fever in GD and HK. It is crucial to provide health education targeted at these high risk groups in order to prevent importation of dengue fever in the two areas.

The genomic sequences of severe acute respiratory syndrome coronaviruses from human and palm civet of the 2003/2004 outbreak in the city of Guangzhou, China, were nearly identical. Phylogenetic analysis suggested an independent viral invasion from animal to human in this new episode. Combining all existing data but excluding singletons, we identified 202 single-nucleotide variations. Among them, 17 are polymorphic in palm civets only. The ratio of nonsynonymous/synonymous nucleotide substitution in palm civets collected 1 yr apart from different geographic locations is very high, suggesting a rapid evolving process of viral proteins in civet as well, much like their adaptation in the human host in the early 2002-2003 epidemic. Major genetic variations in some critical genes, particularly the Spike gene, seemed essential for the transition from animal-to-human transmission to human-to-human transmission, which eventually caused the first severe acute respiratory syndrome outbreak of 2002/2003.

An epidemic of severe acute respiratory syndrome (SARS) began in Foshan municipality, Guangdong Province, China, in November 2002. We studied SARS case reports through April 30, 2003, including data from case investigations and a case series analysis of index cases. A total of 1,454 clinically confirmed cases (and 55 deaths) occurred; the epidemic peak was in the first week of February 2003. Healthcare workers accounted for 24% of cases. Clinical signs and symptoms differed between children (<18 years) and older persons (> or =65 years). Several observations support the hypothesis of a wild animal origin for SARS. Cases apparently occurred independently in at least five different municipalities; early case-patients were more likely than later patients to report living near a produce market (odds ratio undefined; lower 95% confidence interval 2.39) but not near a farm; and 9 (39%) of 23 early patients, including 6 who lived or worked in Foshan, were food handlers with probable animal contact.

Objective: To analysis the risk factors influencing nosocomial infection of severe acute respiratory syndrome (SARS) in health-care workers and to evaluate effectiveness of its control and preventive measures in 13 key hospitals caring for SARS patients., Methods: Number of SARS patients, clinical conditions of them, its attack rate in health-care workers, and characteristics of hospitals, including their environment, isolating measures, etc. were investigated at the 13 hospital in Guangzhou to analyze the risk factors influencing nosocomial infection of SARS and its attack rates in health-care workers before and after implementation of preventive measures and to evaluate their effectiveness., Results: Totally, 841 patients with SARS were treated at the 13 hospitals in Guangzhou and 285 health-care workers caring for them infected nosocomially. Attack rate in health-care workers was higher at general hospitals, hospital accepting more cases in critical conditions and hospitals with poor precautious measures, and lower in hospitals with isolated wards or areas, or department of infection, specially caring for SARS patients, and those with effective intervention measures to prevent secondary infection., Conclusion: Nosocomial infection of SARS in health-care workers was affected by clinical condition of SARS patients, characteristics and environment of hospitals and their personal protective measures adopted.

Objective: To explore epidemiological features and risk factors of severe acute respiratory syndrome (SARS) in Guangdong Province of China, so as to work out effective strategies for its better control., Methods: A total of 1 511 clinically confirmed SARS cases in Guangdong Province of China from November 16, 2002 to Jun 15, 2003 were retrospectively analyzed., Results: The first SARS case was identified in Foshan municipality on November 16, 2002, followed by 1 511 clinically confirmed cases (including 58 deaths) up to May 15, 2003. Of all cases, health care workers and community family cluster cases accounted for 19.38% and 12.04%. 65.86% SARS patients aged 20 - 49 years, and increased incidence was positively related to their ages. 95.97% cases lived in the following five cities around Pearl Delta Area: Foshan, Guangzhou, Shenzhen, Zhongshan, and Jiangmen. Eleven early reported cases in the communities took animal-related positions. Face-to-face contacts with infected droplets were the main transmission route. An epidemic peak occurred during January 28 to February 26, and those cases accounted for 50.69% of total. Incidence, mortality, and case fatality of SARS were 1.77/100,000, 0.07/100,000, and 3.84% respectively. The mean incubation period was 4.5 days., Conclusion: The most effective way to control SARS is to break the chain of transmission from infected to healthy persons-early identification, prompt and effective isolation, and vigorous close contact tracing. Hospital infections among health care workers is critical. Several observations support the hypothesis of an animal origin for the disease.

Objectives: To understand the epidemiological characteristics of severe acute respiratory syndrome (SARS) outbreaks in some areas of Guangdong province and to provide scientific basis for prevention and control measures against it., Methods: Standardized questionnaire was used on individual cases. Data on the epidemiological characteristics as time, place, persons and aggregation status of SARS cases, development of the epidemics, were analyzed with software EPI 6.0., Results: The incidence of SARS in Guangdong province was 1.72/100,000 with case fatality rate as 3.64%. Most cases of SARS occurred between the last ten days of January and the first ten days of February with the peak (61.88% of the patients) occurred in the first ten days of February. As to the distribution of place, Pearl river delta region-economically developed with great number of mobile population-was heavily affected areas (account for 96.66% of the total patients). The majority of patients were young adults and medical staff seemed to be the most affected subgroup (account for 24.9% of the patients in total). Family and hospital aggregation of patients comprised the another two important characteristics of SARS (account for 37.1% of the total patients)., Conclusion: Current knowledge on SARS suggested that it was an air-borne infectious disease with human beings served as the source of infection. The incubation period of the disease was from 1 to 12 days with a median of 4 days. Respiratory secretions and close contact contributed to person-to-person transmission. Most cases were distributed in Pearl river delta region, an area famous for its economic development and heavy flow of mobile population.

Objective: To analyze the epidemiological features of the index cases of severe acute respiratory syndrome (SARS) occurred in different cities in Guangdong province and to trace for the source of infection., Methods: Standardized individual case inventory was adopted to conduct investigation on index cases and on persons who had close contact with index cases in Guangdong province. Data on the epidemiological characteristics, secondary cases and the links among index cases were analyzed., Results: Between November 16, 2002 and April 16, 2003, there had been 13 index cases of SARS including 3 cadres, 3 farmers, 2 retirees, 2 workers and 1 shop attendant, reported from 13 cities in Guangdong province. Between November 2002 and January 2003, there had been 7 cities reported to have identified index cases of SARS with 6 of them being infected in their own cities and 1 imported from Guangzhou city. All of the cases had no close contacts to similar patients but 6 of them later caused 2nd or even 3rd generation cases of SARS. Most cases hit young people (7/13) with a sex ratio of 1:0.6. The fatality rate of index cases was high (4/13)., Conclusion: No evidence showed that there was direct transmission among the index cases. Data regarding the geographical origin of those index cases led to the assumption that the infection had started in six cities of Pearl river delta region and the Hong Kong Special Administrative Region.