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Background: A variety of viruses can cause acute respiratory infections (ARIs), resulting in a high disease burden worldwide. To explore the dominant viruses and their prevalence characteristics in children with ARIs, comprehensive surveillance was carried out in the Pudong New Area of Shanghai. Methods: Between January 2013 and December 2022, the basic and clinical information, and respiratory tract specimens of 0–14 years old children with ARIs were collected in five sentinel hospitals in Shanghai Pudong. Each specimen was tested for eight respiratory viruses, and the positive rates of different age groups, case types (inpatient or outpatient) were analyzed. Results: In our study, 30.67% (1294/4219) children with ARIs were positive for at least one virus. Influenza virus (IFV) was the most commonly detected respiratory virus (349/4219, 8.27%), followed by respiratory syncytial virus (RSV) (217/4219, 5.14%), para‐influenza virus (PIV) (215/4219, 5.10%), and human coronavirus (HCoV, including 229E, OC43, NL63, and HKU1) (184/4219, 4.36%). IFV was the leading respiratory virus in outpatients aged 5–14 years (201/1673, 12.01%); RSV was the most prevalent respiratory virus in both inpatients (61/238, 25.63%) and outpatients (4/50, 8.00%) for ARI patients aged <6 months old. For PIV, HMPV, HCoV, and HRV, the risk of infection usually was higher among young children. Co‐infection with more than two viruses was seen in 3.25% (137/4219). Conclusions: IFV and RSV played important roles in ARIs among children, but the risk populations were different. There are needs for targeted diagnosis and treatment and necessary immunization and non‐pharmaceutical interventions. [ABSTRACT FROM AUTHOR]

Reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants due to immune escape is challenging for the global response to the pandemic. We estimated the Omicron reinfection prevalence among people who had a previous SARS-CoV-2 infection in Shanghai, China. We conducted a telephone survey in December 2022 with those who had previously been infected with Omicron between March and May 2022. Information on their demographics, coronavirus disease 2019 (COVID-19) testing, and vaccination history was collected. The overall and subgroup reinfection rates were estimated and compared. Among the 1981 respondents who were infected between March and May 2022, 260 had positive nucleic acid or rapid antigen tests in December 2022, with an estimated reinfection rate of 13.1% (95% confidence interval [95% CI]: 11.6–14.6). The reinfection rate for those who had a booster vaccination was 11.4% (95% CI: 9.2–13.7), which was significantly lower than that for those with an incomplete vaccination series (15.2%, 95% CI: 12.3–18.1) (adjusted odds ratio [aOR]: 0.579; 95% CI: 0.412–0.813). Reinfection with the Omicron variant was lower among individuals with a previous SARS-CoV-2 infection and those who had a booster vaccination, suggesting that hybrid immunity may offer protection against reinfection with Omicron sublineages. [ABSTRACT FROM AUTHOR]

The aim of this study was to thoroughly document the effects of multiple intervention and control methods to mitigate the ongoing coronavirus disease 2019 (COVID‐19) outbreak in Pudong New Area, Shanghai. After identification of the first confirmed case of COVID‐19 in Pudong on January 21, 2020, the local Center for Disease Control and Prevention (CDC) launched a case investigation involving isolation, close‐contact (CC) tracing and quarantine of persons with a potential exposure risk to prevent and control transmission. Epidemiological features of cases detected by three different strategies were compared to assess the impact of these active surveillance measures. As of February 16, 2020, a total of 108 confirmed COVID‐19 cases had been identified in Pudong, Shanghai. Forty‐five (41.67%) cases were identified through active surveillance measures, with 22 (20.37%) identified by CC tracing and 23 (21.30%) by quarantine of potential exposure populations (PEPs). The average interval from illness onset to the first medical visit was 1 day. Cases identified by CC tracing and PEPs were quarantined for 0.5 and 1 day before illness onset, respectively. The time intervals from illness onset to the first medical visit and isolation among actively screened cases were 2 days (p =.02) and 3 days (p =.00) shorter, respectively, than those among self‐admission cases. Our study highlights the importance of active surveillance for potential COVID‐19 cases, as demonstrated by shortened time intervals from illness onset to both the first medical visit and isolation. These measures contributed to the effective control of the COVID‐19 outbreak in Pudong, Shanghai. Research Highlights: ‐Nearly half of the confirmed COVID‐19 cases in Pudong New Area, Shanghai were detected through those active surveillance measures in early stage of the pandemic. ‐Cases identified from CCs and PEPs were quarantined for 0.5 and 1 day before illness onset, respectively. ‐The time intervals from illness onset to the first medical visit and isolation among actively screened cases were 2 and 3 days shorter respectively than those among self‐admission cases. ‐Early tracing and quarantine of specific populations with a higher exposure risk may have a positive effect on pandemic control in the community. [ABSTRACT FROM AUTHOR]

Limited evidence is available for the associations between fine particulate matter (PM 2.5) constituents and daily cardiovascular disease (CVD) mortality in China. In present study, a time-series analysis was conducted to evaluate the associations of PM 2.5 constituents (two carbonaceous fractions, eight water-soluble inorganic ions and fifteen elements) with daily CVD mortality in Pudong New Area of Shanghai, China, from 2014 to 2016. Results showed that the effect estimates for the associations of PM 2.5 and its constituents with CVD mortality were generally strongest when using the exposures of the previous two day concentrations. The associations of organic carbon, sulfate, ammonia, potassium, copper, arsenic, and lead with daily CVD mortality were robust to the adjustment of PM 2.5 total mass, their collinearity with PM 2.5 total mass, and criteria gaseous air pollutants. An interquartile range increase in the previous two day concentrations of PM 2.5 , organic carbon, sulfate, ammonia, potassium, copper, arsenic, and lead were associated with significant increments of 2.21% (95% confidence interval [95%CI]: 0.54%, 3.88%), 2.83% (95% CIs: 1.16%, 4.50%), 1.90% (95% CIs: 0.35%, 3.45%), 2.29% (95% CIs: 0.80%, 3.77%), 0.94% (95% CIs: 0.13%, 1.75%), 1.53% (95% CIs: 0.37%, 2.69%), 2.08% (95% CIs: 0.49%, 3.68%) and 1.98% (95% CIs: 0.49%, 3.47%) in daily CVD mortality, respectively, in single-pollutant models. In conclusion, this study suggested that organic carbon, sulfate, ammonia, potassium, copper, arsenic, and lead might be mainly responsible for the associations between short-term PM 2.5 exposures and increased CVD mortality in Shanghai, China. Image 1 • Limited evidence is available on PM 2.5 constituents and daily CVD mortality in China. • Significant associations were found between PM 2.5 and CVD mortality in Shanghai. • OC, SO 4 2−, NH 4 +, K, Cu, As and Pb might be mainly responsible for the associations. [ABSTRACT FROM AUTHOR]

Introduction: In developing and underdeveloped countries, undernutrition plays a major role in subverting the immune system, leading to an increase in TB infections; this study investigated the associations between dietary patterns and latent tuberculosis infection risk among young adults in Shanghai. Methodology: In a case-control study, 96 cases of latent tuberculosis infection and 192 healthy controls were studied among contacts of students in clusters of tuberculosis epidemics in colleges from January 2021 to March 2023. A standardized questionnaire assessing sociodemographic, lifestyle, and dietary characteristics was applied. Food intake was estimated using a 95-item semiquantitative Food Frequency Questionnaire. Using the principal component analysis to extract dietary patterns from food groups intake. Logistic regression models were applied. Results: Four dietary patterns were identified: "traditional balanced" pattern, "unsaturated fatty acid" pattern, "snack" pattern, and "protein and fruit" pattern. Four components explaining 64.52% of the total variation in consumption were derived. In a conditional logistic regression analysis, three models were created. After adjusting for various confounders, compared to "snack" pattern, the risk of latent TB infection was 91% lower in the "traditional balanced" pattern (OR 0.05, 95% CI 0.01, 0.38, p = 0.004). Conclusions: To prevent TB infection among young adults living in high TB burden areas, a balanced dietary pattern rather than a "snack" pattern should be promoted in school settings. Future research should explore the risk of developing active tuberculosis in Mtb-infected people with different dietary patterns and the prevention of this risk by healthy dietary patterns. [ABSTRACT FROM AUTHOR]

Few studies have investigated respiratory effects of particulate matter air pollution using a full range of particle size distribution. To explore the short-term associations between size-fractionated particle number concentration (PNC) and chronic obstructive pulmonary disease (COPD) mortality. We conducted a time-series study to explore the associations between size-fractionated PNC and daily COPD mortality in the Pudong New Area of Shanghai, China, from 2014 to 2016. We evaluated particle size distribution from 0.01 μm to 10 μm, which was segregated into 7 ranges to better explore the size-dependent associations. We used over-dispersed generalized additive models to estimate the associations after controlling for time trends, temperature, humidity, day of the week and holidays. A total of 5430 deaths due to COPD were identified during the study period. For size ranges from 2.5 – 10 μm, 1–2.5 μm to 0.3–1 μm, there were stronger associations between PNC and COPD mortality, but the associations were statistically insignificant. However, for the smaller size ranges from 0.3 to 0.01 μm, the associations became statistically significant and the magnitude of association remained stable. An interquartile range increase in PNC at lag 0–1 day for size ranges 0.01–0.03 μm, 0.03–0.05 μm, 0.05–0.1 μm and 0.1–0.3 μm was associated with increments of 4.44% (95% CI: 1.16%, 7.73%), 4.31% (95% CI: 1.16%, 7.47%), 4.22% (95% CI: 1.05%, 7.40%), and 4.28% (95% CI: 0.48%, 8.09%) in COPD mortality, respectively. This study suggested that particles below 0.3 μm in diameter might be mainly responsible for the adverse effect of particulate air pollution on CDPD mortality in Shanghai, China. • A study linking a full range of particle size distribution and COPD mortality. • The associations generally increased with smaller particle size. • Particles below 0.3 μm in diameter may be mainly responsible for the associations. • Particles above 0.3 μm in diameter showed no significant associations. [ABSTRACT FROM AUTHOR]

• The seasonality of influenza activity in Shanghai, China after the 2009 A/H1N1 pandemic is complex. • Annual winter epidemics were found and lasted into spring in some years. • Co-circulation of A/H3N2, A/H1N1, and two lineages of influenza B contributed to the annual winter epidemics. • Semiannual epidemics in the summer, which were found in four of the six surveillance years, were only attributable to A/H3N2. • The current one-season vaccination program in Shanghai, China should be carefully reconsidered. Understanding the complexity of influenza subtype seasonality is critical to promoting a suitable vaccination program. The aim of this study was to identify and compare the seasonality and epidemiological features of seasonal influenza subtypes after the 2009 A/H1N1 pandemic and to lay a foundation for further investigation into the social and environmental factors affecting seasonal influenza virus transmission. Influenza-like illness (ILI) case surveillance was conducted in two sentinel hospitals in Pudong New Area, Shanghai between 2012 and 2018. Weekly data on ILI cases were analyzed. A time-series seasonal decomposition analysis was used to reveal the seasonality of influenza and epidemiological features among different subtypes. In total, 10 977 ILI patients were enrolled of whom 2385 (21.7%) had laboratory-confirmed influenza. Compared to influenza A (16.3%), influenza B (5.4%) was less frequently detected among the ILI patients (p < 0.001). Semiannual epidemic peaks were identified in four of the years during the 6-year study period, while only one annual epidemic peak was found in the other two years. An epidemic peak occurred in each winter season, and a secondary peak also occasionally occurred in summer or spring. A/H3N2 predominated in both summer and winter, while A/H1N1, B/Yamagata, and B/Victoria circulated almost exclusively in winter or spring. Two lineages of influenza B seemed to predominate in alternating years. This study highlights the complexity of seasonal influenza virus activity in a subtropical region of China, presenting both semiannual and annual epidemic peaks in different years. The results of this study may provide further insight into possible improvements in the timing of influenza vaccination in Shanghai, China. [ABSTRACT FROM AUTHOR]