Chinese Social Media Reaction to Information about 42 Notifiable Infectious Diseases

This study aimed to identify what information triggered social media users' responses regarding infectious diseases. Chinese microblogs in 2012 regarding 42 infectious diseases were obtained through a keyword search in the Weiboscope database. Qualitative content analysis was performed for the posts pertinent to each keyword of the day of the year with the highest daily count. Similar posts were grouped and coded. We identified five categories of information that increased microblog traffic pertaining to infectious diseases: news of an outbreak or a case; health education / information; alternative health information / Traditional Chinese Medicine; commercial advertisement / entertainment; and social issues. News unrelated to the specified infectious diseases also led to elevated microblog traffic. Our study showcases the diverse contexts from which increased social media traffic occur. Our results will facilitate better health communication as causes underlying increased social media traffic are revealed.published_or_final_versio

Hand, Foot and Mouth Disease in Vietnam: Epidemiology, Heart Rate Variability and Economic Burden

Over the last two decades, hand, foot and mouth disease (HFMD) has become a major clinical problem in Vietnam and the Asia-Pacific region. HFMD affects children, especially those under 5 years old, and has pandemic potential. Since 1997, there have been several outbreaks with severe clinical phenotypes, including brain stem encephalitis, attacking millions of children and causing thousands of deaths. Synthesizing data on epidemiology, etiology, disease pathophysiology and economic burden of this emerging infection remains essential to inform clinical management and health policy makers in prioritizing the development of intervention strategies. Using data from >56,000 hospitalized cases over an 11 year period, I described the spatial and temporal distribution of HFMD in Ho Chi Minh City, the main hotspot of HFMD in Vietnam. I found that the disease started in the west and then moved to the south-east and finally came back the west of the city. Results from a prospective multi-hospital based study conducted during 2015–2018 showed that of ~1200 enrolled patients, enterovirus A71 (EV-A71) was the most common HFMD pathogen detected, while coxsackievirus A6 (CV-A6) has emerged and replaced CV-A16 to become the second most common virus causing HFMD in Vietnam during the study period. Despite the emergence of other pathogens and the diversity of enterovirus serotypes (~20 serotypes) detected in HFMD patients, EV-A71 was the main cause of severe HFMD. Using long-term data synthesized as part of the research program, I also demonstrated for the first time that compared to EV-A71 subgenogroup B5, subgenogroup C4 was associated with more severe clinical phenotypes. Moreover, the predominance of subgenogroup C4 coincided with large, severe HFMD outbreaks in Vietnam (e.g. in 2011-12 and 2018). Collectively, the data suggest that an EV-A71 vaccine would be likely to substantially reduce the burden of HFMD, but a multivalent vaccine should be developed to control the ongoing HFMD epidemic because CV-A6, CV-A10 and CV-A16 were responsible for approximately 12% of severe HFMD cases and cross-reaction between these CV-As and EV-A71 is poor. In order to improve our knowledge of HFMD pathophysiology, I used ECG signal recorded by a wearable device (e-Patch) to depict the distribution of heart rate variability (HRV) indices by severity and by detected pathogens and found that compared to mild disease HRV parameters reflecting parasympathetic nervous system activation in the severe group decreased whereas those mirroring sympathetic activity and autonomic nervous system imbalance increased. In a similar trend, compared to HFMD associated with non-EV-A71, HRV indices reflecting the imbalance between sympathetic and parasympathetic activation in HFMD associated with EV-A71 were significantly higher. This suggests that children with EV-A71 infection were more likely to have ANS imbalance. Alongside with these findings, the feasibility of this wearable device in children has brought promising applications in HFMD case management by early detection of severe disease in future. To inform health policy makers in Vietnam about the burden of HFMD, I also estimated its economic burden. I showed that the total cost per case for mild and severe disease was $245.8 and$1326.7, respectively. Additionally, I also found that compared to CV-A infections, EV-A71 infection resulted in higher illness costs. At nationwide level, the total economic burden in Vietnam was estimated at >US$90 million for two-year period of 2016 – 2017

Data Science in Healthcare

Data science is an interdisciplinary field that applies numerous techniques, such as machine learning, neural networks, and deep learning, to create value based on extracting knowledge and insights from available data. Advances in data science have a significant impact on healthcare. While advances in the sharing of medical information result in better and earlier diagnoses as well as more patient-tailored treatments, information management is also affected by trends such as increased patient centricity (with shared decision making), self-care (e.g., using wearables), and integrated care delivery. The delivery of health services is being revolutionized through the sharing and integration of health data across organizational boundaries. Via data science, researchers can deliver new approaches to merge, analyze, and process complex data and gain more actionable insights, understanding, and knowledge at the individual and population levels. This Special Issue focuses on how data science is used in healthcare (e.g., through predictive modeling) and on related topics, such as data sharing and data management

Assessment of transmissibility and measures effectiveness of SARS in 8 regions, China, 2002-2003

BackgroundSevere acute respiratory syndrome (SARS) is a form of atypical pneumonia which took hundreds of lives when it swept the world two decades ago. The pathogen of SARS was identified as SARS-coronavirus (SARS-CoV) and it was mainly transmitted in China during the SARS epidemic in 2002-2003. SARS-CoV and SARS-CoV-2 have emerged from the SARS metapopulation of viruses. However, they gave rise to two different disease dynamics, a limited epidemic, and an uncontrolled pandemic, respectively. The characteristics of its spread in China are particularly noteworthy. In this paper, the unique characteristics of time, space, population distribution and transmissibility of SARS for the epidemic were discussed in detail.MethodsWe adopted sliding average method to process the number of reported cases per day. An SEIAR transmission dynamics model, which was the first to take asymptomatic group into consideration and applied indicators of R0, Reff, Rt to evaluate the transmissibility of SARS, and further illustrated the control effectiveness of interventions for SARS in 8 Chinese cities.ResultsThe R0 for SARS in descending order was: Tianjin city (R0 = 8.249), Inner Mongolia Autonomous Region, Shanxi Province, Hebei Province, Beijing City, Guangdong Province, Taiwan Province, and Hong Kong. R0 of the SARS epidemic was generally higher in Mainland China than in Hong Kong and Taiwan Province (Mainland China: R0 = 6.058 ± 1.703, Hong Kong: R0 = 2.159, Taiwan: R0 = 3.223). All cities included in this study controlled the epidemic successfully (Reff<1) with differences in duration. Rt in all regions showed a downward trend, but there were significant fluctuations in Guangdong Province, Hong Kong and Taiwan Province compared to other areas.ConclusionThe SARS epidemic in China showed a trend of spreading from south to north, i.e., Guangdong Province and Beijing City being the central regions, respectively, and from there to the surrounding areas. In contrast, the SARS epidemic in the central region did not stir a large-scale transmission. There were also significant differences in transmissibility among eight regions, with R0 significantly higher in the northern region than that in the southern region. Different regions were able to control the outbreak successfully in differences time

Sars

SARS (Acute Respiratory Syndrome) first presented itself to the global medical community as a case of atypical pneumonia in one small Chinese village in November 2002. Three months later the mysterious illness rapidly spread and appeared in Vietnam, Hong Kong, Toronto and then Singapore. The high fatality rate and sheer speed at which this disease spread prompted the World Health Organization to initiate a medieval practice of quarantine in the absence of any scientific knowledge of the disease. Now three years on from the initital outbreak, SARS poses no major threat and has vanished from the global media. Written by a team of contributors from a wide variety of disciplines, this book investigates the rise and subsequent decline of SARS in Hong Kong, mainland China and Taiwan. Multidisciplinary in its approach, SARS explores the epidemic from the perspectives of cultural geography, media studies and popular culture, and raises a number of important issues such as the political fate of the new democracy, spatial governance and spatial security, public health policy making, public culture formation, the role the media play in social crisis, and above all the special relations between the three countries in the context of globalization and crisis. It provides new and profound insights into what is still a highly topical issue in today’s world

Impact of Repeated Influenza Immunization on Respiratory Illness in Children With Preexisting Medical Conditions

PURPOSE Annual influenza immunization in medical risk groups is recommended in many countries. Recent evidence suggests that repeated inactivated influenza vaccine (IIV) immunization throughout childhood may impair long-term immunity against influenza. We assessed whether prior immunization altered the effect of IIV in children with preexisting medical conditions on primary care–diagnosed respiratory illness (RI) episodes during the influenza season. METHODS Electronic records of IIV-immunized children who met the criteria for annual IIV immunization according to Dutch guidelines were extracted from a primary care database from 2004 to 2015. For each year, we collected information on IIV immunization status, primary care–attended RI episodes (including influenza-like illness, acute RI, and asthma exacerbation), and potential confounders. Generalized estimating equations were used to model the association between prior IIV and occurrence of at least one RI episode during the influenza season, with “current year immunized but without IIV history” as reference group. RESULTS A total of 4,183 children (follow-up duration: 11,493 child-years) were IIV immunized at least once. Adjusted estimates showed lower odds for RI in current year–immunized children with prior IIV compared with those without (odds ratio [OR] = 0.61; 95% CI, 0.47-0.78 for “current year immunized and one IIV in previous 2 years”; OR = 0.85; 95% CI, 0.68-1.07 for “current year immunized and ≥2 IIVs in previous 3 years, including prior year”). CONCLUSION Repeated IIV immunization in children with preexisting medical conditions has no negative impact on, and may even increase, long-term protection against RI episodes diagnosed during the influenza season in primary care

Sars

SARS (Acute Respiratory Syndrome) first presented itself to the global medical community as a case of atypical pneumonia in one small Chinese village in November 2002. Three months later the mysterious illness rapidly spread and appeared in Vietnam, Hong Kong, Toronto and then Singapore. The high fatality rate and sheer speed at which this disease spread prompted the World Health Organization to initiate a medieval practice of quarantine in the absence of any scientific knowledge of the disease. Now three years on from the initital outbreak, SARS poses no major threat and has vanished from the global media. Written by a team of contributors from a wide variety of disciplines, this book investigates the rise and subsequent decline of SARS in Hong Kong, mainland China and Taiwan. Multidisciplinary in its approach, SARS explores the epidemic from the perspectives of cultural geography, media studies and popular culture, and raises a number of important issues such as the political fate of the new democracy, spatial governance and spatial security, public health policy making, public culture formation, the role the media play in social crisis, and above all the special relations between the three countries in the context of globalization and crisis. It provides new and profound insights into what is still a highly topical issue in today’s world