Objectives The aim of this evidence implementation project was to integrate the best available evidence on non-pharmacological fever and febrile symptom management into nursing practice at the Shanghai Public Health Clinical Centre, China. Introduction Fever is challenging for patients with the human immunodeficiency virus (HIV). Guidelines assert that successful non-pharmacological fever management should be the standard of care. To introduce evidence into clinical practice, the Department of Infectious Disease of the Shanghai Public Health Clinical Centre implemented a best practice project. Methods This evidence implementation project utilized the Joanna Briggs Institute Practical Application of Clinical Evidence System (JBI PACES) and Getting Research into Practice (GRiP) audit and feedback tool. Seven audit criteria were established on the best available evidence. The project was divided into three phases and conducted over five months. Results Follow-up audits showed significant improvements. The most significant improvements in compliance occurred in the assessment of suitability of external cooling methods (100%), education for nurses (100%) and patients (100%), and monitoring (93%). A moderate increase was noted in the assessment of fluid intake and output volume (73%). A small increase of 30% in compliance was found in hydration support. No changes in compliance were found in assessment of the cause of fever in the HIV-positive population. Conclusions This project led to various changes in the unit including a formal assessment of intake and output volume for PLWHs with chronic fever, a formal assessment of some factors related to the "cause of fever", tailored education programs and materials for both nurses and patients. All these changes are now part of routine nursing practice. Further audits will need to be carried out to sustain practice behavior change and monitor areas for further improvements.

Non-pharmacological fever management for persons living with HIV: a best practice implementation project.

The coronavirus disease (COVID- 19) epidemic has been spreading across the country The prevention and control of epidemic ore at a critical stage It is essential to prevent and control the epidemic in a way accosting hi the law However over disinfection have been found in many places recently such tut tent disinfection motorcade spraying disinfection and so on which have attracted great attention of the public Disinfection is an important means to cut off the transmission channels and control the epidemic of infectious diseases The government should pay more efforts in health science popularization promote the public to master the disinfection knowledge select the correct and effective disinfection products and adopt the correct disinfection methods for different objects To implement the scientific prevention and control precise implementation of the strategy and maximize the protection of public health

Beware of over Disinfection in Fighting Against the Coronavirus Disease

Bacillus (B.) anthracis is the pathogen that causes fatal anthrax. Guizhou Province is an old foci of anthrax in the southwest of China. Human anthrax has also been frequently reported in Guizhou in recent year. However, there is limited information on the genetic background of local B. anthracis isolates in Guizhou Province. Strain-specific detection of this bacterium using molecular approaches has enhanced our knowledge of microbial genetics. In the present study, we employed Multiple Locus Variable Number Tandem Repeats (VNTR) Analysis (MLVA) assay to analyze the genetic characteristics of B. anthracis strains isolated in Guizhou Province and their relationships to worldwide distributed isolates. A total of 32 isolates of B. anthracis from soil, human, cattle, dog and water of different anthrax epidemics in Guizhou Province from 2006 to 2011 were confirmed with phage lysis test, penicillin inhibition test and PCR. MLVA-8 discriminated them into 28 unique MLVA types (MT G1 - G28), which were novel MTs compared with the previous reports. Cluster tree based on 32 isolates from Guizhou Province and 76 worldwide distributed isolates (30 MTs) showed they were divided into three clusters, designated A, B and C. All the 32 isolates were distributed in cluster A, which were further grouped into A1, A2, A3 and A4 sub-clusters. 32 isolates from Guizhou Province were closely grouped in each of the sub-clusters, respectively. Minimum Spanning Tree (MST) based on the MLVA data showed that the 28 MLVA profiles of isolates from Guizhou Province and 30 MLVA profiles of worldwide distributed isolates formed three clonal complexes (CCs) and ten singletons. 28 novel MTs of B. anthracis from Guizhou were revealed and their relationships to worldwide isolates were showed. The results will provide important information for prevention of anthrax and also enhances our understanding of genetic characteristics of B. anthracis in China.

/pdf/genetic-characterization-of-bacillus-anthracis-in-guizhou-1dolfne0tp.pdf

Genetic characterization of Bacillus anthracis in Guizhou Province, Southwest of China.

Background Analyses of the global spatial and temporal distribution of enteric fever outbreaks worldwide are important factors to consider in estimating the disease burden of enteric fever disease burden. Methods We conducted a global literature review of enteric fever outbreak data by systematically using multiple databases from 1 January 1990 to 31 December 2018 and classified them by time, place, diagnostic methods, and drug susceptibility, to illustrate outbreak characteristics including spatial and temporal patterns. Results There were 180 940 cases in 303 identified outbreaks caused by infection with Salmonella enterica serovar Typhi (S. Typhi) and Salmonella enterica serovar Paratyphi A or B (S. Paratyphi). The size of outbreak ranged from 1 to 42 564. Fifty-one percent of outbreaks occurred in Asia, 15% in Africa, 14% in Oceania, and the rest in other regions. Forty-six percent of outbreaks specified confirmation by blood culture, and 82 outbreaks reported drug susceptibility, of which 54% had multidrug-resistant pathogens. Paratyphoid outbreaks were less common compared to typhoid (22 vs 281) and more prevalent in Asia than Africa. Risk factors were multifactorial, with contaminated water being the main factor. Conclusions Enteric fever outbreak burden remains high in endemic low- and middle-income countries and, despite its limitations, outbreak data provide valuable contemporary evidence in prioritizing resources, public health policies, and actions. This review highlights geographical locations where urgent attention is needed for enteric fever control and calls for global action to prevent and contain outbreaks.

/pdf/spatial-and-temporal-patterns-of-typhoid-and-paratyphoid-2e0epywyzx.pdf

Spatial and Temporal Patterns of Typhoid and Paratyphoid Fever Outbreaks: A Worldwide Review, 1990-2018.

We identified the routes of infection and evaluate the effect of disinfection on the field of an outbreak of an-thrax in a village of Wengan County ,Guizhou ,China ,thus trying to provide with basis for the implementation of policies for pre-vention and control of anthrax .The authors gathered the cases information by searching and interviewing the targeted persons house by house ,and reviewed the medical records in hospitals .The samples including patient’s discharging fluid ,residues of died horse ,and soil from the places where the villagers dismembered horse were gathered and cultured for Bacillus anthracis . The technique of multiple-locus variable-number tandem repeat analysis (MLVA-8) was applied for revealing the genetic rela-tionships among those isolated Bacillus anthracis strains .Five cases of cutaneous anthrax occurred in the outbreak and the total attack rate was 7 .58% (5/66) among those contactors evolved in the activity of carrying ,dismembering ,washing ,chopping and eating the died horse .The attack rate was 100% (3/3) for those who carried ,dismembered ,washed ,chopped and ate that horse ,100% (1/1) for those who carried ,dismembered and ate ,and 7 .14% (1/14) for those who washed ,chopped and ate . The 25% (1/4) of the samples of discharging fluid from the cases with cutaneous anthrax were positive .After disinfection , 15 .38% (4/26) of the soil samples retained positive .The genetic similarity was 100% among the 5 isolate strains .The results suggested that the outbreak of anthrax in villagers occurred through the activities of carrying ,dismembering ,washing and chop-ping the died horse .Strengthening the risk communication and disinfection of the dismemberment places should be the crucial strategies to prevent and control anthrax epidemics in Guizhou in the future .

Epidemiologic analysis on five cases involved in an outbreak of anthrax in a village of Wengan County,Guizhou, China

Objective This study was to evaluate the effects of prevention and control regarding programs on typhoid fever and paratyphoid fever,in Guizhou province,from 2007 to 2012, to provide evidence for the improvement of related programs. Methods Data on typhoid fever and paratyphoid including information on epidemics,individual,cases,measures for prevention and control programs taken and relative government documents were collected and analyzed in Guizhou province,from 2007 to 2012. Information related to the average annual incidence,nature of outbreaks, time span before confirmed diagnosis was made,unit which carried the case report,proportion of laboratory confirmed diagnosed cases and case-management were compared between 2007-2009 and 2010-2012 descriptively while chi-square test with Excelland EpiInfo software were used for data analysis. Results In the period of 2007-2009,a total of 5 978 typhoid fever and paratyphoid fever cases were reported in Guizhou province with the average yearly incidence as 5.29/100 000. In the period of 2010-2012,2 765 cases were reported with the average yearly incidence as 2.57/100 000. When compared to the former,data from the latter period showed that the average yearly incidence had declined 51.31% in all the prefectures. There were still some outbreaks appeared but the total number of cases involved reduced 87.50%. The time span before the confirmation of diagnosis became shorter but the difference was not statistically significant （χ 2=0.08,P=0.99）. Number of cases reported by hospitals at county or above had 11.51% of increase while those cases reported at the township hospitals or below decreased for 61.47%. The proportion of laboratory diagnosed cases increased 23.63%. Rates of timeliness on cards being filled in,inputted and audited showed increase of 8.44%,6.76%and 2.40%respectively. Conclusion Successful measures for prevention and control on typhoid fever and paratyphoid fever had been remarkably taken in Guizhou province,but the potential risk of outbreaks still existed in some areas,suggesting that health education and surveillance programs including laboratory diagnosis,should be strengthened.

Key words: 
Typhoid fever/paratyphoid fever; Evaluation; Effect

[Evaluation on the effects of prevention and control programs regarding typhoid fever and paratyphoid fever in Guizhou province, from 2007 to 2012].

2010年11月4日贯州省望谟县某村发生人间皮肤炭疽流行.为查找流行原因,分析感染途径及来源并检查防控措施落实情况及评价疫源地消毒效果,于11月5-7日开展本次调查.1.对象与方法:拟定炭疽病例个案调查表,根据病例定义走访病家,并到乡镇卫生院、县医院和中医院访谈病例和查看病案资料,按炭疽病例个案调查表收集资料.走访发生病死牛住户,收集登记密切接触者相关信息.病例定义为2010年9月22日至11月7日该村村民中所有出现皮肤炭疽临床表现[按炭疽诊断标准(WS 283-2008)]的患者.密切接触者定义为2010年9月22日至11月7日凡参与该村病死牛搬运、剖剐、洗切加工及食用病死牛的人员.采集病死畜残余物和病死畜剖剐地消毒前后的土壤标本(耙开表层土约5～10 cm,每点采集1～3份,采集约500 g)培养分离炭疽杆菌. 关键词：炭疽;现场调查;消毒效果;评价

Response and evaluation of the disinfection effects on an anthrax outbreak in human being and cattle in Guizhou

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[Evaluation on the effects of prevention and control programs regarding typhoid fever and paratyphoid fever in Guizhou province, from 2007 to 2012].

Response and evaluation of the disinfection effects on an anthrax outbreak in human being and cattle in Guizhou