BackgroundThe epidemic of rabies showed a rising trend in China in recent years. To identify the potential factors involved in the emergence, we investigated and analyzed the status and characteristics of human rabies between 1996 and 2008. Moreover, the status of rabies infection and vaccination in dogs, and prophylaxis of humans after rabies exposure were analyzed.MethodsHuman rabies data in China between 1996 and 2008 collected from the annual reports of Chinese Center for Disease Control and Prevention (China CDC) were analyzed. To investigate the status of dogs and postexposure prophylaxis (PEP) of humans, brain specimens of domestic dogs were collected and detected, and the demographic details, exposure status and PEP of rabies patients were obtained in 2005 and 2006 in Guangxi, Hunan and Guizhou provinces.ResultsThe results showed 19,806 human rabies cases were reported in China from 1996 to 2008, with an average of 1,524 cases each year, and the incidence almost was rising rapidly, with the peak in 2007 (3,300 cases). It was notable that nearly 50% of the total rabies cases nationwide were reported in Guangxi, Hunan and Guizhou provinces. In these three provinces, the rabies infection rate in dogs was 2.3%, and 60% investigated cities had a dog vaccination rate of below 70%; among the 315 recorded human cases, 66.3% did not receive any PEP at all, 27.6% received inadequate PEP, and only 6.0% received a full regime of PEP.ConclusionsIn recent years, rabies is reemerging and becoming a major public-health problem in China. Our analysis showed that unsuccessful control of dog rabies and inadequate PEP of patients were the main factors leading to the high incidence of human rabies in China, then there are following suggestions: (1) Strict control of free-ranging dogs and mandatory rabies vaccination should be enforced. (2)Establishing national animal rabies surveillance network is imperative. (3) PEP should be decided to initiate or withhold according to postmortem diagnosis of the biting animal. (4) The cost of PEP should be decreased or free, especially in rural areas. (5)Education of the public and health care staff should be enhanced.

The Chinese rufous horseshoe bat (Rhinolophus sinicus) has been suggested to carry the direct ancestor of severe acute respiratory syndrome (SARS) coronavirus (SCoV), and the diversity of SARS-like CoVs (SLCoV) within this Rhinolophus species is therefore worth investigating. Here, we demonstrate the remarkable diversity of SLCoVs in R. sinicus and identify a strain with the same pattern of phylogenetic incongruence (i.e. an indication of recombination) as reported previously in another SLCoV strain. Moreover, this strain possesses a distinctive 579 nt deletion in the nsp3 region that was also found in a human SCoV from the late-phase epidemic. Phylogenetic analysis of the Orf1 region suggested that the human SCoVs are phylogenetically closer to SLCoVs in R. sinicus than to SLCoVs in other Rhinolophus species. These findings reveal a closer evolutionary linkage between SCoV in humans and SLCoVs in R. sinicus, defining the scope of surveillance to search for the direct ancestor of human SCoVs.

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The China National Health Survey (CNHS) is the first nationwide multi-ethnic cross-sectional interview and health examination conducted from 2012 to 2017. The survey is designed to study reference intervals for physiological constants as well as determinants of noncommunicable diseases among different ethnic populations in different areas, so that the data can be used to enhance clinical diagnosis strategies and health promotion. CNHS used a stratified, multistage cluster sampling method to obtain a sample of 53 895 people aged 20-80 years in 10 ethnic groups from 11 provinces or autonomous regions all over China. Blood samples were collected from each participant for the establishment of the China Multi-Ethnic Biobank (CMEB). CNHS collected data on demographic and socioeconomic information, lifestyle factors, anthropometric measures, laboratory tests and clinical profiles. These data provide a comprehensive resource for further study on risk factors of noncommunicable disease among different ethnic groups. Information about the CNHS database, including publication list, introduction of the survey design and methods, and guidelines for submitting electronic forms of data application, is available at [http://www.bmicc.cn/web/share/home].

By using multilocus sequence analysis, five Borrelia valaisiana-related strains isolated from rodents and ticks in southwestern China were eventually classified as a new genospecies of B. burgdorferi sensu lato rather than B. valaisiana. The finding explained the differences in transmission cycle and phenotype between B. valaisiana strains from Europe and B. valaisiana-related strains from eastern Asia.Strains of Borrelia burgdorferi sensu lato, the causative agent of Lyme borreliosis, have been divided into at least 13 genospecies (7,8,10,15). The bacterium is maintained mainly in natural foci through the transmission cycles of Ixodes ticks and a wide variety of vertebrate hosts (15). Different B. burgdorferi sensu lato genospecies are distributed unevenly throughout the world and are associated with distinct ecologic features (15).To date, five established genospecies and a group of B. valaisiana-related strains have been isolated in mainland China (7,14,16). B. garinii and B. afzelii are major genospecies in natural foci of northern China and are maintained mainly in a tick-rodent cycle (16). Some B. valaisiana-related strains and B. sinica strains were recently isolated in some regions of the Yangtze River valley (7,14). B. valaisiana-related strains were once tentatively classified as B. afzelii based on the phylogenetic analysis of the rrs gene (2) and then considered to be B. valaisiana based on the phylogenetic analysis of the rrf-rrl intergenic spacer, the rrs gene, and the flagellin gene (4). Recently, Masuzawa et al. suggested that these isolates should be classified as a new genospecies based on a similar phylogenetic analysis (5). In order to clarify the exact taxonomy of B. valaisiana-related strains and explain the differences in transmission cycle and phenotype between B. valaisiana-related strains and B. valaisiana strains, we examined five B. valaisiana-related strains isolated from Guizhou Province in southwestern China by multilocus sequence analysis (MLSA), which was confirmed to surpass the discrimination power of whole-genome DNA-DNA hybridization (the "gold standard" in taxonomy) for B. burgdorferi sensu lato genospecies definition (8, 10). Moreover, new species B. spielmanii and B. californiensis were also confirmed and validated by MLSA (8, 10).Borrelia strains and culture conditions. The five strains used in this study were isolated either from ticks or from the urinary bladders of rodents in Guizhou Province in southwestern China in May 2006, as described previously (1). Strain QTMP2 was from Ixodes granulatus fed from Niviventer fulvescens, strains QSYSP3 and QSYSP4 were from Haemaphysalis longicornis fed from Apodemus agrarius, strain QSDS4 was from A. agrarius, and strain QLZSP1 was from I. granulatus fed from A. agrarius. These strains belong to the B. valaisiana-related group rather than the B. sinica and other B. burgdorferi sensu lato genospecies according to the results of restriction fragment length polymorphism analysis and the analysis of rrf-rrl intergenic spacer sequences...