Exposures to poultry in markets were associated with A(H7N9) virus infection, even without poultry contact. China should consider permanently closing live poultry markets or aggressively pursuing control measures to prevent spread of this emerging pathogen.

BackgroundHand, foot, and mouth disease (HFMD) has become an emerging infectious disease in China in the last decade. There has been evidence that meteorological factors can influence the HFMD incidence, and understanding the mechanisms can help prevent and control HFMD.MethodsHFMD incidence data and meteorological data in Minhang District, Shanghai were obtained for the period between 2009 and 2015. Distributed lag non-linear models (DLNMs) were utilized to investigate the impact of meteorological factors on HFMD incidence after adjusting for potential confounders of long time trend, weekdays and holidays.ResultsThere was a non-linear relationship between temperature and HFMD incidence, the RR of 5th percentile compared to the median is 0.836 (95% CI: 0.671–1.042) and the RR of 95th percentile is 2.225 (95% CI: 1.774–2.792), and the effect of temperature varied across age groups. HFMD incidence increased with increasing average relative humidity (%) (RR = 1.009, 95% CI: 1.005–1.015) and wind speed (m/s) (RR = 1.197, 95% CI: 1.118–1.282), and with decreasing daily rainfall (mm) (RR = 0.992, 95% CI: 0.987–0.997) and sunshine hours (h) (RR = 0.966, 95% CI: 0.951–0.980).ConclusionsThere were significant relationships between meteorological factors and childhood HFMD incidence in Minhang District, Shanghai. This information can help local health agencies develop strategies for the control and prevention of HFMD under specific climatic conditions.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0388-5) contains supplementary material, which is available to authorized users.

In the near future, the inactivated enterovirus 71 (EV71) vaccine is expected to become available on the market in China. Since EV71 is a major cause of hand, foot and mouth disease (HFMD), the vaccine is expected to significantly reduce the number of cases, as well as the detrimental economic effect of the disease. However, for a national vaccination strategy to be developed, policy-makers need more information on the socioeconomic burden of EV71 HFMD infection. Based on the 2011 population data, we estimated the clinical and economic effect of EV71 HFMD infection in children aged 0-9 years in Shanghai, China. The annual cost related to HFMD is >US$7.66 million for a population of 1·42 million children aged 0-9 years with an average cost of US$208.2/case. The extrapolated cost for EV71 HFMD infection was US$3.53 million, comprising 46·1% of the overall cost associated with HFMD. Around 97% of all of the HFMD-related expenses were paid for by the families creating a considerable economic burden. Our findings could provide the necessary recommendations on the most effective national EV71 vaccine implementation, as well as a baseline data for assessing the cost-effectiveness of the vaccine in China.

BackgroundMen who have sex with men (MSM) are at high risk of HIV infection. For developing proper interventions, it is important to know the size of MSM population. However, size estimation of MSM populations is still a significant public health challenge due to high cost, hard to reach and stigma associated with the population.ObjectivesWe aimed to estimate the social network size (c value) in general population and the size of MSM population in Shanghai, China by using the net work scale-up method.MethodsA multistage random sampling was used to recruit participants aged from 18 to 60 years who had lived in Shanghai for at least 6 months. The “known population method” with adjustment of backward estimation and regression model was applied to estimate the c value. And the MSM population size was further estimated using an adjusted c value taking into account for the transmission effect through social respect level towards MSM.ResultsA total of 4017 participants were contacted for an interview, and 3907 participants met the inclusion criterion. The social network size (c value) of participants was 236 after adjustment. The estimated size of MSM was 36354 (95% CI: 28489–44219) for the male Shanghaies aged 18 to 60 years, and the proportion of MSM among the total male population aged 18 to 60 years in Shanghai was 0.28%.ConclusionsWe employed the network scale-up method and used a wide range of data sources to estimate the size of MSM population in Shanghai, which is useful for HIV prevention and intervention among the target population.

HFMD and EV71 infections have a significant health effect on Shanghai children.