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What is already known about this topic? Hepatitis A (HA) is caused by acute hepatitis A virus (HAV) infection and was once very common in China. Following the 2008 introduction of the HA vaccine into the national Expanded Program on Immunization (EPI), the incidence of reported HA in China decreased markedly. However, HA epidemics still occur in Liaoning Province every 3–5 years, although with far fewer cases than in the pre-HA-vaccination era. What is added by this report? Between January 1, 2020 and March 18, 2020, the number of reported cases of HA in Dalian and Dandong cities of Liaoning Province increased significantly compared with the same period in previous years. All cases were sporadic, and cases were seen in nearly every township. The increase in HA occurred one month after local fresh seafood became available with most cases being among adults. A case-control study showed that consuming raw or undercooked seafood, clams, snapping shrimp, and oysters were significantly associated with the increase in HA. What are the implications for public health practices? Strengthening health education for residents to avoid consumption of raw seafood and encouraging HAV vaccination of adults aged 20 to 54 years are important to prevent periodic HAV endemic outbreaks. Further multisectoral cooperation must be emphasized on HA surveillance in areas with a high prevalence of HA.

ObjectivesThe HIV epidemic is around 7%–20% among men who have sex with men (MSM) in Southwest China. The low HIV-testing rate highlights the need for tools to identify high-risk MSM in resource-limited regions. Our aim was, therefore, to evaluate the HIV RISK Assessment Tool for HIV prediction and to characterise the primary infection among MSM in Southwest China.DesignA cross-sectional survey was conducted in Guizhou province between January and December 2018. Participants were recruited from gay communities, among whom the HIV RISK Assessment Tool was evaluated. Logistic regression was used to analyse items associated with HIV and the area under the curve (AUC) of the receiver operating curve was calculated to quantify discrimination performance.Participants1330 MSM participants, of which 83 (6.2%) tested as HIV positive.ResultsA higher composite score of the tool (adjusted OR (aOR) 9.33, 95% CI 4.57 to 19.05) was independently associated with HIV infection. Items positively associated with HIV infection included having 2–5 same sex partners (aOR 2.43, 95% CI 1.28 to 4.64), always (aOR 5.93, 95% CI 1.59 to 22.13) or sometimes (aOR 4.25, 95% CI 2.09 to 8.64) having unprotected anal intercourse, taking both insertive and receptive sex roles (aOR 4.95, 95% CI 2.57 to 9.53) or only the receptive sex role (aOR 2.26, 95% CI 1.21 to 4.24). The tool showed an optimal discrimination ability (AUC=0.827), with a specificity of 0.747 and sensitivity of 0.785. Five MSM were identified with primary infection and had similar sexual risk behaviors as HIV-positive participants.ConclusionsThe HIV RISK Assessment Tool showed an overall good performance in predicting HIV risk among MSM in Guizhou province where the prevalence is still severe. This tool also demonstrated a potential to identify primary infection and is worth being promoted in resource-limited regions.