BACKGROUND: COVID-19 and influenza have similar clinical presentations that can range from mild to severe disease. The World Health Organization recommends that countries use existing influenza surveillance to monitor COVID-19 transmission in communities. We aim to describe the surveillance and investigation of COVID-19 at the early stage of the pandemic in Taiwan.
METHODS: In February 2020, the Taiwan Centers for Disease Control enhanced COVID-19 surveillance through its existing influenza surveillance. We retrospectively tested patients for SARS-CoV-2 who had symptoms of severe complicated influenza but were negative in influenza testing. We conducted an epidemiological investigation and contact tracing for the index patient and secondary cases to prevent virus transmission.
RESULTS: We identified the first COVID-19 patient on February 15 through enhanced COVID-19 surveillance. He had no history of traveling abroad and an unclear history of contact with COVID-19 cases. He presented with influenza-like illness on January 27 and was hospitalized from February 3 to 15. We identified 39 close contacts of the index patient, including 11 family members and 28 healthcare workers. In total, four close family contacts of the index patient tested positive for SARS-CoV-2. An additional 84 close contacts of the four secondary cases were identified and traced; none was diagnosed with COVID-19.
CONCLUSIONS: We recommend enhancing COVID-19 surveillance by testing patients with influenza-like illness. To prevent the spread of COVID-19, we recommend using appropriate personal protective equipment when in close contact with patients who present with influenza-like illness or when caring for patients with pneumonia of unknown etiology.

OBJECTIVE: To perform an epidemiological investigation on a case with visceral leishmaniasis in Zhengzhou City, Henan Province, and to identify the source of infection, so as to illustrate the transmission chain and assess the risk of local leishmaniasis transmission.
METHODS: The medical data were collected from a case with visceral leishmaniasis in Zhengzhou City, and the patient\'s bone marrow smears were detected by microscopy. Serum anti-Leishmania antibody test and PCR assay were performed among high-risk residents and all dogs in the village where the patient lived. Sandflies were captured using light traps and artificial traps, and the captured female Phlebotomus chinensis was subjected to PCR assay. The internal transcribed spacer 1 (ITS1) gene was amplified with a nested PCR assay using the genomic DNA extracted from visceral leishmaniasis patients, positive dogs and sandflies, and the sequences were aligned with those download from NCBI. In addition, a phylogenetic tree was created based on the ITS1 gene.
RESULTS: The visceral leishmaniasis patient had recurrent irregular fever, reduced complete blood counts, low hemoglobin, and a large number of Leishmania amastigotes in bone marrow smears, and was therefore diagnosed as visceral leishmaniasis. Both rk39 rapid diagnostic test and PCR assay tested negative among 324 residents living neighboring the patient\'s residence, while 21.39% (43/201) dogs were positive for rk39 rapid diagnostic test and 13.93% (28/201) positive for PCR assay. There were 17 female Ph. chinensis tested positive for Leishmania (0.82%) by PCR assay, and the ITS gene sequences from visceral leishmaniasis patients, positive dogs and sandflies shared a 100% homology with L. infantum. The Leishmania species was therefore characterized as L. infantum.
CONCLUSIONS: L. infantum infection occurs in visceral leishmaniasis patients, dogs and sandflies in Zhengzhou City, indicating a complete transmission chain and a high transmission risk of visceral leishmaniasis by L. infantum. Intensified control measures are required to prevent local transmission of leishmaniasis in Zhengzhou City.
［摘要］ 目的对河南省郑州市1例内脏利什曼病病例进行流行病学调査，以确定感染来源、明确传播链、评估传播风 险。方法 收集郑州市1例内脏利什曼病患者临床资料，显微镜下检査患者骨髓穿刺液涂片，并对患者居住村庄重点人 群和村庄内所有犬只采用rk39内脏利什曼病快速诊断试剂进行血清抗体检査和PCR检测。在患者家附近悬挂诱蛉灯， 同时人工捕捉白蛉，对捕捉到的雌性中华白蛉进行PCR检测。采用巢式PCR对患者、阳性犬只和阳性白蛉DNA扩增内 转录间隔区1 (ITS1)基因并进行序列比对，同时基于1TS1基因序列构建系统进化树。结果 患者反复不规则发热、全血 细胞减少、血红蛋白偏低，骨髓穿刺液涂片査见大量利什曼原虫无鞭毛体，确诊为内脏利什曼病。采用rk39快速诊断试 剂及PCR法共筛査患者居住地疫点范围内324名居民，抗体检测及PCR结果均为阴性。采用上述两种方法筛査疫点内 犬只201只，其中rk39诊断阳性率为21.39%、PCR阳性率为13.93%。在疫点捕捉2 065只雌性中华白蛉进行利什曼原虫 PCR检测，阳性率为0.82%。患者、阳性犬只和阳性白蛉ITS1基因序列与婴儿利什曼原虫序列同源性为100%，确定感染 虫株为婴儿利什曼原虫。结论 郑州市内脏利什曼病患者、犬只和白蛉中存在婴儿利什曼原虫感染，证实当地存在婴儿 利什曼病完整传播链，且传播风险较高;需强化防控措施，防止利什曼病在当地传播。.

There has been vigorous debate on how different countries responded to the COVID-19 pandemic. To secure public safety, South Korea actively used personal information at the risk of personal privacy whereas France encouraged voluntary cooperation at the risk of public safety. In this article, after a brief comparison of contextual differences with France, we focus on South Korea\'s approaches to epidemiological investigations. To evaluate the issues pertaining to personal privacy and public health, we examine the usage patterns of original data, de-identification data, and encrypted data. Our specific proposal discusses the COVID index, which considers collective infection, outbreak intensity, availability of medical infrastructure, and the death rate. Finally, we summarize the findings and lessons for future research and the policy implications.

BACKGROUND: At the end of 2019, a new epidemic of viral pneumonia emerged in China and was determined to be caused by a novel coronavirus, which was named coronavirus disease 2019 (COVID-19) by the World Health Organization. The epidemic quickly spread, causing a worldwide pandemic. Scientists and clinicians across the globe have shifted their research efforts towards understanding the virus itself and its epidemiology.
METHODS: In mid-January 2020, a Chinese family made a visit to a local city, and within the next 2 wk one after another fell ill with COVID-19. At the beginning of their first illness onset, the family had eaten in a restaurant, which led to the subsequent illness onset in another two families. All cases were diagnosed as COVID-19 by real-time fluorescent reverse transcription-polymerase chain reaction. Epidemiological investigation showed that the transmission chain was complete.
CONCLUSIONS: This chain of social exposure highlights the danger of group aggregative behavior for spread of COVID-19.

BACKGROUND: In December 2019, the first patient with 2019-novel coronavirus (2019-nCoV) was reported in Wuhan, China, and the disease spread rapidly across the country and surrounding countries within 2 mo. As of February 29, 2020, a total of 91 confirmed cases had been reported in Gansu Province. This case report of the diagnosis and treatment of an elderly patient with 2019-nCoV pneumonia complicated by acute exacerbation of chronic obstructive pulmonary disease in Gansu Province aims to provide a better reference for the treatment of patients in the future.
METHODS: The patient, a 94-year-old female, lived in Maiji District of Tianshui, Gansu Province, China. On January 30, 2020, she was admitted to the Fourth People\'s Hospital of Tianshui after 9 d of close contact with a patient with 2019-nCoV pneumonia. She was subsequently admitted to Gansu Provincial Hospital of Traditional Chinese Medicine for isolation and transferred to Tianshui Gansu Provincial Hospital of Infectious Diseases on February 3, 2020 for treatment. Upon initial examination, her body temperature was 36.7 °C , pulse was 80, breathing was 20, and blood pressure was 130/80 mmHg. She was conscious with normal development and normal nutrition. The pharynx was not red, and bilateral tonsils were not red and swollen. The lungs sounded slightly coarse with no dry or wet rales. The first symptoms were cough and fatigue on 2 February. The patient was hospitalized for 12 d. After active treatment, she was discharged on February 14 with a good prognosis.
CONCLUSIONS: A history of exposure to the affected area or patient is a major cause of 2019-nCoV infection, and population clustering is a high risk factor for transmission. Patients may not necessarily have respiratory system symptoms as the only clinical manifestation but may also have concomitant or first onset digestive symptoms. Attention should be paid to the prevention and treatment of multiple organ dysfunction syndrome. Nucleic acid testing is extremely important and needs to be repeated several times. Laboratory and auxiliary examination indicators during the first week of admission are extremely important. It is feasible to carry out dynamic and continuous index monitoring, which can predict and guide the prevention and treatment of multiple organ dysfunction and the prognosis of the disease.

Objective: To investigate the epidemiological and clinical characteristics of a case infected with avian influenza A (H5N6) virus associated with exposure to aerosol and provide evidence for the prevention and control of human infection with avian influenza virus. Methods: Epidemiological investigation was conducted to identify the history of exposure, infection route, and disease progression. Real-time fluorescent quantitative RT-PCR was used to test the samples collected from the case, close contacts, environment and poultry market. Results: The case had no history of exposure to live poultry and poultry market. But before the onset the case had a history of exposure to the live poultry placed in a car with doors and windows closed. The samples collected from the case\'s lower respiratory tract and the remaining frozen chicken meat were all influenza A (H5N6) virus positive. Conclusions: The source of infection was the live poultry, and the infection route might be the exposure to aerosol in a car with doors and windows closed, where the poultry were temporarily stored. It is necessary to promote centralized poultry slaughtering, cold chain distribution and fresh poultry sale, as well as strengthen health education and establish the concept of consuming fresh poultry.
目的： 分析1例由气溶胶暴露引起人感染H5N6禽流感病毒病例的发生和传播途径，为人禽流感防控提供依据。 方法： 对病例开展流行病学调查，明确病例暴露史及感染途径，追踪病例病情进展与转归。对病例、密切接触者、病家环境、禽类交易市场环境标本进行核酸检测。 结果： 病例无活禽、禽类交易市场暴露史，发病前1 d具有禽类临时存放密闭狭小环境气溶胶暴露史。病例下呼吸道提取物及病家冰箱剩余冷冻鸡块表面涂抹标本检出H5N6禽流感核酸阳性。 结论： 病例感染来源为批发市场购买的活禽，禽类临时存放密闭狭小环境气溶胶暴露可能为其感染途径。应在广州市范围推进\"集中屠宰、冷链配送、生鲜上市\"，加强健康宣教，树立消费生鲜禽肉的观念。.

OBJECTIVE: To analyze a case infected with Plasmodium falciparum due to blood transfusion in Taizhou City, so as to provide scientific evidence for malaria control.
METHODS: The epidemiological investigation of a case with P. falciparum malaria was conducted, and the blood donors\'blood samples were collected and detected in laboratory to identify the origin of the infection.
RESULTS: Microscopy detected Plasmodium in the blood samples from a 64-year-old male inpatient with nephropathy, and P. falciparum malaria was diagnosed. The case had no history of travel to Africa or Southeast Asia except blood transfusion, and he had received blood transfusion 14 times during his hospital stay. Detection of blood donors\'blood samples showed P. falciparum in the archived blood samples from an Indonesian student studying in China, as revealed by PCR assay, and the student was found to have a history of malaria.
CONCLUSIONS: The patient was confirmed to be a case with P. falciparum malaria due to blood transfusion. Screening of malaria should be intensified in blood donors to prevent the development of malaria transmitted by blood transfusion.
[摘要] 目的 对泰州市1例因输血感染恶性疟的病例进行分析, 为疟疾防控提供科学依据。方法 对1例恶性疟患者 开展流行病学追踪调查, 通过实验室方法对供血者血样进行检测, 以明确感染来源。结果 1名64岁肾病住院患者的血 液标本镜检查见疟原虫, 确诊为恶性疟。经流行病学调查, 患者除接受过输血外, 无非洲和东南亚等恶性疟流行区旅行 史; 住院期间曾接受14次输血治疗, 对23份供血者血样进行检测, 发现1名印度尼西亚籍留学生留存血样PCR检测呈恶 性疟原虫阳性, 流行病学调查发现该供血者曾有疟疾感染史。结论 该患者为输血感染恶性疟病例, 应加强对献血者的 疟疾筛查, 以预防输血传播疟疾的发生。.

A case of primary pneumonic plague (PPP) caused by Yersinia pestis is reported. This case occurred in the largest plague area in China. The patient died after contact with a dog that had captured an infected marmot. Three of 151 contacts were shown to be positive for antibody against F1 antigen by indirect hemagglutination assay, but none had clinical symptoms. There was no secondary case.