Reemergence of foot-and-mouth disease, South Korea, 2000-2011

Five outbreaks of foot-and-mouth disease have occurred in South Korea during 2000–2011. Macro-analysis of these outbreaks showed a correlation with outbreaks in countries in eastern Asia. Genetic analyses of food-and-mouth disease viruses in South Korea showed a correlation with viruses that are prevalent in neighboring countries.

High Prevalence of the BIM Deletion Polymorphism in Young Female Breast Cancer in an East Asian Country

Background

A rapid surge of female breast cancer has been observed in young women in several East Asian countries. The BIM deletion polymorphism, which confers cell resistance to apoptosis, was recently found exclusively in East Asian people with prevalence rate of 12%. We aimed to evaluate the possible role of this genetic alteration in carcinogenesis of breast cancer in East Asians.

Method

Female healthy volunteers (n = 307), patients in one consecutive stage I-III breast cancer cohort (n = 692) and one metastatic breast cancer cohort (n = 189) were evaluated. BIM wild-type and deletion alleles were separately genotyped in genomic DNAs.

Results

Both cancer cohorts consistently showed inverse associations between the BIM deletion polymorphism and patient age (≤35 y vs. 36-50 y vs. >50 y: 29% vs. 22% vs. 15%, P = 0.006 in the consecutive cohort, and 40% vs. 23% vs. 13%, P = 0.023 in the metastatic cohort). In healthy volunteers, the frequencies of the BIM deletion polymorphism were similar (13%-14%) in all age groups. Further analyses indicated that the BIM deletion polymorphism was not associated with specific clinicopathologic features, but it was associated with poor overall survival (adjusted hazard ratio 1.71) in the consecutive cohort.

Conclusions

BIM deletion polymorphism may be involved in the tumorigenesis of the early-onset breast cancer among East Asians.

Ozone and daily mortality rate in 21 cities of East Asia: how does season modify the association?

Previous studies in East Asia have revealed that the short-term associations between tropospheric ozone and daily mortality rate were strongest in winter, which is opposite to the findings in North America and Western Europe. Therefore, we investigated the season-varying association between ozone and daily mortality rate in 21 cities of East Asia from 1979 to 2010. Time-series Poisson regression models were used to analyze the association between ozone and daily nonaccidental mortality rate in each city, testing for different temperature lags. The best-fitting model was obtained after adjustment for temperature in the previous 2 weeks. Bayesian hierarchical models were applied to pool the city-specific estimates. An interquartile-range increase of the moving average concentrations of same-day and previous-day ozone was associated with an increase of 1.44% (95% posterior interval (PI): 1.08%, 1.80%) in daily total mortality rate after adjustment for temperature in the previous 2 weeks. The corresponding increases were 0.62% (95% PI: 0.08%, 1.16%) in winter, 1.46% (95% PI: 0.89%, 2.03%) in spring, 1.60% (95% PI: 1.03%, 2.17%) in summer, and 1.12% (95% PI: 0.73%, 1.51%) in fall. We found significant associations between short-term exposure to ozone and higher mortality rate in East Asia that varied considerably from season to season with a significant trough in winter.

Population-based cohort study on the risk of malignancy in East Asian children with juvenile idiopathic arthritis

BACKGROUND

To investigate the association and magnitude of risk between JIA, its associated treatment and cancer development in Taiwanese children.

METHODS

Nationwide population-based 1:4 age- and gender-matched retrospective cohort study was designed using the National Health Insurance Research Database of Taiwan. A cohort of 2,892 children <16 years old with JIA was formed as well as a non-JIA cohort of 11,568 in year 2003 to 2005. They were followed up till a diagnosis of malignancy or up to 8 years until 2010. Relative risk (RR), incidence rate ratio (IRR), and adjusted hazard ratio (aHR) of developing malignancy were calculated.

RESULTS

The female to male ratio was 0.79:1. There were 3 cases of incident cancer in the "MTX use, biologics-naïve" group, only 1 in the anti-TNF biologics-containing group and 29 in the "both MTX- and biologics-naïve" group, in comparison, there were 50 cases of cancer in the non-JIA comparator group. During a 16114.16 patient-years follow-up, the RR and IRR for developing a malignancy in both methotrexate- and anti-tumor necrosis factor (TNF) biologics-naïve JIA children were 2.75 (95% confidence interval, 1.75 - 4.32) and 3.21 (2.01 - 5.05), respectively. For leukemia, the IRR was 7.38 (2.50 - 22.75); lymphoma, 8.30 (1.23 - 69.79); and soft tissue sarcoma, 11.07 (0.84 - 326.4). The IRR of other cancers was 2.08 (1.11 - 3.71). The aHR on cancer risk was 3.14 (1.98 - 4.98) in methotrexate- and biologics-naïve group. There were no statistically significant increased risk in JIA patients treated with methotrexate and/or anti-TNF biologics.

CONCLUSIONS

Compared with children without JIA, children with JIA have 3-fold increase of risk on malignancy in East Asia. Seemingly neither methotrexate nor anti-TNF biologics increases the risk further.

Multiple nonglycemic genomic loci are newly associated with blood level of glycated hemoglobin in East Asians

Glycated hemoglobin A1c (HbA1c) is used as a measure of glycemic control and also as a diagnostic criterion for diabetes. To discover novel loci harboring common variants associated with HbA1c in East Asians, we conducted a meta-analysis of 13 genome-wide association studies (GWAS; N = 21,026). We replicated our findings in three additional studies comprising 11,576 individuals of East Asian ancestry. Ten variants showed associations that reached genome-wide significance in the discovery data set, of which nine (four novel variants at TMEM79 [P value = 1.3 × 10(-23)], HBS1L/MYB [8.5 × 10(-15)], MYO9B [9.0 × 10(-12)], and CYBA [1.1 × 10(-8)] as well as five variants at loci that had been previously identified [CDKAL1, G6PC2/ABCB11, GCK, ANK1, and FN3KI]) showed consistent evidence of association in replication data sets. These variants explained 1.76% of the variance in HbA1c. Several of these variants (TMEM79, HBS1L/MYB, CYBA, MYO9B, ANK1, and FN3K) showed no association with either blood glucose or type 2 diabetes. Among individuals with nondiabetic levels of fasting glucose (<7.0 mmol/L) but elevated HbA1c (≥6.5%), 36.1% had HbA1c <6.5% after adjustment for these six variants. Our East Asian GWAS meta-analysis has identified novel variants associated with HbA1c as well as demonstrated that the effects of known variants are largely transferable across ethnic groups. Variants affecting erythrocyte parameters rather than glucose metabolism may be relevant to the use of HbA1c for diagnosing diabetes in these populations.

Regional changes in charcoal-burning suicide rates in East/Southeast Asia from 1995 to 2011: a time trend analysis

BACKGROUND

Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 y of the first reported cases in the early 2000s. The objectives of this analysis were to investigate (i) time trends and regional patterns of charcoal-burning suicide throughout East/Southeast Asia during the time period 1995-2011 and (ii) whether any rises in use of this method were associated with increases in overall suicide rates. Sex- and age-specific trends over time were also examined to identify the demographic groups showing the greatest increases in charcoal-burning suicide rates across different countries.

METHODS AND FINDINGS

We used data on suicides by gases other than domestic gas for Hong Kong, Japan, the Republic of Korea, Taiwan, and Singapore in the years 1995/1996-2011. Similar data for Malaysia, the Philippines, and Thailand were also extracted but were incomplete. Graphical and joinpoint regression analyses were used to examine time trends in suicide, and negative binomial regression analysis to study sex- and age-specific patterns. In 1995/1996, charcoal-burning suicides accounted for <1% of all suicides in all study countries, except in Japan (5%), but they increased to account for 13%, 24%, 10%, 7%, and 5% of all suicides in Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore, respectively, in 2011. Rises were first seen in Hong Kong after 1998 (95% CI 1997-1999), followed by Singapore in 1999 (95% CI 1998-2001), Taiwan in 2000 (95% CI 1999-2001), Japan in 2002 (95% CI 1999-2003), and the Republic of Korea in 2007 (95% CI 2006-2008). No marked increases were seen in Malaysia, the Philippines, or Thailand. There was some evidence that charcoal-burning suicides were associated with an increase in overall suicide rates in Hong Kong, Taiwan, and Japan (for females), but not in Japan (for males), the Republic of Korea, and Singapore. Rates of change in charcoal-burning suicide rate did not differ by sex/age group in Taiwan and Hong Kong but appeared to be greatest in people aged 15-24 y in Japan and people aged 25-64 y in the Republic of Korea. The lack of specific codes for charcoal-burning suicide in the International Classification of Diseases and variations in coding practice in different countries are potential limitations of this study.

CONCLUSIONS

Charcoal-burning suicides increased markedly in some East/Southeast Asian countries (Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore) in the first decade of the 21st century, but such rises were not experienced by all countries in the region. In countries with a rise in charcoal-burning suicide rates, the timing, scale, and sex/age pattern of increases varied by country. Factors underlying these variations require further investigation, but may include differences in culture or in media portrayals of the method. Please see later in the article for the Editors' Summary.

Regional changes in charcoal-burning suicide rates in East/Southeast Asia from 1995 to 2011: a time trend analysis

BACKGROUND

Suicides by carbon monoxide poisoning resulting from burning barbecue charcoal reached epidemic levels in Hong Kong and Taiwan within 5 y of the first reported cases in the early 2000s. The objectives of this analysis were to investigate (i) time trends and regional patterns of charcoal-burning suicide throughout East/Southeast Asia during the time period 1995-2011 and (ii) whether any rises in use of this method were associated with increases in overall suicide rates. Sex- and age-specific trends over time were also examined to identify the demographic groups showing the greatest increases in charcoal-burning suicide rates across different countries.

METHODS AND FINDINGS

We used data on suicides by gases other than domestic gas for Hong Kong, Japan, the Republic of Korea, Taiwan, and Singapore in the years 1995/1996-2011. Similar data for Malaysia, the Philippines, and Thailand were also extracted but were incomplete. Graphical and joinpoint regression analyses were used to examine time trends in suicide, and negative binomial regression analysis to study sex- and age-specific patterns. In 1995/1996, charcoal-burning suicides accounted for <1% of all suicides in all study countries, except in Japan (5%), but they increased to account for 13%, 24%, 10%, 7%, and 5% of all suicides in Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore, respectively, in 2011. Rises were first seen in Hong Kong after 1998 (95% CI 1997-1999), followed by Singapore in 1999 (95% CI 1998-2001), Taiwan in 2000 (95% CI 1999-2001), Japan in 2002 (95% CI 1999-2003), and the Republic of Korea in 2007 (95% CI 2006-2008). No marked increases were seen in Malaysia, the Philippines, or Thailand. There was some evidence that charcoal-burning suicides were associated with an increase in overall suicide rates in Hong Kong, Taiwan, and Japan (for females), but not in Japan (for males), the Republic of Korea, and Singapore. Rates of change in charcoal-burning suicide rate did not differ by sex/age group in Taiwan and Hong Kong but appeared to be greatest in people aged 15-24 y in Japan and people aged 25-64 y in the Republic of Korea. The lack of specific codes for charcoal-burning suicide in the International Classification of Diseases and variations in coding practice in different countries are potential limitations of this study.

CONCLUSIONS

Charcoal-burning suicides increased markedly in some East/Southeast Asian countries (Hong Kong, Taiwan, Japan, the Republic of Korea, and Singapore) in the first decade of the 21st century, but such rises were not experienced by all countries in the region. In countries with a rise in charcoal-burning suicide rates, the timing, scale, and sex/age pattern of increases varied by country. Factors underlying these variations require further investigation, but may include differences in culture or in media portrayals of the method. Please see later in the article for the Editors' Summary.

Food and water security issues in Russia III: food- and waterborne diseases in the Russian Arctic, Siberia and the Far East, 2000-2011

BACKGROUND

The food- and waterborne disease situation in Russia requires special attention. Poor quality of centralized water supplies and sewage systems, biological and chemical contamination of drinking water, as well as contamination of food products, promote widespread infectious diseases, significantly exceeding nationwide rates in the population living in the two-thirds of Russian northern territories.

OBJECTIVES

The general aim was to assess the levels of food- and waterborne diseases in selected regions of Russian Arctic, Siberia and the Far East (for the period 2000-2011), and to compare disease levels among regions and with national levels in Russia.

STUDY DESIGN AND METHODS

This study is the first comparative assessment of the morbidity in these fields of the population of 18 selected regions of Russian Arctic, Siberia and the Far East, using official statistical sources. The incidences of infectious and parasitic food- and waterborne diseases among the general population (including indigenous peoples) have been analyzed in selected regions (per 100,000 of population, averaged for 2000-2011).

RESULTS

Among compulsory registered infectious and parasitic diseases, there were high rates and widespread incidences in selected regions of shigellosis, yersiniosis, hepatitis A, tularaemia, giardiasis, enterobiasis, ascariasis, diphyllobothriasis, opistorchiasis, echinococcosis and trichinellosis.

CONCLUSION

Incidences of infectious and parasitic food- and waterborne diseases in the general population of selected regions of the Russian Arctic, Siberia and the Far East (2000-2011) are alarmingly high. Parallel solutions must be on the agenda, including improvement of sanitary conditions of cities and settlements in the regions, modernization of the water supply and of the sewage system. Provision and monitoring of the quality of the drinking water, a reform of the general healthcare system and the epidemiological surveillance (including gender-divided statistics), enhancement of laboratory diagnostics and the introduction of preventive actions are urgently needed.

Biphasic insulin aspart 30 in insulin-naive people with type 2 diabetes in non-western nations: results from a regional comparative multinational observational study (A(1)chieve)

BACKGROUND

A1chieve(®) (Novo Nordisk A/S, Bagsværd, Denmark) was a prospective, multicenter, noninterventional study in 66,726 people with type 2 diabetes mellitus (T2DM) in 28 countries beginning biphasic insulin aspart 30 (aspart premix), insulin detemir, or insulin aspart in routine clinical care.

SUBJECTS AND METHODS

A subgroup of 27,594 insulin-naive people began therapy with aspart premix with or without oral agents. Safety and effectiveness data were taken from clinic records at baseline and after 24 weeks. Seven regional country groupings were prespecified.

RESULTS

Mean final insulin dose ranged from 0.68±0.26 U/kg/day (Middle East/Gulf) to 0.38±0.14 U/kg/day (South Asia). The baseline glycated hemoglobin (HbA1c) level varied from 10.5±2.0% (Latin America) to 9.2±1.3% (South Asia), with reductions from -2.9±2.1% (Latin America) to -1.9±1.3% (South Asia). The proportion of people reaching an HbA1c level of <7.0% was highest in China (56%) and lowest in North Africa (22%). Fasting plasma glucose level reductions were from -6.4±5.3 mmol/L (Latin America) to -3.6±2.6 mmol/L (South Asia). Most people began aspart premix twice daily, varying from 91% (North Africa) to 70% (Latin America). Improvement in HbA1c increased with baseline dose frequency (once daily, -1.5±1.4%; twice daily, -2.2±1.6%; three times daily, -2.9±2.2%).

CONCLUSIONS

Insulin-naive people with T2DM beginning aspart premix insulin in routine clinical practice in non-western nations had clinically useful improvements in blood glucose control after 24 weeks in all seven regions. Improvements from baseline for glucose control variables were greater than cross-regional differences in those variables at 24 weeks.

Food and water security issues in Russia I: food security in the general population of the Russian Arctic, Siberia and the Far East, 2000-2011

BACKGROUND

Problems related to food security in Russian Arctic (dietary imbalance, predominance of carbohydrates, shortage of milk products, vegetables and fruits, deficit of vitamins and microelements, chemical, infectious and parasitic food contamination) have been defined in the literature. But no standard protocol of food security assessment has been used in the majority of studies.

OBJECTIVES

Our aim was to obtain food security indicators, identified within an Arctic collaboration, for selected regions of the Russian Arctic, Siberia and the Far East, and to compare food safety in these territories.

STUDY DESIGN AND METHODS

In 18 regions of the Russian Arctic, Siberia and the Far East, the following indicators of food security were analyzed: food costs, food consumption, and chemical and biological food contamination for the period 2000-2011.

RESULTS

Food costs in the regions are high, comprising 23-43% of household income. Only 4 out of 10 food groups (fish products, cereals, sugar, plant oil) are consumed in sufficient amounts. The consumption of milk products, eggs, vegetables, potatoes, fruits (and berries) is severely low in a majority of the selected regions. There are high levels of biological contamination of food in many regions. The biological and chemical contamination situation is alarming, especially in Chukotka. Only 7 food pollutants are under regular control; among pesticides, only DDT. Evenki AO and Magadan Oblast have reached peak values in food contaminants compared with other regions. Mercury in local fish has not been analyzed in the majority of the regions. In 3 regions, no monitoring of DDT occurs. Aflatoxins have not been analyzed in 5 regions. Nitrates had the highest percentage in excess of the hygienic threshold in all regions. Excesses of other pollutants in different regions were episodic and as a rule not high.

CONCLUSION

Improvement of the food supply and food accessibility in the regions of the Russian Arctic, Siberia and the Far East is of utmost importance. Both quantitative and qualitative control of chemical and biological contaminants in food is insufficient and demands radical enhancement aimed at improving food security.

Association between body mass index and cardiovascular disease mortality in east Asians and south Asians: pooled analysis of prospective data from the Asia Cohort Consortium

OBJECTIVE

To evaluate the association between body mass index and mortality from overall cardiovascular disease and specific subtypes of cardiovascular disease in east and south Asians.

DESIGN

Pooled analyses of 20 prospective cohorts in Asia, including data from 835,082 east Asians and 289,815 south Asians. Cohorts were identified through a systematic search of the literature in early 2008, followed by a survey that was sent to each cohort to assess data availability.

SETTING

General populations in east Asia (China, Taiwan, Singapore, Japan, and Korea) and south Asia (India and Bangladesh).

PARTICIPANTS

1,124,897 men and women (mean age 53.4 years at baseline).

MAIN OUTCOME MEASURES

Risk of death from overall cardiovascular disease, coronary heart disease, stroke, and (in east Asians only) stroke subtypes.

RESULTS

49,184 cardiovascular deaths (40,791 in east Asians and 8393 in south Asians) were identified during a mean follow-up of 9.7 years. East Asians with a body mass index of 25 or above had a raised risk of death from overall cardiovascular disease, compared with the reference range of body mass index (values 22.5-24.9; hazard ratio 1.09 (95% confidence interval 1.03 to 1.15), 1.27 (1.20 to 1.35), 1.59 (1.43 to 1.76), 1.74 (1.47 to 2.06), and 1.97 (1.44 to 2.71) for body mass index ranges 25.0-27.4, 27.5-29.9, 30.0-32.4, 32.5-34.9, and 35.0-50.0, respectively). This association was similar for risk of death from coronary heart disease and ischaemic stroke; for haemorrhagic stroke, the risk of death was higher at body mass index values of 27.5 and above. Elevated risk of death from cardiovascular disease was also observed at lower categories of body mass index (hazard ratio 1.19 (95% confidence interval 1.02 to 1.39) and 2.16 (1.37 to 3.40) for body mass index ranges 15.0-17.4 and <15.0, respectively), compared with the reference range. In south Asians, the association between body mass index and mortality from cardiovascular disease was less pronounced than that in east Asians. South Asians had an increased risk of death observed for coronary heart disease only in individuals with a body mass index greater than 35 (hazard ratio 1.90, 95% confidence interval 1.15 to 3.12).

CONCLUSIONS

Body mass index shows a U shaped association with death from overall cardiovascular disease among east Asians: increased risk of death from cardiovascular disease is observed at lower and higher ranges of body mass index. A high body mass index is a risk factor for mortality from overall cardiovascular disease and for specific diseases, including coronary heart disease, ischaemic stroke, and haemorrhagic stroke in east Asians. Higher body mass index is a weak risk factor for mortality from cardiovascular disease in south Asians.

Vitamin D status is associated with sun exposure, vitamin D and calcium intake, acculturation and attitudes in immigrant East Asian women living in Sydney

Known determinants of vitamin D status (measured in serum as 25(OH)Dnmol/L) are exposure to sunlight and intake of vitamin D, either from foods or vitamin supplements. Recently, low vitamin D status in East Asian Australian immigrants has been reported. Thus the aim of this study was to investigate associations with vitamin D status in East Asian Australian immigrant women. In this cross-sectional study of women (n=152 aged 18-92), 25(OH)D levels were measured from serum samples (radio-immuno assay). Demographics, sun exposure patterns, dietary intake and acculturation factors were obtained by questionnaire. In spring, 53% of the study population had serum 25(OH)D levels <50nmol/L (deficiency); whereas in summer only 19% were deficient. Associations with vitamin D deficiency were younger age, higher education, more sun protection behavior, fewer minutes of sun exposure on weekends, low vitamin D and calcium intake through foods or supplements and less acculturation to Australian lifestyle. After multivariate adjustment, those who had no intake of vitamin D supplements (OR=5.6, CI=1.4-22), less sunlight exposure on weekends (OR=2.7, CI=1.0-7.3) and lower acculturation to Australian lifestyle (OR=2.5, CI=1.0-6.3) had increased risk of being deficient in vitamin D. Thus there is a need for vitamin D education in this "at-risk" population. This article is part of a Special Issue entitled 'Vitamin D Workshop'.

Health care seeking for childhood diarrhea in developing countries: evidence from seven sites in Africa and Asia

We performed serial Health Care Utilization and Attitudes Surveys (HUASs) among caretakers of children ages 0–59 months randomly selected from demographically defined populations participating in the Global Enteric Multicenter Study (GEMS), a case-control study of moderate-to-severe diarrhea (MSD) in seven developing countries. The surveys aimed to estimate the proportion of children with MSD who would present to sentinel health centers (SHCs) where GEMS case recruitment would occur and provide a basis for adjusting disease incidence rates to include cases not seen at the SHCs. The proportion of children at each site reported to have had an incident episode of MSD during the 7 days preceding the survey ranged from 0.7% to 4.4% for infants (0–11 months of age), from 0.4% to 4.7% for toddlers (12–23 months of age), and from 0.3% to 2.4% for preschoolers (24–59 months of age). The proportion of MSD episodes at each site taken to an SHC within 7 days of diarrhea onset was 15–56%, 17–64%, and 7–33% in the three age strata, respectively. High cost of care and insufficient knowledge about danger signs were associated with lack of any care-seeking outside the home. Most children were not offered recommended fluids and continuing feeds at home. We have shown the utility of serial HUASs as a tool for optimizing operational and methodological issues related to the performance of a large case-control study and deriving population-based incidence rates of MSD. Moreover, the surveys suggest key targets for educational interventions that might improve the outcome of diarrheal diseases in low-resource settings.

Smoking among East Asian college students: prevalence and correlates

OBJECTIVES

To compare the prevalence and correlates of cigarette smoking among East Asian college students.

METHODS

Data were collected from college students (N=16,558) in China, Hong Kong, Malaysia, Singapore, South Korea, and Taiwan (response rate: 78%).

RESULTS

Religion was independently associated with college students' smoking in China (adjusted odds ratio [AOR] = 1.82) and South Korea (AOR = 0.80). Being a heavy drinker and having a higher exposure to secondhand smoke were associated with higher smoking rates (Ps < .001).

CONCLUSIONS

The East Asian economies show a varied prevalence of college smoking but a similar pattern of relationship with its correlates.

Genetics of type 2 diabetes in East Asian populations

Because type 2 diabetes (T2D) is highly familial, there has been a concentrated effort to uncover the genetic basis of T2D worldwide over the last decade. In East Asians, T2D is experiencing a rapidly rising prevalence that is characterized by a relatively lower body mass index, as compared with that in Europeans. To date, at least 15 convincing T2D loci have been identified from large-scale genome-wide association studies and meta-analyses in East Asians. Many of these are likely responsible for pancreatic β cell function, as indicated in studies from Europeans. Many T2D loci have been replicated across the ethnic groups. There are, however, substantial interethnic differences in frequency and effect size of these risk alleles. Despite accumulating genetic information on T2D, there are still limitations in our ability to explain the rapidly rising prevalence and lean phenotype of disease observed in East Asians, suggesting that more extensive work using diverse research strategies is needed in the future.

[The problem of the so-called "change" of the tick-borne encephalitis virus genotype in the middle urals for the last 60 years]

Although the history of the tick-borne encephalitis in Urals dates back to 75 years ago, the problem of the spread and evolution of the tick-borne encephalitis virus (TBEV) largely remains terra incognita. Any research in this area is of great basic and practical importance. A few years ago, a hypothesis about the change of the TBEV genotype in the Sverdlovsk region in the 50-60-year period was put forward. In other words, replacement of the Far-Eastern genotype by Siberian genotype was suggested. The goal of this work was to discuss this hypothesis and the fallacy of this view. Recent large-scale data show the long history of the formation of Siberian TBEV virus population in the Middle Urals, as well as a foreign nature of Far-Eastern genotype through their introduction in the past. The concept of the decisive role of anthropogenic factor in the spread of TBEV in the Urals is discussed as an alternative to the hypothesis of the genotype change.

Social epidemiology and Eastern Wisdom

Social epidemiology is the field of study that attempts to understand the social determinants of health and the dynamics between societal settings and health. In the past 3 decades, large-scale studies in the West have accumulated a range of measures and methodologies to pursue this goal. We would like to suggest that there may be conceptual gaps in the science if Western research models are applied uncritically in East Asian studies of socioeconomic, gender, and ethnic inequalities in health. On one hand, there are common concerns, including population aging and gendered labor market participation. Further, international comparison must be built on shared concepts such as socioeconomic stratification in market economies. On the other hand, some aspects of health, such as common mental disorders, may have culturally specific manifestations that require development of perspectives (and perhaps novel measures) in order to reveal Eastern specifics. Exploring and debating commonalities and differences in the determinants of health in Oriental and Occidental cultures could offer fresh inspiration and insight for the next phase of social epidemiology in both regions.