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Zheng Y, Ye K, Ying M, He Y, Yu Q, Lan L, Xu W. Syphilis epidemic among men who have sex with men: A global systematic review and meta-analysis of prevalence, incidence, and associated factors. J Glob Health 2024; 14:04004. [PMID: 38236688 PMCID: PMC10795860 DOI: 10.7189/jogh.14.04004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2024] Open
Abstract
Background We aimed to estimate the prevalence and incidence of syphilis at global, regional and national levels for human immunodeficiency virus (HIV)-positive and HIV-negative men who have sex with men (MSM) and explore the association between demographic and social behavioural factors and syphilis infection. Methods We searched PubMed, Embase, and the Cochrane Library from 1 January 2012 to 31 December 2022 for studies of reported crude syphilis prevalence or incidence in MSM or with sufficient data to calculate prevalence or incidence rate in MSM. Results We included 376 articles reporting on 409 records from 62 countries to calculate syphilis prevalence and incidence in MSM. The pooled prevalence of syphilis in MSM was 10.4%, with substantial differences between countries and regions. Syphilis prevalence was substantially higher in HIV-positive than in HIV-negative MSM. The pooled incidence of syphilis in MSM was 76.4 per 1000 person-years. Older age, lower education, nitrite or recreational drug use, group sex, and multiple sexual partners were identified as risk factors for syphilis infection. Conclusions A disproportionate geographic pattern of syphilis infection in MSM and significant threats of syphilis infection were revealed. The 'hidden risk' in specific regions and the inadequately elucidated drivers of high-risk behaviours, need to be fully acknowledged and addressed. Registration PROSPERO: CRD42023422218.
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Affiliation(s)
- Yang Zheng
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Department of Allergy, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kangli Ye
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Meike Ying
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Ying He
- Department of General Practice, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Qi Yu
- Department of Endodontics, Stomatology Hospital, School of Stomatology, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lei Lan
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Wenzhi Xu
- Department of Obstetrics and Gynecology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
- Key Laboratory of Reproductive Dysfunction Management of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
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Jingxian F, Yun W, Le W, Ke L, Yizhu C, Quan S, Feng W. Epidemiological characteristics and risk factors of syphilis among blood donors in Huzhou. Transfus Clin Biol 2023; 30:426-429. [PMID: 37604304 DOI: 10.1016/j.tracli.2023.08.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/10/2023] [Accepted: 08/16/2023] [Indexed: 08/23/2023]
Abstract
OBJECTIVE To investigate the epidemiological characteristics and risk factors for syphilis in Huzhou City, and to provide data to support the design of more effective health counselling and screening measures for blood donors. METHODS A retrospective study was conducted to analyse the demographic characteristics and seropositivity of syphilis among blood donors from 2019 to 2021. The differences in the serological status of syphilis among different populations under different demographic factors were compared, and conditional logistic regression analysis was used to identify the risk factors for syphilis. RESULTS The seropositivity rate of syphilis among blood donors in Huzhou City was 133/100,000, which decreased year by year. There were significant differences in the syphilis seropositivity rate among different groups in terms of age, education level, occupation, household registration, marital status and blood donation history (P < 0.05). The multivariate logistic regression model showed that all six factors, including age, education level, occupation, household registration, marital status and blood donation history, had significant effects on syphilis infection (P < 0.01), with OR values and 95% CIs of 2. 387 (1.381-4.127), 3.607 (1.609-8.086), 2.784 (1.657-4.679), 5.074 (1.865-13.804), 11.177 (3.481-35.888), and 11.244 (3.940-32.091), respectively. CONCLUSION There is room for improvement in pre-donation health counselling and screening of high-risk populations. Timely monitoring and updating of demographic data for specific high-risk populations is essential.
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Affiliation(s)
| | - Wang Yun
- Huzhou Central Blood Station, China
| | - Wang Le
- Huzhou Central Blood Station, China
| | - Lv Ke
- Huzhou Central Blood Station, China
| | | | - Sun Quan
- Huzhou Central Blood Station, China
| | - Wang Feng
- Huzhou Central Blood Station, China.
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Zhang S, Ling C, Qian Z, Yin J, Tang Q, Zhang X, Shi Y, Feng B, Ding J, Yang Q. Clinical analysis and methodological evaluation of syphilis infection in patients in a first-class tertiary hospital in Suzhou, China. AMERICAN JOURNAL OF CLINICAL AND EXPERIMENTAL IMMUNOLOGY 2023; 12:74-80. [PMID: 38022871 PMCID: PMC10658164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 07/29/2023] [Accepted: 09/17/2023] [Indexed: 12/01/2023]
Abstract
OBJECTIVE To explore the distribution and epidemiological characteristics of patients with syphilis in a first-class tertiary hospital and to evaluate the coincidence rate between chemiluminescence immunoassay (CLIA) and Treponema pallidum particle agglutination assay (TPPA). METHODS The medical records of 247,501 outpatients and inpatients were retrospectively analyzed. TPPA was used to verify positive and suspected cases, and the coincidence rate between CLIA and TPPA was evaluated. Receiver operating characteristic (ROC) curve was used to determine optimal diagnostic thresholds. RESULTS Of the 247,501 serum samples, 5,173 were detected positive for syphilis using CLIA, with a detection rate of 2.09% and a men-to-women ratio of 1.39. The chi-square test showed that sex and age were both factors that affected the detection rate (χ2=229.51, P < 0.0001). In addition, urology, orthopedics, cardiology, general surgery, gastroenterology, and gynecology represented the top six departments with the highest numbers of positive cases. Comparative analysis showed that the overall coincidence rate between CLIA and TPPA was 80.24%. Analysis of the ROC curve showed that the area under the curve (AUC) was 0.936 (95% confidence interval [CI]: 0.929-0.942, P < 0.0001) using sample/cut-off value (S/CO) as a diagnostic indicator. The results showed that an S/CO value of 3.945 was the best diagnostic value for the CLIA method, with a diagnostic specificity of 93.64% and a sensitivity of 81.90%. CONCLUSIONS Syphilis is widely distributed in various hospital departments and primarily affects middle-aged and older individuals. For cases that have been initially screened as positive or suspicious, TPPA and other tests should be used for verification to avoid misdiagnosis and missed diagnosis.
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Affiliation(s)
- Sheng Zhang
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Chen Ling
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Zhongping Qian
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Jingping Yin
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Qingqin Tang
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Ximeng Zhang
- Department of Neurology, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Yinjuan Shi
- Department of Dermatology, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Bin Feng
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Jie Ding
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
| | - Qian Yang
- Centre of Clinical Laboratory, The First Affiliated Hospital of Soochow UniversitySuzhou 215006, Jiangsu, China
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Djukic M, Eiffert H, Lange P, Giotaki I, Seele J, Nau R. Serological testing for syphilis in the differential diagnosis of cognitive decline and polyneuropathy in geriatric patients. BMC Geriatr 2023; 23:274. [PMID: 37147588 PMCID: PMC10161663 DOI: 10.1186/s12877-023-03981-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Accepted: 04/18/2023] [Indexed: 05/07/2023] Open
Abstract
BACKGROUND In the 19th century, neurosyphilis was the most frequent cause of dementia in Western Europe. Now dementia caused by syphilis has become rare in Germany. We studied whether routine testing of patients with cognitive abnormalities or neuropathy for antibodies against Treponema pallidum has therapeutic consequences in geriatric patients. METHODS A Treponema pallidum electrochemiluminescence immunoassay (TP-ECLIA) is routinely performed in all in-patients treated at our institution with cognitve decline or neuropathy and no or insufficient previous diagnostic workup. Patients with a positive TP-ECLIA treated from October 2015 to January 2022 (76 months) were retrospectively evaluated. In cases of positive TP-ECLIA, further specific laboratory investigations were performed to assess whether antibiotic therapy was indicated. RESULTS In 42 of 4116 patients (1.0%), TP-ECLIA detected antibodies directed against Treponema in serum. Specifity of these antibodies was ensured by immunoblot in 22 patients (11 × positiv, 11 × borderline values). Treponema-specific IgM was detectable in the serum of one patient, in 3 patients the Rapid Plasma Reagin (RPR) test, a modified Venereal Disease Research Laboratory test (VDRL), in serum was positiv. CSF analysis was performed in 10 patients. One patient had CSF pleocytosis. In 2 other patients, the Treponema-specific IgG antibody index was elevated. 5 patients received antibiotic therapy (4 × ceftriaxone 2 g/d i.v., 1 × doxycycline 300 mg/d p.o.). CONCLUSION In approx. 1‰ of patients with previously undiagnosed or not sufficiently diagnosed cognitive decline or neuropathy, the diagnostic workup for active syphilis resulted in a course of antibiotic treatment.
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Affiliation(s)
- Marija Djukic
- Institute of Neuropathology, Universitätsmedizin Göttingen, Göttingen, Germany
- Department of Geriatrics, Protestant Hospital Göttingen-Weende, An der Lutter 24, Göttingen, 37075, Germany
| | - Helmut Eiffert
- Institute of Neuropathology, Universitätsmedizin Göttingen, Göttingen, Germany
- Amedes MVZ for Laboratory Medicine, Medical Microbiology and Infectiology, Göttingen, Germany
| | - Peter Lange
- Department of Neurology, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Ioanna Giotaki
- Department of Neurology, Universitätsmedizin Göttingen, Göttingen, Germany
| | - Jana Seele
- Institute of Neuropathology, Universitätsmedizin Göttingen, Göttingen, Germany
- Department of Geriatrics, Protestant Hospital Göttingen-Weende, An der Lutter 24, Göttingen, 37075, Germany
| | - Roland Nau
- Institute of Neuropathology, Universitätsmedizin Göttingen, Göttingen, Germany.
- Department of Geriatrics, Protestant Hospital Göttingen-Weende, An der Lutter 24, Göttingen, 37075, Germany.
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Chen X, Liu Q, Sun P, Yuan S, Liao H, Zhang X. Prevalence of Syphilis Infections Among Volunteer Blood Donors in Jinan Blood Center, China: A 15-Year Retrospective Study. Infect Drug Resist 2022; 15:6431-6440. [PMID: 36349217 PMCID: PMC9637336 DOI: 10.2147/idr.s386495] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 10/27/2022] [Indexed: 10/29/2023] Open
Abstract
BACKGROUND Syphilis infections among volunteer blood donors increased rapidly in recent years. It is important to analyze the demographics of seropositive donor groups and help to recruit donors from low-risk population. OBJECTIVE The aim of this study was to analyze the syphilis prevalence among volunteer blood donors in Jinan Blood Center and give direction to blood recruitment. METHODS AND MATERIALS A cross-sectional study was conducted among blood donors in Jinan, China. Socio-demographic data and blood donation testing data from January 2007 to December 2021 were extracted from the database of blood management software of Jinan Blood Center for analysis. All blood samples were screened by ELISA, and those anti-TP-positive samples were counted and analyzed by sex, age, educational background, occupation and blood donation times. Logistic regression was used to explore risk factors associated with syphilis infection. RESULTS Totally 700,757 blood samples were collected in the study during 2007 to 2021, 2290 cases were detected anti-TP positive with a positive rate of 0.33%. Female, 35-44 years old, with a lower education degree, farmers and first-time donors were the high-risk subgroups. CONCLUSION Consultation and identification of high-risk population groups should be improved. Measures should be taken to make the donor recruitment more professional and detailed.
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Affiliation(s)
- Xiulian Chen
- Department of Blood Quality Control, Jinan Blood Center, Jinan, People’s Republic of China
| | - Qin Liu
- Department of General Management, Jinan Blood Center, Jinan, People’s Republic of China
| | - Ping Sun
- Department of Blood Screening Laboratory, Jinan Blood Center, Jinan, People’s Republic of China
| | - Shuhui Yuan
- Department of Blood Screening Laboratory, Jinan Blood Center, Jinan, People’s Republic of China
| | - Hang Liao
- Department of Blood Screening Laboratory, Jinan Blood Center, Jinan, People’s Republic of China
| | - Xueliang Zhang
- Vice Director of Jinan Blood Center, Jinan, People’s Republic of China
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Šmit R, Wojtalewicz N, Vierbaum L, Nourbakhsh F, Schellenberg I, Hunfeld KP, Lohr B. Epidemiology, Management, Quality of Testing and Cost of Syphilis in Germany: A Retrospective Model Analysis. Front Public Health 2022; 10:883564. [PMID: 35558533 PMCID: PMC9086961 DOI: 10.3389/fpubh.2022.883564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/31/2022] [Indexed: 11/13/2022] Open
Abstract
Background A multi-dimensional model can be a useful tool for estimating the general impact of disease on the different sectors of the healthcare system. We chose the sexually transmitted disease syphilis for our model due to the good quality of reported data in Germany. Methods The model included gender- and age-stratified incident cases of syphilis (in- and outpatients) provided by a German statutory health insurance company, as well as seroprevalence data on syphilis in first-time blood donors. Age standardized rates were calculated based on the standard German population. The test quality was assessed by extrapolating the number of false-positive and false-negative results based on data from Europe-wide external quality assessment (EQA) schemes. The model analysis was validated with the reported cases and diagnosis-related group (DRG)-statistics from 2010 to 2012. The annual direct and indirect economic burden was estimated based on the outcomes of our model. Results The standardized results were slightly higher than the results reported between 2010 and 2012. This could be due to an underassessment of cases in Germany or due to limitations of the dataset. The number of estimated inpatients was predicted with an accuracy of 89.8 %. Results from EQA schemes indicated an average sensitivity of 92.8 % and an average specificity of 99.9 % for the recommended sequential testing for syphilis. Based on our model, we estimated a total average minimal annual burden of €20,292,110 for syphilis on the German healthcare system between 2010 and 2012. Conclusions The linking of claims data, results from EQA schemes, and blood donor surveillance can be a useful tool for assessing the burden of disease on the healthcare system. It can help raise awareness in populations potentially at risk for infectious diseases, demonstrate the need to educate potential risk groups, and may help with predictive cost calculations and planning.
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Affiliation(s)
- Renata Šmit
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Nathalie Wojtalewicz
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Laura Vierbaum
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Farzin Nourbakhsh
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
| | - Ingo Schellenberg
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
- Center of Life Sciences, Institute of Bioanalytical Sciences (IBAS), Anhalt University of Applied Sciences, Bernburg, Germany
| | - Klaus-Peter Hunfeld
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
| | - Benedikt Lohr
- Northwest Medical Centre, Medical Faculty, Academic Teaching Hospital, Institute for Laboratory Medicine, Microbiology and Infection Control, Goethe University, Frankfurt, Germany
- INSTAND e.V. Gesellschaft zur Foerderung der Qualitaetssicherung in Medizinischen Laboratorien e.V, Duesseldorf, Germany
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Du WY, Yin CN, Wang HT, Li ZW, Wang WJ, Xue FZ, Zhao L, Cao WC. Infectious diseases among elderly persons: Results from a population-based observational study in Shandong province, China, 2013-2017. J Glob Health 2022; 11:08010. [PMID: 35003717 PMCID: PMC8710039 DOI: 10.7189/jogh.11.08010] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background The health of the elderly is one of the major challenges in today's ageing society. However, research on infectious diseases among the elderly is limited. This study aimed to describe the epidemiological characteristics and dynamics of infectious diseases among the elderly population aged ≥60 years in Shandong province, China. Methods Incidence data for infectious diseases were collected from the Shandong Multi-Center Healthcare Big Data Platform from January 2013 to June 2017, which involved 550 432 elderly persons. We compared the incidence of each infectious disease and disease category, stratified by age, gender, and region. Annual percentage change (APC) was estimated using logarithmic linear regression to examine the incidence trends. Poisson regression was conducted to identify the effect of demographic factors on incidence, with incidence rate ratio (IRR) and their 95% confidence intervals (CIs) estimated. Results A total of 27 595 cases of 102 infectious diseases were reported during the study period, with an overall incidence of 1425.51/100 000 person-years. The most common infectious diseases were respiratory and mucocutaneous diseases among the elderly persons, with annual increases of 17.45% and 20.44%, respectively (both P<0.05). In rural areas, the incidence of respiratory, gastrointestinal, blood- and sex-transmitted, and mucocutaneous infections increased significantly, with APCs of 178.52%, 204.66%, 28.24%, 63.01%, respectively (all P<0.05). Elderly males had a higher risk of infections than that of females, with the highest IRRa of 2.94 (95% confidence interval (CI) = 2.89, 3.00) in respiratory diseases. The elderly aged 85-89 years had a much higher risk of respiratory diseases than those aged 60-64 years (IRRa = 9.85, 95%CI: 9.39, 10.33); however, the risk of blood- and sex-transmitted diseases was highest among the elderly aged 65-69 years (IRRa = 1.24, 95% CI = 1.06, 1.45). Conclusions Ageing population are facing a substantial challenge on infectious diseases. More attention should be paid to infections with significant growth. Targeted strategies and measures on elderly persons in different regions and subgroups are urgently needed.
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Affiliation(s)
- Wan-Yu Du
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Chao-Nan Yin
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Hai-Tao Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Zhen-Wei Li
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wen-Jing Wang
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Fu-Zhong Xue
- Department of Biostatistics, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Lin Zhao
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,Department of Occupational Health and Occupational Medicine, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
| | - Wu-Chun Cao
- Institute of EcoHealth, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China.,State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
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