Association between sanitary toilet coverage rate and intestinal infectious disease in Jiangsu Province, China

Intestinal infectious disease is one of the most common diseases in China and is prevalent worldwide. The Chinese government launched a toilet improvement campaign to improve sanitation and reduce the incidence of diseases. This study determined the association between sanitary toilet use and intestinal infectious disease incidence in Jiangsu Province, China during 2011–2019. This study adopted an ecological retrospective research design. All secondary data were obtained through government websites and government information disclosure channels. Multiple linear regression was employed to analyze the association between the incidence of intestinal infectious diseases and sanitary toilet coverage rate and other potential predictors. Data suggested that the aggregate annual incidence of Type A and B intestinal infectious diseases showed a downward trend, the aggregate annual incidence of other infectious diarrhea continued to increase, and hand–foot–mouth disease occurred every other year with the highest annual incidence rate. The incidence was higher in coastal cities. Multiple regression results indicated that the usage of three types of sanitary toilets, compliance rate of water quality, and average ambient temperature have an impact on intestinal infectious diseases. The aggregate annual incidence of Type A and B intestinal infectious disease was negatively correlated with the cumulative use of sanitary toilets (β = − 0.036) and surface water quality (β = − 0.135; p < 0.05). Increase in sanitary toilet use and water quality control can reduce the number of new cases, which will be beneficial for the population in the province. Moreover, the toilet improvement interventions should continue to maintain high-quality construction.

Shenling Baizhu Powder Inhibits RV-SA11-Induced Inflammation and Rotavirus Enteritis via TLR4/MyD88/NF-κB Signaling Pathway

Rotavirus enteritis (RVE) is a common acute intestinal infectious disease caused by rotavirus infection. It is an important cause of death in children younger than 5 years worldwide. Shenling baizhu powder (SBP), a classic traditional Chinese formulation, is one of the most popularly prescribed medicines for digestive diseases. Clinical studies have revealed the protective effects of SBP on RVE. However, the potential mechanism is still unclear. In this study, we aimed to evaluate the anti-rotavirus effect of SBP and its mechanism, focusing on the TLR4/MyD88/NF-κB signaling pathway. Our results demonstrated that, based on the inhibition of the virus-induced cytopathic effect in Caco-2 cells, the concentration for 50% of maximal effect (EC50) and selectivity index (SI) of SBP for RV-SA11 in the serum were 5.911% and 11.63, respectively. A total of 219 active compounds with oral bioavailability ≥30% and drug-likeness ≥ 0.18 were selected from the 10 ingredients present in the formulation of SBP, which acted on 471 potential targets. A total of 226 target genes of RVE were obtained from the GeneCards database. The protein-protein interaction (PPI) network showed that there was a close interaction between 44 common targets of SBP and RVE. The results of Gene Ontology (GO) and Kyoto Encyclopedia of Genes and Genomes (KEGG) enrichment analysis showed that SBP acted on RVE through various inflammatory pathways and the intestinal immune network. Subsequently, we investigated the effect of SBP on TLR4/MyD88/NF-κB signaling pathway in vitro. After infection with RV- SA11, the expression of TLR4, MyD88, and NF-κB mRNA and protein increased significantly, which could be abolished by SBP treatment. In addition, the IL-1β, TNF-α, IL-6, and IFN-β levels increased markedly in Caco-2 cells infected with RV-SV11. Treatment with SBP partly reversed the changes of IL-1β, TNF-α, and IL-6, while further increased the level of IFN-β. In conclusion, our study revealed that SBP can significantly inhibit rotavirus replication and proliferation in vitro. The antiviral effect may be related to the regulation of the TLR4/MyD88/NF-κB signaling pathway, followed by the down regulation of inflammatory cytokines and up regulation of IFN-β induced by rotavirus.

The acute inflectional gastroenteritis case complicated with the spontaneous esophagus rupture in a four-year-old child

The article describes a case of the spontaneous esophagus rupture (the Boerhaave syndrome) in a 4-year-old child developed simultaneously with an acute intestinal infectious disease. The main reasons of prolonged diagnostic process are poor awareness of most of the medical specialists about the Boerhaave syndrome, the rarity of the disease and the diversity of clinical implications. Any case complicated with this orphan disease needs an emergent surgery operation. The development of the Boerhaave syndrome ends fatally in most cases.

Gastrointestinal infections caused by consumption of raw drinking milk in England & Wales, 1992–2017

Systematic, national surveillance of outbreaks of intestinal infectious disease has been undertaken by Public Health England (PHE) since 1992. Between 1992 and 2002, there were 19 outbreaks linked to raw drinking milk (RDM) or products made using raw milk, involving 229 people; 36 of these were hospitalised. There followed an eleven-year period (2003–2013) where no outbreaks linked to RDM were reported. However, since 2014 seven outbreaks of Escherichia coli O157:H7 (n = 3) or Campylobacter jejuni (n = 4) caused by contaminated RDM were investigated and reported. Between 2014 and 2017, there were 114 cases, five reported hospitalisations and one death. The data presented within this review indicated that the risk of RDM has increased since 2014. Despite the labelling requirements and recommendations that children should not consume RDM, almost a third of outbreak cases were children. In addition, there has been an increase in consumer popularity and in registered RDM producers in the UK. The Food Standards Agency (FSA) continue to provide advice on RDM to consumers and have recently made additional recommendations to enhance existing controls around registration and hygiene of RDM producers.