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is a new infectious disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which originated from Wuhan in China and has now spread globally. However, despite the concern focused on SARS-CoV-2, influenza virus continues to circulate and cause disease. Here we report a mixed infection. Physicians should be alert that a positive test for influenza does not rule out the possibility of COVID-19 disease. The SARS-COV-2 outbreak in late December of 2019 in Wuhan, China, has caused many infections and deaths globally. SRAS-COV-2 is a new respiratory tract transmitted disease mainly through respiratory droplet and close contact, aerosol but fecal-oral route is also suspected. As of March 19, 2020, a total of 23,473 cases, and 9840 deaths were reported. 1 In China, several respiratory viruses are also now active including influenza, parainfluenza virus, respiratory syncytial virus, adenovirus, and now SARS-COV-2. Unfortunately, according to the World Health Organization influenza website, 2 the respiratory illness indicators and influenza activity remained elevated overall in the northern hemisphere which are in a "flu" season. The weekly report of the influenza surveillance reported that the United States now has its highest pneumonia and influenza mortality since 2004, except for the 2009 pandemic. 3 During the SARS pandemic in 2003, Yang et al 4 found that the patients with fever, cough or sore throat had a 5% of influenza virus positive rate, and with SARS infection reportedly increasing at the meantime. This raises the concerns that there might be mixed infections of seasonal influenza and the novel coronavirus. Thus, we do think there might be a

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Background Men who have sex with men (MSM) are vulnerable risk group for human immunodeficiency virus (HIV)-1 infection. However, some MSM do not disclose their same-sex behavior and could impact the transmission and prevention of HIV-1 infection. Here, we evaluated the role of nondisclosed MSM in HIV-1 transmission in Guangzhou, China. Methods The HIV-1 pol sequences were obtained from HIV-infected subjects from 2008 to 2015. A transmission network was constructed using HIV TRAnsmission Cluster Engine (HIV-TRACE) at a pairwise genetic distance of 0.5%. The position of nondisclosed MSM in the network was determined by centrality analysis. Results Nondisclosed MSM were inferred in 9.92% (61 of 615) of slightly older, self-reported non-MSM (P = .006). They were more likely to be married (P = .002) and less educated (P < .001) than the MSM with whom they clustered. Closeness centrality was bigger for nondisclosed MSM than for MSM (P < .001), indicating the central position of nondisclosed MSM in the networks. The average shortest path length was smaller for nondisclosed MSM than for MSM (P < .001), whereas radiality was bigger for nondisclosed MSM than for MSM, suggesting a relatively greater contribution of nondisclosed MSM in transmitting HIV-1 than MSM. Assortativity analysis indicated that nondisclosed MSM were more likely to link each other with coefficient of 0.025. Conclusions Nondisclosed MSM are a specific group, and they play an important role in HIV-1 transmission. They could be bisexual and might increase the risk of HIV-1 infection to their sex partners. Therefore, specific prevention and intervention targeting nondisclosed MSM are urgently needed.