Prevention and control scheme of human infection with H7N9 avian influenza (first edition)
This plan is formulated in order to realize early detection, early reporting, early diagnosis, early isolation and early treatment of human cases infected with H7N9 avian influenza, control the spread and spread of the epidemic, and ensure people's health and life safety.
I. Purpose
(1) Early detection of human cases infected with H7N9 avian influenza.
(two) standardize the case discovery, reporting, epidemiological investigation, laboratory testing, close contact management and other epidemic disposal work.
(three) to guide all localities to carry out the prevention and control of human infection with H7N9 avian influenza.
Second, the scope of application
This scheme is suitable for the prevention and control of human cases infected with H7N9 avian influenza at this stage.
At present, the source of infection, infection risk factors, transmission route, incubation period, infection period, clinical characteristics and interpersonal communication ability of the virus are still unclear. This plan will be updated according to the deepening of scientific understanding of the disease and the change of epidemic situation.
Three. Case discovery and report
(1) The definition of the case.
1. Monitoring cases. At the same time meet the following four conditions:
(1) fever (underarm temperature ≥ 38℃);
(2) It has the imaging features of pneumonia;
(3) At the early stage of the disease, the total number of white blood cells decreased or became normal, or the differential count of lymphocytes decreased;
(4) It cannot be diagnosed as pneumonia caused by common pathogens from the clinical or laboratory point of view.
2. For the definition of suspected cases and confirmed cases of human infection with H7N9 avian influenza, please refer to the Diagnosis and Treatment Plan for Human Infection with H7N9 Avian Influenza (20 13No. 1 version) (Wei Power Generation [2013] No.5).
(2) Findings and reports. All kinds of medical institutions at all levels should report directly to the network within 24 hours after discovering cases that meet the definition of monitoring. Select "Other Infectious Diseases" as the category of reported diseases, and indicate "Monitoring Cases of Human Infection with H7N9 Avian Influenza" in the remarks column. Medical institutions that do not have the conditions for direct online reporting shall report to the local county-level disease prevention and control institutions by the fastest means of communication (telephone, fax, etc.). ) within 24 hours, and send infectious disease report card, county-level disease prevention and control institutions should immediately report directly to the network after receiving the report.
All kinds of medical institutions at all levels should report the suspected cases and confirmed cases of human infection with H7N9 avian influenza directly within 2 hours. Select "other infectious diseases" as the category of reported diseases, and indicate "suspected or confirmed cases of human infection with H7N9 avian influenza" in the remarks column. Medical institutions that do not have the conditions for direct online reporting shall report to the local county-level disease prevention and control institutions by the fastest means of communication (telephone, fax, etc.). ) within 2 hours, and send an infectious disease report card. After receiving the report, the county-level disease prevention and control institutions should immediately report directly to the network.
Four. Epidemiological investigation, sampling and detection of cases
(1) epidemiological investigation. County (city, district) disease prevention and control institutions shall, after receiving the suspected cases or confirmed cases of human infection with H7N9 avian influenza reported by medical institutions or medical personnel within their jurisdiction, conduct an investigation according to the Epidemiological Investigation Scheme of Human Infection with H7N9 Avian Influenza (Annex 1), focusing on the basic situation, clinical manifestations, contact and exposure of suspicious animals (such as poultry and pigs) and farmers' markets within 7 days before and after the onset of the disease.
(two) specimen collection, preservation, transportation and laboratory testing. Medical institutions shall collect relevant clinical samples of cases in time. Clinical specimens collected include upper respiratory tract specimens (including throat swab, nasal swab, nasopharyngeal extract, throat lavage fluid and nasal lavage fluid), lower respiratory tract specimens (such as tracheal aspirate, lung lavage fluid and lung tissue specimens) and serum specimens. Respiratory tract specimens (especially lower respiratory tract specimens) should be collected as early as possible, and acute serum and convalescent serum should be collected within 7 days of onset, with an interval of 2-4 weeks. If the patient dies, the family members should be persuaded to agree to the autopsy as much as possible, and the autopsy should be carried out in time to collect tissue samples (such as lung tissue, trachea and bronchial tissue).
Specimen collection, preservation, transportation and laboratory testing shall be conducted in accordance with the Strategy for Specimen Collection and Laboratory Testing of Human Infected with H7N9 Avian Influenza Virus (Annex 2).
After collecting the clinical specimens of the cases, the county-level disease prevention and control institutions and the medical institutions that treated the cases should cooperate closely, package them in accordance with the relevant provisions of biosafety, and send them to the local national influenza network laboratory for testing within 24 hours. Around the influenza surveillance network laboratory should carry out nucleic acid detection, network laboratories with corresponding biosafety conditions can carry out virus isolation, and send the isolated virus to the National Influenza Center in time as required. Network laboratories that have not carried out virus isolation should send the original samples of cases with positive nucleic acid detection to the National Influenza Center in time as required.
In the provinces where people are infected with H7N9 avian influenza, sentinel hospitals carry out routine influenza-like case monitoring, and the number of influenza-like case samples collected is not less than 15 per week, and H7 nucleic acid detection is included in routine detection items.
Verb (abbreviation of verb) case management and infection prevention
According to the requirements of Technical Guide for Hospital Infection Prevention and Control of Human Infected with H7N9 Avian Influenza (20 13 Edition) (Wei Power Generation [2013] No.6), measures such as disinfection, hospital infection control and personal protection shall be implemented.
Tracking and management of close contacts of intransitive verbs
(1) definition.
(1) Medical staff who have not taken protective measures during the diagnosis and treatment of suspected or confirmed cases or family members who have cared for patients;
(2) Persons who have lived together or had other close contact during the period from the onset of suspected or confirmed cases to isolation treatment;
(3) Other personnel who meet the requirements as judged by the on-site investigators.
(2) Tracking management.
The health administrative department at the county level shall organize the follow-up management of close contacts, implement medical observation/health follow-up for close contacts, and shall not restrict their activities. Take 1 time temperature every morning and evening to find out whether there are symptoms of acute respiratory infection. In case of fever (underarm temperature ≥37.5℃), cough and other symptoms of acute respiratory infection, they should be immediately transferred to local designated medical institutions for diagnosis, report and treatment.
Disease prevention and control institutions are responsible for specimen collection and laboratory testing. Two serum samples should be collected from all close contacts of the case (at the beginning of medical observation and 2-4 weeks after the interval), and throat swabs should be collected from close contacts when they have acute respiratory symptoms, and sent to the local national influenza network laboratory for testing.
The medical observation period is 7 days after the last contact with the case without effective protection.
Seven, timely risk assessment.
Health administrative departments at all levels should promptly organize experts to carry out risk assessment and judge the epidemic situation according to the epidemic situation of human infection with H7N9 avian influenza and the progress of etiological research. When reaching the standard of public health emergencies, the corresponding emergency response mechanism should be started in time according to the relevant plans, and the response should be terminated in time according to the relevant regulations.
Eight, do a good job in health education.
All localities should actively carry out public opinion monitoring, actively publicize epidemic prevention and control knowledge and risk communication according to the hot issues concerned by the public and society and the progress in understanding diseases, guide the public to establish correct risk awareness, and promote the public to form correct disease prevention behaviors. In particular, it is necessary to strengthen health education and risk communication for livestock breeding, capture, slaughter, storage, transportation, trading and management personnel and pet owners in livestock farms, free-range households, slaughterhouses and wholesale trading markets.
Nine, strengthen the training and supervision and inspection of medical and health institutions.
Professionals in medical and health institutions are trained in the discovery and reporting of human cases infected with H7N9 avian influenza, epidemiological investigation, specimen collection, laboratory testing, case management, infection prevention and control, and risk communication. , improve the prevention and control ability.
Health administrative departments at all levels shall be responsible for organizing supervision and inspection of the prevention and control work within their respective jurisdictions, and handling problems in a timely manner when found.