Preventive measures of infectious diseases can be divided into: ① preventive measures when the epidemic situation does not appear; ② Epidemic prevention measures after the outbreak; ③ Treatment and preventive measures.
(1) Preventive measures
Before the outbreak, the first task is to do a good job in routine prevention. The main contents are as follows:
1. Units that may have pathogens in the external environment shall take measures to improve drinking water conditions and disinfect drinking water; Combined with urban and rural construction, do a good job in harmless manure, sewage discharge and garbage disposal; Establish and improve the rules and regulations of hospitals and pathogenic microorganism laboratories to prevent the spread of pathogenic microorganisms and nosocomial infection; In medical and health institutions, we should also vigorously implement the food hygiene law and carry out disinfection, insecticidal and rodent control work. Although the above work is mainly carried out by health and epidemic prevention and environmental monitoring departments, clinicians should also actively cooperate.
2. Vaccination, also known as artificial immunity, is to inoculate biological products into the human body, so that the body can produce specific immunity to infectious diseases, thereby improving the immune level of the population and preventing the occurrence and prevalence of infectious diseases.
(1) Vaccination type
Artificial active immunity (1): refers to the inoculation of immunogens to make the human body produce specific immunity. Immunogenic substances include treated pathogens or refined components and toxoids. Its preparation can be divided into:
Live bacteria (epidemic) vaccine: made of live bacteria (virus or rickettsia) strains with strong immunogenicity and weak virulence. Such as tuberculosis, plague and Brucella live vaccine, polio, influenza and measles live vaccine. Its advantages are that it can reproduce in vivo, stimulate the body for a long time, and have less inoculation amount and times. However, because it does not contain preservatives, it is easy to breed mixed bacteria when it is polluted. It must be frozen in general.
Dead bacteria (epidemic) vaccine: made by inactivating live bacteria (viruses, etc.). ) strong immunity. The advantages are no need for attenuation, simple production process, no preservatives, difficult growth of miscellaneous bacteria and easy preservation; The disadvantage is that the immune effect is poor and the inoculation amount is large. There are also polysaccharide vaccines made of bacterial components, such as meningococcal polysaccharide vaccine, which have better immune effect than general vaccines.
Toxoid: It is a non-toxic and immunogenic preparation made by adding formaldehyde to bacterial toxins, such as diphtheria and tetanus toxoid.
2) Artificial passive immunization: Inoculate the human body with serum or preparation containing antibodies, so that the human body can obtain ready-made antibodies and be protected. Because of the short half-life of antibodies, which is generally more than 25 days, it is difficult to maintain a lasting and effective immune level. It is mainly used when there is an epidemic.
Immune serum: the serum containing specific antibodies obtained by immunizing animals with toxins is called antitoxin. It is suggested that the effective immune component of gamma globulin is refined antitoxin, which contains less foreign protein and can reduce the occurrence of allergic reaction. Immune serum is mainly used for treatment and prevention.
Immunoglobulin (gamma globulin and placental globulin): It is made of gamma globulin extracted from human blood or placenta. It can be used as vaccination for susceptible contacts of measles and hepatitis A, but it can't prevent all infectious diseases, and it can't be abused as a universal therapeutic agent.
Passive active immunization: it is only an immunization method used to protect infants and weak contacts when an epidemic occurs. It has the advantages of passive immunity and active immunity, but it can only be used for a few infectious diseases, such as diphtheria. Can be intramuscular injection 1000 ~ 3000 units of diphtheria antitoxin, inoculated with refined diphtheria toxoid.
(2) Planned immunization: Planned immunization is based on the monitoring results of infectious diseases and the analysis of the immune level of the population. According to the scientific immunization program, the specific population is inoculated with vaccines in a planned way, and the corresponding infectious diseases are finally controlled and eliminated. Since the mid-1970s, China has made great achievements. Planned immunization organization management, technical guidance and cold chain system have been established from top to bottom in various places, and the vaccination rate has been continuously improved, and the incidence of corresponding infectious diseases has been steadily decreasing year by year. 1988 and 1990, respectively, China achieved the goal of 85% immunization coverage of children in provinces and counties, and passed the evaluation of the joint group of UNICEF, WHO and the Ministry of Health. At present, with the focus on polio eradication, the planned immunization in China has entered a new stage of controlling and eliminating corresponding infectious diseases.
1) Immunization products and diseases: The main content of planned immunization in China is to provide basic immunization for children under 7 years old with BCG vaccine, poliomyelitis trivalent sugar pill vaccine, DTP mixed preparation and measles vaccine, and strengthen immunization in due course in the future to immunize children against diphtheria, measles, poliomyelitis, pertussis, tuberculosis and tetanus. At present, the vaccination of hepatitis B vaccine in China has been included in the planned immunization management, but not in the planned immunization program. In some areas, the immunization of Japanese encephalitis and epidemic cerebrospinal meningitis is also included in the scope of planned immunization. With the development of planned immunization, it can be expected that other infectious diseases that are harmful to children's health and can be prevented by vaccines will also be included in the scope of planned immunization.
2) Immunization procedure of planned immunization: Immunization procedure is to make uniform provisions on what kind of vaccine to vaccinate children of different ages (months) according to the epidemiological characteristics, immune factors and health facilities of infectious diseases. Only by formulating a reasonable immunization program and strictly implementing it can we give full play to the vaccine effect and avoid waste. The contents of the immunization program include: the initial age of the first seed (the first dose), the inoculation interval of biological products, the time and age range of strengthening immunization.
Children's basic immunization: BCG 1, poliomyelitis trivalent mixed vaccine 3 times, DTP mixed preparation 3 times, and the shortest interval between two injections (twice) is one month; Live measles vaccine 1 needle. Require cities and regions equipped with cold chain equipment to complete basic immunization for children aged 12 months; Children who are not equipped with cold chain and in remote areas can finish it in1August; Pastoral areas (including semi-pastoral areas) and sparsely populated border areas can be completed within 36 months. At the same time, it is also required that the starting age of basic immunization should not be earlier than the prescribed immunization age in both urban and rural areas (but it can be postponed); The minimum interval between two stitches shall not be less than 28 days (but may be longer than 28 days). Only when the basic immunization is completed within the specified time can the vaccination be considered qualified. Whether children aged 0/2 in urban areas should be vaccinated with BCG depends on the local tuberculosis epidemic situation.
3) Implementing planned immunization:
① Organizational measures: Inoculation methods include fixed-point inoculation and decentralized inoculation, and fixed-point inoculation should be carried out in areas with conditions and possibilities to ensure inoculation quality and reduce vaccine loss. Vaccination personnel villages and towns are composed of primary health care departments (groups), and the prevention and protection groups (units and stations) of township hospitals are responsible for vaccination; In rural areas, the prevention and protection group of township hospitals or rural doctors are responsible for vaccination. In areas where there are no rural doctors and health workers, where the working attitude of rural doctors and health workers is not credible, and where the skills of rural doctors and health workers are not suitable, vaccination teams (detachments) can be organized to carry out vaccination.
② Vaccination dose and location: Effective vaccine, correct vaccination dose and vaccination route are the keys to ensure successful immunization. If the dose and route of vaccination are not appropriate, it may cause vaccination accidents, such as individual primary health organizations mistakenly treating BCG as a group of patients with deep abscess who are inoculated subcutaneously.
③ Inoculation implementation steps: Inoculation implementation steps and work requirements are as follows:
④ Contraindications of planned immunization vaccine.
According to the World Health Organization, vaccines used in planned immunization have almost no contraindications.
Children with fever, diarrhea and malnutrition can be vaccinated. When children have diarrhea, they can still take oral polio vaccine, but it is not included in the number of basic immunizations. Try again next time.
Parents or clinicians should encourage and mobilize sick children to vaccinate when they have concerns about vaccination; If you are still unwilling to accept it after persuasion, you can suspend vaccination and replant it in time after recovery;
Children who have a strong reaction to the first dose of DTP vaccine (convulsion, high fever, convulsion) should not be vaccinated with the second dose.
According to the actual situation of planned immunization in China, the principle of dealing with vaccine contraindications is to vaccinate children against six infectious diseases, such as measles, polio, whooping cough, diphtheria, tetanus and tuberculosis, in order to reduce their morbidity and mortality. 1The World Summit for Children in September 1990 adopted the World Declaration on the Survival, Protection and Development of Children and the Plan of Action for Implementing the World Declaration on the Survival, Protection and Development of Children in the 1990s. 199 1 In March, the Chinese Premier formally signed the above two world documents, and solemnly promised to achieve the goals stipulated in the documents. These two documents are related to the vaccination goal, and the contents are as follows: by the year 2000, polio will be eradicated globally; 1995 elimination of neonatal tetanus; By 1995, compared with before the implementation of planned immunization, the mortality rate of measles decreased by 95% and the incidence rate decreased by 90%, which is an important step to eliminate measles in the world for a long time; Maintain a high level of immunization coverage (after 2000).
Children who have been previously diagnosed with a clear history of allergies are generally not vaccinated (except oral polio vaccine);
Children with immunodeficiency can suspend vaccination and replant after recovery;
How to master the contraindications of various vaccines should be based on the instructions for vaccine use.
4) Cold chain: The implementation of planned immunization, cold chain is one of the important measures to ensure the quality of vaccination. The so-called "cold chain" refers to a series of equipment from the production unit to the user unit to ensure that the vaccine can be kept at the specified temperature during storage, transportation and inoculation.
5) Expanded Immunization Program: The World Health Organization put forward the Immu-n (EPI) expanded program, requiring that the vaccination rate of all children in the world should reach at least 90% at 1990 to prevent diphtheria, pertussis, tetanus, measles, poliomyelitis and tuberculosis.
The World Health Organization (WHO) adopted the resolution of 1995 on the goal of eradicating polio. China is located in the western Pacific region, so this solemn task is also our goal. Therefore, China's "Eighth Five-Year Plan" stipulates that by 1995, the coverage rate of planned immunization in towns and villages will reach 85%.
(3) Vaccination reaction
1) general reaction: within 24 hours after inoculation, local inflammatory reactions such as redness, swelling, pain and heat appeared at the inoculation site, and sometimes the nearby lymph nodes were swollen and painful.
The general reaction is normal immune reaction, which can disappear within 1 ~ 2 days without any treatment. If the reaction is strong, only symptomatic treatment is needed. If the intensity response in the vaccinated population exceeds 5%, the batch of vaccines shall not be used any more, and shall be reported to the higher health authorities for inspection and handling.
2) Abnormal reaction: A few people have complications after vaccination, such as syncope, anaphylactic shock, allergic encephalomyelitis, allergic dermatitis and angioneurotic edema. Although the probability of abnormal reaction is low, the consequences are often serious. If you encounter abnormal reactions, you should rescue them in time, pay attention to collecting materials, analyze them, and report to the higher health institutions.
3) Couple disease: Couple disease has nothing to do with vaccination, but it is mistaken for vaccination because of the coincidence of time. Encephalomyelitis often occurs occasionally in winter and intestinal infectious diseases often occur occasionally in summer, which can be distinguished by diagnosis. Vaccination should be carried out in strict accordance with the instructions, pay attention to the early symptoms of some infectious diseases at that time, try to avoid the occurrence of coupling disease, and at the same time do a good job in explaining the family members of patients.
4) Vaccination accident prevention: unqualified product quality, lax disinfection and aseptic operation or incorrect inoculation process (site, dosage and route) are often mistaken for vaccination reaction.
5) Response and treatment of vaccines used in planned immunization.
(4) Inoculation effect evaluation: Inoculation effect evaluation is mostly carried out by biological products institute or health and epidemic prevention station. The specific contents include immunological effect evaluation and epidemiological effect evaluation. The evaluation of epidemiological effect includes the observation of adverse reactions and the comparative analysis of the incidence of experimental group and control group. The evaluation of immune effect is to observe the changes of immune indexes of vaccinators.
3. Protective measures In the epidemic season of certain diseases, certain protective measures can be taken for susceptible people to prevent infection, such as using mosquito nets or repellents to prevent mosquito bites to prevent infections such as malaria, filariasis and Japanese encephalitis; When entering the "epidemic water" polluted by schistosomiasis, you can apply a protective agent (such as a fatty acid coating containing 2% niclosamide) to the exposed part of the skin, or wear anti-cercaria pants and socks sewn with niclosamide impregnated cloth to avoid infection with cercaria.
4. Inspection measures for carriers There are many infectious diseases of pathogen carriers, and the degree of harm is different. According to the disease, the carriers should be checked purposefully in this area. It can also be found in the health examination of recruits, enrollment of new students and recruitment. When necessary, parasites such as malaria and filariasis can be found through general survey. It is also possible to trace and find the pathogen carriers from the convalescent patients and their close contacts. It is necessary to carry out regular inspections on workers in special occupations, such as children's institutions, restaurants, milk factories and water plants, and chefs, because many epidemics are caused by these professional workers.
To establish a registration card, the management of the above-mentioned special professionals should be strict. When the carrier is found, it should be temporarily removed from work for treatment. If the treatment fails, they need to change their careers. At present, there is no satisfactory treatment for carriers of Japanese encephalitis surface antigen. We should strengthen the health education for carriers and their close contacts, correctly understand the possible harm of the carrier status to the surrounding people, consciously form good hygiene habits and take necessary measures.
Health education The usual health education is very important to prevent infectious diseases. It is one of the concrete contents of civilized life to develop sanitary habits such as washing hands before and after meals and not spitting. According to different diseases, we can publicize the symptoms and prevention methods of infectious diseases in a seasonal, planned and purposeful manner, popularize health knowledge and prevent diseases.
(2) Epidemic prevention measures
Refers to the measures taken to prevent the spread and calm down as soon as possible after the outbreak.
1. The key measures for patients are early detection, early diagnosis, early reporting and early isolation.
(1) Early detection and early diagnosis: The key to early detection of patients is to improve primary health care, improve the professional level and sense of responsibility of medical staff, and popularize public health knowledge. Diagnosis can include three aspects: clinical, laboratory examination and epidemiological data. Clinically, characteristic symptoms and signs can be diagnosed early, such as Koch's spot of measles and false membrane of diphtheria. But sometimes laboratory diagnosis is needed to be more objective and correct, such as false membrane smear detection of diphtheria bacilli. In the diagnosis of infectious diseases, epidemiological qualifications are often helpful for early diagnosis, such as patient contact history, past medical history, vaccination history and so on. In addition, age, occupation, season and other characteristics often have important reference value for early diagnosis.
(2) Infectious disease report: Epidemic report is the basis of epidemic management and national legal system. Therefore, it is an important legal duty for every clinician to report infectious diseases quickly, comprehensively and accurately.
1) reporting type: According to the Law on the Prevention and Control of Infectious Diseases promulgated by 1989, the legally reported diseases are classified into Class A, Class B and Class C, with a total of 35 kinds.
Class A infectious diseases: plague and cholera.
Class B infectious diseases: viral hepatitis, bacterial and amebic dysentery, typhoid and paratyphoid, AIDS, gonorrhea, syphilis, polio, measles, whooping cough, diphtheria, epidemic cerebrospinal meningitis, scarlet fever, epidemic hemorrhagic fever, rabies, leptospirosis, brucellosis, anthrax, epidemic and endemic typhus, epidemic Japanese encephalitis, kala-azar, malaria and dengue fever.
Class C infectious diseases: tuberculosis, schistosomiasis, filariasis, echinococcosis, leprosy, influenza, mumps, rubella, neonatal tetanus, epidemic hemorrhagic conjunctiva, infectious diarrhea except cholera, dysentery and typhoid fever.
The State Council can increase or decrease the diseases of Class A infectious diseases according to the situation and publish them; The administrative department of health of the State Council can increase or decrease the diseases of Class B and Class C infectious diseases according to the situation, and publish them.
2) Informants and reporting methods: All staff engaged in medical treatment, health care, sanitation and epidemic prevention are legal informants. When a legal reporter finds a class A infectious disease or a suspected patient, he should report to the health administrative department at the same level and the health and epidemic prevention professional institution at a higher level step by step in the fastest way.
When the legal reporter finds a patient or suspected patient of Class B infectious disease, he should report the epidemic situation by telephone or infectious disease card. When an epidemic situation is discovered, it should be reported to the county-level health and epidemic prevention station in the fastest way.
The legal reporter diagnosed or suspected patients with tuberculosis, schistosomiasis, filariasis, echinococcosis and leprosy in Class C infectious diseases, and reported the epidemic situation to relevant health and epidemic prevention stations according to regulations.
Influenza, infectious diarrhea except cholera and dysentery, mumps, rubella and neonatal tetanus among Class C infectious diseases are only monitored at monitoring points. The legal reporter of the monitoring point shall report the epidemic situation of the above five confirmed and suspected infectious diseases in accordance with the reporting method of Class B infectious diseases.
Suspected patients should be diagnosed or excluded as soon as possible, and a revised report should be issued. When the patient dies, receives treatment, becomes a carrier or has sequelae, a prognosis report should be made.
Fill in the infectious disease report card item by item, with clear handwriting to avoid missing items. /kloc-children under 0/4 must fill in their parents' names for epidemiological investigation.
3) Time limit for reporting: If patients or suspected patients with Class A infectious diseases are found, they should be reported to county-level health and epidemic prevention professional institutions within 6 hours in towns and 0/2 hours in rural areas; If patients or suspected patients with Class B infectious diseases are found, the epidemic situation should be reported within 12 hours. If an epidemic situation or epidemic situation is found, it should be reported to the county-level health and epidemic prevention professional institutions in the fastest way.
No unit or individual may conceal, falsely report or instruct others to conceal or falsely report the epidemic situation.
(3) Early isolation: Isolating patients is an effective way to prevent transmission. The isolation period depends on the longest infection period and inspection results of various infectious diseases (see appendix 1). Isolation requirements vary according to the type of disease.
1) Plague, cholera patients and pathogen carriers, AIDS and pulmonary anthrax must be hospitalized or isolated and treated by doctors. Refusing or not accepting treatment, leaving the hospital or leaving the hospital without authorization before the expiration of the isolation period, the diagnosis and treatment unit may request the public security department to order the patient to be hospitalized or re-isolated to continue treatment.
2) Patients with Class B infectious diseases are hospitalized or isolated under the guidance of doctors.
3) Patients with gonorrhea and syphilis must be cured. Medical personnel shall not spread the patient's medical history.
4) After the patient is discharged from the hospital or released from isolation and medical treatment, medical and health institutions or health and epidemic prevention professional institutions can continue to follow up and manage.
In addition to the above-mentioned diseases that must be isolated in hospitals, some infectious diseases can be isolated by establishing temporary isolation rooms or family isolation in institutions, residential areas and schools, and medical staff will diagnose, treat and care, and guide relevant personnel to disinfect and care.
Some patients with infectious diseases have little influence on the source of infection and do not need isolation. For some infectious diseases with more latent infections, taking measures to isolate patients cannot achieve the purpose of controlling the spread of diseases.
2. Measures for Contacts A contact refers to a person who has been exposed to the source of infection or may be infected and is in the incubation period. The following measures can be taken to prevent contacts from getting sick and becoming a source of infection.
(1) Emergency vaccination: For infectious diseases with long incubation period, contacts can be vaccinated automatically or passively. For example, when measles breaks out, children's contacts can be vaccinated against measles, and weak children can be vaccinated with gamma globulin or placental globulin.
(2) Drug prevention: For some infectious diseases with specific drugs, drugs can be used for prevention when necessary. For example, the antimalarial drugs pyrimethamine, chloroquine or primaquine are used to prevent malaria; Take quinpiprazole, synergistic sulfamethoxypyrazine or artemisinin to prevent drug-resistant malaria; Prevention of cholera with doxycycline; Use penicillin or sulfanilamide to prevent scarlet fever. To prevent drug abuse, so as not to waste drugs and increase the drug resistance of pathogens. Drug prevention is best used only for close contacts, not for general management.
(3) Medical observation: daily consultation and temperature measurement, and pay attention to the early symptoms of some contacts with serious infectious diseases.
(4) Isolation or observation: Contacts of Class A infectious diseases must be strictly isolated (whether contacts in old cholera epidemic areas are isolated or not depends on local conditions), and freedom of movement should be restricted while medical observation is carried out, and observation should be carried out at designated places.
The time for quarantine or detention of contacts shall be calculated from the date of the last contact, which is equivalent to the longest incubation period of the infectious disease.
3. Measures for the source of animal infection Livestock and other animals suffering from serious infectious diseases can be treated in isolation by the veterinary department. Necessary quarantine systems should be established for exported livestock to prevent the spread of plague. Livestock, livestock products or animal raw materials in epidemic areas must undergo quarantine before they can be transported abroad.
When most of the infected wild animals have no economic value, take killing measures, such as deratization (see Appendix 4 for the method of deratization). Some animal carcasses of infectious diseases should be burned and buried deeply, such as those with anthrax.
4. Measures taken for environmental pollution in key areas Due to different transmission routes, measures taken for environmental pollution in key areas are also different. Doctors in lots or medical staff in grass-roots units should pay special attention. Intestinal infectious diseases pollute the environment because of feces, so the focus of measures is to disinfect contaminated items and the environment. Respiratory infectious diseases pollute the environment through air, with emphasis on air disinfection, personal protection (wearing masks) and ventilation. Measures for vector-borne diseases focus on pest control (see Appendix III for pest control methods). Measures to spread infectious diseases through water focus on improving drinking water hygiene and personal protection.
Disinfection refers to the elimination and killing of pathogens on the transmission route, and does not require the killing of all microorganisms (called sterilization). Disinfection can be divided into preventive disinfection and key disinfection. Preventive disinfection refers to drinking water disinfection, air disinfection and dairy disinfection. Focal disinfection refers to the disinfection of existing or previously infected lesions, with the aim of killing pathogens discharged from infection sources.
Epidemic disinfection can be divided into immediate disinfection and terminal disinfection.
(1) Current disinfection: it refers to the timely disinfection of excreta, secretions and contaminated articles in key parts of existing infectious sources, so as to quickly kill pathogens, for example, timely disinfection of feces of patients with diseases. Because disinfection should always be carried out at any time, it is generally necessary to guide the patient's family members to carry out it, or it should be completed by the ward nursing staff.
(2) terminal disinfection: after the source of infection recovers, dies or leaves, thoroughly disinfect the epidemic spot. It should be clear which diseases need terminal disinfection. Generally, it refers to diseases in which pathogens can survive in the external environment for a long time before terminal disinfection. Pathogens of diseases with short survival time, such as measles, chickenpox, whooping cough and influenza, generally do not need disinfection. Before final disinfection, the disinfection scope and items should be clearly defined. Therefore, epidemiological investigation should be carried out before disinfection to consider the scope, items and methods of disinfection.
The main diseases that need final disinfection are:
Intestinal infectious diseases: cholera, typhoid fever, paratyphoid fever, diseases, viral hepatitis, polio, etc.
Respiratory infectious diseases: pneumonic plague, tuberculosis, diphtheria, scarlet fever, etc.
Animal infectious diseases: anthrax, plague, etc.
See Appendix II for disinfection methods.
(3) Therapeutic prevention
Correct and timely treatment of patients can prevent the infection process as soon as possible, reduce the role of infectious sources, and sometimes prevent patients with infectious diseases (such as typhoid fever and malaria) from forming pathogen carriers. Babies born by pregnant women with rubella in the first four months of pregnancy have a great chance of birth defects, so induced abortion can be considered to prevent the birth of defective fetuses.
(4) Preventive measures (actions) of collective institutions
The group structure characteristics and living conditions of collective institutions (operations) are unique, so their preventive measures are also very different. This section only expounds the preventive measures for nursery and collective field work. Chapter 10 "Occurrence and Control of Hospital Infection" introduces the preventive measures of the hospital.
1. Nurseries and kindergartens in nurseries and kindergartens are susceptible to infectious diseases, and are prone to outbreaks of infectious diseases, especially viral hepatitis, bacillary dysentery, viral diarrhea, chickenpox, mumps and viral upper respiratory infections.
(1) preventive measures: the key point is to strengthen health supervision and avoid the entry of infectious sources. Take in children, recruit teachers and nurses to have a physical examination, and there is a regular physical examination system. It is necessary to establish a reasonable system of picking up and dropping off children. When receiving a child, ask if you have been in contact with a sick child. In the morning check-up, we should carefully check whether there are early symptoms and signs, so as to get sick early. Health propaganda should be given to children and parents in order to obtain cooperation. Conscientiously implement the planned immunization work. It is necessary to do a good job in food hygiene, drinking water hygiene and environmental sanitation, and educate children to develop good personal hygiene habits.
(2) Epidemic prevention measures: immediately report the epidemic situation to the health and epidemic prevention station for guidance. Formulate epidemic prevention measures under the leadership of the unit, focusing on controlling the epidemic situation as much as possible so that it does not spread within the organization. Isolate and treat patients immediately. Close contacts (generally speaking, teams with the same activities) are isolated, that is, the team is isolated from other teams for medical observation, appropriate emergency vaccination, preventive drugs and disinfection. Suspend accepting new students until the epidemic is extinguished. Inform all parents, gain understanding and cooperation, and cooperate with them to put out the epidemic and avoid further spread.
2. Collective field work, such as water conservancy construction, road construction, exploration, land reclamation and army camping. Often concentrate more people to work or act together. Because of the large population mobility and poor living conditions, it is prone to the outbreak and epidemic of infectious diseases, such as bacillary dysentery, typhoid fever, viral hepatitis, leptospirosis, schistosomiasis, epidemic hemorrhagic fever, influenza and epidemic meningitis. Therefore, preventive measures should be taken before the operation begins.
(1) Preventive measures: Before the operation, medical personnel should be organized to go deep into the operation area for epidemiological reconnaissance. Understand the environment, drinking water sources, past and present diseases in this area, and ask the health and epidemic prevention departments in this area about infectious diseases and endemic diseases. Medical and health personnel should be organized before entering the site, and pre-job training should be done in combination with local special diseases and health problems. Choose a good living place, build a shed and kitchen, choose a good water source, build a toilet, do a good job in pest control, rodent control and disinfection, formulate the necessary health system, and require the units that send personnel to do a good health check in advance to avoid the entry of infectious sources, and do the necessary vaccination in advance, such as meningococcal polysaccharide vaccine and tetanus toxoid. After entering the site, carry out patriotic health campaign, do a good job in health propaganda, and establish an epidemic reporting system.
(2) Epidemic prevention measures: the key point is to prevent the spread of the epidemic and ensure smooth operation. Patients should be isolated and treated. Contact persons should be given appropriate emergency vaccination, drug prevention and disinfection to avoid getting sick. Report to the health and epidemic prevention department for guidance and help.
(5) Epidemic prevention measures for natural disasters
China has a vast territory, complex terrain and frequent natural disasters. Common natural disasters include earthquake, flood, drought, wind, hail and landslide. In the middle of the night of Tangshan earthquake 1976, residents were asleep, 240,000 people were killed and160,000 people were seriously injured. 199 1 In the summer of, Anhui, Jiangsu and other provinces suffered from catastrophic floods.
Since ancient times, there has been a proverb that "after a major disaster, there must be a major epidemic." It shows that the occurrence of infectious diseases is often accompanied by "catastrophe". Natural disasters can lead to the occurrence or prevalence of infectious diseases, because: ① the disorder of residents' living order; (2) The natural environment is destroyed; ③ There are three reasons for the damage of medical and health institutions. Although natural disasters have occurred, if we make proper decisions and take timely measures to control disasters, we can also control or reduce the occurrence of diseases and achieve the goal of "no major epidemic after the disaster". 1976 Tangshan earthquake and 199 1 catastrophic floods in Anhui, Jiangsu and other provinces in China, due to the wise decision of the central government, the effective measures of governments at all levels and the unremitting efforts of the people in the disaster areas, the epidemic diseases in the disaster areas have been reduced, basically meeting the requirements of "no major disasters after the disaster".
Epidemic prevention measures for natural disasters:
1. Before a disaster occurs, an emergency management mechanism should be established in disaster-prone areas to prepare for danger in times of peace. Make organizational, technical and material preparations.