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Human infection with the H7N9 avian flu prevention and control program (Second edition) (China Min. of Health, May 10 2013)
Source: China Ministry of Health, full page in Chinese: http://www.moh.gov.cn/mohjbyfkzj/s35...143c9396.shtml
WARNING: RAW Automatic translation.
Human infection with the H7N9 avian flu prevention and control program (Second edition)
Guidance throughout the specification to carry out prevention and control of human infection with the H7N9 avian influenza cases found, report, epidemiological investigation, laboratory testing, close contact with management, the protection of people's health and safety, formulated programs.
First, the scope
This program applies to medical and health institutions at this stage to carry out human infection with the H7N9 avian flu prevention and control work, and according to the in-depth understanding of the disease and epidemic situation changes timely updates.
Cases to detect, report
(A) case definition.
Suspected cases of human infection with the H7N9 avian influenza confirmed cases defined with reference to human infection with the H7N9 avian flu (2nd edition, 2013) "(Guardian invention of electricity [2013] 17).
2. Clusters of cases is refers to 7 days in a small range (such as a family, a community, etc.) found that more than 2 cases of and, prompts may exist spread from person to person or person of infection due to common exposure and infection of H7N9 avian influenza confirmed cases or suspected cases ( clusters of cases at least 1 confirmed case).
(B) detection and reporting. Various medical institutions at all levels for the treatment of influenza-like illness, to ask the birds or live poultry market exposure history, focus on live poultry breeding, slaughtering, sale, transportation and other industries crowd, the discovery of human infection with the H7N9 avian flu in cases, confirmed cases should be within 24 hours and 2 hours, respectively through disease surveillance information management system for direct reporting network. Report disease categories select other infectious diseases in people infected with H7N9 avian influenza. Does not have direct reporting network conditions of medical institutions, the fastest means of communication (telephone, fax, etc.) should be sent to the local county CDC reports and report cards, county CDC received a report immediately after the direct reporting network.
Epidemiological investigation, sampling and testing
(A) the epidemiological investigation. County level CDC received the report of the medical institutions in the area of human infection with the H7N9 avian influenza confirmed cases, in accordance with the Chinese Center for Disease Control to develop a "human infection with the H7N9 avian influenza epidemiological survey program should be investigated.
For single cases, the survey includes the basic situation of the case, after the onset of treatment, clinical manifestations, laboratory tests, diagnosis and prognosis, cases of family and home environment, exposure history, close contacts and so on. Cases may be exposed poultry rearing or trading places, should be collected bird faeces, the cages painted swab specimens environment specimens to carry out pathogen detection. If necessary, according to the investigation Organization to carry out active search of cases.
Clusters of cases on the basis of the work to the immediate investigation of suspected cases, and focused on investigating the epidemiological association between the the cases exposure history and case, homology analysis of virus isolated from cases and environmental samples clearly the existence of interpersonal communication or common exposure to infection.
(B) specimen collection, transport and laboratory testing. When the medical staff suspect that the patient was infected with the H7N9 avian influenza virus, should be collected as soon as possible on the lower respiratory tract (especially the lower respiratory tract) and the onset of the 7 days acute phase serum as well as with the acute phase serum acquisition time interval of 2-4 weeks serum .
Conditional medical institutions to carry out the nucleic acid testing to be carried out on respiratory specimens H7N9 virus nucleic acid detection, diagnosis of cases and guide the early use of antiviral drugs; conditions for nucleic acid detection, medical institutions should as soon as possible to take advantage of the rapid antigen detection kit for influenza A virus antigen detection, and detection of influenza virus antigen-positive specimens were sent to local Influenza Surveillance Network Laboratory to further develop the H7N9 virus nucleic acid detection. Specimen collection, packaging, transportation infect humans highly pathogenic microorganisms (viruses) species or sample transport regulations "(Ministry of Health Decree No. 45) should be strictly in accordance with the relevant provisions of the Biosafety.
With BSL-3 biosafety level conditions network laboratories need to immediately carry out virus isolation and virus isolated on demand promptly sent to the National Influenza Center; failure to carry out network laboratory for virus isolation H7 nucleic acid testing positive cases original specimens requirements promptly sent to the National Influenza Center.
Various medical institutions collected serum samples sent to the local Influenza Surveillance Network Laboratory by the local network laboratory, serum samples were sent to the provincial CDC and the National Influenza Centre carried out the antibody detection.
Specific operating points refer to the Chinese Center for Disease Control to develop a "human infection with the H7N9 avian influenza virus specimen collection and laboratory testing strategy.
Fourth, the Report
Various medical institutions at all levels and related personnel found that people infected with H7N9 avian influenza is suspected or confirmed cases, in accordance with the provisions of the fill in the infectious disease report cards, and direct reporting network information management system through the China Disease Surveillance.
Confirmed cases of reported cases of medical institutions but also through human infection with the H7N9 avian influenza information management system reported by the cases of the disease outcome information, and online reporting within 24 hours after their discharge or death of human infection with H7N9 avian influenza survey Table - clinical part "(see" epidemiological investigation of human infection with the H7N9 avian influenza program ").
Deaths, to fill out the medical certificate of death, cause of death registration report information system network direct reporting. After completion of the preliminary investigation, the area of jurisdiction of county CDC online reporting "of human infection with the H7N9 avian influenza questionnaire - epidemiological part of human infection with the H7N9 avian influenza epidemiological survey program (see" "), and according to the progress of the investigation in a timely manner to supplement and improve the questionnaire, updated daily close contacts under medical observation.
Has direct network report cases referral treatment, transferred out of the medical institutions of the cases entry cases of human infection with the H7N9 avian influenza information management system roll-out situation.
Medical institutions receiving cases through the system in this case information for the verification and entry cases treated.
Clusters of cases is confirmed, it should be within 2 hours of direct reporting network management information systems through public health emergencies report the progress report and the final report in a timely manner and according to the progress of the event.
CDC to carry out laboratory testing should be promptly entry specimen information and test results to the the Chinese influenza surveillance system.
, Case management and infection control
Medical institutions should refer to human infection with the H7N9 avian influenza hospital infection prevention and control technology Guide (2013 edition) "(Wei invention of electricity [2013]), to implement the isolation of patients, hospital infection prevention and control, and medical personnel protection measures.
CDC staff to carry out epidemiological surveys and sample collection should be good personal protection and guidance waders practitioners and poultry disposal of having a proper personal protection.
Suspicious exposure and management of close contacts
(A) suspicious exposure management.
The suspicious exposed exposed birds tested positive for the H7N9 avian influenza virus, the environment, has not taken effective protection of breeding, slaughtering, trafficking, transporting personnel and exposed.
To the county level health administrative departments (Health IPPF) in conjunction with the relevant departments of agriculture, industry and commerce, transportation and other organizations suspicious exposed to health inform, instruct fever (axillary temperature ≥ 37.5 ℃) and cough and other symptoms of acute respiratory infection timely medical treatment, and take the initiative to inform the poultry exposure situation.
(B) close contacts management.
Close contacts failed to take effective protective measures in the diagnosis and treatment of suspected or confirmed cases in health care workers or had to take care of the families of patients; 1 day before the suspected or confirmed cases of disease to be treated in isolation or death, have been living together with the patient or other staff; close contact situations or site investigators judgment is required in the management of close contacts to other personnel. Track by the county administrative department of health (health, family planning) of close contacts under medical observation, do not limit their activities, daily morning and evening each measuring body temperature, and learn about the symptoms of acute respiratory infections, temperature measurement may be close The contact own or uniform implementation by the medical and health institutions. Medical observation period from the last exposure or 7 days after no effective protection from contact with the cases occurred.
Once the the close contacts fever (axillary temperature ≥ 37.5 ℃) and cough and other symptoms of acute respiratory infections, and immediately forwarded to the designated medical institutions for diagnosis, reporting, and treatment. Close contacts of acute respiratory symptoms, but also collected swabs sent to the local Influenza Surveillance Network laboratory for testing.
Seven influenza-like illness intensified surveillance
In the occurrence of human infection with the H7N9 avian influenza confirmed cases counties (districts) should be carried out in cases diagnosed after a 2-week intensive monitoring. All secondary and higher medical institutions in line with the the ILI definition of door emergency patients, and hospitalized severe acute respiratory infection in patients, the respiratory specimens should be collected, asking exposure history, and in accordance with the Chinese Center for Disease Control to develop a "human infection with the H7N9 avian influenza The virus sample collection and laboratory detection strategies "to carry out inspection work.
Various medical institutions weekly summary and report the total number of influenza-like illness, hospital of severe acute respiratory infection the total number of patients, the number of sampling, the number of hospitals detection send CDC detecting the number of positive, and positive results.
The specific reported Referring to the technical requirements of the Chinese Center for Disease Control issued enhanced surveillance information reporting. Around according to working conditions appropriate to expand the scope of monitoring and time.
Areas of human infection with the H7N9 avian flu cases has not yet occurred, on the basis of the previous influenza-like illness monitoring, to improve the monitoring intensity.
In 2013, the increase in specimen collection and testing the number of the southern provinces of each influenza surveillance sentinel hospitals were collected weekly ILI cases of human infection with the H7N9 avian influenza specimens of 20 northern provinces from April to September 20 specimens were collected monthly 10 - March of the following year were collected weekly for 20 specimens sent the local Influenza Surveillance Network Laboratory to carry out detection.
8, in a timely manner the epidemic situation is judged
All levels of health (Health IPPF) administrative departments should be based on the situation of human infection with the H7N9 avian flu epidemic pathogen monitoring and research progress in a timely manner organize experts epidemic situation is judged to reach the standard of emergencies, timely initiation of appropriate emergency response mechanism should be in accordance with the relevant plan and termination of the response in a timely manner in accordance with the relevant provisions.
Nine, good health education
All localities should actively carry out the monitoring of public opinion, the hot issue of concern for the public and society, actively carry out epidemic prevention and control knowledge promotion and risk communication, guidance and to promote the public to develop good health habits, in particular to strengthen engaged in live poultry breeding, slaughtering, trafficking, transportation and other industries population health education and risk communication.
10 to strengthen professional training and supervision and inspection of medical and health institutions
Medical and health institutions should carry out human infection with the H7N9 avian influenza discovery and content of reports, epidemiological investigation, specimen collection, laboratory testing, case management and infection prevention and control, risk communication training.
All levels of health (health IPPF) administrative departments responsible for organizing the prevention and control work in the area of supervision and inspection, identify problems in time.
11, vigorously carry out the Patriotic Health Campaign
Patriotic Health Campaign Committee at all levels should play a coordinating role of Procedure, to strengthen the organization, management and supervision and inspection, combined with the towns of Health to create activities, mobilize the masses to mobilize grass-roots units to carry out the environmental health in urban and rural areas within the scope of concentration and control operations. Should focus on strengthening the health management of the farmer's market, efforts to solve the live poultry sales, highlight the health problems of the slaughter there.
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WARNING: RAW Automatic translation.
Human infection with the H7N9 avian flu prevention and control program (Second edition)
Guidance throughout the specification to carry out prevention and control of human infection with the H7N9 avian influenza cases found, report, epidemiological investigation, laboratory testing, close contact with management, the protection of people's health and safety, formulated programs.
First, the scope
This program applies to medical and health institutions at this stage to carry out human infection with the H7N9 avian flu prevention and control work, and according to the in-depth understanding of the disease and epidemic situation changes timely updates.
Cases to detect, report
(A) case definition.
Suspected cases of human infection with the H7N9 avian influenza confirmed cases defined with reference to human infection with the H7N9 avian flu (2nd edition, 2013) "(Guardian invention of electricity [2013] 17).
2. Clusters of cases is refers to 7 days in a small range (such as a family, a community, etc.) found that more than 2 cases of and, prompts may exist spread from person to person or person of infection due to common exposure and infection of H7N9 avian influenza confirmed cases or suspected cases ( clusters of cases at least 1 confirmed case).
(B) detection and reporting. Various medical institutions at all levels for the treatment of influenza-like illness, to ask the birds or live poultry market exposure history, focus on live poultry breeding, slaughtering, sale, transportation and other industries crowd, the discovery of human infection with the H7N9 avian flu in cases, confirmed cases should be within 24 hours and 2 hours, respectively through disease surveillance information management system for direct reporting network. Report disease categories select other infectious diseases in people infected with H7N9 avian influenza. Does not have direct reporting network conditions of medical institutions, the fastest means of communication (telephone, fax, etc.) should be sent to the local county CDC reports and report cards, county CDC received a report immediately after the direct reporting network.
Epidemiological investigation, sampling and testing
(A) the epidemiological investigation. County level CDC received the report of the medical institutions in the area of human infection with the H7N9 avian influenza confirmed cases, in accordance with the Chinese Center for Disease Control to develop a "human infection with the H7N9 avian influenza epidemiological survey program should be investigated.
For single cases, the survey includes the basic situation of the case, after the onset of treatment, clinical manifestations, laboratory tests, diagnosis and prognosis, cases of family and home environment, exposure history, close contacts and so on. Cases may be exposed poultry rearing or trading places, should be collected bird faeces, the cages painted swab specimens environment specimens to carry out pathogen detection. If necessary, according to the investigation Organization to carry out active search of cases.
Clusters of cases on the basis of the work to the immediate investigation of suspected cases, and focused on investigating the epidemiological association between the the cases exposure history and case, homology analysis of virus isolated from cases and environmental samples clearly the existence of interpersonal communication or common exposure to infection.
(B) specimen collection, transport and laboratory testing. When the medical staff suspect that the patient was infected with the H7N9 avian influenza virus, should be collected as soon as possible on the lower respiratory tract (especially the lower respiratory tract) and the onset of the 7 days acute phase serum as well as with the acute phase serum acquisition time interval of 2-4 weeks serum .
Conditional medical institutions to carry out the nucleic acid testing to be carried out on respiratory specimens H7N9 virus nucleic acid detection, diagnosis of cases and guide the early use of antiviral drugs; conditions for nucleic acid detection, medical institutions should as soon as possible to take advantage of the rapid antigen detection kit for influenza A virus antigen detection, and detection of influenza virus antigen-positive specimens were sent to local Influenza Surveillance Network Laboratory to further develop the H7N9 virus nucleic acid detection. Specimen collection, packaging, transportation infect humans highly pathogenic microorganisms (viruses) species or sample transport regulations "(Ministry of Health Decree No. 45) should be strictly in accordance with the relevant provisions of the Biosafety.
With BSL-3 biosafety level conditions network laboratories need to immediately carry out virus isolation and virus isolated on demand promptly sent to the National Influenza Center; failure to carry out network laboratory for virus isolation H7 nucleic acid testing positive cases original specimens requirements promptly sent to the National Influenza Center.
Various medical institutions collected serum samples sent to the local Influenza Surveillance Network Laboratory by the local network laboratory, serum samples were sent to the provincial CDC and the National Influenza Centre carried out the antibody detection.
Specific operating points refer to the Chinese Center for Disease Control to develop a "human infection with the H7N9 avian influenza virus specimen collection and laboratory testing strategy.
Fourth, the Report
Various medical institutions at all levels and related personnel found that people infected with H7N9 avian influenza is suspected or confirmed cases, in accordance with the provisions of the fill in the infectious disease report cards, and direct reporting network information management system through the China Disease Surveillance.
Confirmed cases of reported cases of medical institutions but also through human infection with the H7N9 avian influenza information management system reported by the cases of the disease outcome information, and online reporting within 24 hours after their discharge or death of human infection with H7N9 avian influenza survey Table - clinical part "(see" epidemiological investigation of human infection with the H7N9 avian influenza program ").
Deaths, to fill out the medical certificate of death, cause of death registration report information system network direct reporting. After completion of the preliminary investigation, the area of jurisdiction of county CDC online reporting "of human infection with the H7N9 avian influenza questionnaire - epidemiological part of human infection with the H7N9 avian influenza epidemiological survey program (see" "), and according to the progress of the investigation in a timely manner to supplement and improve the questionnaire, updated daily close contacts under medical observation.
Has direct network report cases referral treatment, transferred out of the medical institutions of the cases entry cases of human infection with the H7N9 avian influenza information management system roll-out situation.
Medical institutions receiving cases through the system in this case information for the verification and entry cases treated.
Clusters of cases is confirmed, it should be within 2 hours of direct reporting network management information systems through public health emergencies report the progress report and the final report in a timely manner and according to the progress of the event.
CDC to carry out laboratory testing should be promptly entry specimen information and test results to the the Chinese influenza surveillance system.
, Case management and infection control
Medical institutions should refer to human infection with the H7N9 avian influenza hospital infection prevention and control technology Guide (2013 edition) "(Wei invention of electricity [2013]), to implement the isolation of patients, hospital infection prevention and control, and medical personnel protection measures.
CDC staff to carry out epidemiological surveys and sample collection should be good personal protection and guidance waders practitioners and poultry disposal of having a proper personal protection.
Suspicious exposure and management of close contacts
(A) suspicious exposure management.
The suspicious exposed exposed birds tested positive for the H7N9 avian influenza virus, the environment, has not taken effective protection of breeding, slaughtering, trafficking, transporting personnel and exposed.
To the county level health administrative departments (Health IPPF) in conjunction with the relevant departments of agriculture, industry and commerce, transportation and other organizations suspicious exposed to health inform, instruct fever (axillary temperature ≥ 37.5 ℃) and cough and other symptoms of acute respiratory infection timely medical treatment, and take the initiative to inform the poultry exposure situation.
(B) close contacts management.
Close contacts failed to take effective protective measures in the diagnosis and treatment of suspected or confirmed cases in health care workers or had to take care of the families of patients; 1 day before the suspected or confirmed cases of disease to be treated in isolation or death, have been living together with the patient or other staff; close contact situations or site investigators judgment is required in the management of close contacts to other personnel. Track by the county administrative department of health (health, family planning) of close contacts under medical observation, do not limit their activities, daily morning and evening each measuring body temperature, and learn about the symptoms of acute respiratory infections, temperature measurement may be close The contact own or uniform implementation by the medical and health institutions. Medical observation period from the last exposure or 7 days after no effective protection from contact with the cases occurred.
Once the the close contacts fever (axillary temperature ≥ 37.5 ℃) and cough and other symptoms of acute respiratory infections, and immediately forwarded to the designated medical institutions for diagnosis, reporting, and treatment. Close contacts of acute respiratory symptoms, but also collected swabs sent to the local Influenza Surveillance Network laboratory for testing.
Seven influenza-like illness intensified surveillance
In the occurrence of human infection with the H7N9 avian influenza confirmed cases counties (districts) should be carried out in cases diagnosed after a 2-week intensive monitoring. All secondary and higher medical institutions in line with the the ILI definition of door emergency patients, and hospitalized severe acute respiratory infection in patients, the respiratory specimens should be collected, asking exposure history, and in accordance with the Chinese Center for Disease Control to develop a "human infection with the H7N9 avian influenza The virus sample collection and laboratory detection strategies "to carry out inspection work.
Various medical institutions weekly summary and report the total number of influenza-like illness, hospital of severe acute respiratory infection the total number of patients, the number of sampling, the number of hospitals detection send CDC detecting the number of positive, and positive results.
The specific reported Referring to the technical requirements of the Chinese Center for Disease Control issued enhanced surveillance information reporting. Around according to working conditions appropriate to expand the scope of monitoring and time.
Areas of human infection with the H7N9 avian flu cases has not yet occurred, on the basis of the previous influenza-like illness monitoring, to improve the monitoring intensity.
In 2013, the increase in specimen collection and testing the number of the southern provinces of each influenza surveillance sentinel hospitals were collected weekly ILI cases of human infection with the H7N9 avian influenza specimens of 20 northern provinces from April to September 20 specimens were collected monthly 10 - March of the following year were collected weekly for 20 specimens sent the local Influenza Surveillance Network Laboratory to carry out detection.
8, in a timely manner the epidemic situation is judged
All levels of health (Health IPPF) administrative departments should be based on the situation of human infection with the H7N9 avian flu epidemic pathogen monitoring and research progress in a timely manner organize experts epidemic situation is judged to reach the standard of emergencies, timely initiation of appropriate emergency response mechanism should be in accordance with the relevant plan and termination of the response in a timely manner in accordance with the relevant provisions.
Nine, good health education
All localities should actively carry out the monitoring of public opinion, the hot issue of concern for the public and society, actively carry out epidemic prevention and control knowledge promotion and risk communication, guidance and to promote the public to develop good health habits, in particular to strengthen engaged in live poultry breeding, slaughtering, trafficking, transportation and other industries population health education and risk communication.
10 to strengthen professional training and supervision and inspection of medical and health institutions
Medical and health institutions should carry out human infection with the H7N9 avian influenza discovery and content of reports, epidemiological investigation, specimen collection, laboratory testing, case management and infection prevention and control, risk communication training.
All levels of health (health IPPF) administrative departments responsible for organizing the prevention and control work in the area of supervision and inspection, identify problems in time.
11, vigorously carry out the Patriotic Health Campaign
Patriotic Health Campaign Committee at all levels should play a coordinating role of Procedure, to strengthen the organization, management and supervision and inspection, combined with the towns of Health to create activities, mobilize the masses to mobilize grass-roots units to carry out the environmental health in urban and rural areas within the scope of concentration and control operations. Should focus on strengthening the health management of the farmer's market, efforts to solve the live poultry sales, highlight the health problems of the slaughter there.
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