Consult about China's first type H1N1 influenza epidemic situation and prevent and control

Consult about China's first type H1N1 influenza epidemic situation and prevent and control
Staff reporter Meng QingPu First type H1N1 influenza wreaks havoc in the whole world for nearly two months, how to assess the measure of prevention and control of China? Infect the constant increase of the case with the native country, should the country adjust the tactics of prevention and control? Compared with world, what kind of characteristic does China make a definite diagnosis of the case and appear again? A few days ago, Beijing Branch of the Chinese Medical Association (the medical association of Beijing) Invite some domestic disease accusing of, clinical domain experts to discuss. The case " draws a portrait " Still China's disease accuses of centre's meeting an urgent need and doing to Deputy Director Yu HongJie and saying within the controllable range to present several great characteristic epidemic situations, infect case, compare with in the world several tens of thousands of example, domestic case quantity too little, only according to figure being enough to reflect the intersection of epidemic situation and overall situation and severity. Synthesize and make a definite diagnosis of the epidemiology investigation result of the case at home, reveal that there are several characteristics. Report case count occupy the first 5 province ' Municipality directly under the Central Government) It is Beijing, Guangdong, Fujian, Sichuan, Shanghai respectively, account for 80% that all cases counted; Have obvious the intersection of region and characteristic, mostly the intersection of port and developed, the intersection of overseas Chinese and many foreign the intersection of contacts and many and the intersection of tourist resources and abundant district. In view of time, after the first case appears in the first ten days of May, nearly have case reports every day, peak to have illness coming on around May 30. Half the in the case is foreign students, it is analyzed that the reason perhaps has a holiday with aesthstic school of the north in mid-May, a large number of foreign students come back home to have something to do. The peak the second report appears to have illness coming on in the first ten days of June, the reason is not clear yet at present. The gender characteristic men and women of the case do not have prominent difference. By the look of age composition, take at 10 years old - 30 years old cases 70%- 80%, 0- 9Few over accounting for 10%, 60 at years old. But this age composition which has represented the tourist, does not represent the whole crowd propagates the situation. Come in more than one month, gather 29 examples of venereal disease altogether at home, involve more than 100 and make a definite diagnosis of the case, accounts for 50%, 4 among them gets up to happen in two generations of native country and spreads. View from the point of making a definite diagnosis of the clinical manifestation of the case, the overwhelming majority is a light disease, do not enter the patient of ICU so far, only a few cases amalgamate symptoms such as pneumonia,etc.. Analyze, the present influenza patient is not for treating the need in hospital in terms of epidemiology, and the need of isolating. Yu HongJie says, it may be the future to gather venereal disease example and native country and break out the first type H1N1 influenza of our country mainly propagates the mode, with the intersection of case and increase of base figure, may appear serious disease die case even. Analyze with existing condition, influenza large to prevail healthy to of our country resident and social influence of economy very much difficult to judge, all in all, the epidemic situation is still within the controllable range. Propose revising the scheme of making a diagnosis as soon as possible The antiviral medicine should be used in " The cutting edge " Have it according to the introduction of expert, at present, the definite diagnosis case reported at home is all hospitalized for treatment, have nearly all used antiviral medicines such as Damien's Philippines,etc. while treating. The first hospital in Peking University breathes head of the department Wang Guang and sends thinking, by the look of clinical manifestation of the case, most first type H1N1 influenza light disease patients do not need hospital treatment. He says, according to American expert's report, from the end of April to mid-May, U.S.A. makes a definite diagnosis of several hundred cases for example, but there is only hospital treatment of the patients of 5.4%, the majority, for the patient of basic diseases such as the elderly or amalgamating chronic pulmonary tuberculosis, fat,etc. among them finally. In these patients who is hospitalized for treatment, only 50% have employed antiviral medicines such as Damien's Philippines,etc.. The expert says, use the antiviral medicine in a large amount, it is apt to make the virus able to bear nature, it is apt to increase and is able to bear the mixing again of medicine one, initiate the virus to make a variation. Meanwhile, the antiviral medicine which the country should store to influenza largely and prevailingly at present, all add up 3% that can only cover the whole crowd, reaches only 20% of Philippines among them, can only cover 0.6% of the crowds. No matter the weight of disease uses Damien's Philippines without exception, waste resources. Advise the related departments to revise the scheme of making a diagnosis of first type H1N1 influenza as soon as possible, confirm the case is admitted to hospital the standard, standardize drug use, guarantee that employs the antiviral medicine to the serious disease patient really needing it. After more than twenty percent of the patients quarantine to find the intensity of domestic prevention and control should adjust the first type H1N1 influenza epidemic situation and take place in right time through the port, our country has established " to stop up input outside, inner non-proliferation " Prevention and control tactics. According to expert's report, our country makes a definite diagnosis of 80% of case in order to input the venereal disease example at present, in that 73% of the cases come from U.S.A., 16% come from Canada. There are 24% that quarantine and discover through the port to make a definite diagnosis of the case, prove that it is obvious to strengthen the quarantine measure result of the port. Under the background of fact that the venereal disease example still accounts for most to import at present, " stop up input outside " Tactics still demand insist on. Vary with epidemic situation, if the native case exceeds the input venereal disease example gradually, can consider changing the tactics. In " inner non-proliferation " The respect, Wang Guang sends and says, in order to safeguard the public to be healthy to the greatest extent, in the initial epidemic situation is unidentified, present a large number of to die under the situation of the case in Mexico, the government classifies Model A H1N1 influenza as infectious disease and prevents and cures the class-B infectious disease that France stipulates, and manage in the light of class-A infectious disease and implement case the report, a report on day, help the epidemic situation to control, but the social cost that pays is very high. Seen from the present, except that popular against season, first type H1N1 influenza is undifferentiated from seasonal influenza, and seasonal influenza is class-C infectious disease. Proceed from the reality, the government should reduce infectious disease of the first type H1N1 influenza and define the level as soon as possible. Ministry of Public Health breathes head of the department Lin JiangTao to think, turns down the intensity of prevention and control of our country's first type H1N1 influenza as soon as possible in Chinese-Japan Friendship Hospital, can save social resources effectively on one hand, on the other hand the government including hygiene system can vacate more energy and do sufficient preparation bigly and popularly for future second wave. As to this, PLA general hospital respiratory medicine Professor Liu would rather, last head of the department Cai to last head of the department expert such as the XiuHong Nies to agree BaiQiang, Beijing Xuanwu Hospital at BJ Union Hospital. They think the method of U.S.A. is worth drawing lessons from. The U.S. government great to influenza prevails and relatively pays attention to, monitoring system and data of seasonal influenza are all very complete. U.S.A. deals with the principle with large and prevailing influenza, adjust the measure intensity according to spread characteristic and clinical severity of disease. The clinical consequence of the present first type H1N1 influenza is minor, it is in hospital rate and case fatality rate are not higher than usual seasonal influenza. So, U.S.A.'s disease accuses of centre's already turning down the intensity of the control measure of the epidemic situation. However, influenza and peak that may appear to autumn and winter, U.S.A. has already drawn up overall plan, include strengthening the domestic epidemic situation to monitor and coordinate with information, further increase the reserve against virus medicine, revise the antiviral guide, improve medical service ability, dispose the production, distribution of vaccine and inoculate etc. on a large scale. The relevant department is assessing the epidemic situation risk and replying the second wave especially popularly according to the introduction of expert, different epidemic situation developing stage, There are different tactics of prevention and control. The relevant department is assessing the epidemic situation risk at present, ferment action of the new round of prevention and control. The total principle is: Until our country appear community break out and in front of the a large number of native case, prevention and control measure change to long-efficiency monitoring and preventing and controlling by the intersection of cost and low influenza progressively. If the epidemic situation community appears to break out, will no longer make a definite diagnosis of every first type H1N1 influenza patient through the laboratory, the light disease case does not need to be in hospital, the hospital treats and cures the serious disease case with all strength; Monitor the influenza virus variation tendency generally infected with in crowds especially, and pay close attention to the situation of key crowds of students in middle and primary schools, the elderly,etc.. On this basis, because the intersection of virus and second, the intersection of third and epidemic situation might initiated to make a variation make technology, preparation of goods and materials to future. The national influenza Shu YueLong, director of centre says, more than 300 first type H1N1 influenza virus and a gene sequence in the world reveal, its high homology, has not obviously made a variation at present. This may relate to the fact that the virus prevail for time shorter. There are for essential feature of influenza virus on variation,but why become, when be if you can't become, clear, it is very necessary to do sufficient preparation. Wang Guang sends and says, compared with several materials with big and prevailing influenza in history, the present first type H1N1 influenza case fatality rate is lower than the great influenza of 1918, slightly higher than the great influenza in 1957 and 1968; Infect the index ' Weigh the index that the virus propagates ability) It is higher than several times in the past, possess great and popular potentiality. The historical materials reveal, influenza is great to last to prevail from one year to 2 at least, often the first wave of diseases is relatively light, the second wave just begins to present more multiple disease case. So, should put the eyes a little farther in counter-measure. Yu HongJie shows, different from medical treatment at different levels of developed country, the residents of our country see the doctor to generally all go to the hospital, and like going to the large hospital. Once more cases appear in the future, there are the hospital, especially large hospitals, how to control the courtyard to be infected with, medical worker's infectious disease is prevented and cured, put in place etc., it is the question that the government and hospital administrator must consider. In addition, should lead the public to realize the function of vaccine correctly. Vaccine antigenic content, pharmaceutical time, appraisal of security are under the uncertain situation at present, discuss too early the function of vaccine, immune tactics meaning are not big. Generally speaking, vaccine inoculation is certainly orientated as the high-risk group at first.

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