Influenza prevents the control technology instruction ' 2008 edition)

Influenza prevents the control technology instruction ' 2008 edition)
Influenza prevents the control technology instruction ' 2008 edition)
Influenza is the acute respiratory tract infectious disease caused by A, B, C three type not influenza virus. Since 1977, popular influenza virus was A(H1N1) in the whole world every year , A(H3N2) With B type. From will it be 1 day incubation period such as disease to 4 day ' Average 2 days) ,Main clinical manifestation, for generating heat, myalgia, having a headache, dry cough, throat aching and rhinitis,etc., present limit since generally, most patient symptom can relieve 7 day 3 day. Basic disease influenza and viral pneumonia can take place, become more serious previously to some patients, or continue bacterial pneumonia of the hair, nasal sinusitis, otitis media and other amalgamation to infect, the serious one causes the death. Influenza can cause every age group crowd to have illness coming on, among them children's infection rate is the highest. But high-risk group such as the elderly, infant and pre-school children and chronic disease patient,etc., incidence of influenza complication, rate and mortality is the highest in hospital. Influenza virus is mainly and exposed to the surface of object that the virus pollutes to travel by the close quarter of respiratory tract droplets, may store air in, travel ' It is less than or equal to 5�� m droplets nuclearly and can be suspended in the air for longer time that containing virus particle) . Virus this travel fast, organization,etc. crowd assemble place to be easy to cause, break out in old people's home, school, nurseries and kindergartens. In the intersection of our country and northern area, influenza prevail autumn and winter, present, prevail peak from December to will it be January next year, summer propagate the basic stop, is shown as the characteristic prevails in typical temperate seasonality; In South China, have the intersection of influenza and activity, autumn and winter and next year (from July to August) every year while being the whole Can present two popular peaks, present popular mode of the tropical, subtropical area. The main tactics that influenza at present in our country prevents and cures are to strengthen influenza to monitor, participate in the global monitoring actively, popularize the influenza vaccinations, guide the using rationally of the antiviral medicine, do a good job of and break out investigation and control, the public who strengthens personal hygiene that respiratory tract infectious diseases such as influenza,etc. prevent guides. First, influenza monitoring system that the influenza monitors our country are that global influenza monitors the important component of the network. The characteristic and virus variation situation that the main purpose to monitor knows the activity intensity, season of influenza virus, offer the basis for poisonous choice of one of global vaccine. Influenza of our country monitors the network and made up of 197 sentry posts and some hospitals and 63 networks laboratory at present. Include the report of one kind of cases of influenza, influenza virus to separate determining, poisonous antigen of one, genetic characteristic and able to bear nature to analyze etc. in main content of the monitoring. The question appearing to the monitoring in recent years, each monitor the unit and should strengthen the work of the following aspects especially: (1) Some hospitals of every sentry post should be according to influenza the definition of one kind of cases and installation requirement of monitoring department strictly, report the total number of cases that one kind of cases of emergency call influenza of the door counts and goes to a doctor, input to " monitoring information system of China's influenza " every Monday . Weekend sum " 11 " , want, arrange the intersection of case report and work properly among the will it be long vacation the Spring Festival, stop, fail to report, report belatedly and lack the intersection of newspaper and phenomenon festivals or holidays. (2) Some hospitals of every sentry post should grasp the sample collection object strictly, guarantee the minimum sampling amount of every week, can't concentrate on assaulting and gathering the sample; Follow the technical requirement that the sample is gathered, kept and transported strictly, make great efforts to reduce the adverse effect on the virus separating rate of the above-mentioned links. The sample gathered should transport to and monitor the network laboratory in 24 hours at 4 ��; Ones that fail to send to in 24 hours, should put - 70 �� or the following is kept. (3) The staff members of the network laboratory should know virus inoculating, technology of going down to posterity skillfully, improve the blood which is reaped the virus to congeal and drip degree. After receiving the sample in the laboratory, should deal with the sample and inoculate the virus within 24 hours, and in 24 hours after finishing the virus to separate and appraise, include in " monitoring information system of China's influenza " of the result . Separated masculine gender as to MDCK cells, should continue inoculating chicken's embryo the primitive sample retained, separate the virus. Every laboratory is while employing China's disease to accuse of the standard that the national influenza centre in the centre issues and consult serum and appraise the virus, find that issues poisonous one that the standard serum HI result price is less than or equal to 20 to all, should send to the national influenza centre within 24 hours; Poisonous one of the others should be sent to the national influenza centre in 2 weeks after HI test is finished. (4) From October of 2008 to March of 2009, every provincial disease will accuse of centre's analyzing the monitoring data every week, key the intersection of analysis and the intersection of influenza and kinds of proportion of case, virus separate positive rate, monitoring finish indexes such as the timeliness,etc., through analyzing, observe, assess the activity situation of influenza in time, edit and release and monitor the bulletin, monitor the unit, medical organization, health authorities and China diseases at all levels and accuse of the centre feedbacking and report in the area under one's jurisdiction. (5) Difficult with the difference because of clinical manifestation and other airway infection of influenza, it is often popular peak season of pathogen of many kinds of respiratory tracts in autumn and winter, can't judge influenza virus activity power according to the proportion level of one kind of cases of influenza briefly. At all levels disease accuse of centre while analyzing the phenomenon of increasing of breathing problem, want, combine influenza virus, separate masculine gender, lead and make a definite diagnosis of influenza break out change of the intensity go on and study and judge synthetically. Can also launch the ad hoc survey that the emergency call of the door and patient's pathogenic table of respiratory tract in hospital form, in order to define the main reason why local breathing problem increases. Second, influenza vaccinations study in a large amount and a lot of the intersection of country and long-term practice prove, it is the most effective means to prevent influenza and complication to inoculate vaccine of influenza, the persons who can be planted in order to reduce notably suffer from the risk of influenza and influenza and relevant complication, at the same time can also reduce, suffer from behind the influenza passing to others' risk. Foreign relevant research show, children inoculate the intersection of influenza and protection of vaccine, it renders a service to be 77%~91% from 1 year old to 15 year old; The adult under the age of 65 inoculates vaccine of influenza and reduces 87% of the influenza relevantly and is in hospital; Over 60 after the old man inoculates vaccine of influenza, it is 58% to protect the relevant effectiveness of the breathing problem of influenza; The elderly inoculate the intersection of influenza and vaccine, can reduce, 27% correlated with pneumonia in hospital 70% influenza. Influenza vaccine used every year contains A( H1N1) , A( H3N2) With B type three kinds of poisonous one. Because of antigenic mutability of influenza virus, and of antibody not induced have protective action of crossing or protect to different malicious weak alternately, so, World Health Organization (WHO) Will monitor the result according to the whole world every year, recommend changing the poisonous one of vaccine. So, vaccine of influenza needs to inoculate and win effective protection every year. At present, vaccine of influenza belongs to class II vaccine in our country, is inoculated voluntarily by the citizen at one's own expense. It should be according to the relevant provisions of " vaccine circulation and immunization campaign management rule " that diseases at all levels accuse of the centre, the positive organization launches the propagation and education of the knowledge of influenza vaccinations activity, improve the public and health care personnel understanding that influenza is endangered and vaccine is applied, expand crowds, especially high-risk group's epidemic disease progressively The coverage rate of the seedling, make the increasingly many person get protection of vaccine. Medical care and health personnel popularize in vaccine of influenza and play a key role in rational application. Diseases at all levels accuse of organization's strengthening and endangering and protecting the propagation and education of knowledge with vaccine to medical care and health personnel's influenza especially, improve their understanding of vaccine of influenza, expand application in medical care and health personnel of vaccine, reduce the medical care and health personnel's chance to pass virus to the high-risk group of influenza effectively, and through recommendation and exemplary role of medical care and health personnel, improve the vaccine inoculation rate of the high-risk group. Diseases at all levels accuse of the centre while launching relevant health education, staff training, organizing and guiding vaccine inoculation, should get hold of the technological links of choosing, inoculating the procedure, taboo disease and inoculating the opportunity etc. of inoculating crowd, dosage form preferably especially: (1) Vaccine type, antigenic group sanction going on the market in 2008 in one and our country of applicable age group to deactivate vaccine vaccine of 2009 influenza, including cracked vaccine and sub-unit vaccine, can be used for being greater than or equal to 6 months old crowd to inoculate. The one of vaccine group of influenza in Northern Hemisphere was from 2008 when WHO recommended to 2009: A/Brisbane/59/2007( H1N1) Similar one, A/Brisbane/10/2007( H3N2) Similar Corporation B/Florida/4/2006 (Yamagata is) Similar one. Infant and pre-school children dosage form is 0.25ml, includes a hemagglutinin 7.5�� g of each kind of group, is applicable to the infant and pre-school children from 6 months to age of 35 months; Adult dosage form is 0.5ml, includes a hemagglutinin 15�� g of each kind of group, is suitable for being greater than or equal to children and adult age of 36 months. (2) Propose, inoculate crowd in principle preferably, inoculating the unit should offer the immune service for the fact that all is willing the person of vaccine inoculation. But because whom different crowd suffer from behind the influenza in hospital rate, complication incidence and mortality different, and such factors as the annual vaccine supply of our country is limited, should recommend after suffering from influenza preferably the crowd with taller risk take place in complication, and there are bigger chances to infect and inoculate personnel of the high-risk group against influenza virus. At present, vaccine of influenza of our country employs the tactics and confirms that the crowd's relevant research is less to have priority, use research evidences and application experience for many years of other countries for reference, combine the national conditions of our country, the crowd is as follows that the suggestion inoculates preferably: 1. The crowd of complication with taller risk takes place after suffering from influenza. ( 1) Infant and pre-school children from 6 months to age of 59 months; ( 2) Greater than or equal to the 60 -year-old old man; ( 3) Suffer from chronic pulmonary tuberculosis ' Including asthma) , cardiovascular vessel disease ( Except the essential hypertension) , nephropathy, hepatopathy, blood disease or metabolize disease ( Including diabetes) Adult sum children; ( 4) There are adult and children that immunity inhibited the state, including the immune inhibition that causes because of taking medicines or HIV to infect; ( 5) Adult and the children (if cognitive obstacle, spinal damaging, epilepsy suffering from disease of nervous system for a long time, or other neural muscle diseases,etc.) ,Endanger and breathing function, or can't deal with the intersection of respiratory tract and secretion, or because suffer from disease this and increase foreign matter, suck risk, or person that can't look after oneself in the lung normally; ( 6) Accept the intersection of aspirin and children and teenagers of treatment for a long time ' From 6 months to 18 years old) ; ( 7) Personnel living in the home for the aged, sanatorium and other chronic sickness nursing organizations for a long time; ( 8) Prepare to the pregnant women in influenza season. 2.There are personnel that bigger chances passed influenza virus to the high-risk group. ( 1) The staff members of the home for the aged, sanatorium and other chronic sickness nursing organizations; ( 2) Less than or equal to the infant and pre-school children of 59 months old, greater than or equal to old man, high kinsfolks who endanger personnel of other influenza 60 years old, and look after, attend to their personnel, especially look after <6 months old baby's personnel; ( 3) Medical health care personnel. (3) Taboo disease 1. Crowd allergic to egg and any kind of vaccine composition. 2.Intermediate or severe acute patient who generated heat. 3.Persons who have suffered from Green's syndrome in Bali. 4.Other situations should inoculate again after consulting a doctor. (4) Vaccine stores vaccine and should be stored 8 �� at 2 ��, can't freeze. Influenza vaccine after freezing can't be used. (5) Inoculate the procedure 1. Having never inoculated vaccine of influenza, or the previous year only inoculated for 6 months of a pharmaceutical influenza vaccine thed children 8 years old, propose inoculating 2 pharmaceuticals, the interval is greater than or equal to 4 weeks; Inoculate a pharmaceutical every year later. Other crowds only need to inoculate a pharmaceutical every year. 2.While inoculating, should grasp vaccine dosage form and the applicable crowd's age range strictly, can't adult dosage form( 0.5ml) Divided into two pharmaceutical times ' Every pharmaceutical 0.25ml) ,Inoculate two infant and pre-school children against, or use for the same infant and pre-school children in different time. 3.Proposing inoculating the route and leaving injecting for the intramuscular injection or deep cover, adult and children should choose the deltoid muscle of upper arm to inject, infant and pre-school children choose the outer intramuscular injection before the thigh. 4.Health care personnel should tell that is inoculated on variety, function, taboo, bad reaction and attentive matters of vaccine by persons who planted or its guardian before inoculating, inquire the health status of the persons who plant and inoculate situations such as taboos,etc., and record accurately to tell and inquire the situation. (6) Inoculate can produce and have antibody which protect competence after the opportunity adult inoculates vaccine of influenza for 2 weeks. The time that the annual influenza activity peak appear of all parts of our country is different from duration, propose the vaccine inoculation opportunity is as follows: 1. The vaccine inoculation of the beginning moves about before most areas in our country should be in every October, vaccine inoculation can run through the whole influenza high and take place season while serving, namely from October to the end of March of next year. 2.South China exist autumn and winter and next year ' From July to August) Two the intersection of influenza and prevailing peak, it is sustainable for vaccine inoculation to serve influenza high to take place season to will it be summer next year. 3.Even if vaccine inoculation unit just gets vaccine after October, should develop the activity of immunizing immediately. Third, resist the drug use of influenza virus Our country sanction, list use resist influenza virus medicine and include M2 albumen ionophore inhibitor ' Buddha's warrior attendant alkane amine and second amine of Buddha's warrior attendant) With neural amino acid enzyme inhibitor ' He of department Wei) Two kinds. Among them M2 albumen ionophore inhibitor is directed against A -type influenza virus, neural amino acid enzyme inhibitor is directed against A type and B -type influenza virus. Use the antiviral medicine to treat the acute influenza patients without complication, can shorten the course of disease, lighten its severity; Can also be used in the families, communities Prevent with influenza in the organization, prevent from exposing the crowd after making a definite diagnosis of a influenza patient and suffering from influenza. Use antiviral medicine prevent influenza, should consider expenses its, use the intersection of compliance and and bad reaction of crowd, and the medicine can't substitute vaccine inoculation. Influenza virus that national influenza monitors the network is able to bear the monitoring result of nature to reveal, our country present and popular A(H1N1) With A(H3N2) The virus M2 albumen is able to bear the location of medicine the poisonous proportions of sudden change take place and has already been up to 100%, has proposed not using alkane amine and second amine of Buddha's warrior attendant of Buddha's warrior attendant to treat and prevent influenza at present in some. At present, of our country the intersection of continent and area find, able to bear influenza virus of medicine to him of department Wei yet? ? Fourth, investigation and control that the influenza gets rich quick (1) Finish the intersection of influenza and kinds of disease, break out, investigate, can improve the intersection of laboratory and person who make a definite diagnosis of that influenza break out, obtain influenza virus and propagate the relevant parameter, appraise the intervention result against virus medicine of sum of rendering a service of vaccine protection of influenza, prevent the tactics from producing evidence in order to make and improve influenza. Diseases at all levels accuse of centre's paying close attention to influenza investigation and treatment that one kind of diseases break out, improve and break out the quality of the investigation. Diseases at all levels accuse of centre's strengthening and gathering the monitoring of the place infectious disease epidemic situation to crowds such as the nurseries and kindergartens organization, all kinds of school, home for the aged, sanatorium,etc. in the area under one's jurisdiction. The phenomenon that the airway infection patient increases of finding and generating heat, should investigate live immediately, gather patient's acute respiratory tracts sample as many as possible, give influenza to monitor the network laboratory to measure nearby. After receiving the sample in the network laboratory, should employ influenza to find fast reagent box and RT-PCR or Real-TimePCR method measure influenza virus at first. If the result is positive, should continue inoculating MDCK cell and chicken's embryo the primitive sample, separate and appraise the virus. (2) Break out clearly before diagnosing, should take and break out the control measure. School crowd assemble place take place when the intersection of influenza and kinds of patient obviously increase, can start the morning and examine the system, find patients in time; Should require patients to recuperate or is hospitalized for treatment at home, and try hard to avoid or reduce the contact with kinsfolks, classmate, teacher; Do a good job of the personal hygiene; According to severity and progress of the epidemic situation, can take measures of suspending classes etc.. Behind it confirm last epidemic situation influenza,can until " whether infectious disease last law " and provisions relevant " health event regulations of meeting an urgent needs public will happen suddenly ", use and resist influenza virus medicine to pay and break out to intervene. Fifth, the public who strengthens the personal hygiene propagate the public who strengthens respiratory tract infectious disease and prevents to propagate, the positive tissue launches the propagation and education in infectious disease preventive treatment knowledge of respiratory tract such as influenza activity. The knowledge main point propagated mainly includes: (1) Keep the good personal hygienic habit, sneeze, use the handkerchief or napkin at the time of the cough. Want, wash hand while being hardworking, sneeze, cough and clean behind the nose needing to wash hands even more; (2) Keep indoor airiness, the peak period prevails to go few the crowd assembles in the place; (3) Should wear the gauze mask when present airway infection symptom, let the doctor make a diagnosis and give treatment as soon as possible, and stay in home and have a rest. China Center for Disease Prevention and Control file ( China's disease accuses of disease and takes place) [2008]The 540th


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