The ministry of health issued by the general office of influenza-like cases outbreak disposal guide (2012 edition) notice

Who do disease control hair [2012] no. 133

        All provinces, autonomous regions, municipalities directly under the central government health TingJu, xinjiang production and construction corps health bureau, China centers for disease control and prevention:

        In order to promote the flu outbreak response disposal work, the protection of the people's life safety and body health, our organization has formulated the influenza-like cases outbreak disposal guide (2012). Hereby printed and distributed to you, please link to the reality, refer to.

General office of the ministry of health

On November 5, 2012

Influenza-like cases outbreak disposal guidelines

(2012 edition)

        A general,

        (a) purpose.

        In order to regulate the influenza-like cases outbreak disposal and management, improve the institutions at all levels of influenza-like cases outbreak disposal ability, do early discovery, early reporting, early treatment, take timely measures to the prevention and control, to effectively control the spread of the epidemic, spreading, and protect the public health and public health and safety are hereby formulated guidelines.

        (2) the applicable scope.

        Suitable for health administrative departments at all levels, disease prevention and control and medical institutions and occurrence of influenza-like cases outbreak in the unit did not reach the standard emergency influenza outbreak disposal work.

        Second, the outbreak related definition

        (a) influenza-like cases: fever (armpit or temperature and ℃), with a cough or sore throat, the lack of one of the laboratory diagnosis of a disease to determine the basis.

        (2) influenza-like cases outbreak: refers to a region or unit short time abnormal increase of epidemiology associated influenza-like cases.

        Third, the discovery of outbreak and report

        (a), 1 weeks, in the same school, 'institutions or other collective units appear 10 cases and above influenza-like cases, timely by phone or fax belong to DeXian (district) level of institution of disease prevention and control report. County (district) level of institution of disease prevention and control, upon receipt of such report shall be immediately to verify the epidemic. After verification confirmed outbreak, through the "China influenza monitoring information system" report epidemic event related information (annex 1).

        (2), 1 weeks, in the same school, 'institutions or other collective units appear more than 30 cases and influenza-like cases occur, or more than 5 patients and hospital admissions for flu-like symptoms (not including clinic staying cases), or the occurrence of 2 patients with influenza-like cases more than death, the disease prevention and control institutions at or above the county level shall, after verified in 2 hours through the sudden public health incident management information system for the report.

        (3) to report to public health emergencies of the information management system of influenza-like cases outbreak, verified for influenza outbreak, all laboratory diagnosis and clinical diagnosis cases were to carry out case network direct quote, and in the sudden public health incident report management information system "in the case of the association. In the "China influenza monitoring information system", for the detection of influenza network laboratory or disease prevention and control institutions shall be responsible for entering epidemic sample laboratory test results. Responsible for the outbreak investigation of disposal of institution of disease prevention and control should be in "sudden public health incident report management information system" fill "influenza-like cases outbreak sampling and testing results table" (attachment 2), and based on the laboratory testing conducted to fill content update; At the same time, according to the request and make progress report and the final report.

        Four, outbreak investigation

        (a) epidemiological survey. After receiving the report, territorial disease prevention and control institutions shall be immediately according to the definition of influenza-like cases diagnosed, to verify whether for influenza-like cases outbreak, verified outbreak should carry out epidemiological survey.

        1. The outbreak of the basic information about the unit and the related factors survey. Contents include: the outbreak of collective unit name, address, reporter, contact way, epidemic spread number; Unit departments (school class) distribution, health conditions and production activities form (teaching methods, such as full-time, night school and boarding, etc.), Nearly two weeks because of sickness absence (absent); A week before the event and after the incident collective activities; Environmental conditions (ventilation, clean condition, dormitory situation), etc. When necessary to carry out special investigation, collecting influence the spread of disease related factors, assessment of the severity of the disease and the development trend.

        2. Case search. Disease prevention and control institutions, township health center (community health service center) related professionals by looking at the morning (afternoon) inspection records, absence records, clinic or medical institutions and medical record one department or class survey methods such as active search influenza-like cases.

        3. Case study. Disease prevention and control institutions can refer to "influenza-like cases investigation list" (attachment 3) and "flu cases severe and death case questionnaire" (annex 4), against influenza-like cases for case study.

        4. Epidemic tracking. Epidemic treatment period, an outbreak unit to the dependency of institution of disease prevention and control unit of the daily report new cases. When necessary, the institution of disease prevention and control of new cases investigation and verification timely, accurate grasp and evaluate epidemic trend, adjust the prevention and control measures.

        (2) specimen collection. To achieve the report standard influenza-like cases outbreak and epidemic disease prevention and control institutions shall place collection outbreak cases sample.

        1. Sample types. Acquisition of influenza-like cases of pharyngeal swab, nose swab, nose swabs, when necessary, can at the same time acquisition acute phase and convalescence double serum sample.

        2. Sampling requirements. The collection should be within three days of respiratory specimens, and give priority to the acquisition of new cases of respiratory specimen; According to the distribution characteristics of the cases, balanced sample selection object, avoid concentration in the same department or class, dormitory. Severe cases and deaths as far as possible all specimens collected. If the accord with influenza-like cases diagnosis standard specimen less, for the specific nature of disease, can be appropriately expand sample range, collect the temperature was 37.5 ℃ ℃ with cough, headache or muscle pain and symptoms of cases. The outbreak of each should be collected at least ten copies of respiratory specimen (if XianZheng cases less than 10 cases, should all sampling). Can't clear etiology diagnosis of disease, can take into consideration the increase sampling batch number and sampling.

        The acute phase serum acquisition object: within 7 days after the onset of influenza-like cases.

        Convalescence serum acquisition object: 2-4 weeks after the onset of influenza-like cases.

        3. Sample preservation and shipping. Specimen collection personnel to fill in "influenza-like cases specimen original registration inspection table" (attachment 5), along with specimen transported to a flu monitoring network laboratory. Sample preservation and transportation of specific methods refer to the national influenza monitoring technology guide "(CDC disease hair [2011] no. 381).

        (3) sample testing. Influenza monitoring network laboratory received outbreak specimen, the requirements in the 24 hours of nucleic acid detection method using flu virus subtype identification, have the flu virus separation ability of the network laboratory should further to influenza virus nucleic acid detection positive samples virus separation. Specific methods and requirements see the national influenza monitoring technology guide ".

        (4) epidemic nature judgment principle. The nature of the outbreak should be combined with clinical and epidemiological and laboratory test results for comprehensive analysis and judgment.

        Five, disease control

        After the outbreak occurred, should take corresponding prevention and control measures.

        (a) case management.

        1. Heating (or temperature and ℃), or temperature was 37.5 ℃ with fear cold, cough headache, muscle ache is advised its timely medical treatment, according to the doctor's advice to take home or hospitalization. Rest period to avoid taking collective activities and in the public places.

        Patients place unit assigned personnel responsible for tracking record in hospital or severe cases of outcome and report to the local disease prevention and control institutions.

        2. The body temperature to restore normally, other flu-like symptoms disappeared after forty-eight hours or according to the doctor suggested, patients can be normal school or work.

        (2) strengthening monitoring. Guidance of institution of disease prevention and control should be within the jurisdiction of the medical institutions do influenza-like cases monitoring report; Guidance of influenza-like cases happened outbreak school and child-care institutions strengthen daily inspection system, because of sickness absence registration system, found influenza-like cases in the short term anomaly should be increased, the education administrative department, and at the same time, the report to the local health department report. According to the medical institutions, schools, nursery institution and other sources of information report situation, carries on the comprehensive analysis, evaluate epidemic trend, find the flu outbreak began timely warning.

        (3) environment and personal hygiene. Pay attention to keep the classroom, dormitory, canteen and other places of the air circulation, often open a window ventilated, keep the air fresh. Collective units and public places should be regular cleaning, keep the environment clean.

        Pay attention to personal hygiene, often air basks in bedding, frequently change clothes, to wash their hands often, not sharing towels handkerchief, etc. Cough and sneeze with paper towel or sleeve cover mouth and nose, appear after flu-like symptoms or contact with the patient to wear masks.

        (4) health education. To carry out health education, the outbreak of unit can use posters, blackboard newspaper, folding and inform letters form publicity health prevention knowledge.

        (5) drug therapy. For the laboratory diagnosis of severe flu cases and appear flu-like symptoms in patients with chronic diseases such as influenza, the elderly high-risk groups, must carry on the antiviral drug therapy, drugs could be preferred Oseltamivir (Oseltamivir) and tie the m wei (Zanamivir), unconditional place to reference the local resistance monitoring results choose paraffin amine drugs (amantadine, rimantadine). If preventive medicine, should by the administrative departments of public health organization expert argumentation.

        (6) other measures. Influenza-like cases during the outbreak, chronic disease patients, the elderly, babies and infants and to reduce or avoid high-risk groups to participate in collective activity. According to the actual situation, can reduce or stop the school and the collective activities of the unit, as far as possible to reduce and avoid the students, staff contact, avoid all or more staff meetings, limit foreign personnel to enter. Necessary conditions according to expert advice to take measures such as closed, holiday.

        Six, epidemic situation assessment and summary

        Influenza-like cases happened outbreak, the local health administration department shall, according to the epidemic situation, organize relevant departments to carry out evaluation to emergent public health events should be standard, according to the relevant plan timely start the corresponding emergency response mechanism.

        Continuous 1 week no new cases, can determine for outbreak is over, after 1 weeks, responsible for the disposal of epidemic disease prevention and control institutions to epidemic disposal summarize the report, and the content includes the timeliness, information integrity, disposal of normative, etc.

        Seven, organization and management

        When local appear influenza-like cases outbreak, the relevant departments should actively carry out the prevention and control measures. Specific duties are as follows:

        (a) the public health administrative department. Organization, coordination epidemic investigation and handling of the works, the organization carries out the medical treatment, positive guidance, publicity departments to strengthen communication and cooperation.

        (2) of institution of disease prevention and control. Outbreak in information collection, Responsible for the investigation and verification and processing and epidemic situation report, etc; Guidance jurisdiction collective units in the prevention and control of infectious diseases; Carry out prevention and treatment of infectious diseases, publicity education and health promotion activities.

        (3) medical institutions. Discovered in time and report influenza-like cases outbreak; Responsible for case diagnosis, treatment and management; Completes the nosocomial infection control; Assist of institution of disease prevention and control to epidemiological investigation, as well as clinical correlation sample collection work.

        (4) an outbreak unit. Discovered in time and report influenza-like cases outbreak; Actively implementing the morning school inspection system, absence (absent) monitoring, reporting and management system; Strengthen and department of health information communication, actively cooperate with the investigation of the health department and the implementation of the measures, Actively carry out patriotic health campaign, clear health garbage and dead Angle; Do unit supporting facilities (such as hand washing equipment, etc.) of the equipment.