General office of national health and family planning commission

About the village card virus disease prevention and control plan (first edition)

The 2016-02-04 national health and population and family planning commission of the People's Republic of China

Who invented the electric [2016] no. 4

Provinces, autonomous regions and municipalities directly under the central government health and family planning commission, the xinjiang production and construction corps health bureau, the Chinese center for disease control and prevention:

Since 2014, the American village card virus infections, several countries in Europe, Asia, Australia and other places more than 10 countries and regions in the input case report. Recently, village card virus outbreak in Brazil. For domestic likely village card virus disease prevention and control of the preparation, by commission to make a "village card virus disease prevention and control plan (first edition)" (which can be downloaded from the national health and family planning commission website www.nhfpc.gov.cn). Hereby printed and distributed to you, please refer to execution.

Attachment: village card virus disease prevention and control program (first edition)

General office of national health and family planning commission

On February 3, 2016

The attachment

Village card virus disease prevention and control plan

(first edition)

Village card Virus Disease (Zika Virus get diseases) is caused by village card Virus (Zika Virus get) and a self-limited acute diseases spread by mosquitoes. Village card virus for the first time in 1947 in Uganda from rhesus monkeys were found in the body, in 1952 in Uganda and Tanzania to separate to the human body. 14 cases of village 2007 years ago, the world only report card virus disease sporadic cases, for the first time in 2007 in the chapel of the Pacific island nation of Micronesia island found village card virus outbreak, subsequently found village card virus infections and outbreak of countries and regions have increased. The first village in May of 2015, Brazil report card virus disease cases, by the end of January 2016, 24 American states and areas, such as Brazil's report local infection. At the same time, Europe, North America and other places of many countries, the report found that imported cases in Taiwan also report one case of imported cases from Thailand. In the village card virus outbreak occurs, countries such as Brazil neonatal microcephaly cases increased significantly, the existing evidence suggests that newborn microcephaly may be related to pregnant women village card virus infection. The rapid spread of the outbreak as well as the possible causal relationship with microcephaly, caused the wide attention of the international community.

Parts of southern China there is the media of village card virus aedes mosquitoes, in recent years, with the mode of transmission of similar imported dengue outbreak continues to increase, and in the southern part of the province caused a large-scale outbreak. As with the relevant national or regional personnel exchanges increasingly close, a village card virus risk in our country. Especially in southern China and aedes mosquitoes density is higher, once has the cases in the input, do not rule out the possibility of local spread in local area. For guidance around the village card virus disease prevention and control work, formulates this control scheme.

An overview, disease

(a) etiology.

Village is a yellow card virus (Flaviviridae) yellow virus genera (Flavivirus), spherical, diameter is about 40-70 nm, envelope. RNA genome for single strand is chain, length of about 10.8 Kb, divided into Asian and African type two genotypes, the current popular in South America virus for Asian. Village card virus and dengue virus of the genus as yellow virus, yellow fever and west Nile virus exists strong serological cross reaction. Virus in mosquitoes source cells (C6/36), mammalian cells (Vero), and other cells in the culture reproduction and disease.

Village card virus resistance is unknown, but yellow virus of the genus generally no acid, no heat, 60 ℃ for 30 minutes can be inactivated, 70% ethanol, 1% sodium hypochlorite, disinfectants, such as grease solvent, peracetic acid and ultraviolet irradiation can be inactivated.

(2) of epidemiology.

1. The source of infection and transmission media

Source: (1) patients, recessive infection and risk of village card virus nonhuman primates is the likely source for the spread of the disease.

(2) the media: aedes aegypti virus main media for village card, aedes albopictus and aedes Africa, yellow head aedes mosquitoes and other aedes mosquitoes can spread the virus.

According to the monitoring, our country related to village card virus to aedes species mainly aedes aegypti and aedes albopictus, including aedes aegypti mainly distributed in hainan, guangdong leizhou peninsula and xishuangbanna, yunnan province, dehong prefecture, lincang city and other regions. Aedes albopictus is widely distributed in China's vast areas of the south of hebei, shanxi, shaanxi.

2. The route of transmission

(1) the spread of mosquito-borne for village card is the main route of transmission of virus. Mosquitoes bite village card virus infection and infection, followed by the bites will infect others.

(2), communication between people.

Mother-to-child transmission (PMTCT) : ever since in placenta of pregnant women were detected village card virus, prompt village card virus can be transmitted through the placenta from mother to fetus. In addition, pregnant women have a village card viremia, may in the process of delivery village card the spread of the virus to the newborn. Was detected in the milk village card virus nucleic acid, but there is no village card virus infected newborn through breastfeeding.

Blood and sexually transmitted: village card virus may be spread through blood transfusion or sexual contact. So far, has been the report 1 case could spread through blood transfusions and cases of sexual contact transmission.

3. The population susceptibility

All groups, including pregnant women, generally for village card virus. Once infected village card virus may have immunity to infection again.

4. The incubation period and infected period

Incubation period (1) : currently, the incubation period of the disease is unclear, limited data suggest possible for 3 ~ 12 days.

(2) the infectious period: the patient's infection period is not yet clear, studies have shown that patients with early viremia, and infectious.

Regional distribution of 5.

Village card virus disease at present mainly in the americas, Africa, southeast Asia and the Pacific island countries and other countries and regions.

(1) distribution by 2014

Virus was found from 1947 to 2007 years ago, the village card virus disease mainly characterized by distributed, only 14 cases were confirmed human cases of infection.

July 4, 2007, Pacific islands of Micronesia chapel island in 185 cases of fever, headache, rash, conjunctivitis and joint pain and other symptoms of the patients, including 49 cases diagnosed with village card virus infection, no severe or fatal cases. After few years, the southeast Asia region of Thailand, Cambodia, Indonesia and new caledonia successively there were reports of sporadic cases.

In 2013-2013, is located in the south Pacific French Polynesia village card virus outbreak occurs, about 10000 cases of reported cases, including 70 cases of severe cases, including nervous system diseases (guillain-barre syndrome, meningoencephalitis) or autoimmune disease (thrombocytopenic purpura, leukopenia) complications.

(2) distribution since 2015

In may of 2015, Brazil reported the first confirmed village card virus infections, as of the end of January 2016, America has 24 countries and regions have reported local village card virus infections, including: Colombia, Brazil, Bolivia, Barbados, curacao, the Dominican republic, Ecuador, el Salvador, French Guiana, guadeloupe, Guatemala, Guyana, Honduras, Mexico, Martinique, Nicaragua, Haiti, SAN Martin, Puerto Rico, panama, Paraguay, suriname, us virgin islands, venezuela.

Since 2015, the north of the United States, Canada, Asia, Taiwan, China, Europe, Denmark, Finland, Germany, Italy, Portugal, the Netherlands, Spain, Sweden, the UK, Switzerland and other countries and regions, have found that village card virus input cases.

So far the Chinese mainland and Hong Kong and Macao region, there is no village card virus disease cases reported.

6. The winter characteristics

Onset time of year with the local media aedes ebb and flow, epidemic peak appeared in the fall. In the tropical and subtropical regions, village card virus disease all can come on all the year round.

(3) the clinical manifestations.

Clinical symptoms include fever, rash (mostly maculopapule), joint pain, muscle pain, conjunctivitis, and so on. Village card after virus infection, about 80% of the human inapparent infection, only 20% of people appear afore-mentioned symptoms, lasts 2 to 7 days after the self-healing, illness and death cases are rare.

Village card virus infection can result in a minority in the nervous system and immune system complications, pregnant women after infection may lead to neonatal microcephaly.

Second, diagnosis, and treatment report

(a) diagnosis.

Medical agencies at various levels shall be in accordance with the "village card virus disease diagnosis and treatment plan to do a good job of the diagnosis of related cases. Should be paid attention to during the diagnosis and diseases such as dengue fever, chikungunya.

Provinces found the first village card virus infection cases confirmed, should by the Chinese center for disease control and prevention laboratory tests confirmed after review. Severe cases, death cases and the outbreak of the index case and initial cases samples shall be sent to the Chinese center for disease control and prevention audit and testing laboratory.

(2) the report.

Medical institutions of various levels found village card virus disease suspected cases, the clinical diagnosis cases or confirmed cases, should be within 24 hours through the national information system for disease surveillance network straight newspaper, reported disease category select "village card virus disease" of other infectious diseases, such as imported cases should be stated in the note column source region, a unified format for "foreign input/X country or region" or "domestic input/X X X province city county".

Various counties (area) in the first case, temporarily in accordance with the requirements for public health emergencies within 2 hours local family planning administrative department of public health at the county level, and at the same time through a public health emergency information report for network management system. Received a report of the family planning administrative department of public health shall, within 2 hours of arrival, the people's government at the corresponding level and the higher the family planning administrative department of public health report.

(3) treatment.

The disease is usually self-limited disease, there is no specific antiviral drugs for the disease, mainly by symptomatic treatment clinically.

Third, laboratory testing

In accordance with the village card virus lab testing technology plan (appendix 1) cases and mosquito-borne specimen collection, packaging, shipping and laboratory tests.

Village card virus disease detection methods include virus nucleic acid detection, IgM antibody detection, neutralizing antibody detection and virus separation, etc. Village and yellow card virus belong to other viruses have stronger serological cross reaction, at present mainly adopts the virus nucleic acid detection.

To carry out the mosquito-borne village card virus detection, for adult mosquitoes or captured aedes mosquito larvae virus nucleic acid detection.

Village card virus belonged to three kinds of pathogens in our country, should be in a second laboratory biosafety laboratory (BSL - 2) detection. Should be in accordance with the "regulations on the administration of biological safety of pathogenic micro-organism laboratory" and related regulations, to do a good job of biological safety protection.

Fourth, epidemiological investigation

After receiving the case report of institution of disease prevention and control, should immediately organize professional conduct investigation, analysis of source of infection, search suspected cases, assess the risk of further infection and popular.

Cases found that the local infection, should carry out active search and mosquito-borne emergency monitoring, analysis of the epidemic dynamics, assess the popular trend, timely targeted control measures are put forward.

For all sporadic cases and outbreaks of the index case, initial cases, severe cases, death, and find out the epidemic situation to determine the nature and scope of investigation, according to the village card virus disease epidemiology investigation table (appendix 2) a detailed case study. Determined after epidemic nature of subsequent cases using "village card virus disease household surveys registration form" (appendix 3) collect epidemiological information briefly.

Five, the prevention and control measures

(a) prevention of input.

1. Pay attention to the international epidemic dynamics

Closely track the village card virus disease outbreak of the international progress information, dynamic in risk assessment, to formulate and adjust the strategy and measures to provide basis for prevention and control of local.

2. According to the need to issue a travel health tips

Around to assist foreign family planning department of public health, business, tourism and the entry-exit inspection and quarantine departments to village card virus disease endemic areas such as travelers and Chinese citizens overseas publicity and education and health tips.

3. The port health and quarantine

The health and quarantine departments once found suspected cases, shall be promptly notified to family planning departments for public health, make the outbreak investigation and disposal.

(2) cases of monitoring and management.

1. Case monitoring and early detection

Medical institutions at various levels and found that patients with fever, rash, muscle joint pain, attention should be paid to understand the patient's history of epidemiology (epidemic areas travel history), consider the possibility of this disease, and sampling inspection in time. In addition, for maternal infant appeared microcephaly, if there are any suspicious epidemiological history, also need to consider the possibility of village card virus infection.

2. Epidemiological investigation

To case study of relevant cases, major surveys the patient 2 weeks before the onset of the activities of the history, find out the suspicious infection site, looking for sources of infection; Survey incidence after a week of activity history at the same time, the search for case, assess the risk of infection and popular.

3. Case search

For input cases, should be detailed track travel history, key search in travel with staff. Such as cases from entry to the incidence after 1 week in county (district) activities, also search suspected cases should be living and working in the area.

In the event of a local infection sporadic cases, with cases of dwelling or adjacent several households, the cases of workplace activities such as place as the center, reference aedes range defined within a radius of 200 meters space as the core, 1 case infected people can delimit the multiple cores, search cases in the core zone. According to different building types, urban or rural speculation aedes range, appropriate to expand or narrow your search radius.

4. Case management

For acute cases of anti-mosquito isolation measures must be taken, anti-mosquito isolation period from the date of onset of not less than 7 days, and shall continue until the fever symptoms subside. Severe cases should be hospitalized.

Medical and health personnel in the diagnosis and epidemiological investigation, the standard protection should be taken. For case management and general hospital infection control measures on the basis of the medical institution shall implement the anti-mosquito mosquito measures to prevent nosocomial transmission.

(3) the media monitoring and control.

Media distribution area, except to do a good job of the above, still need to do a good job of vector surveillance and control.

1. The daily monitoring and control

The family planning administrative department of public health at all levels responsible for leading and organizing the local disease prevention and control institutions to develop community-based aedes density monitoring, including aedes species, density and seasonal ebb and flow, etc. Daily monitoring scope, method and frequency requirements with dengue fever, can consult the dengue vector aedes mosquito monitoring guide the routine surveillance.

When found mine medium aedes figure index and induced mosquito lure egg apparatus index of more than 20, shall promptly submit to the local government organizations to carry out the patriotic health campaign, removal of indoor and outdoor media breeding grounds for aedes and conduct preventive mosquito movement, reduce the density of aedes mosquitoes, in order to reduce or eliminate village card mosquito-borne diseases such as viral disease risk of outbreaks.

2. Emergency monitoring and control

Found in aedes activity season input or local village card virus disease cases of infection, should start the emergency monitoring. Medium aedes emergency monitoring area, the method and frequency requirements with dengue fever, can consult the dengue vector aedes mosquito monitoring guide of the emergency monitoring.

When there is a village card virus disease cases and within a radius of 200 meters of centered on foci of dahe index or a mosquito lure egg index 5, alert or lure core zone (exhibition) a radius of 200 meters of 10 or higher, or Mr. Figure or mosquito lure egg apparatus lure index greater than 20, aedes control should start the emergency media.

Medium aedes emergency control points including: completes the community mobilization, to carry out the patriotic health campaign, to do a good job of mosquito breeding sites clean; Education people do personal protection; Take accurate foci of emergency adult mosquitoes kill, etc., through comprehensive media aedes mosquito prevention and control measures, as soon as Mr. Figure or mosquito lure egg apparatus lure index control under 5.

(4) propaganda and communication.

Is out of the risk areas should be taken to a variety of effective forms, in a comprehensible way to carry out health education activities. Propaganda points include: village card virus disease by aedes mosquitoes (commonly known as tinea or spend anopheles mosquito bites spread; Aedes mosquitoes in the tank, birdbath, tires, flower POTS, vases, etc. Water container breeding; Clear water, double bowl can, eliminate mosquito breeding sites can prevent village card virus disease popular; In outbreak areas should wear long sleeve pajamas, anti-mosquito water up a naked body, using insect repellent, or use of mosquito nets, mosquito nets, etc. To prevent mosquito bites.

In addition to the general travel health tips, should remind pregnant women and pregnant women cautiously to village card virus disease endemic countries or regions, such as is really necessary in these countries or regions, should strictly for personal protective measures, to prevent mosquito bites. If the suspect village card virus infection, should be timely medical treatment, take the initiative to report travel history, and accept the medical follow-up.

(5) training and laboratory capacity building.

1. To strengthen medical personnel training, improve disease recognition ability

For medical staff medical knowledge training, improve the ability of disease diagnosis and identification. Key areas should be in before every season, in combination with the prevention and control of dengue fever, chikungunya village grassroots health workers work card virus disease related knowledge intensive training, strengthen the understanding of village card virus disease, timely discover and report suspected village card virus infection.

2. Establish village card virus detection ability

Set up and gradually promote village card virus lab testing technology. Provincial center for disease control and prevention to establish related technologies and methods of the laboratory testing as soon as possible, make laboratory techniques and reagents reserve, gradually enhance the centers for disease control and prevention on the laboratory detection of the disease, in response to the possibility of the outbreak.

Attachment: 1. The village card virus lab testing technology solutions. Docx

2. Village card virus disease epidemiology case questionnaire. Docx

3. The registration form of village card virus disease household surveys. Docx

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