往返港澳小型船舶防止传染性非典型肺炎卫生检疫工作的探讨

[目的]科学有效地对往返港澳小型船舶进行传染性非典型肺炎卫生检疫，最大限度地防止传染性非典型肺炎传人传出。[方法]针对传染性非典型肺炎的特点(包括症状、体征、传播途径等)，利用相关的仪器和手段，制定和实施针对往返港澳小型船舶的卫生检疫监管措施。[结果]制定了防治传染性非典型肺炎工作预案；成立了传染性非典型肺炎防治工作小组；落实了相关技术人员和实施措施；启动有效的“进出境疑似病人处理程序”。[结论]对往返港澳小型船舶的传染性非典型肺炎的卫生检疫工作到位，措施有效，在工作过程中积累了宝贵经验，为今后开展传染病控制工作奠定了基础。     

基于风险管理的航行港澳小型船舶检疫新模式研究

目的实现对航行港澳小型船舶有效监管的基础上,建立船舶电子信息化平台,合理配置人力和物力,促进船舶快速通关,服务经贸。方法通过矩阵风险评价法,对出入境船舶实施风险分类管理。结果实施小型船舶风险管理检疫新模式,破解所有船舶统一登轮检疫的难题,建立船舶电子监管系统,推广无疫通行,实现通关便利化。结论建立小型船舶风险管理检疫新模式,推行船舶电子监管系统,是全球化经济快速发展对海港检疫工作的新要求,也是科技技术推动海港检疫工作发展的必然产物。     

小型船舶卫生监督与卫生处理管理工作探讨

本文探讨了如何依据有关法律法规,对来往港澳的小型船舶进行卫生监督和卫生处理,以加强入出境小型船舶的卫生监管工作。提出的途径包括:严格执法,加强传染病监测,提高检疫人员素质,提升船舶卫生监督和卫生处理管理水平。     

航行港澳小型船舶卫生监督网络系统的研究

目的研究新的卫生监督管理方法，解决航行港澳小型船舶由于航班不固定等原因造成监管困难而存在卫生比较差的问题，以适应出入境船舶卫生监督工作的要求。方法建立Web服务器和小型船舶卫生监督资料数据库，用户通过计算机网络上报船舶卫生监督信息资料，从而实现信息共享；同时建立预警条件和机制，通过分析数据对存在卫生问题的船舶进行预警。结果该冈络系统在广东检验检疫局运行以来，各分支检验检疫局共上报1287艘船舶的卫生监督记录10936条，其中船员健康证书存在问题的79艘次，啮齿动物及媒介达到危害程度的648艘次，卫生状况存在问题的534艘次，对1244艘次进行了预警。结论解决了长期以来航行港澳小型船舶卫生监督比较困难、卫生状况比较差的问题，为实施“电子监管”提供了有效的科学技术保障，达到了课题设计的预期目标。     

《口岸卫生控制》2005年总目次

·自然灾害与传染病· 地震、洪涝、海啸等自然灾害次生传染病的 流行病学问题与对策于长水姜广起庞作章(卜l) 航行港澳小型船舶卫生监督网络系统的研究 周旭潘德观冯庆文 海港卫生检疫监管模式转变研究赖天然 进境集装箱卫生检疫风险分析与对策研究李海峰 人境船舶靠泊检疫工作与口岸综合卫生条件 关系的研究张北鹰魏龙江姜凤才 高致病性禽流感卫生检疫防制对策探讨 陈河香李春光 出人境邮包快件检验检疫监管模式的创新与对策 詹大江吴隆德吴毓南等 件一4) (4一7) (5一刀 ·讲座论坛· 认识非特异性免疫创新防治感染类疾病 于长水张莹(4一l…     

海港口岸卫生检疫风险管理模式与应用的研究简

目的 提高口岸卫生检疫监管能力和工作效率,保障口岸公共卫生安全,促进外贸经济的快速发展.方法 根据法律法规的相关规定,运用风险分析的原理,结合海港口岸卫生检疫监管特点,对相关风险因子进行评估、量化和分级管理,通过建立数学分析模型,搭建信息管理平台,实现对相关风险因子的综合分析和应用,建立新的海港口岸卫生检疫监管模式.结果 新模式的建立,以出入境船舶检疫监管模式为载体,把国际航行船舶卫生检疫风险、码头经营单位卫生监督风险,船舶代理公司信用管理风险进行综合研判,实现了在卫生检疫风险可控的情况下,提高船舶通关效率、缩短了船舶滞港时间,实现了“提速、减负、增效、严密监管”的目的.结论 新的海港口岸卫生检疫监管模式及电子监管系统的建立,实现了海港口岸卫生检疫风险的有效管理及控制,提升卫生检疫监管能力和水平.     

港澳船舶检疫电子化监管新模式探讨

[目的]研究出入境港澳船舶检疫监管新模式,以适应快速通关的需要.[方法]依照相应的法规,利用互联网和电信系统,在应用<航行港澳船舶检疫自动应答系统>的基础上,设计出一套港澳船舶检疫的电子化监管新模式.[结果]新的监管模式推行对船舶代理及其管理人员进行质量认可,通过对船舶检疫自动应答系统的数据监控和检疫过程监控,构建一个港澳船舶检疫电子化快速通关的监管模式.[结论]该模式的建立,加快了船舶的通关速度,减少船舶在码头的滞留时间,节省人力资源,实现船舶检验检疫的提速、减负、增效、严密监管的要求.     

1例疑似传染性非典型肺炎病例处理情况的报告

[目的]防止传染性非典型肺炎通过口岸进行传播。[方法]6月6日检疫人员在对印尼籍船舶“斯里古尼亚”轮实施入境检疫时，发现1名船员体温为38．7℃(红外线耳温)，伴咳嗽，随即对其进行了医学检查、流行病学调查并送往指定医院进行隔离观察。对船舶及船员严格按照《汕头口岸防制非典型肺炎紧急预案程序》采取检疫监管措施。[结果]病人经住院治疗，6月9日体温下降至36．6℃，病情明显好转，排除其患传染情非典肺炎可能，同意出院。[结论]应尽快制定其它传染病的监测控制预案；出入境检验检疫机构应与地方上较有实力的医院或科研单位，建立长期的协作关系，以便能及时对出入境检疫、传染病监测中发现的病人或疑似病人进行治疗。     

ABC-RA分类管理方法在国境货轮卫生检疫中的应用

目的引入风险分析和ABC分类管理方法对国境港口货轮进行分类管理,提高口岸卫生检疫的监管效率。方法对国境口岸出入境货轮卫生检疫进行风险分析和ABC分类,根据不同的分类实施针对性和差异化的管理。结果船舶卫生检疫的主要不合格项主要有9种,A类、B类和C类各3种。结论采取系统性和针对性的措施对出入境船舶卫生检疫实施ABC-RA分类管理,能提高卫生检疫的监管效率。     

国际航行船舶代理业务管理现状及检验检疫对策

目的建立科学高效的国际航行船舶代理业务监管模式,提高船舶代理业务工作质量、提高检验检疫监管效能、提高船舶通关速度,营造安全、和谐、便捷、高效的口岸环境。方法对国际航行船舶代理企业现状和检验检疫监管模式进行调查研究,分析存在的问题。船舶代理企业存在着管理方式落后,管理理念不佳、内部管理体系不完善、业务素质不高等问题,船舶代理业务的检验检疫监管存在着一定难度。结果一方面加强对船舶代理企业实行资格准入、诚信管理、日常考核、培训考试、持证上岗等制度约束。另一方面,引进AIS船舶自动识别系统,提高检验检疫监管效能。结论船舶代理业务直接关系到检验检疫工作质量,建议国家质量监督检验检疫总局相关管理部门尽快制定国际航行船舶代理业务相关规定与标准,完善卫生检疫监管模式。     

Influenza and SARS: the impact of viral pandemics on maritime health

Global travel and transport play a critical role in the spread of infections. We see this clearly in the first two pandemics of the 21st century: SARS and influenza H1N1-2009. Although air travel contributed to dissemination in these two pandemics, the travel restrictions, quarantines, and heightened vigilance which resulted had an impact on maritime health. Seasonal, pandemic, and avian influenza have some important differences with regards to exposure risks, infectivity, and severity. Most of the data for maritime influenza outbreaks focus on seasonal influenza on cruise ships, but influenza among crew members occurs due to close working conditions and is potentially preventable with staff vaccination programs. To date, avian influenza has low human-to-human transmission; infection typically requires close contact with poultry, but presents with severe disease and a high fatality rate. Pandemic (swine) influenza was readily transmitted between people, including young adults, and caused severe illness in high-risk groups including pregnant women, children, and those with co-morbidities and obesity. In contrast, SARS had lower infectivity compared to influenza, and a longer incubation period. These characteristics slowed its propagation enough that outbreak control measures, such as isolation of infected cases and quarantine of exposed but well persons, were effective in terminating this pandemic. No effective vaccine exists for SARS at this time, whereas countries were able to deploy millions of doses of pandemic influenza vaccine within 7 months after the outbreak was first recognized in Mexico. The lack of a protective vaccine and the higher case fatality rate in SARS will mean that stringent quarantine measures may still be required for outbreak control if SARS ever occurs again. Compliance with international health regulations, and the ability to adapt these to maritime health needs, will be important in the shipping industry.     

Modelling potential responses to severe acute respiratory syndrome in Japan: the role of initial attack size, precaution, and quarantine

BACKGROUND: There has been an outbreak of the severe acute respiratory syndrome (SARS) worldwide. With the use of detailed epidemiological data from other countries, this article describes the possible reason for the SARS epidemic not appearing in Japan, and simulates the impact of different control strategies that can break the transmission cycle of SARS associated coronavirus. METHOD: Mathematical modelling is used for predicting the epidemiological outcome and simultaneously for evaluating the effect of interventions on SARS. The study estimates the initial attack size that would result in failed invasion. Three different interventions have been incorporated into the public health response policies; precautionary public health measures, isolation of infected people, and quarantine of exposed humans. RESULTS: The maximum number of humans newly infected could be roughly estimated on the basis of the initial attack size, using simple formulas. It is seen that the introduction of only a few cases into certain communities would not lead easily to an epidemic. The possible trajectories of SARS epidemic depend on the levels of public health interventions as quarantine and precautionary public health measures greatly affected the transmissibility of the disease. It is shown that there exist threshold levels of interventions at which the SARS epidemic settles down. CONCLUSION: Initial attack size is one of the determinants of whether SARS can successfully invade the community or not. Two of the most effective policy procedures to prevent new infections would be to apply stringent precautionary measures and to impose quicker and more effective quarantine of the exposed populace.     

Evaluation of Border Entry Screening for Infectious Diseases in Humans

In response to the severe acute respiratory syndrome (SARS) pandemic of 2003 and the influenza pandemic of 2009, many countries instituted border measures as a means of stopping or slowing the spread of disease. The measures, usually consisting of a combination of border entry/exit screening, quarantine, isolation, and communications, were resource intensive, and modeling and observational studies indicate that border screening is not effective at detecting infectious persons. Moreover, border screening has high opportunity costs, financially and in terms of the use of scarce public health staff resources during a time of high need. We discuss the border-screening experiences with SARS and influenza and propose an approach to decision-making for future pandemics. We conclude that outbreak-associated communications for travelers at border entry points, together with effective communication with clinicians and more effective disease control measures in the community, may be a more effective approach to the international control of communicable diseases.     

黄骅港口岸船舶卫生状况调查分析

目的 加强对船舶的卫生检疫、卫生监督和卫生处理，防止医学媒介生物及病原体的传播扩散。方法 对2002年来港船舶进行环境卫生检查及鼠虫患检查；对杀虫灭鼠药品、器械进行检查；对船员健康状况进行监测；对压舱水的装载港进行调查。结果 93艘次船舶中有19艘次环境卫生状况差，占20．43％；虫患阳性船舶41艘次，阳性率为44．09％；有15艘次压舱水装载自疫区，占16．13％。结论 必须加强对船舶的卫生检疫、卫生监督及卫生处理工作，并强化对船员的卫生管理和卫生宣传。     

Use of quarantine to prevent transmission of severe acute respiratory syndrome--Taiwan, 2003

On July 5, 2003, Taiwan was removed from the World Health Organization (WHO) list of severe acute respiratory syndrome (SARS)-affected countries. As of July 9, a total of 671 probable cases of SARS had been reported in Taiwan. On February 21, the first identified SARS patient in Taiwan returned from travel to Guangdong Province, mainland China, by way of Hong Kong. Initial efforts to control SARS appeared to be effective; these efforts included isolation of suspect and probable SARS patients, use of personal protective equipment (PPE) for health-care workers (HCWs) and visitors, and quarantine of contacts of known SARS patients. However, beginning in mid-April, unrecognized cases of SARS led to a large nosocomial cluster and subsequent SARS-associated coronavirus transmission to other health-care facilities and community settings. In response to the growing epidemic, additional measures were taken to limit nosocomial and community transmission of SARS, including more widespread use of quarantine. By the end of the epidemic, 131,132 persons had been placed in quarantine, including 50,319 close contacts of SARS patients and 80,813 travelers from WHO-designated SARS-affected areas. This report describes the quarantine measures used in Taiwan and discusses the need for further evaluation of quarantine and other control measures used to prevent SARS.     

广东省传染性非典型肺炎预防控制策略探讨

目的 探讨广东省传染性非典型肺炎(SARS)的预防控制策略和效果。方法 分析广东省SARS疫情和制定预防控制措施。结果 2002年11月16日至200B年5月30日，全省共发生SARS病例1511例，死亡57例，累计发病率1．98／10万。全省21个市中有15个市报告病例，病例主要集中在珠江三角洲地区，其中广州市占86．04％。发病以医务人员为主，占22．90％；病例主要集中在20～39岁，占50．95％；出现明显的医院或家庭聚集性。采取预防控制的策略及效果：加强党政的正确领导，各有关部门密切配合，正确把握舆论导向等组织策略；加强技术指导，重视疫情监测报告，采取综合性预防控制措施(加强医院感染控制、早发现和就地隔离治疗病人、小范围隔离观察密切接触者、强调室内通风、注意个人卫生、增强体质)，加强调查研究和科研攻关，发动全社会共同参与等技术策略。预防控制策略实施后，全省日均发病数从2月份的25．6例下降到5月份的0．3例；医务人员所占比例由1月及以前的30．8％下降到5月份未有医务人员感染；未出现住宅小区或学校聚集性暴发的情况。结论 广东省首次出现SARS暴发流行，通过采取一系列行之有效的组织和技术策略后，广东省SARS疫情初步得到有效控制。各级党政的高度重视和正确领导是做好SARS防治工作强有力的保证。加强SARS防治工作的技术指导，重视疫情监测报告，切实落实有效的综合性预防控制措施，尤其是加强医院感染控制是防制措施的关键。     

Quarantine for SARS, Taiwan

During the 2003 outbreak of severe acute respiratory syndrome (SARS) in Taiwan, >150,000 persons were quarantined, 24 of whom were later found to have laboratory-confirmed SARS-coronavirus (SARS-CoV) infection. Since no evidence exists that SARS-CoV is infective before the onset of symptoms and the quarantined persons were exposed but not symptomatic, we thought the quarantine's effectiveness should be investigated. Using the Taiwan quarantine data, we found that the onset-to-diagnosis time of previously quarantined confirmed case-patients was significantly shortened compared to that for those who had not been quarantined. Thus, quarantine for SARS in Taiwan screened potentially infective persons for swift diagnosis and hospitalization after onset, thereby indirectly reducing infections. Full-scale quarantine measures implemented on April 28 led to a significant improvement in onset-to-diagnosis time of all SARS patients, regardless of previous quarantine status. We discuss the temporal effects of quarantine measures and other interventions on detection and isolation as well as the potential usefulness of quarantine in faster identification of persons with SARS and in improving isolation measures.     

Public health interventions and SARS spread, 2003

The 2003 outbreak of severe acute respiratory syndrome (SARS) was contained largely through traditional public health interventions, such as finding and isolating case-patients, quarantining close contacts, and enhanced infection control. The independent effectiveness of measures to "increase social distance" and wearing masks in public places requires further evaluation. Limited data exist on the effectiveness of providing health information to travelers. Entry screening of travelers through health declarations or thermal scanning at international borders had little documented effect on detecting SARS cases; exit screening appeared slightly more effective. The value of border screening in deterring travel by ill persons and in building public confidence remains unquantified. Interventions to control global epidemics should be based on expert advice from the World Health Organization and national authorities. In the case of SARS, interventions at a country's borders should not detract from efforts to identify and isolate infected persons within the country, monitor or quarantine their contacts, and strengthen infection control in healthcare settings.     

Evidence and effectiveness in decisionmaking for quarantine

When public health decisionmakers turned to quarantine during the recent severe acute respiratory syndrome (SARS) epidemic, difficult questions were raised about the legitimacy and acceptability of restrictive measures to attain public health goals. SARS also brought to light how scientific uncertainty can permeate public health decisionmaking, leading us to think about the relationship between the adequacy of evidence of the effectiveness of an intervention and its role in the justification of public health action. In this article, we critically examine the role of evidence and effectiveness in decision-making for quarantine. It is our contention that the effectiveness of a public health intervention should not be defined exclusively in (absolute and objective) scientific terms but rather conceptualized relationally and normatively in public health decisionmaking.     

SARS control and psychological effects of quarantine, Toronto, Canada

As a transmissible infectious disease, severe acute respiratory syndrome (SARS) was successfully contained globally by instituting widespread quarantine measures. Although these measures were successful in terminating the outbreak in all areas of the world, the adverse effects of quarantine have not previously been determined in a systematic manner. In this hypothesis-generating study supported by a convenience sample drawn in close temporal proximity to the period of quarantine, we examined the psychological effects of quarantine on persons in Toronto, Canada. The 129 quarantined persons who responded to a Web-based survey exhibited a high prevalence of psychological distress. Symptoms of posttraumatic stress disorder (PTSD) and depression were observed in 28.9% and 31.2% of respondents, respectively. Longer durations of quarantine were associated with an increased prevalence of PTSD symptoms. Acquaintance with or direct exposure to someone with a diagnosis of SARS was also associated with PTSD and depressive symptoms.