登革热全球流行势态及对策

当前,登革病毒及其媒介伊蚊已遍布全球热带和亚热带地区。气候变暖、全球化、国际旅行、人居环境改变和病毒变异等,是导致登革热不断扩张的主要因素。现在,登革热已经遍布全球六大世界卫生组织区域,超过125个国家成为登革热地方性流行疫区。迄今为止,全球每年登革热的发病率估计波动在0.5~2亿之间,制图法评估发病率则接近4亿。目前尚无疫苗预防或特异性抗病毒药对治登革热,快速病例检测和临床治疗能够降低重症病例死亡率,而媒介蚊虫控制是现今预防和控制登革热流行的主要手段。为防控输入性登革热传入内陆口岸,总体防控措施为:一是对前往登革热疫区的出境人员及提供准确的登革热疫情评估通告,特别是针对重点人群,即劳务输出人员和出境留学人员,开展登革热防护的健康教育,降低个人感染风险;二是建立完善的疫情预警监测机制,及时做好出入境人员及货物等携带媒介生物的检验检疫,将输入性登革热的传播风险降到最低。     

非洲疟疾输入风险分析及其检疫对策

中国是对非洲派出劳务人员最多的国家之一,与国内疟疾发病率逐年下降形势相反,非洲归国人员疟疾发病率持续增加,输入性疟疾引发国内二代传播风险性日益增大.为有效防控疫情传入,前移国境卫生检疫防线、监测非洲疟疾流行对我国公民的影响意义重大.输入性疟疾患者通常是于归国后一段时间发病,且症状多不典型,致使国境口岸入境人员疟疾检出率偏低,与实际归国的发病率不对称,提示应及时扫除口岸传染病监测存在盲点.基于非洲疟疾流行现状,探究外派人员输入性疟疾防控措施,建议对归国人员实施输入性疟疾染疫嫌疑的追踪管理.     

中国内地寨卡病毒病输入传播风险评估研究

2016年全球寨卡病毒病疫情暴发,使我国面临一定的输入传播风险。本研究基于2016年全球寨卡病毒病报告疫情数据、全球国际航班客流量数据和我国云南和广西边境口岸分布等数据,通过计算输入风险指数评估我国主要城市寨卡病毒病输入风险。应用生态位模型预测中国当前埃及伊蚊、白纹伊蚊的分布区域,结合内地主要城市寨卡病毒病输入风险指数、埃及伊蚊或白纹伊蚊的分布概率等数据,计算主要城市寨卡病毒病输入后继发本地传播风险指数,评估本地传播风险。研究表明北京、上海和广州经国际航班输入寨卡病毒病的风险高;云南省德宏州、临沧市和西双版纳州以及广西防城港市和北海市经陆运口岸输入的风险较高;需加强口岸检疫,及时发现病例。仅考虑埃及伊蚊在该病传播中发挥作用,海口、三亚和湛江存在寨卡病毒病本地传播风险。云南省德宏州、临沧市两地在3-11月份如发生陆运口岸输入寨卡病毒病,存在经埃及伊蚊引起本地传播的中等风险。这些城市需要加强人群和伊蚊的监测,以利于早发现疫情、及早采取防蚊灭蚊等防控措施。     

基层综合医院传染病疫情监测管理探讨

目的探讨基层综合医院传染病疫情的管理方法。方法分析传染病疫情管理现状。结果卫生管理部门执法不严,基层综合性医院的传染病防控机构职责落实不到位、填卡报告方法中间环节多,存在信息失真、缓报和漏报现象。结论加强领导机构,强化传染病管理制度,提高医务人员执行传染病防治法的自觉性,环节控制,专人管理与综合管理相结合,时刻做好预防控制传染病传播工作。     

基层综合医院传染病疫情监测管理探讨

目的 探讨基层综合医院传染病疫情的管理方法.方法 分析传染病疫情管理现状.结果 卫生管理部门执法不严,基层综合性医院的传染病防控机构职责落实不到位、填卡报告方法中间环节多,存在信息失真、缓报和漏报现象.结论 加强领导机构,强化传染病管理制度,提高医务人员执行传染病防治法的自觉性,环节控制,专人管理与综合管理相结合,时刻做好预防控制传染病传播工作.     

鼠疫由马达加斯加传入我国的风险评估

评估鼠疫经病媒生物和交通工具由非洲马达加斯加传入我国的风险,并据风险值提出风险管理措施建议。从传染病传播三要素(传染源、传播途径、易感人群),识别鼠疫传入风险的影响因素,构建马达加斯加肺鼠疫传入的风险评估体系;并结合中马贸易往来频率、截获鼠类概率,中马两地黑家鼠及印鼠客蚤分布、疫区分布、地理水文情况及港口物流情况等进行推测,进行定性和半定量传入风险评估;并根据风险值和鼠疫防治策略,提出应采取的风险管理措施。结果表明,在中国为马达加斯加第一大贸易伙伴的前提下,马达加斯加鼠疫传入我国的最可能方式为船舶、货物、集装箱工具;山东、天津至广东西南沿海为鼠疫可能传入地区;半定量风险评估分值为4 096,显示鼠疫由马达加斯加经船舶等传入我国属于中等偏低的风险,能有效控制。根据风险评估结果,对马达加斯加船舶及货物集装箱加大卫生检疫查验力度、做好鼠、蚤及疫区的监测和防治、宣传普及鼠疫相关知识是主动应对此次疫情传入风险的防控方式之一。     

北京市首起新冠病毒Omicron变异株BA.5引起新冠肺炎聚集性疫情的调查研究

目的对延庆区新冠肺炎聚集性疫情进行流行病学调查和基因测序, 分析病例的感染来源、传播链条、防控措施, 为新冠疫情防控提供参考。方法对病例开展流行病学调查, 应用大数据技术对病例的活动轨迹进行核查, 对风险点位进行调查管控, 判定和管理密切接触者, 并对人员和环境开展核酸检测, 对溯源重点人群采集血清标本进行抗体检测, 对报告的病例进行全基因组测序、比对, 分析感染来源和传播链。结果 2022年7月4日至7月10日, 延庆区聚集性疫情共涉及16例新冠病毒确诊病例(普通型1例、轻型15例), 其中延庆区8例, 顺义区5例, 通州区、昌平区、丰台区各1例, 毒株分型均为新冠病毒Omicron亚型变异毒株BA.5, 潜伏期中位数为3 d。指示病例为1例从美国入境人员, 6月15日至6月30日在上海隔离点隔离, 7月1日隔离期满后返京, 7月4日诊断为确诊病例, 在工作单位传播给同工作、同餐人员引起的聚集性疫情。结论 OmicronBA.5亚分支正成为全球主要流行毒株, 要加强入境人员管理, 做好口岸城市疫情防控工作。加强疫苗接种、核酸检测等常态化防控措施落实, 早期发现疫情后, 采取科学精准的...     

高等院校疫情防控的常态化机制实践与思考

2019年底暴发的新型冠状病毒肺炎,是百年来全球发生的最大的传染病,是新中国成立以来我国遭遇的传播速度最快、感染范围最广、防控难度最严重的重大突发公共卫生事件。针对当前形势,习近平总书记在全国抗击新型冠状病毒肺炎疫情表彰大会上的讲话指出,“当前,疫情仍在全球蔓延,国内零星散发病例和局部暴发疫情的风险仍然存在,夺取抗疫斗争全面胜利还需要付出持续努力。要慎终如始、再接再厉,全面做好外防输入、内防反弹工作,坚持常态化精准防控和局部应急处置有机结合,决不能让来之不易的疫情防控成果前功尽弃”。     

传染病预检分诊制度的建立及管理对策

本文阐述了传染病预检分诊制度的概念、方法及要求,并讨论和分析了基层医疗机构在传染病预检分诊制度管理上的存在问题和困难.建议建立全员重视、业务培训、制度落实、流程改进、持续督查,注意环节质量管理的综合管理考核机制,严格、规范地执行传染病预检分诊制度,有效遏制传染病疫情的发生发展,努力做好科学防治.     

科学防治 战胜疫情

从控制传染源、救治被传染者,到切断传播途径、保护易感人群,正是科学态度、科学方法,让人类面对传染病不再束手无策,拥有了守护健康的法宝。科学技术是社会进步的强大支撑,也是战胜困难挑战的有力保障。新冠肺炎疫情发生以来,从"依法科学有序防控至关重要"的叮嘱,到"坚定信心、同舟共济、科学防治、精准施策"的总要求,习近平总书记对科学防治的要求,为做好新冠肺炎疫情防控工作提供了重要遵循。管理措施越科学,精准防控越到位,阻断疫情就越有力有效。把科学有序的防控要求落到实处,有效遏制疫情蔓延,人民生命安全和身体健康就能得到有力保障。     

Nowo pojawiające się choroby zakaźne w aspekcie bezpieczeństwa krwi

The risk of transfusion-related infectious diseases, the markers for which are routinely tested, is extremely low. Recently, however, blood transfusion service faces the challenge from emerging infectious diseases (EIDs), mainly zoonotic origin. Pathogens are microorganisms, mostly viruses, that usually require vectors for their transmission to humans. The relation of some EIDs to transfusion has been proved, in other cases it is considered likely. The paper presents views on EIDs etiology and spread and explains the epidemiologic basic terminology. It describes the principles and methods of EIDs risk assessment as well as prioritization of EIDs with regard to transfusion risk. It outlines the principles of international cooperation and rapid response to newly emerging threats. More attention is devoted to such diseases as West Nile fever, malaria, dengue and chikungunya which are recently a real epidemiological threat. Preventive measures to reduce the threat of EIDs transmission have also been discussed as well as their impact on the safety and supply of blood and blood components.     

Laboratory-associated infections and biosafety.

An estimated 500,000 laboratory workers in the United States are at risk of exposure to infectious agents that cause disease ranging from inapparent to life-threatening infections, but the precise risk to a given worker unknown. The emergence of human immunodeficiency virus and hantavirus, the continuing problem of hepatitis B virus, and the reemergence of Mycobacterium tuberculosis have renewed interest in biosafety for the employees of laboratories and health care facilities. This review examines the history, the causes, and the methods for prevention of laboratory-associated infections. The initial step in a biosafety program is the assessment of risk to the employee. Risk assessment guidelines include the pathogenicity of the infectious agent, the method of transmission, worker-related risk factors, the source and route of infection, and the design of the laboratory facility. Strategies for the prevention and management of laboratory-associated infections are based on the containment of the infectious agent by physical separation from the laboratory worker and the environment, employee education about the occupational risks, and availability of an employee health program. Adherence to the biosafety guidelines mandated or proposed by various governmental and accrediting agencies reduces the risk of an occupational exposure to infectious agents handled in the workplace.     

Climate-based health monitoring systems for eco-climatic conditions associated with infectious diseases

Despite a century of confidence and optimism in modern medicine and technology inspired by their often successful prevention and control efforts, infectious diseases remain an omnipresent, conspicuous major challenge to public health. Effective detection and control of infectious diseases require predictive and proactive efficient methods that provide early warning of an epidemic activity. Of particular relevance to these efforts is linking information at the landscape and coarser scales to data at the scale of the epidemic activity. In recent years, landscape epidemiology has used satellite remote sensing and geographic information systems as the technology capable of providing, from local to global scales, spatial and temporal climatic patterns that may influence the intensity of a vector-borne disease and predicts risk conditions associated with an epidemic. This article provides a condensed, and selective look at classical material and recent research about remote sensing and GIS (geographic information system) applications in public health.     

北京市东城区学校传染病聚集性疫情分析与防控策略探讨

目的 了解东城区学校传染病聚集性疫情的流行特点,探讨学校传染病疫情调查处理的科学方法.方法 通过对北京市东城区2013年9月至2014年1月出现的10起传染病聚集性疫情进行描述性研究,对接报处置以及控制措施的落实情况进行总结分析,总结学校传染病疫情的流行病学特征、病原学特征,分析现行的疫情监测方法和控制措施的优势与不足.结果 在10起疫情中,5起检出腺病毒,平均罹患率为34.1％,罹患率范围在21.3％～53.1％之间;4起检出流感病毒,平均罹患率19.4％,罹患率在8.3％～53.5％之间;1起检出诺如病毒,罹患率16.48％.结论 秋冬季呼吸道病毒和肠道病毒共同威胁着学生健康.在校学生人数多、办学规模大的学校,尤其小学是学校疫情防控的重点.     

心室复极化时程变异的谱分解技术及其临床应用

当今,心血管疾病发病率日益增加,研究者业已致力于从心曜误事 提取对心脏疾病能早期诊断、监护及预后评估有价值的信息。心室肌发生病变时,心室复极化时程与ＲＲ间期的关系会发生相应变化。且具有明显的特征性。因此有必要建立心室极化时程与ＲＲ间期关系所分析方法,以便对心室复极化时程的生理机抽进一步深入研究,并最终为心血管疾病的诊治提供新的无创性的方法。我们利用系统辨识方法建立了心室复极化时程的ＲＲ间期系统的动态线性参数模型,利用功率谱分解技术把心室复极化时程的功率谱分解成与生理因素有关和与病理因素有关两种成分,定量描述心肌细胞的受损程度。我们开展了这方面的临床研究工作,分别研究正常人各年龄组间以及正常人（老年组）和病人（老年组）间相应指标的变化。对缺血性心脏病人的研究结果表明,在心室复极化时程变异的功率谱中,与病理因素有关的成分显著增大;而且反映心脏病人心肌细胞状态不可测因素（病理因素）的有色随机噪声的能量亦显著增大。心室复极化时程与ＲＲ间期关系的分析方法,具有无创性和可定量性。随着心室复极化时程与ＲＲ间期关系研究的不断深入,将评价心血管疾病和功能的无创性方法日臻完善,必将对临床心血管疾病的早期诊断、治疗和预后评估等发挥积极的作用。     

The present status and future prospect of the molecular diagnostic tests

Assays for DNA or RNA sequences to diagnose infectious, neoplastic and genetic diseases have been widely used through recent progress in the molecular biology and biotechnology, and are now essential in care of patients under the advanced medicine through earlier and more accurate diagnosis. Automated systems have been developed for amplification and detection of nucleic acid sequence for infectious agents, using various nucleic acid amplification technology such as PCR. A fully automated PCR system and automated extraction of specific sequence for infectious agents such as hepatitis C virus RNA has been developed. These automated systems have provided improvement of not only assay efficiency but also quality control of the tests and have contributed to the standardization of them. Importance of development of systems for quality assessment and laboratory accreditation has been emphasized, particularly in those that still have been performed with manual methods. Based on the information on the genome sequence as the outcome of the human genome project, functions of genes and proteins have been studied by post-genomics such as expression profiling using DNA microarray, proteomics, single nucleotide polymorphisms analysis, coupled with bioinformatics. Along with advances in pharmacogenomics, these studies have raised the prospect of the development of tests for individualized medicine based on genetic information such as those predicting individual susceptibility to diseases for prevention and responsiveness to drugs for choice of treatment. For practice of such medicine, each genetic information and tests for it must be carefully evaluated and determined whether it is appropriate for cost-effective medicine through contributions to efficient process of decision-makings on patient care for prevention or avoidance of diseases and thus to cost savings.     

高州市2004-2009年法定传染病流行特征分析

目的 了解近6年来高州市法定传染病流行病学特征,为制定相应的防治对策与措施提供依据。方法 收集高州市2004-2009年法定传染病报告资料进行描述性研究分析。结果 近6年来高州市法定传染病平均年发病率为147.5472/10万,发病率呈上升趋势;传染病以乙类为主,其中又以呼吸道传染病为主;血源及性传播传染病呈上升发展势态;肺结核和乙肝发病率位列首位并居高不下;男性发病率高于女性,老年人和20-29岁年龄段的青年人发病率高。结论 今后高州传染病防治工作应在完善传染病报告与管理的同时加强人员知识培训,要重点做好肺结核、乙肝等传染性疾病以及性传播传染病的防治工作。     

Recent advances in molecular medicine techniques for the diagnosis, prevention, and control of infectious diseases

In recent years we have observed great advances in our ability to combat infectious diseases. Through the development of novel genetic methodologies, including a better understanding of pathogen biology, pathogenic mechanisms, advances in vaccine development, designing new therapeutic drugs, and optimization of diagnostic tools, significant infectious diseases are now better controlled. Here, we briefly describe recent reports in the literature concentrating on infectious disease control. The focus of this review is to describe the molecular methods widely used in the diagnosis, prevention, and control of infectious diseases with regard to the innovation of molecular techniques. Since the list of pathogenic microorganisms is extensive, we emphasize some of the major human infectious diseases (AIDS, tuberculosis, malaria, rotavirus, herpes virus, viral hepatitis, and dengue fever). As a consequence of these developments, infectious diseases will be more accurately and effectively treated; safe and effective vaccines are being developed and rapid detection of infectious agents now permits countermeasures to avoid potential outbreaks and epidemics. But, despite considerable progress, infectious diseases remain a strong challenge to human survival.     

Laboratory tests for infectious diseases and medical reimbursement

Emerging and reemerging infectious diseases, drug-resistant bacteria and nosocomial infection are becoming increasingly serious social problems. To control infectious diseases, it is important to develop effective therapies and to achieve complete prevention of pathogen transmission. For these purposes, rapid detection of pathogenic microorganisms is essential. Recent development and technical innovation in laboratory tests and diagnosis for infectious diseases are remarkable. New techniques such as antigen detection and genetic diagnosis, neither of which require conventional culture, have been intensively developed and introduced into clinical practice. These methods are now widely accepted as effective diagnostic tools because of their high specificity, high sensitivity and rapidity. In this article, we describe the burden of medical expenses under the law on novel infectious diseases and medical reimbursement for diagnostic tests for these diseases.