Bioterrorism : A Public Health Perspective

The intentional release or threat of release of biologic agents (i.e. viruses, bacteria, fungi or their toxins) in order to cause disease or death among human population or food crops and livestock to terrorize a civilian population or manipulate the government in the present scenario of increased terrorist activity has become a real possibility. The most important step in the event of a bioterrorist attack is the identification of the event. This can be achieved by generating awareness, having high degree of suspicion and having a good surveillance system to assist quick detection.Bioterrorist attacks could be covert or announced and caused by virtually any pathogenic microorganism. Bioterrorist agents of major concern have been categorized as A, B and C based on the priority of the agents to pose a risk to the national security and the ease with which they can be disseminated. The five phases of activities in dealing with a bioterrorist attack are preparedness phase, early warning phase, notification phase, response phase and recovery phase.A bioterrorism attack in a public place is a public health emergency. Early detection and rapid investigation is the key to contain such attacks. The role of public health epidemiologist is critical not only in determining the scope and magnitude of the attack but also in effective implementation of interventions.Key Words: Bioterrorism, Anthrax, Botulism, Plague, Smallpox, Public health emergency, Category A, B and C agents     

重症急性胰腺炎中M1巨噬细胞活化与促炎反应关系的研究进展

巨噬细胞具有非常重要的作用，参与广泛的生命活动，包括组织重塑、伤口愈合、炎症、调节免疫及抵御肿瘤、凋亡细胞清理等。重症急性胰腺炎（severe acute pancreatitis，SAP）是一种病情凶险、进展迅速、累及多个脏器、病死率高的外科急腹症。SAP的发生与促炎因子和抑制因子网络平衡失调有关，促炎因子的过度释放是SAP患者病情恶化的重要因素，其中作为“扳机事件”的巨噬细胞浸润与激活启动了SAP的发展。本文针对巨噬细胞活化与SAP促炎反应关系的研究新进展做简要概述。     

2005~2017年中国热浪事件及人口暴露水平趋势

目的 探讨2005~2017年中国热浪事件时空趋势及人口暴露水平。 方法 基于中国2901个区县在2005~2017年期间的逐日日均温再分析数据集,采用相对温度阈值定义方法,统计分析中国热浪事件发生区县数、发生频次、热浪日总天数与单次事件平均持续天数的时空分布特征,并结合中国人口数据计算人口加权热浪日暴露水平。 结果 2005~2017年热浪事件在中国的影响呈整体增加趋势,其中2010年、2013年、2016年与2017年热浪事件整体影响较大;热浪事件在长江流域沿线省份的人口暴露水平较其他地区更高,其中上海市的年均人口加权热浪日暴露水平最高,其次是浙江省。 结论 中国热浪事件在时间上呈现上升趋势,在空间上呈扩张趋势,并以长江流域为热浪事件的人口暴露集中区域。     

平滑肌肌浆网Ca~(2+)释放与STOCs相关性的研究进展

平滑肌细胞肌浆网(SR)上存在两种不同类型的钙释放通道:三磷酸肌醇敏感的钙释放通道(IP3R)和ryanodine敏感的钙释放通道(RyRs)。肌浆网产生的局部瞬时钙释放如钙火花或Ca2+puffs激活邻近胞膜上的钙激活钾通道产生自发性瞬时外向电流(STOCs)。近来研究表明IP3Rs和RyRs都参与肌浆网内钙的调节和平滑肌的舒张。这两种释放通道是否存在协同作用,以及如何影响STOCs,进而调控平滑肌的舒缩活动,不同组织存在很大差异。本文就此方面的研究进展进行综述。     

Recognising clinical instability in hospital patients before cardiac arrest or unplanned admission to intensive care. A pilot study in a tertiary-care hospital.

OBJECTIVE: To investigate the nature and duration of clinical instability (i.e., abnormalities in simple physical observations or laboratory test results) in hospital patients before a "critical event" (i.e., a cardiac arrest or an unplanned admission to intensive care). DESIGN: Retrospective survey of medical records of all patients having critical events (CEs) over 12 months. Data on hospital and Intensive Care Unit (ICU) patients were obtained for comparison with the study population. SETTING: A 300-bed metropolitan teaching hospital with a seven-bed ICU. PATIENTS: All patients having CEs over a 12-month period (January to December 1997). MAIN OUTCOME MEASURES: Number of patients with clinical instability before a CE; duration of clinical instability before a CE; number of medical reviews of each patient before a CE; mortality rate and length of hospital stay for all patients. RESULTS: There were 122 CEs in 112 patients (median, 1; range, 1-4). Of the CEs, 79 were unplanned ICU admissions (14 subsequent to cardiac arrest calls), and 43 were cardiac arrest calls not resulting in ICU admission. Each CE was preceded by a median of two (range, 0-9) criteria for clinical instability. The median duration of instability before a CE was 6.5 hours (range, 0-432 hours), and in that time a median of two (range, 0-13) medical reviews took place. The incidence of CEs in the total hospital population (122 CEs/19,853 admissions) and in ICU patients (79 unplanned admissions/515 admissions) was 0.6% and 15%, respectively. There were 70 deaths (62%) among the 112 patients, compared with a total of 392 deaths (2% of admissions) in the hospital, of which 107 were in ICU. CONCLUSIONS: Very few patients suffer a CE while in hospital. However, those who do frequently manifest abnormalities in simple physical observations and laboratory test results before the CE. More rapid intervention in response to warning signs might provide a better outcome for these patients.     

Ophthalmologic care for persons with diabetes

The provision of ophthalmologic care to diabetic patients was examined in a large, geographically defined population-based study in southern Wisconsin. Of the total of 2,272 patients examined, 902 were taking insulin and were diagnosed before 30 years of age (younger onset) and 1,370 were diagnosed at or after 30 years of age (older onset). Approximately 26% of the younger-onset and 36% of the older-onset diabetic population had never had an ophthalmologic examination. Characteristics of the younger-onset and older-onset population associated with never having had an ophthalmologic examination included living in a nonmetropolitan county, being older at the time of diagnosis, having a shorter duration of diabetes, having fewer years of education, receiving their diabetes care from a family or general practitioner, and having better visual acuity. Eleven percent of younger- and 7% of older-onset persons with Diabetic Retinopathy Study high-risk characteristics for severe visual loss had never been seen or were seen more than two years before the time of the study. Because severe visual loss caused by proliferative diabetic retinopathy may be reduced by timely photocoagulation treatment, this study suggests that a large number of patients who would benefit from ophthalmologic care are currently not receiving it.     

动脉硬化与原发性高血压对心脑血管疾病发病的影响及联合作用：基于8年的随访研究

背景　动脉硬化与原发性高血压均是心脑血管疾病（CVD）的重要危险因素,目前单一因素对CVD发病的影响已得到充分阐明,但关于动脉硬化与原发性高血压二者联合对CVD影响的研究鲜有报道。目的　通过一项以社区人群为基础的大型前瞻性队列研究,分析动脉硬化及原发性高血压在中国人群中对CVD发病的影响,并探讨两者间是否存在联合作用。方法　选取参加开滦研究2010-2011、2012-2013、2014-2015、2016-2017年度随访且同时完成臂踝脉搏博传导速度（baPWV）测量者为观察对象,排除baPWV测量前发生心脑血管事件者和踝肱指数（ABI）<0.9者,最终共有33 820例观察对象纳入统计分析,收集其年龄、性别、收缩压（SBP）、舒张压（DBP）、baPWV、心率、体质指数（BMI）、空腹血糖（FBG）、总胆固醇（TC）、三酰甘油（TG）、低密度脂蛋白胆固醇（LDL-C）、高密度脂蛋白胆固醇（HDL-C）、尿酸（UA）、吸烟、饮酒、体育锻炼、教育程度、糖尿病、服用降压药物及降糖药物情况等资料。研究随访至2017-12-31,以发生心脑血管事件为终点事件。根据baPWV是否>1 400 cm/s以及同期观察对象是否患有原发性高血压,将观察对象分为非原发性高血压及非动脉硬化组（G1组）、非原发性高血压及动脉硬化组（G2组）、原发性高血压及动脉硬化组（G3组）和原发性高血压及非动脉硬化组（G4组）。采用多因素Cox比例风险回归模型分析进一步探究动脉硬化及原发性高血压对CVD发病的影响,并分析动脉硬化与原发性高血压对CVD的联合作用。结果　平均随访时间（3.34±2.38）年,CVD的发病密度为51.67/万人年,各组CVD累积发病率分别为0.28%、1.94%、1.75%、4.70%。4组年龄、男性占比、baPWV、BMI、FBG、TC、TG、LDL-C、HDL-C、SBP、DBP、baPWV、心率、BMI、FBG、TC、TG、LDL-C、UA、吸烟、饮酒、体育锻炼、糖尿病、服用降压药物比例、服用降糖药物比例、CVD累积发病率比较,差异均有统计学意义（P<0.05）。多因素Cox比例风险回归模型结果显示,动脉硬化情况〔HR=2.60,95%CI（1.88,3.61）〕、baPWV/baPWV的标准差（baPWV-SD）〔HR=1.22,95%CI（1.12,1.33）〕、原发性高血压情况〔HR=2.05,95%CI（1.59,2.64）〕、SBP/SBP的标准差（SBP-SD）〔HR=1.26,95%CI（1.14,1.38）〕均为CVD发病的影响因素（P<0.05）;与G1组相比,各组发生CVD的HR分别为3.33〔95%CI（2.08,5.33）〕、2.81〔95%CI（1.57,5.03）〕、5.98〔95%CI（3.79,9.43）〕,且动脉硬化与原发性高血压对CVD发病无交互作用（P=0.789）,在删除服用降压药物人群后重复上述分析结果未发生改变。结论　动脉硬化及原发性高血压均是CVD发病的危险因素,并且两者间存在联合作用。     

心绞痛对急性心肌梗死预后的有益影响

目的探讨梗死前有无心绞痛对急性心肌梗死(AMI)预后的影响.方法对123例首次穿壁性AMI住院患者进行临床回顾性分析,阐明梗死之前心绞痛引起的缺血预适应效应对AMI的面积、心脏事件(心力衰竭、心源性休克、严重心律失常)发生率和心肌保护等方面所起的作用.结果梗死前48h有心绞痛的94例AMI患者(A组)、血清肌酸磷酸激酶(CPK)峰值、心肌肌酸激酶同功酶(CK-MB)、心脏事件(心力衰竭、心源性休克、严重心律失常)发生率与梗死前无心绞痛的39例患者(B组)相比较均明显降低(P<0.05);超声心动图检查左心室射学分数(LVEF),梗死后4周两组无显著差别(P<0.05);24周后LVEF,A组有提高,B组则降低(P<0.05);住院病死率A组显著低于B组(P<0.05).结论 AMI前有心绞痛的患者,心梗后梗死面积缩小,左室功能和临床预后的改善,与心肌缺血预适应(IP)对心脏的保护密切相关.     

边境吸毒人群童年期负性事件与成年期注射吸毒行为的研究

目的 了解边境地区吸毒人群的基本特征,探讨目标人群童年期负性事件与成年期注射吸毒行为的关系。方法 采用自编毒品使用及不良健康行为调查问卷、童年期负性事件调查问卷对某边境地区的405名吸毒者进行现场调查。结果 目标人群存在注射吸毒行为的人占12.3%,成年期出现注射吸毒行为以男性、39岁以上、少数民族、未婚、有小孩、小学及以下文化程度及有职业的人群为主;海洛因平均使用年限15年,冰毒片剂和晶体10年左右,摇头丸为13年;首次使用毒品的平均年龄22～28岁,ATS的首次使用平均年龄22～23岁。ACEs事件超过1件以上者在存在注射吸毒行为者中占84.0%。Logistics回归结果显示,ACE严重程度、年龄及民族可能是目标人群存在注射吸毒行为的影响因素（P <0.05）。结论 在边境吸毒人群中,有童年期负性事件经历者较多,与成年后注射吸毒行为密切相关,对戒毒实践及早期干预有一定指导意义。     

Claiming behaviour in a no-fault system of medical injury: a descriptive analysis of claimants and non-claimants

OBJECTIVES: (i) To determine the proportion of patients in New Zealand who claim compensation from the national no-fault compensation program after experiencing a compensable injury; and (ii) to identify characteristics of injured patients who are least likely to claim despite having sustained a compensable injury. DESIGN: We estimated the percentage of eligible patients who claim no-fault compensation by linking a national claims database (Accident Compensation Corporation) to records reviewed in the New Zealand Quality of Healthcare Study (NZQHS). Bivariate and multivariate analyses were used to investigate socioeconomic and sociodemographic differences between claimants and injured non-claimants. PARTICIPANTS AND SETTING: Patients who experienced an adverse event associated with care in NZ public hospitals in 1998 and claimed compensation with the ACC, the national no-fault insurer (n = 741). Patients identified by the NZQHS as having sustained an adverse event associated with hospital care in the same year who did not file a compensation claim (n = 839). MAIN OUTCOME MEASURES: Adverse events, compensable adverse events, and compensation claims. RESULTS: Among patients judged by NZQHS reviewers to be eligible for compensation, 2.9% (6/210) claimed. Odds of claiming after an adverse event were significantly lower for patients who were elderly (odds ratio [OR], 0.20; 95% CI, 0.14-0.28), from the most deprived areas (OR, 0.36; 95% CI, 0.23-0.57), or of Ma ori or Pacific ethnicity (OR, 0.47; 95% CI, 0.32-0.69 and OR, 0.26, 95% CI, 0.11-0.58). CONCLUSIONS: Despite few apparent institutional or economic barriers, the proportion of injured patients in NZ who seek compensation after sustaining a compensable injury is very low. Hence, substantial underclaiming occurs in both negligence and no-fault systems. The disproportionately low propensity of elderly, poor and minority patients to seek compensation also appears to be pervasive.     

Comorbidity of mental disorders with alcohol and other drug abuse. Results from the Epidemiologic Catchment Area (ECA) Study

The prevalence of comorbid alcohol, other drug, and mental disorders in the US total community and institutional population was determined from 20,291 persons interviewed in the National Institute of Mental Health Epidemiologic Catchment Area Program. Estimated US population lifetime prevalence rates were 22.5% for any non-substance abuse mental disorder, 13.5% for alcohol dependence-abuse, and 6.1% for other drug dependence-abuse. Among those with a mental disorder, the odds ratio of having some addictive disorder was 2.7, with a lifetime prevalence of about 29% (including an overlapping 22% with an alcohol and 15% with another drug disorder). For those with either an alcohol or other drug disorder, the odds of having the other addictive disorder were seven times greater than in the rest of the population. Among those with an alcohol disorder, 37% had a comorbid mental disorder. The highest mental-addictive disorder comorbidity rate was found for those with drug (other than alcohol) disorders, among whom more than half (53%) were found to have a mental disorder with an odds ratio of 4.5. Individuals treated in specialty mental health and addictive disorder clinical settings have significantly higher odds of having comorbid disorders. Among the institutional settings, comorbidity of addictive and severe mental disorders was highest in the prison population, most notably with antisocial personality, schizophrenia, and bipolar disorders.     

The influence of sociodemographic characteristics on health care utilisation in a Swedish municipality

During recent years there has been a debate on factors that might influence health care utilisation, and the possibilities to predict such utilisation in order to facilitate the allocation of health care resources in the community. Currently only the age distribution in the population is usually used for such predictions. In this study the influence of a number of other sociodemographic characteristics on health care utilisation, in addition to age and sex, was assess in a small Swedish community. A postal questionnaire, containing questions on health care utilisation and a number of sociodemographic factors, was sent to a random, stratified sample of the population of H?bo municipality, Sweden. Out of the sampled 1312 subjects, 827 (63%) responded to the questionnaire. Subjects aged 65 years and above had higher odds for having consulted a physician, having been hospitalised and having a cost limitation card compared to those below age 65. Men had significantly lower odds than women for having consulted a physician, having visited other health care providers and having a cost limitation card. Singles, as compared to married subjects, had lower odds for all health care measures except having consulted a physician. Subjects with sick leave or disability pension, as compared to working subjects, had higher odds for most health care utilisation measures. A number of sociodemographic factors were thus associated with health care utilisation and might be considered in the health care resources allocation process.     

An examination of the prevalence of IDF- and ATPIII-defined metabolic syndrome in an Irish screening population

Objectives  To investigate the prevalence of ATPIII- and IDF-defined metabolic syndrome (MetS) in an Irish screening population and to determine the calculated cardiovascular risk for each group. Design  A total of 1,716 subjects were enrolled over a 12-month period. Main outcomes  The ATPIII-defined prevalence of MetS in this population was 13.2%. Using IDF criteria, 21.4% of subjects were identified as having the MetS. Correlation between the two definitions was high; however, IDF criteria identified an additional 9.5% (n = 164) of the population as having MetS, which ATPIII criteria failed to recognise. Conclusion  We noted a higher prevalence of MetS in the studied population when defined by IDF criteria. However, those identified by IDF and not by ATPIII definition did not have a higher cardiovascular risk score by either Framingham or European Score than those without MetS. Thus, application of the ATPIII definition of MetS, may be the more practical.     

评价非洛地平缓释片单药与以其为基础的联合降压方案对中国轻、中度原发性高血压患者的有效性、安全性及耐受性

目的:评价以非洛地平缓释片为基础的联合美托洛尔、赖诺普利或氢氯噻嗪的联合用药方案与非洛地平缓释片单药比较,其对中国轻、中度原发性高血压患者治疗12周后血压达标百分比及安全性、耐受性情况.方法:多中心、随机、开放临床试验.结果:(1)联合治疗12周后血压达标的百分比率:以非洛地平缓释片为基础的联合氢氯塞嗪组意向性治疗(intention-to-treatment, ITT)人群为80.2%;联合美托洛尔组ITT人群为74.1%;联合赖诺普利组ITT人群为80.5%.(2)所有受试者的收缩压和舒张压较基线的下降值:联合氢氯噻嗪组平均为16.8/10.6 mm Hg,联合美托洛尔组平均为16.6/10.7 mm Hg,联合赖诺普利组平均为18.0/12.8 mm Hg.3组之间两两比较差异均无统计学意义(P>0.05).非洛地平缓释片单药治疗14周平均下降24.8/17.5 mm Hg.其中非洛地平缓释片联合赖诺普利方案可以使舒张压快速下降,更早达标.(3)所有服药受试者(ITT集)中的服药依从性为:非洛地平缓释片单药组97.7%;以非洛地平缓释片为基础的联合氢氯塞嗪组89.8%,联合美托洛尔组100.0%;联合赖诺普利组96.4%.与研究药物相关的不良事件:非洛地平单药组21.5%,联合氢氯噻嗪组16.3%,联合美托洛尔组20.0%,联合赖诺普利组29.4%.主要不良事件在非洛地平单药组为头痛,而在联合赖诺普利后主要不良事件为咳嗽.结论:非洛地平缓释片单药具有较强的降压效果,而以非洛地平缓释片为基础的联合美托洛尔、赖诺普利或氢氯噻嗪的联合用药方案可使近80%高血压患者治疗达标,且安全性、耐受性好,依从性高.     

Open air rock concert: an organised disaster.

OBJECTIVE: To describe the planning and implementation of health care provision at a mass gathering, and to describe the conditions treated at such an event. SETTING: When approximately 93,000 fans gathered outdoors in Sydney's Centennial Park, a natural reserve, for Australasia's largest ever outdoor rock concert, there was an obvious potential for medical disaster. PATIENTS: At most disasters or mass gatherings, accurate patient numbers and details are not available, but an organised patient data collection system allowed the case load at this event to be clearly defined. This showed that 450 patients were attended to by the first aid teams. Triage identified 36 of these as having conditions serious enough to require admission to the medical area. Seven of these patients were ultimately transferred to hospital. RESULTS: A brief practical outline is provided of the medical planning for the concert, detailing the staff and equipment, how to avoid potential problems, the use of voluntary organisations, and specific site organisation. Key points in the medical planning, organisation and practicalities, especially those which are vital to any disaster response, are highlighted. CONCLUSION: Solutions to recurrent problems experienced by medical personnel involved with mass gatherings or disasters are suggested. The lack of practice in implementing a multiple casualty or disaster plan may be remedied by organised responses to mass events.     

Whole-brain death reconsidered--physiological facts and philosophy.

Four main areas generating confusion in discussion on brain death are identified as a) the relation of criteria of death to concepts of death, b) the argument about whether death is an event or a process, c) the inadequate differentiation of different neurological entities having different cardiac prognoses, and d) insufficient awareness of the separate issues of 'determining death' and 'allowing to die'. It is argued that if by death we mean the dissolution of the human 'organism as a whole', then whole-brain death is death. Behavioural patterns, legitimate in the presence of a cadaver, should be legitimate from the time whole-brain death is diagnosed.     

Factors associated with requesting and refusing human immunodeficiency virus antibody testing

OBJECTIVE: To ascertain factors associated with having a test for human immunodeficiency virus (HIV) antibody. DESIGN: All attenders at a sexually transmitted diseases (STD) clinic who were at risk of HIV infection and had not been tested previously were included in the study and classified as requesting a test or being offered a test. SETTING: The study was conducted at a central city STD clinic. PARTICIPANTS: Of all patients in 1990, 1835 men and 849 women were excluded because of previous HIV tests and 259 men and 120 women were not tested because of their low risk, leaving a target population of 2249 men and 1153 women. MAIN OUTCOMES: Among men tested the results in 1.2% (9/771) of those requesting a test and in 0.6% (7/1177) of those not requesting a test were positive. There were no positive results among the women tested. RESULTS: Among men, accepting testing was related to intravenous drug use (odds ratio [OR] = 3.49), not having a steady partner (OR = 1.40), and having an STD (OR = 0.57) or a history of STD (OR = 0.67). Among women, accepting testing was related to not having a steady partner (OR = 1.73), being an STD contact (OR = 0.43), having vaginal discharge and/or dysuria (OR = 0.51), and having a history of STD (OR = 0.61), and was unrelated to having an STD. In both men and women accepting testing was unrelated to having multiple sex partners. CONCLUSIONS: The findings are consistent with a failure to associate the risk of HIV infection with risks associated with other STDs. This has implications for health education programs as well as approaches to testing by doctors. Those requesting a test accounted for only 56% (9/16) of infections detected.     

Ascertainment and natural history of treated acromegaly in Northern Ireland.

The prevalence of known cases of acromegaly in Northern Ireland in 1984 was 6.3 per 100,000 population. The incidence of newly-diagnosed cases over the preceding 25 years was 5.5 patients per year, or 0.4 patients per 100,000 population per year. This rate would be equivalent to about 200 new cases per year in the United Kingdom. Four options have been available to most of these patients--surgical hypophysectomy (transfrontal or transsphenoidal), pituitary radiotherapy (usually external cobalt beam), drug treatment with bromocriptine, or no treatment. Choice of treatment has been mainly influenced by tumour size, with the larger pituitary adenomas having surgery initially. No single form of treatment has been successful in achieving a clinical remission or cure in more than a minority of cases. The most successful outcome has been where total pituitary ablation has been achieved. Life-table analysis for the whole group shows life expectancy which is not markedly different for that of an age-matched population from Northern Ireland. Morbidity related to long term osteoarthritis and treatment complications remain a major problem. The incidence of malignant tumours is higher than would be expected.     

Neutrophil function and diagnosis of pre-leukaemic states.

Haemopoietic dysplasia is a condition which often precedes the development of acute non-lymphocytic leukaemia. Before this event, however, patients are at risk from severe infections even in the absence of neutropenia. This paper describes 3 patients with haemopoietic dysplasias in whom neutrophil microbicidal activity was deficient in vitro. The important abnormality appeared to be defective release of myeloperoxidase into the phagocytic vacuole. Two of these patients suffered from numerous baterial infections.     

预防医学专业学生对某起突发公共卫生事件知晓情况的分析

目的 了解预防医学专业学生对突发公共卫生事件的知晓情况,分析学生对此类事件的敏感程度,了解学生对突发公共卫生事件的关注程度和理论联系实际、分析及解决问题的能力,为教学改革提供依据.方法 对某大学预防医学专业一年级~五年级423名本科生和公共卫生与预防医学各专业104名研究生有关手足口病的知晓情况等进行匿名问卷调查,问卷满分为20分.结果 全体学生平均得分仅为6.15±3.95分,其中,研究生平均得分为8.53±3.26分,高于本科生平均得分5.56±3.89分,本科生平均得分随着年级的升高而增加.学生对问卷中疾病病原体和传染源等问题的回答正确率很低.仅有2.1%的学生对发生较多死亡的病例考虑了3个及以上的原因.从权威的专业医学网站和专业学术期刊获取疫情信息的学生仅有1.9%.结论 预防医学专业学生对本次突发公共卫生事件不能全面知晓和进行综合分析,获取信息的途径十分有限,亟需进行教学改革,更新教学理念,加强学生综合能力的培养.

Abstract：

Objective To investigate preventive medical students' awareness for emergency public health event, to understand their attention extent to this event, their ability of linking theory with practice , analyzing and solving problems and to perform the teaching reform based on the findings of this study.Methods 423 undergraduates students of grade 1 to grade S and 104 postgraduates majoring in preventive medicine from an university were investigated by questionnaire anonymously. The total score of the questionnaire was 20. Results The average score of all the participants was 6.15 ±.95, and the postgraduates ' average score was 8. 53 ±3.26, significantly higher than that (5.56±.89) of the undergraduates'(P<0.001). The average score of the latter increased with grades, P<0.001. The corrective rates for most questions were low. Among all the participants, only 2. 1 percent considered three or more causes for having more death cases, only 1.9 percent obtained the information about the disease from the authoritative and professional medical websites and academic journals. Conclusions The preventive medical students were not aware of this emergency public health event completely and were not able to analyze it comprehensively. Moreover, the approaches to acquire the information were very limited. It is urgent to reform education system, renew educational thoughts and enhance the cultivation of contact between theory and practice capabilities.