病毒性新发传染病的主要传播途径及其对卫生检疫的影响

[目的]针对病毒性新发传染病改进国境卫生检疫工作。[方法]对病毒性新发传染病及其传播途径进行分析研究，结合卫生检疫工作实践，提出相关改进措施。[结果]目前我国陆续发现的新发传染病有近20种。对人类威胁最大的6种病毒为：埃博拉、拉沙、马尔堡、西尼罗、登革和马秋波病毒。病毒性新发传染病危害大，传播途径广，应针对其传播途径改进口岸卫生检疫措施，阻止疾病从口岸传人。[结论]面对新发传染病特别是病毒性传染病的可能传人，口岸出入境检验检疫机构必须改进现有口岸卫生检疫工作，领导重视，建立疫情的信息化管理，加强检疫监督和口岸健康促进，消灭可能的传播媒介。     

国境口岸应对新发传染病信息化建设的思考

目的探讨国境口岸应对新发传染病的信息化建设工作现况,为完善口岸应对新发传染病的信息化建设提供参考。方法系统分析口岸新发传染病信息化建设的基本情况。结果口岸卫生检疫工作的电子化、信息化和规范化已取得显著成效,应对新发传染病的信息化建设仍待进一步加强。结论通过建立信息共享机制,整合信息收集平台,加强口岸资源配置,建立信息管理制度,拓展信息传播渠道,全面提升国境口岸应对新发传染病的信息化水平。     

提高口岸应对重大传染病处置能力积极推动卫生检疫制度创新

为了提高口岸一线应对重大传染病疫情的监测及处置能力,为海关制度创新和治理能力建设提供根本遵循,通过对我国现行的卫生检疫模式进行梳理分析,找出我国在国境口岸应对传染病突发事件的短板与不足.目前卫生检疫在法律法规体系、人员、基础建设等方面存在一定的困境.在今后的工作中要提高卫生检疫人员的能力建设,加大对口岸软硬件的支持力度...     

传染病新特点与口岸卫生检疫应对

目的提高国境口岸应对传染病的新特点的能力。方法分析传染病新近出现新的特点和趋势,提出国境口岸卫生检疫的应对措施。结果应对传染病出现全球化、卷土重来的新特点,口岸卫生检疫工作任重道远,加强国际、国内、区域间及人医与兽医的合作,调整卫生检疫模式及内容,建立有效的防控体系。结论在传染病全球化和增多的情况下,建立有效的卫生检疫模式。     

新发传染病风险因素分析及口岸应对策略

阐述了新发传染病出现和爆发的风险因素、传入我国的危险因素及口岸检验检疫部门的应对策略。新发传染病出现和爆发的风险因素多种多样,随着我国对外交往的进一步扩大,新发传染病进入我国的风险也随之增大,传统的疾病监测模式在实际应用中暴露出了局限性,口岸的应对策略须进一步完善。我们要不断完善疫情疫病监测防控体系,建立健全突发事件应急处置机制,强化口岸基础设施建设,加强对新发传染病的科学研究,大力开展培训和演练等构起疫情疫病防控的绿色长城。     

口岸输入性传染病风险识别的现状及优化

随着后疫情时代的到来，国际贸易及出入境人员流动逐渐增多，我国国境口岸面临新发和多发传染病输入和输出的风险。如何对口岸新发和多发输入性传染病开展风险识别及预防控制，提高口岸输入性传染病监测预警水平，是后疫情时代卫生检疫面临的公共卫生问题。本文通过总结分析口岸输入性传染病风险识别的发展历程和现状，发现口岸输入性传染病风险识别中存在预警滞后性、风险识别指标体系差异大以及过度依赖风险体系模型导致疫情误判的问题，提出后疫情时代在口岸输入性传染病风险识别中要充分收集信息、正确甄别信息和恰当评估输入性传染病疫情信息的建议。     

防范重大新发突发传染病跨境输入的新思考

《中华人民共和国生物安全法》首次提出重大新发突发传染病的概念。本文结合近年全球关注的公共卫生事件,概述了重大新发突发传染病特点;分析了重大新发突发传染病风险因素,特别是病原体的变异加重疫情跨境传播风险,可能的超级传播者显著影响疫情扩散,"环境传人"等因素使疫情防控难度加大,高发、多种传染病流行叠加造成疫情波动。在此基础上,本文从重视顶层设计、风险研判、口岸公共卫生核心能力建设等方面提出口岸卫生检疫防范重大新发突发传染病从境外输入的应对措施和建议。     

从新修订的《国际卫生条例》论我国卫生检疫工作滞后

新修订的<国际卫生条例>在内容、格式上作了重大调整,纳入了许多新的观点和内容,突破了传统的传染病管理模式,将原有的3种国际检疫传染病修改为生物、化学、核和辐射所引起的3种国际公共卫生事件;主张实施全球健康保障、流行病预警和应对战略;强调预警及疫情信息畅通和快速传递;对卫生主管机构和口岸应对卫生事件和能力提出了更高的要求.对照新修订的<国际卫生条例>,我国现行的法律及卫生检疫工作现状在诸多方面滞后.为适应新修订的<国际卫生条例>的要求,检验检疫机构应采取如下应对措施:①重新修订<中华人民共和国国境卫生检疫法>及其实施细则;②建立健全国境口岸公共卫生突发事件应急机制;③加强卫生检疫人员知识培训;④加大检疫查验的投入.     

国境口岸应对突发公共卫生事件立法探析

〔目的〕探析完善我国国境口岸应对突发公共卫生事件立法体系,提供国境卫生检疫部门应对突发公共卫生事件处置的法律依据,提高口岸卫生核心能力。〔方法〕分析我国目前应对公共卫生突发事件体制的现状和《国际卫生条例(2005)》对口岸核心能力的要求,提出国境卫生检疫部门在应对口岸突发公共卫生事件方面的立法建议。〔结果〕有利于充分发挥卫生检疫部门的技术指导和快速应对的作用,提高口岸处置突发公共卫生事件的能力,更有效保障人民的生命和财产安全。〔结论〕通过立法赋予国境卫生检疫部门参与甚至主导国境口岸突发公共卫生事件的足够权责,更有利于发挥国境卫生检疫部门在处置口岸突发公共卫生事件的作用,提高口岸卫生检疫核心能力。     

口岸卫生检疫监管体系研究

〔目的〕在人们对健康、疾病的认识发生了巨大变化的今天,探讨我国口岸卫生检疫监管机制、模式的转变,探索建立和完善适应WHO《国际卫生条例(2005年)》要求的口岸卫生检疫监管体系。〔方法〕通过对《国际卫生条例(2005年)》对口岸卫生控制核心能力的要求、对出入境人员、交通工具、物品等卫生控制的规定,以及我国口岸卫生检疫监管工作现状的研究、分析,提出完善口岸卫生检疫监管新机制、新模式的建议。〔结果〕①口岸卫生检疫工作由口岸卫生安全维持系统和口岸突发公共卫生事件应急系统2部分组成,口岸突发公共卫生事件应急系统有赖于口岸卫生检疫监测预警应对机制的建立;②口岸卫生检疫监测预警应对机制包括科学决策的组织指挥体系、快速获悉疫情的监测网络与预警系统、根据事件性质和严重程度做出不同应对的响应系统、强有力的后勤保障系统。〔结论〕适应《国际卫生条例(2005)》的要求,承担国际条约的义务,提高口岸应对国际关注公共卫生突发事件核心能力,防止传染病传入传出,促进和保障社会经济快速健康增长,成为我们的当务之急。     

海湾国家公共卫生安全风险、治理体系和治理能力分析

海湾国家是中国重要的战略合作伙伴,面临双重疾病负担。近年来,海湾国家新发和再发传染病频发,对中国公共卫生安全构成威胁。此次全球新冠病毒肺炎大流行充分暴露出,海湾国家的公共卫生体系建设和治理能力仍存在诸多挑战。本文就海湾国家公共卫生安全风险与治理能力展开分析,并建议中国与海湾国家在完善疾病监测系统、卫生应急能力提升、公共卫生人才培养,以及疫苗、药物及诊疗技术研发等方面开展合作。     

高度不确定新发传染病的应对策略和措施

新发传染病发生和发展具有高度不确定性。本文总结了新发传染病的复杂性和不确定性,提出面对未来万变的新发传染病,人类应不断提高防治能力,完善其各种准备为不变的策略,去应对万变的新发传染病。应做好传染病监测工作网络的布局,建立传染病实验室监测工作网络并保持常规运转,建立和完善医疗救治和处置的平战结合平战转换制度和机制,制定和...     

基于Oracle数据库的数字化远程诊断平台在口岸传染病监测中的应用

目的探索适合口岸发展要求的传染病监测新技术模式,以达到卫生检疫核心能力建设要求。方法国际旅行卫生保健中心利用现有业务系统的后端Oracle数据库,整合图像存储和通信系统(Pictures Archiving and Communication Systems,PACS)功能,借助成熟的3G网络技术和云存储技术,构建基于Oracle数据库的数字化远程诊断平台。结果实现口岸传染病"随时随地"的远程诊断和监测,最大限度地发挥保健中心的技术支撑作用,极大地提升口岸传染病监测能力和突发公共卫生事件应急处置能力。结论该平台的开发与应用对确保口岸卫生安全具有重要的现实意义。     

Emergency preparedness and public health systems lessons for developing countries

Low- and middle-income countries, where emerging diseases often make their debut, are also likely to bear the harshest consequences of a potential influenza pandemic. Yet public health systems in developing countries are underfunded, understaffed, and in many cases struggling to deal with the existing burden of disease. As a result, developed countries are beginning to expand assistance for emergency preparedness to the developing world. Given developing countries' weak infrastructure and many competing public health priorities, it is not clear how to best direct these resources. Evidence from the U.S. and other developed countries suggests that some investments in bioterror and pandemic emergency preparedness, although initially implemented as vertical programs, have the potential to strengthen the general public health infrastructure. This experience may hold some lessons for how global funds for emergency preparedness could be invested in developing countries to support struggling public health systems in responding to current health priorities as well as potential future public health threats.     

Training initiatives within the AFHSC-Global Emerging Infections Surveillance and Response System: support for IHR (2005)

Training is a key component of building capacity for public health surveillance and response, but has often been difficult to quantify. During fiscal 2009, the Armed Forces Health Surveillance Center, Division of Global Emerging Infections Surveillance and Response System (AFHSC-GEIS) supported 18 partner organizations in conducting 123 training initiatives in 40 countries for 3,130 U.S. military, civilian and host-country personnel. The training assisted with supporting compliance with International Health Regulations, IHR (2005). Training activities in pandemic preparedness, outbreak investigation and response, emerging infectious disease (EID) surveillance and pathogen diagnostic techniques were expanded significantly. By engaging local health and other government officials and civilian institutions, the U.S. military's role as a key stakeholder in global public health has been strengthened and has contributed to EID-related surveillance, research and capacity-building initiatives specified elsewhere in this issue. Public health and emerging infections surveillance training accomplished by AFHSC-GEIS and its Department of Defense (DoD) partners during fiscal 2009 will be tabulated and described.     

Identifying the Gaps Between Biodefense Researchers, Public Health, and Clinical Practice in a Rural Community

ABSTRACT:  Objective: It is essential for health care professionals to be prepared for a bioterrorist attack or other public health emergency. We sought to determine how well biodefense and emerging infectious disease research information was being disseminated to rural health care providers, first responders, and public health officials. Methods: Semi-structured interviews were conducted at a federally funded research institution and a rural community in Washington state with 10 subjects, including researchers, community physicians and other health care providers, first responders, and public health officials. Results: The interviews suggest there is inadequate information dissemination regarding biodefense and emerging infectious disease research and an overall lack of preparedness for a bioterrorist event among rural clinicians and first responders. Additionally, a significant communication gap exists between public health and clinical practice regarding policies for bioterrorism and emerging infectious disease. There was, however, support and understanding for the research enterprise in bioterrorism. Conclusions: Biodefense preparedness and availability of information about emerging infectious diseases continues to be a problem. Methods for information dissemination and the relationships between public health officials and clinicians in rural communities need to be improved.     

Public health's response to a changed world: September 11, biological terrorism,and the development of an environmental health tracking network

Historically, the importance of public health has often been recognized during or as a result of major tragedy. The attacks that occurred in the United States in 2001 are no exception. These events have raised awareness of our vulnerability and the need for emergency preparedness, the need for a flexible and sustainable public health infrastructure, and the importance of linkages between environmental exposures and health outcomes. The authors encourage the public health community, along with policymakers, to develop a national environmental health tracking system that can improve our overall public health capacity and prepare us to investigate the critical issues of the day, whether they be emerging infectious diseases, terrorist attacks, or chronic illnesses.     

关于改革完善重大疫情防控救治体系的建议

针对重大疫情防控救治，在系统梳理临床治疗、疾病控制和科学研究三者定位的基础上，结合本次新型冠状病毒肺炎疫情暴露出来的问题，提出了改革完善我国重大疫情防控救治体系的建议。临床治疗方面，要加强医务人员依法报告意识，强化症状检测能力，充分发挥传染病直报系统的作用，建立健全新发突发传染病的国家或地方监测平台。疾病控制方面，要从法律和体制机制上赋予疾控相关权限和保障，提升疾控队伍的数量和质量，加强防控与应急需求为导向的应用性研究和技术储备。科学研究方面，要加强以国家需求为导向的科研立项，建设重大疫情应对中“一锤定音”的科研机构，建立国家和区域传染病重点实验室，加强新发突发传染病防控救治的战略技术储备。     

Influenza preparedness and the bureaucratic reflex: anticipating and generating the 2009 H1N1 event

This paper draws together work on the event to problematise the generative implications of anticipatory governance in the management of emerging infectious disease. Through concerns for preparedness, the need to anticipate outbreaks of disease has taken on a new urgency. With the identification of the H1N1 virus circulating amongst human populations in 2009, public health measures and security practices at regional, national and international levels were rapidly put into play. However, as the ensuing event demonstrated, the social, political and economic disruptions of emerging infectious diseases can be matched by those of anticipatory actions. I argue that the event-making potential of surveillance practices and the pre-determined arrangements of influenza preparedness planning, when triggered by the H1N1 virus, caused an event acceleration through the hyper-sensitised global health security architecture. In the UK, this led to a bureaucratic reflex, a security response event that overtook the present actualities of the disease. This raises questions about the production of forms of insecurity by the security apparatus itself.     

Building academic-practice partnerships: the Center for Public Health Preparedness at the Columbia University Mailman School of Public Health, before and after 9/11.

The Center for Public Health Preparedness at the Columbia University Mailman School of Public Health is part of a national network of academic centers established by the Centers for Disease Control and Prevention to strengthen links between public health practice and academe, especially for public health workforce development. Since its inception in Fall 2000, the Center has been working in partnership with the New York City Department of Health & Mental Hygiene (DOHMH) on planning and competency-based training in emergency preparedness (including bioterrorism and infectious diseases) and evaluation. Initial programs with DOHMH included development of a 3-hour orientation to basic emergency preparedness for their workforce. In the wake of 9/11 and the anthrax events, Center members gave over two dozen presentations at community forums, seminars, and clinical rounds, and over 100 press interviews, provided lay language information through community forum presentations and the School's Web site, and developed a database of volunteers for surge capacity. Subsequent programs include bioterrorism response training for clinicians and emergency medical services personnel, incident command for public health, and a study of evacuation from the World Trade Center on 9/11.