流感大流行与国境口岸流感监测

目的应对甲型H1N1流感大流行。方法对流感监测的意义以及当前全球和中国流感监测发展的现况进行总结分析,对国境口岸如何加强流感监测进行了探讨。结果流感监测是应对流感大流行的基础,国境口岸可从加强国际合作、延伸监测网络、建设口岸实验室网络和流感监测专业队伍等措施加强流感监测,实现早期预警。结论在流感大流行的早期,出入境检验检疫机构必须重视加强国境口岸的流感监测和早期预警,及时掌握第一手资料,积极应对流感大流行,控制传染源入境。     

The 1957 pandemic of influenza in India

Asian influenza appears to have reached India via Madras in May 1957. The main pandemic wave swept through the subcontinent within the next 12 weeks; cases occurring thereafter represent the permanent infiltration of the new virus into the population. Between 19 May 1957 and 8 February 1958 there were reported 4 451 758 cases, with 1098 deaths. The author discusses the attack-rates by age-group, by occupational group, by State and in closed communities such as schools. The disease, in India as elsewhere, seems generally to have run a mild course, although nausea and vomiting and symptoms related to the nervous system were relatively frequently seen.A number of A/Asia/57 virus strains were isolated; their antigenic and biological characteristics are discussed in some detail. In view of the rapid spread of the pandemic, it proved impossible to prepare sufficient vaccine from the new strains in time for adequate field trials or mass immunization of the population.The author reports briefly on the results obtained with iodine in the prevention and treatment of influenza.     

The PHLS response to a pandemic of influenza

This document sets out the Public Health Laboratory Service (PHLS) action plan for responding to an influenza pandemic. The plan entails, in phase 0, interpandemic surveillance by the Communicable Disease Surveillance Centre (CDSC) and the Enteric & Respiratory Virus Laboratory (ERVL) of the Central Public Health Laboratory (CPHL), as well as maintenance by Area & Regional (A & R) Public Health Laboratories of updated diagnostic techniques for influenza. In phase 1 (the emergence of a shifted influenza virus strain) a Pandemic Working Group will be convened to consider what action by PHLS is necessary. In phase 2 (pandemic influenza outside UK) the pre-defined roles for PHLS laboratories and CDSC will be adopted. When a pandemic is imminent in the United Kingdom (phase 3) the Working Group will co-ordinate PHLS activities and the Director of the Service will assess what special studies should be implemented. In phase 4, when the pandemic has reached the UK, the action plan sets out comprehensive measures that will be taken by CDSC, ERVL and A & R Laboratories to gather and collate information, provide DoH with weekly surveillance data and develop recommendations for prophylaxis, clinical management and treatment. When influenza activity has returned to background levels (phase 5) a report will be drafted by the Working Group prior to it being stood down by the Director of the Service. The response is summarised in tabular form in Table 1.Reproduced by kind permissin of thePHLS Microbiology Digest (first published 1993, 10: 147–154)     

The epidemiology and clinical impact of pandemic influenza

It is impossible to predict when the next pandemic of influenza will occur; however, it is almost 35 years since the last pandemic, and the longest inter-pandemic interval recorded with certainty is 39 years. The next pandemic virus is likely to emerge in southeast Asia, as have two of the last three pandemic viruses. Complete global spread is likely to occur in 6 months or less, due to increased travel and urbanisation. It is likely that the usual inter-pandemic pattern of age-specific mortality will deviate temporarily towards higher mortality in younger adults. The extent to which this will happen is unclear, as the shift was extreme in 1918-1919 but less so in subsequent pandemics. Nevertheless, this may have important implications for the protection of essential workers such as health care, emergency service and military personnel. The extent to which elderly persons will be affected will depend upon previous exposure to similar influenza viruses. It is impossible to predict the likely increase in excess mortality that will occur when a new pandemic virus emerges. However, whilst mortality on the scale experienced in 1918-1919 is probably unlikely, there was a high level of mortality among those infected with the A/H5N1 virus in 1997, so it cannot be assumed that a future pandemic will be as mild as those in 1957-1958 or 1968-1969. There is likely to be more than one wave of infection and health services in most countries will be hard pressed to provide vaccines or to manage populations with clinical attack rates of approximately 25-30% and concomitant increases in demand for both primary and secondary health care services.     

Vaccines for pandemic influenza

Recent outbreaks of highly pathogenic avian influenza in Asia and associated human infections have led to a heightened level of awareness and preparation for a possible influenza pandemic. Vaccination is the best option by which spread of a pandemic virus could be prevented and severity of disease reduced. Production of live attenuated and inactivated vaccine seed viruses against avian influenza viruses, which have the potential to cause pandemics, and their testing in preclinical studies and clinical trials will establish the principles and ensure manufacturing experience that will be critical in the event of the emergence of such a virus into the human population. Studies of such vaccines will also add to our understanding of the biology of avian influenza viruses and their behavior in mammalian hosts.     

Medical students and pandemic influenza

To assess knowledge of pandemic influenza, we administered a questionnaire to all medical students at the University of Alberta; 354 (69%) of 510 students responded. Data from questionnaires such as this could help determine the role of medical students during a public health emergency.     

流感大流行非药物性干预措施

流行性感冒(流感)大流行是指人群中出现甲型流感病毒血凝素新亚型或旧亚型重现,人群普遍缺乏免疫力,病毒在人群中快速传播,超出国界和洲界,引起全球范围的广泛流行[1-3].流感大流行的干预措施包括药物性和非药物性干预措施.药物性干预措施包括疫苗和抗病毒药物,但数量有限.特别是对于资源匮乏的国家,非药物性干预措施是阻止疫情蔓延的有效途径[4].常见的非药物性干预措施包括隔离、检疫、社会隔离、旅行措施、医院内感染控制、个人卫生、公共卫生信息沟通和消毒等.     

流感大流行的药物性干预措施

流行性感冒（流感）大流行是指甲型流感病毒出现新亚型或旧亚型重现，人群普遍缺乏免疫力，病毒在人群中快速传播，引起全球范围的广泛流行。如何在流感大流行来临前做好准备，将大流行可能造成的经济、社会影响降到最低，最大程度地保护人类健康，是目前全球亟待解决的问题。流感大流行的干预措施可分为药物性和非药物性干预措施。[第一段]     

全球应对流行性感冒大流行的疫苗策略

2009年4月墨西哥出现一种新的甲型H1N1流行性感冒(简称流感)暴发,并在短短的2个月内传播到全球.6月11日世界卫生组织(WHO)把流感大流行警戒级别提升为最高的6级,表明世界正处在2009年流感大流行的开端[1].     

Introduction to pandemic influenza through history

For the past 400 years, epidemics resembling influenza have been recorded in many countries. Epidemics from as early as the 16th Century in England and the 18th Century in the USA are recognizable as influenza, even in the absences of precise knowledge of their causative agents.