上海市新发和输入性传染病防控工作的实践和思考

新发传染病日益增多,对人类健康、动物健康和环境健康等构成严重威胁。针对新发和输入性传染病,本市通过加强疾病预防三级网络建设,构建拓展传染病监测体系和搭建多部门联防联控合作机制,建立起敏感、高效、有力的新发和输入性传染病防控体系。2003年以来,通过有效防控传染性非典型肺炎、甲型H1N1流感、人感染H7N9禽流感等新发传染病和有效应对埃博拉出血热、中东呼吸综合征以及寨卡病毒病和黄热病等新发和输入性传染病疫情,本市新发和输入性传染病监测与应对能力明显提升,防控体系通过实战检验日渐完善。面对本市面临的特大型国际城市传染病防控压力日益增大,全球化背景下新发和输入性传染病防控形势日益严峻,新发和输入性传染病防控技能有待提高,以及传染病防控人员构成与社会需求不匹配等挑战,本市应加强传染病监测预警技术建设,提高传染病监测敏感性与预警能力,建立新发传染病症候群监测系统,加强人员培训,开展国内外合作交流,切实保障城市公共卫生安全和市民健康。     

加强国境卫生检疫应对新发传染病的挑战

为有效预防和应对新发传染病的发生与流行,保障我国卫生安全.本文通过分析新发传染病发生的原因、影响因素及危害,提出了国境卫生检疫应对新发传染病的7点建议,即通过完善监测、预警体系,疫情控制体系,技术支持和保障体系,队伍建设体系,部门协调体系,国际地区联络体系和宣传教育体系等措施.     

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。     

传染病防控体系建设进展与分析

传染病严重威胁人民群众健康,尤其是近年来新发突发传染病不断出现,给国家经济和人民生活带来极大影响。从2003年严重急性呼吸综合征（severe acute respiratory syndrome, SARS）疫情至今,国内已经陆续经历了甲型H1N1流感、H7N9型禽流感等多次疫情考验。目前,我国已经逐步建立了较为完备的传染病防控体系。在此次应对新型冠状病毒肺炎疫情中,上述防控体系发挥了重要作用,但同时也暴露出一些不足。本文将从SARS疫情、禽流感疫情和新型冠状病毒肺炎疫情等方面分析国家传染病防控体系的进展和不足,为未来防控体系完善提供参考意见。     

安阳县传染病疫情网络直报工作现状及影响因素探讨

<正>2003年的SARS疫情使人们充分认识到我国传染病疫情及突发公共卫生事件监测信息报告体系的落后,建立反应灵敏的、稳固长效的传染病疫情及突发公共卫生事件监测信息报告体系,提高对突发公共卫生事件的快速反应和应急处理能力已     

武汉市突发公共卫生事件流行趋势及处置

2003年SARS的爆发,暴露了传染病监测和报告存在的问题。国务院卫生部明确提出建立畅通的疫情信息网络,2004年1月1日卫生部正式启动突发公共卫生事件和传染病疫情网络报告系统。近10年来,武汉市卫生应急工作以处理各种突发事件、新发疾病、不明原因疾病和重大传染病暴发疫情为中心,以完善应急体系、健全制度、     

疫情报告响应机制应尽快评估

建立完善传染病监测及预警体系、传染病疫情报告响应机制,对于控制疫情态势发展,缩小传染病暴发规模,具有非常重要的意义。2003年,我国在经历SARS疫情之后,政府投入巨额资金建立了中国传染病与突发公共卫生事件监测信息系统(简称“网络直报系统”),对各类传染性疾病展开监测,重点监测并报告不明原因肺炎的发生情况。     

加强公共卫生体系建设提高突发公共卫生事件处理能力

突发公共卫生事件是指突然发生、造成或者可能造成社会公众健康严重损害的重大传染病疫情、群体不明疾病、重大食物和职业中毒以及其他严重影响公众健康事件，如2003年发生的SARS疫情。这场突如其来的SARS疫情，给我区公共卫生体系应对突发公共卫生事件的能力提出了严峻的挑战。为更好地加强公共卫生体系建设，切实提高对突发公共卫生事件的处理能力，     

江苏省近年新发传染病防控研究报告

<正>新发传染病固有的特性决定了容易出现暴发和流行,导致突发公共卫生事件;加之疫情初期病因不明、流行规律不清,无有效措施采取,常常引发社会恐慌,影响社会稳定和经济发展,因此针对新发传染病预防控制技术研究尤为重要。近年来,江苏省构建了针对新发传染病和原因不明传染病的监测、预警和应对体系,以及新型疫苗临床试验评价技术体系,采用系统的现场流行病学调     

突发疫情监测的现状及发展趋势

20世纪70年代以来,全世界发现30多种新的传染病,其中一些造成爆发流行,如艾滋病、埃博拉出血热、疯牛病等,2003年春季的SARS的爆发更是引起了社会的极度恐慌与不安定.突发疫情由于来势凶猛,一般事先难以预测,一旦发生将给公众的健康和生命安全带来极大的危害,开展突发疫情监测及时发现疫情是有效应对突发疫情最重要环节,对提高应急能力、保护人民生命健康、维护社会稳定具有十分重要的意义.……     

Gaps remain in China's ability to detect emerging infectious diseases despite advances since the onset of SARS and avian flu

Early detection of emerging infections in China is critical to the health of the 1.3 billion Chinese people and to the world. China's surveillance system for endemic infectious diseases has improved greatly since 2003, but the country's ability to conduct surveillance for laboratory-confirmed infections remains underdeveloped. This is dangerous for China, the world's most populous country, which has been the focus of global attention since outbreaks of severe acute respiratory syndrome (SARS) and avian influenza. We describe China's public health advances since the 2003 SARS outbreak and conclude that China must now invest far more in pathogen-based surveillance. An enhanced disease-detection system in China will help prevent and contain outbreaks before they cause substantial illness and death in China and other countries.     

口岸应对新发传染病的能力及预备状态的研究

目的探讨口岸如何提高应对新发传染病的能力和建立健全的应对体系。方法对现行的口岸卫生检疫查验模式进行分析,结合卫生检疫工作实践,提出口岸提高应对新发传染病能力及建立预备状态的相关措施。结果自20世纪70年代以来。相继发现了40余种新的传染病,其中一些已对人类造成了严重的危害。新发传染病的控制已成为发展中国家和发达国家共同面对的又一个公共卫生问题,因此提高口岸应对新发传染病的能力及预备状态具有重要意义。结论为确保口岸卫生安全。口岸要快速识别传染病病人并及时上报传染病信息;建立健全的口岸应对新发传染病的预备状态,对疫情进行信息化管理和综合监测。加强人医和兽医的联防和新发传染病的研究。     

从SARS看影响我国传染病预防的伦理社会因素

经过全人类的共同努力，SARS终于平稳下降。此次应对SARS的历程昭示，影响我国传染病预防的伦理社会因素主要有六个方面：医务人员的职业道德；卫生资源的分配；疫滑统计和信息发布；政府采取的行政和法律措施；人们的素质和卫生保健意识；世界各国和社会各界的团结协作。我国战胜传染病还有很长的路要走，应该从这次战役中吸取教训，从各方面努力，提高我国应对各种传染病的能力。     

Lessons learned from SARS: the experience of the Health Protection Agency, England

The United Kingdom was assessed as a low risk country throughout the 2003 global SARS outbreaks. Despite this, 368 reports of potential SARS cases were made to the Health Protection Agency (HPA) between March and July 2003. The public health actions undertaken in response to these reports, the establishment of reporting mechanisms and the development of guidance documents were substantial. Lessons learned from mounting a UK response to SARS included: the importance of international collaboration; formation of a UK-wide, multidisciplinary Task Force; flexible case reporting mechanisms; integration of surveillance and laboratory data; generation of prompt and web-accessible guidance and advice; availability of surge capacity; and contingency planning. Lessons learned are being incorporated into the HPA's preparedness to prevent and control future newly emerging infectious disease threats.     

Behind the mask. Journey through an epidemic: some observations of contrasting public health responses to SARS

SARS has been called the first global epidemic of the 21st century and has been the cause of a massive and varied public health response in many countries of the world. This report describes observations made by two authors on a journey from Manchester in the United Kingdom to Chiang Mai in Thailand during the peak of global transmission. The public response to SARS, particularly characterised by the wearing of face masks, seemed to outstrip official guidance. Though of uncertain protective benefit, the wearing of masks may have contributed to the awareness of the collective and personal responsibility in combating infectious disease. Active and empowered involvement of the general public in implementing and cooperating with public health control measures supported by national and international authorities has clearly helped to bring SARS under control. The public health significance of such potent symbols as the face mask may be considered in strategies to tackle other emerging infections.     

中国流感监测网络的发展与展望

流感引起的每年季节性流行在全球造成严重的疾病负担,而且流感还会不定期引起世界性流感大流行,造成严重社会恐慌、经济损失。由于流感病毒的高度可变性和不可确定性,流感防控面临诸多挑战。监测是预防和控制流感的关键策略,流感也是第一个实行全球监测的传染病。中国流感监测60余年,为我国和全球流感防控做出了巨大贡献。特别是近10余年来,流感监测网络得以飞跃发展,规模显著扩大,监测内容和范围不断完善,监测质量迅速提升。中国流感监测网络是我国和全球新发传染病病原的早期发现体系之一,为新发突发传染病应对准备了技术和人才队伍,有助于全面提升公共卫生系统对新发传染病的防控和预测预警能力。     

2004年SARS流行特征

目的：进一步熟悉、掌握SARS流行病学，为预防SARS提供科学依据。方法：收集全世界SARS病毒的流行资料，分析、比较2002／2003年与2003／2004年两次SARS流行特征。结果：2002／2003年SARS仅数月波及全世界31个国家和地区，累计发生病例8437例，死亡872例，病死率是10．34％（9．69％-10．99％），显示出SARS具有极强的传染性、聚集性、致死性、广泛的地域性。而2003／2004年的SARS表现仅为少数几个国家和地区，累计发生病例16例，死亡1例，病死率是6．25％（0．130％-30．00％），虽然两个年度病死率相似（二项分布，P=0．4965），但2003／2004年病例与死亡绝对数极少，显示出较弱的传染性、局限性和有限的地域性。结论：2002／2003年的SARS具有极强的传染性、聚集性、致死性和广泛的地域性，显示出传染源、传播途径、易感人群3个环节控制难度。而2003／2004年的SARS具有独立性、局限性、有限的地域性，显示出较弱的传染性。     

Lessons from SARS in an age of emerging infections

SARS, the first pandemic of this century, commanded the world's attention and required public health actions at the national and international levels. In an age of emerging infections, the lessons learnt from combating SARS can be used to improve our preparedness capabilities in three key areas to effectively tackle a public health emergency of international concern. The first area is in outbreak alert, which encompasses use of surveillance to detect, assess, notify and report events involving death or disease, and share information widely to enable proper risk assessment. The system must able to build up a comprehensive picture with appropriate warning for zoonotic diseases, environmental health and food safety. The second area is in public health response. In the event of an outbreak alert, the authorities must be able to quickly investigate cases/deaths and institute comprehensive control measures to break the chain of transmission. Protection of healthcare workers and reducing the opportunities for spread of infection through contact tracing and quarantine are important. The third area is in international health. This comprises health requirements for inbound and outbound travellers at the border checkpoints and global information exchange to mitigate the risks of travel abroad. Extrapolating these lessons to a wider public health context, our rapidly changing global infectious diseases situation mandates that we evaluate all available public health tools and build institutional capacity to effectively manage emerging infections.     

HHS/CDC legal response to SARS outbreak

Before the severe acute respiratory syndrome (SARS) outbreak, the Centers for Disease Control and Prevention's (CDC) legal authority to apprehend, detain, or conditionally release persons was limited to seven listed diseases, not including SARS, and could only be changed using a two-step process: 1) executive order of the President of the United States on recommendation by the Secretary, U.S. Department of Health and Human Services (HHS), and 2) amendment to CDC quarantine regulations (42 CFR Parts 70 and 71). In April 2003, in response to the SARS outbreak, the federal executive branch acted rapidly to add SARS to the list of quarantinable communicable diseases. At the same time, HHS amended the regulations to streamline the process of adding future emerging infectious diseases. Since the emergence of SARS, CDC has increased legal preparedness for future public health emergencies by establishing a multistate teleconference program for public health lawyers and a Web-based clearinghouse of legal documents.     

Lessons learned from international responses to severe acute respiratory syndrome (SARS)

In early February 2003, a previously unknown disease causing severe pneumonia was recognised. This disease which is now known as severe acute respiratory syndrome (SARS) is believed to have had its origins in the Guangdong Province of China, and was the cause of a multi-country epidemic resulting in significant morbidity and mortality. The World Health Organization (WHO) has been coordinating the international response to provide the epidemiological, laboratory, clinical and logistic requirements needed to contain this disease. A rapid spread of SARS around the world occurred at its onset, facilitated greatly by air travel. Between November 2002 and July 2003, a total of 8,094 cases and 774 cases were reported from 26 countries worldwide. WHO responded quickly to this multi-country outbreak and on 12 March released a “global alert” about SARS. This was followed by the first WHO travel advisory on 15 March. The Global Outbreak Alert and Response Network was activated, and international experts were brought together to implement enhanced global surveillance systems for SARS. The international community has learned a lot of lessons from the SARS outbreak. Particularly, rapid and transparent information sharing between countries is critical to prevent international spread of the disease. However, information exchange was less than optimal in the early phase of the outbreak.