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  • 摘要:

    This fifth update of the risk assessment on human infection with avian influenza A(H7N9) virus, summarises the epidemiological and virological information on the disease in China and Canada, and assesses the risk to public health in the EU/EEA and to EU/EEA citizens. - See more at: http://ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm.aspx?List=4f55ad51-4aed-4d32-b960-af70113dbb90&ID=1634#sthash.aSz59UoP.dpuf

    来源机构: 欧洲疾病预防控制中心(ECDC) | 点击量:1228
  • 摘要:

    为指导疾病预防控制专业人员和预防接种人员合理使用EV71疫苗,做好受种儿童家长沟通与咨询,中国疾病预防控制中心制定了《肠道病毒71型灭活疫苗使用技术指南》。

    该指南主要包括EV71病原学、临床学、流行病学、EV71疫苗、EV71疫苗使用建议五个部分,对EV71感染的疾病、诊断与治疗、全球流行概况和我国人群的流行特征、疾病负担、EV71疫苗研发进展、接种对象、接种程序和禁忌、接种管理及注意事项等各方面进行了系统阐述,并对EV71疫苗与其他疫苗同时接种、不同企业疫苗的序贯接种、公众交流与信息传播等提出具体的建议和要求。

    来源机构: 中国疾病预防控制中心 | 点击量:32
  • 摘要:

    As of 29 February 2016, the spread of the Zika virus epidemic in the Americas and Caribbean is continuing. In the light of the current disease trend and the association with severe complications (such as adverse pregnancy outcomes or neurological complications), ECDC is proposing an algorithm for public health management of cases

    under investigation for Zika virus infection and an outline of the strategy for the laboratories performing Zika virus infection diagnostic tests.

    This document aims to present an algorithm for deciding whom to test and provide guidance on the laboratory tests for Zika virus infection diagnosis in order to support clinical diagnostic and case reporting through surveillance among EU Member States.

    The information is provisional and subject to revision when new information becomes available.

    来源机构: 欧洲疾病预防控制中心(ECDC) | 点击量:62
  • 摘要:

    US CDC developed the US Zika Pregnancy Registry to:

    ?

    Learn more about the effects of Zika virus infection (Zika) during pregnancy.

    ?

    Learn more about the growth and development of babies whose mothers had Zika

    while pregnant.

    CDC will collect health information about Zika and pregnant women and babies across

    the United States for the registry. CDC, health departments, doctors and healthcare

    providers will use the information from this registry to help pregnant women, children,

    and families affected by Zika

    来源机构: | 点击量:76
  • 摘要:

    From week 40/2015, the start of weekly reporting on influenza activity in the WHO European Region, to week 13/2016, over 120 000 influenza detections across the Region have been reported. Influenza type A viruses are prevailing over type B but, unlike the situation in the 2014–15 season, A(H1N1)pdm09 viruses are prevailing over A(H3N2) and the proportion of B/Victoria-lineage detections has risen substantially, representing ~94% of those assigned to a lineage.

    To date, 24 EU/EEA countries have shared 472 influenza-positive specimens with the Francis Crick Institute, London, for detailed characterisation: one additional country and 48 specimens since the February 2016 report. Since the latter report, 67 viruses have been characterised antigenically and genetic analyses are ongoing.

    The 35 A(H1N1)pdm09 viruses characterised antigenically were similar to the vaccine virus A/California/7/2009. Worldwide, new genetic sub-clusters of viruses within the 6B clade have emerged, with two being designated as subclades: 6B.1 defined by HA1 amino acid substitutions S162N and I216T and 6B.2 defined by HA1 amino acid substitutions V152T and V173I. Of the 178 viruses characterised genetically for the 2015–16 season, 24 (13%) were clade 6B, 147 (83%) were subclade 6B.1 and seven (4%) were subclade 6B.2.

    The six A(H3N2) test viruses characterised by haemagglutination inhibition (HI) assay were poorly recognised by reference antiserum raised against egg-propagated A/Switzerland/9715293/2013, the vaccine virus recommended for use in the 2015–16 northern hemisphere influenza season, despite at least three of the test viruses falling in the same subclade (3C.3a) as the vaccine virus. The test viruses were recognised somewhat better by antisera raised against egg-propagated A/Hong Kong/4801/2014, the virus recommended for use in 2016 southern hemisphere and 2016–17 northern hemisphere influenza vaccines. Of 55 A(H3N2) viruses characterised genetically for the 2015–16 season: one (2%) was clade 3C.3, 32 (58%) were subclade 3C.2a and 22 (40%) were subclade 3C.3a.

    The 23 B/Victoria-lineage viruses were antigenically similar to tissue culture-propagated surrogates of B/Brisbane/60/2008. All 56 viruses characterised genetically for the 2015–16 season fell in genetic clade 1A as do recently collected viruses worldwide.

    Three B/Yamagata viruses have been characterised since the previous report; all reacted well with post-infection ferret antiserum raised against egg-propagated B/Phuket/3073/2013, the recommended vaccine virus for the northern hemisphere 2015–16 influenza season and for quadrivalent vaccines in the 2016 southern hemisphere and 2016–17 northern hemisphere seasons. All 10 viruses characterised genetically for the 2015–16 season fell in genetic clade 3.

    来源机构: | 点击量:51
  • 摘要:

    中华人民共和国国家卫生和计划生育委员会2016-04-05

    黄热病主要在中南美洲和非洲的热带地区流行。我国于2016年3月12日确诊首例输入性黄热病病例,截至3月24日共发现6例输入性病例,均来自安哥拉。为做好黄热病医疗救治相关工作,国家卫生和计划生育委员会组织专家在借鉴世界卫生组织有关指南和总结国内有关病例救治经验的基础上,对黄热病诊疗方案进行修订完善,形成《黄热病诊疗方案(2016年版)》(可从国家卫生计生委网站下载)。现印发给你们,请参照执行。

      各地卫生计生行政部门特别是与疫情发生地有人员往来的口岸地区卫生计生部门,要继续做好相关防控和医疗救治准备工作,保持与口岸卫生检疫、交通等部门的沟通与联动,保证各项防控措施落实到位。要加强病例管理,做到早发现、早诊断、早治疗,按照诊疗方案有关要求为患者提供规范的诊疗服务,做好病例防蚊隔离工作。加强医务人员培训,提高黄热病早期识别和诊疗能力。有疾病传播蚊媒分布的省份要加强环境卫生整治,根据蚊媒监测情况及时、有效开展灭蚊工作,降低蚊媒疾病传播风险。

    来源:国家卫生计生委办公厅关于印发黄热病诊疗方案(2016年版)的通知 - 中华人民共和国国家卫生和计划生育委员会 http://www.nhfpc.gov.cn/yzygj/s3593g/201604/9940aa0e0bee4e5eaaac03a21d18e7e9.shtml

    来源机构: | 点击量:118
  • 摘要:

    中华人民共和国国家卫生和计划生育委员会2016-04-01

    2016年2月,国家卫生和计划生育委员会印发了《寨卡病毒病防控方案(第一版)》(国卫发明电〔2016〕4号)。为适应防控形势的变化,进一步做好防控工作,切实维护人民群众身体健康和生命安全,国家卫生和计划生育委员会组织对此方案进行了修订,形成《寨卡病毒病防控方案(第二版)》(可从国家卫生计生委网站www.nhfpc.gov.cn下载)。

    来源:http://www.nhfpc.gov.cn/jkj/s3577/201604/d27c387de74a48668dc895371c97e523.shtml

    来源机构: | 点击量:75
  • 摘要:

    中华人民共和国国家卫生和计划生育委员会2016-03-30

    近期,报告寨卡病毒感染病例的国家有增多趋势。截至2016年3月8日,至少在非洲、亚洲、欧洲、美洲的55个国家有寨卡病毒传播的证据,以巴西疫情最为严重。2016年2月9日我国江西省发现首例输入性病例,截至2016年3月11日共发现输入性病例13例。为做好寨卡病毒病医疗救治相关工作,国家卫生计生委组织专家在借鉴世界卫生组织有关指南和总结国内有关病例救治经验的基础上,对寨卡病毒病诊疗方案进行修订完善,形成《寨卡病毒病诊疗方案(2016年第2版)》(可从国家卫生计生委网站下载)。现印发给你们,请参照执行。

      各地卫生计生行政部门特别是与疫情发生地有人员往来的口岸地区卫生计生部门,要继续做好寨卡病毒疫情防控和医疗救治准备工作,保持与口岸卫生检疫、交通等部门的沟通与联动,保证各项防控措施落实到位。要加强病例管理,做到早发现、早诊断、早治疗,按照诊疗方案有关要求为患者提供规范的诊疗服务,做好病例防蚊隔离工作。加强医务人员培训,提高寨卡病毒病早期识别和诊疗能力。有疾病传播蚊媒分布的省份要加强环境卫生整治,根据蚊媒监测情况及时、有效开展灭蚊工作,降低蚊媒疾病传播风险。

    来源:国家卫生计生委办公厅关于印发寨卡病毒病诊疗方案(2016年第2版)的通知 - 中华人民共和国国家卫生和计划生育委员会 http://www.nhfpc.gov.cn/yzygj/s3593g/201603/caf676bda9db4c94950126f9cb126b96.shtml

    来源机构: | 点击量:105
  • 摘要:

    ?Influenza virus characterisation, Summary Europe, February 2016

    11 Mar 2016

    From week 40/2015, the start of weekly reporting on influenza activity in the WHO European Region, to week 07/2016 over 70 000 influenza detections across the Region have been reported. Influenza type A viruses are prevailing over type B but, unlike the situation in the 2014–15 season, A(H1N1)pdm09 viruses are prevailing over A(H3N2), and the proportion of B/Victoria-lineage detections has risen substantially, representing ~92% of those ascribed to a B virus lineage.

    To date, 23 EU/EEA countries have shared 424 influenza-positive specimens with the Francis Crick Institute, London, for detailed characterisation: 16 additional countries and 330 specimens since the December 2015 report. Since the latter report, 230 viruses have been characterised antigenically and genetic analyses are ongoing.

    The 166 A(H1N1)pdm09 viruses characterised antigenically were similar to the vaccine virus A/California/7/2009. Worldwide new genetic sub-clusters of viruses within the 6B clade have emerged, with two being designated as subclades: 6B.1 defined by HA1 amino acid substitutions S162N and I216T and 6B.2 defined by HA1 amino acid substitutions V152T and V173I. Of the 123 viruses characterised genetically, 18 (14%) were clade 6B, 98 (80%) were subclade 6B.1 and seven (6%) were subclade 6B.2.

    The 26 A(H3N2) test viruses characterised by haemagglutination inhibition (HI) assay were poorly recognised by reference antiserum raised against egg-propagated A/Switzerland/9715293/2013, the vaccine virus recommended for use in the 2015–2016 northern hemisphere influenza season, despite over 75% of the test viruses falling in the same genetic subclade (3C.3a) as the vaccine virus. The test viruses were recognised somewhat better by antisera raised against egg-propagated A/Hong Kong/4801/2014, the virus recommended for use in 2016 southern hemisphere and 2016–2017 northern hemisphere influenza vaccines. Of 40 A(H3N2) viruses characterised genetically: one (2%) was clade 3C.3, 23 (58%) were subclade 3C.2a and 16 (40%) were subclade 3C.3a.

    The 33 B/Victoria-lineage viruses were antigenically similar to B/Brisbane/60/2008 and fell in genetic clade 1A as do recently collected viruses worldwide.

    The five B/Yamagata viruses characterised fell in genetic clade 3 and reacted well with post-infection ferret antiserum raised against egg-propagated B/Phuket/3073/2013, the recommended vaccine virus for the northern hemisphere 2015–16 influenza season and for use in quadrivalent vaccines in the 2016 southern hemisphere and 2016–17 northern hemisphere influenza seasons.

    - See more at: http://ecdc.europa.eu/en/publications/_layouts/forms/Publication_DispForm.aspx?List=4f55ad51-4aed-4d32-b960-af70113dbb90&ID=1447#sthash.BEgxu8S0.dpuf

    来源机构: | 点击量:34
  • 10   2016-03-14 卫计委:黄热病预防控制技术指南 (编译服务:新发突发疾病防治)     
    摘要:

    黄热病预防控制技术指南

    黄热病 (yellow fever) 是一种由黄热病毒引起,经蚊传播的急性传染病,属于国际检疫的传染病之一。临床主要表现为发热、黄染、出血等,在某些暴发疫情中病死率可高达20%-40%。本病主要在中南美洲和非洲的热带地区流行,在蚊和非人灵长类之间周期性地发生自然感染循环。

    一、疾病概述

    (一)病原学

    黄热病毒(yellow fever virus)属于黄病毒科(Flaviviridae)的黄病毒属(Flavivirus),病毒颗粒呈球形,直径37-50 nm,外有脂质包膜,表面有棘突。病毒基因组为不分节段的单股正链RNA,约由11000核苷酸组成,分子量约为3.8×106。黄热病毒只有一个血清型。该病毒可与黄病毒科其他成员如登革病毒、西尼罗病毒、圣路易脑炎病毒产生交叉血清学反应。

    黄热病毒有嗜内脏如肝、肾、心等(人和灵长类)和嗜神经(小鼠)的特性。经鸡胚多次传代后可获得能够作为疫苗的减毒株。1936年,通过鸡胚连续传代生产出黄热病17D减毒活疫苗,沿用至今,很多黄热病流行国家用其对9月龄婴儿进行常规免疫。美国每年有25万前往热带地区的旅游者和军人接种黄热病疫苗以预防此病。但近年来发现,黄热病疫苗可能引起某些重要脏器发生感染和病变,尤其是60岁以上接种者的发生率可达1/50,000,因此仅建议对前往流行国家且具有真正暴露危险的人群接种此疫苗。

    该病毒抵抗力弱,易被热、乙醚、去氧胆酸钠和常用消毒剂等迅速灭活,在50%甘油溶液中可存活数月,在冻干情况下可保持活力多年。

    (二)流行病学

    1.传染源

    城市型的主要传染源为病人及隐性感染者,特别是发病4日以内的患者。丛林型的主要传染源为猴及其他灵长类,在受染动物血中可分离到病毒。黄热病的隐性感染和轻型病例远较重症患者为多,这些病例对本病的传播起着极为重要的作用。

    2.传播途径

    本病通过蚊叮咬传播。城市型以埃及伊蚊为唯一传播媒介,以人-埃及伊蚊-人的方式流行。丛林型的媒介蚊种比较复杂,包括非洲伊蚊、辛普森伊蚊、趋血蚊属(Hemagogus)、煞蚊属(Sabethes)等,以猴-非洲伊蚊或趋血蚊属等-猴的方式循环。人因进入丛林中工作而受染。蚊吮吸病人或病猴血后经9-12天即具传染性,可终生携带病毒并可经卵传递。

    3.易感者

    人对黄热病毒普遍易感。在城市型中因成年人大多因感染而获得免疫,故患者以儿童为多。在丛林型中则患者多数为成年男性。感染后可获得持久免疫力,未发现有再感染者。

    4.地理和季节分布

    黄热病主要流行于南美洲、中美洲和非洲等热带地区,亚洲的热带国家也有分布。我国的地理、气候、及蚊、猴等媒介和动物条件虽与上述地区相似,但至今尚无本病流行或确诊病例的报道。

    黄热病可分为城市型和丛林型两种。该病全年均可发生,3-4月份的病例较多。

    二、临床表现

    潜伏期一般为3-6天。

    本病临床表现差异很大,病情可从轻度自限性到致死性感染。典型临床过程可分为以下4期。

    (一)病毒血症期。

    急性起病,寒战、发热,可达39-40℃,相对缓脉。剧烈头痛、背痛、全身肌肉痛,恶心、呕吐。结膜和面部充血,鼻衄。可有蛋白尿。症状持续3-5天。

    (二)缓解期。

    感染期发病的3-5天后出现12-24小时的缓解期,表现为体温下降,头痛消失,全身基本状况改善。此期体内病毒被清除,血中可以查到非感染性免疫复合物。轻度患者在此期可以痊愈。

    (三)肝肾损伤期。

    此期持续3-8天,约15-25%患者自缓解期后进入此期。体温再次升高,全身症状重新出现,频繁呕吐,上腹痛等。出现黄疸并逐渐加深,出血表现如瘀点、瘀斑、鼻衄、粘膜广泛出血,甚至腔道大出血。肾功能异常,尿量减少,蛋白尿。心脏损害心电图可见ST-T段异常,少数可出现急性心肌扩张。可出现脑水肿,脑脊液蛋白升高但白细胞不高。高血压,心动过速,休克,顽固性呃逆提示预后不良。

    此期患者约有20-50%在发病后的7-10天死亡。

    (四)恢复期。

    此期患者极度疲乏虚弱,可持续2-4周。也有报道患者在恢复期死亡,部分是由于心律失常。转氨酶升高可持续至恢复后数月。一般无后遗症。

    三、诊断、报告和治疗

    本病无特殊性治疗方法,一般以对症或支持疗法为主。

    医疗机构应按照《黄热病诊断和治疗方案》做好诊断和治疗。

    各级医疗卫生机构发现符合病例定义的疑似或确诊病例时,应参照甲类传染病的报告要求通过国家疾病监测信息报告管理系统进行网络直报,报告疾病类别选择“其他传染病”。符合《国家突发公共卫生事件相关信息报告管理工作规范(试行)》要求的,按照相应的规定进行报告。

    四、实验室检测

    患者血清特异性IgM抗体阳性,恢复期血清特异性IgG抗体滴度比急性期有4倍以上增高,患者标本中病毒抗原阳性,黄热病毒RNA阳性,分离到黄热病毒,均可以确诊。

    (一)血清学检测。

    由于黄病毒之间存在抗原性交叉,在进行血清学实验时应设立合适的对照,对实验结果的解释要慎重。

    1.血清特异性IgM抗体:采用ELISA、免疫荧光等方法检测,捕获法检测IgM抗体的结果较为可靠。一般发病后第5-7天出现IgM抗体。

    2.血清特异性IgG抗体:采用ELISA、免疫荧光抗体测定、免疫层析等方法检测。患者恢复期血清IgG 抗体滴度较急性期呈 4 倍以上升高可确诊。

    (二)病原学检查。

    1.抗原检测:由于黄热病患者早期血中病毒滴度较高,可以通过检测病毒抗原进行诊断。抗原检测方法的敏感性低于病毒分离,但所需时间较少。使用黄热病毒特异的单克隆抗体检测病毒抗原,可以避免和其他黄病毒的交叉反应

    2.核酸检测:应用RT-PCR、Real-Time PCR等核酸扩增技术检测黄热病毒RNA,这些方法特异性强灵敏性高,可用于早期诊断。

    3.病毒分离:发病4天内血清、全血或死亡病例的肝组织均可分离到病毒。可用新生乳鼠脑内接种或Vero细胞和C6/36细胞等敏感细胞培养等方法分离病毒。

    对于黄疸前的患者,应及早采取血标本做病毒分离和抗原、核酸检测,后期主要检测病毒特异性抗体。

    五、预防与控制措施

    1.对前往疫区的人员开展免疫预防和旅游卫生知识宣教

    黄热病可采用疫苗进行预防。接种减毒黄热病毒17D株制备的疫苗,可以有效的预防黄热病毒感染。抗体于接种后7-10天出现,持续至少30-35年。建议对所有到疫区居住或旅行的有真正暴露危险的9月龄及以上人群实行主动免疫。

    教育前往黄热病疫区的旅游者提高防范意识,采取驱蚊剂、长袖衣物等防蚊措施,防止在境外感染并输入黄热病,一旦出现可疑症状,应主动就诊并将旅游史告知医生。

    2.加强国境卫生检疫,严防疾病输入

    对来自流行地区的入境人员要加强卫生检疫,来自疫区的人员必须出示有效的预防接种证明书。口岸检疫部门一旦发现疑似病例,要及时通报卫生部门做好疫情调查和处理。

    3.做好病例的报告和管理

    各级医疗机构发现疑似黄热病病例后要及时报告,使卫生行政和疾控部门尽早掌握疫情并采取必要的防控措施,并对疑似和确诊病例隔离治疗,避免接触患者血液和体液。病房内采用喷洒杀虫剂、使用蚊帐等方式防止蚊虫叮咬。

    疾控部门要及时对病例的感染来源开展流行病学调查,搜索病例、评估疫情扩散风险。

    4.开展蚊媒应急控制

    与其他蚊媒传染病相同,降低蚊虫密度是控制疫情的关键措施。一旦发现病例报告,要立即采取消灭蚊虫孳生地、杀灭成蚊等措施控制媒介密度,防止发生疾病传播。

    5.提高黄热病发现和应对能力

    建议有条件的省级疾控中心和口岸城市的疾控中心建立实验室检测技术和方法,做好技术和试剂储备。

    各地卫生部门应组织印发国家的相关技术指南,提高医务人员对黄热病的发现、识别能力,提高疾控人员的流行病学调查和疫情处置能力。

    文献来源:关于印发埃博拉出血热等6种传染病预防控制指南和临床诊疗方案的通知 - 中华人民共和国国家卫生和计划生育委员会 http://www.nhfpc.gov.cn/yjb/s3577/200807/67f9130ce0b843f697f27702817ec0cb.shtml

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