(1) Prevention and treatment of intestinal infectious diseases
Each unit should have a special person responsible for the prevention and treatment of intestinal infectious diseases. We will fully implement various prevention and control measures to deal with the epidemic situation of intestinal infectious diseases such as cholera and hand, foot and mouth disease in a timely manner. Before April 10, complete the investigation on the distribution and personnel composition of diarrhea clinics (special tables) within the jurisdiction, and organize the technical training of professionals at all levels, especially the medical staff and inspectors of diarrhea clinics (special tables) within the jurisdiction. Before the arrival of the epidemic season, the patriotic health campaign with the theme of "three management and one absolutely" was carried out, the diarrhea clinic (special desk) of medical institutions was supervised and inspected, the personnel, technology and materials were well reserved, and emergency drills for epidemic control and treatment were carried out.
1. Prevention and control of cholera
(1) Strict epidemic reporting and management system and standardized epidemic investigation and handling. Report the epidemic situation in strict accordance with the reporting time and method of Class A infectious diseases stipulated by laws, regulations, norms and documents, and implement the weekly reporting system of zero cases of cholera epidemic from April 20th to June 3rd. The reported cholera epidemic situation should be dealt with in time according to the specific requirements of the Handbook of Cholera Prevention and Control, the epidemic spots and epidemic areas should be quickly delineated, strictly isolated, patients and carriers should be thoroughly treated, environmental disinfection, insecticide and drinking water disinfection should be carried out, stool tests should be carried out for close contacts and diarrhea patients in epidemic areas, and preventive medication measures should be implemented for epidemic areas. Timely collect, analyze, summarize, report and file the case questionnaire and epidemic investigation report of cholera infected persons.
(2) Strengthen the search for cholera epidemic focus, and achieve "early detection, early reporting, early isolation and early treatment" for cholera cases. To strengthen the search for cholera epidemic focus, the district CDC will monitor Vibrio cholerae from May to June at 65438+ 10, and the positive samples will be sent to the municipal CDC for identification in time.
① Water source monitoring: mainly refers to seawater, sewage, river water, etc. , no less than 3 water points per month, each water point shall be sampled once a month, with 6 copies each time.
② Food monitoring: monitoring food that may be contaminated, such as little seafood, freshwater fish, cold salad, cooked food, etc. 20 samples are taken every month.
From June to September, two hotels are selected for monitoring twice a month, including food containers, food, cold salad, seafood, production and processing sites and sewage from sewage outlets. In case of cholera epidemic, 10 suspicious food samples should be collected for pathogen detection.
(3) Strengthen the technical guidance, supervision and inspection of diarrhea clinics (special tables). April 20-10/October 30, 24-hour diarrhea clinic (special treatment station) was opened in the whole region, 3 1. Before the opening of diarrhea clinics, organize personnel to provide technical guidance to diarrhea clinics within their jurisdiction, improve the construction of emergency mobile teams for acute intestinal infectious diseases, and report the list of emergency team members to the District Health Bureau and the District Center for Disease Control and Prevention. All medical institutions are equipped with necessary medical devices and personal protective equipment to rescue and treat patients, and the diarrhea clinic in district-level hospitals must implement independent areas. Hospitals and health centers should set up outpatient clinics in accordance with the relevant requirements of the Law on the Prevention and Control of Infectious Diseases and the Working Rules for Diarrhea Outpatients in Provincial Medical Units. Outpatient medical and inspection personnel should be familiar with the diagnosis, treatment, rescue, inspection, epidemic report and other related business knowledge of diarrhea, and admitted diarrhea patients should be registered in the unified diarrhea patient register in the province, and there should be no omissions. All diarrhea clinics should be equipped with screening reagents and bacterial culture reagents for rapid diagnosis to ensure that "every case of diarrhea should be reported, examined and cured", the number of bacterial cultures should not be less than 10% of diarrhea patients, and the rapid diagnosis rate of cholera must reach 100%. Positive samples used for rapid diagnosis must be sealed by inspectors or medical staff in diarrhea clinics as required, and registered in detail.
(4) Focus on searching epidemic focus.
District CDC should do a good job in technical guidance and supervision of diarrhea clinics within its jurisdiction in accordance with the "Specification for Diarrhea Clinics in Medical Units" formulated by the province, especially to supervise the quality of stool examination in medical units within its jurisdiction, and conduct sampling inspection when necessary. During the epidemic season, strengthen the health quarantine of people from epidemic areas.
2. Prevention and treatment of hand, foot and mouth disease
Conscientiously implement the Guidelines for the Prevention and Treatment of Hand-foot-mouth Disease (Version), the Provincial Action Plan for the Prevention and Treatment of Hand-foot-mouth Disease in, the Provincial Work Plan for the Prevention and Treatment of Hand-foot-mouth Disease in and the Municipal Action Plan for the Prevention and Treatment of Hand-foot-mouth Disease in, focusing on etiological monitoring, risk factor analysis, severe case investigation and cluster epidemic disposal, and comprehensively implement various preventive measures.
(1) Strengthen epidemic monitoring and do a good job in epidemic analysis, prediction, early warning and management. All kinds of medical institutions at all levels should strictly diagnose the epidemic situation, and report the epidemic situation in a timely, standardized and accurate manner. Hand, foot and mouth disease cases should be reported directly through the network within 24 hours, and the timely rate and accuracy of direct reporting through the network should reach100%; Kindergartens, schools and medical institutions should report the clustered cases of hand, foot and mouth disease to the district CDC in the fastest way. District CDC should do a good job in the audit and management of epidemic reports and strengthen epidemic monitoring. District CDC and street supervision CDC workstations should strengthen the flow adjustment and monitoring of ordinary cases and severe cases. Establish epidemic situation analysis, prediction and early warning and emergency response mechanism, timely and scientifically judge the epidemic situation in the jurisdiction, and timely start emergency response according to the epidemic situation and early warning classification in the jurisdiction.
(2) Standardize case epidemiological investigation, information input and routine specimen collection. After receiving the case report or finding the reported case through network search, the CDC should immediately carry out epidemiological investigation and fill in the case questionnaire, and the case investigation rate of hospitalized cases should reach 100%. The investigation and disposal rate of cluster cases reached100%; The case investigation and information reporting rate of severe and dead cases reached 100%. In the case investigation, it is necessary to know the general situation, epidemiological contact history, onset and treatment process, clinical manifestations, laboratory test results, risk factors, etc. The clinical manifestations, clinical test items, complications and other results of severe cases should be contacted with relevant hospitals in time, extracted from medical records and supplemented and revised in time. Questionnaires should be conducted one by one during diversion, and the forms should be filled in neatly and carefully, and there should be no missing items or items. All case questionnaires should be entered into EPIDATA database every day, and the missing information found in the process of entry should be promptly fed back to the investigators for modification and improvement. The case investigation database of the previous week should be summarized and reported to the Infectious Disease Prevention Department of the District CDC before Tuesday, and the District CDC will summarize and report it to the Municipal CDC on Wednesday. For the types and requirements of hand, foot and mouth disease specimen collection, see Annex 1 Key Points of Infectious Disease Monitoring.
(3) It is necessary to standardize the epidemiological investigation and epidemic disposal of severe, fatal and clustered cases in time, standardize the collection of specimens, enter them into the database in time, and write investigation reports. The receiving hospital shall be responsible for the collection of specimens, and the specimens shall be preserved in a standardized manner, and the district CDC shall be notified in time to collect specimens according to regulations and send them to the municipal CDC.
(4) Strengthen training and improve the level of prevention and control technologies such as epidemiological investigation and epidemic disposal. All units should strengthen the training of prevention and control technicians such as epidemic monitoring, epidemiological investigation and network direct reporting; Cooperate with the education department to do a good job in the training of kindergarten and primary school teachers and school doctors. In particular, it is necessary to carry out intensive training for front-line personnel in key areas and places to improve their ability of early detection, early reporting and early prevention and control.
(5) Popularize health education and improve knowledge of disease prevention. Health education is the basis of preventing and controlling hand, foot and mouth disease. All units should make full use of billboards, leaflets, clear paper and other forms, increase the publicity of hand, foot and mouth disease prevention and control, make it a household name, let the masses understand that hand, foot and mouth disease is known, preventable, treatable and controllable, guide the masses to raise their awareness of disease prevention, and develop a civilized and healthy lifestyle and good personal hygiene habits.
(6) Strengthen supervision and inspection and do a good job in prevention and control of key links. Street supervision and disease control workstations should strengthen supervision and inspection of key parts and places such as kindergartens, primary schools, communities and rural areas, guide kindergartens and schools to establish morning check-up and absenteeism registration systems, and implement disinfection measures; Supervise community clinics, community health service stations and other primary medical institutions to establish and improve the education system for the prevention and treatment of hand, foot and mouth disease for parents of infants, the morning check-up system and the registration system for referral treatment of hand, foot and mouth disease; District CDC should move forward, focus on sinking, and go deep into medical institutions, kindergartens, schools, rural areas and communities in its jurisdiction to conduct roving guidance.
3. Prevention and treatment of other intestinal infectious diseases
All medical and health units should strengthen the monitoring of intestinal infectious diseases such as bacillary dysentery, typhoid fever (paratyphoid fever), rotavirus diarrhea and other infectious diarrhea, and do a good job in the pre-detection, triage and diagnosis and treatment of infectious diseases, focusing on mild outpatient diseases. For severe cases (nervous system symptoms or cardiovascular symptoms, etc. ), should be hospitalized for key treatment. Strengthen the monitoring of food and drinking water hygiene, especially the monitoring of tap water in school canteens, street stalls and township pipe networks.
(2) Prevention and control of respiratory infectious diseases
1. Continue to strengthen the management of public health comprehensive monitoring points. Each street supervision and disease control workstation should strengthen the management of public health comprehensive monitoring points within its jurisdiction, pay close attention to the dynamic situation of patients with respiratory fever, and report the monitoring report of patients with respiratory fever in time. Supervise the comprehensive monitoring points of public health at least twice a year with complete records.
2. Do a good job in epidemic investigation and emergency response in time. In accordance with the relevant technical specifications, do a good job in the emergency treatment of infectious atypical pneumonia, human infection with highly pathogenic avian influenza, unexplained pneumonia, influenza-like cases and influenza A cases H 1N 1, timely verify the found and reported epidemic situation, standardize the investigation and disposal of epidemic situation and sample collection, and analyze the characteristics and causes of epidemic situation.
Reserve the technology and materials for emergency detection of human avian influenza, and respond to possible human avian influenza incidents at any time. Carry out on-the-spot investigation and technical drills on human avian influenza and influenza A (H1N/KLOC-0), and make good technical and material reserves for the epidemic situation of human avian influenza.
3. Continue to do a good job in monitoring key respiratory infectious diseases and seasonal influenza. It is necessary to strictly follow the requirements of the National Work Plan for Monitoring, Investigation and Management of Cases of Unknown Pneumonia, further strengthen the monitoring of cases of unexplained pneumonia, and timely investigate and manage cases related to human avian influenza and SARS.
According to the requirements of "A H 1N 1 Influenza Monitoring Program (Second Edition)" and "National Influenza/Human Avian Influenza Monitoring Implementation Program", we will continue to do a good job in the diagnosis, statistics, reporting, specimen collection, preservation and transportation of influenza-like cases. District hospitals, as municipal sentinel hospitals, should continue to monitor influenza-like cases and improve the accuracy and timeliness of reporting influenza-like cases. Articles and reagents needed for specimen collection, preservation and transportation in sentinel hospitals are provided by the Municipal Center for Disease Control and Prevention. The regional CDC is responsible for transporting specimens. See Annex 1 Infectious Disease Monitoring Point for relevant monitoring points.
4. Do a good job in serum epidemiological investigation and environmental specimen collection of people with occupational exposure to human avian influenza. According to the requirements of the Implementation Plan for Monitoring Highly Pathogenic Avian Influenza among Occupational Exposed Population, as one of the monitoring points in the city, the district carried out monitoring work according to the requirements of the plan. See Annex 1 Infectious Disease Monitoring Point for relevant monitoring points.
5. Take the initiative to contact the education department to guide schools at all levels to establish a symptom monitoring system for respiratory infectious diseases such as chickenpox and scarlet fever, and implement the morning check-up and absenteeism registration system. Once the school has fever, cough, rash and other related symptoms, the school's special person or part-time teacher responsible for reporting the epidemic situation of infectious diseases should take the initiative to report to the district CDC.
After receiving the report from the school, the district CDC will immediately carry out on-site epidemiological investigation and specimen collection in conjunction with the supervision and control workstation in the jurisdiction, guide the school to do a good job in disinfection and close contact management after the epidemic is confirmed, and carry out vaccination when necessary. At the same time, through the "public health emergency report management information system", the first report, process report and final report of the incident are carried out according to regulations.
(3) Prevention and control of zoonotic diseases
1. Prevention and treatment of epidemic hemorrhagic fever
(1) Carry out extensive health promotion and educate the masses on the main hazards of hemorrhagic fever and the knowledge of prevention and treatment. If suspicious symptoms are found, seek medical attention in time to avoid delaying treatment.
(2) Strengthen business training. District CDC and street supervision CDC workstations should train grassroots CDC staff and rural doctors, and give full play to the role of grassroots staff in epidemiological investigation and health promotion.
(3) Strengthen epidemic reporting, prevent missing and late reporting, and carry out epidemiological investigation and handling in time. If the epidemic situation is found, it should be investigated and handled as soon as possible, and the epidemiological questionnaire should be reported on time. When the epidemic situation and death cases are found, they should be investigated and handled immediately, and the investigation and handling report should be reported in time.
2. Prevention and control of rabies
Due to the continuous outbreak of epidemic in our city in recent years, suspected rabies injuries have occurred from time to time, and the risk of rising incidence has increased. Therefore, we must strengthen the implementation of various prevention and control measures.
(1) To further expand health promotion, it is necessary to popularize rabies prevention and control knowledge to residents, especially rural people, in various forms. After being bitten or scratched, you should go to the rabies exposure clinic as soon as possible for wound treatment, vaccination and injection of antiserum or antiviral globulin to prevent the disease to the maximum extent.
(2) To further strengthen the construction and management of outpatient clinics for rabies exposure and disposal, strengthen the registration of exposed people, wound treatment, vaccination and injection of antiserum or antiviral globulin according to relevant requirements, and timely grasp the exposure amount and report it monthly.
(3) If an epidemic situation is found, it should be reported immediately and investigated and handled in time to prevent the epidemic from expanding.
3. Brucellosis prevention and control work
(1) Continue to implement the monitoring plan of brucellosis in the whole city. Each street supervision and disease control workstation should strengthen the contact with the street animal husbandry department, find out the basic information of cattle and sheep breeding units within its jurisdiction, grasp the epidemic situation among local animals in time, and strengthen the monitoring of close contacts. According to the unified arrangement of the city, this year, 50 people will be selected from key cattle and sheep breeding units in our district, and 2 ml of serum will be collected from each group to monitor the etiology of brucellosis. The work was finished before the first ten days of September.
(2) When cattle, sheep or people are found to be infected, an epidemiological investigation should be carried out immediately. According to the preliminary results of epidemiological investigation, the epidemic spots were dealt with. All kinds of survey data should be reported immediately.
Second, the epidemic situation management
The management of information report on epidemic situation of infectious diseases and public health emergencies in was based on strengthening professional training and capacity building, and guaranteed by strengthening supervision and technical guidance. All work norms were strictly implemented, legal awareness was enhanced, and the implementation of various rules and regulations was paid close attention to, so as to ensure that information reports were standardized, timely and efficient.
(1) Epidemic reporting and management of infectious diseases
1. Strictly implement the information audit system to improve the report quality.
(1) Carefully examine and improve the information quality of infectious diseases.
District CDC should strictly implement the information review system for direct reporting of infectious diseases on the Internet, ensure that every day (not less than 4 working days and not less than 2 public holidays) comprehensively review and monitor the direct reporting information on the Internet according to the reporting requirements, and do a good job in verifying and confirming the reporting information in a timely manner. After going to work every morning and before leaving work in the afternoon, be sure to review the cards online. In addition to timely reviewing the cards according to the requirements of the Management Specification for Infectious Disease Information Reporting, it is also required that the report forms before 17: 00 every day must be reviewed before 17: 00; Transcripts before 17: 00 on the last day of each month and year must be reviewed before 17: 00, and transcripts before 24: 00 must be reviewed before 24: 00. Put an end to the untimely reporting and review of epidemic information of infectious diseases, and try to shorten the time interval from doctor diagnosis to network report.
Patients or suspected patients with plague, cholera, pulmonary anthrax, infectious atypical pneumonia, poliomyelitis, human infection with highly pathogenic avian influenza, diphtheria, kala-azar, dengue fever, schistosomiasis, unexplained pneumonia, severe cases of hand, foot and mouth disease or other infectious diseases, and unexplained diseases should immediately report to the District Health Bureau and the District CDC by telephone while reporting directly on the Internet.
(2) Continue to standardize the information registration of infectious diseases in medical institutions and the filling of infectious disease report cards.
The contents of the infectious disease report card must be filled in completely and accurately. Infectious disease report cards with incomplete information and logical errors should be verified, supplemented and revised at any time. Check the duplicate every day, keep the first medical card when deleting the duplicate card, and correct the contents of the deleted card into the reserved card. When duplicate infectious disease report cards reported from other places to local areas are found, they should be deleted after card review. Timely diagnosis and correction of suspected cases. Report pathogen carriers and positive test results according to the requirements of case typing and typing report in the Management Specification for Infectious Disease Information Reporting. Check the bulletin board of epidemic situation network direct reporting system daily, arrange and implement relevant work requirements, and make work records.
Further standardize outpatient registration, infectious disease information checking, filling in infectious disease report cards, and direct reporting of infectious diseases on the Internet, clarify the infectious disease reporting process, and link up the infectious disease reporting work of relevant departments to ensure timely and accurate reporting of infectious diseases and reduce missed reports.
(3) Strengthen management and improve the quality of epidemic reports of infectious diseases. The monthly report rate of legal infectious diseases is less than 0.4%, the audit rate is less than 0.2%, there are no duplicate cards in counties and districts, and the comprehensive index of information quality evaluation of infectious disease epidemic report is less than 0.2%. Each network direct reporting unit shall not have zero omission every month.
2. Strengthen the analysis and utilization of information to improve the level of early warning and prediction of infectious diseases.
(1) Continue to implement the epidemic situation analysis system in the form of weekly, monthly and daily reports on public health emergencies and infectious diseases, and provide information to relevant personnel in time to serve decision-making.
(2) Make full use of the information of the network direct reporting system, strengthen the analysis and utilization of information, actively search and report the phenomenon of case aggregation by browsing the report card, and find out the potential outbreak of infectious diseases in time, especially when the cases gather in time and space, and give real-time warning. The threshold of infectious disease treatment in the city: single disease treatment of major infectious diseases and important imported cases; Two cases of general infectious diseases were handled in the same unit within one week. On the basis of monitoring the epidemic situation in this area, the District CDC, according to the city-wide summary case information provided by the Municipal CDC, sent it to relevant business departments for investigation and handling at any time, and the results were fed back to the Municipal CDC in the form of a written report by fax and electronic documents (uploaded to the special analysis column of monitoring information feedback in the National Disease Report Management Information System). The municipal CDC will evaluate the feedback information and improve the disposal level.
(3) The District CDC shall complete verification and fill in the abnormal information card within 2 hours after receiving the single disease warning signal issued by the infectious disease warning information system, and verify and fill in the abnormal information card for other warning signals on the same day. On-the-spot investigation should be carried out on the early warning signals identified as suspected events, and the on-the-spot questionnaire should be filled in within 24 hours after the investigation.
3. Stabilize the team, strengthen technical training and improve the professional quality of personnel.
In view of the new requirements and regulations for information reporting of hand, foot and mouth disease, influenza A (H 1N 1) and other emerging infectious diseases, it is necessary to organize the training of responsible reporters in time to ensure the quality of information reporting of infectious diseases in our region; Strengthen the management training of public health emergencies and related information reports, and further improve the quality of public health emergencies and related information reports in our region. District CDC will hold regular business meetings of epidemic report managers of medical institutions within its jurisdiction, at least 1 time every quarter.
4. Strengthen technical guidance and inspection of medical institutions.
According to the requirements of the Notice on Forwarding the Assessment Criteria for the Prevention and Control of Infectious Diseases in Medical Institutions of Provincial CDC (Trial) and the Daily Supervision Record for the Prevention and Control of Infectious Diseases in Medical Institutions of Provincial CDC (Trial), in daily work, the supervision of medical institutions is conducted once every six months. In particular, if there is no case report in the medical institution 1 month within the statistical rules of the reporting rate of the network direct reporting system, on-site supervision must be carried out, and the results of supervision and evaluation should be reported to the Health Bureau in time. It is suggested that the Health Bureau report regularly to effectively promote the implementation of information management of infectious diseases in medical institutions.
5. Continue to do a good job in network management to ensure data security.
Strengthen the management of reporting system, and the administrator of network direct reporting system should strengthen communication and coordination with the administrator of related special disease system. Do a good job in user rights management, ensure real-time backup of epidemic data, use approval, ensure data security, and do a good job in user rights distribution management. Check the permissions of all users 1 time every six months, and correct the problems immediately if found. Perceive tmall