I. General principles
(1) Purpose
1, improve the sensitivity of human avian influenza monitoring and the timeliness of epidemic reporting, and achieve "early detection, early reporting, early isolation and early treatment".
2, improve the quality of human avian influenza epidemic monitoring report, timely and accurately grasp the incidence and epidemiological distribution characteristics of human avian influenza, and provide a basis for formulating scientific and effective prevention and control measures.
(II) Basis
According to the Law of People's Republic of China (PRC) on the Prevention and Control of Infectious Diseases, the Emergency Regulations on Public Health Emergencies, the Emergency Plan for People Infected with Avian Influenza and other relevant prevention and control plans, this specification is formulated.
(3) Principles of epidemic reporting and information management.
1, in accordance with the principle of "direct network reporting, review and reporting step by step, graded management, graded responsibility, localized management, reporting according to law and management according to law".
2. No unit or individual may conceal, delay reporting, make a false report or instruct others to conceal, delay reporting or make a false report.
(4) Scope of application
This specification is applicable to all kinds of medical and health institutions at all levels (military, armed police, railway, transportation, civil aviation, factories, mines, schools and other departments and systems) and disease prevention and control institutions to carry out human avian influenza epidemic reporting and information management.
Second, the epidemic situation report
The epidemic report of human avian influenza shall be subject to the management of special disease report, and the epidemic report and information management shall be implemented in accordance with the provisions of Class A infectious diseases. In areas where bird flu epidemic has been found, the daily "zero" reporting system for human bird flu epidemic will be implemented.
(1) reporting units and reporters of the epidemic situation
1. Responsible reporting units and reporters: medical and health institutions at all levels, disease prevention and control institutions and their medical staff, quarantine personnel, disease control personnel, self-employed doctors and computer network administrators of disease management systems.
When the responsible reporter finds a case or suspected case of human avian influenza in the course of performing his duties, he should fill in the infectious disease report card carefully according to law, and immediately report the epidemic situation to the local (territorial) disease prevention and control institution by telephone, fax or computer network. The responsible reporter should take measures to prevent and control the epidemic as soon as possible while reporting the epidemic.
2. Obligatory reporting unit and reporter: any unit or individual except the responsible reporting unit and reporter.
(2) Epidemic reporting network
1, all kinds of medical and health institutions at all levels should set up prevention and health care departments, designate special personnel to be responsible for epidemic reporting and epidemic management, and accept professional guidance from local disease prevention and control institutions.
2. Disease prevention and control institutions at all levels shall be responsible for the collection, statistics and analysis of epidemic reports and epidemic data of infectious diseases, and regularly conduct training, business guidance and inspection on epidemic reports for medical and health institutions within their jurisdiction.
3. When medical institutions and personnel of the military and armed police system find cases or suspected cases of human avian influenza in local clinics, they shall report the epidemic situation to the local disease prevention and control institutions in accordance with the regulations, and accept the professional guidance of the local disease prevention and control institutions.
(3) the contents of the report
1, Infectious Disease Report Card, Revision and Outcome Report of Human Avian Influenza Cases or Suspected Cases.
2. Questionnaire on human avian influenza cases.
(4) Reporting requirements
1, determination of the first suspected case and confirmed case
After receiving the report of the first suspected case of human avian influenza in the province, the provincial health administrative department shall send a provincial expert group to make a judgment within 12 hours; After receiving the report of the first clinical diagnosis case in each province, the Ministry of Health should send national experts to make judgments within 24 hours.
Disease prevention and control institutions below the provincial level shall report human cases of avian influenza, suspected cases and medical observation cases step by step, and the health departments at the same level shall investigate, verify and confirm them.
2, all kinds of medical and health institutions at all levels
(1) Medical and health institutions implement the responsibility system of first-visit doctors. When medical personnel receive and treat cases or suspected patients of human avian influenza, regardless of whether the patients are local residents or local permanent residents, they should immediately report to the designated department of the hospital, and the hospital will organize a human avian influenza diagnosis team for consultation. If there are suspected or clinically diagnosed cases, the doctor should fill in the infectious disease report card carefully, indicate the previous hospitalization situation of the patients who are transferred or returned, and take isolated observation on the spot. They should immediately report the epidemic situation to local and local disease prevention and control institutions by telephone, fax or computer network, and send infectious disease report cards. Direct reporting through the network (no need to send an infectious disease report card). All localities should follow the relevant requirements of the Ministry of Health when filling in the Infectious Disease Report Card for human avian influenza patients. The contents of the report include infectious disease report cards, main symptoms and signs, contact history of dead birds and other animals, etc.
(2) For cases listed as clinical diagnosis cases, suspected cases and medical observation cases by expert groups at all levels, the daily course of the cases should be recorded, including daily body temperature, white blood cell and lymphocyte counts, chest X-ray changes, medication and treatment effects. And report to the local disease prevention and control institutions every day.
(3) When a clinically diagnosed case or suspected case is discharged from hospital or dies, it shall report the diagnosis and prognosis of the patient to the local disease prevention and control institution, and require the network direct reporting personnel to modify and report the original report card in time in the network direct reporting system.
(4) case or suspected case transfer report
When a case or suspected case of human avian influenza is transferred to another hospital, the network direct reporting personnel need to transfer the infectious disease report card from our hospital and notify the receiving medical and health institutions to receive the patient's infectious disease report card in the epidemic direct reporting system.
3, disease prevention and control institutions
In the network direct reporting system, audit units at all levels can enter the national disease surveillance case report system through special lines or other means for data statistical analysis. The county (district) disease prevention and control center is the initial evaluation unit and the provincial level is the final evaluation unit for clinical diagnosis cases.
(1) county-level disease prevention and control institutions
(a) the disease prevention and control institutions at the county level shall, after receiving the infectious disease report cards reported by all medical and health institutions within their respective jurisdictions, conduct timely review, and if any omissions or obvious errors are found, immediately verify, supplement and correct them. At the same time, it is necessary to check the human avian influenza epidemic database in time and eliminate duplicate infectious disease report cards in time. Modify the report data. And fill in the "human avian influenza case questionnaire" and other information.
The county-level disease prevention and control institutions shall immediately carry out epidemiological investigation after receiving reports of human avian influenza cases or suspected cases and medical observation cases. Epidemiological investigation includes case investigation of clinically confirmed cases or suspected cases.
③ The investigation adopts the questionnaire of human avian influenza cases issued by the Ministry of Health.
④ The clinical diagnosis cases, suspected cases and medical observation cases reported at the county level must be judged by the county-level expert group, and the reported contents include: case case questionnaire; Record the daily process of the case; Epidemiological investigation report; County expert group to verify the diagnosis basis and consultation summary, the expert group signed and stamped with the official seal of the unit.
(5) Cases excluded by the county-level expert group shall be reported in writing and stamped with the official seal of the unit for future reference; If the excluded cases have been reported to the regional disease prevention and control institutions, a correction report must be submitted. The calibration report should be based on the expert group's exclusion diagnosis basis and consultation summary, signed by the expert group and stamped with the official seal of the unit.
(2) Regional disease prevention and control institutions
(1) Verify the data of clinically diagnosed cases and suspected cases reported by county-level disease prevention and control institutions, submit them to the regional expert group for consultation, and go to the site for investigation if necessary.
(2) consult with the regional expert group to exclude clinically diagnosed cases or suspected cases, and write an error correction report for future reference; Clinical diagnosis cases, suspected cases and medical observation cases that have been reported to the provincial disease prevention and control institutions shall be reported in writing to the provincial disease prevention and control institutions after being excluded by the regional expert group, providing detailed case-related information, and the regional expert group shall exclude the diagnosis basis and conclusion. The report on correction of excluded cases and the report on confirmed cases shall be signed by the expert group and stamped with the official seal of the unit.
(3) provincial disease prevention and control institutions
(a) to verify the clinical diagnosis cases, suspected cases and medical observation cases reported by the disease prevention and control institutions at lower levels, submit them to the provincial expert group for consultation, and go to the scene for investigation when necessary.
(2) To write a correction report for the clinically diagnosed cases or suspected cases excluded by the provincial expert group consultation, and feed it back to the lower-level disease prevention and control institutions for record and future reference; Clinical diagnosis cases, suspected cases and medical observation cases that have been reported to the national disease prevention and control institutions shall be reported to the national disease prevention and control institutions in writing after being excluded by the provincial expert group, providing detailed case-related information, and the provincial expert group shall exclude the diagnosis basis and conclusion. The report on correction of excluded cases and the report on confirmed cases shall be signed by the expert group and stamped with the official seal of the unit.
③ Strengthen the technical support and guidance for human avian influenza epidemic report, and ensure the smooth operation of the national disease surveillance case report information system.
(five) the application procedures and time limit.
1, reporting units and reporters should report the epidemic situation to the local county-level disease prevention and control institutions by telephone or fax or computer network within 2 hours and 6 hours after accepting human avian influenza cases or suspected cases.
2. After receiving the epidemic report, the county-level disease prevention and control institution shall report to the higher-level disease prevention and control institution and the health administrative department at the same level within 2 hours.
3. After receiving the epidemic report, the health administrative department shall report to the people's government at the same level within 2 hours, and report to the health administrative department at the next higher level and the health administrative department of the State Council.
(six) the type and time limit of the epidemic report.
1. New case report: When the responsible reporter finds the first case or suspected case of human avian influenza, the town should report it to the disease prevention and control institutions in the epidemic area within 2 hours, and the rural area should report it to the disease prevention and control institutions in the epidemic area within 6 hours by the fastest communication method, and send the disease card of the infectious disease report card to the local county (district, city) disease prevention and control institutions in the fastest way. It is no longer possible to send infectious disease reports directly through the network.
The new case report belongs to the original report in the network direct reporting system, which requires the network direct reporting personnel to report it promptly and quickly; If you find an input error, you should correct it in time. Only when the report card is reported from the provincial level to the whole country will the information of the report card participate in the statistics, and then the infectious disease report card can be modified.
2. Revision report: the report of the responsible reporter on the dynamic revision of the diagnosis of reported cases or suspected cases of human avian influenza. Including suspected cases to clinically diagnosed cases, suspected cases excluded, clinically diagnosed cases to suspected cases and clinically diagnosed cases excluded. It is required that the responsible reporter should fill in the revised infectious disease report card in time, report to the local disease prevention and control institutions within 2 hours in towns and 6 hours in rural areas, and send the revised infectious disease report card at the same time.
Report corrections directly through the network, and you can no longer send infectious disease correction cards. Just modify the "disease name", which requires completeness and accuracy. Every time it is modified, the card receiving time will be automatically changed to the time of the modification day. Suspected cases are converted into clinically diagnosed cases, and the name of the disease is directly changed to "human avian influenza" when revised; Excluding suspected cases, the name of the disease is directly changed to "other diseases" when it is revised; If a clinically diagnosed case is changed to a suspected case, the name of the disease will be directly changed to "suspected case" at the time of revision; When excluding clinically diagnosed cases, the name of the disease will be directly changed to "other diseases" or "XX infectious diseases" during the revision.
3. Final report: The report of the responsible reporter on the cure, discharge, transfer and death of human avian influenza cases or suspected cases shall be reported to the local disease prevention and control institutions within 2 hours in towns and 6 hours in rural areas, and the infectious disease report card shall be sent at the same time. Outcome Report In the epidemic reporting system, only "discharge date" or "death date and death card receiving date" should be filled in the infectious disease report card, which requires completeness and accuracy. Every time it is modified, the card collection time will be automatically changed to the time of the day.
4. For the cross-regional epidemic report, the disease prevention and control institutions shall notify the local disease prevention and control institutions by telephone within 24 hours after investigation and verification, and send the infectious disease report card and a copy of the human avian influenza case questionnaire to the above-mentioned disease prevention and control institutions by fax or computer network direct reporting system for disinfection of epidemic spots and follow-up management of close contacts.
5, several special cases report
(1) Human cases of avian influenza died of other infectious diseases.
According to the provisions of the Law on the Prevention and Control of Infectious Diseases, when two or more infectious diseases occur at the same time, two infectious disease report cards must be filled out, one for human avian influenza and the other for other infectious diseases.
(2) Cases of people infected with avian influenza and dying of other diseases:
-Non-communicable diseases are not included in the report management, so it is not necessary to revise the death of human avian influenza from other diseases.
(3) Other diseases turn into human avian influenza:
Report the infectious disease report card according to the confirmed time of human avian influenza.
6. Daily epidemic situation report and "zero" report: During the epidemic situation or early warning period of human avian influenza, according to the requirements of the Ministry of Health, summarize the incidence and prognosis of human avian influenza cases and suspected cases in the past 24 hours every morning before 10, and report to the local disease prevention and control institutions by telephone or fax, including the report of "zero" cases.
7, the floating population epidemic information reporting and exchange:
The reporting, registration and statistics of the epidemic situation among the floating population shall be the responsibility of the clinic.
(1) If it is found that people from other places (any area outside the county-level jurisdiction) come to seek medical treatment locally, or if it is found that local patients have a history of traveling in different places during the incubation period (7 days before the onset of the disease, the same below) or after the onset of the disease, the disease prevention and control institutions shall call the county-level disease prevention and control institutions in the areas where the patients have lived or traveled during the incubation period and after the onset of the disease; At the same time, the infectious disease report card and a copy of the human avian influenza case questionnaire will be sent to the above-mentioned disease prevention and control institutions by fax or computer network for disinfection of epidemic spots and follow-up management of close contacts.
When foreign patients and patients from Hong Kong, Macao and Taiwan are found, or mainland patients who have traveled abroad, Hong Kong, Macao and Taiwan are found, disease prevention and control institutions and health administrative departments at all levels shall report to the Ministry of Health in accordance with the reporting procedures and time limit stipulated in the aforementioned Report on New Cases, and the Ministry of Health or the provincial health administrative department authorized by the Ministry of Health shall be responsible for notifying relevant international organizations, countries and regions.
(II) If it is found that patients, suspected patients or close contacts of human avian influenza leave the current management place, the disease prevention and control institutions in the current management place shall immediately report to the health administrative department at the same level, and notify the disease prevention and control institutions at the same level and the relevant transportation, railway and civil aviation departments along the way to track and manage the patients and close contacts.
After receiving the report, the health administrative department shall immediately coordinate the relevant government departments to take measures.
(3) The county-level disease control institutions shall report the investigation notice to the provincial-level disease control institutions step by step. And report the patient's medical date, flight or train number, carriage, cabin and other details step by step, so as to timely release the announcement of medical observation and follow-up investigation of passengers on relevant vehicles.
The county (city, district) disease control department that is required to carry out the investigation shall feedback the clear investigation results to the unit that issued the investigation notice; At the same time, it is responsible for inputting the case questionnaire of close contacts within the jurisdiction into the microcomputer and reporting it in time.
(4) After excluding human avian influenza or suspected human avian influenza, the county-level disease prevention and control institutions where the case is now managed shall promptly notify the county-level disease prevention and control institutions where the patient has lived and traveled during the incubation period and after the onset.
Foreign patients, Hong Kong, Macao and Taiwan patients, or mainland patients who have traveled abroad, Hong Kong, Macao and Taiwan should report to the Ministry of Health within 12 hours according to the work requirements of the above report after excluding human avian influenza or suspected human avian influenza.
(vii) Reporting methods
1, the login account (user ID) and password issued by the local centers for disease control and prevention in hospitals and township health centers at or above the county level, where conditions permit. The contents of the report include the first case report, revised report and outcome report. The completed infectious disease report card is filed by our hospital's prevention and protection department for future reference.
2. County-level disease prevention and control institutions are responsible for reviewing the infectious disease report cards directly reported by medical units within their jurisdiction, and are also responsible for reviewing and entering the questionnaire on non-inflammatory cases of infectious diseases and the questionnaire on non-inflammatory close contacts of infectious diseases.
Disease prevention and control institutions at or above the county level shall timely review the infectious disease report card, human avian influenza case questionnaire and human avian influenza close contact questionnaire.
3. Township health centers that report directly online unconditionally should report the Infectious Disease Report Card to the local county-level disease prevention and control institutions through the fastest way; After receiving the infectious disease report card, the disease prevention and control institutions at the county level should carry out epidemiological investigation, fill in the questionnaire of infectious non-inflammatory cases and the questionnaire of close contacts of infectious non-inflammatory cases, and submit it to the disease prevention and control institutions at the next higher level through direct network reporting.
Third, fill in the disease report card
1. Use the current infectious disease report cards, including the onset card, the revision card (revised diagnosis) and the death card (transfer card).
2. Items to be filled in the new case report: infectious disease report card (√), card number, outpatient number, date of admission, medical record (case) number, patient's name, children under 14, parents' name, gender, age unit, age, place of onset, current address, patient's unit, contact number, occupation and date of onset.
3. Items to be filled in when modifying the report: Select the modification card (√) for the infectious disease report card, the date of diagnosis and the name of the disease.
4. Items to be filled in the transfer report: the infectious disease report card is selected and modified or the death card (√), the discharge date, death and death receipt.
Four. Epidemic reporting management
(1) Medical and health care institutions
1. Epidemic management institutions: Medical and health institutions are the most important sources for finding and reporting epidemics. All kinds of medical and health institutions at all levels must establish epidemic management organizations, designate full-time managers, carry out epidemic discovery, collection and reporting, and report the epidemic to local disease prevention and control institutions in accordance with the provisions of relevant laws and regulations.
2. Epidemic situation management system: including outpatient log, hospitalization registration, laboratory registration management, epidemic situation receiving and dispatching, self-examination and reward and punishment system.
3. Responsibilities of epidemic management personnel: Medical and health institutions at all levels should set up preventive health care departments, which are responsible for collecting epidemic report cards from various departments regularly every day, registering the infectious disease register, and reporting the epidemic situation to local disease prevention and control institutions by telephone or fax within the specified time limit.
4. Quality management
(1) training
All kinds of medical and health institutions at all levels should regularly train the responsible epidemic reporters in their own units and areas of responsibility on relevant knowledge of epidemic reporting, and conduct pre-job training for newly appointed responsible epidemic reporters, interns and advanced students. The training contents include the provisions on epidemic reporting in the Law on the Prevention and Control of Infectious Diseases and its implementation measures, statutory diagnostic standards for infectious diseases, technical guidelines for the prevention and control of human avian influenza, diagnostic standards for human avian influenza, and requirements for filling in infectious disease report cards.
(2) Management system
All kinds of medical and health institutions at all levels shall formulate relevant management systems for epidemic reporting and inspection, and clarify the responsibilities of various departments and personnel, the process of epidemic reporting, inspection and assessment regulations and reward and punishment measures.
(3) Inspection and evaluation
All kinds of medical and health institutions at all levels should strengthen the quality control of all aspects of hospital epidemic report management. Medical staff should check themselves every day; The preventive health care department checks relevant departments every week. It is necessary to strengthen the inspection and verification of all aspects of outpatient service, ward and laboratory, and do a good job in inspection and registration. The inspection results should be used as the basis for the assessment and rewards and punishments of the corresponding departments. The timeliness, completeness and accuracy of the epidemic report are ensured by establishing the responsibility system for the first consultation report of medical staff, the reporting system for the results of infectious disease tests of laboratory staff, and the inspection system for preventive doctors and epidemic managers.
(2) Disease prevention and control institutions
Disease prevention and control institutions at all levels are responsible for the management of epidemic situation reports within their responsibilities, put forward work requirements, deploy work tasks, and undertake the collection, reporting and feedback of epidemic situation data. Training, professional guidance, supervision and inspection on the epidemic situation reporting of medical and health institutions, individual clinics and lower-level disease prevention and control institutions within their respective jurisdictions.
Verb (abbreviation of verb) data analysis and utilization
Collect, summarize, analyze and evaluate the information on the epidemic situation of avian influenza reported by the heads of disease prevention and control institutions at all levels.
1, epidemic situation analysis
Analyze the epidemic situation of the day and the cumulative epidemic situation, including the number of reported cases, the number of admitted cases, the number of deaths and the prognosis of cases, the number of people discharged from hospital after being cured, the incidence rate, mortality rate and fatality rate. 2. Analysis of epidemiological characteristics
(1) time distribution: onset time, visit time, report time, hospitalization time distribution, etc.
(2) Population distribution:
Age, occupation, gender distribution, floating population, key occupational characteristics, etc.
3) Regional distribution: different regional distribution, urban and rural distribution, cluster analysis, etc.
3. Thematic analysis
Report timeliness analysis, case contact history, infection source and transmission chain analysis, epidemic situation analysis, epidemic factors and trend analysis.
4, the analysis results should be reported in a timely manner, submitted to the health administrative department at the same level and the superior disease prevention and control institutions, and timely feedback to the lower disease prevention and control institutions and medical units.
Notification and publication of intransitive verbs
(1) No unit or individual may conceal, delay reporting, falsely report or instruct others to conceal, delay reporting or falsely report the epidemic situation of human avian influenza.
(two) the notification and publication of the epidemic situation, according to the Ministry of health "legal epidemic situation of infectious diseases and public health emergencies information release procedures (Trial)" implementation.
Seven. Information system management
(1) The national disease surveillance case report information system is the main information support system for monitoring and reporting the epidemic situation of human avian influenza.
(2) System requirements
The hardware and software equipment of the epidemic reporting information system must be equipped according to the requirements of the national disease surveillance case information system.
(3) Network management and maintenance
1. The National Center for Disease Control and Prevention is responsible for network operation, database maintenance, information security, technical training and guidance, and statistical analysis and reporting of national monitoring data.
2, disease prevention and control institutions at all levels are responsible for the management, use and maintenance of the network, formulate corresponding system, strengthen the management of information reporting system. Provide technical training and business guidance to medical and health institutions.
(4) Safety and confidentiality
1, information security
(1) The application and exchange of information must comply with the relevant national regulations on information security.
(2) All data, statistical analysis and reported information should be printed and archived, and information should be backed up.
2. System security
(1) Local disease prevention and control institutions should choose safe, reliable and efficient carriers to establish health information dissemination networks according to the relevant technical environment of their provinces (cities).
(2) Disease prevention and control institutions at all levels should set different authorities for reporting information systems, and be responsible for hierarchical management and classification. Without permission, the information reporter shall not transfer or disclose the operating account and password of the information reporting system at will. Make a double backup of the reported database (CD, mobile hard disk) and hand it over to a special person for safekeeping.
(3) The network direct reporting personnel of various medical and health institutions at all levels shall properly keep the account and password issued by the disease prevention and control institutions, and shall not transfer or disclose the operating account and password of the information reporting system without authorization. Leakers will be held accountable according to law.
(5) Evaluation and supervision
Disease prevention and control institutions at all levels should incorporate the information reporting of the national disease surveillance information system into their target responsibilities, conduct business assessment at least once a year, and establish a reward and punishment system.