Article 1 hand, foot and mouth disease prevention and control plan
Hand-foot-mouth disease (HFMD) is a Class C infectious disease caused by various enteroviruses, mainly occurring in infants. Most patients have mild symptoms, mainly manifested as fever and rash or herpes on hands, feet and mouth. A few patients may be complicated with aseptic meningitis, encephalitis, acute flaccid paralysis, respiratory infection and myocarditis. Some critically ill children progress quickly and die easily. In order to do a good job in the prevention and control of hand, foot and mouth disease in our county, prevent the outbreak, and ensure the health and life safety of children, this work plan is specially formulated. I. Work objectives
Through the comprehensive implementation of comprehensive intervention measures focusing on cutting off the transmission route, the spread of hand, foot and mouth disease can be controlled, the incidence rate can be reduced, and major epidemics can be prevented.
Second, the working principle
Prevention first, comprehensive preparation, management according to law, relying on science, strengthening cooperation, unified leadership, classified disposal, and effective response.
Third, organizations and expert teams.
(a) the establishment of hand, foot and mouth disease prevention and control work leading group, headed by Comrade Lv Lijun, Zong Yinong, Chen Nanru and Zhou Fengxue as deputy heads. The leading group consists of eight working groups:
Head of comprehensive coordination group: Chen XX
Member: Hu XX Zhou XX
Li XX (Dean of township hospitals)
Leader of epidemic prevention and control team: Zhou XX
Member: Yuan XX Yang XX Qu XX
Liu XX Zhou XX
Head of medical team: Feng XX
Member: Cai XX Li XX General XX
Head of Health Supervision Team: Xu XX
Member: Li XX Liu XX
Head of Health Education Group: Qi XX
Member: Liu XX Hu XX Wei XX Liu XX
Head of epidemiological investigation team: Qu XX
Member: Song XX Branch XX Week XX
Chief of Information Statistics: Yuan XX
Members: Qu XX, Zhou XX
The County Health Bureau set up an expert guidance group (list attached) composed of experts in epidemiological investigation, laboratory testing, disinfection, pest control, rodent control and health education, and was responsible for proposing prevention and control measures for hand, foot and mouth disease. Participate in the formulation and revision of prevention and control plans and technical programs; To guide the handling of major epidemic situations and the treatment of critical cases; Undertake other tasks assigned by the leading group.
Medical expert group
Team leader: Vice President and Deputy Chief Physician of Feng XX County Hospital
Member: the chairman of the trade union of Baixx County Hospital and the nurse in charge.
Xu XX county hospital, director and deputy chief physician.
Cai XX County Hospital Pediatric Director Attending Physician
XX county hospital emergency department chief attending physician
The County Health Bureau has set up an expert group on medical treatment of hand, foot and mouth disease (the list is attached), which is composed of relevant professionals of the expert group on medical treatment of public health emergencies in the county and relevant medical personnel of the pediatrics department and emergency department of the county people's hospital, and is responsible for the treatment of hand, foot and mouth disease, especially severe cases in the county.
Mobile team for epidemic scene disposal
The county health bureau has set up a mobile team for on-site handling of epidemic situation (the list is attached), which is responsible for the epidemiological investigation and on-site disposal of major hand, foot and mouth disease.
County CDC Tel: * * * * * * *
County People's Hospital has been identified as the designated treatment hospital for hand, foot and mouth disease in the county.
(two) strictly implement the responsibility system for prevention and control work. In order to ensure the prevention and control work well, all units should firmly establish a sense of responsibility and overall situation, establish a working mechanism in which the top leaders take overall responsibility and take charge of leadership, implement specialized personnel, and actively carry out prevention and control work.
Fourth, prevention and control measures
(a) strict epidemic reporting management system. The medical staff who perform their duties in the county's medical institutions and county CDC are responsible reporters. After finding patients with hand, foot and mouth disease, you should fill in the infectious disease report card carefully and report it directly on the Internet in time.
(2) According to the principle of territorial management, the county-level centers for disease control and prevention shall, after receiving the epidemic situation in their respective jurisdictions, conduct epidemiological investigation in time, deeply analyze the distribution and epidemic characteristics of the epidemic situation, and keep abreast of the epidemic situation.
(3) deal with the epidemic. According to the epidemic information, find out the patient's detailed residential address, focusing on the patient's family members, their neighbors and close contacts, villages, units and residential areas.
Seriously implement disinfection measures and cut off the route of transmission. Where the case occurred, a patriotic health campaign should be organized in time, garbage, feces and sewage should be removed and disinfected in time, and the urban and rural health environment should be rectified; Disinfect patients' articles, clothes, vomit, excreta and their containers with a proper proportion of chlorine-containing disinfectant; Use pyrethroid insecticides to kill mosquitoes and flies. Strictly protect drinking water sources, especially in villages with centralized water supply in rural areas, and rectify the surrounding environment of water sources and take protective measures to prevent water pollution.
1, isolate the patients and strictly manage the source of infection. Isolate the source of infection according to the principle of dealing with intestinal infectious diseases, strengthen hospital disinfection and sewage treatment, and put an end to nosocomial infection; For hospitalized patients, it is necessary to limit the number of accompanying and contacting patients and strengthen decontamination measures; For patients who are treated at home and their contacts, the township prevention and protection personnel will specifically guide the surrounding areas to implement isolation measures and disinfection measures.
2. Take effective measures to protect susceptible people. It is necessary to strengthen the management of kindergartens, conscientiously implement the morning check-up system, and isolate and treat patients and suspected patients as soon as possible. Seriously implement the relevant provisions of the "Disinfection Management Measures" to disinfect feces, respiratory secretions and items that may be contaminated (clothes, bedding, tableware, toys, etc.). ) children. When necessary, temporarily close schools, kindergartens and other children's gathering places according to law to protect vulnerable children.
3, medical institutions should be in accordance with the "hand, foot and mouth disease diagnosis and treatment guidelines (XXXX version)", "enterovirus 7 1 (EV7 1) clinical treatment experts * * (XXXX version)" and "enterovirus 71) infection clinical treatment. It is necessary to constantly sum up and exchange experience in diagnosis and treatment, improve the level of clinical treatment and avoid death. At the same time, actively cooperate with the county center for disease control and prevention to carry out epidemiological investigation, disinfection and isolation and various specimen collection. Further strengthen the work of infection department in medical institutions, implement the pre-inspection and triage system, set up special consultation rooms for fever and rash cases, strengthen the disinfection of hospital delivery rooms and pediatric wards, and prevent serious consequences caused by nosocomial infection in newborns and infants.
4. Improve the diagnosis and treatment records. All kinds of medical institutions at all levels, including village clinics, should establish and improve outpatient logs with complete projects. Hospital admission and discharge registration must be carefully filled in, with detailed home address, parents' names and telephone numbers, so as to facilitate the investigation and tracing of the source of infection.
5, to carry out health education, improve the national knowledge level of disease prevention. Through radio, television, newspapers, internet, leaflets and other forms of publicity, the knowledge of prevention of intestinal infectious diseases is introduced positively, and parents are warned not to take their children to public places where people gather in the popular season to avoid contact with them; Correct children's bad hygiene habits and often disinfect their toys, tableware, clothes and articles. Parents should pay attention to their children's personal hygiene and develop good hygiene habits, so as to "wash hands frequently, drink boiled water, eat cooked food, ventilate frequently, dry clothes and bask in the quilt".
6. Strengthen training and improve professional quality. All units should organize hand, foot and mouth disease prevention and control technical training as soon as possible to further enrich and improve the technical force of the prevention and control team. First, carry out prevention and control technical training, improve the technical level of epidemic situation disposal such as flow adjustment, sampling, detection, monitoring and disinfection of disease control teams, and ensure that prevention and control measures are put in place. The second is to carry out the training of diagnosis and treatment technology, strengthen the training of medical staff on the diagnosis, isolation and disinfection of hand-foot-mouth disease, so that clinicians, especially grassroots township doctors and village doctors, can be familiar with the diagnosis and treatment technology of hand-foot-mouth disease as soon as possible, and ensure early detection, early diagnosis, early reporting, early isolation and early treatment.
(4) Strengthen health supervision and inspection. Health supervision departments should take effective measures to strengthen the supervision and inspection of school hygiene and drinking water hygiene. Supervise the primary schools and kindergartens in the area to implement the morning and afternoon inspection system, and guide the registration, reporting, disinfection and health education of absenteeism. At the same time, strengthen supervision and inspection of the implementation of infectious disease prevention and control measures in medical and health institutions, find problems, and order them to make corrections within a time limit. For the spread of infectious diseases such as hand, foot and mouth disease caused by inadequate measures, it should be dealt with seriously in accordance with relevant laws, regulations and provisions.
Verb (abbreviation for verb) protection
(1) financial guarantee. Actively strive for financial support to ensure the funds needed for disease prevention and control.
(2) personnel safety. Enrich all kinds of technicians to the front line of disease prevention and control, and further strengthen the prevention and control work.
(3) material security. Do a good job in the storage and supply of diagnosis and treatment drugs, disinfection and insecticidal drugs and various instruments and supplies.
Article 2 Work Plan for Prevention and Control of Hand, Foot and Mouth Disease
In order to further strengthen the prevention and control of hand-foot-mouth disease, ensure the scientific, standardized and effective implementation of various prevention and control measures, and effectively protect children's health. According to the requirements of the Law on the Prevention and Control of Infectious Diseases, the Rules for Handling the Aggregation and Outbreak of Hand, Foot and Mouth Disease, and the Notice of the General Office of Shaanxi Provincial People's Government on Further Improving the Prevention and Control of Key Infectious Diseases (No.21), combined with the epidemic situation and prevention and control status in our province, this work plan is formulated. I. Overall objectives and working principles
(1) Overall goal: effectively prevent and control the occurrence and prevalence of hand, foot and mouth disease, reduce morbidity and mortality, and ensure children's health and social harmony and stability.
(2) Working principle: adhere to the working mechanism of government leadership, departmental cooperation and the participation of the whole society; Adhere to the principle of prevention first, extensive publicity and combination of prevention and treatment, and strengthen the treatment of critically ill patients; Adhere to territorial management, focusing on scattered children in rural areas and urban-rural fringe areas, focusing on kindergartens and primary schools, implement the "84" standardized disinfection process, strengthen supervision and inspection, and ensure that all prevention and control measures are in place.
Second, prevention and control measures
(1) case discovery and report
1. Medical institutions at all levels should detect hand-foot-mouth disease cases at an early stage in accordance with the relevant provisions of the Guidelines for the Diagnosis and Treatment of Hand-foot-mouth Disease (XXXX Edition) (No.38 [XXXX] of Wei Power Generation) and improve the early identification ability of severe cases. Primary and secondary schools and kindergartens at all levels should strictly implement the morning check-up system, and actively search for cases and find cases early in accordance with the requirements of "Management Standards for Infectious Diseases Prevention and Control in Primary and Secondary Schools" (GB28932-XXXX) and "Standards for Health Care in Kindergarten Institutions".
2. Diagnose and report the cases of hand, foot and mouth disease according to the relevant provisions of infectious disease report.
(1) Report of severe cases: Medical institutions at all levels should directly report severe cases that meet the clinical diagnostic criteria through the network according to the following diagnostic procedures: ① County-level medical institutions must be consulted by the clinical expert group of hand, foot and mouth disease in our hospital; (2) Municipal medical institutions shall be diagnosed by two deputy chief physicians and above among the members of the medical treatment expert group of hand, foot and mouth disease in our hospital; (3) Provincial medical institutions shall be diagnosed by the deputy chief physician or above among the members of the medical treatment expert group of hand, foot and mouth disease in our hospital; ④ Difficult and severe cases can be consulted by provincial or municipal experts on the basis of our expert group.
(2) Death case report: under the guidance of the expert group on prevention and control of hand, foot and mouth disease at or above the municipal level, the medical institutions receiving medical treatment will report directly through the network, and the cases confirmed by the laboratory to have the basis for laboratory diagnosis of viral nucleic acid detection (PCR), and the death cases that cannot be sampled in time due to special reasons will be reported as clinical diagnosis cases after being identified by the expert group.
(3) Cluster epidemic report: within 1 week, there were 5 or more cases of hand, foot and mouth disease in the same kindergarten or school; Or two or more cases of hand, foot and mouth disease occurred in the same class (or dormitory); Or 3 or more cases of hand, foot and mouth disease occurred in the same natural village/neighborhood Committee; Or two or more cases of hand, foot and mouth disease occurred in the same family. Medical institutions, kindergartens, primary schools and other units shall report to the local county-level disease prevention and control institutions within 24 hours when they find the cluster epidemic of hand, foot and mouth disease.
(4) Epidemic report: within one week, hand, foot and mouth disease cases 10 occurred in the same kindergarten or school and other collective units; Or 5 or more cases of hand, foot and mouth disease occurred in the same natural village/neighborhood Committee. Medical institutions, kindergartens, primary schools and other units should report the epidemic situation of hand, foot and mouth disease to the county-level disease prevention and control institutions in the fastest way.
(5) Report of public health emergencies (above Grade IV): Health administrative departments at all levels shall judge the epidemic level based on the Interpretation of Classification Connotation of Public Health Emergencies (for Trial Implementation) in combination with the actual situation of local epidemic situation. And in accordance with the relevant provisions of the Emergency Regulations on Public Health Emergencies, the Administrative Measures for Reporting Monitoring Information on Public Health Emergencies and Infectious Diseases and the Emergency Plan for Public Health Emergencies in Shaanxi Province, timely report the information on public health emergencies online.
(2) monitoring and analysis of epidemic situation
Disease control institutions at all levels should make full use of existing network resources, carry out daily monitoring of hand, foot and mouth disease epidemic situation in their respective jurisdictions, deeply analyze the "three rooms" distribution and epidemic characteristics of hand, foot and mouth disease epidemic situation in their respective jurisdictions, timely grasp the epidemic dynamics, report abnormal situations in time and make corresponding treatment. Counties (cities, districts) CDC standardized the detection of pathogens of hand, foot and mouth disease, scientifically grasped the distribution characteristics and dynamic changes of pathogens within their jurisdiction, and timely put forward targeted prevention and control measures to guide the prevention and control of hand, foot and mouth disease within their jurisdiction.
In the period of high incidence of hand, foot and mouth disease, health administrative departments at all levels should regularly organize relevant departments to carry out epidemic research and judgment to improve the ability of forecasting and early warning.
(3) Disposal of epidemic situation
When a cluster epidemic or an outbreak occurs in various places, it is necessary to do a good job in handling the epidemic in accordance with the relevant provisions of the "Regulations on Handling the Cluster and Outbreak of Hand, Foot and Mouth Disease (XXXX Edition)" (No.80 [XXXX] of the Health Office). In the event of multiple cluster epidemics or outbreaks, the health administrative department shall organize relevant departments to carry out assessment according to the epidemic situation, and when reaching the standard of public health emergencies, it shall promptly start the corresponding emergency mechanism.
1. Treatment of severe and dead cases
Medical institutions at all levels should comprehensively do a good job in early identification, scientific treatment, safe referral, publicity and education and hospital infection management of severe cases; After the death case occurs, it is necessary to discuss the death case in time, analyze the cause of death, and report the death case of hand, foot and mouth disease to the health administrative department in the jurisdiction; Assist disease control institutions to carry out epidemiological investigation on severe and dead cases, and be responsible for specimen collection; Medical institutions that have carried out laboratory testing of hand, foot and mouth disease will back up specimens of severe cases and deaths, which will be reviewed by local municipal disease control institutions.
According to the principle of territorial management of infectious diseases, disease control institutions at all levels timely carry out epidemiological investigation (including symptoms, medical treatment, medication and epidemiology, etc.). ) and carry out laboratory tests on severe or dead cases of hand, foot and mouth disease reported within the jurisdiction, and report them back to the units and medical institutions and enter them into the disease prevention and control system of China; Timely report the epidemiological investigation report of severe cases and deaths to the health administrative department and the higher-level disease control institutions; The CDC where the case address is located is responsible for supplementary investigation of the diagnosis, treatment and epidemiological history of severe and dead cases, and guiding local grassroots medical and health institutions or relevant preventive and protective institutions to carry out case search, epidemic disinfection and health education. Grassroots medical and health institutions are responsible for the follow-up of severe cases after discharge, as well as disinfection and education of epidemic spots.
2. Requirements for handling clustered epidemic situations
When there is a cluster epidemic of hand, foot and mouth disease, the relevant units and departments shall report to the local disease control institutions in a timely manner. County-level disease control institutions shall immediately organize on-site investigation and disposal; Guide relevant units and departments to carry out case search, epidemic disinfection, sample collection, publicity and education. ; At the same time, track the progress of the epidemic and report relevant information to the health administrative department at the same level and the disease control institution at the higher level in time. Medical institutions are responsible for case reporting, treatment and management, as well as hospital infection management. Health administrative departments at all levels should establish an information linkage mechanism with the education administrative departments at the same level. In case of a cluster epidemic in a school or kindergarten, the health administrative department shall immediately inform the education administrative department at the same level of relevant information, guide the school or kindergarten to take corresponding prevention and control measures in time, and suggest taking measures to suspend classes when necessary.
3. Requirements for handling epidemic situation
When an epidemic occurs, the relevant units and departments shall report to the disease control institutions in a timely manner. County-level disease control institutions should immediately carry out epidemiological investigation on the first cases or indicated cases, carry out case search one week before the onset of the first cases, fill in the Registration Form of Major Information on Outbreaks of Hand, Foot and Mouth Disease, and report it to the public health emergency management information system, and collect at least 5 case samples for pathogen detection at each outbreak. Medical institutions require children to be treated at home or hospitalized according to their illness. Township hospitals/community health service centers, village clinics/community health service stations, etc. Responsible for the follow-up work of children with hand, foot and mouth disease treated at home within their jurisdiction, and instruct their parents or guardians to pay close attention to their condition changes. When there are indications for early identification of severe cases (see Annex 2), you should immediately go to the designated medical institution to treat severe cases and avoid contact with other children as much as possible. Hospitalized children should receive treatment in designated areas to prevent cross-infection with other children.
In case of an epidemic situation in schools and kindergartens, the disease control institutions shall make a risk assessment of the epidemic situation, put forward suggestions on suspension of classes or parks, and issue written suggestions on prevention and control measures to guide kindergartens to do a good job in health education of parents or guardians of children and health observation of children at home. The health administrative department shall inform the education administrative department at the same level of relevant information, and guide schools or kindergartens to carry out terminal disinfection.
(4) Handling and management of cases
All localities should strengthen the treatment and management of cases and implement the medical treatment strategy of "village-level follow-up, township management, county-level diagnosis and treatment, municipal assistance and provincial supervision". Health administrative departments at all levels should establish designated hospitals and the number of designated hospitals for hand, foot and mouth disease according to the local epidemic situation and treatment capacity. Designated medical institutions at all levels should actively do a good job in the medical treatment of hand, foot and mouth disease in strict accordance with the technical requirements of the Guidelines for the Diagnosis and Treatment of Hand, Foot and Mouth Disease (XXXX Edition) and the Clinical Diagnosis and Treatment Expert of Severe Hand, Foot and Mouth Disease Infected by Enterovirus 7 1 (EV7 1).
1. Village-level follow-up: Village clinics/community health service institutions should conduct a thorough investigation of children under 5 years old in combination with basic public health services, and assist in the investigation of children with fever or rash according to relevant technical specifications; Responsible for the follow-up of home isolation treatment cases. If abnormal symptoms such as nervous system, respiratory system and circulatory system are found, it is suggested that parents of children refer them to designated medical institutions for treatment. At the same time, it is necessary to do a good job in the follow-up management of critically ill patients after discharge.
2. Township management: Township hospitals and community health service centers shall be responsible for tracking and managing the condition and treatment measures of children treated at home within their jurisdiction according to the online information of the epidemic situation, so as to ensure that all treatment, isolation and management measures are put in place.
3. County-level diagnosis and treatment: Designated medical institutions at the county level set up fever clinics or specialized clinics for hand, foot and mouth disease to conduct pre-inspection and triage, and timely find cases of hand, foot and mouth disease and transfer them to independent hand, foot and mouth disease isolation treatment wards. Responsible for the treatment and management of hospitalized cases of hand, foot and mouth disease; Establish a graded diagnosis and treatment system, and do a good job in early detection, early diagnosis and active treatment of severe cases. Under the premise of ensuring medical safety, severe cases should be referred to designated medical institutions at higher levels in time (see Annex 3); When it is not suitable for referral, the local health administrative department shall report to the higher health administrative department in time, and organize provincial and municipal experts to carry out active treatment on the spot.
4. Municipal treatment: Municipal designated medical institutions should set up fever clinics or hand, foot and mouth disease specialist clinics for pre-inspection and triage, and timely transfer the confirmed cases to the hand, foot and mouth disease isolation treatment ward. Responsible for the treatment and management of severe cases, establish a consultation and discussion system for severe cases of hand, foot and mouth disease, and set up an expert group for clinical treatment of hand, foot and mouth disease to be responsible for the medical treatment of hand, foot and mouth disease cases. In accordance with the relevant principles of the treatment of severe cases (see Annex 4), strengthen the treatment of cases, improve the success rate of treatment and reduce the mortality rate.
5. Provincial supervision: Provincial expert groups conduct supervision, inspection and technical guidance for medical institutions at all levels.
Medical institutions at all levels should strengthen the management of hospital infection, effectively implement the pre-inspection and triage system, and set up fever clinics or hand, foot and mouth disease specialist clinics during the epidemic season of hand, foot and mouth disease. In strict accordance with the relevant requirements such as "Hospital Infection Management Standard" and "Disinfection Management Measures", do a good job in disinfection and personnel protection in key departments and wards to avoid cross-infection in hospitals and ensure the safety of medical staff and other patients. At the same time, strengthen the disinfection of hospital delivery rooms and pediatric wards to prevent serious consequences caused by nosocomial infection of newborns and infants.