Brothers the intersection of mouth and disease prevent and cotrol the guide ' 2008 version)

Brothers the intersection of mouth and disease prevent and cotrol the guide ' 2008 version)
Brothers the intersection of mouth and disease prevent and cotrol the guide ' 2008 version)
The mouths of brothers are ill (Hand-foot-mouth disease, HFMD) It is a common infectious disease caused by many kinds of intestinal virus, rely mainly on the fact that infant and pre-school children have illness coming on. Most patients have slight symptom, regard rash or bleb of positions such as generating heat and hand, foot, oral cavity,etc. as the main characteristic. A few patients can erupt aseptic meningitis, encephalitis, acute relaxing paralysis, airway infection and myocarditis,etc. simultaneously, specific serious disease and infant's condition are sharp in progress, the death incident. Children and adult do not have illness coming on more after infecting, but can propagate the virus. Cause the ill intestinal virus of mouths of brothers to include the intestinal virus 71 type ( EV71) With strange virus (CoxA) Sa Ke, group of A, , but angstrom is viral (Echo) Some serum type. It causes the large percentage of the serious disease case that EV71 is infected with. The intestinal virus is infective and strong, apt to cause breaking out or popular. For instruct all parts do the intersection of brothers and prevention and control, mouth of disease well, make a guide. First, purpose( One) Guide the epidemic situation report that the medical organization, controlling organization of prevention from suffering from the diseases launch the intestinal virosis and monitor; (2) Guide the controlling organization of the prevention from suffering from the diseases and launch epidemiology to investigate that measures with the laboratory; (3) Guide the controlling organization of the prevention from suffering from the diseases, medical organization and prevent and meet an urgent need and handle with the epidemic situation the public. It is mainly the strange virus (Coxasckie virus) of Ke Sa that small RNA virus department, intestinal virus belong to that 2, aetiology cause brothers' mouth disease Group 16, 4, 5, 7, 9, 10 type A, group 2, 5, 13 type B; But virus (ECHO viruses) of angstrom With the intestinal virus 71 type ( EV71) ,Among them the EV71 and Cox Al6 type is the most common. Intestinal virus suitable for, survive and travel under wet hot environment, to ether, go the intersection of chlorine and the intersection of gallbladder and the intersection of sour salt,etc. and insensitivity, 75% of the alcohol and 5% of the lysol also can't deactivate it, but to the ultraviolet ray and dry and sensitive. Various oxidant (potassium permanganate, bleaching powder,etc.) , the formaldehyde, iodine tincture can deactivate the virus both. The virus can be deactivated rapidly at 50 ��, but the price cation environment of the 1mol density two can improve the resistance that the virus deactivates to heat, the virus can survive for one year at 4 ��, can be kept at - 20 �� for a long time, the virus can survive for a long time in the other environment. Third, epidemiology ( One) It is global infectious disease that overview brothers' mouth disease prevails, there are prevailing reports of this disease in most areas of the world. This disease of New Zealand's first report of 1957. Isolated the strange virus of Ke Sa in 1958, proposed a disease of brothers to name in 1959. The pathogen of the disease of the intersection of brothers that find in early days and mouth is mainly Cox A16 type, EV71 in 1969 is first affirmation in U.S.A.. EV71 was infected and infected with and replaced and presented with Cox A16 hereafter, became main pathogen of brothers' port disease. In middle period of the seventies of the 20th century, EV71 taking central nervous system as main clinical feature breaks out in succession popularly in Bulgaria, Hungary, Bulgaria reported 750 cases in 1975, among them 149 people caused paralysedly, 44 persons died. Britain take place caused by Cox A16 the intersection of brothers and the intersection of mouth and disease break out together, patient 1-4 year old infant and pre-school children mostly 1994, most patients have relatively light symptom. The epidemiology data since 1963 of Britain reveal, the prevailing interval of of mouths of brothers was 2-3. On later stage of 1990s, EV71 prevailed in East Asia at the beginning. Malaysia happened mainly the mouths of brothers caused by EV71 prevailed in 1997, 2628 people had illness coming on in April - August, there is patient's death of 29 examples in April - June. A disease of first report of Shanghai in 1981 in our country, hereafter, there is a disease report in 10 odd provinces such as Beijing, Hebei, Tianjin, Fujian, Jilin, Shandong, Hubei, Qinghai and Guangdong. The mouth disease of brothers that caused Cox A16 takes place to break out in Tianjin in 1983, more than 7 000 cases took place among May - October. After it is distributed that low-level in 2, broke out again in 1986. The intersection of Wuhan and institute of viruses isolate EV71 in patient, mouth of brothers, 1995, the intersection of Shenzhen and health and epidemic prevention station isolate EV71 from disease of brothers mouth patient in the sample too 1998. In 1998, EV71 takes place and was infected brothers mouth disease and bleb angina caused and prevailed in Taiwan of our country, monitor the sentry post and click and report 129106 cases together. 405 patients of serious disease happened altogether that year, 78 cases of death, were mostly infants under the age of 5. And myocarditis that complication including encephalitis, aseptic meningitis, lung edema or lung of the serious disease case bleeds, acute and collapses from physical exhaustion. A disease of brothers does not have obvious provincialism prevailingly. Can have illness coming on throughout the year, see more with summer and autumn, the morbidity in winter is comparatively rare. Disease this prevail, can take place kindergarten and nursery infect with family gathering phenomenonning of having illness coming on collectively. Intestinal virus infective and strong and recessiveness infect proportion to be large propagating route to be complicated travelling fast, can cause more broad prevalence within short time, the epidemic situation controls the difficulty to be great. (2) Infect source and spread route people intestinal the intersection of virus and only host, patient and recessive the infeted the intersection of infection and source of disease this. The intestinal virus mainly can also be contacted patient's skin, mucomembranous bubble rash liquid to infect through excrement - mouth and/or respiratory tract droplet transmission. It is still indeterminate whether to can transmit through water or food or not. In several days before the onset, the department that swallows the infeted can detect the virus with the excrement and urine, it is the strongest to be infective in one week after usually in order to have illness coming on. Patient excrement and urine, liquid of bleb and respiratory tract secretion and hand polluted, towel, handkerchief, tooth cup, toy, tableware, milk have, bed clothes, underwear and medical apparatus,etc. can cause copies of disease not to be travelled. Apt perceptual people generally exchange the sense to the intestinal virus, dominant infection and recessiveness can get specific immunity after infecting, duration yet indeterminate. There is no immunity of crossing in various of the virus. Every age group can infect, have illness coming on, with less than or equal to 3 year old age group, most high morbidity have. Fourth, case define (1) The getting acute disease of clinical diagnosed case, generate heat, the palm or foot palm presents spot papule and bleb, the buttock or knee can also present rash. There is inflammation nature blush around rash, there are less blister and inner liquid; It appear oral cavity mucous membrane scattered in bleb,there are obviously on pain. Some infant can with cough, shed symptoms such as tears, losing the appetite, nausea, vomiting and headache,etc.. Serious disease case: 1. Have the intersection of brothers and patient of clinical manifestation, mouth of disease, at the same time with the intersection of skin and bursts of contraction, encephalitis, acute the intersection of slowness and paralysis, the intersection of heart and lungs and depleted, lung edema,etc.. 2. The intersection of brothers and the intersection of mouth and disease prevails the infant and pre-school children of district although have no mouth disease models of brothers to behave, have, generate heat the intersection of companion and the intersection of skin and bursts of contraction, encephalitis, acute the intersection of slowness and paralysis, the intersection of heart and lungs and depleted, lung edema,etc. (2) Diagnosed case clinical diagnosis disease in the laboratory The example accords with one of the following conditions to get the diagnosed case 1 of the laboratory. The virus is separated swallowing the swab or throat lotion, separate the intestinal virus in tissue samples such as excrement and urine or anus swab, cerebrospinal fluid (CSF) or bleb liquid, and brain, lung, spleen, lymph node,etc.. 2. Serology examines the specific IgM antibody in patient serum positively, whether or acute one has rising of more than 4 times with convalescent serum IgG antibody. 3. The nuclear acid is examined Since patient serum, cerebrospinal fluid (CSF), swallow the swab or throat lotion, excrement and urine or the intersection of anus and swab, cerebrospinal fluid (CSF) or the intersection of bleb and the intersection of liquid and brain, lung, spleen, lymph node,etc. and the intersection of organization and sample,etc. measure in the sample to etiology nuclear acid five, epidemic situation report ' One) Since May 2, 2008, the mouths of brothers are ill to include in class-C infectious disease to manage. All types of medical organization want until " whether the People's Republic of China legal infectious disease prevent and cure law " relevant regulations of " the intersection of infectious disease and message report the standardard management to ", report the ill case of mouths of brothers according with the above-mentioned case and defining. (2) While reporting content and method find the ill patient of mouths of brothers, should be in " the legal infectious disease in the People's Republic of China report the " in " of card Other legal management and monitoring infectious disease especially " Make a report on this disease in the column. The medical organization offering directly the network should carry on the straight newspaper of network during 24 hours. The medical organization that the unexecuted network offers directly should send and send infectious disease to report the card within 24 hours. Report the case is divided " The clinical diagnosed case " With " diagnosed case of the laboratory " Two kinds. If is a diagnosed case of the laboratory, should be reporting the card " remarks " Mark out intestinal virus getting concrete to leave, until case should in " remarks " also for serious disease in the fence China marks out " Serious disease " . (3) When some areas or collective unit happens popularly or gets rich quick, according to " regulations of meeting an urgent need that the public health event happens suddenly ", " happen suddenly public the intersection of health event and emergency preplan while being national ", " public health event and epidemic situation of infectious disease happens suddenly and monitor information and report management " and relevant regulations, the information report of the public health event happens suddenly in time. (4) Report information analysis and feedback the controlling organizations of prevention from suffering from the diseases at all levels to report to the epidemic situation information is verified step by step. Controlling organization should have a look around and analyze the monitoring data the district level prevention from suffering from the diseases of the county every day, raising or case presents gathering distribution or the death case appears to find abnormality, should verify and report to the health authorities at the same level and the controlling organization of prevention from suffering from the diseases of higher level in time. The controlling organizations of prevention from suffering from the diseases at all levels should accuse of organization's and medical organization's feedbacking the epidemic situation and analyzing information to subordinate disease in time. Sixth, the intersection of epidemiology and investigation find brothers the intersection of mouth and disease report case count increase obviously and case present distribution, serious the intersection of disease and the intersection of case and large percentage of gathering etc. or appear death at the case, should organize investigating epidemiology. The main purpose to investigate: First, gather the relevant sample, measure the laboratory, define the etiology and appraise the dividing type; Second, it is clinical since it collect materials,in order to lasting pathogenic, virulence of viruses getting more intestinals different, due to disease types clinical and treat and cure,etc.; Expound popular time / circulation way and dangerous factor,etc. that infect that break out this, in order to make the prevention control measure of pertinence; Fourth, appraise the tactics of different prevention and control and validity of the measure. Scheme and questionnaire should be according to investigating purposes are different and is specially designed that epidemiology is investigated. Seventh, laboratory find ' One) Disease high to send season in the intersection of brothers and mouth, every the intersection of province and disease accuse of centre want, organize, launch the intersection of rival and the intersection of foot and the intersection of mouth and the intersection of disease and laboratory of case monitor. Happen in the prevailing province of a disease and gather 5-10 patients' sample to measure at least every week. The sample gathers and keeps technical requirement and sample to inspect by ready samples and see attachment 1 and attachment 2 only. See attachment 3 by sample detection method. If there are serious disease cases, should try hard to gather the sample and measure in the laboratory in disease case to all again. Should gather some samples of case and measure the etiology if the epidemic situation breaks out. Area that measures ability can not send the sample to conditional disease to accuse of the central lab to measure. The relevant information that should pay attention to collecting the case while gathering the sample, fill in the case questionnaire and see attachment 4. (2) Report and the intersection of feedback and every province to measure result finish the intersection of case and the intersection of case and questionnaire that laboratory measure and measure, fruit an overview of already province this Friday while being every ' Attachment 5) Electronic edition last China disease accuse of centre disease control and emergency processing office and virosis spine laboratories gray. After China's disease accuses of centre's reporting the result and paying gathering to analyze to all parts, accuse of centre's feedbacking to every province disease. Contact details: Telephone (fax) 010-63025413,010-63047379,010-83163681 E-mail: cdcjkccb@163.com zhangyong75@sina.com seven, preventing from brothers' mouth disease of control measure and propagating the route more, infant and pre-school children and children generally exchange the sense. It is keys of preventing a disease from dyeing to do individuals of children, hygiene of the family and nurseries and kindergartens organization well. (1) Personal precautionary measures 1. Want, use soap or wash the intersection of hand and liquid,etc., wash hands for children after being before a meal back going out, don't let children drink the unboiled water, eat the raw and cold food, avoid contacting ill children; 2. The watcher should wash hands before contacting children, after changing the diaper, dealing with the excrement and urine for the child, and deal carefully with the filth; 3. Feeding bottle, nipple that infant and pre-school children used should fully wash in front and at the back of using; 4. Unsuitable to take children to the crowd to be gathered, public place bad in airiness during this disease is prevailing, pay attention to, keep the intersection of family and environmental sanitation, room want, ventilate frequently, shine clothing while being hardworking; 5. Children should go to the medical organization to go to a doctor in time when presenting relevant symptom. The intersection of house and children of treatment, don't contact other children, parents want clothes in infant to go on, dry in air or sterilize in time, disinfect the infant excrement and urine in time; It is light disease infant needn't in hospital,should treatment at home, have a rest,in order to reducing by cross infection. (2) Unit in collective control measures 1 of prevention such as nurseries and kindergartens organization and primary school,etc.. The prevailing season of this disease, it is ventilated that places such as classroom and dormitory,etc. should keep good; 2. Wash and sterilize articles such as the toy, personal sanitary ware, tableware,etc. every day; 3. Go on, clean or sterilize, work ' Especially clean the toilet) When, staff members should wear gloves. Should wash hands immediately after the cleaning; 4. Polish and sterilize surfaces of object such as the door handle, balustrade, tabletop,etc. every day; 5. Educate and instruct children how to get used to washing hands correctly; 6. Examine in the morning every day, find suspiciously that suffers from childhood, should take and send the measure examined the infant, had a rest at home off in time; Disinfect the articles that the infant use immediately; 7. When the infant increases, should report to hygiene and education department in time. Control need can determine, take the intersection of nurseries and kindergartens and organization or primary school have a holiday measure as education and Ministry of Health according to epidemic situation. (3) Control measure 1 of prevention of the medical organization. When disease prevails, The hospital should assign to and examine the preexamination, and open up the consulting room (the platform) specially Answer and examine suspected mouth patients of brothers, guide and generate heat to appear the rash infant to the special consulting room (platform) Go to a doctor, the area of waiting and going to a doctor etc. should increase and sterilize the frequency clean, should adopt the clean way of the wet type while cleaning in the room; 2. The medical worker should wash hands or sterilize both hands conscientiously after making a diagnosis, attending to every patient; 3. Non- disposable instrument, article,etc. used want to polish and sterilize to make a diagnosis, attend to patient's course; 4. Should not accept the infant that other non- intestinal virus infected for medical treatment in the same ward. The serious disease infant should isolate for treatment alone; 5. Must continue using sick bed and desk chair,etc. facility and article in hospital that the infant has used after sterilizing; 6. Secretion and excrement and urine and article polluted of the infant's respiratory tract need to disinfect; 7. The medical organization finds mouth patients of brothers and increases or when the intestinal virus is infected with the relevant death case, accuse of organization's report to local health authorities and diseases immediately. Attachment 1. The sample gathers and keeps the technical requirement and has a guide look of Table 2. Brothers mouth disease and case sample inspect by ready samples and register Table 3. Measure the scheme 4 in the ill laboratory of mouths of brothers. Investigate Table 5 in ill case of mouths of brothers. Brothers' mouth disease and clinical sample measure and fruit report form 6. The correct one washes the hand method 7. The intestinal virus sterilizes the method


|