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China emergency begin influenza epidemic is also popular in other areas. The U.S. government on April 26 with domestic multi-state outbreak of swine flu appeared, citing the United States access to public health May 1 to 5 5 days leave the country temporarily suspending always public businesses and economic activities. World Health Organization announced on April 26, Mexico and the United States has been an outbreak of swine flu epidemic constitutes a ;, and three days after the second increase in the influenza pandemic advising system level (27, 4 from the three said, 29 and from the four mentioned in 5, and this system the highest level 6) .5 level advising level is the health sector to governments and published a marker that all countries should now begin immediately for a great outbreak of influenza answer arrange. our hospital as a health and medical creations in at 15:00 on April 30 the hospital held an crisis appointment to transfer urban levels of health government department documents and published an crisis hospital for people infected with A (H1N1) virus epidemic of swine influenza prevention and control measures and conditions. The following is I have received the city, district, hospital for people infected with three levels of A (H1N1) virus epidemic of swine influenza prevention and control of the document. Thus, we can see: April 30 in China, Six years antecedent, : Ministry of Health adult the A (H1N1) swine influenza virus appears opposition the outside of the country is unrealistic and self-prevention is especially important.
just learned: Hong Kong announced the first confirmed cases of Influenza A H1N1 influenza, Zhongguang Wang Beijing on May 1 AP (at 21:42 on May 1, 2009) Hong Kong Special Administrative Region Government announced a prim nightfall, Hong Kong experienced the first cases of H1N1 confirmed cases of influenza, the patient is Mexican, April 30 by the afternoon of Eastern Airlines flight MU505 arriving from Mexico by path of Shanghai. while the patient is not out of the landing in Shanghai, but the width of stay is unknown. summarizing the SAR government has the World Health Organization, Ministry of Health and Shanghai Municipal Health Bureau. Hong Kong, with effect immediately level to handle with influenza prevention and control amounts.
benevolent medicine written in May 1, 2009
country A (H1N1) influenza virus eruptions in real period announce relevant
my log:
2008-04-21 | Memorial ; SARS Edition) pig deaths (mortality rate of pigs 1-4%). ​​human influenza viruses rarely infect pigs, but also found some human cases of swine flu, most have had direct contact with sick people .2009 3 month, Mexico and the United States has occurred of human infection with swine influenza virus, the influenza A virus, H1N1 subtype swine influenza virus tug, the tug contains the swine flu, avian flu and human influenza virus gene shreds, is a current type of swine influenza virus can infect one person. behind the swine flu influenza early clinical symptoms alike to a fever, cough, fatigue, poor desire, diarrhea or vomiting can be symptoms. the disease can rapidly progress sudden high fever, pneumonia, severe respiratory failure can happen, multiple organ abuse, guiding to necrosis.
1 swine influenza viruses are pathogenic
Orthomyxoviridae virus family (0rthomyxoviridae), influenza virus, (Influenza virusA ). Typical viral motes were spherical diameter of 80 nm ~ 120nm, with envelope. capsular membrane has numerous protrusions arranged radially glycoprotein, respectively, hemagglutinin HA, NA and M2 neuraminidase protein. viral particles among nuclear capsid, spiral symmetry, a diameter of 10nm. swine influenza virus negative-strand single-stranded RNA viruses, genome of almost 13.6kb, ranging from the size makeup of 8 divide segments. Despite the different subtypes can be fashioned between a diversity of influenza virus serotypes, yet can cause human infection with swine influenza virus serotypes are H1N1, H1N2 and H3N2.
Swine influenza viruses have enveloped virus, so the ether, chloroform, acetone and other organic solvents were Sensitive, 200mL / L ethyl ether by 4 ℃ overnight, virus infectivity was destroyed; to oxidant, halogen compounds, ponderous metals, ethanol and formaldehyde were likewise sensitive, 10 g / L potassium permanganate, 1 mL / L mercuric chloride treatment 3min, 750 mL / L ethanol, 5min, 1 mL / L iodine 5min, 1 mL / L hydrochloric sour 3min and 1mL / L formaldehyde 30min, can be inactivated swine influenza virus. swine influenza viruses are sensitive to heat, 56 ℃ condition, 30min to inactivate ; UV-sensitive, but with UV-inactivated virus of swine influenza virus can cause multiple resurrection.
Second, epidemiological
the United States in 1976, the so-called H1N1 subtype of swine influenza virus, the virus was isolated from the virus in pigs the same as the first confirmed under normal conditions, swine influenza virus can be transmitted to humans from pigs in the year 1999 in October, Hong Kong, a 10-month-old babe infected with swine influenza virus H3N2, now entirely retrieved. these years, bring ... to an endthe earth with different swine influenza virus strains reported, but no large-scale epidemic. Recently, parts of Mexico and the United States and other outbreaks of swine flu. World Health Organization, Mexico and the United States infections are subtype swine influenza virus H1N1, a strain of the same.
(a) source of infection.
primarily pigs and pigs carrying the virus, infection swine influenza virus were also shown to spread the virus. animals infected with the virus can be transmitted.
(b) transmission.
mainly for respiratory tract can also be transmitted through contact with infected pigs or their faeces, polluted surroundings or aerosols, etc. Some strains such as H1N1 can be spread from person to person, similar to its mode of transmission of influenza, usually through coughing or sneezing of infected persons.
(c) susceptible population.
generally susceptible. Most patients aged 25 to 45 annuals old, the current report are juvenile, aged and children should disburse consideration.
(d) high-risk groups.
in piglet industry, visited 1 week before the onset of pigs, and other locations of sale and massacre of those swine influenza virus infection and exposure to the substance for a high hazard of studio workers.
human infection with swine influenza constantly occurs in winter and spring pigs infected with swine flu generally occurs in summer and autumn.
III clinical
incubation time is commonly 1-7 days or so, more influenza, avian flu a long incubation time.
(a) clinical omens.
people Early after the swine flu symptoms similar to ordinary flu, including fever, cough, sore throat, body aches, headache, chills and fatigue, and some also suffered from diarrhea or vomiting, muscle pain or fatigue, red eyes and so on.
some patients can progress rapidly, savage, sudden high fever, body temperature over 39 ℃, and even secondary to severe pneumonia, acute respiratory trouble syndrome, pulmonary hemorrhage, pleural effusion, pancytopenia, renal failure, sepsis, shock and Reye syndrome, respiratory failure and multiple organ damage, leading to death.
(b) of the signs.
often not obvious pulmonary signs, some patients could be heard and wet rales or signs of pulmonary consolidation, etc. .
(c) prognosis.
prognosis of human infection with swine influenza virus subtype infection is narrated to most of the good prognosis; needy prognosis infected with H1N1, the mortality is about 6%.
(d ) laboratory.
1. Peripheral blood: WBC count is generally not high alternatively lower. caustic cases extra than a rebate of leukocytes and lymphocytes, and platelets;
2. serological diagnosis: can the use of oblique ELISA , antigen capture ELISA, fluorescence immunoassay, etc.;
3. reverse transcription - polymerase necklace response (RT-PCR): the PCR technique is simple, rapid, sensitive, characteristic specifics, have been used to swine influenza Detection of viral genes and molecular epidemiological inquiry;
4. Virus Isolation: Respiratory specimens from patients (throat swab,shanghai escort, oral wash, nasopharyngeal or tracheal aspirate, sputum or lung tissue) was secluded swine influenza virus. commonly used method has egg inoculation method and cell culture. existing diagnostic methods, virus isolation method is more perceptive, but takes 2-3 weeks.
(e) chest imaging.
Merge apparent lung pneumonia sheet images. severe cases a wide range of sheet images.
IV diagnosis of human infection with swine influenza
diagnosis with epidemiological history, clinical declarations and pathology inspection, clinical ashore the early finding, early diagnosis is the key to dispose.
(a) of the human infection with swine influenza diagnostic criteria.
1. medical detection cases: visited swine flu epidemic, or pigs, and swine flu history of close contact, within 1 week of clinical manifestations were flu. classified as cases of medical observation and those of their medical observation for 7 days (according to the disease can be isolated at family or hospital).
2. suspected cases: visited pestilence district, or with pigs and pig history of close adjoin with influenza patients (epidemiological history can also be unknown), 1 week clinical manifestations of influenza, respiratory secretions, pharyngeal attempt son, sputum, serum H subtypes of HIV-positive or nucleic acid testing affirmative.
3. clinically analyzed cases: the diagnosis of suspected cases, and their common history of exposure were confirmed cases were diagnosed.
4. confirmed cases: from respiratory tract specimens or serum isolation to a specific virus; RT-PCR on the specimens, the subsistence of swine influenza virus RNA, confirmed by sequencing, or two 4-fold increase in serum antibody titers can be confirmed human infection with swine influenza.
(b) of the human infection Differential diagnosis of swine influenza.
should be eminent namely human infection with swine influenza and influenza, avian flu, the flu, pneumonia, SARS, catching mononucleosis syndrome, cytomegalovirus infection, Legionella pneumonia, Chlamydia, Mycoplasma Identification of pneumonia.
five treatment
(a) symptomatic and supportive.
patients with suspected and confirmed place should be treated in isolation, emphasizing early treatment.
of human infection with swine influenza present, is a comprehensive symptomatic and supportive treatment. pay attention to repose, more water, pay attention to nourishment, close observation of patient's condition; the early onset of 48 hours is the best treatment for high fever, clinical symptoms, should take chest xray, blood gas check.
(b) narcotic treatment.
1. antiviral therapy: early application of antiviral drugs should be the trial of oseltamivir (oseltamivir Tamiflu). Tamiflu is a neuraminidase inhibitor, on prohibition of swine influenza virus may have effects, dose 75mg / d, 5 days treatment, kid with remind. from the United States recently infected with swine influenza virus isolated from the virus, oseltamivir and zanamivir (zanamivir) is sensitive to amantadine and rimantadine resistance.
2. Antibiotics: Bacterial infection can occur, such as the use of antibiotics.
(c) TCM treatment.
1. toxin attack lung health.
symptoms: fever, nausea cold, sore larynx, headache, muscle pains, cough.
Governing Law: detoxification, Xuanfei via malign.
reference Recipe: Roasted Ephedra, almond, gypsum, Bupleurum, Scutellaria, Arctium, Notopterygium, raw licorice.
commonly secondhand Chinese medicine: Lotus Qingwen Capsule, silver, yellow class arrangements, Shuanghuanglian spoken preparations.
2. drug traffickers lung and stomach.
symptoms: fever, or chills, nausea, spewing, abdominal ache, diarrhea , pate and body, muscle aches.
Governing Law: detoxification, and the dampness.
reference Recipe: puerarin, baicalin, berberine, the herb, Agastache rugosa, Jiang Ban Xia, wise, Magnolia.
prevalent Chinese medicine: Gegenqinlian pellets Ageratum proxies and other.
3. toxin obstruct gas business.
symptoms: lofty fever, coughing,shanghai escort, breast tightness, suffocation, breathlessness and shortness of expiration, irritability, delirium Shenhun fraudulent claims.
Governing Law: explicit wind chilly camp.
reference Recipe: Roasted Ephedra, almond, Trichosanthes, rhubarb, gypsum, ruddy peony, buffalo trumpet.
Angongniuhuang used when required, and Phlegm Qing Xuebijing, Qingkailing, such XNJI.
six, prevention
(a) 控制传染源.
behave human and swine influenza surveillance. Once or pigs other beasts infected with swine influenza virus, should be in agreement with the pig harvest, had a stall selling meat ailment, the patient unit, kin, disinfection, even now by App and other garbage should be swiftly destroyed or buried; acknowledged to the clinic and defense patients at avian flu,toronto escorts, SARS standards good solitude disinfection; specimen cases of pneumonia of unknown reasons in consensus with the requirements of shipping and handling.
(c) to protect healthy people.
amplify good private hygiene, adequate sleep, hard discipline, reduce stress, adequate nutrition ; shirk contact with flu-like symptoms (fever, cough, runny nostril, etc.) or pneumonia and other respiratory patients; attention to personal hygiene, wash hands frequently with soap and water, especially after coughing or sneezing; avert contact with pigs or pig to have a place; Avoid crowded places; with a tissue when coughing or sneezing, cover jaws and neb, and then tissue periodical trash; such as influenza-like symptoms outside (fever, cough,guangzhou escort, runny nose, etc.), should immediately quest medical treatment (medical treatment should be worn masks), to the local public health agencies and description of inspection and quarantine divisions.
(d) strengthen the hospital infection control measures.
patients with suspected or confirmed patients were isolated and dress a surgical mask; remedial staff to do private conservation strengthen the hand hygiene, use of hand disinfectants for hand disinfection quickly; fever clinics and Infectious Diseases, and other key sectors of the medical staff should wear a surgical mask, if I were you, wear goggles or protective masks; of fever clinics and Infectious Diseases, etc. indoor ventilation prerogative sectors should be strengthened.
swine flu vaccine: At present, merely the swine flu vaccine because pigs, no specifically for humans. to the present position, the mediocre person flu vaccine to discourage swine flu not meaningful effect.
with: World Health Organization between the infection, but there were no reports of human infections.
Level 2: an animal influenza virus known to cause infection in humans,----- HALLOWEEN Halloween night, is watched as a potential pandemic menace.
Level 3: There is an animal influenza virus or animal and human influenza caused by recombinant virus or small-scale sporadic human infection, but this is not enough between folk caused by community-acquired infection.
Level 4: animals and animal influenza virus or recombinant virus caused human influenza spread from person to person, experienced of causing community infections. surging pandemic risk. The level is to control the spread of the virus.
Level 5: person to person spread of infection in the same area to at least two countries. strongly suggests that about a pandemic.
level 6: the pandemic level. from person to person displacement of the virus, at least in the same geographical spread in both countries, and spread to different country in the same area of ​​a geographical spread of at fewest 2 and spread to another country in the same area.