中新网11月14日电 据卫生部网站消息，卫生部日前发布关于印发《流感样病例暴发疫情处置指南(2012年版)》(以下简称《指南》)的通知，《指南》指出，连续1周无新发病例，可判定为暴发疫情结束，结束后1周内，负责疫情处置的疾病预防控制机构要对疫情处置情况进行总结。全文如下：

Beijing on November 14, according to the ministry of health news website,Ministry of health has issued about print and distribute[Influenza-like cases outbreak disposal guide(The 2012 version)](Hereinafter referred to as[guide])notice,[guide]Pointed out that,Continuous 1 week no new cases,It can find the end for the outbreak,1 weeks after the end of,Responsible for the disposal of epidemic disease prevention and control institutions to epidemic disposal situation was summarized.Full text is as follows:

　　

流感样病例暴发疫情处置指南(2012年版) Influenza-like cases outbreak disposal guide(The 2012 version)

　　

一、 总则 a/ General rules

　　(一) 目的。

(a) objective.

　　为规范流感样病例暴发疫情的处置和管理，提高各级机构对流感样病例暴发疫情的处置能力，做到早发现、早报告、早处置，及时采取各项防控措施，有效控制疫情的传播、蔓延，保障公众健康和公共卫生安全，特制定本指南。

For the purpose of regulating the influenza-like cases outbreak disposal and management,At all levels to improve the mechanism of influenza-like cases outbreak disposal ability,Do early detection/Early reports/Early treatment,Take timely the prevention and control measures,Effective control of the spread of the epidemic/spread,Protect the public health and public health security,Article1 this guide.

　　(二) 适用范围。

(two) scope.

　　适用于各级卫生行政部门、疾病预防控制和医疗机构及发生流感样病例暴发疫情的单位开展未达到突发事件标准的流感暴发疫情处置工作。

Suitable for health administrative departments at all levels/Disease prevention and control and medical institutions and occurrence of influenza-like cases outbreak in the unit did not meet emergencies standard flu outbreak disposal work.

　　二、暴发疫情相关定义

two/Outbreak related definition

　　(一)流感样病例：发热(腋下体温≥38℃)，伴咳嗽或咽痛之一，缺乏实验室确定诊断为某种疾病的依据。

(a)Influenza-like cases:fever(Axillary temperature was 38 ℃),With a cough or one of angina,Lack of laboratory confirmed diagnosis is the basis of a disease.

　　(二)流感样病例暴发：指一个地区或单位短时间出现异常增多的有流行病学关联的流感样病例。

(two)Influenza-like cases outbreak:Refers to a region or unit short time abnormal increase of epidemiology associated influenza-like cases.

　　

三、暴发疫情的发现与报告 three/The discovery of outbreak and report

　　(一)1 周内，在同一学校、幼托机构或其他集体单位出现10 例及以上流感样病例，及时以电话或传真等方式向所属地县(区)级疾病预防控制机构报告。县(区)级疾病预防控制机构接到报告后，应立即进行疫情核实。经核实确认的暴发疫情，通过“中国流感监测信息系统”报告疫情事件的相关信息(附件1)。

(a)1 weeks,In the same school/'institutions or other collective units appear 10 cases and above influenza-like cases,Timely by phone or fax DeXian belong to(area)Level of institution of disease prevention and control report.county(area)Level of institution of disease prevention and control after receiving the report,Should immediately verify the epidemic.After verification confirmed outbreak,Through the"China influenza monitoring information system"Report the epidemic situation events related information(Appendix 1).

　　(二)1 周内，在同一学校、幼托机构或其他集体单位出现30 例及以上流感样病例，或发生5 例及以上因流感样症状住院病例(不包括门诊留观病例)，或发生2 例以上流感样病例死亡，经县级疾病预防控制机构核实确认后，应当在2小时内通过突发公共卫生事件管理信息系统进行报告。

(two)1 weeks,In the same school/'institutions or other collective units appear more than 30 cases and influenza-like cases,Or the occurrence of 5 cases and above for flu-like symptoms cases in hospital(Do not include outpatient staying cases),Or the occurrence of more than 2 patients with influenza-like cases death,The disease prevention and control institutions at or above the county level after verified,Ought to be in 2 hours through the sudden public health incident management information system for the report.

　　(三)对于报告到突发公共卫生事件管理信息系统的流感样病例暴发疫情，经核实为流感暴发疫情后，所有实验室确诊和临床诊断病例均要进行个案网络直报，并在“突发公共卫生事件报告管理信息系统”中进行个案病例的关联。在“中国流感监测信息系统”中，承担检测工作的流感网络实验室或疾病预防控制机构负责录入疫情样本的实验室检测结果。负责暴发疫情调查处置的疾病预防控制机构应在“突发公共卫生事件报告管理信息系统”填报“流感样病例暴发疫情采样及检测结果统计表”(附件2)，并根据实验室检测开展情况，对填报内容进行及时更新；同时，按照要求做好进程报告和结案报告。

(three)To report to the emergent public health event management information system of influenza-like cases outbreak,Verified for influenza outbreak after,All laboratory diagnosis and clinical diagnosis cases were to carry out case network direct report,And in"Sudden public health incident report management information system"In the case of the association.in"China influenza monitoring information system"in,Bear detection work flu network laboratory or disease prevention and control institutions shall be responsible for entry epidemic sample laboratory test results.Responsible for the outbreak investigation of the disposal of institution of disease prevention and control should be in"Sudden public health incident report management information system"fill"Influenza-like cases outbreak sampling and testing results TAB"(Attachment 2),And according to the laboratory testing development situation,To fill content update;At the same time,According to the request and make progress report and the final report.

　　

四、暴发疫情的调查 four/Outbreak investigation

　　(一)流行病学调查。接到疫情报告后，属地疾病预防控制机构应立即根据流感样病例定义进行诊断，核实是否为流感样病例暴发，已核实的暴发疫情应开展流行病学调查。

(a)Epidemiological survey.After receiving the report,Territorial disease prevention and control institutions shall promptly according to the definition of influenza-like cases diagnosed,Verify whether for influenza-like cases outbreak,Verified outbreak should carry out epidemiological survey.

　　1.疫情发生单位基本信息与相关因素调查。内容包括：疫情发生的集体单位名称、地址、报告人、联系方式、疫情波及人数；单位部门(学校班级)分布情况、卫生条件以及生产活动形式(教学方式，如全日制、夜校和寄宿等)；近2 周因病缺勤(缺课)情况；事件发生前一周及事件发生后集体活动情况；环境状况(通风、清洁状况、宿舍情况)等。必要时可开展专项调查，收集影响疾病传播的相关因素，评估疫情的严重程度和发展趋势。

1. The outbreak of the basic information unit and the related factors survey.Content includes:The outbreak of collective unit name/address/reporter/contact/Epidemic spread number;Unit department(School class)distribution/Health condition and production activities form(Teaching method,Such as full-time/Night school and boarding, etc);Nearly two weeks because of sickness absence(Absent from class)situation;A week before events and event occurs collective activity;Environment condition(ventilation/Clean condition/Dormitory situation), etc.When necessary to carry out special investigation,Collect the related factors influence the spread of disease,Assessment of the severity of the epidemic situation and the development trend.

　　2.病例搜索。疾病预防控制机构、乡镇卫生院(社区卫生服务中心)相关专业人员通过查阅晨(午)检记录、缺勤记录、医务室或医疗机构就诊记录以及逐个部门或班级调查等方式主动搜索流感样病例。

2. Case search.Of institution of disease prevention and control/Township health center(Community health service center)Relevant professional by looking at the morning(noon)Inspection record/Absence record/The clinic or medical institutions and medical record one department or class survey means such as active search influenza-like cases.

　　3.个案调查。疾病预防控制机构可参照“流感样病例调查一览表”(附件3)和“流感重症和死亡病例个案调查表”(附件4)，对流感样病例进行个案调查。

3. Case study.Can be reference of institution of disease prevention and control"Influenza-like cases investigation list"(Annex 3)and"Flu severe and death cases case questionnaire"(Annex 4),Against influenza-like cases for case study.

　　4.疫情追踪。疫情处理期间，疫情暴发单位向属地疾病预防控制机构报告本单位每日新增病例数。必要时，疾病预防控制机构对新发病例进行调查核实，及时、准确掌握和评估疫情趋势，调整防控措施。

4. Epidemic tracking.Outbreak during processing,An outbreak unit to the dependency of institution of disease prevention and control report this unit daily new cases.When necessary,Of institution of disease prevention and control of new cases investigation to verify,timely/Accurate mastery and evaluate epidemic trend,Adjustment prevention and control measures.

　　(二)样本采集。对于达到报告标准的流感样病例暴发疫情，疫情发生地疾病预防控制机构须采集暴发疫情病例样本。

(two)Specimen collection.To achieve the report standard influenza-like cases outbreak,Place of epidemic disease prevention and control institutions shall acquisition outbreak cases sample.

　　1.采样种类。采集流感样病例的咽拭子、鼻拭子、鼻咽拭子，必要时，可同时采集急性期和恢复期双份血清样本。

1. Sampling kinds.Acquisition of influenza-like cases of pharyngeal swab/Nasal swab/Nasopharyngeal swab,When necessary,But at the same time acquisition acute phase and convalescence double serum samples.

　　2.采样要求。应采集发病3 天内的呼吸道标本， 优先采集新发病例的呼吸道标本；根据病例分布特征，均衡选择采样对象，避免集中在同一部门或班级、宿舍。重症病例和死亡病例标本尽量全部采集。若符合流感样病例诊断标准的标本较少，为明确疫情性质，可适当扩大采样范围，采集体温为37.5℃-38℃伴咳嗽、头痛或肌肉酸痛等症状的病例。每起暴发疫情应采集至少10 份的呼吸道标本(如果现症病例不足10 例，应全部采样)。不能明确病原学诊断的疫情，可酌情增加采样批次和采样数量。

2. Sampling requirements.The collection should be within three days of the respiratory specimen, Priority acquisition of the new cases of HIV respiratory specimen;According to the distribution characteristics of the cases,Equilibrium sample selection object,Avoid concentration in the same department or class/dormitory.Severe cases and deaths as far as possible all specimen collection.If the accord with influenza-like cases diagnosis standard specimen less,For the specific nature of disease,Can be appropriately expand sample range,Acquisition body temperature is 37.5 ℃ - 38 ℃ with cough/Have a headache the symptom such as muscle pain or cases.Each up outbreak should acquisition at least 10 copies of respiratory specimen(If XianZheng cases less than 10 cases,Should all sampling).Can't clear etiology diagnosis of the disease,Can discretionary increase sampling batch number and sampling.

　　急性期血清采集对象：发病后7天内的流感样病例。

The acute phase serum acquisition object:Within 7 days after onset of influenza-like cases.

　　恢复期血清采集对象：发病后2-4周的流感样病例。

Convalescence serum acquisition object:2-4 weeks after the onset of influenza-like cases.

　　3.样本的保存和运送。标本采集人员填写“流感样病例标本原始登记送检表”(附件5)，随同标本运送至流感监测网络实验室。样本的保存和运送具体方法参见《全国流感监测技术指南》(中疾控疾发〔2011〕381号)。

3. Sample preservation and shipping.Specimen collection personnel to fill in"Influenza-like cases specimen original registration inspection table"(Annex 5),Along with specimen transported to a flu monitoring network laboratory.Sample preservation and transportation of specific methods see[The national influenza monitoring technology guide](CDC in disease hair [2011] no. 381).

　　(三)样本检测。流感监测网络实验室收到暴发疫情标本后，要求在24 小时内利用核酸检测方法进行流感病毒亚型鉴定，具备流感病毒分离能力的网络实验室要进一步对流感病毒核酸检测阳性标本进行病毒分离。具体方法和要求参见《全国流感监测技术指南》。

(three)Sample testing.Flu monitoring network laboratory outbreak after receipt of samples,Requirements in 24 hours of nucleic acid detection method using flu virus subtype identification,Have the flu virus separation ability of the network laboratory should further to influenza virus nucleic acid detection positive samples virus separation.Specific methods and requirements see[The national influenza monitoring technology guide].

　　(四)疫情性质判断原则。暴发疫情的性质应结合病例的临床、流行病学和实验室检测结果进行综合分析、判断。

(four)Epidemic nature judgment principle.The nature of the outbreak should be combined with clinical cases/Epidemiological and laboratory comprehensive analysis of monitoring results/judgment.

　　

五、疫情控制 five/Epidemic control

　　发生暴发疫情后，应采取相应的预防控制措施。

Happened after the outbreak,Should take corresponding prevention and control measures.

　　(一)病例管理。

(a)Case management.

　　1.发热(体温≥38℃)，或体温≥37.5℃伴畏寒、咳嗽头痛、肌肉酸痛者劝其及时就医，根据医嘱采取居家或住院治疗。休息期间避免参加集体活动和进入公共场所。

1. The fever(38 ℃ temperature was),Or body temperature was 37.5 ℃ with chills/Cough headache/Muscle aches is advised its timely seek medical advice,According to the doctor's advice to take home or hospitalization.Rest period to avoid taking collective activities and in the public places.

　　患者所在单位指派人员负责追踪记录住院或重症病例的转归情况并报告当地疾病预防控制机构。

Patient is in an unit to appoint personnel responsible for track record in hospital or severe cases of outcome and report to the local disease prevention and control institutions.

　　2.体温恢复正常、其他流感样症状消失48 小时后或根据医生建议，患者可正常上课或上班。

2. The body temperature to restore normally/Other flu-like symptoms disappear after 48 hours or according to the doctor advised,Patients can be normal school or work.

　　(二)强化监测。疾病预防控制机构应指导辖区内的医疗机构做好流感样病例监测报告；指导发生流感样病例暴发疫情的学校及托幼机构强化每日检查制度、因病缺勤登记制度，发现流感样病例短期内异常增多，应向教育行政部门报告，同时向当地卫生部门报告。根据医疗机构、学校、托幼机构及其他信息来源的报告情况，进行综合分析，评估疫情趋势，发现流感暴发苗头时及时预警。

(two)Strengthen monitoring.Guidance of institution of disease prevention and control should be within the jurisdiction of a medical institution do influenza-like cases monitoring report;Guidance happen influenza-like cases outbreak school and nursery institution strengthening daily inspection system/Because of sickness absence registration system,Find influenza-like cases in the short term anomaly increase,Should be to the education administrative department report,At the same time report to the local health department.According to the medical institutions/The school/Nursery institution and other sources of information report situation,Carry on comprehensive analysis,Evaluate epidemic trend,Find the flu outbreak began timely warning.

　　(三)环境和个人卫生。注意保持教室、宿舍、食堂等场所的空气流通，经常开窗通风，保持空气新鲜。集体单位和公共场所应定期打扫卫生，保持环境清洁。

(three)Environment and personal hygiene.Pay attention to keep the classroom/dormitory/The dining room and other places of the air circulation,Often open a window ventilated,Keep the air fresh.Collective units and public health should be cleaned regularly,Keep the environment clean.

　　注意个人卫生，勤晾晒被褥，勤换衣，勤洗手，不共用毛巾手帕等。咳嗽和打喷嚏时用纸巾或袖子遮住口、鼻，出现流感样症状后或接触病人时要戴口罩。

Pay attention to personal hygiene,Often air basks in bedding,Frequently change clothes,Diligent wash one's hands,Not sharing towels handkerchief, etc.Cough and sneeze with paper towel or sleeve over his mouth/nasal,Appear flu-like symptoms or contact with patients after to wear a face mask.

　　(四)健康教育。开展健康教育，在疫情发生单位可采用宣传画、板报、折页和告知信等形式宣传卫生防病知识。

(four)Health education.Develop health education,The outbreak of the unit can be used posters/includes/Folding and inform letter and other forms publicity health prevention knowledge.

　　(五)药物治疗。对于实验室确诊的流感重症病例和出现流感样症状的慢性病患者、老年人等流感高危人群，要进行抗病毒药物治疗，药物可首选奥司他韦(Oseltamivir)和扎那米韦(Zanamivir)，无条件的地方可参考当地耐药性监测结果选用烷胺类药物(金刚烷胺、金刚乙胺)。是否进行预防性服药，需由卫生行政部门组织专家论证。

(five)Drug therapy.The lab diagnosed flu severe cases, and appear flu-like symptoms of patients with chronic diseases/Old flu high-risk groups,Must carry on the antiviral drug therapy,Drugs could be preferred oseltamivir(Oseltamivir)And firm that m wei(Zanamivir),Unconditional place to reference the local resistance monitoring results choose paraffin amine drugs(amantadine/rimantadine).If the preventive medicine,Need by the administrative departments of public health organization expert argumentation.

　　(六)其他措施。流感样病例暴发期间，慢性病患者、老年人、婴幼儿等高危人群要减少或避免参加集体活动。根据实际情况，可减少或停止学校和单位的集体活动，尽可能减少和避免与发病学生、员工接触，避免全体或较多人员集会，限制外来人员进入。必要情况下可根据专家建议采取停课、放假等措施。

(six)Other measures.Influenza-like cases during the outbreak,Patients with chronic diseases/Old people/Infants high-risk groups such as to reduce or avoid to participate in collective activity.According to the practical situation,Can reduce or stop the school and the collective activities of the unit,To reduce or avoid as far as possible with the students/Staff contact,Avoid all or more staff meeting,Limit foreign personnel to enter.Necessary conditions according to expert suggests to adopt closed/Measures such as holiday.

　　

六、疫情评估与总结 six/Epidemic situation assessment and summarized

　　发生流感样病例暴发疫情时，当地卫生行政部门应当根据疫情形势，组织相关部门开展评估，达到突发公共卫生事件标准时，应按相关预案及时启动相应应急响应机制。

Influenza-like cases happened when outbreak,The local health administrative department shall, according to the epidemic situation,Organize relevant departments to carry out evaluation,To achieve the standard of emergent public health events,According to the related plan should be timely start the corresponding emergency response mechanism.

　　连续1周无新发病例，可判定为暴发疫情结束，结束后1周内，负责疫情处置的疾病预防控制机构要对疫情处置情况进行总结，内容包括疫情报告的及时性、信息完整性、处置的规范性等方面。

Continuous 1 week no new cases,It can find the end for the outbreak,1 weeks after the end of,Responsible for the disposal of epidemic disease prevention and control institutions to epidemic disposal situation was summarized,Content includes the epidemic situation report timely/Information integrity/Disposal of normative, etc.

　　

七、组织管理 seven/Organization management

　　当局部地区出现流感样病例暴发流行时，各有关部门应积极落实各项防控措施。具体职责如下：

When local appear influenza-like cases when outbreak,All relevant departments should actively carry out the prevention and control measures.Specific duties as follows:

　　(一)卫生行政部门。组织、协调疫情的调查处理工作，组织开展医疗救治，正面引导宣传，加强部门的沟通与协作。

(a)Public health administrative department.organization/Coordinating epidemic investigation and handling of the work,The organization carries out the medical treatment,Positive guide propaganda,Departments to strengthen communication and cooperation.

　　(二)疾病预防控制机构。开展暴发疫情信息收集；负责疫情的调查、核实和处理以及疫情报告等工作；指导辖区集体单位开展传染病防治工作；开展传染病防治的宣传教育与健康促进活动。

(two)Of institution of disease prevention and control.Carry out outbreak information collection;Responsible for the investigation of epidemic/Verify and processing and epidemic situation report, etc;Guidance jurisdiction collective units in the prevention and control of infectious diseases;Carry out prevention and treatment of infectious diseases, publicity education and health promotion activities.

　　(三)医疗机构。及时发现和报告流感样病例暴发疫情；负责对病例进行诊断、治疗和管理；做好院内感染控制；协助疾病预防控制机构做好流行病学调查，以及临床相关样本的采集工作。

(three)Medical institutions.In order to quickly discover and report influenza-like cases outbreak;Be responsible for diagnosis cases/Treatment and management of;Completes the nosocomial infection control;Assist of institution of disease prevention and control well epidemiological survey,And clinical correlation sample collection work.

　　(四)疫情暴发单位。及时发现和报告流感样病例暴发疫情；积极落实学校晨检制度、缺勤(缺课)的监测、报告与管理制度；加强与卫生部门的信息沟通，主动配合卫生部门的调查和各项措施的落实；积极开展爱国卫生运动，清除卫生垃圾和死角；做好单位配套设施(如洗手设备等)的装备。

(four)Outbreak unit.In order to quickly discover and report influenza-like cases outbreak;Actively implementing the morning school inspection system/absence(Absent from class)monitoring/Report and management system;Strengthen and department of health information communication,Actively cooperate with the health department and the investigation of the implementation of the measures;Actively carry out patriotic sanitation campaign,Clear health garbage and blind Angle;Do unit supporting facilities(Such as hand washing equipment, etc)equipment.