What work has the Guiyang Municipal Health Bureau done to prevent intestinal infectious diseases?

1. Prevention and Control of Infectious Diseases

(1) Prevention and Control of Intestinal Infectious Diseases

Each unit must have dedicated personnel in charge of the prevention and control of intestinal infectious diseases. Comprehensively implement various prevention and control measures and promptly deal with intestinal infectious diseases such as cholera and hand, foot and mouth disease. Before April 10, complete the survey on the distribution and personnel composition of diarrhea clinics (dedicated desks) in the jurisdiction, and organize the technical training of professionals at all levels in the jurisdiction, especially the medical staff and laboratory personnel of diarrhea clinics (dedicated desks) training. Before the arrival of the epidemic season, carry out a patriotic health campaign with the theme of "Three Controls and One Elimination", supervise and inspect the diarrhea clinics (special desks) of various medical institutions, reserve personnel, technology and materials, and carry out epidemic control and treatment Emergency drills.

1. Cholera prevention and control work

(1) Strict the epidemic reporting and management system, and standardize the investigation and handling of the epidemic. Report the epidemic in strict accordance with the reporting time limits and methods for Class A infectious diseases stipulated in laws, regulations, norms and documents. From April 20 to October 31, a zero-case weekly reporting system for cholera epidemics will be implemented. Reported cholera epidemics must be handled in a timely manner in accordance with the specific requirements of the "Cholera Prevention and Control Manual", epidemic points and areas must be quickly delineated, and strict isolation must be carried out to thoroughly treat patients and carriers. Environmental disinfection, insecticide and drinking water disinfection must be carried out to Close contacts and diarrhea patients in the epidemic area should collect stool for testing, and implement preventive medication measures in the epidemic area. Collect, analyze, summarize and report cholera infected case investigation forms, outbreak investigation reports and other information in a timely manner and archive them.

(2) Strengthen the search for cholera epidemic sources, and achieve "early detection, early reporting, early isolation, and early treatment" of cholera cases. To strengthen the retrieval of cholera epidemic sources, the district CDC will conduct monthly monitoring of Vibrio cholerae on samples of potentially contaminated external environments and items from May to October, and positive samples will be sent to the Municipal Center for Disease Control and Prevention for identification in a timely manner.

① Water source monitoring: mainly refers to sea water, sewage, river water, etc., no less than 3 water points per month, and each water point is sampled once a month, 6 samples each time.

② Food monitoring: Monitor foods that may be contaminated, such as commercially available small seafood, freshwater fish, cold dishes, cooked foods, etc., and sample 20 samples per month.

From June to September, 2 hotels were selected and monitored twice a month. The monitoring content included food containers, food, salad dishes, seafood, production and processing sites, and sewage from sewage outlets. When a cholera epidemic occurs, 10 suspicious food samples must be collected for etiological testing.

(3) Strengthen technical guidance, supervision and inspection of diarrhea clinics (special desks). This year, the district's diarrheal disease outpatient clinics (special desks) will be open 24 hours a day from April 20 to October 31. Before the opening of diarrheal disease clinics, organize personnel to provide technical guidance to diarrheal disease clinics in the jurisdiction to improve the construction of emergency mobile teams for acute intestinal infectious diseases. The list of emergency team members shall be reported to the district health bureau and district disease prevention and control center. Each medical institution is equipped with necessary medical equipment and personal protective equipment for rescuing and treating patients, and diarrhea clinics in district-level hospitals must implement independent areas. All hospitals and health centers should open clinics in accordance with the relevant requirements of the "Infectious Disease Prevention and Control Law" and the "Provincial Medical Unit Diarrhea Outpatient Work Procedures". All outpatient medical and laboratory personnel must be proficient in diarrhea disease diagnosis, treatment, rescue, inspection, and epidemic prevention. Reports and other relevant business knowledge, the diarrhea patients who seek medical treatment should be registered in the province's unified diarrhea patient registration book, and no items should be missed. Each diarrheal disease clinic should be equipped with rapid diagnosis screening reagents and bacterial culture reagents required for testing. It is necessary to ensure that "every diarrhea must be reported, every diarrhea must be reported, every diarrhea must be tested, and every diarrhea must be treated." Less than 10% of diarrhea patients, the rapid diagnosis rate of cholera must reach 100%, and the positive specimens of rapid diagnosis must be sealed by the inspector or the medical staff of the diarrhea clinic as required. After the patient’s name, age, and address (detailed current address) are registered in detail, Send it to the Municipal Center for Disease Control and Prevention for identification in a timely manner.

(4) Focus on carrying out epidemic source search

The district disease control center should follow the "Working Standards for Diarrheal Disease Outpatient Clinics of Medical Units" formulated by the province to do a good job in diarrheal disease outpatient clinics within its jurisdiction. Technical guidance and supervision work, especially supervision of the quality of stool examinations in various medical units within the jurisdiction, and sampling inspections when necessary. During the epidemic season, health quarantine will be strengthened for people coming from epidemic areas.

2. Prevention and control of hand, foot and mouth disease

Conscientiously implement the "Guidelines for Prevention and Control of Hand, Foot and Mouth Disease (Edition)", "Provincial Action Plan for Prevention and Control of Hand, Foot and Mouth Disease", "Provincial Action Plan for Prevention and Control of Hand, Foot and Mouth Disease" According to the requirements of the "Hand, Foot and Mouth Disease Prevention and Control Work Plan" and the "2019 Hand, Foot and Mouth Disease Prevention and Control Action Plan" and other documents, focus on carrying out work such as monitoring of the etiology of hand, foot and mouth disease, risk factor analysis, investigation of severe cases and handling of clustered epidemics, and early Deploy, take early action, and fully implement various preventive measures.

(1) Strengthen epidemic monitoring and do a good job in epidemic analysis, prediction, early warning and management. Medical institutions at all levels and types should strictly follow diagnostic standards and report the epidemic in a timely, standardized and accurate manner. Cases of hand, foot and mouth disease that meet the case definition should be reported directly online within 24 hours, and the timely and accurate rate of online direct reporting should reach 100% %; when child care institutions, schools, and medical institutions discover clusters of hand, foot and mouth disease cases, they should report them to the district CDC as quickly as possible. The district CDC should do a good job in reviewing and managing epidemic reports and strengthen epidemic monitoring. The district CDC and street supervision and disease control workstations should strengthen the circulation and monitoring of ordinary cases and severe cases. Establish an epidemic analysis, prediction, early warning and emergency response mechanism, scientifically study and judge the epidemic situation in the jurisdiction in a timely manner, and initiate emergency response in a timely manner based on the epidemic situation and early warning classification in the jurisdiction.

(2) Standardize the epidemiological investigation of cases, information entry and routine specimen collection. After each supervisory disease control workstation receives a case report or finds reported cases through Internet searches, it must immediately conduct an epidemiological investigation and fill out a case investigation form. The case investigation rate of hospitalized cases should reach 100%. The investigation and disposal rate of cluster cases reached 100%; the investigation and information reporting of severe cases and death cases reached 100%. When investigating individual cases, it is necessary to have a detailed understanding of the general situation, epidemiological contact history, disease treatment process, clinical manifestations, laboratory test results, risk factors, etc.; As a result, it is necessary to contact the relevant hospitals in time, extract it from the medical records, and make timely supplements and corrections. During the flow adjustment, questionnaires should be conducted one by one, and the forms should be filled out neatly and carefully, without any missing or missing items. All case investigation forms must have a dedicated person in charge, and they must be entered into the EPIDATA database every day. Any problems such as missing information discovered during the entry process shall be reported back to the investigators in a timely manner for revision and improvement. The case investigations of the previous week shall be summarized and reported before Tuesday every week. The database is sent to the Infectious Disease Prevention and Control Department of the district Center for Disease Control and Prevention, and the District Center for Disease Control and Prevention summarizes and reports to the Municipal Center for Disease Control and Prevention on Wednesday. Please refer to Appendix 1 Key Points for Infectious Disease Surveillance for the collection types and requirements for hand, foot and mouth disease specimens.

(3) It is necessary to carry out timely and standardized epidemiological investigations and epidemic management of severe cases, death cases, and clustered cases, standardize specimen collection, timely enter the database, and write investigation reports. Each receiving hospital is responsible for specimen collection, standardizes the preservation of specimens, and promptly notifies the district CDC to take samples and send them to the municipal CDC in accordance with regulations.

(4) Strengthen training and improve prevention and control technologies such as epidemiological investigation and epidemic response. All units must strengthen the training of prevention and control technical personnel such as epidemic monitoring, epidemiological investigations, and direct online reporting; cooperate with the education department to provide training for all teachers and school doctors in daycare institutions, primary schools, and school doctors. In particular, intensive training should be provided to front-line personnel in key areas and places to improve their capabilities of early detection, early reporting, and early prevention and control.

(5) Popularize health education and improve disease prevention knowledge. Health education is the basis for prevention and control of hand, foot and mouth disease. All units should make full use of bulletin boards, leaflets, clear sheets and other forms to increase publicity on the prevention and treatment of hand, foot and mouth disease, so that it becomes a household name and known to everyone, so that the public understands that hand, foot and mouth disease is knowable, preventable and treatable. , controllable, and guide the masses to improve their awareness of disease prevention and develop a civilized and healthy lifestyle and good personal hygiene habits.

(6) Strengthen supervision and inspection, and do a good job in prevention and control of key links. All sub-district supervision and disease control work stations should strengthen supervision and inspection of key locations and places such as child care institutions, primary schools, communities and rural areas, guide child care institutions and schools to establish morning inspections, absenteeism registration and other systems, and implement disinfection measures; Supervise community clinics, community health service stations and other grassroots medical institutions to establish and improve the hand, foot and mouth disease prevention and control knowledge system for parents of infants and young children, the morning examination system, and the hand, foot and mouth disease referral and treatment registration system; the district CDC should check in before Shift, focus lowered, and go deep into the jurisdiction's medical institutions, childcare institutions, schools, rural areas, and communities to conduct tour guidance.

3. Prevention and control of other intestinal infectious diseases

All medical and health units should increase the prevention and control of bacillary dysentery, typhoid fever (paratyphoid fever), rotavirus diarrhea and other infectious diarrhea, etc. Monitor intestinal infectious diseases, conduct pre-screening, triage, diagnosis and treatment of infectious diseases, and provide outpatient symptomatic treatment for mild cases. Severe cases (with neurological symptoms or cardiovascular symptoms, etc.) should be hospitalized and focused on treatment. Strengthen the monitoring of food and drinking water hygiene, especially the monitoring of school canteens, street food stalls, and township pipe network tap water.

(2) Prevention and control of respiratory infectious diseases

1. Continue to strengthen the management of comprehensive public health monitoring points. All street supervision and disease control workstations should strengthen the management of comprehensive public health monitoring points within their jurisdiction, pay close attention to the dynamics of patients with respiratory fever, and promptly submit monitoring reports for patients with respiratory fever. Supervise public health comprehensive monitoring points at least twice a year and keep complete records.

2. Carry out epidemic investigation and emergency response in a timely manner. In accordance with relevant technical specifications, promptly handle the emergency response to outbreaks of SARS, human infection with highly pathogenic avian influenza, unexplained pneumonia, influenza-like cases, and influenza A (H1N1) cases, and conduct timely verification of discovered and reported outbreaks, Standardize outbreak investigation and sample collection, and analyze epidemic characteristics and causes.

Reserve technologies and materials for emergency detection of human avian influenza to respond to possible human avian influenza incidents at any time. Carry out on-site investigations and technical drills on human avian influenza and influenza A (H1N1), and prepare technical and material reserves for human avian influenza epidemics.

3. Continue to monitor key respiratory infectious diseases and seasonal influenza. It is necessary to strictly follow the requirements of the National Surveillance, Investigation and Management Plan for Unexplained Pneumonia Cases, further strengthen the monitoring of cases of unexplained pneumonia, and timely investigate and manage human avian influenza and SARS-related cases.

Continue to follow the requirements of the "Influenza A (H1N1) Surveillance Plan (Second Edition)" and the "National Influenza/Human Avian Influenza Surveillance Implementation Plan" to do a good job in the diagnosis, statistics, reporting, and specimens of influenza-like cases Collection, preservation and transportation work. As municipal sentinel hospitals, district hospitals should continue to monitor influenza-like cases and improve the accuracy and timeliness of reporting of influenza-like cases. The materials and reagents required for specimen collection, preservation and transportation at sentinel hospitals are provided by the Municipal Center for Disease Control and Prevention. The district CDC is responsible for specimen transportation. Please refer to Appendix 1 Key Points for Infectious Disease Surveillance for relevant monitoring points.

4. Carry out seroepidemiological surveys and environmental specimen collection of people occupationally exposed to human avian influenza. In accordance with the requirements of the "Municipal Implementation Plan for Monitoring Highly Pathogenic Avian Influenza in Occupational Exposed Populations", the district, as one of the city's monitoring points, carries out monitoring work in accordance with the requirements of the "Plan". Please refer to Appendix 1 Key Points for Infectious Disease Surveillance for relevant monitoring points.

5. Actively contact the education department to guide schools at all levels to establish symptom monitoring systems for respiratory infectious diseases such as chickenpox and scarlet fever, and implement morning inspection and absence registration systems. Once there is a cluster of related symptoms such as fever, cough, rash, etc. in the school, the dedicated person or part-time teacher responsible for infectious disease epidemic reporting in the school should take the initiative to report to the district disease control center.

After receiving the report from the school, the district disease control center immediately conducted on-site epidemiological investigation and specimen collection with the district supervision and disease control workstation. After the epidemic was confirmed, it guided the school to carry out disinfection and close contact management, if necessary. Get vaccinations. At the same time, the first report, progress report and case closure report of the event must be carried out according to regulations through the "Public Health Emergency Report Management Information System".

(3) Prevention and control of zoonotic diseases

1. Prevention and control of epidemic hemorrhagic fever

(1) Extensively carry out health publicity and Teach and educate the masses about the main dangers and prevention and treatment knowledge of hemorrhagic fever. If you notice suspicious symptoms, seek medical advice promptly to avoid delaying treatment.

(2) Strengthen professional training. District CDCs and street supervision and disease control work stations should provide training for grassroots disease control personnel and rural doctors, and give full play to grassroots personnel in carrying out epidemiological investigations and health publicity. function in work.

(3) Strengthen epidemic reporting, prevent underreporting and late reporting, and conduct epidemiological investigation and processing in a timely manner. When an epidemic is discovered, investigation and handling must be carried out as soon as possible, and epidemiological investigation forms must be reported on time. When outbreaks and fatal cases are discovered, investigation and handling must be carried out immediately, and investigation and handling reports must be submitted in a timely manner.

2. Rabies prevention and control work

Due to the continuous outbreaks of epidemics in our city in recent years, suspected rabies injuries to people have occurred from time to time, and the risk of increased incidence has increased. Therefore, the implementation of various prevention and control measures must be strengthened.

(1) Further expand health publicity and use various forms to disseminate rabies prevention and control knowledge to residents, especially rural people. After being bitten or scratched, you should go to a rabies exposure clinic as soon as possible for wound treatment, vaccination, and injection of antiserum or antiviral globulin to prevent the disease to the greatest extent.

(2) Further strengthen the construction and management of rabies exposure clinics, and in accordance with relevant requirements, strengthen the registration of exposed people, wound treatment, vaccination and injection of antiserum or antiviral globulin, so as to timely grasp the exposure quantity and reported on a monthly basis.

(3) When an epidemic is discovered, it must be reported immediately and investigated and dealt with in a timely manner to prevent the epidemic from expanding.

3. Brucellosis prevention and control work

(1) Continue to implement the "Municipal Human Brucellosis Surveillance Plan", and all street supervision and disease control workstations must strengthen cooperation with Contact the sub-district animal husbandry department to find out the basic information of cattle and sheep breeding units in the jurisdiction, timely grasp the epidemic situation among local livestock, and strengthen the monitoring of people in close contact. According to the unified arrangement of the city, the district will select 50 key people engaged in breeding, experimental testing, etc. from key cattle and sheep breeding units this year, and collect 2 ml of serum from each for brucellosis etiology monitoring. The work was completed by early September.

(2) If cattle, sheep or humans are found to be infected, an epidemiological investigation must be carried out immediately. Based on the preliminary results of the epidemiological investigation, the epidemic foci will be dealt with. All investigation materials must be reported immediately.

2. Epidemic Management

The management of epidemic information reporting on infectious diseases and public health emergencies in 2017 is based on strengthening professional training and capacity building, and on strengthening supervision and Technical guidance serves as a guarantee, strictly implement various work specifications, enhance legal awareness, pay close attention to the implementation of various rules and regulations, and ensure that information reporting is standardized, timely and efficient.

(1) Reporting and management of infectious disease epidemics

1. Strictly implement the information review system and improve the quality of reports.

(1) Carefully review and improve the quality of infectious disease epidemic information.

The District Center for Disease Control and Prevention must strictly implement the information review system for online direct reporting of infectious disease epidemics and ensure that the online direct reporting information is reported every day (no less than 4 times on working days and no less than 2 times on public holidays). Comprehensive review and monitoring are required, and reporting information should be verified and confirmed in a timely manner. Every day after work in the morning and before get off work in the afternoon, you must go online for review. In addition to timely review of cards in accordance with the requirements of the "Working Standards for the Management of Infectious Disease Information Reporting", report cards before 17:00 every day must be reviewed before 17:00; Report cards before 17:00 on the last day of each month and every year must be reviewed before 17:00, and report cards before 24:00 must be reviewed before 24:00. Put an end to late reporting and review of infectious disease epidemic information and try to shorten the time interval from doctor diagnosis to online reporting.

Patients or suspected cases of plague, cholera, pulmonary anthrax, infectious SARS, poliomyelitis, human infection with highly pathogenic avian influenza, diphtheria, kala-azar, dengue fever, schistosomiasis, and unexplained pneumonia Patients, severe cases of hand, foot and mouth disease or outbreaks of other infectious diseases or unexplained diseases should immediately report to the district health bureau and district CDC by phone while making direct reports online.

(2) Continue to standardize the registration of infectious disease epidemic information and the filling out and reporting of infectious disease report cards in medical institutions.

All contents of the infectious disease report card must be filled in completely and accurately. Infectious disease report cards with incomplete reporting information and logical errors must be verified, supplemented, and revised at any time. Check for duplicates every day. When deleting heavy cards, keep the first visit card and correct the content of the deleted card to the retained card. If the infectious disease report card reported from other places is found to be a heavy card, it should be deleted after the card is reviewed. Diagnose and correct suspected cases in a timely manner. Report pathogen carriers and positive test results in accordance with the case classification and typing reporting requirements in the "Infectious Disease Information Reporting Management Standards". Check the bulletin board of the epidemic network direct reporting system every day, make arrangements, deployment and implementation of relevant work requirements, and keep work records.

Further standardize the work such as outpatient registration, infectious disease epidemic information verification, filling in infectious disease report cards, and online direct reporting of infectious disease epidemics in online direct reporting units, and clarify the reporting process of infectious disease epidemics so that relevant departments can Infectious disease epidemic reporting work is coordinated to ensure timely and accurate epidemic reporting and reduce missed reporting.

(3) Strengthen management and improve the quality of infectious disease epidemic reporting. The monthly non-timely reporting rate of statutory infectious diseases is less than 0.4%, the non-timely review rate is less than 0.2%, there are no heavy trucks and zero missing reports in counties and districts, and the comprehensive index of information quality evaluation of infectious disease epidemic reports is less than 0.2%. Each online direct reporting unit shall not have zero missing reports every month.

2. Strengthen information analysis and utilization to improve the level of early warning and prediction of infectious disease epidemics.

(1) Continue to implement the system for analyzing public health emergencies and infectious disease epidemics in the form of weekly and monthly reports and daily reports in the event of outbreaks, and provide relevant personnel with information in a timely manner to support decision-making. Serve.

(2) It is necessary to make full use of the information of the online direct reporting system, strengthen the analysis and utilization of information, actively search for the clustering of reported cases by browsing the report cards, and promptly discover potential infectious disease outbreaks, especially the time of occurrence and When cases gather in space, it is necessary to provide early warning in real time. The city's infectious disease epidemic response thresholds: single-disease response to major infectious disease outbreaks and important imported cases; response to 2 cases in the same unit within a week for general infectious disease outbreaks. The district CDC must monitor the epidemic dynamics in its jurisdiction. Combined with the city-wide clustered case information provided by the Municipal Disease Control and Prevention, it is sent to relevant business departments for investigation and processing at any time, and the results are reported in the form of text reports via fax and electronic documents (uploaded to the special analysis column of the monitoring information feedback of the National Disease Reporting Management Information System ) feedback to the Municipal Center for Disease Control and Prevention. The Municipal Center for Disease Control and Prevention will evaluate the feedback information to improve the level of handling.

(3) The District Center for Disease Control and Prevention shall complete verification and fill in the abnormal information card within 2 hours after receiving the early warning signal for a single disease issued by the infectious disease early warning information system. Other early warning signals shall be verified and completed on the same day. Fill out the exception information card. For early warning signals determined to be suspected incidents, an on-site investigation must be conducted, and an on-site investigation form must be filled in within 24 hours after the investigation is completed.

3. Stabilize the team, strengthen technical training, and improve the professional quality of personnel.

In view of the new requirements and new regulations for reporting information on emerging infectious diseases such as hand, foot and mouth disease and influenza A H1N1, it is necessary to organize timely training for responsible reporters to ensure the information on infectious disease epidemics in our region Report quality; strengthen training on reporting management of public health emergencies and related information, and further improve the reporting quality of public health emergencies and related information in our district. The district CDC will hold regular business meetings for epidemic reporting managers of medical institutions within its jurisdiction, at least once a quarter.

4. Strengthen technical guidance and inspection of medical institutions.

According to the Ministry of Health Monitoring, "Forward the "Provincial Disease Control and Prevention Institutions' Assessment Standards for the Prevention and Control of Infectious Diseases in Medical Institutions (Trial)" and "The Provincial Disease Control and Prevention Institutions' Daily Supervision Records on the Prevention and Control of Infectious Diseases in Medical Institutions (Trial) According to the requirements of "Notice", in daily work, medical institutions are subject to a monthly supervision and half-yearly assessment system. Especially for medical institutions within the scope of the reporting rate statistical rules of the online direct reporting system, if there are no case reports within one month, on-site supervision must be carried out, and the supervision and assessment results must be reported to the Health Bureau in a timely manner. It is recommended that the Health Bureau report regularly to effectively Promote the implementation of infectious disease epidemic information management in medical institutions.

5. Continue to do a good job in network management to ensure data security.

Strengthen the management of the reporting system. Direct reporting network system administrators should strengthen communication and coordination with relevant specialist disease system managers. Do a good job in user rights management, ensure real-time backup of epidemic data, use approval, ensure data security, and do a good job in user rights distribution and management. The permissions of all users are checked every six months, and any problems found are corrected immediately. aware day cat