Human infection of bird flu reported in central China
BEIJING, Jan. 31 (Xinhua) -- A 21-year-old female farmer was confirmed as infected with bird flu in central China's Hunan Province, said the provincial health authority on Saturday.
The patient was found sick on Jan. 23 and hospitalized on Jan. 26. So far she has been in stable condition and recovering.
http://news.xinhuanet.com/english/2009-01/31/content_10741532.htm
March 30, 2009
Source: "Chinese Hospital" magazine Author: Liu Wei Xiu Jinlai
Editor's note: in January this year, before and after our country people confirmed eight cases of bird flu. In 2008, however, total number of reported cases only three cases.
Human avian flu disease outbreak-intensive, so that groups of infectious diseases suddenly serious situation.
As with many infectious diseases, there is the fear of bird flu virus is still unknown from it. "Atypical pneumonia" after the country set up a public health emergency response system, the frequency of bird flu virus attack, and finally there is the opportunity to let the system from paper directly to accept the reality test.
However, in this life to eight patients with final exams for the price of life and death, we found that the original was the emergency system Chao-Gang奉若did not seem the United States, not only failed to resist the brute force approach of avian flu virus, it has been revealed dislocation at the system, such as primary health care of old vacancy problem.
Battle xupu
Health Bureau and the CDC, two of infectious disease reporting system at the requirements and have a dislocation between reality, so that the people溆浦县hospital dilemma.
If it is not because of bird flu, should flower舒荣anonymous work or a sister. Chinese New Year this year happened to go home, let her out of one accident many hats - Human bird flu.
Flower舒荣Xiangxi溆浦县at home, rolling mountains and the people are mixed poultry paradise for generations. There will always nameless chickens and ducks died, the locals used to dying poultry board made of chicken slaughtered in advance pressed salted duck, eat or keep guests.
On the eve of Chinese New Year, Back from Guangzhou Flower舒荣homeland, the village poultry are once again beginning of life and death cycle of her own chickens and ducks have also been involved. In order to avoid all the dead chickens and ducks, she helped kill chickens ducks at home. New Year's Eve, two days before the beginning of flower舒荣fever, by the village barefoot doctor has not improved after treatment, his condition舒荣spend more and more weight, accompanied by their families, the people in the New Year's Day arrived溆浦县hospital.
Unexpected virus
"If the first two days of the morning did not come DENG Hong-hua hospital rounds, the patient was perhaps a missed diagnosis."溆浦县Liu Xiaopeng, vice president of People's Hospital, a lingering fear.
January 26 (New Year's Day) afternoon, the hospital treated up to a temperature of 40.06 ℃ flower舒荣. Liu Xiaopeng knew this day patients, the doctor on duty told him the phone, patients with serious and difficult home, proposed to allow transfers. Liu Xiaopeng did not agree to require a doctor first checks the basic condition to make a decision after the master clear.
舒荣reception flower has two doctors for her to do the routine and chest CT. CT film shows that there is one-third of patients with right lung is changed, there is also left scattered infiltration point - with severe pneumonia, common diseases, because doctors did not particularly care about.
January 27 (the two early) morning to the hospital within two rounds DENG Hong-hua, director of Flower舒荣look at medical records and found a strange phenomenon: the past舒荣Healthy flower, blood does not clear, as with the chest, interleukin value has declined. DENG Hong-hua was aware that it is virus infection.
"The First People's Hospital of Huaihua just a person who died of bird flu patients, the clinical manifestations舒荣flower like the disease, severe, such as low blood and poultry from infected areas, in line with unexplained pneumonia, diagnostic criteria, which are caused by I attach great importance to the main reason. "DENG Hong-hua memory.
Subsequently proved that the DENG Hong-wah on high alert, for the successful treatment舒荣key step in laying a flower. By asking, DENG Hong-hua舒荣flower was found to have a history of exposure to poultry, there is all the more disturbing her mind immediately reported to the medical quality control phone chief Leung Yeung Chau.
Yeung Chau Leung clearly remember the time the call is at 11 o'clock on January 27 many. "I see patients go to the wards and at the same time to report to the Vice-President Liu Xiaopeng." Leung Yeung Chau of "Chinese Hospital" journalist said: "Although people Having never been involved in avian influenza, but I highly doubt that this disease . "
On the eve of Chinese New Year, the Board requested溆浦县area health care institutions each day零报告制度report all diagnosed cases of pneumonia of unknown causes, must be submitted in strict accordance with the provisions, in particular, people should pay attention to avian flu. Hospitals meeting stressed the need to pay attention to cases of pneumonia of unknown causes. Since the outbreak of the hospital Rapporteur vacation, Liu Xiaopeng on the job as temporary. Received a phone when exactly Liu Xiaopeng and Liu County Health Secretary million conversations at work, they immediately reported orally.
Very nervous the next time. 12:00 the same day, the hospital organized a large hospital consultation, the view that the consultation: the diagnosis of severe pneumonia in very clear, consider belong to virus infection, people do not rule out avian influenza, pneumonia of unknown causes in line with the conditions reported. 1 hour later, doctors from the Health Bureau溆浦县shares lead organization governance County People's Hospital, the county and the county hospital of Chinese medicine experts CDC's largest county consultation, consultation findings.
However, the problem out quickly.
According to the procedures, the people溆浦县hospital within two hours in the Chinese Disease Control and Prevention through the information system directly pneumonia of unknown causes at the network's medical history reported to flower舒荣situation, Liu Xiaopeng has a dilemma. "Although the CDC under the Public Health Bureau, but also its own system. The results of consultation, the County CDC CDC immediately reported to the city, the provincial city of CDC CDC also reported phone. Provincial CDC requirements At our 2 hours at straight. But the views of the county health bureau, the first under the Huaihua溆浦县Municipal Health Bureau reported that the request of municipal experts from consultation, if people do not rule out bird flu, and then reported to straight. Administration of the Department of Health to consider many aspects, but the CDC's report, I did not dare go against. "
Health Bureau and the CDC, two of infectious diseases reported to the system with the reality at the wrong leads. This leads to the multi-management issues, so that confusion Liu Xiaopeng.
15:00 the same day, the hospital network in accordance with the requirements of direct reports finish. At this point, the county collected in patients with CDC were car-related specimens sent to the provincial capital Changsha. Health溆浦县put forward at that time, county CDC did not according to plan, submitted too soon, fearing a negative impact on society.
Our source has told,溆浦县Health concerns also received from the stress, "The First People's Hospital of Huaihua recently the case of reception from the people in Guizhou imported cases of avian flu to hospital with severe pneumonia admitted to hospital . Later, in line with the hospital found that patients with the diagnosis of pneumonia of unknown causes, then we have to ask the province of the expert consultation, and reported to the relevant state department. Leaders at all levels, experts come to the hospital an additional workload, from the reception to the death 4 days, the hospital received more than 10 million fee to spend the money.老少边穷region for medical institutions, are spending a small fortune. With the warning, the more inadequate funding for health authorities to溆浦县say, natural to consider their own capacity, hoping to wait until municipal expert opinions issued after more precise Direct Network Report. "
Huaihua City Health Bureau convened the Expert Group was rushed to the emergency xupu. To the way traffic when the city of Huaihua, vice president of First People's Hospital, Department of Respiratory Medicine贻秋Zhang suddenly think of the experts, that the hospital in the rescue of people in Guizhou input of patients with avian flu, the Ministry of Health experts in the treatment of people brought about by the effects of avian flu drug Tamiflu has not yet run out, they immediately ordered the driver make a U-turn, back to Huaihua taking Tamiflu.
Until 6:30 p.m. that day, the Group 3 and his people finally arrive xupu. After consultation, the Group believes that the people溆浦县hospital diagnosis of "well-founded", the diagnosis is still considered a severe viral pneumonia, a high degree of people suspected of bird flu, but the department must wait until the test results superior to the final diagnosis.
Yeung Chau Leung explained that "people because bird flu finally diagnosed the country required the test results issued by CDC, even if there is no diagnosis of Hunan Province right to CDC. The city of the expert group decided to isolate the bird flu in accordance with the treatment of people, brought from the Huaihua preventive medicine Tamiflu has also been applied to patients and nursing staff. "
"The first suspect, the first report, the first treatment, the first referral," the management of a social capital by the creation of county-level public hospitals in the treatment of bird flu person's "4 the most."
The turbulent transfer
"Patients with serious illness, we do not have ICU wards, there is no breathing machine, but there are no special medicines. In accordance with the provisions of Department of Health Administration, critically ill patients should be referred to the three-hospital treatment." Liu Xiaopeng said.
"If bird flu are people, belong to Group B of infectious diseases management, in accordance with the provisions of the spot should be treated in isolation. If the person is not bird flu, the city can receive this one hospital patients, but pre-medical costs 100,000 yuan. "The First People's Hospital of Huaihua insist.
Consultation to discuss at the meeting, the two hospital because a dispute over transfer problem. More difficult is that I heard at another hospital to pay 10 yuan, after lying in the intensive care unit舒荣Flower depression, begin to resist treatment, "not to die."
"Take care of patients with small loss of her mother, grew up and has been out working hard to make a living at home, admitted only 1,000 yuan to pay the money to be spent CT on 270 and there is no ability to renew. If people are not suffering from Avian influenza, severe pneumonia, often hundreds of thousands a few hundred thousand dollars of medical expenses, home can not stand. "DENG Hong-hua was the scene memory.
Costs, about a flower舒荣can achieve transfer. Close to midnight, the two sides are still unable to reach an agreement, decide to wait for test results issued by the provincial CDC after consultation.
Well settled experts, Liu Xiaopeng deep shallow kick back kick to hospital. A few hundred meters of the road, he kept thinking of things to do after dawn: Human bird flu, if not, insist on the transfer; people if the bird flu are on the arrangements of the other two branches of patients with metastasis, and stop receiving new patients .
January 28 (the beginning of the year three), transfer to other hospital patients are busy, the second舒荣flower CT results are in: The right lung is the change from one-third into a two-thirds of the left lung infiltration by point into a sheet, his condition markedly increase. DENG Hong-wah said: "The overall impression is that patients with symptoms and signs do not obviously change, but the results of examination to change very rapidly."
Noon, Hunan CDC reports first results of testing negative, continuing the dignified atmosphere for a long time to relax a bit first. However, the provincial CDC also stressed that for caution's sake, have to wait for second, third test results. Prior to worry because there is no valuable specimens collected from Huaihua City CDC collected samples are being sent to the third way in Changsha. 16:00, Huaihua City Health Bureau and the Government溆浦县xupu at a joint meeting,
City Health Secretary raised the tension out, the Government attaches great importance to pneumonia of unknown causes, not only medical problems to consider, we must also consider the social impact. Regardless of whether patients with avian flu patients who are transferred must do its utmost to treatment.
First off the voice, the silent hall.
Ultimately, the deputy governor of溆浦县position, cost of treatment by the government to advance, but no time 10 million settlement of batches required, Huaihua City, First People's Hospital also, where necessary, agree to receive a flower舒荣. During a meeting of the Hunan province Telephone CDC informed that the second time the test results remain negative, and the atmosphere was relaxed again. Since members of the Group are the backbone of hospital, they run at night after supper Huaihua back.
"Oh, no, it is positive!" 9 o'clock that evening, the third director of the city of CDC CDC received a call from the province, immediately facing the rest of the people are ready said, relaxing atmosphere have been put back again nervous. Tension Phone orders go out immediately on the road at top speed back to the experts. After a moment, then called the Ministry of Health related to the leadership of the phone call will be transferred to patients located in Changsha Xiangya Hospital of Central South University.
January 29 (the beginning of the year four) shortly after midnight, Liu Xiaopeng怀揣him to the county civil affairs bureau 40,000 yuan of medical expenses, led by the people溆浦县hospital medical staff, composed of the best escort team fell Changsha .
No less than the ambulance ride because all the staff, temporary requisition Escort Group Secretary for the county health official cars and an ambulance on the arrangements at the two drivers take turns driving. "City Health Secretary is very concerned about the situation on the road, asked me to call every 1 hour is necessary to report the situation, I do not sleep chant." Liu Xiaopeng excited, more nervous.
"Fortunately, patients can still remain relatively stable body temperature gradually decreased at all the way. Because we found that early and get treatment early, and younger patients with strong resistance, at that time I will definitely be on the estimated cure patients." At the end of the first 7 calls, the escort vehicle group arrived in Changsha, Liu Xiaopeng raised his arm, watch the 7:00 point. Xupu at this time, but also一夜无眠.
达湘雅the hospital, the perianth舒荣specialized in the hospital setting for treatment of human avian influenza wards. Xiangya Hospital spokesman, medical director of mine told Sinorama "Chinese Hospital," in January 2009 because of bird flu person-frequency hair, Xiangya Hospital before the Chinese New Year on the establishment of the relevant expert groups, medical groups, nursing groups and disinfection isolated group, and, in particular, a vacant 50-bed ward, as a ward for treatment of bird flu person.
Xiangya Hospital Consultation Group of Experts found that flower舒荣not only damage the lungs, but also appeared in the liver and heart damage, they used to support therapy for the treatment of organ protection. After 20 days of hospital treatment, the disease gradually舒荣smooth flower until cured.
hat-tip Florida1
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