Sunday, January 26, 2014

People infected with #H7N9 incubation period of four days to

[The changes from last year - to this year, are bolded in red which is my editing. ]

New Year, Zhejiang, Guangdong, Beijing and other places after another reported case of human infection with H7N9 virus in dozens of cases. Through in-depth investigation of reported cases, yesterday, the State Planning Commission released 2014 edition Guardian "people infected with H7N9 avian flu" that the avian influenza virus, or through contact with virus-contaminated environments spread to humans, do not rule out limited non-sustained person to person. Virus incubation period has been shortened by a week last year to define 3-4 days, according to the new country program will shorten the H7N9 bird flu quarantine close contacts of the observation period to four days. Change one of Identification is not highly contagious infectious diseases dropped  last year's treatment program was called "human infection with H7N9 avian influenza is an acute respiratory infection by the H7N9 subtype of avian influenza caused by a virus." New version of "human H7N9 avian flu infection" (hereinafter referred to as the "program") noted that people infected with H7N9 avian influenza is caused by the H7N9 avian influenza virus, acute respiratory infections, which often can be combined cases of severe pneumonia with acute respiratory distress syndrome , septic shock, multiple organ failure and even.   Treatment programs to the H7N9 bird flu a new "identity recognized." And acute respiratory infections in acute respiratory disease What is the difference? Beijing CDC relevant person in charge explained that this is because the past year by the health department of the meta-analysis of H7N9 avian influenza cases summed up, H7N9 virus is not contagious too, only limited human-to-human transmission, it will reduced to its "infectious disease" is more accurate.   Program clearer H7N9 gene sources, can infect human avian influenza virus subtypes H5N1, H9N2, H7N7, H7N2, H7N3, etc., this is H7N9 avian influenza virus. The virus is a novel reassortant virus, a gene encoding HA from H7N3, NA is derived from the gene encoding H7N9, the 6 internal genes from H9N2 avian influenza virus. "This shows that with the increase in cases, we know it is more in-depth, scientific defined by isolated virus, which will help guide and adjust the existing levels of prevention and control strategies", industry experts said. Changes in two pathways through virus-contaminated environment is poisonous  to public concern H7N9 virus transmission, the program clearly states that the specific ways can spread through the respiratory tract or close contact with infected poultry infected secretions or excretions obtained; or by contact with virus-contaminated environments spread to humans; does not exclude limited non-sustained person to person.   Contrast the previous version referred to treatment programs "through the respiratory tract, can also be infected through close contact with poultry secretions or excretions, or direct contact with the virus," CDC relevant person in charge explained that the new version will be "birds secretions or excretions, "summed up as" viral contamination of the environment "is more accurate because the H7N9 cases have indeed touched equipped to carry the virus in poultry cages or containers, and even soil, air and other large environment then infected cases , just its secretions or excretions, this definition will raise awareness and self-protection awareness at the same time, the late-site cleanup and disinfection of the disease control department of health instructive, more comprehensive and specific.   What is "does not exclude limited non-sustained person to person"? The official explained that due to the current understanding of the case from the point of view, H7N9 virus spread from person to person really is limited, not mass spread, with "non-persistent" is to better explain the spread of limited characteristics, which is China's medical scientists for nearly a year by the virus observed summed up, "the present situation, reported cases are cases sporadic and relatively independent, did not see signs of continued infection."   Meanwhile, the program that is now in its secretions or excretions of poultry and live bird markets in environmental samples to detect and separate the H7N9 avian influenza virus, and people infected with H7N9 avian influenza virus is highly homologous. Source of infection may carry H7N9 avian influenza virus in poultry. Currently, the majority of sporadic cases, the incidence of individual family aggregation phenomenon, but there is no evidence of sustained human-to-human transmission between the.3 Changes incubation period incubation period is shortened to 3-4 days  scenario that according to the incubation period of influenza and human infection with H7N9 avian influenza existing case findings, the incubation period is usually 3-4 days. With the previous "one week incubation period" compared to significantly shortened.   Beijing CDC relevant person in charge explained that this is the year to accumulate through the conclusion of the case, just go to the beginning of the H7N9 virus in the country appeared to be in accordance with the estimated incubation period of a stream to determine the incubation period, "one week", but the combination of epidemiological situation and the investigation of cases can be found, usually in contact with the 3-4 days after the onset of H7N9 that will be infected with the avian influenza virus environment, "meaning it has two aspects, the one we can from their own note, if suspected exposure After about four days of poultry self-observation, if there are no symptoms of fever, cough or "pass"; the other hand, in close contact with H7N9 bird flu patients observation period will be shortened, "the official pointed out that the country will be in accordance with the new version treatment programs to be adjusted to shorten Beijing on H7N9 bird flu quarantine close contacts of the observation period will be increased from one week to four days.   Meanwhile, in order to facilitate the public "condemnation", the program clearly the symptoms, signs and clinical characteristics of H7N9 cases. Patients generally showed flu-like symptoms such as fever, cough, sputum less, may be associated with headache, muscle aches, diarrhea and other symptoms. Rapid development in patients with severe disease, occur more in 3-7 days of onset of severe pneumonia, mostly sustained temperature above 39 ℃, difficulty in breathing, may be associated with hemoptysis sputum. Often rapidly progress to acute respiratory distress syndrome, sepsis, septic shock, multiple organ dysfunction and even, in some patients, there may be other symptoms of pleural effusion. Change 4 high-risk groups have a history of exposure in poultry elderly are "high risk"  in the definition of H7N9 infection in high-risk groups, the old and the new version is also a clear distinction between the two, legacy as "a week before the onset of those who come into contact with poultry, such as engaging in poultry farming, trafficking, sale, slaughter, processing industry and other personnel, "the new version was" a week before the onset of contact with birds or those who have been to live poultry markets, especially the elderly, "In this regard, industry experts point out that the current national report Over 200 cases of confirmed cases of bird flu, more than half are older, and therefore have had contact with poultry elderly should pay special attention to prevent, but as for the elderly because of its heat resistance intention is not as good as other young people, or aggravation of chronic viral power and so further study.   Programs that people infected with H7N9 avian influenza in critically ill patients with poor prognosis. Prognostic factors may include patient age, underlying diseases and complications. Drug treatment remains oseltamivir, peramivir, zanamivir and Chinese medicine dialectical theory of governance methods, antiviral drugs should be used within 48 hours of onset. Related to various hospitals to prevent nosocomial infections  program pointed out the strict norms of human infection admitted to hospital H7N9 bird flu infection prevention and control measures in health care institutions. Follow the standard precautionary principle, according to the spread of disease prevention and control measures taken way.January 20, according to the Shanghai Wei Planning Commission informed the first 20 days, the Shanghai 7 new cases of human infection of H7N9 avian influenza in January, including two deaths. Emergency department physicians Shanghai Pudong New Area People's Hospital, 31-year-old Zhang Xiaodong is one of the two deceased.   Beijing CDC relevant responsible person said, early detection, early reporting, early diagnosis, early treatment, strengthening the treatment of severe cases, pay attention to both Chinese and Western medicine is an effective prevention and control, improve the cure rate, the key to reducing mortality. Currently, the city has asked the two hospitals found H7N9 confirmed cases, all within the jurisdiction of two or more hospitals will conduct two weeks of flu-like illness, severe acute respiratory infections in hospital intensive surveillance. Meanwhile heat treatment of patients, medical staff must be asked in detail about whether the exposure history or history of exposure to poultry H7N9 cases, if the suspected H7N9 virus infection should be carried out immediately H7N9 pathogen detection at the same time, CDC reporting system. Link easily into severe risk factors  . 1 Age>   60 years;   2 patients with severe underlying diseases or special clinical situations, such as heart or lung disease foundation, hypertension, diabetes, obesity, cancer, immunosuppression, pregnant women;   3. after the onset of sustained fever (T>   39 ℃) over three days and three days;   4 lymphocyte counts continue to decrease;   5.CRP, LDH and CK continued to increase;   6 Tips chest radiographic pneumonia.   Beijing Times reporter Li Qiumeng 

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