At 13:50 on January 21, 2009[I来说两句 (34) ]
Source: Sohu health
Interviews with guests:陈志海Beijing Ditan Hospital, director of infection in a
Lian-Chun Liang佑安Beijing hospital infection Branch Chief Physician
Sohu health: This year is basically no poultry outbreak of avian flu, and even in human bird flu patients were infected live poultry markets as well as place of residence there were no birds around the epidemic, why people will appear in the avian flu? But also for the number of cases occur?
陈志海: This is a difficult question to answer because in the past, there is not a particularly clear epidemiological history of the human avian influenza cases.
In theory, these cases will certainly have a source, but not necessarily be able to find out. I think this is we need to study it.
For several successive patients, but also understandable. Although there is no bird flu in particular, specifically seasonal, but a high incidence in winter and spring. Now in the winter such a respiratory disease, it should be said is understandable. Just entering in 2009 occurred in patients with four cases, which occurred in 4 cases, respectively, Hunan, Shandong, Shanxi, Beijing, very far apart, did not find the existence of related links.
Lian-Chun Liang: It should be said that only individual birds carrying avian influenza virus, most of the other birds did not carry the avian flu virus. Contact carrying avian influenza virus can be infected poultry.
Sohu health: In that case, if exposed to the avian flu virus is not necessarily the incidence, or may not be very serious disease is not it?
Lian-Chun Liang: human infection with avian influenza virus subtypes caused by different clinical manifestations are not the same, some non-pathogenic subtype of the human body, and some subtypes of the human body can cause serious illness, for example, often say that H5N1 avian influenza subtype, which often complicated after infection severe pneumonia, if not timely diagnosis and treatment, patients can cause death.
Successive year the number of patients, there is no relevance. At present, people infected with sporadic cases of avian influenza-based, highly distributed, has not caused the local outbreak, caused by large-scale epidemic is unlikely.
Two days of avian flu has the best medicine
Sohu health: the current bird flu, is there a more effective treatment measures, the current fatality rate is the number? Some people feel that many patients are "getting on the no saved" is not the case?
Lian-Chun Liang: At present, local reports of mortality is not exactly the same, including the year in each region are reported to be different is not the same, 97 years 18 cases of infection in Hong Kong, six cases of death, so that mortality算起来is 1 / 3, there are places like Vietnam in 2004 23 cases of infection, 16 cases of death, the death rate about 50%.
陈志海: This disease is indeed the case-fatality rate is relatively high, but we can not say no to save. Now internationally accepted statistical comparison, the general is about 60 percent fatality rate, is actually relatively high. From treatment are concerned, there is some of the better treatment. In addition to symptomatic treatment, there is a antiviral oseltamivir, is a lot of people have heard of "Tamiflu", the effect is better. Another type of drug amantadine, rimantadine. Anti-viral drug treatment as early as the effect of the requirements to do, two days the best medicine. Patients in the disease a week after the medication, especially when very serious condition late.
Lian-Chun Liang: First of all we want to detect cases, early diagnosis of early treatment is critical. If ordinary people are infected do not timely diagnosis and treatment of pneumonia can also be dead. Diagnosis and treatment success rate, it may be related to different regions of different medical conditions, diagnosis and treatment, there are certain relations, if the disease early diagnosis, proper treatment, will reduce mortality. If this disease has been for several days before the diagnosis, it will be significantly increased mortality.
Sohu health: the incidence is the moment of exposure to the virus from a patient? Or from the date the onset of symptoms?
Lian-Chun Liang: From the beginning of symptoms. For example, developed fever, myalgia, does not force the same symptoms, such as influenza, which is the incidence.
Two days prior to the onset of the current advocates of early treatment, in addition to anti-retroviral treatment early, there are nutritional support treatment, and for some patients with lung inflammation and even hysteretic respiratory treatment, to improve a great help.
Sohu health: But patients diagnosed in two days is not difficult?
陈志海: It is now our country has developed very sensitive influenza A virus kit, to quickly test the virus. Patients for over-heated, respiratory symptoms, check sputum, mouthwash and other respiratory tract samples can be tested, usually 15 minutes can be the result. Preliminary results can be judged according to what is influenza A virus infection. Influenza and avian influenza viruses are influenza A virus. Combined with epidemiological data, you can diagnose people suspected cases of bird flu. This allows the early use of these drugs.
Sohu health: as long as it is judged that influenza A virus can be used on Tamiflu? Well, ordinary influenza also can be used Tamiflu? In the absence of judge to determine that this person is the avian flu, but in order to ensure that the timeliness of treatment, medication can advance?
陈志海: ordinary human flu Tamiflu can be used, and it also belongs to influenza A virus, influenza A virus as long as they can use. If the rapid test can identify patients infected with the influenza A virus, the use of Tamiflu have very good results.
Sohu health: For the patients with the treatment, the drug is able to guarantee the size of the hospital?
Lian-Chun Liang: the drug Tamiflu is still relatively scarce, but the big hospitals should be on this drug has a reserve. If there is no Tamiflu with amantadine, rimantadine is also possible, which is more common drugs, but also in the incidence of early application or have a certain effect.
Detection of avian influenza virus can be rapid results
Sohu healthy: We know the symptoms of influenza and avian flu is extremely similar, is not determined only by laboratory tests, can not distinguish between symptoms and other methods to judge? Confirmed whether the difficulties? How long will it take? Avian influenza is usually in some small hospitals can check out? Or to the designated hospitals must be confirmed?
陈志海: This involves the issue of bird flu diagnosis. Patients with fever, cough, runny nose, sore throat, deep pain, such as influenza-like performance, we must ask whether there epidemiological history of avian flu. Epidemiological history, including the five elements, (1) whether or not to have bird flu outbreak, (2) whether the contact with dead birds, (3) whether the contact with dead poultry secretion, excretion, (4) whether the contact with a bird flu patients, (5) whether direct contact with virus-related items, which generally refers to the avian flu researchers. In such cases, it is necessary on this case for medical observation, and reporting. Once the report will initiate a rapid response mechanism, very fast, probably within a few hours to check the problem get. Therefore, even if to a small hospital, as long as small hospitals reported, it is timely diagnosis and treatment.
Liang Lian-Chun: But avian flu is through laboratory tests before the final diagnosis. However, the majority based on epidemiological history, clinical manifestations of the preliminary judging, a small portion of it is very difficult to identify with the human influenza, and ultimately confirmed the need for laboratory testing.
Sohu Health: Will there be any bird flu patients were influenza treatment as a result of misdiagnosis?
Lian-Chun Liang: It is now the various medical institutions have set up fever clinics for fever patients with pneumonia, with a focus to strengthen the monitoring, timely diagnosis and treatment, in general will not be misdiagnosed.
Early symptoms similar to bird flu influenza in general, diseases such as flu or pneumonia, if the primary care doctors are not asked in detail about the epidemiological history, it easily to avian flu as an ordinary flu, influenza or pneumonia. Confirmed to go through a very long time, so that patients unable to obtain timely, adequate medical treatment.
Can a small hospital diagnosed with bird flu, to look at medical staff have no such awareness, found that patients with influenza-like or pneumonia patients can not think of avian flu, left the popular history of collecting information, timely diagnosis and laboratory testing.
Bird flu rely on the laboratory tests confirmed that this must be confirmed to the CDC. This laboratory testing can not do grass-roots hospitals, mainly larger hospitals or the Centers for Disease Control (CDC) can be detected. Some even tertiary hospitals may not be able detection, we can be of infectious disease hospital. General Hospital itself is not necessarily able to detect this disease.
Sohu Health: How long will it take?
Lian-Chun Liang: It should be soon. As far as I know should be able to deliver the results the same day.
Food and the possibility of the spread of avian flu smaller
Sohu Health: Professor Chen mentioned that if the first symptoms of influenza to see if there are epidemiological history, to help to determine whether there was the possibility of bird flu, which include food? Whether or not to eat poultry products will be risk of infection? Eat a big meal because it is time for the Spring Festival, egg products consumption is the biggest time, whether such foods should be refused?
陈志海: epidemiological history does not include food. Avian influenza virus is very sensitive to heat, is not difficult to kill.
From the diet, the egg, chicken in this category of food processing should be done in order to eat.一般来说100℃下加热两分钟，病毒就死掉了。 As long as the food cooked on no problem. Now the whole world is not eating the spread of the virus causing bird flu were reported.
Lian-Chun Liang: poultry food should not be refused. At present, most of poultry meat, eggs, are quarantine, it is safe for human consumption, in particular, were cooked to kill the virus.
During the spring of disease prevention should be strengthened
Sohu Health: abroad has been reported that some countries before the avian influenza virus occurred in a small range of human communication, the possibility of domestic this happen? At a time when the Spring Festival travel season, the train cars are overcrowded, will speed up the spread of avian flu?
陈志海: "small-scale spread of the world" at present evidence is not very good. Behind a problem, now comes the spring peak, trains Master particularly large number of people have a lot of shopping malls. As a conventional prevention of respiratory infectious diseases, whether it is influenza or bird flu, or measles, chicken pox like disease, in this season must have a very high vigilance.
For example, children try to avoid these places, then we should pay attention to the surrounding environment, to avoid contact with fever, coughing, sneezing patients. Are sick patients, but also try not to go to public places.
We encountered in public places must be conscious of these people to avoid contact, if contact is necessary to have to wear a mask. Relatively few such cases, vigilance it.
Played vaccine and will try its best to avoid contact with birds
Sohu health: It is now a lot of birds have vaccination, if human contact with birds played vaccine is not dangerous?
陈志海: I H5N1 vaccine for poultry are not familiar with, we should already have, I do not know the scope of use. However, contacts have been injected H5N1 poultry vaccine, the danger may be smaller.
Lian-Chun Liang: Generally speaking there should be no problem, just talking about the vaccine, and now I know are the influenza A virus H1N1, H3N2 and influenza B vaccine, poultry certainly over after the incidence of vaccine significantly reduced, even if the infection, symptoms are also relatively light, this is a human vaccine is the same reason. Therefore, if human beings come into contact with birds that had the vaccine, should not be too dangerous.
Sohu health: the spread of the virus is there a maximum distance? Do not touch the current emphasis on dead birds, if exposed to wild birds or birds of a Class广场鸽how to maintain the distance?
Lian-Chun Liang: First of all, must be able to route of transmission of the disease, the spread of the disease mainly through the respiratory tract, but also in close contact with the spread of avian flu has been to the region, including some laboratory staff, in close contact with such operator.
Sohu health: It is reported that if the avian flu virus to carry the birds chirping, or coughing, saliva smoke there may also be caused by infection.
Lian-Chun Liang: this is the case, but should be a close-up of close contacts. In particular contact with dead poultry is doing a good job of personal protective measures, this is the most basic common sense.
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