【摘要】 目的分析新疆2起人感染H5N1高致病性禽流感疫情应急处置措施,提出针对性防控策略。方法采用流行病学方法分析新疆2例人感染H5N1高致病性禽流感疫情发生过程和处置情况。结果 2例病例均在发病后第10d才首次检测血常规,由于发病前期的诊疗规范性不佳,错过了针对人感染高致病性禽流感抗病毒治疗的最佳时间和未采用有效抗病毒药物(48 h内服用神经氨酸酶抑制剂如达菲)及时治疗,虽然治疗后期多部门联合、专家组会诊,诊疗规范,但最终2例病例分别以合并感染和多器官衰竭死亡为结局;其中1例病例发病前有活禽宰杀市场暴露史,环境监测证实了病例的感染来源于活禽市场。结论对于人感染H5N1高致病性禽流感防控需要多部门、多系统联合,要做到早诊断、早治疗和早隔离,定期培训医护人员尤其是基层人员;应做好环境监测和公众的宣传,均是疾病防控的关键。更多还原

【Abstract】 Objective To analyze the emergency treatment of 2 human cases with H5N1 highly pathogenic avian influenza(HPAI) in Xinjiang, and provide evidence for targeted prevention and control strategy. Methods The epidemic process and emergency disposal of HPAI H5N1 in 2 human cases in Xinjiang were analyzed with epidemiological methods. Results The first blood routine examinations of both 2 cases were carried out at the tenth day after onset of the disease. Both 2 patients died of concurrent infection and multiple organ failure after combined treatment, expert consultation and standardized treatment in the late period of treatment, due to poor diagnosis and treatment in the early stage of the disease, the best time for antiviral treatment was missed and the antiviral drugs(neuraminidase inhibitors within 48 hours, such as Tamiflu) were not taken for treatment in time. One patient had exposure history of fowl in the market before disease onset and the source of infection was confirmed by the environmental surveillance. Conclusions Multi sector association is needed for control and prevention of human infection with HPAI H5N1. Early diagnosis, early treatment, early isolation, regular training in medical staff and basic staff, environmental surveillance and publicity to the public are all the keys to the disease prevention and control.更多还原