铁路旅检口岸公共卫生应急状态检疫查验策略探讨

Discussion on strategies of quarantine and inspection in public health emergency situations at railway ports

目的探讨国际关注公共卫生事件应急状态下,铁路旅检口岸检疫查验策略。方法对天河口岸151例甲型H1N1流感检出病例的体温监测、健康申报、流行病学调查等资料进行整理,将相关信息用Excel建立病例个案信息库,用SPSS软件进行统计分析。结果病例发现渠道构成中,红外测温仪体温筛查占79.47%,旅客提交健康申明卡主动申报占13.91%,医学巡查未发现病例;红外测温仪监测体温准确率为15.23%,总体率95%置信区间为(9.53%,20.93%);42.5%的检出病例入境时体温低于37.5℃;病例流行病学特征与国内一致;输入性病例及本地病例的检出趋势与疫情发展趋势一致。结论体温监测是口岸发现可疑病例的主要途径;红外测温仪监测体温的准确性有待提高;公共卫生应急状态下,红外测温仪的报警温度低限设定为37℃,能有效减少漏检;提交健康申明卡能有效提高阳性检出率;密切关注国际、国内疫情发展动态,适时调整防控措施,是提高检出率的重要保证。

Objective To discuss strategies of quarantine and inspection in public health emergency situation at the railway ports. Methods Collecting the related data of quarantine and inspection of 151 influenza A （ H1N1 ） cases, establishing excel cases database with the related information, and analyzing the data statistically by SPSS software. Results Among all the detecting channels, infrared thermometer accounted for 79.47%, declaration by submitting health declaration card accounted for 13.91%, the medical inspection found no case. The accuracy rate of infrared thermometer used to monitoring temperature was 15.23% , with a population rate of 95% CI （9.53% , 20.93% ）. About 42.5% influenza A （H1N1） cases were with a body temperature below 37.5 % when entering. Epidemiological characteristics of detected cases were the same as domestic ones and the epidemic development trends are also the same. Conclusion Temperature monitoring was the main way to find out suspicious cases. The accuracy of infrared thermometer should be further improved. During public health emergency situations, setting the minimum alarming temperature to 37 ℃ can effectively improve the rate of influenza A （HIN1） detected cases, and submitting health declaration card can also improve the positive detection rate. Paying closely attention to the international and domestic epidemic situation, timely adjusting prevention and control measures accordingly are important guarantees to improve the detection rate.