基于上海市H7N9疫情经验的改进病原检出效果的建议

Suggestions of improving epidemic pathogen detection based on the experience of H7N9 in Shanghai

目的:了解2013年初上海市首次发现H7N9新型禽流感病毒并应急处置疫情的全过程。方法:综合运用访谈、二次资料整理、专家咨询等方法。结果:(1)当班医生的传染病职业敏感性是及时检出H7N9新型禽流感病毒的前提。(2)标本在正常送检之后呈送给了有专业资格的检测机构,是及时发现H7N9新型禽流感病毒的关键。(3)医院上报疫情之后,专家组实地核实疫情时重点考察医院发热门诊的完备程度会挫伤医院报送疫情的积极性。结论:(1)需要进一步加强住院医生传染病和流行病学知识培训;(2)允许医院有序向多家病原检测机构送检标本;(3)专家组核实疫情时适当降低对发热门诊的关注度。

Objective：To review the whole process of emergency disposal of the H7N9 bird flu virus first found in Shanghai in early 2013. Methods：The integrated use of interviews,secondary data compilation,expert consulting method were applied. Results：（1）Professional sensitivity of the doctor on duty was the premise of timely detection of H7N9.（2）Reporting specimens after normal inspection to the professional testing institution was the key to detecting H7N9 bird flu virus in a timely manner.（3）Experts’ too much attention on the use of fever clinics of hospital would affect the enthusiasm of hospital to report the epidemic situation after the hospital reported epidemic situation. Conclusion：（1）It is suggested to further strengthen the trainings of infectious diseases and epidemiology knowledge of resident physicians.（2）It is suggested to allow hospitals to send samples to more than one pathogenic detection institution.（3）Experts are suggested to pay less attention to fever clinics when they verify the epidemic situation.