某院埃博拉出血热筛查病例特点及防控策略分析

Characteristics of screening Ebola haemorrhagic fever cases and analysis of prevention and control strategies

目的分析本院的埃博拉出血热防控策略是否安全有效及经济可持续性。方法通过对收治的39例留观病例的筛查结果及流行病学特征进行分析,结合上级卫生部门的防控政策以及本院的防控策略进行安全性、经济性、有效性及可持续性进行对比分析。结果39例符合埃博拉出血热的留观病例标准者均被排除了埃博拉出血热,确诊为疟疾者9例、上呼吸道感染者25例,不排除生理性发热者5例。39例病例虽然全部来自疫区,但均是埃博拉病毒感染低风险暴露者。抓住此次防控的重点即流行病学史中埃博拉病毒感染暴露风险的决定因素,采取早期启用负压隔离病房筛查,高标准个人防护可以保证筛查工作的安全性,初期采取独立区域单个科室负责筛查,适宜人员参与隔离筛查的防控策略,既保证安全,又使成本投入最低,效率最高,适合我国长期应对埃博拉出血热的防控。结论即使预测我国埃博拉出血热暴发流行可能性极低,但是鉴于该疾病的严重性,作为甲类传染病管理策略很有必要。我国防控的主要压力是大量群体的筛查工作,根据埃博拉出血热感染暴露风险实施分级管理,制定安全且经济有效的防控策略,为我国科学、可持续地应对突发公共卫生事件提供实践经验。

Objective To investigat the safety,effectiveness,economic sustainability of control and protection strategies for Ebola haemorrhagic fever cases in the hospital.Methods To analyze the screening results and epidemiological histories of the 39 cases and the safety,economy,efficiency and sustainability of control and protection strategies in the hospital were compared with the leading department.Results Among the 39 cases,9 cases were malaria,25 cases were upper respiratory infection（URI） and 5 cases were physiological fever possibly,none of them was Ebola haemorrhagic fever.Although all patients came from the affected area,they were at a low risk of exposure of Ebola virus infection.The point of the disease control and protection was the risk evaluation of exposure of Ebola virus.The patients were arranged into a negative pressure isolation ward,the medical staff wore a high level personal protective equipment（PPE） from the beginning.Further more,using an independent region by an individual department and appropriate number of staff could provide not only safety,but also low cost and high efficiency.It was suitable for our country to adopt to deal with Ebola for a long period.It was suitable for our country to deal with Ebola for a long time.Conclusions Although the probability about the outbreak of Ebola haemorrhagic fever in China is very low,in view of the severity of the disease as the first class infectious disease,a proper management strategy is necessary.According to screening results of our hospital,the main stress of prevention and control in China is a large amount of population included.Therefore,our work of conducting risk classification management according to infection exposure risk of the Ebola haemorrhagic fever and designing safe and cost-effective prevention and control strategy had provided practical experience for our country＇s scientific and sustainable response to the public health events.