Identification of Early Warning Signals of Infectious Diseases in Hospitals by Integrating Clinical Treatment and Disease Prevention

The global incidence of infectious diseases has increased in recent years,posing a significant threat to human health.Hospitals typically serve as frontline institutions for detecting infectious diseases.However,accurately identifying warning signals of infectious diseases in a timely manner,especially emerging infectious diseases,can be challenging.Consequently,there is a pressing need to integrate treatment and disease prevention data to conduct comprehensive analyses aimed at preventing and controlling infectious diseases within hospitals.This paper examines the role of medical data in the early identification of infectious diseases,explores early warning technologies for infectious disease recognition,and assesses monitoring and early warning mechanisms for infectious diseases.We propose that hospitals adopt novel multidimensional early warning technologies to mine and analyze medical data from various systems,in compliance with national strategies to integrate clinical treatment and disease prevention.Furthermore,hospitals should establish institution-specific,clinical-based early warning models for infectious diseases to actively monitor early signals and enhance preparedness for infectious disease prevention and control.

Overview of the plague in the late Ming Dynasty and its prevention and control measures

The plague of the late Ming Dynasty(15511644 C.E.)was long lasting,affected a wide range of the population,and had serious consequences.The purpose of this study is to review the medical system in place at the time and the measures instituted to prevent and control the plague during the late Ming Dynasty.Information on the history of the Ming Dynasty(13681644 C.E.),local chronicles,and related research literature were consulted and analyzed in terms of duration,geographical area,and other dimensions of the epidemic.Because of the abnormal climate,wide range of natural disasters,and the impact of war,the epidemic spread over a wide area during the late Ming Dynasty.The government’s epidemic prevention measures were affected by war and other factors,resulting in poor control of the outbreak.However,in terms of the medical system in place during the Ming Dynasty,some of the thinking and methods of prevention and control of the plague were historical and progressive.Some outstanding physicians such as Wu Youke(15821652 C.E.)appeared during this period.His theory of plague prevention and control had a profound influence on the formation and development of pestilence deterrence in later generations.In the late Ming Dynasty,rich experiences and measures of prevention and control were accumulated in the struggle against the plague.These methods and experiences also have a significant,positive guiding influence on the prevention and control of plague in the present day.

Remote sensing and geographic information systems in the spatial temporal dynamics modeling of infectious diseases

Similar to species immigration or exotic species invasion,infectious disease transmis-sion is strengthened due to the globalization of human activities. Using schistosomiasis as an exam-ple,we propose a conceptual model simulating the spatio-temporal dynamics of infectious diseases. We base the model on the knowledge of the interrelationship among the source,media,and the hosts of the disease. With the endemics data of schistosomiasis in Xichang,China,we demonstrate that the conceptual model is feasible; we introduce how remote sensing and geographic information systems techniques can be used in support of spatio-temporal modeling; we compare the different effects caused to the entire population when selecting different groups of people for schistosomiasis control. Our work illustrates the importance of such a modeling tool in supporting spatial decisions. Our mod-eling method can be directly applied to such infectious diseases as the plague,lyme disease,and hemorrhagic fever with renal syndrome. The application of remote sensing and geographic informa-tion systems can shed light on the modeling of other infectious disease and invasive species studies.

The strategic framework of tuberculosis control and prevention in the elderly:a scoping review towards End TB targets

With the rapid pace of population ageing,tuberculosis(TB)in the elderly increasingly becomes a public health challenge.Despite the increasing burden and high risks for TB in the elderly,targeted strategy has not been well understood and evaluated.We undertook a scoping review to identify current TB strategies,research and policy gaps in the elderly and summarized the results within a strategic framework towards End TB targets.Databases of Embase,MEDLINE,Global health and EBM reviews were searched for original studies,review articles,and policy papers published in English between January 1990 and December 2015.Articles examining TB strategy,program,guideline or intervention in the elderly from public health perspective were included.Nineteen articles met the inclusion criteria.Most of them were qualitative studies,issued in high-and middle-income countries and after 2000.To break the chain of TB transmission and reactivation in the elderly,infection control,interventions of avoiding delay in diagnosis and containment are essential for preventing transmission,especially in elderly institutions and aged immigrants;screening of latent TB infection and preventive therapy had effective impacts on reducing the risk of reactivation and should be used less reluctantly in older people;optimizing early case-finding with a high index of suspicion,systematic screening for prioritized high-risk groups,initial empirical and adequate follow-up treatment with close monitoring and evaluation,as well as enhanced programmatic management are fundamental pillars for active TB elimination.Evaluation of TB epidemiology,risk factors,impacts and cost-effectiveness of interventions,adopting accurate and rapid diagnostic tools,shorter and less toxic preventive therapy,are critical issues for developing strategy in the elderly towards End TB targets.TB control strategies in the elderly were comprehensively mapped in a causal link pathway.The framework and principals identified in this study will help to evaluate and improve current program,develop targeted strategy,as well as raise more discussions on the research priority settings and policy transitions.Given the scarceness of policy and evaluated interventions,as well as the unawareness of shifting TB epidemiology and strategy especially in developing countries,the increasing need of a ready TB program for the elderly warrants further research.

Analysis of CDC’s Role in Public Health Emergencies

Objective:To explore the role of the Centers for Disease Control and Prevention(CDC)in public health emergencies.Methods:The details of 12 public health events that occurred between January 2021 to December 2022 were analyzed to explore the roles of the CDC.Results:There were 160 patients involved in 10 public health events in 2021 and 48 patients involved in 2 public health events in 2022.Besides,the proportion of school public health events in 2022 was 0%,which was lower than in 2021,which was 80%(P<0.05).99.38%of patients during public health events were sent to the hospital promptly in 2022,which was higher than that in 2021,which was 81.25%(P<0.05).Furthermore,the average time taken for the CDC to control public health events in 2022 was 20.11±1.62 hours,and the average time taken to send inspection reports was shorter than that in 2021.The public satisfaction score was also higher in 2022 compared to 2021(P<0.05).Conclusion:The role of the CDC is to control infectious diseases.Therefore,it is important to pinpoint the existing problems in the strategies implemented by the CDC so that more improvements can be made to better prevent infectious diseases.

数智化在传染病预防控制中的应用与进展

梳理当前数字化、智能化技术在监测预警及疫苗追溯等传染病预防控制领域的典型应用实例,分析数智化驱动传染病预防控制面临的挑战、问题以及未来发展的方向,以促进传染病预防控制领域的数字化转型和智能化升级。结果表明,数字化、智能化的理论、方法、技术已应用于传染病预防控制领域,但仍面临认识不到位、人员和技术储备不足、数据可及性与可用性差、数据安全与隐私保护等挑战,需进一步更新信息化理念,探索构建疾控行业大模型,从数据要素、网络安全和数据安全、标准规范等方面构建良好生态。

文化教育类校外培训机构传染病防控能力评价指标体系构建

目的:构建文化教育类校外培训机构传染病防控能力评价指标体系,为相关部门提升传染病防控能力和开展管理工作提供参考依据。方法:在日常防控工作经验的基础上,结合既往文献研究和参考幼托机构、中小学校相关传染病管理要求,通过小组讨论和深入个人访谈等方法形成评价指标体系初步框架,通过两轮德尔菲法专家咨询对指标的重要性和可操作性进行判定。结果:邀请19名传染病防控领域专家开展两轮专家咨询,专家积极系数分别为1.00和0.95,专家权威系数为0.87,指标变异系数均<25%;第二轮专家咨询三级指标重要性协调系数为0.22,可操作性协调系数为0.27。从文化教育类校外培训机构基本情况、保障体系、日常防控措施、异常情况应对和防病检查指导5个维度,将机构资质、选址与规模、人员配备、设施设备、制度建设、物资配备、清洁与消毒、健康管理、缺课追踪、现场处置、登记与报告、复课管理和防病检查指导等各方面指标纳入评价指标体系,构建5个一级指标、14个二级指标、44个三级指标的评价指标体系。结论:构建的指标体系具有一定的科学性和合理性,可应用于文化教育类校外培训机构传染病防控能力的评价。

动物疫病防控信息化建设与发展概况

动物疫病防控是保障畜牧业健康发展、维护公共卫生安全和生态文明建设的重要手段。随着信息技术的不断发展,动物疫病防控信息化建设日新月异。提升动物疫病综合防控信息化工作,更好地利用多年来积累的动物疫病数据平台,有效整合与提高动物疫病防控的信息化管理程度,对动物疫病防控工作向科学化、信息化、精准化发展具有重要作用。论文就动物疫病防控信息化建设与发展概况进行了介绍。

重大疫情防控中政社协同治理的理论与实践分析

介绍了政社协同治理的相关理论及其在突发公共卫生事件应对中的实践和进展;并从重大疫情防控具有复杂性风险治理属性,需要深入有效的社会动员机制,需要多部门合作提供社会服务三个方面分析了政社协同治理的必要性。政社协同治理存在如下现实困境:观念转变困难,政社协同的社会服务体系建设受现有体制抵制和干扰,以及社会服务需求和供给不匹配等。文章尝试提出对上述困境有所改进的政社协同治理模型;并建议进一步明确政社协同治理目标,重视总体规划,关注需求的个性化和回应性,以促进疫情防控活动中社会治理能力与治理体系现代化建设。

德州市居民2020年传染病防治素养水平及影响因素分析

目的 了解德州市居民2020年传染病防治素养水平并分析其影响因素,为针对性开展传染病防治健康教育工作提供参考。方法 采用分层多阶段随机抽样方法,抽取德州市11个监测点的15~69岁常住居民进行问卷调查。结果 德州市居民传染病防治素养水平为40.64%。其中,女性居民为40.25%,男性居民为41.07%;25~34岁年龄组最高(50.57%),65~69岁年龄组最低(33.87%)。多因素回归分析结果显示:年龄、婚姻状况、文化程度和职业是居民传染病防治素养水平的影响因素(P<0.05)。结论 德州市居民的传染防治素养水平较以往有所提高,但仍存在薄弱环节;下一步传染病健康教育工作应重点关注高龄、丧偶、低学历和农民群体。

Wildlife-borne microorganisms and strategies to prevent and control emerging infectious diseases

China is one of the countries with the richest wildlife population.The large variety of widely distributed species act as natural or susceptible hosts for numerous infectious diseases.It is estimated that there are more than 1.2 million unknown virus species in China,and there might be 10,000–30,000 unknown bacteria in wild mammals on the Qinghai-Tibet Plateau alone.There are no less than 600,000 species of animal-borne parasites and approximately 2 million species of fungi worldwide.With rapid economic growth and globalization,humans and wildlife interact more frequently,which enhances the probability of wildlife-borne pathogens infecting humans.The occurrence of animal-borne infectious diseases will become the“new normal”we have to face in the future.Therefore,research should be carried out on wildlife-borne microorganisms and the prevention and control of emerging infectious diseases to establish an analytical framework and an evaluation technology system for risk assessment and early warning of potential animal-borne emerging infectious diseases.This will not only improve our understanding of wildlife-borne microbial communities but also enable in-depth analysis,discovery,early warning,and even prediction of major animal-borne emerging infectious diseases that might occur in the future.Furthermore,this research will reduce response times,minimize the social and economic impact and losses,enable interventions related to the emergence or spread of the disease as early as possible,and comprehensively improve our management of infectious disease outbreaks.

传染病监测对预防和控制传染病的有效性研究

目的 本研究旨在探索和分析实行传染病监测在预防和控制传染病方面的有效性效果。方法 回顾性分析我区疾控中心在2019、2020、2021三个年度内的传染病暴发情况,基于信息报道系统中传染病报告病例的基础信息,对比不同年度所记录的传染病报告例数及其占比情况,同时观察传染病病例的分布情况。结果 2019年1月至2021年12月报告传染病共计3800例,其中2019年度记录传染病病例1753例,占比为46.13%(1753/3800);2020年度记录传染病病例1388例,占比为36.53%(1388/3800);2021年度记录传染病病例659例,占比为17.34%(659/3800)。由此可见,传染病报告例数呈逐年下降趋势,对比差异显著(P<0.05)。传染病病例的分布情况显示,手足口病(31.16%)和流感(30.76%)的占比相对较高,显著高于肺结核(15.79%)、感染性腹泻(12.29%)及流行性腮腺炎(10.00%),数据差异具有统计学意义(P<0.05)。结论 对传染性疾病进行监测是预防和控制传染病的一种高效手段,能够很好地促进传染病预防和控制效果的提升。

我国托幼机构儿童传染病防控研究进展

儿童是传染病的高发群体,而托幼机构又是儿童发生传染病传播和流行的主要场所。传染病具有突发性、传染性、流行性和不可预见性等特点,一旦传染病在幼儿园暴发,将严重影响托幼机构的教学秩序,甚至进一步扩大形成某个地区乃至全国或全球的疾病,给孩子、家庭、社会造成较大的影响,成为全国乃至全球性的公共卫生问题。文章通过梳理我国托幼机构儿童传染病的流行现状和研究进展,分别从病原体检测手段、防控法律制度和协同防控体系现状与存在的不足来阐述我国在托幼机构儿童传染病防治研究方面取得的进展,旨在对我国新时期托幼机构儿童传染病防控工作提供参考。

2019—2021年某中医医院传染病报告分析与管理

目的分析某中医医院法定和其他重点监测传染病报告情况,为规范开展医院传染病报告和制定医院传染病报告管理策略提供参考。方法对2019—2021年某中医医院传染病报告数据进行描述性分析。结果2019—2021年某中医医院共报告法定和其他重点监测传染病6865例次,无甲类传染病报告,其中乙类传染病668例次(9.73%),丙类传染病5356例次(78.02%),其他重点监测传染病841例次(12.25%)。排名前5位的传染病分别是流行性感冒、水痘、梅毒、其他感染性腹泻病和肺结核,其中报告病例最多的流行性感冒,在报告时间上每年传染病报告例次数居首位的是第一季度。2019—2021年某中医医院法定和其他重点监测传染病报告例次数呈下降趋势。结论2019—2021年某中医医院法定和其他重点监测传染病报告以呼吸道传染病为主,应根据不同季节、疾病流行趋势,采取有针对性的传染病监测、防控策略。

雾化疫苗研究进展

近年来,随着黏膜疫苗及免疫技术的不断发展,针对呼吸道疾病免疫预防的雾化疫苗及相应雾化吸入免疫技术的报道与应用逐渐增多。雾化疫苗是通过雾化装置将液态和固态免疫原制成雾滴或气溶胶颗粒,以喷雾免疫或气溶胶免疫的形式进入人与动物呼吸道及肺部,并诱导机体产生保护性应答的疫苗。雾化免疫能更好地诱导黏膜免疫应答,同时避免了注射带来的疾病传播风险和疼痛。20世纪50年代鸡新城疫疫苗的喷雾免疫研究拉开了动物呼吸道免疫的序幕,随后开展了鸡传染性支气管炎疫苗的喷雾接种,目前很多禽用疫苗的喷雾免疫已被广泛使用。猪用疫苗的气溶胶免疫研究起步较晚,难度也更大。20世纪70年代末以来,逐步在猪瘟疫苗、猪胸膜肺炎放线杆菌疫苗及猪支原体肺炎疫苗上开展相应的气溶胶免疫研究。相比动物疫苗,人用疫苗的气溶胶免疫研究报道更多,主要集中在麻疹疫苗、结核疫苗和流感疫苗。2019年以来,新型冠状病毒肺炎疫苗的气溶胶免疫快速发展,目前在中国已被批准紧急使用。笔者就动物用及人用雾化疫苗研究现状进行系统陈述,总结分析了各类雾化疫苗的理化参数、安全性、体内趋向性、肺脏局部免疫应答、免疫接种效果,并提出未来在疫苗剂型与组份、雾化发生装置、雾化过程质控、免疫程序与效果评价等方面的研究需求。本综述可为后续相应的呼吸道黏膜疫苗研发提供参考。

基于PPRR理论的精神专科医院传染病防控能力评价指标体系构建

目的构建精神专科医院传染病防控能力评价指标,为提升精神专科医院传染病防控能力建设提供参考依据。方法基于PPRR危机管理理论,综合运用文献法、半结构式访谈法、德尔菲法、层次分析法构建精神专科医院传染病防控能力评价指标体系。结果经过2轮专家函询,专家咨询积极系数均为100%,专家平均权威系数为0.88,协调系数较好,构建了一套包括4个一级指标,20个二级指标,85个三级指标的精神专科医院传染病防控能力评价指标体系,经层次法分析各级评价指标均符合一致性检验要求。结论该评价指标体系有一定的科学性和可靠性,为精神专科医院传染病防控提供了可行性标准。

基于“人机料法环测”管理模式的疑似白喉在医疗机构中的防控策略

白喉是由白喉棒状杆菌引起的死亡率高的急性呼吸道传染病,是我国《传染病防治法》规定的乙类传染病。感染者咽喉部可出现白色伪膜,同时出现发热、声音嘶哑、犬吠样咳嗽、呼吸困难等症状,严重感染患者可能会产生全身性中毒症状,甚至诱发周围神经麻痹和心肌炎,曾严重危害人民健康。虽然现阶段白喉在我国属于罕见传染病,但国内仍有散发病例出现,与此同时,非产毒菌分离率呈上升趋势。本研究通过对西安市某三甲医院检出的疑似白喉患者的防控策略进行梳理,旨在有力、有序推进医疗机构内发现疑似白喉等罕见传染病的防控策略,为医疗卫生行业疑似白喉的医院感染防控提供先进成熟经验。

2019和2022年北京市社区卫生服务机构传染病防控能力调查

目的 了解2022年相较于2019年北京市社区卫生服务机构传染病防控能力变化,为完善北京市基层卫生能力提供政策建议。方法 采用问卷调查方式收集2019和2022年北京市社区卫生服务机构基本情况。结果 相较2019年,2022年北京市社区卫生服务机构平均服务人口由43 491人增长至45 096人,距离最近的二级或三级医院的服务平均距离由4.42 km缩短至2.94 km,发热哨点设置率由5.39%提升至38.77%,传染病防控专职人员占比由5.19%增加至10.05%,传染病防控兼职人员占比由2.98%增加至8.30%,社区卫生服务机构P2实验室数量由32家增长至97家。结论 相较于2019年,2022年北京市社区卫生服务机构的传染病防控能力有所提升,但人力资源、实验室能力等方面仍比较薄弱,建议制定有效提升社区卫生服务机构相关能力的防控政策。

护理人员传染病突发事件防控能力的研究进展

介绍护理人员传染病突发事件防控能力的内涵及现状,其主要能力有临床实践能力、学习与教育能力、心理抗压能力;总结影响护理人员传染病突发事件防控能力的主要因素,包括个人因素(如性别、年龄、学历、参与培训的个人意愿等)、工作因素(如工作满意度、工作年限、职业角色、是否参加培训演练、是否具备相关救援经历等)及组织因素(如医院级别和组织支持等);采用的评估工具有葛森医院安全氛围量表、护士重大传染病疫情应急能力调查问卷等。提出提升护理人员传染病突发事件防控能力的相关策略,以期为提升护理人员传染病突发事件防控能力提供参考。

基于医疗机构为哨点的新发和重点传染病监测预警结果分析

目的以医疗机构为哨点对新发和重点传染病进行监测;增加检测方法及检测种类,加大医疗机构快速检测能力建设,以便及早对目标传染病采取防控措施。方法设置深圳市龙岗中心医院及其下设的社区健康服务中心为监测哨点,将重点科室符合条件的呼吸道感染、感染性腹泻及其他四大症候群病例作为监测对象;同时,增加检测方法及检测种类,加大医疗机构快速检测能力建设。结果2022年11月至2023年6月深圳市龙岗中心医院共送检1323份不同类型监测样本,检出EB病毒等常见病原体及多瘤病毒等罕见病原体。2022年全年和2023年全年分别监测报告3142例和17643例流行性感冒病例,两个年度流行性感冒病例报告例数存在显著差异(P<0.01)。2023年全年深圳市龙岗中心医院共监测报告流行性感冒病例17643例中男性9715例,女性7928例,男女比例为1∶0.82;年龄分布以14岁以下人群为主,占比59.15%;病例职业分布以学生居多(43.59%),其次是托幼儿童(17.16%);全年各月均有流行性感冒病例报告,4月最多,占全年发病人数的35.99%,其次是12月,占23.02%。结论基于医疗机构为哨点的监测体系持续开展新发和重点传染病监测、增加检测的方法及检测种类、加大医疗机构快速检测能力建设,有利于疾病的早期诊断,对当前高发的传染病及时发出预警并提供防控建议。