旅行中谨防传染病

1 旅行中谨防感染艾滋病 艾滋病自1981年首次被发现以来,其传播的速度之快,流行范围之广,对社会和人类的危害之大,成为现代医学史上最严重的感染性疾病.     

排除检查诊断法在传染病快速诊断中的应用

〔目的〕迅速确诊传染病病种,采取有力措施,控制传染病通过口岸进一步扩散。〔方法〕将排查技术应用到传染病的鉴别诊断中。〔结果〕对口岸发现的疑似传染病病例,可采用流行病学的方法进行排查,可根据患者的临床症状和体征排查传染病;可通过实验室进行排查性检验而确诊传染病。〔结论〕排除检查诊断法在传染病诊断中是一种行之有效的方法。它可以迅速初步判断是否患有传染病,缩小可疑传染病的范围,减少检查、检验项目,大大缩短传染病的确诊时间,使病人能够及早治疗,传染病得到及早控制。     

Infectious Disease Surveillance in the 21st Century: An Integrated Web-Based Surveillance and Case Management System

The Massachusetts Virtual Epidemiologic Network (MAVEN) was deployed in 2006 by the Massachusetts Department of Public Health, Bureau of Infectious Disease to serve as an integrated, Web-based disease surveillance and case management system. MAVEN replaced program-specific, siloed databases, which were inaccessible to local public health and unable to integrate electronic reporting. Disease events are automatically created without human intervention when a case or laboratory report is received and triaged in real time to state and local public health personnel. Events move through workflows for initial notification, case investigation, and case management. Initial development was completed within 12 months and recent state regulations mandate the use of MAVEN by all 351 jurisdictions. More than 300 local boards of health are using MAVEN, there are approximately one million events, and 70 laboratories report electronically. MAVEN has demonstrated responsiveness and flexibility to emerging diseases while also streamlining routine surveillance processes and improving timeliness of notifications and data completeness, although the long-term resource requirements are significant.Massachusetts has nearly 90 reportable infectious diseases, resulting in approximately 150,000 disease reports annually. Until 2006, the Massachusetts Department of Public Health (MDPH) Bureau of Infectious Disease (BID) maintained program-specific, siloed databases that were inaccessible to local public health agencies (i.e., 351 city/town-specific health departments in the state) and unable to integrate with electronic laboratory reporting (ELR) (Figure 1), resulting in work redundancy and time delays.Open in a separate windowFigure 1The infectious disease surveillance systems in Massachusetts in 2006^aaA depiction of the data flows for infectious disease surveillance in Massachusetts, prior to the implementation of MAVEN in 2006. Data for specific disease groups and programs were housed in siloed databases. The disparate system was heavily dependent on paper reporting, had inherent time delays, and there were no opportunities for integrated, comprehensive data management and analysis.MA = MassachusettsMAVEN = Massachusetts Virtual Epidemiologic Network