Prevention and Control for Suspected Cases
In the Protocol for Novel Coronavirus-infected Pneumonia Prevention and Control (2nd Edition), released on January 22, the NHC laid out guidelines for monitoring of the patients, epidemiological investigations, and management of suspicious exposures and close contacts, and technical guidelines for laboratory testing. Nine measures of prevention and control, including strengthening organization and leadership, case detection and report, and epidemiological investigation, were provided to guide healthcare facilities and disease control centers at all levels on monitoring, detecting and reporting infections.
According to the Protocol, the definition of suspected cases considers both clinical and epidemiological features. There are three clinical manifestations: fever; radiographic imaging consistent with pneumonia; and normal or decreased white blood cell count, or decreased lymphocyte count in the early stages of the disease. The epidemiological history includes: history of travel to or residence in Wuhan within 14 days prior to the onset of the disease; contact with a patient from Wuhan with fever and respiratory symptoms within 14 days prior to the onset of the disease; clustered cases; or epidemiological relation with confirmed cases. A suspected case is defined by having all the three clinical manifestations plus any of the epidemiological history criteria.
It is stated in the Protocol that if patients who meet the definitions of suspected or confirmed cases are detected, healthcare facilities should conduct epidemiological investigations, specimen collections and lab testing, and strengthen measures for quarantine, disinfection, prevention and control. Suspected cases should be quarantined and treated in single rooms.
疑似病例防控
國(guó)家衛(wèi)生健康委在2020年1月22日發(fā)布的《新型冠狀病毒感染的肺炎防控方案(第二版)》中,明確提出了新冠肺炎病例監(jiān)測(cè)方案、流行病學(xué)調(diào)查方案、可疑暴露者和密切接觸者管理方案以及實(shí)驗(yàn)室檢測(cè)技術(shù)指南,提出加強(qiáng)組織領(lǐng)導(dǎo)、病例發(fā)現(xiàn)與報(bào)告、流行病學(xué)調(diào)查等9項(xiàng)防控措施,指導(dǎo)各級(jí)各類醫(yī)療機(jī)構(gòu)、各級(jí)疾控機(jī)構(gòu)開(kāi)展病例監(jiān)測(cè)、發(fā)現(xiàn)和報(bào)告工作。根據(jù)該防控方案,疑似病例的定義為:有三項(xiàng)臨床表現(xiàn),即發(fā)熱,具有肺炎影像學(xué)特征,發(fā)病早期白細(xì)胞總數(shù)正常或降低,或淋巴細(xì)胞計(jì)數(shù)減少;同時(shí),具有發(fā)病前14天內(nèi)有武漢旅行史或居住史,或發(fā)病前14天內(nèi)曾接觸過(guò)來(lái)自武漢的發(fā)熱伴有呼吸道癥狀的患者,或有聚集性發(fā)病或與確診病例有流行病學(xué)關(guān)聯(lián)等任何一項(xiàng)流行病學(xué)史的患者。
該防控方案指出,醫(yī)療機(jī)構(gòu)發(fā)現(xiàn)符合疑似病例、確診病例定義的患者時(shí),應(yīng)按要求開(kāi)展流行病學(xué)調(diào)查、進(jìn)行臨床標(biāo)本采集與相關(guān)病原檢測(cè);加強(qiáng)隔離、消毒和防護(hù)工作,對(duì)疑似病例進(jìn)行單間隔離治療。