Scheme of making a diagnosis of first type H1N1 influenza

Scheme of making a diagnosis of first type H1N1 influenza
Scheme of making a diagnosis of first type H1N1 influenza
(try edition the first in 2009) Mexico will get rich quick in March of 2009 " People are infected with pig's influenza " Epidemic situation, cause personnel's death. April 30 World Health Organization( Hereafter referred to as WHO) Warn the rank to it is 5 grades to improve influenza largely and prevailingly to claim. Discover, the etiology of this epidemic situation is new first type H1N1 influenza virus after the variation, should be poisonous one includes pig's influenza, bird flu and 3 kinds of genetic fragments of influenza virus of people's influenza, can spread in human world. WHO calls epidemic situation of this influenza as initially " People are infected with pig's influenza " ,But with understanding in depth, have already named it as again " first type H1N1 influenza " now to epidemic situation properties . Of our country Ministry of Public Health claim, include it in " whether the People's Republic of China infectious disease prevent and cure law " fixed class-B infectious disease on April 30, take the preventive, control measure according to class-A infectious disease. According to the materials grasped at present, the first type H1N1 influenza taking place this time is the acute respiratory tract infectious disease caused by new first type H1N1 influenza virus after variation. Spread through droplets, aerosol, direct contact or mediate contact, is mainly shown as influenza and one kind of symptoms clinically, a few case conditions in weight, develop fast, can appear viral pneumonia, amalgamate and breathe the depleted, many internal organs function to damage, the serious one can cause the death. Because such first type H1N1 influenza is that one kind sends disease newly, its characteristic still waits to further observe and summarize. First, aetiology First type H1N1 influenza virus is belonging to and glueing the virus department ( 0rthomyxoviridae) ,First type influenza virus belongs to (InfluenzavirusA) . The typical virus particle takes the form of ball, the diameter is 80nm 120nm, have membrane of bag. There is a lot of projection glycoprotein arranged radially, including erythrocyte hemagglutinin (HA) on the membrane of bag , neural amino acid enzyme (NA) With the ground substance albumen M2. In the virus particle is a nuclear clothing shell, spiral in shape and symmetrical, the diameter is 10nm. Defeated by the chain RNA virus for single burst, the genome is about 13.6kb, made up of 8 independent passages not of uniform size. The virus is bent over to the ethanol, iodine, the iodine tincture is sensitive; To hot and sensitive, 56 ��can deactivate in 30 minutes. Second, epidemiology are by 8 o'clock a.m. on May 8 of 2009 Beijing time, make a definite diagnosis of 2371 first type H1N1 influenza cases in 24 countries and regions altogether in the whole world, distributed in America, Europe, Oceania and Asia. Among them Mexico makes a definite diagnosis of 1112, 42 cases of death; U.S.A. makes a definite diagnosis of 896, 2 cases of death; The Hong Kong Special Administrative Region of our country makes a definite diagnosis of one. Except Mexico and U.S.A., there is not a case report of death in the other countries and regions. (1) Infect the source. The first type H1N1 influenza patient, in order to mainly infect the source. Though the pig has already found first type H1N1 influenza virus in the body, still there is not evidence that indicate the animal is in order to infect the source at present. (2) Propagate the route. Mainly transmit through respiratory tract through the droplets or aerosol, can also be through mucous membrane of place such as oral cavity, nasal cavity, eyes are direct or mediate contact is propagated. Contact the patient's respiratory tract secretion, humoral and may also cause and spread by the articles that the virus pollute. (3) More easily infected group. Crowds generally exchange the sense. Third, clinical manifestation is and incubation period for the auxiliary examination is generally from one day to 7 days, it is mostly from one day to 4 days. (1) Clinical manifestation. Shown as influenza is one kind of symptoms, including generating heat (it is greater than or equal to 37.5 �� that armpit is warm) , it flow tears, have a stuffy nose, it swallow aching, coughing, having a headache, myalgia, weak, vomit and ( Or) Diarrhoea. Complications such as pneumonia,etc. can happen. A few case conditions develop fast, it is not complete or depleted to appear and breathe the depleted, many internal organs function. Patient's original basic disease can also be aggravated. (2) Check in the laboratory. 1.The peripheral blood is alike: The total number of leucocytes seldom or reduce high. 2.Aetiology is checked. ( 1) The virus nuclear acid is measured: With RT-PCR (you had better adopt real-timeRT-PCR) France measures the respiratory tract sample ' Swallowing the swab, oral cavity includes and gargles the liquid, nasopharyngeal or trachea to collect thing, phlegm) First type H1N1 influenza virus nuclear acid of China, the result is positive. ( 2) The virus is separated: Can isolate first type H1N1 influenza virus in the respiratory tract sample. The lung can isolate this virus while organizing while amalgamating viral pneumonia. 3.Serology is checked: The first type H1N1 influenza virus specificity of serum of dynamic detection neutralizes the antibody level and presents 4 times or more than 4 times and rises. (3) Other auxiliary examination. Can learn etc. to check according to the chest image of walking of the condition. Can see the flaky inflammation infiltration shadow of spot in the lung while amalgamating pneumonia. Fourth, diagnose the diagnosis of a disease mainly combines epidemiology history, clinical manifestation and aetiology to check, find, diagnose early early it is the key to preventing and controlling and treating. (1) Suspected case. Can diagnose as suspected case while according with one of the following situations: 1. Suspected with first type H1N1 influenza in 7 days before the onset or made a definite diagnosis of the case to keep in close touch (look after a patient under the condition of not protecting effectively, lives, is exposed to the same environment with the patient together, or contact a secretion of the patient's air or humoral directly) ,A kind of clinical manifestation of influenza appears. 2.Been first type H1N1 influenza prevail in the 7 day before the onset ' Appear lasting human world of virus propagate with based on community's level prevalence and break out) National or regional,influenza will appear by kinds of clinical manifestation. 3.Appear a kind of clinical manifestation of influenza, first type influenza virus finds the masculine gender, but the one that further found and got rid of existing previously is inferior type. (2) Make a definite diagnosis of the case. A kind of clinical manifestation of influenza appears, one or several kinds following laboratories measure the result at the same time: 1. First type H1N1 influenza virus nuclear acid measures the masculine gender ' Can adopt real-timeRT-PCR and RT-PCR) . 2.Separate first type H1N1 influenza virus. 3.The specificity of serum first type H1N1 influenza virus neutralizes the antibody level and presents 4 times or more than 4 times and rises. Fifth, classify and handle the principle clinically (1) Suspected case: Arrange for the ward of separate room to isolate and observe, many people can't be the same as the room. The first type H1N1 influenza virus specificity of doing at the same time is checked. Offer he of department treatment Wei early. (2) Make a definite diagnosis of the case: Accepted for medical treatment by the fixed hospital. The first type H1N1 influenza ward of the income, but many people and room. Offer he of department treatment Wei. Sixth, treat (1) Generally treat. Have a rest, drink the water more, observe the condition change closely; Can bring down a fever and treat to the hyperpyrexia case. (2) Antiviral treatment. In conformity with the early applied antiviral medicine. Preliminary the intersection of medicine and quick test brief on, first type the intersection of H1N1 and to him of department Wei (oseltamivir) influenza virus this Wei (zanamivir) with pitching that rice Sensitive, able to bear medicines to alkane amine and second amine of Buddha's warrior attendant of Buddha's warrior attendant. He of department Wei should use in generating heat 48 hours as much as possible ' The best in 36 hours) ,The course of treatment is 5 days. He of department adult of Wei 75mgb.i.d. in consumption. The patients of children a year old and the above age should give medicine according to the weight: Underweight 15kg person, I 30mgb.i.d.; Weight 15kg 23kg person, 45mgb.i.d.; Weight 23kg 40kg person, 60mgb.i.d.; The person who greater thans 40kg of the weight, 75mgb.i.d.. Have children of difficulty swallowing capsuling, can select he of department Wei for use, mix and hang the liquid. (3) Other treatments. 1.If hypoxemia disease appears or breathe the depleted situation, the corresponding treatment measure that should offer in time, including oxygen intake, achieving machinery to keep in touch with or achieve machinery to ventilate etc.. 2.Appear other the intersection of internal organs and function damage, offer corresponding support treat. 3.To the serious one ' Infected with poisoning shock and amalgamated acutely and breathed poverty-stricken syndrome such as presenting) ,Can consider for low dose of glucocorticoid treatment. Do not recommend using heavy dose of glucocorticoid. 4.While amalgamating bacterial infection, offer antibacterial drug therapy correspondingly. (4) Dialectical treatment of Chinese medicine. 1.Poisonous to attack the lung and defend symptom: Generate heat, evil is cold, swallow aching, has a headache, muscle aching, cough. Manage the law: Clear away heat and detoxify, it is completely evil to ventilate the lung. Consult square medicine: Chinese ephedra of roast meat, almond, plaster of stone, Radix Bupleuri, the root of large-flowered skullcap, burdock, Rhizoma Seu Radix Notopterygii, grow licorice root. Daily Chinese medicine: Lotus flower clear acute communicable diseases capsule, silver yellow type preparation, oral preparation of a pair of the rhizome of Chinese goldthread. 2.Drug-pedlar's lung stomach symptom: Is it or cold, disgusting and vomiting, suffering from abdominal pain suffering from diarrhoea, having a headache, muscles to ache with evil to generate heat. Manage the law: Clear away heat and detoxify, resolve dampness and hit. Consult square medicine: Ge Gen, the root of large-flowered skullcap, the rhizome of Chinese goldthread, Rhizoma Atractylodis, wrinkled giant hyssop, ginger tuber of pinellia, Su Ye, thick Piao. Daily Chinese medicine: Radix Puerariae is connected with little pill, wrinkled giant hyssop healthy tendency preparation,etc. in Qin. 3.Poisonous to stop up angry camp's symptom: Hyperpyrexia, cough, not uncomfortable in chest to feel suffocated, breathe heavily, urge breathe hard, have the fidgets, coma delirious speech very person. Manage the law: Cool camp of clear air. Consult square medicine: Chinese ephedra of roast meat, almond, melon Lou, raw rhubarb, plaster of stone, Radix Paeoniae Rubra, water ox horn. Can select Ann for use if necessary palace cow bezoar pill and phlegm are hot and clear, the blood must be net, clear makes fairy, quiet parenteral solution of refreshment etc..


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