First battle flowing and making a definite diagnosis of right

First battle flowing and making a definite diagnosis of right
First battle flowing and making a definite diagnosis of right
Author: Clothing roc is small old jade-like stone H1N1 second wave of epidemic situations, are testing the system of original prevention and control again. September 21, World Health Organization (WHO) Secretary General Margaret Chan declares formally in Hong Kong, first type H1N1 influenza spreads in the whole world rapidly, second waves of spread has already begun. The situation that China faces is also very severe. The data of Press Office of Ministry of Public Health reveal, in over half of a month when since September, the national reported case has already increased by 9871, has already reached 13263 by the 21st, among them infect the case and take the overwhelming majority within the border. In the face of the fast-developing epidemic situation, over ten experts, academicianses from Beijing, Zhejiang, Chongqing and other places call upon collectively, " CDC (disease accuses of the centre) Delegate power " . Required at a Chinese Medical Association infectious disease seminar in the first ten days of September of theirs " Delegate power " ,Namely CDC should be transferred " Diagnose right " Give hospital that tests ability, permit these some hospitals to use " first type influenza measure reagent " Make a definite diagnosis of the patient. "Issuing reagent can shorten the procedure from confirming to accept for medical treatment greatly, try to treat time. " The intersection of Yunnan Province and the intersection of infectious disease and Fan, director of specialized department, that participate the meeting at that time move the mountain and say. At present, according to the relevant regulations of Ministry of Public Health, measure reagent and only circulate and accuse of the centre (CDC) at disease The network laboratory under the influenza monitoring system, every large hospital needs to transport the sample of the case to CDC and measure and make a definite diagnosis of. Transfer " Make a definite diagnosis of right " ? Fan moves the hospital where the mountain locates to two of Yunnan Province accept first for medical treatment and flow in one of the patient's hospitals by fixed position. Taking 21 H1N1 patients accepting for medical treatment at present in this hospital as examples, they mostly concentrate on generating heat on the 10th - the 11th of September, accepted for medical treatment formally on the 14th. Within these 3-4 days, all these were gone through and disinfected in the school by students' patients, transfer to Yunnan Province CDC and go to a doctor to confirm, and then transfer to the course of the section hospital of infectious disease of Yunnan. "It was the high fever one a few days ago of onset, if this time could treat as soon as possible, the result will be better, and easy to control spreading. " Fan moves the mountain and says. But for testing the authority is transferred, still face different opinions in the technical field. The intersection of Shanghai and counterpart of Fan, Shanghai public health clinical the intersection of Deputy Director and big continent Lu of centre much luckier. "Because there is national influenza that measure the network laboratory in our centre, possess and diagnose reagent, can make a definite diagnosis of the case by oneself, and accuse of the department for disease through the network report of influenza. " Lu HongZhou introduces. In Shanghai, more hospitals of fixed the first, second and third possess the condition of the laboratory, but under the present condition, still need to send the case sample gathered to disease and accuse of the central lab and make a definite diagnosis of. "We have called upon for a long time, but the health bureau requires finally that accuses of making a definite diagnosis of specially by accusing of the central lab in disease. " A relevant person in charge of hospital of Shanghai the first, second and third tells the staff reporter. According to " notice on further improving the measure of first type H1N1 influenza prevention and control of office of Ministry of Public Health " released on July 18, the example to having illness coming on in the area under one's jurisdiction continuously of every province-governed municipality, measure the result and can be regarded as the case the basis made a definite diagnosis of in the laboratory appointed in provincial health authorities. Not limited to CDC laboratory in the laboratory here. "Reagent is just tried out at the beginning, there is no detail to the relevant operation standard, cases are fewer too, accused of centre's diagnosing it is rational by disease, " National disease accused of the chief expert of central virology to only explain, if transfer to the hospital at the beginning, probably because reason of operation,etc. causes and misdiagnoses. As far as staff reporter know, swallow reagent, calculate in order to use generally at present, may make a definite diagnosis of within 6 hours ing quickly, and the patient needs to walk once again and making a definite diagnosis of the procedure before leaving hospital. " before this (first) Use such procedure to be right, but now has already reached second waves of situations, it is the first's to prevent spreading by a large scale, if can try every means to shorten the procedure, to preventing spreading will be beneficial to. " Fan moves the mountain and says. "In fact this reagent is open, it is not reagent of patent. " Introduces to the staff reporter that national disease accuses of centre's resisting first and flowing and synthesizing and coordinating a person in charge of group, because relevant management can only be made a definite diagnosis of by CDC clearly, Ministry of Public Health has just defined the standard to the laboratory qualified to make a definite diagnosis of. Once the light thought, though reagent was produced can not be tense, but existing reagent was basically paid through national funds, just used on the system by the national Ministry of Health, " this is a question of a traditional system " . Agree, let go of reagent, use only, " whether unnecessary to monopolize and diagnose, so long as the network keeps appearing in the newspaper " . As far as staff reporter know, already 7 of detection reagent which research institutions and enterprises produced together passed the test and assessment of the relevant department in July of this year, " but produced the written instructions or comments had never come down " ,A personage of relevant enterprise says, reagent patent is open, but the market of reagent has not unlocked yet at the moment. " too busy to do it " Laboratory Though has not responded it " Unlock " ,The relevant department has already begun to carry on in the system actively " Duplicate " . Soon after appearing from April of this year first type influenza, the Ministry of Health had already predicted that had developed with the epidemic situation, disease may present the question in short to accuse of in the detection laboratory in the system in the future. So, in mid-May, the formal ensuing chapters of Ministry of Public Health require all parts to draw up and set up the project that disease accuses of the central lab, and report to some hospital lists and click as the observation post. "We received one ' over 120 laboratories at that time, the lists of over 200 hospitals '. " One participates in disease among them to accuse of system personage's saying, should notify and is assigned on May 17, require that appears in the newspaper before the afternoon of the 19th. Have all placed on the diseases of some districts and cities and accused of the centre in 120 newly-built laboratories on the lists, still disease is accused of within the system. Can be regarded as according to average level, introduce a hardware apparatus price among 1 million - 2 million yuan in the laboratory. The hospital at the list is just regarded some as, monitored whistle at ordinary times and appeared in the newspaper information such as epidemic situation data at present, do not diagnose right. "We think, report sentry post to, it orders to be meaning diagnosed to decontrol originally, found finally it was not like this. " The above-mentioned disease accuses of personage's introducing. A media reports, under the present epidemic situation figure, a lot of CDC laboratories have already needed to catch up with the worker that very night before this, measure the case sample. "By the look of present epidemic situation change, even if duplicated rapidly, CDC must not be diagnosed over, next should delegate power to the lower levels diagnosing rapidly. " A national disease accuses of centre expert's saying. Until Fan move mountain, seem, let go of, diagnose can influence prevent and control wholly, " training of correlation technique uncomplicated, it is even stronger that large infectious hospital and hardware level of hospital of the first, second and third accuse of the centre than disease. And diagnose power disperses and treats the concentration of the place and can also run side by side. " To laboratory that expand already, Fan move the mountain, think even " yet The result arises " ,"Though Yunnan Province has expanded two points, capable of making a definite diagnosis of now, only provincial disease accuses of the centre, disease of the provincial capital accuses of not possessing either in the centre. " However, for testing the authority is transferred, still face different opinions in the technical field, worry with belonging to Yunnan infectious hospital, full-time Vice President Li Huizhen responsible for H1N1 to some extent. "If put to some hospitals, is unfavorable to the centralized infectious disease principle isolating for treatment, not probably easy to control then. " Li Huizhen thinks. Multiple-choice question that the financial resources provide Doing " unlocking " " duplicate " At the time of this multiple-choice question, the financial resources are probably the most important doing in the test amount factor. The situation according to staff reporter at present, " duplicate " The financial resources taken will be far greater than far " Unlock " ,And still lack enough expense guarantee. The staff reporter knows, are " duplicating " from authority Influenza was monitored in the course in the laboratory, the expenditure of the state revenue has already been greater than 200 million yuan, the direction mainly invested is the apparatus that is purchased laboratory. But the expense total value what, how much should be spent, at present is not very clear. In May of this year, the standing meeting of the State Council determined the state revenue arranged the special fund of public health of 5 billion yuan after should the epidemic situation flowed to first, Ministry of Public Health send it go to research institution, spend nearly one go to 6 provinces and cities to survey and study and prevent and control the situation of expense month. An expert participating in surveying and studying introduces, because departments involved are too many, it is very difficult to preventing and controlling the calculation of the expenses, and " it is higher than treating the expenses preventing and controlling the expenses " . Hereafter, the country adjusted the tactics of prevention and control, in order to treat the serious disease, controlled and spread it as the main fact. Also the expert points out, the with scarce and institutionalized expenditure doing in the test amount to expense of the public health emergency at present, to expand the intersection of laboratory and the easy to operate input, until how stand up existing utilization of resources such as the hospital at first, consider it is not enough. The deficiency of the financial resources, has also led to the fact the staffing of the relevant field is insufficient too. It is an example so as not to accuse of the key national influenza centre of the network, there are 300 staff members now in the similar organization of U.S.A.. And the national influenza centre is from establishing in 1984 to the present, " work out and maintain at 10, in addition about 20 specially engage personnel " . A personage in the know reveals. In this centre, fixed financial input only accounts for the expenditure and less than 30% every year in the country, there are 70% besidesing will support through applying for the domestic and foreign collaborative project constantly by researchers. "This is not very matched with public beneficial work that we are engaged in now. " The expert of the above-mentioned Ministry of Public Health says, " from SARS, to bird flu and even present first type influenza, we are calling upon constantly too, hope to set up agreeing on system in this respect. "


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