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The author:(作者)归海一刀
published in(发表于) 2014/1/30 6:35:38
Zhejiang H7N9 three infections， experts said an outbreak of Spring Festival will not

　　7 q H7N9 festival fun

So far this year China has H7N9 avian influenza 110 cases of confirmed human infections, including Zhejiang, Guangdong, Shanghai, 20 cases of death. Recently, the number added each week H7N9 avian flu confirmed cases of infection in China is close to the peak of the outbreak last year levels.

Chinese new year is approaching, H7N9 avian flu suddenly entered a period of high risk, took place in a family of three in succession of Xiaoshan in Zhejiang infections provoke "person to person" concerns.

How to understand the limited non-sustained person to person? Increase in the mass movement of people infected during the Spring Festival?

This morning, many doubts public H7N9, many experts responded.

Experts point out that H7N9 viruses cannot be transmitted effectively in the crowd. No outbreaks of human infection H7N9 avian influenza outbreak during the lunar new year.

　　Support specialist

Feng Zijian, China CDC Deputy Director National Influenza Center director Li Shu Yue Dragon thrive at Beijing Ditan Hospital Director of infectious disease diagnosis and treatment center

　　"Key words: every spring"

Question 1

Why a rapid increase in the number of infection near the Spring Festival? Diseases concentrated is the movement of people during the Spring Festival in Guangdong and Zhejiang provinces most active areas, infections increase during the Spring Festival?

Feng Zijian: poultry consumption levels of transmission of the virus among poultry has relationships H7N9 H5N1 and other avian influenza have a similar seasonal pattern, is high in winter and spring.

H7N9 avian flu is not a person-to-person transmission of the disease, is a disease spread from poultry to humans, so the movement of persons does not increase the risk of infection.

Latest new human infection H7N9 avian flu clinic H7N9 transmission mentioned in the programme is spread by respiratory secretions or close contact with infected poultry or droppings have acquired her infection; or spread to people through contact with contaminated environment; do not rule out limited non-sustained person to person.

　2 q

　　Will spread it during the Spring Festival?

Shu Yue Dragon: the virus had not changed, does show that it is hard to spread effectively from person to person, it's still a process of poultry to humans. Cases will continue to increase, but throughout the massive proliferation of this situation does not occur during the Spring Festival.

H7N9 H5N1 infection, and case-fatality rate of 20% per cent. And H7N9 avian has no obvious symptoms of infection, it is difficult to identify so H7N9 more difficult to control than H5N1. We cannot accurately predict H7N9 variation direction, must continue to strengthen monitoring.

　"Key words: person to person"

3 q

How to understand the limited non-sustained person to person?

Feng Zijian: limited of people descendants is occasionally occurred of II generation cases, occurred two generation patients, rarely, or almost does not occurred three generations above of patients appeared, this is limited of people descendants; relatively, continued of people descendants or effective of people descendants, can appeared more generation patients, a can pass several a, or three generations patients four generation patients, more algebra of patients, can see community of outbreaks, this called continued of people descendants.

H7N9 244 cases now confirmed cases of infection, and indeed there have been a few second generation patient, but there were three generations of patients.

H7N9 currently person-to-person ability at what level?

Feng Zijian: we have a dedicated to describe this limited epidemiological indicator of person-to-person and sustained person-to-person transmission, called basic communication or base the number.

Based spread is an indicator of R0, efficient person-to-person transmission when the R0 must be greater than one, on average, a patient or an infectious disease can pass on average more than one, the disease can spread among the crowd, this is called a sustained person-to-person transmission. When R0 is smaller than 1, it is unlikely to continue to spread, is broken. H7N9 avian flu transmitted from person capacity R0 is 0.09, were very low, epidemiologically explains the limited person-to-person transmission.

　　"The key word: early detection"

5 q

Awareness of how many current H7N9 avian flu virus? Not all live birds have spread the risk?

Feng Zijian: currently scientists on H7N9 virus of consensus has following several points: a is virus up stems from poultry, main in poultry class in the pop, people just in accidentally situation Xia contact poultry class or virus infection; II is and H5N1 virus compared to, H7N9 virus more easy infection people; three is H7N9 virus still no from avian influenza virus of features, does not like seasonal influenza as in room widely spread; four is pathogenic sexual comparison strong, easy led to heavy syndrome infection.

　6 q

How to better early detection and early treatment?

Li Xingwang: We knows now up Philip or also is panamiwei or, and zanamivir or, this class anti-virus drug on influenza virus is has effect of, but premise is more early with more good, so this on requires we clinical doctor, once you think this patients has influenza symptoms, we now more stressed of is has fever, and has cough this Xia respiratory of symptoms, like suddenly has heat 39 degrees, and accompanied by cough, symptoms on the caused attention.

In this case, we are even in the negative proposition given anti-viral treatment, so that we can reduce the incidence of severe patients. General influenza, especially in front of these high-risk groups, such as the elderly, pregnant women with underlying diseases, late including big fat called a high risk population, once flu symptoms with antiviral medications, don't worry he is human influenza and avian flu are treated.

　　"Key words: infection control"

7 q

H7N9 vaccine ever new developments, how the public good defence to avoid infection?

Shu Yue Dragon: currently, some enterprises have basically completed the human infection H7N9 avian influenza vaccine clinical research, has begun to drug regulators declared.

Li Xingwang: at present, the susceptibility of Fe still has H7N9 avian flu virus.

Feng Zijian: I reminded the general public consumers try to avoid contact with live birds, to purchase white chicken, chilled chickens instead of consumption to purchase live poultry directly to slaughter on the market, in the process of slaughtering live poultry, and when it's difficult to avoid contact with live birds, once you wash your hands as soon as possible after contact can also reduce the risk of infection.

In particular to remind that elderly patients with low immunity, to avoid contact with live birds.

/Journalist Wang TINGTING partially integrated central canton

　　7问H7N9赶春节凑热闹

　　今年以来，全国已确诊人感染H7N9禽流感病例110例，其中浙江、广东、上海死亡20例。近期，我国每周新增人感染H7N9禽流感确诊病例数已接近去年疫情高峰时期水平。

　　春节将至，H7N9禽流感突然进入高发期，发生在浙江萧山的一家三口相继感染发病再度引发“人传人”的担忧。

　　如何理解有限的非持续的人传人？春运的大规模人员流动会使感染人群增多吗？

　　今天上午，针对公众对H7N9存在的诸多疑问，多位专家进行了回应。

　　专家们指出，H7N9病毒还不能在人群中有效传播。春节期间不会暴发人感染H7N9禽流感疫情。

　　支持专家

　　冯子健 中国疾控中心副主任舒跃龙 国家流感中心主任李兴旺 北京地坛医院感染性疾病诊疗中心主任

　　【关键词：逢春运】

　　1问

　　为什么临近春节感染人数增加较快？疫病集中的广东和浙江两省正是春运人员流动最活跃的地区，春运会使感染人群增多吗？

　　冯子健：禽类消费量禽间的病毒的传播水平都有关系，H7N9和H5N1这样其他的禽流感有类似的季节性特征，就是冬春季高发。

　　H7N9禽流感不是一个人传人的疾病，是一个从禽到人传播疾病，所以人员的流动不会增加感染的风险。

　　最新公布的新版《人感染H7N9禽流感诊疗方案》中提到H7N9的传播途径是可经呼吸道传播或密切接触感染禽类的分泌物或排泄物而获得感染；或通过接触病毒污染的环境传播至人；不排除有限的非持续的人传人。

　　2问

　　春节期间会大扩散吗？

　　舒跃龙：这个病毒没有变，没有变显示它难以在人与人之间有效传播，它仍然是一个禽到人的过程。病例还会持续增加，但是在整个春节期间大规模扩散这个情况不会发生。

　　H7N9比H5N1更易感染人，病例死亡率达20%至30%。而且感染H7N9的禽类并无明显症状，不易识别，所以H7N9比H5N1更难防控。我们无法准确预测H7N9的变异方向，必须继续加强监测研究。

　　【关键词：人传人】

　　3问

　　如何理解有限的非持续的人传人？

　　冯子健：有限的人传人就是偶尔发生的二代病例，发生两代病人，很少，或者几乎不会发生三代以上的病人出现，这就是有限的人传人；相对而言，持续的人传人或者有效的人传人，可以出现多代病人，一个可以传若干个，或者三代病人四代病人，更多代数的病人，能看到社区的暴发，这叫持续的人传人。

　　在目前已经确诊的244例H7N9感染病例中，确实出现了几例二代病人，但没有出现一例三代病人。

　　H7N9目前人传人的能力究竟处在什么水平？

　　冯子健：我们流行病学上有一个专门来描述这个有限的人传人和持续的人传人的指标，叫做基本的传播数或者叫基础传播数。

　　基础传播数就是R0这样的一个指标，有效的人传人的时候，这个R0一定要大于一，平均一个病人或者一个传染病平均可以传一个以上，这个病就可以持续在人群中传开了，这叫持续的人传人。当然这R0小于1的时候，它就不可能持续传开，传着就断了。这个H7N9禽流感它的人传人能力R0是0.09，是非常低，从流行病学解释了有限的人传人。

　　【关键词：早发现】

　　5问

　　目前对H7N9禽流感病毒的认知有多少？是不是所有活禽都有传播风险？

　　冯子健：目前科学家关于H7N9病毒的共识有以下几点：一是病毒起源于禽，主要在禽类中流行，人只是在偶然情况下接触禽类或病毒感染；二是与H5N1病毒相比，H7N9病毒更容易感染人；三是H7N9病毒仍没有脱离禽流感病毒的特点，不会像季节性流感一样在人间广泛传播；四是致病性比较强，容易导致重症感染。

　　6问

　　如何才能更好地及早发现，及早治疗？

　　李兴旺：我们知道现在达菲也好还是帕那米韦也好、扎那米韦也好，这类抗病毒药物对流感病毒是有效果的，但是前提是越早用越好，所以这就要求我们临床医生，一旦你觉得这病人有流感症状，我们现在更强调的是有发烧、有咳嗽这种下呼吸道的症状，比如突然有高热39度、伴有咳嗽等症状就该引起重视。

　　这种情况下，即使检测阴性的我们也是主张给予抗病毒治疗，这样我们才能够降低重症病人的发病率。就是一般流感样病例，尤其是前面这些高危人群，比如像老年人、有基础疾病的、晚期的孕妇包括大胖子这样的人叫做高危人群，一旦有流感症状就要用抗病毒药物治疗，不要管他是人的流感还是禽的流感都要治疗。

　　【关键词：防感染】

　　7问

　　H7N9疫苗研制有没有新进展，公众如何做好防护，避免感染？

　　舒跃龙：目前，一些企业基本完成了人感染H7N9禽流感疫苗的临床研究，已经开始向药品监管部门申报。

　　李兴旺：目前，H7N9禽流感病毒对达菲仍具有敏感性。

　　冯子健：我还是提醒一般的市民消费者尽量避免活禽的接触，去采购消费白条鸡、冰鲜鸡代替到市场上采购活禽直接来宰杀，宰杀活禽的过程中、接触活禽的过程中如果难以避免的话，一旦接触之后尽快洗手也可以降低感染的风险。

　　尤其要提醒的是老年人等免疫力低下的患者，要避免活禽的接触。

　　文/记者王婷婷 部分综合央广

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