疑似病例防控
国家卫生健康委在2020年1月22日发布的《新型冠状病毒感染的肺炎防控方案(第二版)》中,明确提出了新冠肺炎病例监测方案、流行病学调查方案、可疑暴露者和密切接触者管理方案以及实验室检测技术指南,提出加强组织领导、病例发现与报告、流行病学调查等9项防控措施,指导各级各类医疗机构、各级疾控机构开展病例监测、发现和报告工作。根据该防控方案,疑似病例的定义为:有三项临床表现,即发热,具有肺炎影像学特征,发病早期白细胞总数正常或降低,或淋巴细胞计数减少;同时,具有发病前14天内有武汉旅行史或居住史,或发病前14天内曾接触过来自武汉的发热伴有呼吸道症状的患者,或有聚集性发病或与确诊病例有流行病学关联等任何一项流行病学史的患者。
该防控方案指出,医疗机构发现符合疑似病例、确诊病例定义的患者时,应按要求开展流行病学调查、进行临床标本采集与相关病原检测;加强隔离、消毒和防护工作,对疑似病例进行单间隔离治疗。
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.