流行性细菌性脑膜炎和乙型脑炎监测项目课件.ppt

Epidemic Bacterial Meningitis and Japanese Encephalitis Surveillance Project流行性细菌性脑膜炎和乙型脑炎监测项目 Surveillance System Overview监测系统总结 Dr. Stephen Hadler, MDWHO China 世界卫生组织驻华代表处April 2007 Outline of this presentation 提纲 Objectives of field surveillance for meningitis and encephalitis 脑膜炎和脑炎现场监测的目的 Clinical presentations and case definitions临床表现和病例定义 What do surveillance staff do?监测人员需要做什么？ What does a hospital focal point do?医院监测负责人需要做什么？ Specimen collection, prioritization, aliquoting and transport 标本采集、优先性、分装和运送 Objectives of Meningitis / Encephalitis Surveillance 脑膜炎和脑炎监测的目的 Identify all cases of meningitis and encephalitis in project areas 发现项目地区所有的脑膜炎和脑炎病例 Rapidly identify and investigate outbreaks 迅速发现和调查爆发 Assure prompt laboratory investigation of each case in sentinel hospitals 保证哨点监测医院的每个病例立即进行实验室方面的调查 Complete case investigations for all cases 对所有病例完成病例调查 Sentinel hospitals– full investigation 哨点监测医院-全面调查 Other hospitals – key clinical and laboratory information 非哨点监测医院-关键临床和实验室信息 Clinical Presentations and Case definition 临床表现和病例定义 Case Definition of Acute Encephalitis Meningitis Syndrome (AMES) 急性脑炎脑膜炎综合症(AMES)病例定义 A case of acute meningitis encephalitis syndrome is defined as a person of any age, at any time of year, with the acute onset of: 急性脑炎脑膜炎综合症被定义为任何年龄、一年中任何时间急性起病，有下列表现者：1. Fever 发热[1]  WITH 伴有 2. Change in mental status 精神状态的改变 [2] [3]  AND / OR 和/或 3. Meningeal signs, neck stiffness, headache 脑膜刺激征、颈项强直、头痛[1] Usually 38.5 °C rectal or 38.0 °C axillary 通常直肠体温 38.5 °C 或腋下体温 38.0 °C [2] Symptoms like new onset seizures, confusion, disorientation, coma, somnolence, irritability or inability to talk, abnormal behavior greater than that seen with usual febrile illness 如新发惊厥、精神混乱、定向障碍、昏迷、嗜睡、易激惹或不能讲话，常见发热性疾病少见的异常行为 [3] Excluding simple febrile seizures 排除单纯的发热性惊厥 Distinguishing Encephalitis and Meningitis 脑炎和脑膜炎的鉴别 It is often not possible to distinguish encephalitis