Beijing infectious disease surveillance system covers most of the country

The number of infectious disease surveillance systems in Beijing is the highest in China

Cover the entire period, the entire population, and the entire region; build a disease control network, covering the three links of epidemic monitoring, detection, and follow-up

The H7N9 bird flu in 2013, the Ebola epidemic in 2014, and the Middle East respiratory syndrome in 2015 ... Almost every year, the epidemic of major infectious diseases is a matter of urgency. As a cosmopolitan city, Beijing has a dense population and frequent international exchanges. In addition, new infections from abroad are often separated by only one aircraft cabin door. Once an outbreak occurs, the consequences are disastrous.

However, neither bird flu, Ebola, yellow fever or Rift Valley fever have ever spread in Beijing in five years. The killing of major communicable diseases on a case-by-case basis has benefited from the Beijing Tianaluodi Network, a disease control and control system constructed by the Beijing Public Health System. This large network covers the three links of epidemic monitoring, detection, and subsequent disposal.

【monitor】

Suspicious cases to report no more than 24 hours

This year, a total of 27 cases of H7N9 infection were found in Beijing. In order to prevent and control infectious diseases such as H7N9, it is important to identify and exterminate the source of infection. Early monitoring and identification are the cornerstones.

Taking H7N9 as an example, when a patient goes to a hospital for a diagnosis due to pneumonia, fever, etc., the doctor will ask him whether he has a history of live bird contact based on the corresponding judgment criteria of bird flu. If he suspects that the patient may be infected with bird flu, The information platform will be reported to the disease control center, and a series of measures such as isolation, disinfection, and virus sampling and detection will be carried out under the direction of the center.

In order to ensure that medical personnel see the doctors and screenings are correct, the CDC regularly carries out regular training for the relevant departments of the disease prevention and infection departments at all levels of medical institutions. At the high incidence of certain infectious diseases, training will be conducted frequently. On the desks of many medical personnel, there are reminder cards issued by the CDC. The above article lists the corresponding criteria for high-risk infectious diseases.

The "tenacity" of the monitoring system not only extends to all medical institutions above Class 1 in Beijing, but also includes more than 1,000 primary and secondary kindergartens, more than 300 parks and tourist attractions in Beijing, as well as swimming pools, hotels and restaurants. As long as there are suspected outbreaks, these sites will be reported to the CDC through the Internet, telephone, etc. at the first time.

At present, Beijing has divided its diseases and symptoms (early symptoms and no corresponding disease diagnosis) and established 78 infectious disease and health risk factors monitoring systems, including the infectious disease reporting system and symptom monitoring system. This is the largest number in China. The most comprehensive and sensitive monitoring system covers the entire time, the entire population, and the entire region. The system is always operating efficiently and will not exceed 24 hours from the occurrence of suspected cases to reports.

[detection]

Major hospital "acquisition" jointly built infectious disease detection network

The discovery of suspected cases is only the first step in the prevention and control of the epidemic. The ability of the laboratory to detect viruses will play a decisive role.

The virus laboratory, molecular biology laboratory, tissue culture room, and sample library ... entered the epidemic endemic control center of the Beijing Municipal Center for Disease Control and Prevention. It seemed to walk into the physical chemistry teaching building in the university. More than a dozen laboratories ranked In every corner of the floor.

"After sampling the patient, we will first extract the nucleic acid from it, which contains the genetic code of the organism. Since the nucleic acid is very microscopic, it is to be put into a PCR machine and amplified in increments of 2 n. This way, even if there is only one virus in the nucleic acid, we can find out.” Shi Weixian, the chief technician of the Beijing Municipal Center for Disease Control and Prevention, opened a case on the computer and pointed at the curve on the screen and told reporters: “This is the final analysis. As a result, the end of the curve is abnormally raised, which proves that it is positive."

PCR, automated workstations, second-generation gene sequencers... In a laboratory filled with “tall” devices, a sample test can be completed in 3-4 hours. However, even more advanced laboratories cannot take on all the flu samples.

According to Wu Shuangsheng, the chief physician of the Ministry of Transport, Beijing has a large area and a large population. The CDC equipment is limited. In order to reduce the time cost of sample transportation and prevent the spread of the epidemic, the Municipal Center for Disease Control and Prevention launched the Union Hospital and Beiyisanyuan Hospital. 38 hospitals with Chaoyang Hospital, which have the ability to detect and pass the appropriate assessments, are included in the network laboratory. These outlets can sample and upload the results in the hospital after sampling. The CDC then reviews the samples.

At present, Beijing has established 55 network laboratories, 23 measles network laboratories and 191 AIDS detection network laboratories, which constitute the Beijing infectious disease laboratory network and have the ability to carry out 56 infectious pathogenic microbe detections.

Little is known, in addition to the detection of infectious diseases, the Municipal Center for Disease Control and Prevention also has the ability to detect food pollutants, toxic and hazardous substances in the environment, toxicology testing, etc. Among them, the detection of specific chemical pollutants such as hormones in food is at the leading level in the country.

Shao Bing, director of the Center Lab, explained that for the worldwide problem of chemical food poisoning factor screening, the central laboratory has constructed a toxicology mass spectrometry library for circulating toxicants in China, and developed a search based on poisoning symptoms in cooperation with related hospitals. The database, which enables non-target screening of chemical food poisoning, reduced the analysis time of a single sample of traditional food poisoning from days or even months to hours. This technology has played an important role in the investigation of unexplained poisoning incidents such as "Beijing Huairoushan Bar Poisoning Incident."

[Disposal]

Confirming the source of infection "It's like criminal detection"

Shi Weixian was very impressed with a human case of H7N9 infection in Beijing in April this year.

On April 5th this year, a male patient living in Huairou was diagnosed with the H7N9 virus. The epidemiological survey conducted by the disease control personnel later revealed that the patient had a history of live poultry exposure. The Qingming Festival was back to Yanqing's hometown and younger brother. Reunion, bought seventy-eight chickens. According to this, his brother was diagnosed and found to be infected with H7N9. Afterwards, Yanqing carried out intensive monitoring in the surrounding area. A week later, one case of human infection with H7N9 was discovered.

Wu Shuangsheng introduced that the early monitoring, testing, and diagnosis of infected patients are not the most arduous tasks. The follow-up of the epidemic is the hardest. According to the requirements of the country, the case-producing area must carry out 10-day enhanced surveillance, and all cases of flu and severe acute respiratory infections that are accepted by all medical institutions above class 2 must undergo H7N9 virus detection, ranging from a few hundred cases to many. Thousands of cases. This year, Fangshan screened out the cases of infection during the enhanced monitoring period.

At the same time, the CDC staff must conduct a large number of episodes ("epidemiological investigations") to confirm the source of infection and prevent the further expansion of the epidemic. Take H7N9's follow-up epidemic situation as an example. If the infected person is a city-based resident and has a history of live poultry exposure, the staff needs to investigate the source of live poultry, whether there is a swap transaction, and the market stalls for their own homes and purchase live poultry are close. Contactors are required to perform sampling tests. Occasionally, one case will also involve multiple regions and a variety of live poultry sources.

"The whole process is like criminal investigation, to find the culprit and accomplices, and then the qualitative conclusion of the case." He said, simply a half-day will be able to "detect the case", complex time will be extended to a week.

【review】

Beijing disease control this 5 years

year 2013

A total of seven monitoring systems in Beijing, within 48 hours of successful discovery, treatment, control and traceability of a case of human infection with H7N9 avian influenza confirmed cases.

Year 2014

In the outbreak of Ebola in West Africa, the CDC developed and organized the Beijing Ebola Prevention and Control Plan for Hemorrhagic Fever and various prevention and control measures. It immediately discovered the report and quickly disposed of 43 cases of observing cases, which affected 5,633 epidemic areas. Country personnel to track and community health monitoring. At the same time, according to the arrangements of the National Health and Family Planning Commission, 6 batches of 7 public health experts have been dispatched to help prevent and control the Ebola outbreak.

May 2015

Korean Middle East respiratory syndrome was imported into Guangdong. The Municipal Center for Disease Control and Prevention organized targeted city-wide technical training, launched 55 network laboratories, and conducted simulated emergency drills for the prevention and control of respiratory diseases in the Middle East.

2016

Discovered and effectively handled the first case of yellow fever and Rift Valley Fever in the country; responded to the impact of the “Shandong Vaccine Incident”, achieved adjustment of poliovirus vaccine immunization strategies, implemented a class of vaccine insurance compensation mechanism, and completed the first national assessment by means of third-party assessments. The investigation of inoculation rate achieved full coverage of real-time monitoring of cold chain in Beijing.

Beijing News reporter Dai Xuan

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