2017年第48期急性传染病疫情及防控工作舆情监测 (2017年11月25日-12月1日)

十院院感疾控处2018-12-04 09:17:35

【目录】

【本期内容摘要】

【呼吸道传染病及防控动态】. 4

禽流感疫情周報(香港卫生署卫生防护中心). 4

日本发现H5N6型高致病性禽流感病毒基因不同有扩散风险. 4

韩国检疫部门:新型H5N6禽流感入韩病源或为野鸟. 5

为防禽流感安徽省5市主城区将逐步取消活禽交易. 5

湖南流感、腮腺炎高发医院日均接诊患儿千余人. 6

Catalonia: Legionella kills two in Blanes7

Measles outbreak reported in Birmingham. 7

Diphtheria: Crises in Yemen and Venezuela result inre-emergence8

【肠道传染病及防控动态】. 9

美国加州爆发20年来最大规模甲肝疫情,已致21人死亡. 9

Utah hepatitis A outbreak update: 75 percent from Salt LakeCounty9

Malaysia: Nine typhoid cases reported in Sarawak10

(香港)旺角食肆懷疑食物中毒個案最新情況. 10

【自然疫源及虫媒传染病及防控动态】. 11

Plague – Madagascar11

香港新增两宗登革热确诊个案患者曾访大马等地. 15

泰国发现一例炭疽病感染患者. 15

Kenya: 100 people treated for anthrax in Bomet15

Monkeypox: 14 additional cases reported in Nigeria outbreak16

Mauritania: CCHF case reported outside of Nouakchott16

研究称可从皮肤中检测出“疯牛病”. 16

【寄生虫病及防控动态】. 17

南昌赣江流域发现大面积钉螺已启动血吸虫病突发疫情三级响应. 18

【其他公卫相关事件及防控动态】. 18

全球3670万人感染艾滋病中国发病数是6年前3倍多. 18

外交部紧急提醒中国公民近期谨慎前往巴厘岛旅行. 19

日本调查称服用克流感病童易出现异常行为. 19


本期热点摘要

呼吸道传染病及防控动态

1、2017年11月19日至25日,國家衞生和計劃生育委員會没有报告新增人感染甲型禽流感(H7N9)個案;沒有新增人類感染甲型禽流感(H5N6)個案;沒有公布新增人感染甲型禽感(H5N1)個案。

2、日本在从岛根县松江市宍道湖湖畔发现的野鸟尸体中检出了H5N6型高致病性禽流感病毒,该病毒与迄今在日本流行的病毒有部分基因存在差异,很可能是由上季在欧洲韩国检疫部门流行的病毒与欧亚大陆的野鸟所携带的病毒基因部分混合而成。

3、韩国检疫部门通报:一种新型的高致病性H5N6禽流感病毒株从10月开始通过迁徙的野鸟进入韩国,导致韩国近期禽流感疫情爆发;该病毒株是由两种病毒基因重组而来,分别是去年在欧洲大肆传播的高致病性H5N8病毒,以及在野鸟间传播的低致病性H3N6病毒。

4、安徽省合肥、芜湖、安庆、马鞍山、铜陵等5 市要全面推行禽产品冰鲜上市,对主城区内人口密集的农贸市场,逐步取消活禽交易。

5、流感、腮腺炎流行季节来临,湖南中医附一儿科门诊急诊患儿数量在千余人左右,大部分的孩子都是感冒发烧咳嗽,还有一些读书的孩子则是腮腺炎。

6、西班牙加泰罗尼亚公共卫生署通报两例军团菌死亡病例,目前病例总数已达到19例;卫生部门已采集了37个高危设施的78个样本以及16个低风险设施的25个样本开展检测工作,同时建立了设施的清洁与消毒效果跟踪评价机制;目前发现了1个高危设施与5例病例之间的联系,相关调查工作仍在继续。

7、英国伯明翰报告9名麻疹确诊病例,当地卫生官员呼吁公众接种疫苗。

8、由于战争以及地方冲突,也门、委内瑞拉再现白喉危机:2017年11月16日,世界卫生组织通报也门在过去几周报告120例白喉病例以及14例死亡病例,其中大部分是儿童;截止2017年42周,委内瑞拉共报告白喉可能病例511例,对88.5%的可能病例进行了样本采集工作,阳性率为32.3%,这些实验室确诊病例涉及17个联邦地区。


肠道传染病及防控动态

9、美国加州暴发20年来最大甲肝疫情,已发现600多个病例,其中21人死亡;暴发原因可能归咎为流浪人口聚集区较差的卫生状况以及较低的甲肝疫苗接种水平。

10、美国犹他州甲肝疫情已报告确诊病例95例,大部分病例为无家可归者或吸毒人员;87例病例为暴发疫情相关病例,约76%的病例为盐湖城县报告。病毒测序显示数个病例毒株与加利福尼亚州和亚利桑那州州的甲肝暴发疫情的毒株相同。

11、马来西亚卫生部门通报Sarawak本月报告9例伤寒病例,所有病例均已住院治疗,没有死亡病例报告;当地初步调查结果显示病例的发生可能与当地供水系统功能异常有关,目前相关设施修复工作正在进行。

12、香港衞生署衞生防護中心就11月20日旺角一食肆的三宗懷疑食物中毒個案公布調查進展:確認五宗新增個案,該食肆近期錄得共八宗個案,涉及30人全部受影響人士情況穩定;流行病學調查顯示,大部分受影響人士曾於該食肆進食鹵味;署方已通知食物環境衞生署相關新增個案,調查仍然繼續。


自然疫源及虫媒传染病及防控动态

13、2017年8月1日至11月22日,马达加斯加卫生部向世界卫生组织报告鼠疫疑似病例、临床诊断病例以及确诊病例共2348例,其中死亡202例,病死率为8.6%:肺鼠疫报告数为1791例(22%为确诊病例、34%为临床诊断病例、44%为疑似病例),腺鼠疫报告数为341例,败血症鼠疫为1例,另有215例无明确说明。

14、香港特区卫生防护中心本月10日至23日,录得两宗登革热确诊个案,病人于潜伏期曾到马来西亚等地。截至23日,香港今年共录得97宗登革热确诊个案,其中一宗为本地个案,96宗外地传入个案主要从泰国、菲律宾、斯里兰卡及越南传入。

15、泰国公共卫生部28日通报在位于曼谷西北约470公里、与缅甸接壤的莱兴府美索地区发现一例村民感染炭疽病例;调查称该患者在屠宰了从邻国走私到泰国的山羊之后感染了炭疽杆菌,其他相关人员的检测结果尚未最终确定。

16、肯尼亚新闻来源报道,由于宴会上出现被炭疽杆菌污染的牛肉,导致约100人在BometLongisa County Referral医院接受抗菌治疗,在这份报道中并没有提到是否在牛肉或者患者身上检测出炭疽杆菌。

17、11月25日前一周,尼日利亚卫生部门报告新增猴痘确诊病例14例,导致9月以来的确诊病例总数达到56例,新出现的病例来自Benue (1), Cross River (3), Edo (1), FCT (2), Imo (2), Katsina (1),Nasarawa (1) and Rivers (3);其中首次报告猴痘病例的州为Imo, Katsina Nasarawa自疫情爆发以来,已从21个州和联邦首都地区记录了155个病例(疑似和确诊病例)。

18、毛里塔尼亚卫生部上周报告了一名来自首都Nouakchott郊区Dar Nairn地区Haye Sakin社区 的克里米亚刚果出血热病例,患者男性,48岁,农民,于11月11日发病。

19、《科学转化医学期刊》(Science Translational Medicine)的报告称可以在皮肤中检测到“疯牛病”,即新变异型克雅氏病(CJD)中破坏人类脑部的变异蛋白质;但皮肤中的异常蛋白质朊病毒含量比大脑含量低1千至10万倍,这个快速发展的致命病症不太可能通过偶然接触所传播。


寄生虫病及防控动态

20、南昌市疾控部门在赣江流域开展例行调查时,在南昌市西湖区滨江公园区域江滩发现大面积钉螺;目前疾控部门已捕获钉螺1186只,其中活螺1075只,并进行了流行病学调查和实验室检测,未发现阳性钉螺。南昌市已启动血吸虫病突发疫情三级响应。


其他公卫相关事件及防控动态

21、到目前为止,艾滋病毒已造成全球3500多万人死亡;去年,全球有100万人死于艾滋病毒相关病症。非洲区域病情最严重,去年艾滋病毒新发感染数占全球的近三分之二。2010年至2016年,中国艾滋病发病数和死亡人数总体呈上升趋势。今年1月至10月,发病数已达46206例,是2010年全年发病数的近3倍。

22、由于印尼阿贡火山持续活跃并不断喷出火山灰和烟雾,可能随时喷发岩浆,外交部领事司和中国驻登巴萨总领馆提醒中国公民近期谨慎前往巴厘岛旅行,在巴厘岛的中国公民保持高度警惕。

23、日本厚生劳动省的调查指出,年幼的流感患者服用感冒药克流感(tamiflu)后出现异常行为的案例越来越多,提醒民众加强幼童护理。


呼吸道传染病及防控动态

禽流感疫情周報(香港卫生署卫生防护中心)

2017-11-28

報告周期:2017年11月19日至25日

1. 自上一期禽流感疫情周報,沒有新增人類感染甲型禽流感(H7N9)個案。最新一宗個案於2017年9月15日報告。自2013年3月(截至2017年11月25日),全球共報告1564宗人類感染甲型禽流感(H7N9)個案(包括766宗在2016年10月1日至2017年9月30日的第五波疫情報告)。

2. 自上一期禽流感疫情周報,沒有新增人類感染甲型禽流感(H5N6)個案。自2014年(截至2017年11月25日),國家衞生和計劃生育委員會(國家衞生計生委)共報告17宗人類感染甲型禽流感(H5N6)個案,所有個案均在中國內地發生。最新一宗個案於2017年11月20日報告。

3. 自上一期禽流感疫情周報,沒有公布新增人感染甲型禽感(H5N1)個案。由2011至2016年,每年有10至145宗確診人類感染甲型禽流感(H5N1)個案呈報給世界衞生組織(世衞) (根據發病日期計算)。2017年至今共有3宗在埃及發生和1宗在印尼發生的個案。最新一宗個案於2017年9月27日報告。

http://www.chp.gov.hk/files/pdf/2017_avian_influenza_report_vol13_wk31_chi.pdf


日本发现H5N6型高致病性禽流感病毒 基因不同有扩散风险

2017-11-30

【环球网综合报道】日本共同社11月29日报道称,日本在从岛根县松江市宍道湖湖畔发现的野鸟尸体中检出了H5N6型高致病性禽流感病毒。鸟取大学28日透露解析结果称,该病毒与迄今在日本流行的病毒有部分基因存在差异。鸟取大学呼吁人们“警惕疫情扩散”。

鸟取大学公共卫生学教授伊藤寿启称,此次的病毒虽然与上季流行的H5N6型为同一类型,但在对病毒基因进行详细解析后发现,它很可能是由上季在欧洲流行的病毒与欧亚大陆的野鸟所携带的病毒基因部分混合而成。

该病毒可能由候鸟带入日本。伊藤表示,“若有大量野鸟感染,家禽等感染概率也会上升”。

报道称,由于与之前的病毒基因存在差异,鸟类的免疫系统或将难以发挥作用,可能导致疫情扩散。此次的基因解析还表明,传染给人类的可能性应该较低。

http://world.huanqiu.com/exclusive/2017-11/11411449.html


韩国检疫部门:新型H5N6禽流感入韩 病源或为野鸟

2017-11-28

韩国检疫部门周一(27日)证实,一种新型的高致病性禽流感病毒从10月开始通过迁徙的野鸟进入韩国,导致韩国近期禽流感疫情爆发,该病毒是由去年在欧洲大肆传播的病毒株基因重组而来。

据《韩国先驱报》报道,韩国动物检疫机构声明,11月17日在韩国全罗道发现了禽流感疫情,调查结果显示,病毒很可能是由迁徙的野鸟带来韩国境内的。

该机构通报称,“从十月份开始,一种由基因重组而产生的新型病毒株通过冬季迁徙的野鸟进入韩国”,“韩国已经组建了一个联合调查小组,从852只死亡家禽以及野鸟的尸体和粪便中分离病毒株,进行比对和分析,试图找出此次禽流感疫情爆发的缘由”。

基因组分析显示,造成此次疫情的是一种新型的H5N6病毒株,该病毒株是由两种病毒基因重组而来,分别是去年在欧洲大肆传播的高致病性H5N8病毒,以及在野鸟间传播的低致病性H3N6病毒。

韩国检疫部门称,这种新型病毒株的基因序列与韩国去年以及今年早些时候爆发的几起禽流感病例中发现的病毒有不同的模式。

据此前报道,11月17日,韩国全罗道一家养鸭场发生H5N6亚型高致病性禽流感。该农场有大约12000只鸭子,所有的鸭子事后都被宰杀。这是自今年6月以来该国首次出现此类疫情。

离平昌冬奥会开幕越来越近,为避免疫情给冬奥会的成功举办带来不利影响,相关部门已经进入紧急状态,并将禽流感警戒提到最高级别。 

http://news.foodmate.net/2017/11/450711.html


为防禽流感 安徽省5市主城区将逐步取消活禽交易

2017-11-28

日前,《安徽省人民政府办公厅关于促进家禽产业转型升级健康发展的意见》(以下简称《意见》)正式印发,其中提到,合肥、芜湖、安庆、马鞍山、铜陵等5 市要全面推行禽产品冰鲜上市,对主城区内人口密集的农贸市场,逐步取消活禽交易(本报11月23日报道)。不少市民给本报来电提出疑问:为何要在这些城市取消活禽交易呢?这是否就意味着以后在农贸市场买不到活禽了?就此,记者采访了相关部门。

讲原因这一措施是为了防疫

省农委畜牧局相关负责人介绍称,政府出台这一《意见》,在合肥、芜湖、安庆、马鞍山、铜陵等5 市要全面推行禽产品冰鲜上市,对主城区内人口密集的农贸市场,逐步取消活禽交易。这一措施与去年下半年至今年上半年的H7N9人感染禽流感疫情相关。根据专家研究显示,人感染禽流感疫情与市场活禽交易有正向关系,市场污染面越大,人感染越多。而实践也证明,在疫情高发季节和高发地区,关闭活禽市场是有效避免人与活禽接触,减少人群暴露和感染的最重要措施。

对于降低发病,控制高峰,可以起到立竿见影的效果。

据了解,许多发生疫情的地区都采取了多种形式的活禽市场管理措施,我省此次出台《意见》,推行禽产品冰鲜上市,并选择在工业化程度较高的合肥等5个城市主城区逐步取消活禽交易,也是基于保护公众健康和维护公共卫生安全的考虑。

谈执行不一定非要完全取消

对主城区人口密集的农贸市场逐步取消活禽交易,那是不是意味着以后老百姓在市场上再也买不到活禽了?省农委畜牧局相关负责人表示,如果疫情控制效果好,且老百姓消费活禽意愿强烈,将根据实际情况酌情推行,并不会彻底取消。

事实上,参考外地经验,彻底取消活禽交易的城市也不多见,大多选择一定区域或一定季节取消活禽交易。比如上海市根据对禽流感等疫情的预测和预警以及对季节性发病规律的评估,自2014 年起,每年农历正月初一至公历四月三十日全市暂停活禽交易。南京市规定主城区活禽交易市场全部关闭,活禽集中在郊区屠宰,全程冷链配送进城;郊区则可定点交易。浙江省则于2014 年规定在设区市的主城区永久关闭活禽交易市场。

http://ah.ifeng.com/a/20171127/6181834_0.shtml


湖南流感、腮腺炎高发 医院日均接诊患儿千余人

2017-11-30

华声在线11月28日讯  流感、腮腺炎流行季节来临,湖南中医附一门诊办主任倪秋华今天告诉记者,近期儿科一天的门诊、急诊患儿数量在千余人左右,大部分的孩子都是感冒发烧咳嗽,还有一些读书的孩子则是腮腺炎。

湖南中医中医附一儿科副主任谢静介绍,患儿中乙型流感较多,家长们要格外注意预防。流感通常有1~3天的潜伏期,当开始出现症状时,主要表现为突然起病的高热、寒颤、头痛、肌肉疼痛、全身不适,发热要持续3—5天才退;普通感冒则主要表现为喷嚏、流涕、咳嗽等上呼吸道局部症状。因此,流感的症状往往比普通感冒要重,即使发热退了,患者还是可以感到明显的乏力。

http://news.voc.com.cn/article/201711/201711291632461528001.html


Catalonia: Legionella kills two in Blanes

November 25, 2017

Two people have died inthe Blanes Legionairres’ disease outbreak, according to the Public HealthAgency of Catalonia (ASPCAT). The outbreak case total now stands at 19.

To date, the ASPCAT haveinvestigated a total of 37 high-risk facilities (cooling towers and hot waterinstallations with return) in which they have taken 78 samples, according toa La Vanguardia (computer translated). Together with the city council, they have also investigated 16low-risk facilities (such as ornamental fountains, sprinkler irrigation, urbancleaning vehicles or non-return water installations) in which they analyzed 25samples. In parallel, they have dictated cleaning and disinfection measures ofthe facilities and are making an analytical follow-up of the evolution of thesefacilities.

In the molecular studies thatallow to compare the environmental and human strains, they have detected aconcordance between one of the high-risk facilities and five of the cases ofthe outbreak. All were infected before starting the control actions. Theinvestigation continues with establishing whether the cases that are beingstudied in the investigation of the outbreak have been due to exposure to asingle origin. The ASPCAT has also initiated the pertinent administrativeactions to determine the responsibilities derived from this outbreak.

http://outbreaknewstoday.com/catalonia-legionella-kills-two-blanes-43367/


Measles outbreak reported in Birmingham

November 28, 2017

Nine children have beenconfirmed positive for measles in Birmingham, prompting local health officialsto call on the public to get vaccinated, according toa local media report.

Public Health England (PHE)West Midlands tweeted earlier today that they are working with the Birmingham CityCouncil to ensure the word gets out about the MMR vaccine.

Dr Bharat Sibal, a PHEconsultant said, “The free MMR vaccine is a safe and effective way ofprotecting against measles, as well as mumps and rubella. It’s particularlyimportant for parents to take up the offer of MMR vaccination for theirchildren when offered at one year of age and as a pre-school booster at threeyears, four months of age.

“If children and young adultshave missed these vaccinations in the past, it’s important to take up thevaccine now from GPs, particularly in light of the recent cases in Birmingham.”

http://outbreaknewstoday.com/measles-outbreak-reported-birmingham-19775/


Diphtheria: Crises in Yemen and Venezuela result inre-emergence

November 25, 2017

War and conflict in Yemen andin Venezuela, a socialistic government and resulting economic and social chaosthat goes hand-in-hand with that form of government, has caused a destruction ofexisting health care systems and an interruption in vaccinations among thepopulation.

The EuropeanCentre for Disease Prevention and Control (ECDC) recently reported the latest diphtheria situations in those desperate countries.

Yemen

On 16 November 2017, WHOreports 120 clinically cases of diphtheria and 14 deaths in past weeks inYemen, mostly in children. At least one million children are currently at riskof contracting diphtheria as a result of the unavailability of vaccines andmedicines in Yemen.

Diphtheria is endemic inYemen. The last recorded cases were in 2013. According to UNICEF , thepercentage of surviving infants who received the 1st and 3rd dose of diphtheriaand tetanus toxoid with pertussis containing vaccine (DTP1/DTP3) in the lastten years was between 81% and 88%.

Venezuela

In Venezuela, in 2017, as ofweek 42, 511 probable diphtheria cases were reported. Samples were taken from452 of the cases (88.5%), of which 146 (32.3%) were laboratory confirmed (69 byisolation and determination of toxin production by Elek test and 38 byPolymerase Chain Reaction). The confirmed cases were reported in 17 federalentities.

According to the reportprovided by Venezuelan authorities, from January to September 2017, vaccinationcoverage in children under one year of age reached 68%, and 42% of childrenaged five had the booster. The Venezuela Ministry of Health has intensifiedvaccination against diphtheria as part of the national plan. Nine million dosesof the vaccine are available for this activity. In addition, national and localauthorities are strengthening epidemiological surveillance, active search andinvestigation of cases and contact tracing.

http://outbreaknewstoday.com/diphtheria-crises-yemen-venezuela-result-re-emergence-37410/


肠道传染病及防控动态

美国加州爆发20年来最大规模甲肝疫情,已致21人死亡

2017-11-27

据中国之声《全国新闻联播》报道,据外媒报道,自从1996年有了可以预防甲型肝炎的疫苗以来,美国加利福尼亚州正发生最大规模的甲型肝炎疫情,人与人之间传染。迄今,加州已发现了600多个病例,其中21人死亡。

分析人士说,糟糕的卫生状况成为甲型肝炎病毒流行的温床。本病由甲型肝炎病毒(HAV)引起,是以肝脏炎症病变为主的传染病,主要通过粪-口途径传播。加州公共卫生部说,大部分感染甲型肝炎的人是无家可归者和在卫生状况不佳的地方使用毒品的人。

洛杉矶市区附近有一个流浪人口聚集的地区。最近一项调查显示,那里的卫生状况低于联合国的难民营标准。据悉,近三个月来,当地政府为了控制疫情采取了冲洗街道、要求民众接种疫苗等措施,但是疫情并没有得到有效控制,医疗部门负责人表示,疫情可能还将持续半年,并有可能进一步向周围地区扩散。

http://news.163.com/17/1126/21/D46TFJ5J000187VE.html


Utah hepatitis A outbreak update: 75 percent fromSalt Lake County

November 29, 2017

In a follow-up tothe hepatitis A outbreak in Utah, state public health has identified 95 confirmed cases ofhepatitis A virus (HAV) infection; many among persons who are homeless and/orusing illicit drugs, since the beginning of the year.

87 are outbreak-associatedcases. Sixty-six of the cases, or nearly 76 % were reported from Salt LakeCounty.

Several cases have beenlinked by investigation and/or viral sequencing to a national outbreak ofhepatitis A involving cases in California and Arizona. Hospitalizationrates of less than 40% have been described in previous hepatitis A outbreaks;however, other jurisdictions associated with this outbreak are reporting casehospitalization rates approaching 70%.

The high rate ofhospitalization may be a result of cases having underlying illnesses (e.g.,alcoholism), or a higher rate of hepatitis comorbidities (e.g., hepatitis B(14%) or C (29%)). In response to the outbreak, public health officialshave been working to identify cases and contacts, provide education, and ensureopportunities for vaccination of close contacts to cases and vulnerablepopulations.

http://outbreaknewstoday.com/utah-hepatitis-outbreak-update-75-percent-salt-lake-county-77540/


Malaysia: Nine typhoid cases reported in Sarawak

November 25, 2017

Malaysian health officialshave reported nine typhoid fever cases this month in Belaga, Kapitdivision, Sarawak, accordingto a Malaysian Digest report. All of the patients are hospitalized at BintuluHospital, Health director-general Datuk Dr Noor Hisham Abdullah said in astatement.

“The situation is undercontrol with no death has been reported.

“Preliminary investigationsat the locality of the epidemic found that the gravity piped water supplysystem is not functioning well.

“The Sarawak HealthDepartment, with the cooperation of the relevant parties, are carrying outrepair works,” he said.

Typhoid fever is apotentially life-threatening illness caused by the bacterium Salmonellatyphi. Salmonella typhi lives only in humans. Personswith typhoid fever carry the bacteria in their bloodstreamand intestinal tract. In addition, a small number of persons,called carriers, recover from typhoid fever but continue to carry thebacteria. Both ill persons and carriers shed S.typhi in their feces.

You can get typhoid fever ifyou eat food or drink beverages that have been handled bya person who is shedding S. typhi or if sewage contaminatedwith S. typhi bacteria gets into the water you usefor drinking or washing food. Therefore, typhoid fever is more commonin areas of the world where handwashing is less frequentand water is likely to be contaminated with sewage.

http://outbreaknewstoday.com/malaysia-nine-typhoid-cases-reported-sarawak-64261/


(香港)旺角食肆懷疑食物中毒個案最新情況

2017-11-27

香港衞生署衞生防護中心今日(十一月二十七日)就十一月二十日調查旺角一食肆的三宗懷疑食物中毒個案,公布調查進展。

衞生防護中心確認五宗新增個案,分別為:

一男一女,他們於十一月十九日晚上於該食肆進食,13至14小時後先後出現腹痛、腹瀉及嘔吐等病徵;兩男一女,介乎25至31歲,他們於十一月十九日用膳,八至15小時後先後出現類似病徵;一男三女,介乎20至32歲,他們於十一月十七日晚膳,13至20小時後先後出現類似病徵;三男四女,介乎40至52歲,他們於十一月二十四日晚上用膳,三至28小時後先後出現類似病徵;及三名男子,介乎43至57歲,他們於十一月二十二日午膳,14至24小時後先後出現類似病徵。其中12人已經求醫,無需入院。全部受影響人士情況穩定。

此外,早前公布的第三宗個案新增一名37歲男病人。

衞生防護中心發言人說:「署方至今就該食肆近期錄得共八宗個案,涉及30人。流行病學調查顯示,其中三宗新增個案在食物環境衞生署開始調查和採取控制措施前已在相關食肆進餐,大部分受影響人士曾於該食肆進食鹵味。署方已通知食物環境衞生署相關新增個案,調查仍然繼續。」

http://www.info.gov.hk/gia/general/201711/27/P2017112700626.htm


自然疫源及虫媒传染病及防控动态

Plague – Madagascar

27 November 2017

From the 1 August through 22November 2017, a total of 2348 confirmed, probable and suspected cases ofplague, including 202 deaths (case fatality rate 8.6 %), were reported by theMinistry of Health of Madagascar to WHO. There were 1791 cases of pneumonicplague, of which 22% were confirmed, 34% were probable, and 44% were suspected.In addition to pneumonic cases, there were reports of 341 cases of bubonicplague, one case of septicaemic plague and 215 cases with type unspecified.

Figure 1: Number of confirmed,probable and suspected plague cases in Madagascar reported by date of illnessonset from 1 August through 22 November 2017

 


In total, 81 healthcareworkers have had illness compatible with plague, none of whom have died.

Since the beginning of theoutbreak, cases of pneumonic and bubonic plague have been detected in 55 out of114 districts (48%), including non-endemic areas and major cities. AnalamangaRegion has been the most affected, with 68% of the cumulative reported cases.

Figure 2: Geographicaldistribution of confirmed and probable pneumonic plague cases in Madagascarfrom 1 August through 22 November 2017


Figure 3: Geographicaldistribution of confirmed and probable bubonic plague cases in Madagascar from1 August through 22 November 2017


All contacts identified(7289) during this outbreak have completed their course of prophylacticantibiotics. Eleven contacts developed symptoms compatible with plague and wereclassified as suspect cases. All contacts had completed their follow up.

The Institut PasteurMadagascar has cultured 33 isolates of Yersinia pestis, which were allsensitive to the antibiotics recommended by the National Program for theControl of Plague.

Plague is endemic in someareas of Madagascar and additional cases of plague may occur, at least untilthe end of the plague season in April 2018. It is therefore important thatcontrol measures continue through the end of the plague season.

Public health response

The Ministry of Public Healthof Madagascar is coordinating the response, with the support of WHO, theInstitute Pasteur Madagascar, and other agencies, stakeholders, and partners.

The Ministry of Public Healthof Madagascar activated crisis units in Antananarivo and Toamasina tocoordinate the outbreak response efforts.

All cases and contacts havebeen provided treatment or prophylactic antibiotics at no cost to themselves.

The public health responsemeasures have included:

l  Strengthened epidemiological surveillance in the all affecteddistricts, and enhanced case finding

l  Rapid investigation of new cases

l  Sample collection, referral and testing

l  Isolation and treatment of all pneumonic cases, as well as treatmentof bubonic cases

l  Active finding, tracing and monitoring of contacts and provision offree prophylactic antibiotics

l  Disinsection, including rodent and vector control

l  Raising public awareness on prevention for bubonic and pneumonicplague

l  Raising awareness among health care workers and providinginformation to improve case detection, infection control measures andprotection from infection

l  Providing information about infection control measures during burialpractices.

WHO has coordinated andmobilised regional and global partners in the Global Outbreak Alert andResponse Network (GOARN) to support the outbreak response and will continuework with partners to ensure further rapid response support as needed.

Working together, theMinistry of Health, WHO, GOARN, and other partners have trained more than 1800community health workers for contact tracing, about 300 doctors as contacttracing supervisors and has established rapid response teams for caseinvestigation. The IFRC, UNICEF and USAID have supported case management,including establishment of plague treatment centres. Laboratory confirmation ofplague cases is conducted by the Institute Pasteur of Madagascar (IPM). WHO andIPM established a system for specimen collection and referral from peripheralareas to the IPM laboratory to strengthen laboratory capacity for testing andconfirmation.

Enhanced measures for exitscreening have been implemented at the International Airports in Antananarivoand Nocibé, to avoid the international spread of pneumonic plague cases. Thesemeasures included: filling a special departure form at the airport (to identifypassengers at risk); temperature screening of departing passengers, andreferring passengers with fever to airport physicians for further consultation;passengers with symptoms compatible with pneumonic plague are immediatelyisolated at the airport and investigated using a rapid diagnostic test andnotified according to the response alert protocol. Symptomatic passengers arenot allowed to travel. A WHO GOARN team, consisting of US Centers for DiseaseControl and Prevention (CDC) and L'Institut de veille sanitaire/ Santé publiqueFrance (InVS/SPF), provided technical support at the airport to establish exitscreening. WHO and partners will support the MOH to re-evaluate the need forcontinuity of the exit screening and will implement appropriaterecommendations.

Nine countries and overseasterritories in the African region (Comoros, Ethiopia, Kenya, Mauritius,Mozambique, La Réunion (France), Seychelles, South Africa, and Tanzania) hadbeen identified as priority countries for plague preparedness and readiness byvirtue of their trade and travel links to Madagascar. These countries have beenimplementing readiness activities, including increased public awareness ofplague, enhancing surveillance for the disease (particularly at points ofentry), and prepositioning of equipment and supplies. WHO will support thesecountries to integrate the plague preparedness and operational readinessactivities into their overall multi-hazard preparedness and readinessfunctions.

WHO risk assessment

No new cases of confirmedbubonic plague have been notified after 8 November 2017 and no new cases ofconfirmed pneumonic have been notified since 14 November 2017. All contactsfinished follow up on 19 November 2017. However, plague in Madagascar is seasonaland WHO expects additional reports of cases. It is therefore important for theMinistry of Health, WHO, and partners to sustain prevention and responseactivities until April 2018. A longer term strategy will be needed for plagueprevention, preparedness, and response.

Based on the currentepidemiology and response capacity, WHO estimates the risk of plague at thenational level is moderate. The risk at the regional and global levels is low.

WHO travel advice

To date, there are noreported cases related to international travel. WHO advises against anyrestriction on travel or trade on Madagascar. WHO recommends that travelmeasures put in place by neighboring countries in relation to this outbreak bediscontinued, given the containment of the pneumonic plague outbreak.

International travellersarriving in Madagascar should be informed that plague is endemic in Madagascar,and about the recent plague outbreak. Travellers should protect themselvesagainst flea bites, avoid contact with dead animals, infected tissues ormaterials, and avoid close contact with patients with pneumonic plague. In caseof sudden symptoms of fever, chills, painful and inflamed lymph nodes, orshortness of breath with coughing and/or blood-tainted sputum, travellersshould immediately contact a medical service. Travellers should avoidself-medication, even if for prophylaxis. Prophylactic treatment is onlyrecommended for persons who have been in close contact with cases, or withother high risk exposures (such as bites from fleas or direct contact with bodyfluids or tissues of infected animals). Upon return from travel to Madagascar,travellers should be on alert for the above symptoms. If symptoms appear,travellers should seek medical care and inform their physician about theirtravel history to Madagascar

http://www.who.int/csr/don/27-november-2017-plague-madagascar/en/


香港新增两宗登革热确诊个案 患者曾访大马等地

2017-11-27

中新网11月24日电 据香港电台网站消息,香港特区卫生防护中心公布登革热个案最新数字,在本月10日至23日,录得两宗登革热确诊个案,病人于潜伏期曾到马来西亚等地。

截至23日,香港今年共录得97宗登革热确诊个案,其中一宗为本地个案。96宗外地传入个案主要从泰国、菲律宾、斯里兰卡及越南传入。

 http://news.163.com/17/1124/16/D4183KCE00018AOQ.html


泰国发现一例炭疽病感染患者

2017-11-29

中新社曼谷11月28日电  泰国公共卫生部28日宣布,经实验室检测证实,在位于曼谷西北约470公里、与缅甸接壤的莱兴府美索地区发现一例村民感染炭疽病例。

公共卫生部官员称,这名患者在屠宰了从邻国走私到泰国的山羊之后感染了炭疽杆菌,检测报告显示其炭疽杆菌呈阳性。其他相关人员的检测结果尚未最终确定。

此前有报道称,美索地区有居民的手上出现了溃疡,可能是由炭疽引起的一种症状。为此,泰国卫生部门对该地区居民进行检验检测,并检查了当地约700只山羊,没有在山羊中发现炭疽的迹象。

作为一项安全措施,目前泰国相关部门已经暂停了边境检查站的山羊进口。

泰国卫生部门官员指出,炭疽病是一种严重的感染疾病,食草动物较易感染。炭疽杆菌可通过皮肤和呼吸系统从牛、山羊等动物传染给人类,并可能引发皮肤严重溃烂及肺炎。

http://news.china.com/internationalgd/10000166/20171128/31733438.html


Kenya: 100 people treated for anthrax in Bomet

November 30, 2017

It appears an anthrax-taintedcow served at a feast resulted in some 100 people being treated for thebacterial infection at the Longisa County Referral Hospital inBomet, according toa Kenyan news source. Asof this report, anthrax has not beenconfirmed in the cow or thepatients.

Seven people were admitted tothe hospital in serious condition, the report notes.

All the patients are said tohave fell ill after their neighbour slaughtered a cow that had suddenly diedand invited them for a feast.

“The report we have is that aneighbor had called for a feast after their cow died without any symptoms ofillness on Tuesday evening and…some of those who ate developed abdominalpains,” Dr Sowek stated.

http://outbreaknewstoday.com/kenya-100-people-treated-anthrax-bomet-10735/


Monkeypox: 14 additional cases reported in Nigeriaoutbreak

November 29, 2017

During the week ending Nov25, Nigerian health officials reported 14 new confirmed monkeypox cases in theoutbreak that began in September, bringing the total confirmed cases to 56.

According to the NigeriaCentre for Disease Control (NCDC), the new cases were reported in the followingstates: Benue (1), Cross River (3), Edo (1), FCT (2), Imo (2), Katsina(1), Nasarawa (1) and Rivers (3).

Three (3) new States (Imo,Katsina and Nasarawa) recorded confirmed cases in the reporting week

There has been a decline inthe number of new suspected cases reported over the last four weeks. Since theonset of the outbreak, a total of 155 cases (suspected and confirmed) have beenrecorded from 21 States and the Federal Capital Territory (FCT).

No death attributable tomonkeypox has been recorded to date.

http://outbreaknewstoday.com/monkeypox-14-additional-cases-reported-nigeria-outbreak-35428/


Mauritania: CCHF case reported outside ofNouakchott

November 27, 2017

Following casesof Crimean-Congo hemorrhagic fever (CCHF) reportedthis spring and summer, theMauritania Ministry of Health has reported an addition CCHF case last week ina 48-year-old male farmer from Haye Sakin community in Dar Nairn, atthe outskirt of the capital city, Nouakchott.

He fell sick on Nov. 11 andwas later treated and discharged last week.

The frequency of these eventsaffirms the relative prevalence of the pathogen and the reservoir and vectorfor CCHF virus (Hyalomma ticks) in the country.

http://outbreaknewstoday.com/mauritania-cchf-case-reported-outside-nouakchott-24013/


研究称可从皮肤中检测出“疯牛病”

2017-11-27

据新德里电视台(NDTV)11月23日报道,11月23日,研究人员称,可以在皮肤中检测到“疯牛病”,即新变异型克雅氏病(CJD)中破坏人类脑部的变异蛋白质,由此提出了对这种传染性疾病的担忧。

这份刊登在《科学转化医学期刊》(Science Translational Medicine)的报告说,因为皮肤中的异常蛋白质朊病毒含量比大脑含量低1千至10万倍,这个快速发展的致命病症不太可能通过偶然接触所传播。

报告指出,研究人员说,这一发现意味着克雅氏病可以通过不涉及大脑的普通手术传播出去。

凯斯西储大学(CaseWestern Reserve University)医学院病理学和神经病学副教授邹文泉(ZouWenquan,音译)说:“众所周知,克雅氏病可以通过涉及朊病毒感染的脑组织手术或治疗手段传播。因而我们在皮肤中发现传染性朊病毒是非常重要的,因为它不仅会引起人们对通过不涉及大脑的普通手术传播克雅氏病的可能性担忧,还表明皮肤病理切片检查和尸体解剖可以提高验尸前或验尸后的克雅氏病诊断水平。”

据报道,每年,全世界100万人里就会有一人罹患克雅氏病。但目前只有皮肤病理切片检查,脊髓穿刺或尸体解剖的方法可以确定患者是否患有这种疾病。克雅氏病患者的大脑中会形成微小的海绵状孔洞,随后出现突然的记忆和视力问题、行为改变和身体失调。这种病是无法治愈的,绝大多数被确诊的患者身体就会快速恶化,活不过一年。

该研究使用新了的高敏感度测试来测量朊病毒水平,皮肤样本来自于38名死于该疾病的患者。在实验室小鼠身上得出的结果表明,此类皮肤朊病毒确实具有传染性,并会诱发疾病。但要进一步了解朊病毒的风险还需更多的研究。

凯斯西储大学医学院病理学和神经病学副教授孔庆中(Qingzhong Kong,音译)说:“在感染克雅氏病毒的皮肤中检测到的朊病毒感染含量出人意料的高,但仍低于感染克雅氏病毒的大脑中的病毒含量。受皮肤朊病毒污染的手术器械的朊病毒传播风险应远低于被脑组织污染的器械。”

这些发现也有助于在验尸前后对侵袭性较小的疾病进行诊断。早在几十年前克雅氏病就已经引起了公众的注意,当时英国人在吃了病牛肉后备诊断出感染一种克雅氏病毒。欧盟于1996年下令对英国牛肉及其衍生品实行全球性禁运,禁令于1999年才解除。世界卫生组织称,1996年10月至2011年3月期间,全球共发现了224例克雅氏病例,主要集中在英国。

http://www.39yst.com/xinwen/508191.shtml


寄生虫病及防控动态

南昌赣江流域发现大面积钉螺 已启动血吸虫病突发疫情三级响应

2017-11-30

央广网南昌11月29日消息  据中国之声《全国新闻联播》报道,近日,南昌市疾控部门在赣江流域开展例行调查时,在南昌市西湖区滨江公园区域江滩发现大面积钉螺,属于血吸虫病突发疫情。目前,南昌市已启动血吸虫病突发疫情三级响应。

据江西省寄生虫病防治研究所防治科长辜小南介绍,钉螺具体发现于南昌生米大桥下游赣江东岸江滩约200米处至朝阳大桥上游约800米处。有螺江滩长约3000米,面积约14.8万平方米,“面积比较大,密度比较高,我们上下游扩大了10里范围内进行巡查,暂时还没有发现其他分布点。”

辜小南介绍,疾控部门已捕获钉螺1186只,其中活螺1075只,并进行了流行病学调查和实验室检测,“抓了一千多只钉螺已经解剖了,没有发现阳性钉螺,即这些钉螺不带血吸虫。”

据了解,南昌市西湖区为血吸虫病非流行区,发现钉螺分布,属于血吸虫病突发疫情。目前,南昌市已启动血吸虫病突发疫情三级响应,展开应急处置工作,并制定了灾螺工作方案,“一个就是要把表皮土要铲掉,第二个就是要把(容易滋生钉螺的)蓝荻草割掉,再喷药就把钉螺杀掉了。”

目前,南昌市疾控部门仍在持续监测钉螺的分布情况,扩大了日常巡查范围,争取尽早发现处置血吸虫疫情。据了解,钉螺是血吸虫病的主要载体,血吸虫病易导致急性或者慢性肠炎、肝硬化等疾病,由于血吸虫细菌一般通过直接接触侵入皮肤,疾控专家提醒市民应尽量避免皮肤接触被感染的江水湖水。

http://china.cnr.cn/NewsFeeds/20171129/t20171129_524043850.shtml


其他公卫相关事件及防控动态

全球3670万人感染艾滋病 中国发病数是6年前3倍多

2017-11-30

12月1日,第30个世界艾滋病日即将来临。到目前为止,艾滋病毒已造成全球3500多万人死亡。去年,全球有100万人死于艾滋病毒相关病症。但据估计,目前仅有70%的艾滋病毒感染者知晓其感染状况。

其中,非洲区域病情最严重,去年艾滋病毒新发感染数占全球的近三分之二。2010年至2016年,中国艾滋病发病数和死亡人数总体呈上升趋势。今年1月至10月,发病数已达46206例,是2010年全年发病数的近3倍。

虽然,没有针对艾滋病毒感染的治愈方法,但通过有效的抗逆转录病毒药物,病毒是可以得到控制的。在2000年和2016年间,抗逆转录病毒药物治疗使大约1310万人的生命得到挽救。

http://news.sina.com.cn/c/2017-11-29/doc-ifyphkhk8764136.shtml


外交部紧急提醒中国公民近期谨慎前往巴厘岛旅行

2017-11-28

人民网北京11月27日电  据外交部中国领事服务网消息,印尼火山和地质灾害减灾中心发布报告显示,11月25日下午5时30分,阿贡火山再次喷发出大量灰黑色火山灰,灰柱高达1500米。此后阿贡火山持续活跃并不断喷出火山灰和烟雾,最高火山灰柱达到4000米并伴有红光产生,火山可能随时喷发岩浆。火山灰不断随风往东和东南方向飘动,并往龙目岛扩散。

目前机场航空预警已升至红色最高级,部分国家航空公司已取消来往巴厘岛的航班。若风向改变,火山灰往西南方向扩散,巴厘岛伍拉莱国际机场可能随时关闭。火山警戒级别现为第三级,火山口周围半径6公里内范围,火山口北-东北、西南-南-东南方向半径7.5公里内范围为危险区域,禁止一切居民或游客活动。

外交部领事司和中国驻登巴萨总领馆提醒中国公民近期谨慎前往巴厘岛旅行,在巴厘岛的中国公民请保持高度警惕,注意自身安全,切勿前往火山周围区域活动,并注意防范滞留风险,合理安排行程。遇紧急情况请及时报警并第一时间与总领馆联系。

中国驻登巴萨总领事馆领保电话:+62-361239902。

外交部全球领事保护服务应急呼叫中心热线:+86-10-12308,+86-10-59913991。

印尼报警电话:+62-110。

医疗救助电话:+62-118。

http://travel.cnr.cn/list/20171128/t20171128_524041265.shtml


日本调查称服用克流感病童易出现异常行为

2017-11-29

日本负责医疗卫生和社会保障的主要部门——厚生劳动省的调查指出,年幼的流感患者服用感冒药克流感(tamiflu)后出现异常行为的案例越来越多,呼吁民众最好让病童睡在一楼养病,高楼层住户最好在窗户加装副锁等。

厚劳省指出,近年来,每年都会接到约50件报告表示,流感患者服药后会有异常行为,有的病童会突然快跑而跌倒,有的突然开窗跳楼,有的会说些奇怪的话。其中发生异常行为的以10多岁以下的儿童患者为主。

据统计,2016年流行性感冒季节时,日本服用克流感后发生突然跳楼或跌倒等异常行为者共38人,服用其他感冒药出现异常行为者有16人,总计为54人。

为了防止类似事件发生,厚劳省已召集专家讨论对策,将于下周公布具体的故事防止对策。内容包括,服用感冒药后两天内勿让病童独处、尽可能让病童睡在1楼、高楼层住户在窗户加装副锁、房门上锁等。

http://news.ishaanxi.com/2017/1128/755573.shtml


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