卫生部流感诊断与治疗专家组发布流感诊断与治疗指南中国版(2011)

2011-11-03 00:00 来源:丁香园 作者:
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Influenza, an acute respiratory infection caused by influenza virus, is one of public concerns to human health. Epidemiologically, influenza is characterized by a sudden outbreak and rapid transmission with varying epidemics, seasonality, and a high morbidity yet low case fatality (usually 0.003% to 0.03% except for human avian flu). The past 300 years has witnessed at least six global pandemics, including four in the 20th century -- three of them originated in China.

Seasonal influenza can typically give rise to rapid onset of acute respiratory disorders with febrile symptoms. Although self-limited in most of the times, influenza with severe infections or complications may necessitate hospital admission. The elderly, young children, pregnant women or those with underlying chronic diseases are at high risk of contracting severe influenza, and a few of them may die of respiratory or multiple organ failure. The human avian flu, on the other hand, is caused by highly-pathogenic avian influenza viruses (such as H5N1) with a case fatality up to 60%. While vaccination remains so far the mainstay for prevention and control of influenza, early use of antiviral agents may help relieve symptoms, shorten the course, reduce complications, attenuate viral shedding and even bring down the mortality. During an epidemic, prophylactic use of antiviral agents may also help reduce the incidence of influenza. Given the genetic variability of influenza viruses, effective prevention and treatment will continue to be a medical matter of top priority.

To further promote awareness and understanding of influenza among the public, government officials and patients, and to improve the clinical diagnosis and treatment, China has developed a series of medical documents, including the Draft Guidelines for Diagnosis and Treatment of Influenza (2002) (1), Interim Technical Guidance for Prevention and Control of Avian Influenza Epidemics (2004) (2) and four editions of Protocols for Diagnosis and Treatment of Influenza A (H1N1) (2009 and 2010) (3,4). Ever since, these documents have played a significant role in improving patient care, medical research and case fatality in relation to several types of influenza viruses in China.

However, reflection on the 2009 pandemic of influenza A (H1N1) virus demonstrated the dire need for a new set of guidelines that are well compatible with late-breaking advances and actually applicable for clinical practices, so as to improve understanding of and preparedness for prevention and control of influenza (including seasonal and avian flu). To this end, the Chinese Ministry of Health commissioned a panel of experts from fields of virology, epidemiology, laboratory diagnostics, clinical medicine, Chinese traditional medicine, and disease control and prevention related to influenza. The new guidelines for diagnosis and treatment of influenza were developed to adapt the bedside practice for vast majority of medical professionals in China, with reference to the previous editions, the latest studies worldwide, and local experience in management of influenza. The core of these guidelines has incorporated up-to-date information on virology, epidemiology, clinical manifestations, diagnosis and differential diagnosis, and treatment and prevention of influenza, hopefully to improve the medical care for this disease, and to reduce the huge threats it potentially imposes to human health and the society.

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编辑: 冯志华

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