重症A-H1N1的救治-ICU.pptVIP

重症A-H1N1的救治-ICU 席修明 2009.10.24 流感对人类的威胁 1918 流感的世界大流行导致5000万人死亡，美国估计675,000人 1957 的流感导致全球1-200万人死亡，美国至少70,000人 成为今天是否做好公共卫生准备的试金石 When it came to treating influenza patients, doctors, nurses and druggists were at a loss. 判断流行病的严重程度 ? Pandemic Severity Index 流行病的死亡率是评价流行严重程度的重要指标 The severity index 可以很好预测流行 为流感今后的流行提供决策 Pre-Pandemic Planning:? Pandemic Severity Index The Persistent Legacy of the 1918 Influenza Virus Map: International Co-circulation of 2009 H1N1 and Seasonal Influenza(As of September 4, 2009; posted September 11, 2009, 6:00 PM ET) Map: International Co-circulation of 2009 H1N1 and Seasonal Influenza(As of October 2, 2009; posted October 2, 2009, 11:00 AM ET) Map: International Co-circulation of 2009 H1N1 and Seasonal Influenza(As of October 16, 2009; posted October 16, 2009, 3:00 PM ET) Map: International Co-circulation of 2009 H1N1 and Seasonal Influenza(As of October 23, 2009; posted October 23, 2009, 3:00 PM ET) Influenza Positive Tests Reported to CDC by U.S. WHO/NREVSSCollaborating Laboratories, National Summary, August 30-October 17, 2009 Percentage of Visits for Influenza-like Illness (ILI) Reported bythe U.S. Outpatient Influenza-like Illness Surveillance Network (ILINet),Weekly National Summary, October 1, 2006 - October 17, 2009 EIP Influenza Laboratory-Confirmed Cumulative Hospitalization Rates,2009-10 and Previous Three Seasons Weekly Laboratory-Confirmed Influenza-Associated Hospitalizations andDeaths, National Summary, August 30 – October 17, 2009 Number of Influenza-Associated Pediatric Deaths by Week of Death:2005-06 season to present Bacterial Coinfections in Lung Tissue Specimens from Fatal Cases of 2009 Pandemic Influenza A (H1N1) United States 22 (29%) of the 77 patients, including 10 caused by Streptococcus pneumo- 10 cases with S. pneumoniae, six with S. pyogenes, seven with S. aureus, two with Streptococcus mitis, and one with H. influenzae; four cases involved multiple pathogens ICU严重新型流感A (H1N1)-Michigan