如何进行暴发查(中英文).pptVIP

如何进行暴发调查How to Investigate an OutbreakRobert E. Fontaine, MD MScUS Centers for Disease Control and PreventionAdvisor to Chinese Field Epidemiology Training Program;什么是暴发或流行？What is an outbreak or epidemic?;暴发和流行病可以突然发生Outbreaks and epidemics may happen suddenly;有些暴发和流行病则是缓慢发展的Others may develop slowly;有些暴发可能在高本底水平上发生Others may happen on a high background level;我们如何发现暴发和流行病？ How do we learn about outbreaks and epidemics?;为什么要对暴发和流行病进行调查？ Why initiate an investigation?;为什么要启动调查？ Why initiate an investigation?;;保护公众免于持续存在或反复发生问题的侵害 Protect the public from continuing or recurrent problem 维持流行病学家工作的有效性 Maintain proficiency of epidemiologists 出于控制规划的考虑Program considerations 出于政治/法律考虑 Political / legal concerns 调查成本和难易Ease and cost of the investigation 可能会采取的控制决策Potential for decisive control 回答重要的公共卫生问题 Answer important public health questions;只有一个传播模式——调查或控制？Infections with only one mode of transmission -- investigate or control?;调查暴发的10个步骤 10 steps of an outbreak investigation;准备现场工作 Prepare for field work;为去现场做准备工作 Prepare for field work;为去现场做准备工作 Prepare for field work;证实暴发存在 Establish existence of an outbreak;证实暴发的存在 Establish existence of an outbreak;一所乡村初中水源性大型副伤寒暴发 A Large Outbreak of Water-borne Paratyphoid Fever in a Rural Junior High School;突发事件监测显示在一所乡村寄宿学校有142例副伤寒病例 Emergency surveillance reported 142 suspect cases of paratyphoid fever (PTF) at a rural boarding school.;验证诊断 Verify the diagnosis;验证诊断 Verify the Diagnosis;诊断可以通过将临床发现进行列表来确立Diagnosis may be established by tabulating clinical findings ;通过血样和便样培养找到病因Agent Identified in Blood and Stool Cultures;定义、计数和采访病例 Define, count, and interview cases.;病例定义可有不同程度的确定性The case definition may have levels of certainty. ;在做调查的过程中不断修正病例定义 As you proceed you modify the case definition ;副伤寒的病例定义很简单 The paratyphoid case definition was simple;努力找到所有可能病例 Try and locate all possible cases 进行系统搜索：发展监测 Conduct systematic search: Develop surveillance 利用多种信息来源 Use multiple sources 将数据列表 Construct