Gu Yanan switches the slides, and the problem in scene 3 appears.

"On what basis did the emergency expert group designate this outbreak as a public health emergency? What levels of emergency response should be recommended for this incident? ”

After saying the question, Gu Yanan looked around and answered again.

"This question is a policy question, and I will answer it by the leader of the emergency response team.

According to the national norms for the reporting and management of information related to public health emergencies, the discovery of one or more cholera cases is a public health emergency.

According to the grading standards for public health emergencies: if the cumulative incidence of cholera within a county or city is less than 9 cases within 7 days, and the distribution of the onset time of the cases is unclear, the cumulative cases shall prevail according to the latest course of the incident.

This outbreak is a general sudden public health event (level IV), and it is recommended to initiate a level 4 emergency response to public health emergencies. ”

Slide transitions.

Gu Yanan: "The next question in scenario 3 is how to carry out emergency response work for epidemic response personnel? This problem will be shared by Zhou Jie of the emergency response team. ”

Zhou Jie stood up, took the laser pointer in Gu Yanan's hand, and operated the notebook at the same time, a new electronic map appeared on the screen, with red and yellow markings on it.

Zhou Jie used a laser pointer to indicate the location on the electronic map, and explained: "The first step in dealing with the epidemic is to establish a case definition and determine the epidemic point and epidemic area. Epidemic site: refers to the place where a sick person, suspected case, or carrier is found. Epidemic sites should be delineated based on epidemiological data. Generally speaking, several households that are closely related to the lives of patients and infected people in the same household or the lives of patients, suspected patients, and carriers are the scope of epidemic sites, and according to the contamination of the source of infection, a source of infection can have more than one epidemic point.

Epidemic areas: In order to prevent secondary infection and outward transmission caused by pollution outside the epidemic sites, the epidemic areas should be demarcated according to the geographical location, water system distribution, traffic conditions, natural villages and other characteristics of the epidemic sites. Generally, in rural areas, one or several villages, one township or adjacent townships, one or several neighborhood committees or neighborhoods are classified as epidemic areas.

Yellow-marked epidemic sites include patients' homes, village clinics, wedding restaurants, and taxis.

The red mark is the endemic area, i.e. the entire village where the patient is located.

After the epidemic sites and epidemic areas are identified, a population survey should be carried out in the epidemic area, on the one hand, active search for cases in medical institutions according to the case definition, and on the other hand, epidemiological investigation should be carried out on close contacts of the patient and fecal anal swab samples should be collected for Vibrio cholerae detection. Dietary, drinking water and environmental hygiene surveys were also conducted, and relevant food, water and environmental specimens were collected.

In response to the case of cholera outbreak on the tabletop, 78 close contacts were identified through epidemiological investigation, including 60 people who attended the wedding banquet on April 29, 11 medical staff from the First People's Hospital of the city, 1 village doctor who received the patient for the first time, 1 taxi driver who took the patient to the First People's Hospital of the city for treatment, and 5 relatives of the patient. ”

Speaking of this, Zhou Jie looked at the colleague in charge of the laboratory who was sitting in the first row, the two exchanged glances, and the colleague in the laboratory spoke: "After laboratory testing, it was found that 4 close contacts tested positive for cholera, but there were no clinical symptoms, and they all attended the wedding banquet together. Vibrio cholerae found in steamed scallops at a wedding restaurant. ”

After the laboratory colleagues finished speaking, Zhou Jie continued, "At the same time as the laboratory test, our on-site personnel should carry out risk factor investigation, put forward the etiological hypothesis according to the preliminary epidemiological investigation, a cholera epidemic caused by the wedding banquet, and statistically analyze the results of the preliminary questionnaire survey, the case and the infected person are the case group, and the uninfected person is the control group, and the results show that eating scallops in the wedding banquet is a risk factor for infection. This is consistent with laboratory findings that the cause of the outbreak was the consumption of scallops at wedding receptions. ”

After Zhou Jie finished talking about emergency treatment, Gu Yanan switched to the next slide, Scene 4: Isolation and disinfection and health education.

Gu Yanan: "This scenario involves a lot of issues, such as how to manage the close contacts of patients? What are the sanitizing jobs? What should be paid attention to in health education and risk communication? Each relevant department will talk about the content for which it is responsible. ”

Gao Fei was the first to stand up, "Let me talk about how to carry out the management of close contacts of patients, first register information, and report physical conditions daily; Medical observation for 5 days, can not participate in dinners, gatherings and other activities, feces are disinfected, and diarrhea is immediately isolated and treated; Carry out propaganda and education on cholera prevention and control among people in close contact. ”

After Gao Fei finished speaking, the colleagues of the sanitization department stood up, "Let me talk about the disinfection work to be carried out in the cholera epidemic, for hospitalized patients, the hospital will arrange full-time personnel to sanitize at any time;

We at CDC are responsible for the terminal disinfection of patients' homes, including rooms and activity spaces where they lived before and during their illness, used items, furniture, vomit, and sewage discharge.

After the patient is cured and discharged, the ward will be terminally disinfected, which will be arranged by the hospital to arrange full-time personnel, focusing on disinfection of the toilets and toilets dedicated to patients in the ward, patient vomit, bedding, etc.

Terminal disinfection of the means of transport used by the sick is carried out, and in this outbreak it is mainly the disinfection of the taxi in which the patient has ridden.

It is also necessary to strengthen the management and disinfection of water quality in centralized and decentralized water supply in epidemic areas. ”

After the colleagues of the sanitizing department finished speaking, the colleagues of the health education department stood up, "Let me talk about health education and risk communication, our health education department will adopt different forms of health education according to the epidemic points, epidemic areas and close contact lists provided by the flow control team.

The targets of the mission include hotel staff, medical staff of the city's First People's Hospital, and other close contacts.

There are various forms of missionary education: the establishment of WeChat groups, the printing of leaflets, the printing of posters, village broadcasts, etc.

The content of the mission is the knowledge of cholera prevention and control: do not drink raw water, do not eat food washed with raw water, do not rinse your mouth and brush your teeth with raw water......"

There are many contents of health education, and colleagues in the health education department picked up a few important ones and said them again, and after speaking, Gu Yanan changed the slide to the next one, Scene 5: Emergency response terminated.

"The tabletop deduction of cholera epidemic cases continued, and on May 16, the District Health Commission organized a discussion on epidemic assessment.

At this time, no further cases of cholera were reported, except for the patient and 4 carriers, and the maximum incubation period had been exceeded.

At present, the patient and the carrier have been cultured negative for two consecutive times, and the isolation was lifted on May 16, and the measures taken in the epidemic site have been implemented, and it has been determined that there is no risk of transmission and spread.

The expert group concluded that the cholera outbreak had been effectively brought under control and recommended that the district government terminate the Level 4 response to the public health emergency.

The Municipal Center for Disease Control and Prevention instructed Dongcheng District CDC to complete the case closure report and report it to the public health emergency network.

The issue to be discussed in this scenario is about the termination of the epidemic, and then Mr. Gu from the Emergency Response Office will tell everyone about the conditions for the termination of the epidemic. ”