-
H7N9*
-
H7N9H7N9H7N9H7N9H7N9H7N9H7N9*
-
H7N9*
-
*3/31H7N94/30126(25)( )4H7N999.4%H7N9()Updated: 2013/5/1:
-
*H7N9():6/3-6/923/31131H7N9(39)() Updated: 2013/06/112
-
*4/13(7)244/151H7N94H7N9(): Updated: 2013/4/23
-
*4/452(56)4/14/5H7N94/10H7N9
H7N9(): Updated: 2013/4/23
-
*H7N9(87)2/193/422/20-2/25112H7N94
H7N9(): Updated: 2013/4/23
-
*24/234/164/21(4)4/274/28H7N9()Updated: 2013/5/1:
-
*1,500H7N9(0.08%)H7N9()Updated: 2013/4/23:
-
*1,000
H7N9(): WHO EISUpdated: 2013/4/23
-
Updated: 2013/06/10
-
*H7N9H7N9
-
H7N9*
-
*: Updated: 2013/4/99:00
-
H7N9*
(n=24) (n=7):16:86:1 ()57.7 (n=23)54.3 (n=7)3/21 (14.3%)1/7
(14.3%)19/19 (100%)5/5 (100%) ()9.0 (n=16)8.76 (n=5) ()-2.2
(n=5)
-
H7N9()10-147-92009 WHO339GOT,GPT,CKCBC*
-
H7N9()7-92-3*
-
631000H7N9*
-
*: Updated: 2013/4/57:00
-
H7N9?*
-
H7N9*
-
*NA/N9 H7N9 (A/wild bird/Korea/A3/2011)
PB2PB1PAHA-H7NPNA-N9MPNS2013
H7N9PB2PB1PAHA-H9NPNA-N2MPNSH9N22010~2012 HA/H7 H7N3
(A/duck/Zhejiang/2/2011)
-
H7N9H7N9H7N9H7N9*
-
H7N93/31GISAIDH7N93HH7NH7N9H9N2Nature
doi:10.1038/nature.2013.12728
-
*H7N9:
-
Determination of viral
pathogenicityProteinPositionPathogenicity2013
H7N9FunctionLowHighPB2627EKKreplication ability701DQDNuclear
ImportPB1-F266NSNinduction of apoptosisHACleavage siteSingle basic
aaMultiple basic aaSingle basic aaHA cleavageNS192DEDunknownC-
terminus (PDZ)RSEVESEV13 C terminal aa truncatedunknown
-
H7N9TamifluAmantadine *
-
H7N9H7N9H7N9
*
-
H7N9()()()
*
-
*102-4-25
-
H7N9()
*
-
H7N9()H7N9H7N9*
-
H7N9
*
-
H7N9
-
38()()
-
14()H7N9()()H7N9()
-
H7N9H7N9
-
H7N9
-
>38*
-
H7N9*
-
H7N9
-
H7N9119*
-
H7N9*
-
Nasopharyngeal SwabInsert dry swab into nostril and back to
nasopharynxLeave in place for a few secondsSlowly remove swab while
slightly rotating it
-
Nasopharyngeal Swabcontinued
Use a different swab for the other nostrilPut tip of swab into
vial containing VTM, breaking applicators stick
-
Oropharyngeal SwabAsk the subject to open his or her
mouthDepress the tongueSwab the posterior pharynxAvoid the
tonsils
-
Collection of laboratory specimens
Upper respiratory tract (above larynx)Standard and Droplet
PrecautionWHOCDCN95Lower respiratory tract
specimensAerosol-generating procedures IPC measuresWHOCDCN95
-
High risk aerosol-generating proceduresEnhance respiratory
protection including the N95 is recommended for such procedures.
The procedures should include:open suctioning of airway
secretionsresuscitation involving emergency incubationcardiac
pulmonary resuscitationendotracheal intubationHowever the following
should not be included: collection of nasopharyngeal specimens
close suctioning of airway secretions administration of nebulized
medications*
-
Intubation and related proceduresCardiopulmonary
resuscitationBronchoscopy Surgery and autopsy
-
H7N9*
-
WHO guidance for infection prevention and control for H1N1
Standard precautionHand hygiene (HH)Use of PPE does not
eliminate hand hygienewhen procedures include relevant risk:medical
mask and PPE for eye protectiona gown and clean glovesDroplet
Precautionsmedical mask if < 1m of patientHH before and after
patient contact and after removal of mask
-
Performing aerosol-generating procedures
Wear a particulate respiratorAdequately ventilated room, min of
6-12 ACHLimit only to those with patient careHH before & after
patient contact and PPE removalSpecial considerations (eg. BiPAP,
Nebulization)above measures also for open suctioning system
-
Personal Protective Equipment
GlovesMaskGownEye protection
-
Packing Specimens for Transportation
Use three packaging layersFirst layer should be water tightUse
absorbent material in all layerNo more than 500 mL should be in the
specimen container
-
Transporting Specimens from Field to Lab
-
Keep specimens at 4 C Fill a cooler with ice packs or coolant
packsDouble-bag specimens if you use dry iceInclude an itemized
list of specimens with identification numbers and laboratory
instructions Packing Specimens for Transportation
-
H7N9*
-
:I14()
*
-
:II(N95)()MOPP*
-
:III
*
-
*
-
*
**********Module 5: Laboratory Diagnosis, Specimen Collection,
and Biosafety Issues*Now we will discuss how to collect specimens.
First, we will describe how to collect a nasopharyngeal swab.
First, insert a dry drayon, rayon, or polyester swab into the
nostril and back to the nasopharynx. Leave the swab in place for a
few seconds. Then slowly remove the swab while slightly rotating
it.Module 5: Laboratory Diagnosis, Specimen Collection, and
Biosafety Issues*Use a different swab for the other nostril. Put
the tip of the swab into a vial containing VTM, and break off the
applicators stick.Module 5: Laboratory Diagnosis, Specimen
Collection, and Biosafety Issues*Next, we will describe how to
collect an oropharyngeal swab. You will swab the posterior pharynx,
the area in the back of the throat behind the tonsils.
Oropharyngeal swabs are preferred specimens.First, ask the subject
to open his or her mouth. Next, depress the tongue using a tongue
depressor. Swab the posterior pharynx, avoiding the tonsils.
Module 5: Laboratory Diagnosis, Specimen Collection, and
Biosafety Issues*Personal protective equipment such as gloves,
masks, gowns, and eye protection should be included in the specimen
collection kit. Multiple sizes of the gloves and masks should be
available to assure that the people collecting the samples can use
the correct size. Module 5: Laboratory Diagnosis, Specimen
Collection, and Biosafety Issues*When you are ready to pack
specimens for transportation from the field to the laboratory, you
must use three packaging layers. This is done to protect specimens
from damage during transportation. The first packaging layer should
be water tight, and all layers should be absorbent in case there
are any leaks. There should be no more than 500 mL of liquid in the
specimen collection container.Module 5: Laboratory Diagnosis,
Specimen Collection, and Biosafety Issues*Here is an image of a
properly packed specimen ready for shipment to a laboratory.
Included are the three layers of packaging, the absorbent packing
material, the specimen ID, the biohazard label, the itemized list
of contents, and the labeling of the outer package as UN 3373
diagnostic specimens. If this material is not available to you,
transport specimens in a cool box with ice.Module 5: Laboratory
Diagnosis, Specimen Collection, and Biosafety Issues*Just as it is
important to keep specimens cold during storage, it is important to
keep specimens cold during transportation. Try to keep specimens at
4 C. A cooler filled with ice packs can be used for this purpose,
but do not use dry ice unless the specimens are double-bagged and
airtight; carbon dioxide from the dry ice can inactivate the
virus.
In all specimen shipments, include an itemized list of
specimens, with specimen identification numbers and instructions
for the laboratory.
