2009 March-April between originating in Mexico and the United States, influenza A H1N1 influenza A (April 30 called "swine flu"), the worlds attention quickly from the financial crisis to the point of both old and new viruses and sexually transmitted diseases. Incidence of the disease quickly, and spread fast. April 24, when the information was first announced by the World Health Organization, the epidemic is limited to Mexico and the United States, Mexico, 18 cases of confirmed cases, seven cases of confirmed cases the United States. To the date hereof of the May 7, 13 d within the epidemic spread to 24 countries and regions, confirmed cases has reached 2371 cases, 44 cases of deaths [1-2] (Figure 1,2). April 25, according to "International Health Regulations (2005)",
World Health Organization (WHO) declared that human infection with influenza H1N1 flu is a "public health emergency of international concern", and twice within the first time in 3 d to improve influenza pandemic warning level, from the first upgrade to level 3 5 [3-5]. This is a strong signal that the imminent influenza pandemic. WHOs actions lead to a global media and government attach great importance, governments have taken measures to mobilize resources to deal with. We can see from the following five aspects to understand the Influenza A H1N1 influenza pandemic of the seriousness and the importance of a global concerted response.
First, the rapid progress of influenza pandemic, widespread, complications of serious consequences for human health danger.
Second, the widespread nature of influenza virus antigen is unstable. Host selective role of influenza virus and influenza virus, influenza virus subtype genetic mutation can produce a small range of antigenic variation, known as antigenic drift (antigenic drift). Drift can lead to a small range of popular and local outbreaks, which is updated every year because of influenza vaccines. At the same time, influenza A virus also can not be determined by genetic variation occurred within the time interval,
By the epidemic in human influenza viruses and in mammals such as pigs, horses, etc., or poultry such as chickens, ducks, birds moderate epidemic influenza A virus recombinant gene emerged entirely new virus subtype, called antigen conversion (antigenic shift). As the antigen conversion to generate new virus subtype, there is no immunity to the whole of mankind is bound to spread around the world. Antigen conversion in history have been caused by several times the global human influenza pandemic [6-7].
Third, the historical record shows the 20th century took place three times of an influenza pandemic :1918-1919 years of "Spanish influenza" in 1957 "Asian flu" and 1968 "Hong Kong flu." The 1918-1919 influenza pandemic, according to documents around the world an estimated 20 million to 100 million people were killed, is considered the most deadly in human history, one of public health events; in 1957 the number of deaths is estimated at 200 million; 1968 the number of deaths is estimated at 1 million [7-8].
Fourth, the time characteristics of influenza A H1N1 influenza pandemic [9-12]: (1) by a new variant strain of influenza virus caused widespread susceptible populations, there have been multinational, intercontinental spread. (2) there have been cases of human transmission. (3) Mexico there are more cases of severe and death. Mexico and other countries in the age of onset and mortality there is a big difference. U.S. epidemiological survey found that patients with a median age of 16 years (3 ~ 81 years), more than 80% at 18 years of age, male to female ratio is 2:3. And in Mexico, mainly in young adults 20 to 50 years of age. So far 44 cases of deaths in 42 cases occurred in Mexico,
2 cases in the United States, and the remaining confirmed cases in 22 countries and regions are not deaths. (4) prior to the onset of influenza in patients 1 d already detoxification, some people are not infected with the disease, but still infectious, a high rate of latent infection. (5) there is no effective vaccine against the disease. (6) for the disease there are two kinds of effective antiviral drugs: oseltamivir (Oseltamivir, Tamiflu) and zanamivir (Zanamivir, Switzerland Le-sha).
Fifth, the global pandemic of influenza on the global economy and society great harm to [7,9]. As this is no immunity for all the new virus, infection, prevalence and mortality will be much higher than ordinary flu. Few countries have such a large response to the sudden illness of the patients required personnel, facilities, equipment and hospital beds. Due to the high prevalence (prevalence phase I clinical attack rate of 10% to 20% in closed populations such as schools and nursing homes can be up to 50% attack rate), will inevitably lead to high level of staff absenteeism rates, seriously affect the energy, transport and communications and other basic services and other social cells in the normal operation,
The normal social and economic order will certainly be severely damaged. In the shadow of the global financial crisis still waving the never-ending situation, such damage would be even greater.
Based on the above five reasons, in addition to seriously work together to prepare and actively deal with no alternative.
It is gratifying that with the 1918-1919 influenza facing humanity than global pandemic, today we are fully qualified, capable and confident careful preparation, calmly, in an invincible position.
First, the rapid development of science and technology so that human beings today, from the source of infection, mode of transmission, prevention and control of infectious diseases susceptible populations three key links to respond effectively to influenza A H1N1 influenza pandemic. To epidemiology as the core public health research and practice to help us fully grasp the law of an influenza pandemic, affecting factors and the prevention and control measures; virology, immunology and genomics and other basic medical research gives us insight into the flu pandemic etiology, pathophysiology and molecular biology,
High-tech response to an influenza pandemic has laid a solid scientific basis; the progress of clinical medicine and modern medicine for our diagnosis and treatment of Influenza A H1N1 influenza patients with the effective means. In the last century, these conditions are not available.
Second, in the WHOs coordination and technical support, mankind has experienced the fight against SARS and bird flu battle baptism. Todays global, modern public health system has been preliminarily established, Chinas public health professional team matures, the public health system has improved steadily. The world, including my own public health emergency response capabilities continue to increase, today we have full capacity to respond to the sudden global pandemic influenza H1N1 influenza. In contrast, the beginning of the last century, public health has just started a few European and American countries, most countries do not have        the public health system, the two are incomparable.
Third, development of human civilization to the present day nations of the world recognized that during a pandemic infectious diseases, all of humanity is threatened to respond positively to WHO "to use this opportunity to strengthen global solidarity, for all of humanity should benefit all countries, and solutions" initiative, make concerted efforts to deal with. Contrast, the beginning of the last century, influenza pandemic, the social background of the First World War.
Fourth, from the early last century, today, the quality of human health has undergone a significant change. The early 50s of last century, 50% of the worlds population live in the average life expectancy 40 years below the level of health, the global average life expectancy is 46.5 years, while the beginning of this century is 65.4 years of age [13]. The beginning of the last century, when an influenza pandemic can only lower the quality of human health.
Fifth, according to the limited knowledge of the author, the Earth has not seen in the history of an organism is another organism destroyed records. Therefore, the influenza A H1N1 influenza virus is not terrible, we are able to defeat it. However, an organism can not adapt to environmental change and self-destructive example of this is there: dinosaurs. Therefore, we fully respond to Influenza A H1N1 influenza pandemic at the same time, do not forget that due to environmental changes lead to the spread of chronic disease has been crazy to human health and pose a great threat to life. This problem is particularly prominent in todays China, we must not be taken lightly.
As of May 7, 2009 Influenza A H1N1 influenza pandemic and response analysis of the situation, our current response strategy is correct. Although the 20th century, developed modern medicine and the human and microbial genetic engineering technology for the control of communicable diseases provides a powerful weapon and exciting prospects, but the 21st century, infectious diseases, the main coping strategies should still rely on traditional public health measures and non-high-tech way to control the environment and changing peoples behavior in response to a changing world [14]. China to take "a high degree of attention and positive response, joint prevention and control, according to scientific disposal" of the 18 characters deal with the principle of
Pay close attention to the implementation of the epidemic abroad, and establish mechanisms for joint prevention and control, adherence to the border inspection and quarantine barriers, timely release of travel health and safety tips, to strengthen domestic human influenza surveillance, the strengthening of domestic swine flu epidemic monitoring and immunization supplies to increase reserves and make vaccine prevention and control techniques research, and actively spread of influenza prevention and control strategy for prevention and treatment knowledge of 8, indicating policy makers have understood the scientific and effective strategy for prevention and control of influenza A H1N1 influenza The key is to control the environment and changing peoples behavior.
Scientific rationality and pragmatic response to influenza A H1N1 influenza pandemic, at least we should pay attention to the following questions.
1. Actively participate in international operations. Control of communicable diseases in the 21st century must be a global unified planning, unified action. Todays communicable disease control is no longer simply a local (or a State) Government. Developed a modern transportation and international exchanges has led to the popularity of the entire planet truly become a community, the distance between countries and regions are constantly being reduced, danger and opportunity to reach every community of the time from the past to year on year, to month meter to todays to-days in order to clock and tomorrow, with sub-terms, in seconds. The good news is China after SARS, the building of professional teams to strengthen public health is paying off,
Has already begun to equal strength to participate in the global infectious disease control the whole process of the past, relying on international organizations, technical guidance and confirmation of the situation has fundamentally changed.
2. At present in our thinking and action must not have been lax. An influenza pandemic in history lessons tell us that pandemics of influenza in the number of deaths caused by the second shock wave more than the first. The main causes of death are: (a) Primary viral pneumonia; (2) Acute respiratory distress syndrome; (3) secondary bacterial infections, particularly pneumonia. Compared with the previous century, and now we have a vaccine technology and experience, there are anti-virus and anti-bacterial drugs. Although the vaccine development time and effort, very difficult, but the concerted efforts of scientists worldwide,
Flu pandemic is expected to be able to have developed before the arrival of the second wave response to influenza A H1N1 influenza vaccine, produced in sufficient quantities to establish an effective mechanism to protect all vaccine to protect people.
3. In response to do the best preparation for the challenges to do the worst. Because the vast majority of people no immunity to influenza A H1N1 influenza virus, in the next few days, weeks, we will see more of the confirmed cases, more inpatients, more deaths. Therefore, to do the worst to meet the challenge. Influenza A H1N1 influenza should strengthen the monitoring of all aspects of doing a good job to accept and care for a large number of patients ready to re-develop a well-planned proper arrangements for the voluntary self-segregation of the light in the home patients; various medical institutions to enhance the acceptance and care for a large number of patients ability
To do a good job of nosocomial infection prevention and control; the general public to pay attention to the progress of an influenza pandemic, through a balanced diet, exercise, smoking, drinking and change their attitude to manage and promote their health, we must carefully follow the health care and public health professionals personnel-related recommendations, do not believe in all kinds of rumors.
4. Respond to influenza A H1N1 influenza, we must do a good job to fight a protracted war preparations. In the northern hemisphere, influenza virus usually early in May to stop. However, in the 1957 flu pandemic, in the summer are also the young mainly sporadic cases of outbreak. Therefore, although some experts have estimated that the influenza A H1N1 influenza pandemic, the first shock wave is likely in 3 to 5 weeks as recessions in North America (since the flu virus can not survive high temperatures, high humidity), but must not be careless. Chinas vast territory, climate complex, occurs the possibility of influenza A H1N1 influenza pandemic can not be underestimated. Moreover, historical experience tells us that
Of an influenza pandemic will be the second wave of highly pathogenic features of the emergence of a greater threat to health.
5. Respond to influenza A H1N1 influenza, can not forget the existence of a large elderly population of Chinas national conditions. At present, China has a population of 60-year-old more than 130 million, from the point of view of herd immunity, the elderly in our country the Influenza A H1N1 influenza prevention and control face a special challenge: the world does not have the first two countries have such a large number of elderly groups. The elderly age lowered immunity, increased susceptibility to influenza. If the Influenza A H1N1 influenza virus infection in the elderly, weak virulence of the virus may also cause a fatal blow to the body, making death rate increased. On the other hand, based on the concept of herd immunity,
Only when the population has immunity when the crowd reached a certain percentage (eg 70% or 90%), the spread of pathogenic micro-organisms is likely to be a natural cut off, otherwise it will appear repeatedly in the vulnerable groups, and undermine the more people health. Influenza A H1N1 influenza vaccine during the development, they need to consider the childs susceptibility, but also take into account the characteristics of the elderly.
6. Pay close attention to vaccine development, response to the second wave of influenza. Development of global coordination in an organized manner Influenza H1N1 influenza vaccine should be the focus of the current influenza vaccine, it should be our response to influenza A H1N1 influenza pandemic is an important measure.
7. To avoid the misuse of antivirals is sustainable response to an influenza pandemic one of the keys. Education and management of doctors and other staff to prevent abuse of the Influenza A H1N1 influenza virus, an effective antiviral drugs should be a response to the influenza pandemic a priority. In China, this was particularly pronounced. Be sure to make the health care workers and the public understand the abuse of antiviral drugs will soon lead to viral resistance. Found in Europe are already reported in the literature of seasonal influenza A H1N1 influenza virus ordinary resistance to Tamiflu [15-17]. If the result of an influenza pandemic on non-rational manner, a large-scale abuse of Tamiflu,
Is likely to lead to a new influenza A H1N1 influenza viruses resistant to Tamiflu. If a new subtype of influenza A virus resulted in resistance to lead to disastrous consequences.
8. Health education and health management is the best vaccine. In the absence of effective vaccines, before all the people without sufficient prior use of an effective vaccine, in the absence of effective protection mechanisms before the universal vaccination, health education and health management is still the best vaccines. Health education is to help individual action or collective action to the detriment of my personal health and other human health, informed decision-making process [18]. Health management is through the provision of scientific information in the field of health to mobilize the national initiative, to identify and remove the health risk factors, maintain and promote health [19].
Let the public about the Influenza A H1N1 influenza outbreak and protection of knowledge, to help the public from the source of infection, mode of transmission and the susceptible population three links are fully aware of influenza pandemic caused by H1N1 Influenza A variety of risk factors to help the public to change unhealthy lifestyles and habits, routinely wash their hands, not crowding together, cover your coughs and sneezes with a tissue to prevent respiratory infectious diseases such as health habits, self-management to promote good health, is still a group of defense in a global pandemic of influenza of the most important weapons.