Tuesday, February 21, 2017

China: NHFPC Holds National Video Conference, Releases Treatment Guidelines For H7N9



China's NHFPC (National Health & Family Planning Commission) held a national video conference today where they warned local officials that a failure to take decisive actions against the H7N9 virus would lead to further spread of the epidemic.
The NHFPC also released new guidelines for the testing and treatment of suspected H7N9 cases, calling for repeated testing in some cases, and early intervention with antivirals, even before test results are known.
Both are high profile statements on the NHFPC homepage, and together they suggest that the reassuring reports from last week (see Reuters China says bird flu spread slows, vows to stiffen controls), may have been a tad optimistic.

 First regarding the video conference, some excerpts from:

Determined to win the battle H7N9 epidemic prevention and control - respond to H7N9 outbreaks joint prevention and control mechanism held a national video conference to further strengthen the prevention and control of H7N9
Published: 2017-02-21

  The national response to H7N9 outbreaks joint prevention and control mechanism to firmly implement the Party Central Committee and the State Council, leaders of the important instructions, the morning of February 21, was held to further strengthen the H7N9 epidemic joint prevention and control of video conferencing, epidemic prevention and control work to nationwide deployment, and then arrangement. National Health and Family Planning Commission Li Bin, director of the Ministry of Agriculture total livestock technician MA Ai - guo, Gan Lin, deputy director of SAIC, Food and Drug Administration of deputy director Sun Xianze attended the meeting. The meeting was chaired by the National Health and Family Planning Commission Deputy Director Cui Li.

  The meeting pointed out that since January 2017, the country has 16 provinces reported H7N9 infections and deaths. Experts predict that the current epidemic preventable and controllable, but if you do not take decisive measures, the epidemic will spread further spread.

  Meeting urged all localities, departments and units should clearly understand the situation and epidemic prevention and control, enhance their sense of urgency, study and adopt more targeted, more resolute measures, to, cut off the transmission, minimizing epidemic on people's health and safety hazards.

  The meeting stressed that to insist on treating the symptoms and disease control, epidemic prevention and control overall grasp. First, we must further strengthen the source of control, it has been found H7N9 cases detected in live bird markets or animal H7N9 positive etiology cities and counties, to implement close the main city live bird market measures as soon as possible. Close to the live bird markets to strict cleaning and disinfection. According to test results, targeted culling live poultry. At the same time, we continue to strictly enforce live poultry markets were closed, disinfection system, strict control of transporting live poultry. Second, we must continue to strengthen the epidemic monitoring and early warning, timely prevention and control of epidemic spread risk. Third, we must continue to strengthen the case for treatment, do our best to protect people's health and safety. Fourth, we should do a good job information release, to strengthen health education. Fifth, we must do a good job to support the agricultural sector excluding H7N9 work, actively promote the transformation and upgrading of the poultry industry.
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The updated guidance for the identification and treatment of H7N9 cases reminds caregivers of the importance of obtaining a good epidemiological history, appears to acknowledge some challenges in obtaining  accurate lab results, and stresses the early administration of antivirals.

All fairly standard advice.   Excerpts follow: 

National Health and Family Planning Commission Notice on Strengthening of human infection with H7N9 avian influenza medical treatment work
Published: 2017-02-20

AXA invention Dian [2017] No. 10

Provinces, autonomous regions, municipalities directly under the Health and Family Planning Commission, the Xinjiang Production and Construction Corps Health Bureau:

  Currently, China is human infection with H7N9 avian influenza (hereinafter referred to as H7N9) epidemic in the high season, new cases continued to occur. To further enhance the country "early discovery, early reporting, early diagnosis, early treatment," the ability to enhance medical treatment and reduce mortality, and effectively protect the interests of people's health, is to strengthen the work of medical treatment H7N9 notified as follows:

  First, the height emphasis on medical treatment work

  to fully understand the current H7N9 epidemic prevention and control situation, always put the people's health and life safety first, follow the principle of the work, "according to the law, scientific, standardized and unified," according to "a strong, orderly, and effective, He has degrees "approach to prevention and control, to further strengthen the H7N9 medical treatment, do their utmost to save the lives of the masses. Timely summary of relevant clinical data were collected, and I reported to the Committee on Medical Administrative Authority 15th of the month.

  Second, strictly implement the "four early" requires

  health planning administrative departments at all levels and types of medical institutions at all levels in accordance with the "human infection with the H7N9 avian flu clinic program (first edition 2017)" (hereinafter referred to as "treatment program") and related technical program requirements, implement the "early discovery, early reporting, early diagnosis, early treatment," the job requirements.

  (A) sooner, center of gravity, strengthen case screening and early diagnosis. Increase front-line grassroots medical institutions and medical personnel training, improve the early recognition. Patients with fever and respiratory symptoms to ask epidemiological history, especially in contact with birds or live poultry markets exposure history. To timely collection of respiratory specimens, especially in the lower respiratory tract specimens for H7N9 virus nucleic acid detection. Highly suspected cases, to repeat sampling inspection.

  (B) the early implementation of the anti-influenza therapy. Subject to the following conditions, as far as possible should be given within 48 hours of onset of influenza anti-viral treatment, without waiting for the results of pathogen detection: First in line "treatment program" suspected cases of diagnostic criteria, before the onset of poultry and their secretions 10 days excretion or history of exposure to live poultry markets over; the second is in line with "treatment program" diagnostic criteria for suspected cases with H7N9 cases have history of close contact, recent fever, cough, sputum and other symptoms; the third is to consider clinical influenza, with " treatment program "easy development of severe risk factors.
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