卫生署传染病控制工作的准备与经验

1,世界贸易组织第六次部长级会议期间的传染病控制工作(2005年12月13日至18日)ControlofInfectiousDiseasesduringWorldTradeOrganisation(WTO)SixthMinisterialConference(13-18December2005)准备与经验PreparationandExperience,香港卫生署张竹君医生Dr.SKChuangDepartmentofHealth,HKSARG,2,内容大纲Content,背景卫生署的角色行动阶段公共卫生行动会议前准备阶段爆发事故管理阶段会议后阶段信息传达,BackgroundRolesofDepartmentofHealthActionphasesPublichealthactionPre-conferencepreparatoryphaseOutbreakmanagementphasePost-conferencephaseCommunication,3,背景Background,世贸是全球唯一处理国与国之间贸易规则的国际机构。WTOistheonlyglobalinternationalorganisationdealingwiththerulesoftradebetweennations.世贸的最高决策单位是部长级会议，该会议最少每两年召开一次。ThehighestdecisionmakingbodyoftheWTOistheMinisterialConference(MC),whichhastomeetatleastonceeverytwoyears.部长级会议可在任何多边贸易协议下就任何事宜作出决定。MCcantakedecisionsonallmattersunderanyofthemultilateraltradeagreements.,4,5,#资讯及通讯科技工作小组,督导委员会主席常任秘书长(工商),住宿工作小组,交通及机场接待工作小组,传媒、宣传及社区关系工作小组,保安及身份确认工作小组,社交活动、商业赞助及联络支援工作小组,会议设施工作小组,6,香港部长级会议统筹办事处总监,驻日内瓦副代表,香港部长级会议统筹办事处副总监,联络及统筹,交通及礼宾,传媒及宣传,资讯及通讯科技,住宿及会场设备,保安及身份确认,财政及支援,7,紧急事故处理架构EmergencyCoordinationduringMC6Multi-agencyCoordinationCentre(MACC),Multi-agencyCoordinationCentrewith19DLOs,保安局,CSsCommittee行政长官委员会,MVCC,HA医管局,FSD消防处,Police警务处,TD运输处,GFS政府飞行服务,22DCOs,Otherdepartmentalemergencycentres其他部门紧急应变中心,SCG,8,卫生署的角色RolesofDepartmentofHealth,就流行病的威胁向第六次部长级会议督导委员会发出预先警告及通知ToprovideearlywarningandadvancednoticeofthreatsofepidemicstoMC6SteeringCommittee调查传染病爆发事故，并迅速展开控制措施Toinvestigateinfectiousdiseasesoutbreaks,institutepromptcontrolmeasures设定现场指挥、医疗监测及执行相关命令的安排Toestablishfieldcommand,medicalsurveillanceandadministrationofrelatedorders,9,大型集会的威胁ThreatsofMassGathering,生化恐怖主义(由保安局领导应变工作)Bioterrorism(responsecoordinatedbySecurityBureau)经由食物传播的疾病Foodborneinfections人与人之间爆发呼吸道疾病或诺沃克病毒感染Persontopersonspreadofrespiratorydiseasesoutbreak,noroviralinfection新出现的传染病、严重急性呼吸系统综合症、禽流感等Emerginginfections,SARS,Avianinfluenza,10,调查及控制时的可见的困难PerceivedDifficultiesinInvestigationandControl,贵宾要员VIPs语言隔阂Languagebarrier保安措施Securitymeasures备受关注Highprofileevent,11,卫生署的防范准备PreparednessbyDH,三个阶段：(threephase)会议前准备阶段(Pre-conferencepreparatoryphase)2005年12月13日0时0分以前(before00:00of13December2005)爆发事故管理阶段(OutbreakManagementPhase)2005年12月13日0时0分至2005年12月21日0时0分(00:00of13Decemberto00:00of15December2005)会议后阶段(Post-conferencephase)2005年12月21日0时0分以后(after00:00of21December2005)爆发事故管理阶段(OutbreakManagementPhase)2005年12月13日至21日(13-21December2005)大量与会人士示威人士出香港之间的时间(lagtimeforhugeflowofparticipants/protestorsoutofHongKong),12,公共卫生行动PublicHealthActions,监测surveillance调查及控制措施InvestigationandControl化验支援Labsupport感染控制措施Infectioncontrol港口卫生措施Porthealthmeasures信息传达Communication,13,会议前准备阶段Pre-conferencePreparatoryPhase,监测(surveillance)备存和收集全球信息，通知相关各方Maintain,gatherglobalinformation,informrelevantparties提醒急症室迅速呈报传染病的资料AlertAEDforpromptnotificationofinfectiousdiseases就第六次部长级会议致函医生，吁请他们提高防范传染病的警觉IssueletterstodoctorsaboutMC6andincreasevigilanceaboutinfectiousdiseases就第六次部长级会议的传染病监测准备通知内地卫生部与广东及澳门卫生当局NotifyMinistryofHealth,Guangdong,andMacaocounterpartsaboutourMC6preparationsforInfectiousdiseasesurveillance,14,会议前准备阶段Pre-conferencePreparatoryPhase,调查及控制措施Invesitgationandcontrol制定生化恐怖袭击应变方案Contingencyplanforbioterrorism为人类感染禽流感的情况制定应变方案Scenarioplanningforhumanavianinfluenzacases拟定调查问卷，并将之翻译成为四种官方语言Developandtranslatequestionnairesinto4officiallanguages传染病调查Infectiousdiseasesinvestigation食物中毒爆发事故Foodpoisoningoutbreaks员工调动计划Staffmobilisatinplans为员工准备进入会议场地的临时许可证Temporarypermitforstafftoentertheconferencevenue食物餐单Foodmenus在会议场地设立指定区域及进行场地视察Designatedareainconferencevenueandsitevisits建立信息传达的渠道Establishcommunicationchannels,15,调查问卷Questionnaires,16,会议前准备阶段Pre-conferencepreparatoryphase,化验支援(labsupport)持续提供样本化验的支持(continueandsupporttestingofspecimen)感染控制措施(infectioncontrolmeasures)培训员工(providetrainingtostaffofMC6)港口卫生措施(porthealthmeasures)制备卫生教育材料(preparehealtheducationmaterials)信息传达(communication)传媒、提供联络名单、发信给专业人员及医生(media,providecontactlists,letterstodoctorsandprofessionals)其它(others)为参与第六届部长级会议筹办工作的员工接种流感疫苗(influenzavaccinationforstaffinvolvedinMC6),17,既定监测系统(existingsurveillancesystems),法定及重要的传染病呈报Statutorynotificationandreportingofcommunicablediseasesofpublichealthsignificance)院舍呈报羣组个案(症状羣)Clusterreportingfrominstitutions(syndromes)定点监测Sentinelsurveillance普通科医生普通科门诊诊所Generalpractitioners/outpatientclinics幼儿中心幼儿园Childcarecentres/kindergartens安老院舍Elderlyhomes化验室检测Labsurveillance,爆发事故管理阶段Outbreakmanagementphase,18,爆发事故管理阶段Outbreakmanagementphase,加强监测(Enhancement)每日监察呈报数字Dailymonitoringofnotificationfigures当出现不寻常的模式高于基线水平的偏离情况时发出警告Generatealertsforuncommonpatterns/deviationfrombaselines监测第六次部长级会议的相关事宜MonitorMC6relatedevents继续收集有关流感及邻近地区爆发其它传染病的全球情报Continuegatheringglobalepidemicintelligenceoninfluenzaandotherinfectiousdiseasesfromneighbouringregions就区域内、本地爆发事故及传媒就第六次部长级会议所关注的爆发事故，向相关各方提供每日报告Providedailyreportonregionalavianinfluenzasituation,localoutbreaksofmediainteresttoallinterestedparties调查及控制措施(investigationandcontrolmeasures)疾病调控小组、患者接触者追踪、稳妥的后勤支持Outbreakteams,cases/contacttracing,securebackupsupport,19,爆发事故管理阶段Outbreakmanagementphase,化验支援(labsupport)确保人手足够，能在非办工时间接收样本Ensuresufficientstaff,readytoreceivespecimensduringnon-officehours感染控制措施(infectioncontrolmeasures)确保卫生署员工获得足够的个人保护装备EnsuresufficientpersonalprotectiveequipmentsforDHstaff港口卫生措施(porthealthmeasures)为旅客测量体温、进行卫生教育Temperaturescreening,healtheducation信息传达(communication)紧急协调中心、热线、支援第六次部长级会议的公关单位Emergencycoordinationcentres,hotlines,supportMC6PRsection后勤支援(logisticsupport)客货车及司机、翻译员Vansanddriversandtranslators,20,信息传达Communication,部门之间(interdepartmental)电子布告板系统联系30个部门决策局的紧急协调中心Bulletinboardsystem-connectstheemergencycoordinationcentresof30department/bureau24小时紧急联络名单Emergencycontacton24hoursbasis卫生署总部当值医生DHheadquartersdutyofficers部门内部(withindepartment)当值室24小时候命(dutyroom/24hrsoncall)视像会议(videoconferencing)支援服务(backup)医护专业人员(healthcareprofessionals)办工时间(officehour)网上中央呈报办公室(CENOonline)传真(fax)电话(telephone)电邮(emails)邮递(post)非办工时间(outsideofficehours)当值医生(medicalcontrolofficer)公众(generalpublic)新闻稿(pressrelease)后备电话线、人手调配(backuptelephonelines,manpowerdeployment),21,信息传达Communication,Initial/Further/DepartmentalIncidentReport,MACCMessageForm,Tel,BBS,MACCIncidentRegister,MACCSituationReport,ForinitialreportmadetoMACCMACCMessageFormwillbefaxedtoECC,ifactivated,ofreportingBureau/Department/Agency,InitialReportPreferablybyBBSusingIncidentReportFormassoonaspracticableevenifinformationisnotyetcompleteFurtherReportPreferablybyBBSusingIncidentReportFormQuoteMACCReferenceNumberAddresstodesignatedMACC/ACfortelephonereport,MACC,Informant,Fax,Email,MACCIncidentReport,MACCLog,BROADCASTONBBS,22,23,会议后阶段Post-conferencephase,所有措施降回基线级别Standdownofallmeasurestobaselinelevel拟备监测调查报告preparereportsofsurveillance/investigation评估关于应急措施持续性及表现管理