传染病报告卡艾滋病性病附卡

1、注意保密传染病报告卡艾滋病性病附卡卡片编号： 患者姓名：_ （患儿家长姓名：_） 民族： _族婚姻状况： 未婚 已婚有配偶 离异或丧偶 不 详文化程度： 文盲 小学 初中 高中或中专 大专及以上户籍地址（详填）： _ 省 _市 _ 县_ 乡(镇、街道)_ 村_(门牌号)疾病名称： 艾滋病病毒感染 艾滋病梅毒（ 期、 期、 期、 胎传、 隐性） 淋病生殖道沙眼衣原体感染（ 确诊病例、 无症状感染） 尖锐湿疣 生殖器疱疹接触史：(可多选)注射毒品史 （在您记忆中有_人与您共用过注射器？）非婚异性性接触史 （在您记忆中有_人与您有过非婚性行为？）配偶/固定性伴阳性男男性行为史 （在您记忆中有_人与您

2、有过同性性行为？）献血（浆）史输血/血制品史母亲阳性职业暴露史手术史其他_(请注明)不详性病史： 有 无 不详最可能的感染途径(单选)：注射毒品异性传播同性传播性接触 + 注射毒品采血(浆)输血/血制品母婴传播职业暴露其他_(请注明)不详检测样本来源(单选)：术前检测受血(制品)前检测性病门诊其他就诊者检测婚前检查(含涉外婚姻)孕产期检查检测咨询阳性者配偶或性伴检测女性阳性者子女检测职业暴露检测娱乐场所人员体检有偿供血(浆)人员检测无偿献血人员检测出入境人员体检新兵体检强制/劳教戒毒人员检测妇教所/女劳收教人员检测其他羁押人员体检专题调查其他_(请注明)实验室检测结论： 确认检测阳性 替代策略

3、检测阳性确认（替代策略）检测阳性日期： _年_ _ 月_ _日确认（替代策略）检测单位： _ _ _艾滋病确诊日期*： _年_月_日报告单位： 联系电话： 报告医生： 填卡日期： 年 月 日备注：* 只有确诊为艾滋病病人时填写此项。 传染病报告卡艾滋病性病附卡填写说明卡片编号：由网络报告系统自动生成，与传染病报告卡一致。报告医生不填写此项内容。网络直报后，由报告单位网络直报录入员将系统自动生成的编号抄录至此处。患者姓名：根据患者身份证或户口簿登记的姓名填写，如患者为14岁以下的未成年人，还应填写其家长或监护人的姓名。与传染病报告卡一致。性病病例可填写代号。民 族：根据身份证或户口簿填写所属民族

4、的名称。婚姻状况：艾滋病病毒感染者或艾滋病病人被调查时的婚姻状况。“未婚”是指迄今没有进行过婚姻登记；“已婚有配偶”是指办理了国家法律婚姻登记手续，并且不处于离异、分居或丧偶的状态，未办理国家法律婚姻登记手续，但同居共同生活，也视为“已婚有配偶”类别。“不详”是指被调查者未能提供目前的婚姻状况或者不能确定其婚姻状况。在表中相应内容前打。文化程度：在相应的文化程度前打。文化程度是指艾滋病病毒感染者/艾滋病病人最高学历或相当学历。文盲：指不识字或识字很少。小学：指小学程度的毕业生、肄业生和在校学生，也包括没有上过小学，但能阅读通俗书报，能写便条。初中：指初中程度的毕业生、肄业生和在校学生，及相当于

5、初中程度的人。高中及中专：指高中及中专程度的毕业生、肄业生和在校学生，及相当于高中程度的人。大专及以上：指大专程度或以上的毕业生、肄业生和在校学生，及相当于大专及以上文化程度的人。户籍地址：指户口所在地地址，至少须详细填写到乡镇（街道）。按身份证或户口簿登记的住址填写。疾病名称：在做出诊断的病名前打。这是艾滋病与性病报告共用的附卡，艾滋病相关报告只在相应的感染或艾滋病前打。接触史：可以多选，根据临床询问病史或流行病学调查情况，在其曾有过的所有接触经历前打。接触史应按照如下规定选择：应尽可能问清接触史，避免选择“不详”，如已经填写了其他的接触史，则不可再选择“不详”。注射毒品史：包括静脉或肌肉等

6、注射毒品，特别是有过共用注射器经历的，不包括单纯口吸、鼻吸等不刺破皮肤、黏膜的吸毒方式。非婚异性性接触史：指与非婚异性性伴（不包括固定的同居异性）的性接触经历。配偶/固定性伴阳性：指配偶/固定性伴已被确认为艾滋病病毒抗体阳性。男男性行为史：指有男性间无保护的肛交或口交经历。献血浆史：指献过血/血浆等。输血/血制品史：指输受过全血/成份血/血浆/血制品等。母亲阳性：指母亲已被确认为艾滋病病毒抗体阳性。职业暴露史：指实验室、医护、预防保健等有关人员，在从事艾滋病防治工作及相关工作的过程中意外被艾滋病病毒感染者或艾滋病病人的血液、体液污染了破损的皮肤或非胃肠道粘膜，或被含有艾滋病病毒的血液、体液污染

7、了的针头及其它锐器刺破皮肤，而具有被艾滋病病毒感染的可能性的情况。手术史：包括口腔、内窥镜等所有侵入性操作和各类手术。其他：上述未列举，但可能造成艾滋病病毒传播的接触史。如在此选项前打，应在后面空白处进行说明。不详：是指无上述明确接触史。性病史：包括既往曾患过梅毒、淋病、非淋菌性尿道炎或生殖道沙眼衣原体感染、尖锐湿疣、生殖器疱疹、软下疳和性病性淋巴肉芽肿等病史，不包括阴道滴虫病、念珠菌性阴道炎和细菌性阴道病等。最可能的感染途径：该项不是询问艾滋病病毒感染者或艾滋病病人的，而是由填表人根据艾滋病病毒感染者或艾滋病病人的高危行为和危险因素判断艾滋病病毒感染者或艾滋病病人最可能的感染途径，并在相应的

8、列举途径前打。如果有不在列举范围内的明确的感染途径，在“其他”前打，并将相应感染途径填写在“其他”后的下划线上。“性接触 + 注射毒品”是指有任何性接触史，同时有注射毒品史，无法判断单一最可能的感染途径的情况。检测样本来源：按照所采集的血清样本的来源，在相应的内容前打。术前检测：指各种手术前开展的检查，含术中或术后曾受过血。受血（制品）前检测：对计划受血或血液制品治疗者的检查，不含术中或术后应急受血。性病门诊：来自性病门诊的样品。其他就诊者检测：除性病门诊以外的其他门诊、住院病人等的样品。婚前检查（含涉外婚姻）：以结婚为目的开展的检查。孕产期检查：孕产期的检查。检测咨询：到检测咨询点的检测。阳

9、性者配偶或性伴检测：艾滋病病毒抗体阳性的配偶或性伴，含非配偶的其他同性或异性性伴。女性阳性者子女检测：艾滋病病毒抗体阳性的女性子女的检查。职业暴露检测：指职业暴露后的检测，职业暴露的定义见“接触史”。娱乐场所人员体检：指公共场所卫生管理条例规定中，对公共场所从业人员健康检查的娱乐场所人员部分的体检。有偿供血（浆）人员检测：包括既往卖血（浆）及当前正规血站的有偿供血（浆）人员。无偿献血人员检测：来自无偿献血，能够识别真实身份的检查部分。出入境人员体检：按照中华人民共和国国境卫生检疫法规定开展的体检。新兵体检：新兵入伍前体检。强制/劳教戒毒人员检测：羁押场所强制/劳教戒毒人员的检查。妇教所/女劳收

10、教人员检测：妇教所、女子劳教所被收教人员的检测。其他羁押人员体检：除强制/劳教戒毒和妇教所、女子劳教所被收教人员以外的羁押人员的检查。专题调查：特指各种专门的流行病学调查，不包括各种日常的检测和筛查。其他：不能归入以上来源的样本。实验室检测结论：确认阳性者可不填写替代策略检测结果。确认（替代策略）检测阳性日期：如确证试验阳性可只填写确证检测阳性日期，否则填写替代策略检测日期。确认（替代策略）检测单位：如开展了确证试验可只填写确证检测单位，否则填写替代策略检测单位，与检测日期一致。艾滋病确诊日期：只在报告时，已经被诊断为艾滋病病人时填写。报告单位：填写发现艾滋病病毒感染者或艾滋病病人的医疗卫生等

11、机构全称。联系电话：填写报告单位负责疫情的相应科室或疫情负责人的联系电话。报告医生：填写发现艾滋病病毒感染者和艾滋病病人的首诊医生。填卡日期：填写本报表的实际日期。 is the most widely spoken language in the history of our planet, used in some way by at least one out of every seven human beings around the globe. half of the worlds books are written in english, and the majority of

12、international telephone calls are made in english. english is the language of over sixty percent of the worlds radio programs. more than seventy percent of international mail is written and addressed in english, and eighty percent of all computer text is stored in english. english has acquired the l

13、argest vocabulary of all the worlds languages, perhaps as many as two million words, and has generated one of the noblest bodies of literature in the annals of the human it is now time to face the fact that english is a crazy language - the most lunatic and loopy and of all languages. in the crazy e

14、nglish language, the blackbird hen is brown, blackboards can be green or blue, and blackberries are green and then red before they are ripe. even if blackberries were really black and blueberries really blue, what are strawberries, cranberries, huckleberries, raspberries, and gooseberries supposed t

15、o look add to this insanity there is no butter in buttermilk, no egg in eggplant, no grape in grapefruit, no bread in shortbread, neither worms nor wood in wormwood, neither mush nor room in mushroom, neither pine nor apple in pineapple, neither peas nor nuts in peanuts, and no ham in a hamburger. (

16、in fact, if somebody invented a sandwich consisting of a ham patty in a bun, we would have a hard time finding a name for it.)to make matters worse, english muffins werent invented in england, fries in france, or danish pastries in denmark. and we discover even more culinary madness in the that swee

17、tmeat is made from fruit, while sweetbread, which isnt sweet, is made from this unreliable english tongue, greyhounds arent always grey (or gray); panda bears and koala bears arent bears (theyre marsupials); a woodchuck is a groundhog, which is not a hog; a horned toad is a lizard; glowworms are fir

18、eflies, but fireflies are not flies (theyre beetles); ladybugs and lightning bugs are also beetles (and to, a significant proportion of ladybugs must be male); a guinea pig is neither a pig nor from guinea (its a south american rodent); and a titmouse is neither is like the air we breathe. its invis

19、ible, inescapable, indispensable, and we take it for granted. but, when we take the time to step back and listen to the sounds that escape from the holes in peoples faces and to ex- the paradoxes and vagaries of english, we find that hot dogs can be cold, darkrooms can be lit, homework can be done i

20、n school, nightmares can take place in broad daylight while morning sickness and daydreaming can take place at night, tomboys are girls and midwives can be men, hours - especially happy hours and rush hours - often last longer than sixty minutes, quick- sand works very slowly, boxing rings are squar

21、e, silverware and glasses can be made of plastic and tablecloths of paper, most are dialed by being punched (or pushed?), and most bathrooms dont have any baths in them. in fact, a dog can go to the bathroom under a tree - no bath, no room; its still going to the bathroom. and doesnt it seem a littl

22、e bizarre that we go to the bathroom in order to go to the is it that a woman can man a station but as man cant woman one, that a man can father a movement but a woman cant mother one, and that a king rules a kingdom but a queen doesnt rule a? how did all those renaissance men reproduce when there d

23、ont seem to have been any renaissance writer is someone who writes, and a stinger is something that stings. but fingers dont grocers dont, haberdashers dont, hammers dont ham, and humdingers dont the plural of tooth is teeth , shouldnt the plural of booth be ? one goose, two geese - so one moose, tw

24、o one index, two indices - one kleenex, two if people ring a bell today and rang a bell yesterday, why dont we say that they a ball? if they wrote a letter, perhaps they also their tongue. if the teacher taught, why isnt it also true that the preacher? why is it that the sun shone yesterday while i

25、shined my shoes, that i treaded water and then trod on the beach, and that i flew out to see a world series game in which my favorite player flied we conceive a conception and receive at a reception, why dont we grieve a and believe a? if a horsehair mat is made from the hair of horses and a camels

26、hair brush from the hair of camels, from what is a mohair coat made? if adults commit adultery, do infants commit infantry? if olive oil is made from olives, what do they make baby oil from? if a vegetarian eats vegetables, what does a humanitarian eat? (and im beginning to worry about those authori

27、tarians.)and if pro and con are opposites, is congress the opposite of you have to believe that all english speakers should be committed to an asylum for the verbally insane. in what other language do people drive in a parkway and park in a driveway? in what other language do people recite at a play

28、 and play at a recital? in what other language do privates eat in the general mess and generals eat in the private mess? in what other language do people ship by truck and send cargo by ship? in what other language can your nose run and your feet can a slim chance and a fat chance be the same and a

29、bad licking and a good licking be the same, while a wise man and a wise guy are opposites? how can sharp speech and blunt speech be the same and quite a lot and quite a few the same, while overlook and oversee are opposites? how can the weather be hot as hell one day and cold as hell the next? how c

30、an the expressions whats going on? and whats coming off? mean exactly the samton and unbutton and tie and untie are opposites, why are loosen and unloosen and ravel and unravel he same? if bad is the opposite of good, hard the opposite of soft, and up the opposite of down, why are badly and goodly,

31、hardly and softy, and upright and downright not opposing pairs? if harmless actions are the opposite of harmful why are shameful and shameless behavior the same and pricey objects less expensive than priceless appropriate and inappropriate remarks and passable and impassable mountain trails are oppo

32、sites, why are flammable and inflammable materials, heritable and inheritable property, and passive and impassive people the same and valuable objects less treasured than invaluable ones? if uplift is the same as lift up, why are upset and set up opposite in meaning? why are pertinent and impertinent, canny a