世衛組織說,為確保恰當有效地對可能感染新型冠狀病毒的患者進行鑒別和調查,同時不因不必要的檢測使醫療係統負擔過度,世衛組織9月29日在其網站發布了修訂後的臨時病例定義,供各成員國醫療機構參考。
The following scheme is recommended for identifying cases that should be tested for infection with the novel coronavirus recently described. The goals of this scheme are to ensure a systematic approach to appropriate identification and investigation of patients who may be infected with the virus without overburdening health care systems with unnecessary testing. It should be noted that this information was developed based on data from two confirmed cases and as such some degree of clinical judgment is required where individual cases are concerned.
Patients falling into this category should undergo routinely available laboratory tests as clinically indicated according to local management guidelines for Community-Acquired Pneumonia to determine the presence of other potential primary aetiologies of pneumonia. Examples of other aetiologies might includestreptococcus pneumoniae, hemophilusinfluenza type B,legionella pneumophila, other recognized primary bacterial pneumonias, influenza, and respiratory syncytial virus. It is not necessary to wait for all test results for other pathogens to be available before testing for novel coronavirus. In addition, patients with a clear history and clinical presentation consistent with chemical pneumonitis or smoke inhalation should not be considered as a patient under investigation.
If the respiratory disease is unexplained, appropriate clinical specimens should be sent for laboratory investigation. Rapid progress has been made in the characterization of the novel coronavirus, and in the development of sensitive and specific diagnostic assays. WHO is collaborating with partner laboratories to make these available as quickly as possible. It is anticipated that the first batch of reagents, together with information and testing algorithms, will be available for urgent testing within the coming days.
Until then, WHO is able to provide contact information of laboratories willing and able to test for the presence of the novel coronavirus. For further details, national authorities should contact their respective International Health Regulations Contact Point at their WHO Regional Office.
Appropriate infection control measures should be instituted while the patient is under investigation. Should Member States require further guidance on Infection Prevention and Control, please refer to WHO interim guidelines onInfection prevention and control of epidemic- and pandemic-prone acute respiratory diseases in health care(WHO/CDS/EPR/2007.6).
Any person who has had close contact** with a probable or confirmed case while the probable or confirmed case was ill should be carefully monitored for the appearance of respiratory symptoms. If symptoms develop with the first 10 days following the contact, the individual should be considered a “Patient Under Investigation” regardless of the severity of illness and investigated accordingly.
If laboratory data, including histopathological examination of fatal cases, cannot be obtained because the patient has died before specimens are taken, clinical specimens cannot otherwise be obtained, or appropriate laboratory testing for other pathogens is not available, then the patient may meet criteria for “Probable Case” as defined below.
A person with laboratory confirmation of infection with the novel coronavirus.
WHO requests that probable and confirmed cases be reported within 24 hours of being classified as such, through the regional focal point for International Health Regulations at the appropriate WHO Regional Office.
* Currently, these areas would include only Qatar and Saudi Arabia (as of 29 September 2012).
** Close contact includes:
原文鏈接:http://www.who.int/csr/disease/coronavirus_infections/case_definition/en/index.html
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