Stark Cameron, Garman Elaine, McMenamin Jim, McCormick Duncan, Oates Ken
NHS Highland, Inverness, Scotland, United Kingdom.
Rural Remote Health. 2010 Jul-Sep;10(3):1413. Epub 2010 Jul 23.
Pandemic Influenza (A/H1N1/2009) caused worldwide concern because of its potential to spread rapidly in human populations. In Scotland, Government policy had been to seek to contain the spread of the virus for as long as possible in order to allow time for service preparations, and for vaccine development and supply.
The first major Scottish outbreak of pandemic A/H1N1/2009 was in the rural area of Cowal and Bute. After two initial cases were identified, contact tracing found a cluster of cases associated with a football supporters' bus. Within 3 weeks, 130 cases had been identified in the area. Rapid provision of treatment doses of anti-viral medication to cases and prophylactic treatment of asymptomatic close contacts, advice on self-isolation and, where required, interruption of transmission by temporary school closure, were successful in containing the outbreak.
Pre-existing Major Incident and Pandemic Flu plans were used and adapted to the particular circumstances of the outbreak and the area. Supporting operational decision-making as close to the cases as possible allowed for speed and flexibility of response. Contact tracing and tracking of cases and results was performed by specialist public health staff who were geographically removed from the cases. This was possible because of effective use of existing telephone conferencing facilities, clarity of roles, and frequent communication among staff working on all areas of the response. Basing the work on established plans, staff experience of rural areas and rural service provision was successful.
甲型H1N1流感大流行（2009年）因其在人群中迅速传播的可能性而引起全球关注。在苏格兰，政府政策一直是尽可能长时间地控制病毒传播，以便有时间进行服务准备、疫苗研发和供应。
苏格兰首次出现的甲型H1N1流感大流行主要疫情发生在考瓦尔和比特的农村地区。在最初两例病例被确认后，通过接触者追踪发现了一群与一辆足球支持者巴士相关的病例。在3周内，该地区已确认130例病例。迅速向病例提供抗病毒药物治疗剂量，并对无症状密切接触者进行预防性治疗，提供自我隔离建议，并在必要时通过临时关闭学校来阻断传播，成功控制了疫情。
采用了预先制定的重大事件和大流行性流感计划，并根据疫情和该地区的特殊情况进行了调整。尽可能在靠近病例的地方支持行动决策，以实现反应的速度和灵活性。病例和结果的接触者追踪和跟踪由与病例在地理上分离的专业公共卫生人员进行。这之所以可行，是因为有效利用了现有的电话会议设施、明确的职责以及参与应对各领域工作的人员之间的频繁沟通。基于既定计划开展工作、工作人员在农村地区的经验以及农村服务提供取得了成功。
