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2009年甲型H1N1流感大流行。荷兰的管理与疫苗接种策略。

The 2009 influenza A (H1N1) pandemic. Management and vaccination strategies in The Netherlands.

作者信息

van der Sande M A B, Jacobi A, Meijer A, Wallinga J, van der Hoek W, van der Lubben M

机构信息

RIVM - Centre Infectious Disease Control, National Institute for Public Health and the Environment, Bilthoven, 3720 BA, Bilthoven, The Netherlands.

出版信息

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz. 2013 Jan;56(1):67-75. doi: 10.1007/s00103-012-1582-4.

Abstract

Prior to 2009, The Netherlands had prepared itself extensively for a potential pandemic. Multidisciplinary guidelines had been drafted to control transmission and limit adverse outcomes for both a phase of early incidental introduction and for a phase with widespread transmission. The Ministry of Health had ensured a supply and distribution schedule for antivirals and negotiated a contract for vaccine purchases. During the pandemic, existing surveillance was expanded, the established infectious disease response structure was activated, and the previously prepared protocols for communication, diagnostics, use of antivirals, and vaccination implementation were operationalized and implemented. When the pandemic turned out to be less severe than many had anticipated, risk communication and rapid modification of guidelines and communication became a major challenge. Antivirals and pandemic vaccines were reserved for those at high risk for severe outcomes only. Overall, the impact of the pandemic was comparable to the impact of an average seasonal influenza epidemic, but with a shift in (severe) outcomes from the very young and elderly toward young adults. Established prepared protocols enabled timely coordinated responses. In preparing for the worst, sufficient attention must be given to preparing for a mild scenario as well.

摘要

2009年之前,荷兰已为可能出现的大流行做了充分准备。已起草多学科指南,以控制传播并限制在早期偶然引入阶段和广泛传播阶段的不良后果。卫生部确保了抗病毒药物的供应和分发计划,并就疫苗采购合同进行了谈判。在大流行期间,扩大了现有监测,启动了既定的传染病应对结构,先前制定的沟通、诊断、抗病毒药物使用和疫苗接种实施方案得到实施。当大流行的严重程度低于许多人的预期时,风险沟通以及指南和沟通的快速调整成为一项重大挑战。抗病毒药物和大流行疫苗仅保留给有严重后果高风险的人群。总体而言,大流行的影响与季节性流感平均流行的影响相当,但(严重)后果从极年幼者和老年人转向了年轻人。既定的准备方案能够实现及时的协调应对。在为最坏情况做准备时,也必须充分重视为温和情况做准备。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/af13/7079869/18b4e975ee6a/103_2012_1582_Fig1_HTML.jpg

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