Báo cáo nghiên cứu khoa học: Một đánh giá của các phản ứng xử đối với dịch cúm A (H1N1) ở tỉnh Thừa Thiên Huế trong năm 2009

Tuyển tập các nghiên cứu khoa học của trường đại học Huế đề tài: Một đánh giá của các phản ứng xử đối với dịch cúm A (H1N1) ở tỉnh Thừa Thiên Huế trong năm 2009...
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Báo cáo nghiên cứu khoa học: "Một đánh giá của các phản ứng xử đối với dịch cúm A (H1N1) ở tỉnh Thừa Thiên Huế trong năm 2009"JOURNAL OF SCIENCE, Hue University, N0 61, 2010 AN ASSESSMENT OF THE TREAMENT RESPONSE FOR THE EPIDEMIC OF INFLUENZA A (H1N1) IN THUA THIEN HUE PROVINCE IN 2009 Nguyen Dung, Hoang Huu Nam, Duong Quang Minh Nguyen Mau Duyen, Nguyen Khoa Nguyen Thua Thien Hue Provincial Health Department Nguyen Dinh Son, Nguyen Thai Hoa Thua Thien Hue Provincial Preventive Health Center SUMMARY The epidemic of Influenza A (H1N1) broke into Vietnam with the first case identified atHo Chi Minh City Tropical Hospital on 31st May, 2009. It quickly spread nationwide, with apattern of infection involving clusters of cases at schools, enterprises, and factories whichaffected community activities and social security.The epidemic hit the Province at the end ofJune, 2009 with the two peaks, one in September and mid-October and one in November. It thengradually reduced at the end of 2009. The first patient, a Vietnamese Australian coming fromAustralia, was hospitalized on the 24th June, 2009. After that, all of the District/City HealthCenters (DHC) organized an area to receive patients, and set up emergency groups fortreatment of influenza A (H1N1). Through an assessment of clinical progress of influenza A(H1N1) cases, the provincial health network devised a strategy to limit infection in thecommunity, and limit the effects of the epidemic to the community and the departments/agenciesactivities. The total number of patients hospitalized from 24th June, 2009 to 30th Decmeber, 2009was 2,051 cases which were almost all mild, well monitored, and isolated for treatment. Therewere 1,084 cases (52.8%) treated in hospitals, and 967 cases (47.2%) treated in controlledcommunities. The number of communes with patients that provided organised treatment in thecommunity was 46%. Among 2,051 cases, the most affected age group was 10-19 (65.53%., Thehighest rate was among pupils and students(79.5%). The mean time for fever resolving afterusing Tamiflu was 1.75 days. There were no severe complications or deaths in the Province. Theepidemic was controlled in the Province; till early 2010, cases were only scattered, andaccording to the evaluation indicators of a national focused influenza surveilance program inHuong Thuy, the rate of influenza A (H1N1) was sharply reduced.1. Introduction The epidemic of influenza A (H1N1) arose in Mexico in April, 2009 and quicklyspread out worldwide, and had a global pandemic alert level of 6/6 according to theWHO. According to the Announcement No. 83 from WHO, until 10th January, 2010,there were more than 208 nations and territories that reported patients positive with 93influenza A (H1N1), of which 13,554 died. Areas which had high infection of influenzaA (H1N1) in the community were North Africa, South Asia, East and Southeast Europe.In Asian areas, there were reports of high deaths in some countries due to influenza typeA (H1N1) infection such as India (1,119), Japan (145), China (continent, 714), SouthKorea (170), Australia (191), Thailand (196), and Malaysia (77). In Vietnam, the firstcase was identified at the Ho Chi Minh City Tropical Hopsital on 31st May, 2009; until20th January, 2010, Vietnam reported 11,166 positive cases, in which 56 were killed. In Thua Thien Hue Province, the epidemic occured at the end of June, 2009,with the two peaks, one in September, and one in mid October and November (15th and17th weeks), it then gradually reduced in winter (November and December). At thebeginning of the epidemic at the end of June 2009, the first patient was a VietnameseAustralian coming from Australia who was hospitalized on 24th June. After nearly twomonths, the epidemic spread widely to the community, where a cluster of cases firstappeared in Huong Thuy district on the 14th August, 2009, and then many clusters ofcases appeared at schools such as Nguyen Hue and Gia Hoi High schools, and VinhNinh Primary school. After that the disease spread out to many schools in the Province.Patients were treated following the protocol of the Ministry of Health with the results ofrecovery and no death. Influenza A (H1N1) of type A was a communicable disease that was especiallydangerous. The disease was caused by a new virus of type A (H1N1). This was a newvirus which had not been reported before. This new virus had genetic materials from arecombination of influenza viruses from pigs and birds (not H5) and humans. Especiallyin Vietnam, there was circulation of avian flu, influenza A (H5N1), thus the risk ofpatients might have been coinfected with the two strains of H1 and H5 influenza viruses.This migh have resulted in the risk of recombination from genoms of the two virusstrains to form a new virus strain, which would be very dangerous due to itscharacteristics of being transmitted easily like influenza A (H1N1) and being a seriousdisease like influenza A (H5N1). The organization of receiving treatment for influenza A (H1N1) patients that wassuitable to the local situation was an urgent problem, which required a feasible andeffective response which prevented deaths and avoided disruptions to the communityand other social activities. To ensure these needs were met, we conducted the followingstudy “An assessment of the treatment response for the epidemic of influenza A (H1N1)in Thua Thien Hue Province in 2009” to describe the appropriateness of theorganization of the treatment response for confirmed and suspected influ ...