中国-世界卫生组织人感染H7N9禽流感联合考察组完成在华任务

中华人民共和国国家卫生和计划生育委员会

　　北京，2013年4月24日 一个中外联合专家组已完成其访问上海和北京、评估人感染H7N9禽流感形势并向国家卫生和计划生育委员会提出建议的任务。
　　

　　世卫组织负责卫生安全事务的助理总干事福田敬二说：“中国的应对堪称典范。中国疾病预防控制中心等机构和受影响地区的地方政府迅速采取行动，分享了有关基因序列和病毒等关键信息，这些对于分析形势并在未来有需要时生产疫苗做好准备十分必要。”

　　福田博士还说：“在这个全球化的世界上，我们所有人都相互关联，疫情的风险是我们的共同风险。这就更凸显出中国在遵守《国际卫生条例》方面发挥榜样作用的重要性。” 

　　该考察组由国家卫生计生委和世卫组织联合领导，成员包括流行病学、病毒学、临床管理、公共卫生和卫生政策领域的国际和中国专家。考察的目的是评估H7N9形势并提出建议。

　　4月19-23日在华期间，考察组与北京和上海参与应对工作的人员见面。在北京，考察组会见了中国疾控中心和北京疾控中心人员。在上海，考察组见到了H7N9工作组成员。他们还访问了上海市公共卫生临床中心、上海疾控中心和上海市动物疫病预防控制中心。考察组探访了一个家禽批发市场，了解到有关市场关闭措施有效性的第一手资料。

　　国家卫生计生委卫生应急办公室主任梁万年博士说：“中国经历过一些不寻常的疾病，例如SARS和2009年H1N1流感大流行。这次H7N9又是一个新领域，不过过去的经验已经教会我们如何面对。”

　　考察组注意到，上海市临床医生以及卫生和农业部门之间存在强有力的报告制度和意识，中国疾控中心也提供了支持。 
　　

　　福田博士表示：“相关应对努力表明，中国此前确实在卫生和防范领域进行了大力投入。”
考察组认为，迄今采取的措施，如关闭上海活禽市场，是及时的、合理的。从上海的情况看，迄今为止禽类感染仅限于活禽市场。但是，考察组提醒，专家对疾病严重程度的理解仍然有限。
　　

　　有些情况特别令人关切，例如，该病毒看起来不大会引起禽类出现明显病症，这使得跟踪并控制该病毒更为困难。

　　几乎所有病例都是散发病例，但也发现数起家庭聚集病例。但是，我们还不确定，这些聚集病例是由于家庭成员均接触到病毒来源还是由于出现了有限人传人。迄今为止的证据还不足以得出存在人际间传播的结论。而且，还没有发现持续人传人病例。

　　该病现已出现100余人散发感染，其中大部分症状严重，已有20余人死亡。但还不清楚有多少人携带该病但没有表现出任何症状。对于该病毒是否能够获得人际间传播能力，也还不清楚。
　　

　　不能完全排除发展为人传人的可能，这也正是目前我们非常认真对待该病毒和疫情并对其密切跟踪的原因。

　　有鉴于此，考察组强调有必要继续进行国内和国际合作。国内的卫生和农业部门需要继续密切合作。国际上，继续分享信息、指导、研究成果和病毒至关重要。

International　H7N9　assessment　team　completes　mission　to　China

BEIJING, 24 April 2013 – A team of international and Chinese experts has completed its mission to visit Shanghai and Beijing and assess the avian influenza A (H7N9) situation, and to make recommendations to the National Health and Family Planning Commission (NHFPC).

"China's response has been exemplary," said Dr Keiji Fukuda, WHO's Assistant Director-General for Health Security. "Government agencies such as Chinese Center for Disease Control and Prevention (CDC) and local authorities of affected areas acted quickly, and have shared critical information such as genetic sequence and virus needed to analyze the situation and to be ready to make vaccine if needed in the future.

"The risks of such an outbreak situation are shared in a globalized world where we are all interconnected. This underlines the importance of the example set by China in following the International Health Regulations." Dr Fukuda added.

The team, which is jointly led by NHFPC and WHO, is comprised of international and Chinese experts in epidemiology, virology, clinical management, public health, and health policy. The purpose of the mission was to assess H7N9 situation and to provide recommendations.

During 19-23 April in China, the team met with those involved in the response, in both Beijing and Shanghai. In Beijing, the team met with staff from China CDC and Beijing CDC. In Shanghai, they met members of the city's H7N9 working group. They also met with the Shanghai Public Health Clinical Center, Shanghai Center for Disease Control and Prevention (CDC) and the Shanghai Center for Animal Disease Control and Prevention. The team visited a wholesale poultry market where they learned first hand about the effectiveness of the shut-down of these markets.

"China has experienced extraordinary diseases such as SARS and the 2009 influenza H1N1 Pandemic," said Dr Liang Wannian, Director General, Office of Health Emergency, NHFPC. "We are in new territory again with H7N9, but our experience has taught us how to face it."

 The team noted the strong reporting systems and awareness in clinicians, municipal health and agricultural authorities in Shanghai, and the support offered by China CDC.

"The response reflects earlier and strong investments in health and preparedness made by China," said Dr Fukuda.

The team estimates that steps taken so far, such as the suspension of live bird markets in Shanghai, were timely and sound. In Shanghai, it appears that so far poultry infections are limited to live markets. However, they cautioned that experts still have only a limited understanding of the full extent of the disease.

The elements that warrant particular concern include the fact that the virus does not seem to cause visible illness in poultry, making it harder to track and control.

Almost all cases have been sporadic cases, but a few family clusters have been identified. However, we are not sure if the clusters were caused by common exposure to a source of virus or due to limited person to person transmission.  Evidence so far is not sufficient to conclude there is person to person transmission. Moreover, no sustained person to person transmission has been found.

The disease has now caused sporadic infections in over 100 people, with the majority developing serious disease including over 20 deaths. It is as yet unclear how many people might have carried the disease without showing any signs of illness. What also remains unclear is whether the virus could gain the ability to become transmissible between people.

The potential development of human-to-human spread cannot be ruled out, which is why this virus and outbreak is being taken extremely seriously and followed so closely.

In light of this, the team highlighted the need for continued cooperation at the national and international level. At the national level, there is a need for the health and agricultural sectors to continue working closely together. Internationally, the continued sharing of information, guidance, findings, and the viruses themselves is critical.