In the coming fall and winter, with respect to acute infectious diseases, we need pay “significant attention” to outbreak of cluster epidemic caused by infection with norovirus and dengue fever, and pay “necessary attention” to outbreak of seasonal flu, hand-foot-mouth disease and avian flu virus infection among humans; with respect to diseases preventable by vaccination, we need to pay “necessary attention” to outbreak of measles, mumps and chickenpox. While maintaining normal epidemic prevention and control, we need to be on alert for coincident outbreak of the foregoing infectious diseases. To prevent and control the outbreak, prevalence and spread of any public health event in schools, the following information about such prevention and control should be kept in mind:

I. Basic information

1. Infection with norovirus

Viral diarrhea caused by norovirus (formerly known as norwalk-like virus) is an intestinal disease that can spread through food, water and contact. Norovirus is highly contagious, and can easily infect common people exposed to it. It is a major cause of mass infection with gastroenteritis infectiosa in schools in recent years. Major symptoms of norovirus infection include vomiting, stomach pain or cramps, and diarrhea. The symptoms usually last 2-3 days, and most people recover completely mainly through symptomatic or supportive treatment, and require no treatment with antibiotics. The prognosis of norovirus infection is commonly favorable.

2. Dengue fever

Dengue fever is an acute infectious disease caused by mosquito-borne dengue virus. Clinical manifestations of dengue virus infection include rapid onset, high fever, headache, muscle and joint pain. Some cases of dengue fever may also manifest rash, bleeding tendency, swollen lymph glands, reduced count of white blood cells, and reduced platelets.

3. Flu

Flu is spread by flu patients, most frequently in closed and crowded environments via air or droplets, or via direct contact with flu patients’ secreta. Symptoms of flu infection include fever, headache, aching muscle, fatigue, nasitis, sore throat and cough, or even gastrointestinal discomfort.

4. Hand-foot-and-mouth disease (HFMD)

The hand-foot-and-mouth disease (HFMD) is spread by HFMD patients and carriers through digestive tracts, respiratory tracts and close contact. Major symptoms of HFMD infection include maculopapules and herpes on hands, feet and in mouths. In severe cases, meningitis, encephalitis, encephalomyelitis, pneumonedema and circulatory disturbance may occur. HFMD infection most commonly occurs to preschool children, and especially the highest incidence rate occurs to the under-three age group.  

5. Avian influenza in humans

Avian flu in humans is a human disease caused by avian flu virus. Avian flu virus-borne poultry is the major infection source of avian flu. Therefore, it is critical to reduce and control the spread of avian flu among bird species, particularly among poultry. Upon early infection with avian flu, patients manifest flu-like symptoms, including fever and cough, accompanied by headache, aching and sore muscle and general discomfort, as well as running noses, nasal obstruction and sore throat. Partial patients with severe lesions in the lungs or rapid progression of the disease may have chest distress and dyspnea, etc.

6. Measles

Measles is a common acute respiratory disease caused by measles virus. It is highly infectious, and is liable to spread in regions densely-populated with people who have not received the vaccine. An epidemic of the disease often occurs every 2-3 years. Measles virus is a paramyxovirus that spreads through droplets of secreta from respiratory tracts. Clinically, measles patients manifest fever, upper respiratory inflammation, conjuntival perostitis, red maculopapular rash on skin, and koplik spots on buccal mucosa. After vanishing of the rashes and spots comes the sequel of chromatosis with bran-like desquamation. Common complications of measles may include otitis media, laryngotracheitis, pneumonia, or in serious cases, measles encephalitis and subacute sclerosing panencephalitis.

7. Chickenpox

Chickenpox is an acute disease caused by initial infection with varicella-zoster virus. It is highly infectious, mainly spread by patients through droplets from respiratory tracts and direct or indirect contact. Chickenpox patients are infectious during the period from 2 days before eruption to 6 days of eruption. Upon early infection, patients may manifest such premonitory symptoms as fever, headache and general fatigue. Eruption commonly occurs within 24 hours of onset. Rashes feature concentric distribution, i.e. more rashes erupt on the trunk and head than limbs. In most cases, patients have slight symptoms and may naturally recover without treatment.

8. Mumps

Mumps is an acute systemic infection caused by mumps virus. Patients are infectious during the period from 6-7 days before manifestation of obviously swollen parotid glands to 9 days of the swelling. Upon early infection, patients may manifest such premonitory symptoms as fever, headache, weakness, fatigue and loss of appetite. For an infected patient, the zygomatic arch and aural regions will ache 1-2 days after onset, and then the salivary gland swells on one or both sides of the patient’s face.

II. Key focuses of prevention and control

1. Perform morning/noon check of students; investigate, inquire about and register causes of absence due to illness; immediately report fever, diarrhea, vomiting cases to the secondary units and refer the cases to doctors, so as to realize early detection and reporting for early isolation and treatment.

2. Wear masks properly; develop good personal hygienic habits, including regular washing of hands, no spitting around or littering of used tissue.  

3. Avoid sharing cups, tableware, towels, toothbrushes or other personal articles with others.

4. Care about food safety by not eating takeouts from unknown sources and eating as less cold food as possible.  

5. Ensure indoor and outdoor environmental cleanness and indoor ventilation; avoid cross ventilation upon opening windows; keep warm; regularly expose clothes and beddings to direct sunlight.

6. Have balanced diet and sufficient sleep; do more exercise; keep warm and defend cold; enhance the physical constitution.

7. Avoid going to crowded public places.

8. Avoid contact with cats, dogs, birds, rodents and their feces or excrement; or otherwise in case of any contact, be sure to wash your hands.

9. When finding any dead or suspected sick animal, do not touch it but make an immediate report.

10. When necessary, cooperate with local health departments in vaccination (children and valetudinary people may get vaccinated against flu at the local disease control center or preventive vaccination clinic) to enhance immunity and realize scientific prevention.

 

 

Guided by Outpatient Department of Lingnan Normal University, LNU

Compiled by Office of International Exchange and Cooperation, LNU

October, 2020