(a) the administrative department of health.
Incorporate the school tuberculosis prevention and control work into the local disease prevention and control work plan and implement the target assessment; In conjunction with the administrative department of education, formulate countermeasures and measures for the prevention and treatment of tuberculosis in schools that are in line with the actual situation in the region; Organize medical and health institutions to provide technical guidance for the prevention and treatment of tuberculosis in schools within their jurisdiction; To formulate plans for dealing with the epidemic situation of tuberculosis in schools in this area, and organize on-site investigation and handling of public health incidents of tuberculosis in schools; Inform the education administrative department of the information on the epidemic situation of tuberculosis in schools within its jurisdiction; Cooperate with the education administrative department to supervise and inspect the implementation of school prevention and control measures within its jurisdiction.
(2) Education administrative department.
Cooperate with the health department to formulate countermeasures and measures for tuberculosis prevention and control in schools according to local conditions; Supervise the implementation of the school tuberculosis epidemic reporting system; Check and urge schools within their jurisdiction to implement various measures for tuberculosis prevention and control; Cooperate with the health department to monitor the incidence of tuberculosis in schools within its jurisdiction and issue health tips in time; Assist the health department to deal with the school tuberculosis epidemic.
(3) medical and health institutions.
Establish a linkage mechanism for tuberculosis prevention and control in schools within their jurisdiction, and guide schools to implement specific prevention and control measures.
1. The disease prevention and control institution (TB prevention and control institution) is responsible for providing schools with professional and technical guidance such as TB prevention and control training; Monitor and analyze the epidemic situation of tuberculosis in schools, and timely inform the schools of the information on the epidemic situation of tuberculosis within their respective jurisdictions; Responsible for the on-site investigation and disposal of tuberculosis epidemic situation in schools; Responsible for the management of patients' diagnosis and treatment; Assist the education department to carry out health education on tuberculosis prevention and treatment in schools.
2. Medical institutions are responsible for the diagnosis, reporting and referral of tuberculosis patients; Inform the local disease prevention and control institutions (tuberculosis prevention and control institutions) of the information of tuberculosis patients in a timely manner; Health education for pulmonary tuberculosis students in the process of medical treatment and treatment; Responsible for the standardized treatment of pulmonary tuberculosis during hospitalization.
(4) school.
According to the deployment of the education administrative department and under the guidance of the health department, the prevention and treatment of tuberculosis will be included in the school work plan; Establish a responsibility system for prevention and control work in which the top leader takes overall responsibility and the principal is specifically responsible, and decompose the responsibility into departments and implement it to people; Clarify the reporter of tuberculosis epidemic; Cooperate with the health department to train school doctors and other related personnel on tuberculosis prevention and treatment knowledge; Carry out health education on tuberculosis prevention and treatment; Cooperate with health departments to deal with tuberculosis epidemic. (1) Institutional measures for disease prevention and control.
1. Provide technical training for schools and assist in health education. In conjunction with the administrative department of education, we will carry out professional training for school doctors and health care teachers, assist schools to carry out health education and publicity on tuberculosis prevention and control knowledge, and regularly conduct supervision, inspection and technical guidance on tuberculosis prevention and control work in schools under their jurisdiction.
2. Provide technical support and guidance for the physical examination of teachers and students in the school. Freshmen in kindergartens, primary schools and junior high schools need to check BCG card marks, ask whether they have a history of close contact with tuberculosis and suspicious symptoms of tuberculosis, and conduct skin test of tuberculin (PPD) for those who have a history of close contact with tuberculosis; High school and college freshmen's entrance examination and teachers' routine examination need to ask whether there is a history of close contact with tuberculosis and suspicious symptoms of tuberculosis. Those with strong positive PPD test (induration average diameter ≥ 15mm or blisters), those with suspicious symptoms or those with abnormal chest X-ray examination were examined by sputum smear for three times, and those with positive sputum smear examination were subjected to sputum culture and anti-tuberculosis drug sensitivity test.
3. Strengthen the active monitoring of tuberculosis epidemic in schools. County (district) level disease prevention and control institutions (tuberculosis prevention and control institutions) should use the infectious disease network direct reporting system and tuberculosis special reporting system to carry out active monitoring of school tuberculosis epidemic, analyze the occurrence and epidemic trend of school tuberculosis, and timely feed back the analysis results to the health and education administrative departments at the same level. Suspected cases of pulmonary tuberculosis reported by the school should be verified immediately.
(2) School measures.
1. Carry out TB health education. Through health education classes, theme class meetings, publicity panels, blackboard newspapers, publicity windows, or lectures, video products and other forms, the core knowledge of tuberculosis prevention and treatment is widely publicized to students and faculty, so as to improve their awareness of tuberculosis, enhance their awareness of self-protection and reduce discrimination against tuberculosis patients.
The core knowledge includes: (1) Tuberculosis is a chronic respiratory infectious disease; (2) Coughing and expectoration for more than 2 weeks, or bloodshot sputum, should be suspected of tuberculosis; (3) People with tuberculosis should go to the county (district) level TB institutions for examination and treatment; (4) In the county (district) level tuberculosis institutions for examination and treatment, you can enjoy the national free policy; (5) As long as we insist on regular treatment, the vast majority of tuberculosis patients can be cured; (6) Cover your nose and mouth when coughing or sneezing; (7) No spitting; (8) After suspicious symptoms of pulmonary tuberculosis appear or are diagnosed as pulmonary tuberculosis, you should take the initiative to report to the school, and you must not conceal your illness or attend classes with illness; (9) Develop the habit of opening windows for ventilation; (10) Ensure adequate sleep, reasonable diet, strengthen physical exercise and improve disease resistance.
2. Create a good school health environment. Do a good job in cleaning the campus environment and eliminate sanitary dead ends. In particular, it is necessary to clean and ventilate classrooms, dormitories, libraries (reading rooms), canteens and other crowded places to maintain indoor air circulation.
3. Implement the school health check-up, morning check-up and registration and tracking system for absence due to illness.
(1) According to the relevant regulations, the examination items of pulmonary tuberculosis will be included in the health examination files of students and faculty as compulsory items for freshmen's physical examination and annual routine physical examination of faculty. For suspected tuberculosis cases found through school physical examination, the school should promptly notify students or parents to go to local medical institutions for examination and diagnosis.
(2) The class teacher or class hygienist shall conduct morning check-up to find out whether each student has suspicious symptoms of tuberculosis such as cough, expectoration, fever and night sweats. After discovering suspicious symptoms of pulmonary tuberculosis, they should report to the school infirmary (clinic) in time, and inform students or parents to check and diagnose in local medical institutions in time.
(3) Implement the registration and tracking system for absence due to illness. The class teacher (counselor) should know the reasons for students' absence in time. If pulmonary tuberculosis is suspected, it should be reported to the school hospital (clinic) in time, and the school hospital (clinic) should follow up the students.
(4) Strengthen epidemic reporting. Suspected cases of pulmonary tuberculosis found by the school through health examination and morning examination shall be reported to the local disease prevention and control institutions in a timely manner.
(5) Establish and improve the contact mechanism between relevant departments in the school, between schools and parents, between schools and local medical and health institutions, and between education administrative departments, and clarify specific contacts and contact information. Sporadic cases of tuberculosis in schools refer to confirmed cases of tuberculosis found in schools, but they have not reached the level of public health emergencies of tuberculosis. At the same time, we will strengthen routine preventive measures and take prevention and control measures based on case management to prevent tuberculosis from spreading on campus.
(1) medical and health institutions.
1. Do a good job in the diagnosis of suspected tuberculosis cases. Teachers and students who have suspicious symptoms of tuberculosis due to illness or referral should be asked about their medical history and previous diagnosis and treatment history in detail, and chest X-ray and sputum smear should be checked according to the diagnostic procedure of "Guidelines for the Implementation of Tuberculosis Prevention and Control Planning in China", and sputum culture should be carried out when necessary. According to the patient's medical history, clinical manifestations, chest X-ray and sputum examination results, a definite diagnosis was made according to the diagnostic criteria of pulmonary tuberculosis (WS288-2008).
2. Screening close contacts. After discovering tuberculosis cases, the disease prevention and control institutions shall timely screen the close contacts between teachers and students in the school where the cases are located. Close contacts of tuberculosis cases refer to people who are in direct contact with tuberculosis cases, mainly including classmates, teachers and classmates in the same dormitory. In the screening of teachers and students in the same class and dormitory, it is necessary to expand the screening scope of close contacts to teachers and students in the same teaching building and dormitory floor; At the same time, the family members who are in close contact with the case are screened. Those who are found in close contact with pure PPD positive and normal chest radiograph during screening can be given preventive medication on the basis of their informed willingness.
3. According to the condition of the confirmed case, issue a diagnosis certificate of suspension from school. Meet one of the following conditions, you can issue a certificate of suspension of diagnosis:
(1) patients with bacterial positive pulmonary tuberculosis (including smear positive and/or culture positive patients);
(2)X-ray chest film shows extensive lung lesions and/or bacterial negative pulmonary tuberculosis with cavities;
(3) There are obvious symptoms of tuberculosis.
4. Responsible for the treatment and management of confirmed cases. Responsible for registering the information of confirmed tuberculosis cases and providing free anti-tuberculosis drug treatment. Cases that have dropped out of school should be included in the tuberculosis prevention and control institutions in their places of residence for treatment and management; For cases treated in school, the local TB prevention and control institutions and schools should combine to implement the whole process of supervision and treatment management.
5. issue a certificate of resumption of study in due course. Meet one of the following conditions, can issue a certificate of reinstatement:
(1) After regular treatment for at least 2 months, the symptoms were relieved or disappeared, chest X-ray lesions were obviously absorbed, and sputum smear tests were negative for three consecutive times (the interval between sputum smear tests was at least 1 month).
(2) After two months of regular treatment, the symptoms of patients with bacterial-negative pulmonary tuberculosis were alleviated or disappeared, chest X-ray lesions were obviously absorbed, cavities were narrowed or closed, and three consecutive sputum smear tests were negative (the interval between sputum smear tests was at least 1 month).
(2) School measures.
1. Do a good job in the registration and management of confirmed cases. Strengthen the registration and tracking of morning check-ups and absenteeism due to illness, and pay close attention to the health status of students in the same class and dormitory as the confirmed cases.
2. Stop and resume trading management.
(1) suspension management. According to the diagnosis of suspension from school in TB prevention and control institutions or designated medical institutions at or above the county level, the school adopts suspension management for students suffering from tuberculosis. Students who drop out of school can be hospitalized at home or treated in isolation, and accept the management of local tuberculosis prevention and control institutions.
(2) Reexamination management. After treatment and rehabilitation, sick students can return to school only after obtaining the rehabilitation certificate issued by tuberculosis prevention and control institutions at or above the county level or designated medical institutions.
3 to assist medical and health institutions to do a good job in the management of tuberculosis cases without suspension. For students with tuberculosis cases diagnosed by medical and health institutions as non-infectious and without dropping out of school, the school doctor or the class teacher shall assist the local tuberculosis prevention and control institutions to urge the patients to take medicine on time, and regularly visit the tuberculosis prevention and control institutions or designated medical institutions for follow-up.
4. Actively assist medical and health institutions to screen close contacts of tuberculosis cases. Students and faculty who have been screened by close contacts and have no abnormalities can attend classes and go to work normally, and the school should require them to conduct close self-observation on their own health status. Once you have suspicious symptoms of tuberculosis such as cough and expectoration, you should go to the local medical and health institutions in time. When a school has 10 cases of pulmonary tuberculosis or pulmonary tuberculosis deaths with epidemiological relevance in the same semester, the county-level health administrative department in charge of the school should consider whether it constitutes a public health emergency, verify the incident and determine the incident level according to the National Emergency Plan for Public Health Emergencies. The health administrative department at or above the county level can also directly determine the public health emergencies of tuberculosis in schools according to the actual prevention and control work and the prescribed working procedures.
Public health emergencies of tuberculosis in schools should be handled in strict accordance with the Emergency Regulations on Public Health Emergencies and related plans. On the basis of implementing the above prevention and control measures, schools and medical and health institutions will further strengthen epidemic monitoring, close contact screening, case rescue management, environmental disinfection, health education and other prevention and control measures. , so as to minimize the harm and impact of the epidemic.
(1) Measures to strengthen disease prevention and control institutions.
With the support and cooperation of the school, timely carry out on-site epidemiological investigation and close contact screening.
2. Guide schools with epidemic situation to strengthen morning check-up, registration and absence from class due to illness, and timely find and report suspected cases.
3. Cooperate with the school to do a good job in TB prevention and health education, and stabilize the mood of teachers, students and parents.
(2) School strengthening measures.
1. Under the guidance of the health department, strengthen the health education on TB prevention and control knowledge for teachers, students and parents of the whole school, and eliminate their panic in time.
2. Strengthen the daily morning check-up in primary and secondary schools and kindergartens and the registration and tracking of absence due to illness. Colleges and universities should establish and improve the collection and submission channels of students' health information in dormitories, classes, hospitals (departments), student offices and school hospitals.
3. Cooperate with the health department to do a good job in on-site investigation of confirmed cases, close contact screening and treatment management.
4. Strengthen measures such as school environmental sanitation and ventilation in public places, and do a good job in disinfection of relevant places under the guidance of the health department.
5. Implement other prevention and control measures required by medical and health departments.