中国公共卫生安全的 现状、挑战与对策思考 Status Quo, Challenges and Countermeasures for China Public Health Security 王陇德 Wang Longde

主要内容 Main Content 一、公共卫生安全的定义 Definition of public health security 二、中国保障公共卫生安全方面的主要工作成就和进展 Major achievements and progress made by China in safeguarding its public health security 三、当前影响中国公共卫生安全的主要问题与挑战 Major problems and challenges impacting China’s public health security at the present 四、促进有效防范和应对突发公共卫生事件的重要机遇 Important opportunities that facilitates effective prevention and responses over public health emergencies 五、突发公共卫生事件应对要点 Stresses for responding to public health emergencies

一、公共卫生安全的定义 Definition of Public Health Security

“为尽可能减少对危及不同地理区域以及跨国公众群体健康的紧急公共卫生事件脆弱性而采取的预见性和反应性行动。” －－摘自《2007年世界卫生报告》 “The activities required, both proactive and reactive, to minimize vulnerability to acute public health events that endanger the collective health of populations living across geographical regions and international boundaries” －－Extracted from The World Health Report 2007

发生紧急公共卫生事件的可能性以及此类事件对公众群体健康造成损害的严重程度和影响地域大小的一种社会状态。 A kind of social situation, including the possibility of occurrence of public health emergencies and the degree of damage and the area impacted caused by such events to collective health of populations

Events that directly endanger the collective health of the public 公共卫生事件分类 Categories of Public Health Events: 直接引致群体健康损害的事件 Events that directly endanger the collective health of the public 由灾害（自然或人为）引发的（次生）群体健康损害事件 Events that endanger the collective health of the public， which are caused by natural or man-made disasters

二、中国保障公共卫生安全方面的 主要工作成就和进展 二、中国保障公共卫生安全方面的 主要工作成就和进展 Major Achievements and Progresses Made by China in Safeguarding Its Public Health Security

（一）提高计划免疫接种率，使疫苗相关疾病引起的突发公共卫生事件发生率显著降低 Raised programmed immunization rate to make a significant reduce in public health emergencies derived from diseases controllable by vaccines

免疫针对疾病发病率达到历史最低水平 The occurrence of immunization targeted diseases were the least in the history 下降 99% 20年共减少相关传染病发病3亿人次、死亡400万人，减少医疗费用400多亿元 In the last two decades, patients of infectious diseases declined by 300 million, people died of infectious diseases declined by 4 million, and medical expenses declined by more than 40 billion yuan.

（二）公共卫生体系建设取得明显成效 Achieved Remarkable Results in Establishing its Public Health System

我国公共卫生体系初具规模。全国建立了国家、省、市、县四级疾病预防控制机构。到2008年底，共有疾病预防控制机构3534个，人员19 我国公共卫生体系初具规模。全国建立了国家、省、市、县四级疾病预防控制机构。到2008年底，共有疾病预防控制机构3534个，人员19.7万。妇幼保健院（所、站）3011个，专科疾病防治院（所、站）1310个，卫生监督所2675个。 China’s public health system begins to take shape. Disease prevention and control organizations were established throughout the country at the state, provincial, municipal and county levels. By the end of 2008, the disease prevention and control organizations totaled 3534 ones, with 197 thousand employees. Besides, there were 3011 women and children’s health centers (institutes, stations,),1310 specialized disease prevention and cure centers (institutions, stations), as well as 2675 health inspection institutes. Source: Yearbook of Public Health in PRC 2009, edited by editorial board of Yearbook of Public Health in PRC. Beijing: Peoples Medical Publishing House, 2009: 564-584.

（三）突发公共卫生事件应急机制建设取得长足进步 Made Significant Progress in Setting Up a Responding Mechanism for Its Public Health Emergencies

1、依法防控，建立突发公共卫生事件应急预案体系 To prevent and control infectious diseases according to the laws, and establish a response plan for public health emergencies Interpretation to Regulation on the Urgent Handling of Public Health Emergencies Law of the People's Republic of China on the Prevention and Treatment of Infectious Diseases

At the municipal level, 98% have the emergency response function 2、建立健全卫生应急组织协调机构 Established and Improved a Coordinating Organization for Its Health Response Department 卫生部及全国31个省级卫生行政部门均成立了应急办Emergency Response Offices were set up at the Ministry of Health and at the health administration departments at the provincial level in 31 provinces 98%的地市级卫生行政部门设有卫生应急职能 At the municipal level, 98% have the emergency response function 成立独立的卫生应急办Independent Office： 43.5% 指定相关部门负责卫生应急工作Relevant department responsible for： 54.5%

3、建立与完善突发公共卫生事件监测报告预警系统 Established and Improved the Monitoring, Reporting and Warning System of Public Health Emergencies 近年来基本建成的实时、在线和以个案病例为基础的医疗机构传染病和突发公共卫生事件直报网络以及“不明原因肺炎”监测体系，为传染病疫情和突发公共卫生事件的及时控制造就了基础条件 The real-time online reporting network by medical units in last years based on individual case of infectious diseases and public health emergencies, and the monitoring system for pneumonia of unknown causes lay the foundation for controlling promptly infectious diseases and public health emergencies

Former Information Reporting Model for Infectious Diseases 原传染病信息报告模式 Former Information Reporting Model for Infectious Diseases Medical Organization Mail Summary County (District) Epidemic Prevention Station Fill in Paper Cards Report in Every Ten Days Summary Provincial Epidemic Prevention Station Chinese Academy of Preventive Medicine Report Monthly

（1）建立了医疗机构法定传染病和突发公共卫生事件直报电子计算机信息网络 Set up a computer information network for medical organizations to directly report statutory infectious diseases and public health emergencies

建成了全球最大的、能覆盖全国的传染病和突发公共卫生事件在线报告系统 Set up the world biggest online reporting system covering the whole country for controlling infectious diseases and public health emergencies

截止2008年底，直报网络已覆盖全国100%的疾病控制中心、97%的县及以上医疗机构、82%的乡镇卫生院；县以上和乡镇两级医疗机构的网络报告率分别达96.98%和82.21%；网络直报系统用户达6.8万个 By the end of 2008, the direct-report network covered 100% national disease control centers, 97% medical institutions at county level or above, and 82% township public health centers; the cases reported through the network by medical institutions at county level or above and the township medical centers reached 96.8% and 82.21% of the total respectively. The system has contributed great to the non-occurrence of major epidemic events in last years in China. 19

提高了疫情报告的及时性 Improved the Promptness of Epidemic Reporting 4.9 0.6 2002 2008 报到县、区防疫站 Report to County (District) Epidemic Prevention Station 报到中国CDC Report to China CDC 诊断-报告（天） Diagnose-Report (days) 20

Direct-report via network 增强了疫情报告系统的敏感性 Enhanced the Sensitivity of the Epidemic Reporting System 系统建立后5年比前5年甲乙类传染病报告病例数年均增加39% The reported cases of A and B Class infectious diseases were averagely increased by 39% year on year in the 5 years after the system was established against the 5 years before 1993-2008年甲乙类传染病报告发病率（1/10万） The incidence of infectious diseases A and B Class reported between 1993 and 2008(1/100,000) Direct-report via network

（2）建立了“不明原因肺炎”病例监测和报告制度 Set up Monitoring and Reporting System for pneumonia of unknown causes

建立了“不明原因肺炎”监测报告体系 Set up Monitoring and Reporting System for Pneumonia of Unknown Causes 拓展疾病监测内容，建立疫情前馈控制机制，提高系统控制效能。在我国首次开展了重点传染病的症状、体征监测，实现了急性呼吸道传染病控制的“关口前移”和监测模式的创新 Expanded the scope of disease monitoring, Established the pre-control mechanism for epidemic, and promoted the control function of the system. For the first time, China has monitored the syndrome and signs of major infectious diseases, enlarged the scope for Acute respiratory infectious diseases and made innovations in its monitoring modes.

不明原因肺炎病例诊断、报告、处理流程 Procedures of Diagnose, Report and Treatment for pneumonia of unknown causes

2005-2008年“不明原因肺炎”病例监测情况 Monitoring Work on Pneumonia of Unknown Causes Between 2005 and 2008 被订正为人禽流感（37例） Re-diagnosed as human cases of bird flu(37 cases) 2005-2008年各地报告“不明原因肺炎”病例391例 Cases of reported pneumonia of unknown causes of the country totaled 391 in 2005-2008 被订正为肺鼠疫（5例） Re-diagnosed as Pulmonary plague (5 cases) 被订正为其它疾病（297例） Re-diagnosed as other diseases (297 cases) 未被确诊（52例） Not Sure(52 cases) 迅速发现人禽流感病例 Quickly detected out human cases of bird flu 通过“不明原因肺炎”监测，2005-2008年发现了人禽流感病例37例, 报告时间比确诊时间平均提前10天 By monitoring pneumonia of unknown causes , 37 human cases of bird flu were identified in 2005-2008, the reporting time was averagely 10 days earlier than the diagnosing time.

The 2007 Pacific Health Summit Forum was initiated and organized by National Bureau of Asian Research，Fred Hutchinson Cancer Research Center and Gates Foundation. The publications of the Forum regards China’s network reporting system for infectious diseases as one of the two sample plates used for reference to cope with major challenges encountered by disease monitoring system, and recommends it to other economic entities and areas.

Training and Drilling for Responding to Health Emergencies 4、做好应急准备，加强应急队伍建设 Ready to Respond to Emergencies and Improving the Quality of Emergency Response Teams 突发疫情演练 Drilling for acute epidemics 卫生应急培训、演练 Training and Drilling for Responding to Health Emergencies

Timely and Effectively Handled Public Health Emergencies 5、及时有效处置突发公共卫生事件 Timely and Effectively Handled Public Health Emergencies

多次实现了大灾之后无大疫 Realized No Epidemic After Disasters for Several Times 1991年长江流域特大洪涝灾害The severe flood disaster stroke the valley of the Yangtze River in 1991 1998年三江流域特大洪涝灾害The severe flood disaster stroke the valley of the Heilong River, the Songhua River and the Wusuli River in 1998 2008年四川汶川大地震Wenchuan Violent earthquake in Sichuan in 2008 2010年青海玉树大地震Yushu violent earthquake in Qinghai in 2010

三、当前影响中国公共卫生安全的 主要问题与挑战 Major Problems Influencing China’s Public Health Security and Challenges at Present

自20世纪70年代以来，新的传染病平均每年增加一种 Since 1970s , averagely every year sees a new kind of infectious disease 快速交流、相互依赖和相互关联的世界为传染病的快速传播创造了机会 The world , featuring fast-exchanging, interdependent and correlative, has created many opportunities for the fast spreading of infectious diseases 国家传统的边境防御已不能防范传染病或传病媒介的侵入 The country boulder is no longer able to stop the invasion of infectious diseases or their vectors 部分传染病死灰复燃，抗生素耐药威胁严重 Some infectious diseases are re-emerged, and the threat brought by antibiotic resistance is grave 监测系统不健全、不敏感，应对能力薄弱 The monitoring system is uncompleted and insensitive, with weak responding capability

所有国家有责任在2012年前建立起能有效发现并控制公共卫生风险的系统。 《国际卫生条例（2005）》要求： International Health Regulations 2005 Requires that: 所有国家有责任在2012年前建立起能有效发现并控制公共卫生风险的系统。 All the countries shall be responsible for setting up a system to effectively discover and control public health risks by 2012.

The Causes for Public Health Emergencies 突发公共卫生事件的引发因素广泛存在 The Causes for Public Health Emergencies are extensive

卫生部《首次中国居民健康素养调查报告》 First Investigation Report on Health Literacy of Chinese Residents by the Ministry of Health (Dec. 18, 2009) The overall level of health literacy of domestic residents is 6.48%. Health literacy concerning major issues of China’s present public health Scientific Concepts on Health 29.97% Literacy on Safety and First-aid 18.70% Literacy on Infectious diseases Prevention 15.86% Literacy on Basic medical Treatment 9.43% Literacy on Chronic Diseases Prevention 4.66%

－－People’s bad life style （一）基础因素 －－国民不健康的生活习惯 Basic Factors －－People’s bad life style

1、不良饮食习惯 Bad eating & drinking habits 生吃、半生吃动物性食物 捕食野生动物 宰杀、食用病死畜禽 Eating uncooked or half-cooked food of animal origin 捕食野生动物 Killing and eating wild animal 宰杀、食用病死畜禽 Killing and eating ill or dead livestock or fowls

暴发甲型肝炎：因生吃、半生吃受到甲肝病毒污染的毛蚶而引起 In 1988, Shanghai Hepatitis A broke out, attacking over 300 thousand persons 暴发甲型肝炎：因生吃、半生吃受到甲肝病毒污染的毛蚶而引起 Resulted from eating uncooked or half-cooked Scapharca subcrenata polluted by Hepatitis A Virus

closely related to killing and cooking masked civet Between 2002 and 2003, infectious SARS happened in South China and shocked the world, involving 26 provinces ( autonomous regions and municipalities ),33 nations and regions. SARS：与宰杀、烹饪果子狸密切相关 closely related to killing and cooking masked civet

鼠疫 Plague 捕食旱獭等染疫动物 Catching and eating plague infected animals like marmots 剥旱獭、羊、猫等染疫动物毛皮 Skinning plague infected animals such as marmots, sheep and cats 接触染疫动物或剥毛皮过程中，细菌通过呼吸道吸入、皮肤破口侵入或被染疫动物身上的跳蚤叮咬而感染 While contacting plague infected animals or skinning them, virus are breathed in or invaded in via respiratory tract, skin wounds, or biting by fleas from a plague infected animal.

四川省人感染猪链球菌病发病与死亡数时间分布 Time Table of Cases and Death Tolls of Streptococcus Suis Type 2 in Sichuan (204 cases, by August 20, 2005) 204 patients 38 deaths

Streptococcus Suis Type 2 broke out in 2005 in Sichuan and other places Ⅱ型猪链球菌病：宰杀、处理病死猪是唯一病因 All were caused by killing and handling ill or dead pigs

2、不良生活习惯 Bad Life Style 人与畜禽接触甚密 Close contact with livestock or fowls 粪便直接排放或使用 Using or discharging feces directly 饭前便后不洗手 Without washing hands before eating or after going to toilet 随地吐痰、咳嗽不捂口鼻 Spitting everywhere and Coughing without covering one’s mouth and nose

不健康生活习惯和行为与常见传染病的关系 Relation Between Infectious Diseases and Unhealthy Life Style and Behavior

人禽流感 Human Cases of Bird Flu 人与禽类生活在同一居室 Living with fowls in the same room 宰杀、处理病死禽 killing and handling ill or dead fowls 禽类粪便不进行无害化处理 Without decontaminating feces of fowls 呼吸道传播，目前仅发现从禽到少数人的感染，尚无人与人之间传播的证据 Transmitted through respiratory tracts. Up to now, cases show that the disease is only transmitted from fowls to a small number of people, and there is no evidence showing the disease is transmitted between persons.

血吸虫病传播链 Transmission chain of schistosomiasis 入水 1、世界上共有5种重要人体寄生血吸虫，其中流行较广的主要有日本血吸虫、埃及血吸虫和曼氏血吸虫等。 2、日本血吸虫病目前主要流行于我国、菲律宾和印度尼西亚，它又是人体血吸虫病中对健康危害最严重的血吸虫病，也是防治难度最大的血吸虫病。 3、目前全球有76个国家、6亿人口受血吸虫病威胁，2亿人被感染。 4、 全球有不少国家开展了大规模的血防工作，并取得成就。日本也曾经是血吸虫病流行的国家，但经过开展有效的防治工作，自1976年以来无感染性钉螺，1977年以来无新感染病例，成功地阻断了血吸虫病传播，消灭了血吸虫病。WHO已将其从流行地区名单中删除。

肝吸虫病 Clonorchiasis 人畜粪便管理不好 Inadequate job on treating feces of man and Livestock 病人、畜粪便中的虫卵入水 Eggs in feces of patients and livestock find way into water 生吃、半生吃淡水鱼 Eating uncooked or half-cooked fresh water fish 虫卵入螺体发育成尾蚴，再进入淡水鱼体内长成幼虫；人食入后感染 An egg enter into the body of an oncomelania hupensis and grows into a cercaria and then lives in the body of a fresh water fish and becomes a larva; a person will be infected after eating the fish.

The Report Released by UN dated Nov. 2006 Says: “ The toilet and the latrine, which helped revolutionize public health in New York, London and Paris more than a century ago, are among the most underused tools to combat poverty and disease in the developing world.” “That is the common euphemism for the reality that more than a third of the world’s people — 2.6 billion — have no decent place to go to the bathroom, while more than a billion get water for drinking, washing and cooking from sources polluted by human and animal feces.” 现仍有超过1/3的人（26亿）没有像样的地方可以解手；10多亿人在受到人类和动物粪便污染的水源中取水饮用、做饭和洗衣。

截止2006年底，我国农村达到粪便无害化处理的厕所仅占22%。大量病原体污染环境，是造成多种传染病、寄生虫病流行的主要原因 By the end of 2006, only 22% of domestic toilets in the countryside were under hazard-free treatment for the feces. Mass pathogens contaminated the environment, which was a major cause for the outbreaks of many infectious diseases and parasitic diseases.

结核病 Tuberculosis 靠呼吸飞沫或病菌附着在尘埃上传播 居室通风不良 The ventilation of a Living room is poor 随地吐痰 Spitting Everywhere 咳嗽、打喷嚏不掩口鼻 Coughing and Sneezing without covering one’s mouth and nose 靠呼吸飞沫或病菌附着在尘埃上传播 Transmitted via respiratory droplets or virus stuck to dusts

Bad Behaviors in Seeking Medical Advice 3、不良就医行为 Bad Behaviors in Seeking Medical Advice 不及时就医 Not seeing a doctor timely 卫生法制观念淡漠 Inadequate awareness of hygiene and legality

（二）加剧因素 Worsening Factors

1、医疗预防服务的可及性不高 Accessibility of Medical prevention Services is Limited 农民及城市贫困人群就医比例低 Only a small number of patients of farmers and poor urban people origin seek medical treatment 适合流动人口需求的医疗点少 Medical service points suitable for the floating population are not enough 医疗费用自付比例高 The proportion of self-paid medical expense is high

2、医疗机构的领导和临床医务人员传染病预防、控制意识薄弱，工作和制度不健全 Weak Leadership of Medical Departments, Inadequate Awareness of Health Care Workers on Prevention and Control of Infectious Diseases, Insufficient work and Incomplete Health System 预防观念淡漠 Weak Awareness of Prevention 传染病人的发现仍处于“偶然”状态 Discovery of patients of infectious diseases is still casual 院内感染控制不力 Inadequate efforts in controlling the spreading of infectious diseases inside hospitals

3、应对突发公共卫生事件的准备不足，能力低下 Inadequate Preparation and Unsatisfied Capability in Responding to Public Health Emergencies

四、促进有效防范和应对突发公共卫生事件的重要机遇 Important Opportunities Facilitating Effective Prevention and Responses to Public Health Emergencies

（一）中共中央、国务院特别关注农民的生活与健康问题 The Central Government and the State Council Attach great importance to matters concerning farmers’ life and health “引导和帮助农民切实解决住宅与畜禽圈舍混杂问题” To guide and help farmers to fundamentally resolve the problem of mixing their houses with livestock pens and henhouses --- 《中共中央、国务院关于推进社会主义新农村建设的若干意见》（中发[2006]第1号） Opinions of CPC Central Committee and the State Council on Promoting the Construction of a New Socialist Countryside (Zhong Fa [2006]No.1)

Law of the PRC on the Prevention and Treatment of Infectious Diseases （二）制订、修订了相关法律 Formulated and Amended Relevant Laws and Regulations 修订了《传染病防治法》 Formulated the Law of the PRC on the Prevention and Treatment of Infectious Diseases 制订了《食品安全法》 Formulated the Food Safety Law of the People’s Republic of China 制订了《突发事件应对法》 Formulated the Emergency Response Law of the People’s Republic of China Law of the PRC on the Prevention and Treatment of Infectious Diseases Emergency Response Law of the People’s Republic of China Food Safety Law of the People’s Republic of China

“将公共卫生整体水平提到了一个新的高度” （三）SARS流行给全社会带来的经验教训 Lessons from SARS Outbreak for the World “将公共卫生整体水平提到了一个新的高度” Promoting the Overall Level of Public Health to a New Height

（四）政府重视 The Government Values the Work 1、各级领导关注公共卫生工作 Leading cadres at all levels highlighted the work on public health 2、建立多部门合作机制 Established a mechanism featuring multi-sectors cooperation 3、加大公共卫生工作投入 Increased spending on public health work

In 2009 ： 基本公共卫生服务补助资金 104亿元 Grant-in-aid fund for basic public health service，10.4 billion yuan 重大公共卫生专项资金 117.8亿元 Special fund for major public health matters, 11.78 billion yuan 国家突发公卫事件医疗救治信息系统建设资金 1.8亿元 Fund for establishing national medical information system for rescue and treatment of public health emergencies, 108 million yuan In 2010(by mid-July) ： 基本公共卫生服务项目补助资金 109亿元 Grant-in-aid fund for basic projects of public health service, 10.9 billion yuan 重大公共卫生专项补助资金 116亿元 Special Grant-in-aid fund for major public health events, 11.6 billion yuan

（五）社会的广泛关注和参与 The work enjoys broad attention and participation among the public 1、民众的公共卫生安全意识普遍提高 The people’s awareness on public health safety is enhanced in the general 2、民间组织参与重大疾病防控积极热情 Non-governmental sectors show great enthusiasm for preventing and controlling major diseases 3、国际组织和人士积极支持中国公共卫生工作 International organizations and personages actively support China’s public health work

全球基金（艾滋病、结核和疟疾） 5.2亿美元 Global Fund (AIDS, tuberculosis and malaria), 0.52 billion USD 盖茨基金会（艾滋病、结核病） 8300万美元 Bill and Melinda Gates Foundation (AIDS, tuberculosis), 83 million USD 克林顿基金会（艾滋病） 983万美元 Clinton Foundation (AIDS), 9.83 milliom USD 默沙东（艾滋病） 3050万美元 Merck & Co. Inc (AIDS) , 30.5 milliom USD 全球营养改善联盟 450万美元 Global Alliance for Improved Nutrition, 4.5 milliom USD ……

（六）国际社会的积极推动 International Community’s Push UN 设立了千年发展目标 Set its Millennium Development Goals （8个具体指标中，3个是公共卫生指标，3个与公共卫生工作相关 Among the eight goals, 3 are public health goals, and 3 are related to public health work ） WHO 修订了《国际卫生条例（2005）》，对各成员国的公共卫生安全工作提出了要求 Amended International Health Regulation 2005, proposing requirements for the public health work of member countries

（七）中国社会的结构特点 Features of the Structure of Chinese Society 政府组织结构严紧 Well-linked structure of governmental organizations 卫生工作运作机制－－全国统一规划部署 Operation mechanism of health work—planning and implementing work is coordinated throughout the country 有利于公共卫生管理策略和措施的实施 Good for the implementation of strategies and measures of public health administration

Tactics for Responding to Public Health Emergencies 五、突发公共卫生事件应对要点 Tactics for Responding to Public Health Emergencies

（一）开展生活方式革命 Launch a revolution against life styles 影响国民健康的生活习惯与行为存在范围是如此之广，种类是如此之多，所以一般的变革不可能产生明显的增进健康的效果，必须进行一场涉及面广、内涵深刻，甚至是脱胎换骨的行为与厕所革命，才能真正达到提高国民健康水平的目的 The bad life style and behavior affecting people’s health witness wide existence and enormous categories. Therefore, a small change will not bring obvious result for people’s health improvement. As a result, it is necessary to launch a thorough revolution against bad behavior and toilets in an all round way, so that to improve people’s health in true sense

1、解决人与畜禽过度密切接触问题 To Resolve the problem of close contact between men and livestock or fowls 2、解决人畜粪便的无害化处理问题 To resolve the problem of hazard-free treatment for feces of men and livestock

血吸虫病控制新策略试点结果 Results of Pilot Work on Controlling Schistosomiasis with New Strategies (2005.5-2009.12，Jinxian County, Jiangxi Province) 2005 （Before Pilot Work） 2006 2007 2008 2009 Rate of Infected Oncomelania (%) 1.04-0.65 0.47-0.15 0.07-0.00 0.00 Average Density of Infected Oncomelania(number/0.1M2) 0.0389-0.0039 0.0047-0.0000 0.0007-0.0000 0.0000 Places with Positive Oncomelania 49 13 1 Rate of Infected Experiment Mouse (%) 79.3 2.2 Rate of Infected People (%) Class 1 Village 11.35 1.76 0.67 0.18 Class 2 Village 4.00 0.56 0.92 Class 3 Village 1.14

3、提高国民基本卫生素养 To enhance people’s basic health Literacy

良好的卫生习惯 Good Health Habits 饭前、便后用流动的水洗手 Washing hands with running water before eating and after going to toilet 不喝生水；不生吃、半生吃水产品及畜肉 Don’t drink un-boiled water; Don’t eat uncooked or half-cooked aquatic products or meat of livestock and fowl origin 不宰杀、加工、食用病死畜禽肉 Don’t slaughter, process and eat ill or dead livestock or poultry 不捕杀、烹饪、食用野生动物 Don’t slaughter, cook or eat wild animals 加工、储存食物时应做到生熟分开 Separate the cooked from the uncooked while processing or keeping food

良好的卫生习惯 Good Health Habits 居室与工作、学习环境保持良好通风 Make living rooms, work and study environments enjoy good ventilation 不随地吐痰，打喷嚏、咳嗽时应用手帕或纸巾捂住口鼻 Don’t spit everywhere. Cover mouth and nose with handkerchief or tissue while coughing or sneezing 不吸烟、不酗酒 Don’t smoke. Don’t got drunk 不沾染毒品 No drug abuse 遵守性道德 Observe sexual ethics

（二）强化医疗机构公共卫生管理 Promoting Medical Institutes’ Management Work on Public Health 1、设置传染病预检分诊机构或专门人员 To set up pre-examination triage organizations or appoint special personnel to control infectious diseases 2、建立检出传染病患者的工作机制 To establish a mechanism to identify patients of infectious diseases 3、制定并实施对甲类或按甲类管理的传染病人及其密切接触者现场控制工作规范 To formulate and implement the specification for filed control work on patients of A Class infectious diseases or patients treated as infected by such diseases as well as those people having close contact with them 4、改善就医条件，防止和控制院内感染 To improve medical services, prevent and control diseases to avoid in-hospital spreading

（三）快速反应体系的建立及专业队伍能力的提高Establishing Rapid Response System and Improving Capability of Professional Teams 1、设立专家库，组建应急队伍 To build expert databases and responding teams 2、制订突发公共卫生事件应急预案 To formulate response plans for public health emergencies 3、完善技术储备 To update necessary technique 4、改革医学教育，强化临床医学生的公共卫生意识及技能，培育适宜人才 To reform medical education, enhance public health awareness and skills of students majoring clinical medicine, and train suitable talents

公共卫生安全状况有了一定改善 Public health safety is improved to some extent 引发突发公共卫生事件的因素广泛存在 Causes leading to public health emergencies are widely existing 促进有效防范和应对突发公共卫生事件的机遇前所未有 Opportunities that may effectively prevent and respond to public health emergencies are the most in history

Thank You!