Notice on issuing a guide to the seal (2022 edition)

National Health Office Medical Letter [2022] No. 202

All provinces, autonomous regions, municipalities, and Xinjiang Production and Construction Corps Health and Health Commission, Traditional Chinese Medicine Administration:

Since May 2022, many non -streaming countries in the world have reported the case of monkey acne and have community communication. In order to make preparations for monkey acne medical treatment in advance, and improve early clinical identification and standardized diagnosis and treatment ability, the National Health Commission and the State Administration of Traditional Chinese Medicine have organized the "Monkey Acne Diagnosis and Treatment Guide (2022)". See it to you, please refer to execution.

Health and health administrative departments and traditional Chinese medicine management departments at all levels should attach great importance to it, carefully organize training related training of monkey acne diagnosis and treatment, and effectively improve the ability of the "four early". And make every effort to do a good job of medical treatment to effectively protect the lives of the people's lives and health.

Office of the National Traditional Chinese Medicine Administration of the National Health and Health Commission of the National Health and Health Commission

June 10, 2022

(Form of information disclosure: proactive disclosure)

Monkey acne diagnosis and treatment guide

(2022 edition)

Monkey acne is a viral disease caused by human and beasts caused by Monkeypox Virus (MPXV). The clinical manifestations are mainly fever, rash, and lymphadenopathy. The disease is mainly popular in China and West Africa. Since May 2022, some non -streaming countries have also reported monkey acne cases and have community communication. In order to improve the early identification and standard diagnosis and treatment ability of clinicians, this diagnosis and treatment guide is specially formulated.

1. pathogenology

Monkey Virus (MPXV) is classified as a genus of acne virus in acne virus. It is one of the four genus acne virus to human pathogenic diseases. The other three are ceiling virus, acne seedlings, and acne virus. The monkey acne virus particles under the electron microscope are brick -shaped or oval, with a size of 200nm × 250nm. There are envelope. The virus particles have structural protein and DNA -dependent RNA polyase. The genomic group is a dual -chain DNA with a length of about 197kb. Monkey acne virus is divided into two branches: West African branch and Congo basin branch. The results of the virus sequencing of some of the non -popular countries are the branch of West Africa.

The main hosts of monkey acne virus are African rodents (including African squirrels, tree squirrels, Gangbia kangaroos, sleeping mouse, etc.).

Monkey acne virus is resistant to dryness and low temperature, and can survive for several months on soil, scalp and clothing. It is sensitive to heat, heating to 56 ° C for 30 minutes or 60 ° C for 10 minutes. Both ultraviolet and general disinfection agents can make them live, and are sensitive to sodium hypochlorite, chloride phenol, pentalaldehyde, formaldehyde, and polymerization formaldehyde.

Second, epidemiology

(1) source of infection

The main source of infection is a rodent infected with monkey acne virus. Long -priests (including monkeys, chimpanzees, people, etc.) can also become a source of infection after infection.

(2) Transmission pathway

The virus invades the human body through the mucous membrane and damaged skin. People are mainly infected by contacting the infection of animal lesions, blood, other body fluids, or infected by the infected animals. People are mainly transmitted through close contact, and can also be transmitted through droplets. Items contaminated by viruses may also be infected. They can also be transmitted vertically through the placenta. Can't exclude sexual communication.

(3) Saskin

The crowd is generally susceptible. Those who have been vaccinated in the past have a certain degree of cross protection for monkey acne virus.

3. Clinical manifestations

The incubation period is 5-21 days, mostly 6-13 days. In the early stage of the onset, cold wars and fever, and the body temperature is mostly above 38.5 ° C. It can be accompanied by symptoms such as headache, drowsiness, fatigue, back pain, and muscle pain. Most patients have enlarged lymph nodes such as neck, armpit, groin and other parts. A rash occurs 1-3 days after the onset. The rash first appears on the face, and gradually spreads to the limbs and other parts. The rash is mostly centrifugal distribution. The rash on the face and limbs is more common than the torso. Both the palms and the feet can appear. It can also affect oral mucosa, digestive tract, genitals, conjunctiva, and cornea. The rash has changed from a few stages of rash, pimples, herpes, pustules to crusting. The herpes and pustules are mostly spherical, with a diameter of about 0.5-1 centimeters. The texture is harder and can be accompanied by obvious itching and pain. About 2-4 weeks from the illness to scabs. Crusted erythema or pigmentation can be left behind, and even scars can be left. The duration of scars can last for several years. Some patients may have complications, including secondary bacterial infections, bronchial pneumonia, encephalitis, keratin infections, and purulent disease in the skin lesion.

Monkey acne is a self -limited disease, and most of them are good. Severe cases are common in young children and low immune functions. The prognosis is related to the infected virus branch, virus exposure, previous health status, and severity of complications. The mortality rate of West African branch is about 3%, and the mortality rate of the DRC basin is about 10%.

Fourth, laboratory inspection

(1) General inspection

Peripheral blood leukocytes are normal or elevated, and platelets are normal or decreased. Some patients may have elevated transaminase levels, decreased blood urea nitrogen levels, and hypoproteinemia.

(2) Pathogenic examination

1. Nucleic acid detection: The nucleic acid amplification detection method can detect monkey acne virus nucleic acids in specimens such as rash, blister liquid, scalp, or nasopharyngeal secretions.

2. Virus culture: Collect the above specimens for virus culture can be separated to the monkey acne virus. Virus training shall be carried out in the biological safety laboratory of level three and above.

5. Diagnosis and identification diagnosis

(1) Diagnostic criteria

1. Suspected cases

The above clinical manifestations appear, and at the same time have any of the following epidemic history:

(1) There is a history of regional residence in the regional residence of overseas acne cases within 21 days before the onset;

(2) A close contact with the case of monkey acne within 21 days before the onset;

(3) I have been exposed to the blood, body fluids or secretions of animals infected by monkey acne virus within 21 days before the onset.

2. Confirmation case

Suspected cases and monkey acne virus nucleic acid testing positive or cultivating monkey acne virus.

For cases that meet the standards of suspected cases or confirmed cases, infectious diseases should be performed in accordance with relevant requirements.

(2) Differential diagnosis

It is mainly distinguished from chickenpox, shingles, herpes zoster, measles, dengue fever and other fever and fever. It also needs to be identified with skin bacterial infections, scabies, syphilis, and allergic reactions.

6. Treatment

At present, there is no alienal anti -acne virus drug, which is mainly symptomatic support and complications.

(1) symptomatic support treatment. Stay in bed, pay attention to supplement nutrition and water, and maintain water and electrolyte balance. For those with high body temperature, physical cooling is the main temperature, exceeding 38.5 ° C, which can be relieved of thermal analgesic drugs, but pay attention to prevent a lot of sweat from causing collapse.

Keep the skin, oral, eye, and nose clean and moist to avoid scratching the skin of the rash to avoid secondary infections. When the rash part is severe, analgesic drugs can be given.

(2) Treatment of complications. Effective antibacterial drugs are given during secondary skin bacterial infection, and the separation identification and drug sensitivity results are adjusted according to pathogenic culture. It is not recommended to apply antibacterial drugs. When a corneal disease occurs, eye drops can be used, supplemented by vitamin A and other treatments. When encephalitis appears, it is given sedative, dehydration and threshold pressure, and protective airway.

(3) Psychological support treatment. Patients often have psychological problems such as nervousness, anxiety, depression, and should strengthen psychological support, guidance and related interpretations. Psychologists should be diagnosed and participated in disease diagnosis and treatment in time according to the condition.

(4) TCM treatment. According to the principle of "governance governance" and "three causes" and "adaptation of the cause" principle of traditional Chinese medicine. Seeing fever, clinical symptoms are recommended to use Shengmu Gegen Decoction, lifting and dispersing, purple snow scattered, etc.; Clinical symptoms are recommended to use Qingying soup, mimonal soup, Xuanzuka soup, Xuanzhujia soup, Xuan, Xuan, and painful lymph node swelling and pain. Bai Chengqi Decoction and so on.

7. Standards for discharge

It can be discharged from the following standards: normal temperature, obvious clinical symptoms, and scabs fall off.

8. Infected infection and control of medical institutions

Suspected cases and confirmed cases should be placed in the isolation ward. Suspected cases areolate.

Medical personnel implement standard prevention, take contact and droplets prevention measures, wear disposable latex gloves, medical protective masks, protective surfaces or goggles, disposable isolation clothes, etc. At the same time, make good hand hygiene.

The patient's secretions, feces and blood pollutants are strictly disinfected in accordance with the "Technical Specifications for Disinfection of Medical Institutions".

Source: Medical and Medical Management Bureau

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