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Throughout history, infectious diseases have accompanied the process of human civilization and have had a profound impact on human civilization. It can be said that the history of mankind is the history of fighting infectious diseases. As William McNeill mentioned in his book Plague and Man: "Intelligence, knowledge and organization can’t change people’s vulnerability and helplessness in the face of parasitic invasion. Since the appearance of human beings, infectious diseases have followed, and when human beings still exist, infectious diseases will exist. Infectious diseases used to be, and will certainly be, one of the most basic determinants affecting human history. "
Since the founding of New China 70 years ago, China has made remarkable achievements in economic, social, scientific and technological fields. Among them, experts and scholars in the fields of infectious diseases and parasitic diseases in China have made outstanding contributions to the prevention and control of infectious diseases and the improvement of people’s health. In 2018, CCTV’s "Go Around China" column produced the documentary "Never Stop Epidemic War", which recorded the wars between medical and health personnel and infectious diseases in China.
Here, we invite Professor Wang Guiqiang, the current chairman of the Infectious Diseases Branch of the Chinese Medical Association and the director of the Infectious Diseases Department of the First Hospital of Peking University, to sort out those things in the field of infectious diseases in China in the past 70 years. Those people … …
At the beginning of the founding of New China, infectious diseases such as smallpox, plague, cholera, schistosomiasis and kala-azar were rampant in China, seriously endangering people’s health. The China Municipal Government attaches great importance to the prevention and control of infectious diseases, and has successively issued a series of principles and policies to organize national efforts to prevent and control infectious diseases. In 1980s, with the classical infectious diseases being gradually controlled, the diagnosis and treatment of viral hepatitis and liver disease became the main work of infectious diseases doctors. From the 1990s to the early 21st century, with the inclusion of hepatitis B vaccination in planned immunization and the popularization of various antiviral treatments, the infectious diseases department began to return to the essence of big infection, and the focus of its work gradually shifted from the diagnosis and treatment of viral hepatitis and liver disease to the construction of big infection discipline focusing on the improvement of the diagnosis and treatment ability of bacteria and fungi.
First, the classic achievements:
These achievements are worth remembering.
(1) Eradication of smallpox
Smallpox is a severe infectious disease caused by smallpox virus, with a mortality rate as high as 25%. As early as the 10th century, China invented human pox vaccination. In 1688, Russia sent doctors to Beijing to study human pox vaccination, and human pox vaccination began to spread all over the world. Human pox vaccination has protected many people’s lives, but the vaccinated people still have a mortality rate of 2%. In 1796, edward Cenna, a British doctor, successfully vaccinated an 8-year-old boy with vaccinia, which ushered in a new era of vaccination against smallpox.
From January to August, 1950, there were 44,211 cases of smallpox in China, which were distributed all over the country. In that year, 7,765 people died of smallpox. In order to eliminate smallpox, in October 1950, the Central People’s Government issued the "Instructions on Launching Autumn Vaccination Campaign" issued by Premier Zhou Enlai, and made a decision to promote universal vaccination throughout the country. Subsequently, the Ministry of Health promulgated the "Interim Measures for Vaccination" to promote free vaccination in the whole country.
In 1950, the vaccination rate of smallpox in Beijing reached 80%, making it the first city in China to eliminate smallpox. By 1952, more than 500 million people had been vaccinated against vaccinia all over the country. By 1958, the number of smallpox cases in China had dropped sharply to more than 300.
In the spring of 1959, six people brought smallpox from Myanmar to Danjia Dazhai, Danjia District, Cangyuan County, Yunnan Province. Subsequently, two people brought smallpox to Cangyuan County, Yunnan Province from abroad. This time, the smallpox epidemic caused 672 people to get sick and 96 people died. This is the last outbreak of smallpox in China. With the recovery of the last case of smallpox in China in 1961, there was no case of smallpox in China.
In 1966, WHO decided to launch a global smallpox eradication campaign at the 19th World Health Assembly, and adopted a resolution to eradicate smallpox. On October 26th, 1977, the last smallpox patient in the world, Somali cook Ali Mao Martin, was cured. On May 8, 1980, WHO announced at the 33rd World Health Assembly held in Nairobi, Kenya, that smallpox, which had been harmful to human beings for thousands of years, had been eradicated. Since then, the global vaccination has stopped. Smallpox was eliminated in China more than ten years earlier than that in the world.
(2) Prevention and control of schistosomiasis
Schistosomiasis japonica has a history of more than 2100 years in China, and it is a zoonotic parasitic disease that seriously harms human health and social and economic development. In the early days of the founding of New China, schistosomiasis was prevalent in 370 counties (cities) in 12 provinces, municipalities and autonomous regions in southern China, with a total of 11.6 million infected people, an area of 14.8 billion square meters of snails and a threatened population of more than 100 million.
From the founding of New China to the early 1970s, comprehensive measures were mainly taken in China, including snail control and treatment with antimony potassium tartrate. Although the breeding grounds of snails were significantly reduced and the number of infected people decreased significantly, schistosomiasis was not eliminated, and antimony potassium tartrate had a long course of treatment and was highly toxic to the heart and liver. In the mid-1970s, praziquantel, a highly effective and low toxic therapeutic drug, came out, which greatly improved the prevention and control of schistosomiasis, and greatly reduced the prevalence and morbidity. Since 1990s, the strategy of schistosomiasis control in China has been adjusted to take praziquantel and health education for a large number of people.
Prevention and control of schistosomiasis is a long-term project. In 2001, WHO thought that the overall strategy of global schistosomiasis control was to reduce the harm of the disease rather than eliminate it, but it regarded schistosomiasis as a disease that could be partially eliminated. Through the comprehensive prevention and control measures focusing on the control of infectious sources, and the Outline of the National Medium and Long-term Plan for the Prevention and Control of Schistosomiasis (2004— The effective implementation of "2015)" has effectively promoted the process of schistosomiasis elimination in China. In 2008, the country reached the standard of schistosomiasis epidemic control, and in 2015, it reached the standard of schistosomiasis transmission control. Since then, the prevention and control of schistosomiasis in China has moved towards transmission blocking and even elimination.
After 2016, the endemic areas of schistosomiasis in China will continue to adhere to the working principle of "prevention first, treating both the symptoms and root causes, classified guidance, comprehensive management, joint prevention and control", implement comprehensive prevention and control strategies based on the control of infectious sources according to local conditions, and strive to achieve the 2020 goal set in the 13 th Five-Year National Schistosomiasis Prevention and Control Plan — — By the end of 2020, 96.5% of schistosomiasis endemic counties (cities, districts) in China have reached the standard of transmission interruption or elimination, among which more than 75% of endemic counties (cities, districts) have reached the standard of elimination, and all endemic counties (cities, districts) in China have reached the standard of "Healthy China 2030".
(3) Prevention and treatment of tuberculosis
Tuberculosis is a chronic infectious disease with the longest history and the largest number of deaths. Before the invention of anti-tuberculosis drugs such as streptomycin in the 1940s, tuberculosis was almost incurable.
As early as 1933, China established the China Tuberculosis Association and opened tuberculosis clinics in some cities. In 1937, the Tuberculosis Branch of Chinese Medical Association was established. In 1949, there were 12 prevention and treatment institutions in China, with more than 600 beds, 29 X-ray machines and 120 medical staff specializing in tuberculosis prevention. At that time, the prevalence rate of tuberculosis in China was as high as 17.5 million/100,000, and the mortality rate was 2 million/100,000.
After the founding of New China, the Central Institute of Tuberculosis Prevention and Control and the BCG Promotion Committee were successively established in Beijing. Tuberculosis prevention institutions at all levels have been gradually enriched and developed. By the mid-1960s, the morbidity and mortality of tuberculosis in big cities such as Beijing and Shanghai had dropped to the same level as that in Japan. The results of the first national tuberculosis epidemiological sampling survey in 1979 showed that the prevalence rate of active tuberculosis in China was 7.17/100,000, and the prevalence rate of smear-positive tuberculosis was 1.87/100,000, which was significantly lower than that in 1949.
Since 1981, the state has formulated and implemented three national ten-year plans for tuberculosis prevention and control. In January 2005, the tuberculosis management information system was launched. In 2011, the General Office of the State Council issued the National Tuberculosis Prevention and Control Plan (2011— 2015). In 2013, the former Ministry of Health issued the Management Measures for Tuberculosis Prevention and Control.
In recent years, the rising trend of tuberculosis epidemic in China has been effectively curbed, and the prevention and treatment of tuberculosis has made remarkable achievements. The fifth national tuberculosis epidemiological sampling survey in 2010 showed that the prevalence rate of active tuberculosis in China was 4.59/100,000, of which the prevalence rate of infectious tuberculosis was 66/100,000, which was 64% lower than that in 1979.
(D) Hepatitis B vaccination into the national immunization program.
China is a high epidemic area of hepatitis B. The second national hepatitis B serological survey in 1992 showed that the positive rate of HBsAg was 9.75%.
In the early 1990s, Professor Tian Gengshan and Academician Zhuang Hui made suggestions to the country, emphasizing the importance of hepatitis B vaccination. In 1992, the former Ministry of Health formally brought hepatitis B vaccination into the planned immunization management, and at the same time promulgated the National Hepatitis B Vaccination Implementation Plan. In 2002, hepatitis B vaccine was included in the national immunization plan, and newborns were provided with hepatitis B vaccine free of charge, and newborns were required to be vaccinated within 24 hours after birth.
In 2006, in order to evaluate the effect of incorporating hepatitis B vaccine into the national immunization program, the former Ministry of Health organized a national hepatitis B seroepidemiological survey. The results showed that the HBsAg positive rate of children at birth decreased from 9.67% in 1992 to 0.96% in 2005, a decrease of 90%. In May 2012, China achieved the goal of controlling the HBsAg carrying rate of children under 5 years old to below 2% through the verification of WHO Western Pacific Region, and achieved the goal of controlling the HBsAg carrying rate of children under 5 years old to below 1% by 2017 ahead of schedule.
In recent years, the vaccination rate of neonatal hepatitis B vaccine in China has remained above 95%, and the infection rate of children has decreased significantly year by year. In 2014, the fourth national hepatitis B serological survey showed that the HBsAg positive rate of children aged 1-4 years in China was 0.3%, which was over 60% lower than that in 2006.
(5) Prevention and treatment of viral hepatitis and liver disease
The development of viral hepatitis and liver disease in recent years is inseparable from the dedication of a large number of experts in infectious diseases in China.
In 2000, at the National Viral Hepatitis Conference held in Xi ‘an, Professor Si Chongwen, Chairman of the Sixth Committee of Infectious Diseases Branch of Chinese Medical Association, led the updating of the Viral Hepatitis Prevention and Control Program. In 2005, Professor Weng Xinhua, Chairman of the Seventh Committee of Infectious Diseases Branch of Chinese Medical Association, and Academician Zhuang Hui, Chairman of Hepatology Branch of Chinese Medical Association, jointly compiled and published the Guidelines for Prevention and Treatment of Chronic Hepatitis B and Hepatitis C.. The publication of these two guidelines has made positive contributions to the prevention and treatment of viral hepatitis in China and guided the clinical practice in the whole country. Since then, the guidelines have been updated successively in 2010 and 2015, and the fourth edition of Guidelines for the Prevention and Treatment of Chronic Hepatitis B and Guidelines for the Prevention and Treatment of Hepatitis C are currently being updated.
1. Hepatitis A
Hepatitis A is a worldwide public health problem caused by hepatitis A virus (HAV) infection, which is mainly transmitted through fecal-oral route. Its prevalence is closely related to social and economic development, living habits, sanitary conditions and vaccination. In 1988, the world’s largest outbreak of hepatitis A occurred in Shanghai, with more than 300,000 people infected. With the rapid development of China’s economy and the improvement of people’s living conditions, hepatitis A vaccine was included in the national planned immunization in 2007, and most areas in China have changed from high-prevalence areas to medium-or low-prevalence areas.
2. Hepatitis B
With the introduction of hepatitis B vaccine into the planned immunization in 1992, the incidence of hepatitis B in China dropped sharply. During the three national surveys in 2014, the HBsAg positive rate of people aged 1-29 in China decreased from 10.1% to 2.6%.
Half of the world’s liver cancer patients are in China, and more than 80% of them are caused by hepatitis B. Effective prevention and control of hepatitis B can effectively reduce the occurrence of liver cancer, and it is also a successful case of preventing tumors through vaccines.
Although hepatitis B has not been completely cured, it is controllable. With the development of new drugs, patients with chronic hepatitis B can effectively control the progress of the disease, block the progress to cirrhosis and liver cancer, and even reverse some decompensated cirrhosis to compensatory cirrhosis and maintain stability.
In 2014, the fourth national hepatitis B serological survey showed that the positive rates of HBsAg among people aged 1-4, 5-14 and 15-29 were 0.3%, 0.9% and 4.4% respectively. It can be seen from this data that the incidence of hepatitis B virus infection has been effectively controlled by hepatitis B vaccination in the younger age group. It is believed that with the passage of time, the occurrence of hepatitis B virus infection will eventually be eliminated.
3. Hepatitis C
Hepatitis C is a chronic disease caused by hepatitis C virus (HCV) infection. The disease progresses continuously and can develop into cirrhosis and liver cancer. In recent years, a large number of direct antiviral drugs (DAA) have been put on the market, and hepatitis C has become a curable chronic viral disease, setting a precedent for curing chronic viral diseases through drug treatment intervention. Of course, there are still some problems in its treatment, such as drug accessibility and drug interaction.
HCV infection in China is a low epidemic area in the world. The national seroepidemiological survey in 2006 showed that the positive prevalence rate of HCV antibody was 0.43% among people aged 1-59. HCV is mainly transmitted through blood and damaged skin and mucosa. In China, HCV antibody screening for blood donors began in 1993, and HCV RNA screening for blood donors with negative HCV antibody began in 2015. Since then, transmission through blood transfusion and blood products has rarely occurred.
Hepatitis C progresses slowly and invisibly, and is often called "silent killer". Patients often lose the best opportunity for treatment as soon as they find cirrhosis or liver cancer. Therefore, people with high risk of HCV infection should take the initiative to go to the hospital for screening.
4. Hepatitis D
Hepatitis D is an acute and chronic hepatitis disease caused by hepatitis D virus (HDV), which is contagious. HDV is a small RNA virus with gene defect, and its replication and transmission must depend on the existence of hepatitis B virus (HBV). Compared with HBV infection alone, HDV with HBV infection is more serious and can rapidly progress to cirrhosis or even liver cancer. Because its infection depends on HBV, improving the vaccination rate of HBV is an effective measure to prevent HDV infection.
5. Hepatitis E
Diseases that are "from mouth to mouth" have a relatively high incidence among the elderly. Outbreaks or pandemics often occurred in China before 2000. After 2000, with the improvement of China’s economic level and health facilities, its epidemic was controlled, but attention should be paid to preventing local outbreaks.
(6) Prevention and control of epidemic hemorrhagic fever
Epidemic hemorrhagic fever, also known as hemorrhagic fever with renal syndrome, is caused by a group of viruses belonging to Hantavirus. Rats are the main source of infection and spread in many ways, with fever, hypotensive shock, congestive bleeding and renal damage as the main manifestations. An epidemic broke out in China in 1980s, with an annual incidence of more than 100,000 cases and a mortality rate of over 10%.
The Party and the state attach great importance to the prevention and treatment of epidemic hemorrhagic fever. Under the leadership of the former Ministry of Health, the Branch of Infectious Diseases and Parasitology of the Chinese Medical Association established the epidemic hemorrhagic fever study group. As Professor Dan Ping served as the team leader, it organized domestic clinical experts to carry out clinical diagnosis and treatment research on hemorrhagic fever. The prevention and treatment plan of epidemic hemorrhagic fever in China was formulated, and a series of effective diagnosis and treatment plans such as preventive treatment were put forward, which greatly reduced the incidence and mortality of hemorrhagic fever.
Second, pay tribute to the predecessors:
They have made outstanding contributions to the development of infectious diseases in China.
After the founding of New China, many predecessors made great contributions to the prevention and treatment of infectious and parasitic diseases in China.
(1) Zhong Huilan
The first honorary chairman of the branch of infectious diseases and parasitology of Chinese Medical Association. Physicians, tropical pathologists and medical parasitologists devoted their lives to the study of internal diseases, especially tropical diseases, and made pioneering research on the etiology, epidemiology, clinical diagnosis, treatment and prevention of relapsing fever, typhus, kala-azar, paragonimiasis and leptospirosis. Established the Institute of Tropical Diseases of Beijing Friendship Hospital. The pathogens of epidemic typhus and endemic typhus were separated, and it was confirmed that crabs could also spread typhus. It is suggested that bone marrow puncture instead of spleen puncture and complement fixation test should be used for early diagnosis of kala-azar. We cooperated with Feng Lanzhou to study the vector of kala-azar, and confirmed that the sandfly is the main vector of kala-azar near Beijing. To confirm the role of dogs as storage hosts in transmission. In the study, I was infected by accident, and combined with my experience and observation of other cases, I put forward the clinical types of early manifestations of kala-azar. A series of diagnosis and treatment norms have been formulated to guide clinical diagnosis and treatment.
(2) Wu Chaoren
He used to be the vice president and director of internal medicine of the First Hospital of Peking University (formerly the First Affiliated Hospital of Beijing Medical College), and he had high attainments in bacteriology research. In 1955, he founded the Infectious Diseases Department of the First Hospital of Peking University, and established the virus research room, parasitic disease research room and antibiotic research room (predecessor of Peking University Institute of Clinical Pharmacology). After 1963, he mainly conducted clinical antibiotic research, which made contributions to the development of antibiotic clinical research in China. Participate in the editor-in-chief of Infectious Diseases and other works. Together with Professor Zhong Huilan and Professor Cao Zhongliang, they set up the Infectious Diseases and Parasitology Group of the Chinese Medical Association (the predecessor of the Infectious Diseases Branch of the Chinese Medical Association), actively carried out academic exchange activities, and held the first national academic conference on viral hepatitis in Changchun in 1962 and the first national academic conference on infectious diseases in Huangshan in 1963, which made great contributions to the development of infectious diseases.
(3) Wang Jiwu
The first chairman of the Branch of Infectious Diseases and Parasitology of Chinese Medical Association, a famous expert in internal medicine and infectious diseases and medical educator, the founder of the Department of Infectious Diseases and Parasitology of Zhejiang University, edited the first infectious diseases masterpiece — — Epidemiology has played an important role in the training of talents and teachers in the field of epidemiology, as well as in the diagnosis and treatment of schistosomiasis, viral hepatitis and leptospirosis.
(4) Cao Zhongliang
As a famous medical educator and infectious disease scientist in China, from controlling cholera epidemic before the founding of New China to eliminating schistosomiasis after the founding of New China, as a leading figure in southwest China, he personally organized diagnosis and treatment on the spot. When there was a leptospirosis epidemic in Sichuan in 1958, he went to the scene to rescue critically ill patients, and then insisted on field research for 30 years. In the field of leptospirosis pulmonary hemorrhage, Huaxi Medical College has established a leading position at home and abroad. Viral hepatitis, especially severe jaundice ascites hepatitis, was also studied in depth.
(5) Mao Shoubai
Medical parasite expert, one of the pioneers of schistosomiasis research in China. In the fields of schistosomiasis epidemiology, immunodiagnosis, experimental treatment, snail control methods and schistosomiasis biology, it has achieved practical scientific research achievements recognized by peers at home and abroad. In 1984, he won the "Leon Birna" prize in the 37th World Health Assembly, which was the first time that a Chinese scholar won this honor.
(6) Dai Ziying
The first vice chairman of the branch of infectious diseases and parasitology of Chinese Medical Association. Firstly, the scheme of treating typhoid fever and paratyphoid fever with low dose of chloramphenicol was put forward. Leading the diagnosis, treatment and research of viral hepatitis and hemorrhagic fever, and the pathogenesis and treatment of sepsis and septic shock. Combining clinical medicine, clinical microbiology and clinical pharmacology, he is the founder of clinical antibiotics in China. Editor-in-chief of Clinical Antibiotics and other works. 1971— In 1972, he led the investigation of clinical application of sulfa drugs, penicillin and streptomycin in China. 1978— In 1981, tetracycline antibiotics were re-evaluated, and suggestions to restrict the use of these drugs were put forward and adopted by the health administrative department. He has made outstanding achievements in advocating the rational use of antibiotics in China.
(7) Tian Gengshan
Chairman of the Second and Third Committees of Infectious Diseases and Parasitology Branch of Chinese Medical Association. During his tenure as deputy director of the former viral hepatitis expert advisory Committee of the Ministry of Health, he organized domestic experts to make suggestions to the state to carry out hepatitis B vaccination for newborns, which was formally included in the planned immunization management by the Ministry of Health, and played an important role in reducing the incidence of hepatitis B. Organized multi-center clinical trials for many times, creating a precedent for multi-center clinical research in infectious diseases in China. He presided over the formulation of China’s "Virus Hepatitis Prevention and Control Program" twice.
(8) Wang Juntao
Chairman of the Fourth Session of Infectious Diseases and Parasitology Branch of Chinese Medical Association. He used to be the vice president of Beijing Second Infectious Disease Hospital (Beijing You ‘an Hospital). Focusing on viral hepatitis, he served as the head of the national key project "Pathogenesis of Chronic Active Hepatitis B and Evaluation of Therapeutic Drugs" during the Sixth Five-Year Plan.
(9) Wang Aixia
Chairman of the Fifth Session of Infectious Diseases and Parasitology Branch of Chinese Medical Association. The first case of AIDS patients and the first case of sexually transmitted human immunodeficiency virus (HIV) infection in China were found and reported, and anti-HIV drugs were first used to treat HIV infection in China. In 1995, the national standards for AIDS diagnosis and treatment were formulated. He was the first in China to study the trend of nosocomial infection bacteria, took the lead in completing the prospective epidemiological investigation of hepatitis C after blood transfusion, and took the lead in proposing to be alert to cross-infection of hepatitis C caused by blood transfusion. First of all, it advocates that the branch of infectious diseases and parasitology should return to the essence of infectious diseases, and the infectious diseases department should be renamed as infectious diseases department.
(10) Si Chongwen
Chairman of the Sixth Committee of Infectious Diseases and Parasitology Branch of Chinese Medical Association, formally applied to rename the Branch of Infectious Diseases and Parasitology of Chinese Medical Association as Infectious Diseases Branch of Chinese Medical Association during his term of office. During his term of office, he organized experts to revise the Prevention and Treatment Plan of Viral Hepatitis in 2000, which effectively guided clinical practice. The Committee for Young and Middle-aged People was established, and the first national conference for young and middle-aged people with infectious diseases was held. The AIDS group and the artificial liver group were established. Editor-in-chief of the first monograph of Infectious Diseases.
(xi) Weng Xinhua
The 7th Chairman of Infectious Diseases Branch of Chinese Medical Association, during his tenure, Infectious Diseases and Parasitology Branch of Chinese Medical Association was officially renamed as Infectious Diseases Branch of Chinese Medical Association. In-depth clinical practice and research have been carried out on the etiological diagnosis of long-term unexplained fever, bacterial infectious diseases and viral hepatitis, and the ability of diagnosis and treatment of bacterial and fungal infections in China has been actively promoted. During his tenure as chairman, he presided over the compilation of China’s Guidelines for the Prevention and Treatment of Chronic Hepatitis B and Hepatitis C..
(XII) Li Lanjuan
The 8th and 9th Chairman of Infectious Diseases Branch of Chinese Medical Association, Academician of China Academy of Engineering. Director of State Key Laboratory of Infectious Diseases Diagnosis and Treatment, Director of Collaborative Innovation Center for Infectious Diseases Diagnosis and Treatment. Editor-in-chief has published 35 monographs such as Artificial Liver, Infectious Microecology and Infectious Diseases, which are the first textbooks in China. He won one special prize of the National Science and Technology Progress Award, one national science and technology progress award (innovation team), two first prizes and two second prizes, and was awarded the titles of "National Excellent Scientific and Technological Worker" and "National Outstanding Professional and Technical Talent", the Science and Technology Progress Award of Heliang Heli Fund, Guanghua Engineering Science and Technology Award and Tan Jiazhen Science Award for Clinical Medicine.
(13) Hou Jinlin
The 10th Chairman of Infectious Diseases Branch of Chinese Medical Association. During his term of office, he actively promoted the prevention and treatment of viral hepatitis and promoted international exchanges and cooperation. As the chairman of the Asia-Pacific Liver Disease Research Association, he hosted the largest annual meeting of Asia-Pacific liver diseases, which improved the academic discourse power of viral hepatitis and liver diseases research in China in the international arena. Presided over the "small shell" project to strengthen the standardized management of mother-to-child blocking of hepatitis B.
Third, towards the future:
The road of "big infection" in infectious diseases
(1) Learn to change its name,
"Infectious Diseases" has officially entered history.
In 2002, in order to conform to the development trend of the discipline, under the initiative of many predecessors in the field of infectious diseases, the Chinese Branch of Infectious Diseases and Parasitology was officially renamed as the Infectious Diseases Branch of the Chinese Medical Association, and the website of the Infectious Diseases Branch of the Chinese Medical Association was established, which was the earliest website among the branches of the Chinese Medical Association.
At that time, the predecessors of infectious diseases had realized that the infectious diseases discipline in China should change from classical infectious disease prevention and control to viral hepatitis and liver disease diagnosis and treatment, and return to the major infectious diseases discipline. The predecessors saw the development direction of infectious diseases in China in time, and put forward that we should strengthen the capacity building of diagnosis and treatment of bacterial and fungal infections. The renaming of the Society points out the direction for the development of infectious diseases.
It can be said that the development of infectious diseases in China has entered the third stage, returning to the essence of infectious diseases, that is, the construction of "big infection" discipline with the improvement of the ability of diagnosis and treatment of bacterial and fungal infections.
(B) the construction of the "big infection" discipline,
Improving the ability of diagnosis and treatment of bacterial and fungal infections is "king"
In fact, as early as 1970s and 1980s, Professor Dai Ziying and Professor Xu Zhaoyue of Shanghai Huashan Hospital realized the importance of improving the ability of diagnosis and treatment of bacterial and fungal infections. They have published many books on the rational use of antibacterial drugs and done a lot of forward-looking work, which laid a solid foundation for the establishment of the Institute of Antibiotics in Huashan Hospital affiliated to Fudan University. Up to now, the Institute of Antibiotics of Huashan Hospital affiliated to Fudan University and the Institute of Clinical Pharmacology of Peking University have played an important role in the research and development of antibacterial drugs, clinical trials and related personnel training in China.
At present, the global situation of bacterial drug resistance is grim, and all countries in the world attach great importance to the problem of bacterial drug resistance. An expert group in Britain predicts that if the current situation of bacterial drug resistance is not solved, by 2050, the death of patients caused by drug-resistant bacteria infection will return to the first place in the world.
China attaches great importance to the prevention and control of bacterial and fungal drug resistance. In 2012, the former Ministry of Health issued the first "Management Measures for Clinical Use of Antibacterials", which clearly stipulated that infectious diseases departments should participate in the management of rational use of antibacterial drugs. However, the status quo that cannot be ignored is that most infectious diseases doctors in China are still mainly engaged in the diagnosis and treatment of viral hepatitis and liver disease, and the ability of diagnosis and treatment of bacterial and fungal infections needs to be improved urgently.
In 2016, the National Health and Wellness Commission issued the "Notice on Improving the Diagnosis and Treatment Capability of Bacterial Fungi in General Hospitals above Grade II", emphasizing that general hospitals above Grade II should set up infection departments and establish a diagnosis and treatment system of bacterial fungal infections with infectious diseases as the main body, which provides a clear orientation for the future development of infectious diseases.
At the beginning of the 11th Committee of Infectious Diseases Branch of Chinese Medical Association, Chairman Wang Guiqiang clearly put forward the construction plan of infectious diseases discipline, and strengthened the promotion of the ability of diagnosis and treatment of bacterial and fungal infections. On the one hand, it is closely related to the national policy orientation; on the other hand, it shows that the infectious diseases academic circles in China have realized that the infectious diseases academic circles should actively participate in the application and management of antibacterial drugs, especially strengthen their own improvement in the diagnosis and treatment of bacterial and fungal infections, so as to cope with the increasingly severe drug resistance situation of bacterial and fungal infections.
(3) Do a good job in the discipline construction of "big infection",
Infection department, clinical microbiology and hospital infection control are indispensable.
Bacterial and fungal infections are distributed in various clinical departments. In addition to clinical diagnosis and treatment of infectious diseases, the infectious diseases department also provides strong support for the prevention and control of infectious diseases in the whole hospital. If the ability of infection doctors is weak, the ability of diagnosis and treatment of bacterial and fungal infections in the whole hospital will be weak. At present, the state emphasizes the rational use of antibacterial drugs and the control of medical expenses, which will greatly increase the medical expenses, prolong the hospitalization time and increase the mortality rate after the occurrence of concurrent infection, especially drug-resistant bacteria infection. Effective control of infection and effective diagnosis and treatment of infectious diseases can significantly improve the operating efficiency of hospitals. Therefore, from the perspective of hospital management, it is very important to do a good job in the construction of infectious diseases.
To do a good job in the construction of "big infection" discipline, on the one hand, the infectious disease discipline should strengthen its own ability improvement and talent echelon construction, on the other hand, it is also very important to do a good job in pathogen diagnosis and nosocomial infection management. Therefore, infectious diseases, clinical microbiology and nosocomial infection management should be organically combined to integrate subject resources, strengthen subject cooperation, and form a joint force to jointly do a good job in the diagnosis and treatment of infectious diseases.
In addition, hospital management departments and national health administrative departments should also attach importance to the construction of infectious diseases disciplines and provide corresponding support for the construction of infectious diseases disciplines.
Fourth, the outlook
At present, although the outbreak of infectious diseases is abnormal, we should always be vigilant and effectively control new and sudden infectious diseases in time. Therefore, on the one hand, the Department of Infectious Diseases undertakes the classical infectious diseases such as public health, prevention and control of classical infectious diseases, and on the other hand, although the incidence of viral hepatitis has been effectively controlled, the existing infected population base is still large, and infectious doctors still undertake a large number of viral hepatitis and liver disease prevention and control work. In addition, infection doctors need to improve the ability of diagnosis and treatment of bacterial fungi and fever of unknown origin, and play a role in the rational use of antibacterial drugs. At the same time, it is hoped that infection doctors will actively participate in the prevention and control of nosocomial infection and the interpretation of clinical microbial results, so as to improve the diagnosis and treatment ability of pathogenic microbial infections in China.
Finally, Professor Wang Guiqiang pointed out that the future development direction of infectious diseases discipline has been made clear, and our generation is a connecting link. We hope that through our efforts, the infectious diseases discipline will be built more comprehensively and with stronger capabilities, so as to meet the requirements of the national health strategy and escort the healthy China strategy.
Five, subject files:
Memorabilia of China Infectious Diseases Department
In 1950, the Ministry of Health promulgated the "Interim Measures for Vaccinium Vaccination" to promote free vaccination throughout the country. Beijing promulgated the Interim Measures for the Prevention and Treatment of Infectious Diseases.
In 1955, the first Measures for the Management of Infectious Diseases was promulgated and implemented by the Ministry of Health. Infectious diseases departments have been set up in university affiliated hospitals all over the country.
In 1961, China announced the complete eradication of smallpox virus, 19 years earlier than the World Health Organization announced that smallpox had been eradicated all over the world.
In 1978, the Ministry of Health issued the Regulations of the People’s Republic of China on the Management of Acute Infectious Diseases, which stipulated that there were 25 kinds of infectious diseases in two categories.
In 1979, after the founding of People’s Republic of China (PRC), the first masterpiece of epidemiology was published.
In 1980, the Branch of Infectious Diseases and Parasitology of Chinese Medical Association was formally established. The Ministry of Health issued the Measures for the Implementation of Vaccination.
In 1982, the Ministry of Health issued the National Regulations on Planned Immunization, which clarified the vaccines used and unified the immunization procedures for children.
In 1985, the first case of AIDS in China was found among tourists coming to China.
In 1989, China’s first Law on the Prevention and Control of Infectious Diseases in People’s Republic of China (PRC) was passed and came into force on September 1st.
Since January 1, 1992, hepatitis B vaccine immunization has been popularized all over the country, and it has been gradually incorporated into children’s planned immunization.
In 2000, the WHO Western Pacific Regional Polio Eradication Confirmation Committee declared China polio-free.
In 2002, the Branch of Infectious Diseases and Parasitology of Chinese Medical Association was officially renamed as the Branch of Infectious Diseases of Chinese Medical Association, and a website was established, which was the earliest website among all branches, and the infectious diseases departments of general hospitals were renamed as infectious diseases departments one after another. The Chinese Academy of Preventive Medicine was renamed China Center for Disease Control and Prevention.
In 2003, a large-scale SARS epidemic broke out in China.
In 2004, China launched the largest infectious disease surveillance network in the world. The revised Law on the Prevention and Control of Infectious Diseases came into force on December 1st.
In 2005, the Guidelines for the Prevention and Treatment of Chronic Hepatitis B and the Guidelines for the Prevention and Treatment of Hepatitis C were released, which were updated in 2010 and 2015 respectively, and the fourth edition is currently being revised.
In 2008, the Ministry of Health issued the Guidelines for the Prevention and Control of Hand, Foot and Mouth Disease (2008 Edition), which included hand, foot and mouth disease in the management of Class C infectious diseases.
In 2009, the Ministry of Health issued a public announcement, explicitly including influenza A (H1N1) as a Class B infectious disease under the management of the Law on the Prevention and Control of Infectious Diseases, and taking measures to prevent and control Class A infectious diseases.
In 2012, the Administrative Measures for Clinical Application of Antibacterials was officially promulgated and implemented on August 1st. The vast majority of counties (cities) in China have basically eliminated leprosy (taking counties and cities as units, the prevalence rate is ≤ 0.01‰ , the average annual incidence or detection rate in recent 5 years ≤ 0.5/100,000) standard.
In 2013, the National Health and Family Planning Commission issued the "Notice on Adjusting the Management of Some Legal Infectious Diseases" to include human infection with H7N9 avian influenza as a legal Class B infectious disease; Adjust influenza A (H1N1) from Class B to Class C and bring it into the existing influenza for management; Lift the prevention and control measures for Class A infectious diseases stipulated in the Law on the Prevention and Control of Infectious Diseases for people infected with highly pathogenic avian influenza.
In 2016, the only EV71 vaccine that can be used to prevent hand, foot and mouth disease was born in China.
In 2018, led by Academician Li Lanjuan, director of the State Key Laboratory of Infectious Diseases Diagnosis and Treatment of Zhejiang University and the Collaborative Innovation Center for Infectious Diseases Diagnosis and Treatment, and jointly completed by 11 units including China Center for Disease Control and Prevention, the project of "Major Innovation and Technological Breakthrough in the Prevention and Control System of Emerging Infectious Diseases Represented by the Prevention and Control of Human Infections with H7N9 Avian Influenza" won the special prize of the 2017 National Science and Technology Progress Award.