This standard specifies the diagnostic criteria and treatment principles for occupational forest encephalitis. This standard applies to occupational forest encephalitis and can also be used as a reference for non-occupational forest encephalitis. GBZ 88-2002 Occupational forest encephalitis diagnostic criteria GBZ88-2002 Standard download decompression password: www.bzxz.net

ICS 13.100
National Occupational Health Standard of the People's Republic of China GBZ88—2002
Diagnostic Criteria of Occupational Forest Encephalitis
Diagnostic Criteria of Occupational Forest Encephalitis Issued on April 8, 2002
Implemented on June 1, 2002
Ministry of Health of the People's Republic of China
Article 5.1 of this standard is recommended, and the rest are mandatory. This standard is formulated in accordance with the Law of the People's Republic of China on the Prevention and Control of Occupational Diseases. Forest encephalitis is an acute viral infectious disease of the central nervous system that is prevalent in forest areas and is transmitted by ticks. It poses a great threat to the health of forestry workers, geologists, border guards, residents in forest areas, and tourists. The formulation of diagnostic criteria for occupational forest encephalitis is helpful for the early diagnosis and treatment of such diseases, and is of great significance for protecting the health of various contacts, especially those working in forest areas.
Appendix A of this standard is an informative appendix.
This standard is proposed and managed by the Ministry of Health of the People's Republic of China. The responsible drafting units of this standard are: Peking University Third Hospital, Jilin Provincial Labor Health Occupational Hospital; participating drafting units: Inner Mongolia Forestry General Hospital, Jilin Fusong County Health and Epidemic Prevention Station. The Ministry of Health of the People's Republic of China is responsible for interpreting this standard. Diagnostic Standards for Occupational Forest Encephalitis
GBZ88-2002
Occupational forest encephalitis refers to an acute viral infectious disease of the central nervous system infected by tick bites during workers' occupational activities in forest areas, with obvious regional and seasonal characteristics. 1 Scope
This standard specifies the diagnostic criteria and treatment principles for occupational forest encephalitis. This standard applies to occupational forest encephalitis, and non-occupational forest encephalitis can also be implemented as a reference. 2 Normative References
The clauses in the following documents become the clauses of this standard through reference in this standard. For any dated referenced document, all subsequent amendments (excluding errata) or revisions are not applicable to this standard. However, parties reaching an agreement based on this standard are encouraged to study whether the latest versions of these documents can be used. For any undated referenced document, the latest version shall apply to this standard.
GB/T16180
Diagnostic principles
Identification of disability degree of work-related injuries and occupational diseases Diagnostic criteria for occupational acute chemical toxicity of nervous system diseases Based on the occupational population working in forest areas in spring and summer and having a history of tick bites, sudden fever, typical clinical manifestations of acute central nervous system damage, and positive specific serological tests, refer to the results of the on-site epidemiological survey of forest encephalitis, conduct a comprehensive analysis, and exclude similar diseases caused by other causes before diagnosis. 4 Diagnosis and classification standards
4.1 Mild forest encephalitis: sudden onset, fever, accompanied by symptoms such as headache, nausea, vomiting, and body temperature usually returns to normal within a week: serum specific antibodies IgM or IgG are positive. 4.2 Moderate forest encephalitis: The above symptoms are aggravated, and there are neck stiffness and positive Kernig sign, Brudzinski sign and other meningeal irritation signs.
4.3 Severe forest encephalitis: The above symptoms are aggravated, and there is one of the following conditions: a) Flaccid paralysis of the neck, shoulder or limb muscles; b) Difficulty in swallowing;
c) Language disorder;
d) Impairment of consciousness or convulsion;
e) Respiratory failure.
5 Treatment principles
5.1 Treatment principles
5.1.1 Mild patients adopt general symptomatic supportive treatment: such as cooling, maintaining water and electrolyte balance, etc.; 5.1.2 Moderate and severe patients should actively prevent and treat cerebral edema, keep the airway open, and use antiviral drugs, antibiotics and other treatments when necessary.
5.1.3 Other treatments: Early use of high-titer immunoglobulin can achieve better therapeutic effects, and interferon can be used in combination when necessary. 3
5.1.4 Treatment during the recovery period: physical therapy, Chinese medicine, functional exercise, etc. 5.2 Other treatments
Patients with mild and moderate forest encephalitis can work as usual after recovery. 5.2.1
2Patients with severe forest encephalitis can also work as usual after recovery. Individuals who need to be assessed for their ability to work can be treated according to GB/T161805.2.2bzxz.net
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Instructions for the correct use of this standard
See Appendix A (Informative Appendix).
Appendix A
(Informative Appendix)
Instructions for the correct use of this standard
A1 This standard applies to the diagnosis, typing and treatment of occupational forest encephalitis, and non-occupational forest encephalitis can be implemented as a reference. A2Forest encephalitis virus often invades the human body through the bite of ticks carrying the virus. The disease is most likely to occur when the number of viruses entering the human body is large or the human body's resistance is low. Sudden onset, fever (mostly high fever), general malaise accompanied by central nervous system damage are its characteristics.
A3 The incubation period of this disease is generally 7 to 14 days (1 to 30 days or longer), so the observation period is stipulated to be at least 2 weeks. Severe forest encephalitis has a shorter incubation period, severe condition and poor prognosis, so such patients should be closely observed for changes in condition to facilitate timely treatment and improve prognosis.
A4 The onset of occupational forest encephalitis is mainly from May to August, and all have a history of tick bites: Laboratory examinations currently commonly use indirect immunofluorescence technology to examine, which can show that specific IgM and IgG are elevated. Complement fixation tests and hemagglutination inhibition tests are also used to see that the titer of double serum increases by more than 4 times, which is helpful to distinguish from other encephalitis. A5 In the diagnostic classification of this standard, mild forest encephalitis is equivalent to the "frustrated type" in previous literature, moderate forest encephalitis is equivalent to the previous mild type, and severe forest encephalitis is the common type and severe type in the past. All manifestations such as impaired consciousness, dysphagia, language disorders and muscle flaccid paralysis on the basis of moderate disease are classified as severe forest encephalitis. A6 Vaccination can effectively prevent forest encephalitis. Since antibodies can only be produced 1.5 to 2 months after vaccination, those entering the forest area should complete the vaccination before March: its validity period is about one year, so forest workers need to repeat the vaccination every year. 5
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