病毒性腸胃炎討論會.ppt

病毒性腸胃炎討論會 Forum on Viral Gastroenteritis,生署 社會醫學顧問醫生 曾浩輝醫生 Dr Thomas Tsang Consultant Community Medicine Department of Health,病毒性腸胃炎 Viral Gastroenteritis,腸胃炎指腸胃(包括小腸及大腸)發炎。若腸胃炎由病毒所引致，這稱為病毒性腸胃炎。 Gastroenteritis is an inflammation of the stomach and intestines (both small and large).,病毒性腸胃炎 Viral Gastroenteritis,在天氣涼的季節較為常見。 It is more commonly found during cooler months of the year. 病毒性腸胃炎可由多種病毒引致，最常見的是諾沃克病毒及輪狀病毒。 Viral gastroenteritis is an infection caused by a variety of viruses. The most common viruses that cause gastroenteritis are Norwalk virus and rotavirus.,病毒性腸胃炎:最新情況 Viral Gastroenteritis: Update,截止 十一月十七日，今年共有41宗由諾沃克類病毒引致的腸胃炎爆發，影響約1000人，大部份個案均發生於院舍，包括幼兒中心、學校及老人院。 As of November 17, there were 41 reported cases of viral gastroenteritis caused by Norwalk-like virus, affecting about 1,000 persons and occurring in institutions like schools, child care centres and homes for the elderly. 在二二年，共有39宗，涉及892人。 In 2002, there were 39 reported cases, involving 892 persons.,* 截至二零零三年十月 Up to October 2003,Number of Outbreak Cases of Norwalk-like Disease, 2001-2003*,Jan,Jan,Jan Feb Mar Apr May Jun,Jul Aug Sep Oct Nov Dec,Month,No of case,No of case,Jan Feb Mar Apr May Jun,Jul Aug Sep Oct Nov Dec,Month,Number of Outbreak Cases of Norwalk-like Disease, 2001-2003*,病徵 Symptoms,病毒性腸胃炎的主要徵狀有: The main symptoms of viral gastroenteritis are: 腹瀉 (diarrhea)； 嘔吐(vomiting)； 其他症狀包括頭痛、發燒及腹痛； Other symptoms include headache, fever, and abdominal cramps; 症狀一般在染病後一至兩天開始出現，可持續一至十天，視乎致病病毒而定； In general, the symptoms begin 1 to 2 days following infection with a virus that causes gastroenteritis and may last for 1 to 10 days, depending on which virus causes the illness.,傳播途徑 Mode of transmission,病毒性腸胃炎具傳染性，任何年齡的人士都有機會染上此病，且易於安老院及學校等院舍環境出現及傳播；其傳播途徑包括：Viral gastroenteritis is contagious. People in any age group may be infected and it is particularly easy to occur and spread in institutional setting like residential care homes for the elderly or schools. It can be transmitted via the following means: 食用或飲用受病毒污染的食物或水； By food or water contaminated with the viruses 接觸患者的嘔吐物或糞便； By contact with vomit or faeces from infected persons; 接觸受病毒污染的物品；或 By contact with contaminated objects; or 經噴沫傳染。 By aerosol spread.,治療 Treatment,治理方面，不論患者是成人或兒童，治療的主要目的同樣是防止病者身體失去大量水分(脫水)。 The most important point for both children and adult is to prevent severe loss of fluids (dehydration). 除非經醫生指示，否則應避免使用抗生素(對病毒感染並無療效)或其他藥物，去治理此病。 Medications, including antibiotics (which have no effect on viruses) and other treatments, should be avoided unless specifically recommended by a physician. 此病對多數人而言並不嚴重。病者如多補充水分，一般都能完全康復，而沒有長期後遺症。 Most people will not be seriously ill by viral gastroenteritis. Those who get viral gastroenteritis require fluid replacement and usually recover completely without any long-term problems.,預防 (1) Preventive measures (1),由於目前並無疫苗預防病毒性腸胃炎，要預防病毒性腸胃炎，市民要採取以下措施，減低染病機會： Currently, there is no effective vaccination against viral gastroenteritis. However, the public is advised to reduce their chance of being infected by adopting the following measures: 處理食物或進食前、如廁後，以及處理嘔吐物或糞便後須徹底洗淨雙手； Wash hands thoroughly before handling food and eating, and after going to toilets and handling vomitus or faecal matter;,預防(2) Preventive measures (2),清理嘔吐物及糞便時須戴上手套，事後須再洗手； Wear gloves while cleaning up vomitus and faeces, and wash hands afterwards; 立即用1：49的稀釋家用漂白水清洗和消毒染污的地方及物件； Clean and disinfect contaminated areas and items promptly and thoroughly with a diluted household bleach in the ratio of 1:49; 患病學童應在家休息，不應上學； Sick students should rest at home and not go to school; 保持室內空氣流通； Maintain good indoor ventilation; 只進食已徹底煮熟的食物，尤其是海鮮及貝殼類海產。 Eat only thoroughly cooked food, particularly seafood and shellfish.,學校在甚麼情況下需要向生署呈報傳染病的爆發? Under what conditions to notify DH of infectious disease outbreak?,疾病蔓延的徵兆 Signs of disease spread 疾病情況： Disease conditions: 例如：嘔吐、腹瀉、出疹、紅眼症、發燒 e.g., vomiting, diarrhea, skin rash, red eyes, fever 因病告假 Sick leave absence 整間學校與同一班房 Whole school vs. same class,學校裏發現學生生病 Children noted to have disease in school,如發現同一班學生中不尋常地出現疾病組群，請與生署聯絡 If there is a cluster of sickness in same class above what is normally expected, notify DH 例如: 三位學童有腹瀉或出疹 Ex: 3 children with diarrhea, or skin rash 有不尋常的事件顯示傳染病於學校爆發 Unusual incidents suggestive of infectious disease outbreaks in school 例如:於一天內發生數次學生嘔吐現象 Ex: multiple vomiting incidents requiring clean up in a day,因病缺席 Sick leave absence,就整間學校而言: In whole school: 記錄整間學校每天因病缺席的人數 Log sick leave absence of whole school every day 確定因病缺席的正常範圍 Determine baseline range 如缺席人數超出正常範圍，請通知生署 Notify DH if above baseline range 就一班而言: Within a class: 調查學生是否因病缺席 Find out if absence is due to s