病毒性腸胃炎討論會.ppt

病毒性腸胃炎討論會ForumonViralGastroenteritis 生署社會醫學顧問醫生曾浩輝醫生DrThomasTsangConsultantCommunityMedicineDepartmentofHealth 病毒性腸胃炎ViralGastroenteritis 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 Gastroenteritisisaninflammationofthestomachandintestines bothsmallandlarge 病毒性腸胃炎ViralGastroenteritis 在天氣涼的季節較為常見 Itismorecommonlyfoundduringcoolermonthsoftheyear 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 Viralgastroenteritisisaninfectioncausedbyavarietyofviruses ThemostcommonvirusesthatcausegastroenteritisareNorwalkvirusandrotavirus 病毒性腸胃炎 最新情況ViralGastroenteritis 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 AsofNovember17 therewere41reportedcasesofviralgastroenteritiscausedbyNorwalk likevirus affectingabout1 000personsandoccurringininstitutionslikeschools childcarecentresandhomesfortheelderly 在二 二年 共有39宗 涉及892人 In2002 therewere39reportedcases involving892persons 截至二零零三年十月UptoOctober2003 NumberofOutbreakCasesofNorwalk likeDisease 2001 2003 Jan Jan JanFebMarAprMayJun JulAugSepOctNovDec Month Noofcase Noofcase JanFebMarAprMayJun JulAugSepOctNovDec Month NumberofOutbreakCasesofNorwalk likeDisease 2001 2003 病徵Symptoms 病毒性腸胃炎的主要徵狀有 Themainsymptomsofviralgastroenteritisare 腹瀉 diarrhea 嘔吐 vomiting 其他症狀包括頭痛 發燒及腹痛 Othersymptomsincludeheadache fever andabdominalcramps 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 Ingeneral thesymptomsbegin1to2daysfollowinginfectionwithavirusthatcausesgastroenteritisandmaylastfor1to10days dependingonwhichviruscausestheillness 傳播途徑Modeoftransmission 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 Viralgastroenteritisiscontagious Peopleinanyagegroupmaybeinfectedanditisparticularlyeasytooccurandspreadininstitutionalsettinglikeresidentialcarehomesfortheelderlyorschools Itcanbetransmittedviathefollowingmeans 食用或飲用受病毒污染的食物或水 Byfoodorwatercontaminatedwiththeviruses接觸患者的嘔吐物或糞便 Bycontactwithvomitorfaecesfrominfectedpersons 接觸受病毒污染的物品 或Bycontactwithcontaminatedobjects or經噴沫傳染 Byaerosolspread 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 Themostimportantpointforbothchildrenandadultistopreventseverelossoffluids 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 includingantibiotics whichhavenoeffectonviruses andothertreatments shouldbeavoidedunlessspecificallyrecommendedbyaphysician 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 Mostpeoplewillnotbeseriouslyillbyviralgastroenteritis Thosewhogetviralgastroenteritisrequirefluidreplacementandusuallyrecovercompletelywithoutanylong termproblems 預防 1 Preventivemeasures 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 thereisnoeffectivevaccinationagainstviralgastroenteritis However thepublicisadvisedtoreducetheirchanceofbeinginfectedbyadoptingthefollowingmeasures 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 Washhandsthoroughlybeforehandlingfoodandeating andaftergoingtotoiletsandhandlingvomitusorfaecalmatter 預防 2 Preventivemeasures 2 清理嘔吐物及糞便時須戴上手套 事後須再洗手 Weargloveswhilecleaningupvomitusandfaeces andwashhandsafterwards 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 Cleananddisinfectcontaminatedareasanditemspromptlyandthoroughlywithadilutedhouseholdbleachintheratioof1 49 患病學童應在家休息 不應上學 Sickstudentsshouldrestathomeandnotgotoschool 保持室內空氣流通 Maintaingoodindoorventilation 只進食已徹底煮熟的食物 尤其是海鮮及貝殼類海產 Eatonlythoroughlycookedfood particularlyseafoodandshellfish 學校在甚麼情況下需要向 生署呈報傳染病的爆發 UnderwhatconditionstonotifyDHofinfectiousdiseaseoutbreak 疾病蔓延的徵兆Signsofdiseasespread疾病情況 Diseaseconditions 例如 嘔吐 腹瀉 出疹 紅眼症 發燒e g vomiting diarrhea skinrash redeyes fever因病告假Sickleaveabsence整間學校與同一班房Wholeschoolvs sameclass 學校裏發現學生生病Childrennotedtohavediseaseinschool 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Ifthereisaclusterofsicknessinsameclassabovewhatisnormallyexpected notifyDH例如 三位學童有腹瀉或出疹Ex 3childrenwithdiarrhea orskinrash有不尋常的事件顯示傳染病於學校爆發Unusualincidentssuggestiveofinfectiousdiseaseoutbreaksinschool例如 於一天內發生數次學生嘔吐現象Ex multiplevomitingincidentsrequiringcleanupinaday 因病缺席Sickleaveabsence 就整間學校而言 Inwholeschool 記錄整間學校每天因病缺席的人數Logsickleaveabsenceofwholeschooleveryday確定因病缺席的正常範圍Determinebaselinerange如缺席人數超出正常範圍 請通知 生署NotifyDHifabovebaselinerange就一班而言 Withinaclass 調查學生是否因病缺席Findoutifabsenceisduet