【轉貼】新型流感 Swine Flu

[Guest]

Q&A》 新型流感全球分佈圖與問答集
2009-04-28中時電子報／郭匡超整理

世界衛生組織為這波致命流感病毒，正式定名為「H1N1新型流感病毒」，有鑒於美、
墨流感疫情有擴大趨勢，衛生署疾管局為消除民眾恐慌心理，並了解新流感相關資訊，
特地推出新流感問答集一解民眾的疑惑。問答集如下：

問：目前新型流感在全球通報疑似病例人數及分佈國家有哪些？
答：截至4月29日統計，HINI病毒蔓延發現疑似通報病例人數為，墨西哥病例2498人，
死亡159人；美國65人，死亡1人；紐西蘭14人、加拿大13人、西班牙2人、哥斯大黎加
2人、以色列2人、南韓1人、法國20人、澳洲90人、德國8人。另南非、挪威也傳有
疑似病毒通報。

問：甚麼是H1N1新型流感？
答：H1N1病毒是人類和禽流感病毒感染給豬隻，再混合變種而成，屬於A型流感病
毒，常見病毒為H1N1、H1N2、H3N1與H3N2。美國疾管局資料顯示，目前墨西哥
與美國爆發的流感疫情，即為H1N1病毒所引起，但目前對此種結合豬流感、人類流感
及禽流感的新病毒型態所知不多。

根據衛生署公布的公報內容顯示，H1N1新型流感（Swine Influenza A （H1N1））的定義為：
臨床條件（Clinical criteria）
具有急性發燒呼吸道疾病（Acute febrile respiratory illness）（發燒超過攝氏38℃），
且其臨床症狀包括從輕微的類流感（influenza-like illness）到較為嚴重的肺炎
（pneumonia）等。

流行病學條件（Epidemiology criteria）具有下列任一個條件：
一、曾經與確定病例或極可能病例具有密切接觸（close contact），即照護、同住、
或與確定病例有呼吸道分泌物、體液之直接接觸。
二、具有確定病例或極可能病例所在地區之旅遊史。

問：目前國內防疫狀態？能否防範未然？
答：疾管局指出有關H1N1新型流感列入第一類法定傳染病，各醫療機構於門、急診服
務時，發現個案有類流感症狀，且有相關疫情國家或地區旅遊史、接觸史等，除採集相
關檢體，開立抗病毒藥劑處方外，應於24小時內通報當地衛生主管機關或上網通報至
疾病管制局之傳染病個案通報系統。

對於輕症病患，應教導其返家居家隔離直至得知檢驗結果，居家隔離期間，病患應注意
衛生習慣並儘量戴口罩，以避免傳染同住家人；如病患狀況嚴重需住院治療或檢驗發現
為H1N1新型流感陽性，則由醫院或地方衛生單位安排隔離治療。

另醫護人員在執行相關醫療行為時，應加強落實感染控制措施，以避免造成院內傳染之
疫情。

問：H1N1新流感傳染方式?
答：新流感傳染途徑與季節性流感類似，主要是透過飛沫傳染與接觸傳染，在症狀出現
前1天到發病後7天均有傳染性。

問：人類罹患H1N1新型流感會出現哪些症狀?
答：H1N1新流感症狀與流感類似，包括發燒、咳嗽、喉嚨痛、全身酸痛、頭痛、寒顫
與疲勞，有些病例出現腹瀉、嘔吐症狀，部分病例出現眼睛發紅、頭痛和流鼻涕等症
狀。

問：如何確定是否感染H1N1新流感?
答：以症狀研判無法判定是否感染豬流感，需採取檢體化驗始可確認。若您有相關旅遊
史、接觸史及疑似症狀，請儘速就醫並主動告知醫師。

問：H1N1新流感病毒會因為吃豬肉會傳染嗎?
答：不會。世界衛生組織（WHO）表示，只要是經過妥善處理與烹調的豬肉，食用上
並無安全疑慮。

問：如何預防H1N1新型流感?
答：一般民眾：勤洗手是最重要的預防手段、維持良好個人衛生、減少出入公共場所或
戴口罩、並與遭感染者保持1公尺以上安全距離。具呼吸道症狀民眾：停止上班上課在
家休息、戴口罩、咳嗽時用衛生紙遮口鼻並丟入垃圾桶、手部接觸到呼吸道分泌物之後
要洗手、儘可能與別人距離保持1公尺以上。

問：接種流感疫苗可以預防H1N1流感嗎?
答：目前WHO與相關專業機構尚在研議是否將季節性流感疫苗用於預防新流感，但是
流感疫苗仍然是目前預防季節流感最有效的方法。

問：H1N1新流感有沒有治療藥物
答：目前克流感(Tamiflu)及瑞樂沙(Relenza)可用於治療H1N1新流感，但使用藥物前
仍應由醫師評估。

問：H1N1流感致死率為多少?
答：由於H1N1新流感在美、墨兩國的致死率大不同，墨國疫情遠比美國嚴重(墨西哥
致死率約6.0%-7.0%)，WHO衛生專家仍在持續觀察，目前仍將全球流感警戒等級已
經緊急提升至第四級。

歐盟重申：是「新流感」非「豬流感」
2009-04-29 新聞速報
【中廣新聞／葉柏毅】

歐盟衛生專員「華西里奧」女士今天重申，H1N1流感，是一種新型流感，為了避免
給外界帶來錯誤印象，同時給養豬業帶來負面影響，她重申，希望外界不要再將H1N1
流感，錯誤地稱為「豬流感」，還是要稱「新型流感」較為適合。 此外，華西里奧女
士也表示，雖然亞洲等地，有部份國家與地區，宣佈禁止進口墨西哥豬肉，但目前可以
瞭解的是，豬肉在經過煮熟之後，沒有任何問題，因此歐盟不會禁止進口墨西哥豬肉。

防豬流感 戴口罩不如常洗手
編譯江先聲溫哥華綜合報導

墨西哥豬流感疫情來勢洶洶，新聞照片上看見很多民眾都戴上口罩，以防遭到傳染。但
加拿大的專家指出，現階段本國民眾預防流感無需戴口罩，勤洗手比戴口罩更具關鍵的
防疫作用。

傳染病專家席默（Andrew Simor）表示，口罩的防疫作用，主要是供在醫院或長期護
理中心等密閉空間內的工作人員，防範從病人身上傳播而來的病毒。

任職於多倫多新寧（Sunnybrook）健康科學中心的席默補充，醫護人員與病人接觸
時，病人咳起來可能把你噴個一身的病毒，這時口罩就發揮作用了。

席默說，一般民眾上街買菜、看電影，不大可能碰到這種情況，口罩並無用武之地。同
時亦沒有任何數據顯示，口罩在一般情況下可以發揮什麼作用。

他建議本國民眾無需一窩蜂的跑去買口罩，反而多注意手部衛生，經常洗手，對防範病
感冒毒的傳播更具關鍵作用。

公共衛生機構的資料指出，流感病毒可以在桌面、扶手、門拉手等堅硬的平面上存活兩
小時或以上，若雙手接觸過這些物件沾上病毒，再觸摸自己的嘴巴、鼻子、眼睛等，便
可能遭感染。

洗手的方法，是用清水及肥皂洗滌起碼15至20秒。上街時則可以用含酒精的濕紙巾擦
手；也可使用含酒精（60-95%）的潔手凝膠，塗在手掌上後搓至乾燥為止。

多倫多西乃山醫院的傳染病顧問麥姬（Allison McGeer）則指出，口罩的最大作用，
其實是供已染上感冒的人使用，以防止他們在咳嗽或打噴嚏時把病毒傳播開去。

至於2003年非典型肺炎（SARS）肆虐期間曾被視為防疫必備工作具的N95型口罩，
是否在流行病爆發時比一般醫護人員配戴的手術口罩有更大防護作用，席默的看法也頗
有保留。

他說，既有科學證據顯示，在絕大部分病疫傳播情況下，比較昂貴的N95口罩其實沒有
必要。少數的例外，是在諸如氣管插管及加護病房通風等會產生氣霧劑現象的情形下，
有可能出現特小的帶病毒微塵，是一般口罩無法過濾的，這時才需要N95型口罩。

[Guest]

Questions & Answers
Swine Influenza and You
April 29, 2009

What is swine flu?
Swine Influenza (swine flu) is a respiratory disease of pigs caused by type A
influenza viruses that causes regular outbreaks in pigs. People do not
normally get swine flu, but human infections can and do happen. Swine flu
viruses have been reported to spread from person-to-person, but in the
past, this transmission was limited and not sustained beyond three people.

Are there human infections with swine flu in the U.S.?
In late March and early April 2009, cases of human infection with swine
influenza A (H1N1) viruses were first reported in Southern California and
near Guadalupe County, Texas. Other U.S. states have reported cases of
swine flu infection in humans and cases have been reported internationally
as well. An updated case count of confirmed swine flu infections in the
United States is kept at http://www.cdc.gov/swineflu/investigation.htm
CDC and local and state health agencies are working together to investigate
this situation.

Is this swine flu virus contagious?
CDC has determined that this swine influenza A (H1N1) virus is contagious
and is spreading from human to human. However, at this time, it is not
known how easily the virus spreads between people.

What are the signs and symptoms of swine flu in people?
The symptoms of swine flu in people are similar to the symptoms of regular
human flu and include fever, cough, sore throat, body aches, headache,
chills and fatigue. Some people have reported diarrhea and vomiting
associated with swine flu. In the past, severe illness (pneumonia and
respiratory failure) and deaths have been reported with swine flu infection in
people. Like seasonal flu, swine flu may cause a worsening of underlying
chronic medical conditions.

How does swine flu spread?
Spread of this swine influenza A (H1N1) virus is thought to be happening in
the same way that seasonal flu spreads. Flu viruses are spread mainly from
person to person through coughing or sneezing of people with influenza.
Sometimes people may become infected by touching something with flu
viruses on it and then touching their mouth or nose.

Can I get swine influenza from eating or preparing pork?
No. Swine influenza viruses are not spread by food. You cannot get swine
influenza from eating pork or pork products. Eating properly handled and
cooked pork products is safe.

How can someone with the flu infect someone else?
Infected people may be able to infect others beginning 1 day before
symptoms develop and up to 7 or more days after becoming sick. That
means that you may be able to pass on the flu to someone else before you
know you are sick, as well as while you are sick.

What should I do to keep from getting the flu?
First and most important: wash your hands. Try to stay in good general
health. Get plenty of sleep, be physically active, manage your stress, drink
plenty of fluids, and eat nutritious food. Try not touch surfaces that may be
contaminated with the flu virus. Avoid close contact with people who are
sick.

Are there medicines to treat swine flu?
Yes. CDC recommends the use of oseltamivir or zanamivir for the
treatment and/or prevention of infection with these swine influenza viruses.
Antiviral drugs are prescription medicines (pills, liquid or an inhaler) that fight
against the flu by keeping flu viruses from reproducing in your body. If you
get sick, antiviral drugs can make your illness milder and make you feel
better faster. They may also prevent serious flu complications. For
treatment, antiviral drugs work best if started soon after getting sick (within
2 days of symptoms).

How long can an infected person spread swine flu to others?
People with swine influenza virus infection should be considered potentially
contagious as long as they are symptomatic and possible for up to 7 days
following illness onset. Children, especially younger children, might
potentially be contagious for longer periods.

What surfaces are most likely to be sources of contamination?
Germs can be spread when a person touches something that is
contaminated with germs and then touches his or her eyes, nose, or
mouth. Droplets from a cough or sneeze of an infected person move
through the air. Germs can be spread when a person touches respiratory
droplets from another person on a surface like a desk and then touches
their own eyes, mouth or nose before washing their hands.

How long can viruses live outside the body?
We know that some viruses and bacteria can live 2 hours or longer on
surfaces like cafeteria tables, doorknobs, and desks. Frequent handwashing
will help you reduce the chance of getting contamination from these
common surfaces.

What can I do to protect myself from getting sick?
There is no vaccine available right now to protect against swine flu. There
are everyday actions that can help prevent the spread of germs that cause
respiratory illnesses like influenza. Take these everyday steps to protect
your health:

* Cover your nose and mouth with a tissue when you cough or sneeze.
Throw the tissue in the trash after you use it.

* Wash your hands often with soap and water, especially after you
cough or sneeze. Alcohol-based hand cleaners are also effective.

* Avoid touching your eyes, nose or mouth. Germs spread this way.

* Try to avoid close contact with sick people.

* If you get sick with influenza, CDC recommends that you stay home
from work or school and limit contact with others to keep from infecting
them.

What is the best way to keep from spreading the virus through coughing or
sneezing?

If you are sick, limit your contact with other people as much as possible. Do
not go to work or school if ill. Cover your mouth and nose with a tissue
when coughing or sneezing. It may prevent those around you from getting
sick. Put your used tissue in the waste basket. Cover your cough or sneeze
if you do not have a tissue. Then, clean your hands, and do so every time
you cough or sneeze.

What is the best technique for washing my hands to avoid getting the flu?

Washing your hands often will help protect you from germs. Wash with
soap and water or clean with alcohol-based hand cleaner. We recommend
that when you wash your hands -- with soap and warm water -- that you
wash for 15 to 20 seconds. When soap and water are not available,
alcohol-based disposable hand wipes or gel sanitizers may be used. You can
find them in most supermarkets and drugstores. If using gel, rub your hands
until the gel is dry. The gel doesn't need water to work; the alcohol in it kills
the germs on your hands.

What should I do if I get sick?
If you live in areas where swine influenza cases have been identified and
become ill with influenza-like symptoms, including fever, body aches, runny
nose, sore throat, nausea, or vomiting or diarrhea, you may want to
contact their health care provider, particularly if you are worried about your
symptoms. Your health care provider will determine whether influenza
testing or treatment is needed.

If you are sick, you should stay home and avoid contact with other people
as much as possible to keep from spreading your illness to others.

If you become ill and experience any of the following warning signs, seek
emergency medical care.

In children emergency warning signs that need urgent medical attention
include:

* Fast breathing or trouble breathing
* Bluish skin color
* Not drinking enough fluids
* Not waking up or not interacting
* Being so irritable that the child does not want to be held
* Flu-like symptoms improve but then return with fever and worse cough
* Fever with a rash

In adults, emergency warning signs that need urgent medical attention
include:

* Difficulty breathing or shortness of breath
* Pain or pressure in the chest or abdomen
* Sudden dizziness
* Confusion
* Severe or persistent vomiting

How serious is swine flu infection?
Like seasonal flu, swine flu in humans can vary in severity from mild to
severe. Between 2005 until January 2009, 12 human cases of swine flu
were detected in the U.S. with no deaths occurring. However, swine flu
infection can be serious. In September 1988, a previously healthy
32-year-old pregnant woman in Wisconsin was hospitalized for pneumonia
after being infected with swine flu and died 8 days later. A swine flu
outbreak in Fort Dix, New Jersey occurred in 1976 that caused more than
200 cases with serious illness in several people and one death.


http://www.cdc.gov/swineflu/swineflu_you.htm

[Guest]

H1N1新型流感 13國黃色警示 墨國紅色警示
2009-05-02中央社

H1N1新型流感在全球擴散，台灣外交部對美國、加拿大等13國發布黃色旅遊警示，
屬提醒注意層級，另對墨西哥則是紅色警示，呼籲民眾不宜前往。 綜合世界衛生組織
（WHO）等單位統計，在全球造成緊張的H1N1新型流感，目前全球出現逾600個確
定病例，分別出現在包括墨西哥、美國、加拿大、西班牙、英國、香港及南韓等國家及
地區。

外交部的旅遊警示分為3級，黃色是提醒注意、橙色是暫緩前往、紅色是不宜前往；目
前已對確認發生H1N1新型流感病例的國家發出旅遊警示。 其中，有13國是發布提醒
注意的黃色旅遊警示，1國建議不宜前往的紅色警示，另尚無國家因新型流感列入橙色
警示。

在黃色旅遊警示方面，截至今天中午為止，包括有加拿大、紐西蘭、哥斯大黎加、奧地
利、荷蘭、瑞士、德國、南韓、美國、秘魯、英國、西班牙、以色列等13國；外交部
呼籲，若民眾要前往相關區域，一定要注意衛生防護。

至於1國紅色警示則是墨西哥，外交部呼籲民眾不宜前往。 此外，在香港部分，外交部
表示是由行政院大陸委員會負責發布，目前陸委會也已宣布，香港達黃燈旅遊警示。