流行性感冒 Q&A ( 年冬天 ) Influenza Q&A (for winter)

Transcription

1 頁編號 : 1 / 7 流行性感冒 Q&A ( 年冬天 ) Influenza Q&A (for winter) 1. 甚麼是流行性感冒? 1. What is Influenza? 答 : 流行性感冒, 簡稱流感, 是一種由 流感病毒引起的急性呼吸道傳染病 A: Influenza, also known as the flu, is an acute contagious respiratory disease that is caused by influenza virus. 2. 本澳流感多發於甚麼時期? 流感病毒可分哪幾類? 答 : 流行多發生於冬 春季 ( 北半球為 10 月 -4 月 ), 而四季均可散發 根據的監測, 本澳流感高峰期通常為每年 2 至 3 月份 流感病毒屬於正粘液病毒科病毒, 根據其表面抗原性質的不同, 可分為甲 乙和丙型三種類別 其中甲 乙型較常見 由於編碼表面抗原的基因, 尤其是甲型流感病毒, 經常發生變異, 導致新亞型的出現而造成流行或大流行 2009 年的大流行甲型 H1N1 流感病毒就是甲型流感病毒其中一種類型 2. When is the flu season in Macau? How many types of influenza virus are there? A: Influenza is epidemic mainly in winter and spring (October to April in Northern Hemisphere). According to the surveillance of Health Bureau, the annual peak period of influenza is from February to March. The subtypes of influenza are influenza A, influenza B and influenza C with which the first two types the commonest. The influenza subtypes are classified by the antigenic properties of the surface glycoproteins. Frequent mutation of the genes encoding the surface glycoproteins, especially for influenza A virus, leads to the emergence of new subtypes that are responsible for epidemics or pandemics. Pandemic (H1N1) 2009 virus was one type of the influenza A virus. 3. 流感的傳染源? 如何傳染? 3. What is the source of flu? How is flu transmitted to people? 答 : 流感的傳染源主要是病人和隱性感 染者 發病 7 天內均有傳染性, 以發病 初期 2-3 日傳染性最強 病毒存在於病 人的鼻涕 口涎和痰液中 主要是通過 飛沫傳播和直接接觸傳播 A: The source of flu is mainly patients and asymptomatic persons. It is contagious for 7 days, mostly in the first 2-3 days, after the onset of the disease. The virus exists in nasal discharge, saliva and sputum and is transmitted through droplet or direct contact transmission.

2 頁編號 : 2 / 7 4. 哪類人群易感? 為甚麼? 4. Who will be easily infected? Why? 答 : 人群對流感病毒普遍易感, 病後可 獲得同型和同株免疫力, 但三型流感病 毒之間和甲型流感病毒的不同亞型之間 無交叉免疫, 加之流感病毒不斷發生變 異 ( 變種 抗原漂移 ), 故可引起反覆發 病 A: All people are equally susceptible. Infection produces immunity to the specific infecting virus, but the duration and breadth of immunity depend on the degree of antigenic drift and the number of previous infections. Thus, people will get repeated infections. 5. 流感的潛伏期有多長? 5. How long is the incubation period for flu? 答 : 一般潛伏期 1-3 天, 可短至 6 小時, 長至 4 天 A: Usually 1-3 days after infection, but may be as short as 6 hours or as long as 4 days. 6. 流感與普通感冒有甚麼不同? 有甚麼症狀? 答 : 普通感冒是最常見的上呼吸道感染, 主要是由鼻病毒等引起的, 起病緩慢, 一般症狀輕, 發熱不高, 無明顯中毒症狀, 臨床表現為急性鼻炎和上呼吸道卡他症狀為主 流感臨床典型表現為突起畏寒 高熱 頭痛 全身肌肉關節痛 疲倦乏力等全身中毒症狀, 呼吸道症狀 ( 流涕, 喉嚨痛, 咳嗽等症狀 ) 輕微或不明顯 病程一般 3-4 天 確診有賴於實驗室檢測 ( 病毒分離與血清學檢查 ) 6. What is the different between flu and common cold? What are the symptoms of flu? A: Common cold is the commonest upper respiratory infectious disease. It is mainly caused by rhinoviruses, etc. The disease usually has a slow progress, with low fever and no obvious toxic symptoms. The clinical manifestations include mainly acute rhinitis and catarrhal symptoms of the upper respiratory tract. The clinical manifestations of flu include sudden onset of rigors, high fever, headache, myalgia, malaise and extreme tiredness. Some respiratory symptoms, such as running nose, sore throat and cough, are mild. The disease will recover in 3-4 days. The diagnostic confirmation depends on the laboratory tests (virus isolation and serological test). 7. 流感會否併發其他疾病? 7. Does flu have any complications?

3 頁編號 : 3 / 7 答 : 可併發繼發性細菌性上呼吸道感染 ( 如急性化膿性扁桃腺炎 ) 繼發性細菌性氣管炎和支氣管炎 繼發性細菌性肺炎 A: Yes, some of the complications caused by flu include bacterial infections of the upper respiratory tract (e.g. acute tonsillitis), bacterial tracheitis, bacterial bronchitis and bacterial pneumonia. 8. 流感嚴重者會怎樣? 會否致命? 8. How serious is flu? Is it fatal? 答 : 重症者 ( 流感病毒性肺炎 ) 可出現高熱不退 衰竭 煩躁 咯血性痰, 繼而呼吸困難 發紺, 抗菌藥物治療無效, 最後可死於呼吸循環衰竭 A: The severe cases (i.e. viral pneumonia) may present with high fever, exhaustion, bloody sputum and later on dyspnea, cyanosis. When the antibiotic drugs become ineffective, one may die due to dysfunction of cardiopulmonary system. 9. 如何診斷及治療流感? 9. How to diagnose and treat flu? 答 : 流行期間根據流感典型臨床表現及實驗室診斷可確診 可使用抗病毒藥物 ( 特敏福 oseltamivir/tamiflu, 樂感清 zanamivir, 金剛胺 amantadine 或金剛乙胺 rimantadine) 治療季節性流感 A: The diagnosis is confirmed according to the typical clinical manifestations and laboratory examinations during the epidemic period. Seasonal flu can be treated by antiviral drugs (oseltamivir/ Tamiflu, zanamivir, amantadine or rimantadine). 10. 接種流感疫苗是否就能有效預防流感? 是否立即有效? 有否有效期? 注射流感疫苗後答 : 流感疫苗是能有效預防流感, 身體需約 2-3 星期時間才能產生抗體, 來預防流感病毒感染 一般時效為 1 年 10. Is vaccination effective in preventing influenza? Does vaccination has expiry date? A: Vaccination is effective in preventing influenza. Anti-infectious seroprotection is generally obtained within 2 to 3 weeks. But the vaccine has to be repeated yearly.

4 頁編號 : 4 / 為什麼現時要優先為前線醫務人員及長期病患者等人士注射流感疫苗? 答 : 一般健康的成年人罹患流行性感冒的症狀雖然比普通感冒來得嚴重, 但通常會在七天內康復 老年人, 患有心 肺 腎臟及代謝性疾病, 或免疫功能不全者的人士特別容易出現細菌性及病毒性肺炎而具有較高的死亡率 醫務工作者因經常接觸病人而較容易受到感染, 而受感染的醫務人員亦容易將病毒傳給和醫務人員有密切接觸的病人, 而這些病人往往是患有上述危險的病人 SARS 的症狀與流感症狀很相似, 早期容易混淆 世界衛生組織在 2003 年 7 月作出建議, 至少應對衛生工作者, 這個既易患 SARS, 又易患上流感的群體接種流感疫苗, 並最好對老年人, 特別是在院舍內居住以及其它脆弱人群包括慢性心血管疾病的患者實施流感防疫接種, 以減少流感個案可能引發 SARS 的懷疑個案而面對的既成本高昂又擾亂社會秩序的一系列預防措施 11. Why does the Health Bureau give prior vaccination to the frontline health care workers and chronic patients? A: Although symptoms of influenza for healthy adults are more severe than common cold, persons will usually recover within 7 days. Elderly persons, patients having cardiac, pulmonary, renal or metabolic diseases or immunocompromised patients who will easily complicate with bacterial or viral pneumonia have a high fatality rate. On the other hand, health care workers who often have contact with patients will easily get infected. They will then transmit the virus to other patients who have close contact with them and who are at great risk to acquire diseases. The early symptoms of SARS and influenza are very similar and easily confused. For these reasons, WHO strongly recommends in July 2003 that at least health care workers, who are at great risk of both influenza and SARS, with the influenza vaccine. The vaccine should also be given to elderly persons, especially when cared for in institutions, and other vulnerable populations, including persons with chronic cardiovascular disease so as to rule out suspected SARS cases. 12. 流感病毒是否經常變種? 是否很危險? 答 : 甲型 乙型流行性感冒病毒的抗原會經常發生變化, 若抗原性質出現較大的變化 ( 即俗稱的變種 ), 或者因為原先 12. Do influenza viruses always experience antigenic drift? Are they dangerous? A: Influenza A and B always experience antigenic drift. If the antigens have experienced great changes (i.e. antigenic shift) or were transmitted to human from mutated animal source (e.g. avian/ swine flu), it would have a pandemic due to lack of

5 頁編號 : 5 / 7 在動物中存在的流感病毒 ( 如禽 / 豬流感 ) 變種後傳給人類, 因為大部分人都沒有免疫力而出現大流行 過去一百多年來, 曾經分別在 及 1968 年發生世界性大流行, 每次大流行引起的死亡數以萬乃至千萬計 發生地區流行時, 一般群體的臨床侵襲率大約在百分之十至二十, 在人員綢密如學校及院舍等處, 則達到百分之五十以上 immunity. During the past 100 years, there were respectively several flu pandemics in 1889, 1918, 1957 and Thousands of lives were lost during each pandemic. The attack rate in general community is about 10-20%, while in some densely populated areas, such as school or nursing homes, more than 50%. 13. 市民應如何預防流感? 13. How to prevent the flu? 答 : 1) 培養健康的生活習慣, 包括均衡飲 食 定時運動 足夠休息和不要吸煙 等等 ; 2) 經常打開窗戶, 保持室內空氣流通 ; 3) 避免前往人多擠迫且空氣流通不佳 的地方 4) 打噴嚏或咳嗽時應用即棄的紙巾掩 著口鼻, 然後把紙巾棄置於有蓋的垃 圾桶內 ; 5) 經常洗手, 特別是手被呼吸道分泌物 污染時, 應使用皂液, 用即棄的紙巾 抹乾, 或使用乾手機, 不應共用毛 巾 ; 避免觸摸眼睛 鼻及口, 如需觸 摸, 應先洗手 ; 6) 每年接種流行性感冒疫苗亦是世界 衛生組織 (WHO) 推薦的有效預防方 A: 1) The best protection against influenza is by having good body resistance: adequate rest, balanced diet, regular exercise, reducing stress and no smoking. 2) Observe environmental hygiene, maintain good indoor ventilation. 3) Avoid crowded places with poor ventilation. 4) Cover nose and mouth when sneezing or coughing, and manage the respiratory secretions with care. 5) Observe personal hygiene, wash hands properly and frequently with liquid soap in order to keep them clean, especially when contaminated by respiratory secretions. Don t share towels. Avoid contact with eyes, nose and mouth before handwashing. 6) Influenza vaccination is an effective preventive measure recommended by World Health Organization (WHO). 7) Consult a doctor promptly if respiratory symptoms developed and wear a mask to avoid further transmission and take a sick leave.

6 頁編號 : 6 / 7 法 7) 如有呼吸道受感染的病徵, 市民應戴上口罩, 減低透過呼吸道受感染的機會 ; 及早求診, 不要上班或上學, 或不要到人煙稠密的地方 14. 世界衛生組織 (WHO) 建議 年北半球冬季流感疫苗的成份有哪些? 答 : 世界衛生組織建議 年北半球冬季流感疫苗包括以下成份 : 甲型 / 加利福尼亞 /7/2009(H1N1) 類病毒 (2009 大流行甲型 H1N1 流感病毒 ) 甲型 / 德克薩斯 /50/2012(H3N2) 類病毒 乙型 / 麻薩諸塞 /2/2012 類病毒. 14. What is the composition of the influenza vaccine recommended by WHO for Northern Hemisphere winter? A: The vaccine recommended by WHO in contains the following : an A/California/7/2009 (H1N1) pdm09-like virus an A/Texas/50/2012 (H3N2)-like virus a B/Massachusetts/2/2012-like virus If quadrivalent influenza vaccine is being used, it should contain the above three viruses and a B/Brisbane/60/2008-like virus. 如採用四價流感疫苗, 它應包括以上三 種病毒及乙型 / 布利斯本 /60/2008/ 類 病毒 15. 哪種情況下不適合注射流感疫苗? 15. Under what conditions are not suitable for vaccination? 答 : 基本上 6 個月以上的嬰幼兒和成人 都可以注射流感疫苗 但最好在注射前 先諮詢醫務人員的意見, 以了解目前身 體狀況是否合適或需要延遲注射 對疫 苗中的活性物質 任何一種輔助劑 或 雞蛋 雞肉蛋白 卵白蛋白 硫酸卡那 A: Generally person aged > 6 month old can have influenza vaccination. But before vaccination, it is best to consult the medical professionals to understand whether the physical conditions are suitable or need delaying the vaccination. Those who are hypersensitivity to the active substances of the vaccine, to any of the excipients, and to eggs, chicken proteins, ovalbumin, kanamycin sulphate, neomycin sulphate, formaldehyde,

7 頁編號 : 7 / 7 霉素 硫酸新黴素 甲醛 十六烷基三甲基溴化銨 聚山梨醇酯八十和硫酸鋇過敏為接種疫苗的禁忌症 應延緩對正在患發熱性疾病或急性感染的病人進行接種 cetyltrimethylammononium bromide (CTAB), polysorbate 80 and barium sulphate. Immunisation should be postponed in patients with febrile illness or acute infection. 16. 注射一劑流感疫苗已足夠嗎? 16. Is it enough to have only one dose vaccination? 答 : 成人及 9 歲以上小孩只需注射一劑 即可, 而 9 歲以下從未注射過流感疫苗 的兒童, 應接種兩劑疫苗, 兩劑之間的 注射時間應至少相隔 4 個星期 A: Adults and children 9 years old should only be vaccinated one dose. Two doses administered at least 4 weeks apart are recommended for children aged <9 years who are receiving influenza vaccine for the first time. 17. 有哪些不良反應? 17. What are the side effects of influenza vaccination? 答 : 接種流感疫苗在一般情況下是非常 安全的 常見的反應 : 局部反應 : 紅 腫 痛 瘀斑 硬結 ; 全身反應 : 發熱 倦怠 發抖 疲倦 頭痛 冒汗 肌痛 關節痛 這些反應通常在 1 至 2 日內會 消失而無需治療 A: On the whole, it is very safe to have influenza vaccination. The most common reactions are: local reactions: redness, swelling, pain, ecchymosis, induration; systemic reactions: fever, malaise, shivering, fatigue, headache, sweating, myalgia, arthralgia. These reactions usually disappear within 1-2 days without treatment. 18. 出現不良反應應如何處理? 18. What can one do if side effects appear? 答 : 輕微的不良反應通常於注射後 1-2 內消失而無需治療, 如病情未見好轉或轉差, 應立即到醫院就診 ( 最好帶備疫苗接種卡以使醫護人員盡快作出相應處理 ) A: Mild reactions usually disappear within 1-2 days without treatment. If the conditions remain the same or become worse, consult the doctor immediately (it is advisable to carry the influenza vaccination card about so that the medical professionals can take prompt treatment).