新型流感防治讲义

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1、H1N1新型流感疫情監視及防治衛生署疾病管制局防疫醫師魏嵩璽9/29/20211大綱疫情現況H1N1新型流感介紹我國因應作為H1N1新型流感個案通報與採檢H1N1新型流感抗病毒藥劑使用H1N1新型流感病人之感控措施建議9/29/20212NovelInfluenzaH1N1intheWorld5/139/29/20213疫情等級9/29/20214台灣疫情現況資料截止日期：2009/05/1312：00疾病/事件本日新增累計檢驗結果備註陽性陰性其他陽性檢驗中H1N1151500142238其他陽性：21A/H3、1A/H1、1BH5N1070610其他陽性：1A/H3ILIclust

2、er（事件數）0000009/29/20215H1N1:a.classicalH1N1(NorthernAmerican)b.avian-likeH1N1(European)c.triple-reassortantH1N1H3N2:a.human-likeb.reassortantsderivedfromhuman(HA),swine(N2)andavianvirusesH1N2:reassortantderivedfromthetriplereassortantH3N2virusesandclassicalH1N1swinevirusesH3N1:reassortantderived

3、fromthetriplereassortantH3N2virusesandclassicalH1N1swinevirusesMajor4subtypesofswineinfluenzaviruses9/29/20216PB2PB1PAHA-H1NPNA-N1MPNSClassicalH1N1PB2PB1PAHA-H1NPNA-N1MPNSreassortantH1N1avianPB2PB1PAHA-H3NPNA-N2MPNSHuman-likeSwineH3N2double-reassortantH3N2after1998PB2PB1PAHA-H3NPNA-N2MPNSPB2PB1P

4、AHA-H3NPNA-N2MPNSavianPB2PB1PAHA-H1NPNA-N2MPNStriple-reassortantH3N2H1N2PB2PB1PAHA-H3NPNA-N1MPNSH3N1PB2PB1PAHA-H1NPMPNSEuropeanswineH1N1NA-N1PB2PB1PAMPNSHA-H1NPNA-N1triple-reassortantH1N1PB2PB1PANSHA-H1NPMPNA-N19/29/20217HAA/California/04/2009HumanH1N1NorthernAmericanSwineH1N1AvianEuropeanSwineH

5、1N1(~75%)9/29/20218感染H1N1新型流感之症狀H1N1新型流感症狀與季節性流感類似發燒、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9/29/20219感染H1N1新型流感之症狀一般流感潛伏期約五天，在H1N1新流感我們觀察到潛伏期最長到6-8天鑑別診斷：在H1N1的病患中，約有40-50%的病患出現腹瀉現象，比一般流感腹瀉比例要來得高目前看到的大多數病患都是輕症，而且不需住院在家休養即可目前在許多國家看到的感染個案，都是和旅遊相關的個案(travelrelated)南半球即將進入冬天，要非常注意!!世界衛生組織記者會5/4NEJM2009;36

6、11-109/29/202110H1N1新型流感傳染途徑人與人間的傳染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一般成人在症狀出現前1天到發病後7天均有傳染性，但對於病程較長之病患，亦不能排除其發病期間繼續散播病毒另兒童病例的可傳染期通常較成人病例為長。9/29/202111流感病毒之分類上呼吸道流感病毒H1N1,H3N2,B高傳染率,低死亡率以社區傳染為主Immuneprotection：治療以抗病毒藥為主下呼吸道流感病毒H5N1低傳染率,高死亡率以院內傳染為主Immunedestruction：治療以類固醇為主From王任賢指揮官9/29/202112WhyH5N1Inf

7、luenzaAVirusInfectionResultsinHighMortality？WhatarethemolecularbarriersAvianinfluenzavirusesreplicatepoorlyinhuman,H5N1virusspecificforalpha-2,3-linkedsialosaccharides(SAα2,3Gal)Humantracheahaspredominantlyalpha-2,6-linkedsi