留院观察一夜伤口未化脓台东被咬男返家 - 振兴医院.ppt

* * * 預防接種建議： 1.從事狂犬病相關高危險群的工作人員(獸醫、研究人員、野生動物研究人員、捕狗人員) ，應事先接受預防注射。2.需滯留在國外狂犬病疫區，特別是要去偏遠和缺乏醫療設施的鄉村地方，活動屬於高危險性，可考慮暴露前預防接種。3.因應行政院農業委員會公布國內野生動物檢出狂犬病毒之情形，訂定狂犬病暴露後疫苗接種對象 4.請民眾避免接觸或豢養來源不明的野生動物；遇罹病野生動物，勿以手觸碰及撿拾。遭受國內家貓或家犬抓咬傷，感染狂犬病的風險極低，惟家中飼養的犬、貓務必定期接受動物狂犬病疫苗接種。 如果在國內被動物抓咬傷，我該怎麼辦？ (一) 於國內動物狂犬病發生的四個鄉鎮（南投縣魚池鄉及鹿谷鄉、雲林縣古坑鄉、台東縣東河鄉）及其他山地鄉，遭受野生哺乳類動物、流浪犬貓抓咬傷或皮膚傷口、黏膜接觸其唾液等分泌物，請立即就醫並接種疫苗。 ?(二) 於國內其他地區遭受野生哺乳類動物（不含流浪犬貓）抓咬傷或皮膚傷口、黏膜接觸其唾液等分泌物，建議立即就醫並接種疫苗。 ?(三) 於國內各地區如家犬/貓出現疑似狂犬病症狀，飼主應立即向當地鄉鎮公所及衛生單位通報。經主管機關評估確有風險後，建議飼主接受狂犬病暴露後疫苗接種。 ? What care will I receive? Rabies Postexposure Vaccinations Postexposure Vaccinations Human Rabies Immune Globulin Rabies Vaccine Programs for uninsured and underinsured patients Rabies postexposure vaccinations consists of a dose of human rabies immune globulin and four doses of rabies vaccine given on the day of the exposure, and then again on days 3, 7, and 14. The vaccine is given in a muscle, usually in the upper arm. This set of vaccinations is highly effective at preventing rabies if given as soon as possible following an exposure. If a person has previously received postexposure vaccinations or received preexposure vaccinations, only two doses of vaccine (on the day of exposure and then 3 days later) are needed. Human rabies immune globulin is not required 第一類法定傳染病 1.?天花 2.?H5N1流感 3.?嚴重急性呼吸道症候群 4.?鼠疫 5.?狂犬病 Treatment  Isolation of the patient to prevent transmission to others Acute general Rx No known beneficial therapy. A case report from 2005 describes a 15-yr-old girl who survived rabies and had been treated with a combination of ketamine, midazolam, ribavirin, and amantadine. It is known as the Milwaukee protocol. The protocol has been unsuccessful in subsequent reports and is considered investigative.  Preexposure prophylaxis with HDCV or RVA (1 ml IM on days 0, 7, and 21 or 28) in individuals at high risk for acquisition: ?? 1.??? Veterinarians?? 2.??? Laboratory workers working with rabies virus?? 3.??? Spelunkers?? 4.??? Visitors to