下列情况仍可施打流感疫苗.PPT

校園流感防治 衛生署 疾病管制局 中區傳染病防治醫療網 王任賢 指揮官 流感的分類 季節性流感 (epidemic influenza) 已經多次造訪人間，大部份人都有抗體 併發症與死亡人數均很少 新型流感 (pandemic influenza) 第一次來到人間，大家都沒有抗體 併發症與死亡人數會很多 季節性流感之防治政策 最高指導原則 呼吸道衛生及咳嗽禮節 防治政策的執行可不必太緊 流感疫苗的效益 減少流感病患死亡 降低流感病毒的排放時間 減輕症狀 流感疫苗無法讓病患免於得到流感 季節性流感疫苗接種的對象 老年人 目的在防止老年人死亡 兒童 目的在減少病毒傳播 醫護同仁 福利 Estimates of the Impact of Full Utilization ofthe Vaccines Currently Advocated for Adults Disease Estimated annual deaths Estimated vaccine efficacy Current vaccine utilization * Additional preventable deaths/y Influenza 20,000 70% 59% 5,740 Pneumococcal infection 40,000 60% 37% 15,120 Hepatitis B 5,000 90% 10% (1-60%) 4,050 Tet/Diph 25 99% 40% ** 15 Traveller’s diseases 10 - - 10 Adult MMR 30 95% variable 30 * Percentage of target groups who are in compliance with current recommendation ** estimated base on seroprevalance data Adapted from Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s Principles and Practice of Infectious Disease. 5th ed. 2000:1831. Onset of Influenza A in Volunteer Days After Inoculation Temp °F Illness Headache, Malaise, Myalgia Nasal Obstruction and Discharge,Throat Pain, Cough -1 0 1 2 3 4 5 6 7 8 23 100 99 97 Shedding of Influenza A in Volunteer Adapted from Mandell GL, Bennett JE, Dolin R, eds. Mandell, Douglas and Bennett’s Principles andPractice of Infectious Disease. 4th ed. 1995:1554. Virus Sheddinglog10 TCID50 per mL nasal wash Day Influenza Virus transmission Ro: average approximately 2-3 (like SARS) Serial interval: 2-4 days Virus shedding maximal at illness onset Correlated with fever and severity of symptoms Duration of shedding in seasonal epidemics: Adults 5 days; children 7-8 days, up to 21 days Data from children (no immunity) might better represent shedding in a pandemic Longer for immunocompromised persons 流感疫苗之不良反應 Nichols et al. Arch Int Med, 1996;156:1546 Nichols et al. Arch Int Med, 1996;156:1546 流感疫苗注射與安慰劑注射之不良反應比較 何人不能施打流感疫苗? 6個月大以下的小孩 對流感疫苗中任何成分有過敏反應者 以前就對流感疫苗過敏者 對雞蛋具有第一型過敏反應者，會表現出hives、口腔及咽喉腫脹、無法呼吸