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按一下以編輯母片標題樣式,按一下以編輯母片,第二層,第三層,第四層,第五層,*,按一下以編輯母片標題樣式,按一下以編輯母片,第二層,第三層,第四層,第五層,*,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,校園流感防治衛生署 疾病管制局,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,流感的分類季節性流感 (epidemic influenza,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,季節性流感之防治政策最高指導原則,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,流感疫苗的效益減少流感病患死亡,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,季節性流感疫苗接種的對象老年人,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,Travellers 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,Estimates of the Impact of Ful,Adapted from Mandell GL, Bennett JE, Dolin R, eds.,Mandell, Douglas and Bennetts Principles and Practice of Infectious Disease.,5,th,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,Adapted from Mandell GL, Benne,Shedding of Influenza A in Volunteer,Adapted from Mandell GL, Bennett JE, Dolin R, eds.,Mandell, Douglas and Bennetts Principles andPractice of Infectious Disease.,4,th,ed. 1995:1554.,Virus Sheddinglog,10,TCID,50,per mL nasal wash,Day,Shedding of Influenza A in Vo,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,Influenza Virus transmissionRo,流感疫苗之不良反應,Nichols et al. Arch Int Med, 1996;156:1546,流感疫苗之不良反應Nichols et al. Arch I,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,Nichols et al. Arch Int Med, 1,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,、,休克,.,此狀況必須由過敏科醫師詳細評估後才可確定,病人以前接受過流感疫苗並在,8,週內產生過,Guillain-Barr,syndrome,者,並換以前曾因流感疫苗而產生過,嚴重,Oculorespiratory Syndrome (ORS),者,何人不能施打流感疫苗?6個月大以下的小孩,何人可緩打打流感疫苗,?,當下有,嚴重的,急性發燒疾病,下列情況仍可施打流感疫苗,:,病患具有輕微的急性病,,,可以有發燒也可沒發燒,病患剛病癒或正在服用抗生素,施打流感疫苗兩天後始可捐血,何人可緩打打流感疫苗? 當下有嚴重的急性發燒疾病,校園流感疫苗施打前之準備,外聘醫師及護理師各名,視學生人數而增加,導師、保健室護士、醫師、護理師均必須於施打前接受流感疫苗及施打細節之訓練,發放同意書及流感疫苗施打說帖,請學童家長簽署後同意書於,施打前,繳回,同意書由疾病管制局發給,施打說帖由,衛生局,主導編撰,對於不同意施打的家長,應由,保健室,打電話訊問原因,排除可能的誤解,校園流感疫苗施打前之準備外聘醫師及護理師各名,視學生人數而,流感疫苗施打說帖之內容,流感之嚴重性,流,感疫苗介紹,施打流感疫苗之好處,流感疫苗施打會衍生出哪些不良反應,哪些反應不歸屬於流感疫苗施打所造成,哪些人不能打或緩打流感疫苗,施打流感疫苗後該注意之保健工作,流感疫苗施打說帖之內容流感之嚴重性,流感疫苗施打時之流程,班級整隊,施打前評估,疫苗施打,施打後在教室觀察30分鐘,流感疫苗施打時之流程班級整隊,懇請賜教,懇請賜教,
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