嚴重急性呼吸道症候群(SARS)與公共衛生

Severe Acute Respiratory Syndrome and Public Health

嚴重急性呼吸道症候群（SARS），從2002年11月開始出現於中國大陸廣東省一帶，首度於2003年2月底於過越南河內被世界衛生組織認定出的一種新興疾病，陸續在中國大陸、香港、新加坡、加拿大與台灣爆發流行。台灣在這次SARS流行中遭受重創，醫療照護體系首當其中，大型醫院被認為是傳播SARS主要的場所，醫護人員遭受感染的機率高於一般人。快速的確定病例與隔離措施被認為是防治SARS的重要策略。 國內公共衛生體系所採取的策略包括病例通報、傳染源的追蹤、檢疫與隔離、疾病監測、發燒測量、大規模社區消毒與關閉院內感染之醫院等措施。本文以公共衛生的觀點來探討SARS的相關議題，主要分析的面向包括流行病學、病例的處理與防疫政策之分析等，並對當前政府的防疫措施與計畫加以檢討與建議。文中並以世界衛生組織發言人Pascale Brudon對於越南政府能夠成功的對抗SARS的三個成功因素：快速的行動（speed of action），有效的領導（leadership）以及政府高度的資訊透明化（transparency shown by the government），來檢驗國內之對抗SARS的不良現象與省思。

An outbreak of severe acute respiratory syndrome (SARS) in Guangdong Province, People's Republic of China, began in November, 2002. SARS was first recognized at the end of February 2003 in Hanoi, Viet Nam. Further outbreaks of SARS have been reported in China, Hong Kong, Singapore, Canada and Taiwan. It is becoming quite clear that Taiwan has been severely affected by SARS. Contact in healthcare settings is thought to be important for transmission, putting healthcare workers at particular risk. To control SARS it is essential to identify cases very fast, and isolate them properly. The strategies of public health interventions in Taiwan included encouragement to report to health authorities after the onset of clinical symptoms, contact tracing for confirmed and suspected cases, and quarantining, monitoring, temperature reading, and travel restrictions for the local transmission areas. The purpose of the present paper is to examine the SARS issue from a public health perspective. The author focuses on the dimensions of epidemiological analysis, and health policy intervention and makes suggestions for further healthcare system provision. Finally, the author also uses the following three factors of how Vietnam beat SARS proposed by World Health Organization representative Pascale Brudon to scrutinize current phenomena in Taiwan: speed of action, leadership, and transparency shown by the government.