某醫學中心附設護理之家A型∕H3流感群突發調查

Investigation of Influenza A/H3 Outbreak in the Nursing Home of a Medical Center

流感 （Influenza） 好發的季節是冬天及春天，且大都在社區流行的疾病，2013 年夏天於某醫學中心附設護理之家發生院內流感群突發，於此季節是罕見的群聚事件，當時有 15 位住民出現呼吸道感染及類流感症狀，其中 11 位證實感染 A 型流感，臨床症狀包括發燒 11 位 （100%），有痰 9 位 （82%），咳嗽 4位 （36%），呼吸喘 4 位 （36%）。11 位 A 型流感患者經衛生福利部疾病管制署reverse transcriptase-polymerase chain reaction （RT-PCR） 檢驗結果，10 位（91%） 驗出 A 型／H3 流感病毒及 1 位 （9.1%） 為 A 型／swH1 流感病毒。經加強隔離防護、住民訪客管理、體溫監測、環境維護、通報回饋及預防性投藥等感管措施介入，6 日之後無新個案產生；希望藉由此次事件的經驗，作為長照機構在處理流感群突發事件時之參考。

The epidemic seasons of influenza A are mostly the winter and summer, andinfluenza A outbreaks mostly occur in communities. There was an influenza A/H3outbreak in the nursing home of a medical center in the summer of 2013, which wasa rare cluster event in a long-term care facility. The clinical manifestations of the11 patients included fever (11, 100%), increased sputum (9, 82%), cough (4, 36%),and dyspnea (4, 36%). Eleven patients demonstrated a positive influenza A rapidtest (enzyme immunoassay test) result; further, the reverse transcription polymerasechain reaction (RT-PCR) test showed that ten patients (91%) were infected withinfluenza type A H3, while only one patient (9.1%) was infected with type A swH1.The outbreak was managed after infection control intervention. This influenza Aoutbreak experience provides valuable information for long-term care institutions.