新冠病毒(SARS CoV-2)大流行期間兒童病房之感染管制措施

Infection Control Measures for SARS CoV-2 in Pediatric Wards During the COVID-19 Pandemic

新冠病毒(SARS CoV-2) Omicron變異株於兒童族群感染具有高病毒量及高傳染性，且臨床症狀與其他秋冬常見之呼吸道病毒感染類似，加上兒童非藥物介入措施(non-pharmacological interventions, NPI)順從性及疫苗接種率低，若無適當之感管措施，容易於兒童病房中造成群聚感染。兒科病房COVID-19群突發事件常發生於社區流行高峰時期，可能造成住院之高風險兒童出現重症，亦可能引起醫護人員感染，並導致醫療照護人力不足。預防兒童病房COVID-19群聚感染，除包括全院規範之感染措施外，另須特別加強住院時病人全面篩檢、醫療人員個人防護裝備選擇（尤其是眼睛黏膜保護）、減少不必要的氣溶膠產生之醫療處置及加強環境清消。而一旦於病房發現確診個案，亦需在第一時間進行隔離措施、流行病學調查及健康管理。具風險因子之兒童若有必要應盡速給予抗病毒藥物治療，並注意重症之危險徵兆。

 

Compared with prior variants, the SARS-CoV-2 Omicron variant causes high viral loads and high infectivity in the pediatric population. However, the clinical manifestations of COVID-19 in children are similar to those caused by other respiratory viruses. Besides, poor non-pharmacological interventions (NPI) compliance and low vaccination coverage in the pediatric population also contributed to the magnitude of the COVID-19 outbreak in Taiwan. Outbreaks of COVID-19 in pediatric wards might spread to the rest of the community, contribute to severe symptoms in children with underlying comorbidities, and infect healthcare workers leading to inadequate healthcare staffing. In addition to universal infection control measures, the infection control bundle for COVID-19 in pediatric wards should include measures such as universal screening for SARS CoV-2 before admission, provision of proper personal protection equipment (especially eye protection) of healthcare workers, minimization of the unnecessary aerosol generation procedures, and enforcement of environmental sanitization. If a new COVID-19 case is detected in the ward, it should be epidemiologically investigated, and the patient should be immediately quarantined and monitored. Children with comorbidities should be prescribed antiviral treatment and receive close monitoring for severe manifestations of COVID-19.