某地區教學醫院──洗腎室流感群聚事件之處理

Experience of managing an influenza A outbreak at a hemodialysis center in a district hospital in Taiwan

2016年10月於某地區教學醫院的洗腎室，發生8位病人及1位工作同仁共9位出現類流感症狀，就醫快篩皆確診A型流感，症狀包括發燒9位（100％），咳嗽7位（77.8％）等，針對上述症狀個案，使用咽喉拭子採樣，流感快速抗原檢驗結果皆呈現A型流感病毒陽性。調查發現除工作同仁以外，病人皆無施打流感疫苗；流感病毒傳播速度快，加上洗腎室屬於密閉式環境，易於短時間發生群聚感染，故感管措施及早介入，包含：立即採取飛沫與接觸隔離防護，分區集中隔離照護，每日體溫監測，要求工作同仁及病人、照顧者皆須佩戴外科口罩，加強手部衛生，並限制照顧者聚集聊天，加強環境清潔消毒及協助安排洗腎病人及工作同仁接種流感疫苗，追蹤自10月25日後無新感染個案發生，使疫情得以控制。

During the influenza outbreak in October 2016, 9 cases of influenza A virus (8 dialysis patients and 1 health-care worker) were confirmed at a hemodialysis center in a district hospital. The clinical features of the infected patients included fever (9/9, 100%), cough (7/9, 77.8%), and so on. The diagnosis of all the cases were confirmed with an influenza screen test using nasal swabs. The patients had received no flu vaccine injection except a work colleague. Influenza virus can easily spread from person-to-person, and the close environment of dialysis centers also allows the virus to spread more quickly. Owing to the high risk of influenza outbreak in dialysis centers, infection control strategies must be performed as soon as possible. The management strategies include the following: highlight the importance of droplet and contact isolation, quarantine patients with influenza-like illnesses at a specific area for further care, monitor body temperature, enhance the implementation of standard precautionary measures such as wearing masks and hand washing, prevent caregivers from gathering to chat, maintain environmental cleanliness, and educate patients on the importance of flu vaccination. No new infected cases have been diagnosed since October 25, 2016, and the outbreak was controlled.