某準醫學中心血液腫瘤科病房A型流感群聚事件處理經驗

Management of an influenza A outbreak in a hematology and oncology ward of a quasi-medical center in north Taiwan

2019年1月某準醫學中心血液腫瘤科病房發生了包括病人及醫療工作人員的A型流感群聚事件。自1月22日至28日，共計7天，確診個案11人（病人7名、護理師4名），疑似個案6人（病人），總計17人。臨床表現除了典型的流感症狀外，也有許多非特異性或不典型的症狀，造成診斷與防治上的困難。多項感管措施介入，包括：落實手部衛生和口罩配戴、加強環境清消、強化陪探病管理、改進流感的監測與診斷、住院病人的分流與隔離、流感的治療與預防性投藥等，疫情得以控制且無併發症或死亡。事件之後參考美國感染症醫學會（IDSA）2018年更新的流感指引，修正院內相關防治措施。現今COVID-19疫情持續全球延燒，鑒於流感與COVID-19部分臨床表現的相似性，更積極有效的流感防治策略，正確診斷，給予適當的治療及感管措施，避免院內感染，成為防治流感及COVID-19的重要課題。

An influenza A outbreak occurred in the hematology and oncology ward of a quasi-medical center in north Taiwan in January 2019. This outbreak included 17 cases, comprising 11 confirmed cases (seven patients and four nurses) and six suspected cases between January 22 and January 28, 2019. The clinical presentation included typical, atypical, and non-specific symptoms and signs; therefore, the disease diagnosis and prevention were difficult. Several infection control measures, including hand hygiene, the use of masks, environmental disinfection, management of visitors and caregivers, improvement of investigation and diagnosis, and patient isolation and cohort, were implemented. The outbreak was controlled without complications and death, and the influenza infection control program was implemented according to the prevailing situation and IDSA 2018 guidelines. During the COVID-19 epidemic, execution of active and effective influenza prevention programs are critical to avoid outbreaks.