淺談臺灣夏季常見傳染病──登革熱簡介與預防照護

A Brief Introduction to A Common Summer Infectious Disease in Taiwan: Prevention and Care of Dengue Fever

登革熱病毒的傳播媒介是由埃及斑蚊或白線斑蚊傳播登革熱病毒所引起。登革熱大多數患者沒有症狀或症狀輕微，即使有症狀，也會在1-2週內改善。通常會在感染後4-10天出現症狀，並持續2-7天。登革熱症狀有：高燒、劇烈頭痛、後眼窩痛、肌肉和關節疼痛、噁心、嘔吐、淋巴腺體腫脹及皮疹等。若不幸遭受到第二次感染的人會增加演變成嚴重登革熱的風險，這時就需要住院治療，在極少數情況下，登革熱會進展重症並導致死亡。
臨床上，可以使用登革熱非結構蛋白1試劑快速進行鑑別診斷。目前沒有針對登革熱具體有效的治療方法，主要以支持性治療為重點；一般臨床上，常用乙醯氨基酚控制疼痛，但避免使用布洛芬和阿斯匹靈等非類固醇抗發炎藥，所導致出血風險的發生。Dengvaxia®(CYD-TDV)及Qdenga®(TAK-003)兩種登革熱疫苗可降低罹患登革熱的風險，但目前台灣尚未上市。預防蚊蟲叮咬、消除病媒孳生、及時發現病例、識別嚴重登革熱感染的任何警告信號以及適當的病例管理，是預防感染登革熱及降低嚴重感染死亡率的關鍵要素。
登革熱是常見的病媒蚊病毒性傳染疾病，給流行地區帶來了巨大的經濟和公共衛生負擔，故登革熱疫苗對於推動疾病管制非常重要。本文針登革熱的流行病學、診斷、治療、照護及預防，搜尋近年文獻期刊將以彙整，冀望提供臨床醫護人員照護上最新新知與參考。

The transmission vectors of the dengue virus are primarily Aedes aegypti or Aedes albopictus mosquitoes. Most patients with dengue are asymptomatic or exhibit mild symptoms, which typically improve within 1 to 2 weeks. Symptoms usually appear 4–10 days after infection and last for 2–7 days. These symptoms include high fever, severe headache, retro-orbital pain, muscle and joint pain, nausea, vomiting, swollen lymph nodes, and rashes. Individuals who experienced a second infection are at an increased risk of developing severe dengue and often require hospitalization. In rare cases, dengue can progress to a severe form that may be fatal.
Clinically, rapid diagnostic testing using the dengue nonstructural protein 1 (NS1) antigen test can quickly identify the disease. Although there is no specific or effective treatment for dengue, supportive care is crucial. Acetaminophen is commonly used to manage pain; however, non-steroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and aspirin, should be avoided due to the risk of bleeding. Dengvaxia®(CYD-TDV) and Qdenga®(TAK-003) are two vaccines that can reduce the risk of contracting dengue; nevertheless, they are not yet available in Taiwan. Preventing mosquito bites, eliminating mosquito breeding sites, early case detection, recognizing warning signs of severe dengue, and appropriate case management are key strategies for preventing dengue infections and reducing mortality in severe cases.
Dengue fever is a common mosquito-borne viral infectious disease that imposes a significant economic and public health burden on endemic regions. Therefore, dengue vaccines play a crucial role in disease control. This article reviews recent literature on the epidemiology, diagnosis, treatment, care, and prevention of dengue, aiming to provide healthcare professionals with the latest knowledge and references for patient care.