長照機構呼吸道融合病毒(RSV)之感染管制措施建議

Respiratory Syncytial Virus Prevention and Infection Control in Long-term Care Facilities

呼吸道融合病毒（Respiratory Syncytial Virus, RSV），為單股鏈狀RNA病毒，一般常在秋季和冬季與其他呼吸道病毒同時傳播，所以很容易被忽略及導致呼吸道感染流行，但因感染後產生之抗體濃度無法持久，所以終身都會反覆感染。RSV引起的住院及死亡個案數尤其是在≥65歲長者中明顯高於兒童。由於缺乏監測和報告，成人門診和急診就診次數很容易被低估。RSV在長照機構是容易發生感染，除疾病侵襲率高並會伴隨著顯著的肺炎發病率和死亡率。呼吸道融合病毒之感染管制措施主要為執行標準防護措施、接觸防護、飛沫防護、嚴格執行個人防護裝備使用，加強RSV篩檢，施打RSV疫苗等。面對後疫情時代各種呼吸道病毒感染，未來有關RSV主要問題著重篩檢與診斷、RSV疫苗介入效用、針對高危險群及長照機構長者能將RSV納入現有呼吸道病原體監測計劃仍是重要的感染管制措施建議。

Respiratory syncytial virus (RSV) is a single-stranded RNA virus that typically spreads in the fall and winter months alongside other respiratory viruses. As a result, it can be easily overlooked, leading to widespread respiratory infections. Because the immunity provided by RSV antibodies after an infection is not longlasting, individuals can be repeatedly infected with RSV throughout their lives. Among the elderly, especially those aged 65 and above, significantly higher rates of hospitalizations and deaths due to RSV are observed compared with children. The lack of monitoring and reporting systems, particularly in outpatient and emergency settings, often results in the true infection rate being underestimated. RSV infections are common in long-term care facilities, in which with infection and mortality rates of pneumonia are high. Infection control measures for RSV include implementing contact precautions, droplet precautions, personal protective equipment, enhanced screening, and vaccination. In the post-pandemic era, key issues for RSV include improving screening and diagnosis, implementing vaccine interventions, and integrating RSV into existing respiratory pathogen surveillance programs for highrisk groups.