2023年某產後護理機構呼吸道融合病毒群聚事件之處理

2023年1月2日衛生單位接獲某產後護理機構疑似呼吸道融合病毒（respiratory syncytial virus, RSV）感染群聚，包含8名新生兒（含5名新生兒RSV陽性）和1名產婦，住民侵襲率為11.4%（9/79），不排除由感染RSV之訪客、陪宿者或照護人員未落實感控措施所致。群聚初期機構擔心負面形象而延遲通報衛生單位，自行採行防治與清消措施，後續因又新增個案，始通報後積極配合衛生單位，使疫情未再擴大。產後護理機構為新生兒RSV感染群聚之高風險場所，2022年下半年起因防疫規定鬆綁，RSV感染數呈急劇上升。若能即時偵測群聚並儘早介入，可避免疫情擴大。但社會期望反應（social desirability responding）易使通報單位延遲通報或低報，而錯失防疫黃金期，建議衛生單位在機構感控教育訓練中，強調群聚通報時效重要性及案例分享，提高通報行為的正向信心。

On January 2, 2023, health authorities received a report of a cluster of respiratory syncytial virus (RSV) infections in a postpartum care institution. The cluster involved 8 newborns (5 cases were RSV-positive ) and 1 postpartum woman, with an attack rate of 11.4% (9/79) among residents. The cluster of RSV transmission was possibly caused by infected visitors, overnight companions, or healthcare providers failing to implement infection control measures. Initially, the institution delayed reporting to health authorities due to concerns about a negative reputation. They took self-remedial measures and disinfection. However, with the emergence of additional cases, they actively cooperated with health authorities after notification, preventing the further spread. Postpartum care institutions pose high risks for RSV clusters. Since the relaxation of epidemic prevention regulations in the second half of 2022, RSV infections have sharply increased. Timely detection and early intervention in clusters can prevent further spread of the disease. However, the phenomenon of“social desirability responding”may lead to delayed or underreporting by reporting entities, resulting in missed opportunities for epidemic prevention. We recommended that health authorities emphasize the importance of timely reporting in cluster control education and training at institutions, as well as share case studies to enhance positive confidence in reporting behavior.