屈公病之流行病學、臨床診斷與防治策略

Epidemiology, Clinical Diagnosis, and Control Strategies of Chikungunya: An Infection Control Perspective from Taiwan

屈公病為屈公病毒所引起之病媒蚊傳染病，近年因氣候變遷、都市化與國際人口移動增加而於全球各地再度流行。屈公病雖然死亡率相對較低，但患者常有慢性關節炎、慢性疼痛及功能受限等合併症，對醫療體系與公共衛生造成長期負擔。臺灣自2007年將屈公病列為第二類法定傳染病，目前病例多屬境外移入，惟鄰近國家疫情增加及病媒蚊廣泛分布，使本土傳播風險逐漸上升。本文綜整國內外文獻，回顧屈公病之流行病學特性、臨床表現、診斷方法與治療照護原則；內容亦探討屈公病急性期症狀、臨床鑑別診斷、檢驗檢查、慢性關節炎後遺症及其對生活品質的影響，並整理目前臨床支持性治療、復健照護與跨專業整合管理策略。此外，本文從臺灣感染控制觀點出發，分析目前防治措施與未來挑戰，包括病媒蚊防治、檢疫、法定傳染病通報制度、醫療機構分流管理及社區防蚊衛教等公共衛生策略。面對全球氣候變遷與區域疫情升溫，未來臺灣應持續強化早期監測與通報機制、提升實驗室檢驗量能、整合智慧化病媒監測科技，並評估高風險族群疫苗接種與疫苗儲備政策。透過醫療體系與公共衛生跨部門合作，可提升整體感染控制韌性，降低屈公病本土化傳播風險。冀望本文能提升第一線醫護人員對屈公病之臨床辨識與防治能力，以強化臺灣未來疫情防範與應變能力。

Chikungunya is a mosquito-borne infectious disease caused by the chikungunya virus. In recent years, the disease has re-emerged globally owing to climate change, urbanization, and increasing international travel. Although the mortality rate is relatively low, many patients develop chronic complications, such as persistent arthralgia, chronic pain, and functional limitations, which may impose a longterm burden on healthcare systems and public health resources. In Taiwan, chikungunya has been classified as a Category II notifiable infectious disease since 2007. Although most reported cases are imported, the increasing incidence in neighboring countries and the widespread distribution of mosquito vectors raise concerns about potential local transmission. This review summarizes the current evidence on the epidemiology, clinical manifestations, diagnostic approaches, and management of chikungunya. It also discusses the differential diagnoses, laboratory testing strategies, and long-term sequelae that affect the quality of life of patients. From the perspective of infection control in Taiwan, key prevention strategies, including vector control, border surveillance, disease reporting systems, hospital triage management, and community-based mosquito prevention, were examined. Strengthening early surveillance, laboratory capacity, and inter-sectoral collaboration is essential for enhancing infection control resilience and reducing the risk of local outbreaks.