頁籤選單縮合
| 題 名 | 2017年桃園市某診所急性C型肝炎群聚調查=Outbreak Investigation of Acute Hepatitis C at an Outpatient Clinic, Taoyuan, Taiwan, 2017 |
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| 作 者 | 江雪美; 楊志元; 廖郁昕; 鄔豪欣; 林茹慧; 楊振煌; | 書刊名 | 疫情報導 |
| 卷 期 | 35:4 2019.02.26[民108.02.26] |
| 頁 次 | 頁45-51 |
| 分類號 | 412.42 |
| 關鍵詞 | 急性病毒性C 型肝炎; 標準防護措施指引; 安全注射行為; 親緣性分析; Acute hepatitis C; Standard precautions; Safe injection practice; Phylogenetic analysis; |
| 語 文 | 中文(Chinese) |
| 中文摘要 | 桃園市政府衛生局於2017年1月至3月接獲同一醫院連續通報3例急性病毒性C型肝炎病例,疫調發現該3名病例潛伏期內均曾至桃園市某診所接受針劑藥物注射。衛生局與疾病管制署為釐清本群聚事件可能感染源,調查群聚疫情規模並防止新增個案,除4次至該診所現場訪視外,並追蹤法傳系統至5月12日,發現該鄉鎮共計有5名急性C型肝炎確定病例,及可能暴露者合併C型肝炎感染者10例。綜合流病調查與實驗室病毒核酸相似度之親緣性分析,感染者之病毒株以1b基因型為主,且具高度同源性。亦發現該診所人員未落實手部衛生、疑似重複抽用單次使用之針劑藥瓶,且未於乾淨區製備針劑藥物。此急性C型肝炎群聚為1992年C型肝炎抗體檢驗納入血液篩檢後,首次高度懷疑醫源性感染導致之事件。並藉由分子流行病學之應用,幫助即時釐清群聚感染者之相關性。為防範醫源性C型肝炎群聚感染,醫療人員在提供病患醫療照護時,應落實感染管制措施並遵守安全注射行為。 |
| 英文摘要 | The Taoyuan City Health Bureau was notified of three cases of acute hepatitis C (AHC) during January to March, 2017. The three AHC cases had received intravenous injections at a clinic in Yangmei District, Taoyuan City within incubation periods. To identify the extent of the suspected outbreak and implement prevention measures, the public health departments conducted a joint on-site investigation at the implicated clinic for four times and kept monitoring for AHC cases by National Notifiable Disease Surveillance System. As of May 12, five confirmed AHC cases and 10 cases of clinic-associated hepatitis C infection were identified. Most of the viral strains were phylogenetically correlated and belonged to genotype 1b. The lapses of infection control practices at the clinic included poor hand hygiene, possible repeated use of single-use vials, and preparation of injection drugs at the contaminated area were suspected to be the causes of this outbreak. This was the first, possibly iatrogenic, outbreak of AHC after screening blood donors for antibody to hepatitis C virus since 1992. In addition, molecular epidemiology was helpful and timely to clarify the relatedness among viral strains from cases in this investigation. To prevent the iatrogenic hepatitis C infection, healthcare personnel should comply with infection control measures and safe injection practices. |
本系統中英文摘要資訊取自各篇刊載內容。