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| 題 名 | 2021年三級疫情初期北部某區域教學醫院COVID-19群聚事件因應處置=Interventions in a COVID-19 Outbreak in a Regional Hospital during The Early Stage of Level 3 Epidemic Alert, Taoyuan, Taiwan, 2021 |
|---|---|
| 作 者 | 戴詩縈; 吳佩圜; 張芳梓; 楊玉玟; 巫坤彬; | 書刊名 | 疫情報導 |
| 卷 期 | 39:8 2023.04.25[民112.04.25] |
| 頁 次 | 頁111-116 |
| 分類號 | 412.42 |
| 關鍵詞 | COVID-19群聚; 院內感染; 應變處置; COVID-19; Healthcare-associated infection; Outbreak; |
| 語 文 | 中文(Chinese) |
| DOI | 10.6524/EB.202304_39(8).0002 |
| 中文摘要 | 2021年國內COVID-19三級疫情期間,北部某區域教學醫院發生醫療照護感染群聚,為當時北部地區最大規模的醫院群聚事件。經匡列醫院相關接觸者391人,社區接觸者58人,總計36名確定病例分布在4個單位,包括3名護理師、12名看護、15名病人、6名陪病或探病家屬。指標病例為護理師,隱藏期6天。疫情擴散主因為病人、看護及陪病、探病者密切接觸並跨病室交流。另有家屬未遵守禁止探病規定,造成10名家庭接觸者確診。經介入感控措施及醫療營運降載,疫情歷時34天,於7月中旬分階段回復營運。 本疫情應變經驗顯示,進入社區流行疫情初期,醫院應落實體溫及相關症狀監測、建立異常回報機制,以早期偵測病例。疫情發生時可運用定期篩檢以加速找出病例及管控疫情。此外,落實看護及陪病者管理及流動管制、禁止探病,以降低COVID-19在院內傳播與擴散至社區的風險。 |
| 英文摘要 | Coronavirus disease 2019 (COVID-19) was first reported in China and subsequently caused a global pandemic. Taiwan experienced the first wave of large-scale community transmissions of COVID-19 in mid-May 2021. The Central Epidemic Command Center maintained the zero-COVID strategy and announced the nationwide level 3 epidemic alert for COVID-19 on May 19, 2021. We described the investigation and response to the largest nosocomial COVID-19 outbreak in a regional hospital (Hospital A) in northern Taiwan during the early stage of level 3 alert. The index case was a nurse without known contact history. Confirmed cases were individuals with PCR-confirmed SARS-CoV-2 infection epidemiologically linked to outbreak cases. The transmission period ranged from 3 days before the onset to the day of isolation. Close contacts were individuals having face-to-face contact with confirmed cases during the transmission period. Persons at risk were individuals who had stayed in the same hospital unit with the confirmed cases for more than 8 hours during the transmission period. All confirmed cases were interviewed to trace contacts and determine the possible route of transmission. All contacts and persons at risk were tested for SARS-CoV-2. Close contacts were quarantined until 14 days after the last contact with confirmed cases. The in- and outpatient services of Hospital A were restricted for outbreak control. We found 391 healthcare-related and 58 community-related contacts. A total of 9,837 of SARS-CoV-2 tests were performed and 36 confirmed cases involving 4 hospital units were identified, comprising of 3 nurses, 12 caretakers, 15 patients, and 6 family members of patients. Delayed reporting of symptoms and COVID-19 testing of infected healthcare workers hindered early detection of the outbreak. Cross-ward and cross-unit interactions between patients and caretakers in the hospital further increased the extent of nosocomial transmission. Visitors who violated the access control of Hospital A increased the possibility of transmission to the community. This nosocomial COVID-19 outbreak occurred in 4 units of a regional hospital, affecting healthcare workers, patients, and community contacts. Strengthening of symptoms surveillance, periodic testing, segregation and flow control measure of healthcare workers, and access control of visitors facilitate early detection of outbreaks and prevent the nosocomial transmission of COVID-19. |
本系統中英文摘要資訊取自各篇刊載內容。