國內爆發 腸病毒無菌性腦膜炎群聚感染

[forester]

國內爆發 腸病毒無菌性腦膜炎群聚感染
更新日期:2009/06/24 10:59 中時健康 楊格非／台北報導
許多民眾都以為腸病毒只會發生在幼兒身上，其實不然衛生署疾病管制局最近接獲了一起感染腸病毒，導致無菌性腦膜炎的群聚感染案例，感染者均為國中生，人數多達14人。疾管局提醒，每個人都應加強衛生習慣，始能遠離腸病毒威脅。

這起罕見的國中生染腸病毒、引發無菌性腦膜炎的群聚感染，是發生在台北市四所國中，從6月1日至6月22日，陸續有14名學生（13男1女）陸續出現頭痛、嘔吐與發燒等症狀就醫。

其中11名患者就讀同一所，當中還包括了一對姊弟。採驗結果證實為感染腸病毒（Echo病毒30型），引發無菌性（病毒性）腦膜炎。

疫調顯示，這些國中生幾乎都玩在一起，下課後一同補習、打球，由於密切接觸，相互感染了病毒，所幸住院治療後，都已逐漸痊癒。

疾管局副局長施文儀表示，Echo病毒30型為腸病毒的一種型別，這四校14名國中生都是同班，或同補習班，或是橄欖球隊員，以及一起打籃球，接觸頻繁，以致相互傳染。

台灣曾在77年與82年曾爆發兩次腸病毒腦膜炎大流行。感染後的症狀與一般感冒或腸胃道症狀相似，包括發燒、寒顫與咳嗽流鼻水等，但腸病毒腦膜炎患者容易頭痛、頸部僵硬。

施文儀指出，腸病毒等病原所引起的無菌性腦膜炎，發炎反應都很輕微，一般來說預後良好，很少出現後遺症，在臨床上只需要給予一些減輕症狀的治療方法，病人都會自然痊癒。

即使如此，施文儀還是提醒民眾，目前正值腸病毒流行期高峰，青少年經常一起打球戲鬧，只要一人罹患此病毒，其他人也很可能被感染。最可怕的是，學童可能將腸病毒從學校帶回家，傳染給家中其他嬰幼兒的機會也相對增加。

因此，不論家長與學童都應落實勤洗手及呼吸道衛生的好習慣，共同保護自己與家中的嬰幼兒不受腸病毒威脅。學校也應該讓學生養成良好的衛生習慣，並隨時注意學生健康狀況，降低腸病毒感染的機會。

腸病毒無菌性腦膜炎群聚感染??? (咦)

[hsu]

我是覺得應該正名一下
現在腸病毒幾乎變成手足口病跟咽峽炎的同義字
但是腸病毒所引起的許多疾病其實跟這兩種病無關
很容易造成民眾誤解



Syndromes Caused by Enteroviruses
Syndrome
Serotypes Most Often Implicated
Comments

Aseptic meningitis
Coxsackieviruses A2, 4, 7, 9, and others and B2–5; polioviruses 1–3; echoviruses 4, 6, 7, 9, 11 and, less commonly, others
Most common in infants and children; course usually benign; may involve rash or encephalitis; virus can often be isolated from the throat, stool, or CSF

Conjunctivitis (hemorrhagic)
Enterovirus 70 (conjunctivitis is rarely accompanied by transient radiculomyelopathy or poliomyelitis-like paralysis); echovirus 7; coxsackievirus A24 (conjunctivitis with less subconjunctival hemorrhage)
May produce subconjunctival hemorrhage and keratitis; outbreaks are rare in the US; recovery usually in 1–2 wk

Epidemic pleurodynia (Bornholm disease)
Coxsackieviruses B1–6
May affect any age group. Chest and upper abdominal pain

Hand-foot-and-mouth disease
Coxsackievirus A16; enterovirus 71
Most common in young children; vesicular exanthem usually brief and benign

Herpangina
Coxsackieviruses A2, 4–6, 8, 10; probably coxsackievirus 3 and others
Most common in infants and children; characteristic palatal and pharyngeal lesions

Myopericarditis
Coxsackieviruses B1–5; coxsackieviruses A4 and 16; echoviruses 9 and 22
May occur at any age; disease at birth (myocarditis neonatorum) produces fever and heart failure and has high mortality; in other forms there is often complete recovery; diagnosis may require PCR of myocardial tissue

Paralysis
Polioviruses 1–3; coxsackieviruses A7 and others; echoviruses 4, 6, and others; enterovirus 71
Transient mild paresis with aseptic meningitis may occur at any age; younger children generally have milder disease; severe paralysis is possible with poliovirus

Rash
Coxsackieviruses A9 and B1, 3, 4, and 5; coxsackieviruses A4–6, and 16 also implicated; echovirus 9 and 16; echoviruses 2, 4, 11, 14, 19, and 25 also implicated; rash with aseptic meningitis may result from coxsackieviruses A9 and B4, echoviruses 4 and 16, and enterovirus 71
Fever is common; rash is usually nonpruritic, does not desquamate, and occurs on the face, neck, chest, and extremities; may be maculopapular, morbilliform, or occasionally hemorrhagic, petechial, or vesicular; course usually benign

Respiratory disease
Echoviruses 4, 8, 9, 11, 20, and others; coxsackieviruses A21 and 24 and B1 and 3–5
Sore throat, coryza, cough and fever most common; course usually mild; may produce GI symptoms in children