手足口病

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优瓦艾
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1 Hand Foot Mouth Disease 手足口病 Advanced Practice Nurse Joey Lam MPHC, BScN(Hons), PRegCert (Community Nursing) University Health Service

2 Current News 新聞 :

3 Current News

4 Communicable diseases 傳染病 DISEASES THAT CAN CAUSE OUTBREAK IN INSTITUTIONS 在機構內可爆發的傳染病疾病 Influenza-like illness Acute gastroenteritis Hand, foot and mouth disease (HFMD) Acute conjunctivitis o 流感 o 急性胃腸炎 o 手足口病 (HFMD) o 急性結膜炎

5 Causative Agent 病原體 Usually caused by enteroviruses such as coxsackieviruses and enterovirus 71 (EV71) 手足口病通常由腸病毒如柯薩奇病毒和腸病毒 71 型導致

6 Local Statistics 香港情況 (Source EV Scan (Week 42, October 13, 2016), communication diseases watch, Centre of Health Protection, HK)

7 Statistic Highlight 數據透視 The usual peak season for HFMD and EV71 infection is from May to July. From 2012 to 2014, a smaller peak also occurred from October to December. 香港手足口病活躍程度處於高水平手足口病和腸病毒 71 型感染的高峰期一般為五月至七月 2012 至 2014 年的十月至十二月亦出現一個較小型的高峰期 Source:

8 Outbreaks 疫情常爆發於 Can occur in Family 家庭 Nursery 托兒所 School 學校 Dormitory 宿舍

9 Key facts 要點 ochildren under 5 years old are more frequently affected oadults can also be infected oincubation period is around3-7 days: patients can transmit the virus to others during this period opatients are most contagious during the first week of illness oinfectious agent can be found in stools for weeks o 多發生於 5 歲以下兒童 o 成人亦可受感染 o 潛伏期 3 至 7 日 : 患者已具傳染性, 感染者多不自覺為病毒散播者 o 發病後的一週內傳染力最強 o 腸道排放病毒時間可更長, 達數週

10 Mode of Transmission 傳播途徑 It is spread by contact with infected persons nose and throat discharges saliva fluid from vesicles stool Contaminated objects 透過接觸患者的鼻或喉嚨分泌物唾液穿破的水泡糞便觸摸受染污的物件

opainful ulcers will develop inside the mouth, and non-itchy skin rash with

11 Clinical features 病徵 ousually begins with fever, poor appetite, tiredness & sore throat. opainful ulcers will develop inside the mouth, and non-itchy skin rash with vesicles will appear mainly on the hands & feet. omostly self-limiting & resolves in 1 week o 通常始於發燒食欲不振疲倦喉嚨痛 o 口腔潰瘍 o 出現在手腳上囊泡與非發癢的皮疹 o 通常在 1 個星期會復原

12 Severe Outcomes 可能的併發症 The EV71 infection is of particular concern as it more likely associates with severe outcomes viral meningitis encephalitis poliomyelitis-like paralysis death 腸病毒 71 型引致的手足口病備受關注因它較有可能會引致嚴重後果 : 病毒性腦膜炎腦炎類小兒痲痺癱瘓死亡

13 Management 治理方法 There is no specific anti-viral drug treatment for HFMD. Patients should drink plenty of water and take adequate rest. Drug, like paracetamol, can be used to reduce fever and pain from oral ulcers. 現時並沒有針對手足口病毒的藥物患者應多喝水和有充足休息藥物如撲熱息痛, 可紓緩發燒和口腔潰瘍引致的痛楚

14 Prevention 預防方法 There is no effective vaccine 現時仍未有疫苗可有效預防手足口病

監測和治療患者 Disinfection Good Food and Environmental Hygiene 消毒

15 Practice of Infection Control 傳染控制 Early Detection, isolation, monitor and treatment of patients 早期檢測, 隔離, 監測和治療患者 Disinfection Good Food and Environmental Hygiene 消毒良好的食物和環境衛生 Good Personal hygiene 良好的個人衛生 Enhancement of Immune System 增強免疫系統

16 Personal intervention 個人

If infection is caused by enterovirus 71, the patient should stay at home for 2 more

17 Infection Control 感染控制 Sick people should stay away from school or gatherings till all vesicles have dried up to avoid spreading the disease. If infection is caused by enterovirus 71, the patient should stay at home for 2 more weeks after all vesicles have dried up. 為免把病毒傳染給別人, 應該避免上學或參加集體活動, 直至所有水泡變乾如感染是由腸病毒 71 型引致, 患者更應在水泡變乾結痂後, 留家休息多兩星期

18 Good Personal Hygiene 良好的個人衛生 odo not share personal items with others odo not share food or drink with others oavoid close contact (such as kissing, hugging, sharing eating utensils or cups, etc.) with infected persons ofrequent hand wash o 不與他人共用個人物品 o 不與別人分享午餐盒或飲料 o 與受感染人士避免近距離接觸 ( 如接吻擁抱分享飲食用具或杯子等 ) o 常洗手

19 Cough manner 咳嗽禮儀

20 Area most often missed 洗手時會被忽略地方

21 Correct Technique of Hand Washing 正確洗手方法

22 To Boost your Immune System 增強個人免疫力 Have a Healthy Lifestyle : Balanced diet Drink more water Eat more vegetables and fresh fruits Regular aerobic exercise Have sufficient rest & regular sleeping hours 實踐健康生活模式 : 均衡飲食 : 多食菜, 少吃三高食物恆常帶氧運動足夠休息, 早睡早起, 有規律睡眠時間

23 Environmental intervention 環境

Good Environmental Hygiene 保持環境衛生 Cleaning of environment with 1: 99 diluted household bleach Disinfect objects and the environment with 1:49 diluted household bleach if they are

24 Good Environmental Hygiene 保持環境衛生 Cleaning of environment with 1: 99 diluted household bleach Disinfect objects and the environment with 1:49 diluted household bleach if they are contaminated by secretions or excreta from infected persons Do not mix household bleach with other cleaning agent 用 1:99 家用漂白水作日常環境清潔用 1:49 家用漂白水, 清潔被患者分泌物或排泄物染污的物件或環境不要將漂白水混合其他家用清潔劑使用

The Use of Bleach 漂白水的使用 Guideline : http://www.chp.gov.

25 The Use of Bleach 漂白水的使用 Guideline : Video:

26 Institutional intervention 機構

27 Early Detection and Monitoring 早期檢測和監測 Inform the Hall Management if you suspect that there is clustering of diseases, 如果懷疑爆發傳染病疾病, 請通知宿舍的管理部門 e.g. Gastroenteritis Influenza-like illness Hand-foot-mouth disease Acute conjunctivitis

measles, certain form of tuberculosis Minimize contact with other people as far as possible. Avoid group activities.

28 Early Isolation 早期隔離 Stay at home and do not attend school if your doctor tell you to do so. This is usually when one is Febrile (Ear temperature 38 C) Suffering from communicable diseases like chickenpox, hand-foot-mouth diseases, measles, certain form of tuberculosis Minimize contact with other people as far as possible. Avoid group activities. 依照醫生指示, 特別是當發熱 ( 耳溫 38 C), 患有傳染病, 如水痘, 手足口病, 麻疹, 結核病時, 應留在家中避免上學盡可能減少與其他人的接觸避免組活動保持良好的個人衛生有呼吸道感染症狀者及其緊密接觸者應戴口罩 Maintain good personal hygiene People with respiratory infection symptoms and their close contacts should wear surgical mask

29 Early Treatment 早期治療 Seek and follow medical advice immediately if you feel unwell

30 Summary 總結 Understand the chain of Propagation of Communicable Diseases Break the Chain Good personal, environment hygiene Hand washing and use alcohol hand rub as needed Build up immunity by healthy lifestyle Disinfection Early detection, isolation and treatment of patients 了解傳染病的傳播途徑破壞傳播途徑良好的個人, 環境衛生洗手和使用酒精搓手建立健康的生活方式消毒早期檢測, 隔離和治療患者

31 For Further enquiry, please contact University Health Service at Or can visit CHP web site for further HFMD information: 對於進一步查詢, 可與大學保健處聯絡或有關手足口病的病徵及預防方法, 請瀏覽衞生防護中心網頁 : Thank you 謝謝

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