行政院衛生署疾病管制局

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1 ISSN 某軍事單位疑似爆發集體感染流行性腦脊髓膜炎之流行病學調查 15 生物及化學恐怖活動 39 合約實驗室病毒檢驗結果趨勢圖 42 國內重要疫情摘要報告 44 國際疫情及新知 51 台澎金馬地區各類法定傳染病個案報告表某軍事單位疑似爆發集體感染流行性腦脊髓膜炎之流行病學調查前言 Neisseria meningitidis 13

2 A 50 B 20 C 8-12 A 1-2 W-135 X Y Z 材料及方法

3 CC 2CC SPS Neisseria meningiditis ~37 5~10% 18~24

4 N. meningitidis 結果 B

5 N. meningitidis

6 討論及結論 Meningococcal meningitis 1805 Vieusseaux Marchiatava Chlli 1887 Weichselbaum 1895 Jaeger % 10% 60~80% 95% 12

7 N. meningitides invasive meningococcal disease 12 bactericidal antibodies multiple myeloma 15 C 3 10~20% 16 A 13, ,18 13 HIV

8 influenza stiffness 50% 10% 11,19 G penicillin G 11,19 7 cefotaxime ceftriaxone rifampin coloniza 19

9 dexamethasone 20 WHO sulfadiazine rifampin A, C, Y, W-135 建議

11 撰稿者 1, 參考文獻 1. 2.Murray PR, Drew WL, Kobayashi GS, et al. Medical Microbiology, CV Mpsby Co., London, 1990: cdc Murray PR., Baron EJ, Pfaller MA., Tenover FC, Yolken RH..Manual of Clinical Microbiology, 7 th eds. American Society for Microbiology, Washington, D.C Isenberg HD. Essential Procedures for Clinical Microbiology, American Society for Microbiology, Washington, D.C Koneman EW, Allen SD, Janda WM, et al. Color Atlas Textbook of Diagnostic Microbiology, 5 th eds. Lippincott-Raven Publisher, Philadelphia, PA Stephens DS. Unloaking the meningococcus: dynamics of carriage and disease. Lancet 1999;353: Mary PG, Arnold LS.: Meningococcal disease. In: Ralph DF, James DC. eds. Pediatric infectious disease. 3 rd ed. WB. Sauncers Company, Harcourt Brace Jovanovich, Inc. 1992: p Apicella MA. Neisseria meningitides. In: Mandell GL, Douglas RG, Bennett JE. eds. Principles and practice of infectious disease, 5 th edition Tzeng YL, Stephens DS. Epidemiology and pathogenesis of Neisseria meningitidis. Microbes Infect 2000; 2(6): Tikhomirov E, Hallaj Z. Control of epidemic meningococcal disease. WHO practical guidelines. 2 nd edition.1998: Caugant DA, Hoiby EA, Rosenqvist E, et al. Transmission of Neisseria meningitidis among asymptomatic military recruits and antibody analysis. Epidemiol Infect 1992; 109(2): Stephens DS, Hajjeh RA, Baughman WS, et al. Sporadic meningococcal disease in adults: results of a 5-year population-based study. Ann Intern Med 1995;

12 (12): Figueroa J, Andreoni J, Densen P. Complement deficiency states and meningococcal disease. Immunol Res 1993; 12(3): Moore PS, Reeves MW, Schwartz B, et al. Intercontinental spread of an epidemic group A Neisseria meningitidis strain. Lancet 1989; 2(8657): Kriz P, Bobak M, Kriz B. Parental smoking, socioeconomic factors, and risk of invasive meningococcal disease in children: a population based case-control study. Arch Dis Child 2000; 83(2): Griffiss JM. Meningococcal infections. In: Isselbacher KJ, Braunwald E, Wilson JD, et al. eds. Harrison s principles of internal medicine. 3 rd edition. 1994: p Schaad UB, Lips U, Gnehm HE, et al. Dexamethasone therapy for bacterial meningitis in children. Swiss Meningitis Study Group. Lancet 1993; 342(8869): Pearce MC, Sheridan JW, Jones DM, et al. Control of group C meningococcal disease in Australian aboriginal children by mass rifampicin chemoprophylaxis and vaccination. Lancet 1995; 346(8966): 20-3.

13 表一流行性腦脊髓膜炎接觸者預防性抗生素使用之建議 Sulfadiazine 500mg, Rifampin* 1000mg, 1 5mg/Kg, 1 10mg/Kg, 600mg, Ciprofloxacin** 500mg Ceftriaxone mg 250mg Sulfadiazine *Rifampin **Ciprofloxacin 18

14 圖一營區簡圖圖二病例之寢室位簡圖床

310 疫情報導民國86 年10 月25 日

310 疫情報導民國86 年10 月25 日 310 疫情報導民國 86 年 10 月 25 日傷寒與副傷寒前言民國 85 年 5 月初, 高雄市某旅行社所舉辦泰國革蘭島及無人島五日遊, 參加者多為經濟部高雄加工出口區某單位員工, 返國後有 4 位團員發生發燒腹瀉發冷及全身酸痛等不適症狀,