...1 ( ).....15.2 (SARS)......15.2....16.3.17.3....18.3........20 疱.4....20 AFP.5....21 AFP....21 15... 5...21.6.....22 6....23... 7....24 O157.... 7..24 RotaNoro. 7 (A E )........24...8....25.9....25.....9....26...10....26... 10.....26...11......27...11....27 b...11.....28...12... 30...12.......31.. 13......42...13... 44 疱......14.. 45...15..46 Q...... 15.. 47

1

1. 1 2 1. 127 1. 2. 8 0227850513 1 2m 805 2. FAX0227850288 2. 3 * (04)24739940 2 FAX(04)24739774 3.* (07)5570025 (1). 15 ml 腖 ( ) FAX(07)5574544 * (03)8223106 FAX(03)8227713 (2). Cary-Blair ( ) 1 4. 50~200 5. 2 800 ml 5 10 ml 1. 12 7 1. (Widal) 50 ml TSB BHI 2.18 2. 1. 1 Selenite ( ) 2

2. 1 Cary-Blair 2 3. 1,000ml 1,000ml 0.05 2 (Sodium thiosulfate) 2 1 2 126 7 1. Cary-Blair buffered glycerol saline 2 2. ( 1 1. ) 2. merthiolate-iodine-for maldehydemif 1. 24 ( ) 1 (PCR) 2. 2. 3

疱 (heparin) ( ) ( ) 3-5ml 1.5 ml 60 ( ) 1.5 ml 疱 ( ) ( 4 13 疱 15 10% 疱

5 (AFP) 1. 2. 10 ( ) 3M(10I) 1. 7 2. 72 3. 4. AFP (AFP) 15 12 3. 12 3. 4. AFP

5 10 1. 267 1. 2. 1 (0.03M Ph7.0 3. 2. ) Cary-Blair 3. 1. 1 ( 1. 127 1. ) 2.8 2. 1 腖 3% 3. 腖 2 Cary-Blair 2. 2 3. 6

3. 10ml 1. 67 1. 3 2. 1 25g 4 3. 15 ml 25g 2. ( 1. 1. 1. 1. (O157) HUS 2. 2. 1g ) 48 Cary-Blair paraffin 2. Cary-Blair SMAC Cary-Blair 2. 3. O157 RotaNoro 1. 3g paraffin 2. 2. 7

8

9 10m 3m (, 却 ) 200ml 1. 67 2. 1 3., 200ml( 1. 2. 1. Cary-Blair 2 2. 3. 1. 1267 2. 1. 2.Cary-Blair

5m 疱 疱 1.5m Cary-Blair 1. 7 1. Cary-Blair 2. (22~35 1 2 ml 3. 2. 1:5~1:10 (22~35 TSB BHI ) 3. 1 ml 1-2 4. 10

67 1. Cary-Blair 7 2. 3. 1. 8 2.12 (Nasopharyngeal swab) 8 2ml 3 48 2 11 b 5 10ml 1. TSB BHI 67 2ml 1610 2. 3.

heparin 1. IgGIgM (10u/ml) 5 67 ~ 3 ml 2., IgM 3 IgG, 10-50 ml., heparin 1. IgGIgM (10u/ml) 5ml 67 2. ~ 3ml 3 2., IgM IgG, 12

10~50ml 1. 67 2. 1. 3. 2. ( ) Heparin (10u/ml) 3-5ml 67 3-6 1 m 1. 67 1. 2. 2. 10~50ml heparin 1. IgGIgM (10u/ml) 5ml 67 ~ 2., IgM IgG 13

疱 疱 ~ 疱, 1. 疱 1 ml 27 ( 疱 7~10 疱 2.2-sp 2-sp 12 3. 70. 疱 疱 ~ 疱 疱 疱 2~4 12 70 7~10 疱 0.2~0.3 ml 2sp 疱 ~ heparin (10u/ml) 5ml 67 14

2. Q 1. 3ml 4567 1. 3 1. 2. 2. 2. ( ( ) ) 7 SARS 5 7 1. 1. 2. 3-5ml 9 2. 50mL 3. 15

疱 疱 1-3 疱 疱 1ml 21 腭 16

17

18 1. BSL3 2. (39 ) 1. 2. (bubo) 3. 4. ( 5 10ml 50 ml TSB BHI * 1. 2. ( ) 3. ( ) ( 1. 4567 2. 3. 1. 2. 3.

19 (C.S.F ( 39~41 ) 1. ( ) 2. 3. * () 1. 20 2.

20 Heparin (10u/ml) 5ml-10ml 1. 2. 1. 3ml 3 2. 1. 67 2. 2 1. 2. 1. 2. 1. 3ml 3 2. 4567

21 1. 2. 1. 3ml 3 2. 4567 1. 2~3ml 3 2. 1. 2. 1. 2. 1. 3ml 3 2. 4567 1. 2. 15 1 3.

1. 2. 15 1.5 3. 22

23

24 ( ) 1. 2. 3. 1. 3ml 3 2. 3. 5 4567 1. 2. ( ) 67 ( A E ) 1. 3ml 3 2. 4567 ABE

10ml 4567 0.5ml 1 phosphate bufferph 7.4 (heparin) 3-5ml 1. 3ml 3 2. 10-14 ( 25

26 Ebola ( ) 1. 2. 1. 3ml 3 2. 4567 1. 2. 1. 3ml 3 2. 4567 1. 2. 1. 3ml 3 2.

27 / PCR/DNA / 1. Thayer Martine chocolate agar CO 2 2.PCR/ DNA 1.35-37 2.2-27 C.S.F. 1. 2.

28

1 2 Cary-Blair Cary-Blair 3 ( 1 ) 4 ( ) (paraffin) ( ) 3ml 5 7 8 (COLLECT TWO PERNASAL NASOPHARYNGEAL SWABS 29

30

31

1. whole blood b Staphylococci Propionibacterium (1)70% (2) 2% Tincture of iodine [ 70% ] (3) 70% (4) (5) 10ml 5ml 1-2ml (6) [SPS 50mlTBS BHIBrain Heart Infusion broth] (7) 0.1%heparin 4.0%sodium citrate P.S. 35 32

2. anti-coagulated whole blood (1) heparin 5-10ml 32 ( EDTA ) 1-3ml (2) (3) (4) 4-8 P.S. sodium citrate 3. serum Q 1 5-10ml 32 2 30 3 1500 10 4 33

5 4-8 4. urine clean-voided 4-8 P.S. 10ml 0.5ml 1 phosphate bufferph 7.4 ph 5. fecal specimen rectal swab AFP SARS mucus Cary Blair transport medium Culture Swab buffered glycerol saline Viral transport Swab digital examination 34

10 72 (PCR) 1 24 6. cerebrospinal fluid, CSF b lumber puncture 70% 2% stylet middle line spinal subarachnoid space 7. nose throat swab SARS 35

Culture Swab 36

Transtube 37

(Corynebacterium diphtheeriae) (Vincens angina) 8. (nasopharyngeal specimen) SARS 腭 (soft palate) ( nichrome ) Amies charcoal ( 8 ) 9. (sputum specimen (bronchial secretions) (bronchoscope) 38

10. (body fluid) (pleural) (peritoneal) (peritoneal) (synovial) ( ) b (aseptic technique) (trocar) 11.(pus) (wound) (abscesses) (boil) (drainage) 70% 竈 竈 10%CO 2 10%H 2 80%N 2 (anaerobic specimen collector)( ) 12. 13. 疱 (vesicular fluid) 疱 39

疱 疱 1~3 疱 (1) 疱 (2) 1ml 27 7-10 疱 疱 (3) 疱 2SP (4) ( ) (5) (4-8) (6) 14. 疱 (vesiclar lesionw) 疱 疱 疱 1~3 (1) 疱 疱 (2) (2~4 ) (3) 7~10 疱 0.2~0.3ml 2SP (4) ( ) (5) 40

(6) (7) (4~8) (8) 15. 1 2 10~15l ⅓ 45 15 1~1.5 3 5~10l 30 Medical Microbiology. 3 rd Ed. Cedric Mims, Hazel M Dockrell, Richard V Goering, Ivan Roitt, Derek Wakelin, Mark Zuckerman, 2004. 41

42

() () () ( () () ( ) ( ( ) ( ) () ( 1) 43

MAT MAT 44

RNA Real-time RT-PCR Multiplex for SARS, Influ A&B Influ H5 Influ H1, H3, RT-PCR Adenovirus, HSV, RSV, Metapneumoviru sparainfluenza && Influenza A&B Adenovirus HSV RSV Parainfluenza && are applied in CDC 45

46

02-27850513~5 02-26531335 02-27850288 02-27856671 02-26522584 02-26531351 02-27885075 02-27864367 02-26531388 02-26513572 02-26531368 02-27830877 02-26531370 02-26531387 02-26531374 02-27883992 02-26531383 02-27822319 47

/. - -. - -, 94 ISBN 986-00-0446-3 1., 412.38026 94002888 6 (02)23959825 http://www.cdc.gov.tw 33 7 (02) 29821919 94 2 85 10 (02) 25781515 643 61 (02) 23617511 2 (04) 2260330 177 (04) 7252792 141 (07) 3324910 http://www.govbooks.com.tw 48 GPN1009400015 ISBN 986-00-0446-3

http//www.cdc.gov.tw 1922 0800-024-582 ISBN9860004463 49 GPN1009400015 85