111學年度 - 健康中心

登革熱

登革熱(Dengue fever),是一種由登革病毒所引起的急性傳染病,這種病毒會經由蚊子傳播給人類。並且依據不同的血清型病毒,分為Ⅰ、Ⅱ、Ⅲ、Ⅳ四種型別,而每一型都具有能感染致病的能力。
患者感染到某一型的登革病毒,就會對那一型的病毒具有終身免疫,但是對於其他型別的登革病毒僅具有短暫的免疫力,還是有可能再感染其他血清型別病毒。

傳播方式

臺灣主要傳播登革熱的病媒蚊為埃及斑蚊(Aedes aegypti)及白線斑蚊(Aedes albopictus),這些蚊子的特徵身體是黑色的,腳上有白斑。其中埃及斑蚊的胸部兩側具有一對似七弦琴的縱線及中間一對黃色的縱線,喜歡棲息於室內的人工容器,或是人為所造成積水的地方;白線斑蚊則是中胸楯板部位中間,有一條白色且明顯的縱紋,並比較喜歡棲息於室外。一天叮咬人的高峰期約在日出後的1-2小時及日落前的2-3小時,此時到戶外活動請做好自我保護措施。

潛伏期

典型登革熱的潛伏期約為38(最長可達14)
病人發病前一天至發病後5天的這段期間,稱為「可感染期」,或稱為「病毒血症期」,因病毒存在血液中,如果感染者在這個時期被斑蚊叮咬,那麼這隻斑蚊將感染登革病毒,病毒在蚊子體內經過8-12天的增殖,這隻斑蚊就具有終生傳染病毒的能力,當牠再叮咬其他人時,就會把體內的登革病毒傳染給另一個人。

發病症狀

每個人的體質不一樣,有些人感染登革熱時,症狀輕微,甚至不會出現生病症狀。而典型登革熱的症狀則是會有突發性的高燒(38),頭痛、後眼窩痛、肌肉痛、關節痛及出疹等現象;然而,若是先後感染不同型別之登革病毒,有更高機率導致較嚴重的臨床症狀,如果沒有及時就醫或治療,死亡率可以高達20%以上,所以民眾千萬不能掉以輕心!發病後的第3~5天,若病情突然加劇,如發生劇烈疼痛、抽搐、昏迷、意識狀況及血壓改變等,須注意是否進展為登革熱重症。  

預防方法

(一)一般民眾的居家預防:
家中應該裝設
紗窗、紗門;睡覺時最好掛蚊帳,避免蚊蟲叮咬清除不需要的容器,把暫時不用的花瓶、容器等倒放。家中的陰暗處或是地下室應定期巡檢,可使用捕蚊燈。家中的花瓶和盛水的容器必須每週清洗一次,清洗時要記得刷洗內壁。放在戶外的廢棄輪胎、積水容器等物品馬上清除,沒辦法處理的請清潔隊運走。平日至市場或公園等戶外環境,宜著淡色長袖衣物,並在皮膚裸露處塗抹衛生福利部核可的防蚊藥劑。

(二)清除孳生源四大訣竅-澈底落實「巡、倒、清、刷」
1.
「巡」
經常巡檢,檢查居家室內外可能積水的容器。
2.「倒」倒掉積水,不要的器物予以丟棄。
3.「清」減少容器,使用的器具也都應該澈底清潔。
4.「刷」去除蟲卵,收拾或倒置勿再積水養蚊。

(三)感染登革熱民眾,應配合的事項:
(對病人、接觸者及周圍環境之管制)

感染登革熱民眾,應於發病後5日內預防被病媒蚊叮咬,病房應加裝紗窗、紗門,病人可睡在蚊帳內。防疫單位應進行孳生源清除工作,並依相關資料綜合研判後,評估是否有必要實施成蟲化學防治措施。登革熱患者周遭可能已有具傳染力病媒蚊存在,所以應調查患者發病前2週以及發病後1週的旅遊史(或活動地點),確認是否具有疑似病例。

 

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