來源WHO:http://www.who.int/csr/don/2004_09_28a/en/ Avian influenza – situation in Thailand 28 September 2004 Two new cases confirmed Since yesterday, the Ministry of Public Health in Thailand has confirmed two new cases of H5N1 avian influenza in humans. The cases are a 26-year-old woman, who died on 20 September, and her 32-year-old sister, who remains hospitalized in stable condition. These new cases bring the total in Thailand confirmed since early September to three. Altogether, Thailand has reported 15 cases, of which 10 were fatal, since the first human cases were detected in January of this year. Investigation of possible human-to-human transmission in a family cluster The most recent cases are part of a family cluster of four cases under investigation to determine whether human-to-human transmission may have occurred. Immediate investigation of any possible human-to-human transmission is always needed to determine whether transmission has been efficient and sustained. Such a situation would be cause for alarm, as it might signal the start of an influenza pandemic. Inefficient, limited human-to-human transmission may occur on rare occasions and is in line with what is known, from epidemiological and laboratory investigations, about the possible behaviour of the H5N1 virus. The initial case in the family cluster was an 11-year-old girl who died of pneumonia on 8 September. Thai authorities regard her as a probable case of H5N1; laboratory confirmation is not possible as no specimens from this patient are available for testing. The girl, who lived in the northern province of Kamphaeng Phet, resided with her 32-year-old aunt, whose infection has been confirmed. Both patients are known to have had contact with dead chickens. The girl’s 26-year-old mother, whose infection is also now confirmed, resided in the Bangkok area, but provided bedside care for her daughter while hospitalized, up to the time of the child’s death. The mother fell ill upon her return to Bangkok, where she died on 20 September. Thai officials have concluded that the mother could have acquired the infection either from some environmental source or while caring for her daughter, and that this represents a probable case of human-to-human transmission. The family cluster also includes the 6-year-old son of the aunt of the initial case. He was hospitalized but is recovering, and samples are being tested. Surveillance for additional cases, among health workers and in the wider community, has been greatly intensified in the province, and hospitals nationwide have been placed on heightened alert for further cases. While the investigation of this family cluster provides evidence that human-to- human transmission may have occurred, evidence to date indicates that transmission of the virus among humans has been limited to family members and that no wider transmission in the community has occurred. Continued vigilance is needed to determine whether the epidemiological situation in humans remains stable. Clinical samples taken from cases in the family cluster were immediately shared with a laboratory in the WHO Global Influenza Surveillance Network. Virus isolated from these samples will undergo genetic and antigenic analysis to determine whether the virus has evolved and, more specifically, whether it has acquired genes that allow improved transmissibility among humans. ------------------------------------------------------------------------------ 來源 疾管局 http://203.65.72.83/ch/dsi/ShowPublication.ASP?RecNo=3645 泰國傳出疑似禽流感人傳人事件，請民眾配合各項防疫措施 人類罹患禽流感最新現況： 自92年12月起，越南及泰國陸續傳出人類感染禽流感H5N1病毒個案，迄今確診病例數42例 （泰國15例，越南27例），死亡病例30例（泰國10例，越南20例），死亡率高達71%。93年 9月28日泰國公共衛生部公佈一件疑似禽流感人傳人事件，目前正調查中，相關資料如附件 一。 防治措施： 目前我國雖無H5N1禽流感疫情，但將對禽畜業者加強監視；此外，為防止境外移入禽流感 個案，對於中、港、澳入境旅客，維持自主健康管理10天之措施；而由東南亞地區（越南 、泰國等地）入境之旅客，如於旅程中，曾出現流感或發燒等症狀，應於入境時據實填寫 「傳染病防制調查表」並告知機場檢疫人員，本局將會進行初步篩檢，以利後續防疫措施 進行。其他國家之防治措施摘要如附件二。 疾病管制局呼籲，國人如至禽流感感染地區（如附件三）旅遊，應避免在無任何防護下接 觸家禽，萬一接觸過禽鳥或其糞便，應馬上用肥皂澈底清洗雙手。回國後10天內應注意自 己身體健康狀況，若出現急性發燒、咳嗽、喉嚨痛、肌肉酸痛等類流感症狀或結膜炎，應 戴口罩立即就醫，並告知醫師曾前往地點及接觸史，以利醫師正確研判病情。 --

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