傳染病 Infectious Diseases

傳染病 Infectious Diseases
  1. 炭疽病
  2. 水痘
  3. 結膜炎 (俗稱紅眼症)
  4. 登革熱
  5. 白喉
  6. 食物中毒
  7. 腸胃炎
  8. 手足口病
  9. 頭蝨
  10. 甲型肝炎
  11. 乙型肝炎
  12. 流行性感冒
  13. 日本腦炎
  14. 痲疹
  15. 猴痘天花
  16. 流行性腮腺炎
  17. 百日咳
  18. 風疹 (德國麻疹)
  19. 嚴重急性呼吸症侯群
  20. 疥瘡
  21. 猩紅熱
  22. 性病
  23. 破傷風
  24. 結核病 (俗稱肺癆病)
  25. 衛生署發佈的傳染病控制指引
  1. Anthrax
  2. Chickenpox
  3. Conjunctivitis
  4. Dengue Fever
  5. Diphtheria
  6. Food Poisoning
  7. Gastroenteritis
  8. Hand, Foot and Mouth Disease
  9. Head Lice
  10. Hepatitis A
  11. Hepatitis B
  12. Influenza
  13. Japanese Encephalitis
  14. Measles
  15. Monkeypox
  16. Mumps
  17. Pertussis (Whooping Cough)
  18. Rubella (German Measles)
  19. Sever Acute Respiratory Syndrome (SARS)
  20. Scabies
  21. Scarlet Fever
  22. Sexually Transmitted Diseases
  23. Tetanus
  24. Tuberculosis
  25. Guidelines on Communicable Disease Published by Department of Health

炭疽病

炭疽病由一種名為無芽炭疽桿菌的細菌引致。該病普遍發生於動物身上。當該病影響至人類時,常發生於與動物有接觸之農業或野外工作者。香港過去十年,炭疽病甚為罕見,只有一宗案例呈報

臨床徵狀

炭疽病之症狀因感染方式而有所不同

  • 皮膚炭疽病﹝經由皮膚傷口而感染﹞
    1. 傷口痕癢,繼而發展為中央部位呈黑色的無痛潰瘍
    2. 淋巴腺腫脹
  • 吸入性炭疽病﹝經吸入炭疽胞子而感染﹞
    1. 呼吸困難
    2. 流鼻水
  • 腸炭疽病
    1. 噁心
    2. 嘔吐
    3. 食慾欠佳
    4. 腹痛
    5. 發熱
    6. 腹瀉
傳播途徑 霧化微細之炭疽病原體可透過破損之皮膚,食入或吸入而感染;而人與人之間接觸傳播則較為罕見。炭疽菌需利用高度技術及特別儀器,才能把它變成較微細的粒子,作為生化武器
潛伏期 潛伏期於接觸後由數小時至七日不等
處理方法 病者應盡早留院觀察及接受有關治療,因早期適當地使用抗生素能有效預防炭疽胞子擴散

水痘

水痘是由泡疹病毒其中一種名為水痘病狀泡疹毒之過濾性病毒引致

臨床徵狀
  1. 輕微發熱
  2. 疲倦
  3. 出疹 – 痕癢、且帶有水泡,主要出現於頭皮、面和身上, 在發熱時出現,水泡並會乾涸及變痂

在大多數案例中,病情屬輕微;但嚴重者可出現併發症如:肺炎、腦部或皮膚感染等

傳播途徑 水痘是一種有高度傳染性之疾病,經由人與人直接接觸、飛沬、空氣傳播。傳染期由出疹前兩日至出疹後七日,直至變痂為止
潛伏期 潛伏期十四日至二十一日
處理方法 若病者有發熱情況,則服用退熱葯物﹝例如:Panadol﹞;出現痕癢情況,則可塗搽外用葯物﹝例如:Lalanine Lotion﹞。病者應避免揉擦眼睛及搔癢皮膚,因繼發性感染會形成疤痕。病者應留在家中,不宜上學直至水痘乾涸為止
預防方法
  • 現時水痘預防疫苗十分通行, 90%曾接受疫苗者皆獲免疫能力
  • 保持良好個人及環境衛生
  • 接觸呼吸道分泌物後﹝例如:打噴嚏後﹞要立即洗手
  • 打噴嚏及咳嗽時,應掩著口和鼻
  • 徹底及頻密清潔兒童之玩具及用具
  • 有水泡或出疹時,應盡早求診治理
  • 避免走進人多擠迫之地方

結膜炎 (俗稱紅眼症)

結合膜受感染稱結膜炎,眼睛呈粉紅色。通常分三類:過濾性病毒、過敏、細菌性

症狀

細菌性結合膜炎,接觸細菌後二十四至七十二小時會出現徵狀,過濾性結合膜炎,會於五至十二日出現徵狀

  • 眼睛呈紅
  • 過多淚水
  • 灼熱或痕癢感覺
  • 排出分泌物
  • 眼皮腫脹
  • 畏光﹝暴露在光線中,眼部感不適﹞
傳播途徑 紅眼極易傳染他人!傳播途徑為接觸病者之眼睛或呼吸道之分泌物、受污染之手指、衣服和物件,包括與別人共同使用眼部化妝品和眼葯等
預防方法
  • 避免在校園內散播疾病
    1. 暫停使用游泳池
    2. 定期用稀釋漂白水消毒校內物品表面例如:門、櫃面、桌面等等
    3. 勸告學生勿用手揉擦眼睛
    4. 用清水和肥皂徹底清潔雙手
    5. 最重要是提醒學生,勿與別人共同使用個人物品,例如:手帕
  • 處理病童方法
    1. 病童不宜上學,防止疾病蔓延學校
    2. 接觸感染之眼睛後,勿再接觸不受感染之眼睛
    3. 觸摸眼或面後,要立即洗手
    4. 清洗受污染之衣服、毛巾和枕袋
    5. 使用清潔之紙巾沬眼睛,並需即時妥善處理及棄置用後物品
    6. 勿與別人共同使用毛巾、手帕及清洗衣物
    7. 若徵狀持續出現,需再尋求醫治
相關網址

登革熱

登革熱是由一種過濾性病毒引致。世界各地都有案例呈報,尤其是熱帶市鎮。每年估計有五億人口受感染,其中最少有一萬二千人死亡,而死亡以小童為主

二零零二年前,香港每年約有三至十七宗登革熱案例呈報,而全部為外地傳入,非香港本土發生。但於二零零二年九月,本港首宗本土登革熱出現於馬灣,幸好這並非致命個案

臨床徵狀
  • 約三至五日發熱
  • 嚴重頭痛
  • 疲倦
  • 肌肉疼痛或關節痛
  • 眼窩後疼痛
  • 食慾欠佳
  • 出疹
  • 出血傾向(流鼻血,牙肉出血)

若病者再度感染登革熱,則病情可能更嚴重,會出現溶血性登革熱

傳播途徑 傳播途徑經由受感染之白紋伊蚊叮咬而傳染,該病不會直接由人傳染人或經飛沬傳染
潛伏期 潛伏期由三至十四日不等,最常見是四至七日
處理方法 病者需送院觀察及接受治療,而病者無須隔離,盡量鼓勵飲用大量清水
預防方法 登革熱現暫無預防疫苗可使用。預防登革熱唯一方法是控制蚊患蔓延及被蚊叮咬。﹝請轉往答問有關預防蚊咬之個人保護﹞
相關網址 衛生署衛生防護中心 - 登革熱

答問有關預防蚊咬之個人保護方法

問題 1:驅蚊劑含有什麼有效成份?可維持多久?用於兒童身上會有什麼副作用?

驅蚊劑可分為棒狀、乳液狀、噴霧狀、霧化狀、貼紙。大部份產品用於戶外活動中, 塗搽於身體外露之部位。有效驅蚊劑之成份包括:DEET 和 Citronella Oil。

  • DEET (N-dierhyl-methylbenzamide)
    • 可維持二至六小時。
    • 美國兒科醫學會及加拿大健康部門提議:適用於小童之驅蚊劑成份不應多于 10% DEET。
    • 文憲顯示:含有 10% 至 35% 之 DEET 驅蚊劑,在大多數情況下,能提供足夠效力防預蚊咬。
    • 副作用:含有微量毒性 – 小童會出現頭痛、哭啼、煩躁、不安、行為改變。若過量使用,則引致神經系統受損。
  • Citronella Oil
    • 葯效較 DEET 為短(有些文憲顯示少於一小時)。
    • 有特別強烈的香味,對某些人可能會過于強烈。
    • 毒害性低。
    • 加拿大健康部提議:含有 Citronella 之液體驅蚊劑不適用於兩歲以下之小童,而產品之份量需按指示使用。驅蚊劑會因雨水、汗水而流失;高溫、風量等環境因素亦會影響效用。

問題 2:電子噴霧式滅蚊器是否較傳統燃點式蚊香為佳?

澳洲和比利時之消費者委員會測試報告顯示,兩者之效用相同,皆含有PYRETHROID 之成份(合成滅蚊葯),可有效殺滅蚊患。

問題 3:電子滅蚊產品,什麼牌子最佳?

難以評論,其實最佳方法是向供應商諮詢有關資料。從醫學角度而論,預防勝於治療,所以最重要是要控制蚊患來預防登革熱,有關資料可向食物及環境衛生署諮詢或尋求協助控制蚊患。

問題 4:被蚊咬應怎樣急救?

請參予有關被昆蟲咬傷及刺傷之資料。建議學生在未來兩星期量度體溫,觀察發熱情況。若出現發熱或患處紅、腫、分泌物增加,請即求診。

白喉

白喉是由一種名為白喉棒狀桿菌 Corynebacterium diphtheriae 所引致的,但自從三聯混合疫苗 (Triple DTP vaccine) 的出現,白喉已變得罕見,而香港近五年更沒有出現患白喉的個案

臨床徵狀
  • 發熱
  • 喉嚨痛
  • 喉嚨出現淺灰色的薄膜
  • 呼吸困難
傳播途徑 白喉可透過與病人或帶菌者接觸而傳播。接觸曾被患者分泌物污染的物件亦可能感染白喉,但機會較低
潛伏期 潛伏期由二至七日不等,通常為期二至五日
治療方法 病人必需留院接受隔離治療,並接受抗生素及抗毒素治療,所有曾與患者有近距離接觸的人仕,均需接受鼻/咽分泌物化驗,並需接受為期七日的觀察。病童應暫停上學,至醫生確疹無礙才可回校。(病人於完成抗生素療程後二十四小時,抽取第一次鼻/咽分泌物作化驗,第二次鼻/咽分泌物抽取需與第一次抽取相距二十四小時,而報告均需呈陰性)
預防方法
  • 香港政府提供之防疫注射計劃,白喉疫苗已包括在三聯混合疫苗中
  • 保持良好的個人及環境衛生
  • 雙手被呼吸系統分泌物弄污後(如打噴嚏後)要立即洗手
  • 打噴嚏或咳嗽時應掩著口和鼻
  • 保持玩具和家具清潔
  • 避免走進人多擠迫的地方

食物中毒

病徵
  • 多人因吃了相同食物而致病
  • 噁心
  • 嘔吐
  • 腹痛痙攣
  • 肚瀉
  • 乏力(可能出現而且影響較深)
  • 頭痛(可能出現)
處理方法
  • 保持冷靜
  • 憶述所進食的物品
  • 通知食品商舖
  • 集合病案數目
  • 給予嘔吐膠袋
  • 清理嘔吐物
  • 給予病人平臥及保持溫暖
  • 如有腹痛痙攣情況,可給予熱敷以作紓緩
  • 如個案少於五人,應送往急診室求醫
  • 如個案多於五人,病人情況開始轉壞,有缺水或神智不清醒的情況,應立即致電999
治療方法
  1. 為防止缺水,應鼓勵多進水份或口服電解液
  2. 如病兒有缺水情況應盡早求醫

腸胃炎

腸胃炎是最常見的小兒科疾病。一般很快便康復,但處理不當可引致嚴重的併發症,甚至死亡。

染感性
  • 腹瀉物是具感染性的
  • 主要傳播途徑為人與人之接觸及經由不潔的雙手傳染
  • 糞便,已受感染的食物、水及動物都是感染媒介
家居護理須知
  • 補充水份及電解質
  • 腸胃炎初期應進食清淡的食品
  • 服用特別為腹瀉而設的口服電解液,以盡快預防及治療脫水
  • 病童如有腹瀉情況出現,應避免上學
  • 要預防交叉感染,必須洗手
如出現以下情況,應盡快求診
  • 腹瀉次數加頻或加劇
  • 發熱、嚴重嘔吐或有劇烈腹痛情況
  • 腹瀉加劇或發現大便混有黏液或血液
  • 出現缺水徵狀 (舌頭異常乾燥,皮膚失去彈性及光澤,眼睛凹陷,神智呆滯,小便量顯著減少)
治療方法
  1. 服用醫生處方之補充水份溶液
  2. 不應只渴開水,因開水並不含有足夠鈉、鉀、及其他重要維生素
  3. 留大便標本以作化驗
  4. 大多數腹瀉性腸胃炎都是因病毒或細菌感染而引起的,一般無須服用藥物,大部份小童會自癒
相關網站

手足口病

手足口病是一種病毒性感染,最常見的病原體是甲類柯薩奇病毒 (Group A Coxsackie viruses),屬於腸病毒的一種,手足口病多數會在夏天及秋天出現。

病徵
  • 發熱
  • 感冒的症狀
  • 手掌、腳掌及臀部會出現無痛的水泡
傳播途徑 病毒散播透過人與人接觸,主要經腸胃道感染,亦可由呼吸道之感染。直接接觸患者穿破之水泡亦會傳播病毒。患者在患病第一周最易把此病傳染他人,而患者的糞便在數周內仍具傳染性
潛伏期 潛伏期為3至7天
治療方法 如兒童發高燒,活力減退或病情惡化,家長應及早攜同子女就醫,徵狀療法主要是助患者退熱以及紓緩因口腔潰瘍而引致的痛楚。在大多情況下,病徵在一周內消退。病童應留在家中,直至退燒及水泡結痂才可回校上課
預防方法
  • 保持良好個人及環境衛生
  • 如打噴嚏後 ,雙手被呼吸系統分泌弄污應立即洗手
  • 打噴嚏或咳嗽時要掩著鼻
  • 小童的玩具或其他用品應常常徹底清洗
  • 如出現水泡或紅疹,應盡早求診
  • 減少到人多擠迫的地方

頭蝨

頭蝨是一種寄生於頭髮上細小的昆蟲,有六隻腳,無翅膀,孵化時之體形如針頭一般,成長後的體形如火柴般,並呈現灰/啡色。頭蝨並不能飛、跳及進入水中,但可經共用梳子而傳播

病徵與病狀
  • 頭皮有搔癢及有被爬行感覺
  • 痕癢
  • 煩躁不安
  • 頭皮由於痕癢而被抓損
傳播途徑
  • 頭蝨可通過直接與感染者接觸而受感染(如在家中或於學校)
  • 穿上已感染之衣物如帽、圍巾、外衣、頭飾
  • 共同使用受感染之梳子、刷子、帽子、毛巾
預防方法
  • 不要與別人共用髮刷、帽子、頭飾或任何衣物
  • 頭髮不宜過長
  • 保持良好個人生,每天用髮刷梳理頭髮
  • 病童應留在家中,不宜上課,直至治療完畢
相關網址
頭蝨

甲型肝炎

病原體 甲型肝炎是由甲型肝炎病毒引起的一種病毒性肝炎。在本港,每年大約有250-500個案
病徵

一些患者可能全無症狀,其他患者可能有:

  • 食慾不振
  • 疲倦
  • 噁心、嘔吐
  • 腹瀉
  • 發燒
  • 上腹不適
  • 黃疸
  • 茶色小便
傳播途徑 甲型肝炎是透過進食受糞便污染的食物、飲品及貝類海產傳播
潛伏期 潛伏期為15至50日
治理方法
  1. 患上甲型肝炎者,應予以隔離。執行仔細的衛生措施;包括勤洗手,糞便和被污染了的尿布要小心處置
  2. 急性肝炎的治療方法主要為支援性﹔包括臥床休息、多喝水和均衡飲食
  3. 患者須避免返回學校,直至黃疸出現超過1星期後或經醫生准許
預防方法
  • 高危接觸甲型肝炎之人士,(如將前往甲型肝炎流行區人士,及習慣吃生或未煮熟貝類海產人士)應接受疫苗注射
  • 處理食物時,應保持清潔衛生
  • 食水應煮沸後才飲用
  • 避免進食高危食物,例如貝類海產、生的食物或半熟食物
  • 應從可靠的地方購買新鮮食物,不要光顧無牌小販
  • 食物應徹底煮熟。用攝氏100度煮食至少5分鐘,可消滅甲型肝炎病毒

乙型肝炎

病原體 乙型肝炎是由乙型肝炎病毒所引起。現時估計全球約有3億人為乙型肝炎帶菌者,當中有75%居住在亞洲。香港也被視為乙型肝炎地方性地區,乙型肝炎帶菌者約為10%
病徵

大部份孩童患者及40-70%成人患者都不會出現症狀。其他可有以下症狀:

  1. 發燒
  2. 食慾減退
  3. 噁心、嘔吐
  4. 腹痛
  5. 眼白變黃
  6. 茶色小便
  7. 淺色大便

其中大約5至10%的成人患者及95%受母體感染的嬰兒均會變成慢性帶菌者。多至25%帶菌者可能日後患上慢性肝﹔甚至因肝硬化或肝癌,而引至死亡

傳播途徑
  • 母親在分娩期間傳給嬰兒
  • 血液接觸
  • 直接接觸帶病毒血液
  • 與人共用受污染的個人物品,例如牙刷及針筒
  • 輸入受病毒污染的血液
  • 性接觸
潛伏期 潛伏期為45日至160日
治理方法 急性肝炎的治療方主要為支援性﹔包括臥床休息、多喝水和均衡飲食。避免飲酒。患者須採取所有措施,避免傳染他人。例如,在進行性行為前應採取安全預防措施和避免與人共用針筒
預防方法
  • 所有在香港出生的嬰兒均會接受有關的防疫注射。第一次在嬰兒出生時在醫院注射,第二、三次則在嬰兒第一個月及第六個月時在母嬰健康院注射。若嬰兒的母親為帶菌者,嬰兒須在出生後24小時內接受額外的乙型肝炎免疫球蛋白注射,以防止病毒經母親傳給嬰兒
  • 避免與人共用私人用品如針筒、剃刀及牙刷
  • 接觸血液及體液時須戴上手套
  • 用稀釋的家用漂白水 (1:49) 消毒受血液染污的物品
  • 進行性行為前應採取安全預防措施

流行性感冒

流行性感冒 (流感) 是一種由病毒引致的疾病,傳染性極高。已知的流感有三種類型:甲型、乙型及丙型。在香港最常見的兩種甲型流感是 H1N1 及 H3N2。流感會不時變種 (基因改變) 而衍生新品種,導致流感廣泛傳播,因此須定期重新研製流感疫苗。

病徵
  • 發燒
  • 頭痛
  • 肌肉疼痛
  • 流鼻水
  • 咳嗽
  • 喉嚨痛
傳播途徑 流感主要在人多擠迫的環境中經空氣或飛沫傳播,亦可透過直接接觸患者的分泌物而傳播
潛伏期 潛伏期為一至三日
治理方法 充足休息及多喝水對治理流感是很重要的。退燒藥 (例如:必理痛) 及咳藥水均有助紓緩症狀。除非患者已出現細菌性感染併發症,否則無須服用抗生素。對初期甲型流感患者,可用抗病毒劑如金剛治療。對于重病者,抗病毒劑也可考慮使用。病童在發燒期間,不應上學
預防方法
  • 流感疫苗是根據世界衛生組織的建議,按照每年社會上流行的流感類型而製備的。對于高危接觸流感之人仕如養老院的長者、醫護人員及長期病患的小童,都應接受注射疫苗
  • 維持良好的個人及環境衛生。
  • 如打噴嚏後,雙手被呼吸系統分泌物弄污應立即洗手
  • 打噴嚏或咳嗽時應掩口鼻
  • 玩具及家具應徹底清洗
  • 最好避免前往人多擠迫的地方

日本腦炎

日本腦膜炎是一種中央神經系統急性病毒傳染病。主要流行於亞洲地區,包括中國、印尼 及日本。此病在香港每年不多於兩宗;本地及外地傳入的個案都有發生

病徵
  • 發燒
  • 頭痛
  • 頸部僵硬
  • 神智不清、精神紛亂
  • 肌肉抽搐
  • 癱瘓
  • 昏迷
傳播途徑 是由已感染庫列蚊叮咬而傳播。庫列蚊叮咬帶病毒的豬隻或野生雀鳥後就會感染。此病並不會直接由人傳人
潛伏期 日本腦膜炎潛伏期一般為4至14日
治理方法 患者須入醫院接受支援性治療,但治療期間無須隔離
預防方法
  • 可接受疫苗注射,但主要對象是那些在傳播季節時前往日本腦膜炎流行區 (尤其是當地郊區),並且在該區逗留一個月或以上之人仕。現時,在本港已有一種日本腦膜炎疫苗。詳情可瀏覽衛生處之健康旅遊網
  • 杜絕蚊子滋生及防止蚊叮 (請參照登革熱病)

痲疹

麻疹是由麻疹病毒所引起,其傳染性極高

病徵
  • 咳嗽
  • 流鼻水
  • 發燒
  • 眼紅
  • 口腔內出現白點
  • 污斑紅疹,由面部擴散到全身

病重者的呼吸系統、消化道及腦部可受影響,引致嚴重後果甚至死亡

傳播途徑 麻疹可透過飛沫或直接接觸病人的鼻喉分泌物而傳播,但透過被鼻喉分泌物弄污的物件傳播的機會則較低。患者在未出疹前1-2天已可把病毒傳染給別人
潛伏期 麻疹潛伏期為8至14日
治理方法 麻疹病人須被隔離。治療方法主要為支援性治療,而由細菌引致的併發症則可採用抗生素醫治。病童在出疹4天內,不應上學
預防方法
  • 香港現時的防疫注射計劃包括兩劑麻疹疫苗注射。兒童在一歲及小一時都要接受麻疹、腮腺炎及德國麻疹防疫注射。防疫注射是最有效預防麻疹的方法
  • 維持良好個人及環境衛生
  • 如打噴嚏後,雙手被呼吸系統分泌物弄污要立即洗手
  • 打噴嚏或咳嗽時應掩著口鼻
  • 經常保持玩具和家具清潔
  • 出疹時,應立刻求醫
  • 避免前往人多擠迫的地方

猴痘天花

猴痘天花是由猴痘天花病毒所引起。這種病一般甚為罕見,多出現於中西非的熱帶雨林區。在二零零三年六月,美國曾爆發過一次猴痘天花疫症,受影響的都是那些曾接觸過受感染的動物如兔子和老鼠的人。在香港,一直沒有猴痘天花的個案出現

病徵
  • 發熱
  • 頭痛
  • 肌肉痠痛
  • 背痛
  • 淋巴結脹大
  • 出疹
傳播途徑 人類被受感染的動物咬傷或接觸牠們的體液後可被感染。另外,接觸患者的飛沬或體液,以至被病毒污染的物件,都可受到感染
潛伏期 潛伏期一般為七至十七天,大多為期十二天
治理方法 患者必須留院接受治療並作隔離。凡與患者有近距離接觸的人士均受接受檢驗
預防方法
  • 天花疫苗可減低染上猴痘天花的機會,不過此做法在香港並不鼓勵
  • 維持個人及環境衛生
  • 雙手被動物體液弄污後要立即清洗

流行性腮腺炎

流行性腮腺炎是由流行性腮腺炎病毒所引起,主要影響唾腺及神經組織。以一歲以上的小童最易受到感染

病徵
  • 唾腺腫痛,通常集中在兩頰
  • 發熱
  • 肌肉疼痛
  • 頭痛
  • 倦怠

在某些個案,此病毒還可造成腦部、胰臟、睪丸感染等併發症

傳播途徑 流行性腮腺炎可經直接接觸患者的唾液或飛沫傳播。患者可在唾腺明顯腫脹之前6至7日及之後9日這段期間傳染未有免疫力的人
潛伏期 流行性腮腺炎潛伏期由12至25日不等,通常為16至18日
治理方法 患者需要留在家中。此病現時並無特定的療法,但可以處方藥物紓緩不適。患者在腮腺腫脹後九天內不宜回校上課
預防方法
  • 本港現時已有疫苗可預防流行性腮腺炎,在接受流行性腮腺炎防疫注射時會一併接受麻疹和德國麻疹疫苗注射(俗稱三合一)
  • 維持良好的個人及環境衛生
  • 如打噴嚏後,雙手被呼吸系統分泌物弄污要立即洗手
  • 打噴嚏或咳嗽時要掩口鼻
  • 經常並徹底地清潔小童的玩具及其他家具
  • 避免到人多擠迫的地方

百日咳

百日咳是由百日咳博德氏桿菌所引致,五歲以下的小童受感染的機會最高

病徵
  • 輕微發燒
  • 流鼻水、打噴嚏
  • 咳嗽,開始時一般較為輕微,但咳嗽會日益嚴重及加劇,導致呼吸困難
  • 咳嗽引致的嘔吐
  • 一些較為嚴重的病例,細菌會令肺部受感染,甚至可導致抽搐及昏迷不醒
傳播途徑 百日咳可透過病人咳嗽時所噴出的飛沫迅速蔓延
潛伏期 百日咳的潛伏期通常為7至10日,超過14日者並不常見
治理方法 病人必須留院接受治療並作隔離。抗生素能有效治療此病。病人在完成十四天的抗生素療程後,還需再等五天,才可回校上課。如果兒童長時間發燒和咳嗽,且在咳嗽時出現嚴重的氣喘情況,應立即送院接受治療
預防方法
  • 注射百日咳疫苗可以有效地預防百日咳。本港兒童在接受百日咳防疫注射時會一併接受破傷風和白喉疫苗注射。完成整個疫苗注射的療程後,將有70-90%成效
  • 維持良好的個人及環境衛生
  • 如打噴嚏後,雙手被呼吸系統分泌物弄污要立即洗手
  • 打噴嚏或咳嗽時要掩口鼻
  • 經常並徹底地清潔小童的玩具及其他家具
  • 避免到人多擠迫的地方

風疹 (德國麻疹)

「德國麻疹」是由風疹病毒所引起。而德國麻疹可令成長中的胎兒出現異常情況。 孕婦如果在懷孕首 3 個月感染德國麻疹,所誕下的嬰兒可能會患上先天性德國麻疹綜合徵, 導致失聰、眼部缺陷、心臟畸形及智力發展遲緩

病徵
  • 全身出疹,一開始主要在臉上,再擴散至全身
  • 淋巴結脹大
  • 輕微發燒
  • 頭痛
  • 倦怠
  • 輕微咳嗽
  • 喉嚨痛
  • 結膜炎
傳播途徑 德國麻疹可透過飛沬或接觸病人的鼻喉分泌物而傳播。病人在出疹前一個星期和出疹後最少4日內都可傳染別人
潛伏期 潛伏期由14至23日不等,通常為期16至18日
治理方法 現時並無特別的治療方法,但可處方藥物紓緩不適。另外,還要追查曾與病人有近距離接觸的孕婦,檢查其免疫狀況。患者在出疹後7日內不應上學及避免接觸孕婦
預防方法
  • 風疹疫苗能有效地預防德國麻疹。香港兒童會在接受德國麻疹防疫注射時一併接受麻疹和流行性腮腺炎防疫注射
  • 已屆生育年齡而未接受免疫注射的婦女,最好在受孕前檢查本身的免疫情況,然後在有需要時接受德國麻疹防疫注射
  • 維持良好的個人及環境衛生
  • 如打噴嚏後,雙手被呼吸系統分泌物弄污應立即洗手
  • 打噴嚏或咳嗽時要掩口鼻,並清理口鼻排出的分泌物
  • 經常並徹底地清潔小童的玩具及其他家具
  • 發現出疹時,當找醫生治理

嚴重急性呼吸症侯群

SARS 是由一種新發現的冠狀病毒所引發的急性呼吸系統傳染病,首宗個案在二零零三年二月於亞洲發現。其後數月間,便傳至北美洲、南美洲、歐洲和亞洲等十數國家,影響多達八千多人,亦造成了全球多過九百人死亡

病徵
  • 發熱 (溫度多高於攝氏 38 度)
  • 發冷
  • 頭痛
  • 全身痠痛
  • 疲倦乏力
  • 咳嗽
  • 呼吸短速
  • 肚瀉
傳播途徑 SARS可透過接觸患者的分秘物或經飛沬傳播
潛伏期 潛伏期一般為2至7天,某些個案可長達10天
治理方法
  1. 患者必須留院治療,肺部X光造影可助確診,另外快速測試亦可用於偵察病人身上的冠狀病毒。目前,SARS的治療方法仍受爭議
  2. 凡與患者居住於同一單位或曾照顧患者的人士,均須接受為期十天的醫療監控。衛生署將為這批人士發出特別指引。在監控期間,他們必須暫停上班留在家中。若非必要,盡量不要離開住所,如真有需要外出,也須戴上口罩並注意個人衛生
  3. 其他與患者曾有過社交接觸而又沒有任何病徵的人士,將獲發有關資料及熱線電話號碼,以便他們發現有任何呼吸系統徵狀時,可往指定之醫療中心求診
預防方法
  • 此病現時仍沒有任何疫苗
  • 維持良好的個人衛生習慣
  • 培養健康的生活模式
  • 維持家居及工作環境的衛生
  • 當發現在呼吸系統受感染的病徵時,要立即找醫生治理,並戴上口罩,暫停上學/上班

SARS 常見問題

SARS 與冠狀病毒

問題 1:SARS 冠狀病毒有多大?

大約是70-80納米

問題 2:SARS 冠狀病毒一般存活多久?

一些研究曾指出病毒在室溫可在塑膠表面上存活多於48小時,在患者的排泌物裡,病毒則可存活長達4天

問題 3:冠狀病毒感染有什麼病徵和病狀?打噴嚏和流鼻水是否感染冠狀病毒時常見的病徵?

受冠狀病毒感染一般會有發高燒,咳嗽、肌肉酸痛和喉嚨疼痛等病徵,有時候,也會有出疹的情況。至於打噴嚏和流鼻水,則不太常見

問題 4:SARS 能否致命?

大部份情況都不會,若能及早發現及治理,痊癒的機會很高。那些嚴重的個案,多數是那些本身已有健康問題的病患或較遲求診的病人,小童的痊癒率一般較成人為高

問題 5:那些康復的 SARS 病患者會否再次受到感染?

到目前為止,還沒有復發的個案出現。那些因為再次發熱而入院治理的人士,可能只是受到其他病毒/細菌感染

問題 6:SARS 康復者有可能得什麼併發症呢?

可發生的併發症包括支氣管擴張、肺部纖維化、肺功能減弱

問題 7:病毒能否經由接觸汗液而傳染?

目前還沒有任何數據支持汗水會傳染 SARS

問題 8:病毒能否在廁座沖水時傳播?

由於冠狀病毒可在大便中存活多達4天,所以沖廁水前應把廁板蓋上

問題 9:接觸鈔票/硬幣時會否受病毒感染?

目前沒有任何證據顯示接觸鈔票/硬幣會受到感染,不過,大家仍需小心注意個人衛生和經常洗手

問題 10:SARS 能否經蚊子傳播?

目前還沒有此類個案發生

問題 11:典型肺炎與非典型肺炎有何不同?

典型肺炎大多是由細菌,例如鏈球菌所引起的。至於非典型肺炎則多由病毒如流感和腺病毒以及衣原體、支原體和一些不知名的病原所引起

問題 12:流感和非典型肺炎有何不同?

流感的病徵例如發高熱、咳嗽、頭痛等一般多在幾天內消失,而且通常不會有肺炎的病狀或其他更嚴重的併發症

患有其他疾病的人士須注意之事項

問題 13:我因為患有濕疹而不能使用皂液?有什麼辦法呢?

可使用低刺激性的皂液。潤膚露亦可減低濕疹問題

問題 14:我患有鼻敏感,還可以使用口罩嗎?

可以。戴口罩前,請先到一處空氣流通及人流較少的地方清理鼻涕,用過的紙巾應放入有蓋垃圾桶,並立刻洗手

問題 15:我若對酒精敏感,可用什麼代替品清潔雙手呢?

若情況允許的話,可使用皂液洗手。另外,可使用不含酒精的即棄毛巾沬手

在上課/使用校內設施時要留意之事項

問題 16:上音樂堂時有什麼要注意的地方?

避免共用樂器,並須在用後徹底清潔。吹奏樂器時,須選在通風的地方,並確保與其他人保持一定距離。欣賞樂曲亦是另一選擇

問題 17:學校應否取消水運會,學校旅行,童軍活動和探訪老人院等項目?

到目前為此,還沒有在游泳池受到感染的個案出現。不過,有呼吸系統病徵的同學應避免前往游泳。其他課外活動在做足預防措施後,仍可如常進行,但應注意個人衛生,避免去人流過盛的地方,不要與其他人共享食物或飲料

問題 18:飲水器應否棄用?

不要直接飲用飲水器的水,應使用瓶子/杯子盛載後才飲用

問題 19:我們要怎樣預防在升降機內受到感染?

使用公共設施後應即時清潔雙手。打噴嚏或咳嗽時要用紙巾掩住口鼻。當呼吸系統受感染時,應戴上口罩

問題 20:在天氣炎熱而學童汗流浹背的情況下,可否使用學校的冷氣機?

可以,但須確保冷氣機的清潔衛生。另外,學童衣服濕透時亦應立即更換

個人衛生

問題 21:校服應否每天清洗?

應該

問題 22:衣服是否需用熱水和漂白劑清洗?

若非被污染之衣服,使用漂白劑清洗便已足夠

問題 23:是否需要每天洗頭?

問題 24:在家中或餐廳人共膳時,有什麼地方須注意?

不要共用食具,養成使用公筷公匙的習慣

清潔與消毒

問題 25:怎樣制作1:99或1:49的漂白水?

  • 1:99 漂白水:把 10 毫升 5.25% 漂白水溶於 1 公升的水中
  • 1:49 漂白水:把 20 毫升 5.25% 漂白水溶於 1 公升的水中

(一般家用漂白水多屬 5.25% 漂白水)

問題 26:滴露能否有效地消毒?

對冠狀病毒並沒有效用

問題 27:漂白水需停留在表面多久才可以沖洗?

大約十分鐘,不要多於三十分鐘便可以

問題 28:怎樣選擇不同種類之「抗SARS」產品?

一般含有多於 70% 酒精的產品便能有效消滅病毒。避免使用噴霧劑清潔較大的範圍,因為要完全清潔整個表面會有相當困難,且容易造成氣霧,另外要避免噴霧劑入眼及小心酒精等易燃物品。在家中,使用家用皂液清潔雙手便已足夠,不必在家使用消毒產品

問題 29:出外食飯時,我們應否使用酒精棉清潔食具?

無此必要,只需使用熱水沖洗食具便足夠,因為病毒在攝氏 60 度以上不可存活多於 30 分鐘。及應光顧一些有衛生保證的食肆

疥瘡

疥瘡是一種由疥瘡傳播的皮膚病,患者的主要病症是痕癢,或於指逢或陰部出現紅疹或小泡。疥瘡通常透過與受感染者直接接觸而傳播,而疥瘡本身則會在離開人體後48-72小時後死亡

病症
  • 患處感到不適,出現紅疹,鑽洞般的小泡。受影響範圍為手指的皮膚,以及手腕、手肘、膝間、肩胛 、乳房及陰部的皮膚褶
  • 極之痕癢,在晚間尤其嚴重
  • 有機會引致皮膚傷口受細菌感染,引到出現小泡或流膿
  • 初次感染疥瘡者,潛伏期可達4-6星期。而曾感染該病的人,再度患上疥瘡後,病症會較早出現﹝1-4日﹞
傳播途徑
  • 直接(皮膚)接觸
  • 共用衣服,毛巾等
治理方法
  • 患者家人應接受醫生檢查及預防性治療
  • 患者必須依醫生指示,完成療程方可上學
  • 並無須要作家居消毒
  • 患者於療程開始前四天所用過的被單及衣服必須用熱水洗燙以消滅蟲卵
  • 不能以上述的方法洗淨的衣服,必須收起最少一星期待蟲卵死亡才可再用
預防方法
  • 保持個人衛生
  • 養成良好個人習慣,每天洗澡,勤洗手,穿著清潔的衣服
  • 不要共用衣服及個人用品
  • 若孩童經常感到痕癢,應盡早尋求醫生協助

猩紅熱

猩紅熱是一種有高度傳染性的疾病。主要感染學齡兒童(5-15歲),由鏈球菌屬的細菌所致

病徵
  • 發燒
  • 喉嚨痛
  • 猩紅色皮疹(沙紙一般的質感)首先出現於腋部、腹肢溝及脛部,並於24小時內遍及全身,嘴唇附近的皮膚通常不受影響。出現猩紅色皮疹的地方,尤其於面部、手心及手指於後期會出現脫皮現象
  • 舌上也會出現紅疹,疹上通常會有一層白色的薄膜很象草莓
傳播途徑 此病通常經飛沬或直接接觸患者的呼吸道分泌物而傳播
潛伏期 2-5日之間
治理方法 患上猩紅熱病的兒童應入院接受治理。抗生素治療是對確診了的兒童最有效的方法。患者最早可於療程的第五天,或根據醫生的指示,方可上學
預防方法
  • 保持個人及環境衛生
  • 雙手若被呼吸道分泌物沾染,必須洗手
  • 咳嗽及打噴嚏必須以手蓋嘴及鼻
  • 當發覺孩童身上出現紅疹時,應及早尋求醫生協助
  • 避免出入人多擠迫的地方

性病

性病是透過與病患者性接觸而傳染的疾病,它不會通過共用廁所板,游泳池,洗噪盆,衣物及食物容器而傳染

包括有:梅毒,淋病,衣原本,泡疹二型,性病疣,滴蟲

預防性病的方法
  • 採用安全性行為
  • 正確使用安全套
  • 不要濫交
若懷疑自己患有性病,應怎辦?
  • 可前往衛生署社會衛生科免費接受檢查及化驗
  • 毋須預約或醫生介紹信
  • 如患有性病,性伴侶亦應同時接受治療
  • 在治療期間,應避免性接觸,以免反覆傳染
  • 如有任何疑問,可致電 2150 7370 社會衛生科查詢

衣原體病

  • 衣原體病由沙眼衣原體引起
  • 經性接觸傳染
  • 四分之三的受感染婦女及一半受感染男性無症狀
  • 潛伏期:一至三星期
  • 患病婦女可有異常陰道分泌,小便刺痛,下腹痛,背痛,噁心,發燒,性交痛及經間流血
  • 患病男性可有異常尿道分泌或小便刺痛,尿道口燒傷及痕癢感,睪丸疼痛及腫脹
  • 不加治療可蔓延至整個生殖系統,引起短期及長期并發症包括不育
  • 懷孕婦女,有証据顯示不加治療的衣原體感染會引起早產
  • 受感染母親所生嬰兒會有眼部及呼吸道的衣原體感染,衣原體是早期嬰兒肺炎及新生兒眼炎的主要原因

疱疹二型

  • 多數泡疹二型由泡疹二型病毒引起
  • 多數患者無或只有輕徵症狀
  • 患病的性伴侶可能無水泡或不知自己已患病,通過與其性接觸也可染病
  • 潛伏期:二星期內
  • 在生殖器官表面出現一個或多個水泡,水泡會破裂變成疼痛的潰瘍,二至四星期後會痊癒
  • 另一次發作會出現在數星期或數月後,通常病症較第一次輕微及短
  • 病毒會長期留在體內,其後的發作會逐漸變疏
  • 泡疹二型可在分娩時傳給嬰兒引起致命的腦炎,如果孕婦在懷孕期間染上泡疹二型而引起第一次發作,嬰兒患病的危險最大,此類孕婦通常需要剖腹生產

愛滋病

愛滋病毒是引起成人愛滋病的病原體。它襲擊負責人類免疫反應的某些白血球

病症
  • 大多數人在受感染的最初幾個月甚至幾年是無症狀的
  • 百分之五十的人會在受感染的十年內發病
  • 潛伏期:一至十年或更長
  • 愛滋病人喪失對常見病原及腫瘤的免疫能力
傳染方式
  • 與愛滋病毒攜帶者進行無保護的性交
  • 與愛滋病毒攜帶者共用針筒,針嘴 (如靜脈注射藥物成癮者)
  • 輸入被愛滋病毒污染的血液
  • 受愛滋病毒感染的懷孕婦女可以在懷孕期,分娩時及母乳喂養時傳播病毒給嬰兒

普通的社交接觸如握手,接吻及共用廁所不會傳染愛滋病

預防
  • 不要共用針筒或針嘴
  • 安全性行為
  • 避免用可能沾有他人血液的物品如剃毛刀,蘇刨
  • 至今沒有疫苗預防愛滋病

  • 性病疣由乳狀瘤病毒引起
  • 潛伏期:數周至數月
  • 在生殖器官長出一個至數個小肉粒,有時呈椰菜花狀
  • 可演變成宮頸,陰唇,陰道,肛門及陰莖癌
  • 性病疣可自行涂藥或由醫生用冷凍,電灼及手術清除

淋病

  • 淋病由淋病雙球菌引起
  • 經過性接觸傳染
  • 潛伏期:二至五天,可長至三十天
  • 男性
    • 可以全無病狀
    • 小便刺痛
    • 尿道口排出黃白色或綠色膿液
    • 若不加醫治,會因尿道挾窄造成困難或因副睪炎造成不育
  • 女性
    • 大部分毫無病徵或病徵輕微
    • 小便刺痛,陰道分泌增加或經期間陰道出血
    • 可導致嚴重并發症包括盆腔炎而至不育
  • 如果孕婦患有淋病,可在生產過程傳給嬰兒而引致失明,關節炎或致命的血液感染

梅毒

  • 梅毒由梅毒螺旋菌引起
  • 經過性接觸而感染
  • 潛伏期 10-90 天 (平均 21 天)
  • 初期
    • 出現梅毒泡 (下疳)
    • 下疳在病菌進入身體的部位出現,通常是不痛的
    • 無論醫治與否,下疳都會在3-6星期後消失
    • 但如果不加醫治,病情會進入第二期
  • 第二期
    • 出現不癢的皮疹
    • 發燒
    • 淋巴結腫脹
    • 疲倦
    • 無論醫治與否,這些病徵都會逐漸消失,但如果不加醫治,病情會進入隱性期及晚期
  • 晚期
    • 可在數年到數十年後出現
    • 損害多種器官包括腦,神經系統,眼,心藏,血管,肝,骨及關節
    • 會造成肌肉不協調,癱瘓,麻痹,失明及痴呆
    • 嚴重的會導致死亡
  • 梅毒可以由孕婦傳染給胎兒,造成胎死腹中或嬰兒先天缺陷包括眼盲或耳聾

滴蟲

  • 滴蟲由一種單細胞原蟲,陰道滴蟲引起
  • 由性接觸傳染
  • 潛伏期:五至二十八天
  • 稀,黃,帶有異味的陰道分泌
  • 可用口服劑滴治療
  • 性伴侶應同時接受治療

破傷風

破傷風是一種由破傷風桿菌引致的疾病。縱然現今醫學昌明,患上破傷風的孩童的死亡率仍高達百份之20-50

病徵
  • 乏力、煩燥不安
  • 頭痛
  • 疼痛性肌肉收縮;開始為下顎肌及頸部肌,其次是軀幹肌
  • 開口障礙,吞嚥困難,四肢僵硬強直
  • 呼吸困難
傳播途徑 破傷風桿菌通常於土壤塵埃中以芽胞形態存在;時而亦能於動物的腸臟中找到。該菌通常由患者的皮膚傷口進入人體,傷口通常由帶有菌芽胞的物件引至;例如釘子,玻璃碎及未經消毒的針嘴,當菌芽胞進入人體後,便會迅速變成菌狀及分泌出能損害神經組織的毒素,引致上述病征
潛伏期 由4至21日不等。通常於第10日出現病徵
治理方法 患者應留院接受破傷風免疫球蛋白,及抗生素等治理,并切底治理傷口。病情嚴重者或須施以肌肉鬆弛劑,氣管造口術及裝置呼吸器協助呼吸。在施行療程的同時亦應注射疫苗以產生自動免疫
預防方法
  • 小童接受的防疫注射中,包括破傷風,白喉和百日咳。這三種混合注射疫苗,如果按照免疫注射時間表接受整套破傷風疫苗注射,防疫效能可持續最少十年。在有需要時,例如皮膚受不潔物件弄傷,應該注射破傷風疫苗加強針
  • 受傷後,傷口應以消毒劑清洗後方可包扎
  • 應視乎傷者傷口的類型及免疫紀錄,在有需要時以破傷風疫苗或破傷風免疫球蛋白預防感染破傷風菌

結核病 (俗稱肺癆病)

結核病 (俗稱肺癆病),是肺部受「結核桿菌」侵襲的疾病。除了肺部外,它亦可以侵襲其他器官,如淋巴、骨骼、關節、脊骨、腦部、腎臟等

病徵

結核病是一個慢性病,受結核菌感染者,大約每十個中有一個會在數星期、數月、數年後發病。病徵包括:

  • 持續咳嗽
  • 痰中帶血
  • 體重下降
  • 持續發熱
  • 夜間出汗。間中有些病人並無病徵,另外,如結核菌影響身體肺部以外其他部位,則會有其他的病徵
傳播方法 結核病是一個由空氣傳播的傳染病,當一個結核病人咳嗽或打噴嚏的時候,會產生一些含有結核菌的小點,在空氣中散播。當其他人呼吸時吸入這些小點,他便有可能會受到感染。身體抵抗力較低的人發病的機會較大
治療方法 如懷疑患上結核病,便需及早看醫生,以作適當的診治。現今治療結核病的藥物是很有效的,絕大部份病人都能夠治癒。一般治療肺結核的療程為期六個月。曾與結核病人有緊密接觸者,應接受檢查 (包括對幼童的結核菌素試針及/或照肺,及對較大兒童和成人照肺檢查)
預防方法
  • 卡介苗防疫注射:衛生署胸肺科對香港所有初生嬰兒提供卡介苗防疫注射服務;此疫苗對小孩是有效的,但對成人則不然
  • 及早診斷和治療:如有結核病病徵,應及早診治,以避免病情惡化和預防散播病菌
  • 保持健康生活
  • 保持個人衛生(例如:避免面向他人咳嗽或打噴嚏)
相關網址

胸肺科診所 - 熱線:2572 6024

結核病常見問題

問題 1:結核病是否一種嚴重的疾病?

結核病不單止影響肺部。於身體抵抗力較低的人,結核菌可從血液擴散至身體其他器官及組織,引致嚴重的感染,例如:腦膜炎、心膜炎、粟粒性結核﹝急性全身性結核﹞及胸膜腔積水。

問題 2:結核病在香港是否很普遍?

是。於香港及中國大陸,結核病的個案比西方發達國家為多。憑著有效的治療方法及為初生嬰兒注射卡介苗疫苗,於過去40-50年間,本港結核病的發病率有整體向下調的催勢。可是,於過去五年間,結核病的新增個案卻持續高企。

問題 3:怎樣才能預防自己受到結核菌感染?

注射卡介苗疫苗,現時衛生署會對所有初生嬰兒提供卡介苗注射服務;對於在香港居住的十五歲以下的兒童,如從未注射過卡介苗,亦會建議他們接受此疫苗的防疫注射。保持健康生活習慣以提高身體抵抗力。(請參閱衛生署「預防肺結核」的單張)

問題 4:若有學童患上肺結核應怎樣處理?

校方可參閱衛生署「傳染病資訊」。而衛生署亦會收集有關病童的資料及作進一步的跟進工作及篩查,而篩查的廣泛性,是根據以下數點來決定:

  • 原發病人本身的傳染性
  • 於過去六個月內在同一院舍/學校有否其他肺結核個案
  • 病童的年齡 – 五歲以下小童屬高危
  • 其他人與原發病人接觸的多寡

問題 5:衛生署現時建議所有與患病學童同班的小童皆接受肺部X光的檢查;究竟肺部X光檢查有何用處?肺片正常又是否代表未受感染呢?

肺部X光檢查+/- 結核菌素試驗,是一種初步檢查。但肺部X光正常並不代表學童沒有受到感染。對病童的家人來說,感染結核的機會大概為百份之一,而其中患有具傳染性結核的只得百份之0.14。

問題 6:在病童得到適當的治理前,他的傳染性有多強呢?

若病童曾接觸過患有高傳染性結核的成年人﹝即痰細菌塗片顯示有結核菌﹞病童的傳染性則較高。幼童縱然罹患肺結核也絕少把結核菌傳染給他人,因為幼童呼吸道分泌中的結核菌數量比成人少,而且幼童多數沒有足夠力量把結核菌由呼吸道藉著咳嗽而形成傳染性的飛沬。但當小童及青少年患上與成人肺結核相似的結核病時,其傳染性則會增高。以下情況會增加其傳染性:

  • 病童的痰細菌/胃液細菌塗片顯示有結核菌
  • 肺X光上有明顯及大面積的地方遭感染或破壞
  • 病童出現嚴重咳嗽及多痰的病徵
  • 室內環境空氣不流通亦會導致傳染機會上升

問題 7:當兒童接受結核治療時,有什麼需要注意?

與成年結核病者無異,病童需要接受三至四種不同的抗結核葯,並需在全監督治療下服葯六個月來根治結核病。只要依時服葯,治療成效是很高的。

一般孩童對服用抗結核葯皆沒有不良反應。不過,可能會出現副作用包括作悶、嘔吐、胃口不皆、發燒、頭暈、耳鳴、黃疸、視野力模糊、皮膚出疹及痕癢等。若服葯的小童有以上病征,必須尋求醫生協助。

問題 8:病童於何時才能上學呢?

一般結核病小童,於接受有效治療兩星期後便不會再有傳染性,可以重返學校上課。

相關網站

衛生署發佈的傳染病控制指引

相關網址、電話及傳真

  • 查詢有關健康資訊,傳染病及防疫針注射資料:2833 0111 (24 小時健康教育熱線)
  • 查詢有關傳染病通佈基制及學童防疫注射資訊:
    地區 傳真 電話
    香港 2572 7582 2961 8729
    九龍 2375 8451 2199 9149
    新界東 2699 7691 2158 5107
    新界西 2439 9622 2615 8571
  • 學前兒童防疫注射查詢 - 家庭健康服務部:2961 8855
  • 於公眾假期及周末,如有緊急事故及通佈可致電衛生署當值醫生:7116 3300 傳呼 9179
  • 衛生署
  • 世界衛生組織
  • 美國疾病控制及預防中心

Anthrax

It is caused by the bacterium Bacillus Anthracis. The disease most commonly occurs in animals. When it affects humans, it is usually amongst agriculture and wildlife workers who handle infected animals. Anthrax is very rare in Hong Kong. There is only 1 reported case in past 10 years.

Clinical features

Symptoms vary depending how the disease is contracted

  • Cutaneous anthrax (infected through skin wounds)
    • Wound becomes itchy, develops into a painless ulcer with a black centre
    • Swollen lymph nodes
  • Inhalation anthrax (infected through inhalation of anthrax spores)
    • Runny nose
    • Difficulty in breathing
  • Intestinal anthrax (infected through ingestion of anthrax spores)
    • Nausea
    • Vomiting
    • Loss of appetite
    • Abdominal pain
    • Fever
    • Diarrhoea
Mode of transmission

The anthrax organism must be rubbed into broken skin, swallowed or inhaled as a fine, aerosolized mist. Transmission from person to person is very rare. For anthrax to be used in biological warfare, it must be aerosolized into very small particles. This requires a great deal of technical skill and special equipment.

Incubation period

It varies from a few hours to 7 days after exposure

Management

Patient should be admitted to hospital. Anthrax can be prevented after exposure to anthrax spores by early treatment with appropriate antibiotics.

Chickenpox

It is caused by varicella-zoster virus, a member of herpes group virus.

Clinical features
  • Low grade fever
  • Malaise
  • Rash - itchy and vesicular rash mainly on scalp, face and trunk; appear with the onset of fever and eventually dry up and form crusts

In majority of the cases, the disease is mild. Complications like pneumonia, brain infection or skin infection may occur in severe cases.

Mode of transmission

It is a highly infectious disease, transmitted by direct person to person contact, droplet and air. The patient will develop lifelong immunity after infection. The infectious period ranges from 2 days before the onset of rash to 7 days after the onset of rash when all lesions are crusted.

Incubation period

It ranges from 14 to 21 days.

Management

Panadol can be taken if patient develops fever. Calamine lotion may be applied on the itchy rash. Patients should avoid rubbing their eyes or scratching their skin. Secondary bacterial infection may lead to formation of scars. Patients should be kept out of school and remain at home until all vesicles have dried up.

Prevention
  • Chickenpox vaccine is now available. 90% of persons who receive the vaccine will acquire the immunity
  • Maintain good personal and environmental hygiene
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Seek medical advices if rashes or vesicles are noticed
  • Avoid going to overcrowded places

Conjunctivitis (Red Eye)

Conjunctivitis, commonly known as pink eye, is an infection of the conjunctiva. The three most common types of conjunctivitis are: viral, allergic, and bacterial.

Signs and symptoms

Symptoms usually appear 24 to 72 hours after exposure for bacterial conjunctivitis and 5-12 days for viral conjunctivitis.

  1. Red, irritated eye
  2. Excessive tears
  3. Some burning and/or scratchy feeling
  4. Discharge
  5. Swelling of the eyelids
  6. Photophobia (discomfort of eyes when exposure to light)
Mode of transmission

Pink Eye Spreads Very Easily! It is spread by contact with discharges of the eyes or respiratory tract of infected people, from contaminated fingers, clothing and other articles, including shared eye makeup applicators, and eyedroppers.

Prevention
  • To avoid spreading infection in school…
    1. Suspend the swimming class
    2. Disinfect surfaces such as doorknobs and counters with diluted bleaching solution regularly
    3. Advise students not to rub eyes with hands
    4. Reinforce them to wash hands frequently with soap and water
    5. Remind students of the importance of not sharing personal articles, such as handkerchief
  • For infected student
    1. Children with conjunctivitis should be kept out of school to prevent the disease from spreading to other students
    2. Do not touch the infected eye because the infection will spread to the good eye
    3. Wash hands thoroughly after touching eyes or face
    4. Wash any clothing touched by infected eyes such as clothes, towels and pillowcases
    5. Use a fresh tissue paper if eyes wiping and discard the tissue properly and immediately after use
    6. Do not share towels, wash clothes, or handkerchiefs with others
    7. Seek medical aids if signs and symptoms persisted
Useful Websites

Dengue Fever

Dengue fever is caused by dengue viruses. It has been reported in many parts of the world and is prevalent in most urban centres in the tropics. It is estimated that 50 million dengue infections occur each year, causing at least 12000 deaths mainly amongst children.

In Hong Kong, before 2002, about 3 to 17 cases of dengue fever were notified each year and all acquired the infection from outside Hong Kong. In September 2002, first local outbreak occurred in Ma Wan. There have been no fatal cases.

Clinical features
  • Fever for 3-5 days
  • Intense headache
  • Malaise
  • Muscle pain / joint pain
  • Pain behind the eyes
  • Poor appetite
  • Rash
  • Bleeding tendencies (nose bleeding, gum bleeding)

The more severe form of dengue fever (dengue haemorrahgic fever) may occur if the person has acquired dengue infection before.

Mode of transmission

It is spread through the bites of infective female Aedes mosquitoes. The disease cannot be directly transmitted from person to person or through droplet spread.

Incubation period

It ranges from 3 to 14 days, commonly 4 to 7 days

Management

Patients should be admitted to hospital for observation and supportive treatment. Isolation of patients is not required. Patients should be encouraged to drink plenty of fluid.

Prevention

No vaccine is currently available for dengue fever. The only method of preventing dengue fever is to control breeding of mosquitoes and prevent mosquito bites. (Refer to FAQ on personal protection against mosquito bites)

Useful website: Centre for Health Protection, Department of Health - Dengue Fever

FAQ on personal protection against mosquitoes

Q1: What are the active ingredients in mosquito repellents? How long does the repelling effect last for? Any side effects on children?

Mosquito repellents come in forms of stick, lotion, pump spray, aerosol and sticker. They are for use mostly on exposed parts of the body while outdoors. The active ingredients found in mosquito repellents are: DEET and Citronella Oil.

  • DEET (N-diethyl-methylbenzamide)
    • Lasts for 2-6 hours
    • Recommendation from American Academy of Pediatrics and Health Canada: Repellents used on children should contain no more than 10% DEET
    • Article in Annals of Internal Medicine: Repellents with 10% to 35% DEET will provide adequate protection against mosquitoes under most conditions
    • Side effects: Mild poisoning - headaches, crying spells, irritability, restlessness, behaviour changes in children. It causes damage to nervous system if a high dose is given.
  • Citronella oil
    • Shorter complete protection time than DEET (<1 hr in some studies)
    • Strong distinctive odour - too strong for some people
    • Low toxicity
    • Recommendation from Health Canada: Citronella insect repellent liquids should not be used on children under 2 yrs of age. The usage instructions of these products should be followed. The effectiveness of the repellent is decreased by factors such as wash off from sweat or rain, higher temperature or a windy environment.

Q2: Is electric vaporizer more effective than traditional burning coils?

According to test reports from the Australian Consumers Association and the Belgium Consumers Association, both the burning and electric vaporize types with pyrethroid (synthetic mosquito pesticide) are equally effective in killing mosquitoes.

Q3: Which is the best brand of electronic mosquito killer?

It is difficult to comment. The best way is to ask the supplier for information. From the medical point of view, prevention is better than cure. Thus mosquito control is vital in preventing dengue fever. Do contact Food and Environmental Hygiene Department for information and assistance in mosquito control.

Q4: What is the first aid for mosquito bite?

Refer to section on Insect bite and sting. Ask the student to observe for fever in the following 2 weeks. Advise the student to consult a doctor if fever is noted or the bite became increasingly red and swollen with discharge.

Diphtheria

It is caused by the bacteria Corynebacterium diphtheriae. Since the introduction of triple DTP vaccine, diphtheria has rarely occurred. In Hong Kong, there has been no reported case in past 5 years.

Clinical features
  • Fever
  • Sore throat
  • Patches of grayish membrane on throat
  • Difficulty in breathing
Mode of transmission

It is transmitted by direct person to person contact. Less commonly, one may get infected through contact with objects soiled with respiratory secretions from an infected person.

Incubation period

It ranges from 2 to 7 days, usually 2 to 5 days.

Management

Patients should be admitted to hospital for isolation and treatment with antibiotic and antitoxin. All close contacts should have laboratory test on secretions taken from nose/ throat and should be observed for any symptoms for 7 days. Patients should be kept out of school until certified free from infection by doctors. (2 negative cultures from both throat and nose swabs taken not less than 24 hours apart and not less than 24 hours after completion of antibiotic treatment)

Prevention
  • Diphtheria vaccine is given in form of a triple vaccine (DTP). It is part of the immunization program offered to children in Hong Kong.
  • Maintain good personal and environmental hygiene.
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Avoid going to overcrowded places

Food Poisoning

Symptoms
  • people who ate the same foods all became ill
  • nausea
  • vomiting
  • abdominal cramps
  • diarrhea
  • weakness (may or may not be present, may be profound)
  • headache (may or may not be present)
Management
  1. Keep calm
  2. Recall the foods or drinks for lunch or snack
  3. Inform the food supply if available
  4. Gather the numbers of casualties
  5. Provide extra bags for vomiting
  6. Cleanse the vomits without any disinfectant procedure
  7. Make the ill lie down and keep them warm
  8. Offer hot pad or hot water bottles to those with abdominal cramps
  9. Bring the sick to A&E department if the casualties are below 5
  10. Call 999 for help if the numbers of casualties are more than 5 or the condition of the students is deteriorating such as dehydration or decrease conscious level
Treatment
  1. Encourage to drink water or electrolyte solutions to advoid dehydration
  2. Hospitalization is required if the child is dehydrated

Gastroenteritis

  • Common paediatric problems
  • Usually self recovery but may be life-threatening.
Contagiousness
  • Diarrheal infections are contagious.
  • Spread from person to person via dirty hands.
  • Direct contact with fecal matter, contaminated food or water, and some pets.
Home Treatment
  • Aim to replace fluid and electrolytes
  • Switch to a milder diet for 1 or 2 days.
  • Use special drinks to replace body fluids quickly, or simply give more liquids.
  • Children with diarrhoea should not attend school
  • Hand washing is important to prevent spread
When should Parents Call Doctor
  • Severe or prolonged episode of diarrhea
  • Fever, vomiting, or severe abdominal pain
  • If the diarrheal stools contain blood or mucus
  • Signs of dehydration (dry lips and tongue, skin that is pale and dry, sunken eyes, listlessness or decreased activity, and decreased urination such as fewer than six wet diapers a day in an infant).
Professional Treatment
  • Maintain adequate fluid intake with appropriate rehydrating solutions.
  • Never rehydrate with water alone because it does not contain adequate amounts of sodium, potassium, and other important nutrients.
  • Stool sample for culture
  • Diarrheal infections caused by viruses and most bacteria are not usually treated with medicines because most children recover on their own.
Useful Websites

Hand, Foot and Mouth Disease

It is a viral infection. It is most commonly caused by Group A Coxsackie viruses which belong to the group of Enteroviruses. It is most common in summer and early autumn.

Clinical features
  • Fever
  • Flu like symptoms
  • Painless vesicles over palms, soles, buttocks
  • Painful mouth ulcers
Mode of transmission

The viruses are spread from person to person, primarily by the fecal-oral route and possibly by the respiratory route. Direct contact with open and weeping skin vesicles may also spread the virus. A person is most infectious during the 1st week of the illness. The virus can be found in stools for many weeks.

Incubation period

The incubation period is 3-7 days.

Management

Parents are advised to seek prompt medical attention if their children develop a high fever, decrease in alertness or deterioration in general condition. Symptomatic treatment should be given for fever, aches or pain from oral ulcers. Symptoms usually resolve after 1 week. Patients should be kept out of school until fever has subsided and all vesicles have dried up.

Prevention
  • Maintain good personal and environmental hygiene.
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Seek medical advices if rashes or vesicles are noticed
  • Avoid going to overcrowded places

Head Lice

Head lice are small, six-legged wingless insects, pin-head size when they hatch, less than match-head size when fully grown and grey/brown in colour. Head lice cannot fly, jump or swim, but spread by clambering from head to head.

Sign and Symptoms
  1. Tickling feeling of something moving in the hair.
  2. Severe itching
  3. Irritability.
  4. Sores on the head caused by scratching.
Mode of Transmission
  • By contact with an already infested person during play at school or at home.
  • By using infested combs, brushes, hats or towels.
  • By wearing infested clothing, such as hats, scarves, coats, sports uniforms, or hair ribbons.
Prevention
  1. Student should be taught never to share coats, hats, hair accessories or other clothing.
  2. Keeping hair short.
  3. Encouraging thorough hair brushing at least daily
  4. Student should not be allowed to attend school until after treatment.
Useful Websites
Head Lice

Hepatitis A

It is one form of viral hepatitis caused by Hepatitis A virus. In Hong Kong, there are about 250-500 reported cases of Hepatitis A infection each year.

Clinical features

Some infected persons may be asymptomatic. Others may have:

  • Poor appetite
  • Lethargy
  • Nausea, vomiting
  • Diarrhoea
  • Fever
  • Abdominal discomfort
  • Jaundice
  • Tea-colored urine
Mode of transmission

It is transmitted by faecal - oral route through contaminated food, drinks or shellfish.

Incubation period

The incubation period ranges from 15 days to 50 days.

Management

Patients with Hepatitis A should be isolated. Careful hygienic measures including hand washing, careful disposal of stool and contaminated diapers should be followed. The treatment of acute hepatitis is largely supportive and includes bed rest, hydration and adequate dietary intake. Patients should be kept out of school until at least 1 week after onset of jaundice or as advised by doctors.

Prevention
  • Hepatitis A vaccine is available for people at high risk of contracting Hepatitis A. They include those traveling to Hepatitis A endemic areas, those who are in the habit of eating raw or partially cooked shellfish.
  • Maintain good hygiene when handling food
  • Drinking water should be boiled
  • Avoid high risk food like shellfish, raw food or semi-cooked food
  • Purchase fresh food from reliable source
  • Cook food thoroughly. Hepatitis A virus is killed by cooking at 100 degree Celsius for at least 5 minutes

Hepatitis B

It is a form of viral hepatitis caused by Hepatitis B virus. It is estimated that 300 million people worldwide are hepatitis B carriers and 75% of these individuals reside in Asia. Hong Kong, being an endemic area, has a hepatitis B carrier rate of about 10%.

Clinical features

Majority of infected young children and 40-70% of infected adults will not develop any symptoms. Others may have:

  • Fever
  • Loss of appetite
  • Nausea / vomiting
  • Abdominal pain
  • Jaundice
  • Tea-colored urine
  • Pale stool

Approximately 5-10% of adults and 95% of perinatally infected infants will become chronic carriers. Up to 25% of the carriers may eventually die of chronic liver diseases, principally liver cancer and cirrhosis.

Mode of transmission

It is transmitted in the following ways:

  1. Mother to infant transmission at or around the time of delivery
  2. Blood contact
    • By direct contact with contaminated blood
    • By sharing contaminated objects or instruments e.g. toothbrushes, needles
    • By transfusion of contaminated blood
  3. Sexual contact
Incubation period

The incubation period ranges from 45-160 days.

Management

The treatment of acute hepatitis is largely supportive and includes bed rest, hydration and adequate dietary intake. Alcohol consumption should be avoided.

Patients should take precautions to avoid infecting others e.g. practice safe sex, avoid sharing of needles.

Prevention

  • All babies born in Hong Kong are vaccinated against hepatitis B. The first dose is given in hospitals while the second and third doses are given at 1 and 6 months in Maternal and Child Health Centres. For babies born to hepatitis B carrier mothers, an additional hepatitis B immunoglobulin is given within first day of life to prevent mother - infant transmission.
  • Avoid sharing of personal items like razors, toothbrushes, needles.
  • Wear gloves while handling blood and body fluids.
  • Disinfect objects contaminated with blood using 1:49 household bleach
  • Practice safe sex

Influenza

It is a highly infectious viral illness caused by various subtypes of influenza. Three types of influenza viruses are recognized: A, B and C. In Hong Kong, the 2 subtypes of influenza A (H1N1 and H3N2) are most commonly seen. Emergence of new subtypes occurs from time to time at irregular intervals. They are responsible for widespread outbreaks and necessitate periodic reformulation of influenza vaccine.

Clinical features
  • High fever
  • Headache
  • Muscle ache
  • Runny nose
  • Cough
  • Sore throat
Mode of transmission

Airborne spread predominates among crowded populations. It may also spread from person to person by direct contact with respiratory secretion from an infected person.

Incubation period

The incubation period ranges from 1-3 days.

Management

Rest and hydration are important. Anti-fever medicine e.g. panadol and cough mixture are useful in relieving symptoms. Unless the illness is complicated by bacterial infection, no antibiotic is required. An anti-viral drug (Tamiflu) is available for early treatment of influenza A infection and may be considered in severe cases. Patients should be kept out of school until fever has subsided.

Prevention
  • Influenza vaccine is prepared according to the prevalence of strains in the community each year as recommended by World Health Organization. People at high risk of contracting influenza should be vaccinated. They include elderly home residents, health care workers, children with chronic illness
  • Maintain good personal and environmental hygiene
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Avoid going to overcrowded places

Japanese Encephalitis

It is an acute viral infection of the central nervous system. Japanese encephalitis (JE) occurs in a large number of countries in Asia including China, Indonesia, Japan. In Hong Kong, fewer than 2 cases of human Japanese Encephalitis are reported each year. Both local and imported cases have occurred.

Clinical features
  • Fever
  • Headache
  • Neck stiffness
  • Confusion, disorientation
  • Seizure
  • Paralysis
  • Coma
Mode of transmission

It is spread by the bite of infected Culex mosquitoes. The mosquito becomes infected by feeding on pigs and wild birds infected with the JE virus. The disease cannot be directly transmitted from person to person.

Incubation period

The incubation period is usually 4 to 14 days

Management

The patient should be admitted to hospital for supportive treatment. No isolation is required.

Prevention
  • Vaccine for JE is available but is indicated mainly for persons spending 30 days or more in a rural agricultural endemic area during the transmission season. Currently, one inactivated JE vaccine is licensed in Hong Kong. Further information can be obtained from DH's Travel Health Website.
  • Eliminate mosquito breeding sites and prevent mosquito bites (Refer to section on Dengue Fever)

Measles

It is a highly contagious illness caused by Measles virus.

Clinical features
  • Cough
  • Runny nose
  • High fever
  • Conjunctivitis
  • White spots inside the mouth
  • Red blotchy skin rash - spreading from face to rest of the body

In severe cases, lung, gut and brain can get involved and lead to serious consequences or even death.

Mode of transmission

It is transmitted by droplet or by direct contact with respiratory secretions of infected persons, and less commonly by objects contaminated with respiratory secretions. The infected individual is contagious from 1-2 days prior to the development of the characteristic rash.

Incubation period

It ranges from 8 to 14 days.

Management

Patients should be isolated. Therapy is mainly supportive and antibiotics may be used to treat bacterial complications. Patients should be kept out of school for 4 days from the appearance of rash.

Prevention
  • Vaccination against measles (in form of the triple MMR vaccine) is part of the vaccination program in Hong Kong. Two doses are given at 1 year old and in Primary 1. This is the most effective preventive measure.
  • Maintain good personal and environmental hygiene
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Seek medical advices if rashes are noticed
  • Avoid going to overcrowded places

Monkeypox

It is caused by monkeypox virus. It is a rare disease that occurs primarily in the rain forest of Central and West Africa. In June 2003, an outbreak of human monkeypox infection was reported in the United States among people who had history of contact with infected pets e.g. rabbit, Gambian rat. There has been no reported case of monkeypox in Hong Kong.

Clinical features
  • Fever
  • Headache
  • Muscle aches
  • Backache
  • Swollen lymph nodes
  • Rash
Mode of transmission

It can spread to humans from an infected animal through an animal bite or direct contact with the animal's body fluids. It can also be spread from person to person by contact with droplets or body fluids of an infected person or with virus - contaminated objects.

Incubation period

The incubation period is between 7-17 days, usually 12 days.

Management

Patients should be admitted to hospital for isolation and treatment. All close contacts should be screened.

Prevention
  • Smallpox vaccine may reduce the risk of monkeypox but it is not recommended for general public in Hong Kong.
  • Maintain good personal and environmental hygiene
  • Wash hands when they are contaminated by body fluids of animals

Mumps

It is caused by the Mumps virus which affects the salivary glands and nerve tissues. Children under 1 year of age are more commonly affected.

Clinical features
  • Painful swelling of parotid glands at the cheeks
  • Fever
  • Muscle pain
  • Headache
  • Malaise

In some cases, Mumps virus may cause infection of brain, pancreas, and testicles.

Mode of transmission It is spread by droplet and by direct contact with respiratory secretions of an infected person. An affected person is contagious from 6-7 days before the onset of swelling of salivary glands to 9 days after.
Incubation period It ranges from 12-25 days, usually 16-18 days.
Management

Patients with Mumps should stay at home. Symptomatic treatment should be given. Patients should stay away from school for 9 days from the onset of swelling.

Prevention
  • Vaccination against mumps is available in form of the triple MMR vaccine. It is part of the immunization program in Hong Kong.
  • Maintain good personal and environmental hygiene.
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Avoid going to overcrowded places

Pertussis (Whooping Cough)

It is caused by the bacteria Bordetella pertussis. Risk of the disease is highest in children under 5 years of age.

Clinical features
  • Low grade fever
  • Runny nose, sneezing, conjunctivitis
  • Cough - mild cough initially, then develops spells of violent coughing followed by distressing gasp
  • Cough associated vomiting

In severe cases, the bacteria can cause lung infection and even lead to seizures and coma.

Mode of transmission

It is highly contagious and is transmitted by droplets released during intense coughing.

Incubation period

It ranges from 7 to 10 days, rarely exceeding 14 days.

Management

Patients need to be hospitalized and isolated. Antibiotic is effective in treating this disease. Patients should stay away from school until at least 5 days of the 14-day course of antibiotic treatment has been received.

Prevention
  • Pertussis vaccine is given in combination with tetanus and diphtheria toxoids to children as part of the immunization program in Hong Kong. It has an efficacy of 70-90% after a complete course of vaccination.
  • Maintain good personal and environmental hygiene.
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Avoid going to overcrowded places

Rubella (German Measles)

It is caused by rubella virus.

Clinical features
  • Diffuse rash - initially on face, spreads to the body
  • Swollen lymph nodes
  • Low grade fever
  • Headache
  • Malaise
  • Mild cough
  • Sore throat
  • Conjunctivitis

Rubella infection can produce anomalies in fetus (congenital rubella syndrome) characterized by deafness, eye lesions, heart malformations, and mental retardation. This is likely to occur if a pregnant woman gets infected during the first 3 months of pregnancy.

Mode of transmission

It can be transmitted by droplets or direct contact with respiratory secretions from an infected person. An affected person is infectious to others from 1 week before to at least 4 days after onset of rash.

Incubation period

It ranges from 14 to 23 days, usually 16-18 days.

Management

Symptomatic treatment should be given. Close pregnant contacts should be traced and their immunity status checked. Patients should be kept away from school for 7 days from the appearance of rash and avoid contact with pregnant women.

Prevention
  • Rubella vaccine is given in form of the triple MMR vaccine. It is part of the immunization program for children in Hong Kong.
  • Child bearing age women who are not immunized preferably should check their immunity status before pregnancy and receive rubella vaccine accordingly
  • Maintain good personal and environmental hygiene.
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Seek medical advices if rashes are noticed

Severe Acute Respiratory Syndrome (SARS)

SARS is an acute respiratory infection caused by a new agent called SARS-associated coronavirus. It was first reported in Asia in February 2003. Over the next few months, the illness spread to more than two dozen countries in North America, South America, Europe and Asia, infecting over 8000 people and causing more than 900 deaths worldwide.

Clinical features
  • High fever (Temp > 38 degree Celsius)
  • Chills
  • Headache
  • Body aches
  • General malaise
  • Coughing
  • Shortness of breath
  • Diarrhoea
Mode of transmission

It is transmitted by respiratory droplets over a short distance or through contact with an infected person's secretions.

Incubation period

The incubation period is typically 2 to 7 days, although in some cases it may be as long as 10 days.

Management
  • Patients with SARS must be hospitalized. A chest radiograph will help to make the diagnosis and a rapid test has been developed to detect coronavirus in patients. Treatment of SARS remains controversial.
  • Those living in the same household or those who have cared for an infected person must undergo daily medical surveillance for 10 days. The Department of Health will issue specific guidelines to those under medical surveillance. During the surveillance period, they must stay off work and rest at home. They should not leave home unless it is absolutely necessary. If they have to leave home, they must wear a face mask and observe good personal hygiene.
  • Asymptomatic social contacts (e.g. friends, colleagues) of an infected person will be provided with specific information and a hotline number. They will be advised to attend a designated medical centre if they develop any symptoms of respiratory illness.
Prevention
  • No vaccine is available.
  • Maintain good personal hygiene
  • Develop a healthy lifestyle
  • Maintain good hygiene at home and in workplace
  • People with symptoms of respiratory tract infection should consult a doctor promptly, stop attending work or school and wear a face mask
Useful websites

Frequently asked questions on SARS

SARS & Coronavirus

Q1. What is the size of SARS Coronavirus?

The size is about 70-80nm

Q2. How long can the SARS Coronavirus survive?

Some research studies have shown that the virus can survive on plastic surface in room temperature for at least 48 hours. In stool of infected patient, the virus remains stable up to 4 days.

Q3. What are the signs and symptoms of Coronavirus infection? How does the rash look like? Are sneezing and running nose common symptoms for coronavirus infection?

Coronavirus infection is usually associated with high fever, cough, myalgia and sore throat. Sometimes it may be associated with rashes. Sneezing and running nose are not the usual symptoms of coronavirus infection.

Q4. Is SARS fatal?

Not in most cases. With early detection and treatment, there is a high chance of recovery. Severe cases are usually seen in patients with pre-existing health problems or those who seek treatment at a late stage. Prognosis in children is better than in adult.

Q5. Do some people who recover from SARS become sick again?

There is no reported relapse up till now. Readmission because of recurrence of fever can be due to other super-imposed infections.

Q6. What are the complications in patients recovered from SARS?

Possible complications include bronchiectasis, pulmonary fibrosis, impaired lung function etc.

Q7. Can the virus be transmitted by contact of sweat?

No data to support transmission by sweat

Q8. Can the virus be transmitted during toilet flushing?

Corona virus can survive in stool for up to 4 days. Therefore toilet bowl should be covered before flushing.

Q9. Can the disease be contracted by handling money?

There is no evidence of transmission through handling money. However, people should pay careful attention to their personal hygiene and wash hands frequently.

Q10. Can mosquito transmit SARS?

No such case has been reported.

Q11. What is the difference between typical pneumonia and atypical pneumonia?

Classical/typical pneumonia is mainly caused by bacteria such as streptococcus. Atypical pneumonia is mainly caused by viruses such as influenza and adenovirus, bacteria such as Chlamydia and mycoplasma and other unknown agents.

Q12. What is the difference between influenza and atypical pneumonia?

Influenza symptoms such as fever, cough and headache usually subside within a few days without any serious complications or signs of pneumonia.

Precautions during school classes/when using school facilities

Q1. What are the precautions during music lessons?

  • Avoid sharing of musical instrument. Thorough cleansing after use.
  • If wind-blowing instruments are used, play in a well-ventilated place and ensure adequate distance between each other.
  • Music appreciation is an alternative.

Q2. Should schools cancel swimming gala, schools picnics and other extra- curricular activities such as scouting, visiting to old age homes etc?

  • Up till now, there are no reports on transmission of the disease in swimming pool. Students with symptoms of respiratory tract infection should not go for swimming.
  • Other extracurricular activities may be continued provided the appropriate precautions are taken. e.g. personal hygiene, avoid overcrowding, no sharing of food and drinks

Q3. Should drinking machine be abolished?

Do not use the drinking machine directly. Can use bottles/cups to refill.

Q4. How can we prevent contracting the disease in a lift?

  • Wash hands properly after using any public facilities.
  • Cover your nose and mouth with a tissue when sneezing or coughing.
  • Wear a facemask if you have symptoms of respiratory tract infection.

Q5. The weather is hot and the children are sweaty. Can the air-conditioning be turned on in school?

Yes, provided the air conditioners are cleaned properly. Besides, the children should change their clothing if they are wet.

Personal hygiene

Q1. Should I wash my school uniform every day?

Yes

Q2. Should clothes be washed with hot water or bleaching agent?

Washing with detergent is adequate unless contaminated.

Q3. Should I shampoo everyday?

Yes

Q4. What precautions should be adopted when sharing food at home or in restaurants?

Do not share eating utensils. Adopt the good practice of using serving spoons and chopsticks.

Cleansing and Disinfectants

Q1. How do we make up 1:99 or 1:49 bleach solution?

  • For 1:99 solution: 10mls of 5.25% bleach solution in 1 liter of water
  • For 1:49 solution: 20mls of 5.25% bleach solution in 1 liter of water (Household bleach is usually 5.25% bleach solution)

Q2. Are Dettol/"Green water" effective disinfectant?

Not effective for coronavirus

Q3. How long should bleach be left on surface before rinsing?

10 minutes but no more than 30 minutes

Q4. How to choose the various "anti-SARS" products? Hand gel? Spray?

  • Products containing 70% alcohol is effective. Avoid spray disinfectants for large areas as it is difficult to spray the whole surface completely and may create aerosols. Caution to be taken to avoid spray getting into eyes. Alcohol is inflammable.
  • Home use liquid soap is adequate for handwashing. No need to use antiseptics.

Q5. Can we use alcohol swabs to clean utensils before meals when we go out to eat?

  • Not necessary. Rinse utensils with hot water. Virus will die in heat above 56 degree Celsius in less than 30mins.
  • Go to restaurants with good hygiene.

Scabies

Scabies is a skin infection caused by a mite who burrows into skin, commonly around the finger webs and genital area. It is typified by severe itching, red papules. It may pass from person to person but does not survive for more than 48-72 hours once are away from the human body.

Clinical features
  1. Pimple-like irritations, burrows or rash of the skin, especially over the webbing between fingers; the skin folds on the wrist, elbow, or knee; the penis, the breast, or shoulder blades. It does not usually affect the neck and head
  2. Severe itching, especially during the nighttime.
  3. Scores on the body caused by scratching and sometimes when complicated by bacterial infection.
  4. For a person who has never been infested with scabies, symptoms may take 4-6 weeks to develop.
Mode of transmission
  • By direct skin contact
  • By sharing clothing, towels etc.
Prevention
  1. Maintain good hygiene.
  2. Encourage good habits like daily showers or baths, frequent hand washing, and wearing clean clothing.
  3. Encourage children not to share comb, brush and clothing with friends.
  4. Seek medical advice if child is constantly scratching.
Management
  1. Prophylactic treatment is recommended for household members.
  2. Children are allowed to return to school after treatment completed.
  3. Environment disinfection is unnecessary.
  4. Bedding and clothing worn during the 4 days before initiation of therapy launched in a washer with hot water and dried cooling a hot cycle.
  5. Clothing that cannot be launched, removed from the child and stored for a week.
Useful Websites

Scarlet Fever

It is a bacterial infection caused by Group A streptococcus. It usually affects school-aged children (5-15 years of age).

Clinical features
  • Fever
  • Sore throat
  • Coarse "sandpaper" like rash - first appears in the axilla, groin, neck and then becomes all over the body within 24 hours; area surrounding the mouth is usually spared; peeling of skin from face, palms and fingers may occur later
  • Red tongue covered by a white coat
Mode of transmission

It is transmitted by droplet or direct contact with respiratory secretions of infected persons.

Incubation period

It ranges from 2 to 5 days.

Management

Patients with scarlet fever should be admitted to hospital for treatment. Antibiotic is effective treatment for confirmed cases. Patients should be kept out of school for 5 days after starting antibiotics or as advised by doctors.

Prevention
  • Maintain good personal and environmental hygiene.
  • Wash hands when they are contaminated by respiratory secretions e.g. after sneezing
  • Cover nose and mouth while sneezing or coughing
  • Clean children's toys and other utensils thoroughly and frequently
  • Seek medical advices if rashes are noticed
  • Avoid going to overcrowded places

Sexually Transmitted Disease (STD)

Sexually transmitted disease (STD) is passed from person to person through sexual contact. It cannot be spread through contact with toilet seats, swimming pools, bath tubs, shared clothing or eating utensils

It includes syphilis, gonorrhoea, chlamydia, genital herpes, genital warts and trichomoniasis

Prevention
  • Practice safe sex
  • Use condoms correctly
  • Avoid multiple sexual partners
If I suspect I have STD, how could I do?
  • Consult social hygiene clinics of Department of Health for free examination and treatment
  • No need to get an appointment in advance or doctor's referral
  • All sex partners should be evaluated, tested and treated at the same time
  • Persons under treatment should abstain from sexual intercourse until they and their sex partners have completed treatment, otherwise re-infection is possible
  • Call 2150 7370 for further information
Useful links

Chlamydia

  • Chlamydia is caused by the bacterium, Chlamydia trachomatis
  • Chlamydia can be transmitted during vaginal, anal or oral sex
  • Three quarters of infected women and about half of infected men have no symptoms
  • If symptoms do occur, they usually appear within one to three weeks after exposure
  • Women might have an abnormal vaginal discharge or a burning sensation when urinating, lower abdominal pain, low back pain, nausea, fever, pain during intercourse or bleeding between menstrual periods
  • Men might have a discharge from their penis or a burning sensation when urinating, burning and itching around the opening of the penis; pain and swelling in the testicles are uncommon
  • Untreated infection can spread into whole reproductive system, causing both short-term and long-term consequences including infertility
  • In pregnant women, there is some evidence that untreated chlamydial infections can lead to premature delivery
  • Babies who are born to infected mothers can get chlamydial infections in their eyes and respiratory tracts, chlamydia is a leading cause of early infant pneumonia and conjunctivitis (pink eye) in newborns

Herpes Genitalis

  • Most genital herpes is caused by herpes simplex viruses type 2 (HSV-2)
  • Most individuals have no or only minimal signs or symptoms
  • Transmission can occur from an infected partner who does not have a visible sore and may not know that he or she is infected
  • The first outbreak usually occurs within two weeks after the virus is transmitted
  • They typically appear as one or more blisters on or around the genitals or rectum. The blisters break, leaving tender ulcers (sores) that may take two to four weeks to heal
  • Typically, another outbreak can appear weeks or months after the first, but it almost always is less severe and shorter than the first outbreak
  • Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years
  • Genital HSV can cause potentially fatal infections, e.g. encephalitis, in babies. The first episode during pregnancy causes a greater risk of transmission to the baby. If a woman has active genital herpes at delivery, a cesarean delivery is usually performed

HIV infection

The Human immunodeficiency virus (HIV) is the causative agent for adult immunodeficiency syndrome (AIDS). It is a virus that infects certain white blood cells responsible for human immune response.

Features
  • Most infected persons are symptom free for the initial months or years after infection.
  • 50% of infected persons will progress to AIDS in 10 years after being infected.
  • Incubation period range from 1 to 10 years or longer.
  • AIDS itself is a whereby victim loses immunity against common infective organisms and or tumors.
Mode of transmission
  • Having unprotected sex with an HIV carrier
  • Sharing needles/syringe with HIV carriers (e.g. in intravenous drug addicts)
  • Transfusion of HIV contaminated blood
  • HIV can also be passed from infected pregnant mother to the baby, through pregnancy, delivery and breastfeeding.
Regular social contact e.g. shaking hands, kissing and sharing toilet facilities would not transmit HIV.
Prevention
  • Do not share needles and syringes
  • Practice safe sex
  • Avoid using other people's shavers, razor blades or other objects that may be contaminated with blood
  • Up till now, there is no vaccine against HIV infection

Genital warts

  • Genital warts are caused by human papillomavirus (HPV)
  • After sexual contact with an infected person, warts may appear within weeks or months
  • Genital warts are single or multiple growths or bumps that appear in the genital area and sometimes are cauliflower shaped
  • They may also lead to cancer of the cervix, vulva, vagina, anus, or penis
  • Visible genital warts can be removed by medications the patient applies or by cryotherapy, cauterization and operation performed by a health care provider

Gonorrhoea

  • Gonorrhea is caused by Neisseria gonorrhoeae
  • Gonorrhea is spread through contact with the penis, vagina, mouth or anus
  • Signs or symptoms appear two to five days after infection; can take as long as 30 days to appear
  • In men
    • May have no symptoms at all
    • A burning sensation when urinating
    • White, yellow or green discharge from the penis
    • Untreated infection can cause difficulty in passing urine due to urethral stricture or epididymitis, a painful condition of the testicles that can lead to infertility
  • In women
    • The symptoms are often mild, but most no symptoms
    • Painful or burning sensation when urinating, increased vaginal discharge or vaginal bleeding between periods
    • At risk of developing serious complications including pelvic inflammatory disease (PID), a condition can damage the fallopian tubes enough to cause infertility
  • If a pregnant woman has gonorrhea, she may give the infection to her baby as the baby passes through the birth canal during delivery. This can cause blindness, joint infection or a life-threatening blood infection in the baby

Syphilis

  • Syphilis is caused by the bacterium Treponema pallidum
  • Passed from person to person through direct contact with a syphilis sore
  • The duration between infection with syphilis and the onset of the first symptom can range from 10 to 90 days (average 21 days)
  • Primary stage
    • Marked by the appearance of sores (called chancre)
    • The chancre appears at the spot where syphilis entered the body, is usually firm, round, small and painless
    • The chancre generally lasts 3 to 6 weeks and it heals with or without treatment
    • However, if adequate treatment is not administered, the infection progresses to the secondary stage
  • Secondary Stage
    • Non-itchiness skin rash
    • Fever
    • Swollen lymph glands
    • Fatigue
    • The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection progresses to the latent and late stages of disease
  • Late Stage
    • May show up many years later
    • Damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones and joints
    • Signs and symptoms include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness and dementia
    • This damage may be serious enough to cause death.
  • Pregnant women with the disease can pass it to the babies they are carrying. Stillbirth or congenital defect of the babies including deafness and blindness can occur

Trichomoniasis Vaginalis

  • Trichomoniasis is caused by the single-celled protozoan parasite, Trichomonas vaginalis
  • The parasite is sexually transmitted through contact with an infected partner
  • Symptoms usually appear in women within 5 to 28 days of exposure
  • Signs or symptoms of infection included a frothy, yellow-green vaginal discharge with a strong odor
  • Trichomoniasis can usually be cured with metronidazole, given by mouth in a single dose
  • Both partners should be treated at the same time

Tetanus

It is caused by the bacteria Clostridium tetani. Despite modern medical care, 20 - 50% of patients with tetanus die.

Clinical features
  • Restlessness / Irritability
  • Headache
  • Painful muscular contractions at the jaws
  • Stiffness of the neck
  • Generalized spasms of muscles
  • Difficulty in swallowing or opening his or her mouth
  • Difficulty in breathing
Mode of transmission

This spore producing bacteria is present in soil, dust and the gastrointestinal tract of animals. Most cases of tetanus are associated with a traumatic injury, often a penetrating wound inflicted by a dirty object, such as a nail, splinter, fragment of glass or unsterile injection. Once the spores are introduced into the body through the wound, they geminate and produce a toxin that attacks the nervous system.

Incubation period

It ranges from 4 days to 21 days, usually about 10 days.

Management

Affected persons should be hospitalized. Treatment including tetanus immunoglobulin antibiotics should be given. Wounds should be irrigated and debrided. In severe cases, muscle relaxants, tracheostomy and mechanical ventilation may be required. Active immunization should be started concurrently with treatment.

Prevention
  • Vaccine against tetanus in form of the triple (DTP) vaccine is given to children as part of the immunization program in Hong Kong. A complete series of tetanus toxoid according to immunization schedule gives effective protection for at least 10 years. After acute injury with superficial wound, booster doses of tetanus are advised.
  • Skin wounds should be thoroughly cleaned with antiseptics.
  • Depending on the type of wound and immunization history of the person, he or she may need to receive tetanus toxoid to prevent tetanus.

Tuberculosis

It is a bacterial infection caused by Mycobacterium tuberculosis. It usually affects the lungs (pulmonary tuberculosis) but may also affect other parts of the body (extra-pulmonary tuberculosis) including lymph nodes, kidneys, bones, joints, guts, brain.

Clinical features

TB is a chronic illness. Symptoms may develop slowly over weeks or months.

  • Low grade fever
  • Night sweats
  • Malaise
  • Weight loss
  • Chronic cough
  • Blood in sputum
Mode of transmission

It is an airborne disease. When an infected person coughs or sneezes, the bacteria get into the air and causes disease if a susceptible person inhales it.

Incubation period

It ranges from several weeks to many years. An affected person has the greatest risk of developing TB within the first two years after infection.

Management

Suspected cases of TB should seek medical advice as soon as possible. Affected patients are prescribed multiple drug therapy for at least 6 months. All close contacts should be screened. The length of sick leave should be as advised by doctors.

Prevention
  • BCG vaccination is available and is part of the immunization program for babies born in Hong Kong. It is effective in protecting young children against TB.
  • Maintain good personal and environmental hygiene
  • Maintain a healthy lifestyle
  • Cover nose and mouth while sneezing or coughing
  • Seek early medical advice if symptoms suggestive of TB appear
Useful websites

Chest Clinic - Enquiry hotline: 2572 6024

Frequently Asked Questions on Tuberculosis

Q1. Is tuberculosis a serious disease?

TB does not only affect the lungs. In immunocomprimised individuals, TB can disseminate through the blood stream to other parts of the body giving rise to meningitis, pericarditis, arthritis, miliary TB, pleural effusion with serious consequence.

Q2. Is tuberculosis prevalent in Hong Kong?

Yes. TB is prevalent in Hong Kong and mainland China as compared with western countries. With effective treatment and the almost universal neonatal BCG vaccination undertaken in Hong Kong, the notification rate of TB has shown an overall downward trend in the past 40 - 50 years. However, the number of newly notified cases remained high in past 5 years and was not falling.

Q3. How can we prevent ourselves against TB?

  1. BCG vaccination
    • Current policy is to vaccinate all newborn babies and children < 15 yrs of age residing in HK without prior BCG vaccination
    • Efficacy of BCG vaccination in newborns is well recognized especially against military TB and TB meningitis. No proven value for BCG revaccination thus, revaccination program stopped in the school year starting from September 2000
  2. Maintenance of good bodily health and leading a healthy lifestyle are essential preventive measures (Refer to information sheet on TB for more preventive measures)

Q4. A student was diagnosed to have pulmonary TB.

  1. What action should be taken by the School?

    • Refer to DH guideline on the management of suspected infectious disease at school
    • DH will gather information regarding the index case and perform active screening
    • Several factors determine the extent of active screening:
      1. Infectivity of index case - smear result of sputum / gastric aspirate
      2. Any other TB case in past 6 months within the same institute
      3. Age of students - higher risk if students are younger than 5
      4. Extent of contact with index case

  2. The Department of Health recommends the whole class to take CXR in Chest Clinic. What is the use of CXR? Are we sure that we shall be all right if CXR is normal?

    • CXR +/- tuberculin skin test is used as a screening tool to detect asymptomatic cases. However, there are some false negative cases. So a normal CXR cannot exclude TB infection.
    • Even among the household contacts, the yield of active TB is in the order of 1% and the yield of infectious bacteriologically positive cases is much lower at 0.14%

  3. How infectious was he before he was treated?

    • The chance of transmission increases when the patient has an acid-fast smear of sputum/ gastric aspirate, an extensive upper lobe infiltrate or cavity, copious production of thin sputum and severe and forceful cough. Poor ventilation also enhances transmission.
    • Exposure to an adult with smear +ve pulmonary TB is the most crucial risk factor for children
    • Young children with TB rarely infect other children or adults:
      • Tubercle bacilli are sparse in respiratory secretions of children with pulmonary TB
      • Cough is often absent or lacks the tussive force required to suspend infectious particles of the correct size
    • Children or adolescents with adult - type pulmonary TB can transmit the organism

  4. What should we pay attention to while a child is on anti- TB treatment?

    • Similar to adult, a 3-4 drugs regimen under direct observation (DOT) lasting for 6 months
    • Chemotherapy is effective and success rate is very high provided drug compliance is good
    • Majorities of patients tolerate the anti - TB drugs well. Possible side effects include nausea and vomiting, decrease in appetite, fever, dizziness, tinnitus, jaundice, blurring of vision, skin rash and pruritus. Should seek medical help if develop the above symptoms.

  5. When can the child return to school?

    In great majority of cases, can be rendered non-infectious 2 weeks after commencement of effective drug treatment. Hence, able to return to school.

References

  • Tuberculosis Control in Hong Kong
  • Chemotherapy of Tuberculosis in Hong Kong (update in 2001)
  • Nelson Textbook of Pediatrics (17th edition)

Guidelines on Communicable Diseases Published by Department of Health

Useful Websites, Telephone and Fax Numbers

  • For general health information on communicable disease and immunization: 24hr health education hotline: 2833 0111
  • For enquiries on and notification of particular communicable disease or enquiries on school immunization programme:
    Regional Office Fax Tel
    Hong Kong 2572 7582 2961 8729
    Kowloon 2375 8451 2199 9149
    New Territories East 2699 7691 2158 5107
    New Territories West 2439 9622 2615 8571
  • During weekends, public holidays or after office hours, urgent report can be made to the duty Medical Control Officer of the DH (Tel.No: 71163300 call 9179)
  • For enquiries on immunization for pre-school children: Family Health Service: 2961 8855
  • Department of Health
  • World Health Organization
  • Centre for Disease Control & Prevention, USA