這是 達醫曉護 的第 1852 篇文章
目前正值暑期,經過半年忙碌而辛苦的工作和學習,很多家庭會選擇海外旅行, 讓家里的大大小小都可以放松一下。世界衛生組織在6月20日發布了國際旅行建議,呼吁大家了解麻疹感染的風險,感染的癥狀,及旅行前確認是否已免疫接種以預防傳播。 為什么會有這么一個旅行建議呢?這是在近年來麻疹在全球流行逐漸增多的背景下出臺的。特別是從2019年初至今,據世衛組織統計,僅2019年前三個月的發病率與去年同期相比增長300%。其中非洲地區比去年增加700%,美洲增加60%,歐洲300%,東地中海地區100%,中國所在的東南亞和西太平洋地區則增加了40%。 那么麻疹到底是何方神圣呢?讓我們一起來看一下! 麻疹是病毒感染性疾病,主要表現為發熱和全身的皮疹。麻疹的傳染性很強,主要通過咳嗽和噴嚏的飛沫傳染。預防麻疹最好的方法是接種2劑麻疹疫苗。未進行免疫接種的人如果接觸到麻疹病毒的話有90%的機率罹患麻疹。 麻疹的傳染期是出疹前后4天。如果感染麻疹病毒的話,大約會在10到12天以后出現癥狀。 麻疹的初期癥狀通常類似感冒的表現,包括發熱、咳嗽,流涕,咽痛,還可能有流淚,紅眼,畏光等結膜炎的癥狀,伴有疲乏不適和倦怠。 發熱可能持續4到7天,約在皮疹出現前48小時內口腔粘膜可能出現白色小斑點。 麻疹的皮疹通常出現于發熱后2到4天,紅色皮疹最先開始于面部并向身體擴散, 大約持續6到7天。 大多數孩子會在出疹2天后開始感覺好轉。咳嗽可能會持續2周。 約30%的麻疹病例會發生并發癥。腹瀉是最常見的并發癥。中耳炎和肺炎等也是常見的呼吸道并發癥,特別在兒童中。麻疹合并腦炎是少見但嚴重的并發癥,發生率為千分之一。 Measles is a viral infection that causes a fever and a distinctive rash on the body. Measles is highly contagious and is spread easily through droplets from coughing and sneezing. The best protection against the disease is through receiving two doses of the measles vaccine. People who are not immunized have a 90 per cent chance of becoming infected if they are exposed to the virus. It can be transmitted by an infected person from 4 days prior to the onset of the rash to 4 days after the rash erupts. Once exposed to the virus, it can take 10 to 12 days for symptoms to appear. · Measles will start with cold-like symptoms, such as a fever, cough, runny nose, sore throat or red eyes and being more tired or lethargic than usual. · Fever may last 4 to 7 days. Small white spots inside the cheeks can develop in the initial stage about 48 hours before rash onset. · A distinctive rash will appear after fever for 2 to 4 days. The rash is red and blotchy and starts on the face, then spread to the rest of the body. It may persist for 6 to 7 days. · Most children who have measles feel better about two days after the rash appears. The cough may persist for two weeks. Complications occur in in about 30% of measles cases. Diarrhea is the most common complication. Ear infections and pneumonia are also common especially in children when they have measles. A rare but serious complication of measles is encephalitis which occurs in up to 1 per 1000 measles cases. 下面我們一起來看一下世衛組織針對旅行者的具體建議(翻譯自世衛組織原文)。敲黑板!準備出行到以上地區的小伙伴們,在做旅行攻略同時都要留神注意以下內容哦!! 近期的麻疹流行突出了在兒童和成年人群中麻疹預防的漏洞和不足。所有國際旅行者應該檢查自己的免疫接種狀態,確認是否已經接種過2劑麻疹疫苗。 接種情況不明的個人在國際旅行前應至少接種一劑麻疹疫苗。世衛組織建議至少在出行前15天完成麻疹疫苗接種。 麻疹疫苗可與黃熱病疫苗等其他推薦給國際旅行者的疫苗一同接種。 世衛組織推薦6個月以上的嬰兒在前往出現麻疹暴發流行情況的國家和地區前應接種一劑麻疹疫苗。在6到9個月齡幼兒已經完成一劑麻疹疫苗接種的幼兒,仍應按照各國的免疫接種時間表,在相應規定的年齡接種兩劑麻疹疫苗。 所有國際旅行者應在出行前向專業醫務人員咨詢,了解麻疹病毒的傳染性和癥狀,提高對麻疹的風險意識。 麻疹疫苗不建議孕婦接種。 以下就是世衛組織的原文節選: ? Recent outbreaks of measles highlight gaps in protection against the disease among children and adults. All travellers should check that their vaccination status is up-to-date and ensure that they have received two doses of measles vaccine. ? Travellers who are uncertain of their measles vaccination status should receive at least one dose of measles vaccine. WHO recommends that travellers get vaccinated against measles at least 15 days prior to travel. ? Measles vaccine can be co-administered with other vaccines recommended for travellers such as yellow fever vaccine. ? WHO recommends that infants from six months of age receive a supplementary dose of measles vaccine if they are travelling to countries experiencing measles outbreaks. Children between 6 and 9 months of age who receive a supplementary dose of measles vaccine should also receive two doses of measles vaccine at the recommended ages according to the national immunization schedule. ? All travellers should seek advice from their healthcare provider and be aware of the risk of exposure to measles virus as well as transmission and symptoms of the disease. ? Measles vaccines are not recommended for pregnant women.
作者:澳大利亞墨爾本大學醫學院兒科博士
百匯醫療(中國)兒科醫師
蔣本然