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Nw 2014073120-ebola 2
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Nw 2014073120-ebola 2
1.
‚√§ Ebola ª√–‡∑»‰∑¬ 2557 ·π«∑“ß°“√¥”‡π‘πß“π ‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π
·≈–§«∫§ÿ¡ ”π—°√–∫“¥«‘∑¬“ | °√¡§«∫§ÿ¡‚√§
2.
“√∫—≠ §”π” 1 1. ∫∑π”
2 2. «—µ∂ÿª√– ߧ尓√‡ΩÑ“√–«—ß·≈– Õ∫ «π‚√§ 4 3. °“√ª√–‡¡‘𧫓¡‡ ’ˬߢÕß°“√µ‘¥‡™◊ÈÕ‰«√— Ebola 5 4. 𑬓¡ ”À√—∫°“√‡ΩÑ“√–«—ß 13 5. °“√ Õ∫ «π‚√§ 17 6. ≈—°…≥–∑“ߧ≈‘π‘°·≈–°“√«‘π‘®©—¬·¬°‚√§ Ebola 30 7. °“√‡µ√’¬¡µ—«Õ¬à“ß àßµ√«®∑“ßÀâÕߪؑ∫—µ‘°“√ à«π°≈“ß 33 8. °“√¥Ÿ·≈√—°…“ºŸâªÉ«¬ 37 9. °“√«“ß·ºπ°“√®—¥ √√∑√—欓°√ 41 ¿“§ºπ«° 43 ë ‡™◊ÈÕ‰«√— Ebola 43 ë √ÿª°“√√–∫“¥¢Õ߇™◊ÈÕ‰«√— Ebola 47 ë §”∂“¡-§”µÕ∫‡°’ˬ«°—∫‡™◊ÈÕ‰«√— Ebola 50 ë ¢âÕ·π–π”‡∫◊ÈÕßµâπ ”À√—∫≈Ÿ°‡√◊Õ∫π‡∑’ˬ«∫‘π ºŸâ∑’Ë¡’Àπâ“∑’Ë 52 ∑”§«“¡ –Õ“¥‡§√◊ËÕß∫‘π ºŸâ∑’Ë∑”Àπâ“∑’Ë¢π àß ‘π§â“·≈– ºŸâ∑’˵âÕߪؑ∫—µ‘ß“π°—∫ºŸâ‚¥¬ “√¢“‡¢â“∑’Ë π“¡∫‘π ë ‡Õ° “√Õâ“ßÕ‘ß 56 æ‘¡æå§√—Èß∑’Ë 1 ‘ßÀ“§¡ 2557 ‚√ßæ‘¡æå Heûs Company Limited ®—¥æ‘¡æå‚¥¬ °≈ÿà¡æ—≤π“√–∫∫‡ΩÑ“√–«—ß∑“ß√–∫“¥«‘∑¬“‚√§µ‘¥µàÕ ”π—°√–∫“¥«‘∑¬“ ISBN 978-616-11-2134-1 ß∫ª√–¡“≥ ”π—°√–∫“¥«‘∑¬“ °√¡§«∫§ÿ¡‚√§ °√–∑√«ß “∏“√≥ ÿ¢
3.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 1 ·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π·≈–§«∫§ÿ¡‚√§ Ebola ©∫—∫π’È ‡ªìπ©∫—∫∑’Ëπ—°«‘™“°“√®“°À≈“¬Àπ૬ߓπ §◊Õ ”π—°√–∫“¥«‘∑¬“ ”π—°‚√§µ‘¥µàÕÕÿ∫—µ‘„À¡à ”π—°‚√§µ‘¥µàÕ∑—Ë«‰ª °√¡§«∫§ÿ¡‚√§ ∂“∫—π«‘®—¬«‘∑¬“»“ µ√å “∏“√≥ ÿ¢ °√¡«‘∑¬“»“ µ√å °“√·æ∑¬å §≥–·æ∑¬»“ µ√廑√‘√“™æ¬“∫“≈ ·≈–§≥–·æ∑¬»“ µ√å ®ÿÓ≈ß°√≥å¡À“«‘∑¬“≈—¬ ‰¥âª√–™ÿ¡®—¥∑”¢÷ÈπÕ¬à“߇√àߥà«π ‡æ◊ËÕ„Àâ∑—π„™â„π°“√‡µ√’¬¡°“√ªÑÕß°—π°“√√–∫“¥¢Õß‚√§ Ebola ∑’Ë Õ“®¡“®“°ª√–‡∑»„π∑«’ª·Õø√‘°“ ´÷Ëß√–∫“¥Õ¬à“ßµàÕ‡π◊ËÕßµ—Èß·µàµâπªï æ.». 2557 ®π∂÷ßªí®®ÿ∫—π ·≈–¡’·π«‚πâ¡«à“®–√–∫“¥µàÕ‰ª ¥â«¬„π¬ÿ§‚≈°“¿‘«—≤πå°“√√–∫“¥¢â“¡∑«’ªÀ√◊բⓡª√–‡∑» Õ“®‡°‘¥¢÷Èπ‰¥â °“√‡µ√’¬¡æ√âÕ¡„π«‘∏’¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π·≈–§«∫§ÿ¡‚√§ Ebola ‚¥¬°”Àπ¥·π«∑“ß°“√¥”‡π‘πß“π ·∫àß∫∑∫“∑Àπâ“∑’Ë¢ÕߺŸâ√—∫º‘¥™Õ∫„π·µà≈–¢—ÈπµÕπ‰«âæÕ —߇¢ª µ—Èß·µà°“√„Àâ°“√√—°…“¥Ÿ·≈ºŸâªÉ«¬ °“√‡°Á∫µ—«Õ¬à“ß àßµ√«® °“√§«∫§ÿ¡ªÑÕß°—π‚√§ ºŸâ„¥®–µâÕß ∑”Õ–‰√ Õ¬à“߉√ ‡¡◊ËÕ„¥ „π°√≥’æ∫ºŸâªÉ«¬∑’Ë¡“¥â«¬Õ“°“√ ß —¬µ‘¥‡™◊ÈÕ‰«√— Ebola ¥—ßπ—Èπ·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π·≈–§«∫§ÿ¡‚√§ Ebola ©∫—∫π’È ®÷ßπà“®–‡ªìπª√–‚¬™πå„π°“√¥”‡π‘πß“π·°à∑ÿ°Àπ૬ߓπ∑’ˇ°’ˬ«¢âÕßµàÕ‰ª Õ¬à“߉√°Áµ“¡·¡â«à“®– ‰¥â欓¬“¡ª√—∫ª√ÿß·°â‰¢Õ¬à“ߥ’·≈â«°ÁÕ“®¡’¢âÕº‘¥æ≈“¥ ∫°æ√àÕß µâÕß·°â‰¢‡æ‘Ë¡‡µ‘¡Õ’° ´÷Ëß ”π—°√–∫“¥«‘∑¬“¬‘π¥’∑’Ë®–√—∫øíߢâÕ‡ πÕ·π–®“°ºŸâ√Ÿâ∑ÿ°∑à“π„π°“√∑’Ë®–ª√—∫ª√ÿß·°â‰¢„À⥒ ¬‘Ëߢ÷Èπ„π‚Õ°“ µàÕ‰ª ”π—°√–∫“¥«‘∑¬“ 11 情¿“§¡ 2557 §”π”
4.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 25572 ®“° ∂“π°“√≥å°“√√–∫“¥¢Õ߇™◊ÈÕ‰«√— Õ’‚∫≈“ (Ebola) „π·Õø√‘°“µ–«—πµ° ≈à“ ÿ¥«—π∑’Ë 23 ‡¡…“¬π æ.». 2557 °√–∑√«ß “∏“√≥ ÿ¢ª√–‡∑»°’π’ (Guinea) √“¬ß“πºŸâªÉ«¬∑’Ë¡’Õ“°“√‡¢â“‰¥â°—∫ ‚√§ Ebola ∑—Èß ‘Èπ 218 √“¬ ‡ ’¬™’«‘µ 141 √“¬ „π®”π«ππ’È¡’ºŸâªÉ«¬ 191 √“¬ ‰¥â√—∫°“√µ√«®∑“ßÀâÕß ªØ‘∫—µ‘°“√ æ∫«à“¡’ºŸâªÉ«¬¬◊π¬—π 115 √“¬ ®“°ºŸâªÉ«¬¬◊π¬—π®”π«π 115 √“¬ ¡’ºŸâ‡ ’¬™’«‘µ 72 √“¬ Õ—µ√“ªÉ«¬µ“¬√âÕ¬≈– 63 „π°“√√–∫“¥§√—Èßπ’È°≈ÿà¡∫ÿ§≈“°√∑“ß°“√·æ∑¬å·≈– “∏“√≥ ÿ¢¡’Õ“°“√ ‡¢â“‰¥â°—∫‚√§ Ebola ®”π«π 26 √“¬ ¡’º≈µ√«®∑“ßÀâÕߪؑ∫—µ‘°“√¬◊π¬—π 16 √“¬ ¡’ºŸâ‡ ’¬™’«‘µ 16 √“¬ ‡¡◊ËÕ®”·π°√“¬æ◊Èπ∑’Ë∑’Ë¡’ºŸâªÉ«¬ ß —¬‚√§ Ebola ®“° 6 ‡¡◊Õß ‰¥â·°à Conakry (ªÉ«¬ 58 √“¬ ‡ ’¬™’«‘µ 24 √“¬), Guekedou (ªÉ«¬ 127 √“¬ ‡ ’¬™’«‘µ 91 √“¬), Macenta (ªÉ«¬ 22 √“¬‡ ’¬™’«‘µ16 √“¬), Kissidougou (ªÉ«¬ 6 √“¬ ‡ ’¬™’«‘µ 5 √“¬), Dabola (ªÉ«¬ 4 √“¬ ‡ ’¬™’«‘µ 4 √“¬) ·≈– Djingaraye (ªÉ«¬ 1 √“¬ ‡ ’¬™’«‘µ 1 √“¬) ‚¥¬¬◊π¬—π√“¬≈à“ ÿ¥‡¡◊ËÕ«—π∑’Ë 22 ‡¡…“¬π 2557 ¢≥–π’ȉ¥â¡’°“√ µ‘¥µ“¡ºŸâ —¡º— °—∫ºŸâªÉ«¬„π∑ÿ°æ◊Èπ∑’Ë∑’Ë¡’°“√√“¬ß“π‚√§ ·π«∑“ß°“√§«∫§ÿ¡·≈–ªÑÕß°—π‚√§‡πâπ‰ª ∑’Ë°“√¥Ÿ·≈ºŸâªÉ«¬·≈–°“√ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ„π‚√ß欓∫“≈ ‚¥¬Õߧ尓√Õπ“¡—¬‚≈° Medecins Sans Frontieres (MSF) ·≈–»Ÿπ¬å§«∫§ÿ¡·≈–ªÑÕß°—π‚√§ ª√–‡∑» À√—∞Õ‡¡√‘°“ (Centers for Disease Control and Prevention, US.CDC) ‰¥â π—∫ πÿπ°“√™à«¬‡À≈◊Õ∑—Èߥâ“π∫ÿ§≈“°√∑“ß°“√·æ∑¬å·≈– °“√µ√«®∑“ßÀâÕߪؑ∫—µ‘°“√πÕ°®“°π’Ȭ—ß¡’°“√ª√–™ÿ¡‡æ◊ËÕ‡πâπ¬È”°“√‡ΩÑ“√–«—ß‚√§°“√ Õ∫ «π‚√§ ·≈–°“√ª√– “π¢âÕ¡Ÿ≈„πæ◊Èπ∑’Ë√Õ¬µàÕ°—∫ª√–‡∑»‡æ◊ËÕπ∫â“π§◊Õª√–‡∑»‰≈∫’‡√’¬ (Liberia) ‡æ◊ËÕ ªÑÕß°—π°“√·æ√à°√–®“¬¢Õß‚√§ ´÷Ëß°“√‡ΩÑ“√–«—ß‚√§¬—ߧߵâÕß¡’°“√¥”‡π‘π°“√Õ¬à“ßµàÕ‡π◊ËÕß ‡π◊ËÕß®“°‚√§ Ebola ¡’√–¬–øí°µ—«∑’ˬ“«‰¥â∂÷ß 3 —ª¥“Àå ¥—ßπ—Èπ¡’§«“¡‡ªìπ‰ª‰¥â∑’ËÕ“®®–¡’°“√ √“¬ß“πºŸâªÉ«¬√“¬„À¡à∑—Èß„πª√–‡∑» Guinea ·≈–ª√–‡∑» Liberia ”À√—∫ ∂“π°“√≥å°“√√–∫“¥„πª√–‡∑» Liberia µ—Èß·µà«—π∑’Ë 13 ¡’π“§¡ æ.». 2557 ´÷Ë߇ªìπ «—π‡√‘Ë¡ªÉ«¬¢ÕߺŸâªÉ«¬¬◊π¬—𵑥‡™◊ÈÕ Ebola ¢Õߪ√–‡∑» Liberia ∂÷ß«—π∑’Ë 24 ‡¡…“¬π æ.». 2557 æ∫«à“¡’ºŸâªÉ«¬Õ“°“√‡¢â“‰¥â°—∫‚√§ Ebola ∑—Èß ‘Èπ 35 √“¬ ‚¥¬‡ªìπºŸâªÉ«¬¬◊π¬—π 6 √“¬ ·≈–ºŸâªÉ«¬ ‡¢â“¢à“¬ 2 √“¬ ·≈–ºŸâªÉ«¬ ß —¬ 27 √“¬ ‚¥¬«—π‡√‘Ë¡ªÉ«¬¢ÕߺŸâªÉ«¬√“¬≈à“ ÿ¥§◊Õ«—π∑’Ë 6 ‡¡…“¬π æ.». 2557 „π°≈ÿࡺŸâªÉ«¬ ß —¬∑—Èß 27 √“¬Õ“®¡’°“√µ—¥ÕÕ°¢÷ÈπÕ¬Ÿà°—∫º≈°“√µ√«®∑“ßÀâÕߪؑ∫—µ‘°“√ ∫∑π”1
5.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 3 ®“°¢âÕ¡Ÿ≈ªí®®ÿ∫—π ∑“ß°√–∑√«ß “∏“√≥ ÿ¢¢Õߪ√–‡∑»‡´’¬√å√“≈’‚Õπ (Sierra Leone) °”≈—ß ¥”‡π‘π°“√ Õ∫ «π‚√§„πºŸâªÉ«¬ 3 √“¬ ∑’Ë¡’Õ“°“√‡¢â“‰¥â°—∫𑬓¡‚√§µ‘¥‡™◊ÈÕ‰«√— °≈ÿࡉ¢â‡≈◊Õ¥ÕÕ° (Viral hemorrhagic fever, VHF) ¡’°“√¥”‡π‘π°“√ Õ∫ «π‚√§·≈–§âπÀ“ºŸâªÉ«¬‡æ‘Ë¡‡µ‘¡ º≈æ∫«à“ ®“°°“√ àßµ—«Õ¬à“߇æ◊ËÕµ√«®À“‡™◊ÈÕ„π°≈ÿà¡ VHF ∑—Èß ‘Èπ 98 µ—«Õ¬à“ß ¡’ 10 µ—«Õ¬à“ß„Àâº≈∫«°µàÕ ‡™◊ÈÕ≈“ ´à“‰«√— (Lassa virus) ·≈– 88 µ—«Õ¬à“ß„Àâº≈≈∫µàÕ‡™◊ÈÕ‰«√— Ebola ·≈– Lassa virus (¢âÕ¡Ÿ≈ ≥ «—π∑’Ë 24 ‡¡…“¬π æ.». 2557) ®“° ∂“π°“√≥å„πªí®®ÿ∫—πÕߧ尓√Õπ“¡—¬‚≈°¬—ß¡‘‰¥âª√–°“» Àâ“¡°“√‡¥‘π∑“߇¢â“ÕÕ°À√◊Õ®”°—¥°“√§â“¢“¬„πª√–‡∑»∑’Ë¡’°“√√–∫“¥‰¥â·°àª√–‡∑»GuineaLiberia ·≈– Sierra Leone [1, 2] °“√§¡π“§¡√–À«à“ߪ√–‡∑»√«¡∂÷ß√–À«à“ß∑«’ª¡’§«“¡ –¥«°¢÷Èπ„πªí®®ÿ∫—π®πÕ“®°≈à“« ‰¥â«à“‡ªìπ¬ÿ§¢Õß‚≈°‰√âæ√¡·¥π ∂÷ß·¡â«à“°“√√–∫“¥¢Õß‚√§ Ebola ®–‡°‘¥¢÷Èπ„π∑«’ª·Õø√‘°“ ·µà¥â«¬‡Àµÿº≈°“√‡¥‘π∑“ß∑’Ë –¥«°¢÷Èπ ®÷ß®”‡ªìπµâÕß¡’¡“µ√°“√‡¢â¡ß«¥„π°“√‡ΩÑ“√–«—ß·≈– ªÑÕß°—π¡‘„Àâ‚√§‡¢â“¡“·æ√à√–∫“¥„πª√–‡∑»‰∑¬ °√–∑√«ß “∏“√≥ ÿ¢ ‚¥¬§«“¡√à«¡¡◊Õ®“° Àπ૬ߓπ∑’ˇ°’ˬ«¢âÕß ª√–°Õ∫¥â«¬¡À“«‘∑¬“≈—¬ °√¡«‘∑¬“»“ µ√å°“√·æ∑¬å ·≈–°√¡§«∫§ÿ¡‚√§ ‰¥â√à«¡°—π°”Àπ¥√Ÿª·∫∫ «‘∏’°“√¥”‡π‘πß“π ‡æ◊ËÕ°“√‡ΩÑ“√–«—ß Õ∫ «π‚√§ ‡æ◊ËÕ„À≥â¢âÕ¡Ÿ≈∑’Ë∂Ÿ°µâÕß √«¥‡√Á«µàÕ°“√∫√‘À“√®—¥°“√‚¥¬‡©æ“–°“√°”Àπ¥¡“µ√°“√ªÑÕß°—π§«∫§ÿ¡‚√§‰¥â∂Ÿ°∑‘»∑“ß¡“°¢÷Èπ ‰¡à Ÿ≠‡ ’¬∑—Èß∑√—欓°√∫ÿ§§≈ ·≈–ß∫ª√–¡“≥‡°‘𧫓¡®”‡ªìπ ”π—°√–∫“¥«‘∑¬“ „π∞“π–∑’ˇªìπ Àπ૬ߓπ à«π°≈“ß∑’Ë¡’Àπâ“∑’Ë„π°“√®—¥√–∫∫ ·≈–æ—≤π“°“√‡ΩÑ“√–«—ß‚√§¢Õߪ√–‡∑» ®÷ß®”‡ªìπ µâÕß®—¥„Àâ¡’°“√√“¬ß“π‚√§π’È ‡π◊ËÕß®“°‡ªìπ‚√§„À¡à∑’ˬ—߉¡à‡°‘¥¢÷Èπ„πª√–‡∑»‰∑¬¡“°àÕπ ¥—ßπ—Èπ ¢âÕ¡Ÿ≈µà“ßÊ ®÷ß¡“®“°°“√·ª≈∫∑§«“¡¢ÕßÕߧ尓√Õπ“¡—¬‚≈° Õߧå°√√–À«à“ߪ√–‡∑» ·≈– Àπ૬ªÑÕß°—π§«∫§ÿ¡‚√§„πµà“ߪ√–‡∑» ·≈–ª√—∫‡π◊ÈÕÀ“„À⇢⓰—∫∫√‘∫∑¢Õߪ√–‡∑»‰∑¬ ´÷Ëß¡’ ¢—ÈπµÕπ¢Õß°“√√“¬ß“π‡°≥±å°“√«‘π‘®©—¬°“√‡°Á∫«—µ∂ÿµ—«Õ¬à“߇æ◊ËÕ àßµ√«®¬◊π¬—π µ≈Õ¥®π ¡“µ√°“√°“√§«∫§ÿ¡ªÑÕß°—π‚√§ ¥—ß√“¬≈–‡Õ’¬¥„π∫∑∑’Ë®–𔇠πÕµàÕ‰ª
6.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 25574 «—µ∂ÿª√– ߧ尓√‡ΩÑ“√–«—ß ·≈– Õ∫ «π‚√§2
7.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 5 °“√ª√–‡¡‘𧫓¡‡ ’Ë¬ß ¢Õß°“√µ‘¥‡™◊ÈÕ‰«√— Ebola 3.1 ·π«∑“ß°“√ª√–‡¡‘𧫓¡‡ ’ˬߢÕß°“√‰¥â√—∫‡™◊ÈÕ‰«√— Ebola “¡“√∂·∫àßµ“¡™π‘¥ ¢Õß≈—°…≥–∑’Ë —¡º— ¥—ß· ¥ß„πµ“√“ß∑’Ë 1 [3] ®“°‡Õ° “√Õâ“ßՑߢÕß European Centre for Disease Prevention and Control æ.». 2557 [3] æ∫«à“ §«“¡‡ ’ˬߢÕß°“√µ‘¥‡™◊ÈÕ„π√–¥—∫µË”®–‡°‘¥¢÷Èπ„π√–¬–·√°∑’˺ŸâªÉ«¬‡√‘Ë¡· ¥ßÕ“°“√ (√–¬– Õ“°“√π”ª√–¡“≥ 7 «—π) ®“°π—È𧫓¡‡ ’ˬߢÕß°“√µ‘¥‡™◊ÈÕ®–‡æ‘Ë¡¢÷Èπ„π™à«ß√–¬–∑⓬¢Õß‚√§ ‡π◊ËÕß®“°ºŸâªÉ«¬¡’®”π«π‰«√— „π°√–· ‚≈À‘µ‡æ‘Ë¡¡“°¢÷Èπ„π°“√»÷°…“ºŸâ —¡º— „°≈♑¥¿“¬„π∫â“πæ∫ «à“°“√∂à“¬∑Õ¥‡™◊ÈÕ√–¬–∑’Ë 2 (secondary transmission) ®–‡°‘¥¢÷Èπ‡¡◊ËÕ¡’°“√ —¡º— ‚¥¬µ√ß ‡∑à“π—Èπ „π°“√√–∫“¥¢Õ߇™◊ÈÕ‰«√— Ebola „πªï æ.». 2543 ∑’Ë´Ÿ¥“π·≈–ÕŸ°—𥓠æ∫«à“ªí®®—¬‡ ’ˬß∑’Ë ”§—≠∑’Ë ÿ¥§◊Õ°“√ —¡º— ´È”‰ª´È”¡“°—∫ “√§—¥À≈—ËߢÕߺŸâªÉ«¬„π™à«ß°“√¥Ÿ·≈√—°…“ ·≈–§«“¡‡ ’Ë¬ß ®–‡æ‘Ë¡¡“°¢÷Èπ‡¡◊ËÕ —¡º— °—∫ºŸâªÉ«¬„π™à«ß√–¬–∑⓬¢Õß‚√§ ·≈–°“√ —¡º— °—∫ ‘ËߢÕ߇§√◊Õß„™â∑’˪π‡ªóôÕπ “√§—¥À≈—Ë߇ªìπ®”π«π¡“°¢ÕߺŸâªÉ«¬ ”À√—∫°“√ —¡º— ®“°°“√µ√«®√à“ß°“¬ºŸâªÉ«¬æ∫«à“‰¡à∑”„Àâ ‡°‘¥§«“¡‡ ’ˬß∑’ˇ撬ßæÕµàÕ°“√µ‘¥‡™◊ÈÕ‰«√— Ebola µ“√“ß∑’Ë 1 √–¥—∫§«“¡‡ ’ˬߵàÕ°“√µ‘¥‡™◊ÈÕ‰«√— Ebola ®”·π°µ“¡≈—°…≥–°“√ —¡º— √–¥—∫§«“¡‡ ’Ë¬ß ≈—°…≥–°“√ —¡º— —¡º— °—∫„§√ µ—«Õ¬à“ß √–¥—∫§«“¡‡ ’ˬߵ˔¡“° —¡º— ‚¥¬∫—߇Ց≠À√◊Õ —¡º— ºŸâ∑’Ë¡’‰¢âÀ√◊ÕºŸâªÉ«¬∑’ËÕ¬Ÿà °“√„™â∑’Ëπ—Ë߇¥’¬«°—π°—∫ºŸâª«¬ À√◊Õ√à«¡„™â À√◊Õ‰¡à¡’§«“¡‡ ’Ë¬ß ‡ªìπ§√—Èߧ√“« „π√∂欓∫“≈ ∫√‘°“√¢π àß “∏“√≥– ‡ªìπµâπ √–¥—∫§«“¡‡ ’ˬߵ˔ ¡’§«“¡„°≈♑¥·∫∫ª√–™‘¥µ—« ºŸâªÉ«¬∑’Ë¡’‰¢âÀ√◊ÕºŸâªÉ«¬ ·æ∑¬åºŸâµ√«®√à“ß°“¬ °“√«—¥Õÿ≥À¿Ÿ¡‘ „π√∂欓∫“≈ ·≈–°“√«—¥§«“¡¥—π‚≈À‘µ ‡ªìπµâπ √–¥—∫§«“¡‡ ’Ë¬ß ¡’§«“¡„°≈♑¥·∫∫ª√–™‘¥µ—« ºŸâªÉ«¬∑’Ë¡’Õ“°“√‰Õ ª“π°≈“ß ‚¥¬ª√“»®“°Õÿª°√≥åªÑÕß°—π Õ“‡®’¬π ºŸâªÉ«¬∑’Ë¡’‡≈◊Õ¥ ∑’ˇÀ¡“– ¡ (√«¡∂÷ß·«à𵓠ÕÕ°∑“ß®¡Ÿ°À√◊ÕºŸâªÉ«¬ ªÑÕß°—π) ∑’Ë¡’Õ“°“√∑âÕ߇ ’¬ √–¥—∫§«“¡‡ ’Ë¬ß Ÿß —¡º— ‡™◊ÈÕºà“π∑“ߺ‘«Àπ—ß ºŸâªÉ«¬∑’Ë¡’Õ“°“√√ÿπ·√ß ∂Ÿ°‡¢Á¡©’¥¬“∑‘Ë¡µ”‚¥¬∫—߇Ց≠ À√◊Õ À√◊Õ‡ªìπºŸâªÉ«¬¬◊π¬—π —¡º— ‡≈◊Õ¥À√◊Õ “√§—¥À≈—ËßÀ√◊Õ‡π◊ÈÕ‡¬◊ËÕ °“√µ‘¥‡™◊ÈÕ‰«√— Ebola À√◊Õ ‘Ëß àßµ√«®∑’˪π‡ªóôÕπ‡™◊ÈÕ‰«√— 3
8.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 25576 °“√§«∫§ÿ¡°“√√–∫“¥∑’Ë ”§—≠¢Õ߇™◊ÈÕ‰«√— Ebola §◊Õ°“√À¬ÿ¥«ß®√°“√ —¡º— ‚¥¬µ√ß √–À«à“ߧπ Ÿà§π µ≈Õ¥®π°“√µ√«®æ∫‚√§·µà·√°‡√‘Ë¡‡æ◊ËÕ∑”„Àâ¡’°“√·¬°ºŸâªÉ«¬‰¥âÕ¬à“ß√«¥‡√Á« ¡’°“√µ‘¥µ“¡ºŸâ —¡º— À√◊ÕºŸâ¡’§«“¡‡ ’Ë¬ß µ≈Õ¥®π°“√„™âÕÿª°√≥åªÑÕß°—π °“√®—¥°“√µàջ溟⇠’¬ ™’«‘µÕ¬à“߇À¡“– ¡ ·≈–§«“¡µ◊Ëπµ—«¢Õßªí®®—¬‡ ’ˬߵàÕ‚√§π’È„π™ÿ¡™π´÷Ëß𔉪 Ÿà°“√ªÑÕß°—πµ—«‡Õß ®“°‚√§π’ȉ¥âÕ¬à“ß∂Ÿ°µâÕß ·≈–°“√·¬°ºŸâªÉ«¬∑’˵‘¥‡™◊ÈÕ≈â«π‡ªìπªí®®—¬ ”§—≠∑’Ë¡’ª√– ‘∑∏‘¿“æ„π°“√ À¬ÿ¥¬—Èß·æ√à°√–®“¬¢Õ߇™◊ÈÕ ∫ÿ§≈“°√∑’˪ؑ∫—µ‘ß“π„π‚√ß欓∫“≈¡’‚Õ°“ µ‘¥‡™◊ÈÕ Ÿß„π¢≥–∑’Ë¥Ÿ·≈√—°…“ºŸâªÉ«¬∑’Ë ß —¬À√◊Õ ¬◊π¬—π«à“µ‘¥‡™◊ÈÕ‰«√— Ebola ‚¥¬¡—°®–‡°‘¥¢÷Èπ‡¡◊ËÕ —¡º— „°≈♑¥°—∫ºŸâªÉ«¬·≈–‰¡à‰¥â «¡Õÿª°√≥å ªÑÕß°—πµπ‡ÕßÕ¬à“߇µÁ¡∑’Ë πÕ°®“°π—Èπ·≈⫬—ß “¡“√∂µ‘¥‡™◊ÈÕ‰¥â®“°°“√ —¡º— Õÿª°√≥凧√◊ËÕß„™â ¢¬–µ‘¥‡™◊ÈÕ„π‚√ß欓∫“≈ À√◊Õ‡§√◊ËÕß¡◊Õ∑“ß°“√·æ∑¬å∑’˪π‡ªóôÕπ‡™◊ÈÕ §«“¡‡ ’ˬߢÕß°“√µ‘¥‡™◊ÈÕ “¡“√∂≈¥≈߉¥â®“°°“√¡“µ√°“√ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ„π‚√ß欓∫“≈Õ¬à“߇¢â¡ß«¥ ·≈–ªØ‘∫—µ‘µ“¡ Õ¬à“ß®√‘ß®—ß °“√µ‘¥µàÕ‚√§ Ebola ®“° —µ«åπ—È𠇧¬¡’√“¬ß“π°“√µ‘¥‡™◊ÈÕ®“° “∏“√≥√—∞‚°µ¥‘«—«√å (Cote d’Ivoire) „π§π∑’輈ҫ“°≈‘ß™‘¡·ªπ´’ªÉ“ ´÷Ëß —µ«å„π°≈ÿà¡≈‘ß·™¡·ªπ´’¡’§«“¡‰«µàÕ°“√µ‘¥ ‡™◊ÈÕ‰«√— Ebola ªí®®ÿ∫—π¬—߉¡à¡’¬“À√◊Õ«—§´’π∑’Ë„™âªÑÕß°—π‚√§‚¥¬‡©æ“– («—§´’π∑’Ë¡’ licensed) À√◊Õ¬“∑’Ë„™â√—°…“ ‚¥¬‡©æ“– (antiviral therapy) „πºŸâµ‘¥‡™◊ÈÕ ºŸâªÉ«¬∑’Ë¡’Õ“°“√√ÿπ·√ß®”‡ªìπµâÕ߉¥â√—∫°“√√—°…“¥Ÿ·≈ Õ¬à“ß„°≈♑¥ 3.2 §«“¡‡ ’ˬߵàÕ°“√µ‘¥‡™◊ÈÕ‰«√— Ebola „πª√–‡∑»‰∑¬ ®“°π—°∑àÕ߇∑’ˬ«∑’ˇ¥‘π∑“ß°≈—∫®“°ª√–‡∑»∑’Ë¡’°“√√–∫“¥ ‚Õ°“ ∑’Ëπ—°∑àÕ߇∑’ˬ«‡¥‘π∑“߉ª¬—ߪ√–‡∑»∑’Ë¡’°“√√–∫“¥·≈–‡¡◊ËÕ°≈—∫¡“ª√–‡∑»‰∑¬·≈â« ®–· ¥ßÕ“°“√ªÉ«¬π—Èπ ¡’§«“¡‡ ’ˬߢÕß°“√µ‘¥‡™◊ÈÕ§àÕπ¢â“ߵ˔¡“° ‡π◊ËÕß®“°°“√µ‘¥µàÕµâÕß¡’°“√ —¡º— ‚¥¬µ√ß°—∫‡≈◊Õ¥ “√§—¥À≈—Ëß Õ«—¬«–¢ÕߺŸâµ‘¥‡™◊ÈÕÀ√◊Õ —µ«å∑’˵‘¥‡™◊ÈÕ À√◊ÕµâÕßÕ¬Ÿà√à«¡°—∫∫ÿ§§≈ À√◊Õ —µ«å∑’˵‘¥‡™◊ÈÕ ´÷Ëßªí®®—¬¥—ß°≈à“«‰¡à§àÕ¬æ∫„ππ—°‡¥‘π∑“ß∑—Ë«‰ª ˆ
9.
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Ebola ª√–‡∑»‰∑¬ 2557 7 °“√‰ª‡¬’ˬ¡§√Õ∫§√—«À√◊Õ‡æ◊ËÕ𠧫“¡‡ ’ˬߢÕßπ—°‡¥‘π∑“ß∑’ˉª‡¬’ˬ¡§√Õ∫§√—« ≠“µ‘ À√◊Õ‡æ◊ËÕπ„πª√–‡∑»∑’Ë¡’°“√√–∫“¥ °Á§àÕπ¢â“ߵ˔‡™àπ‡¥’¬«°—π ¬°‡«âππ—°‡¥‘π∑“ß∑’Ë¡’‰ª‡¬’ˬ¡¥Ÿ·≈≠“µ‘‡æ◊ËÕπ ·≈–¡’°“√ —¡º— ‚¥¬µ√ß °—∫ºŸâªÉ«¬À√◊ÕºŸâ‡ ’¬™’«‘µ √«¡∑—Èß —¡º— —µ«å∑’˵‘¥‡™◊ÈÕ °“√µ‘¥µ“¡ºŸâ —¡º— ∑’ˇ¥‘π∑“ß°≈—∫®“°°“√‰ª ‡¬’ˬ¡§√Õ∫§√—«À√◊Õ‡æ◊ËÕπ∑’˪ɫ¬ ®–™à«¬∑√“∫ªí®®—¬‡ ’Ë¬ß µ≈Õ¥®πªÑÕß°—π°“√·æ√à°√–®“¬¢Õß ‚√§‰¥â ºŸâªÉ«¬∑’Ë· ¥ßÕ“°“√ªÉ«¬·≈–‡¢â“¡“√—∫°“√√—°…“„πª√–‡∑»‰∑¬ ¡’§«“¡‡ªìπ‰ª‰¥â∑’Ë∫ÿ§§≈‡À≈à“π’È®– —¡º— °—∫‡™◊ÈÕ‰«√— Ebola·≈–‡√‘Ë¡· ¥ßÕ“°“√¢≥–‡¥‘π∑“ß ¡“ª√–‡∑»‰∑¬∫π‡§√◊ËÕß∫‘π‚¥¬ “√ ·≈–‡¢â“¡“√—∫°“√√—°…“∑’Ë ∂“π欓∫“≈„πª√–‡∑»‰∑¬ ®”‡ªìπµâÕß¡’°“√·¬°°—°ºŸâªÉ«¬‡À≈à“π’È∑—π∑’‡æ◊ËÕªÑÕß°—π°“√·æ√à√–∫“¥¢Õß‚√§ ºŸâ‚¥¬ “√∑’Ë√à«¡‡¥‘π∑“ß¡“„π‡§√◊ËÕß∫‘π‡¥’¬«°—π°—∫ºŸâªÉ«¬µ‘¥‡™◊ÈÕ‰«√— Ebola Õ“®¡’ºŸâ‚¥¬ “√∑’ˇ√‘Ë¡· ¥ßÕ“°“√ªÉ«¬¢≥–‚¥¬ “√Õ¬Ÿà∫π‡§√◊ËÕß∫‘π´÷Ëß¡’§«“¡‡ªìπ‰ª‰¥â∑’Ë·æ√à ‚√§‰ª¬—ߺŸâ‚¥¬ “√Õ◊ËπÊ ·≈–≈Ÿ°‡√◊Õ∑’ËÕ¬Ÿà∫π‡§√◊ËÕß∫‘π≈”‡¥’¬«°—π ´÷Ëߧ«√ªØ‘∫—µ‘µ“¡§”·π–π”Õ¬à“ß „°≈♑¥ ∂â“°“√ Õ∫ «π‚√§æ∫«à“ºŸâ‚¥¬ “√∑’Ë¡’Õ“°“√‡¢â“‰¥â°—∫𑬓¡°“√µ‘¥‡™◊ÈÕ‰«√— Ebola ·≈– ¡’ª√–«—µ‘°“√‡¥‘π∑“ß„πª√–‡∑»‡ ’ˬ߄π™à«ß 21 «—π°àÕπªÉ«¬ ºŸâ‚¥¬ “√∑ÿ°√“¬∑’Ëπ—ËßÀà“߉ª 1 ∑’Ëπ—Ëß ®“°ºŸâ‚¥¬ “√∑’˵‘¥‡™◊ÈÕ √«¡∑—Èß≈Ÿ°‡√◊Õ∑ÿ°§π¡’§«“¡‡ ’ˬߵàÕ°“√µ‘¥‡™◊ÈÕ ∂â“¡’°“√ —¡º— „°≈♑¥°—∫ “√§—¥À≈—ËßÀ√◊Õ —¡º— °—∫‡ ◊Èպⓠºâ“‡™Á¥µ—« À√◊ÕÕÿª°√≥å ‘ËߢÕ߇§√◊ËÕß„¢â¢ÕߺŸâµ‘¥‡™◊ÈÕ §π‰∑¬∑’Ëæ—°Õ“»—¬„πª√–‡∑»∑’Ë¡’°“√√–∫“¥ §«“¡‡ ’ˬߧàÕπ¢â“ߵ˔ ¬°‡«âπ¡’°“√ —¡º— °—∫ “√§—¥À≈—ËߢÕß —µ«åÀ√◊Õ§π∑’˵‘¥‡™◊ÈÕ ¡’§«“¡ ‡ªìπ‰ª‰¥â¢Õß°“√µ‘¥µàÕºà“π∑“ß‡æ» —¡æ—π∏å∑’ˉ¡à‰¥âªÑÕß°—π°—∫ºŸâªÉ«¬∑’ˇæ‘ËßÀ“¬®“°‚√§ Ebola §«“¡‡ ’ˬߢÕߧπ‰∑¬∑’Ë∑”ß“π„π ∂“π欓∫“≈„πª√–‡∑»∑’Ë¡’°“√√–∫“¥ ¡’§«“¡‡ ’ˬߧàÕπ¢â“ß Ÿß„π∫ÿ§≈“°√∑’Ë∑”ß“π„π ∂“π欓∫“≈·≈–Õ“ “ ¡—§√∑’ˉª∑”ß“π „πª√–‡∑»¥—ß°≈à“« ‚¥¬‡©æ“–°≈ÿࡧπ∑’˵âÕߥŸ·≈√—°…“„°≈♑¥°—∫ºŸâªÉ«¬µ‘¥‡™◊ÈÕ‰«√— Ebola °≈ÿà¡ ∫ÿ§≈“°√¥—ß°≈à“«µâÕ߉¥â√—∫°“√·π–π”·≈–ªØ‘∫—µ‘µπµ“¡¢âժؑ∫—µ‘„π°“√√–¡—¥√–«—ߪÑÕß°—πµπ‡Õß „Àâª≈Õ¥¿—¬®“°°“√µ‘¥‡™◊ÈÕÕ¬à“߇¢â¡ß«¥
10.
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Ebola ª√–‡∑»‰∑¬ 25578 3.3 °“√ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ °“√ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ„π°≈ÿà¡π—°∑àÕ߇∑’ˬ«À√◊ÕºŸâ‡¥‘π∑“߉ª¬—ߪ√–‡∑»∑’Ë¡’°“√√–∫“¥ ”À√—∫π—°∑àÕ߇∑’ˬ« ºŸâ‡¥‘π∑“߉ª¬—ߪ√–‡∑»∑’Ë¡’°“√√–∫“¥π—È𠧫“¡‡ ’ˬߡ’§àÕπ¢â“ߵ˔¡“° ·µà¡’¢âÕ√–¡—¥√–«—ߢ—Èπæ◊Èπ∞“π‡æ◊ËÕªÑÕß°—πµπ‡Õß®“°°“√µ‘¥‡™◊ÈÕ ¡’¥—ßπ’È ë À≈’°‡≈’ˬ߰“√ —¡º— °—∫ºŸâªÉ«¬∑’Ë· ¥ßÕ“°“√ ·≈–/À√◊Õ°“√ —¡º— °—∫ “√§—¥À≈—ËߢÕߺŸâªÉ«¬ ë À≈’°‡≈’ˬ߰“√ —¡º— °—∫»æ ·≈–/À√◊Õ “√§—¥À≈—ËߢÕß»æ ë À≈’°‡≈’ˬ߰“√ —¡º— „°≈♑¥°—∫ —µ«åªÉ“ (ª√–°Õ∫¥â«¬ ≈‘ß ·Õ𵑂≈ªªÉ“ ( —µ«å°’∫§ŸàÕ¬Ÿà „π«ß»å«—«·≈–§«“¬) ÀπŸ ·≈–§â“ߧ“«) ‰¡à«à“®–‡ªìπ —µ«å¡’™’«‘µÀ√◊Õ∑’˵“¬·≈â« À√◊Õ∫√‘‚¿§ ‡π◊ÈÕ —µ«åªÉ“ ë ≈â“ßÀ√◊ÕªÕ°‡ª≈◊Õ°º≈‰¡â/ º—° °àÕπ√—∫ª√–∑“π ë ¡’‡æ» —¡æ—π∏å·∫∫ª≈Õ¥¿—¬∑ÿ°§√—Èß ë ≈â“ß¡◊Õ‡ªìπª√–®” °“√ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ„π∫ÿ§≈“°√∑’Ë∑”ß“π„π ∂“π欓∫“≈ °“√µ‘¥‡™◊ÈÕ„π ∂“π欓∫“≈π—Èπ ¡’§«“¡‡ ’ˬߵ—Èß·µàµË”¡“°‰ª®π∂÷ß Ÿß‰¥â ∂â“¡’°“√æ≈“¥æ≈—Èß ®“°°“√‚¥π‡¢Á¡©’¥¬“À√◊Õ‰ª —¡º— °—∫‡¬◊ËÕ‡¡◊Õ° À√◊Õ —¡º— °—∫Õÿª°√≥å∑“ß°“√·æ∑¬å∑’˪π‡ªóôÕπ‡™◊ÈÕ ‡ªìπµâπ ë °“√ªÑÕß°—π∑’ˇÀ¡“– ¡ª√–°Õ∫¥â«¬: ë »÷°…“„À⇢Ⓞ®‡°’ˬ«°—∫°≈ÿà¡Õ“°“√‰¢â‡≈◊Õ¥ÕÕ°®“°°“√µ‘¥‡™◊ÈÕ‰«√— °àÕπ‰ª∑”ß“π„πª√–‡∑» ∑’Ë¡’‚√§‡À≈à“π’ȇ°‘¥¢÷Èπª√–®”∂‘Ëπ ∂â“¡’Õ“°“√º‘¥ª°µ‘„¥Ê ®–‰¥â —߇°µµπ‡Õß·≈–√’∫‡¢â“√—∫ °“√√—°…“∑’Ë ∂“π欓∫“≈ ë ªØ‘∫—µ‘µ“¡¢âժؑ∫—µ‘„π°“√ªÑÕß°—πµπ‡Õß®“°°“√µ‘¥‡™◊ÈÕÕ¬à“߇§√àߧ√—¥ ‚¥¬„™âÕÿª°√≥å ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ·≈–πÈ”¬“¶à“‡™◊ÈÕÕ¬à“߇À¡“– ¡
11.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 9 3.4 ∂“π°“√≥å∑’ˇªìπ‰ª‰¥âµàÕ°“√·æ√à°√–®“¬¢Õ߇™◊ÈÕ‰«√— Ebola „πª√–‡∑»‰∑¬ ∂“π°“√≥å∑’Ë 1: ∫ÿ§§≈∑’˪√–«—µ‘ ß —¬«à“¡’°“√ —¡º— °—∫‡™◊ÈÕ‰«√— Ebola §π‰∑¬∑’ˇ¥‘π∑“߉ªÀ√◊Õ¡’∂‘Ëπæ”π—°„πª√–‡∑»∑’Ë¡’°“√√–∫“¥¢Õß‚√§·≈– ß —¬«à“®–¡’°“√ —¡º— °—∫‡™◊ÈÕ‰«√— Ebola §«√®–‰¥â√—∫°“√ª√–‡¡‘π·≈–æ‘®“√≥“∂÷ß√–¥—∫¢Õߧ«“¡‡ ’ˬߵàÕ°“√ µ‘¥‚√§‚¥¬„™â¢âÕæ‘®“√≥“∑’˪√“°Ø„πµ“√“ß∑’Ë 1 ∂ⓧ«“¡‡ ’ˬߢÕß°“√µ‘¥‚√§Õ¬Ÿà„π√–¥—∫µË”À√◊Õ ª“π°≈“ß ∫ÿ§§≈¥—ß°≈à“«§«√‰¥â√—∫°“√ Õ∫∂“¡≈—°…≥–°“√ —¡º— Õ’°§√—Èß ·≈–µ‘¥µ“¡«—¥Õÿ≥À¿Ÿ¡‘ √à“ß°“¬µ‘¥µàÕ°—π 21 «—π ∂â“¡’§«“¡‡ ’Ë¬ß Ÿß ‡™à𠇪ìπ∫ÿ§≈“°√∑“ß°“√·æ∑¬∑’Ë¡’ª√–«—µ‘‚¥π‡¢Á¡ √–À«à“ß∑”°“√√—°…“ µâÕß∑”°“√µ‘¥µ“¡∫ÿ§§≈¥—ß°≈à“«Õ¬à“ß„°≈♑¥ ·≈–·¬°∫ÿ§§≈π—Èπ‡æ◊ËÕ µ‘¥µ“¡Õ“°“√¢Õß‚√§ ∂“π°“√≥å∑’Ë 2: ∫ÿ§§≈∑’Ë· ¥ßÕ“°“√‡¢â“‰¥â°—∫𑬓¡°“√µ‘¥‡™◊ÈÕ‰«√— Ebola Õ“°“√∑’ˇ¢â“‰¥â°—∫°“√µ‘¥‡™◊ÈÕ‰«√— ª√–°Õ∫¥â«¬ ¡’‰¢â ª«¥‡¡◊ËÕ¬°≈â“¡‡π◊ÈÕ ‡®Á∫°≈â“¡‡π◊ÈÕ ÕàÕπ‡æ≈’¬ ª«¥»’√…– ·≈–‡®Á∫§Õ„π™à«ß√–¬–‡√‘Ë¡·√°¢Õß°“√· ¥ßÕ“°“√ πÕ°®“°π—Èπ·≈â« „π√–¬–‡√‘Ë¡·√°Õ“®· ¥ßÕ“°“√¢Õß√–∫∫∑“߇¥‘πÕ“À“√ ‡™àπ Õ“‡®’¬π ∑âÕ߇ ’¬ ‡∫◊ËÕÕ“À“√ ª«¥∑âÕß À√◊Õ¡’Õ“°“√∑“ß√–∫∫ª√– “∑ ‡™à𠪫¥»’√…– —∫ π ÕàÕπ‡æ≈’¬¡“° À√◊Õ¡’Õ“°“√ ∑“ß√–∫∫‡≈◊Õ¥ ‡™à𠵓·¥ß §Õ·¥ß À√◊Õ¡’Õ“°“√∑“ß√–∫∫º‘«Àπ—ß ‡™àπ ¡’º◊Ëπ·¥ß ·≈–Õ“°“√ √–∫∫∑“߇¥‘πÀ“¬„® ‡™àπ ‰Õ ‡®Á∫Àπâ“Õ° À“¬„®ÀÕ∫ ∂â“∫ÿ§§≈∑’Ë¡’∂‘Ëπæ—°Õ“»—¬À√◊Õ‡æ‘Ë߇¥‘π∑“ß°≈—∫®“°ª√–‡∑»∑’Ë¡’°“√√–∫“¥·≈–¡’Õ“°“√¥—ß°≈à“« „Àâª√–‡¡‘π‚Õ°“ —¡º— ¥—ßπ’È ë ∂â“∫ÿ§§≈¥—ß°≈à“«‰¡à¡’ª√–«—µ‘ —¡º— À√◊Õ¡’ª√–«—µ‘ —¡º— ∑’Ë√–¥—∫§«“¡‡ ’ˬߵ˔¡’§«“¡‡ªìπ‰ª ‰¥â∑’Ë®–‰¥â√—∫°“√µ‘¥‡™◊ÈÕ™π‘¥Õ◊Ë𠇙àπ ¡“‡≈‡√’¬ §«√¡’°“√ Õ∫ «πÀ“ “‡Àµÿ¢Õß°“√‡°‘¥ ‚√§µàÕ‰ª ë ∂â“∫ÿ§§≈¥—ß°≈à“«¡’ª√–«—µ‘ —¡º— ∑’˧«“¡‡ ’ˬß√–¥—∫ª“π°≈“ßÀ√◊Õ ŸßµâÕß¡’°“√·¬°°—°‡æ◊ËÕ µ‘¥µ“¡Õ“°“√Õ¬à“ß„°≈♑¥ ·≈–„ÀâÕ¬Ÿà„πÀâÕß·¬°‚√§ºŸâªÉ«¬µ‘¥‡™◊ÈÕ µ≈Õ¥®π Õ∫ «πÀ“ “‡Àµÿ¢Õß‚√§‚¥¬∑—π∑’
12.
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Ebola ª√–‡∑»‰∑¬ 255710 ∂“π°“√≥å∑’Ë 3: ºŸâ‚¥¬ “√∫π‡§√◊ËÕß∫‘π∑’ˇ¥‘π∑“ß¡“°—∫ºŸâªÉ«¬∑’Ë¡’°“√‡¢â“‰¥â°—∫°“√ µ‘¥‡™◊ÈÕ‰«√— Ebola ≈Ÿ°‡√◊Õ∑’Ëæ∫«à“¡’ºŸâ‚¥¬ “√∑’Ë¡’Õ“°“√ªÉ«¬·≈– ß —¬«à“‡ªìπ‚√§µ‘¥‡™◊ÈÕ¢≥–‚¥¬ “√Õ¬Ÿà∫𠇧√◊ËÕß∫‘π À√◊Õæπ—°ß“π¿“§æ◊Èπ¥‘π∑’Ëæ∫ºŸâ‚¥¬ “√∑’ˇ¥‘π∑“ß∂÷ß®ÿ¥À¡“¬ª≈“¬∑“ß·≈–¡’Õ“°“√ªÉ«¬ ß —¬ „ÀâªØ‘∫—µ‘µ“¡¢âÕ·π–π”°√≥’ ß —¬‚√§µ‘¥µàÕ¢Õß ¡“§¡¢π àß∑“ßÕ“°“»√–À«à“ߪ√–‡∑» (IATA) Õ¬à“߇§√àߧ√—¥ ‡Õ° “√§”·π–π”¥—ß°≈à“«∫Õ°∂÷ß√“¬≈–‡Õ’¬¥¢Õß«‘∏’°“√®—¥°“√ºŸâ‚¥¬ “√ ∑’Ë· ¥ßÕ“°“√ªÉ«¬¢≥–Õ¬Ÿà∫π‡∑’ˬ«∫‘π «‘∏’°“√≈¥§«“¡‡ ’ˬߢÕß°“√·æ√à‚√§ «‘∏’°“√·®â߇Àµÿ°“√≥å „Àâ®ÿ¥À¡“¬ª≈“¬∑“ß∑√“∫ ·≈–«‘∏’°“√∫—π∑÷°√“¬≈–‡Õ’¬¥¢ÕߺŸâ‚¥¬ “√∑’ËÕ¬Ÿà„π∫√‘‡«≥ 1 ·∂«√Õ∫Ê ºŸâ‚¥¬ “√∑’Ë· ¥ßÕ“°“√ªÉ«¬ Àπ૬ߓπ “∏“√≥ ÿ¢À√◊ÕÀπ૬·æ∑¬å©ÿ°‡©‘π§«√‰¥â√—∫°“√·®âß°àÕ𠇧√◊ËÕß∫‘π¡“∂÷ß ‡¡◊ËÕ¡“∂÷ß·≈⫺Ÿâ‚¥¬ “√∑’˪ɫ¬µâÕß∂Ÿ° àßÕ¬Ÿà„πÀâÕß·¬°‡æ◊ËÕª√–‡¡‘πÕ“°“√§≈‘π‘° ‚¥¬∑’¡·æ∑¬å ‡π◊ËÕß®“°Õ“°“√∑“ߧ≈‘π‘°¢Õß°“√µ‘¥‡™◊ÈÕ‰«√— Ebola „π™à«ß·√°‰¡à¡’§«“¡ ™—¥‡®π ·≈–‰¡à “¡“√∂«‘π‘®©—¬·¬°‚√§®“°°“√µ‘¥‡™◊ÈÕ‰«√— Õ◊ËπÊ ‰¥â‚¥¬Õ“»—¬Õ“°“√∑“ߧ≈‘π‘° °“√ª√–‡¡‘π®“°ª√–«—µ‘ —¡º— ®–‡ªìπ·π«∑“ßæ‘®“√≥“ ”§—≠¡“°°«à“°“√ª√–‡¡‘π®“°Õ“°“√∑“ß §≈‘π‘° °“√ª√–‡¡‘πª√–«—µ‘ —¡º— π—Èπ§«√µ√«® Õ∫«à“¿“¬„π 3 —ª¥“Àå∑’˺à“π¡“π—ÈπºŸâ‚¥¬ “√¡’ ª√–«—µ‘¥—ßµàÕ‰ªπ’ÈÀ√◊Õ‰¡à: ë ‡¥‘π∑“߉ª¬—ߪ√–‡∑»∑’Ë¡’°“√√–∫“¥¢Õ߇™◊ÈÕ‰«√— Ebola (®“°¢âÕ¡Ÿ≈ ≥ ªí®®ÿ∫—π «—π∑’Ë 27 ‡¡…“¬π æ.». 2557 °“√√–∫“¥æ∫„πª√–‡∑»°’π’·≈– “∏“√≥√—∞‰≈∫’‡√’¬); ·≈– ë ¡’ª√–«—µ‘ —¡º— °—∫ —µ«åªÉ“∑’˪ɫ¬À√◊Õµ“¬ ¢≥–∑’ËÕ¬Ÿà„πª√–‡∑»π—Èπ; À√◊Õ ë ¥Ÿ·≈ „°≈♑¥ ·≈– —¡º— ºŸâªÉ«¬Àπ—°À√◊ÕºŸâ‡ ’¬™’«‘µ ∂â“¢âÕ∑’ËÀπ÷Ëß µÕ∫ ù„™àû ·≈–µÕ∫„™à„π¢âÕ 2 À√◊Õ 3 π—Èπ „Àâ®—¥«à“‡ªìπºŸâªÉ«¬ ß —¬∑’Ë¡’‚Õ°“ —¡º— °—∫‡™◊ÈÕ‰«√— Ebola „πª√–‡∑»∑’Ë¡’°“√√–∫“¥π—Èπ„π™à«ß 3 —ª¥“Àå∑’˺à“π¡“ „À⥔‡π‘π ¡“µ√°“√∑“ß√–∫“¥«‘∑¬“¢—Èπ Ÿß ÿ¥„π°“√°”Àπ¥„À⇪ìπºŸâªÉ«¬ ß —¬√“¬·√°¥—ßπ’È ºŸâ‚¥¬ “√·≈–≈Ÿ°‡√◊Õ∑’Ë¡’°“√ —¡º— ‚¥¬µ√ß°—∫ºŸâªÉ«¬√“¬·√° ∑ÿ°√“¬µâÕß¡’°“√ ◊∫À“°≈—∫‰ª ‡æ◊ËÕ Õ∫ «π‚√§·≈–‡ΩÑ“µ‘¥µ“¡Õ“°“√
13.
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Ebola ª√–‡∑»‰∑¬ 2557 11 ºŸâ‚¥¬ “√∑’Ë¡’∑’Ëπ—Ëßµ‘¥À√◊ÕÀà“߉ª‡æ’¬ß∑’Ëπ—Ë߇¥’¬«°—∫ºŸâªÉ«¬ ß —¬√“¬·√° ‡π◊ËÕß®“° °“√ —¡º— ‚¥¬µ√߇ªìπ™àÕß∑“ß°“√µ‘¥µàÕ∑’Ë ”§—≠¢Õ߇™◊ÈÕ‰«√— Ebola ºŸâ‚¥¬ “√∑’Ë¡’∑’Ëπ—ËßÀà“߉ª 1 ∑’Ëπ—Ëß®“°ºŸâªÉ«¬ ß —¬√“¬·√°„π∑ÿ°∑‘»∑“ß®–µâÕß∂Ÿ°√«¡Õ¬Ÿà„π√“¬™◊ËÕ∑’˵âÕß Õ∫¬âÕπ°≈—∫ ∂⓺ŸâªÉ«¬ ß —¬√“¬·√°π—Ëß∑’Ëπ—Ëßµ‘¥∑“߇¥‘π ºŸâ‚¥¬ “√§πÕ◊ËπÊ Õ’° 3 ∑’Ëπ—Ëß ∑’Ëπ—ËßÕ¬Ÿàµ√ߢⓡ®“°ºŸâªÉ«¬ ß —¬ √“¬·√°®–∂Ÿ°µ‘¥µ“¡ºŸâ —¡º— ¥—ß· ¥ß„π√Ÿª∑’Ë 1 [4] ≈Ÿ°‡√◊Õ ≈Ÿ°‡√◊Õ∑’Ë∑”Àπâ“∑’Ë∫√‘°“√ºŸâ‚¥¬ “√„π à«π¢ÕߺŸâªÉ«¬ ß —¬√“¬·√°µâÕß∂Ÿ°µ‘¥µ“¡ ºŸâ —¡º— µ≈Õ¥®π≈Ÿ°‡√◊Õ§πÕ◊ËπÊ ∑’Ë¡’°“√ —¡º— ‚¥¬µ√ß°—∫ºŸâªÉ«¬ √Ÿª∑’Ë 1 ∫√‘‡«≥∑’Ëπ—ËߢÕߺŸâ‚¥¬ “√∑’˵âÕ߉¥â√—∫°“√µ‘¥µ“¡‡ªìπºŸâ —¡º— „π°√≥’ ß —¬ °“√µ‘¥‡™◊ÈÕ‰«√— Ebola „πºŸâ‚¥¬ “√‡§√◊ËÕß∫‘𠇮â“Àπâ“∑’Ë∑”§«“¡ –Õ“¥‡§√◊ËÕß∫‘𠇮â“Àπâ“∑’Ë∑’Ë∑”§«“¡ –Õ“¥‡§√◊ËÕß∫‘π∑’˺ŸâªÉ«¬ ß —¬√“¬·√°π—ËßÕ¬Ÿà ·≈–‡®â“Àπâ“∑’Ë∑’Ë∑”§«“¡ –Õ“¥ÀâÕßπÈ”§«√®–‰¥â√—∫°“√µ‘¥µ“¡ºŸâ —¡º— °“√µ‘¥µ“¡ºŸâ —¡º— ºŸâ‚¥¬ “√ ≈Ÿ°‡√◊Õ ·≈–‡®â“Àπâ“∑’Ë∑”§«“¡ –Õ“¥ „πºŸâ —¡º— ∑ÿ°√“¬ µâÕßµ‘¥µ“¡«—¥Õÿ≥À¿Ÿ¡‘¥â«¬µπ‡Õßµ‘¥µàÕ°—π 21 «—π ·≈–°√Õ°¢âÕ¡Ÿ≈„πª√–«—µ‘ºŸâ —¡º— „Àâ§√∫∂â«π ¥—ß· ¥ß„π·π«∑“ß°“√µ‘¥µ“¡ºŸâ —¡º— (√Ÿª∑’Ë 2) [4]
14.
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Ebola ª√–‡∑»‰∑¬ 255712 √Ÿª∑’Ë 2 ·π«∑“ß°“√µ‘¥µ“¡ºŸâ —¡º— „π°√≥’æ∫ºŸâªÉ«¬ ß —¬µ‘¥‡™◊ÈÕ‰«√— Ebola ·®â߇Àµÿ°“√≥å ß —¬ ‡ªìπºŸâªÉ«¬‡¢â“¢à“¬À√◊Õ¬◊π¬—π°“√µ‘¥‡™◊ÈÕ ß —¬µ‘¥‡™◊ÈÕ ‰¡àµâÕßµ‘¥µ“¡ºŸâ —¡º— · ¥ßÕ“°“√ªÉ«¬¢≥–‚¥¬ “√Õ¬Ÿà∫π‡§√◊ËÕß∫‘π ß —¬µ‘¥‡™◊ÈÕ ¡’Õ“°“√¿“¬„π 21 «—πÀ≈—ß®“°‚¥¬ “√ °“√®”·π°ºŸâªÉ«¬ µ‘¥µ“¡ºŸâ —¡º— : - ºŸâ‚¥¬ “√ +/- 1 ∑’Ëπ—Ëß - ≈Ÿ°‡√◊Õ∫π‡§√◊ËÕß∫‘π∑’Ë∑”Àπâ“∑’Ë¥Ÿ·≈ Index case - ‡®â“Àπâ“∑’Ë∑”§«“¡ –Õ“¥∫π‡§√◊ËÕß∫‘π - ºŸâ‚¥¬ “√·≈–≈Ÿ°‡√◊Õ∑’Ë¡’°“√ —¡º— ‚¥¬µ√ß°—∫ Index case ¡’°“√ —¡º— °—∫ ‘Ëߧ—¥À≈—ËߢÕߺŸâªÉ«¬ √–À«à“ß‚¥¬ “√‡§√◊ËÕß∫‘π ‰¡àµâÕßµ‘¥µ“¡ºŸâ —¡º— ‰¡àµâÕßµ‘¥µ“¡ºŸâ —¡º— ‰¡àµâÕßµ‘¥µ“¡ºŸâ —¡º— ‰¡à„™à „™à „™à „™à Ebola Marburg ºŸâªÉ«¬‡¢â“¢à“¬ „™à Lassa ‡°Á∫√«¡√«¡¢âÕ¡Ÿ≈ºŸâ‚¥¬ “√·≈–´—°∂“¡ Õ¬à“ß≈–‡Õ’¬¥∂÷߇Àµÿ°“√≥å„π‡∑’ˬ«∫‘ππ—Èπ ‰¡à„™à ‰¡à„™à ‰¡à„™à ºŸâªÉ«¬¬◊π¬—π
15.
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Ebola ª√–‡∑»‰∑¬ 2557 13 ‡π◊ËÕß®“°„π°≈ÿà¡Õ“°“√‰¢â‡≈◊Õ¥ÕÕ° (Hemorrhagic fever) ‰¥â·°à‚√§ Ebola ·≈– Marburg ¡’ Õ“°“√§≈⓬§≈÷ß°—π Õߧ尓√Õπ“¡—¬‚≈°‰¥â°”Àπ¥π‘¬“¡‡æ◊ËÕ°“√‡ΩÑ“√–«—ß‚√§∑—Èß Ebola ·≈– Marburg √à«¡°—π [5] „π·µà≈–√Ÿª·∫∫¥—ßπ’È 4.1 𑬓¡ºŸâ —¡º— ‚√§ 𑬓¡ºŸâ —¡º— ‚√§ “¡“√∂ª√—∫‡ª≈’ˬπ‰¥â¢÷ÈπÕ¬Ÿà°—∫ªí®®—¬‡ ’ˬߢÕß°“√µ‘¥‡™◊ÈÕ∑’Ëæ∫„π°“√ √–∫“¥·µà≈–§√—Èß ºŸâ —¡º— ºŸâªÉ«¬‚√§ Ebola À¡“¬∂÷ß ºŸâ∑’Ë —¡º— °—∫ºŸâªÉ«¬‚√§ Ebola ¥â«¬°√≥’µàÕ‰ªπ’È Õ¬à“ßπâÕ¬Àπ÷Ëß°√≥’ ¿“¬„π 21 «—π°àÕπ¡’Õ“°“√ªÉ«¬ ë Õ“»—¬Õ¬Ÿà„π∫â“π‡¥’¬«°—∫ºŸâªÉ«¬ ë ¥Ÿ·≈ºŸâªÉ«¬Õ¬à“ß„°≈♑¥·≈– —¡º— °—∫‡≈◊Õ¥À√◊Õ “√§—¥À≈—Ëß®“°√à“ß°“¬ºŸâªÉ«¬À√◊Õ‡ ◊Èպⓠ¢ÕߺŸâªÉ«¬ ë —¡º— °—∫√à“ߺŸâ‡ ’¬™’«‘µ¢≥–®—¥°“√»æÀ√◊Õ√–À«à“ßß“π»æ ë ∑“√°∑’Ë¥Ÿ¥π¡¡“√¥“∑’˪ɫ¬¥â«¬‚√§ Ebola ºŸâ —¡º— —µ«åªÉ«¬À√◊Õµ“¬ À¡“¬∂÷ß ºŸâ∑’Ë —¡º— °—∫ —µ«åªÉ«¬À√◊Õµ“¬¥â«¬°√≥’µàÕ‰ªπ’È Õ¬à“ßπâÕ¬Àπ÷Ëß°√≥’ ¿“¬„π 21 «—π°àÕπ¡’Õ“°“√ªÉ«¬ ë —¡º— °—∫ —µ«åªÉ«¬À√◊Õµ“¬ (‚¥¬‡©æ“– ≈‘ß·Õ𵑂≈ªªÉ“ ( —µ«å°’∫§ŸàÕ¬Ÿà„π«ß»å«—«·≈–§«“¬) ÀπŸ ·≈–§â“ߧ“«) ë —¡º— °—∫‡≈◊Õ¥À√◊Õ “√§—¥À≈—Ëß®“°√à“ß°“¬¢Õß —µ«åªÉ«¬À√◊Õµ“¬ ë ™”·À≈– —µ«åµ“¬ ë √—∫ª√–∑“π‡π◊ÈÕ —µ«åªÉ“¥‘∫ ºŸâªØ‘∫—µ‘ß“π„πÀâÕߪؑ∫—µ‘°“√µ√«®À“‡™◊ÈÕ°àÕ‚√§À¡“¬∂÷ߺŸâªØ‘∫—µ‘ß“π„πÀâÕߪؑ∫—µ‘°“√ µ√«®À“‡™◊ÈÕ°àÕ‚√§ ·≈–‰¥â —¡º— µ—«Õ¬à“ß àßµ√«®¥â«¬°√≥’µàÕ‰ªπ’ÈÕ¬à“ßπâÕ¬Àπ÷Ëß°√≥’ ¿“¬„π 21 «—π°àÕπ¡’Õ“°“√ªÉ«¬ ë —¡º— µ—«Õ¬à“ß àßµ√«®®“°ºŸâªÉ«¬ ß —¬‚√§ Ebola ë —¡º— µ—«Õ¬à“ß àßµ√«®®“° —µ«åªÉ«¬ ß —¬‚√§ Ebola 𑬓¡ ”À√—∫°“√‡ΩÑ“√–«—ß (Case definition for surveillance)4
16.
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Ebola ª√–‡∑»‰∑¬ 255714 4.2 °“√‡ΩÑ“√–«—ß„π√–∫∫ª°µ‘ (Routine surveillance) ºŸâªÉ«¬ ß —¬ (Suspected case) À¡“¬∂÷ß ºŸâ∑’ˇ¥‘π∑“߉ª¬—ߪ√–‡∑»∑’Ë¡’°“√√–∫“¥¢Õß ‡™◊ÈÕ‰«√— Ebola (®“°¢âÕ¡Ÿ≈ ≥ ªí®®ÿ∫—π «—π∑’Ë 27 ‡¡…“¬π æ.». 2557 °“√√–∫“¥æ∫„πª√–‡∑»°’π’ ·≈– “∏“√≥√—∞‰≈∫’‡√’¬) ·≈–¢≥–∑’ËÕ¬Ÿà„πª√–‡∑»π—Èπ¡’ª√–«—µ‘ —¡º— ¥—ßπ’È ë ¡’ª√–«—µ‘ —¡º— °—∫ —µ«åªÉ“∑’˪ɫ¬À√◊Õµ“¬ À√◊Õ ë ¥Ÿ·≈„°≈♑¥·≈– —¡º— ºŸâªÉ«¬Àπ—°À√◊ÕºŸâ‡ ’¬™’«‘µ √à«¡°—∫¡’Õ“°“√‰¢â·≈–‰¡àµÕ∫ πÕßµàÕ°“√√—°…“Õ“°“√‰¢â∑’ˇ§¬æ∫·≈–∑’ˇ§¬√—°…“Õ¬Ÿà„π æ◊Èπ∑’Ëπ—Èπ ·≈–¡’Õ“°“√‡≈◊Õ¥ÕÕ°º‘¥ª°µ‘„πÕ«—¬«–µà“ßÊ ‡™àπ ∂à“¬Õÿ®®“√–À√◊ÕÕ“‡®’¬π‡ªìπ‡≈◊Õ¥ ¥ ‡≈◊Õ¥ÕÕ°®“°®¡Ÿ° ‡≈◊Õ¥ÕÕ°µ“¡‰√øíπ ‡≈◊Õ¥ÕÕ°„µâº‘«Àπ—ß ‡≈◊Õ¥ÕÕ°„𵓷≈–„πªí “«– ºŸâªÉ«¬¬◊π¬—π (Confirmed case) À¡“¬∂÷ß ºŸâªÉ«¬ ß —¬∑’Ë¡’º≈°“√µ√«®∑“ßÀâÕߪؑ∫—µ‘°“√ ¬◊π¬—𠇙àπ º≈°“√µ√«®¿Ÿ¡‘§ÿâ¡°—π™π‘¥ IgM À√◊Õµ√«®¥â«¬«‘∏’ªØ‘°‘√‘¬“≈Ÿ°‚´àæÕ≈‘‡¡Õ‡√ (Polymerase chain reaction, PCR) À√◊Õ°“√·¬°‡™◊ÈÕ‰«√— (viral isolation) „Àâº≈∫«° ¢âÕ°”Àπ¥ ‡¡◊ËÕæ∫ºŸâªÉ«¬ ß —¬ 1. „Àâ√“¬ß“π∑’¡‡ΩÑ“√–«—ß Õ∫ «π‚√§∑—π∑’ 2. „À⇰Á∫µ—«Õ¬à“ß®“°ºŸâªÉ«¬‡æ◊ËÕ àßµ√«®∑“ßÀâÕߪؑ∫—µ‘°“√ 3. ∫—π∑÷°¢âÕ¡Ÿ≈ºŸâªÉ«¬ ß —¬≈ß„π·∫∫√“¬ß“π/·∫∫ Õ∫ «πæ√âÕ¡™◊ËÕºŸâ —¡º— °—∫ºŸâªÉ«¬ ß —¬ 4. ∂⓺ŸâªÉ«¬‡ ’¬™’«‘µ ·π–π”„Àâ®—¥°“√»æÀ√◊Õß“π»æ¥â«¬«‘∏’°“√∑’˪≈Õ¥¿—¬®“°°“√·æ√à °√–®“¬‡™◊ÈÕ À√◊Õ¡’∑’¡™à«¬®—¥°“√»æ„Àâ ‡æ◊ËÕ„Àâ¡—Ëπ„®«à“®–‰¡à¡’°“√·æ√à°√–®“¬‡™◊ÈÕ
17.
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Ebola ª√–‡∑»‰∑¬ 2557 15 4.3 °“√‡ΩÑ“√–«—ß√–À«à“ß°“√√–∫“¥ 𑬓¡°“√√“¬ß“π‚√§ “¡“√∂ª√—∫‡ª≈’ˬπ‰¥â¢÷ÈπÕ¬Ÿà°—∫≈—°…≥–Õ“°“√·≈–°“√∂à“¬∑Õ¥‚√§ ∑’ˇ°‘¥¢÷Èπ„π°“√√–∫“¥·µà≈–§√—Èß 4.3.1 𑬓¡°“√√“¬ß“π‚√§ ”À√—∫∑’¡‡§≈◊ËÕπ∑’ˇ√Á«À√◊Õ ∂“π’Õπ“¡—¬À√◊Õ‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æµ”∫≈ ºŸâªÉ«¬ ß —¬ (Suspected case) À¡“¬∂÷ߺŸâªÉ«¬À√◊ÕºŸâ‡ ’¬™’«‘µ∑’Ë¡’Õ“°“√‰¢â Ÿß ‡©’¬∫æ≈—π ·≈–¡’ª√–«—µ‘ —¡º— °—∫ ë ºŸâªÉ«¬ ß —¬ ºŸâªÉ«¬‡¢â“¢à“¬ À√◊ÕºŸâªÉ«¬¬◊π¬—π‚√§ Ebola ë —µ«åªÉ«¬À√◊Õµ“¬®“°‚√§ Ebola À√◊Õ ºŸâ∑’Ë¡’Õ“°“√‰¢â Ÿß‡©’¬∫æ≈—π ·≈–Õ“»—¬Õ¬Ÿà„πµ”∫≈∑’Ëæ∫ºŸâªÉ«¬‡¢â“¢à“¬À√◊ÕºŸâªÉ«¬ ¬◊π¬—π‚√§ Ebola ·≈–¡’Õ“°“√· ¥ßÕ¬à“ßπâÕ¬ 3 Õ“°“√µàÕ‰ªπ’È ë ª«¥»’√…– ë Õ“‡®’¬π ë ‡∫◊ËÕÕ“À“√ ë ∂à“¬‡À≈« ë ‡´◊ËÕß´÷¡ ë ª«¥∑âÕß ë ª«¥°≈â“¡‡π◊ÈÕ ª«¥¢âÕ ë °≈◊π≈”∫“° ë À“¬„®≈”∫“° ë –Õ÷°
18.
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Ebola ª√–‡∑»‰∑¬ 255716 À√◊Õ ºŸâªÉ«¬∑’Ë¡’Õ“°“√‰¢â Ÿß‡©’¬∫æ≈—π·≈–¡’Õ“°“√‡≈◊Õ¥ÕÕ°∑’ËÀ“ “‡Àµÿ‰¡à‰¥â·≈– Õ“»—¬Õ¬Ÿà„πµ”∫≈∑’Ëæ∫ºŸâªÉ«¬‡¢â“¢à“¬À√◊ÕºŸâªÉ«¬¬◊π¬—π‚√§ Ebola À√◊ÕºŸâ‡ ’¬™’«‘µ©—∫æ≈—πÕ¬à“߉¡à∑√“∫ “‡Àµÿ·≈–Õ“»—¬Õ¬Ÿà„πµ”∫≈∑’Ëæ∫ºŸâªÉ«¬‡¢â“¢à“¬ À√◊ÕºŸâªÉ«¬¬◊π¬—π‚√§ Ebola 4.3.2 𑬓¡°“√√“¬ß“π‚√§ ”À√—∫∑’¡‡ΩÑ“√–«—ß Õ∫ «π‚√§„π‚√ß欓∫“≈ ºŸâªÉ«¬‡¢â“¢à“¬ (Probable case) À¡“¬∂÷ß ºŸâªÉ«¬∑’ˇ¢â“𑬓¡ºŸâªÉ«¬ ß —¬∑’ˉ¥â√—∫ °“√«‘π‘®©—¬‚¥¬·æ∑¬å À√◊ÕºŸâªÉ«¬ ß —¬∑’ˇ ’¬™’«‘µ (‡ªìπ°√≥’∑’ˉ¡à “¡“√∂‡°Á∫µ—«Õ¬à“ß àßµ√«®¬◊π¬—π ∑“ßÀâÕߪؑ∫—µ‘°“√‰¥â) ·≈–¡’ª√–«—µ‘ —¡º— °—∫ºŸâªÉ«¬¬◊π¬—π ºŸâªÉ«¬¬◊π¬—π (Laboratory confirmed case) À¡“¬∂÷ß ºŸâªÉ«¬ ß —¬À√◊ÕºŸâªÉ«¬ ‡¢â“¢à“¬∑’Ë¡’º≈°“√µ√«®∑“ßÀâÕߪؑ∫—µ‘°“√„Àâº≈∫«°¢Õ߉«√— ·Õ𵑇®π ‚¥¬µ√«®æ∫ RNA virus ¥â«¬«‘∏’ reverse transcriptase-polymerase chain reaction (RT-PCR) À√◊Õ„Àâº≈∫«°¢Õß IgM ·Õπµ‘∫Õ¥’µàÕ‡™◊ÈÕ Ebola ‰¡à‡ªìπºŸâªÉ«¬ (Non-case) À¡“¬∂÷ߺŸâªÉ«¬ ß —¬À√◊ÕºŸâªÉ«¬‡¢â“¢à“¬∑’Ë¡’º≈°“√µ√«® ∑“ßÀâÕߪؑ∫—µ‘°“√„Àâº≈≈∫ ‰¡àæ∫·Õπµ‘∫Õ¥’‡©æ“– À√◊Õ‰¡àæ∫ RNA ¢Õ߇™◊ÈÕ‰«√— ·Õ𵑇®π **µ—«Õ¬à“ߺŸâªÉ«¬∑’Ë àßµ√«®∑“ßÀâÕߪؑ∫—µ‘°“√‡ªìπµ—«Õ¬à“ß∑’ˇ°Á∫„π™à«ß‡«≈“∑’˺ŸâªÉ«¬¡’Õ“°“√ªÉ«¬
19.
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Ebola ª√–‡∑»‰∑¬ 2557 17 5.1 ·π«∑“ß°“√ Õ∫ «πºŸâªÉ«¬ ß —¬‚√§ Ebola °√≥’∑’Ë¡’ºŸâªÉ«¬∑’Ë ß —¬«à“ªÉ«¬¥â«¬‚√§ Ebola ‚¥¬Õ“»—¬‡°≥±å„π°“√«‘π‘®©—¬‡æ◊ËÕ°“√‡ΩÑ“√–«—ß ‚√§∑’ˉ¥â°≈à“«‰«â·≈â« „Àâ√’∫√“¬ß“πºŸâªÉ«¬‰ª¬—ßß“π√–∫“¥«‘∑¬“ ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥ ·≈– àß√“¬≈–‡Õ’¬¥‡∫◊ÈÕßµâπ‰ª¬—ß ”π—°√–∫“¥«‘∑¬“∑—π∑’ ¿“¬„π 24 ™—Ë«‚¡ß‚¥¬„™â·∫∫øÕ√å¡∑’Ë 1: ·∫∫ Õ∫ «πºŸâªÉ«¬ ß —¬µ‘¥‡™◊ÈÕ‰«√— Ebola (√Ÿª∑’Ë 3 ·≈– 4) ‡æ◊ËÕ‡µ√’¬¡æ√âÕ¡„π°“√ÕÕ° Õ∫ «π ‚√§·≈–ª√– “πß“π°—∫ÀâÕß™—π Ÿµ√„Àâæ√âÕ¡À≈—ß®“° ”π—°√–∫“¥«‘∑¬“‰¥â√—∫√“¬ß“π„Àâª√– “π °—∫ ”π—°ß“πªÑÕß°—π·≈–§«∫§ÿ¡‚√§‡¢µ ‡æ◊ËÕ√à«¡°—πÕÕ°‰ª¥”‡π‘π°“√ Õ∫ «π ‡°Á∫µ—«Õ¬à“ß àßµ√«® §«∫§ÿ¡ªÑÕß°—π‚√§„π∑—π∑’ ·≈–‡ΩÑ“√–«—ß‚√§Õ¬à“ß„°≈♑¥µàÕ‰ªÕ’°‡ªìπ‡«≈“‰¡àπâÕ¬°«à“ 42 «—𠇧√◊ËÕß¡◊Õ∑’Ë„™â„π°“√¥”‡π‘π°“√ Õ∫ «π‚√§π’ȉ¥â∂Õ¥§«“¡®“°·∫∫ Õ∫ «π¢ÕßÕߧ尓√ Õπ“¡—¬‚≈° [6] ‚¥¬ “√–¡’¥—ßµàÕ‰ªπ’È √Ÿª∑’Ë 3 ·π«∑“ß°“√√“¬ß“π·≈– Õ∫ «πºŸâªÉ«¬°√≥’∑’ˬ—߉¡à¡’ºŸâªÉ«¬„πª√–‡∑»‰∑¬ °“√ Õ∫ «π‚√§5 ºŸâªÉ«¬ ß —¬‚√§Õ’‚∫≈“ µ“¡π‘¬“¡°“√‡ΩÉâ“√–«—ß„π¢âÕ 4.2 ”π—°ß“πªÑÕß°—𠧫∫§ÿ¡‚√§ ‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æµ”∫≈/»Ÿπ¬å∫√‘°“√ “∏“√≥ ÿ¢ ß“π√–∫“¥«‘∑¬“ ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥ ”π—°√–∫“¥«‘∑¬“ Õ∫ «π ∫—π∑÷°¢âÕ¡Ÿ≈„π·∫∫øÕ√å¡ 1 ·≈–√“¬ß“πºŸâªÉ«¬∑—π∑’ √“¬ß“π¿“¬„π 24 ™—Ë«‚¡ß √“¬ß“π¿“¬„π 24 ™—Ë«‚¡ß ‚√ß欓∫“≈»Ÿπ¬å/‚√ß欓∫“≈∑—Ë«‰ª/‚√ß欓∫“≈™ÿ¡™π
20.
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Ebola ª√–‡∑»‰∑¬ 255718 √Ÿª∑’Ë 4 ·π«∑“ß°“√√“¬ß“π·≈– Õ∫ «πºŸâªÉ«¬°√≥’∑’Ë¡’°“√√–∫“¥„πª√–‡∑»‰∑¬ ºŸâªÉ«¬‡¢â“¢à“¬À√◊ÕºŸâªÉ«¬¬◊π¬—π‚√§Õ’‚∫≈“ µ“¡π‘¬“¡°“√‡ΩÉâ“√–«—ß„π¢âÕ 4.3.2 ºŸâªÉ«¬ ß —¬‚√§Õ’‚∫≈“ µ“¡π‘¬“¡°“√‡ΩÉâ“√–«—ß„π¢âÕ 4.3.1 ”π—°ß“πªÑÕß°—𠧫∫§ÿ¡‚√§ ‚√ß欓∫“≈ à߇ √‘¡ ÿ¢¿“æµ”∫≈/»Ÿπ¬å∫√‘°“√ “∏“√≥ ÿ¢ ß“π√–∫“¥«‘∑¬“ ”π—°ß“π “∏“√≥ ÿ¢®—ßÀ«—¥ ”π—°√–∫“¥«‘∑¬“ Õ∫ «π ∫—π∑÷°¢âÕ¡Ÿ≈„π·∫∫øÕ√å¡ 1 ·≈–√“¬ß“πºŸâªÉ«¬∑—π∑’ √“¬ß“π¿“¬„π 24 ™—Ë«‚¡ß √“¬ß“π¿“¬„π 24 ™—Ë«‚¡ß ‚√ß欓∫“≈»Ÿπ¬å/‚√ß欓∫“≈∑—Ë«‰ª/‚√ß欓∫“≈™ÿ¡™π
21.
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Ebola ª√–‡∑»‰∑¬ 2557 19 ·∫∫øÕ√å¡∑’Ë 1: ·∫∫ Õ∫ «πºŸâªÉ«¬ ß —¬µ‘¥‡™◊ÈÕ‰«√— Ebola «—π∑’Ë............/................./................ 1. √“¬≈–‡Õ’¬¥ºŸâªÉ«¬ ™◊ËÕ.................................................................................................................................‡≈¢∑’˺ŸâªÉ«¬......................................... Õ“¬ÿ.....................«—π‡¥◊Õπªï‡°‘¥..................................................‡æ»..................Õ“™’æ.......................................................... ∑’ËÕ¬Ÿà.......................................................................................................................................................................................... ™◊ËÕ‡®â“¢Õß∫â“π....................................................™◊ËÕ∫‘¥“/¡“√¥“(°√≥’ºŸâªÉ«¬‡¥Á°).................................................................. ‡∫Õ√å‚∑√..............................................................À√◊Õ«‘∏’°“√µ‘¥µàÕÕ¬à“ßÕ◊Ëπ‡™àπÕ’‡¡≈å.............................................................. ‚√ß欓∫“≈........................................................ ∑’ËÕ¬Ÿà............................................................................................................. «—π√—∫√—°…“......................................................... «—π®”Àπà“¬................................................................................................. ∑√“∫«à“¡’ºŸâªÉ«¬√“¬π’È®“°·À≈àß„¥ [ ] ¢à“«≈◊Õ [ ] °“√‡ ’¬™’«‘µ [ ] ºŸâªÉ«¬‡¢â“√—∫°“√√—°…“„π‚√ß欓∫“≈ [ ] §âπÀ“ºŸâªÉ«¬„π™ÿ¡™π 2. Õ“°“√∑“ߧ≈‘π‘° [ ] ºŸâªÉ«¬„π [ ] ºŸâªÉ«¬πÕ° [ ] ¡’™’«‘µ [ ] ‡ ’¬™’«‘µ «—π∑’ˇ ’¬™’«‘µ.................................................................................................. [ ] ¡’‰¢â Ÿß Õÿ≥À¿Ÿ¡‘·√°√—∫ .....Õß»“‡´≈‡´’¬ Õÿ≥À¿Ÿ¡‘ Ÿß ÿ¥.....Õß»“‡´≈‡´’¬ [ ] ‰¡à¡’‰¢â............ [ ] ‰¡à∑√“∫ «—π∑’Ë∑” post-mortem skin biopsy............................................................................................................................................ 𑬓¡ºŸâªÉ«¬: [ ] ºŸâªÉ«¬ ß —¬ [ ] ºŸâªÉ«¬‡¢â“¢à“¬ [ ] ‰¡à‡ªìπºŸâªÉ«¬ ¡’ºŸâªÉ«¬√“¬Õ◊Ëπ∑’ËÕ“»—¬Õ¬Ÿà„π≈–·«°„°≈⇧’¬ß°—∫ºŸâªÉ«¬√“¬π’ÈÀ√◊Õ‰¡à [ ] ¡’ [ ] ‰¡à¡’ æ∫ºŸâªÉ«¬√“¬„À¡à™◊ËÕ............................................ π“¡ °ÿ≈..................................................«—π‡√‘Ë¡ªÉ«¬................................ Õ“°“√¢ÕߺŸâªÉ«¬......................................................................................................................................................................
22.
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Ebola ª√–‡∑»‰∑¬ 255720 √–∫ÿÕ“°“√·≈–Õ“°“√· ¥ß¢ÕߺŸâªÉ«¬ °≈ÿà¡„™àÕ“°“√·≈–Õ“°“√· ¥ß«—π∑’˪ɫ¬¢âÕ —߇°µÕ◊ËπÊ 1234567891011121314 Aª«¥»’√…– §≈◊Ëπ‰ â/Õ“‡®’¬π ‡∫◊ËÕÕ“À“√ ∂à“¬‡À≈« ÕàÕπ‡æ≈’¬ ª«¥∑âÕß ª«¥‡¡◊ËÕ¬°≈â“¡‡π◊ÈÕ °≈◊π≈”∫“° À“¬„®≈”∫“° –Õ÷° Õ◊ËπÊ√–∫ÿ..................................... °≈ÿà¡„™àÕ“°“√·≈–Õ“°“√· ¥ß¢âÕ —߇°µÕ◊ËπÊ B¡’‡≈◊Õ¥ÕÕ°µ“¡‡Àß◊Õ° µ“·¥ß ¡’®ÿ¥·¥ß∑’˺‘«Àπ—ß Õÿ®®“√–¡’‡≈◊Õ¥ªπ Õ“‡®’¬π¡’‡≈◊Õ¥ªπ ‡≈◊Õ¥°”‡¥“ Õ◊ËπÊ
23.
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Ebola ª√–‡∑»‰∑¬ 2557 21 3. ª√–«—µ‘ —¡º— ¿“¬„π 21 «—π°àÕπ¡’Õ“°“√ªÉ«¬ —¡º— °—∫ºŸâªÉ«¬ ß —¬‚√§ Ebola ‡π◊ËÕß®“°‡ªìπ ¡“™‘°„π∫â“π [ ] „™à...................... [ ] ‰¡à„™à................. [ ] ‰¡à∑√“∫............... ™◊ËÕºŸâ∑’˺ŸâªÉ«¬ —¡º— ................................................................................................................................................. §«“¡ —¡æ—π∏凰’ˬ«¢âÕß°—∫ºŸâªÉ«¬........................................................................................................................... «—π∑’Ë —¡º— §√—Èß ÿ¥∑⓬........................................................................................................................................... ™π‘¥·≈–√–¬–‡«≈“¢Õß°“√ —¡º— ......................................................................................................................... —¡º— °—∫ºŸâªÉ«¬ ß —¬‚√§ Ebola ‡π◊ËÕß®“°‡ªìπ∫ÿ§≈“°√∑“ß°“√·æ∑¬å [ ] „™à.......................... [ ] ‰¡à„™à................. [ ] ‰¡à∑√“∫......................... ™◊ËÕºŸâ∑’˺ŸâªÉ«¬ —¡º— ................................................................................................................................................. «—π∑’Ë —¡º— §√—Èß ÿ¥∑⓬........................................................................................................................................... ·≈–√–¬–‡«≈“¢Õß°“√ —¡º— ................................................................................................................................ ∂“π欓∫“≈∑’Ë —¡º— ...............................................®—ßÀ«—¥...............................Õ”‡¿Õ.................................... —¡º— °—∫ºŸâªÉ«¬ ß —¬‚√§ Ebola ‡π◊ËÕß®“°‡ªìπºŸâ√à«¡‡¥‘π∑“ß [ ] „™à.......................... [ ] ‰¡à„™à................. [ ] ‰¡à∑√“∫......................... ™◊ËÕºŸâ∑’˺ŸâªÉ«¬ —¡º— ................................................................................................................................................. «—π∑’Ë —¡º— §√—Èß ÿ¥∑⓬........................................................................................................................................... ·≈–√–¬–‡«≈“¢Õß°“√ —¡º— ................................................................................................................................ ‡ âπ∑“ß∑’ˇ¥‘π∑“ß......................................................................«—π∑’ˇ¥‘π∑“ß.......................................................... —¡º— °—∫ —µ«åªÉ«¬À√◊Õµ“¬ (‚¥¬‡©æ“– ≈‘ß ·Õ𵑂≈ªªÉ“ ( —µ«å°’∫§ŸàÕ¬Ÿà„π«ß»å«—«·≈–§«“¬) ÀπŸ ·≈–§â“ߧ“«) [ ] „™à.......................... [ ] ‰¡à„™à................. [ ] ‰¡à∑√“∫......................... ™π‘¥ —µ«å∑’Ë —¡º— .................................................................................................................................................... «—π∑’Ë —¡º— .............................................................................................................................................................. ™π‘¥·≈–√–¬–‡«≈“¢Õß°“√ —¡º— ......................................................................................................................... ∂“π∑’Ë∑’Ë —¡º— (‡™àπ µÕπ‡¥‘π∑“߉ª·Õø√‘°“ À√◊Õ¢≥–Õ¬Ÿà„πª√–‡∑»‰∑¬)...................................................... .................................................................................................................................................................................................. ™◊ËÕ·æ∑¬åºŸâ√—°…“/ ™◊ËÕ‚√ß欓∫“≈........................................................................................................................................... «—π∑’Ë.......................................................................................................................................................................................... 4. °“√µ√«®∑“ßÀâÕߪؑ∫—µ‘°“√ µ—«Õ¬à“ß∑’Ë 1 ™π‘¥µ—«Õ¬à“ß................................«‘∏’°“√µ√«®..................................... ∂“π∑’Ë àßµ√«®.................................... «—π∑’Ë................................................º≈..................................................................................................................................... µ—«Õ¬à“ß∑’Ë 2 ™π‘¥µ—«Õ¬à“ß................................«‘∏’°“√µ√«®..................................... ∂“π∑’Ë àßµ√«®.................................... «—π∑’Ë..................................................º≈................................................................................................................................... 5. ¢âÕ§‘¥‡ÀÁπ .................................................................................................................................................................................................. .................................................................................................................................................................................................. ..................................................................................................................................................................................................
24.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 255722 5.2 °“√µ‘¥µ“¡ºŸâªÉ«¬·≈–ºŸâ —¡º— ‡¡◊ËÕ‰¥â√—∫√“¬ß“πºŸâªÉ«¬ „Àâ∫—π∑÷°¢âÕ¡Ÿ≈≈ß„π·∫∫√“¬ß“π∑ÿ°√“¬ ‚¥¬‰¡àµâÕߧ”π÷ß∂÷ß °“√®”·π°ºŸâªÉ«¬«à“‡ªìπºŸâªÉ«¬ ß —¬À√◊ÕºŸâªÉ«¬‡¢â“¢à“¬ ·≈–‡°Á∫√“¬ß“ππ—Èπ‰«â∑’Ë ∂“π∫√‘°“√ “∏“√≥ ÿ¢‡æ◊ËÕµ‘¥µ“¡ª√–‡¡‘π°“√√–∫“¥ à«πºŸâ —¡º— ®–µâÕßµ‘¥µ“¡ —߇°µÕ“°“√ ·≈–√“¬ß“π µàÕ‡®â“Àπâ“∑’Ë “∏“√≥ ÿ¢‡¡◊ËÕºŸâ —¡º— ¡’Õ“°“√‰¢â ‚¥¬∫—π∑÷°Õÿ≥À¿Ÿ¡‘ 2 §√—Èß„π 1 «—𠇪ìπ‡«≈“ 21 «—πÀ≈—ß®“°ª√–«—µ‘ —¡º— §√—Èß ÿ¥∑⓬ „πºŸâ —¡º— ∑’Ë¡’Õÿ≥À¿Ÿ¡‘√à“ß°“¬¡“°°«à“ 38.5 ÌC (101 ÌF) „Àâ®—¥‡ªìπºŸâªÉ«¬„À¡à·≈–·¬°ÕÕ°®“°ºŸâÕ◊Ëπ „Àⵑ¥µ“¡ºŸâ —¡º— √à«¡∫â“π¢ÕߺŸâªÉ«¬∑ÿ°√“¬‚¥¬„™â·∫∫ øÕ√å¡∑’Ë 2: ·∫∫∫—π∑÷°ª√–«—µ‘ºŸâ —¡º— ºŸâªÉ«¬‚√§ Ebola [7] ‡¡◊ËÕ¡’Õ“°“√ªÉ«¬„Àâ®—¥‡¢â“‡ªìπºŸâªÉ«¬ ·≈–„™â·∫∫øÕ√å¡∑’Ë 3: ·∫∫√“¬ß“π‡ΩÑ“√–«—߇™‘ß√ÿ°¢ÕߺŸâªÉ«¬ ß —¬‚√§ Ebola [6] ∫—π∑÷°¢âÕ¡Ÿ≈°“√ ‡ΩÑ“√–«—ß„πæ◊Èπ∑’Ë∑’Ë¡’°“√√–∫“¥ ®–µâÕߥ”‡π‘π°“√‡ªìπ√–¬–‡«≈“ 2 ‡∑à“¢Õß√–¬–øí°µ—« (2 ‡∑à“ ¢Õß 21 «—π ‡∑à“°—∫ 42 «—π) À≈—ß®“°«—π∑’˺ŸâªÉ«¬‡ ’¬™’«‘µÀ√◊Õ«—π∑’˺ŸâªÉ«¬®”Àπà“¬ÕÕ°®“° ‚√ß欓∫“≈ ‡¡◊ËÕæ∫ºŸâªÉ«¬∑’Ë¡’Õ“°“√µ“¡π‘¬“¡¥—ß°≈à“«„π‚√ß欓∫“≈™ÿ¡™π ‚√ß欓∫“≈∑—Ë«‰ª ‚√ß欓∫“≈»Ÿπ¬å À√◊Õ‚√ß欓∫“≈„π°√ÿ߇∑æ¡À“π§√ „Àâ√“¬ß“πºŸâªÉ«¬‰ª¬—ß ”π—°√–∫“¥«‘∑¬“ °√¡§«∫§ÿ¡‚√§ ¿“¬„π 24 ™—Ë«‚¡ß ‚√ß欓∫“≈∑ÿ°√–¥—∫„π à«π¿Ÿ¡‘¿“§„Àâ√“¬ß“π𓬷æ∑¬å “∏“√≥ ÿ¢®—ßÀ«—¥∑—π∑’∑’Ëæ∫ºŸâªÉ«¬µ“¡π‘¬“¡¥—ß°≈à“« ‚√ß欓∫“≈„π°√ÿ߇∑æ¡À“π§√„Àâ√“¬ß“π ºŸâÕ”π«¬°“√°Õߧ«∫§ÿ¡‚√§ ”π—°Õπ“¡—¬ °√ÿ߇∑æ¡À“π§√
25.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 23 ·∫∫øÕ√å¡∑’Ë 2: ·∫∫∫—π∑÷°ª√–«—µ‘ºŸâ —¡º— ºŸâªÉ«¬‚√§ Ebola à«π∑’Ë 1 ª√–«—µ‘ºŸâ —¡º— √À— ºŸâ —¡º— ....................................................................... ™◊ËÕ.................................. °ÿ≈...................................... ‡æ» [ ] ™“¬ [ ] À≠‘ß Õ“¬ÿ.........ªï «—π/‡¥◊Õπ/ ªï‡°‘¥ ..................... ∑’ËÕ¬Ÿà (∑’Ë∫â“π) ........................................................................................................................................................................... ∑’ËÕ¬Ÿà (∑’Ë∑”ß“π) ....................................................................................................................................................................... À¡“¬‡≈¢‚∑√»—æ∑å (¡◊Õ∂◊Õ)........................................(∫â“π)......................................∑’ËÕ¬ŸàÕ’‡¡≈å .............................................. à«π∑’Ë 2 ™π‘¥¢Õß°“√ —¡º— [ ] ∫ÿ§≈“°√∑“ß°“√·æ∑¬å °√ÿ≥“„Àâ√“¬≈–‡Õ’¬¥„π à«π∑’Ë 3 [ ] ¡“™‘°„π∫â“π °√ÿ≥“„Àâ√“¬≈–‡Õ’¬¥„π à«π∑’Ë 4 [ ] ºŸâ√à«¡‡¥‘π∑“ß °√ÿ≥“„Àâ√“¬≈–‡Õ’¬¥„π à«π∑’Ë 5 [ ] Õ◊Ëπ Ê °√ÿ≥“„Àâ√“¬≈–‡Õ’¬¥„π à«π∑’Ë 6 °√≥’Õ◊Ëπ Ê ‚ª√¥√–∫ÿ.................................................................................................................. à«π∑’Ë 3 ºŸâ —¡º— ∑’ˇªìπ∫ÿ§≈“°√∑“ß°“√·æ∑¬å µ”·Àπàß [ ] ‡®â“Àπâ“∑’Ë∑”§«“¡ –Õ“¥ [ ] ·æ∑¬å [ ] ºŸâ™à«¬æ¬“∫“≈ [ ] 欓∫“≈ [ ] π—°«‘∑¬“»“ µ√å°“√·æ∑¬å [ ] ‡¿ —™°√ [ ] Õ◊ËπÊ √–∫ÿ ....................................... 1. ∑à“π —¡º— ºŸâªÉ«¬‚¥¬µ√ßÀ√◊Õ‰¡à ‡™àπ °“√√—°…“ºŸâªÉ«¬ª√–®”«—π [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ ∂â“„™à ∑à“π„ à PPE À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ PPE ∑’Ë„ à [ ] ∂ÿß¡◊Õ [ ] Àπâ“°“° [ ] ‡ ◊ÈÕ°“«πå [ ] ·«àπ ”À√—∫ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ 2. ∑à“π‰¥â —¡º— “√§—¥À≈—Ëß®“°ºŸâªÉ«¬À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ ∂â“„™à ∑à“π„ à PPE À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ PPE ∑’Ë„ à [ ] ∂ÿß¡◊Õ [ ] Àπâ“°“° ™π‘¥........................∑” fit test [ ] „™à [ ] ‰¡à„™à [ ] ‡ ◊ÈÕ°“«πå [ ] ·«àπ ”À√—∫ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ 3. ∑à“π¡’º‘«À√◊Õ‡¬◊ËÕ∫ÿ„¥ ∑’ˉ¡à‰¥âªÑÕß°—π°“√µ‘¥‡™◊ÈÕ®“° “√§—¥À≈—ËߢÕߺŸâªÉ«¬À√◊Õ‰¡à [ ] „™à √–∫ÿ................ [ ] ‰¡à„™à [ ] ‰¡à∑√“∫
26.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 255724 4. ∑à“πÕ¬Ÿà„π∑’¡™à«¬™’«‘µºŸâªÉ«¬À√◊Õ‰¡à [ ] „™à ¡’Àπâ“∑’ËÕ¬à“߉√..................................[ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 5. °√≥’ºŸâªÉ«¬‡ ’¬™’«‘µ ∑à“πÕ¬Ÿà„π∑’¡ºà“»æÀ√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ Õ∏‘∫“¬√“¬≈–‡Õ’¬¥∑’Ë∑à“π —¡º— ºŸâªÉ«¬ .................................................................................................................................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. √–¬–‡«≈“∑’Ë —¡º— ºŸâªÉ«¬.......................................................................................................................................................... «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß·√°........................................................ «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß ÿ¥∑⓬.................................................. °“√ª√–‡¡‘π °√≥’¢âÕ 1- 5 µÕ∫‰¡à„™à∑—ÈßÀ¡¥ = ‰¡à‡ ’ˬß/ºŸâ —¡º— ºŸâªÉ«¬‚¥¬∫—߇Ց≠ °√≥’¢âÕ 1 À√◊Õ 2 µÕ∫„™à ·≈–„ à PPE = ‡ ’ˬߵ˔/ —¡º— ºŸâªÉ«¬„°≈♑¥ °√≥’¢âÕ 1 À√◊Õ 2 µÕ∫„™à ·≈–‰¡à‰¥â„ à PPE Õ¬à“߇À¡“– ¡ À√◊Õ¢âÕ 3-4-5 µÕ∫„™à = ‡ ’Ë¬ß Ÿß à«π∑’Ë 4 ºŸâ —¡º— √à«¡∫â“𠧫“¡ —¡æ—π∏å°—∫ºŸâªÉ«¬ [ ] “¡’/ ¿√√¬“/ §ŸàπÕπ [ ] §Ÿà√—° [ ] ∫ÿµ√ [ ] ≠“µ‘ [ ] ‡æ◊ËÕπ√à«¡∫â“π [ ] Õ◊Ëπ Ê √–∫ÿ ........................................ 1. ∑à“π‰¥âÕ¬ŸàÕ“»—¬√à«¡°—π°—∫ºŸâªÉ«¬À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ (∂Ⓣ¡à„™à„ÀâµÕ∫∑’Ë à«π 5) ‡¡◊ËÕºŸâªÉ«¬‡√‘Ë¡¡’Õ“°“√ªÉ«¬ ∑à“πªØ‘∫—µ‘¥—ßπ’È 2. Õ¬Ÿà√à«¡ÀâÕß°—∫ºŸâªÉ«¬ [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 3. ¡’‡æ» —¡æ—π∏å°—∫ºŸâªÉ«¬ [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 4. ®—∫¡◊Õ°—∫ºŸâªÉ«¬ [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 5. °Õ¥ºŸâªÉ«¬ [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 6. ®Ÿ∫ºŸâªÉ«¬ [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 7. ¥Ÿ·≈ºŸâªÉ«¬ [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 8. ∑à“π‰¥â —¡º— “√§—¥À≈—Ëß®“°ºŸâªÉ«¬À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 9. ∑à“π‰¥â —¡º— ‡ ◊Èպ⓺ŸâªÉ«¬∑’ˇªóôÕπ “√§—¥À≈—ËßÀ√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 10. ¢âÕ 8 À√◊Õ 9 µÕ∫„™à∑à“π‰¥â„ àÕÿª°√≥åªÑÕß°—πÀ√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫
27.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 25 PPE ∑’Ë„ à [ ] ∂ÿß¡◊Õ [ ] Àπâ“°“° ™π‘¥........................∑” fit test [ ] „™à [ ] ‰¡à„™à [ ] ‡ ◊ÈÕ°“«πå [ ] ·«àπ ”À√—∫ªÑÕß°—π°“√µ‘¥‡™◊ÈÕ Õ∏‘∫“¬√“¬≈–‡Õ’¬¥∑’Ë∑à“π —¡º— ºŸâªÉ«¬ .................................................................................................................................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. √–¬–‡«≈“∑’Ë —¡º— ºŸâªÉ«¬.......................................................................................................................................................... «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß·√°...................................................... «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß ÿ¥∑⓬.................................................... °“√ª√–‡¡‘π °√≥’‡©æ“–¢âÕ 1 µÕ∫„™à = ‡ ’ˬߵ˔/ —¡º— ºŸâªÉ«¬„°≈♑¥ °√≥’¢âÕ 2, 4, 5 À√◊Õ 7 µÕ∫„™à ·≈–¢âÕ 8 µÕ∫‰¡à = ‡ ’ˬߵ˔/ —¡º— ºŸâªÉ«¬„°≈♑¥ °√≥’¢âÕ 3 À√◊Õ 6 µÕ∫„™à ·≈–¢âÕ 8, 9 „™à ¢âÕ 10 µÕ∫‰¡à„™à = ‡ ’Ë¬ß Ÿß/ ºŸâ —¡º— ºŸâªÉ«¬„°≈♑¥∑’ˇ ’Ë¬ß Ÿß à«π∑’Ë 5 ºŸâ —¡º— ¡’ª√–«—µ‘‡¥‘π∑“ß√à«¡°—∫ºŸâªÉ«¬ ª√–‡¿∑ºŸâ‚¥¬ “√ [ ] ºŸâ√à«¡‚¥¬ “√ [ ] π—°∫‘π/ ºŸâ¢—∫ [ ] ·Õ√å‚Œ ‡µµ/ ‰°¥å [ ] Õ◊Ëπ Ê √–∫ÿ ........................ °√≥’‚¥¬ “√‡§√◊ËÕß∫‘𠓬°“√∫‘π ................................................. ‡∑’ˬ«∫‘π ........................................................... µ”·Àπàß∑’Ëπ—Ëß ·∂«∑’Ë .......................................................... ‡≈¢∑’Ëπ—Ëß ........................................................... °√≥’®”·∂« ·≈–‡≈¢∑’Ëπ—Ë߉¡à‰¥â∑à“ππ—Ëß∑’ˉÀπ [ ] ¥â“πÀπâ“¢Õ߇§√◊ËÕß∫‘π [ ] ¥â“πÀ≈—ߢÕ߇§√◊ËÕß∫‘π [ ] ¥â“π¢â“ߢÕß∑“ßÕÕ°©ÿ°‡©‘π [ ] ∑“߇¥‘πµ√ß°≈“ß [ ] π—Ëßµ‘¥Àπ⓵à“ß [ ] π—Ëß„°≈âÀâÕßπÈ” [ ] ™—Èπª√–À¬—¥ [ ] ™—Èπ∏ÿ√°‘®/ æ√’‡¡’ˬ¡/ ™—ÈπÀπ÷Ëß [ ] ∫√‘‡«≥ªï°‡§√◊ËÕß∫‘π 1. ∑à“π¡’°“√ —¡º— º‘«Àπ—ßÀ√◊Õ‡¬◊ËÕ‡¡◊Õ°∑’Ë¡’‚Õ°“ ¡’‡™◊ÈÕ Ÿß‚¥¬∑’ˉ¡à‰¥âªÑÕß°—πÀ√◊Õ‰¡à ‡™àπ ®Ÿ∫À√◊Õ¡’‡æ» —¡æ—π∏å [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 2. ∑à“π —¡º— “√‡À≈« √«¡‡Àß◊Ëե⫬‰À¡? À√◊Õ “√§—¥À≈—Ëß®“°ºŸâªÉ«¬À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫
28.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 255726 Õ∏‘∫“¬√“¬≈–‡Õ’¬¥∑’Ë∑à“π —¡º— ºŸâªÉ«¬ .................................................................................................................................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. √–¬–‡«≈“∑’Ë —¡º— ºŸâªÉ«¬.......................................................................................................................................................... «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß·√°...................................................... «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß ÿ¥∑⓬.................................................... °“√ª√–‡¡‘π °√≥’∑’ˉ¡à‰¥â —¡º— ºŸâªÉ«¬‚¥¬µ√ß À√◊Õ “√‡À≈«®“°ºŸâªÉ«¬·µà‚¥¬ “√À√◊Õ„™âÀâÕßπÈ”¥â«¬°—π = ‰¡à‡ ’ˬß/ ºŸâ —¡º— ºŸâªÉ«¬ ‚¥¬∫—߇Ց≠ °√≥’¢âÕ 1 À√◊Õ 2 µÕ∫„™à = ‡ ’Ë¬ß Ÿß à«π∑’Ë 6 ºŸâ —¡º— Õ◊ËπÊ 1. ∑à“π —¡º— ºŸâªÉ«¬‚¥¬‰¡à‰¥âªÑÕß°—πº‘«Àπ—ßÀ√◊Õ‡¬◊ËÕ‡¡◊Õ°À√◊Õ‰¡à ‡™àπ ®Ÿ∫À√◊Õ¡’‡æ» —¡æ—π∏å [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 2. ∑à“π —¡º— “√‡À≈« ‡™àπ ªí “«– Õÿ®®“√– À√◊Õ‡≈◊Õ¥®“°ºŸâªÉ«¬À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ Õ∏‘∫“¬√“¬≈–‡Õ’¬¥∑’Ë∑à“π —¡º— ºŸâªÉ«¬ .................................................................................................................................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. √–¬–‡«≈“∑’Ë —¡º— ºŸâªÉ«¬.......................................................................................................................................................... «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß·√°...................................................... «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß ÿ¥∑⓬.................................................... °“√ª√–‡¡‘π °√≥’∑’ˉ¡à‰¥â —¡º— ºŸâªÉ«¬‚¥¬µ√ß À√◊Õ “√‡À≈«®“°ºŸâªÉ«¬·µà‚¥¬ “√À√◊Õ„™âÀâÕßπÈ”¥â«¬°—π = ‰¡à‡ ’ˬß/ ºŸâ —¡º— ºŸâªÉ«¬‚¥¬ ∫—߇Ց≠ °√≥’¢âÕ 1 À√◊Õ 2 µÕ∫„™à = ‡ ’Ë¬ß Ÿß
29.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 27 à«π∑’Ë 7 ∂“π– ÿ¢¿“æ¢ÕߺŸâªÉ«¬ 1. ∑à“π¡’ ÿ¢¿“æ ¡∫Ÿ√≥å ·¢Áß·√ߥ’À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 2. ∑à“π¡’‰¢â À√◊Õ¡’ª√–«—µ‘¡’‰¢âÀ√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ 3. ∑à“π¡’Õ“°“√‡≈◊Õ¥ÕÕ°∫â“ßÀ√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à [ ] ‰¡à∑√“∫ à«π∑’Ë 8 Check list °“√¥”‡π‘π°“√: ‰¡à‡ ’ˬß/ºŸâ —¡º— ‡ ’ˬߵ˔/ ºŸâ —¡º— „°≈♑¥ ‡ ’Ë¬ß Ÿß ºŸâªÉ«¬‚¥¬∫—߇Ց≠ 1. ®—¥‡µ√’¬¡‡Õ° “√„À⧫“¡√Ÿâ [ ] „™à [ ] „™à [ ] „™à 2. ‡ΩÑ“√–«—ß‚√§ [ ] ‰¡à®”‡ªìπ [ ] ¥Ÿ·≈µ—«‡Õß [ ] „À⥔‡π‘π°“√‡ΩÑ“√–«—ß‚√§ 3. °“√„À⬓ªÑÕß°—π≈à«ßÀπâ“ [ ] ‰¡à®”‡ªìπ [ ] ‰¡à‰¥â·π–π” [ ]„Àâæ‘®“√≥“ °“√§”π«π√–¬–‡«≈“„π°“√‡ΩÑ“√–«—ß «—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß·√°................................................................. «—π∑’Ë¢Õß«—ππ’È ................................................................ √–¬–Àà“ß√–À«à“ß«—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß·√°‡∑’¬∫°—∫«—ππ’È ......... «—π √–¬–‡«≈“∑’˵âÕ߇ΩÑ“√–«—ßµàÕ: 21 - √–¬–Àà“ß√–À«à“ß«—π∑’Ë —¡º— ºŸâªÉ«¬§√—Èß·√°‡∑’¬∫°—∫«—ππ’È = ......... «—π °√≥’∑’Ë¡’Õ“°“√ªÉ«¬ ºŸâªÉ«¬√“¬π’ȉ¥â„Àâ√“¬≈–‡Õ’¬¥‡°’ˬ«°—∫ºŸâ —¡º— „À⇢â“√—∫°“√√—°…“À√◊Õ‰¡à [ ] „™à [ ] ‰¡à„™à §”®”°—¥§«“¡¢ÕߺŸâ —¡º— ‚¥¬µ√ß À¡“¬∂÷ߺŸâ∑’Ë —¡º— º‘«À√◊Õ‡¬◊ËÕ‡¡◊Õ°∑’Ë¡’‡≈◊Õ¥À√◊Õ “√§—¥À≈—Ëß®“°ºŸâªÉ«¬ ¢âÕ‡ πÕ·π–........................................................................................................................................................................... .................................................................................................................................................................................................. .................................................................................................................................................................................................. ™◊ËÕºŸâ‡°Á∫¢âÕ¡Ÿ≈................................................................................................ «—π∑’Ë ................................................................
30.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 255728 ·∫∫øÕ√å¡∑’Ë 3: ·∫∫√“¬ß“π‡ΩÑ“√–«—߇™‘ß√ÿ°¢ÕߺŸâªÉ«¬ ß —¬‚√§ Ebola ∑’¡:......................................................................«—π∑’Ë —߇°µ°“√≥å§√—Èß·√°............................................................................ ≈”¥—∫°“√µ‘¥µ“¡ºŸâªÉ«¬µàÕ‡π◊ËÕßµ≈Õ¥/µâÕßµ‘¥µ“¡ºŸâªÉ«¬Õ¬à“ßπâÕ¬ 21 «—π À≈—ßæ∫ºŸâªÉ«¬ 1. √“¬≈–‡Õ’¬¥ºŸâªÉ«¬ ™◊ËÕ.............................................................................................. ª√–‡¿∑ºŸâªÉ«¬ [ ] ºŸâªÉ«¬ ß —¬ [ ] ºŸâªÉ«¬‡¢â“¢à“¬ ™◊ËÕ‡®â“∫â“π∑’ËÕ“»—¬......................................................................®”π«π ¡“™‘°„π∫â“π........................................................... ∑’ËÕ¬Ÿà.......................................................................................................................................................................................... 2. ºŸâ —¡º— √à«¡∫â“π·≈–Õ“°“√ ≈”¥—∫∑’Ë 1 2 3 4 5 6 7 ™◊ËÕ-π“¡ °ÿ≈ §«“¡ —¡æ—π∏å ‡æ» Õ“¬ÿ —¡º— §√—Èß ÿ¥∑⓬ ™π‘¥¢Õß°“√ —¡º— - ¥Ÿ·≈ºŸâªÉ«¬ - ®—¥°“√»æ - ·æ∑¬åºŸâ„Àâ°“√√—°…“ - §π„π§√Õ∫§√—« - «—π∑’ˇ√‘Ë¡¡’Õ“°“√ªÉ«¬ - ‰¢â Ÿß - ª«¥»’√…– - §≈◊Ëπ‰ â/Õ“‡®’¬π - ‡∫◊ËÕÕ“À“√ - ∂à“¬‡À≈« - ª«¥‡¡◊ËÕ¬
31.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 29 ≈”¥—∫∑’Ë 1 2 3 4 5 6 7 - °≈◊π≈”∫“° - À“¬„®≈”∫“° - –Õ÷° - ‡Àß◊Õ°Õ—°‡ ∫ - µ“·¥ß - ¡’º◊Ëπ·¥ßµ“¡µ—« - Õÿ®®“√–¥” - Õ“‡®’¬π‡ªìπ‡≈◊Õ¥ - ‡≈◊Õ¥°”‡¥“ - Õ◊ËπÊ 3. ‘Ëß∑’ˉ¥â®“°°“√ —߇°µºŸâªÉ«¬ .................................................................................................................................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. .................................................................................................................................................................................................. ™◊ËÕºŸâ‡°Á∫¢âÕ¡Ÿ≈................................................................................................ «—π∑’Ë ................................................................
32.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 255730 6.1 ≈—°…≥–∑“ߧ≈‘π‘° °“√∑”§«“¡‡¢â“„®≈—°…≥–∑“ߧ≈‘π‘°·≈–°“√«‘π‘®©—¬·¬°‚√§ ¡’§«“¡ ”§—≠„π°“√µ√«®®—∫ ·≈–°“√√—°…“ºŸâªÉ«¬ ß —¬µ‘¥‡™◊ÈÕ‰«√— Ebola ‚¥¬≈—°…≥–∑“ߧ≈‘π‘°¢Õß‚√§ Ebola π—Èπ°«â“ß·≈– ·µ°µà“ß°—π¡“°¢÷Èπ°—∫ “¬æ—π∏ÿå¢Õ߉«√— Ebola ‚¥¬≈—°…≥–∑“ߧ≈‘π‘°·≈–°“√¥”‡π‘π‚√§ ∑’Ë®–°≈à“«∂÷ßµàÕ‰ª ‡ªìπ°“√√«∫√«¡¢âÕ¡Ÿ≈°“√¥”‡π‘π‚√§¢ÕߺŸâªÉ«¬ Ebola „πª√–‡∑»´“‡Õ’¬√å (Zaire) ·≈–ª√–‡∑»°“√å∫Õπ(Gabon) æ∫«à“ ¡’√–¬–øí°µ—«¢Õß‚√§ª√–¡“≥ 2-21 «—π ‚¥¬¡’√“¬≈–‡Õ’¬¥¢Õß≈—°…≥–∑“ߧ≈‘π‘° ∑’Ë ”§—≠¥—ßπ’È «—π∑’Ë 1-2: ºŸâªÉ«¬Õ“®®–¡’‰¢â Ÿß ∂÷ß 39 ÌC ‡Àß◊ËÕÕÕ°¡“° §√—Ëπ‡π◊ÈÕ§√—Ëπµ—« ÕàÕπ‡æ≈’¬ ª«¥»’√…–∫√‘‡«≥Àπ⓺“°·≈–¥â“π¢â“ß ª«¥‡¡◊ËÕ¬°≈â“¡‡π◊ÈÕ ª«¥°√–∫Õ°µ“ ·≈–‡¬◊ËÕ∫ÿµ“·¥ß À—«„®‡µâπ™â“ (bradycardia) ¢≥–¡’‰¢â §≈◊Ëπ‰ âÕ“‡®’¬π¡“° ∂à“¬‡À≈«‡ªìππÈ” ·≈–ª«¥¡«π∑—Ë«∑âÕß ¿“¬„π 2 «—πÕ“®–¡’Õ“‡®’¬πªπ‡≈◊Õ¥·≈–Õÿ®®“√–ªπ‡≈◊Õ¥ (diarrhea rouge) «—π∑’Ë 3-6: Õ“®®–æ∫µàÕ¡πÈ”‡À≈◊Õß∫√‘‡«≥∑⓬∑Õ¬ §Õ ·≈–√—°·√₵ æ∫Õ“°“√‡®Á∫§Õ·≈– °≈◊π≈”∫“°‰¥â∫àÕ¬ æ∫®ÿ¥∫√‘‡«≥‡æ¥“πÕàÕπ (soft palate) ·≈–¿“«–¢“¥πÈ” (dehydration) «—π∑’Ë 5-7: ª√–¡“≥√âÕ¬≈– 15 ¢ÕߺŸâªÉ«¬®–æ∫¿“«–‡≈◊Õ¥ÕÕ° ‡™àπ ‡≈◊Õ¥°”‡¥“‰À≈ ‡≈◊Õ¥ÕÕ°µ“¡‰√øíπ ‡≈◊Õ¥ÕÕ°„π™àÕß∑âÕß (°√–‡æ“–Õ“À“√·≈–≈”‰ â) ‡≈◊Õ¥ÕÕ°∑“ß™àÕߧ≈Õ¥ ªí “«–‡ªìπ‡≈◊Õ¥ ‡≈◊Õ¥ÕÕ°∫√‘‡«≥∑’Ë©’¥¬“ ·≈–æ∫‡≈◊Õ¥ÕÕ°∫√‘‡«≥‡¬◊ËÕ∫ÿµ“¢“«‰¥â∫àÕ¬ ®–æ∫ ®ÿ¥º◊Ëπ·¥ß°√–®“¬®“°∫√‘‡«≥„∫Àπâ“·≈–°âπ‰ª∑’Ë≈”µ—«·≈–·¢π ·≈â«°≈“¬‡ªìπ®È”·¥ß (popular to maculopapular) ¿“¬„π 24 ™—Ë«‚¡ß º◊Ëπ®–¢¬“¬¡“√«¡°—π ‚¥¬‰¡à¡’Õ“°“√§—π «—π∑’Ë 8-16: æ∫¡’Õ“°“√ –Õ÷°µ≈Õ¥‡«≈“„πºŸâ∑’Ë¡’Õ“°“√√ÿπ·√ß ·≈–Õ“°“√‰¡à¥’ (°“√ –Õ÷° ¡—° —¡æ—π∏å°—∫§«“¡√ÿπ·√ߢÕß‚√§) ·µà°Áæ∫‰¥âπâÕ¬ æ∫¿“«–¢“¥πÈ”√ÿπ·√ß (severe dehydration) „πºŸâ∑’ˉ¡à‰¥â√—∫°“√√—°…“·∫∫ª√–§—∫ª√–§Õß à«π„À≠à®–‡ ’¬™’«‘µª√–¡“≥«—π∑’Ë 12 ®“°°“√ ∑”ß“π¢ÕßÕ«—¬«–≈⡇À≈«À≈“¬®ÿ¥ ‚¥¬‡©æ“–‰µ«“¬ ·≈–µ—∫«“¬ ®–¡’µ—«∫«¡ √–∫∫ ¡Õß·≈– ª√– “∑ à«π°≈“ß ®π∂÷ß‚§¡“ (coma) ¿“«–™äÕ§·≈–‡ ’¬™’«‘µµ“¡¡“ ≈—°…≥–∑“ߧ≈‘π‘° ·≈–°“√«‘π‘®©—¬·¬°‚√§ Ebola6
33.
·π«∑“ß°“√¥”‡π‘πß“π‡ΩÑ“√–«—ß Õ∫ «π ªÑÕß°—π ·≈–§«∫§ÿ¡‚√§
Ebola ª√–‡∑»‰∑¬ 2557 31 „π°≈ÿࡺŸâªÉ«¬∑’ËÀ“¬ªÉ«¬À√◊ÕÕ“°“√¥’¢÷Èπ º◊Ëπ®–À“¬‰ª„π«—π∑’Ë 12 ®–æ∫º‘«Àπ—ß∫√‘‡«≥ΩÉ“¡◊Õ ΩÉ“‡∑â“À≈ÿ¥≈Õ°„π«—π∑’Ë 14-16 ·≈–Õ“®®–¡’Õ—≥±–Õ—°‡ ∫ (orchitis) µ—∫Õ—°‡ ∫´È” (recurrent hepatitis) transverse myelitis ·≈– uveitis ‰¥â [6] 6.2 °“√«‘π‘®©—¬·¬°‚√§ ë Shigellosis ·≈–‚√§µ‘¥‡™◊ÈÕ·∫§∑’‡√’¬√–∫∫∑“߇¥‘πÕ“À“√Õ◊ËπÊ „π°“√«‘π‘®©—¬‡∫◊ÈÕßµâπ‡æ◊ËÕ·¬°ÕÕ°®“°‚√§ Ebola ≈—°…≥–∑“ߧ≈‘π‘°∑’Ëæ∫„π°≈ÿà¡‚√§π’È ‰¥â·°à ∑âÕ߇ ’¬ Õ“®®–¡’∂à“¬‡ªìπ‡≈◊Õ¥ √à«¡°—∫¡’‰¢â §≈◊Ëπ‰ â ·≈–∫“ߧ√—ÈßÕ“®®–¡’Õ“°“√¢Õß ¡’ “√æ‘…„π‡≈◊Õ¥ (Toxemia) Õ“‡®’¬π µ–§√‘« ·≈–∂à“¬Õÿ®®“√–ªπ‡≈◊Õ¥À√◊Õ∂à“¬‡ªìπ¡Ÿ° ª«¥ ¡«π∑âÕß À√◊Õª«¥∂à“¬ §«√µ√«®À“ “‡Àµÿµ”·Àπàß∑’˵‘¥‡™◊ÈÕ √à«¡°—∫°“√‡æ“–‡™◊ÈÕ ·≈–¬âÕ¡/µ√«® π—∫‡¡Á¥‡≈◊Õ¥ À“°µ√«®π—∫‡¡Á¥‡≈◊Õ¥æ∫®”π«π‡¡Á¥‡≈◊Õ¥¢“« Ÿß πà“®–‡ªìπ°“√µ‘¥‡™◊ÈÕ·∫§∑’‡√’¬ ë ∑—¬øÕ¬¥å (Typhoid) ≈—°…≥–∑“ߧ≈‘π‘° ‰¢â ª«¥»’√…– º◊Ëπ Õ“°“√∑’Ë√–∫∫∑“߇¥‘πÕ“À“√ √à«¡°—∫µàÕ¡ πÈ”‡À≈◊Õß‚µ (lymphadenopathy) À—«„®‡µâπ™â“≈ß (relative bradycardia) ‰Õ ·≈–®”π«π ‡¡Á¥‡≈◊Õ¥¢“«µË” Õ“®®–¡’‡®Á∫§Õ√à«¡¥â«¬ ·≈–æ‘®“√≥“√à«¡°—∫°“√‡æ“–‡™◊ÈÕ·∫§∑’‡√’¬„π‡≈◊Õ¥ ·≈–Õÿ®®“√– ë ¡“≈“‡√’¬ (Malaria) ≈—°…≥–∑“ߧ≈‘π‘° ‰¢â‡©’¬∫æ≈—𠪫¥»’√…– „π‡¥Á°∫“ߧ√—ÈßÕ“®®–æ∫∑âÕ߇ ’¬√à«¡¥â«¬ µâÕ߬âÕ¡ ’‡¡Á¥‡≈◊Õ¥‡æ◊ËÕµ√«®À“‡™◊ÈÕª√ ‘µ¡“≈“‡√’¬„π°“√·¬°‚√§ ∂÷ß·¡â«à“µ√«®æ∫‡™◊ÈÕª√ ‘µ ‰¡à “¡“√∂µ—¥°“√µ‘¥‡™◊ÈÕ‰«√— ÕÕ°‰¥â ·µà®”‡ªìπµâÕß„Àâ°“√√—°…“¡“≈“‡√’¬¥â«¬ ë Õ◊ËπÊ ‡™à𠉫√— µ—∫Õ—°‡ ∫, ‚√§©’ËÀπŸ (Leptospirosis), ‰¢â√Ÿ¡“µ‘§ (Rheumatic fever), ∑—¬øí (Typhus) ·≈– Õ“°“√/Õ“°“√· ¥ß∑’ˇ°‘¥®“° mononucleosis µâÕß«‘π‘®©—¬·¬°‚√§„π™à«ß√–¬–µâπ¢Õß°“√µ‘¥‡™◊ÈÕ (early stages of infection)
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