狂犬病(rabies)
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The teaching slide of rabies for a teaching hospital.
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狂犬病(rabies)
- 4. 負股RNA病毒
- 5. 神經的結構
- 7. 進入神經本體複製
- 11. INFECTIOUS PERIOD INCUBATION PERIOD: 3 weeks to 6 months SYMPTOM ONSET DEATH RABID ANIMAL EXPOSES DOG, CAT, FERRET REPLICATION OF VIRUS IN CNS 10 DAY OBSERVATION 6 MONTH QUARANTINE REPLICATION OF VIRUS IN SALIVARY GLANDS DOMESTIC PET EXPOSES HUMAN RABIESVIRUSCONCENTRAION
- 12. 跨物種傳染病
- 13. 麗 莎 病 毒 屬
- 17. 病媒動物 Vector
- 19. Rabies: Who Can Get It? All warm blooded mammals
- 20. Global distribution of mammalian rabies reservoirs and vectors
- 22. Country Variant Test Subject Mortality Rate China RV342 (Dog) Hamsters 100% (6/6) China RV342 (Dog) Dogs 100% (2/2) China GXHXN Cattle, Horse 100% (2/2) 100% mortality rate in different studies (Kuzmin, et al)
- 23. Map of worldwide rabies variant terrestrial reservoir species Mongoose Ferret Badger Ferret Badger
- 24. 狂犬病流病資料 全球: >55,000 human deaths / year1,2 Primarily Africa and Asia Canine variant >60% of victims are children • Transmission • Bite • Non-bite • Wound or mucus membrane contamination • Organ transplants 1. Global Alliance for Rabies Control (GARC) early release of OIE Global Conference on Eliminating Rabies data 2. KnobelD, et al. Bull World Health Organ. 2005;83:360-8. http://www.who.int/rabies/human/en/
- 25. 中國狂犬病病人分布 2013
- 27. Rabies in Ferret Badgers, China
- 28. 28Fauci AS, et al. Harrison’s Principles of Internal Medicine, 17th ed. 感 染 途 徑 及 機 轉
- 30. 人類狂犬病病程 • 潛伏期 • 前驅期 • 急性神經期 – 狂症型 (furious form) – 麻痺型 ( paralytic form) • 昏迷期 • 死亡
- 31. 治療 防禦的第一步
- 32. 治療學的進展
- 33. 1885年 巴斯德發表疫苗結果
- 35. 抗病毒血清的進展 被動免疫
- 36. 如何給予狂犬病免疫球蛋白 • 在傷口內先滴數滴被動免疫製劑 • 距傷口緣約0.5-1cm沿傷口縱軸進針,做環形 全 層注射 • 傷口嚴重或有多處傷口（特別是幼兒），按常 規劑量不足以浸潤注射傷口周圍時，可用生理 鹽水將被動免疫製劑適當稀釋2～3 倍，再進 行浸潤注射 • 當進行全部傷口浸潤注射後，尚有剩餘免疫球蛋白製 劑時，應將其注射到遠離疫苗注射部位的深部肌肉 （肌肉注射），以避免影響疫苗的效果 36
- 37. MMWR Recomm Rep. 2010 Mar 19;59(RR-2):1-9
- 44. 發病者的採檢
- 45. 1. 先帶好防護配備 2. 仔細詢問病史 3. 決定處理程序
- 47. 疫苗可以口服?
- 51. 台灣的狂犬病
- 53. 台灣狂犬病本土病例 Year Cases Deaths 1948 33 33 1949 92 92 1950 83 83 1951 238 238 1952 102 102 1953 52 52 1954 58 58 1955 50 50 1956 (implemented control policies) 46 46 1957 22 22 1958 6 6 1959 0 0 Total 782 782 (100%)資料來源:台灣省衛生統計要覽第22頁，民國52年
- 55. 鼬獾 Ferret badger
- 56. Which one is a ferret badger?
- 58. 每日收件與檢測數
- 59. 台大王弘毅
- 60. 貨源從哪來
- 61. 緊急進口疫苗時程 • 諾華藥廠(國內領有許可 證) – 雞胚蛋產製疫苗 – 緊急專案進口1,040劑, 7/24 (週三)抵台, 7/26到 貨 – 8月2,000劑 (今天確認可擴增量), 9月7,000劑 • 賽諾菲藥廠 – 細胞培養產製疫苗 – 緊急專案進口1,500劑: 800劑 7/25 (週四)抵台, 7/26到貨；另700劑 7/30(下週二) 抵台 – 若有需求8月可再進口萬劑 • TFDA全力配合加速書審；調度時請注意勿交替使用
- 62. EDUCATION
- 63. 小孩教育 不能等
- 64. Geographic differentiation showing gene mutation takes time
- 65. RIGHT VACCINE Raccoons: Vaccinia and Adenovirus Skunks: Vaccinia and Adenovirus Foxes: Vaccinia Ferret Badgers: ???
- 66. Right Delivery System ? 1)Will they eat the bait? 2)How do they eat the bait?
- 67. Correct Time 1)When does juvenile dispersal occur? Correct Place 1)Where are ferret badger habitats 2)What are your ORV goals? 3)How do you get bait to the target?
- 68. One World, One Health AGRICULTURE PUBLIC HEALTH WILDLIFE
- 69. 勿棄養 勿接觸 學自救
Editor's Notes
- http://www.ncbi.nlm.nih.gov/pubmed/23405368 – china variant / killed cattle, horsehttp://www.ojvr.org/index.php/ojvr/article/view/511/805#19
- Rabies control and prevention efforts have reduced the number of human rabies deaths in the United States to only a few per year. Since the 1990s, most cases of fatal rabies acquired in the United States have been associated with bats.Unfortunately this is not the situation worldwide as this audience is particularly well aware. Up to 70,000 people die from rabies per year, most living in Africa and Asia and most having been infected by domestic dogs. Greater than 60% of these victims are children. There is still much work to be done to protect human and animal lives from rabies, both globally and within the United States.