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教 育 專 題 深 入 報 導
═══════════════════════《2003/06/13》═════
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教育專題 ◎ 國際專版與跨種病毒共存
◎ 國際專版 與跨種病毒共存
◎ 國際專版 與跨種病毒共存
◎ 7月徵文 關於畢業典禮
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◎國際專版與跨種病毒共存
摘要
西尼羅病毒現身美國24個州
▓路透社
隨著美國疾病防治中心表示，西尼羅病毒（West Nile Virus）現身美國24個州的消息，北美地區有愈來愈多的民眾開始擔心，西尼羅病毒是否會像去年一樣，帶給人們健康威脅。去年，西尼羅病毒造成美國兩千多人死亡，這使得美國民眾紛紛加入撲殺蚊子的居家清潔維護行動。
究竟，西尼羅病毒是什麼樣的病毒呢？根據流行病學和公衛專家的研究發現，西尼羅病毒是經由蚊子作為傳染媒介，使得被叮咬者發生腦炎疾病的跨種病毒。在自然生態上，蟲媒、鳥類和哺乳動物三者之間會形成一種循環，不斷的將西尼羅病毒傳播出去。當蚊子叮咬到帶有病毒的鳥類血液，又繼續叮咬哺乳動物，感染的現象便會發生。和愛滋病毒及SARS病毒不同的是，西尼羅病毒本身不會經由人與人之間的接觸而直接感染。
1937年，科學家首次在烏干達的西尼羅地區分離出這種會引發腦炎的病毒，西尼羅病毒的命名就是由此產生。西尼羅病毒屬於黃病毒（Flavivirus）的一種，它和日本腦炎同屬，但其抗原特性不同。
感染到西尼羅病毒的人類，會歷經5至15天左右的潛伏期才會發病。一般都是呈現輕微的感染，大部分被感染的人甚至不會出現症狀。發熱、頭痛、喉嚨痛、背痛、肌肉疼痛、疲勞、食慾降低等類似感冒的症狀，都可以在感染西尼羅病毒的患者身上發現。感染情形嚴重者，則會有明顯的頭痛、高熱、頭部堅硬、知覺喪失、昏睡、發抖、抽搐和痲痺等症狀。感染西尼羅病毒的病例，其死亡率大約是3％至15％。
目前為止，西尼羅病毒並沒有疫苗可以抑制，而且，也沒有特別的治療方法，對於比較嚴重的患者，只能採取支持性的治療方法。這點與愛滋病毒和SARS病毒有些類似。美國的衛生官員建議民眾，避免在拂曉或黃昏時外出，以免被蚊子叮咬而感染。在天氣暖和的季節裡，如果有必要外出時，必須穿長袖衣服及長褲，或在衣服上噴驅虫劑防止蚊子叮咬。維護居家清潔，是避免感染西尼羅病毒的不二法門。
原文
West Nile Virus Resurfaces in 24 States, CDC Says
Mon June 09, 2003 06:43 PM ET
By Paul Simao
ATLANTA (Reuters) - U.S. health officials reported on Monday that the
West Nile virus had resurfaced in two dozen states, but they stopped short of
predicting another record outbreak of the deadly mosquito-borne disease.
West Nile has been detected in birds, horses and mosquitoes in at least
24 states so far this year, according to the U.S. Centers for Disease Control
and Prevention, which has tracked the virus since it first emerged in the
United States in 1999.
No human cases have been reported this year.
Dr. Stephen Ostroff, deputy director of the CDC's national center for
infectious diseases, said it was unclear whether the mosquitoes responsible for
spreading the virus would pose as much of a health risk to the public as they
did in 2002.
"Whether or not this season will be a replay of last year is a
little early to say," Ostroff said. He did, however, advise people to
start draining pools of water where mosquitoes breed and to wear protective
clothing and repellents outside.
There were 4,156 cases of West Nile, including 284 deaths, in the
United States last year, according to the CDC. The outbreak was the largest
since the virus first appeared in the Western Hemisphere four years ago.
During the 2002 outbreak, CDC officials confirmed the first known cases
in which West Nile was transmitted through organ transplants and blood
transfusions. The possibility the virus could be spread through breast milk or
sexual contact also has been studied.
Although most people who contract West Nile have no symptoms and those
who do normally suffer little more than flu-like illness, it is believed they
still can carry small amounts of the virus in their blood for several days.
It is estimated that up to 200,000 Americans may have been exposed to
West Nile since 1999, when it killed seven people in the New York City borough
of Queens. An estimated 4.5 million Americans receive blood or blood products
annually.
The prospect that the virus could spread through the nation's blood
supply prompted officials with the Food and Drug Administration, blood banks
and laboratories to work this past winter on a way to screen blood for the
virus.
Dr. Jesse Goodman, director of the FDA's Center for Biologics,
Evaluation and Research, said on Monday that two new tests would be available
for use in high-risk areas this summer.
"We're still very concerned about this and we'll have to see how
these tests perform," Goodman said.
◎國際專版
與跨種病毒共存
摘要
面對西尼羅病毒，器官移植病人風險高
▓路透社
一般說來，目前的科學研究都將西尼羅病毒的感染途徑指向蚊子叮咬，但是，從去年開始，美國國內有多項研究正在進行，以確定這種病毒是否也能透過輸血或器官移植而傳播。因為科學家發現，那些接受感染西尼羅病毒者器官移植的病人，最後都診斷出感染這種會引發腦炎的病毒。一旦這些病例獲得證實，那麼將顯示，西尼羅病毒可在人體之間相互傳染，而不僅由蚊子傳播。
自從發現西尼羅病毒感染途徑有這樣的可能性之後，美國血庫協會（AABB）也要求其國內之血液中心需做一些措施，來防止經輸血感染西尼羅病毒，他們的措施主要是，工作人員必須對捐血人加強問診，而感染西尼羅病毒者，也要在復原14天後或感染28天後才可接受捐血。只是，目前美國也沒有適合血液中心的檢驗方法可以做為常規篩檢之用。想要捐血的民眾也只能憑良心和細心，注意自己的健康狀況，再判斷是否要做捐血的動作。否則，那就不是捐血一袋，救人一命的好事了。
原文
Transplant Patients Vulnerable to West Nile Virus
Mon June 02, 2003 05:33 PM ET
WASHINGTON (Reuters Health) - People who have received organ
transplants may be especially vulnerable to the West Nile virus, doctors
reported here Monday.
The University of Cincinnati treated two transplant patients for the
virus last summer, but detected the virus too late in one patient to help him,
said Debby DeSalvo, lead author of the study.
She presented her data at the American Transplant Congress, the largest
annual gathering of transplant surgeons and researchers in the U.S.
Both patients were white men in their 40s, and both had received a
kidney from a living donor. Neither appears to have been infected by the
transplanted organ.
The first patient came to the university with what appeared to be a
viral gastrointestinal infection and fever. Within days, the man had symptoms
of brain swelling, but an initial CT scan showed nothing abnormal, said
DeSalvo.
He quickly began showing signs of severe neurological problems, and was
treated for bacterial and viral meningitis, and his anti-rejection drugs were
reduced, but he still did not respond. An MRI showed that he had massive
swelling in his brain, which the Cincinnati doctors realized was characteristic
of West Nile virus, even though blood tests they had conducted before were
negative for the mosquito-borne illness.
Before they could treat him any further, the man died, two weeks after
being admitted.
A month later, another man came in, seeming to have a gastrointestinal
infection. Because of the earlier case, the physicians tested for West Nile,
but results were negative. An MRI, however, showed the brain swelling
associated with the illness.
Doctors stopped his immune-suppressing drugs completely, and enrolled the
man in a trial of alpha interferon, a drug being tested for West Nile.
Within days, he recovered, and was continued on the drug for two weeks,
said DeSalvo. Ten months later, he's doing well, she said.
She and her colleagues recommended that physicians keep an eye out for
West Nile in their transplant patients, and to not trust initial blood test
results. Patients should be taken off immune-suppressing drugs, and tried on
alpha interferon, said DeSalvo.
Several physicians in the audience said that they, too, had discovered
West Nile in transplant patients, and that it had been hard to detect. One
physician said her patient, a 63-year-old woman, recovered with normal
supportive care.
◎國際專版
與跨種病毒共存
摘要
猴痘，入侵美國
▓路透社
除了西尼羅病毒，最近還有一種跨種病毒在美國流竄，那就是發生在猴子之間的猴天花──猴痘（Monkeypox）。目前，美國猴痘的通報病例達40例，其中有4人確定感染了猴痘。
猴痘與小水痘都會產生同樣類似天花的臨床疾病症狀。在非洲有散發性人類病例零星發生。靈長類於野生及實驗室環境下也有自然感染猴痘的文獻記載。但是，猴痘由實驗室內靈長類族群傳染給人類，則沒有相關記載。
一般說來，猴痘的特徵為發熱、身體不適、頭痛、劇烈背痛、虛脫衰竭，及偶而有腹部疼痛。一些病人會發展成嚴重的突發性疾病疾死亡。良性的表皮猴痘特徵是卵圓形至環狀的紅色腫塊，通常發生在眼瞼，顏面，身體，或者生殖器。患部會自動自發地在4到6週復原。猴痘是正痘病毒屬，和它屬於同一屬種的，就是天花，只是致死率不像天花那樣可怕。
有科學家表示，可接種痘病毒疫苗以保護人類和猴子避免感染猴痘。人與人之間，可能會藉由接觸傳染。碰觸傷口，新近遭污染之病媒，或者患者呼吸分泌物，都有感染的可能性。此外，猴痘也被認為是人畜共通傳染病。土撥鼠則是被強烈懷疑的傳染源頭，不少家庭流行飼養土撥鼠，問題是，這些土撥鼠是從哪裡進入美國本土的？據了解，日本政府已經明令禁止土撥鼠的進口。日本人比美國人更愛養土撥鼠。
禽流感、狂牛症、SARS、AIDS、西尼羅病毒已經讓人神經緊繃，現在又出現猴痘，人類真該檢討一下，和自然界的關係如何？
原文
Alert Issued as U.S. Monkeypox Cases Grow to 37
Tue June 10, 2003 10:42 AM ET
By Michael Conlon
CHICAGO (Reuters) - Officials in three states tried on Monday to track down
pet prairie dogs believed to be spreading "monkeypox," a
smallpox-like illness not seen before in the Western Hemisphere that may have
infected 37 people.
Only six of the victims were being treated in hospitals, officials
said, and they were expected to recover with bed rest. The disease, caused by
monkeypox virus, is not believed to spread person-to-person.
But in light of the severe acute respiratory syndrome scare and an
approaching summer season when mosquito-borne West Nile virus was likely to again
pose a deadly threat, health officials were moving to attack the newly
diagnosed problem.
Stephen Ostroff of the U.S. Centers for Disease Control and Prevention,
said there were 33 confirmed or suspected cases of monkeypox under
investigation. Locally, officials listed more -- 22 in Wisconsin, 10 in Indiana
and five in Illinois.
"We don't know how many animals or humans have been involved and
we don't know the scope of the problem," Ostroff told reporters in
Atlanta.
UNHEALED LESIONS
He said only people with unhealed lesions need to be quarantined and
the infection does not appear to be as contagious as smallpox, showing no signs
of spreading from person to person.
"We do not have evidence of person-to-person transmission,
although we are looking at that possibility," said Ostroff. He advised
people to consult a veterinarian or local health officials if they owned or had
been exposed to a sick prairie dog, rabbit or Gambian giant rat.
It is believed the disease spread from Gambian rats imported from
Africa as exotic pets. It spread from there to prairie dogs, members of the
squirrel family that live in the dry plains from Texas north to Canada and
which have been rescued from exterminators for use as pets.
Phil Moberly, co-owner of a pet store in the Chicago suburbs where some
of the infected prairie dogs were believed to have become infected, said on
Monday he had bought the apparently infected rats in question from a breeder in
Texas without knowing they were ill.
SEARCH OF PRAIRIE DOGS
Indiana officials say they are trying to track down 31 individuals or
businesses believed to have purchased prairie dogs from Moberly's store since
April 15. Similar efforts were under way in the other two states.
In addition some of the animals may have changed hands during a swap
meet in Wisconsin, where most of the cases of illness have been reported.
Mark Wegner, a communicable disease expert with the Wisconsin Division
of Public Health, said the disease is most likely being spread when people are
scratched or bitten while handling the prairie dogs.
Smallpox has been eradicated worldwide. Smallpox vaccinations, however,
offer protection against monkeypox, meaning that adults who were vaccinated are
most likely to have immunity against it.
Children, however, are at risk. In Africa, the mortality rate for young
children can be as high as 10 percent.
受到SARS影響，今年不少畢業生都沒有畢業典禮、或是變成有點沒看頭的網路畢典。關於畢業典禮，您有沒有特別的回憶？特別的想法？特別的好點子辦畢業典禮？無論是曾在畢典後「算帳」、或是分手、報仇……歡迎您寫下難忘的畢業典禮與大家分享
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