致同社各朋友:
請大家好好保重身體,如非必要也不要到人多的地方, 以下為網絡上一位醫生網友, 除了在醫院裡和病毒搏鬥外, 還花了點時間分享他所知.
我除了向他致敬外, 還希望能和你們分享這份資料!
==================================================前線醫生與你再談非典型肺炎
1) 為何要同大家討論?
我是在其中一間受非典型肺炎影響的醫院工作的醫生, 我有同事受到感染, 也有份參與照料肺炎病人, 覺得有責住將事情向公眾澄清, 讓市民得到正確的資訊, 更希望讓大家得到適當的保護, 以免引起大家不必要的恐懼.
2) 什麼是肺炎?
肺炎即是肺部發炎, 主要成因是受細菌或病毒入侵所致, 也可能因吸入有害物質而引致肺部發炎.
3) 什麼是典型肺炎?
典型肺炎是一系列病徵的總稱, 病者有發燒, 咳嗽, 膿痰及胸痛等病况. 肺X光有肺炎影像.
4) 什麼是非典型肺炎?
非典型肺炎是另一系列病徵的總稱. 病者有發燒, 全身肌肉疼痛, 但沒有膿痰,病情和流感相近, 但肺X光有肺炎跡像.
5) 非典型肺炎有什麼致病原因?
例如, mycoplasma, legionella(退伍軍人症), Chlamydia Psittaci(鸚鵡熱), 甲型流感併發肺炎等.
是次在南中國及本港所爆發之非典型肺炎的致病原還未証實.
6) 是次非典型肺炎是如何傳染的?
我們相信是經飛沬傳染的. 因為受感染的病人是和病人有近距離接觸的醫護人員或其家屬.
我們認為這病不是經空氣或空調散播, 否則會有"大量"與肺炎病人同一病房的其他病人受感染的. 而且會在極快的速度在社區散播, 若是的話患病人數將會有幾何級數地增加
7) 何人是高危人仕?
高危一族如:
a) 在醫院工作或
b) 近日有曾與肺炎病人有近距離接觸或
c) 近日到訪過有非典型肺炎爆發的地方(如中山或廣州)
8) 綜合近期病例, 是次非典型肺炎患者多數有下列病徵:
a) 持續高燒, 至少三天以上
b) 乾咳, 痰不多
c) 肌肉疼痛
d) 部份人有腹瀉現像
e) X 光有肺炎病況
9) 是次的非典型肺炎(SARS)有何可怕?
a. 未發現致病病原
但我們相信是病毒引起, 不是細菌; 因為任何抗生素發現無效.
b. 部份病人肺部功能嚴重受損, 引致呼吸道衰竭, 故危害生命.其致命原因相信是因為感染誘發了過激的免疫反應, 以致身體對肺組織出現自我排斥現像, 故肺部功能被大大削弱.
c. 潛伏期長達七日, 故有帶病毒人仕在未發病或發病早期把病毐散開.
d. 醫院發病的源頭可能來自社區, 而社區的源頭在華南
其中一間醫院有七名醫護人員照顧過同一肺炎病人, 此人在二月尾從中山回港, 三月十日後名醫護人員便相繼病倒.
而我們相信有少數非典型患者還在社區, 他們把病毐傳給與他們有密切接觸的親友後部份病患者害病後出現嚴重的肺炎, 然後把病毒在醫院內擴散, 引致大量與病人有近距
離接觸的醫護人員受感染.
更可怕的是可能身邊有病徵較輕的帶病毒患者正把病毒散播, 但受感染者的病者則可能非常嚴重.
10) 是次非典型肺炎如何醫治?
起初大家都束手無策, 只看見病人病情惡化. 後來我們使用了一種抗病毒藥物名為ribavirin 及高劑量的抗排斥藥類固醇, 很多患病的人情況在短時間內改善. 所以我們更加相信是次肺炎是由病毒引起, 而致病機制是由病毐誘發病人自我排斥而起.
11) 如何防止自己被感染?
我們相信是次肺炎是由口沬傳播, 受影響範圍在三呎內. 否則染病人數一定非常多,並且會短時間內在社區散播. ""大家切記""若染上了上呼吸感染,請戴上面罩, 免得口沬橫飛,影嚮他人. 如非必要也不要去探病,儘量遠離患有咳嗽及流感的病人, 那麼受傳的機會便會很小. 增加室內空氣流通, 可以"沖淡"病毐濃度, 也是重要的措施. 現大部份患者均已住院.所以若非高燒多日未退又
或有氣促, 若非必要就不要湧進醫院,尢其是急症室. 因為最大機會染上肺炎的地方就是醫院.
希望以上資料能幫助大家明白事實真相.
最重要的就是若有人有傷風感冒病徵 (雖只有很小的可能是患上非典型肺炎),無論在那裏都要戴上面罩, 免得病毒擴散. 及經常洗手,讓空氣流通.
若非持績高燒或氣促就不要湧進急症室, 免得在急症室意外"中招"
若有人有傷風感冒病徵,還是看私家醫生好些
致各幹事:
由於本人患嚴重流感, 為免交又感染, 故下星期幹事會要改期至4月7日,敬請原諒.
梁林:煩請轉告各幹事.
各位小心身體!
Take care, health is everything.
這樣家際運動攀登比賽是否要取消.
Franco:
為保障各朋友的安全, 我覺得家際運動攀登比賽也要暫時取消.
各小組負責人也請注意:
如近期小組內的活動是在室內人多的地方舉行,或發現參加者有肺炎病徵者, 也請即時取消活動.
保重保重
Take Care!~
Ms. Tang,
Thanks for the info on SARS.
It is just as bad in Toronto! If you go to local restaurant, the local (non Chinese!) will try to relocate themselves and sit somewhere else! Lots of space in Chinese restaurant, no more line up!
Kwan Wing Shan is under quarantine (volunteer "house arrest") right now because she visited a hospital that is infected. I will take a week off as well.
We have cancelled some meeting for the Visionyouth! BTW, some of the Gold program participants will fly to Vancouver for a 2 weeks training by Ken and Mabel. Will stay up in the Glacier for 4 days and 3 nites plus visit the native village. Sometimes in August time frame! See if anyone (from AKINS) want to join.
Take care!
Edman
Hi Everyone,
It is important to take it seriously. The Youth Leadership Development Program in Vancouver has postponed the graduation ceremony.
Ken Tung
對肺炎不必恐慌五理由
Below is the email forward by my uncle who is working in the hospital in Shatin district. Share with you.
***********************************************
FWD: SARS: Prevention of further spreading in the community
The following is the advice from a PWH frontline Medical Staff working in the "Dirty Team". (i.e. direct care on those patients in Ward 8A)
Please take his advice seriously; SARS is actually more infectious than you can think of.
"In fact, the frontline workers in PWH have been furious at DH (Sorry for my offensiveness). They didn't realize the significance of 90% medical and nursing staff being wiped out in one night by the virus and therefore public health campaign is inadequate, and sometimes false-reassuring. So I would like to quote one of my emails which is quite educational. Could you please forward these messages to all your friends and relatives and ask them to distribute further?
1. Always wear a well-fitted mask (N95 or 3 ply surgical) in escalator, bus, MTR, train, office, restaurant and shopping mall. Don't go to cinema. Push the button in the lift using your key to avoid any direct contact with your bare hand. If you can tolerate a latex glove, wear it.
2. Don't touch your mask, it traps a lot of droplets.
3. All the surfaces within a distance of 5 feet from a patient are highly infectious because of droplets. Wash your hands frequently. Don't rub your eyes, touch your nose or mouth before washing hands.
4. Clean the door handles, furnitures and floor with diluted (1 in 100) bleaching detergent. Dettol is NOT useful. Wash your clothes immediately after going home.
5. Patient is highly infectious 2-3 days (in contrast to what EK Yeoh said) even before developing illness. Treat those without wearing mask potentially infectious even if they look healthy."
(RECEIVED THRU E-MAIL!)
Subject: How the mask can protect you
Hi my dear friend,
I attended a talk organized especially for our community pharmacists
to night.
The speakers include pharmacist in PWH, QEH, KWH and a nurse
specialized in the control of transmitting disease.
The talk is very informative and therefore, i want to share with u all.
SARS (Severe Acute Respiratory Syndrome) is transmitted by droplets
(5 micro) but NOT by air bourne droplets (<5 micro).
This means that it can only be transmitted if the patient coughs,
speaks out loud etc which can force the droplets out thru the
mouth in 3 feet area.
In that case, we can wear masks to protect ourselves.
So what kind of mask should we use?
Most believe that 3M N95 8210 mask is the most effective one.
Yep, it can filter up to 0.3 micro particles, definitely is useful for SARS (as it
is?5 micro) but the surgical masks (green / blue in color) can also filter 5
micro particles. Therefore, it is recommended to use surgical mask which is
proved to be effective and much cheaper.
Besides, there are some drawbacks in using the N95 type.
It is not recommended for those who have asthma, breathing problems
and pregnant woman. As some of you who have used that before may know, the
breathing resistance is very large. You may feel uncomfortable and will
use your hand to adjust it from time to time. In this way, you will contaminate
your hand with the virus which may be present on the surface of the mask.
The nurse told us this may be the reason why HO SIU WAI has contacted
the disease. He wore a N95 mask when he visited 8A ward on that day, he
felt very uncomfy and used his hand to touch the mask, finally he is infected.
Therefore, we should note some important points when wearing masks.
First, wash your hands thoroughly with detergent. It's better to scratch
your hands a little bit to wash off the virus as they can be removed by
physical friction.
Carefully identify the external and internal surface of the mask.
The colored face should be exposed. It is water-resistant, you can test
it by adding a water droplet, it won't diffuse.
Do not touch the mask after you have put it on, the exposed part may
contain virus.
Do not use it for a while and then take a rest by removing it and then
put it on again, in other words, it can't be reused.
Use it only when necessary or with your common sense.
e.g. It's no use to wear one at home when there're no infected or suspected
Patient at home.
One important thing to note is all the masks are designed for ADULTS only.
That means that even children can use it, it may not fit well.
Therefore, parents should make sure their children feel comfortable in using
masks. If the child find it hard to breath or feel dizzy etc, he should not use it.
The paper masks with only two layers of paper is NOT useful. It will
get dampened by droplets and can actually transmit the virus.
The nurse told us that there're only 3 diseases, Tuberculosis (TB),
Measles, Chickenpox which are transmitted by airborne droplets (AIR).
In that case, N95 should be used. 95 means 95 % filtration of air particles.
The company said that they use 0.3 micro particles to test the quality of the masks.
N95 standard is set by the States in 1996. For those who wear this
kind of masks, they need to past very stringent tests to make sure they can
fit the masks correctly. ( e.g. 25 min breathing test)
This is something what i have learnt to night.
It's very important information that I, as a community pharmacist, have the
responsibility to pass on to the public.
I hope that it can be helpful to u all.
Take care,
中醫預防藥方
