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国外传康复后再感染病例 国家传染病中心:对出院患者采额外防御措施

by 林殊
28/02/2020
in 健康, 冠状病毒(COVID-19), 新闻, 时事
Reading Time: 1 min read
0

昨日(27日)日本传出有患者在感染武汉冠状病毒康复后再度感染,造成人心惶惶,人们纷纷对康复后的患者提出质疑,是否存在再感染的风险。国家传染病中心(NCID)对此表示,这不太可能发生在新加坡,因为患者在出院前, 医护人员会对他们采取额外的防御措施。

在此之前,本地已有62名患者康复出院,国家传染病中心的专家表示,这些患者已经过确认体内并无病毒的存在,因此无法将其传染给其他人。

然而,专家也表示,目前仍无法掌握患者是否可多次感染的现象,因为仍未有足够的样本数探究。

国家传染病中心临床主任兼高级顾问医生苏安华素(Shawn Vasoo)认为,对于再度感染的现象是极少发生的状况,但仍保留其说法,并会对此进行评估。 为了能够重复确认,中心已开始对出院后两周的患者,在后续追踪时,采取抽查的可能。

日本大阪政府于26日证实一名40多岁的女性导游于本月1日康复出院后,26日再次被验出阳性反应。 但当局表示,并未掌握太多相关信息,而且正与日本当局确认具体状况。

除了日本传出有康复者再度感染,中国也曾出现类似案例。四川省卫生健康委员会已证实,一名住在四川成都“望江锦园”、感染武汉冠病的民众,治愈后回到家中隔离,但在第10天复检时再次确诊。

专家:若呼吸道存在病毒脱落的现象,即具备出院资格

《海峡时报》也对此向专家请教,国家传染病中心主任梁玉心教授解释,要判断是否具有传染风险则需视患者呼吸道的病毒传播情况,医生在检测上会特别注意是否在呼吸道上仍存在活跃病毒,并具传染风险。

因此医生会对患者使用咽喉擦拭液(nasal or throat swabs),若患者体内不存在病毒,则会出现病毒脱落(Virus-shedding)的情况。

换句话说,如果患者打喷嚏或咳嗽时,并不存在任何病毒能够污染表面或感染他人时,便具有出院的资格。

“只有病人在经过临床康复后,并接受分子诊断表明已停止传播病毒,方可出院。 ”

目前许多患者在住院后情况良好,尤其是在出院的最后几天,但中心也表示,追踪患者也是我国会采取的预防措施之一。

梁玉心也表示,就算病人在经过检测后显示患者已痊愈,无病毒存留在体内,他们仍至少要在医院待上一天,等待二次检测的结果,24小时内会收到结果。 而出院后,患者也会在国家传染病中心的制定诊所接受检查。

中国传出有少数患者出现“再感染”风险

日前,广州市第八人民医院感染病中心ICU主任李粤平表示,对出院病例随访时发现,病人有13例,密切接触者有104例很可能呈“阳性”。

苏安医生也表示并不奇怪,但同时也令人担忧,因为病毒是在肛门拭子(Anal swab)被发现。

他表示,根据2003年SARS的数据也曾显示,患者在康复后约四周内,在粪便中被发现病毒。 但这并不意味着病毒仍活跃,冠状病毒是通过飞沫传播。

苏安医生表示,由于病毒是需要透过呼吸道传播出去,如果在呼吸道内已经出现病毒脱落的现象,这些人也不具备感染他人的特征。 即使粪便中藏有活跃病毒,但也不应该成为现代人的感染源。

针对日本大阪市再度感染的患者,苏安则表示,目前仍未能得知患者的免疫力究竟能维持多久,仍需要临床研究观察其免疫反应。

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