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别傻了!预防流感,宅家方为上策!

时间:2018-03-19 11:53:17 作者:感染说 阅读: 9918 点赞: 63 分享: 47

检索:濮阳市油田总医院 刘金淑

翻译:秦皇岛海港医院 赵 博

撰写:濮阳市油田总医院 刘金淑

东莞市第五人民医院 陈燕卿

审核:东莞厚街人民医院 陈志锦

流感作为全人类重要的公共健康问题,发病率为各种传染性疾病之首。2017年流感更是在国内刷了一波热潮,流感挂号总能在朋友圈里爆赞。流感预防妙招遍布大大小小的微信公众号,然而传统一直认为流感主要通过打喷嚏和咳嗽等飞沫传播,从潜伏期末到发病的急性期均有传染性。

下图这台神器是马里兰大学公共卫生学院开发来捕捉和分析呼出气息中流感病毒的机器,自带霸气的名字——Gesundheit,而且还是二代机型。

根据马里兰大学发布的一项新研究显示,流感病毒的传播比以前认知的要容易的多。人们通常以为,只有通过接触受感染者咳嗽或打喷嚏的飞沫或接触受污染表面来感染流感。然而,流感传播的新资料表明,有可能只是通过呼吸就能将流感传染给其他人,若是遇上流感患者在口若悬河,避之大吉为妥,否则不仅有溺水之危,更有流感之险。

马里兰大学公共卫生学院环境卫生教授,该研究的首席研究员唐纳德米尔顿解释说:“研究人员发现,流感患者仅仅通过呼吸,而不是咳嗽或打喷嚏就会传播病毒到周围的空气中。即使没有咳嗽,流感患者也会产生感染性气溶胶(即长时间悬浮在空气中的微小液滴),特别是在患病的第一天,所以流感患者应该回家,而不是留在工作场所传染他人。”若该建议一旦被新近改名的国家健康保障委员会采纳,得流感就能放假的福利就不单单是学生的专属,广大劳动人民也能惠及。

米尔顿和他的研究团队对142例流感确诊患者进行研究,在自然呼吸、说话、自发咳嗽和打喷嚏过程中捕获并分析流感病毒特征,并评估了自然呼吸产生的流感病毒气溶胶的传染性。研究人员分别在受试者出现症状的第1、2、3天采集了218个鼻咽拭子和218个30分钟呼出气体样本。

从这些样本中收集的传染性病毒的分析表明,大量流感患者常态化地将传染性病毒(不仅是可检测RNA)释放到气溶胶颗粒中,而气溶胶颗粒足够小以致存在空气传播的风险。

令人惊讶的是,在没有咳嗽的情况下获得的23个气溶胶样本中,具有可检测病毒RNA的就有11个,占48%,其中8个含有传染性病毒,这表明在精细气溶胶液滴中,传染性气溶胶的生成并不需要咳嗽。此外,观察到的少数喷嚏与较大的病毒RNA拷贝数无关,这表明喷嚏对流感病毒在气溶胶中分离并不起什么作用。

研究结果表明,保持物表清洁、勤洗手、避免接触流感患者咳嗽,预防流感的防控效果有限。宅在家中,远离公共场所,才是预防流感的正道!

资料来源:马里兰大学公共卫生学院

Flu MayBe Spread Just By Breathing, New Research Shows

A study participant sits in the Gesundheit II machine, which is used to capture andanalyze influenza virus in exhaled breath at the University of Maryland Schoolof Public Health. Courtesy of University of Maryland

It is easierto spread the influenza virus (flu) than previously thought, according to a new University of Maryland-led study released today. People commonly believe thatthey can catch the flu by exposure to droplets from an infected person's coughsor sneezes or by touching contaminated surfaces. But, new information about flu transmission reveals that we may pass the flu to others just by breathing.

The study"Infectious virus in exhaled breath of symptomatic seasonal influenza cases from a college community," published in the Proceedings of theNational Academy of Sciences, provides new evidence for the potential importance of airborne transmission because of the large quantities ofinfectious virus researchers found in the exhaled breath from people suffering from flu.

"We found that flu cases contaminated the air around them with infectious virusjust by breathing, without coughing or sneezing," explained Donald Milton,MD, MPH, professor of environmental health in the University of Maryland Schoolof Public Health and lead researcher of this study. "People with flugenerate infectious aerosols (tiny droplets that stay suspended in the air fora long time) even when they are not coughing, and especially during the firstdays of illness. So when someone is coming down with influenza, they should gohome and not remain in the workplace and infect others."

Researchers from the University of Maryland, San Jose State University, Missouri Western State University and University of California, Berkeley contributed to this study funded by the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health.

Milton and his research team captured and characterized influenza virus in exhaled breath from 142 confirmed cases of people with influenza during natural breathing,prompted speech, spontaneous coughing, and sneezing, and assessed the infectivity of naturally occurring influenza aerosols. The participants provided 218 nasopharyngeal swabs and 218 30-minute samples of exhaled breath,spontaneous coughing, and sneezing on the first, second, and third days after theonset of symptoms.

The analysisof the infectious virus recovered from these samples showed that a significant number of flu patients routinely shed infectious virus, not merely detectable RNA, into aerosol particles small enough to present a risk for airborne transmission.

Surprisingly,11 (48%) of the 23 fine aerosol samples acquired in the absence of coughing haddetectable viral RNA and 8 of these 11 contained infectious virus, suggestingthat coughing was not necessary for infectious aerosol generation in the fineaerosol droplets. In addition, the few sneezes observed were not associated with greater viral RNA copy numbers in either coarse or fine aerosols,suggesting that sneezing does not make an important contribution to influenzavirus shedding in aerosols.

"Thestudy findings suggest that keeping surfaces clean, washing our hands all the time, and avoiding people who are coughing does not provide complete protection from getting the flu," said Sheryl Ehrman, the Don Beall Dean of the Charles W. Davidson College of Engineering at San José State University."Staying home and out of public spaces could make a difference in thespread of the influenza virus."

According to the authors, the findings could be used to improve mathematical models of the risk of airborne influenza transmission from people with symptomatic illness and to develop more effective public health interventions and to control and reducethe impact of influenza epidemics and pandemics. Improvements could be made toventilation systems to reduce transmission risk in offices, school classrooms and subway cars, for example. Meanwhile, we can all heed the advice to stayhome, if possible, when we are beginning to get sick to prevent even greater numbers of flu cases. And, get vaccinated -- it is not perfect but does preventa significant amount of severe illness.

Source:University of Maryland School of Public Health

图文编辑:小小

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