新興傳染病－猴痘簡介與預防照護

猴痘（Mpox）是一種人畜共通疾病，自2022年以來，世界衛生組織已向多個國家發出建議，確定猴痘病例構成國際關注的突發公共衛生事件，並指出動物、人類和環境3者之間有密切關係，加上全球運輸交通便利，一旦疾病爆發，可能會導致更快的傳播速度。猴痘的臨床表徵包括發燒、劇烈頭痛、肌肉痠痛、虛弱和淋巴結腫大，隨後，皮疹從臉部開始出現，然後擴散到手掌、腳底及其他全身部位。皮膚病變依序進展：斑疹、丘疹、水皰、膿皰和結痂。在結痂脫落之前，病毒將持續維持2到4週的傳染性。目前，猴痘除了依據臨床表徵進行鑑別診斷之外，仍需靠實驗室分子技術檢測猴痘病毒脫氧核糖核酸（Mpox virus DNA）進行診斷。在治療方面，牛痘免疫球蛋白及抗病毒製劑是主要治療藥物，並搭配支持性療法及照護，包括營養補充、電解質補充及監測，以防止因食慾不振造成的脫水。在病患住院期間，須採呼吸道及接觸性隔離之外，照護團隊必須嚴格穿著個人防護裝備、落實洗手及謹慎處理患者使用過之衣物或物品，避免醫護人員感染。本文針對猴痘的流行病學、診斷、治療、照護及預防，進行近年文獻期刊的搜尋和彙整，冀望提供臨床醫護人員照護上新知與參考。

關鍵字

猴痘；傳染病；治療；預防照護

並列摘要

Mpox is a zoonotic disease. Since 2022, the World Health Organization has issued recommendations to multiple countries to identify Mpox cases as an international public health emergency. It has been noted that there is a close relationship between animals, humans, and the environment. With the convenience of global transportation, an outbreak of the disease could lead to its rapid spread. Clinical manifestations of Mpox include fever, severe headache, muscle aches, weakness, and enlarged lymph nodes, followed by a rash that starts on the face and spreads to the palms, soles of the feet, and other parts of the body. Skin lesions progresses sequentially to macules, papules, blisters, pustules, and crusts. The virus remains infectious for 2-4 weeks before the crust falls off. Currently, in addition to differential diagnosis based on clinical manifestations, Mpox diagnosis relies on laboratory molecular technology based on detecting Mpox viral DNA. In terms of treatment, the main therapeutic agents are bovine vaccinia immunoglobulins and antiviral preparations, along with supportive therapy and care, including nutritional supplementation, electrolyte supplementation, and monitoring, to prevent dehydration due to decreased appetite. During hospitalization, in addition to respiratory and contact isolation, the care team must strictly wear personal protective equipment, practice hand hygiene, and carefully handle used clothing or items to avoid infection of healthcare personnel. The present article compiles the recent literature on the epidemiology, diagnosis, treatment, care, and prevention of Mpox with the aim to provide clinical staff with new knowledge and references on care.

並列關鍵字

Mpox ； infectious diseases ； treatment ； preventive care

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