結合接觸問卷與飛沫實驗模擬  學童呼吸性傳染病動態

本研究之目的為結合接觸問卷與飛沫實驗，模擬學童呼吸性傳染病動態。研究對象為桃園縣東興國中學童，將接觸調查變項包括年齡、與接觸者的接觸地點、接觸期間、接觸頻率及家庭人口等。以普瓦松迴歸分析其接觸次數與接觸變相之相關性。此外，接觸的定義為雙向交談、至少說三個字及無自然屏障，交談距離約為一公尺。本研究推估學童的感染流感病毒濃度值(v)、總症狀計分(TSS)及標準化接觸率(w)三者的每日變化情形。此外，本研究以十位受測者進行20次咳嗽及說話計數1–20的飛沫實驗，利用微粒分析儀Grimm 1.108及Grimm 1.109，量測總粒數濃度及粒徑分佈。問卷結果顯示七–九年級的有效接觸率分別為0.64 (5%–95%: 0.1–1.64)、0.53 0.1–1.45)及0.44 (0.06–1.24)。推估學童每日感染隨時間變化結果顯示標準化接觸率增加，而病毒濃度與總症狀分數隨之下降。飛沫實驗結果顯示咳嗽產生的總粒數濃度為3.24×107 (particle m-3)；說話產生總粒數濃度為8.93×106 (particle m-3)，估計每一次咳嗽產生的粒數濃度遠高於說話產生的粒數濃度，且飛沫粒徑D(d)皆<4 μm占總粒數濃度的99%。經易感–暴露–感染–復原(Susceptible–Exposed–Infected– Recover)模式，以全班為34人模擬，結果顯示以說話徵狀產生飛沫粒徑D(d1)<4 μm時，結果顯示說話行為於第7天會造成感染人數最多達到9人，咳嗽行為於第6天會造成感染人數最多達到14人。本研究的貢獻為國內首先以問卷的方式，了解學童的接觸行為，以及利用光學微粒分析儀結合飛沫傳播的概念，探討學童感染動態情形。

關鍵字

問卷；有效接觸率；飛沫實驗；易感–暴露–感染–復原(Susceptible–Exposed–Infected– Recover)模式

並列摘要

The objective of this study is to provide a transmission dynamic modeling of respiratory infectious diseases of schoolchildren by linking contact questionnaire survey and droplet experiments. This study conducted a questionnaire survey in Taoyuan County, Dongxing junior high school students with recorded contact variables including the estimated age, contact location, contact duration, contact frequency and household size. Poisson regression analysis between number of contacts and all contact variables were performed. In addition, the contact was defined as a two way conservation in which at least three words were spoken by each party and in which there was no physical barrier between the two parties and the conversation distance less than 1 meter. We also estimated the relationship between viral titers (v), total symptom score (TSS) and normalized contact rate (w) in children. On the other hand, 10 participants were conducted the respiratory droplet experiments by Grimm 1.108/1.109 for estimating the number concentration and size distribution generated by human exhaled 20 coughing and talking 1-20. Results indicated that the effective contact rate for grades 7–9 were 0.64 (5%–95%: 0.1–1.64), 0.53 (0.1–1.45) and 0.44 (0.06–1.24), respectively. Normalized contact rates increased over the days following illness onset, whilst the viral titers and total symptom scores both decreased accordingly. Experiment results shown that the droplet concentration were 3.24×107 (particle m-3) and 8.93×106 (particle m-3) for coughing and talking, respectively, showing the higher concentration for coughing and with 99% droplets size were <4 μm. The major results of Susceptible– Exposed–Infected–Recover (SEIR) modeling shown that the size-dependent (D(d1): <4 μm) median number of droplets per test subject caused maximum 9 infected people (total population size: 34) in day 7 for talking activity. On the other hand, the size-dependent (D(d1): <4 μm) median number of droplets per test subject caused maximum 14 infected people in day 6 for coughing activity. The contribution of the study is to understand schoolchildren’s contact behavior by questionnaire and combine the concept of the droplet spread by optical particle analyzer, to explore transmission dynamic of schoolchildren.

並列關鍵字

Questionnaire ； Infectious contact rate ； Droplet experiments ； Susceptible–Exposed–Infected–Recover (SEIR) model

參考文獻

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結合接觸問卷與飛沫實驗模擬學童呼吸性傳染病動態

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