Presentation on theme: "預防措施及認識 Prevention & Control"— Presentation transcript:
1預防措施及認識 Prevention & Control Severe Acute Respiratory Syndrome (SARS )Severe Respiratory Syndrome (SRS)嚴重急性呼吸道綜合症HKWC-QMH-OSHCND AB-506
2Severe Acute Respiratory Syndrome (SARS) Prevention & Control Knowledge of SARSPrevention at Workplace* Personal Protective Equipment (PPE)* Daily Cleansing* Terminal Cleansing3. Personal Precaution* Healthy Lifestyle & Personal Hygiene4. Donning & Removing PPE for SARS Cases
3INFECTION CONTROL INFECTION INFECTIOUS AGENTS CROSS CONTAMINATION CHAIN OF INFECTIONPROCESS OF INFECTIOUS DISEASEINFECTION RISK
4INFECTION CONTROL (cont.) INFECTION – an illness produced by the invasion and multiplication of an infectious agent in body tissue.INFECTIOUS AGENTS – are microorganisms that can cause diseaseINCREASED SUSCEPTIBILITY – extremes of age; dysfunction immune system; very ill & high level of stress
5INFECTION CONTROL (cont.) AVOIDING CROSS CONTAMINATION“In health care facilities, it is essential that careful hand washing be done by all caretakers to avoid cross-contamination.”(Luckman & Sorensen, Basic Nursing, 3rd Edition, p. 506)
6Chain of Infection Infectious Susceptible Agent Host Portal of EntryReservoirMode ofTransmissionPortal ofExit
7Disrupting the Chain Susceptible Host Infectious Agent Portal of Entry Use disinfectants, antiseptics, antimicrobial drugs WASH HANDSMaintain effective immunization. Limit Exposure Personal hygiene & Health life-styleKeep natural body defenses intact WASH HANDSSusceptibleHostInfectiousAgentPortal ofEntryReservoirMode ofTransmissionPortal ofExitMaintain effective immunization. Limit Exposure WASH HANDSWASH HANDS:- Wear gloves when handling body substancesControl Sources: Air Movement, water & contactsBlock exit. Treat all body substances as potentially infectious WASH HANDS
8WHAT IS SARS (SRS)? 嚴重急性呼吸道綜合症? ATYPICAL Pneumonia:Influenza: Mycoplasma, Chlamydia, AdenovirusChemical:典型肺炎TYPICAL Pneumonia:Bacteria-Streptococcus非典型肺炎:支原體過濾性病毒化學性Unknown agentsSARS - Coronavirus family (變 種冠狀病毒)Paramyxovirus病因不明
10Cumulative Figures on SARS ( ) 3:00 P.M.Most of the deaths occurred in individuals who have a history of chronic diseases, or were patients who sought treatment at a relatively late stage of infection.
11Signs & Symptoms of SARS Frequency 頻數Fever 發燒 ≧ 38℃100%Chills 發冷92%Malaise 全身不適90%Headache 頭痛84%Myalgia 肌肉痛67%Cough 咳嗽50%Dizziness 頭暈49%Rigors 寒顫44%Sore throat 喉嚨痛43%Runny nose 流鼻水39%Productive cough 咳嗽有痰36%Chest X-ray: changes compatible with pneumonia
12Chinese University of Hong Kong Department of Diagnostic Radiology and Organ Imaging Radiological appearances of recent cases of atypical pneumonia in Hong KongDept of Anaesthesia & Intensive Care Severe acute respiratory syndrome (SARS)Campus (SARS) Task Force
13PROGRESS CXRCase 1: A 31-year-old health-care worker presented with 2-day history of fever, chills and myalgia.Figure 1 - CXR at the time of diagnosis showed ill-defined air space opacification in right lower zoneFigure 2 - CXR after 3 days showed partial resoulation of consolidatve changes in right lower zone. There is a new finding of ill-defined air space opacification in left lower zoneFigure 3 - CXR after another 4 days showed progressive resolution of the changes in both lower zones
14Route of Transmission 傳播途徑 *Droplets 飛沫，*Direct contact and Patient’s secretions 直接傳染, 患者的呼吸道分泌物* Fomites 中間媒介Confined areas with poor ventilation密閉空間Aerosol l噴霧擴散
16High Risk Group to Infection 感染病毒高危一族 Low Immunity 抵抗力薄弱Over exhausted & Stressed 過度疲勞Close contacts with infected case 與患者有近距離接觸
17Clinical Diagnosis and Treatment 診斷及治療 * History of Illness, Signs & Symptoms 病徵及病狀* X-Ray Chest X光肺* Blood for analyses 血液分析* High-dose of steroid, Ribavirin and cover with board-spectrum antibiotics 用對抗過濾性病毒的藥物和抑制免疫力的類固醇特效藥
18Wearing Facemask 佩 戴 口 罩Properly donned - satisfactory protectionThe general public may wear a facemask for self protection.Points to note 應注意事項:Wash hands before wearing a facemask 佩戴口罩前必須清潔雙手。
20Wearing Facemask (cont.) Follow the instructions on the packet carefully,Surgical facemask:The facemask should fit snugly over the face.The coloured side of the facemask should face outside.Tie all the strings that keep the facemask in place or fix the rubber bands of the facemask round the ears properly.The facemask should fully cover the nose, mouth as well as the chin.The metallic wire part of the facemask should be fixed securely over the bridge of the nose to prevent leakage.Under general circumstances, the surgical mask should be changed daily
22Wearing Facemask (cont.) Put the facemask into a plastic bag and tie it properly before putting it into a rubbish bin.Wash hands before wearing a facemask.Replace the facemask immediately if it is damaged or soiled.
23Wearing of Respirator N95 Hold respirator in handBands over the headCover Face with MaskFit Respirator N95 to faceTest Respirator N95
24Daily Disinfection* Use domestic detergent to clean floor, and surfaces, then use household bleach 1:50 to rinse floor and services.(Use 20 ml/cc household bleach ml/cc of tap water = 1000 ml/cc dilution)N.B: NEVER mix bleach solution with other chemicals or detergents.
26Daily Disinfection (Cont.) * Pay attention to all sides of beds, head and foot ends, bed side rails, lockers; doors, door-knobs, door handles, pull-push trolleys, taps and sinks.* Use designated cleansing tools: cloth, mops buckets for isolated areas.
27Clean up of Spilt body fluids or vomitus Put on disposable gloves & masks, wipe the vomitus, phlegm or body fluid with paper towel.Use household bleach 1:50 dilution to clean the affected area and the surrounding
28Clean up of Spilt body fluids: phlegm, vomitus or others 溢濺物的處理
29Terminal Disinfection Clean all floors and services first with domestic detergent, then household bleach 1:50 dilution to disinfect the floor, all corners and surfaces.Use domestic detergent to clean bed: head and foot ends, bed frames, mattress, side rails, lockers, pull-push trolley; handles, doors, door-knobs, taps & sinks. Then use household bleach 1:50 dilution to wipe all services washed with detergents.
30Terminal Disinfection (Cont.) * Bedside medical equipment: stethoscope, sphygmomanometer must be cleansed and disinfected before using on other patients* Use 70% Alcohol wipe for parts that cannot be washed. Cuff of sphygmomanometer must be washed with household detergent, rise and dry well before use* All surfaces of isolation room must be washed with household detergents, then disinfect with household bleach 1:50 dilution.
31Precaution in Office Environment 預防措施—辦公室 * Remind staff having cough & fever to consult doctor and be granted leave to stay at home* Personal hygiene, rigorous hand washing & wear masks if suffering from common cold.* Adequate spacing between office workers* Open window to allow circulation of fresh air.* Frequent cleaning of air-conditioning system and filters.* Daily vacuum clean floors and carpets, maintain good housekeeping.
34Precaution - Personal * See to personal health and hygiene * Always cover mouth and nose with handkerchief of paper handkerchiefs/ tissue paper while sneezing, coughing or yawning.* Proper disposal of used paper handkerchiefs/ tissue paper.* Wash hand thoroughly after coughing, sneezing, toileting or using public facilities.* Immediate seek medical advice if having cough and fever
35Personal – Healthy Life Style 預防措施 — 個人 (绩) A balanced diet (adequate fat, protein carbohydrates) and plenty of fluid. Eliminate or minimize caffeine & alcoholic drinks均衡及充足的飲食，避免不健康食品，如咖啡、酒精飲品* Quit Smoking 戒煙
36Jawetz,E; Melnick, J. L. & Adelber, E. A. (1987) Jawetz,E; Melnick, J.L.& Adelber, E.A. (1987). Review of Medical Microbiology, 17th Ed. Appleton & Lange. Chapter 40 pp. 474“The coronaviruses include human strains from the respiratory tract, avian infectioius brochiturs virus (IBV), mouse hepatitis virus (MHV), an enteritis vius of swine and others…………”“Growth of humancoroaviruses are difficult in cell cultures…….The optimal temp. for growth is 33-35C“Coronaviruses of lower animals can establish long-term infections in their natural hosts (pigs, chickens, mice). They may also set up inapparent persistent infections in humans.
37Great Facts about Pork“The 3,000 year old Confucian Book of Rites says, "A gentleman does not eat the flesh of pigs and dogs." Although many Chinese are avid eaters of pork today, physicians of ancient China recognized pork-eating as the root of many human ailments”.Influenza (flu) is one of the most famous illnesses which pigs share with humans. This illness is harbored in the lungs of pigs during the summer months and tends to affect pigs and humans in the cooler months. Sausage contains bits of pigs' lungs, so those who eat pork sausage tend to suffer more during epidemics of influenza. Pig meat contains excessive quantities of histamine and imidazole compounds, which can lead to itching and inflammation; growth hormone, which promotes inflammation and growth; sulphur-containing mesenchymal mucus, which leads to swelling and deposits of mucus in tendons and cartilage, resulting in arthritis, rheumatism, etc.
38Personal – Healthy Life Style (Cont.)預防措施 — 個人 (绩) * Daily & regular exercises (deep breathing, stretch and brisk walking) 常做運動，增強身體的扺抗力* Adequate rest and sleep充足休息及睡眠，睡前摒除雜念* Practice relaxation techniques練習鬆弛技巧* Face stresses positively: Take stress as CHALLENGES 減低壓力
39Daily Disinfection PREVENTION AT HOME 預防措施 -家居 * Use domestic detergent to clean floor, and surfaces, then use household bleach 1:100 to rinse floor and services.(Use 10ml/cc household bleach ml/cc of tap water = 1000 ml/cc dilution)N.B: NEVER mix bleach solution with other chemicals or detergents.
40Daily Disinfection (Cont.) Pay attention to all sides of furniture: telephones, tables, chairs, chests, wardrobes, lockers; doors, door-knobs, door handles, pull-push trolleys, taps and sinks..Toys should be regularly cleansed by immersing in to household bleach 1: 100 dilution for 30 minutes, then rinse well and dry.
43Prevention at Home (Cont.) Do consult doctor immediately if any member of your family is having signs of common cold, fever or coughIf your child or toddler is suspected suffering from flu symptoms, do not sent him/her to school or nursery 。The affected family member should wear a surgical mask to prevent spreading to other family members.The care-giver should also wear surgical mask while attending the affected/sick family member.
47Quarantine and Prevention of Disease Ordinance (Chapter 141) amended to control infectious disease Regulation 4 of the Prevention of the Spread of Infectious Diseases Regulations requires medical practitioners to notify the Director of HealthAmended: Sections 72 and 8(4) & First Schedule to the Ordinance and Form to Quarantine and Prevention of Disease Ordinance (Amendment of First Schedule) Order 2003 and the Prevention of the Spread of Infectious Diseases Regulations (Amendment of Form) Order 2003With the addition of Severe Acute Respiratory Syndrome, a total of 28 infectious diseases are included in the First Schedule to the Ordinance
48The four designated medical centres: * Pamela Youde Child Assessment Centre(Shatin)2/F, Chap Wai Kon Street, Sha Tin* South Kwai Chung Jockey Club Polyclinic310 Kwai Shing Circuit, Kwai Chung* Shek Kip Mei Health Centre2 Berwick Street, Shek Kip Mei* Sai Ying Pun Jockey Club Clinic6/F, 134 Queen's Road West, Western
49HA-SARS COUNSELING 心靈綠洲 - Oasis Psychological Concern on SARS Centre of Personal GrowthAddress: 147B Argyle Street, KH Nurses Quarters, 1/F.Psychological Concern on SARSTel.:： (09:00-17:00, Monday to Sunday)Pager： (17:00-09:00, Monday to Sunday)Association of Hong Kong Nursing Staff (AHKNS)SARS Counseling Hotline： (14:00-17:00, Daily)SARS Enquiry：
55Hong Kong's hygiene laws - safeguarding public health Good health and a clean environment are needed to combat atypical pneumonia.In Hong Kong, where the rule of law prevails, there are comprehensive laws in place that relate to our daily lives and the running of businesses. These laws protect our rights and define the government's powers and responsibilities.This pamphlet highlights the most relevant laws that relate to the control of atypical pneumonia. Members of the public are encouraged to get acquainted with these laws, not just to avoid prosecution, but to better discharge their civic responsibilities and support law enforcement and implementation. If we all play our part, we will all benefit and Hong Kong will become a cleaner and more hygienic city
56Individual The Health Authorities are empowered to require: The owners or occupiers of premises to make improvements residence or related facilities dangerous to health (e.g. water tank, sewage pipe, refuse container)The owners or occupiers of premises to remove the waste at common part of a building, found on a canopy,The owners or occupiers of premises to destroy the vermin at premises found infestedThe owners or occupiers of premises not to obstruct scavenging operation and cleaning workers.No spitting is allowed in public places.Used tissue paper, masks and other waste shall not be disposed of in public places.
57The laws on health and quarantine set out in this pamphlet are contained in the Laws of Hong Kong or laid down in the common law. The relevant statutory laws include -Public Health and Municipal Services Ordinance (Cap. 132)Hawker Regulation (Cap. 132 sub. leg. AI)Places of Amusement Regulation (Cap. 132 sub. leg. BA)Public Cleansing and Prevention of Nuisances Regulation (Cap. 132 sub. leg. BK)Food Business Regulation (Cap. 132 sub. leg. X)Prevention of the Spread of Infectious Diseases Regulations (Cap. 141 sub. leg. B)Education Regulations (Cap. 279 sub. leg. A)Road Traffic (Public Service Vehicles) Regulations (Cap. 374 sub. leg. D)In most cases, a person who contravenes any relevant provision is liable to a maximum fine of $50,000 and imprisonment for one year. The offender may also be subject to civil claims.
58Department of HealthCentral Health Education Unit 24-hour Health Education Hotline:Education and Manpower Bureau Hotline :Social Welfare Department Hotline :Health Talk MaterialsPresentation Slide - Prevention of Respiratory Tract Infections (Microsoft PowerPoint Format ; Picture Format) Last updated on March 27, 2003
60Wellness to All THANK YOU Ref: HA – ICN:SRS Management & Guidelines HKMA -HKUCUHKDH - Leaflets* Prevention of Atypical Pneumonia* Atypical Pneumonia: Guidelines for the WorkplaceWellness to All THANK YOU