→ Babycat:翻譯完可能就明天了，當我沒看到..... 推 61.59.137.50 05/29
[不要全文叫我翻譯，這是大工程]
原文出自http://www.cuhk.edu.hk/sars/chinese/item2.htm#4
-----------------------------------------------------------------------
1. What is Atypical Pneumonia?
*'Pneumonia'(肺炎) means infection of the lungs.
*Symptoms include fever(發燒), cough(咳嗽) and breathing difficulties;(呼吸困難)
and signs on clinical examinations(臨床診斷) and x-ray of the chest.(胸部x光)
*Depending on the type of infective agents, some presented as 'Atypical
pneumonia' or as 'Unusual pneumonia' They can give rise to a wide spectrum
of manifestations ranging from mild to serious infections and health
consequences
--------------------------------------------------------------------------
2. What is SARS?
SARS stands for Severe Acute Respiratory Syndrome. This term describes
more aptly the nature of the current condition as a severe acute type of
'Atypically atypical pneumonia'. WHO definition of Suspect Case and
Probable case of SARS :
*Suspect Case of SARS
--In accordance with WHO, symptoms and signs include:
1.high fever above 38 degree AND
2.one or more respiratory symptoms (cough, shortness of breath, difficulty
breath or hypoxia) AND
3.Close contact with a person who has been diagnosed with SARS (in the
previous 10 days)
(這個精華區有，不用翻譯了吧)
In addition to fever and respiratory symptoms, SARS may be associated
with other symptoms including: headache, muscular stiffness, loss of
appetite, malaise, confusion, rash, and diarrhea.
*close contact means
i) having cared for or
ii) having lived with, or
iii) having had direct contact with respiratory secretions and body
fluids of person with SARS.
*Probable Case
--A suspect case with one of the following:
*Radiographic evidence of pneumonia or respiratory distress syndrome
*Autopsy findings consistent with respiratory distress syndrome without
an identifiable cause
----------------------------------------------------------------------------
3. What are the characteristics Signs and Symptoms of the current
SARS outbreak?
Frequency of Symptoms presented include the following :
(From Lancet, May 7, 2003 -
1,425 SARS patients from Hong Kong – Joint publication UK, CUHK, HKU, DH
and HA hospitals)
香港根據數家醫院1425個病人統計出來的結果
Fever (94.0%)(發燒)
Influenza-like (72.3%)(類似流行性感冒)
Chills (65.4%)(畏寒打顫)
Malaise (64.3%)(不舒服)
Loss of appetite (54.6%)(食慾不振)
Myalgia (50.8%)(肌肉酸痛)
Cough (50.4%)(咳嗽)
Headache (50.1%)(頭痛)
Rigor (43.7%)(發燒前的寒顫)
Dizziness (30.7%)(頭昏眼花)
Shortness of breath (30.6%)(呼吸急促)
Sputum production (27.8%)(唾液變多)
Night sweat (27.8%)(夜間盜汗)
Diarrhoea (27.0%)(腹瀉)
Coryza (24.6%)(鼻炎)
Sore throat (23.1%)(喉嚨發炎)
Nausea (22.2%)(噁心)
Vomiting (14.0%)(嘔吐)
Abdominal pain (12.6%)(腹部疼痛)
Fever + at least 1 other (87.6%)
Fever + at least 2 other (80.3%)
Fever + at least 3 other (70.7%)
(In the Amoy Garden cases(淘大花園的案例) and more recent cases, Diarrhea(腹瀉)
occurred in higher percentage of up to 60 to 70%, fever(發燒) may be less
obviousin less than 5 %)
The mean incubation period for SARS (SARS的潛伏期) is estimated to be 6.4 days
(95% CI 5.2-7.7 days). The mean time from onset of clinical symptoms to
admission to hospital varied between 3 to 5 days, with longer time earlier
in the epidemic. Exceptional cases with up to or more than 10 days or more
have also been reported.
-----------------------------------------------------------------------------
4. Mode of Transmission of SARS?(SARS的傳染途徑)
The available evidence suggests the mode of transmission is most consistent
with droplet spread through respiratory secretions(就是飛沫傳染的意思啦).
Contact with contaminated surfaces (受污染的表面) and other body fluids(體液)
may also be another route of spread. (The unusual spread in Amoy Garden could
be related to special associated environmental hazardous factors - the Main
findings and report on the Investigation has been released by the Department
of Health on April 17. It was also concluded that Airborne spread is most u
nlikely). http://www.info.gov.hk/dh/ap.htm
Although experts are still not sure about the exact mode and peak time
of spread, from the accumulated clinical observations, it is likely that
the Infectivity of SARS is highest when the affected person develops
symptoms i.e. fever and particularly when coughing.(意思就是SARS病患在開始
發燒或是咳嗽時才有可能傳染) Crowded enclosed space together with prolonged
exposure to the affected symptomatic patient gives the highest risk of being
infected (explaining the higher infection rate of medical and health care
personnel).(這在解釋為什麼醫護人員被傳染的風險很高) Early diagnosis and
treatment is most important therefore, not only for the better results of
treatment but also for containment of the spread of the disease.
----------------------------------------------------------------------------
5. The SARS Virus ?
(這個精華區講的比這部分還詳細，此段可以略過)
*In the past few weeks, CUHK microbiologists have initially detected a virus
metapneumovirus(人類間質肺病毒) belonging to the Paramyxoviridae (副黏液病毒科)
family in a number of specimens from the patients. HKU has identified a
different virus Coronavirus(冠狀病毒科). Infection by unusual Chlamydia
(衣原體) species has been reported from previous mainland studies. Many
other laboratories in the WHO collaborative laboratories throughout the
world have also identified metapneumovirus and coronavirus at different
stages.
*WHO has announced on April 16 that a new Coronavirus is now the most
definite virus causing the SARS. Complete genetic decoding of the virus
has been completed in Canada, USA, HKU, CUHK and mainland China etc in
the past few days. Most of the genetic sequences by different centres
look very similar with only a few base differences. All of these latest
findings points to a subgroup of new coronavirus which may have relationship
to certain animal source.
*Possibilities of co-infection by more than one organism/virus cannot be
totally ruled out at this stage. Coordinated collaborative research (under
the expert laboratories of the WHO specialist group) will continue to help
us to further understand the cause, transmission, epidemiology and unusual
clinical behavior of the candidate virus.
*Recent reports from the WHO collaborative centres have found that the
Coronavirus can survive on contaminated surfaces for up to 24 hours. Also
in urine(尿液) and faeces at room temperature(室溫) for at least 1-2 days
and longer (up to 4 days) in stool from diarrhea patients. Under experimental
environment with culture medium, the survival can be further prolonged. The
susceptibility to75% alcohol(75%的酒精), hypochlorite solution (漂白水)and
other known disinfectant has also been clearly proven.
-----------------------------------------------------------------------------
6. Diagnostic Tests for the Virus?
*2 main groups of Diagnostic tests for Coronavirus including 1) rapid
Molecular Genetic tests (PCR tests) from patient's nasal aspirates, oral
secretions, urine or stools and 2) Serological tests(血清測試) for antibodies against
the virus are under intensive investigation both locally and internationally
at the moment. A third test involves direct Virus culture (病毒培養)which
is more of a research tool rather than direct clinical application.
*The serological tests for antibodies using immunofluorescence(螢光免疫分析)
or ELISA(酵素連結免疫吸附分析法) tests may take one to 3 weeks after onset
of symptoms to be reliably positive. This is currently the most reliable
diagnostic test.
(注，ELISA可以看這裡。http://members.tripod.com/~talung/ELISA.html)
*Many new improved rapid PCR molecular tests for the earlier detection and
confirmation of the diagnosis are evolving or are under trials through the
WHO collaborative centres. Early reports on the tests for Coronavirus are
appearing in a number of centers. Currently the PCR tests still have
significant false negative results. Detail definitive scientific
documentation on the sensitivity and specificity of the tests or potential
new tests are still pending.
------------------------------------------------------------------------------
. What are the current treatments and the expected outcome?
Accumulated clinical experience in Hong Kong showed that Combination of an
anti-viral drug and corticosteroid(皮質類固醇) as first line treatment
plus other intensive supportive treatment has resulted in about 80 to 85%
good response in patients who were treated soon after the onset of
symptoms.
There is some recent discussion on whether the antiviral agent ribavirin
(雷巴威林，精華區有詳細介紹) is useful in the clinical treatment of SARS or
not. The USA CDC has some initial tissue culture showing poor inhibitory
action of the drug on cultured coronavirus. However, HKU microbiologist
has demonstrated in vivo the dose related effectiveness of ribavirin in
the treatment of mouse liver infected with coronavirus. The local clinical
experience also show 80 to 85 % good response in cases presented early from
their extensive clinical experiences.
In a joint Press Release on May 10, Professor Yuen kowk yung (HKU) and
Professor Joseph Sung (CUHK) and Dr. EK Yeoh (Secretary for Health, Welfare
and Food) summarized the research and clinical experiences from all local
hospital. The SARS clinical course can be divided into three phases
1) viral replicative phase, (病毒快速複製時期?)
2) immune hyperactive phase, (免疫系統過度反應時期?)
3) lung destructive phase. (肺部破壞時期?)
For good response patients, they do not enter the phase 3.
The timing and dosage of giving the antiviral agent, steroids and other
medications has been readjusted according to the observation and experience.
Importance of convalescent rehabilitation for the lung function has been
emphasized for the severe cases after discharge.
More scientific data and properly controlled clinical randomized studies
are gradually emerging which are necessary to further address the issue in
an evidence based approach..
For the most severely affected patients with poorer response to the regular
first line treatment, serum from convalescent patients and plasmapheresis
has been used with a few favorable responses from PWH. Other alternative
treatment methods with other antiviral agents, immunoglobulin (免疫球蛋白)or
cytotoxic agents(細胞毒性療法?細胞抑制劑?) are under studies for the poor
responding patients in different hospitals in Hong Kong and the rest of the
world. Possibility of adding adjuvant Traditional Chinese Medicine(中藥) for
selected patients has just been started in some hospital by special
arrangement and consultation with experts from Guangdong.
The 4 most important factors related to the fatal cases were: Old Age,(老年人)
Co-morbid chronic illness(慢性病患?), Delay in presentation for treatment
and Severity of the pneumonia. The mean death rate has been readjusted to
15% on May 8 by WHO as better follow up and understanding of SARS is
progressing. The death rate is most significantly affected by the old age
with the highest mortality occurring in patients above 60 years old.
(這部分精華區裡有提到，可以翻精華區)
There is some recent controversy in the calculation of death rate –
The currently used calculation is consistent with WHO (WHO is also actively
reviewing their definition).Please see the note from Department of Health's
for clarification http://www.info.gov.hk/gia/general/200304/26/0426132.htm
Recently, there seems to be a noticeable increasing in the ratio of
elderly affected with SARS with less obvious systemic fever.
It is uncertain though likely that the cohort patients from Amoy Garden
cluster or some newly admitted patients tend to have more severe systemic
diseases and ? poorer response to the current treatment.
Recent reports have found that patients recovering from SARS can still have
coronavirus in the body secretion including urine and stools. It is thus
strongly recommended that the discharged patient should follow closely the
instructions and precautions as advised by the WHO. Up till now, no true
documented cases of any cross infection from the discharged patient has been
reported locally.
-------------------------------------------------------------------------------
8. Are there differences between SARS in the children and the adults?
*From a just published paper in Lancet (April 29) by CUHK Medical Faculty
and doctors from PWH and PMH
http://image.thelancet.com/extras/03let4127web.pdf
(這篇精華區有科景網站的中文翻譯，可以看看)
*SARS seems to have a less aggressive clinical course in younger children of
less than 12 years old with :
o Less severe pneumonia
o Milder symptoms
o Better and more rapid response to treatment
o Less requirement for oxygen therapy and
o Quicker recovery
Updated on May 11, CUHK Campus SARS Task Force
--
其實貼完這個才發現其實精華區資料多多啊
--
冷風吹過 一扇窗戶邊 有個學生 就讀工學院 看著電腦 完全不厭倦
說的笑話 就像阿里山...白雪
考試快到 筆記沒半頁 所有軟體 都是大補帖
遇到朋友 打招呼也不會(不會hey hey 就是不會hey hey)
想要快樂 所以畫個Para Para Girl
--
※ 發信站: 批踢踢實業坊(ptt.csie.ntu.edu.tw)
◆ From: 210.85.210.98