臺灣博碩士論文加值系統

研究背景：腸病毒感染是世界各地引起新生兒與幼童手足口症或是皰疹性咽喉炎的疫情或群聚感染的主因，也是為孩童常見的疾病感染源。 腸病毒的感染途徑主要是透過糞口或是經由飛沫途徑傳染。過去研究於病童呼出氣體中及醫院診間空氣偵測到腸病毒，亦有研究指出家戶與幼稚園為腸病毒傳播的主要模式，然而過去並沒有研究進行家戶成員與學校同學腸病毒呼出氣體濃度與居家、學校環境中空氣樣本腸病毒濃度評估。
目的：偵測與定量腸病毒感染病童病程中呼出腸病毒濃度的變化，以及家戶成員與學校同學呼出腸病毒濃度，了解腸病毒學校與家戶內腸病毒空氣傳播情形與特性。
方法：本研究使用呼出氣體採樣方法，樣本以Real-time qPCR法定量分析病童與其同學、家人的呼出氣體中腸病毒濃度，並偵測學校與家戶空氣中腸病毒濃度。
研究結果：腸病毒確診指標案例病童，呼氣陽性率達83.3%。學校同學呼氣樣本陽性率為2.5%，家戶內成員呼出氣體陽性率為42.9%，孩童呼氣陽性率達63.3%，成人呼氣陽性率為44.4%。孩童呼氣腸病毒濃度平均為9.59 x108 copies/ m3，成人呼氣腸病毒濃度4.12 x109 copies/ m3。家戶內空氣樣本腸病毒陽性率達15.8%，平均濃度為4.97 x102 copies/ m3。

Background: Enterovirus infection is a common source of disease in children and infants and cause HFMD and herpangina outbreaks around the world. Enterovirus infection is usually transmitted via fecal-oral route or airborne route. Previous study had already detected enterovirus in exhaled air and indoor air of hospital. Intrafamilial and kindergarten transmissions were major modes of enterovirus transmission. However, no study evaluated concentration of enterovirus in exhaled air in household members and air samples of household and school.
Aim: Detection of enterovirus in exhaled air of child, their family and school classmates. Evalution of intrafamiliy enterovirus transmission in family and school.
Method: We used exhaled air sampling method and real-time qPCR for enterovirus detection of infected child, their family and school classmates.
Result: There were six index cases of children who had been diagnosed of enterovirus infection, positive rate of exhaled air samples was 83.3%. Positive rate of household members was 42.9%, children of household were 63.3%, adults of household were 44.4%. The mean concentration of exhaled air of children was 9.59x 108copies/ m3, and adults were 4.12x 109copies/ m3. Possitive rate of air samples was 15.8%, the mean concentration of air samples were 4.97x 102copies/ m3.

摘 要 2
Abstract 3
致 謝 4
目 錄 5
第二章、文獻回顧 8
2.1 腸病毒簡介 8
2.2腸病毒流行概況 10
2.3台灣腸病毒疫情流行概況 17
2.4 腸病毒的傳播模式 32
2.5腸病毒採樣方法、檢體特性： 43
第三章、材料與方法 48
3.1研究架構與採樣策略 48
3.2前置作業 50
3.3腸病毒採樣 51
3.4腸病毒萃取 52
3.5腸病毒分析 53
第四章、結果與討論 55
4.1學校與幼稚採樣結果與討論 55
4.2 家戶採樣結果與討論 58
4.3 受試者呼氣濃度、陽性率、空氣樣本結果與討論 64
4.4 研究結果與血清型討論 66
第五章、結論 67
參考文獻 68
圖、表、附件 74
委員意見回覆 125

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