新冠肺炎疫情發展至今,全球遍地開花,且變異株持續發展,只要稍不留意,便會讓疫情一波未平一波又起。用「星星之火足以燎原」來比喻眼前現況,一點也不為過。而提升篩檢率,以掌握疫源與黑數,以利全面防堵,是各界防疫之共識。除可至醫院進行檢驗外,目前亦有居家快篩之選項,雖試劑仍存在誤判機率,但準確度仍有一定水平,自行居家檢驗可減少群聚風險,還可發揮降低醫療機構能量負載之作用,不失為當前自行初步篩檢的良好方案
目前新冠病毒的檢驗方法有三種,分別是抗原檢測、抗體檢測及PCR核酸檢測。全球實驗室診斷主要以PCR核酸檢測為主,以下即提供各檢驗資訊
➤抗原檢測(居家快篩)
目前各大篩檢站所使用的即為抗原快篩,能在10-20分鐘內,是從呼吸道中採集檢體,檢驗是否含有病毒的抗原
◉優點:檢驗時間短,可快速獲得結果
◉缺點:準確率較PCR檢測低,未發病者可能不容易被發現,可能出現偽陽性、偽陰性等情況
➤抗體檢測(快篩試劑)
透過血液偵測血清內的抗體,檢測時間比較短,適用於感染14天以上者,可判斷是否曾經感染過,但潛伏期、感染前期測不到,無法即時做感染管制,且無法判斷是曾經感染還是正在感染,適合用於事後疫調,以釐清感染範圍,或判定感染者是否具抵抗力等用途。主要以檢疫場所施行為主
◉優點:藉以找出曾感染或接受疫苗注射者,以推測體內是否具有抗體
◉缺點:需在感染後期才能驗出,也可能會有偽陰性情況產生
➤PCR核酸檢測(Reverse transcriptase polymerase chain reaction,簡稱 RT-PCR)
為當前全球作為診斷染疫與否的檢測標準,可檢測出檢體中是否含有新冠病毒的遺傳物質
◉優點:準確度高,病毒量低也可檢驗出
◉缺點:耗時、成本高,且需要在生物安全第二級以上的實驗室,並透過專業設備及人員執行
中央流行疫情指揮中心宣布採用抗原快篩試劑,民眾能自行購買後居家自行檢測。目前核准的抗原快篩試劑廠牌其準確度高達80%~95%。雖然準確度較PCR略低,但以基礎防疫檢測已足夠,一旦出現陽性經通報,醫院將進行更精密專業的檢測與處理。而抗原快篩原理是以單株抗體偵測病毒蛋白,僅需15-20分鐘即可快速偵測病毒
根據桃園市小兒科家醫科診所李柏鋒醫師指出,若無症狀且未踏足高風險區域者,不需立刻進行快篩。但若出現症狀且有相關接觸史,就有進行檢測之必要;若無接觸史卻出現症狀,則可先考慮使用居家快篩,或是預約前往診所進行自費快篩。以下即彙整出「居家快篩5要點」,積極防疫不心急,共同守護顧家園!
❶落實前置作業
測試前務必洗淨雙手,再用酒精消毒,將檢測套組所有內容分別攤開在桌上。並確實檢查試劑的有效期限。事先備妥計時器,以掌握在最佳時間進行檢測結果判讀,需超過15分鐘但短於30分鐘內為準,過猶不及皆視為無效
❷詳細閱讀說明
使用居家快篩試劑前,務必詳閱使用說明書,並依步驟說明正確進行採檢及操作,以利提升檢測準確度。若有不了解,也可配合官方教學影片進行操作
❸採陰持續戒備
採檢後若依照說明書示例,判斷採檢結果是「陰性」,試劑會顯示1條線,僅代表採檢當下收集的檢體沒有偵測到病毒,但不能代表完全安全無虞。務必將用過的家用快篩試劑及試劑棒用塑膠袋密封好,以一般垃圾處理
❹採陽主動呈報
若採檢結果為「陽性」,試劑會顯示2條線,即表示可能染疫或出現誤判,當下不需驚慌,冷靜觀察身體情況,並將快篩試劑及試劑棒用塑膠袋密封好,主動連繫當地衛生局或撥打1922防疫專線,依照指示進行後續安排
❺檢後謹慎行事
快篩結果呈陰性者
應持續遵循疾病管制署防疫規範,做好個人防護,維持謹慎健康管理及體況觀察
快篩結果呈陽性者
主動聯繫當地衛生局或撥打1922防疫專線,聽從專業人員指示,若前往採檢院所,務必戴好口罩,切勿搭乘大眾運輸,並將使用過的居家快篩試劑及試劑棒用塑膠袋密封包好,交付給採檢院所人員,依防疫人員指示進行後續事宜
#快篩哪裡買
為響應防疫政策,提供民眾便利居家自行檢測,四大超商、藥妝店及電信通路,陸續開始販售「COVID-19家用快篩試劑」,在家即能自行檢測,可減少外出染疫之風險
▶️7-11(福爾威創、羅氏)
現場購買
▶️全家(福爾威創、羅氏)
到店使用FamiPort事務機台預購並結帳,預購後最快可隔日到店領取,以上2款皆限量販售,售完為止
▶️萊爾富(福爾威創)
現場購買,每店限量100盒
▶️OK MART(羅氏)
門市OK Line群組預購,預計7/9開始領取
▶️康是美(福爾威創、羅氏)
已開始販售
▶️屈臣氏(福爾威創、羅氏)
已開始販售
▶️POYA寶雅(福爾威創)
已開始販售,全台限定33家門市,每人限購一盒,每間門市限量30盒,並可搭配POYA Pay所有優惠使用
▶️全聯福利中心(福爾威創、羅氏)
已開始販售,台北市共109家有藥商許可執照門市
▶️遠傳電信(福爾威創)
已開始販售,全台超過600家擁有藥商許可執照的遠傳門市直接購買
#快篩停看聽
⚠️若已明顯出現COVID-19相關症狀,就不宜再使用COVID-19家用快篩試劑,此時應儘速聯繫相關防疫單位,佩戴醫用口罩並前往指定醫療院所就醫,切勿搭乘大眾運輸工具前往
⚠️居家快篩試劑屬於醫療器材,需在合法藥局、藥妝店、醫材行或指定通路購買。食藥署規定,居家快篩試劑並未准許於網路上販售,不管是正品或仿冒品,依法可開罰3萬元以上,100萬元以下之罰鍰
⚠️快篩高誤判機率者有二,1是無症狀感染者,其敏感度只有40~60%;2是Ct值太高也不易快篩出來,每家廠商的快篩數據不同,大部分是「Ct值大於30」不利使用抗原快篩
Ct值英文全名為「cycle threshold(CT)value」,中文又可稱為「循環數閥值」,這是新冠肺炎病毒基因在實驗室中,透過病毒核酸檢測(PCR)之後所測出來的數值。長庚大學新興病毒感染研究中心主任施信如指出,新冠病毒非常微小,僅約流感病毒的10分之1,想要監測病毒RNA的濃度,就必須透過PCR多次複製特定基因,放大觀測。每將病毒放大1次就是1單位的Ct值,也就是2的次方倍(以Ct值18為例,就是指2的18次方)。如果確診者體內病毒RNA濃度很高,進行PCR檢測時,只要複製幾次就能觀測到病毒,此時Ct值數值相對較低,顯示傳染力較高。相較之下,許多確診者感染時間較久,體內病毒濃度相當低,在做PCR檢測時,就必須重複複製好多次,才能觀測到病毒RNA濃度,這個時候Ct值數值就較高了,卻也代表傳染力低。一般來說,確診者出現症狀時,Ct值低於28,顯示剛被傳染,體內病毒濃度較高。在染疫14至20天後,Ct值逐漸變高,如果到了30以上,傳染力相當低。指揮中心指出,凡Ct值大於34,就符合解除隔離的規範,可讓患者盡快出院
#凱鈞話重點
#居家快篩5要點
polymerase chain reaction中文 在 國家衛生研究院-論壇 Facebook 的最佳解答
「Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China(2020/02/07)+中文摘要轉譯」
➥中文摘要轉譯:
截至2/4日,北京報告13例,大多為年輕健康人。症狀輕微且無人死亡。與過去報導一致,健康人感染後預後較佳。
註:初期流行病學易有偏誤,不可推估大流行時狀況。(財團法人國家衛生研究院-郭書辰醫師整理)
➥In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.
「Methods」
Data were obtained from 3 hospitals in Beijing, China (Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University [8 patients], Beijing Anzhen Hospital, Capital Medical University [4 patients], and College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital [1 patient]). Patients were hospitalized from January 16, 2020, to January 29, 2020, with final follow-up for this report on February 4, 2020. Patients with possible 2019-nCoV were admitted and quarantined, and throat swab samples were collected and sent to the Chinese Center for Disease Control and Prevention for detection of 2019-nCoV using a quantitative polymerase chain reaction assay.3 Chest radiography or computed tomography was performed. Data were obtained as part of standard care. Patients were transferred to a specialized hospital after diagnosis. This study was approved by the ethics commissions of the 3 hospitals, with a waiver of informed consent.
「Results」
The median age of the patients was 34 years (25th-75th percentile, 34-48 years); 2 patients were children (aged 2 years and 15 years), and 10 (77%) were male. Twelve patients either visited Wuhan, including a family (parents and son), or had family members (grandparents of the 2-year-old child) who visited Wuhan after the onset of the 2019-nCoV epidemic (mean stay, 2.5 days). One patient did not have any known contact with Wuhan.
Twelve patients reported fever (mean, 1.6 days) before hospitalization. Symptoms included cough (46.3%), upper airway congestion (61.5%), myalgia (23.1%), and headache (23.1%) (Table). No patient required respiratory support before being transferred to the specialty hospital after a mean of 2 days. The youngest patient (aged 2 years) had intermittent fever for 1 week and persistent cough for 13 days before 2019-nCoV diagnosis. Levels of inflammatory markers such as C-reactive protein were elevated, and numbers of lymphocytes were marginally elevated (Table).
Four patients had chest radiographs and 9 had computed tomography. Five images did not demonstrate any consolidation or scarring. One chest radiograph demonstrated scattered opacities in the left lower lung; in 6 patients, ground glass opacity was observed in the right or both lungs (Figure). As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital.
➥Author: De Chang, Minggui Lin, Lai Wei, et al.
➥Link: (JAMA) https://jamanetwork.com/journals/jama/fullarticle/2761043
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
#2019COVID19Academic
polymerase chain reaction中文 在 國家衛生研究院-論壇 Facebook 的精選貼文
「Epidemiologic and Clinical Characteristics of Novel Coronavirus Infections Involving 13 Patients Outside Wuhan, China(2020/02/07)+中文摘要轉譯」
➥中文摘要轉譯:
截至2/4日,北京報告13例,大多為年輕健康人。症狀輕微且無人死亡。與過去報導一致,健康人感染後預後較佳。
註:初期流行病學易有偏誤,不可推估大流行時狀況。(財團法人國家衛生研究院-郭書辰醫師整理)
➥In December 2019, cases of pneumonia appeared in Wuhan, China. The etiology of these infections was a novel coronavirus (2019-nCoV),1,2 possibly connected to zoonotic or environmental exposure from the seafood market in Wuhan. Human-to-human transmission has accounted for most of the infections, including among health care workers.3,4 The virus has spread to different parts of China and at least 26 other countries.1 A high number of men have been infected, and the reported mortality rate has been approximately 2%, which is lower than that reported from other coronavirus epidemics including severe acute respiratory syndrome (SARS; mortality rate, >40% in patients aged >60 years)5 and Middle East respiratory syndrome (MERS; mortality rate, 30%).6 However, little is known about the clinical manifestations of 2019-nCoV in healthy populations or cases outside Wuhan. We report early clinical features of 13 patients with confirmed 2019-nCoV infection admitted to hospitals in Beijing.
「Methods」
Data were obtained from 3 hospitals in Beijing, China (Beijing Tsinghua Changgung Hospital, School of Medicine, Tsinghua University [8 patients], Beijing Anzhen Hospital, Capital Medical University [4 patients], and College of Respiratory and Critical Care Medicine, Chinese PLA General Hospital [1 patient]). Patients were hospitalized from January 16, 2020, to January 29, 2020, with final follow-up for this report on February 4, 2020. Patients with possible 2019-nCoV were admitted and quarantined, and throat swab samples were collected and sent to the Chinese Center for Disease Control and Prevention for detection of 2019-nCoV using a quantitative polymerase chain reaction assay.3 Chest radiography or computed tomography was performed. Data were obtained as part of standard care. Patients were transferred to a specialized hospital after diagnosis. This study was approved by the ethics commissions of the 3 hospitals, with a waiver of informed consent.
「Results」
The median age of the patients was 34 years (25th-75th percentile, 34-48 years); 2 patients were children (aged 2 years and 15 years), and 10 (77%) were male. Twelve patients either visited Wuhan, including a family (parents and son), or had family members (grandparents of the 2-year-old child) who visited Wuhan after the onset of the 2019-nCoV epidemic (mean stay, 2.5 days). One patient did not have any known contact with Wuhan.
Twelve patients reported fever (mean, 1.6 days) before hospitalization. Symptoms included cough (46.3%), upper airway congestion (61.5%), myalgia (23.1%), and headache (23.1%) (Table). No patient required respiratory support before being transferred to the specialty hospital after a mean of 2 days. The youngest patient (aged 2 years) had intermittent fever for 1 week and persistent cough for 13 days before 2019-nCoV diagnosis. Levels of inflammatory markers such as C-reactive protein were elevated, and numbers of lymphocytes were marginally elevated (Table).
Four patients had chest radiographs and 9 had computed tomography. Five images did not demonstrate any consolidation or scarring. One chest radiograph demonstrated scattered opacities in the left lower lung; in 6 patients, ground glass opacity was observed in the right or both lungs (Figure). As of February 4, 2020, all the patients recovered, but 12 were still being quarantined in the hospital.
➥Author: De Chang, Minggui Lin, Lai Wei, et al.
➥Link: (JAMA) https://jamanetwork.com/journals/jama/fullarticle/2761043
衛生福利部
疾病管制署 - 1922防疫達人
疾病管制署
國家衛生研究院-論壇
#2019COVID19Academic
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polymerase chain reaction中文 在 聚合酶链式反应 - 维基百科 的相關結果
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