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本帖最后由 石桥wshh1975 于 2015-6-19 10:51 编辑
1.从目前证据来说,飞沫预防是恰当的,当然不排除进一步的证据。
2.SARS已明确是飞沫传播,指南推荐用的就是N95口罩,所以,N95口罩的推荐使用不能说明MERS是空气传播。
3.《Guideline for Isolation Precautions: Preventing Transmission of Infectious Agents in Healthcare Settings,》第19页
I.B.3.d. Emerging issues concerning airborne transmission of infectious agents.
I.B.3.d.i. Transmission from patients The emergence of SARS in 2002, the importation of monkeypox into the United States in 2003, and the emergence of avian influenza present challenges to the assignment of isolation categories because of conflicting information and uncertainty about possible routes of transmission. Although SARS-CoV is transmitted primarily by contact and/or droplet routes, airborne transmission over a limited distance (e.g. within a room), has been suggested, though not proven 134-141. This is true of other infectious agents such as influenza virus 130 and noroviruses 132, 142, 143. Influenza viruses are transmitted primarily by close contact with respiratory droplets 23, 102 and acquisition by healthcare personnel has been prevented by Droplet Precautions, even when positive pressure rooms were used in one center 144 However, inhalational transmission could not be excluded in an outbreak of influenza in the passengers and crew of a single aircraft 130. Observations of a protective effect of UV lights in preventing influenza among patients with tuberculosis during the influenza pandemic of 1957-’58 have been used to suggest airborne
transmission 145, 146.
In contrast to the strict interpretation of an airborne route for transmission (i.e., long distances beyond the patient room environment), short distance transmission by small particle aerosols generated under specific circumstances (e.g., during endotracheal intubation) to persons in the immediate area near the patient has been demonstrated. Also, aerosolized particles <100 μm can remain suspended in air when room air current velocities exceed the terminal settling
velocities of the particles 109. SARS-CoV transmission has been associated with endotracheal intubation, noninvasive positive pressure ventilation, and cardio• pulmonary resuscitation 93, 94, 96, 98, 141. Although the most frequent routes of transmission of noroviruses are contact and food and waterborne routes, several reports suggest that noroviruses may be transmitted through aerosolization of infectious particles from vomitus or fecal material 142, 143, 147, 148. It is hypothesized that the aerosolized particles are inhaled and subsequently swallowed.
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