腸病毒感染與預防
中山醫學大學附設醫院藥劑科
[{'start': '0.000', 'end': '3.319', 'text': 'Welcome to listen to the beginning of the school year.'}, {'start': '3.319', 'end': '6.480', 'text': 'Everyone may be particularly concerned about the health of their children.'}, {'start': '6.480', 'end': '7.400', 'text': "Yes, that's right."}, {'start': '7.400', 'end': '9.259', 'text': "Today we're going to take a closer look at"}, {'start': '9.259', 'end': '11.300', 'text': "this pharmacist column you provided, and together we're going to"}, {'start': '11.300', 'end': '15.279', 'text': 'understand the topic of enterovirus. Yes,'}, {'start': '15.279', 'end': '16.579', 'text': 'this is very common,'}, {'start': '16.579', 'end': '18.000', 'text': "but it's also a bit worrying."}, {'start': '18.620', 'end': '21.500', 'text': 'Yes, our goal is to quickly grasp the key points,'}, {'start': '21.500', 'end': '22.679', 'text': 'understand its risks,'}, {'start': '22.679', 'end': '24.739', 'text': 'and most importantly, how to prevent it. Well,'}, {'start': '25.179', 'end': '27.339', 'text': 'first of all, there is a concept that'}, {'start': '27.339', 'end': '29.339', 'text': 'everyone may need to establish first. What is it? Enterovirus is'}, {'start': '30.000', 'end': '32.920', 'text': "actually not a virus. It's not a type."}, {'start': '34.479', 'end': '36.420', 'text': "I thought it was just called enterovirus, but it's"}, {'start': '36.939', 'end': '40.079', 'text': 'actually a general term for a large group of viruses.'}, {'start': '40.079', 'end': '42.259', 'text': "Now it's mainly based on the gene sequence, which is"}, {'start': '42.259', 'end': '44.320', 'text': 'divided into'}, {'start': '44.320', 'end': '45.979', 'text': 'four main types, A, B, C, and D.'}, {'start': '45.979', 'end': '47.859', 'text': 'Wow, it turns out to be a whole family.'}, {'start': '47.859', 'end': '50.140', 'text': 'No wonder there are so many'}, {'start': '50.140', 'end': '53.340', 'text': "different manifestations. So it can cause many different diseases. Let's"}, {'start': '53.340', 'end': '54.079', 'text': 'understand'}, {'start': '54.079', 'end': '57.000', 'text': 'how they are transmitted.'}, {'start': '57.000', 'end': '58.500', 'text': 'I read in the article that there are'}, {'start': '58.500', 'end': '61.640', 'text': 'fecal-oral, droplet, and contact transmission. It'}, {'start': '61.640', 'end': '63.159', 'text': 'feels like there are many channels.'}, {'start': '63.159', 'end': '64.299', 'text': 'Indeed,'}, {'start': '64.299', 'end': '67.120', 'text': 'this is why it is so easy to spread.'}, {'start': '67.120', 'end': '69.299', 'text': 'And the incubation period'}, {'start': '69.299', 'end': '71.579', 'text': 'can be from two days to ten days. And'}, {'start': '71.579', 'end': '73.900', 'text': 'a few days before the onset of the disease, it may'}, {'start': '73.900', 'end': '75.939', 'text': "already be contagious. It's"}, {'start': '77.219', 'end': '79.180', 'text': 'before the onset of the\ndisease. Yes, and the week after the onset of the disease is the'}, {'start': '79.180', 'end': '80.120', 'text': "most contagious. What's"}, {'start': '80.120', 'end': '81.079', 'text': 'more troublesome is that the'}, {'start': '81.079', 'end': '85.480', 'text': 'virus can live in the secretions of the mouth and nose for'}, {'start': '86.459', 'end': '87.599', 'text': 'a week. A week'}, {'start': '87.599', 'end': '88.019', 'text': 'Yes,'}, {'start': '88.019', 'end': '89.780', 'text': 'and it'}, {'start': '89.780', 'end': '92.060', 'text': 'can even stay in the intestine for six to eight weeks.'}, {'start': '92.060', 'end': '92.780', 'text': 'My goodness,'}, {'start': '92.780', 'end': '93.680', 'text': 'six to eight weeks. Does'}, {'start': '93.680', 'end': '95.540', 'text': "n't that mean that"}, {'start': '95.540', 'end': '97.879', 'text': 'even if the child seems to be fine, he or she may still be'}, {'start': '105.239', 'end': '106.900', 'text': "able to infect others? That's absolutely right. Parents really need to pay special attention to this. Even if there are no symptoms, the virus may still be present."}, {'start': '106.900', 'end': '107.219', 'text': 'Wow,'}, {'start': '107.219', 'end': '108.540', 'text': 'this information is very important.'}, {'start': '108.540', 'end': '110.799', 'text': 'If you are really infected, what are the'}, {'start': '121.040', 'end': '122.540', 'text': 'symptoms? In fact, there are many'}, {'start': '122.540', 'end': '124.120', 'text': 'different symptoms. Many people who are infected may just'}, {'start': '129.680', 'end': '133.039', 'text': 'have a mild fever. Some people may not even have symptoms at all'}, {'start': '140.819', 'end': '142.439', 'text': 'and recover on their own. There are also people without symptoms, yes. But the more typical ones, you may have heard of hand, foot and mouth disease, yes, yes, yes, often heard of it, that is, on the hands, feet, mouth, and sometimes on the buttocks, there will be rashes or small blisters. There'}, {'start': '148.439', 'end': '149.780', 'text': 'is another type called'}, {'start': '149.780', 'end': '151.240', 'text': 'herpetic pharyngitis, herpetic pharyngitis, yes, mainly small blisters will grow at the back of the throat, or they will break and become ulcers, then the child'}, {'start': '155.379', 'end': '159.379', 'text': 'will have a sore throat, and then he or she will not want to eat much. It sounds very uncomfortable and must be difficult to feed.'}, {'start': '162.379', 'end': '165.282', 'text': 'The article'}, {'start': '165.379', 'end': '168.282', 'text': 'seems to mention that herpetic pharyngitis is sometimes confused with another type. Yes, you have a good memory. It is'}, {'start': '171.302', 'end': '174.042', 'text': 'sometimes confused with the'}, {'start': '175.302', 'end': '177.102', 'text': 'herpes simplex virus type 1 But there is'}, {'start': '177.102', 'end': '179.682', 'text': 'one place where we can'}, {'start': '179.682', 'end': '182.762', 'text': "make a slight distinction between the two. Herpetic gingivostomatitis. Yes, yes, I think I've seen"}, {'start': '183.242', 'end': '184.862', 'text': 'this term. These two sometimes look a bit similar. How do you tell them apart? For herpetic gingivostomatitis, the gums are usually very red and swollen, and they are'}, {'start': '184.862', 'end': '187.422', 'text': 'more likely to bleed. The gums are red, swollen and bleeding. Yes, and the taste in the mouth may be'}, {'start': '197.682', 'end': '199.202', 'text': 'stronger. This can be used as a reference for distinction. This reminder is quite practical. But I think what parents are'}, {'start': '205.162', 'end': '206.422', 'text': 'most worried about'}, {'start': '206.422', 'end': '208.162', 'text': "is the so-called severe illness. That's right. Under what circumstances should we"}, {'start': '209.242', 'end': '210.782', 'text': 'be very, very alert and even rush to the hospital immediately. This is the key among the keys. The article especially emphasizes that if within seven days after the symptoms appear, within seven days, if a child has several conditions, you should highly suspect that it may be a precursor to a severe illness. For example, he becomes very'}, {'start': '215.622', 'end': '217.762', 'text': 'sleepy, not very awake, and his consciousness is a bit'}, {'start': '224.202', 'end': '226.542', 'text': 'blurred, or his whole body'}, {'start': '237.702', 'end': '239.882', 'text': 'becomes very energyless, his hands and feet are soft and weak, he is sleepy and has poor energy, and his hands and'}, {'start': '239.882', 'end': '241.722', 'text': 'feet are weak. Well, there is another special thing, that is, he seems to be frightened for no reason, or his muscles all over his body suddenly shake and twitch. That is called'}, {'start': '258.702', 'end': '261.562', 'text': "myoclonic convulsion. Myoclonic convulsion It's just a sudden shiver, yes, a sudden shiver for no reason. And then there's continuous vomiting, continuous vomiting, and breathing becomes very rapid or the heartbeat becomes very rapid, especially when"}, {'start': '261.562', 'end': '263.282', 'text': "quiet, the heartbeat exceeds 120 beats per minute, when quiet the heartbeat exceeds 120, yes, don't wait when these signs appear, go to the doctor immediately, okay, you must remember these warning signs. Since enterovirus seems to be difficult to avoid completely,"}, {'start': '263.282', 'end': '266.162', 'text': 'prevention is'}, {'start': '266.662', 'end': '269.242', 'text': 'very important. The'}, {'start': '269.242', 'end': '271.602', 'text': 'article says that there are risks'}, {'start': '278.102', 'end': '280.462', 'text': 'in Taiwan all year round, yes, because of the climate, so'}, {'start': '283.322', 'end': '285.142', 'text': "cleaning is definitely the first line of defense, cleaning. But I saw a very interesting point. The article said that the alcohol we often use doesn't seem to be"}, {'start': '286.462', 'end': '287.562', 'text': 'very'}, {'start': '287.562', 'end': '289.842', 'text': 'effective. Yes, this is'}, {'start': '295.842', 'end': '296.962', 'text': "very important. Many people don't know that enterovirus is more resistant to alcohol than general acid. Is it true? Then alcohol hand sanitizer has very limited effect against enterovirus. What is really more effective is the chlorine-containing bleach, which is hypochlorous acid bleach. Yes, the article also gave very practical suggestions. Generally, for"}, {'start': '296.962', 'end': '299.142', 'text': 'home environment disinfection,'}, {'start': '299.142', 'end': '301.582', 'text': 'use bleach'}, {'start': '303.622', 'end': '306.342', 'text': 'diluted 100 times, the concentration is about 500ppm, 100 times diluted 500ppm'}, {'start': '306.342', 'end': '309.702', 'text': "If you are dealing with children's vomit"}, {'start': '309.702', 'end': '311.782', 'text': 'or places contaminated by excrement, you'}, {'start': '316.182', 'end': '317.642', 'text': 'need to use a more concentrated'}, {'start': '317.642', 'end': '327.965', 'text': 'one, dilute it 50 times, about 1000ppm. Wow, you need to use a more concentrated one, right? In addition, wash clothes at high temperature, disinfect toys and other items, and then put them in the sun.\nThese are all helpful. So the key is to disinfect. You need'}, {'start': '327.965', 'end': '329.525', 'text': 'to use the right things'}, {'start': '329.525', 'end': '330.965', 'text': 'and the concentration must be'}, {'start': '330.965', 'end': '334.405', 'text': 'high.'}, {'start': '347.525', 'end': '350.025', 'text': "Bleach is the best weapon against enterovirus. That's right, this is very important. Okay, in addition to cleaning and disinfection, what about vaccines? I saw it mentioned in the article. Hey, it seems that there is a vaccine available in China now. Right? Currently, there"}, {'start': '350.025', 'end': '352.185', 'text': 'are two vaccines on the market'}, {'start': '352.185', 'end': '353.705', 'text': 'for the EVA71'}, {'start': '362.685', 'end': '363.685', 'text': 'enterovirus that is more likely to cause severe illness. Both are for the A71 type. Yes, yes, and they are given to children aged'}, {'start': '366.105', 'end': '368.225', 'text': 'two months to less than six years old at their own expense. Um, one is a collaboration between Guoguang and Antero, called Antero Antero, which requires two doses with a'}, {'start': '368.225', 'end': '369.705', 'text': '28-day interval between the two doses. The'}, {'start': '369.705', 'end': '372.365', 'text': 'other is a high-end one called En Wenjian. En Wenjian also requires two doses,'}, {'start': '375.205', 'end': '377.805', 'text': 'but the interval is longer, 56 days.'}, {'start': '377.805', 'end': '379.745', 'text': 'However, he has a situation'}, {'start': '379.745', 'end': '381.025', 'text': 'What is the situation?'}, {'start': '381.025', 'end': '383.385', 'text': 'If the child is under two'}, {'start': '383.385', 'end': '384.505', 'text': 'years old when he gets the'}, {'start': '384.505', 'end': '386.065', 'text': 'first dose, then the'}, {'start': '386.065', 'end': '388.725', 'text': 'doctor will recommend that after the child turns two years old, it'}, {'start': '388.725', 'end': '390.105', 'text': 'is best to give an additional dose,'}, {'start': '390.105', 'end': '393.525', 'text': 'so the total will be 2+1=3 doses. Got'}, {'start': '393.525', 'end': '394.285', 'text': 'it?'}, {'start': '394.285', 'end': '396.185', 'text': 'So Antro is two doses. Well, it depends on the'}, {'start': '396.185', 'end': '398.665', 'text': 'age of the first dose, so it'}, {'start': '398.665', 'end': '400.765', 'text': 'may be two or three doses. You'}, {'start': '400.765', 'end': '401.765', 'text': 'can understand it this way. Yes, the'}, {'start': '402.225', 'end': '405.505', 'text': 'difference is mainly in the dose and the schedule planning.'}, {'start': '405.505', 'end': '407.405', 'text': 'Does the article suggest'}, {'start': '407.405', 'end': '410.025', 'text': 'which children should get this vaccine?'}, {'start': '410.025', 'end': '413.725', 'text': 'According to the recommendation of the Taiwan Pediatric Infectious Diseases Society,'}, {'start': '413.725', 'end': '415.025', 'text': 'they say that'}, {'start': '415.025', 'end': '417.385', 'text': 'as long as the children in this age group are'}, {'start': '417.385', 'end': '419.185', 'text': 'between two months old and under six years old, they'}, {'start': '420.905', 'end': '421.585', 'text': 'are recommended to be vaccinated. Yes, you do'}, {'start': '421.585', 'end': '423.165', 'text': "n't have to think about it specially. If I have"}, {'start': '423.165', 'end': '424.805', 'text': 'had enterovirus before, do I'}, {'start': '424.805', 'end': '425.605', 'text': 'not need to get vaccinated?'}, {'start': '425.605', 'end': '429.465', 'text': 'Because having had it does not mean that I have immunity to EV-A71. I see. What about the'}, {'start': '430.285', 'end': '431.725', 'text': 'side effects?'}, {'start': '431.725', 'end': '432.525', 'text': 'Will they be serious?'}, {'start': '432.525', 'end': '434.545', 'text': 'Generally speaking, they are quite mild. The'}, {'start': '446.445', 'end': '447.345', 'text': "most common thing is that the injection site may be red, swollen and painful, or have a slight fever, which is similar to other vaccines, so it's okay. But is there a very important point to remind you, which is this vaccine? Yes, it must be emphasized that"}, {'start': '447.345', 'end': '449.505', 'text': 'this vaccine is mainly for'}, {'start': '449.505', 'end': '451.285', 'text': 'EV-A71 is the only type.'}, {'start': '451.285', 'end': '452.965', 'text': 'It cannot prevent'}, {'start': '452.965', 'end': '454.865', 'text': 'all types of enterovirus infections. This is'}, {'start': '454.865', 'end': '456.225', 'text': 'extremely important.'}, {'start': '456.225', 'end': '458.205', 'text': "So it's not like getting vaccinated"}, {'start': '458.205', 'end': '460.385', 'text': 'is like wearing an iron vest that protects you from all'}, {'start': '463.145', 'end': '464.985', 'text': "enterovirus infections. It's not like that. To prevent other types of enterovirus,"}, {'start': '464.985', 'end': '466.865', 'text': 'in general,'}, {'start': '466.865', 'end': '468.905', 'text': 'washing hands frequently and cleaning and disinfecting the environment are'}, {'start': '468.905', 'end': '470.065', 'text': 'basic skills that are'}, {'start': '470.065', 'end': '471.765', 'text': 'absolutely essential. Yes, yes, yes, basic skills are the'}, {'start': '471.765', 'end': '473.325', 'text': 'most important.'}, {'start': '473.325', 'end': '475.505', 'text': 'Vaccines are an extra layer of protection,'}, {'start': '475.505', 'end': '478.165', 'text': 'especially for the'}, {'start': '478.165', 'end': '483.128', 'text': 'risk of severe illness caused by EV-A71, but they cannot replace good hygiene habits.'}, {'start': '483.165', 'end': '486.128', 'text': 'The two should go hand in hand, and complement each other. Okay,'}, {'start': '486.129', 'end': '489.128', 'text': "let's quickly summarize the"}, {'start': '489.129', 'end': '491.128', 'text': 'key points we learned from this information today.'}, {'start': '491.128', 'end': '491.528', 'text': 'Okay,'}, {'start': '491.528', 'end': '494.088', 'text': 'first, enterovirus is not just one type, it'}, {'start': '494.088', 'end': '495.668', 'text': "'s a large group of viruses."}, {'start': '495.668', 'end': '497.388', 'text': 'Second, there are many ways of transmission, a long'}, {'start': '497.388', 'end': '498.388', 'text': 'incubation period, and it'}, {'start': '498.388', 'end': '500.488', 'text': 'can even be contagious after recovery.'}, {'start': '500.488', 'end': '502.748', 'text': 'Third, there are many symptoms,'}, {'start': '502.748', 'end': '504.428', 'text': 'ranging from mild to severe.'}, {'start': '504.428', 'end': '507.068', 'text': 'Parents must remember the warning signs of severe illness,'}, {'start': '507.068', 'end': '508.248', 'text': 'such as drowsiness, muscle twitching,'}, {'start': '509.508', 'end': '510.528', 'text': 'persistent vomiting,'}, {'start': '510.528', 'end': '511.928', 'text': 'rapid breathing and heartbeat, etc. Yes, warning signs are'}, {'start': '511.928', 'end': '513.488', 'text': 'very important.'}, {'start': '513.488', 'end': '514.048', 'text': 'Fourth,'}, {'start': '514.048', 'end': '515.228', 'text': 'in terms of prevention,'}, {'start': '515.228', 'end': '516.948', 'text': 'cleaning and disinfection are the best way,'}, {'start': '516.948', 'end': '517.988', 'text': 'but remember that'}, {'start': '517.988', 'end': '519.468', 'text': 'alcohol has limited effectiveness.'}, {'start': '519.468', 'end': '521.508', 'text': 'Use chlorine bleach in the'}, {'start': '521.508', 'end': '522.848', 'text': 'right concentration. Yes,'}, {'start': '522.848', 'end': '524.148', 'text': 'use the right method.'}, {'start': '524.148', 'end': '524.628', 'text': 'Fifth,'}, {'start': '524.628', 'end': '527.968', 'text': 'there is now a vaccine against EV-A71. You'}, {'start': '527.968', 'end': '529.228', 'text': 'can discuss this with your doctor to'}, {'start': '529.228', 'end': '531.728', 'text': 'give children of the appropriate age an extra layer of protection. However,'}, {'start': '531.728', 'end': '533.228', 'text': 'after vaccination,'}, {'start': '533.228', 'end': '535.108', 'text': 'hygiene habits should not be relaxed. Absolutely'}, {'start': '535.108', 'end': '536.108', 'text': 'correct.'}, {'start': '536.108', 'end': '537.488', 'text': 'Vaccines and hygiene, a two-pronged'}, {'start': '537.488', 'end': '538.528', 'text': 'approach.'}, {'start': '538.528', 'end': '540.168', 'text': "Okay, let's quickly summarize the"}, {'start': '540.168', 'end': '542.368', 'text': 'key points we learned from this information today.'}, {'start': '542.368', 'end': '542.688', 'text': 'Okay,'}, {'start': '542.688', 'end': '545.388', 'text': 'first, enterovirus is not just one type of'}, {'start': '545.388', 'end': '546.748', 'text': 'virus, but a large group of viruses.'}, {'start': '551.468', 'end': '553.928', 'text': 'Second, there are many ways of transmission, and it can be latent for a long time, and it may even be contagious after recovery. Third, there are many symptoms,'}, {'start': '553.928', 'end': '555.508', 'text': 'ranging from mild to severe.'}, {'start': '555.508', 'end': '558.048', 'text': 'Parents must remember the warning signs of severe illness, such as'}, {'start': '558.048', 'end': '560.368', 'text': 'myopathy, myasthenia,'}, {'start': '560.368', 'end': '562.748', 'text': 'continuous vomiting, rapid breathing and heartbeat, etc. Yes,'}, {'start': '564.148', 'end': '565.868', 'text': 'warning signs are very important. Fourth, in terms of prevention, cleaning and disinfection are the best'}, {'start': '565.868', 'end': '567.628', 'text': 'way,'}, {'start': '567.628', 'end': '570.088', 'text': 'but remember that alcohol has limited effect. Use'}, {'start': '570.088', 'end': '572.128', 'text': 'chlorine bleach correctly'}, {'start': '572.128', 'end': '573.448', 'text': 'and at the right concentration.'}, {'start': '573.448', 'end': '574.768', 'text': 'Yes, use the right method.'}, {'start': '574.768', 'end': '575.228', 'text': 'Fifth,'}, {'start': '575.228', 'end': '578.568', 'text': 'there is now a vaccine against EV-A71. You can'}, {'start': '578.568', 'end': '579.808', 'text': 'discuss this with your doctor to give'}, {'start': '579.808', 'end': '582.308', 'text': 'children of the appropriate age an extra layer of protection. However, after'}, {'start': '595.848', 'end': '599.708', 'text': 'vaccination, hygiene habits should not be relaxed. Absolutely correct. Vaccines and hygiene, a two-pronged approach. Okay, before we end, does the expert have any I would like to leave you with a question to think about. I think we can extend our discussion from the perspective of vaccines. We just'}, {'start': '599.708', 'end': '601.748', 'text': 'mentioned that the current vaccines are'}, {'start': '601.748', 'end': '604.008', 'text': 'mainly targeted at EV-A71,'}, {'start': '604.008', 'end': '606.748', 'text': 'but there are so many types of enteroviruses, and'}, {'start': '606.748', 'end': '608.088', 'text': 'viruses'}, {'start': '608.088', 'end': '610.308', 'text': 'are constantly changing and'}, {'start': '610.308', 'end': '611.168', 'text': 'mutating.'}, {'start': '611.168', 'end': '613.968', 'text': 'So this brings up a future challenge. Do'}, {'start': '613.968', 'end': '615.748', 'text': 'we need'}, {'start': '615.748', 'end': '618.068', 'text': 'or how can we develop a so-called multivalent vaccine that'}, {'start': '618.068', 'end': '620.948', 'text': 'can fight more types of viruses?'}, {'start': '622.888', 'end': '626.288', 'text': "Oh, a vaccine that covers more virus types, that's"}, {'start': '626.288', 'end': '633.148', 'text': 'right, and then continue to monitor which types of enterovirus are prevalent in the community and whether there are'}, {'start': '633.148', 'end': '635.008', 'text': 'any changes.'}, {'start': '635.008', 'end': '639.688', 'text': 'How critical is this for us to formulate public health strategies in the future?'}, {'start': '639.688', 'end': '643.288', 'text': 'This is indeed a question worth thinking about in depth.'}, {'start': '643.288', 'end': '645.088', 'text': "Thank you experts for sharing today. You're"}, {'start': '645.088', 'end': '645.848', 'text': 'welcome.'}]