221.4 📌 章末速蚘

221.4.0.0.1 Yellow Fever
  • ssRNA flavivirus, Aedes / Haemagogus, Africa + S America (NOT Asia)
  • Biphasic + toxic phase (jaundice + hemorrhage + AKI + black vomit, mortality 20-50%)
  • YF-17D vaccine: single dose lifelong; YEL-AVD elderly risk
221.4.0.0.2 Japanese Encephalitis (JE)
  • Asia + N Australia rural rice paddy
  • Culex tritaeniorhynchus; pigs amplify + birds maintain
  • 1% encephalitis (mortality 25%, sequelae 50%)
  • Extrapyramidal movement + altered MS
  • Vaccines: Ixiaro (USA), SA 14-14-2 (Asia), CD-JEVAX (Australia)
221.4.0.0.3 West Nile
  • Culex + birds (corvids); USA + worldwide
  • 80% asymptomatic; neuroinvasive < 1% (encephalitis, AFP polio-like)
  • Elderly highest risk
  • No human vaccine
221.4.0.0.4 Tick-Borne
  • TBE (Europe/Asia, Ixodes ricinus/persulcatus, biphasic, vaccine available)
  • Powassan (USA NE/Great Lakes, Ixodes scapularis, transmits 15 min, severe encephalitis, no vaccine)
221.4.0.0.5 All
  • Supportive treatment — no specific antivirals
  • PCR + IgM diagnosis (cross-reactivity considerations)
  • Mosquito / tick control + DEET + protective clothing = prevention
  • 通報 mandatory most jurisdictions
  • 盧醫垫 hint: 旅遊 returnees + 癌燒 + 神經 sx → flavivirus workup; vaccines for travelers