北野成昭(キタノナルアキ) 作『獣医志Wiki』はクリエイティブ・コモンズ 表示 - 非営利 - 継承 4.0 国際 ライセンスで提供されています。
;細菌性食中毒:飲食物を介してのみ感染、発症にいたる。（起因菌の病原性が低い）
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4.0px 4.0px} </style></head><body><p class="p1"><br></p><table cellspacing="0" cellpadding="0" class="t1"> <tbody> <tr> <td valign="middle" class="td1"> <p class="p2"><span class="s1"><b>病名</b></span></p> </td> <td valign="middle" class="td2"> <p class="p2"><span class="s1"><b>病原体</b></span></p> </td> <td valign="middle" class="td3"> <p class="p2"><span class="s1"><b>疫学</b></span></p> </td> <td valign="middle" class="td4"> <p class="p2"><span class="s1"><b>潜伏期間</b></span></p> </td> <td valign="middle" class="td5"> <p class="p2"><span class="s1"><b>症状</b></span></p> </td> <td valign="middle" class="td6"> <p class="p2"><span class="s1"><b>診断</b></span></p> </td> <td valign="middle" class="td7"> <p class="p2"><span class="s1"><b>予防</b></span></p> </td> <td valign="middle" class="td7"> <p class="p2"><span class="s1"><b>治療</b></span></p> </td> <td valign="middle" class="td8"> <p class="p2"><span class="s1"><b>その他</b></span></p> </td> </tr> <tr> <td valign="middle" class="td9"> <p class="p2"><span class="s1"><b>コレラ</b></span></p> </td> <td valign="top" class="td10"> <p class="p3"><span class="s1">Vibrio cholerae 3類感染症</span></p> <p class="p3"><span class="s1">人の小腸内に定着</span></p> <p class="p3"><span class="s1">エンテロトキシン産生</span></p> </td> <td valign="top" class="td11"> <p class="p3"><span class="s1">1977年以降日本でも発生（集団発生有）</span></p> <p class="p3"><span class="s1">小川型・稲葉型・彦島型に分類</span></p> <p class="p3"><span class="s1">日本では小川型・稲葉型が多い<span class="Apple-converted-space"> </span></span></p> <p class="p3"><span class="s1">糞便に排菌され水・食品を汚染</span></p> </td> <td valign="top" class="td12"> <p class="p3"><span class="s1">数時間～5日（2～3日が多い）</span></p> </td> <td valign="top" class="td13"> <p class="p3"><span class="s1">激しい水様性下痢（米のとぎ汁様）と嘔吐。</span></p> <p class="p3"><span class="s1">脱水による電解質異常やアシドーシス</span></p> </td> <td valign="top" class="td14"> <p class="p3"><span class="s1">糞便検査</span></p> </td> <td valign="top" class="td15"> <p class="p3"><span class="s1">流行地への旅行者の予防接種</span></p> <p class="p3"><span class="s1">上・下水道の整備。帰国者・入国者検疫</span></p> </td> <td valign="top" class="td15"> <p class="p3"><span class="s1">輸液（乳酸リンゲルが有効）</span></p> <p class="p3"><span class="s1">抗生物質投与</span></p> </td> <td valign="top" class="td16"> <p class="p3"><span class="s1">溶血性無→アジア型（古典型）</span></p> <p class="p3"><span class="s1">溶血性有→エルトール型</span></p> </td> </tr> <tr> <td valign="middle" class="td17"> <p class="p2"><span class="s1"><b>腸チフス・パラチフス</b></span></p> </td> <td valign="top" class="td18"> <p class="p3"><span class="s1">Salmonella Typhi(腸チフス)</span></p> <p class="p3"><span class="s1">Salmonella Paratyphi A(パラチフス)</span></p> <p class="p3"><span class="s1">2類感染症 (B、Cは食中毒菌)</span></p> </td> <td valign="top" class="td19"> <p class="p3"><span class="s1">日本では年間300名程度。その内約半数は輸入症例。保菌者のほとんどが胆嚢内に保菌</span></p> <p class="p3"><span class="s1">糞便・尿が感染源</span></p> </td> <td valign="top" class="td20"> <p class="p3"><span class="s1">平均2週間</span></p> </td> <td valign="top" class="td21"> <p class="p3"><span class="s1">稽留と弛緩を繰り返す発熱。皮膚にバラ疹</span></p> <p class="p3"><span class="s1">回腸パイエル版に潰瘍形成。腸出血</span></p> </td> <td valign="top" class="td22"> <p class="p3"><span class="s1">菌分離が必須（初期は血液から、中期以降は糞便・尿から分離）</span></p> <p class="p3"><span class="s1">血清からのウイダール反応</span></p> </td> <td valign="top" class="td23"> <p class="p3"><span class="s1">保菌者の発見と監視体制の確立</span></p> </td> <td valign="top" class="td23"> <p class="p3"><span class="s1">クロラムフェニコール、アンピシリンが有効</span></p> </td> <td valign="top" class="td24"> <p class="p3"><span class="s1">人のみが保金し、動物は保菌しない</span></p> </td> </tr> <tr> <td valign="middle" class="td9"> <p class="p2"><span class="s1"><b>細菌性赤痢</b></span></p> </td> <td valign="top" class="td10"> <p class="p3"><span class="s1">赤痢菌（Shigella属菌）</span></p> <p class="p3"><span class="s1">A型：S.dysenteriae</span></p> <p class="p3"><span class="s1">B型：S.flexneri</span></p> <p class="p3"><span class="s1">C型：S.boydii</span></p> <p class="p3"><span class="s1">D型：S.sonnei （血清型別）</span></p> </td> <td valign="top" class="td11"> <p class="p3"><span class="s1">海外旅行者の発生が増加。1974年以降、ペットショップのサルへの感染が確認</span></p> </td> <td valign="top" class="td12"> <p class="p3"><span class="s1">2～6日</span></p> </td> <td valign="top" class="td13"> <p class="p3"><span class="s1">一過性の発熱</span></p> <p class="p3"><span class="s1">腹痛・しぶり腹・下痢<span class="Apple-converted-space"> </span></span></p> <p class="p3"><span class="s1">初期には悪心・嘔吐・倦怠感</span></p> </td> <td valign="top" class="td14"> <p class="p3"><span class="s1">糞便からの菌分離</span></p> </td> <td valign="top" class="td15"> <p class="p3"><span class="s1">赤痢発生国での生水・生ものの飲食を避ける</span></p> </td> <td valign="top" class="td15"> <p class="p3"><span class="s1">ナリジクス酸、カナマイシン、アンピシリン、コリスチン（耐性菌多いので注意）</span></p> </td> <td valign="top" class="td16"> <p class="p3"><span class="s1">A型が最強で志賀毒素産生</span></p> <p class="p3"><span class="s1">最弱はD型</span></p> </td> </tr> <tr> <td valign="middle" class="td25"> <p class="p2"><span class="s1"><b>A型肝炎</b></span></p> </td> <td valign="top" class="td26"> <p class="p3"><span class="s1">ピコルナウイルス科</span></p> <p class="p3"><span class="s1">A型肝炎ウイルス</span></p> </td> <td valign="top" class="td27"> <p class="p3"><span class="s1">国内では散発的</span></p> <p class="p3"><span class="s1">発展途上国では現在も流行</span></p> <p class="p3"><span class="s1">糞口感染</span></p> </td> <td valign="top" class="td28"> <p class="p3"><span class="s1">3～6週（3～6週（平均4週）</span></p> </td> <td valign="top" class="td29"> <p class="p3"><span class="s1">非特異的な倦怠感</span></p> <p class="p3"><span class="s1">発熱・腹痛・嘔吐</span></p> <p class="p3"><span class="s1">進行すると黄疸・褐色尿</span></p> </td> <td valign="top" class="td30"> <p class="p3"><span class="s1">血検によるビリルビン値、トランスアミナーゼ値の上昇。HAV抗体検出。IgM捕獲ELISA</span></p> </td> <td valign="top" class="td31"> <p class="p3"><span class="s1">ワクチン</span></p> </td> <td valign="top" class="td31"> <p class="p3"><span class="s1">数週間の安静</span></p> </td> <td valign="top" class="td32"> <p class="p3"><span class="s1">死亡率低く、不顕性感染も多い</span></p> </td> </tr> <tr> <td valign="middle" class="td33"> <p class="p2"><span class="s1"><b>ウイルス性胃腸炎</b></span></p> </td> <td valign="top" class="td34"> <p class="p3"><span class="s1">ほとんどはノロウイルスによる。</span></p> <p class="p3"><span class="s1">その他</span></p> <p class="p3"><span class="s1">ロタウイルス</span></p> <p class="p3"><span class="s1">アデノウイルス</span></p> <p class="p3"><span class="s1">サポウイルス</span></p> <p class="p3"><span class="s1">アストロウイルスなど</span></p> </td> <td valign="top" class="td35"> <p class="p3"><span class="s1">糞口感染が主</span></p> <p class="p3"><span class="s1">汚染された水や貝類、特にカキ類が重要</span></p> </td> <td valign="top" class="td36"> <p class="p3"><span class="s1">1～2日</span></p> </td> <td valign="top" class="td37"> <p class="p3"><span class="s1">下痢、嘔吐、腹痛。時に発熱、頭痛</span></p> </td> <td valign="top" class="td38"> <p class="p3"><span class="s1">糞便を用いた電子顕微鏡観察</span></p> <p class="p3"><span class="s1">RT-PCR</span></p> </td> <td valign="top" class="td39"> <p class="p3"><span class="s1">入念な手洗い、汚染物の適切な処理</span></p> </td> <td valign="top" class="td39"> <p class="p3"><span class="s1">整腸剤などの対症療法</span></p> </td> <td valign="top" class="td40"> <p class="p3"><span class="s1">ノロウイルスは形態学的分類では小型球形ウイルスに分類</span></p> </td> </tr> </tbody></table><p class="p1"><br></p><p class="p1"><br></p></body></html>