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風邪、ティッシュ、女性
風邪、ティッシュ、女性

インフルエンザの判定についての基礎知識

インフルエンザの女性

 

高熱が出て病院に駆け込んだら、まだインフルエンザの判定はできないといわれたことはありませんか。インフルエンザの判定にはタイミングが大事なようです。重症化すると怖いインフルエンザ、きちんと知っておきたいですよね。

こちらでは、インフルエンザの判定についてご紹介します。

スポンサーリンク

インフルエンザの判定

感染を調べるには

インフルエンザの女性

インフルエンザにかかっているかどうかを知るためには、その症状の原因がインフルエンザウイルスであることを確かめなくてはなりません。インフルエンザウイルスに感染しているかどうかを調べるには、以下の2つの方法があります。

  • インフルエンザウイルスがいるかどうかを調べるか
  • 身体の中にインフルエンザウイルスに対する抗体が出来ているかどうか

検査方法

迅速診断法
一般の医療機関で用いられる判定方法です。「迅速診断キット」と呼ばれる小さな検査器具を使い、鼻やのどから検体を取って、インフルエンザウイルスがいるかどうかを調べます。たくさんの種類のキットがありますが、ほとんどA型とB型のどちらも検査することができ、15分以内で結果を得ることができます。ただし、発症直後に検査した場合などでは検体の中にあるインフルエンザウイルスの量が少ないために、感染していても陰性になる場合があります。また、流行状況や検査のやり方などの影響で検査陽性であっても実はインフルエンザではない場合もあります。最終的な診断は患者さんの症状等から総合的に判断します。

血清抗体検査
発病後7日以内と、回復した頃の2回、血液を採取し、ウイルスに対する抗体ができているかどうかを調べます。結果が出るまでに約2週間かかります。

ウイルス分離検査
発病後3日以内にのどや鼻から検体を取り、その中からウイルスだけを取り出して、どんなウイルスなのかをしっかりと調べる検査です。結果が出るまでに5~10日ほどかかります。迅速診断法に比べて非常に感度の高い方法ですが、高度な技術が必要な検査なので、一般の診療所や病院では実施できません。

PCR検査
のどや鼻からの検体からインフルエンザウイルスの遺伝子を検出する検査です。インフルエンザA型、B型の区別だけではなく、A香港型、2009年に流行した「新型インフルエンザ」なども正確に診断できます。この検査も高度な技術が必要なので、主に公的機関などでのみ実施され、一般の医療機関では検査できません。

なぜ検査するのか?

キットによる検査は100%正確であるとはいえません。しかし医師が診断をし早期治療をする有効な判断材料になります。特に最近ではインフルエンザウイルスが増殖する際に必要な物質ノイラミニダーゼを阻害剤する薬が登場しています。代表的なものに、タミフルやリレンザなどがあげられます。これらの薬はウイルスが増殖する前の早めの服用が効果的なため迅速に判断できる診断キットでの検査が必要なのです。

検査の難しさ

陰性でもインフルエンザ?!

検査の結果インフルエンザ陰性と出ても、インフルエンザではないと断定されたわけではありません。 検査で陽性と出た場合にはほぼインフルエンザと断定して間違いはありませんが、陰性と出た場合には、インフルエンザであることもインフルエンザでないこともあり得るのです。特に発病後1日以内は感度が低いためインフルエンザであるのに検査では陰性となる可能性があります。また、子供より大人の方が陽性率が低い傾向があります。

検査で陰性と出た場合には最終的には主治医の総合的判断に委ねられる訳ですが、主治医が「検査では陰性だが臨床症状や流行状況から考えてどう考えてもこれはインフルエンザだ」と考えれば発症後48時間以内なら効果のある抗インフルエンザ薬を処方することになります。

タイミングが大切

従って、主治医が抗インフルエンザ薬を処方した場合には検査の結果が陰性であっても指示通りに服薬を続けることを強くお勧めします。 皮肉なことに抗インフルエンザ薬が効果のないと言われる発病後48時間以降にインフルエンザ迅速検査の陽性率は高いのです。強いて言えば発熱した24時間以降48時間以内が検査の陽性率も高く抗インフルエンザ薬の効果も期待できる貴重な時間帯と言うことになるようです。

インフルエンザと闘うな!―ワクチン・タミフルより「ぬれマスク」 (健康双書)
臼田 篤伸
農山漁村文化協会
売り上げランキング: 30,222

まとめ:判定よりもお医者さんの見立てが大事

インフルエンザの検査は一般の医療機関で15分ほどでできるようになりました。しかし発熱したら直ぐにでも受診してインフルエンザの検査を受けることが良いというわけではないようです。この判定結果は注意が必要です。以下、ポイントをご紹介します。

  • 陰性と出た場合には、インフルエンザであることもインフルエンザでないこともあり得る
  • 発病後1日以内はインフルエンザであっても検査では陰性となる可能性がある
  • 発熱した24時間以降48時間以内が検査の陽性率も高く抗インフルエンザ薬の効果も期待できる貴重な時間

もし判定結果が陰性でも医師がインフルエンザと診断したら、しっかり抗インフルエンザ薬を飲むことが大事ですね。

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