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医者

インフルエンザの隔離期間(出席停止期間)

医師

インフルエンザは強い感染力とその症状の重さから、風邪とは違い特別な考え方をされています。インフルエンザに感染した場合は周囲への感染を防ぐため、厚生労働省で隔離期間が定められています。

この隔離期間を守らないと場合によっては処罰されることもあるようです。そんなことにならないためにも、きちんと隔離期間(出席停止期間)を把握しておきましょう。

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隔離期間とは

では、一体何のために隔離期間が設けられているのか、そして隔離期間とは一体どのような内容なのかを詳しく見ていくことにしましょう。

隔離期間の根拠について

医師

インフルエンザの隔離期間は厚生労働省が過去の症例の報告に基づいて作っているガイドラインのなかで定められた、インフルエンザ蔓延防止対策の方法としての基準の一つです。

インフルエンザは身近な病気の一つで風邪のように思われがちですが、症状の重さや後遺症・合併症の危険性は風邪の比ではありません。よく自宅内で隔離したことを患者の家族からチクチク言われるという話を聞きますが、外部への感染を避けるために隔離する必要があるという事を十分理解しておかなければならない、それほどインフルエンザは怖い病気という事なのです。

特に自宅内での隔離については、乳幼児など小さい子供がいる家庭では当然したほうが良いでしょう。風邪奥が感染すると、感染した家族がまた外出時にウィルスを飛散させることになってしまいます。飛沫感染の怖さがあることも隔離期間が定められている理由の一つです。

隔離期間の定め方について

次に、隔離期間の詳細の定め方を紹介していきましょう。厚生労働省では大きく2つの要素からこの隔離期間を定めています。

飛沫感染源の視点
まず1つにはインフルエンザウィルスは、風邪のウィルスと違って長期間の飛沫感染力がありません。つまり、飛沫感染の可能性は感染原因を時間的に遠ざけることで著しく低下させることが可能になるという事です。

インフルエンザウィルスは空気中では長時間生きていられません。体外に排出されたウィルスは数時間で死滅します。逆に風邪の原因となっているアデノウィルスやノロウィルスなどは飛沫感染力が非常に高く、空気中でも何日にもわたって感染力を保っています。

比較的飛沫感染期間が短いインフルエンザウィルスには、隔離することで飛沫感染の影響をかなり低減させることが有効であることがこの第1の基準を決める要素になっています。

間接感染源の視点
次に2つ目となるのが間接的な感染を防ぐという要素です。

これは、具体的にはドアノブやスイッチ、共有施設などに感染者からのウィルスの付着を防ぐ、あるいは付着したウィルスを除去する置いう視点から考察されます。

インフルエンザウィルスの特徴として、アルコールなどによる消毒効果が高いことも認められています。よくスーパーやホームセンターなどの入り口で消毒用のスプレーやジェルが置かれていることがありますが、これはインフルエンザウィルスが除菌することで感染力が低下することから行われていることです。

また、手洗いやうがい、マスクをすることでも感染を防ぐことができます。ウィルスの感染が疑われる時期になるべく外部のものに触れないようにするという事も隔離期間を定める基準として考えられています。

隔離期間の変更について

年々新型のインフルエンザウィルスが発表されその攻撃性も年々強まっていることから、厚生労働省では一旦決められたガイドラインの基準を2012年の4月から新しく変更しました。

以前の基準では、解熱後2日経過するまでと定められていましたが、新基準は以下の通りです。

学童生徒においては、発症した後5日を経過し、かつ解熱した後2日経過するまでを隔離期間とする。
幼稚園児においては、発症した後5日を経過し、かつ解熱した後3日経過するまでを隔離期間とする。

以前は発症してからの期間を定めていませんでした。そのため、解熱2日後が発症から5日よりも早い場合には隔離期間が終了していたことになります。新基準では、解熱してから2日後でも発症から5日を数えることで解熱後の感染をより防ぐことでさらに感染を防ごうという基準になっていることがわかります。

隔離期間の数え方について

この厚生労働省で定められた隔離期間(出席停止期間)の数え方は、次のように数えます。

まず、発症日・解熱日はそれぞれ数えません。飽くまで基準となる日として考えます。つまり、0と数えます。そこからそれぞれ1日目、2日目、・・・と数えていきます。

例えば、発症日から2日後には解熱してそこから2日後経過した場合は発症日から4日目という事になりますから、まだ隔離期間は終了していないという事になります。

また、逆に発症日から4日経過して解熱した場合にも、さらにそこから2日経過するまでは隔離期間が終了しないという事になります。

ここで、一つ浮かんでくる疑問が発症日についてです。解熱日は平熱に戻った日を解熱日と解釈できますが、一体発症日はどのようにして考えればよいでしょうか?

発症日の基準は症状が出始めた日として考えます。感染したのはこの日ではないかという日は感染日と考えます。感染日を事前あるいは正確に把握することはできませんので、症状が出始めた日をきっかけに数えるように考えられています。

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まとめ:隔離期間の意義を理解しよう

インフルエンザにかかると、その症状のつらさから日常の行動ができなくなりますが、解熱後症状が回復してからも十分な注意が必要だという事が理解できたと思います。

だからこそ、しっかりと隔離期間を知りその意味を理解して、周囲の人たちに感染しないようにすることを心がけましょう。

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