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医者の男
医者の男

医療機関側から見たインフルエンザの完治証明書の発行について

医者

インフルエンザで学校や会社を休むと、完治するまでは自宅で療養するように言われますよね。

就業規則や校則などでインフルエンザで休んだ場合には、休養解除のために完治証明書を必要としているところも多いようですが、これらは本当に必要なのでしょうか?また、必要であるならばどのようにして証明するのでしょうか。

今回は医療機関側から見た、インフルエンザの完治証明の発行について、様々な事を紹介していきたいと思います。

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インフルエンザの検査方法

証明書を発行してもらうには検査をしなければなりません。まずは、その具体的な検査方法を説明していくことにしましょう。

迅速診断法

薬

ここ近年でインフルエンザの診断がとてもしやすくなりました。というのは、簡単かつ迅速に診断が可能な検査キットが開発されたからです。この検査キットを使用する方法を迅速診断法といいます。

この診断方法は、鼻や喉などの粘液を検体として、体内にインフルエンザウィルスがいるかどうかを診断します。

この検査方法の特徴は、15分程度で診断ができてしまうというところにあります。診察を受けて、待合室で待っている間には診断が済んでしまうわけですから、患者への負担は少なくて済みます。
また、A型もB型も両方検査することができるというのもこの診断方法の優れているところと言えます。

ただし、感染直後ではインフルエンザウィルスが体内でまだあまり増殖していない場合には検査しても陰性反応の場合がありますが、そのような場合には症状などを総合的に判断されるという事も知っておきたいところです。そういった意味では、検査の精度は他の検査方法に比べると若干低いという事になります。

さらに、この検査キットは数に限りがあるため、一般的な診断方法になってきてはいるものの安易に治療期間中に何度も使用するようなものではないとされています。つまり、通常は初回の診察時にしか使わないという事です。

ウィルス分離検査

インフルエンザの症状が発症してから3日以内に喉や鼻の粘液を検体とし、その中からインフルエンザウィルスのみを抽出し、どのタイプのインフルエンザウィルスなのかを検査する方法が、このウィルス分離検査です。

ウィルス分離検査は非常に高い検査精度が特徴です。というのも、ウィルスそのものを見つけ出して分類するからです。ただ、精度を上げるに伴い非常に高度な技術が要求される検査のため、一般の病院や診療所ではこの検査はできません。そのため、検査結果が出るまでにはおよそ1週間ほどかかります。場合によっては結果が出るまでの日数が数日前後することもあります。

血清抗体検査

インフルエンザの症状が発症してから1週間以内と、解熱後の2回にわたって採血をし、血液中にインフルエンザウィルスに対する抗体が作られているかどうかを検査する方法がこの血清抗体検査です。

ウィルス分離検査ほどの高度な技術は必要とはしませんが、体内に抗体ができているかどうかを調べることで、インフルエンザが完治していると言えるかどうかという事については正確な判断ができる検査方法と言えます。

ただし、検査には大変時間がかかり、検査結果を得るまでには2週間ほどかかってしまいます。

PCR検査

鼻や喉の粘液を検体として、その中にインフルエンザウィルスの遺伝子を持つ細胞があるかどうかを検出する検査がこの検査方法です。

技術的に最も高度で検査精度が高いのもこの検査方法です。A型B型の区別はもちろん、A型のいつ流行ったどのタイプなのか、どのタイプからの派生なのか、新型なのか、どのような亜型でどのような遺伝子構造なのかなどを正確に検査することができます。

ただ、この技術は公的機関でしか実施がされていませんので、一般の病院や診療所ではまず受けることができません。

完治証明にはどのくらいの時間や労力がかかる?

インフルエンザの検査方法を踏まえたうえで、完治していると証明するにはどれくらいの時間がかかり、どの程度の労力が必要なのかを説明していきましょう。

時間的な問題

上記で紹介してきた検査方法で、完治したと判断するまでに時間がかからないものは迅速検査法ただ一つという事になります。

他の診断方法は検査に多大な時間がかかるばかりではなく、非常に高度な技術を必要としますので、膨大な労力をも使うことになってしまいます。

検査方法が高度になればなるほど検査費用も掛かってしまいますし、現実的に考えて一般的に完治しているかどうかの診断を受けられる方法としてはやはり人層検査法以外にはなさそうです。

回復後の検査は可能?

迅速検査法には専用の検査キットがあります。しかしこの検査キット、先述のように生産に時間的コストがかかるとされていて数に限りがあります。

過去に治っているかどうかの検査にこの検査キットを多用するけーさうがあったために、当時の学生がインフルエンザの検査を受けられずに重大な書状に悪化してしまい、結果命を落としてしまったというショッキングな出来事がありました。

現在は医療機関でも検査キットの乱用は制限されており、よほどの事情がない限りはインフルエンザの症状が出て初めて診察を受けるとき以外には使用しないようになっています。

どうしても再診で検査をしてほしいというのであれば、医師に相談してみてもいいかとは思いますが、まず必要ないと言われて終わりになることと思います。

完治証明の検査は必要なのか?

インフルエンザは解熱時期にはほぼ増殖もなくなり、あとは体内に残されたウィルスを排出するだけになっています。また、その排出に要する時間も最大で解熱後2日という事がわかっているため、児童や背年に対しては学校保健法で国が「発症後5日解熱後2日経過していれば自宅待機を解除とする」と定めています。

また、上記のように検査方法がないわけではありませんが、そもそも解熱後2日経過すれば検査の必要がない上に、検査キットにも数に限りがあるとなれば、医療機関側からすれば再検査はしないという結論に達するものだと考えられます。

また、診察を受けた時の状態を証明するという意味での「診断書」ならば発行してもらえますが、病院などの医療機関で証明書を発行するという事になると、それなりの検査などが必要になる場合が多く、よほどの理由でもない限りはそうそう証明書は書いてもらえないでしょう。

ただ、国で定めている通り、または医師の診断通りに解熱後日数が経過していれば、学校や企業などで用意している完治証明書にサインをしてもらうくらいは、してもらえます。

一生インフルエンザにかからない体質の作り方
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まとめ:完治の証明所は本来必要なし!

インフルエンザの完治証明書を発行してもらうための検査には現実的に限界があるという事があります。また、インフルエンザの特徴からしてみても、国で定めている日数を経過していれば問題ないという事もわかります。

それでも学校や企業によっては提出を義務付けているところが多いのも現実です。そのような場合はそれぞれの団体が用意しているであろう書式を手に入れて医師に署名してもらうのが一番スムーズな方法でしょう。

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