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風邪
風邪

インフルエンザ受診のタイミング

風邪

高い熱がでて寒気がする。非常に眠たいし、疲れがひどい。
もしかしたらインフルエンザかもしれない……。と疑っている方はすぐに病院に行きましょう。

しかしながら、あまりにも早い段階で病院にいくと「また明日来てください」といわれてしまうことも少なからずあります。インフルエンザの治療にはタイミングが重要です。

インフルエンザの検査は、通常簡易型の検査キットを使いますが、これはまれに
擬陽性」という診断ミスを起こしてしまいます。確実に診断ができるようになるまでは、インフルエンザに感染後9時間は必要といわれています。

インフルエンザには受診に最適のタイミングがあります。それを心得て医師にかかることで診療の二度手間を減らすことができるでしょう。

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インフルエンザ診療のタイミング

病院

インフルエンザの諸症状は重症の風邪とほとんど変わりがありません。また、極度の寒気や高熱などは肺炎や腎炎などでも起こることがあり、インフルエンザであると確実に診断するためには検査が必要です。

インフルエンザの検査には、分析装置を使った精度の高いものと、簡易検査キットを使ったものがあります。簡易検査キットは小さく持ち運びも容易です。なによりも大量に保存しておけるため、通常の病院ではこの簡易検査キットが利用されています。

インフルエンザウイルスは体内で増殖するさい、鼻や喉の粘膜に多く付着します。インフルエンザウイルスを綿棒で粘膜を拭って摂取、検査キットで確認するのですが、この時にインフルエンザウイルスが少ないとしばしば誤診が起きてしまいます。

このような誤診率は高くても8%から5%程度といわれますが、多くの人が訪れる期間では決して少ない数値とも言えません。インフルエンザの誤診が起きる最大の理由は、インフルエンザウイルスが少ないことによるものですから、慎重な医師は熱がでた日や時間を聞いた上で、二度の診療を進める場合もあります。

インフルエンザウイルスが十分に増えるのは罹患後9時間と言われていますから、インフルエンザウイルスに罹患し、症状がでてすぐ病院にいっても誤診が出てしまうことが多いのです。

9から48時間の間

しかし、そうはいってもインフルエンザの受診は早めに行うことが推奨されることでしょう。インフルエンザウイルスに対する抗ウイルスエンザ薬は感染後48時間をすぎるとほとんど効果を発揮しません。タミフルやリレンザといった抗ウイルス薬は、ウイルスの増殖を抑える働きはありますが、殺菌することは難しいのです。

したがって、9時間後、48時間以内がインフルエンザから身をまもる最適の時間であると言われています。

熱がでてからすべき事

では、なぜ「早すぎる」段階で病院に言ってしまうのでしょうか。実は、発熱が始まる朝に病院にいってしまうのがその最大の理由だと思われます。

朝起きて熱があると思い、すぐに病院に駆け込むことがあると思います。寝る前はなんともなかったのに、朝起きると発熱しているということは非常に多くあります。睡眠中に体が休んでいる時間は、ウイルスにとっては絶好の繁殖時間なのです。

そこで、以下のようなことを心がけて、最適の受診タイミングを見計らいましょう。

熱が出てから、受診は半日まつ

朝になって熱がではじめたら、すぐに病院にかからず、十分に水分をとって午前休を取りましょう。理想を言えば夕方以降に病院での受診を受けるとよいでしょう。

午前中にいってもウイルスが十分に発生していない可能性があり、擬陽性の可能性があります。

抗インフルエンザ薬を出してもらうように頼む

午前中から病院にいった場合でも、検査をしてもらった上で結果が陰性でもインフルエンザ薬を出してもらうという手もあります。インフルエンザ薬は副作用の心配もされていますが、改良されて注射ではなく吸入によって摂取できるものもあるため、非常に楽です。

この段階でインフルエンザ薬を出してもらうことで二度手間を防ぐことができます。

分析装置による検診をしてもらう

もうひとつの方法が、分析装置による精密検査をしてもらうことです。これも有効な手段といえるでしょう。擬陽性の判断がだされにくい、非常に精度の高い検診技術もありますが、少々値段が張るのと、少し大きめの医院でないと検査ができない恐れがあります。

インフルエンザ診療ガイド〈2013‐14〉
日本医事新報社
売り上げランキング: 67,342

まとめ:インフルエンザの受診は発熱して9時間後が理想

インフルエンザの受診は発熱後すぐではなく、9時間後が理想だと言われています。ウイルスの増殖があまりにも少ないと擬陽性の誤診がだされてしまうことがあります。

インフルエンザの初診時に抗インフルエンザ薬を出してもらうというのもひとつの手ですね。また、陽性が「偽の陰性」だったという事はほとんどありません。

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Check Also

考える

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  インフルエンザと症状のよく …

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