I-US ayikhuseli kwi-hepatitis A
Nangona i-hepatitis A isifo esizimeleyo-esithetha ukuba ngokuqhelekileyo iqhuba ikhosi emfutshane kwaye iza kuzincoma yona-isengxaki yempilo yoluntu. Phantse ama-80 ekhulwini labantu abadala abanentsholongwane ye-hepatitis A abanamava angakhawuleziyo, kuquka i-anorexia, i-jaundice, kunye nentlungu kwindawo yesibindi. Nangona sinesitofu sokukhusela isifo se-hepatitis A, intsholongwane ixhatshazwa kakhulu kwaye ukuqhuma kwe-US kwenzeka.
Ngomhla ka-Septemba 1, 2017, iSithili saseSan Diego sichaze imeko yongxamiseko yezempilo ngenxa yokuqhuma kwesifo se-hepatitis A. Ukususela ngoSeptemba 19, 2017, abantu aba-16 babulawa yi-hepatitis A, kunye nabantu abangama-305 babhedlele esibhedlele. I-San Diego isifo se-hepatitis A ukuqhaqhaqhaqhaqhaqhaqhaqhaqheko enkulu enkulu e-US kwimbali yamuva.
I-Hepatitis A
Intsholongwane ye-hepatitis A ibangela ukusuleleka kwesibindi.
I-Hepatitis A yintsholongwane ye-RNA enye engumda we-Picornaviridae. Intsholongwane ye-Hepatitis A ifana ne-enteroviruses, efana ne-poliovirus kunye ne-coxsackievirus, ehlasela inkqubo yesisu ngaphambi kokusasazeka kwamanye amathishu.
Njenge-enteroviruses, i-hepatitis A i-pathogen inamandla kwaye inokumelana nokushisa okuphantsi kwe-20 degrees Celsius kunye ne-pH ephantsi. Ubhulo luyindawo ephantsi-pH, enengqondo kuba kukho iicidi esiswini. Okubaluleke kakhulu, ukutshisa ukutya okujongene nentsholongwane ye-hepatitis A kumaqondo okushisa angaphezu kwama-85 degrees Celsius kunye nokuchithwa kwamanzi kunokubulala intsholongwane.
Indlela yokudluliselwa kwe-hepatitis A i-fecal-oral. Ngamanye amazwi, intsholongwane ye-hepatitis A isasazwa ngeendlela ezincinci zincinci ezenza indlela yazo ekudleni okanye emanzini okanye kwizinto ezifana neetys (oko kukuthi, iifomites).
I-Hepatitis A isasazeka ngenxa yezi zinto zilandelayo:
- Ukuhlamba izandla ngokungafanelekanga ngabaphathi bokutya
- ukuhlanjululwa kwesandla okungafanelekanga ngabanonophelo abakhankanywe kumantombazana omntwana (okanye abadala)
- ukutya okuhlambulukileyo ngexesha lokukhula, ukuvuna kunye nokucutshungulwa
- imithombo yamanzi engcolileyo, kubandakanywa nemithombo ethile kunye nezikhukhula
Ngokubhekiselele kokungcwina, ukongeza kwamanzi okusela ahlambulukileyo, i-shellfish engapheliyo, iziqhamo kunye nemifuno yimithombo ekhutshweyo yokusuleleka kwe-hepatitis A.
Izimo ezininzi, njengalezo ezifunyanwa kwinkathalo yosuku kunye namakhaya aseleyo, kunceda ukuhanjiswa kwe-hepatitis A.
Ngenxa yokuba i-hepatitis A ayilona isifo esingapheliyo kwaye abantu abanokusuleleka kuye ixesha elide, ukuhanjiswa kwezinto eziphambeneyo. Ngaphantsi kweemeko ezifanelekileyo, ukutshintshana kwezinto ezincinci kunokubangela ukugqabhuka.
Ngokwe-CDC, ngowama-2014, kukho iingxelo ezili-1239 ze-hepatitis A e-United States-i-30 yeepesenti yehla ukusuka ngo-2013.
Abantwana abasuleleke nge-hepatitis A bavame ukuxilongwa, oku kuthetha ukuba abanalo iimpawu. Ngokukodwa, malunga neepesenti ezingama-70 zabantwana abangaphantsi kweminyaka emithandathu abanempilo. Nangona ukusuleleka kwe-hepatitis A kubonakala kubantwana, i-jaundice ayiqhelekanga. Ingqalelo, abantwana abangabonakaliyo basasaza isifo kubantu abadala.
Ininzi yabantwana abadala kunye nabadala abanesifo se-hepatitis A banamava alandelayo:
- ukulahleka kwesidlo
- umkhuhlane
- isicaphulelo
- ukuhlanza
- umchamo omnyama
- intlungu
- izigqoko eziluhlaza-okanye zobumba
- intlungu zesisu
Emva kokuvezwa kwintsholongwane ye-hepatitis A, kuthatha iintsuku ezi-15 ukuya kwe-45 ukuba usuleleke ukusuleleka. Izimpawu zokuqala ziquka umkhuhlane, i-anorexia, intlungu yesisu, kunye neentlanzi. I-jaundice iyenzeka emva kweentsuku eziliqela kwaye idlalwa ngaphambili ngenguqu kumchamo nombala wefecal. Iimpawu zihlala zingaphantsi kweeveki ezisibhozo. Phakathi kwama-10 ne-15 ekhulwini abantu abasulelekileyo baneziganeko zeenyanga ukuya ezintandathu.
Nangona ukufa ngenxa yokusuleleka kwe-hepatitis A akuqhelekanga, abantu abadala kunye nabantu abanezifo ezingasigxina (isib., I-hepatitis B okanye i-hepatitis C) basengozini enkulu yokufa kwe-hepatitis A.
Ukutshaya kwesibindi kubangela izilwanyana ezinzulu zesibindi (okt, i-serum aminotransferase) kunye namazinga e-bilirubin. Indlela efanelekileyo yokufumanisa i-hepatitis isebenzisa ukuhlolwa kwegazi ukufumanisa iintsholongwane ze-IgM.
Abantu abasuleleke nge-hepatitis A abakwazi ukusulelwa kwakhona. Bahlakulela iintsholongwane ze-IgG zentsholongwane. Abanye abantu basengozini enkulu yokusuleleka kwe-hepatitis A, kuquka oku kulandelayo:
- abahambi ukuya kumazwe apho i-hepatitis A iqhelekile
- amadoda alala namadoda
- abantu abaneengxaki zokuvalwa, ezifana ne-hemophilia
- abasebenzisi bokusetyenziswa kweziyobisi
- abantu abangenamakhaya abangakwazi ukufikelela kumanzi kunye nokucoceka okufanelekileyo
- Abantu abasebenzisana nezidalwa ezingabambiswanga ngabantu (iifomps, marmosets, kunye nezinye izibilini zingadlulisela i-hepatitis A)
- abantu abasebenza ngokusondeleyo nabantwana (njengabantwana babantwana)
- abantu abanesifo esingasasigxina sesibindi
- amazwe angamanye amazwe avela kumazwe apho i-hepatitis A ihlala khona
Ingqalelo, abahambi ukuya kwiindawo apho i-hepatitis A iphela kufuneka ifumane i-hepatitis A yokugonywa nangona ukuba uhambo lwabo lufutshane okanye bahlala kwiindawo zokuhlala ezivaliweyo.
Akukho unyango oluthile lwe-hepatitis A olukhoyo. Abantu abanentsholongwane ye-hepatitis A bayacetyiswa ukuba bafumane ukondla okwaneleyo kunye nokuphumla okukhulu.
Ukuqubuka kwe-Hepatitis
I-2017 yesifo se-hepatitis A e-San Diego County yiyona nto ibonakalayo ngokutsha kwimbali yase-US. Nangona ukugqabhuka kuqala kuzuza ingqalelo yesizwe ngoSeptemba 2017, bekuye kwadlula iinyanga. Kwimizamo yokulwa nokusabalala kwintsholongwane, izikhulu zedolophu zigonya abantu abayizinkulungwane eziliqela, kuquka abantu abaninzi abahlala kwiinkampu ezingenamakhaya. ISan Diego ineqela elikhulu labantu abangenamakhaya.
Ukongezelela ukugonya abantu, i-San Diego ithathe amanye amanyathelo okukhusela, kuquka ukubeka amashishini okuhlambela kunye nezitishi zokuhlamba izandla kunye nokugcina amaninzi okuhlalisa abantu avulekileyo 24/7. Ngaphezu koko, isixeko sele siqalise amandla-ukuhlamba izitalato nge bleach ngokuqinisekileyo ukubulala intsholongwane. Lo mqathango waphefumulelwa nguLos Angeles, ongasenaso isiphango. Nangona kunjalo, amagosa ezempilo karhulumente eLos Angeles, elele ngaphezu kweekhilomitha ezingama-100 kumntla weSan Diego, ayikaxhala.
Ngaphambi kweSan Diego, ukugqabhuka kokugqibela kwe-hepatitis A e-United States kwenzeka eBeverver County, ePennsylvania. Ukuqhambuka kwakuyinto yesibini kwi-anyanisi eluhlaza esetyenziswe njengesithako kwindawo yokudlela yaseMexico. Ngokubanzi, abantu abayi-601 banesifo sengculaza, 124 babesibhedlele, abathathu bafa. (Indawo yokutyela yaseMexican yayiyindawo yokudlela yaseChi-Chi, eyayisele iqhutywe kwiinkqubo zebhanki ngexesha.)
Ngokomxholo opapashwe kwiNew England Journal of Medicine oye wahlola ukuqubuka kwesifo se-hepatitis ePennsylvania, phakathi kwe-Oktobha 3 no-Oktobha 6, 2003, ama-91 eepesenti angama-240 abanikezeli bevenkile bavavanywa baphila emva kokutya u-salsa ococekileyo, owawusebenzisa i-anyanisi eluhlaza EMexico njengesithako. Abathathi abashiyayo abagulayo bavelele kwi-anyanisi eluhlaza kwezinye izinto zemenyu.
Ngokutsho kwababhali:
Inani elinyukayo lokuqhawuka kokutya okuxelwe liye laxutyushwa kwimveliso emitsha. Amanyathelo okulawula aphakanyisiweyo afaka ukuqinisekisa ukuba abasebenzi bezentsimi baphilile kwaye banokufikelela kwiindawo ezifanelekileyo zokuncedisa kwaye baqinisekise ukuba amanzi asetyenziselwa ukunkcenkceshela nokuhlambulula umkhiqizo awunakonakaliswa nemfesi. Kwizicwangciso zesevisi zokutya, kufuneka kuqwalaselwe ukuba kungenzeka ukuba umkhiqizo ongenakonakala ungabangela ukungcoliseka komnye umveliso kunye nommandla wokulungiselela. Abanikezeli benonophelo lwempilo banokunceda ekuqaliseni umthombo wokuphazamiseka kokutya kwe-hepatitis A ngokuzisa ngokukhawuleza amagosa ezempilo zengingqi kunye neemeko xa kukho iimeko ezichongiweyo.
Ababhali baqaphele ukuba ngenxa yokuba abantwana basengozini ephezulu yokuphatha i-hepatitis A, kufuneka bagcinwe kude neendawo apho isivuno sivunwa khona.
Nazi ezinye izinto eziphawulekayo ezivela kwi-hepatitis A:
- Ngo-Agasti 2016, eHawaii, kwakukho ukugqabhuka okudibaniswe ne-scallops eluhlaza ebenziwa kwiindawo zokutya ze-sushi. I-scallops yavuna ePhilippines.
- Ngo-2016, kwakukho ukugqabhuka kwesithoba kwintlanzi edibeneyo. Kwakukho izibhedlele ezingama-56 kunye nokufa kwaso.
- Ngomhla wama-31 kuMeyi 2013, kwakukho ukugqabhuka kwesigxina esine-10 kwiimbewu zerharnate ezivela eTurkey. Kwakukho izibhedlele ezingama-71 kunye nokufa kwaso.
Uthintelo lwe-Hepatitis A
Nangona kungekho nonyango ye-hepatitis, kukho i-vaccine efanelekileyo. Ukususela ekuqalisweni kwesitofu sokukhusela i-hepatitis A ngo-1995, kukho ukunciphisa ama-92 ekhulwini kwiimeko ze-hepatitis A e-United States.
Ukugonya kwe-hepatitis A kunconywa ukuba kubekho abantu abasengozini enkulu, abantu abanokugula kakhulu xa bengagonywanga, okanye nawuphi na umntu owufunayo .
Ukugonya kwe-hepatitis kufana neepesenti ezingama-100 eziphumelelayo. Ukuze unikeze ukhuseleko lwangexesha elide, i-doses ezimbini zogonyo zinikezelwa, zingaphakathi kweenyanga ezintandathu. Isiconongo sinconywa kubantwana abaneminyaka eyi-12 nangaphezulu. Ukugonywa kukwacetyiswa kubantu abadala abangaphambukiyo abangabantu abanobungozi obuphezulu okanye bahlala kwiindawo apho i-hepatitis A isasazeka khona.
Okwangoku, kukho izigulane ezimbini ze-one-antigen hepatitis A e-United States: i-HAVRIX (i-GlaxoSmithKline) ne-VAQTA (i-Merck & Co). Kukho ukugonya kwe-hepatitis A kunye ne-hepatitis B ebizwa ngokuthi i-TWINRIX (iGlaxoSmithKline), enikwa abantu abadala abaneminyaka engama-18 ubudala kumadala amathathu okanye amane. Zonke ezi zitofu ze-hepatitis azenziwanga (okt, aphile).
Ukuba umntu ongenagqubuthelo utyhila kwi-hepatitis A, kungekudala emva kokuvelela-kwiiveki ezimbini-unokukhetha ezimbini ukukhusela usulelo. Okokuqala, umntu unako ukugonywa. Okwesibini, i-immune globulin inokulawulwa, enika ukhuseleko malunga neenyanga ezintathu. Ezi zimbini zikhetho zisebenza ngokulinganayo; nangona kunjalo, iziphumo ze-immune globulin azihlali.
ILizwi
Ukuqhambuka kwe-hepatitis kwisixeko esikhulu saseMerika njengoSan Diego sibonisa ukuba nakwihlabathi eliphucukileyo kunye ne-sanitation ye-modern, i-hepatitis A ingabangela ingozi enkulu kwimpilo yoluntu. Ukongezelela, ukuqhuma kwangoko kubonakalisa ukukhanya kwimiba ekhethekileyo yokuba abantu abangenamakhaya babelana ngokubhekiselele kwi-hepatitis A. Abantu abaninzi abangenamakhaya bahlala kwiindawo ezixhamlekileyo kwaye abanakho ukufikelela rhoqo kwiindawo zokuhlambulula amanzi kunye nokuhambisa amanzi.
Ukuba unomdla ukuba unobungozi bokusuleleka kwe-hepatitis A, qhagamshelana nodokotela wakho oyintloko ugqirha kwaye ucele isitofu sokugonywa kwe-hepatitis A, efumaneka kumntu ofuna . Kufuneka kwakhona ubuze ugqirha wakho wokunakekelwa ngenyango malunga nokufumana i-hepatitis A ukuba uceba ukuhamba kwindawo engumngcipheko omkhulu, kuquka amazwe aseMntla eMerika, eMzantsi Melika, e-Asia nakwi-Afrika.
Ukuba uyakrokrela ukuba uye wahlulwa kwi-hepatitis A, qha ga mshelana nodokotela wakho. Isifo sokugonywa kwe-hepatitis A okanye i-immune globulin ikhuseleke kwi-virus ye-hepatitis A xa ilawulwa zingakapheli iiveki ezimbini zokungcola. (Intsholongwane kuthatha malunga neveki ezimbini ukuba zibambe.)
Ukongeza kwi-vaccination, kukho amanyathelo athile onokuwuthatha ukuze unciphise ukutyhila kwakho kwi-hepatitis A kwiindawo apho i-hepatitis A iphela.
- Geza izandla zakho rhoqo-ngakumbi emva kokusebenzisa indlu yokuhlambela, ngaphambi kokulungiselela ukutya, kwaye emva kokutshintsha ii-diapers.
- Isinitifiketi yesandla esingaphezulu kwama-60 ekhulwini kotywala ingasetyenziselwa endaweni yesepha kunye namanzi ukucoca izandla.
- Gwema ukuthinta amehlo akho, impumlo, nomlomo ngaphandle kokuba izandla zakho zihlambuluke.
- Gwema ukumanga, ukumbumbana kunye nokwabelana ngokubambisana nabantu abanokugula.
- Gwema ukunxibelelana nabantu ababonakala begula.
- Yidla kuphela ukutya okuphekwe ngokupheleleyo kwaye kunikezelwa kushushu.
- Yidla amaqanda anzima ukupheka.
- Qinisekisa ukuba iimveliso zobisi zixhaswa.
- Geza zonke iziqhamo kunye nemifuno emanzini acocekileyo uze uzenzele.
- Gwema ukutya ukutya okuthengiswa ngabathengisi bokutya.
- Gwema ukutya okuhanjiswe kumaqondo atshisayo.
- Gwema ukutya i saladi.
- Gwema iididi ezenziwe ngemifuno enjenge-salsa.
- Phuza iibhotile okanye i-carbonated water kuphela ngesitywina.
- Gwema amanzi ompompo.
- Gwema i-ice eyenziwe ngamanzi epompo.
- Gwema i-popsicles ekhethiweyo okanye iqhwa elikhethiweyo.
> Imithombo:
> CDC. I-Hepatitis A: Ulwazi oluqhelekileyo . www.cdc.gov.
> Iintsholongwane ze-Hepatitis. Ku: URyan KJ, uRay C. eds. I-Sherris Medical Microbiology, 6e eNew York, NY: McGraw-Hill; 2014.
> Wheeler C, et al. Ukuqhambuka kwe-Hepatitis A ehlanganiswe nama-anyanisi ahlaza. I-New England Journal of Medicine. 2005; 353: 890-897.
> I-San Diego County. IzeMpilo kunye neeNkonzo zeeNtlalo. I-Hepatitis A. http://www.sandiegocounty.gov.
> Isebe lezeMpilo laseMelika kunye neNkonzo zeNtlalo. I-Hepatitis A. www.vaccines.gov.