Ifiveshi ephuzi ibangelwa yi-flavivirus, eyasasazwa yizintshukumo e-Afrika kunye neMzantsi Melika, ngokukodwa kwiindawo ezinamahlathi amakhulu okanye amahlathi. Ukugula okunjengomkhuhlane kungabangela iimpawu ezinjengomkhuhlane, amaqhwa, kunye nomzimba womzimba malunga neentsuku ezintathu ukuya kweyesithandathu ukusuka kwintsholongwane, kwaye iminyango ayimfuneko. Nangona kunjalo, malunga neepesenti ezili-10 ukuya kuma-15 ekhulwini abo basulelekileyo, ingaba yingozi, okubangelwa ngumkhuhlane ophezulu, i-jaundice, kunye nezinye izinto ezixhalabisayo.
Ifiva ephuzi ingaba yingozi.
Imbali, Impact, nokufikelela
Kule minyaka, i-yellow fever iye yalawulwa kangcono kunokuba yayikudlulileyo, ngokuyininzi ngenxa yokuba kukho isitofu sokukhusela kuso. Sekunjalo, i-WHO ilinganisela ukuba malunga nama-84 000 ukuya ku-170,000 abantu banesifo sengculaza ngonyaka. Kukholelwa ukuba amaninzi amaninzi ayengabonakali, ngoko ke umlinganiselo opheleleyo wesiphumo sesifo awucacanga.
Abaninzi abangama-29,000 ukuya kuma-78,000 abantu bayafa ngenxa yokugula ngonyaka.
Ifiveshi ephuzi ikhona kwiindawo ezihlala kuyo apho intsholongwane kunye nobuncwane bangasinda. Oku kuxhomekeka kakhulu kwimozulu kunye nokuba khona kwendawo engqongileyo.
Kwinkoliso yeMzantsi Melika, intsholongwane ayibangeli ukuqhuma kwezixeko. Itholakala kuphela kwimimandla ethile, ngokuqhelekileyo kwimimandla ehlala kude okanye kwihlathi, apho intsholongwane isasazeka kwizilwanyana.
Ekho, i-Amazon, ngokuyinhloko eBrazil, ifikelela ePeru, e-Ecuador, eBolivia, eColombia, eVenezuela naseArgentina.
Amazwe abasengozini aquka iPanama, iTrinidad neTobago, iFrench Guiana, iGuyana, iParaguay neSuriname.
Kodwa malunga neepesenti ezingama-90 ze-yellow fever kucatshangelwa ukuba zenzeke e-Afrika, apho abaninzi abantu abafayo besuleleka sulelo. Itholakala eNtshona naseMntla Afrika, nakwamanye amazwe aseMpuma Afrika.
Amazwe aseAfrika apho kukho umngcipheko we-yellow fever uquka: i-Angola; Bhenin; Bhekina Faso; Burundi; Khameruni; Iriphabliki yaseAfrika eseMbindini; Tshad; Republic of Congo; Khot divwa; Iriphabliki yaseKhongo Ekhululekile; Ekhwithoriyal Gini; Yuthophiya; Gabhon; Gambiya; Gana; Gini; Gini-Bisawu; Khenya; Layibheriya; Mali; Morithaniya; Nayija; Nayijeriya; Rhuwanda; Senego; Sira Liyoni; Sudan; South Sudan; ETogo nase-Uganda.
Ngo-2016, kukho ukugqabhuka kwindlunkulu yaseAngola, apho abantu abangaphezu kwama-200 bafa ngenxa yesifo. Intsholongwane iyasasazeka kwinkunzi kunye nakwamaphondo amaninzi kweli lizwe. Nangona kungabonwa njengento ehlala e-Asia, abahambi kunye nabasebenzi babuyele ekhaya baseTshayina baseAngola abanegciwane.
Intsholongwane isetyenziselwa ukwandisa ngokubanzi kwendawo kunokuba ikhona ngoku. Okokuqala kwafika eUnited States ekupheleni kwee-1600s. Kukholelwa ukuba yenziwe ngokuthengiswa kwabantu phakathi kwe-Afrika kunye ne-Amerika, xa iinkozo kunye neentsholongwane ziqhutywe kunye nabantu ababehlala kwiindawo ezinzima. Kwafika kude kumntla njengoBoston, eNew York, naseFiladelphia, kwaye wahlala kwiidolophu ezisemazantsi ukuya ngasekupheleni kwee-1800. Intsholongwane yayisasazeka ngorhwebo kwiiyambu zaseYurophu njengaseNyakatho njengeCardiff naseDublin, nangona amazwe afana neGrisi ayengengozini enkulu.
Iimpawu
Kuba abaninzi abantu, i-yellow fever ibangela ukugula okucokisekileyo okanye kungabonakali. Kukho iintsuku ezintathu ukuya kweyesithandathu phakathi kokutshatyalaliswa kwintsholongwane ngenxa yokuluma ummi kwaye ugula. Ukuba unesifo esincinci kwaye ungalokothi ugula kakhulu, kulindeleke ukuba ufumane ngokutsha. Nangona kunjalo, abantu abathile, i-yellow fever ibangela izifo, ukubola, i-aches, ukuphuma kwamanzi, amehlo aphuzi kunye nolusu, inambuzane, ukuhlanza, ukudideka, ukutshatyalaliswa, ukungaphumeleli komzimba-kwanokufa.
Kubantu abanamava e-yellow fever , kukho izigaba ezintathu zokugula:
Ukusuleleka kwangoko kusenzeka iintsuku ezintathu ukuya kweyesithandathu emva kokuvelela.
Unokufumana umkhuhlane, ama-muscle aches, i-nausea, ukuhlanza, utywala kunye nokukhathala.
Ukuxolelwa kubakho iintsuku ezimbini ukuya kweentsuku kamva. Umkhuhlane, ukuba ukhona, uhla kwaye iimpawu ziphucule. Oku kungadlulela iiyure ezingama-24 ukuya kuma-48. Uninzi lwabantu luya kufikelela kweli nqanaba. Phantse iipesenti ezili-15 zabantu abanentsholongwane yintsholongwane baya kuba nesifo esibi kakhulu.
Isifo esiqhekezayo : I-Fever, i-nausea, kunye nokuhlanza kwenzeka xa ufumana izifo ezinzima. Izimpawu ezintsha kunye nempawu zivela kwiintsholongwane ezinzulu:
- I-jaundice: Abantu abaninzi abanesifo esibi kakhulu banamaqabunga esikhumba (kuquka iintende kunye neengqimba), abamhlophe bamehlo, kunye nolusu ngaphantsi kolwimi. Lo mqondiso unikezela ngegama elimnxeba.
- Abanye abantu baqala ukukhazamiseka okanye ukuphuma kummandla amaninzi emzimbeni. Ngokukodwa, unokwazi ukuphaphaka kwiipumlo, ezinye iimbumba ze-mucus, okanye kwi-intravenous site, okanye unokubona igazi emhlanjeni wakho.
- Ukubalwa kweeseli ze-White White kungase kube phantsi, oku kuthetha ukuba kukho amangqamuzana omzimba omzimba ngexesha lokusuleleka.
- Iimvavanyo zegazi zingabonisa ukuba isibindi sonakalisiwe, esinokufunyanwa ngobungqina be-enzyme ezinobindi egazini. Oku kwenzeka ngaphambi kokuba i-jaundice ikhule.
- Ukuba isifo siphucula, i-enzyme yesibindi ilindeleke ukuba ikhule kuze kube yiveki yesibini yokugula ize iqale ukuhla.
- Abo bafumana ama-antibodies ezenza isifo sengculaza njengoko iphela. Intsholongwane ihlala egazini kude nalabo abagula kakhulu.
- Isifo esibi singabangela iimpawu zokudideka, kwaye ekugqibeleni, ukungaphumeleli komzimba.
Phantse iipesenti ezingama-20 ukuya kuma-50 ekhulwini abo banezifo ezinzima bafe.
Izizathu
I-yellow fever ibangelwa yi-flavivirus , intsholongwane ye-RNA eyodwa-eqhotyoshelwe ngu-Aedes aegypti. Lo mbuzane, obangela ukuba i-Zika kunye neDengue, eqinisweni, kuthiwa ngumlingo we-yellow fever. Intsholongwane ye-yellow fever inokusasazeka ngamanye umiyane, i-Aedes africanus e-Afrika okanye i-Haemagogus kunye neSabethes eMzantsi Melika.
Intshontsho ihambisa intsholongwane ngokutya kwigazi lomntu osulelekileyo okanye enye i-primate, njenge-monkey, ize ibetha omnye umntu okanye enye inkunzi. Inyosi iyakuthabatha intsholongwane xa ithe igxile igazi elikhuselweyo ngaphambi kokuba umntu okanye isilwanyana iqhubele umkhuhlane kunye neentsuku ezintlanu emva koko.
Iintshukumo zokuThumela
Intsholongwane inezijikelezo ezintathu ezahlukeneyo zokuhamba: i-jungle (i-sylvatic), i-intermediate (savannah) kunye nedolophini. Imfiva ephuzi esasazeka kwisixeko ihluke kakhulu kunomkhuhlane we-yellow ofumaneka ehlathini okanye e-jungle, kwaye yinto yokuqala eyona nto ibangele.
Xa i-yellow fever isasazeka kwihlathi, ngokubanzi isasazeka ngaphandle kwabantu. Isasazeka kwi-non-human primate (njenge-monkey) kwi-non-human primate. Ukuba abantu batyelela indawo yehlathi (bathi ngokumbiwa, ukuzingela, okanye ukhenketho), banokubethwa ngumlingo baze bagule.
Kwisijikelezo esiphakathi (esibizwa ngokuba ngumjikelezo we-savannah), i-yellow fever isasazeka rhoqo phakathi kweenkwenkwezi kunye nabantu ngeentongwane, kwiindawo ezisemaphethelweni kwiindawo ze-jungle. Inokusasaza isilwanyana kumntu, inkawu ukuya kwidonki, kumntu kumntu, okanye kumntu.
Kwimijikelezo yasezidolophini, i-yellow fever isasazeka ngokubanzi phakathi kwabantu ngeentongwane ezihlala kwiidolophini. Ngokuqhelekileyo iqala xa umntu osulelekileyo enentsholongwane ebuyela kwintlango. Ingakhokelela ekuqhambaneni ngokukhawuleza nakubanzi kwiindawo ezisemaphandleni ezininzi.
Ukuxilongwa
Ukuxilongwa kwe-yellow fever kusekelwe kwimbali yekliniki yokuchasana nokulunywa kwumiyane kwindawo ehlala kuyo, kunye nembali yeempawu. Kukho iimvavanyo ezimbalwa ezinokuxhasa okanye ukuqinisekisa ukuxilongwa kwe-yellow fever.
- U vavanyo lwe-Antibody: Olu vavanyo luvavanyo olusisiseko esilungelelweyo lwe -diagnostic ye-yellow fever. Ukhangele ubukho bama-immune proteins kwi-yellow fever egazini lakho, ebonisa ukuba ulwa okanye ulwa nentsholongwane. Kungathatha iintsuku eziliqela ukuba umzimba wakho uvelise ama-antibodies akwaneleyo ukuze ukwazi ukufunyanwa, nangona kunjalo. Ungadinga ukulinda ukuya kwiiveki ezimbini ukufumana iziphumo zakho.
- Uvavanyo lwe-Virus PCR: Iimvavanyo ze- PCR ziyakwazi ukubona izinto eziphilayo zentsholongwane kwigazi lakho. Uvavanyo olubonakalayo lwe-PCR lubonisa ukuba unentsholongwane emzimbeni wakho, ngoko kuthathwa njengesicatshulwa esinamandla sentsholongwane yangoku kunokuvavanywa kwe-antibody. Umlinganiselo obalulekileyo: I-RNA yentsholongwane iyabonakala emva kokusulelwa kwintsholongwane, kodwa ingabonakali lula emva kweentsuku ezili-ntsholongwane. Oku kuthetha ukuba unokufumana umphumo wokuvavanya i-PCR engafanelekanga nokuba unesifo.
- Uvavanyo lwe-Urine: Uvavanyo olutsha olungafumana i-PCR ye-viral emcinini, okwenza ukuxilongwa kusebenze ngakumbi. Nangona kunjalo, lo vavanyo, ngelixa lithembisa, alisetyenziswanga ngokubanzi.
Unyango
Akukho naluphi unyango olwenzelwe i-yellow fever. Nangona kunjalo, isigulo sinokuba nzima kakhulu, kwaye iingxaki ezinxulumene nazo zingadinga ukunonyango. Unyango lwe-yellow fever kufuneka ulawulwe kwaye kwenzeke esibhedlele, kungekhona ekhaya. Oku kungaquka:
- Ukuthintela ukuphuma kwegazi: Ngenxa yengozi yokuphuma kumachiza, unyango olwenzayo, njenge-aspirin, ibuprofen kunye ne-naproxen, kufuneka luphephe ngokubanzi.
- Ukunyuka kwamanzi: Ukugcina i-hydration kulo lonke ukugula kunye nemilomo yomlomo okanye ye-IV ingafuneka, ingakumbi xa ufumana ukuhlanza okanye uxinzelelo lwegazi oluphantsi.
- Ukulawula umkhuhlane: Ngokuqhelekileyo, i-yellow fever inxulumene namafizi aphantsi. Kodwa ukuba imfiva yakho iphakamileyo kunokuba ikulindeleke, unokufuna imithi yokunciphisa ubushushu bakho.
- Ubuhlungu: Ukuba ufumana ubuhlungu besifo okanye ubuhlungu obuqhelekileyo, unokulawulwa ngomlomo okanye ukuxilwa kweentlungu.
- Ukuxhaswa kwegazi: Kwalabo abatshitshiswayo, okwenzekayo xa uxinzelelo lwegazi luphantsi kakhulu, uxinzelelo lwegazi lunokuphakanyiswa ngamachiza anqanda imithwalo yegazi, edlalwa ngokuba ngabapressors.
- Ulawulo lokusilela komzimba: Xa i-yellow fever ibangela ukungafezeki komzimba, ezo zitho kufuneka zixhaswe ngelixa isifo siphucula. Umzekelo, i-ventilator ingafuneka ukuba incedise ngokuphefumla; udialysis unokufuneka ukuba wenze umsebenzi weentso.
Thintelo
Ngenxa yokuba i-yellow fever ijikeleze ixesha elifutshane, ukuhanjiswa kwegciwane kuyayiqondwa kakuhle. Nazi ezinye iindlela ezifanelekileyo zokukhusela usulelo :
- Ukugonywa : Kubantu abathile, ugonywayo lunconywa. Ukuba uhlala kwindawo engapheliyo, usenokuba sele ukhuselwe kwisifo kwaye kufuneka ulandele iziphakamiso ezisemthethweni malunga nokugonywa kwakho kunye nabantwana bakho. Ukuba uhamba kwindawo apho umkhuhlane weqhwa uhlala khona, kuya kufuneka ukuba ube nesigontsho. Ngokuqhelekileyo, izitofu zabahambi azifumanekanga ngokubanzi, kwaye unokufuna ukuqeshwa kwikliniki yokuhamba kwendawo. Kukulungele ukucwangcisa phambili, njengoko kufuneka ufumane ukugonya ubuncinane iintsuku eziyi-10 ngaphambi kohambo lwakho.
- Imiqathango yokulumkisa: Ukuba unendawo engapheliyo, unokuzikhusela wena nabantwana bakho ngokuchasana noomiyane. Nangona kungenakwenzeka njalo ukuba ugweme ngokugqithiseleyo umlingo, ungayigqoka imibala, ngakumbi xa uhamba emahlathini kunye namahlathi, kwaye ungasebenzisa i-spray spray. Kucetyiswa kwakhona ukuba ulale phantsi kweenetha zokukhusela, nokuba ngaba uya kuba segumbini elikufutshane.
- Ukukhusela abanye: Ngokuqhelekileyo, ngenxa yokuba intsholongwane isenokusasazeka kumntu ukuya kumntu ngokusebenzisa umlingo, kunconywa ukuba uhlale phantsi kweenetha zokumelana nentlobo ukuze ugweme ukusasaza intsholongwane ukuba uyazi ukuba usulelekile.
ILizwi
Ukuba uhamba kwindawo apho umkhuhlane weqhwa uhlala khona, kufuneka uthathe amanyathelo okucetyiswa; ukwenza njalo kuya kunciphisa kakhulu ingozi yokusuleleka.
Kwakhona qiniseka ukuba uyaziqonda ngeempawu eziqhelekileyo ukuze ufune unyango xa usulelekile. Ngelixa abaninzi abantu abane-yellow fever banokuphulukana kakuhle, amathuba abo aphezulu kakhulu xa ufumana unyango lobuchwepheshe ngaphambi kokuba kukho iingxaki.
> Imithombo:
> I-Cui S, iPan Y, uLyu Y. Ukufumanisa i-genomes virus ye-yellow fever ukusuka kwimiba emine yasezweni e-China. Int J I-Dis Disfect. 2017 Julayi; 60: 93-95. i-doi: 10.1016 / j.ijid.2017.05.001. Epub 2017 Juni 13.
> Hughes HR Russell BJ, Mossel EC, uKayiwa J, uLutwama J, uLambert AJ. Ukuphuhliswa kwe-RT-PCR yangempela-mali ye-assay ye-real-time ye-yellow fever yentsholongwane yokugonywa yi-yellow fever. J Clin Microbiol. 2018 Apreli 11. pii: JCM.00323-18. I-doi: 10.1128 / JCM.00323-18. [Epub ngaphambi kokuprinta]