Ngeziqhwithi zikaHarvey, i-Irma, noMaria ezihlasela iTexas, eFlorida, nasePuerto Rico, ngokulandelanayo, i-2017 ye-Atlantic yenyanyanyamba yonyaka yimbi yeyona nto imbi kakhulu kwimbali yakutshanje. Ukongezelela kumakhulu amabhiliyoni weedola ekutshatyalaliswa, ezi ziqhwithi zidibanise zithatha amanqaku ebomi.
Nangona imiphumo esheshayo yeCandelo 5 iintshukumo ziyamangalisa, okubangelwa ngamanzi amaninzi aneengongelo ezinobungozi ezinjengezityalo zamanzi.
Ukuhlaziywa kwama-548 kuphazamiseka okusukela ngo-1900 kubonise ukuba i-51 pesenti yalezi ziqhumane zazilandelwa ziziqhamo ezinzima.
Ukugula kwamanzi kuyadluliselwa ngeendlela zomlomo. Iinqununu ze-fecal ezincinci zenza indlela yazo emanzini kunye nokutya, ngaloo ndlela zisasazeka isifo. Emva kokukhukula kwamanzi, izityalo zokuthuthwa kwamanzi zikhuphe kwaye zikhulule iimali ezininzi ezingenakuphulukiswa.
Masiqwalasele ngokuthe kratya kwizifo ezihlanu ezimanzi: i-bacterial dysentery, ikholera, umkhuhlane we-enteric, i- hepatitis A , kunye neptospirosis .
Isifo seBasterial Dysentery
Isifo sesifo sibhekisela kwisifo esithintekayo, isifo sohudo. Iibhaktheriya ezibangelwa isifo segazi zibandakanya i- C. jejuni , E. coli 0157: H7, E. coli engekho 0157: iintlobo ze-H7, iintlobo ze- Salmonella kunye neentlobo ze-Shigella. Bobabini u- E. coli 0157: H7 no- E. coli engekho 0157: Iintlobo ze-H7 zivelisa i-toxin yeShiga. I-Shigella yimbangela ebangela isifo segazi, kwaye njengamanye amagciwane afunyanwa ngokusebenzisa i-stool culture.
Iimpawu eziqhelekileyo zesifo segazi ziquka ukuxhatshazwa okubuhlungu, ubuhlungu besisu, kunye nomkhuhlane.
Ngenxa yokuba iibhaktheriya zihlasela i-colon ne-rectum, i-pus kunye negazi nazo zikhoyo kwi-stool. Ibhaktheriya ingabangela isilonda sesilonda. Ngaphezu koko, iibhaktheriya zinokusasazeka kwigazi-ezibangelwa yi-bacterium, okanye ukusuleleka kwegazi. Izigulane ezenza buthathaka amajoni omzimba okanye abangondlekiyo zingengozini ephezulu ye-bacterium.
Isifo seso sibi kakhulu kunomkhuhlane wesisu- ikakhulukazi kubantwana abangaphantsi kwe-5 kunye nabantu abadala abangaphezu kwama-64. Olu sulelo lubangele lufikelele esibhedlele kwaye luya kufa.
Xa imbangela yesifo segazi singacacanga okanye isigulane sihluleka ukuphucula unyango lokuqala lwe-antibiotic, i-colonoscopy ingakwazi ukuncedisa ukuxilongwa. I-computerized tomography ingasetyenziselwa ukuxilonga isifo somhlaza kwiimeko ezininzi.
Isifo sesifo siphethwe ngamayeza omzimba kunye nemilomo yomlomo okanye i-intravenous fluids. Kubantwana, i-Shigella, i-Salmonella, okanye i-Campylobacter isifo iphathwa nge-azithromycin, i-ciprofloxacin, okanye i-ceftriaxone. Kubantu abadala, i-dysentery iphathwa nge-azithromycin okanye i-fluoroquinolones.
Ukunyangwa kwe-Shiga-toxin-producing e- coli 0157: H7 ne- E.coli engeyi-0157: Iintlobo ze-H7 ezine-antibiotics ziphikisana. Kukho iinkxalabo zokuthi i-antibiotics iya kunciphisa i-hemolytic-uremic syndrome ngokunyusa ukwenziwa kwe-toxin ye-Shiga. I-Hemolytic uremic syndrome yimeko ebulalayo echaphazela igazi kunye neentso.
Ikholera
Ikholera ibhekisela kwisifo sohudo esibangelwa yimimandla ethile yeVibrio cholerae. I-toxin ye-Cholera ifihliwe yi- Vibrio cholerae , eyenza i-adenylyl cyclase, i-enzyme efumaneka kwiiseli ze-epithelial ze-intestine encinci, ngaloo ndlela ivelise i-hypersecretion yamanzi kunye ne-chloride ion emathunjini okukhokelela ekudleni kwesifo.
Umthamo wehudo unokufikelela kwi-15 L ngosuku! Ukulahlekelwa kwamanzi omzimba ngokukhawuleza kubangela ukutshatyalaliswa kwe-hypovolemic, yingozi kakhulu kwaye iyingozi.
Ihorrha yamanzi i-kolera iyigrey, ifufayo, kwaye ingenashushu, i-pus, okanye igazi. Ngezinye izihlandlo lesi sikhundla sibizwa ngokuthi "isitya samanzi."
Izitshixo ze-Stool kunye nokuhlolwa kwegazi kubonisa ubungqina be-kelera.
Kwimihlaba yezikhukula, i-klere ayifumaneki kwi-United States. Ukucocwa kwamanzi kunye nonyango lwamanzi kuphelile i-cholera ehlala e-United States. Zonke iimeko zentsholongwane zekholera e-United States zinokulandelwa ekuhambeni kwamazwe ngamazwe.
Ikholera inokutshabalalisa iintlanga eziphuhlisayo kunye nokunyanga kwamanzi kunye nokunyangwa kwamanzi, kwaye yinto yokufa yendlala, ukuxubha kunye nemfazwe. Ukugqitywa kokugqibela kwekholera e-Western hemisphere kwenzeka emva kokuzamazama komhlaba kwe-Haiti. Ukuqubuka kwamaHaiti kwabulala amawaka abantu.
Ilitye lekona leyeza kunyango yekholera yindawo yokutshintshwa kwamanzi. Amatyala amancinci okanye athileyo, ukutshintshwa kwamanzi kube ngumlomo. Ukutshintshwa kwamanzi okutshatyalaliswayo kusetyenziswa ngesifo esibi kakhulu.
I-antibiotics ingasetyenziselwa ukunciphisa ixesha lokugula kwekholera. Ezi antibiotics ziquka i-azithromycin, i-ampicillin, i-chloramphenicol, i-trimethoprim-sulfamethoxazole, i-fluoroquinolones kunye ne-tetracycline. Ingqalelo, iintlobo ezininzi ze-kelera ezingaphephekiyo zikhoyo.
Nangona kukho isitofu sokukhusela i-k'holera, kubiza, kungekhona oko kusebenzayo, kwaye akunakunceda ekulawuleni iziqhwithi. Ukususela kwimibono yempilo yoluntu, indlela efanelekileyo yokujongana nokugqithwa kwekholera kukuseka ukulahlwa kwenkunkuma kunye nokubonelela ngokutya kunye namanzi acocekileyo.
Ukungena Kwemfiva
Ukungena komkhuhlane kubangelwa zizifo ze-Salmonella zeebhaktheriya. Umkhuhlane we-typhoid uthetha ngokuthe ngqo kumkhuhlane we-enteric obangelwa yi- Salmonella typhi. I-Salmonella idlulela emzimbeni ngethuba elincinci kwaye lihlasela igazi. Iibhaktheriya zinokusasazeka ukusuka kumathambo ukuya kwezinye iinkqubo zesebe, kuquka imiphunga, iinjongo, i-gallbladder, kunye nenkqubo yesantya ephakathi.
Kwiimeko ezinzima, i-enteric fever ibonakalisa njengentloko, ukukhwehlela, i-malaise, kunye nomqala wesisu kunye nobuhlungu besisu, ukubhubhisa kunye nokuqhaqha. Umkhuhlane uya kunyuka ngendlela efanelekileyo, kwaye ngexesha lokuphulukana, ubushushu bomzimba buya buyela ngokuqhelekileyo.
Ngaphandle kweengxaki, umkhuhlane uya kuphuka kwaye umntu onomkhuhlane we-enteric uya kubuya ngeveki okanye ezimbini. Nangona kunjalo, nangemva kokuba umkhuhlane usuphelile, isigulane sinokuphinda siphinde siphinde sigule ngesifo somkhuhlane kwakhona.
Iingxaki ziyabulala kwaye ziquka ukuphuma kwegazi, ukunyuka kwamathumbu emathumbu, nokuphazamiseka. Phantse iipesenti ezingama-30 zabantu abane-fever enteric abangenayo unyango bahlakulela iingxaki, kwaye aba bantu babala i-75 ekhulwini yokufa ngenxa yokungena komkhuhlane. Kubantu abaphathwa nge-antibiotics, izinga lokufa li malunga nama-2 ekhulwini.
Iimizi zegazi zingasetyenziselwa ukuxilonga i-enteric fever. I-Leukopenia, okanye ukulahla kweeseli ezimhlophe zegazi, kwakhona ukuxilongwa.
Ngenxa yokunyuka kwama-antibiotics, i-fluoroquinolones yi-antibiotic ekhethekileyo kunyango lwe-typhoid fever. I-Ceftriaxone, i-cephalosporin, iyasebenza.
Nangona isitofu sokukhusela i-typhoid fever iyafumaneka, ayisoloko isebenza kakuhle. Indlela efanelekileyo yokukhusela umkhuhlane we-typhoid kukuqinisekisa ukulahlwa kwezinto ezifanelekileyo kunye nokusetyenziswa kokutya okucocekileyo kunye namanzi.
Umkhuhlane we-typhoid ungasasazeka kumntu ukuya kumntu; Ngako oko, abantu abanentsholongwane akufanele baphathe ukutya. Abancinci abantu abanesifo sikaSalmonella typhi baba ziimpawu ezingapheliyo, ezinokuthi zisasaze izifo kwaye zingasasaza izifo xa zingaphathwa unyanga ngeeveki ezininzi ngamayeza. Abathwali abangapheliyo banokuphathwa kunye ne-cholecystectomy okanye i-gallbladder ukususwa.
I-Hepatitis A
Nangona ukusuleleka kwe-hepatitis A ngokuqhelekileyo kungekudala kwaye kungabhubhi, iimpawu zale ntsholongwane azixhalabisi. Phantse ama-80 ekhulwini labantu abadala abanentsholongwane ye-hepatitis A, iintlungu zesisu, ukulahleka kwesidlo, ukuhlanza, ukuncwina, kwaye emva koko ngexesha lokugula, i-jaundice.
Ukufa ngenxa yesifo se-hepatitis A akunqabile kwaye ngokuqhelekileyo kubakho kubantu abadala okanye abo abanezifo ezingasigxina, ezifana ne-hepatitis B okanye i-hepatitis C.
Iimpawu ze-hepatitis A zihlala zihlala ngaphantsi kweeveki ezisibhozo. Incinci yezigulane zingathatha iinyanga ezilisithandathu ukuze zibuyele.
I-Hepatitis A ifunyaniswa ngoncedo lovavanyo lwegazi olufumanisa iintsholongwane ezithile.
Akukho unyango oluthile lwe-hepatitis A olukhoyo, kwaye izigulane zikwacetyiswa ukuba zifumane ukuphumla okuninzi nokutya okwaneleyo.
Ngenhlanhla, isitofu sokugonywa kwe-hepatitis A siphumelele malunga neepesenti eziyi-100, kwaye ukususela ekusungulweni kwayo ngo-1995, ubukhulu bentsholongwane e-United States buyehlile ngaphezu kwama-90 ekhulwini. I-vaccination ye-hepatitis A iyanconywa kubantwana abaneminyaka eli-12 ubudala nangaphezulu kunye nabantu abadala abakwiindawo ezinobungozi obuphezulu njengabo bahlala kwiindawo apho i-hepatitis A isasazeka khona.
Ngenxa yokuba ukusuleleka kwe-hepatitis A kuthatha iiveki ezimbalwa ukuba zibambe, kungekudala emva kokuvelela, iimpawu zentsholongwane zinokuthintela ngokugonya okanye ukulawulwa kwe-immune globulin.
Nangona ingahambelani neentlekele zemvelo kunye nezikhukula, ngo-2003 kunye no-2017, kwavela izibhamu ezimbini ze-hepatitis A. Into yokuqala yenzeke eBeverver County, ePennsylvania, kwaye yabuyela emva kwe-anyanisi eluhlaza okwenziwa kwindawo yokutya yaseMexico. Okwesibini kwenzeka eSan Diego kunye-ngenxa yokucocwa kwengcoceko-ingozi yabizwa phakathi kwamalungu angenamakhaya. Ukuhlanganiswa kwezi ziqhamo kubangele amakhulu empilo yezibhedlele kunye nokufa kwabantu abaningana.
Leptospirosis
Kwiminyaka yakutshanje, i-leptospirosis ibuye iphinde ibe yintsholongwane echaphazelekayo ekliniki kunye nokugqithwa okwenzeka kwilizwekazi ngalinye. I-Leptospirosis iyisifo se-zoonotic, oko kuthetha ukuba idluliselwa kubantu kwizilwanyana. Kubonakala ngathi i-leptospirosis inokudluliselwa phakathi kwabantu ababini.
I-Leptospires yincinci, i-coiled, i-motile bhaktheriya idluliselwa kubantu ngamagundane, izilwanyana zasekhaya kunye nezilwanyana zasefama. Ukuxhamla kwabantu ngokuqhelekileyo kubakho ngokubakho kwendalo ngaphandle kwezinto ezingasetyenziswayo kwintsimi ekusebenzisaneni ngqo kunye nomchamo wezilwanyana, iifesi, igazi, okanye izicubu.
I-Leptospirosis isasazwa kwihlabathi jikelele; Noko ke, ixhaphake kakhulu kwimimandla yasempileni kunye neyasentla. Kulinganiselwa ukuba i-leptospirosis ichaphazela abantu abayizigidi ngezigidi, kunye neepesenti ezili-10 zabantu abasulelekileyo besifo sosulelo.
Ngo-1998, kwakukho ukugqabhuka kwe-leptospirosis e-Springfield, e-Illinois, phakathi kwabaqhubi be-triathlon. Ezi zi-triathlet zatshatyalaliswa emva kokubhabha kumanzi amachibi angcolileyo. Kubonakala ukuba, imvula enzima yayibangela ukuqhuma kwezolimo kulwandle.
Ukuthunyelwa kwe-leptospirosis kwenzeka kwiinqununu, isikhumba esikhoxisiweyo, kunye nomlenze womlenze wamehlo nomlomo.
I-Leptospirosis inikezela ngeempawu ezininzi. Kwamanye abantu, i-leptospirosis ayibangela ukuba kubekho iimpawu kwaye ngaloo ndlela i-asymptomatic. Kwiifom ezithobileyo, iimpawu ze-leptospirosis zibandakanya umkhuhlane, intloko, kunye neentsimbi zomzimba. I-leptospirosis enobangela i-jaundice, i-kidney disysction, kunye nokuphuma kwegazi; le ntlupheko yeempawu ibhekiselwa kwisifo sikaWeil. I-leptospirosis enobukhulu ingakhombisa kunye ne-pulmonary hemorrhage, okanye iphuma kumaphaphu, anokuthi angayi kuhamba kunye ne-jaundice.
Uninzi lwabantu abanesifo se-leptospirosis babuya. Ukufa kungenzeka kwiziganeko zezifo eziphambili ezibandakanya ukungasebenzi kwemfucuza kunye nokuphuma kwamaphaphu. Izigulane ezikhulile kunye nezikhulelwe zibuye zengozi yokufa kwesibini kwi-leptospirosis.
Kubalulekile ukunyanga i-leptospirosis kunye namayeza okukhusela ukusilela komzimba. Izigulane kufuneka ziphathwe ngokukhawuleza ngaphambi kokuphela komzimba. I-Leptospirosis inokuphathwa ngoluhlu olubanzi lwee-antibiotics, kubandakanya, i-ceftriaxone, cefotaxime, okanye i-doxycycline.
Ukongezelela kwii-antibiotiki, ukunakekelwa kokuncedisa okufana nokulawulwa kwamanzi e-intravenous kuyadingeka.
Kwiimeko zesifo esibi, i-kidney disy functional ifuna ukuphathwa nge-short-term dialysis. Izigulane ezinegazi lomphunga zingadinga umoya wokungenisa umoya.
Kukho i-leptospirosis yokugonya kwezilwanyana. Abanye abantu abadala baye bachonywa; nangona kunjalo, le yindawo efuna ukufundisisa ngakumbi.
Ukuqulunqa
Nangona iUnited States lizwe elicebile elinokucoceka okucokisekileyo kunye nezibonelelo, iintlekele-njengeziphepho kunye nezikhukhula-zenzeke. Ngeli xesha leenkathazo, izifo ezihamba ngamanzi zingasasazeka.
Ngenxa yokuguquka kwesimo sezulu kunye nokukhutshwa kwegesi yokushisa, uhlobo lwemozulu lubonisa ukuba ngonyaka we-2100, kuya kubakho ukwanda kwindwendwe eninzi, enokubangela ukusabalalisa ngokubanzi izifo ezibangelwa ngamanzi.
> Imithombo:
> I-Abdomen, Perineum, Anus, kunye ne-Rectosigmoid. Ku: LeBlond RF, Brown DD, Suneja M, Szot JF. eds. Ukuhlolwa kweDiscotic Degowin, 10e eNew York, NY.
> Bernstein AS. Ukuguquka kwemozulu kunye nezifo ezithintekayo. Ku: Kasper D, Fauci A, Hauser S, uLongo D, Jameson J, Loscalzo J. eds. Imigaqo yeHarrison ye-Medicine yangaphakathi, i-19e eNew York, i-NY: i-McGraw-Hill; 2014.
> Izifo ezithathelwanayo. Ku: Iserson KV. eds. Amachiza aphuculweyo: Ukubonelela ngononophelo kwiindawo ezinzulu, 2e eNew York, NY: McGraw-Hill
> Pfeiffer M, DuPont HL, Ochoa TJ. Isigulana esibonisa isifo segazi esisisigxina-uhlolo oluhlelekile. J Infect. 2012; 64 (4): 374-86. dx.doi.org/10.1016/j.jinf.2012.01.006
> Schwartz BS. Izifo zoBucter & Chlamydial. Ku: Papadakis MA, McPhee SJ, Rabow MW. eds. Ukuxilongwa kweZonyango kunye neNyango ye-2018 eNew York, NY.