Ma US amatha kutuluka pachiwindi cha hepatitis A
Ngakhale hepatitis A ndi matenda omwe sali olekanitsa-kutanthauza kuti nthawi zambiri imakhala yochepa ndipo idzayendetsa yokha-ikadali vuto lalikulu la thanzi. Pafupifupi 80 peresenti ya anthu akuluakulu odwala matenda a hepatitis A omwe ali ndi zizindikiro zosasangalatsa, kuphatikizapo anorexia, jaundice, ndi ululu pamlingo wa chiwindi. Ngakhale tili ndi katemera omwe amateteza matenda a chiwindi A, kachilombo ka HIV kamakhala kofala kwambiri ndipo kuphulika kwa United States kumachitika.
Pa September 1, 2017, dera la San Diego linalengeza zavuto lachipatala chifukwa cha chiwindi cha matenda a hepatitis A. Kuyambira pa September 19, 2017, anthu 16 anafa ndi matenda a hepatitis A, ndipo anthu 305 anaikidwa m'chipatala. San Diego matenda a hepatitis A kuphulika ndi kuphulika kwakukulu kwa United States m'mbiri yaposachedwapa.
Hepatitis A
Matenda a hepatitis A amachititsa matenda a chiwindi.
Hepatitis A ndi kachilombo ka RNA kamodzi kokha kamene kamapezeka m'banja la Picornaviridae. Matenda a hepatitis A ali ofanana ndi enteroviruses, monga poliovirus ndi coxsackievirus, zomwe zimayambitsa mimba dongosolo lisanafike kufalikira kumatenda ena.
Monga enteroviruses, hepatitis A tizilombo toyambitsa matenda ndi olimba ndipo imatha kupirira kutentha monga madigiri 20 osachepera ndi otsika pHs. Matendawa ndi otsika kwambiri pH, zomwe zimakhala zomveka chifukwa pali zidulo m'mimba. Chofunika kwambiri, Kutentha zakudya zomwe zimawonongeka ndi kachilombo ka hepatitis A pa kutentha kuposa madigiri 85 Celsius ndi madzi odzola akhoza kupha kachilomboka.
Njira yopatsira kachilomboka kwa matenda a chiwindi A imakhala yeniyeni. Mwakulankhula kwina, kachilombo ka hepatitis A kakufalikira pogwiritsa ntchito tinthu tating'onoting'ono tomwe timapanga chakudya kapena madzi kapena zinthu zina monga toyese (ie, fomites).
Chiwindi cha Athepatitis A chikhoza kufalikira chifukwa cha zotsatirazi:
- kusamba m'manja kosayenera ndi ogwira chakudya
- kusamba m'manja ndi osamalidwa omwe amawonekera kwa mwana (kapena wamkulu) nyansi
- zakudya zowonongeka pa kukula, kukolola, ndi kukonza
- zowononga madzi, kuphatikizapo zitsime zina ndi kusefukira kwa madzi
Ponena za kumeza, kuwonjezera pa madzi oledzera osokonezeka, nsomba za m'nyanja, zipatso, ndi ndiwo zamasamba zimapezeka ndi matenda a hepatitis A.
Makhalidwe ambiri, monga omwe amachitira kusamalidwa kwa tsiku ndi nyumba za okalamba, amachititsa kuti matenda a hepatitis A. atengeke.
Chifukwa chakuti matenda a hepatitis A si matenda aakulu ndipo anthu sakhala ndi kachilombo ka HIV kwa nthawi yayitali. Pansi pazifukwa zoyenera, kupititsa patsogolo kwapadera kungayambitse kuphulika.
Malingana ndi CDC, mu 2014, panali 1239 milandu ya chiwindi cha hepatitis A ku United States -chulukitsa 30 peresenti kuyambira 2013.
Ana omwe ali ndi matenda a hepatitis A nthawi zambiri amawotchera, zomwe zikutanthauza kuti alibe zizindikiro. Kwenikweni, pafupifupi 70 peresenti ya ana osachepera zaka zisanu ndi chimodzi ndizochepa. Ngakhale matenda a hepatitis A akuwonetseredwa mwa ana, chifuwa chachikulu si chachilendo. Zindikirani, ana osakayika akufalitsa kachilombo kwa akuluakulu.
Ana ambiri achikulire ndi akuluakulu omwe ali ndi kachilombo ka hepatitis A amakhala ndi zizindikiro zotsatirazi:
- kusowa kwa njala
- malungo
- kunyoza
- kusanza
- mitsempha yamdima
- ululu wamkati
- zofiira kapena zadongo
- ululu wamimba
Atatulukira kachilombo ka hepatitis A, pamafunika masiku 15 mpaka 45 kuti matendawa agwire. Zizindikiro zoyambirira zimaphatikizapo malungo, anorexia, ululu m'mimba, ndi nseru. Jaundice imachitika patapita masiku angapo ndipo nthawi zambiri amayamba kutsogolo kwa mkodzo ndi mtundu wa fecal. Zizindikiro nthawi zambiri zimatha masabata osachepera asanu ndi atatu. Pakati pa 10 ndi 15 peresenti ya anthu omwe ali ndi kachilomboka amawona zizindikiro kwa miyezi isanu ndi umodzi.
Ngakhale kuti imfa yodwala matenda a hepatitis A ndi yachilendo, okalamba ndi anthu omwe ali ndi matenda aakulu a chiwindi (mwachitsanzo, chiwindi cha hepatitis B kapena hepatitis C) ali pachiopsezo chachikulu chofera matenda a chiwindi.
Kutupa kwa chiwindi kumayambitsa michere yambiri ya chiwindi (ie, serum aminotransferase) ndi ma bilirubin. Njira yabwino yodziwira kuti matenda a shupatitis akugwiritsidwa ntchito poyezetsa magazi kuti azindikire ma antibodies omwe ali ndi HIV.
Anthu omwe ali ndi kachilombo ka hepatitis A sangathe kachilombo kachiwiri. Amapanga tizilombo toyambitsa matenda a IgG kwa moyo wathu wonse. Anthu ena ali pachiopsezo chachikulu cha matenda a chiwindi cha A chiwindi, kuphatikizapo zotsatirazi:
- oyendayenda kupita ku mayiko kumene chiwindi cha A hepatitis A chikufala
- Amuna omwe amagonana ndi amuna
- anthu omwe ali ndi vuto lodziletsa, monga hemophilia
- ogwiritsa ntchito mankhwala osokoneza bongo
- anthu opanda pakhomo omwe alibe madzi okwanira komanso oyeretsa bwino
- anthu ogwira ntchito ndi nsomba zopanda munthu (chimps, marmosets, ndi zina zina zingathe kupatsirana chiwindi cha m'magazi A)
- anthu omwe amagwira ntchito limodzi ndi ana (monga abysitters)
- anthu omwe ali ndi matenda aakulu a chiwindi
- anthu ochokera m'mayiko omwe matenda a hepatitis A amatha
Ndipotu, anthu amene amapita ku malo omwe matenda a hepatitis A amakhalapo ayenera kulandira katemera wa hepatitis A ngakhale kuti maulendo awo ndi ochepa kapena amakhala kumalo otsekedwa.
Palibe mankhwala enieni a hepatitis A omwe alipo. Anthu odwala matenda a hepatitis A akulangizidwa kuti alandire chakudya chokwanira komanso kupuma mokwanira.
Kuchepa kwa Chiwindi
Chiwombankhanga cha chiwindi cha 2017 A m'chigawo cha San Diego ndicho chiwerengero chachikulu chaposachedwa m'mbiri ya US. Ngakhale kuti kuphulika kumeneku kunapindula kwambiri dziko lonse mu September 2017, wakhala akuyimira kwa miyezi. Pofuna kuthetsa kufala kwa kachilomboka, akuluakulu a mzindawo adalandira anthu zikwi zingapo, kuphatikizapo anthu ambiri okhala m'misasa yopanda pokhala. San Diego ali ndi anthu ambiri opanda pokhala.
Kuwonjezera pa katemera anthu, San Diego watenga njira zina zothandizira, kuphatikizapo kusungirako zipinda zosambira zosamalidwa ndi malo ogwiritsira ntchito manja komanso kusunga malo osambira ambiri 24/7. Komanso, mzinda wayamba kugwiritsa ntchito mphamvu zotsuka m'misewu ndi kutulutsa madzi kuti zitha kufa. Mchitidwe uwu unauziridwa ndi Los Angeles, yemwe adakumananso ndi chiwopsezo. Komabe, akuluakulu a zaumoyo ku Los Angeles, omwe ali pamtunda wa makilomita oposa 100 kumpoto kwa San Diego, akuopa.
Pamaso pa San Diego, kutuluka kwakukulu kwa matenda a chiwindi a A ku United States kunachitika ku Beaver County, Pennsylvania. Kuphulika kumeneku kunali chachiwiri kwa zobiriwira anyezi zomwe zimagwiritsidwa ntchito monga chogwiritsidwa ntchito mu malo odyera a ku Mexican. Pafupifupi anthu 601 ali ndi kachilomboka, 124 anaikidwa m'chipatala, ndipo atatu adafa. (Malo odyera a ku Mexican anali malo odyera a Chi-Chi, omwe anali atayamba kale kusunga ndalama.)
Malingana ndi kafukufuku amene anafalitsidwa ku New England Journal of Medicine omwe anafufuza ku Pennsylvania, pakati pa 3 Oktoba ndi 6 Oktoba 2003, 91 peresenti ya anthu 240 ogwira ntchito yosungirako zakudya anayesedwa anayamba kudwala atatha kudya salsa yofatsa, yomwe inagwiritsa ntchito anyezi wobiriwira Mexico monga chogwiritsira ntchito. Otsalira otsala omwe adagwidwa ndi matendawa anali ovunda wobiriwira muzinthu zina.
Malingana ndi olembawo:
Chiwerengero chowonjezereka cha anthu omwe amafalitsa chakudya chokhudzana ndi chakudya chakhala chikugwirizana ndi zipatso zatsopano. Njira zowonongeka zomwe zikulimbikitsidwa zikuphatikizapo kuonetsetsa kuti ogwira ntchito kumunda ali ndi thanzi labwino komanso ali ndi malo abwino ogwiritsira ntchito zowononga ndikuonetsetsa kuti madzi ogwiritsira ntchito kuthirira ndi kutsuka zokolola sizidetsedwa ndi zinyenyeswazi. Kukonzekera kwa utumiki wa chakudya, kulingalira kuyenera kuchitidwa kuti kuthekera kuti zowonongeka zowonongeka zingayambitse kuipitsidwa kwambiri kwa zokolola zina ndi malo okonzekera. Othandizira zaumoyo angathandize kuthandizira kumene akugwidwa ndi matenda a hepatitis A mwadzidzidzi pomwe amauza akuluakulu a zaumoyo ndi boma ngati zidziwika.
Olembawo adanena kuti chifukwa ana ali pachiopsezo chachikulu chotenga chiwindi cha A chifuwa chachikulu, ayenera kusungidwa kutali ndi malo kumene zokolola zimakololedwa.
Nazi zina mwazidzidzidzi zotchedwa hepatitis A:
- Mu August 2016, ku Hawaii, kunali kuphulika komwe kunayanjanitsidwa ndi zopsereza zopsereza zomwe zinkagwiritsidwa ntchito pa malo odyera a sushi. The scallops ankakololedwa ku Philippines.
- Mu 2016, kunali kuphulika kwazaka zisanu ndi zinayi zogwirizana ndi strawberries. Panali maulendo asanu ndi awiri ogwilitsidwa ndi odwala komanso zero.
- Pa May 31, 2013, kunali kuphulika kwa chigawo cha khumi komwe kunkapezeka mbewu yamakomanga ku Turkey. Panali maulendo 71 a hospital hospital ndi zero.
Kuteteza kwa chiwindi cha A Hebatitis A
Ngakhale kuti palibe mankhwala ochizira chiwindi, pali katemera wothandiza. Kuyambira pamene chiwopsezo cha hepatitis A chinayamba mu 1995, pakhala kuchepa kwa 92 peresenti ya matenda a hepatitis A ku United States.
Katemera wa hepatitis A umalimbikitsidwa chifukwa cha anthu omwe ali ndi chiopsezo chachikulu, anthu omwe angakhale odwala kwambiri ngati sakadzitetezedwa, kapena wina aliyense amene akufuna .
Katemera wa chiwindi ndi pafupifupi 100%. Pofuna kuteteza chitetezo cha nthawi yayitali, amachiza katemera wapakati, osachepera miyezi isanu ndi umodzi. Katemera umalimbikitsidwa kwa ana a miyezi 12 kapena kuposa. Katemera amathandizidwanso kwa anthu akuluakulu omwe sali odziwika omwe ali pangozi yaikulu kapena amakhala m'madera omwe chiwindi cha A hepatitis A chikufalikira.
Pakalipano, pali majekeseni awiri omwe ali ndi kachilombo koyambitsa matenda a hepatitis A ku United States: HAVRIX (GlaxoSmithKline) ndi VAQTA (Merck & Co). Palinso katemera wotchedwa hepatitis A komanso katemera wa hepatitis B wotchedwa TWINRIX (GlaxoSmithKline), omwe amaperekedwa kwa akuluakulu a zaka 18, oposa zaka zitatu kapena zinayi. Zonsezi za katemera wa chiwindi sizimasinthika (mwachitsanzo, osakhala).
Ngati munthu wosadziwika amadziwika ndi hepatitis A, posakhalitsa pambuyo poonekera-mkati mwa masabata awiri-ali ndi njira ziwiri zomwe angapewere matenda. Choyamba, munthuyo akhoza katemera. Chachiwiri, chitetezo cha mthupi chimatha kuperekedwa, chomwe chimateteza kwa miyezi itatu. Zosankha zonsezi ndizothandiza; Komabe, zotsatira za matenda a immune globulin sizomwe zimakhala zamoyo.
Mawu Ochokera
Kuphulika kwa chiwindi cha chiwindi mumzinda wawukulu wa ku America monga San Diego kumatsimikizira kuti ngakhale m'mayiko otukuka omwe ali ndi ukhondo wamakono, matenda a hepatitis A angathe kuwonongera thanzi labwino. Kuwonjezera apo, kuphulika kwaposachedwa kukuunikira kuunika kwapadera komwe anthu opanda pokhala amakhala nawo ponena za chiwindi cha matenda a chiwindi A. Anthu ambiri opanda pakhomo amakhala m'madera ambiri ndipo alibe mwayi wopezeka mwaukhondo komanso madzi.
Ngati mukudandaula kuti mungakhale pachiopsezo cha matenda a chiwindi cha A chiwindi, funsani dokotala wanu wamkulu ndikupempha katemera wa hepatitis A, womwe umapezeka kwa aliyense amene akufuna . Muyeneranso kufunsa dokotala wanu wachisamaliro za kulandira chiwindi cha hepatitis A ngati mukukonzekera kupita ku dera lalikulu, kuphatikizapo mayiko ku Central America, South America, Asia, ndi Africa.
Ngati mukuganiza kuti mwakhala mukudwala matenda a hepatitis A, funsani dokotala wanu nthawi yomweyo. Katemera wa hepatitis A kapena chitetezo cha chitetezo cha chitetezo cha chitetezo cha chitetezo cha chitetezo cha chitetezo cha chitetezo cha hepatitis A ngati ataperekedwa mkati mwa masabata awiri. (HIV imatenga pafupifupi masabata awiri kuti igwire.)
Kuphatikiza pa katemera, pali njira zina zomwe mungatenge kuti muchepetse chiwopsezo chanu cha chiwindi cha m'magazi A m'madera omwe matenda a hepatitis A amakhalapo.
- Sambani manja anu nthawi zonse-makamaka mukamagwiritsa ntchito bafa, musanayambe kukonza chakudya, komanso mutatha kusintha masaya.
- Mankhwala osokoneza bongo omwe ali oposa 60 peresenti mowa akhoza kugwiritsidwa ntchito mmalo mwa sopo ndi madzi kuyeretsa manja anu.
- Pewani kukhudza maso, mphuno, ndi pakamwa pokhapokha manja anu atakhala oyera.
- Pewani kupsompsona, kukumbatirana, ndi kugawanizana ndi anthu omwe akudwala.
- Pewani kukhudzana ndi anthu omwe amawoneka odwala.
- Idyani zakudya zokha zomwe zophikidwa komanso zotentha.
- Idyani mazira omwe ndi ophika.
- Onetsetsani kuti mankhwala a mkaka ndi osakanizidwa.
- Sambani zipatso zonse ndi ndiwo zamasamba m'madzi oyera ndikudzipangire nokha.
- Pewani kudya chakudya chogwiritsidwa ndi ogulitsa chakudya.
- Pewani zakudya zomwe zimatentha kutentha.
- Pewani kudya saladi.
- Pewani mavitamini opangidwa ndi ndiwo zamasamba monga salsa.
- Imwani madzi otsekemera kapena carbonated kokha ndi chisindikizo chokhazikika.
- Pewani madzi a matepi.
- Pewani ayezi opangidwa ndi matepi.
- Pewani ma popsicle aukali kapena ayezi wokongola.
> Zotsatira:
> CDC. Hepatitis A: Zowonongeka . www.cdc.gov.
> Mavairasi a Hepatitis. Mu: Ryan KJ, Ray C. eds. Sherris Medical Microbiology, 6e New York, NY: McGraw-Hill; 2014.
> Wheeler C, et al. Kuphulika kwa Chiwindi cha Athepatitis A Chophatikiza ndi Anyezi Otentha. The New England Journal of Medicine. 2005; 353: 890-897.
> County la San Diego. Health & Human Services Agency. Hepatitis A. http://www.sandiegocounty.gov.
> US Department of Health & Human Services. Hepatitis A. www.vaccines.gov.