Ndi Hurricanes Harvey, Irma, ndi Maria omwe akuwononga Texas, Florida, ndi Puerto Rico, motero, mphepo yamkuntho ya 2017 ya Atlantic ndi imodzi mwa mbiri yakale kwambiri m'mbuyomu. Kuphatikiza pa mabiliyoni ambirimbiri a madola mu chiwonongeko, mkunthowa unagwirizanitsa anthu ambirimbiri.
Ngakhale zotsatira za mphepo zamkuntho 5 zimakhala zochititsa mantha, zomwe zimachititsa kuti madzi osefukira azitha kuopseza kwambiri monga matenda opatsirana ndi madzi.
Kuwongolera kuphulika kwa 548 kuyambira 1900 kunasonyeza kuti 51 peresenti ya kuphulika kumeneku kunayamba chifukwa cha matalala aakulu.
Matenda amadzi omwe amapezeka m'madzi amatha kupyolera mumsewu wamakamwa. Tizilombo toyambitsa matenda tizilombo toyambitsa matenda timalowa m'madzi ndi chakudya, motero timafalitsa matenda. Pambuyo pa kusefukira kwa madzi, zomera zotentha zimasiya komanso kumasula zonyansa zosatetezedwa.
Tiyeni tiwone bwinobwino matenda asanu omwe amapezeka m'madzi: bakiteriya wamagazi, kolera, enteric fever, matenda a chiwindi A , ndi leptospirosis .
Matenda a Bakiteriya
Katemera amatanthauza kutsekula m'mimba. Mabakiteriya omwe amachititsa kamwazi amapezeka ndi C. jejuni , E. coli 0157: H7, E. coli osati 0157: Matenda a H7, mitundu ya Salmonella , ndi mitundu ya Shigella. E. coli 0157: H7 ndi E. coli osati 0157: Matenda a H7 amapanga shiga toxin. Shigella ndi omwe amachititsa kuti minofu ikhale yowopsa, ndipo ngati tizilombo toyambitsa matenda tingazindikire pogwiritsira ntchito chikhalidwe.
Zizindikiro zofala za kamwazi zimaphatikizapo kupweteka kwapweteka, kupweteka kwa m'mimba, ndi malungo.
Chifukwa mabakiteriya akuukira phuloni ndi rectum, pus ndi magazi akupezekapo mu mpando. Mabakiteriya angayambitse zilonda zam'mimba. Komanso, mabakiteriya akhoza kufalikira ku magazi-chifukwa cha bacteria, kapena matenda a magazi. Odwala omwe afooketsa chitetezo cha mthupi kapena omwe alibe kusowa zakudya ali pa chiopsezo chachikulu cha bachemia.
Mankhwala ndi owopsa kwambiri kuposa chifuwa cha m'mimba makamaka makamaka kwa ana osakwana 5 komanso akuluakulu oposa 64. Matendawa nthawi zambiri amachititsa kuti munthu azidwala matendawa komanso akhoza kufa.
Ngati chifukwa cha minofu sichidziwika bwino kapena wodwalayo sangachite bwino ndi mankhwala oyamba a antibiotic, colonoscopy ingathandize ndi matenda. Mankhwala a computerized tomography angagwiritsidwenso ntchito kuti apeze minofu mu milandu yovuta kwambiri.
Katemera amachizidwa ndi maantibayotiki ndi zam'madzi kapena zamkati. Kwa ana, Shigella, Salmonella, kapena Campylobacter akudwala ndi azithromycin, ciprofloxacin, kapena ceftriaxone. Kwa akuluakulu, kamwazi kamadwala ndi azithromycin kapena fluoroquinolones.
Mankhwala a E. coli opangidwa ndi shiga 0157: H7 ndi E.coli osati: 0157: Matenda a H7 ndi antibiotic ndi otsutsana. Pali nkhawa kuti maantibayotiki adzathetsa matenda a hemolytic-uremic poonjezera kukula kwa poizoni wa Shiga. Hemolytic uremic syndrome ndi matenda omwe amakhudza magazi ndi impso.
Cholera
Cholera imatanthawuza kutsegula m'mimba koopsa chifukwa cha matenda ena a Vibrio cholerae. Toxini ya kolera imayikidwa ndi Vibrio cholerae , yomwe imayambitsa adenylyl cyclase, imadzimadzi omwe ali m'maselo achilendo a m'mimba mwachinyamatito, motero amachititsa hypersecretion ya madzi ndi ma chloride ion m'matumbo omwe amachititsa kuti m'mimba ayambe kutsegula m'mimba.
Kutsegula m'mimba kumatha kufika 15 L tsiku! Kutaya kwa madzi okwanira mwamsanga kumabweretsa chisokonezo cha hypovolemic, choopsa kwambiri ndi chakupha.
Kutsegula m'madzi kwa kolera ndi imvi, mitambo, ndipo palibe fungo, pus, kapena magazi. Nthawi zina sitima imeneyi imatchedwa "mpunga wa madzi."
Zikondwerero zamakono ndi mayeso a magazi zimasonyeza umboni wa matenda a kolera.
Ngakhale m'madera a kusefukira kwa madzi, kolera sichipezeka ku United States. Mankhwala amatsenga komanso zamatsenga masiku ano zathetsa vuto la kolera m'boma la United States. Zotsatira zaposachedwapa za kolera ku United States zikhoza kubwereranso ku maulendo apadziko lonse.
Mayiko otukuka omwe amakhudzidwa ndi vuto lopanda madzi ndi madzi osamba, ndi mliri wa njala, kuwombera, ndi nkhondo. Kuphulika kwakukulu kwa kolera m'dera lakumadzulo kwa dziko lapansi kunachitika pambuyo pa chivomezi cha 2010 ku Haiti. Kuphulika kwa Haiti kunapha zikwi za anthu.
Mwala wapakona wa chithandizo cha kolera ndilo gawo la madzi. Muzigawo zofatsa kapena zochepa, m'malo amadzimadzi amatha kukhala olankhula. Kumalo osakanikirana ndi madzi kumagwiritsidwa ntchito ndi matenda oopsa kwambiri.
Maantibayotiki angagwiritsidwe ntchito kuchepetsa matenda a kolera. Maantibayotiki awa ndi azithromycin, ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, fluoroquinolones, ndi tetracycline. Zindikirani, pali mitundu yambiri yokhazikika ya mankhwala a kolera.
Ngakhale kuti pali katemera wa kolera, ndizofunika mtengo, osati zothandiza, ndipo sizothandiza kuthana ndi ziphuphu. Kuchokera kuwonetsetsa kwa thanzi labwino, njira yabwino yothetsera vuto la kolera ndi kukhazikitsa zonyansa zoyenera komanso kupereka chakudya ndi madzi oyera.
Kutentha kwa Enteric
Kutentha kwa mkati kumayambitsa mitundu ya Salmonella ya mabakiteriya. Kutentha kwa chiwombankhanga kumatanthawuza makamaka kutentha kwa enteric komwe kunayambitsa vuto la Salmonella typhi. Salmonella imadutsa mu thupi kudzera m'matumbo aang'ono ndipo imalowa m'magazi. Mabakiteriya amatha kufalikira kuchokera m'matumbo kupita ku ziwalo zina za thupi, kuphatikizapo mapapo, impso, ndondomeko, ndi mitsempha yapakati.
Mu milandu yovuta, enteric fever imasonyeza ngati mutu, chifuwa, malaise, ndi pakhosi komanso ululu m'mimba, kupweteka, ndi kudzimbidwa. Fever imakwera mwapang'onopang'ono, ndipo pakachira, kutentha thupi kumabwereranso kuthupi.
Popanda mavuto, malungo adzatha ndipo munthu amene ali ndi enteric fever adzachira patatha sabata kapena awiri. Komabe, ngakhale kutentha kwa thupi kumatha, wodwala akhoza kubwerera ndipo amadwala ndi enteric fever kachiwiri.
Zovuta zimakhala zakupha ndipo zimaphatikizapo kutuluka m'magazi, matumbo a m'mimba, ndi mantha. Pafupifupi anthu 30 peresenti ya anthu omwe ali ndi matenda a enteric omwe samalandira chithandizo amakhala ndi mavuto, ndipo anthuwa amawerengera 75 peresenti ya imfa chifukwa cha interic fever. Kwa anthu omwe amachiza maantibayotiki, chiwerengero cha imfa ndi pafupifupi 2 peresenti.
Zikondwerero za magazi zingagwiritsidwe ntchito kuti zizindikire kutentha kwa enteric. Leukopenia, kapena dontho la maselo oyera a magazi, amadziŵiranso.
Chifukwa cha kuchuluka kwa maantibayotiki otsutsa, fluoroquinolones ndi mankhwala omwe amachititsa kuti azitha kulandira matenda a typhoid fever. Ceftriaxone, cephalosporin, imathandizanso.
Ngakhale kuti katemera wa typhoid fever alipo, nthawizonse siwothandiza. Njira yabwino yopezera kutentha kwa typhoid ndi kuonetsetsa kuti kutaya kwachitsulo ndikwanira komanso kudya chakudya choyera ndi madzi abwino.
Chiwindi cha mphepo chikhoza kufalikira kwa munthu aliyense; Choncho, anthu omwe ali ndi matendawa sayenera kusamalira chakudya. Anthu ochepa omwe ali ndi kachilombo ka Salmonella typhi amakhala osakanikirana komanso amatha kufalitsa matenda ngati sachitidwa kwa milungu ingapo ndi mankhwala opha tizilombo. Otsatira odalirika angathenso kuchiritsidwa ndi cholecystectomy kapena kuchotsa ndulu.
Hepatitis A
Ngakhale matenda a hepatitis A kawirikawiri amakhala osakhalitsa komanso osafa, zizindikiro za matendawa ndizovuta kwambiri. Pafupifupi 80 peresenti ya anthu akuluakulu omwe ali ndi matenda a chiwindi, chifuwa cha m'mimba, kusowa kwa kudya, kusanza, kunyowa, komanso m'kudwala, jaundice.
Imfa chifukwa cha hepatitis A ndi yosavomerezeka ndipo kawirikawiri imapezeka mwa anthu okalamba kapena omwe ali ndi matenda a chiwindi, monga chiwindi cha hepatitis B kapena hepatitis C.
Zizindikiro za chiwindi cha chiwindi A nthawi zambiri zimatha masabata osachepera asanu ndi atatu. Ochepa odwala akhoza kutenga miyezi isanu ndi umodzi kuti apeze.
Chiwindi cha hepatitis A chimapezeka ndi chithandizo cha magazi omwe amadziŵa maselo enaake.
Palibe mankhwala enieni a hepatitis A omwe alipo, ndipo odwala amalangizidwa kulandira mpumulo wochuluka ndi zakudya zokwanira.
Mwamwayi, katemera wa hepatitis A ndi pafupifupi 100 peresenti yogwira ntchito, ndipo kuyambira pomwe unayambitsidwa mu 1995, kuchuluka kwa matenda ku United States kwataya 90 peresenti. Katemera wa hepatitis A akulimbikitsidwa kwa ana omwe ali ndi zaka 12 kapena kupitila komanso akuluakulu omwe ali ndi magulu akuluakulu omwe amapezeka m'madera omwe chiwindi cha A hepatitis A chikufalikira.
Chifukwa chakuti matenda a hepatitis A amatenga masabata angapo kuti agwire, posakhalitsa pambuyo poonekera, zizindikiro za matenda angathe kutetezedwa ndi katemera kapena chitetezo cha mthupi.
Ngakhale kuti sizinagwirizane ndi masoka achilengedwe ndi kusefukira kwa madzi, mu 2003 ndi 2017, kuphulika kwakukulu kwakukulu kwa hepatitis A kunachitika. Choyamba chinachitika ku Beaver County, Pennsylvania, ndipo chinachokera kumalo odyera obiriwira omwe ankagwiritsidwa ntchito ku malo odyera ku Mexican. Wachiŵiri unachitikira ku San Diego ndipo chifukwa cha kuchepa kwaukhondo - anthu omwe analibe pokhala anaika chiopsezo. Kuphatikizana kumeneku kunayambitsa mazana ambiri a anthu ogwira ntchito kuchipatala komanso anthu ambirimbiri omwe amafa.
Leptospirosis
M'zaka zaposachedwapa, leptospirosis yatsatiranso ngati tizilombo toyambitsa matenda ndi matenda omwe amabwera m'mayiko onse. Leptospirosis ndi matenda a zoonotic, zomwe zikutanthauza kuti zimafalitsidwa kwa anthu ndi nyama. Zikuwoneka kuti leptospirosis imatha kukhalanso pakati pa anthu awiri.
Matendawa ndi owonda, ophika, mabakiteriya omwe amatha kuperekedwa kwa anthu ndi makoswe, ziweto, ndi ziweto. Nthawi zambiri anthu amatha kutuluka pamtunda, koma amatha kupitanso poyang'anizana ndi mkodzo wamtundu, nyansi, magazi, kapena minofu.
Leptospirosis imagawidwa padziko lonse; Komabe, zimapezeka m'madera otentha komanso ozizira. Zikuoneka kuti leptospirosis imakhudza anthu miliyoni imodzi pachaka, ndipo 10 peresenti ya anthu omwe ali ndi kachilombo amafa ndi matendawa.
Mu 1998, kunali kuphulika kwa leptospirosis ku Springfield, Illinois, pakati pa mpikisano wa triathlon. Ma katatu ameneŵa anali ndi kachilombo atatha kusambira mumadzi a madzi amchere. Zikuoneka kuti mvula yambiri inachititsa kuti ulimi ukhale m'nyanja.
Kutumiza kwa leptospirosis kumapezeka kudula, khungu, ndi chiwalo cha maso ndi pakamwa.
Leptospirosis ikupereka zizindikiro zosiyanasiyana. Kwa anthu ena, leptospirosis sichizindikiro ndipo zimakhala zosavuta. Mu mitundu yofatsa, zizindikiro za leptospirosis zimaphatikizapo malungo, mutu, ndi minofu. Kuopsa kwa leptospirosis kumayambitsa jaundice, kusokonezeka kwa impso, ndi kutuluka magazi; Mtundu uwu wa zizindikiro umatchedwa matenda a Weil. Matenda a leptospirosis amatha kupezeka ndi kutaya kwa mpweya, kapena kutuluka m'mapapo, omwe angakhale osaphatikizidwa ndi jaundice.
Anthu ambiri omwe ali ndi kachilombo ka leptospirosis amachira. Imfa ikhoza kuchitika pakadwala matenda akuluakulu omwe amaphatikizapo kutaya magazi ndi kupuma kwa m'magazi. Odwala ndi oyembekezera ali ndi chiopsezo chowonjezereka cha imfa yachiwiri mpaka leptospirosis.
Ndikofunika kuchiza leptospirosis ndi mankhwala oletsa tizilombo kuti tipewe kufooka kwa thupi. Odwala ayenera kuchiritsidwa mwamsanga musanayambe kugwiritsidwa ntchito. Leptospirosis imatha kuchiritsidwa ndi mankhwala osiyanasiyana a antibiotics, kuphatikizapo, ceftriaxone, cefotaxime, kapena doxycycline.
Kuphatikiza pa maantibayotiki, chisamaliro chothandizira monga kusungirako kwa madzi otsekula m'mimba ndi kofunikanso.
Pa matenda aakulu, vuto la impso likuyenera kuchitidwa ndi dialysis yaifupi. Odwala omwe ali ndi mapapo a m'magazi angafunikire kutsegula mpweya wabwino.
Pali chithandizo cha leptospirosis cha nyama. Ena akuluakulu amathandizanso katemera; Komabe, izi ndi malo omwe amafunikanso kuphunzira.
Kuphatikiza Pamwamba
Ngakhale kuti United States ndi dziko lolemera lomwe lili ndi ukhondo wabwino komanso zowonongeka, masoka, monga mvula yamkuntho ndi kusefukira kwa madzi, zimachitika. Pa nthawi za mavuto, matenda omwe amapezeka m'madzi akhoza kufalikira.
Chifukwa cha kusintha kwa kayendedwe ka nyengo ndi kutentha kwa mpweya woipa, kutentha kwa nyengo kumasonyeza kuti pofika chaka cha 2100, padzakhala kuwonjezeka kwa zochitika za mvula yambiri, zomwe zingathandize kugawidwa kwa matenda opatsirana ndi madzi.
> Zotsatira:
> Mimba, Perineum, Anus, ndi Rectosigmoid. Mu: LeBlond RF, Brown DD, Suneja M, Szot JF. eds. Kufufuza kwa DeGowin's Diagnostic Examination, 10e New York, NY.
> Bernstein AS. Kusintha kwa Chilengedwe ndi Matenda Opatsirana. Mu: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Mfundo za Harrison za Internal Medicine, 19e New York, NY: McGraw-Hill; 2014.
> Matenda opatsirana. Mu: Iserson KV. eds. Kupititsa patsogolo Mankhwala: Kusamalila M'zinthu Zovuta, 2e New York, NY: McGraw-Hill
> Pfeiffer M, DuPont HL, Ochoa TJ. Wodwala akupereka mliri wamatenda-ndondomeko yowonongeka. J Wopanda. 2012; 64 (4): 374-86. dx.doi.org/10.1016/j.jinf.2012.01.006
> Schwartz BS. Matenda a Bakiteriya ndi Chlamydial. Mu: Papadakis MA, McPhee SJ, Rabow MW. eds. Kufufuza kwa Zamankhwala Zamakono ndi Kuchiza 2018 New York, NY.