Ngakhale kuti tizilombo ta Powassan sizodziwika, chaka chilichonse, pali anthu ambiri amene amapezeka kuti ali ndi matendawa.
Vutoli linapezeka koyamba ku Powassan, Ontario, mu 1958, pamene idali kutali ndi ubongo wa mnyamata yemwe anafa ndi matenda a encephalitis, omwe amadziwika kuti ali ndi matenda a Powassan. Pakati pa 1958 ndi 1998, anthu 27 okha anapezeka ndi matenda a Powassan.
Pakati pa 2003 ndi 2017 nambala iyi ili ndi zoposa katatu, ndipo anthu 85 akupezeka.
Malingana ndi olemba a ndemanga ya 2017 yotchedwa "Virus ya Powassan: A Arbovirus Emerging of Public Health Amayi ku North America," kuwuka "kungakhale chifukwa cha kuwonjezereka ndi kuyesedwa kwa mavairasi obwera chifukwa cha arthropod, matenda enieni a matendawa, kapena kuphatikiza zonsezi. "
Chiyambi
Monga matenda a Zika, kachilombo ka dengue , ndi kachilombo ka West Nile, kachilombo ka Powassan ndi mtundu wa flavirus. Chimodzimodzinso ndi kachilombo kena kamene kamayambitsa encephalitis: kachilombo koyambitsa matenda a encephalitis (TBEV). Kutenga ndi TBEV kumakhala kofala kwambiri kuposa kachilombo ka Powassan, ndipo anthu zikwi zingapo ku Ulaya ndi Asia amakhudzidwa ndi matenda a encephalitis ndi meningitis chaka chilichonse.
Zambiri mwa zomwe timadziwa zokhudza kachilombo ka Powassan zomwe zimayambitsa matenda ndizochokera ku TBEV, zomwe zimawoneka kuti ndizofunikira kwambiri pa zaumoyo komanso maphunziro apamwamba kuposa kachilombo ka Powassan.
Mwachidziŵikire, katemera wagwiritsidwa ntchito ku TBEV.
Tizilombo ta powassan ndi kachilombo ka RNA kamodzi kokha. Kachilombo, kachilombo ka Powassan kali ndi mizere iwiri: kachilombo ka Powassan kameneka ndi tizilombo toyambitsa matenda (DTV). M'nkhaniyi, tizitchula za zofanana izi (monga zamoyo komanso mzere wosiyana) ngati kachilombo ka Powassan.
Tizilombo ta powassan timatengera nkhupakupa za Ixodes . Kugawidwa kwa kachilombo ka Powassan kumayambira ku Virginia mpaka kumpoto mpaka ku Nova Scotia. Amapezekanso mkati mwa United States ndi Canada, kuphatikizapo New York, Pennsylvania, Quebec, Michigan, Wisconsin, Minnesota, ndi Ontario. Matenda a powassan amapezeka ngakhale kumadzulo kwa Colorado, California, ndi British Columbia.
Kawirikawiri, kachilombo ka Powassan imagawidwa m'madera akummwera ndi a Great Lakes, ndi Hudson Valley ku New York ndi New England zomwe zimafotokoza zambiri.
Chochititsa chidwi n'chakuti kachilombo ka Powassan imapezekanso ku Russia; Komabe, kufalitsa kotereku kungatheke chifukwa cha kulengeza koyambirira kwa zaka zoposa 100 zapitazo-mwinamwake kuchokera ku minkiti yotumizidwa kunja kwazaka 1800s malonda a ubweya.
Mitundu ya Ixodes yomwe imatulutsa kachilombo ka Powassan imakhala ndi nyama zambiri, kuphatikizapo agologolo wofiira, chipmunks, nsomba zazing'ono, ma skunks, voles, mbewa zoyera, ndi mbewa zoyera. Komabe, nthawi zambiri anthu sagwirizana ndi zinyama zomwe zimakonda kugwa, monga masamba ndi skunks. M'malo mwake, anthu amamenyedwa ndi nkhupakupa za Ixodes atadutsa tsamba lachakuta limene limayendera ndi mbewa zoyera ndi zofiira.
Zizindikiro zachipatala
Kawirikawiri, anthu sangakumbukire akalumidwa ndi nkhuku ya Ixodes .
Anthu ambiri omwe alumidwa ndi nkhupakupa samakhala ndi zizindikiro. Kwa omwe amakhala ndi zizindikiro, zimatha kutenga pakati pa masabata awiri kapena asanu kuti kachilombo kamangidwe. Zowonjezera, zimatenga mphindi khumi ndi zisanu zokha kuti nkhupakugwirizanitse ndikufalitsa kachilombo ka Powassan.
Poyamba, anthu omwe amakhala ndi zizindikiro amakhala ndi matenda a chimfine ndi malungo, omwe angaperekedwe ndi kupweteka mutu, zizindikiro za m'mimba, kugona, kusokonezeka, ndi kupweteka. M'masiku angapo a zizindikiro zoyambirirazi, encephalitis imatha. Encephalitis amatanthauza kutupa kwa ubongo. Kuonjezera apo, chingwe cha msana chingathenso kutentha kumayambitsa meningitis ndi myelitis.
Ubongo ndi msana utatha, zizindikiro zotsatirazi zikuwonetsa:
- Mutu
- Lethargy
- Kugonjetsa
- Mavuto a kulankhula
- Kufa ziwalo
- Mavuto a masomphenya
- Kulankhulidwa
- Kuthamanga
- Kuvutika kupuma
- Kusagwirizana kolakwika
Pafupifupi 10 peresenti ya anthu amene amapanga encephalitis kufa. Komanso, 50 peresenti ya anthu amapitiriza kukhala ndi mavuto osatha a mitsempha. Mavuto osatha a ubongo ndi kuphwanya mutu, kupweteka kwa minofu, ndi kukumbukira zovuta.
Kudziwa
Matenda a powassan amatengedwa kuchokera kuchipatala ndi kuyesa ma laboratory.
Chithandizo cha matendawa chiyenera kukwaniritsa zitatu:
- malungo aakulu kapena olingana ndi madigiri 38 Celsius
- zizindikiro zirizonse za mitsempha yachisokonezo cha mantha
- palibe vuto linalake lachidziwitso kuchipatala
Kuyezetsa magazi ndi njira yoyamba yowonera kachilombo ka Powassan mu labu. Kuyezetsa magazi kumaphatikizapo ma antibodies omwe ali ndi kachilombo koyambitsa matenda a m'magazi, magazi, kapena minofu.
Malingana ndi CDC, pano pali zina zowunikira zokhudza kachilombo ka Powassan:
Electroencephalography (EEG) kwa odwala omwe ali ndi POW virus encephalitis amavomereza zochitika zomwe zimachitika pang'onopang'ono ndipo zotsatira zimatha kufanana ndi zomwe zimapezeka mu herpes simplex virus encephalitis. MRI ya ubongo kwa odwala omwe ali ndi POW virus encephalitis amasonyeza kusintha komwe kumagwirizana ndi microvascular ischemia kapena matenda othetsa matenda m'thupi kapena pa lobes temporal; Zotsatira za ubongo wa CT sizinathandize kwenikweni.
Chithandizo
Palibe mankhwala a kachilombo ka Powassan. Mmalo mwake, zizindikiro zimathandizidwa mothandizidwa ndi madzi otsekemera, opanga mpweya wokwanira, komanso mankhwala omwe amachepetsa ubongo. Komanso, palibe umboni wokwanira kuti ukhale ndi ndondomeko zothandizira.
Steroids ndi intravenous immunoglobulin (IVIG) zonse zakhala zikuwoneka kuti zathandizira kuchiza matenda. Sindikudziwa ngati mankhwala oletsa tizilombo toyambitsa matenda (ie, ribavirin) ndi othandiza. Mwachidziwitso, wodwala wina yemwe anachiritsidwa ndi pegylated interferon ndi ribavirin adamwalirabe ndi matendawa. Zolemba, steroids, IVIG, interferon, ndi ribavirin zonse zimathandiza kuti chitetezo cha mthupi chitetezeke komanso zimakhala zowononga thupi.
Ngakhale kuti sichidziŵika, ubongo wojambula ndi MRI ungakhale wolosera ndipo umasonyeza kuti odwala angapitirire chiani kuposa kale lonse.
Kupewa
Pakalipano, palibe katemera wa kachilombo ka Powassan. Pali katemera wa TBEV, omwe ali ofanana ndi kachilombo ka Powassan, ndipo katemerawa amapezeka ku Russia ndi ku Ulaya. Komabe, katemera wa TBEV sanawonetsetse kuti ali ndi kachilombo koyambitsa matenda a Powassan.
Kuwonjezera apo, kachilombo ka Powassan ndi mtundu wa flavivirus, komanso kuwonjezera pa katemera wa TBEV, pali katemera wa mitundu ina ya flavivirus, kuphatikizapo chimfine ndi yellow encephalitis. Komabe, kachilombo ka Powassan sikhala kofanana ndi mitundu ina ya flavivirus mumagulu enaake kotero kuti katemera enawa ndi ochepa.
Pakalipano, njira yabwino yopewera matenda ndi matenda a Powassan ndi kutsatira njira zothandizira. Pali njira zosiyanasiyana zomwe mungachite kuti muchepetse chiopsezo chotenga nkhuku kuphatikizapo zotsatirazi:
- Peŵani kukhudzana kwambiri ndi nkhupakupa popewera malo okhala ndi tsamba lakuda.
- Yendani kupita pakati pa misewu.
- Gwiritsani ntchito mankhwala odzola omwe ali ndi 20% kapena kuposa DEET, picaridin, kapena IR3535. Onetsetsani kuti zitsalira kumalo oonekera pa khungu.
- Valani zovala zomwe zili ndi manja aatali komanso zofiira. Komanso, tani mathalauza anu mu masokosi anu.
- Mukamapempha ana anu kuti azidziletsa, samani ntchito, maso, ndi pakamwa.
- Gwiritsani ntchito zovala ndi magetsi omwe ali ndi permethrin.
- Sungani mukangobwerera kwanu ndikuyang'ana khungu. Chotsani nkhupakupa nthawi yomweyo.
- Fufuzani zovala zonse, magalimoto, ndi ziweto za nkhupakupa.
- Kupha nkhupakupa pa zovala, kuchapa zovala m'madzi otentha ndi kuuma pa kutentha kwakukulu.
- Onetsetsani ziweto zanu za nkhupakupa mutatha nthawi.
- Chotsani malo okhala ndi nkhuku, monga udzu wamtali, burashi, ndi milu ya masamba, kuchokera ku malo anu.
- Sungani udzu wanu kawirikawiri kuti muchepetse malo omwe mumakhala.
- Pangani mipanda kuti zinyama zakutchire zichoke ku malo anu.
- Chotsani zinyumba zotayidwa ndi zinyalala zina zomwe nkhupakupa zimakhala kuchokera pabwalo lanu.
- Ikani nkhuni mu milomo yabwino kuti tipewe kuperewera ndi makoswe omwe amanyamula nkhuku.
- Malo patio ndi zipangizo zamaseŵera kutali ndi mitengo ndi maburashi.
- Ganizirani kugwiritsa ntchito tizilombo toyambitsa matenda (ie, acaricides) kapena kubwezera galu wanu, kuphatikizapo fumbi, mapulogalamu opangidwa, opopera, kapena mankhwala opatsirana. Lankhulani ndi veterinarian wanu poyamba.
- Taganizirani kuti kukhala ndi chiwonongeko kumayambitsa nyumba yanu.
Amphaka ali ovuta kwambiri kwa mankhwala ophera tizilombo; Choncho, musagwiritsire ntchito tizilombo pamphaka anu popanda kulankhula ndi veterinarian wanu poyamba.
Malangizo Otsogolera
Zaka zaposachedwapa, pakhala kuwonjezeka kwa kafukufuku wokhudzana ndi matenda a Powassan.
Kuyang'anitsitsa, pankhondo yolimbana ndi matenda a Powassan, zidzakhala zofunikira kuti asayansi afotokoze nkhuku zazikulu ndi zazing'ono zomwe zimapezeka kuchokera kumunda kuti zimvetse bwino moyo ndi kusintha kwa ma nkhupakupa komanso zinthu zomwe zimayambitsa matendawa. Zindikirani, akatswiri ena amasonyeza kuti kusintha kwaposachedwa mu moyo wa nkhupakupazi kungathe kufotokoza kuwonjezeka kwa mphamvu ya tizilombo toyambitsa matenda.
Kuwonjezera apo, asayansi akufunika kuti aphunzire bwino kupatsirana kachilombo koyambitsa matenda a Powassan mu ziweto zomwe zimakhala zowonjezera. Mwachindunji, ofufuza ayenera kumvetsa bwino momwe kachilombo ka HIV kamayendera kokha osati tizilombo toyambitsa matenda komanso mchere. Maganizowa athandiza asayansi kupeza zovuta zowonjezera ndikuwone momwe kachilombo ka Powassan kamapitilira m'chilengedwe.
Kuti mumvetse bwino zotsatira za matenda a mitsempha ya nthawi yayitali, zoyesayesa zimayenera kupangidwa kuti zizitsatira magulu a odwala pa nthawi (ie, kafukufuku wamagulu).
Ku Wisconsin, nkhupakupa zina zimatha kutumiza kachilombo ka Powassan ndi matenda a Lyme, zomwe zimachititsa kuti matendawa atheke. Matendawa akhoza kufotokozera zizindikiro za matenda a Lyme ndipo ayenera kupitilizidwa.
Mawu Ochokera
Ngakhale kuti palibe, chiŵerengero cha anthu omwe akudwala kachilombo ka Powassan chikukulirakulira ndipo matenda aakulu akusowa kuchipatala. Powonjezereka ndi kuyesa kwakukulu, ndizotheka kuti kachilombo ka Powassan kadzakhalanso chifukwa cha matenda m'tsogolomu.
Pazifukwa zina, chifukwa cha kuchepa kwa anthu komanso kuchepa kwa kachilombo ka Powassan, ndizotheka kuti odwala omwe ali ndi matenda a encephalitis amapezekanso. M'mawu ena, anthu ena omwe amatha kukhala ndi encephalitis sapezeka ndi matenda a Powassan.
Njira yabwino yothetsera matenda ndi kachilombo ka Powassan ndikuteteza kuti nkhuku ikhale yoyamba. Ngati mumakhala kumalo kumene kachilombo ka Powassan imapezeka makamaka makamaka kummwera chakum'mawa ndi nyanja zam'madzi, gwiritsani ntchito zowonongeka pamene mupita panja ndikukayikanso nkhuku mukakabwerera.
Kumbukirani kuti pali tizilombo tina ta tizilombo toyambitsa matenda omwe amachititsa kuti matenda, monga Borrelia burgdorferi (ie, matenda a Lyme ), kotero kuti kubwezeretsa nkhuku ndi nkhuku ndi njira yabwino yothetsera matenda ena.
Ndikofunika kumvetsetsa kuti ngakhale nkhupakupa yakhala ya thupi lanu kanthawi kochepa chabe, panthawi yomwe muiwona, mutha kukhala ndi kachirombo ka Powassan. Tizilombo tina tizilombo toyambitsa matenda, monga Borrelia burgdorferi , takhala ndi chisomo chokwanira kwa tsiku limodzi.
Ngati mukuganiza kuti inu kapena wokondedwa wanu muli ndi kachirombo ka Powassan, pitani kuchipatala mwamsanga. Kuwonjezera apo, dokotala wanu adziwe chifukwa chake mukuganiza kuti matendawa ali ndi kachilomboka ndi tsatanetsatane wa mbiri yakale yomwe ingakhale yotsekemera. Komanso, lolani wothandizira wanu adziwe za ntchito zanu komanso kumene munayenda-makamaka malo omwe kunja komwe nkhuku yosungira kachilombo ka Powassan imapezeka. Dokotala wanu ayenera kuchenjezedwa onse chifukwa ali ndi mayeso apadera kwa Powassan kachilombo ndipo matendawa amatha kusamalidwa ndi akatswiri odwala matenda opatsirana.
> Zotsatira:
> Matenda a Virus a Bennett, N. Powassan M'nyamata-Connecticut, 2016, MMWR. 2017; 66: 408-409.
> Doughty, CT, Yawetz, S, Lyons, J. Emerging Causes ya Arbovirus Encephalitis ku North America: Powassan, Chikungunya, ndi Zika Virus. Malipoti Amakono Okhudza Neurology ndi Sayansi. 2017: 17; 12.
> Hermance, ME, Thangamani, S. Virus ya Powassan: Arbovirus Yoyamba ya Thanzi Labwino ku North America. Vector-Borne ndi Zoonotic Matenda. May 12, 2017.
> CDC. Virus ya Powassan. www.cdc.gov.