I-US ayivikelekile ekuqhumeni kwesifo se-hepatitis A
Nakuba i-hepatitis A iyisifo esingenakubalwa-okusho ukuthi ngokuvamile iqhuba inkambo emfushane futhi izozixazulula yodwa-isengenkinga yempilo yomphakathi. Amaphesenti angaba ngu-80 abantu abadala abanesifo sofuba esibhedlela i-hepatitis A, okuhlanganisa i-anorexia, i-jaundice, nobuhlungu ezingeni lesibindi. Ngisho noma sinomgomo ovikela ukulwa nesifo sofuba, i-virus isifo esithathelwanayo futhi ukuqhuma kwe-US kwenzeka.
NgoSepthemba 1, 2017, iSan Diego County yatshengisa ukuphuthumayo kwezempilo yomphakathi ngenxa yokuqubuka kwesifo se-hepatitis A eqhubekayo. Kusukela ngoSeptemba 19, 2017, abantu abangu-16 babulawe yi-hepatitis A, kanti abantu abangu-305 baboshwa esibhedlela. I-San Diego i-hepatitis A isifo sokuvuthwa yi-US enkulu ukuqhuma emlandweni wakamuva.
I-hepatitis A
I-virus ye-hepatitis A ibangela ukutheleleka kwesibindi.
I-Hepatitis A iyi-virus e-RNA eyodwa elinezintambo ezivela emndenini wePornanaviridae. I-virus ye-Hepatitis A ifana ne-enteroviruses, efana ne-poliovirus ne-coxsackievirus, ehlasela isimiso semathunjini ngaphambi kokuba isakaze kwezinye izicubu.
Njengama-enteroviruses, i-hepatitis A i-pathogen iqinile futhi ingakwazi ukumelana namazinga okushisa njengephansi ngaphansi kwe-degrees Celsius nama-pH aphansi. I-gut is a low-pH imvelo, okuyinto enengqondo ngoba kunezikhali esiswini. Okubaluleke kakhulu, ukushisa ukudla okuhlaselwe yi-virus ye-hepatitis A emazingeni okushisa angaphezu kuka-85 degrees Celsius kanye nokuchithwa kwamanzi kungaphaza igciwane.
Indlela yokudlulisela i-hepatitis A ngokuyinhloko i-fecal-oral. Ngamanye amazwi, igciwane le-hepatitis A lisakazwa ngezinhlayiya ezincane ezinama-fecal ezenza indlela yazo ekudleni noma emanzini noma ezintweni ezifana namathoyizi (okungukuthi, amafomu).
I-Hepatitis A ingasakazwa ngenxa yalokhu okulandelayo:
- ukuhlanza izandla okungalungile ngabaphethe ukudla
- ukuhlanza izandla okungalungile ngabanakekeli abahlinzekwa emanzini omntwana (noma omdala)
- ukudla okungcolile ngesikhathi sokukhula, ukuvuna nokucubungula
- imithombo yamanzi engcolile, kuhlanganise nemithombo ethile kanye nezikhukhula
Ngokuphathelene nokungenisa, ngaphezu kwamanzi okuphuza ahlambulukile, i-shellfish engavunyelwe, izithelo, nemifino kukhona imithombo ebhalwe phansi yokutheleleka kwe-hepatitis A.
Izimo ezinzima, njengalabo abanolwazi lokunakekelwa kwesikhashana namakhaya asebekhulile, kuqinisa ukuhanjiswa kwesifo sofuba.
Ngoba i-hepatitis A ayiyona isifo esingelapheki futhi abantu abanasifo sengculaza isikhathi eside kakhulu, ukudluliselwa kuyinkimbinkimbi. Ngaphansi kwezimo ezifanele, ukuthunyelwa okuncane kungabangela ukuqubuka.
Ngokusho kwe-CDC, ngonyaka ka-2014, kwakunezinkinga ezingu-1239 ezibikiwe ze-hepatitis A e-United States-ukwehla kwamaphesenti angu-30 kusukela ngo-2013.
Izingane ezithintekile nge-hepatitis A zivame ukungena, okusho ukuthi abanazo izimpawu. Ngokuqondile, amaphesenti angaba ngu-70 ezinganeni ezingaphansi kweminyaka eyisithupha azibonakali. Ngisho noma ukutheleleka kwe-hepatitis A kubonakala ezinganeni, i-jaundice ayivamile. Okuphawulayo, izingane ezingapheliyo zisakaze ukutheleleka kubantu abadala.
Iningi labantu abadala kanye nabakhulile abanesifo sengculaza nesifo se-hepatitis A lezi zimpawu ezilandelayo:
- ukulahlekelwa ukudla
- umkhuhlane
- isiyaluyalu
- ukuhlanza
- umchamo omnyama
- ubuhlungu obuhlangene
- izigqoko ezibomvu noma zobumba
- ubuhlungu besisu
Emva kokuchazwa kwesifo se-hepatitis A, kuthatha izinsuku eziphakathi kuka-15 no-45 ukutheleleka ukubamba. Izimpawu zokuqala zihlanganisa umkhuhlane, i-anorexia, ubuhlungu besisu, nesisulu sokuncelisa inhliziyo. I-jaundice kwenzeka ngemva kwezinsuku ezimbalwa futhi ngokuvamile ilandelwa izinguquko emcimbini nombala we-fecal. Izimpawu ngokuvamile zihlala amasonto ayisishiyagalombili. Phakathi kwamaphesenti angu-10 kuya kwangu-15 abantu abanegciwane bahlangabezana nezimpawu ezinyangeni eziyisithupha.
Nakuba ukufa okubangelwa ukutheleleka kwesifo sohlobo lwe-hepatitis A akuvamile, abantu asebekhulile kanye nabantu abanezifo ezingapheli zesibindi (isb., Isibindi se-B noma i-hepatitis C) basengozini enkulu yokufa kwesifo sofuba.
Imiphumela yokuvuvukala kwesibindi ku-enzyme yesibindi ephakeme (ie, serum aminotransferase) namazinga e-bilirubin. Indlela engcono kakhulu yokuthola i-hepatitis isebenzisa ukuhlolwa kwegazi ukuthola amagciwane ahlobene negciwane e-IgM.
Abantu abanegciwane lesifo sofuba A asikwazi ukutheleleka futhi. Bakha ama-anti-gciwane e-IgG okuphila njalo egazini. Abanye abantu basengozini enkulu yokutheleleka kwe-hepatitis A, kufaka phakathi okulandelayo:
- abahambi baye emazweni lapho i-hepatitis A ejwayelekile khona
- amadoda alala namadoda
- abantu abanezinkinga zokuqeda, njenge-hemophilia
- abasebenzisa izidakamizwa zokuzijabulisa
- abantu abangenamakhaya abanokufinyelela okulinganiselwe kwamanzi asebenzayo kanye nokuhlanzeka okuhlanzekile
- abantu abasebenza nezidakamizwa ezingezona zomuntu (izimpumputhe, ama-marmosets, nezinye izilwane ezincane zingadlulisa isibindi se-A)
- abantu abasebenza ngokubambisana nezingane (njengabantwana abancane)
- abantu abanezifo ezingapheli zesibindi
- amazwe omhlaba avela emazweni lapho i-hepatitis A ekhona khona
Inothi, abahambi baya ezindaweni lapho i-hepatitis A ekhona khona kufanele ikwazi ukuthola ukugoma kwe-hepatitis A ngisho noma ukuhamba kwabo kufushane noma bahlala ezindaweni zokuvakasha ezivaliwe.
Akukho ukwelashwa okuqondile kwe-hepatitis A ekhona. Abantu abane-hepatitis A bayelulekwa ukuba bathole ukudla okunomsoco nokuphumula okuningi.
Ukuqubuka kwesifo sofuba
I-2017 i-hepatitis A ukugqashuka eSan Diego County yiyona ingqungquthela enkulu kunazo zonke emlandweni wase-US. Nakuba ukuqhuma kuqala kutholwe ukunakekelwa kukazwelonke ngoSepthemba 2017, sekube sekuqhamuka izinyanga. Emzamweni wokulwa nokusabalala kwegciwane, izikhulu zedolobha zagoma abantu abayizinkulungwane eziningana, kuhlanganise nabantu abaningi abahlala emakamu angenamakhaya. I-San Diego inenani elikhulu labantu abangenamakhaya.
Ngaphandle kokugoma abantu, iSan Diego ithathe ezinye izinyathelo zokuvimbela, kufaka phakathi ukubeka izindlu zokugeza eziphathekayo neziteshi zokugeza izandla kanye nokugcina izindawo eziningi zokugeza zomphakathi zivulekile 24/7. Ngaphezu kwalokho, idolobha liye laqala amandla-ukugeza imigwaqo nge-bleach ngenhloso yokubulala igciwane. Lesi silinganiso saphefumulelwe eLos Angeles, osengakabhekana nalesi sigameko. Noma kunjalo, izikhulu zezempilo zomphakathi eLos Angeles, eziqhele ngamakhilomitha angaba ngu-100 enyakatho yeSan Diego, ziyasaba.
Ngaphambi kweSan Diego, ukuqubuka okukhulu kokugcina kwesibindi se-hepatitis A e-United States kwenzeka eBeverver County, Pennsylvania. Ukuqubuka kwakuyinto yesibili ku-anyanisi eluhlaza asetshenziswa njengesithako endaweni yokudlela yaseMexico. Ngokuphelele, abantu abangu-601 bathelelwe igciwane, abangu-124 baboshwa esibhedlela, kwathi abathathu bafa. (Indawo yokudlela yaseMexico yayisitolo sokudlela se-Chi-Chi, esasivele senze izinkampani zangasese ngaleso sikhathi.)
Ngokusho kocwaningo olwanyatheliswa eNew England Journal of Medicine oluhlolisisa ukuqubuka kwesifo sofuba esibhedlela ePennsylvania, phakathi kuka-Okthoba 3 no-Okthoba 6, 2003, amaphesenti angu-91 kwabangu-240 abaqashi bezokudlela abahlolwa baphila ngemva kokudla u-salsa omnene, owasebenzisa u-anyanisi ovuthiwe I-Mexico njengesithako. Abashayeli abathintekayo abagulayo baboniswa anyanisi aluhlaza kwezinye izinto zemenyu.
Ngokusho kwabalobi:
Ingxenye ekhulayo yokubikwa kwezidakamizwa ezibhekiswe kokudla iye yahlanganiswa nemikhiqizo emisha. Izinyathelo zokulawula eziphakanyisiwe zihlanganisa ukuqinisekisa ukuthi abasebenzi basezindaweni baphilile futhi banokutholakala ezindaweni ezihlanzekile kanye nokuqinisekisa ukuthi amanzi asetshenziselwa ukunisela nokuhlanza imikhiqizo ayangcoliswa ngendwangu. Ezilungiselelweni zokusiza ukudla, kufanele kucatshangelwe ukuthi kungenzeka ukuthi umkhiqizo ongcolisiwe ungabangela ukungcoliswa okwezinye izitshalo kanye nendawo yokulungiselela. Abahlinzeki bokunakekelwa kwezempilo bangasiza ekunqumeni umthombo wezifo ezibangelwa ukudla kwesifo se-hepatitis A ngokuzisa ngokushesha iziphathimandla zempilo zendawo kanye nesifundazwe lapho kutholakala amacala.
Abalobi bathi futhi ngoba izingane zisengozini enkulu yokuthwala isifo sofuba, kufanele zigcinwe ezindaweni lapho isivuno sivunwa khona.
Nakhu okunye okuphawulekayo kwesifo se-hepatitis A:
- Ngo-Agasti 2016, eHawaii, kwakukhona ukuqubuka okuxhunyaniswe ne-scallops eluhlaza okwakhonjwe ezindaweni zokudlela ze-sushi. I-scallops yayivuna ePhilippines.
- Ngo-2016, kwakukhona ukuqubuka kwesimo esishiyagalolunye kuhlobene nama-strawberry amaqhwa. Kwakukhona izifo ezingama-56 zokushona nokufa.
- Ngo-Meyi 31, 2013, kwakukhona ukuqubuka kwesimo sezwe esilandelayo kulandelwa imbewu yegromegranate eTurkey. Kwakukhona izifo ezingu-71 zokushiswa nezifo zaso.
I-Hepatitis A Yokuvimbela
Nakuba kungekho ukwelashwa kwesifo sofuba, kunomuthi wokugoma ophumelelayo. Kusukela kokusungulwa komuthi wokugoma we-hepatitis A ngo-1995, kuye kwaba nokunciphisa amaphesenti angu-92 kwamacala we-hepatitis A e-United States.
Umuthi wokugoma we-hepatitis A unconywa kubantu abanobungozi obukhulu, abantu abangase babe abagula kakhulu uma bengagonywanga, noma omunye umuntu owufunayo .
Ukugoma kwesifo sokushisa kwesibindi kungamaphesenti angama-100 aphumelelayo. Ukuze unikeze isivikelo sesikhathi eside, kunikezwa ama-doses amabili okugoma, ahlukaniswe okungenani izinyanga eziyisithupha ngaphandle. Umgomo uyanconywa izingane ezineminyaka engu-12 nangaphezulu. Ukugonywa kubuye kunconywe kubantu abadala abangekho emgodini abangabantu abengozi kakhulu noma abahlala ezindaweni lapho i-hepatitis A isakazeka khona.
Njengamanje, kunemigomo emibili ye-single-antigen hepatitis A e-United States: HAVRIX (GlaxoSmithKline) ne-VAQTA (Merck & Co). Kukhona nokugonywa kwe-hepatitis A kanye ne-hepatitis B okuthiwa i-TWINRIX (i-GlaxoSmithKline), enikezwa abantu abadala abaneminyaka engama-18 ubudala emadlalweni amathathu noma amane. Zonke lezi zitofu ze-hepatitis azitholakali (okungukuthi, azihlali).
Uma umuntu ongagciniwe evezwe ku-hepatitis A, ngokushesha ngemva kokuvezwa-kungakapheli amasonto amabili-unezinketho ezimbili zokuvimbela ukutheleleka. Okokuqala, umuntu angagonywa. Okwesibili, i-immune globulin ingasetshenziswa, ehlinzeka ngokuvikelwa cishe izinyanga ezintathu. Zombili izinketho zisebenza ngokulinganayo; Kodwa-ke, imiphumela ye-immune globulin ayiyona impilo yonke.
Izwi elivela
Ukungqubuzana kwesifo sofuba emgodini omkhulu waseMelika njengoSan Diego kubonisa ukuthi ngisho nasezikhusheni ezithuthukisiwe ezinokuhlanzeka kwezinto zanamuhla, i-hepatitis A ingasongela impilo yomphakathi. Ngaphezu kwalokho, ukuqhuma kwamuva kubonisa ukuthi ingozi ekhethekile abantu abangenamakhaya bahlanganyela ngokuphathelene nesifo sofuzo. Abantu abaningi abangenamakhaya bahlala ezindaweni ezinabantu abaningi futhi abanakho ukufinyelela okujwayelekile kokuhlanzeka nokuhlanza amanzi.
Uma ukhathazekile ukuthi ungase ube engozini yokutheleleka kwesifo sofuba, thintana nodokotela wakho oyinhloko futhi ucele umuthi wokugoma we-hepatitis A, otholakala kunoma ubani owufunayo . Kumele ubuze nodokotela wakho oyinhloko mayelana nokuthola i-hepatitis A uma uhlela ukuhamba endaweni engozini enkulu, kuhlanganise namazwe aseMelika Ephakathi, eNingizimu Melika, e-Asia nase-Afrika.
Uma usola ukuthi utholakale ku-hepatitis A, xhumana nodokotela wakho ngokushesha. Kungakhathaliseki ukuthi i-hepatitis A yokugoma noma i-immune globulin ivikela kanjani igciwane le-hepatitis A uma lilawulwa zingakapheli amasonto amabili okuvezwa. (Igciwane lithatha cishe amasonto amabili ukubamba.)
Ngaphandle kokugoma, kunezinyathelo ezithile ongazithatha ukuze unciphise ukuvezwa kwakho kwesifo sofuba esibhedlela A ezindaweni lapho i-hepatitis A ikhona khona.
- Geza izandla zakho njalo-ikakhulukazi emva kokusebenzisa indlu yokugezela, ngaphambi kokulungiselela ukudla, nangemva kokushintsha amathayi.
- I-sanitizer yesandla engaphezu kwamaphesenti angama-60 utshwala ingasetshenziswa esikhundleni sensipho namanzi ukuhlanza izandla zakho.
- Gwema ukuthinta amehlo akho, impumulo nomlomo ngaphandle kokuthi izandla zakho zihlanzekile.
- Gwema ukumanga, ukumbumbana, nokwabelana ngemiphakathi nabantu abangase bagule.
- Gwema ukuxhumana nabantu ababonakala begula.
- Yidla kuphela ukudla okuphekwe ngokugcwele futhi kusetshenziswe kushisa.
- Yidla amaqanda aphephe kanzima.
- Qinisekisa ukuthi imikhiqizo yobisi ayinakekelwa.
- Geza zonke izithelo nemifino emanzini ahlanzekile bese uzihlupha.
- Gwema ukudla ukudla okuhlinzekwa ngabathengisi bokudla.
- Gwema ukudla okunikezwayo ekushiseni okushisayo.
- Gwema ukudla amasaladi.
- Gwema ama-condiments ezenziwe ngemifino enjenge-salsa.
- Phuza amanzi asebhodini noma amanzi aphethwe yi-seal kuphela.
- Gwema amanzi okuthinta.
- Gwema i-ice eyenziwe ngamanzi kampompi.
- Gwema ama-popsicles ahlotshisiwe noma iqhwa elithandekayo.
> Imithombo:
> CDC. I-Hepatitis A: Ulwazi Oluvamile . www.cdc.gov.
> I-Virus ye-Hepatitis. Ku: Ryan KJ, Ray C. eds. I-Sherris Medical Microbiology, 6e eNew York, NY: McGraw-Hill; 2014.
> Wheeler C, et al. Ukuqubuka Kwesifo Se-Hepatitis A Esihlanganiswa nama-anyanisi ahlaza. I-New England Journal of Medicine. 2005; 353: 890-897.
> County San Diego. I-Health & Human Services Agency. I-hepatitis A. http://www.sandiegocounty.gov.
> UMnyango WezeMpilo wase-US kanye Nezinsizakalo Zabantu. I-hepatitis A. www.vaccines.gov.