Nakuba igciwane le-Powassan lingavamile, unyaka ngamunye, kunabantu abaningi okutholwa ukuthi banakho.
Leli gciwane laqala ukutholakala ePowassan, e-Ontario, ngo-1958, lapho lihlukaniswe nobuchopho bomfana osemncane owafa nge-encephalitis, okuyinto ephawulekayo yokutheleleka ngegciwane le-Powassan. Phakathi kuka-1958 no-1998, kwatholakala abantu abangu-27 kuphela abane-virus ye-Powassan.
Phakathi kuka-2003 no-2017 le namba inezingaphezu kuka-kathathu, kanti kutholakala abantu abangu-85.
Ngokusho kwabalobi bokubuyekezwa kuka-2017 okubizwa ngokuthi "i-Powassan Virus: I-Arbovirus Emerging of Health Public Ukukhathazeka eNyakatho Melika," lokhu kungase kubangelwe ukubhekwa nokuhlolwa kwegciwane lesifo se-arthropod, ukuvela kwangempela kwalesi sifo, noma inhlanganisela yazo zombili izici. "
Ingemuva
Njengegciwane le- Zika , igciwane le- dengue , negciwane le- West Nile , igciwane le-Powassan uhlobo lwe-flavirus. Kufana nesinye isifo esithwala isifo esithinta isifo se-encephalitis: igciwane le-encephalitis (TBEV) elithwala umuthi. Ukutheleleka nge-TBEV kuvame kakhulu kunegciwane le-Powassan, nabantu abayizinkulungwane eziningana eYurophu nase-Asia abathintekayo nge-encephalitis kanye ne-meningitis unyaka ngamunye.
Okuningi esikwaziyo mayelana nekhono legciwane lePoasssan lokuphindaphinda futhi elikwazi ukubangela ukugula empeleni kusekelwe ku-TBEV, okubhekwa njengokukhathazeka kwezempilo emhlabeni jikelele nokufunda kangcono kunesifo sePowassan.
Ngokuphawulekayo, imishanguzo yenzelwe i-TBEV.
I-virus ye-Powassan iyigciwane le-RNA elilodwa eline-stranded. Ngokuqinisekile, igciwane le-Powassan liqukethe izigaba ezimbili: igciwane le-Powassan ukulinganisa i-lineage ne- certaine tick tick (DTV). Kulesi sihloko, sizobhekisela kuzo zombili lezi zizukulwane ezifanayo (kodwa ezisezingeni eliphezulu nangokwezakhi zofuzo) njengegciwane le-Powassan.
Igciwane le-Powassan lithathwa yi- Ixodes uhlobo lwemikhaza. Ukusatshalaliswa kwegciwane le-Powassan kugijima kusuka eVirginia kuze kube seNyakatho neNova Scotia. Itholakala naseningizimu ye-United States naseCanada, kuhlanganise naseNew York, ePennsylvania, eQuebec, eMichigan, eWisconsin, e-Minnesota nase-Ontario. Isifo se-Powassan sitholakale sisekude kakhulu njengeColorado, eCalifornia, naseBritish Columbia.
Ngokuvamile, igciwane le-Powassan lisakazwa ezindaweni ezihlala eNyakatho Nase-Great Lakes, ne-Hudson Valley eNew York naseNew England ebika kakhulu.
Kuyathakazelisa ukuthi i-Powassan virus iyatholakala eRussia; Nokho, lokhu kusatshalaliswa okungenzeka kungenxa yesingeniso esisodwa eminyakeni engaphezu kwengu-100 eyedlule-mhlawumbe evela emanzini angenisiwe okubhekiswe ekuhwebeni kwe-1800s ngasekupheleni kwe-1800s.
I- Ixodes ikhathaza ukuthi ithwala igciwane le-Powassan lihambisana nezilwane eziningi, kuhlanganise nezigqoke ezibomvu, ama-chipmunks, ama-groundhogs, ama-skunks, ama-voles, i-deer-white tailed kanye namagundane amhlophe. Kodwa-ke, abantu bavame ukuhlangana nezilwane ezivame ukugubha, njengama-groundhogs kanye nama-skunks. Esikhundleni salokho, kungenzeka ukuthi abantu bayalunywa yizikhawu ze-Ixodes ngemuva kokudlula ematayeni amaqabunga avakashelwe amagundane omhlophe amanyathelo kanye nezinyamazane ezimhlophe.
Izimpawu zomtholampilo
Ngokuvamile, abantu abakwazi ukukhumbula lapho bebanjwe yi- Ixodes tick.
Iningi labantu abalunywe yi-tick ngeke babe nezimpawu. Kulabo abakha izibonakaliso, kungathatha phakathi kwamasonto amahlanu kuya kwahlanu ukuthi isifo sifinyelele. Ngokuphawulekayo, kuthatha amaminithi angu-15 kuphela ukuthi umaki uhlanganise futhi uthumele igciwane le-Powassan.
Ekuqaleni, abantu ababa nezimpawu ezikhulayo bahlakulela ukugula okunjengomkhuhlane nomkhuhlane, okungahambisana nokukhanda ikhanda, izimpawu zamathumbu, ukulala, ukuphazamiseka nokuphuza. Ezinsukwini eziningana zalezi zimpawu zokuqala, i-encephalitis iyaphelelwa yisikhathi. Incephalitis ibhekisela ukuvuvukala kobuchopho. Ukwengeza, intambo yomgogodla ingaphinda ivulele ekuholeni kwamadoda kanye ne-myelitis.
Uma ubuchopho nomgogodla bevuliwe, lezi zimpawu ezilandelayo zibonakaliswa:
- Izinwele
- I-Lethargy
- Ukuzizwa
- Izinkinga zokukhuluma
- Ukukhubazeka
- Izinkinga zembono
- Inkulumo emisiwe
- Ukuvota
- Ukuphefumula okunenkinga
- Ukubambisana okungafanelekile
Cishe amaphesenti angu-10 abantu abakha i-encephalitis bafa. Ngaphezu kwalokho, amaphesenti angu-50 abantu aqhubeka nokuhlakulela izinkinga ezingapheli zezinzwa. Izinkinga ezingapheli zezinzwa zihlanganisa ikhanda eliphindaphindiwe, ukuhlukumeza imisipha, kanye nezinkinga zememori.
Ukuxilongwa
Ukutheleleka ngegciwane le-Powassan kutholakala ngokususelwa ekuhlolweni kwemitholampilo nokuhlolwa kwelabhoratri.
Ukuxilongwa ngemithi kumele kugcwalise izindlela ezintathu:
- umkhuhlane ukwedlula noma ulingana no-38 degrees Celsius
- noma yiziphi izimpawu zesimiso sezinzwa zesisindo
- akukho okunye okusolakala ukuthi ukuxilongwa emtholampilo
Ukuhlolwa kwezemvelo kuyindlela eyinhloko yokuthola igciwane le-Powassan ebhodini. Ukuvivinya umzimba kuveza amagciwane e-virus kwisampula yamanzi omgogodla, igazi, noma izicubu.
Ngokusho kwe-CDC, nenye enye imininingwane yokuxilonga mayelana negciwane le-Powassan:
I-Electroencephalography (EEG) ezigulini ezine-POW virus encephalitis yembula umsebenzi owenziwe okwenzeka kancane kancane kanye nemiphumela ingafana nalabo abonakala ku-herpes simplex virus encephalitis. I-MRI yobuchopho ezigulini ezine-POW virus encephalitis ibonisa izinguquko ezihambisana nesifo se-ischemia ezincane noma izidakamizwa zokudonswa kwezidakamizwa kwi-parietal noma i-lobes temporal; imiphumela yesikhombiso sobuchopho CT ayilusizo ngokukhethekile.
Ukwelapha
Ayikho ikhambi legciwane le-Powassan. Esikhundleni salokho, izimpawu ziyaphathwa ngokusekelwa ngamanzi amanzi, umoya wokuphuza umoya, nemithi eyanciphisa ukuvuvukala kobuchopho. Ngaphezu kwalokho, abukho ubufakazi obanele bokuthuthukisa izincomo zokwelashwa ezisemthethweni.
I-steroids kanye ne-immunoglobulin (IVIG) enomzimba eboniswe ukuthi iyasebenza ekwelapheni ukutheleleka. Akucaci ukuthi ukwelashwa kwe-antiviral (ie, ribavirin) kusebenza kahle. Ngokuqondile, isiguli esisodwa esasiphathwa nge-interferon ne-ribavirin esasifile lesi sifo. I-note, i-steroids, i-IVIG, i-interferon, ne-ribavirin konke okuvimbela ukuphendula kwesimiso somzimba kanye nama-immunomodulators.
Nakuba kungenalo ukuxilongwa, ukucabanga ngombono nge-MRI kungaba ukubikezela futhi kubonise ukuthi iziphi iziguli ezizoqhubeka zibi kakhulu esikhathini eside.
Ukuvimbela
Okwamanje, akukho mgomo wokugoma i-Powassan virus. Kukhona imithi ye-TBEV, efana negciwane le-Powassan, futhi le migomo iyatholakala eRussia naseYurophu. Kodwa-ke, le migomo ye-TBEV ayizange ibonise ukuthi iphumelele ekuvimbeleni ukutheleleka ngegciwane le-Powassan.
Ngaphezu kwalokho, igciwane le-Powassan luhlobo lwe-flavivirus, futhi ngaphezu komuthi wokugoma we-TBEV, kunemigomo yezinye izinhlobo ze-flavivirus, kufaka phakathi i-yellow fever ne-encephalitis yaseJapane. Noma kunjalo, igciwane le-Powassan lilingana nelinye uhlobo lwe-flavivirus ngokwemigomo yamangqamuzana ngakho-ke leminye imithi yokugoma nayo isebenzisekile.
Okwamanje, indlela engcono kakhulu yokugwema ukutheleleka ngegciwane le-Powassan ngokulandela isiqondiso sokuvimbela. Kunezinyathelo ezihlukahlukene zomuntu siqu nezakhiwo ongayithatha ukuze unciphise ingozi yokuchayeka kwamakethi kubandakanya okulandelayo:
- Gwema ukuthintana ngokuqondile nemikhaza ngokugwema izindawo ezinezinhlaka ezinezikhukhula eziphezulu.
- Hamba uye enkabeni yemigwaqo.
- Sebenzisa i-repellent equkethe amaphesenti angu-20 noma ngaphezulu DEET, picaridin, noma i-IR3535. Faka isicelo sokuphulukisa ezindaweni ezivelele zesikhumba.
- Gqoka izingubo eziyimikhono emide futhi ekhanyayo. Futhi, thinta amabhulukwe akho emasokisi akho.
- Uma usebenzisa isicelo sokuphulukisa izingane, gwema uhlelo lokusebenza emehlweni, izandla, nomlomo.
- Sebenzisa izingubo nezimpahla eziqukethe i-permethrin.
- Geza ngokushesha uma ubuyela ekhaya bese uhlola isitifiketi usebenzisa isibuko. Susa wonke amathikithi ngokushesha.
- Hlola zonke izingubo, izimpahla nezilwane ezifuywayo ngamakethi.
- Ukubulala amakhekithi ezembatho, geza izingubo emanzini ashisayo bese usomile ekushiseni okuphezulu.
- Hlola izilwane ezifuywayo ngezinkomba emva kokuchitha isikhathi ngaphandle.
- Susa izindawo zommbizane, ezifana nobude obude, ibhulashi, nezinqwaba zamagqabi, kusuka endaweni yakho.
- Vula utshani wakho njalo ukunciphisa izindawo zemikhakha.
- Yakha izicingo ukugcina izilwane zasendle zisuke endaweni yakho.
- Susa ifenisha elahliwe kanye nezinye udoti lapho amakhakiti ahlala khona egcekeni lakho.
- Gweba izinkuni emithini enhle ukuvimbela ukushaywa yizintambo ngamagundane aphethe imikhaza.
- Indawo yokupaka kanye nemishini yokudlala ngaphandle kwemithi kanye nezibhamu.
- Cabanga ngokusebenzisa i- tick tick pesticides (ie, acaricides) noma ukuphika enja yakho, kufaka phakathi uthuli, amakholaji angenisiwe, ama-sprays, noma imithi yokwelashwa. Khuluma nodokotela wakho wezilwane kuqala.
- Cabanga ukuba u-exterminator uhlanza indlu yakho.
Amakati azwela kakhulu kuma-pesticides; Ngakho-ke, ungasebenzisi i-insecticide ekati lakho ngaphandle kokukhuluma nodokotela wakho wezilwane kuqala.
Imiyalo Yesikhathi Esizayo
Eminyakeni yamuva, kuye kwanda imizamo yocwaningo eqondisa igciwane le-Powassan.
Ukubheke phambili, empini elwa negciwane le-Powassan, kuyoba kubalulekile ukuthi ososayensi bahlaziye imikhakha yabantu abadala nabasanda kutholakala abasuka ensimini ukuze baqonde kangcono umjikelezo wokuphila kanye nokudluliselwa kwemikhakha kanye nezimo eziguquguqukayo ezenza igciwane. Inothi, abanye ochwepheshe basikisela ukuthi izinguquko zamuva emjikelezweni wokuphila walezi zingqungquthela zingachaza ukwanda kwe-pathogen.
Ngaphezu kwalokho, ososayensi kudingeka bafunde kangcono ukuphendula kwe-antiviral kwi-Powassan virus ezincelweni eziphethwe yizilwane ezincelisayo. Ngokuqondile, abacwaningi kudingeka baqonde kangcono umjikelezo wokuphindaphinda wegciwane hhayi kuphela emikhawulweni kodwa futhi nasezilwaneni ezincelisayo. Lezi zindlela zizosiza ososayensi ukuthi babone izinhloso zokwelapha bese bebona indlela igciwane lePowassan eliqhubeka ngayo emvelweni.
Ukuze uqonde kangcono imiphumela yesikhathi eside ye-neurological yokutheleleka, izivivinyo zidinga ukwakheka ezilandela amaqembu weziguli ngokuhamba kwesikhathi (okusho, izifundo zamaqembu).
EWisconsin, imikhaza ethile ingadlulisela isifo sofuba sePowassan nesifo seLyme, okwenza ukutheleleka kokubambisana kwenzeke. Lokhu ukutheleleka komzimba kungachaza izimpawu eziqhubekayo zesifo seLyme futhi kumele kuqhutshwe ucwaningo.
Izwi elivela
Nakuba kungavamile, inani labantu ababhekene negciwane le-Powassan liyanda futhi kugula kakhulu kudinga ukunakekelwa esibhedlela. Ngokuhlolwa okuningi nokwanda okukhulayo, kungenzeka ukuthi igciwane le-Powassan lizoba yisisusa esiphuthumayo sokugula esikhathini esizayo.
Kule ncazelo ehlobene, ngenxa yokuqwashisa umphakathi okulinganiselwe nokuhlola okulinganiselwe igciwane le-Powassan, kungenzeka ukuthi leli gciwane lihlala lingatholakali phakathi kweziguli ezethula nge-encephalitis. Ngamanye amazwi, abanye abantu abaphelela ekutholeni i-encephalitis abakaze bahlolwe ukuthi bane-HIV ye-Powassan.
Indlela engcono kakhulu yokuphatha ukutheleleka ngegciwane le-Powassan ukuvimbela ukuchayeka komkhaza endaweni yokuqala. Uma uhlala ezindaweni lapho kutholakala khona igciwane le-Powassan-ikakhulukazi ezindaweni eziseNyakatho Nase-Great Lakes-sebenzisa izimpendulo uma uphuma ngaphandle bese wenza amasheke uma ubuya.
Khumbula ukuthi kunezinye izifo ezithathelwana ngamakhaza ezivame ukudala ukugula, njengeBrrelia burgdorferi (okungukuthi, isifo seLyme ), ngakho ukubuyisela kanye nokuhlola amathikithi kuwumqondo omuhle wokuvimbela ezinye izinhlobo zokugula, futhi.
Kubalulekile ukuqonda ukuthi ngisho noma umkhiqizo ukhona emzimbeni wakho isikhathi esifushane kakhulu, ngesikhathi usibona, ungenwe igciwane le-Powassan virus. Amanye ama-bacterium-tick-borne-borne, afana ne- Borrelia burgdorferi , abe nesikhathi eside somusa cishe usuku olulodwa.
Uma usola ukuthi wena noma othandekayo usulele ngegciwane le-Powassan, masinyane funa ukwelashwa. Ukwengeza, ake udokotela wakho azi ukuthi kungani usolisa ukutheleleka ngaleli gciwane nemininingwane noma yimuphi umlando wokungabonakali kwamakethi. Ngaphezu kwalokho, vumela umhlinzeki wakho wazi ngemisebenzi yakho nalapho uhamba khona-ikakhulukazi izindawo zangaphandle lapho kutholakala khona umkhaza wokugcina igciwane le-Powassan. Udokotela wakho kufanele alwayiswe kokubili ngoba kukhona ukuhlolwa okhethekile kwegciwane le-Powassan futhi isimo ngokuvamile silawulwa izichwepheshe ezifo ezithathelwanayo.
> Imithombo:
> Isifo Sengculazi se-Bennett, N. Powassan ku-Infant-Connecticut, 2016, i-MMWR. 2017; 66: 408-409.
> Doughty, CT, Yawetz, S, Lyons, J. Emerging Causes of Arbovirus Encephalitis eNyakatho Melika: i-Powassan, i-Chikungunya, ne-Virus Zika. Imibiko yamanje ye-Neurology ne-Neuroscience. 2017: 17; 12.
> Hermance, ME, Thangamani, S. Virus i-Powassan: I-Arbovirus Evelayo Yempilo Yomphakathi Ikhathazeka eNyakatho Melika. Izifo ze-Vector-Borne ne-Zoonotic. Ngo-Meyi 12, 2017.
> CDC. Virus ye-Powassan. www.cdc.gov.