I-yellow fever ibangelwa i-flavivirus, esakazwa yizinyosi e-Afrika naseNingizimu Melika, ikakhulukazi ezindaweni ezinamahlumela amahlathi noma amahlathi. Ukugula okunjengomkhuhlane kungabangela izimpawu ezinjengomkhuhlane, amahlumela, nama-body aches ezinsukwini ezintathu kuya kweziyisithupha kusukela ekutheleleni, futhi ukwelashwa ngokuvamile akudingekile. Kodwa-ke, cishe amaphesenti angu-10 kuya kuma-15 amaphesenti alabo abanesandulela ngculaza, ingaba yinkimbinkimbi, eholele emkhunjini omkhulu, i-jaundice, nezinye izinto ezikhathazayo.
I-yellow fever ingaba yingozi.
Umlando, Umthelela, futhi ufinyelele
Kule minyaka edlule, i-yellow fever iye yalawulwa kangcono kunakudala, ngenxa yokuthi kunegciwane lokuvikela kulo. Noma kunjalo, i-WHO ilinganisela ukuthi abantu abangaba ngu-84 000 kuya ku-170 000 banesifo sohlobo lwe-yellow fever unyaka ngamunye. Kukholelwa ukuthi amacala amaningi awawatholakali, ngakho-ke umthelela ogcwele wethonya lesifo akucacile.
Abantu abangaba ngu-29 000 kuya ku-78,000 bafa ngokugula kulo nyaka wonke emhlabeni.
I-yellow fever ikhona ezindaweni zokuhlala lapho igciwane kanye nomiyane kungasinda. Lokhu kuxhomeke ikakhulukazi esimweni sezulu kanye nokuba khona kwemvelo yamahlathi.
Eningi eNingizimu Melika, igciwane alibangeli ukuqhuma emadolobheni. Itholakala kuphela ezindaweni eziqondile kakhulu, ngokuvamile ezindaweni ezikude noma emahlathini, lapho igciwane landa khona ezilwaneni.
Lapha, ligxile e-Amazon, ikakhulu eBrazil, ifika ePeru, e-Ecuador, eBolivia, e-Colombia, eVenezuela nase-Argentina.
Amazwe asengozini afaka iPanama, iTrinidad neTobago, i-French Guiana, iGuyana, iParaguay neSuriname.
Kodwa kucatshangwa ukuthi cishe amaphesenti angama-90 e-yellow fever ayenzeka e-Afrika, lapho abantu abaningi abafa khona ngenxa yokutheleleka kwenzeka. Itholakala eNtshonalanga ne-Afrika Ephakathi, nakwezinye izingxenye zaseMpumalanga Afrika.
Amazwe ase-Afrika anengozi ye-yellow fever afaka: i-Angola; IBenin; IBurkina Faso; I-Burundi; I-Cameroon; I-Republic of Central African Republic; I-Chad; I-Republic of Congo; I-Cote d'Ivoire; Republic of Democratic Republic of the Congo; I-Equatorial Guinea; ITopiya; I-Gabon; I-Gambia; I-Ghana; I-Guinea; I-Guinea-Bissau; I-Kenya; ILiberia; I-Mali; I-Mauritania; I-Niger; ENigeria; U Rwanda; ISenegal; I-Sierra Leone; ISudan; I-South Sudan; I-Togo ne-Uganda.
Ngo-2016, kwaba nokuqhuma okukhulu enhlokodolobha yase-Angola, lapho abantu abangaphezu kuka-200 babulawa yi-infection. Igciwane lisakazwa enhlokodolobha nasezifundeni eziningi ezweni. Yize kungacatshangwa ukuthi kukhona okwenzekayo e-Asia, abahambi nabasebenzi babuyele ekhaya eChina bevela e-Angola benesifo.
Igciwane lisetshenziselwa ukwelula okuningi ngokwendawo kunokuthi lenze manje. Kwafika kuqala e-United States ngasekupheleni kwe-1600s. Kucatshangwa ukuthi kwalethwa ukuthengiswa kwabantu phakathi kwe-Afrika namaMelika, lapho omiyane negciwane beqhutshwa kanye nabantu ababehlala ezindaweni ezimbi. Kwafinyelela kude enyakatho njengeBoston, eNew York, naseFiladelphia, futhi yahlala emizini yaseningizimu kuze kube sekupheleni kwawo-1800. Leli gciwane laphinde lasakazwa yizohwebo emachwebeni aseYurophu asenyakatho njengeCardiff naseDublin, nakuba amazwe afana neGrisi ayengozi kakhulu.
Izimpawu
Kubantu abaningi, i-yellow fever ibangela ukugula okuncane noma kungabonakali. Kuvame ukuthi kube nezinsuku ezintathu kuya kweziyisithupha phakathi kokuthola igciwane ngokusebenzisa ukulunywa umiyane futhi ugula. Uma unezifo ezincane futhi ungalokothi ugula kakhulu, kulindeleke ukuba uthola ngokugcwele. Nokho, kubantu abathile, i-yellow fever ibangela imfiva, amahlumela, ama-aches, ukuphuma, amehlo aphuzi nesikhumba, isicanucanu, ukuhlanza, ukudideka, ukushaqeka, ukuhluleka komzimba-ngisho nokufa.
Kubantu abanesifo se-yellow fever , kunezigaba ezintathu zokugula:
Ukutheleleka kokuqala kwenzeka kwezinsuku ezintathu kuya kweziyisithupha emva kokuvezwa.
Ungase uzwe nomkhuhlane, ama-muscle aches, isicanucanu, ukuhlanza, isizungu, nokukhathala.
Ukukhulelwa kwenzeka kwezinsuku ezimbili kuya kwezintathu kamuva. Umkhuhlane, uma ukhona, ukwehla kanye nezimpawu ziyathuthuka. Lokhu kungathatha amahora angu-24 kuya kwangu-48. Iningi labantu lilulama kuleli phuzu. Abantu abangamaphesenti angu-15 abantu abanegciwane lesandulela ngculazi bayaqhubeka benesifo esibi kakhulu.
Isifo esibi : Ukushisa, ukucabangela, nokuhlanza kwenzeka uma uhlangabezana nezifo ezinzima. Izimpawu ezintsha nezibonakaliso zivela ezifweni ezinzima:
- I-Jaundice: Abantu abaningi abanesifo esibi kakhulu bahlushwa isikhumba (kufaka phakathi izintende nezindwangu), abamhlophe bamehlo, nesikhumba ngaphansi kolimi. Lesi sibonakaliso sinikeza igama le-yellow fever.
- Abanye abantu baqala ukulimaza kalula noma ukuba negazi kusuka ezindaweni eziningi emzimbeni. Ngokuyinhloko, ungabona ukuphuma kwegazi emakhaleni akho, ezinye izinambuzane ze-mucus, noma kusayithi elinyathelisiwe, noma ungabona igazi emhlanzweni wakho.
- Ukubala kwegazi elimhlophe kungase kube phansi, okusho ukuthi kunamaseli omzimba ambalwa ngesikhathi sokutheleleka.
- Ukuhlolwa kwegazi kungabonisa ukuthi isibindi sonakalisiwe, esingatholakala ngokubona kwe-enzyme yesibindi ephakeme egazini. Lokhu kungenzeka ngaphambi kokuba i-jaundice ikhule.
- Uma ukutheleleka kuthuthukisa, ama-enzyme enesibindi kulindeleke ukuba aphakamise kuze kube sekupheleni kwesonto lesibili lokugula bese eqala ukwehla ekujwayelekile.
- Labo abaphulukisa ama-antibodies enza ukuthi balwe negciwane njengoba liphela. Igciwane lihlala egazini isikhathi eside kulabo abagula kakhulu.
- Isifo esibi singabangela izimpawu zokudideka, futhi ekugcineni, ukwehluleka komzimba.
Cishe amaphesenti angu-20 kuya kuma-50 amaphesenti alabo abanesifo esinzima bangase bafe.
Izimbangela
I-yellow fever ibangelwa i-flavivirus , i-RNA eyodwa-eqanjwe igciwane lesandulela ngculazi elisakazwa yizinyosi ze-Aedes aegypti. Lo mbuyane, obangela ukuba iZika neDengue, empeleni, kuthiwa yi-yellow fever umiyane. Igciwane lesifo se-yellow fever lingasakazwa nezinye izinyane, i-Aedes africanus e-Afrika noma izinyosi ze-Haemagogus neSabethes eNingizimu Melika.
Amantongomane adlulisa igciwane ngokudla egazini lomuntu onegciwane noma ezinye izidumbu, njenge-monkey, bese ehlaba omunye umuntu noma omunye umuntu. Umiyane lungathatha igciwane uma lidla igazi elithathelwanayo ngaphambi kokuba umuntu noma isilwane ikhule nomkhuhlane kuze kube yizinsuku ezinhlanu kamuva.
Imijikelezo Yemijikelezo
Igciwane linemijikelezo emithathu yokudlulisela: i-jungle (i-sylvatic), i-intermediate (savannah), nasemadolobheni. I-yellow fever esakazeka edolobheni ihluke kakhulu kune-yellow fever etholakala ehlathini noma ehlathini, futhi yiyona eyayiyinkimbinkimbi kunazo zonke.
Lapho i-yellow fever isakazeka emahlathini ithola kabanzi ngaphandle kwabantu. Isakazeka kumuntu ongewona wesintu (njenge-monkey) kumuntu ongeyena umuntu oyinhloko yomunyane. Uma abantu bevakashela indawo yehlathi (bathi ngokumba izimayini, ukuzingela, noma ukuvakasha), bangabuye balunywe umiyane bese begula.
Emjikelezweni ophakathi (obizwa nangokuthi umjikelezo we-savannah), i-yellow fever isakazeka njalo phakathi kwezinkawu kanye nabantu ngokusebenzisa izinyosi, ezindaweni eziphezu kwezindawo zehlathi. Ingakwazi ukusabalalisa i-monkey kubantu, i-monkey kuya monkey, umuntu kumuntu, noma isintu kumonkey.
Emjikelezweni wamadolobha, i-yellow fever isakazeka ngokuyinhloko phakathi kwabantu ngokusebenzisa izinyosi ezihlala ezindaweni zasemadolobheni. Kuvame ukuqala lapho umuntu osuselwe igciwane ebuya endaweni ehlathini. Kungabangela ukuqhuma okungazelelwe nokukhulu ezindaweni ezihlala ezindaweni ezisemadolobheni.
Ukuxilongwa
Ukubona ukuthi i-yellow fever isekelwe emlandweni womtholampilo wokudonswa komlingo wokuzumayo endaweni engapheli, kanye nomlando wezimpawu. Kunezivivinyo ezimbalwa ezingase zisekele noma ziqinisekise ukuxilongwa kwe-yellow fever.
- Ukuhlolwa kwe-Antibody: Lolu luhlolo luvivinyo oluhlolwe kahle kakhulu lwe-diagnostic ye-yellow fever. Ibuka ukuthi kukhona ama-proteine e-immune ekhona egazini lakho, okubonisa ukuthi ulwa noma ulwa ngokuphumelelayo nokutheleleka. Kungathatha izinsuku eziningana ukuze umzimba wakho ukhiqize ama-antibodies ananele ukuze ukwazi ukutholakala, noma kunjalo. Kungase kudingeke ulinde kuze kube amasonto amabili ukuze uthole imiphumela yakho.
- Ukuhlolwa kwe-Viral PCR: Ukuhlolwa kwe- PCR kungathola ukuthi i-virtual material yegciwane egazini lakho. Ukuhlolwa okunamandla kwe-PCR kubonisa ukuthi unayo igciwane emzimbeni wakho, ngakho kubhekwa njengenkomba enamandla yokutheleleka kwamanje kune-test antibody. Umkhawulo obalulekile: I-RNA yesandulela ngculazi iyatholakala ngaphambi kokutheleleka, kepha ayitholakali kalula ngemva kwezinsuku ezimbalwa zokutheleleka. Lokhu kusho ukuthi ungathola umphumela wokuhlola we-PCR omubi ngisho noma une-infection.
- Ukuhlolwa kwe-Urine: Isivivinyo esisha kakhulu singathola i-PCR yegciwane emcinini, okwenza ukuxilongwa kusebenze ngokwengeziwe. Noma kunjalo, lokhu kuhlolwa, kuyilapho kuthembisa, akukasetshenziswa kabanzi.
Ukwelapha
Ayikho ukwelashwa okulwa negciwane lesandulela ngculaza. Kodwa-ke, lesi sifo singaba nzima kakhulu, futhi izinkinga ezihlobene nazo zingadinga ukunakekelwa kwezempilo. Ukwelashwa kwe-yellow fever kufanele kuqondiswe futhi kwenzeke esibhedlela, hhayi ekhaya. Lokhu kungafaka:
- Ukuvimbela ukuphuma kwegazi: Ngenxa yobungozi bokuphuma kwegazi, imishanguzo eyenza, njenge-aspirin, ibuprofen, ne-naproxen, kufanele igwenywe ngokujwayelekile.
- Ukungena kwamanzi: Ukugcina i-hydration kulo lonke ukugula nge-oral or IV fluids kungadingeka, ikakhulukazi uma uzwa ukuhlanza noma ukucindezelwa kwegazi okuphansi.
- Ukulawula umkhuhlane : Ngokuvamile, i-yellow fever ihlotshaniswa namafizi ebanga eliphansi. Kodwa uma umkhuhlane wakho uphakeme kunalindelekile, ungadinga imithi ukuze unciphise izinga lokushisa lakho.
- Ubuhlungu: Uma uzwa ubuhlungu besisu noma ubuhlungu obukhulu, kungase kulawulwe ngomlomo noma ukuhlunga ubuhlungu obujova.
- Ukuxhaswa kwengcindezi yegazi: Kulabo abashaqekayo, okwenzeka lapho ukucindezeleka kwegazi kuphansi kakhulu, ingcindezi yegazi ingakhulelwa ngemithi evimbela imithwalo yegazi, evame ukubizwa ngokuthi i-pressors.
- Ukuphathwa kwehluleka komzimba: Uma i-yellow fever ibangela ukwehluleka komzimba, lezo zitho zidinga ukusekelwa ngenkathi ukutheleleka kuthuthuka. Isibonelo, i-ventilator ingadingeka ukusiza ngokuphefumula; i-dialysis ingadingeka ukwenza umsebenzi wezinso.
Ukuvimbela
Ngenxa yokuthi i-yellow fever iye yahamba isikhathi esithile, ukudluliselwa kwegciwane kuqondwa kahle. Nazi ezinye izindlela eziphumelelayo zokuvimbela ukutheleleka :
- Ukugonywa : Kubantu abathile, ukugoma kunconywa. Uma uhlala endaweni eyingozi, kungenzeka ukuthi usuvele ukhulelwe ukutheleleka futhi kufanele ulandele izincomo ezisemthethweni ngokuphathelene nokugoma wena nabantwana bakho. Uma uhamba endaweni lapho i-yellow fever ikhona khona, cishe kuzodingeka ube nomgomo. Ngokuvamise, imithi yabahambi ayitholakali, futhi ungadinga ukwenza i-aphoyintimenti emtholampilo wokuhamba wendawo. Kuhle kakhulu ukuhlela phambili, njengoba kufanele uthole umgomo okungenani izinsuku ezingu-10 ngaphambi kohambo lwakho.
- Izinyathelo zokuzivikela: Uma usezindaweni ezimbi, ungazivikela wena nabantwana bakho ngokumelene nezinyosi. Yize kungenakwenzeka njalo ukuba ugweme ngokuphelele ukulunywa umiyane, ungakwazi ukugqoka izendlalelo, ikakhulukazi uma uhamba emahlathini nasehlathini, futhi ungasebenzisa insect spray. Kunconywa ukuba ulale ngaphansi kwamanetha okuvikela, noma ngabe uzoba ekamelweni elifakiwe.
- Ukuvikela abanye: Ngokuvamile, ngenxa yokuthi igciwane lingasakazeka kusuka kumuntu kuya komuntu nge-umiyane, kutuswa ukuthi uhlale ngaphansi kwamanetha omnyoko ukuze ugweme ukusakaza igciwane uma wazi ukuthi usulelekile.
Izwi elivela
Uma uhamba endaweni lapho i-yellow fever ikhona khona, kufanele uthathe izinyathelo zokunconywa ezinconywayo; Ukwenza kanjalo kuzonciphisa kakhulu ingozi yokutheleleka.
Futhi qiniseka ukuthi uzijwayele izimpawu ezivamile ukuze ufune usizo lwezokwelapha uma usulelekile. Ngenkathi abantu abaningi abane-yellow fever benokuphumula okuhle, amathuba okuba omunye aphakeme kakhulu uma uthola ukunakekelwa kochwepheshe ngaphambi kokuba kube khona izinkinga.
> Imithombo:
> Cui S, Pan Y, Lyu Y. Ukutholwa kwama-genomes e-yellow fever virus ezivela emazweni amane angenisiwe eChina. I-Int J I-Dis Infect. 2017 Jul; 60: 93-95. doi: 10.1016 / j.ijid.2017.05.001. Epub 2017 Jun 13.
> Hughes HR Russell BJ, Mossel EC, uKayiwa J, uLutwama J, uLambert AJ. Ukuthuthukiswa kwesilingo sangempela sesikhathi se-RT-PCR sokuhlukaniswa komhlaba jikelele wegciwane lesifo se-yellow fever. J Clin Microbiol. 2018 Apr 11. pii: JCM.00323-18. i-doi: 10.1128 / JCM.00323-18. [I-Epub ngaphambi kokuphrinta]