Njengoba kuneziphepho ze-Hurricanes Harvey, i-Irma, noMaria ezihlasela iTexas, eFlorida nasePuerto Rico, ngokulandelana, i-2017 yase-Atlantic yesikhwama senkathi yimbi kakhulu emlandweni wamanje. Ngaphandle kwamakhulu ezinkulungwane zezigidi zamaRandi ekubhujisweni, lezi ziphepho zihlangene zathi izibalo zabantu.
Nakuba imiphumela esheshayo yeziqhingi zeSigaba 5 iyamangalisa, okuholela ekutheni amanzi ekhukhulayo aphethe izinsongo ezingenasisindo ezinjengezifo ezithinta amanzi.
Ukubuyekezwa kweziqhumane ezingu-548 kusukela ngo-1900 kubonise ukuthi amaphesenti angu-51 alezi zivunguvungu zandulela izikhukhula ezinzima.
Izifo ezithathelwana ngamanzi zithunyelwa nge-fecal-oral ngomzila. Izinhlayiyana ezincane ze-fecal zenza indlela yazo emanzini nokudla, ngaleyo ndlela zisakaze ukutheleleka. Ngemuva kwezikhukhula ezinzima, izitshalo zasemanzini zihluleka futhi zikhulule amanani amaningi okudoba okungelashwa.
Ake sibheke ngokucophelela izifo ezinhlanu ezibangelwa amanzi: isifo se-bacteria, ukwelashwa, i-enteric fever, i- hepatitis A , ne- leptospirosis .
Isifo samathambo
Isisu sibhekisela kuhudo olubhebhethekayo, olunegazi. Ama-bacterium abangela ukuba amathumba ahlanganise no- C. jejuni , E. coli 0157: H7, E. coli non-0157: izinhlobo ze-H7, izinhlobo ze- Salmonella nezinhlobo ze-Shigella. Kokubili u- E. coli 0157: H7 no- E. coli non-0157: Izinkinga ze-H7 zikhiqiza i-toxin ye-Shiga. I-Shigella yiyona imbangela ejwayelekile kunazo zonke zamathambo, futhi njengamanye amagciwane angatholakala uma usebenzisa isiko lesitokisi.
Izimpawu ezivamile zamathambo zihlanganisa ukuhlukunyezwa okubuhlungu, ubuhlungu besisu, nomkhuhlane.
Ngenxa yokuthi amabhaktheriya ahlasela ikholoni kanye ne-rectum, i-pus negazi nazo zikhona esitokisini. Amabhaktheriya angabangela isilonda sesilonda. Ngaphezu kwalokho, amabhaktheriya angasakazeka egazini-okubangelwa yi-bacteria, noma ukutheleleka kwegazi. Iziguli ezibuthakathaka ama-immune system noma ezingondlekile zingengozini enkulu ye-bacterium.
Isisu sinzima kakhulu kunomkhuhlane wesisu- ikakhulukazi ezinganeni ezincane kunezingu-5 nakubantu abadala asebekhulile kunama-64. Lokhu ukutheleleka kuvame ukuholela esibhedlela futhi kungaba nokubulala.
Uma imbangela yamathambo engacacile noma isiguli sihluleka ukuthuthukisa nge-anti-antibiotic therapy, ikolonoscopy ingasiza ngokuxilongwa. I-tomography yekhompyutha ingasetshenziselwa ukuxilonga isifo samathambo ezimweni ezimbi kakhulu.
Isisu sidluliselwa ngama-antibiotic kanye namanzi asemlomo noma angenayo. Ezinganeni, i-Shigella, i-Salmonella, noma i-Campylobacter ukutheleleka iphathwa nge-azithromycin, i-ciprofloxacin, noma i-ceftriaxone. Kubantu abadala, isisu sisetshenziswa nge-azithromycin noma i-fluoroquinolones.
Ukwelashwa kwe-Shiga-toxin- E. coli 0157: H7 no- E.coli okungewona-0157: Imithi ye-H7 ene-antibiotic inengxabano. Kukhona ukukhathazeka ukuthi ama-antibiotic ayokwehlisa izinga le-hemolytic-uremic syndrome ngokwandisa ukukhiqizwa kwe-toxin ye-Shiga. I-Hemolytic uremic syndrome yisimo esibulalayo esithinta igazi nezinso.
Ikholera
I-cholera ibhekisela kuhudo oluvuthiwe obangelwa izinkinga ezithile ze- Vibrio cholerae. I-toxin ye-cholera ifihlwe yi- Vibrio cholerae , evuselela i-adenylyl cyclase, i-enzyme etholakala emangqamuzaneni e-epithelial emathunjini amancane, ngaleyo ndlela ikhiqiza i-hypersecretion yamanzi ne-chloride ion emanzini okuholela ekuhuleni kwesisu.
Umthamo wokuhuda ungaba ngu-15 L ngosuku! Ukulahlekelwa okukhulu kwamanzi okusheshayo kubangela ukushaqeka kwe-hypovolemic, isimo esiyingozi kakhulu futhi esibulalayo.
Umhudo wamanzi wekholera ungofu, unamafu, futhi awukho iphunga, i-pus, noma igazi. Lesi sitolo ngezinye izikhathi sibizwa ngokuthi "i-rice-water stool."
Ukugcina amasiko kanye nokuhlolwa kwegazi kubonisa ubufakazi bokutheleleka kwekholera.
Ngisho nasezindaweni zezikhukhula, i-k'holera ayitholakali e-United States. Ukwelashwa kwendle kanye nokuphathwa kwamanzi okugeleza kwamanzi kuye kwaqeda ukolora obuningi e-United States. Zonke izimo zamuva zekholera e-United States zingalandelwa emuva ekuhambeni kwamazwe ngamazwe.
I-cholera inonakalisa izizwe ezisathuthukayo ezinokuphuza kwamanzi namanzi okugcoba, futhi yisifo esiwumshayabhuqe, indlala kanye nempi. Ukuqubuka okukhulu kokugcina kwekholera e-Western hemisphere kwenzeka ngemva kokuzamazama komhlaba kuka-2010 eHaiti. Ukuqubuka kweHaiti kwabulala izinkulungwane zabantu.
Ikhanda elingundoqo lezokwelapha ukwelashwa yi-substitution fluid. Ezimweni ezinomusa noma ezilinganiselwe, ukushintshwa kwamanzi kungaba ngomlomo. Ukushintshwa okukhipha amanzi okushisa kusetshenziswa ngesifo esibi kakhulu.
Ama-antibiotics angasetshenziselwa ukunciphisa isikhathi sokugula kwekhamera. Lawa ma-antibiotic afaka i-azithromycin, i-ampicillin, i-chloramphenicol, i-trimethoprim-sulfamethoxazole, i-fluoroquinolones, ne-tetracycline. Inothi, izinhlobo eziningi zekholera ezingamelana nezidakamizwa zikhona.
Nakuba kukhona umgomo wekholera, kuyabiza, hhayi lokho okuphumelelayo, futhi akusizo okuwusizo ekulawuleni iziqhumane. Kusukela embonweni wezempilo yomphakathi, indlela engcono kakhulu yokubhekana nokugqashuka kwekholera ukubeka ukulahla okufanelekile nokuhlinzeka ngokudla okuhlanzekile namanzi.
Ukungena kwe-Fever
Ukungena emkhunjini kubangelwa izinhlobo ze-Salmonella zezincithakalo. Umkhuhlane we-typhoid ukhuluma ikakhulukazi ngomkhuhlane we-enteric obangelwa yi-strain Salmonella typhi. I-Salmonella idlula emzimbeni emathunjini amancane futhi ihlasela igazi. Ama-bacteria angakwazi ukusakazwa kusukela emanzini kuya kwezinye izinhlelo zomzimba, kuhlanganise namaphaphu, izinso, i-gallbladder, kanye nesistimu enkulu yezinzwa.
Ezimweni ezinzima, i-enteric fever ibonisa njengenhloko, ukukhwehlela, i-malaise, nesifo somzimba kanye nobuhlungu besisu, ukuvinjelwa nokuqothulwa. I-fever ikhuphuka ngendlela eqondile, futhi ngesikhathi sokuphumula, izinga lokushisa lomzimba libuyela kancane ejwayelekile.
Ngaphandle kwezinkinga, umkhuhlane uzophuka futhi umuntu onomkhuhlane we-enteric uzothola ngesonto noma amabili. Kodwa-ke, ngisho nangemva kokushisa komkhuhlane, isiguli singaphinda siphenduke futhi sigule ngesifo somzimba.
Izinkinga zibulala futhi zifaka ukuphuma kwegazi, i-perforation yamathumbu, nokushaqeka. Cishe amaphesenti angu-30 abantu abane-fever enteric abangatholi ukwelashwa bakhula izinkinga, futhi laba bantu babhalela amaphesenti angu-75 okufa ngenxa yokungena komkhuhlane. Kubantu abaphathwa ngama-antibiotics, isilinganiso sokufa cishe ngamaphesenti angu-2.
Amasiko wegazi angasetshenziselwa ukuhlola i-enteric fever. I-Leukopenia, noma ukwehla kwamaseli amhlophe egazi, kubuye kuhlolwe.
Ngenxa yokwanda kwama-antibiotic ukumelana, i-fluoroquinolones yi-antibiotic yokukhetha ukwelashwa komkhuhlane we-typhoid. I-Ceftriaxone, i-cephalosporin, nayo isebenza kahle.
Nakuba umuthi wokugwinya komkhuhlane we-typhoid utholakala, akuhlali njalo usebenza. Indlela engcono kakhulu yokuvimbela umkhuhlane we-typhoid ngokuqinisekisa ukulahla okwanele nokusetshenziswa kokudla namanzi ahlanzekile.
Umkhuhlane we-typhoid ungasakazeka kusuka komuntu kuya komuntu; Ngakho-ke, abantu abanalo ukutheleleka akufanele baphathe ukudla. Abambalwa abantu abathwelwe yi- Salmonella typhi baba izithwala ezingapheli, ezingenasifo futhi bangasakaza izifo uma bengelashwa ngamasonto ambalwa ngama-antibiotic. Abathwali bezinyanga ezingapheli nabo bangaphathwa nge-cholecystectomy noma ukususwa kwe-gallbladder.
I-hepatitis A
Nakuba ukutheleleka kwesifo se-hepatitis A ngokuvamile kungapheli futhi akuyona into ebulalayo, izimpawu zalesi sifo azizwa zingakhululekile. Abantu abangamaphesenti angaba ngu-80 abantu abanesandulela ngculazi nesifo somzimba, ubuhlungu besisu, ukulahlekelwa isifiso, ukuhlanza, isisindo sokugcoba, futhi kamuva ngesikhathi sokugula, i-jaundice.
Ukufa ngenxa ye-hepatitis A kuyinto engavamile futhi kuvame ukuvela kubantu asebekhulile noma labo abanezifo ezingapheli zesibindi, njenge-hepatitis B noma i-hepatitis C.
Izimpawu ze-hepatitis A ngokuvamile zihlala zingaphansi kwamasonto ayisishiyagalombili. I-minority of patients ingathatha izinyanga eziyisithupha ukuze ilulame.
I-Hepatitis A iyatholakala ngesizo lokuhlolwa kwegazi oluthola ama-antibodies ethize.
Akukho ukwelashwa okuqondile kwe-hepatitis A ekhona, futhi iziguli zeluleka ukuba zithole ukuphumula okuningi nokudla okwanele.
Ngenhlanhla, ukugoma kwe-hepatitis A kufinyelela cishe ngamaphesenti angu-100, futhi kusukela ekusungulweni kwayo ngo-1995, imvamisa yokutheleleka e-United States ishiye amaphesenti angaphezu kuka-90. Umuthi wokugoma we-hepatitis A unconywa kubantwana abaneminyaka eyi-12 ubudala nangaphezulu kanye nabantu abadala abakumaqembu aphezulu kakhulu njengalabo abahlala ezindaweni lapho i-hepatitis A isakazeka njalo.
Ngenxa yokuthi ukutheleleka nge-hepatitis A kuthatha amasonto ambalwa ukumbamba, ngokushesha nje emva kokuvezwa, izimpawu zokutheleleka zingavinjelwa ngomuthi wokugoma noma ukulawulwa kwe-immune globulin.
Nakuba kungahambisani nezinhlekelele zemvelo kanye nezikhukhula, ngo-2003 no-2017, kwenzeka ukuqubuka okukhulu kokubili kwesifo se-hepatitis A. Okokuqala kwenzeka eBeverver County, ePennsylvania, futhi yabuyela emuva ku-anyanisi eluhlaza okonakele ekhonzweni yokudlela yaseMexico. Esesibili senzeke eSan Diego futhi-ngenxa yokungcola okulinganiselwe-kwavela ingozi phakathi kwamalungu abantu abangenamakhaya. Ngokubili lezi ziqhumane zaholela emakhulwini amaningi esibhedlela kanye nokufa kwabantu abaningi.
Leptospirosis
Eminyakeni yamuva, i-leptospirosis ivuselelwe njenge-pathogen efanelekile emitholampilo ngezingxabano ezenzeka kuwo wonke amazwekazi. I-Leptospirosis yisifo se-zoonotic, okusho ukuthi sidluliselwa kubantu yizilwane. Kubonakala sengathi i-leptospirosis nayo ingadluliselwa phakathi kwabantu ababili.
Ama-leptospires ama-bacteria amancane, ahlanganisiwe, aphethwe yizinyosi, izilwane ezifuywayo nezilwane zasemapulazini. Ukuvezwa komuntu ngokuvamile kwenzeka ngokusebenzisa ukuchayeka kwemvelo kodwa kungase kwenzeke emzimbeni ukuxhumana ngokuqondile nomchamo wezilwane, udoti, igazi, noma izicubu.
I-Leptospirosis isakazwa emhlabeni jikelele; Kodwa-ke, kuvame kakhulu ezindaweni ezihlala ezishisayo nasezindaweni ezingaphansi komhlaba. Kulinganiselwa ukuthi i-leptospirosis ithinta abantu abayizigidi ezilodwa ngonyaka, ne-10 amaphesenti abantu abanegciwane elibulawa yi-infection.
Ngo-1998, kwaba nokuqhuma kwe-leptospirosis e-Springfield, e-Illinois, phakathi kwabathengisi be-triathlon. Lawa ma-triathletes anesandulela ngculaza ngemuva kokugebha emanzini amachibi angcolile. Ngokusobala, imvula enkulu yaholela ekuqhumeni kwezolimo echibini.
Ukudluliswa kwe-leptospirosis kwenzeka kunqamule, isikhumba esikhohlisiwe, kanye nekhanda lomsindo wamaso nomlomo.
I-Leptospirosis inikeza izimpawu ezihlukahlukene. Kwamanye abantu, i-leptospirosis ayibangeli izimpawu futhi ngaleyo ndlela ayifuni kahle. Ngamafomu amancane, izimpawu ze-leptospirosis zibandakanya umkhuhlane, ikhanda, nezinhlungu zomzimba. I-leptospirosis enamandla ibangela i-jaundice, ukungasebenzi kwezinso, nokuphuma kwegazi; lesi sithathu sezimpawu sibhekwa njengesifo sikaWeil. I-leptospirosis enamandla nayo ingabonakala nge-pulmary hemorrhage, noma iphuma emaphashini, okungenzeka noma kungahambisani ne-jaundice.
Iningi labantu abanegciwane leptospirosis lilulamekile. Ukufa kungenzeka ezimweni zezifo ezithuthukisiwe ezibandakanya ukungasebenzi komzimba nokuphuza kwamaphaphu. Iziguli ezikhulile nezikhulelwe nazo zengozi yokufa kokubili kwe-leptospirosis.
Kubalulekile ukwelapha i-leptospirosis ngama-antibiotics ukuvimbela ukwehluleka kwesitho. Iziguli kufanele ziphathwe ngokushesha ngangokunokwenzeka ngaphambi kokuhluleka komzimba kwenzeka. I-Leptospirosis ingaphathwa nge-wide range of antibiotics, kuhlanganise, i-ceftriaxone, cefotaxime, noma i-doxycycline.
Ngaphandle kwemithi elwa namagciwane, ukunakekelwa okusekela njengokuphathwa kwamanzi okugcoba kuyadingeka.
Ezimweni zezifo ezinzima, ukukhubazeka kwezinso kudingeke kulashwe nge-dialysis yesikhashana. Iziguli ezinegazi lamaphaphu zingadinga umoya owenzayo.
Kukhona ukugoma kwe-leptospirosis yezilwane. Abanye abantu abadala nabo bagonywe; Nokho, lokhu kuyindawo edinga ukutadisha okuqhubekayo.
Isingatha phezulu
Nakuba i-United States iyizwe elicebile elinokuhlanzeka kwezingqalasizinda kanye nengqalasizinda, izinhlekelele-njengeziphepho nezikhukhula-zenzeka. Phakathi nalezi zikhathi zezinkinga, izifo ezithinta amanzi zingasakazeka.
Ngenxa yokuguquka kwesimo sezulu kanye nokukhishwa kwegesi lokushisa okushisa, ukufanekisela isimo sezulu kuphakamisa ukuthi ngonyaka ka-2100, kuyoba nokwanda kwezenzakalo ezinzima zokumisa, okungabangela ukusabalalisa okuqhubekayo kwezifo ezibangelwa amanzi.
> Imithombo:
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> Bernstein AS. Ukuguquka kwesimo sezulu kanye nezifo ezithathelwanayo. Ku: Kasper D, Fauci A, Hauser S, Longo D, Jameson J, Loscalzo J. eds. Izimiso zikaHarrison ze-Internal Medicine, 19e eNew York, NY: McGraw-Hill; 2014.
> Izifo ezithathelwanayo. Ku: Iserson KV. ama-eds. Ukwelashwa Okuthuthukisiwe: Ukunakekelwa Ezweni Ezimbi, 2e New York, NY: McGraw-Hill
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