The zvinokonzera Lassa fivhiri hweHIV. Zviratidzo, Treatment uye kuongorora chirwere

Lassa fivha chirwere kungova boka Hemorrhagic kutapukirwa noutachiona. Somugumisiro, zvinokanganisawo itsvo, chiropa raparadzwa, kukura yakakura fivha. The chirwere kunoratidzwa rikwanise rirambe richibvira toxicosis, kana pamwe ganda damage pamusoro midziyo yavo permeability inowedzera zvinoshamisa. Very chirwere zvinouraya, rufu rinowanikwa muna 40% nyaya. Gore negore vanhu hafu yemiriyoni vanotambura Lassa fivhiri. Hosha rinowanikwa muna mavhiki maviri, kunonyanya zvakaoma kutakura muviri vakadzi yechipiri hafu pamuviri, muchiitiko ichi, mwero wokufa kwevanhu anenge 80%.

Geographic nzvimbo kupararira

Muna 1969, masayendisiti muNigeria kusarudza fivha pakati vagari netaundi Lassa chirwere kupesvedzera vaongorori nevakoti kutarisirwa. Dzokushungurudzwa shanu vokutanga, vatatu zvakakonzera rufu varwere. Microbiologists gore Papera kuziva causative pomutumwa. Lassa nefivhiri panguva ino anofukidza nyika dziri kuWest Africa, akadai Guinea, Mali, Nigeria, Senegal nevamwe. Regai lag mumashure Pakuurayiwa epidemiological vomukova uye nechepakati zvikamu kondinendi African. Dzimwe nguva maronda kuitika munyika dzeEurope, Israel, USA, Japan, umo utachiona utachiona hwakakura Kutamiswa vachifamba vagari.

Description Fivha utachiona hwakakura

The causative mumiririri Lassa nefivhiri chinhu nemavhairasi genomic RNA mumiririri mhuri, izvo haana DNA uye majini mashoko encoded imwe kana mbiri tambo RNA. Nemamiriro rinobatana sechivako utachiwana Bolivian uye Argentinean fivha utachiona hwakakura choriomeningitis. Nemavhairasi virion dhayamita pamusoro 80-160 chete nm, zviri akanyudzwa mune raundi lipid hamvuropu vane pamusoro wakafukidzwa fibers. Kuongorora nemaikorosikopu inoratidza nemavhairasi nezvimedu mukati ribosomes gumi anomiririra granules batana yakanaka.

Nokuda kuvapo munyika nezvimedu kufanana jecha zviyo, utachiona anopiwa zita remhuri Arenavirus Arenaviridae (mu Latin arenaceus rinoreva jecha). Mumakore gumi apfuura masayendisiti dzakaonekwa 4 subgroups, zviri Lassa nefivha uye kuparadzirwa munzvimbo dzakasiyana-siyana Africa. Virus kuramba kuchinja nzvimbo dzakapoteredza ndechokuti kukwanisa kwayo kugona kurarama uchikurukura neropa kana muviri zvakavanzika haina akarasika kwenguva refu. Kuderedza kwayakaita rinoshandiswa chloroform uye Eteri.

Sources uye hawkers utachiwana

Vatakuri utachiona vanoonekwa multimammate makonzo yacho kondinendi African, nemaonero Mastomys natalensis. Epidemiological nzvimbo ngozi nhamba utachiona vanhu ndiko 14-18% of zvachose Vagari makonzo, kuti rodent ane utachiona utachiona kuti upenyu, dzimwe nguva pasina zviratidzo chirwere. Panobva chirwere ndechimwewo murume airwara zvose muviri zvinwiwa izvo chirwere kune vamwe.

Terms of Lassa nefivhiri hweHIV vari kupararira chirwere kuburikidza mumhepo nemvura mumate apo vangakosora, sneezing, kufema. Utachiona inowanikwa faeces uye weti makonzo, izvo kuwana zvokudya uye ganda kwevanhu. Chirwere munzvimbo utachiona kunoitika apo inhaled mhepo atomized duku mhuka tsvina, kushandiswa mwando kubva tsime kusvibiswa nemavhairasi uye insufficiently yakabikwa nyama makonzo anowanzonzi vapera zvokudya.

Pakati pachavo nemakonzo zvinoparadzira hutachiwana pamusoro vachionana, kunwa, kudyisa, maberekero. Kubva murwere utachiona ane zvakasiyana munhu kuonana nzira uye unzenza. mai pamuviri inopfuura utachiona muviri kuti mwana. Staff otora imwe pazvirwere chipatara chirwere panguva pakurapa ropa uye kuvhiya kupindira, autopsies, tichishumira varwere zvikuru catarrhal zviratidzo. Muropa varwere mushure chirwere, Lassa fivha kunosiya antibodies, izvo kuramba makore 7, iyo inogona obnaruzht pakutsvakurudza murabhoritari.

The epidemiological mamiriro ezvinhu

The chirwere anoonekwa kuva musimboti wokuzadzika nemavhairasi fivha. Avo vakawanda pangozi vari vagari kumadokero kweAfrica. Chirwere chiri zvose mumusha uye muguta zvakafanana zvichida, nokuda vakawanda makonzo multimammate. Vanopfuura hafu kacho zvinouraya.

The panowanikwa kutapata kuti chirwere nekorasi zvishoma kudzidza, asi izvozvo zviitiko chirwere kunomboitika, pamwe kuramba kurapwa uye kudzivirira Lassa fivha hakurevi kuishandira, hosha iri mumapapu. zvinenge zvose zvikamu Africa chirwere kuvazivi gore rose, asi kupfuura nhamba panomuka vari inotonhora mwaka, apo gurusvusvu makonzo vakatamira pedyo dzimba vanhu.

Nyaya yacho utachiona kufambisa nyika iri kondinendi European vari nzvimbo, asi yokudzivisa kupararira kwakadaro zvose hosha fivha inozviisa pakuomerera zvemari pasi pose. Vanhu aroorane vanoitirwawo pangozi wokutapukirwa. Chinonyanya zvikuru utachiwana pakanyenga dzinodiwa murombo zvoutsanana, murombo munzvimbo dzine vakawanda.

The pathogenesis chirwere

The mucous Kamudzira womunhu muviri ari pasuo nokuda chirwere yaunodya. Virus nokuti ndima incubation nguva, ari mupasi riri node nodes pakuguma Danho chakasimba febrile nguva rinotanga kupararira nezvimedu pamusoro zvose muviri enyika. Mumasero zvinokosha zvomukati, ine utachiona, tora pamusoro nekukuvara cytotoxic lymphocytes, pane Lassa fivhiri. Zviratidzo uye pakurapa chirwere iri kuwedzera mubereko pakati unyanzvi. Nokufamba dzichiri chirwere necrosis chiropa uye itsvo, chirwatata uye kuparadzwa pomwoyo.

The kwokuomerwa hosha kunoenderana kutapata muviri, saka rufu zvakafanorongwa kutyora cellular siyana. Kana pane febrile kumwedzi chirwere inotungamirwa antibodies kubvisa mavhairasi yakaturikwa uye yatovapo yakanonoka - Kunoratidza pacharo sezvo Lassa fivhiri. Photo murwere anoratidzwa pazasi.

Zviratidzo zviri chirwere Lassa

The incubation nguva kunotora vhiki imwe matatu, ipapo rinotanga rikwanise chokutambudzika chirwere pamwe mamirire zviratidzo:

• kwokupisa mamiriro rinotanga zvishoma kuwedzera tembiricha muviri;
• vakaratidzawo zvakawanda zvive, kunzwa simba;
• ipapo myalgia, kurwadziwa huro kana pakuparadza;
• Meso dzinotambura conjunctivitis;
• nezvibereko mumuviri tembiricha kuti chill yakakura utera;
• kukonzera kurwadziwa kumashure, dumbu, chipfuva;
• dzimwe nguva pane kuda kurutsa, manyoka, nokugwinha;
• vangakosora anova kurutsa;
• nokushushikana maonero ari kutarisana nzvimbo.

Kuongorora murwere

Nguva dzose aripo munguva Kuedzwa mumatenhere pamutsipa uye chiso, chipfuva nharaunda, pane Hemorrhagic Migumisiro munzvimbo dzakasiyana, palpation akacherechedza guru yakawedzera node nodes. Kuzviongorora dokeriro rinozivisa nemaronda pamusoro mucosa kunoratidzwa chimiro mavara machena, harbingers pakati nekutambira nemaronda inopa Lassa fivhiri. Zviratidzo kuzviongorora mwoyo vari kuratidzwa muted pasi, bradycardia, uye kuwedzera kana kunodzikira BP. With mberi weboka chirwere kuva myocarditis, bradycardia uye tachycardia kutsiviwa.

Ongororo vanofungidzirwa chirwere inouyisa ganda murwere dzakawanda hemorrhages, mukuwedzera kwavari, pane makwapa akasvibirika, papules, roseola, dzimwe nguva munhu mapundu pamusoro pezvakaita anoyeuchidza kuoneka gwirikwiti. Mwoyo wakuriswa, murwere yainetseka kupfupika mweya, chikosoro, wheezing mumapapu nyoro kana yakaoma hunhu. The womukati nzvimbo peritoneum riri kurwadziwa, kutinhira mudumbu, manyoka. In mukudzidza awanda chiropa. Tsinga zvirwere uyewo hworatidza pacharo Lassa fivha. Epidemiology anoti nyaya nokurasikirwa pfungwa, kunzwa kurasikirwa, tinnitus, pane wakakwana kana kukwana balding musoro.

Laboratory ongororo dzinoratidza ropa leukopenia, ipapo leukocytosis, saka zvava kuruboshwe wbc, ichazivikanwa noku wakawedzera platelet kuverenga uye ungaderedza prothrombin, yakawedzerwa ESR kusvika 50-80 mm / h. zvinoderedza kweropa, vakawedzera prothrombin nguva kunoitika. Itsvo kukundikana anoita huzivikanwe mukuru zviri urea muropa, muchidzidza rinozivisa murwere weti uye proteinuria cylindruria. Weti ine chena masero eropa, masero matsvuku eropa, mapuroteni netsvina, granular sepombi.

Sezvo Lassa Fivha zvinoreva musimboti wokuzadzika zvisikwa chirwere ane vanofungidzirwa utachiwana rinoitwa epidemiological nhoroondo, kudoma preconditions kuratidzwa chirwere nokuti murwere vari munzvimbo utachiona. Somunhu pakutsvakurudza akashandisa X-ray, FDSG, Ultrasound, MRI zvakakuvadza nhengo uye muviri enyika. On tsanangudzo chirwere, varwere vanotsvaka mazano ane pulmonologist, cardiologist, wetsinga, gastroenterologist.

Chakakomba kosi uye matambudziko

Muna 37-52% nyaya, kwokuomerwa hosha kunotungamirira kwazvo maronda ari mapapu (nemabayo kusiyanisa nekuomarara), mwoyo (myocarditis), chiropa (cirrhosis), itsvo (kukundikana). Zvakakomba edema pleural nzvimbo muviri anoratidza Lassa fivhiri. Epidemiology, kurapwa features, dziviriro hapasi kupa Zvaifungidzirwa akanaka uye vane hunorapa nemigumisiro. Vanopfuura hafu vachifanotaura rufu murwere mushure memasvondo maviri kutanga. Inzwi chirwere anopfuurira 3 kwemavhiki, uye anotanga kutapudzwa tembiricha. Recovery anononoka, kunenge zviratidzwa zviratidzo kubvira nguva nenguva pane zvazvo.

Kusiyanisa chirwere pamwe nezvimwe zvirwere

Maererano vazhinji zviratidzo nokuratidzwa chirwere kwakafanana Hemorrhagic fivha vemamwe marudzi. Typhus, nedengue fever, yellow fever, Kyasanur dondo chirwere, West Nile, Chikungunya, Malaria dzinopisa, nezvitsvuku fivha, yomumuzongoza afanane Lassa fivhiri. Marburg, Ebola zvakare pamusoro nhandare vane zvakawanda uye zvinofanira risingabatanidzwi vanofungidzirwa chirwere.

Malaria zvakafanana zviratidzo Lassa chokwadi kuti kana zvirwere zvese pane mukuru muviri tembiricha zviratidzo, nomusoro, yellowing ganda. Musiyano iri chokwadi kuti marariya haisi dzinoratidzwa chitarisiko necrotic nemaronda vari huro, uye vakawanda kuwedzera node nodes, kashoma kuva haemorrhagic syndrome. Uyezve, marariya kunoratidzwa ganda rakachenuruka, kunyanya vangadikitira uye gogonera nokuratidzwa fivha, patchy mapundu.

Hemorrhagic nefivhiri pamwe renal chirwere kunoratidzwa zvakafanana zviratidzo Lassa chirwere, kunoratidzwa nekuonekwa Kurwadziwa musoro uye tsandanyama chinyamunhari chinorwadza, sclerite, conjunctivitis, oliguria. Asi haakonzeri HFRS muvanhu akadzokorora kurutsa, maronda pharyngitis uye manyoka. Kusiyana chirwere Lassa iyerere kubva zuva chirwere rokutanga kunoitika muromo yakaoma, nyota uye kwazvo neutera netsandanyama.

Nokuti leptospirosis mamirire chokuita zviratidzo sezvo fivha, nomusoro, myalgia, conjunctivitis, scleritis, oliguria. Asi kushaya leptospirosis pamwe necrotic nemaronda mumuromo mamiriro chinosiyanisa kubva Lassa fivhiri. Kana leptospirosis haasi vangakosora, manyoka, retching, hapana marwadzo chipfuva haina kuona mu murabhoritari zvidzidzo leukopenia, bradycardia. zviratidzo zvakasiyana vane Lassa fivhiri. Photos sei maperembudzi akauya pazasi.

Marburg Fivha chinhu chakasimba nemavhairasi pemipata zvakaoma. zviratidzo, nezviratidzo zvakafanana Lassa chirwere. A anokudzwa kufa, kukura fivha, Hemorrhagic chirwere, kwakakomba kuzotadzira zvomukati uye epfungwa. Panobva chirwere haisiri yakasimbiswa, zvinofungidzirwa kuti utachiwana iri chakasvitswa nevanhu girini monkeykuva droplet kana mhepo nzira uye neVadzidzi mhuka.

kuchirapa nzira

Varwere All vavaifungira chirwere ichava pasi rokumanikidzirwa muchipatara mune makiriniki enyanzvi. Kana zviri murwere kurapwa vakachengeta vaitofanira hurumende voga pasina kutyorwa. Ushandiswe chinjikira mubhedha chinzvimbo, mutoro kunze, kurapwa nechinangwa abvisa zviratidzo chirwere kuitika. Mune vhiki vakatsunga kukonzera vokutanga, uye kurapwa kuti Lassa nefivhiri pakutanga kushandisa convalescent plasma. Izvi inoshanda chete pakutanga hosha, kubva pakushandisa mishonga nokuti kwenguva refu nefivhiri panguva chinokurwadzai mune zvimwe zviitiko, kuparara chirwere uye kukura yematambudziko.

pakava chirwere ikarapwa pamwe nemishonga simba uye corticosteroids. Mazuva zvokurapa mishonga bhizimisi etiotropic dzakabudirira zvinodhaka itsva uye yokudzivirira. Anobudirira anoramba nhasi kushandiswa kwezvinodhaka pakurapa virazole, ribamidil, ribavirin. Vari kubatwa kwokutanga pavaipfuura chirwere zvokuvataurira nomuromo, panzvimbo mari 1000ed pazuva. Kugamuchirwa Havamboregi kwemazuva 10. Nomutsinga raitongwa mishonga yakakwana 4 mazuva, izvo zvinobatsira kuvandudza nzira chirwere uye kuderedza mwero wokufa kwevanhu.

Kudzivirira chirwere

kurasikirwa yakawandisa upenyu hune nokuda Lassa nefivha. Kudzivirira chirwere rinokosha iri epidemiological munzvimbo ngozi. Kudzivisa kupinda yeugaro nevanhu utachiwana, kumisa kuiwana multimammate makonzo uye dzimwe mhando nemakonzo. Kazhinji, zvokudya uye mvura yokunwa matsime matsva zvigadzirwa nokungwarira pokugara kuti kurambidza ingress kuti weti uye tsvina yose nemakonzo. Sezvo prophylaxis chinopinda kwose kwose makonzo akateverwa unopfuta zvitunha.

Great chokudzivirira ukoshi iri rwakabhadharwa kuna kuvandudza mararamire zvemo African vakawanda, kuvandudza zvokudya chidzoke munhu masoja kudzivirirwa nhengo yakakwana. Wakaitwa hurukuro uye hurukuro kuti dzikurukure tsika - chechetere mhuri, anotsanangura kudiwa zvaidiwa utano mitemo nomumwe nomumwe munhu.

Doctors uye dzimwe navanachiremba chirwere kukiriniki tinosungirwa nechokwadi zvinodiwa nomunhu pachake prophylaxis, dzakadai magiravhusi nezvifukidziro kuti murwere hanya. Vakadzidziswa uye akatuma veko epidemiological ngozi nzvimbo vanachiremba kuti zvakakodzera uye njodzi nemaitiro kubvisa uye nechokwadi chokuti Anti-dambudziko hwechiKomonisiti.

Kuita mabasa ari yatanga denda panowanikwa

Enderana kupatsanura varwere zviito hazvo kuitika, kana chero nzvimbo pane Lassa fivhiri. Kuzvidzora matanho yaitwa nokukurumidza tisinganonoki. Vari nechinangwa pakuronga yakaoma kupatsanura varwere pamwe zvizere voga nezvirwere varwere mumabhokisi, veko Achiyambira kutanga nechirwere. akakodzera vashandi vose vanofanira kupfeka Anti-denda zvokupfeka uye pachake unodzivirira michina.

Zviri rokumanikidzirwa muchipatara vanhu vaifungidzirwa kuva kuonana achirwara, ichipfuta pasina ukoshi zvinhu uye zvemumba Bolney uye kuonana nevanhu, nokupisa mitumbi iri crematorium kwechirwere chacho, disinfection pamusoro kwakavakirwa nemisha. Persons uyo akasvika nzvimbo nzvimbo denda, voga muzvipatara mune zvinoitirwawo kuchangotanga nokufungirana pakati panowanikwa chirwere "zvakachena".

Mukugumisa, zvinofanira kucherechedzwa kuti chinouraya fivha tinokanganwa, kana zvakasimba zvaitwa kuitira kuchengeteka matanho yaitwa inoshanda matanho yekuzvidzivirira zvirwere, nenguva kurapwa iri rakatangwa.