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თარიღი: 21 აგვისტო, 2017

კოკსაკის ვირუსი და ხელის, ტერფის და პირის დაავადება

NATIONAL CENTER FOR DISEASE CONTROL & PUBLIC HEALTH, GEORGIA (NCDC & PH)·WEDNESDAY, AUGUST 16, 2017

ხელის, ტერფის და პირის დაავადება ბავშვთა ასაკში გავრცელებული ენტეროვირუსული ინფექციაა. ხასიათდება სუბფებრილური ცხელებით, მტკივნეული წყლულებით პირის ღრუში და ვეზიკულებით მტევნებსა და ტერფებზე.

გამომწვევი აგენტი - დაავადების ყველაზე ხშირი გამომწვევი კოქსაკივირუსის ჯგუფის ვირუსებია. კოქსაკი A5, 10 და 16 ინფექციის ყველაზე ხშირი. ენტეროვირუსი 71 (EV71) ასევე იწვევს ამ დაავადებას, მძიმე ფორმით.

რეზერვუარი - დაავადებული ან რეკონვალესცენტი ადამიანია

გადაცემის გზები - ვირუსის გადაცემა ხდება ავადმყოფი ადამიანის პირის, ცხვირისა და ხახის გამონადენთან, ნერწყვთან, ვეზიკულას სითხესთან ან ფეკალურ მასებთან პირდაპირი კონტაქტით. ვირუსის გამოყოფას რეკონვალესცენტი განავალთან ერთად განაგრძობს დაახლოებით 1 თვის განმავლობაში.

ეპიდემიოლოგია - დაავადება ძირითადად გვხვდება სპორადული შემთხვევების სახით, მაგრამ ფიქსირდება ეპიდაფეთქებები მთელი მსოფლიოს მასშტაბით. კოქსაკივირუსული ინფექცია განსაკუთრებით გადამდებია. აშშ-ში ეპიდაფეთქებები დაახლოებით ყოველ 3 წელიწადში ერთხელ ფიქსირდება. შემთხვევები ყველაზე ხშირია <10 წლამდე ბავშვებში, თუმცა, ინფექცია შეიძლება განვითარდეს უფრო მოზრდილ ბავშვებში, მოზარდებსა და მოზრდილებშიც. აღმოსავლეთ და სამხრეთ-აღმოსავლეთ აზიის ქვეყნებში, როგორიცაა ტაივანი და მალაიზია. ენტეროვირუსი 71 (EV71) იწვევს დაავადების უფრო მძიმე ფორმას, სერიოზული გართულებებით.

კლინიკური ნიშნები: შემთხვევათა უმეტესობაში დამახასიათებელია სუბფებრილური ცხელების უეცარი დაწყება, უმადობა, ყელის ტკივილი, ხველა, მუცლის ტკივილი, დიარეა და ზოგადი სისუსტე, ზოგჯერ ვლინდება ართრალგია (სახსრების ტკივილი). ეს პერიოდი შეიძლება გაგრძელდეს 3-4 დღეს, ამის შემდეგ პირის ღრუს ლორწოვან გარსზე ჩნდება წყლულები, გამონაყარი ხელისგულებზე, ფეხისგულებსა და დუნდულებზე შეიძლება განვითარდეს 1-2 დღეში. დაავადება შეიძლება ვლინდებოდეს ყველა ზემოთ ჩამოთვლილი ნიშნითა და სიმპტომით, ან მხოლოდ რამდენიმე მათგანით. ჩვეულებრივ, პაციენტი სპონტანურად გამოჯანმრთელდება გართულებების გარეშე.

ლაბორატორიული ტესტირება ძირითადად არ არის საჭირო, გარდა იმ შემთხვევებისა, როცა არსებობს 71 ტიპის ენტეროვირუსთან ექსპოზიციის შესაძლებლობა (EV71). EV71 იწვევს დაავადების მძიმე ფორმას, რომელიც საჭიროებს მეტ კვლევას გართულებების ადრეულ ეტაპზე აღმოსაჩენად.