Sonsannin, makaki ani baganw ka kinni walima u sɔgɔsɔgɔ Alabatosow la: Hɛrɛsi B banakisɛ (Macacine Alphaherpesvirus 1), Valacyclovir, ani Rabies RIG¶

Ka kin, ka sɔgɔsɔgɔ, walima ka daji tu ɲɛ na sonsannin hɔrɔn fɛ turisiw ka batoso la, sigida lamini na, walima duguba kɔnɔ nakɔsɛnɛyɔrɔ la, a ka c’a la, Diɲɛ Kɔrɔ Rhesus Macaque (Macaca mulatta), Kɔnɔ jan / Kansɛri Dun Maka (Macaca fascicularis), Japonkaw ka Maka (Macaca fuscata), Makakɛ Barbari (Macaca sylvanus), walima Baboon (Papio suguya) ka tɛmɛn Bali (Ubud), Tayilandi (Lopburi, Phuket), Ɛndujamana (Varanasi, Jaipur, Shimla), Jibraltar, Zapɔn (Arashiyama), Nepal, walima Afiriki, o ye neuro-virological emergency fila ye. Ka fara Sɔgɔsɔgɔninjɛ banakisɛ tali kan (100 percent fatal once neurological symptoms appear) ani banakisɛ caman ka kinni banakisɛ jugumanw, Kɛmɛsarada la 70 fo 90 Diɲɛ Kɔrɔ Maka sonsannin balikuw (genus Macaca) ye Macacine alphaherpesvirus 1 ( ) banakisɛ taamasiɲɛ tɛ u la u si bɛɛ la ( ) .Herpes B Virus / . Cercopithecine herpesvirus 1). Hali ni Hɛrɛsi B tɛ foyi lase makaw ma ni da kɔnɔ farigan jugumanw tɛ, ni u bolocilen don hadamaden na sonsannin ka kinni fɛ, sɔgɔsɔgɔninjɛ nɔgɔlen fɛ, walima ɲɛda sɔgɔli fɛ, adamadenw ka Hɛrɛsi B banakisɛ min ma furakɛ, o bɛ kɛ sababu ye ka kunsɛmɛnasumaya jiginni ni ninakilidegun bila mɔgɔ la ni a fagali hakɛ bɛ tɛmɛ kɛmɛsarada la 70 fo 80 kan.

Ni aw walima taamaɲɔgɔn dɔ ye fari kari, sɔgɔsɔgɔninjɛ, walima ɲɛgɛnɛsira/ɲɛ sɔgɔsɔgɔninjɛ dɔ sɔrɔ ka bɔ makaka sonsannin walima bagan fɛ, aw bɛ joginda kocogo daminɛ miniti 15 kɔnɔ ni safinɛ ni povidɔni-iyode walima kulorohekisidini ye miniti 5 fɔlɔ kɔnɔ, o kɔ aw bɛ taa teliya la diɲɛ dɔgɔtɔrɔso la walima taama dɔgɔtɔrɔso la walasa ka da hakɛ caman ta Valacyclovir ( .1 g PO three times daily for 14 days) ani Sɔgɔsɔgɔninjɛ kunbɛncogo kɔfɛ (Human Rabies Immune Globulin [HRIG] + 4-dose rabies vaccine). Ni aw b’a fɛ ka sigida anpulu walima dɔgɔtɔrɔso dɛmɛ sɔrɔ, aw bɛ aw ka sigida kɔrɔtɔko nimɔrɔ wele (112 walima 119 Ɛndonezi jamana na, 1669 Tayilandi jamana na, 112 Ɛndujamana kɔnɔ ani Erɔpu tɔnba / Jibraltar, 119 Zapɔn jamana na, 999 ka bɔ Angletɛri jamana kɔnɔ , . 911 Ameriki ani Kanada jamanaw na) walima k’an ka diɲɛ kɔnɔ kunnafonisɛbɛn lajɛ kɔrɔtɔko nimɔrɔw. Walasa ka baganw ka kinni ni wuluwulu furakɛcogo caman dɔn, aw ye sɛbɛn ɲɛ wuluwulu tali ni a tali kɔfɛ kunbɛncogo, . baganw ka kinni ni joginda banakisɛw ladonni, ani joli bɔli jugumanba kunbɛnni.

Aw bɛ o kɛ sisan¶

1. AW KA JIGISƐN SƆRƆ NI ƝƐNABƆLI YE MINITI 15 FƐƐRƐ O YƆRƆBƆLI (THE SINGLE MOST IMPORTANT STEP): Aw kana kɔnɔni kɛ fo aw ka se dɔgɔtɔrɔso dɔ la ka joginda ko. Ɲɛgɛnɛsiraw B banakisɛ ni wuluwulu banakisɛ ye banakisɛw ye minnu datugulen don ni tulumafɛnw ye, minnu bɛ sigi farikolo yɔrɔw kɔnɔ miniti fɔlɔw kɔnɔ sani u ka don farikolo laminiw labanw na. Aw bɛ o yɔrɔnin bɛɛ ka kinni ko ani ka a ko walima ka a sɔgɔsɔgɔ ka to ka fo miniti 15 dafalen waati la ni povidone-iyode (Betadine), kulɔrihekisidini glukonati ( .Hibiclens), walima safinɛ min bɛ kɛ ni safinɛ ye (dish soap / laundry bar) ani jibolisiraw.
2. NI AW BƐ SƆRƆ ƝƐW WAALIMA DA la, aw bɛ JI GƆNƆN WAALIMA KƆGƆ YE MINITI 15 KƆNƆ (NO SOAP IN EYES): Ni makaki bɛ sɔgɔsɔgɔ, ka daji da, walima ka ji/nɔgɔ fiyɛ aw ɲɛ, nugu walima da la, aw bɛ ɲɛ walima ɲɛda da wulilen ko ka to ka kɛ miniti 15 kɔnɔ ni buteliji sanuman ye walima ni saline normale sterili ye** (aw kana safinɛ gɛlɛn, dɔlɔ walima opereli furaji don ɲɛ na abada, o bɛ ɲɛkisɛ tiɲɛ).
3. AW AW KAN’A TO ƝƐNABƆLI SUTURE WAALIMA GLUE KA DA DA: Ni aw ye primate ka kinni datugu ni sɔgɔsɔgɔninjɛ ye walima ni fari kola ye, o bɛ Herpes B banakisɛ, wuluwulu banakisɛ, ani da kɔnɔ banakisɛfagalanw (Eikenella corrodens, Bacteroides, Pasteurella) minɛ ka ɲɛsin farikolojidɛsɛbanakisɛw ni sɔgɔsɔgɔninjɛ tiɲɛnenw ma. Aw bɛ joginda da wuli walasa ji ka bɔ (walima aw bɛ a to a ka surunya dɔrɔn a la, a donna kɔfɛ ni Rabies Immune Globulin ye).
4. AW KA VALACYCLOVIR DAƝƐ (1 GRAM THREE TIMES DAILY) LƐRƐ 24 KA SE 72 KƆNƆ MAKAKI ƝƐNABƆLI KAN: Maka suguya sonsanninw dɔrɔn (Macaques Azi jamana fan bɛɛ la ani Jibraltar) bɛ Hɛrɛsi B banakisɛ ta. Aw bɛ aw jija ka Kɔrɔbɔli kɔfɛ furakɛli daminɛ (PEP) ni Valacyclovir da la 1,000 mg (1 g) every 8 hours (TID) for 14 days (walima Asiklowiri da la 800 mg 5 times daily for 14 days) a ka fisa sanga 24 kɔnɔ (and up to 72 hours) ka a jirali la, sani banakisɛ ka tɛmɛ ka don farikolo cɛmancɛ la.
5. AW KA GLOBULIN IMMUNE (HRIG / . ERIG) ANI ƝƐNABƆLI boloci TILEN 0: Sonsannin walima baganw ka kinni walima sɔgɔsɔgɔninjɛ o sɔgɔsɔgɔninjɛ bɛ joli sama Azi, Afiriki walima Ameriki Latin jamanaw na, o ye WHO Category III Rabies Exposure ye. Ni aw ma wuluwulu boloci kɛ ka kɔn a tali ɲɛ, wuluwulu boloci dɔrɔn TƐ bɔ, aw ka kan ka Rabies Immune Globulin (HRIG 20 IU/kg walima ERIG 40 IU/kg) donna joginda kɔnɔ ani a lamini na tile 0 la walasa ka banakisɛw bali tile 7 fo tile 14 kɔnɔ sani aw farikolo ka a yɛrɛ ka banakisɛfagalanw dilan.
6. AW KA AMOXICILLIN-KLAVULANATI SƆRƆ (AUGMENTIN) ANI TETANUS BOOSTER: Primate da bɛ hadamaden ka kinni falenfɛnw ladege (the most infectious mammalian bite); aw bɛ amɔkisisilini-klavulanati ta 875/125 mg PO BID for 5 to 7 days ani ka aw ka tetanɔsi boloci sɛgɛsɛgɛ (Tdap).

Desizɔn jiri : sonsannin, makari, ani baganw ka kinni walima sɔgɔsɔgɔninjɛ furakɛli¶

Aw bɛ tugu nin kɛnɛyaso ni foro latigɛ jiri in kɔ waati min na ni fɛnɲɛnamaw ka ɲɔgɔn sɔrɔli bɛ na ni kinni, sɔgɔsɔgɔ walima sɔgɔsɔgɔninjɛ ye:

flowchart TD
    Exposure["Primate Bite, Scratch, walima Saliva Splash fari/Ɲɛ kan"] --> WashNow{"1. Aw bɛ nɔgɔ bɔli teliya la (Miniti 0 fo miniti 5 kɔnɔ) ."}
    WashNow -->|"Fari kinni, Puncture, walima Scratch"| Scrub15["AW YE MINITI 15 DAƝƐ KƆLƆSI: Aw bɛ Povidone-Iodine, Chlorhexidine, walima Detergent Soap + Jibolisira kɛ -> Aw bɛ joli bila ka bɔ a la -> Aw kana sutura da abada"]
    WashNow -->|"Aw bɛ sɔgɔsɔgɔninjɛ kɛ ɲɛ, nugu walima da la"| FlushEye["AW YE ƝƐ / MUCOSA JI MINITI 15 YE: Aw bɛ ji buteli gansan walima kɔgɔ 0,9% sterili kɛ (Aw kana safinɛ walima iyode kɛ ɲɛw la abada) ."]
    Scrub15 --> PrimateID{"2. Ka Primate kulu ni dugukoloko dɔn"}
    FlushEye --> PrimateID
    PrimateID -->|"Diɲɛ kɔrɔ MACAQUE (Makaka suguya: Bali, Tayilandi, Ɛndujamana, Japon, Jibraltar, Sinuwa, Filipine)"| DualRisk["Faratiba min bɛ HERPES B VIRUS + RABIES + BACTERIA KAN: Aw bɛ taa Dugukolo kan taama dɔgɔtɔrɔso / dɔgɔtɔrɔso la Lɛrɛ 24 kɔnɔ"]
    PrimateID -->|"Primate non Macaque (Baboon, Vervet, Langur, Capuchin, Sonsannin, Marmoset)"| RabiesOnly["NO HERPES B RISK -> FARAKƐBA YE ƝƐNABƆLI + BAKITERIYA MA: Aw bɛ taa dɔgɔtɔrɔso la min bɛ kɛ ka wuluwulubana furakɛ PEP + Banakisɛfagalanw"]
    DualRisk --> MedProtocol["3. Aw bɛ furakɛli kɛcogo dafalen kɛ a tali kɔfɛ (Tile 0) ."]
    RabiesOnly --> MedProtocol
    MedProtocol --> Regimen["1. HERPES B PEP (Makakɛw dɔrɔn): Valacyclovir garamu 1 PO TID x tile 14 (walima Acyclovir miligaramu 800 PO 5x/tile x tile 14)\n2. RABIES PEP (WHO Cat III): Aw bɛ HRIG (20 UI/kg) don joginda la + Rabies boloci tile 0, 3, 7, 14\n3. ƝƐNABƆLI NI ƝƐNABƆLI : Amɔkisisilini-Klavulanate miligaramu 875/125 PO BID + Tdap Booster"]
    Regimen --> NeuroWatch{"4. Aw bɛ aw kɔlɔsi tile 21 kɔnɔ: Aw bɛ joli-sira-funu, kirinni, sumaya, yeli fila, walima kirinni dɔw?"}
    NeuroWatch -->|"ƆWƆ: Neuro / Fari taamasiɲɛ fɔlɔw"| IVGanciclovir["DƆGƆTƆRƆ KƆRƆBƆLI: Aw bɛ Asikloviri (Acyclovir) tata hakɛ caman tali daminɛ (miligaramu 12,5-15/kg lɛrɛ 8 kɔnɔ) walima Gansikiloviri (miligaramu 5/kg lɛrɛ 12 kɔnɔ) teliya la"]

Fasa 1 : Primate jumɛnw bɛ Herpes B banakisɛ ta ni Rabies (Species and temple guide) .¶

Dugukolo kan sonsannin bɛɛ tɛ Hɛrɛsi B banakisɛ ta, wa, wuluwulu yɔrɔ bɛɛ tɛ ni wuluwulu yɔrɔ kelen ye. Ni aw b’a dɔn tigitigi aw ye primate min ye walima min sɔgɔra, o de bɛ aw ka banakisɛfagalanw sɛbɛncogo jira.

1. Duniya kɔnɔ fɛnɲɛnamaw ka banakisɛw ka matiriyali: Makaw ni baganw, Langurs ani diɲɛ sonsannin kura¶

2. Mun na Alabatoso Makaw bɛ bin turisiw kan (And How to Escape Without Being Bitten) .¶

Kɔlɔsili minnu kɛra Bali Ubud sonsannin kungo la, Tayilandi Lopburi batosow la, ani Gibraltar sanfɛ farakurunba la, olu y’a jira ko makaki ka kinni kɛmɛsarada la 85 ni kɔ bɛ kɛ hadamadenw ka kɛwale kɛrɛnkɛrɛnnen saba senfɛ: 1. Ka dumuni, plastiki bɔrɔw, jifilenw, tile ɲɛkisɛw, walima telefɔniw minɛ: Alabatoso makakaw degecogo dɔnniya fɛ walasa ka ɲɛkisɛw, finiw, telefɔniw ani bɔrɔw minɛ minnu bɛ kirin, k’u minɛ jɔnya la fo minɛbaga dɔ ka jiriden dɔ jago u la (a learned bartering behavior). Ni sonsannin dɔ ye aw ka bɔrɔ, tile ɲɛkisɛw, walima jifilen minɛ, AW KA BƆ YƆRƆBƆLI. Ni i ye i sama ka segin kɔfɛ, o bɛ kɛ sababu ye ka kɔnɔsogonin kinni jugumanba bila i bolo walima i bolokɔni na o yɔrɔnin bɛɛ. 2. Ka nisɔndiya ni ɲinw ye minnu bɛ kɛnɛ kan walima ni ɲɛmajɔli tilennen ye (Primate Threat Display): Macaque ni baboon farikolo kan na, ka ɲɛci tilennen datugu ani ka i dawolo sama ka segin kɔfɛ walasa k’i ɲinw jira (a human smile for a selfie) ye diɲɛ bɛɛ ka primate gesture ye siran-bɛlɛ ni gɛlɛya. Aw bɛ aw dawolo datugu aw ɲinw kan, aw kana aw ɲɛ jɔlen to ɲɔgɔn na, ani aw kana aw biri aw ɲɛ na abada ni makaka cɛkɔrɔba dɔ ye walima ba min bɛ den ta. 3. Yɛlɛli Turisiw ka kamankunw kan (Head and Neck Bite Hazard): Aw kana a to abada batoso feerela ka manje walima bananku bila aw kun na walima aw kamankunw na walasa makari ka wuli aw kɔ kan. Ni kinni walima sɔgɔsɔgɔninjɛ bɛ kɛ kunkolo, ɲɛda walima kɔ la, o de bɛ mɔgɔ faga faratiba lase Herpes B banakisɛ ni Rabies fila bɛɛ ma barisa kunsɛmɛnasumaya (trigeminal, facial) ka sira surunba dɔ di (just centimeters) ka taa ɲɛfɛ ka don kunsɛmɛ na sani banakisɛfagalanw tali kɔfɛ furakɛli ka se ka kɛ.

Taabolo 2nan : Dɛmɛ fɔlɔ ni furakɛli kunbɛnni senfɛ-senfɛ (First 15 minutes to 72 hours) .¶

Ni makaki walima bagan ye fari kari walima ka ɲɛgɛnɛsira dɔ sɔgɔ, aw bɛ nin waatibolodacogo tigitigi in labato.

1. Miniti 0 ka se miniti 15 ma: Virus inactivation mécanique et chimique¶

   [ MINUTE 0: MACAQUE BITE, SCRATCH, OR SALIVA SPLASH ]
                            |
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   +--------------------------------------------------------------------+
   |  DO NOT WAIT FOR A CLINIC START 15-MINUTE SCRUB IMMEDIATELY      |
   |  1. Skin Wound: Scrub for 15 FULL MINUTES with:                    |
   |     - Povidone-Iodine (Betadine), Chlorhexidine, OR                |
   |     - Concentrated Detergent / Dish Soap / Hand Soap + Water.      |
   |  2. Eye/Mouth Splash: Flush 15 FULL MINUTES with Plain Bottled     |
   |     Water or 0.9% Sterile Saline ONLY (No soap/iodine in eye).     |
   +--------------------------------------------------------------------+
                            |
                            v
   [ HOUR 1 TO HOUR 24: HOSPITAL POST-EXPOSURE PROPHYLAXIS (PEP) ]
     - Valacyclovir 1,000 mg (1 g) PO TID x 14 days (for Macaques)
     - Rabies HRIG (20 IU/kg) infiltrated into wound + Vaccine Day 0
     - Amoxicillin-Clavulanate 875/125 mg PO BID + Tetanus Booster

• Mun na miniti 15 dafalen ye wajibi ye: CDC Herpes B Virus Baarakɛjɛkulu fila bɛɛ (Cohen et al., Clinical Infectious Diseases) ani Diɲɛ kɛnɛyatɔnba (WHO) Musoya laadilikanw bɛ ko dafalen miniti 15 kɛ ka to ka ko ani ka a ko ni masin ye (aw bɛ gazi sanuman walima finimugu nɔgɔlen dɔ kɛ ka a ko dɔɔni dɔɔni ɲinw tigɛyɔrɔ walima ɲinw sɔgɔsɔgɔyɔrɔ kɔnɔ, o bɛ a to joli misɛnniw ka bɔ ka daji bɔ).
• Virucidal (banakisɛfagalan) jumɛnw bɛ baara kɛ Herpes B ni Rabies kan?:
• Sugandili fɔlɔ fari la: Povidɔni-iyode (Betadine 7,5% fo 10%), kulorohɛkisidini glukonati (2% to 4%), kloridi bɛnzalkɔniyɔmu, walima du kɔnɔ safinɛ caman / minɛn safinɛ jilama / bara safunɛ ni ji caman ye.
• Ni aw bɛ Alabatoso sira kan ni jifilen ni bololabɔlan dɔrɔn ye do?: Aw bɛ a ko joona ni aw ka buteli kɔnɔ ji tilancɛ ye ka aw to joginda mugumugu kosɛbɛ, ka 70% dɔlɔ bolokɔfɛfɛn kɛ a la, ka boli miniti 3 fo miniti 5 kɔnɔ ka taa batoso dɛmɛ fɔlɔ kɛyɔrɔ la, lafiɲɛbɔyɔrɔ la, walima furakɛliso la min ka surun aw la walasa ka povidɔni-iyodi ni safinɛ min bɛ kɛ ka miniti 15 kuru bɛɛ kɛ. (Kɔlɔsili: Ubud Sacred Monkey Forest la Bali ani Tayilandi batosobaw la, dɛmɛ fɔlɔ dɔgɔtɔrɔso dɔ la min bɛ o yɔrɔ la, povidone-iyode bɛ yen, aw bɛ taa yen o yɔrɔnin bɛɛ, ka aw ko miniti 15 kɔnɔ, ka sɔrɔ ka taa ɲɛfɛ ka taa diɲɛ dɔgɔtɔrɔso dɔ la min bɛ Valacyclovir ni Rabies RIG furakɛ, barisa batosow ka bugudaw bɛ Betadine bila fari dɔrɔn de la, wa u TƐ banakisɛfagalanw walima wuluwuluw di bolociw).

2. Lɛrɛ 1 ka se Lɛrɛ 72 ma: Banakisɛfagalanw tali Hɛrɛsi B banakisɛ la (Valacyclovir vs. Acyclovir) .¶

Ka kɛɲɛ ni Amerika ka banaw kɛlɛli ni u kunbɛnni baaradaw ye (CDC) ani Jamana B banakisɛw sɔrɔyɔrɔ (Georgia State University) kɛnɛyaso ka laadilikanw:

3. Kungolodimi min bɛ kɛ waati kelen na, a tali kɔfɛ (HRIG + 4-Dose Vaccine Schedule) .¶

Hali ni taamakɛlaw bɛ Ameriki walima Erɔpu jamanaw na, olu ka teli ka sɛbɛnw kalan minnu bɛ sɔsɔli kɛ ni kungo kɔnɔ ni laboratuwari makanw minnu minɛna, olu mago bɛ Herpes B ni Rabies ladonni na, Azi ni Afiriki turisiw ka batosow la, aw ka kan ka U FILƐRƐ furakɛ waati kelen na. Aw kana a to sigida dɔgɔtɔrɔso dɔ ka wuluwulu furakisɛ dɔrɔn di aw ma ni Valacyclovir tɛ, ani aw kana Valacyclovir dɔrɔn ta min tɛ Rabies PEP ye:

1. Ka ɲɛsin taamakɛlaw ma minnu boloci ma kɛ (No Prior Pre-Exposure Rabies Series):
2. Taabolo A: Banakisɛfagalanw (Day 0 Only): Infiltrate Hadamaden ka wuluwulu farikolo tangalan Globuline (HRIG at 20 IU/kg farikolo girinya), walima saniyalen Equine Rabies Immune Globulin (ERIG at 40 IU/kg) ni HRIG tɛ sɔrɔ, ka ɲɛsin kinni ni sɔgɔsɔgɔninjɛ taamasiɲɛ bɛɛ jugumanba ni a dakunw ma. A hakɛ tolen o hakɛ min tɛ se ka don joginda (w) kɔnɔ farikolo la (misali la, bolokɔnincinin dɔ kinni) bɛ pikiri kɛ farikolo la yɔrɔ jan na (such as the anterior thigh or deltoid opposite the vaccine arm).
3. Tile 7 HRIG Fenɛtiri kɔrɔlen: Ni yɔrɔjan dɔgɔtɔrɔso min bɛ aw ka tile 0 wuluwulu boloci kɛ yɔrɔ min na, HRIG tɛ yen (a common issue at small island clinics in Indonesia or rural India), aw bɛ se ka tile 7 kɛ boloci fɔlɔ kɛlen kɔfɛ ka pankurun ta walima ka taa dɔgɔtɔrɔsoba dɔ la (Denpasar, Bangkok, Singapore, New Delhi, or home) ka HRIG pikiri kɛ. Aw kana HRIG kɛ tile 7 kɔfɛ, barisa a bɛna aw yɛrɛ ka boloci banakisɛfagalanw jaabi baarakɛtaw bali.
4. Taabolo B: Boloci kɛcogo (4-Dose Intramuscular Vaccine Series): Pikiri kɛ 1.0 mL (walima 0.5 mL ka kɛɲɛ ni marka ye: Verorab, . Rabipur/RabAvert, . Imovax) farikolo kɔnɔ ka don deltoid muscle (never into the gluteal/buttock muscle, walima anterolateral thigh in young children) don Tile 0, 3, 7, ani 14 (ka fara Tile 28 kan ni farikolo tangacogo dɔgɔyara).
5. Ka ɲɛsin taamakɛlaw ma minnu boloci kɛra ka tɛmɛ (Completed Pre-Exposure PrEP or Prior PEP):
6. Aw kana HRIG di a ma. Aw bɛ wuluwulu boloci hakɛ 2 kɛ farikolo la tile 0 ni tile 3 dɔrɔn**.

4. Banakisɛ caman kunbɛncogo (Why Monkey Bites Infect Within 12 Hours) .¶

Primate minnu tɛ hadamadenw ye, olu da kɔnɔ, alfa-hemolytic Streptococci, Staphylococcus aureus, Eikenella corrodens, Pasteurella, Bacteroides, ani Fusobacterium hakɛ caman bɛ sɔrɔ: - Nanbanakisɛfagalan fɔlɔ min bɛ ta da la: Amokisisilini-klavulanate (Augmentin 875/125 mg PO every 12 hours fo tile 5 fo tile 7). - Penicilline-Allergie banabagatɔw: Doxycycline (100 mg PO BID) walima Moxifloxacine (400 mg PO daily), walima Siporofiloksasini (500 mg PO BID) PLUS Metoronidazɔli ( .500 mg PO TID) walima Klindamisini (300-450 mg PO TID) ( ) .never use a single cephalosporin, macrolide, or clindamycin alone, which miss Eikenella and Pasteurella).

Taabolo 3nan : Hɛrɛsi B banakisɛ taamasiɲɛw dɔnni (The 3-to-30-day neurological red-flag window) .¶

Hali ni joginda koli dafalen kɔfɛ ani ka Valacyclovir daminɛ, makaki ye mɔgɔ o mɔgɔ kin walima ka a sɔgɔsɔgɔ, o tigi ka kan k’a yɛrɛ kɔlɔsi don o don fo tile 30 (most clinical Herpes B cases present within 3 to 21 days of exposure, though incubation up to 5 weeks can occur).

   STAGE 1: LOCAL & PERIPHERAL NERVE SIGNS (Days 2 to 10)
   - Fluid-filled blisters (vesicles) or ulceration at the bite/scratch site
   - Shooting pain, electric tingling (paresthesia), numbness, or intense itching
     radiating UP the bitten arm or leg toward the spine
   - Regional swollen lymph nodes, unexplained fever, myalgia, or severe headache
                            |
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   STAGE 2: BRAINSTEM & SPINAL CORD INVASION (Ascending Encephalomyelitis)
   - Persistent intractable HICCUPS (classic sign of brainstem/phrenic nerve involvement)
   - Double vision (diplopia), drooping eyelid, dizziness (ataxia), or slurred speech
   - Neck stiffness (meningismus), confusion, urinary retention, or leg weakness
                            |
                            v
   --> IMMEDIATE ICU ADMISSION FOR INTRAVENOUS GANCICLOVIR OR HIGH-DOSE IV ACYCLOVIR

• Mun na sɔgɔsɔgɔninjɛ basigilen, diplopie, walima sɔgɔsɔgɔninjɛ bɛ sen na, o bɛ banakisɛfagalanw tali teliya IV la:
• A tɛ i n’a fɔ hadamadenw ka fariganbana (HSV-1), Hɛrɛsi B banakisɛ bɛ to ka taa sanfɛ farikolo yɔrɔw la ka sɔrɔ a ma hali fari kuru yelen dɔ kɛ kinni yɔrɔ la (> 50% of patients never develop local vesicles).
• O nɔ na, lasɔmini taamasiɲɛ fɔlɔ ye dimi, jeninida, sɔgɔsɔgɔninjɛ, walima nɛ jugumanba (pruritus) ka kɛnɛyaji bɔ kɛrɛfɛ ka taa a kinin yɔrɔ la, o kɔfɛ, farigan bɛ i n’a fɔ mura, hiccups persistent (singultus, o bɛ sɔrɔ banakisɛw ka funu fɛ medulla oblongata), yeli fila (diplopia), gɛlɛya min bɛ munumunu (dysphagia), walima farikolo yɔrɔw barikantanya jiginni (Landry-type ascending paralysis).
• Dɔgɔtɔrɔso la furakɛli min bɛ kɛ ni Ɲɛgɛnɛsiraw B taamasiɲɛw ye: Valacyclovir da la, o ye banakisɛ kunbɛnni ye kosɛbɛ (PEP) sani bana taamasiɲɛw ka bɔ kɛnɛ kan. Ni sigida kurukuru walima hakiliɲagami taamasiɲɛ o taamasiɲɛ bɔra a la, banabagatɔ ka kan ka taa dɔgɔtɔrɔso la joona joona ani ka banakisɛfagalanw tali jolisira fɛ:
  1. Ni CNS Taamaʃyɛnw tɛ (Local skin vesicles or peripheral paresthesia only): Asiklɔviri (12.5 to 15 mg/kg IV every 8 hours) WALIMA Gansikilowiri ( ) jolisira fɛ (5 mg/kg IV every 12 hours) fo ka se tile 14 fo tile 21 ma fo a taamasiɲɛw bɛɛ ka ban ani ka banakisɛfagalanw ka PCR sɛnɛcogo sɔrɔ.
  2. Ni CNS / Brainstem Taamaʃyɛn suguya o suguya bɛ yen (Fever + headache, tingling, hiccups, diplopia, ataxia, or weakness): Gansikiloviri (5 mg/kg IV every 12 hours) ye fura sugandilen ye min laadilen don CDC Hɛrɛsi B baarakɛjɛkulu fɛ barisa gansikloviri bɛ fanga jira kosɛbɛ in vitro ani in vivo ka ɲɛsin Macacine alphaherpesvirus 1 ma farikolo cɛmancɛ la ka tɛmɛ asikuloviri kan.

Sigida kɔrɔtɔko nimɔrɔw, diɲɛ dɔgɔtɔrɔsow, ani laboratuwaraw minnu bɛ se ka fɛnw lajɛ¶

Ni aw ye aw ka joginda kocogo teliya miniti 15 kɛ yɔrɔ la, aw bɛ taa dugukolo kan dɔgɔtɔrɔso dɔ la walima taama furakɛli dɔgɔtɔrɔso kɛrɛnkɛrɛnnen dɔ la (do not rely solely on a temple first-aid booth or hotel nurse): .

• Bali & Indonezi: Dial 112 walima 119 ka ɲɛsin anpulu ma. Bali dugu kɔnɔ (Ubud / Kuta / Nusa Dua / Canggu), taa ɲɛ BIMC dɔgɔtɔrɔso la (Kuta: +62 361 761263 / . Nusa Dua: +62 361 3000911 / . Ubud Medical Centre: +62 361 971313), Siloam dɔgɔtɔrɔso Denpasar (+62 361 779900), walima SOS Medika Dɔgɔtɔrɔso Bali (+62 361 710505), o stock ye HRIG (Berirab/ .HyperRAB), Verorab boloci, ani Valacyclovir da la (Valtrex).
• Tayilandi (Bangkok, Phuket, Lopburi, Krabi, Chiang Mai): Dial kɛ 1669 ka ɲɛsin EMS ma walima 1155 ka ɲɛsin Turisidi Polisiw ma. Aw ye taa Masamuso Saovabha hakilijigin baarada la (Thai Red Cross Society Snake & Rabies Clinic, Bangkok jamana na: +66 2 252 0161), Bangkok dɔgɔtɔrɔso Phuket (+66 76 254 425), walima Bumrungrad Dugukolo kan dɔgɔtɔrɔso (+66 2 066 8888).
• Endi & Nepal: Dial 112 (108 anpulu) min bɛ Ɛndujamana na; ka Katmandou (Swayambhunath Monkey Temple), taa ɲɛ CIWEC dɔgɔtɔrɔso taama furakɛli yɔrɔ la (+977 1 4524111), sanu-standard primate kinni dɔgɔtɔrɔso min bɛ mara kɔnɔ. Ɛndujamana na, taa dɔgɔtɔrɔsoba dɔ la min bɛ wele ko tertiary corporatif (Apollo, Max, Fortis, Manipal) ani ka fila bɛɛ ɲini Hadamaden ka wuluwulu farikolo tangalan Globuline ( .HRIG) ani Valacyclovir 1,000 mg furakisɛw (Valcivir).
• Jibraltar, Angletɛri, ani Erɔpu tɔnba: Dial 112 walima 190 Jibraltar dugu kɔnɔ (St Bernard's Hospital a bɛ ni Barbary Macaque kinni protocole kɛrɛnkɛrɛnnen ye). Angletɛri jamana na, i ka telefɔni ci 999 walima 111 (UKHSA Rabies and Monkey B Virus Service); EU fan bɛɛ la, i ka telefɔni ci 112.
• Japon, Hong Kong, Singapur, ani Malasi: Dial 119 Zapɔn jamana na, 999 Hɔnkɔn jamana na (Queen Elizabeth / Prince of Wales A&E) ani Mali, walima 995 Singapuri jamana na (Tan Tock Seng Hospital / National Centre for Infectious Diseases [NCID]).
• Amerika & Duniya Herpes B Reference Laboratory: Weele 911 ka ɲɛsin kɔrɔtɔko ma. Dɔgɔtɔrɔ minnu bɛ diɲɛ kɔnɔ, olu bɛ se ka taa National B Virus Resource Center la Georgia Etazini ka Iniwɛrisite la (Atlanta, USA) 24/7 Kɔrɔtɔko telefɔni nimɔrɔ in +1-404-413-6550 walima CDC ka baarakɛyɔrɔ kɔrɔtɔlen (+1-770-488-7100) ka ɲɛsin PCR/serology diagnostics ma ani kɛnɛyaso ka banakisɛfagalanw bilasirali ma.

Ɲininkali minnu bɛ kɛ tuma caman na¶

Sonsannin jumɛnw bɛ Herpes B banakisɛ ta, wa yala a bɛ sonsannin bɛɛ la wa?¶

Ayi, Diɲɛ Kɔrɔ sonsanninw dɔrɔn de bɛ Makaka (macaque) suguya la, i n’a fɔ Rhesus makaku, Long-tailed (kansɛri dun) makaki, Japon makaku, ani Barbary makaku minnu bɛ sɔrɔ Bali, Tayilandi, Ɛndujamana, Nepal, Malasi, Singapuri, Hɔnkɔn, Japon, ani Jibraltar fan bɛɛ la, olu ye Macacine alphaherpesvirus 1 (Herpes B virus) sɔrɔyɔrɔw ye, minnu bɛ sɔrɔ u yɛrɛ la Makakɔrɔba kɛmɛsarada la 70 fo 90 minnu b’a ta taamasiɲɛ tɛ minnu na. Baganw, vervet sonsanninw, Azi lanurs, ani Ameriki cɛmancɛ ni saheliyanfan (Diɲɛ kura) sonsanninw bɛɛ i n’a fɔ kapusiniw, squirrel sonsanninw, ani marmosets, olu TƐ Hɛrɛsi B banakisɛ sɔrɔ u yɛrɛ la, hali ni u mago bɛ hali bi teliya la Rabies Post-Exposure Prophylaxis ni banakisɛfagalanw na.

Mun na ka makaki kinni walima a sɔgɔsɔgɔninjɛ ko miniti 15 kɔnɔ o yɔrɔnin bɛɛ la, o nafa ka bon kosɛbɛ?¶

Ɲɛgɛnɛsiraw B banakisɛ ni wuluwulu banakisɛ lamininen don ni tulumafɛn (tulu) ye min bɛ se ka tiɲɛ, wa u bɛ to farikolo yɔrɔw la miniti damadɔ dɔrɔn kɔnɔ, kinni walima sɔgɔsɔgɔninjɛ kɔfɛ sani u ka siri lamini dusukunnataw la ka taa sanfɛ ka don kɔkolo ni kunsɛmɛ na. Ni banakisɛ donna nɛrɛmuguma kɔnɔ, banakisɛfagalanw tɛ se ka se a ma tuguni. Ni aw ye joginda ko o yɔrɔnin bɛɛ miniti 15 dafalen kɔnɔ ni povidɔni-iyode (Betadine), kulorihekisidini, walima safinɛ safinɛ ye min falen don ni ji ye, o bɛ banakisɛw ka tulumafɛnw wuli ni a magara a la, ka banakisɛ kɛmɛsarada la 99 ni kɔ ko sani farikolojidɛsɛ ka don.

Valacyclovir walima Acyclovir hakɛ tigitigi jumɛn ka kan ka kɛ walasa ka Herpes B banakisɛ kunbɛn makaki ka kinni kɔfɛ?¶

Ikomi Hɛrɛsi B banakisɛ ka dɔgɔn banakisɛfagalanw na siɲɛ 10 ɲɔgɔn ka tɛmɛ hadamadenw ka fariganbanakisɛ (HSV-1) kan, fariganbana furasɛbɛn min bɛ kɛ ni a tata hakɛ dɔgɔman ye, o tɛ se ka kɛ. Ka kɛɲɛ ni CDC Herpes B Virus Working Group ka laadilikanw ye, balikuw ka kan ka Valacyclovir miligaramu 1000 da la (garamu 1) min bɛ ta siɲɛ saba tile kɔnɔ (lɛrɛ 8 o lɛri 8) tile 14 dafalen kɔnɔ, walima ni o tɛ, Acyclovir miligaramu 800 da la min bɛ ta siɲɛ duuru don o don tile 14 kɔnɔ, a ka fisa ka a daminɛ lɛri 24 fo lɛri 72 kɔnɔ, a kinni, a sɔgɔsɔgɔ, walima a ɲɛ sɔgɔsɔgɔninjɛ.

Ni makakɛ sonsannin ye ji daji walima ka ji fiyɛ ne ɲɛ na, ne ka kan ka mun kɛ?¶

Makaki sɔgɔsɔgɔninjɛ walima kaburu/jidaga ji bɔli ɲɛ na, o ye hadamadenw ka Hɛrɛsi B banakisɛfagalan jɛnsɛnni sira ye min sɛbɛnnen don ɲɛkisɛw ni ɲɛkisɛ/sɔgɔsɔgɔninjɛ nɛrɛw fɛ. Aw kana safinɛ, povidɔni-iyode, walima dɔlɔ don aw ɲɛ na; o nɔ na, ​​aw bɛ aw ɲɛkisɛw da wuli ka ɲɛ ko ka to ka miniti 15 dafalen kɛ ni buteliji sanuman ye walima ni saline normale 0,9% sterili ye, o kɔ aw bɛ taa dɔgɔtɔrɔso la joona ka Valacyclovir dacogo daminɛ (garamu 1 siɲɛ saba don o don tile 14 kɔnɔ) ani ka baro kɛ wuluwulu kunbɛnni kan.

Yala ne mago bɛ wuluwulu farikolo tangalan (HRIG) la hali bi ni ne ye wuluwulu boloci kɛ sonsannin ka kinni don na wa?¶

Ɔwɔ, ni aw ma deli ka wuluwulu boloci kɛ ka kɔn a tali ɲɛ ka kɔn taama ɲɛ, sonsannin fari karilen bɛɛ ka kinni walima a sɔgɔsɔgɔ jamana kɔnɔ min bɛ wuluwulu sɔrɔ (i n’a fɔ Ɛndonezi/Bali, Tayilandi, Ɛndujamana, Nepali, Afiriki, walima Ameriki Latin) o ye OMS ka kulu sabanan ye min bɛ wuluwulu boloci hakɛ 4 fila bɛɛ wajibiya ANI Hadamaden ka wuluwulu Immune Globulin passive (HRIG, 20 UI/kg) bɛ don joginda kɔnɔ ani a lamini na. Ikomi wuluwulu boloci bɛ tile 7 fo tile 14 ta walasa ka aw farikolo tangalanw lawuli walasa u ka se k’a yɛrɛ ka banakisɛfagalanw dilan, HRIG bɛ farikolojidɛsɛbanakisɛw di teliya la kinni yɔrɔ yɛrɛ la o dɔgɔkun fɔlɔ faratilen kɔnɔ.

Lakɔlɔsili taamasiɲɛ jumɛnw bɛ sɔrɔ tile 30 fɔlɔw kɔnɔ makari ka kinni kɔfɛ, o kɔrɔ ye ko ne mago bɛ furakɛli kɔrɔtɔlen na IV la?¶

Aw bɛ dɔgɔtɔrɔso ladonni kɔrɔtɔlen ɲini joona ni Gansikiloviri (miligaramu 5/kg IV ye lɛri 12 o lɛri 12) walima Asikiloviri (Acyclovir miligaramu 5/kg IV) tali la ni nin fɛn ninnu dɔ bɛ aw la tile 3 fo tile 30 kɔnɔ makaque tali kɔfɛ: kurukuru walima kurukuru minnu falen don ji la joginda kɛrɛfɛ jeninida, kirinni, sɔgɔsɔgɔninjɛ, walima nɛ jugumanba min bɛ bɔ bolokɔni walima sen kinnilen na; sumaya min ɲɛfɔlen tɛ, walima kungolodimi jugumanba; sɔgɔsɔgɔninjɛ min bɛ to senna, min tɛ se ka furakɛ (Hɛrɛsi B kunsɛmɛnasumaya taamasiɲɛ kɔrɔlen); yeli fila, ɲɛnamini, dumuni munumunu gɛlɛya, walima farikolo yɔrɔw barikantanya.

Gafe minnu bɛ tali kɛ o ko la¶

• Kurukuruni tali, wuluw kunbɛnni, ani banakisɛfagalanw tali kɔfɛ
• Baganw ka kinni ni joginda banakisɛw ladonni
• Rabid fox, raccoon, coyote, walima skunk tile kɔnɔ binkanni lafasali
• Joli jugumanba ni joli bɔli kunbɛnni

Sosow ani ɲɛmɔgɔyaso ka bilasiralikan¶

• Banaw kɛlɛli ni u kunbɛnni baaradaw (CDC, Etazuni): CDC Yellow Book (Kɛnɛya kunnafoniw diɲɛ taamaw kama): Zoonotic Exposures: Kini, sɔgɔsɔgɔ ani farati wɛrɛw ka bɔ Maka sonsanninw na (Herpes B Virus / Macacine alphaherpesvirus 1) ani Rabies.
• Cohen, J. I., Davenport, D. S., Stewart, J. A., ani mɔgɔ wɛrɛw. (B Virus Working Group, Bana minnu bɛ sɔrɔ kɛnɛyaso la / CDC): Ladilikanw ka ɲɛsin B banakisɛ kunbɛnni ni a furakɛli ma (Cercopithecine Herpesvirus 1) ye.
• Jamana ka B banakisɛw sɔrɔyɔrɔ (Georgia State University, Atlanta, Etazuni): Baarakɛcogo kɔrɔtɔlen minnu bɛ kɛ ka Maka ka kinni/sɔgɔsɔgɔninjɛ nɔgɔ bɔ, ka bana sɛgɛsɛgɛ, ani ka a kunbɛnni kɔfɛ.
• Diɲɛ kɛnɛyako tɔnba (WHO): OMS ka dɔnnikɛlaw ka lajɛ min kɛra wuluwulubana kan: Ɲɛgɛnɛsiraw tali suguya sabanan, wuluwuluw doncogo yɔrɔ la joginda la Immunoglobuline (HRIG/ .ERIG), ani Boloci bolodacogo.
• Ameriki ka banakisɛfagalanw ka tɔnba (IDSA): Fura ni farikolo yɔrɔ nɔgɔlenw banakisɛw sɛgɛsɛgɛli n’u furakɛcogo waleyacogo la, ka tugu fɛnɲɛnamaw ka kinni kɔfɛ minnu tɛ hadamadenw ye.