Hantavirus Pulmonary Sindrome (HPS): Ko waɗi aɗa fotaani meeɗde ɓuuɓnude walla ɓuuɓnude ƴiiƴam ɓowɗi e nder suudu walla e nder suudu¶

So a udditii suudu udditirdu, suudu desorɗe, suudu desorɗe, suudu dowri, garaas, nokku ɗo njippirtee, walla RV/camper parking e nokku ɗo ƴiiƴam ɓowɗi njoorɗi walla kaɓirɗe ɓuuɓɗe, **nanngude ɓuuɓri, ɓuuɓri ɓuuɓri, walla ɓuuɓri galle ngam ɓuuɓnude mi-ssfe. Yoorde walla ɓuuɓnude ina aerosolina ɓuuɓri mikroskopiiji e nder ƴiiƴam ɓowɗi yoorɗi, e ƴiiƴam, e ƴiiƴam ɓowɗi tawa ina waɗi Hantavirus (such as Sin Nombre virus carried by the North American Deer Mouse, or Puumala and Dobrava viruses in Europe and Asia) feewde e weeyo, ɗo ɓuuɓnata mboros oo haa e nder ƴiiƴam maa. So tawii won keɓɗo fever, ɓuuɓri, ɓuuɓri ɓalndu tiiɗndi (especially in the thighs, hips, back, and shoulders), ɓuuɓri hoore, ɓuuɓri, walla ɓuuɓri nder 1 to 8 weeks e naatde e galle mo mborosaaji njibini - rewi heen ko caggal balɗe 3 haa 5 ko ɓuuɓri yoorndi walla ɓuuɓri foofaango ɗoon e ɗoon, noddu limoore emergency nokku maa e laawol amen limooje caɗtuɗe regginorde e yahde to opitaal toowɗo Departemaa Emergency e ECMO (Extracorporeal Membrane Oxygenation) baawɗe ɗoon e ɗoon. Kadi ƴeewto-ɗee njilluuji men e... sepsis e anndinde soklaaji septik, leptospirosis (rafi Weil) ummoriiɗo e ndiyam ilam e ƴiiƴam mboros, ɓuuɓri mboros (tooke mboros) ɓuuɓnoowo ƴiiƴam, e ɓuuɓri daabaaji e ɓuuɓri rabies.

E wiyde Centre de contrôle et de prévention des maladies (CDC), Fedde Cellal Amerik (PAHO / WHO), e Centre Orop ngam haɓaade e haɓaade ñawuuji (ECDC), Sindoron ɓuuɓɗo Hantavirus (HPS, ina wiyee kadi Sindrom ɓernde e ɓuuɓri Hantavirus / . HCPS) ina jogii toɓɓere maayde e... 35% to 38% (and up to 50% e nder mborosaaji Andes bonɗi) - hay e sukaaɓe mawɓe celluɓe ɓe ngalaa caɗeele safaara ko adii. Ko waɗi Hantavirus Pulmonary Syndrome ina fooɗa e maayde e nder safaaraaji caɗtuɗi ko caɗeele mum gonɗe e safaaraaji ɗiɗi : e nder balɗe 3 haa 6 gadane (the Febrile Prodrome), ñawɗo oo wayi ko no ɓe keɓi tan ko grippe walla gastroenterite viral (fever, severe thigh/back muscle aches, headache, nausea, abdominal pain, and a completely clear chest X-ray with ZERO runny nose or sore throat), ko ɗum waɗi kilinikuuji toppitiiɗi ko yaawi ina njokki neldude ɓe galleeji. Ndeen, tawa jeertinaaka, ñawɗo oo naatata ko e Fase Cardiopulmonaire Capillary-Leak, ɗo mboros oo addanta ɓalndu nduu ɓuuɓde no feewi, **ina ɓuuɓna ɓuuɓri ndii fof gila e nder mum haa yaasi, ina ɓuuɓna ƴiiƴam ɗam ina heewi poroteyiin e nder waktuuji 4 haa 8 tan, tawi ina ɓuuɓna ɓalndu nduu e nder waktuuji 4 haa 8 tan.cardiogenic + non-cardiogenic shock). Ko ɓuri bonde nii, so tawii doktoor safrooɓe juutniima e ñawɗo Hantavirus ngam sepsis bakteriiji gonɗi e sahaa kala, o rokka ɗum bolusuuji saline keewɗi e nder ƴiiƴam (30 mL/kg), oon ndiyam ɓeydaɗam ina rufa e nder ƴiye ɓuuɓɗe, ina ɓuuɓna ñawɗo oo e dow ŋoral. Jaambaraagal Protokol laɓɓingol ɓowɗi CDC Wet-Bleach e Kuulal 5-Count Triage ƴiiƴam (Hantavirus Triad) ina hisna nguurndam.

Waɗde ɗum jooni¶

1. WOƊƊO ɗoon e ɗoon so a yiyii ƴiiƴam ɓowɗi, ɓulli, walla ɓowɗi maayɗi e nder suudu, e nder suudu, e nder suudu, e nder suudu moteruuji otooji, walla e nder suudu les: WOTO MEƊƊI ɓuuɓnude e ɓuuɓri, WOTO MEƊƊI huutoraade aspirateur (hay HEPA shop.weuer), e WOTO MEƊƊI fufde leping ai compresse or a ina uddita miliyoŋaaji ɗi njiyataa 1-to-5-micron aerosols ɓuuɓɗi mborosaaji e nder nokku fooftere maa ɗo ɗi ndarni e henndu deeƴndu fotde waktuuji.
2. Ventilate nokku udditirɗo oo ko adii fof ko famɗi fof 30 full minutes e udditaade dame e windooji yaasi e yahde RUUTO YAASI (staying upwind while fresh outdoor air flushes the room). Hantavirus ko mboros RNA ɓuuɓɗo (Bunyavirales / Orthohantavirus) mo enveloppe lipid mum ina yaawi ustaade e ultraviolet yaajɗo (UV) lewru e dillugol henndu laaɓndu.
3. Waɗde gannde kaɓirɗe/nitril (e an... N100 / P100 mala FFP3 particulaire respirateur pour les infections louves), caggal ɗuum SOƊƊI no feewi denndaangal ƴiye, ƴiye, e ƴiye maayɗe e ɓuuɓri kesiri 1:10 Household Bleach Solution (1 part liquid chlorine bleach to 9 parts water, walla disinfectant njulaagu winnditiiɗo EPA hono Lysol) e ɗaccude ɗum jooɗoo ɓuuɓde ngam 5 to 10 full minutes hade memmude huunde. Softinde ƴiiƴam ina liggina ƴiiƴam ɗam les haa ɗam waawa wonde henndu tawa hipoklorit sodium ina halka 100% e enveloppe lipid viral.
4. Ƴettu ƴiiƴam ɓuuɓɗam e kaɓirɗe ɓuuɓɗe e ɓuuɓri kaayitaaji ɓuuɓɗi (WOTO MEƊƊI ɓuuɓnude), ɓuuɓnu ɓuuɓri kaayitaaji ɓuuɓɗi e ɓowɗi maayɗi e nder saakuuji ɗiɗi ɓuuɓɗi, loot juuɗe maa gonɗe e gannde e saabunde e ndiyam HADE maa ɓuuɓnude gannde maa.
5. So a heɓii feso (>= 38.0 C / 100.4 F), ɓuuɓri ɓalndu luggiɗndi (thighs, lower back, hips), ɓuuɓri hoore, ɓuuɓri, ɓuuɓri, walla ɓuuɓri nder 1 to 8 weeks (7 to 56 days) caggal nde laɓɓini suudu/kaɓirgal, kammu, walla jogaade leɗɗe: yah to Emergency Department to safrirde ƊOONI (hay so a alaa kosam tawo).
6. Wiy ɗeeɗoo konnguɗi laaɓtuɗi e Infirmier e Cafroowo Triage Emergency Room e nder leƴƴanɗe 30 gadane ɗee: "I was exposed to rodent droppings / mice ___ weeks ago and now have fever and muscle aches. Please evaluate immediately for Hantavirus Pulmonary Syndrome (HPS), order a STAT Complete Blood Count (CBC) with manual peripheral blood smear (checking for the Hantavirus Triad: thrombocytopenia, hemoconcentration, and immunoblasts), and AVOID aggressive IV fluid boluses that can trigger fatal pulmonary edema."

Lekki kuulal : Laɓɓingol mborosaaji kisal e triage clinique Sindrom Pulmonaire Hantavirus¶

Rewrude e ndee ɗoo limre gollorde e safaara ngam haɓaade e nder laɓɓingol e triage médical emergency caggal nde neɗɗo feeñi.

flowchart TD
    Start["Ɓoornugol ɓowɗi, Ɓoornugol, Ɓoornugol ƴiiƴam, walla Ɓoornugol Maayngol Tawaangol e nder Kabin, e nder suudu, e nder suudu, e nder galle, e nder garaas, walla e nder RV"] --> Scenario{"Mbele Aɗa Laɓɓina Jooni WALLA Aɗa Heɓa Maandeeji Caggal nde Njuuɗaa?"}

    Scenario -->|"LAAƁƁINDE TOƁƊE RODENTE JOONI"| CleanRule["CDC 5-STEP PROTOKOL LAAƁƊO ƁURƊO WOƊƊUDE : 1. WOTO MEƊƊI ɓuuɓnude, ɓuuɓnude, walla huutoraade henndu ɓuuɓndu 2. Uddit dame & windooji ɗii fof, yaltu suudu nduu fotde 30 MINIT ngam ɓuuɓnude 3. Waɗde ɓoorno-ɗaa Gannde Nitrile + N100/P400. Fiyru 1:10 Solution Bleach (1 koppi bleach haa 9 koppi ndiyam) dow ƴiiƴam/ɓulli haa ɗi ɓuuɓa no feewi -> Waɗde 5 haa 10 MINITES TIMMƊI 5. Wiftu e ɓuuɓri kaayitaaji ɓuuɓɗi -> Double-bag -> Moptu leydi tiiɗndi e gloves junngo re mo"]

    Scenario -->|"HEƁDE MANDE (Aset 1 haa 8 Caggal nde Rodent / Kabin / Shed / Leɗɗe njiyti)"| ProdromeCheck{"Hol Daawe Maandeeji Ina Woni?"}

    ProdromeCheck -->|"DAANDE 1 FEBRILE PRODROME (Balɗe 1 haa 5): Ɓuuɓri (>38 C / 100.4 F), Ɓuuɓri, Ɓuuɓri mawndi (Koppi, Hips, Ɓaawo), Ɓuuɓri hoore, Ɓuuɓri/Ɓuuɓri reedu, Ɓuuɓri (Tesko: Ko heewi NO so th runny)"| ERTriage["URGENT HOSPITAL ER TRIAGE (DO NOT LET CLINIC DISMISS AS 'THE FLU'): 1. Go to Hospital Emergency Department Immediately 2. Disclose rodent/cabin exposure -> Request STAT CBC with Manual Blood Smear + Chest X-Ray 3. Check CBC for the 5-of-5 Hantavirus Triad : - Ɓoornugol ƴiiƴam (<150 000/uL - teskuyaaji gadani) - Hematokrit/Hemoglobin ɓeydotooɗo (Hemokonsentrasi ummoraade e ɓuuɓri kapilaar) - Limre WBC gonnde e nano tawa ina waɗi >10% limfositteeji atipikal (Immunoblastes)"]

    ProdromeCheck -->|"DAANDE 2 ƁURƊO ƁURDE ƁURDE (Balɗe 4 haa 7 - Winndere waktuuji 4) : Ɓoornugol yoorngol, ɓuuɓri fooftere, fooftere yaawnde (>22/min), SpO2 <94%, ɓuuɓri ƴiiƴam ɗiɗi, ɓuuɓri ƴiiƴam, walla ɓuuɓri ƴiiƴam"| ECMORush["ECMO & ICU ƁURI NGURNDAM (38% Maayde): 1. Noddu 911 / 112 / 999 -> Ɗaɓɓu jolngo ko yaawi to nokku ECMO Tertiaire 2. KUULLE ICU TEŊKUƊE: - KEERTIƊO ƊIƊI TIIMƊI (Woto m0p3idlo bolus) - Vasopressor + Inotrope (Norepinefrin + Dobutamin) ngam ɓuuɓri ɓernde/kapilaar - Kanyulaasiyoŋ VA-ECMO arano so tawii Indeks ɓernde <2,0 L/min/m2 walla PaO2/FiO2 <60"]

    ERTriage -->|"So tawii ko ƴiiƴam ɓuuɓɗam (<150k) walla laabi Kerley B hakkundeeji e dow X-Ray ɓernde"| ECMORush

Feccere 1: No anndirten mborosaaji ɓurɗi bonde e nokkuuji ɗo mborosaaji cuuɗii (Why You Never Have to Touch a Mouse to Get Hantavirus)¶

Timmi 70% e ñawɓe wonduɓe e rafi pulmonaire Hantavirus ina kollita wonde ɓe meeɗaa meemde mooso guurɗo walla maayɗo. E nder ɗuum, eɓe poofa ɓuuɓri mikroskoop nde ɓe ngollata, ɓe ɗaanii, walla ɓe laɓɓinii e nder nokku keeriiɗo ɗo ɓowɗi ladde ɓuuɓnoo walla ɓuuɓnoo yontereeji ko adii ɗuum.

1. Leƴƴi Vektoraaji Aranndeeji (New World HPS vs. Old World HFRS)¶

Hantavirus ina feccii e galleeji ɗiɗi geɗe jookli e galleeji kilinik, heen gooto fof ina jogii nokku keeriiɗo mo mboros ladde (note: common domestic pet hamsters/gerbils and urban house mice *Mus musculus* do NOT carry Sin Nombre HPS virus):

2. Nokkuuji jeeɗiɗi cuuɗiiɗi yimɓe ina foofa Hantavirus tawa ɓe nganndaa ɗum¶

1. Udditde Kabin Seasonal, Shack Hunting, Outbuilding, walla Barn e nder ndunngu/duuɓi: Udditde fannu ceiling, ɓuuɓnude ɓuuɓri/matelas ɗo ɓowɗi njahata e ndunngu, walla ɓuuɓnude les suudu kuɓɓam.
2. Otooji & RV Ɓoornugol henndu e Filteruuji henndu kabine (A Major Overlooked Source): Miijooji deer ina keewi ƴaañde e nder galle ɓuuɓɗo HVAC blower, cowl air intake, e nokku moteriiji otooji, kammu, tarakteeruuji ndema, e RVs, ina maha ɓulli ɓuuɓɗi e dow filter henndu kabin. So a fuɗɗiima oto oo, a huɓɓii ƴulɓe walla fannu A/C, ƴulɓe ɗee ina ɓuuɓna ƴiiƴam mooso aerosol e ƴiiƴam ɗam, feewde e yeeso maa. Woto meeɗ fuɗde filtirde henndu kabine oto mo mooso woni e mum e henndu ɓuuɓndu: ɓuuɓnude henndu nduu les ɓuuɓri ndii e Lysol/disinfectant tawa aɗa ɓoornii mask N100/P100 e gannde.
3. Waɗde Armloads Leɗɗe Stacked E dow Koppi Ma: Miijooji ina njillondiri e nder ɓulli leɗɗe yaajɗi; ƴeftude leɗɗe joorɗe e ɓuuɓnude ɓuuɓri ɓalndu e dow coftal maa aerosols urine yoorɗo les nofru maa tan.
4. Laɓɓinde kaayitaaji karton e nder cuuɗi dowri, e nder cuuɗi les, e nder cuuɗi gonɗi e nder galleeji, walla e nder cuuɗi desorɗe hoore mum.
5. Ɗaanaade ko yaawi e dow leydi walla e dow leydi e nder suudu hoɗorde, Barn, walla Cabin mo alaa ko siifi.

Feccere 2: Porotokol laawɗuɗo CDC ngam laaɓtinde mborosaaji ɓuuɓɗi-ɓuuɓri¶

Hol no Hantavirus wuurirta e yaasi mooso? E nder lewru toowndu, lewru UV ina wara mboros oo e nder... 2 to 3 hours. Kono, nder suudu niɓɓuru, cooyndu, yoorndu, suudu, lowre, walla glovebox oto, Hantavirus gonɗo e nder ƴiiƴam yoorɗam walla e nder ƴiiƴam ina heddii ina wuuri ina safra ngam... 2 to 3 full days e nguleeki suudu (e haa... 2 weeks e nder nokkuuji toowɗi).

Hoto meeɗ meemde ɓuuɓri walla aspirateur. Rewru e ndeeɗoo 6-Ɗatal Dekontaminaasiyoŋ ɓuuɓɗo:

+-------------------------------------------------------------------------+
|  CDC STEP-BY-STEP WET-BLEACH RODENT DROPPINGS CLEANUP PROTOCOL          |
|                                                                         |
|  STEP 1: CROSS-VENTILATE FOR 30 MINUTES BEFORE ENTERING                 |
|  - Open all exterior doors, garage doors, and windows wide.             |
|  - Walk OUTSIDE and stay out for at least 30 FULL MINUTES so fresh air  |
|    exchanges the stagnant indoor air (never turn on indoor fans while   |
|    you are inside the room).                                            |
|                                                                         |
|  STEP 2: PUT ON PERSONAL PROTECTIVE EQUIPMENT (PPE)                     |
|  - Wear non-absorbent Nitrile, Latex, or Rubber Household Gloves.       |
|  - For light mouse droppings in a ventilated kitchen: gloves + eye      |
|    protection are sufficient if you strictly wet-spray without sweeping.|
|  - For HEAVY rodent infestations (piles of nests, dead mice, crawlspaces|
|    or unventilated attics): wear a tight-fitting NIOSH N100 or P100     |
|    Particulate Respirator (or European FFP3 mask) and unvented goggles. |
|                                                                         |
|  STEP 3: MIX FRESH 1:10 BLEACH SOLUTION & SOAK FOR 5 TO 10 MINUTES      |
|  - Mix 1 part household liquid chlorine bleach (5% to 8.25% sodium      |
|    hypochlorite) with 9 parts water (e.g., 1.5 cups / 360 mL of bleach  |
|    in 1 gallon / 3.8 Liters of water) in a pump/trigger spray bottle    |
|    (OR use a commercial phenol/quaternary disinfectant like Lysol if    |
|    bleach will ruin fabric/upholstery).                                 |
|  - Gently mist and SOAK all droppings, urine stains, nests, and dead    |
|    rodents until thoroughly wet (do not blast them with a hard jet).    |
|  - WAIT 5 TO 10 FULL MINUTES for the bleach to inactivate the virus.    |
|                                                                         |
|  STEP 4: WIPE UP WITH PAPER TOWELS & DOUBLE-BAG                         |
|  - Use disposable paper towels to pick up the wet droppings, nest, and  |
|    dead mouse. Place everything inside a plastic bag, seal it shut,     |
|    place that bag inside a SECOND plastic trash bag, seal it, and       |
|    place in an outdoor covered trash bin.                               |
|                                                                         |
|  STEP 5: WET-MOP FLOORS & STEAM/LAUNDER FABRICS                         |
|  - Mop hard floors and wipe countertops with the 1:10 bleach solution.  |
|  - Wash bedding/clothing in HOT water (`>= 60 C / 140 F`) with laundry  |
|    detergent and dry on HIGH heat (or leave heavy rugs/mattresses out   |
|    in direct bright noon sunlight for several hours after disinfecting).|
|                                                                         |
|  STEP 6: SAFE GLOVE REMOVAL                                             |
|  - Wash your GLOVED hands thoroughly with soap and water (or bleach     |
|    solution) FIRST, peel off the gloves turning them inside out, and    |
|    then wash your bare hands with soap and warm water for 30 seconds.   |
+-------------------------------------------------------------------------+

Feccere 3: Anndude Faandaareeji ɗiɗi Hantavirus (Why Urgent Care Doctors Mistake Phase 1 for the Flu)¶

Sabu dumunna ɓuuɓgol Hantavirus ko ** .1 to 8 weeks (median 14 to 21 days)** caggal nde ɓe foofi ɓuuɓri, ñawɓe ina keewi yejjitde ɓe laɓɓinii ɓuuɓri yontereeji tati ko adii nde nguleeki maɓɓe fuɗɗotoo. Siftor fasaadeeji ɗiɗi ceertuɗi e ñawu nguu e no anndirtee Hantavirus ko aldaa e grippe no woorunoo walla COVID-19 :

1. Faandaare 1: Prodrome febrile (Days 1 to 5 - Winndere kaŋŋe diagnostic)¶

Ngam balɗe 3 haa 5 gadane ɗee (range 1 to 7 days), ñawɗo oo ina jogii ɓuuɓri zero e ɓuuɓri fooftere zero, kadi ƴeewndo ɓalndu ina heewi nanndude e ko woodi no feewi : - Maandeeji winndereeji (Present in >90% of Patients): - Fever toowɗo ɗoon e ɗoon (38.3 to 40.0 C / 101 to 104 F) e ɓuuɓri ɓuuɓndi. - Naafigaagal ɓalndu tiiɗngal, luggiɗngal (myalgias) ina toɗɗii pelle ƴiye MAWƊE (thighs, hips, lower back, and shoulders). - Naamne hoore yeeso ɓuuɓɗe, tampere luggiɗnde, e diwgol / ɓuuɓgol hoore (orthostasis). - Ko GI Clue (Present in 50% of Patients): - Nausee, ɓuuɓri keewndi, ɓuuɓri ndiyam, e nafoore reedu diffuse (waktuuji goɗɗi ina tiiɗi haa ina nanndi e apendisit ɓuuɓɗo walla gastroenteritis). - KO #1 KLINIKAL CLUE WONI WONAA COOL WALAA FLU (Absence of Upper Respiratory Symptoms): - Ina wayi no grippe, COVID-19, RSV, walla mboros bonɗo, ñawɓe prodrome Hantavirus ina famɗi ɗo MEƊƊI heɓde ɓuuɓri (rhinorrhea), ɓuuɓri nofru, ɓuuɓri, ɓuuɓri daande (pharyngitis), walla ɓuuɓri sinus. - Kuulal kilinik: Fever + Severe Thigh/Back Muscle Aches + Nausea/Vomiting + ZERO Runny Nose or Sore Throat (1 to 8 weeks after rural/rodent exposure) = Tuumaaɗo Hantavirus Haa Selli ko wonaa ɗuum.

2. Faandaare 2 : Ɓooygol kapilaar-leak ɓernde (Starts Abruptly on Day 4 to 6)¶

So jeertinaani - heewi ko no nguleeki ñawɗo oo fuɗɗorii ɓuuɓde nii - ñawɗo oo naata e Fase Cardiopulmonaire : - Waktu 0 haa Waktu 2: Kosam ɓuuɓɗam, ɗam alaa ko nafata fuɗɗotoo, ina wondi e ɓuuɓri ɓalndu seeɗa e ɓeydagol foofaango (> 20 to 24 breaths per minute). - Waktu 2 haa Waktu 6: Ɓowɗi endoteliyal kapilaaruuji e nder ɓuuɓri ɗiɗmiri ndii ina ustoo timmugol baroowo : Plasma ƴiiƴam keewɗo poroteyiin (with an edema-fluid-to-serum protein ratio > 0.8) ina yalta e ƴiiƴam ina naata e nder ɓuuɓri ƴiiƴam e alveoli. Ɓooygol oksijen (SpO2) ina ɓuuɓtoo gila 97% les e nder... 80s e 70s, ñawɗo oo fuɗɗotoo ko ɓuuɓde ndiyam ɓuuɓɗam ɓuuɓɗam walla ɓuuɓɗam ɓuuɓɗam, e rafiiji ɓalndu ina njaawna gila e cuffing peribronchial e laabi Kerley B haa e ilam alveolar bilateral timmuɗam ("white-out") e nder waktuuji 4 haa 8. - Waktu 6 haa Waktu 24 (Fooyre Ɓoornugol Miokardi): Ina wayi no ɓuuɓri septik bakteriiji (which causes "warm shock" with high cardiac output and low vascular resistance), Hantavirus ina yaltina faktoriyaal ɓuuɓɗo miokardi, baɗɗo Shock Cardiogenic luggiɗiiɗo (low Cardiac Index < 2.0 L/min/m2, Resistance Vasculaire Sistemique toownde SVR, ƴiye ɓuuɓɗe ɓuuɓɗe, asidosis laktik, e bradikardiya/golle kuuraa ɗe ngalaa pulse PEA nanngugol, haa teeŋti noon e sahaa ɓuuɓri endotrakeal).

Feccere 4: "Triad ƴiiƴam periferik Hantavirus" (How Any Hospital Lab Can Spot Hantavirus in 45 Minutes)¶

Tabitinoowo Serologie ELISA IgM/IgG hantavirus e RT-PCR neldaama to departemaa cellal leydi walla to laboratuwaar ƴeewndo ƴetta 24 to 72 hours - e ñawɗo e nder Fase Kardiyopulmonaire ina waawi maayde e nder waktuuji 6. Ko moƴƴi heen tan, wiɗtooɓe to Duɗal jaaɓi-haaɗtirde New Mexico (UNM, nokku ECMO Sin Nombre Hantavirus ɓurɗo mawnude e winndere ndee) hollitii wonde njuɓɓudi Limto ƴiiƴam timmungo (CBC) e ƴiiƴam periferik junngo waɗaama e kala laboratuwaar safrirde e nder hojomaaji 45 ina yiytoo Hantavirus e > 95% sensitivite e keertinagol nde ko famɗi fof 4 e ɗeeɗoo 5 sifaaji hematoloji (including the "Hantavirus Triad") ina tawee heen:

Limooje emergency diiwaan e porotokolle agence¶

Hantavirus ko ñawu nguu ina waawi humpiteede e nder leydi ndii, tawa ina waɗi resooji toppitiiɗi toppitagol e laboratuwaaruuji tuugnorgal :

• Leyɗeele dentuɗe Amerik:
• Neldugol : Noddu 911 e ɗaɓɓude yahdu to nokku safrirde toownde tawa ina waɗi ECMO Veno-Arterial mawɓe/sukaaɓe (VA-ECMO) mbaawka (in the American Southwest, the University of New Mexico Health Sciences Center in Albuquerque is the regional HPS ECMO referral hub).
• Kaaldigal CDC: Cafrooɓe opitaal ina mbaawi jokkondirde e Catal CDC ko feewti e ñawuuji keertiiɗi (VSPB) rewrude e nokku gollordu CDC 24/7 (770-488-7100) walla Laylaytol Hantavirus CDC (877-232-3322) ngam ƴeewde serologie/PCR e ardorde njuɓɓudi safaara.
• Kanaada:
• Noddu 911. Nguurndam Cellal Jaaynde Kanadaa (PHAC) Laboratuwaar ngenndiijo Mikrobiyoloji (Winnipeg) ina waɗa ƴeewndorɗe mboros Sin Nombre e nder sahaa ɓuuɓɗo ; resooji jolngooji ICU ECMO diiwaan ina njuɓɓina ƴeewndo jaawngo e nder Kanadaa hirnaange e hakkundeejo.
• Dental Dowlaaji Dentuɗi & Dental Orop:
• Noddu 999 (Angalteer) walla 112 (UE). To Orop worgo e hakkundeejo (Finlande, Suwed, Almaañ, Farayse, Belsik), virus Puumala (Bank Vole) ina addana Rafi Nefropati (acute kidney injury, thrombocytopenia, fever, back pain, and transient blurred vision), tawi ko e Balkan en e Orop Fuɗnaange-rewo (Slovenia, Croatia, Serbia, Greece), Virus Dobrava-Belgrade ina addana Ɓuuɓri ƴiiƴam tiiɗndi e mboros renal (HFRS) ina ɗaɓɓi hemodiyaalisis ko yaawi e ballal ICU (Laboratoori Pathogens rares et importés UKHSA / ECDC).
• Amerik worgo e hakkundeejo (Andes Virus Zone):
• To Siili, Arjantiin, Beresiil, Paraguwaay, Uruguwaay, e Panama, Virus Andes (ANDV) e ortohantavirus jokkondirɗo e mum ina addana HPS tiiɗɗo (Emergency: 131 to leydi Siili, 107 / 911 to leydi Arjantiin, 192 to Beresiil). Protokol teskinɗo: Sabu Virus Andes ina waawi saabaade neɗɗo e neɗɗo e nder sahaa prodrome e sahaa gonaaɗo e opitaal, gollotooɓe cellal e jokkondirɓe e galleeji ɓadtiiɗi to Amerik worgo ina kuutoroo Airborne + Droplet + Contact Precautions (N95/FFP2 respirator, eye protection, gown, gloves) e karantina/monitoring caggal nde njiy-ɗaa.
• Siin, Koree worgo, Japon, e Asii-Pacifik:
• Virus Hantaan e Virus Seoul ina ngadda Fever hemorragique e sindrom renal (HFRS) e nder laddeeji e gure Asii fuɗnaange (120 to Siin, 119 to Koree worgo e Japon). Ostarali e Nuwel Selannde ngalaa hantavirus (000 / 111), hay so tawii noon yahooɓe ummoriiɓe Amerik walla Orop ina ɗaɓɓi triage ko yaawi. Ƴeew limooje caɗtuɗe.

Naamne keewɗe naamneede¶

Hol ko waɗi mi waawaa huutoraade aspirateur jogiiɗo filter HEPA ngam laɓɓinde ƴiiƴam mooso yoorɗam ?¶

Hay so tawii vacuum galle walla butelaaji ina jogii filtirde HEPA, roll brosse spinning e ɓuuɓol henndu suusngol toowngol e nofru leydi ina ɓuuɓna e **aerosolize ɓuuɓol mikroskopiiji vacuum ɓuuɓɗo e ƴiiƴam ɓowɗi joorɗi e ƴiiƴam ƴiiƴam njuumri e dow leydi ho ko adii nde ɗi meeɗata en -round e dow leydi ho seals ina ɓuuɓna aerosol viral ina yalta e nder suudu nduu. Yanti heen, udditaade saak vacuum walla kanister caggal ɗuum ina feeñnina on laawol ɗiɗaɓol. **Woto meeɗ ɓuuɓnude walla ɓuuɓnude ƴiiƴam mboros** : sahaa kala ɓuuɓnude ɗum fotde hojomaaji 30, ɓuuɓnude ɗum e **1:10 ɓuuɓri galle** haa nde ɓuuɓta, ɗaɓɓu **hojomaaji 5 haa 10**, ɓuuɓnude ɗum e ɓuuɓri kaayitaaji ɓuuɓɗi.

Hol no doktoor waawirta anndude ko seerndi Hantavirus puɗɗoriiɗo e grippe regular walla mboros reedu e nder balɗe 3 gadane ɗee ?¶

To bannge safaara, Hantavirus gadano (`Days 1 to 4`) ina addana nguleeki mawki, ɓuuɓri ɓalndu tiiɗndi e nder **pelle ɓalndu mawɗe (`thighs, hips, and lower back`)**, ɓuuɓri hoore, e heewde ɓuuɓri, ɓuuɓri, walla ɓuuɓri reedu, **e ƁURI WAƊDE maale fooftere toownde (`no runny nose, no stuffy nose, no sneezing, and no sore throat`)**. E dow ƴeewndo ƴiiƴam **45 minit (`Complete Blood Count / CBC`)**, ñawɗo Hantavirus ina fotnoo hollirde **limto ƴiiƴam (`thrombocytopenia < 150,000/uL`)** e nder balɗe gadane ɗee kala, rewi heen ko ɓeydagol hematokrit, limto ƴiiƴam ɓalejam toowɗam e ƴiiƴam banngeeji ɗi mbaylaaki, e limfositteeji ɗi ngalaa sifaa (`immunoblasts`).

Hol ko waɗi ɗum ina bonna so tawii suudu safrirdu rokkii ñawɗo Hantavirus saakuuji mawɗi ndiyam saline IV no ɓe mbaɗata e sepsis jooni jooni nii ?¶

E nder sepsis bakteriiji gaadoraaɗi, ñawɓe ina njogii ƴiiƴam ɓuuɓɗam, ina naftoroo... `2 to 3 liters` e saline nder ƴiiƴam. Kono e nder **Hantavirus Pulmonary Syndrome**, mboros oo ina addana **ɓuuɓri kapilaar mawndi tan e nder ƴiiƴam ɓuuɓɗam ɗam**, tawa kadi ina leefna semmbe pompirde ɓalndu ɓernde. So doktoor werlii `2 to 3 liters` e IV saline e nder ƴiye ñawɗo Hantavirus, oon ndiyam ina yalta no feewi e nder ƴiye ɓuuɓɗe, ina naata e nder saakuuji henndu (`alveoli`), ina addana **ɓuuɓri ɓuuɓndi ɓuuɓndi ndi ɓuuɓnata ñawɗo oo e nder waktuuji seeɗa**. E nder ɗuum, safrooɓe ICU ina kuutoroo **reentaade ndiyam tiiɗɗam**, **leɗɗe vasopressor e inotropic (`Norepinephrine + Dobutamine`)**, e fuɗɗoode **VA-ECMO ɓernde-ɓuuɓri**.

Mbele Hantavirus ina waawi saabaade neɗɗo gooto fayde e goɗɗo, walla ummoraade e puccu am walla e puccu am?¶

**Hantavirusuuji Amerik worgo (`such as Sin Nombre virus carried by deer mice in the US and Canada`) e Hantavirus Orop/Aasi (`Puumala, Hantaan, Seoul`) WOTO saaktu neɗɗo e neɗɗo** - a waawaa nanngude HPS Amerik worgo e muñde, meemde, walla toppitaade ñawɗo mo ñawu nguu heɓi. *(Ko seerti e winndere ndee tan ko **Virus Andes Amerik worgo** to Siili e Arjantiin, baawɗo saabaade hakkunde jokkondiral galleeji ɓadtiiɗi, ina ɗaɓɓi kadi seertude e weeyo/toɓɓere.)* Kulle e pucci **ñawndataa e Hantavirus, kadi ɓuuɓnataa mboros o e nder ƴiiƴam mum en**, hay so tawii noon cagccaly do infectedly a mouse e nder galle maa walla e nder werlaa maa.

So mi tawii ɓuuɓri mooso dow filtirde henndu kabin oto am walla les ɓuuɓri, hol no laɓɓinir-mi ɗum e kisal ?¶

Hoto meeɗ fuɗɗaade ƴulɓe nder oto walla fannu A/C blower so a sikkii ɓowɗi ina njibina e nder boowal henndu HVAC, kadi **hoto meeɗ fuɗde e nder lowre moteri walla filtirde henndu kabine e kompresor henndu**. Puɗɗorto-ɗaa walla darnu-ɗaa oto oo **yaasi e nder weeyo ngo naange jalboo**, udditaa kaɓirgal ngal e dame otooji ɗii fof fotde **30 minit**, ɓoorno-ɗaa **gannde nitril e fooftorde N100/P100**, ɓuuɓna suudu filtirde ɓuuɓri e suudu filtirde suudu nduu no moƴƴi e ɓuuɓri disinfektan njulaagu (`like Lysol`) mala `1:10` ɓuuɓri ɓuuɓri (`avoiding bare electrical connectors`), ɗaɓɓu **hojomaaji 10**, ƴettu ɓuuɓri ndii e filtirde ɓooynde ndee e nder saak ɓuuɓɗo, mbaɗtaa filtirde henndu kabine keso hade maa udditde ɓuuɓri nder suudu nduu.

Ngol ɗoo tinndinoore ina rokka humpitooji ko faati e safaara e kisal nokkuuji, tee lomtinaani toppitagol safaara e nder safrirde karallaagal walla jokkondiral e safaara tiiɗɗo. Sabu Hantavirus Pulmonary Syndrome ina waawi yahrude yeeso gila e ɓuuɓri seeɗa haa e ɓuuɓri fooftere e ɓuuɓri ɓernde e nder waktuuji 4, eɗen mbaawi wasiyaade no feewi ƴettude ballal gadanal e CPR, tawa ko e ballal juuɗe, to Croix-Rouge, St John Ambulance, walla to jannginoowo nokkuyankeewo jaɓaaɗo.

Ardiiɓe jokkondirɓe¶

• Leptospirosis (rafi Weil) caggal nde neɗɗo yani e ndiyam ilam walla ndiyam laaɓɗam : gite boɗeeje e ɓuuɓri calɗi
• Sepsis e septik shock anndinde e triage urgence
• Kosam ɓuuɓɗam (tooke mboros), superwarfarin, e ñaamde fosfiid sink
• Ɓoornugol daabaaji, ndiyam gaañiiɓe, e reentaade ñawu nguu caggal nde ngu heɓi ɗum
• Limooje emergency

Fuɗɗoode e ardorde laawɗunde¶

• Centres ngam haɓaade e reentaade ñawuuji (CDC Catal Patogenuuji keertiiɗi viral, leyɗeele dentuɗe Amerik): Laɓɓingol caggal mborosaaji: Porotokol laawɗuɗo 1:10 ngam haɓaade ñawu nguu e Sindrome pulmonaire Hantavirus (HPS) Ñawndugol safaara, Triad ƴiiƴam periferik, e njuɓɓudi ndiyam ICU (cdc.gov/hantavirus).
• Duɗal jaaɓi haaɗtirde New Mexico (UNM) Nokku ganndal cellal & Porogaraam wiɗtooji safaara Hantavirus (Koster, Hjelle, Crowley, & Wernly): Laabi ƴeewndo ƴiiƴam periferik jaawɗo (5-of-5 Rule) e Oksijenaasiyoŋ gonɗo e nder ɓalndu (VA-ECMO) Hisnude ngam ñawu Hantavirus Refrakteer ɓernde e ƴiiƴam.
• Fedde Cellal Amerik (PAHO) & Fedde Adunaare Cellal (WHO): Hantavirus e nder leyɗeele Amerik: Laabi ngam ƴeewndaade, safrude, haɓaade, e haɓaade (ina heen reentaade neɗɗo e neɗɗo ngam Virus Andes Amerik worgo).
• Centre Orop ngam haɓaade e haɓaade ñawuuji (ECDC) & Duɗal Robert Koch (RKI, Almaañ): Kaayitaaji e ardorde safaara ko faati e ortohantavirus winndere ɓooynde (Puumala Nefropati Epidemik e... Dobrava Feere ƴiiƴam e mboros renal).
• Duɗal ngenndiwal kisal e cellal golle (NIOSH, leyɗeele dentuɗe Amerik): Haɗde ñawu nguu ina wiyee Hantavirus (HPS) E nder gollotooɓe jokkondirɓe e ɓowɗi walla laɓɓinooɓe mbaydiiji e otooji ɗi ɓowɗi njibini (N100/P100 Suɓngo fooftorde).