Nyoka, Macaque, mpe Baboon eswa to e gratter na ba temples: Virus ya Herpès B (Macacine Alphaherpesvirus 1), Valacyclovir, mpe Rabies RIG¶

Koswama, kokatakata, to kobwakelama nsoi na miso na nyama oyo ekendeke na bonsomi na tempelo ya ba touristes, na esika oyo babombaka nature, to na parc urbain, mingimingi Mokili ya Kala Rhesus Macaque (Macaca mulatta), Makaque ya mikila milai / oyo elyaka krab (Macaca fascicularis), Makaque ya Japon (Macaca fuscata), Makaque ya Barbaire (Macaca sylvanus), to Baboon (Papio lolenge) na ngambo mosusu ya Bali (Ubud), Thaïlande (Lopburi, Phuket), Inde (Varanasi, Jaipur, Shimla), Gibraltar, na Japon (Arashiyama), Népal, to Afrika, ezali likambo ya mbalakaka ya neuro-virologique mibale. En plus ya komema virus ya Rabies (100 percent fatal once neurological symptoms appear) mpe mikrobe oyo eswamaka na mozindo oyo euti na mikrobe mingi, 70 kino 90 % ya banyoka oyo bakómi mikóló oyo babengi Old World Macaque (genus Macaca) ezali ba porteurs asymptomatiques ya Macacine alphaherpesvirus 1 (Herpes B Virus / . Cercopithecine herpesvirus 1). Atako Herpès B epesaka eloko mosusu te bobele bampota ya malili ya monoko oyo ezali na likama te na macaques, ntango ekɔtisami na moto na nzela ya koswama ya nyama, koswama oyo ezali na nsɔi, to kosopana ya miso, infection ya virus ya Herpès B ya moto oyo ezwami te esalaka ete encéphalomyélite oyo ezali komata mpe paralysie respiratoire mpe taux ya liwa oyo eleki 70 kino 80 %.

Soki yo to moninga na yo ya mobembo ozali na mpasi ya kobukana ya loposo, koganga, to kosopana ya muqueuse/miso mpo na nyama to baboon ya macaque, bandá kopangusa mpota na boumeli ya miniti 15 na sabuni mpe povidone-iode to chlorhexidine na boumeli ya miniti 5 ya liboso, na nsima kende mbala moko na lopitalo ya mikili mingi to na kliniki ya mobembo mpo na kozwa dose ya monene ya komela Valacyclovir ( .1 g PO three times daily for 14 days) mpe Prophylaxie ya Rabie sima ya exposition (Human Rabies Immune Globulin [HRIG] + 4-dose rabies vaccine). Mpo na ambulance ya esika ofandi to lisalisi ya monganga, benga nimero ya mbalakaka ya esika ofandi (112 to mpe 119 na Indonésie, . 1669 na Thaïlande, . 112 na Inde mpe na Union européenne / Gibraltar, . 119 na Japon, . 999 na Royaume-Uni, . 911 na États-Unis mpe na Canada) to talelá répertoire na biso ya mokili mobimba ya banimero ya mbalakaka. Mpo na ba protocoles ya monene ya koswa banyama mpe ya rage, tala exposition ya rage mpe prophylaxie après exposition, . koswama ya banyama mpe bobateli ya bokono ya ba mpota, mpe kopekisa makila makasi.

Sala boye sikoyo¶

1. BOSALA POTA NA MAKASI PONA 15 MINUTES MOBIMBA MBONGO (THE SINGLE MOST IMPORTANT STEP): Kozela te kino okokoma na clinique mpo na kosukola mpota. Virus ya herpès B mpe virus ya rage ezali ba virus oyo ezipami na lipide oyo efandaka na kati ya baselile ya loposo ya likolo na boumeli ya mwa miniti ya liboso liboso ya kokota na nsuka ya misisa ya périphérique. Mbala moko kosukola mpe kopangusa esika oyo oswaki to kokatakata ntango nyonso na boumeli ya miniti 15 mobimba na ngonga** na kosaleláká povidone-iode (Betadine), gluconate ya chlorhexidine ( .Hibiclens), to sabuni ya kosukola oyo ezali na biloko mingi (dish soap / laundry bar) mpe mai oyo ezali koleka.
2. SOKI ESPAYI NA LISO TO NA MONOKO, KOSOMBA NA MAYI YA PALA TO NA SALINE PENDANT 15 MINUTES (NO SOAP IN EYES): Soki macaque azali kosala since, kosopa, to kosopela mayi/saliva na liso, zolo, to monoko na yo, sukola liso to muqueuse oyo efungwami ntango nyonso na boumeli ya 15 minutes na mayi ya peto ya komela ya milangi to na saline normale stérile (kotia ata moke te détergent ya makasi, masanga, to solution ya scrub ya lipaso na liso, oyo ebebisaka cornée).
3. TIKA JAMAIS SUTURE TO GLUE YA CLINIQUE EKANGA NA KOSIMBA YA NZOTO: Kokanga morsure ya primate na ba points to colle ya loposo esimbaka virus ya Herpès B, virus ya rage, mpe ba anaérobes oraux (Eikenella corrodens, Bacteroides, Pasteurella) contre ba fibres nerveuses mpe ba tendons oyo ebebi. Tika mpota polele mpo etanga mayi (to tika kaka approximation ya kokangama sima ya infiltration na Rabies Immune Globuline).
4. BANDA VALACYCLOVIR YA ORAL (1 GRAM THREE TIMES DAILY) NA KATI YA 24 TO 72 HEURS PONA BA EXPOSURES YA MACAQUE: Kaka ba singes ya genre Macaca (Macaques na Azia mobimba mpe na Gibraltar) ememaka virus ya Herpès B. Insister na kobanda Prophylaxie après exposition (PEP) na Valacyclovir oyo ezwamaka na monɔkɔ 1,000 mg (1 g) every 8 hours (TID) for 14 days (to Acyclovir ya monoko 800 mg 5 times daily for 14 days) malamu mingi na kati ya 24 heures (and up to 72 hours) ya exposition, avant virus ekatisa na système nerveux central.
5. BOSENGA BA RABIES MIBALE IMMUNE GLOBULIN (HRIG / . ERIG) NA VACCINE YA RABIES NA MOKOLO YA 0: Nyoka to baboon nionso oyo eswami to e gratter oyo ebendaka makila na Asie, Afrique, to Amérique latine ezali OMS Catégorie III Exposition ya Rabies. Soki ozwaki mangwele ya rage avant exposition te, mangwele ya rabie yango moko ekoki TE, esengeli pe ozwa Globuline Immune ya Rabies (HRIG 20 IU/kg to mpe ERIG 40 IU/kg) ekɔtaki mbala moko na kati mpe zingazinga ya mpota na Mokolo ya 0 mpo na kosilisa virus na boumeli ya mikolo 7 to 14 liboso ete nzoto na yo esala ba anticorps na yango moko.
6. KOZUA AMOXICILLIN-CLAVULANATE ( .AUGMENTIN) NA TETANUS BOOSTER: Minɔkɔ ya ba primates emekolaka flora oyo bato baswa (the most infectious mammalian bite); kozwa amoxicilline-clavulanate 875/125 mg PO BID for 5 to 7 days mpe vérifier immunisation na yo ya tetanos (Tdap).

Nzete ya mokano: kosilisa koswa to koswa na nyoka, macaque, mpe baboon¶

Landa nzete oyo ya décision clinique mpe ya terrain na moment oyo bokutani ya primate esali que ezala na morsure, gratter, to splash ya muqueuse:

flowchart TD
    Exposure["Primate Bite, Gratter, to Saliva Splash na Loposo/Liso"] --> WashNow{"1. Kolongola bosoto nokinoki (Na boumeli ya miniti 0 kino 5) ."}
    WashNow -->|"Koswa Loposo, Kotɔbɔla, to Kokatakata"| Scrub15["KOPAPA NA MAKASI NA MINUTES 15 MOBIMBA: Salelá Povidone-Iode, Chlorhexidine, to Savon ya Detergent + Mai ya Kotanga -> Tika makila ebima na bonsomi -> Kokanga suture ata moke te"]
    WashNow -->|"Saliva Splash na Liso, Zolo, to Monɔkɔ"| FlushEye["IRRIGER EYE / MUCOSA PENDANT 15 MINUTES: Salelá Mai ya milangi ya pamba to Stérile 0,9% Saline KAKA (Kotia savon to iode ata moke te na miso)"]
    Scrub15 --> PrimateID{"2. Koyeba Groupe ya ba primates na géographie"}
    FlushEye --> PrimateID
    PrimateID -->|"MACAQUE ya mokili ya kala (Genre Macaca: Bali, Thaïlande, Inde, Japon, Gibraltar, Chine, Philippines)"| DualRisk["RISQUE MAKASI YA VIRUS YA HERPES B + RABIES + BACTÉRIE: Kende na Clinique / Hospital ya voyage international na kati ya 24 Heures"]
    PrimateID -->|"Primat oyo ezali ya macaque te (Baboon, Vervet, Langur, Capuchin, Singe ya écureuil, Marmoset)"| RabiesOnly["RISQUE YA HERPES B TE -> RISQUE YA MAKASI MPO NA RABIE + BACTÉRIE: Kende na lopitalo mpo na Rabies PEP + Antibiotiques"]
    DualRisk --> MedProtocol["3. Kopesa Régime médical complet après exposition (Mokolo ya 0) ."]
    RabiesOnly --> MedProtocol
    MedProtocol --> Regimen["1. HERPES B PEP (Macaques Kaka): Valacyclovir 1 g PO TID x mikolo 14 (to Acyclovir 800 mg PO 5x/mokolo x mikolo 14)\n2. PEP ya RABIES (OMS Cat III): Kokotisa HRIG (20 UI/kg) na mpota + Vaccin ya Rabies Mikolo 0, 3, 7, 14\n3. ANTIBIOTICS & TÉTANUS: Amoxicilline-Clavulanate 875/125 mg PO BID + Bobakisi ya Tdap"]
    Regimen --> NeuroWatch{"4. Moniteur pendant 21 jours: Ba vésicule, ba tingling, fièvre, double vision, to ba hiccups?"}
    NeuroWatch -->|"OUI: Bilembo ya Neuro / Loposo ya ebandeli"| IVGanciclovir["KOKOTA NA LOBOTOLO YA LIBOKE: Kobanda Komela Acyclovir IV na dose ya likolo (12,5-15 mg/kg q8h) to Ganciclovir IV (5 mg/kg q12h) Noki"]

Phase 1: Ba primates nini ememaka virus ya Herpès B vs. Rabies (Species and temple guide) .¶

Nyoka nyonso te na Mabele ememaka virus ya Herpès B, mpe etuka nyonso te ya ba primates ezali na endémique ya rage ndenge moko. Koyeba malamu primate nini o bit to o gratter nde e déterminer ordonnance na yo ya antiviral.

1. Matrice mondiale ya ba pathogènes ya ba primates: ba Macaques vs¶

2. Mpo na nini ba Macaques ya Tempelo babundisaka ba touristes (And How to Escape Without Being Bitten) .¶

Bolukiluki oyo esalemaki na zamba ya banyoka ya Ubud na Bali, na batempelo ya Lopburi ya Thaïlande, mpe na Libanga ya Likolo ya Gibraltar emonisi ete koleka 85 % ya koswama ya macaque esalemaka na boumeli ya bizaleli misato ya sikisiki ya bato: 1. Kosimba Bilei, Basaki ya Plastique, Milangi ya Mai, Lunettes ya Moyi, to Batelefone: Ba macaques ya tempelo bapesameli formasyo na mayele mpo na kobɔtɔla ba lunettes, ba chapeaux, ba téléphones, mpe ba sacs crinkly, kokanga yango otage tii ntango moto oyo azali kosimba yango akotɛka yango eteni ya mbuma (a learned bartering behavior). Soki nyamankɛkɛ azwi saki na yo, ba lunettes ya moi, to molangi ya mai, TIKA MBONGO. Kobenda nsima ebandisaka mbala moko koswa ya mozindo ya mbwa na lobɔkɔ to na liboso ya lobɔkɔ na yo. 2. Koseka Na Mino oyo ezali polele to Kotala na miso directe (Primate Threat Display): Na monoko ya nzoto ya macaque na baboon, kokanga contact direct ya miso mpe kobenda mbɛbu na yo sima mpo na kolakisa mino (a human smile for a selfie) ezali geste universel ya primate ya kobanga-aggression mpe défi. Bomba mbɛbu na yo ekangama likoló ya mino na yo, bokima kotala yo mbala moko, mpe kogumbama ata moke te na nivo ya miso elongo na macaque ya mobali oyo ekómi mokóló to mama oyo amemi bebe. 3. Komata na mapeka ya ba touristes (Head and Neck Bite Hazard): Kotika ata moke te motɛki ya tempelo atya manteka to banana na motó to na mapeka na yo mpo ete macaque emata na nkingo na yo. Koswa to koswa na motó, elongi, to nkingo ememaka likama ya liwa mingi mpo na virus ya Herpès B mpe Rabies mpo misisa ya motó (trigeminal, facial) kopesa nzela moko ya mokuse mpenza (just centimeters) mbala moko na kati ya mokuwa ya bɔɔngɔ liboso ete prophylaxie nsima ya kokutana na yango ebandaki kosala.

Eteni ya mibale: Lisalisi ya liboso na litambe na litambe mpe prophylaxie ya monganga (First 15 minutes to 72 hours) .¶

Ntango macaque to baboon ebukani loposo to esopani na muqueuse, landá ntango oyo ya sikisiki na kolanda ntango.

1. Minute 0 à Minute 15: Inactivation mécanique et chimique ya virus¶

   [ MINUTE 0: MACAQUE BITE, SCRATCH, OR SALIVA SPLASH ]
                            |
                            v
   +--------------------------------------------------------------------+
   |  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

• Pourquoi 15 Minutes Complètes Ezali Obligatoire: Ba Etuluku ya mosala ya virus ya Herpès B ya CDC (Cohen et al., Clinical Infectious Diseases) mpe Ebongiseli ya mokili mobimba mpo na bokolongono (WHO) Mabongisi ya rage elakisaka 15 minutes mobimba ya kosukola ntango nyonso mpe kopangusa na masini (salelá gaze ya peto to elamba ya pete mpo na kopangusa na malembe na kati ya esika ya kotɔbɔla mino to ya kokatakata, kopesa nzela na makila ya mikemike ya misisa mpo na kobimisa saliva).
• Ba Agents Virucides Nini Esalaka na Herpès B na Rabies?:
• Pona ya liboso mpo na Loposo: Povidone-iode (Betadine 7,5% kino 10%), chlorhexidine gluconate ( .2% to 4%), chlorure de benzalkonium, to detergent ya ndako oyo ezali na concentré / savon ya basaani ya mayi / sabuni ya bar na mayi ya kotanga mingi.
• Ezali boni soki ozali na nzela ya tempelo na bobele molangi ya mai mpe sanitizer ya maboko?: Sukola mbala moko na ndambo ya mayi na yo ya komela ya milangi ntango ozali kopakola mpota makasi, pakola 70% ya masanga ya kosukola maboko, mpe kokende mbangu na kati ya miniti 3 to 5 na kiosque ya secours ya liboso ya tempelo, esika ya kosukola ya toilette, to pharmacie ya penepene mpo na kosomba povidone-iodine mpe sabuni mpo na kosukola miniti 15 mobimba. (Note: Na Ubud Sacred Monkey Forest na Bali mpe na ba temples minene ya Thaïlande, clinique ya secours ya liboso oyo ezali na esika yango ezali na povidone-iode, kende kuna mbala moko, sukola pendant 15 minutes, mpe sima kende mbala moko na lopitalo international mpo na Valacyclovir mpe Rabies RIG, lokola ba stands ya temple etie kaka Betadine na loposo mpe ekabolaka antiviral to rabies TE mangwele).

2. Ngonga 1 kino Ngonga 72: Prophylaxie antivirale mpo na virus ya Herpès B (Valacyclovir vs. Acyclovir) .¶

Engebene na Centres ya Etats-Unis mpo na kopekisa mpe kopekisa bokono (CDC) mpe Centre national ya ba ressources ya virus B (Georgia State University) malako ya kliniki:

3. Prophylaxie ya Rabie na mbala moko sima ya exposition (HRIG + 4-Dose Vaccine Schedule) .¶

Alors que ba voyageurs na Etats-Unis to Europe batangaka mingi ba papiers oyo ezo débattre soki ba macaques ya laboratoire ya zamba vs captifs esengeli na soins ya Herpès B vs. Rabies, na ba temples touristiques ya Asie na africaine, esengeli o traité NIONSO MIBALE na mbala moko. Kotika te clinique ya mboka epesa yo kaka lisasi ya rage sans Valacyclovir, mpe komela kaka Valacyclovir sans Rabies PEP te:

1. Mpo na ba voyageurs oyo bazangi vaccin (No Prior Pre-Exposure Rabies Series):
2. Etape A: Immunité passive (Day 0 Only): Kokɔta Globuline immunitaire ya Rabie humaine (HRIG na 20 IU/kg kilo ya nzoto), to oyo epɛtolami Globuline Immune ya Rabies Equine (ERIG na 40 IU/kg) soki HRIG ezali te, directement na bozindo mpe na ba bords ya marque nionso ya koswa mpe ya ko gratter. Volume nyonso oyo etikali oyo ekoki kokota na ndenge ya anatomie te na (ba)mpota (na ndakisa, koswama na nsɔngɛ ya mosapi) ekɔtisamaka na misisa na esika oyo ezali mosika (such as the anterior thigh or deltoid opposite the vaccine arm).
3. Fenetre critique ya HRIG ya mikolo 7: Soki clinique ya mosika esika ozuaka vaccin na yo ya rabie ya Mokolo 0 ezali na stock ya HRIG te (a common issue at small island clinics in Indonesia or rural India), ozali na yango kino Mokolo ya 7 nsima ya dose ya liboso ya mangwele mpo na kopumbwa to kokende na lopitalo monene (Denpasar, Bangkok, Singapore, New Delhi, or home) mpo na kozwa HRIG injecté. Kopesa HRIG te sima ya Mokolo ya 7, mpo ekopekisa eyano na yo moko ya anticorps ya mangwele oyo ezali kosala.
4. Etape B: Immunisation active (4-Dose Intramuscular Vaccine Series): Kopesa nkisi 1.0 mL (to 0.5 mL na kotalela marque: Verorab, . Rabipur/RabAvert, . Imovax) na kati ya misisa na kati ya misisa ya deltoïde (never into the gluteal/buttock muscle, to anterolateral thigh in young children) na Mikolo 0, 3, 7, mpe 14 (bakisa Mokolo 28 soki immuno-compromis).
5. Mpo na ba voyageurs oyo bazwaki mangwele liboso (Completed Pre-Exposure PrEP or Prior PEP):
6. Kopesa HRIG TE. Kopesa 2 doses ya booster intramusculaire ya vaccin ya rage na Mokolo ya 0 mpe Mokolo ya 3 kaka.

4. Prophylaxie ya bactérie polymycrobienne ( .Why Monkey Bites Infect Within 12 Hours) .¶

Ba cavités oraux ya ba primates oyo ezali ya moto te ezali na ba concentrations ya likolo ya Streptocoques alpha-hémolytiques, Staphylococcus aureus, Eikenella corrodens, Pasteurella, Bacteroides, mpe Fusobacterium: - Antibiotique ya liboso ya monoko: Amoxicilline-clavulanate (Augmentin 875/125 mg PO every 12 hours na boumeli ya mikolo 5 kino 7). - Bato ya maladi oyo bazali na allergie na pénicilline: Doxycycline (100 mg PO BID) to Moxifloxacine ( .400 mg PO daily), to Ciprofloxacine ( .500 mg PO BID) PLUS Métronidazole ( .500 mg PO TID) to Clindamycine ( .300-450 mg PO TID) ( ) .never use a single cephalosporin, macrolide, or clindamycin alone, which miss Eikenella and Pasteurella).

Eteni ya misato: Koyeba bilembo ya virus ya Herpès B (The 3-to-30-day neurological red-flag window) .¶

Ata nsima ya kosilisa kopangusa bampota mpe kobanda Valacyclovir, moto nyonso oyo macaque eswami to enyatami asengeli komilandela mokolo na mokolo na boumeli ya mikolo 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
                            |
                            v
   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

• Mpo na nini Hiccups, Diplopie, to Tingling Up ya Limb oyo eumelaka esengaka ba Antiviraux IV mbala moko:
• Na bokeseni na bampota ya malili ya bato (HSV-1), Virus ya Herpès B etambolaka mbala mingi na misisa ya périphérique kozanga ata kosala libulu ya loposo oyo emonanaka na esika oyo eswami (> 50% of patients never develop local vesicles).
• Na esika na yango, elembo ya liboso ya likebisi ezali mpasi ya neuropathique, kozika, kolɛmba nzoto, to kolɛmba makasi (pruritus) ko radier proximalement likolo ya extremité oyo eswami, elandi fièvre lokola grippe, hiccups persistants (singultus, oyo euti na kovimba ya virus ya médulle oblongata), komona mbala mibale (diplopia), mpasi ya komela (dysphagia), to bolɛmbu ya makolo oyo ezali komata (Landry-type ascending paralysis).
• Traitement ya ba malades lopitalo pona Herpès B symptomatique: Valacyclovir orale ezali strictement pona prévention (PEP) liboso ete bilembo bimonana. Soki kaka blister local to symptôme neurologique ebandi, mobeli asengeli kokende noki lopitalo ya urgence mpe traitement antiviraux intraveineux:
  1. Kozanga Ba Symptômes ya CNS (Local skin vesicles or peripheral paresthesia only): Acyclovir oyo ekɔtisami na misisa (12.5 to 15 mg/kg IV every 8 hours) TO Ganciclovir oyo epesamaka na misisa (5 mg/kg IV every 12 hours) na boumeli ya mikolo ata 14 kino 21 kino bilembo nyonso ekosila mpe ba cultures ya PCR virale ekozala négative.
  2. Na Ba Symptômes Nionso ya CNS / Troche Cerveau (Fever + headache, tingling, hiccups, diplopia, ataxia, or weakness): Ganciclovir oyo ekɔtisami na misisa (5 mg/kg IV every 12 hours) ezali nkisi ya kopona oyo esengami na Groupe de travail ya Herpès B ya CDC mpo ganciclovir elakisaka makasi in vitro mpe in vivo mingi mingi contre Macacine alphaherpesvirus 1 na kati ya système nerveux central koleka acyclovir.

Mituya ya mbalakaka ya etuka, ba cliniques internationales, mpe ba laboratoires ya référence¶

Nsima ya kosilisa mbala moko kopangusa mpota na yo ya miniti 15 na esika ya mosala, kende mbala moko na lopitalo ya mokili mobimba to na clinique ya nkisi ya mobembo oyo epesameli yo (do not rely solely on a temple first-aid booth or hotel nurse):

• Bali & Indonésie: Kobenga 112 to mpe 119 mpo na ambulance. Na Bali (Ubud / Kuta / Nusa Dua / Canggu), kende mbala moko na lopitalo ya BIMC (Kuta: +62 361 761263 / . Nusa Dua: +62 361 3000911 / . Ubud Medical Centre: +62 361 971313), Lopitalo ya Siloam Denpasar (+62 361 779900), to SOS Clinique ya Medika Bali (+62 361 710505), oyo stock ekɔtisaki HRIG (Berirab/ .HyperRAB), mangwele ya Verorab, mpe Valacyclovir oyo emɛlaka (Valtrex).
• Thailand (Bangkok, Phuket, Lopburi, Krabi, Chiang Mai): Kobenga na telefone 1669 mpo na EMS to 1155 mpo na Police ya Tourisme. Kende na Institut mémorial ya Queen Saovabha (Thai Red Cross Society Snake & Rabies Clinic, na engumba Bangkok: +66 2 252 0161), Lopitalo ya Bangkok Phuket (+66 76 254 425), to Lopitalo ya mokili mobimba ya Bumrungrad (+66 2 066 8888).
• Inde & Népal: Kobenga 112 (108 ambulance) na Inde; na Kathmandu (Swayambhunath Monkey Temple), kende mbala moko na Centre ya kisi ya mobembo ya lopitalo ya CIWEC (+977 1 4524111), clinique ya koswa ba primates oyo ezali na standard ya or na etuka. Na Inde, kende na lopitalo moko monene ya bakompanyi ya kelasi ya misato (Apollo, Max, Fortis, Manipal) mpe kosenga nyonso mibale Globuline Immune ya Rabie humaine (HRIG) mpe Valacyclovir 1,000 mg ba tablettes (Valcivir).
• Gibraltar, Royaume-Uni, mpe Union européenne: Benga 112 to mpe 190 na Gibraltar (St Bernard's Hospital ezali na protocole dédié ya morsure ya Barbary Macaque). Na Royaume-Uni, benga 999 to mpe 111 (UKHSA Rabies and Monkey B Virus Service); na kati ya UE mobimba, benga 112.
• Japon, Hong Kong, Singapour, mpe Malaisie: Benga 119 na Japon, . 999 na Hong Kong (Queen Elizabeth / Prince of Wales A&E) mpe Malaisie, to 995 na Singapour (Tan Tock Seng Hospital / National Centre for Infectious Diseases [NCID]).
• Etats-Unis & Laboratoire ya référence ya Herpès B mondial: Benga 911 mpo na makambo ya mbalakaka. Minganga na mokili mobimba bakoki kotala Centre National de Resources de Virus B na Université d’Etat ya Georgia (Atlanta, USA) 24/7 Line ya mbalakaka na +1-404-413-6550 to na Centre ya misala ya mbalakaka ya CDC (+1-770-488-7100) mpo na ba diagnostics ya PCR/sérologie mpe guidance clinique antivirale.

Mituna oyo batunaka mingi¶

Banyoka nini ememaka mikrobe ya Herpès B, mpe banyoka nyonso bazalaka na yango?¶

Te, kaka banyoka ya Mokili ya Kala ya genre Macaca (macaques), bakisa mpe macaques Rhesus, macaques ya mikila milai (oyo elyaka krab), macaques ya Japon, mpe macaques Barbary oyo ezwami na Bali mobimba, Thaïlande, Inde, Népal, Malaisie, Singapour, Hong Kong, Japon, mpe Gibraltar, ezali ba réservoirs naturels ya Macacine alphaherpesvirus 1 (virus Herpès B), na 70 kino 90 % ya ba macaques oyo ekómi mikóló oyo ememaka yango kozanga bilembo. Ba baboons, ba singes vervet, ba langurs ya Asie, mpe ba singes nionso ya Amérique centrale mpe ya Sud (Mokili ya Sika) lokola ba capuchins, ba singes écureuils, mpe ba marmosets ememaka na ndenge ya bomoto virus ya Herpès B TE, atako esengaka kaka Prophylaxie ya mbala moko ya Rabies Post-Exposition mpe antibiotiques.

Mpo na nini kopangusa eloko oyo macaque eswaki to oyo eswaki yango na boumeli ya miniti 15 mbala moko ezali na ntina mingi?¶

Virus ya herpès B mpe virus ya rage ezingami na enveloppe ya lipide (mafuta) oyo ezali fragile mpe etikalaka na ba cellules ya loposo ya likolo kaka mwa miniti nsima ya koswa to ko gratter liboso ya kokangama na ba nerfs sensoriels périphériques mpe kokende likolo na mokuwa ya mokɔngɔ mpe bɔɔngɔ́. Soki mikrobe yango ekɔti na axon ya misisa, bankisi oyo ebomaka mikrobe ya likoló ekoki lisusu kokóma na yango te. Kopangusa mpota mbala moko na boumeli ya miniti 15 mobimba na povidone-iode (Betadine), chlorhexidine, to sabuni ya kosukola oyo ezali na biloko mingi mpe mai oyo ezali koleka, elongolaka enveloppe ya lipide ya mikrobe soki ekɔti na yango mpe esukolaka koleka 99 % ya mikrobe liboso ete misisa ekɔta.

Dose nini ya sikisiki ya Valacyclovir to Acyclovir esengeli mpo na kopekisa virus ya Herpès B sima ya koswa macaque?¶

Lokola virus ya Herpès B ezali na boyokani mingi te na bankisi oyo ebomaka mikrobe mbala soki 10 koleka herpès ya bato oyo bazokisaka na malili (HSV-1), monganga oyo monganga akomeli moto oyo azali na dose moke mpo na mpasi ya malili ekoki te. Engebene na malako ya Groupe de travail ya virus ya Herpès B ya CDC, mikóló basengeli komela Valacyclovir 1.000 mg (gramme 1) oyo emɛlaka mbala misato na mokolo (nsima ya ngonga 8) na boumeli ya mikolo 14 mobimba, to na lolenge mosusu Acyclovir 800 mg oyo emɛlaka mbala mitano na mokolo na boumeli ya mikolo 14, oyo ebandaki malamu mpenza na boumeli ya ngonga 24 tii 72 nsima ya koswama, konyata to liso kosopana ya mai.

Nasengeli kosala nini soki nyama babengi macaque esopi to esopi mai na liso na ngai?¶

Ba éclaboussures oculaires ya saliva ya macaque to mayi ya cage/piscine ezali nzela oyo ekomamaki na mikanda ya transmission ya virus ya Herpès B ya moto oyo ebomaka na nzela ya conjonctive mpe ba nerfs optiques/trigéminales. KOTIA sabuni, povidone-iode, to masanga TE na liso na yo; na esika na yango, simbá ba paupières na yo polele mpe sukola liso ntango nyonso na boumeli ya miniti 15 mobimba na mai ya pɛto ya komɛla na milangi to na saline normale 0,9% stérile, na nsima kende mbala moko na lopitalo mpo na kobanda Valacyclovir ya komela (1 g mbala misato na mokolo na boumeli ya mikolo 14) mpe kolobela prophylaxie ya rage.

Nazali naino na mposa ya Globuline Immune ya Rabies (HRIG) soki nazwi mangwele ya rage na mokolo oyo nyama eswami?¶

Oui, soki ozuaki nanu ba vaccins ya rabies avant exposition avant voyage, chaque morse to gratter ya nyama oyo ebukaka loposo na mboka oyo ezali na rabie (lokola Indonésie/Bali, Thaïlande, Inde, Népal, Afrique, to Amérique latine) ezali exposition ya catégorie III ya OMS oyo esengaka ESENGELI série ya vaccin ya rabie ya 4 doses MPE Globuline passive ya Immune ya Rabie ya Moto (HRIG, 20 UI/kg) ekɔtaki mbala moko na kati mpe zingazinga ya mpota. Lokola mangwele ya rage esɛngaka mikolo 7 to 14 mpo na kolendisa ebongiseli na yo ya kobundisa maladi mpo na kosala ba anticorps na yango moko, HRIG epesaka ba anticorps oyo esilisaka mbala moko mbala moko kaka na esika oyo eswamaki na boumeli ya pɔsɔ wana ya liboso oyo ezali likama.

Bilembeteli nini ya likebisi na boumeli ya mikolo 30 ya liboso nsima ya koswama ya macaque elakisi ete nasengeli kozwa lisalisi ya nokinoki na IV?¶

Luka mbala moko bokɔti ya lopitalo ya nokinoki mpo na Ganciclovir oyo okɔtisi na misisa (5 mg/kg IV nsima ya ngonga 12 nyonso) to Acyclovir IV ya dose monene soki ozwi moko ya makambo oyo elandi na boumeli ya mikolo 3 to 30 nsima ya kokutana na macaque: ba blisters to ba ulcères oyo etondi na mai pene na mpota; kozika, kolɛmba, kolɛmba, to kolɛmba makasi oyo ezali kongɛnga likoló ya lobɔkɔ to makolo oyo eswami; fièvre oyo ekoki kolimbolama te to motó mpasi makasi; hiccups intractables persistants (elembo ya kala ya kovimba ya mokuwa ya bɔɔngɔ ya Herpès B); komona mbala mibale, kizunguzungu, mpasi ya komela, to bolembu ya makolo.

Ba guides oyo etali yango¶

• Kozala na rage, kokutana na ba chauves-souris, mpe prophylaxie après exposition
• Soin ya koswa ya banyama mpe ya infection ya ba mpota
• Rabid fox, raccoon, coyote, to skunk moyi attaque défense
• Kobima makila makasi mpe kopekisa makila

Maziba mpe bokambi ya Leta¶

• Ba centres ya contrôle mpe ya prévention ya maladie (CDC, Etats-Unis): CDC Yellow Book (Information ya santé mpo na mibembo ya mokili mobimba): Expositions zoonotiques: Koswama, ko gratter, mpe makama mosusu oyo euti na ba singes Macaque (Herpes B Virus / Macacine alphaherpesvirus 1) mpe Rabies.
• Cohen, J. I., Davenport, D. S., Stewart, J. A., mpe basusu. (B Virus Working Group, Bokono ya clinique infectieux / CDC): Makanisi mpo na kopekisa mpe kosalisa mpo na kokutana na virus B (Cercopithecine Herpesvirus 1).
• Centre national ya ba ressources ya virus B (Georgia State University, Atlanta, USA): Procédures ya fonctionnement standard d’urgence pona décontamination ya koswa/ko gratter ya macaque, test ya diagnostic, pe prophylaxie après exposition.
• Organisation mondiale de la santé (WHO): Consultation ya ba experts ya OMS na oyo etali Rabies: Gestion ya exposition ya catégorie III, Infiltration locale ya ba mpota ya Immunoglobuline ya Rabie (HRIG/ .ERIG), mpe Manaka ya mangwele.
• Société ya Amerika mpo na maladi oyo ezwamaka na bato mosusu (IDSA): Mabongisi ya misala mpo na koyeba mpe kokamba ba infections ya loposo mpe ya ba tissus doux sima ya koswama ya ba primates oyo ezali ya bato te.