Inguge, Macaque, na Baboon Bite cyangwa Igishushanyo ku nsengero: Virusi ya Herpes B (Macacine Alphaherpesvirus 1), Valacyclovir, na Rabies RIG¶

Kuba warumwe, ushushanyije, cyangwa ucira mu jisho inguge yidegembya ku rusengero rw’ubukerarugendo, ahantu nyaburanga, cyangwa parike yo mu mijyi, cyane cyane Isi Kera ** Rhesus Macaque (Macaca mulatta) **, ** Umurizo muremure / Kurya igikona Macaque (Macaca fascicularis) **, ** Umuyapani Macaque (Macaca fuscata) **, ** Barbary Macaque (Macaca sylvanus) **, cyangwa ** Baboon (Papio amoko) ** hakurya ya ** Bali (Ubud), Tayilande (Lopburi, Phuket), Ubuhinde (Varanasi, Jaipur, Shimla), Gibraltar, Ubuyapani (Arashiyama), Nepal, cyangwa Afurika **, ni ibintu bibiri byihutirwa bya neuro-virusi. Usibye gutwara ** Indwara ya Rabies ** (100 percent fatal once neurological symptoms appear) hamwe na bagiteri nyinshi zo mu bwoko bwa polymicrobial biteye, ** 70 kugeza 90 ku ijana by'inguge zikuze za Macaque World Worldgenus Macaca) ni ubuzima bwabo bwose butwara ibimenyetso bya Macacine alphaherpesvirus 1 (Herpes B Virus / Cercopithecine herpesvirus 1) **. Mu gihe Herpes B nta kindi itera uretse ibisebe bikonje byo mu kanwa bitagira ingaruka muri macaque, iyo byinjijwe mu muntu binyuze mu kurumwa n’inguge, kwanduza amacandwe, cyangwa kwandura ocular, ** kwandura virusi ya Herpes B itavuwe itera kwiyongera kwa encephalomyelitis hamwe n’ubumuga bw’ubuhumekero burenze 70 kugeza 80% **.

Niba wowe cyangwa mugenzi wawe murugendo urwaye uruhu rwose, kurigata, cyangwa mucosal / amaso aturutse ku nguge ya macaque cyangwa babone, ** tangira igikomere cyiminota 15 gisukuye hamwe nisabune na povidone-iyode cyangwa chlorhexidine muminota 5 yambere **, hanyuma uhite ujya mubitaro mpuzamahanga cyangwa ivuriro ryingendo kuri ** Valacyclovir (1 g PO three times daily for 14 days) ** na ** Indwara Yibisazi Nyuma yo Kumenyekanisha ()Human Rabies Immune Globulin [HRIG] + 4-dose rabies vaccine) **. Ushaka ambulance yaho cyangwa ubufasha bwubuvuzi, hamagara nimero yihutirwa yawe (112 cyangwa 119 muri Indoneziya, 1669 muri Tayilande, 112 mu Buhinde no mu muryango w’ubumwe bw’ibihugu by’Uburayi / Gibraltar, 119 mu Buyapani, 999 mu Bwongereza, 911 muri Amerika na Kanada) cyangwa reba ububiko bwisi yose ya nimero yihutirwa. Kubireba inyamaswa nini no kurwara protocole, reba ibisazi byanduye hamwe na prophylaxis nyuma yo kugaragara, kuruma inyamaswa no kwita ku kwandura ibikomere, na kugenzura cyane amaraso.

Kora ubu¶

1. ** SHAKA INKOMOKO ZIKOMEYE KU MINOTA 15 YUZUYE AKAZI ((THE SINGLE MOST IMPORTANT STEP) **: Ntutegereze kugeza ugeze ku ivuriro ryoza igikomere. Virusi ya Herpes B na virusi yibisazi ni virusi zuzuye lipide zicara imbere mu ngirabuzimafatizo z’uruhu mu minota mike ya mbere mbere yo kwinjira mu mitsi ya periferique. Ako kanya fungura hanyuma usukure kurumwa cyangwa gushushanya ubudahwema kuri ** 15 iminota yuzuye nisaha ** ukoresheje ** povidone-iyode (Betadine), chlorhexidine gluconate (Hibiclens), cyangwa isabune yo kwisiga yibanze (dish soap / laundry bar) n'amazi atemba **.
2. ** NIBA UMWUKA MU IJISHO CYANGWA UKWEZI, KUNYAZA AMAZI YIZA CYANGWA SALINE MU MINOTA 15 (NO SOAP IN EYES) **.
3. ** NTUKIGERE UREKANA UMUTIMA WA CLINIQUE CYANGWA UFATANYIJE URUBUGA RWA MONKEY RWAFunze *: Gufunga kurumwa na prima ukoresheje ubudodo cyangwa imitego y'uruhu imitego ya virusi ya Herpes B, virusi y’ibisazi, na anaerobes yo mu kanwa ( Eikenella corrodens *, * Bacteroide *, * Pasteurella *). Kureka igikomere gifunguye (cyangwa wemerere gusa kugereranya nyuma yo kwinjira hamwe na Rabies Immune Globulin).
4. ** Tangira VALACYCLOVIR MU MUNSI (1 GRAM THREE TIMES DAILY) HAMWE MU MASAHA 24 kugeza 72 KUBIKORWA BYA MACAQUE : Gusa inkende zo mu bwoko *** Macaca * (Macaques muri Aziya na Gibraltar) ** itwara virusi ya Herpes B. Shimangira gutangira ** Prophylaxis Nyuma yo Kumenyekanisha (PEP) hamwe na Valacyclovir 1,000 mg (1 g) every 8 hours (TID) for 14 days (cyangwa ** umunwa Acyclovir 800 mg 5 times daily for 14 days**) nibyiza mugihe cyamasaha 24 (and up to 72 hours) ** yo guhura, mbere yuko virusi yinjira muri sisitemu yo hagati.
5. ** Saba RABI YINSHI IMMUNE GLOBULIN (HRIG / ERIG. Niba utarigeze ukingira urukingo rwibisazi, urukingo rwibisazi rwonyine ntiruhagije, ugomba no kwakira ** Rabies Immune Globulin (HRIG 20 IU/kg cyangwa ERIG 40 IU/kg) yinjiye mu gikomere no hafi yacyo ku munsi wa 0 ** kugirango yanduze virusi mu minsi 7 kugeza 14 mbere yuko umubiri wawe ukora antibodies.
6. ** KIRA AMOXICILLIN-CLAVULANATE (AUGMENTIN) NA TETANUS BOOSTER : Umunwa wikigereranyo wigana flora yumuntu (the most infectious mammalian bite); fata ** amoxicillin-clavulanate 875/125 mg PO BID for 5 to 7 days hanyuma ugenzure urukingo rwa tetanusi (Tdap).

Igiti cyemezo: inkende, macaque, na babon kuruma cyangwa gucunga neza¶

Kurikiza iki gitabo cyamavuriro nu murima mugihe umwanya uhuye nigisubizo cyo kurumwa, gushushanya, cyangwa mucosal:

flowchart TD
    Exposure["Prite Bite, Shushanya, cyangwa Amacandwe Amacandwe kuruhu / Ijisho"] --> WashNow{"1. Kwanduza ako kanya (Mu minota 0 kugeza 5)"}
    WashNow -->|"Uruhu Kuruma, Gutobora, cyangwa Gushushanya"| Scrub15["SCRUB CYANE MU MINOTA 15 YUZUYE: Koresha Povidone-Iyode, Chlorhexidine, cyangwa Isabune ya Detergent + Amazi atemba -> Reka kuva amaraso kubuntu -> Ntukigere udoda"]
    WashNow -->|"Amacandwe Yijugunye mumaso, izuru, cyangwa umunwa"| FlushEye["KUNYAZA IJISHO / MUCOSA MU MINOTA 15: Koresha Amazi Yuzuye Amacupa cyangwa Sterile 0.9% Saline GUSA (Ntuzigere ushyira isabune cyangwa iyode mumaso)"]
    Scrub15 --> PrimateID{"2. Menya Itsinda rya Primate na Geografiya"}
    FlushEye --> PrimateID
    PrimateID -->|"Isi Kera MACAQUE (Genus Macaca: Bali, Tayilande, Ubuhinde, Ubuyapani, Gibraltar, Ubushinwa, Philippines)"| DualRisk["INGARUKA ZIKURIKIRA INTWARI B VIRUS + RABIES + BACTERIA: Jya ku ivuriro mpuzamahanga ry’ingendo / Ibitaro mu masaha 24"]
    PrimateID -->|"Ikigereranyo kitari Macaque (Baboon, Vervet, Langur, Capuchin, Inguge y'inguge, Marmoset)"| RabiesOnly["NTA INTWARI B INGARUKA B -"]
    DualRisk --> MedProtocol["3. Umuyobozi Yuzuye Yuzuye Nyuma yubuvuzi (Umunsi 0)"]
    RabiesOnly --> MedProtocol
    MedProtocol --> Regimen["1. INTWARI B PEP (Macaques Gusa): Valacyclovir 1 g PO TID x iminsi 14 (cyangwa Acyclovir 800 mg PO 5x / umunsi x iminsi 14) \ n2. RABIES PEP (OMS Cat III): Injira HRIG (20 IU / kg) mu gikomere + Urukingo rw'inkingo Iminsi 0, 3, 7, 14 \ n3. ANTIBIOTICS & TETANUS: Amoxicillin-Clavulanate 875/125 mg PO BID + Tdap Booster"]
    Regimen --> NeuroWatch{"4. Gukurikirana iminsi 21: Vesicles zose, Tingling, Fever, Vision Vision, cyangwa Hiccups?"}
    NeuroWatch -->|"YEGO: Ibimenyetso bya Neuro kare / Ibimenyetso byuruhu"| IVGanciclovir["INAMA NJYANAMA YIHUTIRWA: Tangira Dose-Dose IV Acyclovir (12.5-15 mg / kg q8h) cyangwa IV Ganciclovir (5 mg / kg q12h) Ako kanya"]

Icyiciro cya 1: Ni izihe primates zitwara virusi ya Herpes B na Rabies (Species and temple guide)¶

Ntabwo inkende zose zo ku isi zitwara virusi ya Herpes B, kandi ntabwo buri karere k’ibinyabuzima gafite icyorezo kimwe cy’ibisazi. Kumenya neza prima bito cyangwa yashushanyije ugena imiti ya virusi.

1.¶

2. Impamvu urusengero rwa Macaques rwibasiye ba mukerarugendo (And How to Escape Without Being Bitten)¶

Ubushakashatsi bwakorewe mu ishyamba rya Bud's Monkey Monkey, insengero za Lopburi yo muri Tayilande, hamwe na Gibraltar's Upper Rock ryerekana ko hejuru ya ** 85 ku ijana by'indwara ya macaque ibaho mu myitwarire itatu yihariye y'abantu **: 1. ** Gufata ibiryo, imifuka ya plastiki, amacupa y’amazi, indorerwamo zizuba, cyangwa Terefone **: Macaque yurusengero itozwa nuburambe bwo kwambura amadarubindi, ingofero, terefone, nudukapu tworoheje, tukabafata bugwate kugeza igihe umukoresha abacururiza igice cyimbuto (a learned bartering behavior). Niba inkende ifashe igikapu cyawe, indorerwamo zizuba, cyangwa icupa ryamazi, ** REKA AKAZI **. Gusubiza inyuma bikurura ako kanya kanine kuruma mukuboko cyangwa kuboko. 2. ** Kumwenyura ukoresheje amenyo yerekanwe cyangwa kureba neza ((Primate Threat Display) **: Mu mvugo yumubiri wa macaque na babone, ** gufunga amaso ataziguye no gusubiza iminwa inyuma kugirango werekane amenyo yawe (a human smile for a selfie) ni ibimenyetso byerekana isi yose yo gutinya-gutera no guhangana **. Komeza iminwa yawe hejuru y'amenyo yawe, irinde kureba neza, kandi ntuzigere wunama kurwego rwamaso hamwe na macaque yumugabo ukuze cyangwa umubyeyi utwaye uruhinja. 3. ** Kuzamuka ku bitugu bya ba mukerarugendo (Head and Neck Bite Hazard) **: Ntuzigere wemerera umucuruzi wurusengero gushyira ibishyimbo cyangwa ibitoki kumutwe cyangwa ibitugu kugirango macaque izamuke ijosi. ** Kuruma cyangwa gushushanya ku mutwe, mu maso, cyangwa ku ijosi bitwara ibyago byinshi byo guhitanwa na virusi ya Herpes B na Rabies ** kubera ko imitsi ya cranial (trigeminal, facial) gutanga inzira ndende-ngufi (just centimeters) igororotse mu bwonko mbere yo gukwirakwizwa nyuma yo gukwirakwizwa.

Icyiciro cya 2: Intambwe ku yindi ubufasha bwambere hamwe na prophylaxis yo kwa muganga (First 15 minutes to 72 hours)¶

Iyo macaque cyangwa baboon imennye uruhu cyangwa igatobora ururenda, kurikiza igihe cyagenwe.

1. Umunota 0 kugeza kumunota 15: Gukora virusi ya mashini na chimique¶

   [ 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

• ** Impamvu iminota 15 yuzuye ari itegeko **: Byombi ** CDC Herpes B Itsinda Rikora ((CDC)Cohen et al., Clinical Infectious Diseases) ** na ** Umuryango w’ubuzima ku isi (WHO) Amabwiriza y’ibisazi ** yerekana neza ** iminota 15 yuzuye yo gukaraba no gukanika imashini ** (koresha ipasi isukuye cyangwa igitambaro cyoroshye kugirango usukure witonze imbere yinyo yinyo cyangwa inzira, kugirango utume amaraso ava mumitsi yoroheje asohora amacandwe).
• ** Ni ubuhe bwoko bwa virusi bukora kuri Herpes B na Rabies? **:
• ** Guhitamo bwa mbere kuruhu **: ** Povidone-iyode (Betadine 7.5% kugeza 10%) **, ** chlorhexidine gluconate (2% to 4%) **, ** benzalkonium chloride **, cyangwa ** yibikoresho byo murugo / isabune y'amazi isabune / isabune yo mu kabari ** hamwe namazi menshi.
• ** Byagenda bite se niba uri munzira y'urusengero ufite Icupa ryamazi gusa hamwe nisuku yintoki? **: Kanda ako kanya ukoresheje kimwe cya kabiri cyamazi yawe yo kunywa icupa mugihe ukanda igikomere cyane, koresha ** 70% isuku yintoki zinzoga **, hanyuma wihute muminota 3 kugeza kuri 5 ugana ahabigenewe ubufasha bwambere bwurusengero, ubwiherero bwubwiherero, cyangwa farumasi yegeranye kugirango ugure povidone-iyode 15. *.

2. Isaha 1 kugeza Isaha 72: Gukwirakwiza virusi ya virusi ya Herpes B (Valacyclovir v. Acyclovir)¶

Dukurikije ** Ikigo cyo muri Amerika gishinzwe kurwanya no gukumira indwara (CDC) ** hamwe na ** National B Virus Resource Centre (Georgia State University) ** amabwiriza yubuvuzi:

3. Indwara imwe yibisazi Nyuma yo Kumenyekanisha ()HRIG + 4-Dose Vaccine Schedule)¶

Mugihe abagenzi muri Reta zunzubumwe zamerika cyangwa Uburayi bakunze gusoma impapuro zivuga niba macaque zo mu gasozi na zajyanywe bunyago zikeneye ubuvuzi bwa Herpes B na Rabies, ** ku nsengero z’ubukerarugendo zo muri Aziya na Afurika, ugomba kuvura icyarimwe **. Ntukemere ko ivuriro ryaho riguha ibisazi gusa birasa nta Valacyclovir, kandi ntugafate Valacyclovir gusa udafite ibisazi PEP:

1. ** Kubagenzi batakingiwe (No Prior Pre-Exposure Rabies Series) **:
2. ** Intambwe A: Ubudahangarwa bwa pasiporo (Day 0 Only) **: Kwinjira ** Indwara Yabantu Immune Globulin (HRIG kuri 20 IU/kg uburemere bw'umubiri) **, cyangwa yasukuwe ** Kuringaniza ibisazi Immune Globulin (ERIG kuri 40 IU/kg) ** niba HRIG itaboneka, ** muburyo bwimbitse no kumpande za buri kuruma no gushushanya **. Ingano iyo ari yo yose isigaye idashobora guhuza ibikomere (urugero, kurumwa ku rutoki) yatewe inshinge ahantu hitaruye (such as the anterior thigh or deltoid opposite the vaccine arm).
3. • Idirishya rikomeye ryiminsi 7 HRIG *: Niba ivuriro rya kure aho wakiriye urukingo rwumunsi wa 0 urukingo rwibisazi ntirubitse HRIG (a common issue at small island clinics in Indonesia or rural India), ** ufite kugeza kumunsi wa 7 nyuma yinkingo yambere yinkingo yo kuguruka cyangwa gutembera mubitaro bikuru (Denpasar, Bangkok, Singapore, New Delhi, or home) kubona HRIG yatewe **. Ntugakoreshe HRIG nyuma yumunsi wa 7, kuko izahagarika igisubizo cyawe gikingira antibody.
4. ** Intambwe B: Gukingira gukomeye (4-Dose Intramuscular Vaccine Series) **: Injira 1.0 mL (cyangwa 0.5 mL ukurikije ikirango: Verorab, Rabipur/RabAvert, Imovax) ** muburyo budasanzwe mumitsi ya deltoid ** (never into the gluteal/buttock muscle, cyangwa anterolateral thigh in young children) kuri ** Iminsi 0, 3, 7, na 14 ** (wongeyeho ** Umunsi wa 28 ** niba udakingiwe).
5. ** Kubagenzi bakingiwe mbere (Completed Pre-Exposure PrEP or Prior PEP) **:
6. ** Ntutange HRIG **. Administer ** 2 imitsi yo mu bwoko bwa booster ikingira urukingo rwibisazi kumunsi wa 0 numunsi wa 3 gusa **.

4. Indwara ya bagiteri yitwa Polimicrobial Prophylaxis (Why Monkey Bites Infect Within 12 Hours)¶

Imyanya yo mu kanwa itari iy'abantu irimo ubunini bwinshi bwa alpha-hemolytic * Streptococci *, * Staphylococcus aureus *, * Eikenella corrodens *, * Pasteurella *, * Bakteroide *, na * Fusobacterium *: - ** Umurongo wa mbere Antibiotique yo mu kanwa **: ** Amoxicillin-clavulanate (Augmentin 875/125 mg PO every 12 hours iminsi 5 kugeza kuri 7) **. - ** Abarwayi ba Penisiline-Allergique **: ** Doxycycline (100 mg PO BID) ** cyangwa ** Moxifloxacin (400 mg PO daily) **, cyangwa ** Ciprofloxacin (500 mg PO BID) PLUS Metronidazole (500 mg PO TID) cyangwa Clindamycin (300-450 mg PO TID) ** (never use a single cephalosporin, macrolide, or clindamycin alone, which miss Eikenella and Pasteurella).

Icyiciro cya 3: Kumenya ibimenyetso bya virusi ya Herpes B (The 3-to-30-day neurological red-flag window)¶

Ndetse na nyuma yo kurangiza gukomeretsa no gutangira Valacyclovir, umuntu wese warumwe cyangwa yashushanyije na macaque agomba kwikurikirana buri munsi muminsi ** 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

• ** Impamvu Hiccups idahwema, Diplopiya, cyangwa Kuzamura ingingo bisaba Antiviral IV ako kanya **:
• Bitandukanye n'ibisebe bikonje byabantu (HSV-1), Virusi ya Herpes B ikunze kugenda hejuru yimitsi ya periferique itanashizeho ibibyimba byuruhu bigaragara kurubuga.> 50% of patients never develop local vesicles).
• Ahubwo, ikimenyetso cyambere cyo kuburira ni ** ububabare bwa neuropathique, gutwika, kunanirwa, cyangwa guhinda cyane (pruritus) kumurika hafi kuruhande rwarumye **, hagakurikiraho umuriro umeze nkibicurane, ** hiccups idahoraho (singultus, biterwa no gutwika virusi ya medulla oblongata) **, ** iyerekwa kabiri (diplopia) **, ingorane zo kumira (dysphagia), cyangwa kuzamuka intege nke z'ingingo ((Landry-type ascending paralysis).
• ** Kuvura Ibitaro byindwara ya Herpes B **: Valacyclovir yo mu kanwa ni iyo gukumira * (PEP) * mbere yuko ibimenyetso bigaragara. Iyo ibimenyetso byose byaho cyangwa ibimenyetso byubwonko bimaze gukura, umurwayi arasaba ibitaro byihutirwa hamwe na ** ivura virusi itera virusi **:
  1. ** Nta bimenyetso bya CNS (Local skin vesicles or peripheral paresthesia only) **: ** Acyclovir yinjira (12.5 to 15 mg/kg IV every 8 hours) ** CYANGWA ** Ganciclovir yinjira (5 mg/kg IV every 12 hours) ** byibura iminsi 14 kugeza 21 kugeza ibimenyetso byose bikemutse kandi imico ya virusi ya PCR ni mibi.
  2. ** Hamwe na CNS / Ibimenyetso Byubwonko Bwose (Fever + headache, tingling, hiccups, diplopia, ataxia, or weakness) **: ** Ganciclovir yinjira (5 mg/kg IV every 12 hours) ** niwo muti wa ** wahisemo ** wasabwe nitsinda rya CDC Herpes B kuko ganciclovir yerekana cyane * muri vitro * na * muri vivo * imbaraga zirwanya Macacine alphaherpesvirus 1 imbere mumyanya mitsi yo hagati kuruta acyclovir.

Imibare yihutirwa yo mukarere, amavuriro mpuzamahanga, na laboratoire¶

Nyuma yo kuzuza ibikomere byiminota 15 byihuse kurubuga, jya mubitaro mpuzamahanga ** cyangwa ivuriro ryubuvuzi ryitiriwe ** (do not rely solely on a temple first-aid booth or hotel nurse):

• ** Bali & Indoneziya **: Hamagara 112 cyangwa 119 kuri ambulance. Muri Bali (Ubud / Kuta / Nusa Dua / Canggu), jya mu bitaro bya ** BIMC (Kuta: +62 361 761263 / Nusa Dua: +62 361 3000911 / Ubud Medical Centre: +62 361 971313) **, ** Ibitaro bya Siloam Denpasar (+62 361 779900) **, cyangwa ** SOS Medika Ivuriro rya Bali (+62 361 710505) **, ububiko bwatumijwe mu mahanga ** HRIG (Berirab/HyperRAB), Urukingo rwa Verorab, hamwe na Valacyclovir mu kanwa (Valtrex) **.
• ** Tayilande (Bangkok, Phuket, Lopburi, Krabi, Chiang Mai) **: Hamagara 1669 kuri EMS cyangwa 1155 kuri Polisi ishinzwe ubukerarugendo. Jya kuri ** Umwamikazi Saovabha Urwibutso (Thai Red Cross Society Snake & Rabies Clinic, Bangkok: +66 2 252 0161) **, ** Ibitaro bya Bangkok Phuket (+66 76 254 425) **, cyangwa ** Ibitaro mpuzamahanga bya Bumrungrad (+66 2 066 8888) **.
• ** Ubuhinde & Nepal **: Hamagara 112 (108 ambulance) mu Buhinde; muri ** Kathmandu (Swayambhunath Monkey Temple) **, jya kuri ** CIWEC Ibitaro byubuvuzi byubuvuzi (CIWEC)+977 1 4524111) **, ivuriro risanzwe rya zahabu ivura mukarere. Mubuhinde, jya mubitaro bikuru bya kaminuza nkuru (Apollo, Max, Fortis, Manipal) kandi usabe byombi ** Indwara Yabantu Immune Globulin (HRIG) ** na ** Valacyclovir 1,000 mg ibinini (Valcivir) **.
• ** Gibraltar, Ubwongereza, n’Ubumwe bw’Uburayi **: Hamagara 112 cyangwa 190 i Gibraltar (St Bernard's Hospital ifite protocole yabugenewe ya Barbary Macaque). Mu Bwongereza, hamagara 999 cyangwa 111 (UKHSA Rabies and Monkey B Virus Service); hirya no hino muri EU, hamagara 112.
• ** Ubuyapani, Hong Kong, Singapore, na Maleziya **: Hamagara 119 mu Buyapani, 999 muri Hong Kong (Queen Elizabeth / Prince of Wales A&E) na Maleziya, cyangwa 995 muri Singapuru (Tan Tock Seng Hospital / National Centre for Infectious Diseases [NCID]).
• ** Amerika & Global Herpes B Yerekana Laboratoire : Hamagara 911 byihutirwa. Abaganga kwisi yose barashobora kugisha inama ikigo cya ** B B gishinzwe umutungo wa kaminuza muri leta ya Jeworujiya (Atlanta, USA) 24/7 Umurongo wa telefone wihutirwa kuri +1-404-413-6550 cyangwa ikigo cya ** CDC gishinzwe ibikorwa byihutirwa (+1-770-488-7100) ** kubijyanye no gusuzuma PCR / serologiya hamwe nubuyobozi bwa virusi ya virusi.

Ibibazo bikunze kubazwa¶

Ni izihe nguge zitwara virusi ya Herpes B, kandi inkende zose zirayifite?¶

Oya, gusa inkende zo mu Isi Kera zo mu bwoko bwa Macaca (macaque), harimo na Rhesus macaque, imirizo miremire (kurya igikona), macaque yo mu Buyapani, na macaque ya Barbary iboneka hirya no hino muri Bali, Tayilande, Ubuhinde, Nepal, Maleziya, Singapore, Hong Kong, Ubuyapani, na Gibraltar, ni ikigega gisanzwe cya virusi ya virusi ya Macusine 70% macaque ayitwaye mu buryo butemewe. Baboons, inkende za vervet, langurs zo muri Aziya, hamwe n’inguge zose zo muri Amerika yo Hagati n’Amajyepfo (Isi Nshya) nka capuchins, inkende z’ibisimba, na marmoseti ntabwo zisanzwe zitwara virusi ya Herpes B, nubwo zikeneye guhita byanduza indwara ya Rabies Post-Exposure Prophylaxis na antibiotique.

Ni ukubera iki gukubita macaque kurumwa cyangwa gushushanya muminota 15 ako kanya birakomeye?¶

Virusi ya Herpes B na virusi yibisazi ikikijwe n’ibahasha ya lipide yoroheje (ibinure) kandi iguma ku ngirabuzimafatizo y’uruhu hejuru yiminota mike nyuma yo kurumwa cyangwa gutobora mbere yo guhambira imitsi yumutima no mu bwonko. Iyo virusi imaze kwinjira muri nervice axe, antiseptique yo hejuru ntishobora kongera kuyigeraho. Kuramo igikomere ako kanya muminota 15 yuzuye hamwe na povidone-iyode (Betadine), chlorhexidine, cyangwa isabune yo kwisiga hamwe n'amazi atemba ashonga ibahasha ya lipide ya virusi ihuye kandi igahanagura hejuru ya 99% bya virusi mbere yuko igitero cy’imitsi kibaho.

Nuwuhe mubare nyawo wa Valacyclovir cyangwa Acyclovir ukenewe kugirango wirinde virusi ya Herpes B nyuma yo kurumwa na macaque?¶

Kubera ko virusi ya Herpes B yikubye inshuro 10 kutumva virusi irwanya indwara ya herpes ikonje (HSV-1), imiti isanzwe ikonje ikabije ntabwo ihagije. Ukurikije umurongo ngenderwaho witsinda rya CDC Herpes B, abantu bakuru bakeneye Valacyclovir yo mu kanwa mg (garama 1) ifatwa inshuro eshatu buri munsi (buri masaha 8) muminsi 14 yuzuye, cyangwa ubundi buryo bwo mu kanwa Acyclovir 800 mg ifatwa inshuro eshanu kumunsi iminsi 14, byatangiye neza mugihe cyamasaha 24 kugeza kuri 72 uhereye kurumwa, guterura, cyangwa guhumura amaso.

Nakora iki niba inguge ya macaque icira cyangwa ikamena amazi mumaso yanjye?¶

Ocular splashes ya macaque amacandwe cyangwa akazu / amazi ya pisine ninzira yanditse yerekana kwandura virusi ya Herpes B yica abantu ikoresheje conjunctiva na nervice optique / trigeminal. Ntugashyire isabune, povidone-iyode, cyangwa inzoga mumaso yawe; Ahubwo, fungura amaso yawe hanyuma uhanagure ijisho ubudahwema muminota 15 yuzuye hamwe n’amazi meza yo mu icupa cyangwa umunyu usanzwe wa 0,9%, hanyuma uhite ujya mu bitaro gutangira Valacyclovir yo mu kanwa (1 g inshuro eshatu buri munsi muminsi 14) hanyuma uganire kuri prophylaxis.

Ndacyakeneye ibisazi Immune Globulin (HRIG) niba mbonye urukingo rw'ibisazi kumunsi w'inguge yarumye?¶

Nibyo, niba utarigeze ubona inkingo zanduye mbere yurugendo mbere yurugendo, buri nguge yonona uruhu cyangwa igashwanyaguza mugihugu cyanduye (nka Indoneziya / Bali, Tayilande, Ubuhinde, Nepal, Afrika, cyangwa Amerika y'Epfo) ni OMS yo mu cyiciro cya III isaba BYINSHI urukingo rw’ibibyimba 4 bikabije hamwe na virusi ya muntu Rabm Immune Globulin (HRIG). Kubera ko urukingo rw'ibisazi rufata iminsi 7 kugeza kuri 14 kugirango rutere imbaraga z'umubiri wawe gukora antibodi zarwo, HRIG itanga antibodiyite zidahita zangiza aho kurumwa muri kiriya cyumweru cya mbere.

Ni ibihe bimenyetso byo kuburira muminsi 30 yambere nyuma yo kurumwa macaque bivuze ko nkeneye kuvurwa byihutirwa IV?¶

Shakisha ibitaro byihutirwa byinjira kwa Ganciclovir (5 mg / kg IV buri masaha 12) cyangwa Dose ya IV Acyclovir niba ufite kimwe muri ibi bikurikira mugihe cyiminsi 3 kugeza 30 uhereye igihe cya macaque: ibisebe byuzuye amazi cyangwa ibisebe hafi y igikomere; gutwika, gutitira, kunanirwa, cyangwa guhinda gukabije kumurika ukuboko cyangwa ukuguru; umuriro udasobanutse cyangwa kubabara umutwe cyane; hiccups idacogora (ikimenyetso cyambere cya Herpes B ubwonko bwubwonko); kureba kabiri, kuzunguruka, ingorane zo kumira, cyangwa intege nke.

Kuyobora¶

• Indwara yibisazi, guhura na bat, hamwe na prophylaxis nyuma yo kugaragara
• Kurumwa ninyamaswa no kwita kubikomere
• Ingunzu yimbwa, marcoun, coyote, cyangwa skunk kwirwanaho kumunsi
• Kuva amaraso menshi no kurwanya amaraso

Inkomoko nubuyobozi¶

• Ibigo bishinzwe kurwanya no gukumira indwara (CDC.Herpes B Virus / Macacine alphaherpesvirus 1) n'ibisazi *.
• Cohen, J. I., Davenport, D. S., Stewart, J. A., n'abandi. (B Virus Working Group, * Indwara Zandura Clinical * / CDC): * Ibyifuzo byo gukumira no kuvura indwara ziterwa na virusi B (Cercopithecine Herpesvirus 1) *.
• Ikigo cy’igihugu gishinzwe umutungo wa virusi (Georgia State University.
• Umuryango mpuzamahanga wita ku buzima (WHO).HRIG/ERIG), hamwe na gahunda y'inkingo *.
• Indwara zanduza Sosiyete yo muri Amerika (IDSA).