Tsoko, Macaque, uye Baboon Kuruma kana Kukwenya paTemberi: Herpes B Virus (Macacine Alphaherpesvirus 1), Valacyclovir, uye Rabies RIG¶

Kurumwa, kukweshwa, kana kupfirwa muziso netsoko yakasununguka patemberi yevashanyi, nzvimbo inochengeterwa mhuka, kana paki yemudhorobha, kazhinji iNyika Yekare ** Rhesus Macaque (Macaca mulatta), Muswe Wakareba / Gaka-Kudya Macaque (Macaca fascicularis), Japanese Macaque (Macaca fuscata), Barbary Macaque (Macaca sylvanus), kana Mhubu (Papio mhando) ** mhiri ** Bali (Ubud), Thailand (Lopburi, Phuket), India (Varanasi, Jaipur, Shimla), Gibraltar, Japan (Arashiyama), Nepal, kana Africa, iri mbiri neuro-virological emergency. Pamusoro pekutakura Rabies virus (100 percent fatal once neurological symptoms appear) uye mabhakitiriya akadzika epolymicrobial bite, ** 70 kusvika 90 muzana yetsoko dzekare dzekare dzeNyika Macaque (genus Macaca) vatakuri vehupenyu hwese asymptomatic veMacacine alphaherpesvirus 1 (Herpes B Virus / Cercopithecine herpesvirus 1). Kunyange zvazvo Herpes B inokonzera chimwe chinhu kunze kwezvironda zvisingakuvadzi zvemuromo zvinotonhora mumacaques, kana inoculated mumunhu kuburikidza nekurumwa netsoko, tsvina yakasvibiswa nemate, kana kuputika kwemaziso, ** hutachiwana hwehutachiona hweHerpes B husina kurapwa hunokonzera kukwira encephalomyelitis uye kufema mitezo ine nhamba yekufa inopfuura 70 kusvika 80 muzana **.

Kana iwe kana waunofamba naye uchinge uchinge uchinge uchinge uchinge warumwa, kukwenya, kana mucosal/kuputika kweziso kubva kutsoko ine macaque kana gudo, tanga maminetsi gumi nemashanu uchikwesha maronda nesipo uye povidone-iodine kana chlorhexidine mukati memaminitsi mashanu ekutanga, wobva waenda nekukurumidza kuchipatara chenyika dzese1 g PO three times daily for 14 days)** uye Rabies Post-Exposure Prophylaxis (Human Rabies Immune Globulin [HRIG] + 4-dose rabies vaccine). Kuti uwane amburenzi yemunharaunda kana rubatsiro rwekurapa, fonera nhamba yako ye emergency emergency (112 kana 119 muIndonesia, 1669 muThailand, 112 muIndia uye European Union / Gibraltar, 119 muJapan, 999 muUnited Kingdom, 911 muUnited States neCanada) kana tarisa dhairekitori redu repasi rose re nhamba dze emergency. Kuti uwane maprotocol akakura ekurumwa nemhuka uye chimbwamupengo, ona kuratidzwa kwechimbwamupengo uye post-exposure prophylaxis, kurumwa nemhuka uye kutarisira utachiona hwemaronda,uye kudzora kubuda ropa kwakanyanya.

Ita izvi ikozvino¶

1. GORORA RUNDA NEZVIKURU KUTI UPEZE MAMINITI 15 PAPOPOTHE SINGLE MOST IMPORTANT STEP): Usamirire kusvika wasvika kukiriniki kuti ugeze chironda chacho. Hutachiona hweHerpes B uye hutachiona hwechimbwamupengo mavhairasi ane lipid-akafukidzwa anogara mukati memasero eganda epamusoro mukati memaminitsi mashoma ekutanga asati apinda mumagumo etsinga. Kurumidza kukwesha nekukwesha kuruma kana kukwesha uchienderera mberi kwe 15 maminetsi akazara newachi uchishandisa **povidone-iodine (Betadine, chlorhexidine gluconate (Hibiclens), kana kuti concentrated detergent sipo (dish soap / laundry bar) nemvura inoyerera **.
2. KANA MASIRA MUZISO KANA MUmuromo, DIRIRA NEMVURA IRI PANE KANA NESALINE KWEMAMINITI 15.NO SOAP IN EYES): Kana macaque ikaridza muridzo, ikapfira, kana kumwaya mvura/mate muziso, mhino, kana muromo, puruzira ziso rakavhurika kana mucosa nguva dzose kwe15 maminetsi nemvura yokunwa yakachena yemumabhodhoro kana kuti isina utachiona saline (usamboisa mushonga wakakasharara, doro, kana mushonga wekukwesha muziso, izvo zvinokuvadza ziso).
3. USAITA KUREGA CLINIC SUTURE KANA KUTI GLUE KURUMWA NETSOKO: Kuvhara kurumwa neprimate nematichi kana ganda glue traps Herpes B virus, rabies virus, and oral anaerobes (Eikenella corrodens, Bacteroides, Pasteurella netsinga dzetsinga dzakakuvadzwa). Rega ronda rakavhurika kuti ridonhe (kana kubvumira chete fungidziro yakasununguka mushure mekupinda neRabies Immune Globulin).
4. TANGA NEMUNHU VALACYCLOVIR (1 GRAM THREE TIMES DAILY) MUKATI 24 TO 72 HOURS FOR MACAQUE EXPOSURES: Tsoko chete dzerudzi Macaca (Macaques mhiri kweAsia neGibraltar) inotakura utachiona hweHerpes B. Shingairira kutanga Post-Exposure Prophylaxis (PEP) pamwe nemuromo Valacyclovir 1,000 mg (1 g) every 8 hours (TID) for 14 days (kana mumuromo Acyclovir 800 mg 5 times daily for 14 days) zvakanaka mukati ** maawa makumi maviri nemana (and up to 72 hours)** yekufumurwa, hutachiwana husati hwayambukira mutsinga dzepakati.
5. KUDA ZVIviri ZVINHU ZVINHU ZVINOGWARA ZVINODZIDZA GLOBULIN (HRIG / ERIG) UYE NEBAYERO YECHIRABI PAZUVA 0: Tsoko yese kana gudo rinoruma kana kukwenya kunodhonza ropa muAsia, Africa, kana Latin America i WHO Category III Rabies Exposure. Kana usina majekiseni ekudzivirira chimbwamupengo (pre-exposure rabies), mushonga wechimbwamupengo wega HAUNA kukwana, unofanirawo kugamuchira Rabies Immune Globulin (HRIG 20 IU/kg kana ERIG 40 IU/kg) yakapinda mukati nekutenderedza ronda paZuva 0 kuti isaite utachiona mukati memazuva manomwe kusvika gumi nemana muviri wako usati wagadzira masoja ekudzivirira chirwere.
6. GASHIRA AMOXICILLIN-CLAVULANATE (AUGMENTIN) UYE TETANUS BOOSTER: Miromo yeprimate inotevedzera maruva ekuruma kwevanhu (the most infectious mammalian bite); tora ** amoxicillin-clavulanate 875/125 mg PO BID for 5 to 7 days** uye ongorora nhomba yako yekudzivirira tetanus (Tdap)

Muti wesarudzo: tsoko, macaque, uye kurumwa kwegudo kana kukwenya manejimendi¶

Tevedzera uyu muti wekiriniki uye wemumunda wesarudzo nguva yekusangana kweprimate kunoguma nekuruma, kukwenya, kana mucosal splash:

flowchart TD
    Exposure["Primate Bite, Scratch, kana Saliva Splash paGanda/Ziso"] --> WashNow{"1. Kubvisa tsvina pakarepo (Mukati 0 kusvika 5 Maminitsi)"}
    WashNow -->|"Kurumwa neGanda, Kuboora, kana Kukwenya"| Scrub15["SRORA ZVAKASIMBA KWEMAMINITI 15 Akazara: Shandisa Povidone-Iodine, Chlorhexidine, kana Detergent Sipo + Mvura Inomhanya -> Rega kubuda ropa pachena -> Usambofa wakavhara suture."]
    WashNow -->|"Mate Anonyura muZiso, Mhino, kana Mumuromo"| FlushEye["DIRISA ZISO / MUCOSA KWEMAMINITI 15: Shandisa Mvura Yemumabhodhoro Yakachena kana Kuti Yakanatswa 0.9% Saline CHETE (Usamboisa sipo kana iodine mumaziso)"]
    Scrub15 --> PrimateID{"2. Ziva Primate Group uye Geography"}
    FlushEye --> PrimateID
    PrimateID -->|"Nyika Yekare MACAQUE (Genus Macaca: Bali, Thailand, India, Japan, Gibraltar, China, Philippines)"| DualRisk["NJODZI YAKURU YE HERPES B VIRUS + RABIES + BACTERIA: Enda kuInternational Travel Clinic / Chipatara Mukati Maawa 24"]
    PrimateID -->|"Non-Macaque Primate (Mboon, Vervet, Langur, Capuchin, Squirrel Tsoko, Marmoset)"| RabiesOnly["HAPANA HERPES B RISK -> RISK YAKURU YECHIRABI + MABHACTERIA: Enda kuChipatara Kunoitirwa Chimbwamupengo PEP + Mishonga inorwisa mabhakitiriya"]
    DualRisk --> MedProtocol["3. Shandisa Yakazara Post-Exposure Medical Regimen (Zuva 0)"]
    RabiesOnly --> MedProtocol
    MedProtocol --> Regimen["1. HERPES B PEP (Macaques Only): Valacyclovir 1 g PO TID x 14 mazuva (kana Acyclovir 800 mg PO 5x/zuva x 14 mazuva)\n2. RABIES PEP (WHO Cat III): Pinza HRIG (20 IU/kg) muchironda + Rabies Vaccine Mazuva 0, 3, 7, 14\n3. ANTIBIOTICS & TETANAUS: Amoxicillin-Clavulanate 875/125 mg PO BID + Tdap Booster"]
    Regimen --> NeuroWatch{"4. Tarisa Kwemazuva 21: Chero MaVesicles, Kutinhira, Fivha, Kuona Kaviri, kana Hiccups?"}
    NeuroWatch -->|"EHE: Early Neuro / Skin Signs"| IVGanciclovir["KUPIWA CHIPATARA CHECHIRANGANISO: Tanga High-Dose IV Acyclovir (12.5-15 mg/kg q8h) kana IV Ganciclovir (5 mg/kg q12h) Pakarepo"]

Phase 1: Ndeapi maprimate anotakura Herpes B virus vs. Rabies (Species and temple guide)¶

Haasi tsoko dzese dziri paPasi dzinotakura hutachiona hweHerpes B, uye hadzisi nharaunda dzese dzeprimate dzine kufanana kwechimbwamupengo. Kunyatsoziva kuti ndeipi primate bit kana kukukwenya kunosarudza antiviral prescription yako.

1. Global Primate Pathogen Matrix: Macaques vs. Baboons, Langurs, uye New World Monkeys¶

2. Sei Temberi Macaques Achirwisa Vashanyi (And How to Escape Without Being Bitten)¶

Zvidzidzo paBali's Ubud Monkey Forest, Thailand's Lopburi temples, uye Gibraltar's Upper Rock inoratidza kuti inopfuura ** 85 muzana yekurumwa nemacaque inoitika mukati memaitiro matatu chaiwo evanhu **: 1. Kubatirira paChikafu, Mabhegi ePurasitiki, Mabhodhoro eMvura, Magirazi ezuva, kana Mafoni: Macaque emutemberi anodzidziswa neruzivo kubvuta magirazi emaziso, ngowani, nhare nemabhegi akapfava, achiabata nhapwa kusvika mugadziri aatengesa chidimbu chemuchero (a learned bartering behavior) Kana tsoko yakabata bhegi rako, magirazi ezuva, kana bhodhoro remvura, REGAI KUCHIDZOPO. Kudhonzera kumashure kunokonzeresa kurumwa nekanini pakare paruoko rwako kana paruoko. 2. Kunyemwerera Nemazino Akafumurwa kana Kutarisa Kwakananga (Primate Threat Display): Mutauro wemuviri wemacaque negudo, kukiya kutarisisa ziso uye kudhonza miromo yako kumashure kuratidza mazino ako (a human smile for a selfie) ndiyo yepasirese primate gesture yekutya-hasha nekupikisa. Chengeta miromo yako yakavharika pamusoro pemazino ako, dzivisa kutarisa zvakananga, uye usambofa wakatsikitsira pasi pachiyero cheziso nechirume chirume macaque kana amai vakatakura mucheche. 3. Kukwira Pamafudzi eVashanyi (Head and Neck Bite Hazard): Usambobvumira mutengesi wemutemberi kuisa nzungu kana mabhanana pamusoro wako kana pamapfudzi kuitira kuti macaque akwire pamutsipa wako. ** Kurumwa kana kukwenya kumusoro, kumeso, kana mutsipa kunotakura njodzi yepamusoro yekufa kune ese ari maviri hutachiona hweHerpes B uye Rabies ** nekuti cranial nerves (trigeminal, facial) kupa nzira ipfupi-pfupi (just centimeters) yakananga muuropi musati mave post-exposure prophylaxis yatanga kushanda.

Chikamu 2: Nhanho-ne-nhanho yekutanga rubatsiro uye yekurapa prophylaxis (First 15 minutes to 72 hours)¶

Kana macaque kana gudo richityora ganda kana kuridza mucous membrane, tevera iyi chaiyo yenguva yakatarwa.

1. Minute 0 kusvika Miniti 15: Mechanical uye Chemical Viral Inactivation¶

   [ 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

• Nei Maminitsi gumi nemashanu Akazara Achisungirwa: Ose ari CDC Herpes B Virus Working Boka (Cohen et al., Clinical Infectious Diseases) uye World Health Organisation (WHO) Mitemo Yechimbwamupengo tsanangura zvizere maminetsi gumi nemashanu ekugeza uchiramba uchigeza uye nekukwesha nemuchina (shandisa gauze pedhi rakachena kana jira rakapfava kukwesha zvinyoro nyoro mukati mepaboora mazino kana pakukwenya, zvichiita kuti kubuda ropa kudiki kuburitse mate).
• ** Ndeapi maVirucidal Agents Anoshanda paHerpes B uye Rabies?**:
• Sarudzo Yekutanga YeGanda: Povidone-iodine (Betadine 7.5% kusvika 10%), chlorhexidine gluconate (2% to 4%), benzalkonium chloride, kana yakadzika imba yekugezesa / yemvura sipo yedhishi / sipo yemubha ine mvura inoyerera yakawanda.
• **Zvakadini Kana Iwe Uri paTemberi Iine Bhodhoro reMvura uye Ruoko Chechekuchenesa korobha. (Cherechedza: KuUbud Sacred Monkey Forest muBali nematemberi makuru eThai, kiriniki yerubatsiro rwekutanga iripo ine povidone-iodine, enda ikoko nekukasika, geza kwemaminitsi gumi nemashanu, wobva wananga kuchipatara chepasi rose cheValacyclovir neRabies RIG, sezvo matumba etembere anongoisa Betadine paganda uye HAUSAPI majekiseni anorwisa mavhairasi.

2. Awa 1 kusvika Awa 72: Antiviral Prophylaxis yeHerpes B Virus (Valacyclovir vs. Acyclovir)¶

Maererano ne ** US Centers for Disease Control and Prevention (CDC)** uye National B Virus Resource Center (Georgia State University) mirayiridzo yekiriniki:

3.Simultaneous Rabies Post-Exposure Prophylaxis (HRIG + 4-Dose Vaccine Schedule)¶

Nepo vafambi vekuUnited States kana kuEurope vachiwanzoverenga mapepa enhaurirano dzekuti mhuka dzesango vs. dzakatapwa murabhoritari macaque dzinoda Herpes B vs. Rabies care, paAsia neAfrica matemberi evashanyi, unofanira kubata ZVIRI MUKATI imwe chete. Usarega kiriniki yeko ichikupa chirwere chechimbwamupengo pasina Valacyclovir, uye usatore Valacyclovir chete isina Chimbwamupengo PEP:

1. Kune Vafambi Vasina kubayiwa (No Prior Pre-Exposure Rabies Series):
2. ** Danho A: Passive Immunity (Day 0 Only)**: Pinda Chimbwamupengo cheHuman Immune Globulin (HRIG pa 20 IU/kg uremu hwemuviri), kana kunatswa Equine Rabies Immune Globulin (ERIG pa 40 IU/kg) kana HRIG isipo, **zvakananga pakadzika nekumacheto kwese kuruma uye kukwenya chiratidzo **. Chero vhoriyamu yasara isingakwanise kukwana muronda (somuenzaniso, kuruma pachigunwe) inobayiwa intramuscularly panzvimbo iri kure (such as the anterior thigh or deltoid opposite the vaccine arm)
3. Iyo yakakosha 7-Day HRIG Window: Kana kiriniki iri kure kwaunogamuchira mushonga wako weZuva 0 rabies yapera muHRIG (a common issue at small island clinics in Indonesia or rural India), ** iwe unosvika kuZuva rechinomwe mushure mekudzivirira kwekutanga dose kubhururuka kana kuenda kuchipatara chikuru (Denpasar, Bangkok, Singapore, New Delhi, or home) kuwana HRIG jekiseni **. Usapinze HRIG mushure meZuva rechinomwe, sezvo ichidzvanyirira mhinduro yako yekudzivirira yekudzivirira.
4. Nhanho B: Kubaiwa Kunoshanda (4-Dose Intramuscular Vaccine Series): Jekiseni 1.0 mL (kana 0.5 mL zvinoenderana nerudzi: Verorab, Rabipur/RabAvert, Imovax) ** intramuscularly kupinda deltoid tsandanyama ** (never into the gluteal/buttock muscle, kana anterolateral thigh in young children) pa Mazuva 0, 3, 7, uye 14 (pamwe ne Zuva 28 kana immunocompromised).
5. Kune Vafambi Vakambobaiwa (Completed Pre-Exposure PrEP or Prior PEP):
6. **Usape HRIG **. Shandisa 2 intramuscular booster dosi rekudzivirira chimbwamupengo paZuva 0 uye Zuva re3 chete.

4. Polymicrobial Bacterial Prophylaxis (Why Monkey Bites Infect Within 12 Hours)¶

Mhandara dzemumuromo dzisiri dzemunhu dzine huwandu hwealpha-hemolytic Streptococci, Staphylococcus aureus, Eikenella corrodens, Pasteurella, Bacteroides, uye Fusobacterium: - Mutsara wekutanga Oral Antibiotic: Amoxicillin-clavulanate (Augmentin 875/125 mg PO every 12 hours kwemazuva mashanu kusvika ku7). - Penicillin-Allergic Patients: Doxycycline (100 mg PO BID) kana Moxifloxacin (400 mg PO daily, kana Ciprofloxacin (500 mg PO BIDPLUS Metronidazole (500 mg PO TIDClindamycin ()300-450 mg PO TID) (never use a single cephalosporin, macrolide, or clindamycin alone, which miss Eikenella and Pasteurella)

Chikamu 3: Kuziva zviratidzo zvehutachiona hweHerpes B (The 3-to-30-day neurological red-flag window)¶

Kunyangwe mushure mekupedza kukwesha maronda nekutanga Valacyclovir, munhu wese akarumwa kana kukweshwa nemacaque anofanira kuzviongorora zuva nezuva kwe mazuva makumi matatu.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

• Nei Kuramba Kugwinya, Diplopia, kana Kudzvokora Nhengo Inoda Kukasika IV Antivirals:
• Kusiyana nemaronda anotonhora evanhu (HSV-1), Hutachiona hweHerpes B hunogara huchifamba netsinga dzeparutivi pasina kana kugadzira blister reganda rinoonekwa panzvimbo yekuruma (> 50% of patients never develop local vesicles)
• Pane kudaro, chiratidzo chekutanga chekunyevera ndeche ** kurwadziwa kweuropathic, kupisa, kusanzwa, kana kukwenya zvakanyanya (pruritus) ichipenya kusvika kumucheto wakarumwa **, ichiteverwa nefivha yakaita sefuruu, **kuramba kugwinha (persistent hiccups)singultus, inokonzerwa nehutachiona hwehutachiona hwe medulla oblongata) , ** maonero maviri (diplopia), kunetseka kumedza (dysphagia), kana kushaya simba kwemakumbo (Landry-type ascending paralysis)
• Muchipatara Kurapwa Kwezvirwere zveHerpes B: Oral Valacyclovir ndeye kudzivirira (kudzivirira)PEP) zviratidzo zvisati zvaoneka. Kana chero blister yemunharaunda kana chiratidzo chetsinga chatanga, murwere anoda kukurumidza kuchipatara uye **intravenous antiviral therapy **:
  1. Pasina CNS Zviratidzo (Local skin vesicles or peripheral paresthesia only): Intravenous Acyclovir (12.5 to 15 mg/kg IV every 8 hours) KANA Intravenous Ganciclovir (5 mg/kg IV every 12 hours) kweanenge 14 kusvika kumazuva 21 kusvika zviratidzo zvese zvagadziriswa uye hutachiwana hwePCR tsika dzisina kunaka.
  2. NeChero CNS / Brainstem Symptoms (Fever + headache, tingling, hiccups, diplopia, ataxia, or weakness): Intravenous Ganciclovir (5 mg/kg IV every 12 hours) ndiwo mushonga wesarudzo unokurudzirwa neCDC Herpes B Working Group nekuti ganciclovir inoratidza zvakanyanya in vitro uye in vivo potency pakurwisa Macacine alphaherpesvirus 1 mukati me central nervous system kupfuura acyclovir.

Nhamba dzenharaunda dze emergency, makiriniki epasi rose, uye mareferensi marabhoritari¶

Mushure mekupedza 15-maminetsi ekukwesha ronda panzvimbo, enda zvakananga ku ** chipatara chepasirese kana kiriniki yemishonga yekufamba yakatsaurirwa ** (do not rely solely on a temple first-aid booth or hotel nurse):

• Bali neIndonesia: Dial 112 kana 119 zve ambulance. MuBali (Ubud / Kuta / Nusa Dua / Canggu), enda ku BIMC Hospital (Kuta: +62 361 761263 / Nusa Dua: +62 361 3000911 / Ubud Medical Centre: +62 361 971313), Siloam Hospital Denpasar (+62 361 779900), kana SOS Medika Clinic Bali (+62 361 710505), iyo inotengeswa kunze kwenyika HRIG (Berirab/HyperRAB), Verorab vaccine, uye oral Valacyclovir (Valtrex).
• Thailand (Bangkok, Phuket, Lopburi, Krabi, Chiang Mai): Dial 1669 yeEMS kana 1155 yeTourist Police. Enda ku ** Queen Saovabha Memorial Institute (Thai Red Cross Society Snake & Rabies Clinic, Bangkok: +66 2 252 0161)**, Bangkok Hospital Phuket (+66 76 254 425), kana Bumrungrad International Hospital (+66 2 066 8888).
• India & Nepal: Dial 112 (108 ambulensi) muIndia; mu Kathmandu (Swayambhunath Monkey Temple), enda zvakananga ku CIWEC Hospital Travel Medicine Center (+977 1 4524111), kiriniki yegoridhe inoruma mhuka mudunhu iri. MuIndia, enda kuchipatara chikuru chepamusoro chekambani (Apollo, Max, Fortis, Manipal) uye kukumbira zvose ** Human Rabies Immune Globulin (HRIG)** uye Valacyclovir 1,000 mg mapiritsi (Valcivir).
• Gibraltar, United Kingdom, uye European Union: Dial 112 kana 190 muGibraltar (St Bernard's Hospital ine yakatsaurirwa Barbary Macaque bite protocol). MuUK, dial 999 kana 111 (UKHSA Rabies and Monkey B Virus Service); mhiri kweEU, dial 112.
• Japan, Hong Kong, Singapore, neMalaysia: Dial 119 muJapan, 999 muHong Kong (Queen Elizabeth / Prince of Wales A&E) uye Malaysia, kana 995 muSingapore (Tan Tock Seng Hospital / National Centre for Infectious Diseases [NCID])
• United States & Global Herpes B Reference Laboratory: Call 911 zve emergency. Vanachiremba pasi rese vanogona kubvunza National B Virus Resource Center kuGeorgia State University (Atlanta, USA) 24/7 Emergency Hotline pa +1-404-413-6550 kana iyo CDC Emergency Operations Center (+1-770-488-7100) yePCR/serology diagnostics uye kiriniki antiviral nhungamiro.

Mibvunzo inowanzo bvunzwa¶

Ndedzipi tsoko dzinotakura utachiona hweHerpes B, uye tsoko dzese dzinahwo here?¶

Kwete, chete Tsoko dzeNyika Yekare dzerudzi Macaca (macaques), dzinosanganisira Rhesus macaques, Long-tailed (crab-eating) macaques, Japanese macaques, uye Barbary macaques anowanikwa mhiri kweBali, Thailand, India, Nepal, Malaysia, Singapore, Hong Kong, Japan, neGibraltar, ari natural reservoirs (Herpes virus) kusvika 90 muzana yevakuru macaques vakaitakura asymptomatic. Mababoon, vervet tsoko, maLangurs ekuAsia, netsoko dzese dzeCentral neSouth America (Nyika Itsva) dzakaita semakapuchin, tsoko dzetsindi, nemarmoset HAZVISANGANIRI kutakura utachiona hweHerpes B, kunyangwe zvichiri kuda kukurumidza kurapwa kweRabies Post-Exposure Prophylaxis nemishonga inorwisa mabhakitiriya.

Sei kukwesha macaque kuruma kana kukwenya kwemaminetsi gumi nemashanu ipapo kwakakosha?¶

Hutachiona hweHerpes B uye hutachiona hwechimbwamupengo hwakakomberedzwa nehamvuropu ine lipid (mafuta) isina kusimba uye inoramba iri pamusoro pemaseru eganda kwemaminetsi mashoma mushure mekurumwa kana kukwenya isati yasunga kune peripheral sensory nerves uye inofamba ichikwira mumusana neuropi. Kana hutachiona hwangopinda mutsinga axon, maantiseptics epamusoro haachakwanise kusvika kwairi. Kukwesha ronda nekukasika kwemaminetsi gumi nemashanu akazara nepovidone-iodine (Betadine), chlorhexidine, kana sipo yakanyungudutswa yekugezesa nemvura inoyerera inonyungudutsa hamvuropu yehutachiwana hwelipid pakubata uye inosuka chikamu che99 muzana cheutachiona husati hwapinda.

Ndeipi chaiyo dose yeValacyclovir kana Acyclovir inodiwa kudzivirira Herpes B virus mushure mekurumwa nemacaque?¶

Nekuti hutachiona hweHerpes B hunoita ka10 kushomeka kune antivirals pane yemunhu inotonhora-sore herpes (HSV-1), yakajairwa yakaderera-dozi inotonhora-inotonhora mishonga haina kukwana. Maererano neCDC Herpes B Virus Working Group nhungamiro, vanhu vakuru vanoda yemuromo Valacyclovir 1,000 mg (1 giramu) inotorwa katatu zuva nezuva (maawa masere oga oga) kwemazuva gumi nemana akazara, kana neimwe nzira yemuromo Acyclovir 800 mg inotorwa kashanu zuva nezuva kwemazuva gumi nemana, yakatanga zvakanaka mukati memaawa 24 kusvika ku72 kubva pakurumwa, kuputika, kana kuputika kweziso.

Chii chandinofanira kuita kana tsoko yemacaque ikapfira kana kumwaya mvura muziso rangu?¶

Ocular splashes of macaque saliva kana cage/pool mvura inzira yakanyorwa yekuuraya munhu Herpes B virus kutapurirana kuburikidza neconjunctiva uye optic/trigeminal nerves. USAisa sipo, povidone-iodine, kana doro muziso rako; pachinzvimbo, bata maziso ako akasvinura uye ramba uchipukuta ziso kwemaminetsi gumi nemashanu akazara nemvura yekunwa yemubhodhoro yakachena kana sterile 0.9% normal saline, wobva waenda nekukasika kuchipatara kunotanga oral Valacyclovir (1 g katatu zuva nezuva kwemazuva gumi nemana) uye kurukura nezvechimbwamupengo prophylaxis.

Ndichiri kuda Rabies Immune Globulin (HRIG) kana ndikawana jekiseni rechimbwamupengo pazuva rekurumwa netsoko?¶

Hongu, kana usati wambowana pre-exposure rabies pre-exposure pamberi perwendo, tsoko yega yega inopwanya ganda inoruma kana kukwenya munyika ine chimbwamupengo (seIndonesia/Bali, Thailand, India, Nepal, Africa, kana Latin America) iWHO Chikamu III kufumurwa kunoda ZVINO 4-dose rabies vaccine GHRINEI GHRINE GHRUS 20 IU/kg) yakapinda mukati nekutenderedza ronda. Nekuti jekiseni rechimbwamupengo rinotora mazuva manomwe kusvika gumi nemana kukurudzira immune system yako kuti igadzire masoja ekudzivirira chirwere, HRIG inopa masoja ekudzivirira chirwere nekukasika panzvimbo yekuruma mukati mesvondo rekutanga rine njodzi.

Ndezvipi zviratidzo zvekunyevera mukati memazuva makumi matatu ekutanga mushure mekurumwa kwemacaque zvinoreva kuti ndinoda kurapwa kwechimbichimbi IV?¶

Tsvaga pakarepo kuchipatara kwekukurumidzira kuchipatara cheGanciclovir (5 mg / kg IV maawa ose e12) kana chiyero chepamusoro IV Acyclovir kana iwe ukagadzira chimwe chezvinotevera mukati me3 kusvika kumazuva makumi matatu ekutsvaga macaque: blister yakazara-fluid kana maronda pedyo neronda; kutsva, kurira, kuita chiveve, kana kuvava kwakanyanya kunoburitsa ruoko kana gumbo rakarumwa; fivha isingatsananguriki kana musoro wakakomba; kuramba kusingagoneki hiccups (chiratidzo chekare cheHerpes B brains kuzvimba); kuona kaviri, dzungu, kunetseka kumedza, kana kushaya simba kwemakumbo.

Mazano anoenderana¶

• Kuratidzwa kwechimbwamupengo, kusangana nezviremwaremwa, uye post-exposure prophylaxis
• Kurumwa nemhuka uye kuchengetedza utachiona hwemaronda
• Rabid gava, raccoon, coyote, kana skunk masikati kurwisa kudzivirira
• Kubuda ropa kwakanyanya uye kudzora kubuda kweropa

Nzvimbo uye nhungamiro yepamutemo¶

• Centers for Disease Control and Prevention (CDC, United States): CDC Yellow Book (Health Information for International Travel): Zoonotic Exposures: Bites, Scratches, and Other Hazards from Macaque Monkeys (Herpes B Virus / Macacine alphaherpesvirus 1) uye Chimbwamupengo.
• Cohen, J. I., Davenport, D. S., Stewart, J. A., nevamwe. (B Virus Working Group, Clinical Infectious Diseases / CDC): Kurudziro yekudzivirira uye Kurapa kweKuratidzwa kune B Virus (Cercopithecine Herpesvirus 1).
• National B Virus Resource Center (Georgia State University, Atlanta, USA): Emergency Standard Operating Procedus yeMacaque Bite/Scratch Decontamination, Diagnostic Testing, uye Post-Exposure Prophylaxis.
• World Health Organisation (WHO): WHO Nyanzvi Consultation pamusoro pechimbwamupengo: Category III Exposure Management, Local Wound Infiltration of Rabies Immunoglobulin (HRIG/ERIG), uye Zvirongwa zveVaccine.
• Infectious Diseases Society of America (IDSA): *Dzidzira Mirayiridzo yeKuongororwa uye Kutungamirirwa kweGanda uye Soft Tissue Infections Kutevera Non-Human Primate Bites *.