Buuxinta Bullaacadaha Isku-dhafka ah (CSO) ee Wabiga Maxaliga ah, Harada, ama Xeebta Roobabka Mahiigaanka ah ka dib: Wasakhyada Wajaha Ceyriinka ah, Leptospirosis, iyo Sumaynta Immersion Kadib¶

Marka dabaylaha xagaaga, roobka kulaylaha ah, ama baraf dhalaalayo degdega ah ay daadiyaan in ka badan 1.5 ilaa 2.5 sentimitir (0.6 ilaa 1.0 inch) oo roob ah saacadiiba magaalo qadiimi ah oo ay u adeegto Nidaamka Bullaacadaha Isku-dhafan (CSS, dhirta sifaynta biyaha wasakhda ee degmadu ma xamili karaan isku darka qulqulka biyaha dabaylaha waddooyinka iyo bulaacada nadaafadda guriga. Si looga ilaaliyo bulaacada ceeriin in ay ku talaabsato kumanaan guri oo dhulka hoostiisa ah iyo waddooyinka magaalada, weelasha biyaha nadiifka ah ee tooska ahCSODuufaannada) waxay ka furan yihiin hareeraha wabiyada magaalooyinka, kanaalka doonyaha, dekedaha, iyo xeebaha dabaasha, iyagoo soo daaya malaayiin litir oo ** saxaro dad ah oo aan la daweyn, haraaga isbitaallada, qulqulka warshadaha, iyo biyaha waddooyinka kaadida-jiirarka* si toos ah u gala marin biyoodyada madadaalada 24 ilaa 72 saacadood ka dib marka roobku istaago. Haddi doonyaha, doonyaha, saddexlete-talete, dabaasha, kalluumaysatada, shaqaalaha samatabbixinta, ama xayawaanka rabaayada ah ay ku qarqmaan wabiga, harada, ama xeebta inta lagu jiro ama gudahooda 48 saacadood CSO Dheecaan, waxay la kulmaan soo-gaadhis degdeg ah ** leptospirosis (Cudurka Weil)**, enterotoxigenic Escherichia coli (STEC O157:H7, norovirus, hepatitis A, Cryptosporidium,iyo **Vibrio vulnifics* Ka wac lambarkaaga degdega ah (911 gudaha Maraykanka iyo Kanada, 112 guud ahaan Midowga Yurub, 999 gudaha Boqortooyada Midowday) nambarada degdega ah Hagaha haddii qof uu yeesho qandho sare, cagaarshow, bullaae maqaarka casaan-guduudan, ama cidhiidhi xagga neefsiga ah ka dib hadhka biyaha wasakhda ah, oo la tasho hagaha walaalahayada xooga bulaacada nadaafadda dilaac weyn, bulaacada ceeriin ee wadada, iyo xidhitaanka waalka biyaha danbe, bullaacadaha waaweyn ee buux dhaafiyey iyo daadadkii waddooyinkaiyo Biyaha magaalada oo dhan iyo biyo karkari.

Ka badbaadista quusitaanka shilalka ah ama xidhiidhka madadaalada ee ** Buuxdhaafka Bullaacadaha Isku-dhafka ah (CSO(SSO*** plume waxay u baahan tahay fulinta afar borotokool ay dejisay ** U.S. Wakaaladda Ilaalinta Deegaanka (EPA Qaran CSO Siyaasadda Xakamaynta), Xarumaha Xakamaynta iyo Kahortagga CudurradaCDC, Ururka Caafimaadka AdduunkaWHO, iyo ** Hay'adda Ammaanka Caafimaadka ee Boqortooyada Midowday (UK)UKHSA*: ** Dhaqangelinta qasabka ah ee 48-72-saacadood ee roobka ka dambeeya "No-Swim / No- Capsize" daaqadda hoose ee magaalada CSO soo-baxa *, ** samaynta 15-daqiiqo madax-ilaa-lugo diirran oo saabuun iyo biyo ah oo ay ku xigto waraabka cadaadis-sare (500 mL biyo la cabbi karo ama milix nadiif ah oo lagu daray 2% Chlorhexidine ama Povidone-IodineMaqaar kasta oo xoqo, finan, ama leech/cayayaan qaniinyo ka hor inta aanay bakteeriyadu soo gelin maqaarka. 0.9% cusbada adigoon isticmaalin biyaha tuubada gudaha sanka, iyo codsado qiimayn caafimaad oo la beegsaday ka dibDoxycycline 200 mg hal-dose leptospirosis prophylaxis, Tdap xoojinta teetanada, iyo Hepatitis A tallaalka/immunoglobulin 14 maalmood gudahood) marka la nuugo khatarta sare leh ama boogaha furan ay dhacdo.

Hadda samee tan¶

1. ** Isla markiiba ka bax biyaha haddii aad aragto ama urayso CSO Tilmaamayaasha Soo-baxa: Buluushka Brown-Grey, Sabbayn "Qashinka bulaacada" (Qoyan, Codsadayaasha Tampon, Kondhomyada), Xumbada Dusha sare/Slicks Dufan, ama Gulls Ku Quusidda Dhuumaha Hoosta.** Magaalooyin badan CSO Biyo-baxyada ayaa hoos u dhigaya marin-biyoodka webiyada, harooyinka, iyo xeebaha waxayna bilaabaan inay soo daayaan 15 ilaa 30 daqiiqo gudahooda ee roobab culus. Haddi ay duufaan ku dhufato marka aad doon doonaysid, kayaking, paddleboarding, ama dabaasha, ama haddii degmadaada CSO Khariidadda digniinta waxay muujinaysaa dareere firfircoon ama dhawaanwithin the past 48 hours), isla markiiba biyaha ka bax, afkaaga ha xidho si aanay buufinta u kac ku dhicin bushimahaaga, gacmaha iyo wejigana ha ku raacin webiga dhexdiisa.
2. ** Fulin "Xubabka 30-ka Daqiiqo ee Kowaad & Wasakhowga Qubeyska" Kahor Cunista, Cabitaanka, ama Taabashada Wajigaaga.60% to 70% alkohol jel** (xusuusnow in jelka alkoholku uu dilo bakteeriyada sida E.coli iyo Leptospira,laakin ma dilo Norovirus ama Cryptosporidium oocysts, waa in aad ku maydho is jiid jiid iyo saabuun). Ka saar dhammaan suuit qoyan, finan yaryar, jaakadaha badbaadada (PFDs), iyo kabo ku shub bannaanka ama bac qashin ah, si fiican ugu maydh ** biyo diirran iyo saabuun bakteeriyada bakteeriyada ugu yaraan 5 ilaa 10 daqiiqo**, sankana ka afuuf oo tufi candhuuf kasta halkii aad liqi lahayd dhibicda sanka ka dambaysa.
3. ** Waraabi Googo Kasta, Qaniinyada Rower's, xoqid, ama Qaniinyada Bug Hoosta Cadaadis Sarreya oo socda Biyaha 5 daqiiqo oo buuxa, mari Povidone-Iodine ama Chlorhexidine, oo waligaa ha xidhin ama ku duubin nabarka wasakhda ahi si adag u soo shaacbaxday. xoqitaanka qolof cago qaawan) waxay u adeegaan sidii marin toos ah oo loogu talagalay *** Leptospira* spirochetes ***, *** Aeromonas hydrophila **, iyo *** Vibrio vulnificus . Ku xoq oo ku nadiifi nasasho kasta oo maqaarka ah ** saabuun iyo biyo socda oo la cabbi karo (ama a 500 mL dhalada cusbada ee nadiifka ah oo la dalooshay si ay u durduriso qulqulka la cadaadiyo), mari 10% Povidone-Iodine (Betadine) ama 2% to 4% Chlorhexidine Gluconate ( Hibiclens*), oo ku dabool faashad nadiif ah oo nadiif ah oo neefsan karta ( waligaa ha ku xidhin boogta wasakhaysan ee wasakhaysan xabagta maqaarka dareeraha ah ee cyanoacrylate ama xabagyada balanbaalisada oo dhagan, kaas oo ku dabinaya bakteeriyada anaerobic iyo necrotizing gudaha).
4. **Haddii Biyaha Wasaqda ee Wabiga ama Xeebta ay ku soo firdhiyaan indhahaaga ama afkaaga: Ku nadiifi indhahaaga oo nadiif ah 0.9% milix 5 ilaa 10 daqiiqo ah, oo afkaaga ku luqluq oo ku luqluq oo afkaaga ku luqluqdo afkaaga jeermiska dila adiga oo aan liqin. ku waraabi labada indhood adigoo isticmaalaya isha milixda ee nadiifka ah. Tuug oo tufo 0.12% Chlorhexidine ama alkohol/cetylpyridinium afka dhaqida jeermiska disha ilaa 30 ilbiriqsi si loo yareeyo xuubka afka ee fayraska iyo culeyska bakteeriyada.
5. **La xidhiidh dhakhtarka ama rugta daryeelka degdega ah 24 saacadood gudahood haddii aad liqday CSO Biyo ama Boog Furan oo La Liiqay: Weydii Wax ku saabsan Doxycycline Kahortagga Leptospirosis, Tdap Kobciyaha Teetanaha, iyo Hepatitis A Kahortagga Soo-gaadhista Kadib Doxycycline 200 mg kahortagga soo-gaadhista kadib (PEP24 ilaa 72 saacadood gudahood si looga hortago leptospirosis, a Tdap / Td teetanada xoojisa haddii talaalkaagii ugu dambeeyay uu ka badnaa 5 sano ka hor ee nabar wasakh ah, iyo hal dose oo ah **Tallaalka Cagaarshowga A (oo lagu daray). IG haddii difaac la'aan) 14 maalmood gudahood *** haddii aan la tallaalin.
6. ** U fiirso Calamada Cas "Labada Waji" ee soo socda 2 ilaa 30 maalmood: Cellulitis degdeg ah (12 to 72 Hoursvs. Leptospirosis / Cudurka Weil5 to 14 Days.** Isla markiiba u tag Waaxda Gurmadka Degdegga ah ee Cisbitaalka oo si cad ugu sheeg dhakhtarka kala-soocidda "Waxay igu dhex milmeen webiga/ xeebta [Taariikhda]" haddii aad yeelato **(A) Si degdeg ah u faafiya barar maqaarka guduudan/guduudan, xanuun daran oo u dhiganta googooyn yar, ama finan dhiigu ka buuxo 12 ilaa 7 saacadood gudahood. necrotizing fasciitis), AMA (B) Qandho sare, xanuun kubka iyo dhabarka hoose oo aad u daran, indho dhiig leh (conjunctival suffusion malax la'aan), indho/maqaar huruud ah (jaundice), kaadi madow madow, ama dhiig qufac 2 ilaa 30 maalmood ka dib (cudurka leptospirosis / Weil's disease).

Geedka go'aanka: qulqulka bulaacada ee isku dhafan (CSO) sun-saaridda iyo kala-soocidda caafimaadka¶

flowchart TD
    A["Qofka ama Xayawaanka lagu miiray ama lagu miiray Wabiga, Harada, Kanaalka, ama Xeebta Inta lagu jiro ama gudahooda 48-72 saacadood ka dib roobab culus (CSO / dhacdo SSO)"] --> B{"Talaabada degdega ah 1: Sun-saarid 30 Daqiiqo Gudahood ka Bixitaanka Biyaha"}
    B --> C["Ka saar qalabka qoyan ee bannaanka -> Qubeyska 5-10 daqiiqo biyo diirran oo la cabbi karo iyo saabuun -> Ku waraabi DHAMMAAN jeexjeexyada/ finanka 500 mL biyo cadaadis leh + Povidone-Iodine / Chlorhexidine -> Ku nadiifi indhaha oo nadiif ah 0.9% cusbo"]
    C --> D{"Qofku ma liqay biyaha wasakhaysan, ma madixiisa hoos mariyay, mise soo bandhigay jeex/finan/finan furan?"}
    D -->|"HAA: Biyo la liqay, madaxa la geliyo, ama nabar maqaarka oo furan"| E["La-talinta Caafimadka/Daryeelka Degdegga ah ee Isla-Maalin ah (gudahood 24-72 saacadood): 1. Tdap Kobciyaha Teetanaha (haddii >5 sano laga soo bilaabo qiyaastii u dambaysay) 2. Kala hadal Doxycycline 200 mg PO x1 Leptospirosis PEP (biyaha cusub/webiga magaalada)"]
    D -->|"MAYA: Ku firidhfid kooban oo ku firidhsan maqaarka aan hagaagsanayn oo keliya, isla markiiba maydhay"| F["La soco maqaarka iyo heerkulka 30 maalmood; ka nadiifi doonta/qalabka/ dharka qoyan ee leh 0.1% Sodium Hypochlorite (1:50 bleach) ama Quaternary Ammonium"]
    E --> G{"La soco Calamada Cas ee Ba'an ee Caafimaad ee ka badan Maalinta 1 ilaa Maalinta 30aad"}
    F --> G
    G -->|"Saacadaha 12 ilaa 72: Si degdeg ah u faafaya barar maqaarka cas/guduud ah, xanuun daran oo u dhigma inta la gooyo, ama bullaae"| H["QAYBTA DEGDEGGA AH isla markiiba: Aeromonas hydrophila tuhmanaha (biyaha cusub) ama Vibrio vulnificus (brackish/water saltwater) Caabuqa necrotizing -> IV Ceftriaxone/Cefepime + Doxycycline + La-talin Qalliin"]
    G -->|"Maalmaha 1 ilaa 10: Qaraxyo shuban biyood ama dhiig leh, matag, calool xanuun"| I["GI Pathogen Workup: Fuuqcelinta Afka ee cusbada (ORS) -> Saxarada PCR (STEC O157:H7, Salmonella, Campylobakter, Cryptosporidium, Giardia) -> KA FOG JOOGTA daawooyinka antimotility (Loperamide) haddii shuban dhiig leh / qandho"]
    G -->|"Maalmaha 2 ilaa 30: Qandho sare oo degdeg ah, kubka/dhabarka myalgia oo daran, indho cas (conjunctival suffusion), cagaarshow, kaadi madow, ama neefta oo yaraata"| J["QAYBTA XAALADDA DEGDEGGA AH Isla markiiba: Laga shakisan yahay Leptospirosis / Cudurka Weil -> Dhiiga/Kaadi PCR + MAT Serology, Kelyaha/Cagaarshowga Panel -> Bilow Doxycycline ama IV Ceftriaxone isla markiiba ka hor xaqiijinta shaybaadhka"]

Qaybta 1: Sida Buuxinta Bulacadaha Isku-dhafan (CSOShaqeeya & Sababta "Xeerka Roobka Kadib 48-ilaa-72-Saacadood" u jiro¶

In ka badan ** 700 oo degmo oo ku yaal Mareykanka *** (ku uruursan yihiin Waqooyi-bari, Harooyinka Weyn, Midwest, iyo Waqooyi-galbeed ee Pacific, sida New York City, Chicago, Boston, Philadelphia, Washington D.C., Seattle, Portland, St. Louis, iyo Indianapolis), iyo sidoo kale magaalooyinka waaweyn ee guud ahaan **United Kingdom (London Thames Tideway, Manchester, Vancouver, Glasgow)**ToCanada Yurub (Paris Seine, Berlin Spree), ku tiirsan 19-aad iyo horraantii-qarnigii 20-aad Nidaamyada Bullaacadaha Isku-dhafka ahCSS).

1. Fiisigiska Haydarooliga ee a CSO Regulator Weir¶

• ** Socodka Cimilada ee Qalalan:** Inta lagu jiro cimilada qalalan, 100 boqolkiiba bulaacada nadaafadda guriga (musqulaha, saxanadaha, isbitaalada, bullaacadaha warshadaha) waxay maraan hal tubo ilaa ** Warshad Daawaynta Biyaha wasakhda ah (WWTP)**.
• ** Cimilada qoyan oo qulqulaya (> 0.5 to 1.0 inch / 1.3 to 2.5 cm Da'da roobka):** Sababtoo ah barkadaha dabaylaha-mareenka ah ee qabsada waxay ku quudiyaan sida saxda ah ee tuubooyinka dhulka hoostiisa, duufaanka xooggani wuxuu kordhiyaa mugga qulqulka 10-ilaa 50-laab 20 daqiiqo gudahood.
• The Relief Weir: Si looga hortago in warshadda daawaynta daadato lagana joojiyo bulaacada ceeriin ee ka qaraxda musqulaha la deggan yahay, dhulka hoostiisa ** biyo xireenka weecinta (regulator weir ama tide gate*** daadinta qulqulka isku-dhafka ah ee xad-dhaafka ah, oo ka kooban ** wasakh, aan koloriin lahayn, wasakh aan koloriin lahayn oo lagu daray qulqulka waddooyinka magaalooyinka ***, si toos ah uga baxsan webiga ama xeebta xeebta CSO tuubooyinka soo baxa.
• Bulaacadaha nadaafadda oo buuxdhaafay (SSOsMagaalooyinka Bulaacadaha ee Kala Duwan: Xataa magaalooyinka cusub ee leh duufaanta iyo tubooyinka nadaafadda, roobka culus ayaa gudaha u gala biyo-xidheenka wasakhda dhulka hoostiisa (** Qulqulka iyo Galitaanka [I&I]) ama garaaca bambooyinki saldhigyada bulaacadaha korontada ku qaada, taasoo keeneysa ** bulaacada fayodhowrkaSSOs) Xumbo ka soo baxa godad godad ah oo si toos ah u gala dooxooyinka xaafadaha iyo harooyinka.

2. Maxay Biyuhu Wali Khatar u Yihiin 24 ilaa 48 Saac Kadib Markuu Cirku Naxo?¶

Dabbaallayaasha, saddexda ciyaar-yahanka, iyo kuwa doobabka wata ayaa had iyo jeer khalad sameeya inay galaan webiga ama xeebta subaxda ka dib onkod culus sababtoo ah qorraxdu way dhalaalaysaa. ** Kadib a CSO dheecaanku wuu dhamaanayaa, marin biyoodku wuxuu ahaanayaa mid aad u wasakhaysan 48 ilaa 72 saacadood (EPA / Heerka Xiritaanka Xeebta Caafimaadka Dadweynaha)** saddex sababood dartood: 1. Fecal Coliform & Enterococcus Dhimasho-Dhinaca: Iyadoo ultraviolet toos ah (UV) iftiinka qoraxda ee biyaha saafiga ah wuxuu si tartiib tartiib ah u kiciyaa bakteeriyada CSO tubbooyinku waxay ku raran yihiin ** ciid la hakiyey iyo wasakh dabiici ah** (high Nephelometric Turbidity Units [NTU]) kaas oo ka ilaaliya bakteeriyada, fayrasyada, iyo cysts protozoan ka iftiinka UV. 2. ** Dhul-daaqsimeedka & Harooyinka Qunyar socodka ah:** Wabiyada teedsan (sida Hudson, Potomac, Thames, ama Delaware) iyo harooyinka/dekadaha kuxiran, mowjadaha soo galaya ayaa riixaya tuubada bulaacada ceyriin ** korka hoose**, isla markaana dib u soo celisa saxaro isku mid ah oo hore iyo gadaal u dhaafa guryaha doomaha iyo xeebaha * 6 saacadood ilaa 6 wareeg. 3. ** Dib-u-kicinta Sedimentiga Hoose:** Fayrasyada gal-gala (Norovirus, Adenovirus, Hepatitis A) iyo Cryptosporidium oocysts waxay ku xidhaan qaybo dhoobo culus ah oo ku dega sariirta hoose ee webiga ama ciidda xeebta; marka waardiyayaasha, kuwa dooxaha tuura qolofka, ama eydu ay kiciyaan xuubka hoose ee anqawga 2 maalmood ka dib, waxay dib u kiciyaan caabuqyada faafa.

Qaybta 2: 6-da Cudur ee Khatarta Sarreya ee Ceyriinka ah CSO Biyaha (Ka-soo-baxa, Tilmaamaha & Daawaynta Gaarka ah)¶

Marka bukaanka uu ku dhaco jirro ka dib CSO ama dhexgalka biyaha daadadka, takhaatiirta waa in ay kala soocaan ** lix nooc oo cudur-sidaha cudur-sidaha ah ** oo leh waqtiyo kala-duwan oo kala duwan iyo daawaynta ka hortagga jeermiska:

Qaybta 3: Tallaabo-tallaabo Ka Dib Hab-raaca Wasakhaynta Is-miidaaminta (Bini'aadamka, Qalabka, iyo Xayawaanka)¶

1. Wasakhaynta Jirka Aadanaha (The First 30 Minutes)¶

Haddi aad qalibanto kayak, qolof doon, ama doon shiraac ah, ka dhiciso meesha lagu xidho, ama aad ku dabaalato marin biyoodka wakhtiga CSO / SSO talo: 1. Afka, Sanka, iyo Indhaha Marka hore (Marka la joogo Meesha Doonta ama Baabuurka): - tufi, Ha liqin: Isla markiiba ku tufi wax kasta oo biyo ah afkaaga. Si fiican afkaaga ugu raaci biyo la cabi karo oo dhalada ah oo tuf, dabadeed swir 15 to 20 mL daawada jeermiska disha (0.12% Chlorhexidine ama Listerine/Cetylpyridinium chloride) ilaa 30 ilbiriqsi oo tufi. - Indhaha: Labada indhood ku nadiifi ** madhalays 0.9% Isha dhaqida ee sodium chloride** (100 to 250 mL il kasta) iyadoo madaxaagu dhinac u janjeero si aanay dareeruhu u gelin isha kale. - Sanka: Si tartiib ah sankaaga ugu dhufo unug la tuuri karo. Haddii xuubka webiga qaro weyni uu soo galo dulalka sanka, ku luqluq oo keliya ** jeermis 0.9% buufinta milixda ah** (** waligaa ha ku shubin biyaha qasabadda ah ee aan la karkarin ilaa sanka**, sababtoo ah Naegleria fowleri / Acanthamoeba khatarta ah). - Dhagaha (Kahortagga Dhegaha Dabbaasha): Madaxaaga dhinac kasta u leexi si aad biyaha webiga uga daadiso kanaalka dhegta, ka dibna ku dheji ** 4 ilaa 5 dhibcood 1:1 isku dar ah 70% Khamriga isopropyl iyo khalka cad2% Acetic Acid)** marin kasta oo dhegta ah (haddii aanad lahayn daloolin dhegta ama tuubooyinka dhegta) si aad u disho Pseudomonas aeruginosa iyo Aeromonas. 2. ** Gear Geli Bac Shaabadaysan & Qaado Qubays Saabuun 10 Daqiiqo ah:** - Ka saar dharka qoyan, suuutka qoyan, kabaha kabaha, iyo galoofyada dabaysha hoos u dhacda oo ka fog wejigaaga (ka soo jiid ilaaliyaasha finan qoyan xagga hoose si taxadir leh adigoo indhaha iyo afka si adag u xiran, ama marka hore u gudub qubeyska oo ku luqluq shaadhka bannaankiisa ka hor intaadan madaxa ku jiidin). - Ku dhaq jidhkaaga oo dhan iyo timahaaga ** biyo la cabbi karo oo diiran iyo saabuun dareere ah** (ama 4% Chlorhexidine Gluconate xoqin qalliin *** loogu talagalay lugaha, gacmaha, iyo jirkooda) ugu yaraan 5 ilaa 10 daqiiqo. 3. ** Waraabka Dhaawaca Cadaadis-sare iyo Daryeel Labis Furan: - Hubi gacmahaaga (gaar ahaan ** finan calaacasha ah ee doowerka**), qandhada, anqawyada, iyo cagaha hoostooda iftiin dhalaalaya. - Ku nadiifi jeex kasta, finan, ama ku xoq ** ugu yaraan 500 mL biyaha la cabi karo ee la cadaadiyo ama cusbada nadiifka ah** (use an 18-gauge catheter tip on a 35 mL syringe or poke a pinhole in a sterile water bottle cap to generate 7 to 15 psi irrigation pressure). - Codso 10% Povidone-Iodine xal ama 2% Dufanka Mupirocin/Bacitracin oo ku dabool dhaymo dabacsan oo nadiif ah oo nadiif ah. ** Hubi nabarka 6dii saacadoodba mar 72 saacadood ee ugu horreeya ***: haddii xuduud guduudan ay dibadda u soo baxdo (draw a pen line around any redness), isla markiiba u tag Waaxda Gurmadka.

2. Wasakhaynta Dharka qoyan, Jaakadaha Nolosha (PFDs), Kayaks, qolof doon doon, iyo Eeyaha¶

• ** Doomaha Doomaha, Kayaks, Oars, iyo Gear adag:** Weligaa ha buufin a CSO-Doon wasakhaysan oo leh makiinada tamarta cadaadiska sare leh ee dhererka madaxa (taas oo hawada ka saaraysa Norovirus iyo STEC E. coli Taa beddelkeeda, xidho galoofyada nitrile iyo ilaalinta indhaha ***, ku maydh gacanka gacanka iyo seerka ** saabuta iyo tuubada beerta cadaadiska hooseeya **,o ku rid dhammaan sagxadaha la qabsado ** **0.1% Sodium Hypochlorite (1:50 qaska biliijka guriga: 1/3 cup [80 mL] ee klzxh:0145 bleach per 1 gallon [3.8 L] Biyaha)** ama ** Liiska EPA N jrmiska-jeermiska Ammonium-ka ee Quaternary** oo le 10-daqiiqo oo qoyan wakhtiga xidhiidhka**, oo ay ku xigto biyo nadiif ah.
• ** Neoprene Wetsuits, Booties, iyo PFDs (Halka Dharka Waxyeelada biliijka):** Bleach wuxuu hoos u dhigaa neoprene wuxuuna daciifiyaa webbing jaakad naylon ah. Dharka qoyan iyo PFDs ku jira saxan biyo qabow oo lagu qaso ** phenolic ama quaternary ammonium qoyan/qalabka nadiifiyaha (sida Steramine ama Revivex BCD/Wetsuit Sanitizer)** ilaa 15 daqiiqo, si fiican u biyo raaci, oo sudh ** iftiinka qoraxda ee UV dibadda ee tooska ah** si aad u engegto.
• ** Eyda Ku Dabaashay ama Cabtay CSO Biyaha:** Eydu waxay aad ugu nugul yihiin Leptospirosis ba'an iyo * Giardia* / * Campylobacter* enteritis** (xitaa eeyaha laga tallaalay leptospirosis lagama yaabo in laga daboolo dhammaan serovars-jiirka magaalada). Xidhashada galoofyada biyuhu aanay biyuhu galin, tuubada iyo shaambo eyga oo dibada ku wata chlorhexidine shaambada xayawaanka (ka ilaalinaya saabuunta indhaha), qalaji calaacalaha iyo calooshooda, ** ka ilaali inay leefaan dhogortooda qoyan , isla markiiba wac dhakhtarkaaga xoolaha si aad u waydiiso ** Doxycycline afka / Amoxicillin prophylaxis haddii eeygu ka cabbo.

Gargaarka degdega ah iyo tilmaamaha cudurada faafa ee boggan waxaa loogu talagalay hagitaan degdeg ah oo keliya oo marnaba ha beddelin qiimeynta caafimaadka. Waxaan kugula talineynaa inaad ka qaadato Koorsada Gargaarka Koowaad iyo Badbaadada Biyahaee Laanqeyrta Cas ee Mareykanka, Ambalaasta St John, ama bulshadaada ** Laanqeyrta Cas ama Bulshada Bisha Cas*.

Lambarada degdega ah ee gobolka iyo borotokoolka wakaalada¶

• Mareykanka: Wac 911 xaalad kasta oo deg-deg ah oo caafimaad ah (sida cudurka Weil ee looga shakisan yahay ama caabuq nabarka necrotizing). Buux-dhaafka Bullaacadaha Isku-dhafka ah (CSOs) iyo Biyo-soo-baxa Bullaacadaha NadaafaddaSSOs) waxaa nidaamiya U.S. Wakaaladda Ilaalinta Deegaanka (EPA* sida hoos timaada Xeerka Biyaha Nadiifka ah (NPDES Barnaamijka Ogolaanshaha, 1994 CSO Control Policyiyo 40 CFR 122.38 Xeerka Ogeysiinta Dadweynaha ee Harooyinka Waaweyn). Xiritaanka tayada biyaha xeebta madadaalada waxaa maamula **EPA BEACH Act Shuruudaha Tayada Biyaha Madadaalada *** (taasoo kicisa la-talinta xeebta marka Enterococci uu dhaafo celceliska joomatari ee 35 CFU/100 mL ama Qiimaha Xaddiga Tirakoobka [STV] ee 130 CFU/100 mL, ama E. coli ayaa ka badan celceliska joomatari ee 126 CFU/100 mL / STV ee 410 CFU/100 mL). U sheeg degmadaada daadinta wasakhda cayriin ee aan khariidada lahayn 311 / Khadka Degdegga ah ee Utility Biyaha iyo Waaxda Gobolka ee Ilaalinta Deegaanka.
• United Kingdom: Wac 999 xaaladaha degdegga ah ee caafimaadka ama NHS 111 la-talin caafimaad oo degdeg ah ka-dib-dhigista iyo qiimeynta leptospirosis/tetanus (iyadoo la tixraacayo ** Hay'adda Ammaanka Caafimaadka UKUKHSA] / Doomaha Ingriiska * Leptospirosis (Cudurka Weil) Tilmaamaha***). Si aad u soo sheegto dheecaanka bulaacadaha cayriin ama kalluunka lagu dilo webiga ama xeebta, wac ** Wakaaladda Deegaanka 24-Saacadood Khadka Tooska ah ee Dhacdada 0800 80 70 60** (England), ** Khayraadka Dabiiciga ah Wales on 0300 065 3000, ** SEPA ayaa saaran 0800 80 70 60 (Scotland), ama ** NIEA on 0800 80 70 60** (Waqooyiga Ireland). Fiiri qulqulka qulqulka tooska ah ee dabaylaha adigoo isticmaalaya Rivers Trust Map ama Surfers Against Bulacadaha Adeegga Badqabka Badweynta Badaha & Wabiyada
• Kanada: Wac 911 xaaladaha degdega ah ama 811 (HealthLink / Info-Santé / Health811) 24/7 kalkaalisada kala soocida ka dib soo-gaadhista biyaha bulaacada. Degmo CSO ka warbixinta iyo xidhitaannada biyaha madadaalada waxay raacaan Caafimaadka Kanada * Tilmaamaha tayada Biyaha Madadaalada ee Kanada *** (E. coli <= 200 CFU/100 mL celceliska joomatari, <= 400 CFU/100 mL hal muunad ugu badnaan; Enterococci <= 35 CFU/100 mL celceliska joomatari, <= 70 CFU/100 mL hal muunad) iyo ** Deegaanka iyo Isbeddelka Cimilada Kanada (ECCC) Xeerarka wasakhda ah ee nidaamyada biyaha wasakhda.
• Midowga Yurub: Wac 112 si aad u hesho daryeel caafimaad oo degdeg ah. Biyaha dabaasha ee xeebaha iyo gudaha ee dhamaan wadamada xubnaha ka ah Midowga Yurub waxa lagu nidaamiyay EU Bathing Dardaaranka Biyaha (2006/7/EC iyo dib loo eegay ** Dardaaranka Daaweynta Biyaha Wastada Magaalada (UWWTD)**, kaas oo amraya la-talinta wasakheynta muddada-gaaban inta lagu jiro biyaha duufaanka CSO dhacdooyinka ku salaysan **Intestinal Enterococci *** iyo *** Escherichia coli *** heerarka.
• Australia iyo New Zealand: Wac 000 (Australia) ama 111 (New Zealand) wixii degdeg ah. Barnaamijyada daawashada xeebta EPA ee gobolka (sida **NSW *Beachwatch *** iyo EPA Victoria Yarra Watch) iyo **LAWA ee New Zealand (Land, Air, Water Aotearoa *Halkan ma ku dabaalan karaa? Biyaha Madadaalada ***. Ka eeg hagahayaga oo dhamaystiran halkan nambarada degdega ah.

Su'aalaha soo noqnoqda¶

Intee in le'eg ayaa ka dib roobabka culus ay webi, haro, ama xeebta magaalo-magaaladu ammaan u ahayn dabaasha, doonyaha, ama doon raaca sababtoo ah Isku-dhafka Bullaacaduhu (CSOs)?¶

Wakaaladaha caafimaadka dadweynaha (oo ay ku jiraan US EPA, UK Environment Agency, Health Canada, iyo barnaamijyada Beachwatch ee gobolka) waxay ku talinayaan ka fogaanshaha webiyada magaalooyinka, harooyinka, dekedaha, iyo xeebaha xeebaha ee u dhow duufaanta ama CSO soo da'a ugu yaraan 48 ilaa 72 saacadood ka dib marka roobab culus dhammaato. Xataa marka qorraxdu soo baxdo subaxda xigta, ciidda la hakiyey waxay ka ilaalisaa bakteeriyada saxarada, Norovirus, iyo Cryptosporidium iftiinka UV, iyo qulqulka qulqulka qulqulka biyaha wasakhda ah ayaa riixaya bulaacada ceeriin ee kor iyo hoos ilaa 4 ilaa 6 wareegyo baraf ah ka hor inta aan tirinta bakteeriyada ku soo laaban heerar nabdoon.

Maxaan sameeyaa isla markaaba haddii aan qariyo ama aan ku liqo biyaha webiga inta lagu jiro dhacdo Buux-dhaaf ah oo Bullaacaddu?¶

Isla markiiba ku tuf biyaha webiga adiga oo aan liqin, ku luqluq afkaaga biyo dhalooyin ah oo la cabi karo, oo ku dhaq oo ku tuf dhaqida afka ee jeermiska dila (sida 0.12% chlorhexidine ama cetylpyridinium chloride) 30 ilbiriqsi. Indhahaaga ku daadi 0.9% cusbo nadiif ah, ku maydh biyo diirran oo la cabi karo iyo saabuun 10 daqiiqo gudahooda 30 daqiiqo ka dib markaad biyaha ka baxdo, oo xoq oo waraabi maqaar kasta oo go'an, xoqo, ama finan fiiqan biyo nadiif ah oo la cadaadiyo iyo povidone-iodine ama chlorhexidine. La xidhiidh dhakhtar 24 saacadood gudahood si aad ugala hadasho xoojiye teetanada, ka hortagga tallaalka Cagaarshowga A, iyo hal-door Doxycycline oo afka laga qaato (200 mg) prophylaxis leptospirosis.

Waa maxay calaamadaha digniinta hore ee Leptospirosis (Cudurka Weil) ka dib dabaasha ama doonista biyaha wasakhaysan ee wasakhaysan?¶

Leptospirosis caadi ahaan waxay bilaabataa 5 ilaa 14 maalmood (u dhexeeya 2 ilaa 30 maalmood) ka dib marka uu la kulmo qandho sare oo degdeg ah, qarqaryo, madax-xanuun daran, lallabbo, iyo laba calaamadood oo calaamad ah oo ka sooca hargabka caadiga ah: xanuunka murqaha oo xoog leh oo ku yaala kubka iyo dhabarka hoose, iyo suffusion conjunctival (casaan dhalaalaya, indho dhiig oo aan lahayn huruud). Haddii aan la daaweyn, 10 ilaa 15 boqolkiiba bukaanada waxay u gudbaan Wajiga 2 (cudurka Weil), oo ay ku calaamadsan yihiin cagaarshow huruud ah, madow madow ama kaadi maqan ( kelyaha degdega ah ), qoorgooyaha, iyo qufaca dhiigga. U sheeg dhakhtarkaaga qolka degdega ah isla markiiba wax ku saabsan soo-gaadhista webigaaga ama wasakhowga-biyaha si ay isla markiiba u bilaabaan Doxycycline ama IV Ceftriaxone.

Waa maxay sababta jeexan furan ama finan ka soo qulqulaya biyaha wasakhda ah ee xeebta diiran ama jahawareerka leh ay u tahay xaalad degdeg ah oo degdeg ah haddii ay casaan noqoto oo ay xanuunsato?¶

Diirimaad diirran, estuarine, iyo biyaha xeebta oo ay wasakheeyeen biyaha dabaylaha iyo wasakhda wasakhda ee dekedda Vibrio vulnificus, halka wasakhda biyaha saafiga ah ay qulqulayaan dekedda Aeromonas hydrophila. Labada bakteeriyaba waxay ku soo duuli karaan xoqin yar oo maqaarka ah, gooyn lohod ah, ama finan fiiqan waxayna kicin karaan fasciitis necrotizing 12 ilaa 48 saacadood gudahood. Haddii nabar kasta oo soo gaadha biyaha webiga ama xeebta ay si degdeg ah u faafiyaan casaan, barar, qandho, finan guduudan ama finan dhiigu ka buuxo (bullae), ama xanuun daran oo u dhigma cabbirka goynta, u tag qaybta degdegga ah ee isbitaalka isla markiiba si aad u hesho antibiyootiga xididada leh iyo qiimeynta qaliinka.

Tilmaamaha la xidhiidha¶

• Xooga bulaacada fayodhowrka dilaaca weyn, bulaacada ceeriin ee wadada dhexdeeda, iyo xidhitaanka waalka biyaha danbe
• Buuxinta weyn ee bullaacadaha iyo daadadka waddooyinka
• Nasashada ugu weyn ee biyaha magaalada oo dhan iyo biyo karkari
• Ha-cabbin
• Daadad toosan

Ilaha iyo hanuuninta rasmiga ah¶

• ** U.S. Wakaaladda Ilaalinta Deegaanka (EPA:**CSOSiyaasadda xakamaynta (59 FR 18688Shuruudaha Ogeysiinta Dadweynaha ee NPDES ee Qulqulka Bullaacadaha Isku-darka ah ee taga Dooxada Weyn ee Harooyinka (40 CFR Part 122), iyo Shuruudaha Tayada Biyaha Madadaalada (EPA 820-F-12-058: Enterococci & E. coli Thresholds)*.
• ** Xarumaha Xakamaynta iyo Kahortagga Cudurrada (CDC) & Ururka Caafimaadka AdduunkaWHO):** Hagidda Kiliinikada Leptospirosis ee Bixiyeyaasha Daryeelka Caafimaadka (Doxycycline 200 mg Kahortagga Soo-gaadhista Ka Dib & Daaweynta Cudurrada Weil), Vibrio vulnificus & Aeromonas Maareynta Boogaha ee Daadadka/Biyaha bullaacadaha, iyo ACIP Tilmaamaha Kahortagga Soo-gaadhista Ka Dib ee Cagaarshowga A iyo Teetanaha.
• ** Hay'adda Ammaanka Caafimaadka UKUKHSA), Wakaalada Deegaanka (EA), & Doomaha Ingriiska:** Leptospirosis (Cudurka Weil): Tilmaamaha Badbaadada Biyaha ee Kiliinikada iyo Madadaalada ee Rakaabka, Bajaajleyda, iyo Dabbaasha-Biyaha Furan, iyo Kormeerka Muddada Dhacdada (EDMHeerarka Warbixinta Qulqulka Duufaanta.
• Caafimaadka Kanada: * Tilmaamaha tayada Biyaha Madadaalada ee Kanadiyaanka (Daabacaadda 4-aad: Cudur-sidaha Microbiological, Maaraynta Khatarta Buuxa ee Bullaacadaha Isku-dhafka ah, iyo 48-Saacadood ee La-talinta Roobabka Kadib)*.
• ** Bulshada Cudurada Faafa ee AmeerikaIDSA):** * Tilmaamaha Dhaqanka Kiliinikada ee Baadhista iyo Maareynta Caabuqyada Maqaarka iyo Jilicsan (Infekshannada Nabarka Biyaha: Aeromonas hydrophila, Vibrio vulnificus, iyo Mycobacterium marinum) iyo Shubanka Infekshinka ah (STEC O157:H7 Kahortagga ka hortagga dhaqdhaqaaqa)*.