Monkey, Macaque, le Baboon Loma kapa Ho Scratch At Temples: Herpes B Virus (Macacine Alphaherpesvirus 1), Valacyclovir, le Rabies RIG¶

Ho longoa, ho ngoauoa, kapa ho tšoeloa ka mathe ka mahlong ke tšoene e lulang e le sieo tempeleng ea bahahlauli, sebakeng sa polokelo ea lintho tsa tlhaho kapa serapeng sa boikhathollo sa litoropo, hangata ke Lefatše la Khale Rhesus Macaque (Macaca mulatta), Mohatla o molelele / o jang Crab-Eating Macaque (Macaca fascicularis), Macaque ea Japane (Macaca fuscata), Barbary Macaque (Macaca sylvanus), kapa Baboon (Papio mefuta) ho pholletsa Bali (Ubud), Thailand (Lopburi, PhuketIndia, India (Varanasi, Jaipur, Shimla), Gibraltar, Japane (Arashiyama), Nepal, kapa Afrika, ke boemo ba tšohanyetso bo habeli ba neuro-virological. Ntle le ho jara virus ea Rabies (100 percent fatal once neurological symptoms appear) le libaktheria tse tebileng tsa polymicrobial, ** 70 ho ea ho karolo ea 90 lekholong ea litšoene tsa khale tsa Old World Macaque (genus Macaca) ke bajari ba bophelo bohle ba asymptomatic ba Macacine alphaherpesvirus 1 (Herpes B Virus / Cercopithecine herpesvirus 1). Le hoja Herpes B e baka letho haese liso tse se nang kotsi tsa serame sa molomo ho macaques, ha e kenngoa ho motho ka ho loma litšoene, sekoti se silafalitsoeng ke mathe, kapa ho phatloha ha mahlo, ** tšoaetso e sa phekoloeng ea kokoana-hloko ea motho ea Herpes B e baka ho nyoloha ha encephalomyelitis le ho holofala ha matšoafo ka sekhahla sa lefu le fetang 70 ho 80 lekholong.

Haeba uena kapa motho eo u tsamaeang le eena le longoa ke letlalo, ho mengoa, kapa ho phatloha ha mucosal/mahlo ho tsoa ho tšoene ea macaque kapa tšoene, ** qala ho hohla maqeba ka metsotso e 15 ka sesepa le povidone-iodine kapa chlorhexidine nakong ea metsotso e 5 ea pele , ebe u ea sepetlele sa Vaoviral hang-hang.1 g PO three times daily for 14 days) le Rabies Post-Exposure Prophylaxis (Human Rabies Immune Globulin [HRIG] + 4-dose rabies vaccine). Bakeng sa ambulense ea lehae kapa thuso ea bongaka, letsetsa nomoro ea hau ea tšohanyetso ea lehae (112 kapa 119 Indonesia, 1669 naheng ea Thailand, 112 India le European Union / Gibraltar, 119 Japane, 999 United Kingdom, 911 United States le Canada) kapa sheba bukana ea rona ea lefats'e ea dinomoro tsa tshohanyetso. Bakeng sa melaoana e batsi ea ho longoa ke liphoofolo le lefu la rabies, bona ho pepesehela lefu la rabies le post-exposure prophylaxis, ho longoa ke liphoofolo le tlhokomelo ea tšoaetso ea maqeba, le taolo e kgolo ya madi.

Etsa sena hona joale¶

1. HLAHLOLA LEqeba HAHOLO HO FETA METSOTSO E 15 HANG-HANG.THE SINGLE MOST IMPORTANT STEP): U se ke ua ema ho fihlela u fihla tleliniking hore u hlatsoe leqeba. Kokoana-hloko ea Herpes B le kokoana-hloko ea rabies ke likokoana-hloko tse koahetsoeng ke lipid tse lutseng ka har'a lisele tse ka holimo tsa letlalo nakong ea metsotso e seng mekae ea pele pele li kena lipheletsong tsa methapo ea kutlo. Hlakola hanghang ebe o hohla ho loma kapa ngoapa u sa khaotse bakeng sa metsotso e 15 e felletseng ka tšupanako u sebelisa povidone-iodine (Betadinechlorhexidine gluconate,Hibiclens), kapa sesepa sa sesepa se nang le metsi a mangata (dish soap / laundry bar) le metsi a phallang.
2. HAEBA MATHE KA LEIHONG KAPA MOLEMONG, NOSETSA KA METSI A TENG KAPA KA TSELA KA METSOTSO E 15.NO SOAP IN EYES): Haeba macaque e lla, e tšoela ka mathe, kapa e hasanya metsi/mathe ka leihlong, nkong, kapa molomong oa hao, e ntša leihlo le bulehileng kapa lera la hao le sa khaotse ka nako e telele metsotso e 15 ka metsi a nooang a hloekileng a libotlolong kapa letsoai le hloekileng le hloekileng (le ka mohla u se ke ua kenya sesepa se bohale, joala, kapa motsoako oa ho hlapa ka leihlong, e leng se senyang leihlo).
3. Le ka mohla U SE KE UA LUMELA HO TSOA KAPA HO TSOA TŠOENE: Ho koala ho longoa ha primate ka stitches kapa letlalo glue traps Herpes B virus, rabies virus, and oral anaerobes (Eikenella corrodens, Bacteroides, Pasteurella) khahlanong le methapo ea kutlo e senyehileng. Tlohela leqeba le bulehile hore le tsoe (kapa u lumelle feela sebaka se sa tsitsang ka mor'a ho kenella ka Rabies Immune Globulin).
4. QALA MORWA VALACYCLOVIR (1 GRAM THREE TIMES DAILY) KA NAKO EA LINTHO TSE 24 HO TSA 72 HO HLAHALA KA MACAQUE: Ke litšoene feela tsa leloko la Macaca (Macaques ho pholletsa le Asia le Gibraltar) li na le kokoana-hloko ea Herpes B. Tsitlella ho qala Post-Exposure Prophylaxis (PEP) ka Valacyclovir ea molomo 1,000 mg (1 g) every 8 hours (TID) for 14 days (kapa Acyclovir ea molomo 800 mg 5 times daily for 14 days) hantle ka hare ho lihora tse 24 (and up to 72 hours)** ea ho pepeseha, pele kokoana-hloko e tšela tsamaiso ea methapo e bohareng.
5. BATLA KA MMUNE GLOBULIN KA BOBELI BA RABIES (HRIG / ERIG) LE Ente LA MORABI KA LETSATSI LA 0: Tšoene e 'ngoe le e 'ngoe kapa litšoene li loma kapa mongoapo o ntšang mali Asia, Afrika, kapa Latin America ke WHO Category III Rabies Exposure. Haeba ha o so fumane liente tsa lefu la rabies pele ho ts'oaetso ea lefu la sethoathoa, ente ea lefu la rabies feela HA E lekane, u tlameha ho fumana Rabies Immune Globulin (HRIG 20 IU/kg kapa ERIG 40 IU/kg) e kene ka ho toba le ho potoloha leqeba ka Letsatsi la 0 ho fokotsa kokoana-hloko nakong ea matsatsi a 7 ho isa ho a 14 pele 'mele oa hau o iketsetsa li-antibodies.
6. FUMELA AMOXICILLIN-CLAVULANATE (AUGMENTIN) LE TETANAS BOOSTER: Melomo ya diprimate e etsisa dimela tse longwang ke batho (the most infectious mammalian bite); nka ** amoxicillin-clavulanate 875/125 mg PO BID for 5 to 7 days** 'me u netefatse kente ea hau ea tetanase (Tdap).

Sefate sa ho etsa qeto: litšoene, macaque, le ho loma kapa ho laola litšoene¶

Latela sefate sena sa liqeto tsa bongaka le tsa tšimo hang ha ho kopana le litšoene ho fella ka ho loma, ho ngoapa, kapa ho phatloha ha mucosal:

flowchart TD
    Exposure["Primate Loma, Scratch, kapa Mathe a Splash Letlalong/Leihlo"] --> WashNow{"1. Ho hloekisoa hang-hang (Ka har'a Metsotso e 0 ho isa ho e 5)"}
    WashNow -->|"Ho Loma Letlalo, Ho phunya, kapa Mongoako"| Scrub15["HLAHLOLA HAHOLO BAKENG SA METSOTSO E 15 E FELETSENG: Sebelisa Povidone-Iodine, Chlorhexidine, kapa Sesepa sa Sesepa + Metsi a Tsamaeang -> Tlohela mali ka bolokolohi -> Le ka mohla u se ke ua koala suture."]
    WashNow -->|"Mathe a phatloha ka Leihlo, Nkong kapa Molomong"| FlushEye["NOSETSA LEIHLO / MUCOSA KA METSOTSO E 15: Sebelisa Metsi a Tlatselitsoeng ka Botlolong kapa A sa Bileng 0.9% Saline FEELA (Le ka mohla u se ke ua kenya sesepa kapa iodine mahlong)"]
    Scrub15 --> PrimateID{"2. Khetholla Sehlopha sa Primate le Geography"}
    FlushEye --> PrimateID
    PrimateID -->|"Lefatše la Khale MACAQUE (Genus Macaca: Bali, Thailand, India, Japan, Gibraltar, China, Philippines)"| DualRisk["KOTSI E KGOLO YA HERPES B VIRUS + RABIES + BACTERIA: E-ea Tleliniki / Sepetlele sa Machabeng ka Lihora tse 24"]
    PrimateID -->|"Non-Macaque Primate (Baboon, Vervet, Langur, Capuchin, Squirrel Monkey, Marmoset)"| RabiesOnly["NO HERPES B RISK -> KOTSI E KGOLO YA RABIES + BACTERIA: Eya Sepetleleng bakeng sa Rabies PEP + Antibiotics"]
    DualRisk --> MedProtocol["3. Laola Regimen e Felletseng ea Kamor'a Ho Hlaha (Letsatsi la 0)"]
    RabiesOnly --> MedProtocol
    MedProtocol --> Regimen["1. HERPES B PEP (Macaques Feela): Valacyclovir 1 g PO TID x matsatsi a 14 (kapa Acyclovir 800 mg PO 5x/letsatsi x matsatsi a 14)\n2. RABIES PEP (WHO Cat III): Kena ka HRIG (20 IU/kg) leqebeng + Matsatsi a Ente ea Rabies 0, 3, 7, 14\n3. ANTIBIOTICS & TETANAUS: Amoxicillin-Clavulanate 875/125 mg PO BID + Tdap Booster"]
    Regimen --> NeuroWatch{"4. Shebella Matsatsi a 21: Na ho na le Li-Vesicles, Ho tsikitlanya, Feberu, Pono e Habeli, kapa Hiccups?"}
    NeuroWatch -->|"EE: Matšoao a Pele a Neuro / Letlalo"| IVGanciclovir["KAMOO POPELENG EA TŠOHANYETSO: Qala ka Lethal dose le Leholo la IV Acyclovir (12.5-15 mg/kg q8h) kapa IV Ganciclovir (5 mg/kg q12h) Hang-hang"]

Mokhahlelo oa 1: Ke litšoene life tse nang le kokoana-hloko ea Herpes B vs. Rabies (Species and temple guide)¶

Ha se tšoene e 'ngoe le e 'ngoe Lefatšeng e nang le kokoana-hloko ea Herpes B, 'me ha se sebaka se seng le se seng sa litšoene tse nang le lefu la rabies. Ho tseba hantle hore na ke karolo efe kapa e u ngoaphileng ho etsa qeto ea lengolo la ngaka la hau la antiviral.

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

2. Hobaneng ha Temple Macaques e Hlasela Bahahlauli (And How to Escape Without Being Bitten)¶

Liphuputso tse entsoeng Bali's Ubud Monkey Forest, litempele tsa Lopburi tsa Thailand, le Upper Rock ea Gibraltar li bontša hore karolo e fetang **85 lekholong ea ho longoa ke macaque e etsahala nakong ea mekhoa e meraro e khethehileng ea batho **: 1. Ho itšoarella ka Lijo, Mekotla ea Plastiki, Libotlolo tsa Metsi, Likhalase tsa Letsatsi, kapa Mehala: Li-macaque tsa tempele li koetlisetsoa ke boiphihlelo ho hloibila likhalase tsa mahlo, likatiba, mehala le mekotlana e boreleli, ho li tšoara ho fihlela mohlokomeli a li rekisetsa sengoathoana sa litholoana.a learned bartering behavior). Haeba tšoene e u tšoara mokotla oa hao, likhalase tsa letsatsi, kapa botlolo ea metsi, TLOHA HANG-HANG. Ho hula morao ho etsa hore motho a lome hang-hang ka har'a letsoho kapa forearm. 2. Ho bososela ka meno a pepeneneng kapa ho shebisisa ka ho toba (Primate Threat Display): Ka puo ea 'mele oa macaque le litšoene, ho notlela ho shebana le mahlo ka ho toba le ho hula melomo ea hau ho bontša meno (a human smile for a selfie) ke lets'oao la bokahohle la primate aggression le phephetso. Boloka melomo ea hao e koalehile ka holim'a meno a hao, qoba ho sheba ka ho toba, 'me le ka mohla u se ke ua koekoetla fatše boemong ba mahlo u e-na le macaque e tona e hōlileng kapa 'mè ea jereng lesea. 3. Ho Nyolohela Mahetleng a Bahahlauli (Head and Neck Bite Hazard): Le ka mohla u se ke ua lumella morekisi oa tempele ho beha matokomane kapa libanana hloohong kapa mahetleng a hao e le hore macaque e hloelle molaleng oa hao. **Ho loma kapa ho mengoa hloohong, sefahlehong kapa molala ho na le kotsi e kholo ea lefu bakeng sa vaerase ea Herpes B le Rabies ** hobane methapo ea kutlo (cranial nerves)trigeminal, facial) fana ka tsela e khuts'oane haholo (just centimeters) ho kena ka kotloloho mokokotlong oa boko pele post-exposure prophylaxis e ka qala ho sebetsa.

Mokhahlelo oa 2: Mohato ka mohato thuso ea pele le prophylaxis ea bongaka (First 15 minutes to 72 hours)¶

Ha macaque kapa tshwene e pshatla letlalo kapa e fafatsa lera la mucous, latela tatellano ena ea nako.

1. Motsotso oa 0 ho isa ho Motsotso oa 15: Ho Koala Kokoana ea Mechini le Lik'hemik'hale¶

   [ 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

• Hobaneng Metsotso e 15 e Tletseng e Tlama: Ka bobeli CDC Herpes B Virus Working Group (Cohen et al., Clinical Infectious Diseases) le Mokhatlo oa Lefatše oa Bophelo (WHO) Litaelo tsa lefu la Rabies bolela ka botlalo metsotso e 15 ea ho itlhatsoa o sa khaotse le ho hohla ka mochini (sebelisa lesela le hloekileng la gauze kapa lesela le bonolo ho hohla ka har'a leino le phuntsoeng kapa le ho hoaoa, ho lumella mali a manyenyane a tsoang ho ntša mathe).
• Ke Likokoana-hloko life tse sebetsang ho Herpes B le Rabies?:
• Khetho ea Pele ea Letlalo: Povidone-iodine (Betadine 7.5% ho isa ho 10%), chlorhexidine gluconate (2% to 4%), benzalkonium chloride, kapa sehlapo sa ka tlung se teteaneng haholo / sesepa sa metsi sa lijana / sesepa sa bar se nang le metsi a mangata a phallang.
• Ho thoe'ng haeba u le tseleng ea Tempele ka Botlolo ea Metsi le Sanitizer ea letsoho Feela?: Hlatsoa hang-hang ka halofo ea metsi a nooang a libotlolo ha u ntse u itlotsa leqeba ka matla, sebelisa 70% sanitizer ea letsoho ea joala ea 70%, 'me u potlakele ka mor'a metsotso e 3 ho isa ho e 5 ho ea tempeleng ea thuso ea pele, sinki ea kamore ea ho phomola, kapa khemisi e haufi le moo u ka rekang sesepa sa meriana se felletseng le 5. hlapa. *(Hlokomela: Sebakeng sa Ubud Sacred Monkey Forest e Bali le litempeleng tse kholo tsa Thai, tleliniki ea thuso ea pele e sebakeng sa heno e na le povidone-iodine, e-ea moo hang-hang, u hlatsoe metsotso e 15, ebe u ea sepetlele sa machaba sa Valacyclovir le Rabies RIG, kaha maphephe a tempele a kenya Betadine letlalong feela 'me U SE KE UA fana ka liente tse thibelang likokoana-hloko.

2. Hora ea 1 ho isa ho Hora ea 72: Antiviral Prophylaxis for Herpes B Virus (Valacyclovir khahlano le Acyclovir)¶

Ho ea ka ** Litsi tsa US tsa Taolo le Thibelo ea Mafu (CDC)** le National B Virus Resource Center (Georgia State University) tataiso ea bongaka:

3. Tšoaetso ea Rabies ka nako e le 'ngoe ka mor'a Exposure Prophylaxis (HRIG + 4-Dose Vaccine Schedule)¶

Ha baeti ba United States kapa Europe ba atisa ho bala lipampiri tse buang ka hore na li-wild vs. captive laboratory macaque li hloka tlhokomelo ea Herpes B vs. Rabies, litempeleng tsa bahahlauli ba Asia le Afrika, u tlameha ho tšoara BOTHO ka nako e le 'ngoe. Se ke oa lumella tleliniki ea lehae ho u fa lefu la rabies feela ntle le Valacyclovir, hape u se ke ua noa Valacyclovir ntle le Rabies PEP feela:

1. Baeti ba sa Entoa (No Prior Pre-Exposure Rabies Series):
2. Mohato oa A: Tšireletso e Ikemetseng (Day 0 Only): Kena Mafu a Tšireletso ho Rabies a Batho (HRIG ho 20 IU/kg boima ba 'mele), kapa e hloekisitsoeng Equine Rabies Immune Globulin (ERIG ho 40 IU/kg) haeba HRIG e sa fumanehe, **ka kotloloho botebong le mathōkong a ho loma le lets'oao le leng le le leng **. Molumo ofe kapa ofe o setseng o sa khoneng ho kena ka har'a leqeba (mohlala, ho loma ntlheng ea monoana) o entoa ka mesifa sebakeng se hole.such as the anterior thigh or deltoid opposite the vaccine arm).
3. Hritical 7-Day HRIG Window: Haeba tleliniki e hole moo u fumanang ente ea hau ea Rabies ea Letsatsi la 0 e felile ka har'a HRIG (a common issue at small island clinics in Indonesia or rural India), **u na le letsatsi la 7 ka mor'a tekanyo ea pele ea ente ea ho fofa kapa ho ea sepetlele se seholo (Denpasar, Bangkok, Singapore, New Delhi, or home) ho kenya HRIG ente **. Se ke oa fana ka HRIG kamora Letsatsi la 7, kaha e tla hatella karabelo ea hau e sebetsang ea ente ea ente.
4. Mohato oa B: Ente e sebetsang (4-Dose Intramuscular Vaccine Series): Enta 1.0 mL (kapa 0.5 mL ho ipapisitse le lebitso: Verorab, Rabipur/RabAvert, Imovax) ** intramuscularly ka har'a mesifa ea deltoid ** (never into the gluteal/buttock muscle, kapa anterolateral thigh in young children) ka Matsatsi a 0, 3, 7, le 14 (hammoho le Letsatsi la 28 haeba ho na le immunocompromised).
5. Bakeng sa Baeti ba Entetsoeng Pele (Completed Pre-Exposure PrEP or Prior PEP):
6. **Se fane ka HRIG **. Laola litekanyetso tse 2 tsa ente ea lefu la rabies ka har'a mesifa ka Letsatsi la 0 le Letsatsi la 3 feela.

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

Likoti tsa molomo tse sa sebetseng tsa motho li na le li-alpha-hemolytic Streptococci, Staphylococcus aureus, Eikenella corrodens, Pasteurella, Bacteroides, le Fusobacterium: - Lithibela-mafu tsa Molomo oa Pele**: Amoxicillin-clavulanate (Augmentin 875/125 mg PO every 12 hours matsatsi a 5 ho isa ho a 7). - Bakuli ba Penicillin-Allergic: Doxycycline (100 mg PO BID) kapa Moxifloxacin (400 mg PO daily), kapa Ciprofloxacin (500 mg PO BIDPLUS Metronidazole (500 mg PO TIDkapa Clindamycin (300-450 mg PO TID) (never use a single cephalosporin, macrolide, or clindamycin alone, which miss Eikenella and Pasteurella).

Mohato oa 3: Ho lemoha matšoao a kokoana-hloko ea Herpes B (The 3-to-30-day neurological red-flag window)¶

Esita le ka mor'a ho qeta ho hloekisa leqeba le ho qala Valacyclovir, motho e mong le e mong ea longoang kapa ea ngoloang ke macaque o lokela ho itlhahloba letsatsi le leng le le leng ka ** matsatsi a 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

• Hobaneng ho Tsoela Pele ho Hiccups, Diplopia, kapa ho Hobosa Leoto ho Hloka Lithethefatsi tsa Hang-hang tsa IV:
• Ho fapana le liso tse batang tsa batho (HSV-1), kokoana-hloko ea Herpes B e atisa ho nyoloha methapong ntle le ho hlahisa letlalo le bonahalang sebakeng sa ho loma (> 50% of patients never develop local vesicles).
• Sebakeng seo, lets'oao la pele la temoso ke bohloko ba methapo ea kutlo, ho chesa, bohatsu, kapa ho hlohlona ho matla (pruritus) ho hlahisa hoo e batlang e le ho fihla ntlheng e lonngoeng, e lateloe ke feberu e kang ea ntaramane, ho hiccups ho sa feleng (singultus, e bakoang ke ho ruruha ha kokoana-hloko ea medulla oblongata), pono e habeli (diplopia), bothata ba ho metsa (dysphagia), kapa bofokoli ba maoto bo nyolohang (Landry-type ascending paralysis).
• Kalafo ya Molwetsi wa Sepetlele bakeng sa Matšoao a Herpes B: Oral Valacyclovir e etselitsoe thibelo (thibelo).PEP) pele matšoao a hlaha. Hang ha matšoao leha e le afe a sebakeng sa heno kapa matšoao a methapo ea kutlo a hlaha, mokuli o hloka ho kena sepetlele hang-hang le **kalafi e thibelang likokoana-hloko ka methapo **:
  1. ntle le Matšoao a CNS (Local skin vesicles or peripheral paresthesia only): Acyclovir ka methapo (12.5 to 15 mg/kg IV every 8 hours) KAPA Intravenous Ganciclovir (5 mg/kg IV every 12 hours) bonyane matsatsi a 14 ho isa ho a 21 ho fihlela matšoao 'ohle a rarolloa 'me litloaelo tsa vaerase tsa PCR li le mpe.
  2. ** Ka Matšoao afe kapa afe a CNS / Brainstem (Fever + headache, tingling, hiccups, diplopia, ataxia, or weakness)**: Mothapo oa Ganciclovir (5 mg/kg IV every 12 hours) ke sethethefatsi seo u ka se khethang se khothalletsoang ke CDC Herpes B Working Group hobane ganciclovir e bontša matla a maholo haholo a in vitro le in vivo khahlano le Macacine alphaherpesvirus 1 ka har'a tsamaiso ea methapo e bohareng ho feta acyclovir.

Linomoro tsa libaka tsa maemo a tšohanyetso, litliliniki tsa machaba, le lilaboratori tsa litšupiso¶

Ka mor'a ho hlatsoa maqeba a metsotso e 15 sebakeng sa hau, e-ea ka ho toba ** sepetleleng sa machaba kapa tleliniki ea meriana ea maeto ** (do not rely solely on a temple first-aid booth or hotel nurse):

• Bali & Indonesia: Letsetsa 112 kapa 119 bakeng sa ambulense. Bali (Ubud / Kuta / Nusa Dua / Canggu), leba ka kotloloho BIMC Hospital (Kuta: +62 361 761263 / Nusa Dua: +62 361 3000911 / Ubud Medical Centre: +62 361 971313), Sepetlele sa Siloam Denpasar (+62 361 779900), kapa SOS Medika Clinic Bali (+62 361 710505), e leng thepa e tsoang kantle ho naha HRIG (Berirab/HyperRAB), ente ea Verorab, le Valacyclovir ea molomo (Valtrex).
• Thailand (Bangkok, Phuket, Lopburi, Krabi, Chiang Mai): Letsetsa 1669 bakeng sa EMS kapa 1155 bakeng sa Sepolesa sa Bohahlauli. E-ea ho Mofumahali Saovabha Memorial Institute (Thai Red Cross Society Snake & Rabies Clinic, Bangkok: +66 2 252 0161), Bangkok Hospital Phuket (+66 76 254 425), kapa Sepetlele sa Machaba sa Bumrungrad (+66 2 066 8888).
• India & Nepal: Letsetsa 112 (108 ambulense) India; in Kathmandu (Swayambhunath Monkey Temple), e ea ka ho toba CIWEC Hospital Travel Medicine Center (+977 1 4524111), tleliniki ea maemo a khauta ea ho loma litšoene sebakeng seo. India, e-ea sepetleleng se seholo sa thuto e phahameng (Apollo, Max, Fortis, Manipal) le ho kopa ka bobeli Human Rabies Immune Globulin (HRIG) le Valacyclovir 1,000 mg matlapa (Valcivir).
• Gibraltar, United Kingdom, le European Union: Letsetsa 112 kapa 190 ka Gibraltar (St Bernard's Hospital e na le protocol e inehetseng ea ho loma ea Barbary Macaque). UK, letsetsa 999 kapa 111 (UKHSA Rabies and Monkey B Virus Service); ho pholletsa le EU, letsetsa 112.
• Japan, Hong Kong, Singapore, le Malaysia: Letsetsa 119 Japane, 999 Hong Kong (Queen Elizabeth / Prince of Wales A&E) le Malaysia, kapa 995 naheng ea Singapore (Tan Tock Seng Hospital / National Centre for Infectious Diseases [NCID]).
• United States & Global Herpes B Reference Laboratory: Letsetsa 911 bakeng sa maemo a tshohanyetso. Lingaka lefats'eng ka bophara li ka buisana le ** National B Virus Resource Center Univesithing ea Georgia State (Atlanta, USA) 24/7 Emergency Hotline ho +1-404-413-6550** kapa CDC Emergency Operations Center (+1-770-488-7100) bakeng sa tlhahlobo ea PCR/serology le tataiso ea bongaka ea antiviral.

Lipotso tse botsoang khafetsa¶

Ke litšoene life tse nang le kokoana-hloko ea Herpes B, 'me litšoene tsohle li na le eona?¶

Che, ke litšoene tsa Lefatše la Khale feela tsa mofuta oa Macaca (macaques), ho kenyeletsoa Rhesus macaques, macaques a Long-tailed (crab-eating), Japanese macaques le Barbary macaques tse fumanoang ho pholletsa le Bali, Thailand, India, Nepal, Malaysia, Singapore, Hong Kong, Japan, le Gibraltar, ke mehloli ea tlhaho ea "herpes virus" ho karolo ea 90 lekholong ea li-macaque tsa batho ba baholo ba e jereng ka mokhoa o sa bonahaleng. Litšoene, litšoene tsa vervet, li-langurs tsa Asia, le litšoene tsohle tsa Amerika Bohareng le Boroa (Lefatše le Lecha) tse kang capuchin, squirrel monkey le marmosets HA LI jere kokoana-hloko ea Herpes B, le hoja li ntse li hloka hang-hang Rabies Post-Exposure Prophylaxis le lithibela-mafu.

Hobaneng ho hohla ho loma ka macaque kapa ho ngoapa metsotso e 15 hang-hang ho le bohlokoa hakaale?¶

Kokoana-hloko ea Herpes B le kokoana-hloko ea rabies li pota-potiloe ke enfelopo e fokolang ea lipid (mafura) 'me e lula ka holim'a lisele tsa letlalo metsotso e seng mekae ka mor'a ho loma kapa ho ngoapa pele e tlama methapo ea kutlo ea peripheral le ho nyolohela lesapo la mokokotlo le boko. Hang ha kokoana-hloko e kene ka har'a axon ea methapo, likokoana-hloko tse ka holim'a metsi ha li sa khona ho fihla ho eona. Ho hohla leqeba hang-hang bakeng sa metsotso e 15 e felletseng ka povidone-iodine (Betadine), chlorhexidine, kapa sesepa se hlatsoang metsi se nang le metsi a mangata ho qhibiliha enfelopo ea kokoana-hloko ea lipid ha e kopana le ho hlatsoa ho feta karolo ea 99 lekholong ea kokoana-hloko pele ho hlaseloa ke methapo.

Ke tekanyo efe e nepahetseng ea Valacyclovir kapa Acyclovir e hlokahalang ho thibela kokoana-hloko ea Herpes B ka mor'a ho loma macaque?¶

Hobane kokoana-hloko ea Herpes B e batla e fokola ka makhetlo a 10 ho li-antivirals ho feta herpes-sore sore herpes (HSV-1), lengolo la ngaka le tloaelehileng la lethal dose le tlaase ha lea lekana. Ho latela tataiso ea CDC Herpes B Virus Working Group, batho ba baholo ba hloka Valacyclovir 1,000 mg (1 gram) ka molomo makhetlo a mararo ka letsatsi (lihora tse ling le tse ling tse 8) ka matsatsi a 14 a tletseng, kapa ka mokhoa o mong, Acyclovir 800 mg e nooa makhetlo a mahlano ka letsatsi bakeng sa matsatsi a 14, e qalile hantle ka mor'a lihora tse 24 ho isa ho tse 72 ka mor'a ho longoa, ho longoa, kapa ho loma.

Ke lokela ho etsa eng haeba tšoene ea macaque e tšoela kapa e fafatsa ka metsi ka leihlong la ka?¶

Ho phatloha ha mahlo a macaque kapa cage / metsi a letamo ke tsela e tlalehiloeng ea phetiso ea kokoana-hloko ea Herpes B ka conjunctiva le methapo ea optic / trigeminal. SE KE UA kenya sesepa, povidone-iodine, kapa joala ka leihlong la hao; ho e-na le hoo, tšoara mahlo a hao a bulehile 'me u phunye leihlo ka ho tsoelang pele ka metsotso e 15 e tletseng ka metsi a nooang a hloekileng a libotlolong kapa a sa hloekang 0.9% ea letsoai le tloaelehileng, ebe u ea sepetlele hang-hang ho qala Valacyclovir ea molomo (1 g ka makhetlo a mararo ka letsatsi bakeng sa matsatsi a 14) le ho buisana ka lefu la rabies prophylaxis.

Na ke ntse ke hloka Rabies Immune Globulin (HRIG) haeba ke fumana ente ea lefuba ka letsatsi la ho longoa ke litšoene?¶

E, haeba ha u so ka u fumana liente tsa lefu la rabies pele ho leeto, tšoene e 'ngoe le e 'ngoe e pshatlang letlalo e loma kapa ho ngoapa naheng e nang le lefu la rabies (joalo ka Indonesia/Bali, Thailand, India, Nepal, Africa, kapa Latin America) ke karolo ea WHO ea ho pepeseha e hlokang BOTH the 4-dose ea 4-rabies passiveneGHRB le ImmunoGHR 20 IU/kg) e kenelletse ka kotloloho leqebeng le ho potoloha. Hobane ente ea lefu la rabies e nka matsatsi a 7 ho isa ho a 14 ho matlafatsa sesole sa hau sa 'mele ho iketsetsa masole a 'mele, HRIG e fana ka li-antibodies tse thibelang hang hang sebakeng seo motho a lomang ho sona bekeng eo e kotsi ea pele.

Ke matšoao afe a lemosang matsatsing a pele a 30 ka mor'a ho loma ha macaque ho bolela hore ke hloka phekolo ea tšohanyetso ea IV?¶

Batla kamohelo ea hang-hang sepetlele sa tšohanyetso bakeng sa Ganciclovir (5 mg / kg IV lihora tse ling le tse ling tse 12) kapa tekanyo e phahameng ea IV Acyclovir haeba u hlahisa leha e le efe ea tse latelang matsatsing a 3 ho isa ho a 30 ka mor'a ho pepeseha ha macaque: li-blister tse tletseng metsi kapa liso haufi le leqeba; ho chesa, ho tsikinyeha, ho tsieleha, kapa ho hlohlona ho matla ho ntša letsoho kapa leoto le lonngoeng; feberu e sa hlalosoang kapa hlooho e bohloko; li-hiccups tse sa khaotseng (letšoao la khale la ho ruruha ha boko ba Herpes B); ho bona habeli, ho tsekela, bothata ba ho koenya, kapa bofokoli ba matsoho.

Litataiso tse amanang¶

• Ho pepesetsoa bo-rabies, ho kopana le bo-'mankhane, le post-exposure prophylaxis
• Ho longoa ke liphoofolo le tlhokomelo ea tšoaetso ea maqeba
• Phokojoe e bohale, raccoon, coyote kapa skunk ts'ireletso ea tlhaselo ea motšehare
• Ho tsoa mali ho matla le ho laola mali

Mehloli le tataiso ea semmuso¶

• Litsi tsa Taolo le Thibelo ea Mafu (CDC, United States): CDC Yellow Book (Boitsebiso ba Bophelo bo Botle bakeng sa Maeto a Machabeng): Ho pepeseha ha Zoonotic: Ho Loma, ho Scratches, le Likotsi Tse Ling tsa Macaque Monkeys (Herpes B Virus / Macacine alphaherpesvirus 1) le Rabies.
• Cohen, J. I., Davenport, D. S., Stewart, J. A., le ba bang. (B Virus Working Group, Clinical Infectious Diseases / CDC): Likhothaletso tsa Thibelo le Phekolo bakeng sa Ho pepesehela kokoana-hloko ea B (Cercopithecine Herpesvirus 1).
• Setsi sa Naha sa Mohloli oa Kokoana ea B (Georgia State University, Atlanta, USA): * Mekhoa ea Ts'ebetso ea Boemo ba Tšohanyetso bakeng sa Macaque Bite / Scratch Decontamination, Tlhahlobo ea Tlhahlobo, le Post-Exposure Prophylaxis *.
• Mokhatlo oa Lefatše oa Bophelo (WHO): Therisano ea Setsebi sa WHO mabapi le Rabies: Sehlopha sa III sa Taolo ea Ho pepeseha, Ho Kena ha Maqeba sebakeng sa Rabies Immunoglobulin (HRIG/ERIG), le Lichelete tsa Ente.
• Mokhatlo oa Mafu a tšoaetsanoang oa Amerika (IDSA): Itloaetse Litaelo tsa Tlhahlobo le Tsamaiso ea Letlalo le Likokoana-hloko tse Bonolo ka mor'a ho longoa ke Non-Human Primate.