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Prof. Dr. Orhan Yıldız, kene ısırması sonucu oluşan KKKA hastalığının yeni bir hastalık olmadığını söyledi. Hastalığın 2000'li yılların başında Türkiye'nin gündemine geldiğini kaydeden Prof. Dr. Yıldız, 2 yıldır vaka sayılarının azalmasına rağmen, hastalığın bu yıl hızlı artış gösterdiğini belirtti. Prof. Dr. Yıldız, "Bunun sebebini bilemiyoruz. Bu yıl biz insanları koronavirüs tedbirleri nedeniyle evde olur düşüncesi ile beklemiyorduk. Ancak öyle bir şey olmadı. Her yıl nisan ve ekim ayları arasında bu hastalık aktif görülürdü. Özellikle haziran ve temmuz en aktif olduğumuz dönemdir. Havanın sıcaklığı nedeniyle hem de insanların bağ veya bahçe işleriyle uğraştığı, doğada çok fazla bulundukları bir dönemdeyiz. Tokat kene için bilinen bölgelerin başında geliyor. Bu Çorum, Sivas, Yozgat, Erzincan'a kadar uzanan Doğu Karadeniz Bölgesi'ndeki vadilerde ortaya çıkan bir hastalıktır" dedi.
'KAYSERİ'DE 7 VAKA OLDU'
Prof. Dr. Yıldız, bu yıl Kayseri'de şimdiye kadar 7 vaka olduğunu belirterek, "4'ü Erciyes Üniversitesi'nde, 3'ü Şehir Hastanesi'nde tedavi gördü. Hastalardan 2'sini kaybettik. KKKA hastalığı koronavirüsten farklı olarak daha ölümcüldür. Özellikle tarım alanında çalışanlar risk altında. Benzer durum piknikçi ve dağcılar için de söz konusudur. Tarım ve hayvancılık alanında çalışma yapanlar kapalı giysi tercih etmeliler. Pantolonun paça içerisine sokulması iyi bir önlemdir. Kene uçan bir hayvan değil, sizin bulunduğunuz ortamda varsa hayvanlarda veya ağaçlarda, oradan size sıçrayabilen bir hayvandır. Kapalı tutmak gerekir. Kısa kollu giysiler giymemek gerekir. Bu tür riskli yerden ayrılınca mutlaka kene açısından tüm vücudun kontrol edilmesi gerekir" ifadelerini kullandı.
'BU HASTALIK İLE KORONAVİRÜSÜ AYIRMAK ZOR DEĞİL'
Yüksek ateş şikayeti nedeniyle hastalığın koronavirüs ile karıştırılmaması gerektiğini kaydeden Prof. Dr. Yıldız, "Bu hastalıkla koronavirüsü ayırmak zor değil. Bize yüksek ateşle geliyorlar; ama burada halsizlik, baş ağrısı, bulantı, kusma ve ishal ön plandadır. Bunlar koronavirüste de olabilir ama KKKA'da kanamalar başlıyor. Vücutta kırmızı renkli döküntüler oluyor. Gözlerde şişkinlik olabiliyor. Diş eti kanamaları ve vücudun çeşitli bölgelerinde morarmalar gibi çok daha ağır tablo karşımıza geliyorlar. Kan tahlilleri ile hızla bunları birbirinden ayırabiliyoruz. Tıpkı koronavirüste olduğu gibi burada da PCR testi söz konusudur. Hastalıkta en belirgin şey ise kene temasıdır" dedi.
'KENEYİ ELİNİZLE ÇIKARMAYA ÇALIŞMAYIN'
Vücuda yapışan kene nin kesinlikle elle çıkarılmaması gerektiğini söyleyen Prof. Dr. Yıldız, "Kene bir şekilde vücudumuza yapıştı. En yakın sağlık kuruluşuna gideceğiz. Keneyi elinizle kopararak çıkarmaya çalışmayın. Ezerek hiç çıkarmayın. Çünkü bulaşmayacaksa bile bulaşır. Ezme işlemi içerisinde hayvandan kan çıkacağı için bulaşı biz daha da artırmış olacağız. Yakarak çıkarmak her zaman hatalıdır. Sağlık merkezine gidilerek kenenin tutunduğu kafasından itibaren bütün halinde bir parça bile içeride kalmayacak şekilde çıkarılması gerekir ki en az bulaş söz konusu olsun" değerlendirmesinde bulundu.
KIRIM KONGO KANAMALI ATEŞİ NEDİR?
Kırım-Kongo Kanamalı Ateşi (KKKA), kene ler tarafından taşınan Bunyaviridae ailesine bağlı Nairovirüs grubuna ait bir virüsle oluşan ateş, halsizlik, iştahsızlık, kas ağrısı, baş ağrısı, bulantı, kusma, ishal ve ağır vakalarda kanama gibi bulgular ile seyrederek ölümlere neden olabilen zoonotik (hayvanlardan insanlara bulaşan) karakterli bir enfeksiyon hastalığıdır.
KIRIM KONGO KANAMALI ATEŞİNDEN NASIL KORUNULUR?
Tarla, bağ, bahçe, orman ve piknik alanları gibi kene yönünden riskli alanlara gidilirken, kenelerin vücuda girmesini engellemek maksadıyla mümkün olduğu kadar vücudu örten giysiler giyilmeli, pantolon paçaları çorapların içerisine sokulmalı ve ayrıca kenelerin elbise üzerinde rahat görülebilmesi için açık renkli kıyafetler tercih edilmelidir.
Kene yönünden riskli alanlardan dönüldüğünde kişi kendisinin ve çocuklarının vücudunda (kulak arkası, koltuk altları, kasıklar ve diz arkası dâhil) kene olup olmadığını kontrol etmeli, kene tutunmuş ise hiç vakit kaybetmeden çıplak el ile dokunmamak şartıyla vücuda tutunduğu en yakın yerden tutarak uygun bir malzeme ile (bez, naylon poşet, eldiven gibi) çıkarmalıdır.
Kişi keneyi kendisi çıkaramadığı durumlarda en yakın sağlık kuruluşuna başvurmalıdır. Kene ne kadar erken çıkarılırsa hastalığın bulaşma riskinin de o kadar azalacağı unutulmamalıdır.
Hastalık hayvanlarda belirti göstermeden seyrettiğinden hastalığın sık olarak görüldüğü bölgelerde bulunan hayvanlar sağlıklı görünse bile hastalığı bulaştırabilirler. Bu sebeple hayvanların kanlarına, vücut sıvılarına veya dokularına çıplak el ile temas edilmemelidir.
Hastalığa yakalanan kişilerin kan, vücut sıvıları ve çıkartıları ile hastalık bulaşabildiğinden, hasta ile temas eden kişiler gerekli korunma önlemlerini (eldiven, önlük, maske v.b.) almalıdır.
Kene tutunan kişiler, kendilerini 10 gün süreyle halsizlik, iştahsızlık, ateş, kas ağrısı, baş ağrısı, bulantı, kusma veya ishal gibi belirtiler yönünden izlemeli ve bu belirtilerden bir veya bir kaçının ortaya çıkması halinde derhal en yakın sağlık kuruluşuna müracaat etmelidirler.
Hastalığa sebep olan mikrobun taşıyıcısı, saklayıcısı ve bulaştırıcısı olan keneler uçmayan, zıplamayan, yerden yürüyerek vücuda tırmanan eklem bacaklı hayvanlardır. Vücuda tutunan veya hayvanların üzerinde bulunan keneler kesinlikle çıplak el ile öldürülmemeli ve patlatılmamalıdır. Keneler üzerine sigara basmak, kolonya, gaz yağı gibi maddeler dökmek kenenin kasılmasına sebep olarak vücut içeriğini kan emdiği kişiye aktarmasına sebep olacağı için yapılmamalıdır.
BELİRTİLERİ NELERDİR?
Etken Bunyaviridae ailesinden Nairovirus grubundan tek sarmallı RNA virüsü olan Crimean-Congo haemorrhagic fever virüsüdür. Hastalık ülkemizde başlıca hastalık etkenini taşıyan kene nin tutunması veya bununla temas sonucunda bulaşmaktadır. Ülkemizde hastalığın bulaştırıcısı asıl kene türü Hyalomma marginatum'dur. Bunun yanı sıra hastalık viremik dönemdeki hayvanların veya hasta kişilerin kan, doku, vücut çıkartılarına korunmasız temas sonucunda da bulaşabilmektedir.
İnkübasyon süresi kene tutunmasından sonra genellikle 1-3 gün, en fazla 9 gün olabilmektedir. Enfekte kan, vücut sıvısı ve diğer dokularla temas sonrasında 5-6 gün; en fazla ise 13 gün olabilmektedir.
Hastalığın tedavisinin esasını destek tedavisi seçenekleri oluşturmaktadır. Bu gün için hastalıktan korunmaya yönelik etkinliği kanıtlanmış bir aşı veya etkene spesifik bir ilaç bulunmamaktadır. Ülkemizde hastalığa karşı aşı geliştirme çalışmaları devam etmektedir.
Kırım Kongo Kanamalı Ateşi hastalığının kontrolüne yönelik çalışmalar Bakanlığımız tarafından bir program dâhilinde yürütülmektedir. Kişisel korunma önlemlerinin alınması hastalığın kontrolü için ön planda olduğundan Bakanlığımızca vatandaşlarımızın hastalık ve korunma önlemleri konusunda bilgilendirilmesi ve toplumda farkındalık oluşturulması çalışmaları yoğun bir şekilde yürütülmektedir.
Ülkemizde KKKA bahar aylarında görülmeye başlamakta olup yaklaşık %4-5 fatalite hızıyla seyretmektedir. Yıllar itibariyle vaka görülme durumlarına bakıldığında artış ve azalış eğilimlerinden bahsedilebilmekte olup en yüksek vaka 2009 yılında 1318 vaka olarak gerçekleşmiştir. Her ne kadar 2017 yılında 343 KKKA vakası tespit edilmiş olsa da ülkemizde hala önemini korumaktadır.