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Türkiye'de İngiltere varyantı tespit edilen Kovid hastalarının ardından, İstanbul Tıp Fakültesi 'nde bir hastada Brezilya mutasyonu nun teşhis edilmesi, filyasyon uygulamalarında da değişime yol açacak. İstanbul Tıp Fakültesi Dekanı Prof. Dr. Tufan Tükek, artık pozitif teşhis alan tüm hastaların evde ya da hastanede farketmeksizin, tek kişi olarak izolasyonda kalması gerektiğini söyledi.
Prof. Dr. Tükek, "Farklı mutantların görülmesiyle beraber filyasyonda virüs rekombinasyonu değişikliği yarattı. Çünkü iki farklı mutant virüs tek kişide enfeksiyon yaparsa, virüsler kendi içlerindeki genetik materyalleri değiştirip farklı bir virüse dönüşebilir. Bu, korktuğumuz bir durum. O yüzden artık evdeki aile fertleri bile maskesiz aynı ortamda olmamalı, imkan varsa farklı odalarda izolasyonda kalmalı" dedi.
"BREZİLYA VARYANTI BİR HASTADA TESPİT EDİLDİ" Korona virüs pandemi sinin dünyadaki birinci yılı geride kalırken, virüsün yeni mutantları endişe yaratıyor. İngiltere, Güney Afrika ve Brezilya 'da ortaya çıkan yeni varyantlar, hem bulaşıcılık hızı hem de hastalığın seyri açısından virüsün ilk halinden farklılık gösteriyor. İstanbul Üniversitesi İstanbul Tıp Fakültesi Dekanı Prof. Dr. Tufan Tükek kendi hastanelerinde, Türkiye'de ilk kez bir kişide Brezilya varyantının tespit edildiğini vurgulayarak, şöyle konuştu:
"Geçen sene Şubat ayında Çin'den gelen bir turist kafilesinde 6 yaşında ateşli bir çocuk vaka ile alarma geçmiştik. İstanbul Tıp Fakültesi Çocuk Acil'e gelmişlerdi, tabii büyük bir panik oluştu, acaba Kovid çıkar mı, çıkarsa bunun filyasyon nasıl olur, çok kişiye bulaştırmış mıdır vs diye. Ama çok şükür Kovit çıkmamıştı, İnfluenza B teşhisi almıştı o hasta. Tedavisini yapıp taburcu etmiştik. Şimdi de bir hafta kadar önce Brezilya mutasyonu şüphesiyle test yaptığımız bir hastayı tedavi ediyoruz. Koronavirüs tanısı sırasında şüpheleri vardı, çünkü hastanın Brezilya temaslı olma durumu söz konusuydu. Nitekim genetik testlerini yaptığımızda Brezilya varyantı taşıdığını tespit ettik. Ankara'dan da onaylandı test sonucu. Klinik olarak çok farklı değil tabii ki. Hasta yaklaşık 10. gününde, çok şükür desatüre olmadı, oksijen düzeyleri iyi gitti. Ateşi düzeldi, klasik tedaviye yanıt verdi. Tabii genç de bir hasta, 35-40'lı yaşlarda. Bu hasta özelinde bakacak olursak çok farklı bir seyirle karşılaşmadık. Ama şu an için Türkiye'de tek gözüken vaka olduğu için anlamlı tabii"
"İKİ POZİTİF VAKA AYNI YERDE BULUNMAMALI" Yeni varyantların farklı bir virüsmüş gibi algılanmaması gerektiğini belirten Prof. Dr. Tükek, şu ifadeleri kullandı: "Tamamen klasik bildiğimiz Kovid-19'un oluşturduğu klinik bulgu ve semptomlar görülüyor. Sadece yeni filyasyon uygulaması olarak 10 gün dolduktan sonra negatifliğine bakıldıktan sonra izolasyon sonlanacak ve ayrıca hastaların diğer pozitif vakalarla temas etmeden tek kişilik odada takibi gerekiyor. Çünkü rekombinasyondan bahsediliyor virüslerle ilgili, iki farklı mutant virüs tek kişide enfeksiyon yaparsa, virüsler kendi içlerindeki genetik materyalleri değiştirip farklı bir virüse dönüşebilir. Böyle durumlardan tabii ki korkuyoruz. O yüzden mutant virüslerle enfekte olan kişileri ayrı tutup izolasyonunu çok sıkı yapmamız gerekiyor. Biz hastanemizde zaten tek kişilik odalarda tedavi veriyoruz. Türkiye'de genelinde de bu şekilde uygulanması gerekiyor şartları elveren hastanelerde. Mutantlı virüs olup olmadığının tespiti için belli bir süre gerekiyor. Bu süre içerisinde hastalar birbirinden enfeksiyon kapabilir. İleride zaten belki başka mutantlarla da karşılaşacağız. Bütün koronavirüs enfeksiyonlarında bu algoritmayı uygulamak gerekecek. Çünkü şu an 3 mutasyon önemli ama belki bu ileride 5 olacak, 6 olacak. Hastaların çoklu virüsle enfekte olması, genom transferi ile hastalığın daha da farklılaşma riskini doğurur. Bu da pandemiyle mücadele sürecini çok olumsuz etkiler."
"EV İÇİNDE ÇOK DAHA FAZLA DİKKAT GEREKİYOR" Prof. Dr. Tufan Tükek, yeni tip mutantlar nedeniyle özellikle hastalığı evde geçiren aile fertlerinin çok dikkatli olması gerektiğinin altını çizerek şu uyarıları yaptı: "Aile fertleri enfekte olduğunda, mümkün olduğunca bir arada bulunmaması gerekiyor artık. Nasıl olsa aynı enfeksiyonu taşıyoruz diye aynı ortamda kesinlikle maskesiz bulunmamaları lazım. Mümkünse odalarını ayırmak gerekiyor. En azından 10 günlük süre içerisinde buna dikkat etmek lazım."
Sağlık Bakanlığı'nın yeni tip mutasyonların yaygın tespitine yönelik PCR testleri hazırlığı yaptığını söyleyen Prof. Dr. Tükek, "Mutant virüs tarama testlerinin yaygınlaşması için bir hazırlık içinde bakanlık. Geçtiğimiz hafta çok sayıda hastaneye bu kitler dağıtıldı. Bu kitler artık yaygın bir şekilde kullanılmaya başlanacak. Hemen hemen her merkezde önümüzdeki 1 ay içinde farklı mutasyonlara bakabilecek PCR testleri kullanıma girmiş olacak dedi.
"BİR AY İÇİNDE MUTANT TARAMALARI DA YAYGIN OLARAK YAPILACAK" Türkiye'de yaşanan vaka düşüşlerinin ardından, bugünlerde gözlenen hafif yükselme eğiliminin yeni varyantlarla ilgili olup olmadığını söylemek için erken olduğunu vurgulayan Prof. Dr. Tükek, sözlerini şöyle noktaladı: "Yükseliş Var, gibi gözüküyor ama vaka sayıları 8 binden 10-12 binlere çıkarsa, çıkan vakalarda özellikle İngiltere mutasyonu çok daha yüksek oranlarda tespit edilirse, artışın bu mutantlara bağlı olduğunu söyleyebiliriz ancak. Ülkemizde henüz Güney Afrika ve Brezilya suşları çok görülmedi. İngiltere mutantı için söylenen, en başta yüzde 75'lerdeydi hızı, şimdi yüzde 35'lerde olduğu belirtiliyor, her ülkede farklı çıkıyor oranlar, fazla bir artış söz konusu. Hücreye geçiş ve bulaşıcılık özelliği bakımından daha hızlı bu varyant. Ama ölümcül ya da öldürücülük anlamında bir değişiklik yok. Sadece, çok hızlı bulaşması, risk grubu olan, hassasiyeti olan kişilerin hastalığa yakalanma riskini artıracağı için, ölüm oranlarının da artmasından endişe ediliyor. Güney Afrika varyantının biraz daha ağır seyredebileceği söyleniyor ama henüz Türkiye'de onu yaygın olarak gözlemedik"