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Maymun çiçeği virüsü hakkında aramalar hız kazandı. İngiltere'nin ardından Portekiz ve İspanya'da 'Maymun Çiçeği' vakası görüldü. Bu gelişmelerin ardından, "Maymun çiçeği virüsü nedir ? Maymun çiçeği virüsü nasıl bulaşır? Maymun çiçeği (Monkeypox) belirtileri nedir, tedavisi var mı ?" sorularına yanıt aranmaya başlandı. İşte tüm merak edilenler!
MAYMUN ÇİÇEĞİ VİRÜSÜ NEDİR?
Maymun Çiçeği Hastalığına, Poxviridae ailesindeki Orthopoxvirus cinsinin bir üyesi olan maymun çiçeği virüsü (Monkeypox) neden olur.
Monkeypox, öncelikle Orta ve Batı Afrika'nın tropikal yağmur ormanlarında ortaya çıkan ve zaman zaman diğer bölgelere ihraç edilen viral bir zoonotik hastalıktır.
Monkeypox ilk olarak 1958'de laboratuvar maymun kolonilerinde çiçek benzeri bir hastalık salgınının ortaya çıkmasıyla keşfedilmiştir, bu nedenle 'maymun çiçeği' adı verilmiştir. Maymun çiçeği virüsü vakası insanda ilk olarak 1970 yılında Demokratik Kongo Cumhuriyeti'nde görülmüştür. Söz konusu tarihten itibaren diğer Orta ve Batı Afrika ülkelerindeki insanlarda maymun çiçeği virüsü vakası bildirilmiştir.
Maymun çiçeği virüsünün Orta Afrika ve Batı Afrika olmak üzere iki farklı genetik grubu vardır.İnsanlarda görülen Orta Afrika maymun çiçeği virüsü, Batı Afrika virüsüne göre daha şiddetlidir ve daha yüksek ölüm oranına sahiptir.
MAYMUN ÇİÇEĞİ VİRÜSÜ NASIL BULAŞIR?
Monkeypox virüsü insanlara çoğunlukla kemirgenler ve primatlar gibi vahşi hayvanlardan bulaşır, ancak insandan insana bulaşma da gerçekleşebilir.
Monkeypox virüsü bir kişiden diğerine lezyonlar , vücut sıvıları, solunum damlacıkları ve yatak örtüsü gibi kontamine materyallerle temas yoluyla bulaşır. Yetersiz pişmiş et ve enfekte hayvanların diğer hayvansal ürünlerini yemek olası bir risk faktörüdür. Anneden fetüse plasenta yoluyla da bulaşabilir.
MAYMUN ÇİÇEĞİ BELİRTİLERİ
Kuluçka süresi (enfeksiyondan semptomların başlangıcına kadar olan aralık) genellikle 6 ila 13 gün arasındadır, ancak 5 ila 21 gün arasında değişebilir.
Enfeksiyon iki döneme ayrılabilir:
·Ateş, yoğun baş ağrısı, lenfadenopati (lenf bezlerinin şişmesi), sırt ağrısı, kas ağrıları ve şiddetli halsizlik ile karakterize invazyon dönemi 0-5 gün arasında sürer.Lenfadenopati, başlangıçta benzer görünebilen diğer hastalıklarla (suçiçeği, kızamık, çiçek hastalığı) karşılaştırıldığında maymun çiçeği virüsü vakasının ayırt edici bir özelliğidir.
·Deri döküntüsü genellikle ateşin ortaya çıkmasından sonraki 1-3 gün içinde başlar. Döküntü, gövdeden ziyade yüz ve ekstremitelerde daha konsantre olma eğilimindedir. Döküntüler genelde yüzde başlayıp (vakaların %95'inde) ve avuç içlerini ve ayak tabanlarını (vakaların %75'inde) etkiler. Ayrıca oral mukozalar (vakaların %70'inde), genital bölge (%30) ve konjonktiva ile birlikte kornea da (%20)etkilenir. Döküntü, ardışık olarak maküllerden (düz tabanlı lezyonlar) papüllere (hafifçe kabarık sert lezyonlar), veziküllere (berrak sıvı ile dolu lezyonlar), püstüllere (sarımsı sıvı ile dolu lezyonlar) ve kuruyup dökülen kabuklara doğru değişiklik gösterir.
Monkeypox genellikle 2 ila 4 hafta süren semptomları olan kendi kendini sınırlayan bir hastalıktır. Şiddetli vakalar çocuklar arasında daha sık görülür. Maymun çiçeği virüsü vaka ölüm oranı genel popülasyonda %0 ile %11 arasında değişmektedir ve küçük çocuklar arasında daha yüksektir.
MAYMUN ÇİÇEĞİ TEDAVİSİ
Tanıda, polimeraz zincir reaksiyonu (PCR), doğruluğu ve duyarlılığı göz önüne alındığında tercih edilen laboratuvar testidir. Mümkün olduğunda biyopsi bir seçenektir.
Orthopoxvirüsler serolojik olarak çapraz reaktif olduğundan, antijen ve antikor saptama yöntemleri, maymun çiçeğine özgü doğrulama sağlamaz. Bu nedenle, kaynakların sınırlı olduğu durumlarda tanı veya vaka incelemesi için seroloji ve antijen saptama yöntemleri önerilmez.
Henüz maymun çiçeği virüsü enfeksiyonu için kanıtlanmış, güvenli bir tedavi yoktur. Maymun çiçeği salgınını kontrol altında tutmak amacıyla çiçek hastalığı aşısı, antiviraller ve İntravenöz immün globulin (VIG) kullanılabilir. Bununla birlikte, şu anda, orijinal (birinci nesil) çiçek hastalığı aşıları artık halka açık değildir. 2019'da çiçek hastalığı ve maymun hastalığının önlenmesi için daha yeni bir aşı onaylanmakla birliktehenüz kamu sektöründe yaygın olarak mevcut değil.
MAYMUN ÇİÇEĞİ VAKALARI!
İspanya ve Portekiz'de sağlık bakanlıkları, maymun çiçeği (monkeypox) virüsü vakalarına karşı alarma geçti.
Orta ve Batı Afrika'da maymundan insana geçen endemik bir virüsün neden olduğu nadir bir hastalık olan maymun çiçeğinin, İspanya'nın başkenti Madrid'de 8, Portekiz'in başkenti Lizbon'da da 5 kişide tespit edildiği açıklandı.
Madrid'deki hastaların sağlık durumlarının iyiye gittiği bilgisi paylaşıldı.
İspanya Ulusal Mikrobiyoloji Merkezi de Madrid'de tespit edilen 8 vakanın maymun çiçeği virüsü olduğu konusunda ortak bir görüş olmasına rağmen kesin sonuçların analizlerin tamamlanmasının ardından belli olacağını duyurdu.
İspanya Acil Sağlık Hizmetleri ve Uyarılar Koordinasyon Merkezi Direktörü Fernando Simon, İngiltere'nin ardından Portekiz ve İspanya'da görülen maymun çiçeği vakaları arasında bir bağlantı olup olmadığının da araştırıldığını söyledi.
Simon, "Şu anda çok yeni ancak her türlü olasılığa karşı hazırlıklı olmalıyız. Virüsün bulaşması çok düşük bir olasılık olsa da tamamen dışarıda bırakacağımız bir ihtimal değil. O yüzden temkinli olmalıyız. Tüm olasılıklar için çalışıyoruz." şeklinde konuştu.
Maymun çiçeği virüsü Avrupa'da ilk olarak 15 Mayıs'ta İngiltere'de 4 kişide tespit edilmiş, ardından 17 Mayıs'ta Portekiz'de 5 kişide bu virüsün görüldüğü, 15 kişinin de şüpheli durumda gözetim altına alındığı belirtilmişti.
Maymun çiçeğinde, deride döküntü ve kabarıklıklar, ateş, sırt ve kas ağrıları, şişmiş lenf düğümleri en yaygın belirtiler olarak biliniyor.