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წითელა | ჯანმრთელობა | vidal.ge

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წითელა

თარიღი: 07 აპრილი, 2014

რა არის წითელა?

გამომწვევი
წითელა ვირუსით გამოწვეული რესპირატორული დაავადებაა. დაავადებას და ვირუსს, რომელიც იწვევს ამ დაავადებას, ერთი და იმავე სახელით მოიხსენიებენ - წითელა. ჩვეულებრივ, წითელას ვირუსი მრავლდება ფილტვების და ხახის უჯრედებში.

სიმპტომები
უმეტეს შემთხვევაში წითელას გამოვლენა იწყება ადამიანის დაინფიცირებიდან 7-14 დღეში და ხასიათდება შემდეგი სიმპტომებით:
• ლაქოვანი გამონაყარი
• ცხელება
• ხველა
• სურდო
• თვალის სიწითლე და ცრემლდენა (კონიუქტივიტი)
• სისუსტე
• წვრილი თეთრი გამონაყარი პირის ღრუში (კოპლიკის გამონაყარი)

წითელას ტიპიური შემთხვევა იწყება ტემპერატურის მომატებით დაბალი და საშუალო ცხელებით), რომელსაც თან ახლავს ხველა, სურდო, თვალის სიწითლე და ყელის ტკივილი. სიმპტომების დაწყებიდან მეორე ან მესამე დღეს პირის ღრუში შეიძლება გაჩნდეს წვრილი თეთრი გამონაყარი (კოპლიკის გამონაყარი) .
სიმპტომების დაწყებიდან 5-6 დღის შემდეგ ავადმყოფის სხეულზე ჩნდება წითელი გამონაყარი. თავდაპირველად გამონაყარი ჩნდება სახეზე, (შუბლზე), რომელიც შემდეგ ვრცელდება მთელ სხეულზე ზევიდან ქვევით (კისერი, ტორსი, ხელები, ფეხები, ტერფები).
გამონაყართან ერთად ავადმყოფის სხეულის ტემპერატურამ შეიძლება მიაღწიოს 400C- ს.
რამდენიმე დღეში სიცხე იწევს დაბლა და გამონაყარი თანდათან ქრება.

გართულებები
წითელათი დაავადებული დაახლოებით 10 ბავშვიდან 1-ს მაინც უვითარდება ყურის ინფექცია, და 20-დან ერთს პნევმონია. 1000 შემთხვევიდან ერთს უვითარდება ენცეფალიტი, და 1000-დან ერთი ან ორი შემთხვევა მთავრდება ფატალური გამოსავალით. გამონაყარით მიმდინარე სხვა დაავადებები ისეთი, როგორიცაა წითურა, ხშირად ეშლებათ წითელაში დიაგნოზის დასმის დროს.
ამჟამად ყოველწლიურად მსოფლიოში ამ დაავადებით კვდება 200.000 ადამიანამდე.
წითელას შემთხვევების 30%-ს უვითარდება 1 ან მეტი გართულება. ესენია:
• პნევმონია, რომელიც გარდაცვალების ყველაზე ხშირი მიზეზია პატარა ბავშვებში
• ყურის ინფექცია, რომელიც ვლინდება წითელას 10 შემთხვევიდან ერთში და შეიძლება გამოიწვიოს სმენის სამუდამოდ დაკარგვა.
• შემთხვევათა 8%-ში აღინიშნება დიარეა.

აღნიშნული გართულებები უფრო ხშირად გვხვდება 5 წლამდე ასაკის ბავშვებში და მოზრდილებში - 20 წლის ზევით.
სტატისტიკიდან გამომდინარე, ზოგადად 20 ბავშვიდან ერთში წითელა იწვევს პნევმონიას, და 1000-დან ერთს უვითარდება ენცეფალიტი (თავის ტვინის ანთება, რომელმაც შეიძლება გამოიწვიოს კრუნჩხვები ან ბავშვის დაყრუება ან გონებრივი ჩამორჩენილობა). ეს მონაცემები, იძლევა ვარაუდის საფუძველს, რომ მანამდე ჯანმრთელ ბავშვებიშიც კი წითელამ შეიძლება გამოიწვიოს სერიოზული დაავადება, რომელიც მოითხოვს ჰოსპიტალიზაციას.
ორსულებში წითელამ შეიძლება გამოიწვიოს სპონტანური აბორტი, ნაადრევი მშობიარობა ან მცირეწონიანი ბავშვის დაბადება.

გადაცემა
წითელა ვრცელდება ჰაერით - სუნთქვის, ხველებისა და ცემინების დროს. წითელას იმდენად მაღალი კონტაგიოზურობა (გადამდებლობა) ახასიათებს, რომ ნებისმიერ ბავშვს, რომელიც იმყოფება ექსპოზიციის ქვეშ და არ აქვს იმუნიტეტი, დიდი ალბათობით დაავადდება.
წითელა გადამდები (ინფექციური) დაავადებაა და შეიძლება გავრცელდეს გამონაყარის გამოვლენამდე ოთხი დღით ადრე ან შემდგომ. წითელას გადაცემის რისკი იმდენად მაღალია, რომ თუ ერთ პირს დაემართება, იმ ადამიანების 90%-ს, ვისაც აქვს ახლო კონტაქტი და ამავე დროს არ აქვთ იმუნიტეტი , დაავადდებიან წითელათი. ვირუსი ბინადრობს ავადმყოფის ცხვირისა და პირის ღრუს ლორწოვანში. ხველების და ცემინების დროს იგი იფრქვევა და ვრცელდება წვეთების სახით ჰაერში, რაც აადვილებს კონტაქტში მყოფთა დაინფიცირებას. ვირუსის სიცოცხლისუნარიანობა 2 საათამდე გრძელდება.
წითელა ადამიანის დაავადებაა, და არ ვრცელდება ცხოველიდან.

წითელას გავრცელება
წითელა იშვიათია ისეთ ქვეყნებსა და რეგიონებში სადაც ვაქცინაციით მოცვა მაღალ დონეზე რჩება. ითვლება, რომ ჩრდილო და სამხრეთ ამერიკაში, ფინეთსა და ზოგიერთ სხვა ქვეყანაში წითელას ენდემური (ადგილობრივი)გავრცელება შეწყვეტილია ვაცქინაციის გზით. ყოველწლიურად მსოფლიოში 20 მილიონი წითელათი დაავადებისა და 164 000 სიკვდილის შემთხვევა აღირიცხება. გარდაცვალების შემთხვევების ნახევარზე მეტი ინდოეთზე მოდის.
საქართველოში 2004–2005 წლებში, 1973 წლის შემდეგ, პირველად დაფიქსირდა წითელას უდიდესი აფეთქება. ქვეყანაში აღირიცხა წითელას 8 391 შემთხვევა, ასაკობრივი განაწილება შეადგენდა 0–69 წელს.
ავადმყოფთა 41% არ იყო ვაქცინირებული, 35%-ს მიღებული ჰქონდა წითელას ვაქცინის 1 დოზა, 6%-ს ორი დოზა, ხოლო 18%-ში ვაქცინაციის სტატუსი არ იყო ცნობილი. ჰოსპიტალიზირებულთა რაოდენობა შეადგენდა 1 354 (19%), გარდაიცვალა 9.

წითელას ისტორია
წითელას, როგორც დაავადების აღწერილობა ჩვენამდე მოღწეული ერთ-ერთი ყველაზე უძველესი ჩანაწერია მე-9 საუკუნის არაბი ექიმის მიერ, რომელიც თავის სამედიცინო შენიშვნებში აღწერს განსხვავებას წითელასა და ჩუტყვავილას შორის.
1757 წელს შოტლანდიელი ექიმმა, ფრანცის ჰომემ, აღმოაჩინა, რომ წითელას იწვევს ავადმყოფის სისხლში არსებული ინფექციის გამომწვევი. 1954 წელს წითელას გამომწვევი ვირუსი გამოიყო ბოსტონში, მასაჩუსეტში, ჟონ ენდერისა და ტომას პიბლის მიერ. წითელას ვაქცინის გამოგონებამდე, თითქმის ყოველი ბავშვი ხდებოდა ავად 15 წლის ასაკამდე პერიოდში. აშშ-ში ყოველ წელს დაახლოებით 450-500 ადამიანი იღუპებოდა წითელათი, 48000 ხვდებოდა საავადმყოფოში და დაახლოებით 1000 ავადმყოფს უვითარდებოდათ ტვინის დაზიანება ან სიყრუე.

წყარო: http://ncdc.ge/index.php?do=fullmod&mid=496