Isifo seLyme

Isifo seLyme sisifo esosasazeka ngokulunywa kolunye lweentlobo zamakhalane.

Isifo seLyme sibangelwa ziintsholongwane ezibizwa ngokuba IBorrelia burgdorferi (B burgdorferi). Amakhalane amnyama (abizwa ngokuba ngamakhalane emazixhama) angazithwala iintsholongwane. Ayizizo zonke iintlobo zamakhalane ezinokuthwala ezi bhaktiriya. Amakhalane angafakwanga abizwa ngokuba ziinymphs, kwaye aphantse alingane nentloko kanotaka. Iinymphs zichola iintsholongwane xa zitya iimpuku ezincinci, ezinje ngeempuku, ezosuleleke zizo B burgdorferi. Esi sifo ungasifumana kuphela xa ulunywa likhalane elosulelekileyo.

Isifo seLyme saqala ukubikwa e-United States ngo-1977 kwidolophu yase-Old Lyme, eConnecticut. Isifo esifanayo senzeka kwiindawo ezininzi zaseYurophu naseAsia. E-United States, uninzi lwezifo zesifo seLyme zenzeka kwezi ndawo zilandelayo:

• Amantla mpuma, ukusuka eVirginia ukuya eMaine
• Amazwe akumantla akuMbindi, ikakhulu eWisconsin naseMinnesota
• Unxweme oluseNtshona, ikakhulu emantla ntshona

Zintathu izigaba zesifo seLyme.

• Inqanaba 1 ibizwa ngokuba sisifo seLyme sasekuqaleni. Iibhaktheriya azikasasazeki emzimbeni wonke.
• Inqanaba 2 ibizwa ngokuba sisifo seLyme esisasazwe kwangoko. Iibhaktheriya sele ziqalisile ukusasazeka emzimbeni wonke.
• Inqanaba 3 ibizwa ngokuba sisifo seLyme esisasazwe kade. Iintsholongwane zisasazeke emzimbeni wonke.

Izinto ezinobungozi kwisifo seLyme zibandakanya:

• Ukwenza imisebenzi yangaphandle eyonyusa ukubonakaliswa kwamakhalane (umzekelo, igadi, ukuzingela, okanye ukuhamba intaba) kwindawo apho isifo seLyme senzeka khona
• Ukuba nesilwanyana sasekhaya esingathwala amakhalane asulelekileyo ekhaya
• Ukuhamba kwingca ephezulu kwiindawo apho kwenzeka khona isifo seLyme

Iinyani ezibalulekileyo malunga nokulunywa ngamakhalane kunye nesifo seLyme:

• Ikhonkco kufuneka linamathele emzimbeni wakho kangangeeyure ezingama-24 ukuya kwezingama-36 ukwenzela ukusasaza iintsholongwane egazini lakho.
• Amakhalane amnyama angaba mancinci kangangokuba akunakubonwa. Abantu abaninzi abanesifo seLyme abaze babone okanye bazive bekhatshwa yimizimba yabo.
• Uninzi lwabantu abalunywe likhalane abasifumani isifo seLyme.

Iimpawu zesifo saseLyme sasekuqaleni (isigaba 1) siqala iintsuku okanye iiveki emva kosulelo. Ziyafana nomkhuhlane kwaye zinokubandakanya:

• Umkhuhlane kunye nokubanda
• Imvakalelo yokugula ngokubanzi
• Intloko ebuhlungu
• Intlungu edibeneyo
• Intlungu yezihlunu
• Intamo elukhuni

Kungakho irhashalala "iliso lenkunzi", indawo ethe tyaba okanye ephakanyiswe kancinci ebomvu kwindawo yokulunywa ngamakhalane. Rhoqo kukho indawo ecacileyo embindini. Inokuba nkulu kwaye iyanda ngokobukhulu. Olu rash lubizwa ngokuba yi-erythema migrans. Ngaphandle konyango, inokuhlala iiveki ezi-4 okanye ngaphezulu.

Iimpawu zinokuza zihambe. Ukunganyangwa, intsholongwane isasazeka kwingqondo, entliziyweni nakumalungu.

Iimpawu zesifo seLyme esisasazwe kwangoko (inqanaba 2) zinokwenzeka iiveki ukuya kwiinyanga emva kokulunywa likhalane, kwaye zinokubandakanya:

• Ubudenge okanye iintlungu kwindawo ye-nerve
• Ukukhubazeka okanye ubuthathaka kwiimisipha zobuso
• Iingxaki zentliziyo, ezinje ngokutsiba kwentliziyo (ukubetha kwentliziyo), iintlungu esifubeni, okanye ukuphefumla kancinci

Iimpawu zokusasazeka kade kwesifo seLyme (inqanaba lesi-3) zinokwenzeka kwiinyanga okanye kwiminyaka emva kosulelo. Ezona mpawu zixhaphakileyo yimisipha kunye nentlungu edibeneyo. Ezinye iimpawu zingabandakanya:

• Intshukumo yemisipha engaqhelekanga
• Ukudumba ngokudibeneyo
• Ubuthathaka bemisipha
• Ubudenge nokugungqa
• Iingxaki zentetho
• Iingxaki zokucinga (kwengqondo)

Uvavanyo lwegazi lunokwenziwa ukukhangela ii-antibodies kwintsholongwane ebangela isifo seLyme. Eyona isetyenziswa ngokuxhaphakileyo yi-ELISA yovavanyo lwesifo seLyme. Uvavanyo lwe-immunoblot lwenziwa ukuqinisekisa iziphumo ze-ELISA. Yazi, nangona kunjalo, kwinqanaba lokuqala losulelo, uvavanyo lwegazi lunokuba yinto eqhelekileyo. Kwakhona, ukuba uphathwa ngamayeza okubulala iintsholongwane kwinqanaba lokuqala, umzimba wakho awunako ukwenza ii-antibodies ezaneleyo ukuba zibonwe luvavanyo lwegazi.

Kwiindawo apho isifo seLyme sixhaphake khona, umboneleli wakho wezempilo unokukwazi ukufumanisa isifo seLyme esisasazwe kwangoko (iSigaba 2) ngaphandle kokwenza naluphi na uvavanyo lwelebhu.

Olunye uvavanyo olunokuthi lwenziwe xa usulelo lusasazekile lubandakanya:

• Electrocardiogram
• Echocardiogram ukujonga intliziyo
• I-MRI yengqondo
• Impompo yomqolo (i-lumbar puncture yokuvavanya ulwelo lomqolo)

Abantu abalunywe yingcongconi kufuneka bajongwe ngokusondeleyo kangangeentsuku ezingama-30 ukubona ukuba kukho irhashalala okanye iimpawu ezikhulayo.

Idosi enye ye-doxycycline ye-antibiotic inokunikwa umntu kwakamsinya emva kokulunywa likhalane, xa zonke ezi meko ziyinyani:

• Umntu unekiti elinokuhambisa isifo seLyme esiqhotyoshelwe emzimbeni wakhe. Oku kudla ngokuthetha ukuba umongikazi okanye ugqirha ujongile kwaye wachonga uphawu lokukorekisha.
• Ikhalane kucingelwa ukuba liqhotyoshelwe kuloo mntu okungenani iiyure ezingama-36.
• Umntu uyakwazi ukuqala ukuthatha iyeza lokubulala iintsholongwane kwisithuba seeyure ezingama-72 esusile uphawu lokukhathaza.
• Umntu uneminyaka esi-8 nangaphezulu kwaye akakhulelwanga okanye akancancisi.
• Ireyithi yengingqi yamakhalane ethweleyo B burgdorferi yi-20% okanye ngaphezulu.

Ikhosi yeentsuku ezili-10 ukuya kwezi-4 ye-antibiotics isetyenziselwa ukunyanga abantu abafunyaniswa benesifo seLyme, kuxhomekeke kukhetho lweziyobisi:

• Ukhetho zintsholongwane kuxhomekeke kwinqanaba sifo kunye neempawu.
• Ukhetho oluqhelekileyo lubandakanya i-doxycycline, amoxicillin, azithromycin, cefuroxime, kunye ne-ceftriaxone.

Amayeza eentlungu, afana ne-ibuprofen, ngamanye amaxesha amiselwe ukuqina ngokudibeneyo.

Ukuba sifunyenwe kumanqanaba okuqala, isifo seLyme sinokunyangeka ngamayeza okubulala iintsholongwane. Ngaphandle konyango, iingxaki ezibandakanya amalungu, intliziyo, kunye nenkqubo yovalo zinokwenzeka. Kodwa ezi mpawu zisanyangeka kwaye ziyanyangeka.

Kwiimeko ezinqabileyo, umntu uqhubeka eneempawu eziphazamisa ubomi bemihla ngemihla emva kokuba anyangwe ngeyeza lokubulala iintsholongwane. Oku kukwabizwa ngokuba sisifo sesifo seLyme. Unobangela wale syndrome aziwa.

Iimpawu ezenzeka emva kokumiswa kwee-antibiotics zingangabi zimpawu zentsholongwane kwaye zingaphenduli kunyango lwe-antibiotics.

Inqanaba lesi-3, okanye ukusasazwa kade, isifo seLyme sinokubangela ukudumba ngokudibeneyo (iLyme arthritis) kunye neengxaki zesingqisho sentliziyo. Iingxaki zengqondo kunye neenkqubo zovalo zinokwenzeka, kwaye zinokubandakanya:

• Ukuncipha koxinzelelo
• Ukuphazamiseka kwimemori
• Umonakalo wemithambo
• Ubumdaka
• Intlungu
• Ukukhubazeka kwezihlunu zobuso
• Iingxaki zokulala
• Iingxaki zombono

Fowunela umnikezeli wakho ukuba unayo:

• Irhashalala enkulu, ebomvu, eyandayo enokubonakala ngathi iliso lenkunzi.
• Ukulunywa likhalane kwaye ukhule ube buthathaka, ukuba ndindisholo, ukurhawuzelela, okanye iingxaki zentliziyo.
• Iimpawu zesifo seLyme, ngakumbi ukuba ubunokuvezwa kumakhalane.

Thatha amanyathelo okuthintela ukulunywa ngamakhalane. Qaphela ngakumbi kwiinyanga ezifudumeleyo. Xa kunokwenzeka, kunqande ukuhamba okanye ukuhamba ehlathini kunye neendawo ezinengca ephezulu.

Ukuba uhamba okanye unyuka kwezi ndawo, thatha amanyathelo okuthintela ukulunywa ngamakhalane:

• Nxiba iimpahla ezinemibala ekhanyayo ukuze xa amakhalane athe wafika kuwe, abonakale asuswe.
• Nxiba imikhono emide kunye neebhulukhwe ezinde enemilenze emide efakwe kwiikawusi zakho.
• Tshiza ulusu oluveziweyo kunye nempahla yakho kunye nezinto zokugxotha izinambuzane, ezinje nge-DEET okanye ipermethrin. Landela imiyalelo kwisitya.
• Emva kokubuyela ekhaya, susa iimpahla zakho kwaye uhlolisise kakuhle yonke indawo yomhlaba, kubandakanya ne-scalp yakho. Shawa ngokukhawuleza ukuhlamba amakhalane angabonakaliyo.

Ukuba uphawu lokukorekisha luqhotyoshelwe kuwe, landela la manyathelo okususa:

• Yibambe uphawu lokukorekisha kufutshane nentloko okanye umlomo kunye nezixhobo zokuthambisa. MUSA ukusebenzisa iminwe yakho. Ukuba kuyimfuneko, sebenzisa itawuli okanye iphepha letawuli.
• Yikhuphe ngokuthe ngqo ngokuhamba kancinci nangokuzinzileyo. Kunqande ukucudisa okanye ukutyumza amakhalane. Lumka ungashiyi intloko ingene kulusu.
• Coca indawo leyo kakuhle ngesepha namanzi. Hlamba izandla zakho kakuhle.
• Gcina uphawu lwengqayi.
• Jonga ngononophelo kwiveki ezayo okanye ezimbini kwiimpawu zesifo seLyme.
• Ukuba onke amalungu etiki akanakususwa, fumana uncedo lonyango. Yizisa umkhaza kwimbiza kugqirha wakho.

Borreliosis; Isifo seBannwarth

• Isifo seLyme- yintoni oza kuyibuza ugqirha wakho

• Umzimba wesifo seLyme - iBorrelia burgdorferi
• Phawula - amaxhama afakwe kulusu
• Isifo seLyme - iBorrelia burgdorferi ephilayo
• Phawula, inyamakazi-ibhinqa elidala
• Isifo seLyme
• Isifo seLyme - erythema migrans
• Isifo seLyme

Amaziko oLawulo lweWebhusayithi. Isifo seLyme. www.cdc.gov/lyme. Ukuhlaziywa ngoDisemba 16, 2019. Kufumaneka ngo-Epreli 7, 2020.

I-Steere AC. Isifo seLyme (iLyme borreliosis) ngenxa yeBorrelia burgdorferi. Ku: Bennett JE, Dolin R, Blaser MJ, ii-eds. Mandell, Douglas, kunye neBennett's Principles and Practice of Infectious Diseases. Umhla we-9. IPhiladelphia, PA: Elsevier; 2020: isahluko 241.

Wormser GP. Isifo seLyme. Ku: IGoldman L, iSchafer AI, ii-eds. Amayeza eGoldman-Cecil. Ngomhla wama-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 305.