K\u0131r\u0131m-Kongo Kanamal\u0131 Ate\u015fi (KKKA), keneler taraf\u0131ndan ta\u015f\u0131nan Nairovirus isimli bir mikrobiyal\u00a0etken taraf\u0131ndan neden olunan; ate\u015f, cilt i\u00e7i ve di\u011fer alanlarda kanama gibi bulgular ile seyreden\u00a0hayvan kaynakl\u0131 bir enfeksiyondur. Son y\u0131llarda tedavide g\u00f6r\u00fclen geli\u015fmelere ra\u011fmen, bu\u00a0enfeksiyonlarda \u00f6l\u00fcm oranlar\u0131 h\u00e2l\u00e2 y\u00fcksektir. Bu vir\u00fcsler 56\u00baC\u2019de, 30 dakikada inaktive olur\u00a0ve kanda 40 \u00baC\u2019de 10 g\u00fcn ya\u015fayabilir. \u00d6zellikle, son 2-3 y\u0131ld\u0131r yaz aylar\u0131n\u0131n korkulu r\u00fcyas\u0131 haline\u00a0gelen KKKA hakk\u0131nda derledi\u011fimiz yaz\u0131da, hastal\u0131kla ilgili pek \u00e7ok bilgi bulacaks\u0131n\u0131z<\/p>\n
K\u0131r\u0131m-Kongo Kanamal\u0131 Ate\u015fi hastal\u0131\u011f\u0131\u00a0ilk kez nerede tan\u0131mlanm\u0131\u015ft\u0131r?<\/strong><\/p>\n K\u0131r\u0131m-Kongo Kanamal\u0131 Ate\u015fi ilk kez\u00a01944 ve 1945 y\u0131l\u0131 yaz aylar\u0131nda, Bat\u0131 K\u0131r\u0131m\u00a0steplerinde \u00e7o\u011funlukla \u00fcr\u00fcn toplamaya\u00a0yard\u0131m eden Sovyet askerleri aras\u0131nda\u00a0g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. Hastal\u0131\u011fa K\u0131r\u0131m Hemorajik Ate\u015fi ad\u0131 verilmi\u015ftir. 1956 y\u0131l\u0131nda Zaire\u2019de\u00a0ate\u015fli bir hastada Kongo vir\u00fcs\u00fc tespit edilmi\u015ftir.\u00a01969 ise Kongo vir\u00fcs\u00fc ile K\u0131r\u0131m\u00a0Hemorajik Ate\u015fi vir\u00fcslerinin ayn\u0131 vir\u00fcs oldu\u011fu\u00a0belirlenmi\u015f ve K\u0131r\u0131m-Kongo Kanamal\u0131\u00a0Ate\u015fi olarak hastal\u0131k yeniden adland\u0131r\u0131lm\u0131\u015ft\u0131r.<\/p>\n KKHA bug\u00fcne kadar hangi \u00fclkelerde\u00a0g\u00f6r\u00fclm\u00fc\u015ft\u00fcr?<\/strong><\/p>\n Hastal\u0131k s\u0131kl\u0131kla Afrika, Bat\u0131 Asya\u00a0ile Ortado\u011fu ve Do\u011fu Avrupa’da g\u00f6r\u00fclmektedir.\u00a0KKKA vir\u00fcs\u00fcn\u00fcn Bulgaristan,\u00a0Makedonya, Pakistan, Irak, Afganistan,\u00a0\u0130ran, Kosova, Kazakistan, Sahra alt\u0131 Afrika\u00a0\u00fclkeleri, eski Sovyetler Birli\u011fi, Yugoslavya,\u00a0Yunanistan, Arap Yar\u0131madas\u0131, Dubai, Kuveyt,\u00a0\u00c7in ve Moritanya\u2019da salg\u0131nlar yapt\u0131\u011f\u0131\u00a0bildirilmi\u015ftir.\u00a0KKKA, 2002 y\u0131l\u0131nda bahar ve yaz aylar\u0131ndabaz\u0131 illerimizde g\u00f6r\u00fclm\u00fc\u015f ve Sa\u011fl\u0131k\u00a0Bakanl\u0131\u011f\u0131\u2019n\u0131n yapm\u0131\u015f oldu\u011fu \u00e7al\u0131\u015fmalar\u00a0neticesinde hastal\u0131\u011f\u0131n KKKA oldu\u011fu do\u011frulanm\u0131\u015ft\u0131r.<\/p>\n Keneler nas\u0131l tan\u0131n\u0131r ve nerelerde bulunur?<\/strong><\/p>\n Kene otlaklar, \u00e7al\u0131l\u0131klar ve k\u0131rsal alanlarda\u00a0ya\u015fayan k\u00fc\u00e7\u00fck oval \u015fekilli, 6-8 bacakl\u0131,\u00a0u\u00e7amayan, s\u0131\u00e7rayamayan hayvanlard\u0131r.\u00a0Hayvan ve insanlar\u0131n kanlar\u0131n\u0131 emerek\u00a0beslenirler ve bu sayede hastal\u0131klar\u0131 insanlara\u00a0bula\u015ft\u0131rabilirler.\u00a0\u00dclkemiz, kenelerin ya\u015famalar\u0131 i\u00e7in\u00a0co\u011frafi a\u00e7\u0131dan olduk\u00e7a uygun bir yap\u0131ya\u00a0sahiptir. T\u00fcrlere g\u00f6re de\u011fi\u015fmekle beraber\u00a0kenelerin, k\u00fc\u00e7\u00fck kemiricilerden, yaban\u00a0hayvanlar\u0131ndan evcil memeli hayvanlara\u00a0ve ku\u015flara (\u00f6zellikle deveku\u015flar\u0131) kadar geni\u015f\u00a0bir konak\u00e7\u0131 spektrumlar\u0131 mevcuttur.\u00a0\u00dclkemizde halk aras\u0131nda kene, sak\u0131rga,\u00a0yavs\u0131, kerni gibi isimlerle bilinmektedir.\u00a0Keneler zorunlu kan emici artropodlar\u00a0olup, d\u00fcnyan\u0131n her b\u00f6lgesinde ya\u015famaktad\u0131rlar.\u00a0Keneler morfolojik olarak di\u011fer\u00a0artropodlardan farkl\u0131 olup, v\u00fccutlar\u0131 tek\u00a0bir par\u00e7adan olu\u015fmu\u015ftur. V\u00fccudun \u00f6n taraf\u0131nda\u00a0a\u011f\u0131z organelleri yer almaktad\u0131r.\u00a0G\u00fcn\u00fcm\u00fczde yery\u00fcz\u00fcnde yakla\u015f\u0131k 850 kene\u00a0t\u00fcr\u00fc bilinmektedir.\u00a0Hyalomma soyuna ait keneler en etkin\u00a0ve yayg\u0131n olmakla birlikte, 30 kene t\u00fcr\u00fcn\u00fcn\u00a0KKKA vir\u00fcs\u00fcn\u00fc bula\u015ft\u0131rabilece\u011fi\u00a0bildirilmektedir.<\/p>\n Kene ya\u015fam d\u00f6ng\u00fcs\u00fc nas\u0131ld\u0131r?\u00a0<\/strong><\/p>\n KKKA sebep olan Hyalloma t\u00fcr\u00fc keneler,\u00a0\u00e7o\u011funlukla iki konakta geli\u015fim ve\u00a0ya\u015fam d\u00f6ng\u00fclerini tamamlar. Larva ve\u00a0nimfler k\u00fc\u00e7\u00fck omurgal\u0131larda (tav\u015fan, ku\u015f,\u00a0fare, vb.) erginler ise b\u00fcy\u00fck omurgal\u0131 hayvanlarda\u00a0(koyun, ke\u00e7i, s\u0131\u011f\u0131r, at, yabani gevi\u015fenler,\u00a0insan, vb.) konaklarlar.<\/p>\n Kimler risk alt\u0131ndad\u0131r?\u00a0<\/strong><\/p>\n Hastal\u0131k, genellikle meslek hastal\u0131\u011f\u0131 \u015feklinde kar\u015f\u0131m\u0131za \u00e7\u0131kar. Tar\u0131m ve hayvanc\u0131l\u0131kla\u00a0u\u011fra\u015fanlar (\u00e7ift\u00e7iler, \u00e7obanlar\u2026),\u00a0veterinerler, kasaplar, mezbaha \u00e7al\u0131\u015fanlar\u0131,\u00a0sa\u011fl\u0131k personeli \u00f6zellikle risk gurubudur.\u00a0Kamp ve piknik yapanlar, askerler\u00a0ve korunmas\u0131z olarak ye\u015fil alanlarda\u00a0bulunanlar da risk alt\u0131ndad\u0131r.<\/p>\n Nas\u0131l bula\u015f\u0131r?<\/strong><\/p>\n Kenelerin \u0131s\u0131rmas\u0131yla, vir\u00fcsl\u00fc kenelerin\u00a0kan ve salg\u0131lar\u0131yla, KKKA hastal\u0131\u011f\u0131na\u00a0yakalanm\u0131\u015f ki\u015filerin ya da hayvanlar\u0131n kan\u00a0ve v\u00fccut salg\u0131lar\u0131na temasla bula\u015f\u0131r.<\/p>\n KKKA vir\u00fcs bula\u015ft\u0131ktan ne kadar s\u00fcre\u00a0sonra ortaya \u00e7\u0131kar?<\/strong><\/p>\n Kene taraf\u0131ndan \u0131s\u0131r\u0131lma ile vir\u00fcs\u00fcn\u00a0al\u0131nmas\u0131n\u0131 takiben kulu\u00e7ka s\u00fcresi genellikle\u00a01-3 g\u00fcnd\u00fcr; bu s\u00fcre en fazla 9 g\u00fcn\u00a0olabilmektedir. Enfekte kan, ifrazat veya\u00a0di\u011fer dokulara do\u011frudan temas sonucu\u00a0bula\u015fmalarda bu s\u00fcre 5-6, en fazla 13 g\u00fcn\u00a0olabilmektedir.<\/p>\n Belirtileri nelerdir?\u00a0<\/strong><\/p>\n Ate\u015f, k\u0131r\u0131kl\u0131k, ba\u015f a\u011fr\u0131s\u0131, halsizlik, kanama\u00a0p\u0131ht\u0131la\u015fma mekanizmalar\u0131n\u0131n bozulmas\u0131\u00a0sonucu; y\u00fcz ve g\u00f6\u011f\u00fcste k\u0131rm\u0131z\u0131\u00a0d\u00f6k\u00fcnt\u00fcler, g\u00f6zlerde k\u0131zar\u0131kl\u0131k, g\u00f6vde, kol\u00a0ve bacaklarda morluklar, burun kanamas\u0131,\u00a0d\u0131\u015fk\u0131da ve idrarda kan g\u00f6r\u00fcl\u00fcr. \u00d6l\u00fcm\u00a0karaci\u011fer, b\u00f6brek ve akci\u011fer yetmezlikleri\u00a0nedeni ile olmaktad\u0131r.<\/p>\n Kene \u0131s\u0131r\u0131\u011f\u0131nda ne yap\u0131lmal\u0131d\u0131r?<\/strong><\/p>\n Yap\u0131\u015fan keneler ise kesinlikle \u00f6ld\u00fcr\u00fclmeden,\u00a0ezilmeden\/patlat\u0131lmadan ve kenenin \u00a0a\u011f\u0131z k\u0131sm\u0131 kopar\u0131lmadan, bir pensle\u00a0do\u011frudan d\u00fcz olarak, d\u00f6nd\u00fcrmeden yava\u015f\u00e7a\u00a0\u00e7ekilip al\u0131nmal\u0131d\u0131r. Is\u0131r\u0131lan yere; bol\u00a0sabunlu suyla y\u0131kan\u0131p temizlendikten sonra\u00a0iyotlu antiseptik (tent\u00fcrdiyot) s\u00fcr\u00fclmelidir,\u00a0(\u015fayet sabunlu su bulunmaz ise alkol\u00a0i\u00e7eren mendiller kullan\u0131labilinir.)\u00a0\u00c7\u0131plak elle keneye temas edilmemeli,\u00a0e\u011fer elle tutulacaksa eldiven giyilmeli veya\u00a0naylon bir po\u015fet yard\u0131m\u0131 ile keneler toplanmal\u0131d\u0131r.\u00a0V\u00fccuttaki kenelerin \u00fczerine herhangi\u00a0bir kimyasal madde (alkol, kolonya, gazya\u011f\u0131\u00a0v.b) d\u00f6k\u00fclmemeli, sigara veya ate\u015f\u00a0kullanarak keneler uzakla\u015ft\u0131r\u0131lmamal\u0131d\u0131r.\u00a0\u00c7\u00fcnk\u00fc bu maddeler kenenin kusmas\u0131na\u00a0sebebiyet verece\u011finden hastal\u0131k bula\u015ft\u0131rma\u00a0riskini art\u0131rmaktad\u0131r.<\/p>\n KKKA nas\u0131l kontrol edilir ve nas\u0131l korunulur?<\/strong><\/p>\n Hastal\u0131\u011f\u0131n bula\u015fmas\u0131nda keneler\u00a0\u00f6nemli bir yer tutmaktad\u0131r. Bu nedenle kene\u00a0m\u00fccadelesi \u00f6nemlidir fakat olduk\u00e7a da\u00a0zordur.<\/p>\n 1. \u0130nsanlar kenelerden uzak tutulabilir\u00a0ise bula\u015fma \u00f6nlenebilir. Bu nedenle de\u00a0m\u00fcmk\u00fcn oldu\u011fu kadar kenelerin bulundu\u011fu\u00a0alanlardan ka\u00e7\u0131nmak gerekir.<\/p>\n 2. Kenelerin yo\u011fun olabilece\u011fi \u00e7al\u0131,\u00a0\u00e7\u0131rp\u0131 ve g\u00fcr ot bulunan alanlardan uzak\u00a0durulmal\u0131, bu gibi alanlara \u00e7\u0131plak ayak ya\u00a0da k\u0131sa giysiler ile gidilmemelidir.<\/p>\n 3. Bu alanlara av ya da g\u00f6rev gere\u011fi gidenlerin\u00a0lastik \u00e7izme giymeleri, pantolonlar\u0131n\u0131n\u00a0pa\u00e7alar\u0131n\u0131 \u00e7orap i\u00e7ine almalar\u0131,<\/p>\n 4. G\u00f6revi nedeni ile risk grubunda yer\u00a0alan ki\u015filerin, hayvan ve hasta insanlar\u0131n\u00a0kan ve v\u00fccut s\u0131v\u0131lar\u0131ndan korunmak i\u00e7in\u00a0mutlaka eldiven, \u00f6nl\u00fck, g\u00f6zl\u00fck, maske\u00a0v.b. giymeleri gerekmektedir.<\/p>\n 5. Gerek insanlar\u0131 gerekse hayvanlar\u0131\u00a0kenelerden korumak i\u00e7in ha\u015fere kovucu\u00a0ila\u00e7lar (repellent) olarak bilinen b\u00f6cek ka\u00e7\u0131ranlar\u00a0dikkatli bir \u015fekilde kullan\u0131labilir.(Bunlar s\u0131v\u0131, losyon, krem, kat\u0131 ya\u011f veya\u00a0aerosol \u015feklinde haz\u0131rlanan maddeler\u00a0olup, cilde s\u00fcr\u00fclerek veya elbiselere emdirilerek\u00a0uygulanabilmektedir.)<\/p>\n 6. Ha\u015fere kovucular hayvanlar\u0131n ba\u015f\u00a0veya bacaklar\u0131na da uygulanabilir; ayr\u0131ca\u00a0bu maddelerin emdirildi\u011fi pl\u00e2stik \u015feritler,\u00a0hayvanlar\u0131n kulaklar\u0131na veya boynuzlar\u0131na\u00a0tak\u0131labilir.<\/p>\n 7. Kenelerin bulundu\u011fu alanlara gidildi\u011fi\u00a0zaman v\u00fccut belli aral\u0131klarla kene i\u00e7in\u00a0taranmal\u0131d\u0131r.<\/p>\n 8.V\u00fccuda yap\u0131\u015fm\u0131\u015f keneler uygun bir\u00a0\u015fekilde kene ezilmeden, a\u011f\u0131zdan veya ba\u015f\u0131ndan \u00a0tutularak bir c\u0131mb\u0131z veya pens yard\u0131m\u0131yla\u00a0\u00e7\u0131kart\u0131l\u0131r. Is\u0131r\u0131lan yer alkolle \u00a0temizlenmelidir.\u00a0M\u00fcmk\u00fcnse kenenin tan\u0131\u00a0i\u00e7in alkolde saklanmas\u0131 uygun olur.<\/p>\n 9. Di\u011fer canl\u0131lara ve \u00e7evreye zarar vermeden,\u00a0ha\u015fere ilac\u0131 (insektisit) ile uygulaman\u0131n\u00a0uygun g\u00f6r\u00fcld\u00fc\u011f\u00fc durumlarda \u00e7evre\u00a0ila\u00e7lamas\u0131 yap\u0131labilir.<\/p>\n KKKA\u2019n\u0131n tedavisi nedir?<\/strong><\/p>\n Hastal\u0131\u011f\u0131n kesin bir tedavisi bulunmamaktad\u0131r.\u00a0Hastaya destek tedavisi yap\u0131lmal\u0131d\u0131r.<\/p>\n","protected":false},"excerpt":{"rendered":" K\u0131r\u0131m-Kongo Kanamal\u0131 Ate\u015fi (KKKA), keneler taraf\u0131ndan ta\u015f\u0131nan Nairovirus isimli bir mikrobiyal\u00a0etken taraf\u0131ndan neden olunan; ate\u015f,<\/p>\n","protected":false},"author":1,"featured_media":411,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[3],"tags":[],"_links":{"self":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/151"}],"collection":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/comments?post=151"}],"version-history":[{"count":3,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/151\/revisions"}],"predecessor-version":[{"id":492,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/151\/revisions\/492"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/media\/411"}],"wp:attachment":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/media?parent=151"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/categories?post=151"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/tags?post=151"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}