Isifo seLyme

Isifo seLyme yisifo segciwane esisakazwa ngokulunywa kolunye lwezinhlobo zemikhaza.

Isifo seLyme sibangelwa amagciwane abizwa ngokuthi IBorrelia burgdorferi (B burgdorferi). Imikhaza emnyama (ebizwa nangokuthi imikhaza yezinyamazane) ingathwala la magciwane. Akuzona zonke izinhlobo zemikhaza ezingathwala la magciwane. Imikhaza engakavuthwa ibizwa ngama-nymphs, futhi icishe ilingane nekhanda lephini. Ama-Nymphs acosha amabhaktheriya lapho adla amagundane amancane, njengamagundane, atheleleke nge B burgdorferi. Lesi sifo ungasithola kuphela uma ulunywa wumkhaza onaleli gciwane.

Isifo seLyme sabikwa okokuqala e-United States ngo-1977 edolobheni lase-Old Lyme, eConnecticut. Isifo esifanayo senzeka ezingxenyeni eziningi zaseYurophu nase-Asia. E-United States, izifo eziningi zezifo zeLyme zenzeka kulezi zindawo ezilandelayo:

• Izifundazwe ezisenyakatho-mpumalanga, kusukela eVirginia kuya eMaine
• Izifundazwe ezisenyakatho maphakathi, ikakhulukazi eWisconsin naseMinnesota
• I-West Coast, ikakhulukazi enyakatho-ntshonalanga

Kunezigaba ezintathu zesifo seLyme.

• Isigaba 1 sibizwa ngokuthi isifo saseLyme sokuqala sendawo. Amagciwane awakasakazeki emzimbeni wonke.
• Isigaba 2 sibizwa ngokuthi isifo seLyme esisatshalaliswe kusenesikhathi. Amagciwane aseqale ukusabalala emzimbeni wonke.
• Isigaba 3 sibizwa njengesifo seLyme esisatshalaliswa sekwedlule isikhathi. Amagciwane asakazeke emzimbeni wonke.

Izici eziyingozi zesifo seLyme zifaka:

• Ukwenza imisebenzi yangaphandle enyusa ukuvezwa komkhaza (ngokwesibonelo, ingadi, ukuzingela, noma ukuhamba izintaba) endaweni lapho kwenzeka khona isifo seLyme
• Ukuba nesilwane esingahle sithwale imikhaza ethelelekile ekhaya
• Ukuhamba otshanini obuphezulu ezindaweni lapho kwenzeka khona isifo seLyme

Amaqiniso abalulekile mayelana nokulunywa umkhaza nesifo seLyme:

• Umkhaza kumele unamathiselwe emzimbeni wakho amahora angama-24 kuye kwangama-36 ukuze usakaze amagciwane egazini lakho.
• Imikhaza emnyama ingahle ibe mincane kangangokuthi cishe ayinakwenzeka ukuyibona. Abantu abaningi abanesifo seLyme abaze babone noma bezwe umkhaza emzimbeni wabo.
• Abantu abaningi abalunywe wumkhaza abasitholi isifo seLyme.

Izimpawu zesifo saseLyme esivele sasendaweni (isigaba 1) siqala izinsuku noma amasonto ngemuva kokutheleleka. Ziyafana nomkhuhlane futhi zingafaka:

• Umkhuhlane namakhaza
• Ukuzizwa okuvamile
• Ubuhlungu bekhanda
• Ubuhlungu obuhlangene
• Ubuhlungu bemisipha
• Intamo eqinile

Kungaba khona ukuqubuka "kwamehlo enkunzi", indawo ebomvu noma ephakanyisiwe ephakanyisiwe esizeni sokulunywa umkhaza. Imvamisa kunendawo ecacile maphakathi nendawo. Kungaba kukhulu futhi kunwebe ngosayizi. Lokhu kuqhuma kubizwa ngokuthi i-erythema migrans. Ngaphandle kokwelashwa, ingahlala amasonto ama-4 noma ngaphezulu.

Izimpawu zingase zifike zidlule. Kungalashwa, amabhaktheriya angadlulela ebuchosheni, enhliziyweni nasemalungeni.

Izimpawu zesifo seLyme esisatshalaliswe kusenesikhathi (isigaba 2) zingavela emasontweni kuya ezinyangeni ngemuva kokulunywa umkhaza, futhi zingafaka:

• Ukuba ndikindiki noma ubuhlungu endaweni yezinzwa
• Ukukhubazeka noma ubuthakathaka emisipheni yobuso
• Izinkinga zenhliziyo, njengokushaya kwenhliziyo (ukushaya kwenhliziyo), ubuhlungu besifuba, noma ukuphefumula okuncane

Izimpawu zesifo seLyme esisatshalaliswe sekwedlule isikhathi (isigaba 3) singenzeka ezinyangeni noma eminyakeni ngemuva kokutheleleka. Izimpawu ezivame kakhulu ubuhlungu bezicubu kanye namalunga. Ezinye izimpawu zingafaka:

• Ukunyakaza kwemisipha okungavamile
• Ukuvuvukala okuhlangene
• Ubuthakathaka bemisipha
• Ukuba ndikindiki nokushosheka
• Izinkinga zokukhuluma
• Izinkinga zokucabanga (zokuqonda)

Ukuhlolwa kwegazi kungenziwa ukubheka amasosha omzimba kumagciwane abanga isifo seLyme. Okusetshenziswa kakhulu yi-ELISA yokuhlolwa kwesifo seLyme. Ukuhlolwa kwe-immunoblot kwenziwa ukuqinisekisa imiphumela ye-ELISA. Yazi, noma kunjalo, esigabeni sokuqala sokutheleleka, ukuhlolwa kwegazi kungaba yinto ejwayelekile. Futhi, uma welashwa ngemithi elwa namagciwane kusenesikhathi, umzimba wakho awukwazi ukwenza amasosha omzimba anele ukutholwa ukuhlolwa kwegazi.

Ezindaweni lapho isifo seLyme sivame kakhulu, umhlinzeki wakho wezokunakekelwa kwempilo angakwazi ukuthola isifo seLyme esisatshalaliswe kusenesikhathi (iSigaba 2) ngaphandle kokwenza izivivinyo zelebhu.

Okunye ukuhlolwa okungenziwa lapho ukutheleleka sekusakazekile kufaka phakathi:

• I-Electrocardiogram
• Echocardiogram ukubheka inhliziyo
• I-MRI yobuchopho
• Umpompi womgogodla (ukubhoboza i-lumbar ukuhlola uketshezi lomgogodla)

Abantu abalunywe wumkhaza kufanele babhekwe eduze okungenani izinsuku ezingama-30 ukubona ukuthi kukhona ukuqubuka noma izimpawu.

Umthamo owodwa we-doxycycline yama-antibiotic unganikezwa othile ngokushesha ngemuva kokulunywa umkhaza, lapho zonke lezi zimo ziyiqiniso:

• Umuntu unomkhaza ongathwala isifo seLyme esixhunywe emzimbeni wakhe. Lokhu kuvame ukuthi kusho ukuthi umhlengikazi noma udokotela ubheke wakhomba umkhaza.
• Umkhaza kucatshangwa ukuthi unamathiselwe kulowo muntu okungenani amahora angama-36.
• Umuntu uyakwazi ukuqala ukuthatha i-antibiotic kungakapheli amahora angama-72 ekhiphe umkhaza.
• Lo muntu uneminyaka engu-8 noma ngaphezulu futhi akakhulelwe noma akancelisi.
• Izinga lasendaweni lemikhaza ethwele B burgdorferi ingu-20% noma ngaphezulu.

Kusetshenziswa inkambo yezinsuku eziyi-10 kuya kwezingu-4 yemithi elwa namagciwane ukwelapha abantu abatholakala benesifo seLyme, kuya ngokuthi kukhethwe muphi umuthi:

• Ukukhethwa kwama-antibiotic kuncike esigabeni sesifo nasezimpawu.
• Izinketho ezijwayelekile zifaka i-doxycycline, i-amoxicillin, i-azithromycin, i-cefuroxime, ne-ceftriaxone.

Imithi yezinhlungu, njenge-ibuprofen, kwesinye isikhathi ibekelwa ukuqina okuhlangene.

Uma sitholakala kusaqalwa, isifo seLyme singelapheka ngama-antibiotic. Ngaphandle kokwelashwa, izinkinga ezibandakanya amalunga, inhliziyo, nesistimu yezinzwa zingenzeka. Kodwa lezi zimpawu ziselapheka futhi ziyelapheka.

Ezimweni ezingavamile, umuntu ugcina enezimpawu eziphazamisa impilo yansuku zonke ngemuva kokuthi elashwe ngama-antibiotic. Lokhu kwaziwa nangokuthi yi-post-Lyme disease syndrome. Imbangela yalesi sifo ayaziwa.

Izimpawu ezenzeka ngemuva kokumiswa kwama-antibiotics kungenzeka zingabi yizimpawu zokutheleleka okusebenzayo futhi zingaphenduli ekwelashweni ngama-antibiotic.

Isigaba 3, noma ukusatshalaliswa sekwedlule isikhathi, isifo seLyme singadala ukuvuvukala okuhlangene okuhlala isikhathi eside (i-Lyme arthritis) nezinkinga zesigqi senhliziyo. Izinkinga zobuchopho nezesistimu zingenzeka, futhi zingafaka:

• Ukwehla kokuhlushwa
• Izinkinga zememori
• Ukulimala kwemizwa
• Ubudikadika
• Ubuhlungu
• Ukukhubazeka kwemisipha yobuso
• Izinkinga zokulala
• Izinkinga zombono

Shayela umhlinzeki wakho uma une:

• Ukuqhuma okukhulu, okubomvu, okwandayo okungabukeka njengeso lenkunzi.
• Ukhale ngokulunywa umkhaza futhi uthuthukise ubuthakathaka, ukuba ndikindiki, ukulunywa, noma izinkinga zenhliziyo.
• Izimpawu zesifo seLyme, ikakhulukazi uma kungenzeka ukuthi uvezwe imikhaza.

Thatha izinyathelo zokugwema ukulunywa imikhaza. Qaphela kakhulu phakathi nezinyanga ezifudumele. Uma kwenzeka, gwema ukuhamba noma ukuhamba ehlathini nasezindaweni ezinotshani obuphezulu.

Uma uhamba ngezinyawo noma uhamba ngezinyawo kulezi zindawo, thatha izinyathelo zokuvimbela ukulunywa umkhaza:

• Gqoka izingubo ezinombala okhanyayo ukuze kuthi uma imikhaza ifika kuwe, ibonakale futhi isuswe.
• Gqoka imikhono emide namabhulukwe amade nemilenze yephenti efakwe kumasokisi akho.
• Futha isikhumba esivele obala nezingubo zakho ngezinto zokuxosha izinambuzane, njenge-DEET noma i-permethrin. Landela imiyalo esitsheni.
• Ngemuva kokubuyela ekhaya, khipha izingubo zakho bese uhlola kahle zonke izindawo zesikhumba, kufaka phakathi isikhumba sakho. Shawa ngokushesha ngangokunokwenzeka ukuze ugeze noma imiphi imikhaza engabonakali.

Uma umkhaza unamathiselwe kuwe, landela lezi zinyathelo zokuwususa:

• Bamba umkhaza eduze kwekhanda noma emlonyeni ngezimpintshisi. UNGAYisebenzisi iminwe yakho. Uma kudingeka, sebenzisa ithawula lezicubu noma lephepha.
• Yikhiphe iqonde ngokunyakaza okuhamba kancane nokuqinile. Gwema ukukhama noma ukuchoboza umkhaza. Qaphela ukuthi ungashiyi ikhanda lifakwe esikhunjeni.
• Hlanza indawo kahle ngensipho namanzi. Futhi geza izandla zakho kahle.
• Gcina umkhaza embizeni.
• Bheka ngokucophelela isonto elilandelayo noma amabili ukuthola izimpawu zesifo seLyme.
• Uma zonke izingxenye zomkhaza zingenakususwa, thola usizo lwezokwelapha. Letha umkhaza embizeni kudokotela wakho.

I-Borreliosis; I-Bannwarth syndrome

• Isifo seLyme - okufanele ubuze udokotela wakho

• Isifo sesifo seLyme - iBorrelia burgdorferi
• Thikha - izinyamazane ezifakwe esikhunjeni
• Isifo seLyme - iBorrelia burgdorferi umzimba
• Thikha, izinyamazane - owesifazane omdala
• Isifo seLyme
• Isifo seLyme - erythema migrans
• Isifo se-lyme ephakeme

Izikhungo Zokulawulwa Kwezifo iwebhusayithi. Isifo seLyme. www.cdc.gov/lyme. Kubuyekezwe uDisemba 16, 2019. Kufinyelelwe ngo-Ephreli 7, 2020.

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

I-Wormser GP. Isifo seLyme. Ku: IGoldman L, iSchafer AI, ama-eds. Imithi yeGoldman-Cecil. Umhla ka-26. IPhiladelphia, PA: Elsevier; 2020: isahluko 305.