Bayanin gabaɗaya
Zazzabin kogin Nilu (West Nile virus) cuta ce da sauro ke yaɗa ta. Yawancin mutane ba su nuna alamomi amma tana iya shafar kwakwalwa a wasu lokuta.
Alamomi
Alamomi | Yawan faruwa | Tsanani | Farawa |
|---|---|---|---|
| Zazzabi | 95% | Dan kadan | Farkon cuta |
| Gajiya | 80% | Dan kadan | Farkon cuta |
| Ciwon kai | 85% | Dan kadan | Farkon cuta |
| Ƙurji na maculopapular | 50% | Dan kadan | Farkon cuta |
| Rashin jin daɗi | 70% | Dan kadan | Farkon cuta |
| Ciwon tsoka | 65% | Dan kadan | Farkon cuta |
| Ciwon gaɓoɓi | 40% | Dan kadan | Farkon cuta |
| Sanyi | 30% | Dan kadan | Farkon cuta |
| Zawo | 20% | Dan kadan | Farkon cuta |
| Ciwon ido | 12% | Dan kadan | Farkon cuta |
| Rashin son ci | 55% | Dan kadan | Farkon cuta |
| Tashin zuciya | 40% | Dan kadan | Farkon cuta |
| Kumburin ƙwayoyin lymph | 15% | Dan kadan | Farkon cuta |
| Amai | 25% | Dan kadan | Farkon cuta |
| Canjin hankali | 1.5% | Hadari | Kololuwar cuta |
| Rikicewa | 2% | Mai tsanani | Kololuwar cuta |
| Taurin wuya | 3% | Mai tsanani | Kololuwar cuta |
| Shanyewar gaɓoɓi | 0.7% | Hadari | Kololuwar cuta |
| Ciwon kai mai tsanani | 4% | Mai tsanani | Kololuwar cuta |
| Rawar jiki | 1.8% | Matsakaici | Kololuwar cuta |
| Jiri | 1.5% | Matsakaici | Kololuwar cuta |
| Rashin jure haske | 2.5% | Matsakaici | Kololuwar cuta |
| Farfaɗiya | 0.8% | Hadari | Kololuwar cuta |
Hanyoyin yaduwa
Bayanin gabaɗaya
Kwayar cutar West Nile (WNV) ita ce flavivirus da sauro ke yaɗa ta a cikin zagayen sauro-tsuntsu. Sauro irin Culex su ne manyan masu yaɗawa. Mutane maƙare ne na ƙarshen hanya. ~80% na kamuwa ba su nuna alamomi ba; ~20% suna samun zazzaɓin West Nile; <1% cututtukan jijiyoyin kwakwalwa (meningitis, encephalitis, shanyewar gaɓoɓi) tare da CFR ~10%.
Bayanin gabaɗaya
Kwayar cutar kogin Nil ta yamma (West Nile Virus, WNV) tana yaduwa ta hanyar cizon sauro Culex (sauro na dare). Yawancin mutane (kashi 80%) ba sa nuna alamomi ko kadan. Kasa da kashi 1% ne ke samun cutar da ta shafi jijiya (neuroinvasive disease). An fara gano cutar ne a Uganda a 1937. A Najeriya da Yammacin Afirka: an tabbatar da yaduwar cutar, amma ba a yawan gano ta saboda alamominta sun yi kama da wasu cututtukan da sauro ke yaduwa (malaria, dengue). Ba allurar rigakafi na mutane ba.
Alamomin gaggawa
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Tsananin ciwon kai na kwatsam wanda ba ya amsa magani
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Taurin wuya (meningismus)
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Canjin hali na tunani — ruɗewa, sumame
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Farfaɗiya — duk wani karo na farko
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Raunin gaɓoɓi na kwatsam — musamman shanyewar da ba daidai ba
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Zazzaɓi mai tsanani (>40°C) tare da alamomin jijiyoyi
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Wahalar numfashi (kwakwalwa ko diaphragm) CFR ga encephalitis na West Nile: ~10–15%; marasa lafiya >70: 15–29%.
Cikakkun alamomi
Alamomi da alamu mafi yawa
Zazzaɓin West Nile: Zazzaɓi na kwatsam (>39°C), ciwon kai, gajiya, ciwon tsokoki, ƙurji na tabo-tabo (25–50%), kumburin ƙwayoyin lymph. Yana warwarewa kansa cikin kwanaki 3–6. Cutar jijiyoyin kwakwalwa (<1%): Meningitis (zazzaɓi, taurin wuya), encephalitis (ruɗewa, farfaɗiya, parkinsonism), shanyewar gaɓoɓi na kwatsam (raunin gaɓoɓi mara ɗaya, galibi na dawwama).
Sanin alamomi shine mataki na farko don amsa cikin sauri.
Tafiyar cuta
Cizon sauro mai cutar Culex → Shiryawa kwanaki 2–6 → Haɓakawa a cikin ƙwayoyin dendritic → Gajeren lokacin viremia (kwanaki 1–7) → Zazzaɓi: Zazzaɓi na kwatsam, ciwon tsokoki; warwarewa kwanaki 3–6 ga ~99% → Jijiyoyi (<1%): Kwayar cutar ta ƙetare shingen jini-kwakwalwa → Meningitis, encephalitis ko shanyewar gaɓoɓi cikin kwanaki → Warwarewa: Makonni zuwa watanni; shanyewar gaɓoɓi yana warwarewa a hankali kuma galibi ba cikakke ba watanni 6–12.
Binciken cuta
Yadda ake gano wannan cutar
IgM-ELISA — ma'aunin zinare; ana iya gano shi a jini da CSF kwanaki 3–8 bayan alamomi. CSF IgM mai inganci sosai ga cutar jijiyoyin kwakwalwa. PRNT — gwajin tabbatarwa, yana bambance WNV da sauran flavivirus. RT-PCR — yana da amfani a farkon lokaci da kuma ga marasa garkuwar jiki. MRI: T2/FLAIR a thalami, basal ganglia a 50–70% na cututtukan jijiyoyin kwakwalwa.
Magani
Hanyoyin magani da ake da su
Babu maganin antiviral na musamman. Magani na tallafawa kawai. Sauƙin yanayi: Hutawa, ruwan sha, maganin zazzaɓi (paracetamol). Cutar jijiyoyin kwakwalwa: Kulawa a ICU, kula hanyar numfashi (10–15% suna buƙatar injin numfashi), maganin farfaɗiya. Na gwaji: IVIG, interferon alpha-2b. Gyaran jiki yana buƙata ga shanyewar gaɓoɓi — cikakken warwarewa na tsoka <50%.
Yawancin lokuta ana magance su yadda ya kamata tare da gano cutar da wuri.
Cikakkun bayanin rigakafi
Yadda za ka kare kanka
Babu allurar rigakafi ga mutane. Kariya ta dogara ne akan kare sauro. Magunguna na korar sauro (DEET 20–30%, Picaridin), tufafin da aka jiƙa da permethrin, tufafi masu dogayen hannaye musamman da yamma (lokacin da Culex suka fi aiki), gidan sauro na gado. Matakin muhalli: Kawar da ruwan da ya tsaya. Gwajin NAT ga dukan jinin da aka ba.
Shirye-shirye shine mafi kyawun kariya.
Shawarar tafiya
Haɗari: Arewacin Amurka (Yun–Okt), Bahar Rum da Kudu-Gabashin Turai (Yul–Okt), Gabas ta Tsakiya, Afirka (dukan shekara). Shawarar lafiya makonni 4–6 kafin tafiya. Maganin DEET, tufafin permethrin, masauki masu AC da gidan sauro. Babu allurar rigakafi ko rigakafin magani. Bayan dawowa: nemi likita idan zazzaɓi/alamomin jijiyoyi cikin kwanaki 2–14.
Yaya yawancinta?
Ƙididdiga da bayanan yanki
Kwayar cutar da sauro ke yaɗawa da ta fi yaɗuwa a duniya. Amurka: >55,000 na cututtuka da mutuwa 2,700 tun 1999 (~2,000 cututtuka/shekara da aka ruwaito). Turai: Manyan annoba 2010, 2012, 2018 (cututtuka 2,083). Yaɗuwa: Zagayen sauro-tsuntsu-sauro (Culex pipiens, Cx. tarsalis). Yanayi: Yun–Okt a matsakaicin yanayi. Sauyin yanayi yana faɗaɗa yankin Culex zuwa arewa.
Dalilan haɗari
Wanene ke cikin haɗarin mafi girma
Haɗarin fallasa: Yankunan cutar a lokacin yaɗuwa, ayyukan waje, aikin noma, ruwan da ya tsaya kusa da gidaje. Haɗarin cutar mai tsanani/jijiyoyi: Shekaru >60 (mafi girman haɗari; CFR 15–29% ga >70), raunin garkuwar jiki (masu dashen gaɓoɓi haɗari 40x), ciwon sukari, cutar koda mai tsayi.
Cikakkun bayanan matsaloli
Rikitarwa da za ta iya faruwa
Matsalolin jijiyoyin kwakwalwa na gaggawa: Meningoencephalitis (kumburin kwakwalwa), shanyewar gaɓoɓi na kwatsam (10–15% na cututtukan jijiyoyi, galibi na dawwama), farfaɗiya (5–15%). Matsaloli na dawwama (~50% na waɗanda suka tsira): Matsalar tunani, raunin da ya dawwama, damuwa (har 75%), matsalolin motsi (parkinsonism, rawan jiki). Wasu: Myocarditis, chorioretinitis (har 80%).
Murmurewa da hasashe
Sakamakon da ake tsammani da murmurewa
Zazzaɓin West Nile: Kyakkyawan hasashe, yana warwarewa kansa. Gajiyar da ta daɗe har zuwa 50%. Cutar jijiyoyin kwakwalwa: CFR 8–12% baki ɗaya; meningitis ~2–5%, encephalitis ~12–20%, shanyewar gaɓoɓi ~5–10%. ~50% na waɗanda suka tsira suna da matsalolin jijiyoyi na dawwama (matsalar tunani, damuwa 75% bayan shekara 1). 30–40% kawai na marasa lafiya da shanyewar gaɓoɓi suna samun warwarewa mai ma'ana.