Chirwere chechirwere, icho vanhu vakabatana nemakore anopfuura 1 500 apfuura, kare kwakakonzera kuputika kukuru kwehutano, kutora makumi uye mazana emamiriyoni ehupenyu. Nhoroondo haina kuziva hutachiona husina tsitsi uye hunoparadza, uye kusvikira ikozvino, pasinei nekubudirira kwemishonga, zvakanga zvisingakwanisi zvachose kurarama nazvo.
Chii chinotyisa?
Dambudziko ndiro chirwere chevanhu, icho chiri chechimiro chepanyama chinotapukira, mune dzakawanda zviitiko zvinopera mumugumisiro unouraya. Ichi chirwere chinopararira zvikuru, uye kubvuma kwacho kune zvakasikwa. Mushure mokunge denda rakapfuudzwa uye rinorapwa, hutachiona hwakasimba huripo hunoumbwa, kureva kuti, pane ngozi yekuwanazve utachiona (asi yechipiri nguva chirwere chacho chiri nyore nyore).
Mhedziso chaiyo yezita rechirwere haisati yasimbiswa, asi shoko rokuti "denda" mukushandura kubva kuTurkey rinoreva "pota, cone", kubva muchiGiriki- "shaft", kubva muchiLatin- "hit, wound". Muzvakaitika kare uye zvemazuva ano zvesayenzi, munhu anogona kuwana tsanangudzo yakadai sehosha yebhononic chirwere. Izvi zvinokonzerwa nekuti imwe yezviratidzo zvakasiyana-siyana zvechirwere ndeyebubo - kuvhara kumativi ose munzvimbo yeropa rinoputika . Muchiitiko ichi, pane mamwe maitiro ehutachiona, pasina kuumbwa kwebuboes.
Denda ndiro causative agent
Kwenguva yakareba zvakanga zvisinganzwisisi zvinokonzera denda re bubonic, iyo causative agent yakawanikwa uye yakabatana nechirwere chete pamagumo ezana remakore rechina. Vakava bhakitiriya re gram-negative kubva mumhuri ye-enterobacteria - a plate (Yersinia pestis). Iyo pathogen yakanyatsodzidza, maitiro ayo akawanda anobudiswa uye zvinotevera zvinoshandiswa:
- inogona kuva nehupenyu hwakasiyana - kubva ku filiform kusvika kune imwechete;
- kuchengetedza kwenguva refu kwehupenyu hwevanhu vanoparadzaniswa nevarwere;
- kukanganisika kwakanaka kwemazinga ekudzikira, kusviba;
- kunzwisiswa kwepamusoro kune zvinodhaka majekiseni, chiedza chezuva, asidi yekuita kwemamiriro okunze, kutonhora kwakanyanya;
- rine anenge makumi matatu emasangano eorgengenic, anovanza endo- uye exotoxins.
Dambudziko - nzira dzekupinda mabhakitiriya kupinda mumuviri womunhu
Zvakakosha kuziva kuti denda rinoparadzirwa kubva kumunhu kusvika kumunhu, uye kubva kune zvimwe zvipenyu. Plagiarum inopararira muzvisikwa zvepanyama zvinotapukira muzvipenyu zvevatakuri vemhuka, izvo zvinosanganisira mapuranga emusango (masango squirrels, mazamu, mapeji), grey nematsvuku, imba mice, makate, lagiformes, ngamera. Vakatakura (vashambadziri) zvezvirwere zvinokonzerwa nehutachiwana hwehupenyu hwemhando dzakasiyana siyana uye marudzi akawanda ehutachiona hwehutachiwana hunotapukirwa nea causative agent paanodya mhuka dzinorwara dzine denda muropa.
Kusiyanisa kutengesa kwepathogen kuburikidza nefleas kubva kuvanhu vanotakura mhuka kune vanhu uye kubva kumunhu kusvika kumunhu. Isu tinonyora nzira dzinogona kuwanikwa dzekupinda denda mumuviri womunhu:
- Kusvibiswa - kupinda muropa mushure mekurumwa kwezvipembenene zvine utachiona.
- Kubata - paunosangana nemunhu ane paganda kana mucous membrane ye microtrauma, nemitumbi yemhuka inotapukirwa (somuenzaniso, painocheka zvitunha, kushandura matanda).
- Zvimwe - kuburikidza ne mucosa yemakumbo emimba apo paidya nyama yemhuka dzinorwara dzisina kutongerwa zvakakwana kupisa, kana zvimwe zvinogadzirwa mbeu.
- Kukurukura-musha - pamubati wemunhu anorwara, achitaurirana nehupenyu hwake, kushandisa ndiro, zvinhu zvehutsanana nezvimwewo.
- Aerosol inobva kumunhu kusvika kune munhu kuburikidza nemuchengetedze wemupfupa wekufuridzira kana uchikanganiswa, kunyunyuta, kutaura kukuru.
Dambudziko - zviratidzo zvevanhu
Kubva panzvimbo yekutangiswa kwepathogen kunobva kune chimiro chechirwere ichi chichakura, nekukuvadzwa kwezvikamu, nehumwe zviratidzo. Izvi zvinotevera maitiro ehutenda hwemunhu anomira kunze:
- bubonic;
- pulmonary;
- septic;
- mukati.
Mukuwedzera, kune maitiro akadaro asinganzwisisiki echirwere seganda, pharyngeal, meningeal, asymptomatic, kubhabhatidza. Chirwere chinotapurirwa chine nguva yekupedza mazuva matatu kusvika kumasere, dzimwe nguva mazuva maviri (uye primary pulmonary kana septic mawomu) kana mazuva manomwe kusvika 7-9 (muzvirwere kana kuti varwere vanorwara kare). Nokuti mhando dzose dzinoratidzika kamwe kamwe-kamwe nezviratidzo zvakakomba uye kunwa doro, zvinoratidzwa mune zvinotevera:
- kupisa kwemuviri wepamusoro;
- chills;
- headache;
- musculo-articular kurwa;
- nausea;
- kurutsa;
- kushaya simba kwakasimba.
Sezvo chirwere chacho chichikura, kuonekwa kwemurwere kunoshanduka: chiso chinodada, chimiro, vatsvene vemaziso vanotsvuka, miromo nerurimi zvinova zvakaomeswa, masvikiro masikati anooneka pasi pemaziso, chiso chinoratidza kutya, kutya ("denda mask"). Mune ramangwana, murwere anonetseka nekuziva, kutaura kunenge kusingabvumirwi, kushamwaridzana kwekufambisa kunovhiringidzika, kunyengedzwa nekufungidzira kunoonekwa. Mukuwedzera, zvipembenene zvakananga zvinokura, zvichienderana nehuwandu hwehosha.
Denda reBubonic - zviratidzo
Nhamba dzinoratidza kuti denda rebhuonic ndiyo inowanzozivikanwa nehosha inowedzera mu80% yeavo vanotapukirwa nekupinda mukati memaprogen kuburikidza nemuchengetedze uye ganda. Muchiitiko ichi, hutachiona hunopararira kuburikidza ne-lymphatic system, zvichikonzera kukuvadza kumakumbo echiremera, mune zvisingawanzo - axillary kana chibereki. Izvo zvinokonzerwa nemabhoes hazvina kukwana uye dzakawanda, hukuru hwavo hunogona kuenzana kubva pa3 kusvika ku10 cm, uye mukubudirira kwavo vanowanzofamba nenzira dzakasiyana-siyana:
- kuwedzera, kuoma uye kuora kwemaitiro emakirini - mazuva mashomanana mushure mekutanga kwekudhakwa kwechirwere (mumufananidzo we - bubonic plague mune murwere ane buboes inguinal);
- kunyorera kwebubo - pazuva rechina rechirwere;
- kupesana kwepachivande, kuumbwa kwechironda kana nzvimbo yeNecrosis - pazuva rechigumi rematambudziko.
Pulmonary plague
Iyi fomu inowanikwa mu5-10% yevarwere, vane chirwere chinotapira chinenge chichikura mushure mekutachiona kwehutachiona (pakutanga) kana sechinhu chinokonzerwa neforonic (yechipiri). Iyi ndiyo yakasiyana-siyana inotyisa, uye zviratidzo zvakananga zvehosha mune vanhu munyaya iyi zvinoratidzika pamusoro pezuva pazuva 2-3, mushure mokutanga kwekunyanyisa kwechiratidzo. Iyo inogadzirisa causative inokanganisa masvingo emapurmonary alveoli, zvichiita necrotic phenomena. Zviratidzo zvakasiyana ndezvi:
- kukufema nokukurumidza, kufema kwekufema;
- chifuva;
- sputum discharge - pakutanga frothy, zvakajeka, ipapo-neropa remitsipa;
- kurwadziwa mubhokisi;
- tachycardia;
- inodonha muropa.
Chimiro chePaptic chehosha
Iyo yepamusoro-septic maitiro ehosha, iyo inokura apo dutu guru re microbe rinopinda muropa, harisi, asi rakaoma zvikuru. Zviratidzo zvinopisa zvinowedzera mheni zvakasimba, sezvo pathogen inopararira kune nhengo dzose. Kune huwandu hwehutachiona hweganda uye mucous tissues, conjunctiva, mumukaka uye kubuda ropa, kukurumidza kukura kwehutachiona hwehutachiona hwehutachiona . Dzimwe nguva chimiro ichi chinowedzera sechinhu chechipiri chinetso cheimwe mhando dzehosha, iyo inoratidzirwa nekuumbwa kwechipiri buboes.
Utumbo hwomuviri wehosha
Haasi nyanzvi dzose dzinosiyanisa mazamu emhando dzakasiyana nedambudziko racho, achichibata seimwe yezviratidzo zvechimiro chechimiro. Apo chirwere chemukati chinowedzera zviratidzo zvechirwere kune vanhu vanopesana nemamiriro ekupedzisira kudhakwa uye fever, zvinotevera zvakanyorwa:
- kurwadziwa kwepamuviri;
- kushambadzira kwemvura zhinji;
- hove uye mucocutaneous stools;
- tenesmus - zvinorwadza kukurudzira kubvisa mumatumbo.
Dambudziko - Kuziva
Basa rinokosha rinoratidzwa ne "chirwere" laboratory diagnostic, inoitwa nenzira dzinotevera:
- serological;
- bacteriological;
- microscopic.
Nokuti kudzidza kunotora ropa, kubvisa kubva kumabhoes, kuparadzaniswa zvipembenene, phlegm, kupatsanurwa oropharynx, vomit. Kuti uongorore kuvapo kwepathogen, zvinhu zvakasarudzwa zvinogona kukura pamusangano wehutano chaihwo. Mukuwedzera, i X-ray ye lymph nodes nemapapu inoitwa. Zvakakosha kusimbisa chokwadi chekurumwa kwezvipembenene, kusangana nemhuka dzinorwara kana vanhu, shanyira nzvimbo dzakagadziriswa nekuda kwedenda.
Dambudziko - kurapwa
Kana chirwere chichifungidzirwa kana kuti chichiongororwa, murwere anonyatsotarisirwa muchipatara mune chipatara chinotapukira mubhokisi riri roga, kubva pakabuda mhepo yakananga. Kurapwa kwehosha muvanhu kunobva pamabasa akadaro:
- kugamuchirwa kwemishonga inorwisa mabhakitiriya, zvichienderana nechimiro chechirwere ( Levomycetin , Tetracycline, Streptomycin);
- detoxication therapy (Albumin, Reopoliglyukin, Gemodez);
- kushandiswa kwemishonga yekuvandudza microcirculation nekugadzira (Trental, Solcoseryl , Pikamilon);
- antipyretic uye zviratidzo zvechirwere;
- chirongwa chekuchengetedza (mavitamini, mishonga yemwoyo);
- plasmapheresis - ine septic lesion.
Penguva yefivha murwere anofanira kutevera mubhedha wezororo. Chirwere chinorwisa mabhakitiriya chinoitwa kwemazuva manomwe kusvika ku14, mushure mokunge zvidzidzo zvekushandiswa kwezvinyorwa zvinopiwa. Murwere anobudiswa mushure mokunge apora zvachose, sekuratidzwa nekugamuchira katatu kwakashata. Kubudirira kwemishonga kunoenderana nepamusoro pekutengesa kwetenda kuonekwa.
Nzira dzekudzivirira denda mumuviri womunhu
Kuchengetedza kupararira kwehutachiona, zvisingaiti zvekudzivirira zvirongwa zvinoitwa, kusanganisira:
- kuongororwa kwemashoko pamusoro pehutachiwana hwetenda munyika dzakasiyana;
- kuzivikanwa, kusarura uye kurapwa kwevanhu vane chokwadi chekurwara;
- Kuchenesa kwekutakura kubva kune dzimwe nzvimbo dzisina kukodzera maererano nehosha.
Uyezve, basa rinowanzoitwa muhupenyu hwechirwere ichi: kuverenga nhamba yemapuranga emusango, kuitsvakurudza kuti vaone denda rebhakitiriya, kuparadza vanhu vane utachiona, kurwisa fleas. Muchizivikanwa kunyange nemurwere mumwechete munharaunda, zvakadai zvinopesana nehutachiona hunoitwa:
- kusarudzwa kwekuzviisa pamutemo pamwe nekurambidzwa kwekupinda nekubuda kwevanhu kwemazuva mazhinji;
- kuzviparadzanisa kwevanhu vainge vaine chirwere chevarwere vane denda;
- kusuruvara kwemawere muhupi hwechirwere ichi.
Vanhu vangave vachibatana nehosha inorwara, nokuda kwezvinodzivirira, inotungamirirwa kurwisa sarum yeronda pamwe chete nemishonga inorwisa mabhakitiriya. Kuvharirwa kunorwisa denda kumunhu anorwara chirwere chinotapurirwa kunowanikwa mumamiriro ezvinhu akadaro:
- apo paine chimiro chechisikigo chekutapukirwa kana mukubuda kunouya kunzvimbo isina kukodzera;
- kubasa, kusanganiswa nekugona kuwanikwa kune zvitubu zvehutachiona;
- apo pane kupararira kwakawanda kwehutachiwana pakati pezvipfuwo munzvimbo dzakapoteredza.
Dambudziko - kushaya mazita
Kuvonga nekugadzirwa kwemishonga nekuchengetedzwa kwemaitiro ekudzivirira maitiro, chirwere chechirwere hachiwanzoshanda zvakanyanya. Munguva dzekare, apo pasina mushonga wakagadzirwa nokuda kwehutachiona ichi, kufa kwaiva anenge zana muzana. Iye zvino mazamu haadari 5-10%. Panguva imwecheteyo, vangani vanhu vakafa nedenda iri munyika munguva ichangopfuura, havagoni asi kunetseka.
Dambudziko munhoroondo yevanhu
Denda munhoroondo yevanhu rakasiya nzira dzakaipisisa. Zvizhinji zvakapararira ndezvirwere zvakadai:
- "Justinian Plague" (551-580 gg.), Iyo yakatanga muEgypt, inobva kune vanhu vanopfuura mamiriyoni zana vakafa;
- denda re "kufa kwekufa" (XIV yezana remakore) muEurope, rakabururuka kubva kuEngland China, iyo yakareva vanenge mamiriyoni makumi mana vapenyu;
- denda muRussia (1654-1655 gg.) - vanenge 700 000 vakafa;
- denda muMarseilles (1720-1722) - 100 zviuru zvevanhu vakafa;
- denda rehosha (kuguma kwezana remakore reXIX) muAsia - vanopfuura mamiriyoni mashanu vakafa.
Dambudziko mumazuva edu
Denda reBubonic mazuva ano rinowanikwa pamakondinendi ose, kunze kweAustralia neAntarctica. Mune nguva kubva muna 2010 kusvika muna 2015, zvinopfuura 3 000 mamiriro ezvinhu echirwere akaonekwa, nehutano hunouraya hwakaonekwa muna 584 utachiona. Zviitiko zvizhinji zvakanyoreswa kuMadagascar (zvinopfuura 2 000). Foci denda rakaonekwa munyika dzakadai seBolivia, USA, Peru, Kyrgyzstan, Kazakhstan, Russia nevamwe. Dzakaitika kumatunhu eRussia ndeaya: Altai, Eastern Urals, Stavropol, Transbaikalia, Caspian pasiland.