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<\/div>\nT\u00fcrk Mikrobiyoloji Cemiyeti \u2013 KKTC<\/a> Mikrobiyoloji Platformu, maymun \u00e7i\u00e7e\u011fi vir\u00fcs\u00fcn\u00fcn (Mpox) bula\u015fma yollar\u0131, klinik belirtileri, tan\u0131s\u0131, tedavisi, korunma yollar\u0131 ve \u00f6nlemler hakk\u0131nda bilgilendirici a\u00e7\u0131klama yaparak uyar\u0131larda bulundu.<\/p>\n Maymun \u00e7i\u00e7e\u011fi vir\u00fcs\u00fcn\u00fcn, klasik \u00e7i\u00e7ek vir\u00fcs\u00fcn\u00fcn de i\u00e7erisinde bulundu\u011fu \u201cPoxviridae\u201d ailesinde yer alan ve \u201cOrthopoxvirus\u201d cinsi zarfl\u0131 ve \u00e7ift zincirli bir DNA vir\u00fcs\u00fc oldu\u011funa i\u015faret edilen a\u00e7\u0131klamada, vir\u00fcs\u00fcn iki genetik tipi (tip I ve II) bulundu\u011funu belirtti.<\/p>\n Vir\u00fcs\u00fcn ilk kez 1958 y\u0131l\u0131nda Danimarka\u2019da ara\u015ft\u0131rma ama\u00e7l\u0131 kullan\u0131lan maymunlarda ortaya \u00e7\u0131kt\u0131\u011f\u0131n\u0131 belirten cemiyet-platform, \u015funlar\u0131 kaydetti:<\/p>\n \u201c\u0130nsanlardaki ilk maymun \u00e7i\u00e7e\u011fi hastal\u0131\u011f\u0131 ise 1970 y\u0131l\u0131nda Kongo Demokratik Cumhuriyeti\u2019nde dokuz ayl\u0131k bir bebekte g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. 1980 y\u0131l\u0131nda \u00e7i\u00e7ek hastal\u0131\u011f\u0131n\u0131n eradike edilmesiyle birlikte \u00e7i\u00e7ek hastal\u0131\u011f\u0131 a\u015f\u0131s\u0131n\u0131n sonland\u0131r\u0131lmas\u0131ndan sonra Afrika\u2019n\u0131n \u00e7e\u015fitli b\u00f6lgelerinde maymun \u00e7i\u00e7e\u011fi vir\u00fcs\u00fc g\u00f6r\u00fclmeye devam etmi\u015ftir. D\u00fcnya genelinde 2022-2023 d\u00f6neminde bir salg\u0131n ortaya \u00e7\u0131km\u0131\u015ft\u0131r. \u00d6zellikle maymun ve sincap gibi memeli hayvanlar\u0131n vir\u00fcs\u00fcn rezervuar\u0131 (do\u011fadaki kayna\u011f\u0131) olabilece\u011fi belirtilmektedir.\u201d <\/p>\n A\u00e7\u0131klamada, yak\u0131n d\u00f6nemde ortaya \u00e7\u0131kan salg\u0131nlar ve bunlardan sorumlu Mpox tipleri \u015f\u00f6yle s\u0131raland\u0131:<\/p>\n \u201c2022 y\u0131l\u0131nda Avrupa ve d\u00fcnya genelinde insandan insana \u00e7o\u011funlukla cinsel temas sonucu bula\u015fan Mpox salg\u0131n\u0131 ortaya \u00e7\u0131km\u0131\u015ft\u0131r. Mpox\u2019un iki adet genetik tipi (I ve II) olup, bunlar\u0131n kendi aralar\u0131nda iki\u015fer alt tipi (Ia, Ib; ve IIa, IIb) bulunmaktad\u0131r. Alttip Ia \u00e7o\u011funlukla sadece tip I olarak an\u0131lmaktad\u0131r. Ge\u00e7mi\u015fte, tip I\u2019in tip II\u2019ye k\u0131yasla daha a\u011f\u0131r klinik semptomlara ve daha y\u00fcksek oranlarda \u00f6l\u00fcme yol a\u00e7t\u0131\u011f\u0131 bildirilmi\u015ftir. 2022 salg\u0131n\u0131nda bula\u015f\u0131n esas kayna\u011f\u0131 tip IIb olmu\u015f ve bunun daha hafif hastal\u0131k tablosu ve daha d\u00fc\u015f\u00fck \u00f6l\u00fcm oranlar\u0131na neden oldu\u011fu g\u00f6r\u00fclm\u00fc\u015ft\u00fcr. D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) 2022 y\u0131l\u0131nda Mpox salg\u0131n\u0131n\u0131, \u2018uluslararas\u0131 \u00f6neme sahip bir halk sa\u011fl\u0131\u011f\u0131 acil durumu\u2019 olarak ilan etmi\u015f ve bu durum d\u00fcnya genelindeki vaka<\/a>lar\u0131n say\u0131s\u0131n\u0131n gittik\u00e7e azalmas\u0131 nedeniyle May\u0131s 2023\u2019te sona ermi\u015ftir. Afrika k\u0131tas\u0131ndaki farkl\u0131 \u00fclkelerde Mpox tip I ve tip II halihaz\u0131rda saptanmaya devam ederken, 2023\u2019\u00fcn sonlar\u0131ndan itibaren Kongo Demokratik Cumhuriyeti\u2019nde g\u00f6r\u00fclmeye ba\u015flanan b\u00fcy\u00fck \u00f6l\u00e7ekli salg\u0131n di\u011fer Afrika \u00fclkelerine de yay\u0131lmaya ba\u015flam\u0131\u015ft\u0131r. Bu salg\u0131n \u00e7o\u011funlukla cinsel temas sonucu bula\u015fan Mpox tip Ib\u2019ye ba\u011fl\u0131 geli\u015fmektedir. 2022 y\u0131l\u0131nda d\u00fcnyadaki Mpox salg\u0131n\u0131n\u0131n ba\u015flamas\u0131ndan Temmuz 2024\u2019\u00fcn sonunda kadar 116 \u00fclkeden 99.000\u2019i a\u015fk\u0131n vaka<\/a> ve 200\u2019den fazla \u00f6l\u00fcm bildirilmi\u015ftir. Afrika k\u0131tas\u0131nda 2024 y\u0131l\u0131nda \u015f\u00fcpheli ve teyit edilen olgularla birlikte toplam 17.541 Mpox vaka<\/a>s\u0131 ve buna ba\u011fl\u0131 517 (%3) \u00f6l\u00fcm bildirilmi\u015ftir. 2024 y\u0131l\u0131nda Mpox vaka<\/a>s\u0131n\u0131n bildirildi\u011fi 13 Afrika \u00fclkesi Burundi, Kamerun, Orta Afrika Cumhuriyeti, Kongo, Fildi\u015fi Sahili, Kongo Demokratik Cumhuriyeti, Gana, Liberya, Kenya, Nijerya, Ruanda, G\u00fcney Afrika ve Uganda olmu\u015ftur. Salg\u0131n\u0131n bu denli yay\u0131lmas\u0131 \u00fczerine, DS\u00d6 MpoX salg\u0131n\u0131n\u0131 yeniden (iki y\u0131l i\u00e7erisinde ikinci kez) \u2018uluslararas\u0131 \u00f6neme sahip bir halk sa\u011fl\u0131\u011f\u0131 acil durumu\u2019 olarak ilan etmi\u015ftir.\u201d<\/p>\n A\u00e7\u0131klamada, hastal\u0131\u011f\u0131n bula\u015fma yollar\u0131yla ilgili \u015fu bilgiler payla\u015f\u0131ld\u0131:<\/p>\n \u201cBula\u015f insandan insana veya hayvandan insana olabilece\u011fi gibi, k\u0131yafet ve kuma\u015flar gibi vir\u00fcs\u00fcn bulunabilece\u011fi materyaller arac\u0131l\u0131\u011f\u0131yla da ger\u00e7ekle\u015febilmektedir. Vir\u00fcs insandan insana do\u011frudan temas sonucunda deri (dokunma, cinsel temas), a\u011f\u0131z (\u00f6p\u00fc\u015fme) ve genital b\u00f6lgelerdeki lezyonlarla (cinsel ili\u015fki); veya uzun s\u00fcreli yak\u0131n temas sonunda damlac\u0131k yoluyla (konu\u015fma veya nefes al\u0131p verme) bula\u015fabilmektedir. Vir\u00fcs b\u00fct\u00fcnl\u00fc\u011f\u00fc bozulan deri, mukozal y\u00fczeyler (a\u011f\u0131z, farenks, g\u00f6z, genital b\u00f6lge) veya solunum yolu arac\u0131l\u0131\u011f\u0131yla v\u00fccuda girmektedir. Ayn\u0131 evi payla\u015fan bireyler ve cinsel partnerler aras\u0131nda vir\u00fcs yay\u0131labilmektedir. Birden fazla cinsel partneri olan ki\u015filer daha y\u00fcksek risk alt\u0131ndad\u0131r. Mpox enfekte hayvanlardan insanlara \u0131s\u0131r\u0131k ve \u00e7izik yoluyla, veya avlanma, deri soyma, yeme-pi\u015firme sonucu bula\u015fabilmektedir. Bunlar\u0131n yan\u0131 s\u0131ra vir\u00fcs insanlara k\u0131yafet veya kuma\u015f gibi kontamine y\u00fczeyler arac\u0131l\u0131\u011f\u0131yla, sa\u011fl\u0131k merkezlerinde kesici alet yaralanmalar\u0131 sonucu, veya toplum i\u00e7erisinde d\u00f6vme salonlar\u0131 gibi ortamlarda da bula\u015fabilmektedir. Ayr\u0131ca vir\u00fcs\u00fcn hamilelik s\u0131ras\u0131nda anneden bebe\u011fine plasenta yoluyla ge\u00e7ebilece\u011fi de belirtilmektedir.\u201d<\/p>\n -Klinik belirti ve bulgular<\/p>\n Mpox hastal\u0131\u011f\u0131n\u0131n klinik belirti ve bulgular\u0131n\u0131n vir\u00fcsle kar\u015f\u0131la\u015fmay\u0131 takip eden 1 ila 21 g\u00fcn (genellikle bir hafta) i\u00e7inde ortaya \u00e7\u0131kt\u0131\u011f\u0131 kaydedilen a\u00e7\u0131klamaya g\u00f6re, semptomlar ise iki ila d\u00f6rt hafta s\u00fcr\u00fcyor. Ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 zay\u0131f bir ki\u015fide bu s\u00fcre uzayabiliyor.<\/p>\n Mpox\u2019a ba\u011fl\u0131 ortaya \u00e7\u0131kan en yayg\u0131n semptomlar\u0131n d\u00f6k\u00fcnt\u00fc, ate\u015f, bo\u011faz a\u011fr\u0131s\u0131, ba\u015f a\u011fr\u0131s\u0131, kas a\u011fr\u0131lar\u0131, s\u0131rt a\u011fr\u0131s\u0131, yorgunluk ve lenf nodlar\u0131nda b\u00fcy\u00fcme oldu\u011fu ifade edilen a\u00e7\u0131klamada, vir\u00fcsle enfekte ki\u015filerin bir k\u0131sm\u0131nda ise semptom g\u00f6r\u00fclmemedi\u011fi bildirildi.<\/p>\n Hastal\u0131kla ilgili belirti ve bulgulara \u015f\u00f6yle devam edildi:<\/p>\n \u201cHastal\u0131k \u00e7o\u011funlukla ate\u015f, kas a\u011fr\u0131lar\u0131 ve bo\u011faz a\u011fr\u0131s\u0131 ile ba\u015flamaktad\u0131r. D\u00f6k\u00fcnt\u00fcler \u00f6ncelikle y\u00fczde ortaya \u00e7\u0131k\u0131p, sonras\u0131nda t\u00fcm v\u00fccuda yay\u0131lmakta ve avu\u00e7 i\u00e7i ve ayak tabanlar\u0131na kadar ilerlemektedir. Lezyonlar kas\u0131k, genital b\u00f6lgeler ve an\u00fcste de g\u00f6r\u00fclebilmektedir. D\u00f6k\u00fcnt\u00fc ciltte ilk \u00f6nce d\u00fcz bir yara olarak ba\u015flay\u0131p, sonra ka\u015f\u0131nt\u0131l\u0131 veya a\u011fr\u0131l\u0131 olabilen s\u0131v\u0131 dolu bir kabarc\u0131k haline gelmektedir (iki ve d\u00f6rt hafta i\u00e7erisinde d\u00f6k\u00fcnt\u00fcler s\u0131ras\u0131yla mak\u00fcl, pap\u00fcl, vezik\u00fcl ve p\u00fcst\u00fcl halini almaktad\u0131r). D\u00f6k\u00fcnt\u00fc iyile\u015ftik\u00e7e, lezyonlar kurumakta ve kabuk ba\u011flayarak d\u00fc\u015fmektedir. Ciltteki t\u00fcm yara ve lezyonlar tamamen iyile\u015fene kadar hastalar\u0131n bula\u015f\u0131c\u0131 olduklar\u0131 unutulmamal\u0131d\u0131r. \u00c7ocuklar, hamile kad\u0131nlar ve ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 zay\u0131f ki\u015filer Mpox\u2019a ba\u011fl\u0131 ortaya \u00e7\u0131kacak komplikasyonlar a\u00e7\u0131s\u0131ndan risk alt\u0131ndad\u0131rlar.\u201d<\/p>\n -Tan\u0131<\/p>\n A\u00e7\u0131klamada, hastal\u0131\u011f\u0131n tan\u0131s\u0131yla ilgili de \u015fu bilgiler payla\u015f\u0131ld\u0131:<\/p>\n \u201cMpox\u2019ta ortaya \u00e7\u0131kan klinik bulgular\u0131n (d\u00f6k\u00fcnt\u00fc) di\u011fer birtak\u0131m enfeksiyonlardan (su\u00e7i\u00e7e\u011fi, k\u0131zam\u0131k, \u00e7e\u015fitli bakteriyel deri enfeksiyonlar\u0131, uyuz, herpes, sifiliz ve di\u011fer cinsel yolla bula\u015fan enfeksiyonlar) ay\u0131rt edilmesi gerekmektedir. Mpox enfeksiyonu ge\u00e7irmekte olan bir ki\u015fide herpes gibi cinsel yolla bula\u015fan di\u011fer enfeksiyonlar da mevcut olabilir. Ayr\u0131ca, Mpox\u2019tan \u015f\u00fcphelenilen bir \u00e7ocukta su\u00e7i\u00e7e\u011fi hastal\u0131\u011f\u0131 da bulunabilir. Bu nedenle, hastalar\u0131n en erken zamanda tedaviye ba\u015flamas\u0131 ve b\u00f6ylelikle vir\u00fcs\u00fcn ba\u015fka ki\u015filere bula\u015ft\u0131r\u0131lmas\u0131n\u0131 \u00f6nlemek i\u00e7in laboratuvar testlerinin yap\u0131lmas\u0131 b\u00fcy\u00fck \u00f6nem ta\u015f\u0131maktad\u0131r. Vir\u00fcs\u00fcn laboratuvarda saptanmas\u0131 i\u00e7in tercih edilen y\u00f6ntem polimeraz zincir reaksiyonu (PCR)\u2019dur. Deri lezyonlar\u0131ndan (e\u011fer yoksa orofarenks, an\u00fcs veya rektum) al\u0131nan \u00f6rnekte PCR y\u00f6ntemiyle vir\u00fcs DNA\u2019s\u0131n\u0131n saptanmas\u0131 sonucu tan\u0131 konulmaktad\u0131r.\u201d<\/p>\n -Tedavi ve korunma<\/p>\n Maymun \u00e7i\u00e7e\u011fi hastal\u0131\u011f\u0131n\u0131n tedavisinde esas olarak cilt d\u00f6k\u00fcnt\u00fclerinin sonland\u0131r\u0131lmas\u0131, a\u011fr\u0131n\u0131n azalt\u0131lmas\u0131 ve komplikasyonlar\u0131n \u00f6nlenmesinin ama\u00e7land\u0131\u011f\u0131 belirtilen a\u00e7\u0131kalmada, \u201cBu nedenle erken ve destekleyici tedavi hastal\u0131\u011f\u0131n kontrol alt\u0131na al\u0131nmas\u0131 i\u00e7in \u00f6nem ta\u015f\u0131maktad\u0131r. \u00d6nceden su\u00e7i\u00e7e\u011fi hastal\u0131\u011f\u0131n\u0131n tedavisi i\u00e7in geli\u015ftirilmi\u015f olan birtak\u0131m antiviral ila\u00e7lar Mpox tedavisi i\u00e7in kullan\u0131lm\u0131\u015f olup, bu konuda ara\u015ft\u0131rmalar devam etmektedir.\u201d denildi.<\/p>\n -D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc a\u015f\u0131 \u00f6neriyor<\/p>\n \u015eu anda D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc taraf\u0131ndan \u00f6nerilen iki Mpox a\u015f\u0131s\u0131 bulundu\u011fu kaydedilen a\u00e7\u0131klamada, \u015fu bilgilere yer verildi:<\/p>\n \u201cBunlardan biri (JYNNEOS a\u015f\u0131s\u0131) ayn\u0131 zamanda Amerika Birle\u015fik Devletleri G\u0131da ve \u0130la\u00e7 Dairesi (FDA) taraf\u0131ndan da 18 ya\u015f ve \u00fczeri bireylerde kullan\u0131m i\u00e7in onaylanm\u0131\u015ft\u0131r. DS\u00d6 taraf\u0131ndan, \u00f6zellikle salg\u0131n s\u0131ras\u0131nda Mpox enfeksiyonunu \u00f6nlemek i\u00e7in y\u00fcksek risk alt\u0131nda olan ki\u015filerin a\u015f\u0131 yapt\u0131rmalar\u0131 \u00f6nerilmektedir. Vir\u00fcse maruz kalma riski olan sa\u011fl\u0131k \u00e7al\u0131\u015fanlar\u0131, riskli cinsel davran\u0131\u015f\u0131 olan bireyler, ve yak\u0131n zamanda hastal\u0131\u011f\u0131n yayg\u0131n g\u00f6r\u00fcld\u00fc\u011f\u00fc b\u00f6lgelerden (Kongo Demokratik Cumhuriyeti veya kom\u015fu \u00fclkeler gibi) herhangi birine seyahat etmi\u015f ki\u015filer ve onlarla yak\u0131n temasta bulunanlar\u0131n a\u015f\u0131lanmas\u0131 tavsiye edilmektedir.\u201d<\/p>\n -\u00d6nlem<\/p>\n T\u00fcrk Mikrobiyoloji Cemiyeti \u2013 KKTC<\/a> Mikrobiyoloji Platformu, Mpox\u2019a kar\u015f\u0131 \u00f6nlemleri ise \u015f\u00f6yle s\u0131ralad\u0131:<\/p>\n Mpox vaka<\/a>lar\u0131n\u0131n saptand\u0131\u011f\u0131 \u00fclkelere seyahat eden bireyler, deri veya genital lezyonlar\u0131 olan ki\u015filerle yak\u0131n temastan ka\u00e7\u0131nmal\u0131d\u0131r. Cinsel ili\u015fki s\u0131ras\u0131nda prezervatif kullan\u0131lmas\u0131 Mpox bula\u015f\u0131n\u0131 azaltmaya yard\u0131mc\u0131 olmakla birlikte, partneler aras\u0131nda deri veya a\u011f\u0131z temas\u0131 sonucu vir\u00fcs bula\u015f\u0131n\u0131n ger\u00e7ekle\u015febilece\u011fi unutulmamal\u0131d\u0131r. Hasta ki\u015filere ait k\u0131yafet, nevresim tak\u0131mlar\u0131 veya bu ki\u015filerin kulland\u0131\u011f\u0131 malzemelerle temas edilmemelidir. Mpox\u2019un hayvanlarda g\u00f6r\u00fcld\u00fc\u011f\u00fc \u00fclkelerde vah\u015fi hayvanlar\u0131n yenilmesinden, etinin haz\u0131rlanmas\u0131ndan, bu hayvanlarla temas eden malzemelerin ve bu hayvan \u00fcr\u00fcnlerinin kullan\u0131lmas\u0131ndan ka\u00e7\u0131n\u0131lmal\u0131d\u0131r.\u201d<\/p>\n<\/p><\/div>\n