NİPAH VİRÜSÜ ENFEKSİYONU

Yıl 2018, Cilt: 2 Sayı: 2, 74 - 81, 29.09.2018

Semra Öz Büşra Çınar Mustafa Altındiş

Öz

 

Özet

Nipah
virüsü (NiV), Paramyxoviridae ailesinden Henipavirus cinsinin bir üyesidir. İlk
defa 1999 yılında Malezya ve Singapur'da domuz çiftçileri ve domuzlarla yakın
temas halinde olan insanlar arasında ensefalit ve solunum yolu hastalığı
salgını sırasında izole edilmiştir. Pteropus cinsi meyve yarasaları rezervuar
rolü üstlenir. Enfekte yarasalar, enfekte domuzlar veya diğer NiV ile enfekte
kişilerle doğrudan temas sonrası insanlara bulaşı görülebilir. İnsan
enfeksiyonları asemptomatik enfeksiyondan akut solunum yolu enfeksiyonuna ve
ölümcül ensefalite kadar değişebilir. Enfekte insanlarda başlangıçta ateş, baş
ağrısı, kas ağrısı, kusma ve boğaz ağrısı gibi grip benzeri semptomlar
görülebilir. Sonrasında baş dönmesi, uyuşukluk, bilinç değişikliği ve akut ensefaliti
gösteren nörolojik bulgular eklenebilir. Bazı kişilerde akut solunum sıkıntısı
da dahil olmak üzere atipik pnömoni ve ciddi solunum problemleri görülebilir.
Ensefalit ve nöbetler ağır vakalarda ortaya çıkar. Nipah virüs enfeksiyonunun
başlangıç belirtileri ve semptomları nonspesifiktir ve tanıda genellikle
şüphelenilmez. Tanı daha çok klinikle konulur ama vücut sıvılarından gerçek
zamanlı polimeraz zincir reaksiyonu (RT-PCR) ve enzim bağlantılı immünosorbent
testi (ELISA) ile antikor tespitidir laboratuvar temelli kullanılan başlıca
testlerdir. Şu an için özgül bir tedavisi ve aşısı bulunmamaktadır ve destek
tedavisi önerilmektedir. Nipah virüsü enfeksiyonu, endemik bölgelerde hasta
domuz ve yarasa maruziyetinden kaçınarak ve ham hurma sularını içmeyerek
önlenebilir. Bu konuda yapılacak kapsamlı çalışmalarla hastalık tanısını ve
salgınların önelenmesiyle kalınmayıp bu ölümcül patojen için yeni tedavi ve
aşıların bulunmasını sağlanabilir. Günümüzde ulaşım koşulları ve virüsün
insanlar arası iletimi de göz önüne alındığında endemik bölgeler dışında da
dikkatli olunmalı, bu konuda farkındalık oluşturulmalı ve maruziyeti azaltmak
için alanabilecek önlemler hakkında insanlar eğitilmelidir.

Anahtar Kelimeler:
Nipah, Henipah, virüs.

Abstract

Nipah
virus (NiV) is a member of the genus Henipavirus from Paramyxoviridae family.
It was first isolated in 1999 in Malaysia and Singapore during an encephalitis
and respiratory disease outbreak among pig farmers and people in close contact
with pigs. Pteropus genus fruit bats play a reservoir role. Infection can be
seen in humans after direct contact with infected bats, infected pigs or other
NiV-infected persons. Human infections can range from asymptomatic infections
to acute respiratory tract infections and lethal encephalitis. Infected people
may initially have influenza-like symptoms such as fever, headache, muscle
aches, vomiting, and sore throat. Neurological findings with dizziness,
drowsiness, altered consciousness, and acute encephalitis can then be added.
Some people may have atypical pneumonia and severe respiratory problems
including acute respiratory distress. Encephalitis and seizures occur in severe
cases. The
initial signs and symptoms of nipah virus infection are nonspecific and are
usually not suspected. Diagnosis is mostly done clinically but it is
the principal laboratory-based test that detects antibodies from body fluids
using real-time polymerase chain reaction (RT-PCR) and enzyme-linked
immunosorbent assay (ELISA). Currently there is no specific treatment or
vaccination and supportive care is recommended. Nipah virus infection
can be prevented in patients with endemic areas avoiding pig and bat exposure
and not drinking raw palm sap. Comprehensive studies to be undertaken in this
area will not only help to prevent illnesses and epidemics, but also provide
new treatments and vaccines for this deadly pathogen. Nowadays, given the
transport conditions and the transmission of human interactions between
viruses, care must be taken outside of the endemic areas, awareness must be set
in this regard and people should be educated about precautions that may be
taken to reduce exposure.

Keywords:
Nipah, Henipah, virus.

Anahtar Kelimeler

Nipah, Henipah

Kaynakça

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