NG MINH GIANG

T 3 YHDP08
BI BO CO HANTAVIRUS
I. DCH T HC
Hantavirus c th gy bnh cho ngi trong nhiu nm qua ti M, nhng khng c
nhn ra mi cho n thi gian gn y. Nm 1993, mt v dch gy suy h hp t vong trn
cc vng t dnh ring cho ngi n bin gii Utah, Colorado, New Mexico, Arizona.
Cc nh nghin cu khm ph ra rng Hantavirus gy ra dch. T s khm ph ny, bnh
do Hantavirus c bo co mi bang pha ty v nhiu bang pha ng.
Hantavirus c mang bi cc loi gm nhm, c bit l chut.
Virus trong nc tiu v trong phn ca chut nhng khng lm cho ng vt mang mm
bnh b au ( l iu c bit). Ngi tr nn b nhim khi h phi nhim vi cc cht thi
nhim t chut hoc vt tit. Bnh khng ly truyn t ngi sang ngi, nhiu ngi c th
nhim ng thi s gii thch cho vn cng phi nhim vi cc vng c cc cht nhim.
Bnh thng ly t chut sang ngi qua ng h hp, t nhng git kh dung nc
tiu chut, ch him khi ly do chut cn ngi. Nu bc vo nhng nh kho b hoang lu
ngy, nhy nha, c chut sinh sng v phng u nhiu, ngi ta rt d nhim virt Hanta.
Cc vng c bit b nh hng bi HFRS gm Trung Quc, Hn Quc, Nga (Hantaan,
Puumala v Seoul virus) v bc u cng nh Ty u (Puumala v Dobrava virus). Cc vng c
t l mc mi cao nht ca HCPS gm c Patagonian Argentina, Chile, Brazil, M, Canada,
Panama, ni c mt th nh hn ca bnh trn tim c xc nh. Hai tc nhn ca HCPS
pha Nam M l Andes virus (cn gi l Oran, Castelo de Sonhos, Lechiguanas, Juquitiba,
Araraquara, Bermejo virus, trong s ny c nhiu thut ng ng ngha khc), ch c Hantavirus
cho thy ly nhim t ngi sang ngi (!?) v virus Laguna Negra c lin quan cht ch vi
virus Rio Mamore c bit trc y. Ti M, mt s t ca HCPS gm cc loi virus nh
New York virus, Bayou virus, v c th Black Creek Canal virus.
n thng 7.2007 c 6 bang bo co nhim Hantavirus k t nm 1993: New Mexico
(69), Colorado (49), Arizona (46), California (43), Texas (33) v Washington (31). Cc bang
khc ang bo co vi mt s ca c ngha gm c Montana (25), Idaho (19) v Utah (24). Vi
ch 7 ca, Oregon c t l nhim bnh thp hn c ngha trong tt c v lin quan n qun th,
so vicc bang pha Ty.

II. C IM SINH HC LY TRUYN
loi gm nhm ni chung v loi chut ni ring, s ly nhim c th xy ra theo li
transmission horizontale c ngha l t con ny ly sang con khc.
Ngi b nhim qua vic ht th bi bm, tit vt dng li ti bay trong khng kh (aerosol) nh
phn, nc tiu, nc bt ca chut bnh.
Chng ta cng c th b nhim virus qua vt ct trn da, vt chut cn, qua nim mc mt v
ming, do nc hoc thc n bn b nhim Hantavirus trc .

Khng c bng chng v s ly t ngi ny sang ngi khc cng nh v s truyn bnh t vt
t hay vt chch ca cn trng.
Chut v loi gm nhm c xem l cha Hantavirus. Chng khng biu hin ra thnh bnh
(asymptomatique) nhng c th tit virus qua nc bt, nc tiu v phn.
Gia sc c th mang khng th (sro convertir) nhng khng c du hiu no cho thy c biu
hin ra thnh bnh hoc tit Hantavirus ra ngoi.

III. PHN LOI

Tn gi Hantavirus bt ngun t con sng Hantan, ni m cc virus Hantaan (bnh sinh
ca loi bnh st xut huyt Hn Quc) ln u tin c phn lp bi tin s Ho-Wang Lee v
cng s. Bnh ny lin quan n virus Hantaan gi l st xut huyt km theo hi chng thn
(hemorrhagic fever with renal syndrome_HFRS), mt thut ng c chp nhn bi T chc y
t th gii (WHO). Tn gi kinh in trc y l Korean hemorrhagic fever (st xut huyt
Hn Quc) t lu khng cn c s dng na.
Mt s thut ng m t th bnh do Hantavirus ngi nh Hi chng phi do
Hantavirus (HPS_Hantavirus pulmonary syndrome) hoc Hi chng st xut huyt th thn do
Hantavirus (tn ting Anh l HFRS_Hemorrhagic fever with renal syndrome hoc tn ting Php
l Fivre hmorragique avec syndrome rnal_FHSR) hay mt s tc gi khc gi Fivre
hmorragique de Core, Nphropathie pidmique,
Hin nay, y hc m t c 2 th bnh do Hantavirus gy ra trn ngi, gm bnh
vim phi do Hantavirus (thng gp Bc M v Nam M)
St xut huyt km theo suy thn (gp cc nc chu , chu u).
Ti TPHCM, bnh SXH do Hantavirus c xp vo nhm C trong phn loi bnh truyn
nhim nhm bnh t nguy him nht. Biu hin lm sng ca SXH do Hantavirus thng xut
hin sau khi nhim khong 1- 2 tun; khi pht vi cc triu chng st, n lnh, xut huyt
tng t nh bnh SXH Dengue, nhng giai on cui ca bnh c xut hin triu chng suy
thn. Bnh cha c thuc iu tr c hiu.

IV. CC TRIU CHNG BNH HC
Thi k bnh ko di t mt n su tun l.
ngi, Hantavirus c th gy ra 2 nhm hi chng:
1- Hi chng v thn km st xut huyt:
Bt u bng cc du hiu tng t nh cm cm trong vng t 3 n 6 ngy, mt mi cc ,
st, au nhc cc bp tht. i khi c th nhc u, chng mt, au bng v nn ma. Sau
thn b tn thng, suy thn, tng s t bo bch cu (thrombocytes) trong mu, ni cc nt
da, chy mu cam v tiu c mu.

2- Hi chng v phi, Hantavirus pulmonary syndrome (HPS):
Bt u nh cm cm ko theo mt thi gian th kh cp tnh, th ngn v ho.
T vong c th ln n 50%.


V. I TNG NO D B LY NHIM
-Nhng ngi no sng ti nhng ni c nhiu chut.
- Nhng ngi thng i do trong rng, ngoi ng trng hoc thch i cm tri.
- Nhng ngi lm vic trong cc kho hng hay ti nhng va thc la.
- Cc th in th, sa ng nc: v l do ngh nghip phi chui u vo x xnh c
chut sng trong .
- Chuyn vin cc cng ty dit chut, dit su b v cn trng.
- Nhng ngi lm rng, cc chuyn vin phng th nghim: thng s dng cc loi
chut hoc cc loi gm nhm hoang d.

VI. CCH PHNG CHNG

-Gi nh ca sch s ngn np ng thu ht chut b v cc loi gm nhm.
-Bt ht cc hang hc, l hng trong vch ni chut c th vo c.
-Dng by bt git chut.
-Nh mang bao tay khi phi s m chut.
-Chi ra, ty u nh ca bng nc javel (pha 3 mung canh javel cho mt lt nc).
-Khng bao gi qut hay dng my ht bi trc khi sn nh c ra sch.
-Git ra chn mn qun o vi nc nng.