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4 Nentor 2023<\/p>\n
Lija e majmun\u00ebve \u00ebsht\u00eb nj\u00eb virus q\u00eb e ka prejardhjen nga kafsh\u00ebt e egra si brejt\u00ebsit dhe primat\u00ebt dhe q\u00eb ndonj\u00ebher\u00eb kalon te njer\u00ebzit. I p\u00ebrket s\u00eb nj\u00ebjt\u00ebs familje virusesh si s\u00ebmundjet e tjera t\u00eb lis\u00eb.<\/p>\n
Virusi i lis\u00eb s\u00eb majmunit, Monkeypox virus, b\u00ebn pjes\u00eb n\u00eb Familjen Poxviridae, n\u00ebnfamiljen Chordopoxvirinae, gjinia Orthopoxvirus. N\u00eb k\u00ebt\u00eb gjini b\u00ebjn\u00eb pjes\u00eb edhe Variola virus (varicela n\u00eb njer\u00ebz) dhe Co\u00ebpox dhe Vaccinia virus (lija e lop\u00ebve). Virionet infektive jan\u00eb t\u00eb m\u00ebdhenj 220-450 nm, t\u00eb mb\u00ebshtjell\u00eb, n\u00eb form\u00eb tulle ose ovoide. \u00cbsht\u00eb virus me AND. Brenda kapsid\u00ebs s\u00eb virusit ndodhet genoma e p\u00ebrb\u00ebr\u00eb nga ADN dyzinxhirore, lineare si dhe enzimat e nevojshme p\u00ebr replikimin viral. Replikimi ndodh n\u00eb citoplazm\u00ebn e qeliz\u00ebs s\u00eb bujt\u00ebsit.<\/p>\n
Nuk ngjitet materiali gjenetik i virusit n\u00eb materialin gjenetik t\u00eb qeliz\u00ebs s\u00eb bujt\u00ebsit. Ashtu si \u00e7do virus tjet\u00ebr me AND, ndryshon shum\u00eb pak me kalimin e koh\u00ebs, k\u00ebshtu q\u00eb antitrupat edhe si pasoj\u00eb e kujtes\u00ebs imunitare t\u00eb bujt\u00ebsit, vlejn\u00eb p\u00ebr nj\u00eb koh\u00eb t\u00eb gjat\u00eb, n\u00eb ndryshim me viruset me ARN (si p.sh. Covid-19) te t\u00eb cil\u00ebt karakteristike jan\u00eb ndryshimet e vazhdueshme gjenetike q\u00eb k\u00ebrkojn\u00eb p\u00ebrdit\u00ebsimin e vaksinave.<\/p>\n
Edhe pse orthopoksviruset jan\u00eb antigjenikisht dhe gjenetikisht t\u00eb ngjash\u00ebm, ata paraqesin ndryshime t\u00eb dukshme n\u00eb virulenc\u00eb dhe i hasim n\u00eb nj\u00eb gam\u00eb t\u00eb gjer\u00eb bujt\u00ebsish. Studimet krahasuese t\u00eb genom\u00ebs kan\u00eb treguar se orthopoksvirus\u00ebt evoluojn\u00eb vazhdimisht dhe ky evoluim nxitet nga bujt\u00ebsi. Mendohet se gjat\u00eb evolucionit, genoma virale ka p\u00ebsuar humbje progresive t\u00eb gjeneve, kryesisht n\u00eb skajet p\u00ebrfundimtare t\u00eb saj. Capripox virus (CPXV), i cili shkakton nj\u00eb infeksion t\u00eb leht\u00eb te njeriu, p\u00ebrmban genom\u00ebn m\u00eb t\u00eb madhe nd\u00ebr orthopoxviruset e sekuencuar (H\u201d220 kb) dhe ka nj\u00eb shtrirje t\u00eb gjer\u00eb bujt\u00ebsish q\u00eb p\u00ebrfshin njeriun, brejt\u00ebsit, felin\u00ebt, gjedh\u00ebt dhe kafsh\u00ebt sht\u00ebpiake. Nd\u00ebrsa virusi i varicel\u00ebs (lija n\u00eb njer\u00ebz) \u00ebsht\u00eb shum\u00eb patogjen (mortalitet shkon deri 30%), ka genom\u00ebn m\u00eb t\u00eb vog\u00ebl nga t\u00eb gjith\u00eb orthopoxviruset natyral\u00eb (H\u201d186 kb), kodon 20% m\u00eb pak proteina funksionale se Capripox virus dhe ka nj\u00eb gam\u00eb buj\u00ebsish t\u00eb kufizuar.<\/p>\n
![\"\"](\"https:\/\/konica.al\/wp-content\/uploads\/2022\/06\/profesor-Bejo-Bizhaga.jpg\")
\nVirusi i lijes s\u00eb majmunit ka genom\u00eb me madh\u00ebsi 197 nm, me rreth 120kb. Sekuencat e rajoneve qendrore t\u00eb kodimit n\u00eb genom\u00eb jan\u00eb t\u00eb ruajtura mir\u00eb, nd\u00ebrsa skajet e genom\u00ebs jan\u00eb t\u00eb ndryshueshme. Gjenet e zbuluar n\u00eb pjes\u00ebn e fundme t\u00eb genom\u00ebs s\u00eb virusit lidhen ngusht\u00eb me p\u00ebrcaktimin e p\u00ebrgjigjes imunitare t\u00eb bujt\u00ebsit dhe shumica e tyre jan\u00eb p\u00ebrcaktues t\u00eb patogjenitetit t\u00eb virusit dhe p\u00ebrshtatshm\u00ebris\u00eb s\u00eb bujt\u00ebsit. Ky ndryshim progresiv i gjeneve nuk \u00ebsht\u00eb thelb\u00ebsor p\u00ebr patogjenez\u00ebn te njer\u00ebzit, por \u00ebsht\u00eb mekanizmi q\u00eb \u00e7oi n\u00eb shfaqjen e nj\u00eb virusi me p\u00ebrshtatshm\u00ebri shum\u00eb t\u00eb lart\u00eb, i cili shkakton nj\u00eb s\u00ebmundje mjaft serioze dhe \u00ebsht\u00eb i aft\u00eb t\u00eb transmetohet shum\u00eb shpejt nga njeriu te njeriu. Ndryshimi i numrit t\u00eb kopjeve t\u00eb gjeneve mund t\u00eb jet\u00eb nj\u00eb faktor vendimtar p\u00ebr modulimin e p\u00ebrshtatshm\u00ebris\u00eb s\u00eb virusit. Plasticiteti genomik i shtameve t\u00eb Monceypox virus \u00ebsht\u00eb evidentuar sidomos te pacient\u00ebt e trajtuar p\u00ebr s\u00ebmundjen e lis\u00eb s\u00eb majmunit.<\/p>\n
Lija e majmun\u00ebve \u00ebsht\u00eb s\u00ebmundje zoonotike virale q\u00eb shfaqet kryesisht n\u00eb zonat tropikale t\u00eb pyjeve t\u00eb Afrik\u00ebs Qendrore dhe Per\u00ebndimore dhe her\u00eb pas here eksportohet n\u00eb rajone t\u00eb tjera. Shumica e rasteve t\u00eb identifikuara tek njer\u00ebzit kan\u00eb qen\u00eb n\u00eb Afrik\u00ebn qendrore dhe per\u00ebndimore dhe p\u00ebrhapja ka qen\u00eb relativisht e kufizuar. Kontakti me vuajt\u00ebsin e infestuar tregon p\u00ebr r\u00ebnd\u00ebsin\u00eb e kontrollit t\u00eb populacioneve t\u00eb kafsh\u00ebve t\u00eb egrave dhe r\u00ebnd\u00ebsin\u00eb e jasht\u00ebzakonshme t\u00eb sh\u00ebrbimit veterinar n\u00eb nj\u00eb bot\u00eb dhe nj\u00eb sh\u00ebndet.<\/p>\n
Rrug\u00ebt e transmetimit: Rruga e zakonshme e transmetimit p\u00ebr k\u00ebt\u00eb kategori virusesh \u00ebsht\u00eb n\u00ebp\u00ebrmjet kontaktit t\u00eb ngusht\u00eb me vuajt\u00ebsin e infektuar, sendeve t\u00eb tyre personale si veshjet apo shtratin, si dhe kontakti i drejtp\u00ebrdrejt\u00eb me l\u00ebngjet trupore (mikropika, gjak, etj.) t\u00eb pacient\u00ebve, lezioneve t\u00eb tyre dhe sendeve q\u00eb preken nga t\u00eb dyja pal\u00ebt. Transmetohet n\u00ebp\u00ebrmjet mukozave. Njer\u00ebzit mund t\u00eb infektohen me virusin n\u00ebse kafshohen ose g\u00ebrvishten nga nj\u00eb kafsh\u00eb e infektuar, duke ngr\u00ebn\u00eb mishin e kafsh\u00ebve t\u00eb infektuara, n\u00ebp\u00ebrmjet kontaktit me nj\u00eb mbart\u00ebs t\u00eb infektuar, ose duke prekur gjith\u00e7ka t\u00eb kontaminuar prej virusit. Virusi hyn n\u00eb trup n\u00ebp\u00ebrmjet lezioneve t\u00eb l\u00ebkur\u00ebs, traktit respirator ose mukoz\u00ebs (syve, hund\u00ebs dhe goj\u00ebs).<\/p>\n
Simptomat jan\u00eb t\u00eb nj\u00ebjta n\u00eb t\u00ebr\u00eb kategorin\u00eb e vuajt\u00ebsve, p\u00ebrshir\u00eb njeriun. S\u00ebmundja zgjat dy deri n\u00eb kat\u00ebr jav\u00eb dhe simptomat mund t\u00eb shfaqen 5 deri n\u00eb 21 dit\u00eb pas infektimit. Simptomat e lis\u00eb s\u00eb majmunit zakonisht fillojn\u00eb me nj\u00eb kombinim t\u00eb etheve, dhimbje koke, dhimbje muskujsh, dhimbje shpine, t\u00eb dridhura, rraskapitje dhe \u00ebnjtje t\u00eb nyjave limfatike. Simptoma e fundit \u00ebsht\u00eb zakonisht ajo q\u00eb i ndihmon mjek\u00ebt t\u00eb dallojn\u00eb lin\u00eb e majmunit nga lit\u00eb e tjera.<\/p>\n
Pasi ethet jan\u00eb t\u00eb pranishme, simptoma kryesore e lis\u00eb s\u00eb majmun\u00ebve 24 or\u00eb m\u00eb von\u00eb zakonisht shfaqet me skuqje e l\u00ebkur\u00ebs, q\u00eb p\u00ebrhapet n\u00eb gjith\u00eb pjes\u00ebt e trupit t\u00eb vuajt\u00ebsit (gjeneralizohet). Periudha e inkubacionit (intervali nga infeksioni deri n\u00eb fillimin e simptomave) e lis\u00eb s\u00eb majmunit zakonisht zgjat nga 6 deri n\u00eb 13 dit\u00eb, por mund t\u00eb varioj\u00eb edhe nga 5 deri n\u00eb 21 dit\u00eb. \u00cbsht\u00eb i nj\u00ebjt\u00eb n\u00eb t\u00eb gjith\u00eb mbart\u00ebsit, p\u00ebrfshir\u00eb njeriun.<\/p>\n
Infeksioni ndahet n\u00eb dy periudha:<\/p>\n
1. Periudha e invazionit (zgjat 0-5 dit\u00eb) karakterizohet me ethe, dhimbje t\u00eb forta t\u00eb kok\u00ebs, limfadenopati (\u00ebnjtje e nyjeve limfatike), dhimbje n\u00eb kurriz, mialgji (dhimbje t\u00eb muskujve) dhe asteni intensive (lodhje, munges\u00eb energjie). Limfadenopatia \u00ebsht\u00eb karakteristik\u00eb e lis\u00eb s\u00eb majmunit dhe e dallon at\u00eb nga s\u00ebmundjet e tjera q\u00eb fillimisht mund t\u00eb duken t\u00eb ngjashme (lija e dhenve, fruthi, rubeola).<\/p>\n
2. Shp\u00ebrthimet n\u00eb l\u00ebkur\u00eb zakonisht fillojn\u00eb brenda 1 deri n\u00eb 3 dit\u00eb pas fillimit t\u00eb temperatur\u00ebs. Shp\u00ebrthimi ka tendenc\u00eb t\u00eb jet\u00eb m\u00eb i p\u00ebrqendruar n\u00eb fytyr\u00eb dhe gjymtyr\u00eb sesa n\u00eb trup. Prek fytyr\u00ebn (n\u00eb 95% t\u00eb rasteve) dhe p\u00ebll\u00ebmb\u00ebt e duarve dhe k\u00ebmb\u00ebve (n\u00eb 75% t\u00eb rasteve). Prek edhe membranat dhe mukoz\u00ebn orale (n\u00eb 70% t\u00eb rasteve), organet gjenitale (30%) konjunktiva (20%), si dhe kornen\u00eb. Kalon gradualisht nga makulat (lezione me baz\u00eb t\u00eb shesht\u00eb) n\u00eb papula (n\u00eb papula (lezione t\u00eb forta pak t\u00eb ngritura), vezikula (lezione t\u00eb mbushura me l\u00ebng t\u00eb past\u00ebr), pustula (lezione t\u00eb mbushura me l\u00ebng t\u00eb verdh\u00eb) dhe kore q\u00eb thahen dhe bien. Numri i lezioneve varion nga disa n\u00eb disa mij\u00ebra. Tek rastet e r\u00ebnda lezionet mund t\u00eb bashkohen dhe k\u00ebshtu t\u00eb heqin pjes\u00eb t\u00eb m\u00ebdha t\u00eb l\u00ebkur\u00ebs.<\/p>\n
Lezionet e l\u00ebkur\u00ebs i n\u00ebnshtrohen nj\u00eb procesi t\u00eb maturimit, nga degjenerimi makular (lezionet e sheshta) te papulat (lezionet e ngritura), vezikulat (plagat e mbushura me l\u00ebng), m\u00eb pas fshik\u00ebzat (plagat e mbushura me qelb) dhe m\u00eb pas korja p\u00ebrpara se t\u00eb zhduket p\u00ebrfundimisht.<\/p>\n
Personat e rrezikuar: lija e majmun\u00ebve \u00ebsht\u00eb treguar se shkakton vdekje deri n\u00eb 10% t\u00eb pacient\u00ebve t\u00eb infektuar n\u00eb Kongo, krahasuar me rreth 30% p\u00ebr llojet e tjerave t\u00eb live.<\/p>\n
Vdekshm\u00ebria \u00ebsht\u00eb m\u00eb e lart\u00eb te f\u00ebmij\u00ebt dhe t\u00eb rinjt\u00eb, tek individ\u00ebt me imunitet t\u00eb kompromentuar dhe paraqet rrezik t\u00eb ve\u00e7ant\u00eb tek individ\u00ebt me s\u00ebmundje serioze. Lija e majmun\u00ebve gjat\u00eb shtatz\u00ebnis\u00eb gjithashtu mund t\u00eb \u00e7oj\u00eb n\u00eb komplikime si lindje t\u00eb parakohshme ose lindje me fetus t\u00eb vdekur. Mbart\u00ebsit me simptoma t\u00eb lehta t\u00eb lis\u00eb te majmun\u00ebt mund t\u00eb mos zbulohen dhe mund t\u00eb p\u00ebrb\u00ebjn\u00eb si rreziku kryesor i transmetimit nga mbart\u00ebsi n\u00eb vuajt\u00ebsin pasardh\u00ebs.<\/p>\n
Testimi mund t\u00eb jet\u00eb i v\u00ebshtir\u00eb p\u00ebr t\u00eb diagnostikuar lin\u00eb e majmunit pasi shpesh ngat\u00ebrrohet me infeksione t\u00eb tjera si lija e dhenve q\u00eb i p\u00ebrkasin s\u00eb nj\u00ebjt\u00ebs kategori. Lija e majmun\u00ebve konfirmohet nga nj\u00eb vler\u00ebsim klinik nga nj\u00eb profesionist sh\u00ebndet\u00ebsor dhe nj\u00eb test n\u00eb nj\u00eb laborator t\u00eb specializuar. Testi p\u00ebrfshin marrjen e mostrave nga lezionet e l\u00ebkur\u00ebs, l\u00ebngje nga lezionet dhe pjes\u00eb t\u00eb kores s\u00eb that\u00eb, ose pjes\u00eb t\u00eb kores\u00eb.<\/p>\n
Vaksinimi: Vaksina e lis\u00eb s\u00eb majmunit gjendet n\u00eb treg dhe mund t\u00eb mbroj\u00eb kund\u00ebr saj, sepse \u00ebsht\u00eb i nj\u00ebjti virus q\u00eb pothuajse nuk ndryshon. Duhet t\u00eb vaksinohen vet\u00ebm individ\u00ebt apo populacionet dhe grupet e rriskuara. Rezultatet e vaksinimit tregojn\u00eb se ai parandalon rreth 85% t\u00eb rasteve t\u00eb kontaktit me virusin. Vaksina e lis\u00eb s\u00eb majmun\u00ebve nuk shkakton s\u00ebmundje tek i vaksinuari. P\u00ebr shkak t\u00eb ngjashm\u00ebris\u00eb s\u00eb tij me viruset e tjera t\u00eb lis\u00eb, antitrupat e prodhuar kund\u00ebr k\u00ebtij virusi ofrojn\u00eb mbrojtje t\u00eb kryq\u00ebzuar.<\/p>\n
Parandalimi k\u00ebrkon eliminimin e kontaktit direkt me bujt\u00ebsin e infektuar si m\u00ebnyra kryesore e parandalimit t\u00eb live. Njer\u00ebzit (t\u00eb gjith\u00eb vuajt\u00ebsit potencial\u00eb) duhet t\u00eb minimizojn\u00eb kontaktet me kafsh\u00ebt e egra dhe n\u00eb rastet kur kjo nuk mund t\u00eb evitohet, ato duhet t\u00eb kontrollohen t\u00eb jen\u00eb t\u00eb pastra nga lit\u00eb. Nuk duhet t\u2019u afrohen majmun\u00ebve t\u00eb eg\u00ebr, si dhe majmun\u00ebve t\u00eb z\u00ebn\u00eb rob dhe duhet treguar kujdes i nevojsh\u00ebm kur futen n\u00eb habitatet e kafsh\u00ebve t\u00eb egra (zooparqe) p\u00ebr t\u00eb shmangur kontaktet, kafshimet ose g\u00ebrvishtjet prej tyre. P\u00ebr shembull, ketrat e pem\u00ebve jan\u00eb shum\u00eb t\u00eb k\u00ebndsh\u00ebm, por gjat\u00eb kontaktit ata mund t\u00eb g\u00ebrvishtin dhe kafshojn\u00eb duke p\u00ebrhapur virusin. Gjithashtu, konsumi i mishit t\u00eb pagatuar mir\u00eb prej kafsh\u00ebve t\u00eb egra (ve\u00e7an\u00ebrisht brejt\u00ebsve dhe majmun\u00ebve) mbart rrezikun e kontraktimit t\u00eb njeriut dhe kafsh\u00ebve. Nj\u00eb m\u00ebnyr\u00eb p\u00ebr parandalimin e lis\u00eb s\u00eb majmun\u00ebve \u00ebsht\u00eb edhe vaksinimi parandalues kund\u00ebr variol\u00ebs. S\u00ebmundja duhet t\u00eb trajtohet sa m\u00eb shpejt t\u00eb jet\u00eb e mundur p\u00ebr t\u00eb parandaluar komplikime t\u00eb m\u00ebtejshme. Mbart\u00ebsit e diagnostikuar me lin\u00eb e majmun\u00ebve k\u00ebrkojn\u00eb trajtim t\u00eb menj\u00ebhersh\u00ebm mjek\u00ebsor. K\u00ebrkohet regjim pushimi dhe diet\u00eb. Sidomos n\u00eb faz\u00ebn akute t\u00eb s\u00ebmundjes, dieta duhet t\u00eb p\u00ebrb\u00ebhet nga ushqime t\u00eb buta dhe t\u00eb lehta. Vuajt\u00ebsi duhet t\u00eb pij\u00eb shum\u00eb l\u00ebngje dhe t\u00eb shmang\u00eb kafein\u00ebn dhe alkoolet. Te njer\u00ebzit n\u00eb var\u00ebsi t\u00eb m\u00ebnyr\u00ebs se si s\u00ebmundja p\u00ebrparon, pacienti mund t\u00eb ket\u00eb nevoj\u00eb p\u00ebr disa dit\u00eb deri n\u00eb jav\u00eb pushim n\u00eb shtrat pas shtrimit n\u00eb spital dhe pacient\u00ebt q\u00eb v\u00ebrejn\u00eb simptoma ose ankesa t\u00eb pazakonta duhet menj\u00ebher\u00eb t\u00eb flasin me mjekun specialist.<\/p>\n
Konica.Al<\/p>\n","protected":false},"excerpt":{"rendered":"
4 Nentor 2023 Lija e majmun\u00ebve \u00ebsht\u00eb nj\u00eb virus q\u00eb e ka prejardhjen nga kafsh\u00ebt e egra si brejt\u00ebsit dhe primat\u00ebt dhe q\u00eb ndonj\u00ebher\u00eb kalon te njer\u00ebzit. I p\u00ebrket s\u00eb nj\u00ebjt\u00ebs familje virusesh si s\u00ebmundjet e tjera t\u00eb lis\u00eb. Virusi i lis\u00eb s\u00eb majmunit, Monkeypox virus, b\u00ebn pjes\u00eb n\u00eb Familjen Poxviridae, n\u00ebnfamiljen Chordopoxvirinae, gjinia Orthopoxvirus. 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