ROTAVIRUSI
ROTAVIRUSI
Rotavirusi su veoma čest uzročnik teških, akutnih proliva kod odojčadi i male dece. Uglavnom napadaju odojčad i decu do treće godine, ponekad se mogu javiti i do pete godine. Skoro svako malo dete do pete godine se u nekom trenutku zarazi ovim virusom. Imunitet se razvija svakim novim kontaktom sa virusom, tako da su ponovljene infekcije uglavnom lakše i iz tog razloga su najmlađa deca najviše ugrožena, a starija deca se uspešno odupiru ovoj virusnoj infekciji. Pored proliva javlja se i povraćanje.
Ovi virusi su izuzetno zarazni i lako se prenose, najčešće fekalno-oralnim putem preko kontaminiranih predmeta (obično su to igračke koje su bile u kontaktu sa stolicom) i kapljičnim putem od druge zaražene osobe. Ovakav način širenja je upravo uzrok velike rasprostranjenosti i učestalosti infekcije, a neretko i uzrok velikih epidemija. Najčešće se javljaju u zimskim mesecima, ali mogu biti prisutni tokom čitave godine.
Da je reč o rotavirusima potvrđuje se otkrivanjem rotavirusnih antigena u stolici.
SIMPTOMI INFEKCIJE
Simptomi se javljaju nakon 2 dana od kontakta sa virusom. Ova virusna infekcija počinje naglo, povraćanjem koje se nastavlja vodenastim prolivom i bolovima u stomaku. Ponekad se javlja i visoka temperatura. Povraćanje nekada može da izostane, a dominantni simptom su česte i vodenaste stolice, nekada i više od 10 dnevno. Sve ovo jako iscrpljuje bebe i decu, a najveća opasnost preti od dehidracije. Rotavirusi su najčešći uzročnik hospitalizacije dece zbog teške slike dehidracije (gubitak tečnosti i elektrolita). Teške akutne dijareje takođe spadaju među najčešće uzroke smrtnosti odojčadi i dece.
PRVO I OSNOVNO – SPREČITI DEHIDRATACIJU
Lak protiv ove infekcije ne postoji, virus se spontano eliminiše uglavnom kroz tri dana kroz stolicu. Antibiotici uništavaju dobre bakterije koje doprinose borbi protiv virusa, tako da je primena antibiotika u situaciji infekcije rotavirusima ne samo beskorisna, već i štetna.
Kada se jave proliv i povraćanje, najbitnije je sprečiti dehidraciju. Dete treba stalno hidrirati vodom (bebe što češće dojiti), a u težim slučajvima treba davati rehidracione rastvore vode i elektrolita . Rehidracija je nadoknada izgubljene tečnosti i elektrolita. Na tržištu postoji veliki izbor rastvora za rehidrataciju koje treba davati detetu tokom celog dana, postepeno, gutljaj po gutljaj u pravilnim vremenskim intervalima, a ako dete povraća, onda na svakih 20-30 minuta. U težim slučajevima dete može završiti u bolnici, gde će se rehidrirati putem infuzije. Infekcija može da traje dosta dugo i do 8 dana, a u težim slučajevima i duže.
Pored rastvora za rehidrataciju, detetu treba dati i probiotik koji je povećati koncetraciju dobrih bakterija i pomoći eliminaciju virusa iz creva. Ishrana takođe ima vrlo važnu ulogu u ozdravljenju, a kako se infekcija često javlja kod male dece, češće dojenje ili konzumacija adapriranog mleka mogu biti od velikog značaja. Izbegavati proizvode koji sadrže mlečni šećer zbog otežanog varenja i iritacije creva koja može nastupiti.
Vrlo je važno prepoznati da je dete dehidriralo, a simptomi dehidracije su: dete slabo mokri, mokraća je tamne boje i neprijatnog mirisa, koža je neelastična, bleda i hladna, ubrzan je rad srca, usne su suve i ispucale, žeđ je pojačana, može se javiti i vrtoglavica i dezorijentisanost.
Pedijatru se treba javiti ukoliko se jave simptomi dehidratacije, ukoliko dete često povraća i ima dijareju duže od 24 h, ukoliko ima visoku temperaturu ili ukoliko primetite krv u stolici ili je stolica crne boje.
PREVENCIJA
Postoji vakcina protiv rotavirusa koja se daje u uzrastu od 6. do 24. nedelje života u dve doze. Vakcina sadrži oslabljeni virus koji ne može da izazove infekciju, ali izaziva imuni odgovor i štiti od svih tipova ovog virusa. U pripremi je i drugi tip vakcine koja će se dobijati u tri doze oralnim putem.
Pored vakcine, održavanje higijene je važan način prevencije ove infekcije. Često pranje ruku, naročito pre jela, je ključno, a povremeno treba dezinfikovati i dečje igračke i površine sa kojima dete dolazi u kontakt. Dete je zarazno tokom trajanja simptoma, ali i 3 dana nakon prestanka simptoma, pa ga je u tom periodu potebno isključiti iz kolektiva.
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