Viêm màng não do não mô cầu

W khuin Neisseria meningitidis nhin qua kinh hiin v

^i$m mmot^ mo

do nao mo cau

Neisseria meningitidis

l a n da u tie n dfltfc

Weichselbaum xdc dinh la

tac nhdn gdy bgnh vigm mdng ndo

vao nam 1887. Tuy nhign, bgnh

ndo md cau da dugc Vieusseux md

td vdo ndm 1805 khi mgt fi dich

xay ra d khu vUc lan cdn Geneva,

Thuy Sy. Chdu A xay ra mdt so

vu dich bgnh ndo md cdu trong

30 ndm qua nhfl; Trung Qudc ndm

1979 - 1980, A Rdp Saudi ndm

1987, Mdng Cfi nam 1973 - 1974,

Yemen ndm 1988, Vidt Nam ndm

1997.. Chau Au va chau My trong

sufit 30 ndm qua cung cd dich bgnh

nhiTng khdng cao nhfl cdc khu vflc

khdc trgn thg' gidi.

Theo bdo cao ciia Vien Pasteur

TP.HCM, vigm mang nao do nao

md cdu Id benh Idy theo dfldng

hd hd'p, thirdng gap d lfla tuoi

tre vd cd khd nang gay dich.

Hai thfi lam sdng thfldng gdp la

viem mdng ndo va nhiem khuan

huyfit. Cd 5 - 10% ddn so tren the'

gidi Id ngfldi lanh mang trung.

U khu vflc khdng cd dich benh,

ty le mdc Id 0,5 - 10/100.000

24

>» BS. QUYNH VI^N

ddn/ndm, nhifng cd thfi ldn dd'n

1.000/100.000 ddn/nam trong

vung dich.

Tac nhan gdy b^nh: Neisseria

meningitidis la song cau khuan

gram (-). Dfla vao dde tinh khang

nguydn polysaecharid, vi khuan

Neisseria menigitidis dugc chia

thdnh 13 serogroup (nhdm huye't

thanh), trong dd cd 6 nhdm: A, B,

C, W-135, X va Y cd kha ndng gdy

dich. O ehfla cua vi khuan ndo md

cau trong tU nhidn la ngU&i. Thdi

gian u bgnh: 1-1 0 ngay, thdng

thfldng dfldi 4 ngay.

B$nh Idy truyfin qua cdc gigt

ban ra khi benh nhdn hat htfi vd

ngfl&i lanh hit phai, do tid'p xuc

true tidp dinh phai bgnh pham cd

chfla vi khuan vd d nhdn vien y tfi

khi lam thu thudt hdi sflc hd hdp

cho bgnh nhdn.

Ye'u td' nguy erf

- Yiu t6 mdi trUdng:

• Do am va bui cd the ldm gia

tdng sfl xam nhap cua nao mo cdu

do lam tfin thfltfng hdng rdo niem

mac trfle tie'p hodc bdng cdch flc

chg' hg miln dich nigm mac.

• Dieu kidn khi hdu khflng

thudn lgi, tlue'u thodng khi cCing Id

kha nang ddn dd'n Idy lan cua nao

md cdu,

- Yeu tddi ddn: vide di lai vd di

dan tao dilu kign cho sfl lflu hanh

cua cac chung cd dgc Iflc trong vd

ngodi vung/quo'c gia.

- Tdp trung ddng dl xdy ra

dich cho nhdm ngfl&i thdp phuong

(Mecca 1987) va dem mdm benh vi

nflde gdy dich (Chad, Sudan 1988).

- Tdp trung ddng nhdm dl cdm

nhiim Id yd'u tfi nguy ctf gdy dich,

dien hinh trong qudn dgi, noi c6

nhieu o dich dd xay ra, ddc biet Id

trdn cdc tan binh.

- Yiu to' kinh te - xa hdi: dilu

kign sdng kem, nhd d chdt chOi,

thie'u dnh nang mat trdi Id mgt

trong nhiing nguydn nhdn lam cho

ty lg vidm mdng nao do nao mfi

cdu tang cao.

- Yiu to dong nhiem: nhilm

trung dfl&ng hd hd'p trdn cfi th^

gdp phan vao mgt sfi o dich viem

mdng ndo do ndo md cau. Mfii lidn

quan gifla bgnh nhigm triing ho

hap cap tinh vd benh vigm mang

ndo da dflgc tim thdy ca d vung khi

hgu dn ddi vd nhiet ddi.

Bd't evC liia tuoi ndo cung

CO kba nang nhiem b^nh, dgc

bigt d:

- Trd nhd dudi 2 tufii

- Thanh thie'u nien 16 - 21 tufii

- Hgc sinh sinh vidn sfing trong

ky tuc xd vd cac si quan, tdn binh tdp

kfit trong cac doanh trgi qudn d6i.

- Bgnh nhdn cd tinh trang sflc

khde ddc bigt nhU cat bd la lach

hodc mgt sfi khig'm khuyfit ciia h$

thdng miln dich.

Tri^u chiing b^nh rat ddc

trung vdi ban xud't huye't hoai tfl

hinh sao trdn da, y vdn trudc ddy

ggi la tfl ban hinh ban dl vi ban

cd mdu dd do xud't huyfit vd hinh

dang ngoan ngoeo nhfl bdn dfi mOt

vung. Cac dau higu khdc la:

- Bieu hign nhilm trflng ro: sot

cao dgt nggt, cd thfi cd rdt run, ho,

dau hgng, met mdi, nhflc ddu.

- Bieu hien mdng nao: dau dau dd

dgi, buon ndn, ndn, tdo bdn, gdy cflng

(dd'u hidu Kernig va Brudzensky

dflcfng tinh), d tre nhd thdp chite

dong thi thay thdp phong.

THUOC & S0C KHOE sfi 507 (1.9.2014)