Mizoram leh rannung seh natna (scrub typhus)
Lalfakzuala Pautu
Public Health Entomologist,IDSP,DHS
Public Health Entomologist,IDSP,DHS
Rannung seh natna kan tihmai,Scrub typhus hi Orientia tsutsugamushi natna hrik in mihringa natna a thlen hi a ni.Tsutsuga awmzia chu hlauhawm tihna a ni a, mushi tih chuTuhrik (mites) tihna a ni. Tuhrik (Trombiculid mites) te hian Transovarial (a puiin a note ah)leh transtadial (a note in a pui anih thleng an inhlan chhawng) transmission in heng natna hrik hi an kengkual thin a ni. Scrub typhus hi kum 1899 khan Japan ramah chiang taka hriatchhuah hmasakber a ni. A hming Scrub typhus tih hi he natna lo awmtan duhna hmuna hnim hming Shrub (hnim lianlo) atang a phuahchhuah a ni. He natna hi kumtin mi maktaduaih khat velin an vei thin a, a veite hi enkawlna mumal pek an nihloh chuan za a sawmthum velin an thihpui thin a ni. He natna hi Tuhrik Scrub typhus natna hrik pai in mi a seh atanga ni 10-12 chhungin a langchhuak thin ani.
RANNUNG SEH NATNA (SCRUB TYPHUS) THEHDARH DAN
Scrub typhusnatna hrikte hian inthlahpun nan leh thanlen nan (reservoir),sazu lam chiho(rodents) te hi an hmang a, heng sazute atang hian tuhrik in natna hrik chu lachhawngin mihringah an thehdarh ta thin ani.Tuhrikte hi an tehle a, chi(species) tamtak phei chu mitlawngin an hmuhtheihloh a ni.India rama he natna thehdarhtu tuhrik (vector) chu Leptotrombidium deliense ani a, Japan leh khawchhak lam ramah te chuan Leptotrombidium akamushi in a thehdarh thung ani.Tuhriksehna ah khan hmuamhma(eschar) pankhir alo awm thin a, he natna hmuhchuah nan a tangkai hle a mahse hei hi 40-50% ah chauh a awm thin ani.Mite (Tuhrikte) hian an damchhung hian pianhmang leh nihphung danglamna (life cycle) chhawng li an kaltlang thin a, chungte chu, Egg,Larva,Nymph leh Adult te an ni. Larva an nih lai chauh hian he natna hi an thehdarh thei a ni.
RANNUNG SEH NATNA AWMNA HMUN TE
Khawvel hmun thenkhat ah chuan he Scrub typhus natna hi engtiklai pawhin a awm reng a, heng hmunte hi “Tsutsugamushi Triangle” an vuah a ni a, India ram pawh hi a telve ani.Scrub typhus natna lanchhuahna leh awmduhna hmunte chu:-
1. Mites (Tuhrik) awm duhna hmun ,rambua leh dai hnimhmun te.
2. He natna hi hmunbik huam zau vak lo ah a thleng thin.
3. He natna doletna neilo antamna hmun ah.
4. Hun kaltawh a rannungseh tawk ngailote ah a thleng duh bik bawk
HE NATNA HI MIZORAMAH ENGTIKLAI ATANGA LO AWMTAN NGE A NIH ?
He natna hi India ram hmun dangah chuan tunhma a natna lo awm tawh thin, lo lang nawn leh, re-emerging disease a chhiar a ni a, Mizoram ah hian engtiklai atanga lo awm tan nge tih hi hriattheih ani lova, a awmna a rei viau tawh maithei a, natna lo awm thar, emerging disease pawh ani thei tho bawk. Amaherawh chu Mautam (bamboo flowering) 2007-2009 chho vela tang khan he natna hi nasa takin a lo pung chho ta niin a ngaih theih a, mautam avang a, he natna natural reservoir Sazu a pun nasat vang anih a rinawm bawk ani. Kum 2012 kumtir atang khan Directorate of Health Services hnuaia Integrated disease surveillance programme (IDSP) chuan Sawrkar leh Private damdawiin te atangin he natna veite data hi lakhawmin a chhinchhiah zel a, Central IDSP, Delhi ah data hi a thawn thla thin a ni. IDSP, chhinchhiah danin, kum 2012 a tanga July 2018 thla thleng hian a vei mi 2143 leh thihpui mi 42 an awm tawh bawk a ni.
TUNHNAI AH HE NATNA HI ENGVANGA LO PUNG VAK NGE NI THEI ANG ?
Mautak (Mellocana) tam, flowering/death atang khan he natna hi Mizoramah hian a hluar ta hle mai a, min chenchilh (endemic) tlat tawh niin a lang. Tin, kumin 2018 chhung hian he natna hi nasa takin a hluar leh a, he natna hrileng nasa pawh hi hmun 5 laiah a thleng tawh bawk a, mi 1152 in vei tawhin, mi 7 laiin an thihpui tawh bawk a ni. Kumin chhunga heti taka he natna hluar na chhan ni a lang pawimawh tak pakhat chu, tunhnai hian Raw chikhat Mizoten Rawnal kan tih mai, (Dendrocalamus longispathus) hi Mizoram chhungah hian a tam nasa hle mai a, he natna hrileng awmna hmuna zirchianna atanga a landan in, Rawtam hian sazu te hi a tipung niin a hriat a, fur ruahtui tam hian Tuhrikte pawh hi a tipung nasa thei hle a ni. Heng a natna kawltu ber (Reservior) Sazu te leh Tuhrik, he natna thehdarhtu te an pun tak avang hian he natna pawh hi kum dang aiin a hluar ta niin a lang a ni. He natna hi kumdangah chuan October to January thla chhung hian a hluar bik thin a, thal ah leh fur ah te chuan vei an tlem thei hle a ni.
HE NATNA DAMDAWI ATAN HIAN RULSA HI A THA EM ?
Tunlai hian Mizoramah hian, he natna veite enkawl nan “Rulsa eitir a tha” tih hi a lar hle mai a, hei hi engmah scientific prove awmlo a ni a, a lo tha viau maithei a, a thalo maithei bawk, he mi chungchang a paper emaw thuziak hmuhtur a awm lemloh miau avangin. Mi in an ei a “ka dampui” an ti a nih chuan a tha ani mai a, amaherawhchu, damdawi manto tak pawh ni lemlo, zirchianna tamtak an neih hnu a, he natna enkawl nan leh tihdam nan a tha tih an prove tawh ngei te tam tak leitur a awmreng laia, rulsa treatment, a hmuh harsa zawk rin zawk tlat erawh a fuh chiahlo maithei. Scrub typhus natna veite hi enkawlna diktak pek an nih lohin a vei mi 100 zinga mi 30 vel (30%) thlengin an thihpui thei tih ani a, enkawlna engmah pelo mahse 70 % vel hi chu an damchhuak leh tho thin a, Rulsa emaw thildang sa an ei vang ni lo pawh in. “Rulsa a tha” titu te zingah pawh hian, he natna veite treatment atana rulsa chauh hmang a, damdawi dang ei miahlo ngam erawh mi an tamlo maithei a ni. Tin, he natna hi a vei tawh te pawhin an vei nawn leh thei tho bawk a ni.
HE NATNA ENKAWL NANA RULSA HMAN IN A NGHAWNG THEIH TE
He natna enkawl nan hian rulsa hi lo tha tehreng pawh nisela ( ka ring lemlo na a ), He natna veite enkawl nan rul kan thah vak mai chuan ecological balance kan tibuai thei dawn a ni. Rul te hian sazu te hi chaw atan an ei thin a, sazu pung nasa luttuk tur kha nasa takin an veng a, sazu te hi Scrub typhus natna hrikte inthlahpunna leh thanlenna (natural reservoir) an nih avangin a eitu ber damdawi ti a, kan thah zel mai chuan nasa takin an lo pung anga, he natna pawh hi a lo pung nasa lehzual dawn a ni. Chuvangin, Rulsa treatment atana hman hian nghawng thalo tak a thlen theih avangin, sawimawi tlak anilo a ni.
HE NATNA RESERVIOR CHUNGCHANG
India ramah hian sazu chi hrang hrang te hian he natna hi an pai ani tih hi hmuhchhuah a ni tawh a, zirchianna neih belh zel ani mek bawk a ni. Mizoramah pawh hian sazu te mai bakah Chepa (Tupaia belangeri) ah pawh he natna hi hmuhchhuah ani tawh a, tunlaia hrilenna hmun ah te leh hmun dangah pawh he zirchianna hi neih mek zel a ni. Sazu thisen te hi enfiah zel an ni. New Economoc Development Project (NEDP) atang pawhin hetiang lama zirchianna/ research neihna tur sum hi hmuh ani bawk a ni.
HE NATNA THEHDARHTU CHUNGCHANG
Scrub typhus natna hrikte hi tuhrik in mihring ah an thehdarh a, khawvelah hian tuihrik hi chi (species) sang tam tak an awm a, heng zinga thenkhat te hian he natna hi an thehdarh a ni. India ram he natna thehdarhtu ber tuhrik hi Leptotrombidium deliense a ni a, Japan leh khawchhak lam ramah te chuan Leptotrombidium akamushi in a thehdarh nasa ber a ni. Mizoram ah pawh hian Leptotrombidium deliense hian a thehdarh ngei ani tih hi hmuhchhuah ani tawh a, Tuhrik chi dang te hian an thehdarh ve em tih hi zirchianna neih mek a ni.
RANNUNG SEH NATNA (SCRUB TYPHUS) NATNA LANCHHUAH DAN
Tuhrik seh hi a na lemlova,thak angin a rawn langchhuak a,vun nemlai, zakhnuai ah te, kapkar ah te, dulah te leh nghawngah te a seh duh bik a ni.Tlun/khurh leh khawsik, nasa taka luna, mit vel sen remrum,thalthoh leh hnungzang vela thakbawl ang te in he natna hi a rawn langchhuak thin a ni. A changchuan tihrawl leh pumnate pawh a thlen bawk a, a nasat pheichuan thisenzam chat teleh thisenzam block te a thlen thei a, Pneumonia leh thawkna lama harsatna te pawh a thlen thei bawk a ni. Scrub Typhus natna hi thisen ekzam atangin a hmuhchhuah theih a, Mizoramah hian,Rapid Diagnostic Kits(ICT) te hi he natna hriatchhuah nana an hmanbera ni a.
NATNA ENKAWL DAN
Scrub typhus natna hi Antibiotic damdawi hmanga enkawl a ni a, damdawi an hman lartak te chu Doxycycline leh azithromycin te an ni a, Naupang leh Nu naupai lai ah chuan Azithromycin pektur a ni.He natna hi a invenna (vaccine) ala awm hrihlo a ni.Heng damdawi kan han tarlan tak te hi mahni thu a lo ei ve mai hi a him lova, Doctorte rawn phawt hi a thaber leh himber a ni.
SCRUB TYPHUS NATNA LAKA INVEN DAN
He natna awm thinna leh a thehdarhtu tuhrik awmduhna hmun ah te chuan thawmhnaw hak uluk a ngai em em a,thawmhnaw taksa khuh tam thei ang ber hak tur a ni. Rannung duhloh (insectrepellant) damdawi,Odomos, Permethrin, Dibutylphtalate,teleh adang te thawmhnaw ah leh taksa langlai ah te ramchhuah dawn in inchulh tur a ni a, Hnimah te leh phulah te engmah phahlo in thut mai mai lohtur a ni. Inleh a vel fai taka vawn reng hian nasa takin min veng thei bawk a ni. Rannung thahna hlo(Insecticides) kah a tangkai hle bawk ani. Rodent (sazu) leh mite (tuhrik) control hi a tulna hmunah chuan a tangkai hle.
A CONTROL DAN
Heng a hnuai a thil pathumte hi he natna control nan hian an pawimawh hle a ni.
1. Rapid case identification
A rang thei angber leh a hmathei angber a he natna hi damdawi lam thiam ten an hriatchhuah hi a pawimawh em em a ni.
2. Public education
Mipuite hnena he natna chungchang leh a kaichhawn dante a tamthei ang ber zirtir a hrilhfiah a pawimawh hle a ni.
3. Rodent control and habitat modification
Sazu lamchi (rodent) te hi he natna hrikte tana thanpuitlinna hmun (reservoir) an nih avangin sazu te control hi a pawimawh hle a ni. Kan chenna hmunte, sazute tana khawsak remchanglo tura siam hian scrub typhus natna lakah nasatak in min veng dawn a ni.
Scrub typhusnatna hrikte hian inthlahpun nan leh thanlen nan (reservoir),sazu lam chiho(rodents) te hi an hmang a, heng sazute atang hian tuhrik in natna hrik chu lachhawngin mihringah an thehdarh ta thin ani.Tuhrikte hi an tehle a, chi(species) tamtak phei chu mitlawngin an hmuhtheihloh a ni.India rama he natna thehdarhtu tuhrik (vector) chu Leptotrombidium deliense ani a, Japan leh khawchhak lam ramah te chuan Leptotrombidium akamushi in a thehdarh thung ani.Tuhriksehna ah khan hmuamhma(eschar) pankhir alo awm thin a, he natna hmuhchuah nan a tangkai hle a mahse hei hi 40-50% ah chauh a awm thin ani.Mite (Tuhrikte) hian an damchhung hian pianhmang leh nihphung danglamna (life cycle) chhawng li an kaltlang thin a, chungte chu, Egg,Larva,Nymph leh Adult te an ni. Larva an nih lai chauh hian he natna hi an thehdarh thei a ni.
RANNUNG SEH NATNA AWMNA HMUN TE
Khawvel hmun thenkhat ah chuan he Scrub typhus natna hi engtiklai pawhin a awm reng a, heng hmunte hi “Tsutsugamushi Triangle” an vuah a ni a, India ram pawh hi a telve ani.Scrub typhus natna lanchhuahna leh awmduhna hmunte chu:-
1. Mites (Tuhrik) awm duhna hmun ,rambua leh dai hnimhmun te.
2. He natna hi hmunbik huam zau vak lo ah a thleng thin.
3. He natna doletna neilo antamna hmun ah.
4. Hun kaltawh a rannungseh tawk ngailote ah a thleng duh bik bawk
HE NATNA HI MIZORAMAH ENGTIKLAI ATANGA LO AWMTAN NGE A NIH ?
He natna hi India ram hmun dangah chuan tunhma a natna lo awm tawh thin, lo lang nawn leh, re-emerging disease a chhiar a ni a, Mizoram ah hian engtiklai atanga lo awm tan nge tih hi hriattheih ani lova, a awmna a rei viau tawh maithei a, natna lo awm thar, emerging disease pawh ani thei tho bawk. Amaherawh chu Mautam (bamboo flowering) 2007-2009 chho vela tang khan he natna hi nasa takin a lo pung chho ta niin a ngaih theih a, mautam avang a, he natna natural reservoir Sazu a pun nasat vang anih a rinawm bawk ani. Kum 2012 kumtir atang khan Directorate of Health Services hnuaia Integrated disease surveillance programme (IDSP) chuan Sawrkar leh Private damdawiin te atangin he natna veite data hi lakhawmin a chhinchhiah zel a, Central IDSP, Delhi ah data hi a thawn thla thin a ni. IDSP, chhinchhiah danin, kum 2012 a tanga July 2018 thla thleng hian a vei mi 2143 leh thihpui mi 42 an awm tawh bawk a ni.
TUNHNAI AH HE NATNA HI ENGVANGA LO PUNG VAK NGE NI THEI ANG ?
Mautak (Mellocana) tam, flowering/death atang khan he natna hi Mizoramah hian a hluar ta hle mai a, min chenchilh (endemic) tlat tawh niin a lang. Tin, kumin 2018 chhung hian he natna hi nasa takin a hluar leh a, he natna hrileng nasa pawh hi hmun 5 laiah a thleng tawh bawk a, mi 1152 in vei tawhin, mi 7 laiin an thihpui tawh bawk a ni. Kumin chhunga heti taka he natna hluar na chhan ni a lang pawimawh tak pakhat chu, tunhnai hian Raw chikhat Mizoten Rawnal kan tih mai, (Dendrocalamus longispathus) hi Mizoram chhungah hian a tam nasa hle mai a, he natna hrileng awmna hmuna zirchianna atanga a landan in, Rawtam hian sazu te hi a tipung niin a hriat a, fur ruahtui tam hian Tuhrikte pawh hi a tipung nasa thei hle a ni. Heng a natna kawltu ber (Reservior) Sazu te leh Tuhrik, he natna thehdarhtu te an pun tak avang hian he natna pawh hi kum dang aiin a hluar ta niin a lang a ni. He natna hi kumdangah chuan October to January thla chhung hian a hluar bik thin a, thal ah leh fur ah te chuan vei an tlem thei hle a ni.
HE NATNA DAMDAWI ATAN HIAN RULSA HI A THA EM ?
Tunlai hian Mizoramah hian, he natna veite enkawl nan “Rulsa eitir a tha” tih hi a lar hle mai a, hei hi engmah scientific prove awmlo a ni a, a lo tha viau maithei a, a thalo maithei bawk, he mi chungchang a paper emaw thuziak hmuhtur a awm lemloh miau avangin. Mi in an ei a “ka dampui” an ti a nih chuan a tha ani mai a, amaherawhchu, damdawi manto tak pawh ni lemlo, zirchianna tamtak an neih hnu a, he natna enkawl nan leh tihdam nan a tha tih an prove tawh ngei te tam tak leitur a awmreng laia, rulsa treatment, a hmuh harsa zawk rin zawk tlat erawh a fuh chiahlo maithei. Scrub typhus natna veite hi enkawlna diktak pek an nih lohin a vei mi 100 zinga mi 30 vel (30%) thlengin an thihpui thei tih ani a, enkawlna engmah pelo mahse 70 % vel hi chu an damchhuak leh tho thin a, Rulsa emaw thildang sa an ei vang ni lo pawh in. “Rulsa a tha” titu te zingah pawh hian, he natna veite treatment atana rulsa chauh hmang a, damdawi dang ei miahlo ngam erawh mi an tamlo maithei a ni. Tin, he natna hi a vei tawh te pawhin an vei nawn leh thei tho bawk a ni.
HE NATNA ENKAWL NANA RULSA HMAN IN A NGHAWNG THEIH TE
He natna enkawl nan hian rulsa hi lo tha tehreng pawh nisela ( ka ring lemlo na a ), He natna veite enkawl nan rul kan thah vak mai chuan ecological balance kan tibuai thei dawn a ni. Rul te hian sazu te hi chaw atan an ei thin a, sazu pung nasa luttuk tur kha nasa takin an veng a, sazu te hi Scrub typhus natna hrikte inthlahpunna leh thanlenna (natural reservoir) an nih avangin a eitu ber damdawi ti a, kan thah zel mai chuan nasa takin an lo pung anga, he natna pawh hi a lo pung nasa lehzual dawn a ni. Chuvangin, Rulsa treatment atana hman hian nghawng thalo tak a thlen theih avangin, sawimawi tlak anilo a ni.
HE NATNA RESERVIOR CHUNGCHANG
India ramah hian sazu chi hrang hrang te hian he natna hi an pai ani tih hi hmuhchhuah a ni tawh a, zirchianna neih belh zel ani mek bawk a ni. Mizoramah pawh hian sazu te mai bakah Chepa (Tupaia belangeri) ah pawh he natna hi hmuhchhuah ani tawh a, tunlaia hrilenna hmun ah te leh hmun dangah pawh he zirchianna hi neih mek zel a ni. Sazu thisen te hi enfiah zel an ni. New Economoc Development Project (NEDP) atang pawhin hetiang lama zirchianna/ research neihna tur sum hi hmuh ani bawk a ni.
HE NATNA THEHDARHTU CHUNGCHANG
Scrub typhus natna hrikte hi tuhrik in mihring ah an thehdarh a, khawvelah hian tuihrik hi chi (species) sang tam tak an awm a, heng zinga thenkhat te hian he natna hi an thehdarh a ni. India ram he natna thehdarhtu ber tuhrik hi Leptotrombidium deliense a ni a, Japan leh khawchhak lam ramah te chuan Leptotrombidium akamushi in a thehdarh nasa ber a ni. Mizoram ah pawh hian Leptotrombidium deliense hian a thehdarh ngei ani tih hi hmuhchhuah ani tawh a, Tuhrik chi dang te hian an thehdarh ve em tih hi zirchianna neih mek a ni.
RANNUNG SEH NATNA (SCRUB TYPHUS) NATNA LANCHHUAH DAN
Tuhrik seh hi a na lemlova,thak angin a rawn langchhuak a,vun nemlai, zakhnuai ah te, kapkar ah te, dulah te leh nghawngah te a seh duh bik a ni.Tlun/khurh leh khawsik, nasa taka luna, mit vel sen remrum,thalthoh leh hnungzang vela thakbawl ang te in he natna hi a rawn langchhuak thin a ni. A changchuan tihrawl leh pumnate pawh a thlen bawk a, a nasat pheichuan thisenzam chat teleh thisenzam block te a thlen thei a, Pneumonia leh thawkna lama harsatna te pawh a thlen thei bawk a ni. Scrub Typhus natna hi thisen ekzam atangin a hmuhchhuah theih a, Mizoramah hian,Rapid Diagnostic Kits(ICT) te hi he natna hriatchhuah nana an hmanbera ni a.
NATNA ENKAWL DAN
Scrub typhus natna hi Antibiotic damdawi hmanga enkawl a ni a, damdawi an hman lartak te chu Doxycycline leh azithromycin te an ni a, Naupang leh Nu naupai lai ah chuan Azithromycin pektur a ni.He natna hi a invenna (vaccine) ala awm hrihlo a ni.Heng damdawi kan han tarlan tak te hi mahni thu a lo ei ve mai hi a him lova, Doctorte rawn phawt hi a thaber leh himber a ni.
SCRUB TYPHUS NATNA LAKA INVEN DAN
He natna awm thinna leh a thehdarhtu tuhrik awmduhna hmun ah te chuan thawmhnaw hak uluk a ngai em em a,thawmhnaw taksa khuh tam thei ang ber hak tur a ni. Rannung duhloh (insectrepellant) damdawi,Odomos, Permethrin, Dibutylphtalate,teleh adang te thawmhnaw ah leh taksa langlai ah te ramchhuah dawn in inchulh tur a ni a, Hnimah te leh phulah te engmah phahlo in thut mai mai lohtur a ni. Inleh a vel fai taka vawn reng hian nasa takin min veng thei bawk a ni. Rannung thahna hlo(Insecticides) kah a tangkai hle bawk ani. Rodent (sazu) leh mite (tuhrik) control hi a tulna hmunah chuan a tangkai hle.
A CONTROL DAN
Heng a hnuai a thil pathumte hi he natna control nan hian an pawimawh hle a ni.
1. Rapid case identification
A rang thei angber leh a hmathei angber a he natna hi damdawi lam thiam ten an hriatchhuah hi a pawimawh em em a ni.
2. Public education
Mipuite hnena he natna chungchang leh a kaichhawn dante a tamthei ang ber zirtir a hrilhfiah a pawimawh hle a ni.
3. Rodent control and habitat modification
Sazu lamchi (rodent) te hi he natna hrikte tana thanpuitlinna hmun (reservoir) an nih avangin sazu te control hi a pawimawh hle a ni. Kan chenna hmunte, sazute tana khawsak remchanglo tura siam hian scrub typhus natna lakah nasatak in min veng dawn a ni.
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