{"id":20006,"date":"2015-02-20T10:53:27","date_gmt":"2015-02-20T09:53:27","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=20006"},"modified":"2015-02-20T10:53:27","modified_gmt":"2015-02-20T09:53:27","slug":"ockovat-by-se-meli-hlavne-chronicky-nemocni","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=20006","title":{"rendered":"O\u010dkovat by se m\u011bli hlavn\u011b chronicky nemocn\u00ed"},"content":{"rendered":"

Fakultn\u00ed nemocnice Plze\u0148 d\u00e1v\u00e1 jednou t\u00fddn\u011b ve\u0159ejnosti mo\u017enost zeptat se odborn\u00edk\u016f na specifick\u00e9 t\u00e9ma. Tento t\u00fdden se lid\u00e9 ptali na webu FN Plze\u0148 na aktu\u00e1ln\u00ed t\u00e9ma, kter\u00fdm je epidemie ch\u0159ipky v Plze\u0148sk\u00e9m kraji.<\/strong><\/p>\n

Na jejich dotazy odpov\u00eddala vedouc\u00ed l\u00e9ka\u0159ka Infek\u010dn\u00ed kliniky FN Plze\u0148 MUDr. Alena Koubov\u00e1.<\/p>\n

– Jak v\u016fbec pozn\u00e1m ch\u0159ipku? Jak se li\u0161\u00ed od b\u011b\u017en\u00e9 vir\u00f3zy, kter\u00e1 n\u00e1s tak\u00e9 tr\u00e1p\u00ed od podzimu do jara? Martin V\u00edtek<\/p>\n

Virov\u00e1 onemocn\u011bn\u00ed d\u00fdchac\u00edch cest pat\u0159\u00ed mezi nej\u010dast\u011bj\u0161\u00ed infekce podzimn\u00edch, zimn\u00edch a jarn\u00edch m\u011bs\u00edc\u016f, jsou vyvol\u00e1na \u0161irok\u00fdm spektrem p\u016fvodc\u016f, kter\u00e9 se ozna\u010duj\u00ed jako respira\u010dn\u00ed viry (nap\u0159. rhinoviry, koronaviry, respira\u010dn\u00ed syncyti\u00e1ln\u00ed virus a dal\u0161\u00ed). Klinick\u00fd obraz je podobn\u00fd, prob\u00edhaj\u00ed jako infekce horn\u00edch i doln\u00edch d\u00fdchac\u00edch cest, nej\u010dast\u011bji jako r\u00fdma, n\u011bkdy jsou prov\u00e1zen\u00e9 zv\u00fd\u0161enou teplotou a bolest\u00ed hlavy. Na rozd\u00edl od akutn\u00edch respira\u010dn\u00edch infekc\u00ed je ch\u0159ipka onemocn\u011bn\u00edm daleko z\u00e1va\u017en\u011bj\u0161\u00edm jak sv\u00fdm pr\u016fb\u011bhem, tak i mo\u017en\u00fdmi komplikacemi. Onemocn\u011bn\u00ed m\u00e1 n\u00e1hl\u00fd za\u010d\u00e1tek se zimnic\u00ed a rychle stoupaj\u00edc\u00ed teplotou 38 \u2013 40 stup\u0148\u016f, bolestmi sval\u016f, kloub\u016f, zad a hlavy a celkovou schv\u00e1cenost\u00ed a vy\u010derp\u00e1n\u00edm, o n\u011bco pozd\u011bji nastupuj\u00ed p\u0159\u00edznaky posti\u017een\u00ed d\u00fdchac\u00edch cest, p\u0159edev\u0161\u00edm such\u00fd, dr\u00e1\u017ediv\u00fd ka\u0161el. U d\u011bt\u00ed b\u00fdv\u00e1 onemocn\u011bn\u00ed \u010dasto prov\u00e1zeno nevolnost\u00ed, zvracen\u00edm, n\u011bkdy i bolestmi b\u0159\u00ed\u0161ka a pr\u016fjmem. Akutn\u00ed obt\u00ed\u017ee a hore\u010dka v\u011bt\u0161inou b\u011bhem 4 \u2013 6 dn\u016f ustoup\u00ed, naopak slabost, pocen\u00ed a \u00fanava p\u0159etrv\u00e1vaj\u00ed n\u011bkdy i t\u00fddny. D\u016fle\u017eit\u00e9 je i \u010dasov\u00e9 hledisko k rozli\u0161en\u00ed od ostatn\u00edch respira\u010dn\u00edch virov\u00fdch infekc\u00ed. Epidemie ch\u0159ipky prob\u00edh\u00e1 v na\u0161ich podm\u00ednk\u00e1ch ve 2 vln\u00e1ch – prvn\u00ed nast\u00e1v\u00e1 v prvn\u00edch 3 t\u00fddnech v prosinci, druh\u00e1 mezi 4. a 12. t\u00fddnem dal\u0161\u00edho roku.<\/p>\n

– Je mo\u017en\u00e9, pokud m\u00e1 n\u011bkdo v rodin\u011b klasickou ch\u0159ipku (\u017eij\u00edce v mal\u00e9m 2pokojov\u00e9m byt\u011b) n\u011bjak\u00fdmi kroky se ubr\u00e1nit? Lucie<\/p>\n

Pro virov\u00e1 respira\u010dn\u00ed onemocn\u011bn\u00ed v\u010detn\u011b ch\u0159ipky je spole\u010dn\u00fd zp\u016fsob p\u0159enosu. \u0160\u00ed\u0159\u00ed se kap\u00e9nkovou infekc\u00ed, ale i p\u0159\u00edm\u00fdm kontaktem \u2013 tzn. p\u0159enosem infek\u010dn\u00edho nosn\u00edho sekretu na ruce a p\u0159edm\u011bty v okol\u00ed nemocn\u00e9ho. Zvl\u00e1\u0161t\u011b v d\u011btsk\u00fdch kolektivech je d\u016fle\u017eit\u00fd i nep\u0159\u00edm\u00fd kontakt zejm\u00e9na prost\u0159ednictv\u00edm spole\u010dn\u00fdch hra\u010dek. D\u016fle\u017eit\u00e9 je tedy respektov\u00e1n\u00ed z\u00e1kladn\u00edch hygienick\u00fdch pravidel, pou\u017eit\u00ed \u00fastenky p\u0159i kontaktu s nemocn\u00fdm, myt\u00ed rukou, u\u017eit\u00ed nap\u0159. pap\u00edrov\u00fdch kapesn\u00edk\u016f na jedno pou\u017eit\u00ed. S\u00e1m nemocn\u00fd by p\u0159i onemocn\u011bn\u00ed ch\u0159ipkou m\u011bl z\u016fstal v dom\u00e1c\u00edm o\u0161et\u0159ov\u00e1n\u00edm a ne\u0161\u00ed\u0159it n\u00e1kazu nap\u0159. ve sv\u00e9m pracovn\u00edm kolektivu.<\/p>\n

– Kolik dn\u016f lze tolerovat vysok\u00e9 teploty p\u0159i ch\u0159ipce. M\u016fj mu\u017e m\u00e1 vysok\u00e9 teploty \u010dtvrt\u00fd den a l\u00e9ka\u0159 tvrd\u00ed, \u017ee je to norm\u00e1ln\u00ed pr\u016fb\u011bh. Je zcela vy\u010derpan\u00fd, nej\u00ed a pije m\u00e1lo. Marie Nov\u00e1<\/p>\n

Vysok\u00e9 teploty, bolesti hlavy, sval\u016f, kloub\u016f, celkov\u00e1 schv\u00e1cenost a vy\u010derpanost p\u0159i onemocn\u011bn\u00ed ch\u0159ipkou opravdu trvaj\u00ed 4 \u2013 6 dn\u00ed, pak teploty poklesnou a ustoup\u00ed i ostatn\u00ed obt\u00ed\u017ee. Pokud p\u0159etrv\u00e1vaj\u00ed teploty del\u0161\u00ed dobu, je t\u0159eba vy\u0161et\u0159en\u00ed l\u00e9ka\u0159em a vylou\u010den\u00ed ev. komplikace onemocn\u011bn\u00ed. B\u011bhem onemocn\u011bn\u00ed je d\u016fle\u017eit\u00fd klid na l\u016f\u017eku, zv\u00fd\u0161en\u00fd p\u0159\u00edjem tekutin, pod\u00e1n\u00ed antipyretik, analgetik, antitusik a expektoranci\u00ed a p\u0159\u00edsun vitaminu C.<\/p>\n

– Je mo\u017en\u00e9, \u017ee po o\u010dkov\u00e1n\u00ed proti ch\u0159ipce mohu dostat jin\u00fd virus ch\u0159ipky, kter\u00fd je d\u00edky o\u010dkov\u00e1n\u00ed mnohem agresivn\u011bj\u0161\u00ed? Maru\u0161ka<\/p>\n

Ch\u0159ipka je infekce preventabiln\u00ed, proti onemocn\u011bn\u00ed se lze chr\u00e1nit o\u010dkov\u00e1n\u00edm. Proti ch\u0159ipkov\u00e9 vakc\u00edny pat\u0159i mezi bezpe\u010dn\u00e9 a dob\u0159e sn\u00e1\u0161en\u00e9 o\u010dkovac\u00ed l\u00e1tky. P\u0159i ka\u017edoro\u010dn\u00edch epidemi\u00edch se m\u016f\u017ee vyskytnout v\u00edce ch\u0159ipkov\u00fdch vir\u016f, proto WHO doporu\u010dila p\u0159\u00edpravu o\u010dkovac\u00edch l\u00e1tek proti ch\u0159ipce ve form\u011b trivakc\u00edn \u2013 mus\u00ed obsahovat antigeny dvou ch\u0159ipkov\u00fdch vir\u016f A a jednoho typu B, kter\u00e9 se nej\u010dast\u011bji vyskytovaly v minul\u00e9 ch\u0159ipkov\u00e9 sez\u00f3n\u011b. Toto slo\u017een\u00ed navrhuje v\u00fdrobc\u016fm vakc\u00edn sv\u011btov\u00e1 ch\u0159ipkov\u00e1 centr\u00e1la. Pokud u \u010dlov\u011bka o\u010dkovan\u00e9ho proti ch\u0159ipce dojde k akutn\u00edmu respira\u010dn\u00edmu onemocn\u011bn\u00ed, v\u011bt\u0161inou se jedn\u00e1 o onemocn\u011bn\u00ed zp\u016fsoben\u00e9 jin\u00fdmi respira\u010dn\u00edmi viry, tyto tzv. nech\u0159ipkov\u00e9 virosy jsou \u010dasto hodnoceny jako selh\u00e1n\u00ed vakcinace. Virus ch\u0159ipky A je nej\u010dast\u011bj\u0161\u00ed p\u0159\u00ed\u010dinou onemocn\u011bn\u00ed u \u010dlov\u011bka. Jeho antigenn\u00ed slo\u017een\u00ed se m\u011bn\u00ed (k men\u0161\u00edm zm\u011bn\u00e1m jeho povrchov\u00fdch antigen\u016f doch\u00e1z\u00ed t\u00e9m\u011b\u0159 ka\u017edoro\u010dn\u011b, k velk\u00e9 zm\u011bn\u011b doch\u00e1z\u00ed obvykle po 10 \u2013 40 letech), tyto zm\u011bny vedou ke vzniku epidemi\u00ed a\u017e pandemi\u00ed ch\u0159ipky. Onemocn\u011bn\u00ed \u010dlov\u011bka m\u016f\u017ee vyvolat i virus ch\u0159ipky B a C, jedn\u00e1 se v\u0161ak sp\u00ed\u0161e o sporadick\u00e1 onemocn\u011bn\u00ed.<\/p>\n

– Jak\u00fd vy osobn\u011b m\u00e1te n\u00e1zor na o\u010dkov\u00e1n\u00ed proti ch\u0159ipce? Nen\u00ed to zbyte\u010dn\u00e1 injekce nav\u00edc? Zvl\u00e1\u0161\u0165 kdy\u017e jsme se z m\u00e9di\u00ed dov\u011bd\u011bli, \u017ee proti leto\u0161n\u00edmu kmenu ch\u0159ipky to o\u010dkov\u00e1n\u00ed nebylo. Ivana<\/p>\n

Jak ji\u017e jsem uvedla, ch\u0159ipka je onemocn\u011bn\u00ed preventabiln\u00ed, proti kter\u00e9mu je mo\u017en\u00e9 se chr\u00e1nit o\u010dkov\u00e1n\u00edm. V \u010cesk\u00e9 republice je oproti ostatn\u00edm evropsk\u00fdm zem\u00edm proo\u010dkovanost proti ch\u0159ipce st\u00e1le n\u00edzk\u00e1, pohybuje se mezi 5 \u2013 7%. \u010cast\u00fdm d\u016fvodem je podcen\u011bn\u00ed ch\u0159ipky jako z\u00e1va\u017en\u00e9ho onemocn\u011bn\u00ed a ned\u016fv\u011bra v kvalifikovan\u00fd v\u00fdb\u011br vakcina\u010dn\u00edch kmen\u016f. Je ale pravdou, \u017ee leto\u0161n\u00ed typ H3N2 se od vakcina\u010dn\u00edho kmene m\u00edrn\u011b li\u0161\u00ed, proto u o\u010dkovan\u00fdch m\u016f\u017ee doj\u00edt k onemocn\u011bn\u00ed, av\u0161ak s m\u00edrn\u011bj\u0161\u00edm pr\u016fb\u011bhem. O\u010dkov\u00e1n\u00ed proti ch\u0159ipce bych doporu\u010dila zvl\u00e1\u0161t\u011b osob\u00e1m s chronick\u00fdm onemocn\u011bn\u00edm, u kter\u00fdch ch\u0159ipka vede ke zhor\u0161en\u00ed z\u00e1kladn\u00edho onemocn\u011bn\u00ed, m\u00edv\u00e1 t\u011b\u017e\u0161\u00ed pr\u016fb\u011bh a vysok\u00e9 riziko komplikac\u00ed. Rizikovou skupinou jsou osoby s chronick\u00fdm onemocn\u011bn\u00edm d\u00fdchac\u00edch cest, kardiovaskul\u00e1rn\u00edm onemocn\u011bn\u00edm, diabetes mellitus, chronick\u00fdm onemocn\u011bn\u00edm ledvin, lid\u00e9 po splenektomii, tak\u00e9 osoby trvale um\u00edst\u011bn\u00e9 v l\u00e9\u010debn\u00e1ch pro dlouhodob\u011b nemocn\u00e9. O\u010dkov\u00e1n\u00ed je doporu\u010dov\u00e1no i osob\u00e1m, kter\u00e9 jsou v kontaktu s rizikovou skupinou a mohou ch\u0159ipku snadno p\u0159en\u00e9st, nap\u0159. zdravotn\u00edci, zam\u011bstnanci LDN a domov\u016f d\u016fchodc\u016f a rodinn\u00ed p\u0159\u00edslu\u0161n\u00edci rizikov\u00fdch osob.<\/p>\n

– Je tato ch\u0159ipka nebezpe\u010dn\u00e1 pro mal\u00e9 d\u011bti a star\u00e9 ob\u010dany v\u00edce ne\u017e jindy? ali.v<\/p>\n

Onemocn\u011bn\u00ed ch\u0159ipkou m\u00e1 z\u00e1va\u017en\u00fd pr\u016fb\u011bh p\u0159edev\u0161\u00edm u tzv. rizikov\u00fdch skupin nemocn\u00fdch, tj. u osob s chronick\u00fdm onemocn\u011bn\u00edm d\u00fdchac\u00edch cest, ledvin, kardiovaskul\u00e1rn\u00edm onemocn\u011bn\u00edm, chronick\u00fdm metabolick\u00fdm onemocn\u011bn\u00edm, diabetes mellitus, osob s poruchou imunity, po splenektomii a u d\u011bt\u00ed mlad\u0161\u00edch 6 m\u011bs\u00edc\u016f. U star\u0161\u00edch d\u011bt\u00ed m\u016f\u017ee b\u00fdt pr\u016fb\u011bh atypick\u00fd, v pop\u0159ed\u00ed jsou sp\u00ed\u0161e gastrointestin\u00e1ln\u00ed obt\u00ed\u017ee, ale neb\u00fdv\u00e1 t\u011b\u017ek\u00fd. Klinick\u00fd pr\u016fb\u011bh onemocn\u011bn\u00ed ch\u0159ipkou zp\u016fsobenou virem H3N2 nen\u00ed odli\u0161n\u00fd od tzv. klasick\u00e9ho obrazu ch\u0159ipky. V pr\u016fb\u011bhu leto\u0161n\u00ed epidemie zat\u00edm nebyl zaznamen\u00e1n t\u011b\u017e\u0161\u00ed pr\u016fb\u011bh onemocn\u011bn\u00ed u d\u011bt\u00ed ani u gravidn\u00edch \u017een, samoz\u0159ejm\u011b u v\u00fd\u0161e uveden\u00fdch rizikov\u00fdch skupin pacient\u016f m\u016f\u017ee b\u00fdt z\u00e1va\u017en\u011bj\u0161\u00ed a prov\u00e1zen\u00fd komplikacemi.<\/p>\n

Ch\u0159ipka \u2013 jak chr\u00e1nit sebe i okol\u00ed<\/p>\n

– P\u0159i ka\u0161l\u00e1n\u00ed a k\u00fdch\u00e1n\u00ed si p\u0159ikr\u00fdvejte nos a \u00fasta kapesn\u00edkem, kter\u00fd je ur\u010den\u00fd na jednor\u00e1zov\u00e9 pou\u017eit\u00ed.
\n– Kapesn\u00edky ihned po pou\u017eit\u00ed vyho\u010fte do odpadkov\u00e9ho ko\u0161e.
\n– Ruce si pravideln\u011b myjte vodou a m\u00fddlem.
\n– Projev\u00ed-li se u v\u00e1s p\u0159\u00edznaky ch\u0159ipky, kontaktujte l\u00e9ka\u0159e.
\n– Projev\u00ed-li se u v\u00e1s p\u0159\u00edznaky ch\u0159ipky, udr\u017eujte od ostatn\u00edch lid\u00ed odstup alespo\u0148 jeden metr.
\n– Projev\u00ed-li se u v\u00e1s p\u0159\u00edznaky ch\u0159ipky, z\u016fsta\u0148te doma a necho\u010fte do pr\u00e1ce, do \u0161koly nebo na m\u00edsta s v\u011bt\u0161\u00ed koncentrac\u00ed lid\u00ed.
\n– Neobj\u00edmejte se, nel\u00edbejte a nepod\u00e1vejte si ruce p\u0159i pozdravu.
\n– Nedot\u00fdkejte se o\u010d\u00ed, nosu \u010di \u00fast \u0161pinav\u00fdma rukama.<\/p>\n

V\u0161echny ot\u00e1zky a odpov\u011bdi na toto t\u00e9ma najdete na plzensky.denik.cz\/fnchat.<\/p>\n

P\u0159\u00ed\u0161t\u00edm t\u00e9matem bude rakovina mo\u010dov\u00e9ho m\u011bch\u00fd\u0159e. Sv\u00e9 dotazy m\u016f\u017eete pokl\u00e1dat v \u00fater\u00fd od 10 hodin na internetov\u00fdch str\u00e1nk\u00e1ch Fakultn\u00ed nemocnice Plze\u0148 fnplzen.cz\/chat.asp<\/p>\n

Plze\u0148sk\u00fd den\u00edk
\nhttp:\/\/plzensky.denik.cz\/<\/a><\/p>\n","protected":false},"excerpt":{"rendered":"

Fakultn\u00ed nemocnice Plze\u0148 d\u00e1v\u00e1 jednou t\u00fddn\u011b ve\u0159ejnosti mo\u017enost zeptat se odborn\u00edk\u016f na specifick\u00e9 t\u00e9ma. Tento t\u00fdden se lid\u00e9 ptali na webu FN Plze\u0148 na aktu\u00e1ln\u00ed […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":19656,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[9],"tags":[],"class_list":["post-20006","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zpravy"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/20006","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=20006"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/20006\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/19656"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=20006"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=20006"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=20006"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}