{"id":27972,"date":"2017-04-17T23:11:37","date_gmt":"2017-04-17T21:11:37","guid":{"rendered":"http:\/\/www.invarena.cz\/?p=27972"},"modified":"2017-04-17T23:11:53","modified_gmt":"2017-04-17T21:11:53","slug":"jak-je-to-s-ockovanim-proti-tuberkuloze","status":"publish","type":"post","link":"https:\/\/www.invarena.cz\/?p=27972","title":{"rendered":"Jak je to s o\u010dkov\u00e1n\u00edm proti tuberkul\u00f3ze?"},"content":{"rendered":"

OT\u00c1ZKA: Jak je to s o\u010dkov\u00e1n\u00edm proti tuberkul\u00f3ze? Kdy\u017e bylo zru\u0161eno z povinn\u00fdch d\u011btsk\u00fdch o\u010dkov\u00e1n\u00ed, znamen\u00e1 to, \u017ee se proti n\u00ed v\u016fbec neo\u010dkuje, nebo to jen nehrad\u00ed poji\u0161\u0165ovna? \u010cek\u00e1m miminko a zrovna tuberkul\u00f3za je nemoc, proti kter\u00e9 bych ho rad\u011bji o\u010dkovat nechala.<\/strong><\/p>\n

ODPOV\u011a\u010e:<\/p>\n

V sou\u010dasn\u00e9 dob\u011b se proti tuberkul\u00f3ze o\u010dkuj\u00ed jen rizikov\u00ed novorozenci a v tom p\u0159\u00edpad\u011b je o\u010dkov\u00e1n\u00ed pln\u011b hrazen\u00e9 z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. Plo\u0161n\u00e9 o\u010dkov\u00e1n\u00ed proti t\u00e9to nemoci je v \u010cR zru\u0161eno od listopadu 2010 (novelizac\u00ed vyhl\u00e1\u0161ky MZ \u010cR \u010d. 537\/2006 Sb., o o\u010dkov\u00e1n\u00ed proti infek\u010dn\u00edm nemocem). Ji\u017e dva roky p\u0159ed t\u00edm, v b\u0159eznu 2009, bylo zru\u0161eno p\u0159eo\u010dkov\u00e1v\u00e1n\u00ed jeden\u00e1ctilet\u00fdch d\u011bt\u00ed.<\/p>\n

O\u010dkov\u00e1n\u00ed proti tuberkul\u00f3ze nyn\u00ed z\u016fstalo jako povinn\u00e9 pouze u vysoce rizikov\u00fdch d\u011bt\u00ed. Podle vyhl\u00e1\u0161ky o o\u010dkov\u00e1n\u00ed proti infek\u010dn\u00edm nemocem jde o d\u011bti, jejich\u017e rodi\u010de nebo sourozenci, p\u0159\u00edpadn\u011b \u010dlen dom\u00e1cnosti, v n\u00ed\u017e d\u00edt\u011b \u017eije, m\u011bli \u010di maj\u00ed aktivn\u00ed tuberkul\u00f3zu. D\u00e1le je o\u010dkov\u00e1n\u00ed povinn\u00e9 pro d\u011bti ze zem\u00ed s vysok\u00fdm v\u00fdskytem t\u00e9to nemoci (d\u00edt\u011b, n\u011bkter\u00fd z jeho rodi\u010d\u016f nebo sourozenec, p\u0159\u00edpadn\u011b \u010dlen dom\u00e1cnosti se narodil nebo d\u00e9le ne\u017e 3 m\u011bs\u00edce pob\u00fdval ve st\u00e1t\u011b s vysok\u00fdm v\u00fdskytem tuberkul\u00f3zy). O\u010dkov\u00e1ny mus\u00ed b\u00fdt i d\u011bti, kter\u00e9 byly v kontaktu s nemocn\u00fdm s tuberkul\u00f3zou.<\/p>\n

Riziko se zji\u0161\u0165uje hned v porodnici na z\u00e1klad\u011b dotazn\u00edku vypln\u011bn\u00e9ho z\u00e1konn\u00fdm z\u00e1stupcem d\u00edt\u011bte. Indikaci k o\u010dkov\u00e1n\u00ed tedy posoud\u00ed u\u017e l\u00e9ka\u0159 novorozeneck\u00e9ho odd\u011blen\u00ed a p\u0159\u00edpadn\u011b rovnou informuje pracovi\u0161t\u011b kalmetizace. Praktick\u00fd l\u00e9ka\u0159 pro d\u011bti a dorost, kter\u00fd p\u0159eb\u00edr\u00e1 novorozence do p\u00e9\u010de, dost\u00e1v\u00e1 vypln\u011bn\u00fd dotazn\u00edk spolu s propou\u0161t\u011bc\u00ed zpr\u00e1vou. Pokud je d\u00edt\u011b vyhodnoceno jako rizikov\u00e9, odes\u00edl\u00e1 je na kalmetiza\u010dn\u00ed stanici, aby nejpozd\u011bji v \u0161esti t\u00fddnech v\u011bku dostalo vakc\u00ednu proti tuberkul\u00f3ze. U d\u011bt\u00ed, u kter\u00fdch nem\u016f\u017ee situaci posoudit l\u00e9ka\u0159 novorozeneck\u00e9ho odd\u011blen\u00ed, zji\u0161\u0165uje indikace k o\u010dkov\u00e1n\u00ed proti tuberkul\u00f3ze registruj\u00edc\u00ed praktick\u00fd l\u00e9ka\u0159 pro d\u011bti a dorost p\u0159i prvn\u00edm kontaktu se z\u00e1konn\u00fdm z\u00e1stupcem d\u00edt\u011bte.<\/p>\n

O\u010dkov\u00e1n\u00ed vyhl\u00e1\u0161kou stanoven\u00fdch rizikov\u00fdch skupin je hrazeno z ve\u0159ejn\u00e9ho zdravotn\u00edho poji\u0161t\u011bn\u00ed. Zdravotn\u00ed poji\u0161\u0165ovna hrad\u00ed pln\u011b cel\u00e9 o\u010dkov\u00e1n\u00ed proti tuberkul\u00f3ze, tedy aplikaci (l\u00e9ka\u0159i, kter\u00fd d\u00edt\u011b o\u010dkuje) i o\u010dkovac\u00ed l\u00e1tku (distributorovi). V medic\u00ednsky neindikovan\u00fdch p\u0159\u00edpadech, kdy z\u00e1konn\u00fd z\u00e1stupce d\u00edt\u011bte s\u00e1m \u017e\u00e1d\u00e1 jeho o\u010dkov\u00e1n\u00ed proti tuberkul\u00f3ze, p\u0159esto\u017ee to podle l\u00e9ka\u0159e nen\u00ed pot\u0159eba, poji\u0161\u0165ovna o\u010dkov\u00e1n\u00ed nehrad\u00ed ani na n\u011bj nep\u0159isp\u00edv\u00e1. N\u00e1klady (vakc\u00ednu, aplikaci a ve\u0161ker\u00e9 \u00fakony a materi\u00e1ly) hrad\u00ed z\u00e1konn\u00fd z\u00e1stupce d\u00edt\u011bte. P\u0159eo\u010dkov\u00e1n\u00ed v\u0161ak u\u017e nen\u00ed prov\u00e1d\u011bno ani na \u017e\u00e1dost rodi\u010d\u016f, nebo\u0165 jde o postup, kter\u00fd nem\u00e1 odborn\u00e9 opodstatn\u011bn\u00ed.<\/p>\n

M\u016f\u017eeme p\u0159ipomenout, \u017ee plo\u0161n\u00e9 povinn\u00e9 o\u010dkov\u00e1n\u00ed proti tuberkul\u00f3ze u n\u00e1s bylo zru\u0161eno jako v jednom z posledn\u00edch evropsk\u00fdch st\u00e1t\u016f s n\u00edzk\u00fdm v\u00fdskytem tuberkul\u00f3zy. Prov\u00e1d\u011blo se od 50. let 20. stolet\u00ed a m\u011blo sv\u016fj v\u00fdznam v dob\u011b vysok\u00e9ho v\u00fdskytu t\u00e9to nemoci. Dnes je naopak d\u016fle\u017eit\u011bj\u0161\u00ed, \u017ee jeho zru\u0161en\u00ed umo\u017enilo posunout na d\u0159\u00edv\u011bj\u0161\u00ed dobu pod\u00e1n\u00ed prvn\u00ed d\u00e1vky hexavakc\u00edny, kter\u00e1 chr\u00e1n\u00ed proti \u0161esti infek\u010dn\u00edm nemocem v\u010detn\u011b \u010dern\u00e9ho ka\u0161le. Ten p\u0159edstavuje daleko v\u011bt\u0161\u00ed epidemiologick\u00e9 riziko ne\u017e tuberkul\u00f3za a pr\u00e1v\u011b u miminek m\u016f\u017ee prob\u00edhat velmi z\u00e1va\u017en\u011b. Po o\u010dkov\u00e1n\u00ed proti tuberkul\u00f3ze bylo mo\u017eno hexavakc\u00ednou o\u010dkovat nejd\u0159\u00edve za 2 m\u011bs\u00edce, av\u0161ak kv\u016fli komplikac\u00edm se muselo pod\u00e1n\u00ed jej\u00ed prvn\u00ed d\u00e1vky dokonce odsouvat, tak\u017ee ani nebylo mo\u017en\u00e9 dodr\u017eet o\u010dkovac\u00ed kalend\u00e1\u0159.<\/p>\n

Mgr. Old\u0159ich Tich\u00fd vedouc\u00ed tiskov\u00e9ho odd\u011blen\u00ed a tiskov\u00fd mluv\u010d\u00ed <\/p>\n","protected":false},"excerpt":{"rendered":"

OT\u00c1ZKA: Jak je to s o\u010dkov\u00e1n\u00edm proti tuberkul\u00f3ze? Kdy\u017e bylo zru\u0161eno z povinn\u00fdch d\u011btsk\u00fdch o\u010dkov\u00e1n\u00ed, znamen\u00e1 to, \u017ee se proti n\u00ed v\u016fbec neo\u010dkuje, nebo to […]<\/a><\/p>\n<\/div>","protected":false},"author":1,"featured_media":14170,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[11],"tags":[],"class_list":["post-27972","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi"],"_links":{"self":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/27972","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=27972"}],"version-history":[{"count":0,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/posts\/27972\/revisions"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=\/wp\/v2\/media\/14170"}],"wp:attachment":[{"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=27972"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=27972"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.invarena.cz\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=27972"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}