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* CMV (Cytomegalovirus) ở đâu ra ?
– Virus Cytomegalo (CMV) là loại virus THUỘC NHÓM HERPES, tên gọi này là từ tế bào bị nhiễm virus phồng to lên. Đây là tác nhân có thể gây nhiều bệnh cho mọi nhóm tuổi, từ những bất thường bẩm sinh đến các rối loạn bệnh lý, đặc biệt ở người suy giảm miễn dịch.
– Cytomegalovirus liên quan đến virus gây ra bệnh thủy đậu, herpes simplex và tăng bạch cầu đơn nhân. Một lần bị nhiễm CMV, virus sẽ tồn tại trong cơ thể suốt đời, nhưng không phải luôn luôn hoạt động. Chu kì của CMV bao gồm giai đoạn ở thể ngủ và sau đó hoạt động trở lại. Nếu bạn đang khỏe mạnh, CMV chủ yếu ở thể “ngủ” nghĩa là không hoạt động. Bạn có thể truyền virus sang cho người khác trong quá trình CMV tái hoạt động.
– CMV lan truyền từ người này sang người khác thông qua tiếp xúc với dịch cơ thể, ví dụ như máu, nước bọt, nước tiểu, tinh dịch và sữa. CMV thường không lây truyền qua sữa mẹ. Tuy nhiên nếu bạn đang mang thai và nhiễm trùng CMV đang tiến triển, bạn có thể truyền virus sang trẻ.
– CMV có mặt ở khắp nơi trên thế giới, chỉ gây dịch nhỏ. Cuộc sống cộng đồng và vệ sinh cá nhân kém là điều kiện thuận lợi cho sự lây truyền bệnh; khoảng 1% sơ sinh nhiễm CMV, tỉ lệ này cao hơn ở các nước đang phát triển.
– CMV có thể hiện diện trong sữa mẹ, nước miếng, phân người và nước tiểu. Sự lây truyền theo nhiều kiểu khác nhau. Nhiễm ở tuổi chu sinh và trẻ em nhỏ xảy ra rất thường xuyên. Giai đoạn sớm thì truyền qua nhau thai, trong lúc sinh và trong sữa mẹ. Ở trẻ nhỏ thì truyền qua nước bọt. Lúc lớn thì truyền qua đường sinh dục, CMV hiện diện âm thầm trong tinh dịch và dịch tiết cổ tử cung. Nó cũng truyền qua đường máu hoặc ghép cơ quan. 80% người lớn có kháng thể.
– Khoảng 40-80 % người lớn bị nhiễm CMV tại Hoa Kỳ trước tuổi 40. Ở các nước đang phát triển tỉ lệ này cao đến 90 %.
* CON ĐƯỜNG LÂY NHIỄM CMV
1/. Nhiễm CMV ở người lớn và trẻ em lớn:
Nhiễm CMV gây ra Hội chứng tăng bạch cầu đơn nhân nhiễm trùng. Thời gian ủ bệnh 20 – 60 ngày, xuất hiện triệu chứng bệnh sau 2 – 6 tuần với các triệu chứng: sốt kéo dài, đôi khi lạnh run, suy yếu, khó chịu; đau cơ, lách to, viêm họng xuất tiết và viêm hạch ở cổ;…bất thường chức năng gan và bệnh lý lympho bào. Bệnh thường nhẹ, hầu hết bệnh nhân hồi phục không di chứng nhưng viêm gan cận lâm sàng lại thường gặp. Rất hiếm khi nhiễm CMV đưa đến tử vong, trừ các trường hợp bệnh nhân bị suy giảm miễn dịch. Đặc biệt ở bệnh nhân được ghép thận, ghép tủy bị đè nén miễn dịch để lại biến chứng viêm phổi mô kẽ với tỷ lệ cao.
2/. Nhiễm CMV chu sinh:
– Trẻ sơ sinh có thể bị nhiễm CMV trong lúc sinh khi ngang qua âm đạo hoặc nhiễm sau sinh khi bú sữa mẹ hay do tiếp xúc với các dịch tiết khác của mẹ. 40 – 60 % trẻ sơ sinh bú mẹ hơn một tháng mà mẹ có huyết thanh dương tính với CMV sẽ bị lây nhiễm.
– Đa số các trẻ này đều không có triệu chứng, một số trẻ có thể có triệu chứng viêm phổi kẽ kéo dài. Một số triệu chứng khác hay gặp như cân nặng lúc sinh thấp, viêm hạch, nổi mẩn, viêm gan, tế bào lympho tăng và thiếu máu.
– CMV có khả năng được thải không liên tục từ hầu họng và nước tiểu trong nhiều tháng, thậm chí nhiều năm.
3/. Nhiễm CMV bẩm sinh:
– Trẻ nhiễm virus trong thời kỳ thai nghén gây bệnh thể vùi tế bào khổng lồ. Tế bào khổng lồ được tạo thành gọi là Cytomegalo, có nhiều nhân nổi bật, nhiều thể vùi trong nhân. Nhiều cơ quan cũng bị nhiễm dẫn đến bất thường bẩm sinh.
– Hầu như chỉ những thai nhi có mẹ bị nhiễm CMV lần đầu trong khi mang thai mới có triệu chứng lâm sàng.
– Thai nhi có nhiều dạng biểu hiện lâm sàng từ không có triệu chứng đến thể nặng và lan rộng toàn thân. Một số triệu chứng như đốm mảng xuất huyết, gan, lách to, vàng da (60-80%), teo não và đầu nhỏ, nhu mô não bị vôi hóa, chậm phát triển trong tử cung(30-50%), thoát vị bẹn và viêm võng mạc ít thấy hơn.
* Nguy cơ :
– CMV là một loại virus lan truyền rộng và phổ biến có thể xâm nhiễm bất kì ai. Nhưng trẻ nhỏ và người lớn khỏe mạnh bị nhiễm trùng thường có ít triệu chứng hơn, chính vì thế CMV thường không được chẩn đoán phát hiện.
– CMV kháng với mọi loại kháng sinh, chưa hề có phác đồ điều trị và không có vaccine. Nguy cơ nó bùng phát cùng với những nhóm Herpes khác và các siêu khuẩn kháng thuốc rõ ràng là họa diệt vong toàn cầu và là gánh nặng xã hội.
* Triệu chứng chung :
Trẻ sơ sinh bị nhiễm CMV khi còn trong bụng mẹ (CMV bẩm sinh), những đứa trẻ bị nhiễm CMV trong khi sinh hoặc một thời gian sau sinh (CMV sau sinh)- ví dụ như do bú sữa mẹ- và những người có hệ miễn dịch kém thường có nhiều nguy cơ tiến triển các dấu hiệu và triệu chứng hơn là những người khỏe mạnh.
* Triệu chứng ở trẻ em :
– Những phụ nữ mang thai bị nhiễm CMV sẽ có nguy cơ truyền virus sang cho con. Nếu lần đầu tiên bạn bị nhiễm (nhiễm CMV nguyên phát), nguy cơ truyền virus sang cho con sẽ cao hơn những lần bạn tái nhiễm. Sự lây truyền thường xảy ra trong thời kì đầu mang thai, thường trong 3 tháng đầu.
– Hầu hết trẻ em nhiễm CMV trong thời kỳ bào thai thường biểu hiện khỏe mạnh trong lúc sinh, nhưng một số dấu hiệu sẽ tiến triển theo thời gian – đôi khi không chỉ vài tháng hay vài năm sau sinh. Biểu hiện thường gặp nhất xuất hiện sau sinh đó là mất thính lực. Một số trẻ nhỏ cũng có thể tiến triển sự suy yếu thị lực.
* Ngăn ngừa CMV bằng cách nào ?
– Vệ sinh tay thường xuyên bằng xà phòng là yếu tố chủ chốt để ngăn chặn sự lây lan của virus CMV.
- Chrissie Jones, chủ nhiệm dự án nói: “Thông điệp quan trọng nhất là không tiếp xúc với nước bọt của trẻ nhỏ”.
Người mẹ không được ăn chung thức ăn với con trẻ. Việc các bậc cha mẹ ăn nốt đồ ăn thừa của con là khá phổ biến, chẳng hạn như các món cầm tay. Ngoài ra, đừng hôn trẻ vào môi, hãy hôn lên trán.
– Đối với phụ nữ mang thai, con đường phổ biến nhất để lây vi-rút từ trẻ đang phát tán vi-rút qua nước tiểu và nước bọt.
Những trẻ đi nhà trẻ hoặc nhóm chơi có khả năng lây CMV từ trẻ khác”.
*Tóm lại :
Sự thiếu hiểu biết về CMV (Cytomegalovirus) nói riêng và Virus Herpes nói chung trong cộng đồng là không thể chấp nhận được, vì nó là một trong những thảm họa diệt vong và là gánh nặng của nhân loại.
———–Wambuakim————
Tài liệu tham khảo:
- Lý Văn Xuân.Virus học. Nhà xuất bản y học
- Bộ y tế. Trường ĐHYD TPHCM.Virus học. Bộ môn vi sinh
- Hương Cát. Viện Thông tin y học Trung ương VN.CDC
- www.occhd.org/download_file/1358/349
- http://dantri.com.vn/…/canh-bao-bau-bi-khong-nen-an…
GO!!!
This phrase was said by the first cosmonaut on Earth – Yuri Gagarin. (Yuri Gagarin)
He was the first astronaut on Earth. He was Russian! …
Now Russia is becoming a strong country, gas pipelines, a vaccine against COVID-19, an army.
Is this very reminiscent of the communist Soviet Union?
How do you think?
Now we have total control in our country. I am interested in the opinion of foreigners.
Албонумисматико
ПОЕХАЛИ!!
GO!!!
This phrase was said by the first cosmonaut on Earth – Yuri Gagarin. (Yuri Gagarin)
He was the first astronaut on Earth. He was Russian! …
Now Russia is becoming a strong country, gas pipelines, a vaccine against COVID-19, an army.
Is this very reminiscent of the communist Soviet Union?
How do you think?
Now we have total control in our country. I am interested in the opinion of foreigners.
Албонумисматико
ПОЕХАЛИ!!
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