Virusi vya herpes simplex kwa kawaida husababisha tu malengelenge madogo yanayojirudia kwa watu wazima, lakini vinaweza kusababisha ugonjwa mbaya sana na hatari kwa watoto wachanga.
Watoto wanaweza kuambukizwa wakati wa kuzaliwa au baada ya kuzaliwa.
Dalili kuu ni upele wa malengelenge madogo (blisters).
Utambuzi hufanyika kwa kupima sampuli zilizochukuliwa kutoka kwenye malengelenge hayo.
Watoto wachanga wenye herpes simplex hupewa dawa ya kuzuia virusi inayoitwa acyclovir.
Maambukizi haya yanaweza kusababisha kifo kwa watoto wengi wasiopata matibabu.
Ili kuzuia maambukizi, wajawazito walioathirika hupewa dawa za kuzuia virusi mwishoni mwa ujauzito na wanaweza kujifungua kwa upasuaji (C-section).
(Tazama pia Muhtasari wa Maambukizi kwa Watoto Wachanga na Maambukizi ya Herpes Simplex kwa watu wazima.)
Maambukizi ya virusi vya herpes simplex (HSV) hutokea mara nyingi sana kwa watu wazima. Virusi hivi huambukizwa kwa njia ya ngono na huathiri njia ya uzazi. Virusi haviondoki kabisa na hubaki bila kufanya kazi (si amilifu) katika tishu mbalimbali kwa maisha. Wakati mwingine virusi vilivyolala mwilini vinaweza kuanza kufanya kazi tena (reactivate).
Kwa kawaida, HSV huambukizwa kwa mtoto wakati wa kupita kwenye njia ya uzazi ikiwa mama ana maambukizi ukeni. Hata akina mama wasio na dalili za wazi za herpes wanaweza kumwambukiza mtoto wao bila kujua. Wakati mwingine watoto huambukizwa baada ya kuzaliwa kwa kugusana na mtu mwenye maambukizi ya wazi, kama vile mwanafamilia mwenye vidonda mdomoni (cold sores).
Kwa watoto wachanga, HSV inaweza kusababisha ulemavu wa kudumu au hata kifo.
Dalili za Maambukizi ya HSV kwa Watoto Wachanga
Dalili za herpes kwa kawaida huanza kati ya wiki ya kwanza na ya tatu baada ya kuzaliwa, lakini mara chache zinaweza kuchelewa hadi wiki ya nne. Dalili ya kwanza mara nyingi ni upele wa malengelenge madogo yaliyojaa majimaji. Malengelenge haya yanaweza pia kutokea ndani ya kinywa na kuzunguka macho.
This close-up of a newborn's mouth shows sores on and under the upper lip caused by herpes simplex virus.
This close-up of a newborn's mouth shows sores on and under the upper lip caused by herpes simplex virus.
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
This photo shows a newborn who has acquired immunodeficiency syndrome (AIDS) and a rash of small fluid-filled blisters covering the entire body.
This photo shows a newborn who has acquired immunodeficiency syndrome (AIDS) and a rash of small fluid-filled blisters
DR M.A. ANSARY/SCIENCE PHOTO LIBRARY
This photo shows small fluid-filled blisters on the face of a newborn infected with herpes simplex virus.
This photo shows small fluid-filled blisters on the face of a newborn infected with herpes simplex virus.
By permission of the publisher. From Demmler G: Congenital and perinatal infections. In Atlas of Infectious Diseases: Pediatric Infectious Diseases. Edited by CM Wilfert. Philadelphia, Current Medicine, 1998.
This close-up of a newborn's mouth shows sores on and under the upper lip caused by herpes simplex virus.
This close-up of a newborn's mouth shows sores on and under the upper lip caused by herpes simplex virus.
DR P. MARAZZI/SCIENCE PHOTO LIBRARY
This photo shows a newborn who has acquired immunodeficiency syndrome (AIDS) and a rash of small fluid-filled blisters covering the entire body.
This photo shows a newborn who has acquired immunodeficiency syndrome (AIDS) and a rash of small fluid-filled blisters
DR M.A. ANSARY/SCIENCE PHOTO LIBRARY
This photo shows small fluid-filled blisters on the face of a newborn infected with herpes simplex virus.
This photo shows small fluid-filled blisters on the face of a newborn infected with herpes simplex virus.
By permission of the publisher. From Demmler G: Congenital and perinatal infections. In Atlas of Infectious Diseases: Pediatric Infectious Diseases. Edited by CM Wilfert. Philadelphia, Current Medicine, 1998.
Kwa baadhi ya watoto, maambukizi huathiri eneo moja tu mahususi (localized). Kwa mfano, maambukizi yanaweza kuathiri macho, ngozi, na mdomo pekee. Nyakati nyingine, ni ubongo na mfumo wa neva pekee unaoathirika. Ikiwa maambukizi ya eneo moja hayatatibiwa, yanaweza kusambaa na kuenea mwili mzima (widespread infection).
Maambukizi yaliyoenea huathiri viungo vingi kwa pamoja. Kwa watoto walioathiriwa, viungo kama macho, mapafu, ini, ubongo, na ngozi vyote huambukizwa. Dalili ni pamoja na mtoto kuwa mnyonge sana, misuli kulegea, shida ya kupumua, kukata pumzi kwa muda (apnea), na vifafa.
Utambuzi wa Maambukizi ya HSV kwa Watoto Wachanga
Upimaji wa sampuli kutoka kwenye malengelenge na majimaji mengine ya mwili.
Ili kutambua HSV, madaktari huchukua sampuli kutoka kwenye malengelenge na kuzipeleka maabara ili kukuza na kutambua virusi hivyo. Madaktari pia wanaweza kutumia kipimo cha PCR kwenye sampuli hizo. Kipimo hiki hutafuta vinasaba vya virusi, jambo linalowasaidia madaktari kuvitambua kwa haraka sana.
Ikiwa daktari anashuku maambukizi ya ubongo, spinal tap (lumbar puncture) hufanywa ili kuchukua sampuli ya majimaji ya uti wa mgongo.
Matibabu ya Maambukizi ya HSV kwa Watoto Wachanga
Acyclovir
Watoto wenye maambukizi yaliyoenea hupewa dawa ya acyclovir kupitia mshipa wa damu kwa wiki 3, kisha dawa ya kunywa kwa miezi 6. Watoto wenye maambukizi ya eneo moja hupewa acyclovir kupitia mshipa kwa wiki 2. Dawa hii haiondoi virusi mwilini kabisa lakini inasaidia kuzuia visisambae na inapunguza ukali wa dalili.
Maambukizi ya macho hutibiwa pia kwa matone ya trifluridine au jeli ya ganciclovir.
Huduma nyingine kama kuongezewa maji na usaidizi wa kupumua hutolewa kulingana na mahitaji ya mtoto. Watoto wote wenye HSV wanapaswa kufanyiwa uchunguzi wa macho na picha za ubongo (kama CT au MRI).
Ubashiri wa Maambukizi ya HSV kwa Watoto Wachanga
Isipotibiwa, HSV kwa mtoto mchanga kawaida husababisha matatizo makubwa sana. Takribani asilimia 85 ya watoto wenye maambukizi yaliyoenea na asilimia 50 ya wale wenye maambukizi ya ubongo hufa ikiwa hawatatibiwa. Bila matibabu, angalau asilimia 65 ya manusura wa maambukizi ya ubongo au yaliyoenea hupata ulemavu mkubwa wa neva. Hata kwa matibabu, watoto waliopata maambukizi ya ubongo au yaliyoenea wanaweza kuwa na matatizo ya neva au ukuaji.
Maambukizi yaliyobaki kwenye ngozi, macho, au mdomo pekee kawaida si hatari sana kwa maisha. Hata hivyo, isipotibiwa, watoto hawa wengi hupata maambukizi ya ubongo au yaliyoenea mwili mzima.
Matibabu sahihi ya dawa za kuzuia virusi hupunguza vifo na kuongeza uwezekano wa mtoto kukua vizuri.
Uzuiaji wa Maambukizi ya HSV kwa Watoto Wachanga
Wajawazito waliowahi kupata herpes sehemu za siri wanashauriwa kuanza kutumia dawa za kuzuia virusi (acyclovir au valacyclovir) kuanzia wiki ya 36 ya ujauzito.
Ikiwa mjamzito ana vidonda au dalili za herpes wakati wa kujifungua, upasuaji (C-section) unapendekezwa ili kumlinda mtoto.
Watoto waliozaliwa na akina mama wenye maambukizi ya herpes wakati wa kujifungua kwa njia ya kawaida (uke) wanapaswa kupimwa ugonjwa huo mara moja.
