Ngā tohu typhoid (kirika typhoid): te āhua o te kirika, ngā tohu mōrearea, me te whakamātautau e whakawhirinakitia ai

Ko te kirika typhoid he pokenga nā te huakita Salmonella Typhi. Ka horapa mā te kai, te wai rānei kua poke i te huakita, i te nuinga mai i te tūtae o tētahi tangata e pāngia ana, e kawe ana rānei i te huakita. Ina horomia, ka tini haere te huakita, ā, ka horapa ki roto i te toto.

He noa i ngā wāhi he iti te wai mā me te pūnaha parakaingaki (sanitation), i ētahi wāhi o Āhia, o Āwherika, o Amerika Waenga me Amerika ki te Tonga. E ai ki te whakatau tata, 9 miriona ngā tāngata ka māuiui i te typhoid ia tau, ā, tata ki te 110,000 ka mate.

Ko te kirika paratyphoid he māuiui ōrite nā te Salmonella Paratyphi, ā, he ōrite tonu te whakamātautau me te maimoatanga.

Ngā kaikawe (carriers): ka pupuri tonu ētahi tāngata i te huakita i roto i tō rātou tinana i muri i te ngaronga o ngā tohu, i ētahi wā mō ngā marama, ngā tau rānei, ā, ka taea e rātou te tuku ki ētahi atu ahakoa kāore rātou e rongo i te māuiui.

I te nuinga ka tīmata ngā tohu i te 6 ki te 30 rā i muri i te pokenga, he pōturi i te nuinga:

• he kirika e piki haere ana i ia rā, ka tae ki te 39 ki te 40°C (103 ki te 104°F) i te rā tuatoru, tuawhā rānei, ā, ka mau neke atu i te 3 rā
• ānini, ngoikore me te ngenge
• wiriwiri me te mamae tinana
• he maremare maroke
• kore hiakai, hiahia ruaki
• mamae puku, me te uaua o te tiko (constipation), te tikotiko (diarrhoea) rānei, ka puta i te nuinga i muri i ērā atu tohu
• i ētahi wā he pukupuku kiri (rash) o ngā ira māwhero kōmā, papatahi (kara rōhi, rose spots), i te nuinga i te uma, i te puku rānei

Ki te kore he maimoatanga, ka mau pea te typhoid mō te marama kotahi, neke atu rānei. Mā ngā paturopi tika, ka ora katoa te nuinga.

Ka puta ngā raruraru taumaha ki te 10 ki te 15% pea o te hunga i te hōhipera nā te typhoid, i te nuinga i muri i te 2 ki te 3 wiki o te māuiui:

• he toto i roto i te whēkau
• he puta i te whēkau (intestinal perforation), ka taea te whakaputa i tētahi pokenga kino o te kiri o roto o te puku (peritonitis)
• he rangirua, he hiamoe rānei

Tikina he āwhina ohotata ināianei mō:

• te mamae puku ohorere e kino haere tonu ana
• te tūtae pango, whero pōuri rānei
• te ruaki toto, te ruaki rānei e rite ana te āhua ki ngā toenga kawhe (coffee grounds)

Hokinga mai (relapse): tae atu ki te 10% o te hunga ka hoki mai ngā tohu, i te nuinga i te 1 ki te 3 wiki i muri i te whakaoranga. Kite i tō rata mēnā ka hoki mai te kirika i muri i te mutunga o tō maimoatanga.

Ngā kaikawe (carriers): tata ki te 1 ki te 4% o te hunga kua maimoatia e kawe tonu ana i te huakita i te tau kotahi i muri mai. Tērā pea ka tirohia e te rata tō tūtae i mua i tō hokinga ki te mahi me te kai, i te hauora, i te taha rānei o ngā tamariki nohinohi.

• Ko te whakatipu toto (blood culture) te whakamātautau e tino tūtohungia ana: ka whakatipuria e te taiwhanga te huakita mai i tētahi tauira toto. Ka kitea e tētahi whakatipu kotahi i roto i te 50% pea o ngā pokenga, nō reira i ētahi wā ka tango ngā rata neke atu i te kotahi, he pai ake i mua i te tīmatanga o ngā paturopi.
• Ka kitea e te whakatipu hinu kōiwi (bone marrow culture) tata ki te 80%, engari he whakamātautau urutomo (invasive), ā, ka whakamahia i ētahi wā anake.
• I te nuinga he kore kitea (negative) te whakatipu tūtae (stool culture) i te wiki tuatahi.

Kāore e taea te whakawhirinaki ki te whakamātautau Widal. He whānui te whakamahinga nā te mea he iti te utu, engari ka puta pea he hua pai (positive) ki te hunga kāore he typhoid (hei tauira, i muri i tētahi pokenga o mua, i te kano ārai mate rānei), ā, he kore kitea (negative) ki te hunga he typhoid tōna. Kaua tētahi hua Widal anake e whakatau mēnā he typhoid tōu, ko tēhea paturopi rānei e hiahiatia ana e koe. Kāore anō ngā whakamātautau tere (rapid tests) i te tino tika.

Ka tirohia anō e ngā rata te tatauranga toto katoa (CBC), ā, i ngā wāhi e noa ana, ka whakamātautau mō te malaria me te dengue. Ka whakamārama tā mātou aratohu dengue i te rerekē o taua kirika.

Ka maimoatia te typhoid ki te paturopi (antibiotics), e whakapoto ana i te māuiui, e whakaiti ana i te tūpono o ngā raruraru me te mate. Ko tēhea paturopi ka whakamahia, ka hāngai ki te wāhi i pāngia ai te pokenga, nā te mea kei te piki haere te ātete ki ngā paturopi (antibiotic resistance), tae atu ki te typhoid ātete whānui ki ngā rongoā (extensively drug-resistant typhoid). Tērā pea ka tono tō rata i ētahi whakamātautau hei kōwhiri i te mea tika.

• Kainga ngā paturopi kia rite tonu ki tā te rata i tohutohu ai, ā, kia oti katoa te kai, ahakoa ka pai ake tō rongo. Ki te mutu wawe, ka hoki mai pea te māuiui, ā, ka āwhina i te horapa o te ātete.
• Kaua e hoko paturopi me te kore tuhinga rongoā (prescription), kaua hoki e whakamahi i ngā toenga paturopi: mā te paturopi hē e whakaroa te maimoatanga tika.
• Ka mau pea te kirika mō te tata ki te 5 rā i muri i te tīmatanga o te maimoatanga. Mēnā kāore e heke ana i taua wā, ka kino ake rānei tō rongo, hoki anō ki tō rata.
• Okioki, kia nui te inu wai, ā, kainga he kai iti, māmā hoki ina taea. Ka āwhina pea te paracetamol mō te kirika; whāia te pōkai, pātai rānei ki tētahi kaiwhakarite rongoā (pharmacist), ā, pātai ki tētahi rata mō te tamaiti.
• Ka maimoatia te typhoid taumaha i te hōhipera.

Tiakina ētahi atu: horoia paitia ō ringa ki te hopi i muri i te whakamahi i te wharepaku, i mua hoki i te pā ki te kai, ā, kaua e whakarite kai mā ētahi atu kia kī rā anō tō rata kua haumaru. Ko tēhea rongoā, ā, e hia te nui, mā tō rata e whakatau.

• Wai haumaru: inumia he wai pātara, he wai kōhua rānei, he wai kua whakapokekore (disinfected) rānei. Karohia te huka tio (ice) ki te kore i hangaia mai i te wai haumaru.
• Kai haumaru: kainga he kai kua tino maoa, e wera tonu ana. Karohia te miraka mata. Horoia ngā huarākau me ngā huawhenua ki te wai haumaru, waruhia rānei e koe anō.
• Horoia ō ringa ki te hopi me te wai, inarā i muri i te wharepaku, i mua hoki i te kai, i te tunu kai rānei.
• Kano ārai mate (vaccines): ka tūtohu te WHO i tētahi kano ārai mate typhoid conjugate (typhoid conjugate vaccine), kotahi te wero, mō ngā tamariki mai i te 6 marama te pakeke me ngā pakeke i ngā whenua e noa ana te typhoid. Ka taea anō e te hunga haereere te whiwhi kano ārai mate typhoid, he pai ake i ētahi wiki i mua i te wehenga; pātai ki tētahi rata, ki tētahi whare haumanu haerenga (travel clinic) rānei ko tēhea, ā, āhea. Kāore he kano ārai mate e tiaki katoa ana, nō reira he mea nui tonu te tiaki i te kai me te wai.