Isifo se-Lyme

**Isifo se-Lyme**, esaziwa nangokuthi **yi-Lyme borreliosis**, bulwelwe obuthathelwanako obubangwa yi- *Borrelia* bacterium esabalaliswa mikhaza .  Itshwayo elivame khulu lokutheleleka yindawo ekhulako yokubomvu esikhumbeni, eyaziwa nge -erythema migrans, ebonakala endaweni lapho umkhaza ulunywe khona ngemva kweveke kwenzeke.  Iratjhi kanengi ayilunywa namkha ibe buhlungu.  Pheze ama-70 ukuya kwama-80% wabantu abathelelekileko baba ne-rash.  Ezinye iimpawu zokuthoma zingafakahlangana umkhuhlane, ihloko, ukudinwa kanye namadlala avuvukileko .  Ivamise ukurarulula ngesigaba lesi.  Nakungalatjhwa, abanye abantu bangathoma ukulahlekelwa likghono lokunyakazisa ihlangothi elilodwa nofana zombili zobuso, ubuhlungu emalungwini, ukuphathwa yihloko okukhulu nokuqina kwentamo, nofana ukubetha kwehliziyo, hlangana nezinye.  Ngemva kweenyanga ukuya eminyakeni, kungenzeka iinkhathi eziphindaphindiweko zobuhlungu bamalunga nokuvuvuka.   Ngezinye iinkhathi, abantu baba nobuhlungu bokudubula nofana ukuvuvuka emikhonweni nemilenzeni yabo.  Nanyana kunikelwa ukwelatjhwa okufaneleko, abantu abangaba li-10 ukuya kweli-20% baba nobuhlungu bamalunga, imiraro yokukhumbula, nokudinwa okungenani iinyanga ezisithandathu.  

Ubulwelwe be-Lyme budluliselwa ebantwini ngokulunywa mikhaza enesifo somhlobo we- *Ixodes* .  E-United States, imikhaza ekhathazako ivamise ukuba mhlobo we *-Ixodes scapularis*, begodu kufuze inamathele okungenani ama-awa ama-36 ngaphambi kobana ibhaktheriya isabalale.   E-Europe, imikhaza yomhlobo we *-Ixodes ricinus* ingasabalalisa ibhaktheriya msinyana.   E-North America, ibhaktheriya *i-Borrelia burgdorferi* kanye *ne-Borrelia mayonii* ibanga isifo se-Lyme.   E-Europe ne-Asia, *i-Borrelia afzelii* kanye *ne-Borrelia garinii* nazo zibangela ubulwele.  Ubulwelwe lobu abubonakali butheleleka hlangana nabantu, ngezinye iinlwana, nofana ngokudla.  Ukuhlolwa kusekelwe ekuhlanganisweni kweempawu, umlando wokuvezwa kwemikhaza, begodu mhlamunye nokuhlolwa kwama -antibodies athileko egazini.   Ukuhlolwa kweengazi kuvamise ukuba kumbi ekuthomeni kwesifo.  Ukuhlolwa kwemikhaza ngayinye akusizi ngalitho. 

Ukukhandela kufaka hlangana imizamo yokukhandela ukulunywa mikhaza njengokugqoka izambatho ezivala imikhono nemilenze, nokusebenzisa iinhlahla eziqotjha iinambuzane ezisekelwe ku -DEET .  Ukusebenzisa imithi yokubulala iintwala ukwehlisa inani lemikhaza nakho kungaba kuhle.  Imikhaza ingasuswa ngokusebenzisa i-tweezers .  Nangabe umkhaza okhutjhweko bewuzele iingazi, umthamo munye we -doxycycline ungasetjenziswa ukukhandela ukukhula kokutheleleka, kodwana akukhuthazwa ngombana ukukhula kokutheleleka akukavami.  Nangabe kuvela ukutheleleka, ama-antibiotics amanengi ayasebenza, kufaka hlangana i-doxycycline, i-amoxicillin, i-azithromycin, i-ceftriaxone, kanye ne -cefuroxime .  Ukwelatjhwa okujayelekileko kuvamise ukuthatha amaviki amabili nofana amathathu.  Abanye abantu baba nomkhuhlane kanye nobuhlungu bemisipha namalunga ngemva kokwelatjhwa okungathatha ilanga elilodwa nofana amabili.  Kilabo abathola amatshwayo angapheliko, ukwelatjhwa ngama-antibiotic wesikhathi eside akukatholakali bona kuyasiza.  

Ubulwelwe be-Lyme bulwelwe obuvame ukusabalaliswa mikhaza e -Northern Hemisphere .  Kulinganiselwa bona ithinta abantu abama-300,000 ngomnyaka e-United States kanye nabantu abama-65,000 ngomnyaka e-Europe.   Ukutheleleka kuvame khulu entwasahlobo nasekuthomeni kwehlobo.  Ubulwelwe be-Lyme batholwa njengobujamo obuhlukileko kokuthoma ngo-1975 e- Old Lyme, e-Connecticut .  Ekuthomeni bekuthathwa njenge -rheumatoid arthritis yabantwana .  Ibhaktheriya ebandakanyekako yathoma ukuchazwa ngo-1981 ngu -Willy Burgdorfer .  Amatshwayo angapheliko alandela ukwelatjhwa ahlathululwe kuhle begodu aziwa ngokuthi "isifo se-Lyme ngemva kokwelatjhwa" (i-PTLDS).  I-PTLDS ihlukile ebulwelweni be-Lyme obungapheliko ; ibizo elingasasekelwa mphakathi wezesayensi begodu lisetjenziswa ngeendlela ezihlukileko ziinqhema ezihlukileko.   Abanye abasebenzi bezamaphilo bathi i-PTLDS ibangelwa kutheleleka okungapheliko, kodwana lokhu akukholelwa bona kuliqiniso ngombana abukho ubufakazi bokutheleleka okuhlalako okungatholakala ngemva kokwelatjhwa okujayelekileko.  Umjovo wesifo se-Lyme wathengiswa e-United States hlangana nomnyaka ka-1998 ukuya ku-2002, kodwana wahoxiswa emakethe ngebanga lokuthengisa okumbi.    Irhubhululo liyaragela phambili ukwenza imijovo etja. 

## Iinkomba