{"id":31066,"date":"2025-12-29T13:10:19","date_gmt":"2025-12-29T10:10:19","guid":{"rendered":"https:\/\/www.klimikdergisi.org\/?p=31066"},"modified":"2026-01-14T16:21:19","modified_gmt":"2026-01-14T13:21:19","slug":"bir-kizamik-epidemisi","status":"publish","type":"post","link":"https:\/\/www.klimikdergisi.org\/tr\/2025\/12\/29\/bir-kizamik-epidemisi\/","title":{"rendered":"Son D\u00f6nem K\u0131zam\u0131k Epidemisi S\u0131ras\u0131nda Eri\u015fkin K\u0131zam\u0131k Olgular\u0131n\u0131n Klinik ve Epidemiyolojik De\u011ferlendirilmesi"},"content":{"rendered":"

G\u0130R\u0130\u015e<\/b><\/h2>\n

K\u0131zam\u0131k, k\u0131zam\u0131k virusunun neden oldu\u011fu olduk\u00e7a bula\u015f\u0131c\u0131, akut ve d\u00f6k\u00fcnt\u00fcl\u00fc bir infeksiyon hastal\u0131\u011f\u0131d\u0131r. Etken, Paramyxoviridae<\/i> ailesine ait tek iplikli bir RNA virusudur. Hastal\u0131k ate\u015f, \u00f6ks\u00fcr\u00fck, burun ak\u0131nt\u0131s\u0131 ve konjonktivit ile ba\u015flar, ard\u0131ndan karakteristik bir d\u00f6k\u00fcnt\u00fc olu\u015fur (1). K\u0131zam\u0131\u011fa maruz kalan duyarl\u0131 bireylerde atak oran\u0131 %90\u2019d\u0131r. Bula\u015fma, do\u011frudan temas\u0131n yan\u0131 s\u0131ra hava yoluyla da ger\u00e7ekle\u015fir. K\u0131zam\u0131kl\u0131 bir hastan\u0131n solunum salg\u0131lar\u0131ndan kaynaklanan infeksiy\u00f6z damlac\u0131klar iki saate kadar havada as\u0131l\u0131 kalabilir (2). Bu nedenle, hastal\u0131k kamusal alanlarda, ki\u015fisel temas olmadan da bula\u015fabilir. Havaalanlar\u0131nda ve u\u00e7u\u015f s\u0131ras\u0131nda yolcular aras\u0131nda k\u0131zam\u0131k bula\u015ft\u0131\u011f\u0131 bildirilmi\u015ftir (3).<\/p>\n

K\u0131zam\u0131k h\u0131zla yay\u0131ld\u0131\u011f\u0131 i\u00e7in toplum d\u00fczeyinde a\u015f\u0131lama, hastal\u0131ktan korunman\u0131n en etkili yoludur (4). K\u0131zam\u0131k a\u015f\u0131s\u0131n\u0131n, 1960\u2019larda kullan\u0131lmaya ba\u015flanmas\u0131ndan \u00f6nce hastal\u0131k, \u00e7ocukluk \u00e7a\u011f\u0131ndaki \u00f6l\u00fcmlerin \u00f6nde gelen nedenlerinden biriydi ve 1980\u2019lere kadar y\u0131lda iki milyondan fazla \u00f6l\u00fcme yol a\u00e7\u0131yordu. Zay\u0131flat\u0131lm\u0131\u015f canl\u0131 virus i\u00e7eren a\u015f\u0131lar\u0131n rutin ba\u011f\u0131\u015f\u0131klama programlar\u0131na eklenmesiyle k\u0131zam\u0131k olgular\u0131nda ve \u00f6l\u00fcm oranlar\u0131nda belirgin azalma sa\u011flanm\u0131\u015ft\u0131r (1). Virusun tek rezervuar\u0131n\u0131n insan olmas\u0131 nedeniyle eradikasyon hedeflenmi\u015ftir (5).<\/p>\n

T\u00fcrkiye\u2019de k\u0131zam\u0131k a\u015f\u0131s\u0131 1970\u2019ten beri uygulanmaktad\u0131r. \u0130kinci doz 1998\u2019de programa eklenmi\u015f ve ilkokul birinci s\u0131n\u0131f \u00f6\u011frencilerine uygulanmaya ba\u015flanm\u0131\u015ft\u0131r. \u00dclkemizde 2002 y\u0131l\u0131nda, D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc (DS\u00d6) Avrupa B\u00f6lgesi\u2019nin K\u0131zam\u0131k Eliminasyon Hedefi<\/i> do\u011frultusunda K\u0131zam\u0131kla M\u00fccadele Program\u0131 ba\u015flat\u0131lm\u0131\u015f; 2003 ve 2005\u2019te \u00fclke \u00e7ap\u0131nda okullarda k\u0131zam\u0131k a\u015f\u0131lama g\u00fcnleri d\u00fczenlenmi\u015ftir. 2007\u20132011 y\u0131llar\u0131 aras\u0131nda y\u0131ll\u0131k olgu say\u0131s\u0131 5\u2019in alt\u0131nda d\u00fc\u015fm\u00fc\u015f; 2008\u20132010 y\u0131llar\u0131 aras\u0131nda ise yurt i\u00e7i kaynakl\u0131 olgu bildirilmemi\u015ftir. Ancak 2011\u2019de Suriye\u2019deki i\u00e7 sava\u015f nedeniyle ba\u015flayan g\u00f6\u00e7 hareketleri ve Avrupa\u2019da azalan a\u015f\u0131lama oranlar\u0131 sonras\u0131nda ortaya \u00e7\u0131kan k\u0131zam\u0131k salg\u0131nlar\u0131yla, \u00fclkemizde k\u0131zam\u0131k olgular\u0131nda yeniden art\u0131\u015f g\u00f6r\u00fclm\u00fc\u015ft\u00fcr (6). D\u00fcnya Sa\u011fl\u0131k \u00d6rg\u00fct\u00fc verilerine g\u00f6re, A\u011fustos 2022\u2013Temmuz 2023 d\u00f6neminde, T\u00fcrkiye 2974 olgu ile Avrupa B\u00f6lgesi\u2019nde en \u00e7ok olgu bildirilen \u00fclke olmu\u015ftur (7).\u00a0<\/span><\/p>\n

K\u0131zam\u0131k salg\u0131nlar\u0131 hem \u00fclkemizde hem de d\u00fcnya genelinde s\u00fcrmektedir. Amerika Birle\u015fik Devletleri (ABD)\u2019nde hastal\u0131\u011f\u0131n 2000 y\u0131l\u0131nda eradike edildi\u011fi bildirilmekle birlikte 2025 y\u0131l\u0131nda ciddi bir salg\u0131n ya\u015fanmaktad\u0131r; 24 Nisan 2025 itibar\u0131yla, ABD\u2019de Hastal\u0131k Kontrol ve \u00d6nleme Merkezleri (Centers for Disease Control and Prevention, CDC) 884 do\u011frulanm\u0131\u015f olgu ve 3 \u00f6l\u00fcm bildirmi\u015ftir (8).<\/p>\n

Bu \u00e7al\u0131\u015fma, T\u00fcrkiye\u2019de son d\u00f6nemde ya\u015fanan epideminin ard\u0131ndan hastanemizde izlenen eri\u015fkin k\u0131zam\u0131k olgular\u0131n\u0131n epidemiyolojik ve klinik \u00f6zelliklerini de\u011ferlendirmeyi ama\u00e7lamaktad\u0131r.<\/p>\n

Y\u00d6NTEMLER<\/b><\/h2>\n

Bu retrospektif, kesitsel \u00e7al\u0131\u015fmada, hastanemizde Ocak 2022\u2013Eyl\u00fcl 2023 tarihleri aras\u0131nda k\u0131zam\u0131k tan\u0131s\u0131 ile izlenen eri\u015fkin hastalara ait veriler incelendi. \u00c7al\u0131\u015fmaya, k\u0131zam\u0131k imm\u00fcnoglobulin M (IgM) ve\/veya k\u0131zam\u0131k polimeraz zincir reaksiyonu (PCR) testi ile tan\u0131 alan, 18 ve ya\u015f \u00fczeri t\u00fcm hastalar dahil edildi.\u00a0<\/span><\/p>\n

Hastalar\u0131n sosyodemografik \u00f6zellikleri, k\u0131zam\u0131k serolojisi ve PCR sonu\u00e7lar\u0131, klinik \u015fikayetleri (d\u00f6k\u00fcnt\u00fc, ate\u015f, \u00f6ks\u00fcr\u00fck vb.), muayene bulgular\u0131 (Koplik lekesi, konjonktivit, vb.), akci\u011fer grafileri ve laboratuvar parametreleri [hemogram, aspartat aminotransferaz (AST), alanin aminotransferaz (ALT), laktat dehidrogenaz (LDH) ve C-reaktif protein (CRP)] de\u011ferlendirildi. Sosyodemografik de\u011fi\u015fkenlere ait veriler tan\u0131mlay\u0131c\u0131 istatistiklerle (ortalama, standart sapma, y\u00fczde) analiz edildi. Kategorik de\u011fi\u015fkenler, frekans (n) ve y\u00fczde (%) olarak \u00f6zetlendi.\u00a0<\/span><\/p>\n

\u00c7al\u0131\u015fma i\u00e7in Ba\u015fak\u015fehir \u00c7am ve Sakura \u015eehir Hastanesi Klinik Ara\u015ft\u0131rmalar Etik Kurulu\u2019ndan 13 Aral\u0131k 2023 tarihinde 643 karar numaras\u0131 ile onay al\u0131nd\u0131.<\/p>\n

BULGULAR\u00a0<\/span><\/b><\/h2>\n
\"\"<\/a>

\u015eekil.<\/strong> Ocak 2022\u2013Eyl\u00fcl 2023 Tarihleri Aras\u0131ndaki Olgu Say\u0131lar\u0131<\/p><\/div>\n

\u00c7al\u0131\u015fmaya k\u0131zam\u0131k tan\u0131s\u0131 alan 162 olgu dahil edildi. \u0130lk olgu 16 \u015eubat 2022\u2019de saptanm\u0131\u015ft\u0131; ayn\u0131 ay i\u00e7inde bir olgu daha g\u00f6r\u00fclm\u00fc\u015ft\u00fc. Sonras\u0131nda bir y\u0131l boyunca yeni k\u0131zam\u0131k olgusu izlenmezken, 3 \u015eubat 2023\u2019te T\u00fcrk vatanda\u015f\u0131 olmu\u015f yabanc\u0131 uyruklu bir olgunun ard\u0131ndan olgu say\u0131s\u0131 h\u0131zla artm\u0131\u015ft\u0131. En y\u00fcksek olgu say\u0131s\u0131na May\u0131s 2023\u2019te ula\u015f\u0131lm\u0131\u015f olup bu tarihten sonra ba\u015fvurular giderek azalm\u0131\u015ft\u0131. Olgular\u0131n zamansal da\u011f\u0131l\u0131m\u0131 \u015eekil\u2019de sunuldu.<\/p>\n

\"\"<\/a>

Tablo 1.<\/strong> Demografik Veriler (N=162)<\/p><\/div>\n

Olgular\u0131n 98\u2019inin (%60) kad\u0131n ve bunlar\u0131n 5\u2019inin (%5) gebe oldu\u011fu g\u00f6r\u00fcld\u00fc. Gebe hastalardan 2\u2019si 29 haftal\u0131k di\u011fer 3\u2019\u00fc 35 haftal\u0131k gebe olup t\u00fcm\u00fc son trimesterdeydi. Olgular\u0131n ya\u015f ortalamas\u0131 27 y\u0131l (da\u011f\u0131l\u0131m 18\u201351 y\u0131l) idi; 12\u2019si (%7) yabanc\u0131 uyrukluydu. Demografik veriler Tablo 1\u2019de sunuldu. Kendi beyanlar\u0131na dayal\u0131 olarak yaln\u0131zca 17 (%10.5) olgu tam doz k\u0131zam\u0131k a\u015f\u0131s\u0131 olmu\u015ftu.<\/p>\n

\"\"<\/a>

Tablo 2.<\/strong> Klinik Semptom ve Bulgular<\/p><\/div>\n

Hastalar en s\u0131k d\u00f6k\u00fcnt\u00fc, ate\u015f ve \u00f6ks\u00fcr\u00fck \u015fikayetiyle ba\u015fvurmu\u015ftu. T\u00fcm olgularda d\u00f6k\u00fcnt\u00fc mevcuttu; 105 (%65) olguda \u00f6ks\u00fcr\u00fck, 131 (%81) olguda ate\u015f, 29 (%18) olguda konjonktivit ve 21 (%13) olguda Koplik lekesi saptand\u0131. Olgular\u0131n semptom ve bulgular\u0131 Tablo 2\u2019de sunuldu.\u00a0<\/span><\/p>\n

Olgular\u0131n 126 (%78)\u2019s\u0131nda k\u0131zam\u0131k IgM pozitifti. K\u0131zam\u0131k IgM negatif olan 36 olgunun tamam\u0131nda k\u0131zam\u0131k PCR test sonucu ise pozitifti. Olgular\u0131n 62\u2019sinde hem k\u0131zam\u0131k IgM hem k\u0131zam\u0131k PCR test sonucu pozitifken, 64 olguda k\u0131zam\u0131k PCR testi istenmedi\u011fi g\u00f6r\u00fcld\u00fc. K\u0131zam\u0131k PCR testi nazofaringeal s\u00fcr\u00fcnt\u00fc ve idrar \u00f6rneklerinden \u00e7al\u0131\u015f\u0131lm\u0131\u015ft\u0131. Olgular\u0131n 86\u2019s\u0131n\u0131n (%53) serum aminotransferaz d\u00fczeylerinde art\u0131\u015f saptanm\u0131\u015ft\u0131. En y\u00fcksek AST de\u011ferinin 1152 U\/lt\u2019ye kadar y\u00fckseldi\u011fi g\u00f6r\u00fcld\u00fc. Olgular\u0131n 30\u2019unda (%18.5) l\u00f6kopeni, 46\u2019s\u0131nda (%28) trombositopeni geli\u015fmi\u015fti. Hastanede yat\u0131r\u0131larak izlenen olgu say\u0131s\u0131 13 (%8.0) idi. Yatarak izlenen olgular\u0131n 5\u2019inde pn\u00f6moni, 4\u2019\u00fcnde hepatit, 1\u2019inde derin trombositopeni, 1\u2019inde ishal mevcuttu; 2 olgu ise gebelik nedeniyle yat\u0131r\u0131lm\u0131\u015ft\u0131.\u00a0<\/span><\/p>\n

\"\"<\/a>

Tablo 3.<\/strong> Laboratuvar Bulgular\u0131<\/p><\/div>\n

K\u0131zam\u0131k pn\u00f6monisi, k\u0131zam\u0131\u011fa ba\u011fl\u0131 \u00f6l\u00fcmlerin en \u00f6nemli nedenlerinden biridir. \u0130zlenen 5 pn\u00f6moni olgusundan 1\u2019inin balgam k\u00fclt\u00fcr\u00fcnde Pseudomonas aeruginosa<\/i>, bir di\u011ferinin balgam k\u00fclt\u00fcr\u00fcnde ise Streptococcus pneumoniae<\/i> \u00fcremesi saptanm\u0131\u015f; bu olgular sekonder bakteriyel pn\u00f6moni olarak de\u011ferlendirilmi\u015ftir. Di\u011fer 3 olguda etken izole edilmemi\u015f ve k\u0131zam\u0131k pn\u00f6monisi kabul edilmi\u015ftir. Yatarak izlenen olgulara semptomatik tedavi ve destek tedavisi verildi\u011fi ve olgular\u0131n t\u00fcm\u00fcnde klinik iyile\u015fme oldu\u011fu tespit edildi (Tablo 3).\u00a0<\/span><\/p>\n

\u0130RDELEME<\/b><\/h2>\n

K\u0131zam\u0131k, olduk\u00e7a bula\u015f\u0131c\u0131, a\u015f\u0131yla \u00f6nlenebilir bir hastal\u0131kt\u0131r ve bula\u015fman\u0131n \u00f6nlenebilmesi i\u00e7in toplumun en az %95\u2019inde ba\u011f\u0131\u015f\u0131kl\u0131k sa\u011flanmas\u0131 gerekmektedir (9). T\u00fcrkiye\u2019de 2007\u20132011 y\u0131llar\u0131 aras\u0131nda, olgu say\u0131s\u0131 5\u2019in alt\u0131nda kalm\u0131\u015f; 2008\u20132010 y\u0131llar\u0131 aras\u0131nda ise yurt i\u00e7i kaynakl\u0131 olgu bildirimi yap\u0131lmam\u0131\u015ft\u0131r (7). Sonraki y\u0131llarda ise t\u00fcm d\u00fcnyada, a\u015f\u0131 karars\u0131zl\u0131\u011f\u0131, sava\u015flar ve g\u00f6\u00e7 hareketleri nedeniyle salg\u0131nlar ya\u015fanm\u0131\u015ft\u0131r. COVID-19 pandemisi s\u0131ras\u0131nda ba\u011f\u0131\u015f\u0131klama oranlar\u0131n\u0131n d\u00fc\u015fmesiyle birlikte k\u0131zam\u0131k olgular\u0131nda yeniden ciddi art\u0131\u015flar g\u00f6r\u00fclm\u00fc\u015ft\u00fcr.\u00a0<\/span><\/p>\n

Hastanemizin bulundu\u011fu b\u00f6lgede 2022\u20132023 y\u0131llar\u0131 aras\u0131nda, bir\u00e7ok farkl\u0131 \u00fclkeden \u00f6\u011frencilerin oldu\u011fu bir okulda g\u00f6r\u00fclen ilk olgunun ard\u0131ndan tespit edilen 162 eri\u015fkin k\u0131zam\u0131k olgusu bu \u00e7al\u0131\u015fmada irdelendi. Van\u2019da 2015 y\u0131l\u0131nda Sunnetcioglu ve arkada\u015flar\u0131n\u0131n (10) 50 eri\u015fkin hastada yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada, olgular\u0131n 41\u2019i (%84) kad\u0131nd\u0131. Bu sonu\u00e7, bizim \u00e7al\u0131\u015fmam\u0131zdaki kad\u0131n oran\u0131 (%60) ile uyumludur. \u00c7ocuk bak\u0131m\u0131n\u0131n \u00e7o\u011funlukla kad\u0131nlar taraf\u0131ndan \u00fcstlenilmesi ve eri\u015fkinlere bula\u015fmada \u00e7ocuklar\u0131n kaynak olmas\u0131 oransal olarak bu y\u00fcksekli\u011fi a\u00e7\u0131klayabilir. Ancak k\u0131zam\u0131k ya\u015f ve cinsiyetten ba\u011f\u0131ms\u0131z olarak ba\u011f\u0131\u015f\u0131kl\u0131\u011f\u0131 olmayan herkesi etkileyebilir.\u00a0<\/span><\/p>\n

Gebelerde k\u0131zam\u0131k infeksiyonu yaln\u0131zca maternal hastal\u0131k olarak de\u011fil hem anne hem bebek i\u00e7in ciddi gebelik komplikasyonlar\u0131 a\u00e7\u0131s\u0131ndan da riskler ta\u015f\u0131maktad\u0131r. \u0130talya\u2019da 843 k\u0131zam\u0131k olgusunun incelendi\u011fi bir \u00e7al\u0131\u015fmada, 24 olgunun gebe oldu\u011fu ve bu olgularda 2 spontan d\u00fc\u015f\u00fck, 1 terap\u00f6tik d\u00fc\u015f\u00fck, 1 fetal \u00f6l\u00fcm ve 6 erken do\u011fum geli\u015fti\u011fi bildirilmi\u015ftir (11). \u00c7al\u0131\u015fmam\u0131za al\u0131nan 98 (%60) kad\u0131n olgunun 5\u2019i gebeydi. Ancak bu olgular\u0131n hi\u00e7birinde gebelik ile ili\u015fkili bir komplikasyon ya\u015fanmam\u0131\u015ft\u0131.<\/p>\n

K\u0131zam\u0131k, genellikle uzun s\u00fcreli ba\u011f\u0131\u015f\u0131kl\u0131k sa\u011flayan a\u015f\u0131yla \u00f6nlenebilir bir hastal\u0131kt\u0131r. Amerika Birle\u015fik Devletleri\u2019nde 12 ayl\u0131kken a\u015f\u0131lanan bireylerin %96\u2019s\u0131nda ve 15 ayl\u0131kken a\u015f\u0131lananlar\u0131n ise %98\u2019inde k\u0131zam\u0131k antikorlar\u0131 geli\u015fti\u011fi g\u00f6sterilmi\u015ftir (12). Ancak zamanla antikor d\u00fczeylerindeki d\u00fc\u015f\u00fc\u015flere ba\u011fl\u0131 olarak, a\u015f\u0131l\u0131 ki\u015filerde de k\u0131zam\u0131k g\u00f6r\u00fclebilmektedir; bu olgularda semptomlar genellikle daha hafif seyretmektedir. Somali\u2019de Navarro-Colorado ve arkada\u015flar\u0131n\u0131n (13) 2011\u2019de yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada 1370 k\u0131zam\u0131k olgusunun %79.6\u2019s\u0131n\u0131n, Muscat ve arkada\u015flar\u0131n\u0131n (14) 2018 y\u0131l\u0131nda 47 \u00fclkeden 82 596 olguyu kapsayan \u00e7al\u0131\u015fmas\u0131nda ise %62\u2019sinin a\u015f\u0131s\u0131z oldu\u011funu bildirilmi\u015ftir. Bizim \u00e7al\u0131\u015fmam\u0131zda, olgular\u0131n kendi beyanlar\u0131na dayal\u0131 olarak yaln\u0131zca %10.5\u2019inde tam doz a\u015f\u0131 \u00f6yk\u00fcs\u00fc vard\u0131; 145 (%89.5) olgu ise a\u015f\u0131 durumunu bilmiyordu.\u00a0<\/span><\/p>\n

K\u0131zam\u0131k olgular\u0131nda en s\u0131k g\u00f6r\u00fclen bulgular ate\u015f ve d\u00f6k\u00fcnt\u00fcd\u00fcr. \u00dclkemizde Karake\u00e7ili ve arkada\u015flar\u0131n\u0131n (15) 2023 y\u0131l\u0131nda 28 hastada yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada d\u00f6k\u00fcnt\u00fc ve ate\u015fin olgular\u0131n tamam\u0131nda, \u00f6ks\u00fcr\u00fc\u011f\u00fcn %64\u2019\u00fcnde, konjonktivitin %36\u2019s\u0131nda, Koplik lekesinin ise %18\u2019inde g\u00f6r\u00fcld\u00fc\u011f\u00fc bildirilmi\u015ftir. Bizim \u00e7al\u0131\u015fmam\u0131zda da olgular\u0131n hepsinde d\u00f6k\u00fcnt\u00fc mevcut olup %80\u2019inde ate\u015f, %65\u2019inde \u00f6ks\u00fcr\u00fck, %18\u2019sinde konjonktivit %12\u2019sinde Koplik lekesi g\u00f6r\u00fclm\u00fc\u015ft\u00fc.<\/p>\n

Tan\u0131da k\u0131zam\u0131\u011fa \u00f6zg\u00fcl IgM testinin yan\u0131 s\u0131ra, erken d\u00f6nemde hen\u00fcz IgM serokonversiyonu olu\u015fmadan saptanabilen PCR testleri de \u00f6nemlidir. Bassetti ve arkada\u015flar\u0131n\u0131n (16) Ocak 2008\u2013Nisan 2009 d\u00f6neminde \u0130talya\u2019da izledikleri 83 hastan\u0131n 34\u2019\u00fcnde (%41) k\u0131zam\u0131k PCR pozitif, k\u0131zam\u0131k IgM negatif; 5\u2019inde (%6) yaln\u0131zca IgM pozitif; 44\u2019\u00fcnde (%53) ise hem IgM hem de PCR pozitifli\u011fi saptand\u0131\u011f\u0131 bildirilmi\u015ftir. Bizim \u00e7al\u0131\u015fmam\u0131zda da olgular\u0131n 126\u2019s\u0131nda (%78) k\u0131zam\u0131k IgM pozitif idi. K\u0131zam\u0131k IgM negatif olan 36 olgunun tamam\u0131nda k\u0131zam\u0131k PCR ise pozitif saptanm\u0131\u015ft\u0131. Olgular\u0131n 62\u2019sinde hem k\u0131zam\u0131k IgM hem k\u0131zam\u0131k PCR pozitif iken 64 olguda k\u0131zam\u0131k PCR testi istenmemi\u015fti. Bu bulgular k\u0131zam\u0131\u011f\u0131n erken tan\u0131s\u0131nda PCR\u2019nin ak\u0131lda tutulmas\u0131 gerekti\u011fini g\u00f6stermektedir.\u00a0<\/span><\/p>\n

K\u0131zam\u0131k virusu hepatotropik bir virus olmamas\u0131na ra\u011fmen karaci\u011ferde inflamasyona neden olarak hepatit geli\u015fimine yol a\u00e7abilir. Fransa\u2019da 80 k\u0131zam\u0131k olgusunun incelendi\u011fi bir \u00e7al\u0131\u015fmada olgular\u0131n %81\u2019inde karaci\u011fer enzim y\u00fcksekli\u011fi bildirilmi\u015ftir (17). Bizim \u00e7al\u0131\u015fmam\u0131zda ise olgular\u0131n %53\u2019\u00fcnde karaci\u011fer enzim y\u00fcksekli\u011fi saptanm\u0131\u015ft\u0131r. Polonya\u2019da Bogusz ve Paradowska-Stankiewicz\u2019in (18) 2016 y\u0131l\u0131nda 133 k\u0131zam\u0131k olgusu ile yapt\u0131klar\u0131 \u00e7al\u0131\u015fmada hastalar\u0131n %69.9\u2019u hastaneye yat\u0131r\u0131larak izlenmi\u015f olup \u00e7al\u0131\u015fmaya pediyatrik olgular da dahil edilmi\u015ftir. S\u00f6z konusu \u00e7al\u0131\u015fmada mortal seyreden olgu bildirilmemi\u015ftir. Bizim \u00e7al\u0131\u015fmam\u0131zda yer alan 13 (%8.0) hasta da yat\u0131r\u0131larak izlenmi\u015f, t\u00fcm\u00fcnde semptomatik ve destek tedavisiyle klinik olarak iyile\u015fme sa\u011flanm\u0131\u015f ve \u00f6l\u00fcm g\u00f6r\u00fclmemi\u015ftir.<\/p>\n

B\u00f6lgemizde k\u0131zam\u0131k olgular\u0131ndaki h\u0131zl\u0131 art\u0131\u015f bize toplumsal ba\u011f\u0131\u015f\u0131kl\u0131k oranlar\u0131n\u0131n azald\u0131\u011f\u0131n\u0131 ve bu konuda acil \u00f6nlemler al\u0131nmas\u0131 gerekti\u011fini g\u00f6stermektedir. Toplumda salg\u0131n olmasa dahi, d\u00f6k\u00fcnt\u00fc ve ate\u015f \u015fikayeti olan hastalarda k\u0131zam\u0131k ay\u0131r\u0131c\u0131 tan\u0131s\u0131n\u0131n yap\u0131lmas\u0131, serolojik testlerin ve PCR\u2019nin kullan\u0131lmas\u0131, olgular\u0131n halk sa\u011fl\u0131\u011f\u0131 birimlerine bildirilmesi ve izolasyon \u00f6nlemlerinin uygulanmas\u0131 yeni salg\u0131nlar\u0131n \u00f6nlenmesinde kritik \u00f6neme sahiptir.\u00a0<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"

G\u0130R\u0130\u015e K\u0131zam\u0131k, k\u0131zam\u0131k virusunun neden oldu\u011fu olduk\u00e7a bula\u015f\u0131c\u0131, akut ve d\u00f6k\u00fcnt\u00fcl\u00fc bir infeksiyon hastal\u0131\u011f\u0131d\u0131r. Etken, Paramyxoviridae ailesine ait tek iplikli bir RNA virusudur. Hastal\u0131k ate\u015f, \u00f6ks\u00fcr\u00fck, burun ak\u0131nt\u0131s\u0131 ve konjonktivit ile ba\u015flar, ard\u0131ndan karakteristik bir d\u00f6k\u00fcnt\u00fc olu\u015fur (1). K\u0131zam\u0131\u011fa maruz kalan duyarl\u0131 bireylerde atak oran\u0131 %90\u2019d\u0131r. Bula\u015fma, do\u011frudan temas\u0131n yan\u0131 s\u0131ra hava yoluyla da ger\u00e7ekle\u015fir. […]<\/p>\n","protected":false},"author":5,"featured_media":31361,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[5129],"tags":[6193,3377,5805,5373],"class_list":["post-31066","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-ozgun-arastirma","tag-eriskin-olgular","tag-kizamik","tag-kizamik-asisi","tag-salgin"],"acf":[],"_links":{"self":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/31066","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/users\/5"}],"replies":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/comments?post=31066"}],"version-history":[{"count":4,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/31066\/revisions"}],"predecessor-version":[{"id":31431,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/posts\/31066\/revisions\/31431"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media\/31361"}],"wp:attachment":[{"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/media?parent=31066"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/categories?post=31066"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.klimikdergisi.org\/tr\/wp-json\/wp\/v2\/tags?post=31066"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}