<\/span><\/h3>\nB\u0159i\u0161n\u00ed tyfus, zp\u016fsoben\u00fd bakteri\u00ed\u00a0Salmonella enterica typhi<\/em>, pat\u0159\u00edc\u00ed do skupiny hlavn\u00edch st\u0159evn\u00edch patogenn\u00edch bakteri\u00ed u\u00a0\u010dlov\u011bka i\u00a0u\u00a0divok\u00fdch a dom\u00e1c\u00edch zv\u00ed\u0159at, je hore\u010dnat\u00e9 onemocn\u011bn\u00ed doprov\u00e1zen\u00e9 bolestmi hlavy, slabost\u00ed, nechutenstv\u00edm a \u00fanavou. Jen z\u0159\u00eddka se dostav\u00ed pr\u016fjem, \u010dast\u011bji se dostav\u00ed z\u00e1cpa. Inkuba\u010dn\u00ed doba b\u00fdv\u00e1 5-24 dn\u00ed. Pokud nen\u00ed zah\u00e1jena v\u010dasn\u00e1 l\u00e9\u010dba, obvykle se b\u011bhem prvn\u00edch dvou t\u00fddn\u016f dostav\u00ed mr\u00e1kotn\u00fd stav a blouzn\u011bn\u00ed. Onemocn\u011bn\u00ed m\u016f\u017ee b\u00fdt doprov\u00e1zeno komplikacemi, jako je nap\u0159. krv\u00e1cen\u00ed do st\u0159ev, vz\u00e1cn\u011b i protr\u017een\u00ed st\u0159ev, d\u00e1le z\u00e1n\u011bt pob\u0159i\u0161nice, kostn\u00ed d\u0159en\u011b a \u017elu\u010dn\u00edku, kter\u00fd se nej\u010dast\u011bji vyskytuje u \u017een a m\u016f\u017ee v\u00e9st k p\u0159\u00edpadn\u00e9mu bacilonosi\u010dstv\u00ed. Pr\u016fb\u011bh b\u0159i\u0161n\u00edho tyfu b\u00fdv\u00e1 u d\u011bt\u00ed m\u00edrn\u011bj\u0161\u00ed, zat\u00edmco u star\u0161\u00edch osob ho zpravidla doprov\u00e1zej\u00ed komplikace.<\/p>\nO\u010dkov\u00e1n\u00ed:<\/strong>\u00a0P\u0159ed vycestov\u00e1n\u00edm do krajin se \u0161patn\u00fdmi hygienick\u00fdmi podm\u00ednkami se doporu\u010duje prov\u00e9st o\u010dkov\u00e1n\u00ed. Obvykle se doporu\u010duje o\u010dkovat minim\u00e1ln\u011b 10-14 dn\u00ed p\u0159ed vstupem do endemick\u00e9 oblasti, tj. p\u0159ed o\u010dek\u00e1van\u00fdm rizikem expozice. Posiluj\u00edc\u00ed o\u010dkov\u00e1n\u00ed se prov\u00e1d\u00ed jednou d\u00e1vkou ka\u017ed\u00e9 3 roky, vy\u017eaduj\u00ed-li si to okolnosti. V n\u011bkter\u00fdch zem\u00edch je registrovan\u00e1 jen dvoulet\u00e1 platnost postvakcina\u010dn\u00ed ochrany.<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>: Typhim Vi (ne\u017eiv\u00e1 polysacharidov\u00e1; v\u00fdrobce: Sanofi Pasteur); Typherix (ne\u017eiv\u00e1 polysacharidov\u00e1; v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>\u010cern\u00fd ka\u0161el (pertusse)<\/strong><\/span><\/h3>\n\u010cern\u00fd ka\u0161el je vysoce naka\u017eliv\u00e9, akutn\u00ed infek\u010dn\u00ed onemocn\u011bn\u00ed. P\u016fvodcem je\u00a0Bordetella pertussis<\/em>. Inkuba\u010dn\u00ed doba tohoto bakteri\u00e1ln\u00edho onemocn\u011bn\u00ed je pr\u016fm\u011brn\u011b 1-2 t\u00fddny. P\u0159en\u00e1\u0161\u00ed se kap\u00e9nkovou infekc\u00ed a nejnebezpe\u010dn\u011bj\u0161\u00ed je u d\u011bt\u00ed do 6 let. Onemocn\u011bn\u00ed prob\u00edh\u00e1 ve dvou f\u00e1z\u00edch a zpo\u010d\u00e1tku se neli\u0161\u00ed od b\u011b\u017en\u00e9ho z\u00e1n\u011btu d\u00fdchac\u00edch cest. Po f\u00e1zi, ve kter\u00e9 se obvykle objevuje zv\u00fd\u0161en\u00e1 teplota, r\u00fdma, nechutenstv\u00ed a poka\u0161l\u00e1v\u00e1n\u00ed se dostav\u00ed z\u00e1chvaty typick\u00e9ho dr\u00e1\u017ediv\u00e9ho ka\u0161le se zaj\u00edk\u00e1n\u00edm, p\u0159i nich\u017e se naka\u017een\u00e1 osoba dus\u00ed, modr\u00e1 a zvrac\u00ed. P\u0159i z\u00e1va\u017en\u00e9m pr\u016fb\u011bhu se z\u00e1chvaty objevuj\u00ed nep\u0159etr\u017eit\u011b a cel\u00fd stav vede k\u00a0vy\u010derp\u00e1n\u00ed a dehydrataci. U t\u011b\u017ek\u00fdch forem se objevuj\u00ed tak\u00e9 k\u0159e\u010de a t\u011b\u017ek\u00e9 z\u00e1paly plic a\u017e krv\u00e1cen\u00ed do mozku, co\u017e m\u016f\u017ee v\u00e9st k\u00a0jeho z\u00e1n\u011btu.<\/p>\nO\u010dkov\u00e1n\u00ed:<\/strong>\u00a0Z\u00e1kladn\u00ed o\u010dkov\u00e1n\u00ed se provede v dob\u011b od zapo\u010dat\u00e9ho 9. t\u00fddne po narozen\u00ed d\u00edt\u011bte dv\u011bma d\u00e1vkami hexavalentn\u00ed o\u010dkovac\u00ed l\u00e1tky v pr\u016fb\u011bhu prvn\u00edho roku \u017eivota d\u00edt\u011bte, podan\u00fdmi v\u00a0intervalu dvou m\u011bs\u00edc\u016f mezi d\u00e1vkami, a t\u0159et\u00ed d\u00e1vkou podanou mezi jeden\u00e1ct\u00fdm a t\u0159in\u00e1ct\u00fdm m\u011bs\u00edcem v\u011bku d\u00edt\u011bte. Prvn\u00ed posiluj\u00edc\u00ed o\u010dkov\u00e1n\u00ed se provede mezi p\u00e1t\u00fdm a \u0161est\u00fdm rokem a druh\u00e9 mezi des\u00e1t\u00fdm a jeden\u00e1ct\u00fdm rokem v\u011bku d\u00edt\u011bte. U nedono\u0161en\u00fdch d\u011bt\u00ed se o\u010dkov\u00e1n\u00ed provede t\u0159emi d\u00e1vkami o\u010dkovac\u00ed l\u00e1tky podan\u00fdmi v\u00a0intervalech nejm\u00e9n\u011b jednoho m\u011bs\u00edce mezi d\u00e1vkami a \u010dtvrtou d\u00e1vkou podanou nejm\u00e9n\u011b 6 m\u011bs\u00edc\u016f po pod\u00e1n\u00ed t\u0159et\u00ed d\u00e1vky.<\/p>\nO\u010dkovac\u00ed l\u00e1tka:<\/strong>\u00a0Hexacima (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: Sanofi Pasteur); Infanrix hexa (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>D\u011btsk\u00e1 obrna (poliomyelitida)<\/strong><\/span><\/h3>\nD\u011btsk\u00e1 obrna je infek\u010dn\u00ed onemocn\u011bn\u00ed mozku a m\u00edchy postihuj\u00edc\u00ed p\u0159edev\u0161\u00edm d\u011bti, ale i mlad\u0161\u00ed dosp\u011bl\u00e9 jedince.\u00a0P\u016fvodcem obrny je virus, kter\u00fd se p\u0159en\u00e1\u0161\u00ed orofek\u00e1ln\u011b nebo kap\u00e9nkov\u00fdm zp\u016fsobem. B\u011bhem inkubace, 7-14 dn\u00ed, se poliovirus zachycen\u00fd na sliznici d\u00fdchac\u00edch cest pomno\u017e\u00ed a roz\u0161\u00ed\u0159\u00ed zejm\u00e9na do st\u0159evn\u00edho traktu.\u00a0D\u011btsk\u00e1 obrna se projevuje ve form\u011b pom\u011brn\u011b slab\u00fdch ch\u0159ipkov\u00fdch p\u0159\u00edznak\u016f (teplota, nevolnost, bolest hlavy a b\u0159icha, celkov\u00e1 slabost). V n\u011bkter\u00fdch p\u0159\u00edpadech, kdy virus zas\u00e1hne centr\u00e1ln\u00ed nervov\u00fd syst\u00e9m, se v\u0161ak onemocn\u011bn\u00ed m\u016f\u017ee rozvinout a\u017e do obrny r\u016fzn\u00fdch sval\u016f. Nejhor\u0161\u00ed variantou je posti\u017een\u00ed mozkov\u00e9ho kmene, kdy m\u016f\u017ee doj\u00edt a\u017e k selh\u00e1n\u00ed funkc\u00ed \u017eivotn\u011b d\u016fle\u017eit\u00fdch org\u00e1n\u016f s\u00a0fat\u00e1ln\u00edmi n\u00e1sledky.<\/p>\n
O\u010dkov\u00e1n\u00ed:<\/strong>\u00a0Doporu\u010den\u00fd v\u011bk je\u00a0od zapo\u010dat\u00e9ho 9. t\u00fddne po narozen\u00ed d\u00edt\u011bte dv\u011bma d\u00e1vkami hexavalentn\u00ed o\u010dkovac\u00ed l\u00e1tky v pr\u016fb\u011bhu prvn\u00edho roku \u017eivota d\u00edt\u011bte, podan\u00fdmi v\u00a0intervalu dvou m\u011bs\u00edc\u016f mezi d\u00e1vkami, a t\u0159et\u00ed d\u00e1vkou podanou mezi jeden\u00e1ct\u00fdm a t\u0159in\u00e1ct\u00fdm m\u011bs\u00edcem v\u011bku d\u00edt\u011bte. Pravideln\u00e1 posil\u0148uj\u00edc\u00ed d\u00e1vka se aplikuje ve v\u011bku 11 let. Podle doporu\u010den\u00ed n\u011bkter\u00fdch v\u00fdrobc\u016f by se m\u011bly v\u0161echny osoby n\u00e1sledn\u011b p\u0159eo\u010dkovat ka\u017ed\u00fdch 10 let.<\/p>\nO\u010dkovac\u00ed l\u00e1tka:<\/strong>\u00a0Hexacima (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: Sanofi Pasteur); Infanrix hexa (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: GlaxoSmithKline); Imovax polio (inaktivovan\u00e1, v\u00fdrobce: Sanofi Pasteur).<\/p>\n <\/p>\n
<\/span>Hemofilov\u00e9 infekce<\/strong><\/span><\/h3>\nP\u016fvodcem je bakterie\u00a0Haemophilus influenzae<\/em>\u00a0typu b a infek\u010dn\u00ed stavy z\u00e1le\u017e\u00ed na tom, jak\u00e1 \u010d\u00e1st organismu je napadena.\u00a0Tyto bakterie se u mnoha lid\u00ed nach\u00e1z\u00ed v d\u00fdchac\u00edch cest\u00e1ch, ani\u017e by zp\u016fsobovaly jak\u00e9koliv p\u0159\u00edznaky, a proto je i jejich p\u0159enos ve form\u011b kap\u00e9nkov\u00e9 infekce velmi snadn\u00fd.<\/p>\n1. Hemofilov\u00e9 infekce horn\u00edch cest d\u00fdchac\u00edch<\/u>\u00a0\u2013 U dosp\u011bl\u00fdch lid\u00ed se m\u016f\u017ee jednat o relativn\u011b ban\u00e1ln\u00ed stavy spojen\u00e9 s ka\u0161lem, bolestmi v krku, \u00fanavou a hore\u010dkami. U mal\u00fdch d\u011bt\u00ed se vyskytuje velmi nebezpe\u010dn\u00e9 onemocn\u011bn\u00ed z\u00e1klopky hrtanov\u00e9, kter\u00e9 se ozna\u010duje jako akutn\u00ed epiglotitida. Masivn\u00ed otok t\u00e9to oblasti m\u016f\u017ee v\u00e9st k\u00a0uz\u00e1v\u011bru d\u00fdchac\u00edch cest a n\u00e1sledn\u00e9mu udu\u0161en\u00ed.<\/p>\n
2. Z\u00e1pal plic\u00a0<\/u>\u2013 Hemofilus je jednou z mnoha bakteri\u00ed, kter\u00e9 \u010dasto zp\u016fsobuj\u00ed z\u00e1n\u011bty plicn\u00ed tk\u00e1n\u011b. Infekce prob\u00edh\u00e1 jako klasick\u00e1 pneumonie \u2013 projevuje se vlhk\u00fdm ka\u0161lem s vyka\u0161l\u00e1v\u00e1n\u00edm hlen\u016f, hore\u010dkou a celkovou schv\u00e1cenosti.<\/p>\n
3. Meningitida<\/u>\u00a0\u2013 Hemofilus m\u016f\u017ee b\u00fdt i p\u016fvodcem hnisav\u00e9ho z\u00e1n\u011btu mozkov\u00fdch blan. Meningitida se objevuje zejm\u00e9na u kojenc\u016f a batolat. Mezi p\u0159\u00edznaky pat\u0159\u00ed bolesti hlavy, ztuhlost \u0161\u00edje, zvracen\u00ed a poruchy v\u011bdom\u00ed.<\/p>\n
4. Z\u00e1n\u011bt st\u0159edn\u00edho ucha<\/u>\u00a0\u2013 Infekce v t\u00e9to oblasti se projevuje prudkou bolest\u00ed, n\u011bkdy i nevolnost\u00ed a zvracen\u00edm. Pokud nen\u00ed z\u00e1n\u011bt o\u0161et\u0159en, m\u016f\u017ee doj\u00edt k prasknut\u00ed bub\u00ednku a v\u00fdtoku hnisu vznikl\u00fdm otvorem.<\/p>\n
O\u010dkov\u00e1n<\/strong>\u00ed: Z\u00e1kladn\u00ed o\u010dkov\u00e1n\u00ed se provede v dob\u011b od zapo\u010dat\u00e9ho 9. t\u00fddne po narozen\u00ed d\u00edt\u011bte dv\u011bma d\u00e1vkami hexavalentn\u00ed o\u010dkovac\u00ed l\u00e1tky v pr\u016fb\u011bhu prvn\u00edho roku \u017eivota d\u00edt\u011bte, podan\u00fdmi v\u00a0intervalu dvou m\u011bs\u00edc\u016f mezi d\u00e1vkami, a t\u0159et\u00ed d\u00e1vkou podanou mezi jeden\u00e1ct\u00fdm a t\u0159in\u00e1ct\u00fdm m\u011bs\u00edcem v\u011bku d\u00edt\u011bte. U nedono\u0161en\u00fdch d\u011bt\u00ed se o\u010dkov\u00e1n\u00ed provede t\u0159emi d\u00e1vkami o\u010dkovac\u00ed l\u00e1tky podan\u00fdmi v\u00a0intervalech nejm\u00e9n\u011b jednoho m\u011bs\u00edce mezi d\u00e1vkami a \u010dtvrtou d\u00e1vkou podanou nejm\u00e9n\u011b 6 m\u011bs\u00edc\u016f po pod\u00e1n\u00ed t\u0159et\u00ed d\u00e1vky.<\/p>\nO\u010dkovac\u00ed l\u00e1tka:\u00a0<\/strong>Hexacima (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: Sanofi Pasteur); Infanrix hexa (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: GlaxoSmithKline); Hiberix (polysacharidov\u00e1; v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>Cholera<\/strong><\/span><\/h3>\nCholera je nebezpe\u010dn\u00e9 pr\u016fjmov\u00e9 onemocn\u011bn\u00ed, jeho\u017e p\u016fvodcem je bakterie\u00a0Vibrio cholerae<\/em>. Infekce se za\u010dne projevovat b\u011bhem n\u011bkolika hodin a\u017e 5 dn\u016f po po\u017eit\u00ed kontaminovan\u00e9 potravy nebo vody. Typicky vznik\u00e1 n\u00e1hl\u00e1 bolest a k\u0159e\u010de v b\u0159i\u0161e a objev\u00ed se pr\u016fjem. Ten b\u00fdv\u00e1 vodnat\u00fd, stolice m\u00e1 charakter kaln\u00e9 hn\u011bdav\u00e9 nebo na\u0161edl\u00e9 tekutiny, ve kter\u00e9 plavou vlo\u010dky hlenu. Pr\u016fjem b\u00fdv\u00e1 velmi \u00faporn\u00fd, stolice odch\u00e1z\u00ed spont\u00e1nn\u011b, bez nutk\u00e1n\u00ed, a ve velmi kr\u00e1tk\u00fdch intervalech. Nemocn\u00fd tak m\u016f\u017ee ztratit a\u017e jednu t\u0159etinu t\u011blesn\u00e9 hmotnosti b\u011bhem n\u011bkolika hodin. Po pr\u016fjmech doch\u00e1z\u00ed obvykle ke zvracen\u00ed. Rozv\u00edjej\u00edc\u00ed\u00a0ztr\u00e1ty t\u011blesn\u00e9 vody a iont\u016f vedou k rychl\u00e9 dehydrataci.<\/p>\nO\u010dkov\u00e1n\u00ed<\/strong>: O\u010dkov\u00e1n\u00ed je doporu\u010deno dle aktu\u00e1ln\u00ed epidemiologick\u00e9 situace a je ovlivn\u011bno oblast\u00ed pl\u00e1novan\u00e9 cesty. Ve v\u011bku 2-6 let se aplikuj\u00ed 3 polovi\u010dn\u00ed d\u00e1vky v intervalu 1-6 t\u00fddn\u016f, posiluj\u00edc\u00ed d\u00e1vka po 6 m\u011bs\u00edc\u00edch.
\nU d\u011bt\u00ed od 6 let v\u011bku se aplikuj\u00ed 2 d\u00e1vky v intervalu 1-6 t\u00fddn\u016f, posiluj\u00edc\u00ed d\u00e1vky po dvou letech.<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>: Dukoral (inaktivovan\u00e1; v\u00fdrobce: Crucell Sweden AB).<\/p>\n <\/p>\n
<\/span>Ch\u0159ipka<\/strong><\/span><\/h3>\nCh\u0159ipka je naka\u017eliv\u00e9 virov\u00e9 onemocn\u011bn\u00ed postihuj\u00edc\u00ed p\u0159ev\u00e1\u017en\u011b d\u00fdchac\u00ed cesty. Vzhledem ke kr\u00e1tk\u00e9 inkuba\u010dn\u00ed dob\u011b (18 a\u017e 24 hodin) za\u010d\u00edn\u00e1 ch\u0159ipka \u010dasto velmi n\u00e1hle a bez varov\u00e1n\u00ed, tak\u0159ka z pln\u00e9ho zdrav\u00ed. P\u0159esto\u017ee virus do organismu pronik\u00e1 p\u0159es sliznice d\u00fdchac\u00edho \u00fastroj\u00ed, prvn\u00edmi projevy nejsou ani r\u00fdma, ani ka\u0161el.<\/p>\n
Ch\u0159ipka za\u010d\u00edn\u00e1 zpravidla vysokou hore\u010dkou (38 a\u017e 40 \u00b0C). Vzestup teploty obvykle prov\u00e1z\u00ed zimnice a t\u0159esavka. P\u0159id\u00e1vaj\u00ed se siln\u00e9 bolesti hlavy. Ty mohou b\u00fdt spojeny i se sv\u011btloplachost\u00ed a ztuhlost\u00ed \u0161\u00edje. \u010cast\u00e9 jsou bolesti kloub\u016f, sval\u016f, o\u010d\u00ed, zad a nohou. To v\u0161e je spojeno s v\u00fdraznou \u00fanavou. Dal\u0161\u00edm mo\u017en\u00fdm p\u0159\u00edznakem je nevolnost, n\u011bkdy zvracen\u00ed, pr\u016fjem nebo z\u00e1cpa \u010di nechutenstv\u00ed. B\u011bhem dal\u0161\u00edch jednoho a\u017e dvou dn\u016f nastupuj\u00ed ji\u017e klasick\u00e9 p\u0159\u00edznaky posti\u017een\u00ed d\u00fdchac\u00edch cest (r\u00fdma, bolest a p\u00e1len\u00ed v hrdle, such\u00fd dr\u00e1\u017ediv\u00fd ka\u0161el). Ka\u0161el se postupem \u010dasu zvlh\u010duje a m\u011bn\u00ed v produktivn\u00ed hlenovit\u00fd ka\u0161el. Teploty, \u00fanava, bolest hlavy a sval\u016f obvykle vymiz\u00ed b\u011bhem t\u0159\u00ed nebo \u010dty\u0159 dn\u016f. R\u00fdma a ka\u0161el pak trvaj\u00ed zhruba 1-10 dn\u016f. Zv\u00fd\u0161en\u00e1 \u00fanavnost a slabost se mohou v r\u016fzn\u00e9 m\u00ed\u0159e objevovat je\u0161t\u011b m\u011bs\u00edc po onemocn\u011bn\u00ed.<\/p>\n
O\u010dkov\u00e1n\u00ed:<\/strong>\u00a0Mo\u017enost o\u010dkov\u00e1n\u00ed je ji\u017e od 6. m\u011bs\u00edce v\u011bku. Prov\u00e1d\u00ed se ka\u017edoro\u010dn\u011b p\u0159ed vypuknut\u00edm virov\u00fdch n\u00e1kaz v podzimn\u00edch m\u011bs\u00edc\u00edch. Chr\u00e1nit p\u0159ed ch\u0159ipkou dok\u00e1\u017ee po dal\u0161\u00edch 6 a\u017e 12 m\u011bs\u00edc\u016f.<\/p>\nVakc\u00edna\/d\u00e1vka<\/strong>: Ve v\u011bku 6-36 m\u011bs\u00edc\u016f 1 d\u00e1vka o velikosti 0,5 ml nebo 0,25 ml (polovi\u010dn\u00ed d\u00e1vka) nebo dv\u011bma polovi\u010dn\u00edmi d\u00e1vkami v\u00a0intervalu 4 t\u00fddn\u016f.<\/p>\nVakc\u00edna\/d\u00e1vka<\/strong>: Ve v\u011bku od 3 let se o\u010dkuje jedna d\u00e1vka o velikosti 0,5 ml nebo 2 d\u00e1vky pro star\u0161\u00ed a dosp\u011bl\u00e9, kte\u0159\u00ed nebyli v\u00a0p\u0159ede\u0161l\u00e9 ch\u0159ipkov\u00e9 sez\u00f3n\u011b o\u010dkov\u00e1ni, nebo ch\u0159ipkou neonemocn\u011bli.<\/p>\nPosiluj\u00edc\u00ed imunizace nem\u00e1 v p\u0159\u00edpad\u011b o\u010dkov\u00e1n\u00ed proti ch\u0159ipce v\u00fdznam, nebo\u0165 ka\u017ed\u00fd rok je t\u0159eba prov\u00e1d\u011bt p\u0159eo\u010dkov\u00e1n\u00ed v\u016f\u010di nov\u00fdm kmen\u016fm divok\u00fdch ch\u0159ipkov\u00fdch vir\u016f.<\/p>\n
O\u010dkovac\u00ed l\u00e1tka<\/strong>: Fluarix Tetra (inaktivovan\u00e1; v\u00fdrobce: GlaxoSmithKline); Fluenz Tetra (\u017eiv\u00e1 atenuovan\u00e1; v\u00fdrobce: AstraZeneca); Influvac (inaktivovan\u00e1; v\u00fdrobce: Abbott Biologicals B.V.); Preflucel (\u0161t\u011bpen\u00fd \u00a0virion, inaktivovan\u00e1; v\u00fdrobce: BAXTER AG); Vaxigrip (inaktivovan\u00e1, \u0161t\u011bpen\u00fd virion; v\u00fdrobce: Sanofi Pasteur); Vaxigrip Tetra (inaktivovan\u00e1, \u0161t\u011bpen\u00fd virion; v\u00fdrobce: Sanofi Pasteur).<\/p>\n <\/p>\n
<\/span>Japonsk\u00e1 encefalitida B<\/strong><\/span><\/h3>\nJaponsk\u00e1 encefalitida pat\u0159\u00ed mezi infek\u010dn\u00ed tropick\u00e9 nemoci. Jde o z\u00e1n\u011btliv\u00e9 onemocn\u011bn\u00ed mozku vyvolan\u00e9 virem stejn\u00e9 skupiny, jako jsou nap\u0159. viry st\u0159edoevropsk\u00e9 kl\u00ed\u0161\u0165ov\u00e9 encefalitidy, \u017elut\u00e9 zimnice nebo hore\u010dky dengue. K p\u0159enosu doch\u00e1z\u00ed infikovan\u00fdm kom\u00e1rem prost\u0159ednictv\u00edm prasat, skotu nebo pt\u00e1k\u016f. K p\u0159enosu z \u010dlov\u011bka na \u010dlov\u011bka nedoch\u00e1z\u00ed. Inkuba\u010dn\u00ed doba je 4-16 dn\u00ed. Na po\u010d\u00e1tku se objev\u00ed hore\u010dky, kter\u00e9 doprov\u00e1z\u00ed bolest hlavy, zvracen\u00ed a \u010dasto i siln\u00e1 bolest b\u0159icha. Onemocn\u011bn\u00ed graduje poruchami \u0159e\u010di, rozvojem deliria, k\u0159e\u010d\u00ed, n\u011bkdy i t\u011b\u017ek\u00fdch du\u0161evn\u00edch poruch. Dostane-li se n\u00e1kaza a\u017e do tohoto st\u00e1dia, kon\u010d\u00ed smrt\u00ed.<\/p>\n
O\u010dkov\u00e1n\u00ed:<\/strong>\u00a0Je vhodn\u00e9 pro cestovatele, kte\u0159\u00ed se budou pohybovat v zem\u011bd\u011blsk\u00fdch oblastech b\u011bhem a po obdob\u00ed de\u0161\u0165\u016f (p\u0159emno\u017een\u00ed kom\u00e1r\u016f). O\u010dkovat lze ji\u017e od 2. m\u011bs\u00edce v\u011bku. Je pot\u0159eba aplikovat dv\u011b d\u00e1vky vakc\u00edny v rozestupu 28 dn\u00ed (u d\u011bt\u00ed do 35 m\u011bs\u00edc\u016f je mno\u017estv\u00ed d\u00e1vky polovi\u010dn\u00ed), ochrann\u00fd \u00fa\u010dinek nastupuje jeden t\u00fdden po aplikaci 2. d\u00e1vky. Prvn\u00ed posiluj\u00edc\u00ed d\u00e1vka byla stanovena za 12-24 m\u011bs\u00edc\u016f; dal\u0161\u00ed nebyla stanovena.<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>: Ixiaro (inaktivovan\u00e1, adsorbovan\u00e1; v\u00fdrobce: Valneva Austria GmbH).<\/p>\n <\/p>\n
<\/span>Kl\u00ed\u0161\u0165ov\u00e1 encefalitida<\/strong><\/span><\/h3>\nKl\u00ed\u0161\u0165ov\u00e1 encefalitida je infek\u010dn\u00ed onemocn\u011bn\u00ed virov\u00e9ho p\u016fvodu postihuj\u00edc\u00ed mozek a mozkov\u00e9 bl\u00e1ny. Virus kl\u00ed\u0161\u0165ov\u00e9 encefalitidy, pat\u0159\u00edc\u00ed mezi tzv. flaviviry, je p\u0159en\u00e1\u0161en zejm\u00e9na kl\u00ed\u0161\u0165aty, pop\u0159\u00edpad\u011b kom\u00e1ry. Pot\u00e9, co virus pronikne do organismu, nast\u00e1v\u00e1 inkuba\u010dn\u00ed doba (3-30 dn\u00ed), kter\u00e1 prob\u00edh\u00e1 celkem bez komplikac\u00ed. N\u00e1sledn\u011b m\u00e1 onemocn\u011bn\u00ed obvykle dvouf\u00e1zov\u00fd pr\u016fb\u011bh. Prvn\u00ed f\u00e1ze s sebou nese p\u0159\u00edznaky lehk\u00e9 ch\u0159ipky. Ta po n\u011bkolika dnech ustoup\u00ed a nast\u00e1v\u00e1 obdob\u00ed klidu zhruba 2 t\u00fddny. U n\u011bkter\u00fdch pacient\u016f m\u016f\u017ee nemoc touto f\u00e1z\u00ed skon\u010dit a je mo\u017en\u00e9, \u017ee dojde k \u00fapln\u00e9mu uzdraven\u00ed. U jin\u00fdch se nemus\u00ed p\u0159\u00edznaky prvn\u00ed f\u00e1ze v\u016fbec pozorovat a nemoc jim propukne rovnou druhou f\u00e1z\u00ed. Onemocn\u011bn\u00ed v\u00a0tomto st\u00e1diu, se projevuje vysok\u00fdmi hore\u010dkami, prudk\u00fdmi bolestmi hlavy, sv\u011btloplachost\u00ed, nevolnost\u00ed, zvracen\u00edm, ztuhnut\u00edm sval\u016f na \u0161\u00edji, svalov\u00fdm t\u0159esem, obrnou, poruchami sp\u00e1nku, pam\u011bti a koncentrace a celkovou dezorientac\u00ed.<\/p>\n
O\u010dkov\u00e1n\u00ed<\/strong>: Skl\u00e1d\u00e1 se ze t\u0159\u00ed injekc\u00ed, kter\u00e9 se aplikuj\u00ed do svalu ramene a to ve dny 0, za 1 \u2013 3 m\u011bs\u00edce a za 5 \u2013 12 m\u011bs\u00edc\u016f (vakc\u00edna FSME-IMMUN) nebo 9-12 m\u011bs\u00edc\u016f (vakc\u00edna Encepur) po druh\u00e9 d\u00e1vce. V tepl\u00e9m obdob\u00ed roku je nutn\u00e9 p\u0159istoupit ke zrychlen\u00e9mu sch\u00e9matu. U vakc\u00edny FSME-IMMUN se druh\u00e1 d\u00e1vka pod\u00e1 ji\u017e za 14 dn\u00ed po d\u00e1vce prvn\u00ed. U vakc\u00edny Encepur\u00a0 je zrychlen\u00e9 sch\u00e9ma ve dnech 0-7-21, kdy se prvn\u00ed p\u0159eo\u010dkov\u00e1n\u00ed aplikuje za 12-18 m\u011bs\u00edc\u016f po t\u0159et\u00ed d\u00e1vce. Pro zachov\u00e1n\u00ed obranyschopnosti je d\u016fle\u017eit\u00e9, aby doch\u00e1zelo k pravideln\u00e9mu p\u0159eo\u010dkov\u00e1n\u00ed jednou d\u00e1vkou po 3 \u2013 5 letech.<\/p>\nO\u010dkovac\u00ed l\u00e1tky<\/strong>: FSME-IMMUN (cel\u00fd inaktivovan\u00fd virus; v\u00fdrobce: Baxter); Encepur (inaktivovan\u00fd \u00a0TBE \u00a0virus; v\u00fdrobce: Novartis).<\/p>\n <\/p>\n
<\/span>Lidsk\u00e9 papilomaviry (HPV)<\/strong><\/span><\/h3>\nHPV (Human Papilllomavirus) je virus, kter\u00fd napad\u00e1 bu\u0148ky v\u00a0lidsk\u00e9m t\u011ble, hlavn\u011b v\u00a0oblasti poko\u017eky a sliznic. Je zn\u00e1mo asi 300 typ\u016f papilomavir\u016f, z\u00a0nich asi 120 infikuje \u010dlov\u011bka. K\u00a0p\u0159enosu doch\u00e1z\u00ed p\u0159i pohlavn\u00edm styku a v\u00a0sou\u010dasnosti pat\u0159\u00ed k\u00a0jednomu z\u00a0nejroz\u0161\u00ed\u0159en\u011bj\u0161\u00edch pohlavn\u011b p\u0159enosn\u00fdch onemocn\u011bn\u00ed, kter\u00e9mu podl\u00e9haj\u00ed ob\u011b pohlav\u00ed. Podle schopnosti vyvol\u00e1vat infekce se d\u011bl\u00ed na n\u00edzkorizikov\u00e9 a vysokorizikov\u00e9 typy. Leh\u010d\u00ed formy onemocn\u011bn\u00ed se projevuj\u00ed ve form\u011b polyp\u016f d\u00fdchac\u00edch cest, z\u00e1n\u011bt\u016f pohlavn\u00edho \u00fastroj\u00ed nebo genit\u00e1ln\u00edch bradavic. V\u00a0p\u0159\u00edpad\u011b n\u00e1kazy vysoce rizikov\u00fdm typem HPV m\u016f\u017ee doj\u00edt a\u017e k\u00a0rakovin\u011b d\u011blo\u017en\u00edho \u010d\u00edpku, penisu, an\u00e1ln\u00edho otvoru nebo ke karcinomu v oblasti hlavy a krku. Infekce \u010dasto prob\u00edh\u00e1 bez p\u0159\u00edznak\u016f a u n\u011bkter\u00fdch p\u0159\u00edpad\u016f m\u016f\u017ee doj\u00edt k p\u0159irozen\u00e9 eliminaci viru z\u00a0organismu. V\u00a0opa\u010dn\u00e9m p\u0159\u00edpad\u011b doch\u00e1z\u00ed ke klinick\u00fdm projev\u016fm po inkuba\u010dn\u00ed dob\u011b 1-20 m\u011bs\u00edc\u016f. Kl\u00ed\u010dov\u00e1 je v\u010dasn\u00e1 diagnostika, proto\u017ee \u010d\u00edm d\u0159\u00edve k\u00a0n\u00ed dojde, t\u00edm je l\u00e9\u010dba snaz\u0161\u00ed a v\u00edce \u00fasp\u011b\u0161n\u00e1.<\/p>\n
O\u010dkov\u00e1n\u00ed<\/strong>: O vhodnosti a nutnosti o\u010dkov\u00e1n\u00ed se pora\u010fte s Va\u0161\u00edm l\u00e9ka\u0159em. O\u010dkov\u00e1n\u00ed je hrazeno zdravotn\u00ed poji\u0161\u0165ovnou, pokud k\u00a0jeho aplikaci dojde mezi 13-14 rokem v\u011bku d\u00edt\u011bte. Od roku 2018 je toto o\u010dkov\u00e1ni hrazeno poji\u0161\u0165ovnou nejen pro d\u00edvky, ale tak\u00e9 pro stejn\u011b star\u00e9 chlapce. Toto preventivn\u00ed o\u010dkov\u00e1n\u00ed doporu\u010duj\u00ed pro ob\u011b pohlav\u00ed\u00a0mnoh\u00e9 nadn\u00e1rodn\u00ed, evropsk\u00e9 i \u010desk\u00e9 instituce.\u00a0<\/em>Vakc\u00edna proti HPV m\u00e1 nejvy\u0161\u0161\u00ed \u00fa\u010dinnost p\u0159i aplikaci p\u0159ed prvn\u00edm sexu\u00e1ln\u00edm stykem. Nicm\u00e9n\u011b i sexu\u00e1ln\u011b aktivn\u00ed jedinci si mohou vakcinac\u00ed v\u00fdrazn\u011b sn\u00ed\u017eit riziko rozvoje n\u011bkter\u00e9ho z onemocn\u011bn\u00ed, kter\u00e9 je zp\u016fsobeno HPV.<\/p>\nD\u00e1vkov\u00e1n\u00ed<\/strong>:<\/p>\n9-14 let: 2 d\u00e1vky v 0, 6 m\u011bs\u00edc\u00edch
\nod 15 let: 3 d\u00e1vky v 0, 1, 6 m\u011bs\u00edc\u00edch<\/p>\n
O\u010dkovac\u00ed l\u00e1tka<\/strong>: Cervarix (rekombinantn\u00ed, adjuvovan\u00e1, adsorbovan\u00e1; v\u00fdrobce: GlaxoSmithKline); Silgard (rekombinantn\u00ed, adsorbovan\u00e1; v\u00fdrobce: Merck Sharp & Dohme Ltd), Gardasil 9 (rekombinantn\u00ed, adsorbovan\u00e1; v\u00fdrobce: MSD Vaccins).<\/p>\n <\/p>\n
<\/span>Meningokokov\u00e9 n\u00e1kazy<\/strong><\/span><\/h3>\nZdrojem n\u00e1kazy je \u010dlov\u011bk, p\u016fvodcem onemocn\u011bn\u00ed je bakterie\u00a0Neisseria meningitidis<\/em>. K n\u00e1kaze doch\u00e1z\u00ed p\u0159i bli\u017e\u0161\u00edm styku s nemocn\u00fdm nebo i bezp\u0159\u00edznakov\u00fdm bacilonosi\u010dem p\u0159edev\u0161\u00edm p\u0159i velk\u00e9m nahromad\u011bn\u00ed lid\u00ed a vy\u0161\u0161\u00ed fyzick\u00e9 n\u00e1maze. Bakterie se p\u0159en\u00e1\u0161\u00ed kap\u00e9nkovou infekc\u00ed. Meningokokov\u00e9 infekce jsou z\u00e1va\u017en\u00e9 onemocn\u011bn\u00ed zp\u016fsobuj\u00edc\u00ed r\u016fzn\u00e9 formy z\u00e1n\u011bt\u016f mozkov\u00fdch blan (hnisav\u00e9 meningitidy) nebo celkov\u00e9 hore\u010dnat\u00e9 onemocn\u011bn\u00ed (sepse, \u0161ok). Nemoc m\u00e1 velmi \u010dasto dramaticky rychl\u00fd pr\u016fb\u011bh, kdy v kr\u00e1tk\u00e9 dob\u011b, b\u011bhem pouh\u00fdch n\u011bkolika hodin, dojde z pln\u00e9ho zdrav\u00ed k \u017eivotu ohro\u017euj\u00edc\u00edmu selh\u00e1n\u00ed organizmu.<\/p>\nO\u010dkov\u00e1n\u00ed<\/strong>:
\nPolysacharidov\u00e1<\/u>: ve v\u011bku od dvou let 1 d\u00e1vka, posiluj\u00edc\u00ed d\u00e1vka v intervalu nejd\u0159\u00edve po 2-3 letech, l\u00e9pe v\u0161ak po 4-5 letech.<\/p>\nKonjugovan\u00e1<\/u>: ve v\u011bku 2-11 m\u011bs\u00edc\u016f 2 d\u00e1vky v intervalu 1-2 m\u011bs\u00edce, interval posiluj\u00edc\u00ed d\u00e1vky 3\/5 let (3let\u00fd interval u d\u011bt\u00ed mlad\u0161\u00edch 7 let a 5let\u00fd interval u osob star\u0161\u00edch 7 let, jsou-li kontinu\u00e1ln\u011b vystaveny riziku meningokov\u00fdch n\u00e1kaz). Od jednoho roku se aplikuje 1 d\u00e1vka, posiluj\u00edc\u00ed d\u00e1vky op\u011bt v intervalu 3\/5 let.<\/p>\n
U Vakc\u00edny Bexsero se ve v\u011bku 2-5 m\u011bs\u00edc\u016f aplikuj\u00ed 3 d\u00e1vky v\u00a0intervalu 1-2 m\u011bs\u00edce, ve v\u011bku 6 m\u011bs\u00edc\u016f a\u017e 10 let jenom 2 d\u00e1vky s\u00a0minim\u00e1ln\u00edm intervalem mezi d\u00e1vkami 2 m\u011bs\u00edce a u star\u0161\u00edch d\u011bt\u00ed je interval mezi d\u00e1vkami jenom m\u011bs\u00edc. U Vakc\u00edny Trumenba se o\u010dkuje a\u017e od deseti let 2 d\u00e1vkami s\u00a0rozestupem 6 m\u011bs\u00edc\u016f, nebo 3 d\u00e1vkami v\u00a0intervalu 0-2-6 m\u011bs\u00edc\u016f.<\/p>\n
O\u010dkovac\u00ed l\u00e1tka<\/strong>: Neisvac C (konjugovan\u00e1 polysacharidov\u00e1 vakc\u00edna, adsorbovan\u00e1; v\u00fdrobce: Baxter); Menveo (konjugovan\u00e1; v\u00fdrobce: Novartis Vaccines and Diagnostics S.r.l.); Nimenrix (konjugovan\u00e1; v\u00fdrobce: GlaxoSmithKline); Bexsero (adsorbovan\u00e1; v\u00fdrobce: GSK Vaccines); Trumenba (rekombinantn\u00ed, adsorbovan\u00e1; v\u00fdrobce: Pfizer Ltd).<\/p>\nP\u00e1sov\u00fd opar (Herpes zoster)<\/strong><\/p>\nHerpes zoster \u2013 neboli p\u00e1sov\u00fd opar je bolestiv\u00e9 virov\u00e9 onemocn\u011bn\u00ed. Je zp\u016fsobeno reaktivac\u00ed viru plan\u00fdch ne\u0161tovic, kter\u00fd p\u0159etrv\u00e1 nen\u00e1padn\u011b\u00a0v\u00a0nervov\u00fdch bu\u0148k\u00e1ch\u00a0(spin\u00e1ln\u00edch gangli\u00edch) a p\u0159ijde-li podn\u011bt, vr\u00e1t\u00ed se v podob\u011b p\u00e1sov\u00e9ho\u00a0oparu.\u00a0Podn\u011btem pro reaktivaci viru je nej\u010dast\u011bji\u00a0oslaben\u00ed imunity\u00a0(to b\u00fdv\u00e1 \u010dast\u00e9 p\u0159i l\u00e9\u010db\u011b cytostatiky, u\u00a0pacient\u016f HIV pozitivn\u00edch, nemocn\u00fdch Hodgkinovou chorobou). Spou\u0161t\u011bc\u00edm mechanismem b\u00fdv\u00e1 tak\u00e9 \u010dasto \u0161ok, stres, \u00faraz \u010di porucha v\u00fd\u017eivy. Z\u00e1kladn\u00edm znakem nemoci je tvorba puch\u00fd\u0159k\u016f v ohrani\u010den\u00fdch p\u00e1sovit\u00fdch lo\u017eisc\u00edch. Jedn\u00e1 se o vn\u011bj\u0161\u00ed projev z\u00e1n\u011btu nervu. Inkuba\u010dn\u00ed doba je 7\u201314 dn\u00ed. Obdob\u00ed naka\u017elivosti b\u00fdv\u00e1 zhruba 1\u20132 dny p\u0159ed prvn\u00edmi p\u0159\u00edznaky a maxim\u00e1ln\u011b 5 dn\u00ed po objeven\u00ed puch\u00fd\u0159k\u016f (po jejich zaschnut\u00ed).<\/p>\n
O\u010dkov\u00e1n\u00ed<\/strong>: Doporu\u010duje se osob\u00e1m nad 50 let v\u011bku, o\u010dkovan\u00fdm, nebo kter\u00e9 prod\u011blaly onemocn\u011bn\u00ed plan\u00fdmi ne\u0161tovicemi, nebo s oslaben\u00fdm imunitn\u00edm syst\u00e9mem. O\u010dkov\u00e1n\u00ed se doporu\u010duje k prevenci opakovan\u00fdch infekc\u00ed virem p\u00e1sov\u00e9ho oparu.<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>:\u00a0Zostavax (\u017eiv\u00e1; v\u00fdrobce: Sanofi Pasteur); Shingrix (rekombinantn\u00ed; v\u00fdrobce: GlaxoSmithKline).<\/p>\nPlan\u00e9 ne\u0161tovice (Varicella)<\/strong><\/p>\nPlan\u00e9 ne\u0161tovice p\u0159edstavuj\u00ed vysoce naka\u017elivou akutn\u00ed chorobu, kter\u00e1 je zp\u016fsoben\u00e1 lidsk\u00fdm Herpes virem, tzv. HHV-3 (Varicella Zoster Vir). Nej\u010dast\u011bj\u0161\u00edmi ob\u011b\u0165mi tohoto viru jsou d\u011bti od t\u0159\u00ed do deseti let. U t\u011bchto pacient\u016f je pr\u016fb\u011bh nemoci zpravidla bezprobl\u00e9mov\u00fd, av\u0161ak u d\u011bt\u00ed v pubert\u00e1ln\u00edm obdob\u00ed nebo u dosp\u011bl\u00fdch ji\u017e mohou nastat v\u00e1\u017en\u011bj\u0161\u00ed komplikace. Virus plan\u00fdch ne\u0161tovic se \u0161\u00ed\u0159\u00ed vzduchem (kap\u00e9nkov\u00e1 infekce) nebo p\u0159\u00edm\u00fdm kontaktem s naka\u017een\u00fdm. Inkuba\u010dn\u00ed doba trv\u00e1 zhruba \u010dtrn\u00e1ct a\u017e \u0161estn\u00e1ct dn\u00ed. Po tomto obdob\u00ed se objevuj\u00ed prvn\u00ed nespecifick\u00e9 p\u0159\u00edznaky, kter\u00e9 jsou ozna\u010dov\u00e1ny jako tzv. prodromy. U nemocn\u00e9ho \u010dlov\u011bka je pozorov\u00e1na zv\u00fd\u0161en\u00e1 teplota nebo zimnice a mohou nastat \u017ealude\u010dn\u00ed probl\u00e9my nebo pr\u016fjem. V\u00fdznamn\u00fdm sign\u00e1lem je po\u010d\u00ednaj\u00edc\u00ed sv\u011bd\u011bn\u00ed a bolest k\u016f\u017ee v m\u00edst\u011b, kde se pozd\u011bji vytvo\u0159\u00ed puch\u00fd\u0159ky – tzv. ne\u0161tovi\u010dky, kter\u00e9 se mohou vyskytovat v p\u011bti v\u00fdvojov\u00fdch st\u00e1di\u00edch. Nejprve se objev\u00ed drobn\u00e1 zarudl\u00e1 skvrnka, makula. Ta zv\u011bt\u0161\u00ed sv\u016fj objem a vyroste z n\u00ed sv\u011bdiv\u00fd pupen, toto stadium se ozna\u010duje jako tzv. papula. Na tomto pupenu se vytvo\u0159\u00ed puch\u00fd\u0159ek napln\u011bn\u00fd \u010dirou tekutinou. Pot\u00e9, co se tekutina zakal\u00ed, vznikne hnis a puch\u00fd\u0159ek se p\u0159em\u011bn\u00ed na pustulu. Po n\u011bjak\u00e9 dob\u011b puch\u00fd\u0159ky prasknou, vysu\u0161\u00ed se a vytvo\u0159\u00ed se na nich tzv. krusti\u010dky, kter\u00e9 se po jednom a\u017e dvou t\u00fddnech odloupnou. \u010clov\u011bk nem\u016f\u017ee nikoho infikovat teprve pot\u00e9, co se na v\u0161ech puch\u00fd\u0159c\u00edch vytvo\u0159\u00ed krusty.<\/p>\n
O\u010dkov\u00e1n\u00ed<\/strong>: U monovakc\u00edny se o\u010dkov\u00e1n\u00ed prov\u00e1d\u00ed ve v\u011bku od 12 m\u011bs\u00edc\u016f (u vakc\u00edny Varilrix od 9 m\u011bs\u00edc\u016f) 2 d\u00e1vkami s\u00a0intervalem 1-3 m\u011bs\u00edce. U kombinovan\u00e9 vakc\u00edny je to od 15 m\u011bs\u00edc\u016f dv\u011bma d\u00e1vkami s\u00a0rozestupem 6-10 m\u011bs\u00edc\u016f. Interval posiluj\u00edc\u00ed d\u00e1vky nebyl stanoven.<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>: Varilrix (\u017eiv\u00e1; v\u00fdrobce: GlaxoSmithKline); Zostavax (\u017eiv\u00e1; v\u00fdrobce: Sanofi Pasteur); Priorix Tetra (kombinovan\u00e1, \u017eiv\u00e1 vakc\u00edna proti spalni\u010dk\u00e1m, p\u0159\u00edu\u0161nic\u00edm a plan\u00fdm ne\u0161tovic\u00edm; v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>Pn<\/strong>eumokokov\u00e9 n\u00e1kazy<\/strong><\/span><\/h3>\nP\u016fvodcem pneumokokov\u00fdch onemocn\u011bn\u00ed jsou bakterie\u00a0Streptococcus pneumonia.<\/em>\u00a0Zdrojem je v\u00fdhradn\u011b nemocn\u00fd \u010dlov\u011bk nebo bacilonosi\u010d a p\u0159en\u00e1\u0161\u00ed se obvykle kap\u00e9nkov\u00fdm zp\u016fsobem. N\u011bkdy vznik\u00e1 jako vnit\u0159n\u00ed infekce bacilonosi\u010de, jeho\u017e oslaben\u00fd imunitn\u00ed syst\u00e9m podmi\u0148uje p\u0159\u00edpadnou bakteri\u00e1ln\u00ed kolonizaci. Doba inkubace je kr\u00e1tk\u00e1, v rozmez\u00ed 1-3 dn\u00ed. Pneumokokov\u00e1 pneumonie se projevuje zpravidla n\u00e1hlou vysokou teplotou, t\u0159esavkou a zimnic\u00ed. Doprov\u00e1z\u00ed ji vyka\u0161l\u00e1v\u00e1n\u00ed mal\u00e9ho mno\u017estv\u00ed rezav\u00fdch hlen\u016f a bolest\u00ed na hrudi. V t\u011b\u017e\u0161\u00edch p\u0159\u00edpadech se p\u0159id\u00e1v\u00e1 i du\u0161nost a porucha srde\u010dn\u00edho rytmu. Jej\u00ed z\u00e1ludnost a komplikovanost spo\u010d\u00edv\u00e1 v relativn\u011b \u010dast\u00e9 antibiotick\u00e9 rezistenci.<\/p>\nO\u010dkov\u00e1n\u00ed:<\/strong><\/p>\nPolysacharidov\u00e1:\u00a0<\/u>od 2 let v\u011bku, 1 d\u00e1vka, interval posiluj\u00edc\u00ed d\u00e1vky 3-5 let (t\u0159i roky u d\u011bt\u00ed mlad\u0161\u00edch 10 let).
\nKonjugovan\u00e1:<\/u>\u00a0ve v\u011bku 2-6 m\u011bs\u00edc\u016f, 3+1 d\u00e1vka, interval mezi z\u00e1kladn\u00edmi d\u00e1vkami 1-2 m\u011bs\u00edce, interval posiluj\u00edc\u00ed d\u00e1vky 6-12 m\u011bs\u00edc\u016f (ve druh\u00e9m roce \u017eivota). Ve v\u011bku 1-2 roky 1+1 d\u00e1vka, interval mezi z\u00e1kladn\u00edmi d\u00e1vkami 1-2 m\u011bs\u00edce, interval posiluj\u00edc\u00ed d\u00e1vky 6-12 m\u011bs\u00edc\u016f (ve druh\u00e9m roce \u017eivota). Od dvou let v\u011bku, 1 d\u00e1vka, interval posiluj\u00edc\u00ed d\u00e1vky nebyl stanoven.<\/p>\n
O\u010dkovac\u00ed l\u00e1tky<\/strong>: Prevenar 13 (aktivn\u00ed pneumokokov\u00e1 polysacharidov\u00e1 konjugovan\u00e1 vakc\u00edna; v\u00fdrobce: Pfizer Limited); Synflorix (aktivn\u00ed pneumokokov\u00e1 polysacharidov\u00e1 konjugovan\u00e1 vakc\u00edna, adsorbovan\u00e1; v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>P\u0159\u00edu\u0161nice (parotitida)<\/strong><\/span><\/h3>\nP\u0159\u00edu\u0161nice (parotitis epidemica) jsou akutn\u00ed virov\u00e9 onemocn\u011bn\u00ed. Virus p\u0159\u00edu\u0161nic pat\u0159\u00ed do skupiny paramyxovir\u016f, kter\u00e9 jsou p\u016fvodcem tak\u00e9 zard\u011bnek a spalni\u010dek. P\u0159\u00edu\u0161nice jsou vysoce naka\u017eliv\u00e9, podl\u00e9haj\u00ed proto povinn\u00e9mu o\u010dkov\u00e1n\u00ed. Nemoc se p\u0159en\u00e1\u0161\u00ed z \u010dlov\u011bka na \u010dlov\u011bka kap\u00e9nkovou infekc\u00ed. Prvn\u00ed p\u0159\u00edznaky, jako hore\u010dka a bolestiv\u00e9 zdu\u0159en\u00ed p\u0159\u00edu\u0161n\u00edch slinn\u00fdch \u017el\u00e1z, se objevuj\u00ed 15-21 dn\u00ed od naka\u017een\u00ed. Nemocn\u00fd je v\u0161ak infek\u010dn\u00ed u\u017e t\u00fdden p\u0159ed projevem prvn\u00edho p\u0159\u00edznaku a je\u0161t\u011b dva t\u00fddny po jejich odezn\u011bn\u00ed. Pokud onemocn\u00ed star\u0161\u00ed chlapci nebo dosp\u011bl\u00ed mu\u017ei, je nemoc \u010dasto komplikov\u00e1na z\u00e1n\u011btem varlat, po kter\u00e9m m\u016f\u017ee doj\u00edt k\u00a0do\u010dasn\u00e9 sterilit\u011b.<\/p>\n
O\u010dkov\u00e1n\u00ed<\/strong>: Z\u00e1kladn\u00ed o\u010dkov\u00e1n\u00ed se provede \u017eivou o\u010dkovac\u00ed l\u00e1tkou, a to nejd\u0159\u00edve prvn\u00ed den t\u0159in\u00e1ct\u00e9ho m\u011bs\u00edce po narozen\u00ed d\u00edt\u011bte, nejpozd\u011bji v\u0161ak do osmn\u00e1ct\u00e9ho m\u011bs\u00edce v\u011bku d\u00edt\u011bte. Pod\u00e1n\u00ed druh\u00e9 o\u010dkovac\u00ed l\u00e1tky se provede od dovr\u0161en\u00ed p\u00e1t\u00e9ho roku v\u011bku d\u00edt\u011bte do dovr\u0161en\u00ed \u0161est\u00e9ho roku v\u011bku d\u00edt\u011bte.<\/p>\nO\u010dkovac\u00ed l\u00e1tka:\u00a0<\/strong>Priorix (kombinovan\u00e1, \u017eiv\u00e1 vakc\u00edna proti spalni\u010dk\u00e1m, zard\u011bnk\u00e1m a p\u0159\u00edu\u0161nic\u00edm; v\u00fdrobce: GlaxoSmithKline); Priorix Tetra (kombinovan\u00e1, \u017eiv\u00e1 vakc\u00edna proti spalni\u010dk\u00e1m, p\u0159\u00edu\u0161nic\u00edm a plan\u00fdm ne\u0161tovic\u00edm; v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>Rotavirov\u00e9 infekce<\/strong><\/span><\/h3>\nRotavirus je nej\u010dast\u011bj\u0161\u00edm p\u016fvodcem v\u00e1\u017en\u00fdch a nebezpe\u010dn\u00fdch pr\u016fjm\u016f u d\u011bt\u00ed. Nejv\u00edce jsou posti\u017eeny d\u011bti do 5 let, v\u00fdjimkou ale nejsou ani kojenci a batolata do 2 let. Riziko p\u0159edstavuje dehydratace, kter\u00e1 jako n\u00e1sledek pr\u016fjmu a zvracen\u00ed nastupuje u d\u011bt\u00ed velice rychle a m\u016f\u017ee m\u00edt za n\u00e1sledek a\u017e hospitalizaci. P\u0159enos rotavir\u016f je\u00a0fek\u00e1ln\u011b or\u00e1ln\u00ed cestou.\u00a0D\u011bti se nakaz\u00ed nej\u010dast\u011bji tak, \u017ee se dot\u00fdkaj\u00ed toho, co bylo zne\u010di\u0161t\u011bno a n\u00e1sledn\u011b si pak strkaj\u00ed prsty do \u00fast. Inkuba\u010dn\u00ed doba je velmi kr\u00e1tk\u00e1, maxim\u00e1ln\u011b 2 dny. Nemoc se vyskytuje hlavn\u011b u d\u011bt\u00ed od 6 m\u011bs\u00edc\u016f, a to p\u0159edev\u0161\u00edm v\u00a0rozvojov\u00fdch \u010d\u00e1stech sv\u011bta, ve vysp\u011bl\u00fdch zem\u00ed se pak s\u00a0touto infekc\u00ed setk\u00e1me hlavn\u011b u d\u011bt\u00ed okolo druh\u00e9ho roku \u017eivota.<\/p>\n
O\u010dkov\u00e1n\u00ed:<\/strong><\/p>\nVakc\u00edna Rotarix (1 ml): skl\u00e1d\u00e1 se ze dvou d\u00e1vek. Prvn\u00ed od dovr\u0161en\u00ed 6 t\u00fddne v\u011bku d\u00edt\u011bte a druh\u00e1 po 1-2 m\u011bs\u00edc\u00edch od pod\u00e1n\u00ed prvn\u00ed. Nejpozd\u011bji v\u0161ak do 24 t\u00fddn\u016f.<\/p>\n
Vakc\u00edna Rotateq (2ml): Skl\u00e1d\u00e1 se ze t\u0159\u00ed d\u00e1vek. Prvn\u00ed od dovr\u0161en\u00ed 6 t\u00fddne v\u011bku d\u00edt\u011bte a rozmez\u00ed mezi jednotliv\u00fdmi d\u00e1vkami by m\u011bla \u010dinit 1-2 m\u011bs\u00edce. Nejpozd\u011bji v\u0161ak do 32 t\u00fddn\u016f.<\/p>\n
O\u010dkov\u00e1c\u00ed l\u00e1tka<\/strong>: Rotarix (\u017eiv\u00e1; v\u00fdrobce: GlaxoSmithKline); RotaTeq (\u017eiv\u00e1; v\u00fdrobce: Sanofi Pasteur).<\/p>\n <\/p>\n
<\/span>Spalni\u010dky (morbilli)<\/strong><\/span><\/h3>\nSpalni\u010dky pat\u0159\u00ed mezi typicky d\u011btsk\u00e9 onemocn\u011bn\u00ed. Postihuje p\u0159ev\u00e1\u017en\u011b d\u011bti ve v\u011bku kolem 4 a\u017e 5 let. Mohou jimi ale onemocn\u011bt i star\u0161\u00ed d\u011bti a mladistv\u00ed. Spalni\u010dky jsou infek\u010dn\u00ed onemocn\u011bn\u00ed, kter\u00e9 je bohu\u017eel tak\u00e9 vysoce naka\u017eliv\u00e9. Samy o sob\u011b nejsou zase tak z\u00e1va\u017en\u00e9, probl\u00e9my p\u016fsob\u00ed p\u0159edev\u0161\u00edm mo\u017en\u00e9 nebezpe\u010dn\u00e9 komplikace, kter\u00e9 se se spalni\u010dkami \u010dasto poj\u00ed. V p\u0159ev\u00e1\u017en\u00e9 m\u00ed\u0159e jde o z\u00e1paly plic, z\u00e1n\u011bty st\u0159edn\u00edho ucha a dokonce i o z\u00e1n\u011bt mozku (encefalitidu). Mezi charakteristick\u00e9 projevy spalni\u010dek pat\u0159\u00ed hore\u010dky, z\u00e1n\u011bt spojivek, ka\u0161el a typick\u00e1 ko\u017en\u00ed vyr\u00e1\u017eka.<\/p>\n
O\u010dkov\u00e1n\u00ed<\/strong>: Z\u00e1kladn\u00ed o\u010dkov\u00e1n\u00ed se provede \u017eivou o\u010dkovac\u00ed l\u00e1tkou, a to nejd\u0159\u00edve prvn\u00ed den t\u0159in\u00e1ct\u00e9ho m\u011bs\u00edce po narozen\u00ed d\u00edt\u011bte, nejpozd\u011bji v\u0161ak do osmn\u00e1ct\u00e9ho m\u011bs\u00edce v\u011bku d\u00edt\u011bte. P\u0159eo\u010dkov\u00e1n\u00ed se provede od dovr\u0161en\u00ed p\u00e1t\u00e9ho roku v\u011bku d\u00edt\u011bte do dovr\u0161en\u00ed \u0161est\u00e9ho roku v\u011bku d\u00edt\u011bte.<\/p>\nO\u010dkovac\u00ed l\u00e1tka:<\/strong>\u00a0Priorix (kombinovan\u00e1, \u017eiv\u00e1 vakc\u00edna proti spalni\u010dk\u00e1m, zard\u011bnk\u00e1m a p\u0159\u00edu\u0161nic\u00edm; v\u00fdrobce: GlaxoSmithKline); Priorix Tetra (kombinovan\u00e1, \u017eiv\u00e1 vakc\u00edna proti spalni\u010dk\u00e1m, p\u0159\u00edu\u0161nic\u00edm a plan\u00fdm ne\u0161tovic\u00edm; v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>Tetanus<\/strong><\/span><\/h3>\nTetanus je nebezpe\u010dn\u00e9 infek\u010dn\u00ed onemocn\u011bn\u00ed zp\u016fsoben\u00e9 bakteri\u00ed, kter\u00e1 je p\u0159\u00edtomna ve stolici zv\u00ed\u0159at i \u010dlov\u011bka a hnojen\u00edm se dost\u00e1v\u00e1 do p\u016fdy, kde ve form\u011b sp\u00f3r vydr\u017e\u00ed m\u011bs\u00edce i l\u00e9ta. Vstupn\u00ed branou n\u00e1kazy jsou drobn\u00e1 i v\u011bt\u0161\u00ed poran\u011bn\u00ed na lidsk\u00e9m t\u011ble, kter\u00e1 se dostanou do kontaktu s kontaminovanou p\u016fdou. Lid\u00e9 se nej\u010dast\u011bji nakaz\u00ed otev\u0159enou ranou, kter\u00e1 je obvykle hlubok\u00e1 ale \u010dasto i nepatrn\u00e1 (zp\u016fsoben\u00e1 h\u0159eb\u00edkem, t\u0159\u00edskou apod.). Toxiny produkovan\u00e9 bakteriemi blokuj\u00ed uvol\u0148ov\u00e1n\u00ed svalov\u00e9ho stahu, proto se tetanus projevuje k\u0159e\u010demi a ztr\u00e1tou koordinace svalov\u00fdch pohyb\u016f. Inkuba\u010dn\u00ed doba je zpravidla 3-30 dn\u00ed. Na po\u010d\u00e1tku onemocn\u011bn\u00ed si za\u010dne nemocn\u00fd st\u011b\u017eovat na pot\u00ed\u017ee p\u0159i otev\u00edr\u00e1n\u00ed \u00fast, kter\u00e9 je vyvol\u00e1no zv\u00fd\u0161en\u00fdm nap\u011bt\u00edm \u017ev\u00fdkac\u00edch sval\u016f. V t\u00e9to f\u00e1zi nemocn\u00fd \u010dlov\u011bk obvykle nem\u00edv\u00e1 \u017e\u00e1dn\u00e9 jin\u00e9 obt\u00ed\u017ee ani teplotu. Postupn\u011b se ale zv\u00fd\u0161en\u00e9 nap\u011bt\u00ed roz\u0161i\u0159uje i na ostatn\u00ed svaly a doch\u00e1z\u00ed k rozvoji celkov\u00fdch k\u0159e\u010d\u00ed, p\u0159i kter\u00fdch se m\u016f\u017ee nemocn\u00fd udusit. Polovina nemocn\u00fdch sv\u00e9mu onemocn\u011bn\u00ed podlehne.<\/p>\n
O\u010dkov\u00e1n\u00ed:<\/strong>\u00a0Z\u00e1kladn\u00ed o\u010dkov\u00e1n\u00ed se provede od zapo\u010dat\u00e9ho 9. t\u00fddne po narozen\u00ed d\u00edt\u011bte dv\u011bma d\u00e1vkami hexavalentn\u00ed o\u010dkovac\u00ed l\u00e1tky v pr\u016fb\u011bhu prvn\u00edho roku \u017eivota d\u00edt\u011bte, podan\u00fdmi v intervalu dvou m\u011bs\u00edc\u016f mezi d\u00e1vkami, a t\u0159et\u00ed d\u00e1vkou podanou mezi jeden\u00e1ct\u00fdm a t\u0159in\u00e1ct\u00fdm m\u011bs\u00edcem v\u011bku d\u00edt\u011bte. Pravideln\u00e1 posiluj\u00edc\u00ed d\u00e1vka se aplikuje ve v\u011bku 11 let. Podle doporu\u010den\u00ed by se m\u011bly v\u0161echny osoby n\u00e1sledn\u011b o\u010dkovat ka\u017ed\u00fdch 10 let. U nedono\u0161en\u00fdch d\u011bt\u00ed se o\u010dkov\u00e1n\u00ed provede t\u0159emi d\u00e1vkami o\u010dkovac\u00ed l\u00e1tky podan\u00fdmi v\u00a0intervalech nejm\u00e9n\u011b jednoho m\u011bs\u00edce mezi d\u00e1vkami a \u010dtvrtou d\u00e1vkou podanou nejm\u00e9n\u011b \u0161est m\u011bs\u00edc\u016f po pod\u00e1n\u00ed t\u0159et\u00ed d\u00e1vky.<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>: Hexacima (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: Sanofi Pasteur); Infanrix hexa (kombinovan\u00e1, 6 o\u010dkovac\u00edch l\u00e1tek proti difterii, tetanu, pertusi (acelul\u00e1rn\u00ed), hepatitid\u011b B, poliomyelitid\u011b (inaktivovan\u00e1) a konjugovan\u00e1 vakc\u00edna proti\u00a0Haemophilus influenzae<\/em>\u00a0b (adsorbovan\u00e1); v\u00fdrobce: GlaxoSmithKline); Tetavax (adsorbovan\u00e1; v\u00fdrobce: Sanofi Pasteur), Vacteta (adsorbovan\u00e1; v\u00fdrobce: Biodrug).<\/p>\n <\/p>\n
<\/span>\u00a0Vzteklina (rabies)<\/strong><\/span><\/h3>\nJe to typick\u00e1 zoon\u00f3za, tedy onemocn\u011bn\u00ed p\u0159en\u00e1\u0161en\u00e9 zv\u00ed\u0159aty, kdy se \u010dlov\u011bk nej\u010dast\u011bji nakaz\u00ed slinou naka\u017een\u00e9ho zv\u00ed\u0159ete p\u0159i t\u011bsn\u00e9m kontaktu jako je kousnut\u00ed nebo \u0161kr\u00e1bnut\u00ed, ale vz\u00e1cn\u011b jsou mo\u017en\u00e9 i jin\u00e9 zp\u016fsoby p\u0159enosu. P\u0159ena\u0161e\u010di jsou pouze teplokrevn\u00e1 zv\u00ed\u0159ata, t\u00e9m\u011b\u0159 v\u00fdlu\u010dn\u011b savci, u pt\u00e1k\u016f je v\u00fdskyt pouze vz\u00e1cn\u00fd. V \u010cesk\u00e9 republice je nejv\u00fdznamn\u011bj\u0161\u00edm p\u0159ena\u0161e\u010dem li\u0161ka, d\u00e1le pak psi, ko\u010dky, netop\u00fd\u0159i \u010di jezevci, v jin\u00fdch oblastech sv\u011bta i skot, m\u00fdvalov\u00e9, kojoti nebo hyeny. Vzteklina je smrteln\u00e1 t\u00e9m\u011b\u0159 ve stech procentech p\u0159\u00edpad\u016f, pokud nen\u00ed ihned po naka\u017een\u00ed pod\u00e1no o\u010dkov\u00e1n\u00ed a imunoglobuliny.<\/p>\n
O\u010dkov\u00e1n\u00ed:<\/strong>\u00a0O\u010dkov\u00e1n\u00ed se provede v p\u0159\u00edpad\u011b pokous\u00e1n\u00ed nebo poran\u011bn\u00ed zv\u00ed\u0159etem podez\u0159el\u00fdm z n\u00e1kazy vzteklinou (tzv. postexpozice). O\u010dkov\u00e1n\u00ed je tak\u00e9 nezbytn\u00e9 prov\u00e9st u fyzick\u00fdch osob p\u016fsob\u00edc\u00edch na pracovi\u0161t\u00edch s vy\u0161\u0161\u00edm rizikem vzniku vztekliny, jako jsou laborato\u0159e, kde se pracuje s virulentn\u00edmi kmeny vztekliny.<\/p>\nD\u00e1vkov\u00e1n\u00ed<\/strong>: Ve v\u011bku od dvou m\u011bs\u00edc\u016f, 3 d\u00e1vky (z\u00e1vis\u00ed na doporu\u010den\u00ed v\u00fdrobce, n\u011bkter\u00e9 vakc\u00edny se doporu\u010duje pod\u00e1vat 1 rok po z\u00e1kladn\u00edm o\u010dkov\u00e1n\u00ed a ka\u017ed\u00e9 dal\u0161\u00ed posiluj\u00edc\u00ed o\u010dkov\u00e1n\u00ed do 5 let), interval mezi z\u00e1kladn\u00edmi d\u00e1vkami 0 – 7\/14 – 21\/28 dn\u00ed, interval posiluj\u00edc\u00ed d\u00e1vky 2(1) – 5 let (op\u011bt z\u00e1vis\u00ed na doporu\u010den\u00ed v\u00fdrobce).<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>: Verorab (inaktivovan\u00e1; v\u00fdrobce: Sanofi Pasteur), Rabipur (inaktivovvan\u00e1; v\u00fdrobce: GSK Vaccines).<\/p>\n <\/p>\n
<\/span>Zard\u011bnky (rubeola)<\/strong><\/span><\/h3>\nZard\u011bnky pat\u0159\u00ed do skupiny typick\u00fdch d\u011btsk\u00fdch infek\u010dn\u00edch chorob. P\u0159en\u00e1\u0161\u00ed je tzv. rubeola virus, a to kap\u00e9nkovou cestou n\u00e1kazy (vzduchem) stejn\u011b jako se \u0161\u00ed\u0159\u00ed ch\u0159ipka. Rubeola virus pat\u0159\u00ed do skupiny tzv. togavir\u016f, kter\u00fd pat\u0159\u00ed mezi exant\u00e9mov\u00e9 viry. Exant\u00e9mov\u00e9 viry zp\u016fsobuj\u00ed onemocn\u011bn\u00ed prov\u00e1zen\u00e9 vyr\u00e1\u017ekami, jako jsou nap\u0159\u00edklad sp\u00e1la, spalni\u010dky nebo plan\u00e9 ne\u0161tovice. Zard\u011bnky se projevuj\u00ed \u010dervenavou vyr\u00e1\u017ekou: nejprve v obli\u010deji, pozd\u011bji i na trupu i na cel\u00e9m t\u011ble. Pr\u016fb\u011bh nemoci jako takov\u00e9 nen\u00ed nijak z\u00e1va\u017en\u00fd, u\u00a0n\u011bkter\u00fdch nemocn\u00fdch (zvl\u00e1\u0161t\u011b u\u00a0dosp\u011bl\u00fdch) p\u0159ejde bez p\u0159\u00edznak\u016f, asymptomaticky. Pokud osoba jednou nemoc prod\u011bl\u00e1, jej\u00ed t\u011blo vytvo\u0159\u00ed dostatek protil\u00e1tek, tak\u017ee zard\u011bnkami v\u00a0budoucnosti u\u017e nelze onemocn\u011bt, podobn\u011b jako u\u00a0ne\u0161tovic.<\/p>\n
O\u010dkov\u00e1n\u00ed<\/strong>: Z\u00e1kladn\u00ed o\u010dkov\u00e1n\u00ed se provede \u017eivou o\u010dkovac\u00ed l\u00e1tkou, a to nejd\u0159\u00edve prvn\u00ed den t\u0159in\u00e1ct\u00e9ho m\u011bs\u00edce po narozen\u00ed d\u00edt\u011bte, nejpozd\u011bji v\u0161ak do osmn\u00e1ct\u00e9ho m\u011bs\u00edce v\u011bku d\u00edt\u011bte. P\u0159eo\u010dkov\u00e1n\u00ed se provede od dovr\u0161en\u00ed p\u00e1t\u00e9ho roku v\u011bku d\u00edt\u011bte do dovr\u0161en\u00ed \u0161est\u00e9ho roku v\u011bku d\u00edt\u011bte.<\/p>\nO\u010dkovac\u00ed l\u00e1tka<\/strong>: Priorix (kombinovan\u00e1, \u017eiv\u00e1 vakc\u00edna proti spalni\u010dk\u00e1m, zard\u011bnk\u00e1m a p\u0159\u00edu\u0161nic\u00edm; v\u00fdrobce: GlaxoSmithKline); Priorix Tetra (kombinovan\u00e1, \u017eiv\u00e1 vakc\u00edna proti spalni\u010dk\u00e1m, p\u0159\u00edu\u0161nic\u00edm a plan\u00fdm ne\u0161tovic\u00edm; v\u00fdrobce: GlaxoSmithKline).<\/p>\n <\/p>\n
<\/span>Z\u00e1\u0161krt (difterie)<\/strong><\/span><\/h3>\nZdrojem z\u00e1\u0161krtu se st\u00e1v\u00e1 bacilonosi\u010d nebo nemocn\u00fd \u010dlov\u011bk a \u0161\u00ed\u0159\u00ed se nejen vzdu\u0161nou cestou, ale i kontaminovan\u00fdmi p\u0159edm\u011bty, nebo\u0165 jeho p\u016fvodce, bakterie\u00a0Corynebacterium diphteriae<\/em>, m\u016f\u017ee p\u0159e\u017e\u00edvat n\u011bkolik t\u00fddn\u016f v prachu nebo zaschl\u00e9m hlenu. Onemocn\u011bn\u00ed se s obvykle kr\u00e1tkou 2-5denn\u00ed inkubac\u00ed klinicky projevuje t\u011b\u017ekou povlakovou ang\u00ednou, postihuj\u00edc\u00ed nejen mandle, ale i sliznici hrtanu a patra. M\u016f\u017ee doj\u00edt ke zdu\u0159en\u00ed krku, co\u017e v p\u0159\u00edpad\u011b nel\u00e9\u010den\u00ed m\u016f\u017ee v\u00e9st a\u017e k udu\u0161en\u00ed. Komplikacemi z\u00e1\u0161krtu b\u00fdv\u00e1 z\u00e1n\u011bt srde\u010dn\u00edho svalu a obrny s fat\u00e1ln\u00edmi n\u00e1sledky.<\/p>\nO\u010dkov\u00e1n\u00ed<\/strong>: Z\u00e1kladn\u00ed o\u010dkov\u00e1n\u00ed se provede v dob\u011b od zapo\u010dat\u00e9ho 9. t\u00fddne po narozen\u00ed d\u00edt\u011bte dv\u011bma d\u00e1vkami hexavalentn\u00ed o\u010dkovac\u00ed l\u00e1tky v pr\u016fb\u011bhu prvn\u00edho roku \u017eivota d\u00edt\u011bte, podan\u00fdmi v intervalu dvou m\u011bs\u00edc\u016f mezi d\u00e1vkami, a t\u0159et\u00ed d\u00e1vkou podanou mezi jeden\u00e1ct\u00fdm a t\u0159in\u00e1ct\u00fdm m\u011bs\u00edcem v\u011bku d\u00edt\u011bte. Pravideln\u00e1 posil\u0148uj\u00edc\u00ed d\u00e1vka se aplikuje ve v\u011bku 11 let. Podle doporu\u010den\u00ed by se m\u011bly v\u0161echny osoby n\u00e1sledn\u011b o\u010dkovat ka\u017ed\u00fdch 10 let. U nedono\u0161en\u00fdch d\u011bt\u00ed se o\u010dkov\u00e1n\u00ed provede t\u0159emi d\u00e1vkami o\u010dkovac\u00ed l\u00e1tky podan\u00fdmi v\u00a0intervalech nejm\u00e9n\u011b jednoho m\u011bs\u00edce mezi d\u00e1vkami a \u010dtvrtou d\u00e1vkou podanou nejm\u00e9n\u011b \u0161est m\u011bs\u00edc\u016f po pod\u00e1n\u00ed t\u0159et\u00ed d\u00e1vky.<\/p>\n