kukkur khaaainsi

kookar khaansi vargeekaran evam baahya saadhan
ek bachche ko kookar kaas mein khaansi
aaiseedi-10	A37.
aaiseedi-9	033
dijeej-deebi	1523
medalaain plas	001561
imedisin	emerg/394 ped/1778
M.iesaech	D014917

kookar kaas ya kookar khaansi ya kaali khaansi (angreji:partasis, vhooping kaf) jeevaanu ka sankraman hota hai jo ki aarambh mein naak aur gala ko prabhaavit karta hai. yeh praay: 2 varsh se kam aayu ke bachchon ki shvasan pranaali ko prabhaavit karta hai. is beemaari ka naamakaran is aadhaar par kiya gaya hai ki is beemaari se peedit vyakti saans lete samay bhaunkane jaisi aavaaj karta hai. yeh bordetella paratyoosiya kahalaane vaale jeevaanu ke kaaran hota hai. yeh jeevaanu vyaktiyon ke beech shvasan kriya se nishkaasit jeevaanu se failati hai. yeh tab hota hai jab sankraman yukt vyakti khaansate ya chheenkate hain. yeh sankraman yukt vyaktiyon ke shaareerik dravon se sampark hone se bhi failata hai jaise naak ka paani girna.

• jeevaanu sankraman ke aarambh se 7 se 17 dinon ke baad iske lakshan viksit ho paate hain.
• jinmein lakshan viksit ho jaate hain, ve adhikaansh mein 2 varsh ki aayu se kam hote hain.

ye lakshan lagbhag 6 saptaah tak rahate hain aur ye 3 charanon mein vibhaajit hote hain -

charan-1

in lakshanon mein chheenkana, aankhon se paani aana, naak bahana, bhookh kam hona, oorja ka hraas hona aur raat ke samay khaansana shaamil hai.

charan-2

in lakshanon mein lagaataar khaansate rahana aur iske baad bhaunkane jaisi aavaaj aana tab jabki beemaar vyakti saans lene ka prayaas karta hai, aadi shaamil hai.

charan -3

iske antargat sudhaar ki prakriya aati hai jabki khaansana na to lagaataar hota hai aur na gambhir. yeh star 4 saptaah se praay: aarambh hota hai.

yeh kukar khaansi kam aayu ke rogiyon ko hoti hai jinki khaansi 2 saptaah tak rahati hai.

kukur khaansi bachchon mein hone waali ek sankraamak tatha khatarnaak beemaari hai. mukhyat: shvasan tantr ko prabhaavit karti hai jo viksit aur vikaasasheel donon prakaar ke deshon ke liye atyant chinta ka vishay hai. Bhaarat jaise vikaasasheel desh mein pratyek ek lakh ki aabaadi par 587 bachche pratyek varsh is beemaari se grasit hote hain. isse bachchon mein mrutyudar 4.15 pratishat hai jo ki kukur khaansi ke rogiyon ka 10 pratishat, ek varsh ke bheetar marne vaale bachchon ka aadha bhaag hai.

yeh beemaari bordatel paratyoosis naamak sookshmajeevi se hoti hai. sankraman ki saarvadhik beemaariyaan paanch varsh se kam umr mein hoti hain joki nar bachchon ki apeksha maada bachchon mein adhik hoti hai. chhah maheene se kam umr ke shishuon mein is beemaari se mrutyu-dar adhik hoti hai, haalaanki yeh beemaari saal ke kisi bhi maah mein ho sakti hai, kintu jaada tatha varsha ki ritu mein iski sambhaavana saarvaadhik hoti hai. ab prashn uthata hai ki yeh beemaari ek bachche se doosare bachche mein kis prakaar sankramit hoti hai ? is beemaari se grasit bachchon ki naak bahti hai, chheenk aati hai aur vah khaansata hai. naak bahne ke kram mein jo taral padaarth niklata hai, isi ke dvaara beemaari failati hai. khaansi ya chheenk ke dauraan naak, munh tatha saans chhodne ke kram mein jeevaanu aaspaas tatha vaataavaran mein fail jaata hai, jo doosare bachchon mein sankramit hone ka kaaran banta hai. yeh beemaari mukhyat: bachchon ki praarambhik avastha mein, jab unke maata-pita ko unki beemaari ka pata naheen chalta, khel ke maidaan mein, ek bichhaavan par sone aur ek hi bartan mein khaane-peene ke kram mein failati hai.

aisi baat naheen hai ki rog ke keetaanuon ke sankraman (beemaar bachche se svathya bachche mein) ke turant baad beemaari ho jaati hai. rogaanuon ke aakraman ke pashchaat lakshan dikhaai padne mein ek se do saptaah ka samay lag jaata hai. sarvapratham jeevaanu shvasan tantr ki bheetari satah ke sampark mein aakar satah par chipk jaata hai, jahaan uchit maadhyam paakar vruddhi karne lagta hai. uske baad satah par ghaav banta hai. falasvaroop sthaan fool jaata hai. fir tvacha par nekrosis ki kriya hoti hai. nekrosis (rakt pravaah ki kami ki vajah se tvacha ka kshaya) ke kaaran anya baikteeriya aakraman kar tvacha mein teji se vruddhi karna shuroo kar dete hai.

itni prakriya poori hone mein ek-do saptaah ka samay lag jaata hai. uske baad rog apna lakshan dikhaana shuroo karta hai, jo teen bhaagon mein prakat hota hai. shuroo mein bachche ke khaansi hoti hai tatha naak se paani bahata hai. fir dheere-dheere khaansi se bachche ko vishesh pareshaani naheen hoti, kintu dheere-dheere iski gati badhti hai kyonki shvasan-tantr ko prabhaavit karne ki prakriya lagaataar badhti jaati hai. jaise-jaise shvasan-tantr prabhaavit hota hai khaansi aur khaansane ki gati badhti jaati hai aur ek samay aisa aata hai ki khaansi ki vajah se rogi raat ko so naheen paata hai. pehle jo keval jaagrutaavastha mein khaansi hoti thi ab vah neend mein bhi hone lagti hai, jisse bachcha khaansate-khaansate uth jaata hai.

yeh sthiti do se chaar saptaah tak bani rahati hai. uske baad apna ugr aur bhayankar roop dhaaran kar leti hai. ab pehle ki apeksha aur jaldi-jaldi khaansi ka daura padne lagta hai. is dauraan ek aisa sthiti aa jaati hai ki bachche ko saans lene tak mein kathinaai hone lagti hai. uske baad saans lene ke kram mein ek vishesh prakaar ki aavaaj nikalne lagti hai, jaise-kisi kutte ke rone ki aavaaj. yeh aavaaj shvasan-tantr mein sankraman tatha glaatis ke khulne ki vajah se hoti hai, kintu vah hoop-hoop aavaaj hamesha naheen hoti hai. uske baad khaansi ke saath gaadhe rang ka balagam (kaf) niklata hai. ek baat aur ki jab khaansi apna veebhats roop dikha rahi hoti hai to theek uske baad ulti hoti hai aur khaaya-peeya sab baahar nikal jaata hai. khaansi ke dauraan jeebh ka baar-baar munh se baahar aane ke kram mein us par daant padne se ghaav ho jaane ki sambhaavana atyadhik badh jaati hai. baar-baar khaansane ki vajah se chehara laal ho jaata hai. bachcha chintit rahane lagta hai. kai baar to atyadhik udaaseen apne aap mein bhaunchakka, kinkartavyavimoodh ki sthiti mein kuchh samajh naheen paata ki aakhir mujhe kaun-si saja di ja rahi hai. maanasik tanaav ki vajah se poore shareer se paseena chhootane lagta hai, bhojan se virkti hone lagti hai. vah bhojan karna naheen chaahata.

sabhi shishuon ke liye kukar khaansi ka teeka lagavaana aavashyak hai. yeh teekaakaran praay: deeteepi sanyukt roop mein diptheriya, titnes aur kukar khaansi (paratyoorasis) diya jaata hai. pehle wala sankraman aur teekaakaran jindageebhar asankrameekaran ki guaranty naheen deta hai. tathaapi 6 varsh ki aayu ke baad vardhak teekaakaran ki sifaarish naheen ki jaati hai jab tak ki sankraman na hua ho.

is beemaari ke ilaaj ke liye enteebaayotiks ka prayog kiya jaata hai jo iske daure ki bhayaanakata ko kam kar deta hai. yadi rog ki pehchaan praarambhik avastha mein ho jaae to enteebaayotiks ka prayog kaafi laabhadaayak siddh ho sakta hai. irithromaaisin ya empeesilin ka prayog saat se das dinon tak kiya jaata hai. aajkal kloramfenikol ka vyavahaar atyadhik kiya jaata hai kyonki yeh dava atyadhik sasti hai. ghabaraahat door karne ke liye bhi inki goliyaan di ja sakti hain. shvasan-naliyon ki sikudn ko kam karne ke liye bronkodaayaletar diya jaata hai. kaf sirp bhi kaf ko nikaalne ke liye diya jaata hai.