RANNUNG SEH NATNA

- Lalfakzuala Pautu
Public Health Entomologist
IDSP, DHS

Tun laiin Mizoramah rannung seh natna kan tih mai, Scrub Typhus a leng nasa hle mai a. Hemi kawng a mipui ten kan hriattur leh kan zawm turte tlem azawng han thailan ve thain kan hria a ni. Nunna hlu tak chan palh a hlauhawm avangin he natna vei nia inringhlelte chuan a rang thei ang berin Doctorte rawn vat hi a finthlakin a him ber a ni.

Rannung seh natna kan tih mai, Scrub typhus hi Orientia tsutsugamushi natna hrikin mihringa natna a thlen a ni.

Tsutsuga awmzia chu hlauhawm tihna a ni a, mushi tih chu Tuhrik (mites) tihna a ni a, Tuhrik (Trombiculid mites) te hian Transovarial (a puiin a noteah) leh transtadial (a notein a pui a nih thleng an inhlanchhawng thin) transmission in heng natna hrik hi an kengkual ta thin a ni.

Scrub typhus hi kum 1899 khan Japan ramah chiang taka hriatchhuah hmasakber a ni a. A hming Scrub typhus tih hi he natna lo awm tan duhna hmun, hnim hming Shrub (hnim lianlo) atanga phuahchhuah a ni. He natna hi kumtin mi maktaduaih khat velin an vei thin a, a veite hi enkawlna mumal pek an nih loh chuan za a sawmthum velin an thihpui thin.

He natna hi Tuhrik, Scrub typhus natna hrik paiin mi a seh atanga ni 10-12 chhungin a langchhuak thin a ni.

RANNUNG SEH NATNA (SCRUB TYPHUS) DARH DAN -
Scrub typhus natna hrikte hian inthlahpun nan leh thanlenna ber pakhat chu, sazu lam chi ho (rodents) te hi an ni a. Sazute atang hian tuhrikin natna hrik chu lachhawngin mihringah an thehdarh ta thin a ni. Tuhrikte hi an te hle a, Tuhrik chi thenkhat(species) phei chu mit lawngin an hmuh theih loh hial a ni.

India rama he natna thehdarhtu tuhrik (vector) chu Leptotrombidium deliense-te an ni a, Japan leh khawchhak lam ramah te chuan Leptotrombidium akamushi ten an thehdarh thung. Tuhrik sehnaah khan hmuamhma(eschar) pankhir a lo awm thin a, he natna hmuhchuah nan a tangkai hle.

Mahse heihi 40-50% ah chauh a awm thin thung. Mite (Tuhrikte) hian an damchhung hian pianhmang leh nihphung danglamna (life cycle) chhawng li an kal tlang thin a, chungte chu, Egg, Larva, Nymph leh Adult te an ni. Larva an nihlai chauh hian he natna hi an thehdarh thei.

RANNUNG SEH NATNA AWMNA HMUN TE -
Khawvel hmun thenkhatah chuan he Scrub typhus natna hi engtiklai pawhin a awm reng thin a, chung hmunte chu “Tsutsugamushi Triangle” tiin an sawi thin. Chutiang hmunah chuan India ram pawh hi a telve a ni. Scrub typhus natna lanchhuahna leh awmduhna hmunte chu - Mites (Tuhrik) awmduhna hmun, rambua leh dai hnim hmunte a ni. He natna hi hmun bik huamzau vakloah a thleng thin.
Hun kaltawh a rannung seh tawk ngailoteah he natna hi a thleng duh bik bawk.

RANNUNG SEH NATNA-A INDIA DINHMUN -
India ramah hian he natna hi natna lo awm tawh thin, lo lang nawn leh re-emerging disease anga ngaih a ni a. He natna tamna hmunte chu, Sub Himalayan Belt, Jammu atanga Nagaland te, Himachal Pradesh, Sikkim leh Darjeeling-ah te a ni. India chhimlamah chuan he natna hi khaw vawh laiin a thleng deuh ber thin. He natna puan hun hi sik leh sain a hril thui em em a, Tuhrik lam chi te an inthlahpun chak danin a hril thui hle bawk.

Dan naranin he natna hi Furah leh favangah a lang chhuak tam ber thin. Ramngaw thiah darhna hmun te, luikam te, phulhmun te hi Tuhrik te tana inthlah punna hmun tha ber a ni a. India ram hmun hrang hrangah hian he natna hian pun lam a pan zel avangin buaipui tham a tling chho ta a ni.

RANNUNG SEH NATNA, MIZORAM DINHMUN -
Mizoramah hian engtk lai atangin nge he natna hi a lo awm tan tih hriatchian fak a ni lova, amah erawh chu Mautam hun lai atang khan he natna hi a hluar vak a ni tih erawh a hriat theih thung. Health

Department hnuaia IDSP te chuan kum 2012 atang khan District hospital te leh private hospital thenkhat atangin he natna data hi a lakhawm tan a, tun thleng hian Mizoramah he natna vei hi mi 913 awm tawhin mi 34 in an thihpui tawh bawk a ni. Private clinics leh private hospital thenkhatte atanga data hi lakkhawm theih a nih loh avangin a vei zat leh he ntna avanga thi zat hi hei aia an tam viau a rinawm.

Malaria tih lohah chuan rannung atanga kai natna (vector borne diseases) zingah Scrub Typhus hi Mizorama natna buaipuiawm ber a tling hial tawh a ni.

AIZAWL DINHMUN
Rannung seh natna hi thingtlang lam (rural)-a leng thin natna a ni a, mahse tunhnaiah hian khawpuiah pawh he natna hi a hluar sawt hle mai. Aizawl khawpui chhung veng hrang hrang, veng 41 lai atangin a veite hi record an ni a. Aizawl khawchhunga kai tamtak te hi ramhnuaia kal ngai lo leh zin ngai miahlo te an awm nual a, hengte hian an in leh avel atanga an kai a ni tih a ti lang thei. Chuvangin Aizawl khawpui chhung pawh hi he natna atang hian a him biklo va, a vei zawng zawng zinga 30.09% lai hi Aizawl khawchhung ami an ni.

RANNUNG SEH NATNA (SCRUB TYPHUS) NATNA LANCHHUAH DAN -
Tuhrik seh thenkhat hi a na lem lova, thak angin a rawn lang chhuak a, vun nemlai zakhnuaiah te, kapkarah te, dulah te leh nghawngah te a seh duh bik. Tlun/ khurh leh khawsik, nasa taka lu na, mit vel sen rem rum, thal thoh leh hnungzang vela thak bawl angtein he natna hi a rawn lang chhuak tlangpui thin. A chang chuan tihrawl leh pum nate pawh a thlen thin bawk.

A nasat pheichuan thisenzam chat te leh thisenzam block te a thlen hial thei a, Pneumonia leh thawkna lama harsatnate pawh a thlen thei bawk.

Scrub Typhus natna hi thisen ekzam atangin a hmuh chhuah theih a, Mizoramah hian Rapid Diagnostic Kits(ICT) te hi he natna hriat chhuah nana hman ber a ni a, WHO leh Health Ministry lam chuan ELISA hmanga test hi an recommend thung a ni.

SCRUB TYPHUS NATNA ENKAWL DAN -
Scrub typhus natna hi Antibiotic damdawi hmanga enkawl thin a ni. A enkawlna atana damdawi hman lar tak chu, Doxycycline a ni a, Chloramphenicol pawh an hmang thin bawk a, Rifampicin nen an pekpawlh thin bawk. Naupang leh Nu naupailaiah chuan Azithromycin emaw Chloramphenicol emaw pek tur a ni. He natna hi a invenna (vaccine) a la awm rih lo.

Heng damdawi kan han tarlan takte hi mahni thua lo ei ve mai erawh a him lo va, Doctorte rawn phawt hi a tha ber a, a him ber bawk.

TYPHUS NATNA LAKA INVEN DAN -
Rannung seh natna awm thinna leh a thehdarhtu Tuhrik awm duhna hmunah te kan kal a nih pawhin, thawmhnaw hak uluk a ngai em em a. Thawmhnaw, taksa khuh kim thei ang ber hak thin tur a ni. Rannung duh loh (insect repellant) damdawi, Odomos, Permethrin, Dibutylphtalate te leh a dang te thawmhnawah leh taksa lang laiahte ram chhuah dawnin in chulh thin tur a ni. Hnimah te leh phulah te engmah phah lova thut mai mai loh a tha ber bawk. In leh a vel fai taka vawn reng a pawimawh a, hei hian nasa takin min venghim thei bawk a ni. In leh a vel Rannung thahna hlo (Insecticides) hmanga kah a tangkai hle bawk a ni.

A CONTROL DAN
Heng thil pathumte hi he natna control nan hian an pawimawh hle a ni -
1. Rapid case identification -
A rang thei ang ber leh a hma thei ang berin he natna veitu hi damdawi lam thiam ten an hriat chhuah a pawimawh em em.
2. Public education -
Mipuite hnena he natna chung chang leh a kaichhawn dan te a tam thei ang ber zirtir a hrilhfiah a pawimawh hle a ni.
3. Rodent control and habitat modification -

Sazu lamchi (rodent) te hi he natna hrik than puitlinna hmun (reservoir) an nih avangin sazu pung tur control hi a pawimawh hle a ni. Kan chenna hmunte sazu tana khawsak rem changlo tura siam hian scrub typhus natna lakah nasa takin min venghim thei dawn a ni.