Cocuk Enfeksiyon ve COVID-19

.: PREFACE
ÖN SÖZ
PREFACE
Prof. Dr. Ateş KARA
Hacettepe Üniversitesi Tıp Fakültesi, Çocuk Enfeksiyon Hastalıkları BD, Ankara
Article Language: TR
Sevgili Arkadaşlar,
Son bir yıl, hatta altı ay içerisinde, sağlık anlayışımızda çok büyük bir değişimi hep birlikte yaşamaktayız. Aralık ayı içerisinde Çin Halk Cumhuriyeti'nin, Hubei Eyaleti'nin en büyük şehirlerinden olan Wuhan'da özellikle canlı yaban hayvanlarının da satışının olduğu, canlı hayvan pazarı da olan deniz ürünleri pazarı ile ilişkili olduğu tespit edilecek atipik pnömoni vakalarının dikkat çekmesi ile yeni bir salgın başlamış oldu. Bu yeni salgının sorumlusunun bir koronavirüs olduğu ise çok erken fark edilerek, Ocak başında, dünya ile paylaşıldı. Ancak kesin kaynağı ve insana nasıl bulaştığı ise hâlâ tartışmalı durumdadır. Temmuz ayının 6'sına geldiğimizde ise tüm dünyayı etkileyen ve Dünya Sağlık Örgütü'nün resmi rakamları ile, dünya genelinde, SARS-CoV-2 olarak adlandırılan bu yeni koronavirüs ile enfekte olmuş insan sayısı 11 milyon 300 bini geçmiş durumdadır. Kayıpların sayısı ise, 532 binin üzerindedir.

Özellikle penisilinin klinik kullanıma girmesi, hızla birçok yeni antibiyotik sınıfında farklı ajanların bulunması ile 1940'dan 1960'lı yıllara kadar, enfeksiyon hastalıklarının tedavisinde çok ciddi bir ilerleme sağlanmıştır. Benzer şekilde aşıların geliştirilmesi, Dünya Sağlık Örgütü tarafından yaygınlaştırılma çalışmalarındaki başarılar ile birlikte basit halk sağlığı önlemlerinin de uygulamaya konulması ile enfeksiyon hastalıklarının önlenmesinde çok daha büyük zaferler kazanılmıştır. Bu gelişmelerin sonucu olarak, birçok sağlık çalışanı enfeksiyon hastalıklarının, insan yaşamını etkileme döneminin sonuna gelindiğini kabul etmeye başlamıştır. İnsanoğlunun, mikroorganizmalara karşı savaşı kazandığını hatta farklı ortamlarda ilan eden doktorlar da olmuştur. Çiçek hastalığının eradike edilmesi de, ilk etapta bu düşünceyi desteklemiştir. Ancak hemen sonrasında, sıtma, tüberküloz ve diğer sık bakteriyel enfeksiyon etkenlerinin direnç geliştirmesi bu başarının tam olmadığına işaret ederken, özellikle yeni etkenlerin ortaya çıkışı ile aslında yolun çok daha başında olunduğunun ve hatta belki de başarının mümkün olmadığının düşünülmesine neden olmuştur. Ayrıca, daha önce insan oğlunun karşılaşmamış olduğu yeni ajanların ortaya çıkma olasılığı da ciddi bir tehdit olarak değerlendirilmeye başlamıştır. Bilim insanları, influenza virüsünü dünyayı etkileyecek bir salgın için potansiyel tehdit olarak görürken, 2002 yılında SARS, 2012 yılında MERS, koronavirüslerin neden oldukları klinik tablolar olarak karşımıza çıkmıştır. Bu dönem içerisinde 2009 yılında H1N1 influenza virüsü ise, tüm dünyayı etkileyen, göreceli olarak kolay bulaşan ancak mortalitesi düşük olan dünya genelinde salgına neden olmuştur. Bugün COVID-19 olarak adlandırdığımız, SARS-CoV-2'nin neden olduğu salgın, insan yaşamını tehdit ettiği kadar sosyal, ekonomik yaşamında da çok ciddi değişikliklere neden olmuş durumdadır ve belki de yaşam bugünden itibaren belirgin farklılıklar ile devam etmek zorunda kalacaktır. Bizler, bu kitabın içerisinde sizlerin de göreceği üzere çok geniş bir grup olarak bu alanda çalışan çocuk sağlığına gönül veren sağlık personelleri olarak, bu yeni klinik tablo ve virüs ile ilgili olarak; bugüne kadar öğrendiklerimizi, bildiklerimizi paylaşalım istedik. Sizlerden ricamız; en güncel bilgileri sizlerle paylaştığımız yazılarımızda değişikliklerin de olabileceğini değerlendirmeniz.

Bu kitabın editörlüğünü yapabilme onuru için Türkiye Klinikleri'ne, özellikle camiası içinde bulunduğum Çocuk Enfeksiyon Hastalıkları ve Bağışıklama Derneği üyelerine çok kısa süre içerisinde bu kapsamda bir yayını sizlere sunabilir hâle getirdiği için teşekkür ederim.

Geleceğimizin güvencesi olan çocuklarımız için,
Saygılarımla.

Prof. Dr. Ateş KARA
Editör
Dear colleagues,
We have been experiencing a huge change in our health perception during the recent one year, particularly during the recent six months. A new pandemic has emerged through being aware of that atypical pneumonia cases were associated with sea food market where live animals are also sold in Wuhan, one of the biggest cities of Hubai, China. That coronavirus is responsible for this new pandemic has been recognized very early and the knowledge was shared with the world however the exact source and contamination route are still of debate. When sixth of July has been reached, number of the new coronavirus, SARS-CoV-2, -infected individuals has exceeded 11 million and 300 thousand, and deaths have exceeded 532 thousand according to the official data of the World Health Organization (WHO).

Introduction of penicillins and discovery of different antibiotic agents have led to significant developments in treatment of infectious diseases from 1940s to 1960s. Similarly, greater victories could be achieved in prevention of infectious diseases through development of vaccines, the WHO's generalizing the use of vaccines and applying basic public health measures. As the results of these interventions, many health care workers have begun to accept that the period during which infectious diseases influence human's life is being terminated. Even some physicians have announced that the war against microorganisms has been won. Eradication of smallpox has supported this opinion. However while resistance development against malaria, tuberculosis and the other frequent bacterial microorganisms has indicated that this success is not complete, emergence of novel agents has led the opinion that this is the beginning of the way and even success is not possible. Besides, likelihood of emergence of new agents has been evaluated as a severe threat. While scientists felt that influenza virus is a potential threat as a pandemic, SARS in 2002 and MERS in 2012 have emerged as the clinical conditions associated with coronaviruses. During this time, H1N1 influenza virus has led to a pandemic worldwide that spreads relatively easily but has a low mortality rate. The pandemic caused by COVID-19, namely SARSCoV-2, has led to very severe social, economic changes besides causing a threat for human life, and maybe life would have to continue with certain differences.

With this book, we wanted to share our experiences about this virus and novel clinical condition as a great group including health care professionals who set their hearts on pediatrics. We ask you to appreciate that the current knowledge shared here could change in time.

I would like to thank to Türkiye Klinikleri for the honor of being the editor of this book and the members of Pediatric Infectious Diseases and Immunization Society for preparing this comprehensive publication in a short time.

For our children who are the assurance of our future,
Sincerely yours.

Prof. Dr. Ateş KARA
Editor

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30.03.2014

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