{"id":41587,"date":"2025-04-11T15:03:15","date_gmt":"2025-04-11T15:03:15","guid":{"rendered":"https:\/\/www.theconservative.online\/alarmujici-narust-vyskytu-tuberkulozy-v-irsku"},"modified":"2025-04-11T15:03:15","modified_gmt":"2025-04-11T15:03:15","slug":"alarmujici-narust-vyskytu-tuberkulozy-v-irsku","status":"publish","type":"post","link":"https:\/\/www.theconservative.online\/cs\/alarmujici-narust-vyskytu-tuberkulozy-v-irsku","title":{"rendered":"Alarmuj\u00edc\u00ed n\u00e1r\u016fst v\u00fdskytu tuberkul\u00f3zy v Irsku"},"content":{"rendered":"
TBC je sice prim\u00e1rn\u011b onemocn\u011bn\u00ed, kter\u00e9 postihuje pl\u00edce (plicn\u00ed TBC), ale m\u016f\u017ee se roz\u0161\u00ed\u0159it i do jin\u00fdch \u010d\u00e1st\u00ed t\u011bla (mimoplicn\u00ed TBC) a v mnoha p\u0159\u00edpadech aktivn\u011b p\u0159isp\u00edv\u00e1 ke sn\u00ed\u017een\u00ed \u00fa\u010dinnosti imunitn\u00edho syst\u00e9mu \u010dlov\u011bka.<\/div>\n
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V takov\u00e9m p\u0159\u00edpad\u011b doch\u00e1z\u00ed k n\u00e1r\u016fstu onemocn\u011bn\u00ed, jako je HIV\/AIDS, podv\u00fd\u017eiva, cukrovka nebo dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed imunosupresivn\u00edch l\u00e9k\u016f, co\u017e vyvol\u00e1v\u00e1 zna\u010dn\u00e9 obavy o ve\u0159ejn\u00e9 zdrav\u00ed.<\/div>\n
Ze zpr\u00e1v zdravotnick\u00fdch org\u00e1n\u016f EU v\u00edme, \u017ee v roce 2022 do\u0161lo v evropsk\u00e9m regionu k 18 000 \u00famrt\u00ed na tuberkul\u00f3zu u HIV pozitivn\u00edch osob, co\u017e odpov\u00edd\u00e1 1,9 \u00famrt\u00ed na 100 000 obyvatel. To p\u0159edstavuje meziro\u010dn\u00ed n\u00e1r\u016fst po\u010dtu \u00famrt\u00ed o 6 % oproti roku 2021. <\/div>\n
\u0158ada t\u011bchto onemocn\u011bn\u00ed jednozna\u010dn\u011b p\u0159isp\u00edv\u00e1 k celkov\u00fdm n\u00e1klad\u016fm na zdravotn\u00ed p\u00e9\u010di ve spole\u010dnosti, proto\u017ee diagnostika a l\u00e9\u010dba m\u016f\u017ee zahrnovat 6-9m\u011bs\u00ed\u010dn\u00ed u\u017e\u00edv\u00e1n\u00ed antibiotik a zv\u00fd\u0161enou m\u00edru hospitalizace.<\/div>\n
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Dopad na ztr\u00e1tu produktivity je v\u00fdznamn\u00fd tak\u00e9 proto, \u017ee TBC ne\u00fam\u011brn\u011b postihuje dosp\u011bl\u00e9 v produktivn\u00edm v\u011bku (15-54 let), co\u017e vede k vysok\u00e9 m\u00ed\u0159e absenc\u00ed a v mnoha p\u0159\u00edpadech i k trval\u00e9mu odchodu z pr\u00e1ce.<\/div>\n
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N\u00e1stroj Sv\u011btov\u00e9 zdravotnick\u00e9 organizace pro odhad n\u00e1klad\u016f pacient\u016f, kter\u00fd byl vyvinut ve spolupr\u00e1ci s Nadac\u00ed pro tuberkul\u00f3zu KNCV a Japonskou asociac\u00ed pro boj proti tuberkul\u00f3ze, uk\u00e1zal, \u017ee pacienti s tuberkul\u00f3zou ztr\u00e1cej\u00ed kv\u016fli nemoci a n\u00e1ro\u010dn\u00e9 l\u00e9\u010db\u011b v pr\u016fm\u011bru p\u0159ibli\u017en\u011b 3-4 m\u011bs\u00edce pr\u00e1ce.<\/div>\n
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Tyto v\u00fdsledky by m\u011bly Irsko obzvl\u00e1\u0161t\u011b znepokojovat vzhledem k ned\u00e1vn\u00e9mu potvrzen\u00ed jeho Centra pro dohled nad ochranou zdrav\u00ed (HPSC), \u017ee v Irsku v obdob\u00ed 2024, kdy bylo hl\u00e1\u0161eno 289 p\u0159\u00edpad\u016f TBC, m\u00edra v\u00fdskytu tuberkul\u00f3zy nad\u00e1le rostla.<\/div>\n
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Kl\u00ed\u010dov\u00e9 body poskytnut\u00e9 HPSC jsou n\u00e1sleduj\u00edc\u00ed:<\/div>\n
– V\u00fdskyt TBC se v roce 2024 zv\u00fd\u0161il a je nyn\u00ed srovnateln\u00fd s \u00farovn\u00ed p\u0159ed pandemi\u00ed.<\/div>\n
– Po\u010det nahl\u00e1\u0161en\u00fdch p\u0159\u00edpad\u016f p\u0159evy\u0161uje p\u0159edpokl\u00e1dan\u00fd po\u010det p\u0159\u00edpad\u016f pot\u0159ebn\u00fd k dosa\u017een\u00ed c\u00edle „Konec tuberkul\u00f3zy“.<\/div>\n
– Byl zaznamen\u00e1n n\u00e1r\u016fst v\u00fdskytu d\u011btsk\u00e9 tuberkul\u00f3zy.<\/div>\n
– Po\u010det p\u0159\u00edpad\u016f rezistentn\u00edch na rifampicin se zv\u00fd\u0161il<\/div>\n
– \u00daplnost v\u00fdsledk\u016f l\u00e9\u010dby z\u016fstala n\u00edzk\u00e1<\/div>\n
– Po\u010det hl\u00e1\u0161en\u00fdch ohnisek se v roce 2024 prudce zv\u00fd\u0161il<\/div>\n
– 32 p\u0159\u00edpad\u016f ozn\u00e1men\u00fdch v roce 2024 bylo spojeno s 25 klastry.<\/div>\n
Podle zpr\u00e1vy Irish Medical Times (IMT) odpov\u00edd\u00e1 po\u010det ozn\u00e1men\u00fdch p\u0159\u00edpad\u016f m\u00ed\u0159e v\u00fdskytu 5,6 na 100 000 obyvatel, co\u017e p\u0159edstavuje n\u00e1r\u016fst oproti roku 2023, kdy bylo hl\u00e1\u0161eno 224 p\u0159\u00edpad\u016f.<\/div>\n
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Jak upozornilo n\u011bkolik dal\u0161\u00edch irsk\u00fdch m\u00e9di\u00ed, tato m\u00edra v\u00fdskytu se dramaticky vymyk\u00e1 c\u00edli Sv\u011btov\u00e9 zdravotnick\u00e9 organizace sn\u00ed\u017eit do roku 2030 po\u010det p\u0159\u00edpad\u016f tuberkul\u00f3zy o 80 %. Podle HPSC by Irsko muselo m\u00edt 139 p\u0159\u00edpad\u016f TBC nebo m\u00e9n\u011b, aby z\u016fstalo na cest\u011b k dosa\u017een\u00ed tohoto c\u00edle. <\/div>\n
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Strategie pro Irsko 2024-2030 (Striving to End Tuberculosis – A Strategy for Ireland 2024-2030<\/i> ), kterou zadal Dr. \u00c9amonn O’Moore, v\u00fdkonn\u00fd \u0159editel irsk\u00e9 zdravotn\u00ed slu\u017eby pro n\u00e1rodn\u00ed ochranu zdrav\u00ed, a jej\u00edmi\u017e autory jsou Dr. Mary O’Meara, konzultantka v oboru ve\u0159ejn\u00e9ho zdravotnictv\u00ed, a Dr. James O’Connell, odborn\u00fd referent v oboru ve\u0159ejn\u00e9ho zdravotnictv\u00ed, nasti\u0148uje snahu Irska \u00fa\u010dinn\u011b reagovat na \u010detn\u00e9 vz\u00e1jemn\u011b propojen\u00e9 probl\u00e9my, kter\u00e9 tuberkul\u00f3za p\u0159edstavuje.<\/div>\n
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Strategie za\u010d\u00edn\u00e1 uveden\u00edm glob\u00e1ln\u00ed m\u00edry v\u00fdskytu TBC do souvislost\u00ed. Uv\u00e1d\u00ed nap\u0159\u00edklad, \u017ee v roce 2023 onemocn\u00ed TBC 10,6 milionu lid\u00ed a 1,3 milionu na ni zem\u0159e, zat\u00edmco celosv\u011btov\u011b v roce 2023 z\u016fstane v\u00edce ne\u017e ka\u017ed\u00fd \u010dtvrt\u00fd \u010dlov\u011bk neodhalen. D\u00e1le konstatuje, \u017ee b\u011bhem pandemie COVID-19 do\u0161lo k v\u00fdrazn\u00e9mu poklesu po\u010dtu osob l\u00e9\u010den\u00fdch na TBC rezistentn\u00ed v\u016f\u010di l\u00e9k\u016fm, po\u010dtu osob podstupuj\u00edc\u00edch preventivn\u00ed l\u00e9\u010dbu TBC a celosv\u011btov\u00e9ho financov\u00e1n\u00ed boje proti TBC, co\u017e glob\u00e1ln\u00ed z\u00e1t\u011b\u017e TBC jen zhor\u0161ilo. <\/div>\n
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Konkr\u00e9tn\u011b v souvislosti s Irskem auto\u0159i strategie s pot\u011b\u0161en\u00edm zd\u016fraz\u0148uj\u00ed, \u017ee zat\u00edmco v roce 2023 bylo 57 zem\u00ed s n\u00edzk\u00fdm v\u00fdskytem TBC (m\u00e9n\u011b ne\u017e 10 p\u0159\u00edpad\u016f na 100 000 obyvatel), mezi nimi\u017e bylo i Irsko, Irsko si nem\u016f\u017ee dovolit jak\u00e9koliv sebeuspokojen\u00ed ve sv\u00e9m \u00fasil\u00ed o dal\u0161\u00ed sn\u00ed\u017een\u00ed po\u010dtu p\u0159\u00edpad\u016f podl\u00e9haj\u00edc\u00edch oznamovac\u00ed povinnosti.<\/div>\n
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Strategie toti\u017e jasn\u011b uv\u00e1d\u00ed, \u017ee Irsko jako zem\u011b s n\u00edzk\u00fdm v\u00fdskytem tuberkul\u00f3zy by m\u011blo nejen usilovat o dosa\u017een\u00ed c\u00edle Sv\u011btov\u00e9 zdravotnick\u00e9 organizace pro ukon\u010den\u00ed tuberkul\u00f3zy, kter\u00fdm je sn\u00ed\u017een\u00ed v\u00fdskytu tuberkul\u00f3zy o 80 % do roku 2030, ale m\u011blo by tak\u00e9 usilovat o eliminaci tuberkul\u00f3zy (v\u00fdskyt tuberkul\u00f3zy ni\u017e\u0161\u00ed ne\u017e jeden p\u0159\u00edpad na milion obyvatel).<\/div>\n
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Ned\u00e1vn\u00fd n\u00e1r\u016fst po\u010dtu p\u0159\u00edpad\u016f ukazuje, \u017ee spln\u011bn\u00ed t\u00e9to ambice je nyn\u00ed pro irsk\u00e9 zdravotnick\u00e9 org\u00e1ny podstatn\u011b n\u00e1ro\u010dn\u011bj\u0161\u00ed.<\/div>\n
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Zpr\u00e1va HPSC sice potvrzuje, \u017ee hlavn\u00ed faktor zv\u00fd\u0161en\u00e9 incidence souvis\u00ed s nahromad\u011bn\u00edm nezji\u0161t\u011bn\u00fdch p\u0159\u00edpad\u016f, kter\u00e9 je \u010d\u00e1ste\u010dn\u011b zp\u016fsobeno p\u0159etrv\u00e1vaj\u00edc\u00edm dopadem COVID-19, b\u011bhem n\u011bho\u017e byla kontrola TBC v letech 2020-2022 p\u0159eru\u0161ena, ale poukazuje tak\u00e9 na politicky citliv\u011bj\u0161\u00ed p\u0159\u00ed\u010dinu, a to na op\u011btovn\u00fd v\u00fdskyt nemoci v d\u016fsledku imigrace.<\/div>\n
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Zpr\u00e1va potvrzuje, \u017ee zat\u00edmco m\u00edra v\u00fdskytu TBC u osob narozen\u00fdch v Irsku z\u016fst\u00e1v\u00e1 stabiln\u00ed, u osob narozen\u00fdch mimo Irsko byla vy\u0161\u0161\u00ed.<\/div>\n
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Dramatick\u00fdch 72 % p\u0159\u00edpad\u016f tuberkul\u00f3zy v Irsku v roce 2024 toti\u017e poch\u00e1zelo od lid\u00ed narozen\u00fdch mimo Irsko.<\/div>\n
To je v souladu s \u010dl\u00e1nkem, kter\u00fd 21. b\u0159ezna 2024 zve\u0159ejnil list The Irish Times pod n\u00e1zvem „N\u00e1r\u016fst p\u0159\u00edpad\u016f tuberkul\u00f3zy vzdaluje Irsko od c\u00edle eliminace“.<\/div>\n
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\u010cl\u00e1nek uv\u00e1d\u00ed \u00fadaje z HPSC, podle kter\u00fdch bylo v roce 2023 v Irsku nahl\u00e1\u0161eno 224 p\u0159\u00edpad\u016f tuberkul\u00f3zy. Uv\u00e1d\u00ed se v n\u011bm: „\u0160edes\u00e1t \u0161est procent p\u0159\u00edpad\u016f v lo\u0148sk\u00e9m roce se vyskytlo u osob narozen\u00fdch mimo Irsko,“ \u010d\u00edm\u017e je zd\u016frazn\u011bna vy\u0161\u0161\u00ed m\u00edra v\u00fdskytu u osob narozen\u00fdch v zahrani\u010d\u00ed ve srovn\u00e1n\u00ed s osobami narozen\u00fdmi v Irsku. <\/div>\n
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Vliv imigrace na v\u00fdskyt tuberkul\u00f3zy v EU je dob\u0159e zdokumentov\u00e1n. \u00dadaje shrom\u00e1\u017ed\u011bn\u00e9 Evropsk\u00fdm st\u0159ediskem pro prevenci a kontrolu nemoc\u00ed (ECDC), a zejm\u00e9na jeho publikace o sledov\u00e1n\u00ed a monitorov\u00e1n\u00ed tuberkul\u00f3zy v Evrop\u011b, potvrzuj\u00ed, \u017ee a\u010dkoli existuj\u00ed rozd\u00edly specifick\u00e9 pro jednotliv\u00e9 zem\u011b, ne\u00fam\u011brnou z\u00e1t\u011b\u017e v \u00farovni v\u00fdskytu TBC lze nal\u00e9zt mezi migranty. <\/div>\n
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ECDC rovn\u011b\u017e potvrzuje, \u017ee v roce 2022 bylo ve v\u0161ech zem\u00edch EU\/EHP hl\u00e1\u0161eno 36 179 p\u0159\u00edpad\u016f TBC. Po\u010det p\u0159\u00edpad\u016f hl\u00e1\u0161en\u00fdch v Rumunsku (9270) v\u0161ak p\u0159edstavoval 25,6 % v\u0161ech p\u0159\u00edpad\u016f TBC hl\u00e1\u0161en\u00fdch v roce 2022 a m\u00edru na 100 000 obyvatel v\u00edce ne\u017e \u0161estkr\u00e1t vy\u0161\u0161\u00ed ne\u017e v EU\/EHP. <\/div>\n
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Tato skute\u010dnost se t\u00fdk\u00e1 zejm\u00e9na Irska, proto\u017ee rumun\u0161t\u00ed st\u00e1tn\u00ed p\u0159\u00edslu\u0161n\u00edci jsou nyn\u00ed jednou z nejv\u011bt\u0161\u00edch skupin p\u0159ist\u011bhovalc\u016f v tomto st\u00e1t\u011b. Podle irsk\u00e9ho \u00dast\u0159edn\u00edho statistick\u00e9ho \u00fa\u0159adu (CSO) se p\u0159i s\u010d\u00edt\u00e1n\u00ed lidu v roce 2016 odhadovalo, \u017ee v Irsku \u017eije p\u0159ibli\u017en\u011b 29 186 rumunsk\u00fdch st\u00e1tn\u00edch p\u0159\u00edslu\u0161n\u00edk\u016f. Do roku 2022 se v\u0161ak po\u010det obyvatel rumunsk\u00e9ho p\u016fvodu zv\u00fd\u0161il na 43 000, co\u017e odr\u00e1\u017e\u00ed v\u00fdrazn\u00fd n\u00e1r\u016fst za \u0161est let. <\/div>\n
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Irsk\u00e1 strategie pro boj s tuberkul\u00f3zou do roku 2024-2030 rovn\u011b\u017e jasn\u011b uzn\u00e1v\u00e1 souvislost mezi p\u0159ist\u011bhovalectv\u00edm a v\u00fdskytem tuberkul\u00f3zy.<\/div>\n
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Uv\u00e1d\u00ed vlastn\u00ed hodnocen\u00ed, \u017ee v zem\u00edch s n\u00edzk\u00fdm v\u00fdskytem tuberkul\u00f3zy, jako je Irsko, se velk\u00e1 \u010d\u00e1st p\u0159\u00edpad\u016f vyskytuje mezi ned\u00e1vn\u00fdmi migranty a v\u011bt\u0161ina p\u0159\u00edpad\u016f vznik\u00e1 reaktivac\u00ed nemoci, kter\u00e1 se \u010dasto soust\u0159e\u010fuje ve zraniteln\u00fdch skupin\u00e1ch obyvatelstva.<\/div>\n
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Strategie d\u016frazn\u011b doporu\u010duje, aby se na tyto skupiny zam\u011b\u0159ily zv\u00fd\u0161en\u00e9 preventivn\u00ed aktivity, jako je zdravotn\u00ed dohled, selektivn\u00ed o\u010dkov\u00e1n\u00ed proti Bacillus Calmette-Gu\u00e9rin (BCG) a sledov\u00e1n\u00ed kontakt\u016f.<\/div>\n
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Ned\u00e1vn\u00fd v\u00fdzkum nav\u00edc upozor\u0148uje na dal\u0161\u00ed z\u00e1va\u017en\u00fd probl\u00e9m: latentn\u00ed tuberkul\u00f3zn\u00ed infekci (LTBI), kdy jsou jedinci nositeli tuberkul\u00f3zn\u00edch bakteri\u00ed bez aktivn\u00edch p\u0159\u00edznak\u016f. Sv\u011btov\u00e1 zdravotnick\u00e1 organizace odhaduje, \u017ee p\u0159ibli\u017en\u011b \u010dtvrtina sv\u011btov\u00e9 populace je nositelem latentn\u00ed TBC, co\u017e p\u0159edstavuje obrovsk\u00fd rezervo\u00e1r pro potenci\u00e1ln\u00ed budouc\u00ed p\u0159\u00edpady, zejm\u00e9na p\u0159i oslaben\u00ed imunity. Pro Irsko by \u0159e\u0161en\u00ed probl\u00e9mu LTBI mohlo hr\u00e1t kl\u00ed\u010dovou roli p\u0159i pln\u011bn\u00ed n\u00e1rodn\u00edch c\u00edl\u016f, proto\u017ee latentn\u00ed infekce \u010dasto p\u0159ech\u00e1z\u00ed do aktivn\u00edho onemocn\u011bn\u00ed a\u017e n\u011bkolik let po prvn\u00ed expozici. <\/p>\n

Ve Strategii 2024-2030 se proto doporu\u010duje proaktivn\u00ed \u0159e\u0161en\u00ed latentn\u00ed tuberkul\u00f3zy prost\u0159ednictv\u00edm screeningov\u00fdch program\u016f, zejm\u00e9na u vysoce rizikov\u00fdch skupin obyvatelstva, jako z\u00e1sadn\u00ed preventivn\u00ed opat\u0159en\u00ed. Krom\u011b toho odborn\u00edci v oblasti ve\u0159ejn\u00e9ho zdrav\u00ed st\u00e1le \u010dast\u011bji prosazuj\u00ed pou\u017e\u00edv\u00e1n\u00ed pokro\u010dil\u00fdch diagnostick\u00fdch technologi\u00ed, jako jsou testy uvol\u0148ov\u00e1n\u00ed interferonu gama (IGRA), kter\u00e9 umo\u017e\u0148uj\u00ed v\u010dasn\u00e9 a p\u0159esn\u00e9 odhalen\u00ed latentn\u00edch infekc\u00ed. Roz\u0161\u00ed\u0159en\u00ed p\u0159\u00edstupu k t\u011bmto diagnostick\u00fdm n\u00e1stroj\u016fm v r\u00e1mci prim\u00e1rn\u00ed zdravotn\u00ed p\u00e9\u010de by mohlo v\u00fdznamn\u011b zv\u00fd\u0161it schopnost Irska identifikovat rizikov\u00e9 osoby d\u0159\u00edve, ne\u017e se rozvine aktivn\u00ed onemocn\u011bn\u00ed, co\u017e by se l\u00e9pe sladilo s \u0161ir\u0161\u00edmi c\u00edli WHO v oblasti vym\u00fdcen\u00ed tuberkul\u00f3zy. <\/p>\n<\/div>\n

Navrhuje tak\u00e9, aby Irsko v z\u00e1jmu zlep\u0161en\u00ed dohledu nad tuberkul\u00f3zou a pos\u00edlen\u00ed prevence tuberkul\u00f3zy u rizikov\u00fdch skupin zv\u00fd\u0161ilo \u00farove\u0148 spolupr\u00e1ce s evropsk\u00fdmi a dal\u0161\u00edmi mezin\u00e1rodn\u00edmi zdravotnick\u00fdmi organizacemi.<\/div>\n","protected":false},"excerpt":{"rendered":"

TBC je sice prim\u00e1rn\u011b onemocn\u011bn\u00ed, kter\u00e9 postihuje pl\u00edce (plicn\u00ed TBC), ale m\u016f\u017ee se roz\u0161\u00ed\u0159it i do jin\u00fdch \u010d\u00e1st\u00ed t\u011bla (mimoplicn\u00ed TBC) a v mnoha p\u0159\u00edpadech aktivn\u011b p\u0159isp\u00edv\u00e1 ke sn\u00ed\u017een\u00ed \u00fa\u010dinnosti imunitn\u00edho syst\u00e9mu \u010dlov\u011bka. V takov\u00e9m p\u0159\u00edpad\u011b doch\u00e1z\u00ed k n\u00e1r\u016fstu onemocn\u011bn\u00ed, jako je HIV\/AIDS, podv\u00fd\u017eiva, cukrovka nebo dlouhodob\u00e9 u\u017e\u00edv\u00e1n\u00ed imunosupresivn\u00edch l\u00e9k\u016f, co\u017e vyvol\u00e1v\u00e1 zna\u010dn\u00e9 obavy o […]<\/p>\n","protected":false},"author":68,"featured_media":19539,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[199],"tags":[],"editorial-positions":[],"regions":[],"types":[449],"class_list":["post-41587","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-zdravi","types-opinion-cs"],"yoast_head":"\nAlarmuj\u00edc\u00ed n\u00e1r\u016fst v\u00fdskytu tuberkul\u00f3zy v Irsku - The Conservative<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.theconservative.online\/cs\/alarmujici-narust-vyskytu-tuberkulozy-v-irsku\" \/>\n<meta property=\"og:locale\" content=\"cs_CZ\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Alarmuj\u00edc\u00ed n\u00e1r\u016fst v\u00fdskytu tuberkul\u00f3zy v Irsku - The Conservative\" \/>\n<meta property=\"og:description\" content=\"TBC je sice prim\u00e1rn\u011b onemocn\u011bn\u00ed, kter\u00e9 postihuje pl\u00edce (plicn\u00ed TBC), ale m\u016f\u017ee se roz\u0161\u00ed\u0159it i do jin\u00fdch \u010d\u00e1st\u00ed t\u011bla (mimoplicn\u00ed TBC) a v mnoha p\u0159\u00edpadech aktivn\u011b p\u0159isp\u00edv\u00e1 ke sn\u00ed\u017een\u00ed \u00fa\u010dinnosti imunitn\u00edho syst\u00e9mu \u010dlov\u011bka. 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