{"id":8813,"date":"2020-01-27T13:56:29","date_gmt":"2020-01-27T12:56:29","guid":{"rendered":"http:\/\/umed.edu.al\/?p=8813"},"modified":"2020-01-27T13:56:29","modified_gmt":"2020-01-27T12:56:29","slug":"parandalimi-dhe-kontrolli-i-infeksionit-gjate-kujdesit-shendetesor-kur-dyshohet-infeksioni-i-koronavirusit-te-ri-ncov-udhezues-i-perkohshem","status":"publish","type":"post","link":"https:\/\/umed.edu.al\/en\/parandalimi-dhe-kontrolli-i-infeksionit-gjate-kujdesit-shendetesor-kur-dyshohet-infeksioni-i-koronavirusit-te-ri-ncov-udhezues-i-perkohshem\/","title":{"rendered":"PARANDALIMI DHE KONTROLLI I INFEKSIONIT GJAT\u00cb KUJDESIT SH\u00cbNDET\u00cbSOR KUR DYSHOHET INFEKSIONI I KORONAVIRUSIT T\u00cb RI (NCOV) UDH\u00cbZUES I P\u00cbRKOHSH\u00cbM"},"content":{"rendered":"

Hyrje<\/strong><\/p>\n

Ky \u00ebsht\u00eb botimi i par\u00eb i parandalimit dhe kontrollit t\u00eb infeksionit (IPC) kur\u00a0 nj\u00eb koronavirus i ri (nCoV) \u00ebsht\u00eb i dyshuar. \u00cbsht\u00eb p\u00ebrshtatur nga IPC e OBSH-s\u00eb rekomandime p\u00ebr MERS-CoV (Parandalimi i infeksionit dhe kontrollin gjat\u00eb kujdesit sh\u00ebndet\u00ebsor p\u00ebr raste t\u00eb mundshme ose t\u00eb konfirmuara t\u00eb Coronavirus i sindrom\u00ebs s\u00eb frym\u00ebmarrjes n\u00eb Lindjen e Mesme [MERS-CoV] infeksion, udh\u00ebzim I p\u00ebrkohsh\u00ebm Tetor 2019, WHO \/ MERS \/ IPC \/ 15.1 Rev 11), bazuar n\u00eb njohurit\u00eb tona dhe p\u00ebrvojat n\u00eb Wuhan, Kin\u00eb me SARS-CoV dhe MERS-CoV2.
\nOBSH do t\u00eb p\u00ebrshtas\u00eb\u00a0 k\u00ebto rekomandime si informacion t\u00eb ri t\u00eb\u00a0 disponuesh\u00ebm p\u00ebr situat\u00ebn n\u00eb Wuhan, Kin\u00eb.
\nKy udh\u00ebzim ka p\u00ebr q\u00ebllim punonj\u00ebsit e kujdesit sh\u00ebndet\u00ebsor (HCW), menaxher\u00eb t\u00eb kujdesit sh\u00ebndet\u00ebsor dhe ekipe IPC. Udh\u00ebzimet e plota jan\u00eb n\u00eb dispozicion n\u00eb parandalimin e infeksionit dhe kontrollin e epidemis\u00eb- dhe Infeksione akute t\u00eb frym\u00ebmarrjes pandemike n\u00eb kujdesin sh\u00ebndet\u00ebsor. Parimet e parandalimit dhe kontrollit t\u00eb infeksionit dhe strategjit\u00eb e lidhura me kujdesin sh\u00ebndet\u00ebsor p\u00ebr rast t\u00eb dyshuar nCoV<\/p>\n

Strategjit\u00eb p\u00ebr t\u00eb parandaluar ose kufizuar transmetimin e infeksionit n\u00eb sh\u00ebrbimin sh\u00ebndet\u00ebsor vijojn\u00eb si m\u00eb posht\u00eb:<\/p>\n

    \n
  1. Zbulimi i hersh\u00ebm dhe kontrolli i burimit<\/li>\n
  2. Zbatimi i Masave Standarde p\u00ebr t\u00eb gjith\u00eb pacient\u00ebt<\/li>\n
  3. Zbatimi i masave paraprake shtes\u00eb p\u00ebr raste t\u00eb dyshuara<\/li>\n
  4. Kontrollet administrative<\/li>\n
  5. Kontrollet mjedisore dhe inxhinierike<\/li>\n<\/ol>\n

     <\/p>\n

    \u00a01.\u00a0<\/strong>Zbulimi i hersh\u00ebm dhe kontrolli i burimit<\/strong><\/p>\n

    \u00a0<\/strong>Triazhi klinik p\u00ebrfshin\u00eb njohjen e hershme dhe\u00a0 vendosjen e pacient\u00ebve menj\u00ebher\u00eb\u00a0 n\u00eb zon\u00eb t\u00eb izoluar nga pacient\u00ebt e tjer\u00eb(kontrolli i burimit). Kjo \u00ebsht\u00eb nj\u00eb mas\u00eb thelb\u00ebsore dhe e shpejt\u00eb\u00a0 q\u00eb<\/p>\n

    pacient\u00ebve me infeksion t\u00eb dyshuar tu jepet kujdesi i duhur. P\u00ebr t\u00eb identifikuar her\u00ebt rastet e<\/p>\n

    dyshuara, institucionet e kujdesit sh\u00ebndet\u00ebsor duhet:<\/p>\n

    – Inkurajoni punonj\u00ebsit e kujdesit sh\u00ebndet\u00ebsor q\u00eb t\u00eb ken\u00eb nj\u00eb nivel t\u00eb lart\u00eb klinikdyshim<\/p>\n

    – Pyet\u00ebsori i ekzaminimit t\u00eb Institutit dhe njohja dhe informimi i pacient\u00ebve me simptomat p\u00ebr ta kapur sa m\u00eb heret.<\/p>\n

    – Promovimi i higjen\u00ebs s\u00eb frym\u00ebmarrjes \u00ebsht\u00eb nj\u00eb mas\u00eb parandaluese e r\u00ebnd\u00ebsishme.<\/p>\n

    \u00a0<\/strong><\/p>\n

    2. Zbatimi i Masave Paraprake Standarde p\u00ebr t\u00eb gjith\u00eb pacient\u00ebt<\/strong><\/p>\n

    Masat paraprake standarde p\u00ebrfshijn\u00eb higjen\u00ebn e duarve dhe frym\u00ebmarrjes; p\u00ebrdorimi i pajisjeve mbrojt\u00ebse personale n\u00eb var\u00ebsi t\u00eb rrezikut;shmangjen e shpimit aksidentalisht me age ; pastrimi i mjedisit dhe sterilizimi i pajisje q\u00eb p\u00ebrdoren p\u00ebr kujdesin ndaj pacientit.<\/p>\n

    Masat e m\u00ebposhtme mbi higjen\u00ebn e frym\u00ebmarrjes:<\/p>\n

    – Ofroni nj\u00eb mask\u00eb mjek\u00ebsore<\/p>\n

    – Mbuloni hund\u00ebn dhe goj\u00ebn gjat\u00eb kollitjes ose teshtitjes me kartopecet ose brryl m\u00eb pas kryeni higjen\u00ebn e duarve<\/p>\n

    -Sigurohuni q\u00eb pastrimi dhe dezinfektimi i mjedisit kryhen vazhdimisht dhe n\u00eb m\u00ebnyr\u00eb korrekte.<\/p>\n

    -Pastrimi i sip\u00ebrfaqeve mjedisore me uj\u00eb dhe pastrues dhe aplikimi i dezinfektuesve t\u00eb nivelit spitalor q\u00eb p\u00ebrdoret zakonisht (si\u00e7 \u00ebsht\u00eb hipoklori natriumi) \u00ebsht\u00eb precedur\u00eb efektive.<\/p>\n

    -Menaxhoni lavanderit\u00eb dhe mbetjet spitalore n\u00eb p\u00ebrputhje me procedurat rutin\u00eb t\u00eb sigurta.<\/p>\n

     <\/p>\n

    3. Zbatimi i masave paraprake shtes\u00eb p\u00ebr raste t\u00eb dyshuara<\/strong><\/p>\n

    \u00a0 \u00a0 \u00a0 3.1 Masat paraprake t\u00eb kontaktit dhe pik\u00ebzimit p\u00ebr t\u00eb dyshuarit<\/strong><\/p>\n

    – P\u00ebrve\u00e7 Masave paraprake standarde, t\u00eb gjith\u00eb individ\u00ebt, p\u00ebrfshir\u00eb an\u00ebtar\u00ebt e familjes, vizitor\u00ebt dhe personeli mjekesor dhe jo mjek\u00ebsor duhet t\u00eb zbatojn\u00eb Masat paraprake t\u00eb Kontaktit dhe pik\u00ebzimit.<\/p>\n

    – Vendosni pacient\u00ebt n\u00eb dhoma t\u00eb izoluara dhe\u00a0 t\u00eb ventiluara n\u00eb m\u00ebnyr\u00eb adekuate. Ventilim natyral i dhomave\u00a0 konsiderohet t\u00eb jet\u00eb 160 L \/ sekond\u00eb \/ pacient.<\/p>\n

    – Kur dhoma teke nuk jan\u00eb n\u00eb dispozicion, pacient\u00ebt t\u00eb dyshuar p\u00ebr infeksion t\u00eb vendosen s\u00eb bashku.<\/p>\n

    – Vendosni shtret\u00ebrit e pacient\u00ebve t\u00eb pakt\u00ebn 1 m larg.<\/p>\n

    -P\u00ebrdorni mbrojt\u00ebs p\u00eb syrin \/ fytyr\u00ebn (d.m.th. syze ose mask\u00eb fytyre e plot\u00eb).<\/p>\n

    – P\u00ebrdorni doreza.<\/p>\n

    – P\u00ebrdorni pajisje me nj\u00eb p\u00ebrdorim. N\u00ebse pajisjet duhet t\u00eb ndahet midis pacient\u00ebve dezinfektoni ato para dhe pas \u00e7do p\u00ebrdorimi t\u00eb pacientit (p.sh. alkool etilik70%);<\/p>\n

    – Shmangni prekjen e syve, hund\u00ebs ose goj\u00ebs me duar t\u00eb kontaminuara.<\/p>\n

    – Shmangni l\u00ebvizjen dhe transportin e pacient\u00ebve jasht\u00eb dhom\u00ebs n\u00ebse nuk \u00ebsht\u00eb e nevojshme. N\u00ebse transporti \u00ebsht\u00eb i domosdosh\u00ebm, p\u00ebrdorni rrug\u00ebn m\u00eb t\u00eb sigurt p\u00ebr t\u00eb minimizuar ekspozimet ndaj stafit, pacient\u00ebve t\u00eb tjer\u00eb dhe vizitor\u00ebve dhe aplikoni mask\u00eb mjek\u00ebsore tek pacienti.<\/p>\n

    – Sigurohuni q\u00eb punonj\u00ebsit e kujdesit sh\u00ebndet\u00ebsor q\u00eb transportojn\u00eb pacientin t\u00eb veshin veshjet mbrojt\u00ebse t\u00eb p\u00ebrshtatshme si\u00e7 p\u00ebrshkruhet n\u00eb k\u00ebt\u00eb seksion dhe t\u00eb kryej\u00eb higjen\u00ebn e duarve.<\/p>\n

    – Njoftoni zon\u00ebn prit\u00ebse p\u00ebr masat paraprake t\u00eb nevojshme sa m\u00eb shpejt t\u00eb jet\u00eb e mundur para ardhjes s\u00eb pacientit.<\/p>\n

    – Kufizoni numrin e punonj\u00ebsve t\u00eb kujdesit sh\u00ebndet\u00ebsor , an\u00ebtar\u00ebt e familjes dhe vizitor\u00ebve n\u00eb kontakt me nj\u00eb pacient me t\u00eb dyshuar infeksioni.<\/p>\n

    – Mbani nj\u00eb procesverbal p\u00ebr t\u00eb gjith\u00eb personat q\u00eb hyjn\u00eb n\u00eb dhom\u00ebn e pacientit duke p\u00ebrfshir\u00eb t\u00eb gjith\u00eb stafin dhe vizitor\u00ebt.<\/p>\n

    \u00a0<\/strong><\/p>\n

    3.2 Masat paraprake t\u00eb ajrit p\u00ebr gjenerimin e aerosolit:<\/strong><\/p>\n

    \u00a0<\/strong>Sigurohuni q\u00eb punonj\u00ebsit e kujdesit sh\u00ebndet\u00ebsor q\u00eb kryejn\u00eb gjenerimin e aerosolit duhet t\u00eb :<\/p>\n

    – T\u00eb p\u00ebrdornin nj\u00eb respirator t\u00eb grimcave t\u00eb pakt\u00ebn po aq mbrojt\u00ebs sa nj\u00eb N95-\u00e7ertifikuar N95, FFP2 e BE-s\u00eb ose ekuivalent 2,6.<\/p>\n

    – Kur vendosin\u00a0 nj\u00eb respirator t\u00eb grimcave, gjithmon\u00eb t\u00eb\u00a0 kryejn\u00eb kontrollin e vul\u00ebs6.<\/p>\n

    – Mbrojt\u00ebs p\u00eb syrin \/ fytyr\u00ebn (d.m.th. syze ose mask fytyre e plot\u00eb).<\/p>\n

    – Veshje t\u00eb past\u00ebr, rezistente ndaj l\u00ebngjeve, sterile, me m\u00ebng\u00eb t\u00eb gjata dhe doreza.<\/p>\n

    – Kryeni procedurat n\u00eb nj\u00eb dhom\u00eb t\u00eb ajrosur me ventilimin e duhur; ventilimi natyror me t\u00eb pakt\u00ebn 160l \/ s \/ pacienti\u00a0 i rrjedh\u00ebs s\u00eb ajrit ose dhoma me\u00a0presion negativ me t\u00eb pakt\u00ebn 12 ndryshime t\u00eb ajrit n\u00eb or\u00eb dhe drejtimi i kontrolluar i rrjedh\u00ebs s\u00eb ajrit kur p\u00ebrdorni ventilimi mekanik.<\/p>\n

    – Kufizoni numrin e personave t\u00eb pranish\u00ebm n\u00eb dhom\u00eb.<\/p>\n

     <\/p>\n

    \u00a04.<\/strong>Kontrollet administrative<\/strong><\/p>\n

    Kontrollet administrative dhe politikat q\u00eb zbatohen p\u00ebr kontrollin dhe parandalimin e transmetimit t\u00eb infeksioneve p\u00ebrfshijn\u00eb krijimin e infrastrukturave dhe aktiviteteve t\u00eb q\u00ebndrueshme t\u00eb Komitetit t\u00eb Kontrollit t\u00eb Infeksioneve Spitalore.Trajnimi i stafit mjek\u00ebsor; edukimi i pacient\u00ebve; politikat n\u00eb njohjen e hershme t\u00eb infeksionit, qasja n\u00eb testimet e shpejta laboratorike p\u00ebr identifikimin e agjentit etiologjik; parandalimi i mbipopullimi ve\u00e7an\u00ebrisht n\u00eb departamentin e Emergjencave; sigurimi i zonave t\u00eb pritura t\u00eb pritjes p\u00ebr pacient\u00ebt simptomatik\u00eb.<\/p>\n

    Vendosja e nj\u00eb raporti adekuat pacient-personel, sigurimi i rregullt me furnizimet.<\/p>\n

     <\/p>\n

    \u00a05.\u00a0<\/strong>Kontrollet mjedisore dhe inxhinierike<\/strong><\/p>\n

    K\u00ebto p\u00ebrfshijn\u00eb infrastrukturat themelore t\u00eb institucioneve t\u00eb kujdesit sh\u00ebndet\u00ebsor. K\u00ebto kontrolle sigurojn\u00eb ventilimin adekuat n\u00eb t\u00eb gjitha hap\u00ebsirat brenda nj\u00eb institucioni sh\u00ebndet\u00ebsor gjithashtu dhe pastrimin adekuat t\u00eb mjedisit.<\/p>\n

    Ndarja hap\u00ebsinore me t\u00eb pakt\u00ebn 1 met\u00ebr distanc\u00eb duhet t\u00eb ruhet nd\u00ebrmjet secilit pacienti t\u00eb dyshuar dhe t\u00eb tjer\u00ebve.<\/p>\n

    T\u00eb dyja kontrollet e sip\u00ebr p\u00ebrmendura mund t\u00eb ndihmojn\u00eb n\u00eb zvog\u00eblimin e p\u00ebrhapjes t\u00eb shum\u00eb patogjen\u00ebve gjat\u00eb kujdesit sh\u00ebndet\u00ebsor.<\/p>\n

    \u00a0<\/strong><\/p>\n

    Koh\u00ebzgjatja e kontaktit dhe masat paraprake p\u00ebr pikat e Infeksionit.<\/strong><\/p>\n

    Masat paraprake standarde duhet t\u00eb zbatohen gjithmon\u00eb n\u00eb \u00e7do koh\u00eb. Masat shtes\u00eb t\u00eb kontaktit dhe pikave duhet t\u00eb vazhdojn\u00eb derisa pacienti t\u00eb jet\u00eb asimptomatik.<\/p>\n

    Mbledhja dhe trajtimi i mostrave laboratorike nga pacient\u00ebt t\u00eb dyshuar<\/strong><\/p>\n

    T\u00eb gjitha mostrat e mbledhur p\u00ebr ekzaminime laboratorike duhet t\u00eb konsiderohen si potencialisht infektues dhe punonj\u00ebsit e kujdesit sh\u00ebndet\u00ebsor\u00a0 q\u00eb mbledhin dhe\u00a0 transportojn\u00eb k\u00ebto material\u00eb duhet t’i p\u00ebrmbahen masave paraprake standarte me rigorozitet\u00a0 p\u00ebr t\u00eb minimizuar mund\u00ebsine e ekspozimit ndaj patogjenit.<\/p>\n

    – Sigurohuni q\u00eb punonj\u00ebsit e kujdesit sh\u00ebndet\u00ebsor\u00a0\u00a0q\u00eb mbledhin mostrat p\u00ebrdorin veshjen mbrojt\u00ebse\u00a0 t\u00eb p\u00ebrshtatshme (mbrojtja e syve, mask\u00eb mjek\u00ebsore,doreza,kostum me m\u00ebng\u00eb t\u00eb gjata) N\u00ebse mostra \u00ebsht\u00eb mbledhur n\u00ebn procedur\u00ebn e gjenerimit t\u00eb aerosolit, personeli duhet t\u00eb vesh\u00eb nj\u00eb respirator t\u00eb grimcave n\u00ebt\u00eb pakt\u00ebn po aq mbrojt\u00ebse sa nj\u00eb N95 i BE-s\u00eb i \u00e7ertifikuar nga NIOSH FFP2 ose ekuivalent.<\/p>\n

    – Sigurohuni q\u00eb i gjith\u00eb personeli q\u00eb transporton mostrat biologjike jan\u00eb t\u00eb trajnuar mbi k\u00ebto procedura.<\/p>\n

    – Vendosni mostrat n\u00eb en\u00ebt p\u00ebrkat\u00ebse.<\/p>\n

    – Dokumentit emrin e plot\u00eb t\u00eb pacientit, dat\u00ebn e lindjes, plot\u00ebsoni dyshimet q\u00eb keni n\u00eb formularin e k\u00ebrkes\u00ebs laboratorike shoq\u00ebruese. Njoftoni laboratorin sa m\u00eb shpejt t\u00eb jet\u00eb e mundur q\u00eb mostra biologjike \u00ebsht\u00eb duke u transportuar.<\/p>\n

     <\/p>\n

    Mir\u00ebnjohje<\/strong><\/p>\n

    Versioni origjinal i udh\u00ebzimeve IPC MERS-CoV eshte zhvilluar n\u00eb konsultim me WHO Global, Rrjeti i Parandalimit dhe Kontrollit te Infeksioneve dhe S\u00ebmundjeve q\u00eb shfaqen, Rrjeti i Vler\u00ebsimit dhe Reagimit Klinik dhe t\u00eb tjere ekspert\u00eb nd\u00ebrkomb\u00ebtar\u00eb. OBSH fal\u00ebnderon ata q\u00eb ishin t\u00eb p\u00ebrfshir\u00eb n\u00eb zhvillimin dhe azhurnimet e dokumenteve IPC p\u00ebr MERSCoV.<\/p>\n

    Referencat<\/em><\/p>\n

    \u00a01.\u00a0<\/em>Parandalimi dhe kontrolli i infeksionit gjat\u00eb kujdesit sh\u00ebndet\u00ebsor p\u00ebr\u00a0<\/em>raste t\u00eb mundshme ose t\u00eb konfirmuara t\u00eb frym\u00ebmarrjes n\u00eb Lindjen e Mesme\u00a0<\/em>infeksion i sindrom\u00ebs koronavirus (MERS-CoV).\u00a0I p\u00ebrkohsh\u00ebm\u00a0<\/em>udh\u00ebzime. P\u00ebrdit\u00ebsuar n\u00eb Tetor 2019. Gjenev\u00eb, World Health\u00a0<\/em>Organization. N\u00eb dispozicion n\u00eb\u00a0<\/em>https:\/\/www.who.int\/csr\/disease\/coronavirus_infections\/i\u00a0<\/em>pc-mers-cov \/ en \/<\/em><\/p>\n

    2. Parandalimi i infeksionit dhe kontrolli i epidemis\u00eb – dhe\u00a0<\/em>Infeksionet akute t\u00eb frym\u00ebmarrjes pandemike t\u00eb prirura p\u00ebr sh\u00ebndetin\u00a0<\/em>kujdes – Udh\u00ebzimet e OBSH. Gjenev\u00eb, Sh\u00ebndet\u00ebsia Bot\u00ebrore\u00a0<\/em>Organizimi, 2014. N\u00eb dispozicion n\u00eb\u00a0<\/em>http:\/\/apps.who.int\/iris\/bitstream\/10665\/112656\/1\/97892<\/em>41507134_eng.pdf<\/em><\/p>\n

    3.<\/em>Si t\u00eb vendosni dhe hiqni pajisjet mbrojt\u00ebse personale\u00a0<\/em>(PPE). Gjenev\u00eb, Organizata Bot\u00ebrore e Sh\u00ebndetit 2008.\u00a0<\/em>N\u00eb dispozicion n\u00eb\u00a0<\/em>http:\/\/www.who.int\/csr\/resources\/publications\/putontake\u00a0<\/em>offPPE \/ en \/. <\/em><\/p>\n

    4.<\/em>Udh\u00ebzimet e OBSH-s\u00eb p\u00ebr higjen\u00ebn e duarve n\u00eb kujdesin sh\u00ebndet\u00ebsor. Gjenev\u00eb\u00a0<\/em>Organizata Bot\u00ebrore e Sh\u00ebndetit, 2009. N\u00eb dispozicion n\u00eb\u00a0<\/em>http:\/\/whqlibdoc.who.int\/publications\/2009\/97892415979<\/em>06_eng.pdf.<\/em><\/p>\n

    5. Ventilimi natyral p\u00ebr kontrollin e infeksionit n\u00eb kujdesin sh\u00ebndet\u00ebsor<\/em>settings. Gjenev\u00eb, Organizata Bot\u00ebrore e Sh\u00ebndetit, 2009.<\/em>N\u00eb dispozicion n\u00eb<\/em>http:\/\/www.who.int\/water_sanitation_health\/publications\/<\/em>natural_ventilation \/ en \/ index.html.<\/em><\/p>\n

    6. Si t\u00eb kryeni nj\u00eb kontroll t\u00eb vul\u00ebs s\u00eb frym\u00ebmarr\u00ebsit t\u00eb grimcave.<\/em>Gjenev\u00eb, Organizata Bot\u00ebrore e Sh\u00ebndetit 2008.<\/em>http:\/\/www.who.int\/csr\/resources\/publications\/respirators<\/em>kontrolloni \/ sq \/. P\u00ebr informacionet e fundit, ju lutemi konsultohuni me<\/em>Faqja e internetit e koronavirusit WHO n\u00eb<\/em>http:\/\/www.who.int\/csr\/disease\/coronavirus_infections\/en<\/em>\/.<\/em><\/p>\n

    7. Hui DS. Koronaviruset epidemike dhe ato n\u00eb zhvillim (R\u00ebnda<\/em>Sindromi akut i frym\u00ebmarrjes dhe frym\u00ebmarrja e Lindjes s\u00eb Mesme<\/em>Syndrome). Klinika e kraharorit Med. 2017 Mar; 38 (1): 71-86. doi:<\/em>10.1016 \/ j.ccm.2016.11.007<\/em><\/p>\n

    8. Tran K, Cimon K, Severn M, Pessoa-Silva CL, Conly J.<\/em>Procedurat e gjenerimit t\u00eb aerosolit dhe rreziku i transmetimit t\u00eb<\/em>infeksione akute t\u00eb frym\u00ebmarrjes ndaj punonj\u00ebsve t\u00eb kujdesit sh\u00ebndet\u00ebsor: a<\/em>rishikim sistematik. PloS One 2012; 7: e35797.<\/em><\/p>\n

    9. Standardet thelb\u00ebsore t\u00eb sh\u00ebndetit mjedisor n\u00eb kujdesin sh\u00ebndet\u00ebsor.<\/em>Gjenev\u00eb, Organizata Bot\u00ebrore e Sh\u00ebndetit, 2008. N\u00eb dispozicion n\u00eb<\/em>http:\/\/www.who.int\/water_sanitation_health\/hygiene\/setti<\/em>ngs \/ ehs_hc \/ en \/ index.html.<\/em><\/p>\n

    10.Jefferson T, Del Mar CB, Dooley L et al. fizik<\/em>nd\u00ebrhyrjet p\u00ebr t\u00eb nd\u00ebrprer\u00eb ose zvog\u00ebluar p\u00ebrhapjen e<\/em>viruset e frym\u00ebmarrjes. Baza e t\u00eb dh\u00ebnave Kochrane e Sistematike<\/em>Shqyrtime, 2011, 7: CD006207. N\u00eb dispozicion n\u00eb<\/em>http:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/14651858.CD<\/em>006207.pub4 \/ abstract; jsessionid = 074644E776469A4CF<\/em>B54F28D01B82835.d03t02.<\/em><\/p>\n

    11. Menaxhimi i pun\u00ebs bioriskuese p\u00ebr trajtimin e laborator\u00ebve<\/em>ekzemplar\u00eb njer\u00ebzor\u00eb t\u00eb dyshuar ose t\u00eb konfirmuar q\u00eb p\u00ebrmbajn\u00eb roman<\/em>coronavirus: Rekomandime t\u00eb p\u00ebrkohshme. Gjenev\u00eb, Bot\u00eb<\/em>Organizata Sh\u00ebndet\u00ebsore, 2013. N\u00eb dispozicion n\u00eb<\/em>http:\/\/www.who.int\/csr\/disease\/coronavirus_infections\/N<\/em>ovelCoronavirus_InterimRecommendationsLaboratoryBi<\/em>orisk_190213 \/ en \/ index.html<\/em><\/p>\n

    12.WHO manuali i biosiguris\u00eb laboratorike, botimi i tret\u00eb.<\/em>Gjenev\u00eb, Organizata Bot\u00ebrore e Sh\u00ebndetit, 2004. N\u00eb dispozicion n\u00eb<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

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