Iigonti zifike ixesha elide ukusuka ku-Edward Jenner owaziwayo kwi-18th century. Oomkhulu nootatomkhulu bethu banokufumana kuphela ukudubula omnye xa babengabantwana, kodwa abantwana namhlanje banokukhuselwa kwizifo ezi-16 ezahlukeneyo kunye neentlobo ezisixhenxe zomhlaza. Mhlawumbi isitofu esibaluleke kakhulu kwishedyuli samanje yokugonywa kwabantwana, nangona kunjalo, yinto ekhuthazwayo wonke umntu, ngamnye unyaka: umkhuhlane uphendulela.
Ngoxa i-vaccine igxile njengento ebaluleke kakhulu namhlanje njengoko ikhutshwe kuqala, ininzi ishintshile kwiminyaka engama-70 yeminyaka. Njengoko iteknoloji ikhewuleze, isitofu siphephile kwaye siphumelele ngakumbi-kwaye kunye nale nkqubela, iziphakamiso ziye zaguqukela, ngokunjalo, ukwandisa ukusuka kubantu abakujoliswe kuzo ekupheleni kweminyaka engathandathu. Nantsi indlela esiye ngayo apha.
Ukuchonga iGciwane
Intsholongwane yesifo somkhuhlane yahlala yodwa ngexesha lokuqala ekuqaleni kwee-1930 kunye nenkxaso encinane evela kwezinye iifreyiti ezingaziwayo. Abantu babesaqhubeka besuka kwi-1918 yesifo somkhuhlane esathatha ubomi obungaphezu kwezigidi ezingama-50 kwaye sathintela kubantu abahlanu kwihlabathi lonke. Ukuchonga isigxina emva kwalokhu kutshabalalisa kwakuyinqanaba lokuqala ekuphuhliseni isitofu sokukhusela ukuba singabikho kwakhona.
Abasebenzi kwiBhunga loPhando lwezoBucala bathabatha ukuhlamba umlomo (izigulane) kwizigulane zabantu abagulayo ngentsholongwane, bahlanjululwe ukuze kungabikho bhaktheriya, kwaye bazisa ukuphuma kwamanzi-kunye nezinye iisampula zeengulube-kwi-ferrets.
Xa izilwanyana zigule, izazinzulu zathetha ukuba zithatha ixesha elide ukuphuhlisa iimpawu nokuba ingaba isigulane sagula sidluliselwe kwisifo esilungeleyo sokuhlala kwindawo efanayo. Kuyathakazelisa ukuba abaphandi bafumanisa ukuba emva kokuphulukana nesifo esinye, i-ferrets ibonakala ikhuselwe kwezinye iifom.
UWilson Smith, uChristopher Andrewes, kunye noPatrick Laidlaw bapapasha iziphumo zabo kwiLancet kwaye babeka isigaba sokuphuhlisa isitofu.
Phambi kweeVIV
Kwiminyaka embalwa kamva, abaphandi base-USSR babenokuqala ukuphonononga olu phando ukwenza isitofu sokugonywa. Bawuthatha inguquko ephilayo yentsholongwane yesifo somkhuhlane kwaye bayiphonsa amaxesha angama-30 ngamaqanda amaqanda. Inkqubo yokuphindaphinda igxininise intsholongwane njengoko iguqulelwe kwi-egg host, iyanciphisa ngokwaneleyo ukukhuseleka ukunika abantu.
Izilingo zoluntu zaqhutyelwa, kwaye isitofu sagcinwa kubasebenzi befrikansi ukuze sibone ukuba ingayinciphisa ukungabikho emsebenzini ngenxa yezifo zokuphefumula ezifana nomkhuhlane. Nangona iirekhodi zembali zibonisa ukuba isitofu siyasebenza, kubalulekile ukuba uqaphele ukuba iindlela ezazisetyenzisiweyo ngelo xesha zingenakudlulela namhlanje. Kungakhathaliseki, iziphumo zolu gonyoza ziya kuqhubeka zisetyenziswe iminyaka engaphezu kwama-50 kwizinto ezibizwa ngokuba yiSoviet Union.
Ngoxa uphando olwenziwe ngemigodi yokukhuhlane lwaqhubeka kwiminyaka emininzi elandelayo, bekungekho u-2003 ukuba inguquko ephilayo yomkhuhlane wokukhusela iza kutholakala eUnited States. I-vaccine ye-influenza egciniweyo (LAIV) ilawulwa njenge-spray ye-nasal ngaphandle kwe-injection, inika enye inketho kubantwana kunye nabantu abadala ababesaba iinaliti.
I-LAIV yabonisa ukuba isebenze ngakumbi kubantwana abadala kunye nabantu abadala kwaye kwacetyiswa kubo abaneminyaka engama-2-49. Nangona kunjalo, emva kweminyaka embalwa yophando ebonisa ukugonywa akuzange kube yimpumelelo njengoko umkhuhlane uphendulela, isiluleko sasihoxiswa, kwaye ngoku kungoku kugonywa kwaye kugcinwe iigcini ezixhaswayo zokusetyenziswa kwi-United States.
Iigciwane ezingasebenzi
Ngama-1940, ngelixa i-USSR yenza kwaye ivavanya ukugonya kwayo, amanye amazwe afana ne-United States kunye ne-United Kingdom bathatha isondo sabo ekuphuhliseni isibhamu ngokusebenzisa indlela eyahlukileyo ngokusebenzisa i-virus-inverted-or "dead" .
Kuqikelelwa ukuba kuma-67 kumajoni abulawa ngumkhuhlane ngexesha lobulwelwe ngo-1918, kwaye ukuphuhlisa isitofu sokukhusela imikhosi bekuyona nto ephambili kuburhulumente base-United States njengoko yazibophelela kwiMfazwe Yehlabathi II.
NjengamaSoviets, intsholongwane yesifo somkhuhlane yadluliselwa kwimibhobho yeqanda phakathi kwezinye izilwanyana zezilwanyana, kodwa abaphandi base-US baxhamla phambili kwi-teknoloji eyayisandul 'ixesha elitsha, njenge-centrifugation kunye nokuqhwala kunye nokucoca amanzi afunekayo kwimiqanda yenkukhu. Baye basebenzisa iintlobo ezimbini, kungekhona enye. Umkhosi uvavanye ngokugqithiseleyo ukugonywa kwabo kumawaka amavolontiya, usebenzisa amacebo amnandi okwenza ixesha, njengokubambisana nabathathi-nxaxheba kunye nabaphandi ukuba bazi ukuba isitofu sokugonywa okanye indawo ye-placebo yenziwa-isicwangciso esicwangcisiweyo sophando olubizwa ngokuba yimpumelelo . Izifundo ezifunyenwe kuloluphando ziya kuqhubeka nokuzisa uphuhliso lwe-vaccine oluzayo, kubandakanya ukufumanisa ukuba intsholongwane ye-virus inokuguquka kwixesha lexesha, kwaye ukukhuselwa kwezinye iintlobo akuqinisekisile ukukhuselwa kwabanye.
Izazinzulu ziya kuhamba emva koko zifumene iindlela ezintsha ezibandakanya ukudibanisa kunye neenkalo ezihambelana nezifo zentsholongwane ukwenzela ukuba zenze i-stroke ekhuselekileyo yokugonywa-inkqubo ebizwa ngokuba yi-genetic recombination esasetyenziswa nanamhlanje.
Iimpawu zokugonya
Nangona akusiyo yonke imithi yokukhubaza eyenziwa ngokusebenzisa amaqanda, abaninzi baninzi-bashiye abanye abantu abaneengxaki ezinzima zengozi yokuphendula. Le nkxalabo yavelisa uluhlu lwezinto ezintsha ezinobungcali bokugonya umkhuhlane. Enye yeentuthuko zakutshanje kwakunokudalwa kwesitofu sokugonya. Olu hlobo lokugonywa luba neeprotheni ezidalwa yi-virus yefluwu eziza kusasaza loo mkhuhlane kwaye zidibanise ne-virus ehlukileyo eya kukhula kakuhle kwi-laboratory. Iintsholongwane ziphendulela kwaye zenze iiprotheni ezingaphezulu kwiiseli ezinambuzane-kungekhona inkukhu yamaqanda-kwaye loo prothini yintoni abaphandi abafuna ukuyifaka.
Inkqubo ihamba ngokukhawuleza kunendlela yendabuko yokusebenzisa amaqanda kuba ayithembeli ekunikezeni iqanda okanye ekusebenziseni kuphela iintsholongwane zentsholongwane ezikhula kakuhle kumaqanda. Oku kungathetha ixesha lokuphendula ngokukhawuleza xa kwenzeka isigulane esibulalayo segciwane kwixesha elizayo. Kuze kube ngoku, i-vaccine eyodwa kuphela efumaneka eUnited States esebenzisa lobu bugcisa, kwaye yakhululwa ngo-2013.
Iintlobo zeZiphulo ezininzi
Umgudu wokuqala wokugonya umkhuhlane owenziwe kwi-Soviet Union yangaphambili yayisisigxina-okanye sisigxina. Ngelo xesha, kwakukho uhlobo oluthile lomkhuhlane: i-Influenza A. Ekuqaleni kwee-1940, kunjalo, uhlobo lwesibini lomkhuhlane lwachongwa ukuba lwaluhluke ngokuphambili kuneyokuqala: Igciwane B. Xa umkhosi wase-US uphuhlise isitofu esingagcini, yayiquka iintlobo zombini zombini ukunyusa ukukhuselwa. Kwiminyaka kamva, inxalenye yesithathu yayidibaniswe kwisitofu sokukhusela kumgangatho wesibini we-Influenza A, kwaye ngowangonyaka ka-2012, ukuchithwa kwesine-quadrivalent-okanye ezine-stin-strain-strain-approved-for-use-usetyenziso e-United States. Amagciwane amaninzi asetyenziswayo namhlanje, nangona kunjalo, ayenzixazuliso, okanye intlungu emithathu, izitofu.
Isicwangciso sokuHlola
Unyaka ngamnye ukukhutshwa komgudu wokugonya umkhuhlane kufuneka kuguqulwe ukulungelelanisa intsholongwane eguqula intsholongwane. Khawucinge ukuba umzimba wakho wokhuseleko ngumapolisa ekufuneni umbaleki. Ekuqaleni, babetshelwe ukuba bafune umenzi wobubi kwengubo eluhlaza. Kodwa ngaphaya kwekhosi yonyaka, ingubo yommangalelwa yaphela ilanga, kwaye emva kweenyanga, iingubo ngoku iluhlaza. Ukuba amapolisa ahlaziyiweyo kwindlela ebonakalayo yatshintshile, baya kukhangela umntu eengubo eziluhlaza okwesibhakabhaka-ukuvumela umbaleki ukuba angabanjwa. Ngenxa yokuba intsholongwane yesifo sesifo kunye neentlobo zayo ezahlukeneyo zingatshintshwa ngokukhawuleza, imizimba yethu idinga isikhumbuzo sento ekufuneka siyibheke ngayo, ngoko sinokuzilungisa kangcono ukukhusela kwethu xa sisifo.
Inkqubo yokuchonga zeziphi iintsholongwane zentsholongwane kufuneka zifakwe kwixesha elizayo le-vaccine formulations zihlala zenzeke inyanga ngaphambi kokuba zifike. Iziphathamandla zikhangelelanisa uphando olubanzi, kubandakanywa naluphi uhlobo lweengxaki ezijikelezayo emhlabeni jikelele, kwaye zibonakala zixinzeleleke kangakanani iintlobo ezithile, kwaye ke zinika loo nkcazelo kubakhi bezitofu ukwenzela ukuba baqalise inkqubo yobunzima bokuvelisa isitofu kwaye vavanywa ukukhusela ngexesha lexesha lomkhuhlane.
Nangona inkqubo yokukhetha i-stroke yokugonya isekelwe kuphando, akunakwenzeka ukuxela ixesha elizayo, kwaye ngamanye amaxesha iimeko ezibandakanyiweyo kwiigonyana azihambisani neentsholongwane ezijikelezayo xa kufika ixesha lomkhuhlane. Xa oko kwenzeka, ukuphumelela kwesigontsho kuthatha i-hit. Kubalulekile ukuba uqaphele, nangona kunjalo, nokuba nangona xa isitofu singagqithisi kakuhle, kuseyona ndlela eyona ndlela ibhetele yokukhusela ukulaliswa esibhedlele okanye ukufa ngenxa yesifo. Ngokomzekelo, ukugonya umkhuhlane ngexesha le-2014-2015 liqikelelwe ukuba li-19% kuphela ekhuselekileyo ekukhuseleni amacala omkhuhlane. Kodwa nangona izinga eliphantsi lokuphumelela, ukugonywa ngethuba lelo xesha lugqithise iimeko ezingama-1.9 zezifo zentsholongwane, kunye nama-67,000 ezibhedlele. Oku bekukho nantoni ye-vaccination ye-down low engaphantsi kwama-50 ekhulwini kubantu abadala abangaphantsi kwe-65-ngaphantsi kwembundu efunekayo ukuze bafumane umfutho we-immune .
Iingcebiso
Sekude ixesha elide ukususela ngo-1918 umkhuhlane wesifo somkhuhlane, kodwa intsholongwane isinye sezifo ezikhuselweyo zokugonywa e-United States okwangoku-kubulala naphi na abantu abayi-12,000 ukuya ku-56,000 ngonyaka. Njengoko idatha iqokelelwe ngentsholongwane kunye neengongelo ezinokuthi, iingcebiso zandisiwe ukuze zibandakanye abantu abaninzi.
Ekuqaleni isicontsho sasicetyiswa kuphela kubantu ababesengozini eyongeziweyo yeengxaki ezivela kumkhuhlane, njengabantu abadala abangaphezu kweminyaka engama-65 okanye nabani na abaneminyaka engaphezulu kweenyanga ezili-6 abanesifo esingapheliyo esichaphazela intliziyo okanye imiphunga. Ngexesha elide, ke, kwacaca ukuba abantu abaninzi bafuna ukugonywa ukwenzela ukuthintela ukufa nokulaliswa esibhedlele, ngoko ke isincomo sandisa ukuba kubandakanye abantwana abancinci nabafazi abakhulelweyo. Kwaye kwabakho abantu abadala abangaphezu kwama-50, kwaye kamva, bonke abantwana baneminyaka engama-18. Ngenxa yokuba umkhuhlane ubulala abantu abaninzi ngonyaka-ngaphezu kwazo zonke ezinye izifo ezikhuselweyo zokugonya ezihlangene e-United States-i-ACIP yavota ngo-2009 ukwandisa isiluleko sayo wonke umntu ngaphezu kweenyanga ezintandathu.
Ukususela ngeli xesha, isitofu sokugonywa ngumkhuhlane sisisigxina kuphela sokucetyiswa kubantu abakwiiqela elidala kunye neemeko. Oko kuthethwa, abantu abathile-njengabo banesifo esichengeni ubomi kwisifo sokugonya-mkhuhlane-akufanele bagonywe, kodwa loo matyala awanqabile kakhulu, kwaye ngokuqhelekileyo ukuqulunqwa kwesinye isitofu sokugonya kungasetyenziselwa ukuthintela iziphumo ezimbi.
Ukuphuhliswa kwexesha elizayo
Ngenxa yobunzima besifo, intsholongwane yentsholongwane yintlupheko yintsholongwane yokugonywa komkhuhlane. Amaqela ophando ehlabathini lonke asebenza ngokugqithiseleyo kwisitofu sokugonya-esinokufumana ukhuseleko kwiintlobo zentsholongwane kunye nexesha elide, okwenza imfuno yentsholongwane yonyaka ikhuphe into edlulileyo.
> Imithombo:
> Barberis I, iMartini M, Iavarone F, i-Orsi A (2016) Iigciwane lokufumana umkhuhlane: izicwangciso zokugonywa, imbali kunye nezixhobo ezintsha zokulwa nesifo. J Prev Med Hyg. 2016; 57: E41-46.
> Amacandelo okuLawula nokuLawula izifo. Iingcebiso zokugonya kwe-ACIP ye-Influenza.
> Hannoun C. Iimbali eziguqukayo zeentsholongwane zegciwane kunye neentsholongwane zegciwane. Iingcaphephe zoVavanyo . 2013; 12 (9): 1085-94.
> Imbali yeMigomo. Influenza. Ikholeji yamaGqirha ePhiladelphia.