Abantu abasebenza ezindaweni zokunakekelwa kwezempilo bavame ukutholakala namagciwane ngenkathi bephethe noma bezungeza iziguli. Ukugonywa kwabasebenzi bezempilo (HCP), njengabahlengikazi nabahlengikazi, kusiza ekuzivikeleni ezifweni ezinobungozi ezifana nomkhuhlane nokukhwehlela, nokuvikela iziguli abazinakekelayo. Bonke abantu abadala kufanele baqiniseke ukuthi basesimweni esifanele kuzo zonke izigoma eziphakanyiswa njalo. Kodwa uma u-HCP noma usebenza esimweni sokunakekelwa kwezempilo, kunezibhamu eziyisithupha ikakhulukazi eziphakanyiswa yiKomidi Elulekayo Emisebenzini Yokugoma (ACIP).
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UmkhuhlaneAbantu abangaba ngu-12 000 kuya ku-56 000 bafa minyaka yonke e-United States besuka kumkhuhlane, okwenza kube esinye sezifo ezivimbela ukugoma epulazini ezweni namuhla.
Abantu abaningi abasengozini yokungena esibhedlela noma ukufa ngenxa yomkhuhlane nabo nalabo asebevele bekwazi ukuxhumana njalo neHCP. Leli qembu lihlanganisa labo abanezimo ezidinga usizo lwezempilo, izingane ezincane, abesifazane abakhulelwe, kanye nabantu asebekhulile-abanye babo abangakwazi ukugonywa ngokuphepha ngenxa yobudala noma izizathu zezokwelapha.
Ungathola umkhuhlane ngokuphefumula noma ukuhlangana nobuthakathaka bokuphefumula obuphambanisa ngenxa yokukhwehlela noma ukuklolodela noma ngokuthinta izinto ezingcolile njengezinsizakalo. Lokho kusho ukuthi ungenwe igciwane futhi usakaze umkhuhlane ngisho noma ungahlangani ngqo neziguli.
I-ACIP incoma wonke umuntu oneminyaka engaphezu kwezinyanga eziyisithupha ukuthola umuthi wokugoma waminyaka yonke, kubandakanya-ikakhulukazi-HCP nezinye izinhlobo zabanakekeli . Ngokusho kweCDC, abasebenzi abangamaphesenti angu-88 abahlinzeka ngempilo e-United States bathola ukugoma komkhuhlane ngesikhathi sonyaka ka-2016-2017, nakuba lezo zinamba zihlala ngokusekelwe kwendawo ngayinye.
Izilungiselelo zesibhedlela zivame ukuba nezinga eliphezulu lokugoma kunezikhungo zokunakekelwa isikhathi eside ezinjengezindlu zokwelapha, futhi abasebenzi baningi amathuba okuthola umuthi wokugoma uma kudingeka ngabaqashi babo. Ezindaweni lapho kugonywa khona umgomo, amaphesenti angu-97 e-HCP athola igciwane, uma kuqhathaniswa namaphesenti angu-46 kuphela alabo abasebenza ezindaweni lapho kungadingeki khona, ukukhuthazwa, noma ukunikezwa kwisayithi.
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I-hepatitis BI-Hepatitis B isakazeka ngamanzi asemzimbeni afana negazi kanye namathe. Abantu abangaphezu kwezigidi eziyi-1 bakholelwa ukuthi njengamanje banesifo e-United States. Ngenxa yokuthi abaningi balaba bantu abazizwa begula, ngokuvamile abaqapheli ukuthi banegciwane, kodwa bangakwazi ukusakaza kwabanye abantu. Uma ishiywe ingalashwa, igciwane le-hepatitis B lingabangela izimo ezinzima , ezifaka umdlavuza we-cirrhosis nesifo sebindi. Lokhu kuyiqiniso ikakhulu ezinganeni ezincane kakhulu ezithathelwana.
Ukuze i-HCP ingozini yokuthola isifo sofuba esibhedlela, ukugoma kuyisici esibalulekile sokulawula ukutheleleka. Lapho isincomo sokugoma i-HCP ngokumelene nesifo sofuba B kuqala ngo-1982, ukulinganiselwa okungu-10 000 kwenzeka phakathi kwabasebenzi emasimini wezokwelapha namazinyo. Ngo-2004, kwakunama-304 kuphela. Ngo-2015, amaphesenti angama-74 e-HCP oxhumana nabo abagulayo ngokuqondile ayegonywe ngokumelene negciwane. Ngenkathi iphakeme kunabantu abaningi abadala, leli nani lilingaphansi kwe-90% yemigomo evezwe ku-Healthy People 2020, isethi yemigomo kazwelonke ezofezwa ngonyaka ka-2020 ukuze kuthuthukiswe impilo yabantu base-US.
Wonke ama-HCP angakaboshwa ngokumelene nesifo sofuba kufanele athole uchungechunge olugcwele lwezintathu ezintathu, nalabo abangase bahlangane nezikhukhula zomzimba kufanele bahlolwe izinyanga ezingu-1-2 ngemuva kwesilinganiso sokugcina ukuqinisekisa ukuthi imizimba yabo isabele kahle ukugoma.
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Ama-Measles, Ama-Mumps, no-Rubella (i-MMR)Izindwangu zamenyezelwa zaqedwa ezivela e-United States ngo-2000, kodwa lesi sifo sihlala sivamile ezingxenyeni eziningi zomhlaba, futhi kuqhuma izibhamu ezincane lapha ekhaya. Kungenye yegciwane lesandulela ngculaza elaziwa kakhulu esintu futhi elikwazi ukuhlala emoyeni kuze kube amahora amabili emva kokuba umuntu olelekile usuvele eshiye ekamelweni.
Ngenxa yokuthi isishukela asikabi kakhulu e-United States, abazali abasha bangase bangakwazi izibonakaliso zesifo ngakho-ke ningathathi izinyathelo ngaphambi kokuletha izingane ezinesandulela ezindaweni zokunakekelwa kwezempilo. Futhi lokho kungabangela ukuqhuma, njengokunye okwenzeka ngo-2008. Umfana oneminyaka engu-7 ongakazalwa, onomvuthwandaba ovakashele ihhovisi lakhe lezingane futhi engadlulanga igciwane kwezinye izingane ezine-ezintathu zazo ezincane kakhulu ukuze zithole umgomo we-MMR ngaleso sikhathi. Omunye wezinsana kwakufanele abe esibhedlela. Umfana uvakashele izilungiselelo eziningi zokunakekelwa kwezempilo ngaphambi kokuba atholakale enesimungumungeni, engenazo izivumelwano zokuzihlukanisa ezisebenzayo ukuvikela ezinye iziguli noma i-HCP esengozini.
Ngisho nakumazwe athuthukile kwezobuchwepheshe afana ne-United States, cishe umuntu oyedwa kwabayisine abanezimpungumfuno kudingeka abe esibhedlela. Emhlabeni wonke, cishe abantu abayi-100 000 bafa ngesifo minyaka yonke, ikakhulukazi izingane. Ukugonywa kuyindlela ephumelela kakhulu ekuvikeleni ukufa nokukhubazeka emasimini. Ngokusho kweWorld Health Organization, lo mgomo uvimbele ukufa kwabantu abayizigidi ezingu-20 phakathi kuka-2000 no-2016.
Ngenkathi i-rubella nezimbungu zivame ukungabi nasibi kakhulu kunesimungumane, i-HCP engavunyelwe ingasenwa igciwane ngemuva kokuba idluliselwe ezigulini ezinalezi zifo, bese idlulisela amagciwane kumaguli asobuchopho, njengabesifazane abakhulelwe.
I-HCP engavunyelwe eyazalwa ngo-1957 noma ngemuva kumele ifinyelele amanani amabili we-MMR, okungenani izinsuku ezingu-28 ngaphandle. I-HCP ezalwe ngaphambi kuka-1957 ngokuvamile icatshangelwa ukuba ivikeleke isisimungumungwane, ama-mumps, kanye ne-rubella, kodwa ngaphandle kokuthi ingabonisa ubufakazi bokuthi banesifo noma bahlolwe ukuthi banesifo sokuzivikela, kufanele baqhubeke begonywe i-MMR enomthamo owodwa ( uma kungenakho ubufakazi bokuzivikela ngokumelene ne-rubella kuphela) noma ama-2 amanani (uma engekho ubufakazi bokuthi u-mumps kanye / noma isishukela). Abesifazane abangacacile abasebenza ezilungiselelweni zokunakekelwa kwezempilo abangakhulelwa (kodwa kungakafiki) kufanele futhi bathole okungenani umthamo owodwa we-MMR ukuvikela ngokumelene ne-rubella.
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I-Tetanus, i-Diphtheria ne-Pertussis (i-Tdap)Kukhona imithi emibili ye-tetanus ekhona: i- Tdap ne-Td. Bobabili bahlanganisa izingxenye zokuvikela amakhemikhali aphethwe yi-tetanus ne-diphtheria bacteria, kodwa kuphela i-Tdap ihlanganisa ingxenye ye-pertussis.
I-Pertussis, eyaziwa nangokuthi ukukhwehlela, iyisifo sokuphefumula esingaba yingozi kakhulu ezinsaneni ezisencane. Njengomkhuhlane, usakazeka ngokukhwehlela nokunyakaza, kanye nokuxhumana okusheshayo njengokumanga. Ngenxa yokuthi izimpawu zokuqala ze-pertussis zingabonakala zibukeka sengathi zibandayo, abantu abaningi abadala abazi ukuthi banesifo. I-HCP esebenza ngezilungiselelo zezingane ibonakala iyingozi kakhulu kokubili ukuthengiswa nokusabalalisa i-pertussis. Futhi labo abasebenza ezinkampanini zokunakekelwa ezikhulayo ze-neonatal ezikhathini zezibhedlela kumele babe nokuqapha okukhulu kwe-pertussis, njengoba kungase kubonakale kubulalayo izingane ezisanda kusenesikhathi uma zithole igciwane.
Bonke abakwa-HCP abangakaze baqiniseke ukuthi baphonywe ngokumelene ne-pertussis kumele bathole okungenani isilinganiso esisodwa se-Tdap-kungakhathaliseki ukuthi sekuyisikhathi eside kangakanani lapho bethola khona i-Td-futhi baphinde baphonywe ngokumelene ne-tetanus noma ngaphandle kwe-pertussis ingxenye okungenani kanye njalo eminyakeni eyishumi. I-HCP abakhulelwe kufanele futhi bathole i-Tdap ngesikhathi sesithathu sesithathu sokukhulelwa.
Naphezu kwalezi zincomo, noma kunjalo, ingxenye engama-HCP kuphela igonywe nge-Tdap ngo-2015.
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I-VaricellaI-Varicella, noma inkukhu, ayiyona indawo evamile e-United States, ngenxa yokugoma okubanzi. Kodwa ukuqhuma kuqhubeka kwenzeka ezweni lonke, futhi amacala angasakazeka ngokushesha ezindaweni zokunakekelwa kwezempilo. Lesi sifo singaba yingozi ikakhulukazi ezigulini ezikhulile ezigulayo, kubandakanya nabesifazane abakhulelwe.
Njengezinye izifo eziningi, abantu abanegciwane le-varicella bangasakazeka ngosuku noma ezimbili ngaphambi kokuba bathole ukushayeka kwe-telltale. Uma ungumhlinzeki wezempilo oxhumana njalo neziguli, imiphumela ye-infection engaziwa ingabiza. Ucwaningo luye lwabonisa ukuthi umhlinzeki oyedwa one-varicella angakwazi ukudalula iziguli ezingaphezu kuka-30 kugciwane, kanye nezinye izisebenzi eziningi. Ngaphezu kokungathandeki ngokuphelele, abantu abadala bavame ukuba nezimo ezimbi kakhulu ze-varicella, futhi lesi sifo singaba yingozi kakhulu kwabasebenzi abakhulelwe neziguli.
I-HCP engavunyelwe ngaphandle kobufakazi bokuzivikela komzimba noma ubufakazi obubhalwe phansi bokuthi uhlolwe nge-varicella kufanele uthole amanani amabili omgomo, ahlukaniswe amasonto amane ngaphandle.
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I-MeningococcalIzifo ze-meningococcal yi-infection yebhaktheriya engabangela ukuba i- meningitis , isimo lapho ububanzi bobuchopho buye buvuvukala khona. Lesi sifo asivamile kodwa singaba sína, okuholela ekulahlekelweni kwesisindo, ekutheni, noma ekufeni nje kuphela ngamahora. Intsha kanye nabantu abasha basengozini kakhulu.
Akuvamile ukuthi i-HCP ingenwe igciwane lesifo se-meningococcal ezigulini zabo, kodwa kungenzeka, ikakhulukazi kulabo abathintana ngqo nalabo abathintekayo ukuphefumula komuntu onegciwane-ngenkathi belawula indlela yokuhamba emoyeni ngesikhathi sokuvuselela, isibonelo-noma amabhaktheriya ngokwayo endaweni yokubhubhisa.
Uma ngabe u-HCP ovame ukuxhumana ngokuqondile neziguli, noma uma ubamba izibonelo emabhaleni, kufanele uthole umthamo owodwa wokugonywa kwe-meningococcal.
Izwi elivela
Odokotela, abahlengikazi, abasizi bezokwelapha kanye nezinye i-HCP badlala indima ebalulekile ekuvikeleni impilo yemiphakathi. Uyakhathalela abasengozini kakhulu phakathi kwethu, futhi ngenxa yalokho, uzibeke engozini, futhi, ngezifo eziyingozi ozoziphatha. Ukugoma kungenye yezinyathelo ezibaluleke kakhulu wena njengomhlinzeki wezempilo ongayithatha ukuze ungavikele wena nje, kodwa futhi neziguli ozikhathalelayo.
> Imithombo:
> Amasevisi Okulawula Nokuvimbela Izifo. Imithi Yokunconywa Yabasebenzi bezeMpilo.
> Ukugonywa kwe-Action Coalition. Izincomo zokugoma zabasebenzi bezempilo . 2016.
> McLean H, Fiebelkorn A, Temte J. Ukuvimbela imingqimba, i-rubella, i-rubella syndrome yesifo sofuba, nama-mumps, ngo-2013: Izincomo ezifingqiwe zeKomidi Eliluleka Ngezindlela Zokugoma (ACIP). Ukulimala nokufa Ukubika ngeviki. 2013; 62 (RR04): 1-34.
> Shefer A, Atkinson W, Friedman C, et al; Ukugonywa kwabasebenzi bezempilo: Izincomo zeKomidi Elilulekayo Emisebenzini Yokugoma (ACIP). Ukulimala nokufa Ukubika ngeviki . 2011; 60 (RR07): 1-45.
> Williams WW, Lu P, O'Halloran A, et al; Ukubhekwa kokugonywa phakathi kwabantu abadala - United States, 2015. Ukulimala nokufa Ukubika ngeviki. 2017; 66 (011): 1-28.