Imishanguzo ifike isikhathi eside kusukela ekuhlolweni kukaJohn Jenner kwekhulu le-18 leminyaka elidumile. Ugogo nomkhulu wethu kungenzeka ukuthi bathole isibhamu esisodwa lapho beyizingane, kodwa izingane namuhla zivikelwe izifo ezingu-16 ezihlukene nezinhlobo eziyisikhombisa zomdlavuza. Mhlawumbe umuthi wokugoma obaluleke kunazo zonke ohlelweni lwesimanje sokugonywa kwezingane, kodwa yilokho okukhuthazwa wonke umuntu, njalo ngonyaka: ukuguquka komkhuhlane.
Ngenkathi umgomo wokugoma usebenza njengamanje njengalapho uqala ukukhishwa, okuningi kushintshile emlandweni wawo oneminyaka engu-70. Njengoba ubuchwepheshe buye bahamba ngokushesha, lo mgomo usuvikelekile futhi usebenza kahle-futhi ngalezi zintuthuko, izincomo ziye zashintsha, futhi, zanda kusukela kubantu abakhethiwe kulo lonke umuntu oneminyaka engaphezu kwezinyanga eziyisithupha. Nansi indlela esiye ngayo lapha.
Ukukhomba i-Virus
Igciwane lesifo somkhuhlane lalihlukanisiwe okokuqala ngqa ekuqaleni kwawo-1930 ngokusiza okuncane okuvela kwezinye izinhlobo ze-ferrets ezingenayo. Abantu babesaqhubeka bexosha kusukela ngo-1918 umkhuhlane wabhubhane owawuthatha abantu abangaphezu kwezigidi ezingu-50 futhi othintekayo kubantu abahlanu emhlabeni wonke. Ukuqaphela imbangela yalesi sigameko esikhulu kwakuyisinyathelo sokuqala sokuthuthukisa umgomo wokuvimbela ukuthi ungabikho futhi.
Abasebenzi abavela eMkhandlwini Wocwaningo Lwezokwelapha bathatha izigqoko zokugeza (izigqoko) ezigulini zabantu ezigula ngengculaza, zihlungiwe ukuze kungabikho ama-bacteria, bese behambisa ukuphuma kwamanzi-kanye nezinye izibonelo ze-swine flu-zibe yi-ferrets.
Lapho lezi zilwane zigula, ososayensi baqaphele ukuthi kuthatha isikhathi eside kangakanani ukuthuthukisa izimpawu nokuthi ngabe i-ferret egulayo isidlulisela yini ku-ferret enempilo ehlala eqenjini elifanayo. Ngokuthakazelisayo, abacwaningi bathola ukuthi ngemva kokuthola isifo esisodwa, i-ferrets yabonakala ivikelekile kwezinye izinhlobo zegciwane.
UWilson Smith, uChristopher Andrewes noPatrick Laidlaw bashicilela lokho okukutholile eLancet futhi babeka isiteji ekuthuthukiseni umgomo.
I-Vaccines Live
Eminyakeni embalwa kamuva, abacwaningi base-USSR yibona abaqala ukuhlola lolu cwaningo ukuze benze umgomo wokugoma. Bawuthatha uhlobo oluphilayo lwegciwane lesifo sofuba futhi badlulisa izikhathi ezingaba ngu-30 ngamaqanda amaqanda. Inqubo yokuziphendulela yanciphisa igciwane njengoba ijwayele ukuba isetshenziswe amaqanda, iyanciphisa ngokwanele ukuze iphephile ukunikeza abantu.
Ukuhlolwa kobuntu kwaqhutshwa ngaleso sikhathi, futhi umuthi wokugoma wawunikezwa abasebenzi basezimboni ukuze babone ukuthi ngabe kunganciphisa ukungabikho ngenxa yezifo zokuphefumula ezifana nomkhuhlane. Ngenkathi amarekhodi omlando abonisa ukuthi umgomo uzosebenza kahle, kubalulekile ukuqaphela ukuthi izindlela ezazisetshenziswa ngaleso sikhathi ngeke zidlulele. Kungakhathaliseki ukuthi, okutholakala kulo muthi uzoqhubeka usetshenziswa iminyaka engaphezu kwengu-50 kulokho manje owaziwa ngokuthi yiSoviet Union yangaphambili.
Ngesikhathi ucwaningo lwemigomo yemfuluwenza luqhubeka emashumini eminyaka alandelayo, bekungeze kube ngu-2003 ukuthi inguqulo ephilayo yomuthi wokugoma izobe itholakale e-United States. Umuthi wokugoma okhulelwe ophilayo (LAIV) wawuphathwa njenge-spray yangasese kunokuba umjovo, unikeze okunye okukhethwa kukho izingane kanye nabantu abadala abesaba izinaliti.
I-LAIV yabonakala iphumelela kangcono ezinganeni ezindala nakubantu abadala futhi ngakho-ke kunconywa kulabo abaneminyaka engu-2-49. Kodwa-ke, ngemva kweminyaka embalwa yocwaningo ebonisa ukuthi umuthi wokugoma awuphumelelanga njengoba lo mkhuhlane wawudutshulwa, incomo ihoxisiwe, futhi manje imishanguzo engavumelekile futhi evuselelekayo inconywa ukuba isetshenziswe e-United States.
I-Vaccines engasebenzi
Ngama-1940, ngenkathi i-USSR yenza futhi ihlola umgomo wayo wokugoma, amanye amazwe afana ne-United States ne-United Kingdom athatha ugwayi wawo ekuthuthukiseni isibhamu esebenzisa inqubo ehlukile esebenzisa imishanguzo engasebenzi-noma "efile" yegciwane lesifo .
Kucatshangwa ukuthi amasosha angu-67 angama-67 abulawa umkhuhlane phakathi nobhubhiso luka-1918, futhi ukuthuthukisa umgomo wokuvikela amabutho kwakuyinto ebaluleke kakhulu kuhulumeni wase-US njengoba wazikhandla ngeMpi Yezwe II.
NjengamaSoviets, igciwane lesifo sogciwane ladluliswa ngamaqanda amaqanda phakathi kwezinye izilwane, kodwa abacwaningi base-US basebenzisa ngokunenzuzo ukuthuthuka kwezobuchwepheshe okwakusanda kuleso sikhathi, njenge-centrifugation kanye nokuqhwaqhaza kanye nokukhipha okudingekayo okusuka kumaqanda ezinkukhu. Basebenzisa nezinkinga ezimbili, hhayi nje eyodwa. Ibutho lihlolisise ukugoma kwabo ezinkulungwaneni zamavolontiya, besebenzisa amasu amasha okwakhiwa ngaleso sikhathi, njengokuvikela bonke ababambiqhaza nabacwaningi ukuba bazi ukuthi ngabe umgomo noma i-placebo yenziwa yini-inqubo yocwaningo ejwayelekile manje eyaziwa ngokuthi i-double blind-study . Izifundo ezitholwe kulolu cwaningo zizoqhubeka nokuzisa ukuthuthukiswa komuthi wokugoma okuzayo, kuhlanganise nokutholakala ukuthi igciwane lesifo liyakwazi ukuguquka phakathi nenkathi yonyaka, futhi ukuthi ukuvikeleka kwezinye izinkinga akuqinisekisi ukuvikelwa kwabanye.
Ososayensi bazophinde baqhubeke nokuthola amasu amasha ahlanganisa ukuxuba nokulinganisa izingxenye zamagciwane omkhuhlane ukuze enze izinkinga zokugoma eziphephile nangendlela ephephile-inqubo ebizwa ngokuthi ukuguqulwa kofuzo okusasetshenziswa nanamuhla.
I-Recombinant Vaccines
Nakuba kungeyona yonke imishanguzo yetshefu eyenziwa ngokusebenzisa amaqanda, abaningi baseshiya abanye abantu abanezifo ezinzima ezingcupheni yokuphendula. Lokhu kukhathazeka kwaveza uchungechunge lwezinqubo ezintsha zobuchwepheshe bokugoma komkhuhlane. Enye yezentuthuko zakamuva kwakungukudala umgomo wokugoma. Lolu hlobo lokugoma luthatha amaprotheni adalwe yizifo ezibhebhethekisa umkhuhlane okungenzeka ukuthi zizungeze leyo nkathi yempukane futhi zibahlanganise negciwane elihlukile elizokhula kahle esibhedlela. Amagciwane aphindaphinda futhi enze amaprotheni amaningi emangqamuzaneni wezinambuzane-hhayi amaqanda ezinkukhu-futhi lawo maprotheni ayadingeka ukuba abenze umgomo.
Inqubo iyashesha kakhulu kunendlela yendabuko yokusebenzisa amaqanda ngoba ayethembeki ekunikezeni amaqanda noma ekusebenziseni kuphela amagciwane omkhuhlane okhula kahle emaqanda. Lokhu kungasho isikhathi sokuphendula ngokushesha uma kwenzeka umkhuhlane wegciwane obulalayo esikhathini esizayo. Kuze kube manje, umgomo owodwa kuphela otholakala e-United States usebenzisa lobu buchwepheshe, futhi wakhululwa ngo-2013.
Izifo eziningi ze-Vaccine
Umuthi wokugoma wokuqala owawusungulwa eSoviet Union yangaphambili wawuwumuthi owu-monovalent-noma single-strain-vaccine. Ngaleso sikhathi, uhlobo olulodwa kuphela lomkhuhlane luye lwabonakala: Umkhuhlane A. Ekuqaleni kwawo-1940, Nokho, uhlobo oluthile lomkhuhlane lwabonakala ukuthi lwaluhluke kakhulu kunelokuqala: Umkhuhlane B. Lapho isosha laseMelika laqala umuthi wokugoma ongasebenzi, kwakuhlanganisa izinhlobo zohlobo zombili ukukhulisa ukuvikelwa. Eminyakeni eminingi kamuva, uhlobo olwesithathu lwaluhlanganiswe emgodini wokuvikela umgomo wokuvikela uhlobo lwesibini lwe-Influenza A, kanti ngonyaka ka-2012, umgomo wokuqala wokunyathelisa owenziwe nge-quadrivalent noma owenziwe ezine wawuvunyelwe ukusetshenziswa e-United States. Imishanguzo eminingi yomkhuhlane esebenzayo namuhla, noma kunjalo, namanje iminyene, noma i-three-strain, imishanguzo.
I-Target Target
Njalo ngonyaka ukufakelwa komuthi wokugoma kufanele kuguqulwe ukuze kuvumelane nesifo se-influenza esaguqula njalo. Ake ucabange ukuthi amasosha omzimba wakho angamaphoyisa lapho efuna umbaleki. Ekuqaleni, babetshelwe ukuthi bafune umenzi wobugebengu ngengubo eluhlaza okwesibhakabhaka. Kodwa ngaphezu konyaka, ingubo yomenzi wobugebengu yaphela elangeni, futhi ezinyangeni kamuva, lejazi manje seliluhlaza. Uma amaphoyisa engasetshenziswanga ukubukeka okushintshiwe, bazobe besabheka othile egqoke eliluhlaza okwesibhakabhaka-okuvumela umbaleki ukuba akwazi ukuthunjwa. Ngenxa yokuthi igciwane lesifo sogciwane kanye namathanga alo ahlukahlukene angashintsha ngokushesha, imizimba yethu idinga ukukhunjulwa ngalokho okufanele sikubheke, ngakho-ke singakwazi ukulungiselela kangcono ukuzivikela kwethu uma kwenzeka isifo.
Inqubo yokuthola ukuthi yiziphi izinhlobo zegciwane okufanele zifakwe kulezi zindlela zokugoma zonyaka ozayo zivame ukwenzeka izinyanga kusengaphambili. Iziphathimandla zibheke ucwaningo oluhlukahlukene, kufaka phakathi ukuthi yiziphi izinkinga ezijikeleza emhlabeni wonke, nokuthi zithinta kanjani izinkinga ezithile, bese zinikezela labo abakhiqizi bokugoma ukuze baqale inqubo yokukhiqiza umgomo futhi ihlolwe ukuphepha esikhathini sokuphelelwa yisikhathi somkhuhlane.
Ngenkathi inqubo yokukhetha imishanguzo yokugoma igxile ekucwaningweni, akunakwenzeka ukutshela ikusasa, futhi ngezinye izikhathi izinkinga ezifakwe emithonjeni azifani namagciwane ahamba lapho kufika inkathi yempukane. Uma lokhu kwenzeka, ukusebenza kahle komgomo kuthatha isifo. Kubalulekile ukuthi uqaphele ukuthi ngisho noma umgomo ungabonakali kahle, namanje kuyindlela engcono kakhulu yokuvimbela ukunakekelwa esibhedlela noma ukufa ngenxa yomkhuhlane. Isibonelo, ukugoma komkhuhlane ngesikhathi sonyaka ka-2014-2015 kwacatshangwa ukuthi kunamaphesenti angu-19 kuphela okusebenzayo ekuvimbeleni amacala omkhuhlane. Kodwa ngisho nezinga eliphansi lokuphumelela, ukugoma ngesikhatsi kuleso sizini kwavinjelwa amacala anganiselwa kwezigidi ezingu-1,9 ezikhukhumeza, futhi cishe kuma-67,000 esibhedlela. Lokhu kwaba naphezu kwesilinganiso sokugoma ngokumangalisayo esingaphansi kwamaphesenti angu-50 kubantu abadala abangaphansi kweminyaka engama-65-ngaphansi kwembundu okudingekayo ukuze bafinyelele emzimbeni wegciwane .
Izincomo
Sekuyisikhathi eside kusukela ngo-1918 umkhuhlane wamagciwane, kodwa igciwane namanje isifo sezifo ezivimbela ukugoma e-United States okwamanje-okubulala abantu abangu-12 000 kuya ku-56 000 njalo ngonyaka. Njengoba idatha iqoqwe mayelana negciwane kanye nezinsongo zayo ezingase zibe khona, izincomo zande ukuze zihlanganise abantu abaningi.
Ekuqaleni umgomo wawukhuthazwa kuphela kubantu ababesengozini eyengeziwe yokucindezeleka kusuka emkhuhlane, njengabantu abadala abangaphezu kuka-65 noma noma ubani oneminyaka engaphezu kwengu-6 abanesifo esingelapheki esithinta inhliziyo noma amaphaphu. Kodwa-ke, ngokuhamba kwesikhathi, kwacaca ukuthi abantu abaningi badinga ukugonywa ukuze bavikele ukufa nokuhlala esibhedlela, ngakho-ke isincomo sandiswa ukuze sibandakanye izingane ezincane nabesifazane abakhulelwe. Kwabe sekungeziwe abantu abadala abangaphezu kuka-50, futhi ngokuhamba kwesikhathi, bonke abantwana baneminyaka engama-18. Ngenxa yokuthi umkhuhlane ubulala abantu abaningi ngonyaka-ngaphezulu kunezinye izifo ezivimbela ukugoma ezihlangene e-United States-i-ACIP ivotelwe ngo-2009 ukwandisa isincumo sayo wonke umuntu oneminyaka engaphezu kwezinyanga ezingu-6.
Kusukela ngaleso sikhathi, ukugoma komkhuhlane bekuwukuphela komgomo okuphakanyisiwe emhlabeni wonke kubantu bazo zonke izigaba nemibandela. Lokho kuthiwa, abanye abantu-njengalabo abanesifo esithathelwanayo emithonjeni yokugoma-akufanele bagonywe, kodwa lezo zimo ziyinto engavamile kakhulu, futhi ngokuvamile ukufakwa komuthi wokugoma kungasetshenziswa ukugwema imiphumela emibi.
Ukuthuthukiswa Kwesikhathi Esizayo
Ngenxa yendlela eyinkimbinkimbi futhi enamandla yegciwane, umuthi wokugoma womkhuhlane wonke ungumgogodla ongcwele wokuthuthukiswa komuthi wokugoma. Amaqembu okucwaninga emhlabeni wonke asebenza ngonya emgodini wokugoma ongase ube ne-dose eyodwa noma uchungechunge olulodwa-ukuhlinzeka ukuvikelwa kuzo zonke izinkinga zemifucuza kanye nesikhathi eside, okwenza isidingo sokukhukhumeza umkhuhlane waminyaka yonke into idlule.
> Imithombo:
> Barberis I, Martini M, Iavarone F, Orsi A (2016) Imithi ye-influenza etholakalayo: amasu okugoma, umlando namathuluzi amasha okulwa nalesi sifo. J Prev Med Hyg. 2016; 57: E41-46.
> Amasevisi Okulawula Nokuvimbela Izifo. Izincomo zokugoma umkhuhlane we-ACIP.
> Hannoun C. Umlando oguquguqukayo wegciwane lesandulela ngculaza kanye nomkhuhlane. I-Expert Vac Vaccin . 2013; 12 (9): 1085-94.
> Umlando Wezinsana. Umkhuhlane. I-College of Physicians of Philadelphia.