I-polio yisifo sasendulo.
Nakuba kucatshangwa ukuthi isifo sengculazi sokuqala samanje senzeke ngo-1887, lapho kutholakala amacala angu-44 e-Stockholm, eSweden, kungenzeka ukuthi ipholio yayivela emuva ngo-1580 BC.
Uhlobo lwe-enterovirus, i-polio ngokuvamile ibangela izifo ezingenayo izimpawu noma izimpawu ezinobumnene kakhulu, kuhlanganise ne-low-grade fever and throat.
Ezinye izingane zingathuthukisa izimpawu ezibuhlungu kakhulu ze- polio , noma kunjalo, kuhlanganise nalabo abanakho:
- I-aseptic meningitis ye-nonparalytic - ibe nomkhuhlane wezinga eliphansi kanye nomphimbo omunyo ngokuqina kwentamo, emuva, kanye / noma imilenze, nokuzwela okwejwayelekile noma okungavamile, okungahlala ezinsukwini ezimbili kuya kwezingu-10
- I-polio yokukhubazeka - ibe nomkhuhlane wezinga eliphansi nesifo somsindo, bese kuthi emva kwezinsuku ezingu-18 kuya kwezingu-18, zingase zithuthuke ukunyuka kwe-tendon reflexes, ama-muscle acans, nama-muscle spasms, kulandelwa ukuncipha kwe-tendon ejulile ne-flaccid ukukhubazeka. Ezinye zalezi zinezibuthakathaka unomphela kanye nokukhubazeka kanye ne-poliotic polio zibulala okungenani ama-2 kuya ku-10% amacala.
Ipholiyo yafinyelela phezulu e-United States ngo-1952, lapho kwakukhona amacala angaphezu kuka-21 000 we-polio yokukhubazeka.
I-United States ibilokhu ingenalo i-polio kusukela ngo-1979. Ukuqothulwa kokugcina bekukade kuphakathi kweqembu elingavunyelwe lama-Amish emazweni amaningana eMidwest.
Izifo zePolio
Yiqiniso, kwaba ukuthuthukiswa kwemigomo yokuqala yokugoma i-polio eyayimisa izifo zesifo sofuba emva kuka-1952 futhi yasisiza ukuba siphumelele ukusakazeka okuvamile kwesifo sofuba.
Umuthi wokugoma we-Salk, umuthi wokugoma wepholio ongasebenzi, wawuvunyelwe ngo-1955. Lokhu kwalandelwa ukufakwa komuthi wokugoma we-Sabin, umlomo ophilile, ophilile ophikweni lwe-polio, ngo-1961.
Zombili imishanguzo ye-polio yayinezikhwepha namandla abo:
- umgomo we-Sabin uhlinzeka ngokuzivikela komzimba wonke ngokumelene nesifo sofuba, kubandakanya ukungena emathunjini emathunjini, nokuphazamiseka kwegciwane eliphilile (elibhekiswe), elingasiza ekuvimbeleni umkhuhlane womphakathi, kodwa umuthi wokugoma ungase ungabangela ukugoma komzimba ohambisana nokukhubazeka (VAPP) kanye nesifo sofuba esivela kuleso sifo.
- Umgomo wokuvikela u-Salk uhlinzeka ngokuvikeleka okukhulu ngokulwa nesifo sofuba emva kokulinganisa okuyi-3, ikakhulukazi isifo sofuba (ukukhulelwa kwamathumbu emathunjini akuyona into enhle), futhi njengoba kungenayo igciwane lesandulela ngculaza, angeke kubangele ukugoma komuthi wokukhubazeka okuhlobene nokugoma noma ukutholakala kwesifo sofuba
Lapho umuthi wokugoma womlomo we-polio (ovikelwe kuwo wonke amagciwane amathathu wegciwane lesifo sofuba) waqala ngo-1963, wabeka esikhundleni sokugonywa kwe-Salk e-US.
I-version ethuthukisiwe yokugonywa kwe-Salk yatholwa ngo-1987 futhi yaqhubeka nokufaka umgomo wokugoma ngomlomo emazweni amaningi athuthukile ayeqedile i-polio ngenxa yokukhathazeka mayelana ne-poalytic polio (VAPP) ehambisana nokugoma.
Uma ubheka amandla okugoma komlomo we-polio, noma kunjalo, kulula ukubona ukuthi kungani esetshenzisiwe uma usazama ukuthola ipholiyo yasendle ngaphansi kokulawulwa endaweni. Ngokuvamile, ukugoma komlomo we-polio nakho kubiza futhi kulula kakhulu ukunikeza izingane, ngoba akudingi ukudubula.
I-Polioomyelitis ehlanganisiwe yokugoma
I-poliomyelitis yokukhubazeka ehlotshaniswa igciwane (i-VAPP) eyenzeka lapho umthamo we-poliovirus obuthakathaka bukhoma emgodini wokugoma womlomo we-polio uguqula futhi kubangela ukuthi umuntu, noma othintana naye obusondelene kakhulu, ahlakulele izimpawu ze-polio ekhubazekile.
Ukuguquka kwenzeka emathunjini omuntu othole umuthi wokugoma ngomlomo, ikakhulukazi ngemuva kwesilinganiso sokuqala futhi ngokuvamile kubantu abanezinkinga zesistimu yomzimba.
Ngenhlanhla, i-VAPP ayiholeli ekuqhumeni kwe-polio futhi kuyinto engavamile kakhulu, okwenzeka kuphela emva koku-1 ku-2.7 million ukukhishwa komuthi wokugoma ngomlomo.
Noma kunjalo, lokho kwaphela njengamacala angu-5 kuya kwangu-10 ngonyaka e-United States, futhi lapho isifo sofuyo saphela e-United States, isilinganiso sokungena engozini asizange samukele umgomo wokugoma ngomlomo. Lapho kuphela izingane ezithola i-polio zathola ukugoma okuhlobene nokukhubazeka kwe-paralytic poliomyelitis kwaba yisikhathi sokwenza umshini wokugoma eSalk.
UJohn Salamone waba ngummeli wenguquko. Indodana yakhe, uDavid, yaqala i-VAPP ngemuva kokuthola umgomo wokugoma ngomlomo ngo-1990. Ngaleso sikhathi, ukugoma komlomo we-polio kwakusengxenye ejwayelekile yesimiso sokugoma izingane.
Ngasekuqaleni kuka-1977, umbiko we-IOM othi "Ukuhlolwa Kwezinyolo Ze-Poliomyelitis" uthe "izinqumo ezinkulu ezinhlanu eziphathelene nenqubomgomo zazibhekwa njenge-United States ngokuhambisana nesilinganiso samaphesenti angu-60-70 okugonywa manje." Lezi zinketho kubandakanya ukusebenzisa i-OPV kuphela, i-IPV kuphela, nokuhlanganiswa kokubili imishanguzo, njll. Amanani okugoma okuphansi abonakala abe yingxenye enkulu ekuthonyeni izincomo ukuhamba nge-OPV kuphela ngaleso sikhathi.
Njengoba isikhathi sihamba, kwacaca ukuthi ukushintshwa ku-IPV kwakudingekile, kodwa ukwesaba ukushintsha uhlelo olusebenze kahle kakhulu isikhathi eside futhi mhlawumbe nokungaqiniseki ukuthi inkinobho, kuhlanganise nesidingo sokwandisa kakhulu ukunikezwa komuthi ongagciniwe ngesikhathi esincane, ochwepheshe bezempilo baqhubeka bekwenza kuze kufike ngo-1997. Uhlelo lwe-IPV / OPV lokugoma olulinganiselwe lwalushintshwa ngokushintshelwa ohlelweni lwe-IPV lokugoma ngonyaka ka-2000.
I-Poliovirus ephulukisiwe yokugoma
Nakuba kuzwakala kufana ne-VAPP, izinkinga zokuthola igciwane lesandulela ngculaza zihlukile kancane.
Inkinga ye-poliovirus (VDPV) etholakale umuthi wokugoma ibuye ishintshe izakhi zofuzo kusuka emthonjeni womlomo we-poliovirus obuthakathaka (owanqanyuliwe) ophikisana nomlomo we-polio futhi ingabangela izimpawu zokukhubazeka, kodwa iphinde ithuthukise ikhono lokuqhubeka lijikeleza futhi lidale ukuqhuma.
Lokhu kuqhuma noma ukusabalalisa izinkinga ze-poliovirus ezithathwe igciwane (i-cVDPV) ngenhlanhla kakhulu. Uma kwenzeka, kungenxa yokuthi abantu abaningi emphakathini abagonyanga ukulwa nesifo sofuba, njengoba amanani okugoma aphezulu avikela ngokumelene ne-CVDPV, njengoba nje evikela emithonjeni yasendle ye-poliovirus.
Ukuphazamiseka kwakamuva kwe-poliovirus etholakale ngogciwane kwenzeka ngo:
- Mali
- Ukraine
- ENigeria
- Madagascar
Kubalulekile ukukhumbula ukuthi nakuba ama-polio angu-580 ayenzeka ngemuva kokuqubuka kwama-cVPDV emhlabeni wonke kusukela ngonyaka ka-2000 kuya ku-2011 futhi kwakukhona amacala angu-15 500 we-polio okhubazekile ngaleso sikhathi, ukugoma kwepholio ngokwayo kwavimbela amacala angaphezu kwezigidi ezingu-5 eziphethwe yisifo sofuba!
Ngokuqinisekile, ngaphandle kwemigomo yepholio, ngeke sibe ne-VAPP, i-VDPV, ne-CVDPV, kodwa sizobuyela ezinsukwini lapho abantu abangaphezu kuka-500 000 ngonyaka behlalwa khona isifo sofuba.
I-Post-Polio Syndrome
I-Post-syndrome ye-polio yinye igama okufanele lijwayele mayelana nokufunda i-polio.
Njengabantwana abaphulukisiwe emasimini bese bebeka ingozi yokuthuthukisa i-panbaphalitis ye-subacute sclerosing (SSPE), i-post-polio syndrome iyinkimbinkimbi yokuphela kwesifo sofuba.
Cishe ama-25 kuya ku-40% kulabo ababenesifo sofuba esingakwazi ukukhubazeka bangakwazi ukuthuthukisa izimpawu ezintsha eminyakeni engu-15 kuya kweyengu-20 kamuva. Izimpawu ze-post-polio syndrome zingabandakanya ubuhlungu obunzima bomzimba, ubunzima obuthakathaka bomzimba, ngisho nokukhubazeka okusha. Noma bangase babe nokwehla komfutho obuthakathaka odlule.
I-post-polio syndrome ayitholakali ngemuva kokuthola umgomo wokuphila ngepholio.
Okudingayo Ukukwazi Ngeliyoliyo
Ezinye izinto zokwazi mayelana ne-polio zihlanganisa ukuthi:
- Ukuhlanzeka kokuhlanzeka nokuhlanzeka kwendle akuzange kubangele ukuba ipholiyo ishabalale, njengoba ezinye izigameko zokulwa nomgomo ziphikisana. Esikhundleni salokho, isifo sofuba sashintsha kusuka efomini eliyingozi, ukutheleleka izingane eziningi lapho zisengumntwana futhi zilokhu zivikelekile kuma-antibodies omama, kwifomu lesandulela ngculazi, njengoba abantu abambalwa bevezwa futhi bahlakulela ukuzivikela ngesikhathi besencane.
- Kunezinhlobo ezintathu ze-serotypes ezihlukene ze-poliovirus zasendle (WPV). Isivikelo sokwemvelo sinikeza umkhuhlane wangempela ku-serotype ethize yesifo sofuba lapho usulele khona.
- Ukungcoliswa kwe-SV40 emitholampilo yokuqala ye-polio kusukela ngo-1955 kuya ku-1961 ayihlotshaniswa nobungozi bokukhula komdlavuza.
- I-schedule standard yokugoma ihlanganisa amanani amane wokugoma i-polio ezinyangeni ezimbili, izinyanga ezingu-4, izinyanga ezingu-6 kuya kwezingu-18, kanye ne-booster dose eminyakeni engama-4 kuya kwengu-6 ubudala.
- Isigameko se-Cutter sibhekisela enkingeni yokugoma i-polio eyakhiwe yi-Cutter Laboratories engazange igcinwe ngokuphelele, okwenza ukuthi ipholio elikhubazekile okungenani izingane ezingu-200 kanye nabangu-10 abafa ngo-1955.
- Kube okungenani amacala angu-73 e-poliovirus (i-iVDPV) ephuma emithini yokuvikela igciwane lesandulela-ngculaza ehlobene nomzimba, lapho umuntu one-immune disorder disorder eqhubeka nokuchitha i-poliovirus ngemuva kokugoma, ngokuvamile kuze kube izinyanga eziyisithupha. Ngisho noma kwaze kwaba sekuyisikhombisa kulezi zimo kuye kwaziwa ukuchitha igciwane iminyaka engaphezu kwemihlanu, kufaka phakathi eyodwa ene-common variable immunodeficiency (CVID) oye wachitha i-poliovirus esuselwe emitholampilo iminyaka engu-28, lokhu akucatshangwa ukuthi kuyindlela evamile ukusakaza igciwane lesifo sofuba kwabanye.
- Ngenxa ye-VAPP ne-VDPV, ekugcineni kuyoba isigaba somhlaba wonke sokuphuma komlomo wokugoma i-polio kanye nomshini wokugonywa okungekho emthethweni kuze kube yilapho isifo sofuba sichithwa ngokuphelele. Amazwe kaningi awashintshwanga ohlelweni lokugoma i-IPV kuze kube yilapho abonisa izinga eliphezulu lokugoma futhi ingozi yokungenisa ipholiyo yasendle iphansi. Futhi maduzane kuzoba ngumshini wokugoma komlomo we-polio (biopent oral oral vaccine) (bOPV), ukususa uhlobo lwe-2 lomgomo, ukunciphisa ingozi ye-VAPP ne-CVDPV. Ngo-May 2016, ukugoma komlomo we-polio (trivalent oral polio vaccine) (TOPV) ngeke kusetshenziswe, njengoba sizoshintshela ekusebenziseni i-IPV ne-BOPV.
- Ayikho imithi yokwelashwa.
- Ukwengeza kwesifo sofuba, ezinye izinhlobo ze-flaccid ukukhubazeka zibandakanya izifo ezingenayo i-enterovirus, ama-rabies, i-Guillain-Barre syndrome, ukutheleleka kwegciwane le-West Nile, i-myelitis eguquguqukayo, i-myasthenia gravis, njll. Ezinye izimbangela ze-flaccid ukukhubazeka zihlanganisa izimpawu nezinzwa noma noma ingahlukaniswa ne-poliyo ngezinye izindlela.
Okubaluleke kakhulu, yazi ukuthi ipholiyo iseduze nokuqedwa. Uhlobo olulodwa lwe-polio luhlala lukhona emazweni amathathu kuphela, e-Afghanistan, eNigeria nasePakistan, futhi amacala epholio asezingeni eliphansi. Kwakukhona kuphela amacala angu-359 wezifo zasendle ezithandwa yi-poliovirus emazweni angapheli nabangapheli ngo-2014. Okubaluleke nakakhulu, amacala e-polio ngonyaka ngonyaka ka-2015 angaphansi kwalokho ayekhona ngalesi sikhathi ngo-2014 nezinhlobo zegciwane lesandulela ngculazi 2 icala lalingu-1999) kanye no-3 (icala lokugcina lalingu-2012) ukuthi i-polio ibonakala iqedwe.
Funda . Thola igciwane . Misa iziqhumane.
Imithombo:
I-CDC. Izimpumelelo Zempilo Yomphakathi, 1900-1999 Impact of Vaccines I-Universities Iphakanyiselwe Izingane - United States, 1990-1998. I-MMWR. April 2, 1999/48 (12); 243-248.
I-CDC. I-Epidemiology nokuvimbela izifo ezivimbela ukugoma. I-Pink Book: I-Course Textbook - U-13th Edition (2015)
Iminyaka engamashumi amabili nesishiyagalolunye nesishiyagalolunye yokuphindaphinda kwe-Poliovirus ku-Immunodeficient Individual: Impact kwi-Global Polio Eradication Initiative. PLoS Pathog 11 (8): e1005114.
Imishanguzo (Umshicilelo Wesithupha)
Okude. Izimiso Nezenzo Zokugula Eziphathelene Nesifo Sezingane (Umqulu Wesine)