Izifo ze-Epidemics nokuqhekeka kwezifo ezivimbela ukugoma

Imishanguzo yenze umsebenzi omuhle wokulawula izifo emazweni athuthukile, njenge-United States, ukuthi ngezinye izikhathi abazali bakhohlwe ukuthi kubaluleke kangakanani nokuthi ukuphila kuzoba njani ngaphandle kwabo.

Imishanguzo yamanje kanye nezinhlelo zokugoma ezidlule manje zilawulwa izifo eziyishumi eziyisifo esithathelwanayo.

Ngeshwa, asikho sonke esiphila esikhathini esilandelayo sokugoma.

Izifo ezivimbela ukugoma e-Post-Vaccine Era

Ngaphandle kwesibhukela, izifo eziningi zisatshalaliswa ezweni lesithathu nakumazwe asathuthuka, okusho ukuthi kubuya noma kuphi lapho imithi iqala ukubambezeleka noma yokuma. Emhlabeni wonke, i-World Heath Organisation ibika ukuthi kuqhubeka nokugula okuningi okungabantwana kusukela kulezi zifo ezivimbela ukugoma, kuhlanganise:

Senza intuthuko nakuba. I-CDC ilinganisela ukuthi emhlabeni wonke, "ukubulawa kwabantu abayizigidi ezingu-13,8 kuvinjelwe ukugoma isisemungeni ngesikhathi sika-2000-2012" futhi sesiseduze nokuqeda udoli.

I-polio manje isendaweni emazweni amabili nje kuphela - i-Afghanistan ne-Pakistan.

Izifo ze-Epidemics nokuqhekeka kwezifo ezivimbela ukugoma

Izifo zamasifo manje ezivimbela ukugoma zivame kakhulu. Eqinisweni, izifo zesimungumane zenzeke imijikelezo emibili kuya kwemihlanu e-United States, ezithinta abantu abangu-200 000 kuya ku-500,000.

Nakuba amasosha omzimba asetshenziswe kakhulu e-United States, amanye amacala angeniswa avela kwezinye izingxenye zomhlaba. Lokhu kungenxa yokuthi imingqimba ihlala iyimbangela yokufa kwezingane ezincane emhlabeni jikelele.

Ngisho namanani aphansi noma engekho amathonya amaningi, njengama-measles, i-polio, kanye ne-diphtheria e-United States, abazali akufanele bakhohlwe ukuthi lezi zifo nje ukugibela indiza kude nengane yakho. Yile ndlela eyaqala ngayo i-California California Measles Outbreak ekuqaleni kuka-2008 - ingane engavunyelwe eya eSweden yavezwa yisimungumzimba, yagula futhi yabaningi izingane ezinesandulela ngculazi.

Ukuthi lezi zifo zingasakazeka kanjani masinyane futhi ziqokonyiswe ezinye iziqhumane zamuva kanye nezifo eziwumshayabhuqe:

I-Diphtheria

I-Diphtheria yisifo esivimbela ukugoma esibangwa yi- Corynebacterium diphtheriae bacteria. Izimpawu zingabandakanya umkhuhlane, umphimbo womsindo, nephunga eligijima, futhi lingafana nomkhuhlane ovamile. Ama-bacterium e-diphtheria angaveza i-toxin engabangela i-membrane elimhlophe elimhlophe, elingahamba, ukuze lenze umphimbo womuntu onegciwane. Bangakwazi futhi ukuthuthukisa "ukubukeka kwentamo" ngoba izigqoko entanyeni ngoba zanda kakhulu.

Ukutheleleka okunjengemisindo efana ne-strep throat kwi-steroids, futhi akuyona neze into oyifunayo ukuthi izingane zakho zizithole, ikakhulukazi ngoba ezinye zezinkinga zihlanganisa i-myocarditis (ukuvuvukala kwenhliziyo), ukuvinjelwa kwamanzi, i-coma, nokufa. Eqinisweni, abantu abayi-5% kuya kwezingu-10% abangenagciwane abane-diphtheria bafa.

Nakuba manje sekukhona ambalwa amacala okuphefumula e-United States, ngaphambi kokuba umgomo wokugoma nomjovo we-diphtheria (i- D emgodini wokugoma we- D TaP), owaqala ngawo-1920, kwakukhona amacala angaphezu kuka-125 000 nokufa kwabantu abangu-10 000 ngonyaka.

Haemophilus influenzae uhlobo b

Abantu bavame ukudidisa ukutheleleka kwe-bacteria ngogubhu, kodwa empeleni akuhlangene nethonya lomkhuhlane ngaphandle kokuthi okokuqala kutholakala ngesikhathi sesifo sofuba.

I-Haemophilus influenzae hlobo b (Hib), ngaphambi kokusetshenziswa komuthi wokugonywa kwe-Hib njalo, ngaphambi kokusetshenziswa komuthi wokugonywa kwe-Hib, kwakuyimbangela evamile ye-bacterium meningitis futhi yayiyimbangela evamile ye-bacterium (ukutheleleka kwegazi), i-pneumonia, ne-endocarditis (ukutheleleka kwamagagasi enhliziyo ). I-Hib ingabangela nokutheleleka kwamagciwane kwezinye izingxenye zomzimba, kufaka phakathi i-cellulitis (izifo zesikhumba), isifo samathambo esithathelisayo (izifo ezihlangene), kanye ne-osteomyelitis (izifo zamathambo).

I-Epiglottis, enye ingculaza engabangelwa amagciwane e-Hib, yisimo esiphuthumayo sezokwelapha esasatshiswa odokotela nabazali, njengoba izingane ezikhungathekile zidinga ukwelashwa okusheshayo nokuzikhandla ukuze kube khona ithuba lokuphila.

Ngaphambi kokusebenzisa umuthi wokugoma waseHib ngo-1988, izingane ezingaba ngu-20 000 zazinokutheleleka kwe-Hib ngonyaka, kuhlanganise namacala angu-12 000 we-bacterial meningitis. Izinkinga zokuba ne-meningitis zingase zibe nzima, zithinta izingane ezingaba ngu-30%, futhi zibandakanya izithulu, ukugunjwa, ukuphuphuthekisa nokuphuza kwengqondo. Futhi izingane ezinama-5% ezine-bacterial meningitis ezibangelwa amabhaktheriya aseHib zafa.

Izisulu

Ama-measles yisifo sokutheleleka ngegciwane lesandulela ngculazi. Ngaphambi kokugonywa kwesimungumungqangi ejwayelekile e-United States kwaqala ngo-1963, kwakukhona amacala angaba yizigidi ezingu-4 eziyisimungumungwane ngonyaka.

Ngeshwa, izingane ezingamaphesenti angama-20 ezinesifo semigungulu ziyoba nezinkinga, kufaka phakathi izifo zendlebe (10%), i-pneumonia (5%), ne-measles encephalitis (0.1% noma 1 ku-1,000). I-encephalitis ukuvuvukala kobuchopho obungabangela ukugubha, ukuzwa isisulu nokulimala kwengqondo.

Okubaluleke kakhulu, cishe ku-1 kuya kwezingu-3 kuzo zonke izimpikiswano eziyi-1000 zemigqomo ziholela ekufeni.

Ngenxa yokuthi isandulela kakhulu, kusekhona inkinga ezinxenyeni eziningi zomhlaba, kanti abanye abazali basakhathazeka ngokuphepha komgomo we-MMR kanye nezixhumanisi ezibangelwa i-autism, ochwepheshe bezempilo baqaphele ukuhlolwa kwesimungumungwane uma kwenzeka ukugonywa kwezinga lokugoma .

Ama-Mumps

Amagundane uhlobo lwe-parotitis (ukuvuvukala kwe-gland parotid) ebangelwa i-paramyxovirus. Izinkinga zingase zibandakanye i-meningitis, i-encephalitis, i-orchitis (ukuvuvukala kwama-ovari noma amathemikhali), i-pancreatitis, ne-myocarditis.

Ngaphandle kokuvunguza kwamaphutha ngezikhathi ezithile, ama-mumps manje ayatholakali e-United States. Umuthi wokugoma wamathambo waqalwa ngo-1968 futhi waqala ukusetshenziselwa njalo ngo-1977 (yi-M ephakathi kokugonywa kwe-M M R).

Emhlabeni wonke, kwakukhona izigameko ezingaphezu kuka-400 000 ngonyaka ka-2006.

I-Pertussis

I-Pertussis, noma ukukhwehlela okukhwehlela, ibangelwa amabhaktheriya e- Bordetella pertussis . Nakuba manje kuhlotshaniswa nokubangela ukukhwehlela, ukukhwehlela okuqhubekayo kwentsha kanye nabantu abadala, kubalulekile ukukhumbula ukuthi i-pertussis yayisetshenziswa njengenye yezimbangela ezibangela ukufa ngenxa yezifo ezinganeni. Eqinisweni, ngaphambi kokuba kusetshenziswe umuthi wokugoma we-pertussis ngawo-1940, cishe eyodwa kwezingu-750 izingane zase-United States zizofa kusukela ku-pertussis unyaka ngamunye.

Izinkinga ze-pertussis izifo zihlanganisa ukugwinya, ukuphazamiseka kwe-pneumonia, i-apnea, i-encephalopathy (ishintshe isimo sengqondo), futhi kufike ku-1% wezinsana ezithathelelekile empeleni zifa kusuka ku-pertussis.

Ngokungafani neminye yezinye izifo ezivimbela ukugonywa, kuqhubeka kube namacala angaba ngu-5 000 kuya ku-7 000 we-pertussis minyaka yonke e-United States. Lokhu kungenxa yokuthi ukugonywa okuvela emithonjeni ye-childhood pertussis (i-aP ku-DT aP vaccine) ngokuvamile igqoka emva kweminyaka emihlanu kuya kweyishumi, ngakho-ke intsha kanye nabantu abadala bangathola i-pertussis bese beyidlulisela kubantwasana kanye nezingane ezingakapheli imishanguzo yabo ye-pertussis okwamanje. Ukunconywa kwe-booster dose ( Tdap ) eneminyaka engu-12 kufanele kusize ukulwa nalezi zifo ezithinta i-pertussis nakuba kunjalo.

Ipholiyo

Nakuba abantu bengasaboni ucingo nge-polio futhi abanye bacabanga ukuthi sekuqedile kakade, kwakukhona amacala angaphezu kuka-2 000 we-polio emhlabeni wonke ngo-2006. Amacala amaningi manje agxile emazweni ambalwa nje, kufaka phakathi i-Afghanistan nePakistan, lapho kusengapheli.

Ngaphambi kokugonywa kwepholio kwaqala ukusetshenziswa ngo-1955, ukuqubuka kwepholi kwakuvame kakhulu e-United States. I-polio ibangelwa igciwane kanti nakuba izingane eziningi ezithathelwanayo azihlaziyi izimpawu, cishe ku-1 kwabangu-200 abanesandulela ngculazi yokukhubazeka. Abaningi balaba bantwana banokukhubazeka okungapheli futhi ama-5 kuya ku-10% awasaphila.

Ngesikhathi ukuqhuma okuvamile e-United States, kwakukhona amacala angaba ngu-21 000 we-polio yokukhubazeka unyaka ngamunye. Abazali besaba ipholio kangangokuthi amachibi okubhukuda nezindawo zokudlala ezivame ukuvalwa ngesikhathi sehlobo lapho kunezifo eziwumshayabhuqe.

Imikhankaso yegciwane lokugoma emazweni ambalwa asele lapho udoli kuyinkinga futhi waqhubeka nokugoma kuzo zonke ezinye izingxenye zomhlaba kufanele maduzane usho ukuthi umgomo wokuqeda udoli kuyinto engokoqobo.

I-Rubella

I-Rubella ibizwa nangokuthi isisimane saseJalimane noma "isisindo seminyaka emithathu" futhi ngokungafani nezinye izifo ezithintekayo zokugoma, lesi sifo segciwane ngokuvamile sihle kakhulu. Eqinisweni, abantu abaningi abane-rubella abanayo ngisho nezimpawu. Bonke abanye bane-lymphadenopathy (izigulane ezivuvukala), umkhuhlane we-rash, ne-low-grade fever ngokuvamile ohlala izinsuku ezintathu.

Uma i-rubella imnene, kungani sidinga umuthi wokugubha?

Isizathu esiyinhloko ukuthi abantwana abangaba ngu-80% ababelethwe omama abanesibelera ngesikhathi sokuqala kokukhulelwa kwabo bavame ukuhlakulela i-rubella syndrome yesifo sofuba, futhi kube nengozi yokukhulelwa kwesisu. Lezi zingane zivame ukuzalwa ngezifo eziningana zokuzalwa, kuhlanganise ne-cataracts, isithulu, i-glaucoma, ukukhubazeka kwenhliziyo, isifo sofuba, isisindo sokuzalwa esincane, ukuphuza kwengqondo, i-microcephaly (ikhanda elincane), ne-thrombocytopenic purpura (inani eliphansi leplatelet egazini labo).

Ngesikhathi i-rubella isuka ku-1964 kuya ku-1965, kwakukhona amacala angaba ngu-20 000 we-rubella syndrome engavamile. I-Rubella manje ayitholakali e-United States kusukela kokusungulwa komuthi wokugoma ka-rubella ngo-1969 (kuyingxenye yokugonywa kwe-MM R ), kodwa kuseyiyinkinga emhlabeni wonke, ngamacala angaphezu kuka-250 000 ngo-2006.

I-Tetanus

Abazali abaningi bahlobanisa i-tetanus nge "lockjaw" futhi badinga ukudubula i-tetanus uma uhamba ngesivinini esinomsoco.

Ukwelashwa kwezinsana (i-neonatal tetanus enegciwane lesandulela ngculaza) elisetshenziselwa ukuthi lube uhlobo oluvame kakhulu lokutheleleka kwe-tetanus futhi lwalubucayi kakhulu, kwaze kwafa izingane ezingu-95%. Lezi zifo zase zilokhu zihla uma umuthi wokugoma we-tetanus usungulwa ngo-1938 nakuba ngenxa yezimo ezithuthukisiwe zokulethwa kanye nokuhlanzeka.

I-tetetus ibangelwa yi-toxins eyenziwa yi- Clostridium tetani bacteria. Ama-spores we- C. tetani amabhaktheriya avame ukutholakala enhlabathini nasemathunjini ezilwane eziningi. Izinhlamvu zingangcolisa kalula ukusikeka, ama-scrapes, nezinye izilonda - amanxeba angcolile kakhulu.

Ngokungafani nezinye izifo ezivimbela ukugoma, i-tetanus ayithelelanga.

Ukuhlanzeka okuhle nokuqhubeka nokugoma nomuthi wokugoma i-tetanus (i- T emijondolo ye-D T aP no- T dap) iholele emazingeni aphansi we-tetanus e-United States. Kusengenkinga enkulu emhlabeni wonke.

Ezinye izifo ezikhuselweyo ezigulayo

Ngaphandle kwezifo eziyi-10 ezinkulu eziye zanqotshwa noma zilawulwa kahle e-United States ngemigomo, ochwepheshe bezempilo basasebenza ekuqedeni abanye ngemishanguzo emisha.

Lezi zihlanganisa amagciwane namagciwane aguqukayo noma afaka izinhlobo eziningana zokugoma, kodwa asizange aqede izifo ngokuphelele. Lokhu kuhlanganisa umgomo wokugoma, okumele unikezwe unyaka ngamunye, imishanguzo ye-pneumococcal, i-meningococcal, kanye ne-rotavirus, eqondisa kuphela izinhlobo ezithile zamabhaktheriya namagciwane, nezinkukhu ze-inkukhu, i-hepatitis B, nemithi ye-hepatitis A engakaze unikezwe abantu abanele ukuqeda lezi zifo.

Ngeshwa, kunezifo eziningi zokubulala izingane ezingenayo imishanguzo okwamanje, njenge-malaria (ngaphezu kuka-850,000 ukufa ngonyaka ngamunye), isifo sofuba (450,000 ukufa ngonyaka), kanye ne-HIV / AIDS (abangaphezu kuka-320 000 abafa ngonyaka ngamunye).

> Imithombo:

> Plotkin: Imishanguzo, 4th ed.

> Mandell, Bennett, & Dolin: Izimiso Nemikhuba Yezifo Eziphathekayo, 6th ed.

> Isikhathi eside: Izimiso Nezenzo Zezifo Ezithathelwanayo Zengane, 2 ed.

> I-Gershon: Izifo Zokuhlukunyezwa Zasezingane zikaKrugman's, 11th ed.

> Kliegman: uNelson Textbook of Pediatrics, 18th ed.

> CDC. Ukugonywa Okukuvimbela Ukufa kanye neMbono Wokugonywa Emhlabeni Wonke, 2006--2015. I-MMWR. Ngo-Meyi 12, 2006.

> CDC. I-Diphtheria e-Former Soviet Union: Ukuphindwa kwesifo sofuba. Izifo Ezithathelwanayo Ezikhulayo. Disemba 1998.

> Izitshalo ziqhamuka eDublin, 2000. UMcBrien J - I-Pediatr Infect Dis J - 01-JUL-2003; 22 (7): 580-4.

> Izifo ezivimbela izifo: imibono yamanje kumongo womlando, Ingxenye I. Weisberg SS - Dis Mon - 01-SEP-2007; 53 (9): 422-66.