I-polio yisifo sasendulo.
Nangona i-epidemic ye-polio yangoku iyenziwa ukuba yenzeke ngowe-1887, xa iimeko ezingama-44 zabikwa eStockholm, eSweden, i-polio kungenzeka ukuba yayikude ngo-1580 BC.
Uhlobo lwe-enterovirus, i-polio ngokuvamile ibangela izifo ezingenazo iimpawu okanye iimpawu ezinzima kakhulu, kubandakanywa ne-fever low-grade fever kunye nesifo somqala.
Abanye abantwana banokuvelisa iimpawu ezinzima ezibangelwa yi- polio , nangona kunjalo, kubandakanywa nalabo abane:
- I-aseptic meningitis ye-aseptic - ine-fever-grade-grade-degree kunye nesifo somqala ngenxa yokuqina kwentamo, umva, kunye / okanye imilenze, kunye nokuvakalelwa okungavamile, okungahlala kwiintsuku ezi-2 ukuya kwi-10
- I-polio yokukhubazeka - ine-fever-grade-grade-degree kunye nesifo somqala, kwaye emva kweentsuku ezili-18 ukuya kwezi-18, ziyakhula ukunyuka kwama-reflexes, i-acoustic aches, ne-muscle spasms, elandelwa ngokunciphisa i-tendon ephazamisayo kunye ne-paralysis. Abanye bala bantwana banobuthathaka obungapheliyo kunye nokukhubazeka kunye ne-poalytic paralytic kubulala ubuncinane kwi-2 ukuya kwi-10% yamatyala.
I-polio yathintela phezulu kwi-United States ngowe-1952, xa kwakukho iziganeko ezingaphezu kwama-21,000 ze-polio yokukhubazeka.
I-United States ayikho i-polio yamahhala ukususela ngowe-1979. Ukugqitywa kokugqibela bekuphakathi kweqela elingaxelwanga lama-Amish kwiindawo eziliqela eMidwest.
Iipilisi zePolio
Kakade ke, kwakungokuphuhliswa kwezigulane zokuqala zepolisi ezaziye zayeka izifo zesifo se-polio emva kowe-1952 kwaye zisinceda siphumelele ukusasazeka kokusasazeka kwepolori.
Isitofu sokugonywa kwe-Salk, isitofu sokugonywa kwesifo se-polio esingazange senziwe, sasinelayisenisi ngo-1955. Oku kwalandelwa ukufakwa kwesitofu sokugonywa kwe-Sabin, ngomlomo, ukukhusela i-polio, ngo-1961.
Zogqirha zepolio zombini zazinamandla kunye nobuthathaka:
- Isitofu sokugonywa kwe-Sabin sinika i-immunity immunity to lifetime, kubandakanya ukukhulelwa kwamathumbu emathunjini, kunye nokutyhalaza kwintsholongwane ebuthakathaka (ephawulisiweyo), enokukunceda ekukhuselweni komzimba, kodwa isitofu singasabangela ukuba i-poliotic paralytic polio (VAPP) ne-poliotic derived polio
- Isitofu sokugonya iSalk sinika ukhuselo olukhulu kwi-polio emva kwezilwanyana ezintathu, ngokugqithiseleyo i-polio (i-immestinal immune), kwaye kungenjalo, kwaye ekubeni ingekho igciwane lokugonywa kwegciwane, ayikwazi ukubangela i-polio yokukhubazeka okanye i-polio efumaneka
Xa isitofu sokugonywa komlomo we-polio (ekhuselekileyo kuzo zonke iintlobo ezintathu zentsholongwane ye-polio) yaziswa ngo-1963, yatshintsha i-Salk vaccine e-US.
Inguqu ephuculweyo yeSigonyi ye-Salk yaqaliswa ngo-1987 kwaye yaqhubeka yokutshintshela ukukhuselwa komlomo kwipolio kumazwe amaninzi athuthukile aphelile i-polio ngenxa yexhala malunga ne-poalytic parliotic polio (VAPP).
Xa ukhangela amandla okugonywa komlomo we-polio, kodwa kulula ukubona isizathu sokuba sisetyenziswe xa uzama ukufumana i-polio yangaphandle phantsi kolawulo kwindawo. Ngokuqhelekileyo, ukugonya komlomo we-polio kuyinto ebizayo kwaye kulula kakhulu ukunika abantwana, kuba ayifuni ukudubula.
I-Vaccine-Associated Poliomyelitis
I-poliomyelitis echaphazelekayo yokugonywa (VAPP) ifumaneka xa i-stomavirus iphila ngokunyanga kwe-poliovirus ekutshintsheni komlomo we-polio kwaye idala umntu, okanye umnxibelelwano osondelene naye, ukuphucula iimpawu zepolio yokukhubazeka.
Utshintsho luvela emathunjini omntu ofumene ukugonya komlomo we-polio, ngokuqhelekileyo emva kwesosi sokuqala kunye nokuqhelekileyo kubantu abaneengxaki ze-immune system.
Ngethamsanqa, i-VAPP ayikhokelela ekugqibeleni kwe-polio kwaye inqabile kakhulu, kuvele emva kwe-1 kwi-2.7 yezigidi zezilwanyana zokugonya ngomlomo.
Sekunjalo, oko kwaphela njengeziganeko ezi-5 ukuya kwezingama-10 ngonyaka eMelika, kwaye emva kokuba i-polio isuswe e-United States, ubungakanani bengozi-nzuzo abayifumananga nentsholongwane yomlomo we-polio. Xa kuphela abantwana abafumana i-polio babefumana isifo sokugonywa kwesifo sokugonywa kwesifo sokugula, kwaba yithuba lokutshintshwa kwisitofu sokugonywa kwe-Salk.
UJohn Salamone waba ngummeli waloo tshintsho. Indodana yakhe, uDavid, yavelisa iVAPP emva kokufumana isitofu sayo sokugonywa ngeporiyo ngo-1990. Ngelo xesha, ukugonya komlomo we-polio kwakungumlinganiselo oqhelekileyo wehedyuli yokugonywa kwabantwana.
Ngaphambi kowe-1977, ingxelo ye-IOM "UkuVavanywa kweeVilisi zePoliomyelitis" yathi "iinqununu ezinhlanu ezikhethiweyo zenziwa iUnited States kumbandela we-60-70 wezinga lokugonya." Ezi zikhethi ziquka ukusetyenziswa kwe-OPV kuphela, i-IPV kuphela, kunye nokudibanisa zombini izitofu, njl. Izinga lokugonywa okuphantsi libonakala liyinxalenye enkulu ekuthinteleleni isinconywa ukuba ihambe ne-OPV kuphela ngexesha.
Njengoko ixesha lihamba, kwacaca ukuba ukutshintshela kwi-IPV kwakuyimfuneko, kodwa ukwesaba ukutshintsha inkqubo eyayisebenza ngokude kangangoko kwaye mhlawumbi ingaqiniseki ukuba umtshintshi, kubandakanya isidingo sokwandisa kakhulu ukunikezelwa kwesitofu esingagcini kwixesha elifutshane elifutshane, kugcinwe iingcali zempilo ukuba zenze kube ngo-1997. Ishedyuli yokugonywa kwe-IPV / OPV echanekileyo yatshintshwa ngokutshintshiweyo ibe yiprogram yokugonya yonke i-IPV ngo-2000.
I-Poliovirus echithwe yi-Vaccine
Nangona livakala ngathi lifana neVAPP, iintlobo ze-poliovirus ezifumaneka kwi-vaccine ziyahluke kakhulu.
Umgudu we-poliovirus (VDPV) osuselwe kwi-vaccine (i-VDPV) uphinde uxhomekeke kwiinguqu ze-genetic kwi-strovirus (i-atttenuated).
Ezi ziqhekeza okanye ukujikeleza iintlobo ze-poliovirus ezifunyenwe ngophilo (i-cVDPV) ngenhlanhla kunqabile kakhulu. Xa zivela, kuba abantu abaninzi kuluntu abagonyanga ukulwa nesifo se-poliyo, njengoko izinga eliphezulu lokugonya likhusela i-cVDPV, njengokuba zikhusela imimandla ye-poliovirus yasendle.
Ukugqitywa kwangoko kwe-poliovirus etholwe ngophilo kuye kwenzeka:
- Mali
- Yukreyini
- Nayijeriya
- Madagaska
Kubalulekile ukukhumbula ukuba nangona iimeko zepolisi ezingama-580 zenzeke emva kokuphazamiseka kwezi-20 ze-cVPDV emhlabeni jikelele ukususela ngo-2000 ukuya ku-2011 kwaye kwakukho iziganeko eziyi-15 500 ze-polio ekhubazekayo ngelo xesha, isitofu sokugonywa kweporiyo ngokwayo sathintela iimeko ezingaphezu kwezigidi ezi-5 ze-polio ekhubazekayo!
Ngokuqinisekileyo, ngaphandle kwezigulane ze-polio, asiyi kuba ne-VAPP, i-VDPV, kunye ne-CVDPV, kodwa siza kubuyela kwiintsuku apho abantu abangaphezu kwama-500,000 ngonyaka bahlakulela i-poalytic polio.
I-Post-Polio Syndrome
I-Post-polio syndrome yenye yekota ukuba uyazi malunga nokufunda i-polio.
Njengabantwana abayifumana kwi-measles kwaye banomngcipheko wokwenza i-panencephalitis ye-sclerosing sclerosis (SSPE), i-post-polio syndrome yinkxalabo yexesha elide.
Phantse kwi-25 ukuya kwi-40% yabantu ababenesifo sokukhubazeka besifo se-polio bangakwazi ukuvelisa iimpawu ezintsha ukuya kwi-15 ukuya kwiminyaka engama-20 kamva. Iimpawu ze-post-polio syndrome zingabandakanywa iintlungu ezintsha ze-muscle, ubuthathaka obuthathaka obutsha, kunye nokukhubazeka okutsha. Okanye mhlawumbi banokudakalisa kobuthathaka obuthathaka bokugqibela.
I-Post-polio syndrome ayifuni emva kokufumana isitofu sokugonywa kwepholio.
Oko Kufuneka Ukwazi NgePolio
Ezinye izinto ezaziyo malunga nepoliyo ziquka ukuba:
- Ukuphuculwa kokucoceka nokucoceka akuzange kubangele ukuba i-polio iphele, njengoko ezinye i- anti-vaccine i-theorists iphikisana. Endaweni yoko, i-polio yatshintshile ukusuka kwifom yesifo esipheleleyo, ixhaphaza abantwana abaninzi xa beyiintsana kwaye isakhuseleka kubantwana basetyhini, kwifomu yesifo, njengabantu abambalwa abaye bavezwa baze bahlaselwa xa bebancinci.
- Kukho ama-serotypes ahlukeneyo e-poliovirus zasendle (WPV). Ukuzikhusela komzimba kubonelela nge-immortality kwi-serotype ethile yecolio apho usulelekileyo.
- I-SV40 ukungcola kwiipilisi zokuqala zepolisi ukususela ngo-1955 ukuya ku-1961 ayihambelani nomngcipheko wokwanda komhlaza.
- Ishedyuli esifanelekileyo yokugonywa kubandakanya izilingo ezine zokugonya i-polio ezinyangeni ezi-2, inyanga ezi-4, iinyanga ezintandathu ukuya kwezi-18, kunye ne-booster dose eminyaka emi-4 ukuya kwe-6 ubudala.
- I-Cutter Incident ibhekisela kwingxaki yokugonywa kwe-polio eyenziwe yi-Cutter Laboratories engazange ifakwe ngokupheleleyo, eyenza i-polio yokukhubazeka ebantwaneni abangama-200 kunye nokufa kwe-10 ngo-1955.
- Kukho ubuncinane iimeko ezingama-73 ze-poliovirus (iVDPV) echaphazelekayo-immune-immune-related derivatives (iVDPV), apho umntu onesifo esingaqhelekanga sokuzikhusela nge-immune aqhubeka egawula i-poliovirus emva kokugonywa, ngokuqhelekileyo ukuya kwiinyanga ezintandathu. Nangona ukusa kwiingxaki ezisixhenxe kulezi ziganeko ziye zaziwa ukuba zitshabalalise intsholongwane kwiminyaka engaphezu kwemihlanu, kubandakanywa ne-immunodeficiency (e-CVID) efana neyodwa eye yachitha i-poliovirus efunyenwe ngophiloyiminyaka engama-28, oku akucingelwa ukuba yindlela eqhelekileyo ukusasaza isifo sengculazi kwabanye.
- Ngenxa ye-VAPP kunye ne-VDPV, ekugqibeleni kuya kubakho i-phase-out out of the oral vaccine vaccine kunye nokutshintshwa kwi-vaccin ye-polio engenakusebenza kuze kube yilapho ipholio ichithwa ngokupheleleyo. Amazwe aqhelekanga atshintshe kwishedyuli yonke ye-IPV kuze kube yilapho ebonisa izinga eliphezulu lokugonya kunye nomngcipheko wokungenisa i-polio yasendle. Kwaye kungekudala kungekudala ukutshintshwa kwesigodlo somlomo we-polio (bOPV), ukususa uhlobo lwe-2 lwesigontsho, ukunciphisa umngcipheko we-VAPP kunye ne-CVDPV. Ngo-Meyi 2016, ukugonya komlomo we-polio (tOPV) yomlomo oyisisigxina angeke isetyenziswe, njengoko siza kutshintsha ukusetyenziswa kwe-IPV kunye ne-BOPV.
- Akukho nonyango yepolio.
- Ukongezelela kwipolio, ezinye iintlobo zesifo sokukhubazeka esichukumisayo siquka izifo ezingenalo i-enterovirus, i-rabies, i-Guillain-Barre syndrome, izifo zentsholongwane yase-West Nile, i-myelitis ehamba phambili, kunye ne-myasthenia gravis, njl. nangona okanye ingahlula kwi-polio ngezinye iindlela.
Okubaluleke kakhulu, yazi ukuba i-polio isondele ekuphelisweni. Uhlobo lwe-polio olu-1 luhlala luphela kumazwe amathathu kuphela, i-Afghanistan, iNigeria ne-Pakistan, kwaye iimeko zepolisi zihlala phantsi. Kwakukho iziganeko ezingama-359 zezifo zasendle zasendle ezisemgangathweni nakumaxesha angapheli ngo-2014. Okubaluleke nakakhulu, iimeko ze-polio zangonyaka ngo-2015 zingaphantsi kwezinto ebezikho ngeli xesha ngo-2014 kunye neentsholongwane zentsholongwane 2 (ekugqibeleni ityala lalingu-1999) kunye ne-3 (ityala lokugqibela lalingu-2012) i-polio ibonakala ichithwe.
Ufunde. Gonyelwa . Yeka i ziqhwithi.
Imithombo:
CDC. Iimpumelelo kwiMpilo kaRhulumente, 1900-1999 Impembelelo yeeNtsholongwane eYunivesithi ephakanyisiwe kubantwana-e-United States, ngo-1990-1998. MMWR. Aprili 02, 1999/48 (12); 243-248.
CDC. I-Epidemiology kunye noKhuselo lweZilwanyana eziVimbelayo. Incwadi ethi Pink: I-Course Bookbook - I-13th Edition (2015)
UDunn G. Iminyaka engamashumi amabini anesibhozo wePoliovirus Replication kwi-Immunodeficient Individual: Impembelelo kwi-Global Polio Eradication Initiative. I-PLoS iPathog 11 (8): e1005114.
Iigcini (iNgqungquthela yesithandathu)
Ende. Iimigaqo kunye nokuSebenza kwezifo ezithathelwanayo (IiNtsholongwane ezine)