Mishonga yakaita basa rakanaka rakadai rekudzora zvirwere munyika dzakabudirira, dzakadai seUnited States, izvo vabereki dzimwe nguva vanokanganwa kuti zvakakosha sei uye kuti upenyu hunenge hwakaita sei pasina ivo.
Mazuva ano zvirwere uye mapurogiramu apamberi ekudzivirira zvino ave achitungamirira zvirwere gumi zvinotapukira.
Zvinosuruvarisa, isu hatisi vose tinorarama munguva yekuzorora-nguva.
Chirwere-Kudzivirirwa Zvirwere mu Post-Vaccine Era
Kunze kwechibhokisi, zvirwere zvakawanda zvichiri kuwanda munyika yechitatu uye nyika dzichiri kusimukira, zvinogona kureva kudzoka kupi zvako apo zvirwere zvinotanga kunonoka kana kumiswa. Munyika yose, World Heath Organisation inoshuma kuti ikoko inopfuurira kune zvirwere zvakawanda zvevana kubva kune zvirwere-zvinodzivirirwa, kusanganisira:
- diphtheria - madzimai 4,489 uye kufa 2 500 (2011)
- Haemophilus influenzae rudzi b b - kufa kwevakafa 199 000 (2008)
- masero - 122 000 vakafa (2012)
- makumbo - kupfuura 680 000 mhosva muvana nevakuru (2012)
- neonatal tetanus - 59,000 vakafa (2008)
- pertussis - 195,000 vakafa (2008)
- pneumococcal disease - 476 000 vakafa (2008)
- poliomyelitis - chete 404 mhosva muna 2013
- rotavirus - 453,000 vakafa (2008)
- rubella - dzinenge mazana matatu emawere emubereki anonzi rubella syndrome (2012)
- rubella - kupfuura 94,000 maitiro e rubella (2012)
- chibhokisi (rakaparadzwa munyika yose muna 1980)
- Tetanus - 63 000 vakafa (2008)
- yellow fever - 130,000 mhosva uye 44 000 vakafa (2013)
Tiri kufambira mberi kunyange zvakadaro. ICDC inofungidzira kuti pasi pose, "inofungidzirwa kufa kwemamiriyoni 13,8 yakadzivirirwa nehutachiona kupora munguva yeJ22" uye isu tave pedyo nekugumisa poriyo.
Polio ikozvino inowanikwa munyika mbiri chete - Afghanistan nePakistan.
Epidemics uye Kubuda Kwechirwere-Zvidzivirirwa Zvirwere
Epidemics yezvino zvirwere zvinodzivirirwa zvirwere zvaimbova zvakajairika. Kutaura zvazviri, zvirwere zvemasero zvakamboitika mumakore maviri kusvika mashanu kumakore emakore muUnited States, zvichikonzera 200,000 kusvika 500 000 vanhu.
Kunyange zvazvo masikisi yakanyanya kuparadzwa muUnited States, mamwe maitiro anotengeswa anobva kune dzimwe nzvimbo dzenyika. Izvozvo ndezvokuti masero anoramba ari chikonzero chinotungamirira chekufa kwevana vaduku pasi rose.
Kunyangwe nematengo akadzikisa kana asingasviki evanhu vazhinji vane zvirwere, semasero, poriyo, uye diphtheria muUnited States, vabereki havafaniri kukanganwa kuti zvirwere izvi zvinongova kungofambisa ndege kubva kumwana wako. Ndiwo mavambo ekutanga kweCentral California Measles Outbreak akatanga - mwana asina kusununguka uyo akaenda kuSweden akaonekwa kuti ane maserosi, akarwara, uye akawana vamwe vana vakawanda vane utachiona hwehushuga.
Kungokurumidza kukura kwezvirwere izvi zvinogona kupararira zvakasimbiswawo nezvimwe zviitiko zvangobva kuitika uye zvirwere:
- Mutengo we diphtheria, pertussis, uye maserosi yakawedzera zvikuru mushure mekuparara kweSoviet Union semishonga yakava isina kuwanikwa muRussia uye imwe iyo Newly Independent States. Ichokwadi, maitiro e diphtheria akasvika pakukura kwemahara kusvika muna 1995 uye paive nevanofa vanopfuura 4 000 panguva yekubuda.
- kubuda kwemasero muIreland mugore ra2000 mushure mekushandiswa kwemuitiro weMMR vachengeti yakakonzerwa nekuda kwekuchengetedzwa kwekuvhara ropa, zvichiendesa kumhosva 1407 uye kugamuchira vana 111 kuchipatara. Kunyanya pamusoro pezvo, 13 vevana vakanga vachirwara zvikuru zvokuti vaifanira kubvumirwa kune imwe nzvimbo yezvokuchengetedza, mairi manomwe aiva nemagetsi ventilator kuti avabatsire kufema, uye vana vatatu vakafa.
- kuwedzera kwemaronda emasero muEurope, kusvika kusvika 30 000 muna 2011, izvo zvakaita kuti vanhu vasati vafa, makumi maviri nemakumi maviri nemakumi maviri emakemikari encephalitis, uye mapeji 1,482 echirwere. Zviitiko zvakawanda zvakanga zvisingabvumirwi (82%) kana zvisina kukwana vaccided (13%) vanhu, mushure mekuderedza kushandiswa kwemishonga yeMMR nekuda kwekunetseka pamusoro pekukwanisa kusanganiswa ne autism.
- polio inoputika muNetherlands (1992) uye United States neCanada pakati pevanhu veAmish (1978) - vose pakati pevanhu vasingazivikanwi.
- pertussis kuputika muJapan (1979) neSweden (1983) mushure mekudzivirira kwehutano kwakaderera uye zvakaita kuti kufa kwevana 41 muJapan gore iroro.
- chirwere chinoputika muNetherlands (1999 kusvika muna 2000) pakati pevanhu vakawanda vasina kudzivirirwa, izvo zvakaguma nematambudziko 3 292 emasikisi, 72 hospitalizations, uye 3 kufa.
- rubella dambudziko muna 1991 pakati peAmish muPennsylvania, avo vaiva nehutachiona hwekudzivirira mazamu, vakatungamirira kuvakadzi 95 vane pamuviri vachiwana rubella, zvinokonzerwa ne 9 miscarriages uye 11 matambudziko e congenital rubella syndrome.
- muJapan muna 2013, paiva nezviitiko 14,357 zveRubella pamwe nematambudziko anokwana makumi matatu nemakumi matatu emusana we congenital rubella syndrome.
Diphtheria
Diphtheria chirwere chinodzivirirwa chinokonzerwa neCorynebacterium diphtheriae mabhakitiriya. Zviratidzo zvinogona kusanganisira fivhiri, kurwadziwa kwehuro, uye mhepo inoputika, uye inogona kufanana nehuwandu hwehutano. Iyo diphtheria mabhakitiriya inogona kubudisa tsvina inogona kukonzera mutsvuku wakachena, iyo inokwanisa kubuda, kuumba kune munhu ane hutachiona hwehuro. Vanogonawo kukura "hutsi hwenyoka" chitarisiko nokuti glands mumutsipa nokuti yakawedzera.
Utachiona hunoita semanzwiro akaita setip throat on steroids, uye hachisi chinhu chaunoda kuti vana vako vawane, kunyanya sezvo zvimwe zvezvinetso zvinosanganisira myocarditis (kuvhiringidza mwoyo), kudzivirira kwepamugwagwa, coma, uye rufu. Kutaura zvazviri, 5 kusvika ku10% yevanhu vasina kuvharwa vane diphtheria vanofa.
Kunyange zvazvo mava nemapoka mashoma ekudzidzira diphtheria muUnited States, vasati vagara vachipemha nemushonga we diphtheria (D muD DPP vachengeti), iyo yakatanga muma1920, kwaiva nezviuru zvinopfuura 125 000 uye zviuru gumi zvakafa gore negore.
Haemophilus influenzae b
Vanhu vanowanzovhiringidza mabhakitiriya ane hutachiona nehutubu, asi chaizvoizvo harina chokuita nefivha kunze kwekuti yakatanga kuwanikwa munguva yehosha yehosha.
Haemophilus influenzae gwaro b (Hib), kusati kwaro kushandiswa kwechirwere cheHib, chaiva chikonzero chinowanzokonzera bhakitiriya meningitis uye chaive chikonzero chinowanzokonzera bacteremia (hosha yeropa), pneumonia, uye endocarditis (utachiona hwevhavha yemoyo ). Hib inogonawo kukonzera zvirwere zvebhakitiriya kune dzimwe nzvimbo dzomuviri, kusanganisira cellulitis (zvirwere zveganda), suppurative arthritis (maswere anokonzerwa), uye osteomyelitis (bone zvirwere).
Epiglottis, imwe hutachiona hunogona kukonzerwa nehutachiona hweHib, hurumende inotyisa inotyisirwa navanachiremba nevabereki, sezvo vana vakagadzikana vaida kurapwa nokukurumidza uye nyanzvi yekurapa mukana wekupona.
Pasati purogiramu kushandisa chirwere cheHib muna 1988, vanenge 20 000 vana vaiva nehutachiona hweHib gore roga rega, kusanganisira 12 000 matambudziko eBacterial meningitis. Zvinetso zvekuva meningitis zvinogona kuva zvakanyanya, zvinokanganisa nevana makumi matatu zvevana, uye zvinosanganisira matsi, kugunun'una, kupofumadza, uye kuora mwoyo kwepfungwa. Uye vanenge 5 muzana yevana vane bhakitiriya meningitis iyo yakakonzerwa nemabhakitiriya eHib vakafa.
Measles
Measles inorwarisa utachiona husingaperi. Pasati purogiramu masero ekuzvidzivirira yakatanga muUnited States yakatanga muna 1963, pakanga paine mamiriyoni mana ematambudziko emasese gore negore.
Uye zvinosuruvarisa kuti vanenge makumi maviri kubva muzana vevana vaiva nemasikisi vaizove nezvinetso, kusanganisira mawere ekutambudzika (10%), pneumonia (5%), uye masero encephalitis (0.1% kana 1 mu1000). Encephalitis ukuputika kweuropi kunogona kukonzera kukanganisa, matsi, uye kuora kwepfungwa.
Chinonyanya kukosha, inenge 1 kusvikira ku3 kubva pamakironi ane chiuru emasero anoguma murufu.
Nemhaka yokuti inopararira zvikuru, ichiri dambudziko rakawanda munzvimbo dzakawanda dzenyika, uye vamwe vabereki vachiri kunetseka nezvekuchengetedzwa kwemukoko weMMR uye zvingave zvakasungirirwa ku autism, nyanzvi dzehutano dzinorinda maserosi inouya kana .
Mumps
Mavhinga ndiwo maitiro eparotitis (kuvhiringidza kweganda parotid) inokonzerwa ne paramyxovirus. Zvinetso zvinogona kusanganisira meningitis, encephalitis, orchitis (kuputika kweavoes kana masero), pancreatitis, uye myocarditis.
Kunze kwekunyekenyeka kwemakumbo, mazamu haachawaniki muUnited States. Mushonga wemukuchi wakatanga kuiswa muna 1968 uye wakatanga kushandiswa nguva dzose muna 1977 (iyo iri pakati peM vachengeti M M R).
Munyika yose, maive nemakore anopfuura 400 000 maitiro mumatanda muna 2006.
Pertussis
Pertussis, kana kukwidzika kunokonzera, kunokonzerwa neBordetella pertussis mabhakitiriya. Kunyange zvazvo ikozvino iko kunobatanidza nekukonzera kushungurudza, kupfugama kwenguva refu mumadiki uye vanhu vakuru, zvinokosha kuyeuka kuti kuparara kunoshandiswa kuva chimwe chezvikonzero zvinokonzera rufu kubva kune zvirwere zvevana. Kutaura zvazviri, tisati tagara tichishandisa chirwere chinonzi pertussis muma1940, anenge 1 pavana 750 muUnited States aizouraya kubva pertussis gore negore.
Zvinetso zvehutachiona hwepistus zvinosanganisira kugunun'una, pneumonia, apnea, encephalopathy (kuchinjwa kwehutano hwepfungwa), uye kusvika 1% yevana vane utachiona vanowanzofa kubva ku pertussis.
Kusiyana nehumwe humwe hutachiona-hutachidzivirirwa hurwere, huripo huri kuramba huine 5 000 kusvika ku7 000 matambudziko epartusis gore negore muUnited States. Izvi zvinonyanya nokuti kusachengetedzwa kubva muhutano hwemwana hunokonzerwa nehutachiona hwepwere (iPP mumushonga weDT aP ) inowanzovhara shure kwemakore mashanu kusvika kune gumi, saka vechidiki nevakuru vanogona kuwana kuparara uye vozoipfuurira kune vacheche uye vacheche vasina kupedza zvirwere zvavo zvepistosi zvakadaro. A kukurudzirwa kweiyosterster dose ( Tdap ) pazera remakore 12 inofanira kubatsira kurwisana nehutachiona hwehutachiona zvakadaro.
Polio
Kunyange zvazvo vanhu vasingawanzofungi nezvechiriyo zvakare uye vamwe vanofunga kuti yakatozobviswa, pane zvingangova 2 000 matambudziko eporiyo pasi pose muna 2006. Zviitiko zvakawanda zvino zvakanyanyisa mune dzimwe nyika shoma, kusanganisira Afghanistan nePakistan, uko achiri kuoma.
Pasati chirwere cheporiyo chakatanga kushandiswa muna 1955, kuputika kweporiyo kwaiwanzoonekwa muUnited States kunyange zvakadaro. Polio inokonzerwa nehutachiona uye kunyange vana vakawanda vanotapukirwa havakwanisi kuva nezviratidzo, anenge 1 mu2002 avo vanotapukirwa vachiita chirwere cheporiyumu. Vakawanda vevana ava vane urema husingagumi uye 5 kusvika ku10% havagari.
Pakaitika kubuda kweUnited States nguva dzose, kwaiva kusvika kusvika 21 000 mamiriyoni evanhu vakafa mutezo gore negore. Vabereki vaityisa chirwere cheporiyo zvokuti mabhuti ekudhara uye nzvimbo dzekutamba dzaiwanzovharwa munguva yechando apo pane zvirwere.
Misa mishonga yekudzivirira muzvikamu zvishomanana zvakasara apo chirwere chepori chinetso uye yakaramba ichichengetwa muzvimwe zvikamu zvepasi pano haufaniri kureva kuti chinangwa chokugumisa poriyo ndechechokwadi.
Rubella
Rubella inozivikanwawo seGermany masero kana "mazuva matatu masero" uye zvakasiyana nezvimwe zveimwe zvirwere zvinodzivirirwa zvekudzivirira, chirwere chetachiona chinowanzova chinyoro. Ichokwadi, vanhu vakawanda vane rubella havana kana zviratidzo. Vamwe vose vane lymphadenopathy (gumbo rinoputika), rash, uye ine-low-grade fever iyo inowanzogara kwemazuva matatu.
Kana rubella iine unyoro, saka sei tichida chirwere cheRubella?
Chikonzero chikuru ndechekuti kusvika kusvika ku80% yevana vanozvarwa kumadzimai vane rubella munguva yavo yekutanga katatu yekuzvimba vanowanzoita kubatana rubella syndrome, vane ngozi yakawanda yekuparara. Izvi zvinowanzoberekwa nekuremara kwakawanda kwekuberekwa, kusanganisira dambudziko, matsi, glaucoma, kutadza kwemwoyo, kushaya hepatitis, kuderedza kuberekwa, kuchema kwepfungwa, microcephaly (musoro muduku), uye thrombocytopenic purpura (low platelet inopa muropa ravo).
Munguva yekuberekwa kweRubella muna 1964 kusvika muna 1965, pakanga pane vanenge 20 000 matambudziko e congenital rubella syndrome. Rubella ikozvino inowanikwa muUnited States kubvira pakatangwa chirwere cheRubella muna 1969 (icho chikamu cheMM vachengeti), asi ichiri chinetso munyika yose, uye inopfuura 250 000 mhaka muna 2006.
Tetanus
Vabereki vakawanda vanobatanidza tetanus ne "lockjaw" uye vanoda chidimbu chetetanus kana iwe uchinge uchinge uri pamusungo unopinza.
Kuvhara muzvizvarwa zvitsva (neonatal tetanus ine mukondombera wembilical yakagadziriswa) yakashandiswa kuva yakanyanya kufanana nehutachiona hwetetanus uye yakanga yakakomba, kusvika kusvika 95% yevana vakashaya. Izvi zvipembenene zvaive zvichange zvanyanya kuderera apo chirwere chetetanus chakatangwa muna 1938 asi, nekuda kwekuvandudzwa kwemamiriro ezvinhu uye utsanana.
Tetanus inokonzerwa neukisi hunokonzerwa neBlostridium tetani bacteria. Spores e C. tettani mabhakitiriya anowanzowanika muvhu uye mumatumbo emhuka dzakawanda. Iyo spores inogona kusvibisa nyore kutengesa, maronda, uye mamwe maronda - kunyanya maronda ane tsvina.
Kusiyana nezvimwe zvirwere zvose zvinodzivirirwa, tetanus haina kupararira.
Utano hwakanaka uye hwakaramba huchirwere nemishonga yeTetanus (iyo T muzvirwere zveD D aA uye T dap) inotungamirira kumadekari echetetus muUnited States. Iyo ichiri dambudziko guru munyika yose asi.
Zvimwe Mushonga Zvirwere Zvinodzivirirwa
Mukuwedzera kune hutachiona gumi zvakakundwa kana kurongedzwa zvakanaka muUnited States nemishonga, nyanzvi dzehutano zvichiri kushanda pakuparadza vamwe nemishonga mitsva.
Izvi zvinosanganisira mavairasi uye mabhakitiriya anoshandura kana kusanganisira matambudziko akawanda uye zvirwere zvemazuva ano zvinobatsira, asi hazvina kubvisa zvirwere zvachose. Izvi zvinosanganisira chirwere chechirwere, chinofanira kupiwa gore roga roga, zvirwere zvepneumococcal, meningococcal, uye rotavirus, izvo zvinongorayira zvimwe zvirwere zvebhakitiriya nemavirusi, uye chicken pox, hepatitis B, uye hepatitis A zvirwere, zvisati zvave kupa vanhu vakakwana kuti vabvise zvirwere izvi.
- Flu - kunyange zvazvo chirwere chepfupa gore negore chinokurudzirwa kuvana vose vane mwedzi mitanhatu, vanoramba vachiine makore makumi mana nemakumi matatu nemakumi manomwe nemakumi matatu ekuparara kwevana pakati pevana mumakore mashomanana apfuura, kunyanya pakati pevana vasina kubatwa.
- Rotavirus - pasi rose, kune anenge 450 000 kusvika ku600 000 vakafa muvana gore roga roga kubva kuR rotavirus, chinowanzokonzera chirwere. MuUnited States, rotavirus inokonzera mamiriyoni matatu ematambudziko ehuta, izvo zvinotungamirira kune vanenge 80 000 hospital hospital, uye kufa kwema20 kusvika ku40, kunyange izvi zvichiderera zvikuru ikozvino tine miviri miviri yeR rotavirus - RotaTeq uye Rotarix.
- Chickenpox - kunyange zvazvo vabereki vakawanda vachifunga kuti chickenpox chirwere chiduku, vasati vashandise kushandisa Varivax, chirwere chechickenpox muna 1995, pakanga pane mamiriyoni emamiriyoni ematokari yekukuvha gore roga roga, uye avhareji yezvipatara 10 500 uye vanhu 100 vakafa gore negore.
- Hepatitis B - inenge mamiriyoni mazana mana munyika yose inokonzerwa nehutachiona hweH hepatitis B, kusanganisira vanhu vanopfuura mamiriyoni muUnited States. Vana vanogona kuwana hepatitis B kubva ropa neropa remvura uye kana vakaberekerwa naamai vane hepatitis B, ndicho chikonzero zvakakosha kuti vawane mushonga wavo wekutanga wekushaya hepatitis B nokukurumidza pavanenge vaberekwa. Iyi chirongwa chekudzivirira kwechechecheche yakaderedza zvakakonzera matambudziko ehutachiona hwehupatachi B hutachiona. Sezvo vamwe vana vachiwana hepatitis B pasina chero njodzi dzinokonzera njodzi, chirwere chekuberekwa kwehepatitis B chakakosha, kunyange kana amai vasina chirwere che hepatitis B.
- Hepatitis A - kusiyana nehepatitis B, vana vanowanzowana hepatitis A kubva kunezuva uye kubva pakudya zvokudya zvakasvibiswa, kusanganisira zvekudya zvegungwa, zvibereko zvitsva, uye kubva mumatambo ezvitoro. Vana vakawanda munyika dziri kusimukira vanopedzisira vatapukirwa nehutachiona hweH hepatitis A, uye kunyange zvazvo kazhinji isingaiti, ndiyo imwe yezvirwere zvinowanzochengetedzwa-zvinodzivirirwa muUnited States zvakare.
- Pneumococcus - bhakitiriya yepneumococcus kana Streptococcus pneumoniae inogona kukonzera meningitis, pneumonia, bacteremia, uye zvirwere zvekunzwa. Zvirwere zviviri zvepneumococcal, kusanganisira Prevnar iyo inopiwa sechikamu chetsika dzese dzehutano hwehutano, uye Pneumovax, iyo inopiwa kune vakwegura vana vanotambura zvikuru nevakuru, iri kubatsira kuderedza zvirwere izvi. Pamberi pemishonga yaivepo, S. pneumoniae yaizokonzera ma 700 maswere eBacterial meningitis nekufa kwe2002 gore negore muvana. Munyika yose, inofungidzirwa kuti inokonzera kuurawa kwemamiriyoni 1,9 gore roga roga muvana vasati vava nemakore maviri.
- Meningococcus - mabhakitiriya e-meningococcus kana Neisseria meningitides inotungamirira kufa vanopfuura 50 000 gore negore pasi rose. MuUnited States, kune anenge 2 000 kusvika 3 500 matambudziko gore rega rega, uye vanenge 10 muzana yevana vakavhiringidzika vanofa. Manicra uye Menveo meningococcal vaccines vanokurudzirwa kune vose vana pavanenge vane makore 11 kusvika kune gumi nemaviri.
Uye zvinosuruvarisa, kune vana vakawanda vanouraya zvirwere zvisingabatsiri zvirwere asi, sekushaya malaria (vanopfuura 850 000 vakafa gore roga roga), chirwere chetachiona (450 000 vakafa gore negore), uye HIV / AIDS (vanopfuura 320 000 vakafa gore negore).
> Sources:
> Plotkin: Vaccines, 4th ed.
> Mandell, Bennett, & Dolin: Maitiro uye Maitiro Ezvirwere Zvinotapukira, 6th ed.
> Yenguva: Maitiro uye Maitiro eZvepabonde Zvirwere Zvinotapukira, 2nd ed.
> Gershon: Krugman's Infectious Diseases of the Children, 11th ed.
> Kliegman: Nelson Nhamba yeBhuku rePediatrics, 18th ed.
> CDC. Chirwere Chinochengetedza Kufa uye Global Immunization Vision uye Strategic, 2006--2015. MMWR. May 12, 2006.
> CDC. Diphtheria muChina Soviet Union: Kudzokorora kweAlwere Hwepachiona. Emerging Infectious Diseases. December 1998.
> Mishonga inoputika muDublin, 2000. McBrien J - Pediatr Infect Dis J - 01-JUL-2003; 22 (7): 580-4.
> Zvirwere zvinodzivirirwa zvirwere: maonero aripo munhoroondo yekare, Chikamu I. Weisberg SS - Dis Mon - 01-SEP-2007; 53 (9): 422-66.