Mishonga yakauya rwendo rurefu kubvira muna Edward Jenner mukurumbira wezana remakore rechi18. Vanasekuru navanasekuru vedu vangangodaro vakagamuchira pfuti imwe chete pavakanga vari vana, asi vana nhasi nhasi vakachengetedzwa kurwere 16 zvakasiyana uye zvirwere zvinomwe zvekenza. Zvichida chirongwa chinonyanya kukosha pane urongwa hwemazuva ano hwehutano hwehuduku, zvisinei, ndiyo inorayirwa kune munhu wese, gore rimwe nerimwe: chirwere chinoputika.
Kunyange zvazvo chirwere chepfupa chakakoshawo nhasi sezvakangoti yakatanga kusunungurwa, zvakawanda zvakachinja mumakore anenge makumi mana emakore. Sezvo teknolojia yakakurumidza kuwedzera, chirwere chacho chave chakachengeteka uye chinobudirira-uye nekufambira mberi uku, mazano akashandukawo, zvakare, achiwedzera kubva pakusarudzwa kwevanhu vanoenda kune vose vari pamakore matanhatu. Heino mamiriro atakawana pano.
Kuziva Virus
Utachiona hwehutachiona hwakanga hwakananga kwekutanga panguva yekutanga kwema1930 nekubatsira zvishomanana kubva kune dzimwe dzisingazivi. Vanhu vakanga vachiri kudengenyeka kubva muna 1918 chirwere chemvura chinotora huwandu hwehupenyu hwemamiriyoni makumi mashanu uye chakakanganisa mumwe muvanhu vashanu munyika yose. Kuziva chinokonzera kuparadzwa uku kukuru kwaiva chiito chekutanga pakugadzira chirongwa chekudzivirira kuti chirege kuitika zvakare.
Vashandi veMedical Research Council vakatora muromo-kushambidza (gumbo) kubva kuvanhu varwere vanorwara nefivha, vakaisvibisa kuitira kuti pasina mabhakitiriya aivepo, ndokubva atanga kushandiswa kwemvura-pamwe chete nedzimwe sampu dzemaguru-kusvika muchivharo.
Apo mhuka dzakarwara, masayendisiti akacherechedza kuti zvakatora nguva yakareba sei kuti dzive zviratidzo uye kana chirwere ferret ichipfuura chirwere ichi kusvika kune utano hwakanaka huchigara mune imwe cage. Zvinofadza kuti vatsvakurudzi vakaonawo kuti mushure mokunge vadzoka kubva kune rimwe chirwere, firita yakaita seyakadzivirirwa kune mamwe maitiro efivha.
Wilson Smith, Christopher Andrewes, naPatrick Laidlaw vakabudisa zvavakawana muLancet ndokuisa danho rekugadzira chirwere.
Urarame Zvirwere
Makore mashomanana gare gare, vatsvakurudzi veUnited States ndivo vakatanga kutanga kuongorora tsvakurudzo iyi kuti vaite chirwere chinokwanisa. Vakatora mararamiro ehupenyu hwehutachiona hwehutachiwana ndokupfuura kanenge ka30 kuburikidza nemayese embryos. Kudzokorora kunogadzirisa hutachiona sezvazvakashandurwa kune yai yega, kuideredza iyo yakakwana kuti ive yakachengeteka kupa vanhu.
Miedzo yevanhu yakaitiswa ipapo, uye chirwere chacho chaitarisirwa kune vashandi vekufeya kuitira kuti vaone kana zvichigona kuderedza kusava nemhosva nekuda kwezvirwere zvokufema zvakadai sehosha. Kunyange zvazvo zvinyorwa zvenhoroondo zvichiratidza kuti chirwere chacho chinoshanda, zvinokosha kuziva kuti nzira dzekushandisa dzinoshandiswa panguva iyoyo dzingadai dzisingasviki nhasi. Pasinei, zvigadzirwa zvemukoko uyu zvinogona kushandiswa kwemakore anodarika makumi mashanu mune izvo zvino zvinozivikanwa seyaimbova Soviet Union.
Kunyange zvazvo kutsvakurudza nezvezvirwere zvepukirwe zvakapfuurira mumakumi emakore anotevera, hazvingazovi kusvikira muna 2003 kuti chirwere chinorarama chechirwere chinogona kuwanikwa muUnited States. Izvo zvinoraramira zvakakonzerwa nehutachiona (LAIV) yakashandiswa sepine spray panzvimbo yejojo, zvichipa imwe nzira yevana nevakuru vanga vachitya nenyuchi.
IRAIV yakaratidza kuti yakabudirira kuvana vakuru uye vaduku vakuru uye saka yakakurudzirwa kune avo vane makore 2-49. Zvisinei, mushure memakore mashomanana ekutsvakurudza kuri kuratidza kuti chirwere chacho chakanga chisina kubudirira sezvo chirwere ichi chaipfura, chirongwa chacho chakabviswa, uye iye zvino zvirwere zvisingabviri uye zvekare zvinokurudzirwa kushandiswa muUnited States.
Inactivated Vaccines
Mumakore ekuma1940, apo USSR yakanga ichigadzira uye ichiedza chirwere ichi chirwere, dzimwe nyika dzakadai seUnited States neUnited Kingdom dzakatora tsvimbo yavo padziri kukura pfuti vachishandisa nzira yakasiyana-siyana vachishanda-kana "vakafa" -versions ye virus ye flu .
Anofungidzirwa kuti 1 muzana makumi matatu nemasere akafa nehosha mukati mehosha ye1918, uye kuwedzera chirwere chekuchengetedza mauto kwaiva chinhu chikuru kune hurumende yeUnited States sezvo yakashongedza pachayo yeHondo Yenyika II.
Kufanana neveSoviet, chirwere chemapfupa chakapfuura nepakati pemamwe mazamu pakati pemamwe mhuka, asi vatsvakurudzi veUnited States vakashandisa kubudirira mune teknolojia iyo yakanga iri itsva panguva iyoyo, sekuita centrifugation uye kusviba uye kuchingura mvura inodikanwa kubva kumaii mazai. Vakashandisawo matambudziko maviri, kwete chete. Hondo yakashandisa zvirongwa zvekuzvidzivirira muzviuru zvevashandi, vachishandisa nzira dzakanaka dzekuita nguva, dzakadai sekudzivirira vose vatori vechikamu nevatsvakurudzi kuziva kana chirwere ichi kana kuti placebo chaitungamirirwa-chirongwa chekutsvaga chinowanzozivikanwa sechipiri-blind maphunziro . Zvidzidzo zvakadzidzwa kubva kutsvakurudzo iyi zvichaenderera mberi kuzivisa hurongwa hwekuvhara mishonga yeramangwana, kusanganisira kuwanikwa kuti hutachiona hunoshungurudza hunogona kuchinja munguva yemwaka, uye kuti kudzivirirwa kune mamwe matambudziko hakurevi kudzivirirwa kune vamwe.
Masayendisiti aizozoenderera mberi kuti awane nzira itsva dzinobatanidza kusanganisa uye kuenzanisa zvikamu zvehutachiona hwehutachiwana kuitira kuti zvirwere zvakanyanya uye zvakachengeteka zvirwere-chirongwa chinonzi genetic recombination chinoshandiswa nhasi.
Recombinant Vaccines
Kunyange zvazvo zvirwere zvese zvisina zvirwere zvinoshandiswa uchishandisa mazai, vakawanda vachiri-vachisiya vamwe vane chirwere chakakomba chakanyanya pangozi yekuita. Izvi zvakakonzera ruzivo rwezvinhu zvitsva muhutachiona hwekudzivirira zvirwere. Chimwe chezvinhu zvakangobva kuitika ndezvekusika kwechirwere chinogadziriswa. Izvi zvinotora mapuroteni anokonzerwa nehutachiona hwehutachiwana huchave huchienderera mberi nehutano hwegore uye hubatanidza navo nehutachiona hwakasiyana huchakura zvakanaka mu laboratori. Zvirwere izvi zvinopindura uye zvinowedzera mapuroteni mumasero emagunha-kwete huchi mazai-uye mapuroteni iwayo ndizvo zvinotsvakurudzwa nevatsvakurudzi.
Iyo nzira inokurumidza kukunda nzira yakasarudzika yekushandisa mazai nokuti haitenderi mazai evha kana kushandisa zvirwere zvinoputika zvinowedzera zvakanaka mazai. Izvi zvinogona kureva nguva inokurumidza kupindura muitiko wehutachiona hunouraya mune ramangwana. Kusvika ikozvino, chirwere chimwechete chinowanikwa muUnited States uchishandisa teknolojia iyi, uye yakabudiswa muna 2013.
Multiple Vaccine Strains
Chirwere chechirwere chokutanga chakakonzerwa muimbova Soviet Union chaiva monovalent-kana imwe---strain-vaccine. Panguva iyoyo, chirwere chimwe chete cheruruva chakange chave chichizivikanwa: Influenza A. Mukutanga kwema1940, zvisinei, chirwere chechipiri chechirwere chakaonekwa chakange chakasiyana zvakanyanya kupfuura chekutanga: Influenza B. Apo mauto eU.S. akatanga chirwere chisina kujeka, iyo yaisanganisira kushungurudzika kwemhando mbiri kuti kuwedzere kuchengetedzwa. Makore gare gare, chirwere chechitatu chakabatanidzwa muchirongwa chekudzivirirwa kurwendo rwechipiri rweA Influenza A, uye muna 2012, chirwere chokutanga che-quadrivalent-kana chinomwe-chinetso chakagamuchirwa kuti chishandiswe muUnited States. Mishonga yakawanda yemishonga inoshandiswa mazuva ano, zvisinei, inoramba iine katatu, kana katatu-kuoma, zvirwere.
A Target Target
Gore roga rega chirongwa chekudzivirira chirwere chepiruru chinofanira kuchinjwa kuti chienderane nehuwandu hunogara huchichinja hutachiona. Chimbofungidzira muviri wako wechirwere chekuzvidzivirira mapurisa mapurisa pakutsvaga mutiza. Pakutanga, vakaudzwa kuti vatsvake mutadzi mumucheka webhuruu. Asi pamusoro pemakore egore, jasi rekupandukira rakapera muzuva, uye mwedzi yakazotevera, jasi ikozvino rakachena grey. Kana mapurisa asina kuongororwa pamusoro pechimiro chakachinja, ivo vacharamba vachitsvaka mumwe munhu mujasi rebhuruu-achibvumira mutiza kuti arege kubatwa. Nemhaka yokuti chirwere chemapfupa uye tsvina dzayo dzakasiyana-siyana inogona kuchinja zvakakurumidza, miviri yedu inoda chiyeuchidzo chezvatinofanira kutarisa, saka isu tinokwanisa kutadzirira zvidziviriro zvedu patinenge tine utachiona.
Nzira yekutsanangurira maitiro ehutachiwana inofanirwa kuiswa mumwaka inotevera wekudzivirira chirwere ichi inowanzoitika mwedzi isati yapfuura. Vakuru vehurumende vanotarisa kutsvakurudza kwakasiyana-siyana, kusanganisira zvinetso zvinopararira pasi pose, uye kuti zvakanyanya sei matambudziko anoita seaya, uye zvino anopa ruzivo ichocho kuvaki vekudzivirira kuitira kuti vatange matanho ekuwanda kubudisa chirwere uye akaedzwa kuchengetedzwa munguva yekufuratira nguva.
Kunyange zvazvo chirongwa chekusarudza maronda ekudzivirira chirwere chekutsvaga-chakavakirwa, hazvibviri kutaurira remangwana, uye dzimwe nguva matambudziko anowanikwa mumakemikari haafananidzi mavairasi anotenderera kana chirwere chegore chinouya. Kana izvi zvikaitika, kubudirira kwechirwere kunotora hit. Zvakakosha kucherechedza, zvisinei, kuti kunyange kana chirwere ichi chisina kukwana zvakakwana, ichi chichiri nzira yakanakisisa yekudzivisa kupararira kana kufa sekuguma kwechirwere. Semuenzaniso, chirwere chinopfuudza chirwere mukati megore ra2014-2015 chakafungidzirwa kuva ne19% chete chinoshanda mukudzivirira matambudziko ehutachiona. Asi kunyange nehuwandu hwekubudirira huwandu hwehutano, kupora mukati memwaka iwoyo kwakadzivirirwa inofungidzirwa inokwana mamiriyoni 1,9 ekurwara, uye inenge 67,000 hospitalizations. Izvi zvaive pasinei nekushamiswa kwepamusoro kwehutachiona hwehutachiwana huri pasi pe50 muzana kune vanhu vakura pasi pemakore makumi matanhatu nemashanu-pasi pechikumbaridzo chinodiwa kuti vawane hutachiona hwemishonga .
Mazano
Yange iri nguva yakareba kubvira muna 1918 chirwere chemagwenga, asi hutachiona huri humwe hwezvirwere zvakanyanya kuvhara zvirwere zvinodzivirirwa muUnited States iye zvino-kuuraya chero kupi zvako kubva kune 12,000 kusvika ku 56 000 vanhu gore negore. Sezvo deta yave yakaunganidzwa pamusoro pehutachiona uye zvinogona kutyisidzira zvayo, mazano akakurudzirwa kuisa vanhu vakawanda.
Pakutanga chirwere chacho chakakurudzirwa chete kuvanhu vakanga vari pangozi yakawanda yezvinetso kubva kurwere, sekunge vanhu vakuru vanopfuura 65 kana ani zvake akwegura kupfuura mwedzi mitanhatu ane chirwere chisingaperi chine chokuita nemoyo kana mapapu. Nokufamba kwenguva, zvakazove pachena kuti vanhu vakawanda vaifanira kujowa kuitira kuti vadzivirire rufu uye hospitali, saka mazano akawedzerwa kuisa vana vaduku nevakadzi vane pamuviri. Zvadaro vanhu vakuru vanopfuura makumi mashanu vakawedzerwa, uye gare gare, vana vose kusvika pazera remakore 18. Nokuti chirwere ichi chinouraya vanhu vazhinji gore roga rega-kupfuura dzimwe dzose zvirwere-zvinodzivirirwa zvinosanganiswa muUnited States-ACIP yakasarudza muna 2009 kuti iwedzere kukurudzira kwayo kune vose vanopfuura kwemwedzi mitanhatu.
Kubvira panguva iyoyo, chirwere chepukemuru chave chiri chega bedzi chirongwa chepasi rose chakakurudzirwa kuvanhu vezera rose uye mamiriro ezvinhu. Izvo zvichiti, vamwe vanhu-sevaya avo vane hutachiona hunopisa upenyu kune chirwere chepukirwe-havafaniri kuvharwe, asi maitiro acho haawanzogadziriswa, uye kazhinji kushandiswa kwechirwere kunogona kushandiswa kudzivisa zvinokonzera kuipa.
Future Developments
Nemhaka yehutano uye hune simba hwehutachiona, chirwere chepuroviramu chepasi rose chiyeuchidzo chitsvene chekudzivirira chirwere chekupempa. Mapoka ezvekutsvakurudza pasi pose vari kushingaira kugadzira mushonga unogona-pamwe chete nehana imwe chete kana yakatevedzana-inodzivirira kumarudzi ose emhando dzechirwere uye kwenguva yakareba, zvichiita kuti mudikanwi wegore negore unodhonza chinhu akapfuura.
> Sources:
> Barberis I, Martini M, Iavarone F, Orsi A (2016) Inowanikwa fukenza zvirongwa: maitiro ekudzivirira, nhoroondo uye zvishandiso zvitsva zvekurwisa chirwere chacho. J Prev Med Hyg. 2016; 57: E41-46.
> Centres for Disease Control and Prevention. Influenza ACIP vaccine recommendations.
> Hannoun C. Kuchinja kwenhoroondo yezvirwere zvekurwisa uye zvirwere zvekurwisa. Nyanzvi Rev Vaccines . 2013; 12 (9): 1085-94.
> History of Vaccines. Influenza. The College of Physicians of Philadelphia.