Katemera watulukira kutali kuchokera ku kuyesa kwazaka 1800 kwa Edward Jenner. Agogo ndi agogo athu adzalandira mphuno imodzi pamene anali ana, koma ana lero ali otetezedwa ku matenda osiyanasiyana 16 ndi mitundu isanu ndi iwiri ya khansara. Mwina katemera wofunikira kwambiri pa ndondomeko ya katemera wa mwana wamakono, komabe, ndi imodzi yomwe ikulimbikitsidwa kwa aliyense, chaka chilichonse: chimfine chimasewera.
Ngakhale katemera wa chimfine ndi wofunika lero lero monga pamene unamasulidwa koyamba, zambiri zasintha mu mbiri yake ya zaka 70. Monga momwe zipangizo zamakono zathandizira, katemerawa amakhala otetezeka komanso ogwira mtima kwambiri-ndipo ndi kupita patsogolo kumeneku, ndondomeko zakhala zikusinthika, komanso zikufutukula kuchokera kwa anthu omwe ali ndi zaka zoposa zisanu ndi chimodzi. Apa ndi momwe ife tafika pano.
Kuzindikira Virus
Tizilombo toyambitsa chimfine tinkasungulumwa kwa nthawi yoyamba kumayambiriro kwa zaka za m'ma 1930 ndi thandizo laling'ono kuchokera kumapanga ena osadziwika. Anthu adakalipobe chifukwa cha mliri wa mliri wa 1918 umene unapha anthu oposa 50 miliyoni ndipo unakhudza mmodzi mwa anthu asanu padziko lonse. Kudziwa chomwe chinachititsa kuti izi zisawonongeke kwambiri ndizoyambira pakuyamba katemera kuti athetsekanso.
Ogwira ntchito ku Medical Research Council anatenga zovala zotsuka pakamwa kwa odwala omwe ali ndi chiwindi, anazifotera kotero kuti palibe mabakiteriya omwe analipo, kenaka anatulukira madzi omwe amachokera-pamodzi ndi zitsanzo zina za nkhumba-ku ferrets.
Zinyama zikadwala, asayansi adazindikira kuti zinatenga nthawi yaitali bwanji kuti adziwe zizindikiro komanso ngati odwala ferret adadwalitsa matendawa kuti agwire khola limodzi. N'zochititsa chidwi kuti ofufuza anapeza kuti atatha kuchira matendawa, amaoneka kuti amatetezedwa ku fuluwenza.
Wilson Smith, Christopher Andrewes, ndi Patrick Laidlaw adafalitsa zomwe adapeza ku Lancet ndipo adayambitsa njira yopititsira katemera.
Katemera Wamoyo
Zaka zingapo pambuyo pake, ofufuza a USSR anali oyamba kugwiritsa ntchito kafukufukuyu kuti apange katemera wotheka. Anatenga kachilombo ka kachilombo koyambitsa matenda a chimfine ndipo anawapatsira katatu kupyolera m'mazira a mazira. Ndondomekoyi imachepetsa kachilombo ka HIV monga momwe imayendera ndi dzira, yomwe imafooketsa mokwanira kuti ipereke kwa anthu.
Mayesero a anthu anachitidwa nthawi yomweyo, ndipo katemerawo amaperekedwa kwa ogwira ntchito fakitale kuti awone ngati zingachepetse kupezeka chifukwa cha matenda opuma monga chimfine. Ngakhale kuti zochitika zakale zimasonyeza kuti katemerayu ndi othandiza, ndikofunika kuzindikira kuti njira zomwe zinkagwiritsidwa ntchito panthawiyi sizikanakhala zovuta lero. Mosasamala kanthu, zochokera ku katemera uwu zikhoza kugwiritsidwa ntchito kwa zaka zopitirira 50 mu zomwe tsopano zikudziwika kuti kale Soviet Union.
Ngakhale kufufuza kwa katemera wa chimfine kunapitirira zaka makumi angapo zotsatira, sizingakhale mpaka chaka cha 2003 kuti katemera wa chimfine udzakhalepo ku United States. Katemera woteteza matenda a influenza (LAIV) ankachitidwa ngati mankhwala amphongo m'malo mwa jekeseni, kupereka njira ina kwa ana ndi akulu omwe ankawopa singano.
LaIV inagwira ntchito kwambiri kwa ana achikulire komanso akuluakulu ndipo motero analimbikitsidwa kwa a zaka zapakati pa 2-49. Komabe, patatha zaka zingapo kafukufuku wosonyeza kuti katemerayu sanagwire ntchito mofanana ndi momwe chimfine chinagwirira ntchito, malangizowo adatulutsidwa, ndipo tsopano katemera osadziwika ndi ovomerezeka ndi operekedwa kuti agwiritsidwe ntchito ku United States.
Katemera wosatetezedwa
M'zaka za m'ma 1940, pamene USSR inali kuyesa ndi kuyesa katemera wake wa chimfine, mayiko ena monga United States ndi United Kingdom adadzipangira okha phokoso pogwiritsira ntchito njira yosiyana pogwiritsa ntchito mavenda osagwiritsidwa ntchito kapena "akufa" .
Ambiri amodzi mwa asirikali 67 anafa ndi matenda a chimfine panthawi ya mliri wa 1918, ndipo kulandira katemera kuteteza asilikali kunali kofunika kwa boma la US pamene linadzilimbitsa nkhondo yachiwiri ya padziko lonse.
Mofanana ndi Soviets, kachilomboka kamadutsa m'mazira ena pakati pa zinyama zina, koma ofufuza a US anagwiritsa ntchito njira zamakono zamakono zomwe zinali zatsopano panthawiyi, monga kupuma kwa madzi ndi kuzizira komanso kutulutsa madzi oyenera kuchokera kwa nkhuku. Anagwiritsanso ntchito mitundu iŵiri, osati imodzi yokha. Nkhondoyo inayesa katemera wawo ambiri mwa odzipereka, pogwiritsira ntchito njira zamakono zokhazikitsira nthawi, monga kuteteza anthu onse komanso ochita kafukufuku kudziwa ngati katemera kapena malo otchedwa placebo aperekedwa-njira yamakono yofufuzira yomwe imatchedwa kuphunzira kawiri-khungu . Zomwe taphunzira kuchokera ku kafukufukuyu zidzapitiriza kulengeza chitukuko cha katemera, kuphatikizapo kupeza kuti kachilombo ka HIV kamatha kusintha pakati pa nyengo, ndipo kutetezedwa ku zovuta zina siziteteza chitetezo kwa ena.
Asayansi amatha kupeza njira zatsopano zomwe zimaphatikizapo kusakaniza ndi kugwirizanitsa zigawo za mavairasi a chimfine kuti apange chitsimikizo champhamvu komanso chotetezeka cha katemera-njira yotchedwa genetic recombination yomwe ikugwiritsabe ntchito lero.
Katemera wa Recombinant
Ngakhale kuti palibe katemera wa mafupa onse omwe amapangidwa pogwiritsa ntchito mazira, ambiri adakalipo-kusiya anthu ena omwe ali ndi chifuwa choopsa choopsa. Kuda nkhawa kumeneku kunayambitsa njira zatsopano zogwiritsira ntchito katemera wa katemera. Chinthu chimodzi mwa zinthu zomwe zakhala zikuchitika posachedwapa ndi kulengedwa katemera wothandizira. Katemera wamtundu uwu umatenga mapuloteni omwe amachititsa ma virus a chimfine omwe angakhale akufalitsa nyengo ya chimfine ndipo amawaphatikiza ndi tizilombo tosiyanasiyana zomwe zidzakula bwino mu labotale. Mavairasi amatembenuza ndikupanga mapuloteni ambiri m'maselo a tizilombo-osati nkhuku mazira-ndipo mapuloteni ndiwo omwe ochita kafukufuku amafunika kupanga katemera.
Ntchitoyi imakhala yofulumira kwambiri kusiyana ndi njira yomwe amagwiritsira ntchito mazira chifukwa sichidalira mazira kapena kugwiritsa ntchito mavairasi omwe amakula bwino m'mazira. Izi zikhoza kutanthauza nthawi yowonongeka mofulumira pakakhala mliri woopsa wa chimfine m'tsogolomu. Mpaka pano, katemera umodzi wokha ukupezeka ku United States pogwiritsa ntchito njirayi, ndipo idatulutsidwa mu 2013.
Zovuta Zambiri za Katemera
Chithandizo choyamba cha chimfine chimene chinapangidwira m'mbuyomo Soviet Union chinali katemera wotchedwa monovalent-kapena single-strain-vaccin. Pa nthawiyi, mtundu umodzi wa chimfine unadziwika: Matenda a chiwindi A. Kumayambiriro kwa zaka za m'ma 1940, mtundu wina wa chimfine unadziwika kuti unali wosiyana kwambiri ndi woyamba: Influenza B. Pamene asilikali a ku US anayamba katemera wosatetezedwa, Izi zinaphatikizapo zovuta za mitundu yonseyi kuti zithetse chitetezo. Patatha zaka, gawo limodzi lachitatu linaphatikizidwa kulowa katemera kuti ateteze mtundu wachiwiri wa Influenza A, ndipo mu 2012, katemera woyamba kapena odwala anayi anavomerezedwa kuti agwiritsidwe ntchito ku United States. Mankhwala ambiri amfine amagwiritsidwa ntchito lero, komabe, akadali ochepa kwambiri, kapena katatu, katemera.
Cholinga Chotsatira
Chaka chilichonse chiwerengero cha katemera wa chimfine chiyenera kusinthidwa kuti chilowetse kachilombo kamene kamasintha. Tangoganizirani chitetezo chanu cha mthupi ndi apolisi pakufunafuna wothawirako. Poyamba, anauzidwa kuti afufuze wolakwira mu malaya abuluu. Koma pamapeto pa chaka, chovala cha wolakwira chinafalikira padzuwa, ndipo patatha miyezi ingapo, malayawa tsopano ndi ofiira. Ngati apolisi sakusinthidwa pa mawonekedwe omwe asinthidwa, iwo adzalinso akuyang'ana munthu wina atavala malaya abulu-kulola kuti wothawayo asatengedwe. Chifukwa chakuti matenda a chimfine ndi madontho ake osiyanasiyana akhoza kusintha mofulumira kwambiri, matupi athu amafunikira kukumbukira zomwe tiyenera kuyang'ana, kotero tikhoza kukonzekera chitetezo chathu tikakhala ndi matenda.
Ndondomeko yodziwitsa kuti tizilombo toyambitsa matenda tizilombo toyambitsa matenda tizilumikizidwe m'miyezi yotsatira ikuchitika bwanji miyezi isanafike. Akuluakulu akuyang'ana kafukufuku wosiyanasiyana, kuphatikizapo mavuto omwe akuyenda padziko lonse lapansi, ndi momwe zimakhalira zovuta, ndipo amapereka chidziwitso kwa opanga katemera kotero kuti athe kuyambitsa njira yopanga katemera ndikukhala anayesedwa kuti azikhala otetezeka m'nthawi ya chimfine.
Ngakhale njira yosankha katemera wa katemera ndifukufuku, ndizosatheka kunena zam'tsogolo, ndipo nthawi zina mavuto omwe amapezeka mu katemera sakugwirizana ndi mavairasi omwe amayamba pamene nyengo ya chimfine ikubwera. Izi zikachitika, katemera wa katemera umatha kugwira ntchito. Ndikofunika kudziwa kuti ngakhale katemera sagwirizana, ndi njira yabwino kwambiri yopezera kuchipatala kapena imfa chifukwa cha chimfine. Mwachitsanzo, katemera wa chimfine pa nyengo ya chimfine cha 2014-2015 chiyenera kuti ndi 19 peresenti yokha yomwe ikuthandizira kupewa matenda a chimfine. Koma ngakhale panthawi yochepa yopambana, katemera m'nyengo imeneyo sanateteze kuti pafupifupi 1,9 miliyoni milandu ya chimfine, ndipo pafupifupi 67,000 hospitalizations. Izi zinalibe ngakhale kuti peresenti yochepa kwambiri ya katemera ndi yochepa kuposa 50 peresenti kwa anthu ochepera zaka 65-pansi pa chidziwitso chofunikira kuti ateteze chitetezo chake .
Malangizo
Zakhala zaka zambiri kuyambira mliri wa mliri wa 1918, koma kachilombo kameneka ndi kachilombo koyambitsa katemera kwambiri ku United States pakalipano-kupha paliponse pakati pa 12,000 ndi 56,000 anthu chaka chilichonse. Monga momwe deta yasonkhanitsira zokhudzana ndi kachilombo ka HIV ndi ziopsezo zake, malangizowo aonjezera kuti akhale ndi anthu ambiri.
Poyamba katemerawo umalimbikitsidwa kwa anthu omwe anali ndi chiopsezo chowonjezereka kuchokera ku chimfine, monga achikulire oposa 65 kapena wina wamkulu kuposa miyezi isanu ndi umodzi ndi matenda aakulu omwe amakhudza mtima kapena mapapo. Komabe, patapita nthawi, zinawonekeratu kuti anthu ambiri amafunika katemera kuti athetse imfa ndi chipatala, kotero malangiziwo anawonjezeredwa kuphatikizapo ana aang'ono ndi amayi apakati. Kenaka akuluakulu oposa 50 anawonjezeredwa, ndipo kenako, ana onse a zaka zoposa 18. Chifukwa chimfine chimapha anthu ambiri chaka chilichonse-kuposa matenda ena onse omwe amapewa katemera ku United States-ACIP inavomereza mu 2009 kuti afotokoze malangizowo kwa aliyense wa zaka zoposa 6.
Kuchokera nthawi imeneyo, katemera wa chimfine ndilo chokhacho chogwirira ntchito padziko lonse chomwe chinalimbikitsa anthu a misinkhu yonse ndi zikhalidwe. Izi zikunenedwa, anthu ena-monga omwe ali ndi chiopsezo chowopsa ku katemera wa chifuwa-sayenera katemera, koma milanduyi ndi yochepa kwambiri, ndipo nthawi zambiri njira yodzizira katemera ingagwiritsidwe ntchito popewera mavuto.
Zotsatira Zamtsogolo
Chifukwa cha chiwopsezo chachikulu komanso champhamvu cha kachirombo ka HIV, katemera wa chifuwa chonse ndi chithunzithunzi cha chitukuko cha katemera wa chimfine. Magulu ofufuza padziko lonse akugwira mwamphamvu katemera omwe angakhale ndi mlingo umodzi kapena mndandanda-kutetezera ku mitundu yonse ya matenda a chimfine komanso kwa nthawi yayitali, kale.
> Zotsatira:
> Barberis I, Martini M, Iavarone F, Orsi A (2016) Katemera wowonjezera wa nkhuku: Njira zothandizira, mbiri ndi zida zatsopano zothana ndi matendawa. J Prev Med Hyg. 2016; 57: E41-46.
> Zolinga za Kuletsa ndi Kuteteza Matenda. Katemera wa katemera wa ACIP.
> Hannoun C. Mbiri yakale ya katemera wa chimfine ndi kachilombo. Katswiri wodziwa katemera wa Rev. 2013; 12 (9): 1085-94.
> Mbiri ya katemera. Influenza. The College of Physicians of Philadelphia.