INGXIBONGO: UMLANDO, IZIMBANGELA, IZIMPAWU, UKUXILONGWA NOKWELASHWA

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Ikhaya Ezempilo Ukwelashwa kokuphazamiseka Ukuphazamiseka Ukwelapha i-oi-Neha Ghosh ngu UNeha Ghosh ngoMeyi 27, 2020| Kubuyekezwe ngu Sneha Krishnan

Ingxibongo yisifo esithathelwana kakhulu esidalwa yigciwane le-variola (i-VARV), elingelohlobo lwe-Orthopoxvirus genus. Kwakungesinye sezifo ezithathelwanayo esaziwa isintu. Icala lokugcina lengxibongo labonakala eSomalia ngo-1977 nango-1980, iWorld Health Organisation (WHO) yamemezela ukuthi kuqedwe ingxibongo [1] .

Umlando Wesibongo [okubili]

Ingxibongo kucatshangwa ukuthi yavela eNyakatho-mpumalanga ye-Afrika ngonyaka we-10 000 BC futhi ukusuka lapho kungenzeka ukuthi yasakazekela eNdiya ngabathengisi basendulo baseGibhithe. Ubufakazi bokuqala bezilonda zesikhumba obufana nobengxibongo babonakala ebusweni bezidumbu zaseGibhithe lasendulo.

Ngekhulu lesihlanu nelesikhombisa, ingxibongo yavela eYurophu futhi yaba ubhadane phakathi neminyaka ephakathi. Ngonyaka, abantu abangu-400,000 babulawa yingxibongo kanti ingxenye eyodwa kwezintathu zabasindile yaphuphutheka ngekhulu le-18 eYurophu.

Kamuva lesi sifo sasakazekela emizileni yezohwebo nakwamanye amazwe.

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Iyini Ingxibongo?

Ingxibongo ibonakala ngamabhamuza abukhali avela ngendlela elandelanayo futhi ashiya izibazi ezonakalisa umzimba emzimbeni. La mabhamuza agcwala uketshezi olucacile futhi kamuva ubomvu bese akha ama-crust agcina esomile futhi awe.

Ingxibongo kwakuyisifo esithathelwanayo esibi esibangelwa igciwane le-variola. I-Variola ivela egameni lesiLatini elithi varius, okusho ukuthi kunamabala noma kusuka ku-varus, okusho uphawu esikhumbeni [3] .

Igciwane le-variola line-genome yemicu ephindwe kabili, okusho ukuthi inezintambo ezimbili ze-DNA ezisontekile kanye nobude obungu-190 kbp [4] . Ama-poxviruses aziphindaphinda ku-cytoplasm yamaseli aphethwe kune-nucleus yamaseli atholakala kalula.

Ngokwesilinganiso, abantu abathathu kwabayishumi abathole ingxibongo bafa kanti labo abasinda basala nezibazi.

Iningi labaphenyi licabanga ukuthi eminyakeni engaba ngu-6000 - 10,000 edlule ukufuywa kwezilwane, ukuthuthukiswa kokulinywa komhlaba kanye nokuthuthukiswa kwezindawo zokuhlala ezinkulu zabantu kudale izimo ezaholela ekuveleni kwengxibongo [5] .

Kodwa-ke, ngokusho kocwaningo olushicilelwe ephephabhukwini iClinical Infectious Diseases, igciwane le-variola kungenzeka ukuthi lidluliselwe kubantu ngokudluliselwa kwezinhlobo zezinto eziphilayo kusuka kumphathi osephelile [6] .

Izinhlobo Zengxibongo [7]

Isifo sengxibongo sinezinhlobo ezimbili:

• I-Variola enkulu - Kuyindlela ebucayi futhi ejwayelekile kakhulu yengxibongo enezinga lokufa ngamaphesenti angama-30. Kubanga ukushisa kakhulu nokuqubuka okukhulu. Okujwayelekile (ifomu elijwayeleke kakhulu), eliguquliwe (ifomu elithambile futhi lingavela kubantu ababegonywe phambilini), okuyisicaba nokopha kakhulu yizinhlobo ezine ze-variola ezinkulu. I-Flat and hemorrhagic yizinhlobo ezingavamile zengxibongo ezivame ukubulala. Isikhathi sokufukamela sengxibongo esopha kakhulu sifushane kakhulu futhi ekuqaleni, kunzima ukusihlola njengengxibongo.

• I-Variola encane - I-Variola minor yaziwa ngokuthi i-alastrim yindlela emincane yengxibongo eyayinezinga lokufa lephesenti elilodwa noma ngaphansi. Kubangela izimpawu ezimbalwa njengokuqubuka okuncane kakhulu kanye nokulimala.

Usakazeka Kanjani Ingxibongo?

Lesi sifo sisakazeka lapho umuntu otheleleke ngengxibongo ekhwehlela noma ethimula bese amathonsi okuphefumula ekhishwa emlonyeni noma ekhaleni bese ehogela omunye umuntu onempilo.

Leli gciwane lihogelwe bese liwela bese lithelela amaseli amboze umlomo, umphimbo nomgudu wokuphefumula. Uketshezi lomzimba oluthelelekile noma izinto ezingcolile ezifana nokulala noma okokwembatha nakho kungasabalalisa ingxibongo [8] .

Izimpawu Zengxibongo

Ngemuva kokutheleleka ngegciwane, isikhathi sokufukamela siphakathi kwezinsuku eziyi-7-19 (isilinganiso sezinsuku eziyi-10-14) Ngalesi sikhathi, igciwane liyaziphindaphinda emzimbeni, kepha umuntu kungenzeka angavami ukukhombisa izimpawu eziningi futhi angabukeka futhi azizwe enempilo . UDkt Sneha uthi, 'Noma umuntu engenazimpawu, angaba nomkhuhlane ophansi noma ukuqubuka okuncane okungabonakali kakhulu'.

Ngemuva kwesikhathi sokufukamela, izimpawu zokuqala ziqala ukuvela, ezibandakanya okulandelayo:

• Umkhuhlane omkhulu

• Ukuhlanza

• Ikhanda

• Ubuhlungu bomzimba

• Ukukhathala okukhulu

• Ubuhlungu obukhulu beqolo

Ngemuva kwalezi zimpawu zokuqala, ukuqubuka kuvela njengamabala amancane abomvu emlonyeni nasolimini okuhlala cishe izinsuku ezine.

Lezi zindawo ezincane ezibomvu ziguquka zibe yizilonda bese zingena emlonyeni nasemphinjeni bese ziya kuzo zonke izingxenye zomzimba kungakapheli amahora angama-24. Lesi sigaba sithatha izinsuku ezine. UDkt Sneha uthi, 'Ukusatshalaliswa kwamaqubu kuyinto ejwayelekile yengxibongo: ibonakala kuqala ebusweni, ezandleni nasemikhonweni bese isakazeka esiqwini nasemaphethelweni (ukubukeka ngokulandelana). Lokhu kubalulekile ekuhlukaniseni umkhuhlane omncane ku-varicella izifo '.

Ngosuku lwesine, izilonda zigcwala uketshezi olujiyile kuze kube yilapho uqweqwe lwakha phezu kwamaqhuqhuva ahlala izinsuku eziyishumi. Ngemuva kwalokho ocelemba baqala ukuwa, kushiye izibazi esikhumbeni. Lesi sigaba sithatha cishe izinsuku eziyisithupha.

Uma wonke uqweqwe seluwile, umuntu akasathathelani.

Uyini Umehluko Phakathi Kwengxibongo Nenkukhu?

UDkt Sneha uthi, 'Ukuqhuma kombungu okuncane kubonwa ebusweni bese kugudlukela emzimbeni bese kugcina izitho ezingezansi kanti ku-pox kuqhuma kuvela esifubeni nasesiswini kuqala bese kusakazeka kwezinye izingxenye (kuyaqabukela izintende nezinyawo). Isikhathi esisele phakathi komkhuhlane nokuqubuka esikhulayo singahluka kwezinye izimo '.

Ukuxilongwa Kwengxibongo

Ukunquma ukuthi ukuqubuka kuyingxibongo yini, iCenters for Disease Control and Prevention (CDC) incoma ukuthi kusetshenziswe i-algorithm ethi 'Evaluating Patients for Smallpox: Acute, Generalized Vesicular or Pustular Rash Illness Protocol' okuyindlela ejwayelekile yokuhlola iziguli ezineziqubu ngezifo ukuhlinzeka ngezinkomba zomtholampilo zokwahlukanisa ingxibongo kwezinye izifo ezisheshayo [9] .

Udokotela uzobe esehlola ngokomzimba isiguli bese ebuza ngomlando wabo wokuvakasha wakamuva, umlando wezokwelapha, ukuxhumana nezilwane ezigulayo noma ezingajwayelekile, izimpawu eziqale ngaphambi kokuqala kokuqubuka, ukuxhumana nanoma yibaphi abantu abagulayo, umlando we-varicella noma i-herpes zoster yangaphambilini nomlando wokugoma i-varicella.

Izindlela zokuxilonga ingxibongo zihlanganisa okulandelayo:

• Ukuba nemfiva engaphezu kuka-101 ° F futhi okungenani ube nesinye sezimpawu eziwukugodola, ukuhlanza, ukuphathwa ikhanda, ubuhlungu beqolo, ubuhlungu besisu obukhulu nokuguqa.

• Izilonda ezivela kunoma iyiphi ingxenye yomzimba efana nobuso nezingalo.

• Izilonda eziqinile noma ezinzima nezindilinga.

• Izilonda zokuqala ezivela ngaphakathi emlonyeni, ebusweni nasezingalweni.

• Izilonda ezintendeni nasematheni ezinyawo.

Ukuvimbela Nokwelashwa Kwengxibongo

Alikho ikhambi lengxibongo, kepha ukugoma ingxibongo kungavikela umuntu engxibaneni cishe iminyaka emithathu kuya kwemihlanu, ngemuva kwalokho izinga lokuvikelwa kwayo lehla. Ukugonywa kwe-booster kuyadingeka ukuvikela isikhathi eside engxibaneni, ngokwe-CDC [10] .

Umuthi wokugomela ingxibongo wenziwe ngegciwane le-vaccinia, i-poxvirus efana nengxibongo. Umuthi wokugoma uqukethe igciwane le-vaccinia bukhoma, hhayi igciwane elibulewe noma elenziwe buthaka.

Umuthi wokugomela ingxibongo unikezwa kusetshenziswa inaliti ehlukaniswe kabili efakwe ekhambi lomuthi wokugoma. Lapho usususiwe, inaliti iphatha ithonsi lomuthi wokugoma bese ligqobhoza esikhunjeni izikhathi eziyi-15 ngemizuzwana embalwa. Umuthi wokugoma uvame ukunikezwa engalweni engenhla futhi uma umuthi wokugoma uphumelela, kuba nesifo esibomvu futhi esilumayo endaweni egonyiwe ezinsukwini ezintathu kuya kwezine.

Phakathi nesonto lokuqala, isilonda siba yibhamuza eligcwele ubomvu bese liphuma. Ngesonto lesibili, lezi zilonda zomile bese ziqala ukwakha uqweqwe. Ngesonto lesithathu, uqweqwe luyawa lushiye isibazi esikhunjeni.

Umuthi wokugoma kufanele unikezwe ngaphambi kokuba umuntu athole igciwane futhi kungakapheli izinsuku ezintathu kuya kweziyisikhombisa etholwe yileli gciwane. Umuthi wokugoma ngeke umvikele umuntu uma ukuqubuka kwengxibongo kuvela esikhumbeni.

Ngo-1944, umuthi wokugomela ingxibongo obizwa ngokuthi i-dryvax wawunelayisense futhi wakhiqizwa kwaze kwaba maphakathi nawo-1980 lapho i-WHO yamemezela ukuqedwa kwengxibongo [ishumi nanye] .

Ngokusho kwe-U.S. Food and Drug Administration, njengamanje, kunomuthi wokugomela ingxibongo obizwa nge-ACAM2000, owawunikezwe ilayisense ngomhla zingama-31 kuNcwaba 2007. Lo mgomo waziwa ngokwenza abantu abasengozini enkulu yesifo sengxibongo bavikeleke. Kodwa-ke, kubangela imiphumela emibi efana nezinkinga zenhliziyo njenge-myocarditis ne-pericarditis [12] .

Ngo-2 Meyi 2005, i-CBER inikeze ilayisense i-Vaccinia Immune Globulin, Intravenous (VIGIV), esetshenziselwa ukwelashwa kwezinkinga ezinkulu ezingavamile zemigomo yengxibongo.

Umuthi wokugomela ingxibongo unemiphumela engemihle kuya kokubi kakhulu. Imiphumela emibi ethambile ifaka phakathi umkhuhlane, izinhlungu zemisipha, ukukhathala, ikhanda elibuhlungu, isicanucanu, ukuqubuka, ukukhathazeka, izilonda zesathelayithi kanye ne-lymphadenopathy yesifunda.

Ngawo-1960, kwabikwa imiphumela emibi kakhulu yokugonyelwa ingxibongo e-United States, futhi lokhu kwakuhlanganisa ukugoma okuqhubekayo (imigomo eyizigidi eziyi-1.5), ukugonywa kwe-eczema (ukugoma okuyizigidi ezingama-39), ukugoma okulandelayo kwe-postvaccinial (imigomo eyizigidi eziyi-12), ukugoma okuvamile (imigomo eyizigidi ezingama-241 ) ngisho nokufa (ukugoma okuyizigidi ezi-1) [13] .

Ubani Okufanele Agonywe?

• Umsebenzi waselebhu osebenza negciwane elibanga ingxibongo noma amanye amagciwane afana nawo kufanele agonywe (lokhu kwenzeka uma kungabhedukile ingxibongo).

• Umuntu ovezwe ngqo yigciwane lengxibongo ngokuhlangana ubuso nobuso nomuntu onengxibongo kufanele agonywe (lokhu kwenzeka lapho kubheduka ingxibongo) [14] .

Ubani Okungafanele Agonywe?

Ngokusho kwe-WHO, abantu abanezimo zesikhumba noma abanezimo zesikhumba, ikakhulukazi i-eczema noma i-atopic dermatitis, abantu abanamasosha omzimba abuthakathaka, abantu abane-HIV kanye nabantu abathola ukwelashwa komdlavuza akufanele bathole umuthi wokugomela ingxibongo ngaphandle uma bevezwa yilesi sifo. Lokhu kungenxa yengozi yabo eyengeziwe yokuba nemiphumela engemihle.

Abesifazane abakhulelwe akufanele bathole umuthi wokugoma ngoba ungalimaza umbungu. Abesifazane abancelisayo nezingane ezingaphansi kwezinyanga eziyi-12 ubudala akufanele bathole umuthi wokugomela ingxibongo [ishumi nanhlanu] .

Okufanele Ukwenze Ngemuva Kokugonywa?

• Indawo yokugoma kufanele imbozwe ngesiqeshana segayi ngetheyipu yosizo lokuqala. Qinisekisa ukuthi kukhona ukuhamba komoya okufanele futhi akukho ketshezi olungena kuwo.

• Gqoka ihembe elinemikhono egcwele ukuze likwazi ukumboza ibhandishi.

• Gcina indawo yomile futhi ungayivumeli ukuba imanzi. Uma iba manzi, yishintshe ngokushesha.

• Vala indawo ngebhandishi elingangeni manzi ngenkathi ugeza futhi ungahlanganyeli amathawula.

• Shintsha ibhandishi njalo ezinsukwini ezintathu.

• Geza izandla zakho ngemuva kokuthinta indawo yokugoma.

• Ungayithinti indawo futhi ungavumeli abanye bayithinte noma izinto ezifana nethawula, amabhandeshi, amashidi nezingubo ezithinte indawo egonyiwe.

• Hlanza izingubo zakho ngamanzi ashisayo ngesihlanza noma nge-bleach.

• Amabhandeshi asetshenzisiwe kufanele alahlwe ezikhwameni zepulasitiki bese ephonswa kudoti.

• Esikhwameni sepulasitiki faka zonke izinkalakatha eziwile bese uzilahla [16] .

Yayilawulwa Kanjani Ingxibongo Phambilini?

Ukuhlukahluka, okuqanjwe ngegciwane elibangela ingxibongo kwakungenye yezindlela zokuqala zokulawula ukusabalala kwesifo sengxibongo. Ukwehluka kwaba inqubo yokugoma umuntu ongakaze abe nengxibongo ngokusebenzisa okokusebenza okuvela ezilondeni zengxibongo yesiguli esinegciwane. Lokhu kwakwenziwa ngokuklwebha okokusebenza engalweni noma ukuhogela ngekhala futhi abantu baba nezimpawu ezinjengomkhuhlane nokuqubuka.

Kulinganiselwa ukuthi phakathi kwephesenti elilodwa kuya kwamaphesenti ama-2 abantu ababenezinhlobonhlobo bafa uma kuqhathaniswa namaphesenti angama-30 abantu abashona ngenkathi bethola ingxibongo. Kodwa-ke, ukwahlukahluka bekunezingozi eziningi, isiguli singafa noma omunye umuntu angasithola lesi sifo esigulini.

Izinga lokufa lokuhlukahluka beliphansi kayishumi uma kuqhathaniswa nengxibongo eyenzeka ngokwemvelo [17] .

Imibuzo evame ukubuzwa

U. Ingabe ingxibongo isekhona?

TO. Njengamanje, ayikho imibiko yokuvela kwengxibongo noma kuphi emhlabeni jikelele. Kodwa-ke, inani elincane legciwane lengxibongo lisekhona emalabhorethri amabili ocwaningo eRussia nase-USA.

U. Kungani ingxibongo yayibulala kangaka?

TO . Sasibulala ngoba sasiyisifo esisemoyeni esivame ukusabalala ngokushesha sisuke kumuntu onegciwane siye komunye.

U. Bangaki ababulawa yingxibongo?

TO . Kulinganiselwa ukuthi abantu abayizigidi ezingama-300 babulawa yingxibongo ngekhulu lama-20.

U. Ingabe ingxibongo iyoke ibuye?

TO . Cha, kepha ohulumeni bakholelwa ukuthi igciwane lengxibongo likhona kwezinye izindawo ngaphandle kwamalabhorethri angakhishwa ngamabomu abangele ukulimala.

U. Ngubani ongavikelekile engxibaneni?

TO. Abantu abagonywayo abavikelekile engxibaneni.

U. Ngubani owathola ikhambi lengxibongo?

TO . Ngo-1796, u-Edward Jenner wenza umzamo wesayensi wokulawula ingxibongo ngokusebenzisa umgomo ngamabomu.

U. Lwahlala isikhathi esingakanani ubhadane lwengxibongo?

TO . Ngokusho kwe-WHO, ingxibongo ikhona okungenani iminyaka engu-3 000.

Sneha KrishnanImithi EjwayelekileMBBS Yazi kabanzi