Kev Tshawb Fawb Txog Tshuaj Tiv Thaiv Harvard: Cov menyuam yaus uas tsis tau txhaj tshuaj tiv thaiv tsis txaus ntshai

2024 Tus sau: Seth Attwood | [email protected]. Kawg hloov kho: 2023-12-16 16:06

Nyob zoo cov neeg tsim cai lij choj, Kuv lub npe yog Tetiana Obukhanich. Kuv yog Tus Neeg Sib Tw ntawm Kev Tshawb Fawb hauv Immunology (PhD).

Kuv tab tom ua qhov kev thov rov hais dua hauv kev cia siab tias yuav kho qee qhov kev xav tsis zoo txog kev txhaj tshuaj tiv thaiv kom pab koj tsim lub tswv yim sib luag thiab ncaj ncees, txhawb nqa los ntawm ob qho tib si kev tshawb fawb tshuaj tiv thaiv thiab qhov kev tshawb pom tshiab tshaj plaws.

Cov menyuam yaus uas tsis tau txhaj tshuaj tiv thaiv puas txaus ntshai rau pej xeem ntau dua li cov menyuam yaus uas tau txhaj tshuaj?

Cov neeg uas txhob txwm xaiv tsis txhaj tshuaj tiv thaiv lawv cov menyuam tau ntseeg tias yuav ua rau muaj kev phom sij rau cov neeg nyob ib puag ncig lawv.

Nws yog qhov kev xav no uas qhia txog kev sim kom raug cai txwv tsis pub txhaj tshuaj tiv thaiv. Qhov teeb meem no tam sim no tau raug txiav txim siab ntawm tsoomfwv thiab xeev thoob plaws tebchaws.

Tab sis koj yuav tsum paub tias cov txheej txheem tiv thaiv ntawm cov tshuaj tiv thaiv niaj hnub no, suav nrog feem ntau ntawm cov tshuaj tiv thaiv tau pom zoo los ntawm Lub Chaw Tiv Thaiv Kab Mob (CDC), tsis zoo li qhov kev xav saum toj no.

Hauv qab no kuv yuav muab ib qho piv txwv ntawm ntau cov tshuaj tiv thaiv uas tsis tuaj yeem tiv thaiv kev kis tus kab mob, txawm yog vim lawv tsis tau tsim los ua li ntawd (xws li, lawv yuav tsum txo cov tsos mob ntawm tus kab mob), lossis vim lawv tau npaj rau tsis yog. - kab mob sib kis.

Cov neeg uas tsis tau txhaj tshuaj tiv thaiv kab mob hauv qab no tsis ua rau muaj kev pheej hmoo siab dua rau cov pej xeem ntau dua li cov tshuaj tiv thaiv. Qhov no txhais tau hais tias kev ntxub ntxaug rau cov menyuam yaus uas tsis tau txhaj tshuaj hauv tsev kawm ntawv tsis raug cai.

Inactivated polio vaccine (IPV) tsis tuaj yeem tiv thaiv kev sib kis ntawm tus kab mob polio (saib Daim Ntawv Qhia Ntxiv Kev Kawm # 1).

Tsis muaj tus kab mob polio qus hauv Tebchaws Meskas tau ntau dua 2 xyoo lawm. Txawm hais tias nws tau rov pib dua rau hauv lub tebchaws, cov tshuaj tiv thaiv tsis muaj zog yuav tsis tuaj yeem cuam tshuam rau pej xeem kev nyab xeeb. Nws yuav tsum raug sau tseg tias lwm cov tshuaj tiv thaiv, tshuaj tiv thaiv kab mob hauv qhov ncauj (OPV), pab txhawb kev tshem tawm tus kab mob qus.

Txawm hais tias nws muaj peev xwm tiv thaiv tus kab mob poliovirus qus, kev siv OPV hauv Tebchaws Meskas tau raug txiav tawm mus ntev thiab hloov nrog IPV vim muaj kev nyab xeeb.

Tetanus tsis yog kis tau tus kab mob, tab sis tau txais los ntawm qhov tob tob ntawm qhov txhab ntawm C. tetani spores. Kev txhaj tshuaj tiv thaiv kab mob tetanus (raws li ib feem ntawm cov tshuaj tiv thaiv DPT) tsis tuaj yeem cuam tshuam kev nyab xeeb ntawm kev nyob hauv cov chaw pej xeem, nws xav tias tsuas yog tus neeg txhaj tshuaj tiv thaiv xwb.

Diphtheria toxoid (tseem muaj nyob rau hauv cov tshuaj tiv thaiv complex), tsim los tiv thaiv cov tsos mob ntawm tus kab mob diphtheria, tsis txhais hais tias kev sib ntaus sib tua colonization thiab kis ntawm cov kab mob C. diphtheriae. Kev txhaj tshuaj tiv thaiv yog tsim los tiv thaiv tus kheej thiab tsis cuam tshuam rau kev nyab xeeb ntawm kev nyob hauv qhov chaw muaj neeg coob coob.

Cov tshuaj tiv thaiv kab mob acellular pertussis tam sim no (qhov kawg ntawm cov tshuaj tiv thaiv kab mob) tau hloov tag nrho-cell pertussis nyob rau xyoo 1990, ua rau muaj qhov tsis tau muaj dua los ntawm kev hnoos hawb pob.

Kev sim tshuaj tiv thaiv kab mob acellular pertussis rau primates tau pom tias nws tsis muaj peev xwm tiv thaiv kev colonization thiab kis ntawm cov kab mob uas ua rau tus kab mob pertussis B. Pertusiss (saib txoj kev tshawb no # 2 hauv Cov Ntawv Ntxiv). Lub Chaw Tswj Xyuas Khoom Noj thiab Tshuaj (FDA) tau tshaj tawm lus ceeb toom txog cov ntaub ntawv tseem ceeb no [1].

Tsis tas li ntawd, xyoo 2013, ntawm lub rooj sib tham ntawm Pawg Neeg Saib Xyuas Kev Tshawb Fawb ntawm Lub Tsev Haujlwm Saib Xyuas Kab Mob, cov pov thawj ceeb toom tau hais tias ib hom hnoos hawb pob (PRN tsis zoo strain) nyob hauv Tebchaws Meskas tau txais kev muaj peev xwm kis tau cov neeg uas. tau txhaj tshuaj tiv thaiv raws sijhawm (saib CDC daim ntawv #3 hauv daim ntawv ntxiv).

Qhov no txhais tau hais tias cov neeg zoo li no tau kis tus kab mob ntau dua, thiab yog li kev kis tus kab mob, ntau dua li cov neeg tsis tau txais tshuaj tiv thaiv.

Muaj ntau hom kab mob Haemophilus influenzae (H. influenzae), tab sis cov tshuaj tiv thaiv Hib tsuas yog siv tau rau hom b. Txawm tias muaj tseeb hais tias tib lub hom phiaj ntawm cov tshuaj tiv thaiv no yog kom txo tau qhov tshwm sim thiab asymptomatic chav kawm ntawm tus kab mob, nws muab tawm hais tias tom qab pib ntawm nws siv, cov kab mob ntawm lwm yam kab mob H. influenzae (hom a los ntawm f) pib. yeej.

Nws yog cov hom no uas ua rau muaj mob hnyav nrog kev ua nruj ua tsiv thiab nce qhov tshwm sim ntawm cov neeg laus, thaum lawv tsuas yog txhaj tshuaj tiv thaiv menyuam yaus (saib txoj kev kawm No. 4 hauv daim ntawv ntxiv)

Cov tiam tam sim no muaj kev cuam tshuam ntau dua rau cov kab mob sib kis ntau dua li nws tau ua ua ntej kev txhaj tshuaj tiv thaiv Hib. Nyob rau hauv ib lub sijhawm uas tsis yog-b-hom H. influenzae yog qhov tseem ceeb, kev ntxub ntxaug rau cov menyuam yaus uas tsis tau txhaj tshuaj tiv thaiv Hib tsis muaj kev tshawb fawb.

Tus kab mob siab B kis tau los ntawm cov ntshav. Lawv yuav tsum tsis txhob kis tus kab mob hauv cov chaw pej xeem, tshwj xeeb tshaj yog cov menyuam yaus uas tsis muaj kev pheej hmoo (sib koom koob lossis kev sib deev).

Kev txhaj tshuaj tiv thaiv cov menyuam tiv thaiv kab mob siab B tsis tuaj yeem cuam tshuam kev nyab xeeb ntawm zej zog. Tsis tas li ntawd, cov menyuam yaus uas muaj kab mob siab B mob ntev tsis raug txwv tsis pub mus kawm ntawv. Kev txwv tsis pub nkag mus rau cov tsev kawm ntawv ntawm cov menyuam yaus uas tsis tau txhaj tshuaj tiv thaiv kab mob (tsis yog tus kab mob siab kab mob siab) yog kev ntxub ntxaug thiab tsis ncaj ncees.

Yog li, peb tuaj yeem txiav txim siab tias tus neeg uas tsis tau txhaj tshuaj tiv thaiv rau qee yam laj thawj los ntawm tus mob polio, hnoos hawb pob, diphtheria, tetanus, kab mob siab B thiab kab mob hemophilic tsis ua rau muaj kev hem thawj rau tib neeg ntau dua li cov tshuaj tiv thaiv. Kev ua txhaum cai thiab kev ntxub ntxaug ntawm cov neeg zoo li no tsis raug cai.

Cov tshuaj tiv thaiv tsis zoo tshwm sim ntau npaum li cas?

Nws tau sib cav tias kev txhaj tshuaj tiv thaiv tsis tshua muaj qhov tshwm sim loj heev. Hmoov tsis zoo, qhov kev thov no tsis tuaj yeem ua pov thawj scientific.

Ib txoj kev tshawb fawb tsis ntev los no hauv Ontario, Canada pom tias tom qab txhaj tshuaj tiv thaiv, 1 ntawm 168 tus menyuam raug tso rau hauv chav xwm txheej ceev hauv 12 lub hlis ntawm kev txhaj tshuaj thiab 1 ntawm 730 nyob rau hauv 18 lub hlis (saib kev kawm # 5 hauv daim ntawv ntxiv).

Thaum muaj kev pheej hmoo ntawm cov teeb meem tom qab txhaj tshuaj tiv thaiv uas xav tau kev kho mob zoo heev, kev txiav txim siab ntawm kev txhaj tshuaj tiv thaiv yuav tsum nyob nrog cov niam txiv, uas, vim li cas, tej zaum yuav tsis xav ua qhov kev pheej hmoo, txhawm rau tiv thaiv lawv cov menyuam los ntawm cov kab mob uas. lawv yuav tsis ntsib.

Puas yuav txwv txoj cai ntawm cov tsev neeg uas paub txog qhov tsis kam txhaj tshuaj tiv thaiv pab tiv thaiv kev kis tus kab mob xws li qhua pias yav tom ntej?

Cov kws tshawb fawb kab mob qhua pias tau paub ntev txog qhov hu ua measles paradox. Hauv qab no kuv hais los ntawm ib tsab xov xwm los ntawm Poland thiab Jacobson (1994) "Failed Eradication of Measles: The Obvious Paradox of Measles Infection in the Vaccinated Person" (Arch Intern Med 154: 1815-1820).

"Qhov pom tseeb tsis zoo yog tias kev tiv thaiv kev tiv thaiv nce ntxiv, mob qhua pias dhau los ua kab mob ntawm cov neeg txhaj tshuaj" [2]

Kev tshawb fawb ntxiv tau pom tias cov neeg uas muaj lub cev tsis muaj zog tiv thaiv kab mob yog qhov ua rau muaj qhov tsis zoo no. Cov no yog cov uas tsis teb zoo rau thawj koob tshuaj tiv thaiv kab mob qhua pias, mus rau revaccination tiv thaiv kab mob qhua pias, thiab tom qab 2-5 xyoos lawv yuav kis tau tus kab mob no dua, txawm tias lawv tau txhaj tshuaj tag nrho. [3]

Revaccination tsis daws teeb meem nyob rau hauv cov ntaub ntawv ntawm lub cev tsis muaj zog teb, vim qhov no yog ib tug immunogenetic feature. [4] Hauv Tebchaws Meskas, feem pua ntawm cov menyuam yaus tsis zoo rau kev txhaj tshuaj yog 4.7%. [5]

Hauv kev tshawb fawb txog tus kab mob qhua pias nyob rau hauv Quebec, Canada thiab Tuam Tshoj, nws tau pom tias cov kab mob no tseem tshwm sim, txawm tias qhov tseeb tias qhov tshuaj tiv thaiv yog nyob rau theem siab tshaj (95-97% lossis txawm tias 99%, saib kev kawm # 6. 7 hauv daim ntawv ntxiv).

Qhov no yog vim hais tias txawm nyob rau hauv cov neeg uas muaj kev tiv thaiv kab mob siab, cov tshuaj tiv thaiv kab mob tom qab txhaj tshuaj txo qis thaum lub sijhawm. Kev tiv thaiv tom qab txhaj tshuaj tiv thaiv tsis yog sib npaug ntawm kev tiv thaiv ib puag ncig uas tau txais tom qab muaj mob ntuj tsim.

Cov ntaub ntawv sau tseg qhov tseeb tias txhaj tshuaj tiv thaiv cov neeg uas tau mob qhua pias yog kis tau. Tsis tas li ntawd, ob qhov kev kis mob qhua pias loj tshaj plaws hauv xyoo 2011 (hauv Quebec, Canada thiab New York) yog vim yav tas los txhaj tshuaj tiv thaiv cov neeg mob qhua pias. [6] - [7]

Tag nrho cov saum toj no ua rau nws pom tseeb tias kev txwv tsis pub muaj cai tsis kam txhaj tshuaj tiv thaiv, uas yog siv los ntawm ib feem me me ntawm cov tsev neeg, yuav tsis pab daws qhov teeb meem ntawm kev rov tshwm sim ntawm cov kab mob, ib yam li nws yuav tsis tuaj yeem tiv thaiv. kev ntshuam thiab tawm ntawm cov kab mob yav tas los exterminated.

Puas yog txwv txoj cai ntawm cov neeg uas tsis paub tsis kam txhaj tshuaj tiv thaiv tsuas yog kev daws teeb meem xwb?

Cov xwm txheej tsis ntev los no ntawm tus kab mob qhua pias hauv Tebchaws Meskas (xws li qhov tshwm sim tsis ntev los no ntawm Disneyland) yog nyob rau hauv cov neeg laus thiab menyuam mos, thaum lub sijhawm ua ntej txhaj tshuaj tiv thaiv, feem ntau yog menyuam yaus hnub nyoog 1 txog 15 xyoos.

Cov kab mob qhua pias tau hloov mus rau lub neej, thaum kev tiv thaiv kab mob tom qab txhaj tshuaj tsis muaj zog thaum lub sijhawm, ua rau cov neeg laus tsis muaj kev tiv thaiv. Measles yog qhov txaus ntshai rau cov neeg laus thiab menyuam mos ntau dua li cov menyuam yaus hnub nyoog kawm ntawv.

Txawm hais tias muaj kev pheej hmoo loj ntawm kev kis kab mob hauv lub sijhawm ua ntej txhaj tshuaj tiv thaiv, tus kab mob qhua pias tsis tau pom muaj nyob hauv cov menyuam yaus hnub nyoog qis dua 1 xyoos, vim tias kev kis tus kab mob tsis tu ncua los ntawm leej niam.

Tam sim no qhov kev raug mob ntawm cov me nyuam mos rau qhua pias yog qhov tshwm sim ntawm kev txhaj tshuaj tiv thaiv ntev dhau los, thaum lawv niam, txhaj tshuaj tiv thaiv raws li menyuam yaus, tsis muaj peev xwm kis tus mob qhua pias thiab yog li tau txais kev tiv thaiv tas mus li uas lawv yuav kis mus rau lawv cov menyuam thiab tiv thaiv. lawv nyob 1 xyoo lub neej.

Hmoov zoo, muaj ib txoj hauv kev los ua kev tiv thaiv niam txiv. Cov me nyuam mos thiab cov neeg muaj kev tiv thaiv kab mob tuaj yeem tau txais cov tshuaj immunoglobulin ua ib qho kev cawm seej uas muab lub cev nrog cov tshuaj tiv thaiv kab mob los tiv thaiv lossis txo tus kab mob thaum muaj kev sib kis (saib Daim Ntawv Ntxiv 8).

Txhawm rau sau cov lus saum toj no:

1. Raws li cov khoom ntawm cov tshuaj tiv thaiv niaj hnub no, cov neeg tsis muaj tshuaj tiv thaiv tsis ua rau muaj kev pheej hmoo ntau dua ntawm kev kis tus kab mob poliomyelitis, diphtheria, pertussis thiab ntau hom kab mob H. influenza piv nrog cov neeg txhaj tshuaj; qhov tsis tau txhaj tshuaj tiv thaiv kuj tsis muaj kev pheej hmoo kis tus kab mob siab B hauv tsev kawm ntawv ib puag ncig, thiab tetanus tsis kis txhua.
2. Qhov kev pheej hmoo ntawm kev mus rau lub tuam tsev kho mob xwm txheej ceev tom qab txhaj tshuaj tiv thaiv tau nce ntxiv, qhia tias kev txhaj tshuaj tsis zoo;
3. Cov kab mob qhua pias tsis tuaj yeem tiv thaiv tau tag nrho txawm tias kev txhaj tshuaj tiv thaiv tiav lawm;
4. Kev tswj hwm Immunoglobulin yog ib txoj hauv kev zoo los tiv thaiv kab mob qhua pias thiab lwm yam kab mob hauv cov menyuam mos thiab cov neeg muaj kev tiv thaiv kab mob. Nws kuj tseem siv tau thaum muaj kev pheej hmoo kis mob.

Cov lus tseeb saum toj no piav qhia vim li cas kev ntxub ntxaug tawm tsam cov menyuam yaus uas tsis tau txhaj tshuaj hauv tsev kawm ntawv kev kawm dav dav yog qhov tsis ncaj ncees, vim tias tsis muaj tshuaj tiv thaiv ntawm cov neeg tawm tsam tsis txaus ntseeg tsis ua rau muaj kev pheej hmoo tshwj xeeb rau tib neeg.

Ua tsaug rau koj, Tetiana Obukhanich, PhD

Tetiana Obukhanich yog tus sau Vaccine Illusion. Nws kawm txog kev tiv thaiv kab mob hauv cov tsev kho mob muaj koob npe tshaj plaws. Tetyana tau txais nws daim ntawv kawm tiav hauv kev tiv thaiv kab mob los ntawm Rockefeller University hauv New York, thiab tom qab ntawd nws kawm hauv Harvard Medical School (Boston, Massachusetts) thiab Stanford University (California).

APPENDIX

#1. Cuba IPV Study kev koom tes pab pawg. (2007) Randomized tswj sim ntawm inactivated poliovirus tshuaj tiv thaiv nyob rau hauv teb chaws Cuba. N Engl J Med 356: 1536-44

#2. Warfel et al. (2014) Cov tshuaj tiv thaiv kab mob acellular pertussis tiv thaiv kab mob tab sis tsis tiv thaiv kab mob thiab kev sib kis hauv cov qauv tsis yog tib neeg. Proc Natl Acad Sci USA 111: 787-92

No. 3. Lub Rooj Sib Tham ntawm Pawg Neeg Saib Xyuas Kev Tshawb Fawb, Lub Chaw Haujlwm Saib Xyuas Kabmob Sib Kis, Lub Chaw Tiv Thaiv Kab Mob thiab Tiv Thaiv, Tom Harkins Ntiaj Teb Kev Sib Txuas Chaw, Atlanta, Georgia, Kaum Ob Hlis 11-12, 2013

No. 4. Rubach et al. (2011) Kev nce ntxiv ntawm tus kab mob Haemophilus influenzae invasive hauv cov neeg laus, Utah, USA. Emerg Infect Dis 17:1645-50

No. 5. Wilson et al. (2011) Cov xwm txheej tsis zoo tom qab 12 thiab 18 lub hlis txhaj tshuaj tiv thaiv: kev soj ntsuam ntawm cov pej xeem, tswj tus kheej cov ntaub ntawv. PLoS Ib 6: e27897

No. 6. De Serres et al.(2013) Tus kab mob qhua pias loj tshaj plaws nyob rau hauv North America nyob rau hauv ib xyoo caum - Quebec, Canada, 2011: kev koom tes ntawm susceptibility, serendipity, thiab superspreading txheej xwm. J Infect Dis 207: 990-98

No. 7. Wang et al. (2014) Qhov nyuaj ntawm kev tshem tawm tus mob qhua pias thiab tswj tus kab mob rubella thiab mumps: kev kawm hla ntu ntawm thawj koob tshuaj tiv thaiv kab mob qhua pias thiab rubella thiab tshuaj tiv thaiv kab mob qhua pias thib ob, mumps, thiab rubella. ib 9:e89361

No. 8. Immunoglobulin Phau Ntawv Qhia, Lub Chaw Saib Xyuas Kev Noj Qab Haus Huv

Sau: Tetiana Obukhanich

Txhais: Ekaterina Cherepanova tshwj xeeb rau qhov project MedAlternativa.info

Peb ua tsaug rau Ekaterina Cherepanova rau kev pab dawb!