nūhou

Hoʻokahi haneli mau makahiki i hala aku nei, ua hoʻokomo ʻia kahi kanaka 24 makahiki i ka Halemai Nui o Massachusetts (MGH) me ke kuni, ka ʻū, a me ka pilikia o ka hanu.
Ua olakino ka mea maʻi no ʻekolu lā ma mua o ke komo ʻana, a laila hoʻomaka ʻo ia e ʻeha, me ka luhi nui, ke poʻo a me ka ʻeha hope. Ua piʻi aʻe kona maʻi i nā lā ʻelua aʻe a ua hoʻohana ʻo ia i ka hapa nui o kona manawa ma kahi moe. I hoʻokahi lā ma mua o ke komo ʻana, ua loaʻa ʻo ia i ke kuni kiʻekiʻe, ka ʻū maloʻo a me ke anuanu, i wehewehe ʻia e ka mea maʻi he "kulou" a hiki ʻole ke haʻalele i kahi moe. Lawe ʻo ia i ka 648 mg o ka aspirin i kēlā me kēia ʻehā hola a loaʻa iā ia kahi hōʻoluʻolu iki mai ka ʻeha poʻo a me ka ʻeha hope. Eia naʻe, i ka lā o ke komo ʻana, ua hele mai ʻo ia i ka haukapila ma hope o ke ala ʻana i ke kakahiaka me ka dyspnea, i hele pū ʻia me ka ʻeha subxiphoid chest, i hoʻonui ʻia e ka hanu hohonu a me ka ʻū.
I ke komo ʻana, ʻo ka mahana rectal he 39.5 ° C a 40.8 ° C, ʻo ka puʻuwai puʻuwai he 92 a 145 beats / min, a ʻo ka hanu hanu he 28 a 58 beats / min. ʻO ka mea maʻi he makaʻu a me ke ʻano koʻikoʻi. ʻOiai ua wahī ʻia i loko o nā pākeʻe he nui, ua hoʻomau ke anuanu. ʻO ka pōkole o ka hanu, hele pū ʻia me nā paroxysms o ka ʻuʻu ikaika, ka hopena i ka ʻeha nui ma lalo o ka sternum, ka ʻū ʻana o ka phlegm pink, viscous, purulent iki.
Ua ʻike ʻia ka pulsation Apical i ka lima o ka intercostal space ma ka ʻaoʻao hema o ka sternum, a ʻaʻole i ʻike ʻia ka hoʻonui ʻana o ka puʻuwai ma ka percussion. Ua hōʻike ka auscultation i ka wikiwiki o ka puʻuwai, ka puʻuwai kūpaʻa, lohe ʻia ma ka piko o ka puʻuwai, a me kahi ʻōhumu systolic iki. Hoʻemi ʻia ke kani ʻana o ka hanu ma ka ʻaoʻao ʻākau o ke kua mai ka hapakolu ma lalo o nā ʻūhā poʻohiwi, akā ʻaʻole i lohe ʻia nā rales a i ʻole pleural fricatives. ʻO ka ʻulaʻula iki a me ka pehu ma ka ʻāʻī, wehe ʻia nā tonsils. ʻIke ʻia ka ʻili o ka hoʻoponopono ʻana i ka hernia inguinal hema ma ka ʻōpū, ʻaʻohe pehu a palupalu paha i loko o ka ʻōpū. ʻO ka ʻili maloʻo, ka wela o ka ʻili kiʻekiʻe. ʻO ka helu o ke koko keʻokeʻo ma waena o 3700 a me 14500/ul, a ʻo nā neutrophils he 79%. ʻAʻole i ʻike ʻia ka ulu ʻana o ka bacteria ma ka moʻomeheu koko.
Hōʻike ka lekiō umauma i nā aka ma nā ʻaoʻao ʻelua o ka māmā, ʻo ia hoʻi ma ka lobe ʻākau o luna a me ka lobe hema hema, e hōʻike ana i ka maʻi pneumonia. ʻO ka hoʻonui ʻia ʻana o ka hilum hema o ka māmā e hōʻike ana i ka hoʻonui ʻia ʻana o ka pūnāwai lymph, koe wale nō ka hoʻoheheʻe ʻana o ka pleural hema.

I ka lua o ka lā o ka hale maʻi, ua loaʻa i ka mea maʻi ka dyspnea a me ka ʻeha mau o ka umauma, a he purulent a he koko ka sputum. Ua hōʻike ʻia ma ka hoʻokolokolo kino he systolic murmur conduction ma ka piko o ka māmā, a ʻo ke kuʻi ʻana ma lalo o ka māmā ʻākau ua ʻā. ʻIke ʻia nā papules liʻiliʻi ma ka lima hema a me ka manamana lima ʻākau. Ua wehewehe nā kauka i ke kūlana o ka mea maʻi he "grim". I ke kolu o ka lā, ua ʻike ʻia ka purulent sputum. Ua hoʻonui ʻia ka ʻoluʻolu o ka ʻaoʻao hema hema a ʻo ka haʻalulu haʻalulu. Hiki ke lohe ʻia ke kani ʻana o ka hanu Bronchial a me kekahi mau rale ma ka ʻaoʻao hema ma kahi hapakolu o ke ala i lalo mai ka ʻūhā poʻohiwi. ʻO ke kuʻi ʻana ma ka ʻaoʻao ʻākau, ua ʻoluʻolu iki, ua lōʻihi nā leo hanu, a lohe ʻia nā rale i kekahi manawa.
I ka hā o ka lā, ua ʻoi aʻe ka maʻi o ka mea maʻi a ua make ʻo ia ia pō.

ʻIkepili

Ua mālama ʻia ke kāne he 24 mau makahiki i ka haukapila i Malaki 1923 me ke kuni nui, ke anuanu, ka ʻeha o ka ʻiʻo, ka pōkole o ka hanu, a me ka ʻeha o ka umauma pleurisy. ʻO kāna mau hōʻailona a me nā hōʻailona e kūlike loa me ka maʻi maʻi maʻi hanu, e like me ka maʻi influenza, me ka maʻi bacterial lua. ʻOiai ua like loa kēia mau hōʻailona me nā hihia i ka wā o ka maʻi maʻi maʻi 1918, ʻo ka maʻi influenza paha ka maʻi maʻi kūpono loa.

ʻOiai ua like nā hōʻike a me nā pilikia o ka maʻi influenza hou i ka maʻi maʻi 1918, ua hana ke kaiāulu ʻepekema i nā holomua koʻikoʻi i nā makahiki i hala iho nei, me ka ʻike ʻana a me ka hoʻokaʻawale ʻana o nā maʻi maʻi influenza, ka hoʻomohala ʻana i nā ʻenehana diagnostic wikiwiki, ka hoʻokomo ʻana i nā lāʻau antiviral maikaʻi, a me ka hoʻokō ʻana i nā ʻōnaehana nānā a me nā papahana lapaʻau. ʻO ka nānā ʻana i hope i ka maʻi maʻi maʻi 1918 ʻaʻole wale e noʻonoʻo i nā haʻawina o ka mōʻaukala, akā hoʻomākaukau maikaʻi nō hoʻi iā mākou no nā maʻi maʻi e hiki mai ana.
Ua hoʻomaka ka maʻi maʻi maʻi 1918 ma ʻAmelika Hui Pū ʻIa. ʻO ka hihia mua i hoʻopaʻa ʻia ma Malaki 4, 1918, ma kahi kuke pūʻali koa ma Fort Riley, Kansas. A laila ua kākau ʻo Lorrin Miner, he kauka ma Haskell County, Kansas, i nā hihia he 18 o ka maʻi maʻi nui, me ʻekolu mau make. Ua hōʻike ʻo ia i kēia ʻike i ka US Department of Public Health, akā ʻaʻole i mālama nui ʻia.
Manaʻo ka poʻe mōʻaukala ʻo ka hiki ʻole o nā luna olakino o ka lehulehu i ka manawa e pane aku ai i ka maʻi maʻi e pili kokoke ana i ka pōʻaiapili kūikawā o ke Kaua Honua Mua. I mea e pale aku ai i ka hopena o ke kaua, ua noho mālie ke aupuni e pili ana i ka paʻakikī o ka maʻi maʻi. Ua hōʻino ʻo John Barry, ka mea kākau o The Great Flu, i ka hanana i ka hālāwai ninaninau 2020: "Ke wahaheʻe nei ke aupuni, ke kapa nei lākou he anu maʻamau, ʻaʻole lākou e haʻi i ka lehulehu i ka ʻoiaʻiʻo." Ma ka hoʻohālikelike ʻana, ʻo Sepania, kahi ʻāina kūʻokoʻa i kēlā manawa, ʻo ia ka mea mua i hōʻike i ka maʻi maʻi i ka pāpā, e alakaʻi ana i ka maʻi maʻi hou i kapa ʻia ʻo "Spanish flu," ʻoiai ʻo nā hihia mua loa i hoʻopaʻa ʻia ma United States.
Ma waena o Kepakemapa a me Kekemapa 1918, ua manaʻo ʻia he 300,000 ka poʻe i make i ka maʻi maʻi maʻi ma ʻAmelika Hui Pū ʻIa, he 10 ka nui o ka nui o ka make mai nā kumu a pau ma ʻAmelika Hui Pū ʻIa i ka manawa like i ka makahiki 1915. Laha koke ka maʻi maʻi ma o ka hoʻouka kaua a me ka neʻe ʻana o nā limahana. ʻAʻole i neʻe wale nā ​​koa ma waena o nā hub kaʻa ma ka hikina, akā lawe pū kekahi i ka maʻi i nā kahua kaua o ʻEulopa, e hoʻolaha ana i ka maʻi maʻi a puni ka honua. Ua manaʻo ʻia ʻoi aku ma mua o 500 miliona mau kānaka i loaʻa i ka maʻi a ma kahi o 100 miliona i nalowale i ko lākou ola.
Ua kaupalena ʻia ka lāʻau lapaʻau. ʻO ka lāʻau lapaʻau ka mea palliative, me ka hoʻohana ʻana i ka aspirin a me nā opiates. ʻO ka lāʻau lapaʻau wale nō i hiki ke kūpono ʻo ia ka convalescent plasma infusion - i ʻike ʻia i kēia lā ʻo ka convalescent plasma therapy. Eia nō naʻe, ua lohi ka hiki ʻana mai o nā lāʻau lapaʻau maʻi maʻi no ka mea ʻaʻole i ʻike ka poʻe ʻepekema i ke kumu o ka maʻi maʻi. Eia kekahi, ʻoi aku ma mua o ka hapakolu o nā kauka a me nā kahu hānai ʻAmelika i hoʻoneʻe ʻia ma muli o ko lākou komo ʻana i ke kaua, me ka haʻalele ʻana i nā kumuwaiwai olakino. ʻOiai ua loaʻa nā lāʻau lapaʻau no ka maʻi kolera, typhoid, maʻi ahulau, a me ka maʻi maʻi liʻiliʻi, ʻaʻole naʻe ka hoʻomohala ʻana i ka maʻi maʻi influenza.
Ma o nā haʻawina ʻehaʻeha o ka maʻi maʻi influenza 1918, ua aʻo mākou i ke koʻikoʻi o ka hōʻike ʻike maopopo, ka holomua o ka noiʻi ʻepekema, a me ka launa pū ʻana i ke olakino honua. Hāʻawi kēia mau ʻike i nā ʻike koʻikoʻi no ka hoʻoponopono ʻana i nā hoʻoweliweli olakino like honua i ka wā e hiki mai ana.

Virus

No nā makahiki he nui, ua manaʻo ʻia ka mea kumu o ka "flu Spanish" ʻo ia ka bacteria Pfeiffer (i kēia manawa ʻo Haemophilus influenzae), i loaʻa i ka sputum o nā maʻi he nui, akā ʻaʻole nā ​​​​mea āpau. Eia nō naʻe, ua manaʻo ʻia kēia maʻi bacteria i ka paʻakikī i ka moʻomeheu ma muli o kona kūlana moʻomeheu kiʻekiʻe, a no ka mea ʻaʻole i ʻike ʻia i nā hihia āpau, ua nīnau mau ke kaiāulu ʻepekema i kona kuleana ma ke ʻano he pathogen. Ua hōʻike ʻia nā haʻawina ma hope mai ʻo Haemophilus influenzae ka pathogen o ka maʻi maʻi pālua maʻamau i ka maʻi influenza, ma mua o ka maʻi maʻi i hoʻokumu pololei i ka maʻi influenza.
I ka makahiki 1933, ua lanakila ʻo Wilson Smith a me kāna hui. Lawe lākou i nā laʻana mai ka pharyngeal flusher mai nā maʻi maʻi maʻi, holo iā lākou ma kahi kānana bacteria e hoʻopau i ka maʻi bacteria, a laila hoʻāʻo me ka filtrate sterile ma nā ferrets. Ma hope o ʻelua mau lā, ua hoʻomaka nā ferrets i hōʻike ʻia e hōʻike i nā hōʻailona like me ka maʻi maʻi maʻi kanaka. ʻO ka haʻawina ka mea mua e hōʻoia i ke kumu o ka maʻi influenza ma mua o ka bacteria. I ka hōʻike ʻana i kēia mau ʻike, ua ʻike pū ka poʻe noiʻi i ka maʻi ma mua o ka maʻi maʻi hiki ke pale maikaʻi i ka maʻi hou ʻana o ka maʻi like, e waiho ana i ke kumu kumu no ka hoʻomohala ʻana i ka maʻi.
I kekahi mau makahiki ma hope mai, ʻo Charles Stuart-Harris, ka hoa hana o Smith, ʻoiai e nānā ana i kahi ferret i loaʻa i ka maʻi influenza, ua loaʻa ʻole ʻo ia i ka maʻi mai ka ʻike kokoke ʻana i ka sneeze o ka ferret. ʻO ka maʻi i hoʻokaʻawale ʻia mai Harris a laila ua hoʻopilikia maikaʻi ʻia kahi ferret uninfected, e hōʻoia hou ana i ka hiki o nā maʻi maʻi influenza e laha ma waena o ke kanaka a me nā holoholona. I loko o kahi hōʻike pili, ua ʻike nā mea kākau "hiki ke noʻonoʻo ʻia e hiki i nā maʻi maʻi ke hoʻomaka i nā maʻi maʻi."

Kano kano

I ka wā i hoʻokaʻawale ʻia a ʻike ʻia ka maʻi maʻi flu, ua hoʻomaka koke ke kaiāulu ʻepekema e hoʻomohala i kahi kano. I ka makahiki 1936, ua hōʻike mua ʻo Frank Macfarlane Burnet e hiki ke ulu maikaʻi nā maʻi maʻi influenza i loko o nā hua momona, kahi ʻike i hāʻawi i kahi ʻenehana holomua no ka hana ʻana i ka lāʻau lapaʻau i hoʻohana nui ʻia i kēia mau lā. I ka makahiki 1940, ua holomua ʻo Thomas Francis lāua ʻo Jonas Salk i ka lāʻau lapaʻau mua.
ʻO ka pono o ka lāʻau lapaʻau i koʻikoʻi loa i ka pūʻali koa US, ma muli o ka hopena pōʻino o ka maʻi influenza ma luna o nā pūʻali koa US i ka wā o ke Kaua Honua I. Ma ka makahiki 1942, ua hōʻoia nā haʻawina ua maikaʻi ka lāʻau lapaʻau i ka hoʻolako ʻana i ka pale, a ʻoi aku ka liʻiliʻi o ka poʻe i hoʻopaʻa ʻia i ka maʻi maʻi. I ka makahiki 1946, ua ʻae ʻia ka lāʻau lapaʻau mua no ka hoʻohana kīwila, e wehe ana i kahi mokuna hou i ka pale ʻana a me ka mālama ʻana.
ʻIke ʻia he hopena koʻikoʻi ka loaʻa ʻana o ka maʻi maʻi maʻi: ʻo ka poʻe i hoʻopaʻa ʻole ʻia he 10 a 25 mau manawa ke loaʻa i ka maʻi maʻi ma mua o ka poʻe e hana nei.

Ka nānā ʻana

Pono ka nānā ʻana i ka maʻi influenza a me kāna mau maʻi maʻi kikoʻī e alakaʻi i nā pane olakino ākea a hoʻomohala i nā papa hana o ka lāʻau lapaʻau. Ma muli o ke ʻano honua o ka maʻi influenza, pono pono nā ʻōnaehana mākaʻikaʻi aupuni a me ka honua.
Ua hoʻokumu ʻia nā Centers for Disease Control and Prevention (CDC) i ka makahiki 1946 a ua hoʻomaka mua i ka noiʻi ʻana i nā maʻi maʻi e like me ka malaria, typhus a me ka liʻiliʻi. I loko o ʻelima mau makahiki o kona hoʻokumu ʻia ʻana, ua hoʻokumu ʻo CDC i ka Epidemic Intelligence Service e hāʻawi i ka hoʻomaʻamaʻa kūikawā e noiʻi i nā maʻi maʻi. I ka makahiki 1954, ua hoʻokumu ka CDC i kāna ʻōnaehana kiaʻi influenza mua a hoʻomaka e hoʻopuka i nā hōʻike maʻamau e pili ana i ka hana maʻi maʻi maʻi, e kau ana i ke kumu no ka pale ʻana a me ka mālama ʻana i ka maʻi influenza.
Ma ka pae honua, ua hoʻokumu ka World Health Organization (WHO) i ka Global Influenza Surveillance and Response System i ka makahiki 1952, e hana pū ana me ka Global Sharing of Influenza Data Initiative (GISAID) e hana i kahi ʻōnaehana nānā influenza honua. I ka makahiki 1956, ua koho hou ka WHO i ka CDC i kona kikowaena hui ma ke kahua o ka ma'i ma'i ma'i, epidemiology a me ka hoomalu ana, e haawi ana i ke kāko'o 'enehana a me ke alaka'i 'epekema no ka pale 'ana a me ka ho'omalu 'ana i ka ma'i ma'i ma'i. ʻO ka hoʻokumu ʻana a me ka hoʻomau ʻana o kēia mau ʻōnaehana kiaʻi e hāʻawi i kahi palekana koʻikoʻi no ka pane ʻana o ka honua i nā maʻi maʻi influenza a me nā maʻi maʻi.

I kēia manawa, ua hoʻokumu ka CDC i kahi pūnaewele nānā influenza kūloko. ʻO nā mea nui ʻehā o ka nānā ʻana i ka maʻi influenza, ʻo ia ka hoʻāʻo ʻana o ke keʻena hoʻokolohua, ka nānā ʻana i ka hihia ma waho, ka nānā ʻana i ka hihia maʻi, a me ka nānā ʻana i ka make. Hāʻawi kēia ʻōnaehana nānā i ke kākoʻo koʻikoʻi e alakaʻi i ka hoʻoholo ʻana i ka olakino olakino a me ka pane ʻana i kahi maʻi maʻi influenza.

Ua uhi ʻia ka Global Influenza Surveillance and Response System he 114 mau ʻāina a he 144 mau kikowaena maʻi maʻi maʻi, nona ke kuleana no ka nānā mau ʻana i ka maʻi maʻi i loko o ka makahiki. ʻO ka CDC, ma ke ʻano he lālā, e hana pū me nā laboratories ma nā ʻāina ʻē aʻe e hoʻouna i nā mea hoʻokaʻawale i ka maʻi influenza i ka WHO no ka antigenic a me ka genetic profiling, e like me ke kaʻina hana e waiho ai nā limahana US i nā mea hoʻokaʻawale i ka CDC. ʻO ka hui pū ʻana ma waena o ʻAmelika Hui Pū ʻIa a me Kina i nā makahiki he 40 i hala iho nei ua lilo ia i mea nui o ka palekana olakino a me ka diplomacy.