Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi

Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi

Ua lohe a heluhelu paha mākou a pau i ka nūhou e pili ana i ka laha ʻana o ka coronavirus. E like me nā maʻi ʻē aʻe, he mea nui ka ʻike mua ʻana i ka hakakā ʻana i kahi maʻi hou. Eia nō naʻe, ʻaʻole nā ​​​​poʻe maʻi a pau e hōʻike i nā hōʻailona like, a ʻo nā mea hoʻokele mokulele i hoʻolālā ʻia e ʻike i nā hōʻailona o ka maʻi ʻaʻole i ʻike mau i ka mea maʻi i waena o ka lehulehu o nā poʻe kaʻa. Ke kū nei ka nīnau: no ke aha e hōʻike ʻokoʻa ai ka maʻi like ʻole i nā poʻe like ʻole? ʻO ka mea maʻamau, ʻo ka pane mua ka palekana. Akā naʻe,ʻaʻole kēia wale nō ka mea nui e hoʻololi i ka loli o nā hōʻailona a me ka paʻakikī o ka maʻi. Ua ʻike nā kānaka ʻepekema mai ke Kulanui o Kaleponi a me Arizona (USA) ʻaʻole i hilinaʻi wale ka ikaika o ke kū'ē ʻana i nā maʻi maʻi i nā ʻano subtypes o ka maʻi influenza i loaʻa i ke kanaka i kona ola ʻana, akā i ko lākou kaʻina. He aha ka mea i ʻike ʻia e nā ʻepekema, he aha nā ʻano hana i hoʻohana ʻia i ke aʻo ʻana, a pehea e hiki ai i kēia hana ke kōkua i ka hakakā ʻana i nā maʻi maʻi? E loaʻa iā mākou nā pane i kēia mau nīnau ma ka hōʻike o ka hui noiʻi. Hele.

Kumu noiʻi

E like me kā mākou e ʻike ai, ʻokoʻa ke ʻano o ka maʻi maʻi i nā kānaka like ʻole. Ma waho aʻe o ke kumu o ke kanaka (immune system, ka lawe ʻana i nā lāʻau antiviral, preventive measures, etc.), kahi mea koʻikoʻi ʻo ka maʻi maʻi ponoʻī, a i ʻole kona subtype, ka mea e hoʻopilikia ai i kahi maʻi. Loaʻa i kēlā me kēia subtype kona mau hiʻohiʻona ponoʻī, me ka nui o ka hopena o nā hui demographic like ʻole. Hoʻomaopopo ka poʻe ʻepekema ʻo ka H1N1 ("ka maʻi puaʻa") a me ka H3N2 (Hong Kong flu) i lilo i mea maʻamau i kēia manawa, e pili ana i nā poʻe o nā makahiki like ʻole: ʻo H3N2 ke kumu o nā hihia koʻikoʻi o ka maʻi i ka poʻe ʻelemakule. a no ka hapa nui o na make ; ʻAʻole i make ka H1N1 akā pili pinepine i ka poʻe o waena a me nā ʻōpio.

ʻO ia mau ʻokoʻa paha ma muli o ka ʻokoʻa ʻelua o ka nui o ka ulu ʻana o nā maʻi maʻi iā lākou iho a me ka ʻokoʻa i loko hoʻopaʻa kino * i nā keiki.

Ka hoʻopaʻa kino * - kahi ʻano hoʻomanaʻo lōʻihi o ka ʻōnaehana pale, i hoʻokumu ʻia ma ke kumu o nā hōʻeha viral i ʻike ʻia ma ke kino a me kāna mau hopena iā lākou.

I loko o kēia noiʻi, ua kālailai nā mea noiʻi i ka ʻikepili epidemiological e hoʻoholo ai inā pili ka paʻi ʻana i ka wā kamaliʻi i ka maʻi maʻi o ka maʻi maʻi kau a, inā pēlā, inā e hana nui ia ma o homosubtype* hoʻomanaʻo immune a ma o ka laulā heterosubtypic* hoʻomanaʻo.

Homosubtypic immunity* — ʻo ka maʻi me ka maʻi maʻi maʻi maʻi maʻi kau a hoʻoikaika i ka hoʻomohala ʻana o ka pale pale pale i kahi ʻano kikoʻī o ka maʻi.

Heterosubtypic immunity* — ʻo ka maʻi me nā maʻi maʻi maʻi influenza A ka wā e hoʻoikaika i ka hoʻomohala ʻana i ka pale pale pale i nā sub-strains pili ʻole i kēia maʻi.

I nā huaʻōlelo ʻē aʻe, ʻo ka pale ʻana o ke keiki a me nā mea a pau āna i ʻike ai e waiho i kāna hōʻailona ma ka ʻōnaehana pale no ke ola. Ua hōʻike ʻia nā haʻawina mua i ʻoi aku ka ikaika o ka pale ʻana i nā ʻano maʻi i loaʻa iā lākou i ka wā kamaliʻi. Ua hōʻike hou ʻia ka paʻi ʻana e pale aku i nā maʻi maʻi avian influenza hou o ka hui like hemagglutinin phylogenetic (hemagglutinin, HA), e like me ka maʻi mua i ka wā kamaliʻi.

A hiki i kēia manawa, ua manaʻo ʻia ke ʻano o ka pale ʻana i ka maʻi influenza kau. Eia nō naʻe, aia kekahi mau hōʻike hou e hōʻike ana i ka hoʻokumu ʻia ʻana o ka palekana e hiki ke hoʻololi ʻia e ka hoʻomanaʻo ʻana i nā antigens influenza ʻē aʻe (e laʻa, neuraminidase, NA). Mai ka makahiki 1918, ua ʻike ʻia ʻekolu ʻano subtypes o AN i ke kanaka: H1, H2 a me H3. Eia kekahi, ʻo H1 a me H2 no ka hui phylogenetic 1, a ʻo H3 i ka hui 2.

Ma muli o ka hoʻololi ʻana o ka paʻi ʻana i nā loli he nui i ka hoʻomanaʻo immune, hiki ke manaʻo ʻia he hierarchy kēia mau hoʻololi.

Hoʻomaopopo ka poʻe ʻepekema mai ka makahiki 1977, ʻelua mau ʻano o ka maʻi influenza A—H1N1 a me H3N2—ua hoʻolaha ʻia i kēlā me kēia kau ma waena o ka heluna kanaka. I ka manawa like, ʻike ʻia nā ʻokoʻa o ka demographics o ka maʻi a me nā hōʻailona, ​​​​akā naʻe i aʻo maikaʻi ʻole ʻia. ʻO kēia mau ʻokoʻa ma muli paha o ka paʻi ʻana i ka wā kamaliʻi: ʻaneʻane ʻike ʻia ka poʻe ʻelemakule i ka H1N1 ma ke ʻano he kamaliʻi (mai ka makahiki 1918 a hiki i ka makahiki 1975 ʻo ia wale nō ke ʻano subtype e holo nei i loko o ke kanaka). No laila, ʻoi aku ka palekana o kēia poʻe mai nā ʻano like ʻole o kēia wā o ka maʻi o kēia subtype. Pēlā nō, ma waena o ka poʻe ʻōpio, ʻo ka nui loa o ka paʻi ʻana i ka wā kamaliʻi no ka H3N2 hou loa (kiʻi #1), i kūlike me ka helu haʻahaʻa o nā maʻi H3N2 i hōʻike ʻia i nā maʻi maʻi i kēia demographic.

Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi
Kiʻi No. 1: nā hiʻohiʻona like ʻole o ka hilinaʻi o ka pale ʻana i ka paʻi ʻana i ka wā kamaliʻi a me ke kumu o ka evolution viral.

Ma ka ʻaoʻao ʻē aʻe, pili paha kēia mau ʻokoʻa me ka ulu ʻana o nā subtypes virus iā lākou iho. No laila, ʻoi aku ka wikiwiki o ka H3N2 hee* kona antigenic phenotype ma mua o H1N1.

Holoi antigen* - nā hoʻololi ʻana i nā mea ʻili o nā maʻi maʻi.

No kēia kumu, ʻoi aku ka maikaʻi o ka H3N2 i ka pale ʻana i ka pale kino mua i nā pākeke ʻike immunologically, ʻoiai hiki ke kaupalena ʻia ka H1N1 i kona hopena i nā keiki immunologically naïve wale nō.

No ka hoʻāʻo ʻana i nā kuhiakau kūpono a pau, ua kālailai nā ʻepekema i ka ʻikepili epidemiological ma o ka hana ʻana i nā hana likelihood no kēlā me kēia ʻano o nā kumu hoʻohālike helu, i hoʻohālikelike ʻia me ka Akaike Information Criterion (AIC).

Ua hoʻokō ʻia kahi loiloi hou aʻe ma ke kuhiakau i ʻike ʻole ʻia nā ʻokoʻa ma muli o ka paʻi ʻana i ka ulu ʻana o nā maʻi.

Nā hoʻomākaukau no ka noi

Ua ho'ohana 'ia ka 'ikepili mai ka 'Oihana Ola Ola (ADHS) o 9510 mau hihia H1N1 a me H3N2 ma ka moku'āina holo'oko'a. Ma kahi o 76% o nā hihia i hōʻike ʻia i hoʻopaʻa ʻia i nā halemai a me nā laboratories, ʻaʻole i hōʻike ʻia nā hihia i koe i loko o nā laboratories. Ua ʻike ʻia hoʻi ma kahi o ka hapalua o nā hihia i hoʻopaʻa ʻia i ka laboratory i koʻikoʻi i ka hopena i ka hale maʻi.

ʻO ka ʻikepili i hoʻohana ʻia i loko o ke aʻo ʻana e uhi ana i kahi manawa 22-makahiki mai ka makahiki influenza 1993-1994 a i ka manawa 2014-2015. Pono e hoʻomaopopo i ka piʻi nui ʻana o ka nui o ka laʻana ma hope o ka maʻi maʻi 2009, no laila ua kāpae ʻia kēia manawa mai ka laʻana (Table 1).

Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi
Papa helu 1: ʻikepili epidemiological mai 1993 a 2015 e pili ana i nā hihia i hoʻopaʻa ʻia o nā maʻi H1N1 a me H3N2.

He mea nui nō hoʻi e noʻonoʻo ʻia mai ka makahiki 2004, ua koi ʻia nā hale hana ʻoihana ma ʻAmelika e hoʻouna i nā ʻikepili āpau e pili ana i ka maʻi viral o nā maʻi i nā luna olakino o ke aupuni. Eia naʻe, ʻo ka hapa nui o nā hihia i kālailai ʻia (9150/9451) mai ka makahiki 2004–2005, ma hope o ka hoʻomaka ʻana o ke kānāwai.

ʻO nā hihia 9510 a pau, 58 i kāpae ʻia no ka mea he poʻe lākou me ka makahiki hānau ma mua o 1918 (ʻaʻole hiki ke ʻike maopopo ʻia ko lākou kūlana paʻi ʻana), a ʻo kekahi hihia ʻē aʻe no ka mea ʻaʻole i kuhikuhi pololei ʻia ka makahiki hānau. No laila, ua hoʻokomo ʻia nā hihia 1 i ke ʻano hoʻohālike.

I ka pae mua o ka hoʻohālike ʻana, ua hoʻoholo ʻia nā kūpono o ka paʻi ʻana i nā maʻi H1N1, H2N2 a i ʻole H3N2, kikoʻī i ka makahiki hānau. Hōʻike kēia mau manaʻo i ke ʻano o ka ʻike ʻana i ka maʻi influenza A i nā keiki a me kona laha ʻana i ka makahiki.

ʻO ka hapa nui o nā poʻe i hānau ʻia ma waena o nā maʻi maʻi 1918 a me 1957 i loaʻa mua i ka maʻi H1N1 subtype. ʻO ka poʻe i hānau ʻia ma waena o nā maʻi maʻi maʻi 1957 a me 1968 ua aneane pau i ka maʻi me ka subtype H2N2 (1A). A mai ka makahiki 1968, ʻo H3N2 ka subtype nui o ka maʻi, a ua lilo ia i kumu o ka maʻi o ka hapa nui o ka poʻe mai ka hui demographic ʻōpio.

ʻOiai ka laha ʻana o ka H3N2, ua hoʻolaha mau ʻia ka H1N1 i ka heluna kanaka mai ka makahiki 1977, e paʻi ana i ka paʻi ʻana i ka hapa o nā poʻe i hānau ʻia mai ka waena o 1970s (1A).

Inā hoʻohālikelike ka paʻi ʻana ma ka pae ʻano AN i ka hiki ke loaʻa i ka maʻi i ka wā o ka maʻi influenza kau, a laila ʻo ka hoʻolaha ʻana i nā subtypes H1 a i ʻole H3 AN i ka wā kamaliʻi pono e hāʻawi i ke ola āpau i nā ʻano hou o ka subtype AN like. Inā ʻoi aku ka maikaʻi o ka paʻi ʻana i ka pale ʻana i kekahi mau ʻano NA (neuraminidase), a laila ʻo ka palekana o ke ola e lilo i ʻano o N1 a i ʻole N2 (1B).

Inā hoʻokumu ʻia ka paʻi ʻana ma kahi NA ākea, ʻo ia hoʻi. ka pale ʻana i nā ʻano ʻano ʻano ākea ākea, a laila pono e pale ʻia nā kānaka i paʻi ʻia mai ka H1 a me H2 mai ka H1N1 o kēia wā. I ka manawa like, e pale ʻia ka poʻe i paʻi ʻia i ka H3 mai ka H3N2 kau hou (1B).

Hoʻomaopopo ka poʻe ʻepekema ʻo ka collinearity (ma ka ʻōlelo ʻana, parallelism) o nā wānana o nā ʻano hoʻohālike like ʻole (1D-1I) ʻaʻole hiki ke ʻae ʻia ma muli o ka ʻokoʻa liʻiliʻi o nā subtypes antigenic influenza e laha nei i ka heluna kanaka i nā kenekulia i hala.

ʻO ka hana koʻikoʻi i ka hoʻokaʻawale ʻana ma waena o ka paʻi ʻana ma ka subtype HA, NA subtype a i ʻole ka pae pūʻulu HA e pāʻani ʻia e nā poʻe waena o ka makahiki i loaʻa mua i ka maʻi H2N2 (1B).

Ua hoʻohana kēlā me kēia o nā hiʻohiʻona i hoʻāʻo ʻia i kahi hui laina o ka maʻi pili makahiki (), a me ka maʻi e pili ana i ka makahiki hānau (1D-1F), e loaa ka mahele ana o na hihia H1N1 a i ole H3N2 (1G - 1I).

Ua hana ʻia he 4 mau hiʻohiʻona: ʻo ka mea maʻalahi loa i loko o ka helu makahiki wale nō, a ʻo nā hiʻohiʻona ʻoi aku ka paʻakikī i hoʻohui i nā mea paʻi ma ka pae haʻahaʻa HA, ma ka pae subtype NA, a i ʻole ma ka pae hui HA.

Aia ke ʻano o ka hana ʻanuʻu i ke ʻano o ka piʻi kumu makahiki kahi i hoʻonohonoho ʻia ai ka pilikia pili o ka maʻi i ka 1 ma ka pūʻulu makahiki 0-4. Ma waho aʻe o ka pūʻulu makahiki mua, aia pū kekahi: 5–10, 11–17, 18–24, 25–31, 32–38, 39–45, 46–52, 53–59, 60–66, 67–73, 74– 80, 81+.

I loko o nā hiʻohiʻona i hoʻokomo i nā hopena paʻi, ua manaʻo ʻia ka hapa o nā kānaka i kēlā me kēia makahiki hānau me ka paʻi ʻana i ka wā kamaliʻi palekana i ka hoʻemi ʻana i ka pilikia o ka maʻi.

Ua noʻonoʻo ʻia ke kumu o ka hoʻomohala viral i ka hoʻohālike. No ka hana ʻana i kēia, ua hoʻohana mākou i ka ʻikepili i wehewehe i ka holomua antigenic makahiki, i wehewehe ʻia ʻo ia ka awelika antigenic mamao ma waena o nā ʻano o kahi laina viral (H1N1 ma mua o 2009, H1N1 ma hope o 2009, a me H3N2). Hoʻohana ʻia "ka mamao antigenic" ma waena o ʻelua mau maʻi maʻi influenza ma ke ʻano he hōʻailona o ka like ʻana o ka phenotype antigenic a me ka pale pale pale pale.

No ka loiloi ʻana i ka hopena o ka evolution antigenic i ka mahele makahiki maʻi maʻi, ua hoʻāʻo ʻia ka hoʻololi ʻana i ka hapa o nā hihia i nā keiki i nā kau i loaʻa ai nā loli antigenic ikaika.

Inā he kumu koʻikoʻi ke kiʻekiʻe o ka antigenic drift i ka makahiki e pili ana i ka maʻi o ka maʻi, a laila ʻo ka hapa o nā hihia i ʻike ʻia i nā keiki pono e pili pono me ka holomua antigenic makahiki. I nā huaʻōlelo ʻē aʻe, ʻaʻole i hiki i nā ʻano i loaʻa ʻole i nā hoʻololi antigenic koʻikoʻi mai ke kau ma mua ke hiki ʻole ke pakele i ka pale ʻana ma mua o ka poʻe makua ʻike immunologically. E ʻoi aku ka ikaika o ia mau mea i waena o nā heluna me ka ʻike ʻole immunological, ʻo ia hoʻi, ma waena o nā keiki.

Nā hopena noiʻi

Ua hōʻike ʻia ka ʻikepili i kēlā me kēia makahiki, ʻo ka H3N2 kauā ke kumu nui o ka maʻi ma waena o ka poʻe ʻelemakule, ʻoiai ʻo H1N1 i pili i ka poʻe waena a me nā ʻōpio (kiʻi #2).

Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi
Kiʻi No. 2: Ka laha ʻana o ka maʻi influenza H1N1 a me H3N2 ma o ka makahiki i nā manawa like ʻole.

Aia kēia ʻano ma ka ʻikepili ma mua o ka maʻi maʻi 2009 a ma hope o ia.

Ua hōʻike ka ʻikepili i ka paʻi ʻana ma ka pae subtype NA ma mua o ka paʻi ʻana ma ka pae subtype HA (ΔAIC = 34.54). I ka manawa like, ua aneane pau ʻole ka paʻi ʻana ma ka pae o ka hui HA (ΔAIC = 249.06), a me ka pau ʻole o ka paʻi ʻana (ΔAIC = 385.42).

Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi
Kiʻi #3: Ka loiloi ʻana i ke kūpono o nā kumu hoʻohālike i ka ʻikepili noiʻi.

ʻO ka loiloi hiʻona o ke kumu hoʻohālike (3C и 3D) ua hōʻoia ʻo nā hiʻohiʻona e loaʻa ana nā hopena paʻi ma nā pae haiki o nā subtypes NA a i ʻole HA hāʻawi i ka mea kūpono loa i ka ʻikepili i hoʻohana ʻia i ke aʻo ʻana. ʻO ka ʻoiaʻiʻo ʻaʻole hiki ke kākoʻo ʻia ke ʻano o ka paʻi ʻana e ka ʻikepili e hōʻike ana he ʻano koʻikoʻi ka paʻi ʻana i ka hoʻomohala ʻana o ka palekana i ka heluna kanaka makua e pili ana i nā subtypes influenza seasonal. Eia nō naʻe, hana ka paʻi ʻana ma kahi ʻano haiki loa, ʻo ia hoʻi, hana wale ia ma kahi subtype kikoʻī, ʻaʻole ma ke kiko holoʻokoʻa o nā subtypes influenza.

Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi
Papa helu 2: ka loiloi i ke kūpono o nā kumu hoʻohālike i ka ʻikepili noiʻi.

Ma hope o ka hoʻomalu ʻana no ka mahele makahiki demographic, ʻoi aku ka kiʻekiʻe o ka pilikia pili i ka makahiki i nā keiki a me nā poʻe ʻelemakule, e kūlike me ka hōʻiliʻili ʻana o ka hoʻomanaʻo ʻana i ka immune i ka wā kamaliʻi a me ka nāwaliwali o ka hana immune i nā ʻelemakule (ma 3A hōʻike ʻia kahi pihi pili mai ke kumu hoʻohālike maikaʻi loa). ʻOi aku ka liʻiliʻi ma mua o hoʻokahi manaʻo koho hoʻohālikelike, e hōʻike ana i kahi hōʻemi liʻiliʻi o ka pilikia pili (Papa 2). Ma ke kumu hoʻohālike maikaʻi loa, ʻoi aku ka nui o ka hoʻemi pilikia pili mai ka paʻi kamaliʻi ʻana no ka H1N1 (0.34, 95% CI 0.29–0.42) ma mua o ka H3N2 (0.71, 95% CI 0.62–0.82).

No ka hoʻāʻo ʻana i ka hopena o ka hoʻololi ʻana o ka maʻi viral i ka māhele makahiki o ka maʻi maʻi, ua ʻimi nā mea noiʻi i ka emi ʻana o ka nui o nā maʻi i waena o nā keiki i nā wā e pili ana me ka loli antigenic, i ka wā i ʻoi aku ka maikaʻi o nā maʻi me ka antigenic drift kiʻekiʻe i ka hoʻopili ʻana i nā pākeke ʻike immunologically.

Ua hōʻike ka ʻikepili ʻikepili i kahi hui liʻiliʻi maikaʻi ʻole akā ʻaʻole nui ma waena o ka piʻi ʻana o ka hana antigenic a me ka hapa o nā hihia H3N2 i ʻike ʻia i nā keiki (4A).

Immune imprinting i ka wā kamaliʻi: ke kumu o ka pale ʻana i nā maʻi maʻi
Kiʻi No. 4: ka mana o ka hoʻololi viral ma luna o ke kumu pilikia pili makahiki no ka maʻi.

Eia naʻe, ʻaʻole i ʻike ʻia kahi pilina ma waena o nā loli antigenic a me ka hapa o nā hihia i ʻike ʻia i nā keiki ma luna o 10 mau makahiki a me nā pākeke. Inā he mea nui ka hoʻomohala ʻana o ka maʻi viral i kēia māhele ʻana, ʻoi aku ka maʻalahi o ka hopena o ka mana evolutionary ma waena o nā pākeke, ʻaʻole wale i ka hoʻohālikelike ʻana i nā pākeke a me nā keiki ma lalo o 10 mau makahiki.

Eia kekahi, inā ʻoi aku ka nui o ka hoʻololi hoʻololi viral no nā ʻokoʻa subtype-specific i ka puʻunaue ʻana o nā makahiki maʻi maʻi, a laila ke hōʻike ʻia nā subtypes H1N1 a me H3N2 i nā helu like o ka laha antigen makahiki, e ʻike ʻia ko lākou mau makahiki o nā maʻi i like.

No ka ʻike kikoʻī hou aku me nā nuances o ke aʻo ʻana, manaʻo wau e nānā hōʻike nā kānaka ʻepekema.

Epilogue

Ma kēia hana, ua kālailai nā kānaka ʻepekema i ka ʻikepili epidemiological i nā hihia o ka maʻi me H1N1, H3N2 a me H2N2. Hōʻike ka ʻikepili i kahi pilina maopopo ma waena o ka paʻi ʻana i ka wā kamaliʻi a me ka pilikia o ka maʻi i ka wā makua. ʻO ia hoʻi, inā i loaʻa i kahi keiki ma nā makahiki he 50 i ka wā e holo ana ka H1N1 a ʻaʻole i loaʻa ka H3N2, a laila i ka wā makua, ʻoi aku ka nui o ka loaʻa ʻana o ka H3N2 ma mua o ka loaʻa ʻana o ka H1N1.

ʻO ka hopena nui o kēia aʻoʻana he mea nuiʻaʻole wale ka mea i pilikia i ke kanaka i ka wā kamaliʻi, akā, i keʻano o ke kauoha. ʻO ka hoʻomanaʻo hoʻomanaʻo, e ulu ana i ke ola a pau, "hoʻopaʻa" i ka ʻikepili mai nā maʻi maʻi viral mua, e kōkua ana i ka counteraction ʻoi aku ka maikaʻi iā lākou i ka wā makua.

Manaʻo ka poʻe ʻepekema e hiki ai i kā lākou hana ke wānana maikaʻi i nā pūʻulu makahiki i ʻoi aku ka maʻalahi i nā hopena o kēlā mau subtypes o ka influenza. Hiki i kēia ʻike ke kōkua i ka pale ʻana i ka laha ʻana o nā maʻi maʻi, ʻoi aku ka nui inā pono e hāʻawi ʻia kahi helu liʻiliʻi o nā lāʻau lapaʻau i ka heluna kanaka.

ʻAʻole manaʻo kēia noiʻi i ka loaʻa ʻana o nā lāʻau lapaʻau nui no kēlā me kēia ʻano o ka maʻi maʻi, ʻoiai he mea maikaʻi loa ia. Kuhi ʻia ia i ka mea i ʻoi aku ka maoli a me ka mea nui i kēia manawa - pale i ka laha ʻana o ka maʻi. Inā ʻaʻole hiki iā mākou ke hoʻopau koke i ka maʻi virus, a laila pono mākou e loaʻa nā mea hana āpau e hiki ai ke hoʻopaʻa ʻia. ʻO kekahi o nā hoa pili ʻoiaʻiʻo loa o kekahi maʻi maʻi, ʻo ia ka manaʻo mālama ʻole iā ia ma ka ʻaoʻao o ka mokuʻāina ma ka laulā a me kēlā me kēia kanaka. ʻO ka makaʻu, ʻoiaʻiʻo, ʻaʻole pono ia, no ka mea hiki ke hōʻeha wale i nā mea, akā ʻaʻole ʻeha ka mālama ʻana.

Mahalo no ka heluhelu ʻana, noʻonoʻo, e mālama iā ʻoe iho a me kāu poʻe aloha a loaʻa i ka hopena pule maikaʻi! 🙂

Kekahi mau hoʻolaha 🙂

Mahalo no kou noho pū ʻana me mākou. Makemake ʻoe i kā mākou ʻatikala? Makemake ʻoe e ʻike i nā mea hoihoi hou aʻe? E kākoʻo iā mākou ma ke kau ʻana i kahi kauoha a i ʻole ka ʻōlelo ʻana i nā hoaaloha, cloud VPS no nā mea hoʻomohala mai $4.99, he analogue kū hoʻokahi o nā kikowaena hoʻokomo-level, i hana ʻia e mākou no ʻoe: ʻO ka ʻoiaʻiʻo holoʻokoʻa e pili ana iā VPS (KVM) E5-2697 v3 (6 Cores) 10GB DDR4 480GB SSD 1Gbps mai $ 19 a pehea e kaʻana like ai i kahi kikowaena? (loaʻa me RAID1 a me RAID10, a hiki i 24 cores a hiki i 40GB DDR4).

ʻO Dell R730xd 2 mau manawa maʻalahi ma Equinix Tier IV kikowaena data ma Amsterdam? Eia wale nō 2 x Intel TetraDeca-Core Xeon 2x E5-2697v3 2.6GHz 14C 64GB DDR4 4x960GB SSD 1Gbps 100 TV mai $199 ma Netherlands! Dell R420 - 2x E5-2430 2.2Ghz 6C 128GB DDR3 2x960GB SSD 1Gbps 100TB - mai $99! Heluhelu e pili ana Pehea e kūkulu ai i ka ʻoihana ʻoihana. papa me ka hoʻohana 'ana o Dell R730xd E5-2650 v4 kikowaena waiwai 9000 euros no ka peni?

Source: www.habr.com

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