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IUPUI MICR J210 - Anti-bacterial Vaccines

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MICR J210 1st Edition Lecture 17 Outline of Last Lecture I. Meningitis II. Enterobacteriaceae III. Escherichia coliIV. Salmonella typhiV. Shigella dysenteriaeVI. Vibrio choleraVII. Campylobacter jejuniVIII. Clostridium difficile IX. Strep. pneumoniae X. Neisseria meningitidis XI. Haemophilus influenzaXII. Strep. AgalactiaeXIII. E. coli.Outline of Current Lecture I. Impact of VaccinesII. Types of VaccinesIII. Herd ImmunityIV. Bordetella pertussisV. Corynebacterium diphtheriaVI. Clostridium tetaniVII. DTap VaccineCurrentThese notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.- Impact of Vaccineso Statistics from 2002 10.6 million deaths under age 5 worldwideo Most important weapon against infection that we haveo Much better than antibioticso Vaccines present multiple foreign epitopes to the host immune systemo Builds lifetime immunity against infectious dieseases - Types of Vaccineso Live attenuated vaccines Contain bacteria or viruses that have been altered (weakened by passage through eggs, cells in culture or from other hosts) so they can cause mild disease which leads to immunity.  They don’t have all of the virulence factors but have enough surface proteins to mount response- MMR (Measles, Mumps, Rubella) viral vaccine- BCG (Bacillus-Calmette-Guerin): Mycobacterium bovis (bovine [cattle] TB) instead of Mycobacterium tuberculosis (human TB)o Test and treat individuals---in the US we don’t vaccinate against TBo Heat or chemically Killed vaccines  Contain killed bacteria or inactivated viruses- Use this type if bacteria/virus doesn’t let itself be attenuated- Influenza vaccine, Bordetella pertussis vaccineo Purified component/subunit vaccine (conjugate) Contain inactivated toxin (toxoid) that are produced by the microbe or purified surface component of the microbe that have been made harmless- Corynebacterium diphtheria toxoid vaccine (DPT)- Pneumococcal capsular vaccine (PPV)o Recombinant vaccines  Genes for desired antigens are inserted into a vector, usually a virus, that has a very low virulence. The vector expressing the antigen may be used as the vaccine, or the antigen may be purified and injected as a subunit vaccine- Hepatitis B Virus (HBV) vaccine- Herd immunityo Refers to a reduction in the probability of infection of susceptible members of a population when a significant proportion of the individuals are immune. o This reduction is observed because the chance of coming in contact with an infected individual is less. In other words, disease transmission is blocked when acritical percentage of the population has been vaccinated. Measles viral vaccine is only 90% effective but other 10% are protected because virus is not being spread around- Vaccinating the community reduces the bacterial reservoir Depending on the disease, need to vaccinate 75-95% of population to induce herd immunity- Bordetella pertussiso Gram-negative coccobacillus with capsule Causes Pertussis (Whooping Cough)- highly contagious bacterial infection that causes a severe cougho Whooping cough because they cough so much that they cannot catch a breath—lack of oxygeno Spread from one person with whooping cough to anothero Infection occurs in the trachea. Toxins that are released cause inflammation and damage to the airway More common in infants (<1 yr), but also seen in children and adults Major cause of infant mortality before vaccine era (pre 1940s) Disease starts with symptoms similar to common cold Whooping cough (paroxysms) cause lack of oxygen. Gagging or vomiting may occur after severe coughing spells. Cough may be worse at night and may lead to death B. pertussis binds to ciliated epithelial cells in airway, releases pertussis toxin and damages those cells o Vaccine for pertussis: The good news and the bad news In 1942, the American scientist Pearl Kendrick combined the whole-cell pertussis vaccine with diphtheria and tetanus toxoids to generate the first DTP combination vaccine. - The pertussis portion of the DTP shot was killed B. pertussis bacteria- Though effective, the P vaccines caused unwanted neurological side-effects in children Vaccine discomfort permeated the publics’ state of mind during the late 1970's and early 1980's. - Vaccinations dropped and pertussis cases rose.- In response to this, acellular (toxoid and component) pertussis vaccines (aP) were developed throughout the 1980'so Vaccine is against the toxoid itself and some components but not the entire cell itselfo It is a subunit vaccine The first DTaP vaccine was FDA approved in 1991 and was shown to be just as effective as the DTP vaccines, with no major side effects (DTaP is much more expensive than DTP vaccine)- More expensive and more complex to manufacture- Whole cell vaccines were removed from the American market in 2001o Other countries still use the old DTP vaccine- Corynebacterium diphtheriaeo Gram (+) bacillus, with cell sticking together to odd shapes called Chinese letter appearanceo Causes Diphtheria  Highly contagious and potentially life-threatening infection - usually attacks the throat and nose. In more serious cases, it can attack the nerves and heart. Bacteria lives in upper respiratory tract - Attacks nose and throat, can also cause problems in the heart and nerves using a toxin Person to person transmission via respiratory droplets. During its growth on throat, The bacterium produces a toxin that is carried in the bloodstream. - Coded by a bacteriophage called corynephage which carries the toxin producing gene (tox gene)o Bacteriophage infects this bacteria and then the toxin is released. - Toxin inhibits protein synthesis of host cells and may damage heart and nervous systemo Early symptoms are sore throat and mild fever  Lymph adenopathy (swollen lymph nodes in the neck)o Progresses to lymphadenopathy of the neck o Pseudomembrane forms over the throat and tonsils and lymph nodes in throat swell (forming “bull neck”)  can make it hard to swallow.  May lead to death by asphyxiation- May have to intubate Throat is inflamedo diphtheria vaccine (the “D” in DTaP) is very effective. (conjugate) Vaccine is toxoid from C. diphtheriae protects almost everyone who has received the full series of recommended doses. diphtheria cases have fallen from 206,939 in 1921 to only a few a year in the


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IUPUI MICR J210 - Anti-bacterial Vaccines

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