Vaccine Test 2

for diptheria antitoxin

• 1. gram negative bacteria
• 2. exotoxin: diptheria toxoid
• a. creates toxin that inhibits RNA translation
• 3. infects only humans

• 1. respiratory droplets
• 2. fomites (such as on toys)
• Rare:
• 3. skin lesions or clothes that touched skin lesions

• 1. pseudomembrane after 2-3 days
• 2. fever
• 3. swollen neck
• 4. sore throat

• 1. inflammation of nerves
• 2. heart muscle damage
• 3. lung infection
• 4. blocking of airway
• 5. paralysis
• 6. W/treatment: 1 out of 10 ppl die
• w/out treatment :1 out of 2 ppl die

• 1921: 200,000 cases, 15,000 deaths
• 2000-2010: < 5 cases
• Worldwide (2011): 5,000 cases

discovered in 1890 by Behring. injected inactivated culture into child, his body created antibodies or antitoxins

horses used to produce antitoxin for passive immunity. discontinued in 1997.

• 1. inactivate toxin (now called a toxoid) w/ formalin
• 2. aluminum phosphate adsorbed used as adjUVANT
• 3. ENHANCED BY pertussis vaccine

• Tdap (for older children and adults)
• DT ( kids < and = 7 years)
• Td (older children and adults)
• a: means acellular. less risky to use partial cell. other countries use whole cell for a more robust immune response
• lower case: low dose

• 5 doses given intramuscularly
• 2 mos, 4 mos,6 mos, 5-18 mos, booster somewhere in 4-6 years

• 1. MILD:
• a. fever (1 in 4),
• b.redness/soreness where shot was given
• c. fussiness (1 in 3)
• d. tiredness or poor appetite (1 in 10)
• e. vomiting (1 in 50)
• Moderate: seizure, non stop crying
• Severe: serious allergic reaction, long term seizures, permanent brain damage

• 1. gram positive anaerobic bacteria
• 2. expresses tetanolysin and tetanospasmin (neurotoxins) exotoxins
• 3. infects animals and humans

• 1. not transmitted person to person
• 2. enters through injured skin
• 3. spore present in soil, intestines ,and feces of animals
• 4. has been found in contaminated heroin

• 1. headache
• 2. lockjaw
• 3. sudden , involuntary tightening of the muscles
• 4. painful muscle stiffness all over body
• 5. fever and sweating
• 6. high blood pressure and fast heart rate
• 7. in severe cases opisthotonus, or arching of the back

• 1. tetanospasmin inactivated w/ formalin
• 2. 5 shots,

• 1. gram negative bacteria
• 2. contains pertussis toxin and other harmful proteins
• 3. infects only humans

• Pertussis toxin: secreted exotoxin that induces lymphocytosis, sensitivity to histamine,  immune enhancement
• filamentous hemogglutinin: involved in attachment to ciliated respiratory epithelium

• 1. respiratory droplets (coughing sneezing)
• 2. very contagious!
• 3. even vaccinated ppl can be infected if in community

• 1. 7-10 days after infection
• 2. sometimes occur as long as 6 weeks after infection
• 3. Three stages:
• A. mild fever, runny nose
• B. fits of numerous, rapid coughs, vomiting an exhaustion after coughing fits
• C. SIII: susceptible to other respiratory infections.

• 1. 2 /3 get apnea
• 2. 1 of 4 get a lung infection
• 3. 1/2 of 100 get convulsions
• 4. 1 /300 get brain damage
• 5. 1 100 will die

• 1. US: overall decrease from 90s til now except for the 10-19 and 20+ age group. sharp increase
• 2. worldwide:16 million cases, 200,000 deaths in 2008
• 3. (95%) of cases not in US

• 1. How it works: catalyzes ADP ribosylation of GTP binding proteins.
• 2. leads to disruption of cellular disregulation

• 1. Acellular vaccine component contains PT and FHA
• 2. inactivated by formalin (to make the toxoid)

no

• 1. gram positive bacteria
• 2. causes extreme inflammation
• 3. infects humans,mammals,birds, and reptiles

1. respiratory droplets

• 1. bad cough (3 weeks or longer)
• 2. pain in chest
• 3. coughing up blood or sputum
• 4. weakness or fatigue
• 5. weight loss
• 6. loss of appetite

• 1. mantoux tuberculin skin test
• 2. size of swelling determines negative or positive result

1. 50% untreated people die from tuberculosis

• 1. BCG (bacillus calmette guerin) oldest vaccines to treat in world
• 2. given to over 4 bil ppl since 1960s except US and netherlands now
• a. bc low risk of infection
• b. only slows down disease
• c. can't tell if infected or vaccinated with test
• 3. live attenuated
• 4. does not prevent:
• a. infectino
• b. not induce neutralizing bodies
• c. not prevent reinfection of pulmonary infection

• 1. 1 dose usually intradermal. not subcuteanouse
• 2. can be an oral or mutlineedle vaccine
• 3. scheduled for immediately after birth
• 4. lasts 20+ years

• 1. subcuteaneous abscess (300-400/10^6) cases
• 2. musculoskeletal lesions (<1 per million)

(For <1 year patients)

• 1. ssRNA virus
• 2. highly contagious
• 3. 90% of ppl not immune to it will become infected

• 1. rash
• 2. fever 
• 3. cough
• 4. runny nose
• 5. conjunctivitis (red watery eyes)
• 6. koplik spots (bluish centered white spot founds inside the mouth)
• 7. malaise

• 1. mucus, sneezing or coughing
• 2. virus can survive on surfaces outside the body for about 2 hours.
• 3. Symptoms appear 7-14 days after infection.
• 4.Can be spread to others from four days before or after the rash appears.

• 1. rotatiq: bovine origin
• 2. rotarex : human origin, more robust response
• CON: intussusception: intestines collapsing on itself can happen

• 1. 1920: 30% of adults died from measles-related pneumonia
• 2. 2014:
• 10% acquire permanent hearing loss
• 5% acquire pneumonia (leading cause of death)
• 0.1% develop encephalitis
• 0.1% die
• can cause miscarriages
• 3. worldwide: almost 500,000 deaths in 2004. 164,000 deaths in 2008.

1. neutralizing antibodies attack F and H proteins, anti-H antibodies being most effective

Known for major cause of morbidity in soldiers during the Civil War, WWI, and WWII

• 1. loss of appetite
• 2. fever
• 3.  headache
• 4. muscle aches
• 5. tiredness
• 6. swollen and tender salivary glands under ear and jaw

• 1. mucus. thru coughing, sneezing , or drinking after someone.
• 2. virus can live outside of body for two hours
• 3. infected person should be isolated for 5 days. that infected person most likely was infected 12-25 days before signs.

• 1. Inflammation of testes. painful but does not cause infertility.
• 2. very rare: inflammation of ovaries, brain, breasts.
• 3. most ppl recover within 2 weeks from this disease . death is unusual

• 1. HN protein: covered with glycoprotein spikes consisting of the hemagglutinin-neuraminidase (HN) protein, which binds sialic acid to allow virion attachment to cells, 
• 2. fusion (F) protein: which induces viral and cellular membranes to fuse together during virus entry.

• also known as
• German measles
• 3 day measles
• rubella virus
• ssRNA

• 1. fever 
• 2. rash

• 1. thru mucus when coughing and sneezing
• 2. symptoms appear 14-17 days after infection

• Complications:
• 1. most ppl will recover
• 2. more rare: encephalitis, arthritis
• 3. for pregnant women: CRS. Congenital Rubella Syndrome. infection of organs that effects all organs of fetus

1. hearing impairment, possible retardation, pulmonic stenosis (obstruction of right ventricle to heart), etc

neutralizing antibodies against E1 protein

• 1. trivalent vaccine
• 2. live attenuated, from a children and fetus originally.
• a. measles: attenuated from human kidney to chicken cells
• b. rubella: attenuated from chicken cells
• 3. Mother: given protection from mother vaccination/antibodies (should receive vaccination a month before or more but not during pregnancy)
• a. Measles: protection 12-15 mos
• b. Mumps: protection to 3 mos
• c. Rubella: protection to 2 mos
• 4. Generates IgM, IgG, IgE: 
• a. M appears 2-6 weeks after vaccine
• b. G for years to come
• c. located in nasal secretions
• d. also induces CD8+ cytotoxic T cell reaction

• 1. administered intramuscularly 12 mos of age
• 2. booster 4-6 years of age

have more Ab when infected with measles than the vaccine

• 1. ppl w/ HIV or AIDS
• 2. w cancer
• 3. who has low platelet count
• 4. who has been treated with drugs that affect the immune system
• 5. has recently had a vaccine in the last 4 weeks

• 1. none really
• 2. MILD:
• a. 1/6 ppl get fever
• b. 1/20 get rash
• 4. Moderate: 
• a. seizure after fever
• b. stiffness joints in young women
• occur less often after the second dose.
• 5. Serious
• A. serious allergic reaction
• b. in children : deafness, coma, or lowered consciousness

• 400,000, 15,000 , and 100,000 from 60s to nearly 0 in 90s 
• random spike in late 80s due to foreign born hispanics not vaccinated

a little increase in 2000s due to overall lack of vaccination trend

• 1. causes shingles and chickenpox
• 2. dsDNA

1. fever, tired, achy, loss of appetite, spots, immediately afterwards, spots in certain pattern

• 1. pain, itching, tingling where rash will develop
• 2. blisters form, then scab in a week, clear in 2 weeks
• 3. forms in a stripe that wraps around in single strip around body

transmitted via respiratory droplets AND skin contact

• 1. via skin infection
• 2. reactivation of VZV
• 3. IS contagious  to uninfected

• 1. forms an episome in sensory neuron. doesn't produce any proteins or dna 
• 2. some type of stress. travels from neuron to surface of skin. (exact opposite of travel from dormancy)

• 1. 0-4 days: mucosal membrane infection
• 2. 4-6: viral replication in lymph nodes
• 3. Day 10: viral replication in other organs
• 4. Day 10-14: visual rash, infection of skin

• 1. dehydration
• 2. pneumonia
• 3. bleeding problems
• 4. 10,000 hospitalizations in US, 
• 5. 150 deaths
• 6. if pregnant, .4-2% chance of baby getting congenital varicella syndrome:
• a. scarring of skin
• b. problems with brain, arms, legs
• c. low birthweight

postherpetic neuralgia: pain where the rash once was

• 1. Varivax
• 2. live attenuated 
• 3. 2 doses: 1 at 12 months, 2nd at 4-5 years
• 4. for children under 13
• 5. 70-90% effective in preventing
• 6. administered subcutaneously

• 1. Zostavax
• 2. 14x the dose of Varivax
• 3. based off of Oka strain
• 4. 50% effective
• 5. one dose 
• 6. ppl > 60

• 1. what varicella vaccines are based off of
• 2. accumulate mutations, 11x human, 12x guinea pig, 5x human

• cell mediated and humoral response, glycoprotein E, ORF-4 protein, attack ligands of the virus
• b. natural infection provides more robust response.
• c. genetic factors play role in humoral response to vaccine
• d. effective for 20 + years

Varicella Vaccines:

• Risks:
• Soreness (1 in 5)
• Fever (1 in 10)
• Mild rash (1 in 25)
• Seizures (very rare) Pneumonia (very rare

Has been 39% increase in shingles since Varivax has been administered over 18 years....are they linked?