7childhood immunization recommendations DiseaseVaccineTDaP- Tetanus, Diptheria, Pertussistetanus & diptheria toxoid, acellular fragments of B. pertussisPneumococcal PneumoniaS. pneumoniae polysaccharide conjugatesHib H. influenzae type b meningitispolysaccharide conjugated with proteinHepatitis Ainactivated virusHuman Papillomavirusantigenic fragments of virusInfluenza Ainjection: inactivated virus; nasal: attenuatedHepatitis BMMR- Measles, Mumps, Rubellaattenuated virusesChickenpoxattenuated Varicellavirus
8case study: Varicellavirus March 12, yo female ER admission3d Hx rash, 1d Hx shortness of breath, fever (101.1OF)Dx: septic shockhospital stayTx: acyclovir, Abx (ciprofloxacin, meropenem, STX, ticarcillin w/clavulanate, tigecycline) & mechanical ventilationpneumonia & acute respiratory distressmulti-organ dysfunctionpancytopenianosocomial infectionsLRI: Enterobacter cloacaeUTI: Pseudomonas aeruginosasepsis: Stenotrophomonas maltophiliaprognosis: dead on day 21Click here to read and here to listen, if you have concerns about a link between autism & vaccinations.
9immunological identification methods immunological assaysAg-Ab interactiondirect detect Agindirect detect AbSensitivity: probability of false negative SN-N-OUT SeNsitive when Negative rules OUTSpecificity: probability of false positive SP-P-IN SPecific when Positive rules IN9
10monoclonal antibodies (mAbs) hybridoma: cancerous B cell fused to Ab producing spleen cell mAb
14enzyme-linked immunosorbent assay (ELISA) direct ELISAindirect ELISA
15the rapid strep test70–85% pharyngitis cases are viral- no Abx, bacterial cases are self-limitingS. pyogenes causes pharyngitis and long-term sequelae (rheumatic fever, kidney disease)No symptoms are specific to streptococcal pharyngitisrapid strep test95–98% specificity; 70-95% sensitivity
16chapter 18 learning objectives How and when is immunological memory generated?Where do memory B cells, effector memory T cells and central memory T cells “live?”Compare and contrast the affinity and speed of the primary vs. the secondary immune response.Distinguish the four ways that immunity can be acquired. Be able to recognize and give an example of each.Describe the serological tests discussed in lecture; include direct and indirect versions of each. Understand how to interpret positive and negative results for each. As technology has advanced, how has that made these serological tests more specific?Define specificity and sensitivity. How do these terms relate to the serological tests you described above.Describe the GENERAL mechanism for producing monoclonal Abs. Why are they necessary?
19Acquired Immune Deficiency Syndrome ~1930: SIVcpz crosses species barrier1959: death in Congo1968: HIV in U.S. (Africa Haiti)1981MMWR P. cariniihomosexuals, PCP, CMV, Kaposi’s sarcoma200,000 people infected1983discovery of HIVAIDS in 28 nations2012>35 million people with HIV/AIDS, 3.3 million <15 YO2.3 million infected, 260,000 <15YO6,300 new infections daily1.6 million people died, 210,000 <15YO75 million total infections, 36 million total deathswhen timeline comes up, mention the retrospective epidemiology & how that shapes disease containmentRyan white banned from school in 1985, in 1988 Greg Louganis HIV+ (knew for 6 months) and cuts head in diving accident. “Came out” in Published story in 1996 with HIV+ status
20HIV transmission infected body fluid transmission via: sexual contact (MSM, MSW, WSW, artificial insemination)blood-contaminated needlesorgan transplants & blood transfusionbreast milktransplacental infection of fetus20
26Ab Fluorescence and Fluorescence Activated Cell Sorting (FACS) 26
27HIV/AIDS worldwide 70% of world’s HIV/AIDS (20 million) 88% of world’s HIV/AIDS children1.6 million infected in 20121.2 million died (75% of deaths worldwide)
28HIV/AIDS in the US1.1 million have HIV/AIDS, 1/5 don’t know they’re infected1.7 million have been infected, 650,000 have died50,000 new infections per yearMSM: 44x MSW, 40x women54% blacks20% womenSoutherners
29chapter 19 learning objectives Contrast congenital and acquired immune deficiencies. How can microbiology aid in the treatment of congenital immune deficiencies?Describe the origin, modes of transmission, and host cells for HIV. What do each of these host cells have in common? Does HIV behave the same way in all host cells?How is HIV transmission different in developing vs. developed countries?How is HIV diagnosed initially? How does this differ from the monitoring that is done to track HIV conversion to AIDS? Why is it necessary that viral RNA and viral DNA is looked for? What does each tell you about HIV?Generally speaking, AIDS is defined by a drop in a certain body cell and a serum rise in something else. What are these?Describe why FACS is necessary to track the population of the body cell mentioned above?Where are the majority of people living with AIDS?