8. Vaccine Preventable Childhood Diseases and Disease Eradication

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cornpops
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8. Vaccine Preventable Childhood Diseases and Disease Eradication
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2011-08-11 15:14:14
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PH162A midterm3
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public health microbiology midterm 3 lecture 8
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  1. Bacterial Meningitis etiology
    • usually virus
    • Neisseria meningitidiss - gram-negative diplococcus
    • Haemophilus influenzae - gram-negative bacillus
  2. Bacterial Meningitis transmission
    respiratory route - crowding important
  3. Bacterial Meningitis pathogenesis
    • establish infection in the throat
    • rare, can spread to meninges via the bloodstream
    • have capsules - prevent initial phagocytosis
    • multiplication leads to inflammation of the meninges
  4. Bacterial Meningitis clinical
    • intense headache
    • stiff neck
    • vomiting
    • for N. meningitidis purple-black skin lesions can occur
  5. Bacterial Meningitis diagnosis
    • gram stain of spinal fluid after centrifugation
    • culture on appropriate media and biochemical tests to confirm
    • latex agglutination
    • PCR
  6. Bacterial Meningitis treatment
    with antibiotics early to be effective
  7. Bacterial Meningitis prevention
    • N. meningitidis:
    • isolation of cases during epidemics
    • screening for carriers
    • treating contacts of cases
    • vaccines

    • H. influenzae:
    • treatment of initial sore throat to prevent spread
    • vaccine
  8. Diptheria etiology
    • Corynebacterium diptheriae
    • gram-positive bacillus
  9. Diptheria transmission
    droplet infection
  10. Diptheria pathogenesis
    disease caused by a potent exotoxin - interferes with protein synthesis in cells
  11. Diptheria clinical
    • swollen neck
    • characteristic pseudomembrane
  12. Diptheria diagnosis
    • growth on specialized medium
    • culture and gram stain
    • biochemical tests
    • identifying toxin with reagent antibody
    • PCR
  13. Diptheria treatment
    passive immunization with antibody against toxin
  14. Diptheria prevention
    toxoid vaccine - produces neutralizing antibodies against toxin
  15. Pertussis (whopping cough) etiology
    • Bordetella pertussis
    • gram-negative coccobacillus
  16. Pertussis transmission
    respiratory route
  17. Pertussis pathogenesis
    toxin mediated - disables cilia on the respiratory epithelium and kills the cell
  18. Pertussis clinical
    • usually in young children
    • starts like common cold
    • spasm-like cough with "whoop"
  19. Pertussis diagnosis
    • clinical
    • culture with biochemical tests
    • PCR
  20. Pertussis treatment
    antibiotics
  21. Pertussis prevention
    vaccines
  22. Tetanus etiology
    • Clostridium tetani
    • gram-positive bacillus
    • anaerobic, endospore forming
  23. Tetanus reservoir
    soil
  24. Tetanus transmission
    direct contact with soil or objects contaminated with soil
  25. Tetanus pathogenesis
    • caused by potent exotoxin made by bacteria that infect wound
    • strict anaerobe, usually occurs in deep wounds
    • host produces antibodies that neutralize toxin, but often not fast enough
  26. Tetanus clinical
    • involuntary, prolonged contractions of muscles
    • neonatal tetanus occurs when umbilical cord cut with soil contaminated instruments
  27. Tetanus diagnosis
    clinical
  28. Tetanus treatment
    passive immunization with antibodies that neutralize toxin
  29. Tetanus prevention
    toxoid vaccine
  30. Mumps etiology
    • mumps virus
    • ssRNA
  31. Mumps transmission
    respiratory
  32. Mumps diagnosis
    clinical
  33. Mumps treatment
    no curative treatment
  34. Mumps prevention
    vaccine
  35. Mumps pathogenesis and clinical
    • infects salivary glands, causing enlargement
    • other tissues can become involved
    • immune response good, usually life-long protection
  36. Viral Exanthemas
    • skin eruption occurring as a result of a generalized infection throughout the body
    • measles, rubella, chickenpox, smallpox
  37. Measles etiology
    • measles virus
    • ssRNA
  38. Rubellla (German measles) etiology
    • rubella virus
    • ssRNA
  39. chickenpox etiology
    • varicella-zoster virus
    • dsDNA
  40. smallpox etiology
    • smallpox virus
    • dsDNA
  41. Viral Exanthemas transmission
    • respiratory route
    • from skin to respiratory route also possible
  42. Viral Exanthemas pathogenesis
    • primary multiplication in the respiratory tract
    • moves to lymph nodes and multiply
    • goes systemic, multiplying
    • host responds with both CMI and humoral immunity, lifelong protection
  43. measles clinical
    • rash
    • respiratory symptoms
    • conjunctivitis
  44. rubella clinical
    • usually asymptomatic or mild
    • rash, swelling of lymph nodes
    • most dangerous to fetus in first trimester
  45. chickenpox clinical
    • usually mild, characterized by vesicles
    • becomes latent in nerve tissue, can reactivate later if immune system depressed causing shingles or zoster - infectious
  46. smallpox clinical
    fever and rash with nodules
  47. Viral Exanthemas diagnosis
    clinical
  48. Viral Exanthemas treatment
    no curative treatments
  49. Viral Exanthemas prevention
    live attenuated vaccines
  50. smallpox eradication
    • "Target Zero" strategy
    • ring immunization - cases are identified and their contacts are immunized
  51. Smallpox eradication characteristics
    • humans are the only reservoir
    • infection always result in characteristic signs, no subclinical/latent carriers
    • antibodies are protective against infection
  52. disease eradication
    demonstrates potential of public health interventions for preventing disease in the population, as opposed to just treating individual
  53. Poliomyelitis (Polio) etiology
    • poliovirus
    • ssRNA virus
  54. Poliomyelitis transmission
    fecal-oral route
  55. Poliomyelitis pathogenesis
    • virus multiplies in intestine
    • rare, spreads to central nervous system in the blood
    • multiplies in neurons
    • leads to paralysis of the areas of infected neurons
    • humoral immune response confers lifelong immunity
  56. Poliomyelitis clinical
    • majority asymptomatic
    • more likely to be symptomatic when acquired later in life
    • some influenza-like symptoms, paralysis
  57. Poliomyelitis diagnosis
    • clinical
    • isolation
    • antibody detection
    • PCR
  58. Poliomyelitis treatment
    no curative treatment, only supportive
  59. Poliomyelitis vaccines
    • sabin: live-attenuated vaccine
    • given orally
    • stimulates IgA
    • requires boosters
    • can revert to wild type and cause disease in immunocompromised

    • Salk: killed/inactivated virus vaccine
    • injected
    • only prevents disease, not infection
    • no boosters
  60. Dracunculiasis (Guinea Worm) etiology
    • Dracunculus medinensis
    • nematode (roundworm)
  61. Dracunculiasis transmission
    fecal-oral route
  62. Dracunculiasis life cycle
    • humans drink unfiltered water with copepods and larvae
    • larvae penetrate host's stomach and intestinal wall - mature and reproduce
    • migrate to surface of skin, causing blister, discharge larvae
    • larvae released into water
    • consumed by copepod
  63. Dracunculiasis clinical
    • worm causes intense pain as migrates to extremities
    • causes swelling, then blister progressing into lesion
  64. Dracunculiasis treatment
    • no medicine
    • when worm emerges from skin, slowly wrapped around a stick to extract
  65. Dracunculiasis prevention
    • do not drink contaminated water
    • filter contaminated water
    • stop people with emerging worms from entering drinking water sources
    • treat water with larvicides to kill copepods
    • develop new, clean water sources

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