Prevention And Control - Passive And Active Immunization
Prevention and Control –passive and active immunization
How do we acquire immunity?
Passive Immunity in Infants
Artificial Passive Immunity Gamma globulin– Ig’s from pooled blood of at least 1,000human donors variable content non-specific Specific immune globulin– higher titers of specific antibodies
Artificial Passive Immunity Gamma globulin– Ig’s from pooled blood of at least 1,000human donors variable content non-specific Specific immune globulin– higher titers of specific antibodies Antisera and antitoxins of animal origin
Risks of Passive ImmunizationIf Antibody is produced in another species, thehuman recipient can produce an ImmuneResponse against itIn some patients: IgE production against isotypicAb - systemic mast cell activation - type IhypersensitivityIn others ! IgM or IgG vs isotype - complementactivation - Type III hypersensitivity
How do we acquire immunity?
Artificial Active Immunity Vaccination (Immunization)– exposing a person to material that is anantigen but NOT pathogenic.
Phases of immune response
Designing vaccinesImportant questions to consider:1- Which part of the immune system should beactivated?2- Is immunologic memory sufficiently stimulated?This depends on the disease.- Influenza has a short incubation (1-2 d); effective immunity againstflu depends on maintaining high levels of Ig through repeatimmunizations- Polio virus has a longer incubation ( 3d) and gives memory cellstime to produce serum Ig and activate immune cell effectors
Childhood vaccines 7 major vaccines:––––HepBDTaP (Diphtheria, Tetanus, Pertussis)IPV (smallpox /vaiolo)MMR (measles, mumps, and rubella / morbillo,parotite, rosolia)– Hib (Haemophilus influenzae type B)– Var (Varicella)– PCV (Pneumococcal Conjugate Vaccine)*children require booster shots for most (American Academy of Pediatrics, 2002)
Adult vaccines(dependent on risk group) For those living in close quarters– Meningitis (Hib)– Pneumonia (PCV)– Influenza For travelers to endemic ingitsYellow feverPolio
Large scale vaccination programs Dramatic improvements inpublic health. Nobody in this room hashad – Smallpox, Polio, Measles,Chickenpox– Mumps, Rubella Because of vaccination Smallpox is the onlyhuman disease to ever beeradicated
Characteristics of a good vaccine Safe / Few side effectsGive long lasting, appropriate protectionLow in costStable with long shelf life (no special storagerequirements) Easy to administer Public must see more benefit than risk
Types of vaccines whole agent subunit of the agent– recombinant– individual parts alone
Whole agent vaccinesKilled using heat or formaldehydeLive virusKilled virusepitopesepitopesInactivated polio vaccine (Salk)Influenza (Classic)
Whole agent vaccines Attenuated attenuated - a process that lessens thevirulence of a microbeoral polio vaccine (Sabin),MMR (measles, mumps, rubella)Influenza -- Flumist
Attenuation of viruses by passagethrough non-human cells12341. Pathogenic virus isolated frompatient, grown in human cells2. Infect monkey cells with culturedvirus3. Virus acquires many mutationsthat allow it to grow well inmonkey cells4. Mutations make the virus unableto grow well in human cells! Vaccine candidate
Construction of recombinant attenuated virus1.2.3.4.Isolate virusClone genomeIsolate virulence geneMutate or delete virulencegene5. Resulting virus is Viable Immunogenic Not virulent Can be used as a vaccine
Vaccines stimulate immune memory Killed virus vaccine requires multiple doses(booster shots) to adequately stimulate aprotective immune response Live virus vaccines replicate in the host. No requirement for boosters.
Vaccines stimulate immune memory Killed virus vaccine requires multiple doses(booster shots) to adequately stimulate aprotective immune response Live virus vaccines replicate in the host. No requirement for boosters.
Advantages for live vaccines– multiply like natural organism– require fewer doses and boosters– long-lasting Disadvantages for live vaccines– special storage– back mutation– side effects
Subunit vaccines Single antigen or mixture of antigens Safer (cannot reproduce) However, often less effective thanwhole agent vaccines Can be costly Always require boosters
Overcoming Subunit vaccineproblems1. Multiple doses2. Use adjuvants prolongs stimulation of immuneresponse works by trapping the antigens in achemical complex and releasesthem slowly
Types of vaccinesLivevaccinesLiveKilledAttenuated InactivatedvaccinesvaccinesToxoidsCellular fractionvaccines Small poxvariolavaccine BCG Typhoidoral Plague Oral polio Yellowfever Measles Mumps Rubella IntranasalInfluenza Typhus Diphtheria Tetanus Meningococcal Hepatitis Bpolysaccharide vaccinevaccine Pneumococcalpolysaccharidevaccine Hepatitis Bpolypeptidevaccine Typhoid Cholera Pertussis Plague Rabies Salk polio Intramuscularinfluenza JapaniseencephalitisRecombinantvaccines
Vaccine delivery systems and adjuvants
Vaccine delivery systems and adjuvantsISCOMS as peptide delivery systems
Vaccine delivery systems and adjuvants
Representative results of DNA vaccine trials
DNA vaccines Vs Traditional vaccinesDNA vaccines Uses only the DNA frominfectious organisms. Avoid the risk of usingactual infectiousorganism. Provide both Humoral &Cell mediated immunity Refrigeration is notrequiredTraditional vaccines Uses weakened or killedform of infectiousorganism. Create possible risk ofthe vaccine being fatal. Provide primarilyHumoral immunity Usually requiresRefrigeration.
DISADVANTAGES Limited to protein immunogen only Extended immunostimulation leads tochronic inflammation Some antigen require processingwhich sometime does not occur
Vaccine delivery systems and adjuvants
Routes of administration Deep subcutaneous or intramuscular route(most vaccines) Oral route (sabine vaccine, oral BCGvaccine) Intradermal route (BCG vaccine) Scarification (small pox vaccine) Intranasal route (live attenuated influenzavaccine)
Routes of administration Gene gun delivery:- Adsorbed plasmid DNA into goldparticles Ballistically accelerated into bodywith gene gun.
HOW DNA VACCINE WORKSBY TWO PATHWAYSENDOGENOUS :- Antigenic Protein is presented bycell in which it is producedEXOGENOUS :-Antigenic Protein is formed inone cell but presented by different cell
Scheme of immunization Primary vaccination– One dose vaccines (BCG, variola, measles,mumps, rubella, yellow fever)– Multiple dose vaccines (polio, DPT, hepatitis B) Booster vaccinationTo maintain immunity level after it declines aftersome time has elapsed (DT, MMR).
Periods of maintained immunity dueto vaccines Short period (months): cholera vaccineTwo years: TAB vaccineThree to five years: DPT vaccineFive or more years: BCG vaccineTen years: yellow fever vaccineSolid immunity: measles, mumps, andrubella vaccines.
Levels of effectiveness Absolutely protective(100%): yellow fevervaccine Almost absolutely protective (99%): Variola,measles, mumps, rubella vaccines, anddiphtheria and tetanus toxoids. Highly protective (80-95%): polio, BCG, HepatitisB, and pertussis vaccines. Moderately protective (40-60%) TAB, choleravaccine, and influenza killed vaccine.
Vaccination Coverage Vaccination coverage is the percent of atrisk or susceptible individuals, orpopulation who have been fully immunizedagainst particular diseases by vaccines ortoxoids. To be significantly effective inprevention of disease on mass orcommunity level at least a satisfactoryproportion (75% or more) of the “at risk”population must be immunized.
New approaches Cancer HIV/AIDS MalariaVaccines against bioterrorism Anthrax Small pox plague
Prevention and Control - passive and active immunization How do we acquire immunity? Passive Immunity in Infants Artificial Passive Immunity Gamma globulin - Ig's from pooled blood of at least 1,000 human donors variable content non-specific Specific immune globulin - higher titers of specific antibodies Artificial Passive Immunity
for the semi-passive recurring revenue rental properties can generate. You'll notice I said "semi-passive" here. The reason I say this is because owning rental properties can be a lot of work if you're taking on the management of those properties yourself. So, depending on your rental property strategy, you can be as passive or active .
Using Passive Income to Begin Truly Wealthy ut for many people, passive income goes further than this. For many people, passive income isnt necessarily about working less but rather it is about increasing their income. More so than any other type of business, a passive income model will allow you to scale. Why?
Now you can play any source you like (audio or video) in your main system and listen to it – via your BeoLink installation – in the room with the BeoLink Passive and your extra speakers. But this is not all. You can even control the daily playback functions in your main system via the BeoLink Passive, using the Beo4 remote control.
prevention of substance misuse. This "prevention set-aside" is managed by the Center for Substance Abuse Prevention (CSAP) in SAMHSA and is a core component of each state's prevention system. On average, SAPT Block Grant funds make up 68% of primary prevention funding in states and territories. In 21 states, the prevention set-aside .
Intrusion Prevention: Signature Policies 201 Intrusion Prevention: Signature Policies - New 203 Intrusion Prevention: Sensors 204 Intrusion Prevention: Sensor - New 205 Intrusion Prevention: Sensor - Associating Sensor to a Firewall Policy 206 Intrusion Prevention: Alerts and Reports 208 Intrusion Prevention: View Rule File 210
effect is measured as a movement to a more passive corrosion potential, hence anodic inhibitor films are often called passive films. [1] Passive films are thin, only about 10-3 to 10-2 µm, and consequently, they have little effect on heat transfer. Passive films can be very effective, but pitting occurs when anodic inhibitors are
Procedures is a publication of the National Center for Injury Prevention and Control of the Cen-ters for Disease Control and Prevention. Centers for Disease Control and Prevention Julie L. Gerberding, M.D., M.P.H., Director Coordinating Center for Environmental Health and Injury Prevention Henry Falk, M.D., M.P.H., Director National Center for Injury Prevention and Control Ileana Arias, Ph.D .
Andreas M unch and Endre S uli Mathematical Institute, University of Oxford Andrew Wiles Building, Radcli e Observatory Quarter, Woodstock Road Oxford OX2 6GG, UK Barbara Wagner Weierstrass Institute Mohrenstraˇe 39 10117 Berlin, Germany and Technische Universit at Berlin, Institute of Mathematics Straˇe des 17. Juni 136 10623 Berlin, Germany (Communicated by Thomas P. Witelski) Abstract .
