Bacterial vaccines

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Doaa abu shammala

Immunity

•Sometimes called specific or adaptive immunity, acquired immunity is those features of the immune system that are "learned" during a person's lifetime rather than the ones the individual is born with. This is the part of the immune system that deals with specific invaders and learns to recognise them

by exposure to them.

Immunity

•The other part of the immune system, the one that we are born with, is called the innate immune system and consists of many mechanisms which are all nonspecific that is they are not programmed to recognise any

particular invaders.

Acquired immunity

•Acquired immunity is further divided into two parts :

•1-humoral immunity which principally operates through a type of lymphocyte called a B-cell which originates in the bone marrow and is matured both in the marrow and

the spleen.

•2-cell mediated immunity which principally operates through a type of lymphocyte called a T-cell which also originates in the bone marrow but is matured in an organ called

the thymus.

Immunization

•Historically, infectious disease has been the leading cause of death in the human population. Over the last century, two important factors have been developed to combat their spread; Immunizations are successful because they utilize the immune system's natural specificity as well as its inducibility.

Immunization

sanitation and immunization. Immunization (commonly referred to as vaccination) is the deliberate induction of an immune response, and represents the single most effective manipulation of the immune system mankind has developed.

•The principle behind immunization is to introduce an antigen, derived from a disease causing organism, that stimulates the immune system to develop protective immunity against that organism, but which does not itself cause the pathogenic effects of that organism .

•An antigen (short for antibody generator), is defined as any substance that binds to a specific antibody and elicits an adaptive immune response.

•Most viral vaccines are based on live attenuated viruses, while many bacterial vaccines are based on acellular components of micro-organisms, including harmless toxin components.

•Many antigens derived from acellular vaccines do not strongly induce an adaptive response, and most bacterial vaccines require the addition of adjuvants that activate the antigen presenting cells of the innate immune system to enhance immunogenicity.

•The most important elements of the immune system that are improved by immunization are the B cells (and the antibodies they produce) and T cells. Memory B cell and memory T cells are responsible for a swift response to a second encounter with a foreign molecule .

Passive immunization

•Passive immunization is when these elements are introduced directly into the body, instead of when the body itself has to make these elements.

•Bacterial Vaccines Bacterial diseases can be prevented by the use of immunizations that induce either active or passive immunity. Active immunity is induced by vaccines prepared from bacteria or

their products ..

•Passive immunity is provided by the administration of preformed antibody in preparations called immune globulins .

•The immune globulins usefil against bacterial diseases. Passive-active immunity involves giving both immune globulins to provide immediate protection and a vaccine to provide longterm protection .

Passive immunization

•Passive immunization is where pre-made elements of the immune system are transferred to a person, and the body doesn't have to create these elements itself. Currently, antibodies can be used for passive

immunization.

•This method of immunization begins to work very quickly, but it is short lasting, because the antibodies are naturally broken down, and if there are no B cells to produce more antibodies, they will disappear.

Passive immunization

•Passive immunization can be naturally acquired when antibodies are being transferred from mother to fetus during pregnancy, to help protect the fetus before and shortly after birth.

•Artificial passive immunization is normally given by injection and is used if there has been a recent outbreak of a particular disease or as an emergency treatment to poisons (for example, for tetanus). The antibodies can be produced in animals or in vitro.

Active immunization

•Active immunization entails the introduction of a foreign molecule into the body, which causes the body itself to generate immunity against the target. This immunity comes from the T cells and the B cells with their antibodies.

Active immunization

•Active immunization can occur naturally when a person comes in contact with, for example, a microbe. If the person has not yet come into contact with the microbe and has no pre-made antibodies for defense (like in passive immunization),

Active immunization

•the person becomes immunized. The immune system will eventually create antibodies and other defenses against the microbe. The next time, the immune response against this microbe can be very efficient; this is the case in many of the childhood infections that a person only contracts once, but then is immune.

•Artificial active immunization is where the microbe, or parts of it, are injected into the person before they are able to take it in naturally. If whole microbes are used, they are pre-treated. Depending on the type of disease, this technique also works with dead microbes, parts of the microbe, or treated toxins from the microbe.

http://upload.wikimedia.org/wikipedia/commons/f/f7/B_cell_activation.png

http://upload.wikimedia.org/wikipedia/commons/2/29/T_cell_activation.png

Bacterial vaccines

•1-Capsular poly saccride vaccines

•2-Toxoid vaccines

•3-Puriefied protein vaccines

•4-Live attenuated bacterial vaccines

•5-Killed bacterial vaccines •

A. CAPSULAR POLYSACCHARIDE VACCINES:

•)1 (streptococcus pneumoniae vaccine contains the capsular polysaccharides of the 23 most prevalent types. It is recommended for persons over 60 years of age and patients of any age with such chronic diseases as diabetes and cirrhosis or with compromised spleen function or splenectomy.

•A second vaccine containing the capsular polysaccharide of 7 pneumococcal serotypes coupled to a carrier protein (diphtheria toxoid) is available for the protection of young children who do not respond well to the unconjugated vaccine.

•A potential problem regarding the use of the pneumococcal vaccine containing 7 serotypes is that of serotype replacement. Will the vaccine reduce the incidence of disease caused by the serotypes in the vaccine but not the overall incidence of pneumococcal disease because other serotypes that are not in the vaccine will now cause disease

•)2 (Neisseria meningitidis vaccine contains capsular polysaccharide of four important types (A, C, W-135 and y) It is given when there is a high risk of meningitis during an outbreak, when military recruits enter boot camp, or for travelers to areas where meningitis is hyperendemic.

• )3 (Haemophilus influenzae vaccine contains the type b polysaccharide conjugated to diphtheria toxoid or other carrier protein. It is given to children between the ages of 2 and 15 months to prevent meningitis .

•The capsular polysaccharide alone is a poor immunogen in young children, but coupling it to a carrier protein greatly enhances its immunogenicity. A combined vaccine consisting of this vaccine plus the diphtheria, pertussis, and tetanus (DPT) vaccines is available .

•)4 (One of the vaccines against typhoid fever contains the capsular polysaccharide of Salmonella typhi. It is indicated for persons living or traveling in areas where there is a high risk of typhoid fever and for persons in close contact with either infected patients or chronic carriers .

B.Toxoid Vaccines :

)1(Corynebacterium diphtheriae vaccine contains the toxoid (formaldehyde-treated exotoxin).

Immunization against diphtheria is indicated for every child and is given in three doses at 2, 4, and 6 months of age, with boosters given 1 year later and at intervals thereafter.

•

•)2( Clostridium tetani vaccine contains tetanus toxoid and is given to everyone both early in life and later as boosters for protection against tetanus.

•)3( Bordetella pertussis vaccine contains pertussis toxoid but includes other proteins as well.

C. PURIFIED PROTEIN VACCINES :

)1 (There are two types of B. pertussis vaccines:

an acellular vaccine containing purified proteins and a vaccine containing whole killed bacteria. The acellular vaccine is now recommended in the United States .

•The principal antigen in the acellular vaccine is inactivated pertussis toxin (pertussis toxoid), but other proteins, such as filamentous hemagglutinin and pertactin, are also required for full protection.

•Pertussis toxin for the vaccine is inactivated genetically by introducing two amino acid changes that eliminate its toxic (ADP-ribo sylating) activity but retain its antigenicity

•It is the first vaccine to contain a genetically inactivated toxoid. The vaccine is indicated for every child as a protection against whooping cough It is usually given in combination with diphtheria and tetanus toxoids (DPT or DtaP vaccine)

• )2 (The vaccine against Lyme disease contains a purified outer surface protein (OspA) of Borrelia burgdorferi as the immunogen. OspA is made by recombinant DNA techniques.

•It is recommended for those who live in areas of endemic disease and whose occupation or recreation makes them likely to be exposed.

•)3( Bacillus anthracis vaccine contains "protective antigen" purified from the organism. It is given to persons whose occupations place them at risk of exposure to the organism.

D. LIVE. ATTENUATED BACTERIAL VACCINES:

)1( The vaccine against tuberculosis contains a live, attenuated strain of Mycobacterium bovis called BCG and is recommended for children at high risk for exposure to active tuberculosis in some countries.

•)2 (One of the vaccines against typhoid fever contains live, attenuated Salmonella typhi. It is indicated for persons living or traveling in areas where there is a high risk of typhoid fever and for persons in close contact with either infected patients or chronic carriers.

•)3( The vaccine against tularemia contains live, attenuated Francisella tularensis organisms and is used primarily in people who are exposed in their occupation, such as laboratory personnel, veterinarians, and hunters.

E. KILLED BACTERIAL VACCINES:

•( 1 (Vibrio cholerae vaccine contains killed organisms and is given to persons traveling to areas where cholera is endemic.

•)2 (Yersinia pestis vaccine contains killed organisms and is indicated for persons at high risk for contracting plague .

•(3 (The vaccine against typhus contains killed Rickettsia rickettsiae organisms and is used primarily to immunize members of the armed forces .

•)4(The vaccine against Q fever contains killed Coxiella burnetii organisms and is used to immunize those who are at high risk for being exposed to animals infected with the organism .

Passive immunity

•Antitoxins (immune globulins) can be used for either the treatment or prevention of certain bacterial diseases. The following preparations are available .

•)1 (Tetanus antitoxin is used in the treatment of tetanus and in its prevention (prophylaxis). In treatment, because the goal is to neutralize any unbound toxin to prevent the disease from getting worse, the antitoxin should be given promptly.

•In prevention, the antitoxin is given to inadequately immunized persons with contaminated ("dirty") wounds. The antitoxin is made in humans to avoid hypersensitivity reactions. In addition to the antitoxin, these people should receive tetanus toxoid.

• .The toxoid and the antitoxin should be given at different sites in the body to prevent the antitoxin from neutralizing the toxoid

• .)2( Botulinum antitoxin is used in the treatment of botulism. Because the antitoxin can neutralize unbound toxin to prevent the disease from progressing, it should be given promptly

•It contains antibodies against botulinum toxins A, B, and E, the most commonly occurring types. The antitoxin is made in horses, so hypersensitivity may be a problem.

•)3 (Diphtheria antitoxin is used in the treatment of diphtheria. The antitoxin can neutralize unbound toxin to prevent the disease from progressing; therefore, the antitoxin should be given promptly .

•The antitoxin is made in horses, so hypersensitivity may be a problem.

Bacterial vaccines - Gaza

At birth\first registrationBCG Mycobacterium bovis .single dose 0.05 ml

Intradermal left upper arm

2 month:

DPT first primary 0.5 ml intramuscular in lateral aspect of thigh

4.6.12.month will give DPT

SCHOOL CHILDREN:

6 years TD Tetanus Toxoid

0.5 ml intramuscular left upper arm

15 years TD

0.5 ml intramuscular left upper arm

Hib Haemophilus influenzae type b

For first 3 monthes

Polysaccrides capsule

Cold chains

•Cold chains are common in the food and pharmaceutical industries and also some chemical shipments. One common temperature range for a cold chain in pharmaceutical industries is 2 to 8 °C .

but the specific temperature (and time at temperature) tolerances depend on the actual product being shipped.

•This is important in the supply of vaccines to distant clinics in hot climates served by poorly developed transport networks. Disruption of a cold chain due to war may produce consequences similar to the Smallpox outbreaks in the Philippines during the Spanish-American war.

Cold chains need to be evaluated and controlled.

Carriers and logistics providers can assist shippers

The use of Refrigerator trucks, Refrigerator cars, Reefer (ship)s, Reefer (container)s, and refrigerated

warehouses is common .

Shipment in insulated shipping containers or other specialised packaging

Temperature data loggers help monitor the temperature history of the truck, warehouse, etc and the temperature history of the product being shipped .

Documentation is critical

Normal reaction

*Pain and tenderness at the injection site but are mild and transient and end within 2-3days

*Fever in 2%of cases*Paracetamol may be needed for pain and

fever*Mild skin rash

*Skin eruption ,consist of small red spots

DPT SIDE EFFECTInjection site abscess and neurological symptoms and signs (convulsions,encephalitis,encephalopathy, should be investigated

Pain

Fever

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