Microbio Lecture Slides 1.6 PDF

Prevention Strategies & Vaccines  WHY DO WE CARE? PREVENTION STRATEGIES FOR INFECTIOUS DISEASE  Last week we learned about the two components of the immune system, innate & adaptive, which helps our body fight infection.  Today we’ll be discussing how to PREVENT...

Prevention Strategies & Vaccines  WHY DO WE CARE? PREVENTION STRATEGIES FOR INFECTIOUS DISEASE  Last week we learned about the two components of the immune system, innate & adaptive, which helps our body fight infection.  Today we’ll be discussing how to PREVENT infectious diseases SURVIVAL OF HUMAN POPULATIONS BY YEAR  CLASS OBJECTIVES  Define vocabulary words  To be able to educate yourself and your patients on how to prevent infections using the below learning objectives:  Compare & contrast contagious and communicable  Differentiate endemic, epidemic, and pandemic  Elaborate on and be able to identify the types of transmission and an example of each  List and give examples of the Standard Precautions for clinical settings  Describe which standard precautions for clinical settings (& PPE) would be best for different types of threats, e.g. blood-borne, vs. inhalation/respiratory, etc.  Define the following terms and give three examples of each: sterilization, disinfection, and antisepsis  Define the three levels of disinfection and give examples of each. When would each type of disinfectant be used?  Communicable infection- one that is spread from host to host Contagious means that the infection is easily transmitted Reservoir- the living or non- living normal residence of an infectious agent. Zoonotic diseases are those with infectious agents that reside and replicate within non-human animals Vectors- living creatures that transmit a pathogen to humans; i.e. mosquitoes Host- organism that provides nourishment and/or shelter to the agent  DISEASE PREVALENCE Endemic- presence of infection is maintained at constant level within area or group aka “baseline” Epidemic- rise in disease cases above area/group “baseline” Pandemic- epidemic spread across multiple countries/continents  TYPES OF TRANSMISSION A. General Transmission 1. Abiotic environmental factors  Fomites are inanimate objects that transmit pathogens  Soil & water harbor pathogens 2. Animal/Insect Vectors  Arthropods  Other animals including farm animals B. Human-to-Human Transmission 1. Vertical transmission- infectious agents are passed from mother-to-offspring during pregnancy (transplacental transmission), childbirth, or breastfeeding i.e. ZIKA 2. Horizontal transmission- other human-human transmission  Direct contact- i.e. HIV, Herpes  Indirect contact- i.e. norovirus  Droplets (i.e. bodily fluids)- i.e. HIV  Respiratory/Airborne- i.e. influenza  Fecal-oral- i.e. norovirus  HOW TO PREVENT INFECTIONS: STANDARD CLINICAL PRECAUTIONS  Basic guidelines established by the U.S. Center for Disease Control: 1. Good hand hygiene includes washing with soap and water or hand rubbing with alcohol-based products before and after direct contact with patients, devices, and other objects 2. Personal protective equipment (PPE) includes gloves, masks, and gowns that create a barrier between the medical professional and infected individuals or contaminated objects 3. Respiratory hygiene and cough etiquette means that individuals, including patients, should cover their mouths when coughing or sneezing 4. Proper patient placement requires that patients with infectious diseases should be separated from non- infected patients 5. Maintenance of a clean environment means that the facility and commonly used objects are routinely cleaned and disinfected 6. Careful handling of laundry calls for precautions be used to protect mucous membranes from exposure to infectious agents 7. Safe injection practices include careful handling and cleaning of injection paraphernalia; syringes and needles should never be re-used 8. Sharps safety ensures that needles and other sharp tools, such as scalpels, are used and disposed of properly  >1,000 healthcare professionals are injured by needles or other sharp devices every day GOOD HYGIENE: PRIMARY WAY TO PREVENT INFECTIOUS DISEASES  How to properly wash your hands SCIENCE WITH KENNEN: WEAR YOUR MASKS Check him out on IG, Youtube, Facebook: @ScienceWithKennen PATHOGEN ELIMINATION: ANTISEPTICS VS. DISINFECTANTS VS. STERILIZATION  ANTISEPSIS  Antisepsis: Use of chemical agents on skin or other living tissue to inhibit or eliminate microbes; no sporicidal action is implied  Alcohols- all groups of organisms except spores  Iodophors- similar to alcohol, but more toxic to skin  Chlorhexidine- broad antimicrobial (kills at a slower rate than alcohol)  Parachlorometaxylenol (PCMX)- primarily gram+ bacteria  Triclosan- bacteria, not safe for humans?  DISINFECTION  Disinfection: Use of physical procedures or chemical agents to destroy most microbial forms; bacterial spores & other relatively resistant organisms (e.g., mycobacteria, viruses, fungi) may remain viable  Level used is determined by relative risk surfaces pose as reservoir for pathogens  Low-level disinfectants- used to treat noncritical instruments & devices (e.g. blood pressure cuffs, electrocardiogram electrodes, & stethoscope)  Ex. i.e., quaternary ammonium compounds  Intermediate-level disinfectants- used to clean surfaces or instruments on which contamination with bacterial spores & other highly resilient organisms is unlikely (e.g. semicritical instruments & devices like laryngoscopes, vaginal specula, anesthesia breathing circuits, etc.  Ex. alcohols, iodophor compounds, & phenolic compounds  High-level disinfectants- used for items involved with invasive procedures that cannot withstand sterilization procedures (e.g., certain types of endoscopes & surgical instruments with plastic or other components that cannot be autoclaved)  Ex. Moist heat & use of liquids such as glutaraldehyde, hydrogen peroxide, peracetic acid, & chlorine compounds STERILIZATION  Sterilization- total destruction of all microbes, including the more resilient forms such as bacterial spores, mycobacteria, nonenveloped (nonlipid) viruses, & fungi using physical, gas vapor, or chemical sterilants  Steam under pressure- widely used, inexpensive, nontoxic, reliable (autoclave)  Ethylene oxide gas- sterilize temp or pressure sensitive items  Hydrogen peroxide vapors- sterilization of instruments  Chemical sterilants- peracetic acid & glutaraldehyde GERMICIDAL PROPERTIES OF DISINFECTANTS AND ANTISEPTIC AGENTS Germicide: Chemical agent capable of killing microbes; includes virucide, bactericide, sporicide, tuberculocide, and fungicide ALSO A SCIENTIST Michel Yao, PhD -MSc, Health- Université de Montréal -PhD, Public Health- Université de Montréal  WHO’s Program Manager for Emergency Response for Africa  Also in Netflix’s “Pandemic: How to Prevent an Outbreak”  https://www.facebook.com/WHOAFRO/videos/dr-michel- yao-world-health-organization-who-afro-emergency- operations-manager-ou/193232565084897/  @drmichelyao1 on Twitter WHY YOU SHOULD CARE CLASS OBJECTIVES  Understand why vaccines are important  Compare & contrast routine, required, & elective vaccines  Describe the origination of variolation & vaccination  Describe the different type of vaccines  List the characteristics of vaccines  Define adjuvants and provide an example  Be able to have a discussion with an anti-vax or on-the-fence patient/patient's parent about vaccination, why it's important, and debunk some common vaccine myths  Learn where to find out more information on vaccines if you don’t remember, or want to learn more VACCINATIONS ARE ESSENTIAL TO AVOID GETTING SICK HISTORY OF VACCINATION  Individuals who survived smallpox, plague, & cholera rarely contracted the disease again, even when surrounded by others suffering from that particular disease  Among ancient cultures, Egyptians & Chinese exposed individuals to powders formed from crusts & scales of pockmarks taken from individuals recovering from smallpox (Variola major virus)  Individuals developed either mild forms of the disease or no apparent disease at all  https://ourworldindata.org/vaccination  VARIOLATION VS.VACCINATION  Edward Jenner (1796)- intentional inoculation with material from individuals with cowpox (Variola minor, a related virus that infects cattle, but causes mild disease in humans) protected against smallpox  Variolation- deliberate inoculation of an uninfected person with smallpox virus (e.g. contact with pustular matter) that was widely practiced before era of vaccination as prophylaxis against severe form of smallpox  “cowpox inoculation” or “vaccine inoculation” (from Latin vacca = cow)  Vaccination- The act of introducing a vaccine into the body to produce immunity to a specific disease  HOW VACCINES WORK  HOW VACCINES WORK: https://www.tiktok.com/@hotvickkrishna/video/6937457241968643334?i s_from_webapp=v1&item_id=6937457241968643334&lang=en https://www.tiktok.com/@hotvickkrishna/video/6946300405756349702?i s_from_webapp=v1&item_id=6946300405756349702&lang=en  VACCINES CAN BE PREPARED FROM VARIOUS MATERIALS DERIVED FROM PATHOGENIC ORGANISMS  Live-Attenuated vaccines- based on living organisms but had virulence & ability to replicate reduced by treatment with heat, chemicals, etc. Typically cause only subclinical or mild forms of disease, but do carry possibility that mutation might enable organisms to revert to wild type. Booster shots not usually needed.  Ex. MMR, smallpox, chickenpox, yellow fever  Inactivated (killed) vaccines- organisms that are dead because of treatment with physical or chemical agents, or inactivated toxins (toxoids- diphtheria & tetanus vax). Difficult to guarantee that every organism in a preparation is dead. Incapable of infection, replication, or function but still provokes immunity. Booster shots sometimes needed.  Ex. Polio shot, Hep A, Flu  Subunit, recombinant, polysaccharide, and conjugate vaccines- use specific pieces of the germ—like its protein, sugar, or capsid (a casing around the virus). Some can infect host cells but cannot induce disease; Booster shots sometimes needed; adjuvants often used  Ex. Hib, Hep B, HPV, Shingles  Ex. J&J Covid- uses a recombinant vax model- weakened live adenovirus with spike protein  VACCINES CAN BE PREPARED FROM VARIOUS MATERIALS DERIVED FROM PATHOGENIC ORGANISMS  DNA vaccines- naked DNA extracted from pathogen & engineered to remove some of genes critical to development of disease. Host cells to take up DNA & express the pathogen gene products. Typically lasts longer than other methods where vaccine is rapidly eliminated from host  Ex. India’s Covid vax, no DNA vaccines approved for humans in US (yet)  RNA vaccines- RNA vaccines work by introducing an mRNA sequence (the molecule which tells cells what to build) which is coded for a disease specific antigen; faster & cheaper to produce than “traditional” vaccines  Ex. Pfizer & Moderna Covid Vax  Best immune responses: Live-attenuated vaccines → inactivated vaccines → everything else  Replicating organisms= good immune responses → safety of a vaccine may be inversely proportional to its effectiveness  CHARACTERISTICS OF VACCINES  Vaccines must fulfill several criteria to be effective in protecting large numbers of individuals: 1. Effective protection against intended pathogen must occur without significant danger of actually causing the disease or of producing severe side effects 2. Protection that is provided must be long lasting. 3. Vaccine must induce immune responses most effective against intended pathogen across a broad range of individuals 4. Neutralizing antibodies must be stimulated in order to minimize reinfection 5. Vaccine must be economically feasible to produce 6. Vaccine must be suitably stable for storage, transport, & use WHY BOOSTERS?!  Maybe too specific, but I've been wondering for awhile why COVID boosters were recommended so close to the original vaccination date when other vaccines, like Tdap, last a very long time before the booster is required. If it was a new vaccine like for that of flu, I'd understand, but a "booster" is there to help the body remember the same thing, right? Is the body just stupider when it comes to COVID?  https://www.tiktok.com/@hotvickkrishna/video/7039798030660275462?is_from_we bapp=v1&item_id=7039798030660275462&lang=en DID WE RUSH THE COVID VACCINE?  CAN VACCINES CAUSE GENETIC MUTATIONS?  No, due to the Central Dogma of Molecular Biology  Unlike vaccines using weakened pathogens, DNA & RNA vaccines only carry the information needed to produce one or more bacterial or viral proteins and cannot generate the entire pathogen  https://www.chop.edu/centers- programs/vaccine-education- center/video/can-mrna-vaccines-alter-a- persons-dna  Not on the test, but very helpful: https://www.medicalnewstoday.com/art icles/dna-vs-mrna-vaccines-similarities- and-differences  HOW DO TESTING AND CLINICAL TRIAL PROCESSES WORK?  HOW DO WE ADDRESS THE ARGUMENT THAT VACCINES AREN'T TESTED THE WAY THEY ARE ADMINISTERED SINCE MULTIPLE VACCINES ARE OFTEN GIVEN AT THE SAME TIME?  They ARE tested (and together) ☺  Rotarix was tested with Pediarix (DTaP-HepB-IPV), Prevnar, and Hib  Prevnar 13 was tested with DTaP, IPV, hepatitis B and Hib  Prevnar 13 was tested with MMR, Varicella, and hepatitis A  MenC with DTaP-IPV-HepB-Hib  MenC with MMR  MMR and Varicella with Hib, Hepatitis B, and DTaP  Hepatitis A and hepatitis B with either MMR or DTaP-IPV-Hib  Flumist with MMR and Varicella  Kinrix (DTaP-IPV) with MMR and Varicella  HPV9 with Tdap and Meningococcal vaccines  Tdap with influenza vaccine  Meningococcal vaccine with influenza vaccine  Source with sources: https://vaxopedia.org/2017/08/20/are-vaccines-tested-together/  GREAT site: https://vaxopedia.org/2017/04/25/50-ways-to-get-educated-about-vaccines/  BUT IF I’M HEALTHY WHY SHOULD I GET A VACCINE? HERD IMMUNITY  Can provide excellent protection to a population, even if every individual is not vaccinated  Herd immunity- resistance to spread of an infectious disease within a population due high levels of pre-existing immunity (previous infection OR vaccination)  With ↑ vaccination, chances of an infectious agent “finding” an unprotected individual becomes ↓ = population resistant as a whole  HOWEVER  Infection can still spread in unvaccinated individuals  New mutant forms might arise that could evade the immune response & produce disease in vaccinated individuals as well  “Breakthrough strains”  BREAKTHROUGH STRAINS  https://www.youtube.com/watch?v=zcbPV2B8FPM SO HOW DO WE KNOW IF A VACCINE IS EFFECTIVE?  Vaccine effectiveness (VE) depends on:  1) characteristics of the person being vaccinated (such as their age and health)  2) the similarity or “match” between the virus the vaccine is designed to protect against and the viruses spreading in the community  WHAT IS AN ADJUVANT?  An adjuvant is an ingredient used in some vaccines that helps create a stronger immune response in people receiving the vaccine  Help produce a stronger immune response  However more likely to experience “side effects” like injection site soreness, redness, & swelling  Some vaccine components themselves can serve as adjuvants  Ex. Pertussis component (from Bordetella pertussis) in DTP (Diphtheria-Tetanus-Pertussis) vaccine  Other adjuvants include alum  Aluminum salts (aluminum hydroxide, aluminum phosphate, and aluminum potassium sulfate)  Safety review of aluminum salt pharmacokinetics in vaccines: https://pubmed.ncbi.nlm.nih.gov/22001122/  https://www.cdc.gov/vaccinesafety/concerns/adjuvants.html  DID YOU KNOW…. THERE IS MORE ALUMINUM IN BREAST MILK (7 MG), FORMULA (38MG), & SOY FORMULA (117 MG) THAN IN ALL THE VACCINES ADMINISTERED IN THE FIRST 6 MONTHS OF LIFE (4.4 MG) HTTPS://WWW.CHOP.EDU/CENTERS-PROGRAMS/VACCINE-EDUCATION-CENTER/VACCINE- INGREDIENTS/ALUMINUM  WHAT ELSE IS IN VACCINES?  Thimerosal??? (ethylmercury, NOT to be confused with methylmercury)- Preservative  Methylmercury is the dangerous stuff found in fish. Can be toxic.  Ethylmercury is structurally different, cleared from the body quickly, and shown to be safe.  Precautionarily removed/reduced from vaccines in 1999 as a show of good will by American Academy of Pediatrics  https://www.cdc.gov/vaccinesafety/concerns/thimerosal/inde x.html  Summary of all the studies: https://www.cdc.gov/vaccinesafety/pdf/cdcstudiesonvaccines andautism.pdf FORMALDEHYDE? (PRESERVATIVE)  WHAT ABOUT ABORTED FETAL TISSUE?  Viruses need cells to grow (remember, they don’t have their own machinery like pro & eukaryotes)  VZV, Rubella, Hep A, & Rabies grown in fetal embryo fibroblast cells  These fetal embryo fibroblast cells came from elective termination of pregnancy in the 1960s (WI-38 & MRC-5)  However, because of cell culture & storage, the same cell lines have been used forever  VACCINES DO NOT CONTAIN THESE CELLS OR THEIR DNA DO VACCINES CAUSE AUTISM? RACIAL INEQUALITIES IN VACCINATION RATES https://covidtracking.com/race  FOLLOW UP RESOURCES  AMAZING INFOGRAPHICS- @niniandthebrain on IG https://www.instagram.com/niniandthebrain/?hl=en, @virus.vs.labcoat on IG https://www.instagram.com/virus.vs.labcoat/?hl=en @deplatformdisease on IG https://www.instagram.com/deplatformdisease/?hl=en  @jessicamalatyrivera on IG https://www.instagram.com/jessicamalatyrivera/?hl=en  Reels & TikToks @christinaaaaaaanp on IG & TikTok  Covid Tracking Project https://covidtracking.com/  CDC Overview, History, and How the Safety Process Works: https://www.cdc.gov/vaccinesafety/ensuringsafety/history/index.html  Childhood Vaccine info: https://www.cdc.gov/vaccines/parents/index.html  2020 Easy to Read Vax Guide: https://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread.html  En espanol: https://www.cdc.gov/vaccines/schedules/easy-to-read/child-easyread-sp.html  Vaxopedia (wonderful!): https://vaxopedia.org/  Vaccine myths debunked: https://vaxopedia.org/tag/vaccine-myths/  Children’s Hospital of Pennsylvania: https://www.chop.edu/centers-programs/vaccine-education-center  History of Vaccines: https://www.historyofvaccines.org/content/blog/vaccine-randomized-clinical-trials  ALSO A SCIENTIST  Dr. Kizzmekia Corbett, PhD Assistant Professor of Immunology & Infectious Diseases, Harvard T.H. Chan School of Public Health  The vaccine concept incorporated in mRNA-1273 was designed by Corbett’s team from viral sequence data and rapidly deployed to industry partner, Moderna, Inc. only 66 days after viral sequence release https://asm.org/Biographies/Kizzmekia-S-Corbett,-Ph-D https://www.hsph.harvard.edu/news/press-releases/kizzmekia- corbett-joins-harvard-chan-school/