Microbiology & Parasitology Midterms PDF

MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM SANITIZATION L1: INHIBITING THE GROWTH OF The reduction of microbial populatio...

MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM SANITIZATION L1: INHIBITING THE GROWTH OF The reduction of microbial populations to MICROORGANISM IN VIVO levels considered safe by public health standards, such as those applied to restaurants TOPIC OVERVIEW A. MICROBIAL CONTROL TYPES OF AGENTS a. Chemical Methods b. Physical Methods Bactericidal B. PRINCIPLES OF DISEASE AND agents, EPIDEMIOLOGY Agents Fungicidal a. Terminologies in Epidemiology MICROBICIDAL having the agents, Algicidal b. Terminologies in Diseases AGENTS suffix “-cidal” agents and c. Examples of Pandemic kill organism Viricidal agents d. Chain of Infection (or Virucidal agents) Agents A MICROBIAL CONTROL having the Bacteriostatic MICROBIO- suffix “-static” agent STATIC AGENTS merely inhibit (Chloramphenico A1 CHEMICAL METHODS their growth l, Clindamycin) and STERILIZATION reproduction Involves the destruction or elimination of all microbes, including cells, spores and STERILE TECHNIQUE viruses Practiced when it is necessary to Dry heat, autoclaving (steam under pressure), ethylene oxide gas and various exclude all microorganisms from a liquid chemicals (such as formaldehyde) particular area, so that the area will be sterile DISINFECTION Aseptic techniques - used to Describes the elimination of most or all eliminate and exclude pathogens pathogens (except bacterial spores) from Sepsis - refers to the presence of nonliving objects pathogens in blood or tissues Usually disinfected by liquid chemicals or Asepsis - refers to absence of wet pasteurization pathogens in blood or tissues Disinfectants: chemicals used to Antiseptic techniques disinfect inanimate objects, such as bedside equipment and operating rooms ○ Developed by Joseph Lister (alcohol, sodium hypochlorite) (1867) ○ Are solutions used to disinfect PASTEURIZATION skin and other living tissues A method of disinfecting liquids ○ Dilute carbolic acid (phenol) To eliminate pathogens from milk and to cleanse surgical wounds most other beverages and equipment PAGE 1 CAMPOLET, LEANNE IZZA – BSPH2  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM ways to prevent, control or eradicate A2 PHYSICAL METHODS diseases in populations PATHOLOGY HEAT The study and diagnosis of disease The most practical, efficient and inexpensive method of sterilization ETIOLOGY Dry-heat: baking in a thermostatically The study of a cause of disease or controlled oven provides effective pathology sterilization of metals, glassware, some powders, oils and waxes. Uses hot air to sterilize materials that can withstand B1 EPIDEMIOLOGY TERMINOLOGIES high temp Moist heat: heat applied in the presence of moisture, as in boiling or steaming, is INFECTIOUS DISEASE (infection) faster and more effective than dry heat, Disease caused by a pathogen (TB, flu) and can be accomplished at a lower Communicable disease: infectious temp disease that is transmissible from one to ○ An autoclave is like a large metal another pressure cooker that uses steam Contagious disease: communicable under pressure to completely disease that is easily transmitted destroy all microbial life. Be set to ZOONOTIC DISEASE run 20 mins at a pressure of 15 psi Infectious diseases that humans acquire and a temp of 121 degrees celsius from animal sources COLD INCIDENCE OF DISEASE Freezing: metabolic activities are slowed, Defined as the number of new cases of greatly inhibiting their growth and can that disease in a defined population kill some microbes during a specific time period Refrigeration merely slows the growth of most microorganisms but does not kill MORBIDITY RATE microbes Refers to the frequency or proportion of individuals in a population who are RADIATION (UV) affected by a specific disease, illness, or Kills only those microorganisms that are health condition (new and existing) exposed to direct sunlight to destroy during a specified time period per a DNA of microbes and kill specifically defined population (usually Dessication - to remove moisture but per 1,000, 10,000, 100,000 population) not reliable method of sterilization MORTALITY RATE B PRINCIPLES OF DISEASE AND AKA death rate EPIDEMIOLOGY The ratio of the number of ppl who died of a particular disease during a specified time period per a specified population EPIDEMIOLOGY (usually per 1,000, 10,000 or 100,000 Study of factors that determine the population) frequency, distribution and determinants of diseases in human populations and PAGE CAMPOLET, LEANNE IZZA – BSPH2 2  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM SPORADIC DISEASE (S-sometimes lang) SUBACUTE DISEASE Disease that occurs only occasionally Come on more suddenly than a chronic (sporadically) within the population of a disease, but less suddenly than an acute particular geographic area disease Botulism, cholera, plague, typhoid Bacterial endocarditis fever They are kept under control as a result of CHRONIC DISEASE immunization programs and sanitary Insidious (slow) onset and lasts a long conditions time, require ongoing management and may lead to complications ENDEMIC DISEASES (ende mawawala) TB, Syphilis Diseases that are always present within the population of a particular geographic SYMPTOMS OF A DISEASE area Some evidence of a disease that is TB, STDs, Common Cold experienced or perceived by the patient The number of cases of the disease may Subjective fluctuate over time, but it will ever die ○ Symptomatic disease (or clinical out completely disease) Depends on a balance among several ○ Asymptomatic disease (or factors, including the environment, subclinical disease) genetic susceptibility of the population, behavioral factors, number of ppl who SIGN OF DISEASE are immune, virulence of the pathogen Defined as some type of objective and reservoir or source of infection evidence of a disease Such as lab test results, which are not EPIDEMIC DISEASES (nepedemi - napadami) perceived by the patient AKA outbreak Defined as a greater than usual/exceeds B3 COMMON EXAMPLES OF PANDEMIC the number of cases of a disease in a particular region, usually occurring within a relatively short period of time HIV/AIDS Does not necessarily involve a large Human immunodeficiency virus or number of people acquired immunodeficiency syndrome The AIDS epidemic began in the US PANDEMIC DISEASE around 1979, but the epidemic was not Disease that is occurring in epidemic detected until 1981 proportions in many countries It was not until 1983 that HIV – the virus simultaneously – sometimes worldwide that causes AIDS – was discovered HIV is thought to have been transferred to humans from other primates B2 TERMINOLOGIES IN DISEASES (chimpanzees in the case of HIV-1, and sooty mangabeys – a type of old world ACUTE DISEASE monkeys, in the case of HIV-2 Has a rapid onset and lasts for a short period (few days to weeks) Influenza PAGE CAMPOLET, LEANNE IZZA – BSPH2 3  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM TUBERCULOSIS 5. There must be a portal of entry ( a way Among infectious diseases, TB is second for the pathogen to gain entry into only to HIV/AIDS as the greatest killer another person) worldwide due to single infectious agent 6. There must be a susceptible host TB is a worldwide pandemic. In 2010, the largest number of new TB cases occurred STRATEGIES FOR BREAKING CHAIN OF in Asia, accounting for 60% of new cases INFECTION globally 1. Practicing effective hand hygiene Over 95% of TB deaths occur in low and procedures middle income countries, and TB is 2. Maintaining good nutrition and among the top three causes of death for adequate rest and reduce stress woman aged 15 to 44 3. Obtaining immunizations against To complicate matters, many strains of common pathogens Mycobacterium tuberculosis have 4. Practicing insect and rodent control developed resistance to the drugs that measures are used to treat TB 5. Practicing proper patient isolation ○ Multidrug-resistant tuberculosis procedures (MDRTB), or in some cases, 6. Ensuring proper decontamination of extensively drug-resistant surfaces and medical instruments tuberculosis (XDR-TB) 7. Disposing sharp and infectious wastes properly MALARIA 8. Using gloves, gowns, masks, respirators The fifth leading cause of death from and other PPE, whenever appropriate to infectious diseases worldwide (after do so respiratory infections, HIV/AIDS, diarrheal 9. Using needle safety devices during diseases and TB) blood collection Four kinds of malaria parasites infect humans: Plasmodium falciparum, P. TB MEDS vivax, P. ovale and P. malariae Rifampicin Usually, people get malaria by being Isoniazid bitten by an infective female Anopheles Pyrazinamide mosquito Ethambutol Streptomycin B4 CHAIN INFECTION 6 COMPONENTS OF INFECTIOUS DISEASE PROCESS: 1. There must be a pathogen 2. There must be a source of the pathogen (reservoir) 3. There must be a portal of exit (a way for the pathogen to escape from the reservoir) 4. There must be a mode of transmission (a way for the pathogen to travel from a person to another person) PAGE CAMPOLET, LEANNE IZZA – BSPH2 4  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM ○ Skin-to-skin contact (e.g touching, L2: HEALTHCARE EPIDEMIOLOGY hugging) ○ Contact with body fluids (e.g., blood, saliva). TOPIC OVERVIEW ○ example: Skin infections (e.g., impetigo). A. HEALTHCARE EPIDEMIOLOGY ○ example: Sexually transmitted B. MODES OF TRANSMISSION infections (e.g HIV, gonorrhea) C. HAIs a. types INDIRECT b. ways to reduce HAIs happens when pathogens are D. INFECTION CONTROL transferred via a contaminated E. STANDARD PRECAUTIONS intermediate object or person. F. CLINICAL SPECIMENS ○ Touching contaminated surfaces (e.g, doorknobs, medical equipment). A HEALTHCARE EPIDEMIOLOGY ○ Sharing personal items (e.g, towels, utensils). Defined as the study of the occurrence, ○ Respiratory infections (if surfaces determinants, and distribution of health and are contaminated with respiratory disease within healthcare settings. secretions). The primary focus of healthcare epidemiology is B2 DROPLET TRANSMISSION on infection control and preventing healthcare-associated infections (HAls), activities designed to study and improve Occurs when respiratory droplets (larger patient-care outcomes. than 5 microns) containing pathogens are expelled from an infected person 2 INFECTIOUS DISEASES and directly reach another person's Healthcare-associated infections or HAls mucous membranes (nose, mouth, eyes). infections that are acquired within Coughing, sneezing, or talking. hospitals or other healthcare facilities Influenza, COVID-19, and other respiratory infections. Community- acquired infections infections that are acquired outside of B3 AIRBORNE TRANSMISSION healthcare facilities B MODES OF TRANSMISSION Involves the spread of infectious agents through tiny airborne particles (smaller than 5 microns) that can remain B1 CONTACT TRANSMISSION suspended in the air for extended periods and be inhaled by individuals. Influenza - Can be spread through small DIRECT respiratory droplets that remain airborne pathogens are transferred from one for a short time. infected person to another person COVID-19 - Transmitted through without a contaminated intermediate respiratory droplets and aerosols, object or person. PAGE CAMPOLET, LEANNE IZZA – BSPH2 5  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM especially in crowded or poorly ventilated ○ Insert or remove contact lenses spaces. Wash your hands after you: ○ Use the restroom C HAIs ○ Handle uncooked foods, particularly raw meat, poultry, or fish C1 MOST COMMON TYPE OF HAIs ○ Change a diaper ○ Cough, sneeze, or blow your nose The most common type of HAl is UTI, ○ Touch a pet, particularly reptiles followed by surgical site infections and exotic animals (Infections occurring after surgical ○ Handle garbage procedures), lower respiratory tract ○ Tend to someone who is sick or infections (pneumonia), and injured bloodstream infections (septicemia). Prevention: Hand hygiene, proper Wash your hands in the following sterilization of equipment, and infection manner: control protocols ○ Use warm or hot running water ○ Use soap Patients Most Likely to Develop HAls: ○ Wash all surfaces thoroughly, elderly patients including wrists, palms, back of women in labor and delivery hands, fingers, and under premature infants and newborns fingernails (preferably with a nail surgical and burn patients brush) patients with diabetes or cancer ○ Rub hands together for at least 10 patients having an organ transplant to 15 seconds patients receiving treatment with ○ When drying, begin with your steroids, anticancer drugs,, or radiation, forearms and work toward your immunosuppressed patients hands and fingertips, and pat Extended hospital stays your skin rather than rubbing to avoid chapping and cracking C2 WAYS TO REDUCE NUMBER OF HAIs D INFECTION CONTROL The primary way to reduce the number of HAIs pertains to the numerous measures that is strict compliance with infection control are taken to prevent infections from guidelines. occurring within healthcare settings. ways to break various links in the chain of Handwashing → the single most infection important measure to reduce the risks of transmitting pathogens from one patient to another or from one anatomic site to another on the same patient. Wash your hands before you: ○ Prepare or eat food ○ Treat a cut or wound or tend to someone who is sick PAGE CAMPOLET, LEANNE IZZA – BSPH2 6  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM PHENOL (carbolic acid) D1 MEDICAL ASEPSIS/CLEAN TECHNIQUE For decontamination of the hospital environment, including laboratory Its goal is to exclude pathogens. surfaces,and for noncritical medical and include frequent and thorough surgical items; handwashing; personal grooming; wearing of clean masks, gloves, and SURGICAL ASEPSIS/STERILE TECHNIQUE gowns when appropriate; proper includes practices used to render and disinfection; proper disposal of needles, keep objects and areas sterile (free of contaminated materials, and infectious microbes). waste; and sterilization. Its goal is to exclude all microbes. practiced in operating rooms, in labor Disinfection → use of chemical sterilants and delivery areas, and during invasive a chemical liquid that destroys bacteria. procedures. Alcohols (e.g., 60%-90% solutions of Other surgical aseptic techniques ethyl, isopropyl, and benzyl alcohols) include surgical scrubbing of hands and ○ For disinfection of thermometers, fingernails before entering the operating rubber stoppers, external surfaces room; wearing sterile masks, gloves, caps, of stethoscopes, endoscopes, and gowns, and shoe covers; using sterile certain other equipment solutions and dressings; using sterile drapes and creating a sterile field; and CHLORINE AND CHLORINE COMPOUNDS using heat-sterilized surgical (Clorox, Halazone, hypochlorites, Warexin) instruments. For disinfection of countertops, floors, blood spills, needles, syringes; water E STANDARD PRECAUTIONS treatment FORMALDEHYDE (formalin) To be applied to the care of ALL patients Limited uses because of irritating fumes, in ALL healthcare settings, regardless of pungent odor, and potential the suspected or confirmed presence of carcinogenicity; an infectious agent. Used for preserving anatomic specimens Constitutes the primary strategy for the prevention of healthcare-associated HYDROGEN PEROXIDE transmission of infectious agents For disinfection of inanimate surfaces; between patients and healthcare limited clinical use; personnel. Contact with eyes may cause serious eye damage E1 VACCINATIONS IODINE (iodine solutions or tinctures) and iodophors (povidone-iodine, Betadine,) healthcare personnel are at particular risk for Primarily for use as antiseptics; also for several vaccine-preventable infectious diseases disinfection of rubber stoppers, Hepatitis B vaccine thermometers, endoscopes Influenza (annually) Measles-mumps-rubella (MMR) Varicella (chickenpox) Tetanus-diphtheria-pertussis (Tdap) PAGE CAMPOLET, LEANNE IZZA – BSPH2 7  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM Meningococcal vaccine (for respiratory secretions from the patient to microbiologists who are routinely others. exposed to isolates of Neisseria meningitidis) E5 EYE PROTECTION E2 HAND HYGIENE Goggles and disposable or non disposable face shields. The most important and most basic technique in preventing and controlling E6 RESPIRATORY PROTECTION infections and preventing the transmission of pathogens Ignaz Philipp Semmelweis (1818-1865) requires the use of a respirator with N95 or ○ "Father of Handwashing," the higher filtration to prevent inhalation of "Father of Hand Disinfection," and infectious particles. the "Father of Hospital Epidemiology." F CLINICAL SPECIMENS E3 PERSONAL PROTECTIVE EQUIPMENT various types of specimens, (blood, urine, feces, and CSF) that are collected from Gloves can protect both patients and patients and used to diagnose or follow healthcare personnel from exposure to the progress of infectious diseases. infectious materials that may be carried Must be of the highest possible quality. on hands. ○ Healthcare professionals who Isolation Gowns are usually the first collect and transport clinical piece of PPE to be donned. They protect specimens should exercise the healthcare worker's arms and extreme caution during the exposed body areas and prevent collection and transport of clinical contamination of clothing with blood, specimens to avoid sticking body fluids, and other potentially themselves with needles, cutting infectious material. themselves with other types of sharps, or coming in contact with any type of specimen. E4 MASK Healthcare personnel who collect clinical specimens must strictly adhere to the worn by healthcare personnel to protect safety policies known as Standard them from contact with infectious Precautions. material from patients worn by healthcare personnel when F1 BLOOD engaged in procedures requiring sterile technique to protect patients from exposure to pathogens that may be Hematology → study of blood present in a healthcare worker's mouth Plasma → the liquid portion of blood or nose. As it circulates throughout the body, placed on coughing patients to limit blood is usually sterile. potential dissemination of infectious PAGE CAMPOLET, LEANNE IZZA – BSPH2 8  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM However, blood sometimes contains Meningoencephalitis →inflammation or bacteria (bacteremia) → may indicate a infection of both the brain and the disease. meninge bacteremias may occur after oral surgery, To diagnose these diseases, CSF must be tooth extraction, or even aggressive tooth collected into a sterile tube by a lumbar brushing that causes bleeding. puncture (spinal tap) under surgically Bacteremia may occur during certain aseptic conditions. stages of many infectious diseases (bacterial meningitis, typhoid fever and F4 SPUTUM other Salmonella infections, pneumococcal pneumonia, urinary infections, endocarditis, brucellosis, accumulates deep within the lungs of a tularemia, plague, anthrax, syphilis, and patient with pneumonia, tuberculosis, or wound infections). other lower respiratory infection. can provide important information about F2 URINE a patient's lower respiratory infection. a patient's saliva will not provide clinically relevant information about the patient's ordinarily sterile while it is in the urinary lower respiratory infection and will be a bladder. waste of time, effort, and money. However, during urination, it becomes contaminated by indigenous microbiota F5 THROAT SWABS of the distal urethra (the portion of the urethra farthest from the bladder). The ideal specimen for a urine culture is a collected to determine whether a patient has clean-catch, midstream urine specimen. strep throat (Streptococcus pyogenes "Clean-catch" refers to the fact that the pharyngitis). area around the external opening of the urethra is cleansed by washing with soap and rinsing with water before urinating. F6 FECAL/STOOL SPECIMENS "Midstream" refers to the fact that the initial portion of the urine stream is should be collected at the laboratory and directed into a toilet or bedpan, and then processed immediately to prevent a decrease the urine stream is directed into a sterile in temperature, which allows the pH to drop, container. causing the death of many Shigella and Salmonella species. F3 CEREBROSPINAL FLUID (CSF) CSF specimens must be rushed to the laboratory and must not be refrigerated. Refrigeration might kill any fragile pathogens present in the specimen. Meningitis → inflammation or infection of the membranes (meninges) that surround the brain and spinal column. Encephalitis → inflammation or infection of the brain. PAGE CAMPOLET, LEANNE IZZA – BSPH2 9  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM than one person, or, in some cases, by an L3: IMMUNOLOGY animal TOPIC OVERVIEW ACTIVE ACQUIRED IMMUNITY A. TERMS AND DEFINITIONS Immunity that is acquired in B. IMMUNITY NATURAL response to the entry of a live a. types pathogen into the body (i.e., in C. IMMUNOLOGY response to an actual infection) a. types of vaccine b. how vaccines work ARTIFICIAL Immunity that is acquired in c. herd immunity response to vaccines D. PHARMACISTS AS VACCINATORS PASSIVE ACQUIRED IMMUNITY A TERMS AND DEFINITIONS Immunity that is acquired by a IMMUNOLOGY fetus when it receives maternal The scientific study of the immune NATURAL antibodies in utero or by an system and immune response infant when it receives maternal The primary functions of the immune antibodies contained in system are to differentiate between colostrum "self" and "nonself" (something foreign), and destroy that which is nonself Immunity that is acquired when ARTIFICIAL a person receives antibodies ANTIGENS (kalaban) contained in antisera or Molecules that stimulate the immune gamma globulin system to produce antibodies. ANTIBODIES (kakampi) B IMMUNOLOGY proteins produced by the immune system in response to antigens VACCINE defined as material that can artificially B IMMUNITY induce immunity to an infectious disease, usually after injection or, in some The condition of being immune cases, ingestion of the material (oral polio vaccine). TYPES OF ACQUIRED IMMUNITY A person is deliberately exposed to a 1. ACTIVE ACQUIRED IMMUNITY harmless version of a pathogen (or toxin), If the antibodies are actually produced which will stimulate his/ her immune within the person's body system to produce protective antibodies and memory cells. 2. PASSIVE ACQUIRED IMMUNITY person receives antibodies that were produced by another person or by more PAGE CAMPOLET, LEANNE IZZA – BSPH2 10  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM To safely achieve this, a substantial proportion of population should be B1 TYPES OF VACCINES vaccinated, lowering the overall amount of virus able to spread in the whole ATTENUATED population. The process of weakening pathogens. One aim is to protect the vulnerable Adenovirus, chicken pox (varicella), group that cannot get vaccinated measles (rubeola), mumps, German Ex. For Covid 19 - 85% or higher; Measles measles (rubella), BCG (for protection - 95%; Polio - 80% against TB), cholera, tularemia, typhoid fever (oral vaccine) C PHARMACISTS AS VACCINATORS INACTIVATED Vaccines made from pathogens that APRIL 5, 2021 - The Philippine Pharmacists have been killed by heat or chemicals Association (PPhA) has been accredited by the hepatitis A, influenza, Japanese Professional Regulation Commission and the encephalitis, anthrax, cholera, pertussis Professional Regulatory Board of Pharmacy to train and certify Filipino pharmacists to TOXOID administer COVID-19 vaccines and other A toxoid is an exotoxin that has been vaccines to adults through the PPhA inactivated (made nontoxic)by heat or Immunizing Pharmacist Certification Program. chemicals. Diphtheria, tetanus Section 4, Article I of RA No. 10918, a person practicing pharmacy can administer adult vaccines as approved by the Food and Drug B2 HOW VACCINES WORK Administration (FDA) provided that they shall undergo the training on the safe administration of adult vaccines and management of Adverse Vaccines stimulate the recipient's Event Following Immunization (AEFI) for immune system to produce protective pharmacists and hold a certificate of training antibodies. issued by an institution duly accredited by the The protective antibodies and/or Professional Regulation Commission (PRC). memory cells produced in response to the vaccine then remain in the recipient's Section 5, Article I of RA No. 10918 defines body to "do battle with" a particular adult vaccines as cervical cancer, flu (influenza), pathogen, should that pathogen enter pneumococcal, other pre-exposure prophylactic the recipient's body at some time in the vaccines to be administered to patients aged future. eighteen (18) years and above, and such other vaccines as may be defined by the Department B3 HERD IMMUNITY of Health (DOH) in an administrative issuance; Section 40, Article IV of RA No. 10918 states AKA population immunity that in addition to the requirement provided in indirect protection from infectious Section 4, paragraph (g) thereof, licensed and disease that happens when a population trained pharmacist who shall administer adult is immune (through vaccination or vaccines shall ensure that the vaccine to be immunity developed from past administered shall have a doctor's prescription infection). PAGE CAMPOLET, LEANNE IZZA – BSPH2 11  MICROBIOLOGY & PARASITOLOGY - MIDTERMS BSPH 2114 1ST SEMESTER – SIR KENNETH PEREA – T 3:30-6:30 PM which is not more than seven (7) days old and submit a monthly vaccination report and AEFI report to DOH regional offices using the prescribed form; PAGE CAMPOLET, LEANNE IZZA – BSPH2 12