Abdul Ghaffar

Microbiology and Immunology

 Milestones
Milestones in
in immunization
immunization

3000BC 1500BC

Evidence of sniffing Turks introduce

powdered small variolation
pox crust in Egypt

1700AD
2000BC
Introduction of
Sniffing of small variolation in England
pox crust in China and later in the US

2
 Introduction
Introduction of
of variolation
variolation

The
The wife
wife ofof the
the British
BritishAmbassador
Ambassador in in
Turkey,
Turkey, inin March
March 1717 1717 wrote,
wrote, following
following
the
the variolation
variolation of of her
her son,
son, to
to aa friend
friend inin
England:
England: TheThe small
small pox,
pox, so
so fatal,
fatal, so
so general
general
amongst
amongst us, us, isis entirely
entirely harmless
harmless herehere
by
by the
the invention
invention of of ingrafting.I
ingrafting.I am am
patriot
patriot enough
enough to to bring
bring this
this invention
invention intointo
fashion
fashion in in England.
England.

3
Milestones
Milestones in
in immunization
immunization

1780AD
Edward Jenner discovers
small pox vaccine

4
 Edward Jenner

Discovery of small pox vaccine

5
 Edward Jenner
Among patients awaiting small pox vaccination

6
Modern
Modern era
era of
of the
the vaccine
vaccine

1885 1934
Rabies vaccine Pertussis
(Pasteur)

1920s 1955
Diphtheria and Salk polio
Tetanus

7
Modern
Modern era
era of
of the
the vaccine
vaccine

1960s 1985
Mumps measles Haemophilus
and rubella virus
Sabin polio

1990s
Hepatitis and
varicella

8
Pre-
Pre- &
& post-vaccine
post-vaccine incidence
incidence of
of
common
common preventable
preventable diseases
diseases

9
Different
Different modes
modes of
of acquiring
acquiring
immunity
immunity

Immunity

Natural Acquired
resistance

Passive Active

Artificial Natural Artificial Natural

10
 Passive
Passive Immunity
Immunity

Natural Artificia
l
Placental Antibodies or
transfer of IgG immunoglobulins

Colostral Immune cells

transfer of IgA

11
 Passive
Passive Immunization
Immunization

disease antibody indication

source
diphtheria, tetanus human, horse prophylaxis, therapy
vericella zoster human immunodeficiencies
gas gangrene,
botulism, snake horse post-exposure
bite, scorpion sting

rabies, human post-exposure

hypogamma- human prophylaxis
globulinemia

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Advantages
Advantages and
and Disadvantages
Disadvantages
of
of Passive
Passive Immunization
Immunization
Advantages Disadvantages
no long term
protection
serum sickness
immediate
protection risk of hepatitis
and Aids
graft vs. host
disease (cell
graft only)

13
 Active
Active Immunization
Immunization

Natural Artificial
Attenuated
organisms
killed organisms
exposure to sub- sub-cellular
clinical infections fragments
toxins
others

14
 Live
Live Attenuated
Attenuated Vaccines
Vaccines

polio* hepatitis A
not used in std. not required in
schedule SC
measles, mumps yellow fever
& rubella Military and travelers

Varicella zoster
tuberculosis
children with no
not used in this
history of chicken pox country

15
Killed
Killed Whole-Organism
Whole-Organism Vaccines
Vaccines

polio Q fever
population at risk
influenza typhoid, cholera, plague
elderly and at risk epidemics and travelers
rabies pertussis
post exposure replaced by the
acellular vaccine

16
Microbial
Microbial Fragment
Fragment Vaccines
Vaccines

Bordetella. Pertussis
virulence factor protein
Haemophilus influenzae B
protein conjugated polysaccharide
Streptococcus pneumoniae
Polysaccharide mixture
Neisseria meningitidis
polysaccharide

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Microbial
Microbial Fragment
Fragment Vaccines
Vaccines

Clostridium tetani (tetanus)

inactivated toxin (toxoid)

Corynebacterium diphtheriae
inactivated toxin (toxoid)
Vibrio cholerae
toxin subunits

Hepatitis B virus
cloned in yeast

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Modification
Modification of
of Toxin
Toxin to
to Toxoid
Toxoid

Toxin Toxoid

chemical
modification

toxin moiety antigenic determinants

19
Future
Future Vaccines
Vaccines

anti-Idiotype Vaccine
DNA

Immuno-dominant peptide

20
Recommended Childhood
Immunization Schedule

21
 Adverse
Adverse Events
Events Occurring
Occurring
Within
Within 48
48 Hours
Hours DTP
DTP of
of Vaccination
Vaccination
Event Frequency
local
redness, swelling, pain 1 in 2-3 doses

systemic: Mild/moderate
fever, drowsiness, fretfulness 1 in 2-3 doses
vomiting
anorexia 1 in 5-15 doses
systemic: more serious
persistent crying, fever 1 in 100-300 doses
collapse, convulsions 1 in 1750 doses
acute encephalopathy 1 in 100,000 doses
permanent neurological deficit 1 in 300,000 doses

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 Adverse
Adverse event
event occurring
occurring
within
within 48
48 hours
hours DTP
DTP vaccination
vaccination
Event Frequency

Local:
redness, swelling, pain 1 in 2-3 doses

Mild/moderate systemic:
fever, drowsiness, fretfulness vomiting, 1 in 2-3 doses
anorexia 1 in 5-15 doses

More serious systemic:

persistent crying, fever 1 in 100-300 doses
collapse, convulsions 1 in 1750 doses
acute encephalopathy permanent 1 in 100,000 doses
neurological deficit 1 in 300,000 doses

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