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Immunization
Published in Julius P. Kreier, Infection, Resistance, and Immunity, 2022
Michael F. Para, Susan L. Koletar, Carter L. Diggs
Artificially induced immunity may not be complete, and even with generally functional vaccines, one cannot always assume that protection has developed after immunization. One way of evaluating the immune response following injection of vaccine is the measurement of circulating antibodies to the antigens in the vaccine. The process of development of antibodies is called seroconversion. In some instances, the presence of circulating antibodies correlates well with development of protection. This is the case with hepatitis B and rubella vaccines. Antibody levels, however, do not tell the whole story. If there is a strong immunologic memory response, protection may exist in the absence of detectable antibody. For example, following vaccination with agents such as live attenuated measles and rubella vaccines, there will be an initial IgM antibody response, followed by a rise in IgG antibody titers. Over time, the antibody titers will fall, and although they may fall to undetectable levels, when infection occurs there is a rapid response by the memory cells. In such situations there is a prompt increase in IgG antibodies specific for the virus and protection from disease. The mere presence of antibody, however, may not be sufficient to assure protection from disease, but rather a minimum level of antibody may be required. Such is the case if immunity to tetanus is to be induced by injection of tetanus toxoid.
Pregnancy, Delivery and Postpartum
Published in Miriam Orcutt, Clare Shortall, Sarah Walpole, Aula Abbara, Sylvia Garry, Rita Issa, Alimuddin Zumla, Ibrahim Abubakar, Handbook of Refugee Health, 2021
Zahra Ameen, Katy Kuhrt, Kopal Singhal Agarwal, Chawan Baran, Rebecca Best, Maria Garcia de Frutos, Miranda Geddes-Barton, Laura Bridle, Black Benjamin
Vaccination is the only means of inducing immunity to tetanus toxin, and some of the cases of affected neonates have been in babies whose mothers reported they had been vaccinated. It is therefore important to confirm the vaccination history and repeat the doses if unclear. The WHO recommends vaccinating the pregnant mother to prevent neonatal tetanus, as antitoxins cross the placental barrier. Pregnant women who have not been vaccinated in childhood or adolescence should receive at least two doses of tetanus vaccine before giving birth:The first dose should be administered at the first consultation.The second dose should be administered at least four weeks after the first dose and ideally at least two weeks before the due date to maximise the maternal antibody response and passive antibody transfer to the infant.After the birth, continue to a total of five doses. Once administered, these five doses confer lifelong protection.
Neurotoxicology
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Sean D. McCann, Trevonne M. Thompson
Clostridium tetani is a ubiquitous bacterium found in the soil and dust which produces the toxin tetanospasmin, or tetanus toxin, a protein that, like BTX, interferes with neurotransmitter release by impairing vesicle fusion. Unlike BTX, however, tetanospasmin is endocytosed by inhibitory interneurons, where it cleaves the protein synaptobrevin, an essential component of the machinery responsible for vesicle fusion. This leads to an inability of inhibitory interneurons to release GABA and glycine, producing a clinical syndrome of severe uncontrolled muscle contraction, phenotypically similar to strychnine poisoning discussed previously. Given the prevalence of this organism in our environment and the high morbidity and mortality associated with this disease, prevention is critical. Tetanus immunization has become routine throughout the developed world. Once symptoms develop, treatment includes supportive care, including mechanical ventilation if needed, use of BZD and magnesium sulfate to control muscle contractions, antibiotics directed against C. tetani (e.g. metronidazole), and tetanus immune globulin. Initiation of the vaccination series is necessary because contracting tetanus does not confer future immunity.
Use of genetically modified lactic acid bacteria and bifidobacteria as live delivery vectors for human and animal health
Published in Gut Microbes, 2022
Romina Levit, Naima G. Cortes-Perez, Alejandra de Moreno de Leblanc, Jade Loiseau, Anne Aucouturier, Philippe Langella, Jean Guy LeBlanc, Luis G. Bermúdez-Humarán
In summary, numerous studies currently support the use of GM strains of L. lactis to induce both mucosal and systemic immune response.19,22 In this context, the first attempt to evaluate the potential of L. lactis as a mucosal vaccine, more than 30 years ago, was performed with a GM strain of this bacterium producing an anchored form of the protective antigen (PAc) of Streptococcus (S.) mutans.61 This study shows for the first time that L. lactis can be used as a live mucosal vector to efficiently deliver an antigen to the immune system. Then, Wells et al. reported that the use of a live GM L. lactis strain producing tetanus toxin fragment C (TTFC) as a model antigen was able to protect mice against a lethal challenge with tetanus toxin after subcutaneous administration of this strain.62 Later, the same group evaluated the effect of oral or nasal administration of GM TTFC-producing strains of lactococci in mice.63,64 Oral immunization in mice with these GM lactococci results in a lower humoral response (i.e., TTFC-specific serum IgG and mucosal IgA antibodies) than intranasal administration, but the measured protective efficacy (challenge with tetanus toxin) was the same.
Community-based new born care practice and its associated factors among women who give birth at home in Ethiopia: cross-sectional study
Published in Current Medical Research and Opinion, 2022
Medhanit W/senbet, Wondwosen Molla, Ruth Tilahun, Yabibal Gebeyehu, Meiraf Daniel Meshesha, Jarsso Tadesse Hirbu, Habtamu Endashaw Hareru, Wagaye Alemu, Temesgen Muche, Aneleay Cherinet Eritero, Seid Shumye, Nebiyu Mengistu, Solomon Yimer, Derebe Madoro, Zerihun Figa, Dawit Getachew Assefa, Eden Daganchew Zeleke, Daniel Sisay, Aregahegn Wudneh, Moges Tadesse
From the total of 540 respondents, the majority 398 (73.1%) were multiparas while the rest 145 (26.9%) were primiparous. The majority 398 (73.7%) of the respondents had at least one-time antenatal care follow-up during their last pregnancy. Only 92 (17%) of mother were visited antenatal care clinic before 16 weeks of gestation, as recommended. At least two-thirds (68%) of the respondents were received counselling about essential newborn care (ENC) practice during ANC visits. From the total of respondents, 307 (56.9%) were received before they gave birth. Furthermore, only 12 (3.9%) of women were finished all doses of tetanus toxoid (TT) vaccine. Three- fourths (75.7%) of the respondents reported as they spent more than 30 min to reach the nearest health institution. Only 93 (17.2%) women stated they received immediate PNC check-up within seven days of delivery. From the total of 540 participated, 136 (25.2%) of the women had at least one bad obstetrical history in their lifetime. Among those who had had obstetrical history, the majority 72 (52.9%) of the women had at least one history of neonatal loss, followed by 36 (26.5%) had at least one history of stillbirth while the rest 28 (20.6%) had at least one history of neonatal loss, as see Table 3.
Antenatal vaccination for influenza and pertussis: a call to action
Published in Journal of Obstetrics and Gynaecology, 2021
Despoina Gkentzi, Maria Zorba, Markos Marangos, Ageliki Vervenioti, Ageliki Karatza, Gabriel Dimitriou
According to the World Health Organisation (WHO), in the last two decades, the global mortality of children < 5 years of age has declined. However, neonatal mortality has decreased at a much slower pace. (http://www.who.int/maternal_child_adolescent/documents/levels_trends_child_mortality_2015). Neonates and infants in the first few months of life have an immature and relatively ineffective immune system. Therefore, there is need for the global health community to identify and implement effective strategies in the field. Maternal vaccination has been recognised as an important public health intervention to protect both pregnant women and their offspring from various infectious diseases. The combination of improved hygienic practices during delivery as well as the universally recommended maternal tetanus toxoid vaccine administration have resulted in a 92% reduction of neonatal tetanus mortality (Healy 2012).