Adaptive Immune Response Malaria

Adaptive Immune Response Malaria ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS ON Adaptive Immune Response Malaria My project topic is malaria. I am attaching the rubric and Powerpoint example. Harvard University NUR 5000 Adaptive Immune Response Malaria Citation is APA 7th edition. attachment_1 attachment_2 Measles ADVANCED PATHOPHYSIOLOGY EVIDENCE BASED PROJECT Microbiology: Measles Virus Pathogenicity of Measles Single Strand, nonsegmented, negative sense RNA genome Morbillivirus genus of the Paramyxovirinae subfamily of the Paramyxoviridae family (Laksono, de Vries, McQuaid, Duprex, & Swart, 2016) Only one serotype 7,456 genotypes (Furuse, & Oshitani, 2017) Microbiology: Measles Virus Virulence Two main glycoproteins on the Measles Virus’ surface are hemagglutinin, H protein and fusion, F protein. The H protein is engaged when it senses and binds to the nectin-4 receptor (found on the surface of respiratory epithelial cells) and CD150 receptor (found on macrophages and dendritic cells in the respiratory tract) The F protein is activated by the H protein and inserts its fusion peptide into the target cell’s membrane. (Gomes, Santos, & Porotto, 2017) Phot retrieved from: Measles Interaction/Spread of Infection The Measles Virus (MV) enters Host via the respiratory tract. Virus binds to CD150 receptor sites on the dendritic, myeloid, or lymphoid cells of the upper respiratory or dendritic cells or macrophages in the lower respiratory tract. The infected cells migrate to nearby tertiary lymphoid tissues and on to draining lymph nodes. Lymph nodes are mainly where MV replication occurs, and are rich in CD150 containing B-cell and T-cell lymphocytes. MV then spreads systemically to organs like the GI tract, kidney, liver, skin and rarely it will infect neurons, astrocytes, and oligodendrocytes. In dendritic cells the infection spreads to neighboring nectin-4 epithelial cells or keratinocytes in the skin. (Laksono, de Vries, McQuaid, Duprex, & Swart, 2016) Host Measles Interaction: Evading Host Defenses The Measles Virus evades host defenses by inhibiting the Immune cells Interferon (IFN), that acts to suppress viral RNA replication, with its proteins P, C, and V. Then MV essentially takes over and destroys immune cells which are vital to the body’s defense and immune system. MV Immune (Griffin, 2016). Cells IFN production Measles RNA Replication Infected Immune Cell ? Host/Measles Interaction: Immune Response Restricted Innate Immune Response ? Extensive replication of Measles Virus ? Systemic Spread ? Clinically Silent Latent Period ? Increased cytokines and chemokines ? Adaptive Cellular Immune Response ? Incomplete clearance of Viral RNA ? Prolonged Immune Suppression ? Activation of Life-long Immunity (Griffin, 2016). Mode of Transmission Measles is transmitted through respiratory routes from person to person ? Large droplets in direct contact ? Small aerosols over long distances ? ? can survive in air or on surfaces for up to 2 hours Another less important route is the conjunctiva (Laksono, de Vries, McQuaid, Duprex, & Swart, 2016) Communicability ? Measles is a highly communicable disease with 90% spread rate. ? ? Any susceptible or non-immunized person exposed to an infected person is at risk for contracting the disease. Measles is shed from the nasopharynx and respiratory tract and is spread when an infected person coughs and releases droplets or aerosols. ? An infected person can be contagious 4 days before onset of rash, to 4 days after rash. ? Maximum communicability is from onset of prodrome (2-4 days before rash) through the first 2-4 days of rash. (Hamborsky, Kroger & Wolfe, 2015) 1676 Thomas Sydenham, MD, distinguished small pox from measles Brief History of disease 1846 Peter Panum described incubation period and life-long immunity The College of Physicians of Philadelphia.(2019). Harvard University NUR 5000 Adaptive Immune Response Malaria 1916 Measles specific antibodies identified 1954 Thomas Peebels MD isolated the virus Unknown origin, for a long time Measles was confused with small pox and scarlet fever. It was first described in the 7th century (Hamborsky, Kroger & Wolfe, 2015). 1963 John Ender’s Measles Vaccine, Edmonston-B strain, Licensed 1971 MMR Vaccine debuts 1989 Second dose MMR recommendation 2000 Endemic Measles eliminated from U.S. 2016 Measles certified eliminated from Americas Global Measles Incidence ? There are 6 WHO Regions; Africa, Americas, Eastern Mediterranean, Europe, SouthEast Asia, and Western Pacific. ? In 2016 the global number of measles related deaths fell below 100,000 for the first time Measles case distribution by month and WHO Region (20152019) (Krishnamoorthy, Sakthivel, Eliyas, Surendran, &Sarveswaran, 2019). ? The graph shows a recent surge in the number of measles cases in 2019 compared to the previous 3 years. (provisional data based on monthly data reported to WHO (Geneva) as of November 2019) Retrieved from ctive/Global_MR_Update_November_2019.pptx?ua=1 Highly Communicable Public Health Concern Travel Epidemic or Pandemic Complications ? ? ? ? ? Death Pneumonia Acute Disseminated Encephalomyelitis (ADEM) Measles Inclusion Body Encephalitis (MIBE) Subacute Sclerosing Panencephalitis (SSPE) (Bass, 2019) (Laksono, de Vries, McQuaid, Duprex, & Swart, 2016) Clinical Presentation: Prodromal Phase Phase lasts 2-4 days, usually begins 9-19 days after exposure Activity of Pathogen and Host Response ? Highly contagious during this phase. ? The virus is shedding in mucous, and sputum. ? The “3 C’s” , Coryza (runny nose), cough, and conjunctivitis. ? The “3 C’s” are caused by epithelial damage in the upper and lower respiratory tract. ? Fever, anorexia, and malaise. ? ? Worsen several days before rash appears Fever, anorexia and malaise are caused by the systemic immune response to infection ? Koplik spots on buccal mucosa appear 1-2 days before rash. ? Koplik spots rash can be explained by infection of the dermal endothelial cells keratinocytes, which are then cleared by the virus-specific T-cell response. (Hamborsky, Kroger & Wolfe, 2015) (Laksono, de Vries, McQuaid, Duprex, & Swart, 2016) Retrieved from Clinical Presentation: Exanthem Phase Exanthem Phase 5-6 days ? Virus clearance and destruction happens during this phase. ? Can still be infectious up to 4 days after rash onset ? Maculopapular rash that begins at the hairline, and moves to the face, head and downward to the extremities. (Hamborsky, Kroger & Wolfe, 2015) ? This reaction is in response to the Measles Virus (MV) infecting the dermal endothelial cells and keratinocytes. Then, MV specific T-cells infiltrate the skin to clear infected cells, Starting at the head closest to the site of infection and moving downward following the path of infection. (Laksono, de Vries, McQuaid, Duprex, & Swart, 2016) Measles Detection ? There is no single serologic laboratory test capable of confirming with 100% confidence every true case of measles (Gastanaduy, et al., 2019). ? Confirmation of measles infection is through detection of measles-specific IgM (immunoglobulin M) antibody and measles RNA by real-time RT-PCR (reverse transcriptase-polymerase chain reaction) (Gastanaduy, et al., 2019). ? Virus Isolation via ? Serum blood sample for measles IgM ? ? ? Harvard University NUR 5000 Adaptive Immune Response Malaria The IgM response may not be detectable until 3 days after symptoms onset Throat or nasopharyngeal swab, or Urine Sample for viral culture Initial specimens should be obtained within 7 days if not more than 10 days of rash onset (Hamborsky, Kroger & Wolfe, 2015). Prevention, Management and treatment This Photo by Unknown Author is licensed under CC BY-NC This Photo by Unknown Author is licensed under CC BY-ND This Photo by Unknown Author is licensed under CC BY Prevention Postexposure prophylaxis Management and Treatment 2 dose schedule of MMR Vaccine because 2-5% of recipients do not respond to the first dose (Hamborsky, Kroger & Wolfe, 2015). 1st dose at age 12-15 mo. And 2nd dose age 4-6 yrs. Adults at high risk receive 2 doses, Adults born after 1957 receive 1 dose (Gastanaduy, et al. 2019). There are 2 options for exposed persons who are unable to demonstrate immunity that may protect them from or modify the clinical course. 1. MM Vaccine within 72 hours of initial exposure. 2. Immunoglobulin within 6 days of exposure. Mainly Symptom management, fever control with antipyretics, prevent dehydration, infection control, treatment of other complications such as pneumonia, otitis media, seizures, or respiratory problems. (Bass, 2019) Vitamin A supplementation reduces complications, decreases risk of death, and prevents slowed recovery due to Vit. A deficiency. (Bass, 2019) Health Strategies: Global and National ? Global Strategies ? Global Vaccine Action Plan with an objective to eliminate measles in 5 of 6 WHO regions by 2020 ? Measles and Rubella Strategic Plan was launched by the M&R Initiative (Krishnamoorthy, Sakthivel, Eliyas, Surendran, &Sarveswaran, 2019). ? National/Local Strategies ? Maintaining high vaccination rates approaching 95% or better. ? Education about vaccines, encouraging physicians to educate, vaccinate in office and promote vaccination in their communities (Bass, 2019). ? Some state legislature are making bills to eliminate non-medical exemptions (Dolesh, 2019). Health Strategies Investigation to Control Outbreak ? Rapid identification and reporting of measles to local and state health departments. ? Measles cases to be reported within 24 hours from the State Health Department to the CDC. ? Gather essential components for Case Investigation: ? ? ? ? ? ? ? Positive diagnosis of measles. Gather immunization histories for positive cases. Determine sources of infection. Evaluate potential for transmission. Identify susceptible contacts or those without presumptive evidence of immunity. Classify importation status Retrieve specimens for genotyping. (Gastanaduy, et al., 2019) Control in Medical Settings ? Implement airborne and standard precautions. ? Airborne precautions require negative air pressure isolation room, with door closed and away from susceptible contacts. ? Ask patients to wear medical mask. ? Patient contacts who are not immune to measles or presumptive immunity should be vaccinated, offered immune globulin, or placed on airborne precautions until 21 days after their last exposure. ? Immediate review of measles immunity in exposed staff. ? Vaccination of personnel without presumptive evidence of immunity. (Gastanaduy, et al., 2019). References: 1. Bass III, P. F. (2019). Measles makes a comeback: What to know, what to do. Contemporary Pediatrics, 36(7), 18–23. Retrieved from,shib&db=ccm&AN=137650582&site=eds-live&scope=site 2. Dolesh, R. J. (2019). Measles: The Childhood scourge is back. Parks & Recreation, 54(6), 52–57. Retrieved from Harvard University NUR 5000 Adaptive Immune Response Malaria direct=true&AuthType=ip,shib&db=fth&AN=136885544&site=eds-live&scope=site 3. Furuse, Y., & Oshitani, H. (2017). Global transmission dynamics of measles in the measles elimination era. Viruses (1999-4915), 9(4), 82. 4. Gastanaduy, P. A., Redd S. B., Clemmons, N. S., Lee, A. D., Hickman, C. J., Rota, P. A., Patel, M. (2019) Chapter 7: Measles. VaccinePreventable Diseases Surveillance Manual. Retrieved from 5. Gomes, B., Santos, N. C., & Porotto, M. (2017). Biophysical Properties and Antiviral Activities of Measles Fusion Protein Derived Peptide Conjugated with 25-Hydroxycholesterol. Molecules, 22(11), 1869. 6. Griffin, D. E. (2016). The Immune response in measles: Virus control, clearance and protective immunity. Viruses (1999-4915), 8(10), 282. 7. Hamborsky J., Kroger A., & Wolfe S. (2015). Measles. Epidemiology and prevention of vaccine-preventable diseases. Retrieved from 8. Krishnamoorthy, Y., Sakthivel, M., Eliyas, S., Surendran, G., & Sarveswaran, G. (2019). Worldwide trend in measles incidence from 1980 to 2016: A pooled analysis of evidence from 194 WHO Member States. Journal of Postgraduate Medicine, 65(3), 160. 9. Laksono, B. M., de Vries, R. D., McQuaid, S., Duprex, W. P., & de Swart, R. L. (2016). Measles virus host invasion and pathogenesis. Viruses (1999-4915), 8(8), 210. 10. The College of Physicians of Philadelphia. (2019). The History of Vaccines: Timeline. Retrieved from NURS 5000 Evidence Based Project Rubric The purpose of this assignment is to apply concepts of infection to a particular pathogen. Infection and Infectious Disease Pick a pathogen that is a public health concern. It can be an emerging or rare pathogen or one that has been around for a while but presents a significant threat. It can be a virus or bacteria or even a fungus. Discussion should focus on the following aspects: Microbiology: (25 points) • Pathogenicity, virulence, and the aspects of the host / pathogen interaction (immune response, pathogen adaptations to evade host defenses) • Mode of transmission and communicability Brief history or background of disease (25 points) • Natural history of the pathogen (what factors contributed to the emergence of the pathogen, trends in incidence); areas in the world that are impacted • Public health concern: what factors contribute to the concern over the pathogen? Clinical issues (25 points) • Clinical presentation of the disease; link the signs and symptoms to the activity of the pathogen and the host response • Methods used to detect the pathogen. The scientific basis for the testing should be included. Management and Treatment (25 points) • Successful treatment or vaccines • Public health strategies/control measures that are being used/or being developed You may not use your textbook or other textbooks as a reference. References must be articles from peer reviewed journals. Articles should not be over 5 years old unless it is original research. Information from reputable agencies (CDC, Infectious Disease Society of America, etc.) or reputable news sources can be used if needed to discuss outbreaks etc. Again, the focus should be physiology. All sections are all equally weighed. Factors in the points assigned per section will include the depth of analysis and evidence of understanding of the physiology, as well as synthesis and inclusion of appropriate sources. Use APA format for references. The format of your presentation is up to you. 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