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Requirement
Understanding Infection Written Assignment (Unit 2)
You have been asked to review the current routine UK vaccination schedule. As part of this review process, you are expected to recommend two additional diseases for future inclusion in the schedule.
For each of the two diseases:
Discuss its mechanism of pathogenesis (80 % mark)
Include a brief rationale for its future inclusion in the routine schedule (20% mark)
Solution
Routine UK Vaccination Schedule
Immunisation is a very important aspect of the childhood and it continues throughout the life. Every country has their own immunisation schedule. The variations are dependent on the epidemiology of diseases in that particular region. The history and traditions of that country. In UK JCVI( Joint Committee on vaccination and Immunisation ) recommends the government which vaccines to be included and among what the group of people. There are many factors of consideration before that vaccination is introduced. There are factors like the effect of disease on the population of UK. What are the side effects of the vaccine in long term and short term basis? What are the scope and effectiveness of the vaccine and the cost involved in the introduction of the new vaccine? Different countries use different factors to reach a conclusion before they introduce a vaccine. Hence every country has a different immunisation schedule. In case the vaccination schedule is not followed properly it is important to notify a medical practitioner (Donegan et al, 2014). It will make sure that if the vaccination is not followed properly the immediate measures should be taken and the recommended pattern is restored.
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In case there is a requirement of a vaccination which is not a part of UK Vaccination Schedule then it has to be obtained through private provisions. In this case, they have to visit a private hospital or practitioner. It is very important to keep a record of theses vaccines. As in the case of any side effects the history of vaccinations can be helpful. In the case of overseas travel, there may be additional vaccinations recommended by the government.
Immunisation is a way in which we are protected against serious diseases. Vaccination enables us to fight the diseases which attack the body. As children grow they are many threats they are exposed to. The main threats are infections and diseases (Morillo et al, 2015). They are many diseases which are a gift of the modern world. They can cause disability or death. Before vaccines are available many people died of deadly diseases in the UK and across the world. In the absence of vaccines, there was no certain prevention from many deadly diseases. Vaccines give us the best possible way of prevention of diseases. Timely and routine vaccinations have been introduced by many countries. It helps to protect children and the entire community. There is a term called population protection. In these maximum number of people in a community is immunised (Rivera and Messaoudi, 2016). So it gives less number of hosts for the disease to spread. The chances of people who are not immunised are difficult be infected. Children are our future. It is a countries most valuable asset. Vaccinations help in building a strong and disease free nation. Immunisation has come up as the biggest success to mankind . It has saved millions of lives after its invention.
The disease like small pox got eradicated due to proper and timely vaccination. It has caused millions of deaths in its time. The world now is a much more disease free place. Without timely vaccination eradication of many diseases would not have been possible. There are many diseases whose cure has not been found out (Martines et al,2015). For them, their prevention is the only cure. Vaccination has helped us achieving 100% prevention of many deadly diseases through timely immunisation campaigns. The UK has eradicated Polio in 2002 with effective vaccination programmes. Vaccines work in a very simple way to provide immunity. The vaccine contained the weaker version of any deadly bacteria or virus. When the body detects the entry of any foreign pathogen it is designed to create antibodies. As the pathogen are very weak in nature it does not cause any disease . But it allows the body to build antibodies against it. So as the pathogen attacks next time the antibodies are already present and it does not allow to cause disease (Mohd Hanafiah et al, 2013). Another example is Diphtheria which disappeared from the UK due to effective vaccination programmes.
When a vaccine is developed it is tested in laboratories for years. Also, there is a requirement of license before that vaccine is introduced for public. In order to get a license, the manufacturers need to establish the safety and efficiency of the vaccine to prevent diseases. In the current scenario, new diseases are developing at a very rapid rate. The vaccination schedules need to be upgraded at very frequent intervals. There are diseases which are recently developed but they are not yet included in the vaccination schedule.
Firstly there is Ebola. Ebola is a viral disease. This makes the spread of Ebola very convenient and rapid. It is caused by Ebola virus. It has a short incubation of two days. The disease was first identified in 1976. Its outbreak mostly occurs in the Sub-Saharan African region. The largest Ebola outbreak has been in March 2014 in Guinea. As this outbreak started from a one-year-old child. From this we can make out that how small instance can cause devastating effects. This was also declared as an epidemic and to be an international public health emergency. The condition went worse due to this epidemic that the hospital staff treating the patients got infected , Leaving the patients to die without treatment. This was detected as the most severe of the emergencies in the modern times. From this, we can make out that how a single case can turn out into a catastrophe.
The Ebola virus replicates very nicely in many cells. It replicates very fast in macrophages, dendrite cells, liver cells and adrenal gland cells. This viral replication triggers the inflammatory response. Ebola comes in human contact to the body through infected fluids and skin breaks . Once this virus targets the macrophages and infects the immune cells it is carried by the nearest lymph node in which further reproduction of virus takes place. From here virus goes to the blood stream and infects the whole body. Here macrophages which are the first line of defence of the body and attack the virus first but they are the first one to get infected by the virus. The infection causes programmed cell death in these macrophages. The other types of cells such as white blood cells also go programmed cell death. This causes the low concentration of lymphocytes. This causes weaken defence mechanism .
The Endothelial cells are infected within 3 days of exposure to virus. This causes injury to blood vessels. Hence causes profuse bleeding in the infected person . There are major chances of going into shock due to blood volume loss. Further, it goes into the haemorrhagic stage. From the above stages, we can see that within 3 days of infection the virus is capable of causing death. The spread of the virus is extremely easy and moreover, there is no such treatment for Ebola. This makes the requirement of vaccines even more important. Ebola does not have any particular age group target. It can target anyone. The mode of spread has made it even more dangerous. Hence it is important to develop Ebola vaccine. As prevention from this deadly disease can be the only cure.
Hepatitis C virus is a very small virus. The origin of the virus is said to be 200-300 years old. There are various Genotypes. In is suggested that the virus may have evolved in South East Asia. Later it spread to Africa . Blood transfusion is a method of spread of the virus. There is currently no vaccine to stop the spread of Hepatitis c Virus.
Hepatitis C virus targets liver cells. It goes to the liver cells and replicates very fast. It develops cell necrosis. Along with this, it develops hepatic stenosis, oxidative stress and insulin resistance. The molecule on host cells binds with the viral cell through which the virus gains entry into the body. It is an RNA-dependent virus (Sarrazin et al, 2012). It undergoes very frequent mutation. Due to frequent mutation, there is difficulty in developing the vaccine and treatment. This disease also is known as the invisible disease. As in early stages, most of the people don’t have any signs or symptoms. This is the most serious virus among hepatitis A and B. The symptoms can be mild fever and poor appetite. These are a very common symptom and you might not be able to diagnose hepatitis C from them. There is symptoms like nausea, stomach pain, joint pain , abnormal bowel movement and the warning sign is yellowing of skin and eyes. This is suggestive of hepatitis. The diagnosis can be done by a blood test alone. Though there is the treatment of hepatitis C. But due to its silent nature, it is very deadly. Hence prevention from this disease can be the best cure.
In future, it is suggested to include Ebola and hepatitis C vaccines. As Ebola has been an epidemic in recent times. Vaccines are much required for this. Also in a case of hepatitis C, it is important to develop vaccines for the disease as its diagnosis is done at a very late stage.
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Donegan, K., King, B., & Bryan, P. (2014). Safety of pertussis vaccination in pregnant women in UK: observational study.
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Morillo-Gutierrez, B., Worth, A., Valappil, M., Gaspar, H. B., & Gennery, A. R. (2015). Chronic infection with rotavirus vaccine strains in UK children with severe combined immunodeficiency. The Pediatric infectious disease journal, 34(9), 1040-1041.
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Rivera, A., & Messaoudi, I. (2016). Molecular mechanisms of Ebola pathogenesis. Journal of Leukocyte Biology, jlb-4RI0316.
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Martines, R. B., Ng, D. L., Greer, P. W., Rollin, P. E., & Zaki, S. R. (2015). Tissue and cellular tropism, pathology and pathogenesis of Ebola and Marburg viruses. The Journal of pathology, 235(2), 153-174.
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Mohd Hanafiah, K., Groeger, J., Flaxman, A. D., & Wiersma, S. T. (2013). Global epidemiology of hepatitis C virus infection: New estimates of age?specific antibody to HCV seroprevalence. Hepatology, 57(4), 1333-1342.
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Sarrazin, C., Hézode, C., Zeuzem, S., & Pawlotsky, J. M. (2012). Antiviral strategies in hepatitis C virus infection. Journal of hepatology, 56, S88-S100.
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