HPA310: The Haemophilus Vaccine: A Victory for Immunologic Engineering

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craatny

Health Medical

HPA 310

Penn state university

HPA

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What is the pathophysiological role of the leukocytes in the present situation?

How sure could you be at this stage, a few hours after admission to the hospital, that Josephine is indeed ill with bacterial meningitis? What other diagnoses might be considered?  What bacterial agents, other than H. influenzae, cause meningitis? List and briefly describe other illnesses caused by H. influenzae.

  1. Why did Josephine become ill?  Shouldn’t her immune system have stopped the infection from the beginning? Could there be some kind of immunodeficiency?

Catherine received telephone calls from the director at the daycare center. The center’s staff was deeply worried and wished to know the risks for the remaining children of the center and for other center personnel. What should the day care center say to the parents? Should all the children receive preventive treatment? Be specific - Your advice will be of the utmost importance given that the news media may soon become aware of the present series of cases and a whole region alerted.

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The Haemophilus Vaccine: A Victory for Immunologic Engineering: [19FA] HPA 310, Sec 001: Hl Care Med Needs (WC, Parsons) 12/3/19, 7)34 PM The Haemophilus Vaccine: A Victory for Immunologic Engineering NATIONAL CENTER FOR CASE STUDY TEACHING IN SCIENCE The Haemophilus Vaccine: A Victory for Immunologic Engineering Arne Tärnvik Department of Infectious Diseases, Umeå University, Sweden Half past three in the afternoon of November 27, 1987, Catherine received a phone call from her mother. She felt a moment of panic. Was Josephine all right? Catherine worked at a cay care center and Josephine, her 34-month-old daughter, was minded by Catherine's mother during the day while Catherine was at work. "You have to come immediately. Josephine is feverish," her mother said. "She is also delirious." There was no need for Catherine and her mother to say what they both had on their minds. In the day care center in Umeå, Northern Sweden, where Catherine worked two children had developed bacterial meningitis this fall. The first case occurred on September 19th and the second on November 13th. The children were 11 and 21 months old, respectively, and had been hospitalized at the Department of Pediatrics, University Hospital of Umeå. They had both been given an intravenous 10-day course of cefuroxime, an antibiotic related to penicillin although with a broader antimicrobial spectrum. In both cases, Haemophilus influenzae had been cultured from a specimen of cerebrospinal fluid. All of the parents and personnel of the day care center were well aware of the risks associated with bacterial meningitis. In Western countries, the case fatality risk is 2 percent. Among those who survive, 25 percent develop permanent sequelae, 10 percent in the form of sensorineural hearing impairment. "I'm on the way, Mother. Wrap her in a blanket and meet me at the parking lot in front of your house." After nearly being involved in an accident at Pig Hills corner, Catherine arrived at her mother's house and from there went with her and Josephine to the hospital. It occurred to Catherine that she had forgotten to check Josephine's condition, probably because she was so anxious to get to the hospital as quickly as possible. In the emergency room, she found Josephine unconscious. She was convinced this must be https://psu.instructure.com/courses/2008829/pages/the-haemophilus-vaccine-a-victory-for-immunologic-engineering Page 1 of 2 The Haemophilus Vaccine: A Victory for Immunologic Engineering: [19FA] HPA 310, Sec 001: Hl Care Med Needs (WC, Parsons) 12/3/19, 7)34 PM possible. In the emergency room, she found Josephine unconscious. She was convinced this must be meningitis and tried to give this information to the nurse immediately. "Two children at the day care center where I work have recently been diagnosed with bacterial meningitis." The phone call from the emergency room nurse to the pediatric ward was brief. She only had to maintain the name of the day care center and was told to send the patient immediately to the pediatric ward. Within minutes after Josephine was admitted to the pediatric ward, she was injected with cefuroxime and an intravenous line for fluid replacement was started. Josephine was subjected to a lumbar puncture and a sample of cerebrospinal fluid showed an increased number of leukocytes (8.2 x 109/L), most of which were neutrophils (7.3 x 109/L), i.e., the cells expected to increase in bacterial infection. This is more than 1000-fold the number of cells found in the cerebrospinal fluid of healthy individuals. During Josephine's first night in the hospital, Catherine never left her bedside. The next morning, Josephine's temperature was still high (39.5° C.), but the nurses seemed satisfied with Josephine's improvement overnight. Her blood pressure, heart rate, and eye reflexes had been checked throughout the night. At this point, Catherine was confused and had several questions. In addition, she anticipated that there might be telephone calls from the day care center and from journalists once the occurrence of three cases of a severe contagious disease in a day care center became known in the community. Hospital personnel felt it was critical that all answers to the media's questions be consistent and medically correct. Copyright held by the National Center for Case Study Teaching in Science, University at Buffalo, State University of New York, all rights reserved. Used with permission. https://psu.instructure.com/courses/2008829/pages/the-haemophilus-vaccine-a-victory-for-immunologic-engineering Page 2 of 2
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Attached.

The Haemophilus Vaccine: A Victory for Immunologic Engineering
I.
II.

Pathophysiological role of the leukocytes in the present situation
How sure could you be at this stage, a few hours after admission to the hospital, that
Josephine is indeed ill with bacterial meningitis?
a. Other diagnoses to consider
b. Other bacteria agents that cause meningitis
c. Other illnesses caused by h. Influenzae

III.

Why did Josephine become ill? Shouldn’t her immune system have stopped the infection
from the beginning? Could there be some kind of immunodeficiency?”

IV.

What should the day care center say to the parents?
a. Should all the children receive preventive treatment?

Attached.

Surname 1
Student’s Name
Professor’s Name
Course
Date

The Haemophilus Vaccine: A Victory for Immunologic Engineering
In the absence of disease, the brain is a pathogenically sterile site guarded against attack
by highly specialized barriers, including the restrictive blood-brain barrier (BBB), tough dura
mater, and hard bony skull (Agyeman et al., par. 1). Meningitis is a disorder that entails
inflammation of the meninges following an infection. Bacterial meningitis is a serious medical
event that requires prompt diagnosis and treatment. Among bacteria species responsible for
human meningitis is the Haemophilus influenzae bacteria (Hib), unencapsulated or encapsulated
strains. To be infected, people must first receive a state of nasopharyngeal colonization, which is
moderately usual in early life. The pathogen must cross the nasopharynx into the gore system,
persevere host shield processes in the intravascu...


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