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#31 of 66 Old 11-03-2007, 10:50 PM
 
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Ah ha! Learn something new every day...
[filing away new tidbit on diphtheria...]

-Angela
Watch this very short video..

http://www.youtube.com/watch?v=Dh4C-qmfuro

You'll never forget what a bacteriophage is after that....lol

Nutty stuff, huh?
Like little...aliens or something...
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#32 of 66 Old 11-04-2007, 12:24 AM
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Well, dying wouldn't end in immunity. So I'll focus my fuzzy head on what happens in the living who are infected with tetanus. Do you have a link or reference? So far I can wrap my head around some of this. A virus parasitizes the tetanus bacteria and when the bacteria finds anaerobic tissue to thrive in, the virus releases tetanus toxin. This toxin then inhibits antigen processing and presenting, so that an inadequate amount of T and B cells are made to mount a response that leaves the infected alive and with protective immunity?
Phagocytosis is not the same as a bacteriophage; although the root phage means, in both cases, 'to eat'. So viruses (bacteriophage) are not involved with tetanus pathogenesis. You have almost gotten the rest right though. The tetanus exists in the environment as a spore and when it gets into an anaerobic environment germinates into the vegetative state, releases exotoxin and the toxin is what inhibits the subsequent immune cascade and causes neurotoxicity. This is where the literature is sparse: If a non-immune person survives a tetanus infection untreated (not likely) then theoretically the individual would have been able to mount a sufficient immune response to overcome the infection and would have antibody to the toxin as well as bacterial antigens as well as cell-mediated immunity. Treatment with TIG (and gigantic doses of antibiotics) are going to inhibit the host immune response by passive immunity much in the way that Rhogam inhibits maternal antibody response against Rh+ fetal erythrocytes.

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If Clostridium tetani are so common as to be in dirt and water would this exposure over long periods confer natural immunity to the bacterium multiplying and thriving in tissue? This would inhibit the amount of toxin naturally wouldn't it? Also does the bacterium always have the virus parasite(do we know what virus?) or is this only sometimes?
Again, viruses have nothing to do with this, I think the phagocytosis threw you? OK, you could spend years (nay, decades) eating soil contaminated with tetanus spores and stand probably less than a 50/50 chance of developing protective immunity and that is with a constant, sufficient enough exposure for a very long time. So again, theoretically if the immunity acquired is adequate then a wound that is contaminated with tetanus could be overcome by the body's acquired defenses. So you see, I would prefer to roll up my sleeve every 10 years for a nice, measured, sterile preparation of inactivated tetanus toxoid. Does all of this answer your questions?

SM
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#33 of 66 Old 11-04-2007, 12:44 AM
 
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This is SO interesting to me, because I remember reading in the past that other cultures or populations naturally acquire tetanus immunity. I wonder why we don't study this more. Really, I don't understand at all why they put so much money into studying so many other things, when it seems like we should be constantly researching better options for these vaccines that we are injecting into almost every single baby in the country.

So, mamakay, the quote about the Indians who acquired immunity, does that mean basically by eating dirt and living in less hygienic conditions than we do here, they are immune?
Science mom, maybe there is a better way than the vaccine you are currently rolling up your sleeve to get. Maybe there is some way that could be invented that simulates the way people naturally acquire immunity, instead of having to take a shot that also contains many other things we don't need in our bodies.

I had been thinking that the TIG was the answer for an alternative in the case of a tetanus prone injury. I didn't realize it was manufactured from a person. Does that make anyone else nervous?
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#34 of 66 Old 11-04-2007, 01:15 AM
 
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If no one knows for sure whether or not we can acquire natural immunity since no one cares enough to do definitive studies, and even people who are immunized/hyperimmunized can die from tetanus and no one actually knows the clinical efficacy of tetanus toxoid because, again, no one's cared enough to actually do studies, I think, theoretically, I am just as protected as someone who gets vaccinated.

So I, literally, will keep my sleeves rolled down.
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#35 of 66 Old 11-04-2007, 01:46 AM
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This is SO interesting to me, because I remember reading in the past that other cultures or populations naturally acquire tetanus immunity. I wonder why we don't study this more. Really, I don't understand at all why they put so much money into studying so many other things, when it seems like we should be constantly researching better options for these vaccines that we are injecting into almost every single baby in the country.

So, mamakay, the quote about the Indians who acquired immunity, does that mean basically by eating dirt and living in less hygienic conditions than we do here, they are immune?
Science mom, maybe there is a better way than the vaccine you are currently rolling up your sleeve to get. Maybe there is some way that could be invented that simulates the way people naturally acquire immunity, instead of having to take a shot that also contains many other things we don't need in our bodies.

I had been thinking that the TIG was the answer for an alternative in the case of a tetanus prone injury. I didn't realize it was manufactured from a person. Does that make anyone else nervous?
If you read the studies of 'naturally acquired' immunity, it is quite a crap-shoot so no thanks to eating copious amounts of feces-laden dirt for 60 years to maybe acquire sufficient immunity to tetanus; yeah that doesn't have its own inherent risks. Blood products will always carry some risk but in light of a high tetanus-risk wound and/or definite tetanus infection, I wouldn't give it a second thought.

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If no one knows for sure whether or not we can acquire natural immunity since no one cares enough to do definitive studies, and even people who are immunized/hyperimmunized can die from tetanus and no one actually knows the clinical efficacy of tetanus toxoid because, again, no one's cared enough to actually do studies, I think, theoretically, I am just as protected as someone who gets vaccinated.

So I, literally, will keep my sleeves rolled down.
You haven't read the study that involved some cases of deaths in spite of high titres so your statement is based upon what? There are primate and human studies that do demonstrate protective immunity derived from tetanus vaccination so the correlate of protective antibodies is not exactly theoretical you know. You just have to search for them and not make up your mind based upon an abstract that briefly described some case reports (just a suggestion).

SM
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If no one knows for sure whether or not we can acquire natural immunity since no one cares enough to do definitive studies, and even people who are immunized/hyperimmunized can die from tetanus and no one actually knows the clinical efficacy of tetanus toxoid because, again, no one's cared enough to actually do studies, I think, theoretically, I am just as protected as someone who gets vaccinated.

So I, literally, will keep my sleeves rolled down.
Yes, that sums it up nicely!
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If you read the studies of 'naturally acquired' immunity, it is quite a crap-shoot so no thanks to eating copious amounts of feces-laden dirt for 60 years to maybe acquire sufficient immunity to tetanus; yeah that doesn't have its own inherent risks. Blood products will always carry some risk but in light of a high tetanus-risk wound and/or definite tetanus infection, I wouldn't give it a second thought.

You haven't read the study that involved some cases of deaths in spite of high titres so your statement is based upon what? There are primate and human studies that do demonstrate protective immunity derived from tetanus vaccination so the correlate of protective antibodies is not exactly theoretical you know. You just have to search for them and not make up your mind based upon an abstract that briefly described some case reports (just a suggestion).

SM
I've provided my links.

If you have some to back up what you've written I'll be more than happy to read them.

The correlate of protective antibodies demonstrated by protective immunity derived from tetanus toxoid vs. natural immunity are exactly theoretical since the studies (I can only assume we're talking about the same ones since you haven't linked to them) do not demonstrate whether or not the subjects were tested for natural immunity before being given the series of vaccinations. Therefore, we are not sure (but can infer) if the antibodies were present before or as a result of vaccinations.

Additionally, as I've read in other studies, presence of antibodies doesn't necessarily equal immunity, does it?

Reality is, we just don't know
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#38 of 66 Old 11-04-2007, 02:39 AM
 
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I don't think it's from eating tetanus from the soil that people become "naturally immune". It looks like tetanus exists in most people's guts in low levels, and I guess finds little anaerobic niches there to excrete the toxin, and that's how we become immune in the absence of vaccination.
I don't think anyone really knows how close the correlate of protection is to "the truth". Most people who get tetanus are unvaxed (virtually all of the kids in the US who get tetanus are supposedly unvaxed...all one case a year...but still)...so...

I dunno. Vaxed or unvaxed, your chances of developing tetanus are extraordinarily low. And GBS (the IOM favored a causal relationship between the tetanus vaccine and GBS) is pretty horrific in it's own way, too. With both tetanus vaxes and GBS, we're talking about really small numbers, though.
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#39 of 66 Old 11-04-2007, 08:15 AM - Thread Starter
 
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Again, viruses have nothing to do with this, I think the phagocytosis threw you?

SM
This quote from the book The War Within Us by Cedric Mims, from chapter 8- How Microbes Cause Disease, page 163-

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Tetanus toxin, also, seems of no value to the microbe, and it is interesting that in each case the toxin is not produced by the actual bacteria, but by a virus (phage) that parasitizes the bacterium. In a way the bacteria are innocent.
I haven't found the same info anywhere else, but haven't searched for it either. So this is misinformation?
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#40 of 66 Old 11-04-2007, 11:43 AM
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This quote from the book The War Within Us by Cedric Mims, from chapter 8- How Microbes Cause Disease, page 163-

I haven't found the same info anywhere else, but haven't searched for it either. So this is misinformation?
Yes, that is patently incorrect. I would toss that book or file it in with your science fiction. The author seems to be confusing diphtheria toxin production or possibly even botulism toxin production but the toxin gene of tetanus is held within a plasmid. Is this a very old text?

SM
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#41 of 66 Old 11-04-2007, 12:14 PM
 
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And GBS (the IOM favored a causal relationship between the tetanus vaccine and GBS) is pretty horrific in it's own way, too. With both tetanus vaxes and GBS, we're talking about really small numbers, though.
Do you have any handy links on the relationship? Sounds interesting....

-Angela
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Yes, that is patently incorrect. I would toss that book or file it in with your science fiction. The author seems to be confusing diphtheria toxin production or possibly even botulism toxin production but the toxin gene of tetanus is held within a plasmid. Is this a very old text?

SM
Copyright 2000 actually. I had previously read a virus was involved in the toxin production in the case of diphtheria in the CDC pink book chapter on diphtheria. After reading this I thought it was the case in both instances, as was stated in the book.
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#43 of 66 Old 11-04-2007, 02:45 PM
 
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Do you have any handy links on the relationship? Sounds interesting....

-Angela
The actual IMO thing is in a book I don't think can be found online , but it's listed on the adacel package insert:


http://www.vaccines.mil/documents/772ADACEL.pdf

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Certain neurological conditions have been reported in temporal association with some tetanus toxoid-containing vaccines or tetanus
and diphtheria toxoid-containing vaccines. A review by the Institute of Medicine (IOM) concluded that the evidence favors acceptance of
a causal relation between tetanus toxoid and both brachial neuritis and Guillian-Barré syndrome.
Other neurological conditions that
have been reported include: demyelinating diseases of the central nervous system, peripheral mononeuropathies, cranial
mononeuropathies and EEG disturbances with encephalopathy (with or without permanent intellectual and/or motor function
impairment). The IOM has concluded that the evidence is inadequate to accept or reject a causal relation between these conditions and
vaccines containing tetanus and/or diphtheria toxoids. In the differential diagnosis of polyradiculoneuropathies following administration
of a vaccine containing tetanus toxoid, tetanus toxoid should be considered as a possible etiology. (17)
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#44 of 66 Old 11-04-2007, 05:23 PM
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I've provided my links.

If you have some to back up what you've written I'll be more than happy to read them.

The correlate of protective antibodies demonstrated by protective immunity derived from tetanus toxoid vs. natural immunity are exactly theoretical since the studies (I can only assume we're talking about the same ones since you haven't linked to them) do not demonstrate whether or not the subjects were tested for natural immunity before being given the series of vaccinations. Therefore, we are not sure (but can infer) if the antibodies were present before or as a result of vaccinations.
Not exactly theoretical, more practical. Go to PubMed and type in 'tetanus immunity' or 'tetanus vaccination' and you will pull thousands of studies that discuss immunisation protocols that include testing recipients for the presence of anti-tetanus toxin antibodies. There is no natural immunity excepting some aboriginal groups and that is sparse. Ask yourself how many infants died of neonatal tetanus or didn't make it to senescence to obtain their 50% chance of natural immunity in those aboriginal groups.
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Additionally, as I've read in other studies, presence of antibodies doesn't necessarily equal immunity, does it?

Reality is, we just don't know
The mere presence of antibodies is not indicative of immunity, a minimum level. Here are some articles to get you started with regards to tetanus vaccination and outcomes:

Tetanus Antibody Titers and Duration of Immunity
to Clinical Tetanus Infections in Free-Ranging

Rhesus Monkeys (Macaca mulatta)
. American Journal of Primatology 68:725–731 (2006)

http://www.cdc.gov/mmwr/preview/mmwrhtml/su5501a7.htm

http://www.cdc.gov/mmwr/preview/mmwrhtml/ss5203a1.htm

http://www.ncbi.nlm.nih.gov/sites/en...ubmed_RVDocSum

If you are looking for immunisation/challenge studies in a clinical setting, you won't find them for obvious reasons but the Rhesus monkey report is quite convincing of the protective effect of tetanus immunisation.

SM
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Copyright 2000 actually. I had previously read a virus was involved in the toxin production in the case of diphtheria in the CDC pink book chapter on diphtheria. After reading this I thought it was the case in both instances, as was stated in the book.
I looked up the book and author and it received a favourable review by Nature so I don't know what to tell you. Did you misread the quote you posted? I am befuddled because what I told you is correct and can be verified in most any microbiology text that discusses tetanus genetics and pathology.

SM
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#46 of 66 Old 11-04-2007, 06:12 PM - Thread Starter
 
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I looked up the book and author and it received a favourable review by Nature so I don't know what to tell you. Did you misread the quote you posted? I am befuddled because what I told you is correct and can be verified in most any microbiology text that discusses tetanus genetics and pathology.

SM
I copied the text word for word and stated the chapter and page it can be found on in the book. Do you think I somehow took it out of context? It seems pretty straightforward in meaning to me. First he gave info on tetanus, then diphtheria. He writes that diphtheria bacteria does not seem to benefit from the effect of the toxin, then he goes on to write the words I quoted about tetanus toxin. We all make mistakes. I haven't found the same information repeated anywhere else yet. Perhaps you can recommend a "good", recent microbiology text?
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I copied the text word for word and stated the chapter and page it can be found on in the book. Do you think I somehow took it out of context? It seems pretty straightforward in meaning to me. First he gave info on tetanus, then diphtheria. He writes that diphtheria bacteria does not seem to benefit from the effect of the toxin, then he goes on to write the words I quoted about tetanus toxin. We all make mistakes. I haven't found the same information repeated anywhere else yet. Perhaps you can recommend a "good", recent microbiology text?
I'd just assume it was a fluke error.
It's a good example of how no one's right about hardly anything 100% of the time, and that's ok.

ETA:
There's also a chance that that's his own "pet theory" that he doesn't think has been explored one way or another to his satisfaction, but he's personally 100% convinced it's "the truth". And maybe he couldn't resist putting it in there like that? Or something like that?

Does he have a email address online somewhere, I wonder? Maybe one of us could email him and ask?
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If you are looking for immunisation/challenge studies in a clinical setting, you won't find them for obvious reasons but the Rhesus monkey report is quite convincing of the protective effect of tetanus immunisation.

SM
OMG!
http://www3.interscience.wiley.com/c...TRY=1&SRETRY=0

Have you read the fulltext?
Does it say why in the world all those monkeys were getting tetanus???
Tht is by FAR the highest rate of tetanus I've ever heard of before in any animal on earth!
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#49 of 66 Old 11-04-2007, 06:49 PM
 
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There's also a chance that that's his own "pet theory" that he doesn't think has been explored one way or another to his satisfaction, but he's personally 100% convinced it's "the truth".
That is exactly what I was thinking, too.

Maybe it is put in the book as a challenge to other scientist to prove him wrong?
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#50 of 66 Old 11-04-2007, 07:53 PM
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I copied the text word for word and stated the chapter and page it can be found on in the book. Do you think I somehow took it out of context? It seems pretty straightforward in meaning to me. First he gave info on tetanus, then diphtheria. He writes that diphtheria bacteria does not seem to benefit from the effect of the toxin, then he goes on to write the words I quoted about tetanus toxin. We all make mistakes. I haven't found the same information repeated anywhere else yet. Perhaps you can recommend a "good", recent microbiology text?
I don't think you took anything out of context if you quoted directly. Is there a reference for that statement? We could look that up first and if that doesn't pan out, I like MK's suggestion of contacting him. I am most intrigued right now. As far a micro text, what are you looking for? I presume that you purchased the Mims text because of the more plain English? From what I have read of the book, it is a good one so I don't think your poor, fuzzy head will be filled with erroneous information. It could be an editing error. I will check and see what some colleagues can recommend for a text anyhow.

MK, I have read the full text. I would suspect that the tetanus incidence in that colony is a reflection of close surveillance and constant replenishment of the organism into the environment since they are a research colony. So, do you think tetanus vaccination of the colony was a waste of time (not to put you on the spot)?

SM
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I know that there is a homeopathic remedy that can treat tetanus and get rid of it. I don't remember the name of it but I know its out there!!
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I would suspect that the tetanus incidence in that colony is a reflection of close surveillance and constant replenishment of the organism into the environment since they are a research colony.
Yeah...I've watched a lot of Discovery channel shows on monkey tribes in the wild before, where they gave little names to individual members and tracked them for life...and it didn't ever, ever seem like there was any way 25% of them were getting tetanus, though, you know? And lots of other animals (dogs, for one) are able to get tetanus, but it's really really really rare. And no human society on the planet has ever had a tetanus rate that high. So it's just....really weird, whatever was happening wih those monkeys. Although it does demonstrate the effectiveness of the tetanus vaccine, I guess.

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So, do you think tetanus vaccination of the colony was a waste of time (not to put you on the spot)?
Oh, no. Not at all. Tetanus is horrible. Poor monkeys.
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#53 of 66 Old 11-04-2007, 09:32 PM
 
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Here's another study on several colonies, but here, tetanus vaccination doesn't seem to have helped:

http://www3.interscience.wiley.com/c...14166/ABSTRACT

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One half of an annual birth crop of thesus monkeys inoculated with tetanus toxoid at the age of one year had protective levels of tetanus antitoxin seven years postinoculation. However, the immunization program had no significant effect on either the total or tetanus motality rates during the study.
ETA:
Wait...is that the same colony?
This link is just an earlier study? So it took 2 doses to have an effect, I guess?
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#54 of 66 Old 11-05-2007, 02:03 AM
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MK, Same colony. In the older paper they found that 1/2 of the birth cohort in 1973 was randomly vaccinated with 1 round of tetanus toxiod. They have no information on the type (this does make a difference), lot or anything else.

What is interesting to note is that no monkeys with previous tetanus infection(s) had detectable levels of tetanus antitoxin and it doesn't appear as though cell-mediated immunity is germane because some monkeys were repeatedly infected. So it looks like 2 doses of adsorbed veterinary tetanus toxoid reduced tetanus mortalities to zero.

SM
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What is interesting to note is that no monkeys with previous tetanus infection(s) had detectable levels of tetanus antitoxin
I noticed that, too...

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and it doesn't appear as though cell-mediated immunity is germane because some monkeys were repeatedly infected.
Wasn't it just one monkey that happened to?

Oh...and about this:
Quote:
In the older paper they found that 1/2 of the birth cohort in 1973 was randomly vaccinated with 1 round of tetanus toxiod.
They still couldn't really correlate the supposed protective titre with a reduction in incidence though. A lot of them should have been protected (according to what ever they were calling the correlate of protection for a monkey...not sure if they borrowed it from humans or what there) but the incidence wasn't reduced.

But either way, the second dose does appear to have done something good.
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#56 of 66 Old 11-05-2007, 02:36 AM - Thread Starter
 
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Does he have a email address online somewhere, I wonder? Maybe one of us could email him and ask?
Not that I've found, didn't look for long though. The only website from the book is http://academicpress.com/
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I don't think you took anything out of context if you quoted directly. Is there a reference for that statement? We could look that up first and if that doesn't pan out, I like MK's suggestion of contacting him. I am most intrigued right now. As far a micro text, what are you looking for? I presume that you purchased the Mims text because of the more plain English? From what I have read of the book, it is a good one so I don't think your poor, fuzzy head will be filled with erroneous information. It could be an editing error. I will check and see what some colleagues can recommend for a text anyhow.
Unfortunately he doesn't reference any of the information in the book. I believe he was attempting to make it as concise and straightforward as possible. I didn't purchase the book, its on loan from the library. I'd prefer something a bit heavier honestly. Its such a slim book, but it does seem to have a lot of information condensed into it. I'm new to this so I'm not sure what I should be looking for in the text exactly. Something with pictures would be fascinating, but not necessary. As I'm not in the field I don't have the opportunity to see these things for myself, so it would be a neat bonus. Its very kind of you to offer to check for recommendations. Thank you.
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#58 of 66 Old 11-05-2007, 03:12 AM
 
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still....reading...links....so....much.....informa tion......

now I think I'm the one with the fuzzy head...remind me again to be careful what you wish for (or in this case ask for links)....brain...slowly.....turning....grey
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#59 of 66 Old 11-05-2007, 03:31 AM
 
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From one of mamakay's links:

Quote:
The data suggest a silent oral immunization by tetanus bacilli thus boosting under unhygienic conditions the tetanus immunity with advancing age.
I have never been happier about my child's love of playing in mud and that bizarre stage she went through where she licked her hands and wrists all the time. And I gotta say it, it also makes me very glad we are not obsessive hand washers around here. Some of the more fastidious people here would probably be downright upset about how infrequently I made DD wash her hands before we moved into our really old house (we do it more now because of the possibility of lead paint dust, not because of germs).
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#60 of 66 Old 11-05-2007, 10:35 AM
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Quote:
Originally Posted by attachedmamaof3 View Post
still....reading...links....so....much.....informa tion......

now I think I'm the one with the fuzzy head...remind me again to be careful what you wish for (or in this case ask for links)....brain...slowly.....turning....grey
HaHaHa, you have a good sense of humour. Keep reading, the sensation of brain oozing out your ears can't be beat.

SM
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