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#1 of 66 Old 11-03-2007, 04:09 PM - Thread Starter
 
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http://www.cdc.gov/vaccines/pubs/pin...ds/tetanus.pdf

From the CDC pink book, tetanus chapter, page 4-

Quote:
Because of the extreme potency of the toxin, tetanus disease
does not result in tetanus immunity.
Can someone please back up/explain this statement?

I am currently spending most of my spare time researching vaccines, immunology, diseases, epidemiology, and issues surrounding pregnancy, birth, and newborn tests and procedures as I am pregnant with my third child. I have two I'm schooling at home, so I'm sure you can all understand my spare time is limited by house cleaning, cooking, spending time with the family, etc. Plus this is just a lot for me to NEED to know in what seems a short amount of time, as I am about 22 weeks( I think . I have several books on immunology I am currently diving into, however I'm not very far into any of them. I am doubtful any of them have information specific to tetanus immunity, or lack thereof, anyway. If anyone could please help me out with the validity/explanation of this statement I sure would appreciate it. I'm feeling unwell(sore throat with white spots on my tonsils and just plain tired) so sorry if this is muddled sounding or run on .
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#2 of 66 Old 11-03-2007, 04:16 PM
 
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Okay. The way I understand it is this (in the simplest terms I can!!) :

If you get the chicken pox, you carry with you immunity to chickenpox. Your body carries 'memory pieces' (or information) of chkpx around inside of it in order to recognize chkpx should it invade your body again and make the fight against it more effective. Thus, it is rare to hear of someone having chickenpox twice.


What THIS is saying is that tetanus is so toxic to your body that your body is unable to carry 'memory pieces' (or information) of it. So you will not be immune to tetanus disease just because you've already had it.
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#3 of 66 Old 11-03-2007, 04:20 PM
 
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#4 of 66 Old 11-03-2007, 04:29 PM
 
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...and if the natural disease can't convey immunity a vaccine sure can't.
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#5 of 66 Old 11-03-2007, 04:55 PM - Thread Starter
 
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Forgive my ignorance, but what exactly does the toxin do(or not do) to the immune defenses to cause the inability to produce immunity?
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#6 of 66 Old 11-03-2007, 04:59 PM - Thread Starter
 
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attachedmamaof3-

Please feel free to state your personal opinion! I'm curious now . If I'm influenced you have my assurance I won't feel it was unduly so.
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#7 of 66 Old 11-03-2007, 05:04 PM
 
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I am sure someone much more knowledgeable than me will answer but here is how I see it:

Immunity can be built to a virus or bacteria.

A poisons is not something we can build immunity to because the poison has to be removed from the body rather than stored.

But the theory in vaccinating against a poisons (tetanus, diphtheria, pertussis) is that the body can build up tolerance.

Sort of like building up a tolerance to smoking cigarettes. One at a time.
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#8 of 66 Old 11-03-2007, 05:47 PM
 
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#9 of 66 Old 11-03-2007, 06:55 PM
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A tetanus infection is so dangerous because it can kill you or cause severe, permanent damage before/if your body can mount an immune response sufficient to neutralise the bacteria. Tetanus is an exotoxin producer and the toxin inhibits phagocytosis, which in turn inhibits antigen processing and presentation which is necessary for T and B cell proliferation so this is inhibited as well.

Can you mount an immune response to natural exposure? Maybe, sometimes but it requires adequate, repeated and prolonged antigenic stimulation and this takes years and decades to maybe achieve an adequate protective titre. The vaccine is an inactivated toxoid so the immune response is against the exotoxin and my preference to the former.

SM
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#10 of 66 Old 11-03-2007, 07:45 PM
 
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Okay Quest, but only because you asked!

I think it's ludicrous that an agency can state:
Quote:
Because of the extreme potency of the toxin, tetanus disease
does not result in tetanus immunity.
If having tetanus disease doesn't convey immunity, how in the world will passive immunization or tetanus toxoid?!? (Given tetanus disease is an exotoxin reaction to bacteria.)

and in the same breath suggest immunization/vaccines of any kind given their statement on page 7:
Quote:
Efficacy of the toxoid has never been studied in a vaccine trial.It can be inferred from protective antitoxin levels that a complete tetanus toxoid series has a clinical efficacy of virtually 100%; cases occurring in fully immunized persons whose last dose was within 10 years are extremely rare.
hmmmmm....I don't think so. Clinical? Infer? Virtual? : Not when you're injecting a
Quote:
formaldehyde-treated toxin
Not to mention, at last count in 2003 (if I remember correctly) there were a whopping 20 people with reported tetanus in the US. Pardon me for saying so, but I think it's safe to infer that it's pretty rare for ANYONE to get!!!

Thanks, but I'll take my chances. Ridiculous. I call this "G.W.B science" if you ask me.
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#11 of 66 Old 11-03-2007, 07:58 PM
 
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I've always wondered what's up with this:

Crone NE, Reder AT. Severe tetanus in immunized patients with high anti-tetanus titers. Neurology 1992;42:761-764. Article abstract: Severe (grade III) tetanus occurred in three immunized patients who had high serum levels of anti-tetanus antibody. The disease was fatal in one patient. One patient had been hyperimmunized to produce commercial tetanus immune globulin. Two patients had received immunizations one year before presentation.
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It's been awhile since I read up on it, but seems very interesting to me that highly vaccinated individuals would be MORE susceptible to tetanus. I don't understand the mechanics, but makes me wonder.

-Angela
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No. way.

That doesn't say what I think it does. Does it?!?!

That a patient was given too much tetanus toxoid on purpose in order to produce TIG?!

or was given too much on purpose in order to skew the amount of anti-toxin antibodies that would show in a study?
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Quote:
Originally Posted by attachedmamaof3 View Post
No. way.

That doesn't say what I think it does. Does it?!?!

That a patient was given too much tetanus toxoid on purpose in order to produce TIG?!

or was given too much on purpose in order to skew the amount of anti-toxin antibodies that would show in a study?
Where do you think the get TIG from? To my knowledge almost all IG products are made intentionally.

-Angela
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#15 of 66 Old 11-03-2007, 08:14 PM
 
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I think that's what some people do for a living; they get super-mega-vaxed for something and donate antibodies.
Weird job, huh?
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#16 of 66 Old 11-03-2007, 08:18 PM
 
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You know what? I'm ashamed to say as an AVID anti-vaxxer I guess I never thought about it : I mean, I "intellectually know" what it is..I know it's IG, etc et al...but

I certianly never thought it came from another PERSON. Strange missing piece, I guess.

Okay, I'm officially freaked out.

Seriously?
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Quote:
Originally Posted by alegna View Post
It's been awhile since I read up on it, but seems very interesting to me that highly vaccinated individuals would be MORE susceptible to tetanus. I don't understand the mechanics, but makes me wonder.

-Angela
I don't think anybody on the planet knows what's up with how that works.
My own personal speculation is that it probably has something to do with these cells:
http://en.wikipedia.org/wiki/Regulatory_T_cell
I could be totally off, though.
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Quote:
Originally Posted by attachedmamaof3 View Post
You know what? I'm ashamed to say as an AVID anti-vaxxer I guess I never thought about it : I mean, I "intellectually know" what it is..I know it's IG, etc et al...but

I certianly never thought it came from another PERSON. Strange missing piece, I guess.

Okay, I'm officially freaked out.

Seriously?
That's why there is a always a concern accepting an IG product. They're all blood products. In the case of TIG, if you really need it, it's worth the risk. And in theory the risk is very low. But it's still a blood product.

-Angela
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#19 of 66 Old 11-03-2007, 08:21 PM
 
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Originally Posted by mamakay View Post
I don't think anybody on the planet knows what's up with how that works.
My own personal speculation is that it probably has something to do with these cells:
http://en.wikipedia.org/wiki/Regulatory_T_cell
I could be totally off, though.
As good of a theory as any....

things that make you go hmmmm.....

-Angela
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#20 of 66 Old 11-03-2007, 08:26 PM
 
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Things that make me wish the gov't could just pay ME directly to infer and do non-studies. *sigh*

I could SO make a career out of it. I could start right now.
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#21 of 66 Old 11-03-2007, 09:09 PM
 
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Originally Posted by attachedmamaof3 View Post
Things that make me wish the gov't could just pay ME directly to infer and do non-studies. *sigh*

I could SO make a career out of it. I could start right now.
Ah, but they WILL pay you to get over-immunized so you can be a source of TIG. Move to Bethesda and read the local classifieds.

Makes me REALLY wonder what's going on with the NIH ads looking for habitual cocaine users.
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#22 of 66 Old 11-03-2007, 09:27 PM - Thread Starter
 
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Originally Posted by mamakay View Post
mamakay-

Unfortunately most of the links aren't working for me.
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#23 of 66 Old 11-03-2007, 09:30 PM
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Ah, but they WILL pay you to get over-immunized so you can be a source of TIG.
Not if you're a horse!
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#24 of 66 Old 11-03-2007, 09:39 PM
 
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Quote:
Originally Posted by Quest View Post
mamakay-

Unfortunately most of the links aren't working for me.
The pubmed links?
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#25 of 66 Old 11-03-2007, 09:49 PM
 
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http://www.ncbi.nlm.nih.gov/sites/en...t_uids=1092755


Quote:
Comments were made on misinterpretations concerning the natural resistance and natural immunization against tetanus. Arguments were given explaining why the disease itself did not determine adequate immunity. When, however, adequate conditions appear, tetanus toxin is known to stimulate the immune system and produce detectable humoral antibodies. Various possibilities resulting from the postulated harboring of tetanus bacilli by the human body and their eventual toxin production were analyzed and related to the human tetanus pathology. The existence of natural immunization was unquestionably demonstrated by presence of protective levels of tetanus antitoxin in the blood of the majority of 59 surveyed subjects considering that none of them had ever received any tetanus toxoid and most of them never received a single shot of any drug. The results of this survey originated a few arguments that may support the answer to some still intriguing phenomenona such as: 1. The relatively small number of cases of overt disease among people and animals born and living in large tetanus-risk regions all over the world. 2. The existence of "poor responders" and "good responders" to the primary tetanus toxoid stimulus. 3. The age distribution of tetanus showing evident prevalence among newborns and children. 4. The wide individual variations in the clinical picture of human tetanus as indicated by the localization and limitation of the symptoms and their severity.

http://www.ncbi.nlm.nih.gov/sites/en...t_uids=3980089

Quote:
Literature on natural immunity to tetanus is scarce. We examined antitetanus antibody levels with the enzyme-linked immunosorbent assay in 200 people living in an isolated community and clarified the influence of age and sex on immunity. In 197 subjects, antitoxin antibodies were measured. No sex differences were noted, and 30% had protective levels (above 0.01 IU/ml). The percentage of those considered protected was age dependent.

Here’s the fullest of that one:

http://www.pubmedcentral.nih.gov/art...bmedid=3980089

http://www.ncbi.nlm.nih.gov/sites/en...t_uids=6680401

Quote:
Among 48 adults without a history of tetanus immunization, we found with the aid of indirect hemagglutination test 20 individuals with protective tetanus antibody titers, 23 with low levels of antitoxin (under 0,1 I.U./ml) and 5 devoid of tetanus antitoxin. In two blood samples of 99 unvaccinated children under 3 years of age (taken at 7 months intervall) 12,1% showed tetanus antitoxin in the first serum sample and 16,2% in the second sample. Protective antibody titers could be found only in 4 children in each of the first and second serum sample. The data suggest a silent oral immunization by tetanus bacilli thus boosting under unhygienic conditions the tetanus immunity with advancing age.
http://www.ncbi.nlm.nih.gov/sites/en...t_uids=6827147

Quote:
A serologic survey using a highly sensitive enzyme-linked immunosorbent assay confirmed the anticipated finding of naturally acquired antibodies to tetanus toxin both in humans and animals on the Galápagos Islands. In 57 inhabitants (mean age, 31.3 years) who had not been vaccinated against tetanus, antibody to tetanus toxin was detected in the blood in varying titers (geometric mean [reciprocal] titer [GMT], 0.015 international units [IU]/ml). In one individual the titer of antibody was greater than 12.5 IU/ml. Two individuals who had never been vaccinated against tetanus but who had reported having had clinical tetanus had titers of antibody to tetanus toxin of 0.02 IU/ml and 0.3 IU/ml, respectively. All nine of the animals studied showed antibody to tetanus toxin (GMT, 0.028 IU/ml).
http://www.ncbi.nlm.nih.gov/sites/en...t_uids=6114281

Quote:
Tests among 410 Indians not artificially immunised against tetanus showed that 80% had measurable antitoxin. Single doses (100 Lf or 250 Lf) of a potent tetanus toxoid were given to such individuals with naturally acquired antitoxin. The 100 Lf dose produced on average a ten-fold rise in antibody level, and the 250 Lf dose a twenty-fold rise. In adults who had been artificially immunised, a 5 Lf dose produced a four-fold to ten-fold rise in antibody level. In infants three doses of triple vaccine produced satisfactory antitoxin concentrations. The levels of antibody achieved after a single 250 Lf dose should protect for 5 years. Single-dose vaccination may be better than the conventional three-dose scheme for a population that is unlikely to comply with a three-dose regimen and in whom naturally acquired antitoxin is associated with partial tolerance to tetanus toxoid. Naturally acquired antitoxin in Indians is probably the result of chronic clostridial contamination of the small bowel. This contamination can induce immune tolerance in the gut and systemically and may be the reason for the poor responses to vaccination in all except infants.
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#26 of 66 Old 11-03-2007, 10:03 PM - Thread Starter
 
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Originally Posted by Science Mom View Post
A tetanus infection is so dangerous because it can kill you or cause severe, permanent damage before/if your body can mount an immune response sufficient to neutralise the bacteria. Tetanus is an exotoxin producer and the toxin inhibits phagocytosis, which in turn inhibits antigen processing and presentation which is necessary for T and B cell proliferation so this is inhibited as well.

Can you mount an immune response to natural exposure? Maybe, sometimes but it requires adequate, repeated and prolonged antigenic stimulation and this takes years and decades to maybe achieve an adequate protective titre. The vaccine is an inactivated toxoid so the immune response is against the exotoxin and my preference to the former.

SM
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?

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?
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#27 of 66 Old 11-03-2007, 10:12 PM - Thread Starter
 
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Thanks mamakay. I need to rest my eyes a bit, but I'll be back to read those quotes.
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#28 of 66 Old 11-03-2007, 10:15 PM
 
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Originally Posted by Quest View Post
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?

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?
I've *never* heard the virus bit.

-Angela
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#29 of 66 Old 11-03-2007, 10:17 PM
 
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Diphtheria is a bacteria that needs infection with a virus (called a bacteriophage) to produce a nasty toxin, but not tetanus. It's just a bacteria.
What it needs is an oxygen free (anaerobic) environment to multiply/germinate/go nuts/whatever.
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#30 of 66 Old 11-03-2007, 10:33 PM
 
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Originally Posted by mamakay View Post
Diphtheria is a bacteria that needs infection with a virus (called a bacteriophage) to produre a nasty toxin, but not tetanus. It's just a bacteria.
What it needs is an oxygen free (anaerobic) environment to multiply/germinate/go nuts/whatever.
Ah ha! Learn something new every day...
[filing away new tidbit on diphtheria...]

-Angela
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