Diseases

Not all vaccination programs are completely successful in eradicating a disease. One that was, is
the smallpox vaccine.
Eradication of smallpox

This disease was caused by the variola virus. 12-30% of sufferers died while many who
recovered were often blinded. In 1967, WHO (the World Health Organisation) vaccinated
more than 80% of the worlds population who were at risk and when a case was reported

all possible contacts in the area were vaccinated (ring vaccination).

Eradication in rural areas proved a challenge, but the last case occurred in Somalia in
1977 and in 1980, WHO declared the world free of smallpox.

Reasons for the success of the vaccine included:

1.

The variola virus did not mutate and change its antigens.

2.

It was made from a live harmless strain of a similar virus, so it mimicked a natural
infection, multiplying and continually presenting the immune system with a large dose of
antigens.

3.

It could be freeze-dried and kept for six months aiding distribution.

4.

Infected people were easy to identify.

5.

It was easy to administer and the disease did not linger in the body.

6.

Smallpox does not infect animals.

7.

Less successful vaccination programs have included those against measles, tuberculosis,
malaria and cholera.
Measles

This disease offers the promise of eradication if worldwide surveillance was followed-up by
vaccination.
However, so far it has failed because:
1.

A poor response to the vaccine has been shown by some children, who need boosters.

2.

High birth rates and shifting populations make following-up cases difficult.

3.

Migrants and refugees may spread the disease.

4.

Measles is highly infective and 95% immunity of a population is required to prevent

transmission.

5.

The vaccine only has a 95% success rate.

Tuberculosis

This disease was once thought to have been eradicated, but is actually showing a resurgence.
The reasons include:
1.

Some TB bacteria are resistant to drugs used to treat them because they can mutate.

2.

AIDS can allow TB to infect an individual due to their compromised immune system.

3.

Poor housing and homelessness lowers peoples' natural resistance.

4.

There have been breakdowns in the TB control program.

5.

It is actually caused by two different bacteria with two different antigens, which can live
inside human cells, making them hard to fight.

6.

It can be carried in cattle.

Malaria

This is a disease caused by Plasmodium, a protoctist (eukaryotic) that has hundreds or even
thousands of different antigens. It also has three different stages in its life cycle, meaning that
developing a vaccine is incredibly challenging and has not yet been achieved.
Cholera

This disease is caused by Vibrio cholerae, which can live in the intestines where antibodies produced by vaccines that are injected - cannot get to it. An oral vaccine is in development.

Antibiotics
These are drugs used to treat or cure infections and to be effective they must kill or disablethe
pathogen, leaving host cells unharmed. Most antibiotics are used to treat bacterial andfungal
infections, there are very few that are effective against viruses. A few antibiotics are synthetic
but most are derived from living organisms. They work by either interfering with the growth or
metabolism of the bacteria or fungi. They may inhibit the synthesis of the cell wall, translation or
transcription of proteins, interfere with membrane function or enzyme action.
Antibiotics need to be carefully chosen. This is done by screening them against the strain of
bacterium or fungus obtained from the sufferer. The samples obtained are grown on agar plates
and antibiotic discs placed on to the plate. The disc with the greatest diameter of inhibition zone,
is the most effective. Broad spectrum antibiotics are effective against a wide range of bacteria,
while narrow spectrum antibiotics affect only a few.

Penicillins are well known antibiotics, which work by preventing the synthesis of peptidoglycan
polymer cross links in the cell walls of bacteria. They are only effective when the organism is

making new cell walls, i.e. growing. Many bacteria are now resistant to penicillin as they have
penicillinases (enzymes which destroy penicillin). Resistance to antibiotics, is coded for by small
rings of DNA found in bacteria, called plasmids.
Some bacteria may contain up to five plasmids, each conferring resistance to a different
antibiotic. DNA and therefore plasmids can be passed between members of the same species of
bacteria during conjugation, or sexual reproduction. Specialised tubes or pili join one bacterium
to another during conjugation.
Resistance to antibiotics is increasing and has a great impact on the treatment of a disease
because it prolongs illness and increases mortality. Hospitals try and keep some antibiotics as a
last resort and drug companies are continually looking for new ones. Newer antibiotics can come
with some drawbacks, for example people have been injured by Levaquin which is used to treat
bacterial infections