The emergence of antibiotic resistant organisms have recently been linked with antibiotic tolerance. Recent studies have noticed how these two trends have paralleled similar instances and occurrences, almost like one leads to the other. This is the most recent discovery to antibiotic resistance, this is due to the fact that organisms with the ability to tolerate and withstand antibiotics have a higher chance of obtaining mutations in the population. Therefore, it is easy to make the conclusion that limiting tolerance or slowing this process will delay emergence overall.

Antibiotics resistance has been increasing exponentially. While tolerance is a rate of limiting the amount of antimicrobials that are dying, this is an important aspect to consider when discussing this topic at hand. Combinations of medications have been a strategy recently used where antimicrobials are combined to also slow the rate of tolerance. While new antibiotic resistant organisms are still being found, such as in Sweden, where they believe it was related or apart of the E.coli family, research is currently being done to make a decision and conclusion about this organism. So many unsafe practices relative to antibiotics are still being conducted that causes these organisms to still be apparent. The use of antibiotics when not necessary is one main example. These gaps in their use and as mentioned above, antibiotic combination has created a monster.

Not to mention the effects that they are causing on non humans such as farm animals and what this does to food production. It is more than just a human issue, its a food production and food-borne illness issue. This issue is known as the farm-to-plate continuum in the industry where antibiotic resistance being spread can be done by both direct and indirect contact but most commonly by indirect. However, what is there that we can do? We need antibiotics, but we also need them to work and be effective without becoming toxic. It is necessary to clarify one thing, antibiotics resistance is not referring to the body being completely resistant to antibiotics but that bacteria in their microbiome has been altered to not be able to absorb and react to the antibiotics. This is what makes it one of the worlds most urgent health concerns, as well as all the confusion it causes. As more and more germs are sharing their resistance capabilities with one another, new ways of surviving drugs are evolving. While it is common to come across products that contain the description “no growth promoting antibiotics” this does not necessarily mean what it implies. This just means that the animal had been off the antibiotic for enough time so that when tested for antimicrobials in the blood there was a small enough trace that falls under the minimum to include this label. Personally, this is just a scam to overcharge me for a product because it is believed to be better when its not truly any different.

The thought of no antibiotics being for use is almost impossible to imagine. The world of surgeries and medical procedures would have to be halted or changed completely. Superbugs are a repercussion of the rise of antibiotic resistance. The highest risk germ available today is Clostridium difficile. Superbugs however are a result of their normal drugs no longer working on their bacteria and this builds up to eventually affect other microbiomes and become more widespread. Any germ can become a superbug!

Salmonella is commonly a topic of concern alongside the talk of antibiotic resistance because of how wide spread it is found in poultry and animal products. This is due to the conceived behavior that lots of evidence shown and proved that the use of agents in food animals contributes to the illness of Salmonella and its growth. This fact alone contributes to why this is a main concern for the control of antibiotics in animals. This makes a lot of sense to me just in the fact that we are able to link these two things and how they contribute to the other just with my basic understanding of microbiology.

Otherwise known as “whooping cough”, vaccines used against this terrible, highly contagious infection have been around for over a hundred years. However, the vaccine has been changing rapidly. It will never stay the same. Most recently, the vaccine has been improved so that morbidity has been reduced at significant rates and in such a broad way that it has created great attention that allows it to be used alongside other vaccines as a building block to create identical effects. The development of this what they call a “whole-cell” and “acellular” form of the vaccine is what created this movement. These, which are commonly used on children are given so much attention because it is vital that they are in their best form to protect against the illness that is most easily spread between those in this age range. My twin sister at a very young age, young enough in that all I remember is the vague occurrence of my parents having to rock me outside of the house to not hear or be infected by my sisters cough at night, got the croup. A completely different illness but similar in that a very bad cough is experiences and is very contagious. This is what I think of every time I hear whooping cough just because it is more severe and I cant image a baby having to go through this with such a weak immune system. This describes the prime age range of those who are usually affected by the illness. That is why these two new forms of the vaccine are important to those studying the vaccine because it is important to consider which vaccine to be given whether acellular or whole-cell as well as the regulation and schedule or administering the vaccine to your child. This is an important factor to consider with any vaccine and especially pertussis because the time of exposure is a driving factor of this vaccine specifically.

As i just mentioned, lost of studying and trials have been underway to determine what exactly goes into the pertussis vaccine and why it is so important to watch and adhere to a specific schedule when receiving the vaccine. Scientists have narrowed these down into 3 groups. These groups are: scientific factors, sociological factors, and pragmatic factors. When I read these I had no clue what they meant by these extremely relative terms. However, I broke these down in my head as the factors that determine which vaccine you need, how much you need, and when you need it. For infants, it is important to consider immune response, as well as public acceptability. Public acceptability is very important to consider in todays age and time. Infants receiving vaccines is a very sensitive topic, something that I personally don’t understand knowing so much about herd immunity and the effect this would have on whooping cough if all would be vaccinated.

The only means of control for Pertussis is immunization. This is due to the highly contagious cough that can last all the way up to 100 days that accompanies the illness and is a signal of being infected. Maternal immunization is also very important to consider with this illness. This would be connected with the acellular form of the vaccine, where mothers are vaccinated to reduce the number of infant deaths. However, it means nothing if the vaccine being administered is not effective or the quality is lacking. That is why so much regulation is gone into vaccines. Before the vaccine was generated in the 1940’s this illness killed nearly 9,000 children. This is a statistic important to remember and recall when considering the quality of the vaccine.

Recent studies have been trying to find a connection between biofilms and pertussis and whether they have an effect on the illness as a whole. Knowing that these type of infections are extremely chronic, it is important to consider their ability to be resistant towards antibiotics. Biofilms are most commonly directly associated with inflammation and are usually found affecting cells inside us rather than extracellular. Biofilms are also known for leading to cancer in the future of those who have been affected by these microorganisms. This is the current mode of study for the Pertussis vaccine.

The title sums it up! I am very uneducated when it comes to the Polio Virus, and the vaccines IPV and OPV. With some digging I am now educated!

IPV and OPV are the two vaccines in place to prevent the Polio virus. Their names are the Inactivated Polio Virus, and the Oral Polio Vaccine. OPV is the vaccine that is administered orally while IPV is given through syringes as injections into the body. Given this, IPV is obviously the more complicated vaccine compared to OPV. Which makes perfect sense to me that OPV is the more known and accessible form of the vaccine, alongside the fact that it does not require a physician or trained individual to administer the vaccine. The inactivated vaccine should be given to children over four increments until the age of 6. This differs if the child is planning to leave the country due to an increased risk of developing polio in specific areas. Herd immunity is a huge asset of this disease because the higher portionality of those who get vaccinated as children will decrease the risk of spread because you do not have to continue to get vaccinated as long as you did when you were a child. There are also those who should not receive the polio vaccine due to increased allergies, illnesses, or if you are immunocompromised.

Recent studies into the OPV vaccine have led scientist to believe that there are many undercover benefits associated with live vaccines such as the polio vaccine. Non-specific benefits that can be described as effects of the safeguard from target infection that the vaccine is eliminating. A large reduction in mortality have accompanied this phenomenon. This has also been recognized alongside the Measles vaccine. These non-specific effects prove and support the fact that stopping live vaccines could have very traumatic results overall across populations.

There are constant changes and improvements occurring recently and to come in 2020 alongside the polio vaccine to make it more effective. For instance, it has been discovered that there are many flaws with the current inactivated vaccine in place. Financial and systematic problems include the fact that the vaccine has to be stored and transported at a very specific temperature that is not too cold where it will freeze and not too warm where it will melt. This temperature is between 2 degrees Celsius and 8. This sounds like a very impractical inconvenience to me. How does one keep this vaccine in this temperature frame at all times, is there not something we can do to modify the vaccine so that this isn’t the case? But what do I know??? When i continued reading the article I realized that yes they are working to change this! Those currently studying and proposing ideas for the development of new vaccines have raised the idea of an air drying technique that would use the material already inside the vaccine, its silk fibroin. They have been practicing with this technique and have came to the conclusions that the fibroin films on IPV maintained high potency D-antigen values recommending that their storage for long periods of time at room temperature proved their hypothesis correct. This would also eliminate financial barriers by allowing the vaccine to be administered via microneedles.

I can now say that I know more about the Polio vaccines. To my understanding, both are under great construction. This is important due to the increased instances of disease in the past 3 months where the number of cases have near tripled. Over a total of 15 countries, Polio has been receiving lots of attention especially with the Type 2 form where scientists are linking this to the type 2 OPV vaccine. This has been a problem in the past as well. In 2016, physicians and those studying the disease recognized trends of occurrences alongside the type 2 OPV vaccine which led to the switch from tOPV vaccines to the new and improved bOPV. Trivalent vaccine not being administered anymore seemed to be a fix to the problem….. obviously not. While most of the recent outbreaks are in places like Africa and China, it is still a major concern as it is mainly children being affected following the switch to bOPV. Type 1 has appeared in Indonesia and Papua New Guinea. I view this as under administered, or lack of access to necessary vaccines in countries with less healthcare assistance. This needs to change!!!We should be able to eradicate this disease entirely!

Lots of time, effort, money, and knowledge go into studying the microbiome and making connections about how it shapes medicine today and more importantly how it will shape medicine in the future. It is not new knowledge that the human microbiome is what aids the process of human development and what keeps us healthy and safe against invading materials. Receiving our first microorganisms from our mothers when exiting the birth canal, the process began of growing and conforming to become strong and host ever stronger immune systems to get us to where we are today. Lots of people are studying this phenomenon, making it require in return lots of funds. These resources are being brought forth by the “Human Microbiome Project”. Lots of new findings have deemed this project as successful. For instance, we no longer maintain just the medicine view that the microorganisms we have and hold are solely for the purpose of infecting us, and causing disease, but that these organisms are apart of us and use the body as hosts for survival to make us a human body. We need them! More recently we have noted that it is possible to translate gut microbiota from one organism to another and in doing this you have increased your chance to 90% of being able to fight off or eliminate the Clostridium difficile infections that you host. With so many new findings and approaches being used and manipulated to give the population the results they are wanting and feening for, more funds are being brought in to sustain these studies. The progress is overwhelming to most, with an expected increase of $1.9 million dollars in funds to go towards these projects, the studies are at our fingertips.

However, we cant stop there. It is not correct to say that we know all, or no disputes remain, or even that what has been concluded so far constitutes as final fact, because none of these are true. Lots of points remain unsaid, lots of accusations remain unstudied, and most importantly lost of disputes between medical specialists and scientists are active. One of these disputes is deciding or educating on what classifies you as having a healthy microbiome versus what groups you with those who do not have a healthy microbiome but one that is unhealthy. What does an unhealthy microbiome show? What does it mean? These are some of the questions still being answered. To me this is very important, kind of concerning since this is a very general question that seems like it would be the first answered….. hmm… because how does one know how the microbiome affects health if they don’t know what constitutes a healthy biome versus what doesn’t, if they don’t know the line how do they know you are over it???? Interesting. (hyperlink for pic)

Due to their not being a clear-cut decision made yet regarding what constitutes a healthy microbiome, there are lots of discrepencies on how to approach the microbiome to make conclusions regarding not only clinical studies and those regarding medical interventions but also those directly linking health problems to the cause. The epidemiological side of this project to me is the most interesting and beneficial. If we can use the normal human microbiota and what we know about our microbiome to come to conclusions regarding why we have a certain disease and what caused it, we are superior. It is important to note that this will only come following the discovery of what makes each specific microbiota unique. What exactly is it about gut microbiota that make it different from oral microorganisms to allow it to be able to (recently discover) interact or tap into our psychological mentality and provide us with therapeutic remedies when facing difficult times. They are giving us nutrients that in return help us have energy and longevity that promote our psyche. We know that oral microbiota do not do this though, so what separates them? How many licks does it take to get to the center of a tootsie pop? The world may never know…. KIDDING.

Hopefully we will know soon but these are all important aspects to consider. Our lifestyle, the food we eat and the diet we maintain, the medicine we take, these are all components of what drive our microbiota to create the symbiotic relation we hold with them. It is even safe to say that scientists have concluded very recently that the microbiota can affect our brain which leads to, as we know, neurological disorders, mental disorders, cancers, and even neurodegenerative diseases which can be passed down through generations. This is a mind blowing discovery that should not go unnoticed.

Pathology studies are being conducted most recently to trace and analyze the path that microbiome modifications follow to become such powerful organisms but also to look at transplants, look at the microbiome in other organisms not human, use statistics, etc to become as well educated as possible in 2020. However, until a decision is made regarding what constitutes a healthy biome compared to the alternative, the information isn’t useless, but its …..useless.

The Corona Virus has been flooding the news and getting an extreme amount of attention in the states since its outbreak in China; however, I would be more worried about his bestie the flu virus. Locally, the strains of the current flu virus that are spreading have caused more damage (at the moment) as well as towards the end of 2019, and as we have approached and entered into 2020, than the Corona Virus. The centers for disease control have officially reported this, alarming the public to where their concerns should lie. While deaths from this virus are declining and have been predicted to be declining more in 2020, the CDC credits this to vaccination availability as well as the increased statistic of the number of vaccine participants compared to past years. The vaccination quantity rung in at an amazing… 170 million compared to the 155 million in 2018/19 which assisted the CDC in coming to this conclusion. For me personally, I understand the hype behind the Corona Virus, its something new, we aren’t used to hearing about it but we are used to hearing the word “flu” now.

The “sickest” month of 2019 was February, this is where the season peaked for this specific strain of influenza. (image)

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For the specific 2019/20 season of the flu, the CDC observed a decline of this virus towards the end of the month in December but a new spike of cases halfway though January in which they indicate will last until flu season comes to an end in another month or even two. As Dr. Cramer stresses, WASH YOUR HANDS. While the general person does not know or understand the meaning behind an enveloped virus, I do. So, let me hop on my soap box. (image)

Regular hand washing can make the biggest difference in the spread of this disease. The simplest task. The CDC has forecasted that the strains prominent currently will be reoccurring and peaking at the beginning of March. While this is the bad news, there is good news as well! The good news is, you can obviously start spreading washing hands awareness to prove them wrong! OR the fact that all predictions lead towards that by the end of March these specific viruses will be at their most dramatic decline. A positive statistic to this fairly negative turn-of events for the 2019/20 season is that the recorded hospitalizations is significantly lower than those of past seasons, as well as the estimates that have been made for upcoming strains and seasons. I think it is important to link this accomplishment with the previously mentioned increased awareness of vaccines as well as their growing productivity and ability. Overall the approximations of flu statistics from this season have led the CDC to conclude (all minimum values) 22,000,000 illnesses, 10,000,000 medical visits, 210,000 hospitalizations, and 12,000 deaths. The vaccine is the key to all of these statistics. Manufacturers have given producers and those studying the virus the prediction of as little as 162 million and as high 169 million prescriptions of the drug to be administered by the end of the season. This statement comes directly from the CDC describing the unique vaccine for the 2020 season: “H3N2 viruses have presented an increasing challenge for vaccine virus selection due to frequent changes in the H3N2 viruses.” . What this is saying, is essentially the flu virus is obtaining a lot of resistance. It is becoming stronger. HOWEVER…. it is important to remember, a flu shot even in its least effectiveness can still protect thousands and save millions. Get vaccinated! The vaccine is effective. In conclusion, while the flu virus is changing, growing, and becoming stronger this does not mean to halt vaccines or deem them as ill-affective. It means to press for them harder!

Andrew Wakefield would be at the top of Professor Cramers hit list… why? Because he did exactly what my title infers, he put two and two together and concluded that he reached ten. Lol. Wakefield was formally a doctor conducting studies on, as well as making a career out of gastrointestinal surgeries with a focus on inflammatory bowel disease. Most importantly, not mentioned in that lengthy description of his profession, the title he is most associated with today, “anti-vaccine activist”. This derives from his research conducted and published in 1998 where he hypothesized but more so sermonized that the MMR vaccine provokes the later development of Autism as well as gastrointestinal disease... or what I like to call his “ten”. His study began without randomization of his cohort and with an extremely small sample size, 12 participants all picked due to physician referral. Whatever this means…. in my eyes I see this as an extremely biased mode of gathering participants. Why did the physician feel the need to refer? Did they all have the same criteria that make the data skewed in only one direction favoring Wakefields hypothesis…? Claiming that the participants were sent through several examinations and tests prior to their inclusion in the study is one checkpoint that is discussed in articles about the MRI’s used to assess the twelve. This would be data and research released that independent scientists could use to verify his findings. However, scientists did look into this data as well as interviews and documents made public by the General Medical Council, and their findings just did not add up…(shocker).

Besides altering his data, lying publicly, and publishing a false article for personal gain Andrew Wakefield, Im sure is a great guy and doctor. I just wonder if the patients knew Wakefield was going to scew their medical histories as well as their tests conducted to support his argument that he had indeed reached a major breakthrough. A breakthrough that occurred, you guessed it, in his own institution, the “Royal Free Hospital and Medical School in London”. This strikes scientists as well as outsiders as major foreplay as this would be a huge financial gain and popularity scheme for his institution. Lets get to the specifics to see exactly what Wakefield claims he discovered through his extremely small sample size. Wakefield reported that allegedly nine out of the twelve participants developed Autism from the MMR vaccine because they were in fact “normal” at birth. Independent scientists have found this to be false as the data they have retracted does NOT show these findings but that 3/9 of these supposed “autism victims” were not even given an autism diagnosis! As well as parents have came back to contradict his claim that all patients were healthy at birth when five had actually experienced developmental concerns at a very young age. Essentially, Wakefield was doing the most to make sure his data was skewed in his favor by lying about medical histories, changing data regarding the onset of symptoms following the vaccine from months to days, and most importantly the fact this study was funded to his institution.

Finally, I would like to conclude with the public response from this retracted study and how this seriously affected many outlooks on the MMR vaccine. Most importantly it comes back to the refutes and evidence that has been made public, proving to the educated, as well as the uneducated, a simple way of saying “he did it to gain money as he is a anti-vaccine lobbyist”. In simple terms. For myself, it is important that articles and facts are posted informing those who don’t know much about the vaccine or Autism what is accurate versus what is absurd so that we are not gullible in what we hear or see on the internet and in the news. As for Wakefield, as of 2012, he works and still supports anti-vaccine lobbies. While there are still those who choose to not participate in vaccines for various reasons, this proposition has almost throughly been terminated by most. The facts are everywhere, the evidence is undeniable that the motives for Wakefields propositions were for personal gain. However, I believe I would be doing myself an injustice if I didn’t mention that I feel as if the public is also in a state of confusion regarding the vaccine as a whole. Governments are the ones who are typically responsible for how vaccines and immunizations are promoted to the public eye. Websites and packets can be found from various sources but these are going to be specific to the culture you are immersed in which effects the information included in these sources. There is danger in the point of view. This is where I find it most important to be educated on the subject instead of led by deceiving public media. Stick to the facts!

My name is Kennedy Brunner and I am a sophomore at The University of North Carolina at Chapel Hill. I am studying Pharmacy and plan to attend Pharmacy school in Charleston, South Carolina. A fun fact about me is that I have a twin sister who doubles as my room-mate in college and we are polar opposites. I have blonde hair and green eyes and she has brunette hair and brown eyes. She is my best friend! I am originally from Charlotte, North Carolina which is about 3 hours away from here.

My favorite meme is:

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I am very excited for this semester in microbiology! Thank you! 🙂

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Be yourself; Everyone else is already taken.

— Oscar Wilde.

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