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Micro Exam #5 1996 - «Lym/V" MEDICAL MICROBIOLOGY AND...

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Unformatted text preview: «Lym/V " MEDICAL MICROBIOLOGY AND IMMUNOLOGY Fall 1996 Exam V Monday, December 9, 1996 1. A spwific.hypermnun human immunqglobulin and acyclovir would be most appropriate an effective in treatmentflofgp I WW “WMDWMM .A- an X . B. a newborn with congenitale tome alovirus infection D. 7E. a newborn whose mother hadrfihicken “'iii‘?ii€i5§‘€§9eek of pregnanc V fn‘éddle“s;¢efi’f°”fé‘5§ntly diagnose Wit ‘ aWuLaésatsrxtsghuaan exposed by needlestick to hepatitis B virus—infected blood X m-wm‘m,M.m~mv»“mwrrm-~m_mdm.m._ w” t F. an AIDS patient with retinitis and interstitial pneumonia X infectious mononucleosis ‘ W 2. I Januagy and Februar of each year in Louisville, a large number of infants are -... “WWW .. “mam, ., , m” “Gamma-7, .«flw:nqwmwmm may, », ,, r, admitted toKbsair hi dren s osplta ecause of serious infections with one or the other of the o owmg two uman Viruses: WWW” M “ MMW'WM my _ “WWW... fivmqnmr-wmnmmw. ‘ ,r,.._imen-, 9:5: as A. adenovirus & coxsackie B virus B. measles virus & chickenpox virus , C. coronavirus & rhinovirus D / . Epstein-Barr virus & parvovirus 819 f r ® ratings & respiratory syncytial virus ‘/ F. varicella virusmfluenza A virus 3. Which of the following human viruses is the fitlaj’ihause of seriousjower—respiratory “Wm—me , _. Wasawwm w w W, _ swamwmsw tract infection 1n adults, am, er y re“ A. adenovirus types 4 & 7 B. rhinovirus C respiratory syncytial virus A influenza A and Bwvirus . pm‘fi'éfiia virus types 1, 2 and 3 F. Epstein—Barr virus (EBV) The following list of answers (A—J, in alphabetical order) are to be used in answering questions #4, 5 and 6: Lassa virus Machupo virus Marburg virus parvovirus B19 yellow fever virus Colorado tick fever virus dengue virus Ebola virus Hantaaaxirus herpes simplex virus—1 meow? crepe k/( This virus can cause a hemorrhagic fever & shock syndrome in humgps as awrflesigiultwg‘f 4-“ an antibody—dependent enhancement (ADglmphenomenon4 although the majority of i . ‘(W‘ _ { TWMW m“,wa magma» _ ,, :mwwmmwg-ma-MWMM><fi¢gsd<azvsanpg,.bxr—mwggikssrmfim \/ c mica in ecfigfis of humans” are classrcal fever—arthralgia-rash. /Q 5. This virus has a ntural m nal reservoir, but is not an arbovirus. The virus can cause a hemorrhagic fever J tynarome in humans who are exposed to and infecté? by the Virus, Bu? {fiewvms r’ n ' ’ s ~ wwnemmvv Mam—m ‘ ‘ . . ' wigs”) \fi ' ' «means-4am, «m». "was? Q can acut Truman's? _ mmfimew x1” x \/6. A live—attenuated vaccine is FDA—licensedh’fggmp‘rotectioon against this’vvi‘rusrand is récomfié'h'déd" 6Fpéf ‘fis‘t‘rav‘él‘ing‘tdfiféa where virus is endemic. >,’,)Pl<\‘>r-‘QWV¢M .m A 7. Which of the following is important cause of viral gastroenteritis in humans ? \_W ‘‘‘‘‘ w mu.“ w..__.~ ~.—..s._i . ., ,._V,WW_____W_ 7A. adenovirus types 40 & 41 ‘/ B. human caliviruses l/ . human rotaviruses v’ if G) parainfluenza viruses 0 Norwalk virus y 10. 11. In a atient with “oral hair leukoplakia,” what specifichmpmsihle for these lesions‘an‘gy getected invamhigpsy of the lesions by either RT—PCR or is is as» awmwnwmmw .k Vie-Mm»va mm“ @ Epstein-Barr virus (EBV) . human papilloma virus type 6 (HPV—6) C. parainfluenza virus type 1 . coxsackie A virus E. molluscum contagiosum virus Which of the following is NOT a characteristic of measles virus infectionsgghumans ? A. maculopapular rash on the face/ warm. "WV-MW“ ‘B. Koplik spots in the oral cavity is” “Mamarmmmw . speciiicwlii’emng immunity after natural infection V" D. most in ections are subclgigakyflit’lfiiflgggpparengmtoms X y postl—iiitflé’ckiiofiyswe‘nceph ahtis invapprfloitirnat’eglymlAper‘lJOQQ‘meafilescases $1 Wuammfl as, A 4 . v «. ‘w-wrsmw,«.sm,hm_. WWmmwaww a Lasa- 974;»vhm- wwwwmm so thatwhuman arboviral infections can be “prevented byelimination of the mosquito ’ "Shgranuga—‘rvmflmhmuv (mmuwmmnm‘m Wmefey», My no 5 e. vectors: “All grille folimuiingimses are classified as arboviruses, EXCEPT‘Q ‘”'”"'”W‘*MWYN“‘WIWM'H w-wwww swwmmzumkewwws-wze «s w s n in nu» Mmost arbowmses are characterized by thelraraaagatiyeshamansysingaauusxsgtors, Una-Main)” V yellow fever virus l/ dengue virus l/ Sin Nombre/Muerto Canyon hantavirus A. B. St. Louis encephalitis Virus? E. F. Easternw equine encephaii't’is virus California encephalitis virus 9/ by BOTH human WWkW Which e of the f ; il 3 ndrom's ca be used adenoviruse es simplex virus . M» lferatoconjunctivitis a chrothMhep'at‘itiEY” herpangina x maculopapular rash x! myocarditis x mononucleosis X l3. 14. 15. \/ Which of the following would be the most appropriate topical anti—viral therapyhljgrwthe —~—~——.--_,...v W WM"... clinical syndrome in the previous question “film‘s; caused by herpes simplex virus ‘2 Wm». casem- .. .__ H a v r M a»,‘xvwrwwwml~vmflv§flcmurwhwafi2'ne'me ,. (:WWWmM.$WWW<wsmWMA>.2v 4" e. we", A. amanti‘dine B. ribavirin X 050 r t D. ara—A gvidarabine) E. vitamin A X F. recombinant interferon—a X Creutzfeldt-Jakob disease (CJ D) and gigtmflglmfigrfigiflgg syndrome gGSSS) in.,humaus.y§§afi‘y‘3’“ ' , am“; l a new human memberpf the heipgsyflimruswfamily {natal agents; 15n93y,rta.s,,‘,‘p.r.ions” morbilliviruses human papovaviruses related to SV40 virus HTLV-l'and related retroviruses human adenoviruses {MK WWPOM RT-PCR of human clinical samples has indicated that bats are the animal sourcflefifgrfithe waww- A; now-tan: maze-3%“? ‘m:‘§aswmw}tfi§t~ « m “a W'Qfiflkhgiwyv'! ,xgthflWmLa-Dz.anfik‘%;bww « s @310. fitmmf the raeeuthumugasw of ,Lnfegttszn which occvrin, th ._ Sm}? with the WW “I M ;«- V «WM—rnpaw urn-fig'w‘vmau'm- r w. A. pulmonary syndrome hantavirus B. California encephalitis virus @ rabies virus D. dengue virus AE. lymphocytic choriomeningitis (LCM) virus F. Norwalk virus All of the following viruses have single-stranded RNA genomes, and all EXCEPT one hWWe polarity. _Which one virus is the exception ? m~....~..wu www.mm A. California encephalitis virus l/ B. lymphocytic choriomeningitis (LCM) virus I/ C. Hantaan virus / D. {a Lassa virus l/ I influenza A Virus V” human rhinovirus The following set of answers (A—J, listed in alphabetical order) are to be used in answering questions #16—18: 20. A. adenovirus types 40 & 41 B. cytomegalovirus F. human papillomavirus types 16 &18 G. measles virus C. Epstein—Barr virus H. molluscum contagiosum virus D. herpes simplex virus-2 I. parvovirus B19 E. human herpesvirus-6 J. rubella virus Er thema infectiosum (“fifth disease”) in children and “h dro s fetalis” in pregnant females are htlmwresult ofiprimarywinpfection a human virus that has a specific tropism for erythroid precursors. What is this humannvirus ? I V What human virus(es) are the major cause of cervical carcinoma in adult females ‘2 Wm»: a”, . mwfim'muw’ 'Murwmm ammm ’(Exn‘lD.Lv,~v-m «we». 1113.24 («as What human virus is the cause of “infectious mononucleosis,” which occurs most WWHMNMMD,WW¢;M m I ,m,m whim-muva«iw‘mmwwmzmwmwwflti‘YlfiWe7&mmm.r.»:er“Wig; commonly with ado.1escents,an,_. .Xogggridififfaiéflfii§.§.§§.%i§£§fl.fliihm§§"eEe._Plla¥Y‘lg“i3? may” .- ,r r . revsmghuestion m l § 1, whatis for the virus during long- ’ 2mm hair—gu‘vws‘ammn, For the infectious mononucleosis-causing virus magi; the major human cell type which acts as an in vi 1: “my wuwmmawwwwwwgm-MWWM fmwremvvww w term, latentiflnfections of humans. in... "‘mmerI-v*.."f a. “xx-Wu...» A. T lymphocyte @ B lymphocyte . macrophage D. endothelial cell ‘E. hepatocyte Thereis NO specific anti-viral drug against this virus, but vitamin A therapy and Wmmmwmammmwmaww passive wigununization with human IG (rigggpwqujygwgygeflmmung IgGlmgfian reducethe severity of this virus infection in non—immune immungcomprOInised individuals WW w” a, i r WWWMH «Mn-va vwWWm-mwvh— mm”. «um mums ,m. Wm m, V 9X139§§§stqthisthumm W KAI.) measles virus B. cytomegalovirus Epstein—Barr Virus influenza A virus varicella—zoster virus respiratory syncytial virus 311F599 21. 22. 23. 24. Oral rehydration therapy is relatively inexpensive and can be highly effective therapy for children su erin mfimfiifefiéftiofhmifhfone3i”th”é‘”‘i'ol13w “girafifz’irf‘vims'é's‘: W “V s .... mum.» em, ,s ass-Muss parvovirus Bl9 influenza A & B virus coxsackie A virus A. @ rotavirus ,. parainfluenza virus types 1—3 D. E. F. Epstein—Barr virus Which one of the following six viruses is NOT a member of the paramyxovirus Emily? an m A. measles virus w" 'B mumps virus «if Q rubella virus D. parainfluenza virus W E. equine morbillivirus W F. respiratory syncytial virus at O The oral syndrome fl “herééngina’; and another syndromewlchgfisftéé figflggi‘lfit' and—mouth disease” are both caused By the same human virus. and these viral, diseases Warmmnssg“amtngfaisf.sumsssr‘sndjéssiy7ran. ,What is this Virus? ' coxsackie A virus . Epstein—Barr Virus (EBV) adenovirus type 3 herpes simplex virus-1 parvovirus B19 human papillomavirus type 1 (HPVd) 'TUP'JPO All of the following characteristics EXCEPT one are important risk factors for mc“reas“de mo‘“r‘l“)"d‘1 i’t‘y‘ and/6r morta ity-wait "Tiff Iu63%infifififEcfionfwafid‘Wofild time “immunization with the infiqsnexacsines Which.Phergéistisficistil? s’O‘fhat ’ individfials. with thiacharastsristic 31,929 w0u1d. 1191,2999 the list‘éf fié‘fédfis for whom immunization (is strorf recommended. ‘2‘ «A m~~~s .~ mu," _ , ’J” Y * _ “may Mnan ., D‘JIWW7.\;A“V A 265 years—of—age V B residents of nursing homes & chronic care facilities M” a pregnant females aged 18 to 30 ’L f D. adults & children with chronic cardiopulmonary disease r/ E. persons w1th profound immunodefiCIency or immunosuppression /" 25. 26. ('2'? 17 This infectious agent was previously 0 e of the major causes of meningiwmmflin infants lWear;o£;age, but the incidence of meningitis in children of this age group has v yum-arm»: w; been significantlyflreducedfl within the last decade by“fl‘fi‘fi’fiififisfit‘tfirsxrtWitfi'i «WWW» AW a.» '4, mgwu.;...mw, Vfidwcarmw,wwfinmfiuwyk~ , «mm a a» 1444.3 «new.» an; a» i'i-Ymfiwffiv‘ ‘e‘whfl'lr highly effective vaccine against thismafgentr What is thisufivfifectious agent mumps virus Bordetella pertussis poliovirus types 1—3 Haemophilus influenzae type b varicella-zoster virus Streptococcus pneumoniae 71mm???) The major cause of the V“comrknon cold” igmaug‘uwl‘bts‘duringgany twelve month period in Louisville is: Wymavewa ,1 MWwMMJIW-mewumma‘x rhinovirus adenovirus influenza A virus herpes simplex virus type 1 parainfluenza virus coxsackie B virus rnrnposw% Which of the followin is the best description of the influenza vaccine recommended -meWimvmm-av ,. ,iw,m/w«4wwmmm=wmflm ,-J:WMMWWW§¢E $ 3; “mmulw W”; and licensed for children (£12 years-of—ggg) who are at special I'lS or serious I an“ ‘ .,_,,mmw mmmwwm Lyssa-«mew» MMJ~1Amm m-m—mmmw wagdmwaw influenza disease ? “My;me A. chemically—inactivated influenza virions subunit vaccine containing glycoprotgrns from iu_ir / C D E recombinant subunit vaccine containing frm st ‘ /«9¢W«'§Q9NMWW\E _, ,, . ' e—reassortment viruses from human .' “mum: «is: e uine inflUnrus strain WWW'W Ww’gm, —attenuated human influenza Virions ,a . vmw N’muwrrfle‘i: mam", , “cold—adapted” 1' ‘wrw-WV‘ «W‘s-u m ' mas-N». 3,193,154“ » zaw't'wi\.dbv~zfv’fl«,w Which of the(taunts/Jaamflystlaaattuseatatlsamasttltlgslyaaaflfigaté for causing “19 tastiaflssnataaaqgni,g,..mammals.me,i,ttt9rm£9,r.e the end of this, after "055ng the bridgfifith?‘FW?MX:§£§.E§EFHQ- W i A A. influenza A, H1N1 subtype influenza A, H2N2 subtype anagrams!3933739999? v“ 7 E. influenza B influenza C 29. 30. 31. A five-year-old male was examined by his pediatrician in Jefferson County last August, with the physician noting the followingsymptoms from the examination plus backgfbuna'tfi‘téffié‘iibqy fisfifoffie'adache, low- ' 3 L“ ' '“T'lifiofivfifilfwtli’emm hobla atisnilert‘ re . W ” acterial etio ogy, she say; .myswm» _ e?5llowmg is the maim7fim v AVA ;v>‘.:$W&MbRaa—‘M&<w>€twaak physician/briefly considered a lumbar putur to ‘ “'erwwr' «a 'atwywwwfi fi'Mdaszmsavs 3-;€«v€e"*4“xi~. w (lei-391% that-4111.8 elimsalrtsxséwme ha ital 6&9!“ng most likely tviralrcause, ( A. herpes simplex virus type 1 or type 2 . eastern or western equine encephalitis virus C. F. adenovirus types 3 & 7 lymphocytic choriomeningitis virus Four of the following five human viruses are im ortant causes of congenital or fetal _ I i _ , , 5 . _ ., r, infections 1n non—immune_females who 9; ected durin regnancy, w ereas one echovirus or coxsackie virus measles virus or varicella virus —;w~»—vw'»-KWWWCT¢WHW‘64MWW. ~ : a:oa»~éa;.ra»w3=reamwu firm) 'MAWW. .uaawwm virus is ver important infltransmission the birth process when a non-immune “’“WW‘IWNM thmfl‘wmmwmmmwrfibfié . V , wwwfivmr mm‘mww 3 ,J P ‘ ~ v v Ti mother is infected very lateuin pregnancy, ut rare cause I a the fetus earlieggrimtligwprggiigpcy. Which one Of the “idllOerng’s ’ y q w .iwm.l5wwmrmx m-Wm important in neonatal transmission, but relatively unimportant in congenital transmission ‘ WWHM'WW >wwwmmwwmww‘mw w mm ‘ WWW herpes simplex virus type - 2 y rubella virus parvovirus 819 human immunodeficiency virus — l C D E cytomegalovirus A previously healthy 28—year—oldgale was brought to the emergency room of Baptist East Hospital by his wife on a Friday evenmg 1n Fefiruary of TWYfi‘ipTofifsbf lethargy and confusion folfouwfiingg tlfiaumplaifitflmwbifd‘hfificfie that 5 Egan that ‘ mornigggmlhwefiphysicianmowgvggywinflediafél?’ suspé’E‘i‘egfi‘ a viral elio‘l‘dmwa'df’this‘CNS disease, angmbwggavanV thera yflflth an anti-vita age??? ' Wliwli of the followmg is the . . . l N” «H'WW‘WWW$W*"”W"“.""?W*rmw. Wm most appropriate anti—Viral agent formtvhewmost likely Vll'al etiology‘.s “(x—yWuWJ-m» v r -. 4951wa >,7 arr-mssszwmw manwmawpvm smmwfl1w'Aw’anu-QW r...” ,._ . amantadine ribavirin t»? ganciclovir >" ritanovir (anti-protease) ~’ ® acyclovir B. C D E F recombinant interferon-oz 9- 32. 33. 34. I. /’”’dg\ Thei’rotavira , aggLnes that have been clinically tested foref cacy inyyoungmchildren and ma soon the FDA as art of nomial c 1 dhood immunization are: Wme WflwaWV-mv ah‘gmusz mam. .mm “V‘Wwfl’mnlrm l’hwwuwi smkflymmvw my} a m,dh‘fmfi*m.«apw a live-recombinant vaccinia viruses expressing human rotaviral genes nary-A «MM momma“ > ‘ >~«'mnw’x..4yz u~rxv~v;m/¢A,xu:,h1fik;¢umw1%«m live—reassortment rotaviruses withfgfenegsegments from amm l & human a .mg‘wvmwrru am, a: .. afl‘maan». aw.“ «mun-.m‘ mum Jam mum sawmml ML. d!\M;V'A_)... ._. “any W mymwmmmn‘mm— C. whole—inactivatedrotaviral particlesmfrom huufimpanstrains of rotavirus D. subtly!t.Ysgcissapsntaiui9g 9995151 .proftéins purifiédjffl. " {QtaviruSes V E. recom.b.i.nant§uizsnit Vaccines.sontaiguasspsis.prstéinssisprsssed from human totaflralgenes, in rccumbinant yeast ” " F. synthetic rotaviral .Vcapsig peptides coupled. to bacterial toxoids, with the peptide sequences derived from human rotaviral strains F.0_1._........glowin ...§ll£.£§.:§lflm.gef 9:130:91?strain.9f.fil291a.,}flm§ .19 the humanpoiiuhtion _ s sundertaken in Kitwit, laire, and the surrounding area to. identify the natural reservoir host'foF'this in the spring ofwl99‘5‘hthyerewyyere extensive epidemiologic “WWW? nW-ma—wfiws” \~ H ,M- w). 2 v renew: ems s», «am: r; 1w}: w or» . 9‘ “Wm -r i “a rm, fly ( «New: *fiflaivdwm mm: ;. Ma. ‘v’ia‘g’t'v? 1.. c. thxsutam A; fox» a e. m» In virus. the results of these studies, the natural reservoir _of Ebola— Wmmmnmuw...wmm.“mm..n.,ew.W-,;:-mv.~aw,wmagmas-ems.mmwm.myMR MM ‘ie>r«-ama~.m~u A. a rodent B. a non-human primate C. a bird * D. an insect a reptile unknown, with none of the above (A—E) confirmed as the host -w,__..~..w...,.w.., _ in ,Mnmuwu. . as." 1995 because of serious inflammation of the myocar turn and destruction ofpwcagdiac Wmmmmmmwfl‘wm rw‘umm - ~ A five—yeasold boy was admitted to a large urban pWital inSeptember of ’flwfiwmxwwfiw .ifmnwnfimuv-cxmcmwwAM-nsu we was tissue, resultin in ermanent‘c‘érdiac“dairi‘aéewthat re utred a hea‘, anuthree a q . MW... 4 ‘ "W‘WIW vawwawwuvwwghw» vikfiggfiqmumgfim‘cwficfig)”; 9; y» «mew-wag w ‘ weelgsafterhis initial hospital admission What is the most likely viral etiology for this Child’sedggfiggv. a amnu be .. A. herpes simplex virus type 1 B. mumps virus C. varicella—zoster virus D. human herpesvirus—6 adenovirus type 6 coxsackie B virus at? m—.¢.nwur«abw»«n, ~ “4- t. VA .a Wen/anuwwuwm - t. 4,; femaleuinwh‘is office, with/the“ worried parent‘s’statingflthat the previouslykhealthy child ‘ ur‘puw‘w‘w/flnrw4 -, at, its.“ "¥Va(‘y. , Leg-mammarg». A 35- [flingififilwwrefikcgf Octoberrarloglrpediatdcian in Louisvillateralsinedtartléflwth Old hada«Lilzarlgingfitqough andacemedtabecharifigfi‘éfiblé bréathing- Th9PFQiQEIiCian had seen a number of similar‘cases in the'prggeding“twohweeksrinvfifvfingv children from iw'fimwj .i “K, V, t , '. v r r» ~ «w- r »' .7 r ,., ,V ,. «1., . -, , v’r.~',>c:"“um,».a'v§4éx§€"«: v 6 months t 5 years of age who had a constriction of the airway and the characteristic “Kmnhm—Um «A _» :21. «Wm: .-~v n < > r » r , mnmmwawsucm’uwem'rave-czmwfw “m wr’rswt-mxrwr ,‘u' m» r k ,:,..‘ _. 1’ " i; I , h in» cough, and dorreetiy' diagnosed this classical clinical syndromeas: A. pharyngoconjunctival fever due to enterovirus infection B gingivostomatitis due to primary herpes simplex virus infection broncheopneumonia due to respiratory syncytial virus infection / A liEXE§9EE§SE?9bE9PShitiS due F9Parajflflueazaxiw191799?“ . vesrcular pharyngitis due to rhinovirus infection F. bronchiolitis acquired from influenza immunization in the previous week 36. An 8—month-olth difficulty in breathing was taken to an urban’pediatric hibiiiita m ' armmaraaar mittea iié‘i‘ to the hos ital was i eumonia. 1s“ifi'r§”fit’sierra???“"fiatanie was Similar'to that of h p_ ,5 1k? ’“F‘m‘fiwfiwwmmbwwmw‘> “W? a mp imam“; VHJ. h... L x «We: JHWULJ WNW, r Mm L y ‘ over ‘56 other infants admiftéawib e hospital du ing the previous two weeks“. ythWLAWL’er-fix‘hhv”ni 1‘35??? rammmmmwvmm w :rtwurapr u nuwrwfl‘ MM, Where isthis hospitalml‘ocated ? Miami, Florida A. Louisville, Kentucky Paris, France /, B. C. D Los Angeles, California (ED Melbourne, Australia! F. London, United Kingdom 37. For which of the follow'ng individuals in Kentucky or Indiana would a prescription of Oralifiifiamaéiner andst,anmadden.fififfiifiifijfififififififl' -7 @ premature infant with serious bronchiopneumonia who has received no ‘He:mmm‘arWE'-Ws~tmmwlmmmwrm mm.««.m~mxww v ‘ “mam-“WNW”, K My «is.an vaccinations since birth except first dose of hepatitis‘B” , flame-mama nuwmmn-fimmmks i r'wnWm'W. , K...” . . W B. X 86-year-old resrdent of nursmg home who was notVaccmated in past 6 r \ a, a irwwlqw-m an,“ mm'.vM»«~€| nanrwwamwmi . W , r2 :.s..w»r\-M.“r ‘WT‘E‘KV‘MwmuW-rzlw-nmum ‘Lvt'wo‘um—n we. Min-w 4m“... (Maw. . Maw“, m4 , has now developed several esrcula lesi ~nwxawzzmmx v ~ 7 W’V“!th<»x..<./rsn».‘u nah, .a Qéirwthe,_S,i7i€_of,iaéfiflmffé‘fi >o~1~ . _ momma \x C. X 26—yearzoldmfeaiajwe who received a varigella vaccine two weeks ago & D an adoleamatrwithtpharyngitisérrtqasillitiS rrmvmraw E. ‘ a previouslyflhe‘althy, Zuear-old'medical student with‘fever, chills: sore rthz u» x-WW we ruin-vac mwmwi x w throat & myalgia - \ .M,i;cc-m:MLwWe.Wm. on r. r “and”; Wm“.- M '10 38. 39. 40. Vaccination, a procedure that was introduced b Edward Jennerz wasunthe major www.mfimAfw-t .3. contribution to the birth of immunologvand to the eradication of smallpox. This H. 1...;‘.»\a4w .mn-smerzmma-urmmw “(Mtthxhfliic’itae Vishnu . nun/MM ,3. Wimmwmn“'“'Mfi'~‘fimgs,‘zr§ awrkwm-«pa,mawmmwvr ' . . . . . . . procedure resppnsrficlemfrgr "complications in immunocomprorniseg individualsuang if vaccinati iswdggl’ won‘a lair. e scale in’t‘hé futd’féj‘iiien it will be either“ an attenuated Waawsrwwwvf * H was.“ strain of vaccinia (MYA) gr canarypgztnvirus. Wflgnggwggme followinngg‘agugg a alybrM‘l mm a. 1:: ~ 5: w M complication of vaccination with vaccinia in immunocom romised individuals and {an Maw.w arm-"umr' .w “a.” .wwwmu, “Wmmwwma...
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