Protocol

A vaccine will be created and distributed to persons at highest risk of contracting this

emerging deadly disease.

INTRODUCTION

This emerging deadly disease is causing brain abscesses in patients that contract it. In

order to create a drug to combat the symptoms of the disease, it would take years of

research and money that we, the research team, do not have. On average it takes 12 years

for a drug to make its way from the research lab to the patient (CBRA). Creating a cure is

not an effective way to combat this disease. The only way to protect citizens is disease

prevention. This can be done in multiple ways, such as preventing transmission by

breaking up the transmission cycle by eliminating one of the links that keeps the cycle

going. In order for a pathogen to persist it must be able to exit an infected host, survive

the environment during transmission, enter a new host, and multiply in the new host

(Goddard 2012). The two points in the transmission cycle that could possibly be targeted

is the vector and the reservoir. The vector is Ixodes pacificus, or commonly known as the

black legged tick (CAPC 2015). The elimination of this species of tick would take years

in order to complete because it is found in 90 counties in five different western states

(Dennis, Nekomomoto, Victor, Paul, and Piesman 1998). This widespread dispersion

prevents this target of control from being a feasible prevention technique. The next point

in the cycle that could be targeted is the reservoir. The reservoir is Aphelocoma

californica, or the western scrub jay. This Avian species can be found along the western

part of North America (Curry 2002). The widespread dispersion of the species would

make the task of elimination difficult, costly, and time consuming. This would not be an

efficient initial protocol for prevention of the disease. The only way to combat the disease

efficiently and effectively would be to create a vaccine that protects against the bacterial

agent, Lactococcus jimmi, and distribute the vaccine first to those at highest risk of

contracting the disease.

The main goal in the production and distribution of the vaccine is affordability. Keeping

costs down will give more people access to the vaccine and create a broader range of

coverage. A broad range of coverage is of utmost importance when dealing with this

emerging deadly disease because of the wide distribution of both the vector and reservoir.

Stopping the transmission cycle before it gets started will allow the disease to become

obsolete. The protocol given will provide the steps needed in order to obtain this goal.

PROTOCOL

Steps

1. Creation of Vaccine

The bacterial pathogen that is responsible for this emerging deadly disease is L.

jimmi. Vaccines that guard against bacterial pathogens are made in a number of

ways, such as identifying the bacterial toxin and making a toxoid, using the

polysaccharide of the bacteria, or using two or more proteins from the bacteria

(Children’s Hospital of Philadelphia). Any of the previous three routes of making

a vaccine would work in the production of the vaccine. In order to proceed

efficiently we have decided to utilize the polysaccharide coating in order to create

the vaccine. Polysaccharides and proteins add to the complex arrangement of the

peptidoglycan layer of gram-positive bacteria (Charpot-Chartier and Kulakauskas

2014). There are three groups of polysaccharides: exopolysaccharides, capsular

polysaccharides, and cell wall polysaccharides. Capsular polysaccharides form a

shield around the bacterium. Targeting these polysaccharides specifically in the

creation of our vaccine will allow us to disrupt the bacterium’s defenses and allow

phagocytosis to occur (Bentley, Aanensen, Mavroidi, Saunders, Rabbinowitsch,

Collins, Donhoe, Harris, Murphy, Quail, Samuel, Skovsted, Kaltoft, Barrell,

Reeves, Parkhill, and Spraft 2006).

2. Distribution of Vaccine

Distribution of the vaccine will be based off of three things: age distribution,

geographic location of residence, and lifestyle.

Age Distribution: The age distribution for vaccination is mainly 21 years of age to

70 years of age with mild precautions for those above 70 years of age. In other

words children are not our main focus in the distribution of the vaccine. This

information is based off the age distribution of patients that have been reported as

having contracted the disease.

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Age Distribution of Patients

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Geographic Location of Residence: The vaccine will be distributed to those who

reside along the Pacific coast in the Western United States. The states included in

this description are Washington, Oregon, and California. The major counties of

concern are San Luis Obispo County, Humboldt County, San Francisco County,

Los Angeles County, and Santa Barbara County in California and Thurston

County in Washington. These counties were identified as the western scrub jay’s

hotspots.

Lifestyle: The vaccine will be distributed to individuals who have an occupation

or hobby that places them in areas where the vector, I. pacificus can be found.

This includes forested or brushy areas, north coastal scrub, and open grasslands

(Slowik and Lane 2001). An example of an occupation that increases the

likelihood of contracting the disease is farming. Hobbies include jogging, bird

watching, and hiking.

Individuals of highest concern are those that fit all three of the previously listed

criteria: 21 to 70 years of age, live in Thurston, San Louis Obispo, Humboldt, San

Francisco, Los Angeles, or Santa Barbara County, and partake in outdoor

lifestyles.

Materials and Methods

Materials: There are approximately 5,255,112 individuals living in the hotspot counties

of Thurston, San Louis Obispo, Humboldt, San Francisco, Los Angeles, and Santa

Barbara (US Census Bureau). The percent of people in these counties that are in the age

range from 21 to 70 is approximately 64% (Wikipedia). The percent of people in the

United States that participate in some form of outdoors activity is 49.4% (The Outdoor

Foundation 2013). The total number of single dose vaccine vials needed is approximately

1,700,000. This number is based off the total population in the hotspot counties

(5,255,112) times the percent of people that fall in the required age group (64%) times

the percent of people who participate in some form of outdoor recreation (49.4%). The

same number (1,700,000) of 3 mL 1.5 inch needle syringes will be needed.

Methods: The vaccine will be created using the polysaccharide coating as the basis of the

vaccination. The vials will then be filled with the vaccine and distributed. Distribution

will take place at local clinics and hospitals in the six major counties: San Luis Obispo

County, Humboldt County, San Francisco County, Los Angeles County, and Santa

Barbara County in California and Thurston County in Washington. Television

commercials, radio announcements, and flyers will be used to spread the word about the

impeding threat of the emerging deadly disease and the vaccine as a solution. The

vaccine will be distributed in three phases. Phase one will distribute vaccines to only the

individuals who meet the criteria: 21 to 70 years of age, live in Thurston, San Louis

Obispo, Humboldt, San Francisco, Los Angeles, or Santa Barbara County, and partake in

outdoor lifestyles. Phase one will last approximately one week then phase two will begin.

Phase two will distribute vaccinations people of all ages living in the six major counties

and partaking in outdoor lifestyles. Phase two will last approximately one week then

phase three will begin. Phase three will allow anyone, regardless of age, geographic

location, and lifestyle, to obtain the vaccination.

Phase 121 to 70 years of age, live in Thurston, San Louis Obispo, Humboldt, San Francisco,

Los Angeles, or Santa Barbara County, and partake in outdoor lifestyles

Phase 2 People of all ages living in the six major counties and partaking in outdoor lifestyles

Phase 3 Anyone (regardless of age, geographic location, and lifestyle)

CONCLUSION

The most plausible way to protect humans from the bacteria L. jimmi, is by creating a

vaccine that will break the cycle between the bacterial agent L. jimmi and humans.

Vaccinations will boost the patient’s immune system by creating a set of antibodies that

recognize the polysaccharide coat of L. jimmi. 

The vaccination will be distributed primarily in locations where the reservoir, the western

scrub jay resides, in the western portion of the United States, along the pacific coast. L.

jimmi are able to complete their life cycle and increase their numbers inside the western

scrub jay. Where ever the western scrub jay goes the increased risk of exposure to L.

jimmi also increases. Sending vaccinations to locations where the western scrub

jay primarily resides will decrease the rate of infection amongst individuals who reside in

the same geographical area. 

People who are urged to receive the vaccine are those who primarily spend their time

outdoors in areas where they can be exposed to the vector I. pacificus. I. pacificus passes

on L. jimmi to humans when they are in the process of completing their blood meal. Since

individuals will be vaccinated and have a set of antibodies against the bacteria, they will

not have to be weary when they are outdoors working or just enjoying the day outdoors. 

According to the U.S Department of Health and Human Services, we can ensure that our

vaccine has been successful by performing an antibody test. However, this can be

expensive to test every patient who has received the vaccine (U.S. Department of Health

and Human Services). Instead, we will have hospitals report new cases of our disease. If

any new case develops in someone that has been previously vaccinated an antibody test

will be run.

If the steps are followed precisely, as defined in the protocol, then we should be able to

eliminate the possibility of infection of L. jimmi. Therefore stopping the spread of this

deadly infectious disease and save lives.

REFERENCES

Bentley SD, Aanensen DM, Mavroidi A, Saunders D, Rabbinowitsch E, Collins M, Donohoe K, Harris D, Murphy L, Quail MA, Samuel G, Skovsted IC, Kaltoft MS, Barrell B, Reeves PR, Parkhill J, Spratt BG. 2006. Genetic Analysis of the Capsular Biosynthetic Locus from all 90 Pneumococcal Serotypes. PLoS Genet. 10.1371/journal.pgen.0020031. Web.

(CAPC) Companion Animal Parasite Council. 2015. Vector-Borne Diseases – Ixodes Scapularis and Ixodes Pacificus. <https://www.capcvet.org/capc-recommendations/ixodes-scapularis-and-ixodes-pacificus>.

(CBRA) California Biomedical Research Association. Fact Sheet New Drug

Development Process.

www.ca-biomed.org/pdf/media-kit/fact-sheets/CBRADrugDevelop.pdf. Web.

Chapot-Chartier, M-P and S. Kulakauskas. 2014. Cell Wall Structure and Function of

Lactic Acid Bacteria. Microb Cell Fact. 10.1186/1475-2859-13-S1-S9. Web.

Children’s Hospital of Philadelphia. Making Vaccines: How are Vaccines Made?.

http://www.chop.edu/centers-programs/vaccine-education-center/making-vaccines/how-

are-vaccines-made.

Curry, R. 2002. Western Scrub-jay: Aphelocoma californica. Phiadelphia, Pa.: Birds of North America.

Dennis, D. T., T. S. Nekomoto, J. C. Victor, W. S. Paul, and J. Piesman. 1998. Forum: Reported Distribution of Ixodes scapularis and Ixodes pacificus (Acari: Ixodidae) in the United States. J Med Entomol. 35(5):629-638. Web.

Goddard J. 2012. Public Health Entomology. 1439848823, 9781439848821.

The Outdoor Foundation. 2013. Outdoor Participation Report. www.outdoorfoundation.org/pdf/ResearchParticipation2013.pdf.

Slowik, T. J. and R. S. Lane. 2001. Nymphs of the Western Black-legged tick (Ixodes pacificus) Collected from Tree Trunks in Woodland-grass Habitat. J Vector Ecol. 26(2): 165-171.

U. S. Census Bureau. 2013. Population Estimates.

http://www.census.gov/popest/about/terms.html.

U.S. Department of Health and Human Services. The effectiveness of

immunizations. http://archive.hhs.gov/nvpo/concepts/intro6.htm.

Wikipedia. Demography of the United States.

https://en.wikipedia.org/wiki/Demography_of_the_United_States.