Subject:- Community
Health Nursing
Topic:- Immunity
PRESENTED BY,
MR. KAILASH NAGAR
ASSIST. PROF.
DEPT. OF COMMUNITY HEALTH NSG.
DINSHA PATEL COLLEGE OF NURSING, NADIAD
Definition
Types of immunity
Innate immunity
Acquired immunity
Local immunity
Herd immunity
State or quality of being immune.
Resistance exhibited by the host against any foreign
antigen and towards injury caused by
microorganisms and their products.
2 types
Innate or Native
Immunity
Acquired or
Adaptive
Immunity
Immunity
Innate Acquired
Immunity Immunity
Non
Specific
Active Passive
Specific
Artificial:
Natural Vaccines
•Contact •Killed Natural Artificial
with •Attenuated •Placenta •Immune
disease •Toxoid •mother’s serum
•Recombinant milk
DNA
E.g.rubella,mum
Resistance possessed by
an individual by birth i.e.
inherited.
Provides first line of
defense against infections.
3
3 levels
levels:
Species Racial Individual
immunity immunity immunity
Age
Hormones
Nutrition
AGE:
•Foetus or new born and old persons
(2 extremes of life) carry higher
susceptibility to various infections.
•In foetus,immune system is
immature where as in old age there is
gradual waning of immune
responses.
•In some diseases,clinical illness is
more severe in adults than in young
children due to more active immune
response which causes greater tissue
damage.e.g: chicken pox and
poliomyelitis.
HORMONES:
• Certain disorders enhance succeptibility
infections.e.g:-
hormonal diabetes mellitus,adrenal to dysfunctions
hypothyroidism and
•Staphylococcal sepsis is more common in diabetes ,which may
be caused by increased level of carbohydrates in tissues
•Corticosteroids depress host resistance by its
antiinflammatory,antiphagocytic effects and by inhibiting
antibody formation.
Nutriti
on:
•Both humoral and cell mediated
immunity are reduced in
malnutrition
•In Kwashiorker (severe protein
defficiency),cell mediated immune
response reduces.
Epithelial surfaces
Antibacterial
substances
Cellular factors
Inflammation
Fever
Acute phase proteins
1. Epithelial
surfaces:
Skin:
provides mechanical barrier to microorganisms
provides bactericidal secretions
the resident bacterial flora of skin and mucous
surfaces prevent colonization by pathogen
alteration of normal flora may lead to invasion by
extraneous microbes and cause serious
diseases.e.g,clostridial enterocolitis following oral
antibiotics.
Respiratory
tract:
• respiratory tract is lined by moist musous surfaces
which act as trapping mechanism.
• inhaled particles are arrested in nasal passage on
moist mucous membrane surfaces.
• the hair like cilia propels the particles towards
pharynx and are swallowed or coughed out.
• some particles which manage to reach alveoli are
ingested by phagocytes
Intestinal tract:
•saliva present in mouth inhibits many microorganisms.
•acidic ph of gastric juices destroys the swallowed bacteria if
any.
• normal flora of intestine prevent colonization of pathogens.
Conjunctiva:
•Tears flush away bacteria and other dust particles
• lysozyme present in tears has bactericidal action.
Genitourinary tract:
Urine eliminate bacteria from urethra by its flushing
action.
Acidic ph of vaginal secretion of female due to
fermentation of glycogen by lactobacilus makes vagina
free from microorganisms.
In males, semen is believed to have some antibacterial
substance.
2.Antibacterial substances in blood and
tissues:
There are no. of antibacterial substances present in blood and tissues
Beta lysin: relatively thermostable substance active against anthrax
and
related bacilli.
Basic Polypeptide: e.g., leukins and plakins
Acidic substances:lactic acid present in tissue and infected area
Interferon : protects against certain acute and viral infections.
3. Cellular
factors:
Once the infective agent cross the epithelial
barriers,tissue factors come into play for defense.
Process:
Deposition of
fibrin that Phagocytic
Accumulation entangles the
Invasion of cells ingest
of
tissues by these
phagocytes organisms(act
infective agent organisms and
in site of as barrier to destroy them.
infection spread of
infection)
4.Inflammation:
An important non-specific defense mechanism
Occurs as a result of tissue injury, initiated by entry of
pathogens.
Leads to vasodilation,increased vascular permeability and
cellular infiltration
Due to increased vascular permeability, plasma pours out and
dilutes the toxic products present.
Fibrin barrier is laid to wall off the site of infection
5.Fe
ver:
Rise in temperature following infection is natural
defense mechanism.
Destroys the infecting organism
Stimulates the production of interferon, which help in
recovery from viral infections
.
6. Acute phase proteins: after injury ,there is sudden
increase or decrease in plasma concentration of certain
proteins, collectively called Acute phase proteins
E.g. C reactive protein (CRP),Mannose
binding proteins etc.
They activate the alternative pathway of complement
Prevent tissue injury and promote repair of
inflammatory lesions
• The resistance acquired by an individual during life by recognizing
and selectively eliminating specific foreign molecules.
• Provides second line of defense against infection.
Antigen specificity: immune system or antibodies can
distinguish among antigens, even between two
proteins that differ in only one amino acid.
Diversity: immune system is capable of generating large
antibody diversity in its recognition molecules.
Immunologic memory: immune system exhibits memory
on second encounter of same antigen by generating a
secondary response which is more specific m quick.
Self/non-self recognition: does not react with body’s own
molecule but effectively eliminates foreign antigens.
Active acquired
immunity Acquired
active passive
Passive acquired
immunity
immunity Natural
Natural active
passive
immunity
immunity
Artificial
Artificial active
passive
immunity
immunity
Active immunity:
• also known as adaptive immunity
• Resistance developed by an individual as a
result of an antigenic stimulus
• Used for prophylaxis to increase body resistance
• 2 types: • natural active immunity
• artificial active immunity
Passive
immunity:
Resistance transmitted passively to a receipent in a
readymade form.(receipent’s immune system
plays no active role)
Used for treatment of acute infection
2 types: : • natural passive immunity
• artificial passive immunity
Active Immunity Passive Immunity
Produced actively by host’s immune Received passively,no active participation
system of host’s immune system
Induced by infection or by immunogens Conferred by administration of readymade
antibodies
Long-lasting & effective protection Short-term & less effective protection
Immunity effective only after lag Immediate immunity
period(time required for generation
of antibodies.)
Immunological memory present No memory
Booster effect on subsequent dose Subsequent dose less effective
Negative phase may occur No negative phase
Not applicable in immunodefficient, Applicable in immunodefficient
Natural active immunity:
Results from either a clinical or an inapparent infection by
a microbe.
Usually long lasting
E.g., person recovering from chicken pox and measles
develop
natural active immunity.
* premunition: “special type of immunity seen in syphilis”.
immunity to the re-infection lasts only as long as the
original infection remains active.(once the disease is cured
the
patient becomes susceptible to the spirochetes again)
Artificial active Immunity:
Resistance induced by vaccination.
Vaccines: preparations of live or killed microorganisms and
their products (antigens or toxoids)
bacterial vaccines: live or attenuated- BCG for
tuberculosis
killed- Cholera vaccine
Subunit- Typhoid Vi antigen
Bacterial products- Tetanus
toxoids
Viral Vaccines: live or attenuated-oral polio
vacine-Sabin
killed-injectable polio vaccine-Salk
Subunit-Hepatitis B Vaccine
Natural
passive
Immunity
Resistance passively
: mother to
transferred from
foetus or infant, through
placenta(transplacentally) and
through milk(colostrum).
Artificial passive immunity:
resistance passively transferred to a recipient
by administration of antibodies.
Agents used: • hyperimmune sera of animal
• convalescent sera
• pooled human gamma globulin
“These are used for prophylaxis and
therapy”.
Combined immunization:
combination of active and passive method of immunization
Whenever passive immunization is employed for immediate
protection, combined immunization is preferred
E.g. protection of non-immune individual with a tetanus
prone wound i.e., injection of TIG in one arm and first dose
of tetanus toxoid in other arm followed by full course of
phased tetanus toxoid injections.
“TIG provided the protection necessary till active
immunity is able to take effect”
Natural infection or live vaccine administered orally or
intranasally provides local immunity at site of entry such
as
:gut mucosa,nasal mucosa
IgA plays important role in local immunity.
Overall level of immunity in a community
Is relevant in control of epidemic diseases
“Eradication of communicable diseases depends on the
development of high level of herd immunity rather than
on development of high level of immunity in individuals”
