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Dorothy P. Debbie
Senior Lecturer
Department of Microbiology and Immunology
Cornell University College of Veterinary Medicine
A Shot in the Arm or a Hard Pill to Swallow?: Comparing Vaccine Formulations

The immune response to a vaccine is influenced by the nature of the vaccine and the delivery method. In this interrupted case study, students traveling to a typhoid fever endemic area must decide which of two typhoid fever vaccine formulations would be most appropriate for them. One vaccine, which is given by injection, consists of a subunit of the bacterium that causes typhoid fever, Salmonella Typhi, whereas the other consists of live, attenuated bacteria taken by ingesting a pill. The students apply basic immunology concepts to understand how different vaccine formulations lead to different immune responses. Using this knowledge and information about the disadvantages of each vaccine type, students discuss which vaccine would be best for different populations. The case was designed for an upper level undergraduate microbiology course but could also be used as a unit in a basic biology course or courses for pre-medical or pre-nursing students to provide basic information on how vaccines work.

Danielle's Difficulty: Risks, Treatments, and Prevention of Clostridium difficile

The incidence of Clostridium difficile infection (CDI), including severe infection, has increased in both institutional settings and the general community. This case study presents the story of an elderly woman who spent time in a hospital and then in a rehab center after she injured herself in a fall. The woman subsequently developed acute gastrointestinal tract symptoms and was readmitted to the hospital, where she eventually succumbed to sepsis due to CDI.  Her granddaughter Danielle subsequently developed CDI. Students are asked to discuss the risk factors for development of CDI and to consider options for treatment and prevention. The role of C. difficile toxins in the development of disease as well as its transmission and recurrence also are covered. The case was designed for an upper level undergraduate microbiology course, but could also be used for pre-medical or pre-nursing students or a medical microbiology or infectious disease course for pharmacy, medical or nursing students.