Introduction

We have recently received additional information about newly reported cases of Blooming
Meningitis from Beaumont and Corpus Christi, Texas as well as Miami, Florida. According to the
hospital physicians and local authorities in Beaumont, 117 infected patients were admitted to area
hospitals where they were treated in isolation, but eventually died within a week. Beaumont
doctors have said that handling cases of this disease are very difficult and time consuming
especially because patients respond poorly to medical treatment and have a low chance of survival.
Doctors also mentioned that admission to a hospital is often delayed due to the nature of the
symptoms and the novelty of the disease so getting infected almost always results in death. Miami
officials have reported that samples from 648 humans have been identified via genome analysis
and antibody testing to be infected with the new disease. All 648 people were admitted to the
hospital, but only one survived. In Corpus Christi, an infected 18-year-old male with no history of
pre-existing medical conditions, animal exposure, and contact with a suspected patient or
confirmed case has been admitted to the intensive care unit (ICU). From this new information, it
is clear to see that this disease both spreads and kills quickly and effectively. Given the extremely
deadly and infectious nature of this disease, our team has decided to focus our area of control
around the relationship between humans and the pathogen itself. Based on the observations of all
of the reported cases, particularly the patient in Corpus Christi that had no prior history of health
conditions or exposure to the pathogen, it is likely that the disease has multiple means of spreading
such as but not limited to vector to human, reservoir to human, and human to human. Considering
this and the knowledge of how poorly infected patients react to medical treatment, it is imperative
that we break the link between the pathogen and the human host. If this link is effectively broken,
then despite the number of people that come into contact with the pathogen, they should be safe
from infection. The best way to enact this sort of control is to use a vaccine. Vaccines are relatively
quick acting, long lasting, and a safe means of providing people immunity to infectious diseases.
Our lab has already begun creating this vaccine with the use of prior knowledge and data from the
creation of past meningitis vaccines and also the analysis of the tissue samples from the single
survivor of the 648 infected patients in Florida (it is possible this singular patient survived the
disease because of his/her genetics or perhaps a specific mutation that can be used to our
advantage). The following report will discuss in detail the methods and protocol of how we plan
on distributing and monitoring the effectiveness of the vaccine for this deadly disease.

Protocol, and Methods

The new developing disease identified was of a genus Proteus, a common disease-
causing group of bacterial meningitis. Bacterial meningitis can be lethal and especially effective
in infecting, invading, and causing death, especially of immune compromised people or children.
An effective way to prevent this disease is breaking the chain between the pathogen and the host
by using the method of vaccination. The following protocol analyzed important aspects and
procedures that will be followed in order to effectively distribute and prevent this arising pathogen
and disease from spread, infecting, and killing more people.
Vaccine Effectivity:
Vaccines are highly effective at being able to prevent disease from having a life-threatening
effect, due to the induction of a much stronger secondary immune response. Modern methods of
making vaccinations are created by separating and purifying microbial parts, taking genetic
information and manipulating gene expression to create intentional less infectious mutants of
microbes, vaccine protein expression, synthesis of microbial antigens, and other manipulations of
expression for RNA and proteins other than DNA (Plotkin 2005). Vaccines do not only prevent
disease from affecting an individual, but also prevent the spread from person to person. In a 2005
study, experimenters studied the efficiency of influenza vaccines over 14 randomly controlled
trials and found 79% efficacy and 38% effectiveness (Isaacs and McIntyre). H. influenzae, a
bacteria causing a meningitis disease, has been nearly eliminated by case since the introduction of
a vaccine, facing 90% reductions for serotypes that have vaccine availability (McIntyre et al.
2012). Vaccinations also take many factors into consideration to most effectively, and continually
improve, immunity for each individual. Types of vaccine most preferred for a particular pathogen
must be decided based on epidemiology factors. Combined vaccines, although relatively
marketable and cheaper, can lead to a lowered strength in immune response due to not as many
antibodies being produced. This means that vaccinations for particular diseases need to be
carefully observed for the most effective boosters when combined with other vaccines in order to
maintain the immunity that the vaccination provides for each disease. Price is also a major factor
in the effectivity of the vaccine. Price of vaccinations can hinder the effectivity of a vaccine as the
lower availability translates to lower immunity among the community, and highly effective
vaccines must have sufficient quality and availability in order to be implemented successfully to
stop the disease completely (Makwana and Riordan 2007). In addition, conjugate vaccinations for
various types of bacterial meningitis of Haemophilus influenzae type b, Neisseria meningitidis
group C and seven serotypes of Streptococcus pneumoniae have been proven effective in
preventing or controlling epidemics in Africa, New Zealand, and the United States. As more
serotypes prove to be pathogens of disease, these vaccinations will need to cover a broader scope
of disease, including the newly emerging disease analyzed in this paper, however this provides a
framework of effectivity and proves how successful vaccinations are at stopping epidemics
(Riordan 2010). These factors of effectivity were used to optimize the success of the creation of
the vaccine for this new emerging disease, and also best concludes that using a vaccination, when
all factors were considered of breaking pathways of the pathogen, is an extremely effective way
of stopping the emerging disease.

Disadvantages to Vaccines and Solutions:

The downsides of vaccinations and problems associated were analyzed in order to come
up with creative solutions to improve the effectivity of the vaccine and inclusivity of the immunity
among larger groups of people. The first considerable downside included the problems associated
with bacterial vaccines inability to protect infants. Observations of vaccines for bacterial diseases
have been analyzed, proven to not be ineffective in immune defense for children under the age of
two years old, which are greatest at risk to infection. This is due to the immaturity of their natural
immune system. Bacterial meningitis has an increase infectability and mortality in younger
children due to the immaturity of their immune response to these invading pathogens. Vaccinations
allow T cells to obtain a memory response to presented antigens of the pathogen in order to provide
immune protection, yet this is lacking in young infants. Specifically, this lack of a sufficient
response in infants is due to a lack of maturation of B lymphocytes unique to the response required
for bacterial invaders, and an imbalanced regulation of T lymphocytes. Vaccinations for S.
pneumoniae, H.influenzae, and N. meningitidis attempted to provide protection for younger
infants, however this notable immaturity has misguided the analysis of these vaccines which are
ineffective for young infants to obtain this immunity, and further research is required to guarantee
immunity for young infants regarding these bacterial vaccinations. (Makwana and Riordan 2007).
Another problem arises for immunocompromised people who are unable to be given the
vaccine to obtain immunity. For immunocompromised patients, the idea of herd immunity is
extremely important in the defense of pathogens. If a majority of people in a community have the
resistance by vaccinations, the exposure of disease of dangerous pathogens to
immunocompromised people can be drastically reduced. This is a way of defense when
immunocompromised people are unable to obtain vaccinations for themselves due to negative
reactions or illness. However, a growing negligence in the United States for routine vaccinations
threatens the immunity of people to many diseases, but especially affects the
immunocompromised. Close-contact transmission grows as a less percentage of a community
decides to vaccinate against a particular pathogen and disease, risking the lives of people with
impaired immunity. General education about immunocompromised people and a greater effort to
educate about at-risk people by decreased herd immunity can further increase the concern and push
for mass vaccination to protect all people, especially the immunocompromised, from coming in
contact with the disease (Shearer et al. 2014).
To solve the problem of lack of immunity for infants and immunocompromised people,
herd immunity is the main solution. Haemophilus influenzae type b, known as Hib, was a vaccine
that drastically reduced the cases of diseases of Hib. This not only functioned by putting up a
strong immune response, but reduced the transmission of pathogens therefore increasing herd
immunity (Makwana and Riordan 2007). This proves the effectivity of herd immunity and the push
to change the public negligence toward routine vaccinations can counter the disadvantages.
Advertisements and education within workplaces, schools, and in public areas of the community
as well as requirements under law for vaccinations and protection of infants and
immunocompromised people can counter the disadvantages of routine vaccine negligence.
. The final problem to consider is the instability of the vaccination. Bacterial vaccines can
be affected by instability which would affect the functionality of the vaccine for memory
immunity. Vaccines like pertussis, cholera, and typhoid show stability as these vaccinations are
generally killed cell bacteria vaccines. Live bacterium vaccinations can lose effectiveness overtime
by environmental conditions associated to the exposure of UV light or thermal conditions. Other
factors of refrigeration storage of some vaccines can degrade the effectiveness of the vaccine
without a stabilizing agent. Other vaccinations like Hib conjugate vaccines, an example of bacterial
meningococcal vaccines, need to be stored in freezer conditions because in the liquid state the
vaccines can degrade by hydrolysis reactions. Vaccinations combined with others can often face
stability issues due to various components interacting in a liquid state, and are better stabilized in
freezer conditions. Other problems of stability can arise by general degradation over extended
periods of time and mutations on plasmid of bacteria DNA, generally to impair the infectability of
the pathogen, that could undergo genetic deletion or other manipulations (Corbel 1996). All these
factors were considered to minimize the problems faced by vaccine instability when making the
vaccine, and similar conditions used for other bacterial meningococcal vaccines in freezer
conditions were implemented.
Methods:
The process of making the bacterial meningococcal vaccine for this arising pathogen of
genus Proteus didn’t take as much time to produce and prepare for mass distribution because
vaccines for meningitis had already been developed prior. MPSV4, MCV4, and Serogroup B
meningococcal vaccine all targeted the different receptors on the bacteria itself (Brennan 2019).
The new vaccine was made using a patented method called the liquid Hib component which is a
method to reconstitute lyophilized meningococcal component resulting in a vaccine that is a
combination of two different vaccines. By using this method different components of meningitis
bacteria can be targeted at the same time. The main reason this vaccine was effective was because
using the new Liquid Hib component allowed for a vaccine that targeted multiple weak points in
meningitis. This allows the immune response to recognize those weak points and if exposed to the
real thing, the immune system would have a much stronger and more effective mode of attack.
The X-men vaccine works by an exposure of a live attenuated version of meningitis. This effort
was funded with the help of the Bill and Melinda Gates Foundation, CDC, The EVA and PATH
(Aguado et al. 2015). With the funding of these agencies a Vaccine for this new bacterial
meningitis was manufactured in laboratories around the nation and sent to hospitals, schools and
affected areas around the world (Aguado et al. 2015). Since the whole process from research to
manufacturing to delivery was heavily subsidized the cost per dose ranged from $0.35-$1.35
(Aguado et al. 2015). The new vaccine is called X-men, and developing the X-men vaccine
required 100 million dollars. It was completed in just a couple of months.
After the development of an effective vaccine, responsibilities for manufacturing
and distributing the vaccination to different regions considered high risk for the illness must be
designated. Introducing the vaccine to the population will require various services to ensure the
delivery and storage of vaccines. To address meeting demands for vaccines, health authorities and
government officials must work together to deploy vaccination services effectively. Distributing
the vaccines requires a cold chain infrastructure with monitoring and tracking to permit shipping
from vaccine manufacturers to immunization centers. Warehousing of the vaccine must also meet
strict regulatory requirements to prevent the degradation of the medication. This warehouse must
protect against unauthorized pests or environmental hazards, maintain a temperature of 2-8 °C,
and be operated by appropriately trained employees (Hessel 2009). To establish prepared
administration centers, materials necessary for immunization, such as syringes and needles, will
be pre-sourced to prevent shortages of materials. In addition to providing storage and
transportation for the vaccine, the vaccination program will establish public information
campaigns designed to reduce panic and deliver vaccination information. Communication with
healthcare workers involves comprehensive training for vaccination center workers and
immunizers (Hessel 2009).
The efficiency of the immunization program can be measured in terms of net health
benefits and net medical-care costs. Net health benefits include abatements in mortality and
morbidity associated with the disease which are compared to mortality and morbidity related to
vaccine side effects. Net medical-care benefits refer to the cost of the vaccine and its distribution,
the medical-care savings due to prevention of the disease, and the cost of treating complications
due to the vaccine (Willems and Sanders 1981). If the benefits of the vaccination program
outweigh the costs, then the vaccination is considered constructive when examining efficiency.
The most effective method of monitoring vaccine success is through data collection
and surveillance. Data such as death reports and number of cases provide critical data needed to
study the disease, such as monitoring the symptoms and strength of the disease, raising awareness
of the disease, and monitoring the spread of the disease (Office of Public Health Scientific Services
2014). In addition, surveillance programs within the CDC are specifically tasked with monitoring
indicators of vaccine-preventable diseases. For meningococcal disease surveillance, indicators
such as the proportion of cases reported to the National Notifiable Diseases Surveillance System
or NNDSS with complete information including birthdate or age and event date, the proportion of
cases that are reported as confirmed, the proportion of cases with known outcome, the proportion
of confirmed cases with serogroup testing, and the proportion of case-patients with complete
vaccination history (Roush and Wharton 2011).
Conclusion
To sum this, report up, the pathogen responsible for causing Blooming Meningitis, of genus
Proteus, has proven to be very dangerous and effective. Unfortunately, medical treatment and
intervention has been unsuccessful. Of the 648 patient admissions, there has only been one
survivor. This goes to show how lethal this pathogen truly is and that a link in the transmission
cycle needs to be broken. Because the pathogen is a modified strain of meningitis, we were able
to modify the current meningitis vaccine and tailor it to this pathogen. Additionally, we took tissue
samples from the one survivor of this deadly pathogen in hopes of finding a genetic component or
point mutation that lead to his/her survival. The existing meningitis vaccines all targeted bacterial
receptors, which proved to be effective. Our developed vaccine, as previously stated, is based on
the liquid Hib method (a patented method), which is essentially a combination of two vaccines.
By using this method, we will be able to target various aspects of the pathogen. Our vaccine, named
X-men, will cost $0.35-$1.35 per unit because our cost to develop the vaccine was only $100
million, which is significantly less than other vaccines. We were able to keep the cost down
because this vaccine was simply a modified version of a pre-existing vaccine. We expect health
professionals and government officials to cooperate and determine the locations in dire need of
this vaccine and distribute it accordingly. A key factor to keep in mind when transporting and
shipping the X-men vaccine is that it needs to be stored at 2-8 °C. Pre-sourcing syringes and
needles will also play a vital role in distributing this vaccine to the masses because it will prevent
shortages and delays. Part of our vaccine campaign will also include informative advertisements
and public statements to inform the public about the pathogen and the importance of getting the
vaccine. In order to monitor our progress and vaccine efficacy, we will monitor health outcomes,
vaccine administration, and costs related to the vaccine and patient care. Data collection and
surveillance will be the most successful means of monitoring these pathogens. This data may
include mortality rates, time from disease onset to death, survival rates, and other medically
pertinent facts and figures.

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