Patent Application: US-45564495-A

Abstract:
the present invention provides a board game for use as a didactic teaching - aid for individuals that are interested in the immune system . the game comprises a playing board having a continuous main course having a plurality of playing spaces . each playing space contains a number that matches the number of an immune scenario vignette that constitutes an exposure to an infectious disease or to an immune disease state , such as an auto - immune disease or an immune - deficiency . a method of curing or treating the disease , and information about the disease is provided in a disease handout that the players reference while tending to their disease at a hospital , clinic or pharmacy , depending on the nature of the exposure . when a player attains immunity , they become immune to those diseases that are subsequently encountered .

Description:
when a specific pathogen enters the body , it may be phagocytized by a macrophage . the pathogen is then processed , and small potentially immunogenic peptides are transported into the lumen of the endoplasmic reticulum for display on the cell membrane of the macrophage . a t lymphocyte ( t helper or t h cell ) specific for the presented antigen that has the ability to recognize this particular antigen will bind with it and become &# 34 ; activated .&# 34 ; the activated t h cell divides rapidly , creating a large number of t h cells referred to as &# 34 ; clones &# 34 ; of the progenitor t cell . all of the cells within a particular clone lineage can recognize the same antigen . these cells can then activate a variety of other cells , including specific b lymphocytes ( b cells ), cytotoxic t cells ( t c cells ), and delayed type hypersensitivity cells ( t dth cells ). activated b cells differentiate into plasma cells that secrete antibodies , which can either bind to specific pathogens and target them for destruction or , in the case of igε , lead to an allergic response . activated t c cells bind to infected body cells and kill them by directing programmed cell death ( apoptosis ) or perforin - mediated cell lysis . the following are preferred directions for the game . it is , however , possible to modify the game parameters to increase or decrease the speed of play , incentives and disincentives , game pieces , chance means , and the like without significantly affecting the concept game of the present invention . it is also an important aspect of the present invention that the content of the disease handout , and immune scenario vignettes , are true to contemporary medical knowledge . it is also important that the materials provide the pupil with material that is relevant and is at a level that is understandable to those educationally challenged in the area of immunology . 1 . receives a game piece , such as a flat disk with a distinctive marking , for example a colored stick - on label ( blue , green , yellow , red , etc .). each student also receives a &# 34 ; disease handout &# 34 ; ( described herein ) that includes a number of brief scenarios related to the diseases and allergies they have read about previously . 2 . each player rolls a die twice to determine what his or her blood type will be during the game . the sum of the two rolls will correspond to a specific blood type shown in the &# 34 ; transfusion table &# 34 ; on the game board . the blood type of each player in the group is recorded , and this list can be referred to during the game . 3 . the players roll the die to determine who will go first . order of play proceeds clockwise , beginning with the player who has rolled the highest number . 4 . during the turn of each player , the player rolls the die and moves forward along the board the appropriate number of spaces . the number printed in each space corresponds to a specific scenario on the disease handout . the player reads the scenario and follows the directions given . in most cases , as a result of exposure to a specific pathogen , the player will receive a lymphocyte card , each one specific for the pathogen to which the player has been exposed . hypothetical shapes representing certain bacterial and viral surfaces are shown on the game board . the lymphocytes on the card received after exposure to a particular antigen have receptors in a design that locks together with one particular antigen . representative cards showing these hypothetical shapes are depicted in fig2 a to 2m . after the player suffers the consequences given on the disease handout , the lymphocyte card serves as an indicator that the player has &# 34 ; memory &# 34 ; cells to protect the player if later exposed to the same pathogen . 5 . if a player must go back to a medical facility or pharmacy , the players must place his or her game piece in the available space in that facility . if no space is available , the player must go back further ( 4 - 6 spaces back ) to the &# 34 ; rest &# 34 ; space crossed prior to that facility . note that residing in a &# 34 ; hospital &# 34 ; causes the player to lose a turn ; residing in a &# 34 ; clinic &# 34 ; or &# 34 ; pharmacy &# 34 ; does not cost the player a turn . 6 . when nearing the finish line , one may roll a number that is more than the number of spaces available to move . in that case , the player advances one space during that turn . 7 . the player who reaches the finish line first wins the game . during the game , the players will observe that some diseases have more severe consequences than others . some require recuperation in hospitals that cause the player to lose one turn . other scenarios require only minor setbacks , e . g ., going back several spaces to a clinic or pharmacy . however , any of the consequences may be increased when a hospital or clinic is full or when all the spaces in a pharmacy &# 39 ; s parking lot are filled . in these situations , the player is required to go back further to the previous &# 34 ; rest &# 34 ; space . further , during the first 15 - 20 minutes of the game , there will be a rather slow progression toward the finish line , unless a person is lucky enough to land on &# 34 ; rest &# 34 ; spaces during each turn . the tempo increases as the game progresses due to exposure to more pathogens . such exposure causes the body to build up its immune system ; this is evidenced by a growing collection of lymphocytes cards in the player &# 39 ; s possession . on occasion , a player may fall on a space that provides the player a free vaccination , or an opportunity to take a vaccination , against a specific pathogen . if the player chooses to take the vaccination , the player must go back to a clinic . this may be considered a setback , however , the setback is minimal compared to the consequence of getting the disease later in the game . the game emphasizes several important points about the immune system . first , it illustrates specificity , i . e . the ability of a given lymphocyte to recognize only one specific antigen , and in this particular case a pathogen . unless a player has been exposed to a particular pathogen , either through illness or vaccination , &# 34 ; memory &# 34 ; cells are not available to allow early recognition and destruction of that pathogen when contact occurs . second , the &# 34 ; memory &# 34 ; characteristic of the immune system is demonstrated as players are able to progress along the game board at a faster pace as time passes due to the accumulation of more lymphocytes . third , the consequence of not receiving a vaccination against a specific pathogen when given the chance is demonstrated when a player suffers a major setback due to exposure to that pathogen later in the game . fourth , the ability of the immune system to cause damage to a person in the form of an allergic reaction is demonstrated by the consequences of coming into contact with certain allergy - causing substances . the game board , as depicted in fig1 a , fig1 b , fig1 c and fig1 d , may be played as is shown or may be modified in an academic setting according to how a teacher may deem appropriate . for example , student players may be required to answer specific questions about a disease and / or disease - causing agent before they can proceed to their next turn . since the game board contains only numbers , the disease handout can be modified to include diseases , disease models , or specific antigens and epitopes that are different from those listed herein , depending of the level of sophistication of the players . it is also envisioned that other game concepts may be developed that may reinforce ideas and concepts related to other biological topics such as those relating to maternity and children ( e . g . to teach expectant mothers about the importance of vaccinations during lae maze classes ), more directly related to a particular disease , such as aids , or encompassing different phases of the immune response , such as primary and secondary immune responses . an important aspect of the invention lies in a handout delineating specific immune - scenarios that are the subject of the exercise . examples of subject matters include information about a disease or disease model , and important characteristics of the immune response to the stated pathogen or disease condition . a wide range of disease states may be included in the handout , including autoimmune responses , anaphylactic responses , graft rejection and immune deficiencies both inherited and acquired . it may also highlight interactions of the immune system with pathogens that mimic or take advantage of an immune response to propagate , thereby gaining entry into the host . other disease states that can be the subject of handouts are different cancers . another aspect of immune disease or of an immune state concerns those diseases wherein the host is rendered immunodeficient through aging or by a chemically induced immune deficiency , as in the case of radio - or chemo - therapy . a wide variety of infectious disease pathogens are also potential subjects for disease handouts , including viruses , bacteria , fungi , and helminths . infectious pathogens may include those that infect the host chronically and are opportunistic pathogens , or those that cause infectious disease . another aspect of the disease handout may be a drawing that summarizes the immune response , and shows the interaction between macrophages , helper t ( t h ) cells , and cytotoxic t ( t c ) cells ( fig3 ). in alternative embodiments , this summary may be incorporated into each of the lymphocyte cards , as depicted in fig4 a to fig4 m . aids : the hiv ( human immunodeficiency virus ) invades helper t cells after binding to a specific molecule ( cd4 + ) on the cell &# 39 ; s surface . as the infection progresses , the number of t h cells declines . since these cells are necessary for stimulating both the humoral ( antibody ) and cellular immune responses , a decline in their number can lead to increasing difficulty in resisting other infectious agents . finally , a patient develops aids , a disease characterized by inability to resist even the organisms that grow naturally in the body . spread of this virus occurs through contact with infected body fluids such as blood and semen , since these fluids carry both free virus particles and infected t h cells . due to the complex nature of this virus , no effective immunization procedure has been developed . animal dander allergy : when a person who is sensitive to animal dander inhales this substance , a reaction involving watery , itchy eyes and runny nose will occur . a sensitive person is one who has had a prior exposure to the dander that has caused the formation of ige antibodies to occur . these antibodies bind to mast cells in the tissues and basophils in the blood . when the sensitized person is exposed to dander again , antigens from the dander will combine with the ige and cause the mast cells and basophils to release chemical mediators that result in the allergic symptoms . although no true vaccination is available , allergy &# 34 ; shots &# 34 ; are given in some cases to induce the formation of blocking igg antibodies that can reduce the allergic reaction . bacterial pneumonia : this disease is caused by a bacterium , streptococcus pneumoniae , which is transmitted by infected respiratory droplets . although healthy persons frequently don &# 39 ; t contract the disease even when they are exposed to the organism , those who have had a recent viral respiratory infection , such as influenza , or those who have lowered resistance , are more susceptible . specific antibodies are produced as a result of having pneumonia , or after immunization with a vaccine made with antigens from the capsule of the bacterium . bee sting allergy : if a person is allergic to bee venom , the mast cells in the person &# 39 ; s tissues and the basophils in the blood have been previously sensitized to the allergen ( bee venom ) by the binding of specific ige molecules to their surfaces . now , the bee venom combines with those ige molecules and causes the mast cells and basophils to undergo degranulation , allowing the release of chemicals that can cause anaphylaxis . blood transfusion reactions : the blood type of a person is determined by the presence or absence of certain carbohydrate antigens ( a , b , or rh ) on the surface of red blood cells . if the &# 34 ; a : and &# 34 ; rh &# 34 ; antigens are present , the blood is a + , if only the b is present , the blood is b - , if only the rh is present , the blood is o + , etc . the blood of each person contains antibodies against the antigens not present on his / her red blood cells . therefore , an antigen and its specific antibody do not coexist in the same person . if an incompatible blood type is transfused into a recipient , antibodies in the recipient cause clumping and lysis of the transfused red cells . chickenpox : chickenpox is a disease caused by a type of herpes virus called varicella virus . it is transmitted by infected airborne droplets . although it initially infects the respiratory tract , this virus localizes in the skin after about two weeks to form vesicles filled with fluid . these rupture and form a scab before healing . specific b lymphocytes are activated , with the aid of t h cells , and produce antibodies that attach to these specific virus particles to inactivate them and to protect a person from developing chicken pox if exposed to the virus again in the future . cytotoxic t cells , also stimulated by helper t cells , help eliminate the virus by killing the body cells that are infected with virus . common cold : the common cold can be caused by a number of different viruses including rhinoviruses and adenoviruses . these viruses , passed by the respiratory route , cause iga antibodies to form . however , since there are at least 200 different agents that can cause the common cold , repeated infections are common . as people age , they contract fewer colds due to accumulated immunity during their lifetime . occasionally , a cold can lead to some complications such as laryngitis and middle ear infection . no immunizations are available for the common cold . diphtheria : diphtheria is a disease of the upper respiratory tract that is caused by a bacterium called corynebacterium diphtheriae . the bacteria grow in the throat and produce a grayish membrane that can block the passage of air to the lungs . as they grow , the bacteria produce a toxin that circulates in the blood and damages the heart and kidneys , often leading to death if the patient is not treated with antibiotics . antitoxin ( igg ) forms that can neutralize the toxin . a vaccine consisting of an inactivated form of the toxin ( toxoid ) gives long - lasting immunity to this disease . food allergy : a person can eat a piece of pecan pie at supper time and a specific chemical found in the pecans is thereby released in that person &# 39 ; s gi tract . if the person has been sensitized , which means the presence of a specific ige on the person &# 39 ; s mast cells and basophils that can bind to this chemical , the complex of antigen , ige , and cells causes the release of histamine and other chemicals that may result in a localized reaction or a systemic reaction called anaphylaxis . hepatitis b virus : hepatitis b virus is transmitted by infected blood or other body fluids such as semen , breast milk , and saliva , and can cause an acute form of liver disease that may or may not be noticeable . although antibodies to the virus develop , the disease may become chronic and may lead to either cirrhosis or cancer of the liver . recently , a genetically engineered vaccine has been developed that can prevent infection with this virus by inducing specific protective antibodies . influenza : the &# 34 ; flu &# 34 ; is caused by a virus that is spread from person to person by airborne droplets or by contact with contaminated hands or surfaces . influenza virus replicates in cells of the respiratory tract to cause damage that can lead to complications such as bacterial pneumonia . specific iga antibodies block the binding of flu viruses to the respiratory cells ; however , since these viruses frequently change their surface structure , new iga antibodies need to be made each year by receiving a vaccine made from the latest strains . measles ( rubeola ): measles is an extremely infectious viral disease spread by infected respiratory droplets . viruses first replicate in the respiratory tract and then spread through the blood to the skin and mucous membranes of the body including the conjunctiva . igg antibodies form to inactivate the virus . cytotoxic t cells interacting with virus - infected cells in the small blood vessels are the cause of the typical measles rash . measles can be prevented by a highly effective , attenuated , live measles virus vaccine . mumps : mumps is a viral disease characterized by swelling of the parotid glands and a general feeling of tiredness and loss of appetite . the virus is spread by respiratory droplets that enter the mouth and nose . during the disease , various antibodies form . cytotoxic t cells also are present but their function in recovery from the virus is unclear . after recovery , the person has life - long immunity . there is also an attenuated live - virus vaccine given to young children . poison ivy allergy : an allergic reaction to poison ivy is caused when the ivy sap sensitizes a certain subgroup of t cells called t dth cells . when these cells have subsequent exposure to the sap , they signal the migration of macrophages to the area where the skin was exposed . the macrophages and t dth cells cause inflammation that is manifested as the typical rash of poison ivy . once a person has become &# 34 ; sensitized ,&# 34 ; the person will continue to react upon exposure to the plant . the best way to prevent the rash is to avoid touching the plant or its sap . polio : initially , polioviruses replicate in the cells of the throat and gastrointestinal tract where they rarely cause a serious problem . however , if they enter the blood and travel to the central nervous system , they can replicate and cause paralysis . specific antibodies can block the transmission of polioviruses and prevent damage to the central nervous system . immunization consists of either a killed - virus or live - virus vaccine , both of which give long - lasting immunity . pollen allergy : if a person who is sensitive to a certain type of pollen inhales that pollen , an allergic reaction involving runny nose , sneezing , itching , and watery eyes will occur . to be sensitive , a person must have had a prior exposure to the pollen to allow ige antibodies to form and attach to the surface of mast cells and basophils . then when the sensitized person comes in contact with the pollen at another time , the pollen antigens combine with the bound ige antibodies , which then cause the mast cells and basophils to release histamine and other chemical mediators that cause the allergic response to the pollen . in certain cases , immunization with the antigen can lead to the formation of igg antibodies that block the allergic reaction . staphylococcal infections : although staphylococci are found normally on the human skin , and in the respiratory and gastrointestinal tracts , certain strains of staphylococci can cause a number of diseases . staphylococcus aureus is a common cause of &# 34 ; staph &# 34 ; infections of the skin such as abscesses , acne , and impetigo . antibodies that form against the organisms are not completely protective and a person may have repeated infections . the primary defense is a healthy phagocytic response . streptococcal sore throat : pathogenic streptococcus pyogenes living in the throat or nasal passages of an infected individual can be passed on to a healthy individual through sneezing , kissing , sharing eating utensils , etc . these bacteria can cause inflammation in the throat region known as strep throat or pharyngitis . antibodies can form against a specific strain of s . pyogenes ; however , since there are many different strains , a person may contract strep throat repeatedly . tetanus : if a person steps on a nail that has spores of the bacterium clostridium tetani on its surface , the spores , which commonly are found in soil contaminated with animal feces , can germinate and multiply in the anaerobic environment of the injured tissue . as they grow , these bacteria release a toxin that acts on the nervous system to cause severe muscle spasms that can be fatal . immunization with an inactivated form of the toxin ( toxoid ) can prevent these spasms by inducing the formation of specific igg molecules that neutralize the toxin . tuberculosis : this disease , primarily of the lungs , is caused by a bacterium called mycobacterium tuberculosis , and is transmitted by sputum droplets from an infected person . once a person has been infected , both cellular immunity and delayed type hypersensitivity ( dth ) develop . the dth reaction involves t dth cells that become sensitized by the antigens from the tb organism and then cause the migration of macrophages to the site of infection . in an otherwise healthy person , the t dth and cytotoxic t cells confine the organism to the original site of infection . however , if the person is immunocompromised , as would be the case in an hiv - infected person , the organisms may spread and cause a systemic infection that can be life - threatening . whooping cough ( pertussis ): whooping cough is caused by a bacterium called bordetella pertussis that infects the respiratory tract from droplets spread when an infected patient coughs . the cough , called a &# 34 ; paroxysmal &# 34 ; cough , is so severe that it can lead to difficulty in breathing . a characteristic &# 34 ; whooping &# 34 ; sound occurs when the patient attempts to get his breath . after recovery , immunity is good due to the presence of igg antibodies . a vaccine prepared from heat - inactivated whole bacteria is given regularly to young children to immunize them against this disease . the disease handout detailed hereinabove provides examples of diseases ranging from viral infection to chronologically - induced immune dysfunction . disease handouts may be developed with differing levels of detail , subject matter and emphasis thereby tailoring the game to match the level and subject matter defined for the players . a set of immune scenarios may be provided and numbered to correspond to the numbers located within a corresponding space . of course , the subject matter will be encompassed within the materials disclosed in the disease handout previously provided to the player . the numbered descriptions in the following example have been written to match the diseases in the disease handout provided above . the example is provided to illustrate individual immune scenarios or vignettes of a game , but are not limited to the subject matter maintained therein . the numerals in the example are the same as the numerals of the spaces on the game board to which they pertain . 1 . you have had contact with someone who is infected with the varicella ( chickenpox ) virus . show your lymphocyte card that can interlock with this virus . if you do not have the card , you get chickenpox and must go back to a &# 34 ; rest &# 34 ; space and obtain it . 2 . you get to take a free flu shot that causes you to make the specific lymphocyte card for influenza a virus . obtain the specific lymphocyte card for influenza a . 3 . you have been exposed to the influenza a virus . show your lymphocyte card that can interlock with influenza a . if you do not have the card , go back to the nearest hospital or clinic ( if a room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that medical facility and obtain the specific card . 4 . you get to take a free vaccination against poliovirus . this causes you to make the specific lymphocytes that recognize the virus . obtain the specific lymphocyte card . 5 . you have come in contact with corynebacterium diphtheriae . show your lymphocyte card that can interlock with this bacterium ; otherwise , you just came down with diphtheria and must go back to the nearest &# 34 ; hospital &# 34 ; ( if a room space is available ) or to the &# 34 ; rest &# 34 ; space at least 5 spaces back from that hospital and obtain the card . 6 . if you want to receive a tetanus vaccination , go back to the &# 34 ; clinic &# 34 ; ( if a room space is available ) arid obtain the specific lymphocyte card that interlocks with the bacterium clostridium tetani . 7 . you have come in close contact with someone who is infected with the ( rubeola ) measles virus . show your lymphocyte card that interlocks with rubeola . if you do not have the card , go back to the nearest clinic or hospital ( if a room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that medical facility and obtain the card . 8 . there has been another outbreak of mumps at the local junior high school where you work . show your lymphocyte card that can interlock with this virus ; otherwise , you get mumps with complications and must go back to the nearest medical facility ( if a room space is available ), or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . there you can obtain the specific lymphocytes . 9 . you are allergic to poison ivy . if you rolled a 4 , 5 , or 6 to get to this space , you accidentally rubbed against some poison ivy vines , and must go back to the &# 34 ; clinic &# 34 ; ( if a room space is available ) or &# 34 ; pharmacy &# 34 ; ( if parking space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility for medication . try not to scratch . 10 . show your lymphocyte card that interlocks with influenza a ; otherwise , you get the flu ( from a virus ) that eventually develops into pneumonia caused by the bacterium streptococcus pneumoniae . go back to the &# 34 ; hospital &# 34 ; ( if a room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from the hospital and obtain the lymphocytes for protection against influenza a . 11 . if you rolled a 4 , 5 , or 6 to get to this space , your subcutaneous tissues have become infected with a pathogenic strain of staphylococcus bacteria after getting a cut on your finger . for this infection , antibiotics are required and you must go back to the nearest clinic or hospital ( if a room space is available ) or &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . 12 . if you just rolled a 2 or 6 to get to this space , you have come in contact with hiv . obtain an &# 34 ; hiv &# 34 ; card and place it in your corner of the game board . you must give up at least half of your lymphocyte cards ( player &# 39 ; s choice of cards ) every time you pass a &# 34 ; clinic &# 34 ; or &# 34 ; hospital &# 34 ; that you have not passed before . since there are only 2 hiv cards per game , no more than 2 players will have hiv during the game . 13 . if you occupy this space at the same time as a person who has hiv , you become infected with the virus and must obtain an &# 34 ; hiv &# 34 ; card , unless both hiv cards are taken . if you already have hiv , any person occupying this space with you gets hiv also , and must obtain an &# 34 ; hiv &# 34 ; card if available . no more than 2 players will have hiv during the game . 14 . if you rolled a 4 , 5 , or 6 to get to this space , you have inhaled some animal dander to which you are allergic and must go back to the &# 34 ; clinic &# 34 ; ( if a room is available ) or &# 34 ; pharmacy &# 34 ; ( if parking is available ) or &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . 15 . you set up a tent in a hayfield and are exposed to a variety of pollen . if you rolled a 4 , 5 , or 6 to get to this space , you are allergic to one specific type and must go back to the &# 34 ; pharmacy &# 34 ; ( if a parking space is available ) or &# 34 ; clinic &# 34 ; ( if a room space is available ) or &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . 16 . if you rolled a 3 , 4 , or 5 to get to this space , you accidentally ate a food item to which you are allergic and must go back to the nearest clinic or hospital ( if a room space is available ) to be treated for anaphylaxis . alternative : go back to the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . 17 . you have been in close contact with a person who has tb . if you rolled a 3 , 4 , or 5 , your tb test is positive and you must go back to the &# 34 ; hospital &# 34 ; ( if a room space is available ) and get a chest x - ray to determine the progress of your infection and to take anti - tb medication . alternative : go back to the &# 34 ; rest &# 34 ; space at least 5 spaces back from that hospital . 18 . if you rolled a 2 , 3 , or 4 to get to this space , then you just had another car accident . first , go back to the nearest clinic or hospital to get a blood transfusion . if that facility is full , go back to the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . second , follow the instructions on the &# 34 ; blood transfusions &# 34 ; table . if you roll an incompatible type , go back to the &# 34 ; rest &# 34 ; space at least 5 spaces back from where you were located when you rolled the die for the transfusion . 19 . you have the chance to get a vaccination against the bacterium corynebacterium diphtheriae . if you want the vaccine , go back to the &# 34 ; clinic &# 34 ; ( if a room is available ) and obtain the specific lymphocyte card . if you do not take the vaccine , stay where you are . 20 . you have come into contact with poliovirus . show your lymphocyte card for polio . if you do not have the card , you contract polio and must go back to the &# 34 ; hospital &# 34 ; ( if a room space is available ) or &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . there you can obtain the specific card . 21 . you have the option to take a vaccination for measles virus . if you want the vaccine , go back to the &# 34 ; clinic &# 34 ; ( if a room space is available ) and obtain the lymphocyte card . 22 . you stepped on a nail contaminated with spores from the bacterium clostridium tetani . show your lymphocyte card for tetanus ; otherwise , you begin to feel the effects of tetanus and must go back to the &# 34 ; hospital &# 34 ; ( if a room space is available ) or &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . there you can obtain the specific lymphocyte card . 23 . you have been infected with rhinovirus 13 that causes the common cold syndrome . show your lymphocyte card for this virus ; otherwise , go back to a &# 34 ; pharmacy &# 34 ; ( if a parking space is available ) or &# 34 ; clinic &# 34 ; ( if a room space is available ) for medication , or to the &# 34 ; rest &# 34 ; space at least spaces back from that facility . obtain the specific lymphocyte card for this strain of virus . 24 . you have been infected with a rhinovirus 79 that causes the common cold syndrome . show your lymphocyte card for this virus . if you do not have the card , go back to an available &# 34 ; pharmacy &# 34 ; ( if a parking space is available ) or &# 34 ; clinic &# 34 ; ( if a room space is available ) for medication , or go back to the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility since you develop complications . obtain the lymphocyte card that interacts with rhinovirus 79 . 25 . you have been infected with adenovirus 8 , which can cause the common cold syndrome . show your lymphocyte card that interlocks with this virus . if you do not have it , go back to &# 34 ; pharmacy &# 34 ; ( if a parking space is available ) or &# 34 ; clinic &# 34 ; ( if a room space is available ) for medication , or go back to the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . obtain the specific lymphocyte card that interacts with adenovirus 8 . 26 . you have been infected with rhinovirus 94 , which can cause the common cold syndrome . show your lymphocyte card that can interlock with this virus ; otherwise , go back to an available &# 34 ; pharmacy &# 34 ; ( if parking space is available ) or &# 34 ; clinic &# 34 ; ( if room space is available ) for medication , or go back to the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . obtain the specific lymphocyte card for this virus . 27 . if you want to get a pertussis vaccination , go back to the clinic ( if room space is available ) and get the specific lymphocyte card that can interlock with the bordetella pertussis bacterium . 28 . you have been working in a nursery taking care of infants , one of which has pertussis ( whooping cough ). show your lymphocyte card that can interlock with the pertussis bacterium . if you do not have it , go back to the &# 34 ; hospital &# 34 ; ( if room space is available ) or &# 34 ; rest &# 34 ; space at least 5 spaces back from that hospital while you get the specific lymphocyte card . 29 . you have the option to get a hepatitis b vaccination . if you take the vaccine against this virus , go back to the &# 34 ; clinic &# 34 ; ( if room space is available ) and obtain the specific lymphocyte card that can interlock with the hepatitis b virus . 30 . while working in a clinic , you accidentally stick yourself with a needle contaminated with the blood of a patient who has hepatitis b virus ( hbv ). show your lymphocyte card that can interlock with this virus . if you do not have the card , go back to the &# 34 ; hospital &# 34 ; ( if room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from the hospital to get the card . 31 . you have the chance to be immunized against the mumps virus . if you take the vaccine , go back to the &# 34 ; clinic &# 34 ; ( if room space is available ) so that you can get the lymphocyte card that interlocks with this virus . 32 . someone who has one of the many pathogenic strains of streptococcus pyogenes living in their oronasal cavity just sneezed on you . if you rolled a 4 , 5 , or 6 to get to this space , you are not immune to this strain . as a result , you get another case of &# 34 ; strep throat &# 34 ; and must go back to the nearest &# 34 ; hospital &# 34 ; or &# 34 ; clinic &# 34 ; ( if room space is available ), or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility . 33 . you are allergic to bee venom , but enjoy working with flowers . if you rolled a 3 , 4 , or 5 to get to this space , you have been stung by a disturbed honeybee and must go back to a &# 34 ; hospital &# 34 ; or &# 34 ; clinic &# 34 ; ( if room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that facility to get some epinephrine to prevent anaphylaxis . 34 . if you rolled a 5 or 6 to get to this space , you were given a blood transfusion from the player on your left . if you can receive it safely , stay where you are . if that blood cannot be given to you safely , go back to the &# 34 ; hospital &# 34 ; ( if room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that hospital for further treatment . if the blood you received has the hiv , you must obtain an &# 34 ; hiv &# 34 ; card ( if one is available ). ( no more than 2 players will have the hiv ). 35 . the player to your right needs a blood transfusion . if you can donate blood to that person , move ahead to the next &# 34 ; rest &# 34 ; space . 36 . if you rolled a 4 , 5 , or 6 to get to this space , you were given a blood transfusion from the player on your right . if that blood cannot be given to you safely , go back to the nearest &# 34 ; hospital &# 34 ; ( if room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that hospital for further treatment . if the blood you received has the hiv , you must obtain an &# 34 ; hiv &# 34 ; card ( if one is available ). ( no more than 2 players will have the hiv ). 37 . if you can donate blood to the player on your left , you have the potential to save that person &# 39 ; s life and can move ahead to the next &# 34 ; rest &# 34 ; space . if you cannot donate blood to this person , stay where you are . 38 . you were given a blood transfusion during recent surgery in a foreign country that did not adequately screen blood samples . if you rolled a 1 or 2 to get to this space , that transfused blood was contaminated with hiv and you must obtain an &# 34 ; hiv &# 34 ; card . 39 . if you rolled a 4 , 5 , or 6 to get to this space , your immune system has failed to recognize and destroy some cancerous cells in your body . you may recover , but that recovery will require some time . go back to the nearest &# 34 ; hospital &# 34 ; ( if room space is available ) or the &# 34 ; rest &# 34 ; space at least 5 spaces back from that hospital and recover from this episode . the apparatus and methods disclosed and claimed herein may be made and executed without undue experimentation in light of the present disclosure . while the apparatus and methods of this invention have been described in terms of preferred embodiments , it will be apparent to those of skill in the art that variations may be applied to the apparatus , methods and in the steps or in the sequence of steps of the method described herein without departing from the concept , spirit and scope of the invention . all substitutes and modifications apparent to those skilled in the art are deemed to be within the spirit , scope and concept of the invention as defined by the appended claims . the following references , to the extent that they provide exemplary procedural or other details supplementary to those set forth herein , are specifically incorporated herein by reference . benjamini , e . and s . leskowitz . 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