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9.

4 The Search for Better Health



1. What is a healthy organism?

1.2.1 Discuss the difficulties of defining the terms health and disease

Definitions:
Health: state of complete physical, psychological, mental and social wellbeing - not merely
absence of disease or illness
Disease: state of impaired functioning of an organism, including impaired physical, psychological,
social and mental functioning. Diseases can be caused by: infection, heredity, nutrition,
physiological malfunction, environment and chemicals

Difficulties:
Health: has many components (physical, mental, social) and subjective features which can show a
false understanding or belief in their own level of health (eg. a person infected with the HIV
pathogen may be healthy if the symptoms of disease AIDS have not yet appeared)
Disease: is difficult to define as it has many components. Disease describes a state of impaired
functioning, thus it depends on an organisms normal level of functioning, and how they expect
their quality of life to be.

1.2.2 Outline how the function of genes, mitosis, cell differentiation and specialisation assist in the
maintenance of health

Genes
Genes are units of inheritance
Genes control protein synthesis and provide the code for proteins required for growth and repair as
well as producing enzymes which maintain metabolism (ie. ensure the continuation of all bodily
functions)
Genes can also regulate the cell cycle and limit the growth and reproduction of cells. For example:
Proto-oncogenes are genes that normally help cells grow. When a proto-oncogene is
mutated it can become permanently turned on or activated when it is not supposed to be.
When this happens, the cell grows out of control, which can lead to cancer. This bad gene is
called an oncogene
Tumour suppressor genes produce proteins that slow down cell division, repair DNA
mistakes or program cell death. When tumour suppressor genes mutation, uncontrolled
division can occur
Example: Cystic fibrosis is a genetic disorder caused by a defect in the CFTR gene on the 7
th

chromosome- the protein that controls the movement of salt in and out of the cells. As a result, an
individuals mucus glands secrete very thick sticky mucus, clogging air passages in the lungs,
leading to trapped bacteria and, therefore, an increased risk of illness. People with CF also find it
hard to obtain nutrients from foods and can also have a disastrous effect on the reproductive
system: in females, thick mucus makes fertilization of the egg difficult and males are often infertile
as the tube that carries sperm often becomes blocked with mucus, meaning sperm are still made,
but they are not released during ejaculation
Example: Down Syndrome is caused by trisomy 21 where there are 3 copies of chromosome 21,
instead of 2 copies. This results in severe learning, speaking and additional physical, mental and
psychological difficulties

Mitosis
Mitosis is cell division that produces identical cells enabling genetic material to be copied exactly
and, therefore, perform the correct functions
These cells are important for cell growth, repair and maintenance, as well as reproduction
Mitosis replaces the millions of cells that die daily

Cell differentiation
When cells mature they become specialised in structure to suit a specific function in the body- if
cells dont differentiate they form a tumour
Enables cells to work together effectively in a healthy body to carry out complex processes in a
controlled and coordinated way to maintain and repair tissues

Cell specialisation
Specific genes are switched on to perform a particular function in the body
All the specialised body cells work together in a coordinated way to maintain the health and proper
functioning of the organism

1.3.1 Use available evidence to analyse the links between gene expression and maintenance and
repair of body tissues

Gene expression: occurs when a gene is switched on. When a gene is expressed, DNA within the gene
converts into polypeptides that control the structures and functions of a cell

Damaged DNA: results in gene alteration - can no longer code for correct polypeptide. This can cause
harmful mutations, such as cancer. If these mutations are not repaired, mutations can reproduce in
daughter cells - creating a flow on effect

Maintenance and repair of body tissues:
Gene expression assists the maintenance of health by regulating the cell cycle and limiting the growth and
reproduction of cells. For example:
Proto-oncogenes are genes that normally help cells grow. When a proto-oncogene is mutated it
can become permanently turned on or activated when it is not supposed to be. When this happens,
the cell grows out of control, which can lead to cancer. This bad gene is called an oncogene
Tumour suppressor genes produce proteins that slow down cell division, repair DNA mistakes or
program cell death. When tumour suppressor genes mutation, uncontrolled division can occur


2. Over 3000 years ago the Chinese and Hebrews were advocating cleanliness in food, water and
personal hygiene

2.2.1 Distinguish between infectious and non-infectious disease

Infectious Disease: caused by pathogens invading the body. Infectious disease/s can be transferred from
one person to another. Pathogen examples: viruses can cause influenza, bacteria can cause tonsillitis and
fungi can cause tinea

Non-infectious Disease: cannot be transferred from one person to another (unless the disease has been
genetically inherited, such as breast cancer). Non-infectious disease involves no pathogens

2.2.2 Explain why cleanliness in food, water and personal hygiene practices assist in control of disease

Why:
Food, water and personal hygiene are all potential sources of infection by pathogens. Therefore,
cleanliness in food, water and personal hygiene practices can assist in controlling disease by effectively
reducing the number of microorganisms entering the body, hence reducing the risk of infection

Cleanliness in food
Contaminated food is a source of pathogens, which can readily spread disease
Heating can be used to kill microbes
Refrigeration slows down growth of microbes
Dehydrating foods (eg. fruit and vegetables) and smoking meat also kills microbes

Cleanliness in Water:
Lack of clean water (often in developing countries) plays a huge role in spreading disease as
pathogens are carried in unclean water
Water purification and sewage facilities (eg. minimising disease contamination from faeces) is vital
to maintain good health
Example: the final process of water treatment is disinfection, where a small amount of chlorine is
added to the water to kill any bacteria or microorganisms that may be present

Personal Hygiene:
Personal hygiene: process of keeping clean in order to maintain health
Washing hands before eating prevents pathogens entering via the mouth
Covering mouth when coughing prevents airborne droplets
Washing the hair and body prevents build up of pathogens
Sterilisation - complete removal of all traces of microbes. Required in situations where pathogens
are particularly dangerous (eg. surgical rooms)
Disinfection: reduces microbes to a safe level (eg. washing clothes and dishes with disinfectant
soaps or powders)
Example: during the 1500s, the black plague was highly prevalent in Europe between 25% and
50% of Europe's population had fallen victim to the pestilence. During this time, medical personnel
lacked knowledge of disease causes and prevention strategies for example, many suggested not
to clean as this was believed to worsen the plagues symptoms

2.2.3 Identify the conditions under which an organism is described as a pathogen

Pathogen: an organism that can cause disease

To cause disease, a pathogen must be in the right conditions to multiply and be transmitted (ie. warm,
virulence, dirty, unsanitary environment)

Transmission can occur:
Direct: transferred directly from host to host (ie. person to person by not covering mouth when
coughing)
Indirect: transferred from environment to host (ie. by infected food or water)
Vector: transferred from one host to another by another organism (eg. Anopheles mosquitoes
cause malaria)

To survive, pathogens must:
have virulence: be present in sufficient numbers to cause the disease
able to survive on or within the body without being destroyed by bodys natural defences (eg. not
be engulfed during phagocytosis, during the bodys second line of defence against pathogens)
escape from one host to another and survive this transmission

2.3.1 Identify data sources, plan and choose equipment or resources to perform a first-hand
investigation to identify microbes in food or in water

Aim: To examine a range of microorganisms found in water and food macroscopically (eye can see)

Equipment:
100mL sample of outdated vegemite solution
100mL tap water
3 x agar plates
Inoculating loop
Bunsen burner
Incubator

Method:
1. Collect 3 sterile nutrient agar plates. Use one as a control and the others to inoculate with mouldy
food and water
2. Seal (with sticky tape) and label the control plate
3. Sterilise the inoculating loop in a Bunsen flame. When it cools dip it into some outdated vegemite
solution and inoculate (in a zigzag motion from top to bottom) one of the plates. Quickly seal and
label to reduce the change of contamination from the surrounding environment
4. Using a sterile inoculating loop, inoculate some local-running water on the third plate. Quickly seal
and label to reduce the change of contamination from the surrounding environment
5. Place all sealed and labelled plates into an incubator at approximately 35 degrees Celsius
6. After a 7 days observe any colonies of organisms and identify each one
7. Keep plates sealed and dispose properly

Risk assessment:
Risk Management of risk
Infection from microorganisms
Burning extremities from heated inoculating loop
(after Bunsen Burner use)
Keep plate sealed properly
Wash hands thoroughly before and after experiment
Be aware of the heat, wait until cools

Results:





Plate Colony description and diagram
Control None
Water -circular growth
-entire margin
-translucent opacity
-smooth
Food -irregular growth
-filamentous margin
-opaque opacity
-rough

Variables:
Control: nutrients available to microbes, incubation temperature, amount of sample, growth time
Independent: vegemite solution sample, water sample and clean (control) sample
Dependent: growth and type of microbes

The control variable was used in this experiment to compare (with other 2 infected/inoculated agar
plates) and to ensure a fair test

Conclusion: the control plate had no bacteria or fungi present, whilst the agar plate contaminated with
water had a single type of bacterial growth present (circular, entire, translucent, smooth) and the spoiled
vegemite agar plate also had a single type of fungal growth observed (irregular, filamentous, opaque,
rough)

2.3.2 Gather, process and analyse information from secondary sources to describe ways in which
drinking water can be treated and use available evidence to explain how these methods reduce the
risk of infection from pathogens

The treatment of water usually has 4 stages:

Coagulation:
Alum and other chemicals are added to water to form tiny
sticky particles (floc) which attract dirt particles. The
combined weight of the dirt and the floc become heavy
enough to sink to the bottom during sedimentation,
therefore, removing dirt and other particles suspended in
water

Sedimentation
The heavy particles (floc) settle to the bottom and the clear
water moves to the filtration process

Filtration
The water passes through filters, some made of layers of
sand, gravel, and charcoal that help remove even smaller
particles

Disinfection
A small amount of chlorine is added to kill any remaining bacteria or microorganisms that may be
in the water
Water is placed in a closed tank for disinfection to take place. The water then flows through pipes
to homes and businesses in the community


3. During the second half of the nineteenth century, the work of Pasteur and Koch and other
scientists stimulated the search for microbes as causes of disease

3.2.1 Describe the contribution of Pasteur and Koch to our understanding of infectious diseases

Louis Pasteur discovered that microorganisms caused all
diseases while researching the microbial fermentation of
wine. He demonstrated that these microorganisms were
present in the air with his famous meat broth experiment
(1862) destroying the theory of spontaneous generation
because when the meat broth was pasteurised and
covered it did not spoil. Pasteur also established the
principle of immunity and, as a result, was able to create
vaccinations for anthrax, chicken cholera, swine erysipelas
and rabies

Robert Koch developed a general system for identifying
the pathogen causing a specific disease. This system
became known as Kochs postulates:
1. Detect germ in sick host
2. Isolate and grow germ
3. Inoculate a healthy host with the newly grown
germ
4. Recover the germ from the now sick host to make
sure it is the same infectious agent

Koch also developed agar plate technique for growing
organisms

3.2.2 Distinguish between:

Pathogens Structure/diagram Size Reproduction Other Examples
Prions - Protein that can cause
disease
- Does not contain
genetic material

- Molecular - Multiplies when it
come into contract
with a normal prion
and converts them
into an infectious
prion
- Cannot be
destroyed
by heating
or
chemicals
- Non-living
- Kuru
- Mad cow
disease
Viruses - Non-cellular
- Protective protein coat
encloses genetic
material

- 30-300nm - cannot reproduce
themselves
- uses host cell
reproductive
mechanisms to make
copies of itself
- treatment
is very
difficult
- non-living
- influenza
- AIDS
- Measles

Bacteria - Single-celled
- Cell wall
- 0.5-100um - Asexual > binary
fission
- Bacteria
can be
- Tetanus
- Anthrax
- No membrane bound
nucleus or organelles

beneficial
and only
few cause
disease
Fungi - Eukaryotic (no
nucleus)
- Has a cell wall
- Unicellular or
multicellular

- Varies from
microscopic
to
macroscopic
- Asexual and sexual
reproduction
- Play an
important
role as
decmposer
s in the
ecosystem
- Can be
used to
produce
bread and
yeast
- Tinea
Protozoan
s
- Single-celled
- Eukaryotic (no
nucleus)
- Membrane bound

- 1-300um - Asexual > binary
fission
- Most are
motile
(capable of
motion)
- Malaria
- African
sleeping
sickness
Macro-
parasites
- Multicellular
- Eukaryotic (no
nucleus)
- Macroscopic - Sexual or asexual
reproduction
- Some
cause
disease
directly,
whilst
others act
as vectors
in the
transmission
of disease
- Tapewor
- Elephanti-
asis

3.2.3 Identify the role of antibiotics in the management of infectious disease

Antibiotics: substances capable of destroying or inhibiting the growth of bacteria that cause disease

Antibiotics are chemicals that act selectively - attacking the bacteria, not the host
Antibiotics work at the cellular level - destroying bacteria cells
Example: Penicillin destroys cell walls (and cells burst)

Two types of antibiotics:
Broad-spectrum: affect a wide range of bacteria
Narrow-spectrum: act on only one or two types of bacteria

3.3.1 Perform an investigation to model Pasteur's experiment to identify the role of microbes in decay

Aim: To model Pasteurs experiment to identify the role of microbes in decay

Hypothesis: The broth in the straight-necked flask will start to decay

Method:
1. Add meat broth to both flasks until 1/3 full
2. Fit the stoppers and tubing to the flasks
3. Heat each flask to boil gently for 15 minutes. Ensure a small amount of water is trapped in s-bend
of flask
4. Leave in a warm position out of direct sunlight for 3 weeks
5. Observe any cloudiness, scum, bubbles and fungal colonies every 2-3 days. Record any changes


Results:
Day no. Observations straight neck flask Observations s-bend flask
0 No growth No growth
7 Some microbial growth- floating on
surface
No growth
14 More growth- 4 colonies floating on
surface
No growth

Variables:
Independent (change): flask neck (straight of swan-necked)
Dependent (measure): microbial growth/decay
Constant (same): amount/type of broth, boiled, boiled from same amount of time, observation period (7
day between)

The control:
Control: straight-necked flask. Used to compare and to ensure a fair test

Conclusion:
The swan-necked flask showed no microbial growth. The microorganisms in the air were trapped in the
bend of the neck and were prevented entry into the flask. Microbial growths were observed in the
straight-necked flask. This demonstrated that microbes in the air cause decay of meat broth.

3.3.2 Gather and process information to trace the historical development of our understanding of the
cause and prevention of malaria



3.3.3 Identify data sources, gather process and analyse information from secondary sources to
describe Malaria in terms of its:

Cause: 4 species of the protozoan, Plasmodium

Transmission: infected person is bitten by female Anopheles mosquito, which injects infected saliva into
healthy host

Host response: host produces antibodies to fight the pathogens, but the antigens continually change at
each stage of the parasites life cycle, so the immune response isnt effective

Major symptoms:
General cases: sudden fever (chills/headache/sweating), nausea, vomiting, pain in joints and
muscles
Severe cases: seizures, confusion, kidney failure, breathing difficulty, coma, brain damage

Treatment:
Natural resistance may develop very slowly
Use of quinine - works against parasites in red blood cells
Use of primaquine phosphate - works in blood and liver cells
However, some strains of plasmodium are resistant

Prevention:
Vector control: mosquito nets (eg. free for high-prevalence areas), spraying with pest insecticides
and screening on windows and doors
Antimalarial medicines and personal protection against mosquito bites (eg. insecticide spray,
wearing full-length clothing during high-transmission season)

Control: issuing free insecticides and creating new policies regarding use of mosquito nets in high-
transmission areas

3.3.4 Process information from secondary sources to discuss problems relating to antibiotic
resistance

Overuse of antibiotics can lead to antibiotic-resistant bacteria known as Super bugs (eg. Golden
Staph)
New types if antibiotics need to be discovered, otherwise people will die from common infections
that have previously be treated with antibiotics

Ways to reduce the problem/issue:
Doctors raise awareness of the impact of the issue and reduce prescriptions for antibiotics
Change laws and regulations to reduce the amount of prescribed antibiotics
Make it illegal to sell antibiotics over counter without prescription in countries worldwide (eg.
India)


4. Often we recognise an infection by the symptoms it causes. The immune response is not so
obvious, until we recover

4.2.1 Identify defence barriers to prevent entry of pathogens in humans:

First line of defence: prevents entry from invading organisms

Skin:
tough outer barrier to prevent penetration by microbes
contains a population of harmless bacteria that inhibits the multiplication of invading pathogens
oil and sweat glands produce antibacterial and antifungal substances that further inhibit growth of
pathogens

Mucous membranes:
line digestive, respiratory, urinary and reproductive tracts
produce a thick layer of gluey mucus which traps pathogens
harmless microbes live in the moist mucus, producing substances that inhibit the growth and entry
of pathogens

Cilia
tiny hairs lining the trachea that beat in an upward motion, moving mucus with trapped pathogens
towards the throat (then cough, etc)

Chemical barriers:
The alimentary canal
acidic conditions of stomach and alkaline conditions of intestine destroy pathogens

Urine
Slightly acidic to ensure pathogens are destroyed
flushes and cleans the ureters, bladder and urethra
prevents the growth of pathogens

Urinary and vaginal tracts
acidic conditions which inhibit the growth and entry of pathogens

Other body secretions:
Tears
contain lysozymes which destroy the cell walls of some bacteria
when blinking the surface of the eye is washed and pathogens flushed away

Saliva
contains chemicals that destroy micro-organisms and washes them away from the teeth and lining
of the mouth

4.2.2 Identify antigens as molecules that trigger the immune response

Antigens: molecules which are present on surface of foreign invaders (non-self) and act as markers.
Antigens then trigger the immune response, which is activated to destroy the pathogen

4.2.3 Explain why organ transplants should trigger an immune response

An organ transplant will trigger an immune response as the organ is from the body of someone else and,
therefore, carries foreign antigen molecules on its surface. As a result, the immune system is
automatically activated to attack in order to defend the body

Methods used to reduce the likelihood of the immune system rejecting transplanted organs:
tissue matching: ensuring the donated organ has a tissue type similar to their own to reduce the
immune response
immuno-suppressant drugs: used to suppress the immune systems response to the organ. These
drugs must be taken for the rest of their life and also negatively affects their ability to fight off
illnesses and disease

4.2.4 Identify defence adaptations, including:

Second line of defence: (non-specific) recognises any antigen and makes no distinction between them the
immune response will be the same regardless of the nature of the
antigen

Inflammation response:
occurs as a result of cells being infected or injured in some
way
Chemicals (eg. histamine) are released, causing blood
vessels to dilate so fluid containing phagocytes can enter
tissues and destroy invaders
The infected site becomes hot and swollen, which inhibits
the activity of pathogens

Lymph system:
Responsible for filtering lymph fluid and removing
pathogens, dead cells and other debris
Occurs in lymph nodes, containing phagocytes that destroy
foreign material that is brought into lymph node by tissue
fluid

Cell death to seal off pathogen:
If an area of the body is infected and other areas of the body are unable to control the pathogen, a
layer of dead cells form around infection site. A layer of macrophages will then follow which seals
off and contains pathogens which eventually die and are consumed by macrophages

Phagocytosis:
Process in which phagocytes surround and engulf a foreign particle. The foreign particle is then
bathed in the enzyme - lysozyme, which destroys it.


4.3.1 Gather, process and present information from secondary sources to show how a named disease
results from an imbalance of microflora in humans
Candidiasis (thrush)
Cause: Candida albicans (fungi), hormone imbalances, changes in vaginal acidity, immune
suppression, use of broad-spectrum antibiotics (kills good bacteria that keep candida in check)
Symptoms: change in vaginal discharge (slight yeasty odour, appear thick yellow or white), skin
around vagina may become red, inflamed, itchy and/or swollen (including the anus)
Prevention: looser or cooler clothing (eg. cotton or natural fibres), rinse and dry under foreskin and
daily after sex, avoid washing with soaps, minimise use of antibiotics
Conditions of growth: candida always present in body in small amounts. However, when an
imbalance occurs and it grows unchecked it will result in negative consequences (eg. thrush)


5. MacFarlane Burnet's work in the middle of the twentieth century contributed to a better
understanding of the immune response and the effectiveness of immunisation programs

Background: Sir MacFarlane Burnet (1899-1985)

Australian scientist and a founder of immunology
Burnet studied viruses and how the body defends itself against infection by microorganisms
Burnet investigated mechanisms by which the body is able to defend itself against foreign material
such as pathogens.
As a result of his research, he discovered that
all B and T cells for all the possible antigens
are already present in the body. In the case of
an invasion by a pathogen or similar, the B
and T cells specific to the particular antigen
are activated to destroy the foreign material.
This is called the Clonal selection theory.
Therefore, Burnet helped us to gain a better
understanding of the immune system,
leading to the establishment of more
effective immunisation programs

5.2.1 Identify the components of the immune
response

Third line of defence: immune response activated is
specific to particular invader

Antibodies
Proteins called immunoglobulins.
Produced by B cells in response to the presence of an antigen in the body

T cells
Produced in the bone marrow and mature in the thymus
Control cell mediated immunity (attacks infections INSIDE cell > intracellular)

Four types of T cells:

1. Memory T-cells: remain in body to respond quickly to future invasions by the same antigens
2. Suppressor T-cells: stop the action of the immune response when the infection has been defeated
3. Cytotoxic (killer) T-cells: once activated, they move to the site of the infection and release
chemicals that destroy the infected cells and pathogens that are inside the cell
4. Helper T-cells: after they recognise the antigen they release chemicals call cytokines that activate
the cloning of specific B and T cells

B cells
Produce and mature in bone marrow
Control antibody mediated immunity (attacks infections OUTSIDE body cells)

Two Types of B cells:

1. Plasma: produce and secrete large amounts of antibodies. These antibodies bind to the foreign
antigen, making them easier targets for phagocytes
2. Memory: B cells which are specific to an antigen type which has been encountered previously
(during the primary immune response.) Since these B cells are able to live for a long time, the
immune response will be faster following a second exposure to the same antigen (the body is more
prepared and, therefore, has greater immunity

5.2.2 Describe and explain the immune response in the human body in terms of:

Interaction between B and T lymphocytes

A macrophage comes across a particle with foreign antigens on its surface. The macrophage engulfs the
particle and displays the foreign antigen on its surface. The macrophage travels to the lymph nodes and
the foreign antigens on the macrophages surface are recognised by helper T cells and B cells. The
different cells collaborate, with the common purpose of attacking the antigen. Helper T cells release
interleukin which stimulates T and B-Cells to differentiate into their different types. The activated Plasma
B cells release antibodies and work alongside cytotoxic (killer) T cells, which program cell death, to
destroy the foreign material. When the pathogen has been defeated, Suppressor T cells stop all activity

The mechanisms that allow interaction between B and T lymphocytes
B cells have self molecules on their surface (called MHC2 molecules), T cells recognise these
self markers and do not attack the B cells

The range of T lymphocyte types and the difference in their roles

Types:
5. Memory T-cells: remain in body to respond quickly to future invasions by the same antigens
6. Suppressor T-cells: stop the action of the immune response when the infection has been defeated
7. Cytotoxic (killer) T-cells: once activated, they move to the site of the infection and release
chemicals that destroy the infected cells and pathogens that are inside the cell
8. Helper T-cells: after they recognise the antigen they release chemicals call cytokines that activate
the cloning of specific B and T cells

5.2.3 Outline the way in which vaccinations prevent infection

Vaccination
process of deliberately putting weakened, dead of
modified antigens into persons body
the immune system reacts to these foreign molecules,
creating memory T and B cells which last years
afterward, inducing active immunity to the antigen
without danger of getting the injected disease
this means that if the same pathogen enters the body
again, the 3rd line of defence will be prepared to
attack. The pathogen is usually destroyed before
symptoms appear (eg. no rash or fever occurring
despite the measles pathogen entering the body)
however, because pathogens keep altering the antigens on their cell membranes, memory
lymphocytes from previous infections are useless, therefore, the immune system must learn the
antigen of new pathogens

Types of immunisation:
1. Active immunisation: stimulates a person to make their own antibodies
2. Passive immunisation: injection of antibodies produced by another person to produce short term
immunity (this is a major reason why breastfeeding is encouraged, as the baby ingests antibodies
present in the mothers milk)
3. Naturally-acquired immunity: person unintentionally exposed to a pathogen and the body
develops antibodies (memory B and T cells) to combat the particular pathogen for years to come

5.2.4 Outline the reasons for the suppression of the immune response in organ transplant patients.

The transplanted organ contains foreign antigens so the recipient naturally produces antibodies
against them. This is known as tissue rejection
Close compatibility of the tissues reduces the risk of rejection (eg. identical twins have the same
antigens)
Immunosuppressive drugs and using x-rays kill most lymphocytes to suppress tissue rejection,
however, the natural immune response to other antigens is also suppressed; increasing the
chances of infection
Example: Cyclosporine A suppresses T cells activated by a transplant but has little effect on B cells
so they are able to produce antibodies to help resist infection.

5.3.1 Process, analyse and present information from secondary sources to evaluate the effectiveness
of vaccination programs in preventing the spread and occurrence of once common diseases,
including:

Smallpox

Background
Cause: Variola virus
Transmission: direct or prolonged face-to-face contact with infected person/s
Symptoms: fever, headache, muscle aches and pains, nausea and an inflamed rash which develops
into small blisters which split and scab, leaving scars
Treatment: isolate infected patients in negative-pressure rooms, vaccinate them within the first 4
days after exposure and provide supportive treatment (eg. ensure hydration, nutrition)

Current vaccination programs (started in 1967 by WHO)
mass immunisations and follow-up surveillance to target outbreaks

Spread before vaccination program
19
th
Century: responsible for 1/10 of all deaths in Europe
20
th
Century: Caused more than 300 million deaths

Spread after vaccination program
Completely eradicated in 1979
Therefore, highly effective

Diphtheria

Background:
Cause: Corynebacterium diphtheria (bacteria)
Transmission: respiratory droplets (from coughing or sneezing) or coming into contact with clothes
or objects contaminated with discharges from lesions of an infected person
Symptoms: runny nose, sore throat, fever, malaise, swollen lymph nodes in throat, breathing and
swallowing problems
Treatment: hospitalisation and isolation to prevent the spread of infection, antibiotics to destroy
the bacteria (eg penicillin), consumption of the diphtheria antitoxin, surgery to remove the grey
membrane in throat, rest

Current vaccination program
Part of WHO 1974 Expanded Program on Immunisation (EPI)

Spread before vaccination program
100 years ago 50% of cases resulted in death
1921 there were 206 000 cases

Spread after vaccination program
Between 1980-2000 the total number reported cases decreased by less than 90%
The vaccine program certainly been effective in reducing the spread of disease and increasing
immunity to the disease. However, the disease is still present in developing countries and has not
yet been eradicated

Polio

Background
Cause: Poliovirus
Transmission: contact with food, water or hands contaminated with the faeces (poo) or throat
secretions of an infected person (eg. cough or sneeze)
Symptoms:
Mild: fever, malaise, headache, nausea and vomiting, muscle stiffness
Serious: brain infection and paralysis, swallowing and breathing problems, long-term disability and
death
Treatment: antibiotics, pain-relieving medication, ventilators to assist breathing, heat treatments
and ensuring a nutritious diet

Current vaccination program
Part of WHOs 1974 EPI

Spread before vaccination program
Estimated 350 000 cases worldwide in 1988

Spread after vaccination program
407 cases worldwide in 2013 - a decline of more than 99% since 1988
Highly effective vaccination program


6. Epidemiological studies involve the collection and careful statistical analysis of large quantities of
data. Such studies assist the causal identification of non-infectious diseases

6.2.1 Identify and describe the main features of epidemiology using lung cancer as an example

Epidemiology: study of patterns and causes of health and disease in populations. The aim of
epidemiology is to improve health (eg. fund allocation, national health priorities, establish groups at risk)

Example:
Epidemiological studies have been able to establish links between smoking and lung cancer. This
knowledge enables government agencies to take preventative measures, such as warnings on
smoking packets, to show the adverse effects smoking has on the human body and reduce the
prevalence of smoking.

Involves:
Collecting large quantities of data and analysing statistics to look for trends (cause and effect) over
an extended period of time with the same results. Example: lung cancer: who gets it, when, where,
what are their lifestyles like? Performing the study over many decades and continuously finding
evidence that smoking is the largest contributor towards lung cancer
Study over a diverse range of individuals. Example: studying prevalence of lung cancer over a
broad range of ages, gender, race and similar
Use of a control group to compare and increase reliability. Example: study the lifestyles of those
without lung cancer

Discovered lung cancer trends:
Smokers are 10x more likely than non-smokers to die from lung cancer
The more cigarettes smoked each day, the greater the incidence of lung cancer
The longer a person smokes the greater the chance of developing lung cancer
Greater risk of developing lung cancer due to passive smoking
As it became more socially acceptable, the number of females smoking increased and the
incidence of lung cancer in women increased
Smoking accounts for 85% of cases of lung cancer in men and 75% in women

6.2.2 Identify causes of non-infectious disease using an example from each of the following
categories:

Non-infectious diseases:
not caused by pathogens
not transmitted from one organism to another

Inherited diseases: caused by gene and chromosomal abnormalities which occur during the process of
meiosis

Example: DOWN SYNDROME
cause: inheritance of an third copy of chromosome 21 (trisomy 21)
symptoms: sufferers usually have learning and speech difficulties, a characteristic appearance and
often a shortened life-span
mothers who have children later in life are more likely to have a down syndrome child

Nutritional deficiencies: caused by incorrect or insufficient dietary intake

Example: SCURVY
cause: deficiency in vitamin C
symptoms: bleeding gums, tooth loss
treatment: increasing intake of vitamin C through foods and drinks (eg. citrus fruit)

Environmental diseases: Factors of the environment which cause disease

Example: MESOTHELIOMA (cancer)
Caused: exposure to asbestos
Symptoms: (do not arise until 20-30 years after exposure) include chest pain, chronic cough and
the presence of blood in lung fluid
Treatment: no known cure for mesothelioma, but treatments such as surgery and chemotherapy
help improve wellbeing

6.3.1 Gather, process and analyse information to identify the cause and effect relationship of
smoking and lung cancer

British doctors study
1946: Austin Hill and Richard Doll carried out an epidemiological study to establish the causative
relationship between smoking and lung cancer
1950: wrote their findings
1954: began longitudinal study which lasted over 50 years
Control case study, then a cohort study of British
doctors - comparing rates of lung cancer between
smokers and non-smokers
Every 10 years the results were published
2004: their findings were published in the British Medical Journal. They found that smokers die 10
years younger, on average, than non-smokers and if smoking is stopped by age 50 the risk of death
due to lung cancer is halved

6.3.2 Identify data sources, plan and perform a first-hand investigation or gather information from
secondary sources to analyse and present information about the occurrence, symptoms, cause,
treatment/management of a named non-infectious disease

Cancer: caused by UVA and UVB rays
Two main types of skin cancer:
1. Melanoma
2. Non-melanoma:

Occurrence
2/3 Australians will be diagnosed with skin cancer by 70 years old
~ Control case study: involves patients who
already have a certain condition, compared
with people who dont have the condition
~ Cohort study: follows patients who
presently have the condition compared
with a control group (without condition)
GPs have over 1 million patient consultations per year for skin cancer
In 2011, 2087 people died from skin cancer in Australia

Symptoms
Any crusty, non-healing sores
Small, red, pale or pearly lumps
New spots, freckles, mole, changing in colour, thickness or shape over weeks

Cause
between 95 and 99% of skin cancers are caused by exposure to the sun (eg. tanning)
exposure to other UVA and UVB rays, such as solariums

Treatment
surgical removal (or scraping)
freezing the cancer spot with liquid nitrogen
Radiotherapy
Chemotherapy

Management = Sun protection
SLIP on protective clothing (cover as much as possible)
SLOP on broad-spectrum sunscreen (SPF30+ / 20 mins before / every 2 hours)
SLAP on a hat (protecting face, neck, ears)
SEEK shade
SLIDE on sunglasses (that meet Australian standards)

Sources: SUN SMART Australia & CANCER COUNCIL Australia (websites)


7. Increased understanding has led to the development of a wide range of strategies to prevent and
control disease

7.2.1 Discuss the role of quarantine in preventing the spread of disease, plants and animals into
Australia or across regions of Australia

Quarantine: controlling of the import and export of animals, plants and other products.

Role of quarantine:
Protects the health of human, animal and plant populations of Australia
Prevents the entry of foreign pests and infectious diseases into Australia
Prevent the entry of items considered a risk
Therefore, preventing the spread of disease INTO and AROUND Australia

How is quarantine achieved?
Laws preventing entry of items of risk
Isolating animals and plants prior to entry
Inspecting agricultural vehicles and machinery for soil and plant matter contamination

Examples:

AQIS (Australian Quarantine and Inspection Service)
Manages quarantine controls at Australian boarders
Provides import and export inspection and certification
Continuously looks to improve the effectiveness of Australias quarantine by working closely with
other government agencies
Stopped diseases, such as foot and mouth, from entering Australia
Undergoes inspections and provides bins to put fruit in when entering particular fruit growing
areas (minimise fruit flies)

7.2.2 Explain how one of the following strategies has controlled and/or prevented disease:

Genetic engineering to produce disease-resistant plants and animals

Genetic engineering of crops has made them resistant to various pests and diseases. Therefore,
controlling disease and reducing or eliminating the need for pesticide chemicals

Example: Cotton Bollworm
Cotton Bollworm: pest that chews holes in cotton, tomato and peanut crops, making crops prone
to fungal disease
Pesticides dont work on Bollworm because it has evolved resistance
The cotton plant has been genetically modified by inserting Bacillus thuringiensis (Bt) soil bacteria
into the cottons genetic material. Bt is poisonous for Bollworm and will die after eating the plant



7.3.1 Perform an investigation to examine plant shoots and leaves and gather first-hand information
of evidence of pathogens and insect pests

Aim: To examine plant shoots and leaves and use resource information to describe the evidence of
pathogens and insects

Method:
1. Examine plant shoots and leaves in the schoolyard
2. Describe the type of evidence found when plants are infected with pathogens and insect pests
3. Record this information and draw a scientific diagram of observations

Results:

Psyllids (sap-sucking insect -organism)
Suck sap from new leaves, causing oval lumps on upper surface
corresponding to lower surface
Immature psyllids (nymphs) feed inside leaves, settle in one
spot and embed themselves - forming a lump
May cause leaves to become distorted and discoloured and cause terminal shoots to die back

Aphids (insect - organism)
Small, pear-shaped insects with soft, fragile bodies
Secrete honeydew into plant when piercing leaves to obtain sap
Causes distortion of new leaves and flowers

Sooty mould (black, sticky fungi - pathogen)
Often arises on plants after insects which secrete honeydew (eg.
Aphids)
Dark black mould covers the leafs surface and blocks out sources of
light, reducing the ability for photosynthesis and inhibiting plant
growth

Black spot (fungus - pathogen)
Starts with feathery black spots on upper surface of leaves, often
surrounded by a yellow halo
Eventually, infested leaves turn completely yellow and fall off
prematurely

Conclusion: From the observations found, it is obvious that the infestation of pathogens and specific
insects can severely inhibit the growth of plants

7.3.2 Process and analyse information from secondary sources to evaluate the effectiveness of
quarantine in preventing the spread of plant and animal disease into Australia or across regions of
Australia

Preventing pathogens INTO Australia:

Border control: passengers and cargo are checked at entry points into Australia. X-ray machines, detector
dogs and surveillance assist this process

Animal quarantine: animals coming into Australia spend weeks at a quarantine station where they are
examined to ensure they are completely free of disease before being released

Plant quarantine: all plants, part of plants or plant products are examined before coming into Australia.
Most plant products are refused entry into Australia, whilst others are allowed entry once they are treated
by officers with likely pathogens destroyed

Human quarantine: captains of ships and aircrafts are required to notify AQIS if any passengers display
symptoms of prohibited diseases (eg. rabies, malaria). The aircraft is also usually sprayed with insecticide
to kill any pests that have entered Australia in aircraft

Examples:

Plant: Citrus greening
Citrus greening has been controlled through plant quarantine (examining plants and treating likely
pathogens through the quarantine process
This has been highly effective, as Australia remains free from Citrus greening

Animal: Foot and Mouth Disease
Foot and mouth has been controlled through animal and human quarantine
Australia banned the import of any cloven-hoofed animals or their products from infected regions
during 2011 outbreak
Passengers entering Australia from infected areas were subject to thorough processing, including
treatment to ensure they are not carrying infected soil on shoes.
These measures have been extremely effective since Australia has been free from the disease since
1972

Preventing pathogens ACROSS Australia:

(AQIS strategies)
There is a restriction on fruit movement, as fruits and other foods can carry diseases or pests, which can
spread from one part of Australia to another. Each State and Territory has legislation that ensures
inspection points to protect the agricultural industries by reducing the prevalence of pests and disease. In
Fruit-fly Exclusion Zones (FFEZ), all fruit must be placed into provided quarantine bins to ensure no fruit-
flies are able to carry diseases into agricultural areas this has been highly effective as these areas have
remained relatively risk-free from pests for many years (ie. fruit flu is restricted to QLD)

Examples:

Plant: Phylloxera
Ground surveys have been conducted for phylloxera, especially in vineyards
Aerial surveys using near infra-red photography can be employed to identify vines
Zones, ranging from infested zones to exclusion zones, exist and have been highly effective in
controlling the disease to specific areas

Animal: Equine flu
Effected zones were labelled according to risk of infection from affected to non-infected areas
As outbreaks progressed, horse movements were assessed and monitored the determine the level
of risk of transferring disease
These controls have been extremely effective as Australia is the only country that has been able to
eradicate this disease.

7.3.3 Gather and process information and use available evidence to discuss the changing methods of
dealing with plant and animal diseases, including the shift in emphasis from treatment and control to
management or prevention of disease

Treatment: strategies to cure disease OR relieve symptoms
Control: reducing disease spread once already present
Prevention: strategies to stop occurrence and incidence of disease
Management: improve the outcomes of chronic conditions AND the sufferers quality of life,
hence, reducing the use of HC and HC costs

History of treatment and control to management or prevention of disease:

When drugs were discovered, the emphasis of dealing with disease was treatment and control (eg.
penicillin). As antibiotic resistance developed (ie. super bugs), the emphasis shifted towards prevention
and management of disease (eg. vaccines, quarantine). Thus, the shift in emphasis was a direct result of
an increased understanding of the functioning of the immune system and the development of more
advanced technologies

Treatment and control
Strategy Example Advantages Disadvantages
Pesticides - DDT to kill malaria
vector
- Controls spread of vector
- Controls spread of insect
pest
- Detrimental to
environment
- Resistant strain
development
Antibiotics - Treats different
bacterial infections
- Effective at treating
infections
- Eliminates the need for
surgery
- Bacteria can develop
resistance to
antibiotics, making it no
longer effective and
often leading to
superbugs
Medical intervention - Treatment of cancer
(surgery, radiation,
chemotherapy)
- Can destroy cancer cells,
leading to greater cancer
survival rate
- Side effects can be
harmful or painful
- Not always successful

Prevention and management
Strategy Example Advantages Disadvantages
Vaccination Polio vaccine Prevents individuals
from contracting
infection
Decreases prevalence of
disease in population
Very small percentage
may suffer from side
effects
Quarantine Prevention of:
fruit flies
phylloxera
foot and mouth
Pathogens have not
entered Australia (eg
Mad Cow Disease)
Diseases have been
prevented from
spreading ACROSS and
INTO Australia
Some diseases cannot
be removed from
infected areas and can
only be controlled by
preventing further
spread
Public health programs QUIT for life Targets whole
population (educates)
Statistics have proven
effectiveness
May not be effective for
all members of
population (ie. may not
stop all people from
smoking)