Health and Disease

OCR AS Biology
Unit 2
Module 2: Food and Health

Learning Outcomes
Discuss what is meant by the terms
health and disease
Define and discuss the meanings of
the terms parasite and pathogen

What is health?
health is more than just the absence
of disease
What is meant by health?
What is meant by disease?

Health
absence of disease

Disease
disorder of a systems normal functions

What is health?
You have been given 6 case studies
In your groups
discuss the health of each individual
Rank them from 1 6
1 healthiest
6 unhealthiest

Remember you must be able to give

reasons for your choices

Definitions
Health
A state of complete physical, mental and
social well-being, which is more than
just the absence of disease.

Disease
A problem with mind or body leading to
a departure from good health.

Good Health
Free from disease
Able to carry out mental and physical
tasks expected by society
Well fed, balanced diet
Housing and sanitation
Happy and positive outlook
Well integrated into society

The Health Triangle

Physical health means the health of
the body
Mental health means the health of
the mind.
Social health means forming good
relationships.

The Health Triangle

Physical

Social

Mental
If you take any of these away - the
triangle collapses

What is health?
In your groups
Go back to the original 6 case studies
Have your opinions changes
Rank them from 1 6
1 healthiest
6 unhealthiest

Remember you must be able to give

reasons for your choices

Disease
There are nine broad overlapping
categories of disease (see handout)
Diseases can also be grouped into
Single cause e.g. malaria
Multifactorial e.g. heart disease

Disease
Acute
Sudden rapid changes and lasting for a
short time

Chronic
Long term debilitating
Develops slowly and persists

pathogen
Infectious diseases are diseases caused by
pathogens.
A pathogen
is defined as an organism which causes
disease
Lives by taking nutrition from the host
May cause damage to the host

Disease transmission is the transfer of a

pathogen from infected to uninfected
people

Parasite
A parasite is defined as
Organisms that live in or on another
living things
Benefit at the hosts expense
Can be
Internal parasite e.g. tapeworm
External parasite e.g. head louse

Infectious Disease
Organisms that can cause infectious
disease include

Bacteria e.g. cholera and TB

Fungi e.g. athletes foot and ringworm
Virus e.g. cold, influenza and AIDS
Protoctista e.g. amoeboid dysentery,
malaria

Learning Outcomes
Describe the causes and means of
transmission of malaria, AIDS/HIV
and TB (symptoms not required)
Describe the global impact of
malaria, AIDS/HIV and TB

Infectious diseases
A pathogen can:

Gain entry to the host

Colonize the tissues of the host
Resist the defences of the host
Cause damage to host tissues

Transmission
The most common forms of transmission
are
By means of a vector
By physical contact
By droplet infection

Malaria and tuberculosis

Pathogens invade cells and spread through the
tissues

HIV
Virus can lie dormant in T lymphocytes
Weakens the immune system to opportunistic
infections (AIDS)

Malaria
Causative organism
Protoctista
genus Plasmodium
P. falciparum is the
most widespread
Methods of
transmission
insect vector
Female Anopheles
mosquito
See diagram

Global distribution
Widely distributed
through the tropics and
sub tropics

Annual incidence
300 million

Annual mortality
worldwide
1.5 1.7 million

Malaria
Global impact

Increasing drug
resistance by
Plasmodium
40% of worlds
population live in
malarial areas
Difficulty in developing
a vaccine
Increase in epidemics
as environmental and
climatic changes favour
mosquitoes
Mosquitoes are
developing resistance
to insecticides

Control measures

Use sleeping nets to

prevent mosquitoes
biting at night
Use of drugs to fight of
Plasmodium
Reduce mosquito
populations
drain marshes and
swamps
destroy mosquito larva
oil or insecticide on
water, use carnivorous
fish

TB (tuberculosis)
Causative organism
Mycobacterium
tuberculosis
Mycobacterium
bovis
Methods of
transmission
inhalation of
droplets from
infected person
via infected milk

Global distribution
Worldwide in
developing countries
and among migrants
and inner cities in
developed countries

8.8 million new

cases every year
1.5 million deaths

TB (tuberculosis)
Global impact
Some strains are
resistant to drugs
(1950s)
AIDS pandemic
Poor housing and rising
homelessness
Breakdown of TB
control programmes

Control measures
Contact tracing,
through testing for
bacteria and screening
for symptoms

2005 BCG vaccine

ruled ineffective
DOTS (directly observed
short course treatment)
Long course of
antibiotics

HIV/AIDS
Causative organism
Human
Immunodeficiency Virus
Methods of transmission
Body fluids, esp.
semen, vaginal fluids
and blood
Sexual intercourse,
shared needles,
child birth, breast
feeding
Infected blood products

Global distribution
World wide
Highest prevalence in subSaharan Africa and Southeast Asia

HIV/AIDS
Global impact
39.5 million people
living with HIV
2006
4.9 million new cases
2.9 million deaths from
AIDS

Affects the affluent and

the impoverished
TB is an associated
opportunistic infection

Control measures
Use of condoms
Health education (safe
sex)
Screening of blood
donations
Heat treatment of blood
products to kill viruses
Needle exchange
schemes
Contact tracing

Immunity
Module 2: Food and Health
Health and Disease

Learning Outcomes
Define the terms immune response,
antigen and antibody.
Describe the primary defences
against pathogens and parasites
(including skin and mucous
membranes) and outline their
importance.
Describe, with the aid of diagrams
and photographs, the structure and
mode of action of phagocytes.

Definitions
Immune response
Specific response to a pathogen
Involves the action of lymphocytes and the
production of antibodies

Antibodies
Protein molecules produced and released in
response to a antigen

Antigen
Foreign molecule protein or glycoprotein
Provokes an immune response

Primary Defences
The bodys primary defences attempt
to stop pathogens from entering
body tissues
This includes

The skin (epidermis)

Mucous membranes
Eyes protected with tears
Ear canal lined with wax

Epidermis
The outer layer of the epidermis is a
layer of dead cells which contain the
fibrous protein keratin.
These cells are produced in the
process keratinisation the cells
dry out and the cytoplasm is
replaced with keratin.
This layer of cells acts as a barrier

Mucous membranes
Mucous membranes protect surfaces
which are at risk of infection
Mucus is secreted by the epithelial linings
of airways, digestive system and
reproductive systems
In the airways ciliated cells move mucus
up to the mouths where it can be
swallowed
In the stomach, hydrochloric acid kills
most pathogens that we ingest.

Secondary Defences
Non-specific immune response
Phagocytes

Specific Immune response

B and T lymphocytes
Antibody production

Phagocytosis
Phagocytes engulf and digest pathogenic
cells
Neutrophils
found in the blood and body tissues
Collect at an area of infection

Macrophages
Travel in blood as monocytes
settle into the lymph nodes where they
develop
Stimulates production of T lymphocytes

Phagocyte - photographs

Neutrophil

Macrophage

Macrophage
engulfing
tuberculosis
bacterium

Stages in phagocytosis
Pathogens are recognised by antigens on
their surface
Phagocyte moves towards pathogen and
receptors on the cell surface membrane
attach to antigens on the pathogen
Phagocyte engulfs the pathogen creating a
phagosome
Lysosomes fuse with the phagosome
releasing digestive enzymes
End products absorbed into the cytoplasm.

Phagocytosis Animations
http://www.microbelibrary.org/image
s/tterry/anim/phago053.html

Stages of Phagocytosis

Learning Outcomes
Describe the structure and mode of action
of T lymphocytes and B lymphocytes,
including the significance of cell signalling
and the role of memory cells.
Describe, with the aid of diagrams, the
structure of antibodies.
Outline the mode of action of antibodies,
with reference to the neutralisation and
agglutination of pathogens.

Immune Response
Immune response is the activation of
lymphocytes in the blood to help
fight disease
T- Lymphocytes
Produced in bone marrow
Mature in the Thymus

B-Lymphocytes
Produced and matures in bone marrow

Immune response
Pathogen enters body
Clonal selection
Antigens bind to complementary
glycoproteins on B and T lymphocytes
This stimulate the immune response

Clonal expansion
B and T lymphocytes divide by mitosis

T-lymphocytes
T lymphocytes divide into 3 types of
cell
T helper cells (Th)
Release cytokines
stimulate B cells to develop
Stimulate phagocytosis (cell signalling)

T killer cells (Tk)

Attack and kill infected body cells

T memory cells (Tm)

B lymphocytes
B lymphocytes develop into two
types of cell
Plasma cells (P)
Flow in blood
Manufacture and release antibodies

B memory cells (Bm)

Immunological memory
Remain in blood for a number of years
Stimulate the production of plasma cells quickly
upon reinfection by same pathogen.

Cell signalling in immune

response
Identification of pathogens
Sending distress signals
Antigen presentation
Instructions
Communication using cytokines

Stages in immune response

Infection and reproduction of
pathogen
Presentation of antigens
Clonal selection
Clonal expansion
Differentiation (proliferation)
Action antibody production

Antibodies
Proteins a.k.a. immunoglobulins
Specific shape complementary to
that of an antigen
Antibody shape
4 polypeptide chains held together by
disulphide bridges
Variable region
2 binding sites specific to an antigen

Hinge regions allow flexibility

Antibody structure

Mode of action of antibodies

Neutralisation
Antibodies bind to toxins neutralising
their effects
Antibodies combine to viruses and
prevent them from entering the cell.

Agglutination
Pathogen clump together
Too large to enter host cells
Helps phagocyte to engulf and digest
pathogens

Learning outcome
Compare and contrast the primary
and secondary immune responses.

Primary Immune response

Production of plasma cells
Antibodies produced to combat
infection
Takes a few days for number of antibodies in blood to rise

Secondary immune
response
B memory cells circulate in blood
Rapidly produce plasma cells upon
reinfection
Plasma cells produce antibodies
Rapid response

Primary and secondary

immune response

Learning Outcomes
Compare and contrast active,
passive, natural and artificial
immunity.
Explain how vaccination can control
disease.
Discuss the responses of
governments and other organisations
to the threat of new strains of
influenza each year

Immunity
Natural immunity
gained as part of normal life processes

Artificial immunity
Gained by deliberate exposure to antibodies or
antigens

Active immunity
Results from stimulation of immune response

Passive immunity
Introduction of antibodies
Short lived

Immunity
Immunit
y

Active

Passive

Natural

Long term immunity

Infected by the disease
inducing an immune
response
Takes time

Immediate protection
Antibodies from mother
-Across placenta
-In colostrum (breast
milk)
Short term immunity

Artificial

Long term immunity

Immunisation or
vaccination
Takes time

Immediate protection
Injected with antibodies
e.g. tetanus injections
Short term immunity

Vaccination
Vaccine

Preparation of antigen
Injected or given by mouth
Stimulates primary immune response
Boosters given to stimulate secondary
immune response

Antigenic material
Living attenuated micro-organisms
Can not cause symptoms
Multiply
E.g. TB, poliomyelitis

Dead micro-organisms

Harmless but induce immunity

E.g. typhoid, cholera

Preparation of antigens
E.g. hepatitis B vaccine

Harmless toxin

E.g. tetanus vaccine

Control of disease
Vaccinations can be used to control
disease by providing immunity to all
those at risk
Herd immunity
Use a vaccine to provide immunity to all
of the population at risk

Ring immunity
Vaccinate everyone in surrounding area
to prevent transmission of disease

Influenza
Viral disease of the respiratory system
Associated with

Fever
Sore throat
Headache
Muscle pains
Weakness

Can lead to pneumonia

Can be fatal
New strains arise by mutations (some
virulent)

vaccination programmes
Epidemic
Disease suddenly spreads rapidly to
infect many people

Pandemic
Large scale outbreak of a disease

Governments research and try to

predict which strains of flu are going
to appear each year

Vaccination programmes in UK
All people aged over 65
Young people with asthma
People who work in high-risk categories
such as medical professionals
The strains of flu used in the
immunisation programme change each
year.

Learning Outcomes
Outline possible new sources of
medicines, with reference to
microorganisms and plants and the
need to maintain biodiversity.

New Medicines
Why do we need new medicines
Pathogens become resistant to existing
drugs e.g. antibiotics
New disease emerge
New vaccines needed e.g. HIV
Existing vaccines can be improved

Discovery of New Medicines

By accident
E.g. Alexander Fleming and the
discovery of penicillin

Traditional medicine
Anaesthetics
Observation of wildlife
Modern research

Natural medicines
Discovery of natural drugs has
concentrated on tropical plants due to the
great diversity of species in tropical
rainforests
Examples
Madagascan periwinkle anticancer
Sweet wormwood antimalarial

It is important that plant species do not

become extinct before we can discover
their value.

Smoking and Disease

Module 2: Food and Health
Health and Disease

Learning Outcome
Describe the effects of smoking on
the mammalian gas exchange
system, with reference to the
symptoms of chronic bronchitis,
emphysema (chronic obstructive
pulmonary disease) and lung cancer.

Smoking - Intro
WHO considers smoking to be an
epidemic
Cigarette smoke contains
Tar a group of chemicals including
carcinogens
Carbon monoxide
nicotine

Reasons to give up
smoking

Short term effects of Tar

Tar settles in linings of airways and
alveoli
Inceases diffusion distance of gases
Chemicals can cause an allergic reaction
Lumen of airway narrows restricting air flow.

Paralyses cilia
Mucus secreting cells enlarge produce
more mucus
Increase risk of infection

Long term effects of tar

Smokers cough

Irritation of airways
Damages lining of airways and alveoli
Lining replaced by scar tissue
Smooth muscles thickens, lumen
narrows and airflow is permanently
restricted.

Diseases linked with smoking

Chronic Obstructive Pulmonary
disease
Combination of diseases that includes
Asthma
Chronic bronchitis
emphysema

Chronic Obstructive Pulmonary

Disease

Chronic Bronchitis
Inflamed lining
Smooth muscle
layer thickens
Goblet cells and
mucus glands
secrete more
mucus
Damage to cilia

Symptoms

Shortness of breath
Wheezing
Persistent cough
Increase risk of lung
infection

Emphysema
Loss of elasticity of
alveoli
Alveoli burst
Air spaces are
larger reducing
surface area for
gas exchange

Symptoms
Shortness of breath
Difficulty exhaling
Blood less well
oxygenated
fatigue

Lung Cancer
Cigarette smoke contains
carcinogenic compounds including
benzopyrene
Carcinogens enter cells of lung tissue
Mutation affects the gene controlling cell
division
Uncontrolled cell division leads to a
tumour
Bronchi become blocked by cancerous
growths

Symptoms of lung cancer

persistent cough
Coughing up blood
Weight loss
Pain in chest

Learning Outcomes
Describe the effects of nicotine and
carbon monoxide in tobacco smoke
on the cardiovascular system with
reference to the course of events
that lead to atherosclerosis, coronary
heart disease and stroke.

Nicotine and carbon monoxide

Nicotine and carbon monoxide pass
from the lungs into the circulation
Changes occur that can lead to
Atherosclerosis
Coronary heart disease
stroke

Nicotine
Addictive drug
stimulant
Releases adrenaline which increases
heart rate and blood pressure
Stimulates decrease in blood flow to
extremities
Increases chance of blood clots
Makes platelets sticky

Carbon monoxide
Enters red blood cells and combines
with haemoglobin to form
carboxyhaemoglobin
Reduces oxygen carrying capacity of
the blood
Damages linings of arteries

Cardiovascular disease
Multifactorial
There is a number of risk factors
Of which smoking is just one

Degenerative disease of the heart

and circulatory systems
20% death worldwide
Up to 50% developed countries

Atherosclerosis
Atherosclerosis
Accumulation of fatty material
(atheroma) in artery walls, reducing flow
of blood to the tissues
Reduces the size of the lumen
Reduces blood flow

Definitions
Atheroma
Contains cholesterol, fibres, dead
muscle cells and platelets

Plaques
Build up of atheroma
Make arteries less elastic and reduce the
flow of blood

atherosclerosis

Stages in development of
Atherosclerosis
Damage to endothelium of arteries
invasion of phagocytes to repair damage
Secretions from phagocytes stimulate
growth of smooth muscle and the
accumulation of cholesterol
Atheroma builds up
Atheroma forms plaque
Size of lumen reduced, Blood flow reduced

Stages in atherosclerosis

Thrombosis
Blood flow past the plaque is not
smooth which increases the risk of
blood clotting.
Thrombus
Blood clot in artery which stops flow
May dislodge and be carried in the blood

Coronary heart Disease

Lumen of coronary arteries narrowed
by plaque
Reduces the blood flow to heart
muscles
3 forms
Angina
Heart attack / myocardial infarction
Heart failure

Stroke
Death of part of the brain
Can be sudden
Two causes
Thrombus
Blood clot blocks a narrow artery in the brain

Haemorrhage
an artery leading to the brain burst
Aneurysm = weakness in wall of artery

Learning Outcomes
Evaluate the epidemiological and
experimental evidence linking
cigarette smoking to disease and
early death.

Epidemiology
The study of the distribution of
diseases in order to find a means of
preventing and controlling it.
Epidemiological studies
Identify links between disease and risk
factors
Identifies which countries / age range /
gender may be at greater risk.

Epidemiological studies
Information gained can be used to:

Target funding
Target research
Target screening
Target education and advice
Predict future incidences of the disease

Smoking and diseae

1950s doctors first noticed a
correlation between lung cancer and
smoking.
About half of smokers die of smoking
related diseases
Smokers are three times more likely
to die in middle age than nonsmokers

Linking smoking to lung cancer

if stop smoking the risk of lung
cancer decreases
Smokers 18 times more likely to
develop lung cancer than non
smokers
25% smokers die due to lung cancer

Linking smoking to lung

diseases
98% emphysema sufferers are
smokers
20% smokers suffer emphysema
smokers twice as likely to die from
pneumonia and influenza
COPD is rare in non smokers

Linking smoking to CVD

This is less evident as CVD are
multifactorial
However, substances in cigarette
smoke can influence the
cardiovascular system and likely to
enhance atherosclerosis

IMPORTANT POINT

All conclusions drawn by

epidemiological data show
an association and not a
causal link.

Experimental Evidence - Dogs

Dogs exposed to unfiltered smoke
developed changes similar to COPD
and early signs of lung cancer.
Dogs smoking filtered cigarette
smoke developed changes which can
lead to lung cancer

Experimental evidence - Tar

Chemical analysis of tar shows that it
contains known carcinogens
When painted onto the bare skin in
rats the tar caused cancer in the skin
cells.