GENERAL PRINCIPLES OF TREATMENT AND CONTROL

SYLLABUS OBJECTIVES

Students should be able to :

Distinguish among pathogenic, deficiency, hereditary and physiological diseases; D 1.1

Discuss differences among me methods used to treat and control me four main
groups of disease. D 1.2

CONTENT

Major groups of disease

Health, as defined by me World Health Organization, is me complete physical, mental and social
well-being of an individual, and not just me absence of disease. Disease is the condition in which
the normal state of an organism is modified or damaged. Diseases may be classified as;
pathogenic, deficiency, hereditary or physiological.

Pathogenic diseases: One of the main causes of disease in an organism is me presence of another
organism, a parasite, living on or in its body from which it gels its food. In so doing, parasites
often damage tissues or produce toxins which poison its host, causing diseases. Pathogen is a
. term used to describe parasites which cause disease. The diseases are referred to as pathogenic.

The main groups of pathogenic organisms include viruses and bacteria. These organisms are
responsible for a wide range of pathogenic diseases. Viral diseases include influenza, dengue,
polio, chicken pox and AIDS. Bacterial diseases include rheumatic fever, sore throat, food
poisoning, leprosy, cholera, typhoid, syphilis and gonorrhoea. Other important pathogens are
found in the protozoa (malaria parasite), roundworms and fungi (ringworm and athlete's foot).

Deficiency Diseases: Deficiency diseases are caused by the shortage or lack of certain essential
factors in the diet, e.g. anaemia, protein energy malnutrition (PEM) and rickets. These diseases
are more common in developing and under -developed countries man in developed countries. This
may be due to the following reasons:

Shortage of a particular type of food

Low income; shortage of money and an inability to buy the right kinds of food
Lack of proper education

Hereditary Diseases: Hereditary diseases are passed from one generation to another and as such
cannot be cured. An individual suffers from a hereditary disease simply because the factors that
cause me disease have been passed to him by one or both of his parents, e.g. sickle-cell anaemia
and haemophilia.

Physiological Diseases: A body organ may malfunction or its cellular structure may change over a period
of time. The proper working of the body is affected and this results in physiological
diseases. Two such diseases common in the Caribbean are diabetes and hypertension.
Treatment and Control

Treatment refers to steps taken to deal with a disease in an individual who is ill, for example,
taking medication, changing the diet, or changing some pattern of behaviour. Control refers to
measures taken to prevent disease spreading throughout a population. Control measures for some
diseases also include treating those persons who are already ill thus removing a source of
infection. The treatment and control of diseases depend on the cause of the disease and the
method of transmission.

Pathogenic disease

Pathogenic diseases can be controlled in different ways. The method selected depends on two
main factors; (i) the pathogen and (ii) the method of transmission i.e how the pathogen gets from
one person to another.
Pathogens may be:

1. Airborne: The organisms are carried in tiny droplets of moisture released by

coughing,
sneezing and talking. These diseases spread rapidly in overcrowded conditions e.g.
buses,
classrooms, or public meetings.

2. Waterborne: Some organisms are found in contaminated water. Large numbers of

people
are infected quickly when organisms enter water supplies through insanitary practices
such as improper disposal of faeces.
3. Foodbourne: Unwashed hands and/or contaminated water used in ,food
preparation can
infect food. Some pathogens use animals which humans eat as agents of transmission.
Food that is not properly cooked, or kept in sanitary conditions after cooking, can cause
infection.

4. Direct contact: Pathogens are sometimes spread by direct bodily contact with an
infected
person or contact with objects handled by them. such as towels, clothing hair combs etc.
5. Animal home: Animals which transmit pathogens are called vectors. Pathogens
may be
carried by vectors (i) on their body surface e.g. houseflies or (ii) inside their bodies e.g.
mosquitoes.
Effective treatment of pathogenic diseases would involve eliminating the pathogen. This can be
done by using medication/drugs which kill the pathogen and relieve the symptoms of the disease
such as fever. swelling etc.
Control measures are aimed at preventing transmission, This may involve killing vectors or
destroying their breeding grounds, improvements in public sanitation and personal hygiene, as
well as public education on how a particular disease is spread. Vaccination campaigns and
quarantine laws are also very important for preventing the spread of some diseases from one
country to another, as well as within a country.
Deficiency Diseases
The lack or absence of certain essential factors in the diet may result in clearly defined symptoms.
The addition of these factors to the diet usually removes these symptoms. For example, a lack
of iron in me diet of man results in anaemia. The person experiences shortness of breath, general
tiredness and has a pale appearance. Eating foods rich in iron or taking iron supplements would
control iron-deficiency anaemia.

Hereditary Diseases

Hereditary diseases cannot be cured because of how they are transmitted. Until it becomes
possible to alter the genetic makeup of an individual only the symptoms of genetic disorders can
be controlled. In all cases of hereditary diseases, genetic counselling is advised.

Haemophilia, or 'bleeder's disease', is a disease where the blood fails to clot or clots at a very
slow rate resulting in excessive bleeding from small cuts and wounds. Persons suffering with this
disease could be informed on what to expect and what activities to avoid. Various commercial
preparations are now available which encourage blood clot formation in cases of severe bleeding.
These clotting factors are taken from the blood of healthy individuals.
Physiological diseases

Most physiological diseases cannot be completely cured but their symptoms may be controlled
through diet, exercise and/or drugs, as seen with diabetes and hypertension. Improvements in
nutrition and lifestyle changes are also important in preventing physiological disorders. In this
connection, public awareness and education are very important in reducing the incidence of these
diseases (both of which are very common in the Caribbean).

Diabetes is the condition where the body is unable to regulate the concentration of glucose in the
blood because the pancreas fails to secrete enough of the hormone insulin. There is a high blood
glucose level and excretion of glucose in the urine. There are two types of diabetes:
Type 1. insulin dependent diabetes, is a severe form of the disease which usually starts in
early life. It is caused by the destruction of the insulin producing cells of the pancreas, the
islets of Langerhans. Treatment is the administration of insulin by injection.

Type 2. non-insulin dependent diabetes, usually starts later in life and has no known cause.
In many cases it is associated with being overweight or consuming large quantities of
sugary foods for many years. Blood glucose levels can be controlled by weight loss and
diet or drugs which stimulate the pancreas to increase its production of insulin.

Hypertension is the condition where the blood pressure remains above normal levels usually due
to narrowing or hardening of the arteries. In some cases fatty material is deposited in the arteries
reducing the space through which blood must be forced by the heart. A high salt and fat intake,
overweight, Jack of regular exercise, stress and smoking all contribute to hypertension.

The roles of diet and exercise

Diabetes and hypertension are both treated by sticking to low calorie diets. In the case of
diabetes particular attention should be paid to carbohydrate intake especially that of sugar. For
hypertension, the intake of fat should also be drastically reduced and the amount of salt kept to
a minimum. Regular exercise and changes in life style would also help to control hypertension
and diabetes. Exercise helps to bum up sugar, reducing its level in the blood and preventing
obesity. It also reduces stress. Drugs can also be taken to reduce the blood pressure.
 VECTORS

SYLLABUS OBJECTIVES

Students should be able to;

Explain the role of vectors in the transmission of disease; D 2.1

Explain the importance of knowing the life history of a vector. D 2.2

CONTENT

A vector is an organism that transmits a disease causing organism from one person to another.
It carries the pathogen either inside or outside its body. Mosquitoes, for example, carry the
pathogen for malaria and dengue fever inside their bodies. Houseflies may carry the pathogens
for cholera, typhoid fever and gastro-enteritis on their bodies.

Vectors such as the housefly provide a mechanical means of transmission for pathogens. When
the vector crawls or walks on contaminated material, mainly faeces, pathogens becomes attached
to body hairs or sticky pads on the feet. These pathogens are then deposited on food as the insect
flies over or walks on the food. Alternately, the organisms may pass through the vector',
digestive tract and be deposited on the food in its faeces or saliva.

When, however, a pathogen is carried inside the vector, the vector acts as a second host in which
the pathogen has to complete part of its life cycle. Transmission may be by saliva during biting
or by regurgitation or deposition on the skin, in which case, the pathogen penetrates into the body
when the host robs or scratches the skin.

Life history of the mosquito

The mosquito is a vector for a number of diseases including malaria, dengue fever, yellow fever
and elephantiasis. Different species of mosquito carry different diseases. In the absence of
mosquitoes, the pathogens cannot complete their life cycle and would therefore be unable to cause
diseases. Hence eliminating certain species of mosquitoes can eradicate the diseases they spread.

Although diseases transmitted by mosquitoes may be cured by using drugs, or prevented by

isolating infected persons and protecting others from being bitten, the best control measure is to
destroy the mosquitoes in all their different developmental stages and to destroy their breeding
places. A knowledge of their life history and habits is therefore essential.

Adult mosquitoes usually lay their eggs on the surface of stagnant water. The Aedes aegypti,
which carries yellow fever and dengue, prefers clean water. Within a few days the eggs hatch into
active larvae, sometimes called wrigglers, which feed on microscopic organisms in the water. The
larvae breathe using air tubes which obtain atmospheric oxygen and gills which extract oxygen
dissolved in the water. They grow and feed for about a week or two and then change into pupae.
Pupae hang from the surface of the water and breathe in air. Inside the pupal case larval tissue
are reorganized to form adult organs. After a few days a young adult emerges.
Life cycle of a mosquito
The mature female mosquito requires a meal of blood for her eggs to mature, When she bites
an individual she secretes saliva which prevents blood from clotting. If she bites an infected
person she takes in the pathogens with the blood. The pathogen goes through a stage of its life
cycle and enters the salivary glands of the mosquito. When an infected mosquito bites a healthy
person, saliva containing the pathogens is injected into the person's blood.
The adult, larvae and pupae can be killed using chemicals. Breeding places should be drained
frequently (e.g. drains and pools) or removed (e.g. empty tins and bottles). Where draining is not
possible (e.g. lakes) the surface can be sprayed with oil. This reduces the surface tension of water
and larvae and pupae would be unable to breathe. This method is no longer used on a large scale
because it causes the deaths of many other aquatic organisms. Biological control has become
increasingly popular. This involves introducing natural predators, of the larvae and pupae, e.g.
fish, into the water.

Life history of the Housefly

Houseflies are household pests. They spread diseases by collecting pathogens on their hairy
bodies, on sticky pads on their feet or taking them in along with food into their digestive systems.
Pathogens are picked up from faeces, sewage and rotting material and deposited on food, drinks
or open wounds. They do not discriminate in their food source and may fly from a rotting animal
to garbage and then to prepared foods in the kitchen, all in a few minutes. They defecate on the
food while feeding and may also regurgitate semi-digested food.

The adult female housefly lays eggs in moist rotting animal and plant material including human
faeces. If conditions are favourable, within a few hours to about three days, larvae or maggots
emerge. The larval stage lasts for about one to two weeks during which the larvae feed, grow
and moult. The larvae then change into pupae. Pupae do not feed. Inside, the larval tissues are
broken down and adult structures develop. A few days later, a young adult emerges. Within two
weeks, an adult becomes sexually mature and can begin to lay eggs.

Knowledge of this life cycle is important in getting rid of houseflies and preventing them from
spreading disease. Potential breeding grounds should be destroyed. Adults and maggots can be
killed with chemicals. Food for human consumption should be properly stored and kept covered.
 AIDS AND OTIIER SEXUALLY TRANSMITTED DISEASES
SYLLABUS OBJECTIVE

Students should be able to:

Discuss the causative agent, transmission and control of A1DS and one other
sexually transmitted disease (SID). D 2.3

CONTENT

AIDS

Causative agent Acquired Immunodeficiency Syndrome (AIDS) is the progressive destruction

of the immune syst.em by the Human Immunodeficiency Virus (IDV). When a person is infected
with HIV. the virus binds to the surfaces of specific white blood cells (called T4 cells or helper
cells) and inactivates or destroys these cells which are an important part of the immune system.
This weakens the immune system. The infected person becomes susceptible to pathogens which
are normally destroyed by these cells and vulnerable to a wide range of diseases. Death results
from any of these diseases.

Transmission: AIDS was first diagnosed in 1981 in a small population of homosexual men but
now occurs in heterosexual males and females with multiple sexual partners, haemophiliacs.
intravenous drug users infants and small children.

HIV may be transmitted by any activity which allows the body fluids of an infected person to
enter the bloodstream of another person. This may take place:
(i) during sexual intercourse;
(ii) by sharing contaminated needles to inject drugs;
, (iii) by blood transfusions with blood from an infected person;
(iv) if there is close contact between cuts and open wounds of infected and non infected
persons
(v) from an infected mother to her developing baby through the placenta or to her
breast feeding infant. through breast milk.
It is not spread by casual contact or through sneezing and coughing.

Signs. symptoms and nature of the disease: After exposure to the virus. there is a period between
six weeks to years before the virus or an antibody against. the virus is detected in the blood.
Infection with lDV does not necessarily result. in AIDS.

The infected person may not develop symptoms for many years. The most common symptom is
swollen lymph nodes. Fatigue. fever. chronic diarrhoea and a rash may appear later. Some
infected persons never experience any symptoms and are termed carriers. They make antibodies
against the virus, which can be detected by a blood test

11
As the immune system deteriorates, the disease progresses to what is known as 'full blown AIDS'
and a wide range of illnesses appear. These include a rare type of pneumonia, a rare and
disfiguring type of skin cancer, known as Kaposi's sarcoma, other forms of cancer and
tuberculosis.

Control

To date there is no known cure for AIDS. In 1994, WHO estimated that 18 million people
worldwide were infected with HlV. New infections were occurring at a rate of 10,000 new
infections per day. AIDS can be controlled if the spread of HIV is reduced. This could be
achieved in several ways:

1. Modifying sexual behaviour; abstinence, one safe partner and the use of barrier
methods
such as condoms during intercourse;
2. Using clean needles and syringes;
3. Testing all donated blood for the presence of antibodies to IHV;
4. Educating the public about the disease through the media, emphasizing its method
of
transmission and the risks involved;
5. Testing pregnant women for the antibodies and administering early treatment to
reduce the risk of babies being infected;
6. Testing all newborn babies for the antibodies against HIVand then identifying.
informing and treating infected mothers;
7. Insisting on safety precautions e.g. use of gloves, goggles, gowns, for health care
practitioners.

For those persons already infected with the virus and suffering with AIDS, certain drugs are used

to prevent and treat many of the diseases that typically develop. These drugs are costly and not
readily available in third world countries. A recently developed drug seems to be able to prevent
the virus from multiplying.

OTHER SEXUALLY TRANSMITTED DISEASES

AIDS can be sexually transmitted, however, sexual intercourse is not the only method of
transmission. Gonorrhoea, syphilis and Herpes genitalis are three diseases transmitted through
sexual intercourse.

GONORRHOEA

Causative Agent Gonorrhoea, commonly known as "clap", is worldwide in distribution and

very common. It is caused by a bacterium. Mortality rates from gonorrhoea are negligible but
it is responsible for a very high percentage of sterility in males as well as females.

Transmission: The bacterium is transmitted during sexual intercourse with an infected person.

Signs and symptoms: In males, the first symptoms are a burning sensation on urination and a mild
discharge. In females, in most instances, symptoms are so mild that they tend to go unnoticed.
Untreated, infection may spread and cause blocking of tubes rendering females sterile.

Treatment: '(be use of the antibiotic penicillin is very effective in curing the disease.

SYPHILIS

Causative Agent: Syphilis is caused by a bacterium. It is rare in developed countries but very
common in underdeveloped countries.

Transmission: Syphilis may be transmitted from an infected mother across the placenta to her
unborn child. The main means of transmission is through sexual contact.

Signs and Symptoms: During the early stages of infection, a small, hard, painless swelling
appears at the site of infection. This may go unnoticed and heals even without treatment. The
infected person then develops a rash on face, trunk and limbs which may last for several weeks.
'Ibis may disappear spontaneously. If untreated, about ten years later. some persons may show
more severe symptoms some of which may be fatal. These may include intense back pains, lack
or muscular coordination, wasting of muscles, insanity, blindness and heart attacks.
Treatment: Infected persons can be successfully treated by antibiotics.

HERPES GENITALIS

Causative agent: Herpes, like AIDS, is caused by a virus.

Signs and symptoms

A small, red, painful sore appears on the genital organs of both sexes. Swollen glands and fever
develop. These symptoms disappear after a few weeks but may return at irregular intervals during
the person's lifetime, especially during times of stress or when the person's resistance is low.
Treatment: There is no known cure for Herpes genitalis. Drugs exist which make the sores Jess
painful. Sexual intercourse should be avoided to prevent transmission (0 uninfected persons.

Control of STDs

Sexually transmitted diseases are preventable. Their spread can be controlled by:
J. Restricting sex to one safe partner:
1 Tracing contacts; (This is especially important with gonorrhoea because the woman may
not develop any symptoms.)
4. Effective diagnosis and treatment; (Vague symptoms may cause disease to go unnoticed.)

S. Education; (Knowing the facts about STDs is very important in its prevention.)

6. Use of condoms.

Social implications of STDs

The treatment of diseases including STD's involves a cost. The treatment and care of persons
with a lifelong illness is very costly to a family, as well as to a country, Prevention of these
diseases can be very cheaply and easily achieved.

A country has to provide medical services in the form of drugs, specialized care, and counseling to
patient and family members. This puts a strain on limited resources especially in developing and
underdeveloped countries.
Persons with STDs, especially those infected with HIV are often shunned by family members
as well as the society. They become afraid, lonely, depressed and confused and there are few
public facilities to take them in.

STD's are more common among the age group which, at the time of infection, are contributing
to the development of their family and country. When they are ill and can no longer make a
meaningful contribution, their families suffer. When the final outcome is death, then there is a
tragic loss to family and country. Many parents die because of AIDS leaving children which
become the responsibility of other family members or the state.

STDs can spread very rapidly through a population, largely because of ignorance. Persons ignore
symptoms or keep their illness a secret from partners. Those who do go for treatment may not
reveal the names of their partners. Many use home remedies which cannot cure the disease
although some of them mask the symptoms.
 DEFENSE AGAINST DISEASE
SYLLABUS OBJECTIVES

Students should be able to:

Describe the role of blood in defending the body against disease; D2.4
Explain the principles of immunization against communicable diseases. D2.5
CONTENT

The blood plays an important role in defending the body against disease. A scratch, cut or wound
on the skin serves as a point of entry for pathogens which could result in pathogenic diseases.
These organisms should be prevented from entering and once entered should be quickly destroyed.
The body responds to this in several ways:
(i) Formation of a blood clot;
(ii) Engulfing and destroying invading organisms, especially bacteria;
(ill) Production of antibodies.

Antibody production can also be induced by artificial means.

Clotting of blood

The formation of a blood clot is a natural defense mechanism of the body. This seals the wound,
reduces the loss of blood, and prevents the entry of pathogens into the body. In addition when
the clot hardens into a scar, it protects the delicate new tissue while the area is being repaired.
Clotting is a complex process. In the blood are a number of substances which are essential for
clot formation. These include the proteins prothrombin and fibrinogen, calcium ions and vitamin
K. When a blood vessel is damaged, the damaged platelets and cells release a chemical which
helps to convert prothrombin to thrombin. Thrombin acts on fibrinogen converting it to insoluble
fibrin. Fibrin forms a network of fibres across the wound which traps red blood cells and
platelets. This forms a clot. Beneath the clot, new tissue grows and heals the wound ~
Phagocytes

Once pathogens have entered the bloodstream, they can be transported all over the body. They
must be quickly destroyed before they cause disease. Phagocytes are one type of white blood cell
which defends against these microorganisms. They destroy bacteria circulating in the blood, or
at the site of a wound, by engulfing and digesting them with an amoeboid action. Some of the
phagocytes are killed by the toxins produced by the pathogens. The dead cells collect at the
wound as a white fluid known as 'pus' which gradually becomes absorbed as the wound heals.
 4.
6.
5.

The person has obtained artificial immunity. For some diseases, e.g, typhoid and cholera,
antibody levels decrease with time. A second or third dose of the vaccine, called boosters. is
needed to maintain the antibody levels, so the person remains protected.

'Ready-made' antibodies can also be introduced into the bloodstream. This is done when
immediate protection is necessary. For example, when a person has been. exposed to a deadly
disease, such as rabies, there is no time for the body to make antibodies. Antibodies are quickly
injected to protect the individual. This immunity lasts only for a short time. as the injected
antibodies are themselves destroyed.

The process of providing artificial immunity is called immunization. Immunization has been very
effective in eradicating or reducing the incidence of certain communicable diseases.
There are some diseases, for which the body cannot make antibodies fast enough (0 prevent
illness. Some of these are either fatal or likely to leave a person with physical disabilities, e.g,
polio, if the person survives. A person can be artificially protected against such diseases by
vaccination. This process involves the introduction of a preparation called a vaccine which may
be administered orally or by injection. The process of giving the vaccine is called inoculation.
A vaccine is made from pathogens that have been killed or weakened by some treatment, In this
Slate, these organisms are unlikely to cause diseases but they are still recognized as foreign. The
lymphocytes therefore produce antibodies against them, just as they would during an actual attack.

DRUG ABUSE
SYLLABUS OBJECTIVE

Students should be able to:

Discuss the physiological, social and economic effects of drug abuse. D 3.1
CONTENT

17
A drug may be defined as any chemical substance, other than food, that when taken into the
body, alters its structure and/or function. Drugs may be used for treating, diagnosing and
preventing diseases. Used in this way, drugs are beneficial. However. when drugs are used in
excessive amounts for non-medical purposes, this is drug abuse. Psychological, physical and
social problems arise from such use,
Social Problems caused by Drug Abuse

Drug abuse often leads to accidents. crime, prostitution, and suicide. If a drug is illegal then
persons found with it can be prosecuted. Illegal drugs are expensive and drug dealers earn a lot
of money selling them. There is great temptation among unemployed youth to go into the
business. Many serious crimes such as murder and wounding are associated with drugs.

Petty stealing is one way drug users finance their habits. Many young women (and men) also
become prostitutes to earn money for drugs.

Drug abusers often lose interest in school, work, play and companionship of friends. Families
may be neglected because one or both parents use all their time and resources on drugs. This leads

to serious problems with family relations, absenteeism from work and loss of jobs.

Economic problems are common. especially if the abused drug is expensive. Treatment for the
drug abuser is also very expensive and not very successful. Scarce resources are spent on drug
education efforts, rehabilitation centres and public assistance to abandoned families and those
who
become psychiatric problems as a result of abusing drugs.

Dependence

A drug user may become psychologically dependent on a drug. Drug use becomes compulsive
and the user become so obsessed with the drug that obtaining and using the drug becomes the
main aim in life, regardless of the cost and/or risks involved. The health may deteriorate, the diet
is neglected and social and economic problems arise as they give up their usual relationships and
spend all their time and resources on drugs.

A drug user is said to be physically dependent when he or she suffers withdrawal symptoms if
the drug intake is decreased or stopped. These symptoms vary but are usually very unpleasant
and in some cases painful. When drugs are taken by injections, there is the added risk of infection
from certain diseases, including the AIDS virus.
Abused drugs are not necessarily illegal drugs. Some abused drugs may be legally purchased
and
are socially accepted. Alcohol and caffeine are two such examples.
Caffeine
Caffeine is a stimulant found in many drinks commonly used in our society. These drinks
include
coffee, tea, cola and cocoa. Caffeine is also found in some pain killing prescriptions and non-

prescription cough and cold remedies. Caffeine is addictive. Some users experience serious
withdrawal symptoms, such as severe headaches, if they are deprived of coffee. Over use of
caffeine is also associated 'with heart disease.
Alcohol abuse

Alcohol is probably the most commonly used and abused drug in the world. In most
countries
it may be purchased legally and is socially accepted. Alcoholic beverages include wines,
beers
and spirits (including whisky, rum, brandy, liqueurs and vodka). Alcohol is also widely used
as
a solvent in the manufacture of organic compounds, including varnishes, dyes and lacquers;
substances used in "glue-sniffing". ('Glue-sniffing' or solvent abuse is a growing problem
among
young children. They inhale volatile substances which produce a sensation of temporary
euphoria
but could lead to death by respiratory failure.)

Physiological effects: Alcohol does not need to be digested and is readily absorbed from the
stomach into the blood stream which distributes it throughout the body. Its effects are very
rapidly felt because of this. It is a depressant which slows the transmission of impulses
through
out the nervous system. In small quantities it causes a relaxed feeling and increased
confidence
as inhibitions disappear. However as intake increases, the drinker may become over
confident and
aggressive and physically uncoordinated.

Frequent heavy drinking of alcohol damages several body organs. It damages the lining of
the
mouth, oesophagus and stomach. It destroys cells of the liver leading to cirrhosis and
hepatitis.
Cells of the pancreas are destroyed resulting in reduced insulin production. Alcohol
consumption
reduces appetite and this leads to nutritional diseases. Alcohol consumption may lead to
hypertension and heart disease.

Alcohol is a very addictive drug. It is difficult for alcoholics to function without the drug as it

causes changes at certain synapses so that impulses will not cross them effectively. This also
affects a part of the brain which controls emotions. In the absence of alcohol depression sets
in.

Alcohol causes irreversible damage to nerve cells resulting in loss of sensation and muscle
weakness. Its effects on the CNS are many. The cerebrum is first affected. Vision is affected,
there is slurring of speech and misjudgment in thinking; as centres for the control of balance
become affected movement becomes increasingly uncoordinated and staggering and falling
occurs;
reaction time is reduced. If excessive amounts are consumed the medulla becomes affected.
This
may lead to death as the centres for breathing and control of the heart rate are depressed.
Emotional changes range from boisterousness, verbal and physical aggression to quiet
withdrawal
and even tearfulness.

Even small quantities damage the unborn child. It reduces growth and retards mental
development and produces physical defects. Babies born to alcoholic mothers never develop
properly.
Social problems: There is no doubt that alcohol abuse creates social problems. These
include:

Break: down of family relations: Alcohol causes behavioural changes which often lead
to verbal and physical aggression. Violent behaviour may be exhibited resulting in wife

beating and physical, verbal or even sexual abuse of children. The abused wife may
attempt to kill her husband or commit suicide.

The family may have financial problems as more and more of their income is spent on
drinking. The alcoholic parent may also be fired adding to the strain on the family.
Besides being abused the children of alcoholics suffer severe embarrassment and may
become withdrawn. Their performance in school also suffers because of the emotional
stress and the frequent disruptions at home. There is a high incidence of alcoholism
among children of alcoholic parents as children turn to alcohol (or other drugs) to
relieve their distress.

Finally, the family may break up all together. Divorce or separation is sometimes the
only
way om for the spouse who has tried unsuccessfully to solve money problems or deal
with
the shame and disgrace brought to the family. The breakup of the family may lead to
delinquency among the children. As the single parent struggles to cope the children
may
be neglected and go astray.

Accidents: Alcohol affects the CNS. It reduces reaction time and interferes with
muscular control. There is misjudgment in thinking and focusing and the ability of the
eye to follow objects is impaired. These, together with the increased aggression,
contribute to vehicular and industrial accidents. The user fails [0 recognize his or her
impairments and instead, due to increased confidence, takes more risks. In all countries

the greatest cause of vehicular accidents is drinking.

Crime: Behavioural changes associated with alcoholic consumption may lead to minor
wounding and or more serious crimes including sexual assault on children and rape or
even murder. To support the addictive habit. petty larceny or fraud may also occur.

Economic problems: As dependence on alcohol increases, an increasing proportion of

income is
spent on purchasing drinks. This reduces the amount of money spent on other things. When
alcoholic consumption leads to job loss, hence loss of income, then numerous problems arise.
Default on loan payments may occur and repossession of home and property may occur. The
family of an alcoholic may become dependents of the state.
At the level of the country, alcoholics are more often absent from their jobs and are usually
Jess
productive than their associates. Health and welfare services, provided to alcoholics and their

dependents, are costly. A very high percentage of hospital services and space is used to treat
alcoholics. their abused dependents or their accident victims. Widespread alcoholism places a

heavy burden on the economic resources of a country.

Marijuana
This is a drug found in the dried leaves stems and flowers of the Indian hemp plant,
Cannabis.
This plant grows wild in many parts of the world but is also cultivated illegally. Marijuana
goes
by several other names including 'pot', "ganja', 'weed', and 'grass'.

The leaves of the plant are dried, crushed and then rolled into thin home-made cigarettes,
called
'joints', 'reefers' or 'sticks', It is also smoked in ordinary pipes or special pipes called chalices.

It is occasionally ingested in drinks, cakes and other foods.

Physiological effects: Marijuana is the most common abused illicit drug. Its specific effects
vary
from user to user according to the amount used and the expectations of the user; however, it
is
classified as a hallucinogen. It affects the user's mood and thinking. In low doses, it produces
a
feeling of well-being and relaxation. There is a feeling of inner joy. The user feels "high".
Perceptions of time and distance may be distorted. Hallucinations and delusions may also
occur.

When smoked, it quickly enters the blood stream and acts on the nervous system. It slows
reflexes and interferes with the skills needed for safe driving. Balance and stability may be
impaired, so too is memory, thinking and speech. Dizziness, light-headedness, and blurred
vision
are common.

It increases heartbeat, pulse rate and blood pressure. It increases the amount of carbon
monoxide
in the blood which decreases the amount of oxygen delivered to the heart. This becomes a
serious problem with persons suffering from hypertension and cardiovascular diseases.
Marijuana irritates the trachea and bronchi causing sore throats and bronchitis. Prolonged
heavy
smoking leads to cancer of the upper respiratory tract.

Marijuana use may result in lower productions of sex hormones in men and women. Women
may also experience irregular menstrual cycles. Both men and women may su1Jer temporary
infertility. Marijuana use during pregnancy may result in premature babies of low weight.

Regular marijuana use by a young person can interfere with learning and emotional
development.
The user is unable to concentrate; there is decreased attention span, distortion in perception,
lack
of motivation, poor control of impulses and loss of interest in social activities.
Continual use results in blood shot eyes and dry mouth and throat.

Social and economic effects: Marijuana use has less severe effects than alcohol abuse at the
individual level. However, it is thought that its use contributes to the use of harder drugs,
Many
troubled young people use marijuana, to the extent that they become less productive or non-
contributing members of society.

As the drug is illegal, it is associated with criminal activities because it becomes a lucrative
crop
to grow and sell at home or abroad. A large percentage of the time and financial resources of
Caribbean police and military services is spent seeking out and destroying ganja fields,
apprehending drug smugglers, and ensuring that ships and planes leaving the islands are not
carrying marijuana. In some islands travelers are taxed to pay for these searches.

Drugs are taken to cure illness, reduce pain and relieve stress. Billions of pills and capsules are
legally manufactured every year by the pharmaceutical industry. Antibiotics are legal. Weight
control or diet pills are readily available. Doctors regularly prescribe sedatives and tranquilizers,
in addition sleeping aids are widely available without a prescription. There is growing concern
about the numbers of these drugs being used and the ease with which they can be purchased.

Diet Pills: Some diet pills work by increasing the metabolic rate and cause the body to bum
more
calories. These drugs are stimulants belonging to a group which includes the amphetamines.
After using these pills for a long time a person can become addicted to them. This happens to
many teenagers who become obsessed with weight loss and use diet pills to control their weight.

These drug users show all the signs common to drug abusers. Young people lie, steal from
parents and friends to gel money for the drugs. They may suffer from depressions, their
schoolwork deteriorates and they become loners as their friends find it difficult to deal with
them.

Antibiotics: An antibiotic is an anti-bacterial mug. The prolonged, indiscriminate and inexact

use of antibiotics has contributed to an increase in the number of resistant strains of bacteria. It
has become more and more difficult to find antibiotics which are effective against diseases such
as tuberculosis. The concern is that, in the near future, there will be serious outbreaks of
infectious diseases which cannot be controlled.

Steroids: These chemicals are used to treat rheumatism and other inflammatory ailments. They
may also be administered to post-operative patients to promote muscle growth and tissue
regeneration. Recently, a growing number of amateur and professional athletes are using steroids
to accelerate muscle development and to improve strength. Medical research has revealed that
anabolic steroids can have harmful effects, especially in young people who are still developing
physically. Continued and prolonged use may lead to heart disease, liver damage and
abnormalities of the sex organs.

Tranquilizers: These are drugs used to reduce hyperactivity, anxiety and tension. They may even

induce sleep. Tranquilizers are widely prescribed, widely available and also widely abused.
Overuse leads to addiction, toxicity and other undesirable effects. Some well-known brand
names
are Valium, Phenobarbitone, and Secondly. Addiction is more common among women.

8.
7.

9.
 THE SOCIAL AND ECONOMIC IMPLICATIONS OF DISEASE

SYLLABUS OBJECTIVE

Students should be able to:

Discuss the social and economic implications of disease in plants and animals. D 3.2

CONTENT

The effects of diseases on Man, his livestock and his crops can be devastating, if not deadly. The
issue of preventing and controlling diseases is therefore a serious one. Families, governments
and
other social institutions, spend vast sums of money dealing with the effects of the diseases,
whereas, much of this expenditure can be avoided, if certain preventative measures are taken
instead. Nevertheless, when the effects of the diseases are examined, this expenditure can be
easily justified.
Social implications
A healthy person is more likely to be happy and productive than a person who is ill. Diseases
always affect productivity, either directly or indirectly. This may be illustrated using examples.
Hypertension is a disease common in Caribbean society. Hypertension, if not controlled,
commonly leads to heart attacks, strokes and sometimes death. A stroke victim often suffers
some degree of paralysis. When this happens, this person is no longer a fully functional
individual. He is off the job, sometimes permanently, and may be totally dependent on others
for his every need.
For an independent person, especially a breadwinner, this has certain negative psychological and

emotional effects. His changed behavior affects family life; frustration and depression are
common, suicide is not uncommon,

A loss of income coupled with additional medical expenses would mean further difficulties for
a family already under stress. For example, children may not be able to continue their education.

They may have to help support the family or they may become delinquent.
When the disease involved is a STD, more so AIDS, there are other problems to consider. There
is the alienation from friends and even family members. Family members of the victim are in
turn avoided and socially isolated. The victim may be emotionally abandoned, at a time when
such support is most needed.
Death may be the result of a disease. The loss of a loved one is a traumatic experience for
everyone concerned. When this also means the loss of the breadwinner of the family or small
children are left without one of their parents, it has other serious implications.
The abuse of drugs also carries with it social effects. These effects are many and varied
It could involve physical and mental abuse of close family members. The
abuser could be imprisoned for several reasons. This sentence carries with it social consequences
for family members. Drug abuse could also mean job loss.

Economic effects

"Prevention is better than cure." There is a cost involved in prevention, but it is often less
expensive, economically and emotionally to prevent than it is to treat. Besides, there are diseases
which cannot be cured but may be prevented e.g. AIDS, some forms of hypertension and heart
disease, etc.

Some countries allocate funds towards screening programmed, immunization programmed, training
health care workers, increasing public awareness through the media, improving living conditions,
providing food supplements and public assistance, all in an effort to reduce the incidence of
diseases. All of these efforts are costly.

These, however, cannot prevent the occurrence of all diseases. Money must also be spent on the
treatment of diseases. The economic effects of diseases have more far reaching effects when
livestock and crops are considered.

A sick person may lose part or all of his income and in addition has anadded expense of
providing treatment for his illness. However, when crops and/or livestock are lost through
diseases, this could have serious economic effects to individuals as well as to a country.

In many Caribbean islands agriculture is the main stay of their economy. When fanners select
varieties of plants to produce better yields and hence better economic returns, and such varieties
are then affected by a disease, this could mean economic disaster not only to the farmer and his
workers bur to me country. With less agricultural produce available locally, there is a higher food
import bill and less money to be gained from food export. (This will be all too obvious in
countries which have been affected by me recent outbreak of the Pink Mealy Bug, which is a
pest, not a disease, but has me same effect.)

In a chicken farm, where chickens are housed in enclosed spaces, the presence of a disease could
easily mean the loss of me entire stock. 'This would be a severe financial loss to me individual
and country.

Loss of productivity

An important aspect of economic loss is the loss of productivity. If large numbers of workers are
chronically ill men they are incapable of giving their best. Their level of productivity is lowered
by frequent absences due to sick leave and a lower work rate when on the job. They also produce
poor quality goods so the company or institution for which they work earns less.

Diseased plants and animals do not necessarily die but they produce less for the amount of money
and effort spent to raise them. Farmers, and in turn, the country earns less.