The Search for Better Health

What is a healthy organism?

• Discuss the difficulties of defining the terms 'health' and 'disease'
• Outline how the function of genes, mitosis, cell differentiation and specialisation assist in
the maintenance of health.
• Use available evidence to analyse the links between gene expression and maintenance and
repair of body tissues

Health and Disease

Discuss the difficulties of defining the terms 'health' and 'disease'

WHO defines health as: a state of complete physical, mental and social well-being and not merely
the absence of disease or infirmity

Physical health: physical state of body e.g. fitness, body weight, amount of energy and proper
functioning of body systems.
Mental health: ability to function effectively in society and cope with changing situations in our lives.
Social health: ability to interact, communicate and socialise effectively.

Disease: any condition that adversely affects the normal functioning of any part of a living thing

Why is it difficult to define health and disease?
• It's extremely difficult to achieve healthy status if the definition is taken literally
• Different individuals have different ideas about what is considered and appropriate level of
health.
• Terms used in everyday conversation have different meanings to scientific definitions
• People with chronic disease may describe themselves healthy as they have learned to cope
with it daily.
• Health can vary with age/fitness etc. e.g. forgetfulness is bad in the young, but is considered a
normal part of being old.

Maintenance of Health

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

Cell Differentiation and Specialisation:

Differentiation: Stem cell matures and takes on different structural features so can be structurally
suited to perform a specific function. This occurs after mitosis.

Specialisation: Specific genes are switched on in a cell to perform a particular function.

E.g. Nerve cells differentiate to have an elongated structure to suit function of message transfer.
Genes are switched on in these cells to allow them to transfer electrochemical messages.

Differentiation and specialisation maintains health because it ensures different tissues e.g. muscles,
blood & nerves, work in a controlled/coordinated way to maintain health of the body. If these
processes didn't occur, the body can't function.

Mitosis

Growth

Repair: Cells wear out and need replacing e.g. RBC (3 month life) and skin cells constantly dying. Rate
of mitosis needs to be controlled to maintain correct cell numbers.

Genetic stability: Each daughter cell contains same amount of chromosomes as each other and
parent cell. Allows cell to function normally, and tissues to be repaired/maintained.

Genes: code for proteins that regulate cell cycle and mitosis
• Are units of inheritance: control polypeptide synthesis (needed for all processes, growth &
repair)
• Regulate cell cycle and limit growth/reproduction of cells
• Some disease are due to faulty genes e.g. cystic fibrosis is a genetic disease caused by
mutation in CFTR gene.
• Mutations are changes in genes; they sometimes do nothing, or may cause tumours or kill the
cell.

The cell cycle is regulated by these genes:
• DNA repair genes: code for proteins that are responsible for the stopping of the cell cycle.
Other proteins remove and repair damaged regions of DNA. If these genes mutate, DNA is not
repaired and the correct protein is not made.
• Proto-oncogenes: code for proteins which stimulate cell growth & mitosis. Mutations to these
lead to oncogene expression which causes uncontrolled cell growth and the prevention of
apoptosis, leading to tumours.
• Tumour suppressor genes: code for proteins that slow down/stop cell growth & mitosis. Also
code for proteins that cause apoptosis if these is an uncontrolled increase in cell numbers.
Mutations to these genes can lead to formation of tumours and cancer.
Genes work in balance in a healthy cell. If the cell cycle is disrupted, it leads to uncontrolled cell
replication which doesn't allow differentiation to maintain specialised functions, and can cause
formation of tumours and cancers.

Genes and Health

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

Genes, Proteins and Healthy Bodies

• Genes can be switched on or off by conditions both inside and outside the cell. A gene is
expressed when it is switched on and the DNA code is converted into a polypeptide.
• Everyone has some faulty genes, but sometimes the faults may result in a genetic disease as
the gene is not expressed correctly.

E.g. Cystic fibrosis (CF) is inherited and affects 1 in 2500 Aussies.
• People with this have difficulty breathing and digesting food.
 • Usually have shortened life expectancy (~35 in Australia)
• No cure for CF currently
• Treatment: regular medication, physiotherapy and exercise.
• Lung transplants are an option for people with severe lung disease due to CF.

• CF is caused by a mutation in the CFTR gene on chromosome 7.
• The CFTR gene codes for the CFTR protein, which forms a protein channel in the cell
membrane that moves chloride ions to the outside of the cell.
• If the protein doesn't work properly, chloride ions are not moved to the outside of the cell,
and causes mucus buildup.
• CF results in sticky mucus on the outside of cells and affects 3 main parts of the body:
o Lungs: mucus clogs airways, making breathing difficult and increasing risk of bacterial
infection in lungs.
o Pancreas: blocks ducts so digestive enzymes can't get into the small intestine, so food
can't be properly digested.
o Sweat glands: too much sweat is lost, so salt/water balance is disrupted.
• Gene therapy:
o Treatment currently in clinical trial
o Healthy CFTR gene inserted into lung cells of a patient to correct defective gene.
o 1993: first experimental gene therapy was given to patient with CF.
o Common cold virus modified to act as a vector carrying normal gens to CFTR cells in
airways of the lung.
o Other studies have tested fat capsules, synthetic vectors, nose drops or drizzling cells
down a flexible tube to CFTR cells lining lung airways, to deliver the therapy.
o Current research includes testing aerosol delivery of gene therapy using nebulisers.

Link between gene expression and health?
• Gene is expressed when it is switched on and produces its coded polypeptide.
• CFTR gene when correctly expressed produces a protein that is a channel across cell
membrane for chloride ion movement.
• Mutation in this gene results in it not being expressed, and the protein channel being non-
functional.
• Results in build up of thick mucus on outside of cells, and symptoms: difficulty breathing,
digesting and lung infections.
• Therefore for an organism to maintain health, genes must be correctly expressed.
Over 3000 years ago, the Chinese and Hebrews were advocating cleanliness in food, water and
personal hygiene.
• Distinguish between infectious and non-infectious disease.
• Identify data sources, plan and choose equipment or resources to perform a first-hand
investigation to identify microbes in food or in water.
• Explain why cleanliness in food, water and personal hygiene practices assist in control of
disease.
• Identify the conditions under which an organism is described as a pathogen.
• 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.


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

Early Civilisations
Civilisation Disease Prevention/Treatment
Babylonians • Open water channels over long distances to villages & cities
• Toilets in wall recesses, drained well
• Isolated the sick to reduce spread of disease
Egyptians • Kept houses clean, bathed frequently, used pure water
• Had more than 700 drugs to treat disease (some still in use)
Chinese • 200BC: personal hygiene culture amongst educated
• Diseases were classified and books written
• Smallpox described by AD 497
• Chopsticks enforced within an army by some general I don't remember
Hebrews/Jews • Used egyptian hygiene practices
• Had rules:
• Rest after 6 days of work (sabbath)
• Keep body clean
• Protection against infectious diseases: isolate lepers, disinfect homes
after illness
• Disposal of rubbish and excrement
• Protection of water and food supply
• Prohibition of risky food combinations and risky foods e.g. pork, meat
and milk etc.
• Had good drainage systems
Romans • Pioneered public sanitation
• Had lots of aqueducts
• Bathing

Hygiene: Personal and community hygiene

Personal hygiene: keeping bodies and orifices clean to reduce risk of pathogens invading, or
transmission.
1. Wash hands with soap and water before preparing and eating food, and after going to the
bathroom. This prevents pathogen spread that can cause diseases like diarrhoea
 2. Clean body, hair and teeth regularly to prevent pathogenic build up (especially bacterial
plaques) to numbers that can cause disease e.g. gingivitis that can cause swollen gums and
eventually, loss of teeth.
3. Cough/sneeze into hanky to prevent airborne droplets from spreading to others. Don't cough
onto your hands as that will aid transmission.

Community hygiene: prevents build-up of pathogenic organisms in community, reduces disease
spread
1. Sewage and garbage disposal: reduces risk of pathogen numbers increasing and spreading
through a community and causing disease.
2. Sterilisation and disinfection of equipment (e.g. hospitals, surgeries, doctors,
hairdressers/barbers, dentists etc.) and reduces risk of pathogen spread.
3. City planning reduces overcrowding and risk of transmission of disease through the
population; important in controlling the disease.

Cleanliness in Food: Pathogens can be transferred from environment to person in food. E.g.
Hepatitis A can be transmitted by eating foods handled by someone who has the disease, or by
eating uncooked shellfish grown in polluted waters.
Some food preparation guidelines:
• Wash hands before and after food (especially raw food) handling
• Tie back hair and cover wounds in preparation
• Use hot soapy water to wash dishes
• Use different chopping boards for meats and vegetables
• Thaw frozen foods in the fridge, or rapidly in the microwave
• Store food out of the danger zone (hot food >60˚C, cold food <5˚C)
• Chicken and mince based foods should be cooked thoroughly
• Raw vegetables to be thoroughly washed
• Foods should be covered in storage

Cleanliness in water
• Water contaminated with faeces can contain unsafe levels of pathogens e.g. protozoans
Cryptosporidium or Giardia, which can cause cramps, diarrhoea, nausea and vomiting.
• Cholera is waterborne, untreated sewage contamination causes it.

Infectious and Non-Infectious Diseases
Distinguish between infectious and non-infectious disease.
Identify the conditions under which an organism is described as a pathogen.


Term Definition
Infectious Caused by pathogens which invade the body and reproduce in tissues.
disease E.g. cold, flue, kuru, influenza, cholera, hepatitis, mumps, measles, malaria
Non-infectious Disease caused by a factor other than a pathogen (genetics,
disease lifestyle/environment, physiological malfunction). Cannot be transmitted, causes
are often multifactorial
E.g. scurvy, obesity, cancer, lead poisoning, alcoholism, cardiovascular disease
Pathogen Any organism or infective agent that lives in/on another living organism and
causes disease
E.g. virus, bacteria, fungi, protozoa, worms (macroparasite), prions
Vector Organisms that transmit a pathogen from a host to another e.g. mosquito, fly
Host Organism that supports a pathogen internally/externally to its own detriment
Virulence Virulence is the intensity of the disease that a pathogen causes
Macroscopic Pathogens that can be seen with the naked eye e.g. tapeworms, ticks, lice
parasite
Microscopic Pathogens that can only be seen with a microscope e.g. bacteria, protozoans,
parasites viruses, unicellular fungi
Endoparasite Pathogens that live inside the host
Ectoparasite Pathogens that live outside the host
Epidemic Outbreak of infectious contagious disease that spreads rapidly in a short time
that affects many people
Pandemic Widespread epidemic affecting a large part of the population

Conditions under which an organism is described as a pathogen:
• It causes disease when it invades the host.
• Ability of a pathogen to cause disease depends on its ability to:
o Invade host
o Reproduce in/on host
o Avoid being affected by host's immune response

How can pathogens be spread?
• Droplet infection (sneezes/coughs)
• Body contact (shaking hands, touching mouth etc.)
• Sexual contact (exchanging bodily fluids)
• Contamination of food/water
• Carrier vectors (flies and cockroaches carrying microbes)
• Injecting vectors (mosquitoes with malaria)

Drinking Water
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.

Water Treatment

Method Process Way of reducing
infection risk
Coagulation and Coagulant chemicals added (e.g. alum) to water to Up to 99.9% bacteria,
flocculation react with slow/non-settling particles. This produces a and 99% viruses
floc (big heavy particle) that settles rapidly removed, as they are
carried on the
suspended particles
Sedimentation Particles settle out from the standing water and will Suspended particles
sink to the bottom with pathogens
removed, along with
some organic matter
 Filtration Water passes through substance that helps remove Even smaller particles in
even smaller particles e.g. sand filtration or membrane water are removed
filtration along with the
pathogens they carry
Disinfection Oxidation: adding chemicals e.g. O3 and Cl2, or Microbes and potential
irradiating water with UV light. This kills microbes pathogens are
killed/inactivated.

Water testing: Testing components determines whether water is meeting guidelines, and is suitable
for drinking and other uses.
Things tested for:
• Coliforms - Bacteria such as Escherichia coli, that are associated with faecal contamination are
an indicator that other diseases faecal contaminant pathogens are also present. Killed by
chlorine.
• Cryptosporidium and Giardia are microbes that infect endotherms in their intestines. These
are introduced to water through faecal matter or animal carcasses.
• Chlorine is added to water to kill pathogens, and there must be enough chlorine in the water
to ensure that it remains disinfected as it travels through pipes to people.
• Fluoride is added to tap water in small amounts to aid dental health
• Low levels of trace elements e.g. aluminium, iron and manganese occur naturally in water, and
may cause staining and taste problems.
• Trihalomethanes (by-products of disinfection process)
• Turbidity: a measure of how many suspended particles there are in water, which make it
appear discoloured/murky. These particles could have pathogens.
• Water should be clear and colourless.

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.
• Describe the contribution of Pasteur and Koch to our understanding of infectious diseases.
• Perform an investigation to model or process information to describe Pasteur's experiment
to identify the role of microbes in decay.
• Distinguish between:
o Prions
o Viruses
o Bacteria
 o Protozoans
o Fungi
o Macro-parasites
And name one example of a disease caused by each type of pathogen.
• Gather and process information to trace the historical development of our understanding of
the cause and prevention of malaria.
• Identify data sources, gather, process and analyse information from secondary sources to
describe one named infectious disease in terms of its:
o Cause
o Transmission
o Host response
o Major symptoms
o Treatment
o Prevention
o Control
• Identify the role of antibiotics in the management of infectious disease.
• Process information from secondary sources to discuss problems relating to antibiotic
resistance.

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

Before Pasteur and Koch
• Theory of spontaneous generation; living things could arise from non-living matter
• Lack of microscope technology prevented scientists from understanding causes and methods
of disease transmission

Louis Pasteur's Experiment

He was able to conclude that spontaneous generation is not how food is spoiled.
The factors that cause decay are found in air and the environment, and must come in contact with
food in order for it to decay.
Pasteur did more experiments to show that most infectious diseases are caused by pathogens,
leading to the germ theory.

He contributed to our understanding of disease prevention by developing technique of
pasteurisation.
• Proved that microbes causing wine to spoil can be killed by heating to 55˚C for several minutes
• Pasteurisation is now used to sterilise milk and beer.
• Prevents spread of disease as people aren't ingesting pathogens that cause disease.

Also developed technique of inoculating animals with weakened microbes so they are protected
against more virulent forms: vaccination.

Robert Koch: Studied cause of disease.
• First to develop way of growing pure bacteria cultures on jelly in a petri dish
• Investigated cause of anthrax, isolated and identified the bacterium which caused sheep
anthrax.
• Developed Koch's postulates, rules that need to be followed before a scientist can confirm a
particular microbe as the cause of a disease.

Koch's postulates:
1. The microbe believed to cause the disease must always be present in the organism when the
disease occurs.
2. The microbe must be isolated and grown in pure culture (agar plate) in a laboratory.
3. Microbes from the pure culture must produce the same symptoms of the disease when
injected into a healthy host.
4. The microbe must be isolated from the host in which the disease was induced and grown in a
pure culture. This culture is compared to the original culture, and the two microbes must be
identical.

His postulates will work for viruses, but they must be cultured in host cells as they can only
reproduce inside living cells. Chicken eggs are often used.

Koch also isolated and described the bacteria which cause tuberculosis and cholera. He also
developed tuberculin to test for TB in humans and prevent spread of disease.

Pasteur’s Experiment
Perform an investigation to model or process information to describe Pasteur's experiment to
identify the role of microbes in decay.

Modelling Pasteur's Experiment

Aim: To identify if microbes in the air cause decay

Method:
1. Pour equal amounts of broth into 3 identical test tubes, label A, B and C
2. Boil broth in each tube for 2 minutes
3. Place stopper on test tube A, place stopper with a straight glass tube on B, and place a stopper
with a swan necked glass tube on test tube C.
4. Leave for 2 weeks at room temperature
 5. Observe and record colour of broth

Results:
Broth that was covered had no growth
Uncovered broth went cloudy (with a tube from the outside to the inside)
Swan-necked broth remained clear

Discussion:
• Broth was boiled at beginning to sterilise broth and ensure it has no microbes in it. This means
the cause of decay has to originate from the outside environment, making the experiment
valid.
• Open swan-necked flask allows for contact with outside air, but prevents microbial entrance.
• Straight tube lets microbes and air in, so a comparison can be made as to whether microbes
actually cause decay or not.
• Results were the same as that of Pasteur's, thus microbes (and contamination from the outer
environment) is essential in causing decay, life cannot spontaneously arise.

Types of Pathogens
Distinguish between:
o Prions
o Viruses
o Bacteria
o Protozoans
o Fungi
o Macro-parasites
And name one example of a disease caused by each type of pathogen.

Types of Pathogens
Pathogen Description Diseases
Prion • Infective abnormal protein • Kuru in humans
• No genetic material • Creutzfeld Jacobs
• Genetic prion converts normal protein into prion Disease
protein • BSE in cattle (mad
• Infects nerve cells, causing the cell to burst. Results in cow disease)
holes in the brain of infected patients. • Scrapie in sheep
• Resistant to heat and chemicals: it's not alive; you can't
kill it
Viruses • 0.01-0.3µm in size (can only be seen under electron • Chicken pox
microscope) • Measles
• Structure: outer protein coat enclosing DNA or RNA • Mumps
(are not cellular) • Polio
• No enzyme systems • Rubella
• Must be inside another living cell to reproduce; use • Influenza
enzyme system and metabolism of host cell to • Ebola
reproduce. • Small pox
• Host cell is killed, virus particles are released
Bacteria • 0.5-5µm in size • Cholera
• Unicellular • Tuberculosis
• Prokaryotic - no membrane bound organelles • Diptheria
• Has cell wall • Tonsillitis
 • One chromosome • Typhoid
• Also has circular plasmid of DNA • Legionnaires
• Have ribosomes and enzymes disease
• Reproduce by binary fission
• Can produce toxins which attack organs
Protozoans • 2-500µm • Amoebic dysentery
• Unicellular • Malaria
• Eukaryotic cells • Toxoplasmosis
• Aquatic • African sleeping
• No cell wall sickness
• Are heterotrophic
• Reproduce asexually or sexually
• Damage living tissue
Fungi • Unicellular: yeast • Tinea
• Multicellular: moulds • Thrush
• Cause inflammation of body surfaces • Ringworm
• Reproduce asexually or sexually, most commonly • Athlete's foot
through spore release
• Fungi have a cell wall made of chitin
• Heterotrophic
• Eukaryotic
Macroparasites • Multicellular • Hookworm -
• Vary in size from a few mm to 5m tapeworms elephantitis
• Eukaryotic cells • Tapeworm - taenia
• Can be endoparasites or ectoparasites • Lice
• Some secrete toxins or invade and damage internal • Ticks
organs • Liver flukes


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

Malaria
• Plasmodium protozoans cause malaria
• Transmitted by the female anopheles mosquito

Life cycle

Symptoms:
• Violent chills
• Intense fever and headaches
• Convulsions
• Anaemia
• Enlarged spleen

Treatment: Artemisinine (and quinine) drugs

Prevention: Take prophylactics before exposure, wear protective clothing and get vaccinated. Use
insect repellent and mosquito nets to prevent bites.

Control measures taken by governments include: insecticide spraying to control mosquito
populations, support of development of a trial malaria vaccine etc.

Historical Development of our Understanding of Malaria Cause and Prevention

Time Event
 400BC Hippocrates (ancient Greece) observes that malaria occurs more often at certain times
of year, in areas close to marshes
100BC Romans find that draining marshes reduces malaria risk
~1600 Peruvian Indians use bark of Chinchona tree (quinine) to treat malaria symptoms. Was
brought back to Europe and known as Jesuit powder
1880 Alphonse Laveran (French) identifies the Plasmodium protozoan, by studying the blood
of malaria sufferers, and comparing this to healthy blood. Attempts to find source of
parasite by studying air, soil and water in marshy areas. Was not successful.
1897 Ronald Ross (British army doctor in India) confirms malaria is caused by Plasmodium,
and identifies mosquito as the vector. He found the protozoan in the stomach walls of
dissected mosquitoes. Experimented and mapped the life cycle of the protozoan and
show that there is time spent in the mosquito, and time in the human host. Showed it
moved through mosquito bites
1940 DDT (insecticide) developed and used against mosquitoes as part of global eradication
program
1962 'Silent Spring' by Rachel Carson alerts people to damage that can be done by
uncontrolled pesticide use
1970s DDT is banned in many countries
1960s to Range of prophylactic (preventative) drugs are developed to prevent people from
now contracting malaria. Resistant plasmodium are now common in the population.


Cholera
Identify data sources, gather, process and analyse information from secondary sources to describe
one named infectious disease in terms of its:
o Cause
o Transmission
o Host response
o Major symptoms
o Treatment
o Prevention
o Control

Cholera

Cause:
• Bacterium Vibrio cholerae
• In the gut, it attaches to the intestinal wall and produces a cholera toxin that is responsible for
the diarrhoea

Transmission:
• Ingestion of food or water contaminated with bacteria
• Waterborne: transmitted through waterways
• Contaminated foods grown in sewage areas e.g. shellfish

Host response:
• Mucosal immune system develops memory against the toxin produced as well as the bacteria
• Antibodies are produced, leading to future resistance

Major symptoms:
• Severe acute watery diarrhoea
• Severe dehydration
• Vomiting of clear fluid
• muscle cramps etc.

Treatment:
• Oral rehydration salts: rehydrate body
• IntraVenous drip: rehydrates body
• 80% of cases can be treated using rehydration
• Antibiotics given can reduce volume of diarrhoea and reduce need for rehydration treatment,
but should only be given to those with severe dehydration.

Prevention:
• Sterilisation: proper disposal and treatment of infected faecal waste water and contaminated
materials. Clothing/bedding should be washed with hot water and chlorine bleach
• Sewage: Kill pathogens with UV, chlorine or ozone before it enters waterways.
• Water purification: Boil water before drinking/using, use anti-microbial filtration, and add
chlorine to water.

Control:
• Provide medical supplies e.g. oral rehydration solutions and IV fluids
• Send patients to cholera treatment centre
• Implement proper sanitation measures to prevent disease from spreading via waterways
• Stockpile oral cholera vaccine to prevent more outbreaks

Countries you can get cholera (yippee)
• Asia: Yemen, Vietnam, Laos, Papua New Guinea etc.
• Sub-saharan Africa: Nigeria, Congo, Malawi, Tanzania etc.

Antibiotics
Identify the role of antibiotics in the management of infectious disease.
Process information from secondary sources to discuss problems relating to antibiotic resistance.

Role of Antibiotics
Before antibiotic invention, lots of people died of simple infections.

1928: Alexander Fleming discovered penicillin, the first antibiotic.
An antibiotic is a substance that can destroy/inhibit growth of bacteria, usually secreted by other
microbes to destroy competing bacteria.

Howard Florey (and Chan) purified penicillin so it was available for medical use in 1941.

Examples of antibiotics: penicillin, tetracycline, amoxylin, clavulanic acid

How they work:
• Inhibit cell wall formation while bacteria are reproducing; they explode as they grow
• Damage to cell membrane
• Interference with protein synthesis and metabolic activity
• Inhibition of nucleic acid metabolism (DNA and RNA) and inhibits reproduction

Cannot be used on viruses, as they do not do any of the above that can be interfered with.

Side effects of antibiotics:
• Nausea or allergic reactions
• Disruption to natural bacteria in the GI, respiratory and urogenital tracts, enabling other
pathogens to invade and cause disease without competition.

Antibiotic resistance:
• When an antibiotic kills bacteria, there may be 1 or 2 individuals that have a natural
resistance.
• These can multiply without competing with other bacteria that have been killed.
• Strains of bacteria that are resistant to antibiotics become more common in the population;
modern natural selection.
• Some resistant bacteria are called 'superbugs'
o Staphylococcus aurea (Golden staph) now has resistant strain called MRSA (methicillin
resistant staphylococcus aureus) which is resistant to al antibiotics except vancomycin.
Now there is a bacteria which is resistant to vancomycin called vancomycin resistant
enterococi (VRE) which has no treatment.
• Horizontal gene transfer (bacteria sex) can transfer plasmid DNA and resistant genes through
contact with other bacteria through the pili hairs on the bacterium.
• Increased chance of catching resistant bacteria in hospitals because many patients have
already taken antibiotics, so only resistant bacteria are capable of growing.
• Diseases that were once previously treatable with current antibiotics will become untreatable
and we will have nothing that we can treat the disease with. People will die!

Human activities have contributed to antibiotic resistance and super bugs:
• Overuse of antibiotics and unnecessary prescriptions
• Not taking a full course of antibiotics
• Giving food producing animals antibiotics to prevent infections and promote growth
• Use of cleaning products that contain antibacterial substances at low concentrations, allowing
some bacteria to survive

How to avoid further resistance:
• Reduce antibiotics given; only use on bacterial infections, do not use on viral infections.
• Should use antibiotics that target a specific pathogen rather than broad spectrum
• Normal hygiene practices should be adhered to in hospitals
• Take the whole course of antibiotics, don't stop when symptoms subside.
• Do not take antibiotics prescribed for someone else
• Don't use anti-microbial cleaning products

Antibiotics Practical
Experiment: the Effectiveness of Various Antibiotics on Bacterial Growth

Introduction:
• Antibiotics are chemical compounds usually produced by/obtained from moulds, yeasts and
bacteria. Now, lots are produced synthetically.
• Antibiotics either inhibit bacteria growth, or destroy them.
• Commercial antibiotic sensitivity disc e.g. MASTRING-S will be used, to see different effects of
antibiotics.
• Hospitals/pathology laboratories determines which treatment will be most effective.
 • The sensitivity disc is a piece of paper in which each spoke contains a different antibiotic.
• This is placed on a plate with bacterial growth, and the antibiotic diffuses out in a circular
pattern.
• If the antibiotic works, a clear agar circle will be visible as bacteria are killed. Diameter of
inhibition zone can be used to determine which antibiotic is the most effective against a
particular bacterium.

MASTRING-S CODE

Green Chloramphenicol C 10 pg
Pink Penicillin G PG 1.5 pg
Grey Ampicillin AP 2 pg
White Streptomycin S 10 pg
Brown Tetracycline T 10 pg
Mauve Sulphatriad ST -

Aim: To determine the effect of various antibiotics on different bacteria

Hypothesis: The antibiotics will have varying effects on the growth of different bacteria.
Streptomycin will be the most effective for both.

Risk Assessment:
Danger: we are growing bacteria and fungi which may be pathogenic.
Reason: Pathogens may invade our bodies and cause disease.
Prevention:
• Incubate plates at 28˚C; it is lower than body temperature so the ones that grow at this
temperature won't survive at 37˚C in our body if they invade.
• Seal plates and never reopen them: prevent pathogens from leaving plates
• Sterile swabs, open lid at 45˚ angle to prevent cross contamination and ensure pure samples
• Wash hands before and after handling, wear gloves. This prevents cross contamination from
hands.
• Autoclave (sterilise) and incinerate plates after use. This destroys pathogens.

Materials and Equipment:
• Incubator
• 2 commercial antibiotic sensitivity discs
• 2 broth cultures of different bacteria: Staph epidermis and Escherichia coli
 • 5 petri dishes containing sterile nutrient agar
• Disinfectant spray and soap
• Marking pen
• Sticky tape
• Forceps
• Ruler
• Container of disinfectant

Procedure:
1. Collect 2 petri dishes of sterile nutrient agar and label them including the names of each
bacteria.
2. Moisten a sterile cotton swab in the E. coli broth.
3. Raise a lid of petri dish 45˚; then, starting at one edge of the agar, gently rub the cotton swab
across the entire surface of the agar in a diagonal pattern.
4. Replace lid of petri dish and dispose of cotton swab in container of disinfectant.
5. Using the same method, cover the entire surface of the other place with S. epidermis.
6. Obtain 2 antibiotic sensitivity discs.
7. Using sterile forceps and sterile techniques, place one antibiotic sensitivity disc on each plate -
lightly press the disc (writing on top side) with tips of forceps.
8. Seal each plate.
9. Set up 3 agar plates, one swabbed with each bacteria, and one unopened.
10. Observe after incubation, for presence of clear areas around each spoke
11. Measure diameter of any clear areas; record results.

Results
Effect of Different Antibiotics on Bacterial Growth
Diameter of inhibition zone (mm) Diameter of inhibition zone (mm)
Antibiotic Used E. Coli S. Epidermis
C - Chloramphenicol 27 25
PG - Penicillin G 0 30
S - streptomycin 22 30
ST - sulphatriad 0 0
T - Tetracycline 23 22
AP - Ampicillin 24 15

Conclusion:
Antibiotic C - Chloramphenicol is the most effective for e. coli, while penicillin and streptomycin are
most effective for S. Epidermis. This is because the inhibition zones were greatest for these
antibiotics. The hypothesis was incorrect, as streptomycin was only the most effective for S.
Epidermis.

Discussion:
• Chloramphenicol has the greatest exclusion zone for E. coli
• Penicillin and streptomycin were the best to control S. Epidermis
• S. Epidermis is more sensitive to antibiotics in general; the ones we tested had greater
diameters of inhibition zones.
 • E. Coli usually inhabits the intestinal tract of humans. A course of antibiotics may decrease the
natural microflora, which leads to a lack of competition for potential harmful pathogens. They
may multiply at an uncontrolled rate.
• Advantages of broad spectrum antibiotics: Kills off multiple pathogenic species potentially, if
you're unsure of which microbe is causing disease, it is good to take.
• Disadvantages of broad spectrum antibiotics: Kills off natural microflora that may be harmless,
making it easier for pathogens to multiply.
• Control plates with only bacterial cultures on it were used to make sure that the antibiotics
used are responsible for the inhibition zones, and not other factors.
• The unopened agar plate was used as a control to ensure that the introduced bacteria would
be the ones to cause growth, and spontaneous generation doesn't occur.
• Agar plates, swabs, forceps and antibiotic discs must be sterile to reduce cross contamination
and ensure that the introduced bacteria are from the inoculating loop only.
• Zone of inhibition is a circle, because that is how the antibiotic diffuses outwards evenly from
one original point.

Often we recognise an infection by the symptoms it causes. The immune response is not so
obvious, until we recover.
• Identify defence barriers to prevent entry of pathogens in humans:
o Skin
o Mucous membranes
o Cilia
o Chemical barriers
o Other body secretions
• Gather, process and present information from secondary sources to show how a named
disease results from an imbalance of microflora in humans.
• Identify antigens as molecules that trigger the immune response.
• Explain why organ transplants should trigger an immune response.
• Identify defence adaptations, including:
o Inflammation response
o Phagocytosis
o Lymph system
o Cell death to seal off pathogen

First Line of Defence
Identify defence barriers to prevent entry of pathogens in humans:
o Skin
o Mucous membranes
o Cilia
o Chemical barriers
o Other body secretions

The First Line of Defence
The body's 1st line of defence against pathogens are physical and chemical barriers, that prevent
pathogens from entering the body. It is non-specific

Barrier Method of Defence Diagram
Skin • Outer layers of skin contain
keratin, microbes cannot penetrate
unless it's broken
• Is naturally acidic, oil glands
secrete acidic sebum, sweat is
acidic. This inhibits lots of microbe
growth
• Oil and sweat glands also make
antibacterial and antifungal
substances that inhibit pathogens
• Skin is quite dry, growth of
microbes is pretty much impossible
without moisture
• Has own population of harmless
bacteria which discourage/destroy
invading pathogens
Mucous • Mucous membranes line the
Membranes digestive, respiratory, reproductive
and urinary tracts.
• Thick mucous traps pathogens and
carries them out of the body with
the help of cilia/coughing/sneezing
• Contains antibody IgA which reacts
with potential pathogens,
preventing them from invading
• Contains natural flora which
secrete substances to inhibit
pathogen invasion Cilia surrounding mucous ball
Cilia • Are tiny hair-like structures that
project from the cells lining the
respiratory surfaces like the nose,
trachea and bronchial tubes
• Cilia beat and sweep the mucous
containing pathogens out of the
body through the nose or pharynx
where they are coughed out or
swallowed
• Cilia in the nose filter inhaled air
• Reflex actions such as coughing
and sneezing help to remove
pathogens
Chemical • Chemicals in many parts of the
barriers body are produced that make
surface inhospitable for pathogens
• Pathogens in food/drink are usually
destroyed by acidity of the
stomach or alkalinity of the small
intestine
• Urethra and vagina and skin
surface are acidic, inhibiting
pathogen growth

Other body • Urine is sterile and slightly acidic.

secretions Flushes ureters, bladder and
urethra and prevents growth of
most microbes
• Fluids such as nasal secretions,
saliva, tears and sweat contain
lysozyme which breaks down cell ^me when I fail the hsc
walls of certain bacteria

Thrush
Gather, process and present information from secondary sources to show how a named disease
results from an imbalance of microflora in humans.

Background Information
Body surfaces that interact with the outside environment has a population of natural flora. These
include: skin, digestive system lining, respiratory system lining, female reproductive system lining,
and mucous membranes.

Bacteria e.g. Streptococcus salivarius on tongue and Escherichia coli in the gut are part of the natural
microflora we have.
• They gain supply of nutrients, stable environment, constant temperature, protection and
transport
• Microflora presence makes it difficult for pathogens to establish themselves and multiply

When microflora is suddenly changed/reduced, other organisms can grow and cause change or
disease. Antibiotic use is a common way to cause this, as broad spectrum drugs can often kill off all
the natural microflora.

Thrush - Candida albicans
Thrush is a fungus, and is naturally occurring in the mouth, respiratory tract, female genital tract and
GI tract.

Symptoms of vaginal thrush: Itching, burning, unusual discharge and genital pain, swelling, soreness,
redness, rash, burning in urination etc.

Treatment:
• Anti-fungal: creams, ointments, tablets or a vaginal suppository
 • Medicines can be prescribed or over the counter e.g. butaconazole, miconazole
• Depending on severity, the treatment timespan can be increased or decreased

Prevention:
• Eat well-balanced diet
• Eat yoghurt or take supplements with lactobacillus
• Don't take as many broad spectrum antibiotics
• Don't use as many synthetic fibred/tight undies
• Replace feminine products frequently
• Wash underwear in hot water
• Don't sit in wet clothing
• Don't douche or use scented feminine products
• Wipe front to back when using the toilet

Development of disease:
• Number of Candida albicans is usually kept low by competition from other microbes.
• When natural microflora balance is upset, the number of C. albicans increases and disease
develops
• Natural balance can be upset by taking antibiotics; they reduce the number of bacteria in the
natural population, creating less competition for the thrush fungus.
• Thrush multiplies in an uncontrolled manner and lets the disease be established.
• Other factors that may contribute to development: immune suppression, diabetes mellitus,
steroid use, pregnancy, oral contraceptives, illness and IV drug use

Second Line of Defence
Identify antigens as molecules that trigger the immune response.
Identify defence adaptations, including:
o Inflammation response
o Phagocytosis
o Lymph system
o Cell death to seal off pathogen

The Second Line of Defence

Antigen:
• Anything that will mount/trigger an immune response
• Body recognises it as a foreign molecule
• On all body cells, there are 'marker' molecules which identify the cell as belonging to the body.
• If something enters with foreign markers, the immune system recognises them as 'non-self'
and attacks.
• An antigen can be part of bacteria, fungi, viruses, protozoans, toxins, abnormal cells,
macroparasites or proteins (like in allergic reactions)

The 2nd line of defence is non-specific and involves:

Phagocytosis
o Phagocytes surround a foreign particle, engulf it & destroy it using enzymes
o Are not specific, will attack any antigen.
o 2 main types: macrophages and neutrophils.
• Limits:
o Pathogens may repel phagocyte
 o Pathogens may escape from the phagocyte before being destroyed
o With severe infections, many phagocytes are destroyed

Summary:
1. Microbe binds to the membrane of phagocyte
2. Phagocyte engulfs microbe and forms a phagosome
3. Lysosome fuses with phagosome and releases enzymes called lysozymes
4. Lysozymes kill and digest the microbe. Some products are used by the cell and there is some
residual material.
5. Residual material is removed from the cell. Dead white blood cells and residual materials form
pus.

Inflammation
• Invasion of tissues by pathogens
• Release of histamine and prostaglandins, leading to:
1. Dilation of blood vessels: increased blood flow to bring phagocytes to site of infection --
> redness + heat
2. Increased permeability of the walls of blood vessels: plasma can move out of blood
vessels carrying phagocytes to site to engulf more pathogens --> swelling and pain
3. Increase in temperature: fever increases phagocytosis rate and inhibits growth of
pathogens by inhibiting some enzymes --> heat



Lymphatic system
• Consists of:
o Lymph nodes
o Lymph vessels
o Lymph fluid
o Tonsils
o Spleen
o Thymus gland
• Drains fluid away from tissues and returns it to the blood supply via a large vein near the heart
• Lymph passes through lymph nodes which act as filters, destroying bacteria, cell debris and
other foreign material (phagocytosis)
• Lymph nodes gradually enlarge from toxin/pathogen accumulation when there is an infection
• Lymph nodes also make specialised lymphocytes which are involved in the 3rd line of defence


Cell death to seal off the pathogen
• When a pathogen is unable to be destroyed, cells cluster around tissue so pathogen is
enclosed in a cyst.
• Cells that surround the pathogen die, so it is isolated and also dies, thus preventing spread.
 • Debris inside cyst is destroyed by phagocytes that surround it e.g. when people have leprosy
or tuberculosis, cysts form.

Other secretions in the 2nd Line of Defence
• Interferons: proteins made in virus-infected cells, induce other cells to produce antiviral
enzymes that stop viral replication. These are non-specific and effective in short term
infections e.g. influenza
• Interferons are now being mass produced using recombinant DNA technology!

Organ Transplants
Explain why organ transplants should trigger an immune response.

Organ Transplants
• Each cell has a marker: a Major Histocompatibility Complex molecule (MHC marker) which
signals that it belongs to the same body as the rest of the cells. These markers are unique to
each person except for identical twins.
• An introduced organ/tissue has MHC markers on the outside of the cell. These are recognised
as foreign to the patient, and the immune response is triggered.
• The immune system attacks and can destroy the new tissue, leading to rejection of the organ.
• MHC markers on transplanted donor tissue won't match perfectly.
• Before transplantation, donor and recipient have their tissues 'typed'. This match difference
must be minimised, as the better the match between MHC markers, the higher the chance of
succession.
• In early transplantation days, rejection was a constant problem, and new drugs are now used
to lessen the immune response. However, this makes the patient more susceptible to
infection.

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.
• Identify components of the third line of defence as:
o Antibodies
o T cells
o B cells
• Describe and explain the immune response in the human body in terms of:
o Interaction between B and T lymphocytes
o The mechanisms that allow interaction between B and T lymphocytes.
o The range of T lymphocyte types and the difference in their roles.
• Outline the way in which vaccinations prevent infection.
• 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 small pox, diphtheria and polio.
• Outline the reasons for the suppression of the immune response in organ transplant
patients.

The Third Line of Defence
Identify components of the third line of defence as:
o Antibodies
o T cells
o B cells
Describe and explain the immune response in the human body in terms of:
o Interaction between B and T lymphocytes
 o The mechanisms that allow interaction between B and T lymphocytes.
o The range of T lymphocyte types and the difference in their roles.

Background:
• We're born with a natural immunity (1st and 2nd lines of defence) which involve barriers to
entry of pathogens, and production of phagocytes (macrophages and neutrophils), and the
inflammatory response. This is non-specific.
• Acquired immunity (3rd line of defence) involves production of white blood cells: T and B
lymphocytes.
• These act against specific antigens.

White Blood Cells
• Are all produced in the bone marrow. Phagocytosis is used to move into the blood stream and
then tissues to engulf antigens.
• Stem cells in bone marrow form T and B lymphocytes.
• B cell: leave bone marrow as mature B cells (hence the name), and migrate to the lymphatic
system. These can differentiate into:
o Plasma cells (make antibodies)
o Memory B cells
• T cells: Leave bone marrow as immature T cells, where they mature in the thymus (hence
name) gland, above the heart on the trachea. Mature T cells can differentiate into:
o Helper T cells
o Cytotoxic (killer) T cells
o Suppressor T cells
• B and T cells are stimulated to clone & differentiate by chemicals called cytokines, produced
by helper T cells.
• T and B cells circulate in blood and lymph and are stored in the lymph nodes, spleen and
tonsils.



T Lymphocytes (T cells): Cell Mediated Response
• Destroys cells that have been invaded already
• Act against bacteria and viruses inside cells, protozoa, fungi, worms, transplanted organs and
cancer cells

Helper T cells (Th)
• Each cell has a receptor protein on its membrane that recognises only 1 antigen
• These are activated when same antigen is recognised on the macrophage
• Helper T cells release Interleukin II (a cytokine) that stimulates B cells and cytotoxic T cells, and
memory T & B cells.
 • Specific, and replicate themselves when stimulated
• Causes increase in rate of phagocytosis

Cytotoxic (Killer) T cells
• Activated by Th cells to clone themselves
• Move from lymph nodes to infection site
• Attaches to infected body cell, releases perforin. This breaks the cell membrane of infected
cell and prevents pathogen from reproducing.
• Broken cell & pathogen is then engulfed by a macrophage.
• Transplant tissue & cancer cells are recognised as antigens and destroyed in a similar way.
• Some cells produce interferon which prevents cells from being invaded by a virus.

Suppressor T cells: make chemicals to inactivate cytotoxic T cells & B cells once antigens are
destroyed.

Memory T cells:
• Produced at same time as cytotoxic T cells.
• Circulate in lymphatic system
• When same antigen re-enters, memory cells are activated; they rapidly produce specific
cytotoxic T-cells and destroy the antigen before symptoms can be felt.
• This is a much more rapid response to antigens, than at the initial infection.

B Lymphocytes (B cells): Antibody Mediated Response (Humoral response)
• Produce Y-shaped antibodies that circulate in blood and lymph
• Antibodies attack toxins, bacteria and viruses that have invaded
• Activated by helper T cells to rapidly clone and then differentiate into:

Plasma cells: make antibodies specific to antigen. These are released into blood and lymph to
infected area, destroying the antigen.

Memory B cells: circulate in lymph and are reactivated if reinfected with the same antigen. Will
rapidly divide to produce more plasma cells and large quantities of antibodies.

Antibodies (proteins): Destroy antigens
• Agglutination: clumps pathogens together to make it easier for macrophages to engulf.
• Binding to viruses and bacteria active sites, preventing them from entering cells to reproduce
• Can bind to antigens & release a chemical called complement, which destroys the antigen


Interactions between T and B cells
• Set sequence of events with interactions between both cells is necessary to complete a
specific immune response.
1. Pathogen enters, and is engulfed by a macrophage. The macrophage displays its antigen on
the surface of the macrophage, at the MHC (Major histocompatibility complex) marker site.
2. Macrophages move the lymph nodes to present antigens. Helper T cell with a receptor specific
for that antigen, binds to it. Macrophages produce a cytokine called interleukin I which
activates Helper T cells to clone.
3. Helper T cells activate B cells that have encountered the same antigen to clone and
differentiate into plasma cells which produce antibodies or memory B cells. They activate B
cells by producing interleukin II.
4. Helper T cells also activate other T cells to clone and differentiate using interleukin II

• Suppressor T cells cause reduction in number of B plasma and cytotoxic T cells once antigen
has been destroyed.

Vaccination
Outline the way in which vaccinations prevent infection.

Vaccination: Provides artificially acquired immunity without need for a person to have suffered the
initial disease.
• Involves injection/swallowing of an antigen triggers immune response, destroying the antigen
and producing memory B and T cells.
• These rapidly detect and respond to subsequent infection, producing in large quantities:
o Antibodies
o Cytotoxic T cells

Active Immunisation: Stimulates a person to make his/her own antibodies.
Introduces:
• Killed bacteria or viruses
• Weakened live pathogens (e.g. polio, measles, whooping cough)
• Modified toxins
The body recognises these substances as antigens. T and B cells are activated to produce cytotoxic T
cells, plasma cells, antibodies and T & B memory cells.
Person does not feel symptoms of disease: antibodies and T cells destroy the antigen, but memory
cells are made and stored in the lymph system.

If the same antigen enters the body again:
• Memory cells activate production of Cytotoxic T and B cells.
• B cells form plasma cells, rapidly secrete a much large amount of antibodies.
• This secondary response is more rapid (requires less antigen), produces more antibodies and is
longer lasting as more antibodies remain in the blood.
Active acquired immunity vaccines: tetanus and diphtheria injections, and polio vaccine syrup.

Passive Immunisation: Involves injection of antibodies (immunoglobins) produced by another
person/animal
• Only produces short-term immunity: no memory cells are produced.
• E.g. Injection of Hepatitis antibodies as temporary protection when people travel to areas
where the disease is widespread.
 • Passive immunity also occurs when antibodies in a mother's blood pass over via the placenta
or breast milk to the blood of the baby.

Summary:
• Active immunity
o Vaccine
o Invasion of pathogen
• Passive immunity
o Serum
o Mother's antibodies

Vaccine timeframes:
• Normal immune response takes several weeks to work.
• Protection from infection will not occur immediately after vaccination.
• Most vaccinations need to be given several times (boosters) to build up T and B memory cell
numbers and produce long lasting protection.
• A child who has only been given 1-2 doses of DTPa (diphtheria-tetanus-pertussis) vaccine is
only partially protected against those diseases and may become sick if exposed.
• Protective effect is not always lifelong.
• Some can last up to 30 years, and then a booster dose is given e.g. tetanus
• Some give protection for 5 years after a full course e.g. pertussis (whooping cough)

Future vaccine research:
• Genetic modification allows a gene that codes for an antigen of a disease-causing organism to
be isolated from the DNA of the organism, and transferred into bacteria.
• Bacteria produce large quantities of the protein that can be purified and used as a vaccine.
 • Approach has been used with GM yeast to produce the hepatitis B vaccine.

Effectiveness of Vaccination Programs
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
small pox, diphtheria and polio.

Vaccinations are amongst the most successful and cost effective disease prevention methods
available.
Introduction of routine immunisations has dramatically reduced incidence of disease and death.

1974: World Health Organisation (WHO) launched the Expanded Program on Immunisation (EPI) to
increase the percentage of world's infants immunised against the 6 target diseases: diphtheria,
tetanus, whooping cough, polio, measles and tuberculosis.
This campaign increased the percentage of all infants immunised from 5% in 1974 to 80% in 1997,
preventing 3 million deaths per year.

Mass immunisation:
• Prevents occurrence of disease in individuals
• Helps to decrease spread of disease throughout population
• If majority of the population is immunised, chance of an infected individual coming into
contact with an unprotected person is extremely low, transmission of disease is stopped.
• This is 'herd immunity'

Despite vaccination program success, there has been a recent increase in number of cases of
whooping cough. Because some people aren't getting themselves or their children vaccinated, which
may be because:
• People are becoming complacent, thinking they won't get the disease because most people
are immunised and don't get it.
• They've never experienced how serious these diseases are
• They think the risk of side effects is too great

Smallpox
• Caused by virus Variola major; airborne or spread by direct contact.
• Undergoes 12 day incubation period after entering throat and lungs, eventually spreads to skin
• Symptoms: High fever, headache, backache, blistering rash (appears first on face, arms and
legs, then spreading to the body). Often fatal.
• Numerous accounts in literature, first appeared more than 10000 years ago in Asia or Africa.
Spread around world by explorers and traders.
• Introduced into Mexico in 1519, killed millions of people.
• First recorded Australian incidence was 1789, was devastating for the locals as they had no
immunity to it at all.

• Has killed more than any other infectious disease, was responsible for 1/10 of all deaths in
Europe in the 19th century, more than 300 million deaths in the 20th century.

Edward Jenner: Developed a vaccine for smallpox in 1796
• Was not effective as procedure was not widely used.
• 1840s: Made free in Britain, but not widely used until it became compulsory
• 1940s: Eliminated in the USA and Europe.
 • Travellers to all countries were required to have a vaccination until 1971 when some countries
only needed vaccinations for people travelling in places where smallpox still existed.

• 1967: Still 33 countries in which smallpox was a problem: overcrowding, extreme poverty,
poor hygiene and nutrition increased spread.
• WHO committed itself to worldwide mass immunisation to eradicate it.
• Involved routine mass immunisations, supplementary doses, targeting people who missed out,
and sending out teams for surveillance on all possible cases of infection.
• Was very effective. 1970: only 17 countries still had smallpox. 1973: only 6 countries. 1980: it
was eradicated, and is now only found in research laboratories.

Summary:
Before Vaccination Program After Vaccination Program
Occurrence: Caused 1/10 of all deaths in Europe in 1967: 33 countries with smallpox, 1976: only 6
19th century, 300 million deaths in 20th century countries with smallpox. Eradicated by 1980
Spread around world by travellers and explorers; Now only found in laboratories where
present around most of the world scientists are studying viral DNA
Vaccination program: 1840s Britain, the vaccine was invented by Edward Jenner.
• Made available for free, but not widely used until it became compulsory.
• Was required for travellers until 1971.
 • WHO's vaccination campaign mass vaccinated people in many countries
• Campaign was extremely effective as the virus is now eradicated.


Diphtheria
• Caused by highly contagious and fast-acting bacteria, often kills within a week of the start of
symptoms. Transmitted by close contact with respiratory droplets.
• Symptoms: Sore throat, fever, rapid pulse, destruction of throat lining, formation of leather
membrane across throat. This can lead to death by suffocation, or by toxins which cause
damage to other organs e.g. the heart.
• If patient recovers, they can be left with permanent nerve and heart problems.

Prior to vaccine development:
• Mortality rates were high: 90% of larynx diphtheria. 2/3 of these deaths were children under 5
years
• Was referred to as the deadly scourge of childhood: 1921 there were 206000 cases with 15500
deaths in the USA alone.

Immunisation programs:
• Introduced in Australia in the 1930s and 1940s. Resulted in rapid decrease in diphtheria
incidence. Similar programs were successful in Europe and other countries.
• 1974: still only 5% of children were immunised against diphtheria worldwide. The introduction
of the WHO EPI saw percentage of children immunised increase to 80% by 1990;
corresponding to a greatly decreased mortality rate.
• There has been only 1 reported case of diphtheria in Australia from 1994-2006. Current
immunisation program involves the administration of the triple antigen - DTP.
• Still is a chance of resurgence of disease due to people who neglect/refuse to vaccinate.

Summary
Before Vaccination Program After Vaccination Program
Occurrence: Mortality rates high, 90% especially in Only 1 reported case in Australia from
childhood. 1921: 206000 cases in the USA alone 1994-2006
Highly contagious, probably spread worldwide Very low spread, however there is a chance
of resurgence with anti-vaccinators.
Vaccination program: 1930s and 1940s in Australia, Europe and other developed countries
By 1990: 80% children were immunised worldwide (50% in Africa)
• Highly decreased mortality rates.
• Triple antigen (DTP) given out in schools
• Vaccination program has been highly effective, as most of us can now survive to adulthood.

Polio / Poliomyelitis
• Viral disease transmitted by inhaling infected droplets and through direct contact.
• Causes fever and headache, speech, swallowing, breathing difficulties and paralysis.
• Death occurs in 50% of cases, and nerve damage and paralysis in 50% of the sufferers.

• First occurred thousands of years ago, prior to vaccine development by Jonas Salk in 1955,
thousands of children died/were paralysed.
• Years following vaccine introduction, 200 people contracted disease from this vaccine and 11
of them died.
• Albert Sabin introduced safer vaccine in 1961, and after widespread immunisation, there was
a 60-70% reduction in the disease. It became rare in industrialised nations, and incidence
further decreased after WHO's EPI in 1974.

Vaccination programs:
• 1988: World Health Assembly (WHA) voted to launch a global goal to eradicate polio.
• Global Polio Eradication Initiative involved widespread vaccination of children under 5 years,
in countries where the disease was endemic.
• 1997: almost 450 million children were immunised during National Immunisation Days.
• 719 cases of wild polio virus in 2000: represents 99% reduction in cases since program began
in 1988, with 350000 estimated cases.
• When GPEI was launched, the wild polio virus was endemic in more than 125 countries on 5
continents, paralysing >1000 children each day.
• By the end of 2006, there are only 4 countries with endemic wild polio virus - Nigeria, India,
Pakistan and Afghanistan.

WHO: Aimed to eradicate polio by 2005 (that failed) but it's hopeful that this will be achieved soon.
• 1994: North and South America were certified polio free
• 2000: Western Pacific Region (and Australia) were free
• 2002: Europe had eradicated polio
• In countries where disease incidence is low but transmission still occurs, polio cases can be
seen amongst non-vaccinated individuals.
• Countries that were previously polio free have outbreaks occasionally as the disease is
imported from one of the remaining endemic countries.

Summary

Before Vaccination Program After Vaccination Program
 Occurrence: 50% death rate, and 50% 99% reduction in cases since 1988
paralysis rate for all sufferers
Spread across world, many cases in the US Only in 4 countries with endemic polio: Nigeria,
India, Pakistan and Afghanistan
Vaccination program: 1961 when a safer vaccine by Albert Sabin was produced
• 60-70% reduction in the disease; it became very rare in developed nations.
• 1997: ~450 million children were immunised
• Was extremely effective; when WHO and rotary worked together, the disease was eliminated
in most countries very rapidly.

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

Transplant organs contain antigen proteins that are recognised as foreign to the patient. This
triggers an immune response which attacks and possibly destroys new tissue; which is tissue
rejection. Blood transfusions are only successful if the protein the donor blood has is matched with
the recipient.

Each cell in the body has a Major Histocompatibility Complex molecule (MHC) which signals that it
belongs to the same body as the rest of the cells. These markers are unique to each person except
that of identical twins. Before an organ transplant, donor and recipient have their tissues 'typed' to
find out antigens in each. Donor/patient transplants are matched as closely as possible to ensure
high chances of successful transplants.

New drugs are used to counteract tissue rejection.

Cyclosporine:
• Helper T cells attack foreign tissue, and cyclosporine kills helper T cells.
• Must be taken for life, initially in larger doses that are later reduced
• B cells survive the drug and provide some immunity through antibody function
• Overall, immune response is reduced as B cells are also activated by helper T cells, which are
killed off
• Chance of being infected with a pathogen is a possible implication of these drugs, but is the
price for prolonging life.

Epidemiological studies involve the collection and careful statistical analysis of large quantities of
data. Such studies assist the causal identification of non-infectious diseases.
• Identify and describe the main features of epidemiology using lung cancer as an example.
• Gather, process and analyse information to identify the cause and effect relationship of
smoking and lung cancer.
• Identify causes of non-infectious disease using an example from each of the following
categories:
o Inherited diseases
o Nutritional deficiencies
o Environmental diseases
• 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.

Epidemiology
Identify and describe the main features of epidemiology using lung cancer as an example.
Gather, process and analyse information to identify the cause and effect relationship of smoking
and lung cancer.

Epidemiology: The scientific study of patterns of occurrence of disease in human populations and
the factors that affect these patterns.
• Describes, statistically analyses and hypothesises to the cause of disease in the population
• Can be used to study infectious and non-infectious diseases as well as events e.g. car
accidents, suicides and work-related accidents.
• Results from epidemiological studies are used by public health authorities to develop
strategies to control disease and improve public health.
• Epidemiological studies can also be used to evaluate those strategies that are in place

3 major types of studies:
1. Descriptive
2. Analytical
3. Intervention

Descriptive Studies
• Usually the first type of study done when looking for the cause of a disease
• Provide information about patterns of disease, including
o Frequency: how much the population is affected
o Sections of the population affected (age, gender, occupation, socioeconomic status etc.)
o Geographical location
o Time period in which individuals are affected
• E.g. In a study to determine cause of lung cancer, data collected included:
o Information about smokers and non-smokers
o Age, gender
o Smoking habits and drinking habits
o Diet & occupation etc.

Analytical Studies
• Undertaken after descriptive studies are completed
• Collects more data which is statistically analysed to develop hypotheses about likely disease
causes
• Indicators about disease used in these studies include:
o Morbidity: number of cases of the disease
o Mortality: percentage of population that dies from the disease
o Incidence: number of new cases in a specific time
o Prevalence: number of people affected at any one time
• Types include: case-control studies and cohort studies
Case-control studies: Compare people with the disease (case) to people without (control)
• Looks for differences in exposure to possible causes
• 1947: Case control set up in London by Dr Richard Doll compared patients with lung cancer to
patients with other conditions. Results showed that most patients with lung cancer were
smokers, suggesting a link.
Cohort studies: Studying 2 or more similar groups of people who are free from the disease.
• Groups often differ in 1 main factor; exposure to the potential cause of the disease
• Groups are followed over a long period of time to compare resulting incidence of disease
studied.
 • After Doll's 1947 case-control study established a link between smoking and lung cancer, a
cohort study was set up in 1951 by A. B. Hill.
• This followed more than 40,000 doctors over 10 years. 1 group were smokers (test) and others
non-smokers (control). At the end of the study, the test group had much higher incidences of
lung cancer. This study also revealed that the greater the number of cigarettes smoked daily,
the greater the chance of dying from lung cancer.

Intervention studies: Used to test the effectiveness of a treatment (e.g. clinical trial of new drug), or
a public health campaign to change behaviour of population of a whole e.g. 'Quit' campaign

Main features of epidemiological studies should include:
• Being conducted over an extended period of time
• Have large sample sizes (thousands) that represent a broad range of society
• Collects a range of relevant data from large group of affected and unaffected people (case-
control)
• Use control groups
• Collect data on incidence, prevalence, mortality and morbidity of the disease
• Statistically analyse the data to identify patterns and trends in disease occurrence
• Identify possible disease cause and risk factors
• Develop management plan to control/eliminate disease and educated public
• Evaluate the effectiveness of control and treatment groups

Smoking and Lung Cancer
• Cause and effect relationship: an action that is taken that will initiate/influence another
second action to occur. For this relationship to be established, a number of criteria must be
met, including:
o High risk that disease develops when person is exposed to the potential cause
o Must be consistency in results found by researchers in each study carried out
o Must be shown that higher levels of the cause leads to a greater risk of developing the
disease
o Must be a particular time relationship; cause occurs before the disease

Tips for reading graphs and analysing: Use specific examples from the stimulus in your answers.
Make sure to refer to the stimulus well.

Non-Infectious Diseases
Identify causes of non-infectious disease using an example from each of the following categories:
o Inherited diseases
o Nutritional deficiencies
o Environmental diseases
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.

Non-Infectious Diseases: Are not caused by a pathogen
Cause Example
Inherited: caused by genes inherited from parents Huntington's Disease, Diabetes,
(sometimes environmental factors are needed to trigger the Cystic Fibrosis, Haemophilia
genes e.g. Type 2 diabetes)
Environmental: Exposure to environmental factors Asthma, skin cancer, lead poisoning,
mesothelioma, Foetal Alcohol
Syndrome
Nutritional: Excess or deficiency of nutrients in diet Anorexia nervosa, bulimia nervosa,
obesity, scurvy, rickets,
hypervitaminosis A

Example: Hypervitaminosis A (nutritional)
• Douglas Mawson's 1911-1914 mapping expedition to Antarctica
• Xavier Mertz died and Mawson became very sick. Thought to have been caused by
hypervitaminosis A.
• They had to eat their huskies, especially the livers which stored large amounts of Vitamin A.
• Mawson survived by experienced symptoms of: severe stomach pain, having large clumps of
hair fall out, soles of his feet peeled off.
• Hypervitaminosis is possible with vitamins A and E as these are fat soluble and are stored in
the liver.

Cystic Fibrosis: Inherited
Cause: Mutation to cystic fibrosis transmembrane conductance regulator (CFTR) gene on
chromosome 7.
• Faulty gene changes the protein that regulates normal movement of NaCl in and out of cells
• Causes mucus-secreting organs to produce abnormally thick mucus.
• CFTR gene is recessive

Occurrence: Varies with ethnic groups.
• 1 in 3300 in Caucasians
• 1 in 9500 in Hispanics

Symptoms: Affects respiratory, digestive and reproductive systems and sweat glands. Mucus
secreted is very thick and blocks pathways in lungs and digestive tracts. Causes problems with
breathing and digestion of nutrients.
• Recurrent and severe chest infections
• Malabsorption of nutrients
• Large, foul smelling farts
• Diabetes
• Excess salt in sweat
• Liver failure
• Infertility
Average life expectancy is 30-40 years.

Treatment and management: No current cure, as it is an inherited genetic disease. Only ways to
alleviate symptoms
• Giving supplements to counter effect of insufficient digestion & nutrient absorption
• Daily physiotherapy and breathing exercises to prevent excessive mucus build up in lungs. This
prevents frequent infections.
• Antibiotics and other medications are given to control infections.
• If lungs are too badly damaged, lung transplants are an option.
• Gene therapy is currently being researched in the hope that it will be able to eventually cure
cystic fibrosis.


Increased understanding has led to the development of a wide range of strategies to prevent and
control disease.
• Discuss the role of quarantine in preventing the spread of disease and plants and animals
into Australia or across regions of Australia.
• 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.
• Explain how one of the following strategies has controlled and/or prevented disease:
o Public health programs
o Pesticides
o Genetic engineering to produce disease resistant plants and animals.
• Perform an investigation to examine plant shoots and leaves and gather first-hand
information of evidence of pathogens and insect pests.
• 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.

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

Biosecurity in Australia
Quarantine: a period of isolation or system of measures maintained by public authority at ports and
frontiers to prevent spread of a contagious disease.

• Geographical isolation helps, but globalisation changes this as international travel and trade
increases.
• 60,000+ km of coastline offers a variety of pathways for pests and diseases.
o Department of Agriculture: screens, inspects and clears people, mail, baggage, ships etc.
entering Australia every year using X-rays, surveillance and detector dogs.
o Australia uses pre-border, border and post-border measures, using various technologies
o Today, quarantine protects import/export industries as well as the environment, native
wildlife, lifestyle and tourism.

Quarantine regulations: Applied to goods such as plants/animals or their products attempting to
enter country.
• Citrus canker: bacterial disease found in Indonesia and New Guinea and hot, wet areas. Affects
citrus by attacking an above ground part. Could destroy citrus industry if introduced to
Australia.
• AQIS: Sets traps for Asian honey bees, as they have tiny mites which could wipe out native
bees and ruin honey industry.

Quarantine regulations applied within Australia: Preventing spread of inter-regional disease
• Sugar cane borders in far north of NSW; only authorised and inspected cane can be taken from
one side to the other, preventing spread of disease between sugar cane regions
• Fruit fly checks to stop fruit flies being brought from Qld into NSW
• Phylloxera insects: plant lice found on grapevines in eastern states: restrictions taking vines
into SA.

In hospitals, quarantine is most effective for diseases that aren't highly infectious, virulent or have
severe easily diagnosed symptoms. Flu is bad for quarantine because it can spread before infection
is recognised. Is also limited with slow developing animal diseases e.g. mad cow

Since importance of quarantine was identified in 1908, Australian quarantine has been effective
against many diseases and pests.
• Australia remains free of yellow fever, plague, rabies and mad cow disease.
• Gradual increase in disease and pests that have evaded quarantine e.g. malaria
• Quarantine relies on responsible people unfortunately.


Quarantine of Plant Diseases
Within Australia: Fruit fly Into Australia: Citrus canker
Occurrence Inspections prevent Queensland fruit fly 2005, Emerald. Queensland and Northern
from crossing NSW border Territory devastated, growers felt great
loss
Current Native to Queensland, with Declared free of citrus canker in 2009
status Mediterranean fruit fly introduced to
Western Australia
Quarantine Border inspections between states, Strict import inspections
measures report fruit infected with maggots,
report unusual sightings to Exotic Plant
Pest Hotline
Effectiveness Extremely effective, NSW infestation has Extremely effective, Australia has been
not occurred as of yet citrus canker free since 2009

Quarantine of Animal Diseases

Within Australia: Equine Flu Into Australia: Foot and Mouth Disease
Occurrence Outbreak in late 2007, eradicated Outbreak before 1872: it's a highly infectious
in early 2008 disease that affects cloven-hooved animals.
Current None in Australia •
status
Quarantine No random imports, educating Detailed response plans and arrangements,
measures horse handlers about good industry preparedness is constantly being
biosecurity reviewed. National vaccination policy, and
research & development of new tech to
Once outbreak detected, infected control. Banned import of these animals and
areas were quarantined, their products from infected regions.
facilities/equipment were
decontaminated, horses were
tracked/observed, horse activities
were banned, vaccinations given
and awareness campaign was put
into place.
Effectiveness Ineffective, equine flu penetrated Extremely effective, as Australia has not
the quarantine barrier and spread experienced an outbreak yet.
 rapidly. However, quarantine
measures were successful in
reducing disease spread and the
disease was eradicated in early
2008.

Quarantine policies mostly involve:
• Quarantine and controls placed on animal movement
• Slaughter/disposal of infected animals or vaccination of them
• Decontamination of infected areas
• Observation of animals that may be in danger of contracting disease
• Halting of activities that may spread disease
• Establishment of disease-free areas

Prevention and Control of Diseases
Explain how one of the following strategies has controlled and/or prevented disease:
o Public health programs
o Pesticides
o Genetic engineering to produce disease resistant plants and animals.

Prevention: Stopping occurrence of the disease in individuals

Control: Of a disease involves regulating the incidence of disease in the population and stopping
further spread

Public Health Programs: Designed to educate people to prevent disease

1. Government regulations to ensure clean water and sewage treatment, garbage disposal and
healthy food stands.
• Strict guidelines when sterilising equipment in hospitals, clinics and surgeries etc.
• Standard procedures must also be followed when preparing and storing food.
2. Australia has the highest rate of skin cancer due to lifestyle and location.
• "Slip, Slop, Slap, Wrap" campaign is public education.
• Targeted kids up to age 11 and parents, because unprotected exposure in first 15 years
of life doubles lifetime risk of skin cancer
• Public education occurs through media: TV and radio ads, media, fact sheets, posters
and stickers.
• Epidemiological studies show a positive community response to this and similar
campaigns
3. Cervical cancer:
• Advertising campaign encourages women to have pap smear every 2 years: a pap smear
could save your life
• Pap smear register
• GARDASIL HPV vaccine in Australia being funded under the National Immunisation
Program for free, to prevent cervical cancer.
4. National Tobacco Quit campaign
• Targets 18-40 year old smokers to reduce number of people taking up smoking, also
encouraging others to quit.
• Hopefully reduces incidence of disease associated with smoking
• Epidemiological studies and surveys have shown the campaign is successful in informing
public

Pesticides: Chemicals that are used to kill pests, pathogens and pathogen vectors.
Occurrence of disease can be prevented and spread of disease through population can be
controlled. 3 groups of pesticides:
1. Insecticides
2. Fungicides
3. Herbicides (kills weeds)

DDT: Insecticide
• Widely used in WWII to kill typhus lice: controlled disease by eliminating the vector that
transmitted the pathogen.
• Also used widely to kill the Anopheles mosquito, which carries the malaria plasmodium:
controlling malaria incidence
• DDT effectiveness was reduced as the malaria mosquito built up resistance, and many
countries have banned it due to environmental effects.
• Other insecticides e.g. pyrethrum are now more used and are less harmful and more effective:
controlling spread of malaria better.

Insecticides also control the aphid that carries the potato leaf-roll virus which causes stunted growth
and yield loss in potatoes. Pesticides are used to kill aphids and prevent the disease.
Pesticide use are used to widely to spray items brought into Australia.
However, organisms can build up resistance through natural selection, and pesticide use over time
because much less effective.


Genetic engineering: Producing disease-resistant plants and animals
• Bt cotton: Bacillus thuringiensis (soil bacteria) genes inserted into plants to produce natural
insecticide that kills insect pests. Cotton and corn have been modified in this way.
• Resistant potatoes to the Colorado beetle and potato leaf-roll virus have also been produced.
• Many disease resistant transgenic species have been produced e.g. in Canada frog genes have
been put into potato plants to cause them to make the same chemicals as the frogs, making
them resistant to infection by a broad range of disease causing fungi and bacteria.
• Researchers are investigating producing transgenic animals that are resistant to mastitis, or
the ticks that infest cattle in northern Australia.
• Using genetic engineering prevents occurrence of disease in organisms, and controls spread of
disease through population, reducing disease incidence.
• However, there are concerns about ethics, effects on the environment and biodiversity, and
pesticide resistance to new organisms will develop.

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

Organisms that can cause plant disease:
• Macro-parasites: Insects & nematodes
• Micro-parasites: Fungi, bacteria and viruses (all parts of plant are vulnerable)

Plant Pathogen Investigation
Aim: to observe and describe evidence of pathogens and insect pests on plants
Equipment: Hand lens, magnifying glass, binocular microscope, gloves if necessary

Method:
1. Examine and draw labelled diagrams of diseased and non-diseased plant material provided.
2. Look for evidence of attack such as discolouration, browning or blotching, swelling, leaf
curling, bites out of leaves, stunted growth, fungus or a powdery substance on the surface of
the plant.
3. Use available information to identify the type of plant pathogen that is affecting each plant.

Risk Assessment
Risk Reason Prevention
Plant pathogens Unsure of whether they are Wear gloves to minimise
pathogenic to humans contact, wash hands after use.
Elemental exposure in Insects, harsh sunlight and branches Wear protective gardening gear
plant collection can cut, bite and damage skin.

Iron Deficiency - Citrus (Environmental and non-infectious)
• When plant is not able to take in enough iron, leaves become light green --> yellow --> white
• Veins remain green until end of process, happening gradually.
• Youngest leaves are first affected.
• If deficiency is severe, leaves will be reduced in size, and dieback occurs. Fruit crop is reduced.
• All citrus plants can be affected.
How to control:
• Lower pH of soil (usually occurs in alkaline soils) but this is slow
• Apply iron chelates to soil or foliage
• Apply variety of animal manures but make sure that poultry manure, mushroom compost and
other composts are not alkaline first.

Citrus Leafminer Phyllocnistis citrella (macroparasite)
• Caused by moth larvae
• Eggs are deposited along midrib of young leaves. When larvae hatch out, they tunnel in the
leaf for 5-6 days.
• Silvery lines produced stand out against green of the rest of leaf; leaves may become severely
distorted.
• When larva is fully grown, it curls the leaf and uses it to make a shelter to pupate in.
• Cycle takes 2-3 weeks: mature citrus trees can usually survive attacks.
How to control:
• Limit water and fertiliser in summer/autumn to avoid growth flush when pest population is
highest.
• Fertilise in winter.
• Use white oil in summer/autumn if young growth needs to be protected. Apply thoroughly
until the spray runs off the leaves.



Black Spot - Rose Plants (micro-parasite)
• Fungus causes black spots on leaves of roses.
• Frequently turn yellow and fall early.
• If plant is continually defoliated, it will be weakened. Dieback and death may follow.
• In very susceptible varieties, young stems attacked leads to a reduction in size and number of
flowers and stem dieback.
• Worse in humid weather at temperatures between 13-24˚C.
How to control:
• Organic/non-chemical: Discard leaves that are badly affected, decrease humidity around
plants as much as possible. Don't plant roses in shady places, pick up and burn diseased fallen
leaves etc.
• Chemical: Use zineb or triforine and spray on a regular basis when weather becomes warm
and humid.

Rose Aphids
• Aphids suck sap from plant tissues, distorting new leaves and flowers
• Aphids excrete large amounts of honeydew which can cover the plant.
• This is a food source for sooty moulds which form a black covering over affected areas,
reducing photosynthesis.
• Severe infestation can result in defoliation and loss of the flower crop.
Control: Spraying of rose bushes with white oil

Orange Rust - Fungus
• Orange-yellow powder on undersides of some Oxalis leaflets.
• 2000 species of rust are known, and all are parasitic on flowering plants or ferns.
• No other group of fungi is as dangerous for agriculture and horticulture.
 • Fungi feed off glucose made in photosynthesis but can cause reduction in number of leaves,
and plant death.
Control: Spray leaves with fungicide.

Investigation Conclusion:
We were able to see the effects of pathogens, macro and micro, on the growth of plants.

Changes in Management and Prevention of Disease
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.

Background Information

Treatment of disease: Strategies employed to cure disease or relieve symptoms once organisms
already have the disease

Control of disease: Reducing spread through population of organisms once it's already present.
Prevention of disease: Involves use of strategies that stop occurrence of disease in organisms.
Management of disease: Programs that improve outcomes of chronic conditions and improve
quality of life sufferers.

Historical precedence:
• When drugs such as penicillin were discovered, emphasis was treatment and control of
disease.
• Antibiotic resistance shifted emphasis towards prevention and management of diseases.
• Shift in emphasis was made possible by our increased understanding of immune system
• Preventative measures expanded with increasing understanding of genetics
• Lots of problems associated with disease treatment wouldn't exist if the disease was
prevented in the first place.


Animal Disease: Poliomyelitis

Treatment/control: Bed rest, pain relievers, portable ventilators to assist breathing when paralysed.
No cure exists.
Advantage: Relieves pain and ensures patient survives.
Disadvantages: Patient continues to suffer, disease isn't cured (only prolongs life), burden on
healthcare system, high costs.
Prevention/management: polio vaccination
Advantage: Prevents all consequences of having polio, money spent, suffering etc.


Plant Disease: Cotton Bollworm Disease
Treatment/control: insecticides
Advantage: kills off insects including cotton bollworm
Disadvantages: Plants may still be damaged by bollworm and crops still die. Prolonged use leads to
resistance over time and other possible side effects.
Prevention/management: Genetic engineering Bt cotton that has a natural resistance to disease
Advantages: Prevention of initial crop loss, reduces need for pesticides which may be harmful to
human and environmental health.