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1.1 Discuss the difficulties of defining the terms health and

disease

Health is more than merely the absence of disease. Health is defined by the
World Health Organisation (WHO) as a state of complete physical, mental and
social well-being, and not merely the absence of disease or infirmity.
This definition allows the whole person to be taken into account rather than just
whether they have a disease or not. An individual who does not have a disease
may still not be considered healthy. On the other hand, a person who suffers
from a disease could still be classified as healthy.
Physical health refers to the physical state of the body and includes things like
our level of fitness, body weight, amount of energy and the proper functioning of
the systems in the body.
Mental health is related to our ability to function effectively in society and to
cope with changing situations in our lives.
Social health is our ability to interact, communicate and socialise effectively.
One problem with the WHO definition is that it is very broad, and if taken literally,
it would be very difficult to achieve a healthy status. It would be very unlikely
that a person has a complete state of physical, mental and social well-being at
any one time.
The concept of health for individuals is very subjective on their lifes
circumstances. What is healthy for one may not be regarded as healthy for
another person. A person who is physically fit and not suffering from any disease
would consider themselves to be healthy whereas a person who has a disability
or a chronic disease, may describe themselves as healthy because they have
learnt to adapt and cope with this disability or disease in their everyday life.
Health is a constantly changing state and is relative to others and ourselves over
a period of time.
Disease can be defined in many ways, but one of the most common is any
condition that adversely effects the normal functioning of any part of a living
thing.
This definition is also quite broad and the problem with this is that conditions
that would not normally be classified as a disease would be included if this
definition if it were taken literally. It could mean that a broken arm would be
classed as a disease because it adversely affects the normal functioning of the
body. Similarly, pregnancy could be classified as a disease.
The normal function referred to in the definition may be at different levels for
different individuals. E.g. Absent mindedness in the elderly may be a normal
facet of aging whereas it could be the manifestation of a disease in the young.
Another issue in defining health and disease is the ways in which the words
are used. These terms used in every day conversations by the general public will
have different meanings to the scientific definitions.

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1.2 Outline how the function of genes, mitosis, cell

differentiation and specialisation assist in the maintenance of
health

The maintenance of health is dependent on the information stored in the DNA of

each cell. A gene is a hereditary unit that controls the production of polypeptides
that make up the proteins in the cell. These proteins are responsible for normal
cell functioning, growth and repair. A malfunction in a particular gene may result
in the inability of the cells to function properly and lead to the onset of disease.
For example, cystic fibrosis is a genetic disease that is caused by a mutation to
the CFTR gene.
DNA Repair genes code for proteins that are responsible for the stopping pf the
cell cycle while other proteins remove the damaged regions of DNA and replace
them with a new correct sequence.
Proto-oncogenes code for proteins that stimulate cell growth and mitosis.
Mutations to this gene lead to the expression of oncogenes that would normally
be silent. This causes the uncontrolled production of cells and prevents cell
death.
Tumour suppressor genes code for proteins that slow down or stop cell growth
and mitosis. These genes also code for proteins that induce cell death if there is
an uncontrolled increase in cell numbers.
Mitosis is the process of cell division by which identical body cells are produced
to allow for growth; repair of damaged tissue, replacement of worn out cells; and
genetic stability in which there is a precise and equal distribution of
chromosomes to each daughter nucleus, so that all resulting cells contain the
same number and kind of chromosomes as each other and the parent cell.
This allows all cells to function normally and tissues in the body to be repaired
and maintained. If cells are damaged through disease, they are replaced by the
division of healthy cells close to the injury or disease site.

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3.1 Describe the contribution of Pasteur and Koch to our

understanding of infectious diseases

Prior to the work of Pasteur, Koch and others, the theory of spontaneous
generation was the accepted explanation for disease and decay. This theory
involved the idea that life (such as maggots that were present in rotting flesh)
arose spontaneously from non-living things.
Pasteur was able to disprove this theory and he established the germ theory of
disease. This theory states that germs/microbes cause disease and all living
microorganisms come from pre-existing living things. Koch determined that each
disease is caused by a specific microorganism.
Pasteur contributed in finding that microorganisms were the cause of wine, beer
and vinegar spoilage. He discovered that the solution to the wine and vinegar
problems was to heat these solutions long enough to kill the contaminating
bacteria that were present after fermentation. This was the beginning of the
process of pasteurisation that is still widely used today.
He found that the rotting of food was due to the activity of living organ isms. He
carried out his famous swan necked flask experiments to gain evidence to
support his theory germ theory of disease. These experiments involved using
flasks that were not sealed. Meat broth was boiled in the flasks and as they
cooled the air was drawn in from the outside. Any microorganism present in the
air did not reach the broth as they were trapped in the narrow necked and curve
of the glass. No fungal or bacterial growth was observed in these flasks. Bacterial
growth occurred if the curve of the glass was broken off and the contents of the
flask exposed to the air.
This added further evidence to disprove the theory of spontaneous generation. It
proved that the organisms that contaminated the broth and caused it to decay
was carried in the air and not spontaneously generated. After 150 years the
broth in the swan necked flask is still free of bacterial growth.
Pasteur also uncovered the relationship between microorganisms and disease,
and as specific bacteria became known for specific diseases the spontaneous
generation became less and less widely supported and the germ theory of
disease was more widely accepted.
Koch developed the agar plate technique for growing microorganisms that is still
used today and used it to culture the isolated anthrax bacillus (AB). He studied
the blood of sheep that had died from AB and identified the rod shaped bacteria
that he isolated and grew in cultures. These cultured bacteria were injected into
healthy sheep that subsequently developed AB.
These experiments added further weight to the germ theory of disease as they
showed that a microorganism grown outside the body caused a disease.
Koch determined that each disease is caused by a specific microorganism.
The principals he used to identify the specific microorganism that was
responsible for a disease came to be known as Kochs postulates and are still
used today to identify the specific microorganism that causes a particular
disease.

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Kochs Postulates:
1. The same microorganism must be present in every diseased host.
2. The microorganism must be isolated and cultured in the laboratory and
accurately described and recorded.
3. When a sample of the pure culture is inoculated into a healthy host, this
host must be able to develop the same symptoms as the original host.
4. The microorganism must be able to be isolated from the second host and
cultured and identified as the same original species.
One of Kochs subsequent big breakthroughs was the discovery of the bacterium
responsible for tuberculosis, mycobacterium tuberculosis. He was also
responsible for identifying the bacteria that causes cholera.

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3.2 Distinguish between:

Prions
Viruses
Bacteria
Protozoans
Fungi
Macro-parasites
And name one example of a disease caused by each type of
pathogen

A prion or proteinaceous infectious particle is a protein that is capable of

causing disease. Unlike other types of pathogens, prions do not contain any
genetic material (DNA or RNA). They are smaller than smaller than all other
pathogens. Normal prion proteins are coded for by genes in an organisms DNA. It
is unclear what the function of these prion proteins is, but they are present
mainly in the nerve cells of the brain. Normal prion proteins do not cause disease
and can be destroyed by heat.

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A mutation to the gene that codes for these normal proteins causes the
production of a different form of this prion protein. This form has a different
structure and is the disease-causing prion. This prion is also resistant to most
normal methods used to break down proteins and cannot be destroyed by
heating or treating with chemicals.
Infectious prions are capable of multiplying and are thought to do this when they
come into contact with the normal prion proteins, altering their structure and
changing them into infectious prion proteins.
Prion diseases cause degeneration of brain tissue. Humans may be affected in
two ways: acquired infection (eg; through food or medical procedures.) or
through apparent hereditary transmission. This means that prion diseases are
unusual as they can be both infectious and hereditary diseases.
Diseases caused by prions are called spongiform diseases because the brain
tissue of individuals that are infected by these diseases is full of holes, like that
of a sponge. All of these diseases are fatal.
An example such a disease is kuru, a disease that was found in tribes in the Fore
highlands of Papua New Guinea. The symptoms include uncontrollable shaking,
continuous trembling, and grimacing of the face which led to the name laughing
death. It was transmitted by eating, during funeral ceremonies, the infected
brain tissue of dead relatives. It was usually fatal within 6-12 months. Only
women and children contracted the disease, as the men did not take part in the
burial ritual. The transmission of disease stopped when the cannibalism practices
of the tribe stopped.
Viruses are non-cellular pathogens that have both living and non-living
characteristics. They contain genetic material and are able to pass on hereditary
information (a characteristic of living organisms), are not composed of cells and
can be crystallised (characteristics of non-living things). They are the smallest
known reproducing things
Viruses are larger than prions and many times smaller than bacteria. A virus is
made up of a protective protein coat that encloses the genetic material, which
may be either DNA or RNA. Viruses are unable to reproduce on their own and can
replicate only inside host cells. The viral protein coat contains chemicals that
allow the virus to attach itself to the surface of the host cell. Once the virus
attaches itself to the cell, it enters and takes of the cells reproductive
mechanisms to make copies of itself. The cell becomes so full of copies that it
dies and bursts, releasing the new viruses so they can repeat the process with
other host cells.
At present, there are no cures for viral diseases but there are vaccines which
reduce their incidence. Viral diseases include measles, mumps, chickenpox,
AIDS, Influenza and glandular fever.
Bacteria are single-celled procaryotic organisms. Their genetic material is a
single large chromosome a circular thread of DNA double helix. They are larger
than viruses but smaller than protozoans and vary in size from 0.5 to 100
micrometres. Bacteria are classified on the bases of their shape they can be a
spherical shape (coccus), a rod shape (bacillus), a spiral shape (spirillum), a
comma shape (vibrio) or an oval shape (rickettsiae). Bacteria reproduce by

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asexual reproduction using the process of binary fission (dividing in two). The
time it takes for the number of bacteria to double is known as the generation
time. This varies for different species and is between 10 minutes and 24 hours.
This means that many bacteria can be produced in short space of time.
Some bacteria are beneficial whereas others are not. Those that arent release
toxins or chemicals that are harmful to the hosts body. These toxins can either
inhibit protein synthesis, damage cell membranes, disrupt transport of material
across cell membranes, or interfere with normal nerve function. Some examples
of diseases that are caused by bacteria include tetanus, meningococcal disease
and food poisoning.
Protozoans are single-celled eucaryotic organisms. They usually reproduce by
the process of asexual binary fission and range from 1-300 micrometres
Some protozoans possess a long whip-like tail called a flagellum to enable them
to move about. These protozoans are known as flagellates. Ciliates have many
hair-like projections called cilia surrounding the cell. These beat rapidly to propel
them along. Protozoans such as Amoeba possess projections of the cytoplasm,
called pseudopods, to move them around. Sporozoa are protozoans such as
Plasmodium that do not have structures for motion and reproduce by spores.
Diseases caused by protozoans include malaria, giardiasis and trypanosomiasis.
Fungi are eucaryotic organisms. Fungi do not contain chlorophyll and are not
capable of producing their own food. They can be unicellular, such as yeasts, or
multi-cellular, for example mushrooms. Most are composed of a system of
microscopic tubular filaments or threads known as hyphae, which branch and
spread to form a structure known as mycelium. Fungi range in size (micro to
macroscopic), and also in reproductive methods (asexual, sexual or even both).
Most fungi are saprophytic (live on dead organisms) and hence act importantly
as decomposers. Most pathogenic fungi are dermatophytes (live in skin, nails and
hair), and a small number cause diseases such as candidiasis (thrush) and
athletes foot (tinea).
Micro-parasites are parasites that are visible to the naked eye and are larger
than other pathogens. They are multicellular eucaryotic organisms that vary in
size from the tiniest louse to very long tapeworms. Some macro-parasites cause
disease directly, whereas others will act as vectors in the transmission of a
disease. Macro-parasites can be divided into two groups:
1
2

Endoparasites live inside the hosts body and include flatworms

(tapeworms) and roundworms. They cause diseases such as taeniasis
(tapeworm disease), and elephantiasis (caused by a filarial worm).
Ectoparasites are parasites that live outside the body, usually sucking
blood. Examples include mosquitoes and lice. Some of these parasites
inject toxins while feeding; these can cause inflammation, allergic
reactions and sometimes partial paralysis. Ectoparasites can also act
as vectors for the transmission of other pathogens. The flea is vector
for the bacterium Yersinia pestis, which causes bubonic plague.

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3b) Gather and process information to trace the historical development

of our understanding of the cause and prevention of malaria.
Malaria is one of the most prevalent infectious diseases in the world today, with
more than 300 million cases reported and 1.5-3 million deaths, mostly of African
children under 5 years old, each year. Malaria starts suddenly and is
characterised by intermittent violent chills and intense fevers, severe headaches,
convulsions and delirium. Anaemia is also a common symptom, as well as an
enlarged spleen. Death will result when the tissue dies from a lack of oxygen or
serious brain/kidney infections.
The historical development of our understanding of the cause of malaria can be
broken up into three stages:

Recognising the symptoms and hypothesise as to the cause

Discovering the microorganism responsible
Determining the life cycle and mode of transmission of the protozoan
that causes malaria.
Step 1: Recognising the symptoms and hypothesising the cause

The symptoms of malaria have been reported since the beginnings of recorded
history. In Chinese methodology for example, three demons are pictured: One
with a hammer, one with cold water, and one with a stove. These demons were
held responsible for the headache, chill and fever suffered with malaria. The
Greeks, however realised that those who live in swampy areas had a higher
chance of developing the disease. Hence they believed that it may have been
due to the drinking of the swamp water, or the inhalation of the dirty air that
resulted in the disease.

Step 2: Discovering the micro-organism.

Pasteurs and Kochs work ignited the search for the cause of malaria. In 1880
Charles Laveran discovered the pathogen that causes malaria while looking at
the blood of malaria patients. This organism was a protozoan that he classified
as Plasmodium.

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In 1885, Golgi, an Italian neurophysiologist, established that there were at least

two forms of the disease: one that causes a fever third day. In 1886, he observed
that each of these forms produced differing amounts of new parasites
(merozoites) and that the peak of the fever coincided with the release of the
merozoites into blood.
Later, other scientists found that there was in fact two more malaria parasites
and the initial pathogens name was changed form Plasmodium to P. falciparum.

Step 3: Determining life cycle of the parasite and the mode of transmission.

In 1897, Ronald Ross, demonstrated that the malaria parasite could be

transmitted from infected patients to mosquitoes. He tested this hypothesis in
birds and was successful in showing that the mosquitoes were able to pass the
malaria parasite from bird to bird. He determined the main steps in the cycle of
transmission of the malaria parasite and identified that only a certain strain of
mosquito transmitted the malaria parasite.
Life Cycle of Malaria:
The mosquito ingests infected red blood cells, the cells are digested and the
malarial parasite is released in the intestine of the mosquito. The parasites
migrate from the intestine to the salivary glands where they remain ready to
enter another host when the mosquito next feeds.

Prevention of Malaria
Although drugs are available for the treatment of malaria, a complete cure is
difficult. This is because the parasite can remain dormant for many years in the
liver before becoming active again. Different drugs are used against the different
stages of the malarial parasite. Malaria is still one of the most serious infections
in the world and is particularly common in some tropical and sub-tropical areas.
The Anopheles mosquito, the main carrier of malaria is common in these areas.
Control of the disease is also becoming more difficult as mosquitoes become
increasingly resistant to chemicals such as DDT that have been effective against
them in the past. Eradication of the vector for the malarial parasite is proving to
be virtually impossible.
History of Prevention:
The ancient Chinese used the anti-fever properties of the Qinghao plant in order
to treat malaria. In order to prevent it, however, the ancient Greeks and Romans
decided to build drains to remove stagnant water. After they had done this, the
incidence of these fevers fell.
In the mid-1600s the first drug to treat malaria was produced. This was known
as quinine. It was extracted from the bark of the Peruvian cinchona tree. After it
was shown that the mosquito was responsible for the transmission of malaria,
procedures were followed to reduce the chance of being bitten by a mosquito.
Many areas where the mosquitoes were bred were drained, bodies of water were
sprayed with oil to prevent breeding and protective clothing was worn to reduce
the risk of being bitten.

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Following this, a range of drugs were developed, each of which had a positive
immediate effect such as Atebrin, but over time, the virus evolved and became
resistant, hence reduces the drugs effectiveness. Additionally, the use of DDT
was employed to eradicate large numbers of mosquitoes. This also resulted in
the same consequence where initially large populations were wiped out, but over
time, the species evolved and became resistant to the pesticide.
Overall, the best method of prevention is those that reduce the risk of being
bitten

3c) Describe an infectious disease in terms of its cause,

transmission, host response, major symptoms, treatment,
prevention and control.

Disease: Influenza
Cause: Influenza is caused by infection with the influenza virus. There are two
types (A and B) are the two main types of influenza viruses that infect humans,
and each contains RNA surrounded by a protein coat. They differ from each other
as they carry different antigens on their surfaces. There are a number of different
strains of both the influenza A and B viruses.
Transmission: The transmission of influenza virus can be either direct of
indirect:

Direct contact: The viral particles are inhaled through the nose and mouth
in droplets that have been exhaled by an infected person when they
sneeze or cough.
Indirect contact: The infected person touches the respiratory tract, and
then touches some else, such as a handrail. A second person touches the
handrail and soon afterwards, then places their hand on their nose or
mouth.

Host Response to the influenza virus: The immune response is initiated by

the presence of the virus in the body. This produces antibodies and other
immune-response cells specific for the particular strain of the influenza virus that

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has infected the body. The immune response is responsible for destroying the
viral particles that have invaded the body.
Major symptoms of Influenza: Fever, Headache, inflammation of the upper
respiratory tract, sore throat, muscle pain, coughing and sneezing as well as
nasal catarrh (inflammation the mucous membrane causing excess production of
mucous).
Treatment: Influenza is caused by a virus and therefore there is no treatment
that will cure it. The main method of treatment is to relieve the symptoms, get
plenty of bed rest and drink extra fluids. Bed rest allows the body to fight the
disease and then recover. Aspirin or paracetamol can be given to help alleviate
headaches, sore throat and muscle pain and to reduce fever. Antibiotics are
ineffective in the treatment of viral diseases, but can be used if secondary
bacterial infections develop.
Prevention: The primary method of prevention of influenza involves the use of
influenza vaccines. New vaccines are produced each year and are derived from
the influenza A and B viruses that circulated during the previous influenza
season. If the virus vaccine and the circulating virus are closely related, the
effectiveness is fairly high. As the influenza virus is constantly changing by
mutation, the vaccines have to be constantly updated. Other strategies include
wearing protective masks, avoiding crowded areas and ensuring that adequate
nutrition and sleep is obtained.
Control: To reduce the spread of the disease through the population a number of
strategies could be employed. These include:

Implementing immunisation programs along with education programs to

encourage at risk individuals to be vaccinated.
Isolation infection individuals to reduce the spread of influenza throughout
the population this would include infected individuals remaining at home
to stop the spread of the virus to their work or school colleagues.

3a) Perform an investigation to model Pasteurs experiment to

identify the role of microbes in decay

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

Hypothesis: The flask that has the S-shaped glass will not show signs of
microbial growth. The flask with the straight glass tubing that is open to the air
will show signs of microbial growth.
Equipment:

Beef broth made from beef stock cubes, filtered to remove any
cloudiness
2 conical flasks: each with a single-hole stopper to fit.
Glass tubing bent into an S-shape fitted into one of the stoppers
Straight glass tubing fitted into the other stopper
Heating equipment (Bunsen burner, tripod, gauze mat etc.)

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Risk Assessment: While handling glass flasks and stoppers, take caution as
glass is fragile and breakage may cause injury. Wear safety glasses while boiling
the broth as hot water may spit out the glass tubing. Be cautious with the
Bunsen burner, flames and hot equipment can cause severe burns.
Method:
1

Add the filtered beef broth to each of the flasks until they are approximately
one third full.
Fit the stoppers to the flasks
Heat each flask so that it boils for 20 minutes. After boiling, ensure there is
a small amount of water trapped in the S-bend
Leave flasks out of direct sunlight for several weeks.
Every 2-3 days, observe the contents of the flask

2
3
4
5

Results: After several weeks we observed that the flask with the S-bend has had
no microbial growth while the flask with the straight glass tubing open to the air
has substantial microbial growth in the flask.
Conclusion: we were successful in modelling Pasteurs swan-necked flask
experiment and found that his hypothesis that microbes in the air caused the
decay of foods was correct.

3.3 Identify the role of antibiotics in the management of

infectious disease

Antibiotics are chemicals made by microbes that can kill or stop the growth of
bacteria and fungi without destroying the host. In 1928 Alexander Fleming
discovered the first antibiotic, penicillin. It was not able to be used at this stage
and was not until a decade later that Howard Florey (an Australian) ad Ernst
Chain purified penicillin. It then became available for medical use in 1941.
Penicillin is a naturally occurring substance produced by a living thing and since
its discovery many synthetic forms of antibiotics have been made. (Eg.
Tetracyclines, cephalosporins, sulphonamides)

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Broad-spectrum antibiotics, such as sulphonamides, act on a wide range of

bacteria and are useful when the identity of the bacteria causing infection is not
known. Other types of antibiotics, such as penicillin, act on only one or two types
of bacteria and are known as narrow-spectrum antibiotics.
The antibiotics act on the bacteria to destroy them in a number of different ways:

Some accumulate in the cells of the bacteria and prevent them from
forming a new cell wall when they are dividing. (Eg. Penicillin.)
Some destroy the cell membrane, effectively destroying the bacteria.
(Eg. Amphotericin)
Some interfere with protein synthesis so the bacteria are unable to
make essential compounds, resulting in the death of the cell. (Eg.
Erythromycin.)

3d) Discuss problems relating to antibiotic resistance

Bacteria, during the normal process of natural selection, have evolved strains
that are resistant to many, if not all, of the antibiotics that are used to treat
infectious diseases in the world today. Antibiotic resistance is being further
accelerated by a number of common practices. These include:
-

The overuse of antibiotics for the treatment of many diseases and not just
bacterial diseases. Eg: prescribing of antibiotics for the treatment of
coughs, colds and the flu. These are caused by viruses which are not

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affected by antibiotics. This practice just gives the bacteria more chances
to build up populations of resistant strains.
A very common practice is only taking the course of antibiotics until the
symptoms of the particular disease disappear. This is dangerous as not all
the bacteria may be killed before the end of the course of tablets. This
allows the bacteria that are resistant yet another chance to survive,
reproduce and develop more populations of resistant strains.

Microorganisms that cause diseases once easily cured, such as tuberculosis,

have developed resistant strains that are not responding to the cheaper firstline antibiotics. As a result of this, the effects of these diseases are now more
severe and because they take much longer to cure, the infectious period is
longer, meaning that there is a greater chance of passing on the resistant strain
of the microorganism to other members of the community.
When second-line or third-line antibiotics have to be used they are usually
much more expensive and more toxic. The drugs needed to treat multi-resistant
tuberculosis are 100 times more expensive than those used to treat the nonresistant forms, and in countries where this is too expensive to use, the disease
is untreatable and therefore spreads.
Antibiotic resistance is a major problem for the treatment of some diseases, as
the current trend indicates that in the near future some diseases will have no
treatment, unless there is a significant breakthrough in producing more effective
drugs.
Strategies to slow the development of antibiotic resistance:
-

Only prescribe antibiotics for bacterial infections and when it will be of

benefit to the patient
The antibiotic prescribed should target the pathogen and not be broadspectrum
Not take antibiotics for viral infections such as the cold and flu
Taking the whole course of the antibiotic and not stop when the symptoms
go away
Never take antibiotics that are prescribed for someone else

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4.1 Identify defence barriers to prevent entry of pathogens in

humans:
Skin
Mucous Membranes
Cilia
Chemical Barriers
Other Body secretions

The first line of defence is a non-specific defence and involves the body using
both chemical and physical barriers to try to prevent the entry of pathogens into
the blood and tissues. The most vulnerable area of the body for the entry of the
body for the entry of pathogens are the openings, such as the mouth and nose,
and the internal passages, such as the alimentary canal and urinogenital tract.
The skin is a physical barrier that forms a tough outer barrier that covers the
entire body and prevents penetration by microbes. It is fairly dry which helps to
prevent the growth of pathogens. The skin also contains its own population of
harmless bacteria that help to stop the invading microbes from multiplying. Oil
and sweat glands in the skin produce antibacterial and antifungal substances
that further inhibit the growth of invading pathogens. If the continuous barrier is
cut, the blood clots almost immediately to produce a temporary patch to
maintain the barrier until new skim forms.
The respiratory, digestive, reproductive and urinary tracts are covered with
membranes that produce a thick layer of mucus which traps entering pathogens.
The pathogens are held in the mucus until they are removed by processes such
as coughing and sneezing. The mucus can contain an antibody that prevents
bacteria and viruses from attaching to the surface. The mucus also provides a
moist, nutritious layer in which the harmless microbes live and produce
substances that inhibit the growth and entry of pathogens.
Cilia are tiny hairs that line the respiratory surfaces of the trachea and bronchial
tubes. The cilia are constantly beating in an upwards direct to move the mucus
containing the trapped pathogens towards the throat where they are then
removed by coughing or sneezing or swallowing.
Different types of chemicals secreted in different parts pf the body act as a
barrier to the invading pathogens. In the alimentary canal, pathogens entering
with food or drink, or swallowed with mucus, will be destroyed by the acidic
conditions of the stomach or the alkaline conditions of the intestines. The urinary
and vaginal openings and the surface of the skin are also acidic, which inhibits
the growth of pathogens.
Other body secretions include:

Urine is sterile and slightly acidic and flushes and cleans the ureters,
bladder and urethra. It also helps to prevent the growth of
microorganisms
Tears contain lysozymes that destroy the cell walls of some bacteria. As
the tears are produced and the eyelid blinks, the surface of the eye is
cleaned and the pathogens are washed away.
Saliva also contains lysozymes and washes microorganisms from the
teeth and the lining of the mouth.

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4a) Gather, process and present information from secondary

sources to show how a named disease results from an
imbalance of microflora in humans

Thrush is a disease caused by the excessive growth of a yeast-like fungus call

Candida albicans. The fungus occurs naturally in the bowel and the vagina, along
with a variety of other microflora, and normally causes no problems in a healthy
person. If, however, the environment changes, the balance of these
microorganisms may be disturbed and an overgrowth of Candida may occur,
especially in the vagina.
Symptoms of thrush include vaginal itching and discomfort, thick discharge,
redness and swelling, stinging or burning experience may be experience when
passing urine. It must be noted, however, that other conditions, such as genital
herpes or urinary tract infections, may display the same symptoms and an
accurate initial diagnosis is important.
A change in the environment of the vagina leading to thrush may be caused by
the oral contraceptive pill, diabetes, pregnancy, immune system disorders and
general illness. The use of some antibiotics can also be a major cause of this
disease because these drugs kill most, if not all, types of bacteria in the body.
The resulting imbalance of microflora leads to the excessive growth of Candida,
and thrush-like symptoms begin to appear. In addition, a change in pH of the
vagina caused by spermicides and feminine hygiene products can also lead to
the overgrowth of Candida.
Treatment usually involves the use of antifungal cream, but also may involve the
insertion of suppositories such as micronazole. In some cases, the insertion of
natural yoghurt into the affected area may help to retain the balance of
microflora in this region.
Prevention techniques involve careful washing of vulnerable areas, the avoidance
of some types of antibiotics and the practice of wiping front to back after using
the toilet to avoid spreading yeast from the anus to the vagina.

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4.2 Identify antigens as molecules that trigger the immune

response

An antigen is any molecule the body recognises as foreign and that triggers the
immune response.
On the surface of cells in the body, there are marker molecules that allow the
body to recognise the cells as self.
When pathogens enter the body, they have chemical markers, called antigens,
on their surface; the immune system recognises these as not belonging to the
body (non-self). The presence of these antigens causes the immune response to
be activated to destroy the foreign organisms.
It is not only pathogens that have antigens on their surface. Any cell, cell
fragment, protein debris or toxin produced by bacteria can also contain antigens.
The venom of poisonous snakes contains a number of antigens. In these cases
the immune response will be activated because the body recognises all these
antigens as foreign molecules.

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4.3 Identify defence adaptations, including:

- Inflammation response
- Phagocytosis
- Lymph system
- Cell death to seal of pathogen

The inflammation response is a non-specific defence mechanism and occurs at

the site of infection. When the cells are infected or injured in some way, the
release chemical alarm signals such as histamines and prostaglandins. These
chemicals cause the blood vessels to dilate, increasing blood flow to the site of
infection or injury and causing the area to become red, hot and swollen. These
chemicals also increase the permeability of the blood vessels; this allows the
movement of phagocytes from the blood into the tissues so they can attack the
invading pathogens. Phagocytes are a special type of white blood cell. Plasma
also moves into the tissues, bringing more phagocytes and producing swelling in
the area, forcing tissue fluid into the lymph and taking debris and pathogens with
it. Chemicals that increase the temperature are released. This inhibits the growth
of pathogens, inactivates some enzymes and toxins made by pathogens and
increases the rate at which the biochemical reactions occur in the body.
Phagocytosis is a non-specific process where white blood cells, called
phagocytes, attack foreign substances and engulf and destroy them.
Phagocytosis is not always effective as some pathogens can repel phagocytes;
some bacteria have special capsules which the phagocytes cannot grasp, and
some pathogens escaped before being completely destroyed. Pus is a mixture of
dead phagocytes, bacteria, tissue fluid and damaged body cells.
Macrophages are the largest phagocytic cells are involved in wound healing,
inflammation and the immune response. Macrophages pseudopodia and engulf
dead and damaged cells, debris, antibody coated microbes and damaged fatty
particles. They then release digestive enzymes and lytic enzymes to destroy the
particles. After a macrophage has destroyed the pathogen, parts of the partially
digested antigen are displayed on the surface of the macrophage. Contact with
T-cells stimulates the production of more helper T-cells for that particular
antigen. Thus, macrophages are part of the non-specific response but also
involved in the production of specific defence cells.
The lymph system is a system of vessels and lymph nodes that returns fluids and
proteins to the blood. The lymphatic system is important in controlling tissue
fluid balance, lipid transport and defence against disease. Lymph is a colourless
fluid that drains from the interstitial spaces into lymph capillaries, blind end
tubes with valves which prevent lymph flowing back into the tissues. The lymph
passes through the lymph nodes and eventually joins up with the circulatory
system at the heart. Lymph nodes are located along the lymphatic vessels and

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Biology

act as filters, removing microbes, foreign particles, tissue debris and dead cells
from circulation.
Cell death to seal off pathogen: a cluster of cells may surround the pathogen and
damaged tissue. A cyst may even form. The area is sealed off and other cells
such as white blood cells and healthy cells may be sacrificed to make sure the
pathogen is sealed off.

4.4 Explain why organ transplants should trigger an immune

response

When a person has an organ transplant, the new organ they are receiving from
somebody else has different antigens. The transplanted organ is therefore
identified as foreign and the immune response is activated to attack the organ in
order to defend the body. To try to prevent this from happening, the tissue

type of the donor is matched to the recipient as closely as possible so that

there is a high number of matching marker molecules. This will mean that
there are fewer foreign (antigen molecules) on the surface, a situation
which may lead to less violent immune response.
The patient can also be treated with immunosuppressant drugs, which will
also lessen the immune response so that the transplanted organ is not
attacked. This has the disadvantage of making the patient more
susceptible to infection from pathogens and they must take precautions
(such as isolation) to reduce their potential exposure to any infections.

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Biology

5.1 Identify the components of the immune response:

- Antibodies
- T Cells
- B Cells

T cells are lymphocytes that are produced in bone marrow and mature in the
thymus gland where they are programmed for a specific antigen. T cells
provide cell-mediated immunity, being partly effective against body cells which
have been infected by a virus or other pathogen. There are many different types
of T cells; killer T cells (cytotoxic T cells), helper T cells and Suppressor T cells.
Memory T cells recognise the antigen if it is reintroduced.
Cytotoxic cells destroy cells identified as non-self. They are formed when either a
macrophage or an infected cell displays the antigen. The T cell binds with the
infected cell and inserts a toxic chemical called perforin, a protein which causes
the cell membrane to rupture, and the cell lyses (disintegrates). They also target
cancer cells and foreign graft cells.
Helper T cells stimulate the production of plasma cells and help activate B cells
to produce antibodies. Many B cells cannot go into production unless helper T
cells for that antigen have first acted. Helper T cells secrete chemicals, such as
lymphokines and interleukins, which cause activated B cells or T cells to divide
and also to stimulate the macrophages for phagocytosis. The production of Killer
T cells is stimulated by helper T cells.
Suppressor T cells turn off the immune response and suppress the production of
antibodies. Some believe they are actually a form of helper T cells.
B cells are white blood cells, formed in the bone marrow like all white blood cells.
They mature in the bone marrow and are released into the blood stream. They
provide what is called antibody-mediated immunity. The presence of an
antigen activates B cells to divide and differentiate into either plasma cells or
memory cells. Plasma cells secrete immunoglobulins called antibodies with a
shape compatible to that of the antigen. The antibody can bind with its particular
antigen to form an antibody-antigen complex. This binding destroys the antigen
by either immobilising it, or by blocking and neutralising an active binding site of
the antigen, or by causing the antibody-antigen complexes to agglutinate (stick
together) and clump which makes them easier to eliminate by phagocytosis.
The memory B cells remain in the body for a long time and can identify that
particular antigen. A later infection of the same antigen will be detected by the
memory cells, which cause a rapid, large-scale production of the needed
antibody. Memory cells provide immunity.
Antibodies are proteins called immunoglobulins. They are produced in response
to the presence of an antigen in the body. When the appropriate B cells are
activated they form plasma cells that produce antibodies, the antigen binding
sites of which match the shape of the antigen they are specific for, much like
enzymes being substrate specific. These antibodies then seek out the antigen
and bind to a part of it, forming the antigen-antibody complex, which causes the
deactivation of the antigen.

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Biology

5.2 Describe and explain the immune response in the human body
in terms of:
- interaction between B and T lymphocytes
- the mechanisms that allow interaction between B and T
lymphocytes
- the range of T lymphocyte types and the difference in their
roles

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Biology

5.3 Outline reasons for the suppression of the immune response in

organ transplant patients

Whenever a patient receives an organ transplant, the bodys immune system

recognises the foreign tissue as an antigen and the immune response is
triggered. This often happens despite the fact that the tissue proteins of the
donor are matched as closely as possible with those of the recipient. Killer T
cells, macrophages and antibodies begin to attack the tissue that has been
distinguished as non-self by the lymphocytes and tissue rejection usually
follows. As a result, special immunosuppressive drugs need to be administered
to organ transplant recipients to prevent this rejection process.

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Biology

Outline the way in which vaccinations prevent infection

Immunisation is a process which stimulates the immune system to produce

lymphocytes or antibodies to fight an infection, giving immunity to that disease.
Vaccination is a method of providing immunisation, in which weakened or dead
pathogens are introduced to the body.
Vaccines act as an antigen, inducing the immune response; plasma cells and
memory cells are produced. The vaccine does not cause the disease or the
symptoms so the plasma cells are not really needed. The memory cells are
important as they give the body immunological memory for a particular
pathogen. If that pathogen enters the body, the circulating memory cells can
respond very quickly and in greater numbers so that the person does not suffer
the symptoms or the disease. As the number of memory cells can decrease over
time, booster injections are sometimes needed to maintain immunity.
Vaccines can contain either the killed bacteria or viruses (e.g. cholera or
typhoid); living attenuated forms of the pathogen (e.g. rubella or poliomyelitis0;
or a toxoid (e.g. Tetanus or diphtheria).

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5a) Evaluate the effectiveness of vaccination programs in

preventing the spread and occurrence of once common
diseases including smallpox, diphtheria and polio

Many diseases including smallpox, diphtheria and polio were once very common
and caused widespread suffering and many deaths. Vaccination programs have
been one of the most successful programs used in preventing the spread and
occurrence of these diseases. Since the introduction of vaccination programs
such as the Expanded Program on Immunisation (EPI), launched by World Health
Organisation (WHO) in 1974, the percentage of the worlds infants immunised
against 6 target diseases has increased from 5% in 1974 to 80% in 1997. This
has prevented approximately three million deaths per year. Mass immunisation
programs have not only been effective in reducing the occurrence of disease in
the individual but also decreased the spread of disease through the population.
Vaccination programs have been very effective in preventing the spread and
occurrence of the disease smallpox. The program has been so successful that it
has totally eradicated the disease from the world.
Smallpox has killed more people than any other infectious disease and was
responsible for one-tenth of all deaths in Europe in the 19 th century.
A vaccine for smallpox was developed by Edward Jenner in 1798 but was not
widely used. In 1967 there were still 33 countries where smallpox was still a
major health problem. The WHO carried out worldwide immunisation programs
that involved routine mass immunisations with supplementary doses given on
special immunisation days. People who missed out on the routine immunisations
were targeted and special surveillance teams were sent out to all possible cases
of smallpox.
In 1979 WHO declared they had eliminated the virus from the world population
and eradicated the disease smallpox.
Diphtheria is a deadly disease, often killing its sufferers within a week. Mortality
rates were very high with two thirds of the deaths being children under the age
of five. In 1921, there were 206,000 cases with 15,000 deaths in the US.
Immunisation programms introduced in Australia, Europe and other developed
countries in the 1930s and 40s resulted in a rapid decrease in the incidence of
diphtheria. However, in 1980 there were still nearly 100,000 cases worldwide.
When the WHO introduced the EPI in 1974 only 5% of children in the world were
immunised against diphtheria. Infants were given 3 doses of the combined
diphtheria-tetanus-pertussis vaccine. By 1990 the number of children immunised
increased to 80% and resulted in a greatly decreased mortality rate worldwide.
By 2005 the incidence of diphtheria had dropped to just over 8000 cases, 6000
of these were in the South-East Asia region. This vaccination program was very
effective as the global incidence dropped significantly.

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Polio is an extremely serious disease with death occurring in 50% of cases and
nerve damage and paralysis in 50% of sufferers. After a safe vaccine was
developed by Albert Sabin, and following widespread immunisation there was a
60-70% reduction in the incidence of the disease. Polio had become very rare in
industrialised nations and the incidence decreased even further after the EPI was
introduced in 1974.
A global Polio eradication Initiative was launched in 1988 by the World Health
Assembly (WHA). When this program began there was 350,000 cases in 125
countries with more than 1000 children being paralysed each day. In 1997,
almost 450 million children under five were immunised during National
Immunisation Days.
By 2000 there was only 719 cases of polio, thats a 99% reduction of cases. At
the end of 2006 on four countries experienced fewer than 7000 cases reported.
The types of vaccination programs and the planted implementation of these
vaccination programs have been very successful in reducing the spread and
occurrence of the once common diseases smallpox, diphtheria and polio.
Smallpox has been completely eradicated and the occurrence and spread of
diphtheria and polio has been drastically reduced due to the successful
implementation of planned vaccination programs.