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Focus 1
Health (defined by WHO) is a state of complete physical, mental and social wellbeing and not merely
the absence of disease and infirmity
Disease is the impairment of health or any condition that adversely affects the normal functioning of
any part of a living thing, producing specific signs and symptoms often at a specific location.
Non-infectious diseases cannot be transmitted from one person to another via the environment e.g.
nutritional deficiencies (scurvy from vitamin C deficiency), inherited diseases and diseases caused by
environmental agents (lead poisoning and lung cancer caused by smoking)
Infection diseases are those caused by a pathogen e.g. measles, influenza, gonorrhoea and tinea.
Infection refers to a pathogen being present in a host but it doesnt necessarily equate with disease.
A microorganism may be present in an organism but may not be pathogenic some are a part of the
natural flora of the body
e.g. bacterium Escherichia coli is present in large numbers in our alimentary canals but it does no
harm to the human host. However, if E. coli enters the urinogenital system, it is pathogenic.
Most pathogens (and thus the disease they cause) can be transmitted from person to person either
by direct contact or through the air.
A contagious disease is one spread from person to person by contact.
E.g. Diptheria fever is an infectious disease caused by bacteria that infect the tonsils, throat and nose
and extend into respiratory passages that can become blocked so that the patient can suffocate.
Treatment is now available for diptheria but most babies in Australia are immunised against it and
do not develop the disease even if they come into contact with the causative bacteria later on.
Maintenance of health
Outline how the function of genes, mitosis, cell differentiation and specialisation assist in
the maintenance of health
Genes (hereditary unit) sections of DNA that code for the production of polypeptides (protein
synthesis) proteins control all metabolism and cell growth.
A gene malfunction may disrupt the metabolic pathway and affect the health of a person.*
Mitosis cell division that produces identical cells important for growth and reproduction
Mitosis replaces millions of cells that die each day - failure would lead to impaired functioning
Two types of genes control cell division: proto-oncogenes (stimulates cell division) and tumor
suppressor genes a mutation in either of these genes can interfere with normal cell division,
causing the development of tumors
Mutations in both these genes will affect the way they are expressed and can lead to
uncontrolled cell division, resulting in tumors e.g. Colon cancer occurs when there are
mutation in the proto-oncogene beta-catenin and the tumor suppressor gene APC
Growth and repair also depends upon the correct expression of DNA repair genes (genes which code
for proteins that repair damaged DNA during the first growth stage of the cell cycle)
e.g. the gene p53 codes for a protein that stops the cell cycle at this stage so DNA repair genes can
repair damaged DNA prior to cell division
Another example:
Focus 2
Infectious disease
Non-infectious diseases
A pathogen is any organism that causes a disease e.g. parasite (macroscopic or microscopic) or
infective agent (viruses or prions) that lives in or on a host
Organism is described as a pathogen if it causes the disease (needs right conditions to multiply
and be transmitted)
o Direct transmission (contact with source)
o Indirect transmission (pathogen transferred through environ. food/water/air)
o Vector transfer (carried from person to person or by an organism e.g. mosquito
Hygiene
Explain why cleanliness in food, water and personal hygiene practices assist in control of
disease
Steps need to be taken to prevent the entry, multiplication and dispersal of pathogens transmitted
in air, food, water and hands. Basic hygiene practises to control disease:
Identify data sources, plan and choose equipment or resources to perform a first-hand
investigation to identify microbes in food or in water
Sterile techniques
The nutrient agar plates should be autoclaved (heated in a
pressure cooker)
All surfaces should be wiped with methylated spirits to
minimise risk of contamination
Sterilise inoculating loop in non-luminous blue Bunsen flame
Petri dish should be on table and lid lifted at angle no greater
than 45o when opening, pointing away from anyone
Do not talk at station
Seal dish with sticky tape and label around edge
Place upside down in incubator
Do not open once closed and sealed
Method Results
1. Wipe all surfaces with a cotton swab with Control (unopened) - nothing
methylated spirits. Pond water - yellow, brown and white
2. Sterilise inoculating tube in blue Bunsen colonies (round)
flame Bottled water - range of colonies
3. Pour sample over inoculating loop Bubbler water - cream colonies
4. Open lid of agar at around 45o Tap water - nothing
5. Spread sample onto agar using inoculating Final: bottle and pond water has the most
loop in zigzag motion number of colonies
6. Close dish and seal with sticky tape on
edge Controls
7. Label with a permanent marker Same agar
8. Place dish in oven at 37oC for 48 hours Same sterility methods
Reduce risk of exposure to harmful bacteria: plates remain sealed & destroyed in a pressure cooker.
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 from over 16,000 square kilometres of catchment area runs into creeks or streams.
These creeks and streams lead to several main dams managed by the Sydney Catchment Authority.
After the water arrives in the dams, it settles, allowing some of the organic material and other
impurities to separate to the bottom as sediment.
Water then leaves the dams and passes to one of the ten water filtration plants managed by Sydney
Water.
Solids and dissolved materials such as iron and manganese are removed in the filtration plants.
These filtration plants also add chemicals to bind microbes, dirt and other suspended matter
together. The resulting 'clumps' of waste are then removed by filtration. Filters have been improved
since 1998 to trap spores of Cryptosporidium more effectively.
After the filtration processes are completed, fluoride is added to the water. This is a requirement of
the Department of Health, and is a measure that is taken to improve dental health.
Following fluoridation, water is treated with either chlorine or monochloramine (a compound
formed from chlorine and ammonia) to kill most organisms that may still be present after the
filtration process. Any remaining cryptosporidium spores are mostly inactivated by these chemicals.
Samples of Sydney's drinking water are tested through all stages of its treatment. Things usually
tested for include coliform bacteria, colour (drinking water should be almost colourless) and
turbidity (the amount of suspended material in the water).
Focus 3
Describe the contribution of Pasteur and Koch to our understanding of infectious diseases
Spontaneous generation - living organisms can arise spontaneously from nonliving matter
Some agents (for example, viruses and prions), cannot be grown in a lab dish. They grow only if
given a living cell.
The healthy susceptible host is seldom a human, but rather a lab animal or livestock. Testing the
infectivity of a possible pathogen of humans in lab animals always leaves the question: if the
pathogen doesnt detectably infect the lab animal, does that mean it doesnt infect humans?
Note that a careful scientist always includes uninoculated control animals, so that the only
difference between the test animals and the control animals is the inoculation. This
comparison is included to remove the possibility that the test animals got sick for other reasons,
such as genetic makeup or the conditions during the experiment.
So what tests do you perform to identify and learn about a new virus?
A number of test procedures are done if a new disease is suspected to be caused by a virus:
Tissue and cell samples from infected patients would be fixed and viewed using an electron
microscope. This procedure would allow visualisation of viral particles in the samples. This
method does not require the ability to grow and isolate the virus. However, the
characteristics of the viral particles observed in the samples might suggest the type or group
of viruses causing the disease and what type of isolation systems should be investigated.
Serum from infected patients would also be tested against a battery of known viruses to look
for the presence of specific anti-viral antibodies.
Various samples, based on the type of disease, from the infected patients would be
inoculated into a variety of isolation systems. These systems would include: lab animals
(mice, rats, guinea pigs, etc.), embryonated eggs, and cell culture systems. Lab animals would
be studied to see if death occurs or if disease conditions appear. Tissues from the animals
could be studied by EM. The embryonated eggs and cell culture systems would be observed
for the appearance of viral-specific changes.
Any viruses isolated would be inoculated into new animals to try to reproduce the disease. If
the disease can be reproduced; we can then use these animal models to study the disease.
PRAC Modelling Pasteurs experiment
Pasteur's experiments reputes Spontaneous Generation and supports microbes cause decay
Method
1. Pour 100ml preservative-free clear beef broth in a beaker with a swan-necked glass tubing
and a beaker with a straight glass tubing
3. Boil beef broth on hot plate for 15mins to sterilise
4. Ensure that after boiling there is a small amount of water trapped in the swan-neck
(condensation)
5. Store for a week in warm conditions away from direct sunlight
6. Make observation every 2 days (look for cloudiness, scum, bubbles and fungal colonies)
Results: (Microbes cause decay) decay occurred in the straight glass tubing flask only (cloudy)
Effectiveness of model:
Very effective model very similar to Pasteur's - kept everything the same except the shape of
tubing e.g. sterilisation, broth, left for a period of time & can see through flask to see decay,
very obvious (broth clear to cloudy - visual)
Identify data sources, gather process and analyse information from secondary sources to
describe one named infectious disease in terms of its cause, transmission, host response,
major symptoms, treatment, prevention and control
Transmission
Bacteria ingested in contaminated food or water (sewage infected water etc)
Bacteria infects bowel of human and gets into their faeces
Direct life cycle (no animal host or insect vector)
Host response
The toxin produced by the bacteria causes antibodies to be produced
Antibodies provide resistance to same strain of bacteria
Major symptoms
Na and K transport systems in intestine interrupted
Bacteria attached to microvilli lining in guy and there is excessive secretion of fluids and
electrolytes
Lining of intestine is broken down by bacterial enzymes (no reabsorption of fluids, nutrients
etc)
Cramps
Inflamed bowel with diarrhoea
Dehydration
Blood pressure fails
Treatment
Fluids and salts replaced
Antibiotics in very early stages
Glucose (helps patients reabsorb fluid)
ORS (oral rehydration solution)
Control
Laws, infrastructure and economics to create an environment where the pathogen can't
survive or be transmitted
1. Chlorination of water and effective sewerage system
Notifiable disease with WHO
Malaria
Gather and process information to trace the historical development of our understanding
of the cause and prevention of malaria
Cause: Prevention/treatment:
Recognition of symptoms hypothesising Destruction of malaria parasite using drugs
cause Destruction of mosquito vector or
Discovering responsible micro-organism prevention of breeding
Determining lifecycle and transmission Prevention
Timeline
Key:
Time Development
270 BC Chinese first recognised the disease (symptoms)
240 Anti-fever properties of Qinghao plant described
2000 ya Greeks described symptoms of disease and called it malaria
2000 ya Greeks and Romans built drains to take away stagnant water (recognised significance
of water)
1880 Charles Laveran discovered the malaria causing pathogen (protozoa plasmodium)
Late 1800s Ronald Ross discovered the main steps in the transmission of malaria and identified
the Anopheles claviger mosquito as the vector of the malaria parasite (understanding
of lifecycle)
Late 1800s Preventative measures such as draining stagnant water, spraying oil on water to stop
breeding of mosquitos and the wearing of protective clothing were implemented
1930 Antimalarial drug developed
Late 1950s WHO implemented a program to try and eradicate malaria DDT spraying, protective
measures, biological control of mosquitoes e.g. sterilising male mosquitoes
1981 Start of search of malaria vaccine
2000s Developing new treatments genetic engineering genetically modify parasites with
the gene responsible for transferring proteins manipulated so it can be switched off
denying the parasite the proteins it needs to survive
Antibiotics
Antibiotic Resistance
Causes:
Widespread use of antibiotics increases the chance of this happening
Often used for viral disease (cold, flu) which have no effect
People often do not take the antibiotics for the whole course (more bacteria survive)
- person stops antibiotic early (some resistant and some not resistant bacteria alive GENE
TRANSFER - gene of resistance passed to bacterial without it)
Food-producing animals are given antibiotics (overexposure to antibiotics on consumption)
Cleaning products containing antibacterial ingredients
Problems caused by resistance:
Some bacterial infections are becoming very difficult to treat e.g. superbugs Golden Staph
and TB having to resort to very expensive, strong antibiotics
Antigens
Antigen any molecule the body recognises as foreign and that trigger the immune response (may
be part of a pathogen or toxic molecule) ie foreign marker
Inflammation response
Damaged/infected cells produce HISTAMINES which stimulate blood flow to area of
infection (blood vessels dilate)
increased blood flow brings phagocytes (white blood cells) to area to destroy pathogens
Localised increase in temp (hot & swollen) decreases survival of pathogens
Phagocytosis
Specialised white blood cells (macrophages & neutrophils) engulf foreign particles and
destroy them with the enzyme lysozyme
Lymph System
Lymph = fluid that bathes our cells
Pathogens present in fluid are collected into lymph ducts & transported to lymph nodes
where they are filtered out and killed
Organ Transplants
Outline the reasons for the suppression of the immune response in organ transplant
patients
Donor organ will have marker molecules on its surface different from those on the cells in
the recipients body they act as antigens that identify the organ as foreign material
initiates an immune response (rejection)
Cytotoxic T cells activated and move to the transplanted organ to attack and destroy its cells
Immunosuppressant drugs given to suppress immune system to lower risk of rejection
reduces activity of T cells but much greater risk of infections (need to be taken for the
remainder of the recipients life)
Tissue typing: tissue of donor and recipient matched as closely as possible to reduce severity
of immune response
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 Candida albicans
Cause:
Symptoms: vaginal itch or general discomfort, thick discharge, redness, swelling, stinging or burning
sensation when passing urine
Diagnosis: swab of affected area examined for Candida fungus presence under microscope
Prevention: careful washing and drying, avoidance of some antibiotics, wiping from front to back
Spent most of his life studying viruses and how the body defends itself against infection by
microorganisms esp viruses
Investigated mechanisms by which the body is able to recognise its own cells and uses its
immune system to defend itself against invasion by foreign material e.g. viruses without
attacking itself in the process
Developed the clonal selection theory gained understanding of immune system & role of
B and T cells lead to the development of vaccines
Identify the components of the immune response: antibodies, T cells and B cells
Describe and explain the immune response in the human body in terms of:
When a macrophage comes across a foreign particle with an antigen attached to its surface, it
surrounds and engulfs it in the process of phagocytosis.
As a part of this process, the antigen is moved to the surface of the macrophage, which then takes it
to the lymph nodes.
The antigen-presenting macrophage is then presented to the helper T-cells, which has the T cell
receptor that corresponds to that particular antigen and causes the helper T-cell to be activated.
The helper T cell can also be activated by the B-cell that have attached the specific antigen to the
matching antibodies on the surface of their cell. This is then presented to the helper T-cell.
When the helper T cells are activated they release cytokines that activate more of the same helper
T-cells and also the production of clones of the B cells that are specific to that antigen.
The cytokines released by the helper T cells also activate the production of clones of the cytotoxic T
cells that have that particular antigen receptor on their surface.
When the immune response has successfully defeated the infection, suppressor T cells stop the
activity of B cells and cytotoxic T cells.
Summary
Vaccinations
Memory B & T cells specific to antigen are produced and remain in body if same antigen re-
enters body in future: secondary response (destroy antigens before numbers are large enough to
cause symptoms):
Immunity the ability of an organism to resist infection by the prior introduction of a pathogen into
the body
Vaccination a method of providing artificially acquired immunity without the need for a person to
have suffered the disease initially
Active immunisation
Passive
Process, analyse and present information from secondary sources to evaluate the effectiveness of vaccination programs in preventing the
spread and occurrence of once common diseases including smallpox, diphtheria and polio
Disease Before vaccination program First vaccine Vaccine program/ when After Vaccination Program Effectiveness
Occurrence Spread produced/used introduced Occurrence Spread of vaccine
program
Small 1/10 of all deaths in World wide 1796 Jenner 1967 1979 WHO Not present Highly
Pox Europe (19th century) 33 countries developed vaccine Routine mass immunisation declared diseases anywhere successful
Over 300 million in 1967 (not widely used) Supplementary doses given eliminated from (eradicated
deaths (20th c) 1967 WHO mass on special immunisation days world population
10-15 million cases immunisation Targeted people who missed
each year until 1968 program out
(2 million deaths) Teams for surveillance sent
out for cases of small pox
Diptheria Thousands of cases World wide 1923 not widely EPI aimed to increase % of Incidence Spread through Very effective
(e.g. 1921-206000 1980 most used kids vaccinated infants decreased to many countries (drop in global
cases in US + 15500 cases in SE 1930-1940 Australia given 3 injections of triple approx. 8000 (6000 of 8000 incidence from
deaths) Asia (rapid decrease in antigen vaccine (tetanus, cases worldwide cases in SE Asia) 100 000 in 1980
1980 100 000 cases incidence) diphtheria. whooping cough) in 2005 (mostly Low incidence to 8000 in 2005)
worldwide 1974 only 5% at 2, 4 + 6 months old kids under 5) in developed but need to
children immunised countries maintain
in WHO EPI vaccination
(extended program rates as disease
of immunisation) still present in
SE Asia
Polio Thousands of cases Many 1955 Salk Original vaccine by Salk 60-70% decrease Rare in Effective in
per year countries 1997 oral vaccination caused problems in number of industrialised industrialised
1988 350 000 cases (125 Sabin vaccine safer cases countries nations but
world wide countries on Global Polio Eradication 2000 719 cases Problem in needs greater
5 initiative (a 99% reduction developing participation to
continents) 450 million kids immunised in cases since nations (esp be as effective
on National Immunisation 1988) India) as small pox
Days
"Discuss how our understanding of the functioning of the immune system has led to the development and application of vaccination programs to
prevent disease, and assess its impact on society and the environment".
Focus 6: Epidemiological studies
Epidemiology
Identify and describe the main features of epidemiology using lung cancer as an example
Epidemiology the scientific study of the distribution/ patterns of occurrence of diseases in different
groups of human populations and factors that affect these patterns using statistical analysis
1. Randomised trials
2. Cohort Studies
e.g. Doll and Hill study 1951
3. Case-control study
Cause and effect relationship action taken that influences a second action to occur. Criteria:
Must be a high risk disease develops when a person is exposed to the possible cause
Must be consistency in results found by researchers in each study
Must be shown that higher levels of the cause lead to a greater risk of developing the disease
Must be a particular time relationship cause occurs before the disease
Lung Cancer
Gather, process and analyse information to identify the cause and effect relationship of
smoking and lung cancer
Non-infectious diseases
Identify causes of non-infectious disease using an example from each of the following
categories:
inherited diseases
nutritional deficiencies
environmental diseases
Addisons Disease
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
Quarantine
Discuss the role of quarantine in preventing the spread of disease, plants and animals into
Australia or across regions of Australia
Department responsible: Department of Agriculture, Fisheries and Forestry (DAFF) formerly AQIS
(Australian Quarantine and Inspection Service)
Role: to prevent spread of disease and entry of disease causing organisms (plants & animals) in Aus
Protects the rural industry (food source & source of employment)
Protects national trade in plant and animal products (exports)
Protects biodiversity (Australian flora & fauna) killing organisms damages food chains
Strategies
Pests carried through people, animal, fruit products and soil (must undergo inspection)
They screen, inspect and clear people, parcels, baggage, ships, animals, plants and cargo using X-
ray machine, surveillance and detector dogs
No animals or animal products into the country e.g. to avoid foot and mouth virus animals
entering country spend time in quarantine stations before being released
No uninspected fruit or plant products allowed may contain e.g. red banded mango caterpillar
or citrus canker bacteria
Quarantine officers monitor reports from plane & ship captains about health of passengers
Residual sprays used in planes when no passengers are on board
Mosquito trapping programs at Australias international airports
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
e.g. movement of grape plant material from phylloxera infected areas (QLD & VIC) to non-infected
areas is prohibited and machinery must be disinfected highly effective program
e.g. plum pox (sharka) is a virus that infects stone fruit spread throughout Europe, Africa, UK,
USA, Canada & Middle East (but not in Australia) importation of fresh stone fruit prohibited,
seeds must be screened & stone fruits heat treated highly effective program
Foot and mouth disease (viral) not lethal but causes production losses free of this since 1872
highly effective program
Rabies fatal viral disease usually spread by a bit from infected animal with symptoms of foaming
at the mouth (occurrence: 55,000 die per year with 15 million people receiving post exposure
treatment) in most countries except Aus, NZ, UK, Japan and a few small islands strict controls
on entry of animals has helped prevent the disease highly effective
Plant Prac
Perform an investigation to examine plant shoots and leaves and gather first-hand
information of evidence of pathogens and insect pests
Aim: to gather first-hand information of evidence of pathogens and insect pests in plants
Method (Primary & secondary sources looked at a variety of plants and pictures)
Risk Assessment
Orchid: leaf mottled, yellowing of leaves with a bit of browning less chlorophyll produced
mosaic pattern mosaic virus
Rose: aphids (insects suck plant sap) clustered around upper, younger shoots, leaves
wrinkled/folded up should be flat and insect free
Cabbage: margins damaged, holes in leaf body, evidence of small droppings, small green
caterpillar present cabbage white butterfly caterpillar/ black rot (bacteria) shrivel +
yellowing
Powdery Mildew fungus on grapes, eucalyptus white powdery residue/tinge
Scale insect bottlebrush white circle around insect, discolouration of leaf (yellowing)
Explain how one of the following strategies has controlled and/or prevented disease:
public health programs - occurrence of disease. has reduced using many strategies
pesticides
genetic engineering to produce disease resistant plants and animals
Control of a disease involves regulating the incidence of the disease in the population and stopping
any further spread of disease.
Vaccination programs highly effective e.g. diphtheria, polio (very few people in Aus get it
as it is given at 2, 4, 6 & 18 months, preschool and early high school) preventing disease in
the Australian population. Also eradicated small pox worldwide.
Sewage systems/water treatment access to clean water provided to public using effective
sewage treatment prevention of water borne diseases e.g. cholera
slip, slop, slap campaign decrease in melanoma, skin cancer - encouraging sun protection
Anti-smoking campaigns to prevent lung cancer decreases rates e.g. Quit for life, public
education programs, advertisements, legislation preventing smoking in public places
Safe sex campaigns decrease in STD occurrence e.g. AIDS
Quarantine prevention of foot and mouth 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
Preventative measures decrease the incidence rate of the disease and eliminates the disadvantages
of treatment. For example:
Prevention = vaccinations
Advantages: Disadvantages:
Prevents the individual from contracting the disease Very small percentage of
Decreases the prevalence of the disease in the pop. individuals may suffer
Lower treatment costs side effects
Less suffering better quality of life
Decreased rate of development of resistant strains of bacteria
Non-infectious diseases e.g. cardiovascular disease, lung cancer, STIs, skin cancer (melanomas)
Prevention in great numbers = public health programs educates and encourages people to change
lifestyle to prevent disease
Advantages: Disadvantages:
The occurrence of disease in the population is reduced using a Costly although reduces
wide range of strategies cost in the long term