1. Unit 4 – Immunology and Public Health Infectious Disease and Epidemiology

2. Learning Intention: To learn about infectious diseases and epidemiology Success Criteria: By the end of the lesson I should be able to State that infectious diseases can be transmitted by direct physical contact, water, food, body fluids, inhaled air or vector organisms. State that infectious diseases can be controlled b quarantine, antisepsis, vector control, individual responsibility (e.g. good hygiene, care in sexual health, appropriate storage and handling of food) and community responsibility (e.g quality water supply, safe food webs, appropriate waste disposal systems). Describe the following spreads of disease: –Sporadic (occurring occasionally) –Endemic (regular cases occurring in an area) –Epidemic (unusually high numbers of cases in an area) –Pandemic (a global epidemic) Describe disease control measures to include preventing transmission, drug therapy, immunisation or a combination of these.

3. Infectious Disease Infectious diseases are caused by pathogens such as –viruses, (e.g. measles) –bacteria, (e.g. cholera) –fungi, (e.g. athlete’s foot) –protozoa (e.g. malaria) –multicellular parasites (e.g. hookworm)

4. Bacteria Bacteria are single- celled organisms and can cause diseases such as: -Cholera -Typhoid -Salmonella -Pneumonia -Tuberculosis

5. Case Study - How do malaria, sleeping sickness, influenza, TB and HIV evade the host immune response? What do we need to know? 1. Background on the disease – · cause (virus, protozoa, fungi, bacteria) · transmission · epidemiology 2. How it evades the hosts immune system · Antigenic variation or direct attack? · Explain the method using the chosen disease as an example 3. How are scientists trying to combat these diseases if they can evade the immune system?

6. Viruses A virus can only survive outside a host for a very short time, however they are responsible for many diseases; -AIDS -Chicken pox -Influenza -Herpes And some cases of cancer, e.g. Cervical cancer caused by the Human papillomavirus (HPV)

7. Fungus Fungi are widely used by humans but some can cause diseases like: -Thrush -Ringworm -Athlete’s Foot

8. Protozoa Protozoa are single- celled organisms which are typically mobile. They can cause: -Malaria -Sleeping sickness -Dysentery Malarial infestation by Plasmodium http://www.youtube.com/watch?v=OEDhe4 MPEMc

9. Multicellular parasites Multicellular parasites include tapeworms and hookworms (pictured). They can cause -Anaemia -Diarrhoea -Low birth weight Short clip of tapeworms in situ http://www.youtube.com/watch?v=JeDD0H decGk

10. Pathogen Transmission These pathogens can be transmitted in many ways: -Direct physical contact -Inhaled air -Indirect physical contact

11. Pathogen transmission -Exchanging body fluids -Faecal-oral route -Vector organisms

12. Transmission Summary Disease can be transmitted by : –direct physical contact, –water, –food, –body fluids, –inhaled air –vector organisms.

14. Controlling transmission Because we know how pathogens are transmitted we can interrupt it by the following; - Antisepsis – inhibiting or destroying a microorganism by sterilising everything that could carry a pathogen or prevent them reaching somewhere.

15. Controlling transmission Quarantine – isolating the person who is infected or has been in contact with an infected person to prevent spreading of the disease. The length of the quarantine is usually just over the length of time it usually takes for someone to display symptoms after being infected.

16. Individual responsibility Knowing what we do about transmission of pathogens there are a number of things that can be used to prevent it; -Good hygiene – washing hands, brushing teeth, showering -Care in sexual health – use of condoms to prevent sexually transmitted diseases -Handling and storage of food – washing hands, keeping raw and cooked food separate and at the appropriate temperatures.

17. Community responsibility Clean water supply – our water is filtered and chlorinated to prevent growth of microorganisms… is everyone as lucky? Safe food webs – for example, milk pasteurisation (heating at 72 o C to kill any microorganisms) Waste disposal – keeping any refuse collected regularly and buried or incinerated.

18. Community responsibility Control of vectors – Taking care to eradicate any animals which can carry diseases e.g. Bubonic plague was caused by bacteria carried by fleas on rats so being in close proximity to rats carrying those fleas put you at high risk. Malaria is caused by a protozoa carried by female mosquitoes in their saliva. How could you protect people from this animal vector?

19. Swine flu in Scotland – Data Handling Exercise – Collect worksheet

20. Epidemiology of infectious diseases Epidemiology is the study of the characteristics of an infectious disease. We would look at: -The location of an initial outbreak -The pattern and speed of the spread -The geographical distribution

21. Patterns of distribution Sporadic – occurs in scattered or isolated instances with no connection between them Endemic – recurs as a regular number of cases in a particular area Epidemic – affects an unusually high number of people in a particular area Pandemic – occurs as a series of epidemics spreading across continents or the whole world

22. Methods of Controlling Disease Based on epidemiological studies control measures can be considered Control measures include –preventing transmission, –drug therapy, –immunisation –a combination of these.

23. Preventing Transmission It is important to put measures in place to stop the transmission of disease from person to person and region to region Millions of school days are lost each year by pupils because of transmissible disease.

24. Drug Therapy For people already infected with a transmissible disease then drug treatment is important to reduce spread TB antibiotics

25. Immunisation Immunisation is what happens in your body after you have had a vaccination. The vaccine, which contains inactivated or weakened viruses or bacteria (or parts of them), stimulates your immune system so that it can recognise and protect you from future infection (i.e. you become immune to the infection).

26. Questions The uptake of vaccine against measles and the number of reported cases of measles in Scotland over a ten year period is shown in the table below YearVaccine Uptake (%)Number of reported cases (all ages) 200293.0395 200391.0315 200490.0396 200587.5412 200683.0530 200779.5792 200886.0482 200991.5322 201095.0112

27. 1.Draw a line graph of this information – hint: you will need to create a graph with TWO Y axis, one for each set of information with the Year along the X axis. 2.Describe the trend in vaccine uptake between 2002 and 2009. 3.Use the data in the graph to justify the following statement: “As vaccine uptake increases the number of reported cases falls”. 4.Are there any results which contradict this statement 5.Calculate the percentage decrease in the number of reported cases of measles from 2002 to 2003.

28. Answers 1.Marks – two scales and labels, plotted and joined dots 2.Decreased from 2002 to 2007 then increased – bonus if use data to support this. 3.Vaccine uptake increases from 79.5% in 2007 to 95% in 2010, the number of cases falls from 792 in 2007 to 112 in 2010.Or converse of data for 2002 to 2007. 4.2003. 5.395-315=80/395 x 100 = 20.25 or 20%