Health and Disease

OCR AS Biology
Unit 2
Module 2: Food and Health
Learning Outcomes
Discuss what is meant by the terms
health and disease
Define and discuss the meanings of
the terms parasite and pathogen
What is health?
health is more than just the absence
of disease
What is meant by health?
What is meant by disease?

Health
absence of disease
Disease
disorder of a systems normal functions
What is health?
You have been given 6 case studies
In your groups
discuss the health of each individual
Rank them from 1 6
1 healthiest
6 unhealthiest
Remember you must be able to give
reasons for your choices
Definitions
Health
A state of complete physical, mental and
social well-being, which is more than just
the absence of disease.

Disease
A problem with mind or body leading to a
departure from good health.
Good Health
Free from disease
Able to carry out mental and physical
tasks expected by society
Well fed, balanced diet
Housing and sanitation
Happy and positive outlook
Well integrated into society
The Health Triangle
Physical health means the health of
the body

Mental health means the health of the
mind.

Social health means forming good
relationships.
The Health Triangle
If you take any of these away - the
triangle collapses
Physical Social
Mental
What is health?
In your groups
Go back to the original 6 case studies
Have your opinions changes
Rank them from 1 6
1 healthiest
6 unhealthiest
Remember you must be able to give
reasons for your choices
Disease
There are nine broad overlapping
categories of disease (see handout)
Diseases can also be grouped into
Single cause e.g. malaria
Multifactorial e.g. heart disease
Disease
Acute
Sudden rapid changes and lasting for a
short time

Chronic
Long term debilitating
Develops slowly and persists
pathogen
Infectious diseases are diseases caused by
pathogens.
A pathogen
is defined as an organism which causes disease
Lives by taking nutrition from the host
May cause damage to the host
Disease transmission is the transfer of a
pathogen from infected to uninfected
people
Parasite
A parasite is defined as
Organisms that live in or on another living
things
Benefit at the hosts expense
Can be
Internal parasite e.g. tapeworm
External parasite e.g. head louse
Infectious Disease
Organisms that can cause infectious
disease include
Bacteria e.g. cholera and TB
Fungi e.g. athletes foot and ringworm
Virus e.g. cold, influenza and AIDS
Protoctista e.g. amoeboid dysentery,
malaria
Learning Outcomes
Describe the causes and means of
transmission of malaria, AIDS/HIV and
TB (symptoms not required)
Describe the global impact of malaria,
AIDS/HIV and TB
Infectious diseases
A pathogen can:
Gain entry to the host
Colonize the tissues of the host
Resist the defences of the host
Cause damage to host tissues

Transmission
The most common forms of transmission are
By means of a vector
By physical contact
By droplet infection
Malaria and tuberculosis
Pathogens invade cells and spread through the
tissues
HIV
Virus can lie dormant in T lymphocytes
Weakens the immune system to opportunistic
infections (AIDS)
Malaria
Causative organism
Protoctista
genus Plasmodium
P. falciparum is the
most widespread

Methods of transmission
insect vector
Female Anopheles
mosquito
See diagram
Global distribution
Widely distributed
through the tropics and
sub tropics
Annual incidence
300 million
Annual mortality
worldwide
1.5 1.7 million
Malaria
Global impact
Increasing drug
resistance by
Plasmodium
40% of worlds
population live in
malarial areas
Difficulty in developing a
vaccine
Increase in epidemics as
environmental and
climatic changes favour
mosquitoes
Mosquitoes are
developing resistance to
insecticides
Control measures
Use sleeping nets to
prevent mosquitoes
biting at night
Use of drugs to fight of
Plasmodium
Reduce mosquito
populations
drain marshes and
swamps
destroy mosquito larva
oil or insecticide on
water, use carnivorous
fish
TB (tuberculosis)
Causative organism
Mycobacterium
tuberculosis
Mycobacterium
bovis

Methods of transmission
inhalation of droplets
from infected person
via infected milk

Global distribution
Worldwide in developing
countries and among
migrants and inner cities
in developed countries
8.8 million new cases
every year
1.5 million deaths
TB (tuberculosis)
Global impact
Some strains are resistant
to drugs (1950s)
AIDS pandemic
Poor housing and rising
homelessness
Breakdown of TB control
programmes
Control measures
Contact tracing,
through testing for
bacteria and screening
for symptoms
2005 BCG vaccine
ruled ineffective
DOTS (directly observed
short course treatment)
Long course of
antibiotics
HIV/AIDS
Causative organism
Human
Immunodeficiency Virus

Methods of transmission
Body fluids, esp. semen,
vaginal fluids and blood
Sexual intercourse,
shared needles,
child birth, breast
feeding
Infected blood products

Global distribution
World wide
Highest prevalence in sub-
Saharan Africa and South-
east Asia
HIV/AIDS
Global impact
39.5 million people living
with HIV
2006
4.9 million new cases
2.9 million deaths from
AIDS
Affects the affluent and
the impoverished
TB is an associated
opportunistic infection
Control measures
Use of condoms
Health education (safe
sex)
Screening of blood
donations
Heat treatment of blood
products to kill viruses
Needle exchange
schemes
Contact tracing
Immunity
Module 2: Food and Health
Health and Disease
Learning Outcomes
Define the terms immune response,
antigen and antibody.
Describe the primary defences against
pathogens and parasites (including
skin and mucous membranes) and
outline their importance.
Describe, with the aid of diagrams and
photographs, the structure and mode
of action of phagocytes.
Definitions
Immune response
Specific response to a pathogen
Involves the action of lymphocytes and the
production of antibodies
Antibodies
Protein molecules produced and released in
response to a antigen
Antigen
Foreign molecule protein or glycoprotein
Provokes an immune response
Primary Defences
The bodys primary defences attempt
to stop pathogens from entering body
tissues
This includes
The skin (epidermis)
Mucous membranes
Eyes protected with tears
Ear canal lined with wax
Epidermis
The outer layer of the epidermis is a
layer of dead cells which contain the
fibrous protein keratin.
These cells are produced in the
process keratinisation the cells dry
out and the cytoplasm is replaced
with keratin.
This layer of cells acts as a barrier
Mucous membranes
Mucous membranes protect surfaces which
are at risk of infection
Mucus is secreted by the epithelial linings of
airways, digestive system and reproductive
systems
In the airways ciliated cells move mucus up
to the mouths where it can be swallowed
In the stomach, hydrochloric acid kills most
pathogens that we ingest.
Secondary Defences
Non-specific immune response
Phagocytes

Specific Immune response
B and T lymphocytes
Antibody production
Phagocytosis
Phagocytes engulf and digest pathogenic
cells
Neutrophils
found in the blood and body tissues
Collect at an area of infection
Macrophages
Travel in blood as monocytes
settle into the lymph nodes where they develop
Stimulates production of T lymphocytes
Phagocyte - photographs
Neutrophil Macrophage
Macrophage
engulfing
tuberculosis
bacterium
Stages in phagocytosis
Pathogens are recognised by antigens on
their surface
Phagocyte moves towards pathogen and
receptors on the cell surface membrane
attach to antigens on the pathogen
Phagocyte engulfs the pathogen creating a
phagosome
Lysosomes fuse with the phagosome
releasing digestive enzymes
End products absorbed into the cytoplasm.
Phagocytosis Animations
http://www.microbelibrary.org/images
/tterry/anim/phago053.html
Stages of Phagocytosis
Learning Outcomes
Describe the structure and mode of action
of T lymphocytes and B lymphocytes,
including the significance of cell signalling
and the role of memory cells.
Describe, with the aid of diagrams, the
structure of antibodies.
Outline the mode of action of antibodies,
with reference to the neutralisation and
agglutination of pathogens.

Immune Response
Immune response is the activation of
lymphocytes in the blood to help fight
disease
T- Lymphocytes
Produced in bone marrow
Mature in the Thymus
B-Lymphocytes
Produced and matures in bone marrow
Immune response
Pathogen enters body
Clonal selection
Antigens bind to complementary
glycoproteins on B and T lymphocytes
This stimulate the immune response
Clonal expansion
B and T lymphocytes divide by mitosis
T-lymphocytes
T lymphocytes divide into 3 types of cell
T helper cells (T
h
)
Release cytokines
stimulate B cells to develop
Stimulate phagocytosis (cell signalling)
T killer cells (T
k
)
Attack and kill infected body cells

T memory cells (T
m
)

B lymphocytes
B lymphocytes develop into two types
of cell
Plasma cells (P)
Flow in blood
Manufacture and release antibodies
B memory cells (B
m
)
Immunological memory
Remain in blood for a number of years
Stimulate the production of plasma cells quickly
upon reinfection by same pathogen.
Cell signalling in immune
response
Identification of pathogens
Sending distress signals
Antigen presentation
Instructions
Communication using cytokines
Stages in immune response
Infection and reproduction of
pathogen
Presentation of antigens
Clonal selection
Clonal expansion
Differentiation (proliferation)
Action antibody production
Antibodies
Proteins a.k.a. immunoglobulins
Specific shape complementary to that
of an antigen
Antibody shape
4 polypeptide chains held together by
disulphide bridges
Variable region
2 binding sites specific to an antigen
Hinge regions allow flexibility
Antibody structure
Mode of action of antibodies
Neutralisation
Antibodies bind to toxins neutralising their
effects
Antibodies combine to viruses and
prevent them from entering the cell.
Agglutination
Pathogen clump together
Too large to enter host cells
Helps phagocyte to engulf and digest
pathogens
Learning outcome
Compare and contrast the primary
and secondary immune responses.
Primary Immune response
Production of plasma cells
Antibodies produced to combat
infection
Takes a few days for number of anti-
bodies in blood to rise

Secondary immune response
B memory cells circulate in blood
Rapidly produce plasma cells upon
reinfection
Plasma cells produce antibodies
Rapid response

Primary and secondary immune
response
Learning Outcomes
Compare and contrast active, passive,
natural and artificial immunity.
Explain how vaccination can control
disease.
Discuss the responses of governments
and other organisations to the threat
of new strains of influenza each year

Immunity
Natural immunity
gained as part of normal life processes
Artificial immunity
Gained by deliberate exposure to antibodies or
antigens
Active immunity
Results from stimulation of immune response
Passive immunity
Introduction of antibodies
Short lived
Immunity
Immunity Active Passive
Natural
Long term immunity
Infected by the disease
inducing an immune
response
Takes time
Immediate protection
Antibodies from mother
-Across placenta
-In colostrum (breast milk)
Short term immunity
Artificial
Long term immunity
Immunisation or vaccination
Takes time
Immediate protection
Injected with antibodies
e.g. tetanus injections
Short term immunity
Vaccination
Vaccine
Preparation of antigen
Injected or given by mouth
Stimulates primary immune response
Boosters given to stimulate secondary
immune response

Antigenic material
Living attenuated micro-organisms
Can not cause symptoms
Multiply
E.g. TB, poliomyelitis
Dead micro-organisms
Harmless but induce immunity
E.g. typhoid, cholera
Preparation of antigens
E.g. hepatitis B vaccine
Harmless toxin
E.g. tetanus vaccine
Control of disease
Vaccinations can be used to control
disease by providing immunity to all
those at risk
Herd immunity
Use a vaccine to provide immunity to all
of the population at risk
Ring immunity
Vaccinate everyone in surrounding area
to prevent transmission of disease
Influenza
Viral disease of the respiratory system
Associated with
Fever
Sore throat
Headache
Muscle pains
Weakness
Can lead to pneumonia
Can be fatal
New strains arise by mutations (some
virulent)
vaccination programmes
Epidemic
Disease suddenly spreads rapidly to infect
many people
Pandemic
Large scale outbreak of a disease

Governments research and try to
predict which strains of flu are going to
appear each year
Vaccination programmes in UK
All people aged over 65
Young people with asthma
People who work in high-risk categories
such as medical professionals

The strains of flu used in the
immunisation programme change each
year.
Learning Outcomes
Outline possible new sources of
medicines, with reference to
microorganisms and plants and the
need to maintain biodiversity.
New Medicines
Why do we need new medicines
Pathogens become resistant to existing
drugs e.g. antibiotics
New disease emerge
New vaccines needed e.g. HIV
Existing vaccines can be improved
Discovery of New Medicines
By accident
E.g. Alexander Fleming and the discovery
of penicillin
Traditional medicine
Anaesthetics
Observation of wildlife
Modern research
Natural medicines
Discovery of natural drugs has concentrated
on tropical plants due to the great diversity
of species in tropical rainforests
Examples
Madagascan periwinkle anticancer
Sweet wormwood antimalarial
It is important that plant species do not
become extinct before we can discover
their value.
Smoking and Disease
Module 2: Food and Health
Health and Disease
Learning Outcome
Describe the effects of smoking on the
mammalian gas exchange system,
with reference to the symptoms of
chronic bronchitis, emphysema
(chronic obstructive pulmonary
disease) and lung cancer.
Smoking - Intro
WHO considers smoking to be an
epidemic

Cigarette smoke contains
Tar a group of chemicals including
carcinogens
Carbon monoxide
nicotine
Reasons to give up
smoking
Short term effects of Tar
Tar settles in linings of airways and
alveoli
Inceases diffusion distance of gases
Chemicals can cause an allergic reaction
Lumen of airway narrows restricting air flow.
Paralyses cilia
Mucus secreting cells enlarge produce
more mucus
Increase risk of infection
Long term effects of tar
Smokers cough
Irritation of airways
Damages lining of airways and alveoli
Lining replaced by scar tissue
Smooth muscles thickens, lumen narrows
and airflow is permanently restricted.
Diseases linked with smoking
Chronic Obstructive Pulmonary
disease
Combination of diseases that includes
Asthma
Chronic bronchitis
emphysema
Chronic Obstructive Pulmonary
Disease
Chronic Bronchitis
Inflamed lining
Smooth muscle
layer thickens
Goblet cells and
mucus glands
secrete more
mucus
Damage to cilia
Symptoms
Shortness of breath
Wheezing
Persistent cough
Increase risk of lung
infection
Emphysema
Loss of elasticity of
alveoli
Alveoli burst
Air spaces are
larger reducing
surface area for gas
exchange
Symptoms
Shortness of breath
Difficulty exhaling
Blood less well
oxygenated
fatigue
Lung Cancer
Cigarette smoke contains
carcinogenic compounds including
benzopyrene
Carcinogens enter cells of lung tissue
Mutation affects the gene controlling cell
division
Uncontrolled cell division leads to a
tumour
Bronchi become blocked by cancerous
growths
Symptoms of lung cancer
persistent cough
Coughing up blood
Weight loss
Pain in chest
Learning Outcomes
Describe the effects of nicotine and
carbon monoxide in tobacco smoke
on the cardiovascular system with
reference to the course of events that
lead to atherosclerosis, coronary heart
disease and stroke.

Nicotine and carbon monoxide
Nicotine and carbon monoxide pass
from the lungs into the circulation
Changes occur that can lead to
Atherosclerosis
Coronary heart disease
stroke
Nicotine
Addictive drug
stimulant
Releases adrenaline which increases
heart rate and blood pressure
Stimulates decrease in blood flow to
extremities
Increases chance of blood clots
Makes platelets sticky
Carbon monoxide
Enters red blood cells and combines
with haemoglobin to form
carboxyhaemoglobin
Reduces oxygen carrying capacity of
the blood
Damages linings of arteries

Cardiovascular disease
Multifactorial
There is a number of risk factors
Of which smoking is just one
Degenerative disease of the heart and
circulatory systems
20% death worldwide
Up to 50% developed countries
Atherosclerosis
Atherosclerosis
Accumulation of fatty material
(atheroma) in artery walls, reducing flow
of blood to the tissues
Reduces the size of the lumen
Reduces blood flow
Definitions
Atheroma
Contains cholesterol, fibres, dead muscle
cells and platelets
Plaques
Build up of atheroma
Make arteries less elastic and reduce the
flow of blood
atherosclerosis
Stages in development of
Atherosclerosis
Damage to endothelium of arteries
invasion of phagocytes to repair damage
Secretions from phagocytes stimulate
growth of smooth muscle and the
accumulation of cholesterol
Atheroma builds up
Atheroma forms plaque
Size of lumen reduced, Blood flow reduced
Stages in atherosclerosis
Thrombosis
Blood flow past the plaque is not
smooth which increases the risk of
blood clotting.
Thrombus
Blood clot in artery which stops flow
May dislodge and be carried in the blood
Coronary heart Disease
Lumen of coronary arteries narrowed
by plaque
Reduces the blood flow to heart
muscles
3 forms
Angina
Heart attack / myocardial infarction
Heart failure
Stroke
Death of part of the brain
Can be sudden
Two causes
Thrombus
Blood clot blocks a narrow artery in the brain
Haemorrhage
an artery leading to the brain burst
Aneurysm = weakness in wall of artery
Learning Outcomes
Evaluate the epidemiological and
experimental evidence linking
cigarette smoking to disease and early
death.

Epidemiology
The study of the distribution of diseases
in order to find a means of preventing
and controlling it.

Epidemiological studies
Identify links between disease and risk
factors
Identifies which countries / age range /
gender may be at greater risk.
Epidemiological studies
Information gained can be used to:
Target funding
Target research
Target screening
Target education and advice
Predict future incidences of the disease

Smoking and diseae
1950s doctors first noticed a
correlation between lung cancer and
smoking.
About half of smokers die of smoking
related diseases
Smokers are three times more likely to
die in middle age than non-smokers
Linking smoking to lung cancer
if stop smoking the risk of lung cancer
decreases
Smokers 18 times more likely to
develop lung cancer than non
smokers
25% smokers die due to lung cancer
Linking smoking to lung diseases
98% emphysema sufferers are smokers
20% smokers suffer emphysema
smokers twice as likely to die from
pneumonia and influenza
COPD is rare in non smokers
Linking smoking to CVD
This is less evident as CVD are
multifactorial
However, substances in cigarette
smoke can influence the
cardiovascular system and likely to
enhance atherosclerosis
IMPORTANT POINT
All conclusions drawn by
epidemiological data show
an association and not a
causal link.
Experimental Evidence - Dogs
Dogs exposed to unfiltered smoke
developed changes similar to COPD
and early signs of lung cancer.
Dogs smoking filtered cigarette smoke
developed changes which can lead
to lung cancer
Experimental evidence - Tar
Chemical analysis of tar shows that it
contains known carcinogens
When painted onto the bare skin in
rats the tar caused cancer in the skin
cells.