1. B2 Keeping healthy Route map Over the next 12 lessons you will study : Friday 21 October 2011 B2.1 What’s up Doc? B2.2 Microbe attack! B2.3 Antibodies – not antibiotics! B2.4 Vaccines End of module test B2.5 Vaccination and the government B2.6 The end for antibiotics ? B2.7 Where do new medicines come from ? B2.8 Clinical trials B2.9 Circulation B2.10 Causes of disease B2.11 Health studies 1 B2.12 Health studies 2

3. Decide whether the following statements are true or false: Introduction: Good health is very important. Illness in humans is usually caused by one of four things: 1: Microorganisms , for example the common cold or chicken pox 2: Lifestyle diseases , for example smoking induced lung cancer 3: Age , for example osteoarthritis of the joints 4: Genetic disorders , for example sickle cell or cystic fibrosis Microbes are everywhere. Many microbes can make us ill, this is why we should not eat decaying food. There are three types of microbes, bacteria, fungi and viruses. Many life threatening illness are due to viruses. Not all bacteria are harmful, some found in our gut help us digest our food. Extension questions: 1: Explain why should always wash your hands after going to the toilet or handling raw meat like chicken ? 2: Explain why good hygiene at home is important and give an example of where bacteria can be useful ? 4: Explain how viruses spread from person to person and what symptoms does chicken pox cause ? 5: Why can the numbers of bacteria or viruses in your body increase rapidly? Know this: A: Know that some bacteria and most viruses are harmful. c: Know that the human body is adapted to prevent microbes form entering and causing disease. Friday 21 October 2011 B2.1 What’s up, Doc?

4. B2.1 a Look at the photograph and information and answer all the questions: Bacteria, viruses and fungi are all microbes which are able to cause disease in humans. Not all diseases are caused by microbes, for example heart disease is caused by a number of lifestyle factors like a high fat diet. Microbes can be found anywhere, in us or in animals, in the air, the soil, on food or on unclean surfaces and in water. Some microbes are potentially lethal like AIDS. Explain why it is very important not to touch microbes or areas that microbes are likely to be found ? You are covered from head to toe by so-called ‘friendly bacteria’....what does this phrase mean ? List one disease caused by a bacteria, a virus and a fungi ? Assessment for learning...key concepts Fungi Viruses Bacteria >50 um 15 to 300 nm 1 – 10 um Thrush, ringworm, athletes foot Polio, flu, HIV, measles, mumps, smallpox and chicken pox Dysentery, cholera, anthrax, tonsillitis, tuberculosis

5. Key concepts B2.1 b Look at the photograph and information and answer all the questions: Why should we all a0 wash our hands after visiting the loo and b) not eat food that has gone past its use by date ? Hospitals are trying to reduce infections in patient, what should they do to reduce the likelihood of an infection ? Microbes can be passed from human to human or passed from an unclean surface, food or even an animal. All around us are large reservoirs of microbes that can potentially cause disease and illness. Although its difficult to avoid microbes passed from human to human we can all clean our homes, wash our hands and make sure we store and cook food

6. B2.1 c Look at the photograph and information and answer all the questions: Your body has many ways of preventing disease causing microbes from entering the body. These barriers like the skin or strong acid found in your stomach provide the first line of defence against microbial entry into your body. Should these barriers fail, the immune system and immune cells responds to the presence of these microbes. Explain what happens if you cut your skin and why is this response important in protecting us against invading microbes ? The ciliated epithelia cell pictured left protects which organ in stopping dust, bacteria and most viruses from entering its spongy tissue ? The stomach is full of very strong acid, how does this help to defend us against invading microbes ? Human Eye...antiseptic tears Cilia...traps microbes Stomach...acid kills bacteria Skin...waterproof layer Assessment for learning...key concepts

7. B2.1 Plenary Lesson summary: bacteria viruses toxins useful Friday 21 October 2011 MRSA is a bacteria that is carried by about 30% of the population without causing any ill effects. In unclean hospitals, these bacteria can get into wounds and in many cases cause death. Over 4000 people died from MRSA in 2007. In France where hospitals are cleaned, less than 10 people died in the same year . How Science Works: Research into how microbes can cause illness and how microbes multiply when condition are ideal inside the human body.. Preparing for the next lesson: 3: The cause of the common cold is a bacteria ? 2: Most human infections are caused by viruses ? 1: All bacteria cause diseases ? The three types of microbe are __________, fungi and __________. Bacteria make us feel unwell when they produce chemicals called __________ and damage our body cells. Not all the bacteria in our bodies are harmful, some bacteria in the gut are __________. Decide whether the following statements are true or false : False True False True False True

9. B2.2 Microbe attack Extension questions: 1: Explain why condition inside the human body are idea to help bacteria to multiply ? 2: List three ways in which microbes can enter the human body ? 3: List three ways how the human body is adapted to resist infection form invading microbes ? 4: Explain how antibiotics help the body fight infection ? 5: Explain how by taking antibiotics can cause side effects ? Know this: a: Know how microbes can cause illness in humans. b: Know how antibiotics can help the body fight infection. Friday 21 October 2011 Introduction: Microbes that enter the body through the digestive system, the blood or just a cut in our skin can multiply rapidly doubling their numbers every twenty minutes meaning that within just 8 hours of invading your body a single bacteria can produce a billion bacteria. Antibiotics like penicillin can help the body fight infection by slowing or killing invading microbes. Antibiotics can have side effects, because they can kill non lethal bacteria found in your gut and on your skin. This can allow in more lethal bacteria that can cause disease like thrush.

10. Key concepts B2.2 a Look at the photograph and information and answer all the questions: Explain the purpose of scab formation following a cut to the skin ? Explain why white blood cells are rushed to the site of injury ? Following a simple cut caused by an object with a surface covered in bacteria, the bacteria enter the local area and start multiplying in number. The immune system will then increase blood flow which send white blood cells to the cut area. This also causes pain and swelling. The white blood cells and dead bacteria form a pus which eventually will be reabsorbed by the healing skin tissue. Human

11. B2.2 b Look at the photograph and information and answer all the questions: Look at the diagram opposite and explain why the first stage in bacterial division is to double its chromosomal DNA ? List three things dividing bacteria require ? Unlike multicellular organisms, increases in the size of bacteria (cell growth) and their reproduction by cell division are tightly linked in unicellular organisms. Bacteria grow to a fixed size and then reproduce through binary fission, a form of asexual reproduction. The following is the process of bacteria' s cell divide: 1. Cell elongates and DNA is replicated 2. Cell wall and plasma membrane begin to divide 3. Cross-wall forms completely around divided DNA 4. Cells separate How bacteria replicates and multiplies Key concepts

12. B2.2 c Look at the photograph and information and answer all the questions: Bacteria are all around us. Given good growing conditions, a bacterium divides after double the chromosomal DNA forming two daughter cells, each with the same genetic material as the parent cell. If the environment is optimum, the two daughter cells may divide into four in 20 minutes. Oh my! 1, 2, 4, 8, 16, 32, 64... And so on ! Look at the diagram opposite left, if the doubling time is 20 minutes how many bacteria will there be after a) just 80 minuets and b) 6 hours Explain why you should not eat food that has been left out on a hot afternoon ? Bacteria is everywhere even on the fresh food that ewe but....explain how fridges keep food fresh ? How bacteria replicates and multiplies Key concepts

13. B2.2 Plenary Lesson summary: Decide whether the following statements are true or false : False True False True False True lungs microbes antibodies cuts Friday 21 October 2011 Did you know that when the skin is cut, it heals so quickly that a scar is formed. Many years ago before the days of good hygiene this helped us survive. Scientists have know developed plasters that slow down healing and reduce scaring of the skin because we all now live in a a much cleaner World. How Science Works: Research into how white blood cells and antibodies search and destroy invading disease causing microbes. Preparing for the next lesson: Microbes can enter the body through openings such as the mouth and nose, or through ___________. Mucus and cilia trap microbes in the air your breathe in to protect your __________. White blood cells destroy ___________ that enter the body by digesting them or producing ____________. 3: White blood cells carry oxygen form the lungs to respiring cells ? 2: Left unchecked, microbes will continue to multiply and kill you ? 1: Antibodies are specific to each type of microbe ?

15. B2.3 Antibodies - not antibiotics! Extension questions: 1: Give three ways and invading microbe can enter the body, for example through cut skin ? 2: Explain the role of White blood cells as the most important part of the human immune system? 3: explain how antibodies help white blood cells search and destroy invading microbes' ? 4: Explain the expression using your knowledge of antibodies and the immune system ‘you never catch the same cold twice’ Friday 21 October 2011 Introduction: Invading microbes have all have unique surface proteins called antigens. White blood cells make antibodies that can recognise and bind to these antigens. By binding onto the surface of invading microbes, antibodies help white blood cells find the microbes before engulfing them. These white blood cells found in bone marrow roam the blood searching and then destroying infectious microbes ! Furthermore, the antibodies they produce remain in the blood for the rest of your life giving you immunity to that disease causing microbe. Know this: a: Know that while the bodily defences keep most microbes out, those that enter are quickly destroyed by white blood cells. b: Antibodies give you immunity but it takes time to produce them for a new microbes.

16. B2.3 a Look at the photograph and information and answer all the questions: Many viral diseases are spread from person to person. Flu, Smallpox and Polio viruses enter and infect the cells of your body through exhaled water droplets that enter through your nose or mouth. Some viruses like HIV rely on the exchange of bodily fluids, for example during unprotected sex or needle sharing. Explain why a viral infection cannot be caught by touching an unclean surface or eating ‘off’ food products ? Why should you cover you nose and entire face when you sneeze ? Explain why the government now give out clean needles free to all addicts who take illegal drugs like heroin ? Key concepts

17. B2.3 b Look at the photograph and information and answer all the questions: Bacteria can be found in every living organism, on every surface and even in the air we breathe. Some bacteria are very useful, whilst others cause diseases like cholera and dysentery. There are a number of ways in which bacteria can enter your body. By understanding how bacteria enters our body, we can reduce our risk of contracting or spreading a disease. Why is it important to refrigerate fresh foods and never use these foods beyond their ‘use by date’ found printed on the back of the packaging ? Why should you always thoroughly wash your hands after a) handling raw meat b) visiting the toilet and c) handling animals ? If there was a flood and raw sewage seeped into pipes supplying your home with drinking water...what could you do to ensure the water was safe to drink ? Key concepts

18. Key concepts B2.3 c Look at the photograph and information and answer all the questions: Explain why different antibodies have to be made for each new microbe that infects your body ? What cell make antibodies in response to an invading microbe ? When microbes enter the blood stream they begin dividing rapidly sometimes as quickly as once every 20 minutes. Each microbes has unique surface proteins called antigens. Antibodies which are able to bind on these surface proteins are made by white blood cells. Although this can take between 2 to 5 days, these antibodies help white blood cells search and destroy the microbes Human Microbes Microbes multiply Antibodies are made Virus Bacteria Microbes Antibodies White blood cell White blood cell

19. B2.3 Plenary Lesson summary: Decide whether the following statements are true or false : False True False True False True white immune viral antibodies Friday 21 October 2011 It is estimated that 500 to 1000 species of bacteria live in the human gut and a roughly similar number on the skin. Bacterial cells are much smaller than human cells, and there are at least ten times as many bacteria as human cells in the body (approximately 10 trillion bacteria cells). These bacteria cause no ill health and are with us from birth to death ! How Science Works: Research in to how antibodies as part of the immune system help white blood cell search and locate invading microbes. Preparing for the next lesson: In most examples, the body and its ______ system will overcome a bacterial or _______ infection by producing both ________ blood cells which trap and engulf microbes and _______ which help the body search and locate the invading foreign microbe. 3: Antibodies are chemicals that kill microbes ? 2: Immune means you can catch a disease again ? 1: Red blood cells destroy invading microbes ?

21. B2.4 Boosting your immunity- Vaccines Decide whether the following statements are true or false: Introduction: A strong immune system means that you are less likely to get infections. A good diet, regular exercise and low stress all help to build a strong immune system. Vaccines are injections that contain tiny parts of microbes. A vaccination will make you immune to that disease – you will not be able to catch it. Antibiotics are chemicals that can kill bacteria in the body. Extension questions: 1: Explain how your immune system fights infection and what factors may weaken your immune system ? 2: Explain how vaccines work and list three diseases that you have been vaccinated against since you were born ? 3: School is a place children are likely to pick up infections, why ? 4: Why should you finish a course of antibiotics even if you feel better ? 5: Why will the doctor not give you antibiotics to treat a cold and why are scientists not 100% sure a flu jab will protect you from all flu viruses ? Know this: a: Know that a stress free life, regular exercise and a good diet strengthen your immune system. b: Know that vaccines contain parts of a microbe make you immune to that microbe. Friday 21 October 2011

22. Key concepts B2.4 a Look at the photograph and information and answer all the questions: Why do scientists use parts of microbes or inactive microbes in a vaccine ? When the antibodies are produced which recognise a specific microbes what happens to these antibodies over long periods of time ? Vaccines contain parts of a virus or inactive whole viruses which although are unable to cause serious illness will trigger white blood cells to make antibodies that will recognise the surface proteins on the microbes. Once these anybodies have been made they will stay in the blood and give that person acquired immunity meaning that they the viruses will not be able to cause illness in that person. Vaccination Microbes multiply Antibodies are made

23. Key concepts B2.4 b Look at the photograph and information and answer all the questions: Explain the difference between the first and second immune response to vaccination ? If you do not have your MMR booster at school age you are at risk of contracting mumps, measles or rubella explain why ? Dead viruses are injected into the bloodstream. In the UK, you are immunised against polio, mumps, measles, smallpox and rubella. Vaccines contain dead or harmless microbes. White blood cells make antibodies specific to the virus. These cells remember when they are next exposed to the same virus. Once a particular antibody has been made by white blood cells, they stay in the body for the rest of your life, ready to destroy any more microbes. Vaccination Vaccines and your immune systems response

24. B2.4 c Look at the photograph and information and answer all the questions: Against vaccination For vaccination Think of two opposing views imagine having a conversation with that person to try and change their view ? Only about 65% of patients inoculated will have full immunity Small risk of adverse reaction to the vaccine Cost of providing a vaccine can be many pounds Not all parent have their children vaccinated so these children can acts as reservoirs of infection Vaccination reduces the chance of a patient contracting a potentially life threatening illness Can save the NHS many thousands of pounds in treatment and care costs Is relative simply to vaccinated the entire population using doctors and nurses What parent doesn't want to keep their children healthy and spare them from serious diseases? So when we are told that we should have our children vaccinated for 11 different diseases during their early childhood, most parents readily do so. For some, this has led to tragic results. Thus there is a great debate about the relative benefits and safety of vaccines. In the last 20 years, this debate has spilled over into the public arena and has intensified greatly, resulting in lass children being vaccinated. 3 in 100,000 children have an adverse risk to a measles vaccine whereas 1 in 4000 children will have serious health effects from contracting measles. Do you think the vaccine benefits outweigh the risks ? Key concepts

25. B2.4 Plenary Lesson summary: Friday 21 October 2011 The vaccination for smallpox a killer virus and now successfully eradicated was discovered by Edward Jenner. He experimented on a boy by infecting him with puss from milkmaids that had a similar disease called cow pox. Getting cow pox prevented the boy from getting the more serious small pox that could be fatal. How Science Works: Research into how the government strive to enable all children to have access to vaccine against key disease like measles, mumps, polio, smallpox and rubella. Preparing for the next lesson: 3: Stress and a bad diet can weaken your immune system ? 2: A vaccine contains a form of the microbe ? 1: Antibiotics can kill bacteria and viruses ? immune exercise vaccines antibiotics A good diet and regular __________ are important in building a strong immune system. ___________ can prevent a person ever catching an illness, they become __________ to it. If your immune system cannot cope with an infection you may be given __________ to kill the bacteria in your body. Decide whether the following statements are true or false : False True False True False True

27. B2.5 Vaccinations and the government Extension questions: 1: Name a thee vaccination you’ve had and which disease to they give you protection from ? 2: Explain why do people of third world countries catch more disease and have higher death rates when compared to the UK ? 3: Explain why are vaccines never 100% safe ? 4: Explain why doctors encourage parents to vaccinate their children at a young age and explain how vaccines protect you ? 5: Some parents do not immunise their children, explain why ? Friday 21 October 2011 Introduction: In the UK there are mass vaccination programmes for some diseases such as measles, mumps and rubella (MMR). This means that fewer people suffer from these diseases which can cause death or serious health populations in a small percentage of those who contract the disease. Parents have to balance the possible side effects of the vaccine with the protection it provides. Doctors encourage parents to have their children vaccinated at an early age to prevent them getting the disease. Know this: a: Know that the UK government spends millions of pounds on vaccine every year b: Know the benefits and the risks associated with mass vaccination.

28. B2.5 a Look at the photograph and information and answer all the questions: Mass vaccination works by ensuring that the entire population is vaccinated against a life threatening disease like polio or smallpox. If a small number of people ‘opt out’ then the disease can still exist in a population putting more of us at risk. Governments spend large amounts of money ensuring that we all participate mass vaccination programs. Explain why it is essential that all the population is vaccinated against particular microbe ? Should the government charge for vaccine or provide them free of charge ? What arguments would you use to persuade someone to vaccinated their child ? Vaccinated Not vaccinated Not vaccinated and infected Key concepts

29. Key concepts B2.5 b Look at the photograph and information and answer all the questions: Explain the link between rates of whooping cough vaccinations and cases of whooping cough detected in infants ? Explain why the number of cases started to rise in the 1970’s ? Whooping cough prior to the 1940s killed of seriously brain damaged many thousands of children (infants) In 1946, the vaccine was first introduced, vaccination rates were almost 95% within 5 years. In the 1970, some reports linked the vaccine to brain damage. Vaccination rates fell and 100 deaths from whooping cough were reported. After these report were disproved vaccination rates began to rise, however only after a decade . Microbe Antibodies incubation illness recovery measles vaccination Measles vaccinations incubation illness recovery 1940 1950 1970 1980 1990 Year Whooping cough vaccinations Whooping cough cases 2000 People (1000s)

30. B2.5 Plenary Lesson summary: vaccination measles protection Friday 21 October 2011 In the 1950’s there were 50 million cases of smallpox world wide. In 1967 the World Health Organisation (WHO) began a campaign to wipe it out through vaccinations, By 1977 the last natural case of small pox was recorded in east Africa. How Science Works: Research what superbugs are and how they can overcome antibiotics, google MRSA? Preparing for the next lesson: diseases In the UK there are mass __________ programmes for some diseases such as _______. This means that fewer people suffer from these _______, parents have to balance the possible side effects of the vaccine with the __________ it provides. Decide whether the following statements are true or false : False True 3: Mass vaccination programmes can help eradicate diseases like smallpox ? False True 2: MMR means measles, mumps and rubella ? False True 1: Vaccines don’t have any side effects ?

32. B2.6 The MMR vaccine Extension questions: 1: Why was the triple vaccine introduced in 1988 ? 2: Do you think the first study that Dr Wakefield published showing a link between MMR vaccines and autism included enough data ? 3: Why do you think the MMR vaccine became unpopular in 1999 ? 4: Look at the summary of the study done in 2004 a) do you think this study shows a link between autism and the MR vaccine and b) do you think the sample size was large enough ? 5: Do you think the BMA was right to strike off Dr. Wakefield ? Know this: a: Know the benefits and risk of a mass vaccination program. b: Know how to establish the reliability of scientific data. Friday 21 October 2011 Introduction: 1988 The MMR triple vaccine is introduced in the UK, a year after a measles outbreak which killed 17 children. 1998 Dr Wakefield and his team hit the headlines with a study that suggested a link between MMR and autism. The research features 12 children, 8 of whom it is claimed developed the condition after having their MMR vaccines. 1999 The MMR triple vaccine becomes unpopular following a rise parental demand for single dose vaccines. 1999-2005 Numerous studies worldwide fail to establish a link between MMR and autism. 2004 A new study looked at the vaccination records of 1,294 children, diagnosed with autism between 1987 and 2001.These children were compared with 4,469 children of the same sex and age, registered with the same surgery without autism. Overall, 78% of the children with autism had received MMR however 82% of the other children had also been given MMR. 2008 Since the initial MMR study by Dr Wakefield, all further research has discredited the link between the vaccine and autism. 2010. Dr Wakefield is struck off and no loner allowed to practise as a doctor.

33. Key concepts B2.6 a Look at the photograph and information and answer all the questions: The MMR (mumps, measles & rubella) vaccine is given to all children before the age of five . 1: Dr Wakefield links autism to the triple ‘MMR’ vaccine. Parents are worries and vaccination rates fall 2: Dr Wakefield was found to work for a company who sold single vaccines and is investigated by the BMA. Vaccination rates rise 3: Dr Wakefield was found guilty of gross misconduct and ‘struck off’ by the BMA. Vaccination rates are still lower than normal with measles casing rising Explain the link between the number of people vaccinated against measles and the number of reported cases of measles ? Describe what happened between 2000 and 2010 and explain why vaccinations rates has not yet fully recovered ? Microbe Antibodies incubation illness recovery measles vaccination Measles vaccinations incubation illness recovery 1975 1980 1990 1995 2000 Year Measles vaccinations Measles cases 2010 People (1000s)

34. B2.6 b Look at the photograph and information and answer all the questions: Scientists cannot make vaccine for every single disease, which one would you target and why ? Give two reasons why children of developing countries have a higher death rate form viruses when compared to children form the UK Smallpox, believed to have originated 3,000 years ago, is one of the most devastating diseases known to man. Epidemics swept across continents, The disease killed as many as 30% of those infected. Between 65–80% of survivors were marked with deep pitted scars In 1967, when WHO launched an intensified plan to eradicate smallpox, the "ancient scourge" which threatened 60% of the world's population, killed every fourth victim, scarred or blinded most survivors, and eluded any form of treatment. By 1977 they had succeeded. Key concepts

35. B2.6 Plenary Lesson summary: disease vaccinated mumps risk Friday 21 October 2011 Smallpox also called is the only disease that has been completely wiped out throughout the world. Smallpox is also potentially one of the most devastating biological weapons ever conceived. Due to the success of an intense worldwide public health initiative, not one documented naturally occurring case of this highly infectious, deadly disease has occurred since October 26, 1977. How Science Works: Research into the use of antibiotics, what they do and how they work in the human body. Look into also about the consequences if the over use of antibiotic over the last 50 years. Preparing for the next lesson: If all children were _______ against measles, _______ and rubella then there would be a much lower _____ of any child catching and possibly dying from that disease. A few children would still get the ______ because vaccination are not 100% successful. Decide whether the following statements are true or false : False True 3: Smallpox no longer exists because of worldwide vaccination ? False True 2: Small pox use to kill every fourth victim ? False True 1: It is against law not to have your children vaccinated against MMR ?