DISEASES AND IMMUNITY.

CANDIDATES SHOULD BE ABLE TO:

CORE
• Define pathogen as a disease-causing organism
• Define transmissible disease as a disease in which the pathogen can be
passed from one host to another
• State that the pathogen for a transmissible disease may be transmitted
either through direct contact, e.g. through blood or other body fluids, or
indirectly, e.g. from contaminated surfaces or food, from animals,or from the
air
• State that the body has defences:
– mechanical barriers, limited to skin and hairs in the nose
– chemical barriers, limited to mucus and stomach acid
– cells, limited to phagocytosis and antibody production by white blood cells
– which can be enhanced by vaccination
SUPPLEMENT
• State that antibodies lock on to antigens leading to direct destruction of
pathogens, or marking of pathogens for destruction by phagocytes
• Explain how each pathogen has its own antigens, which have specific shapes,
so specific antibodies which fit the specific shapes of the antigens are needed
• Define active immunity as defence against a pathogen by antibody production
in the body
• Explain that active immunity is gained after an infection by a pathogen, or
by vaccination
• Explain the process of vaccination:
– harmless pathogen given which has antigens
– antigens trigger an immune response by lymphocytes which produce antibodies
– memory cells are produced that give long-term immunity.
CORE
• Explain the importance of hygienic food preparation, good personal hygiene,
waste disposal and sewage reatment in controlling the spread of disease.
SUPPLEMENT
• Explain the role of vaccination in controlling the spread of diseases
• Explain that passive immunity is short-term defence against a pathogen by antibodies
acquired from another individual, e.g. mother to infant
• State that memory cells are not produced in passive immunity
• Explain the importance of passive immunity for breast-fed infants

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• State that some diseases are caused by the immune system targeting and destroying body
cells, limited to Type 1 diabetes
DEFINITIONS OF KEY TERMS.

Immunity-is the defense against pathogens.

Pathogen- is a disease -causing organism’

Transmissible disease-is a disease in which a pathogen can be passed from one

host to another.

Active immunity- is a defence against a pathogen by antibody production in the

body.

Antibody- a protein produced by lymphocytes that lock on to antigens leading to

direct destruction of pathogens, or marking of pathogens for destruction by
phagocytes.

Antigen- a protein molecule on the cell membrane of any cell.

NB; Each pathogen has its own antigens which have specific shapes on their
cell membranes on which antibodies attach.

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Examples of diseases caused by pathogens.

DISEASE PATHOGEN GROUP TO WHICH THE

PATHOGEN BELONGS
Cholera Vibrio cholera Bacteria.
AIDS HIV Virus
Malaria Plasmodium malariae Protoctist.
Athlete’s foot Candida. Fungi

 Antibodies are antigen specific.

METHODS OF TRANSMISSION OF DISEASES.
IDIRECT CONTACT.
1.Through the air.
 Pathogens are in tiny droplets of liquid from the airways and lungs of
infected people.
 Examples of airborne diseases are, Influenza, TB.
2.Contaminated food and drink.
 People preparing food do not wash their hands, food not cooked properly,
human faeces contaminated water supply, flies transfer pathogens on
their bodies.
3.Insect vectors.
 Insects e.g. female Anopheles mosquito, feeds on the blood of an infected
person and then suck blood from an uninfected person e.g. malaria.

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 DIRECT CONTACT.
 Uninfected people touch infected people or items that infected people
have used e.g. athlete’s foot, Ebola
1. Blood.
 Blood from an infected person enters the blood of an uninfected person
e.g. in an unsterilized needle shared between drug addicts

2.Body fluids.

 Pathogens pass from infected person to sexual partner in blood, semen or

vaginal fluids.

BARRIERS TO INFECTION.

1.Mechanical Barriers.
 The dead outer layers of the skin form a barrier to entry of
pathogens.
 Pathogens can not pass through the keratin on the skin surface.
 Keratin is resistant to weak acids/alkali, enzymes and toxins produced by
bacteria.
 Hairs in the nasal passage also trap dust particle which may
contain pathogens.
2.Chemical Barriers.
 Gastric walls secrete hydrochloric acid which kills pathogens in food.
 Goblet cells on the lining of the trachea and bronchi secrete mucus that
traps small dust particles that may also contain pathogens.
 Vaginal acids kill bacteria.

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 Tears contain an enzyme called, lysozyme which breaks down the cell
walls of some bacteria and protects eyes from infection.
SAMPLE QUESTION
N16P314 The body has defences against pathogens.

(a) (i) Define the term pathogen. [1]

(ii) State two ways a pathogen can be transmitted. [2]

(iii) The body can defend itself against pathogens.

Complete Table 4.1 by stating examples of the body’s

defences.

Table 4.1

SAMPLE QUESTION.
M19 P42Q6 Fig. 6.1 is a diagram of the virus that causes

measles.

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Fig. 6.1

(a) (i) State the name of the parts of the virus shown in Fig.

6.1 labelled X and Y. [2]

(ii) Bacteria belong to the Prokaryote kingdom.

State two ways in which the structure of bacteria differs

from the structure of viruses. [2]

(b) Viruses and some bacteria are pathogenic. Diseases caused

by pathogens are transmissible.

(i) State two ways that a pathogen can be transmitted

indirectly. [2]

(ii) The body has barriers to defend itself against pathogens.

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 State two mechanical barriers of the body. [2]
 Phagocytes engulf bacteria and viruses into vacuoles where they are digested
and destroyed.
MAIN STAGES OF PHAGOCYTOSIS.

 Lymphocytes (B-lymphocyte’s and T-lymphocytes.)

 They are the second type of white blood cells.
 Lymphocytes are smaller than the phagocytes.
 They are two types of lymphocytes
 Both types divide by mitosis in response to the presence of the
antigens.

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 B-LYMPHOCYTES.
 The cells remain in the bone marrow until they are mature and then
spread throughout the body, concentrating in lymph nodes.
 B-lymphocytes have receptors that are specific to the antigens that
have entered the body.
 In response to the entry of the foreign antigen the B-lymphocyte
divides to give plasma cells (antibody producing cells) and memory
cells.

NB: Memory cells remain circulating in the body for a long time. If
the same antigen is reintroduced a few weeks or months after the first
infection, they quickly recognize the antigen and quickly divide to
give many plasma cells and more memory cells.

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 FUNCTIONS OF B-LYPHOCYTES IN RESPONSE TO THE
PRESENCE TO FOREIGN ANTIGEN.

ANTIBODIES.
 Each pathogen has cell markers on its cell membrane called antigens.

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  Antibodies stick on the antigens and destroy the pathogen or marking
them for phagocytes to act on them.
NB: Antibodies are antigen specific i.e. their shapes are
complementary.
AN OUTLINE OF HOW ANTIBODIES PROTECT THE BODY.

Antibodies have different functions according to the type of antigen to which they
bind.

1.They bind with viruses and bacterial toxins preventing them from entering
or damaging cells.

2.They immobilize bacteria.

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  Antibodies attach to flagella of bacteria making them less active and easier
for phagocytes to engulf.

3. They cause agglutination (clumping together) of bacteria.

 Antibodies with multiple antigens binding sites cause the clumping together
of bacteria reducing the chances of spread throughout the body.

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4.Punch holes in the cell wall of bacteria.

 Some antibodies act as perforins. They punch some holes in the cell wall of
bacteria causing them to burst when they absorb water.

5.Antibodies coat bacteria.

 Antibodies coat bacteria, making it easier for the phagocytes to engulf them;
phagocytes have receptor proteins for the antibodies.

6.They neutralize toxins.

 They combine with toxins, neutralizing them and making them harmless,
these antibodies are called antitoxins.

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 SAMPLE QUESTION.
N11P32Q4 Proteins in the blood are involved in

protection of the body.

Three proteins found in the blood are

• antibodies • thrombin • fibrinogen

(a) (i) Name the type of white blood cell that produces

antibodies.

(ii) Outline how antibodies protect the body.[2]

Marking points
(i) Lymphocyte.

(ii) attach to, bacteria / viruses / pathogens ;

 cause them to, aggregate / stick together;

 stop them spreading ;
 help phagocytes engulf them ;
 cause bacteria to burst / kill bacteria / destroy bacteria ;
 stop bacteria moving / immobilise bacteria ;
 neutralise, toxins / poisons / harmful substances ;

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 stop, viruses / bacteria, entering cells ;

T-LYMPHOCYTES.
There are two main types of T-Lymphocytes:
Helper T-cells.
 Helper T-cells when exposed to antigens, divide by mitosis to give
more Helper T-cells and T-memory cells.
 Helper T-cells secrete chemicals called cytokines which stimulate B-
Lymphocytes to divide to give plasma cells(antibody secreting cells).
Killer T -cells.
 Killer T-cells attach themselves to the surface of infected cells and
secrete toxic substances such as hydrogen peroxide, killing the body
cells and the pathogens inside.

ACTIVE AND PASSIVE IMMUNITY.

1.ACTIVE IMMUNITY.
Active immunity- is immunity gained when an antigen enters the
body, an immune response occurs and antibodies are produced by
plasma cells.
 Active immunity is gained after an infection by a pathogen (i.e.
natural active) or by vaccination (artificial active).
 The body produces its own antibodies and memory cells are produced.
 Memory cells can last for many years

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 Active immunity provides long term protection because memory cells
quickly recognize the pathogen when it enters for the second time.
 In response to the pathogen, memory cells quickly divide to give more
memory cells and plasma cells which produce many antibodies.
 The antibodies quickly deal with the pathogen before the disease
develops.
CHANGES IN CONCENTRATION OF ANTIBODIES AND
NUMBER OF BACTERIA AFTER THE FIRST INFECTION.

 It takes longer time to deal with the pathogen during the first
infection.
 Number of bacteria started to decrease after a day when the
concentration of antibodies started to increase rapidly.
 Bacteria were completely eradicated after four days.

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 CHANGES IN CONCENTRATION OF ANTIBODIES AND
NUMBER OF BACTERIA AFTER A SECOND INFECTION.

 Immune response is faster during the second infection this is because

memory cells will be present in the blood.
 Memory cells quickly recognize the pathogen and quickly divide to
give more memory cells and plasma cells which secrete large
quantities of antibodies.

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  During the second infection, there is rapid increase in the
concentration of antibodies
 Bacteria are eliminated in less than a day
 Bacteria are eliminated before they can cause any disease.

CHANGES IN THE CONCENTRATION OF ANTIOBIES DURING FIRST

AND SECOND INFECTION.

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Production of memory cells during the first infection resulted in rapid production
of antibodies.

Memory cells quickly divide to give antibody producing cells.

ACTIVE IMMUNITY.

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Active immunity is immunity gained when an pathogen inters the body ( natiral
active) or when or a vaccine is injected (artificial active).

Active immunity involves antibody production.

ARTIFICIAL ACTIVE IMMUNITY.

 Artificial immunity is immunity gained by vaccination
Vaccination and its role in controlling spread of diseases.

Vaccine -is a preparation containing antigens, weakened pathogen or

dead pathogen that normally cause disease.
 When the vaccine is injected into the body, it is recognized by the
lymphocytes.
 Lymphocytes divide to give memory cells and plasma cells which
secrete antibodies with shapes complementary to the antigens.
 Memory cells give long term immunity.

PASSIVE IMMUNITY.

Passive immunity- is immunity gained without an immune response,

antibodies are injected(artificial passive) or pass from mother to child
across the placenta or in breast milk (natural passive).

 Passive immunity provides ;

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  new child temporary immunity to pathogens.
 immediate protection as already made antibodies are injected.
 short term protection because memory cells are not produced.

SAMPLE QUESTION.

M16P42Q2(d) Heroin abuse may lead to HIV infection. There

is currently no approved vaccine that prevents the spread of

HIV. Vaccination stimulates active immunity against specific

pathogens.

(i) Explain how vaccination stimulates active immunity. [4]

(ii) Explain what is meant by passive immunity. [2]

N17 P42Q5(d) The immune system is not very effective

against pathogens, such as H. pylori, that live inside the

alimentary canal. This means that active immunity and passive

immunity do not provide complete protection against H. pylori

infections.

Explain how active immunity differs from passive immunity.[4]

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SAMPLE QUESTION

J17 P43 Q6(c) The spread of meningitis can be controlled by

using vaccines.

(i) Explain how vaccination provides active immunity. [4]

(ii) If meningitis disappears from a country, explain why the

vaccine should continue to be used in that country. [2]

(d) People who have meningitis are treated with injections of

antibodies to give them passive immunity.

(i) Suggest why the antibodies must be injected rather than

taking them by mouth. [2]

(ii) Explain why passive immunity does not give long-term

protection against diseases, such as meningitis. [2]

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 MARKING POINTS.

6(c)(i)

 (vaccine contains) harmless / attenuated / dead pathogen / antigen ;

 (antigens / vaccine) stimulate an immune response ;
 lymphocytes / white blood cells, make antibodies ;
 Antibodies are antigen specific ;
 Memory cells are produced. ;
 rapid, immune response occurs when the body is exposed to
the same pathogen .
 Gives long-term immunity ;

6(c)(ii)

 bacteria may still be present in the population

 in carriers / in people who have no symptoms ;
 infected people moving into the, country
 if few people are, immune / vaccinated, bacterium is more
likely to be transmitted ;
 some people cannot respond to, antigens / vaccines ;
 protects people who travel to other countries ;

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  booster vaccinations are sometimes required.

6(d)(i)

 antibodies are made of protein ;

 proteins / antibodies, are digested / denatured, in the
alimentary canal ;
 direct route to site of infection ;

SUMMARY: METHODS OF ACQUIRING ACTIVE AND PASSIVE IMMUNITY

AUTO-IMMUNE DISEASES.

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Auto-immune diseases are diseases are diseases which caused by the immune
system targeting and destroying body cells.

 Lymphocytes mistakenly identify own cells as foreign cells and

start to produce antibodies against own antigens.
 In some cases, T-lymphocytes destroy specific cells.
 Type 1 diabetes is an example of auto-immune disease.
 In this case lymphocytes destroy cells which secrete insulin
 Insulin helps to lower blood glucose level.
 Type 1 diabetes patients are insulin dependent.
SYMPTOMS OF TYPE 1 DIABETES.
 Presence of glucose in urine.
 Weight loss.
 Frequent urination.
 Poor eye sight.
 tiredness
 breathlessness ;
 dizziness / fainting / light-headedness / coma ;
 sticky / sweet, urine ;
 urinary tract infection
 recurrent thrush ;
 thirsty (all the time) / drinking lots of water ;
 dry mouth ;
 hunger / eating a lot of food ;
 sweet-smelling breath ;
 change(s) in behaviour ; e.g. irritability / confusion / mood swings
 nausea / vomiting ;

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 blurred vision / blindness ;
 cuts / grazes / wounds, that do not heal ;

N18P42Q4(v) The doctor thought that person A had

Type 1 diabetes.

Describe three symptoms of Type 1 diabetes.[3]

TREATMENT OF TYPE 1 DIABETES.

 Insulin injection .
 Regular blood glucose tests ;
 Regular meals / controlled diet ;

J16 P42Q6(c) Describe the symptoms and treatment of

Type 1 diabetes. [5]

CONTROLLING SPREAD OF DISEASES.

1.Hygienic food preparation.
 Food should be covered to keep flies away.
 Kitchen surfaces should be cleaned with disinfectants to kill
bacteria.
 Food should be cooked thoroughly to make sure any bacteria are
killed.
 Cooked food that is eaten cold should be kept separate from raw
food especially meat.
 Water used for cooking and or drinking should be boiled or
sterilized by adding water purification tables if it comes from
sources that might be contaminated.

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 2.Personal hygiene.
 People of all ages should wash their hands after going to the toilet
to urinate or defecate and also before handling or heating food.
 Hair should be washed with shampoos to prevent dandruff and
headlice.
 Everyone should wash themselves frequently, especially in hot
weather.
 Dental hygiene is most important in fighting dental caries.
 Cuts and bruises should be washed with an antiseptic and plasters
applied to open wounds.
3. Proper waste disposal.
 Household waste should be put into covered bins and collected at
regular intervals.
 Some of the rubbish in landfill sites rotten by decomposers.
4. Sewage treatment.
 Toilet waste is a serious health hazard if it is not disposed properly
through drainage pipes to a sewage treatment works.
 Human wastes are broken down by microorganisms in sewage
treatment works
 The pathogens that cause typhoid and cholera are transmitted
through faeces and transmitted to people who drink food or water
contaminated with raw sewage.

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