here - University of Texas School of Public Health - The University of ...

HEADS UP World Wide 

The Immune System 

& Infectious Diseases 

Exploring the field of infectious disease research, biosafety levels, and 

biological laboratories where the most dangerous pathogens are studied 

www.sph.uth.tmc.edu/headsup 

© The University of Texas Health Science Center at Houston

The University of Texas Health Science Center at Houston 

Dr. James Willerson 

The University of Texas School of Public Health 

Dr. Guy Parcel 

The Immune System and Infectious Diseases 

Exploring the field of infectious disease research, biosafety levels, and 

biological laboratories where the most dangerous pathogens are studied 

Acknowledgments 

The University of Texas School of Public Health Michael & Susan Dell Center for Advancement of Healthy Living 

Dr. Deanna Hoelscher 

Nathalie Sessions 

Katherine Skala 

Pam Greer 

Dr. Nancy Murray 

Rhonda Hatcher 

Jason Cabot 

The University of Texas Health Science Center at Houston Center for Clinical and Translational Sciences 

Nancy Benedict 

Dr. Maureen Goode 

Dr. Pablo Okhuysen 

Joy Lilljedahl 

Madelene Ottosen 

Sandra Williams 

Spring Branch Independent School District 

Dr. Duncan Klussman Linda Buchman Sue Loudis Joyce Olson 

Project GRAD Houston 

Ann Stiles Dr. Laurie Ballering Dr. Kwame Opuni 

Lead Content Advisor 

Dr. Leanne Field 

Content Developers and Advisors 

Dr. Shreela Sharma 

Melanie Mowry 

Melissa Cleaver 

Ruben Marquez 

Dr. Kim Schuenke 

Dr. Douglas Watts 

Rhonda Hatcher 

Katherine Skala 

Special Thanks 

Dr. L. Tony Beck Dr. Gilbert Castro Dr. Mary Hobbs Ellen Breckenridge 

A special note of appreciation is extended to the dozens of wonderful educators who have successfully implemented HEADS UP 

and served as training facilitators and supporters of project initiatives. We appreciate all you do! 

The HEADS UP project is supported by a Science Education Partnership Award (SEPA), Grant Number R25 RR020543 from the National 

Center for Research Resources (NCRR), National Institutes of Health (NIH). Its contents are solely the responsibility of the authors and do not 

necessarily represent the views of NCRR or NIH. 

© The University of Texas Health Science Center at Houston

HEADS UP 

The Immune System & Infectious Diseases 

Table of Contents 

Overview and Guidelines for Using this Curriculum ..........................................................4 

TEKS arranged by Activity .................................................................................................9 

TEKS arranged by Number ...............................................................................................12 

Timeline .............................................................................................................................17 

Flowchart ...........................................................................................................................18 

Mini Lab Notebook and Answer Key ................................................................................19 

Preface 

Teacher 411: The Immune System ..........................................................................44 

Classroom Activity: Immune System Cell Chart ...................................................60 

Immune System Glossary ......................................................................................67 

Unit 1: Staph Wars 

Teacher 411: MRSA ...............................................................................................80 

Unit 1 Video Worksheet and Answer Key ............................................................82 

Classroom Activity: The Immune System versus The Superbug ...........................85 

Unit 1 Glossary ......................................................................................................99 

Unit 2: Hunting the Big Fever: Finding and Fighting Infectious Diseases 

Teacher 411: Lassa Fever ....................................................................................104 

Unit 2 Video Worksheet and Answer Key ..........................................................106 

Classroom Activity: Research Poster Project and Sample ..................................109 

Classroom Activity: Who Should Receive the Vaccine? ....................................113 

Enrichment Activity: EIS Case Study..................................................................116 

Unit 2 Glossary ....................................................................................................133 

Unit 3: Just Another Day at the BSL4 

Teacher 411: Biological Laboratories and Biosafety Levels ...............................138 

Unit 3 Video Worksheet and Answer Key ..........................................................140 

Classroom Activity: Biological Laboratories Memory Game .............................143 

Unit 3 Glossary ....................................................................................................149 

Teacher 411: Vaccines .....................................................................................................155 

Teacher 411: HIV/AIDS ...................................................................................................158 

Immune System-related Released TAKS Questions and Answer Key ...........................160 

Illustrations/video graphics for transparencies ................................................................167 

Master Glossary arranged Alphabetically ........................................................................209 

Master Glossary arranged by Unit ...................................................................................218 

Science Fair Project Ideas ................................................................................................227 

Additional Resources .......................................................................................................229 

HEADS UP The Immune System & Infectious Diseases © 2008 University of Texas Health Science Center at Houston

HEADS UP World Wide: The Immune System and Infectious Diseases 

Overview and Guidelines 

Welcome to HEADS UP The Immune System and Infectious Diseases! We know that you will 

enjoy implementing these high quality materials produced specifically for middle and high 

school students (primarily with a 7th grade aim). Materials, intended to support/enhance 

curricula, are designed by health science experts and classroom teachers and aligned with the 

Texas Essential Knowledge and Skills (TEKS) and National Science Education Standards. 

Prior to implementation, we encourage you to review the guidelines and components carefully. 

Familiarity with the materials and format will help promote effective use. 

Texas Essential Knowledge and Skills 

Middle School Science, Middle School Health, High School Biology, High School IPC, and 

Middle and High School Career Orientation TEKS are met by The Immune System and Infectious 

Diseases. These are summarized in the TEKS Master List document and are also indicated on 

individual Video Worksheets and Classroom Activities. Assessment Tools (including TAKS 

Warm-ups) are provided to help test the objectives and are discussed further under Module 

Components. 

Timeline and Flowchart 

The amount of time needed to implement The Immune System and Infectious Diseases will vary 

depending upon class period length and schedules. The timeline provides estimated instruction 

times for components. To meet the objectives outlined for the module, components are designed 

to occur in the order presented in the Flowchart. As this may not always be possible or desirable, 

individual components such as videos and classroom activities may be selected independently to 

suit your needs. 

What follows is a summary of Module Components and Instructional Strategies. Please refer 

to individual components for detailed instruction. We highly recommend all instructions be read 

before beginning activities. 

© The University of Texas Health Science Center at Houston 

Module Components 

Teacher 411 Information Sheets 

Teachers have a great deal of complicated content to remember. With integrated models used in 

schools and the rapid advancements in science it is even possible teachers will have little 

background in some of the subjects they teach. Because of this, each unit in The Immune System 

and Infectious Diseases includes Teacher 411 information sheets. This information is not 

necessarily intended for distribution to students, but rather to give teachers insight into the latest 

research developments and more confidence in teaching the material. 

Videos and Printed Material 

Video is the featured component of the module used to present key concepts, spark questions, 

deepen understanding, and educate students about careers related to immunology. Most module 

Page 4 of 231

objectives are met through the Content Videos. Career Stories are special segments included to 

deepen understanding and stimulate interest and help students identify with peers, scientists, and 

other featured experts. 

PDF documents (and some Word files) include Guidelines, Teacher 411s, Classroom Activities, 

Lab Notebook templates, Glossaries, Assessments, and more. Activities add depth to concepts, 

but primarily serve to reinforce video instruction. 

There are three Content Videos, two Ethical Dilemmas videos, and eleven Career Stories. 

Content Videos 

• Staph Wars 

• Hunting the Big Fever: Finding and Fighting Infectious Disease 

• Just Another Day at the BSL4 

Career Stories 

Pablo Okhuysen Infectious Disease Researcher 

Joseph McCormick Epidemiologist/Professor/Dean 

Susan Fisher-Hoch Professor of Epidemiology 

Blanca Restrepo Assistant Professor of Epidemiology 

Donald Bouyer Assistant Professor of Pathology 

Michael Holbrook BSL4 Facility Director 


Patrick Newman Pathology Research Associate 

Melissa de la Garza Assistant Veterinarian 

D. Mark Estes Veterinary Immunologist 

Joseph Petrosino Assistant Professor 

Victoria Sutton Center for Biodefense Director 

Glossaries 

The Immune System and Infectious Diseases presents terms that will probably be new for most 

students (and maybe teachers, too!). Each unit includes a glossary of terms related to that section. 

In addition, two master glossaries are included; one sorted by unit and one alphabetically. 

Lab Notebook 

To engage students in the learning process and personalize their Immune System and Infectious 

Diseases experience, a Lab Notebook template is provided. Students have the opportunity to 

make notes about new terms and careers, test their knowledge of new concepts, journal their 

thoughts, and draw images. Teachers may print as many or as few copies as possible (two-sided 

black and white) for distribution to students or, for those with computer access students could be 

given the Lab Notebook electronically. 

Classroom Activities 

Activities and labs take time, but science teachers know that a well-organized activity has the 

greatest potential for learning that lasts. This module has been designed to provide opportunities 

for hands-on learning either individually, in small groups or as a class. Activities are encouraged 

as an essential part of the learning process. 

Estimated class time needed and TEKS met are indicated on each activity. When applicable, 

student handouts and/or transparencies are provided. All activities follow this format: 

• Objective 

• Overview 

• Materials Needed 

• Preparation 

• Presentation 


Activities may require materials not contained in the module, but are usually items accessible to 

teachers or can be obtained at low cost. Presentation steps are detailed, but can certainly be 

adapted to fit your own teaching style. 

Assessment Tools 

Two types of assessment tools are included in the module, providing teachers with the 

opportunity to test student knowledge—video worksheets and released TAKS questions. 

Video Worksheets help students learn key terms presented in the videos. Each unit includes a 

worksheet that students can complete while viewing each of the Content Videos. Worksheets 

could also be used as a vocabulary self-check or assessment. 

Included in the master PDF and as a separate Word file, a document entitled Released TAKS 

Questions related to immunology and infectious disease is included to aide students in 

preparing for higher level thinking required on the TAKS test. 

Additional Resources 

The world of immunology is constantly evolving. Therefore, the number of resources available 

(particularly on the Internet) seems endless. The Additional Resources document provided on 

the Teacher CD is a listing of select web sites that feature resources for teachers and students 

about the topics covered in The Immune System and Infectious Diseases. 

Per teacher request, also included is a Science Fair Project Ideas document with a list of ideas 

and links for immunology-related topics. 

The field of immunology is exciting. We encourage teachers to create a Current Events file to 

collect news stories, encourage students to do the same, and plan class time to discuss events that 

relate to the topics covered in The Immune System and Infectious Diseases and beyond! 


Instructional Strategies 

The main goals of the HEADS UP project are to increase student interest in science and health 

science careers but more so to encourage students to become lifelong scientific thinkers. While 

these goals are difficult to measure, there are strategies that can assist students on the path to 

choosing science as a viable career option. As you review these strategies, integrate them into 

your own teaching style to encourage students to become critical thinkers and to ask good 

questions—two qualities that are the basis of scientific thinking. 

The Parking Lot 

Many times during the course of discussion or activities, students will ask questions that may be 

inappropriate to answer at that particular moment. A student may even ask a question for which 

the teacher doesn’t know the answer. These questions are perfect for the Parking Lot. The 

Parking Lot is a large space of highly visible chalkboard/whiteboard off to the side of the front 

of the classroom. When students ask questions that are especially insightful or unanswerable at 

the moment they are asked, write the question on the board with a check-box in front of it. 


Throughout the module, many questions will be answered; others will not. As questions are 

answered, place a check-mark beside them. On the day you review for a test, point out to the 

students all of the questions that they now know the answers to; things that they didn’t know just 

a week or two ago. 

The HEADS UP curriculum is interesting and exciting! It is intended to spark questions and 

provoke thought. Undoubtedly, there will be questions that go unanswered even after the entire 

curriculum is presented. Unanswered questions can be handled in a variety of ways: invite 

students to spend a library day researching or offer extra credit for each answer a student finds 

and is willing to present to the class. If your class has Internet access, set aside time to visit web 

sites listed in this module’s Additional Resources section or develop a strategy to match your 

unique teaching style. 

Students who learn to ask questions and seek out answers are those who become life-long 

learners. HEADS UP encourages this level of critical thinking to help inspire future scientists. 

Get them Moving 

The HEADS UP curriculum is not passive. Students are expected to participate in large and 

small group settings. The teacher’s role in HEADS UP is different from the traditional “chalk 

and talk” methods popular years ago. The HEADS UP teacher is a facilitator between the 

students and the knowledge. Much of the direct instruction is handled by scientists, other experts, 

or actors in the videos. The classroom teacher reinforces learning and encourages further 

discovery. “Get them moving” simply means that the students shouldn’t be sitting still for too 

long—get them talking, get them volunteering, get them involved in a hands-on activity; get 

them doing anything but sitting still. 

Validation 

Budding scientists need to know there are no stupid questions. Student responses deserve 

positive feedback, but so do their questions. Students will learn far more effectively from what 

they discover on their own than by what teacher simply tell them. 

It is perfectly acceptable to let students know you do not always have the answers. Science, for 

both teachers and students, is most rewarding when it is about discovery. We learn more every 

day and no one has all the answers. 



Reproduction and Use 

HEADS UP materials are copyrighted by and are the property of The University of Texas 

Health Science Center at Houston and may not be reproduced or distributed without written 

permission, except by Texas public school educators under the following conditions: 

1) Any portion reproduced or distributed will be used exclusively for nonprofit educational 

purposes; and 

2) No monetary charge is made for the reproduced materials, any document containing 

them, or any activity at which they are distributed; however, a reasonable charge to cover 

only the cost of reproduction and distribution may be charged. 

Disclaimer 

HEADS UP project developers do not endorse or recommend any commercial products, 

processes, or services. The views and opinions expressed in HEADS UP do not necessarily 

state or reflect those of The University of Texas Health Science Center or the National Institutes 

of Health and may not be used for advertising or product endorsement purposes. 

Links to Internet sites are included only for the convenience of World Wide Web users. 

HEADS UP is not responsible for the availability or content of these external sites, nor does the 

project endorse, warrant or guarantee the products, services or information described or offered 

at these other Internet sites. 

It is not the intention of HEADS UP to provide specific medical advice, but rather to provide 

users with information to better understand health and health science research developments. 

Specific medical advice will not be provided, and the project staff urges you to consult with a 

qualified physician for diagnosis and for answers to your personal questions. 


Principal Investigator 

Nancy G. Murray, DrPH 

Project Director 

Nathalie Sessions 

www.sph.uth.tmc.edu/headsup │ headsup@uth.tmc.edu 

Health Education And Discovering Science 

while Unlocking Potential 


PREFACE 

Immune System Cell Chart 

HEADS UP 


TEKS by Activity 

Middle School Science: 6.1 A; 6.2B-D; 6.3 C; 6.10; 7.1 A-B; 7.2 C-D; 7.3C; 7.5 A; 7.9 A-B; 7.10 B; 7.11 A-B; 8.1 

A; 8.2 C-D; 8.3 C; 8.6 

Middle School Health: 6.3 B; 7.3A-C; 8.3A-C 

High School Biology: 1 A; 2 A, C, D; 4 C-D; 10 A 

High School IPC: 1 A; 2 A, C, D 

The Immune System Versus the Pathogens 

Middle School Science: 6.1 A; 6.2B-D; 6.3 C; 6.10; 7.1 A-B; 7.2 C-D; 7.3 C; 7.5 A; 7.9 A-B; 7.10 B; 7.11 A-B; 8.1 

A; 8.2 C-D; 8.3 C; 8.6 

Middle School Health: 6.3 B; 7.3A-C; 8.3A-C 

High School Biology: 1 A; 2A; C, D; 4 C-D; 10 A 


UNIT 1 

Video: Staph Wars 

Middle School Science: 6.2; 6.3C; 6.9A-B; 6.12 B; 7.2 A; 7.3 C; 7.9 A-B; 7.10 B; 7.11 A; 7.12 B-C; 

8.2; 8.10B; 8.11A; 8.12B-C 

Middle School Health: 6.3 A; 7.3A-C; 7.12A-B; 8.3A-C; 8.12A-B 

High School Health: 115.32.b.2.A-D; 115.32.b.6.A-B 

High School Biology: 1 A; 2 A, C, D; 4 C-D; 10A 


Make Your Own Superbug 

Middle School Science: 6.1 A; 6.2B-D; 6.3 C; 6.10; 7.1 A-B; 7.2 C-D; 7.3 C; 7.5A; 7.9 A-B; 7.10 B; 

7.11 A-B; 8.1 A; 8.2 C-D; 8.3 C; 8.6 

Middle School Health: 6.3 B; 7.3A-C; 8.3 A-C 


High School IPC: 1 A; 2A, C, D 

HEADS UP The Immune System & Infectious Diseases © 2008 University of Texas Health Science Center at Houston 


UNIT 2 

Video: Hunting the Big Fever: Finding and Fighting Infectious Disease 

Middle School Science: 6.2; 6.3C; 6.9A-B; 6.12 B; 7.1; 7.2; 7.3 C-E; 7.4 B; 7.9 A-B; 7.10 B; 7.11 A; 7.12 B-C; 8.1; 

8.2; 8.3 D-E; 8.4 B; 8.5 

Middle School Health: 6.3 A; 7.3A-C; 8.3 A-C; 7.12 A-B; 8.12 A-B 

High School Health: 115.32.b.2.A-D; 115.32.b.5.D; 115.32.b.10.A-C 

High School Biology: 1 A; 2 A, C, D; 4C-D; 10A 


Career Orientation: Middle School 127.2(8); High School 127.12(8) 

Research Poster Project 

Middle School Science: 6.1; 6.2 A; 6.3 A; D, E; 6.5 A; 6.10 B; 6.11 A-B; 7.1; 7.2 A, D, E; 7.3 A, D, E; 7.5 A; 7.9 

A-B; 7.10 B; 7.11 A-B; 8.1; 8.2 A-D; 8.5 A; 8.9 A-B; 8.10 B; 8.11 A-B 

Middle School Health: 6.3A; 7.3A and C; 7.12A-C; 8.3A and C; 8.12A-C 

High School Health: 115.32.b.2.A, 115.33.c.2.B 

High School Biology: 1 A; 2 A, C, D, 4 C-D; 10 A 


Who Should Receive the Vaccine? 

Middle School Science: 6.1; 6.2 A-D; 6.5 A; 6.11 A-B; 7.1, 7.2 A-D; 7.3 A, B, D; 7.5 A; 7.9 A-B; 7.10 B; 7.11 A-B; 

8.1; 8.2 A-D; 8.4; 8.5 A; 8.11A-B 

Middle School Health: 6.3 A; 7.3 A-B; 8.3 A-B 

High School Health: 115.32.b.2.A-D, 115.32.b.10.A-B, 115.33.c.2.A 

High School Biology: 1 A; 2 A,C, D; 4C-D; 10 A 


EIS Case Study 

Middle School Science: 6.1 A; 6.2B-D; 6.3 C; 6.10; 7.1 A; 7.2B-D; 7.3 C; 7.9; 8.1 A; 8.2 C-D; 8.3 C; 8.6 

Middle School Health: 6.3A, 6.3C, 7.3.A-C, 7.12.A-C, 8.3.A-C, 8.12.A-C 

High School Health: 115.32.b.2.A-D, 115.32.b.10.A-B, 115.33.c.2.A-B 



Career Orientation: Middle School 127.2(7B); 127.2(8A); High School 127.12(7B); 127.12(8A) 



UNIT 3 

Video: Just Another Day at the BSL4 

Middle School Science: 6.2; 6.3C; 6.9A-B; 6.12 B; 7.1; 7.2; 7.3 C-E; 7.4 B; 7.9 A-B; 7.10 B; 7.11 A; 7.12 B-C; 8.1; 

8.2; 8.3 D-E; 8.4 B; 8.5 

Middle School Health: 6.3 A; 7.3 A-C; 8.3 A-C; 7.12 A-B; 8.12 A-B 

High School Health: 115.33.c.1.B; 115.33.c.2.A 



Biological Laboratories Memory Game 

Middle School Science: 6.1; 6.2 D; 7.1; 7.2 D; 8.1; 8.2 D 

Middle School Health: 7.3 A-C; 7.12 A; 8.3.A-C; 8.12 A 

High School Biology: 1 A, 2A, C, D; 4 C-D; 10 A 


High School Health: 115.32.b.2.D, 115.33.c.2.A-B 

CAREER STORY VIDEOS 

Middle School Science: 6.1, 6.2, 6.3, 7.1, 7.2, 7.3 D-E, 7.4B, 7.5, 8.1, 8.2, 8.3D-E, 8.4B, 8.5 

Middle School Health: 7.12.A, 7.12.F, 8.12.A, 8.12.F 

High School Health: 127.12 (3); 12.7.12 (5); 127.12.(6); 127.12 (8) 

Career Orientation: 

Middle School 127.2 (3); 127.2 (5); 127.2 (7) 

High School 127.12 (3); 12.7.12 (5); 127.12.(6); 127.12 (8) 

MINI LAB NOTEBOOK 

Middle School Science: 6.3A-C, 6.4A-B, 7.4A-C, 7.3A-C, 7.4A-B, 8.3A-C, 8.4A-B 

Middle School Health: TEKS provided for individual Classroom Activities 

Career Orientation: 

Middle School 127.2(1); 127.2(2B); 127.2(3); 127.2 (6 A, C, E) 

High School 127.12(1); 127.12(B); 127.12(3); 127.12(6 A, C, E) 



Middle School Science 

Immune 

System 

Cell Chart 

The 

Immune 

System 

versus the 

Pathogens 

Video: 

Staph 

Wars 

HEADS UP The Immune System Infectious Diseases 

Make Your 

Own 

Superbug 

Video: 

Hunting 

the Big 

Fever 

TEKS by Number 

Research 

Poster 

Project 

Who 

Should 

Receive 

the 

Vaccine? 

EIS Case 

Study 

Video: Just 

Another 

Day at the 

BSL4 Lab 

Biological 

Laboratories 

Memory 

Game 

Career 

Story 

Videos 

6.1 A X X X X X X X X 

6.2 A X X X X X X 

6.2 B X X X X X X X X X 

6.2 C X X X X X X X X X 

6.2 D X X X X X X X X X X 

6.3 A X X X 

6.3 B X X 

6.3C X X X X X X X X X 

6.3 D X X 

6.3 E X X 

6.4 A X 

6.4 B X 

6.5 A X X 

6.9 A X X X 

6.9 B X X X 

6.10 X X X X X 

6.11 A X X 

6.11 B X X 

6.12 B X X X 

7.1 A X X X X X X X X X X 


7.2 A X X X X X X 

7.2 B X X X X X 

7.2 C X X X X X X X X 

7.2 D X X X X X X X X X X 

7.2 E X X X 

7.3 A X X 

7.3 B X 

7.3C X X X X X X X 

7.3 D X X X X X 

7.3 E X X X X 

7.4 A X 

7.4 B X X X X 

7.5 A X X X X X X 

7.9 A X X X X X X X X X 


7.10 B X X X X X X X X 

7.11 A X X X X X X X X 

7.11 B X X X X X 

7.12 B X X X 

7.12 C X X X 


8.2 A X X X X X X 

8.2 B X X X X X X 

8.2 C X X X X X X X X X X 

8.2 D X X X X X X X X X X X 

8.3 A X 

8.3 B X 

8.3 C X X X X X 

8.3 D X X X 

8.3 E X X X 

8.4 A X 

8.4 B X X X X X 

8.5 X X X X X 

8.6 X X X X 

8.9 A X 

8.9 B X 

8.10 B X X 

8.11 A X X X 

8.11 B X X 

8.12 B X 

8.12C X 

HEADS UP The Immune System Infectious Diseases © 2008 University of Texas Health Science Center at Houston 

Mini Lab 

Notebook 


Middle School Health 

Immune 

System 

Cell Chart 

The Immune 

System versus 

the Pathogens 

Video: 

Staph 

Wars 

HEADS UP 

The Immune System Infectious Diseases 

Make Your 

Own 

Superbug 


Video: 

Hunting the 

Big Fever 

Research 

Poster 

Project 

Who 

Should 

Receive the 

Vaccine? 

EIS Case 

Study 

Video: Just 

Another 

Day at the 

BSL4 Lab 

6.3 A X X X X X X 

6.3 B X X X 

6.3C X 

Biological 

Laboratories 

Memory Game 



7.3C X X X X X X X X X 

7.12 A X X X X X X 

7.12 B X X X X 

7.12 C X 

7.12 F X 



8.3 C X X X X X X X X X 

8.3 D X X X X X X X 

8.3 E X X X X X 

8.4 A X X 

8.4 B X 


Career 

Story 

Videos 


High School Biology 

Immune 

System 

Cell Chart 


Immune 

System 

versus the 

Pathogens 

Video: 

Staph 

Wars 

HEADS UP 


Make Your 

Own 

Superbug 


Video: 

Hunting the 

Big Fever 

Research 

Poster 

Project 

Who Should 

Receive the 

Vaccine? 

EIS Case 

Study 

Video: Just 

Another Day 

at the BSL4 

Lab 

Biological 

Laboratories 

Memory Game 

1 A X X X X X X X X X X 


2 C X X X X X X X X X X 

2 D X X X X X X X X X X 




High School Health 

Video: 

Staph 

Wars 

Video: 

Hunting the 

Big Fever 

Research 

Poster 

Project 

Who 

Should 

Receive the 

Vaccine? 

EIS Case 

Study 

Video: Just 

Another 

Day at the 

BSL4 Lab 

1 B X 

Biological 

Laboratories 

Memory 

Game 

2 A X X X X X X X 

2 B X X X X X X 

2 C X X X X 

2 D X X X X X 

5 D X 

6A X 

6 B X 

6C X 

6D X 

10 A X X X 

10 B X X X 

10 C X 

127.12 (3) X 

127.12 (5) X 

127.12 (6) X 

127.12 (8) X 


Career 

Stories 

Video 


High School IPC 

Immune 

System 

Cell Chart 


Immune 

System 

versus the 

Pathogens 

Video: 

Staph 

Wars 

HEADS UP 


Make Your 

Own 

Superbug 


Video: 

Hunting the 

Big Fever 

Research 

Poster 

Project 

Who Should 

Receive the 

Vaccine? 

EIS Case 

Study 

Video: Just 

Another Day 

at the BSL4 

Lab 

Biological 

Laboratories 

Memory Game 







Middle School Career Orientation 

Video: 

Hunting the 


Big Fever EIS Case Study Video 

HEADS UP 



Mini Lab 

Notebook 

127.2 (1) X 

127.2 (2B) X 

127.2 (3) X X 

127.2 (5) X 

127.2 (6A) X 

127.2 (6C) X 

127.2 (6E) X 

127.2 (7) X 

127.2 (7B) X 

127.2 (8) X 

127.2 (8A) X 

High School Career Orientation 

Video: 

Hunting the 


Big Fever EIS Case Study Video 

Mini Lab 

Notebook 

127.12 (B) X 

127.12 (1) X 

127.12 (3) X X 

127.12 (5) X 

127.12 (6) X 

127.12 (6A) X 

127.12 (6C) X 

127.12 (6E) X 

127.12 (7B) X 

127.12 (8A) X 

127.12 (8) X X 



HEADS UP 


Timeline 

Component 

Presentation of concepts presented in: 

Estimated Time Location in module Page 

Teacher 411: The Immune System 

Teacher’s discretion Teacher CD 43 

Immune System Glossary 


Distribution of Mini Lab Notebook 

Classroom Activity 



30-40 minutes 

Teacher CD 59 

Unit 1 Content Video: Staph Wars 

15 minutes 

DVD menu 

Unit 1 Video Worksheet 


During video or at 

Teacher’s discretion 

Teacher CD 81 

The Immune System versus The Superbug 

1.5-2 hours 

Teacher CD 84 

Career Story Video 

DVD menu 

Pablo Okhuysen Infectious Disease Researcher 

4 minutes 

Unit 2 Content Video: Hunting the Big Fever: 

Finding and Fighting Infectious Diseases 

25 minutes 

DVD menu 





Teacher CD 105 


2 hours over multiple 

class periods and/or as 

homework 


Career Story Videos 

DVD menu 

Joseph McCormick Epidemiologist/Professor/Dean 

8 minutes 

DVD menu 

Susan Fisher-Hoch Professor of Epidemiology 


3.5 minutes 


90 minutes-1.75 hours 

over two class periods 


Career Story Video 

DVD menu 

Blanca Restrepo Assistant Professor of Epidemiology 

Enrichment Activity 

10 minutes 

EIS Case Study 

1-2 hours over multiple 

class periods and/or as 

homework 


Unit 3 Content Video: Just Another Day at the BSL4 15 minutes 

DVD menu 







Career Story Videos 

45 minutes 


Donald Bouyer Assistant Professor of Pathology 

Michael Holbrook BSL4 Facility Director 

Patrick Newman Pathology Research Associate 

Melissa de la Garza Assistant Veterinarian 

D. Mark Estes Veterinary Immunologist 

Joseph Petrosino Molecular Virology & Microbiology 

Victoria Sutton Center for Biodefense Director 

4.5 minutes 

6.5 minutes 

4 minutes 

8 minutes 

4 minutes 

5.5 minutes 

4 minutes 


DVD 

DVD 

DVD 

DVD 

DVD 

DVD 

DVD 

menu 

menu 

menu 

menu 

menu 

menu 

menu 


HEADS UP The Immune System & Infectious Diseases Flowchart 

PREFACE UNIT 1 UNIT 2 UNIT 3 

TEACHER 411 TEACHER 411 TEACHER 411 TEACHER 411 

• The Immune System • Staphylococcus aureus MRSA • Lassa Fever • Biological Laboratories and 

Biosafety Levels 

CONTENT VIDEO CONTENT VIDEO CONTENT VIDEO CONTENT VIDEO 

• Stay tuned for an update on the 

HEADS UP web site! 

• Staph Wars 

Featured Expert: 

• Infectious Disease Researcher: 

Pablo Okhuysen 

• Hunting the Big Fever: Finding and 

Fighting Infectious Disease 

Featured Experts: 

• Epidemiologist: Joseph McCormick 

• Epidemiologist: Susan Fisher-Hoch 

• Just Another Day at the BSL4 

Featured Experts: 

• Assistant Professor of Pathology: 

Donald Bouyer 

• WRCE Director: David Walker 

• BSL4 Facility Director: 

Michael Holbrook 

• Pathology Research Associate: 

Patrick Newman 

CLASSROOM ACTIVITIES CLASSROOM ACTIVITIES CLASSROOM ACTIVITIES CLASSROOM ACTIVITIES 

• Immune System Cell Chart 

• Video Worksheet 



• The Immune System versus 

• Research Poster Project 

• Biological Laboratories 

The Superbug 

• Who Should Receive the Vaccine? 

• Enrichment Activity: EIS Case Study 

Memory Game 

CAREER STORIES CAREER STORIES CAREER STORIES CAREER STORIES 

• See stories in Units 1, 2, and 3 • Infectious Disease Researcher • Epidemiologist / Professor / Dean • Assistant Professor of Pathology 

• Epidemiologist / Professor 

• BSL4 Facility Director 

• Assistant Professor of Epidemiology • Pathology Research Associate 

• Assistant Veterinarian 

• Veterinary Immunologist 

• Assistant Professor of Microbiology 

• Center for Biodefense Director 

SUPPLEMENTS SUPPLEMENTS SUPPLEMENTS SUPPLEMENTS 

• Immune System Glossary 

• Unit 1 Glossary 



• Illustrations/graphics for 

• Additional Resources document • Teacher 411: Vaccines 

• Additional Resources document 

transparencies 

• Invite a guest speaker (such as local • Teacher 411: HIV/AIDS 

• Invite a guest speaker (such as a 

• Additional Resources document 

health department epidemiologist) • Additional Resources document 

researcher from UTMB) 

ASSESSMENT TOOLS ASSESSMENT TOOLS ASSESSMENT TOOLS ASSESSMENT TOOLS 





• Immune System Cell Chart 

• Make-Your-Own Superbug Sheet • Who Should Receive Vaccine Ballot • Memory Game Cards 

• Mini Lab Notebook 


• Poster Evaluation Rating Sheet • Mini Lab Notebook 

• Released TAKS Questions 


• EIS Case Study Questions 






Health Education And Discovering Science while 

Unlocking Potential 


& Infectious Diseases 

© 2008 University of Texas Health Science Center at Houston 

____________’s 

Lab Notebook 


Preface: The Immune System Preface: The Immune System 

Invaders in the System 

Bacteria are small single-celled organisms. Most 

bacteria in the world are harmless to humans 

and many are even helpful; for example, bacteria 

in our intestines help us digest food. 

However, some bacteria (pathogens) can cause 

disease. Pathogens have characteristic 

“weapons” and “armor” that enhance their ability 

to enter the body, multiply, and exit from the body 

while thwarting the varied protective aspects of 

the immune system. 


Defining the Terms: 

The three terms below are related to the 

bacteria's ability to enter the body and multiply. 

Give a brief description of how each of these 

terms accomplishes this. 

1. Flagella 

2. Biofilm 

3. Toxins 



Immune System Cells 


When an invader attacks the body, the 

immune system attacks using 5 different 

types of cells. In the chart below list the steps 

of attack in order including the cell name and 

function. 

1. 

2. 

3. 

4. 

5. 

Cell Name Function 



On the Defense: 

1. Outer immune defenses: Defenses that act 

as a barrier between the body and pathogens. 

2. Innate Immune defenses: Defenses that are 

activated immediately or within hours of a 

microbe’s entrance into the body, will try to kill 

anything that is foreign (non-specific). 

3. Adaptive Immune Defenses: Defenses that 

respond to specific disease-causing agent that 

get past the outer and early immune defenses, 

makes an “army” of cells specifically designed 

to attack that antigen and produces memory 

cells that can make future responses more 

efficient. 


The immune system has several forms of 

defense to fight disease. For each of 

these terms give and example of how the 

body uses this type of defense to fight 

disease. 

1. Outer Immune Defense: 

2. Innate Immune Defense: 

3. Adaptive Immune Defense 



Layers of the skin 

The skin, which covers the external surface of the body, 

and the mucous membranes, which cover the internal 

surfaces of the body, function as effective barriers against 

the entry of pathogens: 

The skin is comprised of thick layers of cells that cannot 

be penetrated unless wounded 

In the figure to the right, label and identify each item: 

A. 

B. 

C. 

D. 

E. 

F. 

G. 

H. 

I. 


A 

B 

C 

D 

Page 23 of 231 

E 

F 

G 

H 

I

Unit 1: Staph Wars Unit 1: Staph Wars 

Background 

Methicillin Resistant Staphylococcus aureus 

(MRSA) 

In the 1950s, serious staph infections could be 

treated successfully with a variety of antibiotics. 

However, within only a few years, strains resistant 

to penicillin emerged. Over time, S. aureus strains 

in the hospital environment became resistant to 

multiple antibiotics. These strains, known as MRSA 

developed resistance to other B lactam antibiotics, 

such as amoxicillin, methicillin, and oxacillin and to 

other classes of antibiotics as well. 

Microscopic image of MRSA 


Healthcare-Associated versus 

Community-Associated MRSA 

Cases of MRSA infection used to be seen almost 

exclusively in hospitals or nursing homes where 

many individuals have weakened immune systems. 

MRSA is now seen increasingly in the community, 

even among otherwise healthy individuals such as 

athletes and military personnel. 

Record your thoughts: 

Why do you think that MRSA is being found more 

commonly in the community? 


In the blanks below, list several ways that 

MRSA can be transmitted. 

1. 

2. 

3. 

4. 


Modes of Transmission 


Prevention 

Now that you have identified the modes of 

transmission, list several practical ways to 

prevent the spread of MRSA. 

1. 

2. 

3. 

4. 



Develop an action plan: 

Imagine you are a principal of a high school where 

there has been a small outbreak of MRSA. Know that 

you are familiar with the infection and the modes of 

transmission, the school board is asking you to 

develop an action plan to stop the outbreak. You need 

to develop an action plan that you will present to the 

community to determine how the infection is being 

transmitted and what you plan to do to stop it. In the 

outline below briefly list the steps you plan to take: 

I. 

II. 

III. 

IV. 

V. 


Community Presentation: 

In preparing for your community presentation, it will be 

important that you answer several questions that may 

arise during the meeting from community members. 

What steps are you taking to stop the outbreak? 

How is the infection being spread? 

How can we be sure our children are safe at 

school? 

What do we need to do if we suspect our child may 

have MRSA? 


Important Terms 

Term Definition 

Hemorrhagic Loss of blood or other body 

fluids as a result of 

infection from a pathogen, 

Incidence 

Prevalence 

Vaccine 

Zoonotic 

disease 

Unit 2: Hunting the Big Fever: 

Finding & Fighting Infectious Diseases 

usually a virus. 

Rate at which new cases 

of disease infection occur 

over a certain period of 

time. 

Percentage of people that 

have a specific disease at 

a given point in time. 

A weakened, partial, or 

killed version of a 

pathogen which, when 

administered, will induce 

an immunological 

response to disease; 

A disease that can be 

transmitted by animals to 

humans. 


Draw a picture or symbol that could 

represent these terms. 

Hemorrhagic 

Incidence 

Prevalence 

Vaccine 

Zoonotic 

disease 






What is Lassa fever 

and where is it found? 

Lassa fever is an acute viral hemorrhagic 

disease found in parts of Western Africa. It is 

caused by Lassa virus, a single-stranded RNA 

virus belonging to the virus family Arenaviridae. 

The virus is named after the town of Lassa in 

Nigeria where the disease was first identified in 

1969. Lassa fever is usually an endemic 

disease, constantly infecting some portion of 

the population; the greatest concentration of 

cases has been found in Nigeria and in the area 

known as the Manu River Union (Liberia, Sierra 

Leone, Guinea), although cases of disease also 

have been found in neighboring countries such 

as the Ivory Coast, Mali, and Senegal. 




Cases of Lassa Fever 

What is an epidemic? 

What is an endemic? 




How do humans get Lassa virus? 

Lassa fever is a zoonotic disease, an infection 

that normally exists in an animal population and is 

transmitted to humans through contact with the 

animal or materials contaminated by it. The virus 

also can be spread from person-to-person. 

Rodents breed frequently and produce very large 

litters. Although their natural habitat is in 

savannas and forests, the rodents readily live in 

human dwellings and scavenge on human food 

remains, which brings them in contact with 

humans. Once infected, the rodent remains 

infected for life and it continues to shed the virus 

in its urine and droppings. 




Rat-to-human transmission: 

List several ways that Lassa fever can be 

transmitted from rats to humans: 

Human-to-human transmission: 

List several ways that Lassa fever can be 

transmitted from human to humans: 




Exciting Career Stories 

Immunologist: Joseph McCormick 

Epidemiologist: Susan Fisher-Hoch 

Assistant Professor of Epidemiology: 

Blanca Restrepo 




What do you think about 

these careers? 

What is the most interesting aspect of these 

careers to you? 

What kinds of places do you think employ these 

people? 

How are these careers important to health? 




What is a vaccine? 

A vaccine is defined as a suspension of 

attenuated or killed microorganisms (e.g. 

bacteria or viruses), or of antigenic proteins 

derived from them, administered for the 

prevention, amelioration, or treatment of 

infectious diseases. The vaccine can’t cause 

disease in a person, but it will trigger a 

person’s immune system to respond to the 

pathogen. In essence, a vaccine gives the 

immune system a “sneak preview” of the 

pathogen and “educates” it in advance about 

how to defend against it, should the real 

pathogen infect the body in the future. 




In your own words: 

Describe a vaccine: 

Give an example of a vaccine: 

Who gets vaccines and why? 




Test Your Knowledge 

Answer true or false to the following 

statements related to vaccines 

Vaccines will weaken the immune system. 

True False 

Vaccines can give a person the serious disease it 

is supposed to prevent. 

True False 

Vaccines often cause serious side effects. 

True False 

Healthy people don’t need vaccines. 

True False 




Vaccines aren’t effective. 

True False 

I don’t need vaccines for diseases I’ve never 

heard of because people don’t get these 

diseases anymore. 

True False 

I was immunized when I was a baby so I am 

protected for life. 

True False 

I got a flu vaccine last year so I don’t need one 

this year. 

True False 



Breaking down the BSL 

BSL 1 lab 

BSL 2 lab 

Biosafety Level 1 

Laboratory; 

lab in which researchers 

work with microbes that 

are unlikely to cause 

human disease; lowest 

level lab and often used for 

teaching . 

Biosafety Level 2 

Laboratory; 

lab in which researchers 

work with pathogenic 

bacteria and viruses that can 

cause human disease but 

are not easily spread 

through the air; safety 

precautions include gloves, 

lab coat, and biosafety 

cabinet; 

ex: Measles, Salmonella, 

Rabies. 



Draw an illustration of what you think these 

labs might look like or what special features 

they might have: 

BSL 1 Lab 

BSL 2 lab 



Breaking down the BSL 

BSL 3 lab 

BSL 4 lab 

Biosafety Level 3 Laboratory; 

lab in which researchers work 

with pathogenic viruses and 

bacteria that can spread 

through the air and cause 

serious or life threatening 

disease for which there may be 

no treatment or vaccine; safety 

precautions include double pair 

of gloves, protective gowns, 

masks, negative air pressure; 

ex: SARS, Anthrax 


lab in which researchers work 

with some of the most 

infectious pathogens in the 

world, mostly pathogenic 

viruses that can be easily 

spread and have a high 

mortality rate; highest level lab; 

requires well-trained personnel; 

safety precautions include 

airtight room surrounded by 

concrete walls, 

decontamination showers, 

airtight suits, high security; 

ex: Ebola, Lassa Fever 



Draw an illustration of what you think these 

labs might look like or what special features 

they might have: 

BSL 3 Lab 

BSL 4 lab 


Unit 3: Just Another Day at the BSL4 Unit 3: Just Another Day at the BSL4 

Now that you know a little more about the 

BSL, take a look at some of the diseases 

that are handled in the BSL. 

Anthrax 

Ebola 

Influenza 

Measles 

Virus 

Plague 

An infectious usually fatal disease. Can be 

transmitted to humans through contact with 

contaminated animal substances. 

A highly lethal virus that causes massive internal 

bleeding. It is thought that the virus originated in 

central Africa and was passed to humans from 

primates. 

A contagious respiratory illness caused by 

influenza viruses. 

A highly contagious disease that is spread by 

droplets or direct contact with nasal or throat 

secretions of infected persons. 

An infectious disease of animals and humans 

spread a rodent flea that is carrying the plague 

bacterium or by handling an infected animal. 

Rabies A preventable viral disease of mammals most 

Houston at 

often transmitted through the bite of a rabid 

Virus 

animal and affects the central nervous system. 

Center 

Rift Valley (RVF) is an acute, fever-causing viral disease 

that affects domestic animals (such as cattle, 

Fever 

buffalo, sheep, goats, and camels) and humans. 

Science 

RVF is most commonly associated with 

mosquito-borne epidemics during years of 

Health 

unusually heavy rainfall. 

Salmonella A germ is a group of bacteria that can cause 

Texas of 

diarrheal illness in humans. 

Typhus One of several similar diseases caused by louseborne 

bacteria 

University 

A virus is spread by infected mosquitoes, and 

2008 

can cause death.. © 

West Nile 

Virus 

Now, write the name of each of the 

various diseases in the appropriate 

box for the level of safety you think 

is needed to handle that disease. 

BSL 1 BSL 2 

BSL 3 BSL 4 



Working in the Biological Laboratories 

During this unit you learned about 

many different careers in the BSL lab. 

In the space provided, describe what 

you think the responsibilities are in 

each of the different careers. 



Pathologist 

Veterinary Immunologist 

Veterinarian 

BSL4 Director 

Center for Biodefense Director 


Notes Notes 



Notes Notes 



The Immune System: 

HEADS UP 


Mini Lab Notebook ‐ Answer Key 

Defining the Terms: 

The three terms below are related to the bacteria's ability to enter the body and multiply. Give 

a brief description of how each of these terms accomplishes this. 

1. Flagella Help bacteria to swim through the protective mucus that overlies the body’s 

mucous membranes and reach the surface of the mucous membranes. 

2. Biofilm A complex structure adhering to surfaces that are regularly in contact with 

water, consisting of colonies of bacteria and usually other microorganisms such as 

yeasts, fungi, and protozoa that secrete a mucilaginous protective coating in which they 

are encased. 

3. Toxins A chemical substance or poison that can harm the human body; a common 

virulence factor among bacteria and other pathogens. Toxins are released by 

pathogenic bacteria, also kill incoming phagocytic white blood cells. This allows the 

pathogens to escape the phagocytes and multiply in body tissues. 

1. Neutrophil 

Cell Name Function 

Circulate in the blood and are the first to 

“answer the call” when a bacterial pathogen is detected 

in body tissues and the inflammatory response is initiated. 

2. Macrophage The largest of the immune system cells and they migrate 

throughout the body’s tissues. They are the second to “answer the 

call” when bacterial pathogens infect body tissues and the process 

of inflammation begins. 

3. B-Cell Recognize and bind to pathogens that are free floating in the body 

or are “hanging out” in between cells. They are like “special force 

Ninjas” that can identify and bind to extracellular bacteria and 

viruses before they can sneak away. 

4. Natural Killer The primary function of a natural killer cell is to 1) target, 2) dock 

to, and 3) kill body cells that have been invaded by viruses. 

Because they are part of the innate immune system, they will kill 

every cell that has been invaded. 

5. T-Cell Recognize, target and kill body cells that have viruses multiplying 

within them and leave behind memory cells. They are like “special 

force snipers” that can specifically identify and kill cells that have 

been invaded by viruses. 



Preface 

1. Outer Immune Defense: ex. Nasal Passage 

2. Innate Immune Defense: ex. Natural Killer Cells, Neutrophils, Macrophage 

3. Adaptive Immune Defense: ex: T Cells, B Cells 

Unit 1: Staph Wars 

In the blanks below, list several ways 

that MRSA can be transmitted. 

1. Physical Contact 

2. Touching people hands 

3. Exposure to bodily fluids 

A. Tough outer layer of dead 

cells 

B. Epidermis 

C. Dermis 

D. Nerve 

E. Hair Shaft 

F. Sweat Gland 

G. Vein 

H. Artery 

I. Lymph Vessel 

Now that you have identified the 

modes of transmission, list several 

practical ways to prevent the spread 

of MRSA. 

1. Hand Washing 

2. Laundering soiled clothes 

3. Wearing a face mask 

4. Wearing rubber gloves 



Unit 2: Hunting the Big Fever 

What is an epidemic? 

An excessive outbreak of cases of disease that affects more individuals in a community or region than 

normally expected during that period of time. 

What is an endemic? 

Disease that is constantly present in a particular location or population. 

Rat‐to‐human transmission: 

List several ways that Lassa fever can be transmitted from rats to humans: 

Rats shed the virus in urine and droppings. Therefore, the virus can be transmitted through 

direct contact with these materials, through touching objects or eating food contaminated with 

these materials, or through cuts or sores. Because rodents often live in and around homes and 

scavenge on human food remains or poorly stored food, transmission of this sort is common. 

Contact with the virus also may occur when a person inhales tiny particles in the air 

contaminated with rodent excretions. This is called aerosol or airborne transmission. Finally, 

because rodents are sometimes consumed as a food source, infection may occur via direct 

contact when they are caught and prepared for food. 

Human‐to‐human transmission: 

List several ways that Lassa fever can be transmitted from human to humans: 

This type of transmission occurs when a person comes into contact with virus in the blood, 

tissue, secretions, or excretions of an individual infected with the Lassa virus. The virus cannot 

be spread through casual contact (including skin‐to‐skin contact without exchange of body 

fluids). Person‐to‐person transmission is common in both village and health care settings, 

where, along with the above‐mentioned modes of transmission, the virus also may be spread in 

contaminated medical equipment, such as reused needles (nosocomial transmission). 

Source: http://www.cdc.gov/ncidod/dvrd/spb/mnpages/dispages/Fact_Sheets/Lassa_Fever_Fact_Sheet.pdf 

In your own words: 

Describe a vaccine: 

A weakened, partial, or killed version of a pathogen which; when administered, will induce an 

immunological response to disease; gives the immune system a “sneak preview” of the pathogen and 

“educates” the immune system on how to defend itself in advance. 

Give an example of a vaccine: 

Vaccines against flu, measles, cholera, bubonic plague, and hepatitis A. 

Who gets vaccines and why? 

Children are recommended to receive vaccinations as soon as their immune systems are 

sufficiently developed to respond to particular vaccines, with additional 'booster' shots often 

required to achieve 'full immunity'. Besides recommendations for infant vaccinations and 

boosters, many specific vaccines are recommended at other ages or for repeated injections 



throughout life ‐‐ most commonly for measles, tetanus, influenza, and pneumonia. Pregnant 

women are often screened for continued resistance to rubella. The human papilloma virus 

vaccine is currently recommended in the U.S. 

Test Your Knowledge 

Answer true or false to the following statements related to vaccines 

Vaccines will weaken the immune system. False 

Vaccines can give a person the serious disease 

it is supposed to prevent. False 

Vaccines often cause serious side effects. False 

Healthy people don’t need vaccines. False 

Vaccines aren’t effective. False 

I don’t need vaccines for diseases I’ve never heard of because 

people don’t get these diseases anymore. False 

I was immunized when I was a baby so I am protected for life. False 

I got a flu vaccine last year so I don’t need one this year. False 

Unit 3: Just Another Day at the BSL 4 Lab 

Now, write the name of each of the various diseases in the appropriate box for 

the level of safety you think is needed to handle that disease. 

BSL 1 BSL 2 

Influenza Measles 

Salmonella 

Rabies 

Typhus 

SARS 

Anthrax 

Plague 

West Nile Virus 

BSL 3 BSL 4 

Ebola 

Rift Valley Fever 



During this unit you learned about many different careers in the BSL lab. In the 

space provided, describe what you think the responsibilities are in each of the 

different careers. 

Pathologist 

A pathologist is a physician who specializes in diagnosing diseases by examining 

tissue, blood, and body fluids using sophisticated laboratory techniques. Most 

training programs for pathology include 4 years of medical school followed by 5‐6 

years of residency and fellowship training. 

Veterinary Immunologist 

Scientist who studies any aspect of immunology conducted in agricultural and 

companion animals as well as wildlife. 

Veterinarian 

Veterinarians care for the health of pets, livestock, and animals in zoos, 

racetracks, and laboratories. Some veterinarians use their skills to protect humans 

against diseases carried by animals and conduct clinical research on human and 

animal health problems. Others work in basic research, broadening our 

knowledge of animals and medical science, and in applied research, developing 

new ways to use knowledge. 

BSL4 Director 

The laboratory director is responsible for ensuring that, before working with 

organisms at Biosafety Level 4, all personnel demonstrate a high proficiency in 

standard microbiological practices and techniques, and in the special practices 

and operations specific to the laboratory facility. This might include prior 

experience in handling human pathogens or cell cultures, or a specific training 

program provided by the laboratory director or other competent scientist 

proficient in these unique safe microbiological practices and techniques. 

Center for Biodefense Director 

Control and operate the center and oversee ongoing research. 



Teacher 411: The Immune System 

Intended as reference material for teachers and should not be given to students as classroom material. 

Glossary terms indicated in bold. 

Our Immune System Versus the Pathogens 

A healthy immune system depends on the body’s amazing ability to distinguish between what is 

foreign to the body, and what cells are the body’s own. Every cell in the body has molecules on 

the surface that identify the cell as “self” to the body’s immune system. When the body’s 

immune system encounters anything with surface markers that say “foreign” or “not self” the 

immune system quickly launches an attack. Anything that triggers this immune response is 

called an antigen. The immune system can recognize millions of different enemies and it 

produces exactly the right combination of cells to combat each one of them. 

A key characteristic of the immune system is its body-wide communication network. As soon as 

a pathogen enters the body, immune cells respond to the trigger and begin to change and 

produce powerful chemicals. These chemicals allow the immune cells to regulate their own 

growth and behavior, to send out the alarm to other cells in the system to enlist their help in the 

fight, and to direct new recruits to trouble spots. 

The Pathogen Offense 

The body’s immune response depends in part on what type of pathogen it is fighting. There are 

numerous types of pathogens; because bacteria and viruses are the most common types of 

pathogens to cause infections in humans, we will discuss those here. 

Bacteria and viruses are smaller than our body cells. For example, the average human red blood 

cell is 7 micrometers in diameter while bacteria are usually 1 to 10 micrometers in diameter (see 

figure below). These two types of cells can be viewed by light microscopy. Viruses, which 

range in size from 20 to 300 nanometers in diameter, can only be visualized with an electron 

microscope. 

HEADS UP The Immune System & Infectious Diseases © 2008 University of Texas Health Science Center at Houston Page 44 of 231

Bacteria are small singlecelled 

organisms. Most bacteria in 

the world are harmless to 

humans and many are even 

helpful; for example, bacteria in 

our intestines help us digest 

food. However, some bacteria 

(pathogens) can cause disease. 

Bacterial pathogens have 

characteristic “weapons” and 

“armor” (called virulence 

factors) that enhance their 

ability to enter the body, multiply, and exit from the body while thwarting the varied 

defenses of the immune system. A partial list of these virulence factors is included below. 

1. Flagella help bacterial pathogens swim through the protective mucus that overlies the 

body’s mucous membranes and reach the surface of the mucous membranes. 

2. Pili are straight, hair-like structures that extend from the bacterial cell surface. The tip 

of the pilus mediates the attachment of bacteria to the surface of the mucous 

membranes. Once the bacteria are firmly attached, they cannot be swept away in 

mucus and expelled from the body. 

3. Groups of bacteria can bond together on surfaces forming structures known as biofilms 

(e.g. plaque, on teeth). Within these structures, they are more resistant to attack by 

immune cells than individual bacteria. Some scientists estimate that up to 80% of all 

are infections are due to biofilms. Infectious biofilms have contributed to urinary tract 

infections, middle-ear infections, and the formation of dental plaque. 

4. Invasive virulence factors help bacterial pathogens invade across the mucous 

membranes into the tissue space below. For example, pathogens make an enzyme that 

dissolves the tight connections between the cells of the mucous membranes. This 

allows the bacteria to pass between the cells and reach the tissues beneath the mucous 

membranes. 

5. The capsule, an armor-like coating made of polysaccharides or proteins, protects 

bacterial pathogens from being engulfed and digested by the body’s phagocytic white 

blood cells, neutrophils and macrophages. Thus, bacteria with capsules can multiply in 

body tissues, in the very presence of the immune defenders that are designed to “eat 

and kill” them. 

6. Toxins, released by pathogenic bacteria, also kill incoming phagocytic white blood 

cells. This allows the pathogens to escape the phagocytes and multiply in body tissues 

(e.g. the Panton-Valentine exotoxin made by MRSA). 



The process of viral reproduction involves five steps: 

1. enter the body, 

2. attach to and penetrate a host cell, releasing viral 

DNA or RNA, 

3. replicate, making many copies of viral DNA or 

RNA and viral proteins (in an assembly line 

fashion), 

4. assemble progeny viruses (lots of them!) 

5. exit the host cell, often damaging or killing the 

cell in the process 

The progeny viruses then attach to nearby host cells and 

repeat the process. 

Viruses are strands of DNA or RNA wrapped in a 

protein coat; they come in many different configurations 

(examples pictured at left). Because viruses are not cells 

and cannot reproduce independently, they must invade 

our cells and use their cellular machinery in order to 

reproduce. For this reason, viruses are often not 

considered to be living organisms. 

The Immune System Defense 

The immune system is a complex and dynamic system of cells, tissues, and organs distributed 

throughout the body (see diagram on page 4). It includes the skin and mucous membranes, the 

bone marrow, the thymus, the spleen, and the lymphatic system, a network of vessels that allows 

the lymphocytes and other immune cells to circulate throughout the body, looking for and 

responding to foreign invaders. 

Tissues and organs of the immune system operate at three levels to protect us from disease. The 

first two levels are part of the innate (nonspecific) or early immune defenses. Innate immune 

defenses are designed to detect and respond to pathogens immediately. These defenses respond 

within minutes to hours after a pathogen first enters the body. 

1. First level of defenses: The innate defenses at body surfaces act as natural barriers to 

prevent pathogens (disease-causing microbes such as bacteria, viruses, parasites, and 

fungi) that enter the body from invading into deeper body tissues; 



2. Second level of defenses: If pathogens breach the first level of defenses and gain entry 

into host tissues, they meet additional innate defenses designed to recognize and destroy 

them. Important anti-bacterial defenses include phagocytic white blood cells and 

complement (blood proteins delivered to the site of infection by the process of 

inflammation); anti-viral defenses include interferon, natural killer cells, and 

complement. 

3. Third level of defenses: Adaptive (specific) immune defenses (T and B lymphocytes) 

respond later (several days) after a pathogen has entered the body, making a tailor-made 

response to individual structures on the pathogen’s surface. After recognizing and 

binding to these structures, T and B lymphocytes become activated to divide into a clone 

of cells with two different functions: 1) Effector lymphocytes identify, bind to, and 

eliminate the pathogen and 2) Long-lived memory lymphocytes circulate in the body in 

the lymphatic system for years after the pathogen have been destroyed. If the same 

pathogen attacks again, the memory lymphocytes will recognize it, become activated and 

make a faster, more vigorous tailor-made response, to destroy and eliminate it from the 

body. 



First Level of Defenses: Innate Protection at Body Surfaces 

The skin and mucous membranes serve as important first barriers to prevent pathogens that have 

entered the body from invading into deeper body tissues. In order to be successful, pathogens 

must be able to overcome these important superficial defenses. 

The skin, which covers the external surface of the body, and the mucous membranes, which 

cover the internal surfaces of the body, function as effective barriers against the entry of 

pathogens: 

1. The skin (see figure below) is comprised of thick layers of cells that cannot be penetrated 

unless wounded. Oil and sweat released by glands in the skin also make the skin an 

inhospitable environment and discourage the growth of pathogenic microbes. 

2. The mucous membranes (see figure on page 6) line the inner surfaces of the body, 

including the conjunctiva of the eyes, the respiratory tract, the intestinal tract, and genital 

and urinary tracts. They consist of epithelial cells that are covered by thick, sticky mucus 

which effectively traps pathogens and passes them harmlessly out of the body. Chemicals 

in the mucus also kill or inhibit the growth of bacterial pathogens. 



MUCOUS MEMBRANES OF THE INTESTINAL TRACT 

AND A MUCOUS MEMBRANE CROSS SECTION 

Second Level of Defenses: Innate Defenses of Tissue and Blood 

Tissues and Organs of the Immune System 

The bone marrow (see figure at right), located inside of 

the long bones in our body, produces the stem cells that 

mature into all the different types of immune cells. The 

bone marrow is essential to the functioning of the 

immune system, because it constantly produces new 

immune system cells to replace the ones that are worn 

out or used up on a daily basis. The bone marrow also 

is the site where B lymphocytes mature and learn how 

to recognize pathogens. 

The lymphatic system is the immune system’s highway and communication network (refer to 

figure on page 4). Within this system, immune cells encounter and respond to invading 

microbes. It consists of a network of lymph vessels and lymph nodes in which lymphocytes 

circulate; it functions to collect fluids from tissues and to return them to the blood. The lymph 

vessel system looks very similar to the network of arteries and veins found in the circulatory 

system but instead of carrying blood, lymph vessels carry colorless liquid called lymph, which is 

derived from tissue fluids. 

Lymph nodes are stationed strategically throughout the body along the lymph vessels, with 

clusters in the neck, armpits, abdomen, and groin. Lymph nodes contain specialized 

compartments where immune cells congregate and respond to pathogenic microbes. 



The spleen is located on the left side of body between the stomach and diaphragm. It filters 

foreign cells and old red blood cells out of the blood. It also serves as a meeting ground where 

immune cells battle pathogens. Although the spleen is closely associated with the circulatory 

system, it is not essential for life and it can be safely removed if necessary. 

The thymus is located in the chest between the breast bone and heart. T lymphocytes travel from 

the bone marrow to the thymus where they mature and learn how to recognize pathogens. 

Cells of the Immune System 

There are numerous types of immune system cells, and we will discuss five of these types 

(see figures below), in two groups: the cells that take part in the innate/early immune defenses, 

and those that take part in the adaptive/late immune defenses. 

IMMUNE SYSTEM CELLS 

IMMUNE SYSTEM CELLS (CARICATURES) 



Cells Participating in the Innate/Early Immune Defenses 

For Bacteria: 

Phagocytes are large white blood cells that can engulf, kill and digest any kind of foreign 

particle or pathogen. As part of the innate or early immune defenses, they make a quick 

response, usually within hours of invasion. We discuss here two major types of phagocytes: the 

neutrophils and macrophages, both of which are important defenses against bacterial pathogens. 

For Viruses: 

Neutrophils circulate in the 

blood and are the first to 

“answer the call” when a 

bacterial pathogen is detected 

in body tissues and the 

inflammatory response is 

initiated. They are “called out” 

of the bloodstream and migrate 

into the infected tissues to “eat 

and kill” the pathogens. 

“Send in the Marines!” 

Macrophages 

are the largest of the immune 

system cells and they migrate 

throughout the body’s tissues. 

They are the second to “answer 

the call” when bacterial 

pathogens infect body tissues 

and the process of inflammation 

begins. Macrophages are like 

“Army Drill Sergeants” when it 

comes to attacking pathogens! 

Natural Killer Cell 

The primary function of a natural 

killer cell is to 1) target, 2) dock 

to, and 3) kill body cells that have 

been invaded by viruses. 

Because they are part of the 

innate immune system, they 

will kill every cell that has been 

invaded. Natural Killer Cells are 

like highly trained “Navy Seals” 

with a “natural instinct” for killing 

virus-infected cells. 



Third level of defenses: Adaptive (specific) immune defenses 

Lymphocytes are “strategic special forces” that travel around the body in the lymphatic system, 

and when they meet a pathogen, will clone themselves to form a large, effective “army” to defeat 

the pathogen, leaving behind memory cells to “remember” the pathogen in the future. 

Lymphocytes are part of adaptive or late immune defenses and their major function is to target 

and make a tailor-made response to specific pathogens that survive the innate/early immune 

defenses. They are able to make tailor-made response to invading microbes because they have 

specific recognition molecules on their surfaces. Lymphocytes begin to respond within 3-5 days 

after the pathogen has entered the body and make a peak response within two weeks. If the 

identical pathogen enters the body again in the future, the long-lived memory lymphocytes that 

are left behind to circulate in the lymphatic system, will recognize it and make a faster and 

stronger immune response to quickly defeat the pathogen and vanquish it from the body. 

There are two types of lymphocytes, T cells and B cells. T cells come in two varieties: 

Helper T cells and Cytotoxic T cells (a.k.a. Cytolytic T lymphocytes or “Killer” T cells). 

Cytotoxic T cells recognize, target and kill body cells that have viruses multiplying within them 

and leave behind memory cells. They are like “special force snipers” that can specifically 

identify and kill cells that have been invaded by viruses. The memory cells left behind 

remember the virus and will respond more quickly and vigorously if it invades body cells in the 

future. 

Cytotoxic T cells recognize 

and target host cells that 

have pathogens multiplying 

within them. They are like 

“special force snipers” 

that can specifically identify 

and kill cells that have been 

invaded by viruses. 

B cells recognize and bind to pathogens that are free floating in the body or are “hanging out” in 

between cells. They are like “special force Ninjas” that can identify and bind to extracellular 

bacteria and viruses before they can sneak away. After binding to the pathogens, B cells become 

activated, dividing into a clone of antibody-producing cells, called plasma cells and leaving 

behind memory B cells. Plasma cells secrete antibodies which bind to and effectively coat the 

pathogens. Such coated, or opsonized, pathogens are more easily “eaten” by the phagocytic 

cells, the neutrophils and macrophages, than are uncoated pathogens. The net result is efficient 

elimination of pathogens from the body! The memory B cells left behind will respond more 

quickly and vigorously should the same bacteria or virus enter the body in the future. 



B cells recognize and 

bind to pathogens that are 

free floating in the body or 

are “hanging out” in between 

cells. They are like 

“special force Ninjas” 

that can identify and bind to 

extracellular bacteria and 

viruses before they can 

sneak away. 

The Immune System in Action: Two Stages in the Defensive Reaction 

Innate Immune Defenses- Early Responses to Pathogens 

If a pathogen successfully breaches the defenses at body surfaces, they meet a second level of 

innate immune defenses stationed in body tissues and in the blood. Different strategies are used 

by these innate defenses to fight bacterial vs viral pathogens. 

Fighting Bacteria: 

1. Phagocytosis 

It is the job of the phagocytic white blood 

cells, the neutrophils and macrophages, to 

engulf bacterial pathogens, digest and kill 

them. 

The steps in this process are illustrated in the 

diagram on the right: 

1) bacteria are engulfed and taken into 

a phagosome; 

2) the phagosome fuses with a lysosome, 

which contains “killing chemicals”; 

3) the bacteria are digested and; and 

4) the debris is exocytosed from the cell. 

Phagocytosis is easy to spot because pus is the 

result of the battle between the phagocytes and 

bacterial pathogens. 

PHAGOCYTOSIS 

PHAGOCYTOSIS 

(CARICATURE) 



2. Inflammation is a response that the body makes to injury and to the introduction of 

pathogens into the tissue. It is easy to identify because of its characteristic symptoms: 

redness, heat, swelling, and pain at the site of injury (see diagram on following page). These 

symptoms indicate that the body is responding to presence of pathogenic bacteria in the 

tissue by mobilizing blood proteins (called complement) and phagocytic white blood cells 

from the blood stream and delivering them to the site of infection. 

The diagram below illustrates the major events that occur in the inflammatory response: 

1) Vasodilation - an increase in the diameter of the small blood vessels near the site of 

the infection to increase the blood flow to the injured area; 

2) Vasopermeability - an increase in the permeability of these blood vessels which 

allows complement and other blood proteins (see below) to leak into the infected 

tissues 

3) Emigration of phagocytes - movement of the phagocytes (first neutrophils and then 

macrophages) from the blood vessels into the tissues 

3) Phagocytosis - migration of the phagocytes to the site of the infection to “eat and kill” 

the bacteria 

4) Resolution of the response with repair of the damaged tissue (not pictured) 

The Inflammatory Process 

delivers blood proteins (including complement) and phagocytic 

white blood cells to the site of the infection to engulf and 

destroy bacterial pathogens! 



3. Complement (see figure below) is a set of 20 proteins, synthesized in the liver, that 

circulate in the blood and are delivered to the site of infected tissues through the process 

of inflammation. When activated, they combine with one another to attack the pathogen 

by: 

a. Opsonization: coating the pathogen so they are more easily phagocytosed by 

phagocytic white cells; 

b. Forming the Membrane Attack Complex (MAC attack!): poking holes in a 

pathogen’s membranes, which causes them to lyse. 



Fighting Viruses: 

The process of inflammation, so important in the defense against bacterial pathogens, is much 

less important in the body’s defenses against viruses. Rather, interferon and natural killer 

cells are the innate immune defenses the body uses to limit the growth of viruses and to destroy 

virus-infected cells. Complement proteins (discussed above) also participate in the destruction 

of viruses. 

Interferons (figure below) are proteins produced by cells that have been invaded by a virus. 

They are made by the cell within hours after a virus enters and begins to multiply. Interferons 

are released from the infected cell and they attach to the surface of healthy cells nearby, alerting 

them that a virus is in the area. If the healthy cell is subsequently infected with a virus, it 

produces antiviral proteins that “interfere with” and stop the multiplication of the virus inside 

the cell. 

INTERFERONS & INTERFERON CARICATURE 



Natural Killer Cells also act quickly to defend the host against viruses. They can “naturally” 

recognize body cells that have been infected by viruses and target them for destruction. They 

are able to kill virus-infected cells by sending into the cell a signal for “self-destruction,” a 

process known as apoptosis (see figure below). 

Apoptosis of a virus-infected cell 

the result of signals sent into the 

cell by a Natural Killer Cell 

Adaptive Immune Defenses – Late Responses to Pathogens 

If a pathogen survives the first and second level of innate defenses, then the adaptive (specific) 

immune defenses are activated to make a late response to stop the pathogen in its tracks! These 

immune defenses respond within days (rather than hours) following the entry of a pathogen into 

the body and peak within two weeks. T and B lymphocytes mediate adaptive immunity. Once 

activated, these amazing cells make a tailor-made response to individual pathogens that destroys 

them, whether they are inside or outside of body cells. During these responses, long-lived 

memory T and B lymphocytes are left behind to circulate in the lymphatic system for years. If 

the same pathogen enters the body in the future, the memory lymphocytes respond more quickly 

and vigorously to eliminate it from the body. The specific targeting of individual pathogens and 

immunological “memory” are two hallmarks of the adaptive immune defenses. 

There are two varieties of adaptive immune defenses: humoral (antibody-mediated) and 

cell-mediated. Different types of adaptive responses are needed so that the immune system can 

effectively target microbes that are “outside” and “inside” of body cells. 

Cell-Mediated Immunity is mediated by two types of T lymphocytes: 

Helper T cells and Cytotoxic T cells. 



Helper T cells recognize pieces of the pathogen that are “presented” to them by dendritic cells, 

specialized antigen presenting cells. After binding to the pieces of the pathogen and to the 

specialized proteins (MHC proteins) that display them on the surface of the dendritic cell, an 

individual T helper cell is activated to divide into a clone of “activated” T helper cells and 

memory T helper cells. “Activated” T helper cells orchestrate both humoral and cell-mediated 

immune responses by sending cytokine “cell signaling” molecules to B cells and to 

macrophages, telling them to “get activated” and respond to the pathogens they have 

encountered. The memory T helper cells which are left behind circulate for years in the body 

and will orchestrate a faster and stronger response if the same pathogen invades the body in the 

future. 

A Cytotoxic T Cell 

recognizes, binds to and 

destroys a virus-infected cell 

via apoptosis. 

Cytotoxic T cells (a.k.a. Cytolytic T lymphocytes and “Killer” T cells) recognize, dock with, 

and kill virus-infected cells, in a similar fashion to Natural Killer Cells. However, unlike Natural 

Killer Cells which have no memory of the pathogens they meet, when cytotoxic T cells are 

activated, they divide into a clone of effector cells that destroy virus-infected cells (via 

apoptosis) and leave behind memory cytotoxic T cells. The latter will respond more quickly 

and vigorously when the same virus infects a body cell in the future. 



Humoral (Antibody-mediated) Immunity targets pathogens that are “free floating” in the body 

and are living outside of cells. Humoral immunity, led by B cells, involves several steps. 

1. A B cell binds to a specific bacterial or viral pathogen floating in the body. 

2. The B cell receives a cytokine signal from an “activated” helper T cell that also has 

encountered the same pathogen. The cytokine signal tells the B cell to “get activated” and to 

divide into a clone of antibody- producing B cells (called plasma cells) and memory B cells. 

3. Plasma cells produce and release huge quantities of antibodies--proteins that recognize and 

bind to the free floating pathogens. 

4. Antibodies act in several different ways (diagram at right). 

a. Antibodies bind directly to pathogens, opsonizing 

(coating) them so that they can readily be phagocytosed 

and destroyed by the phagocytic white blood cells, the 

neutrophils and macrophages. 

b. Antibodies bound to the surface of pathogens also 

activate the complement system, which in turn, 

1) opsonizes the pathogen with complement proteins 

(making them easier to phagocytose) and 2) lyses them 

via the membrane attack complex. 

c. Once pathogens are coated with antibodies, they are 

effectively “neutralized” and can no longer bind to 

healthy body cells. 

5. The memory B cells left behind in the body will continue to circulate and will respond to the 

same pathogen more vigorously and quickly if they encounters it again in the future. 

Memory B cells “remember” the specific pathogen they were exposed to. A memory B cell 

is like a fingerprint card in the computerized FBI national fingerprint data bank. If that 

pathogen enters the body again, the body can search the data bank of memory B cells, 

quickly identify a nasty culprit, and mount a large and fast immune response to quickly 

defeat the intruder. 

Sources: 

Edited by Leanne Field, PhD, The University of Texas at Austin. 

Field, Leanne (2007). Course packet for Biology 226T: General Microbiology: Virology, Immunology, and Host-Microbial Interactions. The University of Texas at Austin. 

Field, Leanne (2006). Course packet for Biology 361: Human Infectious Diseases. The University of Texas at Austin. 

Mims, Cedric (2000). The War Within Us – Everyman’s Guide to Infection and Immunity. 

U.S. Department of Health and Human Services, National Institutes of Health, Understanding the Immune System: How It Works. NIH Publication No. 03-5423, Sept. 2003. 



Time: 30-40 minutes 

Classroom Activity: 


TEKS: Middle School Science: 

6.1 A, 6.2 B-D, 6.3 C, 6.10 

7.1A-B, 7.2C-D, 7.3C, 7.5A, 7.9A-B, 7.10B, 7.11A-B 

8.1A, 8.2C-D, 8.3C, 8.6 

Middle School Health: 6.3B, 7.3 A-C, 8.3 A-C 

High School Biology: 1A, 2A, C-D, 4C-D, 10A 

High School IPC: 1A, 2A, C-D 

Objective 

Familiarize students with the structure and function of the main types of immune system cells 

Overview 

Students working individually or in groups draw and/or color different immunological cells and 

create a chart a chart outlining the function of each 

Materials Needed 

o Colored pencils 

o Transparencies of “Immune System Cells,” “Immune System Cell Characters,” and 

“Immune System Cells Chart – Example” sheets 

o Copies of the “Immune System Cells Chart” for each student or group 

o Optional: Post images/sheets on the board or project with a computer and LCD 

o Optional: Glue and scissors if using cotton balls, yarn, beads, etc. to enhance drawings 

Preparation 

1. Review “Teacher 411: The Immune System” 

2. Read activity Presentation steps and related documents. 

3. Prepare materials needed and gather supplies. 

Presentation 

1. Explain to students that there are many types of immune system cells and that they 

will be learning about five of these types (refer to “Immune System Cells” sheet). 

2. These five types of immune system cells can be divided into two groups: the cells that take part in the 

innate/early immune defenses and those that take part in the adaptive/late immune defenses. The 

function of all of these cells is to eliminate pathogens from the body! 

3. Each type of cell performs a specific function: 

Neutrophils are phagocytic cells that circulate in the blood and tissues and are the first to “answer the 

call” when a bacterial pathogen is detected in body tissues and the process of inflammation begins. 

Their function is to “eat and kill” bacteria and to eliminate them from the body. 

Macrophages, the second type of phagocytic cells, are the largest of the immune system cells and 

they migrate throughout the body’s tissues. They are the second to “answer the call” when a bacterial 

pathogen is detected in body tissues and inflammation occurs. Their function is to “eat and kill” the 

pathogens and eliminate them from the body. 



Both neutrophils and macrophages are part of the innate immune/early immune defenses and they are 

designed to eliminate bacterial pathogens within minutes to hours of their entry into the body! 

4. Natural Killer Cells find and destroy body cells that have been invaded by viruses. As part of the 

innate immune system, they also respond within hours after viruses enter the body. 

Cytotoxic T cells also recognize and target body cells that are infected with viruses in a similar 

fashion to Natural Killer Cells. As part of the adaptive or late immune defenses, cytotoxic T cells 

make a delayed but tailor-made response that begins days after the viruses enter the body. Unlike 

Natural Killer Cells, which have no memory of the pathogens they meet, when cytotoxic T cells 

respond, they divide into a clone of cells that destroy the virus-infected cells and leave behind 

memory cytotoxic T cells. The long-lived memory cells circulate in the body for years and respond 

more quickly and vigorously should the same virus infects a body cell in the future. 

5. B cells, also part of the adaptive or late immune defenses, make a delayed by tailor-made response to 

both bacterial and viral pathogens that are “hanging out” between cells. After binding to the 

pathogens, B cells become activated, dividing into a clone of antibody-producing cells, called plasma 

cells, and leaving behind memory B cells. The antibodies secreted by the plasma cells bind to and 

effectively “coat” the pathogens. Such coated pathogens are more easily “eaten” by the phagocytic 

cells, the neutrophils and macrophages, than are uncoated pathogens. The net result is elimination of 

pathogens from the body! The long-lived memory cells circulate in the body for years and respond 

more quickly and vigorously should the same bacterial or viral pathogen enter the body in the future. 

6. To remember the different types of cells and their functions, it might help to think of them as different 

“characters” (refer to “Immune System Cell Characters” sheet). 

Think of “Send in the Marines!” for Neutrophils. Remember, they are the first to “answer the call” 

when a bacterial pathogen is detected and the process of inflammation begins. 

They may seem slow because of their large size, but Macrophages are like “Army Drill Sergeants” 

when it comes to attacking pathogens! Remember, they are the second to “answer the call” when 

bacterial pathogens infect body tissues and the process of inflammation begins. 

Natural Killer Cells are like highly trained “Navy Seals” with a “natural instinct” for detecting 

(finding) body cells that have been invaded by viruses. They 1) target, 2) dock to, and 3) kill virusinfected 

cells, eliminating the pathogen from the body. 

Cytotoxic T cells are like “Special Force Snipers” that can specifically target and destroy cells 

invaded by viruses and leave behind memory cells to remember the pathogen in the future. 

B cells are like “Special Force Ninjas” that can bind to pathogens before they can sneak away. Once 

activated, they produce antibody which binds to and coats pathogens, making them more easily 

“eaten” by the phagocytic cells, the neutrophils and macrophages. The memory B cells left behind 

remember the pathogen in the future. 

7. Instruct students to fill in the chart with pictures of the five immune system cells, 

their names, and main function (refer to “Immune System Cell Chart – Example”) 

8. Once students have had an opportunity to work on the chart, review answers together 

as a class or collect as a homework assignment. 

____________________________________________________________________________________________________________________________________________________________ 

Sources: 

Edited by Leanne Field, PhD, The University of Texas at Austin 

Concept by Melanie Mowry, MPH, The University of Texas Health Science Center at Houston 



Immune System Cells 

Neutrophil: first to “answer the call” 

Macrophage: largest immune system cell 

Natural Killer: find and destroy virus-infected cells 

Cytotoxic T Cell: find and destroy virus-infected cells; 

memory cytotoxic T cells left behind remember the pathogen in 

the future and make a fast response! 

B Cell: respond to viruses and bacteria “hanging out” between 

cells, coating them with antibody so that neutrophils and 

macrophages can easily “eat” them; memory B cells left behind 

remember the pathogen in the future and make a fast response! 



Immune System Cell 

Characters 

Neutrophil = Send in the “Marines!” 

Macrophage = “Drill Sergeants” 

Natural Killer = “Navy Seals” 

Cytotoxic T-Cell = “Special Force Snipers” 

B-Cell = “Special Force Ninjas” 



Immune System Cell Chart – Example 

PICTURE OF CELL CELL NAME CELL FUNCTION 

Neutrophil 


first to answer 

to invading pathogen 


Student Name _________________________ 





Immune System Cell Chart – Answer Sheet 


Neutrophil 

Macrophage 

Natural Killer Cells 

Cytotoxic 

T Cell 

B Cell 


first to 

“answer the call” 

largest immune system cell 

find and destroy virusinfected 

cells 

find and destroy 

virus-infected cells; 

memory Cytotoxic T cells 

left behind remember the 

pathogen in the future and 

make a fast response! 

respond to viruses and 

bacteria “hanging out” 

between cells, coating them 

with antibody so that 

neutrophils and 

macrophages can easily 

“eat” them; memory B cells 

left behind remember the 

pathogen in the future and 

make a fast response! 


HEADS UP 


Glossary of Terms for Teacher 411: The Immune System 

Term Definition Illustration 

“Activated” T 

Helper Cells 

Adaptive 

(Specific/Late) 

Immune Defenses 

Antibodies 

Antigen 

Orchestrate both humoral and 

cell-mediated immune responses 

by sending cytokine “cell 

signaling” molecules to B cells 

and to macrophages, telling 

them to “get activated” and 

respond to the pathogens they 

have encountered. 

Defenses that respond when 

pathogens get past the first and 

second levels of the innate 

immune defenses. The T and B 

lymphocytes that comprise the 

adaptive immune defenses make 

tailor-made responses directed 

against specific pathogens. 

Once activated, T and B cells 1) 

form clones of cells to eliminate 

the pathogen and 2) leave behind 

memory cells that make future 

responses more efficient. 

Y-shaped proteins produced by 

activated B cells (plasma cells). 

Secreted antibodies bind to 

specific pathogens targeting 

them for elimination by 

phagocytic white blood cells or 

complement proteins. 

A foreign substance that 

stimulates the adaptive immune 

system. 



Term 

Apoptosis 

Definition 

Illustration 

B Cells 

Bacterium (Bacteria) 

Biofilm 

Programmed cell death or “cellsuicide”; 

the method used by the 

immune system to destroy virusinfected 

cells. 

Mediate humoral immunity. B 

cells recognize and bind to 

extracellular pathogens that are 

free floating in the body or are 

“hanging out” in between cells. 

After binding, they are activated 

to form a clone of effector cells 

(plasma cells) that produce 

antibody and memory cells. The 

antibody coats the pathogens 

targeting them for destruction by 

phagocytes or complement 

proteins. 

A small, single-celled 

microscopic organism; some can 

cause disease. 

A complex structure adhering to 

surfaces that are regularly in 

contact with water, consisting of 

bacteria and sometimes other 

microorganisms such as yeasts, 

fungi, and protozoa that secrete 

a mucilaginous protective 

coating in which they are 

encased. 



Term 

Bone marrow 

Definition 

Illustration 

Capsule 

Cell-Mediated 

Immunity 

Complement 

Found inside of the long bones 

of the body; stem cells in the 

bone marrow produce the 

“formed elements” of the blood: 

white blood cells, red blood cells 

and platelets. 

An armor-like coating made of 

polysaccharides or proteins that 

protect the bacteria from being 

engulfed and digested by the 

body’s phagocytic white blood 

cells, neutrophils, and 

macrophages. 

An adaptive immune response 

mediated by T cells; responds to 

and destroys pathogens that live 

inside cells. 

20 proteins, synthesized in the 

liver, that circulate in the blood 

and are delivered to the site of 

infected tissues through the 

process of inflammation. 



Term 

Cytotoxic T-cell 

Definition Illustration 

Early immune 

defenses 

Emigration of 

phagocytes 

Flagella 

Recognize, target and kill body 

cells that have viruses 

multiplying within them and 

leave behind memory cells. 

See innate immune defenses. 

Movement of the phagocytes 

(first neutrophils and then 

macrophages) from the blood 

vessels into the tissues during 

the process of inflammation.. 

A structure that helps bacteria to 

swim through the protective 

mucus that overlies the body’s 

mucous membranes and reach 

the surface of the mucous 

membranes. 



Term 

Humoral immunity 


Immune system 

Inflammation 

Inflammatory 

Process 

An adaptive immune response 

mediated by B cells and 

antibody; protects against 

extracellular pathogens that are 

“free floating” in the body. 

A complex and dynamic system 

of cells, tissues, and organs 

distributed throughout the body. 

It includes the skin and mucous 

membranes, the bone marrow, 

the thymus, the spleen, and the 

lymphatic system, a network of 

vessels that allows the 

lymphocytes and other immune 

cells to circulate throughout the 

body, to enable them to find and 

respond to foreign invaders. 

The body’s response to injury 

and to the introduction of 

pathogens into tissue; designed 

to deliver phagocytic cells and 

blood proteins (including 

complement) from the blood 

stream to infected tissues. It is 

easy to identify because of 

characteristic symptoms: 

redness, heat, swelling, and pain 

at the site of injury. 

Delivers blood proteins 

(including complement) and 

phagocytic white blood cells to 

the site of the infection to engulf 

and destroy bacterial pathogens 




Innate 

(Nonspecific/Early) 


Interferon 

Invasive virulence 

factors 

Late immune 

defenses 

Defenses found at body surfaces 

and in tissue and blood; 

designed to quickly eliminate 

pathogens within hours of the 

time they enter the body; do not 

exhibit immunological memory. 

Proteins produced by cells that 

have been invaded by viruses. 

Interferons are made by cells 

within hours after a virus enters 

and begins to multiply. They are 

released from infected cells and 

attach to the surface of healthy 

cells nearby, causing them to 

produce antiviral proteins which 

will protect them should a new 

virus enter the cell. 

Help bacterial pathogens invade 

across the mucous membranes 

into the tissue space below. For 

example, pathogens make an 

enzyme that dissolves the tight 

connections between the cells of 

the mucous membranes. This 

allows the bacteria to pass 

between the cells and reach the 

tissues beneath the mucous 

membranes. 

See adaptive immune defenses. 



Term 

Lymph node 


Lymph vessels 

Lymphatic System 

Lymphocytes 

Immune system organs which 

serve to filter foreign antigens 

and to provide a location where 

pathogens can interact with T 

and B lymphocytes; will swell in 

response to infection. 

The immune system’s network 

of tubes which carry lymph, 

immune cells, and pathogens; 

ultimately joins to the blood 

stream at the thoracic duct. 

Network of lymph vessels and 

nodes in which lymphocytes 

circulate; functions to collect 

fluids from tissues and to return 

them to the blood. 

Lymphocytes are part of 

adaptive or late immune 

defenses and their major 

function is to target and make a 

tailor-made response to specific 

pathogens that survive the 

innate/early immune defenses. 

They are able to make tailormade 

response to invading 

microbes because they have 

specific recognition molecules 

on their surfaces. 



Term 

Macrophage 

Definition 

Illustration 

Membrane Attack 

Complex 

Memory B-cell 

“Memory” T Helper 

Cells 

The largest of the immune 

system cells that migrate 

throughout the body’s tissues. 

They are the second to “answer 

the call” when bacterial 

pathogens infect body tissues 

and the process of inflammation 

begins. 

Complement proteins that 

assemble in the outer membrane 

of bacteria and the envelopes of 

viruses forming pores that cause 

the pathogens to lyse. 

Memory B cells are 

lymphocytes that are left behind 

to circulate in the body for years 

after a primary humoral immune 

response has been made to an 

extracellular pathogen. Should 

the same pathogen enter the 

body again, these cells will 

quickly recognize and respond 

to the invader, making a stronger 

and vigorous secondary immune 

response to quickly eliminate it 

from the body. 

Memory T helper cells are 

lymphocytes that are left behind 

to circulate in the body for years 

after a primary immune response 

has been made. They circulate 

for years in the body and will 

orchestrate a faster and stronger 

response if the same pathogen 

invades the body in the future. 



Term 

Mucous membranes 

Definition 

Illustration 

Natural killer cell 

Neutrophil 

Nonspecific immune 

system 

Epithelial cells which line the 

internal surfaces of the body and 

act as barriers to prevent 

microbes from reaching deeper 

body tissues; the first level of 

defenses against pathogens; part 

of innate immunity. 

An innate immune cell 

important in antiviral defenses. 

The primary function of a 

natural killer cell is to 1) target, 

2) dock to, and 3) kill body cells 

that have been invaded by 

viruses. 

Phagocytic white blood cells 

that circulate in the blood and 

are the first to “answer the call” 

when a bacterial pathogen is 

detected 

in body tissues and the 

inflammatory response is 

initiated. 




Term 

Opsonization 


Outer immune 

defenses 

Pathogen 

Phagocytes 

Coating of pathogens with 

antibody or complement 

proteins to render them more 

easily phagocytosed by 

phagocytic white cells. 

Defenses that act as a barrier 

between the body and 

pathogens, includes skin and 

mucous membranes. 

A disease causing 

microorganism. 

Large white blood cells that can 

engulf, kill and digest 

pathogenic microorganisms. As 

part of the innate or early 

immune defenses, they make a 

quick response, usually within 

hours of invasion. 



Term 

Phagocytosis 

Definition 

Illustration 

Pili 

Resolution 

Skin 

Process by which white blood 

cells defeat invaders by 

engulfing, killing and 

“digesting” them. 

Straight, hair-like structures that 

extend from the bacterial cell 

surface. The tip of the pilus 

mediates the attachment of 

bacteria to the surface of the 

mucous membranes. Once the 

bacteria are firmly attached, they 

cannot be swept away in mucus 

and expelled from the body. 

Repair of damaged tissue 

Thick layer of cells which cover 

the body and cannot be 

penetrated by a pathogen unless 

wounded; contains oil and sweat 

glands; provides the first level of 

external defenses against 

pathogens; part of the innate 

immune system. 




Specific immune 

system 


Spleen 

Thymus 

Toxin 

Immune system organ which 

filters the blood, removing 

pathogens old red blood cells; 

located on left side of body 

between the stomach and 

diaphragm. 

Immune system organ which 

“teaches” T-cells how to fight 

pathogens; located in chest 

between breast bone and heart. 

A chemical substance or poison 

that can harm the human body; a 

common virulence factor among 

pathogenic bacteria. Exotoxins 

released by pathogenic bacteria 

kill body cells and also 

incoming phagocytic white 

blood cells. This allows the 

pathogens to escape the 

phagocytes and multiply in body 

tissues. 



Term 

Vasodilation 


Vasopermeability 

Virus 

The first event that occurs in the 

inflammatory process; an 

increase in the diameter of the 

small blood vessels near the site 

of the infection to increase the 

blood flow to the injured area. 

The second event that occurs in 

the inflammatory process; an 

increase in the permeability of 

these blood vessels which allows 

complement and other blood 

proteins (see below) to leak into 

the infected tissues. 

Extremely small, infectious 

agent which is obliged to 

replicate within a host cell. 

____________________________________________________________________________________________________________________ 

Sources: 

Field, Leanne (2007). Course packet for Biology 226T: General Microbiology: Virology, Immunology, and Host-Microbial Interactions. 

The University of Texas at Austin. 


Centers for Disease Control and Prevention web site: www.cdc.gov 

www.dictionary.com 



Teacher 411: Staphylococcus aureus and MRSA 



Staphylococcus aureus (S. aureus) 

Staphylococcus aureus is a bacterium with a spherical shape and a tendency to cluster. This 

characteristic is reflected in the genus name (Latin: bunch of grapes.). On laboratory media, S. 

aureus grows as golden-colored colonies, hence the species name (Latin: golden). Commonly 

referred to as “staph”, this microorganism naturally colonizes the skin and the noses of 25-30% 

of the U.S. population, without causing symptoms. 

However, S. aureus can be a dangerous pathogen, causing both suppurative (pus-forming) and 

toxigenic diseases. This microorganism causes 70% of skin and soft tissue infections, including 

pimples and boils, impetigo (crusted skin lesions), blepharitis (an eyelid infection), and cellulitis 

(a deeper infection of soft tissues). Some strains of S. aureus can cause exotoxin-mediated 

disease such as Staphylococcal Scalded Skin Syndrome (a childhood disease in which the skin 

peels off when just lightly touched) and Toxic Shock Syndrome (a disease most associated with 

women who use highly absorbent intravaginal tampons). This pathogen also may cause very 

serious infections when it invades surgical wounds, the bloodstream, or the lungs. 

S. aureus has numerous virulence factors that allow it to successfully thwart the body’s 

immune defenses. For example, Protein A, on the surface of the bacterium, disables antibodies 

by binding them upside-down. This not only renders the antibodies useless but it also cloaks the 

bacterium in antibodies, hiding it from cells of the innate (nonspecific) and adaptive (specific) 

immune system. 

This pathogen also produces several different types of exotoxins that can damage body cells, 

including immune system cells. 

Methicillin Resistant Staphylococcus aureus (MRSA) 

In the 1950s, serious staph infections could be treated successfully with a variety of antibiotics. 

However, within only a few years, strains resistant to penicillin emerged. Over time, S. aureus 

strains in the hospital environment became resistant to multiple antibiotics. These strains, known 

as MRSA (Fig 1.1) developed resistance to other Β lactam antibiotics, such as amoxicillin, 

methicillin, and oxacillin and to other classes of antibiotics as well. 

Figure 1.1. Microscopic image of MRSA 

Images from Public Health Image Library, Centers for Disease Control and Prevention 


Figure 1.2.MRSA skin lesion 


Transmission of MRSA 

S. aureus and MRSA are transmitted by: 

• direct skin-to-skin contact 

• contact with fomites or objects such as towels, clothing, or work-out equipment or other 

surfaces that can harbor MRSA 

• close contact in crowded living conditions with a person who has MRSA 

• poor hygiene in caring for and covering an infected wound 

Healthcare-Associated versus Community-Associated MRSA 

Cases of MRSA infection used to be seen almost exclusively in hospitals or nursing homes 

where many individuals have weakened immune systems. MRSA is now seen increasingly in 

the community, even among otherwise healthy individuals such as athletes and military 

personnel. In 2005, 85% of MRSA cases were healthcare-associated; 14% were communityassociated, 

and approximately 1% of the U.S. population is colonized by MRSA. 

Healthcare-Associated MRSA typically infects older, hospitalized individuals, many of whom 

have underlying health issues. Patients with this form are MRSA may have a variety of disease 

manifestations including pneumonia, bone and bloodstream infections. These MRSA strains are 

typically resistant to multiple antibiotics because the genes for resistance are carried on a large 

mobile genetic cassette/element. 

Community-Associated MRSA typically affects those who are young and healthy (athletes and 

inmates are at an especially high risk) and these individuals typically present with skin and soft 

tissue infections that are often mistaken for “spider bites.” Such infections can spread rapidly and 

have been fatal. Such rapid progression of disease is associated with a unique exotoxin produced 

by these strains, Panton-Valentine Leukocidin. Rarely, a serious infection of the lungs, 

necrotizing pneumonia, also can be caused. This form of MRSA is only resistant to the Β lactam 

class of antibiotics because the genes for resistance are carried on a smaller mobile genetic 

element/cassette. 

Prevention of Community-Associated MRSA 

MRSA is treatable but can require long courses of strong antibiotics. Infection can also reoccur 

after it has been cured. The most effective way to avoid MRSA infection is to maintain good 

hygiene, cover wounds, wash hands, and not share personal items. 

______________________________________________________________________________ 

Sources: 

Centers for Disease Control and Prevention web site www.cdc.gov 




HEADS UP 


Staph Wars 

Video Worksheet 

Running Time: Part 1: 7.5 minutes Part 2: 7 minutes 


6.2, 6.3C, 6.9A-B, 6.12 B 

7.2, 7.3 C, 7.9 A-B, 7.10 B, 7.11 A, 7.12 B-C 

8.2, 8.10B, 8.11A, 8.12B-C 

Middle School Health: 6.3 A; 7.3A-C, 7.12A-B; 8.3 A-C, 8.12A-B 



Objective 

Peek student interest in infectious disease and introduce basic concepts of the human immune system. 

Overview 

While covering a high school wrestling tournament at which several team members are missing due to an 

illness, student reporter, Alex Rodriguez and videographer Sydnee, uncover there’s more to the story than 

meets the eye. 


o DVD player/computer drive or VCR (if using VHS version) 

o Copies of worksheet for each student 

o Pens or pencils 

Procedure 

1. Introduce the video and distribute worksheets and make sure students have pencils or pens. 

2. Play the video and ask students to complete the worksheet as they watch the video. 

3. Briefly review concepts presented in the video and correct answers to the worksheet. 

4. For additional information, in class or as a student assignment, visit these sites: 

MRSA in schools FAQ: www.cdc.gov/ncidod/dhqp/ar_mrsa_in_schools.html 

MRSA Podcast: http://www2a.cdc.gov/podcasts/player.asp?f=6936 

Clean Hands Save Lives! http://www.cdc.gov/cleanhands/ 

Why Don’t We Do It On Our Sleeves? Respiratory Etiquette Video 

http://www.coughsafe.com/media.html 

5. Facilitate a class discussion about ways to prevent Staph and MRSA infections. 



Staph Wars 


Answer the following questions while watching the Staph Wars video. 

1. MRSA is a common ________________ infection. 

2. MRSA is unique because it is _________________ to regularly used antibiotics. 

3. Two of the symptoms that are caused by MRSA include ______________ and 

______________. 

4. MRSA infections can be especially serious if they enter the 

______________________ where they can cause an ______________. 

5. The best method to prevent the spread of MRSA is ______________ 

_______________. Other methods include ______________, 

___________________, __________________. 

Discussion questions: 

6. What are some ways microbes can enter the human body? 

7. How does the human body act as a host to a microbe? 

8. What are two ways in which microbes are useful? 

9. How can the wrestlers and others at the school, reduce their chances of 

contracting MRSA? 



1. bacterial 

2. resistant 

3. blisters, inflammation, boils 

4. bloodstream, infection 

Staph Wars 


Answer Key 

5. hand washing, taking a shower, covering wounds, wearing gloves 

6. Microbes can enter the body through a cut in the body’s first line of defense, the skin. 

It could transfer from your hand or any other contaminated object or travel through the air 

and enter through the eyes, nose and/or mouth. 

7. There are 10 to 20 times more microbes in the human body than there are cells. The human 

body acts as a perfect host to microbes. Once the microbe enters, it is provided food and 

protection by the host body. After the microbe moves past the skin, it buries deeper into 

the warm, moist tissues where it can reproduce. The goal of the microbe is to reproduce 

and eventually spread to another host. 

8. Some fungi produce antibiotics. There are good bacteria helpful in the process of digestion. 

Some bacteria are necessary in various ecosystems. 

9. Wash hands with soap and water or an alcohol-based hand sanitizer. 

Shower immediately after participating in exercise. 

Cover cuts with a clean dry bandage until healed. 

Avoid sharing personal items (like towels and razors) that come into contact with bare skin. 

Use a towel between skin and shared equipment such as weight-training benches. 

Keep frequently touched surfaces that come into direct contact with people's skin clean. 



Unit 1 Classroom Activity: 

The Immune System versus The “Superbug” 

Time: Part 1: 45 minutes Part 2: 60-75 minutes 


6.1 A, 6.2 B-D, 6.3 C, 6.10 

7.1A-B, 7.2C-D, 7.3C, 7.5A, 7.9A-B, 7.10B, 7.11A-B 

8.1A, 8.2C-D, 8.3C, 8.6 

Middle School Health: 6.3B, 7.3 A-C, 8.3 A-C 



Objective 

Expand student knowledge on the interaction of the immune system and pathogens. 

Overview 

Students work in pairs representing either immune system defenses or functions then apply their knowledge to in a 

matching activity and/or create their own “superbug.” 

Part 1: Content 


o Copies of “Stages of the Infectious Process” for each student or group 

o Copies of “The Human Body’s Immune Defenses” and “Weapons to Fight Against the Body’s Immune 

Defenses” for each student (or post/project on the board) 

o Copies of “Summary of the Body’s First Level of Defenses” (or post/project on the board) 

Preparation 

1. Review concepts presented in “Teacher 411: The Immune System.” 

2. Complete the “Immune System Cell Chart” activity included in this module. 



Presentation 

The content provided in this lesson could be presented as a whole or divided up at the teacher’s discretion as to best 

meet the needs/levels of the students. 

1. Distribute copies of “Stages of the Infectious Process” handout and review these concepts as a class or in small 

groups. 

2. Discuss that the term “superbug” is in the news more and more. Explain to students that a “superbug” is a bug 

that can overcome host defenses. 

3. Read “The Human Body’s Immune Defenses” and “Weapons to Fight Against the Body’s Immune Defenses” 

together as a class or in small groups. 

Part 2: Classroom Activities 

The following two activities could be done in either order. 

The Immune System Card Activity 


o Copies of “Stages of the Infectious Process” for each student or group 


o Sets of cards with Immune System Defenses* 

o Sets of cards with Immune System Defense Functions* 

*If possible, print each set of cards on different colored paper. 



Presentation 

1. Organized students into groups of four. 

2. Assign two members as “Immune System Defenses” and two members as “Immune System Functions.” 

3. Distribute cards (see template provided). 

4. Begin the activity by asking the “Immune System Defenses” students to place one of their cards down. 

Then, instruct the “Immune System Functions” students to place a card with a correlating function . 

5. If there is a match, the function pair keeps both cards. If the function card does not match the defense card, 

the defense pair keeps both cards. Continue the activity until all cards are gone. 

6. Facilitate a class discussion of outcomes and concepts learned. 

7. Ask students to discuss ways in which you can prevent transmission of pathogens in the first place! 

(Examples: cover your nose and mouth; wash your hands) 

The “Superbug” Activity 


o Copies of ““The Human Body’s Immune Defenses ” and “Weapons to Fight Against the Body’s Immune 

Defenses” for each student (or post/project on the board) 


o Copies of “My Superbug” worksheet for each student 

o Colored pencils 

o Paper 

Presentation 

1. For this activity, students will create their own make-believe bacterium “superbug.” 

2. Ask students to select five host defenses their “superbug” will be able to fight against. 

3. Then ask students to make a list of five “weapons” their “superbug” has to fight against the host defenses. 

4. Ask students to draw pictures of their superbug and weapons (allow them to get creative). 

5. As a take-home assignment, students research the actual virulence factors bacteria have to defeat the host 

defenses they selected and write a brief report. 

6. Facilitate class discussion of outcomes and concepts learned. 

7. Optional enrichment opportunity: Students could be assigned antibiotics in which the “superbug” must 

overcome. 

____________________________________________________________________________________________________________________________________________________________ 

Sources: 

Written by Leanne Field, PhD, The University of Texas at Austin 

Edited by Rhonda Hatcher and Nathalie Sessions, The University of Texas Health Science Center at Houston 


Field, Leanne (2007). Course packet for Biology 226T: General Microbiology: Virology, Immunology, and Host-Microbial Interactions. The University of Texas at Austin. 

Sherwood, Willey,Woolverton, 2008, Prescott, Harley, and Klein’s Microbiology (7 th Edition), McGraw-Hill, p. 898-910. 



Stages of the Infectious Process 

from the Pathogen’s point of view 

1. TRANSMISSION (FROM ONE HUMAN HOST TO ANOTHER) 

Pathogens can be transmitted from one human host to another either directly or indirectly. 

Direct transmission occurs most often from one person to another person. This is called 

person-to-person transmission. For example, in airborne transmission, pathogens 

travels on airborne droplets when one person coughs or sneezes and another person 

breathes in the droplets. Pathogens have many other ways of being transmitted via the 

person-to-person route, like skin-to-skin contact. 

Indirect transmission refers to the transmission of a pathogen through a go-between, 

either a vehicle or a vector. 

Vehicles are the non-living materials or objects that transmit the pathogen from one host 

to another. Examples include food, water and air. Gastrointestinal pathogens that cause 

diarrheal diseases are frequently transmitted by eating food or drinking water that is 

contaminated with pathogens. Respiratory pathogens are frequently transmitted through 

the air. Objects (called fomites), such as thermometers, eating utensils, blankets, drinking 

cups and neckties also can serve as vehicles of infection. 

Vectors are living transmitters of pathogens such as biting arthropods (mosquitoes, ticks, 

fleas) or vertebrate animals (dogs, cats, bats). Many viruses are transmitted in this way. 

For example, West Nile virus is transmitted via the bite of a mosquito and rabies virus is 

transmitted when a dog or other wild animal that has rabies bites another animal or 

human. 

2. ENTER THE BODY AT A SURFACE (THE SKIN OR MUCOUS MEMBRANES) 

AND OVERCOME THE FIRST LEVEL OF THE IMMUNE DEFENSES 

The pathogen’s first encounter with the body is at a surface – either the surface of the 

skin or an internal surface within the body, like the respiratory and digestive tracts. The 

layers of cells that line these internal body surfaces are called the mucous membranes. 

The skin is a strong barrier and it is not easily penetrated by microbes. Usually, the skin 

must be injured (cut, scratched or burned) in order for pathogens to enter via this route. 

In contrast, most pathogens enter into the body via one of the internal surfaces of the 

body. Unlike the skin, which is cool and dry, these surfaces are warm and moist and are 

more vulnerable to pathogens. However, these internal body surfaces are well defended 

by the first level of immune defenses. These include physical and chemical barriers and 

automatic cleansing mechanisms. To be successful in these dynamic environments, 

pathogens must be equipped with special devices (virulence factors) that allow them to 

overcome these and other immune defenses that they meet inside of the body. Examples 

of the first level of immune defenses of the skin and the respiratory and gastrointestinal 

tracts are summarized in the Summary Table. 



3. ATTACH TO BODY SURFACES 

Once pathogens have arrived on the skin or have entered the body at an internal surface, 

they must first attach, either to skin cells or to the cells of the mucous membranes. Both 

viral and bacterial pathogens have special virulence factors that allow them to 

successfully attach and “hold on” so they are not swept away by the automatic cleansing 

mechanisms of the body surfaces. The structures that make attachment possible are found 

on the surface of pathogens. Bacterial pathogens attach to host cells very tightly with 

hair-like structures called pili (appendages that stretch out and facilitate attachment to 

receptors on the surface of body cells). Viral pathogens attach using proteins that are part 

of the outermost structures of the virus. 

4. MULTIPLY AT A SURFACE AND/OR INVADE INTO DEEPER BODY TISSUES 

AND MULTIPLY; OVERCOME THE SECOND AND THIRD LEVELS OF 

BODY DEFENSES) 

Following attachment, pathogens begin to multiply. In some cases, this multiplication 

occurs on the surface of skin cells or on the surface of the cells that make up the mucous 

membranes. In other cases, pathogens are equipped with additional virulence factors 

which help them to invade inside of the cells of the mucous membranes and multiply 

and/or invade across the mucous membranes and reach deeper body tissues and blood. 

Examples of virulence factors that help bacterial pathogens invade across the mucous 

membranes and survive in body tissues include enzymes and toxins. 

Once pathogens reach deeper body tissues or the bloodstream, they continue to multiply. 

The body responds with second and third levels of defenses designed to eliminate the 

pathogens from the body! A full blown “war within us” takes place between the 

multiplying pathogens and the host’s immune defenses! Either the pathogens or the host’s 

immune defenses will win! The outcome of this war may be a disease. 

5. EXIT FROM THE HOST 

The final stage in the infectious process is exit from the host. From the point of view of 

the pathogen, successful escape from the body to reach the next unsuspecting host is just 

as important as entry into the body. Pathogens can escape from the skin’s surface via 

skin-to-skin contact or on a non-living object. They are shed from the internal surfaces in 

saliva, feces, and air-borne droplets to the next person or into the environment. Pathogens 

growing in the blood can be transmitted via the bite of an insect. It is important that the 

pathogen be shed from the body in large enough numbers to successfully infect the next 

host! 

REMEMBER! 

THE GOAL OF THE PATHOGEN: 

TO “GET IN”, MULTIPLY, AND “GET OUT” TO REACH THE NEXT HOST! 

THE GOAL OF THE HOST: 

TO STOP THE PATHOGEN AT EACH STAGE IN THE INFECTIOUS PROCESS 

USING IMMUNE DEFENSES! 



The Human Body’s Immune Defenses 

The human body’s immune defenses are designed to respond when a pathogen enters the body. The 

human body constantly faces attack from foreign invaders that can cause infection and disease. These 

invaders include living microbes, such as bacteria, fungi, parasites, and viruses. Fortunately, the body 

has a number of external and internal safeguards that prevent most dangerous invaders from causing 

harm. The human body has three levels of immune defenses. 

LEVEL 1: DEFENSES OF THE SKIN AND MUCOUS MEMBRANES 

The skin and the mucous membranes are equipped with 

physical barriers and chemical weapons to defend them 

against pathogens. For example, automatic cleansing 

mechanisms within the respiratory and gastrointestinal 

tracts are designed to keep pathogens moving and to expel 

them from the body. The skin too is an unwelcome 

environment for pathogens to grow. These defenses stand 

ready to stop pathogens as soon as they enter the body and 

to quickly eliminate them! Some of the key defenses of 

the skin, the respiratory and the gastrointestinal tracts are 

listed in the Summary Table. 

LEVEL 2: DEFENSES OF DEEPER BODY TISSUES 

If pathogens successfully invade into deeper body tissues or are introduced into these tissues by a cut or 

break in the skin, they meet a second level of host defenses. These defenses stand ready to respond 

within minutes to hours of the time that pathogens are detected in the body! Multiple immune defenses 

work together to eliminate pathogens from the body and different responses are made against viruses 

compared with bacteria. The immune responses made in response to bacterial pathogens are summarized 

below. 

The process of inflammation is the body’s localized response to injury and to the introduction of 

pathogens into the tissue. It is easy to identify because of its characteristic symptoms: redness, heat, 

swelling, and pain at the site of injury. These symptoms indicate that the body is responding to presence 

of pathogenic bacteria in the tissue by dramatically 

dilating small blood vessels in the area and rushing 

protective proteins (complement) and white blood 

cells (phagocytes) from the bloodstream to the infected 

tissues. The phagocytes, which include neutrophils and 

macrophages, purposefully move toward the bacteria to 

engulf, kill and digest them. The twenty complement 

proteins assist in this process by assembling on the 

surface of the pathogens. Some of the complement 

proteins allow the phagocytes to more easily engulf the 

bacteria, while others form pores in the pathogen’s 

membranes, causing them to lyse. The end result of 

this war is the destruction of the bacterial pathogens 

and their elimination from body tissues! 

You are no doubt familiar with pus, which is the produced during the body’s inflammatory response. It 

contains dead and living bacteria, dead and living white blood cells and other debris from the battlefield. 

Whenever you see pus, you know that the phagocytes are at the site of the infection and they are doing 

their best to fight and destroy the invaders! 



LEVEL 3: DEFENSES THAT IDENTIFY AND DESTROY PATHOGENS AND LEAVE 

MEMORY CELLS BEHIND 

Another type of immune cells, the lymphocytes are “strategic special forces” that are designed to make a 

tailor-made response to pathogens that survive Level 1 and Level 2 defenses. They take from 5 days to 

two weeks to make an effective response the first time they meet the pathogen but this response time is 

cut in half the second and subsequent times they encounter the same pathogen! There are two types of 

lymphocytes – T cells and B cells. T cells come in two varieties: Helper T cells and Cytotoxic T cells. 

T Cell B Cell 

T and B lymphocytes travel around the body in the lymphatic system and when they meet a pathogen, 

they clone themselves to form a large, effective “army” to defeat the pathogen, leaving behind memory 

cells to “remember” the pathogen in the future. If the same pathogen attacks again (even years later!), the 

memory lymphocytes will recognize it and will become activated to make a response much more quickly 

(in 2-3 days). The resulting clone of cells will mount a stronger and more vigorous tailor-made response 

to quickly destroy and eliminate the pathogen from the body and leave more memory cells behind. 

Memory lymphocytes patrol the body for years, and they stand ready to spring into action whenever they 

meet the same pathogen in the future. This amazing capacity to remember the invader each time it enters 

the body and to quickly respond is a hallmark of the lymphocytes. No other cells in the body have this 

incredible ability! 

“Strategic Special Forces” 

We manipulate the lymphocytes to protect us from disease through the process of vaccination (also called 

immunization). When you receive a vaccine (that contains killed, living or weakened microbes or pieces 

of microbes) your lymphocytes are “primed” to make an immune response and to leave memory cells 

behind that continue to patrol your body. If the real pathogen (the one you were vaccinated against) enters 

your body sometime in the future, the memory cells will clone themselves to quickly respond and protect 

you from getting the disease! 



SUMMARY OF THE BODY’S FIRST LEVEL OF DEFENSES 

BODY SURFACE DEFENSES 

SKIN 1) Made of a thick layer of tightly 

packed cells 

2) Sloughing/shedding of skin cells 

3) Skin’s surface is cool and dry 

4) Oil and sweat 

5) Resident bacteria 

RESPIRATORY TRACT 1) Nose hairs 

GASTROINTESTINAL 

TRACT 

2) Mucus (covers the cells that make 

up the mucous membranes) 

3) Shedding of cells that make up the 

mucous membranes 

4) Tight junctions between the cells 

of the mucous membranes 

5) Resident bacteria in the nose and 

throat 

6) Sneezing and coughing 

7) Ciliated cells that line the trachea 

and bronchi 

8) Phagocytic white blood cells 

(macrophages) in the lungs 

1) Flow of saliva in the mouth 

2) Chemicals present in saliva 

3) Mucus (covers the cells that make 

up the mucous membranes) 

4) Shedding of cells that make up the 

mucous membranes 

4) Tight junctions between the cells 

of the mucous membranes 

3) Stomach acid 

4) Fast flow of the small intestines 

5) Abundant resident bacteria in the 

colon 


FUNCTION OF DEFENSES 

Act as an anatomic barrier to pathogens 

Remove pathogens 

Limits growth of bacterial pathogens 

Contain chemicals that kill bacterial 

pathogens 

Take up space so pathogens can’t find 

room to attach 

Trap pathogens 

Sticky consistency; acts as a physical 

barrier and traps pathogens 

Remove attached pathogens 

Prevents pathogens from invading in 

between cells 

Take up space and prevent pathogens from 

attaching 

Propel pathogens “up and out” of the 

respiratory tract 

Beat upward, moving pathogens trapped in 

the mucus “up and out” of the respiratory 

tract and away from the lungs 

“Eat and kill” any pathogens that reach the 

lungs 

Washes pathogens away 

Kill bacteria 

Sticky consistency; acts as a physical 

barrier and traps pathogens 

Remove attached pathogens 

Prevents pathogens from invading in 

between cells 

Kills pathogens 

Move pathogens “down and out” of the 

gastrointestinal tract and out of the body 

Take up space and prevent pathogens from 

attaching 


Weapons Bacterial Pathogens Use 

to Fight Against the Body’s Immune Defenses 

Bacterial pathogens, like Staphylococcus aureus, have “weapons” and “armor” that enhance 

their ability to complete the infectious stages by interfering with the body’s immune 

defenses. 

• Flagella help bacteria to swim through 

the protective mucus that overlies the 

body’s mucous membranes and helps 

them reach the surface of the cells that 

make up the mucous membranes. 

• Pili are straight, hair-like structures 

that extend from the bacterial cell 

surface. The tips of the pili aid in the 

attachment of bacteria to the surface of 

the mucous membranes. 

• Groups of bacteria can bond together on surfaces forming structures known as biofilms. 

Within these structures, they are more resistant to attack by immune cells than individual 

bacteria. Some scientists estimate up to 80% of all infections are due to biofilms. 

Infectious biofilms have contributed to urinary tract infections, middle-ear infections, and 

the formation of dental plaque. 

• Invasive virulence factors help bacteria invade across the mucous membranes and reach 

the tissue spaces below. For example, pathogens make an enzyme that dissolves the tight 

connections between cells of the mucous membrane. This allows the bacteria to pass 

between the cells and reach the underlying where they multiply. 

• The capsule, is an armor-like coating made of polysaccharides or proteins that surrounds 

the bacterial cell. Once bacterial pathogens reach body tissues, they are quickly attacked 

by the body’s phagocytic white blood cells (neutrophils, and macrophages) which are 

delivered to the site of the infection by the process of inflammation. The pathogens with 

capsules are able to avoid engulfment by the phagocytes and they can multiply in tissues, 

despite the defenders. 

• Toxins, released by the bacteria, also kill incoming phagocytic white blood cells allowing 

the bacteria to escape and multiply in body tissues. 



Card Template for Immune System Defenses – Page 1 of 2 

Cilia of respiratory track 


Flow of saliva 

Oil and sweat Stomach acid 

Nose hairs Sneezing and coughing 


Card Template for Immune System Defenses – Page 2 of 2 

Shedding of skin 

Resident bacteria in the 

nose and throat 


Mucus 

Saliva chemicals 

Cool and dry skin Lung macrophages 


Card Template for Immune System Defense Functions – Page 1 of 2 

Beat upward and move 

pathogens up and out of 

the respiratory tract 

Contains chemicals that 

kill bacterial pathogens 

on the skin 

Trap pathogens 

in the nose 


Washes pathogens away 

Kills pathogens 

in stomach 

Propel pathogens 

“up and out” of the 

respiratory track 


Card Template for Immune System Defense Functions – Page 2 of 2 

Removes pathogens 

on the surface of the skin 

Take up space and 

prevent pathogens from 

attaching in the nose 

and throat 

Limits growth of bacterial 

pathogens on the skin 


Sticky substance that 

traps pathogens 

Kills bacteria 

in the mouth 

“Eat and kill” any 

pathogens that reach 

the lungs 


The Immune System Card Activity 

Answer Sheet 

Immune System Defense Immune System Defense Function 

Cilia of respiratory track Beat upward and move pathogens 

up and out of the respiratory track 

Oil and sweat Contain chemicals that kill bacterial 

pathogens on the skin 

Nose hairs Trap pathogens in the nose 

Flow of saliva Washes pathogens away 

Stomach acid Kills pathogens in the stomach 

Sneezing and coughing Propel pathogens “up and out” of 

the respiratory track 

Shedding of skin Removes pathogens lying on the skin 

Mucus Sticky substance that traps pathogens 

Resident bacteria in the nose and throat Take up space and prevent pathogens 

from attaching in the nose and throat 

Saliva chemicals Kills bacteria in the mouth 

Cool and dry skin Limits growth of bacterial pathogens 

on the skin 

Lung macrophages “Eat and kill” any pathogens that reach 

the lungs 



My Superbug is called: 

___________________________ 

My Superbug looks like this: 

My superbug fights against these human body host defenses: 

1. _____________________________ 

2. _____________________________ 

3. _____________________________ 

Weapons my superbug uses to fight against host defenses are: 

1. _____________________________ 

2. _____________________________ 

3. _____________________________ 



HEADS UP 


Unit 1 Glossary of Terms 


Antibiotic 

Resistance 

Bacterium 

(Bacteria) 

Fomite 

Fungus (Fungi) 

A bacterium’s ability to 

survive after antibiotic 

treatment; results from the 

over-exposure or overuse of 

antibiotics which allows the 

bacterium to mutate its genes 

or acquire new genes that 

render the treatment 

ineffective. 


microscopic organism; some 

can cause disease. 

An inanimate object, such as a 

towel or shirt that is capable 

of transmitting a pathogen; 

S.aureus is commonly 

transmitted via fomites. 

A diverse group of microorganisms 

that range from unicellular forms 

(yeasts) to multicellular molds and 

mushrooms. Fungi play varying 

roles including producing 

antibiotics, decomposing dead 

organisms; some fungi cause 

disease in plants, humans and other 

animals. 




Host 

Immunologist 

Infection 

Inflammation 

An organism (such as the 

human body) that harbors a 

pathogen (such as a virus, 

bacterium, or 

fungus).bacterium, or fungus). 

A specialist concentrating on 

disease processes that involve 

the immune system including 

allergies. 

The multiplication 

(colonization) of pathogens in 

the body without symptoms. 

The body’s response to injury 

and to the introduction of 

pathogens into tissue; 

designed to deliver phagocytic 

cells and blood proteins 

(including complement) from 

the blood stream to infected 

tissues. It is easy to identify 

because of characteristic 

symptoms: redness, heat, 

swelling, and pain at the site 

of injury. 




Lethal 

Microbe 

Microorganism 

Methicillinresistant 

Staphylococcus 

Aureus 

(MRSA) 

Normal flora 

Of, pertaining to, or causing 

death; deadly; fatal. 

A minute life form; a 

microorganism, especially a 

bacterium that causes disease. 

An organism too small to be 

seen with the naked eye. 

Also called a microbe, germ, 

or bug. 

A species of Staph bacteria 

that has changed in such as 

way that it has become 

resistant to penicillin and 

other antibiotics; if it infects 

skin and penetrates body 

tissue can cause boils and 

blisters. 

Microbes which naturally 

grow on surfaces or inside of 




the human body and do not 


Pathogen 

Toxin 

A disease causing 

microorganism. 

A chemical substance or 

poison that can harm the 

human body; a common 

virulence factor among 

pathogenic bacteria. 

Exotoxins released by 

pathogenic bacteria kill body 

cells and also incoming 

phagocytic white blood cells. 

This allows the pathogens to 

escape the phagocytes and 

multiply in body tissues. 

Transmission The process by which disease 

is spread. 

Virulence 

A characteristic possessed by 

a microbe that contributes to 




factor 

Virus 

its pathogenicity (its ability to 

cause disease). 

Extremely small, infectious 

agent which is obliged to 


Sources: 

Edited by Leanne Field, PhD, The University of Texas at Austin and Katherine Skala, The University of Texas Health Science Center at Houston 




Willey, Joanne, Sherwood, Linda, Woolverton, Christopher (2008). Prescott, Harley, & Klein Microbiology, Seventh Edition. 





Teacher 411: Lassa Fever 



What is Lassa fever and where is it found? 

Lassa fever is an acute viral hemorrhagic disease found in parts of Western Africa. It is caused by 

Lassa virus, a single-stranded RNA virus (Fig 2.1) belonging to the virus family Arenaviridae. The virus 

is named after the town of Lassa in Nigeria where the disease was first identified in 1969. Lassa fever is 

usually an endemic disease, constantly infecting some portion of the population; the greatest 

concentration of cases has been found in Nigeria and in the area known as the Manu River Union 

(Liberia, Sierra Leone, Guinea), although cases of disease also have been found in neighboring countries 

such as the Ivory Coast, Mali, and Senegal (Fig 2.2). 

Figure 2.1: Lassa virus under the electron microscope Figure 2.2: Cases of Lassa Fever 

Image from the CDC Special Pathogens Branch Image from the Health Protection Agency 

How is Lassa Fever spread? 

Lassa fever is a zoonotic disease, an infection that normally exists in an animal population (a disease host 

or reservoir) and is transmitted to humans through contact with the animal or materials contaminated by 

it. The virus also can be spread from person-to-person. Several species of wild African rodents from the 

genus Mastomys, known as multimammate rats, carry the virus. The Mastomys rodents breed frequently 

and produce very large litters. Although their natural habitat is in savannas and forests, the rodents readily 

colonize human dwellings and scavenge on human food remains, which brings them in contact with 

humans. Once infected, the rodent remains infected for life and it continues to shed the virus in its urine 

and droppings. 

Figure 2.3: a multimammate rat 

*image from the CDC Special Pathogens Branch 

How do humans get Lassa virus? 

Transmission or spread of the Lassa virus can occur from rats-to-humans or via the person-to-person 

route. 

Rat-to-human transmission occurs when: 

o humans come directly into contact with multimammate rat droppings or urine by eating food 

contaminated with rodent droppings or urine; touching objects that are contaminated with urine 

or droppings and then touching their own mouths, eyes, or noses; inhaling tiny particles of dried 

droppings or urine that have become airborne; 

o humans are bitten by an infected multimammate rat; or 

o a human eats an infected rat, as they do on occasion in Africa. 



Person-to-person transmission occurs when humans come into contact with blood or other bodily fluids 

(urine, saliva, semen) from an infected individual through use of contaminated medical equipment; reuse 

of needles; breaks in the skin, or sexual activities. 

What are the symptons of Lassa Fever? 

About 200 million people who live in West Africa are at risk for contracting Lassa fever. The Centers for 

Disease Control and Prevention estimates that about 80% of individuals who develop Lassa fever will 

have only mild symptoms, while the other 20% will have severe multisystem disease. Symptoms can vary 

dramatically and may take anywhere from one to three weeks to appear after contact with the Lassa virus. 

Because symptoms can vary and are often nonspecific, it may be difficult to distinguish Lassa fever from 

other diseases based on symptoms alone. It is possible, however, to diagnose the disease using several, 

different laboratory tests. 

Mild symptoms may include: 

• Fever 

• Sore throat, cough, tonsillitis 

• Back and chest pain 

• Diarrhea, vomiting, abdominal pain 

• Hearing loss 

More severe symptoms may include: 

• Facial and neck swelling 

• Haemorrhage 

• Conjunctivitis 

• Hypotension (drop in blood pressure) leading to shock 

• Fluid in the lung cavity 

• Protein in the urine 

• Mucosal bleeding 

• Neurological problems, such as tremors, seizures, brain dysfunction, and deafness 

About 25% of the patients who have symptoms severe enough to warrant hospitalization, die from the 

disease. When Lassa fever occasionally rises to epidemic levels, about 50% of those infected die from 

the disease. Deafness occurs in about a third of people who get Lassa fever, regardless of the mildness or 

severity of the infection. 

How do you treat and prevent Lassa Fever? 

Lassa fever is treatable with an antiviral drug, Ribavirin, which is most effective when given in the early 

stages of the disease. As there is currently is no vaccine to prevent people from contracting the disease, 

the disease is best prevented by reducing rodent populations, practicing good hygiene routines, and 

keeping homes and hospitals clean. The risk to tourists is considered to be extremely low because Lassa 

fever is transmitted only through direct contact with the rat and its urine or droppings, or through close 

contact with a person infected with Lassa fever. Only a few cases of Lassa fever have ever been 

confirmed outside of Western Africa. 

______________________________________________________________________________ 

Sources: 

Centers for Disease Control and Prevention www.cdc.gov 

Health Protection Agency: http://www.hpa.org.uk/infections/topics_az/VHF/Lassa/ 

McCormick, JB. NIAID Biodefense Lecture Series 2005, http://www.nyas.org/ebriefreps/ebrief/000378/presentations/mccormick/player.html. 



HEADS UP 


Hunting the Big Fever: Finding and Fighting Infectious Disease 


Running Time: Part 1: 10.5 minutes Part 2: 5.5 minutes Part 3: 9 minutes 


6.2; 6.3C; 6.9A-B; 6.12 B 

7.1, 7.2, 7.3 C-E, 7.4B, 7.9 A-B, 7.10 B, 7.11 A, 7.12 B-C 

8.1, 8.2, 8.3 D-E, 8.4B, 8.5 

Middle School Health: 6.3 A, 7.3A-C, 8.3A-C, 7.12A-B, 8.12A-B 



Objective 

Peek student interest in infectious diseases affecting many parts of the world such as Lassa fever and 

highlight careers such as epidemiology and immunology. 

Overview 

Continuing coverage of their story from Unit 1, student reporter, Alex Rodriguez and 

videographer Sydnee, meet and hear stories of world renowned experts, Drs. Joseph McCormick 

and Sue Fisher-Hoch. 





Procedure 

1. Introduce the video and distribute worksheets, pens/pencils. 


3. Briefly review the concepts of the video and go over the correct answers to the worksheet. 





Answer the following questions while watching the Hunting the Big Fever video. 

1. An epidemic is an ___________ caused by an _____________ disease. 

2. In the Greek root of the word epidemiologist, epi means____________ and 

demas means ________________. 

3. Epidemiologists work in ________________ as well as the human 

population. 

4. Lassa fever is most commonly carried by ____________. 

5. To look at the outbreak of a disease, researchers collect 

both______________ and ______________ data. 

6. Two ways to kill bacteria include _____________ and _________________. 

7. In 1918, an infection of _____________ was responsible for killing more 

people than the World War I. 

8. An example of an environmental problem that could aid the spread of 

disease is_______________. 





1. outbreak, infectious 

2. around, people 

3. laboratories 

4. rats 

5. prevalence and incidence 

6. disinfectant, heat 

7. influenza 

8. Global warming or pollution 

Answer Key 




Emerging and Re-emerging Infectious Diseases 


Time: 120 minutes (may be split over multiple class periods) 


6.1, 6.2A, 6.3 A, D-E, 6.5A, 6.10B, 6.11A-B 

7.1, 7.2A, D-E, 7.3A, D-E, 7.5A, 7.9A-B, 7.10B, 7.11A-B 

8.1, 8.2A-D, 8.5A, 8.9A-B, 8.10B, 8.11A-B 

Middle School Health: 6.3A, 7.3A and C, 7.12A-C, 8.3A and C, 8.12A-C 

High School Biology: 1A, 2A, C-D, 4C-D, 1 


High School Health: 115.32.b.2.A, 115.33.c.2.B 

Objective 

Teach students the concept of developing professional scientific research posters and aid students in 

preparing poster projects for science fairs. 

Overview 

Students select an emerging or re-emerging infectious disease and/or a current scientist they wish to learn 

more about, prepare a mini scientific research poster, and present the poster for a class project, mini 

research poster session or school science fair. Optional enrichment opportunity: Students develop 

PowerPoint presentations to accompany their research posters. 


o Tri-fold display boards or tradition poster board 

o Markers 

o Glue/tape 

o Scissors 

o Copies of “Poster Evaluation Rating Sheet” (for grading and/or poster session/ science fair judging) 

Preparation 



3. If conducting a poster session or science fair, recruit judges to evaluate student performance. 

Presentation 

1. Ask students to select an emerging/re-emerging infectious disease they wish to learn more about. 

2. Using the library, Internet, their textbooks, etc. students research the microbe, how it infects, what 

populations it infects, the history of disease, etc. 

3. Students present their research in poster format for a class project, mini research poster session or 

school science fair. 

4. Students should also prepare a 3-minute verbal explanation. Rather than just read the poster, they 

should state the main points and use the graphics and photos as support. 

Optional enrichment opportunity: Students develop PowerPoint presentations to accompany their 

research posters. 

5. To provide a framework for the project/poster design, explain to students that scientific posters are 

one way researchers share their discoveries with others. Usually posters are presented to an audience 

who is walking through a hallway or exhibit at a conference. The researcher typically stands next to 

their poster to present/explain the poster and answer questions—like at a science fair. 


6. An effective poster presents information that is important to the audience and easy to see 

and read (Review criteria of “Poster Evaluation Rating Sheet” included with this activity). 

7. A good poster should not contain large amounts of text or long sentences. Use bullet points and as 

many images, photographs, drawings, and graphs as possible. Make sure that the type is large enough 

to be read and that enough contrast exists between the color of the type and poster's background. 

8. As students to organize the poster into the following sections: 

Title: Write a short phrase or research question that quickly tells the audience what the poster/project 

is about (What emerging/re-emerging infectious disease/microbe is featured?). 

• Make the title the most prominent block of text on the poster (center or left justify at top). 

• Do not use all caps since that’s difficult to read. 

• Use small words such as of, from, with, to, the, a, an, and and to separate details in the title. 

Hypothesis/Purpose: The audience should be able to recognize the hypothesis/objectives within 20 

seconds of seeing your poster. A hypothesis is an educated guess about how things work. For 

example, "If _____, then_____ will happen." The hypothesis should be stated in a way to help answer 

an original question and that is measurable through experiments. 

In the research you gathered on your topic, what question(s) were researchers trying to answer? 

Materials and Methods: Experiments test whether hypotheses are true or false. Experiments should 

also be repeated several times to make sure that the first results weren't just an accident. How did 

scientists test their hypotheses? What were the experiments? 

Results should be easy to locate on the poster. Many viewers/visitors will only be interested in the 

objectives and final results. Others, who have more of an interest in the topic, will try to read the 

poster from beginning to end. Given these different approaches, specific sections should be easy to 

locate. 

Conclusions 

how it infects, what populations it infects, the history of disease, etc. 

Analyze Your Data and Draw a Conclusion: Once your experiment is complete, you collect your 

measurements and analyze them to see if your hypothesis is true or false. 

Scientists often find that their hypothesis was false, and in such cases they will construct a new 

hypothesis starting the entire process of the scientific method over again. Even if they find that their 

hypothesis was true, they may want to test it again in a new way. 

Bibliography 

List of sources used for your project. 

9. Use the “Poster Evaluation Rating Sheet” included with this activity for you and/or judges 

to assess student performance. 

10. Grade or award class incentives such as extra credit for those with the best poster ratings. 

_________________________________________________________________________________________________________________________________________________________________________________________ 

Sources: 

Edited by Nathalie Sessions, The University of Texas Health Science Center at Houston. 

Concept by Melanie Mowry, MPH, The University of Texas Health Science Center at Houston. 

Presentation adapted from Hess, G.R., K. Tosney, and L. Liegel. 2006. Creating Effective Poster Presentations. www.ncsu.edu/project/posters, visited 12/6/07. 

www.writing.eng.vt.edu/ 

www.postersession.com 

www.training.nih.gov/careers/careercenter/publish.html#poster 

www.sciencebuddies.org 


Poster Evaluation Rating Sheet 

Student Presenter ______________________________________________________ 

Poster Title ___________________________________________________________ 

Rate the poster presentation on a scale of 1-5 

1=strongly disagree; 3=neutral; 5=strongly agree 

Appropriateness 

The poster meets the requirements of the assignment. 1 2 3 4 5 

Appearance 

1. Display attracts viewer’s attention. 1 2 3 4 5 

2. Words are easy to read from an appropriate distance (3-5 feet). 1 2 3 4 5 

3. Poster is well organized and easy to follow. 1 2 3 4 5 

4. Graphics and other visuals enhance presentation. 1 2 3 4 5 

5. The poster is neat and appealing to look at. 1 2 3 4 5 

Organization 

6. Clearly defined sections (title, hypothesis/objectives, methods, 

results, conclusions). 


1 2 3 4 5 

7. No more than one short paragraph for each section. 1 2 3 4 5 

8. Overall use of color and design attract attention to main ideas. 1 2 3 4 5 

Text 

9. Appropriate size for viewing from comfortable distance. 1 2 3 4 5 

10. Sufficient content to understand importance of problem. 1 2 3 4 5 

11. Methods, results, conclusions easily understood in reasonable 

time. 

1 2 3 4 5 

12. Correct grammar used. 1 2 3 4 5 

Visuals 

13. Visuals communicate the subject and support main ideas. 1 2 3 4 5 

14. The number of visuals is sufficient. 1 2 3 4 5 

Presentation 

15. Student presenter’s response to questions demonstrates 

1 2 3 4 5 

knowledge of subject and project. 

16. Overall, this is a good poster presentation. 1 2 3 4 5 

Comments 

______________________________________________________________________ 

______________________________________________________________________ 

Adapted from Hess, G.R., K. Tosney, and L. Liegel. 2006. Creating Effective Poster Presentations. www.ncsu.edu/project/posters, visited 12/7/07 


LOGO 

BACKGROUND 

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PURPOSE AND HYPOTHESIS 

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yyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy 

yyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyYyyyyyyyyyyyyyyyyyyyyyyy 

yyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyyy. 

CHART or PICTURE 

TITLE OF STUDY XXXXXXXXXXXX 

XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 

PEOPLE WHO DID THE STUDYCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCCC 

UNIVERSITIES AND HOSPITALS THEY ARE AFFILIATED WITH 

MATERIALS AND METHODS RESULTS 

We hope you find this template useful! This one is set up to yield a 48x36” (4x3’) horizontal poster. 

We’ve put in the headings we usually see in these posters, you can copy and paste and change to your hearts 

content! We’ve left our text in red so you’ll know what text you have brought in, and be sure to get rid of 

anything we put in. We suggest you use black text against a light background so that it is easy to read. 

Background color can be changed in format-background-drop down color menu. 

The boxes around the text will automatically fit the text you type, and if you click on the text, you can use the 

little handles that appear to stretch or squeeze the text boxes to whatever size you want. You can simply 

delete the lines by going to format-colors and lines and selecting no line. 

The dotted lines through the center of the piece will not print, they are for alignment. You can move them 

around by clicking and holding them, and a little box will tell you where they are on the page. Use them to 

get your pictures or text boxes aligned together. 

How to bring things in from Excel and Word 

Excel- select the chart, hit edit-copy, and then edit-paste into PowerPoint. The chart can then be stretched to 

fit as required. If you need to edit parts of the chart, it can be ungrouped. Watch out for scientific symbols 

used in imported charts, which PowerPoint will not recognize as a used font and may print improperly if we 

don’t have the font installed on our system. 

Word- select the text to be brought into PowerPoint, hit edit-copy, then edit-paste the text into a new or 

existing text block. This text is editable. You can change the size, color, etc. in format-text. We suggest you 

not put shadows on smaller text. 

Scans 

We need images to be 72 to 100 dpi in their final size, or use a rule of thumb of 2 to 4 megabytes of 

uncompressed .tif file per square foot of image. For instance, a 3x5 photo that will be 6x10 in size on the 

final poster should be scanned at 200 dpi. 

We prefer that you import tif images into PowerPoint. Images that are greater than 16 megabutes will show 

on the screen, but will not print. JPEG files are OK, but if you can convert them to tif we prefer it. The 16 mb 

limit applies to the image size, and not the compressed file size, of the JPEG. 

Preview: To see your in poster in actual size, go to view-zoom-100%. This is a good way to be sure your 

pictures are going to look OK. 

Feedback: If you have comments about how this template worked for you, email to sales@megaprint.com. 

We listen! Call us at 800-590-7850 if we can help in any way! 

CHART or 

PICTURE 

CHART or 

PICTURE 

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bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb. 

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d. 

CHART or 

PICTURE 

CONCLUSIONS 

CHART or 

PICTURE 

LOGO 

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bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb 

bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbBbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb 

bbbbbbbbbbbbbbbbbbbbbbbbbbbbbbbb. 

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dddddddddddddddddddddddddddddddddddddddddddddd. 

BIBLIOGRAPHY 

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99999999999999999999999999999999999999999999999999 

Page 112 of 231 

CHART or 

PICTURE 

printed by 

www.postersession.com

Time: Part 1: 45 minutes 

Part 2: 45-60 minutes 


Who should receive the vaccine? 


6.1, 6.2A-D, 6.5A, 6.11A-B 

7.1, 7.2A-D, 7.3A-B and D, 7.5A, 7.9A-B, 7.10B, 7.11A-B 

8.1, 8.2A-D, 8.4, 8.5A, 8.11A-B 

Middle School Health: 6.3A, 7.3A-B, 8.3A-B 



High School Health: 115.32.b.2.A-D, 115.32.b.10.A-B, 115.33.c.2.A 

Objective 

Allow students to participate in respectful debate 

Overview 

After discussing the recent flu vaccine shortage, students vote on who they believe should receive the 

vaccine; write a one-page paper explaining their viewpoint; and participate in a mini-debate. 


o Copies of “Who Should Receive the Vaccine?” Voting Ballot for each student 

o Copies of “Background Information” for each student (optional) 

o Stop watch or timer (for debate) 

Preparation 

1. Review “Teacher 411: Vaccines” 



Presentation 

Part 1 

1. As a class, discuss the recent flu vaccine shortage (See “Background Information” on following page 

of this activity.) 

2. Distribute “Who Should Receive the Vaccine?” ballot sheets and ask students to vote on who they 

believe should receive the vaccine. 

3. Make a class graph of the results. 

4. As a homework assignment, ask students to write a one-page paper explaining their viewpoint, 

backing up their opinions with facts they’ve learned so far. If the voting results aren’t varied enough, 

assign a different category to each group for research and debate. 

Part 2 

5. Organize students into groups of three or four and have them read their papers to the class. 

6. Once all groups have presented their papers, facilitate a 15-minute debate. 

_________________________________________________________________________________________________________________________________________________________________________________________ 

Sources: 


Developed by Melissa Cleaver, Spring Branch Independent School District and Rhonda Hatcher, The University of Texas Health Science Center at Houston 


“Experts Have Been Predicting Flu Vaccine Shortage for Years” www.usatoday.com 

“Fighting Influenza” www.rapidcityjournal.com/nie/archives/2004/101804 

“Flu Shot Frequently Asked Questions” www.kcmo.org/health.nsf/web/flushotfaq 

“Flu Shot Shortage Looms” www.cnnmoney.com 

“U.S. Produces Record Amount of Flu Vaccines” www.khou.com/news/health/stories/khou070920_ac_fluvaccine.f0fc5287 



Background Information 

Flu Vaccine Shortage 

What is the flu? 

Influenza is a respiratory infection caused by influenza viruses. When you are near someone who has the 

flu and they sneeze or cough, the viruses can pass through the air and enter your body through the nose or 

mouth. Between 5% and 20% of people in the United States get the flu each year. The flu can be serious 

or even deadly for elderly people, newborn babies and people with certain chronic illnesses. 

Influenza kills about 36,000 people a year in the U.S and over 200,000 people are hospitalized with 

serious complications. The financial cost to the U.S. is more than $87 billion dollars in health care and 

loss of productivity. 

What are the symptoms? 

Most people do not die from the flu, but many feel as if they will die because of the disease symptoms are 

so severe. Symptoms of the flu come on suddenly and may include body or muscle aches, chills, cough, 

fever, headache and sore throat. The main way to prevent from getting the flu is to get a yearly flu 

vaccine. The official start of flu season is October and can continue into the month of May. 

What is the flu vaccine? 

There are two types of flu vaccines. The “flu-shot” is an inactivated vaccine. This means it contains 

killed viruses and is given by a needle into the arm. The nasal-spray flu spray is a vaccine made with 

live, weakened flu viruses that cannot cause the flu. You inhale this vaccine into your nose. Influenza 

virus strains change every year. The government looks at other countries where people contract the flu 

before we do and decide which strains to include in the vaccine based on that information. The vaccine 

costs between $3 and $10 a dose. Since flu strains change every year, manufacturers must create a new 

vaccine for each flu season. It is difficult to predict the annual demand. Just about every doctor’s office or 

clinic stocks the vaccine and most insurance companies cover all or part of the cost. 130 million doses 

were made available in the U.S. in 2007. 

Who should get a flu shot? 

Anyone who wants to lower the chances of getting the flu can get vaccinated. There are certain groups of 

people that definitely should get vaccinated each year. Either they are at higher risk of having serious flu 

complications or they live with or care for those people. People at high risk are: 

• Children between 6 months and 5 yrs of age 

• Pregnant women 

• People 50 years old or older 

• People of any age with chronic medical conditions 

• People who live in nursing homes and other long term care facilities 

Is there always enough flu vaccine supply? 

Actually, in 2004, the Chiron Corporation, a company that manufactured the flu vaccine, had to shut 

down. This created a real shortage. Some people blamed the government for the shortage. Others blamed 

the fact that manufacturers can not create a stockpile from year-to-year or are faced with very expensive 

lawsuits. Some believe if customers were allowed to pre-pay for the vaccine this would help vaccine 

companies cover costs. Because the vaccines are relatively inexpensive to purchase, producing the flu 

vaccine for consumers is not as profitable for the manufacturers to make as other drugs. For this reason, 

many pharmaceutical companies do not bother to manufacture and sell them. In response to the shortage 

in 2004, people stood in line for hours at clinics, hospitals and supermarket pharmacies to get 

vaccinations. Staff members were directed to give shots only to those in the high-risk groups. But, even 

targeting only these groups, there was still not enough vaccine for everyone. 




Name ______________________________________________________ 

Voting Ballot 

Check ONE box for the group you think should receive the vaccine. 

Elderly 

Children 

Sick people 

People ages 30-50 

No one 

Why did you choose this group? 

______________________________________ 

______________________________________ 

______________________________________ 

What are the facts you know so far? 

______________________________________ 

______________________________________ 

______________________________________ 

______________________________________ 



Unit 2 Enrichment Activity: 

Epidemic Intelligence Service (EIS) Case Study 

Time: 75-90 minutes administered across multiple class periods; Part 3 could be assigned as 

homework (estimated time does not include activities recommended in Preparation section) 


6.1A, 6.2B and D, 6.3C, 6.10 

7.1A, 7.2B-D, 7.3C, 7.9 

8.1A, 8.2C-D, 8.3C, 8.6 

Middle School Health: 6.3A, 6.3C, 7.3.A-C, 7.12.A-C, 8.3.A-C, 8.12.A-C 

Middle School Career Orientation: 127.2(7B), 127.2(8A); 

High School Career Orientation: 127.12(7B), 127.12(8A) 



High School Health: 115.32.b.2.A-D, 115.32.b.10.A-B, 115.33.c.2.A-B 

Objectives 

Familiarize students with terminology involved in investigating an outbreak or epidemic; 

interpret and create research data; reinforce principles covered in Units 1 and 2 of HEADS UP 

The Immune System & Infectious Diseases; and explore careers in public health. 

Overview 

Students work in groups to analyze data and problem-solve for a gastroenteritis outbreak case. 


• One copy per student pairs or small groups of “EIS Case Study Packet” 

• One copy per student pairs or small groups of “Patient Data” sheet 

• Once copy per student or group of “Conclusion” sheet 

• Pencils 

Preparation 


2. As a class, view Unit 2 video: Hunting the Big Fever. 

3. Complete Unit 1 classroom activity “The Immune System versus The Superbug” and Unit 2 

classroom activity “Who Should Receive the Vaccine?” 

4. Complete Unit 2 classroom activity “Research Poster Project” (optional). 

5. Familiarize yourself with the Terminology page and prepare to discuss definitions. 

Additional resources: 

Glossaries provided with the HEADS UP curriculum 

Centers for Disease Control and Prevention: www.cdc.gov 

Virginia Department of Health: www.vdh.virginia.gov/epidemiology 

_________________________________________________________________________________________________________________________________________________________________________________________ 

Sources: 

Adapted from CDC-EIS, 2003: Oswego – GI Illness Following a Church Supper (401-303) – Student’s Guide pages 1-12 


Edited by Nathalie Sessions, Rhonda Hatcher, and Shreela Sharma, PhD, The University of Texas Health Science Center at Houston 

Centers for Disease Control and Prevention web site www.cdc.gov 

Gross MB. Oswego County revisited. Public Health Reports 1976;91: 160-70. 

Sherwood, Willey,Woolverton, 2008, Prescott, Harley, and Klein’s Microbiology (7 th Edition), McGraw-Hill. 




Terminology 

Epidemiology The study of factors determining the frequency and distribution of the 

disease, injury, and other health-related events and their causes in defined 

human populations. 

Epidemiologist A person specializing in epidemiology who is specifically involved in 

developing study designs and methods for accurately measuring the cause 

of disease and its frequency in a population in the United States and abroad; 

focuses on the social and medical aspects of disease and on behavioral risk 

assessment and examines the disproportionate rates of disease and disability 

among minorities. 

Epidemic 

Outbreak 

and 

Pandemic 

A disease that increases in occurrence above the normal level in a given 

population. 

The terms “outbreak” and “epidemic” are often used interchangeably, 

although “outbreak” is sometimes used to refer to a more localized situation 

and “epidemic” for more widespread situations. 

“Pandemic” refers to global epidemics—epidemics that spread to more than 

one continent—such as HIV, threat of the avian flu, etc. 

EIS Officer Epidemic Intelligence Service (EIS) officer; a person with expertise in 

medicine, epidemiology, statistics, behavioral science, veterinary medicine, 

nursing and other fields who can be employed in the CDC's 2-year program 

of training and service in applied epidemiology. 

Acute In medicine, an acute disease is a disease with a rapid onset and/or a short 

course resulting in cure or death (as opposed to a chronic course). 

Pathogen Any virus, bacterium or other agent that causes disease in its host. 

Gastrointestinal 

illness 

Vector-borne 

disease 

An illness that affects the gastrointestinal tract. Symptoms may include 

some or all of the following: nausea, vomiting, diarrhea, and fever. 

A vector-borne disease is one in which the pathogenic microorganism is 

transmitted from an infected individual to another individual by an 

arthropod or other living agent, sometimes with other animals serving as 

intermediary hosts. 

Vehicle A non-living transmitter of infection. 



Presentation 

Part 1 

1. Divide students into pairs or small groups. Distribute copies of the “EIS Case Study Student 

Packet” and make sure each student has a pencil. 

2. Discuss the role and responsibilities of an EIS Officer and others he/she would work with 

during an investigation such as the local health officer. Ask students to take notes during the 

discussion and allow time for them to write answers to the questions in their packets. 

3. As indicated/provided in the “EIS Case Study Packet,” have students construct a table of 

skills/experience that would make someone a successful EIS Officer. Ask one member of 

each group to share their table with the class. 

4. Read the Case Background to students. Have students take notes or highlight important 

information on their copies. 

5. Ask students to complete Questions 1 and 2 in their groups. 

Case Background 

On April 19, 1940, a local health officer in a village in New York reported 

the occurrence of an outbreak of acute-gastrointestinal illness to the District 

Health Officer in Syracuse. Dr. A. M. Rubin, epidemiologist-in-training, 

was assigned to investigate the case. 

When Dr. Rubin arrived, he learned from the health officer that all persons 

known to be ill had attended a church supper held the previous evening, 

April 18. Family members who did not attend the church supper did not 

become ill. Dr. Rubin focused his investigations on the supper itself. He 

interviewed each person and collected personal information about the 

occurrence and time of onset of symptoms, and which foods were consumed 

at the supper. 

Part 2 

1. Allow students to share ideas of steps to be taken (answers to Questions 1 and 2). 

2. Ask, “What sort of questions would you ask the church supper participants?” Make a list. 

3. Read the Clinical Description and have groups answer Question 3. 

4. Discuss student answers. 

Clinical Description 

The onset of illness in each person was acute, characterized chiefly by 

nausea, vomiting, diarrhea, and abdominal pain. No one reported having a 

fever and all recovered within 24 to 30 hours. 



Part 3 

1. Read the Supper Description. 

2. Distribute copies of the “Patient Data” sheet. Ask students to read the information and to 

their own Data Table and to make a graph by plotting the food items eaten and number of 

those who became ill from those items. If computer access is available, students could create 

the graph using an online tool such as www.nces.ed.gov/nceskids/createagraph/default.aspx 

or other computer program. 

3. Ask students to complete Questions 4 and 5. 

Supper Description 

The supper was held in the basement of the village church. Foods were 

brought by numerous members of the congregation. The supper began at 

6 p.m. and ended at 11 p.m. The food was spread out on a table and 

consumed over a period of several hours. 

SAMPLE GRAPH 

Part 4 

1. Discuss the results and student answers to Questions 4 and 5. 

2. Distribute copies of “Case Conclusion” and read to the class. 

3. Facilitate class discussion. 



Case Conclusion 

The following is quoted verbatim from the report prepared by Dr. Rubin. 

The ice cream was prepared by the Petrie sisters as follows: 

On the afternoon of April 17 raw milk from the Petrie farm at Lycoming was brought to boil over a 

water bath, sugar and eggs were then added and a little flour to add body to the mix. The chocolate 

and vanilla ice cream were prepared separately. Hershey's chocolate was necessarily added to the 

chocolate mix. At 6 p.m. the two mixes were taken in covered containers to the church basement and 

allowed to stand overnight. They were presumably not touched by anyone during this period. 

On the morning of April 18, Mr. Coe added five ounces of vanilla and two cans of condensed milk to 

the vanilla mix, and three ounces of vanilla and one can of condensed milk to the chocolate mix. Then 

the vanilla ice cream was transferred to a freezing can and placed in an electrical freezer for 20 

minutes, after which the vanilla ice cream was removed from the freezer can and packed into another 

can which had been previously washed with boiling water. Then the chocolate mix was put into the 

freezer can which had been rinsed out with tap water and allowed to freeze for 20 minutes. At the 

conclusion of this both cans were covered and placed in large wooden receptacles which were packed 

with ice. As noted, the chocolate ice cream remained in the one freezer can. 

All handlers of the ice cream were examined. No external lesions or upper respiratory infections were 

noted. Nose and throat cultures were taken from two individuals who prepared the ice cream. 

Bacteriological examinations were made by the Division of Laboratories and Research, Albany, on 

both ice creams. Their report is as follows: 'Large numbers of Staphylococcus aureus* and albus were 

found in the specimen of vanilla ice cream. Only a few staphylococci were demonstrated in the 

chocolate ice cream. 

Report of the nose and throat cultures of the Petries who prepared the ice cream read as follows: 

“Staphylococcus aureus and hemolytic streptococci were isolated from nose culture and 

Staphylococcus albus from throat culture of Grace Petrie. Staphylococcus albus was isolated from the 

nose culture of Marian Petrie. The hemolytic streptococci were not of the type usually associated with 

infections in man.” 

Discussion as to Source: The source of bacterial contamination of the vanilla ice cream is not clear. 

Whatever the method of the introduction of the staphylococci, it appears reasonable to assume it must 

have occurred between the evening of April 17 and the morning of April 18. No reason for 

contamination peculiar to the vanilla ice cream is known.** 

In dispensing the ice creams, the same scooper was used. It is therefore not unlikely to assume that 

some contamination to the chocolate ice cream occurred in this way. This would appear to be the most 

plausible explanation for the illness in the three individuals who did not eat the vanilla ice cream. 

Control Measures: On May 19, all remaining ice cream was condemned. All other food at the church 

supper had been consumed. 

Conclusions: An attack of gastroenteritis occurred following a church supper at Lycoming. The cause 

of the outbreak was contaminated vanilla ice cream. The method of contamination of ice cream is not 

clearly understood. Whether the positive Staphylococcus nose and throat cultures occurring in the 

Petrie family had anything to do with the contamination is a matter of conjecture." 

Note: Patient #52 was a child who while watching the freezing procedure was given a dish of vanilla 

ice cream at 11:00 a.m. on April 18. 

*For information about Staphylococcus aureus, refer to the “Teacher 411: MRSA” included in HEADS UP 

The Immune System & Infectious Diseases. 



**Editor’s note: The most likely source of this outbreak was the Petrie sisters. Both carried Staphylococcus aureus 

in their nares. The pathogen may also have colonized their skin or been present on their hands. One or both of the 

sisters probably introduced the staph into the vanilla ice cream mix as they prepared it. Because the mix was left 

overnight in the church basement at room temperature (rather than being stored in a refrigerator), this gave the 

organisms the opportunity to multiply and to elaborate staphylococcal enterotoxins. Those who consumed the ice 

cream consumed the pre-formed exotoxins, which were responsible for the symptoms of gastroenteritis. 

In 1940, it was possible to identify bacterial species, but sophisticated molecular techniques did not exist. Today, 

investigators can determine whether strains isolated during an outbreak are genetically identical to each other using 

DNA "fingerprinting" techniques such as Pulse Field Gel Electrophoresis (PFGE). Had Dr. Rubin had access to this 

technology, he would have been able to compare the PFGE profiles of the Staphylococcus aureus isolates from the 

ice cream with those from the Petrie sisters. If the profiles matched, this would have proven that one or both of the 

Petrie sisters were the source of the bacterial contamination of the vanilla ice cream. Such analyses depends on the 

teamwork of disease detectives, like Dr. Dr. Rubin and public health laboratory scientists who have the education 

and training to carry out PFGE and many other sophisticated molecular methods. 

Part 5 

1. Show career videos provided on the DVD of this program – especially Joseph McCormick, 

Susan Fisher-Hoch, Blanca Restrepo, and Pablo Okhuysen. 

2. Ask students to complete the “Skills Needed for a Successful Career in Public Health” table 

and ask them to share their answers. 

3. Discuss reasons a person might want to consider a career in public health. What changes 

have happened in our society over the past 50 years that might affect careers chosen today? 

For more information about CDC careers visit: www.cdc.gov/about/opportunities.htm 

Additional Enrichment Activity (optional) 

Conduct communicable disease simulation found at: 

www.woodrow.org/teachers/esi/1998/r/health/vashonepres.htm 

Students take part in a simulation which safely allows them to visualize how rapidly an infection 

can spread within a population. 




Answer to Questions in Student Packet 

Question 1: Is this an epidemic or an outbreak? Why or why not? 

Both epidemic and outbreak are usually defined as the occurrence of more cases of disease 

than expected in a population. Of the 75 persons interviewed, 46 were ill with gastroenteritis 

during a 24-hour time period. This is clearly above the "expected" or background rate of 

gastroenteritis in a community. The terms "outbreak" and "epidemic" are used interchangeably 

by many epidemiologists, although some consider the term “outbreak” to refer to a more 

localized situation, and “epidemic” to refer to a more widespread (and perhaps prolonged) 

situation. Traditionally, the term “epidemic” has been more frightening to the public than 

“outbreak,” so most field investigators have used the latter term when talking to the press or 

public. On the other hand, the term “epidemic” is now at risk of being overused, particularly for 

social problems to which advocates want to draw public attention and concern. 

Question 2: What steps did Dr. Rubin and his team take to find the source of the illness? 

What other steps do you think could be taken? 

• Traveled to site 

• Met with health officer to find out what happened 

• Interviewed each person who attended church supper and collected information about the 

occurrence and time of onset of symptoms and which foods were consumed 

• Prepared and analyzed data 

• Made a hypothesis 

• Prepared and submitted a report 

There is no single "right" list, but every field epidemiologist ought to have a systematic approach 

to an outbreak investigation. The benefit of having a list is that, in the heat of the investigation, 

you will not overlook some critical step. The steps are not fixed in order. In some situations, 

control measures (listed as step 10 below) can and should be implemented immediately. 

Verification of the diagnosis may come at the same time as verification of an epidemic, or 

laboratory confirmation may come weeks after the investigation is over. Many components are 

dynamic: case definitions, line listings, descriptive epidemiology, and hypotheses all can (and 

sometimes should) change with additional information. 

Steps of an outbreak investigation 

1. Identify potential investigation team and resources and prepare for field work 

(administration, clearance, travel, contacts, designation of lead investigator, etc.) 

2. Establish the existence of an epidemic 

3. Verify the diagnosis 

4. Construct a working case definition 

5. Find cases systematically, develop line listing 

6. Perform descriptive epidemiology 

7. Develop hypotheses 

8. Evaluate hypotheses 

9. As necessary, reconsider/refine hypotheses and execute additional studies 

10. Implement control and prevention measures (as early as possible) 

11. Communicate findings 

12. Summarize investigation for requesting authority 

13. Prepare written report(s) 



Question 3: What form of transmission might have caused this illness? Vehicle? Vector? 

Explain. 

Vehicle. Vehicles are the non-living materials or objects that transmit the pathogen from one 

host to another. Examples include food, water and air. Gastrointestinal pathogens that cause 

diarrheal diseases are frequently transmitted by eating food or drinking water that is 

contaminated with pathogens. 

If needed, refer back to Unit 1 classroom activity “The Immune System versus The Superbug.” 

Question 4: What can you learn from the above data? 

Answers may vary among students/groups. 

Facilitate a discussion of their interpretations of the data. 

Question 5: Which food is the most likely vehicle of infection? 

The vanilla ice cream is the most likely vehicle of infection. 




Student Packet 

Define the following terms in the space provided. 

Epidemiology 

Epidemiologist 

Epidemic 

Outbreak 

EIS Officer 

Acute 

Pathogen 

Gastrointestinal 

illness 

Vector-borne 

disease 

Vehicle 



Case Background 

On April 19, 1940, a local health officer in a village in New York reported 

the occurrence of an outbreak of acute-gastrointestinal illness to the District 

Health Officer in Syracuse. Dr. A. M. Rubin, epidemiologist-in-training, 

was assigned to investigate the case. 

When Dr. Rubin arrived, he learned from the health officer that all persons 

known to be ill had attended a church supper held the previous evening, 

April 18. Family members who did not attend the church supper did not 

become ill. Dr. Rubin focused his investigations on the supper itself. He 

interviewed each person and collected personal information about the 

occurrence and time of onset of symptoms, and which foods were consumed 

at the supper. 

1. Is this an epidemic or an outbreak? Why or why not? 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

2. What steps did Dr. Rubin and his team take to find the source of the 

illness? What other steps do you think could be taken? 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 



Clinical Description 

The onset of illness in each person was acute, characterized chiefly by 

nausea, vomiting, diarrhea, and abdominal pain. No one reported having a 

fever and all recovered within 24 to 30 hours. 

3. What form of transmission might have caused this illness? Vehicle? 

Vector? Explain. 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 



Supper Description 

The supper was held in the basement of the village church. Foods were 

brought by numerous members of the congregation. The supper began at 

6 p.m. and ended at 11 p.m. The food was spread out on a table and 

consumed over a period of several hours. 

Using information from the Patient Data sheet, complete the data table below. 

FOOD ITEMS 

SERVED 

Baked ham 

Spinach 

Mashed 

potato 

Cabbage 

salad 

Jello 

Rolls 

Brown bread 

Milk 

Coffee 

Water 

Cakes 

Vanilla 

ice cream 

Chocolate 

ice cream 

Fruit salad 

Data Table 

Number of persons who ate Number of persons did NOT eat Attack Rate 

specified food specified food Ratio 

PERCENT 

PERCENT 

ATTACK 

ILL 

ILL 

ILL NOT ILL TOTAL 

ILL NOT ILL TOTAL 

RATE 

(ATTACK 

(ATTACK 

RATIO 

RATE) 

RATE) 



Using data from your table above, make a graph by plotting FOOD ITEMS 

EATEN on the horizontal axis and NUMBER WHO BECAME ILL on the 

vertical axis. 

4. What can you learn from the above data? 

____________________________________________________________ 

____________________________________________________________ 

5. Which food is the most likely vehicle of the infection? What is your 

hypothesis for how this food was contaminated and how would you prove 

your hypothesis? 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 

____________________________________________________________ 



Fill in the table below with skills someone would want to have to be successful 

in these public health careers. 

Skills Needed for a Successful Career in Public Health 

Career Skills Needed 

EIS Officer 


Professor of Epidemiology 

Infectious Disease Researcher 

What are other public health careers? 




Patient Data from investigation of gastrointestinal illness outbreak 

Oswego, New York 1940 




Conclusion 

The ice cream was prepared by the Petrie sisters as follows: 

On the afternoon of April 17 raw milk from the Petrie farm was brought to boil over a water 

bath, sugar and eggs were then added and a little flour to add body to the mix. The chocolate and 

vanilla ice creams were prepared separately. Hershey’s chocolate was necessarily added to the 

chocolate mix. 

At 6 p.m., the two mixes were taken in covered containers to the church basement and allowed to 

stand overnight. They were presumably not touched by anyone during this period. 

On the morning of April 18, Mr. Coe added five ounces of vanilla and two cans of condensed 

milk to the vanilla mix, and three ounces of vanilla and one can of condensed milk to the 

chocolate mix. Then the vanilla ice cream was transferred to a freezing can and placed in an 

electrical freezer for 20 minutes, after which the vanilla ice cream was removed from the 

freezing can and packed into another can which had been previously washed with boiling water. 

Then the chocolate mix was put into the freezer can which had been rinsed without tap water and 

allowed to freeze for 20 minutes. 

At the conclusion of this, both cans were covered and placed in large, wooden receptacles which 

were packed with ice. As noted, the chocolate ice cream remained in the one freezer can. 

All handlers of the ice cream were examined. No external lesions or upper respiratory infections 

were noted. Nose and throat cultures were taken from two individuals who prepared the ice 

cream. 

Bacterial examinations were made on both ice creams. Large numbers of Staphylococcus aureus 

were found in the vanilla ice cream and a few were found in the chocolate ice cream. 

Report of the nose and throat cultures of the Petrie sisters who prepared the ice cream stated that 

Staphylococcus aureus was found in both Grace and Marian Petrie. 

The source of the bacterial contamination of the vanilla ice cream is not clear. It does seem 

reasonable to assume the staphylococci must have been introduced to the ice cream between the 

evening of April 17 and the morning of April 18. The same scooper was used for both ice creams 

which could be the explanation for the illness in the individuals who did not eat the vanilla ice 

cream. 



HEADS UP 




Acute 

Antibiotic 

Centers for 

Disease Control 

and Prevention 

(CDC) 

Contagious 

Short-term illness; can be mild or 

fatal. 

A substance derived from a 

microbe that is used to harm or kill 

other microbes. 

Federal agency under the 

Department of Health and Human 

Services whose mission is to 

promote health and quality of life 

by preventing and controlling 

disease, injury, and disability; 

headquarters in Atlanta, Georgia. 

Capable of being transmitted by 

bodily contact with an infected 

person or object: contagious 

diseases. 




Emerging 

disease 

Endemic 

Epidemic 


Any group of diseases that have 

newly appeared in humans or are 

increasing in incidence. 

Disease that is constantly present 

in a particular location or 

population. 

A disease that increases in 

occurrence above the normal level 

in a given population. 

A scientist who studies the 

distribution, transmission, and 

control of diseases. 

Epidemiology Study of the distribution, 

incidence, prevalence, causes, and 

control of disease in a population. 



Hemorrhagic 

Incidence 

Lassa Fever 

Legionella 

pneumophila 

Loss of blood or other body fluids 

as a result of infection from a 

pathogen, usually a virus. 

Rate at which new cases of disease 

infection occur over a certain 

period of time. 

An acute viral hemorrhagic 

disease found in Western Africa. 

Pathogenic bacteria that can cause 

Legionnaires’ disease. 



Legionnaires’ 

disease 

Mastomys 

natalensis 

Outbreak 

Population 

census 

Form of pneumonia caused by the 

pathogenic bacterium Legionella 

which was first discovered at an 

American Legion convention in 

Philadelphia in 1976; mainly 

spread through air-conditioning 

systems and water pipes. 

A type of wild bush rat found in 

Africa; carrier of the Lassa virus 

which can be transmitted to 

humans through their droppings 

causing Lassa fever. 

See Epidemic. The terms 

“outbreak” and “epidemic” are 

often used interchangeably, 

although “outbreak” is sometimes 

used to refer to a more localized 

situation and “epidemic” for more 

widespread situations. 

Official count of people in a 

population, needed to establish 

prevalence or incidence of a 

specific disease. 



Prevalence 

Tuberculosis 

(TB) 

Vaccine 

Zoonotic 

disease 

Percentage of people that have a 

specific disease at a given point in 

time. 

A highly contagious bacterial 

infection caused by 

Mycobacterium tuberculosis; 

typically spread through the air; 

characterized by the formation of 

tubercles in the lungs (pulmonary 

TB) and sometimes other organs. 

A weakened or killed version of a 

pathogen which; when 

administered, will induce an 

immunological response to 

disease; gives the immune system 

a “sneak preview” of the pathogen 

and “educates” the immune system 

about how to defend itself in 

advance. 

A disease that can be transmitted 

from animals to humans. 

Sources: 








Teacher 411: Biological Laboratories and Biosafety Levels 



Laboratory research is a key component for preventing and responding to outbreaks of infectious 

disease, whether naturally occurring or terrorist-related. In biological research, laboratories are 

categorized into one of four Biosafety Levels (BSLs). Each BSL has specific safety practices, 

facilities, and safety equipment tailored to address the transmissibility of disease agents being 

researched and the laboratory activities that will take place. The different levels of laboratories 

are categorized as follows: 

• BSL1: Typically educational training and teaching laboratories involving work with 

microbes that are unlikely to cause disease in healthy humans (e.g., Bacillus subtilis). 

(Fig 3.1) 

• BSL2: Typically clinical, diagnostic, teaching, and research laboratories in which work 

is done with disease-causing pathogenic bacteria and viruses that are not easily spread 

through the air (e.g. measles virus, salmonellae, rabies virus, HIV). Safety equipment 

includes: gloves, lab coat, and biosafety cabinet. (Fig 3.2) 

• BSL3: Laboratories in which research or work is done with potentially life-threatening, 

airborne pathogenic viruses and bacteria for which there may be no treatment or vaccine. 

(e.g. SARS coronavirus, Mycobacterium tuberculosis, eastern equine encephalitis virus.) 

Safety facilities and equipment include: negative air pressure rooms; gloves; protective 

gowns; masks or respirators; and specialized biosafety cabinets. (Fig 3.3) 

• BSL4: Highly specialized laboratories where work with exotic, highly infectious, and 

life-threatening pathogens is done. Agents are primarily viruses which may be 

transmitted by the aerosol route and have a very high mortality rate (e.g. Ebola virus, 

Lassa virus). 

Safety facilities and equipment include: building with specially designed ventilation and 

waste management systems; full-body, positive pressure suits; decontamination showers; 

and high security for certain agents. (Fig 3.4) 

Figure 3.1: BSL1 Figure 3.2: BSL2 Figure 3.3: BSL3 Figure 3.4: BSL4 

BSL2, 3, and 4 labs are called biocontainment laboratories. These are facilities designed to 

provide a safe place to work with infectious disease agents, including some of the world’s most 

dangerous agents. This protects both the lab workers from infection and protects the environment 

by preventing agents from spreading elsewhere in the lab building or into the community. 

An example of a BSL 4 biocontainment laboratory is the University of Texas Medical Branch’s 

Robert E. Shope, M.D. Laboratory in Galveston. This laboratory and researchers who use it are 

part of the Western Regional Center of Excellence for Biodefense and Emerging Infectious 

Diseases Research (WRCE), a federally-funded grant that supports research on human 



pathogens so that the diseases they cause can be diagnosed and new drugs and vaccines can be 

developed. Researchers who use the BSL4 laboratory study viruses like Lassa virus, Ebola virus, 

Nipah virus, and Marburg virus—deadly, exotic agents that have no treatment or vaccine. 

The structure of this BSL4 laboratory is nicknamed “a submarine within a bank vault” because it 

is an 8-inch poured reinforced concrete building surrounded by a 10-inch concrete shell that can 

withstand winds up to 140 miles per hour (Fig 3.5). Any air that comes out of the building passes 

through multiple HEPA filters. All equipment is secured in an airtight room, and researchers 

must use a keycard to enter the building. Within the security provided by this structure, the 

laboratory further increases the safety of the research conducted in the facility by: 

• Employing only highly trained staff 

• Wearing full-body suits under positive pressure when in the laboratory, that are 

decontaminated in a chemical shower when exiting the laboratory 

• Following standard procedures to contain any virus that is spilled or contaminates the air 

• Working with only small quantities of virus at a time 

• Working with agents in biosafety cabinets 

• Maintaining the laboratory under negative pressure 

• Filtering air before it goes outside, and cooking waste before it goes into the sewer 

system 

Well-designed laboratories help researchers conduct research on biological materials in a very 

safe manner. However, it is the excellent training and dedication of researchers who 

meticulously follow proper research and biosafety protocols that ultimately keeps the research 

process safe. 

Fig 3.5: Inside of UTMB’s BSL 4 Lab, a “submarine within a bank vault” 

WORKING AREA 

____________________________________________________________________________________________________________________________________________________________ 

Sources: 

Edited by Kimberly Schuenke, PhD, The University of Texas Medical Branch at Galveston 

Biosafety in Microbiological and Biomedical Laboratories (BMBL), 5 th edition. Washington, DC: US Department of Health and Human Services, Centers for Disease Control and Prevention, 

and National Institutes of Health, 2007. Available at: http://www.cdc.gov/OD/ohs/biosfty/bmbl5/bmbl5toc.htm 



HEADS UP 


Just Another Day at the BSL4 


Running Time: Part 1: 9.5 minutes Part 2: 5.5 minutes 


7.1, 7.2, 7.3 C-E, 7.4B, 7.9 A-B, 7.10 B, 7.11 A, 7.12 B-C 

8.1, 8.2, 8.3 D-E, 8.4B, 8.5 

Middle School Health: 6.3 A, 7.3A-C, 8.3A-C, 7.12A-B, 8.12A-B 



Objective 

Excite students about cutting-edge research and scientific careers by: 

• explaining what biological agent research is all about and why it's needed 

• explaining what a Biosafety Level 4 lab is and why these types of facilities are needed 

• ease concerns regarding biological agent research conducted in local communities 

• highlight the work and researchers of the Western Regional Center for Excellence in 

Biodefense Research (WRCE) at The University of Texas Medical Branch in Galveston 

Overview 

Continuing coverage of their story from Units 1 and 2, student reporter, Alex Rodriguez and 

videographer Sydnee, wrap up their story after visiting the WRCE in Galveston. 





Procedure 

1. Introduce the video and distribute worksheets, pens/pencils. 


3. Briefly review the concepts of the video and go over the correct answers to the worksheet. 





Answer the following questions about the Just Another Day at the BSL4 video. 

1. Bacteria and viruses that are capable of causing disease in animals or 

humans are called __________________. 

2. What is the difference between germ warfare and bio defense research? 

3. What does WRCE stand for? 

4. Where is the WRCE located? 

5. What is the function of the WRCE? 

6. What kind of microbes are found at the BSL4? 

7. How can the BSL4 lab be a safe environment for researchers? 

8. What would your day be like if you worked in a BSL4 lab? 



1. pathogenic 



Answer Key 

2. Germ warfare is when someone, like a bioterrorist, uses a bacteria or virus 

to make people sick (anthrax attack). 

Bio defense research is people who come up with methods to detect the 

pathogens bioterrorists could use. They are working on ways to protect and 

treat those who are exposed to the pathogens. 

3. WRCE stands for Western Regional Center for Excellence in Bio defense 

research. 

4. The WRCE is located in Galveston, Texas on the University of Texas 

Medical Branch campus. 

5. The WRCE’s function is to diagnose and treat dangerous infectious diseases 

in humans. 

6. Very dangerous microbes are found in the BSL4. 

7. The air pressure is lower in the BSL4 to help contain microbes that are very 

dangerous and help the researchers work safely with the different viruses. 

There are four levels of labs ranging from the lowest risk labs (BSL1) to the 

highest (BSL4). The higher level lab researchers are required to take more 

precautions, such as wearing more protective outer gear, working in a 

vaulted atmosphere and following more security measures. Researchers are 

decontaminated before they exit the lab. 

8. Answers may vary. 





Time: 45 minutes (15 minute video + 30 minutes for activity) 

TEKS: Middle School Science: 6.1, 6.2 D, 7.1, 7.2 D, 8.1, 8.2 D 

Middle School Health: 7-8.3.A; 7-8.3.B; 7-8.3.C; 7-8.12A 



High School Health: 115.32.b.2.D, 115.33.c.2.A-B 

Objective 

Introduce students to new terminology related to biological laboratories 

Overview 

In a “Memory Game” style activity, students are asked to match terms and definitions 


o Copies of “Biological Laboratories Glossary Cards” templates for pairs of students 

o Construction paper (optional) 

o Pencils or markers 

o Glue or tape (unless printing templates double-sided) 

o Scissors 

Preparation 

1. Review “Teacher 411: Biological Laboratories and Biosafety Levels.” 

2. Watch the video included with this module entitled, “Just Another Day at the BSL4.” 



Presentation – Part 1: Preparation of Cards by Students 

1. As a class, watch the “Just Another Day at the BSL4” video. 

2. Organize students into pairs. 

3. Using the suggested list of terms and templates included with this activity, inform students 

that they will be making vocabulary cards of terms from the video for a special activity. 

4. Distribute templates to each pair of students. 

5. Ask students to fill in terms on the “Terminology Template.” Then ask them to write their 

own definition of the word on the “Definition Template,” based on what they learned in the 

video. Textbooks, notes, a dictionary, etc. could also be used as resources. If desired, 

students could also be asked to draw a picture representing the term. 

6. Once the templates are prepared, ask students to tape or glue them on construction paper 

(optional) and cut them into squares. 

7. If desired, collect the cards and grade them for accuracy or review together as a class. 



Presentation – Part 2: Memory Game 

1. If presenting on a different day, review terms and definitions as a class. 

2. Organize students into the same pairs as in Part 1. 

3. Ask each pair to mix up their cards and place them in a grid, text side down. 

4. Players take turns flipping pairs of cards over in an attempt to match terms with definitions. 

On each turn, the player will first turn one card over, then a second. If the two cards match, 

the player scores one point, the two cards are removed from the game, and the player gets 

another turn. If they do not match, the cards are turned back over. The object is to match 

more pairs of cards than the opposing player. (One point is scored for each matched pair, 

and the player with the highest score after all cards have been matched wins.) When cards are 

turned over, it is important to remember where they are for when the matching card is turned 

up later in the game. 

5. Reward the individual/pair who has the most points with an appropriate incentive such as 

extra credit or class privilege. 

____________________________________________________________________________________________________________________ 

Sources: 

Edited by Kimberly Schuenke, PhD, The University of Texas Medical Branch at Galveston 


www.rinkworks.com/games/memory.shtml visited 12/10/07 



Suggested Terms for Biological Laboratories Memory Game Cards 

Anthrax 

Bio-containment laboratory 

Biodefense research 

Bioterrorism 

BSL 1 lab 

BSL 2 lab 

BSL 3 lab 

BSL 4 lab 

Containment 

Ebola 

Germ warfare 

Influenza 

Measles Virus 

Outbreak 

Pathogenic 

Plague 

Rabies Virus 

Rift Valley Fever 

Salmonella 

Typhus 

West Nile Virus 

WRCE 



Biodefense 

research 

Biological Laboratories Glossary Cards 

TERMINOLOGY TEMPLATE – SAMPLE 

Outbreak 

Anthrax Containment 

Pathogenic BSL 2 Lab 




TERMINOLOGY TEMPLATE – BLANK 



My definition: 

Picture: 

Dictionary definition: 


Picture: 



Picture: 



DEFINITION TEMPLATE 


Picture: 



Picture: 



Picture: 




HEADS UP 




Anthrax 

Bacterium 

(Bacteria) 

Biocontainment 

laboratory 

Biodefense 

research 

An infectious, usually fatal 

disease of warm-blooded 

animals, especially of cattle 

and sheep, caused by the 

bacterium Bacillus anthracis. 

The disease can be transmitted 

to humans through contact with 

contaminated animal 

substances, and is 

characterized by ulcerative 

skin lesions. 


organism that requires a 

microscope to see, some can 


Facilities designed to provide 

a safe place to work with 

infectious disease agents, 

including some of the world’s 

most dangerous agents; 

BSL 2, 3, and 4 labs are 

biocontainment labs. 

Research that focuses on new 

ways to detect pathogenic 

viruses / bacteria and 

discovering ways to treat and 

protect people and animals 

from diseases that 

bioterrorists could use. 




Bioterrorism 

BSL 1 lab 

BSL 2 lab 

BSL 3 lab 

The unlawful release of 

biological agents with the 

intent to intimidate or coerce 

a government or civilian 

population to further political 

or social objectives. 


a laboratory in which 

researchers work with 

microbes that are unlikely to 

cause human disease; lowest 

level lab and often used for 

teaching. 




pathogenic bacteria and 

viruses that can cause human 

disease but are not easily 

spread through the air; safety 

precautions include gloves, 

lab coat, and biosafety 

cabinet; 

ex: Measles, Salmonella, 

Rabies. 




pathogenic viruses and 

bacteria that can spread 

through the air and cause 

serious or life threatening 

disease for which there may 

be no treatment or vaccine; 

safety precautions include 

double pair of gloves, 

protective gowns, masks, 

negative air pressure; 

ex: SARS, Anthrax. 




BSL 4 lab 

Containment 

Ebola 



researchers work with some 

of the most infectious 

pathogens in the world, 

mostly pathogenic viruses that 

can be easily spread and have 

a high mortality rate; the 

highest level laboratory; 

requires well-trained 

personnel; safety precautions 

include airtight room 

surrounded by concrete walls, 

decontamination showers, 

airtight suits, high security; 


Prevention of the spread of 

organisms outside of 

laboratory facilities and into 

the environment. 

A highly lethal virus that 

causes massive internal 

bleeding. It is thought that the 

virus originated in central 

Africa and was passed to 

humans from primates. No 

treatment or vaccine is 

available. 




Germ 

warfare 

Influenza 

Measles 

Virus 

Microbe 

Using pathogenic viruses and 

bacteria to harm others. 

A contagious respiratory 

illness caused by influenza 

viruses. It can cause mild to 

severe illness, and at times 

can lead to death. The best 

way to prevent the flu is by 

getting a flu vaccination each 

year. 

A highly contagious vaccinepreventable 

disease and most 

deadly of all childhood 

rash/fever illnesses. It is 

spread by droplets or direct 

contact with nasal or throat 

secretions of infected persons. 

A minute life form; a 

microorganism, especially a 

bacterium that causes disease. 




Pathogenic Capable of causing disease, a 

characteristic of many 

microbes, both bacteria and 

viruses. 

Plague 

Rabies Virus 

Rift Valley 

Fever 

Plague is an infectious disease 

of animals and humans 

caused by the bacterium, 

Yersinia pestis. People 

usually get plague from being 

bitten by a rodent flea that is 

carrying the plague bacterium 

or by handling an infected 

animal. 

A preventable viral disease of 

mammals most often 

transmitted through the bite of 

a rabid animal; a fatal disease 

that affects the central 

nervous system. 

(RVF) is an acute, fevercausing 

viral disease that 

affects domestic animals 

(such as cattle, buffalo, sheep, 

goats, and camels) and 

humans. RVF is most 

commonly associated with 

mosquito-borne epidemics 

during years of unusually 

heavy rainfall. 




Salmonella A group of pathogenic 

bacteria that cause diarrheal 

illness in humans. 

Typhus 

West Nile 

Virus 

WRCE 

Any one of several similar 

diseases caused by louseborne 

bacteria, in the genus 

Rickettsia. Characterized by 

symptoms of chills, fever, 

headache and a rash, 1-3 

weeks after the louse bite 

occurs. 

A viral disease spread by 

infected mosquitoes, which 

can cause a serious, life- 

threatening infection of the 

brain (encephalitis). Virus 

transmission may occur in 

parts of the country where 

mosquitoes are still active. 

“Western Regional Center of 

Excellence” for Biodefense 

and Emerging Infectious 

Disease Research; a regional 

laboratory center which 

focuses on the diagnosis, 

treatment, and prevention of 

dangerous infectious diseases. 

Sources: 

Edited by Kimberly Schuenke, PhD, The University of Texas Medical Branch at Galveston. 








Teacher 411: Vaccines 



A vaccine is defined as a suspension of attenuated or killed microorganisms (e.g. bacteria or 

viruses), or of antigenic proteins derived from them, administered for the prevention, 

amelioration, or treatment of infectious diseases (1). The vaccine can’t cause disease in a person, 

but it will trigger a person’s immune system to respond to the pathogen. In essence, a vaccine 

gives the immune system a “sneak preview” of the pathogen and “educates” it in advance about 

how to defend against it, should the real pathogen infect the body in the future. 

Four types of vaccine in wide use today include: 

1. Inactivated (Killed) Vaccines: Pathogens are treated with chemicals or heat so that 

they are no longer capable of causing disease but can still trigger an effective immune 

response. 

Examples: Vaccines that protect against Vibrio cholerae, influenza, Hepatitis A and polio (Salk 

vaccine). 

2. Live (Attenuated) Vaccines: Pathogens are grown in special cultures until they lose 

their virulence but retain their ability to induce protective immunity. In other words, 

attenuated pathogens are less virulent mutants that can infect the human host but are 

incapable of causing disease. 

Examples: Vaccines that protect against many childhood viral diseases including, polio (the Sabin vaccine), 

measles, mumps, rubella, and varicella-zoster (chicken pox). 

3. Subunit Vaccines: A vaccine that consists of parts of the pathogen (i.e. bacterial or viral 

components) that elicit a protective immune response. 

Examples: Vaccines that protect against Bordetella pertussis (the cause of whooping cough) and 

bacterial meninigitis (capsular polysaccharide vaccines or conjugated capsular vaccines against Neisseria 

meningitidis, Hemophilus influenzae and Streptococcus pneumoniae) 

4. Toxoid Vaccines: A vaccine that consists of a purified bacterial exotoxin that has been 

treated to lose its toxicity but retain its immunogenicity. 

Examples: Vaccine to protect against C. diphtheriae (the cause of diphtheria) and Clostridium tetani 

(the cause of tetanus) 

How do Vaccines Work? 

Vaccines are designed to activate the adaptive immune system to make a response to the antigens 

in the vaccine and to leave behind memory T and B lymphocytes. When the pathogen enters the 

body in the future, the memory T and B cells will respond more quickly and vigorously to 

“recognize” and eliminate the pathogen from the body. 

For example, a flu vaccine introduces a killed version of the influenza virus into the body. The 

immune system responds (in approximately ten days to two weeks), creating antibodies against 

the virus and leaving memory cells behind. When the body is infected with influenza virus, the 

chances of developing the flu are lessened because the T and B memory cells will recognize and 

respond to the virus within approximately two to five days, producing antibodies that will 



eliminate the virus from the body (Fig 3.1 & 3.2). Memory cells will once again be left behind, 

ready to respond should the same virus enter the body again! 

Figure 3.1: Without a vaccine, the immune system is slow to react to the transmitted Influenza virus resulting in 

disease 

Figure 3.2: Introducing a dead virus through a vaccine allows the immune system to make antibodies against the 

Influenza virus ahead of time. When a person is later exposed to the Influenza virus, it is more likely that memory T 

and B lymphocytes circulating in the body will be able to recognize that particular virus and immediately produce 

antibodies against it, preventing that person from developing influenza. 

Ideal Characteristics of a Vaccine 

Ideally, vaccines should: 

• increase a person’s resistance to developing disease 

• create resistance to disease that lasts as long as possible 

• remain stable and effective even after storage and shipping 

• be safe (with minimal and acceptable side effects, if any) 

• be affordable 

In 1796, Edward Jenner used cowpox, a mild and nonfatal virus related to smallpox, to create a 

vaccine to protect against the far more deadly smallpox. The word “vaccine” comes from vacca, 

the Latin word for “cow.” With the help of Jenner’s smallpox vaccine, smallpox has been 

eradicated. Other significant contributors to vaccine history include Louis Pasteur, who 

developed the first vaccine for rabies, Dr. Jonas Salk who developed the first successful polio 

vaccine, and Albert Sabin, who created an oral, attenuated vaccine for polio. 

Because many individuals do not understand the science behind vaccines, many myths about 

vaccinations have developed. 



Common Myths about Vaccines 

1. Vaccines will weaken the immune system. 

FALSE—Vaccines strengthen the immune system by helping it to recognize pathogens 

that it may come into contact with in the future. 

2. Vaccines can give a person the serious disease it is supposed to prevent. 

FALSE—If the vaccine is inactivated, or is a subunit or toxoid vaccine, it is impossible 

for the vaccine to give the person the disease. Rarely, vaccination with an attenuated 

pathogen may cause a mild or serious form of the disease, especially if the individual is 

immunocompromised. Very rarely, the attenuated polio vaccine (Sabin vaccine) has 

reverted to full virulence, causing the disease poliomyelitis. 

3. Vaccines often cause serious side effects. 

FALSE—Some vaccines carry a small risk of side effects, such as redness or swelling at 

the injection site. Only rarely have vaccines caused more serious side effects (e.g. the 

inactivated Bordetella pertussis vaccine). 

4. Healthy people don’t need vaccines. 

FALSE—Vaccinations help keep people healthy because they work to protect the body 

from pathogens. The best time to get a vaccination is when you are healthy and before 

you have been exposed to the pathogen. 

5. Vaccines aren’t effective. 

False. Vaccines work 85-99% of the time and are one of the most effective ways to help 

your immune system keep you healthy. Vaccines also protect populations from disease, a 

phenomenon known as herd immunity. 

6. I don’t need vaccines for diseases I’ve never heard of because people don’t get these 

diseases anymore. 

FALSE—Many diseases do not occur as often as they used to (in part because of 

vaccines), but that does not mean that the bacteria or viruses have disappeared 

completely! Although the disease (such as polio or measles) may not be common in the 

United States now, it may still be common in other countries. You may want to visit 

those countries some day or have visitors from those countries. 

7. I was immunized when I was a baby so I am protected for life. 

FALSE—Some vaccines do last forever but most require “boosters” to “remind” your 

immune system how to fight off the pathogen. 

8. I got a flu vaccine last year so I don’t need one this year. 

FALSE—Flu viruses mutate quickly, so new strains appear every year. You need a new 

flu shot every year to make sure you are protected against this year’s strain of flu. 

____________________________________________________________________________________________________________________ 

Sources: 


Dorland’s Illustrated Medical Dictionary (29th ed.), W.B. Saunders, Co., Philadelphia. 

Mims, 2001. Mims’ Pathogenesis of Infectious Disease (5th ed.) Academic Press, San Diego. 

Wood, P., 2006. Understanding Immunology (2nd ed.), Pearson/Prentice Hall, London. 

Wikipedia www.en.wikipedia.org 



Teacher 411: HIV and AIDS 



HIV or the Human Immunodeficiency Virus, is a single-stranded RNA retrovirus, (Fig 5.1) which was 

first discovered in the Democratic Republic of Congo in 1959. Like other viruses, HIV requires a host 

cell to survive. As a retrovirus, HIV uses a key enzyme, reverse transcriptase to make a DNA copy 

from its RNA genome. Once this “proviral” DNA is integrated into the host’s DNA, a host enzyme 

(RNA Polymerase II) is used to complete the multiplication cycle, resulting in the production of progeny 

viruses. HIV infects immune system cells such as dendritic cells, monocytes, macrophages and helper Tlymphocytes, 

which orchestrate the entire immune system. HIV has virulence factors, including several 

surface proteins, which allow it to enter and multiply inside of T cells (Fig 5.2). When progeny viruses 

exit from the helper T cells, they do not always damage or kill the cells. This is why many people infected 

with HIV can be symptom-free for a long period of time, for as many as ten years. 

Figure 5.1: Photo of HIV Figure 5.2: Diagram of the structure of HIV 

Images from Centers for Disease Control and Prevention 

HIV infection progresses through three stages, as defined below. While host immune responses may hold 

the infection in check for years, eventually, helper T cell numbers decline to such a low level that the last 

stage of the disease, Acquired Immune Deficiency Syndrome, is manifested. As HIV destroys these 

lymphocytes and thus the body’s ability to coordinate and regulate other factors in the immune system, it 

severely cripples a person’s ability to fight off infection. This makes a person with HIV a compromised 

host and makes it easy for other types of pathogens to infect and cause disease. Thus, people with HIV 

can be vulnerable to opportunistic infections caused by pathogens that would normally be fought off by 

a fully functioning immune system. 

HIV infection progresses over three stages: 

1. Primary HIV infection occurs two to four weeks after exposure to HIV. Symptoms are similar 

to those of the flu or mono. 

2. Asymptomatic (Latent) HIV usually lasts for 7-11 years. During this period, most individuals 

do not have symptoms. While viruses are not found in the bloodstream during this stage, they are 

sequestered in the patient’s lymph nodes where they continue to multiply. 

In some patients, a syndrome known as AIDS Related Complex (ARC) may occur during 

this stage. Symptoms of ARC include persistent fevers, fatigue, weight loss and swollen lymph 

glands. Patients with ARC frequently progress to AIDS. 

3. AIDS or Acquired Immune Deficiency Syndrome does not occur until HIV has destroyed almost 

80% of a person’s helper T cells (TH cell count < 200 cells per cubic mm of blood). This stage is 

characterized by multiple opportunistic infections (including tuberculosis, herpes and Hepatitis 

C), which can be fatal in a person with a suppressed immune system. The two most common 

disease manifestations are Kaposi’s Sarcoma and Pneumocystis pneumonia. Although not all HIV 



positive individuals develop AIDS, people who have been exposed to HIV in the past have 

usually developed AIDS within about 10 years after initial HIV infection. 

According to the Centers for Disease Control and Prevention, HIV infection is the fifth leading 

cause of death in the U.S. for individuals ages 25-44, and is the leading cause of death for 

African-American men ages 35-44. It is estimated that 850,000 to 950,000 U.S. residents are 

living with HIV infection, one-quarter of whom are unaware of their infection. Approximately 

40,000 new HIV infections occur each year in the United States, and approximately 5 million 

new HIV cases occur each year worldwide. 

Figure 5.3: Percent Adults living with HIV in 2006 

Image from UNAIDS 

Additional Resources for Teachers 

• Centers for Disease Control HIV/AIDS Branch: http://www.cdc.gov/hiv/az.htm 

• Discovery Channel “The Science of HIV” curriculum: 

http://school.discovery.com/lessonplans/programs/thescienceofhiv/ 

• National Institutes of Health AIDSinfo: http://aidsinfo.nih.gov/ 

• University of Missouri “Talking with Children about HIV/AIDS”: 

http://extension.missouri.edu/explore/hesguide/humanrel/gh6000.htm 

Additional Resources for Students 

• Rhode Island Department of Health Office of HIV/AIDS: http://www.health.state.ri.us/hiv/kids.php 

• Cells Alive!: http://www.cellsalive.com/hiv0.htm 

• AVERT AIDS International: http://www.health.state.ri.us/hiv/kids.php 

• HIV InSITE for Adolescents and Youth: http://hivinsite.ucsf.edu/insite?page=pb-youth 

• National Institutes of Health Medline Plus: http://www.nlm.nih.gov/medlineplus/aids.html 

• USDHHS and SAMHSA “Tips for Teens: HIV/AIDS”: http://ncadi.samhsa.gov/govpubs/PHD725/ 

• American Social Health Association: http://www.iwannaknow.org/basics2/hiv_aids.html 

____________________________________________________________________________________________________________________ 

Sources: 

Centers for Disease Control and Prevention www.cdc.gov 

American Association for the Advancement of Science Healthy People Library Project (2005). “The Science Inside HIV and AIDS” 

Joint United Nations Programme on HIV/AIDS www.unaids.org/en/ 




Released TAKS Questions 

from the Texas Education Agency 

related to the immune system and 

infectious diseases 


1. Which of these does a virus need in order to multiply? 

A Chloroplasts from a host cell 

B A host cell to provide oxygen for the virus 

C New ADP from a host cell 

D A host cell to replicate the virus’s DNA 

2. The myxoma virus was used to control an overpopulation of European rabbits in Australia. 

When first introduced in the mid-1900s, the virus greatly reduced the European rabbit 

population. Today the virus is not an effective control of the European rabbit population. 

Fewer European rabbits are affected by the virus today because they have- 

A learned to avoid the virus 

B moved away from infected areas 

C undergone a change in diet 

D developed resistance to the virus 

3. Cholera-causing bacteria have a single flagellum that allows these bacteria to- 

A move 

B reproduce 

C excrete water 

D produce sugar 

4. Which of these is a function of the cell membrane in all cells? 

A Producing cellular nutrients 

B Preserving cellular wastes 

C Neutralizing chemicals 

D Maintaining homeostasis 

5. Which of the following is found in both cells and viruses? 

A Silica 

B Genetic material 

C Digestive cavity 

D Flagella 


6. People infected with the human immunodeficiency virus (HIV) have an increased risk of 

dying from secondary infections. Which of these best explains how HIV increases the danger 

of secondary infections? 

A HIV produces antigens that damage red blood cells 

B HIV adds genetic material from harmful microbes 

C HIV destroys helper T cells 

D HIV consumes beneficial microbes in the body 

7. Many species of bacteria can be found in the human mouth. Which of these explains the 

great variety of bacteria in the mouth? 

A Large volumes of air cause bacteria to change form. 

B Salivary glands cause mutations in bacterial populations. 

C The presence of nutrients makes the mouth a favorable habitat. 

D Calcium in the teeth provides a suitable pH environment. 

8. Which two body systems work together to fight infection? 

A The immune system and the muscular system. 

B The circulatory system and the immune system. 

C The endocrine system and the digestive system. 

D The nervous system and the respiratory system. 

9. Organs that work together to accomplish specific function form – 

A cells 

B tissues 

C systems 

D individuals 

10. After an experiment, scientists concluded that one species of bacteria could break down a 

certain kind of hazardous waste. Before announcing this conclusion, the researchers should- 

A repeat the experiment to make sure the results are reproducible 

B write a formal hypothesis statement 

C ignore the results of similar experiments by other researchers 

D plot the data on appropriate graphs 


11. Which of these is a hypothesis that can be tested through experimentation? 

A Bacterial growth increases exponentially as temperature increases 

B A fish’s ability to taste food is affected by the clarity of aquarium water 

C Tadpoles’ fear of carnivorous insect larvae increases as the tadpoles age 

D The number of times a dog wags its tail indicates how content the dog is 

12. All of the following symptoms are likely associated with bacterial infection except- 

A skin rashes or lesions 

B elevated body temperature 

C swollen glands or tissues 

D increased red blood cell count 

13. Some antibiotics cause patients to exhibit digestive side effects. These side effects are most 

often the result of- 

A bacteria being killed in the digestive tract 

B the antibiotics being converted into stomach acids 

C too much water being drawn into the digestive tract 

D the stomach wall being torn 

14. Which system of the body would be directly affected if a large number of T cells were 

attacked by a virus? 

A Cardiovascular system 

B Immune system 

C Endocrine system 

D Respiratory system 

15. Some bacteria thrive in hostile environments, such as salt flats, boiling-hot springs, and 

carbonate-rock interiors, primarily because of bacteria’s 

A biochemical diversity 

B small sizes 

C round shapes 

D methods of movement 


16. One characteristic shared by a virus and a living cell is that both- 

A store genetic information in nucleic acids 

B have a crystalline structure 

C gain energy directly from the sun 

D use glucose for respiration 

17. The cell above most likely belongs to an organism of the kingdom— 

A Animalia 

B Plantae 

C Fungi 

D Eubacteria 

18. The chart above shows the results of an experiment performed in the 1920s using a bacterial 

species that causes pneumonia in humans. The experiment involved several procedures 

using two different bacterial strains, R and S. What is a possible explanation for the results 

in Group 2? 


A Living S-strain bacteria can transform into a pathogenic form of R-strain bacteria. 

B Living R-strain bacteria are controlled by a mouse’s immune system. 

C Dead S-strain bacteria can cause disease. 

D Dead R-strain bacteria can confer resistance to S-strain bacteria. 

19. Which body system is directly responsible for delivering nutrients to cells throughout the 

body? 

A Circulatory system 

B Immunity system 

C Endocrine system 

D Respiratory system 

PUBLIC SERVICE ANNOUNCEMENT: Facts About the Flu Vaccine 

1. The vaccine may be administered either as a nasal spray or as an injection. 

2. Prior to administration, nasal-spray vaccines must be stored at 15 C or lower. 

3. In an experiment, vaccine recipients had 85% fewer flu episodes than non-recipients. 

4. The vaccine virus is heat and fails to replicate at temperatures of 38 C-39 C. 

20. Which statement above makes the most valid arguments of receiving the flu vaccine? 

A Statement 1 

B Statement 2 

C Statement 3 

D Statement 4 


1. D 

2. D 

3. A 

4. D 

5. B 

6. C 

7. C 

8. B 

9. C 

10. A 

11. A 

12. D 

13. D 

14. B 

15. A 

16. A 

17. B 

18. B 

19. A 

20. C 

Answer Key 


HEADS UP The Immune System & Infectious Disease © 2008 University of Texas Health Science Center at Houston 


Skin 





Mucous Membrane 



Mucus Membrane Cross Section 





Lymph Nodes 



Spleen 



Thymus 







Caricatures 



Neutrophil 



Neutrophil Caricature 



Macrophage 



Macrophage Caricature 



Natural Killer Cell 



Natural Killer Cell Caricature 



T-Cell 



T-Cell Caricature 



B-Cell 



B-Cell Caricature 



Relative Pathogen Sizes 



Bacterium 



Bacterium 



Bacterium 



Bacterium 



Viruses 



Virus 







Phagocytosis 



Phagocytosis Caricature – Vertical 



Phagocytosis Caricature – Horizontal 



Complement 



Apoptosis 



Interferons 



Interferon Protein Caricature 



Humoral Immunity 



Opsonization 



Complement Activation 



Neutralization 



Cell-Mediated Immunity 



HEADS UP 


Master Glossary of Terms – Sorted Alphabetically 

411 / Unit Term Definition 

Immune 

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411 


Helper Cells 

Orchestrate both humoral and cell-mediated immune 

responses by sending cytokine “cell signaling” molecules to 

B cells and to macrophages, telling them to “get activated” 

and respond to the pathogens they have encountered. 

2 Acute Short-term illness; can be mild or fatal. 

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Adaptive 


Immune System 

Defenses that respond when pathogens get past the first and 

second levels of the innate immune defenses. The T and B 

lymphocytes that comprise the adaptive immune defenses 

make tailor-made responses directed against specific 

pathogens. Once activated, T and B cells 1) form clones of 

cells to eliminate the pathogen and 2) leave behind memory 

cells that make future responses more efficient. 

3 Anthrax An infectious, usually fatal disease of warm-blooded 

animals, especially of cattle and sheep; caused by the 

bacterium Bacillus anthracis. The disease can be transmitted 

to humans through contact with contaminated animal 

substances, such as hair, feces, or hides, and is characterized 

by ulcerative skin lesions. 

2 Antibiotic A substance derived from a microbe that is used to harm or 

1 Antibiotic 

resistance 

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kill other microbes. 

A bacterium’s ability to survive after antibiotic treatment; 

results from the over-exposure or overuse of antibiotics 

which allows the bacterium to mutate its genes or acquire 

new genes that render the treatment ineffective. 

Antibodies Y-shaped proteins produced by activated B cells (plasma 

cells). Secreted antibodies bind to specific pathogens, 

targeting them for elimination by phagocytic white blood 

cells or complement proteins. 

Antigen A foreign substance that stimulates the adaptive immune 

system. 

Apoptosis Programmed cell death or “cell-suicide”; the method used by 

the immune system to destroy virus-infected cells. 

B cells Mediate humoral immunity. B cells recognize and bind to 

extracellular pathogens that are free floating in the body or 

are “hanging out” in between cells. After binding, they are 

activated to form a clone of effector cells (plasma cells) that 

produce antibody and memory cells. The antibody coats the 

pathogens targeting them for destruction by phagocytes or 





Immune 

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Bacterium 

(Bacteria) 

3 Biocontainment 

laboratory 

A small, single-celled microscopic organism; some can 


Facilities designed to provide a safe place to work with 

infectious disease agents; including some of the world’s 

most dangerous agents; BSL 2, 3, and 4 labs are 


3 Biodefense research Research that focuses on new ways to detect pathogenic 

viruses / bacteria and discovering ways to treat and protect 

people and animals from diseases that bioterrorists could use. 

Immune Biofilm A complex structure adhering to surfaces that are regularly in 

System 

contact with water, consisting of bacteria and sometimes 

411 

other microorganisms such as yeasts, fungi, and protozoa 

that secrete a mucilaginous protective coating in which they 

are encased. 

3 Bioterrorism The unlawful release of biological agents with the intent to 

intimidate or coerce a government or civilian population to 

Immune 

System 

411 

further political or social objectives. 

Bone marrow Found inside of the long bones of the body; stem cells in the 

bone marrow produce the “formed elements” of the blood: 

white blood cells, red blood cells and platelets. 

3 BSL 1 lab Biosafety Level 1 Laboratory; a laboratory in which 

researchers work with microbes that are unlikely to cause 

human disease; lowest level lab and often used for teaching. 


researchers work with pathogenic bacteria and viruses that 

can cause human disease but are not easily spread through 

the air; safety precautions include gloves, lab coat, and 

biosafety cabinet; 

ex: Measles, Salmonella, Rabies 


researchers work with pathogenic viruses and bacteria that 

can spread through the air and cause serious or life 

threatening disease for which there may be no treatment or 

vaccine; safety precautions include double pair of gloves, 

protective gowns, masks, negative air pressure; 



researchers work with some of the most infectious pathogens 

in the world, mostly pathogenic viruses that can be easily 

spread and have a high mortality rate; the highest level 

laboratory; requires well-trained personnel; safety 

precautions include airtight room surrounded by concrete 

walls, decontamination showers, airtight suits, high security; 





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Capsule An armor-like coating made of polysaccharides or proteins 

that protect the bacteria from being engulfed and digested by 

the body’s phagocytic white blood cells, neutrophils, and 

Cell-Mediated 

immunity 

2 Centers for Disease 

Control and 

Prevention (CDC) 

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macrophages. 

An adaptive immune response mediated by T cells; responds 

to and destroys pathogens that live inside cells. 

Federal agency under the Department of Health and Human 

Services whose mission is to promote health and quality of 

life by preventing and controlling disease, injury, and 

disability; headquarters in Atlanta, Georgia. 

Complement 20 proteins, synthesized in the liver, that circulate in the 

blood and are delivered to the site of infected tissues through 

the process of inflammation. 

2 Contagious Capable of being transmitted by bodily contact with an 

infected person or object: contagious diseases. 

3 Containment Prevention of the spread of organisms outside of laboratory 

Immune 

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facilities and into the environment. 

Cytotoxic T-cell Recognize, target and kill body cells that have viruses 

multiplying within them and leave behind memory cells. 

Early immune 

defenses 


3 Ebola A highly lethal virus that causes massive internal bleeding. It 

is thought that the virus originated in central Africa and was 

passed to humans from primates. No treatment or vaccine is 

available. 

2 Emerging disease Any group of diseases that have newly appeared in humans 

Immune 

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phagocytes 

or are increasing in incidence. 

Movement of the phagocytes (first neutrophils and then 

macrophages) from the blood vessels into the tissues during 


2 Endemic Disease that is constantly present in a particular location or 

population. 

2 Epidemic 

A disease that increases in occurrence above the normal level 

in a given population. The terms “outbreak” and “epidemic” 

are often used interchangeably, although “outbreak” is 

sometimes used to refer to a more localized situation and 

“epidemic” for more widespread situations. 

2 Epidemiologist A scientist who studies the distribution, transmission, and 


2 Epidemiology Study of the distribution, incidence, prevalence, causes, and 

control of disease in a population. . 




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Flagella A structure that helps bacteria to swim through the protective 

mucus that overlies the body’s mucous membranes and reach 

the surface of the mucous membranes. 

1 Fomite An inanimate object, such as a towel or shirt that is capable 

of transmitting a pathogen; S.aureus is commonly 


1 Fungi (fungus) A diverse group of microorganisms that range from 

unicellular forms (yeasts) to multicellular molds and 

mushrooms. Fungi play varying roles including producing 

antibiotics, decomposing dead organisms; some fungi cause 

disease in plants, humans and other animals. 

3 Germ warfare Using pathogenic viruses and bacteria to harm others. 

2 Hemorrhagic Loss of blood or other body fluids as a result of infection 

from a pathogen, usually a virus. 

1 Host An organism (such as the human body) that harbors a 

Immune 

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pathogen (such as a virus, bacterium, or fungus). 

Humoral immunity An adaptive immune response mediated by B cells and 

antibody; protects against extracellular pathogens that are 


Immune Immune system A complex and dynamic system of cells, tissues, and organs 

System 

distributed throughout the body. It includes the skin and 

411 

mucous membranes, the bone marrow, the thymus, the 

spleen, and the lymphatic system, a network of vessels that 

allows the lymphocytes and other immune cells to circulate 

throughout the body, to enable them to find and respond to 

foreign invaders. 

1 Immunologist A specialist concentrating on disease processes that involve 

the immune system including allergies. 

2 Incidence Rate at which new cases of disease infection occur over a 

certain period of time. 

1 Infection The multiplication (colonization) of pathogens in the body 

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without symptoms. 

Inflammation The body’s response to injury and to the introduction of 

pathogens into tissue; designed to deliver phagocytic cells 

and blood proteins (including complement) from the blood 

stream to infected tissues. It is easy to identify because of 

characteristic symptoms: redness, heat, swelling, and pain at 

Inflammatory 

Process 

Innate 



the site of injury. 

Delivers blood proteins (including complement) and 

phagocytic white blood cells to the site of the infection to 

engulf and destroy bacterial pathogens 


Defenses found at body surfaces and in tissue and blood; 

designed to quickly eliminate pathogens within hours of the 

time they enter the body; do not exhibit immunological 

memory. 



3 Influenza A contagious respiratory illness caused by influenza viruses. 

It can cause mild to severe illness and at times can lead to 

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death. 

Interferon Proteins produced by cells that have been invaded by 

viruses. Interferons are made by cells within hours after a 

virus enters and begins to multiply. They are released from 

infected cells and attach to the surface of healthy cells 

nearby, causing them to produce antiviral proteins which will 


factors 

protect them should a new virus enter the cell. 

Help bacterial pathogens invade across the mucous 

membranes into the tissue spaces below. For example, 

pathogens make an enzyme that dissolves the tight 

connections between the cells of the mucous membranes. 

This allows the bacteria to pass between the cells and reach 

the tissues beneath the mucous membranes. 

2 Lassa Fever An acute viral hemorrhagic disease found in Western Africa. 

Immune Late immune See adaptive immune defenses. 

System 

411 

defenses 

2 Legionella 

pneumophila 

Pathogenic bacteria that can cause Legionnaires’ disease. 

2 Legionnaires’ Form of pneumonia caused by the pathogenic bacterium 

disease 

Legionella pneumophila which was first discovered at an 

American Legion convention in Philadelphia in 1976; mainly 

spread through air-conditioning systems and water pipes. 

1 Lethal Of, pertaining to, or causing death; deadly; fatal. 

Immune Lymph node Immune system organs which serve to filter foreign antigens 

System 

and to provide a location where pathogens can interact with 

411 

T and B lymphocytes; will swell in response to infection. 

Immune Lymph vessels The immune system’s network of tubes which carry lymph; 

System 

immune cells and pathogens; ultimately joins to the blood 

411 


Immune Lymphatic System Network of lymph vessels and nodes in which lymphocytes 

System 

circulate; functions to collect fluids from tissues and to 

411 

return them to the blood. 

Immune Lymphocytes Lymphocytes are part of adaptive or late immune defenses 

System 

and their major function is to target and make a tailor-made 

411 

response to specific pathogens that survive the innate/early 

immune defenses. They are able to make tailor-made 

response to invading microbes because they have specific 

recognition molecules on their surfaces. 

Immune Macrophage The largest of the immune system cells that migrate 

System 

throughout the body’s tissues. They are the second to 

411 

“answer the call” when bacterial pathogens infect body 

tissues and the process of inflammation begins. 




2 Mastomys 

natalensis 

A type of wild bush rat found in Africa; carrier of the Lassa 

virus which can be transmitted to humans through their 

droppings causing Lassa fever. 

3 Measles Virus A highly contagious vaccine-preventable disease and most 

deadly of all childhood rash/fever illnesses. It is spread by 

droplets or direct contact with nasal or throat secretions of 

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Complex 

infected persons. 

Complement proteins that assemble in the outer membrane 

of bacteria and the envelopes of viruses forming pores that 

cause the pathogens to lyse. 

Memory B-cell Memory B cells are lymphocytes that are left behind to 

circulate in the body for years after a primary humoral 

immune response has been made to an extracellular 

pathogen. Should the same pathogen enter the body again, 

these cells will quickly recognize and respond to the invader, 

making a stronger and vigorous secondary immune response 


Cells 

to quickly eliminate it from the body. 

Memory T helper cells are lymphocytes that are left behind 

to circulate in the body for years after a primary immune 

response has been made. They circulate for years in the body 

and will orchestrate a faster and stronger response if the 

same pathogen invades the body in the future. 

1; 3 Microbe A minute life form; a microorganism, especially a bacterium 

that causes disease. 

1 Microorganism An organism too small to be seen with the naked eye. 

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Also called a microbe, germ, or bug. 

Mucous membranes Epithelial cells which line the internal surfaces of the body 

and act as barriers to prevent microbes from reaching deeper 

body tissues; the first level of defenses against pathogens; 

1 Methicillin-resistant 


aureus (MRSA) 

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part of innate immunity. 

A species of Staph bacteria that has changed in such as way 

that it has become resistant to penicillin and other antibiotics; 

if it infects skin and penetrates body tissue can cause boils 

and blisters. 

Natural killer cell An innate immune cell important in antiviral defenses. The 

primary function of a natural killer cell is to 1) target, 2) 

dock to, and 3) kill body cells that have been invaded by 

viruses. 

Neutrophil Phagocytic white blood cells that circulate in the blood and 

are the first to “answer the call” when a bacterial pathogen is 

detected 

Nonspecific 

immune system 






1 Normal flora Microbes which naturally grow on surfaces or inside of the 

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human body and do not cause disease. 

Opsonization Coating of pathogens with antibody or complement proteins 

to render them more easily phagocytosed by phagocytic 

white cells. 

2 Outbreak See Epidemic. The terms “outbreak” and “epidemic” are 

often used interchangeably, although “outbreak” is 


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Outer immune 

defenses 


Defenses that act as a barrier between the body and 

pathogens, includes skin and mucous membranes. 

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Pathogen A disease causing microorganism. 

3 Pathogenic Capable of causing disease, a characteristic of many 

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microbes, both bacteria and viruses 

Phagocytes Large white blood cells that can engulf, kill and digest 

pathogenic microorganisms. As part of the innate or early 

immune defenses, they make a quick response, usually 

within hours of invasion. 

Phagocytosis Process by which white blood cells defeat invaders by 

engulfing, killing and “digesting” them. 

Immune Pili Straight, hair-like structures that extend from the bacterial 

System 

cell surface. The tip of the pilus mediates the attachment of 

411 

bacteria to the surface of the mucous membranes. Once the 

bacteria are firmly attached, they cannot be swept away in 


3 Plague Plague is an infectious disease of animals and humans 

caused by the bacterium, Yersinia pestis. People usually get 

plague from being bitten by a rodent flea that is carrying the 

plague bacterium or by handling an infected animal. 

2 Population census Official count of people in a population; needed to establish 

prevalence or incidence of a specific disease. 

2 Prevalence Percentage of people that have a specific disease at a given 

3 Rabies Virus 

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point in time. 

A preventable viral disease of mammals most often 

transmitted through the bite of a rabid animal; a fatal disease 

that affects the central nervous system. 

Resolution Repair of damaged tissues by immune cells 




3 Rift Valley Fever (RVF) is an acute, fever-causing viral disease that affects 

domestic animals (such as cattle, buffalo, sheep, goats, and 

camels) and humans. RVF is most commonly associated 

with mosquito-borne epidemics during years of unusually 


3 Salmonella A group of pathogenic bacteria that cause diarrheal illness in 

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humans. 

Skin Thick layer of cells which cover the body and cannot be 

penetrated by a pathogen unless wounded; contains oil and 

sweat glands; provides the first level of external defenses 


system 

against pathogens; part of the innate immune system. 


Spleen Immune system organ which filters the blood, removing 

pathogens and old red blood cells; located on left side of 

1 Staphylococcus 

aureus (Staph) 

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body between the stomach and diaphragm. 

A common bacterial pathogen which causes 70% of all skin 

and soft tissue infections in the U.S.; known for its ability to 

become resistant to antibiotics. 

Thymus Immune system organ which “teaches” T-cells how to fight 

pathogens; located in chest between breast bone and heart 

Immune Toxin A chemical substance or poison that can harm the human 

System 

body; a common virulence factor among pathogenic bacteria. 

411; 1 

Exotoxins released by pathogenic bacteria kill body cells 

and also incoming phagocytic white blood cells. This allows 

the pathogens to escape the phagocytes and multiply in body 

tissues. 

1 Transmission The process by which disease is spread. 

2 Tuberculosis (TB) A highly contagious bacterial infection caused by 

Mycobacterium tuberculosis; typically spread through the 

air; characterized by the formation of tubercles in the lungs 

(pulmonary TB) and sometimes other organs. 

3 Typhus Any one of several similar diseases caused by louse-borne 

bacteria, in the genus Rickettsia. Characterized by 

symptoms of chills, fever, headache and a rash, 1-3 weeks 

after the louse bite occurs. 

2 Vaccine A weakened or killed version of a pathogen which; when 

administered, will induce an immunological response to 

disease; gives the immune system a “sneak preview” of the 

pathogen and “educates” the immune system about how to 

defend itself in advance. 




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Vasodilation The first event that occurs in the inflammatory process; an 

increase in the diameter of the small blood vessels near the 

site of the infection to increase the blood flow to the injured 

area. 

Immune Vasopermeability The second event that occurs in the inflammatory process; an 

System 

increase in the permeability of these blood vessels which 

411 

allows complement and other blood proteins (see below) to 

leak into the infected tissues. 

1 Virulence factor A characteristic possessed by a microbe that contributes to 

Immune 

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its pathogenicity (its ability to cause disease). 

Virus Extremely small, infectious agent which is obliged to 


3 West Nile Virus A viral disease spread by infected mosquitoes, which can 

cause a serious, life- threatening infection of the brain 

(encephalitis). Virus transmission may occur in parts of the 

country where mosquitoes are still active. 

3 WRCE “Western Regional Center of Excellence” for Biodefense and 

Emerging Infectious Disease Research; a regional laboratory 

center which focuses on the diagnosis, treatment, and 

prevention of dangerous infectious diseases. 

2 Zoonotic disease A disease that can be transmitted from animals to humans. 

Sources: 

Edited by Leanne Field, PhD, The University of Texas at Austin and Katherine Skala, The University of Texas Health Science Center at Houston 




Willey, Joanne, Sherwood, Linda, Woolverton, Christopher (2008). Prescott, Harley, & Klein Microbiology, Seventh Edition. 





HEADS UP 


Glossary of Terms – Sorted by Unit 


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Helper Cells 

Adaptive 


Immune System 

Orchestrate both humoral and cell-mediated immune 

responses by sending cytokine “cell signaling” molecules to 

B cells and to macrophages, telling them to “get activated” 

and respond to the pathogens they have encountered. 

Defenses that respond when pathogens get past the first and 

second levels of the innate immune defenses. The T and B 

lymphocytes that comprise the adaptive immune defenses 

make tailor-made responses directed against specific 

pathogens. Once activated, T and B cells 1) form clones of 

cells to eliminate the pathogen and 2) leave behind memory 

cells that make future responses more efficient. 

Antibodies Y-shaped proteins produced by activated B cells (plasma 

cells). Secreted antibodies bind to specific pathogens, 

targeting them for elimination by phagocytic white blood 

cells or complement proteins. 

Antigen A foreign substance that stimulates the adaptive immune 

system. 

Apoptosis Programmed cell death or “cell-suicide”; the method used by 

the immune system to destroy virus-infected cells. 

B cells Mediate humoral immunity. B cells recognize and bind to 

extracellular pathogens that are free floating in the body or 

are “hanging out” in between cells. After binding, they are 

activated to form a clone of effector cells (plasma cells) that 

produce antibody and memory cells. The antibody coats the 

pathogens targeting them for destruction by phagocytes or 

Bacterium 

(Bacteria) 


A small, single-celled microscopic organism; some can 


Biofilm A complex structure adhering to surfaces that are regularly in 

contact with water, consisting of bacteria and sometimes 

other microorganisms such as yeasts, fungi, and protozoa 

that secrete a mucilaginous protective coating in which they 

are encased. 

Bone marrow Found inside of the long bones of the body; stem cells in the 

bone marrow produce the “formed elements” of the blood: 

white blood cells, red blood cells and platelets. 

Capsule An armor-like coating made of polysaccharides or proteins 

that protect the bacteria from being engulfed and digested by 

the body’s phagocytic white blood cells, neutrophils, and 

macrophages. 




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Cell-Mediated 

immunity 

An adaptive immune response mediated by T cells; responds 

to and destroys pathogens that live inside cells. 

Complement 20 proteins, synthesized in the liver, that circulate in the 

blood and are delivered to the site of infected tissues through 


Cytotoxic T-cell Recognize, target and kill body cells that have viruses 

multiplying within them and leave behind memory cells. 

Early immune 

defenses 


phagocytes 


Movement of the phagocytes (first neutrophils and then 

macrophages) from the blood vessels into the tissues during 


Flagella A structure that helps bacteria to swim through the protective 

mucus that overlies the body’s mucous membranes and reach 

the surface of the mucous membranes. 

Humoral immunity An adaptive immune response mediated by B cells and 

antibody; protects against extracellular pathogens that are 


Immune system A complex and dynamic system of cells, tissues, and organs 

distributed throughout the body. It includes the skin and 

mucous membranes, the bone marrow, the thymus, the 

spleen, and the lymphatic system, a network of vessels that 

allows the lymphocytes and other immune cells to circulate 

throughout the body, to enable them to find and respond to 

foreign invaders. 

Inflammation The body’s response to injury and to the introduction of 

pathogens into tissue; designed to deliver phagocytic cells 

and blood proteins (including complement) from the blood 

stream to infected tissues. It is easy to identify because of 

characteristic symptoms: redness, heat, swelling, and pain at 

Inflammatory 

Process 

Innate 



the site of injury. 

Delivers blood proteins (including complement) and 

phagocytic white blood cells to the site of the infection to 

engulf and destroy bacterial pathogens 


Defenses found at body surfaces and in tissue and blood; 

designed to quickly eliminate pathogens within hours of the 

time they enter the body; do not exhibit immunological 

memory. 



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Interferon Proteins produced by cells that have been invaded by 

viruses. Interferons are made by cells within hours after a 

virus enters and begins to multiply. They are released from 

infected cells and attach to the surface of healthy cells 

nearby, causing them to produce antiviral proteins which will 


factors 

Late immune 

defenses 

protect them should a new virus enter the cell. 

Help bacterial pathogens invade across the mucous 

membranes into the tissue spaces below. For example, 

pathogens make an enzyme that dissolves the tight 

connections between the cells of the mucous membranes. 

This allows the bacteria to pass between the cells and reach 

the tissues beneath the mucous membranes. 


Lymph node Immune system organs which serve to filter foreign antigens 

and to provide a location where pathogens can interact with 

T and B lymphocytes; will swell in response to infection. 

Lymph vessels The immune system’s network of tubes which carry lymph; 

immune cells and pathogens; ultimately joins to the blood 


Lymphatic System Network of lymph vessels and nodes in which lymphocytes 

circulate; functions to collect fluids from tissues and to 

return them to the blood. 

Lymphocytes Lymphocytes are part of adaptive or late immune defenses 

and their major function is to target and make a tailor-made 

response to specific pathogens that survive the innate/early 

immune defenses. They are able to make tailor-made 

response to invading microbes because they have specific 

recognition molecules on their surfaces. 

Macrophage The largest of the immune system cells that migrate 

throughout the body’s tissues. They are the second to 

“answer the call” when bacterial pathogens infect body 


Complex 

tissues and the process of inflammation begins. 

Complement proteins that assemble in the outer membrane 

of bacteria and the envelopes of viruses forming pores that 

cause the pathogens to lyse. 

Memory B-cell Memory B cells are lymphocytes that are left behind to 

circulate in the body for years after a primary humoral 

immune response has been made to an extracellular 

pathogen. Should the same pathogen enter the body again, 

these cells will quickly recognize and respond to the invader, 

making a stronger and vigorous secondary immune response 

to quickly eliminate it from the body. 




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Cells 

Memory T helper cells are lymphocytes that are left behind 

to circulate in the body for years after a primary immune 

response has been made. They circulate for years in the body 

and will orchestrate a faster and stronger response if the 

same pathogen invades the body in the future. 

Mucous membranes Epithelial cells which line the internal surfaces of the body 

and act as barriers to prevent microbes from reaching deeper 

body tissues; the first level of defenses against pathogens; 

part of innate immunity. 

Natural killer cell An innate immune cell important in antiviral defenses. The 

primary function of a natural killer cell is to 1) target, 2) 

dock to, and 3) kill body cells that have been invaded by 

viruses. 

Neutrophil Phagocytic white blood cells that circulate in the blood and 

are the first to “answer the call” when a bacterial pathogen is 

detected 

Nonspecific 

immune system 



Opsonization Coating of pathogens with antibody or complement proteins 

to render them more easily phagocytosed by phagocytic 

Outer immune 

defenses 

white cells. 

Defenses that act as a barrier between the body and 

pathogens, includes skin and mucous membranes. 

Pathogen A disease causing microorganism. 

Phagocytes Large white blood cells that can engulf, kill and digest 

pathogenic microorganisms. As part of the innate or early 

immune defenses, they make a quick response, usually 

within hours of invasion. 

Phagocytosis Process by which white blood cells defeat invaders by 

engulfing, killing and “digesting” them. 

Pili Straight, hair-like structures that extend from the bacterial 

cell surface. The tip of the pilus mediates the attachment of 

bacteria to the surface of the mucous membranes. Once the 

bacteria are firmly attached, they cannot be swept away in 


Resolution Repair of damaged tissues by immune cells 




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Skin Thick layer of cells which cover the body and cannot be 

penetrated by a pathogen unless wounded; contains oil and 

sweat glands; provides the first level of external defenses 


system 

against pathogens; part of the innate immune system. 


Spleen Immune system organ which filters the blood, removing 

pathogens and old red blood cells; located on left side of 

body between the stomach and diaphragm. 

Thymus Immune system organ which “teaches” T-cells how to fight 

pathogens; located in chest between breast bone and heart 

Toxin A chemical substance or poison that can harm the human 

body; a common virulence factor among pathogenic bacteria. 

Exotoxins released by pathogenic bacteria kill body cells 

and also incoming phagocytic white blood cells. This allows 

the pathogens to escape the phagocytes and multiply in body 

tissues. 

Vasodilation The first event that occurs in the inflammatory process; an 

increase in the diameter of the small blood vessels near the 

site of the infection to increase the blood flow to the injured 

area. 

Vasopermeability The second event that occurs in the inflammatory process; an 

increase in the permeability of these blood vessels which 

allows complement and other blood proteins (see below) to 

leak into the infected tissues. 

Virus Extremely small, infectious agent which is obliged to 


1 Antibiotic 

resistance 

A bacterium’s ability to survive after antibiotic treatment; 

results from the over-exposure or overuse of antibiotics 

which allows the bacterium to mutate its genes or acquire 

new genes that render the treatment ineffective. 

1 Fungi (fungus) A diverse group of microorganisms that range from 

unicellular forms (yeasts) to multicellular molds and 

mushrooms. Fungi play varying roles including producing 

antibiotics, decomposing dead organisms; some fungi cause 

disease in plants, humans and other animals. 

1 Fomite An inanimate object, such as a towel or shirt that is capable 

of transmitting a pathogen; S.aureus is commonly 


1 Host An organism (such as the human body) that harbors a 

pathogen (such as a virus, bacterium, or fungus). 




1 Immunologist A specialist concentrating on disease processes that involve 

the immune system including allergies. 

1 Lethal Of, pertaining to, or causing death; deadly; fatal. 

1 Infection The multiplication (colonization) of pathogens in the body 

without symptoms. 

1; 3 Microbe A minute life form; a microorganism, especially a bacterium 

that causes disease. 

1 Microorganism An organism too small to be seen with the naked eye. 

1 Methicillin-resistant 


aureus (MRSA) 

Also called a microbe, germ, or bug. 

A species of Staph bacteria that has changed in such as way 

that it has become resistant to penicillin and other antibiotics; 

if it infects skin and penetrates body tissue can cause boils 

and blisters. 

1 Normal flora Microbes which naturally grow on surfaces or inside of the 

human body and do not cause disease. 

1 Staphylococcus A common bacterial pathogen which causes 70% of all skin 

aureus (Staph) and soft tissue infections in the U.S.; known for its ability to 

become resistant to antibiotics. 

1 Transmission The process by which disease is spread. 

1 Virulence factor A characteristic possessed by a microbe that contributes to 

its pathogenicity (its ability to cause disease). 

2 Acute Short-term illness; can be mild or fatal. 

2 Antibiotic A substance derived from a microbe that is used to harm or 

kill other microbes. 

2 Centers for Disease Federal agency under the Department of Health and Human 

Control and Services whose mission is to promote health and quality of 

Prevention (CDC) life by preventing and controlling disease, injury, and 

disability; headquarters in Atlanta, Georgia. 

2 Contagious Capable of being transmitted by bodily contact with an 

infected person or object: contagious diseases. 

2 Emerging disease Any group of diseases that have newly appeared in humans 

or are increasing in incidence. 

2 Endemic Disease that is constantly present in a particular location or 

population. 

2 Epidemic 

A disease that increases in occurrence above the normal level 

in a given population. The terms “outbreak” and “epidemic” 

are often used interchangeably, although “outbreak” is 



2 Epidemiologist A scientist who studies the distribution, transmission, and 


2 Epidemiology Study of the distribution, incidence, prevalence, causes, and 

control of disease in a population. . 




2 Hemorrhagic Loss of blood or other body fluids as a result of infection 

from a pathogen, usually a virus. 

2 Incidence Rate at which new cases of disease infection occur over a 

certain period of time. 

2 Lassa Fever An acute viral hemorrhagic disease found in Western Africa. 

2 Legionella Pathogenic bacteria that can cause Legionnaires’ disease. 

pneumophila 

2 Legionnaires’ 

disease 

2 Mastomys 

natalensis 

Form of pneumonia caused by the pathogenic bacterium 

Legionella pneumophila which was first discovered at an 

American Legion convention in Philadelphia in 1976; mainly 

spread through air-conditioning systems and water pipes. 

A type of wild bush rat found in Africa; carrier of the Lassa 

virus which can be transmitted to humans through their 

droppings causing Lassa fever. 

2 Outbreak See Epidemic. The terms “outbreak” and “epidemic” are 

often used interchangeably, although “outbreak” is 



2 Population census Official count of people in a population; needed to establish 

prevalence or incidence of a specific disease. 

2 Prevalence Percentage of people that have a specific disease at a given 

point in time. 

2 Tuberculosis (TB) A highly contagious bacterial infection caused by 

Mycobacterium tuberculosis; typically spread through the 

air; characterized by the formation of tubercles in the lungs 

(pulmonary TB) and sometimes other organs. 

2 Vaccine A weakened or killed version of a pathogen which; when 

administered, will induce an immunological response to 

disease; gives the immune system a “sneak preview” of the 

pathogen and “educates” the immune system about how to 

defend itself in advance. 

2 Zoonotic disease A disease that can be transmitted from animals to humans. 

3 Anthrax An infectious, usually fatal disease of warm-blooded 

animals, especially of cattle and sheep; caused by the 

bacterium Bacillus anthracis. The disease can be transmitted 

to humans through contact with contaminated animal 

substances, such as hair, feces, or hides, and is characterized 

3 Biocontainment 

laboratory 

by ulcerative skin lesions. 

Facilities designed to provide a safe place to work with 

infectious disease agents; including some of the world’s 

most dangerous agents; BSL 2, 3, and 4 labs are 


3 Biodefense research Research that focuses on new ways to detect pathogenic 

viruses / bacteria and discovering ways to treat and protect 

people and animals from diseases that bioterrorists could use. 




3 Bioterrorism The unlawful release of biological agents with the intent to 

intimidate or coerce a government or civilian population to 

further political or social objectives. 


researchers work with microbes that are unlikely to cause 

human disease; lowest level lab and often used for teaching. 


researchers work with pathogenic bacteria and viruses that 

can cause human disease but are not easily spread through 

the air; safety precautions include gloves, lab coat, and 

biosafety cabinet; 

ex: Measles, Salmonella, Rabies 


researchers work with pathogenic viruses and bacteria that 

can spread through the air and cause serious or life 

threatening disease for which there may be no treatment or 

vaccine; safety precautions include double pair of gloves, 

protective gowns, masks, negative air pressure; 



researchers work with some of the most infectious pathogens 

in the world, mostly pathogenic viruses that can be easily 

spread and have a high mortality rate; the highest level 

laboratory; requires well-trained personnel; safety 

precautions include airtight room surrounded by concrete 

walls, decontamination showers, airtight suits, high security; 


3 Containment Prevention of the spread of organisms outside of laboratory 

facilities and into the environment. 

3 Ebola A highly lethal virus that causes massive internal bleeding. It 

is thought that the virus originated in central Africa and was 

passed to humans from primates. No treatment or vaccine is 

available. 

3 Germ warfare Using pathogenic viruses and bacteria to harm others. 

3 Influenza A contagious respiratory illness caused by influenza viruses. 

It can cause mild to severe illness and at times can lead to 

death. 

3 Measles Virus A highly contagious vaccine-preventable disease and most 

deadly of all childhood rash/fever illnesses. It is spread by 

droplets or direct contact with nasal or throat secretions of 

infected persons. 

3 Pathogenic Capable of causing disease, a characteristic of many 

microbes, both bacteria and viruses 




3 Plague Plague is an infectious disease of animals and humans 

caused by the bacterium, Yersinia pestis. People usually get 

plague from being bitten by a rodent flea that is carrying the 


plague bacterium or by handling an infected animal. 

3 Rabies Virus A preventable viral disease of mammals most often 

transmitted through the bite of a rabid animal; a fatal disease 

that affects the central nervous system. 

3 Rift Valley Fever (RVF) is an acute, fever-causing viral disease that affects 

domestic animals (such as cattle, buffalo, sheep, goats, and 

camels) and humans. RVF is most commonly associated 

with mosquito-borne epidemics during years of unusually 


3 Salmonella A group of pathogenic bacteria that cause diarrheal illness in 

humans. 

3 Typhus Any one of several similar diseases caused by louse-borne 

bacteria, in the genus Rickettsia. Characterized by 

symptoms of chills, fever, headache and a rash, 1-3 weeks 

after the louse bite occurs. 

3 West Nile Virus A viral disease spread by infected mosquitoes, which can 

cause a serious, life- threatening infection of the brain 

(encephalitis). Virus transmission may occur in parts of the 

country where mosquitoes are still active. 

3 WRCE “Western Regional Center of Excellence” for Biodefense and 

Emerging Infectious Disease Research; a regional laboratory 

center which focuses on the diagnosis, treatment, and 

prevention of dangerous infectious diseases. 

Source: 

See HEADS UP The Immune System & Infectious Diseases Glossary of Terms – Sorted Alphabetically 


Immunology-Related 

Science Fair Project Ideas 

� Do air ionizers / air purifiers really protect your immune system? 

� How does long-term use of antibiotics affect your immune system’s 

effectiveness? 

� Why is your immune system unlikely to defeat cancer without assistance from 

medical treatment? What is the effect of chemotherapy/radiation on the immune 

system? 

� Do a woman’s eating habits during pregnancy affect the immune system of her baby? 

� How do vaccines work and why should a person be vaccinated? 

� How is your immune system affected when your tonsils are removed? 

� How does stress affect your immunity to the flu? 

� Why does HIV/AIDS make you more susceptible to other infections? 

Ideas from “All Science Fair Projects” Web Site [www.all-science-fair-projects.com] 

Elementary School Level 

Title: How the Body's Immune System Responds to a Virus 

Description: Demonstrate and make illustrations that show how viruses can appear as foreign invaders 

in the blood. 

More info: http://www.all-science-fair-projects.com/project961_110.html 

Instructions: http://www.iit.edu/~smile/bi9212.html 

Title: Does dog saliva kill bacteria effectively? 

Description: This project examines how effective dog saliva is against bacteria. 


Instructions: http://www.gi.alaska.edu/ScienceForum/ASF12/1234.html 

Middle School Level 

Title: What types of food cause the oral allergy syndrome? 

Description: Oral allergy syndrome mainly occurs in people who are also sensitive to tree or grass 

pollens and involves itching, swelling or the development of a rash where certain types of 

food (e.g. fresh fruit and vegetables) touch the lips and mouth. For example, people who 

are allergic to birch pollen may also be allergic to apples. 




High School Level 

Title: Explain the cytopathic effect of human rhinovirus infection on HeLa cells 

Description: A video shows the cytopathic effect of human rhinovirus infection on HeLa cells. At the 

start of the video, uninfected cells are shown. Since HeLa cells are an adherent cell line, 

they normally grow flat and stuck down firmly on the tissue culture flask. After infection 

with rhinovirus, the cells change shape, becoming round and more refractile (brighter) 

under phase contrast microscopy. Some infected cells detach from the tissue culture flask 

and float in the medium: 


Instructions: http://www.microbiologybytes.com/video/virus.html 

Title: Investigation of the immunological mechanism inducing cows’ milk sensitive 

enteropathy 

Description: This research project aims to investigate a possible link between the biological basis for 

allergy to cows' milk and the general rise in allergies among children. The aim of this 

project is to see if there is an association between the behavior of certain immune cells in 

children who are allergic to cows’ milk and the general increase in development of 

allergies of all kinds among children. 


Title: The prevalence and natural history of peanut allergy and the investigation into its 

genetic environment and immunological determinants 

Description: This research project aims to investigate the prevalence of peanut allergy in UK children 

and the factors affecting the development of peanut allergy. 


Title: Manipulation of PGE(2) Levels with Various Cytokines of Thyroid Associated 

Ophthalmopathy 

Description: Graves’s Disease is a form of hyperthyroidism often accompanied by Thyroid Associated 

Ophthalmopathy (TAO), an autoimmune-mediated inflammation of the extraocular 

connective tissue. Despite numerous studies to locate the specific factors that regulate the 

swelling and produce an effective cure, neither of these goals has been achieved. 

Recently, scientists discovered that Prostaglandin E(2) (PGE(2)) is present in 

significantly increased levels in the orbital tissues of patients with TAO, and must be an 

important factor in the inflammatory response around the eyes. The primary goal of this 

research project was to determine the mechanisms that lie behind the up-regulation of 

PGE(2) in patients with TAO and establish correlations among Th1 and Th2 cytokines, 

growth factors, and PGE(2). 




HEADS UP 



Internet sites are provided for convenience and are not necessarily intended as an endorsement. 

HEADS UP Project Web Site www.sph.uth.tmc.edu/headsup 

Science Institutions/Organizations 

The University of Texas Health Science Center at Houston www.uthouston.edu 

National Center for Research Resources (NCRR) www.ncrr.nih.gov 

Science Education Partnership Award (SEPA) www.ncrrsepa.org 

National Institutes of Health (NIH) Office of Science Education science-education.nih.gov 

National Institute of Allergy & Infectious Disease http://www3.niaid.nih.gov 

American Association of Immunologists www.aai.org 

Immunization Action Coalition www.immunize.org 

American Society for Microbiology www.asm.org 

Medline medlineplus.gov 

Classroom Activities 

Anti-bacterial Action Handout school.discoveryeducation.com/curriculumcenter/bacteria/activity2.html 

Who’s the Source of the Infection? 

school.discoveryeducation.com/curriculumcenter/viruses/activity2.html 

Using Balloons to Teach Immunology www.aai.org/educating/using.htm 

Transmission of HIV (Lesson) www.aai.org/educating/teaching.htm 

Shots Are a Good Thing: Whys Shots are Cool www.aai.org/educating/shotsare.htm 

Infection Connection Game medmyst.rice.edu/html/curriculum.html 

Diary of a Disease medmyst.rice.edu/html/teach.html 

Super Agent medmyst.rice.edu/html/teach.html 


www.woodrow.org/teachers/esi/1998/r/health/vashonepres.htm 

School Resources for Teachers 

http://www.nigms.nih.gov/Publications/Classroom 



HEADS UP 




Vaccine Activity 

Experts Have Been Predicting Flu Vaccine Shortage For Years 

http://www.usatoday.com/news/health/2004-10-19-flu-leinwand-questions_x.htm?loc=interstitialskip 

Flu Shot Shortage Looms http://money.cnn.com/2004/10/05/news/midcaps/chiron/index.htm 

Microbe Meals medmyst.rice.edu/html/teach.html 

Vocabulary Terms (Medical Mysteries) medmyst.rice.edu/html/teach.html 

Cool links (Medical Mysteries) medmyst.rice.edu/html/links.html 

Using the ELISA Assay for Disease Detection- Student Handout 

biotech.biology.arizona.edu/labs/ELISA_assay_students.html 

Using the ELISA Assay for Disease Detection- Teacher Guide 

biotech.biology.arizona.edu/labs/ELISA_assay_teacher.html 

Immunology Problem Sets and Tutorials, Activities, and Web Resources 

www.biology.arizona.edu/immunology/immunology.html 

Microbe World Activities and Experiments www.microbeworld.org/resources/experiment.aspx 

Last Clean Chance-Hand Washing Video 

www.charmeck.org/Departments/Health+Department/Communications/Last+Clean+Chance.htm 

Detectives in the Classroom-A Middle School and High School Epidemiology Curriculum for Science, 

Mathematics, and Health Educators www.montclair.edu/Detectives/ 

Web-based Experiences 

Immune System Defender Game nobelprize.org/educational_games/medicine/immunity/ 

Why Don’t We Do It On Our Sleeves? Respiratory Etiquette Video 

http://www.coughsafe.com/media.html 

Health Science Careers / Education 

Health Opportunities in Texas H.O.T. Jobs – A Cool Guide to Health Careers www.texashotjobs.org/ 

East Texas Area Health Education Center (AHEC) http://www.etxahec.org/ 

National AHEC Organization www.nationalahec.org/home/index.asp 

U.S. Department of Labor Teacher’s Guide www.bls.gov/oco/teachers_guide.htm 



HEADS UP 





Virtual Immunology Lab www.hhmi.org/biointeractive/vlabs/ 

Bacterial Identification Lab www.hhmi.org/biointeractive/vlabs/ 

Simulated ELISA www.biology.arizona.edu/IMMUNOLOGY/activities/elisa/elisa_last.html 

Infectious Disease 

Robert Wood Johnson Foundation-New Study: Hospitalizations Related to Superbug Infections Double 

over Six Years www.rwjf.org/programareas/resources/product.jsp?id=23971&pid=1140&gsa=1 

Avian Flu (CDC) www.cdc.gov/flu/avian/ 

Pandemic/Avian Flu (Department of Health and Human Services) www.pandemicflu.gov 

Anthrax www.dshs.state.tx.us/idcu/disease/anthrax/ 

Articles/News Reports/Publications 

Herpes outbreak suspends high school wrestling in Minnesota 

www.usatoday.com/sports/preps/wrestle/2007-01-30-minnesota-wrestling_x.htm?loc=interstitialskip 

Singin’ the West Nile Blues 

publicaffairs.uth.tmc.edu/hleader/archive/Infectious_Disease/2007/wnv-0801.htm 

APHA Prescription for Pandemic Flu 

www.apha.org/advocacy/policy/APHA+Prescription+for+Pandemic+Flu.htm 

Don’t Fear or Panic-An Economist’s View of the Pandemic Flu 

www.bmonesbittburns.com/economics/reports/20051011/dont_fear_fear.pdf 

Microbe Magazine Online http://www.asm.org/microbe/

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