10 Diseases and immunity

Key objectives
The objectives for this chapter are to revise: l the characteristics and importance of
l definitions of the key terms passive immunity
l how the pathogen for a transmissible disease l the importance of breastfeeding for the
may be transmitted development of passive immunity in infants
l the defences of the body and ways of l the cause of cholera and how it is
controlling the spread of disease transmitted
l how the cholera bacterium causes diarrhoea
l how antibodies work and how to explain
their specificity
l how active immunity is gained and the
process and role of vaccination

Key terms
Term Definition
Pathogen A disease-causing organism
Transmissible disease A disease in which the pathogen can be passed from one host to another
Active immunity Defence against a pathogen by antibody production in the body
Antibodies Proteins that bind to antigens, leading to direct destruction of pathogens or marking of
pathogens for destruction by phagocytes

Pathogens and transmission

Pathogens responsible for transmissible diseases can be spread either
through direct contact or indirectly. When writing about disease-causing
organisms, remember to use the term ‘pathogens’ rather than ‘germs’.

Direct contact
Direct contact may involve transfer through blood or other body fluids.
l For example, HIV can be passed on by drug addicts who inject drugs
into their bloodstream if they share needles with other drug users, as
the needle will be contaminated.
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l Anyone cleaning up dirty needles is at risk of infection if they

accidently stab themselves.
l Surgeons carrying out operations have to be especially careful not to
be in direct contact with the patient’s blood.
l A person with HIV or another sexually transmitted disease (see Chapter 16)
who has unprotected sex can pass on the pathogen to their partner
through body fluids.

Indirect contact
Indirect contact can involve infection from pathogens on contaminated
surfaces, for example during food preparation.

© Dave Hayward 2022 67

 Pathogens and transmission

l Raw meat carries bacteria that are killed if the meat is cooked
adequately. However, if the raw meat is prepared on a surface that
is then used for other food preparation, for example cutting up
vegetables that are later eaten raw, the pathogens from the meat can
be transferred to the fresh food.
l People handling food are also potential vectors of disease, for example
if they do not wash their hands after using the toilet.
l Intensive methods of animal rearing may contribute to the spread of
infection unless care is taken to reduce the exposure of animals to
infected faeces.
l Houseflies act as animal vectors. They walk about on exposed food
and place their mouthparts on it. Then they pump saliva onto the food
and suck up the digested food as a liquid. Unfortunately, they may
have already carried out this process on contaminated food or faeces,
transferring bacteria in the process.
l Airborne infections can be spread by a person with an infection sneezing
or coughing. Droplets containing the pathogen float in the air and may
be breathed in by other people or fall onto exposed food. Examples of
diseases spread in this way include colds, flu, measles and sore throats.
Pathogens cannot usually be passed on by touching a person with the
disease. The pathogen is carried in body fluids such as blood. However,
food can be contaminated when a person with pathogens on their skin
(e.g. dirty hands) handles it.

Controlling disease
l Clean water supply: faeces contain bacteria, which can contaminate
water used for drinking, such as streams, rivers and reservoirs. On a
small scale, drinking water can be boiled to destroy any pathogens.
On a large scale, drinking water can be protected from sewage
contamination, or treated to make it safe. This treatment involves
filtration and chlorination.
l Hygienic food preparation: keeping food-preparation surfaces clean,
avoiding the preparation of raw and cooked food on the same surface,
cooking food thoroughly to kill any bacteria present.
l Good personal hygiene: washing hands after using the toilet, moving
rubbish or handling raw food; avoiding the handling of money when in
contact with unwrapped food.
l Waste disposal: to avoid the development of a breeding ground for
pathogens.
l Sewage treatment: to prevent pathogens in faeces from contaminating
drinking water and to stop vectors such as flies or rats feeding and
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transmitting the disease organism.

Cholera
This disease is caused by the bacterium Vibrio cholerae, which results in
acute diarrhoea. It is transmitted in contaminated water – for example,
from sewage leaking into the drinking water supply.
How cholera causes diarrhoea
Figure 10.1 summarises how cholera causes diarrhoea. When Vibrio
cholerae bacteria are ingested, they multiply in the small intestine and
invade its epithelial cells. As the bacteria become embedded, they

68 Cambridge IGCSE Biology Study and Revision Guide Third Edition

 10 Diseases and immunity

release toxins (poisons) that irritate the intestinal lining and lead to
the secretion of large amounts of water and salts, including chloride
ions. The salts decrease the osmotic potential of the gut contents,
drawing more water from surrounding tissues and blood by osmosis (see
Chapter 3). This makes the undigested food much more watery, leading
to acute diarrhoea, while the loss of body fluids and salt leads to
dehydration and kidney failure.
Water or food
ingested, which
is contaminated
with cholera
bacteria.

Faeces become
watery diarrhoea
small intestine
and this leads to
dehydration and
kidney failure.
Bacteria
reproduce
large intestine rapidly in the
small intestine
The toxins reach and invade the
the large intestine. epithelial cells.
They prevent it from The bacteria
absorbing water release toxins.
from digested food.
 Figure 10.1 How cholera causes diarrhoea

Diarrhoea
Diarrhoea is the loss of watery faeces. It is sometimes caused by bacterial
or viral infection, for example from food or water, resulting in the intestines
being unable to absorb fluid from the contents of the colon or too much
fluid being secreted into the colon. Undigested food then moves through
the large intestine too quickly, resulting in insufficient time to absorb water
from it. Unless the condition is treated, dehydration can occur.
The treatment is called oral rehydration therapy – drinking plenty of
fluids (sipping small amounts of water at a time) to rehydrate the body.

Defences against diseases

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The body has three main lines of defence against disease:

l Mechanical barriers:
l The epidermis of the skin is a barrier that prevents bacteria getting
into the body.
l Hairs in the nose help to filter out bacteria that are breathed in.
l Chemical barriers:
l The acid conditions created by hydrochloric acid in the stomach
destroy most of the bacteria that might be taken in with food.
l Mucus, produced by the lining of the trachea and bronchi, is sticky
and traps pathogens.

© Dave Hayward 2022 69

 Defences against diseases

l Cells:
l One type of white blood cell produces antibodies that attach
themselves to bacteria, making it easier for other white blood cells
to engulf them.
l Another type of white blood cell engulfs bacteria (a process called
phagocytosis) and digests them (see Chapter 9).

Antibodies and immunity

Antibodies are proteins that bind to antigens. They are produced by
lymphocytes, formed in lymph nodes in response to the presence of
pathogens such as bacteria. The pathogens have antigens on their
surface; there is a different antigen with a specific shape for each type
of pathogen. Therefore, a different antibody with a complementary shape
has to be produced for each antigen. The antibodies make bacteria clump
together and mark them in preparation for destruction by phagocytes,
or neutralise the toxins produced by the bacteria. Once antibodies have
been made, they remain in the blood to provide long-term protection.

Active immunity
Some of the lymphocytes that produced the specific antibodies, as
a result of infection by a pathogen, remain in the lymph nodes as
memory cells for some time, and can divide rapidly to produce more
antibodies to respond to further infections by the same pathogen. This
creates immunity to the disease caused by the antigen.
Active immunity can also be achieved by vaccination.

Vaccination
l Vaccination gives a person immunity to a specific disease organism
that may otherwise be life threatening if a person is infected by it.
l Vaccination involves a weakened form of the pathogen that has
antigens, or antigens from the pathogen, being introduced into the
body by injection or swallowing.
l The presence of the antigens triggers an immune response:
lymphocytes make specific antibodies to combat possible infection.
l Some of these cells remain in the lymph nodes as memory cells.
l These can reproduce quickly and produce antibodies in response
to any subsequent invasion of the body by the same pathogen,
providing long-term immunity.
l Mass vaccination can control the spread of diseases. A significant
proportion of a population needs to be immunised to prevent an
epidemic of a disease – ideally over 90%. If mass vaccination fails, the
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population is at risk of infection, with the potential for epidemics.

Passive immunity
l Passive immunity is a short-term defence against a pathogen.
l It is achieved by injecting the patient with serum taken from a
person who has recovered from the disease. Serum is plasma with
the fibrinogen removed. It contains antibodies against the disease –
for example, tetanus, chickenpox, rabies.
l It is called passive immunity because the antibodies have not been
produced by the patient. It is only temporary because it does not
result in the formation of memory cells.

70 Cambridge IGCSE Biology Study and Revision Guide Third Edition

 10 Diseases and immunity

l When a mother breastfeeds her baby, the milk contains some of the
mother’s lymphocytes, which produce antibodies.
l These antibodies provide the baby with protection against infection
at a time when the baby’s immune responses are not yet fully
developed. However, this is another case of passive immunity, as it is
only short-term protection – memory cells are not produced.

Sample question
Distinguish between the terms active immunity and passive immunity. [4]

Student’s answer
Revision activity
Active immunity is a defence against pathogens ✓ by producing antibodies to Make a set of flashcards
fight them ✓. Passive immunity is the same ✗, but is only short term ✗. for this topic:
l You could include
details such as the
Teacher’s comments key definitions,
how a pathogen is
The definition of active immunity is correct. However, passive transmitted, and a list
immunity is not the same as active immunity; in passive immunity, the of body defences.
antibodies are acquired from another individual. The statement about l Look at each flash
passive immunity being short term is correct, but is given as part of a card in turn, put it out
biologically incorrect statement, so it does not gain a mark. of sight, and then try
to say what was on the
card, or write it down.
Correct answer l Repeat the process
Active immunity can be gained by infection with a pathogen, or until you manage to
by vaccination. In active immunity the body produces antibodies get it right. Then move
to respond to further infections by the same pathogen. In passive on to the next card.
immunity, antibodies are acquired from another individual. Passive Keep the set of cards
immunity only offers short-term protection. for revision before
your exams.

Exam-style questions
1 a Define the term transmissible disease. [1]
b State two ways in which pathogens can be transmitted:
i directly [2]
ii indirectly [2]

2 Describe the role of osmosis in causing diarrhoea in a person

infected with cholera bacteria. [4]
3 a Draw a diagram to show how lymphocytes and phagocytes
fight pathogens and destroy them. Annotate your diagram. [6]
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b Distinguish between active and passive immunity. [4]

© Dave Hayward 2022 71

 73

CtrlWarm-Up & Exam

+ Shift Select Questions
to bring onto page
It’s easy to think you’ve learnt everything until you try some questions. Don’t panic if there’s a
bit you’ve forgotten, just go back over that bit until it’s firmly fixed in your brain.

Warm-Up Questions
1) What are the unique molecules found on the surface of pathogens called?
S

2) What is meant by a transmissible disease?

3) How does the skin defend against the entry of pathogens?
4) What is meant by passive immunity?
S

Exam Questions

1 There are many defences that help to prevent pathogens from entering the body.

(a) Describe the role of hairs in the nose.

[1]
(b) Describe a chemical defence of the body against pathogens found in food.
[1]
[Total 2 marks]

2 The methods used to prevent the spread of a disease depend on how the disease is transmitted.
It is important for chefs to wash their hands thoroughly before cooking. Suggest why.

[Total 1 mark]

3 The human immune system fights pathogens using a number of different mechanisms.

(a) Name and describe the mechanism for destroying pathogens which is shown in the diagram.

white blood cell

pathogen

nucleus
[2]
(b) Describe the role of antibodies in the immune response.
S

[3]
[Total 5 marks]

4 Child A and child B are born to different women on the same day.
Child A is vaccinated with the rubella vaccine, but child B is not.
Supplement

Supplement

Three years later the two children are exposed to the rubella virus.
Explain why child B becomes ill but child A does not.

[Total 5 marks]

Section 7 — Diseases and Immunity

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 10 Pathogens and immunity
+ pathogen a disease-causing organism
+ transmissible disease a disease in which the pathogen can be passed from one host to another
0 + active immunity defence against a pathogen by antibody production in the body

+ passive immunity short-term defence against a pathogen by antibodies acquired from another individual, such as
from mother to infant

Exercise 10.1 Food poisoning in the USA

Food poisoning is a major cause of illness in both developed and developing countries. You are asked to
display a set of data in the form of a bar chart, and then to think about the limitations in the information that
these data provide (A02).

The table shows the number and percentage of reported cases of food poisoning acquired in people's homes in the
USA in 2011, caused by five different pathogens.

Pathogen Number of cases Percentage of cases

Norovirus 5461731 58
Salmonella 1027 561 11

Clostridium 965958 lO

Campylobacter 845024 9
Staphylococcus 241148 3

a Explain what is meant by the term 'pathogen.

IGCSE Biology
b Plot these data as a bar chart.

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C Suggest why the percentage of cases does not add up to 100.

d Suggest why the actual number of cases of food poisoning may have been much greater than the numbers shown
in the table.

e List three measures that people can take to avoid food poisoning in their home.

10 Pathogens and immunity

Exercise 10.2 Waste disposal in Australia
In this exercise, you are not given much help in constructing your answers, so you will need to think about
this carefully before you start to write. It would be good to jot down some ideas on a piece of rough paper
first, to help you to plan your answers. Answering these questions will help you to develop A02.

The graph shows information about the amount of solid waste generated in Australia in 2002-3 and in 2006-7, and
how this waste was disposed of.

Disposed as
landfill

Amount of
solid waste
produced I
1000 tonnes

2002-2003 2006-2007

a Compare the data for 2006-7 with the data for 2002-3. (You should be able to think of at least three different
comparisons to make, but see if you can make four.) Use numbers from the graph to support your comparisons.

IGCSE Biology
b Suggest the benefits of increasing the amount of waste that we recycle, rather than disposing of it in landfill sites.

C Calculate the total production of waste in 2002-3 and in 2006-7.

Show your working.

Total waste in 2002-3

Total waste in 2006-7

ii Now calculate the increase in total waste between 2002-3 and 2006-7.

iii Now use your answer to ii to calculate the percentage increase in waste between 2002- 3 and 2006-7, using
this formula:
t . increase in total waste X
percen age mcrease = total waste in 2002-3 100
Show your working.

10 Pathogens and immunity

0 Exercise 10.3 Eradicating polio
This exercise will help you to practise your skills in describing what is shown in a graph and also in
considering what you can safely conclude from the data. Remember that just because two things show a
correlation, that does not necessarily mean that one causes the other - although, of course, there may be a
genuine causal relationship between them.

Polio (short for poliomyelitis) is a disease caused by a virus, which is transmitted from one person to another
through food or water contaminated with faeces from an infected person. Many people show no symptoms when
they are infected, but in a small percentage of cases, the virus enters the spinal cord and causes damage to neurones
that normally send nerve impulses to muscles. This results in paralysis. Polio is much more common in young
children than in adults.
The World Health Organization (WHO) is committed to eradicating polio from the world. This is being done by a
vaccination programme.
The graph shows the estimated number of cases of polio in the world between 1980 and 2005, and the percentage of
children who were vaccinated each year.

100
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a Suggest why children are more likely to get polio than adults. (You may be able to think of more than one reason.)

IGCSE Biology
0 b Describe the changes in the numbers of polio cases between 1980 and 2005. (Remember to quote figures from the
graph in your answer.)

C Discuss the extent to which the data in the graph indicate that vaccination has caused a decrease in polio cases.

d The polio vaccine is unusual, because it can be given by mouth rather than by injection.
Suggest why most vaccines have to be given by injection. (Think about what happens inside the alimentary canal.)

e The polio vaccine contains polio viruses that have been treated to make them unable to reproduce in the body.
Explain how the polio vaccine makes a person immune to polio.

f Polio viruses contain DNA. The viruses in the polio vaccine have DNA in which the base sequence has several
differences from the base sequence in the normal polio virus. Suggest how this makes them unable to reproduce
in the human body.

10 Pathogens and immunity

 10 Diseases and immunity
Core
1 a Define the term pathogen.

b State three ways in which a pathogen can be transmitted.

c Complete the table by giving three examples of body defences.

For each example, describe how it defends the body.

Body defence How it defends the body

1
2
3

Supplement
2 State what could be done to enhance the body’s defences to protect a person from a life-

threatening disease.

3 Outline the role of the immune system in:

a antibody production, making five key points

b phagocytosis, making three key points.

Cambridge IGCSE™ Biology Workbook Third Edition Photocopying prohibited 41

10 DISEASES AND IMMUNITY

4 Explain the process of vaccination, making three key points.

5 Distinguish between passive immunity and active immunity. You should make four clear points.

Exam-style questions
Core
1 a Define the term transmissible disease.

[2]

b Describe how a pathogen is transmitted by

i direct contact

ii indirect contact.

[2]
[Total: 4]

Supplement
2 Explain the effect of cholera bacteria on the body.

[6]

42 Photocopying prohibited Cambridge IGCSE™ Biology Workbook Third Edition