AS and A LEVEL
Delivery Guide
H022/H422
BIOLOGY B
(ADVANCING BIOLOGY)
Theme: Controlling
communicable diseases: 3.2.3
October 2015
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AS and A LEVEL
BIOLOGY B (ADVANCING BIOLOGY)
CONTENTS
Introduction Page 4
Curriculum ContentPage 5
Thinking ConceptuallyPage 8
Thinking ContextuallyPage 13
3
Introduction
KEY
Delivery guides are designed to represent a body of
knowledge about teaching a particular topic and contain:
• Content: A clear outline of the content covered by the
delivery guide;
• Thinking Conceptually: Expert guidance on the key
concepts involved, common difficulties students may
have, approaches to teaching that can help students
understand these concepts and how this topic links
conceptually to other areas of the subject;
• Thinking Contextually: A range of suggested teaching
activities using a variety of themes so that different
activities can be selected which best suit particular
classes, learning styles or teaching approaches.
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4
A Level content only
Curriculum Content
3.2.3 Controlling communicable diseases
(a) the principles of vaccination
To include the different forms of vaccines (live vaccine,
dead microorganisms, pathogen fragments) and the
importance of booster vaccinations.
(b) the role of vaccination programmes in the prevention
of epidemics.
To include reference to the establishment of herd immunity.
(c) the biological problems in the development of
vaccines and the use of vaccination programmes
To include issues with vaccine development, mutation rate
and antigen variability (eg in HIV and the influenza virus(es))
and live vaccines.
AND
vaccine use – storage of vaccine, distribution of vaccine
and the nutritional status of the target population eg if
protein deficient.
(d) the ethical issues related to the development and use
of vaccines
To include the use of a vaccine in girls against Human
Papilloma Virus (HPV) to prevent cervical cancer.
HSW10
(e) the use of antibiotics in the treatment of
communicable disease
To include an outline of the modes of action of antibiotics
eg inhibition of bacterial protein, DNA and cell wall synthesis.
(f ) how the misuse of antibiotics can lead to the evolution
of resistant strains of bacteria
To include reference to TB and MRSA.
(g) practical investigations on the effect of antibiotics on
Gram-positive and Gram-negative bacteria
To include the bacteriostatic and bacteriocidal effects of
antibiotics and the effects of disinfectant use and other
hygiene practices.
M0.1, M0.2, M0.4, M1.1, M4.1
PAG1, PAG7
HSW3, HSW4, HSW5, HSW6, HSW8
5
Curriculum Content
The control of communicable diseases by vaccination is arguably one of the greatest feats achieved by modern medicine but
the topic provides a number of specific challenges for teachers. These include:
• being aware of developments with regards to antibiotic resistance and the control of antibiotic resistant bacteria in a
clinical setting.
• stimulating students with enthusiasm for a strand of medicine that, due to its level of control and a stringent vaccination
programme, rarely effects the developed world.
• evoking in students a balanced view of the ethical considerations surrounding vaccination and the economical costs of
herd immunity.
• helping students to perceive sequences of events at the cellular and molecular level in what are likely to be very
abstract concepts.
Activity
Resources
Development of antibiotic resistance
http://www.abpischools.org.uk/page/modules/infectiousdiseases_medicines/medicines3.cfm?coSiteNavigation_allTopic=1
MRSA is used as the example to guide students through this four step guide to show the effect of antibiotics on the
development of antibiotic resistant bacteria.
Students could use the resource to gather information and present it in the form of a flow chart to cement learning
and understanding.
Types of Pathogen
http://www.abpischools.org.uk/page/modules/infectiousdiseases_pathogens/index.cfm
General descriptions of pathogens including bacteria, virus, fungi and protozoa are explained with examples of a disease that
each pathogen causes.
Students could be split into groups with each focusing on one pathogen. They could then present their findings to the class and
summarise the findings on each type of pathogen.
6
Curriculum Content
Activity
Resources
How vaccines work
http://www.nhs.uk/Conditions/vaccinations/Pages/How-vaccines-work.aspx
The NHS publish a timeline of when childhood vaccinations should be administered (select the ‘NHS vaccination schedule’ tab).
If it is utilised online, students can use hyperlinks for more information if needed.
Students could summarise key topic areas such as how vaccines are made, how they are used to eliminate disease as well as
information about each vaccine and the disease it controls.
Gram staining activity
http://www.brainpop.com/games/virtuallabsgramstaining
brainpop provide a virtual lab where students can carry out Gram staining on-line to test a contaminated yogurt sample.
Students can practise Gram staining either as a preparatory homework or lesson starter to allow them to practise the steps
required for the procedure. This could be used for students to plan their own method prior to carrying out the procedure.
7
Thinking Conceptually
Approaches to teaching the content
Teaching Aims Content Outline
3.2.3 unless stated otherwise
Two contrasting routes through the specification content are
suggested over the following pages. They are:
Conceptual Route
Ethical Route
The ethical route highlights the distinctions between two very
different types of content: the technical detail of epidemiology
and its causal agents, and the open-ended range of its ethical
judgements. Detail, precision and rigour are necessary to fully
understand the processes, but imagination and maturity are
necessary to appreciate the applications and their relevance
to society. Freedom to innovate and explore are encouraged
in the interactive contextual resources provided.
Conceptual Route
This builds up from the basic structure of the pathogens and
leads on from the prevention of disease in society to the
treatment of infection and the associated risks in a hospital
environment. It would suit able students with a good
background in molecular biology and an ability to clearly
sequence actions.
8
Revise the ultrastructure of a typical eukaryotic plant
cell and a prokaryotic cell, as visible under an electron
microscope
2.1.1 (h) (i)
and (h) (ii)
Revise the structure of a typical virus
3.2.1(c)
Revise how pathogens cause communicable disease
3.2.1(a)
State the principles of vaccination
(a)
Illustrate the biological problems in the development of
vaccines
(c)
Describe the use of vaccination programmes
(c)
Consider specifically the vaccination programme used in
the United Kingdom
(b)
Outline the role of HPV vaccination in the United Kingdom
(b)
Identify and discuss the ethical issues related to the
development and use of vaccines
(d)
Describe the action of antibiotics in the treatment of
communicable disease
(e)
Consider how the misuse of antibiotics can cause the
development of resistant strains of bacteria
(f )
Revise the use of Gram stain to identify bacteria
3.2.1 (d) (ii)
Revise the culturing of bacteria to identify Gram-positive
and Gram-negative cultures
3.2.1 (d) (i)
Carry out a practical investigation into the effect of
antibiotics on Gram-positive and Gram-negative bacteria
(g)
Investigate the preventative measures taken to reduce the
spread of resistant bacteria in hospitals
(g)
Thinking Conceptually
Ethical Route
This route starts by exciting students with the impact that
communicable diseases have on society, the advances
that medicine has made in controlling the spread of
such diseases and the fight back these diseases are
having against medicine such as Methicillin Resistant
Staphylococcus aureus and Clostridium difficile.
It would suit students with a humanities background who
are more likely to engage if the content relevant to society
is presented first. Newspaper articles, web based news
sites or the NHS website can be used to ignite discussion
of communicable diseases.
Explain how the misuse of antibiotics can lead to the
evolution of resistant strains of bacteria
(f )
Revise the use of Gram stain to identify bacteria
3.2.1 (d) (ii)
Revise the culturing of bacteria to identify Grampositive and Gram-negative cultures
3.2.1 (d) (i)
Practically investigate the effect of antibiotics on
Gram-positive and Gram-negative bacteria
(g)
Extend the investigation on Gram-positive and
(g)
Gram-negative bacteria by investigating the effects of
antibacterial hand washes
Teaching Aims Content Outline
3.2.3 unless stated otherwise
Provide a forum for the ethical issues related to the
development and use of vaccines particularly those
for children
(d)
State the principles of vaccination
(a)
Discuss the biological problems in developing
vaccines
(c)
In groups revise the social, ethical, economic and
biological factors involved in the attempts to control
and prevent diseases
3.2.1 (i)
(g)
Consider the role of vaccination programmes in the
prevention of epidemics
(b)
Research the precautions taken to reduce the spread
of resistant bacteria in hospitals
3.2.1(a)
Outline the role of HPV vaccination in the United
Kingdom
(b)
Discuss how pathogens cause communicable
diseases
Discuss the attitude of society to the role of
vaccination programmes
(c)
Outline the modes of action of antibiotics on bacteria (g)
Outline the use of antibiotics in the treatment of
communicable diseases
Outline the programme of vaccination used in the
United Kingdom
(b)
(e)
9
Thinking Conceptually
Common misconceptions or difficulties students may have
The concepts learned in 3.2.3 are relevant to the following
areas of the syllabus and a link could be made back to the
older topic and the 3.2.3 material re-introduced in the later
topics in order to prepare students for synoptic questions.
Understanding the complexity of antibiotic resistance
development and the role of vaccination is made much
simpler if students have a firm grasp of cellular biology, in
particular prokaryotic cell and viral structure.
The ethical dimension to decision-making about vaccination
and its role in society often finds students unprepared
in exams. It is important that students have a clear
understanding of the idea of ethical as meaning morally right,
and that they are used to assessing moral rights and wrongs
without resorting to clichés.
The other major difficulty students encounter is not
appreciating the evolution of antibiotic resistant bacteria and
its impact on causing disease. This is specifically addressed in
both teaching routes set out above.
AS and A Level
3.2.1 (e) how the incidence and prevalence of disease can
change over time
3.2.1 (f ) calculations of incidence rates and prevalence rates,
mortality rates and their importance in epidemiology
3.2.1 (g) the analysis, interpretation and use of
epidemiological data
only
A Level only
4.3.2 (a) the factors that alter the birth rate and death rate in
human populations
5.1.1 (b) gene mutations
5.1.2 (a) the role of natural selection in changing allele
frequencies within populations
5.1.2(b) the link between the changes in the amino acid
sequence to the change in structure and properties of proteins
Conceptual links to other areas of the specification – useful
ways to approach this topic to set students up for topics
later in the course.
Teaching of this topic should be firmly bedded in an
understanding of the social, ethical, economic and biological
factors involved in the attempts to control and prevent
diseases 3.2.1 (i) and how pathogens cause communicable
disease 3.2.1 (a). A secure grasp of the prokaryotic cell
structure, 2.1.1 (h) (i), is also needed.
10
Thinking Conceptually
Activities
Resources
Evolution of antibiotic resistant bacteria animation
http://www.sumanasinc.com/scienceinfocus/antibiotics/antibiotics_fla.html
The misuse of antibiotics leading to the evolutionary
process of antibiotic resistance is explained in a narrated or step through format. The mode of action of antibiotics is explained
along with their impact on the bacteria as a process of natural selection.
There is an option to have the animation narrated so it can be used in class for teaching or by individual students with access to a
computer in a class or private study setting.
Accompanying activities could involve written summaries or translating the information into another form such as a flow chart to
cement learning and understanding.
Hand wash investigation
The following resource can be used to inform students of the correct hand washing technique:
http://teamsciencerocks.weebly.com/bacteria-lab-report.html
A range of handwashes can then be used prior to deliberately contaminating nutrient agar plates (relates to PAG7).
A similar investigation could be carried out with a serial dilution of a single hand wash (relates to PAG7).
11
Thinking Conceptually
Activities
Resources
Carrying out Gram staining
Laboratory applications in microbiology provide a step by step animation showing the steps of gram staining. If used online the
students can test themselves using the ‘test yourself’ questions that follow the animation.
http://highered.mheducation.com/sites/0073402370/student_view0/exercise9/gram_stain.html
A more detailed video tutorial can be used if the students are to be guided through the practical step by step.
https://www.wisc-online.com/learn/career-clusters/health-science/mby4808/gram-stain-procedure
Students should be supplied with pre-prepared bacterial colonies or could produce their own as part of the ‘Hand wash
investigation’. Students should take a sample of the bacterial colony using aseptic technique (PAG3). They can then carry out
Gram staining to identify gram-positive and gram-negative bacteria (PAG1).
Extension: Statistical analysis of results to determine whether handwashes are more or less effective on Gram-ve rather than
Gram+ve (Maths Skill M1.9)
http://www.hometrainingtools.com/a/bacteria-handwashing-newsletter/
Key facts on vaccines
Vaccines Europe provide a comprehensive overview of what a vaccine is, types of vaccine, how vaccines work and how vaccines
are produced.
http://www.vaccineseurope.eu/about-vaccines/key-facts-on-vaccines/how-are-vaccines-produced/
Students could research each aspect and collate their findings to produce an information booklet on vaccines or each topic could
be researched independently by a group who could then present their findings to the rest of the class.
12
Thinking Contextually
ACTIVITIES
Activities
Resources
Interactive materials detailing the use of vaccination and the development of antibiotic resistant bacteria are listed below.
A useful broad context in which to begin to understand the impact of antibiotic resistant bacteria evolution along with the
methods attempting to control it is to consider the documentary ‘Rise of the Superbugs’. The social context of ‘Extensive
Drug resistant TB’ in the documentary allows students to develop interests and curiosity into the development and impact
of the pathogen.
The video can be found at any of these sites:
http://topdocumentaryfilms.com/rise-superbugs/
http://www.disclose.tv/action/viewvideo/141180/Rise_of_the_Superbugs_Documentary/
http://www.dailymotion.com/video/xvxd9k_rise-of-the-superbugs_news
‘Rise of the superbugs’ provides a TB-led context for exploring antibiotic resistance and relating it to the advances in
medicine. This can be used with resources from ‘Big Picture Education’ to allow students to analyse a case study and provide a
comprehensive review with ethical considerations.
http://bigpictureeducation.com/antibiotic-resistance-case-study
The documentary is almost 45 minutes long but provides a fascinating insight into the development of drug resistant diseases
and a look at how scientific research and hospitals operate, which will be of particular interest to year 13 students.
13
Thinking Contextually
Activities
Resources
Human vs Superbugs
BBC iWonder site
The resource gives a broad introduction into how antibiotic resistance develops through to how the advance in resistance may
be halted.
http://www.bbc.co.uk/guides/z8kccdm
Select each section to receive thought-provoking diagrams, video clips and animations. The areas covered include: how antibiotic
resistance develops, human impact on antibiotic resistance, how the problem is being tackled and potential future solutions.
A suggested activity after exploring the resources is to produce a drug information flyer illustrating the importance of completing
a course of antibiotics and the potential consequences of not doing so.
Beginning of vaccination
Science channel
This resource gives a brief introduction into how the first vaccine was produced by Edward Jenner in 1796.
http://www.sciencechannel.com/tv-shows/greatest-discoveries/videos/100-greatest-discoveries-the-beginning-of-vaccination.htm
The clip gives a brief overview of the discovery of vaccination.
This resource gives details of the battle against disease and the success of vaccination in chronological order.
http://www.historyofvaccines.org/content/timelines/all
After watching the clip and researching the timeline students could produce a newspaper article from 1796 detailing what has
been discovered and what it could potentially mean for the future.
Vaccine production
The history of vaccination
The resource gives a comprehensive overview of the different types of vaccine and the pathogens for which they are used.
http://www.historyofvaccines.org/content/articles/different-types-vaccines
Students could work in small groups to produce a summary of one of the types of vaccination and then present their findings to
the class. A worksheet could then be drawn up as a table with column headings detailing the pro’s and con’s of each method of
vaccination.
14
Thinking Contextually
Activities
Resources
Human Papilloma virus
NHS
The resources give a comprehensive overview of what HPV is and some of its potential consequences.
www.nhs.uk/Conditions/vaccinations/Pages/hpv-human-papillomavirus-vaccine.aspx
The second resource gives greater details of the consequences of contracting HPV
www.gov.uk/government/uploads/system/uploads/attachment_data/file/318585/8874_HPV_leaflet_2014_04.pdf
A suggested activity is to divide the class into two groups who should use the resources to plan a ‘for and against’ ethical debate.
As these are publicity materials to encourage the use of HPV vaccination they are by nature easier to use to support the ‘for’
argument and so could be used to differentiate for a less able group with the ‘against’ argument being used for the more able.
HSW10
Pandemic and Plague inc.
These resources are video games built on simulations of epidemic disease spread. They both allow students to create pathogens
and see how specific mutations affect the spread of the disease.
http://pandemic3.com/
Pandemic allows game play at two levels (Relaxed and Realistic) and gives the students the choice of a range of pathogens with
which they can try and cause a pandemic across the world in a short time frame. The instructional guide allows the participation
of students with less experience in computer gaming to try and infect the world with their pathogen.
http://www.ndemiccreations.com/en/22-plague-inc
Plague inc. has a more polished, commercial feel and is not free. It is available as an app for ipad, iphone and Android.
The combination of watching the global spread of a disease, and the link with the microscopic, mutational changes of the
pathogen is thought-provoking.
15
Thinking Contextually
Activities
Resources
Ebola
The resource is a factsheet that gives students a comprehensive description of the problem Ebola virus poses by thoroughly
explaining the symptoms, mode of transmission, treatments and vaccines, and methods of prevention and control.
http://www.who.int/mediacentre/factsheets/fs103/en/
The second resource includes a number of reviews into the spread of the Ebola virus over the first 6 months of the epidemic. They
give details of the impact Ebola is having on the different countries along with the attempts to control the spread of the disease.
http://www.who.int/csr/disease/ebola/ebola-6-months/en/
The suggested activity using resource one is to produce an information leaflet that could be handed out to the general public if
the Ebola virus spread to Britain. The resource should be simple enough to get the points across but still explain a comprehensive
range of control measures.
One of the reviews in the second resource could be used by the students to produce a short newspaper article on Ebola virus and
the attempts at a vaccination programme. These could them be collated to produce an Ebola Fact file.
There is also an excellent BBC Horizon special: ‘Ebola – The Search for a Cure.’ First broadcast on BBC2 10/09/2014. Free iplayer
availability may be limited.
16
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