Viruses and Infectious Diseases

Problems/Case Studies

"Biological Terrorism: The Anthrax Scare of 2001" Kathleen A. Cornely, Providence College. State University of New York at Buffalo's National Center for Case Study Teaching.
In the weeks following the September 11, 2001, terrorist attacks on the World Trade Center and the Pentagon, anthrax-laced envelopes were mailed to individuals in government and the news media by an as-yet-unidentified bioterrorist. Thousands were treated for exposure, and five people were killed. At the same time, scientists solved the last remaining pieces of the anthrax puzzle, and the mechanism of infection of the anthrax toxin is now well understood. Developed for a second-semester biochemistry course, this case presents students with a wealth of biochemical, microbiological, and immunological material to analyze while exploring important societal issues related to national preparedness against bioterrorist attacks, funding for biodefense research, and the use and misuse of antibiotic therapy
This case is appropriate for undergraduate biochemistry, microbiology, and public health courses.
 
"The Fish Kill Mystery" Erica F. Kosal, North Carolina Wesleyan College. State University of New York at Buffalo's National Center for Case Study Teaching.
In this case, students speculate on what may have caused a major fish kill in an estuary in North Carolina. In the process they explore how land runoff and excess nutrients affect aquatic communities and learn about the complex life cycle of the dinoflagellate Pfiesteria.
The case is appropriate for an introductory environmental science course, a general biology course that covers ecology, or a general zoology course.

"Anthrax Attack! A Case on Bioterrorism" Kari A. Mergenhagen, University at Buffalo. State University of New York at Buffalo's National Center for Case Study Teaching.
This case study presents a fictitious bio-terrorist plan to release anthrax in the United States. Students are assigned character roles and, through research, role-playing, and teamwork, develop a plan to minimize or avert the attack.
The case is appropriate for courses designed for health professionals, general biology courses, and social science courses.

"The 1st New Disease of the 21st Century " Otto Sanchez, University of Ontario Institute of Technology. State University of New York at Buffalo's National Center for Case Study Teaching.
This case study uses a PowerPoint-driven approach combined with role-playing to present the epidemiology and pathophysiology of Severe Acute Respiratory Syndrome (SARS). Students learn about the etiology and pathophysiology of the disease, then argue different health professional perspectives on a plan of action for dealing with its consequences.
Developed for a pathophysiology course for undergraduates, the case could also be used in a microbiology course or in a course in public or international health.

"Abracadabra: Magic Johnson and Anti-HIV Treatments". Brian J. Rybarczyk, University of North Carolina, Chapel Hill. State University of New York at Buffalo's National Center for Case Study Teaching
This case introduces students to HIV, its life cycle, treatment, and problems associated with treatment options. The case, which incorporates critical thinking skills, active learning, self-directed study, and peer-to-peer learning, was developed for use in an undergraduate upper-level biology course entitled "The Molecular Basis of Disease."
This case could be used in an immunology class, a molecular evolution class, or a general biology class to introduce viruses.

"Closing the Gap: Antiretroviral Therapy for the Developing World". Robin Pals-Rylaarsdam, Trinity Christian College. State University of New York at Buffalo's National Center for Case Study Teaching
In this problem-based learning/role playing case, students apply their knowledge of the biology of HIV/AIDS and antiretroviral therapy to developing foreign aid policy for the HIV/AIDS crisis in sub-Saharan Africa.
The case was developed for a non-majors course in human biology. It has also been used in a microbiology course for pre-nursing students and in an upper-level microbiology course for biology majors.

"Sex and Vaccination". Erik Zavrel and Clyde Freeman Herreid, University at Buffalo, State University of New York. National Center for Case Study Teaching.
This case study focuses on the controversy surrounding the decision by Texas Governor Rick Perry to mandate the compulsory vaccination of girls in the Texas public school system against the human papillomavirus (HPV) prior to entering the sixth grade. The interrupted case method is particularly appropriate for this subject, with successive sections providing a general overview of the disease, the reasons for and against such a mandatory vaccination program, and a disclosure of what ultimately transpired in Texas.
Designed for an introductory biology course or an ethics course. The case study has a bioethics emphasis.

"The Case of a Tropical Disease and Its Treatment: Science, Society, and Economics". Cathy Santanello and Jennifer Rehg Southern Illinois University at Edwardsville. Designed for a Costa Rican study abroad course, but appropriate for traditional science courses as well, this case highlights the epidemiological and socioeconomic factors associated with Chagas disease. Adrian is a banana plantation worker who develops a mysterious illness. By reading his story, students learn about infectious diseases, pathogens, and vectors endemic to this area of Central America. Students are asked to diagnose Adrian’s illness and consider his dilemma with respect to treatment options. Students also examine alternate approaches to treating this illness that plagues thousands of Central and South American citizens.
The case is appropriate for courses with a component on health care, pharmacology, microbiology, medical anthropology, ethnobotany, or epidemiology.

" The Curse of the Mummy".    Problem-Based Learning Activities for General Biology.  Allen, D. E. and Duch, B. J. (1998).   New York:  Saunders College

    Stage 1:  Two doctors have been commissioned to investigate an unopened tomb of a mummy.  The students conjecture the infectious agents present, protection, and preservation of the body based on the conditions in the burial chamber.

    Stage 2:  The doctors obtain artifacts and specimens from the burial chamber.  Further investigation of disease through animal vectors and introduction of reservoir are part of the investigation.

    Stage 3:  Descriptions of ailments and symptoms are given to students.  Gram-positive bacilli, septicemia, and bacterial characteristics become important as         students diagnose the illnesses of the doctors.   

Human Immunodeficiency Virus (HIV) and the Health-Care Professional. DE Allen.  Thinking Toward Solutions:  Problem-Based Learning Activities for General Biology.  Allen, D. E. and Duch, B. J. (1998).   New York:  Saunders College Publishing, p 78-84.

        Stage 1: Describes a lawyer representing a patient claiming to have been infected with HIV after a surgical procedure.  Students investigate the incidence of HIV infection in the medical field and restrictions on professional activities of HIV-infected individuals.

        Stage 2:  The ethical issues and formalities of CDC reports surface in this investigation.  Modes of HIV transmission are discussed and students develop more in-depth questions to make the case.

        Stage 3:  Students learn about the use of DNA sequences coding for gp120 to provide information of the relatedness of HIV patients.  Students evaluate the   evidence to go on with the case against the dentist.

"Mad Cows of Kent". DE Allen.  Thinking Toward Solutions:  Problem-Based Learning Activities for General Biology.  Allen, D. E. and Duch, B. J. (1998).   New York:  Saunders College Publishing, p 63-69.

        Stage 1: Mad cow disease is investigated including how it is spread among domesticated animals and the ethics of media and promotion of hamburger meat.

        Stage 2:  The hypothesis for the origin of BSE and GSS is from prions (proteinacious infectious particles).  Students investigate how prions cause infectious disease and whether Prusiner's hypothesis is valid considering the cloned protein in the scenario was not infectious. 

        Stage 3:  Students discuss protective measures that still need to be taken to prevent mad cow disease in America.  Students evaluate whether prions are the most likely transmissible agent.

"The Donor's Dilemma".  Biological Inquiry:  A workbook of investigative cases.  Waterman, Margaret, and Stanley, Ethel.  Campbell-Reese. pp.  27-41. 
The investigation leads students to discuss West Nile virus as a man attends a blood drive and is inquisitive as to whether or not he may have the virus.  Genetics, viral genetics, blood testing, vectors, mutations, PCR, and protein synthesis and translation are investigated.  The scientific application gives students the opportunity to graph and learn from figures and diagrams. 


CNN Video Clips

Topic: West Nile Virus: Environmental Science 6th Ed. CNN Ed (1:57 min)
The West Nile virus first appeared in the U.S. during the summer of 1999 and has currently spread to over 33 states, infecting thousands of Americans.  The virus causes flu-like symptoms for most individuals; however, it can be fatal to those with weak immune systems.  In an attempt to predict the virus, NASA developed a technology to track the spread of the virus.  The technology identifies changes in temperature, vegetation, and moisture, which can influence the migration patterns where mosquitoes and birds infected with the virus are likely to spread.  Health officials believe that the results of the satellite data should provide risk maps of where the virus may appear.  The worksheet includes the URL for the CDC website.  (Student worksheet provided on CD)

Topic: Pfiesteria Outbreak: Environmental Science 6th Ed. CNN Ed (1:46 min)
In the late 1980s, Dr. JoAnn M. Burkholder and the North Carolina State University staff discovered laboratory fish were mysteriously dying.  Upon further investigation, Dr. Burkholder found that the culprit was a new toxic dinoflagellate, which was later named Pfiesteria piscicida.  Since the initial discovery, hundreds of millions of fish have been killed in waters near North Carolina, Virginia, and Maryland.  Pfiesteria attacks its prey by releasing a neurotoxin that stuns and eventually kills fish.  The neurotoxin can also be released into the air and can be dangerous to humans.  The worksheet includes the URL to the EPA website.  (Student worksheet provided on CD)

Topic: How Pfiesteria Kills: Biology 7th Ed. CNN Ed 2003 (2:30)
In the late 1990s, massive fish kills on the coast of North Carolina were blamed on outbreaks of Pfiesteria.  Joanne Burkholder was one of first to study the organism, and she claims it kills by emitting a toxin.  Other researchers can find no evidence of a toxin.  They contend the organism kills fish directly by attaching to them and feeding on their skin.  Burkholder dismisses other researchers' results, saying that they are studying a nontoxic strain.  Both groups agree that Pfiesteria is a menace and that understanding it is the key to preventing future outbreaks. (Student worksheet provided on CD)

Topic: Smallpox Threat: Biology 6th Ed. CNN Ed 2002 (5:12)
The most recent smallpox outbreak in the United States occurred in 1947 and was promptly halted with a vaccination program. Global vaccination eliminated the disease as a natural threat in 1977, but some fear it could be used in biological attacks. No one over age 30 has been vaccinated and those who were vaccinated years ago may have only limited immunity. The symptoms and course of the disease are described. It is less contagious than flu or measles and is fatal in about 30 percent of cases.  (Student worksheet provided on CD)

Topic: Preventing HIV Entry: Biology 6th Ed. CNN Ed 2002 (1:48)
Robert Gallo of the Institute for Human Virology describes a promising new strategy in the fight against AIDS. It has been difficult to develop a vaccine against HIV because the viral proteins are constantly changing. Now, researchers believe they have found a stable target for a vaccine. It is a portion of a viral protein (gp120) that is exposed during the binding of the virus to a human cell. If the vaccine works as hoped, the immune system would attack the virus before it could enter and infect a cell. The worksheet includes the URL for the Institute for Human Virology web site. (Student worksheet provided on CD)

Topic: Natural Anthrax: Biology 6th Ed. CNN Ed 2002 (2:20)
A rancher in southwest Texas, part of the "Anthrax triangle," is interviewed. Anthrax is a common animal pathogen in this region, where wet springs are followed by hot dry summers. Animals ingest anthrax spores then sicken and die quickly, bleeding from all orifices. The most recent case of anthrax in this region was cutaneous anthrax. It occurred in a man who skinned an animal known to have died of the disease. It is unlikely that anyone could use animals with anthrax to create a bioterror weapon. (Student worksheet provided on CD)

Topic: Anthrax Bioterror: Biology 6th Ed. CNN Ed 2002 (3:04)
The process by which anthrax is weaponized is described. The goal is to produce spores that enter the alveoli and move to lymph nodes in the chest where they germinate. The three ways in which humans become infected are discussed and the symptoms and treatment of inhalation anthrax are described. Inhalation anthrax can be highly deadly; an accident at a Soviet factory killed 65 people. Many lived some distance from the factory. A vaccine exists which is 93 percent effective after 18 months of treatments. (Student worksheet provided on CD)

Topic: Salon Infections: Biology 7th Ed. CNN Ed 2003 (2:05)
An outbreak of Mycobacterium fortuitum infections that affected 110 women was traced to foot baths in a single nail salon.  The infections caused red bumps on the legs that later developed into boils.  It was cured with antibiotics, but some women were left with permanent scars.  The cause of the infection was improperly sanitized equipment. (Student worksheet provided on CD)

Topic: Global AIDS: Biology 7th Ed. CNN Ed 2003 (2:18)
Twenty years after the AIDS epidemic began, it shows no sign of leveling off.  Twenty million have died, and an estimated forty million are infected.  The countries that are the hardest hit are those that have the fewest resources to fight the disease.  In Botswana, almost half of adults are infected.  The infection rate is growing fastest in countries of the former Soviet Union.  Treatment is key to survival and is largely unavailable.  During 2001, about 25,000 people died in the West where about half a million are receiving treatment.  In Africa, only about 30,000 are receiving treatment, and 2.2 million people died. (Student worksheet provided on CD)

Topic: MonkeyPox: Biology 8th Ed. CNN Ed 2004 (2:33)
Exposure to infected prairie dogs and person-to-person contact were responsible for an outbreak of monkeypox in 2003. In Africa, this disease kills up to 10 percent of those infected. In the United States, infected people were hospitalized, but there were no deaths. Patients were treated with the smallpox vaccine. Monkeypox virus is unlikely to cause an epidemic because it usually cannot spread person-to-person repeatedly. The worksheet includes the URL for the Centers for Disease Control and Prevention's web page about monkeypox.  (Student worksheet provided on CD)

Videos

Cell Wars Humoral Immunity

Cell Wars Introduction

Cell Wars Pandemics

Cell Wars Small Pox Vaccine Development

Cell Wars Small Pox Vaccine Jenner

Articles

"HIV and AIDS" Wessner, David. Ed. Pallandino. The Benjamin Cummings Special Topics in Biology Series. HIV and AIDS. Pearson Education, Inc. 2006.  
This article gives an overview about HIV and AIDS.  First, it focuses on explaining HIV and then AIDS and how they are related.  In this section it explains what a virus, HIV, the Immune System, and AIDS is and how HIV is transmitted.  Other major topics include treatment, discussion on a search for a vaccine, current issues, what the future holds, and other resources for students and Educators. 

"Alien Germ Warfare: Could extraterrestrials succumb to earthly pestilence?" Adams, Cecil. Charleston City Paper.  10 July 20, 2005.
This article questions whether Steven Spielberg's The War of the Worlds has any validity.  It questions the transmission of human diseases from bacteria could affect different species of extraterrestrials.

Avian H5N1 virus: "Lethal bird flu detected in Turkey, Romania"  Vick, Karl. The Washington Post. 14 October, 2005
This article gives a brief synopsis of what the avian H5N1 virus has done and plans of action that the U.N. and Europe plan on taking.

"S.C. Officials Write Grim Flu Scenario: State could be hit hard, DHEC says" Maze, Jonathan. The Post and Courier. 14 October, 2005.
This article address the possible affect of the bird flu on South Carolina, how heal officials have planned for the worst, and what can be done to protect ones self.

"Avian Flu: The Uncertain Threat" Science Times Section. New York Times. 28 March 2006.
- "The Worrier--At the UN: This Virus has an Expert 'Quite Scared'" McNeil, Donald G. Jr. The New York Times. 28 March 2006.
This article is based on the opinion of Dr. David Nabarro, the chief avian flu coordinator for the United Nations. He gives his opinions about the serious risk for a pandemic outbreak of the avian flu.
-"The Skeptic--On the Front: A Pandemic is Worrisome but Unlikely" Rosenthal, Elisabeth. The New York Times. 28 March 2006.
This article is based on the opinion of Dr. Jeremy Farrar, a doctor at the hospital for Topical Diseases in Ho Chi Minh City, Vietnam. He has worked with numerous cases of avian flu in humans and has doubts that a mutation causing a pandemic will occur. If it does occur he worries about the ability to make a vaccine and the effectiveness of the drugs available to treat the avian flu.
-"Q+A" Grady, Denise and Kolata, Gina. The New York Times. 28 March 2006.
This article is a question and answer section addressing issues surrounding the avian flu. It addresses such issues as the serious of the risk of a bird flu pandemic, how detection of a pandemic takes place, if the bird flu affects all birds, and 10 other questions.

"Biological Terrorism" Goodwin, Steve and Philis, Randall.  The Benjamin Cummings Special Topics in Biology Series. Biological Terrorism. Pearson Education, Inc. 2003.
In this article biological weapons are explained, potential biological weapons are discussed, the viruses Smallpox, Anthrax and their vaccines, the subject of the toxin Clostriduium Bolulinum is touched on and the epidemiology of Biological Weapons, and finally additional resources are provided for students and educators.

"Tumor Busting Viruses" Nettlebeck, Dirk M. and Curiel, David T. Current Issues in Biology. Scientific American, Inc. October 2003. 13-21.
Virotherapy is a strategy that uses genetically engineered viruses to attack and destroy cancer cells. This article explains how and why most virotherapy utilizes the adenovirus and how the virus is engineered to find and attach to the tumor cell. There are many strategies that the virotherapist can use to accomplish this and this article explains several of them. The article is followed by a comprehension quiz and some critical thinking questions.

"Detecting Mad Cow Disease" Prusiner, Stanley B. Current Issues in Biology. Scientific American, Inc. July 2004. 2-11.
This article explains how prions are normally produced by the body but they can be abnormally folded, which leads to diseases such as mad cow. New tests are being designed to detect prions. the old technique was not practical for universal applications. The new test is flawed in that it relies on high levels of abnormal proteins, which often only occur in older animals. The need for more tests that have universal applications is extremely high and this article describes many strategies that scientists are currently working on to accomplish this. The article is followed by a comprehension quiz and some critical thinking questions.

"The Danger of AIDS" Blood: The Bearer of Life and Death. A report from the Howard Hughes Medical Institute. 1993. Pg 13.
This is a short article that explains how the virus is spread, what cells the virus attacks, and  how that leads to the death of someone who is infected with the virus. It also explains how the virus uses the CD4 protein on the white blood cells as receptor sites for entry into the cell.

"Shivering and Shaking to Death" The Race Against Lethal Microbes. A Report from the Howard Hughes Medical Institute. 1996. Pg. 42-45.
This article describes how malaria is making a come back and how drug therapy is failing because the parasite can mutate so rapidly. Molecular biology is opening doors to new ideas. For example, mutating a mosquito gene so the mosquito can not pass the parasite. The article outlines the life cycle of the parasite and also its amazing ability to outsmart the human immune system.

"An All-American Girl Meets TB" The Race Against Lethal Microbes. A Report from the Howard Hughes Medical Institute. 1996. Pg. 10-11.
A healthy teenager contracts a resistant form of TB at her high school. She has to have part of her lung removed in order to help the antibiotics have a fighting chance against the bacteria.

"The Dangers of Attachment" The Race Against Lethal Microbes. A Report from the Howard Hughes Medical Institute. 1996. Pg. 18-19.
This article details some of the mechanisms that bacteria use to attach themselves to human cells. If more is understood about these mechanisms, then new drugs could be developed to interrupt or completely stop the attachment from ever occurring.

"The Major Killers" The Race Against Lethal Microbes:  Learning to Outwit the Shifty Bacteria, Viruses, and Parasites that Cause Infectious Disease.  Howard Hughes Medical Institute, 1996.
TB and measles are the most infectious organisms in the world.  This short article reviews worldly impact of infectious organisms.

"The Return of Tuberculosis-In a New, More Menacing Form." Hall, Stephen. The Race Against Lethal Microbes:  Learning to Outwit the Shifty Bacteria, Viruses, and Parasites that Cause Infectious Disease.  Howard Hughes Medical Institute, 1996.
Tuberculosis is the leading cause of death in the world from a single infectious disease. Some forms of TB are drug-resistant.   8 million new cases are found world-wide each year.  Students are introduced to mutations in the surviving microbes which cause resistance to drugs.  America is a melting-pot nation, which brings in molecular footprints from around the world.  The relevance of the topic is that the mode of infection is breathing in microbes from the air.  It is everyone's problem.

"Bird flu strikes fear in hearts of many Americans." Stobbe, Mike.  Post and Courier, Monday, October 17, 2005.
Fear of an Avian flu outbreak prompted much interest directed toward the U.S. Centers for Disease Control.  Officials suggest a supply of Tamiflu.  The H5N1 strain had not yet been found in America. <>

"SC officials write grim flu scenario:  State could be hit hard, DHEC say".  Maze, Jonathan. Post and Courier.  Friday, October 14, 2005.
The article discusses possible SC death tolls from a flu outbreak as well as the social implications of a pandemic.

"Threat is theoretical:  There's no sign bird flue can easily infect humans".  Siegal, Marc. Post and Courier, Friday, October 14, 2005.
In this editorial by an internist at the NYU School of Medicine, Siegal describes the media's coverage of the bird flu and referring to it as a possible pandemic having heightened public awareness and fear of the H5N1 virus strain. 

"The Kissing Bug" Deborah Franklin.  The Race Against Lethal Microbes:  Learning to Outwit the Shifty Bacteria, Viruses, and Parasites that Cause Infectious Disease.  Howard Hughes Medical Institute, 1996.  
Trypanosoma cruzi feast on sleeping humans. This leads to Chagas' disease, resulting in high fever with swollen face and glands.  10 to 18 million Latin American residents are currently infected.  This is a disease of the rural poor.  Countries are running into the problem of T. cruzi tainting their blood supply. 

"Can AIDS Be Tamed?" Maya Pines.   The Race Against Lethal Microbes:  Learning to Outwit the Shifty Bacteria, Viruses, and Parasites that Cause Infectious Disease.  Howard Hughes Medical Institute, 1996.
Cocktail drugs are mandatory in trying to win the fight against HIV/AIDS.  The mutation rate of HIV causes resistance to drugs.  A helpful diagram of virus replication is included. 

"Some Hard-Won Victories." The Race Against Lethal Microbes:  Learning to Outwit the Shifty Bacteria, Viruses, and Parasites that Cause Infectious Disease.  Howard Hughes Medical Institute, 1996.
Contagious diseases are explored, including the last man in the world to catch smallpox.  Vaccinations and sequencing of genes are discussed.

"Are Viruses Alive?"  Villarreal, Luis.  Scientific American.  pp. 13-19.
Viruses are today thought of as a gray area between living and non-living entities.  They cannot replicate on their own but can do so in living cells as they affect the behavior of the host.  Viruses should be considered on an evolutionary scale as important to the history of life.  Scientists have defined viruses as having a "borrowed life".  The article aims to define life and the impact viruses have had on evolution.                                                                                                                                                                                                                                                                                                                                                                      
"The Challenges of STDs".  Ross, Phillip.  Scientific American.  pp. 43-53. 
STDs kill 30,000 Americans each year, one of the leading causes of death.  The evolutionary biology of STDs is discusses, as in the trade-offs of the vehicles of infection employed.  People do not naturally become immune to STDs, unlike some other pathogens.  Syphilis, chlamydia, , herpes, and HIV are also discussed as well as the future of world health. 

Teaching Resources

Emerging and Re-emerging Infectious Diseases.  NIH Curriculum Supplement Series Grades 9-12. 
This workbook is meant for instructors with specific curriculum guides and activities for teaching infectious disease.  Some activities are more laboratory based, while others serve as a review for students.