new biology/health curriculum “viruses and bacteria, antibiotic development and antibiotic...

Slide 1NEW BIOLOGY/HEALTH CURRICULUM
9th and 10th Grade Curriculum
“Pure Michigan Science” - MSTA Conference
March 9th and 10th, 2012
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Thank you for giving me the opportunity to talk with you today about a very exciting new curriculum that you will soon be able to share with your 9th and 10th grade biology/health students. I think you will find the two-module lesson plan to be interesting for your students and an easily packaged curriculum for you, as a science/biology teacher. This is one more tool in your tool box, but, it is designed to make it as easy as possible for you, the teacher, to instruct your students and meet many of the biology content standards and competencies.
© MARR Coalition 2002 – 2012 H.S. Curriculum Content
What is the MARR Coalition?
The Michigan Antibiotic Resistance Reduction (MARR) Coalition is a multi-stakeholder, non-profit organization
Supported by an annual, competitive grant from the CDC “Get Smart – Know When Antibiotics Work” Division
The MARR Mission is to:
Encourage appropriate use of antimicrobial agents
Reduce antimicrobial resistance rates through diverse collaboration in the public and professional communities
Promote appropriate use of antibiotics through educational programs and interventions
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Founded by a grant from General Motors in 1997, interested in lowering health care costs. We are able to be as successful as we are through the collaboration and support of entities such as CDC, MDCH, MHA, BCBS, MSIPC, IDSA, and many others.
Educational programs and intervention are directed to the community as well as to healthcare professionals. Michigan is one of six states funded for this purpose by the CDC.
Community Education
elementary students and adults
Consumer education materials (“Antibiotics: What You Should Know” and “MRSA”, posters, fact sheets, FAQs)
MARR website: www.reducemisuse.org
Booths and Exhibits
Legislative education
Health Fairs such as the Michigan Pharmacists Association, FordMotor engine plant employee health days, church health fairs and so on.
IDSA, PEW Trust and educational meetings with legislators
Community presentations to nursing homes, colleges, school PTAs, church groups and others
Getting the Message Out to the Community:
General Public and Professionals
Sharing executive summaries of select AR reports
Development of brochures, public and physician education tools
Presentations
Organizational collaborations
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MARR uses its website to keep the public and professional communities aware of new messages from the CDC about vaccines, healthy living skills, hygiene, data and research. When MRSA first became prevalent, we developed the brochure in conjunction with the MDCH. The CDC is aware that MDROs is not just an in-patient issue but is in the community now. I expect that we may be developing more information about this in the near future. MARR would like to begin putting copies of the MDCH and HEDIS Executive Summaries on its website for those who want more specific, detailed information related to antibiotics resistance.
National Antibiotic Prescribing
CDC Abstract, 10/22/2010
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So, what are some of the reasons we care about antibiotic prescribing in this country? Image made available courtesy of the CDC. This shows that Michigan is in the second highest tier for antibiotic prescriptions per capita.
$5 B annual est. cost to treat viruses with antibiotics – which don’t work, almost 100,000 life-threatening infections with MRSA
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MICHIGAN AND OREGON PROGRAMS COLLABORATE
High School Curriculum Project
MDE, MDCH, science teachers, physicians, nurses, a pharmacist, and microbiologists
9th and 10th grade biology modules
Pre-packaged two day curriculum modules:
Viruses and bacteria,
How antibiotics work
Instructional video for teacher
PowerPoint presentation for students
Note worksheet for students
Report/evaluation
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Great support by Kevin Richard, Science Consultant of the MDE and Cheryl Hach of the Kalamazoo Math and Science Center and the member of the content committees in both Oregon and Michigan.
MICHIGAN SCIENCE CONTENT STANDARDS AND EXPECTATIONS – “BIOLOGY”
Scientific Reflection and Social Implications – B1.2
Organization and Development of Living Systems – L2.p2, L2.p3, B2.1,B2.4, B2.4h, B2.4i
Interdependence of Living Systems and the Environment – L3.p1, L3.p2A, L3.p2B, L3.p2D, L3.p4A
Evolution and Biodiversity – L5.p1, B5.1A,
B5.1cB B5.1c, B5.1d, B5.3g, B5.3A, B5.3f
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RECENT PILOT OF CURRICULUM IN THE KALAMAZOO MATH AND SCIENCE CENTER
Pilot in December with 11th and 12th graders
Pre- and Post-test given
How bacteria can be beneficial to the body
Body’s defenses to preventing bacteria from entering
What an antibiotic is and how it works
What is antibiotic resistance
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Module One: What We Will Learn
What are microbes?
What are viruses?
What are bacteria?
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SO THIS IS SOME OF MODULE I OF BIOLOGY CURRICULUM. IT IS NOT 100% FINAL YET, BUT, WE ARE IN THE PROCESS OF DOING THINGS TO MAKE THE CONTENT as INTERESTING AS POSSIBLE FOR STUDENTS.
ThiS iBEGINS AN OUTLINE OF part one of THE two 45 minute DEVEOPED FOR 9TH AND 10TH GRADE STUDENTS. We will learn: READ SLIDE.
What Some Viruses Look Like
(not to scale)
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There are many different kinds of viruses.
Viruses are extremely tiny and can only be seen under a highly magnified microscope
The human immunodeficiency virus (in red) causes HIV
The Influenza virus causes the flu
Instructor’s note: You may ask the class these questions to begin a discussion: Have you or someone you know recently had a cold or the flu? How did they feel? What were the symptoms? Did they use any medicine to help them get better? How long did it take for them to get over their virus?
Influenza Virus Anatomy
Text:
This is the structure of an influenza virus. Note that the RNA material is the core or center of the virus structure. Antibodies recognize and bind to the external structure, neuraminidase and hemagglutinin, and inactivate the virus also making it easier for the white blood cells to degrade. The reason that we need to receive a new influenza vaccine each year is that from year to year these external structures may change as a result of mutations in the RNA. New yearly vaccines incorporate the new neurominidase and hemagglutinin to stimulate production of antibodies that will bind better to these mutated structures and prevent infection more efficiently.
Viruses Invade Host Cells
Viruses lack some of the machinery to grow and reproduce by themselves
A virus invades a live host cell inside your body and starts replicating itself
The host cell releases the copied viruses
Each released virus will look for a new live host cell to invade and repeat the process
Virus infecting a cell
Key points:
Germs enter your body through any opening they can find.
Viruses infect a cell in your body and turn it into a virus copy machine.
This graphic shows the stages of a viral infection:
Adsorption: the virus finds a suitable cell and attaches itself
Entry: the virus injects its genetic information (DNA or RNA) into the cell and takes control
Replication: the virus transforms the cell into a miniature copy machine and makes millions of copies of its genetic information
Assembly: new copies of the virus are assembled inside the cell
Release: the new viruses are released and the process starts all over again, spreading the infection to more and more healthy cells
Additional activity
This 3½ minute animated video shows how viruses in your body can multiply and make you sick (from National Public Radio website):
http://www.npr.org/blogs/krulwich/2011/06/01/114075029/flu-attack-how-a-virus-invades-your-body
How Do We Contract Viruses?
Simple contact with an infected person (shaking hands [direct contact] or sneezing [respiratory or airborne spread])
Exchange of bodily fluids such as saliva
Sexual contact (e.g., HIV, HPV)
Contaminated food or water
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What Are Some Diseases
result in cervical cancer)
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Here are some diseases caused by viruses that you all may be familiar with: read above
Other Facts About Viruses
Some viral infections can be prevented by vaccines (e.g., influenza, HPV, hepatitis B, measles and mumps)
Treatment for the common cold is
directed toward relief of symptoms
with over-the-counter (OTC)
immune system is fighting the virus
Antiviral medications are available for
certain viruses
Antiviral medications are available for certain viruses (e.g., neuraminidase inhibitors for influenza, inhibitors of DNA replication Herpes Simplex, various types of anti-HIV medications that interfere with different functions of viral infection and proliferation.
ONE OF THE BEST WAYS TO AVOID CONTRACTING A VIRUS IS BY KEEPING YOUR HANDS CLEAN. IT IS MOST EFFECTIVE TO USE REGULAR SOAP AND WARM WATER AND WASH VIGOROUSLY FOR 20 = 30 SECONDS.
Although immunization to prevent some viral infections or symptomatic relief for others, such as colds, are common methods for treating viral infections, antiviral medications are available for some viral infections, such as influenza, herpes simplex, and HIV infection.
Key points:
The flu, colds, and most coughs are caused by viruses.
Antibiotics don’t work on viruses.
Some viral infections can be prevented by vaccines (examples: influenza, polio, chicken pox).
The best way to treat a viral infection, like a cold or flu, is with rest, plenty of liquids, and over-the-counter medicine designed to relieve your specific symptoms such as body aches and fever.
What Are Bacteria?
Single-celled microscopic organisms
human cells
Aid in digestion
Digest sewage into simple chemicals
Extract nitrogen from air and make it available to plants for protein production
Some are harmful (pathogenic):
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Text:
Now we will move into one of our major topics - bacteria. Bacteria are extremely small and can only be seen through microscope. They are single-celled organisms but they are larger than a virus – viruses are even smaller than bacteria. Most bacteria are good and play a positive roll in nature. They aid in digestion, change sewage into simple chemicals, extract nitrogen from the air which plants use for protein production. Some bacteria, however, are harmful – also known as pathogenic. Pathogenic bacteria can damage tissues in the body or produce toxins, causing disease.
What Some Bacteria Look Like
(not to scale)
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Here are a couple of examples of what some bacteria look like. These are not to scale, but, the one on the left is known as E coli which often causes urinary tract infections. Some specific types of E coli can cause very serious
gastrointestinal infections or foodborne illnesses. The strep bacteria on the right (purple) can cause strep throat or skin infections.
Natural Habitats of Bacteria
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Bacteria proliferate more in certain types of environments. They favor moisture and are often found in soil, around plants and in water. Bacteria also thrive in or on animals and humans such as on their skin, upper airway and mouth (where it is moist), in the stomach and intestines and in the vagina.
Most Bacteria Are Harmless
Animals
Humans
Occupy (colonize) sites that might otherwise be invaded by harmful (pathogenic) bacteria
Aid in digestion
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It is important to emphasize that most bacteria are harmless or even helpful. Bacteria recycle organic matter and wastes in soil, water and plants. Bacteria aid in the digestion of cellulose in the stomachs of cows or llamas. Bacteria can
reside (or colonize) humans in sites that might otherwise become invaded by harmful or pathogenic bacteria. Bacteria also aid in human digestion.
Identification of Bacteria
Generally identified by:
shape when viewed under the microscope
procedure called Gram stain, which is positive or negative, depending on absence or presence of an outer membrane and the thickness of the cell wall
whether they require oxygen to grow or are poisoned by oxygen
nutrients they can use to grow
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There are certain features that allow us to identify the presence of bacteria. These include: the shape when viewed under a microscope, a Gram stain procedure that determines the absence or presence of an outer membrane and the correlated thickness of the cell wall, whether it requires oxygen or is poisoned by oxygen, nutrients to grow, and the sequences of proteins made by the bacteria, or sequences of the bacterial DNA or RNA.
Host Defenses Against
entry into the tissue:
Stomach acid
Frequent flushing out of eyes by tears, or of bladder by urine
Mucus in the lungs and coughing
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Some of the host cell defenses used to fight off pathogenic bacteria include: intact skin (no cuts, scrapes, etc.), protective lining of the upper airway, GI tract and vagina, stomach acid , and frequent flushing of the eyes by tears, or of the bladder by urine, and mucus in the lungs and coughing. These all help the body protect the host cells from invasion by the pathogenic bacteria.
Host Defenses Against Pathogenic Bacteria (cont.)
Immune System
Produces specific antibodies (proteins)
Bind and inactivate the bacteria
Cause inflammation and increase blood flow
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In addition, the body’s immune system notifies the body that bacteria and their products are present. This causes the immune system to produce specific antibodies or proteins. These antibodies go to the site of the infection to bind an
inactivate the bacteria. Antibodies can cause swelling or inflammation which increases blood flow to the area, and recruits white blood cells to ingest and kill the bacteria.
How Does Bacteria Damage
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With all of these defenses in place, how do bacteria win and damage the host cell?
How Bacteria Cause Infection
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Harmful or pathogenic bacteria have special features allowing them to overwhelm the immune system defenses and cause infection. These features are called “virulence factors”.
Bacterial Offense
“Virulence Factors”
Produce toxic compounds that damage
host cells or surround tissue
Produce proteins that either disrupt
the host cells or stimulate uptake into the host cells, allowing them to penetrate deeper into different parts
of the body
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Text:
These are some of the features that allow bacteria to be strong enough to overcome the immune system and harm the host cells’: ability to attach themselves to the host cells’, production of toxic compounds that cause damage to the host cells’ or the surrounding tissue, production of proteins that disturb the host cells’ or stimulate uptake into the host cells’ allowing the bacteria to penetrate deeper into the body, and having a feature or component that prevents or limits the host cells’ immune response.
Module Two: What We Will Learn
Antibiotics
Strategies for overcoming antibiotic resistance in bacteria
Appropriate use
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Text:
We will talk about why antibiotics were developed, how antibiotics work against bacteria, how bacteria become resistant, and strategies for overcoming antibiotic resistance in the future.
What is an Antibiotic?
A chemical that kills bacteria or stops them from growing
Antibiotics work only against bacteria, not viruses
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Key points:
Antibiotics are chemicals that kill bacteria or stop them from growing.
There are different types of antibiotics, each designed to work on specific types of bacteria.
Only a healthcare provider can prescribe the right antibiotic for your bacterial infection. It is important to use the right drug for your bug!
Instructor’s note:
Ask the students if they have ever taken an antibiotic. Ask them about their experience: did they visit the doctor? Did they take all of the medicine? Did the medicine make them feel better?
Timeline of Antibiotics and Development of Resistance
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We are going to begin with the timeline of antibiotics and the development of resistance.
Antibiotic Timeline
1940s
The first antibiotics are mass produced for humans and work well
1990s
1950s
Antibiotic resistance begins as soon as the first antibiotics are used
Today
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Antibiotic Timeline:
Bacteria have been around for a long, long time. They were among the first forms of life on this planet. By the time dinosaurs appeared, bacteria had already been here for millions of years. Antibiotics have also been around since prehistoric time, since they were produced by some bacteria and other microbes to defend themselves against aggressive bacteria. Humans discovered penicillin in the 1920s and this began a search for others as well. By the 1940s, antibiotics began to be used to cure bacterial infections. Before antibiotics, people often died from bacterial infections. This timeline puts the evolution of antibiotics into perspective; within just a few years of their introduction into use by doctors - bacteria were becoming resistant to these important, life-saving medicines.
Key points:
Bacteria have been around for millions of years, surviving the ice age and the dinosaurs.
In the 1940s, antibiotics were mass produced and first used by humans to treat infections in people.
Before antibiotics were discovered and made available for physicians to prescribe, there was no effective treatment for bacterial infections. People often died from these infections. In 1924, President Calvin Coolidge’s 16-year old son, who had the best treatment available, died from an infected blister on his foot.
Bacteria have continued to develop new resistance, outsmarting our antibiotics. If we don’t use antibiotics properly, they may not work in the future. Today, microbiologists and researchers are discovering strains of bacteria that are resistant to multiple types of antibiotics. We even have some pathogenic bacteria that do not appear to respond to any of the antibiotics currently available.
Key Knowledge About Antibiotics
The first antibiotics were made from products of soil microbes (fungi and bacteria)
These microbes were fighting with other microbes for space to live and grow in the soil
Chemists developed the first mass-produced antibiotics in the 1940s
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The first antibiotics were naturally occurring products of soil microbes such as fungi and bacteria. They evolved as weapons to fight with other microbes to preserve their own space to live and grow in the soil. Chemists developed the first mass-produced antibiotics in the 1940s. Almost as soon as physicians began prescribing antibiotics in the 1940s, mutant bacteria that were resistant to the antibiotics were selected as the susceptible bacteria were killed off.
Key Knowledge About Antibiotics
Chemists then made new, more sophisticated antibiotics
In a short period of time, bacteria developed resistance to these new antibiotics
Today some newer antibiotics are synthetic, designed to jam and kill the mutating bacteria
Bacteria continue to mutate and survive new antibiotics
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Text:
As resistance began to increase, chemists made new, more sophisticated antibiotics. Within a short period of time, even the more sophisticated antibiotics lost their original effectiveness against bacteria as they continued to mutate and become resistant. Today, some newer antibiotics are synthetic, designed to prevent the proliferation and kill the bacteria. Unfortunately, bacteria continue to be able to mutate and survive our newest antibiotics that have been developed.
Key Concepts to Remember
About Antibiotics
A newly developed antibiotic is most effective when it is first released for human treatment
Today some bacteria have developed multidrug resistance, and, in some cases, bacteria are resistant to all available antibiotics
Over time, even fewer antibiotics will be effective, unless newer ones can be developed to replace them
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Text:
A new antibiotic is most effective against bacteria as soon as it is approved for human use by the Food and Drug Administration (FDA). Shortly after it becomes broadly used, it will select resistant bacteria.
Today, some bacteria have developed multidrug resistance, and, in some cases, bacteria are resistant to all available antibiotics
Over time, even fewer of our current antibiotics will be effective, unless newer ones are developed to replace the antibiotics that are no longer working well.
Research and development of new antibiotics has slowed down. It takes up to ten years to get FDA approval for a new drug and it can cost over $1 billion to develop and test it.
There is less financial incentive to develop an antibiotic, which is usually taken for a limited period of time, as opposed to a drug for high blood pressure that would be taken for life by a larger group of people.
How Antibiotics Work
If you think of bacteria as a lock, then an antibiotic is like a key
I’M A LOCK!
I’M A KEY!
Bacterial Lock and Antibiotic Key
Four things can happen:
The antibiotic key can unlock the bacteria and kill them
The antibiotic key can become damaged so it cannot open the bacterial lock
The bacterial lock can make slight changes so the key (antibiotic) no longer fits in the lock
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If you think of bacteria as a lock and antibiotics as a key – four things can happen:
Text:
The antibiotic key is the right key and unlock the bacteria and kills them
The antibiotic key becomes damaged and cannot open the bacterial lock
The bacterial lock can alter (mutate) itself to the antibiotic key no longer can open the lock
The bacterial keyhole becomes blocked (by mutation), preventing the antibiotic from entering
How Do Antibiotics Fight Bacteria?
Antibiotics disrupt a specific function of a bacterium, preventing its growth and replication by:
interfering with DNA or RNA replication
disrupting the production of the bacterial cell wall
preventing the production of proteins and smaller molecules that are necessary for growth and replication
Dissolving the cell membrane, causing leakage of cytoplasmic contents
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Text:
Antibiotics are designed to disrupt a specific function of the bacteria, causing it to no longer be able to grow and replicate by one of four ways:
Interfering with DNA or RNA replication
Disrupting the production of the bacterial cell wall
Preventing the production of proteins needed for the bacteria to grow and replicate
Dissolving the cell membrane, causing leakage of cytoplasmic contents
Key Concepts to Remember About Antibiotics
A newly developed antibiotic is most effective when it is first released for human treatment, since later use will inevitably select resistant bacteria
Today some bacteria have developed multidrug resistance, and, in some cases, bacteria are resistant to all available antibiotics
Over time, even fewer antibiotics will be effective, unless newer ones can be developed to replace them
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Text:
A new antibiotic is most effective against bacteria as soon as it is approved for human use by the Food and Drug Administration (FDA). Shortly after it becomes broadly used, it will select resistant bacteria.
Today, some bacteria have developed multidrug resistance, and, in some cases, bacteria are resistant to all available antibiotics
Over time, even fewer of our current antibiotics will be effective, unless newer ones are developed to replace the antibiotics that are no longer working well.
Research and development of new antibiotics has slowed down. It takes up to ten years to get FDA approval for a new drug and it can cost over $1 billion to develop and test it.
There is less financial incentive to develop an antibiotic, which is usually taken for a limited period of time, as opposed to a drug for high blood pressure that would be taken for life by a larger group of people.
How Does Resistance Develop?
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The genetic material from resistant bacteria is transferred to susceptible bacteria (again – sensitive in this context means the same as susceptible)
Selective pressure causes proliferation of resistant cells, which are preserved and able to multiply, while the susceptible cells are killed.
Selective Pressure
The presence of an antibiotic selects the growth of an organism that has become resistant by mutation or acquiring new DNA.
Mechanisms include:
Patient non-compliance (only taking for a few days or skipping doses)
Inadequate dosing (dose to low, or doses spaced too far apart)
Misuse of antibiotics
Inappropriate use (patient taking antibiotics prescribed for a different infection)
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Selective pressure means that the presence of an antibiotic selects the growth of an organism to become resistant by mutation or acquiring new DNA. Mechanisms for selective pressure include:
Patient is non-compliant (does not take any medication, takes it for only a few days, or skips doses)
Inadequate dosing (not high enough dosage or doses spaced too far apart) (not taken as prescribed by care provider)
Misuse of antibiotics such as
Overuse (prescribing when not needed)
Inappropriate use (patient taking antibiotics that were prescribed for a different infection)
Unnecessary use of a broad-spectrum antibiotic (prescribing an antibiotic that can adversely affect colonizing bacteria in the GI tract while targeting strep throat).
Important Things to Remember About Antibiotics
Antibiotics kill bacteria, not viruses.
Taking an antibiotic unnecessarily
the antibiotic.
Take your antibiotics as prescribed by your care provider.
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Why Should We Be Concerned About Antibiotic Resistance?
Antibiotic resistance is a serious global problem
Resistant infections are difficult to treat –
the bacteria may be resistant to multiple
types of antibiotics
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Why Should We Be Concerned About Antibiotic Resistance? (cont.)
It takes 10 years to develop a new antibiotic and over $1B to fund the development
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Additional Environmental Concerns
Antibiotics are being used to treat meat animals and poultry to prevent infections rather than to treat them, and to promote faster growth; this excessive antibiotic usage can lead to selection of antibiotic resistant bacteria which can get into humans, either from close contact or consumption of infected meat or dairy products
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Text:
Federal legislation is pending to establish parameters about appropriate use of antibiotics in animal husbandry. Many people do not know how to properly dispose of old or unused antibiotics or other medication. Contact your pharmacy to see if they have a policy of accepting unused medication or if they can direct you to a proper disposal location.
Preventing Bacterial Infection
Cover coughs and sneezes
Eating healthy foods
NEVER take an antibiotic for
a viral infection, like a cold or flu
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Key points:
Prevention is the best medicine -- take care of your body! Eat healthy foods, hydrate yourself with water, exercise regularly and get plenty of rest to keep your immune system strong and functioning.
Keep your hands clean! Washing them with soap and warm water for at least 30 seconds if the best way to get bacteria and viruses off your hands. If you need to cough or sneeze, use a tissue or cough into your sleeve.
Only your care provider can determine whether you have a viral or bacterial infection and what treatment you need.
Never take an antibiotic for a viral infection!
Instructor’s note: If you would like to demonstrate proper hand washing technique, use Glo Germ lotion and a black light to demonstrate how germs spread from person to person.
Instructions: Place a little bit of Glo Germ lotion on the first student’s hands in each row. Have the student rub it in and shake hands with the person next to him, repeating the handshaking to the end of the row.
Turn off the lights in the room. Turn on the black light and hold it over the students hands to illuminate the white lotion. Just like germs, the lotion is spread by hands touching.
What Else Can You Do?
If you are prescribed antibiotics, take all of the medication as prescribed by your care provider
Do not stop taking an antibiotic before the end of the treatment course just because you start to feel better; residual bacteria may multiply, causing recurrence of symptoms that may require retreatment increasing the likelihood of selecting resistant cells
Never share or save antibiotics
Spread the word, not the resistance
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Thank you for your attention!
Pre-packaged lesson Modules I and II will be available at the MARR website soon.
517-664-5263 or email at: [email protected]
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new biology/health curriculum “viruses and bacteria, antibiotic development and antibiotic...

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