2. End-of-chapter questions1 Cholera, malaria, measles and tuberculosis (TB) are infectious diseases. Which row shows the type of organism that causes each of these diseases?
2 Non-infectious diseases are best defined as:
A diseases caused by malnutrition
B all diseases of old age
C all diseases that are not caused by a pathogen
D all diseases that can be transmitted from mother to child.
3 An antibiotic sensitivity test was carried out on bacteria isolated from a patient with a blood disease. Four antibiotics were tested, A, B, C and D. The results are shown in the figure.
Which antibiotic should be chosen to treat the blood disease?
4 Which of the following diseases is transmitted by an insect vector?
A cholera
B HIV/AIDS
C malaria
D TB
5
a State
three ways in which HIV is transmitted.
The table shows statistics for four regions of the world and the global totals for HIV/AIDS in 2010. [3]
b Suggest three sources of data that UNAIDS may use to compile the data in the table. [3]
c Explain why it is important to collect the data on the HIV/AIDS pandemic shown in the table [3]
d i For North America, the ratio of the number of people dying from AIDS to the number of people living with HIV in 2010 was 20000:1.3 million or 0.015: 1.
Calculate the ratio for sub-Saharan Africa. [1]
ii Suggest reasons for the difference between the ratios for North America and sub-Saharan Africa. [3]
[Total: 13]6 a Describe how malaria is transmitted.
The figure shows the global distribution of malaria in 2010.
b Describe and explain the global distribution of malaria. [5]
c Outline the biological reasons for the difficulties in developing and introducing control methods for malaria. [6]
[Total: 14]
7 a Describe how cholera is transmitted. [2]
The table shows the number of cases of cholera and deaths from the disease for the five countries with the greatest outbreaks as reported to the WHO in 2010.
b With reference to the table:
i calculate the case fatality rate for Haiti in 2010 [1]
ii suggest why the case fatality rate varies between countries [3]
iii explain why it is important that the WHO collects data on outbreaks of cholera. [3]
c The WHO also collects data on 'imported' cases of cholera. Among countries reporting these cases in 2010 were Australia, Malaysia and the USA.
i Suggest what is meant by the term 'imported case'. [1]
ii Explain why there are no epidemics of cholera in highly economically developed countries such as Australia and the USA. [2]
[Total: 12]
8 a i Name the causative organism of TB. [1]
ii Explain how TB is transmitted. [2]
b i State the regions of the world with the highest number of cases of TB. [3]
ii Suggest reasons for the high number of cases of TB in some parts of the world. [4]
[Total: 10]
3. End-of-chapter answers
1 A 2 C 3 D 4 CExam-style questions 5 a unprotected sexual intercourse;
sharing needles (between intravenous drug users)/ re-use of unsterilised needles;
blood transfusion/blood products;
(mother to child) across the placenta/at birth/in breast milk; [max. 3]
b doctors?/hospital records;
tests for HIV status (e.g. at antenatal clinics for pregnant women);
death certifi cates; [3]
c to determine how numbers of people infected are changing;
to see where medical resources should be targeted;
e.g. drugs for treating HIV infection;
to monitor success of HIV/AIDS programmes in reducing spread of HIV infection;
and in treating people who are HIV+ so they do not develop AIDS;
to see if more education is required;
to provide support to national/regional health organisations; [max. 3]
d i 0.052 : 1; [1]
ii better health care in North America;
better diagnosis, so people who are HIV+ start treatment early;
more affl uent countries, so drugs available to (nearly) all people who are HIV+; [3]
[Total: 13] 6 a female Anopheles (mosquito);
takes a blood meal from an infected person;
transfers, parasite/pathogen/Plasmodium, in saliva when takes a blood meal from an uninfected person; [3]
b distribution: malaria occurs, between the tropics/tropics and sub-tropics/in equatorial regions/South and Central America, Africa and SE Asia; [1]
explanation:
Anopheles/mosquito/vector, distributed throughout tropical regions;
Plasmodium falciparum cannot complete its life cycle within mosquitoes at temperatures less than 20 °C;
Anopheles needs high rainfall/high humidity/ standing water;
Anopheles lays eggs in water;
no transmission at high altitude;
as too cold for parasite to complete life cycle;
no transmission in deserts; as no breeding grounds for mosquitoes; [max. 4]
c
Plasmodium is intracellular parasite; inside red blood cells/liver cells; antigenic concealment; antibodies are ineff ective; short stage in plasma when antibodies are eff ective;
Plasmodiumis eukaryotic; has many genes/ antigens; difficult to develop a vaccine; resistance to drugs used to treat malaria/as prophylactics; example of drug;
Anopheles/vector breeds in small pools of water; difficult to control all breeding places; mosquitoes come into contact with humans; mosquitoes become resistant to insecticides; [max. 6]
[Total: 14]
7
a bacteria pass out in faeces of infected person; carried in water/food consumed by uninfected person; [2]
b i 2.22; [1]
ii treatment for cholera involves supply of oral rehydration therapy/ORT; and provision of safe drinking water;
better response to emergencies (in some countries);
effectiveness of response may depend on number of cases;
reference to very high number of cases in Haiti;
may depend on remoteness of regions affected by cholera;
or ways in which emergency supplies/ personnel can reach aff ected areas; reference to high case fatality rates in Nigeria/ Cameroon;
use of data to compare case fatality rates in individual country with global rate; [max. 3]
iii cholera is a serious disease;
death can occur very quickly after infection;
spreads quickly in population (especially after a disaster);
deaths are avoidable;
if ORT is available immediately;
data is useful to predict situations/places where cholera may occur;
WHO can coordinate responses to outbreaks; [max. 3]
c i infected person travelled from an area with an outbreak of cholera; [1]
ii water supply is not contaminated with (human) sewage/faeces;
piped water/water supply is treated to kill bacteria;
V. cholerae destroyed in sewage treatment; [max. 2]
[Total: 12]
8 a i Mycobacterium tuberculosis; [1]
ii infected person, coughs/sneezes/spits; aerosol/droplets, containing bacteria breathed in by uninfected person; [2]
b i Sub-Saharan Africa;
South East Asia;
countries of old Soviet Union/Russian Federation;
India/Pakistan/Afghanistan;
South America/Bolivia;
Papua New Guinea; [max. 3]
ii TB linked with HIV infection;
HIV weakens immune system;
TB is an opportunistic disease;
many people are infected although show no symptoms;
transmission where there is overcrowding/ poor housing;
poverty;
poor ventilation of housing;
poor nutrition;
poor access to health care;
poorly organised treatment for people with TB; [max. 4]
[Total: 10]