BI302 - Understanding Viral Infections

Understanding Viral
Infections:
Is Ebola the Next
International Pandemic?
Key Stage 3 Programme
Pupil Name
PhD Tutor
1
Timetable Tutorials
Tutorial Date Time Location
1 (Launch Trip)
6 (Feedback)
Timetable Homework Assignments

Homework Assignment Description Due Date
Finding Information Use the attached articles to

Tutorial 1
answer the questions on Ebola Virus Disease.
Recognising Reliable Sources Find your own

Tutorial 2
information and comment on its reliability.
Balancing Arguments and Critical Analysis Critique

Tutorial 3 and compare sources to come to a balanced
conclusion.
Draft Literature Review Find information and begin

Tutorial 4 to structure your literature review, present to your
peers and gather feedback to improve.
Final Literature Review Write a full academic

literature review, using sources from the tutorials and
Tutorial 5
Assignment Submission Lateness and Plagiarism

Lateness
Submission after midnight on ____________________ 10 marks deducted
Plagiarism
Some plagiarism 10 marks deducted
Moderate plagiarism 20 marks deducted
Extreme plagiarism Automatic fail
2
Grade Marks What this means
1st 70+ Performing to an excellent standard at GCSE
2:1 60-69 Performing to a good standard at GCSE
2:2 50-59 Performing to an excellent standard at Y7/8
3rd 40-49 Performing to a good standard at Y7/8
Working towards a pass 0-39 Performing below a good standard at Y7/8
Did not submit DNS No assignment received by The Brilliant Club
Lateness
Any lateness 10 marks deducted
Plagiarism
Some plagiarism 10 marks deducted
Moderate plagiarism 20 marks deducted
Extreme plagiarism Automatic fail

Name of PhD Tutor

Title of Assignment
Name of Pupil
Name of School
ORIGINAL MARK / 100 FINAL MARK / 100
DEDUCTED MARKS FINAL GRADE
If marks have been deducted (e.g. late submission, plagiarism) the PhD tutor should give an explanation in this section:
Learning Feedback Comment 1 - Enter Key Learning Priority Here

What you did in relation to this Key Learning Priority How you could improve in the future
Enter feedback here Enter feedback here

Learning Feedback Comment 2 Enter Key Learning Priority Here

Learning Feedback Comment 3 Enter Key Learning Priority Here

Resilience Comment
How you showed learning resilience during the course How you could build learning resilience in the future

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Course Rationale Page 5
Mark Scheme Page 6
Glossary of Keywords Page 7
Tutorial 1 What is life? Page 8
Homework Assignment 1 Page 15
Tutorial 2 Viruses: The w Page 20
Tutorial 3 Viruses: The Why Page 37
Tutorial 4 Ethics Page 44
Homework Assignment 4` Page 52
Tutorial 5 Presentations Page 53
Final Assignment Page 56
Tutorial 6 Feedback Page 57
Appendices
Referencing correctly Page 59
Using the VLE Page 60
Useful sources Page 61
Notes Page 65
4
more than 1000 people (a number on the rise at the time of writing 21.08.2014). There is currently no
licenced vaccine for Ebola. Meanwhile, the manipulation of viruses proves an ever more viable option in
curing a number of cancers and immune disease. Earlier in 2014 a group of Tanzanian children naturally
immune to malaria began to help scientists develop the first potentially viable vaccine against the
parasite.
As a human race we are at the dawn of a new age in fighting infections and curing disease. It is more
important than ever that the scientists of tomorrow have a deep and critical understanding of the
problems, and solutions, we face.
Microorganisms are touched upon in the KS3 and KS4 curriculums, forming a topic of most GCSE courses
- with an emphasis on bacterial infections. This programme of study will focus on viral infections, an equally
important yet seemingly ignored area of Biology at the secondary stage. In the first tutorial pupils will
learn the differences between viral infections and those caused by bacteria, and will debate the long
Following this, pupils will gain a deep understanding of how and why viruses infect organisms, using Ebola
as a case study. Pupils will learn about the epidemiology of the Ebola, appreciate the difference between
epidemics and pandemics, and understand how scientists work to prevent these situations as well as
develop treatments or cures. Through the assignments pupils will learn skills in research and critical
analysis which will enable them to succeed at GCSE, A-level and higher education. By the end of the
programme pupils will be able to produce an academic literature review of the Ebola virus.
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Skill 1st 2.2
Writing is coherent and organised, At times the writing is poorly organised
following a logical sequence. with a lack of coherent structure.
Almost faultless spelling, punctuation The spelling, punctuation and grammar
and grammar. are weak in places.
Uses appropriate new and scientific Uses simple vocabulary correctly but
language correctly and effectively. may struggle with the effective use of
new scientific language.
Use of new scientific vocabulary shows
Scientific
a detailed understanding of the Scientific language may be used
Fluency
concepts covered. incorrectly at times.
Writing is of an appropriate style for a Inconsistent style throughout
scientific document. document, writing cannot be
considered scientific.
Confidently uses concepts from the
tutorials in an unfamiliar context (ie Only uses concepts from the tutorials in
using knowledge of DNA replication to an unfamiliar context when directed.
discuss virility of Ebola strains).
The literature used effectively The literature used goes some way to
summarises the context of the Ebola summarise the context of the Ebola
virus. virus, but there are obvious gaps left
which could have been researched.
Current theories, reports or work in the
field are used to provide evidence for Little reference is made to current
the relevance of the work. theories, reports or work in the field. As
a result relevance of the work may not
An effective range of sources are used,
be clear.
which are reliable, relevant and
balanced (ie sources are taken from Sources may be unreliable, not
newspapers, journals and textbooks). appropriate for the subject or heavily
Magic
biased with limited attempts to
Source-erer The candidate is able to go beyond
balance these.
the obvious choices, or those
suggested throughout the course. Such References provided are almost always
as using library books and websites from suggested sources and no
beyond those suggested. attempt has been made to think
imaginatively.
All outside sources are referenced
correctly as outlined in appendix 1. Most sources are referenced correctly,
with a few minor errors.
Find a table of what makes an appropriate
and reliable source in appendix 2.
There is clear and secure critical There are limited examples of critical
analysis of most sources (ie this source analysis, or any criticism attempted is
was published by the Kenyan insecure (ie is source is not reliable
government who would not wish to because I found it through Googl ).
damage tourism in the region
Arguments are poorly structured or
The Art of There is a clear and well-structured illogical.
Criticism flow of argument throughout.
Conclusions are poorly reasoned and
Conclusions are well reasoned and not always supported by the literature
included, limitations my not be
clearly supported by the literature
recognised.
included, but limitations are also
recognised.
6
Word Definition
Antibiotic A medicine which prevents the growth of, or kills, bacteria.
Antibody A molecule produced by the immune system to fight infection.
A molecule produced by pathogens which causes an immune response in

Antigen
the host
A microorganism which can cause disease, but may also be helpful to their
Bacteria
hosts.
Contagious Likely to spread and infect other organisms.
Daughter Cell Cell produced after replication.
Widespread occurrence of an infectious disease in a community at a

Epidemic
particular time.
Cells (or organisms whose cells) which contain a nucleus and other structures
Eukaryotic
enclosed by membranes.
Foreign Any molecule which is not recognised as s or from that organism.
Genome The complete set of genetic information in a cell or organism.
Haemorrhagic Fever Internal bleeding which can result in mild to fatal symptoms.
Host The organism in which the pathogen causes disease or lives.
Invasiveness How efficiently a pathogen spreads through the body.
A scientific piece of writing which aims to summarise and critically analyse

Literature review
current research.
Pathogen Any microorganism which causes disease.
Pandemic If a disease is prevalent across a whole country or the world.
An organism or microorganism which relies on a host (or multiple hosts) for

Parasite
their life cycle
Cells which (or organisms whose cells) do not contain a nucleus or other
Prokaryotic
structures enclosed by membranes.
Replicate To make an exact copy of.
Symptoms A physical or mental feature which indicates a disease.
Poison produced by a microorganism (usually bacteria) which acts as an

Toxins
antigen in the host
Vaccine A substance which provide immunity against a disease.
Virus An infective agent which is only able to replicate inside host cells.
7
August 23rd 1976. A group of tourists grope their way through the Congo, central Africa. They re led by
a local man who knows the jungle paths well, he speaks little English but the tourists trust his casual
manner and easy wit.
After several hours hiking they come to a clearing which will be their camp for the night. The guide points
out an irregular shape to the side of the clearing, the tourists are startled it a large monkey lying
immobile on the ground. The guide gestures to the tourists to begin assembling their tents, a task th
become proficient in over the last few weeks, while he goes and investigates the monkey.
Skinned, and expertly skewered over a campfire, the tourists watch (slightly warily) as the monkey
becomes a charcoal black. As the guide tucks in, only one of the tourists is brave enough to try. As the
eldest member of the group he wants the show the younger ones how it done, plus it be an excellent
story for his pupils come the start of term just 3 days of his holiday left.
Four days later the daring teacher is in an African hospital, suffering from the symptoms of Malaria he
curses himself for drinking all that stream water. His diagnosis came through today, and he is relieved to
finally receive a chloroquine injection to treat his nausea and vomiting.
Five days later, on September 1, Yambuku Mission Hospital announced a man had died from an unknown
haemorrhagic fever. Scientists isolated a sample of the virus and found it was a new species of Filoviridae,
later named Ebola after the river running through Zaire.
This story is based on true events, although some artistic license has been used in its telling.
Discuss the story with your tutor and your group what does it make you want to find out more about?
Notes
8
By the end of this tutorial you will be able to:
antibiotics are ineffective against viruses.
Use this template to write down any ideas you already have about the topics in this
programme
Cells
Viruses What I already Bacteria

know
Diseases /
infections
Viruses
9
Viruses are a confusing thing. Most scientists would tell you that viruses are not even alive! But what do they
mean by this? If they are not alive then how do they cause disease? This first tutorial will focus on the
background information that you will need to understand these questions.
Cells: First The Basics
Cells are the basic building blocks of life. Every living thing is made up of cells, from the tiniest fish in the ocean
to the tallest oak tree in the forest. Cells do many different jobs, some of these are the same across all cells and
some cells are specialised to carry out certain roles. For example the sperm cell looks very different to a skin cell as
it need a very long tail to propel itself through the female reproductive system and join with the egg.
The following images are of an animal cell and a plant cell. Your tutor will discuss with you the main features of these
cells and the differences between them.
Animal? Cell?
Organelle (cell part) Function
(Y/N) (Y/N)
Cell Membrane
Cytoplasm
Nucleus
Mitochondria
Cell Wall
Chloroplasts
Vacuole
10
Below is a concept cartoon. These show discussions between pupils about a topic. Some of the
statements made are correct, some may be completely incorrect and some may be open to debate.
In this concept cartoon, pupils are discussing two images, one is a eukaryotic cell (what scientists call any
cell from an animal or plant) and the other is a prokaryotic cell (bacteria).
With a partner, decide which of the statements is correct and discuss why the others might be misconceptions. There
is some room for you to write down any ideas on the next page.
11
Notes
Can you match up the following illnesses to what causes them?
Malaria Salmonella Common Cola Athletes Foot
Virus Bacteria Parasite Fungi
12
How do bacteria make you ill?
Bacteria can make us feel ill in two ways:
Producing toxins poisonous substances which harm our cells. As we have already discussed, bacteria
are living cells and once they enter our body they try and multiply as quickly as possible. The more bacteria
there are, the more toxins will be produced and the more unwell you will feel. That we often refer to
an incubation period which is when we are infected but don t yet have any of the symptoms which make
us feel poorly.
Invasiveness, or the spread of bacteria through your body. This causes you to feel sick because bacteria
have molecules called antigens on their surface, when bacteria get into your body these antigens trigger
a response from your immune system. Your immune system produces molecules called antibodies, as well
as lots of other things, to try and fight off the bacteria. In the process of trying to fight off the infection,
your own cells can be harmed and it is actually this that can make you feel unwell!
Head scratcher!
Do all bacteria make us feel ill?
What is a pathogen?
How do viruses make you feel ill?
Before we consider this question it is important to understand exactly what a virus is.
These diagrams are of viruses (not all viruses look

like this, just like specialised cells they can look
and behave very differently from one
another). Can you label any of the features on
these images using what you may have
learned in science lessons or at home? What
are the common features?
13
Viral Hitch-hikers
The way in which viruses cause symptoms is very different from bacteria. The key thing is that viruses need
to be inside our cells to multiply. Our cells may elicit, or attempt to elicit, an immune response against viral
infections but many viruses have developed some very clever ways to avoid detection. Once inside our
cells, viruses use our mechanisms of cell division to replicate their own genetic information. Th re really
like tiny little high-jackers, hitching a free ride inside our cells! We will learn more about how they do this
in tutorial 2.
Unfortunately for their host (the organism the virus infects), the viral invasion usually leads to the death of
the cell which causes damage leading to symptoms of the viral infection.
A common viral infection is the common cold, typically caused by a species called rhinovirus (note: this
word is in italics because that is the scientifically accepted way to denote the classification of an
organism).
30 Second synopsis
From what you have learned so far, what do you think the biggest difference is between bacteria
and viruses?
Antibiotics (A medicine which prevents the growth of, or kills, bacteria)
Antibiotics work by targeting and attacking various processes which occur inside cells, for
example cell division. Targeting a process may render a cell incapable of division, or else kill
it entirely. Many of the processes targeted are comparable across both eukaryotic and
prokaryotic cells.
Based on this information, and what you have already learned about bacterial and viral
infections, discuss the following scenario with a partner and be ready to explain your
conclusion to the rest of the group.
Lizzy has been feeling unwell for several days with a sore throat and a terrible
head ache; she thinks she must have a bug. She decides to go to the doctor but
he does not prescribe her any antibiotics. Instead he tells her to go home, rest,
drink lots of water and take paracetamol for the head ache
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To do as
well as you can in this assignment, read the mark scheme first and aim to the 1st criteria.
Use the following pieces of scientific literature, on p17 to p20, to answer the questions below. Your tutor
will tell you how they would like you to complete this work (in the spaces provided, VLE, or word processed).
1. When and where were the first cases of Ebola?
2. What disease was the first case first mistaken as?
3. Give two examples of how Ebola could be transferred to a human.
4. What was the relevance of the patients at Yambuku Mission Hospital receiving injections?
5. Which of the following are symptoms of Ebola? Circle all that apply
Rash Sneezing Muscle pain Vomiting and diarrhoea
Internal and External bleeding Sensitivity to light
6. What treatments or vaccines can be given to Ebola patients?
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7. When was information first released about the 2014 breakout?
8. Look at the figure shown on p23, at 51 days after 1st March 2014, how many people had survived an
Ebola infection? Represent this as a percentage.
9. Using what you currently know about EVD (Ebola Virus Disease) choose one of the following people;
a doctor, scientist or tourist from 1976 and write detailed advice on what you would like to have
been able to tell them.
16
Top tip
Read the articles once, then go back and read the questions. Read the articles again but this time with
the questions in your mind so you can begin to answer.
glossary, in a dictionary or using the internet
First Outbreak
Between 1 September and 24

October 1976, 318 cases of acute
viral haemorrhagic fever occurred in
northern Zaire. The outbreak was
centred in the Bumba Zone of the
Equateur Region and most of the
cases were recorded within a radius
of 70 km of Yambuku.
There were 280 deaths, and only 38

serologically confirmed survivors.
The index (first) case in this outbreak
had onset of symptoms on I
September
1976, five days after receiving an

injection of chloroquine for
presumptive malaria at the
outpatient clinic at Yambuku Mission
Hospital
Within one week several other

persons who had received injections
at the same hospital also suffered from Ebola haemorrhagic fever, now called Ebola virus disease (EVD),
and almost all cases that followed had either received injections at the hospital or had had close contact
with another case. Most of these occurred during the first four weeks of the epidemic, after which time the
hospital was closed, 11 of the 17 staff members having died of the disease.
The Spread of Ebola
Ebola is introduced into the human population through

close contact with the blood, secretions, organs or other
bodily fluids of infected animals. In Africa, infection has
been documented through the handling of infected
chimpanzees, gorillas, fruit bats, monkeys, forest antelope
and porcupines found ill or dead or in the rainforest.
Ebola then spreads in the community through human-to-

human transmission, with infection resulting from direct
contact (through broken skin or mucous membranes) with
the blood, secretions, organs or other bodily fluids of
infected people, and indirect contact with environments
contaminated with such fluids. Burial ceremonies in which
mourners have direct contact with the body of the deceased person can also play a role in the
17
transmission of Ebola. Men who have recovered from the disease can still transmit the virus through their
semen for up to 7 weeks after recovery from illness.
Health-care workers have frequently been infected while treating patients with suspected or confirmed
EVD. This has occurred through close contact with patients when infection control precautions are not
strictly practiced.
Signs and Symptoms
EVD is a severe acute viral illness often

characterized by the sudden onset of fever,
intense weakness, muscle pain, headache and
sore throat. This is followed by vomiting,
diarrhoea, rash, impaired kidney and liver
function, and in some cases, both internal and
external bleeding.
People are infectious as long as their blood and

secretions contain the virus. The incubation
period (the time interval from infection with the
virus to onset of symptoms) is 2 to 21 days.
Treatment and Vaccines
No licensed vaccine for EVD is available. Several

vaccines are being tested, but none are available
for clinical use. No specific treatment is available.
New drug therapies are being evaluated.
Severely ill patients require intensive supportive care. Patients are frequently dehydrated and require oral
rehydration with solutions containing electrolytes or intravenous fluids (fluids injected directly in a vein).
Ebola haemorrhagic fever in Zaire, 1976, Report of an International Commission: Bulletin of the World
Health Organisation, 1978.
http://www.who.int/mediacentre/factsheets/fs103/en/ (first accessed 14/08/2014)
18
Outbreak
On 23 March 2014, the World Health

Organization (WHO) issued its first communiqu
on a new outbreak of Ebola virus disease (EVD),
which began in December 2013 in the Republic
of Guinea, then spreading to the Prefecture of
Macenta, 80 km to the east. Located on the
Atlantic coast of West
Africa, Guinea is the first country in this

geographical region to report an EVD outbreak
with more than one case. Cases have now also
been reported at several other locations in
Guinea, as well as in neighbouring Liberia.
Fig. 1. Cumulative incidents of EVD from March April 2014.
Classification* and Pathogenesis**
EVD is a severe haemorrhagic fever caused by viruses classified by the International Committee on
Taxonomy of Viruses as belonging to the genus Ebolavirus in the family Filoviridae. The case fatality rate
in EVD is so high, approaching 90% in some outbreaks, that members of the family Filoviridae have been
classified as Category A potential bioterrorism agents by the Centres for Disease Control and Prevention.
All bodily fluids are infectious, requiring the use of full-body protective clothing by medical and
surveillance staff. Patients initially present with fever, headache, joint/muscle and abdominal pain
accompanied by diarrhoea and vomiting. In its early stages, EVD is easily confused with other tropical
fevers, such as malaria or dengue, until the appearance of the haemorrhagic terminal phase, presenting
with the characteristic internal and subcutaneous (of the skin) bleeding, vomiting of blood and reddening
of the eyes. If sufficient blood is lost, this leads to renal (kidney) failure, breathing difficulties, low body
temperature, shock and death.
*Classification is the way in which scientists group organisms, also called taxonomy the names used are
all of Latin derivation and are shown in Italics.
**Pathogenesis is how a disease develops.
The 2014 Ebola virus disease outbreak in West Africa, G. Gather: The Journal of General Virology, 2014.
19
From what you have read about Ebola so far, are you scared of the virus? Why?
Do you believe all of the information in the sources that were provided to you? Why?
Notes
how viruses multiply in their hosts.
Do you already know something about how cells divide? Do you already know something about DNA?
Discuss this with your partner for a few minutes, be ready to feedback your ideas to the rest of the group.
20
Head Scratcher!
Look at the 3 images above, can you name them? What are the
differences between them?
Does a virus have a nucleus?
The Cell Cycle
The cell cycle is a series of events in which a cell replicates and divides to form daughter cells. There are
3 main stages to the cell cycle:
Growth
Replication (or DNA synthesis)
Division (or mitosis)
The growth stage is the c

preparation for replication.
The replication stage is when all

the genetic information in the
nucleus is copied and doubled.
In division this doubled genetic

information is split to form two
new cells.
21
Activity: Draw line to match up the order, name and description of each stage of the
cell cycle.
1 2 3
Cell division DNA Replication Cell Growth
The genetic The copied genetic

information in the The cell rests and information is split
nucleus is copied, prepares itself for into two new cells,
doubling the replication. called daughter
amount. cells.
If you are really interested in the cell cycle, go here to

find out about exactly how cells divide:
http://www.biology4kids.com/files/cell2_mitosis.html
Viral Replication
On the next page are two screen grabs from different websites about how viruses use
eukaryotic cells to replicate. Look briefly at the images and answer the questions in pairs or
as a whole group.
Which website would you trust more? Why?
Do you think either website is appropriate for the level we are working at?
22
23
In tutorial 1 you were asked to try and label some of the features of a virus. We can now look at this in
much more detail and see how some of these features enable viruses to survive.
Herpes Simplex Virus The Ebola Virus
The envelope protein (or glycoprotein) of a virus is essential for it to

A lot of the words in these
You can think of these envelope proteins as being like the viruses diagrams are different, but actually
invisibility cloak! The infecting virus will use proteins from host cells to mean essentially the same thing.
Just ask your tutor if you are stuck!
The envelope does a similar job to the cell membrane or cell wall in eukaryotic or prokaryotic cells.
The viral genome is a store of the viral genetic information. Viruses have much less genetic information
than most other living organisms. For example the herpes simplex virus (shown above) has 37 genes,
whereas humans have over 24, 000 genes! This is why we need complex structures like chromosomes but
viral genes are just kept in the tiny capsid.
Using the screen grabs on p24 and the information above, can you put the following
sequence of events into the correct order?
The virus injects its New viruses are

genome into the assembled inside
host cell. the host cell.
The virus takes

Viruses are released from inside the host .
over the host cell
cell, usually killing it and causing harm to
and uses it to
the whole host (symptoms).
replicate its genes
The virus binds to

the host cell
surface, using its
envelope proteins.
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Viral Diseases (Host Relationships)
In this task you will be quickly summarising information to present and share with the rest of your group
and your tutor. Choose one of the following viruses and use the information on the following pages to
create an A3 poster or a quick presentation.
Just to
If you don have chance to find extra information or put a presentation together on a
computer, d worry!
When undergraduate, Masters and even PhD students present their research to
professors and peers they will usually do so in the form of a poster presentation.
The best posters can go on to win prizes!
Your poster or presentation will focus on the relationship between the virus and the organism(s) it infects.
Some questions to consider could be; which organisms does the virus infect? How does the virus gain
entry to the host? Does the virus cause disease in every organism? What are the symptoms of the
infection? How contagious is the virus? How many infected organisms die on average?
Choose one of the following viruses:
Avian Flu (H5N1) p 27
Smallpox p 28
Bovine Spongiform Encephalopathy (B ad Cow Disea - p 29
25
Bird flu, or avian flu, is an infectious viral illness that spreads among birds. In rare cases it can affect
humans.
There are many types of bird flu, most of which are harmless to humans. However, two types have caused
serious concern in recent years. These are the H5N1 (since 1997) and H7N9 (since 2013) viruses. Although
these viruses don't infect people easily and are usually not transmitted from human to human, several
people have been infected around the world, leading to a number of deaths.
Bird flu affects many species of birds, including chickens, ducks, turkeys and geese. It can be passed
between commercial, wild and pet birds. Birds do not always get sick from infection, so seemingly healthy
birds may still pose a risk to people who come into contact with them.
Signs and symptoms
Like other types of flu, bird flu symptoms often include a high temperature, aching muscles, headache
and respiratory symptoms such as a cough or runny nose. Most people with the condition rapidly develop
more severe respiratory problems.
Diarrhoea, vomiting, abdominal (tummy) pain, chest pain, and bleeding from the nose and gums have
also been reported as early symptoms in some people. Within days, potentially fatal complications such
as acute respiratory distress syndrome and multiple organ failure may develop.
Having flu-like symptoms is extremely unlikely to mean you have bird flu, unless you have been in recent
close contact with birds in an area where outbreaks have been reported.
Human cases
The World Health Organization (WHO) has confirmed that by July 2013, 633 people had been infected
with the H5N1 virus and 377 had died. These cases occurred in Azerbaijan, Bangladesh, Cambodia, China,
Djibouti, Egypt, Indonesia, Iraq, Laos, Myanmar, Nigeria, Pakistan, Thailand, Turkey and Vietnam.
Indonesia, Egypt and Vietnam experienced most cases and fatalities.
Most cases were among middle-aged to elderly men. With the exception of one person, who travelled to
Taiwan while infected, there have been no reports of human infections outside mainland China. For both
viruses, there have been some reports of limited human to human transmission, usually as a result of very
close contact between family members.
People who have had bird flu generally developed the virus after coming into close and prolonged
contact with infected birds. Millions of birds have been killed during outbreaks to prevent the disease
spreading and being passed on to people.
How bird flu spreads to humans
Bird flu is spread through direct contact with infected birds (dead or alive), an infected bird's droppings,
or secretions from their eyes or respiratory tract.
Close and prolonged contact with an infected bird is generally required for the infection to spread to
humans. For example:
touching infected birds that are dead or alive

inhaling or being in contact with dried dust from the droppings or bedding of infected birds
inhaling or being in contact with droplets sneezed by infected birds
culling, slaughtering, butchering or preparing infected poultry for cooking
Bird flu is not transmitted through cooked food. Poultry and eggs are safe to eat in areas that have
experienced outbreaks of bird flu.
http://www.nhs.uk/conditions/Avian-flu/Pages/Introduction.aspx
26
Introduction
Smallpox is an acute contagious disease caused by the variola virus, a member of the Arthopoxvirus
family. It was one of the world's most devastating diseases known to humanity. It was declared eradicated
in 1980 following a global immunization campaign led by the World Health Organization.
Smallpox was transmitted from person to person via infective droplets during close contact with infected
symptomatic people. Vaccine administered up to 4 days after exposure provided protective immunity,
prevented infection and lessened the severity of the disease.
The last known natural case was in Somalia in 1977. Since then, the only known cases were caused by a
laboratory accident in 1978 in Birmingham, which killed one person and caused a limited outbreak.
How Smallpox Is Spread
Smallpox disease is highly contagious. It spreads from person to person primarily by breathing in the virus,
which is transmitted in saliva, during close, face-to-face contact with an infected person.
Smallpox can also be spread by handling the clothes or sheets of an infected person and by directly
contacting infected bodily fluids. Very rarely, smallpox has spread among people in small, enclosed
spaces, likely via contaminated air through the ventilation system. Animals and insects do not spread
smallpox. Once infected, a person's incubation period - as the virus moves inside the body's cells,
multiplies, and spreads - ranges from seven to 17 days before symptoms appear. During this pre-
symptomatic incubation period, an infected person is not contagious and cannot spread the virus to
others.
An infected person is most contagious once symptoms appear and can spread smallpox to others until
all smallpox blisters have healed and scabs have dropped off.
Symptoms
Smallpox gets its name from its most common symptom: small blisters erupting on the face, arms, and
body that become pustules (filled with pus).
Symptoms of smallpox include:
Flu-like fatigue, headache, body ache, and occasionally vomiting.

High fever.
Mouth sores and blisters that spread the virus into the throat.
A progressive skin rash that follows a predictable pattern:
The rash starts with flat red sores that a few days later become raised bumps.
The bumps turn into fluid-filled blisters.
The blisters become pustules.
The pustules crust over, usually in the second week of smallpox.
Scabs form over the blisters and then fall off, usually in the third week of the disease, resulting in
scars that are often disfiguring.
Blindness commonly resulted when blisters formed near the eyes.
http://www.who.int/csr/disease/smallpox/en/
http://www.webmd.com/a-to-z-guides/smallpox-causes-treatment
27
What is bovine spongiform encephalopathy?
Bovine spongiform encephalopathy (BSE), commonly known as mad-cow disease, is a fatal, neurological
(neurodegenerative) disease in cattle, that causes a spongy degeneration in the brain and spinal cord.
The disease is a type of transmissible spongiform encephalopathy (TSE).
The disease has a long incubation period of 4-5 years and it is fatal for cattle within weeks to months of
its onset. The nature of the BSE agent is still being debated.
Strong evidence currently available supports the theory that the agent is composed largely, if not entirely,
of a self-replicating protein, referred to as a prion. It is transmitted through the consumption of BSE-
contaminated meat and bone meal supplements in cattle feed.
BSE was first diagnosed in the United Kingdom in November 1986 and has since appeared in many other
countries including Europe, North America and Japan. Good progress is being made towards its
eradication in the UK.
The disease is an example of a zoonoses (a disease which can be transmitted between organisms of
different species) because it is thought to have originated from a disease called Scrapie (scrap-e) which
affects goats and sheep.
How to recognise the disease
Signs of the disease are not usually seen until the cow is at least four or five years old. Most cattle with
BSE show a gradual development of signs over a period of several weeks, or even months, although some
can deteriorate very rapidly. Most BSE cases will show at least one of the following signs:
change in behaviour
apprehension or nervousness (flighty)
repeated, exaggerated reactions to touch or sound
weakness or high stepping of the legs, particularly the hind legs
reluctance to cross concrete or drains/turn corners/enter yards/go through doorways/permit
milking
aggression towards other cattle and humans
manic kicking when milked
head held low
difficulty in rising
tremors under the skin
loss of body condition, weight or milk yield
excessive nose licking.
http://www.defra.gov.uk/ahvla-en/disease-control/notifiable/bse/
http://www.who.int/zoonoses/diseases/bse/en/
28
Notes
Page | 35
The skills in this assignment are based -
as well as you can in this assignment, read the mark scheme first and aim to the 1st criteria.
This week you will research independently. You will find two or three sources of information about the
2014 Ebola outbreak in West Africa. These sources can be in any format, from a newspaper article to an
educational website. The sources could also be about any aspect of the outbreak, from how it happened
to working with communities to prevent it. All your sources need to be literature, a written piece of work,
rather than something like a TV news report.
Choose one of the following topics as the focus for your research:
The initial outbreak in Guinea

The timescale of the viruses spread through Africa
International aid
How did Ebola affect local and international economies?*
A good place to start is Googling some key phrases (Ebola outbreak in Guinea, Ebola in 2014, stopping
the spread of Ebola). BBC News and the World Health Organisation (WHO) website are good places to
start your search.
write a maximum of 650. Your tutor will tell you how they would like you to submit the work.
Structure
100 words should introduce the background to the question you have chosen.

questions below to further structure your writing here)
100 words to sum up what you have found out and decide which (if any) of your sources are reliable
or not.
Consider the following questions when judging the reliability of a source:
1. Is it from a source with a good reputation (eg the BBC or University)?
2. Does it give the name of an author?
3. Is the content able to be edited by members of the public (eg Wikipedia)?
4. Has the source been peer reviewed? This means that other experts in the field have read it and
suggested improvements before it has been published. This is usually the accepted process for scientific
literature or research.
(At the start of tutorial 3 you will have the chance to share what you have learned with your friends. This
e and gather information
that could be useful for your final assignment. It will be useful for you to keep a note of the resources you
find (even have a copy of them to give out if you can!) so that you can share them, and also which you
thought were reliable or not.)
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Speed Sharing!
You going to spend the first part of this session sharing resources from your homework. Half of the group
will sit down in the same place, and the other half will move around spending 3 minutes at each station.
During this 3 minutes you will swap anything interesting you found out for assignment 2. Have a pen and
paper at the ready to take down notes.
Notes
Reflect :
What is the most interesting thing you found out about Ebola from a friend?
How do viruses spread?
Think: What do you think are the main ways in which a virus spreads between organisms? Be as specific
as you can.
Pair: What methods did both you and your partner name?
Page | 37
Since viruses can only multiply in host cells, it is less easy for them to be spread than, for example, a
bacteria. That said, viruses can still be extremely contagious. Once they have gained access to the host
cells there are a number of ways for them to spread, usually by one of three main methods; bloodstream,
airways, other bodily fluid.
Case studies:
Read the following case studies carefully and consider:
How did the virus spread?

What could have been done to help stop the spread of the disease?
In November 2002, an outbreak of

severe acute respiratory syndrome
(SARS) began in the Guangdong
province of China, just on the border
of Hong Kong. The outbreak was not
reported to the World Health
Organisation (WHO) until February
2003.
Initial symptoms are flu-like and may

include fever, myalgia, lethargy
symptoms, cough, sore throat, and
other nonspecific symptoms. The only
symptom common to all patients
appears to be a fever above 38 C.
Shortness of breath may occur later.
The patient has symptoms as with a
cold in the first stage, but later on
they resemble influenza. SARS may
occasionally lead to pneumonia.
Fig.1. Floor plan - floor 9, Metropole Hotel.
On February 21st a Chinese doctor who had been treating cases in Guangdong stayed on the 9th floor
of the Metropole Hotel in Hong Kong (see fig 1). The next day he was admitted to intensive care and he
died on March 4th. On February 23rd a businessman who had stayed on the same floor of the hotel flew
to Vietnam, where he was later admitted to hospital before being evacuated to Hong Kong. Before he
was evacuated though, at least 38 health workers had already developed symptoms of SARS.
Over the next month, relatives and fellow hotel residents of the 9th floor of the Metropole
were admitted to hospital across Asia.
Head Scratcher!
What could have been done differently to stop the spread of the SARS virus
in 2003?
Page | 38
Page | 38
In the autumn of 1918 the Great War in Europe was winding down and peace was on the horizon. The
Americans had joined in the fight, bringing the Allies (Britain, France and the USA) closer to victory against
the Germans. Deep within the trenches these men lived through some of the most brutal conditions of life,
which it seemed could not be any worse. Then, in pockets across the globe, something erupted that
seemed as harmless as the common cold. The influenza of that season, however, was far more than a
cold. In the two years that it ravaged the earth, a fifth of the world's population was infected. The flu was
most deadly for people ages 20 to 40. This pattern of morbidity was unusual for influenza which is usually
a killer of the elderly and young children.
An estimated 675,000 Americans died of

influenza during the pandemic, ten times as
many as in the world war. Of the US soldiers
who died in Europe, half of them fell to the
influenza virus and not to the enemy. 1918 would
go down as unforgettable year of suffering and
death and yet of peace.
The influenza pandemic circled the globe. It

spread following the path of its human carriers,
along trade routes and shipping lines.
Outbreaks swept through North America,
Europe, Asia, Africa, Brazil and the South
Pacific. The Great War, with its mass
movements of men in armies and aboard ships,
probably aided in its rapid attack. The origins
of the deadly flu disease were unknown but
widely speculated upon. Some of the allies
thought of the epidemic was a biological warfare tool of the Germans.
The SARS outbreak in 2002/3 was an epidemic. This means that the disease was widespread, but only in
a particular place at one time. In 2003 people were very worried that SARS could become a pandemic. A
pandemic is when a disease spreads completely across a whole country or the whole world and a very
high proportion of the population are effected.
the common flu) is an international pandemic. Very few people die from the flu, especially in more
developed countries, but it is prevalent across the globe.
At the time of writing (21.08.2014), Ebola is an epidemic confined to West Africa, and scientists are doing
all they can to prevent the spread of the disease. In Kenya (East Africa) borders and airports have been
closed to incoming traffic and flights from infected areas after it was feared the virus might have spread
there. If Ebola was found in Kenya, the WHO could decide to class the outbreak as a pandemic. Although
at the moment only a very small number of the population of East Africa have died, or even been infected.
30 second synospsis
Describe, using examples, the difference between an epidemic and pandemic.
Page | 39
How can we prevent viral infections from spreading?
Look at the following images and decide which method of viral transmission is being prevented or could
be prevented (blood, airways, other bodily fluid).
Page | 40
T -
as well as you can in this assignment, read the mark scheme first and aim to the 1st criteria.
You have already learned how to assess whether or not a source is reliable, in this assignment you will be
applying these skills by looking at two sources which do not necessarily agree with one another.
It is always important to use conflicting arguments in your work, because it shows you understand both
sides. You need to be able to pick out what you think is wrong with a source and come to a decision
about which one you are going to trust. This is called critical analysis, and will be a really important tool
in your final assignment.
a decision about how appropriate they were for you.
Read the following articles and the write max.500 words on them. The main focus of this piece of writing
will be for you to articulate your decision making process on paper. It might be useful to consider the
following statements or questions during the course of your writing:
What is the main point (or points) each source is trying to make?
Where does each source come from is it reliable?
Who wrote the piece, do they have any biases (are they trying to make you believe something for
a particular reason, eg to sell a product)?
Is there any information in the sources that you immediately recognise as incorrect?
In what way do the sources contradict one another?
Page | 41
President claims Ebola can be controlled and contained with the right resources,
despite claiming 900 lives in west Africa
Barak Obama has said a global effort is required to combat the spread of Ebola which he blamed on
weak and overwhelmed health systems in west Africa.
Speaking at the end of a summit of African leaders in Washington, the president said the disease which
has claimed the lives of more than 900 people in Liberia, Sierra Leone and Guinea can be controlled
and contained with the right resources. A single case has also been confirmed in Nigeria.
"The Ebola virus both currently and in the past is controlled if you have a strong public health infrastructure
in place and countries that have been affected are first to admit that what's happened here is their public
health systems have been overwhelmed. They weren't able to identify and then isolate cases quickly
enough," he said. "You did not have a strong trust relationship between some of the communities that
were affected and health workers. As a consequence it spread more rapidly."
Obama said the US is working with European countries and the World Health Organisation (WHO) to
respond to the crisis. The US centres for disease control moved Ebola to its highest category of health
threat.
But the president said it was too early to decide whether an experimental drug given to an American
health worker who contracted Ebola and has been flown back to the US could be distributed in Africa.
Obama said the Ebola outbreak was discussed in his collective meetings with African leaders behind
closed doors on the third and final day of the largest summit of the continent's governments held in
Washington. He said that one consequence was a decision to establish an African centre for disease
control. HIV/Aids was also on the agenda with a plan to double the number of children receiving life saving
antiretroviral drugs.
Ref: Chris McGeal, The Guardian, 7th August 2014.
th
Epidemiology and surveillance
Between 14 and 16 August 2014, a total of 113 new cases of Ebola virus disease (laboratory-confirmed,
probable, and suspect cases) as well as 84 deaths were reported from Guinea, Liberia*, Nigeria, and Sierra
Leone.
Health sector response
The response of WHO and other partners to the Ebola Virus outbreak is continuing to grow in Guinea,
Liberia, Nigeria and Sierra Leone. To reduce the likelihood that those who are infected will carry the
disease outside their communities, the governments have set up quarantine zones in areas of high
transmission including severely-affected cities.
This prevents people living in these areas from moving to other parts of the country and potentially
increasing EVD transmission. However, it also means that barriers to travel limit their access to food and
other necessities. While preventing further transmission of EVD is crucial, it is essential that people in those
zones have access to food, water, good sanitation and other basic supplies.
WHO is working with the United Nations World Food Programme (WFP) to ensure people in the quarantine
zones receive regular food aid and other non-medical supplies. WFP is now scaling up its programme to
distribute food to the around 1 million people living in the quarantine zones in Guinea, Liberia and Sierra
Leone.
Food has been delivered to hospitalized patients and people under quarantine who are not able to leave
their homes to purchase food. Providing regular food supplies is a potent means of limiting unnecessary
movement.
Page | 42
WHO does not recommend any travel or trade restrictions be applied except in cases where individuals
have been confirmed or are suspected of being infected with EVD or where individuals have had contact
with cases of EVD.
World Leader Failing to Hel Over Ebola Crisis in Africa
The international community has made "almost zero" response to the Ebola outbreak in west Africa, with
western leaders more interested in protecting their own countries than helping contain the crisis that has
now claimed more than 1,200 lives, a senior international aid worker said on Tuesday.
Brice de la Vigne, the operations director of Mdecins Sans Frontires (MSF), said politicians in
industrialised countries urgently needed to take action, or risk the outbreak spreading much further.
"Globally, the response of the international community is almost zero," he told the Guardian. "Leaders in
the west are talking about their own safety and doing things like closing airlines and not helping anyone
else."
His comments came as the World Health Organisation announced that the death toll in the world's worst
Ebola outbreak has now exceeded 1,200. The haemorrhagic disease, which kills up to 90% of those
infected, is ravaging Liberia, Sierra Leone and Guinea, and also has a toehold in Nigeria, Africa's biggest
economy.
De la Vigne, who has just returned from a tour of Guinea, Sierra Leone and Liberia, said the scale of the
outbreak was comparable to a catastrophe such as the 2010 Haitian earthquake, which killed 300,000
people.
"The solution is not that complicated but we need to have political will to do so. Time is running against
us. But you need very senior people with high profiles, the kind of people who can co-ordinate a response
to a million people affected by an earthquake," he said.
His words were echoed by Dr Gabriel Fitzpatrick, who is working at theMSF field hospital in Kailahun, the
epicentre of the crisis in Sierra Leone. "If this Ebola outbreak happened in a western community, in London,
you'd get a few cases and that would be it," he said. "The main objective here is not to dramatically
increase the person's chance of survival, it's to contain the spread."
Page | 43
Is it easy to balance an argument?
How do you know what is right and wrong?

Understand why developing vaccines for viruses like Ebola is very difficult.
Africa are so difficult to control and eradicate.
f trialling experimental drugs.
What do vaccines do?
contain dead or live fragments of a virus which are injected into the body. After they have been injected
they trigger an immune response which forms antibodies in the patients. If the patient becomes infected
with the virus again, these antibodies will be produced to fight off the infection.
Even though developing vaccines is quite tricky, it has been done successfully for many viruses such as
influenza, hepatitis C, measles and smallpox the only virus to have ever been completely eradicated.
Why do you think it has been difficult to develop a vaccine for Ebola?
Page | 44
Preventing the spread and developing a vaccine against Ebola has been even trickier, there are lots of
barriers to overcome!
We do not currently know the natural host of Ebola; although most scientists believe it to be the
fruit bat, other think it could be a species of monkey. This means that it has been difficult to set up
programmes to control or eliminate the virus in these organisms.
Because the disease occurs in such remote areas of Africa, obtaining samples of the virus is very
difficult. Therefore studying particular parts of the life cycle of the virus is almost impossible, making
it hard to understand how it actually causes disease.
Ebola is a very dangerous biohazard, so it needs to be very safely contained by any laboratory
and it takes a high degree of skill to work with the virus.
There are 5 species of EVD, and the genomes of these are highly variable (there are lots of
differences between the genes from one species to another).
Despite this, progress has been made on developing vaccines and an example of some significant
research is outlined below.
The Vaccine Research Centre (VRC) has developed an Ebola vaccine candidate in collaboration with
Okairos, a Swiss-Italian biotech company.
The investigational vaccine, which was designed by VRC scientists, contains no infectious Ebola virus
material. It is a chimpanzee viral vector (a virus which has been emptied of any harmful genetic
information) into which two Ebola genes have been inserted. This is a non-replicating viral vector,
which means the vaccine enters a cell, delivers the gene inserts and does not replicate further
meaning it is not harmful to the patient.
The gene inserts encourage the body to make an immune response. This could treat a patient already
infected, or serve as a vaccine to protect those in danger from Ebola outbreaks. The investigational
vaccine has recently shown promise in trails in primates. The VRC vaccine will enter into a phase 1
clinical trial, which could start as early as autumn 2014, pending approval by the Food and Drug
Administration (FDA).
http://www.niaid.nih.gov/topics/ebolamarburg/research/pages/default.aspx
Page | 45
The following extract is from the Guardian newspaper, it gives an excellent background
context as to why
In June and July approximately 5,000 women and children in Sierra Leone died of diseases. The vast
majority of these deaths were avoidable.
The Ebola outbreak in the country killed 233 people during the same period, and the story made headlines
around the world. Why do the relatively small number of
while the thousands of women and children who die of other illnesses barely get mentioned? Is it an
attempt to raise awareness, mobilise resources and halt the epidemic? Or is sensationalism to blame?
Children dying in Africa is old news, while an Ebola outbreak sounds like the setting for a Hollywood
blockbuster.
The people in the global health community, UN agencies, NGOs, charities and academic institutes, who
spend most of their lives in relative obscurity desperately trying to raise awareness and funds, now appear
on news bulletins and in the newspapers. Understandably, the focus of their discourse is the
pathophysiology, containment and treatment of the Ebola outbreak. There are the predictable calls for
more funding to be allocated to neglected tropical diseases.
The news that US National Institutes of Health is speeding up the development of an Ebola vaccine has
also been well received as the public seeks a neat solution to a complex problem. In truth, expanded
research programmes and vaccines for a rare diseases like Ebola may do nothing to improve the health
of poor people. What few commentators are discussing is what unites the well-publicised Ebola victims
and the everyday, forgotten deaths. They are all victims of weak healthcare systems, which are distrusted
by the people they are designed to help.
Unlike influenza, Ebola is not easy to contract. If patients came early to healthcare facilities and were
effectively isolated, the epidemic would stop. It is that simple. So why is the Ebola epidemic proving so
hard to contain? First, healthcare facilities in Sierra Leone are weak. They often lack the most basic
equipment and are chronically understaffed by poorly trained, overworked healthcare personnel.
Second, there is widespread distrust of the public healthcare system. The reasons for this distrust are
complex. The media are fond of reporting cultural beliefs about the cause and treatment of disease.
The millions of dollars poured into programmes to tackle HIV, malaria and tuberculosis have done little to
tackle the weaknesses described above, and to prepare Sierra Leone for the Ebola outbreak.
Counting the numbers of mosquito nets distributed or number of children vaccinated is an easy but
inadequate response to the unmet healthcare needs of people in Sierra Leone.
Sierra Leone is not unique, and the challenges described here apply to many other countries. Let us hope
Sierra Leone never has to tackle another Ebola outbreak. But it would be foolish to assume that the future
does not hold similar challenges, be those infectious disease epidemics or a surge in the burden of non-
communicable diseases. There is one lesson we should learn from the Ebola outbreak: protecting the
health of the poor requires an effective and accountable healthcare system.
Take some time to read through the article on your own, you might want to highlight
what you think the important points are.
Discuss the article with your friends and your tutor, focussing on these questions:
Does the author think Ebola deserved all the press it received?
What does the author think is the main problem is preventing the spread of Ebola?
What does the author think is the answer to future epidemics (both EVD and other tropical
diseases)?
Page | 46
Notes
In the UK we are very lucky to have a well-developed, largely free, health service. In the countries where
Ebola epidemics, and many other infectious diseases, occur this is not the case and may be one of the
main reasons why the diseases are so dangerous.
Think back to the case study about Spanish Flu last tutorial, one of the reasons it killed so many was
because of the poor, unstructured and overcrowded healthcare in place at the end of WW1.
to he
If this is true, why did many people continue to die?
Read the case studies below to help you answer this question.
Page | 47
Voices from the front line:
"When I first arrived on the ground, people were not

willing to allow access to humanitarian workers to
come in and deal with cases.
It's been steadily declining since then in terms of

numbers - but the main issue we have been facing
over the last weeks has been villages still not willing to
allow us access.
So we have been making strong efforts to do a lot of

communication.
There is a level of frustration in Guinea that I haven't

experienced in a long time - not just reticent
populations; it's a lack of co-ordination.
We can deal with cholera outbreaks all over the world.

Ebola is a big scary monster and we are not quite sure
how to quite deal with it."
"I investigate first the rumours, perceptions

and attitudes of communities relating to
Ebola fever in order to help the
communication team. I also help the medical
team interact with communities in the
villages to break down barriers.
People are very very afraid, because they

have never heard of Ebola before.
We have many rumours, for example, that

the fever was disseminated by [Guinea's]
President Alpha Conde because he is from
another ethnic group.
The villages are in remote areas where there

is little access to news and the level of
educa
Page | 48
"At the beginning of the outbreak there were lots of
patients in the hospital, it made it very difficult
because it was overcrowded and we were running
out of equipment.
Lots of staff in the hospital had not had training on

controlling highly infective diseases, and a few had
never even heard of Ebola.
For the Ebola virus the fear element is the thing which
is causing problems in the community and in the
recruitment of health staff to help with the outbreak
itself.
Ultimately it is spread in a very specific manner, by

close contact with patient fluids, blood and at the
end stages when the body increases secretions of
saliva and sweat.
In the west this is something we could educate

about and control quite easily but many traditions to
do with burial in Africa demand close contact with
the dead kissing and hugging for example, it is not
Write down ideas from the front line case studies which suggest why Ebola has become
so wide spread:
Ethics of experimental drugs
what any side-effects might be or even if the drug works?
the term. Basically it means how situations affect social,

cultural (those two are especially difficult to distinguish between) and economic aspects of society.
For example, how ethical is it to eat McDonalds? Some people might argue
that the company is contributing towards a rise in global obesity and therefore it is socially and
culturally unethical to eat a double cheeseburger. Others could say

them.
Page | 49
Considering the following statement: ou should always try if nothing else works!
Do you agree or disagree based on the two different situation? What would you think if you had a cold?
What would you think if you had a potentially fatal infection like EVD?
Justify the scores you gave for each situation:
Not easy, is it?
In August 2014 a group of ethicists met to discuss whether an experimental drug should be made more
widely available to those suffering from EVD.
You have already seen some of the cultural implications of western aid in the epidemic; it is against this
complex historical backdrop that scientists had to make the decision. They had to consider many things,
amongst them anticipating what might happen if the drug is introduced and proves ineffective or even
harmful, how the media and the local community will react and the consequences of this reaction for
victims, healthcare workers, and others, and how the selection process for candidate drugs should take
place (there are only 800-1000 doses).
Imagine you are in the committee with a final decision over who will get the experimental treatment. You
have two (hypothetical) choices, outlined below, with a partner come to a decision and then write a
conclusion of a couple of sentences which includes some evidence to back up your decision.
If you are stuck you can ask your tutor for help, but each pair only gets one chance to ask!
Page | 50
Choice 1
Guinea is the country coping best with the spread of EVD, their healthcare system is standing up best to
the spread of infection and there has been no reports of infected people crossing its borders for several
weeks. There are 470 patients in hospital recovering from or diagnosed with EVD currently.
Choice 2
In Sierra Leone there are more women and children believed to be infected than any other country
around 850. Many villages are still reporting outbreaks, and dozens of people have died in their homes
before aid could be got to them.
Notes
Page | 51
The skills here will focus on all sections of the mark scheme. To do as well as you can in this assignment,
read the mark scheme first and aim to the 1st criteria.
subject, presenting this in
University of Leeds
For your final assignment you will write a literature review. It will be slightly different than a university style
one because you will be asked to analyse sources like newspapers and academic websites (like what we
have been looking at so far) rather than research papers, but the format will still be the same. If you feel
comfortable reading scientific journal articles then you can, of course, use these as well.
For this assignment you are going to start collecting evidence to answer a question, and organising the
information you collect. You will present this in tutorial 5 and use the feedback to inform your final
assignment. You will have a maximum of 5 minutes to present and answer any questions.
You are going to present under the following headings, which will also then form the sections of your final
literature review.
1. The Big Picture
This section should include some background information about Ebola and also the context of
your question
2. Main Body
Talk about the key information you have found
Critically analyse your sources
Compare your sources with one another
Start to form an argument which answers the question
3. Conclusion
Your final conclusion to the question based on your research
The evidence you have collected to support this conclusion
Use what you have learned over the last few weeks (knowledge and skills) to come to a final conclusion
which answers this question.
Because this big picture question is quite broad, you might want to focus on one of the following smaller
questions to direct your research:
1. Can the spread of Ebola be prevented in less developed regions like Africa?
2. How can the international community work together best to halt Ebola?
3. Is it ethically right to give untested drugs to Ebola patients?
Page | 52
tively present research to your peers.
Provide honest and constructive feedback to your peers in a kind and helpful way.
best of your abilities.
In this tutorial you will have the chance to present what you have found so far to your peers. You will then
get feedback from them. Some of this might be good, and you will know what your strengths are and
what you need to keep doing. Some of it might be constructive criticism, and will point out something you
could have done better or a gap in your knowledge that you could fill.
All scientists go through this process, it is called Peer Review.
Page | 53
Use the mind map outline to note down everything you have learned about Ebola so far during the
programme. Then, during the presentations write down anything extra you have learned from your friends.
How Ebola
spreads
Is Ebola the Is using

next experimental
international drugs ethical?
pandemic?
How did
international
aid help the
epidemic?
Page | 54
Top Tips
Have a range of different sources been looked at?
Have the sources been analysed critically?
What stands out as really good or interesting?
What could be improved? How?
Is there enough background information to inform someone who knows nothing about Ebola?
Are there any unanswered questions?
Is there enough evidence to support the conclusion?
After all the presentations have finished, read through the comments you have received
and answer the following questions.
What went well?
Have you read enough literature? Is there anything you can add for the final assignment?
Page | 55
Have you come to a reasoned conclusion that is backed up with evidence?
Is there anything else that you need to think about for your final assignment?
To do well in your final assignment you should read the mark scheme carefully and see what skills are being
assessed in your final assignment. Read through the 1st criteria and aim for this. When you finished your
final assignment you may want to re-read the mark scheme criteria to see if you think you have met the
criteria
Using all the feedback you received from tutorial 5, you are going to write up your final assignment. This
should be word processed and 1500 words (+/- 10%).
Like in your presentation, follow this structure and the word limits. Within these sections make sure to use
paragraphs effectively to separate different points. You may also use your own headings to show the
structure to your argument.
1. The Big Picture (300)
This section should include some background information about Ebola and also the context of
your question
2. Main Body (1000)
Talk about the key information you have found

Critically analyse your sources
Compare your sources with one another
Start to form an argument which answers the question
3. Conclusion (200)
Your final conclusion to the question based on your research

The evidence you have collected to support this conclusion
Page | 56
What is the Purpose of Tutorial 6?
To receive feedback on final assignments.
To share examples of best practice with the other pupils in your group.
To write targets for improvement in school lessons.
To reflect on the programme including what was enjoyed and what was challenging.
Final assignment feedback

What I could have improved on

Pa ge | 57
Reflecting on The Scholars Programme
What did you most enjoy about The Scholars Programme?

What did you find challenging about the programme? How did you overcome these challenges?

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When you get to university, you will need to include references in the assignments that you write, so we
would like you to start getting into the habit of referencing in your Brilliant Club assignment. This is really
important, because it will help you to
ideas and pass them off as your own. Whether plagiarism is deliberate or accidental, the consequences
can be severe. In order to avoid losing marks in your final assignment, or even failing, you must be careful to
reference your sources correctly.
What is a reference?
A reference is just a note in your assignment which says if you have referred to or been influenced by
another source such as book, website or article. For example, if you use the internet to research a
particular subject, and you want to include a specific piece of information from this website, you will need
to reference it.
Why should I reference?

Referencing is important in your work for the following reasons:
It gives credit to the authors of any sources you have referred to or been influenced by.
It supports the arguments you make in your assignments.
It demonstrates the variety of sources you have used.
It helps to prevent you losing marks, or failing, due to plagiarism.
When should I use a reference?

You should use a reference when you:
Quote directly from another source.
Summarise or rephrase another piece of work.
Include a specific statistic or fact from a source.
How do I reference?
There are a number of different ways of referencing, and these often vary depending on what subject you
are studying. The most important to thing is to be consistent. This means that you need to stick to the
same system throughout your whole assignment. Here is a basic system of referencing that you can use,
which consists of the following two parts:
1. A marker in your assignment: After you have used a reference in your assignment (you have read
something and included it in your work as a quote, or re-written it your own words) you should mark
this is in your text with a number, e.g. [1]. The next time you use a reference you should use the next
number, e.g. [2].
2. Bibliography: This is just a list of the references you have used in your assignment. In the
bibliography, you list your references by the numbers you have used, and include as much
information as you have about the reference. The list below gives what should be included for
different sources.
a. Websites Author (if possible), title of the web page, website address, [date you accessed
it, in square brackets].
http://www.bbc.co.uk/guides/z3kgjxs#zg2dtfr [11 July 2014].

b. Books Author, date published, title of book (in italics), pages where the information came
from.
E.g. S. Dubner and S. Levitt, (2006) Freakonomics, 7-9.
c. Articles where the article comes from
(newspaper, journal etc.), date of the article.
E.g
Guardian, 10 July 2014.
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VLE username
VLE password
Please remember the following key details...
You are able log into the VLE either through the link on our website (www.thebrilliantclub.org) or
going directly to the VLE site at (https://portal.thebrilliantclub.org/sign-in).
Please update your profile with your full name and email address- this will allow you to retrieve
forgotten passwords or usernames
If you forget your log-in details you can request them to be emailed to you by clicking the link on the
VLE home page. (If you are still having problems you can email: schools@thebrilliantclub.org)
What is the VLE?

The VLE is a virtual learning environment for all pupils on the Scholars Programme it is used for:
- messaging your tutor
- submitting homework
- submitting your final assignment
- accessing resources for your tutorials
- finding out more information about university and careers
How should I use the VLE?

The VLE is a professional academic environment in which pupils are able to message their PhD Tutor. Here
are a few things to consider:
- Ensure you keep a professional tone in the messages you send to your tutors.
- Ensure you always reply to your tutors in a timely manner.
- Thank your tutor for the effort they are putting in to give you your feedback etc.
- Submit all homework to your tutor on time.
IMPORTANT: Final assignment

When you submit your final assignment, please remember that you need to do so through the
tab and not as an attachment to a message.
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I caught Ebola in Guinea and survived
The number of people who have contracted the Ebola virus in Guinea, according to the World
Health Organization, has risen to 208 - and 136 of them have died. About half of these cases have
been confirmed in a laboratory - earlier cases were not tested.
There is no cure for Ebola but with early medical support some people's bodies are able to develop
antibodies to fight it off.
One survivor, who asked not to be named, told the BBC his story.
Testimony:
The symptoms started with headaches, diarrhoea, pains in my back and vomiting.
The first doctor I saw at a village health centre said it was malaria - it was only when I was
brought to a special unit at the hospital in [the capital] Conakry that I was told I had the
Ebola virus.
I felt really depressed - I had heard about Ebola so when the doctors told me, I was very
scared.
I tried to be positive - I was thinking about death, but deep inside I thought my time had
not come yet and I would get over it. That's how I overcame the pain and the fear.
Doctors from the charity Medecins Sans Frontiers (MSF) were here to comfort me and give
their moral support. I tried to stay positive although I was scared when I saw my relatives
dying in front of me.
There was a moment when I thought I might die when I lost two of my uncles and their
bodies were taken away. On that night none of us could sleep - we thought we would never
make it to the morning.
Some doctors from MSF came to collect and wrap the bodies and sterilise the area. It all
happened in front of us. A short while after I was admitted to the hospital for treatment I
started feeling better, step by step.
'Shook my hands'
At first I was scared to eat as I thought I would be sick but after a while I took a few drops
of water and realised it was OK and the diarrhoea gradually stopped as well.
The doctors would come to see me and ask questions and one day nearly all my answers
were "no" - the doctors were pleased and I realised that I would make it. That was a very
powerful feeling for me. It was a great feeling when I walked out of the hospital.
We had a little celebration with the doctors, all the nurses and the people who had been
waiting for me.
They took pictures of me, they shook my hands - I saw that they felt safe touching me and
I realised I was better. I was really happy on that day. Now I feel good although I sometimes
get some pain in my joints.
I prefer not be identified in the media - many people are aware that I had the disease but
many others are not.
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We have been through difficult times - people were afraid of us. You know about African
solidarity - usually when someone dies people visit you but when we lost one and then two,
three, four members of our family, nobody came to visit us and we realised we were being
kept at bay because of fear. It gets even worse if everybody hears about your condition on
the radio and television.
Even people close to us, neighbours and relatives, are met with suspicion when they mention
they know us.
Immediately the other person takes two or three steps back for fear of contracting the virus.
People are very poorly informed about the disease. Nine people in my family had the virus in
total. My wife and my cousin survived too, so it is the three of us out of nine.
We were very affected by the deaths of our relatives but we were also relieved that not all of
us had died.
It would have been such a catastrophe if we had all passed away. This was a lesson on a
spiritual level and it has changed the way I look at life. The short time we spent in hospital has
really transformed us. I feel lucky. I feel very happy to be alive.
Ref: BBC News, 24th April 2014. http://www.bbc.co.uk/news/world-africa-27112397
Terrifying as the Ebola epidemic is, we must not lose our research ethics
Testing experimental treatments is only possible if afflicted communities feel respected Um have
you seen Outbreak
This is what a very smart doctor friend of mine posted to my Facebook wall yesterday. She was
referencing the medical disaster film about a deadly virus during a discussion about the ethics of
using experimental treatments for Ebola victims. She was exaggerating for effect, of course, but
she was making a very serious point. When the alternative is pretty much a gruesome death, why
on earth not permit the use of unproven and untested treatments?
As it turns out, I agree with her. It would be unethical not to. The only way to find out if these
treatments really work is to test them in this epidemic. However, it would also be wrong to think
that, terrifying as they may seem, epidemics like Ebola mean that research ethics go out of the
window. In fact, as the World Health
Organisation recognised in a statement on Tuesday, ethics has to be at the heart of research into
experimental interventions ethical criteria must guide the provision of such interventions. These
include transparency about all aspects of care, informed consent, freedom of choice,
confidentiality, respect for the person, preservation of dignity and involvement of the community.
Despite appearances, the point of ethics isn to slow research down, or to tie researchers and aid
workers up in bureaucratic knots while they try to cope with deadly diseases. The point of ethics is
to ensure the safety of participants and the soundness of the research. Now, worrying about the
safety of participants during an epidemic that has no cure may seem perverse, but considering
that Ebola is not, in fact, 100% fatal (mortality rates vary from
50%-90% depending on the strain) means that the seemingly compassionate distribution of
experimental therapies could do more harm than good. Remember: we don t know if they work.
Which is why those who participate must be free to do so and fully aware of the risks.
Decades ago, HIV/Aids activists campaigned successfully for access to experimental treatments
on the grounds that the alternative was, for them, death. Yet it was not just a do or die calculus
that gave their claim moral weight they were a well-informed patient population, freely entering
into research. They understood the risks; they were not coerced. Rather, they eventually became
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partners in the research enterprise (shaking that enterprise out of some outdated assumptions
while they were at it).
For the provision of experimental treatments in the Ebola epidemic to be ethical, it must be ensured
that the communities receiving those treatments are also able freely to enter into a transparent
and fair research partnership. This is why the WHO statement should be seen as just the beginning
of a wider, global discussion that must include multiple voices from the affected nations in Africa.
They must be free to decide how this would work out in their cities and villages.
But why bother about transparency, freedom and fairness when there are lives at stake? In short,
because it saves lives. The history of medical research in Africa is littered with horrific examples of
western science running roughshod over the rights and liberties of local peoples. This colonial
legacy can manifest in an understandable and quite justified culture of uncertainty and mistrust
around the objectives of western researchers, despite their best intentions. When communities in
which research is done feel that scientific agendas are being imposed upon them by outside
powers, that legacy is exacerbated. This can only make it more difficult to do the good, reliable
science we need to combat epidemics.
Actually finding out whether the experimental treatments for Ebola and other epidemics work is
only possible if affected communities believe that their interests and values are respected. This
only happens when researchers act ethically. Imagine an outbreak of Ebola in Birmingham, say,
and the EU pitching and running experiments without consulting with the city council, or failing to
share the results of the experiments, and you begin to see how things might go wrong when you
ignore peop freedoms and rights.
This is why, during epidemics, it is essential that ethical criteria guide the provision of any
experimental treatm ot just the right thing to do morally, it s the right thing to do
scientifically. We all want this research to get done it would be immoral not to do it. All the more
reason to ensure that we do it right.
Ref: Dan Connor, The Guardian, 14th August 2014.
UN: Ebola Outbreak Could Become Pandemic
Anxious health ministers from 11 countries in emergency meeting
Health ministers from 11 West African countries began a two-day Emergency Ministerial meeting in
Accra, Ghana, Wednesday amid concern the outbreak of the Ebola virus that began in Ghana could
spread across their region as an uncontrolled pandemic.
In a statement distributed at the United Nations, the World Health Organization, WHO, classified the
current Ebola outbreak as the worst ever.
The outbreak traces back to cases appearing in rural Guinea in March, which spread across Guinea,
Liberia and Sierra Leone. So far, a total of 750 cases and 455 deaths have been reported in the affected
countries, according to WHO.
Reuters reported Wednesday the Red Cross was forced to temporarily suspend some operations in the
-wielding
mob that was concerned the medical workers were responsible for spreading the disease.
The WHO regional director for Africa, Dr. Luis Gomes Sambo, speaking at the opening session of the
Accra meeting, called for urgent, collective cross-actions to bring an end to the outbreak.
Sambo observed that the continuing spread of the Ebola virus is largely associated with some cultural
practices and traditional beliefs that are contrary to recommended public health preventive measures.
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Also, the extensive movement of people within and across borders has facilitated the rapid spread of
the infection across three countries.
afraid but do not believe that the disease exists and because of that people get sick and the
Reuters noted that health authorities are trying to stop relatives of Ebola victims from giving traditional
funerals in which family members wash the body and eat a meal in the presence of the deceased prior
to burial.
Given the highly contagious nature of the disease, WHO guidelines require health care medical
professionals working with Ebola patients to wear full rubber protection suits, including face mask and
goggles, gloves, rubber boots and a full-
In a series of heart-breaking emails written home, U.S.-based doctor William Fisher described the brutal
reality of the rampant Ebola epidemic he experienced working for three weeks with physicians from
Mdecins Sans Frontires, or Doctors Without Borders, in a cement building in West Guinea set up to
treat victims.
In an email June 2, Fisher described the death of a patient:
one of the first two patients I admitted on May 30 died. I walked into
his room and he was on the floor half naked surrounded by bloody emesis and diarrhoea. I put him back
in bed, bathed him, and put fresh clothes on him and as I finished he died.
-year-old man who was incredibly strong and rendered completely

helpless. His sister is next door and will likely die in the next hour. This is all in front of the other patients
in the room, many of whom are family members or neighbours. The despair is suffocating. My computer
His description of the workers clothed with a head-to-foot rubber suit was equally compelling:
temperature in my suit 46 C or about 115 F. We spend between 1-2 hours in there at a time, typically,
2-3 times per day. You lose all sense of time once y
your breathing and heart rate and head out when they start to increase, as it takes 10 minutes to
actually get out.
Addressing the delegates at the ministerial meeting in Accra, Dr. Sherry Ayittey, the minister of health
for millions of people in dire need for solutions. We have a small window of opportunity to prevent the
outbreak of Ebola from sprea
The Ebola virus has alarmed international health officials because the frequency of international air
travel has increased the possibility the outbreak in one nation might quickly be transmitted to other
countries by patients in the incubation phase of the infection.
Ref: WND 2nd July 2014. http://www.wnd.com/2014/07/u-n-warns-ebola-could-become-

pandemic/#iprxrSFYPgsW7Gd0.99
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Course Title
Key Stage 4 Programme
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BI302 - Understanding Viral Infections

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Understanding Viral

Timetable Homework Assignments

Finding Information Use the attached articles to

Recognising Reliable Sources Find your own

Balancing Arguments and Critical Analysis Critique

Draft Literature Review Find information and begin

Final Literature Review Write a full academic

Assignment Submission Lateness and Plagiarism

Submission after midnight on ____________________ 10 marks deducted

Some plagiarism 10 marks deducted

Moderate plagiarism 20 marks deducted

Extreme plagiarism Automatic fail

Name of PhD Tutor

Learning Feedback Comment 1 - Enter Key Learning Priority Here

Enter feedback here Enter feedback here

Enter feedback here Enter feedback here

Enter feedback here Enter feedback here

Enter feedback here Enter feedback here

Mark Scheme Page 6

Glossary of Keywords Page 7

Tutorial 1 What is life? Page 8

Homework Assignment 1 Page 15

Tutorial 2 Viruses: The w Page 20

Homework Assignment 2 Page 36

Tutorial 3 Viruses: The Why Page 37

Homework Assignment 3 Page 41

Tutorial 4 Ethics Page 44

Homework Assignment 4` Page 52

Tutorial 5 Presentations Page 53

Final Assignment Page 56

Tutorial 6 Feedback Page 57

Referencing correctly Page 59

Using the VLE Page 60

Useful sources Page 61

Antibiotic A medicine which prevents the growth of, or kills, bacteria.

Antibody A molecule produced by the immune system to fight infection.

A molecule produced by pathogens which causes an immune response in

Contagious Likely to spread and infect other organisms.

Daughter Cell Cell produced after replication.

Widespread occurrence of an infectious disease in a community at a

Foreign Any molecule which is not recognised as s or from that organism.

Genome The complete set of genetic information in a cell or organism.

Host The organism in which the pathogen causes disease or lives.

Invasiveness How efficiently a pathogen spreads through the body.

A scientific piece of writing which aims to summarise and critically analyse

Pathogen Any microorganism which causes disease.

Pandemic If a disease is prevalent across a whole country or the world.

An organism or microorganism which relies on a host (or multiple hosts) for

Replicate To make an exact copy of.

Symptoms A physical or mental feature which indicates a disease.

Poison produced by a microorganism (usually bacteria) which acts as an

Vaccine A substance which provide immunity against a disease.

antibiotics are ineffective against viruses.

Viruses What I already Bacteria

Cells: First The Basics

Can you match up the following illnesses to what causes them?

Malaria Salmonella Common Cola Athletes Foot

Virus Bacteria Parasite Fungi

Bacteria can make us feel ill in two ways:

Do all bacteria make us feel ill?

How do viruses make you feel ill?

These diagrams are of viruses (not all viruses look

Antibiotics (A medicine which prevents the growth of, or kills, bacteria)