Human Diseases, Vaccines, Immunity and IPR

What to remember

• Diseases are caused by pathogens (virus, bacteria, fungi, protozoa, worms) or by lifestyle and genes. Many infectious diseases are spread by vectors such as mosquitoes, and are controlled by hygiene, vector control and vaccines.
• Immunity can be natural or acquired, and vaccines give safe, active immunity. India runs the Universal Immunisation Programme, and misuse of antibiotics is creating drug-resistant germs.
• Intellectual Property Rights protect creations of the mind. Patents, copyright, trademarks and Geographical Indications each protect different things, and TRIPS is the global agreement on them.

Pathogens and types of disease

A pathogen is a germ that causes disease. Diseases are of two broad types: communicable (spread from person to person or through air, water, food or vectors) and non-communicable (not spread by germs, such as diabetes or heart disease). Diseases may also be deficiency diseases (lack of a nutrient) or genetic diseases (passed through genes).

Major diseases and their vectors

A vector carries a pathogen from one host to another. Control of the vector controls the disease.

HIV attacks the helper T cells of the immune system and causes AIDS. It spreads through unsafe blood, sexual contact, shared needles and from mother to child; it does not spread by touch or mosquitoes. Tuberculosis is treated with a long course of several drugs; the full course must be completed. Malaria is treated with antimalarial drugs; the old drug quinine comes from cinchona bark. National programmes exist for TB, malaria, HIV and leprosy.

Immunity and vaccines

Immunity is the body's power to resist disease. Innate immunity is present from birth (skin, mucus, stomach acid, white cells). Acquired immunity develops after exposure to a germ or vaccine. It can be active (the body makes its own antibodies) or passive (ready-made antibodies are given, such as mother's milk to the baby or antiserum for snake bite).

White blood cells fight germs. B cells make antibodies. T cells attack infected cells and help control the response. After infection some memory cells remain, so the second attack is dealt with faster. A vaccine has a harmless form of the germ or a part of it, and trains the body to make memory cells.

India's Universal Immunisation Programme gives free vaccines to children and pregnant women against diseases such as tuberculosis (BCG), polio, diphtheria, pertussis, tetanus, measles and hepatitis B. Pulse Polio campaigns helped India to be declared polio-free by the World Health Organization. Mission Indradhanush aimed to reach children missed by routine immunisation. Edward Jenner developed the first vaccine for smallpox, and smallpox has been eradicated from the world.

Antibiotics and resistance

Antibiotics kill or stop bacteria. They do not work on viruses, so they should not be used for cold or flu. Alexander Fleming discovered penicillin from the mould *Penicillium*.

Antimicrobial resistance (AMR) happens when germs change so that drugs no longer kill them. It is caused by taking antibiotics without need, not completing the course, use of antibiotics in animals and poor hygiene. Resistant infections are harder and costlier to treat. Remedies: use antibiotics only on a doctor's advice, complete the course, improve sanitation and vaccination. In India, some antibiotics are sold only with a prescription, and a national action plan on AMR exists.

Non-communicable diseases

Non-communicable diseases (NCDs) are long-lasting and are linked with lifestyle, age, genes and environment.

Prevention is by healthy food, exercise, no tobacco or alcohol, and regular check-ups. The National Programme for Prevention and Control of Non-Communicable Diseases and Ayushman Bharat health and wellness centres support screening. Deficiency diseases include night blindness (vitamin A), rickets (vitamin D), scurvy (vitamin C), beriberi (vitamin B1), anaemia (iron) and goitre (iodine).

Intellectual Property Rights

IPR are legal rights over creations of the mind. They allow creators to earn from and control their work for some time.

The TRIPS Agreement (Trade-Related Aspects of Intellectual Property Rights) of the World Trade Organization sets minimum global standards for IPR. WIPO (World Intellectual Property Organization) is the UN body for IPR. India's laws include the Patents Act, the Copyright Act, the Trade Marks Act and the Geographical Indications of Goods Act. The Controller General of Patents, Designs and Trade Marks works under the Department for Promotion of Industry and Internal Trade. India moved from process-only patents to product patents for drugs, food and chemicals in 2005, and has a safeguard (Section 3(d)) under which a mere new use or new form of a known substance may not be patentable. Compulsory licensing lets the government allow others to make a patented medicine in cases of public health need. Turmeric and neem are examples where traditional knowledge was defended against patents; the Traditional Knowledge Digital Library keeps records of Indian traditional knowledge.

Public health programmes and hygiene

Many infections can be stopped by simple steps. Clean drinking water, boiling or filtering water, washing hands with soap, covering food, safe toilets and proper waste disposal reduce cholera, typhoid and diarrhoea. Removing stagnant water near homes stops mosquitoes from breeding. Sleeping under bed nets helps against malaria. Wearing a mask, covering the mouth when coughing and early treatment reduce spread of tuberculosis and respiratory infections.

ORS (oral rehydration solution) of salt and sugar in water saves children from dehydration during diarrhoea. Quarantine keeps a possibly infected person apart for some time, and isolation separates a sick person. An epidemic is a sudden rise of a disease in an area; a pandemic spreads across many countries; an endemic disease is always present in a region. Herd immunity happens when enough people are immune that the disease cannot spread easily, protecting even those who are not vaccinated. The National Health Mission supports village health workers (ASHA) and primary health care, and surveillance systems track outbreaks.

Exam traps

• Malaria is caused by a protozoan, not a virus or bacterium.
• Dengue spreads by Aedes; filariasis by Culex; malaria by Anopheles.
• Antibiotics do not act on viruses.
• Active immunity uses one's own antibodies; passive immunity uses ready-made ones.
• Vaccination gives memory cells; antiserum gives quick but short protection.
• Copyright protects expression, not an idea.
• A patent protects an invention; a GI protects a regional product.
• WIPO is the UN body; TRIPS belongs to the WTO.

One-liners

• Female Anopheles spreads malaria.
• Aedes mosquito spreads dengue.
• HIV attacks helper T cells.
• BCG vaccine is given against tuberculosis.
• Jenner developed the smallpox vaccine.
• Fleming discovered penicillin.
• Smallpox has been eradicated.
• AMR means germs no longer respond to drugs.
• Lack of iodine causes goitre.
• Vitamin C deficiency causes scurvy.
• A patent is generally valid for 20 years.
• Kondapalli toys have a GI tag.

Practice questions

1. Malaria is caused by a

   1. Bacterium
   2. Virus
   3. Fungus
   4. Protozoan
   Answer

   D. Protozoan

   Plasmodium is a protozoan parasite.

2. Which mosquito spreads malaria?

   1. Culex
   2. Female Anopheles
   3. Aedes
   4. Male Anopheles
   Answer

   B. Female Anopheles

   Only the female Anopheles mosquito spreads malaria.

3. Dengue is spread by which mosquito?

   1. Aedes
   2. Culex
   3. Anopheles
   4. Housefly
   Answer

   A. Aedes

   Aedes mosquitoes carry the dengue virus.

4. Kala-azar is spread by

   1. Flea
   2. Tsetse fly
   3. Tick
   4. Sandfly
   Answer

   D. Sandfly

   The sandfly carries Leishmania.

5. Tuberculosis is mainly spread through

   1. Mosquito bites
   2. Contaminated water
   3. Air droplets
   4. Blood transfusion only
   Answer

   C. Air droplets

   TB spreads by droplets from coughing and sneezing.

6. Which of the following diseases is caused by a bacterium?

   1. Cholera
   2. Dengue
   3. Measles
   4. Polio
   Answer

   A. Cholera

   Cholera is caused by Vibrio cholerae.

7. HIV mainly attacks

   1. Red blood cells
   2. Helper T cells
   3. Platelets
   4. Neurons
   Answer

   B. Helper T cells

   HIV destroys helper T cells, weakening immunity.

8. Which cells of the immune system produce antibodies?

   1. Red cells
   2. Platelets
   3. Neurons
   4. B cells
   Answer

   D. B cells

   B lymphocytes make antibodies.

9. The first vaccine in the world was developed against

   1. Rabies
   2. Smallpox
   3. Measles
   4. Polio
   Answer

   B. Smallpox

   Edward Jenner developed the smallpox vaccine.

10. The BCG vaccine protects against

    1. Tuberculosis
    2. Typhoid
    3. Tetanus
    4. Hepatitis B
    Answer

    A. Tuberculosis

    BCG is the vaccine for tuberculosis.

11. Who discovered penicillin?

    1. Robert Koch
    2. Edward Jenner
    3. Alexander Fleming
    4. Louis Pasteur
    Answer

    C. Alexander Fleming

    Fleming discovered penicillin from Penicillium mould.

12. Antibiotics are NOT effective against

    1. Cholera
    2. Viruses
    3. Typhoid
    4. Tetanus
    Answer

    B. Viruses

    Antibiotics act on bacteria, not viruses.

13. Antimicrobial resistance mainly arises from

    1. Eating more fruits
    2. Regular exercise
    3. Wrong or unnecessary use of antibiotics
    4. Drinking boiled water
    Answer

    C. Wrong or unnecessary use of antibiotics

    Misuse allows resistant germs to survive and spread.

14. Lack of iodine in the diet causes

    1. Scurvy
    2. Beriberi
    3. Rickets
    4. Goitre
    Answer

    D. Goitre

    Iodine is needed for thyroid hormones; lack causes goitre.

15. Scurvy is caused by deficiency of which vitamin?

    1. Vitamin C
    2. Vitamin A
    3. Vitamin B1
    4. Vitamin D
    Answer

    A. Vitamin C

    Vitamin C deficiency causes scurvy.

16. Which of the following is a non-communicable disease?

    1. Typhoid
    2. Measles
    3. Malaria
    4. Diabetes
    Answer

    D. Diabetes

    Diabetes is not spread by germs.

17. Uncontrolled cell division is the main feature of

    1. Goitre
    2. Asthma
    3. Cancer
    4. Anaemia
    Answer

    C. Cancer

    Cancer is abnormal, uncontrolled growth of cells.

18. Immunity gained by receiving ready-made antibodies is

    1. Herd immunity
    2. Passive immunity
    3. Active immunity
    4. Innate immunity
    Answer

    B. Passive immunity

    Ready-made antibodies give passive immunity.

19. A vaccine works by

    1. Training the body to form memory cells
    2. Killing all germs in the blood
    3. Replacing white cells
    4. Supplying antibodies directly
    Answer

    A. Training the body to form memory cells

    Vaccines produce memory cells for faster future response.

20. The patent term in India is generally

    1. Life of the inventor
    2. 20 years from filing
    3. 5 years
    4. 50 years
    Answer

    B. 20 years from filing

    Standard patent term is 20 years from the date of filing.

21. Copyright protects

    1. A new machine
    2. Expression of ideas such as books and music
    3. A regional product
    4. A brand logo only
    Answer

    B. Expression of ideas such as books and music

    Copyright covers original works of authorship, not bare ideas.

22. A Geographical Indication tag is given to

    1. A computer program
    2. A new drug
    3. A product linked to a region
    4. A company name
    Answer

    C. A product linked to a region

    GI identifies goods whose quality comes from a place.

23. Which of the following carries a GI tag from Andhra Pradesh?

    1. Mysore silk
    2. Darjeeling tea
    3. Kullu shawl
    4. Kondapalli toys
    Answer

    D. Kondapalli toys

    Kondapalli toys are a GI product of Andhra Pradesh.

24. The TRIPS Agreement is administered under the

    1. World Trade Organization
    2. IMF
    3. WHO
    4. UNESCO
    Answer

    A. World Trade Organization

    TRIPS is a WTO agreement.

25. Which UN body deals with intellectual property worldwide?

    1. WIPO
    2. FAO
    3. UNICEF
    4. UNDP
    Answer

    A. WIPO

    WIPO is the World Intellectual Property Organization.

26. The Traditional Knowledge Digital Library was set up mainly to

    1. Record weather
    2. Train doctors
    3. Sell medicines
    4. Prevent wrong patents on Indian traditional knowledge
    Answer

    D. Prevent wrong patents on Indian traditional knowledge

    It records traditional knowledge so patent offices can refuse wrong claims.

27. Compulsory licensing allows

    1. Free export of drugs
    2. Banning a drug
    3. Others to make a patented medicine in public health need
    4. Extending a patent forever
    Answer

    C. Others to make a patented medicine in public health need

    The government can authorise others to make the product under set conditions.

28. A person who takes ready-made antiserum after a snake bite gets

    1. Lifelong immunity
    2. Passive immunity
    3. Active immunity
    4. Innate immunity
    Answer

    B. Passive immunity

    Antiserum has ready antibodies; protection is quick but short.

29. Which step best prevents the spread of dengue in a locality?

    1. Removing stagnant water where Aedes breeds
    2. Taking antibiotics
    3. Boiling milk
    4. Eating more salt
    Answer

    A. Removing stagnant water where Aedes breeds

    Controlling the vector's breeding sites controls dengue.

30. A patient with viral fever asks for antibiotics. The correct advice is that

    1. They are vitamins
    2. They cure all fever
    3. They are useless against viruses
    4. They give lifelong immunity
    Answer

    C. They are useless against viruses

    Antibiotics do not act on viruses.

31. Consider the statements: 1. Malaria is caused by a protozoan. 2. Dengue is caused by a bacterium.

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Dengue is caused by a virus.

32. Consider the statements: 1. HIV spreads by mosquito bites. 2. HIV can spread through shared needles.

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    HIV does not spread by mosquitoes but does by shared needles.

33. Consider the statements: 1. Smallpox has been eradicated. 2. The first vaccine was developed by Edward Jenner.

    1. 1 only
    2. 2 only
    3. Neither 1 nor 2
    4. Both 1 and 2
    Answer

    D. Both 1 and 2

    Both statements are correct.

34. Consider the statements: 1. Antibiotics work on viruses. 2. Incomplete antibiotic courses can help resistance develop.

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    Antibiotics do not work on viruses.

35. Consider the statements: 1. Copyright protects ideas as such. 2. A patent protects a new invention.

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    B. 2 only

    Copyright protects expression, not ideas.

36. Consider the statements: 1. TRIPS is an agreement of the WTO. 2. WIPO is a UN agency.

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    C. Both 1 and 2

    Both statements are correct.

37. Consider the statements: 1. Filariasis is spread by the Culex mosquito. 2. Kala-azar is spread by the Anopheles mosquito.

    1. 1 only
    2. 2 only
    3. Both 1 and 2
    4. Neither 1 nor 2
    Answer

    A. 1 only

    Kala-azar is spread by sandflies.

38. Consider the statements: 1. Innate immunity is present from birth. 2. Memory cells help a faster response to a second infection.

    1. 1 only
    2. 2 only
    3. Neither 1 nor 2
    4. Both 1 and 2
    Answer

    D. Both 1 and 2

    Both statements are correct.

39. Match the disease with its cause: 1. Tuberculosis - A. Virus 2. Polio - B. Bacterium 3. Ringworm - C. Fungus

    1. 1-A, 2-B, 3-C
    2. 1-C, 2-B, 3-A
    3. 1-B, 2-A, 3-C
    4. 1-B, 2-C, 3-A
    Answer

    C. 1-B, 2-A, 3-C

    TB is bacterial, polio viral, ringworm fungal.

40. Match the disease with its vector: 1. Malaria - A. Aedes 2. Dengue - B. Anopheles 3. Filariasis - C. Culex

    1. 1-C, 2-A, 3-B
    2. 1-B, 2-C, 3-A
    3. 1-A, 2-B, 3-C
    4. 1-B, 2-A, 3-C
    Answer

    D. 1-B, 2-A, 3-C

    Malaria - Anopheles, dengue - Aedes, filariasis - Culex.

41. Match the deficiency with the disease: 1. Vitamin A - A. Rickets 2. Vitamin D - B. Night blindness 3. Iron - C. Anaemia

    1. 1-B, 2-A, 3-C
    2. 1-A, 2-B, 3-C
    3. 1-B, 2-C, 3-A
    4. 1-C, 2-A, 3-B
    Answer

    A. 1-B, 2-A, 3-C

    Vitamin A - night blindness, D - rickets, iron - anaemia.

42. Match the right with what it protects: 1. Patent - A. Invention 2. Trademark - B. Brand name 3. Copyright - C. Books and music

    1. 1-A, 2-C, 3-B
    2. 1-B, 2-A, 3-C
    3. 1-A, 2-B, 3-C
    4. 1-C, 2-B, 3-A
    Answer

    C. 1-A, 2-B, 3-C

    Each pair is correct in option A.

43. Which of the following is a lifestyle-related risk for heart disease?

    1. Vaccination
    2. Hand washing
    3. Drinking boiled water
    4. Smoking and lack of exercise
    Answer

    D. Smoking and lack of exercise

    Smoking, poor diet and inactivity raise heart disease risk.

44. Pulse Polio campaigns mainly give

    1. Vitamin tablets
    2. Oral polio vaccine drops
    3. Antibiotic injections
    4. Malaria drugs
    Answer

    B. Oral polio vaccine drops

    Oral polio drops are given to children in pulse campaigns.

45. Which of the following is passed on through genes?

    1. Cholera
    2. Malaria
    3. Tuberculosis
    4. Haemophilia
    Answer

    D. Haemophilia

    Haemophilia is a genetic disorder.