Section 2. Scrub up

1. Play the Disease transmission game. How long does the disease take to spread through the classroom and what proportion of people survive the epidemic?

2. How long would it take the disease to work through everyone in the building?

3. When you had the disease, did you infect you friends first? What would happen in real life?

4. Which of the following routs of transmission does the game demonstrate?

1. droplet contact (respiratory route) - through coughs and sneezes, kissing, cups, etc.

2. faecal-oral transmission – from contaminated food or water

3. direct physical contact, including sexual contact

4. vertical transmission – mother to child

5. iatrogenic transmission- due to medical procedures

6. vector born – carried by insects or other animals

7. indirect contact – by touching contaminated surfaces

5. Match these diseases with the routs of transmission in 4

a. athlete’s foot

b. chickenpox

c. cholera

d. HIV

e. Influenza

f. Malaria

g. Meningitis

h. MRSA (Methicillin-resistant Staphylococcus aureus)

i. Poliomyelitis

j. Rabies

k. Syphilis

6. What examples of disease epidemics do you know?

DISEASE TRANSMISSION GAME

Choose one person to be the “carrier” of an unknown and highly infectious disease to start an epidemic.     ↓ Discuss what a “carrier” is.	The carrier infects two people in the classroom by handling them each a piece of paper.   ↓ Discuss what to do with the carrier to prevent further spread of the disease	When you receive the piece of paper, you must toss a coin twice.	If you get two heads, you are immune to the disease.   ↓ Discuss how it is possible for someone to be immune.	If you get only one head, you are infected, but your life is saved by treatment. However, before you get treatment, tear the paper into two pieces and give each piece to a new person.   ↓ Discuss what kind of treatment might save the infected people.	If you get no heads, no treatment can save you. You die. However, before you die, tear the paper into two pieces and give each piece to a new person. ↓ Discuss what to do with the bodies and clothing of the victims to avoid spreading the disease.

Section 3. Reading

Read the article:

THE PLAGUE

Over the course of human history, the bubonic plague has killed 200 million people. In one pandemic around 1347, over half the population of Europe died and along with their deaths came economic collapse, food shortages, and a breakdown of law and order.

The first sign that the plague had arrived was the rats that came out into the streets to die in huge numbers. The people fled their homes, isolated themselves from other people or prepared for likely death. When they died, it was in a particularly horrible way. Initial symptoms were chills, then fever. Within hours victims would be doubled up with stomach pains, and unable to lie down with terrible headaches. Then came large red swellings - hard painful lumps on neck, arms and inner thighs, some as big as oranges. There was bleeding and a horrible smell.

The medicine of the time could not explain it. Doctors tried blood letting - draining the illness out by cutting a vein and letting it bleed. It didn’t work. Because it was obvious that you could get the disease from contact with victims and their clothing, the response of most people was to abandon anyone who caught it. There were very few quailed doctors, but they were plenty of quack doctors who would, for a very high price, care for the sick. They wore long gowns and bird-like masks filled with herbs and oils and they washed in vinegar for protection. Through strange, these measures were actually quite effective.

Though it was known that survivors of an infection didn’t catch it a second time, the random way that one person could be struck down by disease and another survive was explained in terms of God’s will, not immunity. People believed that a loving god would not create anything so bad unless it was to punish those who had done some kind of wrong. The Italian writer Giovanni Boccaccio lived through the epidemic and described people’s reactions to the death all around them. He described the Flagellants, for example, who believed that if they walked from town to town and beat themselves in public, then they would escape the disease.

According to Boccaccio, many people adopted a fatalistic attitude – leaving it in God’s hands. The hedonists, he said, dedicated their lives to pleasure – eating, drinking, and casual sex while they had the chance. They were going to die anyway. Others, like nuns, applied fatalism to its logical extreme and ignored the risks involved in having close contact with the dying. They actually nursed the sick. Nuns (women living in religious communities) have an important place in the history of professional nursing, and though during the plague epidemics they said they were only doing God’s will and had no choice in the matter, they were much admired for their charity and courage.

Answer the questions:

1. What did the pandemic of 1347 achieve?

a) It killed 200 million people; b) It set back social progress; c) It wiped out the population of Europe;

2. Which of these is not amongst the characteristic symptoms of bubonic plague listed in the text?

a) abdominal cramps; b) swellings; c) restlessness;

3. Why were long gowns and masks worn during the plague?

a) for religious reasons; b) to avoid contagion; c) to conceal identity;

4. Who were the Flagellants?

a) people who want to die; b) people who didn’t believe in God; c) people who made themselves suffer in order to survive;

5. Who believed they were going to die?

a) everybody; b) nuns; c) the hedonists.

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