Biology 216 - Lect 1 (Fall 2002)
Intro to Infectious Disease
I. Introductions:
A. LH - Med tech (CLS) adviser, Connections (NCAMTE),
not a CLS, resource.
Qualifications - MS, PhD, Post-doc, present
Types of Research - GC, Cholera,
Pseudomonas, biodegradation
B. Course Objectives - Prereq: Bio 11, 270
Everyone has different needs
(research, clinical, pre-med, elective)
Could emphasize mechanisms only
(easily fill a 5 unit course).
Could emphasize clinical only
1. Become literate in medical bacteriology
- familiar with medically relevant bacteria.
Bacteriology, transmission, pathos (define),
diagnosis, treatment , control.
Ex. Diphtheria
2. Diagnostic strategies (isolation, serology,
basis of tests, Ag/Ab & DNA)
3. Evaluation of literature and research in med micro -
Critically read literature, evaluate data, significance.
Highlight hotest areas of research today.
4. Overall - Equivalent to second year
medical school w/o clinical correlations.
C. Syllabus - How to use Baron Text, Baily & Scott;
Exams in Lab (2 hour); Extra reading
D. URLs: http://www.csuchico.edu/biol/personnel/Hanne/Hanne.html
(Linked to: ASM, NCASM, MMWR, EID...)
http://www.camlt.org/cls/
E. Deficiency handout - Importance of immunology;
Exams (old on 329 bulletin board and web); Grading
F. Misc - 4 week drop; Stop or slow down if unclear;
You are not students, but pre-professionals
- Go beyond the course and text (profession vs job).
II. Today - Orientation to Med Bact:
Careers, Organizations, Journals, Nobel, History
III. Careers in Med Micro
A. Medical Technology = Clinical Laboratory Scientists
(Hospital lab - hematology, micro, clinical chem, other)
1. Education - BS micro or biology (w/ specific courses)
+ 1 year internship
Before 1960 - 2 year college
Rigorous educational training important due
to changing techniques (DNA probes)
Rumors of elimination of licensure - unlikely
(effect on health care would be dramatic)
2. Internships - NAACLS
(National Assoc for Acred of Clin Lab Sci - branch of AMA)
Drop in number of programs - due to expenses
(financial accountability of lab)
Today - approx 40 trained in state per year
- many university affiliates (SFSU, UCD)
Feather River and SFSU. Most pay stipend + health insurance.
3. Job outlook, salaries
4. CLIA 88 (Clinical Lab Improvement Amendment)
- Replaces CLIA 67 - Implemented in 1992
Sets standards for who can run specific tests
(Waived, Moderate, High Complexity)
Inspections, Proficiency testing,
Continuing Education (12/year); Includes physian labs
B. Public Health Micro - Infectious diseases controllable in population
Ex. Rabies, TB, GC, water, food, West Nile Virus.
Past students - Rich Trump (Butte),
Anne Verling, Grif Evans (CA state),
Steve Killian (Alameda Co),
Monica Paniagua (San Juaquin)
Tracy Baptista (Butte County)
1. Education - BS micro + 6 month training
(by state health dept or county)
2. Job outlook, salaries
C. Academic Research - backbone of research
published in journals and ultimately applied.
University Researcher - Davis, UCSF
(Rich Rockwell, Karen Marr), US Fish/Wildl (Tillie Wright)
BS in biology; Bio199;
Outlook - good, pay low, stepping stone
into graduate school or biotech
D. Industry/biotech - Product development and manufacture
More education = more control and responsibility.
BS vs MS vs PhD.
Genentech, Microgenic, Chiron, Dey Labs
- Career Day February 2002
Other - QC (detergent company), Analytical chemistry
(CH2M Hill, Agriculture JL Analytical)
E. Teaching - "Those who can, do;
Those who cann't, teach".
Not a good degree for high school. JC, College (at least MS)
IV. Professional organizations - JOIN
A. ASM - nucleus of the profession
- quality assurance and education. (www.asmusa.org)
National and Local (membership forms, fees, meetings, journals)
Local meeting: Concord Hilton
B. Med Tech - CAMLT (national and local); ASCP;
Amer Soc for Clin Lab Sci (old is ASMT)
V. Professional Journals - Reports in Lab
A. J. Clin. Micro - analysis of lab diagnosis
B. Infection and Immunity - research on pathogenesis
C. J. Infect. Dis -
D. MMWR (http://www.cdc.gov/epo/mmwr/mmwr.html),
Calif Morbidity
E. Clinical Microbiology Reviews
F. Internet - Emerging Infectious Diseases
(http://www.cdc.gov/ncidod/EID/eid.htm)
VI. Nobel Prizes - For cornerstone contributions
- Listed on bulletin board - http://www.nobel.se/
(Know 3)
Given by Swedish Academy of Sci since 1901
(November every year)
Interest from Alfred Nobel estate (inventor of dynamite)
- approx $1million
Chem; Physics; Econ; Peace; Literature; Phys/Med
20 - 30 % in medicine go for work in micro
(ie considered very significant field)
1901 - Emil von Behring - diphtheria antitoxin therapy
1905 - Robert Koch - TB and skin testing
(only scratches surface of his contributions).
1939 - Gerhard Domagk - prontosil (sulfa drug)
1945 - Fleming and Florey - penicillin
1952 - Selman Waksman - streptomycin
1978 - Nathans, Smith, Arber - restriction/modification enzymes
1980 - Paul Berg - Recombinant DNA
1984 - Milstein, Kohler - hybridoma/monoclonal technology
1987 - Susumu Tonegawa - immunogenetics (gene rearrangement)
1989 - Michael Bishop - oncogenes
1990 - Thomas, Murray - Transplantation surgery
and immunosuppression
1991 - Erwin Neher and Bert Sakmann - Ion channels
1992 - Edmond Fischer and Edwin Krebs
- Phosphorylation and cellular regulation
1993 - Kary Mullis and Michael Smith (Chemistry award) - PCR
Phillip Sharp and Richard Roberts - Introns
1996 - Peter Doherty and Rolf Zinkernagel - CMI specificity
1997 - Stanley Prusiner - Prions
VII. Brief History - Major milestones - Know names/time periods.
Science "builds" - Advances depend upon
technology and previous knowledge.
A. Pre-Robert Koch (before 1850)
Today - concept of germs and contagion
are engrained (cough cover, sewage, vaccines)
Western world has low mortality from disease.
1500s - 25-50 % chance of living to adulthood.
1. Girolamo Fracastoro (Fracastorius) - 1546
Correlation between diseases and causes
(air and water have invisible agents)
2. Anton van Leeuwenhoek
- 1676 clothes merchant/janitor from Holland
Ground lenses for microscope (300x mag)
Observations: skin, hair, insects, wood, cloth,
communicated to Royal Society of London.
Rainwater - Microbe Hunter/Paul de Kruif p 8.
Made little speculation about significance of bugs.
3. Louis Pasteur and others in mid 1800s.
Many correlations about microbes in disease (not proof)
a. Bact in disease tissue (diph, anthrax)
(Which came first? bacteria or disease?
b. Anthrax in soil near corpses (remove corpses or bury).
c. Anthrax tissue infectious
4. John Hunter - Inoculates self with GC material
- need for isolation in pure culture.
B. Robert Koch - late 1800s - father of med bact
German physician "I hate this bluff that my medical practice is.
How can I cure diphtheria if
I don't know what causes it?"
1. Pure culture - potato slices - need nutrients
for fastidious (OTB) bugs.
- Enriched gelatin - liquify at 35 C; proteases
- Agar - seaweed polysaccharide; Melt 100 C/ solid 44 C.
2. Proof of etiology (cause of disease)-
Koch-Henle (mentor) postulates.
a. Microbe in sick/not healthy host
b. Isolate from host in pure culture.
c. Inoculate susceptible host -> same disease
d. Reisolate same bug.
3. By 1900 most major pathogens isolated and ID
(Neisseria, Pasteurella, Yersinia..)
C. Post Robert Koch - 1900 - present
1. Paul Ehrlich (1900) - father of antibiotics
(MOVE TO ANTIBIOTIC LECTURE)
2. Advances in biochem, immun, genetics, molecular biology
Detailed dissection of disease components with goal of interceding.
Sequencing pathogens: Vibrio cholerae, Neisseria meningitidis Gp B
Applications: Whooping cough vaccine (protective Ag);
Chlorpromazin and cholera, New pneumococcal vaccine
3. New crises - Legionaires; Pseudomonas; AIDS;
Lyme; Campylobacter; ETEC;
New Gp A Strept (produce SLE - erythrogenic);
Hepatitis C....; Gp B Strept;
Hantavirus; E.coli O157:H7; TB; VRE; Ehrlichiosis
Chlamydia and atherosclerosis,
Nanobacteria and kidney stone development
Anthrax, West Nile Virus
VIII. Summary
Med micro has come a long way
Will continue to change
This semester - develop foundation for future learning