UNIT 8

1. Heath and illness

1.1 Health and its determinants

The Worlds Health Organisation (WHO) defines health as a state of complete

physical, mental and social well-being.

Whether or not a person is healthy depends on a number of factors known as

determinants of health.

The determinants of health

The determinants of health include individual biological factors, the environmental

factors and factors related to lifestyle and public health measures, all of which affect
our health.

The positive impact of these factors on a persons health is denoted by a plus sign (+)
and the negative impact, by a minus sign (-).

Biological determinants of health are an individuals personal characteristics

related to the physiological make-up of the human body. For example,
increasing age (-) or certain characteristics the individual is born with, which
they might have inherited from their parents (congenital conditions), such as
tendency to develop short-sightedness (-) or having teeth that are resistant to
decay (+).

Environmental determinants of health are the features of our environment. For

example. Fresh air (+), excessive and continuous noise (-) or the presence of
pathogenic organisms in the environment (-), such as viruses, bacteria,
protozoa, fungi and some invertebrate parasites (e.g. tapeworms), which cause
damage when they enter our bodies.

A lifestyle is the set of habits that reflects an individual or groups way of life.
The factors that contribute to maintaining a healthy lifestyle (+ factors) include
the following habits:
- Keeping basic standards of personal hygiene
- Doing regular physical activity (this is age-appropriate).
- Not consuming harmful substances, such as drugs, alcohol or tobacco.
- Not self-medicating, in other words, not taking any medicine unless it has
been prescribed by the doctor.
- Getting enough sleep (the recommended eight to nine hours)
 The implementation of public health measures for a population is a positive
health determinant (+). Some of these measures involve establishing a good
healthcare system including services for prevention, treatment and
rehabilitation, proper sanitary control of food and water, and proper management
of waste and pollutants to avoid poisoning from and the proliferation of
pathogens.

1.2 illnesses

An illness is any physical or mental symptom that causes the body to not function
properly.

Types of illnesses

Illnesses can be classified into two types depending on their origin: infectious and non-
infectious.

Non- infectious illnesses are not caused by pathogens; rather, they develop
as a result of other causes (such as aging, accidents, congenital conditions or
lifestyle habits). Such illnesses include injuries (traumas) or degenerative
diseases that affect the different organs. These illnesses cannot be transmitted
from one individual to another. In other words, they are not contagious.
Infectious illnesses are caused by pathogens (viruses, bacteria, protozoa, fungi
and some invertebrates such as tapeworms) that enter the body. Examples of
these illnesses include the flu, chickenpox and the common cold. These illnesses
can be transmitted (are contagious).
the transmission of infectious illnesses

Infectious illnesses can be transmitted directly or indirectly.

Direct transmission. The pathogen passes directly from a sick person to a

healthy person (for example, by sneezing or through direct contact).
Indirect transmission. The pathogen uses different vehicles for transmission
(water, food or animals), called vectors, to spread from an ill person to a healthy
person.
2. How the human body defends itself
2.1 The bodys defences

Human beings, like all other living things, have a defence system called the immune
system.

The immune system is the set of defence mechanisms that provide the human body
with immunity, meaning resistance to infections caused by pathogens. This defence
systems response to pathogens is called immune response.

We have two types of immunity: innate (non-specific) immunity and acquired

(specific) immunity.

2.2 Innate or non-specific immunity.

Innate immunity develops while we are in the womb. We are all born with innate (or
natural) immunity. This is non-specific immunity, meaning it protects your body from
all invading pathogens. Non-specific defences include:

External defences. The main defences are the skin, which is impermeable to
most microorganisms; the mucus membranes, consisting of tissues that line the
internal passageways which secrete mucus that prevents bacteria from growing;
bodily secretions (such as tears and saliva), which destroy or damage
pathogens; and natural bacteria flora which prevents the growth of pathogens.
Phagocytes. These are white blood cells that capture pathogens by means of
pseudopodia and digest them.

The inflammatory reaction which occurs when we get a wound is an example of an

innate immune response.
2.3 Acquired or specific immunity

Acquired immunity develops throughout our lives as we are exposed to different

pathogens and is a pathogen-specific immune response. The acquired immune response
is carried out by lymphocytes (a type of white blood cell) and certain substances made
them. There are different processes involved in acquired immune response. One of these
processes is the humoral immune response, which can be either primary or secondary.

Primary humoral immune response

The primary humoral immune response occurs when a pathogen enters our body for
the first time. It occurs in three stages:

Activation. Certain lymphocytes, of the B type, detect the pathogen and are
activated to fight against it. Activation lasts for several days.
Multiplication and production of antibodies. The activated B lymphocytes (B
cells) multiply by cell division. They also begin to manufacture a number of
proteins, called antibodies, which are capable of binding specifically to the
pathogen and destroying it.
Acquisition of immunological memory. Once the pathogen is destroyed, only
some of the B lymphocytes that were sensitised to it remain in our bodies. There
are memory B lymphocytes.
Secondary humoral immune response

The secondary humoral immune response is triggered if a second invasion by the

same pathogen occurs. When this occurs, the memory B lymphocytes recognise this
pathogen, and are activated and divide very rapidly. This reduces the time required to
produce antibodies in bulk, and pathogens are destroyed more effectively.
3. Helping our bodies to fight illness

Sometimes it is necessary to help the body to fight off infectious illnesses using
vaccines, serums or medications.

3.1 Vaccines

Vaccines are synthetic preparations containing inactive pathogens (weakened or

dead forms), which are unable to cause disease. Vaccines prevent diseases but do not
cure them. Therefore, they must be administered before exposure to a disease.

How a vaccine works

When a vaccine is administered to an individual, their immune system recognises the

inactive pathogens it contains and triggers a primary humoral immune response. In
other words, their B lymphocytes recognise the inactive pathogen from the vaccine,
produce antibodies and acquire immunological memory.

Vaccination is an artificial method for acquiring immunity to a particular

pathogen, without suffering from the disease it causes.

If a live pathogen infects an individual who is vaccinated against it, the memory B
lymphocytes developed after vaccination trigger a secondary humoral immune response,
in which the pathogen is eliminated and the individual will not get sick.

3.2 Serums

Serums are synthetic preparations that contain antibodies against a specific pathogen.

when a serum is administered to a person, antibodies that help to fight off a particular
pathogen are introduced into the body.
This provides immediate but short-lived immunity against this pathogen (there is no
need to wait for the person to generate an immune response, but serum antibodies are
eliminated after a short time and immune memory is not developed).

Serums are especially useful in combating serious infectious diseases (such as tetanus
and diphtheria) and snake bites and bites from other animals that inject poisons (poisons
also trigger immune responses), when the individual does not have enough time to
produce their own antibodies after they have been exposed to the pathogen or poison.
3.3 Medications

Medications are compounds that contain substances called active ingredients, which
cure an illness or relieve the symptoms it produces.

Antibiotics, antivirals and analgesics are considered to be the most important types of
medication available, given the beneficial effects they produce.

Antibiotics destroy bacteria or prevent them from reproducing, without

destroying the bodys cells. They are very effective against bacterial infections.
Each different type of antibiotic can only be used to fight one specific type or
group of bacteria and cannot be used to fight viruses or other microbes.
Antivirals kill viruses without damaging the virus-infected cells. Although we
have the ability to get over most viral illnesses because out immune system
protects us, antiviral medicines help to treat these illnesses. Just like antibiotics,
there are specific types of antivirals for different types of virus.
Analgesics, also called painkillers, have no curative effect but are used to
alleviate pain. Paracetamol and aspirin (acetylsalicylic acid) are the most
common forms of analgesics. Some painkillers also act as antipyretics, meaning
they reduce fever.

4. Transplants and organ donation

Transplants consist of replacing organs, tissues or cells that do not function properly
in one organism (the recipient) with other that do function properly, from the same or
another body (the donor).

Bone marrow cells are currently transplanted for leukaemia patients, in addition to
transplanting tissues such as skin and organs such as the heart, kidney, liver or lungs.
For most transplants, the donor is a different person than the recipient. Sometimes,
however, the donor is also the recipient. This type of transplant is called an autologous
transplant. Sometimes the donor is an animal, in which case the transplant is called
xenotransplantation.

Transplant rejection

Transplant rejection occurs when the recipients immune system recognises the
transplant as a foreign body and attacks it. To prevent rejection, compatible donors are
sought. Compatible donors are donors whose cells, tissues and organs are recognised by
the recipients immune system. The patient has to undergo treatment by taking
medication (immunosuppressants), which suppresses the immune system.
4.2 Donation

A transplant requires a donor who is willing to give part of their own body to help
another person.

Donation is a selfless act of solidarity towards other ill people who are given the
opportunity to live or have an improved quality of life. It is also an altruistic act, as the
donor does it voluntarily and is not rewarded in any way.

Spain has the highest organ donation rate in the world, but the availability of organs and
tissues is still too low and many patients die while on waiting lists.

The National Transplant Organization (ONT) regulates organ donation in Spain and
coordinates the entire national transplant system. The system is free and guarantees that
all citizens have the same opportunities to benefit from a transplant.

Who can be a donor?

Living donors. Living individuals can donate tissues, such as blood or any organ they can
live without, such as a kidney.
People who have suffered brain death. we say a person is brain dead if they have died but
their heartbeat is maintained artificially, so the organs that are going to be transplanted are
kept in good condition.