Infectious Disease and Human Density Module 5 Lesson 5

LESSON 5: INFECTIOUS DISEASE AND HUMAN DENSITY

OVERVIEW:
Students will explore the relationship between the risk of infectious disease and
population densities. The lesson is in two distinct parts, the second of which is revealed
to students only at the end of the lesson. In the first part, students will investigate a set of
case studies about people suffering from some infectious illness in a neighborhood.
From the data provided, students will try to figure out what is the source of the infectious
agents causing people to get sick. In the second part of the lesson, students will look at
their hands under an ultraviolet light in order to see if they have any glow powder on
their skin. This harmless powder will have been applied to one of the case study files
before the lessons began. The second part of the lesson reinforces how easily and
surreptitiously infectious diseases are spread. Students will be asked to reflect on what
factors most influence the spread of infectious disease within human communities.

SUB-QUESTION:
How do infectious diseases spread so quickly in urban areas?

WAYS OF KNOWING URBAN ECOLOGY:

Students will…
Understand • Explore the pathways and genesis of infectious disease (human impact,
ecosystem state and structure, forces and drivers).
Talk No specific goals connected with talking urban ecology in this lesson.

Do • Evaluate and analyze infection data in a disease outbreak simulation.

• Construct a hypothesis about the nature of a disease outbreak.
Act No specific goals connected with doing urban ecology in this lesson.

SAFETY GUIDELINES

The specific safety issues associated with this lesson involve thoroughly washing your
hands following the activities. The light sensitive powder is relatively harmless, but
students may associate the powder with infectious disease. In addition, some students
may experience skin irritation. See http://www.germwise.com/pdfs/msds-glogerm-
powder.pdf for more information.

PREPARATION:

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Infectious Disease and Human Density Module 5 Lesson 5

Time:
1 class period

Materials:

Day 1:

Activity 5.1
GloGerm powder (http://www.glogerm.com/) or equivalent
For each student:
Public Health Worksheet

Activity 5.2
For each student or group of students:
UV lamp

INSTRUCTIONAL SEQUENCE

Activity 5.2 will actually be implemented during the student activities in Activity 5.1.
Activity 5.2 investigates the role of social contact in the spread of infectious disease.
You should apply some of the glow powder to the student work sheets before handing
them out. The glow powder is harmless and invisible under normal lighting conditions.
As the students handle the worksheets they will get some of the powder on their hands.
Then, when the first lesson is complete, you can initiate Activity 5.2 and discover how
the glow powder has been distributed using the special UV light included in the packet.

Introducing the Lesson

Remember, the students are initially aware of only the first part of the lesson (Activity
5.1). They will conduct that activity without knowledge of the glow powder. This is
critical if Activity 5.2 is to have its intended impact!

Activity 5.1: You are the Public Health Investigator!

1. Have your students review the interview transcripts and complete the PHI Data
Analysis Sheet.
2. Ask your students to review the data and look for any activities which may be
consistent across all of the people interviewed.
3. Have your students fill out the PHI Final Analysis Sheet with their understanding of
the source of the infection and the common clues that helped them reach this
conclusion.
4. Have students come up with questions about their own neighborhood such as “Do I
know where my water supply comes from?” Have students share these questions and

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Infectious Disease and Human Density Module 5 Lesson 5

Activity 5.2: Am I Infected?

1. Depending on the number of ultraviolet (UV) lights available, students can either
work independently, in pairs, or as a group.
2. Using the worksheet as a guide, students will examine their hands under an
ultraviolet light. Some students will show the presence of the glow powder,
others will not.
3. After viewing their hands, students should try to find which of the data files were
“infected” with the glow powder. Once this has been discovered, students can
reflect on the hidden nature of infectious disease.

Teaching Alternatives
Although the glow powder is harmless, it does require soap and water to clean up. In
some instances, access to sinks and running water may be limited, or pose an undue
management stress to the class. If this is the case, the teacher can choose to do this
activity as a discussion for the entire class. Instead of revealing the powder on the skin,
discuss a food poisoning scenario by reviewing what everyone had for lunch. Make a
data table on the board or screen. Look for common items and estimate the number of
people who would be sickened if a certain food was tainted. The data obtained from the
class can be used for discussion.

Concluding the Lesson

1. As an end of the class reflection, have students consider the following question:
o How did physical contact increase the spread of the glow powder, which
was serving as a surrogate for an actual disease?
o How might you respond to news of a food poisoning incident in the school
or neighborhood?
Teacher Background Knowledge
The University of Minnesota has developed a public health disease outbreak scenario
game called Outbreak at Waters Edge. The game uses an infectious disease outbreak
incident similar to what we use in this lesson. The game takes a full period to play. They
have done a great job at simulating the details:
http://www.mclph.umn.edu/watersedge/index.html

There is also River City, which occurs in an online virtual world:

http://muve.gse.harvard.edu/rivercityproject/index.html
While it is geared towards middle school, it is also appropriate for high school students.

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Infectious Disease and Human Density Module 5 Lesson 5

Name: _________________________________ Date: _________ Class/Period:________

Lesson 5.1 You are the PHI

Objective: In this activity, you are playing the role of a Public Health Investigator (PHI)*
assigned to a case. In your city, there has been a recent outbreak of sickness that is affecting
dozens of people. The doctors report that the illness is caused by a bacterial infection. All of
these people have reported a similar illness over the past 24 hours. They have reported nausea,
diarrhea, fever and chills. However, the infection is generally not transferable from person-to-
person. Therefore, people who are sickened by the bacteria must be acquiring the infection from
a source.

Your job is to help find the source of infection and work with medical professional and public
works employees to eliminate the risk to other people. You are going to the hospital to interview
the people who are sick and in order to discover if there is any information that might lead you to
the source of the outbreak. You are asking them about their activities over the past week. One
thing you know for sure is that the city drinking water has been tested and is safe.

Below are some transcripts from your interviews. Read over the transcripts carefully and see if
you find any patterns that might help you discover the source of the infectious outbreak. Using
the case studies provided below, and the data available throughout the classroom, you are going
to figure out how the people got sick, or at least try to pinpoint where they got sick. You are
searching for common activities that they participated in that may reveal clues to their illness.
These are the actual steps that a public health agency would go through when an outbreak
occurs. Hurry, as the number of people being made sick by the outbreak is mounting!

Directions:

1. Read each of the scenarios below and distributed throughout the class room at various
data stations.
2. Look for details of their activities.
3. On the data sheet below, list the key activities in which each of the people participated.
4. From the data you collected, provide your best analysis as to where the infection may
have spread or had its origin.

*
In the real world, “public health investigators” are called public health workers.

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Infectious Disease and Human Density Module 5 Lesson 5

CASE FILE

PHYSICIAN REPORT:

Time Frame: cases present for past 24 hours

City-Wide Impact: dozens of people

Symptoms: nausea, diarrhea, fever, and chills

Preliminary Diagnosis: BACTERIAL INFECTION

WATER SAFETY REPORT:

City-wide water quality reports indicate that drinking water

tested in central locations is SAFE.

PATIENT INTERVIEWS:

Interviews were conducted with five patients at Central Hospital

exhibiting symptoms: Jose, Lisa, Mia, Ken, and Natasha. See
attached transcripts.

OBJECTIVE:

Identify the source of infection in order to prevent further

spread of the outbreak. Work quickly as infection is spreading
quickly.

METHODS:

1. Read each of the attached interview transcripts.

2. Look for details of their activities.
3. On the PHI Data Sheet, list the key activities in which
each of the people participated. Are there any activities
that each of the people share?
4. From the data you collected, provide your best analysis on
the PHI Final Analysis Sheet as to where the infection may
have spread or had its origin.

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Infectious Disease and Human Density Module 5 Lesson 5

ATTACHMENT: INTERVIEW TRANSCRIPTS

Person #1 (Jose, Male, 34 years old)

During the weekend, I went to a concert in the park. I
had food from the concession stand. My sister brought
some fresh fruit back from a trip to Mexico and we had
it on Sunday. My family went to Bill’s restaurant on
Tuesday for dinner. I had an apple from work, they
were giving them out for free. I always carry my water
bottle to work and use it each day, but I thought I had
washed it out well enough.
http://www.flickr.com/photos/dsevilla/350577393/

Person #2 (Lisa, Female 17 years old)

I go to the local high school and I drink from the
fountain there. My family eats at Bill’s Restaurant –
usually once a week on Saturday. I was at a concert at
the local park over the weekend. They were selling food
from a concession stand and we ate there as well. I
went swimming at the city pool on Sunday and we had
take-out food with friends that night from an Asian
restaurant in my neighborhood.

http://www.flickr.com/photos/korso87/2351851085/

Person #3 (Mia, Female 27 years old)

I was working out of town last week and ate most of my
meals in local restaurants in that city. I came home on
Saturday and we went to the concert in the park and had
a meal from the stand. They were selling hotdogs,
burgers and stuff. It was hot on Sunday, so we went
swimming at the pool. I went for a long bike ride on
Sunday afternoon. On the ride home, I stopped to get an
ice cream from a little store across town.

http://www.flickr.com/photos/muriel215/3809574161/

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Infectious Disease and Human Density Module 5 Lesson 5

ATTACHMENT: INTERVIEW TRANSCRIPTS (page 2)

Person #4 (Ken, Male 18 years old)

My mom cooked a big meal on Friday and we had
friends over at the house. They brought some food from
a local grocer that grows their own vegetables. We
went to the beach on Saturday – it was hot and I wanted
to go swimming. We had fried clams at the beach – we
got them from the clamshack that sells food near the
parking lot. My family and I saw a concert over the
weekend, the city set it up for free in the park. We could
just go there. On Sunday, my parents took me to see my
grandmother, who was cooking her lasagna. Its really
great, but it was kind of hot for a big meal. I started to
feel sick that night.

http://www.flickr.com/photos/tinker-tailor/4434187230/

Person #5 (Natasha, Female 52 years old)

Our family had a meal together on Friday and we had
friends over at the house. Later in the weekend, we
went to the circus and then to a concert hosted by the
city. Sunday, I was home all day and I was eating the
normal food that we have around the house. I always
carry a water bottle with me and I fill it at water
fountains, but it has never made me sick before.

http://www.flickr.com/photos/ariaphotography/4694709030/

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Infectious Disease and Human Density Module 5 Lesson 5

DATA ANALYSIS SHEET

In the table below, organize the activities of the five people

and try to find common activities that might give you a clue as
to where they might have picked up the bacterial infection.

Person Site #1 Site #2 Site #3 Site #4 Site #5

1

Jose

Lisa

Mia

Ken

Natasha

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Infectious Disease and Human Density Module 5 Lesson 5

FINAL ANALYSIS

1. Where do you think the source of the bacterial infection lies?

2. What were the most important common clues to the source of the infection?

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Infectious Disease and Human Density Module 5 Lesson 5

Name: _________________________________ Date: _________ Class/Period:________

Lesson 5.1 You are the Public Health Worker

Objective: In this activity, you are playing the role of a public health worker assigned to a
case. In your city, there has been a recent outbreak of sickness that is affecting dozens of people.
The doctors report that the illness is caused by a bacterial infection. All of these people have
reported a similar illness over the past 24 hours. They have reported nausea, diarrhea, fever and
chills. However, the infection is generally not transferable from person-to-person. Therefore,
people who are sickened by the bacteria must be acquiring the infection from a source.

Your job is to help find the source of infection and work with medical professional and public
works employees to eliminate the risk to other people. You are going to the hospital to interview
the people who are sick and in order to discover if there is any information that might lead you to
the source of the outbreak. You are asking them about their activities over the past week. One
thing you know for sure is that the city drinking water has been tested and is safe.

Below are some transcripts from your interviews. Read over the transcripts carefully and see if
you find any patterns that might help you discover the source of the infectious outbreak. Using
the case studies provided below, and the data available throughout the classroom, you are going
to figure out how the people got sick, or at least try to pinpoint where they got sick. You are
searching for common activities that they participated in that may reveal clues to their illness.
These are the actual steps that a public health agency would go through when an outbreak
occurs. Hurry, as the number of people being made sick by the outbreak is mounting!

Directions:

1. Read each of the scenarios below and distributed throughout the class room at various
data stations.
2. Look for details of their activities.
3. On the data sheet below, list the key activities in which each of the people participated.
4. From the data you collected, provide your best analysis as to where the infection may
have spread or had its origin.

Person #1 (Jose, Male, 34 years old)

During the weekend, I went to a concert in the park. I had food from the concession stand. My
sister brought some fresh fruit back from a trip to Mexico and we had it on Sunday. My family
went to Bill’s restaurant on Tuesday for dinner. I had an apple from work, they were giving
them out for free. I always carry my water bottle to work and use it each day, but I thought I had
washed it out well enough.

Person #2 (Lisa, Female 17 years old)

I go to the local high school and I drink from the fountain there. My family eats at Bill’s
Restaurant – usually once a week on Saturday. I was at a concert at the local park over the
weekend. They were selling food from a concession stand and we ate there as well. I went

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Infectious Disease and Human Density Module 5 Lesson 5

swimming at the city pool on Sunday and we had take-out food with friends that night from an
Asian restaurant in my neighborhood

Person #3 (Mia, Female 27 years old)

I was working out of town last week and ate most of my meals in local restaurants in that city. I
came home on Saturday and we went to the concert in the park and had a meal from the stand.
They were selling hotdogs, burgers and stuff. It was hot on Sunday, so we went swimming at the
pool. I went for along bike ride on Sunday afternoon. On the ride home, I stopped to get an ice
cream from a little store across town.

Person #4 (Ken, Male 18 years old)

My mom cooked a big meal on Friday and we had friends over at the house. They brought some
food from a local grocer that grows their own vegetables. We went to the beach on Saturday – it
was hot and I wanted to go swimming. We had fried clams at the beach – we got them from the
clamshack that sells food near the parking lot. My family and I saw a concert over the weekend,
the city set it up for free in the park. We could just go there. On Sunday, my parents took me to
see my grandmother, who was cooking her lasagna. Its really great, but it was kind of hot for a
big meal. I started to feel sick that night.

Person #5 (Natasha, Female 52 years old)

Our family had a meal together on Friday and we had friends over at the house. Later in the
weekend, we went to the circus and then to a concert hosted by the city. Sunday, I was home all
day and I was eating the normal food that we have around the house. I always carry a water
bottle with me and I fill it at water fountains, but it has never made me sick before.

Gather and Analyze Your Data

In the table below, organize the activities of the five people and try to find common activities
that might give you a clue as to where they might have picked up the bacterial infection.

In the chart below, answers will vary, but should focus on key aspects of the patients’ behavior:
what did they eat, and where did they go. What were their possible exposures?

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Infectious Disease and Human Density Module 5 Lesson 5

Person Site #1 Site #2 Site #3 Site #4 Site #5

1

Jose

Lisa

Mia

Ken

Natasha

1. Where do you think the source of the bacterial infection lies?

Most likely the infection was the local concession stand at the park

2. What were the most important common clues to the source of the infection?

Students should list location and food sources as important clues