Dr. Rachel Bergstrom, Assistant Professor, and Dr. Marion Field Fass, Department of Biology, Beloit College, Beloit, Wisconsin
A 2015 SENCER Model
Since the identification of HIV/AIDS in 1981, the world has become more aware of the threat of new diseases, the spillover of diseases from other species to humans, and of the potential for disease carriers, both human and non-human, to amplify diseases through travel and environmental changes. This course works to understand the disease risks that face us by merging perspectives from microbiology, ecology, epidemiology, and human behavior. Where are these pathogens coming from, and where will they go?
Emerging Infectious Diseases is taught as a workshop course at Beloit College, a small liberal arts college in Wisconsin. The course meets three times a week for 2 hours each, merging lecture, activities, and lab. Scientific concepts, such as viral life cycle, are taught by hands-on simulations as well as textbook readings. The course can also be adapted for a traditional lecture lab schedule. This course is a second level course in biology, with a pre-requisite of one college-level biology course. It is taken mostly by non-majors who want to deepen their understanding of public health. Emerging Infectious Diseases is also open to biology majors interested in human health and disease as an ecology elective. Emerging Infectious Diseases has been taught since 1995 by five different faculty members
Instructor’s Goals
The overarching goal of this course is to develop an understanding of the biological, social and political factors that contribute to the emergence of infectious diseases, the persistence of diseases of poverty, and the effectiveness of strategies for their control. These scientific understandings are important skills of citizenship, as graduates make personal and political decisions about immunization, quarantine, and funding for public health. In order to achieve this goal, students develop a toolkit for analysis of and response to disease outbreaks and epidemics, including recognizing patterns of disease emergence and amplification, and evaluating strategies for disease control. For each disease studied, the students have the opportunity to rehearse and apply their skills to strengthen their ability to identify potential risks factors for (and consequent to) disease outbreaks and epidemics.
Student Learning Objectives
- Understand the differences between bacteria, viruses, eukaryotic parasites and their hosts.
- Understand the function of the human immune system in protecting against disease and in causing some of the damages associated with disease. ¨
- Develop skills in reading and analyzing data on the health status of populations.
- Assess environmental, medical and political strategies for controlling infectious diseases.
- Understand the genetic and behavioral risks for the “next big epidemic.”
- Carry out an experiment.
- Stain and describe bacterial samples.
- Evaluate and communicate news reports from the CDC on newly emerging infections
- Develop a toolkit for analysis of and response to disease outbreaks and epidemics, including recognizing patterns of disease emergence and amplification, and evaluating strategies for disease control
- Develop expertise about one specific disease- its method of transmission, how it causes disease, how it is treated, and the environmental factors that have contributed to its distribution.
Who Developed This Course?
Rachel A. Bergstrom, Assistant Professor of Biology, is a neuroscientist with interests in cellular and molecular aspects of neurodegeneration. She uses tissue culture models (primary mouse neurons and cell lines), cell imaging, and cell and molecular biology techniques to address long-range cell-surface receptor signaling and to analyze how the loss of normal signaling regulation contributes to axon degeneration in particular and neurodegeneration in general. Rachel teaches Emerging Infectious Diseases, Cell Biology, and Neurobiology.
Marion Field Fass, Professor Emerita, is interested in the intersection of individual biological, public health, sustainability, and environmental factors that lead to the emergence of new diseases. Her research has focused on the measurement of community health needs and on methods of assessment of student learning. She has been active in science curriculum reform, working on projects with BioQUEST Curriculum Consortium, PKAL, and the American Society for Microbiology and has been part of SENCER since its inception. She received the 2012 William E. Bennett Award for Extraordinary Contributions to Citizen Science from the National Center for Science and Civic Engagement.
Linking Science and Social Issues
Viral life cycle taught through Development of HIV drugs
Horizontal gene transfer in bacteria taught through Increase in antibiotic resistance
Evolution of microbes taught through Influenza outbreaks
Ecology and changing ecosystems taught through Spillover of pathogens from animal hosts to
humans, spread of diseases from continent to continent
Immune response taught through HIV, impact of poverty on disease vulnerability
Nutrition and role of micronutrients taught through Benefits of vitamin A on mortality
Epidemiology and factors in disease spread taught through Ebola virus outbreak
Host- vector –pathogen interaction taught through Challenge of malaria control
The Course
Emerging Infectious Diseases is 200-level course taken mostly by non-majors, enabling students in other majors to deepen their understanding of public health. Emerging Infectious Diseases is also open to biology majors interested in human health and disease as an ecology elective. Emerging Infectious Diseases has been taught since 1995 by five different faculty members. The course is taught in a workshop format, meeting 3 times a week for 2 hours each time. To stimulate active learning, students take responsibility for building a knowledge base in the fields of epidemiology, disease biology, and immunology by researching and presenting information about new diseases, biological concepts, and scientific strategies and political approaches for disease control. Beloit College has a history of innovative scientific pedagogy, and Emerging Infectious Diseases builds on methods from ChemConnections, the BioQUEST Curriculum Consortium, and SENCER.
Through case studies and reports of past and current outbreaks, students learn and apply the basic tools of epidemiology to track new diseases. They also must master the biology that explains disease spread. Students are encouraged to apply knowledge and patterns learned from studying one disease or outbreak to new diseases and outbreaks, with the understanding that there are frequently similarities in disease transmission routes and outbreak control strategies. Models of disease in a population, especially the epidemiological triangle, are used throughout the course as a framework to identify and understand the complexities of disease transmission. Laboratory activities develop basic microbiology and data analysis skills, and are a combination of bench work and computer simulations. Throughout all activities, students work collaboratively to organize concepts and ideas and engage in significant peer-teaching. The final projects for the course, a group research study, an individual research paper and a group video project, provide the opportunity for students to apply their knowledge of epidemiology, human behavior, and disease biology to highlight the risks of emerging diseases.
Three books have created the framework for the course: Laurie Garrett’s (1994), The Coming Plague, defined the challenges of emerging diseases and remains a compelling story of outbreaks and responses. Peter Hotez’s (2013) Forgotten People, Forgotten Diseases, demonstrates the burden of diseases of poverty and the impact of intervention programs. David Quammen’s (2013) Spillover: Animal Infections and the Next Human Pandemic, brings an ecological analysis to the question of “what’s next?” (Professor Bergstrom, in the most recent versions of the course did not use Spillover, but used many of its questions.) We have complemented these books with scientific background from a variety of microbiology books, and with readings from the CDC, Science and other sources. Providing guidance for student reading has been essential; vocabulary quizzes and reading reviews assist students in finding the important science through the narrative structure of the texts and encourage them to keep up with the reading.
ACTIVITIES
Bacterial Genetics Art Project
Flu Modeling Activity
Flu Modeling Graphs
Malaria Eradication
Outbreak Timeline Analysis
Telephone Viral Mutation Activity
Viral Lifecycle Activity
Yogurt Investigation
Extra Credit Movie Analysis
SARS Citruscanker Activity
Case Studies
Epidemiologist with EIS
Medical Doctor
Research Scientist
Science Journalist
Wildlife Biologist
Worksheets
Group Worksheet
Summary Sheet (Student)
Summary Sheet (Instructor)
Evaluating Learning
Most of the assessment in this course is from active learning assignments and class presentations rather than exams. Students are quizzed weekly about vocabulary and readings, but this makes up only 5% of their grade, and serves to keep them up on reading. A final project with in class presentation enables students to synthesize their learning and apply it to a new situation.
Assessments
MMWR Rubric
Next Big One
Final Exam Project
Background and Context
Course History
This course began in 1995 as a Biological Issues course to fulfill a laboratory science requirement for non-majors. Biological Issues was conceived to engage non-scientists in scientific controversies, using investigative case methods and real world laboratory investigations. It has been adapted over the last 20 years to focus on the outbreak of the year, to bring in more molecular biology, and to explore ecological, evolutionary, and behavioral factors in emerging diseases. It has followed the evolving understandings of Emerging Infectious Diseases as outlined by the Institute of Medicine (1992, 2003) and updates on the One Health Initiative. http://www.onehealthinitiative.com/ (2015). It became a core course for the Health and Society major at Beloit College, established in 2006.
This course was first taught by Professor Marion Field Fass. Visiting professors, including Heather Pelzel, PhD, now at University of Wisconsin-Whitewater, Gilbert Jose, PhD and Amy Briggs, PhD at Beloit College, also taught the course and added their own adaptations. Professor Fass retired in 2014 and Emerging Infectious Diseases is now taught by Professor Rachel Bergstrom as part of her regular course rotation. Professor Bergstrom has updated activities and adapted the course.
In the workshop format of this class of 24 students, each class is composed of short lecture, student activities/ labs, and student reports. Students are challenged to discuss, explain and create graphical data. Student lab activities also include basic microbiology such as gram staining and transformation. In order to understand viral evolution, they participate in a “telephone DNA” simulation, supported by readings from the scientific literature. Koch’s postulate is practiced in a lab where students are given yogurt “patients” and design experiments to identify the agent responsible for yogurt. The students then confirm that the agent is, indeed, responsible for turning milk into yogurt.
In 2014, Professor Bergstrom was able to structure activities around the emerging Ebola outbreak in West Africa. A highlight of her semester was a Skype interview with a reporter for Vanity Fair who covered the outbreak on the ground in West Africa.
Institutional Context (how does it fit into the curriculum)
A course on Emerging Infectious Diseases has fit well into the ethos and the curriculum at Beloit College. Beloit College’s curriculum emphasizes interdisciplinary, experiential and international perspectives. Beloit has supported curriculum innovation in the sciences, and was the home of ChemLinks, ChemConnections and the BioQUEST Curriculum Consortium. In these context, Emerging Infectious Diseases builds international connections in science courses and continues Beloit’s tradition of innovative pedagogy. Professor Fass has been involved with SENCER since its inception, and SENCER approaches have become a part of many courses at Beloit College.
Emerging Infectious Diseases has a prerequisite of one college level biology course, so it does not fulfill the one course (on-campus) laboratory science requirement for all Beloit College students. This course may fulfill the one course laboratory science requirement for students who have completed college level biology in high school. In addition, this course is one option for students to fulfill a Quantitative Reasoning requirement. Students engage individually and in small groups with data about population health, disease outbreaks and develop and analyze short surveys about health on campus. Students use Gapminder (www.gapminder.org) to compare the health status of different countries and to assess changes over time.
Emerging Infectious Diseases fulfills a core requirement for the Health and Society major and is an elective for majors in biology, international relations, psychology, and environmental studies. The Biology Department continues to review its role in the biology curriculum; students requested that it be included as an elective for the major, and it has been a major elective for since 2008, but our recent experience (both MFF and RAB) is that upper-level biology majors don’t engage fully.
Related Resources
This course has survived and evolved, and is a model of interdisciplinary science and SENCER courses at Beloit College. Visiting faculty who have taught the course had adapted it to their environments and have become involved with SENCER because of their experience with this course. Professor Fass has utilized it as the core for presentations on Global Health at SENCER meetings, BioQUEST Curriculum Consortium workshops, ASM-CUE and consultations. Many of the activities used in Emerging Infectious Diseases have been published in Biology International, No. 49, Global Health Has No Borders, edited by Marion Fass, Julie Seiter, Ethel Stanley and Margaret Waterman. (biologyinternational.org/volume-49/)
Students have served as teaching assistants in this class, furthering their own understandings, their teaching skills and their understanding of public health. One of the teaching assistants, Shanna Dell, was the editorial assistant for Global Health Has No Borders, and served as an intern with SENCER. At present she is an RN, enrolled in an MPH program at Johns Hopkins. Other students have worked on research connected with the course, including research on the representation of SARS in the media and the preventive health behaviors of college students in an influenza outbreak.
In the most recent iteration of the course (Spring 2015), the students carried out a campus survey of screening behaviors for sexually transmitted infections (STI). The preliminary results from this survey indicate that a significant portion of the sexually active students on campus are not being regularly screened for STI. Further analysis of the survey results remains to be completed, and Rachel Bergstrom will be working through the course in Spring 2016 and with the campus health center in the 2015-16 academic year to determine the best approach to encourage increased screening behaviors among students.
The Emerging Infectious Diseases course has had a direct impact in the city of Beloit. Students who had taken the course, and were Health and Society majors, developed the Beloit Public Health Initiative, a student-run project designed to reduce sexually transmitted disease rates in the city of Beloit. This group of students developed educational projects, collaborated with the schools and community agencies, and have received grant funding for their work. Their understanding of disease and of the interdisciplinary factors contributing to its spread underlie their work. This group is now in its 4th year. (http://www.healthybeloit.org)