26.

Human Health and Disease

Summary Sheet
• Good health is a state of optimum physical fitness, mental maturity and alertness with freedom from
anxiety and social well being with freedom from social tensions. When the functioning of one or more
organs or systems of the body is adversely affected, characterized by various signs and symptoms, we
say that we are not healthy, i.e., we have a disease.
• Health can be affected by –
(i) genetic disorders – deficiencies with which a child is born and deficiencies/defects which the child
inherits from parents from birth.
(ii) infections and
(iii) life style including food and water we take, rest and exercise we give to our bodies, habits that we
have or lack etc.
• Diseases may be broadly classified into two types: acquired and congenital.
• Acquired diseases are contracted after birth due to various reasons like infection, degeneration, diet,
addiction, depression, etc.
These diseases are of further two types: communicable (infectious) and non- communicable diseases
(non infectious).
o Communicable (infectious) diseases can pass from an infected person to a healthy one. E.g. AIDS.
o Non-communicable diseases remain confined to the person who develops them and do not spread to
others. These diseases are caused by agents other than pathogens. Among non-infectious diseases,
cancer is the major cause of death.
• Congenital diseases are diseases which a person has already contracted at birth. Congenital diseases can
be of two basic types: hereditary or genetic diseases and diseases due to environmental factors.

Common Diseases in Humans

• Pathogen is an organism that causes certain diseases in animals and plants. Bacteria, viruses, fungi,
nematodes, some algae, etc. are included under pathogens. Most parasites are therefore pathogens as
they cause harm to the host by living in (or on) them. The pathogens can enter our body by various
means, multiply and interfere with normal vital activities, resulting in morphological and functional
damage. Pathogens have to adapt to life within the environment of the host. For example, the pathogens
that enter the gut must know a way of surviving in the stomach at low pH and resisting the various
digestive enzymes.
• Vectors, on the other hand, do not cause disease themselves but transmit the pathogen from infected
person to a healthy person i.e., spread the disease. In this process they themselves remain uninfected
e.g., female Anopheles mosquito.

Bacterial diseases
(i) Typhoid is a contagious disease of intestine caused by Salmonella typhi. The organisms of the disease
are present in the stool and urine, therefore, carried by contaminated food and water. Bacterium enters
via mouth, lives in the intestine and causes lesions in the intestinal walls. Incubation period of the
bacterium is 1-3 weeks. Sustained high fever (39° to 40 °C), weakness, stomach pain, constipation,

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headache and loss of appetite are some of the common symptoms of this disease. Intestinal perforation
and death may occur in severe cases. Typhoid fever could be confirmed by Widal test.
(ii) Pneumonia is a serious disease of lungs characterised by accumulation of mucus fluid in alveoli and
bronchioles to an extent that breathing becomes difficult. It is caused by Streptococcus pneumoniae or
Diplococcus pneumoniae and Haemophilus influenzae. A healthy person acquires the infection by
inhaling the droplets/aerosols released by an infected person or even by sharing glasses and utensils with
an infected person.
(iii) Dysentery is an infection of the intestinal tract causing severe diarrhoea with blood and mucus by
Shigella.
(iv) Plague is caused by a bacterium called Yersinia.
(v) Diphtheria is an acute infectious disease Corynebacterium diphtheriae.

Viral diseases
Common cold is caused by some 100 types of Rhino viruses. Virus infects nose and upper respiratory
passage (but not the lungs) causing inflammation of mucous membranes. There is irritation of nasal tract,
nasal congestion, flow of mucus, sneezing, sore throat, hoarseness, cough, tiredness, headache and slight
fever. Droplets from cough or sneezes of an infected person are either inhaled directly or transmitted through
contaminated objects and infect a healthy person.

Protozoan diseases
(i) Amoebiasis or Amoebic dysentery is a protozoan infestation of upper part of large intestine caused by
monogenic protozoan Entamoeba histolytica. It is characterised by abdominal pain, mild diarrhoea
alternating with constipation, passing out of mucus, pieces of necrotic mucous membrane and blood in
faeces, and faeces with cysts. Houseflies act as mechanical carriers and serve to transmit the parasite
from faeces of infected person to food and food products, thereby contaminating them. Drinking water
and food contaminated by the faecal matter are the main source of infection.
(ii) Malaria is caused by a digenetic (have two hosts to complete its life cycle) protozoan parasite known as
Plasmodium. Life cycle of Plasmodium requires two hosts-human and mosquito for completion.
Plasmodium enters the human body as sporozoites (infectious form) through the bite of infected female
Anopheles (vector). The sporozoites reach the liver cells via blood where they initially multiply. These
then attack the RBCs resulting in their rupturing. The rupture of RBCs is associated with the release of
haemozoin, a toxin which causes the chill and high recurring fever every three to four days. Sexual
gamete stages (gametocytes) develop in red blood cells. The female Anopheles mosquito when bites
an infected human being takes up the gametocytes with the blood meal. The malarial parasites enter into
the mosquito’s body and undergoes fertilization and further development to form sporozoites that finally
move to the salivary glands of the insect. The bite of these mosquitoes introduces the sporozoites inside
the human body, thus initiating the above mentioned cyclic process again.

There are four species of Plasmodium which cause four main types of malaria in human. They are
(a) Plasmodium vivax (causes benign tertian malaria in which fever recurs every 48 hours); (b) P. malariae
(causes quartan malaria in which fever appears every 72 hours, and often produces persistent subclinical

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malaria); (c) P.falciparum (causes cerebral malaria or malignant tertian malaria where fever recurs every
48 hours) and (d) P.ovale (causes mild tertian malaria).

Nematode diseases
(i) Ascariasis is caused by the common round worm Ascaris lumbricoides. Symptoms of this disease
include internal bleeding, muscular pain, fever anemia and blockage of the intestinal passage. Symptoms
of these disease include internal bleeding, muscular pain, fever, anemia and blockage of the intestinal
passage. The eggs of the parasite are excreted along with the faeces of infected persons which
contaminate soil, water, plants, etc. A healthy person acquires infection through contaminated water,
vegetables, fruits etc.
(ii) Filariasis or Elephantiasis is a helminthic disease caused by Wuchereria (W. bancrofti and W. malayi),
the filarial worm. They cause a slowly developing chronic inflammation of the organs in which they live
for many years, usually the lymphatic vessels of the lower limbs. The pathogen spread from one human
being to another through female mosquitoes like Culex, Anopheles and Aedes. The disease can be
prevented by taking precautions against mosquito bites.

Fungal diseases
• Many fungi belonging to the genera Microsporum,
Trichophyton and Epidermophyton are responsible for
ringworms which is one of the most common infectious
diseases in man. Appearance of dry, scaly lesions on
various parts of the body such as skin, nails and scalp
are the main symptoms of the disease. These lesions are
accompanied by intense itching. Heat and moisture help
these fungi to grow, which makes them thrive in skin
folds such as those in the groin or between the toes.
Ringworms are generally acquired from soil or by using
towels, clothes or even the comb of infected
individuals.

Immunity
• The overall ability of the host to fight the disease-
causing organisms, conferred by the immune system is
called immunity. The study of body’s defence
mechanisms against pathogens is called Immunology.
Edward Jenner (1749 - 1823) is known as Father of
Immunology.
• The human immune system consists of lymphoid
organs, tissues, cells and soluble molecules like
antibodies. It plays an important role in allergic
reactions, auto immune diseases and organ
transplantation.

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Lymphoid organs: Thymus and Bone marrow are primary lymphoid organs where T-lymphocytes
and B-lymphocytes mature respectively and acquire antigen specificity. Lymph nodes, spleen, tonsils,
Peyer’s patches of the small intestine, appendix and mucosal associated lymphoid tissue (MALT) are
secondary lymphoid organs where lymphocytes undergo proliferation and differentiation. The
secondary lymphoid organs provide the sites for interaction of lymphocytes with the antigen, which then
proliferate to become effector cells.

The bone marrow is the main lymphoid organ where all blood cells including lymphocytes are produced.
The thymus is a lobed organ located near the heart and beneath the breastbone. The thymus is quite large
at the time of birth but keeps reducing in size with age and by the time puberty is attained it reduces to a
very small size. Both bone-marrow and thymus provide micro-environments for the development and
maturation of T-lymphocytes. The spleen is a large bean shaped organ. It mainly contains lymphocytes
and phagocytes.

It acts as a filter of the blood by trapping blood-borne microorganisms. Spleen also has a large reservoir
of erythrocytes. The lymph nodes are small solid structures located at different points along the
lymphatic system. Lymph nodes serve to trap the micro-organisms or other antigens, which happen to
get into the lymph and tissue fluid. Antigens trapped in the lymph nodes are responsible for the
activation of lymphocytes present there and cause the immune response.
There is lymphoid tissue also located within the lining of the major tracts (respiratory, digestive and
urogenital tracts) called mucosa associated lymphoid tissue (MALT). It constitutes about 50 per cent of
the lymphoid tissue in human body.

• Antibodies are immunoglobulins (Igs) which are produced in response to antigenic stimulation.
Antigens are substances which, when introduced into the body, stimulate the production of antibodies.
Most antigens are proteins but some are carbohydrates, lipids or nucleic acids.
• Immunoglobulins are glycoproteins made up of four polypeptide chains (linked by disulphide bonds)
two heavy (H) and two light (L). Light and heavy chains are sub divided into variable and constant
regions. They are mainly of five types as discussed in the flow chart.

Innate immunity
• Innate immunity is non-specific type of defence that is present at the time of birth. This is accomplished
by providing different types of barriers to the entry of the foreign agents into our body. Innate immunity
consists of four types of barriers. These are

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o Physical barriers: Skin of our body is the main barrier which prevents entry of the micro-
organisms. Mucus coating of the epithelium lining the respiratory, gastrointestinal and urogenital
tracts also help in trapping microbes entering our body. Cilia occuring in nasal tract helps in
throwing out the entrapped microorganisms.
o Physiological barriers: The oil and sweat secreted by sebaceous and sudoriferous glands, saliva,
tears, bile and acidity of gastric juices all prevents microbial growth.
o Cellular barriers: Certain types of leucocytes (WBCs) like polymorphonuclear leucocytes (PMNL),
neutrophils and monocytes and natural killer cells (type of lymphocyte) in the blood and
macrophages in tissues can engulf microbes, viruses, cellular debris, etc.
o Cytokine barrier: Virus infected cells secrete proteins known as interferons which protect non
infected cells from further viral infections.

Acquired immunity
• If a pathogen is able to pass the body’s non-specific defences, the immune system reacts with a series of
specific defences that attack the disease causing agent. Unique features of acquired immunity are
specificity, diversity, discrimination between self and non-self and memory.
• Acquired immunity is of two types – active and passive.
Active immunity is resistance induced after contact with foreign antigens, e.g., microorganisms. Active
immunity is slow and takes time to give its full effective response. Injecting the microbes deliberately
during immunisation or infectious organisms gaining access into body during natural infection induce
active immunity.
Passive immunity occurs when antibodies produced artificially are injected into a person to counteract
antigens such as snake venom, rabies, tetanus toxin, Salmonella infection, etc. The yellowish fluid
colostrum secreted by mother during the initial days of lactation has abundant antibodies (IgA) to protect
the infant. The foetus also receives some antibodies (IgG) from their mother through the placenta during
pregnancy.

Immune response
• The specific reactivity induced in a host by an antigenic stimulus is known as the immune response. It
is of two types - primary and secondary immune response. The reaction of the body’s immune system to
the first attack of microbes (antigens) is called primary immune response. It takes much longer time to
develop because of the requirement of suitable receptor development. The reaction of the body’s
immune system to any subsequent infection of the same microbe is termed secondary immune
response or anamnestic response. This response is quicker and more intense than the primary immune
response.
• The immune responses are carried out with the help of two special types of cells i.e., B-lymphocytes
(humoral immunity) and T-lymphocytes (cellular immunity).
(a) T-lymphocytes or f-cells when triggered off by antigens, produce a clone of T-cells such as
(i) Cytotoxic or Killer T-cells (directly attack and destroy antigens by secreting a protein perforin),
(ii) Helper T-cells (stimulate the B-cells to produce antibodies), (iii) Suppressor T-cells (check
from attacking the body’s own cells), (iv) Memory T-cells are sensitized T-cells (retain memory of
antigen specificity for future, sometimes lifelong).

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(b) B-lymphocytes or B-cells produce antibodies and therefore, generate antibody mediated or
humoral immunity. They give rise to the (i) plasma cells (Effector B-cells) (the antigen specific
T-cells stimulate specific B-lymphocytes to multiply rapidly forming clone of plasma cells) and
(ii) memory B-cells (some of the activated B cells remain dormant as memory B cells until
activated once again by a new quantity of the same antigen).
• Vaccination: It is the process of development of immunisation against a particular disease by
inoculation of harmless antigenic material like attenuated pathogen or its toxoid into a healthy person.
It develops due to formation of memory cells by the immune system. Immunisation is the process by
which the body produces antibodies against the antigens of vaccine preventable diseases through
administration of specific vaccines. Vaccine is a suspension of killed or attenuated pathogenic
microorganisms or antigenic preparations made out of it, which on administration provides immunity
towards the pathogen.
If a person is infected with some deadly microbes to which quick immune response is required as in
tetanus, we need to directly inject the preformed antibodies, or antitoxin (a preparation containing
antibodies to the toxin). Even in cases of snakebites, the injection which is given to the patients, contain
preformed antibodies against the snake venom. This type of immunisation is called passive
immunisation.
Recombinant DNA technology has allowed the production of antigenic polypeptides of pathogen in
bacteria or yeast. Vaccines produced using this approach allow large scale production and hence greater
availability for immunisation, e.g., hepatitis B vaccine produced from yeast.
• Allergy: It is the excessive immune response to common antigens, called allergens. Common examples
of allergens are mites in dust, pollens, animal dander, etc. Symptoms of allergic reactions include
sneezing, watery eyes, running nose and difficulty in breathing. Allergy involves mainly IgE antibodies
and chemicals like histamine and serotonin from the mast cells. It causes marked dilation of all the
peripheral blood vessels and the capillaries become highly permeable so that large amounts of fluid leak
out from the blood into the tissues. The blood pressure decreases drastically often resulting in the death
of the individual within a short time.
• Autoimmunity: It is a condition in which structural or functional damage is produced by the action of
immunologically competent cells or antibodies against normal components of the body. It actually
implies injury to self. Examples of autoimmune diseases are rheumatoid arthritis
• Organ transplantation: It is the implantation of an organ or tissue from one part of the body to another
or from one person (donor) to another (recipient). Tissue matching, blood group matching are essential
before undertaking any graft/transplant and even after this, the patient has to take immuno-suppresants
all his/her life. The body is able to differentiate ‘self’ and ‘non-self’ and the cell-mediated immune
response is responsible for the graft rejection.
• AIDS: AIDS or Acquired immuno deficiency syndrome is a deficiency of immune system, caused by
HIV (Human immunodeficiency virus). There is a reduction in the number of helper T-cells, which
stimulate antibody production by B-cells resulting in loss of natural defence against viral infection. HIV
is a retrovirus that attacks helper T-cells. Its genome consists of two single-stranded RNA strands. After
the entry of the virus into the body of the person, it enters into macrophages where RNA genome of the
virus replicates to form viral DNA with the help of reverse transcriptase enzyme. This viral DNA gets
incorporated into host cell’s DNA and directs the infected cells to produce viruses. The macrophages

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continue to produce virus and in this way acts like a HIV factory. Simultaneously, HIV enters into
helper T-lymphocytes (TH), replicates and produce progeny viruses. The progeny viruses released in the
blood attack other helper T-lymphocytes. This is repeated leading to a progressive decrease in the
number of helper T lymphocytes in the body of the infected person.
• Virus of AIDS is transmitted by transfusion of infected blood or blood products, use of contaminated
needles and syringes to inject drugs or vaccines, sexual intercourse with an infected partner without a
condom and from infected mother to child through placenta. The incubation period of AIDS ranges
between 6 months to 10 years. AIDS can be diagnosed by ELISA test.
• Prevention of AIDS: As AIDS has no cure, prevention is the best option. In our country the National
AIDS Control Organisation (NACO) and other non-governmental organisation (NGOs) are doing a lot to
educate people about AIDS. WHO has started a number of programmes to prevent the spreading of HIV
infection. Making blood (from blood banks) safe from HIV, ensuring the use of only disposable needles
and syringes in public and private hospitals and clinics, free distribution of condoms, controlling drug
abuse, advocating safe sex and promoting regular check-ups for HIV in susceptible populations, are
some such steps taken up.
• Cancer: Cancer or malignant neoplasm is a disease of uncontrolled proliferation of cells without any
differentiation. It commonly originates in the tissues in which the cells are regularly replaced by mitosis.
Normal cells show a property called contact inhibition, by virtue of which contact with other cells
inhibits their uncontrolled growth. Cancer cells appear to have lost this property. As a result of this,
cancerous cells just continue to divide giving rise to masses of cells called tumors. Neoplasm or tumour
is of two types: (i) benign neoplasm or tumour this is a solid neoplasm or tumour that stops growing
by itself and does not invade other tissues and remain confined to a particular site, (ii) malignant
neoplasm or tumour – in malignant tumours, neoplastic or tumor cells grow very rapidly, invading and
damaging the surrounding normal tissues. Cells sloughed from such tumors reach distant sites through
blood and whenever they get lodged in the body, they start a new tumor there. This property called
metastasis is the most feared property of malignant tumors.
• Causes of cancer: Chemical and physical agents that can cause cancer are called carcinogens. These are
(i) Overexposure to ionising radiations like X-rays, UV rays, gamma rays, etc. which literally punch
holes in the DNA, breaking the correct genetic sequences,
(ii) Chemicals like nicotine, caffeine, steroids and arsenic air pollutants cause cancers of lungs, brain,
breast or blood.
(iii) Cancer causing viruses called oncogenic viruses have genes called viral oncogenes. Furthermore,
several genes called cellular oncogenes (c-onc) or proto oncogenes have been identified in normal
cells which, when activated under certain conditions, could lead to oncogenic transformation of the
cells.
• Techniques such as radiography (use of X-rays), CT Scan (computed tomography), MRI Scan
(magnetic resonance imaging) are very useful to detect cancers of the internal organs. The common
approaches for treatment of cancer are surgery, radiation therapy and immunotherapy.
• Treatment of cancer: The common approaches for treatment of cancer are surgery, radiation therapy
and immunotherapy. In radiotherapy, tumor cells are irradiated lethally, taking proper care of the normal
tissues surrounding the tumor mass. Several chemotherapeutic drugs are used to kill cancerous cells.
Some of these are specific for particular tumors. Majority of drugs have side effects like hair loss,

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anemia, etc. Most cancers are treated by combination of surgery, radiotherapy and chemotherapy. Tumor
cells have been shown to avoid detection and destruction by immune system. Therefore, the patients are
given substances called biological response modifiers such as α-interferon which activates their
immune system and helps in destroying the tumor.

Drugs and alcohol abuse

• Drug addiction or drug abuse is taking drugs for purpose other than clinical use, in amount,
concentration or frequency that impair physical, physiological and psychological functions of the body.
Opiate/Opioids narcotics are the drugs derived from dried latex of unripe capsular fruits of poppy
plant, Papaver somniferum. Opioids bind to specific opioid receptors present in our central nervous
system and gastro intestinal tract. They are also called pain killers as opiates have narcotic, analgesic,
astringent (that causes contraction of body parts) and sedative effect (neuro depressant). Heroin
commonly called smack is chemically diacetylmorphine which is a white, odourless, bitter crystalline
compound. This is obtained by acetylation of morphine.
• Cocaine is natural coca alkaloid obtained from leaves and young twigs of coca (= cocca) plant–
Erythroxylum coca, native to South America. It is commonly called coke or crack. Cocaine has
vasoconstrictor properties and therefore is a good local anesthetic. It is chewed, eaten or sniffed in its
powdered form or taken as a drink. It is a powerful CNS stimulant (interferes with the transport of the
neurotransmitter dopamine) and induces a sense of well being and pleasure (euphoria) and delays
fatigue. Its overdose causes hallucinations. Other well known plants with hallucinogenic properties are
Atropa belladona and Datura.
• Cannabinoid compounds are (obtained from leaves, resin and flowering tops (inflorescence) of hemp
or Cannabis sativa (= C. indica) are called cannabinoids which interact with cannabinoid receptors
present principally in the brain and affects the cardiovascular system. The flower tops, leaves and
resin of Cannabis plant are used in various combinations to produce hashish, ganja, bhang and
marijuana. These days cannabinoids are being abused by some sportspersons.
• Drugs like barbiturates, amphetamines, benzodiazepines, lysergic acid diethylamides (LSD, derived
from Claviceps purpurea), and other similar drugs that are normally used as medicines to help patients
cope with mental illnesses like depression and insomnia are often abused.
Tobacco is used for smoking, chewing and sniffing. Its main stimulating component is a poisonous,
volatile alkaloid nicotine, which causes addiction. It stimulates adrenal gland to release adrenaline and
nor-adrenaline into blood circulation, both of which raise blood pressure and increase heart rate. High
concentration of nicotine paralyses nerve cells. Smoking is associated with increased incidence of
cancers of lung, urinary bladder and throat, bronchitis, emphysema, coronary heart disease, gastric ulcer,
etc. Tobacco chewing is associated with increased risk of cancer of the oral cavity. Smoking increases
carbon monoxide (CO) content in blood and reduces the concentration of haembound oxygen. This
causes oxygen deficiency in the body.

Adolescence and Drug/Alcohol Abuse

Adolescence means both ‘a period’ and ‘a process’ during which a child becomes mature in terms of his/her
attitudes and beliefs for effective participation in society. The period between 12-18 years of age may be
thought of as adolescence period. In other words, adolescence is a bridge linking childhood and adulthood.

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Adolescence is accompanied by several biological and behavioural changes. Adolescence, thus is a very
vulnerable phase of mental and psychological development of an individual.

Addiction and dependence

• Addiction is a psychological attachment to certain effects such as euphoria and a temporary feeling of
well-being associated with drugs and alcohol. These drive people to take them even when these are not
needed or even when their use becomes self destructive. Dependence is the tendency of the body to
manifest a characteristic and unpleasant withdrawal syndrome (severe physical and physiological
disturbances that occur on stopping intake of a drug) if regular dose of drugs or alcohol is abruptly
discontinued. It is characterized by anxiety, nausea, shakiness etc.
• Effects/symptoms of drug abuse: Manifested in the form of reckless behaviour, vandalism and
violence. Coordination of body parts, working of nervous and muscular systems is influenced; disturbed
peristalsis and secretion of digestive enzymes affect liver and kidneys as they become involved in
metabolism and elimination of their products. The damaged liver undergoes cirrhosis; arrhythmia,
brachycardia and tachycardia develop impotency; taking of drugs intravenously may spread serious
infections like AIDS and hepatitis B due to sharing of infected needles and syringes.
Adverse effects of drug abuse in males include reduction of size of the testicles, decreased sperm
production, breast enlargement, premature baldness and enlargement of the prostate gland.
While in females one can notice masculinisation (features like males), increased aggressiveness,
abnormal menstrual cycles, excessive hair growth on the face and body, enlargement of clitoris and
deepening of voice. At times, a drug/alcohol addict becomes the cause of mental and financial distress
to the entire family.
• Prevention and Control
Some of the measures mentioned here would be particularly useful for prevention and control of alcohol
and drugs abuse among adolescents
(i) Avoid undue peer pressure
(ii) Education and counseling
(iii) Seeking help from parents and peers
(iv) Looking for danger signs
(v) Seeking professional and medical help

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