Immunity, Infectious Disease and Pandemics

Learning Objectives

  1. Discuss basic components of the immune system.
  2. Describe the two basic types of leukocytes.
  3. Explain the keystone of immunology.
  4. Identify the origin and purpose of stem cells.
  5. Define immunity.
  6. Explain immune response: specific, nonspecific, cell mediated, adaptive.
  7. Define acquired immunity.
  8. Describe autoimmune responses.
  9. Explain CMI (cell-mediated immunity) and what it does.
  10. Discuss factors impacting the immune system.
  11. Discuss stressors, acute and chronic.
  12. Explain psychoneuroimmunology.
  13. Explain the connection between stress and immunity.
  14. Explain the link between immunity and viral infections.
  15. Discuss the link between stress, immunity, and chronic diseases.
  16. Identify factors that deplete immunity.
  17. Define anti-nutrients.
  18. Identify supplements that enhance immunity.
  19. Identify foods that aid immunity.
  20. Explain the benefits of various vitamins, minerals, and herbs.
  21. Identify foods to eat and those to avoid.
  22. Discuss actions and strategies for enhancing the immune system.
  23. Identify three types of vaccines.
  24. Explain advantages/disadvantages of live vaccines and inactive vaccines.
  25. Discuss the importance of vaccines.
  26. List factors contributing to the emergence of infectious diseases.
  27. Explain the role of vectors, biologic and mechanical.
  28. Explain the role of arthropod vectors, endoparasites and ectoparasites.
  29. Define zoonosis
  30. Describe how fungi can create disease.
  31. Discuss protozoa and what they can cause.
  32. Define bacteria and their life forms.
  33. Discuss transmission, symptoms, diagnosis, and complications of botulism, salmonella, campylobacteriosis, and E coli.
  34. Describe causes, transmission, and symptoms of shigellosis, cholera, and typhoid fever.
  35. Identify effective ways to prevent the transmission of foodborne diseases.
  36. Describe the three stages of pertussis and why it is of concern today.
  37. Discuss transmission and symptoms of streptococcus A, bubonic plague, glanders, leptospirosis, and clostridium difficile infections.
  38. Explain cause, symptoms, transmission, and prevention of lyme disease.
  39. Explain transmission and infection routes of the viruses.
  40. Discuss microbial spread of viruses.
  41. Discuss diseases caused by viruses i.e., trypanosomiasis, cryptosporidiosis.
  42. Define antibiotic resistance, superbug, MRSA, and VRSA.
  43. Identify guidelines for using antibiotics appropriately.
  44. Explain how to prevent spread of antibiotic resistant infections.
  45. Identify co-morbid factors that contribute to MRSA/VRSA.
  46. Discuss the control of MRSA and VRSA outbreaks.
  47. Discuss vancomycin, gentamycin resistance.
  48. Describe the CDC guidelines for the proper use of vancomycin.
  49. Describe the characteristics and components of viruses.
  50. Discuss the history of virus discoveries.
  51. Discuss classifications of viruses.
  52. Explain viral entry and phases of replication.
  53. Explain how viruses are transmitted and the routes of infection.
  54. Explain bacteriophage therapy and its uses and benefits.
  55. Describe DNA and RNA viruses.
  56. Explain coronavirus, SARS, calicivirus, orthomyxovirus, paraviruses, and paramyxovirus.
  57. Discuss HIV statistics, transmission, and treatment.
  58. Identify a major protozoan disease, a parasitic disease, and rickettsias disease.
  59. Discuss the role of mosquitoes in spreading disease.
  60. Describe the etiology, epidemiology, and treatment of trypanosomiasis, cryptosporidiosis, malaria, typhus-rickettsias, dengue fever, and viral hemorrhagic fever.
  61. Explain what arenaviridae are and diseases that they cause.
  62. Discuss diseases caused by flaviviruses.
  63. Explain the difference between endemics, pandemics and epidemics.
  64. Describe various stages of pandemics.
  65. Explain antigenic shift and drift.
  66. Identify influenza types, subtypes, strains.
  67. Describe the symptoms and transmission of influenza.
  68. Identify the components of H5N1: avian flu, incubation period, and clinical manifestations.
  69. Explain the effectiveness and importance of the influenza vaccines.
  70. Discuss how influenza pandemics are different from other pandemic threats.
  71. Identify serious problems with pandemics.
  72. Explain transmission/incubation/clinical signs of swine flu.
  73. Discuss the history of H5N1 virus.
  74. Identify symptoms of avian flu caused by H5N1.
  75. Explain avian flu transmission.
  76. Identify medications used in the treatment of pandemic influenza.
  77. Explain how the avian flu pandemic influenza is different from avian influenza.
  78. Discuss Severe Acute Respiratory Syndrome (SARS).
  79. Compare influenza and SARS.
  80. Identify ways to prevent spread of SARs or infectious influenza.
  81. Discuss antiviral vaccine development.
  82. Discuss the history of bioterrorism.
  83. Explain why BioWar is of grave concern.
  84. Classify bioterrorism agents or diseases.
  85. Describe BSL (Bio safety lab classifications).
  86. Discuss biological /viral agents’ use as biologic agents of bio war.
  87. Describe the botulinum toxins and how they might be used in biowarfare.
  88. Explain the symptoms, diagnosis, treatment, and prevention of the plague, smallpox, and viral hemorrhagic fevers.
  89. Identify possible clues to a biological warfare or terrorist attack.
  90. Discuss The Four R’s for nurses.
  91. Explain the role of the school nurse in bio-terror or pandemics.
  92. Describe how the nursing role/scope of practice may change or expand during times of crisis.
  93. Describe an effective disaster plan.
  94. Explain political and financial factors related to public education.
  95. Discuss the nursing role in pandemics or other infectious threats to health.
  96. Describe indications of possible BW agent attack.
  97. Identify resources for nurses who wish to become better prepared.
  98. Discuss current pandemic challenges.
  99. Discuss community preparation, family and individual plans.
  100. Identify supplies that should be stored as part of a disaster preparedness plan.

Course Contents

Introduction and Course Focus

1. The Immune System

The Immune System Overview
Brief History
Components of the Immune System

  • White Blood Cells
  • Two Basic Types of Leukocytes
  • Macrophages and Phagocytes
  • Lymphocytes and Lymph Organs
  • Lymph Nodes
  • Lymphocyte Sub-Types
  • The Two Major Types of T Cells
  • A Deeper Look at B Cells
  • Neutrophils/Granulocytes
  • Eosinophils and Basophils
  • The Spleen
2. The Immune Response

Defense Against Antigens and Types of Immunity

  • What Is Immunity?

Autoimmune Disease
More on Allergies
Active Immunity
A Closer Look at Immune Responses

  • Humoral Response (Humoral Immunity)
  • Cell-mediated Immunity (CMI)

Passive Immunity
Nonspecific and Specific Immunity

3. Factors That Impact the Immune System

Factors Affecting Immunity

  • Impact of Heavy Metals on the Immune System
  • Stress and the Immune System


  • Ten-Year Study
  • Mood and Immunity
  • Type A and Type B Personalities and Stress

Diseases Associated with Stress

  • Asthma
  • Post- traumatic Stress Disorder
  • Migraine Headaches
  • Alzheimer’s Disease
  • Diabetes
  • Psoriasis/Eczema
  • Gastrointestinal Diseases
  • Myocardial Infarction
  • Wound Healing
  • Psychological Stress and Viral Infection
  • Increasing Demands to Sustain a Life Style


4. Boosting the Immune System

Supplements and Diet

  • Depleting the Immune System

Supplements that Enhance Immunity

  • Vitamins
  • Carotenoids (Beta-carotene)
  • Minerals

Foods that Strengthen the Immune System

  • Immune Enhancing Diet

Foods to Avoid

  • High Fat Foods
  • High Nutrient Diet

Tonics, Specifics, Heroics, Protectors and Cleansers

  • Tonics
  • Specifics
  • Heroics (or “Forcing Herbs”)
  • Protectors and Cleansers

Immune Herbs: Surface and Deep-acting Herbs

  • Echinacea
  • Astragalus
  • Goldenseal
  • Ginkgo Biloba

Other Herbs of Interest

  • Gotu Kola
  • Rosemary
  • Green Tea Extract
  • Soybean
  • Pau d’arco (Tabebuia pentaphylla)
  • Ginger
  • Garlic
  • Cayenne
  • Seaweed

Herbal Teas
Live Cultured Foods

  • Live Cultured Food
  • Mushroom Family

Other Immune System Enhancers

  • Exercise
  • Yoga and Stretching
  • Hand Hygiene
  • Laughter and Humor
  • Music
  • Sleep
  • Positive Thinking
  • Tea
  • Hydrotherapy
  • Acupuncture


5. Vaccines

Vaccine Types

  • Sub-unit vaccines
  • Inactivated Vaccines
  • Polysaccharide Vaccines (a subunit of inactivated vaccines)
  • Live Virus Vaccines
  • Recombinant Vaccines


6. Infectious Diseases Today

Today’s Facts

  • Heart Disease
  • Infectious Diseases Are Number One Killers
  • Factors Contributing to Emergence or Re-Emergence of Diseases
  • Re-Emergence
  • Pathogenic Microbes
  • Zoonoses


  • Biologic and Mechanical Vectors
  • Arthropod Vectors

Parasites, Fungi, Helminths, Protozoa

  • Parasites
  • Ectoparasite and Endoparasites
  • Fungi — Eukaryotic Microorganisms

Protozoa and Helminths

  • Protozoa
  • Helminths (Worms)

Some Diseases Caused by Worms

  • Schistosomiasis
  • Dracunculiasis, (Racunculiasis) or Guinea Worm (GWD)
  • Onchocerciasis
  • Summary
7. Bacteria

Anatomy of a Bacteria Cell

  • Endotoxin and Exotoxins

Some Foodborne Infections Caused by Infectious Bacteria
Campylobacteriosis — Campylobacter Jejuni
E. Coli Infection
Typhoid Fever (differs from Typhus)

8. Other Infectious Diseases

Clostridium Difficile Infection
Bubonic Plague
Streptococcal A
Lyme Disease

9. Antibiotic Resistance MRSA/VRSA: The Superbug


  • Factors that Increase Antibiotic Resistance
  • Control of MRSA Outbreaks
  • Prevention of MRSA Outbreaks

Infection Control Guidelines (CDC)

  • HIV and MRSA

Vancomycin, Gentamycin Resistance: Antibiotic Exposure Co-morbid Factor

  • VRE and VRSA
  • Antibiotics Mismanagement
  • Risk Factors for VRE or VRSA Infections
  • Preventing Transmission of VRE and VRSA
  • Surveillance Programs for Detecting Outbreaks of Nosocomial Infections
  • Transmission
  • Precautions
  • Antibiotic Treatment of VRE
  • Treatment of VRSA
  • CDC Guidelines for the Proper Use of Vancomycin
  • Nursing Implications


10. Virus Overview


  • What Is a Virus?
  • The Viral Envelope
  • A Brief History of Virus Discoveries
  • Viral Replication

Phases of Replication

  • Characteristics of Viruses Summarized

Viral Entry

  • Infection Can Occur Via
  • Main Mechanisms for Spread throughout the Host

A Deeper Look at Virology

  • What Is Virology?
  • Classification of DNA and RNA Viruses
  • Subviral Agents
  • Bacteriophage and the Lysogenic Effect and Phage Therapy
  • Structural Overview of Bacteriophage
  • The Lysogenic Life Cycle of Temperate Bacteriophages
  • Phage Therapy
  • Benefits of Phage Therapy


11. DNA and RNA Viruses and the Diseases They Cause

General Virus Types: DNA and RNA

  • Associated Diseases
  • Transmission
  • Clinical Course and Diagnosis
  • Treatment and Therapy
  • Prevention
  • Vaccination

RNA Viruses

  • Coronaviruses
  • SARS—Severe Acute Respiratory Syndrome
  • Calicivirus

Norovirus Infection

  • Symptoms
  • Transmission

Orthomyxoviruses/Influenza Viruses

  • Transmission
  • Site of Infection


  • Picornavirus Diseases
  • Paramyxovirus
  • Transmission

Measles (Rubeola)

  • Symptoms
  • Complications of Measles

Nipah Virus/Paramyxoviridae

  • Symptoms


  • Retrovirus — HIV/AIDS


  • Definitions
  • Diagnosis

Four Retroviruses

  • Viral Load
  • Transmission
  • Treatment
  • Summary of the AIDS/HIV Facts and Cycle

Lentiviruses (subgroup of retroviruses)

12. Other Microbial Diseases of Concern Today

Trypanosomiasis (Chagas Disease)

  • Clinical Symptoms


  • Symptoms of Cryptosporidiosis
  • Risk for Cryptosporidiosis

Typhus — Rickettsias
Viral Hemorrhagic Fevers (VHF)

  • Clinical Manifestations
  • Differential Diagnosis
  • Treatment
  • Epidemiology of Disease Transmission
  • Prevention/Prophylaxis
  • Bunyavirus
  • Arenaviridae
  • Lassa Fever
  • Filovirus (Ebola)


  • The 13-infectious Flavivirus


13. Endemics, Epidemics, Pandemics, & New Influenzas
  • Endemic
  • Epidemic
  • Pandemic: The Difference Between an Epidemic and a Pandemic

Pandemics – A Brief Historical Overview
Stages of a Pandemic

  • Interpandemic Period
  • Pandemic Alert Period
  • Pandemic Period
  • Pandemic Summary

Drift, Shift, Types, Subtypes, and Strains

  • Antigenic Drift
  • Antigenic Shift

Influenza Types and Strains

  • Types of Influenza
  • Strains of Influenza

Human Influenza Viruses Versus Avian Influenza Viruses

  • Low Pathogenic Versus Highly Pathogenic Avian Influenza Viruses
  • Putting It Together: Types and Subtypes


14. The Next Pandemic Threat

Swine Flu or Avian Influenza?
Influenza Pandemics Are Different
Serious Problems with Pandemics

  • Global Quick Spread
  • Economic and Social Costs of Pandemics
  • Potential Costs per Individual
  • Surge Capacity – Inadequate Medical Supplies
  • Dramatic Death Toll
  • Swine Flu
  • Transmission
  • Clinical Signs
  • Diagnosis
15. The H5N1 Virus: Avian Flu or Bird Flu

Pandemic Concerns Today
Seasonal Flu Versus Pandemic Flu

  • Seasonal Flu
  • Pandemic Flu

Do Nurses Need to Worry About the Avian Flu: H5N1 Virus?

  • Brief History of H5N1 Virus
  • Avian Flu Expected Soon in the United States
  • Changing Statistics
  • Is H5N1 the Same Strain as Was Found in 1918 Spanish Flu?

Avian Flu Caused by H5N1

  • Symptoms of Avian Flu
  • Pathophysiology
  • Incubation
  • Avian Influenza Transmission
  • Diagnostic Problems
  • Influenza Diagnosis Confirmation
  • New Testing For Influenza Strains
  • Gold Standard Testing

Prevention of Pandemic Influenza

  • Ban Importation of Chicken
  • Culling
  • Treatment
  • Vaccine Development
  • The Avian Flu Pandemic Influenza is Different from Avian Influenza
  • Influenza Compared to SARS
  • Severe Acute Respiratory Syndrome (SARS)
  • Ways to Prevent Spread of SARS or Infectious Influenza
16. Bio War and Genetic Engineering

The New Biological Weapons

  • Delivery and Detection of Biological Warfare
  • Nursing Responsibility
  • Classification of Bioterrorism Agents or Disease
  • Genetic Alterations
  • Gene Sequences Available Online
  • West Nile Virus Released?
  • Replication of Norovirus
  • Storage of Infectious Agents

Biotech or Bioterror

  • Historical Overview: Use of Biological Agents
  • The History of Biological Warfare (BW)
  • Challenges
  • Protective Measures

Biosafety Laboratory Standards (BSL)

  • Biosafety Level 1
  • Biosafety Level 2
  • Biosafety Level 3
  • Biosafety Level 4


17. Main Biologic Agents

Natural Evolution or Intentional Infliction

  • Morbidity
  • Vaccination
  • Reportability
  • Inhalation Anthrax
  • Clinical Features
  • Diagnosis
  • Cutaneous Anthrax
  • Diagnosis
  • Treatment
  • Gastrointestinal Anthrax
  • Diagnosis and Treatment


  • Pathophysiology
  • Dissemination
  • Symptoms
  • Diagnosis
  • Treatment
  • Prevention/Prophylaxis


  • Pathophysiology
  • Clinical Features
  • Diagnosis
  • Treatment
  • Prevention/Prophylaxis


  • History of Tularemia as a Bio Weapon
  • Vector Transmission
  • Pathophysiology
  • Clinical Manifestations
  • Diagnosis
  • Treatment
  • Prophylaxis/Prevention


  • Pathophysiology
  • Clinical Features
  • Diagnosis
  • Treatment
  • Prevention/Prophylaxis

Q fever

  • Pathophysiology
  • Clinical Features
  • Diagnosis
  • Treatment
  • Prevention /Prophylaxis


  • Pathophysiology
  • Clinical Signs
  • Diagnosis
  • Treatment
  • Prevention
  • Residual Immunity

Viral Encephalitides

  • Pathophysiology
  • Clinical Manifestations
  • Diagnosis
  • Treatment
  • Prevention

Viral Hemorrhagic Fevers

  • Pathophysiology
  • Clinical Manifestations
  • Diagnosis
  • Treatment
  • Prophylaxis

Botulinum Toxin

  • Pathophysiology
  • Clinical Manifestations
  • Diagnosis
  • Treatment
  • Prevention/Prophylaxis


  • Pathophysiology
  • Clinical Manifestations
  • Diagnosis
  • Treatment
  • Prevention

Staphylococcal Enterotoxin B.

  • Toxicity
  • Diagnosis
  • Symptoms
  • Treatment for SEB Poisoning


18. New Era in Public Health: Nursing on the Front Line

Public Health

  • The Four R’s for Nurses as Adopted by Many Organizations
  • Children Are Vulnerable
  • The School Nurse in Bio-terror or Pandemics
19. Nurses Can Educate People – Now

What Nurses Need to Look at Today
Public Health Nursing

  • FluSurge

What Nurses Can Do Today

  • Expanded Scope of Practice
  • Nursing Infection Control Precautions for Influenza A (H5N1)
  • Isolation Precautions


  • Indications of Possible BW Agent Attack or a Pandemic
  • Resources for Nurses Who Wish to Become Better Prepared


20. Planning, Preparation, and Guidance

Surveillance and Laboratory Issues
Community Services
Medical Care

  • Influenza Pandemic Preparedness

Vaccines and Drugs
Pandemic Challenges
Backyard Local Farmers with Fresh Eggs

  • Isolating Flocks from Wild Bird Populations, Human Contact, and Each Other
  • Minimizing Bird-to-Human Contact
  • Other Ways of Preventing Spread of Virus Among Animals

Community Preparation
Family and Individual Plans
Water Treatment

  • Boiling
  • Chlorination
  • Water Treatment Purification Tablets
  • Distillation
  • Outdoor Water Sources: Purify the Water Before Drinking It.

Food Items

  • Long-Term Bulk Foods

Responsibilities of the Individuals and Families
Justified Alarm

  • Other Components

The Next Pandemic

  • Political and Financial Need
  • Financial Perspective

Government Response Today

  • Federal Actions
  • State and Local Responsibilities

Have a Disaster Plan, and Know It

  • Can You Locate Your Disaster Plan?


Customer Comments

“I really enjoyed this course. I learned a lot!”

– D.M., RN, CA