Teacher Notes & Web-Resources Guide for
The Many Faces of Tuberculosis: A Web-based Exploration
Elliott Gimble, Life Science/HHMI Outreach Program
Summer 2008
“Though conventional tuberculosis is highly treatable and curable (with
a 90 percent rate of success), TB kills more people worldwide in a typical
year, according to the Global TB Report Card, than ‘all wars,
earthquakes, floods, tsunamis, airline accidents, terrorist attacks, and
murder’ combined. Nearly two million people succumb to the disease
annually, mostly in the developing world, where 98 percent of new
infections arise.”
(From: http://www.pbs.org/wgbh/rxforsurvival/series/diseases/tuberculosis.html)
Introduction: This web-based activity for students explores the microbiology,
pathology, and socio-political aspects of tuberculosis (TB), a vital and growing global
health threat. The ultimate goal is for students to integrate their understanding of the
immune system, microbial taxonomy, and disease with critical thinking about global
health policy.
Students should come to this activity after having studied the human immune system and
some microbial taxonomy; that is, an understanding of the differences between bacteria,
archaea, viruses, and protists. Some other additional ideas, web sites, and resources
(some specific to TB) are listed below for teachers looking to expand beyond tuberculosis
or hoping to adapt this activity further for their classrooms.
Goals: This web-based student activity has two goals:
1. (Student Goal): Examine and relate the microbiology and pathology of tuberculosis
and appreciate the socio-political impacts of this global disease.
2. (Teacher Goal): Provide curriculum ideas and source suggestions for teachers
developing additional web activities that explore other microbial
diseases.
Guiding Questions
Pick some or all of these questions or suggested topics as focal points for the assignment,
depending on the depth and emphasis you seek.

What are the symptoms of the disease?

What is the pathology of the disease?
• What is wrong inside the body/organism? Which parts are affected and how?
• How does the immune system respond to the disease?

How is the disease transmitted?
• Is there a microbial or an animal vector? Describe its life cycle.
• How is it contagious or passed on to others?
Summer 2008 Workshop in Biology and Multimedia for High School
Teachers
Harvard University Life Sciences – HHMI Outreach Program

How prevalent is the disease?
• Who and how many people or organisms are affected?
• Are there demographic or geographic patterns in the spread of the disease?
• What are the social, political, economic, or genetic factors that influence
prevalence?

What is the prognosis for a person with the disease?
• How long do infected people/organisms live? Is it curable or only treatable?
• In which ways and how seriously are their lives affected?

What treatments are available?
• Are they costly? Are they available to the general public? If not, why not?
• What paths are researchers taking to try to prevent, control, treat or cure
the disease? What does the latest research suggest?

Case Study: A Case or Outbreak
• Research and describe one specific case or an outbreak of the disease (and
perhaps pertinent factors that led to it) as an illustration of the disease’s
potential impact.
Activity Ideas
Using disease to integrate several topics in the curriculum can take many forms. Here are
a few suggestions, from a single class period activity to a longer, independent project or
paper.
Webquest – Use the TB worksheet to have students explore tuberculosis on-line (in class
or as homework) and complete the worksheet.
Jigsaw – Have different groups of students focus their individual research on different
diseases (or distinct aspects of a single disease) and in class, share what they have learned
in small groups with others who have studied other diseases or aspects.
Poster – Using the required topics as a guide, incorporate information on a creative and
visually appealing poster to be used in a gallery walk or presented to the class. (A student
information grid for up to 6 diseases is part of this Teacher Guide.)
PowerPoint or other presentation – Students assigned a specific disease present to the
class individually or in teams of two. Or use the TB worksheet to develop your own
PowerPoint lecture using the information, video clips, and resources described.
Brochure – Assigning some or all of the guiding question topics, student teams develop
an informative and creative brochure describing a specific disease.
Term Paper – Using the guiding questions (or others), assign a 5-7 page term paper on a
specific disease, chosen by the student from a list. Consider having each student in a
class section research a different disease.
Summer 2008 Workshop in Biology and Multimedia for High School
Teachers
Harvard University Life Sciences – HHMI Outreach Program
Resources
CDC
http://www.cdc.gov/DiseasesConditions/
The Center for Disease Control has many fact sheets and other information. This site
provides a good starting place with an excellent list of diseases and links to specific
sources.
Other Disease Information Sites
http://www.merck.com/mmhe/sec17/ch193/ch193a.html#sec17-ch193-ch193a-438
http://www.mayoclinic.com/health/tuberculosis/DS00372/DSECTION=causes
http://www3.niaid.nih.gov/topics/tuberculosis/default.htm
http://www.textbookofbacteriology.net/tuberculosis.html
Includes more details of M. tuberculosis as an organism and disease pathology.
World Health Organization
http://www.who.int/en/
http://www.stoptb.org/
http://www.who.int/mediacentre/news/releases/2008/pr05/en/index.html
Includes maps, reports, statistics and information on MDR-TB. The Stop TB site includes
information and videos specific to this disease and information on WHO’s partners in
addressing TB.
Microbeworld
http://www.microbeworld.org/microbes/types.aspx
Information on microbial life and taxonomy.
Harvard Life Sciences/HHMI Outreach
http://outreach.mcb.harvard.edu
Excellent Lessons and Animations may be found here (the Immune System and
Evolution are especially relevant to this unit).
Nobel Prize
http://nobelprize.org/
Source of information on the scientists and science behind many discoveries. Also some
very useful animations and games specific to diseases or topics.
Additional Activities and Websites
1. NIH Curriculum – Emerging and Re-Emerging Infectious Diseases
http://science-education.nih.gov/supplements/nih1/diseases/default.htm
NIH’s high school curriculum (free and on-line) with excellent activities and videos
including the story of Debi French, a high school student who found herself fighting a
case of active TB.
2. Medline TB tutorial
http://www.nlm.nih.gov/medlineplus/tutorials/tuberculosis/htm/index.htm (select to play
it either with questions or as self-playing without questions). This excellent tutorial/slide
show from the National Library of Medicine describes the disease, its prevalence, causes
and treatment. May be a good review for those who learn best this way or who have
extra time and inclination.
Summer 2008 Workshop in Biology and Multimedia for High School
Teachers
Harvard University Life Sciences – HHMI Outreach Program
3.The Most Dangerous Woman in America: Questions about Quarantine
http://www.pbs.org/wgbh/nova/typhoid/
Video and activities to go with it about Typhoid Mary. Presents the public health
challenges and issues surrounding carriers and quarantine. Could lead to
discussion/debate in class, especially in conjunction with the Michael Speaker case; see
the article below:
http://travel.nytimes.com/2007/06/02/health/02tick.html
4. National Center for Case Study Teaching in Science
http://www.sciencecases.org/mdr_tb/mdr_tb.asp
This case study is one of several relating to microbes (and other topics in biology) at this
SUNY- Buffalo website, dedicated “to promote the development and dissemination of
innovative materials and sound educational practices for case teaching in the sciences.”
5. Rx for Survival
http://www.pbs.org/wgbh/rxforsurvival/index.html
This multi-part PBS series on infectious disease and the scientists and patients involved
with them includes an excellent web site with education resources, video clips, links, etc.
See also, for example, the July 18, 2008 edition of Science for information about the fight
against antibiotic resistant TB.
6. Vitamin D and TB
http://www.hsph.harvard.edu/review/rvw_spring06/rvwspr06_tb.html
Recent research suggests Vitamin D may reduce TB infection.
Answer Key to Part 2 of the Many Faces of TB exercise
Part 2 – TB: The pathogen and the disease
1. How many people are thought to be infected with TB worldwide? (2 billion - 1/3 world
population)
2. What is the name of the bacteria that causes TB? Mycobacterium tuberculosis (Mtb).
3. How many people worldwide have active TB? (8 million) How many a year die of it?
(2 million)
4. Although many people have TB in their body (are infected) only ___ in 10 will ever
see the disease become active during their lifetime. (1)
(Note: Patients with TB in the body but no symptoms has a case of “latent TB”; those
with symptoms have “active TB.”)
5. In the US, the Centers for Disease Control estimate ________ people in the United
States have active TB and another ___ to ____ million have latent TB. (13,799, 10-15)
6. Tuberculosis typically affects what part of the body? (lungs)
7. How is TB passed on from person-to-person? (in airborne droplets during breathing, etc.)
Summer 2008 Workshop in Biology and Multimedia for High School
Teachers
Harvard University Life Sciences – HHMI Outreach Program
8. Why are people with weak immune systems more susceptible to developing active TB?
They can’t fight it off.
9. What does the TB bacteria do in someone with active TB? (multiply, attack lungs, etc.
move about via circulation).
10. Symptoms include: (cough, loss of weight/appetite, fever, chills, night sweats)
11. How are Multidrug-Resistant (MDR-TB) and Extensively Drug-Resistant (XDR TB)
Tuberculosis different than regular TB? (forms in which TB can’t be killed by at least
the 2 best antibiotics and sometimes others too).
12. When was Mycobacterium tuberculosis (Mtb) discovered and who did so? (1882,
Robert Koch).
13. Name the organism(s) where Mtb is found: (only in humans).
14. TB can be treated successfully by using __________________ but these must be
taken for months or even years. Multidrug resistant TB requires even more drug therapy
over longer periods. (a variety of antibiotics)
15. Approximately _______________ people suffer from HIV and TB, according to the
WHO; which disease is the primary cause of death for these patients? (11.4 mill; TB)
Summer 2008 Workshop in Biology and Multimedia for High School
Teachers
Harvard University Life Sciences – HHMI Outreach Program