Three years ago, a biology lesson about smallpox would likely have centered on health officials’ boast that a worldwide campaign had eradicated the longtime scourge. And a classroom lesson about anthrax could have focused on how pasteurization removes from milk and juices the bacterium that causes the disease.
But just as many facets of life in the United States have changed since Sept. 11, 2001, so has the way in which teachers might approach the topic of infectious diseases. Instead of being viewed as rare or vanquished threats to public health, smallpox and anthrax cause worry as potential weapons of terror.
That change in perspective gives teachers a fresh opportunity—if handled carefully—to teach about the nature of diseases, the function of cells, and other elemental concepts of biology, according to curriculum experts.
A few high school teachers have started experimenting with the best way to approach the subject of bioterrorism, but few are jumping into such instruction. Many are deterred by the weighty implications of any smallpox outbreak or similar deadly threat.
“Most people don’t teach about it at all,” Donna R. Sterling, an associate professor of science education at George Mason University, in Fairfax, Va., said of bioterrorism. “It’s a difficult topic, and it could easily get emotional.”
But the topic should be addressed, say Ms. Sterling and other educators, who suggest that it be integrated into discussions about infectious diseases and the way they attack the human body. If the possibility of bioterrorism is ignored, they believe, students won’t have the requisite scientific knowledge to grasp the policy debates that span from public health to national defense.
“If kids can understand something, they feel like they have a little more control over it,” said Tobie Brandriss, a biology teacher at Hunter College High School in New York City. “I don’t think using [the topic of bioterrorism] in the classroom increases their level of insecurity or anxiety. It’s already out there.”
“It’s almost like [students] don’t have a choice” about whether to learn about the potential for such attacks, said Vicky T. Esterera, a research associate at Rice University’s Center for Technology in Teaching and Learning, in Houston. “They need a way to filter out what is true and what is not true.”
The topic of infectious diseases, and the molecules that transmit them, is a central theme in high school biology. And it can be a launching point into teaching about bioterrorism.
“You can learn everything you need to know about biology through infectious diseases,” said Jacqueline S. Miller, the lead author of a biology curriculum published by the Education Development Center. “It’s a wonderful foot in the door. [Teachers] can use it as a framework for learning.”
Even before the prospect of biological terror entered the mainstream consciousness after the 2001 terrorist attacks on the United States, science educators had devised curricula that use infectious diseases as a teaching tool for the structure of the cell.
In 1999, the National Institutes of Health published a curriculum supplement on new and reappearing infectious diseases. The federal agency chose the topic because experts at the National Institute of Allergy and Infectious Diseases had identified it as one of the important issues in their field, according to Bruce A. Fuchs, the director of NIH’s office of science education. The curriculum includes a section on smallpox, he added, because even in the late 1990s, public-health officials feared a re-emergence of the highly contagious viral disease.
“It’s way more applicable [now] than we had ever imagined,” Mr. Fuchs said.
The Education Development Center, a Newton, Mass.-based nonprofit organization, included the topic as one of five units in its introductory-biology curriculum published in 1998.
The unit doesn’t directly address anthrax and smallpox, or other potential bioterror weapons, Ms. Miller said, but teachers could use the materials and then make a short leap to talking about bioterrorism.
The EDC curriculum singles out cholera and influenza. Cholera, a severe intestinal disease that has led to seven pandemics in the past 200 years, is caused by the vibrio cholerae. Like all other diseases caused by bacteria, it can be treated with antibiotics because its cells can be killed without harming the human host.
By contrast, the flu is caused by a virus, which is spread by using the cellular reproductive abilities of the host. Any medication that targets the virus would also endanger the cells of the host. Vaccination is the best prevention, and medical treatment is usually limited to easing the symptoms.
The same principles can be explored when teaching about bioterrorism, Ms. Miller said.
Anthrax is caused by the bacillus anthracis and can be treated with antibiotics.
In the fall of 2001, anthrax bacteria were mailed to U.S. Sens. Tom Daschle, D-S.D., and Patrick J. Leahy, D-Vt., and several journalists. Twenty-two people contracted anthrax during the incidents, and five of them died, according to the U.S. Centers for Disease Control and Prevention.
Smallpox, by contrast, is caused by the variola virus. Although the World Health Organization declared the disease eradicated in 1980, health officials fear that terrorists could obtain samples of the virus that have been preserved and set off an outbreak by releasing the virus in public places. It could easily spread through the population because routine vaccination against the disease stopped once health officials declared that it had been wiped out.
Medical treatment for smallpox is limited to treating the symptoms of high fevers and the painful rash that starts in the mouth and eventually covers the victim’s body. Because medical treatment cannot stop the disease, its fatality rate is higher than that of anthrax and much harder to contain.
While lessons on diseases can make a potential terrorist attack seem dire, experts say teachers also should mention comforting news, such as how difficult it would be for terrorists to obtain and use deadly bacteria and viruses, and the assurance that public-health officials know ways of containing outbreaks.
“If kids have that background, then you can have conversations about what [they] think about vaccinating everybody against smallpox,” said Ms. Sterling of George Mason University. “If they don’t have the background information, then you can’t have a very substantive conversation.”
Teachers are finding creative ways to show the potential impact of microorganisms that could be used as weapons.
At Hunter College High School, a public school for high-achieving students run by the City University of New York, Ms. Brandriss conducts an activity in which every student in her class gets a small cup of liquid. One student’s cup is filled with sodium hydroxide; the rest get plain water.
After each student retains a sample from his or her original cup, she tells everyone to exchange some of the liquid with three or four others.
When the teacher pours a chemical indicator into everyone’s cup to see who has any trace of sodium hydroxide, students are shocked to find that between a third and half of the class has caught “the disease,” Ms. Brandriss said. They’re even more surprised when she tests the original samples and finds that all but one class member started with water.
“It really brings home how fast a bioterrorist infection could spread, and how unknowingly someone can be a carrier and spread it,” Ms. Brandriss said.
Other educators give students roles to play in simulating an anthrax scare. Rebecca Schall Josvai, the regional outreach director of a federally financed project designed to bring biotechnology into high school classrooms, assigns students to act as police officers, paramedics, or state lab workers. Their job is to decide what they need to do to prevent the spread of anthrax-causing bacteria in their classrooms.
Anthrax can cause a skin rash, intestinal disease, or respiratory infection, which can be deadly.
“I always want them to do something hands-on,” said Ms. Josvai, whose project—called Bio-Link—has its headquarters at the Madison Area Technical College in Wisconsin. “They get the idea of how they would handle a terrorism event if it happens in their school.”
‘The Right Perspective’
Mr. Fuchs said the NIH curriculum on infectious diseases includes a series of simulations that help students understand how best to immunize the population against smallpox. The lessons culminate with a computer simulation in which students act as public- health workers to determine how much of the population should be inoculated to stave off a smallpox outbreak.
It does not address the controversy arising from such mass inoculations, largely because the curriculum was written before the prospect of an outbreak came up.
Such role-playing gives students the experience of acting as professional scientists might if an outbreak occurs, Mr. Fuchs said. It also may give them a sense of security.
“Having a realistic understanding of the threat and our ability to deal with it,” he said, “can only help kids put it in the right perspective.”
And that perspective is an important ingredient in any lesson about bioterror, teachers say.
Said Carol Thibodeau, a science teacher at Caribou High School in Caribou, Maine: “You don’t want them looking over their shoulder every five minutes and being scared to death any time they go somewhere.”