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This case study explores the recent (2010 - 2016) outbreak of neural tube defects, specifically anencephaly, in a rural three-county region of Washington state, particularly Yakima, WA. The case study focuses on the biological aspects of teratogens that may cause birth defects as well as epidemiological investigations of disease outbreaks. By the end of the case, students will have explored how our environment may have severe biological consequences on the human body during pregnancy and will have evaluated governmental and scientific investigations of a rare outbreak of birth defects. This clicker case study was developed for a non-majors biology course entitled "Human Development: Conception to Birth," although it could be taught in any introductory biology course for majors or non-majors during a unit on human reproductive biology or developmental biology. The case assumes that students have no prior knowledge of developmental biology or birth defects. The case study could also be adapted for upper-division courses by getting more in-depth on the specifics of teratogen mechanisms, the developmental biology and physiology of neural tube defects, or more complex epidemiological analyses.

When women smoked daily during pregnancy, researchers identified 6,073 places where their babies' DNA was methylated differently from the DNA of nonsmokers' infants. Many of the differences were found on or near a collection of genes related to lung and nervous system development, smoking-related cancers and birth defects such as cleft lip and palate.

This video excerpt from NOVA uncovers the genetic mystery that nearly killed Alexis, now 14, and introduces the debate surrounding genetic testing at birth. After diagnosing Alexis and her twin brother Noah with cerebral palsy at a young age, doctors later discovered that the twins shared a rare genetic mutation that led to a condition that mimics cerebral palsy. The twins improved after receiving treatment, but then Alexis took a turn for the worse. Thanks to whole genome sequencing, doctors discovered a second problem linked to the mutation and gave her a different treatment that saved her life.

Scientists and healthcare professionals initially exhibited little concern over the Zika virus even after evidence of human infection was first identified in 1952; Zika appeared to be both rare and unassociated with morbidity or mortality. Around 2015 all of this changed as journalists, scientists, public health officials, and laypeople scrambled to learn about its varied modes of transmission and devastating consequences (e.g., birth defects and autoimmune disorders). Although research continues to rapidly evolve, this case study directs students to reliable scientific sources (e.g., Centers for Disease Control and World Health Organization) that will likely continue to provide the most current information in order to explore questions such as: Where did the virus come from? How does it spread? What can we do to prevent it? Students will also consider the public health challenges and possible solutions associated with emerging infectious diseases. The case was originally written for an upper-level biology or public health course in which students already have some basic background knowledge regarding viruses, vaccines, and infectious disease.

In the 1950s, Idaho sheep ranchers had a problem. About a quarter of their lambs were being born dead or deformed-sometimes with a single eye centered in the middle of their forehead, like the Cyclops of Greek legend, or missing their upper jaw. There were times when the pregnant ewes couldn't give birth at all, carrying the mutated fetuses until they were surgically delivered or the ewes themselves died. Unbeknownst to the farmers, the cause was a poisonous plant, western false hellebore (Veratrum californicum). Eventually, the plant would inspire a successful cancer therapy-but at the time, the sheep were what mattered.

The behavior of a person's genes doesn't just depend on the genes' DNA sequence - it's also affected by so-called epigenetic factors. Changes in these factors can play a critical role in disease.

Lesson plans from a 5 day summer workshop through the CDC