Status Updates From Plague Time: The New Germ T...

a mild variant of the cholera organism can maintain itself along the coast of Louisiana and Texas, where protection of water and hygiene are substandard and where eating of raw shellfish appears to contribute to the maintenance of the organism. Yet Louisiana and Texas do not have a bad cholera problem. Fairly large numbers of people seem to become infected, but almost nobody gets cholera.

How then can minds become better prepared to recognise infectious causation? One step would be to recognise that the microbial world with which humans intimately interact is far more rich and diverse than we have thought and perhaps than we would like to think. A prepared mind recognises that we know very little about what these microbes are doing.

Imagine, for example, that the only damage a vaccine caused in humans was a very slight amount of brain damage—enough, say, to lower an IQ score by five points in one out of every hundred children. This amount of damage would probably be considered intolerable for a human vaccine. But would we be do concerned if one out of every hundred Felixes took an extra second to figure out how to sneak up on the kitchen table

The virulence antigen strategy requires that vaccine experts shift away from eradication as a goal. This shift is dictated for some diseases by the ability of vaccines to prohibit disease but not infections. When children are vaccinated against pertussis (whooping cough), for example, the disease is generally prevented but the organism is still present and transmissible.

Consider the Soviet war in Afghanistan. Although the Soviet Union had overwhelming superiority in fire power, the United States saw that it could tip the balance in favor of the Afghan rebels by providing Stinger missiles, which could knock out the main Soviet threat: attack helicopters. The United States provided this weapon after considering which of the two sides was more dangerous to U.S. interests.

Ever since the anti-malaria campaign fell apart in the 1960s, master planners have been dangling the prospects of an effective vaccine that could eradicate malaria. It is a desperate hope of last resort. Humans have never controlled a sexually reproducing protozoal parasite by vaccination. Vaccination against viral and bacterial diseases has a long record of success, but this success tells us little

If Menelaus could avoid being deterred by any of these forms, the sea god would eventually transform himself into a benign cooperative shape. By anticipating Proteus’ changeability and developing a strategy for coping with it, Menelaus could control his adversary and resolve his predicament. This allegory is illustrative of the way we must face the problem of infectious disease.

The sea nymph Idothea told the lost and desperate Menelaus what he needed to do to get back home to Sparta. Menelaus would have to force the instructions out of her father, the sea god Proteus. But Idothea warned Menelaus that the encounter would be challenging. Proteus would change his form to avoid being controlled. At one moment he might be a serpent, at another a leopard or a wild boar.

Three decades after the Stalingrad outbreak, a promising young medical student named Ken Alibek was asked by his Soviet professor to analyse the unusual cluster of tularaemia cases. After intensive study Alibek reported his conclusion to the professor: the epidemic must have been caused intentionally. The professor then told Alibek to “forget you ever said what you just did. I will forget it too......

Amherst sent a letter from his base in New York to the ranking officer for western Pennsylvania, Colonel Henry Bouquet, who was based in Philadelphia: “Could it not be Contrived to Send the Small Pox among those Disaffected Tribes of Indians? We must, on this occasion, Use Every Strategem in our power to Reduce them.” Bouquet wrote back, “I will try to inoculate the——with Some Blankets

There may be many different causes of the diffuse collection of ailments that are grouped together under the label chronic fatigue syndrome. A possible infectious cause is the Borna disease virus. Japanese researchers found it in one third of their patients diagnosed with chronic fatigue syndrome at about ten times the rate at which it was found among healthy controls.

Knowing that T. gondii is transmitted to humans from cat feces. I find myself casting suspicious glances at our litter box, which our cat uses eagerly during the cold months of January through March though rarely during the rest of the year. When I hear the telltale scratching from inside the box, I wonder what the cat might be tracking around the house after it leaves the box.

Torrey has found T. gondii more commonly in schizophrenia patients than in controls, and has found schizophrenia less commonly where cats are not kept as pets. Schizophrenia is also more common among people who were born in late winter and early spring, and in urban rather than rural environments. These associations suggest infectious causation though they do not implicate a particular pathogen

Although the available evidence cannot exclude with certainty contaminated polio vaccines as the source of the AIDS pandemic, the balance of evidence argues against it—contaminated vaccines do not appear to have been responsible for what is shaping up to be one of the worst pandemics in human history. Does this conclusion mean that we do not need to worry about vaccines as a source of emerging disease?

Two research groups have recently found evidence of retroviruses in breast tumors but not in surrounding healty tissue. One of the research groups, based at the Mount Sinai School of Medicine in New York, compared the viral sequences with sequences of previously identified viruses and found them to be indistinguishable from those of a virus that causes tumors in mice, the mouse mammary tumor virus.

Most of the attention-grabbing emerging diseases are caused by pathogens transmitted to humans from other species, the so-called zoonoses. Reemerging diseases such as cholera, influenza, and dengue are included in discussion, but it is the more exotic zoonotic diseases, such as Ebola, that seem most intriguing and frightening--probably because they raise the possibility of previously unknown horrors

the best reconstruction of evidence traces the origins of the exceptionally virulent 1918 viruses not to Asia but to the western front of Europe, where the conditions of trench warfare and the transport of severely ill patients apparently favored evolutionary increases in the virulence of the influenza viruses that were circulating there.

the war metaphor provides an engaging mental picture for the disease eradicators. It casts the disease as an enemy and allows them to use the medical versions of spears, clubs, and fire—antibiotics, disinfectants and vaccines—to destroy or ward off the enemy.

Although antibiotics are a marvellous solution for the individual patient, they are a poor way to control disease in a population. Their flaw stems from an ethical dilemma: what is best for the individual patient may often be at odds with what is best in the long term for the society. The individual patient usually benefits by taking antibiotics. The society pays a price over the long term

Some of the uncertainty can be resoved by looking at identical twins. If pairs of twinds tend not to share a given chronic condition, we know that we have to look beyond genes to understand the problem. That leaves us with only two alternatives: infection or some noninfectious environmental influence.

All the diseases that were accepted as infectious during the last quaarter of the nineteenth century were either entirely or largely acute--the diseases were obvious because sufferers had obvious symptoms just after they were infected--but all the human diseases that hve been accepted as infectious during the past quarter century have been entirely or largely chronic. They are the stealth infections.

Sexually transmitted pathogens must act like criminals living in a town that is heavily patrolled by police. Like human criminals, they have developed a variety of strategies for evading recognition, surveillance and capture. Because the immunological police soon become very familiar with their appearance, most sexually transmitted pathogens keep a low profile.