This was a strange and uncertain year. Given the tumultuous nature of 2016, it is probably no surprise that I found myself asking some strange questions that my readers seemed only too grateful to have answered.
Antibiotic resistance is one of the most pressing issues affecting public health today, and there is no other bacterial organism that better represents the urgency of this threat than MRSA, methicillin-resistant Staphylococcus aureus. This ubiquitous bacteria plays two roles, both as a skin-dwelling commensal and disease-causing pathogen, and is one of the most prevalent and deadly disease-causing bacteria in our communities at large and in our hospitals in particular. An early chapter of its ongoing metamorphosis from skin floral bug to virulent antibiotic-resistant pathogen took place in an unlikely setting: among a population of injection drug users living in Detroit in the early 1980s who were partaking in an unusual practice of homegrown infection prevention.
Bloodletting and leech therapy has a long and storied past. For thousands of years, physicians and healers have employed the bloodsucking leech to treat myriad conditions that assail the human body, the original panacea that would treat anything from “farts to fevers.”(1) The ectoparasite was the ancient physician’s most versatile treatment and so essential that its very name, derived from the Anglo-Saxon word “loece,” refers to a physician or healer and indicates the degree to which worm and doc have long been deeply entwined.(2)
In September of 1939, Nazi Germany invaded Poland, marking the beginning of World War II in Europe. By the war’s end in 1945, Poland had suffered the deaths of more than five and a half million citizens – a fifth of her pre-war population – with the majority of these the victims of war crimes at the hands of the Germans. A large community in southeastern Poland, however, escaped persecution and the horrors of deportation and death thanks to an ingenious ruse employed by two Polish physicians. With the help of a sham “vaccine,” Drs. Eugene Lazowski and Stanisław Matulewicz fabricated a fictional epidemic that would save the lives of thousands.
Epidemics do not simply appear out of nowhere. They can simmer for months, isolated within a small segment of a population, escaping the notice of the public health community before boiling over into the larger community, triggering the identification of a spreading contagion. Too often, those individuals who recognize a nascent threat of outbreak and sound the alarm do not receive the public recognition they deserve.
This past spring, a street dog and her puppy were captured in Cairo, Egypt. Her vaccination certificates were forged, and she was shipped to the United States by an animal rescue organization in a shipment that included seven other dogs and 27 cats. Days later, following her placement in a Virginian foster home housing several other dogs, this rescue developed the frank signs and symptoms of rabies, and she was quickly euthanized.
Just thirty-odd years ago, a HIV diagnosis was a death sentence. Advances in pharmaceuticals and in our understanding of the mechanisms of HIV infection mean that today it is a manageable, chronic disease on par with diabetes, hypertension, and cardiovascular disease. People with HIV are living longer, and a graph recently published by the Centers for Disease Control and Prevention (CDC) shows that in the United States the average age at death from HIV infection has dramatically increased since 1987. (1)
Three scientists that developed treatments for debilitating parasitic infections were awarded the Nobel Prize in physiology or medicine today for their ground-breaking advancements in tropical medicine.
Advancements in the medical sciences follow a well-trod path: observation of a problem, reasoned hypothesis and experimentation, and implementation of a solution. This course is governed by logic and, occasionally, reinforced by unorthodox thinking with the ultimate goal of improving the viability of man. An exception to this rule is the invention of the rubber glove. One of the most important breakthroughs in the practice of medicine was born not of careful problem-solving and the scientific process, but of a romantic gesture, a clinical schoolboy’s crush, an event which one observer described as “Venus [coming] to the aid of Aesculapius.”
Forensic biology has made tremendous strides in the past few decades thanks largely to advances in DNA techniques and analysis. Genomic sequencing has generated new methods of human identification reaching far beyond fingerprints and dental records, providing crucial information in the course of investigations, valuable evidence in historical fieldwork, and personal closure in the wake of tragedy.