The plague is an old microbial foe that has haunted our cities and our ports for millennia, killing millions of people in waves of pandemics since antiquity. But Yersinia pestis no longer has the same presence, or stranglehold, in our society and seems negligible when we consider the current state of microbial affairs – increasing levels of antibiotic resistance and novel and emerging viral pathogens, just to name a couple of today’s most pressing issues. Even its moniker, “the plague,” has been appropriated for more contemporary microorganisms that appear to come from nowhere and quickly, fatally sweep through a population – SARS and HIV are prime examples of two new “plagues.”
Next week, the hot and happening place to be is in the Kingdom of Saudi Arabia as millions of Muslims gather to complete their pilgrimage to the sacred city of Mecca, a journey known as the Hajj. For public health practitioners within Saudi Arabia and beyond its borders, the Hajj poses serious challenges in the prevention and control of infectious diseases among the millions of faithful worshipers who seek to complete one of the five pillars of Islam.
Vaccines were once thought of as an axiomatic good, a longed-for salvation in the form of a syringe, banishing crippling and deadly infections like polio, smallpox and tetanus. But within the past few decades we have seen the emergence of anti-vaccination movements and a rise in cases of childhood diseases that are entirely preventable with a quick jab to the arm.
This past June a federal judge ordered the relocation of thousands of prisoners from two prisons in the San Joaquin Valley in California to protect imprisoned men against a small fungus, Coccidioides immitis, that could infiltrate the gated and locked Pleasant Valley and Avenal state prisons and continue to cause isolated cases of a debilitating illness, valley fever.
The Democratic Republic of Congo is home to one of the largest and most biologically diverse rain forests in the world, featuring an incredible variety of animals including bonobos, forest elephants, and mountain gorillas. The country is also the stomping ground of a staggering array of microbial organisms and the region is well known as a wellspring of novel human pathogens, some with big household names and others little known. Some of these diseases, such as HIV/AIDS, have emerged as recognizably major pandemics; others, such as Ebola virus, have been limited to small, localized outbreaks; others still, such as the mosquito-borne Chikungunya virus, pose the risk of becoming new threats to global health.
Maryn McKenna has an unsettling and sobering article at Nature examining the the emergence of carbapenem-resistant Enterobacteriaceae. Since 2002, this large family of bacteria, gram-negative organisms that include many symbionts as well as the gut-dwelling Escherica coli and Klebsiella species that cause hospital infections, are increasingly in possession of a carbapenem-resistance gene rending our best antibiotics useless.
Microbial Misadventures is a recurring series on Body Horrors looking at instances and incidents where human meets microbe in novel and unusual circumstances that challenge our assumptions about how infections are spread.
Conjunctivitis is spread through particularly artful and gross means – the contamination of objects with eye gunk, smeared inadvertently hither and thither as a person wrestles with the itchy, gritty misery that defines what is commonly known as pinkeye. Many of us know that infectious diseases inevitably come from someone, some one, but we don’t often know from whom. Conjunctivitis is easy enough for the amateur Sherlock or epidemiologist-in-training – find the disconsolate soul with red, dripping eyes and follow the (sticky) trail.
“During her hospital stay, a total of 142 larvae were manually extracted, aided by the application of raw bacon which served as an attractant and petroleum jelly occlusion.”
You might be surprised to know that finding interesting articles on infections and infestations is a thankless and occasionally banal job. It is rare, as you find yourself trawling through the dusty and dense annals of Pubmed and Jstor, that you stumble upon a really good paper, the true gold twinkling among the pyrite of multisyllabic articles on viral proteomics, immunology and dull epidemiological trends in diseases. When you discover a treasure that renders you mute, like the one I recently discovered on a screwworm infestation that was wrangled by physicians with processed pork products, it’s like chancing upon a chupacabra in your backyard. The sight is both rare and awful, but also mesmerizing to behold. Also, you need to tell everyone about the chupacabra that you found.
Japan is in the midst of a rubella outbreak that has already infected over 5,000 people in just the first four months of this year. Since the early 2000s, the country has undergone cyclical five-year rubella epidemics, with community-wide outbreaks cresting in the spring and summer. But in the past two years the number of infections has surged dramatically from a hundred-odd cases every year into the thousands, and a weird epidemiological pattern has emerged thanks to a quirk in Japan’s vaccination policy in the 1970s: 77% of cases in the rubella outbreak have occurred in men over the age of 20 (1).
Rabies is one of mankind’s long-feared diseases. And rightfully so: for centuries, a bite from a crazed, slavering animal was almost always a guarantee of a slow warping of the mind and a pained, gruesome demise. A death sentence.