“A lot kills, a little cures,” wrote the father of toxicology, and botulinum toxin is the poster child for this important pharmaceutical concept. Depending on the dosage and route, this potent bacterial toxin is either a devastating foodborne poison – one of the most deadly toxins known to man, capable of causing paralyzing death – or a wildly popular wrinkle antidote, harnessed and wielded in the pursuit of clearer skin.
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.
Flushing a vein with a liter of saline is standard protocol in clinics and hospitals. To receive fluids intravenously is an ubiquitous therapeutic, a common tool to alleviate many conditions, so standard that there are even businesses that offer an IV and a bag of saline as a cure for the common hangover.
Intravenous fluid resuscitation relies on the principle of replenishing our precious bodily fluids through delivery directly into the blood vessels, but where did this concept come from? How did a remedy that breaches the skin and veins, violating the sanctity of the human body to inject a liter of foreign substance enter the medical armamentarium? It has its origins in mankind’s quest to defeat a bacteria infamous for causing such prolific diarrhea that it causes fatal shock: cholera.
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.
The New England Journal of Medicine recently published a short letter on two cases of vaccine-derived polio infection that arose in a German pediatric cancer ward three years ago. Two severely immunocompromised girls from the Middle East – one from Libya and the other from Saudi Arabia – had traveled with their families seeking specialized medical treatment in Germany.
There’s nothing quite like syphilis. The sexually transmitted bug that sullied Christopher Columbus’ journey either to the New World or his return back to the Old – we’re still debating this grand chicken-or-egg epidemiological mystery – has deranged the minds of dictators and kings, was once a leading cause of committed hospitalizations to the psych ward, and even sparked fashion trends among members of the European royal courts who sought to cloak its debilitating, tell-tale symptoms (1).
One of the most iconic works in American art – the painting “Christina’s World” – currently hangs in the Museum of Modern Art in New York City as a prized piece of Americana and one of the museum’s most popular exhibits. In his artwork, Andrew Wyeth, a master of American realism, honors a dear friend, a woman who is today both an icon and a true medical mystery.
Conjunctivitis, that infamous, sticky-itchy-oozy infection of the eye, can strike anywhere and anyone. For the most part, however, pink eye sticks to its preferred domain, afflicting youthful targets in schoolyard haunts where the infection spreads from dirty little hand to once-clean little eye with the tenacity and enthusiasm of wildfire. Though wholly reliant on direct inoculation to the eyeball, it is easily transmitted, whether by the sticky digits of children unfamiliar with good hygiene or via errant eye gunk inadvertently smeared on a communal surface.
In fact, just over a half of the world has herpes.
Over the course of the last year, the WHO released two articles exploring the prevalence of herpes infection worldwide and offering some hard numbers for an often overlooked viral infection. The WHO study uses the most recent estimates from 2012 and is the first attempt to calculate and identify the preponderance of herpes in the global population (1). What they find is that herpes is dang near everywhere and infects dang near everyone.
They are considered the most noble creature to grace Earth. They have massive brains, complex forms of communication, the ingenuity for tool use, and the capacity to express emotions, including grief and empathy. Yet, as impressive as they are in size and majesty, elephants can still be felled by the most human of ailments: tuberculosis.
The early twentieth century was a period of frenetic drug development, a seemingly endless series of pharmaceutical and medical discoveries: antibiotics to treat bacterial infections, chemotherapeutics to battle cancers, and barbiturates to tranquilize anxieties, among many others. A huge number of these revolutionary medical treatments were discovered in the first half of the 1950s, an unprecedented era of advances in chemistry yielding a pharmacopoeia that would transform disease and the practice of medicine.
Authorities in Brazil have recently issued an unusual and unprecedented announcement to women: don’t get pregnant, at least not just yet. Amidst an intractable outbreak of the mosquito-borne Zika virus, public health authorities in Brazil are highly suspicious of an unusual surge of cases of microcephaly among newborn children.
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.
Sherlock Holmes is one of the most famous characters in English literature, revered by fans of mystery from Victorian London to the present day, where he is still celebrated for his keen eye, wealth of knowledge, and aptitude for deductive reasoning. Indeed, Holmes has grown in status from a protagonist in a magazine serial to a genuine pop culture icon; his adventures with Dr. Watson have been featured in fifty-odd short stories and four novels and over 220 films and television shows since his creation by the Scottish physician, ship’s surgeon, and author Sir Arthur Conan Doyle (1).
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)
Halloween is my favorite time of year, and my obsession with the queer and supernatural wonders of the natural world – namely horrifying parasites and bizarro infections – regularly overflows into the Body Horrors blog.
So in celebration of All Hallows’ Eve, a night of masquerade and devilry, I present a small selection – no small task, trust me! – of the more sinister and spine-tingling articles from the Body Horrors archives. All tricks, no treats! Enjoy.
The Pacific broad tapeworm thrives in the guts of the sea lions that frolic in the waves of the Pacific Ocean, has been identified in the preserved poop of Peruvians mummified some five millennia ago, and is now making its way to seafood-loving Europeans through the briny conduits of the world-wide commercial fish trade.
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.
Infectious diseases have long been the companions of war and natural disaster. For those that barely escaped death in the calamities of antiquity, walking away with what appeared to be a light injury, the agony of a gangrenous wound or convulsive, back-breaking muscle spasms would deal an impending final blow. For centuries, a dreaded complication from an innocent blister or a bullet wound was the untreatable and catastrophic tetanus, caused by Clostridium tetani.
It is common knowledge that the discovery of penicillin in the laboratory of Alexander Fleming radically changed the world of medicine and public health, allowing us to treat and cure once intractable and deadly bacterial infections. Less well-known is the winding road from discovery, past numerous roadblocks including production limitations and the second World War, to widespread use. A decade and a half of limited access to the world’s first antibiotic came to an end in 1943, when a prolifically moldy cantaloupe was purchased from a grocery store in Peoria, Illinois. We would double down in our battle against infectious diseases less than a decade later, when two female scientists inspired by the humble discovery of penicillin would identify the first known antifungal agent in the mucky soil of a Virginia dairy farm.
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.”
Smallpox has haunted man for almost as long as we have been walking this earth. The variola virus that causes the deadly pox had been known to liquidate entire communities, towns, and cities since antiquity, stalking along trade routes and capitalizing upon human behavior and patterns of movement. Egyptian mummies unearthed from their tombs bear the pocked faces of fortunate survivors; Chinese emperors, Indian peasants, Russian Tzars, and Australian Aborigines – around the world, millions succumbed to virus in the centuries before the discovery of an effective vaccine.
The mother gazes at her naked, lethargic infant, wan with a pustular red rash dotting his chest. She’s dressed in the fashion of the day: a high-necked black blouse with leg-of-mutton sleeves, a heavy full-length skirt, a formless red feather jutting from her hat. She holds a white handkerchief to her distorted scarlet face, one arm hanging limply at her side, seemingly in despair over the lamentable circumstances that have brought her to this bare waiting room.
It was the work of the lunar god, a “disease of the moon,” thought the Mesopotamians. The Romans attributed it to demonic possession. Priests and peasants in the Middle Ages considered the “falling sickness” a contagious evil.
Today our understanding of seizures and epilepsy rests not with lunar cycles or the supernatural, but with scientific insights into the developing brain and the pathologies of various diseases. We now know that there are over forty different disease processes that can cause the syndrome known as epilepsy, ranging from metabolic disorders to tumors, from trauma to congenital diseases.
The Nuremberg Code was drafted in 1947 following the appalling revelations of human experimentation committed in Nazi concentration camps. The overarching goal of the Code was to establish a set of rules for the ethical conduct of research using human subjects, guaranteeing that the rights and welfare of such participants would be protected. Two important principles guide and define this Code: the concept of voluntary, informed consent and that no experiment shall be conducted in which “there is an a priori reason to believe that death or disabling injury will occur.”
It seems to have started, as many things medicinal do, with Hippocrates. We may not understand precisely why, some 2000 years ago, the great Greek physician chose to insert the bladder of a pig into a patient’s chest and then inflate this porcine balloon. But it may have had something to do with tuberculosis and with the phenomenon of “pulmonary collapse,” which has had a surprisingly long and fruitful run in the annals of medical history.
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.
Ringworm is one of the most common and widespread childhood maladies. Deceptive in its naming, ringworm is no parasite but rather a fairly mild, though atrociously itchy, fungal skin infection that affects 300 million people worldwide. An infection with the contagious Tinea capitis fungus is usually summarily dismissed by means of antifungal medications, but for decades prior to the discovery of such cures in the 1950s, infections with ringworm and other species of fungus were as intractable and as challenging as their bacterial counterparts. The mid-twentieth century, as modern an era as it seems, marked the early days of effective antimicrobial treatments, and though practical pharmaceuticals for bacterial, viral, and fungal afflictions were on the horizon, they were still far from universally available.
The cells of our immune system are the guardians of the human body, forever contending with various unwelcome intruders from viruses to drugs to lowly yet painful splinters. They are as industrious as they are indispensable.
The plague is back, and this time it’s not thanks to far-voyaging ships or caravans traversing some distant trade routes, but to corn. This disease, caused by one of man’s oldest bacterial foes, Yersinia pestis, and spread by flea-infested rodents, is often overlooked in modern times in favor of more headline-grabbing epidemics like Ebola, HIV, and antibiotic-resistant STDs. But the plague has always kept close quarters with mankind and continues to surprise us with its adaptability.
Laissez les bons temps rouler! Tomorrow is the final and momentous hurrah of the Carnival season, which culminates with Mardi Gras, otherwise known as Fat Tuesday. In New Orleans, the city I call home, Carnival is a season of festivities, decadence, and tradition, one that is celebrated amongst neighbours and visitors alike. Our revelry is an egalitarian one – everyone is welcome to come witness and participate in Carnival. But, for over a century, just a couple of hours away from the Crescent City, there lived a community of exiles, quarantined and barred from society, who were forced to forge their own Mardi Gras traditions. In honor of the biggest party of the year, I’m republishing my article on the celebration of Mardi Gras at one of America’s last leper colonies, just a few hours up the Mississippi river in Carville, Louisiana.
The measles outbreak emerging from “the happiest place on Earth” in Anaheim, California, is grabbing headlines and provoking conversation in the media regarding how best to appeal to parents opposed to vaccines.
Using clear facts and appealing to common logic has failed, repeatedly. Blaming and shaming only seem to provoke heel-in-the-sand reactions and encourage retreat. So how does one persuasively sway opinion and convince the skeptics of the safety and utility of vaccinating against preventable diseases?
Abracadabra! Many of us are familiar with this mystical incantation. Its arcane staccato and euphonious intonation has become deeply ingrained in our language through the word’s use as a magical catchphrase. The hex was, in my childhood experience, rather useless when it came to opening locked cabinets and provoking instantaneous transformations; nothing was conjured and very little materialized except for my own disappointment. But millennia past, this word was held in reverence, and it was used for a whole other purpose altogether. Abracadabra was not a silly-sounding piece of magician’s gibberish, but the “most famous of the ancient charms or talismans employed in medicine” and a powerful invocation against a very specific and very dangerous curse: malaria.
In March of 1942, a young woman was dying of sepsis in a New Haven hospital. In just one day, she would be miraculously revived by a newly discovered experimental drug, seemingly by “black magic” as one consulting physician would mutter. The woman’s full recovery with the new antibiotic known as penicillin was the very first occasion of its usage in the United States and would jump-start the pharmaceutical industry’s interest in and manufacture of the drug (1).
Tensions can run high when living with roommates. Quibbles over dishes, the rent and utilities, and even questionable hygiene practices can inflame tempers and sabotage relationships, leaving passive-aggressive notes and broken homes in their wake. There are many ways of managing a good home life within a shared household of semi-strangers, but we’ll save that for another time in another column. This is about a roommate dispute gone totally to the worms.
The Hajj, the pilgrimage to Mecca by millions of Muslims from around the world, is one of the largest gatherings of man on the face of the earth. This annual event took place just last month with relatively little fanfare from the news media, which is, from an epidemiological standpoint, a very good thing. Every year, public health officials wring their hands at the thought of possible outbreaks caused by the global pathogen du jour capitalizing upon the convergence of millions of worshipers in the Saudi Arabian desert. SARS stole the headlines in 2009, Middle Eastern Respiratory Virus or MERS had it last year, and Ebola seemed a likely contender for this calendar year.
Chagas disease, caused by the protozoan parasite Trypanosoma cruzi, continues to make inroads in the United States and physicians are both unprepared to diagnose and under equipped to treat cases of the disease in their patients.
Chagas is a rare disease in the United States and has typically been associated with immigration from Central and South America, where the disease is endemic. The dynamics of the disease are changing, however, and strong evidence continues to emerge indicating that local infection is occurring among the American population, particularly in the southern states.
Mining is low on the list of enviable occupations. The hazards one faces when plying one of humanity’s most ancient professions, burrowing deep into the earth to harvest its hidden treasures in the form of precious stones and metals, range from grungy to downright gruesome. The occupation is widely considered to be one of the world’s most dangerous, and it was only in the 1950s that the mining industry in the United States finally saw fatalities due to accidents dip under a thousand a year (1).
Rose-thorn disease sounds like a malady of lovesick teenagers, an illness of romance reserved for budding Romeos and Juliets swooning from their first forays into passion and lovesickness, an affliction arising from the shocking stick and sting of heartbreak. The sweet name of this malady, however, in no way belies the actual crustiness of its symptoms.
Microbes are the omnipresent yet frequently unacknowledged adversary on the battlefield. Though microscopic in size, their very macroscopic effects can decimate armies, foil the best planned war initiatives, and change the course of history.
In the period October 1980-May 1981, 5 young men, all active homosexuals, were treated for biopsy-confirmed Pneumocystis carinii pneumonia at 3 different hospitals in Los Angeles, California. Two of the patients died. All 5 patients had laboratory-confirmed previous or current cytomegalovirus (CMV) infection and candidal mucosal infection. Case reports of these patients follow.
Last week, the State Department performed a small but smart gesture towards countering the continued outbreak of the Ebola virus in West Africa by releasing a video featuring President Barack Obama speaking to the people of Liberia, Sierra Leone, Guinea, and Nigeria.
This may come as a total shock, but pure forms of illicit drugs can be hard to come by. Certain controlled substances are frequently adulterated, if not outright contaminated, by products that range from the household to the industrial to the pharmaceutical. Of course, some substances are more easily, frequently, and profitably adulterated than others: cocaine purchased on the retail level is on average 31%, well, not cocaine, while the purity of heroin on the street is even lower, resting around 65% (1).
Unbeknownst to many of the public, August was National Immunization Awareness Month. I know, I know: it’s been overshadowed by some very exotic and thrilling headliners this month. The Ebola epidemic blazing defiantly in West Africa. The jaw-dropping videos shown on Discovery Channel’s “Shark Week.” The ALS Ice Bucket Challenge clogging everyone’s social feeds. Vaccines are just not as sexy or as flamboyant as these issues. Truthfully, they’re a bit dull to talk about, not a topic you would tend to bring up at cocktail parties or at the water cooler. Read More
Just as we jetsetters and nomads wander the wide world’s winding roads and byways by foot, on horseback, atop a bicycle or packed into an automobile, so too do infectious diseases make use of our ever-improving networks of thoroughfares. They ride along in human bodies, their journeys fueled by our social mobility and contact, two factors unavoidably intensified anytime we embark upon a voyage. But as these pathogens travel new routes and encounter new bodies, they can change and mutate. Luckily for researchers, by examining commonly traveled routes where we once naively believed that only humans trod, the active evolution and epidemiology of a pathogen can be revealed, providing insight into the development and patterns of disease affecting mankind.
In the twentieth century, men toiling in British and American coal mines relied on a primitive alert system for imperceptible dangers: the bright canary bird. Miners toted the caged birds into the depths of the earth to serve as early warnings against poisonous and potentially fatal gas leaks. If the tiny birds suddenly slumped in their cages due to the presence of odorless and colorless carbon monoxide, miners would beat a hasty retreat to safer, cleaner air.
Many pitfalls await the undergraduate in the laboratory. Bunsen burners! Liquid nitrogen! The slack work ethic of one’s peers! The dreaded group projects! But the most common risk budding researchers face are the rubber glove-donners themselves, perpetrator and victim rolled into one lab coat-wearing pipetter, armed and often dangerous with great knowledge but little know-how.
It’s one of the easiest ways to care for your health, a ritual we participate in daily: brushing those osseous outcroppings, our teeth. For those of us who heed the pleas of our dentists, flossing is a part of our routines, too. But the state of affairs of our glistening maws – the density of plaque, the presence of gingivitis, a full set of chompers – is important beyond mere aesthetics. Good oral fitness, particularly steps taken to limit the bacterial status quo, plays an important role in the goings-on of our body as a whole; a dirty mouth – and not the kind prone to sailor-like profanity – can provide important clues as to how susceptible you are to heart attacks and strokes.
Medicine is an imperfect science, its history shot through with barbaric and dubious practices from grave robbing to bloodletting. Since even before the time of that father of modern medicine, it can seem that physicians have more often violated Hippocrates’ decree “above all, do no harm” than abided by it.
“Water-borne pathogen.” Three gut-twisting words with enough power to make any epidemiologist, public health official, or globetrotting tourist double over. One of the most common forms of disease transmission is the microbial hijacking of our most precious fluid. This mechanism of infection is employed by a motley crew of microscopic organisms that have adapted to prey upon our unquenchable thirst, from pervasive bacteria like cholera and typhoid to often less famous but no less formidable parasites such as giardia and dracunculiasis.
Ask any political scientist: regime change has unforeseen consequences. The vacuum left in the wake of a collapsing leadership and the disorganization that follows, whether greeted with joy in the case of liberation or fear in the case of tyranny, brings unexpected change. For the central Asian states of the former Soviet Union in the early 1990s, among these aftereffects was the appearance of a curious and frightful little worm that saw, in the collapse of the monolithic political powerhouse, a bright opportunity for itself.
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.
Shout “fire” in a crowded room and watch the occupants fly for the exits. Speak the word “malaria” and watch as all within earshot reach for the nearest can of DEET. The incontrovertible fact of malaria’s relationship with mosquitos is one that has been known since Sir Ronald Ross discovered the parasite nesting within the belly of a mosquito in 1897. Such is the natural order, an incontestable necessity of the protozoan parasite’s life cycle. Humans, however, are rather adept at bucking that system – see cronuts, labradoodles, and the college bowl ranking system for examples. Also due to the interference of mankind, as a 1995 Taiwanese medical mystery proved, malaria can indeed be spread without the assistance of their obnoxious arthropod cronies.
Salmonella may well be one of the most disreputable microbes in Western society. It’s infamous for its food-poisoning capabilities and has a well known history of wrecking the bonhomous vibe following a good summer barbecue, not to mention its singular ability to cast a sickly shadow over the breathtaking bounty of an all-you-can-eat buffet.
The public health game is a tough one to play. How do you achieve educating and transforming the public’s behavior for the common good without coming off as a bully or dour spoil-sport? The stakes are impossible: The indifferent audience, the management of the reproachful “tsk-tsk, you should know better” tone, and there’s only so many ways to proselytize a message of “getting one’s act together.” And where’s the cash for such endeavors?
Hanuman is a pivotal and memorable character in the Hindu epic poem, the Ramayana. Known for his faithful devotion to Rama, the monkey-king is famous for rescuing Lord Rama’s bride Sita after she is kidnapped by the demon king Ravana, all the while defeating his demon army as commander of his monkey army. Hanuman is revered throughout south and southeast Asia not only for his devotion to Rama, but also for his steadfast spirit, his indefatigable strength, and his noble humility. He is also something of a rogue – the Coyote, the Loki, the trickster of Hindu mythology, the mischievous troublemaking deity with a heart of gold and a glint in his eye. Read More
Well, it’s here. The mosquito-borne chikungunya virus finally trekked its way into the Western Hemisphere, arrived in the Americas, and has begun infecting Caribbean mosquitoes, confirming one of the worst fears of public health officials on this side of the prime meridian. This pathogen, notorious for its explosive outbreaks and debilitating joint pains, arrived on the Caribbean island of Saint Martin and has caused over 200 infections since December 5 of 2013. The outbreak marks the first time that chikungunya has been locally transmitted by native mosquitoes in the Americas.
Successful World War II-era campaigns to eradicate dengue has kept the United States free from the mosquito-borne virus for almost forty years but the virus is making a comeback and we have globalization to thank: an increased flow in international travel to and from tropical destinations are causing isolated outbreaks in Hawaii, Texas, and Florida. Just last week, Texan public health officials confirmed 18 cases of dengue in the southernmost tip of Texas and a recently discovered case in Long Island, NY suggesting that the virus, dubbed “breakbone fever” for its excruciating aches and pains, is gaining an unwelcome foothold in the States.
The professional musician who follows her dream of performing on the stage is greeted by an array of unusual occupational hazards. These are not limited to those late night hours spent in bars exposed to cigarette smoke and aggressive groupies but the risks of carpal tunnel, hoarseness, hearing loss, and the longterm effects of strange sleeping schedules as well. For those that provide their marching bands, funk joints, and jazz ensembles with that crucial brass sound, however, they may be at additional risk from a tiny threat hiding within their very own instrument.
Our demons have their origins in our dread of death and the unknown. Today is Halloween, a time for costuming ourselves and confronting those fears (and, most importantly, for outsized consumption of sweets). For those of us celebrating Halloween disguised as vampires, werewolves and zombies, we owe a great debt to one of the world’s deadliest and most feared zoonotic viruses, rabies. This past summer I wrote about the fascinating microbial origins of some of our most enduring humanoid monsters in “The Bestial Virus: The Infectious Origins of Werewolves, Zombies & Vampires.”
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.
This past May I had the pleasure to chat with Desiree Schell of the radio and podcast show Skeptically Speaking about how infectious diseases and parasites can shape society for an episode examining the impact of science and medicine on specific communities. Over at their website, you can download the hour-long episode “Community Specific Science” featuring myself, Danielle Lee and Dr. Joe Henrich and hear more about how science journalism and the social sciences are investigating the ways in which the livelihoods and health of certain groups – delineated by ethnicity, culture or religion – are affected by scientific research and medicine. Lee speaks for the first third of the episode on the state of science coverage in media that serves minority audiences, while Henrich finishes the show with his research on cultural outliers, those societies not generally considered Western, Educated, Industrialized, Rich, or Democratic – what Dr. Henrich refers to as WEIRD – and the state of behavioral research.
Earth! Fire! Wind! Water! Heart! “Captain Planet and Planeteers” is a classic of 1990s television and may soon appear on the big screen as a live-action movie. The animated television series featured five earnest teenagers equipped with magical powers fighting eco-villains intent on destroying the ozone, rainforest and the wetlands and guided by the sage wisdom of Gaia, the spirit of Earth, and Captain Planet. Today, the program is recognized for its environmental “edutainment” pitch and the emerald-mulleted, square-jawed appearance of its titular superhero.
Today in The New York Times coverage of a report published yesterday on a Saudi hospital-borne outbreak of Middle East respiratory syndrome released by The New England Journal of Medicine, a potential epidemiological phenomenon was briefly addressed: men have made up the majority of infected cases and the low rates of infection among women may be due to an emphasis on the wearing of the face veil, known as the “niqab,” in Arab culture.
Spears. Bows and arrows. Swords. Guns. Bombs. Drones. Microbes. The evolution of weapons and forms of warfare shadows our technological advancements, from the field of metallurgy to that of microbiology.
Parasites and viruses once thought to make their homes exclusively in exotic locales beyond America’s borders are now gaining a foothold in the country and they are exacting significant economic tolls and placing heavy burdens on health care systems. Neglected tropical diseases such as cysticercosis, echinococcus, toxocariasis, dengue, West Nile virus and Chagas have found their way into the country due to a synergistic combination of factors, including globalization, migration, trade and climate change.
It is the 161th birthday of the German microbiologist Julius Richard Petri, whom we can thank for those low-tech but indispensable tools of the microbiology lab: the petri dish. Google honors Petri‘s birthday today with their lovely Google Doodle riffing on his invaluable discovery.
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.
I am partial to the odd tipple and, as a resident of the licentious, enabling city that is New Orleans, I’m fortunate to be adequately supported in my booze-seeking ways by the high number of bars and restaurants within stumbling distance of my front porch. But what to do for those of us prohibited from indulging in one of the world’s greatest mood modulators, for those of us, say, incarcerated in America’s prison-industrial complex? In that case, American ingenuity and tenacity wins, always: become a smalltime craft brewer and make your own.
This week, I was honored with a Best Life-In-Science Award from ScienceSeeker for my article on the earliest known cases of HIV/AIDS, “The Sea Has Neither Sense Nor Pity: the Earliest Known Cases of AIDS in the Pre-AIDS Era.” There were some serious heavyweight contenders in this inaugural contest and I am beyond delighted that this fascinating story was recognized. It’s nice to be acknowledged (and rewarded!) for work that is largely spent in loud cafes while drinking bitter espresso long gone cold and staring helplessly at my computer keyboard. Thank you to the judges – Fraser Cain, Maggie Koerth-Baker, and Maryn McKenna and to ScienceSeeker for this distinction and award.
The year 2018 has recently been declared our new target year for eliminating polio from the world by the World Health Organization, the Gates Foundation and Rotary International. It is clear that the next five years will pose no small challenge; we have spent over 60 years vaccinating millions of children and adults since Salk and Sabin’s discovery of viable polio vaccines, and we have long struggled in particular with three countries where the virus is endemic: Afghanistan, Pakistan and Nigeria.
A recently published paper in Scientific Reports has found that climate variability in the form of the North Atlantic Oscillation (NAO) has had a significant impact on the occurrence of disease outbreaks in Europe over the past fifty years. Researchers in France and the United Kingdom studied 2,058 outbreaks occurring in 36 countries from 114 infectious diseases from 1950 to 2009 and found that climatic variations and seasonal changes in air pressure across the continent attributed to the NAO influenced the outbreak occurrences of eleven diseases. Every conceivable route of transmission – by air, food, water and vector – was influenced by NAO conditions.
Everyone has their own collecting quirk. I myself collect animal skulls, inconveniently large earrings and unusual stories of infectious disease cases and outbreaks. To each their own, yes? I’ve decided that, instead of stockpiling these stories away in some recess of my brain, I’ll be sharing them online in a new recurring series on Body Horrors called Microbial Misadventures.
One of the hardest questions to answer in an infectious disease outbreak investigation is “Why?”
Why then? Why there? These questions can be almost impossible to answer – not only because of their heady metaphysical nature but also because of the difficulty of assessing the minute interactions between microbe, environment and human host. Public health officials are often left shrugging their shoulders, half-heartedly admitting to an unsatisfied public that they just don’t know and indeed may never know, later drowning their sorrows in dark and smoky bars with cup after cup of the metabolic waste products of unicellular fungi.
April! We’ve passed the vernal equinox and spring is springing, flowers are blooming, we’re shedding our sweaters and jackets and all will be warm once again. We can put our winter blues to rest and bask in the knowledge that summer will soon be upon us.
Hey ya’ll! Welcome to Body Horrors at Discover! My name is Rebecca and I am a microbiologist-epidemiologist-public health scholar, your modern Renaissance lady. For my graduate dissertation two years ago, I began Body Horrors as an experiment in writing about the public health of infectious diseases and parasites – an experiment that is still running today, a carefully cultured organism that’s constantly evolving and growing. I am delighted to have been invited by the lovely people at Discover to join a crew of great science bloggers and to see what becomes of this fanciful blogging organism.
Much of the United States is mesmerized by the belligerent squawks from North Korea’s Kim Jong-un and the volatile tension straddling the Korean peninsula, but I’m more concerned about what is happening in China right now and the troubling trickle of news on a new bird flu strain H7N9.
If you ever find yourself working in an infectious disease laboratory, whether it’s of the diagnostic or research variety, the overarching goal is not to put any microbes in your eye, an open wound or your mouth. Easy enough, right? Wear gloves, maybe goggles, work in fume hoods and don’t mouth pipette. When working with pathogenic bacteria and viruses, priority number one is Do Not Self-Inoculate.
Just two months ago, I had the distinct pleasure of acting not as a science scholar but as a research participant. Instead of having my face in a book, I willingly offered it to a woman who diligently scraped my forehead in search of Demodex mites. I know that it’s everyone’s humble dream to contribute their own exquisite arachnological flora to Science with an S and so, yes Reader, I can feel your oozing envy.
Two recent studies that shed light on the inner workings of our bacterial ecosystems, otherwise known as our microbiota, have me musing on the nature of disease and pathology, of harmony and balance.
The Wall Street Journal has a superb write-up of a Nepalese man infected with extremely drug resistant tuberculosis (XDR-TB) who is currently detained at the US border in South Texas. XDR-TB is resistant to four of the major types of antibiotics that are used to treat and control TB infections and this man is the first person with this particularly dangerous strain of TB to cross the border and be quarantined in this country (1).