Plague Time: The New Germ Theory of Disease

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Plague Time: The New Germ Theory of Disease
Plague Time, The New Germ Theory of Disease Ewald.jpeg
Author Paul W. Ewald
LanguageEnglish
Subject Evolutionary biology
Publisher Anchor Books
Publication date
January 8, 2002
Pages282
ISBN 978-0385721844
616.07

Plague Time: The New Germ Theory of Disease is a non-fiction book by evolutionary biologist Paul W. Ewald. It argues that the role of pathogens has been overlooked in medicine, as a primary cause of many chronic diseases. It is his second book, following Evolution of Infectious Disease in 1994.

Contents

Collecting accounts from medical history, Ewald describes the ways in which infectious agents are underestimated, in favour of genetic or environmental causes of disease. As an evolutionarily biologist, he takes the long-term perspective of the virus or bacteria circulating in its lifecycle. Although much is known about the acute phase of infections, he argues we have systematically overlooked the medical effects of long-term infections. [1]

Overview

Part I: A sphere of infection

In part one, Ewald describes the lifecycle of different viruses, and the way this can manifest in medical disease. Respiratory viruses must spread between people in a short period of time before the immune system response, while sexually transmitted infections must maintain a longer lifespan in the human body, sometimes for one’s entire life. He also compares the trade-offs in lifecycle of diarrhea-born, vector borne, and hospital acquired infections.

Ewald argues against the aggressive application of the Koch postulate, which establishes a very high burden of proof for establishing an infectious cause for a disease. It is difficult to link an individual virus to a disease that manifests some decades later. He describes signs of arteriosclerosis first appearing asymptomatically in teenagers. He describes research linking T-cell Leukemia, to an infection in mothers milk, without manifestation until adulthood.

From an evolutionary point of view, genetic causes of chronic disease on their own, should be selected against in evolution. Likewise, twin studies should be much more compelling, and are not. Large exhaustive research projects like the war on cancer have also come up short. The onset of many diseases today is thought to be a combination of lifestyle and bad luck. Regarding diseases as part of a larger, stealthy, and patient lifecycle may be an opportunity to make progress against illnesses that have stymied research under other perspectives.

Part II: Infectious threats now

In part two, Ewald criticizes contemporary medical research for focusing on risk factors such as lifestyle and nutrition, and failing to see how these risk factors contribute to the lifecycle of an infectious agent.

He also describes the search for the origin of the AIDS virus, and outlines the now discredited [2] [3] theory of an accidental origin in the 1950s polio vaccine.

Part III: Beyond the fear of infection

Although there have been some great successes in eradication campaigns, Ewald describes ways in which some interventions against pathogens may select for more harmful effects in the long term.

Instead of eradication, he favours strategies that push pathogens to become more benign. In HIV and Malaria for example, he describes how mosquito-proof housing functions to keep the very sick away from vector transmission, while allowing the more benign variants to spread. Similar effects are seen in cholera with water sanitation projects - new variants appear with less motivation to cause harmful diarrhoea symptoms.

He cites examples of the most aggressive sexually transmitted infections appearing during times of warfare, exactly when an aggressive strategy most benefits the pathogen. Mitigating the effects of infectious disease should involve shaping an evolutionary strategy for variants that do less harm. Likewise, vaccines should be designed to select for only the most dangerous properties of a pathogen, and serve to benefit benign variants of it.

Related Research Articles

<span class="mw-page-title-main">Infection</span> Invasion of an organisms body by pathogenic agents

An infection is the invasion of tissues by pathogens, their multiplication, and the reaction of host tissues to the infectious agent and the toxins they produce. An infectious disease, also known as a transmissible disease or communicable disease, is an illness resulting from an infection.

<span class="mw-page-title-main">Pneumonia</span> Inflammation of the alveoli of the lungs

Pneumonia is an inflammatory condition of the lung primarily affecting the small air sacs known as alveoli. Symptoms typically include some combination of productive or dry cough, chest pain, fever, and difficulty breathing. The severity of the condition is variable.

<span class="mw-page-title-main">Epidemic</span> Rapid spread of disease affecting a large number of people in a short time

An epidemic is the rapid spread of disease to a large number of hosts in a given population within a short period of time. For example, in meningococcal infections, an attack rate in excess of 15 cases per 100,000 people for two consecutive weeks is considered an epidemic.

<span class="mw-page-title-main">Koch's postulates</span> Four criteria showing a causal relationship between a causative microbe and a disease

Koch's postulates are four criteria designed to establish a causal relationship between a microbe and a disease. The postulates were formulated by Robert Koch and Friedrich Loeffler in 1884, based on earlier concepts described by Jakob Henle, and the statements were refined and published by Koch in 1890. Koch applied the postulates to describe the etiology of cholera and tuberculosis, both of which are now ascribed to bacteria. The postulates have been controversially generalized to other diseases. More modern concepts in microbial pathogenesis cannot be examined using Koch's postulates, including viruses and asymptomatic carriers. They have largely been supplanted by other criteria such as the Bradford Hill criteria for infectious disease causality in modern public health and the Molecular Koch's postulates for microbial pathogenesis.

<span class="mw-page-title-main">Germ theory of disease</span> Prevailing theory about diseases

The germ theory of disease is the currently accepted scientific theory for many diseases. It states that microorganisms known as pathogens or "germs" can cause disease. These small organisms, too small to be seen without magnification, invade humans, other animals, and other living hosts. Their growth and reproduction within their hosts can cause disease. "Germ" refers to not just a bacterium but to any type of microorganism, such as protists or fungi, or other pathogens that can cause disease, such as viruses, prions, or viroids. Diseases caused by pathogens are called infectious diseases. Even when a pathogen is the principal cause of a disease, environmental and hereditary factors often influence the severity of the disease, and whether a potential host individual becomes infected when exposed to the pathogen. Pathogens are disease-carrying agents that can pass from one individual to another, both in humans and animals. Infectious diseases are caused by biological agents such as pathogenic microorganisms as well as parasites.

In biology, immunity is the state of being insusceptible or resistant to a noxious agent or process, especially a pathogen or infectious disease. Immunity may occur naturally or be produced by prior exposure or immunization.

Virulence is a pathogen's or microorganism's ability to cause damage to a host.

Mycoplasma pneumonia is a form of bacterial pneumonia caused by the bacterium Mycoplasma pneumoniae.

Paul W. Ewald is an American evolutionary biologist, specializing in the evolutionary ecology of parasitism, evolutionary medicine, agonistic behavior, and pollination biology. He is the author of Evolution of Infectious Disease (1994) and Plague Time: The New Germ Theory of Disease (2002), and is currently director of the program in Evolutionary Medicine at the Biology Department of the University of Louisville.

<span class="mw-page-title-main">Opportunistic infection</span> Infection caused by pathogens that take advantage of an opportunity not normally available

An opportunistic infection is an infection caused by pathogens that take advantage of an opportunity not normally available. These opportunities can stem from a variety of sources, such as a weakened immune system, an altered microbiome, or breached integumentary barriers. Many of these pathogens do not necessarily cause disease in a healthy host that has a non-compromised immune system, and can, in some cases, act as commensals until the balance of the immune system is disrupted. Opportunistic infections can also be attributed to pathogens which cause mild illness in healthy individuals but lead to more serious illness when given the opportunity to take advantage of an immunocompromised host.

Gregory M. Cochran is an American anthropologist and author who argues that cultural innovation resulted in new and constantly shifting selection pressures for genetic change, thereby accelerating human evolution and divergence between human races. From 2004 to 2015, he was a research associate at the anthropology department at the University of Utah. He is co-author of the book The 10,000 Year Explosion.

<span class="mw-page-title-main">Vertically transmitted infection</span> Infection caused by pathogens that use mother-to-children transmission

A vertically transmitted infection is an infection caused by pathogenic bacteria or viruses that use mother-to-child transmission, that is, transmission directly from the mother to an embryo, fetus, or baby during pregnancy or childbirth. It can occur when the mother has a pre-existing disease or becomes infected during pregnancy. Nutritional deficiencies may exacerbate the risks of perinatal infections. Vertical transmission is important for the mathematical modelling of infectious diseases, especially for diseases of animals with large litter sizes, as it causes a wave of new infectious individuals.

Community-acquired pneumonia (CAP) refers to pneumonia contracted by a person outside of the healthcare system. In contrast, hospital-acquired pneumonia (HAP) is seen in patients who have recently visited a hospital or who live in long-term care facilities. CAP is common, affecting people of all ages, and its symptoms occur as a result of oxygen-absorbing areas of the lung (alveoli) filling with fluid. This inhibits lung function, causing dyspnea, fever, chest pains and cough.

Artificial induction of immunity is immunization achieved by human efforts in preventive healthcare, as opposed to natural immunity as produced by organisms' immune systems. It makes people immune to specific diseases by means other than waiting for them to catch the disease. The purpose is to reduce the risk of death and suffering, that is, the disease burden, even when eradication of the disease is not possible. Vaccination is the chief type of such immunization, greatly reducing the burden of vaccine-preventable diseases.

<span class="mw-page-title-main">Medical microbiology</span> Branch of medical science

Medical microbiology, the large subset of microbiology that is applied to medicine, is a branch of medical science concerned with the prevention, diagnosis and treatment of infectious diseases. In addition, this field of science studies various clinical applications of microbes for the improvement of health. There are four kinds of microorganisms that cause infectious disease: bacteria, fungi, parasites and viruses, and one type of infectious protein called prion.

<i>Evolution of Infectious Disease</i>

Evolution of Infectious Disease is a 1993 book by the evolutionary biologist Paul W. Ewald. In this book, Ewald contests the traditional view that parasites should evolve toward benign coexistence with their hosts. He draws on various studies that contradict this dogma and asserts his theory based on fundamental evolutionary principles. This book provides one of the first in-depth presentations of insights from evolutionary biology on various fields in health science, including epidemiology and medicine.

<span class="mw-page-title-main">Sexually transmitted infection</span> Infection transmitted through human sexual behavior

A sexually transmitted infection (STI), also referred to as a sexually transmitted disease (STD) and the older term venereal disease (VD), is an infection that is spread by sexual activity, especially vaginal intercourse, anal sex, oral sex, or sometimes manual sex. STIs often do not initially cause symptoms, which results in a risk of transmitting them on to others. The term sexually transmitted infection is generally preferred over sexually transmitted disease or venereal disease, as it includes cases with no symptomatic disease. Symptoms and signs of STIs may include vaginal discharge, penile discharge, ulcers on or around the genitals, and pelvic pain. Some STIs can cause infertility.

In biology, a pathogen, in the oldest and broadest sense, is any organism or agent that can produce disease. A pathogen may also be referred to as an infectious agent, or simply a germ.

<span class="mw-page-title-main">Infectious diseases (medical specialty)</span> Medical specialty dealing with the diagnosis, control and treatment of infections

Infectious diseases (ID), also known as infectiology, is a medical specialty dealing with the diagnosis and treatment of infections. An infectious diseases specialist's practice consists of managing nosocomial (healthcare-acquired) infections or community-acquired infections. An ID specialist investigates and determines the cause of a disease. Once the cause is known, an ID specialist can then run various tests to determine the best drug to treat the disease. While infectious diseases have always been around, the infectious disease specialty did not exist until the late 1900s after scientists and physicians in the 19th century paved the way with research on the sources of infectious disease and the development of vaccines.

The following outline is provided as an overview of and topical guide to concepts related to infectious diseases in humans.

References

  1. Reed, Mike (February 7, 2001). "Ewald introduces new germ theory of disease". The Amherst Student. Amherst College.
  2. Hillis DM (2000). "AIDS. Origins of HIV". Science. 288 (5472): 1757–1759. doi:10.1126/science.288.5472.1757. PMID   10877695. S2CID   83935412.
  3. Birmingham K (2000). "Results make a monkey of OPV-AIDS theory". Nat Med. 6 (10): 1067. doi: 10.1038/80356 . PMID   11017114. S2CID   10860468.