Artifact 7

Corey Johnston

3/31/19

BI-245X-01

Tuberculosis: The Forgotten Plague

Tuberculosis is an infectious disease that is lethal if left untreated. According to Irwin Sherman, “tuberculosis is not only an infectious disease, but a societal one as well.” Unfortunately, millions of people have died due to the continual spread of this disease, and if matters aren’t treated more seriously, this disease will continue to take its toll on society, particularly in poor countries. In poor countries, with limited resources, risk of contracting TB is substantially high. Without the proper medical supplies, drugs, and sanctuary that hospitals give, contracting tuberculosis will be deadly. It will spread from person to person, and won’t back down. This is the unfortunate truth people in this world must realize. Without educating poor countries of this disease and up-regulating medical spending and research, tuberculosis will continue to cause devastation in places around the world.

In the 1800s, in Western Europe, people believed that those with tuberculosis were beautiful and erotic. It is believed that tuberculosis produces a sense of euphoria, increased appetite, and a strong sexual desire. It led to “extreme thinness, long neck and hands, shining eyes, pale skin, and red cheeks. All of this stigma behind the unknown disease increased TB’s spread through western Europe. Little was understood at the time and these people drowned in their own blood because of this disease.

In the 19^thcentury, as immigration to the United States had begun to boom, so did the “boom” of TB. Improper use of ventilation systems allowed for TB to take a huge spread in urban areas. “As more and more impoverished immigrants arrived in the United States, they were forced to live crowded together in these miserable tenements.” These places usually housed about 8 to 10 people and in filthy conditions. The lack of ventilation helped the spread of pulmonary TB in the United States. Much of this spread however was placed on the Jews and was used as an anti-Semitism tool to justify the spread of the disease. Many Jews were poor, malnourished, and living in terribly crowded spaces and so many of these people became infected with this disease and were put to blame.

Later in the century, it was found that the microbes that cause this disease are called mycobacteria. It is an opportunistic infection, meaning it takes advantage of certain poor health situations of its host, e.g., people with AIDS. People who have contracted AIDS, are at higher risk of this disease and it becomes very hard to treat at that point. As a treatment method, people were isolated from their families in order to recover and prevent the spread. At a minimum, people are isolated for 6 months, and could be treated for up to several years. Because of being isolated, and the feeling of being outcasted from the community, there became a social stigma with developing tuberculosis. People soon began to not want to get treated because of the fear of being an outcast or isolated from all family members and friends. The consequence to this is that it led to the continual spread of this silent disease.

Also, as TB continues to spread and drugs are made to stop this spread, the disease became clever and developed a drug resistance and demolished any hope of being treated. These diseases emerged, as treatments became available and used to save many. They emerged in order to remain alive and viable. Just as people develop certain antibodies for diseases, diseases mutate in order to survive, as did TB. There are two types of drug resistant TB. The first is MDR-TB, multi-drug resistant TB. This disease requires more drugs to cure the patient, a lot of times resulting in death and other complications. The second is the more severe case, called XDR-TB, or extensively drug-resistant TB. This disease offers little hope of a cure, and the justification for many, of feeling hopeless, and that no person wants to spend a life with them.

Tuberculosis, as well as its drug resistant strains, require the attention of many to conquer the disease. In order to achieve a TB “free” world, there needs to be a greater attention to the struggle. People in poor countries can neither access nor afford medical aid for this disease. Also, preventative care is not even offered in “high-burden countries”. Thirdly, research and development is severely underfunded. Lastly, this situation needs to be taken seriously by political figures and financial investors if any of this is going to take place. The priority needs to be a person and family-centered service to all who have contracted this disease so that spreading this disease is halted. This strategy is plausible, and if people want to stop the unfortunate truth that this disease offers, then steps need to be taken in order to save the lives of millions.

Artifact 6

Corey Johnston

3/17/19

BI-245X-01

The Irish Potato Famine and How Molecular

Technology Has Saved the Lives of Millions

During the period from 1700 through 1840, the overall population in Ireland grew tremendously. However, as the population increased and economic tension grew with England, Ireland was on the verge of a devastating disaster. Land owners often took advantage of people by offering high wages for small pieces of land. Crops were often taken away from Ireland’s growing population and were forcefully sent to England. Also, as population grew, living conditions deteriorated and housing became troublesome. All of these factors increased the need for the potato. This crop was essential to Irish dwellers because of its high nutritional value. Oftentimes, people relied solely on potatoes and milk for their source of nutrients. This crop was so essential that, by the early 1840’s, about half of Ireland’s population relied solely on this crop. In 1846, the Britain’s Parliament reduced British financial commitment to Ireland as well. During the years of 1845 to 1852, blight caused the escalating downfall of potato production. The potato blight was caused from a fungal-like organism called Phytophthora infestans. This organism was found to be originated from North America and brought back to Europe during trade in the form of the strain, HERB-1. By 1846, three-quarters of the potato crop was lost to the blight. Infection of the crop spread from plant to plant through microscopic spores that took passage in the wind and rain caused them to stick to the leaves of the potato. The fungus has tube-like threads that insert themselves into the plant and basically suck the nutrients out of the plant until it withers. The potato blight resulted in millions of deaths, from starvation, disease, or the journey to America, which was inquired by a lack of food and poor health. This emigration to North America was so disastrous that people often referred to these ships as “coffin ships” because of the many deaths that took place on them. Population fell by about 20 and 25%. As a result of malnutrition and terrible living standards, people became very vulnerable to many infectious diseases. Diseases such as measles, diarrhea, tuberculosis, whooping cough, and cholera began to take its toll on the many souls that were able to push through the famine. Without the development of molecular innovation, diseases like such would still be spread worldwide.

As mentioned above, molecular technology led to reduction of famines, insect vectors for diseases, as well as innovative production of human embryos. CRISPR is an innovative modification that allows for the substantial growth of crops across the world. Food sources, such as salmon are genetically modified and result in the faster production, as well as larger growth of these fish. This, in turn, allows the ever-growing population to have the availability of more food for nutrition. Also, genetically modified crops, such as corn and potatoes have been engineered to resist certain fungi and are rapidly produced to maintain such large populations around the world. Gene drives have been put in place to reduce the number of insect vectors made available to the world. Many species of insects have been wiped out completely to reduce the number of insect-spread diseases. Many ethical implications have been surrounded by the idea of the riddance of certain mosquito species as there has not been a solution to whether these insects impact the environment in a positive way. A recent scientist developed babies using genome editing to resist infections by HIV. These just go to show the technological advances humans are making to resist disease and outlast overpopulation. There are also certain risks that are involved in these advances. There has not been any evidence to show the negatives to gene-modification of crops and so this poses as a potential threat to society. Also, in gene drives, people do not always know environmental implications of getting rid of certain species, and so this also poses as a threat. Lastly, genome editing is such a new topic, that there is no information of long-term illnesses that could arise from them. All of these things however have been used in society to better the world, and as of now have rid the world of many diseases.

Artifact 5

Corey Johnston

3/10/19

BI-245X-01

Ethical Implications Surrounding Medicine

and Society’s Perception of Medical Professionals

Throughout history, there have been many situations regarding unethical circumstances in practicing medicine. This was flagged at the end of WWII in the Nuremburg Trials. Since, there have been ethical codes which medical professionals must follow in order to take part in things like clinical trials or clinical studies. Much of these codes came not only from Nazi experiments during WWII, but from experiments such as those in the Tuskegee Syphilis Study. There are also a number of ethical issues surrounding infectious diseases, such as vaccinations, along with population biases to certain ethnicities. The consequences of these unethical studies in regards to gender, race, and social status, have all impacted societies trust in medical studies as well as medical professionals.

There have been many ethical issues when dealing with infectious diseases. In an article by Heather Ann Thompson, she writes that in many prisons, such as Attica, doctors have performed many disgusting, under-the-table experiments on prisoners, whom “happily” volunteered for his or her study. At Attica, the medical professional there asked for volunteers to perform in an experiment where he would be ultimately presenting these prisoners with leprosy. For many, the answer was yes, simply because it was an easy way to get money while incarcerated. Little is known to what extent these prisoners were told the full story behind the experiment, but it is known that the doctor was influencing these prisoners with an awful and disfiguring disease in that of leprosy. There have been many unethical studies in regards to infectious disease, far beyond those of these prison experiments. This has been a custom for many centuries, as many doctors want answers to certain diseases, losing sight that we are all human, and no matter what race, social background, or stage we are in life, we all deserve the same rights as people and deserve to be treated as such.

The Tuskegee experiment is one of the prime examples of unethical studies being conducted in the United States, during a time of civil reform. Individuals in this study were not given details about the nature of the study, but were simply told that they would be treated for syphilis, but in fact were not. Government doctors in the US public health services supposedly wanted to learn whether syphilis showed different symptoms in different races. They targeted older, black males, who were not economically stable. They told these individuals that they had “bad blood” and “this was their last chance for special treatment”. These doctors broke the Nuremburg Code which was developed after the study had started. Also, even after penicillin was found to be the cure for syphilis, and these individuals sought help from other professionals, they were quickly re-directed back to the study and told that they were getting the help that was needed. This ties in with the issue of informed consent in today’s society. That people who are being put in clinical studies/trials are to be informed of the nature of the study and each study has to have a set of guidelines for participants to follow. This study ended after 50 years, when a press release of the study was informed to the public. All that was owed to the participants was a “lump sum” of $38,000. For all of the pain and suffering that these individuals faced over the course of these experiments, surely, they deserved more. Also, this does not even consider the people who died because of the experiment/ “study”. There has also been reports of unethical studies as shown in the Guatemalan venereal disease study. US government researchers and their Guatemalan colleagues experimented without consent on more than 5,000 Guatemalan soldiers, prisoners, people with psychiatric disorders, orphans, and even prostitutes. They exposed 1,308 adults to syphilis, gonorrhea, or chancroid. This is another prime example of why ethical panels are used in today’s medical studies, to prevent awful acts of humans such as these.

All of these unethical studies have had a huge impact on how people perceive medical professionals in today’s society. Unethical experiments such as those listed above have caused a mistrust in medical professionals worldwide and nationally. Prime examples are shown in the Tuberculosis outbreak in Alabama, where people lost trust in doctors and thought that they would be ostracized if seen by doctors. These people say, “I don’t want nobody knowing my business”. This is the stigmatism of that area and has been that way since word of unethical practices have been released. Also, after the Tuskegee Syphilis study was released to the public, many people, especially those in the black community, did not want to rely on medical help simply because they could not trust doctors to treat them with respect and could not ensure that doctors wanted to help their patients. This has caused the mistrust in medical professionals around the US for a long time, and a prime reason that clinical trials suffered to achieve many volunteers for a long time. Until people start to find trust in medicine, this will be a issue for a long time to come, especially in regards to vaccination.

Artifact 4

Corey Johnston

3/3/19

BI-245X-01

Smallpox: Jenner’s Role and Eradication

For many centuries, smallpox took a devastating tole on the human race. It led to the death of hundreds of millions of people. Many people took to futile remedies consisting of bloodletting, leaches, fasting, laxatives, purgatives, and diuretics. Others included heat or sweat therapy, or even cold therapy. Many people took to worshipping Hindu gods and goddesses such as the Hindu goddess, Shitala, to help prevent or even to cure smallpox. The Chinese took to nasal insufflation, which involved putting crusts into the nose of people. The Moslem approach involved a term called variolation or inoculation. Here, a needle probed the patient resulting in a few pustules developing. This approach was advocated by people such as Lady Mary and even Voltaire, “for the sake of staying alive and keeping women beautiful.”

“Smallpox was indiscriminate, with no respect for social class, occupation, or age; it killed or disfigured princes and paupers, kings and queens, children and adults, farmers and city dwellers, generals and their enemies, and the rich and poor.” This was the inevitable result for many, until Edward Jenner took part in the story and changed history. In 1789, Jenner conducted an experiment to investigate the stories of milkmaids being “immune” to smallpox. Here, he gave his son swinepox, and later inoculated his son with smallpox, and to his relief, his son did not show any smallpox symptoms. Therefore, Jenner assumed that since there was no symptoms, cowpox must have conferred immunity to the smallpox. This was the breakthrough that this world needed.

However, there were many reactions to Jenner’s discovery, some good, and some bad. There were social objections that included the loss of fees for inoculators, and the idea that smallpox reduced the poor population. There were people with religious objections who thought that the discovery was an interference with God’s plan. There were also scientific objections to include: objections of the safety of the vaccine; that the source of the vaccine is from and animal’s disease; and the unknown duration of immunity was not known. Originally, the method used for propagation of the vaccine included an arm-to-arm method. This, however, led to the possibility of spreading other blood diseases, such as hepatitis and syphilis, both of which were detrimental without a treatment. The benefits of getting the vaccination is that it decreased the risk of getting smallpox entirely, as well as increased the chance for herd immunity, that is, those who did not get vaccinated could become masked from the disease by those who did get vaccinated.

The years preceding the discovery of Jenner, proved to have its difficulties as well. In England, vaccines were compulsory and this was quickly protested. Louis Pastuer came up with the term of vaccination after a discovery of vaccine for chicken cholera. Leicester became a site where compulsory vaccination laws were frowned upon. Also, there was a radical experiment in Leicester, where patients were isolated, contacts were quarantined, mandatory notifications of cases, all of which foreshadowed “selective epidemiological control”. After protests, parents allowed for conscientious objection to vaccines.

In the coming years, progress was made. The global war on Smallpox was led by the World Health Organization Smallpox Eradication Program, which focused on a Global effort to improve international reporting and the production of international reference labs to monitor vaccine quality. Intensive searches for smallpox were carried out, and in 1980, the World Health Organization certified that Smallpox had been eradicated from the world.