Nazi Mosquitoes?

When people discuss historical uses and development of biological weapons, much emphasis is rightly given to the Soviet, US, and Japanese bioweapon programs. However, there are some other efforts that are very notable but little discussed, including those of Germany.

While most know of Germany's efforts, led by Anton Dilger, to infect American horses bound for the war with glanders (in Baltimore) not much is known about further German efforts. There is a general consensus among scholars the German Chancellor Hitler's experience with chemical weapons as a solider in WWI largely biased him against chemical and biological weapons.

A recent news article, however, reports National Socialist Germany's efforts under Heinrich Himmler to use malaria-infected mosquitoes during WWII. The article reports that the mosquitoes were bread, but not deployed.

As a bioweapon during a war, I tend to think mosquitoes would be a poor choice given the unpredictability of their flight patterns which could easily place one's own soldiers at risk. Moreover, malaria is a treatable and recognizable condition making it less attractive. 

However, entomological warfare with the covert release of mosquitoes infected with, for example, dengue (as Fidel Castro accused were used against him) might work to create havoc and make a region inhospitable for living. As such, it is a concern that merits consideration.

Don't Fear the Leper

Leprosy, or Hansen's Disease, is a term that strikes fear into the heart of everyone, almost exclusively in those who know little about the disease. Since biblical times, lepers were casted outside of society and interaction with them was minimized. Leper colonies were created, even in the US. 

One of the most infamous of these colonies was on the island of Molokai in Hawaii. This colony, which was the result of a forced segregation policy, lasted for over 100 years until 1969. This colony has been the subject of at least two books and a film focused on the experiences of Father Damien, a  Catholic priest who resided there and ultimately became infected, was also made. I saw the film last night and found it interesting and instructive to those interested in the history of this disease.

However, leprosy is not easily spread between humans and since the 1940s--prior to the ending of forced segregation--effective antibiotic treatment has been available. In my experience, I have only known of one case in the Pittsburgh area in an immigrant, who did not spread it further. 

Like HIV thousands of years later, leprosy illustrates that fear of infectious disease has been a recurrent theme and will likely continue so long as novel infectious diseases continue to appear--a safe bet.

Your Friendly Neighborhood Live Vaccine

A really intriguing study suggesting a non-specific general health effect of live vaccines was just published in JAMA. 

The study compared a half million children immunized with the MMR vaccine as their most recent vaccine compared to DTap-IPV-HiB. The hypothesis tested was that MMR, with its live components, would have a non-specific immune enhancing effect due to greater immune stimulation than with the killed vaccine. To assess this the incidence of hospitalization for any infection was determined.

The researchers found a statistically protective effect (IRR 0.86) with those who received MMR as their most recent vaccine.

What this study may have uncovered is a non-specific immune boosting effect of live vaccines. If true, it may mean that live vaccines should be placed in the immunization schedule at the times most opportune to provent childhood morbidity, as suggested by an accompanying editorial.

Further, the animus that the anti-vaccine movement has against live vaccines has again shown to be completely unfounded and not reality based. 

Rat Bite Fever, Buyer Beware

A fatal--and rare--infection that killed a San Diego boy reinforces an important fact about infectious diseases: they are often zoonotic. A zoonotic infection is one that arises from a species jump. HIV is a zoonosis from chimpanzees, rabies is a zoonosis from dogs, and in this case, Rat Bite Fever is a zoonosis from rats. 

Rat Bite Fever is a rare illness caused by a bacterium known as Streptobacillus monilliformis and it is fatal in about 20% of cases. Plain penicillin is all that is needed to abort the infection, if the disease is recognized. 

Rats carry the bacteria without symptoms so it's not obvious if a rat is infected or not. As such, caution is advised when handling rats (use gloves), especially in those with an immunocompromising condition. 

This fatal case has sparked a lawsuit against Petco but I can't imagine they are unequivocally to blame for this tragic occurrence. 

Ghostbuster For Life

Although I had no personal connection with Harold Ramis, his recent death from autoimmune vasculitis is tragic to me. Mr. Ramis' work in Ghostbusters and Ghostbusters II affected me in an unequivocally positive manner. 

As a child growing up in a region rightly dominated with the likes of Terry Bradshaw, Franco Harris, Lynn Swann, Roberto Clemente, Willie Stargell, and Mario Lemieux, I longed to find heroes to whom I could fully relate. Of course Jonas Salk, Andrew Carnegie, Henry Frick, and George Westinghouse were also figures who loomed large, they were, however, from prior eras or not readily available. 

Onto the scene came Ghostbusters in 1984. While the premise of grown men fighting ghosts might seem silly, it was the romanticism of the movie that irrevocably captured me as 9 year old child. 

Scientists saving the world by using their extreme intelligence to face the unknown was something that totally captivated me. This was a world I wanted to (and want to) live in. I can remember scouring college catalogues looking for a "parapsychology" major. Even today, when I hear songs from the movie I can't help but feel admiration for the fictional heroes of the film (embarrassing confession: I get very psyched up when Bobby Brown sings "You try to mess with my boys, that's not legal" in the theme from Ghostbusters II)

In many ways, I believe my passion for infectious disease was--in some small part--motivated by a love for the movie. While microbes are real entities, battling them can be thought of in a similar vein as the travails of the Ghostbusters. 

As an infectious disease physician facing much less daunting tasks than the end of the world, I think of myself, perhaps foolishly, as being in the spirit of Dr. Egon Spengler, Dr. Peter Venkman, Dr. Ray Stanz, and Winston Zeddemore (paradoxically actor Ernie Hudson actually has a PhD). And, when I don my Ghostbusters t-shirts or my white coat--a few degrees less powerful and cool than a proton pack--I feel a kinship with 4 heroic characters that will be with me always.