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Friday, December 16, 2005

Plague Time : The New Germ Theory of Disease

Plague Time : The New Germ
Theory of Disease by Paul Ewald


In Plague Time, Paul W. Ewald make a
large number of interesting and somewhat
surprising observations about diseases.
He uses what is called evolutionary
biology -- applying the principles of
evolution toward disease.

(Just as a side note, this is not
meant to have any religious implications.
I'm not familiar with the precise
arguements of intelligent design.
But I myself don't see a contradiction
between believing in God the Creator
as First Cause and evolution as one
of the mechanisms by which life here
on Earth -- however it started
originally -- has operated and still
operates.)

He puts forth a logical argument
for the true cause of chronic
diseases such as most all cancers,
strokes, heart disease and other
illnesses with associate with both
growing older and a generally
unhealthy lifestyle as being
diseases caused by infectious agents.

Preumably, if he could find, identify
and learn how to eliminate the
infections causing these diseases,
we would live much healthier, longer
lives -- no matter how poorly we ate
or how little we exercised or
otherwise took care of ourselves.

He actually does not say that, we're
left to draw that conclusion on our own.

One fundamental belief of biology
has been that pathogens inevitably
co-evolve into benign forms. The
assumption is that if a given microbe
or virus remains lethal, it will
eventually kill off all its host and
therefore will die off itself.

Ewald points out that evolution is
more complicated. Infections do
evolve in ways that promote their
long term survival. However, there's
a crucial variable -- if they make
someone extremely sick, can they
still easily jump from person to person?

Sick people tend to stay in bed away
from others. If they quickly die
without spreading, the disease will
remain limited -- such as Ebola.

If the disease can spread even when
it makes people extremely sick -- such
as mosquito-spread diseases such as
yellow fever, dengue and West Nile
fever, it has no evolutionary
motivation to evolve into a "nice" form.

One weakness of the book is that
it is almost all argument -- he has
no evidence that most of our chronic
diseases are caused by infectious
diseases. Basically, the book is a
call to fund the basic research.

He focuses on arguing against the
position that cancer, heart disease
etc are caused by bad genes. I agree
that genes are probably overrated.

But he writes little to demolish the
basic asumption of alternative health
that chronic diseases are caused by
poor diet, environmental poisons and
inadequate nutrition.

He does mention the belief of many
that these diseases are caused by
chronic inflammation. He says yes,
most of us do have chronic inflammation
and yet it is a cause of poor health.

But what causes the inflammation to
begin with? That's a sign that the
body is fighting an infection.

Of course, if you read THE ANTI-INFLAMMATION
ZONE by Dr. Barry Sears you get
a complete picture of how chronic
inflammation is caused by the way
so many of us eat far too many
carbohydrates than protein or
good fat.

Dr. Sears describes the resulting
imbalance of hormones and the chain
of bad effects on our bodies in
great biochemical detail.

Ewald does not address the role
of diet and nutrition in causing
chronic inflammation.

Unfortunately, some of his argument
is rhetorical. That is, he points
out examples where medical science
did ignore the infectious cause
of a chronic disease. Peptic
ulcers being caused by h. pylori
and cervical cancer in women
caused by the papilloma virus.

Then says that currently doctors
are ignoring similar examples.
Which of course he can't cite
because we don't have the facts
yet to cite.

It's possible he's right and maybe
we should invest much more
research into it, but right now
the facts don't support his contention.

One good thing about this book
is Ewald's propositions for
controlling infectious diseases.
He points out that we're not going
to eliminate most infectious diseases
(smallpox was the exception, not
the rule -- and we may still have
to deal with terrorist-unleashed
smallpox someday), so we should
do what we could to encourage
them to evolve into much nicer
organisms.

For instance, he cites how many
years ago the Tennessee Valley
Authority controlled malaria outbreaks
in the wake of the dams they built
in Arkansas. They simply forced
everyone in the area to live in
mosquito-proof homes (The TVA
supplied the screens).

Therefore, mosquito could not
bite people sick with malaria.
Therefore, the disease evolved
into organisms that allowed their
hosts to live, not die.

So he proposes that as a solution
to malaria in developing countries
in the tropics, where many people
still catch and die from it.

He also proposes that cholera and
other water-bourne diseases could
be controlled by make public water
safe -- as the United States did.

These sound like terrific ideas.
The only trouble is, the expense
of paying for them.

Those of you who've never travelled
in developing countries probably do
not realize how many people live in
shacks of wood boards or corrugated
iron -- with open windows, doors
and cracks between all the building
materials.

I once spent several nights with
friends in rural Thailand. They had
a very nice, concrete block modern
house -- with a wood door placed
sideways in the doorway to prevent
chickens from wandering in. Of
course mosquitoes had no trouble.

It'd be nice if they all could
move into houses with secure walls
and screened windows -- with indoor
plumbing with pure tap water.

But who's going to pay for this
for 1 to 2 billion people?

One point he made I really liked -- is
that if you have the cold or even
the flu and take over the counter
drugs which mask the symptoms so
that you carry on your regular
daily life -- you are spreading
your illness to other people.

He proposes that employers and
fellow employees enocurage people
who're sick to stay home instead
of going to work and spreading
infections to your co-workers.

He also suggests we ignore the
commercials inciting us to mask our
symptoms and then go out (and infect
others.)

He makes the simple hygienic point
and the evolutionary point -- that
is, if cold and flu viruses cannot
spread when they make us severely
ill, they evolution will favor
mutations that do not make us
feel so sick.

But as long as we continue to
spread these germs even though
they're making us severely ill,
we are encouraging their mutation
into more severe forms.

I would add to that point also that
it's healthier for you as a person
with a cold or flu infection to stay
home and rest and NOT mask the
symptoms, because they are your
body's efforts to rid itself of
the virus.

So you will get well faster if you
let your nose run!

And another thing you will not find
in this book -- solutions for you
as an individual.

If his thesis that most or all
cancers and heart disease etc are
caused by infections is true -- so
far, his arguments -- no matter
how compelling -- are all we have.

We don't know what those infections
are or how to fight them.

Until they are found and studied by
medical science, we as individuals
are still on our own.

You'll learn nothing in this book
about how to better safeguard your
own health.

Continue to follow all the rules of
good health and to keep your immune
system strong.

Also, although he may be correct
that whatever causes cancer and heart
disease is far more of a long term
risk to human health than any epidemic
acute disease (such as a bird flu
pandemic), we have to live through
the short term to reach the long term.

Therefore, you need to protect yourself
from bird flu.

And if Ewald is correct, strengthening
your immune system will also help to
protect you from almost all cancers,
strokes, heart diseases and more.