January 10, 2018 • 28 mins
Tuberculosis is often thought of as a disease of the past, but it remains a problem in many parts of the world. Microbiologist and author Kathryn Lougheed joins Holly for a discussion of TB’s long history and the need to address it in the modern age.
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Episode Transcript
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Speaker 1 (00:01):
Welcome to steph you missed in history class from how
Stuff Works dot Com. Hello, and welcome to the podcast.
I'm Holly Fry and I'm Tracy V. Wilson. So, like
months and months ago, like the beginning of our colleague
Julie put a book on my desk titled Catching Breath
(00:24):
and Making an Unmaking of Tuberculosis, and I was so
excited about it that it became comical in the office.
I think my actual immediate reaction was, we have to
have this author on because so many great people died
from TV, which I know is not the most respectful
way to look at it, but I was really excited
about this book. When I was a child, I was
afraid of tb because my grandmother, long before I was
(00:46):
born or my mother was born, and my grandmother was
a child, she had to live in a tuberculosis sanatorium
for a while because she had TV. And I like
heard this story and in my child mind, like TV
became a thing that my consume Me yeah, and I
like that, was afraid of that, and I was afraid
of dying in childbirth for some reason. With the good
(01:09):
news is you don't how to do either of those things. Um,
and it turns out that this book is also a
delight to read. So if you're concerned that a book
about a medical thing in history might be dry or boring,
it is absolutely not. Catherine Locked the author. Her ability
to demystify scientific concepts and make them super easy for
(01:29):
people who are not scientists to understand is really fantastic.
I asked her about it in the interview and she
said it was hard, but it does not come off
his heart. And her writing style really surprised me because
she's quite witty. She is a microbiologist. She has a
decade of research and tuberculosis specifically, so her knowledge even
prior to researching this book is really vast and it
(01:50):
spans centuries. So many many months later, Holly finally managed
to get all the pieces in place to have her
on the show. She was gracious enough to roll with
having to schedule around a five hour time difference for
a phone interview, so we are delighted and thankful that
she did so. Thankful that's it seems like it should
be easy, but it really does become tricky when you're
(02:11):
scheduling around people's lives. Five hours suddenly can become a lot.
So we're going to operate in there and learn a
little bit about how tuberculosis became such a massive threat
to humanity right out of the gates. Your background is microbiology,
but will you share with us what piqued your interests
(02:32):
in tuberculosis specifically? Okay? Um? So, So, I always wanted
to be a micronologist since I was really young, just
always been fascinated by the idea of this sort of
invisible world bacteria that surrounds us, just out of sight. Um.
And when it came to deciding what I wanted to
(02:53):
work on, I simply worked for tuberculosis because it was
the biggest infectious disease killer around and it's it's just
quite fascinating thinking about how you get get these pathogens
which end up killing their hosts, which isn't something that
bacteria specifically sets out to do. And I just wanted
to be part of the work that goes into trying
(03:13):
to combat the biggest infectious disease killer. And do you
find it challenging as a scientist too? Then when you're
writing a book conveys scientific concepts to potential non scientist readers, Yeah,
that that did turn out to be a big sort.
It was difficult when I was writing the book to
try and make sure I didn't go to science, and
(03:35):
I know that a lot of the people who have
read it and actually scientists then complain that it's not
science enough. So yeah, it's difficult getting the balance. But
I think what I've tried to do in the book
is find some of the interesting stories from speculosis history
and try and use them to get across what's turned
it into this world's biggest killer. And in the introduction
to your book, you characterize yourself as wanting to rebrand
(03:58):
tuberculosis for modern public awareness. Can you speak a little
bit about why it needs rebranding. So when I tend
to tell people that I've worked on subaculosis at a
party or at a baby group, quite often, Um, a
lot of people seem to see TV is this old
fashioned disease that affected poets in the nineteenth century, and
(04:21):
that it sort of disappeared when we invented antibiotics and
is no longer a problem. And it was a huge
problem in the nineteenth century. But I don't think a
lot of people realize that it's still with us and
it's still killing something like one point seven million people
a year and causing ten million new cases every year.
So I kind of wanted to rebrand TV. Is this
(04:42):
modern day monster rather than this relic of the past.
And the history of TV is really fascinating, but I
do think we need to remember that it's not a
disease of history. And when you talk a little bit
about how TV and Homo sapiens have this sort of
hand in hand relationship that you talk about through evolution,
(05:04):
mm hmm, okay, So it's it's thought that TV was
probably infecting humans back when we were first starting out
in Africa's cradle of life. And the idea is that
TV then went to spread around the world with the
first humans who will leading Africa during the out of
Africa migrations. And you can still see all of these
(05:25):
different lineages of TV in various parts of the world.
And despite all the globalization that spread us humans everywhere, um,
we still see these specific lineages of TV infecting specific populations.
And the idea is that TV has effectively grown up
alongside humanity. It's been with us throughout our entire history
(05:46):
and in a way has learned from us. And that's
one of the reasons why it's so difficult to eradicate
TB today just because it's been with us so long.
Then why do you think it became so prevalent as
a global threat before we figured out a way to
deal with it. So I think the biggest thing that
(06:09):
turned t D into the problem is today was when
humans stopped living hunt to gather a lifestyles and moved
to living at first in small villages, and then thanks
to urbanization and industrialization, we've got the rise of these
big cities which many of us live in today. And
it was humans living in unhealthy, overcrowded conditions which really
(06:34):
gave TV everything it needed to flourish and become this
mass killer when it was infecting Hunt together as it
had a very small pool of hosts to infects, and
it was just one of many diseases that when we
started living in towns and cities, suddenly found itself. With
all of these hosts, it could spread you very easily,
(06:55):
and that's kind of what turned it into what it
is today. I was really delighted that you mentioned in
your book the Jewitt City vampires and the New England
vampire panic. They were actually a topic of a previous episode. Um,
will you talk a little bit about how you see
that point in history as really representative of how humans
(07:17):
have dealt with tuberculosis historically. Yes. So I loved the
story of the New England Vampires when I came across there,
and I touched on it in the book, more from
the TV side of things than the actual the history
of the New England Vampires. So I included this story
(07:38):
because I feel like it represented the sheer panic that
would surround this disease back in the nineteenth century. So
TV was a disease which was killing a huge number
of people. It's been estimated it's killed something like one
in certain people who have ever lived by this point
in history, and it was a disease that could down
(08:00):
whole families, sometimes months apart or years apart. But nobody
knew anything about bacteria at this point, and they didn't
know it was an infectious disease. They didn't know it
was spreading through people coughing or living in overcrowded little houses. Um,
And there wasn't anything anyone could do about it. So
once you got it, you were quite possibly going to
(08:22):
die from it, and people were willing to try anything
to try and save their loved ones from this disease.
So I think that's where this whole folk belief of
the vampires rising from the grave at night to feed
upon the living came from um in terms of consumption
and TV. So the idea behind the folk belief was
(08:43):
that someone who had previously died of TB or consumption
is they have known back down, was coming back to
life at night to come and feed on family members
who were still alive. And the way to stop this
mischievous undead person was to go to the graveyard and
carry out various quite gaulish unto digging up the body,
(09:09):
removing the heart, turning it into a potion, and then
feeding this to the person who had t V. And
it was just I think it was just the case
of people wanting to try anything to save their loved
ones when there wasn't any science that could do anything
for them. I loved that Catherine included the New England
(09:33):
vampire panic in her book. It made me so excited.
When I got to that part, I was like, I
know about this. We are going to have more with
microbiologist and history author Katherine Lackey, but first we will
pause for a quick sponsor break. In this next segment
(09:55):
of my interview with Katherine Lacked, she shares her thoughts
on why tuberculosis bea so romanticized in the nineteenth century.
When you speak to the weird romanticism about tuberculosis that
did happen in the nineteenth century, yeah, I always find it.
(10:15):
It's it's probably what t D is best known for
among many people, this idea that it was this romantic,
passionate disease that could inspire creativity. And it was quite
prevalence in Victorian London the nineteenth century, and I think
part of the reason for that is that it's famously
killed a large number of poets. It was killing a
(10:38):
lot of other people as well, often the very poor
people in the city, although that wasn't quite sort of
romantic um. And so it was this disease where it
sort of found its way into the culture of the day,
and see these operatic heroines who were dying of consumption.
It was in a lot of literature and art, and
(10:59):
it just inspired a huge amount of the culture of
the day. I think women, the ideal of beauty among
women was seen to be this very pale, fragile consumptive look,
which is quite strange when you think about it today
that people were glamorizing this infection. But I think it
was just a response to a disease that was killing
such huge numbers of people. And I'm curious because I
(11:23):
know it has changed over time, but what has TV
treatment historically involved and how is it treated today comparatively.
So it took a really long time for any sort
of TV treatment that worked to be introduced. There were
all of these historical attempts at treating it that wouldn't
(11:45):
have done very much, and I think in Victorian England
you had a lot of remedies that were just never
going to work. The first real treatment, I suppose, was
the invention of the sanatorium where people could be sent
for the good diet, exposure to sunlight, exercise, and that
(12:05):
went some way to treating TV, but it obviously wasn't
a perfect cure. There were also at the turn of
the twentieth century some fairly barbaric surgical treatments used to
try and cure the disease, such as collapsing someone's lung,
sometimes permanently, um to just also kill the TV infection
that was in that lung and that was really the
(12:27):
only way that people could be cured if they had
a serious TV infection. And then in the nineties and
fifties you started seeing antibiotics being introduced and this revolutionized
the treatment of TV. And actually the antibiotics that were
introduced in the fifties are still the ones that are
commonly used today. So the treatment for a normal, um
(12:49):
non drug resistant case of TV today would be a
combination of four antibiotics that you would take for several months.
So you take four of them for two months and
then carry on taking two of the others for another
four months after that. UM, so six month treatments in
total with some fairly horrible, quite old fashioned antibiotics. And
(13:10):
we are seeing a few new ones being introduced now,
but not at a break that's quick enough to deal
with the problem of drug resistance. I'm glad you mentioned
drug resistant TV because that was what I was going
to bring up next. Will you talk a little bit
about how drug resistance TV has evolved and sort of
when we realized that was happening. Yes, So, drug resistance
(13:35):
is always it's pretty much inevitable with any bacterial infection.
The problem is is when it gets set in place
in the population and takes hold. And today we're seeing
huge numbers of cases of drug resistant TB. I don't
think we fully understand how much there is out there,
just because it's not very well documented at the moment um.
(13:56):
So we can have cases today called multi drug resistant TV,
which was the resistant to a couple of the frontline
drugs that you used to treat it UM, and this
can go all the way to completely or totally drug
resistant TV, which is practically untreatable by current the drug
the current drug regimens. So the first time people started
(14:20):
to realize it was a problem UM So I can't
remember the exact dates actually that we first started seeing
a strain of TV called xdr TV emerging in parts
of Africa, which managed to get itself into the news
just because a huge number of the people who are
infected with these strains of TV were dying from it UM.
(14:44):
There's also been a lot of recent talking India about
their huge drug resistance problem, which wasn't People didn't realize
it was such a problem until plainly recently. How TV
drug resistant strains emerged is that you get resistance in
just one bacterium and then this multiplies and then start
(15:06):
spreading to other people if it's left unchecked. And one
really good example of this was in was following the
collapse of the Soviet Union. So before before the collapse,
you had a really good TV program, everything was well controlled,
people had access to decent health care. However, when everything
fell into ruin, people didn't have access to the same medicines,
(15:27):
and drug resistance strains were able to have emerged and
go unchecked. And we can actually trace back modern day
drug resistance strains to this point in time and see
that they saw of a number of them started off
in the form of Soviet Union and then just gradually
grew over time and developed resistance to further drugs until
(15:48):
they reached a point where they're not really that treatable
with any of the drug regiments that we have available today.
You mentioned in your book that TV treatment even now
is really really rough on the patient. UM. Will you
talk about some of the risks in both previous versions
of treatment, including collapse lungs, like what was the mortality
(16:10):
like versus the actual cure um. I don't know the
exact numbers, but without treatment for people who have a
sort of serious TV infection around will die. Um, this
is less if they have a TV infection, that's um,
sort of a little bit more below the radar, I suppose.
(16:33):
And then it's then around these people will die from
if left untreated. So it works out around people with
an untreated TD infection will go on to die from it.
And today TV is essentially a treatable disease and we
shouldn't be seeing any death. However, we are seeing one
point seven million a year and unfortunately a lot of
that not down to the disease itself, but it's down
(16:55):
to all the social factors that are wrapped up to
TV and the fact that a lot of people aren't
being died nosed, or they don't have access to the
proper treatment regiments. Um, what do you think is the
most important moment in tuberculosis? Is long, long history. That's
(17:16):
that's an interesting question. I I suppose. I would say
the neo ethnic revolution where people stopped living these come
together a lifestyles and moved to having little villages and
relying on agriculture and farming to survive. And that was
really set in motion TV's rise to becoming this huge
global killer. The Industrial revolution as well was an assid
(17:39):
turning point for TV, because he started getting these huge
cities and people were living in really horrible, overcrowded conditions
and it was a very unhealthy lifestyle, and this made
them more likely to catch TB and then to go
on to die from it. Um, we actually started seeing
a decline in TB in cases like the UK and
(17:59):
the S following the Industrial Revolution, when people started living
healthier lifestyles and having better health care, better cleanness, last
polluted cities, etcetera. And so that was sort of big
turning point for humans, I suppose in our fight against TV,
and in the modern world in the UK and US
(18:19):
another high income countries, TV is no longer such a
huge problem, So I think. I mean, this is one
of the big problems with TV is that it is
a disease of inequality and poverty and social factors. It's
not just the bacteria. So when you say that's why
there is this misconception that it's sort of history's disease,
(18:39):
because the people that are talking about it are usually
more effluent than the people actually dealing with it. Yeah,
I think so it's um, Yeah, it's it's difficult because
sort of campaigning for a disease which isn't really that
much of a problem in the UK um countries such
(19:00):
as the US as well. But unfortunately it's going to
take high income countries to be able to combat the
problem with everyone's going to have to work together and
we're not going to be able to get rid of
TV in places like the US UK unless we get
rid of it in the countries where it is a
huge problem. So India, China, South Africa, Pakistan, Indonesia and
(19:22):
Nigeria are the places where TV is currently the biggest
problem in THESA or low income countries Prepared with our
own I think it's a really great point to make
that TV cannot be eradicated in affluent countries unless we
also address it in countries where it's much more prevalent. Yeah,
(19:43):
we are also going to talk with microbol Just Catherine
lackeyed some more in just a moment after we pause
for one more quick sponsor break, So coming up find
out what sort of testing we're really going to need
(20:03):
to address the one point seven million annual deaths that
still happen from tuberculosis. In your book, you make the
case for raising TV awareness and making testing the kind
of thing that people should be doing, even if they're asymptomatic.
Will you talk a little bit about that. Yeah? So.
Um one of the big problems with TV is that
(20:25):
we don't have any really good diagnostic tests that is
able to accurately tell us whether someone has the disease.
I mean, there are methods of diagnosing it, but they're
not always that good for use in countries where, for example,
there isn't a dedicated power supply um or it's extremely
hot and dusty, and you can't be using these high
(20:46):
tech pieces of labor tooitments unless someone really well trained
in them and you've got all the infrastructure and support
that's required to sort of analyze the test results after
you run the test itself. UM So, yeah, I would.
I would love to see a world where people who
are thought to have TV are tested using these modern,
(21:08):
great new diagnostics. Um. I think it's more likely that
we're going to have to develop new diagnostic tests that
can be used out in places where they don't have
access to these to the new technologies, and it would
be nice to see everyone being tested. You have sensems
of TV. But importantly, I'd also like to see a
sort of a drug resistance profile being taken to new
(21:30):
cases of TV, so we can pick up whether someone's
infection is going to be a drug resistant one before
they start treatment with the traditional drugs, which won't work
if it's not sensitive strain, if it's a drug resistance strain.
And to wrap up, is there any We talked a
little bit about the Jewit City vampires and some other
(21:52):
historical moments that you think are important. But do you
have a favorite sort of time in history to talk
about or do you know that has a unique story
of TV within it. Yeah, So when I was starting
out writing the book, I sort of thought to myself,
I wanted to go back in time and find the
(22:13):
first case of TV and have a look at how
far back we could actually diagnose this disease. And one
of the problems is that bacteria don't leave behind fossils,
so you can't chase them all the way back into history.
But the earliest diagnosed case in a human comes from
this little village called athlete Yam that's dust off the
coast of Israel, So it's been submerged under the sea
(22:35):
for something like nine thousand years because of the conditions,
so my layer of sediments and cool water. It meant
that the bodies buried in this village were extremely well preserved,
so when they were excavated in the night, people were
able to detect tiny amounts of bacterial DNA from the
TV pathogen in two of the people who were buried there,
(22:58):
so a mother and a bait be and find that
these are quite possibly the earliest diagnosed case of TV around.
And I really liked that story because I came at
writing the book from a very scientific perspective, and as
I went about writing it, I started to think more
about the actual people who were involved in the story.
Um so yeah, it was. It was very interesting to
(23:20):
find out about this village where this oldest case of
TV was found. Obviously TV goes back a lot further
in time, but it's much harder to diagnose it in
ancient remains. And then finally, where can people find you
if they want to learn more about your book or
your work? I have a blog called Germsoo dot blogspot
(23:40):
dot co dot uk where people can come and find me,
and I sometimes blog about science and my book and
other thoughts about the world of TV in general. Many
many things to care from lockeed for taking time to
(24:01):
speak with me. Uh. We're going to have a link
to her blog that she mentioned in the show notes
for this episode, so you can get there really easily
and learn about all the things that she has to share,
because she is really incredibly fun to read. Writer awesome. Yeah,
do you have listener mail for us? I do, and
it won't scare us about the possibility of contracting TV
and not knowing it. It will delight us with gifts.
(24:23):
I'm doing a little bit of an unboxing because this
is an unusual and wonderful day when Tracy is actually
in Atlanta and in the office with me. We are
in a studio looking at one another across the table.
It's pretty exciting. So instead of opening a parcel and
holding it up for her in front of a camera
on a computer, I can just show her cute things.
This is from our listener Christina, when she writes, Hi,
(24:44):
Holly and Tracy, I just wanted to say how much
I enjoy listening to your podcast. I am an illustrator.
And then she tells us where she lives and where
she works. I'm not going to include that in the
interest of her privacy, but she says, one of my
former students turned me onto your podcast, and I've been
binging it ever since. We illus traders work long hours
straight through on projects, and it always helps to have
educational and entertaining audio to keep us company in the
(25:06):
wee hours of the morning or when we're on a
twelve on a two hour commute. I know that thing.
I do it when I sew Yeah. Enclosed are two
calendars featuring an I P I created back in two eleven.
I hope you enjoy the many historically charged characters and
the merry quotations that come with each one. Thank you
for keeping me saying have a wonderful year, Christina. Oh
(25:27):
my goodness, Christina, these calendars are like cracked me. They're
so wondrous. I'm handing them to Tracy. So what These
are animals? The most beautiful and detailed illustrations UM of
animals as various historical figures. This is a dog David Bowie. Yes.
And there's um alten Maker. Yes. They're really amazing and
(25:51):
her art is mind blowingly beautiful. I cannot be more delighted.
There's a king tut and came out that is so gorgeous.
Since I like anything with Egyptian imagery and I am
a crazy cat lady, seelasically heaven to me. I feel
like this sloth Josephine Baker is like a special homage
(26:12):
to previous hosts of the show, which included some big
time sloth fans. And also they did a podcast on
jo swim Baker. Yeah, so I just I seriously love,
love love these so much. Uh. This is one where
there's also a Mary Smelly, which is Mary Shelley is
a skunk that is so beautiful I kind of can't
deal with it. This one has William Shakespeare. It's really
(26:36):
really wonderful. There is also Teddy Roosevelt as a big
gray cat, which is perfect. Um. Obviously, Christina, we are
delighted beyond all measure by this gift. Thank you so much.
This also perfectly settles my my current quandary of what
kind of calendar wall calendar I was going to get
for next year, because I love a calendar, but it's
hard to decide sometimes. Well, and this is the right
(26:58):
size to go on the wall by my computer, because
I have a Hamilton's calendar that I put for the
big wall calendar but this is good for the adjacent
to computer and I can then look at Kitty Roosevelt.
It's the cutest thing. I mean, these are so gorgeous.
I love, love love them. So we're going slightly bananas
(27:18):
over here, Christina. We are going to um take some
pictures of this and make sure they get up on
social media. Uh. And we thank you so much. What
a great way to start a new year. Yeah, is
with a cat as king hut. If you would like
to write to us about this or any other episode,
you can do so at History Podcast at how stuffworks
(27:39):
dot com. You can also find us pretty much everywhere
on social media as Missed in History. You can visit
our website, which is missed in History dot com. Sift
through our archive of all the episodes, look at show
notes for the episodes Tracy and I have worked on,
and just see what we've been up to. Uh, we
hope we do. Come and visit us at missed in
History dot com. For more on this and thousands of
(28:04):
other topics, visit how stuff works dot com. M
Welcome to steph you missed in history class from how
Stuff Works dot Com. Hello, and welcome to the podcast.
I'm Holly Fry and I'm Tracy V. Wilson. So, like
months and months ago, like the beginning of our colleague
Julie put a book on my desk titled Catching Breath
(00:24):
and Making an Unmaking of Tuberculosis, and I was so
excited about it that it became comical in the office.
I think my actual immediate reaction was, we have to
have this author on because so many great people died
from TV, which I know is not the most respectful
way to look at it, but I was really excited
about this book. When I was a child, I was
afraid of tb because my grandmother, long before I was
(00:46):
born or my mother was born, and my grandmother was
a child, she had to live in a tuberculosis sanatorium
for a while because she had TV. And I like
heard this story and in my child mind, like TV
became a thing that my consume Me yeah, and I
like that, was afraid of that, and I was afraid
of dying in childbirth for some reason. With the good
(01:09):
news is you don't how to do either of those things. Um,
and it turns out that this book is also a
delight to read. So if you're concerned that a book
about a medical thing in history might be dry or boring,
it is absolutely not. Catherine Locked the author. Her ability
to demystify scientific concepts and make them super easy for
(01:29):
people who are not scientists to understand is really fantastic.
I asked her about it in the interview and she
said it was hard, but it does not come off
his heart. And her writing style really surprised me because
she's quite witty. She is a microbiologist. She has a
decade of research and tuberculosis specifically, so her knowledge even
prior to researching this book is really vast and it
(01:50):
spans centuries. So many many months later, Holly finally managed
to get all the pieces in place to have her
on the show. She was gracious enough to roll with
having to schedule around a five hour time difference for
a phone interview, so we are delighted and thankful that
she did so. Thankful that's it seems like it should
be easy, but it really does become tricky when you're
(02:11):
scheduling around people's lives. Five hours suddenly can become a lot.
So we're going to operate in there and learn a
little bit about how tuberculosis became such a massive threat
to humanity right out of the gates. Your background is microbiology,
but will you share with us what piqued your interests
(02:32):
in tuberculosis specifically? Okay? Um? So, So, I always wanted
to be a micronologist since I was really young, just
always been fascinated by the idea of this sort of
invisible world bacteria that surrounds us, just out of sight. Um.
And when it came to deciding what I wanted to
(02:53):
work on, I simply worked for tuberculosis because it was
the biggest infectious disease killer around and it's it's just
quite fascinating thinking about how you get get these pathogens
which end up killing their hosts, which isn't something that
bacteria specifically sets out to do. And I just wanted
to be part of the work that goes into trying
(03:13):
to combat the biggest infectious disease killer. And do you
find it challenging as a scientist too? Then when you're
writing a book conveys scientific concepts to potential non scientist readers, Yeah,
that that did turn out to be a big sort.
It was difficult when I was writing the book to
try and make sure I didn't go to science, and
(03:35):
I know that a lot of the people who have
read it and actually scientists then complain that it's not
science enough. So yeah, it's difficult getting the balance. But
I think what I've tried to do in the book
is find some of the interesting stories from speculosis history
and try and use them to get across what's turned
it into this world's biggest killer. And in the introduction
to your book, you characterize yourself as wanting to rebrand
(03:58):
tuberculosis for modern public awareness. Can you speak a little
bit about why it needs rebranding. So when I tend
to tell people that I've worked on subaculosis at a
party or at a baby group, quite often, Um, a
lot of people seem to see TV is this old
fashioned disease that affected poets in the nineteenth century, and
(04:21):
that it sort of disappeared when we invented antibiotics and
is no longer a problem. And it was a huge
problem in the nineteenth century. But I don't think a
lot of people realize that it's still with us and
it's still killing something like one point seven million people
a year and causing ten million new cases every year.
So I kind of wanted to rebrand TV. Is this
(04:42):
modern day monster rather than this relic of the past.
And the history of TV is really fascinating, but I
do think we need to remember that it's not a
disease of history. And when you talk a little bit
about how TV and Homo sapiens have this sort of
hand in hand relationship that you talk about through evolution,
(05:04):
mm hmm, okay, So it's it's thought that TV was
probably infecting humans back when we were first starting out
in Africa's cradle of life. And the idea is that
TV then went to spread around the world with the
first humans who will leading Africa during the out of
Africa migrations. And you can still see all of these
(05:25):
different lineages of TV in various parts of the world.
And despite all the globalization that spread us humans everywhere, um,
we still see these specific lineages of TV infecting specific populations.
And the idea is that TV has effectively grown up
alongside humanity. It's been with us throughout our entire history
(05:46):
and in a way has learned from us. And that's
one of the reasons why it's so difficult to eradicate
TB today just because it's been with us so long.
Then why do you think it became so prevalent as
a global threat before we figured out a way to
deal with it. So I think the biggest thing that
(06:09):
turned t D into the problem is today was when
humans stopped living hunt to gather a lifestyles and moved
to living at first in small villages, and then thanks
to urbanization and industrialization, we've got the rise of these
big cities which many of us live in today. And
it was humans living in unhealthy, overcrowded conditions which really
(06:34):
gave TV everything it needed to flourish and become this
mass killer when it was infecting Hunt together as it
had a very small pool of hosts to infects, and
it was just one of many diseases that when we
started living in towns and cities, suddenly found itself. With
all of these hosts, it could spread you very easily,
(06:55):
and that's kind of what turned it into what it
is today. I was really delighted that you mentioned in
your book the Jewitt City vampires and the New England
vampire panic. They were actually a topic of a previous episode. Um,
will you talk a little bit about how you see
that point in history as really representative of how humans
(07:17):
have dealt with tuberculosis historically. Yes. So I loved the
story of the New England Vampires when I came across there,
and I touched on it in the book, more from
the TV side of things than the actual the history
of the New England Vampires. So I included this story
(07:38):
because I feel like it represented the sheer panic that
would surround this disease back in the nineteenth century. So
TV was a disease which was killing a huge number
of people. It's been estimated it's killed something like one
in certain people who have ever lived by this point
in history, and it was a disease that could down
(08:00):
whole families, sometimes months apart or years apart. But nobody
knew anything about bacteria at this point, and they didn't
know it was an infectious disease. They didn't know it
was spreading through people coughing or living in overcrowded little houses. Um,
And there wasn't anything anyone could do about it. So
once you got it, you were quite possibly going to
(08:22):
die from it, and people were willing to try anything
to try and save their loved ones from this disease.
So I think that's where this whole folk belief of
the vampires rising from the grave at night to feed
upon the living came from um in terms of consumption
and TV. So the idea behind the folk belief was
(08:43):
that someone who had previously died of TB or consumption
is they have known back down, was coming back to
life at night to come and feed on family members
who were still alive. And the way to stop this
mischievous undead person was to go to the graveyard and
carry out various quite gaulish unto digging up the body,
(09:09):
removing the heart, turning it into a potion, and then
feeding this to the person who had t V. And
it was just I think it was just the case
of people wanting to try anything to save their loved
ones when there wasn't any science that could do anything
for them. I loved that Catherine included the New England
(09:33):
vampire panic in her book. It made me so excited.
When I got to that part, I was like, I
know about this. We are going to have more with
microbiologist and history author Katherine Lackey, but first we will
pause for a quick sponsor break. In this next segment
(09:55):
of my interview with Katherine Lacked, she shares her thoughts
on why tuberculosis bea so romanticized in the nineteenth century.
When you speak to the weird romanticism about tuberculosis that
did happen in the nineteenth century, yeah, I always find it.
(10:15):
It's it's probably what t D is best known for
among many people, this idea that it was this romantic,
passionate disease that could inspire creativity. And it was quite
prevalence in Victorian London the nineteenth century, and I think
part of the reason for that is that it's famously
killed a large number of poets. It was killing a
(10:38):
lot of other people as well, often the very poor
people in the city, although that wasn't quite sort of
romantic um. And so it was this disease where it
sort of found its way into the culture of the day,
and see these operatic heroines who were dying of consumption.
It was in a lot of literature and art, and
(10:59):
it just inspired a huge amount of the culture of
the day. I think women, the ideal of beauty among
women was seen to be this very pale, fragile consumptive look,
which is quite strange when you think about it today
that people were glamorizing this infection. But I think it
was just a response to a disease that was killing
such huge numbers of people. And I'm curious because I
(11:23):
know it has changed over time, but what has TV
treatment historically involved and how is it treated today comparatively.
So it took a really long time for any sort
of TV treatment that worked to be introduced. There were
all of these historical attempts at treating it that wouldn't
(11:45):
have done very much, and I think in Victorian England
you had a lot of remedies that were just never
going to work. The first real treatment, I suppose, was
the invention of the sanatorium where people could be sent
for the good diet, exposure to sunlight, exercise, and that
(12:05):
went some way to treating TV, but it obviously wasn't
a perfect cure. There were also at the turn of
the twentieth century some fairly barbaric surgical treatments used to
try and cure the disease, such as collapsing someone's lung,
sometimes permanently, um to just also kill the TV infection
that was in that lung and that was really the
(12:27):
only way that people could be cured if they had
a serious TV infection. And then in the nineties and
fifties you started seeing antibiotics being introduced and this revolutionized
the treatment of TV. And actually the antibiotics that were
introduced in the fifties are still the ones that are
commonly used today. So the treatment for a normal, um
(12:49):
non drug resistant case of TV today would be a
combination of four antibiotics that you would take for several months.
So you take four of them for two months and
then carry on taking two of the others for another
four months after that. UM, so six month treatments in
total with some fairly horrible, quite old fashioned antibiotics. And
(13:10):
we are seeing a few new ones being introduced now,
but not at a break that's quick enough to deal
with the problem of drug resistance. I'm glad you mentioned
drug resistant TV because that was what I was going
to bring up next. Will you talk a little bit
about how drug resistance TV has evolved and sort of
when we realized that was happening. Yes, So, drug resistance
(13:35):
is always it's pretty much inevitable with any bacterial infection.
The problem is is when it gets set in place
in the population and takes hold. And today we're seeing
huge numbers of cases of drug resistant TB. I don't
think we fully understand how much there is out there,
just because it's not very well documented at the moment um.
(13:56):
So we can have cases today called multi drug resistant TV,
which was the resistant to a couple of the frontline
drugs that you used to treat it UM, and this
can go all the way to completely or totally drug
resistant TV, which is practically untreatable by current the drug
the current drug regimens. So the first time people started
(14:20):
to realize it was a problem UM So I can't
remember the exact dates actually that we first started seeing
a strain of TV called xdr TV emerging in parts
of Africa, which managed to get itself into the news
just because a huge number of the people who are
infected with these strains of TV were dying from it UM.
(14:44):
There's also been a lot of recent talking India about
their huge drug resistance problem, which wasn't People didn't realize
it was such a problem until plainly recently. How TV
drug resistant strains emerged is that you get resistance in
just one bacterium and then this multiplies and then start
(15:06):
spreading to other people if it's left unchecked. And one
really good example of this was in was following the
collapse of the Soviet Union. So before before the collapse,
you had a really good TV program, everything was well controlled,
people had access to decent health care. However, when everything
fell into ruin, people didn't have access to the same medicines,
(15:27):
and drug resistance strains were able to have emerged and
go unchecked. And we can actually trace back modern day
drug resistance strains to this point in time and see
that they saw of a number of them started off
in the form of Soviet Union and then just gradually
grew over time and developed resistance to further drugs until
(15:48):
they reached a point where they're not really that treatable
with any of the drug regiments that we have available today.
You mentioned in your book that TV treatment even now
is really really rough on the patient. UM. Will you
talk about some of the risks in both previous versions
of treatment, including collapse lungs, like what was the mortality
(16:10):
like versus the actual cure um. I don't know the
exact numbers, but without treatment for people who have a
sort of serious TV infection around will die. Um, this
is less if they have a TV infection, that's um,
sort of a little bit more below the radar, I suppose.
(16:33):
And then it's then around these people will die from
if left untreated. So it works out around people with
an untreated TD infection will go on to die from it.
And today TV is essentially a treatable disease and we
shouldn't be seeing any death. However, we are seeing one
point seven million a year and unfortunately a lot of
that not down to the disease itself, but it's down
(16:55):
to all the social factors that are wrapped up to
TV and the fact that a lot of people aren't
being died nosed, or they don't have access to the
proper treatment regiments. Um, what do you think is the
most important moment in tuberculosis? Is long, long history. That's
(17:16):
that's an interesting question. I I suppose. I would say
the neo ethnic revolution where people stopped living these come
together a lifestyles and moved to having little villages and
relying on agriculture and farming to survive. And that was
really set in motion TV's rise to becoming this huge
global killer. The Industrial revolution as well was an assid
(17:39):
turning point for TV, because he started getting these huge
cities and people were living in really horrible, overcrowded conditions
and it was a very unhealthy lifestyle, and this made
them more likely to catch TB and then to go
on to die from it. Um, we actually started seeing
a decline in TB in cases like the UK and
(17:59):
the S following the Industrial Revolution, when people started living
healthier lifestyles and having better health care, better cleanness, last
polluted cities, etcetera. And so that was sort of big
turning point for humans, I suppose in our fight against TV,
and in the modern world in the UK and US
(18:19):
another high income countries, TV is no longer such a
huge problem, So I think. I mean, this is one
of the big problems with TV is that it is
a disease of inequality and poverty and social factors. It's
not just the bacteria. So when you say that's why
there is this misconception that it's sort of history's disease,
(18:39):
because the people that are talking about it are usually
more effluent than the people actually dealing with it. Yeah,
I think so it's um, Yeah, it's it's difficult because
sort of campaigning for a disease which isn't really that
much of a problem in the UK um countries such
(19:00):
as the US as well. But unfortunately it's going to
take high income countries to be able to combat the
problem with everyone's going to have to work together and
we're not going to be able to get rid of
TV in places like the US UK unless we get
rid of it in the countries where it is a
huge problem. So India, China, South Africa, Pakistan, Indonesia and
(19:22):
Nigeria are the places where TV is currently the biggest
problem in THESA or low income countries Prepared with our
own I think it's a really great point to make
that TV cannot be eradicated in affluent countries unless we
also address it in countries where it's much more prevalent. Yeah,
(19:43):
we are also going to talk with microbol Just Catherine
lackeyed some more in just a moment after we pause
for one more quick sponsor break, So coming up find
out what sort of testing we're really going to need
(20:03):
to address the one point seven million annual deaths that
still happen from tuberculosis. In your book, you make the
case for raising TV awareness and making testing the kind
of thing that people should be doing, even if they're asymptomatic.
Will you talk a little bit about that. Yeah? So.
Um one of the big problems with TV is that
(20:25):
we don't have any really good diagnostic tests that is
able to accurately tell us whether someone has the disease.
I mean, there are methods of diagnosing it, but they're
not always that good for use in countries where, for example,
there isn't a dedicated power supply um or it's extremely
hot and dusty, and you can't be using these high
(20:46):
tech pieces of labor tooitments unless someone really well trained
in them and you've got all the infrastructure and support
that's required to sort of analyze the test results after
you run the test itself. UM So, yeah, I would.
I would love to see a world where people who
are thought to have TV are tested using these modern,
(21:08):
great new diagnostics. Um. I think it's more likely that
we're going to have to develop new diagnostic tests that
can be used out in places where they don't have
access to these to the new technologies, and it would
be nice to see everyone being tested. You have sensems
of TV. But importantly, I'd also like to see a
sort of a drug resistance profile being taken to new
(21:30):
cases of TV, so we can pick up whether someone's
infection is going to be a drug resistant one before
they start treatment with the traditional drugs, which won't work
if it's not sensitive strain, if it's a drug resistance strain.
And to wrap up, is there any We talked a
little bit about the Jewit City vampires and some other
(21:52):
historical moments that you think are important. But do you
have a favorite sort of time in history to talk
about or do you know that has a unique story
of TV within it. Yeah, So when I was starting
out writing the book, I sort of thought to myself,
I wanted to go back in time and find the
(22:13):
first case of TV and have a look at how
far back we could actually diagnose this disease. And one
of the problems is that bacteria don't leave behind fossils,
so you can't chase them all the way back into history.
But the earliest diagnosed case in a human comes from
this little village called athlete Yam that's dust off the
coast of Israel, So it's been submerged under the sea
(22:35):
for something like nine thousand years because of the conditions,
so my layer of sediments and cool water. It meant
that the bodies buried in this village were extremely well preserved,
so when they were excavated in the night, people were
able to detect tiny amounts of bacterial DNA from the
TV pathogen in two of the people who were buried there,
(22:58):
so a mother and a bait be and find that
these are quite possibly the earliest diagnosed case of TV around.
And I really liked that story because I came at
writing the book from a very scientific perspective, and as
I went about writing it, I started to think more
about the actual people who were involved in the story.
Um so yeah, it was. It was very interesting to
(23:20):
find out about this village where this oldest case of
TV was found. Obviously TV goes back a lot further
in time, but it's much harder to diagnose it in
ancient remains. And then finally, where can people find you
if they want to learn more about your book or
your work? I have a blog called Germsoo dot blogspot
(23:40):
dot co dot uk where people can come and find me,
and I sometimes blog about science and my book and
other thoughts about the world of TV in general. Many
many things to care from lockeed for taking time to
(24:01):
speak with me. Uh. We're going to have a link
to her blog that she mentioned in the show notes
for this episode, so you can get there really easily
and learn about all the things that she has to share,
because she is really incredibly fun to read. Writer awesome. Yeah,
do you have listener mail for us? I do, and
it won't scare us about the possibility of contracting TV
and not knowing it. It will delight us with gifts.
(24:23):
I'm doing a little bit of an unboxing because this
is an unusual and wonderful day when Tracy is actually
in Atlanta and in the office with me. We are
in a studio looking at one another across the table.
It's pretty exciting. So instead of opening a parcel and
holding it up for her in front of a camera
on a computer, I can just show her cute things.
This is from our listener Christina, when she writes, Hi,
(24:44):
Holly and Tracy, I just wanted to say how much
I enjoy listening to your podcast. I am an illustrator.
And then she tells us where she lives and where
she works. I'm not going to include that in the
interest of her privacy, but she says, one of my
former students turned me onto your podcast, and I've been
binging it ever since. We illus traders work long hours
straight through on projects, and it always helps to have
educational and entertaining audio to keep us company in the
(25:06):
wee hours of the morning or when we're on a
twelve on a two hour commute. I know that thing.
I do it when I sew Yeah. Enclosed are two
calendars featuring an I P I created back in two eleven.
I hope you enjoy the many historically charged characters and
the merry quotations that come with each one. Thank you
for keeping me saying have a wonderful year, Christina. Oh
(25:27):
my goodness, Christina, these calendars are like cracked me. They're
so wondrous. I'm handing them to Tracy. So what These
are animals? The most beautiful and detailed illustrations UM of
animals as various historical figures. This is a dog David Bowie. Yes.
And there's um alten Maker. Yes. They're really amazing and
(25:51):
her art is mind blowingly beautiful. I cannot be more delighted.
There's a king tut and came out that is so gorgeous.
Since I like anything with Egyptian imagery and I am
a crazy cat lady, seelasically heaven to me. I feel
like this sloth Josephine Baker is like a special homage
(26:12):
to previous hosts of the show, which included some big
time sloth fans. And also they did a podcast on
jo swim Baker. Yeah, so I just I seriously love,
love love these so much. Uh. This is one where
there's also a Mary Smelly, which is Mary Shelley is
a skunk that is so beautiful I kind of can't
deal with it. This one has William Shakespeare. It's really
(26:36):
really wonderful. There is also Teddy Roosevelt as a big
gray cat, which is perfect. Um. Obviously, Christina, we are
delighted beyond all measure by this gift. Thank you so much.
This also perfectly settles my my current quandary of what
kind of calendar wall calendar I was going to get
for next year, because I love a calendar, but it's
hard to decide sometimes. Well, and this is the right
(26:58):
size to go on the wall by my computer, because
I have a Hamilton's calendar that I put for the
big wall calendar but this is good for the adjacent
to computer and I can then look at Kitty Roosevelt.
It's the cutest thing. I mean, these are so gorgeous.
I love, love love them. So we're going slightly bananas
(27:18):
over here, Christina. We are going to um take some
pictures of this and make sure they get up on
social media. Uh. And we thank you so much. What
a great way to start a new year. Yeah, is
with a cat as king hut. If you would like
to write to us about this or any other episode,
you can do so at History Podcast at how stuffworks
(27:39):
dot com. You can also find us pretty much everywhere
on social media as Missed in History. You can visit
our website, which is missed in History dot com. Sift
through our archive of all the episodes, look at show
notes for the episodes Tracy and I have worked on,
and just see what we've been up to. Uh, we
hope we do. Come and visit us at missed in
History dot com. For more on this and thousands of
(28:04):
other topics, visit how stuff works dot com. M
Stuff You Missed in History Class News
Hosts And Creators
Holly Frey
Tracy Wilson
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