Tuesday, November 06, 2012

Plague

I warned you I might talk about this. How could it be any more boring than watching the election returns?

I’ve been totally fascinated about the plague ever since our trip to Europe. At least once a day we would see some magnificent cathedral or building that according to the guide had stood half-completed for a couple of decades because of the plague. Europe lost a third of their population during the 1348 plague known as the “black death.”  Entire families were wiped out.  Bodies piled upon bodies in the streets waiting for the death wagon to make its daily rounds. The economic impact alone was devastating. The tax base dried up and cathedrals stood unfinished for years. I wondered which great Renaissance artist did not live to sculpt another David.

I came home intrigued by the idea of something that could destroy so much.

What captured my mind was the magnitude of the disease coupled with the lack of medical care. About the only treatment was bloodletting--which is to say any treatment was worse than none.  Their best guess as to cause was “bad air.”  Basically, if you got it you died. And millions of people died. It was a hopeless situation.

I read a couple of books that told me a lot of interesting things like the differences between Bubonic and Pneumonic plague. I learned how the disease is spread: rats. But not just rats—from the fleas on the rats. And not just the fleas--from flea vomit. Yes, you heard that right: flea vomit. I also learned about sanitation back then, which was nonexistent.

I also found out the plague popped up all over the world at all times but there were two major outbreaks.  The one I read the most about was the one in 1348 but there was also another major one in 1665. There were few medical advances between 1348 and 1665. The 1665 plague was a bit shorter because the Great Fire of London that year burned down most of the city along with all those pesky rats and their hitchhiking, puking fleas. I’m not sure they connected the fire with the end of the plague but I’m sure they were just glad it stopped.

Gradually, medical care improved. We learned to take baths and stop throwing our shit out onto the street. We discovered penicillin and vaccines against polio and small pox. We stopped getting the plague. But no one actually figured out why so many people died from it.

Until Dr Stephen O’Brien came on the scene in the 1980’s. He changed the question from “Why did one-third die?” to “Why did two-thirds of the population survive?”

O’Brien came up with this question while doing research on AIDS in the 1980”s. He realized there were a few people exposed to HIV who did not get AIDS. AIDS had a lot in common with the plagues: both had no known medical treatment or cure. Both killed almost everyone it touched. Both killed without mercy.

It’s interesting to remember that when AIDS first came onto the radar screen of medicine there was no testing to identify blood donations tainted with HIV. Hemophiliacs at that time regularly took a clotting factor distilled from multiple blood donations. The multiple donations almost insured the clotting factor contained at least some blood from HIV infected donors. So it was a crap shoot: take the clotting factor and risk AIDS or not take it and risk death from hemophilia?

O’Brien found a man who had been exposed to HIV by way of regular injections of the clotting factor and yet lived. Just like the two-thirds of plague resistant people.

He wanted to know what those people had that the others didn’t. He dug deeply enough to see a genetic mutation within the body of the guy who resistant to HIV. It was named CCR5 Delta 32. So he started exploring the plagues. He set out to find descendants of plague survivors from 400 years before. He wanted to compare their genes to people who survived exposure to HIV. Talk about the Mother of all genealogy research.

But he hit pay dirt.

He found an isolated village in England 120 miles north of London called Eyam, who had voluntarily quarantined themselves in 1665 after someone in their village contracted the plague from a travelling salesman. In an incredible act of generosity they agreed that no one would leave the village and no outsiders be allowed in. This contained the disease. Again, some lived and some died. So our hero O’Brien wanted to find some descendants of those who lived and check out their genes. What was inside their bodies that had kept their ancestors alive? Miracle of all, being a sleepy little village, there was not a lot of moving away and there were a few people in town who could take their family tree all the way back to 1665.

I will pause here a bit so you can catch your breath. Go ahead and re-read that last paragraph if you need to. I know it’s a lot to absorb.

Here’s what he found: the same genetic mutation-- CCR5 Delta 32. He found it both within the descendants of plague survivors and in the body of the guy who was exposed to HIV without contracting the disease.

Who would have ever thought there could be a connection between these two diseases?

My story ends here. I don’t know if anyone has continued with research to deliberately create this mutation in someone without it. It certainly would be handy if we could do this. For the most part, we have been content to know that we need to avoid rats and fleas or to protect ourselves while having sex.

This is just an interesting story I thought you might find interesting, too. Beaven has warned me that not everyone will find this as interesting as I do.

I have no brilliant insights today unless you consider the two-thirds who survived. People who, without any special actions on their part, escaped certain death because of something within their bodies that is so small that you would need the most sophisticated electronic microscope to even know about its existence. Medical science couldn’t save them. Nothing they did themselves saved their lives. They had everything they needed right there within their own bodies and didn’t even know it.

A positive genetic mutation. Grace.

No comments: