WEBVTT - Author Interview: Kathryn Lougheed on Tuberculosis 0:00:01.160 --> 0:00:04.120 Welcome to steph you missed in history class from how 0:00:04.160 --> 0:00:13.280 Stuff Works dot Com. Hello, and welcome to the podcast. 0:00:13.360 --> 0:00:17.240 I'm Holly Fry and I'm Tracy V. Wilson. So, like 0:00:17.400 --> 0:00:20.720 months and months ago, like the beginning of our colleague 0:00:20.800 --> 0:00:23.880 Julie put a book on my desk titled Catching Breath 0:00:24.160 --> 0:00:26.880 and Making an Unmaking of Tuberculosis, and I was so 0:00:26.960 --> 0:00:29.800 excited about it that it became comical in the office. 0:00:30.320 --> 0:00:32.600 I think my actual immediate reaction was, we have to 0:00:32.640 --> 0:00:35.040 have this author on because so many great people died 0:00:35.040 --> 0:00:37.639 from TV, which I know is not the most respectful 0:00:37.680 --> 0:00:39.960 way to look at it, but I was really excited 0:00:39.960 --> 0:00:41.800 about this book. When I was a child, I was 0:00:42.000 --> 0:00:46.600 afraid of tb because my grandmother, long before I was 0:00:46.640 --> 0:00:48.479 born or my mother was born, and my grandmother was 0:00:48.520 --> 0:00:52.400 a child, she had to live in a tuberculosis sanatorium 0:00:52.440 --> 0:00:55.520 for a while because she had TV. And I like 0:00:55.600 --> 0:00:58.400 heard this story and in my child mind, like TV 0:00:58.560 --> 0:01:02.760 became a thing that my consume Me yeah, and I 0:01:02.960 --> 0:01:04.600 like that, was afraid of that, and I was afraid 0:01:04.600 --> 0:01:09.040 of dying in childbirth for some reason. With the good 0:01:09.040 --> 0:01:13.000 news is you don't how to do either of those things. Um, 0:01:13.080 --> 0:01:15.880 and it turns out that this book is also a 0:01:15.880 --> 0:01:19.360 delight to read. So if you're concerned that a book 0:01:19.360 --> 0:01:22.160 about a medical thing in history might be dry or boring, 0:01:22.240 --> 0:01:26.040 it is absolutely not. Catherine Locked the author. Her ability 0:01:26.080 --> 0:01:29.120 to demystify scientific concepts and make them super easy for 0:01:29.120 --> 0:01:32.600 people who are not scientists to understand is really fantastic. 0:01:32.720 --> 0:01:35.040 I asked her about it in the interview and she 0:01:35.200 --> 0:01:36.720 said it was hard, but it does not come off 0:01:36.760 --> 0:01:39.759 his heart. And her writing style really surprised me because 0:01:39.760 --> 0:01:43.240 she's quite witty. She is a microbiologist. She has a 0:01:43.280 --> 0:01:47.240 decade of research and tuberculosis specifically, so her knowledge even 0:01:47.280 --> 0:01:50.680 prior to researching this book is really vast and it 0:01:50.760 --> 0:01:55.680 spans centuries. So many many months later, Holly finally managed 0:01:55.720 --> 0:01:57.360 to get all the pieces in place to have her 0:01:57.400 --> 0:01:59.880 on the show. She was gracious enough to roll with 0:02:00.080 --> 0:02:03.200 having to schedule around a five hour time difference for 0:02:03.280 --> 0:02:06.560 a phone interview, so we are delighted and thankful that 0:02:06.600 --> 0:02:09.720 she did so. Thankful that's it seems like it should 0:02:09.720 --> 0:02:11.960 be easy, but it really does become tricky when you're 0:02:11.960 --> 0:02:15.960 scheduling around people's lives. Five hours suddenly can become a lot. 0:02:16.400 --> 0:02:18.160 So we're going to operate in there and learn a 0:02:18.200 --> 0:02:21.720 little bit about how tuberculosis became such a massive threat 0:02:21.760 --> 0:02:30.000 to humanity right out of the gates. Your background is microbiology, 0:02:30.000 --> 0:02:32.200 but will you share with us what piqued your interests 0:02:32.280 --> 0:02:38.640 in tuberculosis specifically? Okay? Um? So, So, I always wanted 0:02:38.680 --> 0:02:41.760 to be a micronologist since I was really young, just 0:02:41.919 --> 0:02:44.960 always been fascinated by the idea of this sort of 0:02:45.040 --> 0:02:50.240 invisible world bacteria that surrounds us, just out of sight. Um. 0:02:51.040 --> 0:02:53.160 And when it came to deciding what I wanted to 0:02:53.160 --> 0:02:56.079 work on, I simply worked for tuberculosis because it was 0:02:56.160 --> 0:02:59.600 the biggest infectious disease killer around and it's it's just 0:02:59.680 --> 0:03:03.880 quite fascinating thinking about how you get get these pathogens 0:03:03.880 --> 0:03:07.080 which end up killing their hosts, which isn't something that 0:03:07.200 --> 0:03:10.880 bacteria specifically sets out to do. And I just wanted 0:03:10.919 --> 0:03:13.520 to be part of the work that goes into trying 0:03:13.520 --> 0:03:16.840 to combat the biggest infectious disease killer. And do you 0:03:16.880 --> 0:03:20.280 find it challenging as a scientist too? Then when you're 0:03:20.280 --> 0:03:27.120 writing a book conveys scientific concepts to potential non scientist readers, Yeah, 0:03:27.200 --> 0:03:29.680 that that did turn out to be a big sort. 0:03:30.000 --> 0:03:32.400 It was difficult when I was writing the book to 0:03:32.440 --> 0:03:34.920 try and make sure I didn't go to science, and 0:03:35.240 --> 0:03:36.560 I know that a lot of the people who have 0:03:36.600 --> 0:03:39.880 read it and actually scientists then complain that it's not 0:03:39.960 --> 0:03:43.360 science enough. So yeah, it's difficult getting the balance. But 0:03:43.440 --> 0:03:44.840 I think what I've tried to do in the book 0:03:44.920 --> 0:03:48.920 is find some of the interesting stories from speculosis history 0:03:49.000 --> 0:03:51.760 and try and use them to get across what's turned 0:03:51.800 --> 0:03:55.120 it into this world's biggest killer. And in the introduction 0:03:55.160 --> 0:03:58.280 to your book, you characterize yourself as wanting to rebrand 0:03:58.320 --> 0:04:02.080 tuberculosis for modern public awareness. Can you speak a little 0:04:02.080 --> 0:04:05.440 bit about why it needs rebranding. So when I tend 0:04:05.480 --> 0:04:08.720 to tell people that I've worked on subaculosis at a 0:04:08.800 --> 0:04:12.840 party or at a baby group, quite often, Um, a 0:04:12.880 --> 0:04:15.280 lot of people seem to see TV is this old 0:04:15.280 --> 0:04:20.839 fashioned disease that affected poets in the nineteenth century, and 0:04:21.240 --> 0:04:24.440 that it sort of disappeared when we invented antibiotics and 0:04:24.680 --> 0:04:27.960 is no longer a problem. And it was a huge 0:04:27.960 --> 0:04:30.279 problem in the nineteenth century. But I don't think a 0:04:30.279 --> 0:04:32.480 lot of people realize that it's still with us and 0:04:32.520 --> 0:04:35.960 it's still killing something like one point seven million people 0:04:36.160 --> 0:04:39.360 a year and causing ten million new cases every year. 0:04:39.760 --> 0:04:42.040 So I kind of wanted to rebrand TV. Is this 0:04:42.120 --> 0:04:45.320 modern day monster rather than this relic of the past. 0:04:45.400 --> 0:04:48.839 And the history of TV is really fascinating, but I 0:04:48.880 --> 0:04:51.440 do think we need to remember that it's not a 0:04:51.440 --> 0:04:55.160 disease of history. And when you talk a little bit 0:04:55.200 --> 0:04:58.440 about how TV and Homo sapiens have this sort of 0:04:58.800 --> 0:05:01.760 hand in hand relationship that you talk about through evolution, 0:05:04.400 --> 0:05:08.839 mm hmm, okay, So it's it's thought that TV was 0:05:08.880 --> 0:05:12.760 probably infecting humans back when we were first starting out 0:05:12.800 --> 0:05:16.360 in Africa's cradle of life. And the idea is that 0:05:17.040 --> 0:05:19.440 TV then went to spread around the world with the 0:05:19.480 --> 0:05:22.479 first humans who will leading Africa during the out of 0:05:22.520 --> 0:05:25.560 Africa migrations. And you can still see all of these 0:05:25.600 --> 0:05:28.920 different lineages of TV in various parts of the world. 0:05:28.960 --> 0:05:34.000 And despite all the globalization that spread us humans everywhere, um, 0:05:34.080 --> 0:05:38.800 we still see these specific lineages of TV infecting specific populations. 0:05:39.240 --> 0:05:41.960 And the idea is that TV has effectively grown up 0:05:42.000 --> 0:05:46.839 alongside humanity. It's been with us throughout our entire history 0:05:46.880 --> 0:05:49.479 and in a way has learned from us. And that's 0:05:49.480 --> 0:05:52.440 one of the reasons why it's so difficult to eradicate 0:05:52.520 --> 0:05:54.920 TB today just because it's been with us so long. 0:05:57.080 --> 0:06:00.840 Then why do you think it became so prevalent as 0:06:00.839 --> 0:06:03.480 a global threat before we figured out a way to 0:06:03.520 --> 0:06:09.400 deal with it. So I think the biggest thing that 0:06:09.800 --> 0:06:13.520 turned t D into the problem is today was when 0:06:13.640 --> 0:06:17.240 humans stopped living hunt to gather a lifestyles and moved 0:06:17.279 --> 0:06:21.279 to living at first in small villages, and then thanks 0:06:21.320 --> 0:06:25.800 to urbanization and industrialization, we've got the rise of these 0:06:26.000 --> 0:06:28.880 big cities which many of us live in today. And 0:06:29.680 --> 0:06:34.720 it was humans living in unhealthy, overcrowded conditions which really 0:06:34.760 --> 0:06:38.000 gave TV everything it needed to flourish and become this 0:06:38.200 --> 0:06:41.240 mass killer when it was infecting Hunt together as it 0:06:41.320 --> 0:06:44.600 had a very small pool of hosts to infects, and 0:06:45.160 --> 0:06:47.840 it was just one of many diseases that when we 0:06:47.880 --> 0:06:52.160 started living in towns and cities, suddenly found itself. With 0:06:52.240 --> 0:06:54.800 all of these hosts, it could spread you very easily, 0:06:55.240 --> 0:06:57.440 and that's kind of what turned it into what it 0:06:57.520 --> 0:07:02.120 is today. I was really delighted that you mentioned in 0:07:02.120 --> 0:07:04.719 your book the Jewitt City vampires and the New England 0:07:04.800 --> 0:07:10.080 vampire panic. They were actually a topic of a previous episode. Um, 0:07:11.840 --> 0:07:14.000 will you talk a little bit about how you see 0:07:14.080 --> 0:07:17.520 that point in history as really representative of how humans 0:07:17.800 --> 0:07:24.960 have dealt with tuberculosis historically. Yes. So I loved the 0:07:24.960 --> 0:07:27.560 story of the New England Vampires when I came across there, 0:07:27.560 --> 0:07:29.960 and I touched on it in the book, more from 0:07:30.000 --> 0:07:33.120 the TV side of things than the actual the history 0:07:33.160 --> 0:07:38.440 of the New England Vampires. So I included this story 0:07:38.560 --> 0:07:42.840 because I feel like it represented the sheer panic that 0:07:42.880 --> 0:07:47.560 would surround this disease back in the nineteenth century. So 0:07:47.680 --> 0:07:50.880 TV was a disease which was killing a huge number 0:07:50.960 --> 0:07:54.120 of people. It's been estimated it's killed something like one 0:07:54.160 --> 0:07:56.960 in certain people who have ever lived by this point 0:07:56.960 --> 0:08:00.400 in history, and it was a disease that could down 0:08:00.480 --> 0:08:04.880 whole families, sometimes months apart or years apart. But nobody 0:08:04.960 --> 0:08:07.880 knew anything about bacteria at this point, and they didn't 0:08:07.880 --> 0:08:10.200 know it was an infectious disease. They didn't know it 0:08:10.240 --> 0:08:15.480 was spreading through people coughing or living in overcrowded little houses. Um, 0:08:16.400 --> 0:08:19.320 And there wasn't anything anyone could do about it. So 0:08:19.520 --> 0:08:22.560 once you got it, you were quite possibly going to 0:08:22.600 --> 0:08:26.320 die from it, and people were willing to try anything 0:08:26.400 --> 0:08:28.640 to try and save their loved ones from this disease. 0:08:29.040 --> 0:08:32.840 So I think that's where this whole folk belief of 0:08:32.960 --> 0:08:36.320 the vampires rising from the grave at night to feed 0:08:36.400 --> 0:08:39.839 upon the living came from um in terms of consumption 0:08:39.880 --> 0:08:43.679 and TV. So the idea behind the folk belief was 0:08:43.800 --> 0:08:47.480 that someone who had previously died of TB or consumption 0:08:47.559 --> 0:08:50.880 is they have known back down, was coming back to 0:08:50.960 --> 0:08:54.840 life at night to come and feed on family members 0:08:54.880 --> 0:08:56.960 who were still alive. And the way to stop this 0:08:57.160 --> 0:09:01.320 mischievous undead person was to go to the graveyard and 0:09:02.600 --> 0:09:08.880 carry out various quite gaulish unto digging up the body, 0:09:09.520 --> 0:09:11.880 removing the heart, turning it into a potion, and then 0:09:11.880 --> 0:09:14.880 feeding this to the person who had t V. And 0:09:14.920 --> 0:09:17.120 it was just I think it was just the case 0:09:17.160 --> 0:09:19.839 of people wanting to try anything to save their loved 0:09:19.840 --> 0:09:23.840 ones when there wasn't any science that could do anything 0:09:23.880 --> 0:09:33.040 for them. I loved that Catherine included the New England 0:09:33.080 --> 0:09:36.160 vampire panic in her book. It made me so excited. 0:09:36.160 --> 0:09:37.280 When I got to that part, I was like, I 0:09:37.320 --> 0:09:40.120 know about this. We are going to have more with 0:09:40.360 --> 0:09:43.920 microbiologist and history author Katherine Lackey, but first we will 0:09:44.000 --> 0:09:54.880 pause for a quick sponsor break. In this next segment 0:09:55.040 --> 0:09:58.080 of my interview with Katherine Lacked, she shares her thoughts 0:09:58.080 --> 0:10:02.600 on why tuberculosis bea so romanticized in the nineteenth century. 0:10:06.640 --> 0:10:10.520 When you speak to the weird romanticism about tuberculosis that 0:10:10.600 --> 0:10:15.079 did happen in the nineteenth century, yeah, I always find it. 0:10:15.200 --> 0:10:18.040 It's it's probably what t D is best known for 0:10:18.760 --> 0:10:21.599 among many people, this idea that it was this romantic, 0:10:22.040 --> 0:10:26.480 passionate disease that could inspire creativity. And it was quite 0:10:26.480 --> 0:10:31.520 prevalence in Victorian London the nineteenth century, and I think 0:10:31.559 --> 0:10:33.880 part of the reason for that is that it's famously 0:10:34.960 --> 0:10:38.560 killed a large number of poets. It was killing a 0:10:38.600 --> 0:10:41.040 lot of other people as well, often the very poor 0:10:41.080 --> 0:10:43.520 people in the city, although that wasn't quite sort of 0:10:43.600 --> 0:10:47.160 romantic um. And so it was this disease where it 0:10:47.240 --> 0:10:49.520 sort of found its way into the culture of the day, 0:10:49.520 --> 0:10:53.440 and see these operatic heroines who were dying of consumption. 0:10:53.960 --> 0:10:59.200 It was in a lot of literature and art, and 0:10:59.440 --> 0:11:01.520 it just inspired a huge amount of the culture of 0:11:01.559 --> 0:11:05.280 the day. I think women, the ideal of beauty among 0:11:05.320 --> 0:11:09.640 women was seen to be this very pale, fragile consumptive look, 0:11:10.120 --> 0:11:12.880 which is quite strange when you think about it today 0:11:12.920 --> 0:11:16.120 that people were glamorizing this infection. But I think it 0:11:16.240 --> 0:11:19.040 was just a response to a disease that was killing 0:11:19.040 --> 0:11:23.920 such huge numbers of people. And I'm curious because I 0:11:23.960 --> 0:11:26.679 know it has changed over time, but what has TV 0:11:26.760 --> 0:11:30.920 treatment historically involved and how is it treated today comparatively. 0:11:34.200 --> 0:11:37.520 So it took a really long time for any sort 0:11:37.559 --> 0:11:40.959 of TV treatment that worked to be introduced. There were 0:11:41.000 --> 0:11:45.040 all of these historical attempts at treating it that wouldn't 0:11:45.040 --> 0:11:47.840 have done very much, and I think in Victorian England 0:11:47.880 --> 0:11:50.760 you had a lot of remedies that were just never 0:11:50.840 --> 0:11:55.160 going to work. The first real treatment, I suppose, was 0:11:55.360 --> 0:11:59.200 the invention of the sanatorium where people could be sent 0:11:59.320 --> 0:12:05.320 for the good diet, exposure to sunlight, exercise, and that 0:12:05.400 --> 0:12:08.480 went some way to treating TV, but it obviously wasn't 0:12:08.480 --> 0:12:11.400 a perfect cure. There were also at the turn of 0:12:11.440 --> 0:12:16.200 the twentieth century some fairly barbaric surgical treatments used to 0:12:16.240 --> 0:12:19.280 try and cure the disease, such as collapsing someone's lung, 0:12:19.480 --> 0:12:24.160 sometimes permanently, um to just also kill the TV infection 0:12:24.240 --> 0:12:27.040 that was in that lung and that was really the 0:12:27.080 --> 0:12:29.360 only way that people could be cured if they had 0:12:29.400 --> 0:12:33.200 a serious TV infection. And then in the nineties and 0:12:33.280 --> 0:12:38.520 fifties you started seeing antibiotics being introduced and this revolutionized 0:12:38.520 --> 0:12:42.480 the treatment of TV. And actually the antibiotics that were 0:12:42.520 --> 0:12:45.120 introduced in the fifties are still the ones that are 0:12:45.120 --> 0:12:49.160 commonly used today. So the treatment for a normal, um 0:12:49.360 --> 0:12:53.160 non drug resistant case of TV today would be a 0:12:53.240 --> 0:12:57.640 combination of four antibiotics that you would take for several months. 0:12:57.640 --> 0:13:00.040 So you take four of them for two months and 0:13:00.080 --> 0:13:02.440 then carry on taking two of the others for another 0:13:02.440 --> 0:13:05.800 four months after that. UM, so six month treatments in 0:13:05.880 --> 0:13:09.760 total with some fairly horrible, quite old fashioned antibiotics. And 0:13:10.160 --> 0:13:12.800 we are seeing a few new ones being introduced now, 0:13:12.840 --> 0:13:15.200 but not at a break that's quick enough to deal 0:13:15.320 --> 0:13:19.720 with the problem of drug resistance. I'm glad you mentioned 0:13:19.800 --> 0:13:21.880 drug resistant TV because that was what I was going 0:13:21.920 --> 0:13:24.400 to bring up next. Will you talk a little bit 0:13:24.440 --> 0:13:28.400 about how drug resistance TV has evolved and sort of 0:13:28.440 --> 0:13:35.600 when we realized that was happening. Yes, So, drug resistance 0:13:35.920 --> 0:13:39.240 is always it's pretty much inevitable with any bacterial infection. 0:13:39.280 --> 0:13:41.400 The problem is is when it gets set in place 0:13:41.440 --> 0:13:45.160 in the population and takes hold. And today we're seeing 0:13:45.240 --> 0:13:48.800 huge numbers of cases of drug resistant TB. I don't 0:13:48.800 --> 0:13:52.040 think we fully understand how much there is out there, 0:13:52.120 --> 0:13:56.520 just because it's not very well documented at the moment um. 0:13:56.840 --> 0:14:00.960 So we can have cases today called multi drug resistant TV, 0:14:01.160 --> 0:14:04.120 which was the resistant to a couple of the frontline 0:14:04.160 --> 0:14:06.880 drugs that you used to treat it UM, and this 0:14:07.040 --> 0:14:10.120 can go all the way to completely or totally drug 0:14:10.160 --> 0:14:16.280 resistant TV, which is practically untreatable by current the drug 0:14:16.360 --> 0:14:20.160 the current drug regimens. So the first time people started 0:14:20.200 --> 0:14:25.840 to realize it was a problem UM So I can't 0:14:25.840 --> 0:14:29.400 remember the exact dates actually that we first started seeing 0:14:29.560 --> 0:14:33.440 a strain of TV called xdr TV emerging in parts 0:14:33.520 --> 0:14:38.240 of Africa, which managed to get itself into the news 0:14:38.280 --> 0:14:40.200 just because a huge number of the people who are 0:14:40.200 --> 0:14:44.600 infected with these strains of TV were dying from it UM. 0:14:44.640 --> 0:14:48.720 There's also been a lot of recent talking India about 0:14:48.800 --> 0:14:53.160 their huge drug resistance problem, which wasn't People didn't realize 0:14:53.160 --> 0:14:57.600 it was such a problem until plainly recently. How TV 0:14:57.720 --> 0:15:02.320 drug resistant strains emerged is that you get resistance in 0:15:02.440 --> 0:15:06.440 just one bacterium and then this multiplies and then start 0:15:06.480 --> 0:15:09.920 spreading to other people if it's left unchecked. And one 0:15:09.920 --> 0:15:12.600 really good example of this was in was following the 0:15:12.600 --> 0:15:16.480 collapse of the Soviet Union. So before before the collapse, 0:15:16.560 --> 0:15:19.720 you had a really good TV program, everything was well controlled, 0:15:19.840 --> 0:15:23.800 people had access to decent health care. However, when everything 0:15:23.880 --> 0:15:27.640 fell into ruin, people didn't have access to the same medicines, 0:15:27.720 --> 0:15:30.760 and drug resistance strains were able to have emerged and 0:15:31.200 --> 0:15:34.880 go unchecked. And we can actually trace back modern day 0:15:34.960 --> 0:15:37.840 drug resistance strains to this point in time and see 0:15:37.840 --> 0:15:40.320 that they saw of a number of them started off 0:15:40.520 --> 0:15:44.040 in the form of Soviet Union and then just gradually 0:15:44.080 --> 0:15:48.840 grew over time and developed resistance to further drugs until 0:15:48.880 --> 0:15:51.200 they reached a point where they're not really that treatable 0:15:51.200 --> 0:15:53.600 with any of the drug regiments that we have available today. 0:15:55.720 --> 0:15:59.640 You mentioned in your book that TV treatment even now 0:15:59.800 --> 0:16:02.640 is really really rough on the patient. UM. Will you 0:16:02.680 --> 0:16:06.080 talk about some of the risks in both previous versions 0:16:06.120 --> 0:16:09.920 of treatment, including collapse lungs, like what was the mortality 0:16:10.000 --> 0:16:17.280 like versus the actual cure um. I don't know the 0:16:17.440 --> 0:16:22.080 exact numbers, but without treatment for people who have a 0:16:22.200 --> 0:16:26.560 sort of serious TV infection around will die. Um, this 0:16:26.640 --> 0:16:29.360 is less if they have a TV infection, that's um, 0:16:29.560 --> 0:16:32.640 sort of a little bit more below the radar, I suppose. 0:16:33.000 --> 0:16:36.520 And then it's then around these people will die from 0:16:36.680 --> 0:16:39.920 if left untreated. So it works out around people with 0:16:40.000 --> 0:16:42.600 an untreated TD infection will go on to die from it. 0:16:43.040 --> 0:16:46.320 And today TV is essentially a treatable disease and we 0:16:46.360 --> 0:16:50.040 shouldn't be seeing any death. However, we are seeing one 0:16:50.080 --> 0:16:52.680 point seven million a year and unfortunately a lot of 0:16:52.720 --> 0:16:55.200 that not down to the disease itself, but it's down 0:16:55.240 --> 0:16:57.080 to all the social factors that are wrapped up to 0:16:57.200 --> 0:16:59.520 TV and the fact that a lot of people aren't 0:16:59.520 --> 0:17:02.240 being died nosed, or they don't have access to the 0:17:02.280 --> 0:17:08.240 proper treatment regiments. Um, what do you think is the 0:17:08.280 --> 0:17:16.439 most important moment in tuberculosis? Is long, long history. That's 0:17:16.440 --> 0:17:19.560 that's an interesting question. I I suppose. I would say 0:17:19.600 --> 0:17:22.880 the neo ethnic revolution where people stopped living these come 0:17:22.960 --> 0:17:27.800 together a lifestyles and moved to having little villages and 0:17:27.920 --> 0:17:31.200 relying on agriculture and farming to survive. And that was 0:17:31.240 --> 0:17:35.320 really set in motion TV's rise to becoming this huge 0:17:35.320 --> 0:17:38.960 global killer. The Industrial revolution as well was an assid 0:17:39.000 --> 0:17:42.240 turning point for TV, because he started getting these huge 0:17:42.240 --> 0:17:46.879 cities and people were living in really horrible, overcrowded conditions 0:17:46.920 --> 0:17:49.720 and it was a very unhealthy lifestyle, and this made 0:17:49.760 --> 0:17:52.119 them more likely to catch TB and then to go 0:17:52.240 --> 0:17:55.160 on to die from it. Um, we actually started seeing 0:17:55.160 --> 0:17:58.760 a decline in TB in cases like the UK and 0:17:59.119 --> 0:18:02.760 the S following the Industrial Revolution, when people started living 0:18:02.840 --> 0:18:08.880 healthier lifestyles and having better health care, better cleanness, last 0:18:08.880 --> 0:18:12.639 polluted cities, etcetera. And so that was sort of big 0:18:12.720 --> 0:18:15.520 turning point for humans, I suppose in our fight against TV, 0:18:16.359 --> 0:18:19.280 and in the modern world in the UK and US 0:18:19.280 --> 0:18:22.399 another high income countries, TV is no longer such a 0:18:22.480 --> 0:18:25.639 huge problem, So I think. I mean, this is one 0:18:25.680 --> 0:18:27.560 of the big problems with TV is that it is 0:18:27.560 --> 0:18:32.760 a disease of inequality and poverty and social factors. It's 0:18:32.800 --> 0:18:36.480 not just the bacteria. So when you say that's why 0:18:36.680 --> 0:18:39.520 there is this misconception that it's sort of history's disease, 0:18:39.840 --> 0:18:41.960 because the people that are talking about it are usually 0:18:42.040 --> 0:18:48.440 more effluent than the people actually dealing with it. Yeah, 0:18:48.600 --> 0:18:52.720 I think so it's um, Yeah, it's it's difficult because 0:18:52.920 --> 0:18:57.080 sort of campaigning for a disease which isn't really that 0:18:57.200 --> 0:19:00.719 much of a problem in the UK um countries such 0:19:00.760 --> 0:19:03.359 as the US as well. But unfortunately it's going to 0:19:03.400 --> 0:19:06.280 take high income countries to be able to combat the 0:19:06.320 --> 0:19:08.520 problem with everyone's going to have to work together and 0:19:08.760 --> 0:19:10.240 we're not going to be able to get rid of 0:19:10.280 --> 0:19:13.520 TV in places like the US UK unless we get 0:19:13.600 --> 0:19:15.240 rid of it in the countries where it is a 0:19:15.320 --> 0:19:22.879 huge problem. So India, China, South Africa, Pakistan, Indonesia and 0:19:22.960 --> 0:19:25.919 Nigeria are the places where TV is currently the biggest 0:19:25.920 --> 0:19:28.800 problem in THESA or low income countries Prepared with our 0:19:28.800 --> 0:19:36.560 own I think it's a really great point to make 0:19:36.640 --> 0:19:40.159 that TV cannot be eradicated in affluent countries unless we 0:19:40.240 --> 0:19:43.320 also address it in countries where it's much more prevalent. Yeah, 0:19:43.600 --> 0:19:46.320 we are also going to talk with microbol Just Catherine 0:19:46.400 --> 0:19:49.119 lackeyed some more in just a moment after we pause 0:19:49.240 --> 0:20:01.040 for one more quick sponsor break, So coming up find 0:20:01.040 --> 0:20:03.320 out what sort of testing we're really going to need 0:20:03.800 --> 0:20:06.960 to address the one point seven million annual deaths that 0:20:07.080 --> 0:20:13.720 still happen from tuberculosis. In your book, you make the 0:20:13.720 --> 0:20:16.720 case for raising TV awareness and making testing the kind 0:20:16.760 --> 0:20:19.800 of thing that people should be doing, even if they're asymptomatic. 0:20:19.800 --> 0:20:22.720 Will you talk a little bit about that. Yeah? So. 0:20:23.040 --> 0:20:25.800 Um one of the big problems with TV is that 0:20:25.840 --> 0:20:29.040 we don't have any really good diagnostic tests that is 0:20:29.080 --> 0:20:32.880 able to accurately tell us whether someone has the disease. 0:20:33.119 --> 0:20:35.720 I mean, there are methods of diagnosing it, but they're 0:20:35.760 --> 0:20:40.200 not always that good for use in countries where, for example, 0:20:40.240 --> 0:20:43.800 there isn't a dedicated power supply um or it's extremely 0:20:43.800 --> 0:20:46.080 hot and dusty, and you can't be using these high 0:20:46.160 --> 0:20:50.520 tech pieces of labor tooitments unless someone really well trained 0:20:50.520 --> 0:20:52.960 in them and you've got all the infrastructure and support 0:20:53.359 --> 0:20:56.680 that's required to sort of analyze the test results after 0:20:56.720 --> 0:21:00.960 you run the test itself. UM So, yeah, I would. 0:21:01.000 --> 0:21:04.000 I would love to see a world where people who 0:21:04.240 --> 0:21:07.680 are thought to have TV are tested using these modern, 0:21:08.720 --> 0:21:12.439 great new diagnostics. Um. I think it's more likely that 0:21:12.480 --> 0:21:15.119 we're going to have to develop new diagnostic tests that 0:21:15.160 --> 0:21:18.320 can be used out in places where they don't have 0:21:18.359 --> 0:21:21.800 access to these to the new technologies, and it would 0:21:21.800 --> 0:21:24.240 be nice to see everyone being tested. You have sensems 0:21:24.240 --> 0:21:27.080 of TV. But importantly, I'd also like to see a 0:21:27.440 --> 0:21:30.920 sort of a drug resistance profile being taken to new 0:21:30.960 --> 0:21:33.159 cases of TV, so we can pick up whether someone's 0:21:33.160 --> 0:21:35.760 infection is going to be a drug resistant one before 0:21:35.800 --> 0:21:38.879 they start treatment with the traditional drugs, which won't work 0:21:39.200 --> 0:21:44.119 if it's not sensitive strain, if it's a drug resistance strain. 0:21:46.000 --> 0:21:49.639 And to wrap up, is there any We talked a 0:21:49.680 --> 0:21:51.920 little bit about the Jewit City vampires and some other 0:21:52.000 --> 0:21:54.840 historical moments that you think are important. But do you 0:21:54.880 --> 0:21:59.560 have a favorite sort of time in history to talk 0:21:59.600 --> 0:22:02.920 about or do you know that has a unique story 0:22:02.960 --> 0:22:07.600 of TV within it. Yeah, So when I was starting 0:22:07.600 --> 0:22:10.000 out writing the book, I sort of thought to myself, 0:22:11.080 --> 0:22:13.119 I wanted to go back in time and find the 0:22:13.160 --> 0:22:15.640 first case of TV and have a look at how 0:22:15.720 --> 0:22:19.160 far back we could actually diagnose this disease. And one 0:22:19.200 --> 0:22:22.040 of the problems is that bacteria don't leave behind fossils, 0:22:22.080 --> 0:22:24.840 so you can't chase them all the way back into history. 0:22:25.320 --> 0:22:29.600 But the earliest diagnosed case in a human comes from 0:22:29.600 --> 0:22:32.919 this little village called athlete Yam that's dust off the 0:22:32.960 --> 0:22:35.680 coast of Israel, So it's been submerged under the sea 0:22:35.760 --> 0:22:39.520 for something like nine thousand years because of the conditions, 0:22:39.520 --> 0:22:43.639 so my layer of sediments and cool water. It meant 0:22:43.680 --> 0:22:47.560 that the bodies buried in this village were extremely well preserved, 0:22:47.920 --> 0:22:50.920 so when they were excavated in the night, people were 0:22:50.920 --> 0:22:54.439 able to detect tiny amounts of bacterial DNA from the 0:22:54.480 --> 0:22:58.680 TV pathogen in two of the people who were buried there, 0:22:58.720 --> 0:23:01.480 so a mother and a bait be and find that 0:23:01.560 --> 0:23:06.520 these are quite possibly the earliest diagnosed case of TV around. 0:23:06.600 --> 0:23:09.359 And I really liked that story because I came at 0:23:09.400 --> 0:23:12.400 writing the book from a very scientific perspective, and as 0:23:12.440 --> 0:23:14.680 I went about writing it, I started to think more 0:23:14.720 --> 0:23:17.240 about the actual people who were involved in the story. 0:23:17.720 --> 0:23:20.560 Um so yeah, it was. It was very interesting to 0:23:20.600 --> 0:23:24.000 find out about this village where this oldest case of 0:23:24.040 --> 0:23:26.920 TV was found. Obviously TV goes back a lot further 0:23:27.040 --> 0:23:29.760 in time, but it's much harder to diagnose it in 0:23:30.000 --> 0:23:34.720 ancient remains. And then finally, where can people find you 0:23:34.720 --> 0:23:36.480 if they want to learn more about your book or 0:23:36.520 --> 0:23:40.920 your work? I have a blog called Germsoo dot blogspot 0:23:40.960 --> 0:23:43.560 dot co dot uk where people can come and find me, 0:23:44.080 --> 0:23:47.600 and I sometimes blog about science and my book and 0:23:48.119 --> 0:23:59.120 other thoughts about the world of TV in general. Many 0:23:59.160 --> 0:24:01.280 many things to care from lockeed for taking time to 0:24:01.320 --> 0:24:03.360 speak with me. Uh. We're going to have a link 0:24:03.400 --> 0:24:05.200 to her blog that she mentioned in the show notes 0:24:05.240 --> 0:24:08.000 for this episode, so you can get there really easily 0:24:08.640 --> 0:24:10.680 and learn about all the things that she has to share, 0:24:10.760 --> 0:24:15.200 because she is really incredibly fun to read. Writer awesome. Yeah, 0:24:15.359 --> 0:24:17.119 do you have listener mail for us? I do, and 0:24:17.160 --> 0:24:19.840 it won't scare us about the possibility of contracting TV 0:24:19.960 --> 0:24:23.360 and not knowing it. It will delight us with gifts. 0:24:23.960 --> 0:24:25.840 I'm doing a little bit of an unboxing because this 0:24:25.880 --> 0:24:28.600