Natural Defense by Emily Monosson

Author:Emily Monosson
Language: eng
Format: epub, pdf
ISBN: 978-1-61091-720-9
Publisher: Island Press
Published: 2017-04-25T16:00:00+00:00

Chapter 6

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Provocation: The Next Generation of Vaccines?

MY FATHER, JUST RETURNED from the US Navy, was a mischievous, apple-cheeked twenty-year-old looking forward to his junior year in college when meningitis struck. It was 1946 and the last thing he recalled was brushing his teeth at home in the bathroom. For the next ten days he lay unconscious in a hospital bed, his body fighting off an invisible army of bacterial invaders. Aided by the new miracle drug, penicillin, he survived, but not entirely unscathed. Shortly after recovering, my father was jolted by seizures, his brain permanently damaged by the infection. For the remainder of his life he managed the condition with a combination of powerful antiepileptic drugs (while baffling his doctors by referring to the electronic brainstorms as a “free high”).

Meningitis is a catch-all term for swelling of the tissues surrounding the brain and spinal cord. Specific viruses, fungi, and injury can all trigger the potentially fatal condition, but one of the most frightening and lethal causes is bacterial infection. Bacterial meningitis can kill within a day, is often incurable, and may leave survivors with amputated limbs, hearing loss, or brain seizures. My father was relatively lucky. One of the more obstinate causes of meningitis is Neisseria meningitidis, a bacterium adept at spreading in places where people are gathering for the first time: freshmen dorms, summer camps, day care, military barracks. Some 5–20 percent of us carry Neisseria in our noses and throats and unwittingly spread it to those with whom we share a meal, a drink, or a kiss. Most of us won't get sick. But a few of us may die from the infection, even today.

In the 1960s, annual outbreaks over a four-year period killed fourteen members of the Fort Ord community in California. At the time, the sprawling base was processing upwards of 1,000 new recruits a week—fertile ground for Neisseria. One study showed that by the end of basic training—eight weeks of sweating, sleeping, dining, and drinking with their brothers in arms—recruits carrying the bacterium rose from some 20 percent to as high as 90 percent.1 With no vaccine available there were few options for prevention, save widespread “chemoprophylaxis”—treating thousands proactively with the antimicrobial drug sulfadiazine. These were the days before we knew of the microbiome, or the looming crisis of antibiotic resistance. Inevitably, Neisseria strains began resisting the drug and it largely went out of use, though, until recently, widespread prophylactic antibiotics were still sometimes the only option against Neisseria.

The ongoing threat of meningitis in military recruits, combined with fears that the disease could spread into surrounding communities, turned Neisseria into a target for vaccine makers. The first vaccine, tested on recruits in 1969, was a phenomenal but limited success. It reduced the incidence of disease, but was effective against just one of a dozen known serotypes (members of the same strain, but which are recognized as different by our immune system), half of which cause the majority of disease in humans. Even so,

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