Dr. Joanne Stolen: The continuing fight against TB
I attended the latest Cafe Scientifique spearheaded by local Dr. Elmer Koneman. He actually instigated the production of the documentary on TB called the “The White Death,” convincing University of Colorado cinematographer Hans Rosenwinkel to take on the project and actually appearing in a scene where “the father of microbiology,” Robert Koch “announces he has found the cause of tuberculosis.” So Dr. Koneman, microbiologist, can add “actor” to his long list of accomplishments, which include professor, author, harpsichord builder and supporter of the arts – especially music and films. You see him regularly at Breckenridge Music Festival concerts. The slide show and discussion by Dr. Rosenwinkel before the actual showing of the documentary gave us an insight on the challenges of film making. The documentary is 95 percent finished, but watching it with an audience and getting feedback allowed him to see how the finished product might be tweaked. This project also had footage of the Keystone Science Center Symposium and the commentary of scientists on the current state of the disease.
Dr. Robert Koch was awarded the Nobel Prize in 1905 for this discovery but was increasingly frustrated in later life with his inability to find a cure. Almost half a century later, in 1952 Selman Waksman of Rutgers University won the Nobel Prize for the discovery of streptomycin, the first effective drug against TB. I did my graduate work in the building he built with his Nobel Prize money. Now almost half a decade later the bacteria still challenges medical science. The World Health Organization claims approximately 4,000 people a day worldwide are currently dying from tuberculosis, with an annual rate in the range of 1.5 million. Modern medicine and patient non-compliance has pushed the bacteria to become resistant to most of the antibiotics we have. One major problem with TB is patients need to take antibiotics regularly for months – not just a week as with some other infections. When a patient does not take the prescribed course of medication, the strongest bacteria survive and pass on their genes to the next generation (survival of the fittest). Dr. Koneman pointed out drug companies don’t want to spend the money to develop new antibiotics which will become obsolete in a short period of time. It takes years and millions of dollars to go from the research bench, to clinical trials to FDA approval, and many prospects fail.
The bacterium that causes TB has been with mankind since humans started to farm and domesticate cattle. TB was common among the poor in the middle ages and is now found commonly in prisons, in homeless populations, and the shanty towns of Third World countries. For the past 25 years, the bacteria found an ally in the HIV virus that causes AIDS, because it preys on people with weakened immune systems. These people become walking, germ-spreading TB factories and eventually die of the disease. Patients that have the means are on a drug cocktail to control AIDS, and the challenge for doctors is to find drugs to treat TB that won’t interact with the other drugs they are taking. The documentary ends on a hopeful note, but I am not so optimistic. First we have the conquer AIDS, then poverty worldwide, a daunting task that is challenging the best of minds of science.
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