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The Perfect Predator: A Scientist's Race to Save Her Husband from a Deadly Superbug: A Memoir Cover Image
$29.00
ISBN: 9780316418089
Availability: Usually Ships in 1-5 Days
Published: Hachette Books - February 26th, 2019

Steffanie, an infectious disease epidemiologist at UCSD, and Tom, an evolutionary sociobiologist and experimental psychologist also at UCSD, are a couple on vacation in Egypt. Tom becomes quite sick and soon is taken to a clinic in Luxor. 

He does not improve, so he is subsequently flown to another hospital in Germany, where it is discovered that he is suffering from a pancreatic pseudocyst and is also infected with a multi-drug resistant strain of Acinetobacter baumannii. This is one of the most dangerous nosocomial (hospital-borne) pathogens. They begin administering meropenem, tigecycline and colistin—heavy duty, last resort antibiotics. 

Tom is transferred to the intensive care unit at the Thornton Hospital in San Diego, where they have more experience with this bug. However, his condition worsens and he goes into septic shock and is put on a ventilator. A drain that had been placed in his pseudocyst slips, causing the A. baumannii infection to enter his whole body. He is placed in a medically-induced coma and his doctors wonder how soon he will need dialysis. He receives many other antibiotics, but to no avail. Tom is dying.

Steffanie is overwhelmed and begins a scientific search for an answer. She discovers several therapeutic alternatives to the use of antibiotics, only one of which she deems workable. This is a treatment that uses bacteriophages (viruses that can attack and kill bacteria). A phage is much smaller than a bacterium and can only be seen with an electron microscope.

After locating sources of phages and seeking approval from the FDA for an eIND (experimental investigational new drug), she and her colleagues begin the work needed to create a product that may save Tom’s life. The correct phages, in the case of A. baumanini, need to be type-specific. This means that they had to be matched to Tom’s bacterial isolate. They also had to undergo a difficult purification process, and since bacteria actually evolve during treatment, several different phages would be used.

Between the chapters, there are eight interludes that relate the often horror-filled hallucinatory recollections that Tom experienced throughout his ordeal.

The startling details of this medical adventure describe the first time an A. baumannii phage therapy was administered intravenously to a human being in North America, and likely will help propel the FDA into forming appropriate regulatory protocol. 

The Perfect Predator is ultimately a happy story, and also a profoundly significant work because its details illustrate not only the result but the method of excellent and elegant science. 

We are very happy to include Dr. Strathdee’s answers to to some of our questions.

 

32nd Avenue Books Toys & Gifts: How is a phage’s suitability determined? 

Dr. Strathdee: First, it must be determined whether a phage can be found that matches the bacterial isolate.  The bacterial culture is streaked on a petri dish and incubated so that the colonies can be visualized.  The environmental sample (or purified phage) is added to the petri dish and incubated.  If a phage is present that matches the bacteria, plaques are seen as holes in the agar.  The plaques can be plucked out and added to a new bacterial suspension to expand it, before purification.  Ideally, the phage is also sequenced to ensure that it is a lytic phage that kills bacteria, as opposed to temperate phage (sometimes referred to as ‘lazy’ phage that integrates into the bacterial DNA and ‘hits the snooze button’).  Temperate phage is not ideal for phage therapy but if those  are the only phage that can be found, gene editing can be performed to convert it to lytic phage.

 32nd Avenue Books Toys & Gifts: Can you describe your plans for future research? 

Dr. Strathdee: IPATH is engaged in research to determine optimal phage dosing and pharmacokinetics, as well as to move phage into clinical trials.  We are also fundraising to develop phage banks of fully characterized phage for major superbugs that could be available on every continent.

32nd Avenue Books Toys & Gifts: Are phages obtainable for other AMR (anti-microbial resistant) pathogens?

Dr. Strathdee: Oh yes.  Phage have been found for almost every bacterial species.  Sometimes these are temperate phages that need genetic modification, as described above.

 32nd Avenue Books Toys & Gifts: Do you see a time when humans will essentially be disease free? 

Dr. Strathdee: No. I don’t think its realistic to try to purge our bodies of micro-organisms as some play beneficial roles.  Bacteria and phage have co-evolved for millennia and the invisible arms race between them will continue.  We need more research to understand how bacteria, phage and our immune system interact.  We believe that phage can be developed to stay ahead of antimicrobial resistance, which means having large, ever-expanding phage banks available.   

For more information, see https://IPATH.USCD.EDU and ThePerfectPredator.com.

Steve Brehm

32nd Avenue Books Toys & Gifts


Spillover: Animal Infections and the Next Human Pandemic Cover Image
$18.95
ISBN: 9780393346619
Availability: Usually Ships in 1-5 Days
Published: W. W. Norton & Company - September 9th, 2013

The next big human pandemic--the next disease cataclysm, perhaps on the scale of AIDS or the 1918 influenza--is likely to be caused by a new virus coming to humans from wildlife. Experts call such an event "spillover" and they warn us to brace ourselves. David Quammen has tracked this subject from the jungles of Central Africa, the rooftops of Bangladesh, and the caves of southern China to the laboratories where researchers work in space suits to study lethal viruses. He illuminates the dynamics of Ebola, SARS, bird flu, Lyme disease, and other emerging threats and tells the story of AIDS and its origins as it has never before been told. Spillover reads like a mystery tale, full of mayhem and clues and questions. When the Next Big One arrives, what will it look like? From which innocent host animal will it emerge? Will we be ready?


The Great Influenza: The Story of the Deadliest Pandemic in History Cover Image
$19.00
ISBN: 9780143036494
Availability: Usually Ships in 1-5 Days
Published: Penguin Books - October 4th, 2005

Magisterial in its breadth of perspective and depth of research, The Great Influenza provides us with a precise and sobering model as we confront the epidemics looming on our own horizon. As Barry concludes, "The final lesson of 1918, a simple one yet one most difficult to execute, is that...those in authority must retain the public's trust. The way to do that is to distort nothing, to put the best face on nothing, to try to manipulate no one. Lincoln said that first, and best. A leader must make whatever horror exists concrete. Only then will people be able to break it apart."

At the height of World War I, history's most lethal influenza virus erupted in an army camp in Kansas, moved east with American troops, then exploded, killing as many as 100 million people worldwide. It killed more people in twenty-four months than AIDS killed in twenty-four years, more in a year than the Black Death killed in a century. But this was not the Middle Ages, and 1918 marked the first collision of science and epidemic disease.


Inside the Hot Zone: A Soldier on the Front Lines of Biological Warfare Cover Image
$34.95
ISBN: 9781640121423
Availability: Usually Ships in 1-5 Days
Published: Potomac Books - January 1st, 2020

Inside the Hot Zone is an insider's account of one of the most dangerous workplaces on earth: the United States Army Medical Research Institute of Infectious Diseases (USAMRIID) in Fort Detrick, Maryland. Retired U.S. Army Col. Mark G. Kortepeter, a leading biodefense expert, recounts his journey from the lecture hall to the role of department chief, to the battlefield, to the Biosafety Level-4 maximum containment lab, and finally, to the corner office.

During Kortepeter's seven and a half years in leadership at USAMRIID, the United States experienced some of the most serious threats in modern germ warfare, including the specter of biological weapons during the Iraq War, the anthrax letters sent after 9/11, and a little-known crisis involving a presumed botulism attack on the president of the United States. Inside the Hot Zone is a shocking, frightening eye-opener as Kortepeter describes in gripping detail how he and his USAMRIID colleagues navigated threats related to anthrax, botulism, smallpox, Lassa, and Ebola.

Kortepeter crafts a rich and riveting narrative as he wrestles with life-and-death decisions managing biological weapon exposures. The stories are real, but they could just as easily serve as plotlines in popular fiction or Hollywood thrillers. He gives the reader a seat at the table as each crisis unfolds, with an unvarnished and personal perspective on the dangers, the drama, the fear, the frustrations, the irony, and the uncertainty he encountered as a physician in the role of "Biodefender."


STREET TALK

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