The article is up on AmanzMY and I couldn’t be happier. I have been sitting on this draft for about 3 months before I hit the button.
Initially I asked Tarmizi Halim (a microbiologist) and Afiq Asri to help me with the article, but Afiq Asri (he is my favorite Twitter epidemiologist although he is a biomedical engineer) was not able to commit. Then I asked Noor Adila (a virologist) and she contributed to the article. Standing at 2,400 words the article sounds and feels comprehensive for public consumption.
Because it is for the public consumption, it was significantly dumbed-down. Here is a list:
Originally, I used “microorganism” or “microbes” instead of “pathogen” as the generalized grouping. The change was made because technically viruses are not living things, they are just a bunch of proteins things, and things and they are obligate intracellular parasite, whereas not so much for bacteria. If I said “viruses” are “microorganism”, I should commit suicide. This nuance could spark World War Z. And that’s why we can’t give antibiotics to person with bacterial infection, because -biotic means living things but viruses aren’t living. You can dose a bear with nail clipper to kill it (wait what?).
Originally for the example of binomial system, I was inclined to use Homo sapiens, but I didn’t because Malaysian are allergic when the word “homo” is mentioned (for reasons). Initially, I opted with Steptococcus pneumoniae but I could not find the English equivalent to the word strep which I later realized it means straight, so Streptococcus means straight spheres where Staphylococcus mean grapey sphere. This and this resources can help.
I did not mention about HIV. For an article that talks about viruses and immunity, this is pretty odd because HIV causes severe immune deficiency (which is AIDS). Well, it was intentional because to make a nice story about HIV, it would demand an article of its own. The draft that I have in mind for now would require two long-form articles to discuss HIV. This is where I should introduce Dr. Adeeba Kamarulzaman, who once advocated needle-sharing program to curb HIV/AIDS, and she was heavily criticized for doing that. Also, I am planning to take a train going back to (I guess) 1930s to study the HIV’s simian cousin, the SIV.
The article was crafted originally to set the groundwork for many articles about communicable diseases in the future. Specifically, the article came into play when I was interviewing Afiq Asri about his recent paper published in Science. The paper was about a device with the size of a shoebox that is designed to be used in the field for detecting diseases with a fraction of a cost and time. However, when I was doing the interview, I realized that I need a foundational article to go with it. Which means, we will be expecting an article on AmanzMY about Afiq Asri.
I was not brave enough (at first) to write about BCG vaccine, but I think it would serve as the best example because you could see the scar on your shoulder. During the review process, I sent that section on BCG vaccination to Afiq Asri for a quick check. He cautioned me that I should not imply a lifetime protection with vaccination. Specifically with BCG vaccination, it has been characterized to provide adequate level of immunity for 10-15 years. However, it does not mean that a person is at a huge risk after 10-15 years period. Suffice to say, children have to be protected against Tuberculosis at all cost. At ALL COST.
I made a cursory glance on the IAV vaccine. Here’s the thing: IAV has too many subtypes (16 HA subtypes; 9 NA subtypes). Because of their segmented genome and the fact that they have more than one biological reservoir (human, birds, pigs), pathogenic mutation could appear anytime. Their polymerase complex (and just like almost every viral polymerase) sucks at correcting genetic typos, which contributes to rapid mutations. New strain of IAV could appear every year. To make matter worse, vaccine against IAV that was administered in the previous year wouldn’t be protective in the next year. Even worse, our IAV vaccine isn’t as good (less than 80% protection), but it is the best thing that we have for now. We could easily have another textbook written to discuss why this happens.
Just in case if you have not realized, I made no mention to Measles, Mumps, and Rubella (MMR) for two reasons. First, MMR vaccine was the centerpiece of an event that started in 1998 with a fraudulent publication of a paper (already retracted) that linked MMR vaccine to colitis and autism spectrum disorder (ASD), which, my reason number 2, then nucleated the vaccine scaremongering and eventually led to (1) drop in vaccination in the UK from 92% in 1996 to 84% in 2002, (2) with low vaccination rate, measles was declared endemic in UK in 2008, (3) tons of money were being used just to refute the fraudulent claim linking MMR vaccine to autism. This video by Healthcare Triage on YouTube can be really helpful to understand the situation.
In hindsight, this article should have come before my Zika article in 2016. When I initially sketched the rough ideas for this topic, I did not anticipate it would even cross 1,500 words mark. Since this article was designed to be foundational in nature, I thought spending time a little more wouldn’t hurt. But this is not the end. I have planned a big article on the Spanish Flu 1918, a big article on HIV/AIDS a big article on vaccination, and a medium-length article on immunology. The question is… do I actually have time to write all these?
Pretty cool huh, when young scientists banded together to enlighten the public.