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microbial challenge

PREFACE XV
ABOUT THE AUTHORS XXIV
PART 1 Discovery of Microbes and the History
of Public Health 1
۱ Pre-Germ Theory, Microbiology, and Medicine 2
۲ Post-Germ Theory, Microbiology, and Medicine 26
۳ Controlling the Spread of Infectious Diseases 62
Part 2 The Microbial Challenge 87
۴ Identifying the Challenge 88
۵ The Microbial World 120
۶ Beneficial Aspects of Microbes: The Other Side of the Coin 140
۷ Bacteria 170
۸ Viruses and Prions 200
۹ Bacterial Genetics 228
Part 3 Microbial Disease 257
۱۰ Concepts of Microbial Disease 258
۱۱ Epidemiology and Cycle of Microbial Disease 292
۱۲ Bacterial Diseases 328
۱۳ Viral and Prion Diseases 390
۱۴ Protozoan, Helminthic, and Fungal Diseases 460
PART 4 Meeting the Microbial Challenge 505
۱۵ The Immune Response 506
۱۶ Control of Microbial Diseases 540
PART 5 Current Microbial Challenges 563
۱۷ Harnessing the Power of Microbes: Peril and Promise 564
۱۸ Partnerships in the Control of Infectious Diseases:
The Future of Public Health 590
Appendix Main Sources for Case Studies 624
Glossary 627
Index 659
Brief Table of Contents v
Table of Contents
PREFACE XV
ABOUT THE AUTHORS XXIV
PART 1 Discovery of Microbes and the History
of Public Health 1
۱ Pre-Germ Theory, Microbiology, and Medicine 2
Case Study: Wounded Civil War Soldiers Who Glowed in the Dark 3
Preview 6
The Origin of Life and Spontaneous Generation 6
Visualizing Germs 6
Robert Hooke 7
Anton van Leeuwenhoek 8
Battlefield Medicine 9
The Crimean War and Florence Nightingale, the Sanitarian 9
Medical Innovations During the American Civil War 11
Contagion in Hospitals 15
BOX 1.1 Burial on the Battlefield During the American Civil War 16
Semmelweis and Handwashing 18
Lister 19
Villemin and Crede 20
Contagion and Public Health 21
John Snow and Cholera 21
Summary 22
Key Terms 22
Self-Evaluation 23
۲ Post-Germ Theory, Microbiology, and Medicine 26
Case Study: Saved by a Syringe Full of Dodge Pond Bacteriophages 27
Preview 31
Scientific Rigor Proves Germs Cause Disease 32
Louis Pasteur and Robert Koch 32
Yersin the Underdog and the Bubonic Plague 34
BOX 2.1 Typhoid Mary: A Public Health Dilemma 36
The Golden Age of Microbiology 37
BOX 2.2 Pasteur and the Development of the Rabies Vaccine 37
Establishing Pure Cultures of Bacteria in the Laboratory 39
Phage Biology 42
Ellis Island Federal Immigration Station and the 6-Second Medical Examination 44
Discovery of Antibiotics 46
The Modern Era of Microbiology 47
Cell Culture Paved the Way for the Development of Poliovirus Vaccines 47
Discovery of the Structure of DNA and the Proof of DNA as the Genetic Material 49
Medical Microbiology and the Future of Medicine 54
Genomic Medicine 56
Metagenomics 56
The Connection Between Gut Microbes and Health 56
Summary 57
Key Terms 57
Self-Evaluation 59
۳ Controlling the Spread of Infectious Diseases 62
Case Study: The Romans and Toilet Phobia 63
Preview 64
Sanitation 64
Development of Sanitation 65
Human Waste Disposal 68
BOX 3.1 When Nature Calls in the Woods 69
Clean Water 71
BOX 3.2 Arsenic in the Well and in the Woods 75
Hand Hygiene 77
Food Safety 78
Infectious Disease Surveillance 80
Disease-Specific Surveillance 80
Syndrome/Symptom-Based Surveillance 81
Event Surveillance 82
Summary 82
Key Terms 83
Self-Evaluation 83
Part 2 The Microbial Challenge 87
۴ Identifying the Challenge 88
Case Study: Don’t Forget to Safely Wash Your Hands! 89
Preview 93
The Challenge 93
Factors Responsible for Emerging Infections 98
World Population Growth 98
BOX 4.1 The Mystery of the Elizabethkingia Outbreak
in Wisconsin 99
Urbanization 102
Ecological Disturbances 104
Technological Advances 110
Microbial Evolution and Adaptation 112
Human Behavior and Attitudes 113
Summary 116
Key Terms 117
Self-Evaluation 117
۵ The Microbial World 120
Case Study: Microbes in the New York City Subway
System 121
Preview 123
Some Basic Biological Principles 123
Cell Theory 123
Metabolic Diversity 123
Requirement for Oxygen 124
Genetic Information 124
What Makes a Microbe? 125
BOX 5.1 “Monster” Bacteria 125
Procaryotic and Eucaryotic Cells 126
Microbial Evolution and Diversity 126
BOX 5.2 Some Bizarre Bacteria 131
BOX 5.3 Conan the Bacterium 132
Table of Contents vii
Introducing the Microbes 133
Prions 134
Viruses 135
Bacteria 135
Protozoans 135
Algae 135
Fungi 136
Summary 136
Key Terms 137
Self-Evaluation 137
۶ Beneficial Aspects of Microbes: The Other Side of the Coin 140
Case Study: Take Two Fecal Pills and Call Me in the Morning 141
Preview 143
Microbes in the Environment 144
Microbes as Decomposers 144
Microbes and the Biogeochemical Cycles 145
Microbes in Food Production 148
Foods 148
Algae 148
Food Production 148
Bread Products 149
Dairy Products 149
BOX 6.1 Talking Starter Cultures and Sourdough Bread 150
BOX 6.2 Claimed Medical Benefits of Good Gut Microbiota 152
Wine, Beer, and Other Alcoholic Beverages 154
BOX 6.3 Wine Tasting 154
Harnessing Microbes as Research Tools 155
BOX 6.4 Killing Cancer with Oncolytic Viruses 156
Harnessing Microbes in Industry 157
Harnessing Microbes for Bioremediation 160
BOX 6.5 An Account of the Exxon Valdez Oil Spill 160
Sewage and Wastewater Treatment 162
BOX 6.6 Microbes Clean Up Lead, South Dakota 164
Summary 167
Key Terms 167
Self-Evaluation 167
۷ Bacteria 170
Case Study: Don’t Touch That Armadillo! 171
Preview 175
Cell Shapes and Patterns 175
Naming Bacteria 176
Anatomy of the Bacterial Cell 176
Envelope 176
Cytoplasm 180
BOX 7.1 Promiscuous Bubonic Plague Bacteria 181
Appendages 187
Bacterial Growth 188
Lag Phase 188
Log (Exponential) Phase 189
Stationary Phase 190
Death Phase 191
Significance of Bacterial Growth 191
Culturing Bacteria: Diagnostics 192
viii Table of Contents
Oddball (Atypical) Bacteria 195
Mycoplasmas 195
Chlamydias 195
Rickettsias 195
Summary 196
Key Terms 196
Self-Evaluation 197
۸ Viruses and Prions 200
Case Study: Dr. Crozier’s Puzzling Eye Color Change 201
Preview 204
Viruses as Infectious Agents 204
Virus Structure 206
BOX 8.1 Big and Bizarre Viruses 207
Nucleic Acids 208
Protein Coat 208
Viral Envelopes 210
Viral Classification 210
Viral Replication 211
Adsorption 211
Penetration 212
Replication 214
Assembly 214
Release 214
Host Cell Damage 215
Cultivation of Viruses 216
Embryonated (Fertile) Chicken Eggs 216
Cell Culture 216
Diagnosis of Viral Infection 218
Phage Therapy 220
Virotherapy 220
Biology of Prions 222
Summary 223
Key Terms 224
Self-Evaluation 225
۹ Bacterial Genetics 228
Case Study: Solving the Mystery of Why Vampire Bats Can Live on Blood 229
Preview 231
DNA Structure 231
DNA Replication 231
Transcription: DNA to mRNA 234
Translation: mRNA to Protein 235
Gene Expression 238
Chromosomes 239
Bacterial Genetics 240
Mutations 240
Recombination 241
Transformation 241
Transduction 242
Conjugation 243
Synthetic Biology 248
BOX 9.1 Engineering Live Microbes as Therapies 248
Summary 251
Key Terms 252
Self-Evaluation 253
Table of Contents ix
Part 3 Microbial Disease 257
۱۰ Concepts of Microbial Disease 258
Case Study: The Smelly Chicken Factory Worker 259
Preview 263
BOX 10.1 You Need Guts to Survive: “Know Thyself” ۲۶۳
Biological Associations 269
BOX 10.2 A Poem About the Human Microbiome 270
Parasitism: A Way of Life 272
Bacteria Talk to Each Other: Quorum Sensing 272
Quorum Sensing in Bacterial Infections 274
Quorum Quenching to Treat Superbug Infections 275
Microbial Mechanisms of Disease 276
Pathogenicity and Virulence 277
Defensive Strategies 279
Offensive Strategies: Extracellular Products 281
Virulence Mechanisms of Nonbacterial Pathogens 284
Course of a Microbial Disease 286
Incubation Period 286
Prodromal Period 286
Period of Illness 286
Period of Decline 286
Convalescence Period 286
Summary 287
Key Terms 288
Self-Evaluation 289
۱۱ Epidemiology and Cycle of Microbial Disease 292
Case Study: You Can Get Fatal Herpes from a Monkey! 293
Preview 296
Concepts of Epidemiology 296
Cycle of Microbial Disease 304
Reservoirs of Infection 304
Modes of Transmission 307
BOX 11.1 Oh, Rats! 314
Portals of Entry 315
Portals of Exit 317
Healthcare-Associated Infections 317
Hospital Environment as a Source of Healthcare-Associated Infections 318
Control Measures 320
BOX 11.2 Iraqibacter 320
One Health 321
Epidemiology of Fear 322
Summary 324
Key Terms 324
Self-Evaluation 325
۱۲ Bacterial Diseases 328
Case Study: From Sea to Sepsis 329
Preview 333
Healthcare-Associated Infections (HAIs) 333
HAIs Caused by Gram-Negative Bacteria 335
Foodborne and Waterborne Bacterial Diseases 337
Food Intoxication (Food Poisoning) 339
Foodborne and Waterborne Infection 345
BOX 12.1 Double Disaster Strikes Haiti 348
x Table of Contents
Airborne Bacterial Diseases 352
Upper Respiratory Tract Infections 353
Lower Respiratory Tract Infections 357
Mycobacterium Avium Complex (MAC) 363
Sexually Transmitted Infections (STIs) 364
Syphilis 364
Gonorrhea 367
Chlamydia 368
Contact Diseases (Other Than STIs) 368
Peptic Ulcers 368
Leprosy 370
BOX 12.2 Politics of the Leprosy Bacillus 370
Staphylococcus aureus Infections 373
Soilborne Diseases 375
Anthrax: Inhalation, Cutaneous, Gastrointestinal 375
BOX 12.3 1979, The Year of the “Biological Chernobyl” ۳۷۶
Tetanus 377
Leptospirosis 378
Arthropodborne Diseases 379
Plague: Bubonic, Pneumonic, Septicemic 379
Lyme Disease, or Borreliosis 381
Ehrlichiosis 383
Summary 384
Key Terms 384
Self-Evaluation 386
۱۳ Viral and Prion Diseases 390
Case Study: Surviving Ebola 391
Preview 392
Foodborne and Waterborne Viral Diseases 393
Gastroenteritis and Noroviruses 394
Hepatitis A and E 394
Poliomyelitis 395
Airborne Viral Diseases 398
Common Cold 399
Respiratory Syncytial Virus (RSV) and Metapneumovirus Infections 400
Influenza 400
BOX 13.1 The Coming Flu Pandemic? 403
SARS and MERS 407
Measles (Rubeola), Mumps, and German Measles (Rubella) 410
Chickenpox and Shingles 413
Hantavirus Pulmonary Syndrome 415
Smallpox and Monkeypox 416
Sexually Transmitted Viral Infections (STIs) 419
HIV/AIDS 419
Genital Herpes 427
Genital Warts 427
Contact Diseases (Other Than STIs) and Bloodborne Viral Diseases 429
Infectious Mononucleosis and Cytomegalovirus Infections 430
Hepatitis B and C 431
Rabies 433
Ebola Virus Disease 436
Arthropodborne Diseases 442
Mosquitoborne Viruses 444
Dengue Fever 448
Yellow Fever 448
Tickborne Diseases 450
Table of Contents xi
Prion Diseases 451
Mad Cow Disease 451
BOX 13.2 Where the Deer and the Antelope Play 451
Human TSEs 452
BSE–vCJD Link 453
Summary 454
Key Terms 454
Self-Evaluation 456
۱۴ Protozoan, Helminthic, and Fungal Diseases 460
Case Study: Killer Bagpipes 461
Preview 463
Neglected Parasitic Infections (NPIs) 463
Biology of Protozoans 463
Protozoan Diseases 464
Foodborne and Waterborne Protozoan Diseases 464
Arthropodborne Protozoan Diseases 470
Sexually Transmitted Protozoan Infections 477
Biology of Helminths 477
Helminthic Diseases 478
Foodborne and Waterborne Helminthic Diseases 478
BOX 14.1 Man’s Best Friend 481
BOX 14.2 Sushi Eaters Beware! 485
Arthropodborne Helminthic Diseases 487
Direct Contact Helminthic Diseases 489
Biology of Fungi 493
Fungi in the Environment 494
Fungal Diseases of Animal Species 494
BOX 14.3 “Oh, Christmas Tree, Oh Christmas Tree, How I Love
My Christmas Tree” ۴۹۵
Fungal Diseases of Humans 495
BOX 14.4 Ringworm: An Author’s Experience (Teri Shors) 498
Summary 499
Key Terms 500
Self-Evaluation 501
PART 4 Meeting the Microbial Challenge 505
۱۵ The Immune Response 506
Case Study: Baby Jacob 507
Preview 508
Basic Concepts 508
Efficacy, Variations, and Detriments 510
Foreignness 510
Anatomy and Physiology of the Body’s Defenses 511
Leukocytes 511
Blood Plasma 512
The Lymphatic System 514
Primary Immune Structures 514
Secondary Immune Structures 516
Immune Function: Innate and Adaptive Immunity 517
Innate Immunity 517
Adaptive Immunity 522
BOX 15.1 Send in the Monoclonal Search Team 525
Immune Response Summary 527
Immunization 528
xii Table of Contents
Active Immunization 530
Passive Immunization 531
Vaccine Safety 532
Childhood Immunization 533
Clinical Correlates 534
Human Immunodeficiency Virus 534
BOX 15.2 Vaccination and Autism 535
Leukemia 535
Immunodeficiencies 535
Summary 536
Key Terms 536
Self-Evaluation 537
۱۶ Control of Microbial Diseases 540
Case Study: A Pain in the Back 541
Preview 542
Disinfection and Disease Control 543
Disinfection Methods 543
Cleaning Products, Soap, and Handwashing 545
Tech Gadgets and Germs 546
Antibiotics 546
Types of Antibiotics 547
Mechanisms of Antimicrobial Activity 547
Clinical Challenges to Antibiotic Therapy 549
Acquisition of Antibiotic Resistance 550
Mechanisms of Antibiotic Resistance 551
Antibiotic Misuse 553
BOX 16.1 MRSA, VRE, CRE, and Others: A Very Dangerous Alphabet Soup 555
Working Toward the Solution 555
Antiviral Drugs 556
Types of Antiviral Drugs 556
BOX 16.2 Drug Development 558
Antiviral Resistance 559
Summary 559
Key Terms 559
Self-Evaluation 560
PART 5 Current Microbial Challenges 563
۱۷ Harnessing the Power of Microbes: Peril and Promise 564
Case Study: Fighting the World’s Deadliest Animal 565
Preview 567
Biological Agents as Weapons 568
War and Disease 568
History of Biological Weaponry 569
Early History to World War II 569
World War II to 1972 569
۱۹۷۲ to September 11, 2001 570
Emergence of Biological Terrorism 571
Assessment of the Threat of Biological Weaponry 571
Category A Biological Threats 573
Anthrax 573
BOX 17.1 Categories of Biological Diseases and Agents 573
Smallpox 575
Countermeasures to Biological Weaponry 576
Table of Contents xiii
In the Aftermath of September 11, 2001 577
Past and Future Threats: Influenza and Digital Attacks 578
Influenza 578
BOX 17.2 Creating the Armageddon Virus? 578
Digital Attacks 578
Engineering Genetic Modifications: Customizable Organisms 580
Bt Corn and Roundup Ready Crops 580
Controversies Surrounding Genetically Modified Organisms 580
Current Concerns: The Power and Peril of CRISPR/Cas Technology 581
What Is CRISPR? 581
Concerns About Widespread Use of CRISPR/Cas 582
Bioethics Catching Up with Technology 583
Regulating Genetic Engineering: The Asilomar Conference 583
Need for Regulation with CRISPR/Cas Genome Editing 583
BOX 17.3 Sulfanilamide and the Birth of the Modern FDA 584
Regulating Genetic Engineering: The Napa Conference 585
Summary 585
Key Terms 586
Self-Evaluation 586
۱۸ Partnerships in the Control of Infectious Diseases:
The Future of Public Health 590
Case Study: The Threat of a Pandemic Keeps Virus Hunters Awake at Night 591
Preview 596
Background 596
Partnerships in Infectious Disease Control 598
At the Local Level 598
At the National Level (United States) 599
At the International Level 606
The Private Sector 610
Partnerships: The Way to Go 611
An Ongoing Battle 611
BOX 18.1 A-Pork-Alypse Now 612
BOX 18.2 Good Personal Health Practices 615
BOX 18.3 Important Public Health Strategies to Contain Infectious Disease 615
Research 615
BOX 18.4 Are You Ready for a Zombie Apocalypse? 616
Health for All 617
One Health Initiative 618
Summary 618
Key Terms 620
Self-Evaluation 620
Appendix Main Sources for Case Studies 624
Glossary 627
Index 659

xiv Table of Contents
Preface
Birth and Development of
The Microbial Challenge
After 50 years in the classroom at Providence College in
Rhode Island teaching microbiology to biology majors,
Dr. Robert Krasner decided to develop a microbiology course
for nonbiology majors. Outbreaks of disease were in the
news frequently, and, judging by the questions students in
a nonmajors, general biology course asked, it was apparent
that they, too, needed to know more about microbes
and human–microbe interactions. Actually, he had been
thinking about teaching a nonmajors course for a number
of years, but to his surprise there was no text available.
Hence, he used handouts, online resources, magazine and
newspaper articles, and videos. He even called in a few
speakers to supplement his lectures. This strategy worked,
but it was cumbersome, required too many handouts, and
resulted in confusion; so he decided to write his own text.
At about that time, Dr. Krasner decided to study public
health microbiology and was accepted into the Harvard
School of Public Health for the 1999–۲۰۰۰ academic year,
۴۱ years after he had completed his PhD. He had wanted to
do this for many years, but raising a family and educating
his children were his top priority. Now it was his turn! As
far as he was able to determine, Dr. Krasner was the oldest
student on a full-time basis to earn the Master of Public
Health (MPH) degree at Harvard. His classmates were
primarily young medical students who had postponed
their fourth year of medical school to earn a MPH before
completing medical school. His Harvard studies included
۶ weeks in a tropical disease laboratory in Brazil culminating
in a 2-week field trip to Manaus in the Amazon.
While at Harvard’s School of Public Health, every day
Dr. Krasner passed by an inscription that reads, in several
languages, “The highest attainable standard of health is one of
the fundamental rights of every human being.” This inscription,
his studies at Harvard, and his travel experiences
were major factors in the birth and in the public health
perspective of his text, The Microbial Challenge.
During the development of the third edition, Dr. Teri
Shors, Professor in the Department of Biology and Microbiology
at the University of Wisconsin Oshkosh, signed on
as a coauthor. Her creativity, judgment, and knowledge
resulted in a text Dr. Krasner continued to be proud of. Her
specialty is virology, and together the two of them brought
many years of teaching experience to this text. Dr. Krasner
passed away in 2014 at the age of 84. Dr. Shors has taken
up the torch to carry on Dr. Krasner’s vision to provide
nonmajors with a better understanding of the microbial
world we live in. For this Fourth Edition she enlisted