A Candle in the Dark

Much more recent a figure than my other Important People, I feel Carl Sagan deserves a mention today. His birthday was November 9, 1934.

I am not nearly eloquent or knowledgeable enough compared to others I know to comment on his amazing works and his pioneering the concept of making science accessible (and cool!) to the public, but I appreciate them and love the works all the same.

He was not just a television figure, a host of a TV show, as captivating and renowned as Cosmos was. He was a real astronomer, an astrophysicist, a man who worked on real satellites, and looked through telescopes in laboratories, and realized things like the fact that Venus is, in reality, a hot and dry hellscape, and not a balmy paradise as once imagined.

From the beginning of his career, Sagan was the advocate that science needed. In a time that scientists and officials scoffed at the notion of bringing science to the masses, Sagan realized how important it was for the general population to, at the very least, be interested in and value science, even if they didn't understand the deeper concepts involved. You don't need to be a rocket scientist to see the value of learning about our planet from a perspective we've never seen before.

Before his death in 1996, Carl Sagan designed the plaque and record that traveled on the Voyager satellites, that represented all of humankind to any civilization or species that might intercept them, millions or billions of years in the future. He was also involved in establishing SETI -the institute for the Search for Extraterrestrial Intelligence. He also authored Contact, which would later be made into an award-winning movie starring Jodie Foster, and many books regarding humanity's presence in the universe and the possibility for extraterrestrial life. He was a pioneer in promoting skepticism and scientific thinking in day-to-day life, and showed people how amazing and fantastical their own world was, their own planet was, how much more wonderful reality was than anything we could ever dream up.

Images: Quote from Cosmos, "Pale Blue Dot" - The Earth, as it appears from Pluto, photographed by Voyager 1 Allen Radio Telescope Array at SETI Carl Sagan portrait by Pat Linse - "An Awful Hole, A Wonderful Life" by Michael Shermer via Skeptic "Sounds of Earth" - the golden record carried on Voyager 1 and 2

Events in Natural History: The Pyrenean Ibex

2000: The last Pyrenean Ibex (Bucardo), named Celia, is found dead near the French border, her skull crushed by a fallen tree. The reason for the extinction of the species is unknown, as their habitat was protected since 1918. Since that time, approximately 40 individuals existed at any given time within the Ordesa National Park. Genetic bottlenecking causing lethal recessive genes to appear is a hypothesis.

2002: Previously collected somatic cells from Celia are fused with the emptied oocytes of Capra hircus. 254 embryos reconstructed. 54 embryos transferred to 12 mountain goat/domestic goat hybrids. Of these, two survive beyond two months gestation.

2003: Both pregnancies spontaneously terminate in January. No live births. First attempt at cloning declared a failure in July.

2008: Additional funding procured from Aragon District government of the Pyrenees. 439 embryos reconstructed. 57 transferred into surrogate females. 7 pregnancies result. One pregnancy persists beyond third month.

2009: Surrogate female gives birth to full-term female Pyrenean Ibex in late January. First species brought back from extinction.

2009: Ibex calf dies seven minutes after birth. First species to become extinct twice.

Buck and doe of Pyrenean Ibex subspecies documented by Richard Lydekker, 1898.

Recent History: Cryptosporidosis!

It's still summer, so let's take a quick look at the history of a disease that (these days, in the United States), is most commonly acquired from pools and lakes while swimming. It can cause miserable stomach cramps, diarrhea, vomiting, and can be extremely dangerous to those with compromised immune systems. And not too long ago, it caused some major problems for almost a quarter of the largest city in Wisconsin...

1993. Milwaukee, WI. 

Anyone live on Milwaukee's south side in March 1993? Personally, I was staying with my cousin over spring break, who lived in the area. As luck would have it, her house was served by the Howard Avenue Water Purification Plant...a plant that would soon make history. Of 880,000 people served by that treatment plant, 403,000 fell sick within a span of just over two weeks. Cramps, fever, vomiting, and diarrhea plagued so many people that some south side businesses were completely shut down due to lack of employees! Over $64 million (the most conservative estimate) was lost in productivity in a relatively small area in under a month.

Though "only" 104 people died in the end, people never expected something like this happening in the "modern" era. It was a massive blow to public confidence in their drinking water being safe, and in their municipal services in general. However, thanks to this massive outbreak, water treatment plants and wastewater management all over the country are now far safer, have much better monitoring, sanitation, and filtration systems, and mini-outbreaks (that were not originally attributed to the same factors) have been nearly eliminated.

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History Break! - 

1894. Milwaukee, WI:

Photograph: Milwaukee Public Health Laboratory

The huge cryptosporidosis outbreak was definitely not Milwaukee's first run-in with water-borne illness. The Public Health department in Milwaukee began daily testing of water qualities back in 1894, and realized that the relatively high typhoid fever (which were not outbreaks, but constant) rates in the city were due to the dumping of almost 54 million gallons of raw sewage into Lake Michigan every day. 

Similar typhoid fever quarantine signs were used across the country, including in Milwaukee.

Even though tenements were being cleaned up and there wasn't sewage in the streets for the most part, the raw sewage getting into the ground water led to almost as much typhoid as ever. They argued for the installation of water treatment plants, and the typhoid rates fell to record lows within less than a year after their construction. In fact, before the typhoid fever inoculation was available, Milwaukee maintained one of the lowest outbreak/death rates from the disease in any large city.

Jones Island Wastewater Treatment Plant being constructed - 1917.

The Public Health Laboratory in Milwaukee may have had to deal with multiple deadly epidemics and outbreaks, but from them, they've made impressive advances. After the typhoid reduction, the analysis techniques and statistical analysis used in placement of the treatment plants led to their specialists consulting with several other cities to reduce their own typhoid problems. Since the Cryptosporidium outbreak, the laboratory has been recognized as an international leader in detection and diagnostics of Giardia and Crypto.

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Cryptosporidium:

Back to Crypto, and 1993! Cryptosporidium spp. was recognized as a group of enteritis-causing coccidians way back in 1907, when people were first beginning to differentiate diarrheal illnesses, instead of simply designating them "dysentery" or "typhoid". However, it was not thought to be of much importance and largely ignored until 1976. In that year, it was differentiated from the other coccidians in its family, and was recognized as a major cause of diarrheal water-borne illness worldwide.

Cryptosporidium oocysts found in human stool sample

Today, we know that Cryptosporidium is:

Cryptosporidium can be avoided by thoroughly cooking food, avoiding contact with human and animal feces and always washing raw foods thoroughly. One of the most important things to do to avoid Crypto is avoiding swallowing water while swimming in lakes, ponds, pools, and rivers. Since it's chlorine-resistant, it survives even in treated pools. 

Even though Crypto is present in up to 90% of surface waters, treated water in most cities is free of oocysts, thanks to the use of microfilters smaller than 1 micron and (more commonly) the use of ozone as a disinfectant. 

Resources:

CDC - Cost of Illness in the 1993 Waterborne Cryptosporidium Outbreak in Milwaukee, WI

NEJM - A Massive Outbreak of Cryptosporidium Infection Transmitted Through Public Water Supply

PubMed Health - Cryptosporidium Enteritis

CDC Fact Pages - Parasites: Cryptosporidium (also known as "Crypto")

City of Milwaukee Health Laboratory History

Recent History: Organ and Tissue Transplantation

Though the concept of transplanting one part of someone's body onto someone else's body has existed for centuries [see painting], even the concept of transferring tissue from one part of someone's body to an injured part has only been successfully implemented since 1823.

The legendary transplantation of a soldier's leg by Saints Cosmas and Damian, assisted by angels - Artist Unknown, ca. mid-1500s.

Of course, human-to-human transplants of tissues have an even shorter history than autografting, and organ transplants shorter yet. But within the past century, amazing strides forward have been made within the medical arts and practice of transplanting parts from (both living and deceased) people into other people.

Here's a brief timeline of some significant milestones:

1823 - Germany - First autograft of skin, from one part of the body to another. 

Mid-Late 1800s - First auto-transplants of bone segments - significant advances made during US Civil War - well-established practice by 1900

[Initial phase of skin auto-graft, 1924]

1905 - Moravia [Czech Republic] - First human-to-human transplant - corneas!

1908 - Switzerland - First successful skin transplantation from a deceased donor to a live recipient.

Early 1900s - First successful person-to-person (deceased and living) transplantation of soft tissues, bones, and corneas

1949 - U.S. Navy Tissue Bank established - first processing and storage facility for bone and tissue transplant materials and donations

1954 - Boston, MA, USA - First organ transplant! - Live identical twins - Kidney

[Flushing the kidney before transplanting]

[The twins, several decades on, in as close to perfect health as an organ recipient can be]

1955 - Canada - First successful heart valve allograph - descending aortal valve

1962 - Boston, MA, USA - First kidney transplant from a deceased donor to a live recipient - same doctors (Dr. Joseph Murray and Dr. David Hume) as first living kidney transplant

1966 - Minneapolis, MN, USA - First successful pancreas transplant

1967 - Denver, CO, USA - First successful liver transplant

1967 - Cape Town, South Africa - First successful heart transplant!

[First transplant patient Washkansky recovering well after receiving the heart of a car wreck victim]

[Dr. Christiaan Barnard was the doctor who performed the first transplant - he was sort of a big deal]

1968 - USA - Uniform Anatomical Gift Act establishes the Uniform Donor Card as a legal document for anyone 18 years of age or older to legally donate his or her organs upon death.

1979 - USA - First living pancreas transplant - mother-to-child - part of pancreas transplanted to child allowed mother to retain enough pancreas for herself, and allowed child to also receive enough pancreas

1981 - Stanford, CA, USA - First successful heart-lung transplant

1983 - Toronto, Ontario, Canada - First successful single-lung transplant

1983 - USA - FDA approves Cyclosporine! A revolutionary anti-rejection drug. For the first time, the average survival rate of organ recipients exceeds 5 years.

1986 - Toronto, Ontario, Canada - First successful double-lung transplant

1986 - QLD, Australia - "Brisbane Technique" for splitting donor livers developed - tested on animals before human use.

1986 - USA - First heart-only transplant in 14 years - beginning of modern era of heart transplantation

1987 - Australia - First segmental liver transplant to a child - allowing a liver that matched but was too big for the child to be used

1988 - UK - First successful intestinal transplant - small intestine, including bowel.

1988 - France - First successful two-in-one liver transplant - one liver split in half, given to two patients

1989 - Chicago, IL, USA (German team leading) - First successful living-related liver transplant - one lobe of functional liver transplanted into relative with non-functional liver

1990 - Palo Alto, CA, USA - First successful related lung transplant - one lobe of lung transplanted from a woman to her 12-year-old daughter

2002 - Australia - First single-segment liver transplant on a newborn baby - youngest liver transplant at 24 days old

2005 - Japan - First living donor islet transplant! - now performed with both living and deceased donors - can eliminate insulin-dependency in Type 1 diabetes with higher success rates and lower complication rates than full-pancreas transplants

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Sources:

Legacy of Life, Schooley Mitchell (It's a telecom company, don't ask - it was some good info)

Chapman, JR, 1992, Transplantation in Australia—50 years of progress. MJA 157: 47 - Available on PubMed

Donate Life Australia

Hartford Hospital - Heart transplant in perspective

LifeLink Tissue Bank

New York Organ Donor Network

More recent history. Not too much of this on here, but the story behind the photo (from the National Archives, history from Time or Life magazine [the story clipping PDF with the photo didn't have the magazine name, but it's in a similar style to late 1990s Time]) just touched on what the people on the front lines of war went through, and still go through. I believe that it was part of a larger story on the state of mental health care provided by veteran's services.

The man on the stretcher apparently survived, but one of the men carrying him back contracted an infection while in the swamps. Something happened resulting in him not getting treated until he was septic, and he died. The man on the stretcher wrote home about how troubled he was, about how much he hated himself for not dying right away so that his buddy wouldn't have had to help with transport. His mom said that he was an extremely straight-laced person before he left, but after his friend's death (which was doubtless not the only friend who died, but the one he felt guilty for), he fell apart. Even when he was shipped home, his extreme PTSD and guilt/anxiety/severe depression was treated as nothing; the only thing he could get care for was physical therapy and continuing care for his legs. He killed himself 18 months after getting back.

The photo is one of those also available on the National Archives online. If anyone knows the complete source of the story, let me know; I'd love to read the rest of the article.