THE GERM CODE COPYRIGHT © 2013 JASON TETRO All rights reserved. The use of any part of this publication, reproduced, transmitted in any form or by any means electronic, mechanical, photocopying, recording or otherwise, or stored in a retrieval system without the prior written consent of the publisher—or in the case of photocopying or other reprographic copying, license from the Canadian Copyright Licensing agency—is an infringement of the copyright law. Doubleday Canada and colophon are registered trademarks Library and Archives of Canada Cataloguing in Publication is available upon request. eISBN: 978-0-38567854-4 The headings for chapters 2 and 12 were replicated from images courtesy of The Centers for Disease Control Prevention: Larry Stauffer and Charles D. Humphrey, respectively. The heading for chapter 10 was replicated from an image courtesy of Jasper Lawrence [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0-2.5-2.0-1.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons. The heading for chapter 11 was replicated from an image courtesy of Ude, http://www.tci.uni- hannover.de/ (Own work) [GFDL (http://www.gnu.org/copyleft/fdl.html) or CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons. Cover design: CS Richardson Illustration on cover, this page, ii, this page, this page, this page, and this page: Alila Medical Images / Shutterstock.com Published in Canada by Doubleday Canada, a division of Random House of Canada Limited www.randomhouse.ca v3.1 To my parents, Peter and Patricia Tetro CONTENTS Cover Title Page Copyright Dedication Introduction 1. Cracking the Germ Code 2. A War We Cannot Win 3. Every Crowd Has a Germy Lining 4. Germs Love Lovers 5. The Sneeze That Went Around the World 6. A Pandemic State of Mind 7. Campying in the Jungle 8. The Rat That Does Not Fear the Cat 9. The Germ Code Strikes Back 10. Germ Scene Investigation 11. The Germ Economy 12. Don’t Panic Acknowledgements INTRODUCTION The most important relationship in each of our lives is with germs. They are with us from the moment we are born until our last breath. They surround us, outnumber us, live on and in us, and interact with us, both to our benefit and our detriment. They are essential to keep us healthy, and at times they happen to make us sick and possibly threaten our lives. Yet, despite playing such a pivotal role in our existence, germs are often forgotten or even ignored by us, and we spend little to no time building a lasting bond with them. Can we be blamed? Not really. Building a successful and balanced rapport between two humans can be difficult enough, never mind a population of unseen entities. For millennia, philosophers, psychologists and communication experts have struggled to explain how we develop and maintain our various connections, both with people and the environment. Simply defining such a relationship can present a significant challenge. One way to summarize our shared life with germs stems from the work of American author and relationship counsellor John Gray. In the 1990s, he offered what was to become a hugely popular perspective on how humans interrelate. His titular theory, Men Are from Mars, Women Are from Venus, has since entered common parlance in discussing the discordance between men and women. As for our existence with germs, a different sort of planetary metaphor might be used to describe how we coexist with microbes: “Humans Are from Earth, Germs Are from Uranus.” The pun is biologically correct, but only up to a point. Germs happen to be found everywhere, and they play an integral role in every aspect of human existence. The sheer ubiquity of germs and humans demands a properly managed coexistence. But since the dawn of humanity, our relationship has been fraught at best. Our history is replete with stories of a love-hate connection that never seems to be balanced. As Gray pointed out in his book, the reason for imbalance stems not from the fact that the two parties are a bad match, but from a mutual lack of understanding of their fundamental differences. As a result, perceptions become lopsided, and rather than developing a coexistence, men and women come into opposition and, eventually, unnecessary war. In this regard, the balance between humans and germs was doomed from the start, as we didn’t realize germs existed until the seventeenth century. We did, however, know the consequences of their presence, manifested in outbreaks, epidemics and pandemics. But before these microscopic creatures were seen under the microscope, their actions were explained in an almost religious way, as if ethereal or otherworldly beings were responsible for the disruption to human existence. Even when the godly or alien context was put to rest, germs were regarded not as entities but as phenomena, such as “miasma,” or bad air. Should miasma make an appearance in one’s village, death would surely follow. When germs were eventually recognized as the cause of infection—a momentous occasion some two hundred years after their discovery—we did not marvel at the revelation, nor did we devote the majority of our efforts to understanding the fundamentals of germy life. Instead, we went on the offensive in the hope of ridding the earth of these supposed killers. This warlike mentality grew over the decades that followed, fostered by negative attitudes towards them in literature, film and other media. While the goal might have been to exploit the public’s fear of the unknown, the consequence was our continual inability to think of germs as fellow inhabitants of the earth who deserve respect. Today, we live in a more enlightened world where our information about germs, while not complete, is still robust enough to give them a second look. We have just as much information on their positive and beneficial contributions to our lives as we do their harmful impact. We have gained an understanding of how they live in the environment and how they interact with us. They are not always causing infection. Some people have even harnessed germs to help humanity, developing medicinal and nutritional products that improve human health and our environment. Our world has begun to see how achieving coexistence is far more important than the futile attempts at total eradication. As Gray and so many others have pointed out in their treatises, theses, essays and books, a successful, balanced relationship requires, first, knowledge of the fundamentals that form the basis of a person’s actions —otherwise known as the code—and, second, the application of that code in everyday life. The code is usually simplistic—for example, Mars/Venus—while the application requires study and understanding. Consider the most basic code of human relationships, the alphabet. English is one of the languages based on the twenty-six letters of the Latin alphabet. Yet presenting someone who does not speak English with the following: ABCDEFGHIJKLMNOPQRSTUVWXYZ will do little to provide that person with the ability to communicate. Understanding the application of this code, however—including the development of words, the use of grammar and proper pronunciation— will. As anyone who has learned how to speak a language realizes, the knowledge of the code may be fairly easy, but learning how to understand and master its application can be a lengthy, and at times frustrating, experience. Moreover, when presented with the fact that the same code can be applied in a different manner to create entirely different languages, one can see that understanding a code is nothing without knowing how it is applied. If asked what the germ code might be, most people would probably say something like “They make us sick and can kill us.” While not entirely incorrect, this is a rather limited view of the nature of germs in the world. For the most part, germs are no different from other creatures that share the earth with us—including insects, which also are generally maligned. Many of us see insects and germs as our mortal enemies, continual nuisances at best, or even predators. But of course, insects are simply looking for food and shelter wherever they can find it. The fact that they tend to like the stores of human food—which includes, for some, human blood—as well as the relative comfort of human abodes, does not make them heinous in any way. They are doing nothing wrong. Yet, because humans tend to see insects as simply pests trying to ruin our lives, we refuse to look at them in a good light and ignore their benefits to the ecology. The same can be said of germs. If they were out to destroy us, they would have succeeded a very long time ago. Yet the human race continues to progress—and even grow—meaning that our relationship with germs is not one of life or death, but rather one of coexistence. Yet until we can appreciate how germs live, what their real code might be as well as how it is used, we have really no chance at reaching any kind of true harmony. As the Germ Guy, I’ve tried to bridge the gap between science and society by taking a calm approach to germs and how they relate to us. My main focus has been to dispel the myth of the killer pathogen while being sure to keep people aware that germs can cause infection and that, in a small share of cases, there can be complications and even death. But one message that seems to continually be avoided in the media, as well as in my discussions with people on the street, is the actual reason behind our misunderstanding of what germs mean to us. With this in mind, I’ve written this book to help smooth out relations between humans and germs. The text is written to provide an understanding of why we seem to continually be at odds with them and how we can look at them in a different light and move forward towards a better coexistence. While my goal throughout the book is to emphasize balance, there can be no denying that knowledge of—and, unfortunately, attention to—the role of germs in our lives has tended to come from the ways in which they make us sick. For that reason, a large portion of the book is devoted to germs that cause illness. The days of plague, smallpox and cholera still stand as the most memorable moments in our relationship with germs and are the basis not only for the declaration of war but also the development of weapons to fight them. But the battle is unending, marked by the influenza pandemic of 2009 and other worrisome outbreaks such as SARS, E. coli O157:H7 and West Nile virus. The impact of infectious diseases isn’t limited to our health; our social behaviour and laws have also been dictated by germs of the past and present. Our social mores have changed over the centuries thanks to worldwide outbreaks of sexually transmitted infections such as syphilis, gonorrhea, herpes and HIV.