Review by New York Times Review
l. I ? In the 1940 s, scientists developed the first ?íÉrw® cure for tuberculosis, the drug streptomycin. Sy.???!® The disease almost immediately showed -w signs of resistance, so researchers devised a CbreathG combination therapy to hold tuberculosis at ?JSSs? bay temporarily. Yet, as Lougheed, a science journalist and former disease researcher, explains, tuberculosis continues to evolve in new and menacing ways - spurred on in part by our very efforts to contain it. Lougheed's history of tuberculosis dates it back to ancient mummies and medieval bones. She touches on New England folklore that links the disease to vampirism, as well as TB's 19th-century associations with creativity (think: Frederic Chopin, Keats and the Brontes). Still, she is generally flippant about the cultural significance of disease; she calls Thomas Mann's "The Magic Mountain" "a looong German book set in a ?? sanatorium." Fortunately she becomes more engaged as she delves into contemporary research on the pathogen itself. Tuberculosis establishes a complex presence in the people it infects: Upon entering the body usually through the lungs, it is engulfed by immune cells called macrophages. In most cases, instead of succumbing to them, the bacteria spur the creation of organized structures, called granulomas, fortified by walls that are several cells thick, making them hard for drugs to penetrate. This means that as patients undergo treatment, the bacteria may be exposed to "sub-lethal concentrations" of drugs, which can hasten the evolution of resistance. In addition, granulomas often enter a quiescent state, during which they may be even less susceptible to therapy. Lougheed offers an impressive survey of current attempts to diagnose and treat the disease, from the experimental use of cancer drugs that modify the immune system to statins, which are typically prescribed to lower cholesterol. (As it happens, M. tuberculosis can feed on cholesterol within the body.) Without underplaying the challenges, especially of TB's multidrug-resistant and extensively drug-resistant strains, she presents a league of smart scientists whose ingenuity and commitment offer at least some sense of hope.
Copyright (c) The New York Times Company [December 24, 2018]
Review by Booklist Review
Microbiologist Lougheed aims at rebranding TB as a modern monster rather than a mothballed relic of history. Her surprisingly entertaining discussion of tuberculosis is imbued with a quirky sense of humor, weird facts, lots of science, and a healthy respect for the illness. TB is a bigger killer than HIV/AIDS and malaria. It has gone by many names (consumption, the white plague, phthisis); been romanticized; and infected many famous figures, including Keats, Chopin, Gauguin, and Kafka. It is curable but hard to kill, and TB treatment is a bitch. Typical cases require 6 to 9 months of multiple medications; drug-resistant cases necessitate antibiotic therapy of 20 months or longer. HIV and poverty are TB's partners in crime. Lougheed's biography of this tough mycobacterium includes a discussion of the BCG vaccine, molecular archaeology, sputum culture, drug discovery, and GeneXpert molecular diagnostic testing. She also finds room for giant African pouched rats trained to sniff TB's smell print, an Egyptian mummy, and the peculiar susceptibility of elephants to tuberculosis. A successful introduction to the continued challenges presented by perhaps the deadliest infection in human history.--Miksanek, Tony Copyright 2017 Booklist
From Booklist, Copyright (c) American Library Association. Used with permission.
Review by Publisher's Weekly Review
British medical researcher Lougheed creditably covers the long, painful history of tuberculosis, the world's leading infectious killer, and the impressive recent advances in combatting it. The slow-growing and tough TB bacterium has infected humans since prehistory, but our immune system largely kept it under control up until the industrial revolution, when humans packed into cities and their health and immune systems declined. Improvements in public health after 1900 reduced infections, and it was widely believed that anti-TB antibiotics-which were developed after just after WWII-would eliminate the threat. But resistance appeared; widespread poverty in the developing world, combined with other diseases attacking the immune system such as HIV, has produced a worldwide epidemiological crisis. Lougheed delivers an expert account of this history, although her efforts to enliven a dismal subject with cheerful anecdotes and jokes do not always succeed. She is at her best when describing the research done in the late 20th and early 21st centuries. Dazzling technical advances, new drugs, the development of genomics, insights into the bacterium's metabolism, and massive but halting political efforts may eventually turn the tide, but as Lougheed writes, TB is "very much a disease of the present and, sadly, the future." (Sept.) © Copyright PWxyz, LLC. All rights reserved.
(c) Copyright PWxyz, LLC. All rights reserved
Review by Library Journal Review
Causing 1.8 million deaths a year, a count that surpasses that of either malaria or HIV/AIDS, tuberculosis (TB) clocks in as the deadliest infectious disease. TB researcher Lougheed takes a closer look at this ancient yet potentially curable illness that continues to ravage humans around the world, particularly in areas with high poverty and limited access to health care. She has crafted a biography of TB, exploring its historical evolution and humans' response to it. Beginning with the work of molecular archaeologists to diagnose TB in ancient remains, Lougheed moves through history covering a variety of topics such as the migration of TB to all corners of the globe. According to the author, if we ever hope to overcome the disease, a comprehensive, collaborative approach combining science and efforts to combat poverty and improve access to health care will be necessary. With humor and clarity, she skillfully distills the complex science surrounding mycobacterium TB into a comprehensible narrative. VERDICT Sure to be appreciated by scientists as well as lay people interested in learning about this persistent disease. Make no mistake, however-this is serious science.-Ragan O'Malley, Saint Ann's Sch., Brooklyn © Copyright 2017. Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
(c) Copyright Library Journals LLC, a wholly owned subsidiary of Media Source, Inc. No redistribution permitted.
Review by Kirkus Book Review
An exegesis on tuberculosis, a scourge that continues to threaten humanity: in 2015, there were 10.4 million new cases and 1.4 million deaths.London-based microbiologist Lougheed left the TB field after years of drug research that yielded few results. Indeed, her text makes clear that Mycobacterium tuberculosis is a bug that has co-evolved with humans since the birth of our species, acquiring extraordinary survival strategies. When the bugs land in a lung, the immune system sends macrophages to engulf and eat them, but they convert the macrophages to squats and live on various immune cell lipids. In turn, these infested macrophages group into granulomas that cluster in the lung, each with its own ecology. Further complicating the problem of combatting the disease is the fact that M. tuberculosis has an especially thick cell wall. Antibiotics only work against actively growing cells, so if the TB bug is sleeping, it can persist and then become the source of reactivation of a latent infection. Then there are the bugs with mutations that have resulted in multiply drug-resistant TB. Lougheed examines all these microbe-immune system interactions by dissecting current research papers as though readers were part of a weekly session of post-doctoral candidates keeping up-to-date. (The book could have used further editing for a general audience.) The author also explains the need for daily treatment regimens of multiple pills or injections that can last for years. As Lougheed notes, as well, TB flourishes in the presence of poverty, malnutrition, crowded living conditions, and co-infections. Unfortunately, this makes certain areas particularly vulnerable to the disease, including migrant and refugee camps. Not just a medical history, but a call to action. TB is not some quaint 19th-century romantic tragedy but rather a very real and present danger that requires investments in diagnostics and new drugs and greater attention to social and racial inequities. Copyright Kirkus Reviews, used with permission.
Copyright (c) Kirkus Reviews, used with permission.
