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Chapter 3 : Dangerous Friends and Friendly Enemies

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Abstract:

We live in a delicate balance with our microbial partners. Although we live in harmony with most, some relationships are unfriendly. Sometimes friendly microbes turn against us. Sometimes familiar enemies that we have learned to live with gain the upper hand. And sometimes swift, lethal strangers quickly overwhelm us. Although we can reach accommodation with some of our adversaries, we keep most at bay using public health measures and our most sophisticated defense—the immune system. Microbes are key players in our amazing, intricate, and dynamic personal ecosystems. Defined by surfaces like the teeth, tongue, and cheeks, the habitats of the mouth are bathed in nutrient-rich fluids along with digestive enzymes and saliva. Our expanding human population leads to two of the most important changes—increased urbanization and movement into previously remote areas. We have used antibiotics as an effective way of stopping invading microbes since the discovery of penicillin in the first part of the 20th century. We take advantage of our immune system ability to develop memory when we undergo vaccination. Our own immune system almost always causes collateral damage in its attempts to thwart an invader. We have virtually eliminated measles, mumps, diphtheria, whooping cough, and most recently ear infections and meningitis. But microbes evolve resistance to our antibiotics and new devices for evading our vaccines. Perhaps new approaches that rely on understanding and entering into their microbial conversations can replace our present strategy to eliminate them.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3

Key Concept Ranking

Immune Systems
0.5159021
Rocky Mountain Spotted Fever
0.43610492
Infectious Diseases
0.41784018
0.5159021
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Figure 1

C.J. Peters

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 4

A tube has an “in side” and an “out side.”

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Microbes residing on our skin, mouth, and intestinal tract are on both the “out side” and the “in side” of our tube. Microbes invading muscle, bone, and internal organs are REALLY inside.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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“Microorganisms do communicate. They do it chemically.”

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 7

Stanley Falkow

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Our skin harbors at least thirty different kinds of microbes. On our backs there may be several hundreds to thousands per square centimeter; on damper surfaces, thousands of times that many.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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1. Microbes infecting this catheter are glued to its surface.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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2. Once glued in place, they begin to divide.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 14

3. After enough time, the entire surface is coated with microbes and their glue.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 15

The mouth offers a hospitable environment for over 400 different kinds of microbes.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 18

The stomach's acid environment is a powerful deterrent to microbes.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 19

The small intestine, still hostile to those who have negotiated the stomach, offers some hope.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 20

The colon is like a densely populated metropolis, an urban melting pot for microbes.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 22

cells dive into the thick mucus coating the stomach lining . . .

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 23

. . . where their toxins, combined with the acid environment and our own defensive responses, diminish the mucus layer and lead to damage.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 25

1. Bacteria in the colon . . .

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 26

2. . . . are killed off by antibiotics . . .

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 27

3. . . . leaving the field open to opportunists like

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 29a

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 29c

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 33

Most rabbits were highly susceptible to the virus. These were killed off—until the less susceptible (shown here in brown) reproduced and became the majority population.

Most viruses were at first lethal. As they killed their host rabbits, they, too, reached a dead end. Their less lethal forms (shown here in blue) became the majority population.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 35

1. The normal red blood cell is a smooth, rounded, flexible disk that slips easily through the narrowest blood vessels.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 36

2. In sickle cell disease, the cells become elongated, shaped somewhat like a sickle, and more fragile. The sickled cells are removed quickly from circulation.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 39

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 40

Dogs, cats, skunks, raccoons, and bats can all harbor rabies virus, which causes a deadly infection in them. We encounter the virus, which causes the same fatal disease in humans, if we are bitten by a rabid animal.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 41

Ticks transmit a bacterium named among its normal rodent hosts. We get Rocky Mountain spotted fever when we become a meal for the tick, which transmits the bacterium to us.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 42

Cattle are a common host to a bacterium named which causes the disease infectious abortion. We get infected with through contact with meat and unpasteurized dairy products from a diseased cow.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 43

Parrots and other birds are subject to an epidemic disease caused by a bacterium named The bacterium, which causes pneumonia in us, can be transmitted to humans when we come in contact with an infected bird.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 44

“And I . . . with my own hands, buried five of my children in a single trench, and many others did the like . . . And no bells rang and nobody wept no matter what his loss, because almost everyone expected death . . . And people said and believed, 'This is the end of the world.'”—Siennese chronicler, 1354 (Schebill, F., “Sienna,” in Part V, by Will Durant.)

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 45

A relatively benign relationship among rats, fleas, and becomes the Black Death when humans inadvertently find themselves caught in the cycle.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 46

A mysterious disease, the English sweating sickness, swept England in the 1500s, then disappeared. Some suspect it might have been caused by a hantavirus.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 48a

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 48b

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 49

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 50

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 51

1. Our immune system recognizes, tags, and neutralizes a familiar “flu” virus.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 52

2. Through mutation, the outer coat of the virus changes . . .

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 53

3. . . . to one that our immune system doesn't recognize.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 54

Understanding how climate and diseases are linked can help us predict and prevent outbreaks. Warm, wet conditions offer fertile breeding grounds for many infectious diseases. Unusually heavy rains overwhelm water systems designed for less extreme conditions, exposing people to diseases like cholera. Heavy rains also lead to more standing water. That plus a warm climate make a more Favorable breeding ground for mosquitoes.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 55

Mosquitoes transmit a variety of diseases to humans, including malaria, dengue fever, yellow fever, and encephalitis. When the climate is wet and warm, the mosquito population explodes, increasing our probability of becoming a mosquito's meal and the recipient of a microbial pathogen.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 56

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 57

1. Complement proteins (pink) circulating in our bloodstream (among the blood cells) . . .

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 58

2. . . . latch onto bacteria that have gotten inside us.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 59

3. The invaders, tagged by the complement proteins on their surface . . .

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 60

4. . . . are detected by macrophages and consumed.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 61

Complement proteins stick to our own cells as well as to foreign cells. But because of differences in the chemical composition of the surfaces, they tend to drop off our cells readily.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 62

1. Invading microbe

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 63

2. Antigen (a piece of the microbe)

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 64

3. T cells, the commanders.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 65

4. B cells, the artillery.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 66

5. Macrophage, the terminator.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 67

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 68

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 69

Once an invader has been defeated, the immune system has an insurance policy. It leaves a population of long-living B cells and T cells that match the antigens from the invader. They are ready to respond quickly should the invader ever reappear.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 70

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 71

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Image of Figure 72a
Figure 72a

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72b

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72c

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72d

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72e

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72f

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72g

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72h

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 72i

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 73

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 74

John Snow mapped a radiating circle of cholera victims and found the now infamous Broad Street pump at the center.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 75

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 76

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 77

Immunization—the administration of a vaccine—is a highly effective way of preventing some diseases, like polio, measles, and diphtheria.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 78

Vaccines may be living pathogens (bacteria or viruses) that have been rendered incapable of causing disease; they may be dead pathogens, or parts of dead pathogens.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 79

All have the common property of being antigenic, i.e., they bind to their matching receptors on T cells and B cells . . .

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 80

. . . which then multiply into a population of cells ready to respond should the real thing invade.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 81

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 82

After a century of improved sanitation and antibiotics, infectious diseases in the United States are no longer the number one cause of death.

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 83

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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Figure 84

Citation: Needham C, Hoagland M, McPherson K, Dodson B. 2000. Dangerous Friends and Friendly Enemies, p 89-136. In Intimate Strangers. ASM Press, Washington, DC. doi: 10.1128/9781555818159.ch3
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