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home:pathogenesis:kochs_postulates [08.28.2012] – [Rethinking Koch] paulalberthome:pathogenesis:kochs_postulates [09.14.2022] (current) – external edit 127.0.0.1
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 According to T.D. Brock at the American Society of Microbiology,((Brock TD. (1999). //Robert Koch: a life in medicine and bacteriology//. American Society of Microbiology Press, Washington)) attempts to rigidly apply Koch’s postulates to the diagnosis of viral diseases may have significantly impeded the early development of the field of virology. It also impeded the understanding of chronic disease. According to T.D. Brock at the American Society of Microbiology,((Brock TD. (1999). //Robert Koch: a life in medicine and bacteriology//. American Society of Microbiology Press, Washington)) attempts to rigidly apply Koch’s postulates to the diagnosis of viral diseases may have significantly impeded the early development of the field of virology. It also impeded the understanding of chronic disease.
  
-In 1932, Razumov noted a large discrepancy between the viable plate count and total direct microscopic count of bacteria taken from aquatic habitats,(({{pubmed>long:18502944}})) yet his work was dismissed, underestimate, or both – undoubtedly because it was not consistent with Koch's postulates. +In 1932, Razumov noted a large discrepancy between the viable plate count and total direct microscopic count of bacteria taken from aquatic habitats,(({{pmid>long:18502944}})) yet his work was dismissed, underestimate, or both – undoubtedly because it was not consistent with Koch's postulates. 
  
 The faithful adherence to Koch's ideas about disease has led researchers to overestimate their comprehension of how pathogens cause disease. The faithful adherence to Koch's ideas about disease has led researchers to overestimate their comprehension of how pathogens cause disease.
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 For most of the twentieth century, the predominant feeling about the treatment, control and prevention of infectious diseases was optimism. For most of the twentieth century, the predominant feeling about the treatment, control and prevention of infectious diseases was optimism.
  
-**//Mitchell L. Cohen//** (({{pubmed>long:10963605}}))+**//Mitchell L. Cohen//** (({{pmid>long:10963605}}))
 </blockquote> </blockquote>
  
 In 1931, Henry Sigerist wrote, "Most of the infectious diseases ... have now yielded up their secrets.... Many illnesses ... had been completely exterminated; others had [been brought] largely under control...."((Sigerist, H. E. //The Great Doctors 372// (Dover Publications, New York, 1971).)) Between 1940 and 1960, the development and successes of antibiotics and immunizations added to this optimism, and in 1969, Surgeon General William H. Stewart told the United States Congress that it was time to "close the book on infectious diseases."((Garrett, L. In: //AIDS in the World// (eds Mann, J. M., Tarantola, D. J. M. & Netter, T. W.) 825–839 (Harvard Univ. Press, Cambridge, Massachusetts, 1992).))  In 1931, Henry Sigerist wrote, "Most of the infectious diseases ... have now yielded up their secrets.... Many illnesses ... had been completely exterminated; others had [been brought] largely under control...."((Sigerist, H. E. //The Great Doctors 372// (Dover Publications, New York, 1971).)) Between 1940 and 1960, the development and successes of antibiotics and immunizations added to this optimism, and in 1969, Surgeon General William H. Stewart told the United States Congress that it was time to "close the book on infectious diseases."((Garrett, L. In: //AIDS in the World// (eds Mann, J. M., Tarantola, D. J. M. & Netter, T. W.) 825–839 (Harvard Univ. Press, Cambridge, Massachusetts, 1992).)) 
  
-<html><!-- Source: http://www.nature.com/nature/journal/v406/n6797/full/406762a0.html --></html>+<html><!-- Source: https://www.nature.com/nature/journal/v406/n6797/full/406762a0.html --></html>
  
-With "victory" declared, increasing emphasis was directed at the "non-infectious" diseases such as cancer and heart disease. Often, research on infectious disease or activities on their prevention and control were de-emphasized and resources were reduced or eliminated. As recently as the 1980s, pharmaceutical companies, believing that there were already enough antibiotics, began reducing the development of new drugs or redirecting it away from antibiotics.(({{pubmed>long:8153617}})) (({{pubmed>long:8994797}})) +With "victory" declared, increasing emphasis was directed at the "non-infectious" diseases such as cancer and heart disease. Often, research on infectious disease or activities on their prevention and control were de-emphasized and resources were reduced or eliminated. As recently as the 1980s, pharmaceutical companies, believing that there were already enough antibiotics, began reducing the development of new drugs or redirecting it away from antibiotics.(({{pmid>long:8153617}})) (({{pmid>long:8994797}})) 
  
  
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 <blockquote>When someone talks about imbalance of humors of the miasmic origin of disease, I always detect among listeners the amused tolerance a parent gives to an explanation from his 3-yr-old son. A discourse on Koch’s postulates, on the other hand, is treated with great solemnity. In this light, my premise that there is no more dangerous half-truth among students of disease today than the postulates of Koch may be considered sacrilegious.  <blockquote>When someone talks about imbalance of humors of the miasmic origin of disease, I always detect among listeners the amused tolerance a parent gives to an explanation from his 3-yr-old son. A discourse on Koch’s postulates, on the other hand, is treated with great solemnity. In this light, my premise that there is no more dangerous half-truth among students of disease today than the postulates of Koch may be considered sacrilegious. 
  
-//**Robert P. Hanson**// (({{pubmed>long:3286904}}))</blockquote>+//**Robert P. Hanson**// (({{pmid>long:3286904}}))</blockquote>
  
  
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 <blockquote>Life has changed since the 1880s when Robert Koch elucidated his guidelines, later to be called Koch’s postulates, for determining whether a microorganism is the cause of a disease. The horse-drawn buggy bumping over dirt roads has been replaced by the computer-assisted automobile speeding along paved highways. It would be absurd to expect modern cars to abide by traffic rules and standards designed for horse-drawn carriages. Yet, many continue to hold Koch’s postulates as the unchanging standard for determining causation in medicine, despite a revolution in biotechnology and leaps in medical knowledge. Recent findings based on the application of new technologies, especially in the fields of microbiology and infectious disease, demand a renewed dialogue on proof of causation and revised guidelines for defining a causal relationship between a microbe and a disease. <blockquote>Life has changed since the 1880s when Robert Koch elucidated his guidelines, later to be called Koch’s postulates, for determining whether a microorganism is the cause of a disease. The horse-drawn buggy bumping over dirt roads has been replaced by the computer-assisted automobile speeding along paved highways. It would be absurd to expect modern cars to abide by traffic rules and standards designed for horse-drawn carriages. Yet, many continue to hold Koch’s postulates as the unchanging standard for determining causation in medicine, despite a revolution in biotechnology and leaps in medical knowledge. Recent findings based on the application of new technologies, especially in the fields of microbiology and infectious disease, demand a renewed dialogue on proof of causation and revised guidelines for defining a causal relationship between a microbe and a disease.
  
-//**David N. Fredricks and David A. Relman**//(({{pubmed>long:8665474}}))+//**David N. Fredricks and David A. Relman**//(({{pmid>long:8665474}}))
 </blockquote> </blockquote>
  
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 The blind adherence to Koch's postulates precludes a more nuanced understanding of disease: it is in fact a group of genetically indistinct organisms, a [[home:pathogenesis:microbiota|metagenomic microbiota]], which may cause and drive chronic disease.  The blind adherence to Koch's postulates precludes a more nuanced understanding of disease: it is in fact a group of genetically indistinct organisms, a [[home:pathogenesis:microbiota|metagenomic microbiota]], which may cause and drive chronic disease. 
  
-In a 2005 //Lancet// paper, Brogden //et al.// point to the existence of dozens of polymicrobial diseases, caused by combinations of viruses, bacteria, fungi, and parasites.(({{pubmed>long:15652608}})) In these infections, the presence of one micro-organism generates a niche for other pathogenic micro-organisms to colonise, one micro-organism predisposes the host to colonisation by other micro-organisms, or two or more non-pathogenic micro-organisms together cause disease. This topic is discussed further in the article [[home:pathogenesis:successive_infection|Successive infection and variability in disease]].+In a 2005 //Lancet// paper, Brogden //et al.// point to the existence of dozens of polymicrobial diseases, caused by combinations of viruses, bacteria, fungi, and parasites.(({{pmid>long:15652608}})) In these infections, the presence of one micro-organism generates a niche for other pathogenic micro-organisms to colonise, one micro-organism predisposes the host to colonisation by other micro-organisms, or two or more non-pathogenic micro-organisms together cause disease. This topic is discussed further in the article [[home:pathogenesis:successive_infection|Successive infection and variability in disease]].
  
  
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 {{tag> Pathogenesis Study_Design}} {{tag> Pathogenesis Study_Design}}
 +<nodisp>
 ===== Notes and comments ===== ===== Notes and comments =====
  
   * Legacy content   * Legacy content
-    * http://bacteriality.com/2007/08/28/horizontal-gene-transfer/+    * https://bacteriality.com/2007/08/28/horizontal-gene-transfer/
  
  
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  L. Garrett. 2000. Betrayal of Trust: The Collapse of Global Public Health. New York. Hyperion: 474.  L. Garrett. 2000. Betrayal of Trust: The Collapse of Global Public Health. New York. Hyperion: 474.
  
-B. Gewen. ‘The Great Influenza’ and ‘Microbial Threats to Health’: Virus Alert. The New York Times March 14, 2004, available at: http://www.nytimes.com/ 2004/03/14/books/review/14GEWENT.html.+B. Gewen. ‘The Great Influenza’ and ‘Microbial Threats to Health’: Virus Alert. The New York Times March 14, 2004, available at: https://www.nytimes.com/ 2004/03/14/books/review/14GEWENT.html. 
 + 
 +===== References =====</nodisp>
  
-===== References ===== 
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