7 ms·

I got dysentery in a human challenge trial

49 points by yoyojojofosho 2y ago

fred_is_fred 2y ago
The idea that the phage could help before, during, and after is pretty interesting. Because although sometimes there are Prophylactic antibiotics, they aren't generally given to an entire population to my knowledge. And since diseases like this tend to be endemic to specific areas rather than a case here and there worldwide, so having something that's almost the equivalent of vaccine (although presumably short lived?) could really be effective for locals and travelers. Reducing the load ending back up in the water supply would then further reduce cases (ideally, although the extremely low load for this one may make it difficult). Way more to learn here. The Soviets were really big on phage research also, wonder if they still have any interesting learnings: https://pmc.ncbi.nlm.nih.gov/articles/PMC7653335/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7653335/ https://www.economist.com/science-and-technology/2023/05/03/western-firms-are-becoming-interested-in-a-soviet-medicine https://www.economist.com/science-and-technology/2023/05/03/...
teractiveodular 2y ago
Dysentery is no joke: the defining symptom, blood in your stool, comes from your intestinal lining sloughing off. A good friend of mine got it in India and said the waves of pain whenever she had to defecate were worse than giving birth without anesthetics. The one upside is that dysentery is common enough in India that it was promptly recognized and treated, with a single giant horse pill targeting both bacillary & amoebic dysentery that basically cured her in 24 hours.
- carlmr 2y ago
  [flagged]
  - readthenotes1 2y ago
    I suspect that it may be a figure of speech, like "that tastes like piss" (or "ass" or "sh#t"). I always wondered how people knew about that
    - resonious 2y ago
      I think giving birth without anesthesia is far more common that tasting piss or shit. But what do I know...
      - hzay 2y ago
        Pretty common. I did.
        SapporoChris 2y ago
        You might wish to clarify. The board guidelines do encourage to assume the best in any comment, but many do not.
        janalsncm 2y ago
        Curious, would you say it was the most painful thing you’ve experienced?
        Dove 2y ago
        I'm not the person you're asking, but I may be able to satisfy your curiosity a little. I have given birth without anesthesia -- in fact, I did so twice. I found it arduous and difficult, and there certainly were moments of pain, but I would not describe the experience overall as exactly painful. You know how when you've been running for a long time and you really want to stop? That was the primary unpleasant sensation for me. Something between a muscle cramp and a side ache, though quite intense. Really uncomfortable, really hard work. Very distressing if you freak out about it and get frightened, but actually a pretty cool experience if you lean into it. Toward the end of labor there was some significant pain, enough to make me yell, but there was also so much going on that I was very distracted from it. You can experience some pretty significant pain and not be very badly distressed by it if you're super focused on some goal and working hard for it, and boy does childbirth have that effect. ;) Now, you shouldn't overly generalize from my personal experiences. Every pregnancy is different, and every delivery is different. But I have always thought the characterization of childbirth as the greatest possible pain was overblown. In my experience, it was more like a major athletic event which involved some significant injury - a marathon or a boxing match or something in that neighborhood. You do really injure yourself enough that it takes some weeks to heal, but I honestly think that part of the equation is comparable to a bad sprain. Maybe a bit worse, but much more like an athletic injury than some of the horrible diseases people get. At any rate, it is not the most significant pain I've personally experienced. That prize goes to an infected gall bladder / passed gall stone. I've also had leg cramps which I thought were more painful than childbirth, though they didn't last as long. To relate it to the original claim, I definitely think it's plausible that dysentary is worse. Internal organs dying is high on the pain scale. (If you're curious about why I chose to avoid anaesthesia, I hadn't liked it during my first delivery. I had a long and painful labor during which anesthesia was delayed, and when I finally got it, I found it didn't much lift my distress -- I later understood that was because my pain wasn't pain exactly, it was me doing a poor job of working with my body. Aaand I was at a dumb hospital that had put me on my back, which is painful, and I didn't know any better. Anyway. I didn't see it as really relieving my discomfort, but it did confine me to bed for a couple days and robbed me of being my most alert and best self during a very important moment in my life. My second two deliveries were better experiences than my first.)
  - pvaldes 2y ago
    She most probably participated in a birth event, some years ago
    - glouwbug 2y ago
      This thread is appropriately hackernews
      - mannycalavera42 2y ago
        I strongly plus one on this :proud-of-you-meme
    - EGreg 2y ago
      What do you mean by "participated"? How would one know the subjective pain to compare it, unless she actually gave birth?
  - watwut 2y ago
    Births without anesthesia are not unusual at all. Tho it is also a figure of speech.
    - FuriouslyAdrift 2y ago
      The use of epidural, spinal, or combined spinal-epidural blockade is fairly common, now. Up to 80% in some parts of the US. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2719581 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
      - watwut 2y ago
        20% is enough to make it "not rare". It means that more then 20% of women with children have experienced that - because if you have multiple children, one could be with epidural and another without it.
- deleted 2y ago
  [deleted]
tomcam 2y ago
“Drink the Phage” will be the name of my retro death metal album
- ojbyrne 2y ago
  I was left wondering if anyone has ever finished “Infinite Jest.”
  - andrewflnr 2y ago
    The author did, ctrl-f "brick". :)
  - seanhunter 2y ago
    Well I have not had dysentery but I have read "Infinite Jest" and had no trouble finishing it. It's an amazing book and particularly so for someone like me who was obsessed with "Hamlet" as a teen. That said it's a serious modern novel and while it contains a lot of very funny parts it's also at times difficult. If you like David Foster Wallace his other two novels "Broom of the system" and "The Pale King" are also great. The Pale King was left unfinished when he died and was completed (from various drafts and notes) as a labour of love and respect from his notes by his editor. It's genuinely extraordinary and could possibly even have been his greatest work if he had been able to fully complete it. As is there are certain minor things in it that I'm sure he would have revised (eg I noticed some sentences are repeated etc). If you're not sure about David Foster Wallace I can really recommend his essays and literary criticism as consistently insightful and extraordinary and also his journalism. From his essays for a starting point I would recommend "De Unibus Pluram" and also "Fictional futures and the conspicuously young", and also "Roger Federer as Religious Experience"[1]. Of his journalism I would strongly recommend "Getting away from already being pretty much away from it all" which is an amazing write up of the experience of visiting a rural state fair and "A supposedly fun thing I'll never do again" which is the same sort of thing about going on a cruise ship. Both are very funny and perceptive. If you like those you know what you're getting into with this novels. [1] Especially if you like tennis. He also wrote an amazing essay about a tennis player who is very good but not quite good enough to make the top level and is struggling to break through. THat one is amazing but the title escapes me.
p0w3n3d 2y ago
Phags are really promising in case of antibiotics-resistant bacterias. However I wonder how long does it take to find out the bacteria is resitant, breed new phages and apply them. It's because from my experience doctors usually give me antibiotics even BEFORE they find out what bacteria I have. "Oh you have pneumonia, better give you clavulanic acid". Next time they provide me with something else. When I asked "should we make a bacterial culture" - they say "it will take so much time, better take the antibiotics now". For a sick person after antibiotics therapy and after culture test results, those days/weeks to raise another culture of phages might be deadly.
- Dilettante_ 2y ago
  This post starts with a jumpscare
  - rtkwe 2y ago
    Haha, yeah phags is barely a contraction as is ignoring it's unfortunate homophone. You're saving one letter not typing phages.
    - jjk166 2y ago
      More likely it was a typo
- blakesterz 2y ago
  This makes it seem like it's just easy, but doesn't really say that for sure I guess: What if the bacteria become resistant to the phages too? Well, that can happen easily – probably even easier than with antibiotics. Cells have been duking it out with viruses since the beginning of life. (Did you know CRISPR-Cas9, now used for gene editing, evolved in nature as a way for bacteria to recognize and cut up phage DNA?) But the difference is that whereas new antibiotics are very hard to find, there is a nigh-inexhaustible evolutionary font of phages constantly pulling ahead in the arms race. So in short: once a bacteria becomes resistant to your special phage, just find a new phage.
- 2y ago
briandw 2y ago
I can only think of The Oregon Trail when reading about Dysentery.
- magneticnorth 2y ago
  Yeah, I enjoyed the author's tangent about the game in the article.
yapyap 2y ago
thank you
stonethrowaway 2y ago
> Stated another way, more people die from dysentery now, every year than ever died from any cause on the Oregon Trail. So let’s calm down about the Oregon Trail, okay? Okay fine. Fuck.
- scifi 2y ago
  [flagged]
kylehotchkiss 2y ago
Getting paid $4,000 to participate in a trial that could potentially save thousands of lives for a disease is incredible. But even better that it's a somewhat neglected disease that doesn't often occur in the western world. Sounds like the experiment was a success and I am hopefully/excited to see this rolled out!
- shubb 2y ago
  I had a friend who participated in such a trial and ended up with long term liver injury. It's not money for nothing and it's a bigger choice than people credit.
mordechai9000 2y ago
"My friend Ozy said that Infinite Jest was a really good book for reading in a dysentery ward." I made the mistake of trying to read Sometimes a Great Notion by Ken Kesey when I had covid last. I never finished it, and when I try to read it now it reminds too much of how awful I felt.

49 points by yoyojojofosho 2y ago

The idea that the phage could help before, during, and after is pretty interesting. Because although sometimes there are Prophylactic antibiotics, they aren't generally given to an entire population to my knowledge. And since diseases like this tend to be endemic to specific areas rather than a case here and there worldwide, so having something that's almost the equivalent of vaccine (although presumably short lived?) could really be effective for locals and travelers. Reducing the load ending back up in the water supply would then further reduce cases (ideally, although the extremely low load for this one may make it difficult). Way more to learn here. The Soviets were really big on phage research also, wonder if they still have any interesting learnings: https://pmc.ncbi.nlm.nih.gov/articles/PMC7653335/ https://pmc.ncbi.nlm.nih.gov/articles/PMC7653335/ https://www.economist.com/science-and-technology/2023/05/03/western-firms-are-becoming-interested-in-a-soviet-medicine https://www.economist.com/science-and-technology/2023/05/03/...

teractiveodular 2y ago

Dysentery is no joke: the defining symptom, blood in your stool, comes from your intestinal lining sloughing off. A good friend of mine got it in India and said the waves of pain whenever she had to defecate were worse than giving birth without anesthetics. The one upside is that dysentery is common enough in India that it was promptly recognized and treated, with a single giant horse pill targeting both bacillary & amoebic dysentery that basically cured her in 24 hours.

carlmr 2y ago
[flagged]
- readthenotes1 2y ago
  I suspect that it may be a figure of speech, like "that tastes like piss" (or "ass" or "sh#t"). I always wondered how people knew about that
  - resonious 2y ago
    I think giving birth without anesthesia is far more common that tasting piss or shit. But what do I know...
    - hzay 2y ago
      Pretty common. I did.
      - SapporoChris 2y ago
        You might wish to clarify. The board guidelines do encourage to assume the best in any comment, but many do not.
      - janalsncm 2y ago
        Curious, would you say it was the most painful thing you’ve experienced?
        Dove 2y ago
        I'm not the person you're asking, but I may be able to satisfy your curiosity a little. I have given birth without anesthesia -- in fact, I did so twice. I found it arduous and difficult, and there certainly were moments of pain, but I would not describe the experience overall as exactly painful. You know how when you've been running for a long time and you really want to stop? That was the primary unpleasant sensation for me. Something between a muscle cramp and a side ache, though quite intense. Really uncomfortable, really hard work. Very distressing if you freak out about it and get frightened, but actually a pretty cool experience if you lean into it. Toward the end of labor there was some significant pain, enough to make me yell, but there was also so much going on that I was very distracted from it. You can experience some pretty significant pain and not be very badly distressed by it if you're super focused on some goal and working hard for it, and boy does childbirth have that effect. ;) Now, you shouldn't overly generalize from my personal experiences. Every pregnancy is different, and every delivery is different. But I have always thought the characterization of childbirth as the greatest possible pain was overblown. In my experience, it was more like a major athletic event which involved some significant injury - a marathon or a boxing match or something in that neighborhood. You do really injure yourself enough that it takes some weeks to heal, but I honestly think that part of the equation is comparable to a bad sprain. Maybe a bit worse, but much more like an athletic injury than some of the horrible diseases people get. At any rate, it is not the most significant pain I've personally experienced. That prize goes to an infected gall bladder / passed gall stone. I've also had leg cramps which I thought were more painful than childbirth, though they didn't last as long. To relate it to the original claim, I definitely think it's plausible that dysentary is worse. Internal organs dying is high on the pain scale. (If you're curious about why I chose to avoid anaesthesia, I hadn't liked it during my first delivery. I had a long and painful labor during which anesthesia was delayed, and when I finally got it, I found it didn't much lift my distress -- I later understood that was because my pain wasn't pain exactly, it was me doing a poor job of working with my body. Aaand I was at a dumb hospital that had put me on my back, which is painful, and I didn't know any better. Anyway. I didn't see it as really relieving my discomfort, but it did confine me to bed for a couple days and robbed me of being my most alert and best self during a very important moment in my life. My second two deliveries were better experiences than my first.)
- pvaldes 2y ago
  She most probably participated in a birth event, some years ago
  - glouwbug 2y ago
    This thread is appropriately hackernews
    - mannycalavera42 2y ago
      I strongly plus one on this :proud-of-you-meme
  - EGreg 2y ago
    What do you mean by "participated"? How would one know the subjective pain to compare it, unless she actually gave birth?
- watwut 2y ago
  Births without anesthesia are not unusual at all. Tho it is also a figure of speech.
  - FuriouslyAdrift 2y ago
    The use of epidural, spinal, or combined spinal-epidural blockade is fairly common, now. Up to 80% in some parts of the US. https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2719581 https://jamanetwork.com/journals/jamanetworkopen/fullarticle...
    - watwut 2y ago
      20% is enough to make it "not rare". It means that more then 20% of women with children have experienced that - because if you have multiple children, one could be with epidural and another without it.
deleted 2y ago
[deleted]

tomcam 2y ago

“Drink the Phage” will be the name of my retro death metal album

ojbyrne 2y ago
I was left wondering if anyone has ever finished “Infinite Jest.”
- andrewflnr 2y ago
  The author did, ctrl-f "brick". :)
- seanhunter 2y ago
  Well I have not had dysentery but I have read "Infinite Jest" and had no trouble finishing it. It's an amazing book and particularly so for someone like me who was obsessed with "Hamlet" as a teen. That said it's a serious modern novel and while it contains a lot of very funny parts it's also at times difficult. If you like David Foster Wallace his other two novels "Broom of the system" and "The Pale King" are also great. The Pale King was left unfinished when he died and was completed (from various drafts and notes) as a labour of love and respect from his notes by his editor. It's genuinely extraordinary and could possibly even have been his greatest work if he had been able to fully complete it. As is there are certain minor things in it that I'm sure he would have revised (eg I noticed some sentences are repeated etc). If you're not sure about David Foster Wallace I can really recommend his essays and literary criticism as consistently insightful and extraordinary and also his journalism. From his essays for a starting point I would recommend "De Unibus Pluram" and also "Fictional futures and the conspicuously young", and also "Roger Federer as Religious Experience"[1]. Of his journalism I would strongly recommend "Getting away from already being pretty much away from it all" which is an amazing write up of the experience of visiting a rural state fair and "A supposedly fun thing I'll never do again" which is the same sort of thing about going on a cruise ship. Both are very funny and perceptive. If you like those you know what you're getting into with this novels. [1] Especially if you like tennis. He also wrote an amazing essay about a tennis player who is very good but not quite good enough to make the top level and is struggling to break through. THat one is amazing but the title escapes me.

p0w3n3d 2y ago

Phags are really promising in case of antibiotics-resistant bacterias. However I wonder how long does it take to find out the bacteria is resitant, breed new phages and apply them. It's because from my experience doctors usually give me antibiotics even BEFORE they find out what bacteria I have. "Oh you have pneumonia, better give you clavulanic acid". Next time they provide me with something else. When I asked "should we make a bacterial culture" - they say "it will take so much time, better take the antibiotics now". For a sick person after antibiotics therapy and after culture test results, those days/weeks to raise another culture of phages might be deadly.

Dilettante_ 2y ago
This post starts with a jumpscare
- rtkwe 2y ago
  Haha, yeah phags is barely a contraction as is ignoring it's unfortunate homophone. You're saving one letter not typing phages.
  - jjk166 2y ago
    More likely it was a typo
blakesterz 2y ago
This makes it seem like it's just easy, but doesn't really say that for sure I guess: What if the bacteria become resistant to the phages too? Well, that can happen easily – probably even easier than with antibiotics. Cells have been duking it out with viruses since the beginning of life. (Did you know CRISPR-Cas9, now used for gene editing, evolved in nature as a way for bacteria to recognize and cut up phage DNA?) But the difference is that whereas new antibiotics are very hard to find, there is a nigh-inexhaustible evolutionary font of phages constantly pulling ahead in the arms race. So in short: once a bacteria becomes resistant to your special phage, just find a new phage.
2y ago

briandw 2y ago

I can only think of The Oregon Trail when reading about Dysentery.

magneticnorth 2y ago
Yeah, I enjoyed the author's tangent about the game in the article.

yapyap 2y ago

thank you

stonethrowaway 2y ago

> Stated another way, more people die from dysentery now, every year than ever died from any cause on the Oregon Trail. So let’s calm down about the Oregon Trail, okay? Okay fine. Fuck.

scifi 2y ago
[flagged]

kylehotchkiss 2y ago

Getting paid $4,000 to participate in a trial that could potentially save thousands of lives for a disease is incredible. But even better that it's a somewhat neglected disease that doesn't often occur in the western world. Sounds like the experiment was a success and I am hopefully/excited to see this rolled out!

shubb 2y ago
I had a friend who participated in such a trial and ended up with long term liver injury. It's not money for nothing and it's a bigger choice than people credit.

mordechai9000 2y ago

"My friend Ozy said that Infinite Jest was a really good book for reading in a dysentery ward." I made the mistake of trying to read Sometimes a Great Notion by Ken Kesey when I had covid last. I never finished it, and when I try to read it now it reminds too much of how awful I felt.