"Even on a train, deep under the earth, you can't escape them" "True, the carriage seems almost empty but that's an illusion because it's actually teeming with life" "None of us is ever truly alone because we all carry microbes, a huge army of them" "Every square centimetre of our skin holds at least two thousand bacteria, bacteria that feed, breed and sometimes even travel" "Although most of the time we are completely unaware of them there are, in fact, hundreds of millions of alien life forms living in and on each one of us we carry around more microbes than we have human cells" "Think of them as very close family:" "It's probably the most important relationship we'll ever have, because whether they're in the air we breathe or the food we eat, microbes shape our lives" "In this programme, we'll reveal the secrets of the microbes that live in and around us" "The ways they spread, and the speed with which they can take over" "Microbes range from mutant bacteria that cause life-threatening disease... to tiny viruses that can bring devastating plague" "But the body has developed superhuman defences of its own" "By following people as they get ill and get better, we'll reveal how the body counter-attacks" "Most startling of all are the medical pioneers who are now using the microbes themselves as weapons to treat diseases" "Injecting patients with bacteria to treat asthma" "And using viruses to destroy cancer what we're now doing is turning killers into cures" "Imagine a party of your best friends carrying your worst enemies:" "Viruses" "Viruses are a billion times smaller than us which is why they can infiltrate a party without being seen" "Viruses are really simple:" "Just tiny parcels of genetic material" "But once inside us, they multiply and destroy" "Ones picked up easily include herpes, transmitted by kissing, giving us cold sores" "Or Hepatitis, which attacks the liver and makes you jaundiced" "Flu viruses, transferred by sneeze or hand-shake, cause spiking temperatures and hot flushes" "Or viral meningitis, which can be rapidly fatal" "Early symptoms include a blotchy rash" "we are able to survive daily attacks by such lethal threats" "Because our bodies have evolved a number of very effective ways of fighting back" "we'll follow what happens to three-year old Alex we started filming her soon after she became infected with the chicken-pox virus" "And for a while, though infected, she looked and felt fine" "But within days, the pustules started to appear, as you can see in this series of time-lapse photographs" "She's had a couple of days of the spots coming, and not being too bad, and then" "Yesterday she was very quiet, today she's basically not moved from the position she's in now, so obviously the body's switching everything else off" "I presume to fight off what it doesn't like" "Alex caught chicken-pox from her older brother," "Josh, who recovered within a few days" "But how will his sister get on?" "Invading viruses, like the ones that cause chicken-pox, multiply incredibly fast and they can pose a real threat to our health" "Fortunately though our bodies have evolved sophisticated defences against viruses in fact nothing that modern medicine has yet produced can match the human body's immune system in the game of viral attack It's like a war game" "The human body is a sprawling city;" "the spiky ball, a virus" "A virus that manages to elude our outer defences and get right inside the body has just one objective:" "To make more copies of itself, to multiply" "First, it has to find a suitable cell to infect..." "Done." "Once inside, they're ready to take over" "A virus uses the cell as a factory to make copies of itself" "The cell bursts and dies, releasing more viruses into the body" "Alex's pustules are packed with viruses, and more are erupting all the time" "But Alex's body has also begun mobilising its own phenomenal defences" "Millions of years of struggle between us and microbes has created our sophisticated immune system" "The most important defence against viruses are these Helper T-Cells:" "They hunt out and identify harmful invaders" "Once they've identified the enemy, they send a message to Killer T-Cells" "These lock on and destroy" "And we have other less obvious defences" "She has bouts when she gets a bit hot if she's been to sleep but she wakes up and she has a drink, and she cools herself down naturally" "Alex's high temperature is actually a sign that her body is fighting back" "Many viruses that infect us operate best at normal body temperature" "So our bodies respond to invasion by turning up the heat" "Although it makes Alex feel lousy a raised temperature is helping rid her body of infection" "But sometimes, even this is not enough" "Alex's temperature becomes dangerously high and she's rushed to hospital" "Attack by the chicken pox virus has left her vulnerable to invasion by a different predator:" "Bacteria" "Bacteria are bigger, and much more complex than viruses, and they can also be extremely dangerous" "Alex's body has defences against bacteria:" "Anti-bodies which travel in the blood, and white cells that seek out and engulf their prey" "Shall we check dolly's chest?" "You check dolly's chest" "Say:" "Cough, cough" "OK, it's medicine time, honey" "It's possible that Alex's natural defences could cope, but her doctors aren't prepared to take the risk, so she's given anti-biotics to fight the bacteria" "Good girl, good girl," "Make you better" "Come on, come on, daddy get you a lolly" "You want to put- put the pain on you and not especially when they're saying:" "Make it go away, Mummy, make it go away" "You can't do anything for them, and that's the worst I think for any parent it took a mixture of five different types of anti-biotics to finally get her bacterial infection under control" "A week after being rushed into hospital, Alex is home and feeling back to normal" "Her immune system destroyed the chicken pox viruses, and the anti-biotics cleared the bacterial infection" "Anti-biotics are really wonderful drugs" "But the problem with anti-biotics is that we have over-used them" "They have saved many lives" "But for how much longer will they go on being effective?" "From the moment we began targetting bacteria with anti-biotics, we were engaged in an arms race, a race which, with the benefit of hindsight, only one side was ever going to win" "At first, small doses of anti-biotics like penicillin worked miracles" "They stopped harmful bacteria in their tracks" "But very soon doctors began to notice that they needed to give ever larger doses of anti-biotics just to have the same effect" "And as we've gone on developing ever more sophisticated weapons, they've gone on developing better defences" "The problem is, bacteria don't stand still waiting to die:" "They evolve, very fast" "They can do this because they reproduce at a phenomenal rate a new generation every twenty minutes" "So, no matter how big the hit, some bacteria will always survive" "It's why they are the most successful organism on this planet; and when bacteria become resistant to anti-biotics the results can be terrifying" "October 1999 and in London two trains heading in opposite directions on the same line collided in a fiery explosion" "As a result of the Paddington rail crash, 31 people died and over 400 were injured" "Among them, was 52 year old Tim Streatfeild" "He was burned almost beyond recognition" "when they got him into hospital they discovered that almost half his skin had been burned off" "Our skin is our first line of defence against infection from microbes without this barrier, we're incredibly vulnerable" "Tim was soon infected and what was worse, the infection was VRE or Vanco-Mycin Resistant Enterococcus" "These superbugs are terrifying because they've evolved resistance to all standard anti-biotics" "But Tim's hospital had one experimental drug left to try:" "Linezerind" "They gave it to him, and hoped" "For four weeks, Tim was in a coma" "He remembers nothing of the life - threatening drama played out in his body" "You have a lot of nightmares when you're asleep for that time," "And a lot of the people you- who have been operating on you, or have been helping you, appear in your nightmares, so you have this strange feeling that you've actually have been awake for four weeks" "but you've had other- other adventures than the ones you've had" "The new anti-biotic saved his life with the infection under control, Tim had to have numerous skin grafts" "Slowly, the new skin started to grow restoring his protective barrier against other infections" "Slowly, Tim started to get his life back" "OK, on you go with the hand again" "Good man" "Despite the anti-biotics the infection is still not completely gone" "You're inspired" "Tim is kept in isolation to reduce the risk of the bacteria escaping, and infecting others" "Now that I'm more mobile, it is getting somewhat frustrating," "I mean I feel like a caged lion, really, kind of- with er feeling I want to go around, meet other people etc" "So it's- it's- the benefits are- of being barrier-nursed are slipping away rather fast" "Tim's burns still need daily attention" "when you've finished, Mr. Streatfeild!" "But his recovery is quite remarkable" "Aren't I lucky I'm alive, basically" "Best way of looking at it, and um not too disfigured but" "I was never really a vision of beauty before anyway, so I'm quite happy" "Tim's story shows us just how exposed we now are to the threat from resistant bacteria" "And that threat is getting greater and greater" "Terrible diseases we thought we'd conquered are re-emerging" "Diseases like tuberculosis, which destroy the lungs, are coming back in ever more dangerous and resistant forms" "Stopping their spread is vitally important, and that sometimes requires extreme measures" "On the Texas border, between the United States and Mexico, a nightly struggle plays out between border guards and migrants from Latin America" "well we've got a group that's setting up close to the railroad tracks, and looks like they're trying to discuss which way they're gonna go" "They might have one of our units in sight" "So from here it's anyone's guess what they're gonna do" "what makes this game of Cat and mouse so deadly is that the guards are trying to stop an invasion" "An invasion by tuberculosis" "TB which kills two million people a year is coming back" "Many of those they catch are carrying the bug" "Among those caught last night was Juan Lopez" "He's just walked two thousand miles to try to find work" "He lost everything when a hurricane destroyed his home in Honduras" "I was hiding." "There were two dogs" "I had some sandwiches with me" "The dogs smelled the sandwiches and they came to me and started to play" "I stood up and the sheriff was passing and he arrested me" "Everyone who's caught is routinely screened for infectious diseases" "And since a third of the world is infected with TB, there's a good chance that Juan has it" "The role of the medical team here at the facility is to sreen immigrants for diseases that might be contagious to the US population, so we- we serve as defenders of the public health Here it is..." "After a short wait, Juan meets Dr. Miranda to hear the results of his X-ray" "The news is bad" "I want you to realise that you can see this side is normal, this side is abnormal" "Can you see there's more whiteness on this side than on the other side?" "This is the place where tuberculosis usually occurs" "As a doctor I suspect that you do have tuberculosis" "My suspicions are that it is quite serious" "Juan's left lung has pockets of infection in it" "If these are left untreated, they'll form chronic abscesses" "He's immediately put into a special isolation room" "TB is so infectious he's completely cut off from the outside world" "Even the air in this room is filtered" "And it's not just illegal immigrants like Juan who get locked up" "US citizens who are found to carry TB, and who refuse to take their medicine, can be forcibly held and treated" "The US takes the threat of TB very seriously indeed we will not be able to eradicate tuberculosis in this country or industrialised countries as long as there's a large reservoir of tuberculosis outside our borders" "what we would like to do is be able to treat them and then if they do qualify for entry to the United States let them do that, or if not at that point deport them, but deport them free of disease" "Juan has a choice." "Either he can be immediately deported, or he can stay to be treated" "He opts for treatment" "My intention was to go home with something to give to my children" "I don't have a house, I wasn't able to do that, so I'll just go home to be with my children" "Treatment takes up to six months and at the end he still faces almost certain deportation" "But Juan at least will be cured before he is sent home" "Juan's story is a common one in the developing world, but tuberculosis is now a growing threat in big cities like New York or London" "But for all the damage it's done" "TB has given us some real clues into the treatment for another plague, a plague that threatens the developed world" "On the night of June 24th 1994 a thunder-storm hit London" "Soon afterwards, hospital emergency wards started to fill with desperately ill people" "Over a thousand men women and children from across the city came in complaining of a similar symptom - a sudden inability to breathe" "Many were pale, sweating, on the point of passing out" "Doctors were alarmed by what was happening and puzzled about its cause was it the beginning of some sort of outbreak?" "A chemical spill?" "Or even the early signs of a biological attack by a terrorist group?" "In fact, it was none of these things what all the people rushed into hospital were actually suffering from was asthma" "The lightning storm had caused a huge cloud of pollen to be released into the atmosphere over London and pollen, although normally harmless, in susceptible people can cause asthma in susceptible people" "It was a striking example of how vulnerable we're becoming to asthma and other allergic disorders" "Decades ago, we appeared to have conquered infectious diseases like tuberculosis" "And now we see this dramatic rise in allergies" "Some doctors think the fall of one has led to the rise of the other" "Bacteria are certainly not all bad" "Some are essential for our health" "The bacteria which grow on my skin, for example, help protect me against other dangerous infections" "But we're beginning to realise that the benefits may be more than skin deep" "Bacteria may help prevent allergies" "what happens in an asthma attack is that the body over-reacts:" "It treats harmless things like pollen as though they were dangerous infections" "The airways become inflamed and swollen, this narrowing makes it harder to breathe" "Asthma can kill" "Mark Dyer has been asthmatic since childhood" "It doesn't stop him playing football, but the threat of an attack is always present" "The only way I can describe it when you have an asthma attack is you're being strangled while somebody's sat on your chest at the same time" "You're trying to breathe in and nothing's actually happening" "It's quite scary when it actually gets quite bad" "But the trick is not to let it get that bad" "I go everywhere with my Ventolin inhaler sometimes if I forget it, it's always playing on your mind at some point you think:" "Am I getting wheezy?" "Am I feeling a bit chesty?" "Although probably you're not" "One explanation for the recent dramatic rise in allergic diseases like asthma is known as the 'Hygiene Hypothesis'" "Put simply, our body's white cells over-react because they haven't got enough to do" "I like to think of this 'Hygiene Hypothesis' as the immune system becoming mischievous, much like a child becomes mischievous when it doesn't have anything to do, and instead of reacting to things like bacteria and viruses that are normally present in our environment" "because we live in a healthy if not to say sterile- environment, the immune system looks for other things to do, and what it does then it starts to respond to things like allergens:" "Pollens, house dust-mites" "There's certainly plenty of evidence that children who muck in and mix in with other children from an early age are much less likely to develop allergies" "Children who go to nurseries before the age of two are generally less allergic" "And that's perhaps because they pick up lots of infections from other children" "As adults, we obsessively avoid dirt" "But these babies have no such inhibitions - everything and anything is worth a lick" "An adult reaction is to take grimy toys away from children, but perhaps these babies have got it instinctively right" "Perhaps the odd bit of dirt helps lay down the foundations for a healthy future" "wild animals go further" "Elephants acquire the microbes they need to stay healthy by eating the dung of other elephants" "It may not look appetising to us, but they instinctively do it" "Now it's unlikely we're ever going to want to encourage our children to do this, but amongst the microbes the elephants are hoovering up, there is, surprisingly enough, something that's now being tested as a treatment for asthma" "Micro-bacterium Vacchi, which is found in soil, is a close relative of the microbe which causes tuberculosis" "And strangely enough, they've discovered that getting infected by it appears to help asthmatics" "Like a seesaw stimulating one side of the immune system can suppress the other side the side that causes allergies" "Mark was keen to try it" "There's two reasons really I'd like to take part in the trial:" "The first reason is purely selfish:" "To try and reduce the effect of asthma on myself, and hopefully I can benefit from the trial;" "and secondly is I'd like to do my bit for- for others, really" "And so he became a guinea pig and had himself injected with live microbes" "It's a sort of vaccination but a vaccination against asthma" "So, is it working?" "Well, the early signs are good" "On average there is a 30% reduction in the magnitude of the asthmatic response in the laboratory, and I think this is encouraging well, since the injection it's- there has been a marked difference" "I haven't had to use my Ventolin inhaler as much, if at all, and my asthma seems to be very much more controlled" "The idea of using microbes to treat asthma is still very controversial we need to wait and see what happens to people like Mark before getting too enthusiastic" "But the approach, using disease to treat disease, is definitely one that's gaining ground" "And in Glasgow, they've taken this idea to its extreme" "Twenty five year old Robert Swan has a brain tumour that has affected his speech and paralysed his right side" "He recently agreed to let doctors do something truly radical:" "To drill a hole in his head and inject into it live viruses" "I was twenty one at the time" "I was an electrician for Scottish Power" "I was loving life" "I was getting on brilliantly..." "This happened." "For a while they didn't know what was wrong" "Then he was told he had an inoperable brain tumour called a Glyoma" "I started getting headaches and" "Just?" "'cause somebody would say something to me and about five minutes later I couldn't remember it" "I think he knew he was dying we used to speak about it you know - wanted a party at his funeral things like that, to write down something for him to be said..." "There's things that you have to talk about, you know- well, he wanted to talk about" "Robert was given standard anti-cancer treatments, but his brain tumour kept on growing" "So, as a last resort, he agreed to have viruses injected directly into his brain" "Robert knew he'd be a guinea pig he was the first to try it" "He knew there were risks" "He knew it might not work" "But by this point, he felt he had no choice." "With no further intervention, he was going to die we'd been told it may not make any difference," "Then Robert wanted to do it so you can't say no to him if he says he's quite determined" "I was all right about that because it was either that or, you know, just treatment all the time and..." "The virus they chose to inject into Robert's brain was Herpes Simplex" "The same virus that causes cold sores" "It's particularly effective at destroying rapidly-dividing cells" "I thought, well, could this virus destroy rapidly-dividing tumour cells?" "And yet not affect cells which are no longer dividing?" "And in the brain, for instance, most of the cells in the brain are no longer dividing so that made us think:" "Well could this be used as a therapeutic tool 'cause we had turned something which was potentially bad into something that was potentially good" "Hoping against hope, they decided to go ahead" "First they drilled a hole into Robert's head;" "then they injected the virus straight into the tumour" "This was really the first time in the world that something like this had been done" "In a way, it's a relatively simple procedure, but a fairly radical thing to be doing, sticking virus into somebody's brain, so it was a whole new- new area and quite an amazing thing to be doing" "Against all the odds, Robert is still alive four years later" "This is his brain scan" "The tumour's still there we've high-lighted it in red" "It hasn't shrunk but it seems to have stopped growing, and Robert continues to improve" "He has check-ups with his consultant, Dr. Rampling ...I say it's getting better" "lmproving steadily?" "Aye well, this is your latest scan" "Once again it shows that the tumour is very much static;" "it's changed a little bit in consistency perhaps, but it's difficult to tell because the types of scan are different" "But certainly no worse and no sign that the virus has escaped in any way and done any harm" "No one really knows what will happen in the future, but for the time being, Robert's life is returning to somewhere near normal, and he's able to do things he loves most, like supporting Celtic Football Club" "Makes me feel excellent" "I've been OK ever since;" "I've had the dose" "I shouldn't be alive, I should be lying..." "lying..." "So it seems we can manipulate viruses and use them to treat such diseases as cancer" "But how can we use our increasing knowledge of viruses to tame the most dangerous virus of all?" "HIV, the virus that causes AIDS, is such a threat because it can not only hide from our normal defences but it also disables them" "It gets inside the cells that are supposed to destroy it and instead, destroys them" "At least 33 million people are now infected with HIV and most will die" "In the next five years, this number is expected to triple to over 100 million" "Niambani Orphanage, on the outskirts of Nairobi in Kenya, is home to seventy children with HIV and AIDS" "They come here to die" "Since the first officially recorded death from AIDS in 1959, the disease has killed around 15 million people, and 90% of them have come from sub-Saharan Africa, and over one quarter of them are children" "As well as the mounting death toll, AIDS is leaving a legion of orphans, most of whom are also infected with the virus" "In Kenya alone, it's been estimated that there around 350,000 infected orphans" "Children like these have no real future unless a cure is found or more likely, we find better ways of slowing the progress of the virus" "The battle being fought inside the bodies of these children is a battle they are losing" "The viruses, having invaded and destroyed most of the body's natural defences, multiply unchecked" "In the slum areas of Nairobi, one in four people are HIV-Positive" "But what is encouraging is amongst the people who live here, are a few rare individuals who seem to have a natural resistance to AIDS" "Salome is one of those rarities" "She is also a prostitute and on average has sex with six men a day" "I live in Majengo." "The way I see my life here is good, but not that good, because I really don't like the way I live" "I just don't like the work I do" "Astonishingly" "Salome doesn't have HIV, despite being repeatedly exposed to the virus" "Her immune system is different to ours" "It's able to detect HIV wherever it's hiding, and so can mount a far stronger counter-attack" "And this ability seems to be inherited" "Salome's daughter, Mastidia, is also a prostitute and she is also not infected" "Both women are taking part in a study to try to develop an AIDS vaccine" "You haven't got a problem, but this doesn't mean you shouldn't be careful" "Dr. Kimani, I'm being careful but it could be bad luck if I get HIV through medication" "I'm taking, or through the water" "These women who are resistant to HIV most of them are illiterate they are not educated and it's been a big problem to convince them they're actually not HIV-positive because they've actually seen their friends dying and they know they've been doing the same sort of business" "Dr. Kimani has so far identified 130 women who, like Salome, seem to have natural immunity" "Salome, and the other prostitutes like her, are unlikely superhumans" "Yet they clearly have special powers" "The quest now is to find out exactly what it is that makes them different and to see if this natural resistance can be replicated by a vaccine" "Blood was taken from my body, possibly to be told that I have no virus, but if this vaccine could eventually come, it could help" "I've got something special that I would like my friends to have so they can be cured and we can carry on with our lives" "It's a very very exciting finding, and I'm happy to be involved in it" "Because this group has been accused of spreading HIV in our cities and if it could be the same- same group that can offer some solutions, well and good" "The blood samples have been sent to Oxford, where the drive to develop a vaccine is well under way" "So far, from the women's blood, they've managed to extract specialised white cells that appear to give them high levels of protection against AIDS" "And they've made an experimental vaccine to boost the production of these white cells in normal people" "But can natural immunity be copied in this way?" "Shouldn't be too bad" "I'll let you know" "OK, ready?" "Local MP, Evan Harris is one of twenty men who's volunteered to test the new vaccine" "The vaccine is the only hope for future generations in some of these African countries, who will never be able to afford the therapy and the infrastructure, to treat HIV we have to be preventive" "No one yet knows just how effective this new vaccine, based on the prostitutes' blood, will be" "The scientists developing it are cautiously optimistic" "And if the trials in Oxford are successful, then the next stage will be to test it in Nairobi" "Prostitutes will continue to be intensively studied because once we've properly understood natural immunity why some people fight off infections when others don't then we'll be in a much better position to protect ourselves, not only from AIDS but also from other future plagues" "The war we've been fighting with microbes for millions of years is not over, nor will it ever be" "As quickly as we find solutions to old problems new diseases will undoubtedly emerge" "But by learning more about them and about ourselves, we should ensure that we do, at the very least, manage to stay ahead"