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Koch’s Postulates

Kaushal Mehta
Koch’s Postulates

Koch’s postulates are criteria for establishing that specific microbes cause specific diseases

Koch was a German physician who played a major role in establishing that microorganisms
cause specific diseases. In 1877, he published some early papers on anthrax, a disease of
cattle that can also occur in humans. Koch demonstrated that certain bacteria, today known as
Bacillus anthracis, were always present in the blood of animals that had the disease and were
not present in healthy animals.

He knew that the mere presence of the bacteria did not prove that they had caused the
disease; the bacteria could have been there as a result of the disease. Thus, he experimented
further. He took a sample of blood from a sick animal and injected it into a healthy one. The
second animal developed the same disease and died. He repeated this procedure many times,
always with the same results. (A key criterion in the validity of any scientific proof is that
experimental results be repeatable.) Koch also cultivated the microorganism in fluids outside
the animal’s body, and he demonstrated that the bacterium would cause anthrax even after
many culture transfers. Koch showed that a specific infectious disease (anthrax) is caused by
a specific microorganism (B. anthracis) that can be isolated and cultured on artificial media.
He later used the same methods to show that the bacterium Mycobacterium tuberculosis is the
causative agent of tuberculosis.

Koch’s research provides a framework for the study of the etiology of any infectious disease.
Today, we refer to Koch’s experimental requirements as Koch’s postulates.

They are summarized as follows:

1. The same pathogen must be present in every case of the disease.

2. The pathogen must be isolated from the diseased host and grown in pure culture.

3. The pathogen from the pure culture must cause the disease when it is inoculated into a
healthy, susceptible laboratory animal.

4. The pathogen must be isolated from the inoculated animal and must be shown to be the
original organism.

Exceptions to Koch’s Postulates

1. Koch’s postulates are modified to establish aetiologies of diseases caused by viruses

and some bacteria, which cannot be grown on artificial media.

2. Some diseases, such as tetanus, have unequivocal signs and symptoms.

3. Some diseases, such as pneumonia and nephritis, may be caused by a variety of

microbes.

4. Some pathogens, such as S. pyogenes, cause several different diseases.

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Koch’s Postulates

Kaushal Mehta
5. Certain pathogens, such as HIV, cause disease in humans only, so testing raises
ethical concerns

6. Pathogens like HIV do not cause a diseased state, instead they allow other
opportunistic pathogens to cause secondary infections.

Although Koch’s postulates are useful in determining the causative agent of most bacterial
diseases, there are some exceptions. For example, some microbes have unique culture
requirements. The bacterium Treponema pallidum is known to cause syphilis, but virulent
strains have never been cultured on artificial media. The causative agent of leprosy,
Mycobacterium leprae, has also never been grown on artificial media. Moreover, many
rickettsial and viral pathogens cannot be cultured on artificial media because they multiply
only within cells.

Circumvention 1: Use of alternative methods of culturing and detecting certain microbes.

When researchers looking for the microbial cause of legionellosis (Legionnaires’ disease)
were unable to isolate the microbe directly from a victim, they took the alternative step of
inoculating a victim’s lung tissue into guinea pigs. These guinea pigs developed the disease’s
pneumonia like symptoms, whereas guinea pigs inoculated with tissue from an unafflicted
person did not. Then tissue samples from the diseased guinea pigs were cultured in yolk sacs
of chick embryos, a method that reveals the growth of extremely small microbes. After the
embryos were incubated, electron microscopy revealed rod-shaped bacteria in the chick

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Koch’s Postulates

Kaushal Mehta
embryos. Finally, modern immunological techniques were used to show that the bacteria in
the chick embryos were the same bacteria as those in the guinea pigs and in afflicted humans.

Circumvention 2: Molecular biological techniques such as PCR can also be used to confirm
the presence of same pathogen in the diseased tissue, even if it is not isolated or cultured.

In a number of situations, a human host exhibits certain signs and symptoms that are
associated only with a certain pathogen and its disease. For example, the pathogens
responsible for diphtheria and tetanus cause distinguishing signs and symptoms that no other
microbe can produce. They are unequivocally the only organisms that produce their
respective diseases. But some infectious diseases are not as clear-cut and provide another
exception to Koch’s postulates. For example, nephritis (inflammation of the kidneys) can
involve any of several different pathogens, all of which cause the same signs and symptoms.
Thus, it is often difficult to know which particular microorganism is causing a disease. Other
infectious diseases that sometimes have poorly defined aetiology are pneumonia, meningitis,
and peritonitis (inflammation of the peritoneum, the membrane that lines the abdomen and
covers the organs within them).

Still another exception to Koch’s postulates results because some pathogens can cause several
disease conditions. Mycobacterium tuberculosis, for example, is implicated in diseases of the
lungs, skin, bones, and internal organs. Streptococcus pyogenes can cause sore throat, scarlet
fever, skin infections (such as erysipelas), and osteomyelitis (inflammation of bone), among
other diseases. When clinical signs and symptoms are used together with laboratory methods,
these infections can usually be distinguished from infections of the same organs by other
pathogens.

Ethical considerations may also impose an exception to Koch’s postulates. For example,
some agents that cause disease in humans have no other known host. An example is human
immunodeficiency virus (HIV), the cause of AIDS. This poses the ethical question of
whether humans can be intentionally inoculated with infectious agents.

Circumvention 3: In 1721, King George I told several condemned prisoners they could be
inoculated with smallpox to test a smallpox vaccine. He promised their freedom if they lived.
Human experiments with untreatable diseases are not acceptable today.

Circumvention 4: Sometimes accidental inoculation of a pathogen can occur, which can be

used for confirmation. A contaminated red bone marrow transplant satisfied the third Koch’s
postulate to prove that a herpes virus caused cancer.

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