“Nightmare Bacteria” on the Move and Moving Fast

Antibiotic resistant bacteria is on the rise across the United States. According to the CDC, “more than 23,000 Americans die each year from infections caused by germs resistant to antibiotics.” They recently released a report with even more startling news. In 2017 there were over 200 cases of “nightmare” bacteria found in 27 states. According to LiveScience:

One particularly concerning type of antibiotic-resistant bacteria is called carbapenem-resistant Enterobacteriaceae, or CRE, which has been dubbed “nightmare” bacteria. These bacteria are not only resistant to many antibiotics but are also highly lethal, killing up to 50 percent of infected patients, according to the CDC.

Doctors liken the spread of CRE and other antibiotic-resistant germs to a wildfire, which is difficult to contain once it spreads widely.

Even more concerning is that 1 in 10 people show no symptoms at all.  And while the “nightmare bacteria” known as CRE has not been found in all states (yet), general antibiotic resistance is just about everywhere.

The CDC suggests an aggressive approach. No, they don’t want you to go out and buy containment suits and build a bunker, though that is my suggestion. They emphasize that “early and aggressive action—when even a single case is found—can keep germs with unusual resistance from spreading in health care facilities and causing hard-to-treat or even untreatable infections.” This includes health care providers identifying resistant germs rapidly and “using infection control measures such as hospital gloves, gowns and more stringent cleaning in the rooms of infected patients. They also recommend testing patients without symptoms who may carry and spread the germs.”

What is Disease X?

Forget about preparing for zombie outbreaks. We should all be preparing for Disease X instead. Each year the WHO meets to create a list of diseases that pose a serious international public health risk “because of their epidemic potential and for which there are no, or insufficient, countermeasures.”

Many of the diseases listed are routine players, such at Ebola, Lassa Fever, SARS, and Zika. But this year, the WHO added “Disease X.” According to the WHO, “Disease X represents the knowledge that a serious international epidemic could be caused by a pathogen currently unknown to cause human disease…”

John-Arne Rottingen, a scientific adviser to the WHO committee says:

“Disease X could be be sparked by a zoonotic disease – one that jumps from animals to humans – and then spreads to become an epidemic or pandemic in the same way H1N1 Swine flu virus did in 2009…As the ecosystem and human habitats change there is always the risk of disease jumping from animals to humans. It’s a natural process and it is vital that we are aware and prepare. It is probably the greatest risk.”

So what does the WHO recommend? Sure, worrying helplessly might seem fun, but they suggest better diagnostics, existing drugs & vaccine improvements, and more research.They do not explicitly suggest a zombie preparedness kit, but you could certainly use your imagination for what Disease X may turn out to be, and plan accordingly.

Zombie Fungus Among Us

A fungus found in tropical forests, Ophiocordyceps unilateralis, (save that for your next game of Scattergories) uses a mind controlling chemical concoction to control the brains of ants.

Once an ant is infected with the fungus, the cells of the fungus multiply and start working with each other. They build short tubes as a way to communicate and exchange nutrients. They also begin to invade the ants muscles, but leave the brain untouched:

Together, these brainless cells can commandeer the brain of a much larger creature…

Over the course of a week, it compels the ant to leave the safety of its nest and ascend a nearby plant stem. It stops the ant at a height of 25 centimeters—a zone with precisely the right temperature and humidity for the fungus to grow…

It effectively cuts the ant’s limbs off from its brain and inserts itself in place, releasing chemicals that force the muscles there to contract. If this is right, then the ant ends its life as a prisoner in its own body.

The fungus forces the ant to lock its little ant legs around a leaf, and “eventually, it sends a long stalk through the ant’s head, growing into a bulbous capsule full of spores.” This is a pretty gruesome thing to do to an ant, even if you are a bug hater like me.

“Post-Antibiotic Apocalypse”

Forget about preparing for zombie outbreaks. Well, not completely, for obvious reasons. The obvious reasons are that I believe it’s only a matter of time before 28 Days Later becomes a reality, but it’s not worth the energy worrying about. Instead, we should all worry about “the end of modern medicine” as we know it. Increasing antibiotic resistance means not being able to treat what we consider today to be regular, run of the mill infections. It means all surgery, c-sections, cancer treatments, and transplants become potentially lethal.

An article in The Guardian notes:

Each year about 700,000 people around the world die due to drug-resistant infections including tuberculosis, HIV and malaria. If no action is taken, it has been estimated that drug-resistant infections will kill 10 million people a year by 2050.

Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases, spoke recently at a symposium at Harvard Business School. He says the spread of antibiotic resistance is caused by several things:

Rampant overprescribing, to the widespread use of the drugs to promote livestock growth, and to the relative trickle of new drugs being developed as possible replacements…

The greatest antibiotic use — 70 percent — is in livestock, and more than half of that isn’t because the animals are sick, but for “growth promotion” in crowded settings….

The slow pace of drug development is largely due to poor economic incentives. Antibiotics tend to be inexpensive and taken by patients for a relatively short time, so there is less demand for them than for drugs for chronic conditions. Further, new antibiotics are used more sparingly so they will remain effective when resistance develops to other drugs, a strategy that, while sound from a public health standpoint, does not boost profits.

Drug companies, eager to unethically make as much money as possible, are in on the 28 Days Later plot. Oops, I mean drug companies should reconsider their strategy because if everyone dies no one is going to buy their drugs anyway.

On an more uplifting note, Halloween is coming up! This is a good time for everyone to watch or re-watch 28 Days Later, as well as the darker sequel 28 Weeks Later (or your favorite zombie-pandemic movie). Just be careful you don’t watch 28 Days instead, which I have accidentally done before.

Severe Respiratory Failure

I had a mild heart-stopping moment just now when I was reviewing the WHO’s update on H1N1, published today on their web site, which hints at the real possibility of impending doom:

Severe respiratory failure

Perhaps most significantly, clinicians from around the world are reporting a very severe form of disease, also in young and otherwise healthy people, which is rarely seen during seasonal influenza infections. In these patients, the virus directly infects the lung, causing severe respiratory failure. Saving these lives depends on highly specialized and demanding care in intensive care units, usually with long and costly stays.

During the winter season in the southern hemisphere, several countries have viewed the need for intensive care as the greatest burden on health services. Some cities in these countries report that nearly 15 percent of hospitalized cases have required intensive care.

Preparedness measures need to anticipate this increased demand on intensive care units, which could be overwhelmed by a sudden surge in the number of severe cases.

Vulnerable groups

An increased risk during pregnancy is now consistently well-documented across countries. This risk takes on added significance for a virus, like this one, that preferentially infects younger people.

Data continue to show that certain medical conditions increase the risk of severe and fatal illness. These include respiratory disease, notably asthma, cardiovascular disease, diabetes and immunosuppression.

When anticipating the impact of the pandemic as more people become infected, health officials need to be aware that many of these predisposing conditions have become much more widespread in recent decades, thus increasing the pool of vulnerable people.

Obesity, which is frequently present in severe and fatal cases, is now a global epidemic. WHO estimates that, worldwide, more than 230 million people suffer from asthma, and more than 220 million people have diabetes.

Moreover, conditions such as asthma and diabetes are not usually considered killer diseases, especially in children and young adults. Young deaths from such conditions, precipitated by infection with the H1N1 virus, can be another dimension of the pandemic’s impact.

Higher risk of hospitalization and death

Several early studies show a higher risk of hospitalization and death among certain subgroups, including minority groups and indigenous populations. In some studies, the risk in these groups is four to five times higher than in the general population.

Although the reasons are not fully understood, possible explanations include lower standards of living and poor overall health status, including a high prevalence of conditions such as asthma, diabetes and hypertension.

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