The Spread of Superbugs

The U.S. Centers for Disease Control and Prevention has just published a first-of-its-kind assessment of the threat the country faces from antibiotic-resistant organisms.

And the news is not good.  In fact it’s downright scary. The agency’s overall conservative assessment of the problem includes frightening statistics such as:

• Each year, in the U.S., 2,049,442 illnesses caused by bacteria and fungi that are resistant to at least some classes of antibiotics
• Each year, out of those illnesses, there are 23,000 deaths
• Each year, those illnesses and deaths result in $20 billion of additional healthcare spending
• Each year, an additional $35 billion lost to society in foregone productivity.

The report marks the first time the agency has provided hard numbers for the incidence, deaths and cost of all the major resistant organisms. It also represents the first time the CDC has ranked resistant organisms by how much and how imminent a threat they pose, using seven criteria:

• health impact
• economic impact
• how common the infection is
• how easily it spreads
• how much further it might spread in the next 10 years
• whether there are antibiotics that still work against it
• whether things other than administering antibiotics can be done to curb its spread

Out of that matrix, their top three “urgent” threats they identified were:

• Carbapenem-resistant Enterobacteriaceae (CRE), a family of ICU germs that includes Klebsiella and  E. coli, that have become are resistant to almost all antibiotics, resulting in  9,000 infections per year and at least 600 deaths
• Antibiotic-resistant gonorrhea, which currently responds to only one drug: 246,000 infections per year
• Clostridium difficile,  which causes 250,000 illnesses, 14,000 deaths.

In addition, the CDC identified 12 resistant bacteria and fungal infections which the agency dubs “serious” i.e., requiring “prompt and sustained action.”  They include the hospital-acquired infections  Acinetobacter, Pseudomonas aeruginosa, and Vancomycin-Resistant Enterococcus (VRE) ; the foodborne organisms Campylobacter, Salmonella and Shigella; MRSA; Candida and TB.

The last category, “concerning” i.e., requiring “careful monitoring and prevention” includes rare but potent vancomycin-resistant staphylococcus aureus  (VRSA), as well as strains of streptococcus resistant to two different categories of drugs.

For each organism, the report explains why it is a public health threat, where the trends are headed, what actions the CDC is taking, and what it is important for health care institutions, patients and their families, and states and local authorities to do to help.

Commenting on the report, Ed Septimus MD, professor of internal medicine at Texas A&M Health Sciences Center in Houston says “It’s up to us to make the recommendations in this report happen. If we do nothing but say, ‘Here’s the problem,’ then the problem will continue to grow.”

Well said Doctor, well said.

Life without a Lung and other Vital Organs

Listening to the new Pope Francis address the crowds on a cold, wet and emotional night  in St Peter’s Square you’d never have known he had only one lung.

We all know now of course. Thanks to intense press speculation and the power of the internet there’s barely a detail of his pre-pontiff life that has not been published in the 24 hours since the cardinals signaled their decision with plumes of white smoke emanating from the chimney of the Sistine Chapel.

And while no one is saying exactly why he underwent a pneumonectomy (surgical removal of a lung) back in the 1950s, there’s been plenty of speculation.  Back then, before antibiotics, removal of a lung wasn’t that uncommon in cases of severe pneumonia, whooping cough or TB.

Whatever the reason, living with one lung is not entirely uncommon. In America alone, it’s estimated that more than 40,000 people have only one lung. And most of them do just fine because the body tends to compensate by making the other lung grow larger.

Which got us to thinking, which other organs can you live without?

Top of the list would be the kidney.  Most humans have two kidneys, but need only one to survive. However some people may be born with only one, while others agree to part with one for donation. Generally, people can live with one kidney with few or no health problems. People can even live with no kidneys, but they of course require frequent renal dialysis.

Then there’s the appendix. Nobody is exactly sure what the appendix is for and no one is really ever aware that they have an appendix until it becomes inflamed or ruptures and has to be removed. Once gone, after a brief period of recovery, life goes on as before.

And, as one in three women over the age of 60, who have undergone hysterectomy know you can live quite comfortably without a uterus. For younger women, there may be some wrench over the loss of fertility, but for others the cessation of monthly periods may be the cause of celebration.

Men can also survive without their reproductive organs – should cancer necessitate removal of either the testes or penis.

Humans can also live without their spleen should it have to be removed because of trauma or medical conditions such as thrombocytopenia. However because the spleen is part of the immune system, those who have undergone splenectomy are more prone to infections.

We can also survive without most of our gastrointestinal tract too. The stomach, gallbladder, pancreas and colon can be removed and although each is associated with it’s own challenges and problems, loss of these organs is not incompatible with life.

And the list goes on…  Today thanks to advances in biomedical engineering, people can even live without a heart.

While we wouldn’t wish the loss of an organ on anyone, it’s good to know just how dispensable most of them are! Turns out our vital organs may not be so vital after all.

Nonprofits Calls on America to Expand Health Research

Policymakers and public health experts from across the globe gathered on Capitol Hill this week to call on the United States to bolster its commitment to fighting the deadly diseases that afflict the developing world.

Organized by the Global Health Technologies Coalition, the briefing featured a panel discussion in which participants explained how vaccines, drugs, diagnostics, and devices can catalyze improvements in a country’s health infrastructure. Panelists also examined how the U.S. can assure that residents of the developing world have a voice in the development and use of new health tools.

“Thanks to U.S. investment and innovation, undeniable progress has been made in preventing, diagnosing, and treating conditions like HIV/AIDS, malaria, tuberculosis, and other neglected tropical diseases,” said Jana Armstrong, Executive Director of the Drugs for Neglected Diseases initiative North America, “But the fight against infectious disease is by no means won. American leaders in both the public and private sectors must recommit to this fight.”

Word on Health agrees, but wonders why the pharmaceutical and biotech industry wasn’t invited to the party. The Global Business Coalition on HIV/AIDs, Malaria and Tuberculosis (GBC) was created to turn business assets into disease-fighting assets and has been pivotal in joining the corporate sector, governments and civil society together in common cause. Many pharmaceutical and biotech companies are members of GBC and have done outstanding work in this area. If you work for one of them, we’d love to hear from you.