Causes for Concern: Emerging Epidemics

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A chronicle of dangerous infectious outbreaks around the globe.

The Rise of the Superbug
By Alexander Bernstein
The rise of the superbug. No this isn’t your typical Hollywood pamphlet advertising the latest cheesy horror movie. Rather, the rise of the superbug is a factual and serious issue that may cause serious global health problems in the ensuing future. So what exactly constitutes a superbug? No it’s not a beetle in a superhero costume (although that would be rather entertaining). Instead, the much cruder truth is that the so-called “superbug” is a drug resistant bacteria that often cannot be adequately treated even with the most powerful last resort antibiotics.  As we approach a “post antibiotic existence” as has been explained by the World Health Organization, the threat of drug resistant bacterial strains is becoming more and more serious.
Of course, as is often the case with humans, we have brought upon this problem onto ourselves. The widespread use of antibiotics for minor and unnecessary issues has led to the genetic selection for resistant bacteria, most notably in India, which as of now appears to be the epicenter of the epidemic.
If no evasive action is undertaken, then the future does most certainly seem quite grim as the WHO Director-General Margaret Chan warns “Things as common as strep throat or a child’s scratched knee could once again kill”.  However, it is currently unclear how to deal with this problem as more and more antibiotics are used, or rather overused, in larger than ever quantities. Experts believe that the problem is so severe in India, the country that produces around a third of the world’s antibiotics, due to poor sanitary conditions and a society that condones using antibiotics for the mildest of symptoms and illnesses. Furthermore, due to the expensive nature of some anti-bacterial drugs, many people don’t actually complete the full regiment of, say 10 days, but rather take the pills for 5 and save the rest in an attempt to avoid spending excess money. However, long gone are the days when this was primarily a problem in India, as recent data shows reports of these genetically altered superbugs found in over 40 countries worldwide including France, South Africa, and Canada.
Indeed the consequences of this spread are already pronounced as Europe alone sees around 25,000 resistant bacteria related deaths each year. Furthermore, the toll does not end with just the loss of human life, as an estimated 1.5 billion euros were spent in additional medical costs and losses in productivity. To an already faltering economy, such augmented expenditures can have incredibly deleterious effects.
What can be done about this problem though? If these new resistant strains don’t respond to even the most powerful of antibiotics, than how can we deal with them in an efficacious manner? Unfortunately there exists no simple answer. One of the main problems with these superbugs is their expression of the NDM-1 gene, which, carried by highly mobile plasmids, allows for swift and successful transmission and multiplication. Perfect breeding conditions in India, where antibiotics are treated as cold medicine and nearly half of the 1.2 billion people don’t have access to sanitary restrooms, doesn’t exactly help eradicate the problem either. While there have been some attempts to produce new effective drugs against these microbes, since no such medicine currently exists, Dr Karthikeyan Kumarasamy, a microbiologist from Chennai, and an expert on the superbug epidemic, believes that the best current form of treatment is the spread of awareness and information and the implementation of preventative policies such as frequent hand washing. Making it more difficult to prescribe antibiotics in India’s 100,000 hospitals, as was suggested by the country’s newly appointed antibiotic resistance task force, may also aid in the curbing of superbug spread. New advances will have to be made in leaps and bounds to avoid an imminent outbreak, however, as an estimated near 100 million Indians are already carrying the NDM-1 gene. No matter how this problem originated, as is the case with a highly globalized and interconnected world, it will take an incredibly united international effort to prevent the impeding biological disaster that is to come. At this point we have but just two remaining options: solve the issue we all helped create, or face the disastrous consequences. 

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