Don’t snog your pet – rocket surgery research

We’ve covered the dangers of antibiotic resistance on the the blog many times before.
We’ve covered the dangers of unhygienic pets on the blog many times before.
Now, some rocket surgeons at Glasgow Poly Caledonian University have put the two together with some groundbreaking research:

I hope you are all sitting down, because the advice in this article is pretty shocking stuff, and may make you immediately rethink how intimately you’ve been living your life with your household pet.
I’m talking about near-incredible recommendations like:

Avoid kissing pets on the mouth

Seriously, just avoid kissing pets full stop.

Don’t let them pets lick your mouth or nose

This is basically french-kissing pets. It’s also to be avoided full stop.
And the nose fetish thing? Eww. No.

Pet owners should wash hands after stroking animals, particularly before meals

WHO KNEW?!?!?
WHO?!?!? KNEW?!?!?

Make sure pets eat from their own bowls and don’t use household utensils

I’m going to be a bit sick now.
And this from a guy whose beagle can’t even use a knife and fork anyway.

At least they stopped short of suggesting that you also always use a condom.
(At least, I hope they did: I haven’t read the whole paper yet.)

It really seems like these things shouldn’t need to be said to humans. We’re literally the most intelligent species on earth, and that’s why we really shouldn’t need to be reminded or warned not to snog our canines who were literally chewing on some faeces they found on the pavement just five minutes ago.

It’s also why household pets shouldn’t be allowed into establishments serving or selling food. It’s not about me being mean to your French Bulldog, it’s just about basic common sense and decent hygiene. It’s about your poor choices putting other people’s health at risk.

Honestly, you people disgust me.

Normally, I’d put this sort of thing into the Darwin Awards category: removing oneself from the gene pool through one’s own stupidly reckless behaviour. But that doesn’t work here, because sadly, this might – might – not actually finish you off, but it will lead to the proliferation of antibiotic-resistant bacteria which – as I mentioned above – might finish other people off.

Now, thanks to this “new” research from Dr Adele Dickson et al., we’re able to actually demonstrate that your disgusting behaviour is bad for the human race in general.

Thus, for the good health of humanity, please stop this sort of stuff immediately. Ugh.

Antibiotic resistance apocalypse predicted

Yes, according to the front page of today’s (poorly-named) Independent:

Fullscreen capture 2016-05-19 083721 AM.bmp

“OMG!” I hear you saying. “You’re a microbiologist, 6000. Why didn’t you warn us about this?”

Yeah, you’re absolutely right.

I
Should
Have
Said
Something

Sorry.

 

(please enjoy the full 84 page report here)

Superbugs

While the events of the past few days may make the apocalypse seem to be coming via other means, I still feel that climate change and the terrorists won’t knock us off quickly enough for us to avoid death by the scourge of antibiotic resistance.

Here’s a Cape Talk interview with the WHO’s Dr Marc Sprenger on the pisspoor Kieno Kammies show this morning.

 

But it seems that a lot of people simply don’t understand what a antibiotic resistance and superbugs are. Research has shown that there are two main categories of misunderstanding here. Both are bad, but you can completely understand the confusion of the 20% of people who have simply misheard the word and believe that it’s actually a “Superb Hug”. That wouldn’t be bad at all. It would be… well… superb. And a hug. Everyone loves hugs. Especially superb ones.

That’s not going to kill you.

The other 80% of those who don’t get what antibiotic resistance is, think that it’s the patient who becomes resistant to the antibiotic:

The researchers asked them about it and got blank faces in response. When probed—and here’s the bit that really shocked me—almost everyone assumed that it’s the person who becomes resistant to antibiotics, not the microbes. You take enough of something, they reasoned, and your body gets used to it and builds up a tolerance. It’s such an intuitive idea that even after they read simple descriptions that explained how bacteria become resistant, they reverted to the resistant-patient idea.

I hope his probe was properly sterilised between interviews.
The implication of this misconception is:

…a pretty serious one, because some people reasoned that if they don’t finish their courses, they’re less likely to become “resistant.” Ironically, that decision could increase the odds of developing an actual drug-resistant infection by leaving a pool of surviving microbes that have experienced and withstood the antibiotics.

Even the term “Superbugs” was described as misleading. Oh dear. I’ve buggered up the title of my post. Properly.

The issues here seem to be much greater than merely the apparent apathy over the dangers of antibiotic resistance, or, as we’re now suggested to describe it: “drug-resistant infection”.

If you change the noun to infections or germs, and make resistant the adjective, you make a huge difference to people’s ability to work out what’s going on. It’s opened my eyes to how much more research we need to be doing on public-health communication.

The problem is that people don’t even understand the concept of what they supposed to be apathetic about. And if we’re ever going to get them to be apathetic about it (and don’t worry, yes, this is merely the first step of my master plan), then we, as microbiologists and healthcare professionals, need to remedy that.

Even though, soon, we’re not going to be able to remedy anything else.

Worth repeating?

Worth repeating? Given the lack of action on this issue, despite the repeated warnings from people far more qualified and eminently more important than me, you could be excused for thinking not. However, given the gravity of the situation being described and the impact it will have on our ability to survive as a species – yeah, probably.

We’re back on that old chestnut of antibiotic resistance, I’m afraid. The topic rearing its ugly head on here thanks to this guest editorial in the South African Medical Journal for May 2015, penned by Marc Mendelson of UCT and Malebona Precious Matsoso from the DoH. It’s a local journal, written by local people, about local issues. Just like the Southern Suburbs Tatler. Except sane.
It makes such happy reading:

If our overuse and misuse of antibiotics is not halted now, about 10 million people will die annually from drug-resistant bacterial infections within 35 years. The hammer blow will fall hardest on Africa and Asia, accounting for 4.1 and 4.7 million deaths, respectively, and the world’s economy will lose more than 7% of its gross domestic product (USD210 trillion) by 2050.

If 10 million deaths sounds terrible, it’s because it is terrible. Put in context, annual deaths from HIV worldwide are around 1.5 million. TB accounts for 1.4 million deaths. Heart disease kills about 2.5 million people each year. Three big killers and we’re only just halfway there.

Fortunately, this is all way in the future, isn’t it? Well, no. It’s not:

This is not a futuristic scenario … it is being played out right here, right now, in South Africa and other countries across the globe. Decisions to withhold surgery based purely on the patient being colonised by pan-resistant bacteria are being made, and people are dying of untreatable infections in our hospitals and communities. Quite simply, our abuse of antibiotics is destroying modern medicine as we know it. Unless the international community can alter its path, we will lose the ‘miracle of antibiotics’.

So it’s here, and it’s going to get much worse, so why isn’t something being done about it? We’ve touched on this here before:

Of course, if this problem wasn’t so insidious, we’d all be panicking about it already. If there were a 9/11 or a Hurricane Sandy – a single event – there would be far more awareness. (Not that mere awareness would really help anyway.)
But that’s not the case with the antibiotic resistance problem. It’s sneaking up on us and, for those of us in the know, it’s rather worrying.

And on that note, for me, probably the most significant line in Mendelson’s and Matsoso’s musings:

These numbers should make people sit up, listen and change behaviour. But more often than not, it has to be personal to achieve this.

Yes. Sadly, that’s probably what it will take. And sadly, this will happen to people as well. It’s happened to me already this year.

I was reminded of this satirical piece by Andy Borowitz, penned in reference to climate change, but with a nice, ironic “resistance” twist:

Scientists have discovered a powerful new strain of fact-resistant humans who are threatening the ability of Earth to sustain life, a sobering new study reports…
While reaffirming the gloomy assessments of the study, Logsdon held out hope that the threat of fact-resistant humans could be mitigated in the future. “Our research is very preliminary, but it’s possible that they will become more receptive to facts once they are in an environment without food, water, or oxygen,” he said.

Maybe the same will be true once we find ourselves without antibiotics as well.

We live in hope. Briefly.

H58 is coming

Well, in fact, H58 is already here. And it’s going to kill you.

Let’s take a step back for just  a moment here though. And let’s consider Ebola, which is something else that kills you a lot. The (probably a little underestimated) figures for the 2014 (but still ongoing) West Africa Ebola epidemic suggest that 11,000 people died. That’s pretty awful. But it pales into some sort of disgraceful insignificance when you compare it with the 200,000 people who die from typhoid each year.

Typhoid is indisputably nasty. That said, it’s different from Ebola in that while it’s much more widespread, the mortality rates are not quite as high. And a lot of that is probably down to the fact that it’s caused by a bacterium (it’s called Salmonella typhi and yes, it’s related to the food poisoning bug that you get from not cooking your chicken enough) and not by a virus. As any fule kno, bacterial diseases can be treated with antibiotics, killing the bugs and making the person remain alive. Good news for typhoid sufferers.

That is, until now.

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Because a new strain of Salmonella typhi is here: Salmonella typhi H58. And H58 is resistant to antibiotics like ciprofloxacin and azithromycin – drugs that people use to treat typhoid. According to the Guardian:

An international team of researchers analysed the DNA of nearly 2000 typhoid pathogens from countries across Asia and Africa and found that a single multiple- drug resistant strain had swept through Asia and crossed into Africa over the past 30 years.
Nearly half of the organisms studied belonged to the resistant strain, called H58, which has steadily pushed out older strains that are susceptible to common antibiotics people buy over the counter or take to protect themselves from the disease.

And H58 is rapidly becoming the dominant strain of S.typhi, easily pushing the other, lesser, more antibiotic-susceptible, more treatable, less deadly strains out of the way:

In some regions, H58 is displacing strains that have been established for hundreds of years: “We were all amazed at what we saw. When you see the data, it’s pretty stark. It’s very convincing that it’s becoming the dominant strain,” said Gordon Dougan, a senior researcher at the Sanger Institute near Cambridge.
“This beast can get into a new area and it’s at an advantage, because a lot of competition is wiped out by antibiotics.”

Hear that? When a senior researcher at the Sanger Institute near Cambridge calls it a beast, you know it’s properly dangerous. Senior researchers at the Sanger Institute near Cambridge aren’t employed to throw words like that around willy-nilly. They’re beige and they’re dull and they’re sensible. The accountants auditors of the microbiological world. Using the word “beast” to describe a strain of bacteria is off-the-fricking-scale to a senior researcher at the Sanger Institute near Cambridge. This is obviously serious stuff.

Serious, and urgent:

The global spread of the strain requires “urgent international attention,” the scientists write in the report. “This is killing 200,000 people a year and no one is really noticing,” said Nick Feasey, a co-author on the study at Liverpool Tropical School of Tropical Diseases.

So – a time for action then? I doubt it. I’ve been telling you all for ages that we’re all going to die horrible deaths at the (metaphorical) hands of drug-resistant bacteria, and no-one has done a damn thing about it.

One of the reasons for this continued lack of decisive action against the spread of antibiotic resistance is that it’s an insidious thing; there’s been no one defining event – no instant train smash – to draw attention to it. Sadly, with the destruction of infrastructure in Nepal – where H58 is prevalent – after the recent earthquakes, we might well see a big spike in the number of cases, which may stick it into the global spotlight until the next plane crash, court case or contentious political statement.

All of which are obviously far more important.

UPDATE: Finally, someone is listening