There is shadow war happening in the U.S. It’s in your neighborhood, it’s in your home. Everyone you know is affected, or perhaps we should say, infected. It really is only a matter of time.
As we’ve progressed through infectious disease week at Sermo, we have interviewed some of the top researchers and physicians. They are smart, well-funded. They work only with the best and brightest and they are still losing. The microbes are thriving and our best weapons are becoming powerless.
How are infectious diseases winning?
They play dead
One MRSA researcher at Northeastern University realized that when you attack microbe cells with a powerful antibiotic some of them respond by going dormant. In this dormant state they did not absorb the medicine and then will reawaken once the attack has stopped.
They hide deep
HIV/AIDS researcher Sagar A. Vaidya, M.D., Ph.D., notes that with AIDS a person can appear “cured” for years with no detection of the virus in the blood stream and then quietly the virus will reappear and the patient will become symptomatic again. Vaidya states:
“It’s quite a challenge given that HIV can lie hidden, dormant in the DNA of many types of cells for years despite effective therapy. Even bone marrow transplantation, which destroys the body’s entire immune system before replacing it with a new one, failed to ‘cure’ the virus.”
They hitch a ride
Our global society is perhaps the biggest boost microbes have received. The Chikungunya virus has traveled from West Africa to the Caribbean and is now threatening the southern United States. West Nile virus has blossomed along the the eastern coast of the U.S. and into New England. Many similar diseases are traveling along with their hosts by car, rail, and plane to new destinations where they can flourish. These “new to the area” viruses can stump physicians until a cluster of patients appear, and by then it is often too late, the microbes are in the population.
“What doesn’t kill you, makes you stronger” is a microbe mantra. We annually see the adaptation of influenza strains, even changing throughout the season as they travel around the globe. Scientists must forecast which strains will be circulating to create preventive vaccines, and while their accuracy is improving (they had a perfect match this year to the swine flu virus, for instance), it is not 100%.
Unfortunately, our biggest threat is that the ever more powerful antibiotics we’re developing could be hurtling us towards a “super bug,” something that will adapt to a point no medication can touch. Many leading researchers aren’t talking about “if” an outbreak will happen, but “when.”
Our best defense is to wash our hands. Physicians must stay vigilant about new diseases cropping up and properly dosing antibiotics only when necessary. According to Dr. James Wilson of the National Infectious Disease Forecasting Center, we need to look at easy access to local antibiograms for proper disease tracking and medication dosage, and we need to look at regulating antibiotics to help prevent abuse.
What do you think? Can educating patients help control microbes? How prepared is your state if an infectious disease outbreak occurs? What can we do to improve patient outcomes in a way that is safe for the entire population? If you’re an M.D. or D.O., we will be discussing this in further depth inside Sermo. Please join us.