The Bugs We Fear

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Back in May, I wrote a post detailing some of what I perceive to be threats facing humanity. This is the second of what will be seven posts providing more details on each of these threats. This one concerns infectious diseases.

 

Starting in the 1940's, modern medicine discovered the magic bullet of antibiotics. Antibiotics have prolonged the lives of hundreds of millions of people by enabling bacterial diseases to be stopped before they created sepsis inside of humans, and caused massive organ failure. The practice of medicine soon became the story of the prescription of antibiotics, and the eventual over-prescription of the same. Once the knowledge of the power of antibiotics became known, the customer (i.e., the patients) were insistent on being prescribed antibiotics even when they suffered from a viral infection, like a cold. All of society believed that antibiotics were able to put the suffering of the past from bacterial infection out of the memory of humanity.

 

Except. Except that human greed and the needs of commerce got in the way. Except that human behavior caused the effectiveness of antibiotics to be compromised. Now, barely 77 years after the first widespread use of an antibiotic to treat diseases, the news is full of stories about bacteria that are resistant to all but the most powerful antibiotics, and even some strains of bacteria have developed resistance to all forms of antibiotics. How did we get here? It started when agricultural researchers discovered that by applying low-dosages of antibiotics to animal feed, weight gain for the animals was increased and disease incidence was reduced. Since agriculture in the US relies upon high animal density in farms and feed lots, and since anything helping the profit margins of farmers was viewed as a God-send, commercial animal feeds began to incorporate antibiotics as a key additive. Unfortunately, this served as an ideal breeding ground for bacteria to show the powers of evolution. Ever wonder why all antibacterial commercial products claim that their product kills 99.99% of bacteria? It's because there are always a few bacteria that have a mutation that enables them to survive the onslaught of the chemicals aimed at killing them. It may not be a concern for a kitchen countertop to have some bacteria that survive bleach or other similar kitchen cleaner. But it is totally different when a strain of bacteria survives a dosage of antibiotics inside of a farm animal. That strain now faces less competition since many other bacteria were inhibited by the antibiotics in the feed. Soon, the resistant strain is circulating among farm animals, and slowly the antibiotic in the feeds lose their effectiveness as the population of resistant bacteria increases in the environment. Since they began to incorporate antibiotics, animal feeds have used most of the types of antibiotics, which means that effectiveness of many antibiotics have been lowered over time. Market demand is now pushing agricultural firms to proclaim that their animals are antibiotic-free, but only time will tell if that movement will grow fast enough to keep antibiotics at least partially useful.

 

Human behavior also plays a role. As noted earlier, patients often demand a prescription for an antibiotic even when their infection is viral. This dosage of unneeded antibiotics increases the chance of developing a resistant strain directly inside of a human. Add to this the tendency for some folks to stop taking a medicine once they feel better, and you end up with the worst case for developing antibiotic resistance. By not taking the full course of antibiotics, it is more likely that some of the bacteria will survive, and then their traits will be passed on to subsequent generations of bacteria. One way or another, the bacteria will outwit us as we currently use antibiotics.

 

But bacterial infections are only a part of the disease story. Viruses cause many more diseases, and there are several factors in our modern world that enhance the possibility of a viral infection causing huge problems in our society. First, viruses are mobile. They can hitch a ride upon any animal infected with the virus. Whether that is a chicken carrying the latest variant of bird flu, or whether it is an international traveler that had unknowingly been exposed to the latest version of Ebola or Marburg disease from Africa, viruses can travel amazingly fast in our modern, interconnected world. Then there is this little issue about climate change. Regardless of the source of a warmer climate, one result is that mosquitoes that are intolerant of cold, are now expanding their ranges into temperate climates. Thus malaria is expanding its range. Other viral diseases that once were known only in Africa are now showing up in Sardinia, a handy stopping place on the way to infect southern Europe.

 

Yet another factor is affecting viral disease transmission. Through extensive research, humanity has managed to control the immune system to enable it to react to viral invaders that can cause diseases. Thus, humanity has wiped out the dread disease smallpox as a scourge. Only remote pockets of polio remain, which means this crippler of people is nearly extinct. Who remembers iron lungs where the sufferers of polio were kept, enabling them to breath until they regained at least a semblance of muscle strength? The use of vaccines has greatly limited tetanus, and diphtheria, and whooping cough. The old childhood diseases of measles, mumps, and chickenpox are no longer rites of passage for children. All have been vanquished through the use of vaccines.

 

Except. Except that a growing percentage of the population no longer believes that the benefits of vaccination exceed the perceived costs. Especially with the growth of the internet, there are groups convinced that vaccines are causing the growth of conditions such as autism. And therefore they are opting out of mandatory vaccination protocols. Either opting out, or spacing vaccinations out over a longer period than recommended, all in a belief that they are protecting their children from a fate worse than the disease that the vaccine is intended to prevent. What this is doing is increasing the percentage of the population who does not have immunity to the disease, and as a result, diseases that had been nearly eliminated are making a comeback. In 2017 there was an outbreak of measles, mainly within the Somali immigrant population around Minneapolis. According to the CDC, the rate of measles vaccination of Somali children was only 54% in this area. This enabled measles imported from a visit from Africa to spread throughout the community, until 65 cases were recorded. Of those, 20 required hospitalization. I remember my own case of measles, back in 1961. I contracted it right after my tonsillectomy, another rite of passage that is no longer nearly universally prescribed. It was not fun, but I did not suffer any of the permanent effects that could have resulted.

 

How should we deal with infectious diseases in the future? Certainly there is a need for more pharmaceutical research in antibiotics. If we can stay ahead of the resistance curve, we may still be able to keep the tragedy of blood poisoning from killing thousands and thousands each year. Unfortunately, pharmaceutical companies are not investing heavily into antibiotic research. The perceived market is deemed too small to justify the vast expenditures required for drug development. This is an area where government-directed research is required since the lack of private company research does not appear to be amenable to a market-based solution. The current trend towards reducing antibiotic supplementation in animal feed needs to become universal. This may be a problem though, in other countries where a simple and cheap way to control animal disease and increase animal yield is not viewed as an existential threat.

 

Finally, for viral diseases, there may not be good ways to deal with them. The warming of the climate will result in the spread of many diseases beyond their current tropical ranges. Unless we can put the climate warming genie back into the bottle, we may have to deal with the effects. Vaccine development is required, and investment in additional vaccine capacity for diseases such as yellow fever. But the hardest problem to deal with may be the human resistance to acknowledge that science has the answer for disease prevention. It may never be possible in this fractured society to convince a large enough percentage of the population of the benefits of a vaccine. There will always be self-sustaining groups who convince themselves that they know more than all of the scientists in the world. After all, the scientists are the elites who have failed us, right?

 

Posted first on my blog at https://evenabrokenclock.blog/

Comments

James Travil Added Nov 3, 2018 - 8:22pm
When the title said "bugs" I thought it was going to be about cockroaches or the like, lol! Regardless informative. I'm fascinated by viruses because they are the only living things that can die then live again, even centuries or millennia latter. Film has popularized the idea of the mythical "zombie virus" but the fact is that viruses are in a way zombies themselves. Ebola is a now well-known and scary virus because of the way it kills and the fact that it has such a high mortality rate. But Rabies is much worse, it has nearly a 100% mortality rate and dying from it is particularly gruesome, but people never think much about it. 
Jeff Jackson Added Nov 3, 2018 - 9:12pm
Yes, Even, the misuse of antibiotics has caused the evolution of some very nasty bugs. I am told that there are some STDs in Asia that aren;t showing up here much, which is good because they require some extremely strong stuff to kill them. Eventually, we will not be able to find anything to kill the viruses, or so some think. Good topic to think about.
Lindsay Wheeler Added Nov 3, 2018 - 9:30pm
This is why we need to stop immigration! These people are re-introducing diseases that have been eradicated in the US and others are bringing in stuff we never had like the Zika virus. 
 
It is funny how Liberal ideology overrides commonsense. Liberals are devoid of commonsense. They don't care. They only care that they bring these people in. They worry about one person dying, one is too much, yet these same people have no problem bringing in thousands of disease carriers which threaten millions!
Leroy Added Nov 3, 2018 - 10:23pm
Interesting article, Even.
 
Antibiotics gave us life.  It will be our destroyer.
 
I was told that I had an infection and there was only one traditional antibiotic to treat it.  If it didn't work, I would have to try an antibiotic of last resort, colistin.  Colistin is what they give pigs in China, and I ate lots of pork.  I was a little concerned.  If you think Americans consume and farmer use too many antibiotics, you would be amazed by China.   If I had to hazard where the next major epidemic arises, I would place my bets on China.
Koshersalaami Added Nov 3, 2018 - 10:53pm
“They know more than all the scientists in the world.” Sounds like arguments we’ve been having about climate. 
John Minehan Added Nov 3, 2018 - 11:03pm
I tend to believe in "herd immunity," although Dr. Otto presented some cogent arguments against it.  When I was serving in the Horn of Africa in 2004, the area around Mogadishu had a measles outbreak and a good number of children died.
 
The failure of the Somali state was much less of a crisis than is usually perceived, but public health is an area where this is less true,
opher goodwin Added Nov 4, 2018 - 2:17pm
Great article! It seems to me that as the genetic engineering process becomes cheap and easy  (CRISPR)it won't be long before we have a bunchy of terrorist designed viruses or bacteria!
I agree with Leroy. The next big antibiotic resistant bacteria is going to come from China or the far East.
Dino Manalis Added Nov 4, 2018 - 2:36pm
 Antibiotics have to be used carefully and take vaccines for serious ailments!
Bill H. Added Nov 4, 2018 - 10:37pm
 
Not to mention how many antibiotics we consume in our meat.
It's surprising we have any resistance at all!
Even A Broken Clock Added Nov 4, 2018 - 11:28pm
James - the thought of rabies is certainly scary. But so are the hemorrhagic viruses like Ebola and Marburg. Then again, bacterial diseases like cholera also are no picnic, basically causing you to shit yourself to death. There's a lot of bad actors out there that will do us harm if we catch them.
Even A Broken Clock Added Nov 4, 2018 - 11:30pm
Jeff - just remember that an antibiotic will do nothing for a viral infection. Most of the STD's except for AIDS are bacterial, but resistant gonorrhea is already visiting our shores. Your prediction is coming true as you speak.
Even A Broken Clock Added Nov 4, 2018 - 11:35pm
Ah yes, Lindsay, the ability to transform any post whatsoever into a diatribe about liberals is truly amazing. For your information, it is not necessary for an individual to "come illegally to this country" in order to bring in infections. Global transportation networks will do that just nicely with legal movements of people.
 
I seem to remember in the height of the last large-scale Ebola outbreak that the conservative herd mentality was castigating humanitarian doctors for working to prevent the spread of Ebola. If they had their way (and Donald was at their forefront), they'd have banned any movement into the US from anyone who had been in an area where infection occurred. A real Christian attitude - NOT!  Mush as I suspect you share.
Even A Broken Clock Added Nov 4, 2018 - 11:37pm
Leroy, I believe you on the prediction of the next big outbreak. I definitely do not trust any food item coming from China. Too many examples of adulteration. And the issue with antibiotics in feed - even if we do away with it in the US, there are plenty of other places where it is relied upon.
Even A Broken Clock Added Nov 4, 2018 - 11:40pm
Kosher - the loss of faith in scientific expertise is another of my posts in this series. With the internet now, every point of view can find reinforcing beliefs out there. Shoot, if nowhere else, you can find it on Reddit. I find the loss of faith in the scientific method as a very scary thing.
Even A Broken Clock Added Nov 4, 2018 - 11:41pm
John - I'd be interested in reading about your experience in the Horn. Have you written a post? If not, please consider doing so.
Even A Broken Clock Added Nov 4, 2018 - 11:43pm
Opher - CRISPR is definitely the genie that has escaped the bottle. And if someone is so inclined to put the human race at risk just to fulfill their particular fantasy, then it will happen. I happen to think CRISPR has so much potential for good that we must figure out how to deal with the risk it also engenders.
Even A Broken Clock Added Nov 4, 2018 - 11:46pm
Dino - thanks for commenting. You are correct.
 
Bill - I really don't know if the antibiotics make it into the muscle tissue. I think the risk is more in what happens within the digestive tract of the animals. I'd be interested in finding out if there are antibiotic residues in the meat itself if anyone knows about that subject.
James Travil Added Nov 5, 2018 - 2:29am
If you really want to be scared they made a movie about weaponized Rabies called Quarantine. Very scary stuff and very realistically done. 
goldminor Added Nov 5, 2018 - 5:28am
Here is something which you may find of interest. It is part of a comment which I just made on another post, but it is certainly relevant to this topic. Here we go.
 


I have never had a flu shot, and seldom get sick. Then again, just 2 years ago I did get sick along with many others in the area in which I live. That flu 2 years ago was a powerful flu. It was long lasting at about almost 2 months duration. It made me think of the Spanish flu epidemic of the early 1900s.
 
The reason for the comparison is that there is a solar cycle named the Gleissberg cycle. This cycle induces cold trends, especially in the Northern Hemisphere. The last one was back in the early 1900s, or right around the time of when the Spanish Flu struck. Guess where we are right now climate wise? Are we about to experience another serious global flu epidemic? I say that as the flu which hit me was one of the strongest I have ever experienced in my life.
 
I came very close to dying back in 1954 to a flu virus at the age of 4 years old. It is very likely that it was due to the US Army testing biological warfare techniques back at that time off of the California coast around San Francisco. They had dropped flu viruses which then came in on the prevailing wind pattern. At the height of my illness I told my mom one morning that the cowboys were chasing the Indians around the room. The wallpaper was of cowboys and Indians. She ran to get the doctor. I then remember Dr Mallia standing at the foot of my bed with my parents, and they were all looking fairly grim faced. The Dr stated that if my condition got worse that they could place me on an Iron Lung, but that would be a last resort. My body temp was hovering at around 106 F.
 
After surviving that episode, I then had severe sinus conditions every winter. All the way up until the end of the 1960s, when I first moved into the mountains of California, when I became old enough to leave home. That was the end of my yearly sinus episodes, and from that point on it became very rare for me to ever take ill with the flu or colds. That is why that very strong flu from several years ago made me wonder about its strength. Especially as I have spent the last 10+ years studying climate related material which made me aware that there could be a potential connection between the cyclical 100+ year cold trend and the Spanish Flu Epidemic.


 
 
 
 
opher goodwin Added Nov 5, 2018 - 5:33am
EABC - there is the difficulty. Genetic modification can be an absolute boon but the technique has become so simple that it can be carried out in your front room. 
I think this is the most amazing and frightening potential.
In the right hands it can transform the world for the good - agriculture, health, manufacturing (plastics, oil and a whole new range of materials from bugs) and removal of all those deleterious genes.
In the hands of religious fanatics (who might want to bring about 'the end of days') it could signal the end of humans on this planet.
Ward Tipton Added Nov 5, 2018 - 8:15am
This is only part of the reason I raise my own food. 
Even A Broken Clock Added Nov 5, 2018 - 10:18am
James - thanks. Wasn't aware of that movie.
 
Goldminor - I'm not aware of a correlation between cold weather and strength of response to the flu virus. If it is colder than normal, we will see. I myself don't know whether the viruses that were deliberately released back in the 1950's contained any flu variants. I am familiar that some viruses were released to the prevailing winds. As for recent viruses, certainly last years was very strong in the response, but there is a great deal of variability in personal response to a virus.
The Burghal Hidage Added Nov 5, 2018 - 11:45am
A topic that validates my overarching thesis: nature will always find her balance and it will always be on her terms, not ours.
 
Many species on this planet exist within a simultaneous homeostasis: the planet's and their own. Where climate, presence of predators and other naturally occurring factors exist most of these species remain within that balance. When, however, a species upsets the natural order nature will always counter to maintain that precious balance. As we are more "advanced" and capable as a species of manipulating the environment around us rather than adapting to the environment given, we present ourselves as prime targets for nature's course correction. To some this may sound vaguely supportive of an environmentalist agenda, which I hasten assure all is not the case. We should be good stewards of the land and seas to be sure, but should not allow ourselves to be deluded into thinking that we have attained such primacy on this planet as to substantially control the climate or sea levels or any other natural phenomenon. Sorry to bust your bubble, but in the bigger scheme of things we are just not that important.
 
Viruses and their nature is one of the most striking examples of this. Viruses, though considered lower order, are legion in their numbers, adaptable to a host of environments and intelligent. Intelligent in the procreative sense, always changing and adapting to further it's existence. It is part of nature's armory employed to maintain her balance. Some would say intelligent design or the hand of God. Call it as you like,it all means the same. 
 
Nice article Clock :)  Good topic  
Leroy Added Nov 5, 2018 - 2:05pm
"But Rabies is much worse, it has nearly a 100% mortality rate and dying from it is particularly gruesome, but people never think much about it."
 
So far, my son has survived.  He hasn't started foaming in the mouth yet.  No, he doesn't have rabies.  I thought everyone could use a good laugh.  When he was about two, he bit his grandmother on the neck.  She went to see the doctor.  She was so insistent that she had a problem and wanted the doctor to do something about it, he gave her injections for rabies.  I kid you not.  She's a hypochondriac.
opher goodwin Added Nov 5, 2018 - 7:22pm
Leroy - that is ridiculous. How can you defend a US health system that would do that? The rabies injection is a nasty one and very costly. There was nil chance!
Ward Tipton Added Nov 5, 2018 - 10:21pm
The doctor would have to provide it in the US, or face getting sued in many cases. FUBAR comes to mind.
Even A Broken Clock Added Nov 6, 2018 - 9:23am
Burghal - thanks for your comment. I would quibble with you about how humanity is able to affect the environment. In just one way, I'd use the example of farming causing erosion, and with fertilization, it is creating dead zones in the oceans at the deltas of the great rivers. That is one case where we are directly affecting at a regional scale, the balance you describe. I do think that we are not above nature, but are a part of it, and if we do get too far out of hand, we're likely to be swatted away.
Even A Broken Clock Added Nov 6, 2018 - 9:25am
Rabies injection story - Leroy, any chance that his grandmother was injected with a placebo? Like just saline? That would seem more likely than a real injection, if the doctor realized she was a bit of a hypochondriac?
Bob Added Nov 6, 2018 - 11:04am
Excellent article. First, I agree that the antibiotics fed to animals is a large variable in the hastening of bacterial evolution which resists the antibiotics on the market. 
 
I'd like to address the proactive way to prevent infection as well. One extremely important aspect to preventing bacterial infection is cleanliness. We need to ensure that children (it is difficult to change the habits of adults) wash their hands properly after using the restroom, they need to use hand sanitizer frequently (alcohol or non alcohol based), cough/sneeze into their elbows, clean their hand after blowing their nose, and cautiously touch the toilet flusher (I use my foot in public places), door knobs, and other frequently grasped items for use by the general public. Preventing the spread of infection goes a long way in preventing the need for antibiotics.   
 
As always I need to address the work environment and healthcare. One problem with people living paycheck to paycheck without any savings is they are forced to go to work even when they are extremely ill (bronchitis, pneumonia, strep etc.). When someone is ill and they don't have a job with paid sick time, they go to work and spread the infection like wild fire in the wind. This is especially concerning in the food industry as we rarely know what goes on in the kitchen. When people are packed like sardines in class rooms, offices, kitchens, and other close quarters areas, we have these large outbreaks of bacterial illnesses. I work for the public and shake hands with people very often, immediately after the introduction I use hand sanitizer and offer them some too. Some people take offense to it, others are glad. Some people consider these practices as "being a pussy" but they go a long way in preventing the spread of illness.  
 
I am rarely sick and never get the flu shot. I've also noticed that since I quit smoking (2 years now) I have not had a lung infection. I used to get one every year between Dec-Feb like clock work. Good and Bad habits have massive influence on the spread of infection or prevention thereof. 
 
Once again, great observations.
 
Kind Regards,
Bob 
 
opher goodwin Added Nov 6, 2018 - 11:58am
Bob - the problem with this is that we seem to be getting an epidemic of immunity diseases that scientists are blaming on not enough exposure to bacteria at an early age - i.e. too much cleanliness.
Even A Broken Clock Added Nov 6, 2018 - 5:08pm
Bob - thanks for the response. I do agree with Opher that there does seem to be a bit of a problem with younger children not being exposed to a "healthy" level of bacteria while they were developing their immune system. Now, having said that, I was just on a cruise, and you can be sure that I did most of the steps you talked about in terms of sanitizer and hand washing. Didn't use my feet to deal with door handles, though. There's definitely been enough stories about infections passing through ships that make you conservative there.
 
One of the habits I find disconcerting is passing the peace at church. Everyone is encouraged to shake the hand or hug everyone else around. Now that is an opportunity for sharing infections. But I don't wipe off grocery buggy handles with antiseptic wipes.
Ward Tipton Added Nov 7, 2018 - 5:57am
"Bob - the problem with this is that we seem to be getting an epidemic of immunity diseases that scientists are blaming on not enough exposure to bacteria at an early age - i.e. too much cleanliness."
 
See! And people thought I was wrong for eating the occasional mouth full of dirt and even the rare crunchy booger or two! 
Bob Added Nov 7, 2018 - 10:40am
Even- I just want to emphasize that I use my foot for the public toilet flusher and not the door. I pull my sleeve to my hand and open the door with the covered hand. I know it sounds overly cautious, but I prefer a proactive approach over a reactive one. 
 
Please note that I am not advocating zero exposure to common bacteria, I agree that kids need the immunity testing environments but on the same token hygiene and cleanliness are necessary for a healthy life.
 
I do health inspections for the public. I've seen some obscene homes. Animal urine and feces on piles of clothes for months on end. Dishes in the sink piled to the bottom of the cabinets with flies and mold on these dishes. Christmas dinner on the table in March.
The complaint came in from the school. I was asked to do a wellness check because the children often missed school for being sick. Fortunately I was able to work with the family with getting aid to clean the house. It took a week with 5 people working at it to get the house clean, but it was done. 
Imagine using a paint scraper to pull dog feces off of the kitchen floor. This was the worst case I've seen, but I expect to encounter one that is worse. Life always has a way to prove one wrong. When you think you've seen it all, something always comes a knockin'.
Even A Broken Clock Added Nov 8, 2018 - 5:01pm
Bob - thanks for the additional explanation. I do not envy you your job, and thank you for doing it. When we see complaints about government, I think about the type of job you do and am glad to pay my taxes.
 
We had a horrific case in our town about a woman who they finally called for medical assistance. She was literally stuck to the bed, bedsores having mated with the sheets. Extremely emaciated and dehydrated, with a limb turning septic, she fortunately only lived for a very short time. Her 40-some year old daughter who was her caretaker lived in the house, along with her son and daughter-in-law. The house was in a similar state of slovenliness as you describe. The daughter was just sentenced to jail. I have no idea if the grandson or his wife face charges, but in my mind they were just as culpable in the abuse of the grandmother.