The Ghost of Christmas Future: Global War on Bacteria

As world leaders scramble to defend against the latest terrorism threat, prevent the demise of NATO and solve global warming, we face a less talked about yet far more sinister problem, one the World Health Organization (WHO) calls “a major threat to public health.”

Scientists have concluded that we are now on the cusp of the Post-Antibiotic Era, a time when bacteria will be resistant to all of the drugs mankind has to offer, rendering routine infections untreatable and increasing the likelihood of death from common illnesses such as E. coli or tuberculosis.

Unlike terrorism, which is statistically less likely to cause death than car accidents, heart attacks, or shark attacks, bacteria and the infections they produce are omnipresent. A so-called ‘antibiotic apocalypse’ could prove far worse than Al Qaeda, ISIS, Iran’s nuclear ambitions and global warming combined.

Over time, microbes naturally develop resistance to the drugs used against them. Last resort antibiotics — also knows as ‘broad spectrum’ antibiotics — are used when doctors don’t know what type of infection they’re dealing with, however, they are also the most likely to stimulate resistance. One such drug, called Colistin, has been overused to the extent that certain bacteria known as ‘superbugs’ are now resistant to it.

Though no one knows when this growing menace will reach its tipping point, one of the key hurdles has already been overcome. Chinese scientists recently discovered the transmission of antibiotic-resistant superbugs in both pigs and humans. The MCR-1 gene is a new mutation identified by Chinese scientists that prevented Colistin from killing bacteria. The report in The Lancet Infectious Diseases journal showed resistance in a fifth of the animals tested, in 15% of raw meat samples and in 16 patients. Another mutation called NDM-1 (New Delhi Metallo-beta-lactamase-1), is believed to have developed in India and spread by antibiotic over-use and poor sanitation. While these mutations seem confined to China and India for the moment, it is only a matter of time before they spread through international travel and trade.

So, why not just create new antibiotics to deal with these new strains of bacteria? The answer is largely financial. There hasn’t been a new class of antibiotics since the 1980’s — they are just not as lucrative as, say, anti-cholesterol drugs or cancer treatments, so pharmaceutical laboratories have stopped investing in their production. It costs up to $2.6 billion dollars to produce and market a single drug. But consider the economic consequences if large populations of people can’t go to work or school due to untreatable infections. Imagine the impact on public safety if large numbers of healthcare workers, first responders, police, and military personnel are too sick to report for duty.

Another problem with creating new, stronger antibiotics is the increasingly harmful effect they can have on the body. Drug resistant superbugs kill tens of thousands each year in the United States. Cases of E.coli and Klebsiella bacteria have increased by two-thirds in recent years and are now the most frequent cause of hospital acquired infections. Just this week in the United States, a warehouse-store chain’s chicken salad was linked to an E. coli outbreak that struck 19 people in seven states. E. coli causes severe stomach cramps, vomiting and diarrhea, and in serious cases can lead to kidney failure and death. Klebsiella causes urinary tract infections and pneumonia and left, untreated, can also lead to death. In Toronto, 7% of all gonorrhea infections are now untreatable. According to the WHO, 150,000 deaths a year are caused by drug resistant tuberculosis.

A UK study estimated that 700,000 deaths occur worldwide due to antibiotic resistance and predicts that figure could grow to 10 million by 2050, costing the world’s healthcare systems trillions of dollars. At this rate, scientists predict that common diseases such as these could be untreatable within 10–20 years. Routine surgeries will become major risks to life, as will chemotherapy, organ transplants, and hip and knee replacements.

Disturbingly, only 34 countries have a national plan to deal with rising levels of antibiotic resistance. Dr. Mike Turner of the Wellcome Trust medical charity in the U.K. has said: “Drug-resistant infections are one of the biggest threats to the future of global health. Yet in most areas of the world we have no idea which drugs are being sold to whom and for what purpose. This is an appalling state of affairs.”

There is hope, but we have to act fast. The need for continued research into alternative therapies such as bacteriophages, bacteriocins and antimicrobial peptides is urgent. These specialized treatments work by infecting the bad bacteria, causing them to implode. Additionally, they develop with the bacteria so that resistance is less of a problem, building up our own immune systems.

Another possible solution is the use of the iChip (short for isolation chip), to collect naturally occurring microbes from soil that can be used to culture new, better functioning antibiotics, such as Teixobactin.

In the meantime, there are a few common sense steps governments and citizens can take to mitigate the dangers:
* Promote basic infection prevention through good hygiene (think hand washing!), rest and plenty of exercise;
* Discourage the use of antibiotics for colds or coughs unless directed by a medical professional – they do nothing for viral infections;
* Consider banning use of the same antibiotics in veterinary and human medicine;
* Ban the use of antibiotics in livestock, as Europe has done;
* Significantly raise the price of broad-spectrum antibiotics to restrict their usage in the marketplace.

Read more about it at:
* World Health Organization: http://www.who.int/mediacentre/factsheets /fs194/en/
* Center for Disease Control: http://www.cdc.gov/drugresistance/biggest_threats.html
* Infectious Disease Society of America: http://www.idsociety.org/Index.aspx

Written by HSPolicyWonk for Homeland Security (HS) Vortex, a platform where insiders from the policy, law enforcement, fire service and emergency management fields converge to discuss issues related to Homeland Security.

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