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Nowegian Superbug Solution

By On · Add Comment · In antibiotics, artesunate, drug resistant HIV, drug-resistant malaria, extremely drug-resistant (XXDR) TB, Norway, superbugs

Last post I discussed a new and deadly form of superbug: extremely drug-resistant (XXDR) TB. Two more drug-resistant microorganisms that will likely become a health threat in upcoming years have also surfaced–they are drug-resistant malaria and drug-resistant HIV.

Like XXDR TB, these two new superbugs are a result of over- and misused drug responses. In the case of DR-malaria, the drug in question is artesunate–a derivative of artemisinin, the world’s last weapon against malaria. On the Thai-Cambodian border, DR-malaria is popping up, experts believe, as a result of over-the-counter purchases and self-administering of artesunate.

Although artesunate has some use in fighting malaria, it is not meant to be a stand -alone drug. This weakened drug response makes it easy for the malaria bug to withstand and develop resistance. Artesunate has been banned in Cambodia; despite this, it continues to be sold to locals in small, unlicensed shops for self-treatment of malaria.

DR-HIV is starting an upsurge in South Africa. Because of short drug supplies, many people do not take the full course of antiretroviral treatment, and drug-resistance results. For the unfortunates that fail on one antiretroviral regimen, other drugs can be tried; but for each successive one the risk of mass drug-resistance increases–not a good prospect in the fight on HIV in sub-Saharan Africa, where 2/3 of the world’s 33 million HIV cases exist.

As I pointed out in my last post, the evolution of drug-resistant microorganisms is a truly frightening notion on the surface. But all is not futile. I talked about maintaining one’s own health as the best possible defense against microorganisms–superbugs or not. This includes adopting all health-enhancing behaviors, as well as abandoning those health-depleting behaviors we have become all to accustomed to. One in particular is proving to be an incredible long-term solution to slowing down the growth of drug-resistant microorganisms, and it is being practiced with great success in Norway.

The Norwegian public health system has adopted a program to combat drug-resistant bugs, and it’s basis is to cut back on the use of antibiotics. Bravo Norway! They have recognized there that the majority of antibiotics are prescribed for benign symptoms, like minor coughs or fevers.

“We don’t throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better,” says one Norwegian doctor. “Penicillin is not a cough medicine,” says one marketing message on a package of Norwegian tissue paper. Hallelujah!

I’m pleased to see a country making a mass effort to contain a menacing global problem. The World Health Organization (WHO) says antibiotic resistance is one of the leading public health threats on the planet. I couldn’t agree more–time to take proactive measures. And Norway is doing just that. We could do the same here in the U.S. but it will take a concerted effort by physicians; something I think will be much harder to count on. Only time will tell which direction it all goes. But with the looming dangers of DR-TB, DR-malaria and DR-HIV we better start doing something. As I keep preaching, all we can do is take the best care of ourselves possible by practicing health-enhancing behaviors. It will be the strong that survive if a superbug onslaught is allowed to fester.

Welcome to the Future

By On · Add Comment · In drug resistance, evolution, extremely drug-resistant (XXDR) TB, immune system, microorganisms, superbugs, tuberculosis (TB)

As they say, the future is here. Experts have warned for years the coming of superbugs (I, myself, have warned extensively about drug-resistant microorganisms in my book, The Six Keys to Optimal Health, and here in this blog)–their looming invasion and the consequences we’d have to face in a world where microorganisms develop resistance to the only weapons we have to fight them–drugs!

Well that world has arrived: Recent reports disclose two new frightening superbugs that could have global health officials scrambling for years to come. The first (I’ll touch on the second in an upcoming post) is a case of highly drug-resistant tuberculosis (TB) found in a Peruvian national studying English in the U.S. (West Palm Beach, FL area). Doctors say this extremely drug-resistant (XXDR) TB has never been seen before in the U.S. and is, in fact, so rare that only a handful of other people in the world are thought to have had it.

According to Dr. David Ashkin, one of the nation’s leading experts on tuberculosis, “[This infected student] is really the future. This is the new class that people are not really talking too much about. These are the ones we really fear because I’m not sure how we treat them.”

The XXDR TB-strain of TB is contagious, aggressive, and especially drug-resistant, doctors say. TB germs can float in the air for hours, especially in tight places with little sunlight or fresh air. So every time an infected person coughs, sneezes, laughs or talks, he or she could spread the deadly germs to others. Tuberculosis is the top single infectious killer of adults worldwide, and it lies dormant in one in three people, according to the World Health Organization (WHO). Of those, 10 percent will develop active TB, and about 2 million people a year will die from it.

Simple TB is easy to treat–a $10 course of medication for six to nine months. But if treatment is stopped short, the bacteria fight back and mutate into a tougher strain. It can cost $100,000 a year or more to cure drug-resistant TB, which is described as multi-drug-resistant (MDR), extensively drug-resistant (XDR) and XXDR. There are now about 500,000 cases of MDR tuberculosis a year worldwide. XDR tuberculosis killed 52 of the first 53 people diagnosed with it in South Africa three years ago.

Although this all seems scary and futile, I do not take that stance. It’s true that antibiotics and other microorganism-fighting drugs have been over- and misused. And it’s also true that we have few to no external weapons to fight superbugs. But we still have one mighty tool in our arsenal, one that evolves along with the ever-changing environment in the same way mutating microorganisms do: our immune system.

The human immune system is the only weapon I’m putting my money on. A healthy human body expressing a healthy immune system is rather formidable–our ability to thrive over the course of history proves it. We encounter plagues that take out the weakest (with a few random exceptions) of our ranks, but ultimately, we adapt…and the dance goes on.

No doubt, our own endeavors have created new and enigmatic challenges–like extremely drug-resistant (XXDR) TB–but we will persist, for now. I don’t see drug-resistant tuberculosis as the dawn of the new Roman Empire, but we will have to be smart about it. Without a doubt, our most talented minds in chemistry and biotechnology will find new drugs to combat these dangerous superbugs, but ultimately, we’ll have to maintain strong, healthy bodies. We’ll have to make sure that all our functional systems are operating at their highest levels. This includes the immune system, the nervous system, the cardiovascular system and all other systems of the body.

Practicing the health-enhancing behaviors I outline in my book and here in this blog are the only things that will ensure your own strength and survival. Some healthy people will get sick and probably die from drug-resistant microorganisms. But if I have to bet on which people will have the greatest chance of survival from a superbug onslaught–I’ll put my money on healthy, optimally functioning people every time.

Antibiotic Overuse Raises Ethical Questions

By On · Add Comment · In Alzheimer's disease, antibiotics, brain, death, dementia, drug-resistant, Hastings Center, nursing homes, old man's friend, pneumonia, superbugs, terminal illness
As medical technology advances, modern society is increasingly faced with tough ethical questions–questions regarding right to life and quality of life issues. Take for example a new study which suggests that antibiotics are overused in people dying of dementia diseases and should be considered more carefully in light of the growing problem of drug-resistant superbugs. In other words, should people at the end stage of disease be given life-saving treatments despite the fact that time is not on their side? Or should medical practitioners consider the larger implications to the public health as a whole?

According to study co-author Dr. Susan Mitchell, a senior scientist with the Harvard-affiliated Hebrew Senior Life Institute for Aging Research in Boston, “Advanced dementia is a terminal illness; if we substituted ‘end-stage cancer’ for ‘advanced dementia,’ I don’t think people would have any problem understanding this.” What she is referring to is withholding antibiotics from people in the end-stages of Alzheimer’s disease, a fatal brain disease. Although many dementia patients die from infections like pneumonia, the underlying cause of illness and deterioration is damage to brain cells.

In the study, over two hundred people with advanced stage dementia residing in nursing homes in the Boston area were followed over an eighteen month period or until they died. Almost half the subjects died during the study. All subjects failed to recognize loved ones, had stopped speaking, were unable to walk or feed themselves, and were incontinent. Researchers looked at the patient’s medical records and found that 42% received antibiotics–many intravenously–within two weeks of their death. And here’s the kicker: The closer the patients were to dying, the more likely they were to receive antibiotics.

The problem with the practice of administering antibiotics to people near death is that we are in the midst of a superbug (antibiotic resistant strains of bacteria) epidemic; and the indiscriminate use of anti-bacterial medicines is more than a little to blame. Liberal prescribing of antibiotics is common in nursing homes, in children with ear infections, in adults with coughs and sore throats, and in many other ailments which, for the most part, will resolve on their own over time, or for which antibiotics are useless, like viral infections. But the fact is that, in nursing homes, the standard of care is for doctors to see the residents only one time per month or once every two months. According to Dr. Daniel Brauner, a geriatrician and ethicist at the University of Chicago Medical Center who was not involved in the study, “I’m sure a lot of these antibiotics were prescribed over the telephone.” I’m sure of that, too.

So the question remains: Should medical treatments be administered to people who are at the end stage of terminal illness? I’m certain there is no real answer. If the person is your loved one–your wife, husband, mother, father, and so forth–I’m quite convinced the answer will be YES! We all want the extra time with our closest family members. But in the bigger picture, perhaps a dignified death with the help “the old man’s friend”, as pneumonia was once called, is in order. As bioethicist Bruce Jennings, consultant at the Hastings Center, a research institute on medical ethics, says, “You might rescue the patient from life-threatening pneumonia and they live a few days, weeks or even months longer, but the extra time you have bought them by that rescue is not beneficial.”

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