{"id":6835,"date":"2019-04-07T22:33:53","date_gmt":"2019-04-08T05:33:53","guid":{"rendered":"https:\/\/worldcampaign.net\/?p=6835"},"modified":"2019-04-08T17:20:19","modified_gmt":"2019-04-09T00:20:19","slug":"message-of-the-day-disease","status":"publish","type":"post","link":"https:\/\/worldcampaign.net\/?p=6835","title":{"rendered":"Message of the Day: Disease"},"content":{"rendered":"

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Mysterious Infection Spans Globe in a Climate of Secrecy<\/em>, The New York Times<\/span><\/p>\n

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The front-page headline in today’s Sunday New York Times is a smack in the face reminder that the world is totally connected.<\/p>\n

For better or worse. Like it or not. Get used to it.<\/p>\n

The article will also be a revelation for most people.<\/p>\n

And not the fun kind.<\/p>\n

More like the Book of Revelations kind.<\/p>\n

Another kind of apocalypse reminder.<\/p>\n

Disease has never known boundaries. It’s completely changed the world more than once.<\/p>\n

But it’s only been in recent decades that the boundaries, natural and otherwise, that might localize an outbreak or epidemic or even pandemic, have melted away.<\/p>\n

We wonder now, looking back, if the Millennial generation and younger even have any real idea of what AIDS looked like to the world when they were toddlers or children, or not yet born.<\/p>\n

And how many of the rest of us have put this out of our consciousness?<\/p>\n

Remember when suddenly the mystery plague appeared that terrified almost everyone? When the typical response was to what was happening in the rich countries, especially the US, as if it didn’t otherwise exist? When the bigoted and moronic homophobes acted as if it was a gay disease and a curse from God for their sins? And when liberals generally were scared to touch anyone who might have the disease in any event?<\/p>\n

We remember well when a young woman in one of our extended families came to us for help in the mid-nineties seeing no solace or hope anywhere else.<\/p>\n

A straight woman with AIDS.<\/p>\n

Whoops–guess it’s not a gay man’s disease after all.<\/p>\n

The more intelligent and better angels of our nature eventually took root. Led by at first a few brave and visionary souls–and the horrible sight of the dying–opinion rallied to doing something, and fast (though never fast enough), and we got results.<\/p>\n

But never forget that as Frederick Douglas said, power accedes to nothing but a demand.<\/p>\n

The group ACT UP, regardless of shortcomings or views about it, exemplified that demand.<\/p>\n

Then, as noted above, the fields of reality and perspective and compassion and action got broader.<\/p>\n

But then we got to where the real problem was–not only heterosexual–but global, and a pandemic arising from the conditions of, and afflicting, in the main, as usual, the have-nots, mostly people of color, especially in Sub-Saharan Africa.<\/p>\n

Many public and private efforts–massive ones–did occur in positive response, although the various levels of denial and bigotry in these very places did, and do, get in the way.<\/p>\n

We may be on the way to conquering this plague. Or not.<\/p>\n

Like most afflictions, hunger, poverty and so on–we make progress (and also call bureaucratic arithmetic that no one could live on “progress’) and then forget. And the accumulating inter-related problems threaten to explode worse than ever.<\/p>\n

About 40 million people are living with HIV, the virus that causes AIDS. We may or may not be closer to a cure, but we don’t have one. We do have treatment that if we lived in a humane world of basic decency and equality everyone would get.<\/p>\n

About 22 million out of 40 million get that treatment.<\/p>\n

About a million die every year.<\/p>\n

And there’s about two million new cases of HIV every year.<\/p>\n

As we often say–even though the percentages have gotten better over time on the above, which has been crucial–you do the math.<\/p>\n

Oh, and really, don’t forget that this turns into some serious multi-dimensional math when you mix in the numbers on hunger, poverty, lack of equality in resources way over an arbitrary poverty line, global population, environment and so on.<\/p>\n

There’s no guarantee even the current treatments will continue having efficacy, nor can we know what new strains or other unforseen mechanisms of infection might develop. Its still officially a pandemic. This could still turn into God’s curse–on us all for our inhumanity and stupidity. Noah redux.<\/p>\n

Interestingly, one thing most people and experts agree on, no matter how divergent their views may be on other issues, is the increasing threat of disease, of global pandemics more threatening than ever, of unpreparedness for them, and of creation of them by misuse of the very medicines that have prevented them in many instances.<\/p>\n

We would submit, as always, that documented facts and simple historical observation make clear that everything is completely inter-related. And we’ve also said often that it may be more likely than not that global cataclysm, which we barely survive as a species, may be the only thing that will wake us up.<\/p>\n

You know, to take care of each other.<\/p>\n

We remember asking numerous Gen Xs and Millennials what they thought it would take to unite humanity.<\/p>\n

Alien invasion.<\/p>\n

Not said with even a hint of dry humor.<\/p>\n

Seriously.<\/p>\n

And point taken.<\/p>\n

So what will be the equivalent?<\/p>\n

Well, we cover many of them often. But maybe not the one that could turn out to be the most likely enough.<\/p>\n

Disease.<\/p>\n

Hence, the main headline in today’s Sunday New York Times.<\/p>\n

Here’s the story, the first in a critical series, Deadly Germs, Lost Cures<\/em>:<\/p>\n

“A Mysterious Infection, Spanning the Globe in a Climate of Secrecy”<\/a><\/p>\n

By Matt Richtel and Andrew Jacobs, The New York Times, April 7, 2019<\/p>\n

The rise of Candida auris embodies a serious and growing public health threat: drug-resistant germs.<\/em><\/p>\n

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Last May, an elderly man was admitted to the Brooklyn branch of Mount Sinai Hospital for abdominal surgery. A blood test revealed that he was infected with a newly discovered germ as deadly as it was mysterious. Doctors swiftly isolated him in the intensive care unit.<\/p>\n

The germ, a fungus called Candida auris, preys on people with weakened immune systems, and it is quietly spreading across the globe. Over the last five years, it has hit a neonatal unit in Venezuela, swept through a hospital<\/a> in Spain, forced a prestigious British medical center to shut down its intensive care unit, and taken root in India, Pakistan and South Africa<\/a>.<\/p>\n

Recently C. auris reached New York<\/a>, New Jersey<\/a> and Illinois, leading the federal Centers for Disease Control and Prevention to add it to a list of germs deemed \u201curgent threats.\u201d<\/p>\n

The man at Mount Sinai died after 90 days in the hospital, but C. auris did not. Tests showed it was everywhere in his room, so invasive that the hospital needed special cleaning equipment and had to rip out some of the ceiling and floor tiles to eradicate it.<\/p>\n

\u201cEverything was positive \u2014 the walls, the bed, the doors, the curtains, the phones, the sink, the whiteboard, the poles, the pump,\u201d said Dr. Scott Lorin, the hospital\u2019s president. \u201cThe mattress, the bed rails, the canister holes, the window shades, the ceiling, everything in the room was positive.\u201d<\/p>\n<\/div>\n<\/div>\n

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C. auris is so tenacious, in part, because it is impervious to major antifungal medications, making it a new example of one of the world\u2019s most intractable health threats: the rise of drug-resistant infections.<\/p>\n

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Dr. Shawn Lockhart, a fungal disease expert at the Centers for Disease Control and Prevention, holding a microscope slide with inactive Candida auris collected from an American patient.<\/span>Credit<\/span>Melissa Golden for The New York Times<\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n
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For decades, public health experts have warned that the overuse of antibiotics was reducing the effectiveness of drugs that have lengthened life spans by curing bacterial infections once commonly fatal. But lately, there has been an explosion of resistant fungi as well, adding a new and frightening dimension to a phenomenon that is undermining a pillar of modern medicine.<\/p>\n

\u201cIt\u2019s an enormous problem,\u201d said Matthew Fisher, a professor of fungal epidemiology at Imperial College London, who was a co-author of a recent scientific review<\/a> on the rise of resistant fungi. \u201cWe depend on being able to treat those patients with antifungals.\u201d<\/p>\n

Simply put, fungi, just like bacteria, are evolving defenses to survive modern medicines.<\/p>\n<\/div>\n<\/div>\n

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Yet even as world health leaders have pleaded for more restraint in prescribing antimicrobial drugs to combat bacteria and fungi \u2014 convening the United Nations General Assembly in 2016 to manage an emerging crisis \u2014 gluttonous overuse of them in hospitals, clinics and farming has continued.<\/p>\n<\/div>\n<\/div>\n

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Read the next article in this series: In a Poor Kenyan Community, Cheap Antibiotics Fuel Deadly Drug-Resistant Infections<\/em><\/a><\/div>\n<\/div>\n
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Resistant germs are often called \u201csuperbugs,\u201d but this is simplistic because they don\u2019t typically kill everyone. Instead, they are most lethal to people with immature or compromised immune systems, including newborns and the elderly, smokers, diabetics and people with autoimmune disorders who take steroids that suppress the body\u2019s defenses.<\/p>\n

Scientists say that unless more effective new medicines are developed and unnecessary use of antimicrobial drugs is sharply curbed, risk will spread to healthier populations. A study the British government funded projects<\/a> that if policies are not put in place to slow the rise of drug resistance, 10 million people could die worldwide of all such infections in 2050, eclipsing the eight million expected to die that year from cancer.<\/p>\n

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Dr. Johanna Rhodes, an infectious disease expert at Imperial College London. “We are driving this with the use of antifungicides on crops,” she said of drug-resistant germs.<\/span>Credit<\/span>Tom Jamieson for The New York Times<\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n
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In the United States, two million people contract resistant infections annually, and 23,000 die from them, according to the official C.D.C. estimate. That number was based on 2010 figures; more recent estimates from researchers at Washington University School of Medicine<\/a> put the death toll at 162,000. Worldwide fatalities from resistant infections are estimated at 700,000<\/a>.<\/p>\n

Antibiotics and antifungals are both essential to combat infections in people, but antibiotics are also used widely to prevent disease in farm animals, and antifungals are also applied to prevent agricultural plants from rotting. Some scientists cite evidence that rampant use of fungicides on crops is contributing to the surge in drug-resistant fungi infecting humans.<\/p>\n

What You Need to Know About Candida Auris<\/em><\/a><\/p>\n<\/div>\n<\/div>\n

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Yet as the problem grows, it is little understood by the public \u2014 in part because the very existence of resistant infections is often cloaked in secrecy.<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n
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With bacteria and fungi alike, hospitals and local governments are reluctant to disclose outbreaks for fear of being seen as infection hubs. Even the C.D.C., under its agreement with states, is not allowed to make public the location or name of hospitals involved in outbreaks. State governments have in many cases declined to publicly share information beyond acknowledging that they have had cases.<\/p>\n

All the while, the germs are easily spread \u2014 carried on hands and equipment inside hospitals; ferried on meat and manure-fertilized vegetables from farms; transported across borders by travelers and on exports and imports; and transferred by patients from nursing home to hospital and back.<\/p>\n

C. auris, which infected the man at Mount Sinai, is one of dozens<\/a> of dangerous bacteria and fungi that have developed resistance.<\/p>\n

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A projection of the C. auris fungus on a microscope slide.<\/span>Credit<\/span>Melissa Golden for The New York Times<\/span><\/figcaption><\/figure>\n<\/div>\n<\/div>\n
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Other prominent strains of the fungus Candida \u2014 one of the most common causes of bloodstream infections in hospitals \u2014 have not developed significant resistance to drugs, but more than 90 percent of C. auris infections are resistant to at least one drug, and 30 percent are resistant to two or more drugs, the C.D.C. said.<\/p>\n<\/div>\n<\/div>\n

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Dr. Lynn Sosa, Connecticut\u2019s deputy state epidemiologist, said she now saw C. auris as \u201cthe top\u201d threat among resistant infections. \u201cIt\u2019s pretty much unbeatable and difficult to identify,\u201d she said.<\/p>\n

Nearly half of patients who contract C. auris die within 90 days, according to the C.D.C. Yet the world\u2019s experts have not nailed down where it came from in the first place.<\/p>\n

\u201cIt is a creature from the black lagoon,\u201d said Dr. Tom Chiller, who heads the fungal branch at the C.D.C., which is spearheading a global detective effort to find treatments and stop the spread. \u201cIt bubbled up and now it is everywhere.\u201d<\/p>\n

Candida Auris<\/strong><\/p>\n<\/div>\n<\/div>\n

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A deadly, drug-resistant fungus is infecting patients in hospitals and nursing homes around the world. The fungus seems to have emerged in several locations at once, not from a single source.<\/p>\n<\/header>\n

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