Infection Report 1: Why are infections such a problem again?
© 2014 Roy Benaroch, MD
Once again, infections are in the headlines.
Ironically, it wasn’t that long ago, around the 1950’s, that many people thought we had infections beat. Antibiotics could cure any infection, and the pace of new drug development was exploding. We were sure to outwit the stupid microbes. We’ve learned a lot since then:
1. Evolution by natural selection works. When the environment puts pressure on living things, the population best equipped to thrive under those conditions expands. In other words, the use of antibiotics encourages bacteria to become resistant. This is especially true when antibiotics are used indiscriminately, incorrectly, and inappropriately. And antibiotics can cause other side effects, too. In the long run, if our only weapon against infection is antibiotics, we are going to lose.
2. New viruses are guaranteed to appear, and are guaranteed to spread. The last 50 years has seen the rise of AIDS, SARS, MERS, and Ebola. There is no way to prevent the appearance of new viral infections.
3. The success of public health efforts to contain disease undermines public confidence in the need for public health efforts. I know, that sounds weird. But once disease XX becomes rare (typically through a whole lot of public health effort), people stop worrying about it. They even sometimes begin to distrust the system and the people whose work stopped the disease in the first place. Once strategies to contain disease are offhandedly dismissed, the diseases come back.
4. The world is big, and the world is interconnected. Diseases no longer lurk only in secluded areas or remote villages. Conditions in resource-poor parts of the world contribute to the development of new infections: living closely with animals, poor sanitation, lack of health education and resources, and ineffective government or public support for health maintenance and surveillance. Once new infections appear, they’re bound to spread—people routinely travel by planes across entire continents.
Sound grim? Maybe. Threats certainly loom, and they’re much closer than the horizon. What should you be doing to protect yourself and your family? This week’s daily posts will be about infections new and old, the ones in the news and the ones most likely to make your family sick. You might be surprised to learn that what you are worrying about and what you should be worrying about aren’t the same things, and that there are simple and safe things that you really should be doing to protect your family from real threats. The media is seething with news and worry—but I think, for the most part, they’re missing the point.
Next: Ebola and you