Journalist and Author
Lung tissue containing the original SARS coronavirus (CDC, 2003)
There’s lots of news to catch up with regarding the new coronavirus that emerged last summer in the Middle East and has been causing concern to international health authorities all autumn: additional cases, additional deaths, and new lab evidence that is more than a little concerning.
Well, this is ironic. The Food and Drug Administration is warning the country of the possibility of health care infections caused by the antiseptics used to disinfect skin before health care procedures — that is, to prevent infections. They consider it a serious enough problem that they have scheduled a hearing about it next week.
There’s been an extraordinary outbreak going on over the past few months here in the United States: cases of fungal meningitis, a rare illness, primarily caused by Exserohilum rostratum, a plant pathogen that is equally rare as a cause of human infections. Since the beginning of October, 541 people have been made ill by the infection, in 19 states, and 36 have died. The cause has been traced to contamination in steroid injections for pain relief, made by a compounding pharmacy in Massachusetts which — according to federal investigative reports — was operating outside the lines of what compounding pharmacies are allowed to do. More than 14,000 people are believed to have received the shots.
I haven’t been covering the outbreak because I’ve been following other stories, and also because friends in the mainstream media, particularly the excellent health-science team at the Boston Globe, have been covering it well. (Here’s an archive from their paid site and one from their free site.) But last night I happened to get a close and moderately exclusive look at this complex story, so I thought I’d share.
Bad news today from an investigation conducted by Consumers Union that was released on the web and will be published in the January issue of the nonprofit’s magazine, Consumer Reports. Tests on pork chops and ground pork, bought in six cities under a variety of labels, showed high rates of contamination with a range of bacteria, many of which were antibiotic-resistant — and also showed evidence of a drug so controversial that it is banned in some other countries.
Lung tissue containing the original SARS coronavirus (CDC, 2003)
(This post has been updated; read to the end.)
Holidays. It never fails.
Today, while the United States has been largely off-line following our Thanksgiving holiday (and while Northern Europe was on its way to the pub for Friday evening revelry), the World Health Organization announced four new cases of the novel coronavirus that caused a great deal of worry immediately before the October hajj season. (Earlier posts here and here.)
In its bulletin, released by the WHO’s Global Alert and Response team (GOAR), the agency said:
On a day when we all think about food, I want to revisit, and update, my favorite food-related story of the year.
Constant readers may remember, from back in June, the story of 9-year-old Martha Payne of Scotland. Her blog “Never Seconds,” featuring photographs of her unhealthy school lunches, caused so much embarrassment in her school district that the county council tried to shut her down. The news of their mendacious unfairness rippled across the media and the Internet, and hundreds of thousands of people — including a number of celebrities, and thousands of Superbug readers — applied enough pressure to get the decision reversed.
Martha (whom I’ve never met) seems to be a smart, sensible kid, with caring, thoughtful parents; her mother is a primary-care doctor, and her father has a small farm. With rare maturity, they resisted enormous pressure to monetize her celebrity, and turned the attention into a benefit for someone else.
Actually, lots of someones. They asked readers and supporters to donate to a charity, Mary’s Meals, that feeds schoolchildren in some of the world’s poorest areas — including Malawi, where Scottish roots date back to the arrival of explorer David Livingstone in the 1860s. At this point, five months later, Martha and her family have raised £120,000 (almost $200,000), enough to build a kitchen and distribute school supplies to thousands of kids.
My grandparents — children of Irish and Scottish immigrants, for whom calories per penny was a much more important food value than fine cuisine — had a little mnemonic for Thanksgiving. It went like this:
Turkey, tetrazzini, ptomaine.
Perhaps that requires a little explanation.
The turkey part should be self-evident. Tetrazzini — a cream-sauce casserole based on spaghetti, one of those early 20th-century dishes invented to honor Italian opera stars — was what they did the second day with the turkey leftovers. Ptomaine (the “p” is silent) was what they worried lay in wait for them on the third. A late 19th-century term that has passed out of use, it derived from the notion that poisonous compounds lurked in rotting food.
For people who grew up before the antibiotic era — and who learned to cook when refrigerators were literal ice chests that kept things cool at best — “food poisoning” was a reasonable fear, and a risk they refused to take. On the Saturday after Thanksgiving, no matter how delicious it appeared, whatever remained of the turkey went into the trash.
Tuesday marked the start of the United States’ Get Smart About Antibiotics Week, an annual observance by the Centers for Disease Control and Prevention that tries to direct attention to the root causes of antibiotic resistance and possible fixes. (It is also European Antibiotic Awareness Day, and also the first day of Australia’s Antibiotic Awareness Week. I don’t know of other national observances; if you do, leave them in the comments!)
To mark the day and jump-start awareness, the CDC and a number of US medical and public-health organizations held press events. The observances and the policy statements that came from them were important — but reading between the lines, it is discouraging how much there is yet to do.
(By the way, constant readers: Sorry to be gone so long. Some challenges in the extended family of Casa Superbug; almost all better now, hope everything will be over by the weekend. Meanwhile…)
[Read more…]
We’ve all been so justifiably preoccupied with former Hurricane Sandy that you may have missed a story unfolding in England this past week. So, as a distraction from the trees, traffic and sludge:
Ronald Brown, an English veteran of World War II, would quietly complain from time to time about his bad leg, the reminder of a land mine that he stepped on in August 1944 in France. Army surgeons felt it was safer to leave the mine’s fragments in his flesh than to try and fish them out, and ever after, Brown’s knee set off airport scanners and ached too much for his grandchildren to sit on it.
I’ve been offline not just for deadlines (as usual), but also because I was preparing for the annual conference of the National Association of Science Writers; I am a member and was a presenter on a couple of panels. The NASW meeting is twinned every year with a second meeting hosted by the nonprofit Council for the Advancement of Science Writing; NASW sessions are peer-to-peer journalism learning, whereas CASW ones feature academic researchers talking about their newest work.
This year’s meetings (collectively called SciWri12, or #SciWri12 if you want to find them on Twitter) were held in Raleigh, NC, and one of the most striking talks there was a report from epidemiologist Steven Wing of the University of North Carolina, Chapel Hill about his decade-long work investigating the local health effects of very large swine farms. (I’ve written about Wing’s work before.)
The newest news is a paper that he and his team published just as his talk commenced, in the journal Environmental Health Perspectives, which finds an association between air pollution and odor in the near vicinity of swine farms, and hikes in blood pressure in local residents. When you put the pieces together — most hog c0nfinement operations are in poor, non-white areas; cardiovascular disease is endemic in African Americans; North Carolina lies within the worst US area for cardiovascular disease, known as the “Stroke Belt” — you can see that anything that makes blood pressure chronically worse is bad news for public health.
Lung tissue containing the original SARS coronavirus (CDC, 2003)
Have we dodged a bullet? Or is the other shoe yet to drop?
The uncertainty over the novel coronavirus that was recognized last month is captured in a research report and editorial just released this evening by the New England Journal of Medicine. (I believe these are the first peer-reviewed papers on the new organism, though it has several times been written up in the European CDC’s bulletin, EuroSurveillance.) The papers are a treatment report and analysis of the first known case, the 60-year-old Saudi man who died in June, and an examination of the larger issues raised by this case and the second known one, which occurred in Qatar and London in September.
Short summary of the situation from the second paper, co-authored by the former chief of the division of viral diseases at the US CDC:
Since there has been no evidence of human-to-human transmission or virus transmission to healthcare workers, [the novel virus] is not currently a public health risk. (NEJM Anderson 2012)
Earlier this week, something happened to me that happens to at least 48 million people in the United States every year: I got a foodborne illness. After a completely normal weekend and Monday, I woke in the middle of the night unusually thirsty; I glugged a big glass of water and stumbled back to bed. I got up Tuesday morning still thirsty, feeling kind of chilled and sluggish, and with no appetite. I skipped my usual fruit and yogurt, downed my usual two cups of coffee, skipped my usual hour-long walk and went to my desk.
About two hours later, my abdomen started to cramp.
About 30 minutes after that, I realized it would be a good idea if I went into the bathroom fairly soon.
I was there for a while. [Read more…]
Lung tissue containing the original SARS coronavirus (CDC, 2003)
On Feb. 21, 2003, a 65-year-old physician who lived in the Chinese province that abuts Hong Kong crossed into the territory surrounding the city and checked into a hotel in Kowloon. He was given a room on the ninth floor. Sometime during his stay — no one has ever fully traced his path — he encountered roughly a dozen other people; most of them were hotel guests whose rooms were on the same floor, but some were staying on other floors, and some were visitors to events there. The physician had been sick for a week with symptoms that had started like the flu, but were turning into pneumonia, and the next day, he checked out of the hotel and went to a Hong Kong hospital. Before the end of the day, he died.
In the next few days, the people who had crossed paths with the physician left the hotel. Most of them were visitors to the special administrative region: Hong Kong is not only a port and transit hub, but a business and shopping destination for much of the Pacific Rim. They went to Vietnam, Singapore, Canada, and Ireland. As they traveled, some of them started to feel as though they had picked up the flu.
I’m cheating a bit here, since summer ended before dawn yesterday. But for the last entry in Superbug Summer Books, I wanted to leave you with something recent, and something rich, and today’s pick qualifies twice over: It was released just last week, and it is full — stuffed — with excellent science writing, more than enough to keep you reading until I pick up this intermittent book feature, in adapted form, later this fall.
“The Best Science Writing Online 2012” (Scientific American/Farrar, Straus and Giroux) is the latest in a series begun in 2006 by Bora Zivkovic, now the editor of Scientific American‘s blog platform, and a series of guest editors. The series was originally dubbed “The Open Laboratory” and published independently. This year’s iteration has been brought forward by a major publisher, the new Scientific American imprint of Farrar, Straus and Giroux, with all the extra market legitimacy that suggests.
News, via the Washington Post‘s hard-working health reporter Brian Vastag: After 6 months with no cases, carbapenem-resistant Klebsiella has surfaced again at the Clinical Center of the National Institutes of Health, and has killed a boy from Minnesota who came to the specialty hospital after a bone-marrow transplant meant to address an immune deficiency. This sad event makes the boy the 19th patient to contract the extremely resistant hospital organism, and the 12th to die from it, since the outbreak began.
You can find here my last post analyzing this outbreak (which was originally reported by the Post following a write-up by NIH staff in the journal Science Translational Medicine). I’m looping back to the subject not just because of this new death, but also to add a few new publications to the discussion, one of them mine.
I confess: It can get lonely sometimes, being Scary Disease Girl. The universe of people who are deeply invested disease geeks is passionate (thank you, constant readers) but it isn’t that large. And let’s face it, keen interest in things that could bring an end to civilization as we know it — hitherto-unknown pathogens, rampant antimicrobial resistance, nanotechnology run amok — isn’t like to earn repeat invitations to most dinner parties.
So you can imagine how I welcomed the publication of Fred Guterl’s new book, “The Fate of the Species: Why The Human Race May Cause Its Own Extinction And How We Can Stop It” (Bloomsbury), a lean and thoughtful exploration of the possible impact on humankind of scary diseases, and many other potentially bleak futures. In a series of deeply reported what-if essays, Guterl explores the worst-case scenarios that climate change, species loss, and viruses both real and digital might bring — and what steps we might take now to avert these imagined but plausible outcomes.
A necessary disclosure: Guterl is the executive editor of Scientific American, where I am a columnist on contract. But the book didn’t come to me as a result of that relationship; it was sent to me by a publicist who noticed this books series and had no notion of our connection.
A final post from the ICAAC meeting, which concluded at one end of the Moscone Center in San Francisco Wednesday just as the Apple iPhone 5 launch was beginning at the building’s other end. (Definitely a crossing of geek streams.)
There’s far too much going on at a meeting like this to cover everything. So what emerges, as journalists move around the session rooms and exhibit floors, are stories regarding whatever caught a reporter’s eye based on his or her existing interests and news sense.
What caught my eye was a lot of research into foodborne illness, and particularly into the possibility of food being a reservoir for antibiotic resistance (which, constant readers will know, is something I’m interested in). [Read more…]
News from the ICAAC meeting: The “Indian superbug” NDM-1 — actually a gene which encodes an enzyme which confers resistance to almost all known antibiotics — has been found for the first time in a pet, somewhere in the United States.
When you consider the close contact we have with our pets — letting them lick us, smooching them on the head, allowing them to sleep on the bed — you’ll understand why this could be such bad news. [Read more…]
A quicker post today from the ICAAC meeting because there’s lots of news coming down this afternoon. At a conference like this, where the focus is on new behavior of pathogens and new drug compounds to contain them, there is a natural focus on emerging antibiotic resistance. Out of the first two days of (hundreds of) papers and posters, here are just a few unnerving reports.
This week I’m at ICAAC (the Interscience Conference on Antimicrobial Agents and Chemotherapy), a massive infectious-disease and drugs meeting that is sponsored every year by the American Society for Microbiology. ICAAC is an unabashed scary-disease geekgasm, the kind of meeting at which the editor of a major journal tweets from one room, “‘Modern medicine will come to a halt’ in India because of catastrophic multi-drug resistance” while a microbiologist alerts from another: “Rat lungworm traced to salads on a Caribbean cruise. Snails had apparently gotten to the greens.”
Good times.
Meanwhile, I was learning more about ticks.
