Maryn McKenna

Journalist and Author

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How The New Coronavirus Might Be Like SARS: Hospital Spread (Part 2)

May 9, 2013 By Maryn Leave a Comment

The most recent official update on the novel coronavirus raises the possibility that most of the recent cluster — 13 cases out of 30 — may be due to the novel disease spreading within one hospital. (Yesterday there were reports of the spread having to do with dialysis. I’m skeptical of that.) Infectious disease experts find the idea of hospital spread very worrisome, because when the related disease SARS arose 10 years ago, hospitals unknowingly caused its first rapid spread. International health authorities are taking this threat seriously: On Monday, the World Health Organization published a multi-page infection-prevention guide for any hospitals that might take in victims.

When SARS broke out of southern China in early 2003, I was in the midst of a year-long project shadowing members of the disease-detective corps of the Centers for Disease Control and Prevention, known as the Epidemic Intelligence Service. Some of the most explosive SARS outbreaks they were sent to investigate were in hospitals, and front-line health care workers were some of the earliest victims.

This is the second of two excerpts from a book I wrote in 2004 about the EIS, Beating Back the Devil, describing what the early days of SARS were like. In the previous one, a hospital swamped by SARS locks its doors, with its sick staff inside. In this one, a doctor who worked in that hospital — and alerted the world to the threat — loses his life to the disease.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, coronavirus, HAI, hong kong, MERS, NCoV, SARS, Science Blogs, Who

How The New Coronavirus Might Be Like SARS: Hospital Spread

May 7, 2013 By Maryn Leave a Comment

The most recent update on the novel coronavirus that has been spreading in the Mideast since last summer adds three more cases to the outbreak, and raises the possibility that most of the recent cluster — 13 cases out of 30 — may be due to the infection spreading within one hospital. Infectious disease experts find that worrisome, because when the related disease SARS arose 10 years ago, hospitals unknowingly amplified its first rapid spread. International health authorities are taking this threat seriously: On Monday, the World Health Organization published a multi-page infection-prevention guide for any hospitals that might take in victims.

When SARS broke out of southern China in early 2003, I was in the midst of a year-long project shadowing members of the disease-detective corps of the Centers for Disease Control and Prevention, known as the Epidemic Intelligence Service. Some of the most explosive outbreaks they were sent to investigate were in hospitals, and front-line health care workers were some of the earliest victims.

I thought it would be worth remembering what the early days  of SARS were like, while we wait to see what this new virus does next. So over the next few days, I’m going to run a couple of excerpts from a book I wrote in 2004 about the EIS, Beating Back the Devil. In this one, a hospital swamped by SARS locks its doors, with its sick personnel inside. In the second excerpt, a doctor who worked in that hospital — and alerted the world to the threat — loses his life to the disease.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, coronavirus, HAI, hong kong, MERS, NCoV, SARS, Science Blogs, Who

News Round-Up: Food, Foodborne Illness, And Antibiotic Resistance In Food

May 5, 2013 By Maryn Leave a Comment

OK, still catching up. Today: food, foodborne illness, and antibiotic use and resistance in food — lots of news in a multi-item rundown. (Under normal circumstances, I’d give each of these items a post of its own; but since they all happened in the past few weeks, it seems better to note them and move on.)

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, CDC, consumer reports, E. coli, EIS, food, food policy, foodborne, Resistance, salmonella, Science Blogs, Turkey

Transparency Unlocked: More New Saudi Coronavirus Cases Reported Quickly

May 4, 2013 By Maryn Leave a Comment

In my last post 36 hours ago, I raised questions about Saudi Arabia’s apparent delay in reporting new cases of the novel coronavirus that has been causing low-level unease since last summer. (For the full history of that, check these posts.) So it’s only fair to say that, within 24 hours, the Saudi government behaved very differently with a new report.

The bad news is, the new report is about yet more cases of the novel virus. But the good news is, the report of the new cases was quickly shared internationally, by the government’s Deputy Minister for Public Health, via the international disease-alert mailing news ProMED.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, China, coronavirus, H7N9, hCoV-EMC, influenza, MERS, NCoV, SARS, Saudi Arabia, Science Blogs, transparency, Who

New Diseases and National Transparency: Who Is Measuring Up?

May 2, 2013 By Maryn Leave a Comment

I’m still catching up on all the news that happened during the weeks I was away, and I had a food-policy post just about set to go today. And then this happened.

I opened my morning mail to find a note from a private list I subscribe to, published by a company that monitors hazards for businesses with expatriate employees. The note flagged new news from Saudi Arabia:

Saudi Arabia: Seven more case of novel coronavirus reported
Seven people in Al-Ahsa governate in the Eastern province have been confirmed infected with the novel coronavirus. Five have died and the other two are critically ill in intensive care. It is unclear whether there are any links between these cases or whether they are “sporadic” infections. Overall the risk to travellers remains low.

This was odd. You’ll remember the new coronavirus, distantly related to SARS, which surfaced last year in a slow and not well-disclosed manner (for the back story, see these posts from last September, October, November and December). Since the initial reveal last year, there has been very little information released about the virus and whatever illness it might be causing. The World Health Organization has been monitoring the gradual accumulation of cases, but there has been almost nothing published since last fall. In fact, though teams from Columbia University and the Centers for Disease Control and Prevention have been to the Kingdom of Saudi Arabia to help investigate the new illness, neither entity has published anything since those trips were made. And at the point at which I opened my inbox this morning, the WHO’s last update on the new virus had been published on March 26.*

Meanwhile, of course, the infectious disease world has been riveted by the rapid emergence in China of a different virus, the new avian flu H7N9, and many questions have been aimed at whether the Chinese government, which attempted to conceal the emergence of SARS 10 years ago, has learned the lesson of transparency. (I talked about that history, and how the world found out about SARS, in this segment from On the Media a few weeks ago.)

Almost since H7N9 emerged in March, though, the WHO and other bodies have been averring that China is actually doing a good job this time around. And with this overnight news from Saudi, it seems that the questions about disease-outbreak transparency may have been directed at the wrong country.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: avian flu, CDC, China, coronavirus, H7N9, hCoV-EMC, influenza, MERS, NCoV, SARS, Saudi Arabia, Science Blogs, transparency, Who

'Catastrophic Threat': UK Government Calls Antibiotic Resistance a 'Ticking Time Bomb'

March 11, 2013 By Maryn Leave a Comment

On the heels of the director of the U.S. Centers for Disease Control declaring emerging antibiotic resistance a “nightmare,” the U.K.’s Chief Medical Officer released a report today in which she calls resistance a “catastrophic threat” which poses a national security risk as serious as terrorism. In an interview published overnight, she warns that unless resistance is curbed, “We will find ourselves in a health system not dissimilar to the early 19th century” in which organ transplants, cancer chemotherapy, joint replacements and even minor surgeries become life-threatening.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, CDC, Resistance, Science Blogs, UK

'We Have a Limited Window of Opportunity': CDC Warns of Resistance 'Nightmare'

March 6, 2013 By Maryn Leave a Comment

It’s not often that you get to hear a top federal health official deliberately deploy a headline-grabbing word such as “nightmare,” or warn: “We have a very serious problem, and we need to sound an alarm.”

Dr. Thomas Frieden, director of the US Centers for Disease Control and Prevention, said both Tuesday, during a press conference announcing new CDC statistics on the advance of the highly drug-resistant bacteria known as CRE. His language — plus the fact that he conducted the entire press conference himself, instead of just making a brief opening statement — seem to me a clear signal that the CDC is taking this resistance problem seriously, and hoping we do too.

And we should. Here’s what the CDC announced Tuesday:

  • Healthcare institutions in 42 states have now identified at least one case of CRE.
  • The occurrence of this resistance in the overall family of bacteria has risen at least four-fold over 10 years.
  • In the CDC’s surveillance networks, 4.6 percent of hospitals and 17.8 percent of long-term care facilities diagnosed this bug in the first half of 2012.

Those are dire reports.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, CDC, CRE, CRKP, KPC, NIH, Resistance, Science Blogs

Almost-Untreatable Gonorrhea: Proof That It's Here

January 11, 2013 By Maryn Leave a Comment

If you’ve been following this blog for a while, you might have noticed a thread on health authorities’ growing concern over gonorrhea not responding to the drugs used against it. (And if you didn’t notice you can find those posts here.) A paper published Wednesday evening shows that worry has not been misplaced.

The concern is this: Treatment of STDs in infected people, and programs that aim to keep STDs from spreading from those people to others, rely on drugs that are inexpensive to buy, simple to administer, and work after a single dose and clinic visit. Since the late 1990s, there have been only two drugs that fulfill those criteria: an oral drug called cefixime and an injectable called ceftriaxone (both belonging to the same broader drug family called third-generation cephalosporins). Since the early 2000s, there have simultaneously been signs that resistance to cefixime has been spreading from the Pacific Rim — Japan and Hawaii — to North America, Europe and the rest of the world.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, ECDC, gonorrhea, Resistance, Science Blogs, Who

An Old Disease Returns: Dengue Is in Florida and May Be Heading North

December 22, 2012 By Maryn Leave a Comment

This month, Slate has been running an intermittent series on pandemics under the guidance of new science editor Laura Helmuth. The latest entry in the series is one that I wrote (my first time writing for Slate, which is exciting). It’s about the under-appreciated threat to the United States of a disease that we barely think about: the mosquito-borne illness called dengue, formerly known as “breakbone fever.”

Dengue was once endemic in the United States. When I started researching it for this piece, I discovered a whole series of historical outbreaks I knew nothing about: Charleston, SC, 1828; Savannah, Ga., 1850; Austin, 1885; Galveston, 1897; most of Louisiana, 1922; Miami, 1934. Dengue was not eliminated here until the government undertook mass mosquito-eradication programs in the 1940s, because mosquito-borne illnesses were making so many military members so sick that the toll was hampering the war effort. (Public-health history buffs: Those were the campaigns that gave rise to the CDC, which grew out of a government agency called the Office of Malaria Control in War Areas.)

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: babesiosis, CDC, dengue, Lyme, mosquitoes, Science Blogs, tickborne, ticks, Who

Fungal Meningitis From Injections: Not Even Close To Over

December 4, 2012 By Maryn Leave a Comment

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.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, Science Blogs

WHO Announces Family Cluster of Cases of New Coronavirus

November 23, 2012 By Maryn Leave a Comment

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:

  • Four additional laboratory-confirmed cases have been identified; one of the four has died.
  • One case is in Qatar, the location of one of the original two cases earlier this year.
  • Three of the new cases, including the dead person, are in Saudi Arabia, site of the other original case (who also died).
  • Two of the three Saudi cases, including the dead person, are members of the same family.
  • In that family, two other people have also fallen ill, and one has died. The man who recovered showed no laboratory evidence of infection with the novel coronavirus. Analysis of the case of the person who died is continuing.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, coronavirus, MERS, Qatar, SARS, Saudi Arabia, Science Blogs, Who

Advice for the Annual Observance of Food-Poisoning, Umm, Thanksgiving Day

November 20, 2012 By Maryn Leave a Comment

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.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, FDA, food, food policy, foodborne, Science Blogs, Thanksgiving, Turkey, USDA

The Persistence of Resistance And Some Reasons Why

November 13, 2012 By Maryn Leave a Comment

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…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, CDC, E. coli, Resistance, Science Blogs

The New Coronavirus: Uncertainty, and How to Talk About It

October 17, 2012 By Maryn Leave a Comment

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)

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, coronavirus, MERS, Qatar, SARS, Saudi Arabia, Science Blogs, Who

Becoming Part of the Story (Maybe): The Peanut Butter Recall

October 5, 2012 By Maryn Leave a Comment


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…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, food, food policy, foodborne, salmonella, Science Blogs

Why the New Coronavirus Unnerves Public Health: Remembering SARS

September 26, 2012 By Maryn Leave a Comment

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.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, coronavirus, hong kong, MERS, Qatar, SARS, Saudi Arabia, Science Blogs, Who

The Outdoors Hates You: More New Tick-Borne Diseases (ICAAC 1)

September 10, 2012 By Maryn Leave a Comment

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.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: babesiosis, CDC, Lyme, Science Blogs, tickborne, ticks

A New Tick-Borne Illness, and a Plea to Consider the Insects

September 5, 2012 By Maryn Leave a Comment

A tick’s mouth parts under 40x magnification.

In the summer of 2009, two men from northwest Missouri showed up at Heartland Regional Medical Center in St. Joseph, tucked up against the Kansas border 50 miles north of Kansas City. The men were seriously sick. They had high fevers, fatigue, aches, diarrhea and disordered blood counts: lower than normal amounts of white blood cells, which fight infection, and also lower than normal platelets, cells that control bleeding by helping blood to clot. But they had none of the diseases that were high on the differential diagnosis, the list of possible causes that doctors work their way down as they try to figure out what has gone wrong: no flu, no typhus, no Clostridium difficile, and none of the serious foodborne illnesses — no Salmonella, no Shigella, and no Campylobacter.

The two men had one thing in common, though: About a week before being hospitalized, each remembered, he had been bitten by a tick.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: babesiosis, CDC, Ebola, Insects, Lyme, Science Blogs, ticks

CDC: First Death From "State Fair Flu"

August 31, 2012 By Maryn Leave a Comment

The Centers for Disease Control and Prevention today reported the first death from influenza A H3N2 variant (H3N2v), the swine flu strain that has been crossing intermittently from pigs to humans since last year. The victim was an “older adult with multiple underlying health conditions,” according to the CDC, and the Associated Press fills in that the victim was a 61-year-old woman from “central Ohio’s Madison County [who] died this week… after having contact with hogs at the Ross County Fair.” In a statement, the Ohio Department of Health says that she was one of 102 cases so far in the state this year. In total, the CDC says, there have been 289 cases so far this year (with Indiana leading, at 138 cases); in 2011, there were 12. Fifteen people have been hospitalized.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, CDC, influenza, pigs, Science Blogs

The 'NIH Superbug': This Is Happening Every Day

August 24, 2012 By Maryn Leave a Comment

I mentioned in my last post that I’ve been away on assignment and have been trying to catch up to an onslaught of news. One of the things that broke while I was gone was a new paper in Science Translational Medicine describing the ferocious impact on a hospital at the National Institutes of Health of the arrival of carbapenem-resistant Klebsiella pneumoniae, known for short as KPC or CRKP.

Even though the news is now several days old — the paper went live at noon Wednesday and has been covered in most major media since — I think it’s worth doubling back to take a closer look. Because, with all respect to my media colleagues, I think some of this week’s stories have omitted the larger context. So, a different kind of post for me — less news, more analysis, based on this book, this magazine story, and these past posts on antibiotic resistance. Here we go:

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, carbapenems, CDC, CRKP, Klebsiella, KPC, NIH, Resistance, Science Blogs

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