Prevention Is Key To Antibiotic Resistance

June 20, 2013

FlatsAntibiotics are an important tool, one that we wasted by becoming too dependant on them in the 70 years they’ve been around. It’s great that they can prevent minor infections, but it’s more important to save them for important things: fast acting, deadly disease like tuberculosis, preventing serious infection from surgery, and protecting those with weakened immune systems from secondary infections.

New evidence on leprosy has shed a lot of light on how first world countries have moved past the disease, while it’s still a problem in countries like India.

Let me just tell you, until this new research it was assumed that better medicine/technology in countries without it and an evolved, more virulent strain in countries still battling it (one, or the other, or some combination of those two things) were probably responsible for the difference.

Nope.

Samples going back as far as the 1300s from all over Europe of the leprosy bacteria, Mycobacterium leprae, have been genetically sequenced, and it turns out the bacteria hasn’t changed much, and outbreaks of leprosy in other countries aren’t that much different than the ones Europeans faced.

So how did we get rid of it? Public health policy. We cleaned up our water, organized our waste disposal, and learned that washing our hands is the number one thing you can do to prevent infections (but you can’t really wash your hands without clean water!).

Leprosy isn’t that virulent. In fact, it still exists in the US—armadillos carry and spread the disease. It can take years to manifest, but it’s very treatable (untreated it can cause bone and nerve damage).

Still, a return to focusing on preventative policies can help stop even virulent diseases.

Does this sound like common sense? It should, but the unfortunate truth is that in many hospitals, doctors don’t take hand washing seriously, with less than 10% washing between patients in some hospitals. Although hospitals are fighting back with reminders (using cameras and observers incognito), the problem really stems from the fact that anyone born after 1940—when penicillin really took off—hasn’t seen what it’s like to live in a world without antibiotics, so it’s easy not to take the spread of infection seriously.

But it is serious.

The biggest problem with population growth isn’t the strain on resources—many jobs have been created to solve that problem, and they’re doing wonderfully—it’s crowding. Disease will be able to spread fast and furious when 90% of the world’s population—more than 7 billion and growing—live in the same couple dozen cities. It’s why MERS, avian flu, and tuberculosis are such looming threats.

All this to say, by taking preventative measures, we can extend the ever shortening life of antibiotics.

How else can we prevent the spread of disease in an ever more crowded world? Let me hear your thoughts!

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