By Kate Kelland
LONDON, March 11 (Reuters) - Antibiotic resistance poses a catastrophic threat to medicine and could mean patients having minor surgery risk dying from infections that can no longer be treated, Britain's top health official said on Monday.
Sally Davies, the chief medical officer for England, said global action is needed to fight antibiotic, or antimicrobial, resistance and fill a drug "discovery void" by researching and developing new medicines to treat emerging, mutating infections.
Only a handful of new antibiotics have been developed and brought to market in the past few decades, and it is a race against time to find more, as bacterial infections increasingly evolve into "superbugs" resistant to existing drugs.
"Antimicrobial resistance poses a catastrophic threat. If we don't act now, any one of us could go into hospital in 20 years for minor surgery and die because of an ordinary infection that can't be treated by antibiotics," Davies told reporters as she published a report on infectious disease.
"And routine operations like hip replacements or organ transplants could be deadly because of the risk of infection."
One of the best known superbugs, MRSA, is alone estimated to kill around 19,000 people every year in the United States - far more than HIV and AIDS - and a similar number in Europe.
And others are spreading. Cases of totally drug resistant tuberculosis have appeared in recent years and a new wave of "super superbugs" with a mutation called NDM 1, which first emerged in India, has now turned up all over the world, from Britain to New Zealand.
Last year the WHO said untreatable superbug strains of gonorrhoea were spreading across the world.
Laura Piddock, a professor of microbiology at Birmingham University and director of the campaign group Antibiotic Action, welcomed Davies' efforts to raise awareness of the problem.
"There are an increasing number of infections for which there are virtually no therapeutic options, and we desperately need new discovery, research and development," she said.
Davies called on governments and organisations across the world, including the World Health Organisation and the G8, to take the threat seriously and work to encourage more innovation and investment into the development of antibiotics.
"Over the past two decades there has been a discovery void around antibiotics, meaning diseases have evolved faster than the drugs to treat them," she said.
Davies called for more cooperation between the healthcare and pharmaceutical industries to preserve the existing arsenal of antibiotics, and more focus on developing new ones.
Increasing surveillance to keep track of drug-resistant superbugs, prescribing fewer antibiotics and making sure they are only prescribed when needed, and ensuring better hygiene to keep infections to a minimum were equally important, she said.
Nigel Brown, president of the Society for General Microbiology, agreed the issues demanded urgent action and said its members would work hard to better understand infectious diseases, reduce transmission of antibiotic resistance, and help develop new antibiotics.
"The techniques of microbiology and new developments such as synthetic biology will be crucial in achieving this," he said. (Editing by Jason Webb)
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Yes, the black plague -- responsible for <a href="http://www.smithsonianmag.com/people-places/mall_aug99.html?c=y&page=2" target="_hplink">killing 56 million people in Europe the 14th century</a> -- is still around, but it isn't as deadly or prevalent as it was in Medieval times. Dr. Robert Gaynes, an infectious disease expert at Emory University and author of the book <a href="http://estore.asm.org/viewItemDetails.asp?ItemID=1036" target="_hplink">Germ Theory: Medical Pioneers in Infectious Diseases</a>, said that people contract the disease when they gain access to previously undistrubed ecosystems, thereby making "these types of diseases become evident as a result of animal contact." These days, the disease is most commonly spread by bites from fleas that are infected with Yersinia pestis. When the bacteria enters into a person's skin, it leads to headache, chills, and <a href="http://www.bt.cdc.gov/agent/plague/factsheet.asp" target="_hplink">swollen lymph glands</a>, according to the CDC. Early <a href="http://www.bt.cdc.gov/agent/plague/factsheet.asp" target="_hplink">treatment with antibiotics</a> is essential for survival, as the disease can cause respiratory failure and shock if left untreated. Every year, about 1,000 to 3,000 <a href="http://healthland.time.com/2011/05/10/first-case-of-bubonic-plague-in-2011-appears-in-new-mexico/" target="_hplink">bubonic plague cases</a> occur around the world, with 10 to 20 of those cases in the United States, <em>TIME</em> reported. The first 2011 case of bubonic plague was confirmed in May in a New Mexico man. The reason is murky for why black plague seems to be less deadly today than in the Medieval times, Weinberg said, but it probably has to do with more rats and unclean living conditions back then, as well as a lack of appropriate medicines. In addition, the bacteria back then may be different from the current form, he added.
<a href="http://www.medicinenet.com/scarlet_fever/article.htm#history" target="_hplink">Scarlet fever</a> was among the rash of diseases that commonly afflicted people in the 19th century (alongside yellow fever, rubella and measles), according to MedicineNet. Scarlet fever most often afflicts children, causing rash and fever. Fortunately, scarlet fever is a lot less common today than it was centuries ago, but it still can be deadly. Today, we now know that scarlet fever is just a form of group A streptococcus (strep), Weinberg said. But instead of just turning into a regular case of strep throat, scarlet fever manifests as a red skin rash. With antibiotics, the disease is easily treated, though complications can occur that <a href="http://www.medicinenet.com/scarlet_fever/article.htm#history" target="_hplink">can lead to sepsis</a> (bacteria in the blood, tissue or bone), according to MedicineNet. Just this summer, Reuters reported that a Hong Kong kindergarten was closed after tests revealed that a child there may have <a href="http://www.reuters.com/article/2011/06/21/us-scarletfever-china-idUSTRE75K14Q20110621" target="_hplink">died from scarlet fever</a>. Scarlet fever is relatively common in that part of the world, but this year a Hong Kong health department spokesman told Reuters that there seem to be more cases of it this year than in past years.
<a href="http://articles.sfgate.com/2011-09-20/bay-area/30178479_1_whooping-cough-booster-shots-childhood-vaccine" target="_hplink">Whooping cough</a>, caused by the Bordetella pertussis bacteria, was a common illness among children in the early 1900s, according to HealthCentral. However, when the vaccine for whooping cough was introduced in the 1940s, cases dropped. But while whooping cough cases are still dramatically lower than 50 years ago, there are still cases that persist today possibly because the vaccine against the disease doesn't provide lasting protection later in life, Weinberg said. Another reason is that older people seem to be able to carry whooping cough in their throats without actually getting sick (due to being vaccinated at a younger age), but that whooping cough is then passed on to infants who haven't yet been vaccinated against the disease, Gaynes said. "This problem has led to a recent recommendation by [the] CDC to have adults get TDAP once as adults (it contains pertussis in the vaccine) and not just a tetanus booster, which is needed every ten years," Gaynes told HuffPost. Recent research presented just last month shows that the <a href="http://articles.sfgate.com/2011-09-20/bay-area/30178479_1_whooping-cough-booster-shots-childhood-vaccine" target="_hplink">protection from the whooping cough vaccine</a> is decreased dramatically once a child reaches age 8 or 9, the <em>San Francisco Chronicle</em> reported. <a href="http://www.cdc.gov/features/pertussis/" target="_hplink">Whooping cough is very contagious</a> -- spread by cough and sneezing -- and is so named because of the sound people who have it make when they cough. Last year, 27,550 people had whooping cough in the United States, according to the CDC. The disease is the deadliest for babies, as it can lead to pneumonia, convulsions and even death.
Polio, the paralysis-causing disease that afflicted former president Franklin D. Roosevelt, isn't completely gone from the world today. However, it has been eliminated from the western world, Weinberg said. The Mayo Clinic reports that the last known <a href="http://www.mayoclinic.com/health/polio/DS00572" target="_hplink">case of polio in the U.S.</a> was in 1979. Polio is still present in <a href="http://www.who.int/mediacentre/factsheets/fs114/en/" target="_hplink">Afghanistan, Pakistan, India and Nigeria</a>, where unrest and dangerous conditions can make it more difficult to get everyone vaccinated against the disease, according to the World Health Organization. Recently, the WHO reported that a dangerous strain of polio -- called wild poliovirus type 1 -- had <a href="http://www.huffingtonpost.com/2011/09/20/polio-china-pakistan_n_971787.html" target="_hplink">made its way from Pakistan to China</a>. Polio<a href="http://www.mayoclinic.com/health/polio/DS00572" target="_hplink"> causes paralysis</a> and can make it hard to breathe, the Mayo Clinic reported. It can even lead to death.
Gout has been known throughout history as the "<a href="http://www.bl.uk/learning/langlit/booksforcooks/1700s/1700sfood.html" target="_hplink">disease of kings</a>" and the "rich man's disease," as it was most commonly seem among the gluttonous rich in the 1700 and 1800s, according to the British Library. Gout is considered an ancient form of <a href="http://www.cdc.gov/arthritis/basics/gout.htm" target="_hplink">inflammatory arthritis</a>, and is caused by metabolic disorder that has not been properly controlled. It occurs when uric acid crystals build up in tissues and fluids, thereby leading to a red, swollen joint that is very painful, according to the Centers for Disease Control and Prevention. The condition is most common in overweight men and women who have gone through menopause. Gout rates have <a href="http://arthritis.webmd.com/news/20101110/gout-cases-on-the-rise-in-u-s" target="_hplink">been on the rise</a> since the 1960s, with cases doubling between 1960 and 1990 and then continuing to rise through 2008, according to WebMD. More than 8 million Americans currently have gout. WebMD reported that the <a href="http://arthritis.webmd.com/news/20101110/gout-cases-on-the-rise-in-u-s" target="_hplink">rise in gout cases</a> may be due to people living longer, as the condition is seen in women only after they have passed menopause. In addition, "you can go years with hyperuricemia and no symptoms. But at some point, enough uric acid accumulates to have a flare-up of gout, so if you're living longer you are more likely to reach that threshold," gout expert Dr. John S. Sundy told WebMD. In addition, Gaynes speculated that it may not even be that gout rates are actually rising -- rather, detection and diagnosis may have improved throughout the years.