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Deadly invisible pathogens are on the march. Ebola, and now the Zika virus, the ongoing cholera epidemics, and the enormous casualties from tuberculosis, malaria, and varieties of avian Influenza--all of these should be waking us up to the global spread of disease and the public health challenges when it comes to dealing with mutational virulence. Millions die every year. But the political leaders of nations don't seem to respect the warnings from our scientists. Pandemic, the critical book by Sonia Shah, is a jeremiad and should spark policymakers' public concern. Unfortunately, basketball and March Madness have occupied more public attention among our political leaders.
A large U.S. hospital has a larger budget than the beleaguered World Health Organization, which is tasked, by nearly two hundred nations, with heading off epidemics and pandemics and trying to limit their spread.
Errant microbes are getting assistance from environmental upheavals, global travel, poor sanitation and starved public health facilities, as well as political corruption and dense urbanization.
Yet the big money still goes into armaments, where the profits prosper. Presidents make speeches about terrorism and national security. Congress holds constant hearings, rubberstamping military budgets. Have you heard these bacteria and viruses--those most certain terrorist perils--discussed in a nationally televised address by any President or brought up in major Congressional hearings? Of course, you haven't. There haven't been any.
Over the years, I have tried mostly in vain to get this country's leadership to wake up to this looming century of pandemic threats. True, grants from big foundations and some public money have been used to reduce malaria and other infectious diseases. But it has been too little and, for many men, women and children, too late.
Frustration often leads to satire. Let me share with you an unanswered letter I wrote to President Barack Obama on June 3, 2011. I was told that some scientists at the Centers for Disease Control and Prevention were pleased with the message.
Dear President Obama:
My name is E.coli 0104:H4. I am being detained in a German laboratory in Bavaria, where I was charged with being "a highly virulent strain of bacteria." Together with many others like me, the police have accused us of causing about 20 deaths and nearly five hundred cases of kidney failure--so far. Massive publicity and panic all around.
You speak regularly about crushing the resistance of your enemies. But you splash around so many antibiotics (obviously, I don't like this word and consider it genocidal) in cows, bulls, chickens, pigs, and fish that your species is creating massive antibiotic resistance, provoking our mutations so that we can breed even stronger progeny. You are regarded as the smartest beings on Earth, yet you seem to have too many neurons backfiring.You can't see me, but your scientists can. They are examining me and I know my days are numbered. I hear them calling me a "biological terrorist," an unusual combination of two different E.coli bacteria cells. One even referred to me as a "conspiracy of mutants."
It is not my fault, I want you to know. I cannot help but harm innocent humans, and I am very sad about this. I want to redeem myself, so I am sending this life-saving message straight from my petri dish to you.
This outbreak in Germany has been traced to food--location unknown. What is known to you is that invisible terrorism from bacterium and viruses take massively greater lives than the terrorism you are spending billions of dollars and armaments to stop in Iraq, Afghanistan and Pakistan.
Malaria, caused by infection with one of four species of Plasmodium, a parasite transmitted by Anopheles mosquitoes destroys a million lives a year. Many of the victims are children and pregnant women. Mycobacterium tuberculosis takes over one million lives each year. The human immunodeficiency virus (HIV) causes over a million deaths each year as well. Many other microorganisms in the water, soil, air, and food are daily weapons of mass destruction. Very little in your defense budget goes for operational armed forces against this kind of violence. Your agencies, such as the Centers for Disease Control and Prevention, conduct some research but again nothing compared to the research for your missiles, drones, aircraft, and satellites.
Your associates are obsessed with possible bacteriological warfare by your human enemies. Yet you are hardly doing anything on the ongoing silent violence of my indiscriminate brethren.
You and your predecessor George W. Bush made many speeches about fighting terrorism by humans. Have you made a major speech about us?
You speak regularly about crushing the resistance of your enemies. But you splash around so many antibiotics (obviously, I don't like this word and consider it genocidal) in cows, bulls, chickens, pigs, and fish that your species is creating massive antibiotic resistance, provoking our mutations so that we can breed even stronger progeny. You are regarded as the smartest beings on Earth, yet you seem to have too many neurons backfiring.
In the past two days of detention, scientists have subjected me to "enhanced interrogation," as if I have any will to give up my secrets. It doesn't work. What they will find out will be from their insights about me under their microscopes. I am lethal, I guess, but I'm not very complicated.
The United States, together with other countries, needs more laboratories where scientists can detain samples of us and subject us to extraordinary rendition to infectious disease research centers. Many infectious disease scientists need to be trained, especially in the southern hemisphere, to staff these labs.
You are hung up on certain kinds of preventable violence without any risk/benefit analysis. This, you should agree, is utterly irrational. You should not care where the preventable violence comes from except to focus on its range of devastation and its susceptibility to prevention or cure!
Well, here they come to my petri dish for some more waterboarding. One last item: You may wonder how tiny bacterial me, probably not even harboring a virus, can send you such a letter. My oozing sense is that I'm just a carrier, being used by oodles of scientists taking advantage of a high-profile infectious outbreak in Europe to catch your attention.
Whatever the how--does it really matter to the need to act Now?
E-cologically yours,
E.coli 0104:H4 (for the time being)
OCEAN SPRINGS, AL -- A grandmother made me rethink all the bio-remediation hype. The "naturally-occurring oil-eating bacteria" have been newsworthy of late as they are supposedly going to come to the rescue of President Obama and BP and make good on their very premature statement that "the oil is gone."
We were talking about subsurface oil in the Gulf when she said matter-of-factly, "The bacteria are running amok with the dispersants." What? "Those oil-eating bacteria - I think they're running amok and causing skin rashes." My mind reeled. Could we all have missed something so simple?
The idea was crazy but, in the context of the Gulf situation - an outbreak of mysterious persistent rashes from southern Louisiana across to just north of Tampa, Florida, coincident with BP's oil and chemical release, it seemed suddenly worthy of investigating.
I first heard about the rash from Sheri Allen in Mobile, Alabama. Allen wrote of red welts and blisters on her legs after "splashing and wading on the shoreline" of Mobile Bay with her two dogs on May 8. She reported that "hundreds of dead fish" washed up on the same beach over the following two days. This was much too early for the summer sun to have warmed the water to the point of oxygen depletion, but not too early for dispersants and dispersed oil to be mixed into the Gulf's water mass. By early July, Allen's rash had healed, leaving black bruises and scarring.
Other people - both residents and visitors to the Gulf coast - wrote of similar rashes or other skin problems like peeling palms. The rashes have been diagnosed as scabies and staph infections, including MRSA, the potentially lethal Methicillin-resistant Staphylococcus aureus bacteria. Most cases lingered for months, as the rash did not respond well to antibiotics, steroid creams, or steroid shots.
That should have been a clue that maybe the primary cause was not biological, but chemical. A secondary biological infection might clear up with antibiotic treatment, but then keep reoccurring because the primary chemical illness had not been treated.
Retired Registered Nurse Allison Schmidt agrees. Referring to Allen's case, she said, "I can say without hesitation that these skin rashes have nothing to do with scabies. Scabies is a parasite, which causes a skin infection and is extremely contagious. It spreads from person to person by direct skin contact or by wearing an article of clothing worn by an infected person." Schmidt said, "If this were scabies you would see entire families infected and NOT just a single family member."
Another clue to the real cause of the mystery rash is its prevalence across the entire oil-impacted Gulf. Something in the water or air, or both, could explain this. While public officials and BP claim that dispersant use was halted in May for Corexit 9527A and on July 19 for Corexit 9500A, evidence collected by Gulf residents has shown that dispersants are being used in nearshore and inland waters, close to highly populated areas across the Gulf. Further, oil and the Corexit marker have been found in air and inland water.
I have heard from Gulf residents and visitors who developed a rash or peeling palms from contact with Gulf water, including such activities as swimming or wading, getting splashed, handling oiled material or dead animals without gloves, and shucking crabs from the recently opened Gulf fisheries. I have also heard from people who developed the same symptoms after contact with Gulf air by wiping an oily film off their airplane's leading edges after flying over the Gulf (absorbent pad tested positive for oil) or swimming in outdoor pools, or splashing in puddles, after it rained.
Outraged by the unprecedented release of oil and toxic chemicals in the Gulf, Nurse Schmidt and Mike McDowell developed a project to test Gulf rainwater for harmful chemicals. Schmidt said, "We are convinced the chemicals used in the Gulf to help disperse oil have evaporated and will eventually come down mixed with the rain."
Another clue, more like a condemnation, is that NOAA and EPA decided (link*) to use dispersants in the Gulf without considering what harm the chemicals and dispersed oil might do to people, specifically, the general public. Dr. Sylvia Earle, former chief scientist of NOAA, and other scientists, criticized the agencies' decision, in part, based on concern about harm to human health. Other scientists have also criticized the agencies' decision. Citing the National Academy of Sciences, a Texas Tech University professor testified in Congress that the chemicals break down cell walls, making organisms (including people) more susceptible to oil. The professor called the Gulf an "eco-toxicological experiment," which is inexcusable, because OSHA has known about harm from solvent exposure since at least 1987. Don't these federal agencies talk amongst themselves - or with others?
Which all brings me back to the grandmother. After talking with her, I've been reading about bacteria, and I now think the Great Gulf Experiment is going very badly for humans. One can only wonder about the rest of the ecosystem.
There are two distinct types of bacteria based on the structure of their cell walls. Gram-positive bacteria have a single-membrane cell wall, while Gram-negative bacteria have a double-membrane cell wall. Methicillin-resistant Staphylococcus aureus (MRSA) bacteria are "Gram-positive," while the oil-eating bacteria are Gram-negative.
But! A component of the double-membrane cell wall structure of Gram-negative bacteria can irritate human skin, causing inflammation and activating the immune system. In other words, oil-eating bacteria, just because they are Gram-negative, can cause skin rashes. In the case of Alcanivorax borkumensis, the reaction can erupt on the skin like MRSA infections.
To make things a little scarier, some of the oil-eating bacteria have been genetically modified, or otherwise bio-engineered, to better eat the oil - including Alcanivorax borkumensis and some of the Pseudomonas. Oil-eating bacteria produce bio-films. According to Nurse Schmidt, studies have found that bio-films are rapidly colonized (p. 97) by other Gram-negative bacteria - including those known to infect humans.
Scientists anticipated early on that the Gulf leak would cause populations of oil-eating bacteria to soar. Still, infections are not likely in healthy people. However, exposure to oil weakens a person's immune system function, as does the mental stress of dealing with disaster trauma. And then there are people who are more at risk than others to bacterial infections, especially when first challenged with oil and solvent exposure. This includes children, people with cystic fibrosis or asthma, and African Americans (who are prone to blood disorders), to name a few.
Is this the perfect storm - an exploding population of opportunistic Gram-negative bacteria (some natural, some not), millions of gallons of food (oil) for the bacteria, and a susceptible population of stressed-out people?
Perhaps. If the outbreak of skin rashes across the Gulf is any indication, the health care providers, media, and Congress ought to be taking a hard look at this question. Further, people ought to be connecting the dots to illnesses that surfaced in Exxon Valdez spill responders and to the illnesses occurring now in Michigan residents coping with the Enbridge oil pipeline spill.
In the Gulf, Nurse Schmidt believes, "This is like a major bacterial storm. It could be the reason we are seeing a variance of symptoms in different individuals. In some people, we see respiratory complications, while in others we see skin or GI symptoms. I think it is due to a multitude of colonized bacteria - which may have been triggered by BP's disaster. "
The nurse and I think the grandmother is onto something.