“I just thought it’s just an infection, you know? I really didn’t realize what they meant by infection.” Those are the words of Cheryl Perron, mother of then 19 year old David Ricci (“reach-y”) who was struck down by the superbug CRE. (p.53)
David’s story began one morning on his way to work. Walking along side railway tracks he got sucked underneath a speeding train by its backdraft. His right leg crushed, he was rushed to hospital. Still conscious, he watched a doctor take out a machete-style knife and begin “hacking” his leg off. His friends, standing outside the room, could hear him screaming before he passed out. David never made it to the Mother Theresa Orphanage in Calcutta where he worked as an HIV/AIDS volunteer.
Then things got worse. Some of his amputated leg became infected with CRE. “They said I don’t have that much longer,” says a weakened David on what looks like a cell phone video taken by one of his friends. His family got him home to Seattle as soon as they could but the ordeal continued. David was placed under quarantine. His infection continued to spread. Multiple antibiotics were tried but failed. Then a doctor remembered one from the 1940s that was shelved because it was too poisonous. But it was the only one left so they tried it. As David put it, “It started to eat away at my organs on the inside, you know? I could just feel it, just— just this poison rushing through my blood.” One option remained – cut off the rest of his right leg to within 6 inches of his hip and maybe, just maybe, they’d get all the CRE. But they wouldn’t know for months, so in the meantime all they could do was wait …
That was 2011. David’s story was told 2 years later in the outstanding PBS Frontline episode “Hunting the Nightmare Bacteria.” We’re presenting it here because CRE is now on the move across the United States. As we reported 2 weeks ago, it was an outbreak at the University of California hospital system in Los Angeles this year that brought the problem to the public’s attention. But with a little digging we found out that CRE had also surfaced in Illinois, Pennsylvania, and Washington, dating back to 2012. And since our last report we’ve learned of more outbreaks occurring this year in North Carolina, Wisconsin, and a second hospital in California, Cedars-Sinai.
The unique feature of the US outbreak is they’re all caused by the same thing, a medical device called an endoscope. It’s threaded down the throat deep into the intestines to diagnose and treat people suffering serious illnesses of the GI tract. It’s the only tool we have to do the job and so it’s used all the time, in about 500,000 procedures every year across the country. The problem is, the endoscope has a design flaw. It’s such an intricate complex device that it can’t be properly cleaned between procedures and so the CRE from one patient will sometimes transfer to the next. Nevertheless, because it’s an indispensable tool in the treatment of life-threatening disease we continue to use it.
The total number of people affected so far is probably less than 1,000. But the story doesn’t lie in the numbers. It lies in the lives of the people afflicted and everyone close to them. And what it does to the ones that survive changes them forever.
David’s story begins at the 12 minute mark and resumes again at 46 minutes. Our hope, though, is that once you meet David you’ll want to see the episode in its entirety.