A Personal Story

We may think of a serious infection as something akin, say, to a broken arm: it’s painful, you apply a fix, and after a while you’re good to go. But that’s not how infectious disease works, especially those that are resistant to antibiotic treatment. Resistant infections can mean multiple surgeries, a bad reaction to an antibiotic, repeated flare-ups, and having to deal with the prospect of death. Emotional trauma will sometimes set in and linger for years. The effect will be felt by the whole family.

Linaman2To understand why it works this way we offer the story of Chris Linaman. He injured his ACL playing basketball. He needed surgery to repair the ligament and it proved successful. But several weeks into his recovery he contracted MRSA. Here’s Chris explaining what happened:

Can you tell us about your MRSA infection, and how it affected you and your family?

Chris: My nightmare started as a basketball injury. I’d had a successful ACL surgery, and several weeks into my recovery was doing great and thought my incision was fully healed. But that all changed very quickly. After a weekend trip to visit friends, I went to sleep on a Sunday night feeling fine, and woke up Monday morning to find my knee had swollen to the size of a melon. It was bright red and hot to the touch. Within hours, my MRSA infection had been diagnosed, and I was in emergency surgery—the first of several surgeries I would need over the course of four days.

Unfortunately, that wasn’t the end of my struggle to survive MRSA.

Just a few days after being sent home from the hospital, my wife found me nearly unconscious, with a swollen face and a temperature of 105 degrees. She rushed me back to the hospital, and the doctors told her to begin making plans because they didn’t expect me to make it. Luckily, the spinal tap showed the infection had not yet gotten to my brain. But I needed to have even more surgeries to get rid of it, and I also lost my epidermis—the outer layer of my skin—over my entire body, due to an allergic reaction to the antibiotic they were using to treat me.

Ultimately, the doctors were able to get the infection under control within a few weeks, but the road to recovery was long and painful. Even after my infection was cleared, and I was out of the hospital, my body was still reeling from all it had been through. My leg muscles were wrecked from all of the surgeries, and it took extensive physical therapy to get me back to anything resembling normal. To help put it in perspective, my original ACL surgery had been in early May, and it wasn’t until mid-July that I was even able to walk around the block in my neighborhood, a feat that took more than an hour.

Beyond the physical trauma, the whole ordeal also nearly ruined our family financially, and it was emotionally devastating as well. At the time, our two kids were just 2 and 4 years old, and they didn’t understand what was going on. It still breaks my heart to think about it. Those were the darkest days of my life, and, honestly, it’s hard to believe that I’m still here.

Why do you think it’s so important for superbug survivors to share their stories?

Chris: I don’t think enough people realize the extent of what’s at stake. People have maybe heard the term “post-antibiotic” era but don’t really understand what that could mean to them and their families. While it’s still very difficult for me to talk about—even today, more than 10 years later—sharing my experience can help show what that future could look like if we don’t keep up the fight and do what we can today. As horrible as my MRSA infection was, I’m the “good” outcome—I survived. Way too many others have not.

***

The CDC tells us that: (1) In the US alone more than two million people are sickened every year with antibiotic-resistant infections, with at least 23,000 dying as a result (2) Almost half of these deaths are due to MRSA alone, and (3) These numbers are based on conservative assumptions and are likely minimum estimates.

Chris Linaman told his story this week to The Pew Charitable Trusts. His full interview can be found here.

The National Security Beat: Bugs v. Bullets – Who’s the Mightier?

Whether caused by a bug or a bullet death is death, injury is injury, and disability is disability. Yet how we assess these threats – from microbe & man – and how we marshal our resources to meet them is starkly different. Left to the political class, national security is defined exclusively as guys with guns: so that’s what gets national attention, drives government policy and funding priorities.

SecurityHowever, a growing chorus of voices across the science and medical community are challenging that worldview saying that not only is it wrong, it’s dangerously wrong, because we’re turning a blind eye to what hurts us more – and has always hurt us more – microbes.

For example, the New England Journal of Medicine reminds us that “in the past 100 years, the ‘Spanish Flu’ of 1918–1919 [which killed more people than WWI] and HIV–AIDS, caused the deaths of nearly 100 million people.” The article was tellingly titled “The Neglected Dimension of Global Security – A Framework for Countering Infectious Disease Crises.”

In today’s world, “We are just one major global pandemic away from significant economic and humanitarian catastrophe … [therefore] “we can no longer view disease pandemics solely through the lens of health because they threaten whole economies and large swaths of humanity,” said Judith Rodin, in her opening remarks at the prestigious National Academy of Medicine’s forum, “The Neglected Dimension of Global Security: A Framework to Counter Infectious Disease Crises.”

Michael Osterholm, PhD, MPH, founding director of the Infectious Disease Center for Research & Policy at the University of Minnesota, agrees: “Infectious disease is the deadliest enemy faced by all of human kind,” he says. In his new book Deadliest Enemy, he explains why: Because it has “the potential to alter the day to day functioning of society, halt travel, trade, and industry, or foster political instability.”

bugs 1In Osterholm’s view “there are only two microbial threats that … fit this description” for pandemic potential. One is “antimicrobial resistance and the very real threat of moving ever closer to a ‘post-antibiotic era’ … a world more like that of our great-grandparents where deaths due to infectious diseases we now consider treatable are once again commonplace.” The other is influenza, “the one respiratory-transmitted infection that can spread around the world in short order and strike with lethal force.” Some variant of the bird flu, for example.

This new thinking is nicely summed up in an interview that took place at the University of Arizona before a public audience this past February. David Gibbs, Professor of History, was speaking with “arguably the most important intellectual alive today,” Noam Chomsky, Professor Emeritus of Linguistics at MIT.

After discussing the threats posed by climate change and nuclear war, the two weighed in on infectious disease. Professor Gibbs nicely frames the issue. The italicized emphases in Chomsky’s reply are mine.

Professor Gibbs: “In popular discussion, the phrase ‘national security’ has come to mean security against military threats almost exclusively. This narrative downgrades the significance of nonmilitary threats, such as climate change, antibiotic resistant bacteria, or viral epidemics. It would seem that there is an imbalance between perceived military threats, which receive overwhelming governmental funding and press attention on the one hand, and nonmilitary threats, which receive relatively little on the other hand. How do we account for the apparent overemphasis on military threats?”

Noam Chomsky:

Well [with] military threats, you can see them actually, you can imagine it. People don’t think about it enough. But if you think about it for a minute, you can see that a nuclear attack could be the end of everything. These other [nonmilitary] threats are kind of slow, maybe we won’t see them next year. Maybe the science is uncertain, maybe we don’t have to worry about it. Climate change is the worst, but there’s others.

Take pandemics. There could easily be a severe pandemic. A lot of that comes from something we don’t pay much attention to: Eating meat. The meat production industry, the industrial production of meat, uses an immense amount of antibiotics. I don’t remember the exact figure, it’s probably like half the antibiotics. [It’s around 80%.] Well antibiotics have an effect: They lead to mutations that make them ineffective. We’re now running out of antibiotics that deal with the threat of rapidly mutating bacteria. A lot of that just comes from the meat production industry.

Well, do we worry about it? We ought to be. You go into a hospital now, it’s dangerous. We can get diseases that can’t be dealt with, that are moving around the hospital. A lot of that traces back to industrial meat production. These are really serious threats, all over the place. … but it’s hard to bring out the enormity of these issues, when they do not have the dramatic character of something you can show in the movies, with a nuclear weapon falling and everything disappears.

Chomsky’s seemingly simple reasoning actually has a lot of hard science behind it; in fact, it garnered one researcher the Nobel Prize in Economics in 2002 for explaining the wayward thinking behind poor decision making in areas such as risk assessment. In brief: We assume that if examples of something come easily to mind they must also be more frequent. But that’s false. The classic example that has made its way into first year university textbooks is the easy availability of images we call up – when, for example, national security is discussed – of planes crashing into the World Trade Center. That’s exactly what Chomsky means when he says that “something you can show in the movies” will trump the mundane, regardless of how menacing the mundane may actually be.

And what’s more mundane than microbes: those unpronounceable, polysyllabic, Latin-named, invisible creatures, that never say anything, carry guns or topple buildings, that are talked about in code in fancy journals that no one has heard of, by people – scientists – a rather reclusive species that most of us have never met?

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