Showing posts with label infectious diseases. Show all posts
Showing posts with label infectious diseases. Show all posts

7/24/2012

Superbug: The Fatal Menace of MRSA Review

Superbug: The Fatal Menace of MRSA
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Based on my background in biological science, I was very, very excited to get this book, and I was not disappointed.
Maryn McKenna's new book SUPERBUG, deals with the development of MRSA (Methicillin-resistant Staphylococcus aureus), which is also known as a superbug, it is multiple-drug resistant and impressively deadly. It takes massive amounts of drugs with often serious side-effects to even have a chance of beating it.
Historically, MRSA was a disease of hospitals, and only in people that were already suffering from a weakened immune system - but that is no longer the case. A new strain has come up that affects people who have not had any contact with hospitals. It is known as community-acquired MRSA, and is surprisingly lethal.
McKenna's style is aptly suited to this type of book, as there is a lot of medical jargon that requires a deft hand to explain to people with little to no knowledge in that particular area. This is accomplished through what I can only describe as a massive amount of interviews and research with individuals whose lives have been affected by MRSA.
This book raises a lot of issues regarding the sanitary procedures performed at hospitals, the over-prescription of antibiotics in both people and animals, and the sheer speed in which MRSA can adapt.
Reading this book may seem like some sort of scare tactic, and it is. But it is the sort of thing people NEED to hear. McKenna uses people whose lives have been affected by MRSA to tell the story, and only breaks away from the narrative for context.
Simply put, it is a superbly written science book that reads like a novel.
There are parts of this book which may be difficult to read if you are squeamish, specifically where she describes the various symptoms that people infected with MRSA had to deal with. And, not all the people you meet throughout the book survive, as MRSA is an indiscriminate killer.
SUPERBUG is a very impressive book that has some very important lessons to teach us about microbial evolution, and the huge effect it can have on the human population.

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3/06/2012

Virus That Ate Cannibals: Six Great Medical Detective Stories Review

Virus That Ate Cannibals: Six Great Medical Detective Stories
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This is an wonderful book for students of science or anyone interested in the recent history of virology. Carol Eron is an excellent writer and provides a wonderful view into how viruses (and unconventional agents now known to cause Kuru and CJD) were studied in the last century. Too bad the book is out of print. I highly recommend getting your hands on this one!

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8/13/2011

The Anthrax Letters: A Medical Detective Story Review

The Anthrax Letters: A Medical Detective Story
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This is the second book I've read on the anthrax attack. The first, The Killer Strain: Anthrax and a Government Exposed (2003) by Washington Post journalist Marilyn W. Thompson is a good book (with a different emphasis), but this is a better one. Written by Rutgers University Professor Leonard A. Cole, who is an expert on bioterrorism, The Anthrax Letters is both more extensive and goes into greater depth than Thompson's book.
Perhaps the most important thing (from my point of view) that Professor Cole does is argue convincingly against the FBI's disaffected loner theory of who did it. Instead Cole presents a lot of evidence that strongly suggests that Al Qaeda may indeed have been responsible.
First of all, the leading suspect, Attorney General John Ashcroft's "person of interest," Steven Hatfill, actually had an alibi. He was working in another state at the time some of the letters were mailed in Trenton, New Jersey. More importantly though, Cole sees a link between Iraq's known bioweapons program and Al Qaeda; he believes that the Ames anthrax strain in the Daschle letter was possibly purified and concentrated by "the Iraqi BW team." (p. 201)
Furthermore the fact that there were at least two types of "weapons" sent by mail suggests more than a lone perpetrator. Additionally, the mystery of why the tabloid people in Florida were targeted (and indeed how they became targets) is explained when one learns that two of the suspected 9/11 hijackers rented an apartment from Gloria Irish, the wife of Mike Irish, editor of the Sun tabloid, an American Media Inc. publication. One of the men, Marwan Akl-Shehhi, told her that he was a pilot and was taking flying lessons. (p. 42) And it is not to be forgotten that the Al Qaeda suspects were interested in learning to fly crop dusters. That alone makes it clear that they expected to have access to and intended to use either chemical or biological weapons. Finally, there is the unsettling fact that one of the hijackers was actually treated for a black lesion on his leg that could very well have been cutaneous anthrax.
Cole also suggests that it was no coincidence that the anthrax attacks began less than a month after September 11, 2001.
To all of this I would add the fact that the Bush administration has become entirely mute on this question, which may suggest that they know who did it but for reasons unknown to us are not telling. What could those reasons be? Originally I thought it was because the FBI had bungled the evidence and didn't have enough left to stand up in court, or that something about the perp or information he or she had would be embarrassing to the government. Now I think it is possible that Al Qaeda was indeed responsible but the Bush administration won't acknowledge that because it would have to reveal secret information about our counter-terrorism program, and also possibly because such information may work into the hands of Al Qaeda's desire to psychologically terrorize the US population.
Another interesting point that Cole brings up is the question of exactly how many cases of anthrax illness were caused by the mailed spores. He reports that there were eleven confirmed cases with five deaths. However, as noted in the final chapter, there is a twelfth case that the CDC would not confirm, that of postal inspector William Paliscak who had inhaled dust in which there were spores, and who had anthrax spores on his clothing and in his car. The problem is that the CDC was not able to culture anthrax from blood samples taken from Paliscak. Cole speculates that Paliscak and possibly others at the Brentwood postal facility did indeed contract anthrax, asking, "Could bacilli have been embedded in the brains of Bill Paliscak and others who were exposed to spores...?" He adds that there were eight deaths at Brentwood in the year following the anthrax attack when usually there are only two a year. Four of the people who died had inexplicably enlarged hearts. (p. 237)
Also significant is Cole's point that what we learned from the attacks is that we are not nearly as well prepared as we thought, and that the use of the postal service as a means of disseminating a bioterrorist weapon was greatly underrated. What was not realized prior to these attacks was that anthrax spores in the size of about three microns would easily slip through the 20-micron pores in a typical envelope resulting in cross-contamination of the mail. The two women, Kathy Nguyen and Ottilie Lundgren, who died of inhalation anthrax even though spores were never found in their homes or in their mailboxes, were probably the victims of cross-contamination. Cole posits that by the time the mailboxes were swabbed the spores had dissipated. In support of this idea Cole quotes Harvard microbiologist Matthew Meselson as saying, "a single organism [of anthrax] has a chance of initiating infection." (p.110)
This raises the question of how many other people died because of their exposure to the bacterium, cases that were either not reported or unrecognized as anthrax killings.
This leaves me with an idea. Cole reports that how the perps got the very, very fine and slippery weapons-grade anthrax spores into the envelops without getting some into the air and eventually into their lungs is not known. With Al Qaeda's complete disregard for human life, they may not have warned their operatives of the dangers. Perhaps the FBI ought to look for some dead Al Qaeda operatives in the US and double-check the cause of death.

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