Ebola, the real bogeyman, and you

Ever since I was 15, my sister and I have used “Ebola” as a short form derivative of every bad bug we’ve ever gotten. “Oh god, I’ve been laid up all day with Ebola,” “that taco from last night gave me Ebola,” etc, etc. We were able to say it with such offhand tone because we knew that really, Ebola wasn’t exactly a threat here in Southern California. It was simply shorthand for “really sick.”

After reading “The Hot Zone” I stopped saying the word at all. Faced with the visceral reality of what hemorrhaging out of every orifice is really like and the panic it engenders in local communities, it didn’t seem so funny a hyperbole. That stuff is scary. You should read the book if you haven’t, which will not only make you start washing your hands a little more, it will also help you appreciate the new role veterinarians are facing as the front line against emerging zoonotic diseases.

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Ebola is scary, very scary, don’t get me wrong. But we’re probably not about to be thrust into the middle of the next Zombie Apocalypse, which is what many people are expecting if my Facebook feed is any indication. If you’re in the mood to freak out, be my guest, but let me give you a better thing to be worrying about. The number of people losing their marbles over two US citizens being flown in within a self contained bubble is pretty silly when you look at all the other scary things facing us every day that, while less camera-ready than a guy in a space suit stumbling into Emory, are much more likely to truly mess up your day.

Remember: A person with a known diagnosis, held inside a containment unit, isn’t the problem here.

The guy coughing on the plane home from Heathrow who feels like garbage but doesn’t want to miss his daughter’s birthday party? That’s going to be the problem. The traveller who takes 4 Advil before hitting the thermal imaging cameras at the Shanghai airport to fool the system into thinking she doesn’t have a fever? Or the person who doesn’t even realize they’re sick until after he or she gets home? There’s the problem, at least so far as Ebola is concerned.

But Ebola isn’t the problem I’m so worried about, not really. As awful as Ebola is, there’s a much bigger tsunami lurking in the background and it’s already here.

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When the associate director of the CDC tells us, “We’re in the post antibiotic era,” THAT makes me panic. And it’s already happening.

The Real Losing Battle

We forget how recently antibiotics have developed in the annals of medical history- Alexander Fleming’s famous penicillin discovery only happened in 1928, less than a century ago. Before that, we were routinely felled by scrapes, coughs, childbirth, urinary tract infections. We’ve done a good job keeping apace of bacteria’s insanely effective evolution to defeat the antibiotic’s mechanisms of action, but we’re finally losing the battle.

It’s the result of a multitude of causalities: a slowdown in new drug development and approval. Misuse of antibiotics in both human and veterinary medicine. The ability for antibiotics to be used over the counter in food production facilities. The latter is now being removed thanks to the FDA’s Guidance 213- taking antibiotics back behind the prescription pad, where they belong.

resistance

But it may be too little too late. The last line of defense in treating drug resistant infections, carbapenem, is now itself encountering resistant bugs. THIS scares me. It should scare you too, more than Ebola, even if Ebola makes people bleed out of their eyeballs. Bacterial infections can be gruesome too, CNN. Is that what it’s going to take?

In the meantime, I do not want to get a fever. Because if I get a fever someone is going to think I have Ebola thanks to the current media frenzy and then I’ll have to go to a hospital, where the real enemy is waiting to kill me. I’m avoiding hospitals like the plague (which is another disease that responds to antibiotics and might not in the future.) DANGIT, we just can’t win, can we?

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  • http://www.somethingwagging.com Pamela | Something Wagging

    Thank you for this important reminder. I haven’t taken antibiotics in over 40 years. But I hate the idea that humans (and non-human animals) won’t be able to benefit from them because of rampant overuse.

    I wish the infographic had mentioned refusing to buy meat and milk from animals treated heavily with antibiotics. Not only is it a result of cruel factory farming, it’s a major contributor to antibiotic resistance.

    • http://www.pawcurious.com Dr. V

      The good news is due to Guidance 213, the use of antibiotics in livestock for any reason other than an individual animal is ill and thus gets a prescription for it, is being prohibited. Long overdue.

  • JaneK

    thanks for the creep-out, Dr. V :) I am so much against using antibiotics unless truly necessary that I one time I waited until my sinus infection got so bad (thinking it wasn’t really an infection and I could just “nettie pot” my way to health), I needed 2 rounds and a butt-shot. I guess there is a balance :) but it is scary how resistant bugs are becoming. And for people who suffer with diseases like Cystic Fibrosis, it is a real health crisis.
    thanks for keeping us enlightened – and somewhat freaked out….

    • http://www.pawcurious.com Dr. V

      It is super scary. All we can do in the meantime is focus on being as responsible as we can, and certainly my profession needs to be on the forefront of advocating responsible antibiotic usage. We’re trying :)

  • Cathey

    Thanks so much for this call out, Dr. V!! This is a huge issue that is getting NO press!

  • Michelle Granzow

    thanks for this!! I wish the media would focus on what is truly scary, like you said. Anti-biotic resistance and the re-emergence of diseases long thought gone, thanks to huge international travel/migration and non-vaccination. Rubella is being diagnosed lots in California(according to my MD friend), and is popping up in other locations again as well. Measles and other diseases are rearing their ugly and deadly heads as well. POLIO is being diagnosed at what seems to be a higher rate. These are the things people need to be looking out for!