India superbug germs
Since its been hyped as bacteria which only catches while traveling in India for Medical reason, it could potentially hurt the Medical Tourism Industry of India. Doctors and hospitals in India are saying that this bacteria has been hyped wrongly by the British Media and even went on to questions the study.
This virus has been found in people from many countries and study has only chosen people who traveled to India has raised some eyebrows. Indian Doctors have questioned that why nobody in United States or other any other country has been tested for the superbug virus.
India has also objected the naming of virus after New Delhi and the logic of naming the bacteria over the place it was first discovered since HIV Virus was discovered in New York City and it has not been named NYC Virus.
The Indian health ministry in a statement, said:
While such organisms may be circulating more commonly in the world due to international travel but to link this with the safety of surgery hospitals in India and citing isolated examples to show that due to presence of such organism in Indian environment, India is not a safe place to visit is wrong
Experts are saying that this will hurt the booming Medical tourism industry in India. In past few years India has become first choice of travelers for surgeries and treatment of other diseases with world class facilities at less than half the price comparing to the Western Countries.
Some feels that main reason of targeting India over the bacteria is politically motivated to hurt Medical Tourism Industry in India. Several famed doctors in England have also questioned the study of bacteria and slammed British media for over hyping the issue and presenting in wrongly.
In the end doctors feels that people need to be educated about the superbug bacteria as its causing panic in the minds of general people. Targeting India for the bacteria is wrong as there isn't enough evidence to support the claim and they feel that Medical tourism in India will suffer until things are not cleared over the issue.
However, bedbugs can cause itching that can lead to excessive scratching. That can cause breaks in the skin that make people more susceptible to these bacteria, noted Dr. Marc Romney, one of the study’s authors.
The study is small and very preliminary, “But it’s an intriguing finding” that needs to be further researched, said Romney, medical microbiologist at St. Paul’s Hospital in Vancouver.
Five bedbugs were crushed and analyzed. MRSA, or methicillin-resistant Staphylococcus aureus, was found on three bugs. MRSA is resistant to several types of common antibiotics and can become deadly if it gets through the skin and into the bloodstream.
Two bugs had VRE, or vancomycin-resistant Enterococcus Faecium, a less dangerous form of antibiotic-resistant bacteria.
Both germs are often seen in hospitals, and experts have been far more worried about nurses and other health-care workers spreading the bacteria than insects.
It’s not clear if the bacteria originated with the bedbugs or if the bugs picked it up from already infected people, Romney added.
The study was released Wednesday by Emerging Infectious Diseases, a publication of the U.S. Centers for Disease Control and Prevention.
Now, the emergence in India of a particularly nasty form of antibiotic-resistant bacteria, which renders even the last-resort drugs obsolete, could bring about an era of unstoppable infections. To contain the bacteria, South Asian governments must quickly reform their public health practices and medical manufacturers must fast-track the development of new drugs. But with the Indian political establishment prioritizing building up its lucrative private health sector over making costly public health reforms, and policies aimed at recalibrating drug research and development in the West stymied, the political will to accomplish the job is scarce.
In India, antibiotic use is virtually unregulated. Antibiotics are widely available without a prescription and, as in the United States, affluent people tend to consume the drugs whether medically necessary or not -- for everything from colds to diarrhea. Meanwhile, when ill, India's poor tend to scrape together a few rupees to buy a couple doses of antibiotic at a time, enough to quell their symptoms but not enough to clear their infections. Both patterns of consumption contribute to the development of drug-resistant bacteria. So, it is no wonder that, even before the new super-resistant strain was first documented, over 50 percent of the bacterial infections that occurred in Indian hospitals were resistant to commonly used antibiotics.
Then, in 2010, a study of a New Delhi-area hospital found that 24 percent of bacterial infections there could resist the last-resort carbapenem antibiotics. Thirteen percent not only resisted carbapenem drugs, but overcame 14 other antibiotics, making treatment options exceedingly limited. The gene that conferred this extreme drug-resistance was dubbed "New Delhi metallo-beta-lactamase 1" or NDM-1. Scientists found that, unlike other drug-resistant bacteria, NDM-1 bacteria are able to quickly and prolifically spread their genes to other bacteria, easily jumping the barriers of species and genus. The pandemic potential of such a microbe is enormous. Indeed, according to Tim Walsh, a University of Cardiff medical microbiologist who has been chasing the dangerous gene, NDM-1 infections already turned up in more than 35 countries last year -- often in the bodies of medical tourists, who had traveled to India or Pakistan for cheap surgeries and other procedures. And NDM-1 bacteria have also been found in drinking water and in puddles around New Delhi.
Part of the problem in taming the bug is an ongoing failure to develop drugs to combat it. Despite growing global demand (and the World Health Organization's recognition that drug-resistant pathogens are one of the greatest threats to human health) the drug industry hasn't launched a new class of antibiotics to treat the class of bacteria susceptible to the NDM-1 gene in 45 years. As a result, there are only two imperfect drugs that can treat NDM-1 infections. The first, an antibiotic called colistin, was first sold over fifty years ago and fell into disuse in the 1980s, when less toxic drugs were developed using more modern methods. The second, tigecycline, is a pricey intravenous drug approved only for soft-tissue infections, not the urinary tract infections and pneumonias that comprise the majority of hospital-acquired infections. With more frequent use of these two limited drugs, it will be only a matter of time before NDM-1 bacteria can resist them as well.
According to the Infectious Diseases Society of America, the drug industry has actively avoided developing new antibiotics. This is a business decision: drugs that are prescribed for months and years, such as anti-arthritis or cholesterol-lowering drugs, and those for which patients and insurers will pay almost any sum, such as anti-cancer drugs, provide better return on investment. Antibiotics are costly to develop, only prescribed for a handful of days at a time, and, despite their curative powers, rarely fetch more than $100 per course. Further, all antibiotics eventually render themselves -- and the R&D investment behind them -- obsolete, since their use inevitably creates new drug-resistant pathogens. The United States and the EU have formed a task force on the issue, but as yet, no promising new drug is in the pipeline to treat NDM-1 bacteria. As a result, says Ramanan Laxminarayan, director of the Public Health Foundation of India, "places like India will just have to wait" as NDM-1 continues to evolve and spread.
Creating tomorrow's antibiotics is a huge challenge, but it is only half of the battle. Stanching the spread of NDM-1 and other drug-resistant bacteria will also require greatly improved stewardship of today's antibiotics: better surveillance of resistant strains, better control of infections in hospitals, and improved sanitation and hygiene. Here, Indian political priorities, and the country's haphazard sanitary infrastructure may prove disastrous.
In the wake of pro-market reforms in the early 1990s, India's economy has been expanding at a rate of 8 percent a year. But despite this growth, government spending on health hovers at around one percent of GDP a year, a proportion that critics condemn as far too low for a country with a prospering economy that is still heavily burdened by infectious disease. (Only Burundi, Cambodia, Myanmar, Pakistan, and Sudan spend proportionally less.) In India's finance-starved public hospitals, overcrowding is common and corruption rife. Nearly one-third of patients report having to resort to bribes just to get clean bed sheets. In most, says Laxminarayan, "you will find a person in the bed, another person under the bed, and one on the side of the bed." Patients' relatives, often the sole providers of nursing care, crouch on crumbling walkways outside hospital buildings under the blazing sun. The infamous open sewers of India's slums ooze nearby. These conditions are ripe for the rapid spread of pathogens, including NDM-1.
As the country's stunted public health infrastructure languishes, the private health sector has boomed. Encouraged by government tax exemptions, corporate hospital chains such as Apollo and Fortis, which are owned by large pharmaceutical and technology companies, dot the landscape, islands of apparent sterility amid the grime. Now, 80 percent of total Indian health expenditure goes to private clinics and hospitals. Besides caring for India's affluent, many of these hospitals market their upscale services to "medical tourists," patients from the UK, the United States, the Middle East, and elsewhere, who fly to India for procedures that are cheaper and quicker there than they would be home. It is a growth industry that brings in hundreds of thousands of foreign patients and over $300 million annually now, which is set to top $2 billion in coming years.
It was in the bodies of medical tourists who had traveled to India and Pakistan that the new super-resistant gene was first discovered by British scientists in 2009. But when those scientists named it "NDM-1," after the city from which it seemed to originate, and warned that other medical tourists might be at risk, Indian politicians, news media, and physicians cried foul, suggesting a conspiracy to undermine the medical tourism sector. India's National Centre for Disease Control spent days openly denying the public health relevance of NDM-1. Government authorities sent letters to Indian researchers who had collaborated with British scientists on the NDM-1 studies, demanding that they disavow their research. They also tried to prevent scientists from taking samples of NDM-1 out of India for research purposes.
Better nationwide surveillance of infectious pathogens could help target containment efforts, but here, too, capacity is limited. India's disease surveillance program collects information from only 2 of the country's 640 districts. Precious few hospitals have the well-equipped labs required to conduct microbiological sleuthing. Without convincing nationwide data, it's all too easy for politicians to dismiss reports about NDM-1 as the exaggerations of outsiders.
As the controversy over NDM-1 swirled, in 2011 New Delhi convened an advisory committee on the issue of antibiotic resistance which floated a proposal to ban the sale of antibiotics without a physician's prescription, and restrict the use of last-resort IV antibiotics to highly specialized hospitals. But after pharmacists went on strike in August 2011, the proposal was withdrawn. Experts say the move was nothing more than a gesture, in any case. The policy had little chance of being implemented and enforced: In India, health policy is implemented at the state level, not the federal level.
Nobody knows how many people may have already died from NDM-1 bacterial infections, nor how many more may sicken or die should the gene become more widespread. It may be that NDM-1 has to gain more notoriety and "get a lot more scary," as the Times of India put it last spring, before political will to do something about it coalesces. For now, experts such as Walsh estimate that NDM-1 bacteria silently lurk in the guts of up to 200 million people in India alone, evolving, exchanging genes with other bacteria, and being shed into the environment. In an interconnected world, they will not remain quarantined there for long.