Libertarianism and antibiotics

From: BillK (bill@wkidston.freeserve.co.uk)
Date: Tue Nov 12 2002 - 17:42:16 MST


Damien Sullivan writes:

> But now vancomycin bacteria are cropping up -- vancomycin being the
> antibiotic of last resort. Your use of antimicrobial soap or bad use
> of medical antibiotics increases my risk of dying. Sounds like a real
> market failure to me. Anders, you might think about staying in
> Sweden -- at least they seem to be taking the problem of hostile
> replicators seriously. Our new government here would probably rather
> subsidize use of antibiotics by agribusiness than ban and regulate
> their (mis)use.

The report that you quote comes from The Detroit Free Press and seems to
be, (how should I phrase it?), written in rather over-excited language.
If you go to The Centers for Disease Control and Prevention (CDC) site
you will get the official version issued October 11, 2002, where it
states that they have now detected two VRSA cases, the one in Michigan
above and another in Pennsylvania.
See: http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5140a3.htm

Quote: "Staphylococcus aureus is one of the most common causes of
hospital- and community-acquired infections (1,2). Since the recognition
of vancomycin-resistant enterococci in 1988, the emergence of
vancomycin-resistant S. aureus (VRSA) (minimum inhibitory concentration
[MIC] >32 µg/mL [3]) has been anticipated. The transfer of the genetic
element containing the vanA vancomycin resistance gene from Enterococcus
faecalis to S. aureus was demonstrated in the laboratory in 1992 (4);
the first clinical infection with VRSA was reported in July 2002 (5).
This report describes the second documented clinical isolate of VRSA
from a patient. "

So, yes, antibiotic resistant bacteria is a well-known problem and is
not at all confined to this particular antibiotic or this particular
bacteria. Antibiotics were discovered in the 1940's and resistance has
been noticed increasing in many strains of bacteria for a long time.

The main CDC URLs for Antimicrobial Resistance are:
http://www.cdc.gov/ncidod/hip/ARESIST/aresist.htm
http://www.cdc.gov/ncidod/hip/vanco/vanco.htm

The VISA/VRSA Fact Sheet says that they now have detected eight VISA
cases in different cities around the USA, (as well as the two VSRA
cases).
http://www.cdc.gov/ncidod/hip/ARESIST/visa.htm

Quote: "The patients with VISA infections were chronically ill and
probably developed their VISA infection in a healthcare setting. No
spread to family members, household contacts, other patients, or
healthcare workers was detected."

(As they only have two VRSA cases it would appear to be difficult to
detect an epidemiology that says drug addicts were the cause in this
particular case, Mike. Do you have any references to provide?)

The CDC Home URL is: http://www.cdc.gov/

If you really want to frighten yourself, read some of their press
releases and health advisories on
http://www.cdc.gov/od/oc/media/archives.htm

Their Morbidity and Mortality Weekly reports are also enjoyable reading
for hypochondriacs, but not suitable for those of a nervous disposition.
See: http://www.cdc.gov/mmwr/

To end on a lighter note, they also have a good section on medical
Hoaxes and Rumors,
see: http://www.cdc.gov/hoax_rumors.htm

Have you heard the one about a new strain of HIV being transmitted
through the air? :-)

BillK

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