UK civilian hospitals in danger via drug-resistant Iraq bug

[Guest guest]

Armed forces 'superbug' menaces UK

Experts fear an infection caught by troops in Iraq and Afghanistan

will invade civilian hospitals

Beaumont, foreign affairs editor

Sunday December 16, 2007 The Observer

The UK, the United States and Canada are facing growing fears over a

drug-resistant 'superbug' being brought back by wounded soldiers from

Afghanistan and Iraq that threatens to contaminate civilian hospitals.

The intensified concern comes amid sharply rising infection rates in

the US and fresh worries in Canada that the bug could be imported into

its civilian healthcare system. Military health officials who have

studied the bacterium in Afghanistan believe the infection of wounded

British soldiers in field hospitals there is probably inevitable.

The US military originally thought the bug came from contaminated

Iraqi soil, but troops in Afghanistan have also been infected.

Canada's public health service last week revealed it had ordered the

screening of all its wounded soldiers being repatriated from Afghanistan.

The bacterium, Acinetobacter baumannii, first emerged as a 'mystery

infection' afflicting US service personnel returning from the war in

Iraq in 2003-04. It was described by a scientific journal specialising

in hospital epidemiology as the 'most important emerging

hospital-acquired pathogen worldwide'. The journal added that it was

potentially a 'major threat to public health' due to its ability to

mutate rapidly and develop a resistance to all known drugs.

Although different types of acinetobacter have been known for decades

in hospitals, the new 'T' strain identified in the injured troops is

particularly virulent and has been observed to appear in US servicemen

within two hours of being admitted to a field hospital. It affects the

spinal fluid, bones and lungs, causing pneumonia, respiratory failure

and other complications. Equally worrying is its resilience. Extremely

difficult to eliminate from medical facilities once established, the

bug can survive for up to 176 days in a human host. US officials

concede that, once established in the medical evacuation chain, the

germ is almost impossible to stamp out.

Although the Ministry of Defence tried to play down fears of the

infection when the first suspected British cases were reported last

year in the Lancet, its increasingly rampant progress through

America's military hospital system has been causing intense alarm

elsewhere.

Canadian military doctors investigated the infection in Canadian

troops at an intensive care unit in Kandahar and published a report in

the journal BMC Infectious Diseases earlier this year.

The officers warned that their findings about the infection risk were

'equally applicable to US and British military field hospitals as

well', adding that 'the environmental and logistical problems that

faced [the medical units involved] are common across field hospitals

in Afghanistan and Iraq'. They added that 'unrestricted use of

antibiotics' at the field hospitals to compensate for poor

environmental conditions had contributed to the emergence of the new

superstrain.

In addition to a new screening regime, Canadian infectious disease

officials will meet early next year to develop a national strategy to

deal with the risk of the new strain spreading to civilian hospitals.

One of the report's authors, Major Homer Tien, told The Observer from

Kandahar yesterday that further outbreaks appeared inevitable. 'No one

really knows how it is being transmitted. What is certain is that it

is a big concern,' he said. 'A lot of the work I was doing was trying

to pinpoint the source of the infection. We still can't say what the

source was. If we can't prevent it, the next question is how we can

keep the hospitals back home in the UK and Canada from being infected.'

Concern is all the higher because, as in the UK, injured Canadian

troops are treated in the civilian healthcare system, while most

Americans are treated in an extensive network of military hospitals.

Infection rates have risen steeply in the US. In 2001 and 2002, around

2 per cent of admissions were infected at a specialist army burns unit

in Texas. By 2003 the rate had risen to 6 per cent, then 12 per cent

by 2005, a rate consistent with other facilities. So far, 27

servicemen have died from the infection.

In stark contrast to Canada and the US, the attitude towards the

threat in the UK has been sanguine and low-key.

An MoD spokesmen last week insisted there had not been a case since

November 2004 and it employed 'robust and stringent infection control

procedures which fully meet NHS requirements adequate to deal with the

problem'.

http://observer.guardian.co.uk/uk_news/story/0,,2228205,00.html