Factual · Powerful · Original · Iconoclastic
Mass hysteria is a poor method for allocating medical research resources. Surely we all agree on that in principle. But when it concerns any given hysteria, principle flies out the window.
Consider vaccine development efforts for the bacterium methicillin resistant staphylococcus aureus, or MRSA, compared to that of three germs that have killed no Americans — indeed few non-Americans — yet have prompted a frenzy. These three include Ebola virus, SARS, and avian flu H5N1.
MRSA suddenly received widespread attention because of a report on its prevalence released in the October 17 issue of the Journal of the American Medical Association. It can cause infections in the bloodstream, lungs, and urinary tract.
Traditionally it has been associated with hospital surgical incisions, but as it becomes more common it's spreading beyond its normal breeding grounds.
According to the JAMA paper, prepared by the Centers for Disease Control and Prevention, there were more than 94,000 invasive MRSA infections in America in 2005, causing almost 19,000 deaths. Those figures appear to be increasing.
About 14% of MRSA cases now occur outside health care settings, such as school locker rooms. The germ lives harmlessly on intact skin, but even tiny openings such as a scratched knee or shaving cut allows it to enter the bloodstream and wreak havoc.
While the JAMA findings were startling to the public, our public health authorities have long known of the growing MRSA problem and have done very little about it.
In contrast, consider the reactions to the three mass hysteria diseases. The National Institutes of Health began a human clinical trial for the Ebola virus almost four years ago. Clinical trials for SARS (Severe Acute Respiratory Syndrome) began almost three years ago. Both vaccines were developed by and are being tested by the U.S. government. Your tax dollars also paid for the development of the first approved human avian flu vaccine that the government is currently stockpiling.
As to MRSA, federally-supported research is still at the mouse level. Fortunately, two private companies, Nabi Pharmaceuticals and Merck & Co., have begun testing such vaccines on humans. But get this. The Nabi program is "on hold for further clinical development pending partnership or external funding of the program."
And just what threat do the three mass-hysteria diseases pose?
Ebola is so hard to transmit that it only appears every few years and has killed nobody outside of two African countries. That said, the disease has been the subject of best-selling books like Richard Preston's "The Hot Zone." The disease was even featured in a film starring Dustin Hoffman in which the virus threatens to wipe out the entire U.S.
Do Hollywood and the best-seller lists influence the government funding decisions? You bet.
SARS infected only 27 Americans, killing none. Worldwide, it killed 774 people between its discovery in late 2002 and mid-2003, when it simply disappeared. SARS caused deaths in 11 countries. Yet during the disease's short life, between just two newspapers, the New York Times and the Washington Post, there were over 850 articles — more than one article per death.
Does the press influence the government's decisions? You bet.
As to avian flu, Congress has specifically allocated $5.6 billion for this disease. One influential pundit proposed spending $100 billion each year in American tax dollars on the alleged threat.
Yet H5N1 has not killed any Americans. Even worldwide so far this year H5N1 has caused only 69 infections and claimed 46 lives, isolated in seven countries where poultry farming involves regular exposure to bird intestines and feces. Moreover, even as U.S. MRSA cases increase, worldwide H5N1 cases and deaths are occurring at a lower rate this year than the previous two years.
Granted, most of the fear is not over what H5N1 is currently doing but rather what it might do if it became pandemic either by mutating in just the right way or combining in just the right way with seasonal flu in a person or an animal carrying both viruses.
In fact, all of the recorded worldwide recorded deaths from Ebola, SARS, and avian flu to date combined — 2,621 — are fewer than the number of Americans who die of MRSA every two months. MRSA also annually kills more Americans than AIDS, yet the federal AIDS research budget is over 13 times larger than the allocation for the entire field of antimicrobial resistance.
And in case you think our health officials simply haven't had a chance to gear up against the MRSA threat, you should know it was first identified in — ready? — 1961.
Want a bit more irony?
Flu of any type rarely kills directly; rather it opens the door to opportunistic bacterial infections that cause fatal pneumonia. You'll often hear that the "Spanish Flu" of 1918-1919 usually did kill directly; that's false. Staphylococcus is one of the worst of these opportunistic germs, yet the current pneumococcal vaccine doesn't protect against it.
In other words, if avian flu did become pandemic an MRSA vaccine would probably greatly reduce its impact. It would also save lives of those with seasonal flu. Likewise, an MRSA vaccine would prevent countless AIDS deaths, because AIDS patients also almost always die of opportunistic infections. "HIV patients have an 18-fold higher risk for community-acquired MRSA than the general population," according to a presentation last year at the International AIDS Conference.
There is no perfect formula for funding disease research. But letting panic-mongers in the press, government, and even Hollywood influence the decisions is clearly wrong. We need a government that pays more attention to medical statistics than to headlines. The one we have now is killing us.