Thursday, October 18, 2007

Influenza Epidemic and Methicillin Resistant - Staphylococcus Aureus (MRSA)

By Dr. W. John Martin, M.D., Ph.D.


Specialization among infectious disease experts has worked against an in depth understanding of the complexities of different pathogens working cooperatively to cause serious and even fatal human infections. The anticipated human epidemic of an avian derived strain of H5N1 influenza should be a wake up call to address this important question. Influenza can render the body particularly susceptible to certain types of bacteria that can thereby flourish; and could potentially become the driving force of a continuing worldwide pandemic. Prominent among these bacteria, are toxin producing Staphylococcus aureus, some of which can be resistant to various antibiotics, including methicillin.


Pioneering research during the 1918 influenza epidemic clearly identified a virus component as the initiating cause of illness. Yet there are ample indications that bacteria were responsible for "the gravity of the secondary pulmonary complications," and the "common causes of death." The idea of a mixed infection is contained in the oft quoted letter written by a military physician in 1919.


"Camp Devens is near Boston, and has about 50,000 men, or did have before this epidemic broke loose…. This epidemic started about four weeks ago, and has developed so rapidly that the camp is demoralized and all ordinary work is held up till it has passed….. These men start with what appears to be an ordinary attack of LaGrippe or Influenza, and when brought to the Hosp. they very rapidly develop the most viscous type of Pneumonia that has ever been seen. Two hours after admission they have the Mahogany spots over the cheek bones, and a few hours later you can begin to see the Cyanosis extending from their ears and spreading all over the face, until it is hard to distinguish the coloured men from the white. It is only a matter of a few hours then until death comes, and it is simply a struggle for air until they suffocate. It is horrible. One can stand it to see one, two or twenty men die, but to see these poor devils dropping like flies sort of gets on your nerves. We have been averaging about 100 deaths per day, and still keeping it up. There is no doubt in my mind that there is a new mixed infection here, but what I don't know."


Among the bacteria commonly cultured were Pneumococcus, Streptococcus and Staphylococcus. While H1N1 influenza virus has been retrieved from victims of the 1918 epidemic, no formal study has been reported of possible toxin producing bacteria from this period.


The vast majority of bacteria are essentially harmless to mankind. Bacteria can, however, become infected with their own sets of viruses, some of which can transfer toxin producing capacities to otherwise relatively harmless bacteria. Bacteria viruses can also transfer the capacity of bacteria to resist certain types of antibiotics. The combination of toxin producing capacity with antibiotic resistance is now occurring, especially among Staphylococcus aureus. Of great concern is a toxin complex known as Panton-Valintine-Leucocidin or PVL. This toxin can easily incapacitate the host inflammatory response by directly killing white blood cells (leucocytes). The toxin can also destroy otherwise healthy tissues if the bacteria producing the toxin can gain entry into the tissues. The PVL toxin was originally detected in antibiotic susceptible bacteria.


Antibiotic resistance among bacteria is a consequence of genetic selection of the surviving bacteria in patients treated with various antibiotics. These resistance genes become commonplace especially if carried by bacteria infecting viruses. The emergence of these bacteria is mainly seen in hospitals and other healthcare facilities. Indeed, a major risk factor from hospital admission is acquiring a multiple antibiotic resistant bacterial infection. The phenomenon is well documented among Staphylococcus aureus. Originally highly susceptible to penicillin type antibiotics (known as beta-lactams and commonly represented by the antibiotic methicillin), many hospital acquired Staphylococcus aureus are now methicillin resistant. In addition, they are resistant to many other types of antibiotics commonly used in the hospital setting. Examples of resistance to the toxic "antibiotic of last resort" (vancomycin) are now showing up in Staphylococcus aureus and other bacteria in certain hospitals.


The PVL toxin producing Staphylococcus aureus has started on the path of becoming antibiotic resistant. At present most community associated isolates are resistant to methicillin (CA-MRSA). In time, they will surely become resistant to a wider range of antibiotics by simply exchanging genetic information with hospital associated bacteria (HA-MRSA). The only barrier left to widespread severe infection, is the normally non-tissue invasive quality of Staphylococcus aureus. Influenza infection can provide such an opportunity by destroying the cells lining the air passages. Examples of fatal illness from a combination of regular influenza with CA-MRSA have been reported with little emphasis of a portend of what could occur in the face of an influenza epidemic and multiple antibiotic resistant, PVL toxin producing bacteria. Worse still, this is but one example of the enormous risks posed by pathogens teaming up in a biological warfare against mankind and his animals.


What should be done? Foremost is an all out attack on the emergence of toxin producing and/or multiple antibiotic resistant bacteria. Financial incentives exist for developing additional antibiotics to replace those for which resistance has developed. This approach should give way to a more common sense approach of preventing infection through decontaminating areas in which harmful bacteria reside.


A lack of awareness of decontamination strategies among Government and public health officials is apparent in their recommendations of simply using alcohol hand washing and short acting oxidizing agents such as bleach. Far more preferable is to use agents such as phenols and their derivatives that can retain antibacterial activity over many months. Surveillance for toxin producing and antibiotic resistant bacteria need to be in place in hospitals and settings where large numbers of individuals assemble. Examples include jails, schools, churches, sporting amenities, and workplaces where skin trauma is likely to be encountered. A comprehensive hygiene program, such as the one offered by Preventec inc., in Atlanta GA, should be instituted at such facilities and its effects monitored.


The benefits of this type of program may well extend to other types of infectious agents, including viruses and fungi. An additional complication of the 1918 influenza epidemic was the subsequent occurrence of neurological diseases, including a Parkinson-like syndrome known as encephalitis lethargica. Underappreciated research implicated a herpes-like virus in this illness. Swine flu vaccination triggered another set of neurological diseases, most prominently a Guillain Barre syndrome that are also consistent with a virus activation process. Viruses that are not effectively recognized by the immune system are prevalent within the community.


Termed stealth adapted viruses, they undoubtedly contribute to outbreaks of community acquired infectious illnesses with prominent neurological and/or psychiatric manifestations. Bacterial genes have been identified in cultures of stealth adapted viruses and atypical bacteria have been isolated from stealth adapted virus infected patients. The term viteria refers to viruses capable of breaching the genetic barrier between bacteria and human or animal cells.


They may well hasten the genetic intermixing between bacteria and also help facilitate the transmission of stealth adapted viruses back to humans. Hopefully, periodic cleansing of environments that pose a high risk of human infections with newly emerging viruses and bacteria will delay the emergence of devastating illnesses, such that mankind experienced with the 1918 pandemic. Additional information on this topic can be obtained by visiting www.s3support.com and www.progressiveuniversity.org


Dr. W. John Martin is considered by many of his peers to be the worlds foremost leading Pathologist, and research scientist in his field. He's coined the new term, "Enerceuticals," referencing the energy enhancing solutions for living cells.


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Dr. Martin is a Seminarist, published author, and a regular expert guest on Dana Dudley's "ASK MOM" live call in radio show. His new Progressive University, currently in pre-launch, is unique in providing new educational training and opportunities.


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