5 questions: The biggest infectious disease threat
As a longtime nurse, Mary Lou Manning has seen some horrific infectious diseases, from AIDS to anthrax to Ebola.
As a longtime nurse, Mary Lou Manning has seen some horrific infectious diseases, from AIDS to anthrax to Ebola.
But Manning, who has published more than 35 articles on infectious diseases, focuses more on how to prevent the spread of infection in the first place.
Manning's work as an ambassador for global infection prevention has taken her to numerous countries. In 2007, she joined a post-tsunami recovery team in Indonesia. During the recent Ebola crisis, Manning was on the faculty of a Centers for Disease Control and Prevention safety training program for health-care workers going to West Africa. She also was part of a CDC rapid Ebola preparedness assessment team in Philadelphia.
Previously with Children's Hospital of Philadelphia, where she held positions aimed at infection control, Manning now teaches doctoral courses in patient safety and other issues as an associate professor at the Thomas Jefferson University School of Nursing. She also is president of the Association for Professionals in Infection Control and Epidemiology, whose 15,000 members worldwide have a primary focus of infection prevention.
She recently spoke to us about infectious diseases.
What did we learn from the Ebola crisis? Are we prepared for the next one?
I'm very optimistic. The crisis itself revealed pretty large gaps or holes in public health preparedness and hospital preparedness and our response capability. It's been a huge wake-up call on so many levels. Now, probably, the U.S. and the world are better prepared to really look for, find, and react to or intervene or stop these infectious-disease threats that can move around the world.
One example: We've definitely learned the importance of travel histories. Certainly, we knew that before. But in this day and age when people can travel all over the world so quickly, and those pathogens or organisms or germs pretty much travel with people, we've really learned the importance of travel history with every patient, all of the time.
Now, every patient that comes into a hospital will be asked where they have traveled in the last two weeks.
Those in the public-health sector and in the health-care sector have to be very diligent about realizing that patients can come into an organization at any time, any place, that may have something unusual.
Many people were close to panic about Ebola. But are there other infectious diseases that are of even more concern in the U.S.?
We have a lot more to fear from antibiotic-resistant organisms, also dubbed superbugs. According to the CDC, drug-resistant bacteria infect more than 2 million people in the U.S. every year. And they kill at least 23,000. In my mind, that is the No. 1 threat to U.S. public health today.
When antibiotics were discovered in the 1940s, we were able to treat so many different kinds of infections. It became common practice for many physicians to give antibiotics. But we haven't been good stewards of antibiotics. We have overused them. And not only in humans, but certainly in agriculture, as well. Bacteria have learned how to adapt and be flexible and develop resistance.
These superbugs are continuing to escalate. More and more individuals are getting infections with these bacteria. Then the antibiotics that we have to treat them with become less and less effective because the organisms have learned how to resist the antibiotics. That's what makes them such a formidable problem.
Are there any new ones?
In one of the early Star Wars movies, there was something called the Phantom Menace. Now, there is actually a superbug that was dubbed by scientists as the Phantom Menace. We've known about it, but now it's getting harder and harder to treat. It is also an organism that is hard to detect. Bacteria are smart. They are highly adaptable to their environment.
What's being done in the professional realm?
The U.S. now has a national action plan for combatting antibiotic-resistant bacteria. The White House released it in March of 2015. Later, the White House held a forum on antibiotic stewardship and how to put this national action plan in place. So it's gotten a lot of attention on the national level. That forum wasn't just for health-care organizations. It also was for food producers and others. There are a lot of individuals that have a stake in this.
What can - and should - regular people do?
For prevention in general, washing your hands is absolutely No. 1, all the time. That is the No. 1 way to prevent transmission.
But when we take it to that whole idea of antibiotic resistance: Don't ask for or pressure your health-care provider for antibiotics when you don't need them. Or even if your health-care provider says, "I'm going to give you an antibiotic," another question could be, "are these necessary? Tell me why."
The Association for Professionals in Infection Control and Epidemiology has an exquisite resource for individuals here.
As a consumer, you have to understand that if more and more people take antibiotics when they're not necessary, drug-resistant bacteria will continue to thrive and spread and adapt.
There is also a personal risk. If I take antibiotics when they're not warranted, the next time I actually need those antibiotics, my body will already have some experience with them, and they may not work as well.