Fascinating but also very frightening

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A few days ago I was listening to a podcast of a BBC Radio 4 programme. I wanted to include a link to it but much to my great annoyance I simply cannot find it again! The subject was why wars and conflicts increase the spread of antibiotic-resistant bacteria. This sounded really unexpected and I was very curious. I tried to think why that might be – perhaps due to displaced people living in crowded refugee camps with poor sanitation, or to destruction of healthcare facilities, or to movement of refugees around the world carrying diseases with them. Well no doubt all those factors play a part, but one key reason was totally leftfield. Exposure of bacteria to heavy metals increases their antibiotic resistance several hundred fold. And bombs and missiles deposit large amounts of heavy metals in war zones. Relatively harmless bacteria, living in soil for example, may then be exposed to heavy metals, and overcoming that challenge will simultaneously render them resistant to antibiotics. Then something like a simple scratch from a thorn can quickly turn into a life-threatening and untreatable infection. And bacteria spread far more easily than viruses, because a virus cannot live outside its host but bacteria live in all kinds of places and can be carried around on an imported vegetable, for example, or a mail order package. As the interviewee explained, the number of multidrug resistant bacterial infections he has seen has shot up from one every two or three months to one a week to ten a week. And there are no new antibiotics in the pipeline. We are soon going to be back in the situation we were in before the first antibiotics, when common infections we think nothing much of now can easily lead to many deaths. He really did sound genuinely frightened – and with good reason. In the American Civil War in the 1860s, around 750,000 people died, and famously three quarters of these were due to disease. We might very soon find ourselves back in the same situation. And the wars going on will increase this risk massively.