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The more a person thinks about the recent outbreak of swine flu the more convincing is the argument that these deadly microbes such as MRSA and VRE must be stopped. In 1918 there was a influenza epidemic at a military camp near Boston. Hundreds of people died. Here is a letter written by one of the camp physicians. It is the first idea of a mixed infection.

“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 colored 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.”

W. John Martin M.D. Ph.D. first talked about this type of occurrence. Dr. Martin wrote, “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.”

Dr. Martin went on in his interesting article to say, “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.”

There are so many simple things that can be done to stop the spread of these hospital acquired infections, and some hospitals are making wonderful progress. But, why aren’t all hospitals putting the guidelines into practice?

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