Waiting for the “Big One”

Although humans die in large numbers every day, every hour, from heart disease and automobile crashes, deaths from exotic viruses seem to command far more urgent attention in the media. Whenever a virus breaks out, there is always speculation as to whether it will be the next “Big One.” Like the influenza pandemic of 1918-19, which killed 50 million worldwide, the Hong Kong flu of 1968-69 with a least one million deaths, or the very different disease of HIV/AIDS which has killed about 30 million over three decades and counting.

Researchers do indeed think there will be a next “Big One,” and that it will probably be due to a novel virus which emerges from some animal-human interaction. 

Which is why SARS has been back in the news lately.

Last month, a couple of cases of a SARS-like infection were detected in the Middle East. The media immediately pounced on the story, speculating whether these two isolated cases would snowball into the sort of SARS epidemic we saw 10 years ago.

In 2002, a true outbreak of SARS did occur. It emerged from a species of bat in China and infected 8,000 people, killing one in 10 before it was brought under control.

But, unlike the fear-mongering media, scientific researchers now realize that new strains of SARS virus, like the one that now appears to have emerged in the Middle East, cannot, in fact, be easily spread from person to person.

For a virus to be truly threatening of a global pandemic, it has to be both very pathogenic (causing serious illness and potentially death) and highly contagious (easily transmitted from one person to another). The two together determines its virulence. Many viruses are either highly pathogenic or highly contagious. But, fortunately, very few are both. 

For example, a typical cold virus is highly contagious but not very pathogenic. (Full recovery usually occurs within several days.) HIV, on the other hand, is very pathogenic, but very easy to avoid catching and easily prevented by simple, common-sense precautions. 

The last time we had a virus that was both extremely pathogenic and highly contagious was the influenza of 1918. And, the good news is, it appears that this year’s SARS virus, while potentially deadly, is not particularly contagious, having occurred in only two individuals to date.

So despite the scare tactic headlines surrounding the latest SARS “outbreak,” it doesn’t appear to pose any imminent danger. In fact, the greatest dangers emerging lately aren’t coming from Nature at all, but from medical products, procedures, and devices themselves. 

Overuse of antibiotics has already resulted in Methicillin Resistant Staphylococcus Aureus (MRSA) bacteria and related strains of “flesh-eating” bacteria. Hospital acquired infections now attack 2 million Americans per year and cause 100,000 deaths. Last summer, I found out that MRSA may also be able to emerge from so-called “sterile” injections in medical clinics. And indeed, as I predicted in a prior Daily Dispatch, just last month The Centers for Disease Control reported 10 such cases in orthopedic and pain clinics from Delaware to Arizona.  

And right now contaminated “sterile” injections are all over the news again.

The latest outbreak is fatal fungal meningitis from injections of contaminated steroid pain medications for neck and back pain. With scores of new cases being reported—and the death toll climbing—every day.

To make matters worse, the steroids in these injections suppress the immune system. Essentially destroying any “fighting chance” there might have been to effectively combat the fungal contaminant. Plus, for all their focus on drugs and dietary supplements, it appears the FDA has totally lax oversight when it comes to many medical formulations prepared for injection. And last, but certainly not least, reviews of these injections have found no evidence that they actually work!

Some things are just fundamentally really bad ideas. 

With all of these problems in mind, I have to wonder why anyone is still getting these steroid injections at all. And why any doctor would administer them. Especially when there are other therapies that work better, are safer, and are widely available.

You don’t have to resort to any injection for neck or back pain. Spinal manual therapy (administered by a chiropractor or physical therapist) is a much more safe and effective method of relieving back and neck pain. Without any risk of deadly infection. 

“New SARS-Like Virus Detected in the Middle East,” Time Healthland (http://healthland.time.com), 9/24/12
“Invasive Staphylococcus aureus Infections Associated with Pain Injections and Reuse of Single-Dose Vials—Arizona and Delaware, 2012,” Centers for Disease Control Morbidity and Mortality Weekly Report 2012; 61(27): 501-504