from Anne in Adelaide, Australia: a world with and without antibiotics

April 15. Memories of Contagion 2: a world with and without antibiotics – all in 80 years.

1941. Kings African Rifles from Nyasaland in Somalia. My father, Mervyn Smithyman, on the left.

I fear we have become complacent about the power of science to discover ways to deal with diseases that attack us: bacteria that are evolving all the time. What makes us think that we will discover a safe and effective vaccine for Covid-19?

In 1941, My father’s life was saved by the use of one of the first antibiotics, Sulfapyridine, which was called M&B (May and Baker). It was also used on Winston Churchill in 1943 when he contracted pneumonia.

My father, on the other hands was a lowly officer with the Kings African Rifles (a battalion of Nyasaland askaris) stationed at Zeila on the Gulf of Aden in British Somalia.

He said, ‘When I was on that line at Zeila, the conditions were very poor, the town had no latrines. When the tide went out the miles of sand were exposed. The tide would come in and clear out the mess and rubbish.’

‘In Zeila I contracted bacillary dysentery, and I was very sick. The Colonel sent an ordinary two-seater plane to evacuate me. I lay next to the pilot. They landed me at the Dire Dawa army hospital, in Ethiopia. I was in a coma. Apparently, they dug my grave. In my coma it seemed as if there was a man up there with a machine gun directed at my stomach. The doctor was a fellow from Durban. He told me afterwards that he had these sample M & B pills, May & Baker. He said to the nurse, “I’ve had these samples and they may be useful in dysentery; this poor chap is going to die, we might as well try it.”‘

‘Well, I was obviously very fit and strong at the time, very resistant, so with a few pills I was OK. I woke up one morning and there was no pain. I saw the most beautiful thing I had ever seen: it was the blue sky and a small cloud out of the window of the hospital tent. But I had a terrible pain in my shoulder and, as I slowly got better in the hospital, they said that I had a ‘winged scapula’. So I was not fit for army duty and had to be sent back south with the wounded.’

In the book Pandemic by Sonia Shah, I read that we are currently close to the situation where antibiotics will be ineffective against the superbugs that armouring themselves against attack and are spreading throughout the world. The internet is full of stories of super-resistant bacteria that are found in farm animals and people across many countries. One called the mcr-1 superbug is causing concern, ‘Health officials fear the mcr-1 gene, carried by a highly mobile piece of DNA called a plasmid, will soon be found in bacteria already resistant to all or virtually all other types of antibiotics, potentially making infections untreatable.’

Part of the problem is the overuse of antibiotics in farm animals which has allowed bacteria to develop resistance.

Most frightening of all is the NDM-1 (New Delhi metallo-ß-lactamase-1) gene that was found in bacteria in 2008 and is now widespread in India. With this strain the bacteria becomes resistant to the most powerful antibiotics. ‘The NDM-1 gene allows the bacterium to produce an enzyme that neutralizes the activity of these antibiotics … The World Health Organization is concerned that NDM-1 could see in “the doomsday scenario of a world without antibiotics.” ‘

If NDM-1 crosses to other bacteria, further diseases will become extremely difficult to treat. Medical operations will become almost impossible to perform safely.

Eighty years ago, antibiotics were like a miracle in the world, going on to save millions of us. But we have abused this most amazing medical discovery and now we are facing a possible pandemic that will make Covid-19 look like a side-show.

I owe my life to M&B. My father travelled down Africa to the army hospital in Pietermaritzburg, South Africa. While convalescing, he met and married my mother.

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