Plucked by Maryn McKenna
Author:Maryn McKenna
Language: eng
Format: epub
Publisher: National Geographic Society
Published: 2019-08-06T00:00:00+00:00
* * *
THAT THE NETHERLANDS put such trust in farm antibiotics is surprising because it was cautious and proscriptive about human use. It used fewer antibiotics in medicine than any other European country—a quarter, for instance, of what people take in France. Government regulations defined which antibiotics doctors could prescribe, to keep resistant bacteria from occurring, and strict national standards for hospital hygiene aimed to keep them from spreading. The standards, known as “search and destroy,” were created in 1988 and aimed at MRSA, the drug-resistant staph that had emerged in England in 1961 and swept the world. MRSA is a particular peril in hospitals because staph clings to skin. Any health care worker can pass it along if they are neglectful or distracted when it comes time to wash their hands, and many did. By the 1990s, MRSA was a deadly epidemic in hospitals worldwide.
But it was not in the Netherlands. The Dutch rules assumed that anyone might carry MRSA into a hospital without knowing it, and they required that anyone who worked in a hospital or was being admitted as a patient from certain high-risk situations had to be checked first to see whether they were carrying the bug. Someone who had been cared for in a hospital in another country had to go into an isolation room as soon as they entered a Dutch hospital, until tests proved they were not carrying the resistant germ. Anyone who was proved to be carrying resistant staph—whether it was a patient, or a physician, nurse, or low-level health worker—had to follow a mandatory regimen of showering with strong antiseptic soap and squirting antibiotic gel up their noses before being allowed into the hospital again.
The rules were harsh, and costly for hospitals to follow, but they worked. The check-in tests that hospitals performed showed that resistant staph, MRSA, was very rare, carried by fewer than one person out of 100. So it was an unpleasant surprise in October 2003 when Eric van den Heuvel, a pig farmer whose property is about 15 miles from Oosterlaken’s, brought his daughter Eveline to a local hospital to be checked in advance of surgery. The next week, the hospital called him: She was carrying MRSA.
Eveline was two years old. She had been born with several serious defects in the structure of her heart; she had already had one emergency surgery, to repair a hole between the ventricles, and now she needed another. The hospital had checked her in accordance with the search-and-destroy rules, even though they did not expect to find anything, because she had not been in a hospital in a year and her family had not traveled to countries where MRSA was common. Yet the routine check showed she not only was carrying MRSA; she was colonized by a strain that had never before been recorded in the Netherlands. The hospital could not permit her to have surgery until she was clear. The staff there asked her parents to put her through the
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