[image|http://www.sfgate.com/templates/columnists/j_carroll/bylinelogo.gif||||] JON CARROLL
Thursday, October 18, 2007

I often get letters from people concerned about social injustices. "If only I can get this story out," they say, "then maybe someone will pay attention. All the public and the politicians need are the facts." In other words, the problem is ignorance, and once the media get all over the case, steps will be taken, laws will be passed, evildoers will be punished.

Yeah, well, maybe.

A few weeks ago, a CBS foreign correspondent named Kimberly Dozier published an opinion piece in the Washington Post called "What I Faced After Iraq." Dozier was wounded, airlifted out of the country and then contracted something called Acinetobacter baumannii, a multi-drug-resistant bacteria that almost cost her her leg.

Dozier: "Acinetobacter can multiply to dangerous levels when a person's immune system is compromised by blood loss or massive tissue damage. Only one antibiotic is 90 percent effective against it, and that drug can be toxic to the kidneys. That was the problem I had, forcing me to choose between losing my kidneys or going off the drug and hoping that my body would fight the bacteria on its own. I did the latter, and survived. But that took another measure of luck."

Dozier was not alone in contracting Acinetobacter baumannii. In fact, British and American soldiers who fought in the Iraq war have been getting it since 2004. Some of them have been dying. Plus, the disease has spread to civilians, including Iraqi civilians. The number of cases is growing.

Well. A CBS reporter writing a piece in the Washington Post: Surely that will attract attention. Surely questions will be asked. Since the epidemic began, the Army has been putting it forth that Acinetobacter baumannii is found "in the soil of Iraq." But, it now turns out, that ain't so. The only place the disease has been contracted is in hospitals.

Have you noticed any publicity on this matter? I haven't, which is odd. Deadly Disease in American Hospitals! Hard to Diagnosis, Cure Uncertain. Risk! Threat!

Interestingly, two weeks before Dozier's piece, Los Angeles Times reporter Jia-Rui Chong wrote a thrilling article ("A strange, drug-resistant bacterium was infecting troops. Few had heard of it, and no one was sure of its origin.") about, you guessed it, Acinetobacter baumannii. Not only that, in February of this year, Steve Silberman in Wired magazine published an exhaustive examination ("The Pentagon created the perfect machine for saving the lives of soldiers wounded in Iraq. But then GIs started getting sick. The culprit: a drug-resistant supergerm infecting the military's evacuation chain") of the bacteria and the efforts to fight it.

But it was known about long before then. In 2004 a task force was put together to find the nexus of the problem.

Silberman says that Tim Endy, the former communicable disease research director at Walter Reed, drafted a document that set the task force in action. " 'My concern was that we were changing the bacterial environment in our hospitals, and I wasn't seeing a whole lot being done about it,' says Tim Endy. ... 'And now there were infections in patients who had never been to Iraq. The potential consequences to health care and to the cost of health care are huge.' "

The group examined the "it's in the dirt" hypothesis. It also looked at the even more sensational "the enemy is rubbing infected feces on IEDs" claim. Nope and nope. It's found in hospitals. That's not particularly unusual: Hospitals are a terrible place to be in if you're sick - although, of course, better than lying in the gutter. A lead investigator on the military task force told a group of civilian epidemiologists: "This appeared to be a hospital-associated outbreak throughout our entire health care system."

In other words, to quote Silberman, "The wounded soldiers were not smuggling bacteria from the desert into military hospitals after all. Instead, they were picking it up there. The evacuation chain itself had become the primary source of infection. By creating the most heroic and efficient means of saving lives in the history of warfare, the Pentagon had accidentally invented a machine for accelerating bacterial evolution and was airlifting the pathogens halfway around the world."

So why is this not a big story? For one thing, the Army has not exactly sounded an alarm. Indeed, it's been sticking to the "it's in the dirt" story, which means that as long as you don't get Iraqi dirt blown into your open wound, you're fine. Understand, the numbers of people infected with this disease are very small - but the thing about infectious drug-resistant bacteria is they can turn a small problem into a big one pretty darn fast.

Not to be an alarmist about it, but there's a super germ right here in the U.S.A. that is hard to diagnosis and even harder to treat and, oh yeah, it's killing people

Wait, what are we talking about?! We decided?! My best interest?! How can you know what my best interest is? How can you say what my best interest is? What are you trying to say - I'm crazy? When I went to your schools, I went to your churches, I went to your institutional learning facilities. So how can you say that I'm jcarroll@sfchronicle.com.