November 14, 2019

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An infectious read

Epidemiologist's race to thwart deadly bacteria a real-life thriller

Hey there, time traveller!
This article was published 27/4/2019 (201 days ago), so information in it may no longer be current.

Hey there, time traveller!
This article was published 27/4/2019 (201 days ago), so information in it may no longer be current.

Tom Patterson (centre left) developed a painful stomach illness while on vacation in Egypt in 2015 with his wife, epidemiologist Steffanie Strathdee (top). (The Canadian Press files)

Tom Patterson (centre left) developed a painful stomach illness while on vacation in Egypt in 2015 with his wife, epidemiologist Steffanie Strathdee (top). (The Canadian Press files)

A race against time to thwart a deadly foe, which threatens a loved one and may spread devastation. Courageous characters altruistically joining forces to defeat an international menace. Hair-breadth escapes and stirring twists of fortune.

Usually the stuff of fiction, Canadian-born epidemiologist Steffanie Strathdee incorporates such excitement into her page-turning memoir of fighting a deadly infection that is immune to antibiotics.

Strathdee’s husband Tom Patterson developed a painful stomach illness while on vacation in Egypt in 2015. Medevaced first to Germany, and later to San Diego, where the pair taught at the University of California (UCSD), the most dangerous threat to his life turns out to be the drug-resistant Acinetobacter baumannii, also known as "Iraqibacter" because of its prevalence in people returning from the Middle East between 2003 and 2009.

"This bacterial kleptomaniac collected genes from other bacteria that arm it for resistance to antibiotics," Strathdee writes; it evades "the host’s immune system," partly by developing "a slimy capsule that inhibits the immune response."

The bacteria roiled a 15-centimetre pseudocyst in Patterson’s abdomen and "allied" with pancreatic inflammation and other infections causing pain, vomiting, fever and deadly complications.

As one powerful antibiotic after another fails to have any effect, Strathdee, supported by UCSD chief of infectious diseases Robert (Chip) Schooley, begins to consider enlisting germ-eating viruses to target the intractable infection.

Using such "bacteriophages" against infections began about the same time as the antibiotic revolution following Alexander Fleming’s discovery of penicillin in the late 1920s, and its development as a miracle drug in the following decades. However, "phage therapy" fell out of favour in the West with the explosion of antibiotic use, although a few eastern European research centres remained in Poland and Georgia.

Strathdee, with journalist Teresa Barker, chronicles the emotional roller-coaster of family, friends and medical personnel dealing with Patterson’s illness. His daughters and Strathdee face fearsome decisions and complexities dealing with a person in intensive care for months on end.

Occasional interludes from Patterson’s memories provide a nightmarish counterpoint to the scientific issues and decisions Strathdee and the widely varied care team must face every day. It’s as tense as any chase or fight scenes in a novel.

As she researches phage therapy and searches desperately for scientists and clinics willing to experiment with it — as Patterson slips closer and closer to death — various individuals and groups step up heroically, dedicating themselves, their scientific work and their reputations to his case.

Strathdee effectively balances the emotional weight of the experience with scientific, historical and medical information even the lay reader can understand.

One of the few places where the narrative slows down involves the paperwork that must be filed giving her "Consent to Emergently Administer" treatments "not approved for clinical use in the United States or western Europe." Even this plodding document serves to emphasize the dangerous choices she and Patterson’s doctors must make, for his health and their own legal safety.

Medical labs and researchers from the U.S. navy and private enterprise provide inspirational donations of time, care and risk as the plan comes together. Time slipping away — combined with the fact that it’s a true story — helps the story surpass mere fictional adventure.

Strathdee never sounds rancorous, though she discusses the overuse of antibiotics in agriculture and medicine that contributed to her husband’s condition. Nor is the book overly optimistic about the future of phage therapy, in spite of the increasing danger of resistant infections.

It is enough that the reader is emotionally involved in this story, and policies and prognoses are left up in the air. If it were fiction, the sequel would be eagerly anticipated, to reveal whether the infection or the killer virus is the Perfect Predator.

Bill Rambo teaches at The Laureate Academy in St. Norbert. He is washing his hands more carefully than ever.

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