If ever there was a book that wasn’t for the faint hearted, it’s this one. I don’t mean that it’s painful to read. Despite being a translation (I’ll come back to this), it’s fluent and easy to get through the words – it’s just the contents that are nerve wracking.
We’ve all heard the news stories about “superbugs” – bacteria like MRSA (originally short for methicillin resistant staphylococcus aureus, but now, in sinister fashion, the MR means multi-resistant) that stalk hospitals and elsewhere, killing patients and refusing to respond to antibiotics. The first part of Thomas Häusler’s book concentrates firmly on scaring us to death about just how unstoppable these simple, but deadly bacteria, always around ready to take on a suitable wound, are becoming. The trouble is that bacteria breed very quickly. That means it doesn’t take long for a variant to occur that happens to be able to resist an antibiotic, and once the mutation crops up, natural selection means it may well have a better chance of surviving. Especially if antibiotics are sprayed around heavy-handedly by doctors and the livestock industry as Häusler makes it very clear they have been.
Is all lost? Are we to return to the bad old days, pre-antibiotics, where deaths from these killer bacteria were rife? Luckily, before we all go away and end it all, we are offered an alternative. Bacteria have a natural enemy – specialist viruses that prey on bacteria called phages (great word – and it doesn’t do any harm that they under an electron microscope they bear a distinct visual resemblance to the lunar lander – very sci-fi). This proves to be one of those “told you so” things, where those who get all snotty about modern science can say “we knew better in the old days”. Phages were popular as a weapon against bacteria before antibiotics were introduced, particularly in Eastern Europe, and have continued to be used there but not elsewhere. Since the earlier part of the twentieth century, there has been a lot of doubt about the effectiveness of phages – not helped by a period when they were marketed like patent medicine. What Häusler does is to show how phages offer hope when combined with modern techniques, if the antibiotics give up.
Of course there is a long and chequered history of using natural predators to dispose of an unwanted infestation. Ladybirds (ladybugs) are popular environmentally friendly solutions to aphids, for instance. But the “chequered” part refers to the habit of many predators, when let loose, of doing unexpected damage. While phages are very targeted, so unlikely to stray, there is always the concern that something might go wrong – viruses can mutate too. Also enough isn’t known about phages. Some are effectively symbiotic, and instead of killing a bacterium, these “temperate phages” can turn a low risk infector into a killer. And then it’s not always easy to get the right phages to the right place to kill the bacteria as they’re relatively big compared with the chemical molecules of a drug, and the body has a tendency to break them down. That makes it a more balanced, more interesting story than simply “hey, here’s a new cure, no need to worry.”
If you can cope with the content, there’s not that much to criticize, though the book does slightly lose impetus after a while (I found, for instance, the story of Georgiy Eliava, a phage pioneer’s struggle against the Soviet machine took me too far off track). It does also occasionally slip into tabloid language – I know MRSA is often labelled a “superbug”, but the use of “bug” as an alternative for bacterium grates.
On the whole, despite the very depressing content, this was a good book. Many translations feel lumpy, somehow, like a loaf that hasn’t risen properly – this is very readable, and it would be impossible to tell it was a translation if the reader hadn’t been told. The story is told well, and strikingly too. There’s excellent use of the stories of real people involved in the fight against bacteria – both medics and patients. It’s just… I think now I’ve read it, I want to wash my hands. In fact, I’ll go and do it now…