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HindustanTimes Mon,01 Sep 2014

Linking India to superbug unfair and wrong, says India

IANS  New Delhi, August 12, 2010
First Published: 22:07 IST(12/8/2010) | Last Updated: 22:26 IST(12/8/2010)

India on Thursday termed as unfair and wrong linking a multiple drug-resistant superbug detected in Britain to India saying a number of such bacteria have also been reported from other countries. Health experts said it was politically motivated as Western doctors were alarmed at the prospect of losing business to India's booming health tourism.

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"Several superbugs are surviving in nature and they have been reported from countries like Greece, Israel, the US, Britain, Brazil, Puerto Rico and many others and it is unfair to link the superbud to India," said VM Katoch, director general, Indian Council of Medical Research (ICMR).

According to a report in a British scientific journal, a new superbug had been detected in at least 37 cases in Britain, mainly among patients who had travelled to India and Pakistan for cosmetic surgery, cancer treatment and transplants.

Scientists have warned that the superbug - an enzyme they have called New Delhi metallo-beta-lactamase-1 or NDM-1 - could spread worldwide because it is resistant to almost all antibiotics and nothing has been developed to combat it.

When asked why it has been named New Delhi metallo-beta-lactamase-1 or NDM-1, Katoch said it is a general trend to name the bacteria after the country from where the first strand of bacteria is reported and in this case it is India.

"It is a scientific study and has been (presented) wrongly by the media. There is no public health threat and no need to unnecessarily sensationalise it," he said.

According to Katoch, infection can happen from several other things - soil, water and E Coli bacteria in the intestines.

"As of now we don't have any rules to check hospital-acquired infections. We are also working to set up a cell that will issue guidelines and keep a record of hospital- acquired infections," he said.

When asked if such reports will affect the booming medical tourism in the country, he said: "Of course, it will dent the image of the sector. But by providing proper knowledge and information we can tell the world that it's a natural phenomenon and nothing to get scared."

The Indian health ministry in a statement, said: "While such organisms may be circulating more commonly in the world due to international travel but to link this with the safety of surgery hospitals in India and citing isolated examples to show that due to presence of such organism in Indian environment, India is not a safe place to visit is wrong."

The ministry also took strong exception to naming of the bug as "New Delhi metallo beta lactamase". "...strongly refute the naming of this enzyme as New Delhi metallo beta lactamase and also refute that hospitals in India are not safe for treatment including medical tourism," the ministry said.

Indian health experts said blaming India for the presence of the superbug is politically motivated and "so much humbug" and triggered by alarm among Western doctors at the prospect of losing business to Indians.

"Why are foreigners flocking to India for cosmetic and other surgeries," asks SP Bajaj, chairman of the plastic surgery at the Jaipur Golden Hospital here. "Because they are not only getting world class treatment and facilities at a fraction of the cost but they are attended to without loss of time," Bajaj told IANS.

"About 99 per cent of the foreign patients go back hale and hearty, even though one percent might carry bugs. Then does it follow that India should be singled out for the resistant bug, which they have conveniently named as New Delhi metallo-beta-lactamase-1 or NDM-1," said Bajaj.

"Such patients might have to wait several years in their own countries to get even routine surgery done and at prohibitively higher cost," said Bajaj who was formerly head of the burns and plastic surgery department of Safdarjang and Ram Manohar Lohia Hospitals. 

"Indian surgeons are the world's best in liver transplantation and also at the very top in endoscopic procedures. In fact American doctors are coming here to learn the procedure from us."

Earlier, Bajaj pointed out, patients from the Western world avoided India because of the lack of cleanliness and expertise. "But there's been a sea change and Indian doctors and surgeons are as good as the world's best today." 

Bajaj described the statements by British medical experts as being politically motivated. "They might have been alarmed by the prospect of losing business to Indians."

Medical tourism in India is expected to be worth $2.3 billion by 2012, according to an estimate.

Prof KN Prasad, microbiologist at the Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, said much hue and cry was unnecessarily being raised over the superbug NDM-1, said to have originated in India.

Prasad pointed out that there were more than 150 resistant strains of bugs worldwide that are resistant to antibiotics. "So why should medical experts in Britain or other Western countries single out India?"

"Already 40 types of bugs similar to NDM-1 are existing globally, that also includes the German Imipenem Resistant Metallurgical Strain. The Indian variant is just the 41st strain. These things happen," Prasad said.

Prasad, however, cautioned that antibiotics are easily available over the counter without any medical prescription, leading to their indiscriminate consumption, which only makes them less effective against bugs.

For instance, he pointed out that in India, a single antibiotic is manufactured by 10 different companies, with the result that the product lacks consistency in quality.

Prasad said the bugs are bound to evolve and develop newer modes of resistance over a period of time. 

However, Prof Arvind K Baronia said: "With ground realities being what it is in India, anything is possible. Meat and vegetables are being contaminated with harmful compounds to give them a longer life or make them look fresh, so patients operated here might be possibly carrying the superbugs to UK".

Baronia is professor and head of Critical Care Medicine, SG Post Graduate Institute of Medical Sciences, Lucknow.


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