Menace from South Africa

New strain of pneumonia bug defies most antibiotics

Penicillin's reputation as a miracle drug, won on the battlefields of World War II, has been repeatedly proved in combatting one of the commonest and deadliest forms of pneumonia: the type caused by berry-shaped bacteria appropriately called pneumococci. Though increasingly resistant strains of these microbes have appeared occasionally in recent years, larger doses of the drug--and a whole battery of newer antibiotics--have managed to subdue them. Now from South Africa comes an alarming report about the appearance of one or more strains of pneumococci that largely defy the germ-killing powers not only of penicillin but of most other antibiotics.

The first evidence of these virulent new bugs was detected in May at the King Edward VIII Hospital in Durban, a port on the Indian Ocean, where five children ranging in age from three months to two years came down with unusually persistent cases of pneumonia. Three eventually died of meningitis. The two who recovered did so only after long treatment.

Worse news soon came from Johannesburg, 300 miles inland. A three-year-old boy admitted to Baragwanath Hospital for heart surgery had his operation postponed for five weeks until he was cured of a stubborn case of pneumonia. But after surgery he again developed pneumonia, and analysis of the guilty bacteria proved them to be similar to those identified in Durban. They were astonishingly resistant to penicillin and also to many newer antibiotics. In the boy's case, the hardy new pneumococci finally succumbed to combined doses of rifampin and fusidic acid, but doctors noted that he was already recovering when the drugs were administered.

According to Dr. David W. Fraser, of the Center for Disease Control in Atlanta, the newly virulent pneumococcal strains have so far appeared only in South Africa. But that is no cause for complacency. Tests showed that staff members at Baragwanath and 80 patients at another Johannesburg hospital also harbored the new strain. Though some showed no symptoms of pneumonia, others became ill and one patient died. The danger, says Epidemiologist Fraser, is that patients' relatives and hospital staff members can carry the bacteria in their throats and remain well, yet transmit the infection to others who will become seriously ill. Thus a seemingly healthy air traveler from Johannesburg could, within a day, carry the virulent new pneumococci to any part of the world.

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