The term “skin infection” doesn’t set off alarm bells for most people. They’re pesky, perhaps embarrassing, but with the right ointment or medication it shouldn’t be much of a problem. But that’s not the story Sonia Shah tells, a career science journalist and mother of two. In her recent book “Pandemic: Tracking Contagions from Cholera to Ebola and Beyond,” and in an interview with NPR, she describes something else entirely; something that few of us would imagine.
Ever-so-innocently it began: her son’s complaints about that frayed knee bandage, well-earned by his Huckleberry Finn-style outdoor adventures. The red stain in the middle of it probably meant the scab re-opened—the boy just needed to slow down. But when Sonia saw him limping a few days later she peeled off the bandage and: “We found a mountain range of pus-filled boils. One peak summited at over an inch – an inch! – and had wept a sickly stream of liquid into the gummed-up bandage.”
Down at the pediatrician’s office came the diagnosis of a methicillin-resistant Staphylococcus aureus (MRSA) infection, a barrage of heavy duty antibiotics, and instructions to carry out “a brutal regime in which we’d have to force the pus out of the boils using hot compresses and vice-like squeezing. This would be … excruciatingly painful, since the layer of pus extended deep into the tissue … Each drop would have to be meticulously captured and disposed of, lest it find its way into a microscopic fissure in our skin or worse, embed itself in our rugs, sheets, couches, or counters where it could lie in wait for up to a year.”
Which meant the family was at risk: her other son, the father of her two children, and Sonia herself. They probably hadn’t seen the last of this as they were told of whole families who came down with MRSA continually re-infecting each other for years. Another physician warned that her son could have lost his leg.
They acted fast: “We washed. We laundered. We maintained a sterile box with hand sanitizers, disposable gauzes, and antiseptic sprays. A set of cast-off pots lived on the stove for boiling bandages and compresses, which we did religiously. One doctor recommended twice-weekly 20 minute baths in a bleach solution – ½ cup per bath – for months or even years. You know, we first started fighting them with lots of antibiotics and getting them lanced and doing all this stuff with – you know, going to the doctor for them all the time, and then it turned out that if you just sort of stopped everything, they kind of went away on their own.”
But none of the various physicians, Sonia believed, quite knew how to prevent the infection from re-occurring, or from spreading to the rest of the family.
Sure enough, her son’s second bout hit a few months after the first, requiring another round of semi-toxic antibiotics.
A third MRSA infection appeared on the inside of his elbow after another few months. By this time, Sonia says, “There was no doubt: MRSA lived inside his body. Because there was no fissure in this protected bit of skin that would have allowed an external invader to creep in. My husband squeezed five tablespoons of pus from the swollen lesions.”
Then MRSA jumped to Sonia herself. Six months after her son’s boils healed a burning spot appeared on the back of her thigh. “I could see a small spider bite, one that felt as if a torch were being held to my skin. At the doctor’s office she took her scalpel to it and started to dig. Half an hour later I staggered home in tears with a giant wad of gauze to soak up the MRSA-infested pus that poured out for days.”
A pattern emerged: An eruption of boils in random places, popping up unexpectedly, they’d last for weeks, slowly get more and more painful, and it would debilitate movement: “Like, I would get a lot on my legs so it would be hard to drive, it would be hard to bend down; sometimes it was hard to walk.”
Sonia said something else was happening too: “The lack of a clear consensus [how to stop it], the open-minded time frame, and the repellant nature of the treatment began to shake our resolve. We started to wonder: Are they making it up [as they go along]?” (My emphasis.)
In other words, MRSA, even at the level of a “skin infection,” undermines the body and the mind—even the mind of Sonia Shah, who, you would think, is as fortified as they come. Both her parents are doctors. Sonia has a BA in neuroscience. She just published, “Pandemic,” (above), her third book in 10 years about disease-causing bugs. She has given two TED Talks on the subject, and has lectured at universities across the country, including Harvard and MIT. The father of her children and the man with whom she lives is a PhD in molecular biology whose research focuses on pathogens, how they spread disease, and the implications for antibiotic resistance and treatment.
Yet their resolve and faith in medicine has been shaken. So if it would do that to them, what would it do to us? What does it do to the more than 80,000 people who are felled by a “severe” MRSA infection every year, as the Centers for Disease Control calls them?
As for the future, Sonia says, “I think we might always have MRSA. It’s not really known, and this is sort of the problem. Whether it’s going to come back and be a problem again. If we had surgery, if we had, you know, an accident, would it spread to other parts of our body? It’s like, we really don’t know the answers to those questions. For now we’re fine, and, you know, this is the world we live in. So it’s just a risk you have to live with.”