Superbug is not about an entomological caped crusader.
It's more like a grown-up version of Scary Stories to Tell in the Dark.
The bug in question is MRSA, an antibiotic-resistant bacteria that kills more Americans every year than AIDS. Superbug is the story of how we created our own monster-under-the-bed, how it spreads through hospitals and communities, and why it's damn near impossible to control. If you have a cut or a pimple while reading this book, you are pretty much guaranteed to freak yourself out. And I mean that in the best possible way.
MRSA is the pumped-up version of a ridiculously common bacteria. One in three of us carts around Staphylococcus aureus on our skin or up our noses without ever noticing a difference. It never was benign—S. aureus is still the most common hospital-acquired infection in the U.S., and it can cause everything from rashes to toxic shock syndrome. But S. aureus mostly attacks the weak, people whose immune systems are too sick or too old to hold it in check.
MRSA throws all that out the window. The issue with MRSA isn't just its resistance to antibiotics. It's that it attacks the healthy, as well as the sick. And that it can kill the healthy, too.
I was used to hearing about MRSA mostly in the context of hospital-acquired infections. Superbug disabused me of that notion. MRSA may have first been noticed in hospitals, but it can come from the playground as easily as the emergency room, and it's actually gotten to the point where community-acquired and hospital-acquired strains cross into each other's territory often enough that researchers aren't sure such clear-cut categories even make sense anymore.
Written by journalist Maryn McKenna—a "Scary Disease Girl" who used to cover the CDC for The Atlanta Journal-Constitution—Superbug does a great job of explaining how hospital- and community-acquired MRSA evolved, and how they've intertwined with our modern way of life, from the doctor's office to the dinner table. Like any in-depth discussion of bacterial genetics, it does occasionally get mired down in acronym soup, but McKenna handles it well, reminding the reader at the right times what that concept from a few chapters ago means—and managing to do so in a way that doesn't feel textbook-y.
The book doesn't offer easy answers, because, frankly, there are none at this point. There are search-and-destroy policies that seem to be able to keep MRSA in check in hospitals, but they're expensive and difficult to employ in the United States, where MRSA rates are only voluntarily reported and enforcement of sanitary rules varies widely from hospital to hospital. (Countries with socialized medicine—and the standardized policies and consolidated medical records that come with it—have had better luck.)
The important thing here is awareness, and not just of the fact that MRSA exists. That does matter—particularly for doctors who don't always recognize what they're dealing with fast enough—but from an Average Person standpoint there are plenty of scary diseases in the world and you'd go nuts if spent too much time worrying about them all. Instead, Superbug's importance lies in making us aware of how daily choices in familiar places influence the evolution and spread of disease.
When I was 14, I read a book called The Coming Plague that sparked my interest in the stories of science. Its big question: "Where will the next major epidemic come from?" I remember that book being full of locations I thought of as exotic. (Though, to be fair, from my position in central Kansas, "exotic" meant just about anywhere else.) Combine that with reading The Hot Zone around the same time period, and small me was left with the idea that disastrous diseases were things that rose up out of the evolutionary ether in some dark corner of the globe, and swooped in on unsuspecting Americans via international travel or disgruntled research monkeys.
Superbug starts in Chicago.
Where will the next major epidemic come from? According to Superbug, that epidemic is already here. It grew out of our hospitals, our prisons and our high-school locker rooms. We fed it with our demand for antibiotic ointments, prescriptions we didn't need and factory-farmed cows packed together and pumped full of their own antibiotics. We spread it with unwashed hands. The story of MRSA is more prosaic than tales of tracking Ebola through the African jungle, but that's exactly what makes it terrifying, and fascinating.
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Disclaimer: I received a free review copy of this book from author Maryn McKenna, who I personally know. That said, I receive a lot of free review copies of books. I only tell you about the ones I think you really need to read.
Image of MRSA growing in culture courtesy Flickr user Simon Goldenberg, via CC.
