Leading Article: A killer bug and a learning curve

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The Independent Online
THERE are no known statistics about the incidence of hypochondria in Britain. But even those untainted by it have been following with morbid fascination the progress of the 'killer bug' that causes the condition known as necrotising fasciitis.

The name itself combines both medieval-sounding and modern horror: this is necro as in necrophilia, necropolis and necromancy, a prefix indicating 'death, dead body, dead tissue', as the dictionary puts it; and fasciitis, deriving from the fascia or tissue planes under the skin, sounds remarkably like fascism.

The media's preoccupation with this hitherto little-known disease lay, however, not so much in its etymology as in its epidemiology and in the appalling speed with which the bacteria delivered death or disfigurement by liquefying the flesh and tissue of its victims. Without swift surgery, if necessary amputation, victims could be dead within 24 hours - and modern medicine seemed largely powerless to help them, except by the primitive method of excising the affected flesh or limb. The horror of it all was summed up in the tabloid headline of the week: 'Killer Bug Ate My Face'.

The episode raises two linked questions: did the public health authorities react optimally to what seemed to be an excepional outbreak; and have the media, as some scientists claimed, created unnecessary anxiety by sensationalising the story?

There seem to be no grounds for criticising the NHS at the medical level; but in public relations terms, official reactions have shown a tendency to patronise and play down the significance of what has been happening. True, the authorities admitted from the start that the cluster of cases in Gloucestershire was unusual. But the main thrust of all statements was summed up on Wednesday by Dr Kenneth Calman, the Government's Chief Medical Officer, when he said: 'Even taking the Gloucestershire cases into account, there is no evidence of any increase in the normal incidence of this disease . . . I am perfectly satisfied that everything that can be done is being done and the public can be confident.' He added that a nationwide intelligence system was now in place to report cases.

In other words: There, there, don't worry your little heads, we medical people know all about this and everything is normal and under control.

Yet within a few days the norm of an annual 10 cases had this year risen to 15 in five months: not necessarily a statistically significant surge, but none the less surely cause for concern. As for the Gloucestershire cluster, it is arguably premature to dismiss it as a statistical quirk, even though no two cases appear to have been linked. Virginia Bottomley, the Health Secretary, was even less convincing in her insistence that there was 'nothing untoward' in what had happened: a phrase ill-suited to so carnivorous a disease.

The public is rightly sceptical of bland assurances that all is well, not least since about half the cases seem to have been contracted in hospitals. It would have been wiser to state that this is indeed a horrifying disease, hitherto little known to the public but now flushed out into the open, and one whose present apparent increase is causing both concern and heightened counter-measures where possible.

Media coverage may have caused some unnecessary alarm. But that has been more than compensated for by the resulting raised awareness of the danger of being necrotised. The chances of that may be no greater than of being struck by lightning. But since very swift treatment is the best hope of minimising damage, the fight against the disease can only have been helped by a spell of heavy publicity. GPs as well as the public have been alerted. The scare element will soon fade, leaving a better informed public - and enriching common parlance with a fresh and uniquely sinister medical term.

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