Superbug in UAE 'no cause for panic'

The NDM-1 strain, resistant to antibiotics, is likely to arrive in UAE hospitals - but health officials stress they are prepared for it.

A new superbug resistant to antibiotics is likely to arrive in UAE hospitals - but health officials stress that there is no cause for panic. Doctors said the make-up of the UAE's population leaves it particularly susceptible to infections from other parts of the world. Infection control experts predict it is only a matter of time before the new bug, which is believed to have originated in Pakistan and India, is found in hospitals here.

The potential for worldwide spread of infections caused by New Delhi-metallo-beta-lactamase (NDM-1) is "clear and frightening", according to a study in the Lancet Infectious Diseases journal. So far the bug has been identified in 37 patients who returned to the UK after surgery in India or Pakistan. A further 44 cases were found in Chennai and 73 elsewhere on the subcontinent. Health authorities in the US have recorded three cases there since January, all from patients who had received treatment in India.

NDM-1 is the gene responsible for an enzyme that makes bacteria impervious to almost all antibiotics. Experts fear that if it jumps between strains of bacteria the effect would be untreatable infections spreading from patient to patient. Dr Hassan Shurie, the head of infection control for the Dubai Health Authority, said the mobile nature of the population left it vulnerable to foreign infections. "In terms of is it possible it will come here, the answer is yes," he said. "We have high traffic and it is easy for people to travel from one place to another. We have many patients that come from Asia, Europe and the United States." However, that vulnerability meant hospitals were well prepared. "We have some of the best infection control policies anywhere," he said. "The mobility of the population here forces everyone to be more alert of infections coming from other countries." A report by the Health Protection Agency in the UK said the enzyme was "strongly linked to India and Pakistan" and many of the UK cases had recent medical exposure in the Indian subcontinent. Almost three quarters of Asian nationals in the UAE would opt to go to their home countries for medical treatment, according to a 2009 survey carried out for The National by YouGovSiraj, the international research organisation. Prof Sebastian Amyes, from the centre for infectious diseases at the University of Edinburgh, said it was likely the enzyme would be found elsewhere. "It will probably get to the Gulf with its large mobile population and significant portion of Asian expatriates," he said. "In theory it could spread to patients all around the world. It is presumed to have started elsewhere but been detected first on the Indian subcontinent." The risk was not great at the moment, he added, but depended on how effectively hospitals controlled the infections. Dr Mohamad Yaman, the chief medical officer of Al Mafraq Hospital in Abu Dhabi, said infection control was taken very seriously by health authorities. Over the past two years everyone at the hospital has undergone "rigorous training" on how to prevent the spread of antibiotic-resistant bugs. "It is not just the clinical staff like the doctors, nurses and paramedics," he said, "but also the administrative staff. Obviously a lot of our patients are from countries like India and Pakistan, so we are always alert. No country in the world is free of bugs. The world is now so open that something which exists in one country is likely to spread to others." The UAE does not have a central infectious disease surveillance system, but the Health Authority-Abu Dhabi (HAAD) hopes to launch an emirate-wide database as early as next year. It would track any infectious activity in hospitals, allowing public health officials to spot any potential outbreaks. Dr Jens Thomsen, of the public health and research department at HAAD, previously said the surveillance system would help to identify potential outbreaks early, allowing adequate counter measures to be taken. "This would result in better patient outcomes," he said, "plus more choices for physicians on how to treat infectious diseases, a reduction of healthcare-associated infections and deaths, cost savings and a better use of available resources." Yesterday, a HAAD statement said its operations centre was keeping a close watch on the situation, but to date there was nothing to report. Experts in the US have been warning of the NDM-1 threat since June, when the Centers for Disease Control and Prevention (CDC) alerted doctors to an "enzyme that destroys many commonly used antibiotics, rendering them ineffective". "In order to prevent transmission of bacteria possessing NDM-1 in the US, CDC is alerting clinicians to be aware of NDM-1 in patients who have recently received medical care in India or Pakistan," the agency said in a statement. "The reports are that this is very common in India, this suggests that it spreads relatively easily between people," said Dr Alexander Kallen, a CDC medical officer. "If that's the case, these bugs don't respect international borders and it's likely we will see additional cases in the US." [e-mail] * With additional reporting by James Reinl in New York