Superbug detected in health tourists from South Asia

MARK COLVIN: They're known as "health tourists" and they travel to developing countries such as India and Pakistan for cheaper medical treatment.

But experts warn that these travellers could be bringing home a new breed of superbug which is often resistant to antibiotics.

A study published in the British medical journal "The Lancet" says cosmetic surgery patients have carried the bug from South Asia to the UK.

And an Australian infectious diseases expert says the bacteria have also shown up in Canberra.

Brendan Trembath reports.

BRENDAN TREMBATH: The top hospitals in India and Pakistan are treating more and more foreigners who fly in for cosmetic surgery; from nose jobs and facelifts to breast augmentation.

The hospitals boast skilled doctors and nurses and modern equipment.

But according to a study published in The Lancet Infectious Diseases a number of cosmetic surgery patients have carried a new type of superbug from South Asia to Britain.

DAVID LIVERMORE: The threat comes from the fact that these bacteria are so resistant.

BRENDAN TREMBATH: Dr David Livermore is the director of the antibiotic resistance monitoring unit at the Health Protection Agency in North London.

DAVID LIVERMORE: Nowadays we've got five or six good antibiotics that are active in MRSA (Methicillin Resistant staphylococcus aureus) infections; here we're down to one or two, not very good, rather old antibiotics.

BRENDAN TREMBATH: The Lancet study found 37 cases of the so called NDM-1 gene in Britain.

The ND stands for New Delhi.

Several patients had recently gone to India or Pakistan for cosmetic surgery. The study's authors warn that the bacteria could spread worldwide.

A similar germ was identified in Australia just a couple of months ago. Professor Peter Collignon is an infectious diseases physician at the Australian National University.


PETER COLLIGNON: We've had a case in Canberra where somebody's come back from having a medical procedure done in India that has left them with some medical problems but in addition carrying bugs that are untreatable, they're very much like those germs that you've spoken about in the Lancet but these ones are actually even worse in that they are truly untreatable if the person should develop a serious infection with it.

And a study we've done here shows that if people from Canberra go travelling, particularly to Asia, over half of them pick up very resistant bacteria e-coli bugs, presumably mainly from food that then would be very difficult to treat if they got an infection from it.

BRENDAN TREMBATH: Is it because people aren't washing their hands; how is it happening?

PETER COLLIGNON: You transmit the bugs by poor hand hygiene for instance or poor infectious control in hospitals. People are bringing in a lot of these bugs. You've got to actually make sure you've to a safe water supply, a safe food supply, not use these important antibiotics needlessly in food animals.

If you do all that, you can not only stop the rise of these superbugs, you can actually make them go down in numbers. And because there's not a lot of new antibiotics in the pipeline, to be wasting them if you like to make chickens get a big fatter a bit quicker, seems to be appalling when the cost of that is superbugs being carried in the community and particularly when you got to areas that have got less controls and less good infrastructure than Australia.

BRENDAN TREMBATH: If somebody is a tourist or is considering medical tourism going to India or a country like that for some sort of procedure, what can they do to protect themselves?

PETER COLLIGNON: Well I think it's actually being very careful with the food you eat but it's also being very careful, like we need to be in Australia, to make sure the staff and everybody are doing the appropriate things.

And in hospitals that is making sure people use hand hygiene, which means before they touch you making sure they use alcohol hand rubs, so that any germs that they have on their hands that they've picked up maybe from another patient, doesn't get transferred to you.

And also to have the least amount of procedures done to you as possible. In other words, don't have an intravenous, one of those plastic catheters in your arm any longer than it needs to be because it's a short-cut for bugs to get from your skin into your bloodstream and cause serious infections.

And it's essentially making sure the practices in place are as good as possible.

BRENDAN TREMBATH: The medical services in India and Pakistan might be cheaper but Professor Collignon warns that the types of bugs about are much worse than anything in the developed world.

MARK COLVIN: Brendan Trembath.