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<TITLE>Solution to killer superbug found in Norway</TITLE>
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<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">This philosophy would certainly make our waters cleaner!</FONT></SPAN><SPAN LANG="en-us"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">*******</FONT></SPAN><SPAN LANG="en-us"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"></SPAN><A HREF="http://news.yahoo.com/s/ap/20091231/ap_on_he_me/when_drugs_stop_working_norway_s_answer"><SPAN LANG="en-us"><U><FONT COLOR="#000080">http://news.yahoo.com/s/ap/20091231/ap_on_he_me/when_drugs_stop_working_norway_s_answer</FONT></U></SPAN><SPAN LANG="en-us"></SPAN></A><SPAN LANG="en-us"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><B></B></SPAN><B><SPAN LANG="en-us"><FONT COLOR="#000080" SIZE=5 FACE="Arial">Solution to killer superbug found in Norway</FONT></SPAN></B></P>
<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><I><FONT COLOR="#000080">By MARTHA MENDOZA and MARGIE MASON, Associated Press Writers</FONT></I></SPAN><SPAN LANG="en-us"><I> <FONT COLOR="#000080">Martha Mendoza And Margie Mason, Associated Press Writers</FONT></I></SPAN><SPAN LANG="en-us"><I><FONT COLOR="#000080"></FONT></I></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Wed Dec 30, 9:04 pm E</FONT></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">T</FONT></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">OSLO, Norway –</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Aker University Hospita</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">l</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> is a dingy place to heal. The floors are streaked and scratched. A light layer of dust coats the blood pressure monitors. A faint stench of urine and bleach wafts from a pile of soiled bedsheets dropped in a corner.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Look closer, however, at a microscopic level, and this place is pristine. There is no sign of a dangerous and contagious</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">staph infectio</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">n</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> that killed tens of thousands of patients in the most sophisticated hospitals of</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Europ</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">e</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">, North America and Asia this year, soaring virtually unchecked.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">The reason:</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Norwegian</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> stopped taking so many drugs.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Twenty-five years ago, Norwegians were also losing their lives to this bacteria. But</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Norway's public health syste</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">m</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> fought back with an aggressive program that made it the most infection-free country in the world. A key part of that program was cutting back severely on the</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">use of antibiotic</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Now a spate of new studies from around the world prove that Norway's model can be replicated with extraordinary success, and</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">public health expert</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> are saying these deaths — 19,000 in the U.S. each year alone, more than from</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">AID</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">S</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> — are unnecessary.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"It's a very sad situation that in some places so many are dying from this, because we have shown here in</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Norwa</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">y</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> that Methicillin-resistant Staphylococcus aureus (MRSA) can be controlled, and with not too much effort," said Jan Hendrik-Binder, Oslo's MRSA</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">medical advise</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">r</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">. "But you have to take it seriously, you have to give it attention, and you must not give up."</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">The World Health Organizatio</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">n</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> says</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">antibiotic resistanc</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">e</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> is one of the</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">leading public healt</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">h</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> threats on the planet. A six-month investigation by The Associated Press found overuse and misuse of medicines has led to mutations in once curable diseases like</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">tuberculosi</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> and</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">malari</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">a</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">, making them harder and in some cases impossible to treat.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Now, in Norway's simple solution, there's a glimmer of hope.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">---</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Dr. John Birger Haug shuffles down Aker's scuffed corridors, patting the pocket of his baggy white scrubs. "My bible," the</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">infectious disease specialis</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">t</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> says, pulling out a little red</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Antibiotic Guid</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">e</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> that details this country's impressive MRSA solution.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">It's what's missing from this book — an array of antibiotics — that makes it so remarkable.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"There are times I must show these golden rules to our doctors and tell them they cannot prescribe something, but our patients do not suffer more and our nation, as a result, is mostly infection free," he says.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Norway's model is surprisingly straightforward.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">• Norwegian doctors prescribe fewer antibiotics than any other country, so people do not have a chance to develop resistance to them.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">• Patients with MRSA are isolated and medical staff who test positive stay at home.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">• Doctors track each case of MRSA by its individual strain, interviewing patients about where they've been and who they've been with, testing anyone who has been in contact with them.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Haug unlocks the dispensary, a small room lined with boxes of pills, bottles of syrups and tubes of ointment. What's here? Medicines considered obsolete in many developed countries. What's not? Some of the newest, most expensive antibiotics, which aren't even registered for use in Norway, "because if we have them here, doctors will use them," he says.</FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">He points to an antibiotic. "If I treated someone with an infection in Spain with this penicillin I would probably be thrown in jail," he says, "and rightly so because it's useless there."</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> </SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">Norwegian</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> are sanguine about their</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">coughs and cold</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">, toughing it out through low-grade infections. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Haug. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Convenience stores in downtown</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Osl</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">o</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> are stocked with an amazing and colorful array — 42 different brands at one downtown 7-Eleven — of soothing, but non-medicated, lozenges, sprays and tablets. All workers are paid on days they, or their children, stay home sick. And drug makers aren't allowed to advertise, reducing patient demands for prescription drugs. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">In fact, most marketing here sends the opposite message:</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">"</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">Penicilli</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">n</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> is not a</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">cough medicin</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">e</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">," says the tissue packet on the desk of Norway's MRSA control director, Dr. Petter Elstrom. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">He recognizes his country is "unique in the world and best in the world" when it comes to MRSA. Less than 1 percent of</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">health care provider</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> are positive carriers of MRSA staph. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">But Elstrom worries about the bacteria slipping in through other countries. Last year almost every diagnosed case in Norway came from someone who had been abroad. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"So far we've managed to contain it, but if we lose this, it will be a huge problem," he said. "To be very depressing about it, we might in some years be in a situation where MRSA is so endemic that we have to stop doing advanced surgeries, things like</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">organ transplant</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">, if we can't prevent infections. In the worst case scenario we are back to 1913, before we had antibiotics." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">--- </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Forty years ago, a new spectrum of antibiotics enchanted</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">public health official</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">, quickly quelling one infection after another. In wealthier countries that could afford them, patients and providers came to depend on antibiotics. Trouble was, the more antibiotics are consumed, the more resistant bacteria develop. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Norway responded swiftly to initial MRSA outbreaks in the 1980s by cutting antibiotic use. Thus while they got ahead of the infection, the rest of the world fell behind. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">In Norway, MRSA has accounted for less than 1 percent of</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">staph infection</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> for years. That compares to 80 percent in Japan, the world leader in MRSA; 44 percent in Israel; and 38 percent in Greece. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">In the U.S., cases have soared and MRSA cost $6 billion last year. Rates have gone up from 2 percent in 1974 to 63 percent in 2004. And in the United Kingdom, they rose from about 2 percent in the early 1990s to about 45 percent, although an aggressive control program is now starting to work. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">About 1 percent of people in developed countries carry MRSA on their skin. Usually harmless, the bacteria can be deadly when they enter a body, often through a scratch. MRSA spreads rapidly in hospitals where sick people are more vulnerable, but there have been outbreaks in prisons, gyms, even on beaches. When dormant, the bacteria are easily detected by a quick nasal swab and destroyed by antibiotics. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Dr. John Jernigan at the</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">U.S. Centers for Disease Control and Preventio</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">n</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> said they incorporate some of Norway's solutions in varying degrees, and his agency "requires hospitals to move the needle, to show improvement, and if they don't show improvement they need to do more." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">And if they don't? </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"Nobody is accountable to our recommendations," he said, "but I assume hospitals and institutions are interested in doing the right thing." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Dr. Barry Farr, a retired epidemiologist who watched a successful MRSA control program launched 30 years ago at the University of Virginia's hospitals, blamed the</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">CD</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">C</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> for clinging to past beliefs that hand washing is the best way to stop the spread of infections like MRSA. He says it's time to add screening and isolation methods to their controls. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">The CDC needs to "eat a</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">little cro</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">w</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> and say, 'Yeah, it does work,'" he said. "There's example after example. We don't need another study. We need somebody to just do the right thing." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">--- </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">But can Norway's program really work elsewhere? </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">The answer lies in the busy laboratory of an aging little public hospital about 100 miles outside of London. It's here that microbiologist Dr. Lynne Liebowitz got tired of seeing the stunningly low Nordic MRSA rates while facing her own burgeoning cases. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">So she turned Queen Elizabeth Hospital in Kings Lynn into a petri dish, asking doctors to almost completely stop using two antibiotics known for provoking</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">MRSA infection</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">One month later, the results were in: MRSA rates were tumbling. And they've continued to plummet. Five years ago, the hospital had 47 MRSA</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">bloodstream infection</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">. This year they've had one. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"I was shocked, shocked," says Liebowitz, bouncing onto her toes and grinning as colleagues nearby drip blood onto slides and peer through microscopes in the hospital laboratory. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">When word spread of her success, Liebowitz's phone began to ring. So far she has replicated her experiment at four other hospitals, all with the same dramatic results. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"It's really very upsetting that some patients are dying from infections which could be prevented," she says. "It's wrong." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Around the world, various medical providers have also successfully adapted Norway's program with encouraging results. A medical center in Billings, Mont., cut MRSA infections by 89 percent by increasing screening, isolating patients and making all staff — not just doctors — responsible for increasing hygiene. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">In Japan, with its cutting-edge technology and modern hospitals, about 17,000 people die from MRSA every year. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Dr. Satoshi Hori, chief infection control doctor at</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Juntendo University Hospita</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">l</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> in Tokyo, says doctors overprescribe antibiotics because they are given financial incentives to push drugs on patients. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Hori now limits antibiotics only to patients who really need them and screens and isolates high-risk patients. So far his hospital has cut the number of MRSA cases by two-thirds. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">In 2001, the</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">CD</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">C</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> approached a Veterans Affairs hospital in Pittsburgh about conducting a small test program. It started in one unit, and within four years, the entire hospital was screening everyone who came through the door for MRSA. The result: an 80 percent decrease in MRSA infections. The program has now been expanded to all 153 VA hospitals, resulting in a 50 percent drop in MRSA</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">bloodstream infection</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">, said Dr. Robert Muder, chief of</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">infectious disease</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">s</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"> at the VA Pittsburgh Healthcare System. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"It's kind of a no-brainer," he said. "You save people pain, you save people the work of taking care of them, you save money, you save lives and you can export what you learn to other hospital-acquired infections." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Pittsburgh's program has prompted all other major hospital-acquired infections to plummet as well, saving roughly $1 million a year. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"So, how do you pay for it?" Muder asked. "Well, we just don't pay for MRSA infections, that's all." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">--- </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Beth Reimer of Batavia, Ill., became an advocate for MRSA precautions after her 5-week-old daughter Madeline caught a cold that took a fatal turn. One day her beautiful baby had the sniffles. The next? </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"She wasn't breathing. She was limp," the mother recalled. "Something was terribly wrong." </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">MRSA had invaded her little lungs. The antibiotics were useless. Maddie struggled to breathe, swallow, survive, for two weeks. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"For me to sit and watch Madeline pass away from such an aggressive form of something, to watch her fight for her little life — it was too much," Reimer said. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Since Madeline's death, Reimer has become outspoken about the need for better precautions, pushing for methods successfully used in</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Norwa</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">y</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">. She's stunned, she said, that anyone disputes the need for change. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">"Why are they fighting for this not to take place?" she said. </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">____ </FONT></SPAN></P>
<P DIR=LTR><SPAN LANG="en-us"><FONT COLOR="#000080">Martha Mendoza is an AP national writer who reported from Norway and England. Margie Mason is an AP medical writer based in Vietnam, who reported while on a fellowship from The Nieman Foundation at</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080"></FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"> <FONT COLOR="#000080">Harvard Universit</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">y</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"><FONT COLOR="#000080">.</FONT></SPAN><SPAN LANG="en-us"></SPAN><SPAN LANG="en-us"></SPAN></P>
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