- The Washington Times - Monday, June 27, 2011

Ultramodern Hong Kong is tussling with a centuries-old bug long forgotten in many developed countries - an outbreak of drug-resistant scarlet fever that has killed the first children there in a decade.

A mutated strain of the disease that appears to be more contagious is also on the rise in Hong Kong.

The number of cases has spiked this year to more than 500, with health officials issuing warnings in the southern Chinese city jammed with 7 million people and hypersensitive to any type of disease outbreak.

Medical experts warn the main strain of the bacterial infection is likely transmitted easier. It is 60 percent resistant to two drugs of choice, up from a resistance level of 10 percent to 30 percent previously.

The illness leaves children with a fever, sore throat, bright red tongue and sandpapery rash. Penicillin still cures it, but doctors worry options will be limited if the germ eventually outsmarts that antibiotic before a vaccine is developed.

“That’s the cause of lots of nightmares,” said Dr. Edward Kaplan, who heads a World Health Organization research center at the University of Minnesota that focuses on the strep germ, which causes scarlet fever.

“The fact that we still have penicillin is something we all get down on our knees and say prayers about each night.”

The widespread availability of penicillin and the development of other new antibiotics in the 20th century virtually wiped out diseases that were once major killers in developed countries, such as tuberculosis.

However, the overuse and misuse of drugs have allowed old bugs to fight back and eventually overpower antibiotics, rendering some of them useless.

Penicillin, once useful to treat a number of ailments from gonorrhea to pneumonia, has lost much of its potency because of resistance that has built over decades.

Some say it is a miracle it still works for the streptococci group that causes an array of diseases from strep throat to toxic-shock syndrome and flesh-eating disease.

“That’s the one thing that we’re both a bit fearful of and also, in one respect, really surprised that the bug hasn’t developed penicillin resistance yet,” said Mark Walker, a microbiologist and strep expert who heads the Australian Infectious Disease Research Center.

“We’re very lucky. We still have a treatment we can use and additionally there are vaccines that are under development.”

Even penicillin has its problems because many people are allergic to it.

For them, treatment means trying older antibiotics or newer drugs as a last resort, which doctors typically try to avoid for fear of rendering those drugs useless, too.

A vaccine against the germ that causes scarlet fever is likely years away.

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