Eight years ago, my husband had an emergency operation. It was a banded gut which meant nothing could get through his digestive tract. Considerable pain was involved, along with copious vomiting of liquid the colour of Tibetan monk’s robes. It was horrific, but, once he was in hospital, hooked up to a drip and on diamorphine (street name: heroin), the whole thing was easily sorted out with surgery. We were very thankful he was within reach of a hospital and not with those monks in the middle of Tibet (as he sometimes is). The only problem was that in hospital he picked up the Superbug.
The Superbug is the common name for Methicillin Resistant Staphylococcus Aureus (MRSA), a bacterial infection which is usually picked up in hospitals, and has developed a robust resistance to antibiotics. It manifests as boils on the skin, septicemia and infections of the internal organs. It’s not that they never get better, but they can take a very long time to heal. How long depends on the age and base health of the patient. In the worse-case scenario, confusion, fever and delirium follow, ending in death. The pity of it is that it is over-enthusiastic use of antibiotics, once hailed as the miracle cure-all, which has precipitated the growth of this monster.
Or is it, like Frankenstein’s monster, not really a monster at all - just misunderstood? The projection of our own ignorance? The wilful child of dramatic press-cuttings? The very portrait of our fear?
The media love to tell us about MRSA infections ‘cutting deadly swathes through hospital wards, with headlines such as ‘Monster Bugs Thrive as Chemical Arsenal Fails’ and ‘"I watched my husband die in agony," says MRSA widow’ . (Even in retrospect, that last one still cuts.) The reaction of the medical profession to this rumour-mongering is to close ranks in a stone wall of denial.
But, despite the shades of 1984, it’s not quite Armageddon yet. For a start, new cures are being found in the laboratories. And secondly, there is tea-tree oil. When my husband’s enormous and indescribably leaking wound was diagnosed, he was immediately put on a combination of three antibiotics. The wound showed no signs of healing.
Then one of my yoga students, who is a nurse, suggested we tried tea tree oil. We did. My husband put drops of oil in his bath and applied tea-tree ointment every couple of hours. Within a week the indescribable no longer needed describing, as the wound cleaned up and began to heal. It was amazing. I wondered why tea-tree oil hadn’t been suggested in the first place.
What has surprised me most in researching and writing this article has been the automatic defensiveness of anyone employed by the Department of Health as soon as the letters MRSA have been uttered in the same sentence as ‘I’m writing an article ...’ Mention of tea-tree oil has been met with utter incomprehension. Which just goes to show what an emotional and imaginative lot we still are, despite all our technology. Our district nurse, who is slightly more institutionalised than my yoga student, told me that though tea-tree oil has a nice smell (personally, I don’t think so at all - it smells of antiseptic) all evidence as to the effectiveness of tea tree oil is merely anecdotal. But I mustn’t quote her on that because she has a clause written into her contract preventing her from talking to the press and I don’t want her to lose her job, as she does a very good job. So don’t take this experience of ours as having any scientific basis. It was purely subjective. Perhaps the antibiotics decided to start working finally, after a fortnight. Don’t try this at home and all that, and if you do, it’s at your own risk, and I should tell you now that some people are allergic to neat tea-tree oil.
Whew. Unwittingly, I had stumbled on a minefield. I have spent the last twenty months crawling slowly through it, attempting to detonate some of the myths and mysteries in order that we may talk about MRSA without raising our blood pressure.
The Miracle Cure
In the beginning, antibiotics were hailed, quite rightly, as life-savers. Thousands and thousands of lives were saved. Medicine had joined the ranks of science, somewhere beyond the ken of ordinary folks, and entered the realm of magic. Doctors had the delight of seeing patients getting better where once they would surely have died. Penicillin was first ‘discovered’ by Alexander Fleming in 1928 - though an old country cure for infected wounds had long been to rub them with the mould of a citrus fruit. Research and development was not immediate, and meanwhile, in 1935, a German chemist called Gerhard Gomagk was working with sulphonamides. These, strictly speaking, are not antibiotics, as they do not kill bacteria directly, but they prevent them from reproducing. By the 1930s they were already proving miraculously effective in treating a range of infections from meningitis to VD. These sulpha drugs, as they are now known, were the foundation stone for some of today’s largest drug companies, but even by the end of the decade, the shortcomings were apparent - horrendous side effects, such as nausea, vomiting, sleep disorders and, more rarely, kidney, liver and eye failure - to name but a few. And, by the fifties, the drugs were proving fifty percent or more ineffectual: the bugs were already fighting back.
In 1944, the American Professor Selman Waksman isolated the antibiotic streptomycin, which was found to be effective against the great killer of the time, tuberculosis. Waksman enjoyed acclaim, fame and wealth as a result. Unfortunately, the side effects of streptomycin were not so widely publicised: kidney damage, allergic reactions, nausea, fever and ear damage, sometimes leading to loss of both hearing and balance. And because it was so much used, resistant strains were already developing by 1946. Still, better than being dead. Nowadays Streptomycin is regarded as pretty well useless and is rarely prescribed in the west, though it continues to be sold over the counter in the Third World. Meanwhile there is an untreatable strain of TB living comfortably in New York.
Out of Control?
The pattern was set. As one antibiotic waned in effectiveness and its side effects recognised, it would be quietly withdrawn from use in the west and replaced by another, while the surplus stock would be sold cheaply to the Third World. This is still going on today. Dysentery, which was a major worldwide killer in the 19th century, had nearly disappeared by 1920. Antibiotics, which at first proved effective in its cure, have now contributed significantly to the mutation of an antibiotic-resistant strain of dysentery. Lack of clean drinking water, closely allied with poverty (i.e., no money to pay for fuel to boil the water), is the major cause. Once again, it is a major killer - but only in the Third World, so far. Tens of thousands (check stats) die every year, most of them children, because of the scientific progress we have made in the west. When it gets to the ‘first world’, perhaps research will be done to combat it.
Though more care is being exercised as we become more educated about the flip-side of antibiotics, they are still overused. The fault is not necessarily medical: GPs are overworked, and people expect prescriptions. Sometimes people have to go through several prescriptions till they hit the one which is right for their infection. Sometimes it is easier for a doctor to fob someone off with a quick script than to explain to them the difference between viral and bacterial infections. Quite simply, antibiotics fight bacteria and not viruses. In the recent flu epidemic the casualty department of the local hospital was flooded with people coming in, expecting a magic scribble of the doctor’s hand to whisk them back to health. Patiently the people waited, only to be told to go back home to bed with a Lemsip. Posters have begun to appear on surgery walls: ‘Antibiotics do not cure colds or flu’.
It is rumoured that the government’s Standing Medical Advisory Committee has advised the medical profession to ease up on unnecessary prescriptions of antibiotics. Nonetheless, the fact remains that the supply is patient - sorry, client - led. In Glastonbury, where there is widespread mistrust of antibiotics, the doctors give visible thought to their prescription. Sometimes they are apologetic, sometimes they say, here’s a prescription, but only use it if you’re not improving by tomorrow. One poor locum, who had evidently been treated to a lecture on the evils of antibiotics by a previous patient, was quite aggressive when suggesting antibiotics might, in one case, be necessary. By contrast, a doctor in my home town of Marlow last summer automatically prescribed penicillin for a viral infection my daughter had, no questions asked. I didn’t dare point out that I thought penicillin was for bacterial infections, not viral, and have the prescription still. It serves as an ironic momento of my youth, when penicillin was poured lavishly onto my glandular fever, as lavishly as custard over school pudding. It did little for my glandular fever (and I had no secondary infection) but I am now immune to penicillin. This is a pity, since penicillin is in fact one of the milder antibiotics, and I do believe that antibiotics are wonderful in their right place. Like when I had mastitis, for example. Only a hundred years ago, mastitis, or ‘milk fever’, was a big killer; now we don’t even think about it.
I digress. A report issued on November 5th 1999 revealed the findings of two years of research: that over-prescription of antibiotics increases bacterial resistance. Geographical pockets of MRSA have been found to be directly related to the amount of prescriptions dished out by the local surgery. So: water is wet. But it’s nice to know the evidence is not anecdotal.
On a less visible level, antibiotics have become part of our daily life, whether we know it or not. Last year, the Soil Association published a report on the misuse of antibiotics in agriculture. They have been routinely used, both in crop sprays and as growth-promoters in the feed of all intensively farmed cattle since the 1950s. Rather than toning this down, government licence has recently been given to allow a previously little-used antibiotic to be fed to virtually every broiler in the country. As a result, antibiotics are flowing freely through the food-chain, in the water supply, lurking in our very plant-pots.
The rise and rise of Golden Staph
Consequently, MRSA is riding on the crest of a wave. Staphylococcus aureus itself, or ‘Golden Staph’, is everywhere, living on the skin - especially the armpit, nose and groin - of one in three people. One in nine of those carriers are harbouring the Superbug. MRSA means, as we have already seen, that it is resistant to Methicillin. Actually, it’s resistant to a bit more than that. When I began writing this, combinations of antibiotics were and still are being used, and the only antibiotic which could still stand up to it on its own was Vancomycin. Apart from the fact that Vancomycin is highly toxic, Vancomycin-resistant Staphylococcus aureus is now well established. The Superbug is resistant to most antibiotics - so far.
Bacteria in themselves are not necessarily a problem. They live all over us, in us, through us, with us. Our bodies are nine parts bacterial, one part human. MRSA is harmless to a healthy body, but when the immune system has been challenged by an operation, severe sickness or chemotherapy, especially in very young or very old people, it becomes more serious. Antibiotics are relied upon heavily to see the body through any of the above, yet hospitals are the major sources of MRSA infection - a simple case of supply and demand. As animals in the desert gather round a drinking hole, so MRSA feasts on the sick.
It is estimated that 9-10% of people who go into hospital are now at risk of infection. The doomsday scenario is obvious: that as the efficiency of antibiotics decreases and the likelihood of infection by untreatable MRSA increases, it could be that our sophisticated advances in surgery etc. be rendered useless.
Prevention is better than Cure
MRSA is passed on through shed skin scales; it could be passed on through the hands of doctors and nurses or it could be lurking on the sides of the hospital baths. It is able to survive quite a while (how long?) away from the warmth of a human body, making infection control difficult in the current, budget-restricted, hospital climate.
However, the government is now responding to increasing public alarm. On November 22nd, 1999, the government issued a new framework for managing hospital acquired infections in all NHS hospitals. In it, John Denham, the health minister, announced: ‘The idea that the ‘Superbugs’ are unbeatable is rubbish. With good practice and careful hygiene they can be beaten.’ Infection Control Teams (ICT) are to be set up in order to assess and address everything from fire safety to contractor control.
Underpinning everything however is hygiene. Hand washing with carbolic soap, which used to be such standard practice for nurses and doctors in my youth, seems to have fallen by the wayside. It is such a humble, ordinary, unexciting thing to be considered when compared with all the latex gloves, computers and CD ROMs around today. Yet if doctors simply washed their hands between seeing each patient, the spread of MRSA could be considerably minimised.
Tea Tree Oil
When Captain Cook and his crew arrived in Australia in the eighteenth century (check), they found (among other things) sick Aborigines bathing their wounds in the mud of hot springs into which had dropped the leaves of a particular tree. The British expedition infused the leaves of this tree to make a tea which proved effective against scurvy and various infections. Hence the name tea-tree. There are in fact about three hundred varieties of the tea-tree in Australia where it is in household use to this day. Australian troops serving in Asia during the second world war had it in their medical kits, where it became known as ‘the medicine kit in a bottle’. It was particularly effective against foot rot, but it was not until the mid-eighties that they began to cultivate it.
Tea tree oil is unique amongst essential oils in that it combats bacterial, viral and fungal infections. I first encountered tea tree oil in 1989 in India - an Australian girl kindly gave me a bottle, against what ailment I cannot recall. As I was unsure how to use it, I was carrying it around for a long time before it got used up. I was unaware, for example, that it could be used neat, but neat tea tree oil is very effective against cold-sores. Diluted in warm water it seems to clear up any skin complaints, and a 4% tea-tree oil solution absorbed by a tampon makes a marvelously effective pessaryr against thrush. Now a bottle lasts me a fraction of the time, and I have even adopted the Australian habit of adding it to a bucket of water to use as a household disinfectant. So much nicer than these gut-gobbling enzyme-rich cleaners that fast-talking celebrities insist we pour over our floors and down our toilets. Chemically, tea tree contains 48 organic compounds, including a high amount (68%) of terpines, which are antiseptic and germicidal; being 11 - 13 times stronger than carbolic, it makes an excellent hand-wash. It also contains alcohols in the form of monoterpines, which lend tea-tree its non-irritating, non-toxic and anti-viral properties. Having said that, again I should stress that a very small proportion of people are allergic to tea tree oil, and one should try a sample on a patch of skin before using it medicinally, just to check that one is not.
One of the advantages of tea tree oil is that it actually dissolves the pus but leaves the wound clean. This is unique, as most germicides destroy the tissue along with the bacteria. In my husband’s case, the tea tree oil ointment cleared up the pus very quickly and allowed the wound to begin healing.
Jean Tew, retired nurse, aromatherapist and masseur at Musgrove Park Hospital in Taunton, has promoted the use of tea tree oil in preventing hospital acquired infections. At least one surgeon in the cardiology department now routinely has his patients bathed pre-operatively with tea-tree oil - with the registrar’s permission. There are leaflets available in the surgical wards on the benefits of this practice, and post-operative infections are apparently lowering.
Stella Andersen, a herbalist who practises in Wales, has successfully treated a number of cases of MRSA using a dilution of tea tree oil. One octogenarian was suffering terribly with an internal MRSA infection following a hip replacement. Compresses of tea-tree oil, along with castor oil to allow penetration, were applied every few hours. The infection cleared up rapidly. The hospital were sceptical, and cut him open again, just to check. Yes, he was clear. Miraculously, he survived the second incision without re-contracting MRSA.
In an article in Nursing Times, 1997, Alison Mennie, RGN, writes about the use of tea tree oil at St. John’s Hospice in Doncaster. Tea tree oil was used for a large number of conditions, from mouth-washes for patients undergoing treatment for cancer, to MRSA. She comments that ‘the medical staff were sceptical at first’, but that the efficacy of tea-tree oil treatments has filtered through the hospitals and community staff in the area and its use is increasing.
It is interesting to notice that it is women, and, moreover, women who might be termed ‘alternative’ or ‘borderline’, who are promoting the use of tea-tree oil. They are not qualified to write articles in the Lancet, but they are increasing the anecdotal evidence.
Mainstream Use of Tea Tree Oil
Meanwhile, research has been done into the effectiveness of tea tree oil in the war on MRSA. A team of microbiologists at the University of Western Australia, led by Professor Tom Riley, proved as early as 1993 that Melaleuca alternifolia (to give tea tree oil its Latin name) is effective in killing the Superbug bacteria. Patients with MRSA were divided into two treatment groups. Of the group receiving routine care (ie. Tricolsan body washes and Mipurocin nasal ointment thrice daily), two recovered, five remained chronic and five were incomplete. Of the group receiving intervention care (ie. body washes of tea tree oil and applications of tea tree nasal ointment), 6 were cleared, three remained chronic and two were incomplete. The results were announced at the HIS (Hospital Infection Society) in Edinburgh in 1998. More research has been and is being done, but it will probably take a lot more before any implementation takes place.
A team of microbiologists at theUniversity of East London have taken samples of MRSA from hospitals and public health laboratories across the UK and compared the effects of tea tree oil with those of Vancomycin. Preliminary findings are proving that tea tree oil is both effective and safe, whereas Vancomycin is losing its effectiveness but not its toxicity.
Well, tests must be done, of course. It is a system established to prevent dangerous substances being issued to an unsuspecting public. One only has to consider the case of thalidomide to realise that. And one only has to consider that thalidomide is still being administered in ‘third world’ countries to realise that morality can sometimes be an empty word.
Another advantageous outcome is that tea-tree oil is relatively cheap. As Alison Mennie points out, patients recover more quickly when treated with tea tree oil, thus reducing the overall cost of their palliative care. A very practical reason for taking tea-tree oil seriously? Well - here comes the shady, anecdotal part.
I was surprised that tea-tree oil is not more widely recognised and used - until I was informed, in a roundabout sort of way, that yes, the hospital where my husband picked up the Superbug has done substantial testing, the results of which demonstrate that tea tree oil is the most effective way of combating MRSA. They don’t choose to advertise the fact because they are in the thrall of the big drug companies. Apparently these giants supply computers and other expensive equipment, on the tacit understanding that their drugs will continue to be prescribed.
Interestingly, following an alarmist story on the Superbug four years ago in the Daily Telegraph, Essential Oils of Oxford wrote pointing out that actually, tea-tree oil has been laboratorily tested and proved substantially effective against this apparently indestructible monster. There was no response and no follow-up article.
Another funny thing is the reaction of the Department of Health press office to my enquiries concerning MRSA - never mind tea tree oil. Four months ago I spoke to them, and was told I must fax my questions, which were, and remain:
- Has any research been done into alternatives to antibiotics in the fight against MRSA?
- More specifically, has any research been done into the effectiveness of tea tree oil?
- Though it is used in some hospitals, how official is this? Are there any government directives on the use of alternatives to antibiotics?
- Has any research been done at Musgrove Park Hospital, Taunton, into the effectiveness of tea tree oil against MRSA?
- If any research has been done anywhere into the possibility of using tea tree oil to counteract MRSA, what are the results?
- How important is the influence of big drugs companies in the battle against MRSA?
- Do the big drugs companies fund research?
- Do they supply any incentives to hospitals to keep on using antibiotics rather than finding alternatives? (ie. do they supply computer equipment etc. on the tacit understanding that doctors will continue to rely heavily on their products?)
There was no reply. When I phoned, I was told that various people were dealing with my enquiries. No reply. I phoned these people. Many times. Mysteriously they were always out of the office. Once I got hold of Alison Pitts-Bland, senior information Officer of the NHS Media Centre. She wanted to know what MRSA stood for.
I told her. I also mentioned its common or garden name: the Superbug. ‘Well, how am I supposed to know what it stands for?’ she demanded, with what is usually termed in novels as asperity. ‘Perhaps because you’re the senior information officer of the NHS Media Centre, and MRSA gets considerable press coverage, most of it negative?’ I suggested.
‘But we don’t know every spit and cough and we’re not doctors either,’ she responded. In a sea of Blairspeak (i.e., all style, dodgy euphemisms and no substance) this was treasure. ‘Great!’ I replied. ‘Can I quote you on that?’
She laughed, but she didn’t say no. So there you go. With some more badgering, I was eventually faxed the latest government guidelines on MRSA and some rather negative press coverage of the same. The rest was silence. The thought of picking up the phone again and dialling the denial centre just makes me weary. The refusal to respond is the most eloquent response I have had.
I am not out to prove a government conspiracy. The silence is probably due more to embarrassment than anything else. Moreover, solutions to the Superbug are being found. For example, three new antibiotics are about to come on the market which do kill the Superbug. The reason they were not there five years ago is that, while antibiotics were still effective, they stopped researching new ones. When their inefficiency became apparent, new ones were developed. Because of the length of time it takes to make sure a product is ‘safe’, the new antibiotics are only just being introduced.
What’s more, there is another solution to the Superbug: bacteriophages. These are viruses parasitic upon bacteria, which, by infecting and then reproducing inside the Superbug, destroy it. They have been in use in Russia for the last twenty years. When I mentioned this to the one person ( the only man, interestingly) who would speak to me at the DOH Media Centre, he had no idea of what I was talking about.
Well, we do live in interesting times - a Chinese euphemism for chaos. According to the Vedic tradition, we are now in Kali Yug - the age of destruction. In defence of modern life we cite advancement in the fight against disease, improved medical treatment, higher standard of living, longer lifespans, etc. etc. Some medical treatment available in the west is little short of miraculous, and yet all of it could become impossible if the Superbug has its way. An alarmist message. I really feel the main conspiracy is that of fear.
The positive side of the interesting times is that the status quo is being challenged. Though big drug companies may seem to be ‘getting away with it’, more and more people are querying the omniscience of doctors and more and more doctors are recognising the value of alternatives to conventional medicine in the healing process. Currently, there is a clear need for more assessment of alternative therapies in order to sort the valid from the quacks.
As always, humanity is on the cusp of change. I have no doubt whatsoever that the ancient gifts of tea tree oil will eventually be proven, recognised and in widespread use. Nor do I have any doubt that new solutions will arise which are quite unthinkable at the moment. And it is inevitible that, as long as we tip the balance of Nature, Nature will fight back.
Personally I believe that the solution lies, not in laboratory retorts and reports, but in the crucibles of our own being. I wish I was an Aborigine, lying in the tea-tree infused mud of the hot-springs, and that Captain Cook had never come. But he did, and here we are: living in a world ruled by drug companies where children die for lack of clean water. The real fight is not between Golden Staph and Tea Tree oil but between self-pity and responsibility. To allow the latter to win, we have to stop blaming hospitals, doctors, the DOH - even drug companies. Neither should we blame ourselves, for blame is always divisive. Only by taking responsibility for our own lives can we take the first individual steps towards a collective solution.