Public awareness of C. difficile must rise


Most bacteria never have a breakout year. But when the nerve center for the nation’s fight against deadly diseases last fall ranked C. diff. first among the three most “urgent” threats to public health, an overdue spotlight shone on an epidemic that much of the press overlooked for decades.

Scientists at the Centers for Disease Control and Prevention (CDC) weren’t the only ones calling attention to the threat from C. diff last year. Comedian Tig Notaro made headlines for her darkly sarcastic stand-up performance highlighting her own bout with the superbug.

Then in December, HBO began airing the somber workplace comedy “Getting On,” set in the long-term care ward of a Southern California hospital. The show is the first major television program to mention C. diff. routinely in its scripts.

What accounts for this breakthrough? First, the show originated in Britain in 2009, to rave reviews. Public debate about C. diff., and the system of mandatory disclosure of statistics regarding its prevalence at caregiving facilities, is much stronger in the U.K. Second, it’s not coincidental that the original show had three women at its helm as writers and performers. Not only do women make up the lion’s share of the long-term care workforce in both the U.K. and U.S., who do battle daily with the disease while adhering to commonsense precautionary measures. But also, women–in part because of longer lifespan and the heightened risk of C. diff. exposure in geriatric care environments where they predominate — are the majority of reported C. diff. cases and fatalities.

More than 28,000 Americans will die of C. diff. this year. The disease involves a common bacteria transmitted through bodily fluids. Most people’s digestive tracts contain bacteria that counteract C. diff. and keep it in check. But some antibiotics kill the counteracting bacteria, which can allow C. diff. to flourish, gradually taking over the intestines. C. diff. infections, or CDIs, manifest with flu-like symptoms that include fever, abdominal cramps, and diarrhea. Unrecognized and without proper treatment, a CDI can prove deadly within just a few days. Regular hand-washing with soap, thorough cleaning using chlorine (since alcohol-based rinses do not kill C. diff.), and limiting antibiotic use help prevent C. diff.

Like “The Office,” the long-running NBC series that also originated with the BBC, “Getting On” draws humor from awkward dynamics among co-workers. In the first two episodes of the program in the U.S., C. diff. was mentioned nearly often enough to be considered a cast member. Indeed, the disease figures prominently in the profile of the foremost character. For the growing coalition of public-health advocates, the show is a welcome addition to the cable lineup. We need network programming and producers in other media to follow suit.

The fight against deadly superbugs is in part a fight for the media spotlight. In order for America to mount the full-scale effort to recognize and prevent C. diff., public awareness about the disease must rise. Silence about the disease, because its symptoms involve defecation, is no laughing matter. Prominent and recurring media attention to C. diff. is absolutely indispensable to stopping it.

Christian John Lillis is co-founder and director, The Peggy Lillis Memorial Foundationthe first national organization dedicated to reducing and eradicating Clostridium difficile infections, or CDIs, through education and advocacy.


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