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Illnesses could affect many things that are normal to us. Like going to the store, there  could be an illness anywhere. On the counters, on the shopping cart and even say in the meat. 

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Illnesses could affect many things that are normal to us. Like going to the store, there  could be an illness anywhere. On the counters, on the shopping cart and even say in the meat. 

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Illnesses could be lethal, they could mutate, even some from thousands of years ago could still be around. A illness that killed 30% or more of a continent's population. What dangers could they bring to society? 

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Illnesses could be lethal, they could mutate, even some from thousands of years ago could still be around. A illness that killed 30% or more of a continent's population. What dangers could they bring to society? 

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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Illnesses are pretty hard to take care of but easy to prevent. Even small things like washing your hands could be helpful to prevent major illnesses.

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Illnesses are pretty hard to take care of but easy to prevent. Even small things like washing your hands could be helpful to prevent major illnesses.

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It's not like anybody believes their shopping carts are clean. Most supermarkets place a dispenser of sanitizing wipes nearby, as if to hint at the exact opposite.

But in case you were on the fence, yes, they're gross.

A study of 85 random shopping carts conducted by Dr. Charles P. Gerba found that 50 percent carried E. coli, while 72 percent contained coliform bacteria. "The exceptionally high level of coliform bacteria suggests that fecal material may be involved in cart contamination," the report further stated.

In other words, your cart most likely harbors bathroom germs.

According to Donna Duberg, an assistant professor of clinical laboratory science at Saint Louis University, these pathogens find their way into our carriages through a number of avenues. "Certainly children can be a source of the germs," she explains, as toddlers often ride in carts when accompanying their parents, but Duberg doesn't downplay the role of the consumers either. "We may bring in germs with our hands," she adds.

Depending on our immune systems, many of these pathogens have the potential to make us sick, too. "Especially the fecal coliforms," notes Elizabeth Scott, an assistant professor of biology at Simmons University in Boston. "The concern is that we can pick up pathogens from the cart that can be transmitted directly to our mouths or to other foodstuffs."

Is this really that big of a concern, though? Germs are everywhere, from to They're always going to be present, so how bad could a shopping cart be?

Duberg cites Gerba's findings for the answer: "[There are] 138,00 total bacteria per square inch of a shopping cart - an amount which exceeds the number of bacteria in the average public restroom," she says. "These are fecal bacteria capable of causing illness."

Unfortunately, fecal germs aren't the only bacteria to be wary of. "There are bacteria capable of causing food-borne illnesses such as Salmonella, Shigella, Listeria, and, of course, E. coli O157H7 that may be hiding in the food we are purchasing, especially the fruits and vegetables and raw meats," says Duberg. "You can tell by doing a quick scan of food recalls," such as these online safety alerts posted by the FDA, she adds.

Taking both fecal and food-borne pathogens into account, it's no wonder there are disinfecting wipes in almost every supermarket. But as it turns out, they may not be as effective as we think.

"In theory, it's a good idea, but rather hard to achieve," explains Scott. "Where do you apply the disinfectant? How effective is the disinfectant? It's much better to practice careful hand hygiene and use alcohol hand sanitizer and hand washing."

Duberg adds that most of the wipes are utilizing benzalkonium chloride - and not bleach or alcohol - a disinfecting agent. This means that in order to sanitize, shoppers should be thoroughly wetting the surface areas (handles, grates, coffee cup holders) with the wipes. But if a shopper wanted to disinfect, Duberg says most brands of benzalkonium chloride recommend you leave the surfaces wet for up to four minutes.

The good news, she adds, is that if you thoroughly wet the surfaces with a benzalkonium chloride wipe, "you're going to get way over 99 percent" of the germs.

Or, if you'd rather skip that step, you can just grab a hand-held basket instead. Baskets might contain the same pathogenic bacteria as a cart, but as Scott says, "If it's baskets vs. carts, at least baskets aren't used to carry kids."

But just to be safe, you should probably make time to wipe down the basket, too.

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Maybe a bit grosser than you initially thought.

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Even though it isn't guaranteed to cause health problems, there are quite a few gross things that can happen when you don't wash your hands. Because, as we all know, germs are everywhere. And it often doesn't take much to pick them up throughout the day, or pass them along to others.

Thankfully, the immune system usually steps in before bacteria and viruses can do any real damage. But if you aren't washing your hands regularly, you may be unnecessarily putting yourself at risk. After all, "the number one way to prevent disease is hand washing," Dr. Elizabeth Trattner, tells Bustle. So even though it can be easy to put it off, it's much healthier to pop off to the bathroom and give your mitts a quick scrub, especially after coming in contact with dirty surfaces or if you happen to be sick.

"The best hand washing technique is to rinse hands under warm water, then lather with soap for 20 to 30 seconds, getting all areas of the hands," Brianne Bell, registered dietician and food service supervisor, tells Bustle. "Rinse under warm water and dry with a clean towel." That should help reduce the risk of all the gross things below, which may be more likely to happen if you don't wash your hands.

1. You Might Catch More Colds

According to the Centers for Disease Control and Prevention (CDC), about 80 percent of infectious disease is spread by touch. And really, all it takes is the simple act of grabbing a germ-riddled doorknob and then touching your nose, in order to get infected. So let this serve as motivation to whip out the soap on a more regular basis, not only for your own sake, but for everyone else's health as well.

Of course, that doesn't mean you need to become paranoid. Most of the time your body protect you from germs, especially if your immune system is strong. But even still, washing up whenever you've been around someone with a cold is always a good idea.

2. Fecal Matter Can End Up In Your Food

It's a gross truth, but fecal matter is lurking in more places than you might think - including your hands. And rather disgustingly, those particles can get into food and make you sick, according to the CDC.

It may not be something you want to imagine. But as long as you're washing your hands after using the bathroom, changing a diaper, walking your dog, or even using public transportation, you should be able to lower your risk.

3. You Could Get Or Spread Food Poisoning

There are many ways to come down with a case of food poisoning, including eating undercooked meats, or food that has gone bad. You can also get pretty darn sick by preparing meals with dirty hands. (See above information about fecal matter).

According to the CDC, a large percentage of food-borne disease outbreaks are spread by contaminated hands. But appropriate hand washing practices can reduce the risk of food-borne illness and other infections. So do yourself, and everyone else, a huge favor by washing before you handle food.

4. You're Infecting Everyone You Touch

Sure, it's polite to cover your sneeze with your hand than it is to let if fly. And yet, how often do you really wash up after doing so? It's easy to forget, or to touch a few surfaces first - and just like that the germs spread.

Again, hand washing is the best way to prevent the transfer of disease, which is why "this is one of the first things you learn in medical school or in any health profession," Dr. Trattner says.

In a pinch, using hand sanitizer can cut back on the transfer of germs, Bell says. But nothing beats a good ol' scrub when it comes to reducing the amount of bacteria and viruses on your hands.

5. You Can Get Pink Eye

Pink eye, also known as conjunctivitis, is an eye infection many people catch in elementary school, mostly because it's highly contagious and thus spreads like wildfire among kids. But adults can get it, too.

In fact, often all it takes is a quick moment of hand-to-eye contact when you have an infected person's secretions on your hand, according to the American Academy of Ophthalmology, before the typical symptoms of redness, itchiness, and pus in the eyes will begin.

6. Your Snacks Can Get Contaminated

Think of all the times you've plunged a dirty hand into a bag of chips, box of crackers, or bowl of popcorn. If you aren't washing your hands, it's so easy to contaminate these shared foods with germs, according to the New York State Department of Health.

This is also why you may not want to share food or utensils with someone who is sick, especially if they have the norovirus. According to the CDC, if you get the norovirus illness, you can shed billions of norovirus particles that you can't see without a microscope, and it only takes a few of these particles to make people sick.

7. You Might Pick Up Hepatitis A

Not washing your hands can also lead to hepatitis A. "This is a serious liver virus that spreads when people do not wash their hands before making food and drinks," Dr. Tania Elliott, board-certified allergist/immunologist at NYU Langone Health, tells Bustle. "It also spreads through sexual contact with people who have hepatitis A, and by eating foods contaminated with the virus."

You can, however, make it less likely to happen. As Dr. Elliott says, "Washing your hands with soap and warm water after using the bathroom, changing a diaper, or before making food and drinks can help stop the spread of hepatitis A."

8. Diarrhea May Become A Frequent Visitor

Not washing your hands regularly can increase your chances of catching an illness that leads to diarrhea. One of these might be shigellosis, a bacterial infection with symptoms that include watery diarrhea, abdominal cramps, and fever, according to the CDC.

There is good news, though, in that simply washing your hands - especially after coming in contact with germ-y surfaces - can prevent about 30 percent of diarrhea-related sicknesses, the CDC says.

9. You Might Catch The Epstein-Barr Virus

We talked about poop in your food. Now what about urine, or saliva? Turns out, these are carriers of diseases like typhoid, cytomegalovirus, and Epstein-Barr virus, which are spread by contaminated hands, according to the CDC.

Epstein-Barr is the virus that causes mononucleosis, AKA the "kissing disease," which can lead to fever, weakness, swollen neck glands, and fatigue that lasts for weeks. "This is spread through saliva, so kissing, sharing food or beverages, or touching something with saliva on it are all ways in which it can be transmitted," Dr. Elliott says. "Hand washing, especially after touching the face and mouth [...] can help prevent the spread."

10. It Could Contribute To Antibiotic Resistance

According to the CDC, reducing the number of infections people get by washing your hands can help prevent the overuse of antibiotics, which is the single most important factor leading to antibiotic resistance around the world.

"Antibiotics are often overused when someone has a viral infection (remember, antibiotics only fight bacterial infections, not viruses)," Dr. Elliott says. "So, the fewer viral infections (by proper hand washing and other sanitary measures), the less use of unnecessary antibiotics."

In fact, hand washing can also prevent people from getting sick with germs that are already resistant to antibiotics and that can be difficult to treat, according to the CDC. So help out everyone on the planet, and wash your those hands!

11. Acne Can Crop Up

Not washing your hands can also increase the chances of an acne breakout, all thanks to the way bacteria can transfer from your hands to your face.

"Touching, rubbing, and picking [at the] face are common causes for more acne," Dr. Yoram Harth, board-certified dermatologist and medical director of MDacne, tells Bustle. "When the hands are not washed, the bacteria on the skin of our hands spread to the face and can cause more acne."

Germs truly are lurking around every corner. And they can obviously cause and spread all sorts of diseases, from the common cold, to the norovirus, and even hepatitis A. But by getting into the habit of washing your hands regularly - especially before touching food - you may be able to enjoy a more germ-free life.
This post was originally published on 4/12/2016. It was updated on 6/7/2019.

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11 Gross Things That Can Happen When You Don't Wash Your Hands Enough

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Even though it isn't guaranteed to cause health problems, there are quite a few gross things that can happen when you don't wash your hands. Because, as we all know, germs are everywhere. And it often doesn't take much to pick them up throughout the...

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Illnesses and diseases have always been treated with antibiotics, but what happens when the world encounters an otherworldly virus or if illnesses evolve into something more than humans could handle?

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Illnesses and diseases have always been treated with antibiotics, but what happens when the world encounters an otherworldly virus or if illnesses evolve into something more than humans could handle?

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alien A non-native organism. (in astronomy) Life on or from a distant world.

annual Adjective for something that happens in every year.

astronaut Someone trained to travel into space for research and exploration.

constant Continuous or uninterrupted.

Enceladus The sixth largest of Saturn's more than 50 moons. Enceladus is bright white and covered with a thick shell of ice. Deep beneath that ice sits what appears to be a global ocean of salty liquid water. Enceladus is a round sphere, 500 kilometers (310 miles) across. It is a little less than one-third the width of Earth's moon.

environment The sum of all of the things that exist around some organism or some device and the condition those things create for that organism or device. Environment may refer to the weather and ecosystem in which some animal lives, or, perhaps, the temperature, humidity and placement of components in some electronics system or product.

Europa One of the moons of Jupiter and the sixth-closest satellite to the planet. Europa, 1,951 miles across, has a network of dark lines on a bright, icy surface.

extraterrestrial (ET) Anything of or from regions beyond Earth.

extremophile A microorganism that lives in conditions of extreme temperature, acidity, alkalinity or concentrations of chemicals.

germ Any one-celled microorganism, such as a bacterium, fungal species or virus particle. Some germs cause disease. Others can promote the health of higher-order organisms, including birds and mammals. The health effects of most germs, however, remain unknown.

geyser A vent (opening) in Earth's surface that intermittently sends up a tall spray of steam or hot water. The sometimes explosive discharge of water and steam is propelled by the geothermal heating of water below ground.

Jupiter (in astronomy) The solar system's largest planet, it has the shortest day length (10 hours). A gas giant, its low density indicates that this planet is composed of light elements, such as hydrogen and helium. This planet also releases more heat than it receives from the sun as gravity compresses its mass (and slowly shrinks the planet).

lander A special, small vehicle designed to ferry humans or scientific equipment between a spacecraft and the celestial body they will explore.

Mars The fourth planet from the sun, just one planet out from Earth. Like Earth, it has seasons and moisture. But its diameter is only about half as big as Earth's.

microbe Short for microorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

NASA Short for the National Aeronautics and Space Administration. Created in 1958, this U.S. agency has become a leader in space research and in stimulating public interest in space exploration. It was through NASA that the United States sent people into orbit and ultimately to the moon. It also has sent research craft to study planets and other celestial objects in our solar system.

orbiter A spacecraft designed to go into orbit, especially one not intended to land.

organism Any living thing, from elephants and plants to bacteria and other types of single-celled life.

planet A celestial object that orbits a star, is big enough for gravity to have squashed it into a roundish ball and has cleared other objects out of the way in its orbital neighborhood. To accomplish the third feat, the object must be big enough to have pulled neighboring objects into the planet itself or to have slung them around the planet and off into outer space. Astronomers of the International Astronomical Union (IAU) created this three-part scientific definition of a planet in August 2006 to determine Pluto's status. Based on that definition, IAU ruled that Pluto did not qualify. The solar system now includes eight planets: Mercury, Venus, Earth, Mars, Jupiter, Saturn, Uranus and Neptune.

robot A machine that can sense its environment, process information and respond with specific actions. Some robots can act without any human input, while others are guided by a human.

satellite A moon orbiting a planet or a vehicle or other manufactured object that orbits some celestial body in space.

Saturn The sixth planet out from the sun in our solar system. One of the four gas giants, this planet takes 10.7 hours to rotate (completing a day) and 29 Earth years to complete one orbit of the sun. It has at least 53 known moons and 9 more candidates awaiting confirmation. But what most distinguishes this planet is the broad and flat plane of seven rings that orbit it.

science fiction A field of literary or filmed stories that take place against a backdrop of fantasy, usually based on speculations about how science and engineering will direct developments in the distant future. The plots in many of these stories focus on space travel, exaggerated changes attributed to evolution or life in (or on) alien worlds.

terrestrial Having to do with planet Earth, especially its land. Terra is Latin for Earth.

viable Able to live and survive. (in biology) Able to survive and/or live a normal lifespan.

weed (in botany) A plant growing wild in, around - and sometimes smothering over - valued plants, such as crops or landscape species (including lawn grasses, flowers and shrubs). Often a plant becomes such a botanical bully when it enters a new environment with no natural predators or controlling conditions, such as hard frosts. (in biology, generally) Any organism may be referred to as a "weed" if it enters an environment and begins to overwhelm the local ecosystem.

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Keeping space missions from infecting Earth and other worlds

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Scientists are always looking for ways to stop Earthly microbes from polluting other planets. The same goes for bringing bits of other planets back to Earth.

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Bacteria and other microbes can make us sick. But there's a lurking danger with some germs that's far more frightening than a bout of food poisoning or an infected wound. Today, drugs exist to fight most of these germs. They're called antibiotics. Before these medicines came along, common infections frequently killed people. And that's where the danger lies: What will happen if antibiotics no longer kill germs?

Already some antibiotics have lost their superpowers. Many others are beginning to lose theirs. Biologists describe this problem as resistance. Across the globe, germs are becoming resistant to antibiotic medicines. In a sense, these "superbugs" have begun to laugh at those former wonder drugs.

But resistance is no laughing matter. As germs toughen up against drugs that are supposed to slay them, treatable conditions such as TB - tuberculosis - can spread. And surgeries that rely on antibiotics could turn from life-saving to life-threatening.

The threat is huge

"Alarming levels" of drug-resistant bacteria already exist in many parts of the world. That's the conclusion of a 257-page report published in April. It was issued by the World Health Organization (WHO).

This United Nations agency, based in Geneva, Switzerland, recently reviewed how well these germ slayers perform in 114 countries. In some places, it found, antibiotics no longer work for half of all people being treated against common diseases. Those diseases include pneumonia and gonorrhea.

The Centers for Disease Control and Prevention (CDC), based in Atlanta, Ga., also has been investigating the problem . It estimates that in the United States alone, antibiotic-resistant infections now sicken some two million people each year. At least 23,000 of them die.

But even antibiotic-resistant germs that don't kill can be a problem. Their infections become harder to treat - and more expensive. Consider one estimate - $233 million - published May 20 in the journal Antimicrobial Resistance and Infection Control. That's how much researchers calculated that it costs the United States each year to deal with just one resistant superbug. That germ causes a lung disease known as pneumonia.

Drug-immune bugs that flourish in the human gut can enter the environment with every flush of the toilet. Researchers discovered how big this problem is when they analyzed wastewater from 11 sites in one French city. Antibiotic-resistant bacteria tainted 96 percent of their samples. A May 1 paper in Clinical Infectious Diseases describes the disturbing details.

Some scientists have scouted for such germs in the environment. They collected superbugs at hospitals. Then they probed the germs, identifying parts of their genes that appear to make them resistant to antibiotics. Next, the researchers looked in the outdoor environment for that same genetic fingerprint of superbugs. And they turned up that superbug DNA in 71 places - from the soil and sea water to human wastes. The researchers reported their findings May 8 in Current Biology.

Why it's happening

Drug designers have created antibiotics to kill bacteria, as well as some fungi and other germs. But sometimes, a few treated germs survive. They survive because they're stronger. Or they may have certain genetic mutations that allow them to break down the drug. They might even have evolved a way to keep the drugs from harming their operational machinery. Over time, all germs susceptible to a drug will die off. That will leave behind only superbugs - those microbes that medicines can't kill.

This is not surprising. In fact, it's quite natural. Part of evolution, it's known as survival of the fittest.

Scientists stumbled onto the first antibiotic, penicillin, around 1930. Since then, research has produced a medicine cabinet full of additional ones. It appeared that these would make many of the worst bacterial infections ever more manageable. So, during the 1970s, drug developers began focusing on noninfectious health problems, such as cancer and heart disease. As a result, in the past 30 years, no new types of antibiotics have been developed.

Right now, bacteria are outsmarting antibiotics faster than developers can make new ones. And there are no signs things will change, says Stewart Cole. He directs the Global Health Institute at the Ecole Polytechnique Fédérale de Lausanne in Switzerland.

Writing in the May 12 Philosophical Transactions of the Royal Society B, he argues that the "golden age" of antibiotic development "is a distant memory, and the likelihood of there being another seems slim." This lack of new types of germ killers, he says, has been allowing superbugs to morph and thrive.

One of the most famous of them is known as MRSA (pronounced MER-sah). The letters stand for methicillin-resistant Staphylococcus aureus . Methicillin is a widely used antibiotic. And Staph aureus is a germ that can cause boils, food poisoning, toxic-shock syndrome and more. These bacteria sicken (and sometimes kill) by releasing potent natural poisons - called toxins - into the body.

Despite its name, MRSA is resistant to far more antibiotics than just methicillin. That makes this superbug particularly nasty in hospitals and prisons. These are places where people often have open wounds or weak immune systems. Both increase a person's chance of picking up an infection.

Too much of a good thing

Drug resistance can develop at any time. But its likelihood climbs as the use of an antibiotic increases. And this is especially true when an antibiotic is overused. That's when a doctor prescribes it for infections it has no hope of curing.

For instance, doctors sometimes prescribe antibiotics to treat an infection before they learn if the disease is caused by bacteria. If viruses are responsible, then antibiotics will be useless. The reason: Antibiotic medicines do not kill viruses. Yet by giving an antibiotic to someone with a viral infection, that drug will reach good bacteria living in our bodies. And over time, some of these bacteria will become resistant to the drug.

Last year, the CDC reported that up to half of the antibiotics that U.S. doctors prescribed went to people who didn't actually need them.

Take, for example, someone who visits a doctor for a lingering cough. Viral infections cause most coughs. So a viral cough won't be helped by drugs and will tend to go away on its own. Yet 71 percent of the time, doctors will still prescribe antibiotics for patients coming in with a common cough, a May 21 study finds.

"I think there's this perception among both doctors and patients that coughs don't go away without antibiotic treatment," Jeffrey Linder told Science News for Students . Linder, who coauthored the new report, is a doctor at Brigham & Women's Hospital in Boston, Mass. He and Michael Barnett, also from the hospital, tracked the drugs that doctors prescribed during more than 3,000 U.S. clinic visits between 1996 and 2010. They reported their findings in the Journal of the American Medical Association .

A small number of people who visit a doctor with a cough turn out to have bacterial pneumonia. These cases do require antibiotic treatment. But Linder says doctors should easily be able to recognize these few from the hordes of people coming in with a routine, viral cough.

Perilous profit

Antibiotic overuse also has become a problem on farms. In the United States, animals - not people - receive about 80 percent of all antibiotics. Sometimes the drugs are used to save an infected animal or prevent disease from spreading through a herd. More often, though, feed suppliers put small amounts of these drugs into the food that will be given to healthy animals. These antibiotics help speed the animals' growth. And this has boosted farmers' profits.

But using antibiotics just to beef up livestock is "a direct threat to human health," argues Kellogg Schwab. He's an environmental microbiologist at Johns Hopkins University in Baltimore, Md. Earlier, he and his coworkers detected bacteria that are resistant to antibiotics in the exhaust air blowing out of farm buildings. That suggests these superbugs can spread through the air from animals to people.

SteveOehlenschlager / iStockphoto

Germs that are immune to antibiotics also can hitch a ride into your body through ground beef or the chicken breast on your cutting board. Biologists have found that much of the fresh beef, pork and poultry sold in grocery stores contains bacteria resistant to antibiotics.

Even if those germs don't sicken us or cause other immediate harm, they can offload their resistance genes into other bacteria that normally live inside our bodies. Sometimes, like with the MRSA superbug, resistance is carried on circular pieces of DNA called plasmids. These plasmids can slip easily from one bacterial cell into another.

In this way, our gut microbes can become "a reservoir of resistance," says Sharon Peacock. She's a microbiologist at the University of Cambridge in England. Later, "when we actually get sick and need an antibiotic, we may already carry a resistance gene" that may keep that drug from working, she says.

In the United States, farmers have fought against banning antibiotics as growth promoters. They say it will reduce their profits because more animals will get sick, slowing their growth. But that's not been the experience in other countries.

The U.S. Food and Drug Administration, or FDA, has proposed banning antibiotic use in healthy animals. But for more than 30 years, the livestock industry and Congress have fought such action. Recently, the FDA stepped up its efforts to end this practice.

In December 2013, FDA laid out a plan to phase out within three years the use of antibiotics on farms to boost livestock growth. Its stated reason: concern that farm use of these drugs has made more germs immune to the antibiotics needed to fight life-threatening infections in people. And that's a worry because the same germs that sicken animals often sicken people.

Antibiotic resistance is a complex and growing problem. Many microbiologists worry that the time when antibacterial medicines no longer work could be coming. Thankfully, doctors and many patients are becoming more aware of the problem. Researchers also are hard at work creating new tools to keep superbugs from taking over.
Next: How scientists are trying to tackle the problem
Power Words

antibiotic A germ-killing substance prescribed as a medicine (or sometimes as a feed additive to promote the growth of livestock). It does not work against viruses.

bacterium (plural bacteria) A single-celled organism forming one of the three domains of life. These dwell nearly everywhere on Earth, from the bottom of the sea to inside animals.

boils (in medicine) A skin infection that starts as a hard, red, painful lump. Eventually, it gets bigger, softens and fills with pus. A common source of these is a bacterium known as Staphylococcus aureus.

bioengineer A researcher who applies technology for the beneficial manipulation of living things. Bioengineers use the principles of biology and the techniques of engineering to design organisms or products that can mimic, replace or augment the chemical or physical processes present in existing organisms. This field includes researchers who genetically modify organisms, including microbes. It also includes researchers who design medical devices such as artificial hearts and artificial limbs.

Centers for Disease Control and Prevention, or CDC An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.

cholera A bacterial disease that infects the small intestine, causing sever diarrhea, vomiting and dehydration. It is spread by germs from feces that contaminate water or food.

DNA (short for deoxyribonucleic acid) A long, spiral-shaped molecule inside most living cells that carries genetic instructions. In all living things, from plants and animals to microbes, these instructions tell cells which molecules to make.

evolution A process by which species undergo changes over time, usually through genetic variation and natural selection, that leave a new type of organism better suited for its environment than the earlier type. The newer type is not necessarily more "advanced," just better adapted to the conditions in which it developed.

fungus (plural: fungi) Any of a group of unicellular or multicellular, spore-producing organisms that feed on organic matter, both living and decaying. Molds, yeast and mushrooms are all types of fungi.

gene A segment of DNA that codes, or holds instructions, for producing a protein. Offspring inherit genes from their parents. Genes influence how an organism looks and behaves.

germ Any one-celled microorganism, such as a bacterium, fungal species or virus particle. Some germs cause disease. Others can promote the health of higher-order organisms, including birds and mammals. The health effects of most germs, however, remain unknown.

gonorrhea A serious disease that can infect the genitals, rectum and throat. This sexually transmitted disease is very common, especially among people between the ages of 15 and 24. Untreated, it can cause infertility or death. "Untreated gonorrhea may also increase your chances of getting or giving HIV - the virus that causes AIDS," according to the U.S. Centers for Disease Control and Prevention.

growth promoter (in livestock agriculture) A medicine, usually an antibiotic, added in small doses to the feed given to animals raised for meat. Used as a preventive medicine, it can reduce the risk that animals will become sick, which would slow their growth. And that would decrease a farmer's profits.

immune system The collection of cells and their responses that help the body fight off infection.

infection A disease that can be transmitted between organisms.

influenza (or flu) A highly contagious viral infection of the respiratory passages causing fever and severe aching. It often occurs as an epidemic.

livestock Animals raised for meat or dairy products, including cattle, sheep, goats, pigs, chickens and geese.

microbe Short formicroorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

microbiology The study of microorganisms, principally bacteria, fungi and viruses. Scientists who study microbes and the infections they can cause or ways that they can interact with their environment are known as microbiologists.

mutation Some change that occurs to a gene in an organism's DNA. Some mutations occur naturally. Others can be triggered by outside factors, such as pollution, radiation, medicines or something in the diet. A gene with this change is referred to as a mutant.

plasmid A small circular loop of DNA that is separate from the main chromosomal DNA of bacteria.

pneumonia A lung disease in which infection by a virus or bacterium causes inflammation and tissue damage. Sometimes the lungs fill with fluid or mucus. Symptoms include fever, chills, cough and trouble breathing.

resistance (as in drug resistance) The reduction in the effectiveness of a drug to cure a disease, usually a microbial infection. (as in disease resistance) The ability of an organism to fight off disease.

superbug A popular term for a disease-causing germ that can withstand medicines.

toxic shock syndrome A rare and potentially deadly bacterial infection caused by Staphylococcus aureus. This bacterium release toxins - natural poisons - into the body of its host. Symptoms include a sudden high fever, muscle aches, vomiting, diarrhea, a rash and sometimes seizures.

toxin A poison produced by living organisms, such as germs, bees, spiders, poison ivy and snakes.

tuberculosis A bacterial disease that causes unusual growths in the lungs or other tissues. Untreated, it can kill. The infection usually spreads when a sick individual coughs (or talks, sings or sneezes), spewing germs into the air.

virus Tiny infectious particles consisting of RNA or DNA surrounded by protein. Viruses can reproduce only by injecting their genetic material into the cells of living creatures. Although scientists frequently refer to viruses as live or dead, in fact no virus is truly alive. It doesn't eat like animals do, or make its own food the way plants do. It must hijack the cellular machinery of a living cell in order to survive.

World Health Organization An agency of the United Nations, established in 1948, to promote health and to control communicable diseases. It is based in Geneva, Switzerland. The United Nations relies on the WHO for providing international leadership on global health matters. This organization also helps shape the research agenda for health issues and sets standards for pollutants and other things that could pose a risk to health. WHO also regularly reviews data to set policies for maintaining health and a healthy environment.

Citations

E. Landhuis. " The war on superbugs." Science News for Students. July 16, 2014.

B. Harder. " Joining the Resistance: Drug-immune microbes waft over hogs." Science News. Jan. 1, 2005.

A.L. Mascarelli. " Infectious animals." Science News for Students. April 17, 2013.

J. Raloff. " Antibiotics afield." Science News. Nov. 26, 2005.

J. Raloff. " Growth-promoting antibiotics: On the way out?" Science News. March 23, 2012.

J. Raloff. " Retail meats host drug-resistant bacteria." Science News. Oct. 20, 2001.

N. Seppa. " Danes keeping drugs out of livestock." Science News. April 8, 2003.

Original Journal Source: M. Barnett and J. Linder. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. Journal of the American Medical Association (JAMA). Published May 21, 2014. doi: 10.1001/jama.2013.286141.

Original Journal Source: J. Nesme et al. Large-scale metagenomic-based study of antibiotic resistance in the environment. Current Biology. Published May 8, 2014. doi: 10.1016/j.cub.2014.03.036.

Original Journal Source: S. Peacock. Health care: Bring microbial sequencing to hospitals. Nature. Published May 29, 2014. doi:10.1038/509557a.

Original Journal Source: B. Spellberg, J. Bartlett and D. Gilbert. The future of antibiotics and resistance. New England Journal of Medicine. Published Jan. 24, 2013. doi: 10.1056/NEJMp1215093.

Original Journal Source: S. Cole. Who will develop new antibacterial agents? Philosophical Transactions of the Royal Society B. Published May 12, 2014. doi: 10.1098/rstb.2013.0430.

Original Journal Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Antibiotic-resistant threats in the United States, 2013.

Original Report Source: World Health Organization. Antimicrobial resistance global report on surveillance, 2014.

Teachers' questions: Superbugs: A silent health emergency

Esther Landhuis is a freelance journalist in the San Francisco Bay Area. She worked on her high school newspaper and spent a decade studying biology before discovering a career that combines writing and science.

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Have antibiotics become too popular? Overusing these medicines fuels resistant germs that pose a global health threat.

# data[].attributes.attachment_link.readable_text
Bacteria and other microbes can make us sick. But there's a lurking danger with some germs that's far more frightening than a bout of food poisoning or an infected wound. Today, drugs exist to fight most of these germs. They're called antibiotics. Before these medicines came along, common infections frequently killed people. And that's where the danger lies: What will happen if antibiotics no longer kill germs?

Already some antibiotics have lost their superpowers. Many others are beginning to lose theirs. Biologists describe this problem as resistance. Across the globe, germs are becoming resistant to antibiotic medicines. In a sense, these "superbugs" have begun to laugh at those former wonder drugs.

But resistance is no laughing matter. As germs toughen up against drugs that are supposed to slay them, treatable conditions such as TB - tuberculosis - can spread. And surgeries that rely on antibiotics could turn from life-saving to life-threatening.

The threat is huge

"Alarming levels" of drug-resistant bacteria already exist in many parts of the world. That's the conclusion of a 257-page report published in April. It was issued by the World Health Organization (WHO).

This United Nations agency, based in Geneva, Switzerland, recently reviewed how well these germ slayers perform in 114 countries. In some places, it found, antibiotics no longer work for half of all people being treated against common diseases. Those diseases include pneumonia and gonorrhea.

The Centers for Disease Control and Prevention (CDC), based in Atlanta, Ga., also has been investigating the problem . It estimates that in the United States alone, antibiotic-resistant infections now sicken some two million people each year. At least 23,000 of them die.

But even antibiotic-resistant germs that don't kill can be a problem. Their infections become harder to treat - and more expensive. Consider one estimate - $233 million - published May 20 in the journal Antimicrobial Resistance and Infection Control. That's how much researchers calculated that it costs the United States each year to deal with just one resistant superbug. That germ causes a lung disease known as pneumonia.

Drug-immune bugs that flourish in the human gut can enter the environment with every flush of the toilet. Researchers discovered how big this problem is when they analyzed wastewater from 11 sites in one French city. Antibiotic-resistant bacteria tainted 96 percent of their samples. A May 1 paper in Clinical Infectious Diseases describes the disturbing details.

Some scientists have scouted for such germs in the environment. They collected superbugs at hospitals. Then they probed the germs, identifying parts of their genes that appear to make them resistant to antibiotics. Next, the researchers looked in the outdoor environment for that same genetic fingerprint of superbugs. And they turned up that superbug DNA in 71 places - from the soil and sea water to human wastes. The researchers reported their findings May 8 in Current Biology.

Why it's happening

Drug designers have created antibiotics to kill bacteria, as well as some fungi and other germs. But sometimes, a few treated germs survive. They survive because they're stronger. Or they may have certain genetic mutations that allow them to break down the drug. They might even have evolved a way to keep the drugs from harming their operational machinery. Over time, all germs susceptible to a drug will die off. That will leave behind only superbugs - those microbes that medicines can't kill.

This is not surprising. In fact, it's quite natural. Part of evolution, it's known as survival of the fittest.

Scientists stumbled onto the first antibiotic, penicillin, around 1930. Since then, research has produced a medicine cabinet full of additional ones. It appeared that these would make many of the worst bacterial infections ever more manageable. So, during the 1970s, drug developers began focusing on noninfectious health problems, such as cancer and heart disease. As a result, in the past 30 years, no new types of antibiotics have been developed.

Right now, bacteria are outsmarting antibiotics faster than developers can make new ones. And there are no signs things will change, says Stewart Cole. He directs the Global Health Institute at the Ecole Polytechnique Fédérale de Lausanne in Switzerland.

Writing in the May 12 Philosophical Transactions of the Royal Society B, he argues that the "golden age" of antibiotic development "is a distant memory, and the likelihood of there being another seems slim." This lack of new types of germ killers, he says, has been allowing superbugs to morph and thrive.

One of the most famous of them is known as MRSA (pronounced MER-sah). The letters stand for methicillin-resistant Staphylococcus aureus . Methicillin is a widely used antibiotic. And Staph aureus is a germ that can cause boils, food poisoning, toxic-shock syndrome and more. These bacteria sicken (and sometimes kill) by releasing potent natural poisons - called toxins - into the body.

Despite its name, MRSA is resistant to far more antibiotics than just methicillin. That makes this superbug particularly nasty in hospitals and prisons. These are places where people often have open wounds or weak immune systems. Both increase a person's chance of picking up an infection.

Too much of a good thing

Drug resistance can develop at any time. But its likelihood climbs as the use of an antibiotic increases. And this is especially true when an antibiotic is overused. That's when a doctor prescribes it for infections it has no hope of curing.

For instance, doctors sometimes prescribe antibiotics to treat an infection before they learn if the disease is caused by bacteria. If viruses are responsible, then antibiotics will be useless. The reason: Antibiotic medicines do not kill viruses. Yet by giving an antibiotic to someone with a viral infection, that drug will reach good bacteria living in our bodies. And over time, some of these bacteria will become resistant to the drug.

Last year, the CDC reported that up to half of the antibiotics that U.S. doctors prescribed went to people who didn't actually need them.

Take, for example, someone who visits a doctor for a lingering cough. Viral infections cause most coughs. So a viral cough won't be helped by drugs and will tend to go away on its own. Yet 71 percent of the time, doctors will still prescribe antibiotics for patients coming in with a common cough, a May 21 study finds.

"I think there's this perception among both doctors and patients that coughs don't go away without antibiotic treatment," Jeffrey Linder told Science News for Students . Linder, who coauthored the new report, is a doctor at Brigham & Women's Hospital in Boston, Mass. He and Michael Barnett, also from the hospital, tracked the drugs that doctors prescribed during more than 3,000 U.S. clinic visits between 1996 and 2010. They reported their findings in the Journal of the American Medical Association .

A small number of people who visit a doctor with a cough turn out to have bacterial pneumonia. These cases do require antibiotic treatment. But Linder says doctors should easily be able to recognize these few from the hordes of people coming in with a routine, viral cough.

Perilous profit

Antibiotic overuse also has become a problem on farms. In the United States, animals - not people - receive about 80 percent of all antibiotics. Sometimes the drugs are used to save an infected animal or prevent disease from spreading through a herd. More often, though, feed suppliers put small amounts of these drugs into the food that will be given to healthy animals. These antibiotics help speed the animals' growth. And this has boosted farmers' profits.

But using antibiotics just to beef up livestock is "a direct threat to human health," argues Kellogg Schwab. He's an environmental microbiologist at Johns Hopkins University in Baltimore, Md. Earlier, he and his coworkers detected bacteria that are resistant to antibiotics in the exhaust air blowing out of farm buildings. That suggests these superbugs can spread through the air from animals to people.

SteveOehlenschlager / iStockphoto

Germs that are immune to antibiotics also can hitch a ride into your body through ground beef or the chicken breast on your cutting board. Biologists have found that much of the fresh beef, pork and poultry sold in grocery stores contains bacteria resistant to antibiotics.

Even if those germs don't sicken us or cause other immediate harm, they can offload their resistance genes into other bacteria that normally live inside our bodies. Sometimes, like with the MRSA superbug, resistance is carried on circular pieces of DNA called plasmids. These plasmids can slip easily from one bacterial cell into another.

In this way, our gut microbes can become "a reservoir of resistance," says Sharon Peacock. She's a microbiologist at the University of Cambridge in England. Later, "when we actually get sick and need an antibiotic, we may already carry a resistance gene" that may keep that drug from working, she says.

In the United States, farmers have fought against banning antibiotics as growth promoters. They say it will reduce their profits because more animals will get sick, slowing their growth. But that's not been the experience in other countries.

The U.S. Food and Drug Administration, or FDA, has proposed banning antibiotic use in healthy animals. But for more than 30 years, the livestock industry and Congress have fought such action. Recently, the FDA stepped up its efforts to end this practice.

In December 2013, FDA laid out a plan to phase out within three years the use of antibiotics on farms to boost livestock growth. Its stated reason: concern that farm use of these drugs has made more germs immune to the antibiotics needed to fight life-threatening infections in people. And that's a worry because the same germs that sicken animals often sicken people.

Antibiotic resistance is a complex and growing problem. Many microbiologists worry that the time when antibacterial medicines no longer work could be coming. Thankfully, doctors and many patients are becoming more aware of the problem. Researchers also are hard at work creating new tools to keep superbugs from taking over.
Next: How scientists are trying to tackle the problem
Power Words

antibiotic A germ-killing substance prescribed as a medicine (or sometimes as a feed additive to promote the growth of livestock). It does not work against viruses.

bacterium (plural bacteria) A single-celled organism forming one of the three domains of life. These dwell nearly everywhere on Earth, from the bottom of the sea to inside animals.

boils (in medicine) A skin infection that starts as a hard, red, painful lump. Eventually, it gets bigger, softens and fills with pus. A common source of these is a bacterium known as Staphylococcus aureus.

bioengineer A researcher who applies technology for the beneficial manipulation of living things. Bioengineers use the principles of biology and the techniques of engineering to design organisms or products that can mimic, replace or augment the chemical or physical processes present in existing organisms. This field includes researchers who genetically modify organisms, including microbes. It also includes researchers who design medical devices such as artificial hearts and artificial limbs.

Centers for Disease Control and Prevention, or CDC An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.

cholera A bacterial disease that infects the small intestine, causing sever diarrhea, vomiting and dehydration. It is spread by germs from feces that contaminate water or food.

DNA (short for deoxyribonucleic acid) A long, spiral-shaped molecule inside most living cells that carries genetic instructions. In all living things, from plants and animals to microbes, these instructions tell cells which molecules to make.

evolution A process by which species undergo changes over time, usually through genetic variation and natural selection, that leave a new type of organism better suited for its environment than the earlier type. The newer type is not necessarily more "advanced," just better adapted to the conditions in which it developed.

fungus (plural: fungi) Any of a group of unicellular or multicellular, spore-producing organisms that feed on organic matter, both living and decaying. Molds, yeast and mushrooms are all types of fungi.

gene A segment of DNA that codes, or holds instructions, for producing a protein. Offspring inherit genes from their parents. Genes influence how an organism looks and behaves.

germ Any one-celled microorganism, such as a bacterium, fungal species or virus particle. Some germs cause disease. Others can promote the health of higher-order organisms, including birds and mammals. The health effects of most germs, however, remain unknown.

gonorrhea A serious disease that can infect the genitals, rectum and throat. This sexually transmitted disease is very common, especially among people between the ages of 15 and 24. Untreated, it can cause infertility or death. "Untreated gonorrhea may also increase your chances of getting or giving HIV - the virus that causes AIDS," according to the U.S. Centers for Disease Control and Prevention.

growth promoter (in livestock agriculture) A medicine, usually an antibiotic, added in small doses to the feed given to animals raised for meat. Used as a preventive medicine, it can reduce the risk that animals will become sick, which would slow their growth. And that would decrease a farmer's profits.

immune system The collection of cells and their responses that help the body fight off infection.

infection A disease that can be transmitted between organisms.

influenza (or flu) A highly contagious viral infection of the respiratory passages causing fever and severe aching. It often occurs as an epidemic.

livestock Animals raised for meat or dairy products, including cattle, sheep, goats, pigs, chickens and geese.

microbe Short formicroorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

microbiology The study of microorganisms, principally bacteria, fungi and viruses. Scientists who study microbes and the infections they can cause or ways that they can interact with their environment are known as microbiologists.

mutation Some change that occurs to a gene in an organism's DNA. Some mutations occur naturally. Others can be triggered by outside factors, such as pollution, radiation, medicines or something in the diet. A gene with this change is referred to as a mutant.

plasmid A small circular loop of DNA that is separate from the main chromosomal DNA of bacteria.

pneumonia A lung disease in which infection by a virus or bacterium causes inflammation and tissue damage. Sometimes the lungs fill with fluid or mucus. Symptoms include fever, chills, cough and trouble breathing.

resistance (as in drug resistance) The reduction in the effectiveness of a drug to cure a disease, usually a microbial infection. (as in disease resistance) The ability of an organism to fight off disease.

superbug A popular term for a disease-causing germ that can withstand medicines.

toxic shock syndrome A rare and potentially deadly bacterial infection caused by Staphylococcus aureus. This bacterium release toxins - natural poisons - into the body of its host. Symptoms include a sudden high fever, muscle aches, vomiting, diarrhea, a rash and sometimes seizures.

toxin A poison produced by living organisms, such as germs, bees, spiders, poison ivy and snakes.

tuberculosis A bacterial disease that causes unusual growths in the lungs or other tissues. Untreated, it can kill. The infection usually spreads when a sick individual coughs (or talks, sings or sneezes), spewing germs into the air.

virus Tiny infectious particles consisting of RNA or DNA surrounded by protein. Viruses can reproduce only by injecting their genetic material into the cells of living creatures. Although scientists frequently refer to viruses as live or dead, in fact no virus is truly alive. It doesn't eat like animals do, or make its own food the way plants do. It must hijack the cellular machinery of a living cell in order to survive.

World Health Organization An agency of the United Nations, established in 1948, to promote health and to control communicable diseases. It is based in Geneva, Switzerland. The United Nations relies on the WHO for providing international leadership on global health matters. This organization also helps shape the research agenda for health issues and sets standards for pollutants and other things that could pose a risk to health. WHO also regularly reviews data to set policies for maintaining health and a healthy environment.

Citations

E. Landhuis. " The war on superbugs." Science News for Students. July 16, 2014.

B. Harder. " Joining the Resistance: Drug-immune microbes waft over hogs." Science News. Jan. 1, 2005.

A.L. Mascarelli. " Infectious animals." Science News for Students. April 17, 2013.

J. Raloff. " Antibiotics afield." Science News. Nov. 26, 2005.

J. Raloff. " Growth-promoting antibiotics: On the way out?" Science News. March 23, 2012.

J. Raloff. " Retail meats host drug-resistant bacteria." Science News. Oct. 20, 2001.

N. Seppa. " Danes keeping drugs out of livestock." Science News. April 8, 2003.

Original Journal Source: M. Barnett and J. Linder. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. Journal of the American Medical Association (JAMA). Published May 21, 2014. doi: 10.1001/jama.2013.286141.

Original Journal Source: J. Nesme et al. Large-scale metagenomic-based study of antibiotic resistance in the environment. Current Biology. Published May 8, 2014. doi: 10.1016/j.cub.2014.03.036.

Original Journal Source: S. Peacock. Health care: Bring microbial sequencing to hospitals. Nature. Published May 29, 2014. doi:10.1038/509557a.

Original Journal Source: B. Spellberg, J. Bartlett and D. Gilbert. The future of antibiotics and resistance. New England Journal of Medicine. Published Jan. 24, 2013. doi: 10.1056/NEJMp1215093.

Original Journal Source: S. Cole. Who will develop new antibacterial agents? Philosophical Transactions of the Royal Society B. Published May 12, 2014. doi: 10.1098/rstb.2013.0430.

Original Journal Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Antibiotic-resistant threats in the United States, 2013.

Original Report Source: World Health Organization. Antimicrobial resistance global report on surveillance, 2014.

Teachers' questions: Superbugs: A silent health emergency

Esther Landhuis is a freelance journalist in the San Francisco Bay Area. She worked on her high school newspaper and spent a decade studying biology before discovering a career that combines writing and science.

# data[].attributes.attachment_link.description
Have antibiotics become too popular? Overusing these medicines fuels resistant germs that pose a global health threat.

# data[].attributes.attachment_link.readable_text
Bacteria and other microbes can make us sick. But there's a lurking danger with some germs that's far more frightening than a bout of food poisoning or an infected wound. Today, drugs exist to fight most of these germs. They're called antibiotics. Before these medicines came along, common infections frequently killed people. And that's where the danger lies: What will happen if antibiotics no longer kill germs?

Already some antibiotics have lost their superpowers. Many others are beginning to lose theirs. Biologists describe this problem as resistance. Across the globe, germs are becoming resistant to antibiotic medicines. In a sense, these "superbugs" have begun to laugh at those former wonder drugs.

But resistance is no laughing matter. As germs toughen up against drugs that are supposed to slay them, treatable conditions such as TB - tuberculosis - can spread. And surgeries that rely on antibiotics could turn from life-saving to life-threatening.

The threat is huge

"Alarming levels" of drug-resistant bacteria already exist in many parts of the world. That's the conclusion of a 257-page report published in April. It was issued by the World Health Organization (WHO).

This United Nations agency, based in Geneva, Switzerland, recently reviewed how well these germ slayers perform in 114 countries. In some places, it found, antibiotics no longer work for half of all people being treated against common diseases. Those diseases include pneumonia and gonorrhea.

The Centers for Disease Control and Prevention (CDC), based in Atlanta, Ga., also has been investigating the problem . It estimates that in the United States alone, antibiotic-resistant infections now sicken some two million people each year. At least 23,000 of them die.

But even antibiotic-resistant germs that don't kill can be a problem. Their infections become harder to treat - and more expensive. Consider one estimate - $233 million - published May 20 in the journal Antimicrobial Resistance and Infection Control. That's how much researchers calculated that it costs the United States each year to deal with just one resistant superbug. That germ causes a lung disease known as pneumonia.

Drug-immune bugs that flourish in the human gut can enter the environment with every flush of the toilet. Researchers discovered how big this problem is when they analyzed wastewater from 11 sites in one French city. Antibiotic-resistant bacteria tainted 96 percent of their samples. A May 1 paper in Clinical Infectious Diseases describes the disturbing details.

Some scientists have scouted for such germs in the environment. They collected superbugs at hospitals. Then they probed the germs, identifying parts of their genes that appear to make them resistant to antibiotics. Next, the researchers looked in the outdoor environment for that same genetic fingerprint of superbugs. And they turned up that superbug DNA in 71 places - from the soil and sea water to human wastes. The researchers reported their findings May 8 in Current Biology.

Why it's happening

Drug designers have created antibiotics to kill bacteria, as well as some fungi and other germs. But sometimes, a few treated germs survive. They survive because they're stronger. Or they may have certain genetic mutations that allow them to break down the drug. They might even have evolved a way to keep the drugs from harming their operational machinery. Over time, all germs susceptible to a drug will die off. That will leave behind only superbugs - those microbes that medicines can't kill.

This is not surprising. In fact, it's quite natural. Part of evolution, it's known as survival of the fittest.

Scientists stumbled onto the first antibiotic, penicillin, around 1930. Since then, research has produced a medicine cabinet full of additional ones. It appeared that these would make many of the worst bacterial infections ever more manageable. So, during the 1970s, drug developers began focusing on noninfectious health problems, such as cancer and heart disease. As a result, in the past 30 years, no new types of antibiotics have been developed.

Right now, bacteria are outsmarting antibiotics faster than developers can make new ones. And there are no signs things will change, says Stewart Cole. He directs the Global Health Institute at the Ecole Polytechnique Fédérale de Lausanne in Switzerland.

Writing in the May 12 Philosophical Transactions of the Royal Society B, he argues that the "golden age" of antibiotic development "is a distant memory, and the likelihood of there being another seems slim." This lack of new types of germ killers, he says, has been allowing superbugs to morph and thrive.

One of the most famous of them is known as MRSA (pronounced MER-sah). The letters stand for methicillin-resistant Staphylococcus aureus . Methicillin is a widely used antibiotic. And Staph aureus is a germ that can cause boils, food poisoning, toxic-shock syndrome and more. These bacteria sicken (and sometimes kill) by releasing potent natural poisons - called toxins - into the body.

Despite its name, MRSA is resistant to far more antibiotics than just methicillin. That makes this superbug particularly nasty in hospitals and prisons. These are places where people often have open wounds or weak immune systems. Both increase a person's chance of picking up an infection.

Too much of a good thing

Drug resistance can develop at any time. But its likelihood climbs as the use of an antibiotic increases. And this is especially true when an antibiotic is overused. That's when a doctor prescribes it for infections it has no hope of curing.

For instance, doctors sometimes prescribe antibiotics to treat an infection before they learn if the disease is caused by bacteria. If viruses are responsible, then antibiotics will be useless. The reason: Antibiotic medicines do not kill viruses. Yet by giving an antibiotic to someone with a viral infection, that drug will reach good bacteria living in our bodies. And over time, some of these bacteria will become resistant to the drug.

Last year, the CDC reported that up to half of the antibiotics that U.S. doctors prescribed went to people who didn't actually need them.

Take, for example, someone who visits a doctor for a lingering cough. Viral infections cause most coughs. So a viral cough won't be helped by drugs and will tend to go away on its own. Yet 71 percent of the time, doctors will still prescribe antibiotics for patients coming in with a common cough, a May 21 study finds.

"I think there's this perception among both doctors and patients that coughs don't go away without antibiotic treatment," Jeffrey Linder told Science News for Students . Linder, who coauthored the new report, is a doctor at Brigham & Women's Hospital in Boston, Mass. He and Michael Barnett, also from the hospital, tracked the drugs that doctors prescribed during more than 3,000 U.S. clinic visits between 1996 and 2010. They reported their findings in the Journal of the American Medical Association .

A small number of people who visit a doctor with a cough turn out to have bacterial pneumonia. These cases do require antibiotic treatment. But Linder says doctors should easily be able to recognize these few from the hordes of people coming in with a routine, viral cough.

Perilous profit

Antibiotic overuse also has become a problem on farms. In the United States, animals - not people - receive about 80 percent of all antibiotics. Sometimes the drugs are used to save an infected animal or prevent disease from spreading through a herd. More often, though, feed suppliers put small amounts of these drugs into the food that will be given to healthy animals. These antibiotics help speed the animals' growth. And this has boosted farmers' profits.

But using antibiotics just to beef up livestock is "a direct threat to human health," argues Kellogg Schwab. He's an environmental microbiologist at Johns Hopkins University in Baltimore, Md. Earlier, he and his coworkers detected bacteria that are resistant to antibiotics in the exhaust air blowing out of farm buildings. That suggests these superbugs can spread through the air from animals to people.

SteveOehlenschlager / iStockphoto

Germs that are immune to antibiotics also can hitch a ride into your body through ground beef or the chicken breast on your cutting board. Biologists have found that much of the fresh beef, pork and poultry sold in grocery stores contains bacteria resistant to antibiotics.

Even if those germs don't sicken us or cause other immediate harm, they can offload their resistance genes into other bacteria that normally live inside our bodies. Sometimes, like with the MRSA superbug, resistance is carried on circular pieces of DNA called plasmids. These plasmids can slip easily from one bacterial cell into another.

In this way, our gut microbes can become "a reservoir of resistance," says Sharon Peacock. She's a microbiologist at the University of Cambridge in England. Later, "when we actually get sick and need an antibiotic, we may already carry a resistance gene" that may keep that drug from working, she says.

In the United States, farmers have fought against banning antibiotics as growth promoters. They say it will reduce their profits because more animals will get sick, slowing their growth. But that's not been the experience in other countries.

The U.S. Food and Drug Administration, or FDA, has proposed banning antibiotic use in healthy animals. But for more than 30 years, the livestock industry and Congress have fought such action. Recently, the FDA stepped up its efforts to end this practice.

In December 2013, FDA laid out a plan to phase out within three years the use of antibiotics on farms to boost livestock growth. Its stated reason: concern that farm use of these drugs has made more germs immune to the antibiotics needed to fight life-threatening infections in people. And that's a worry because the same germs that sicken animals often sicken people.

Antibiotic resistance is a complex and growing problem. Many microbiologists worry that the time when antibacterial medicines no longer work could be coming. Thankfully, doctors and many patients are becoming more aware of the problem. Researchers also are hard at work creating new tools to keep superbugs from taking over.
Next: How scientists are trying to tackle the problem
Power Words

antibiotic A germ-killing substance prescribed as a medicine (or sometimes as a feed additive to promote the growth of livestock). It does not work against viruses.

bacterium (plural bacteria) A single-celled organism forming one of the three domains of life. These dwell nearly everywhere on Earth, from the bottom of the sea to inside animals.

boils (in medicine) A skin infection that starts as a hard, red, painful lump. Eventually, it gets bigger, softens and fills with pus. A common source of these is a bacterium known as Staphylococcus aureus.

bioengineer A researcher who applies technology for the beneficial manipulation of living things. Bioengineers use the principles of biology and the techniques of engineering to design organisms or products that can mimic, replace or augment the chemical or physical processes present in existing organisms. This field includes researchers who genetically modify organisms, including microbes. It also includes researchers who design medical devices such as artificial hearts and artificial limbs.

Centers for Disease Control and Prevention, or CDC An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.

cholera A bacterial disease that infects the small intestine, causing sever diarrhea, vomiting and dehydration. It is spread by germs from feces that contaminate water or food.

DNA (short for deoxyribonucleic acid) A long, spiral-shaped molecule inside most living cells that carries genetic instructions. In all living things, from plants and animals to microbes, these instructions tell cells which molecules to make.

evolution A process by which species undergo changes over time, usually through genetic variation and natural selection, that leave a new type of organism better suited for its environment than the earlier type. The newer type is not necessarily more "advanced," just better adapted to the conditions in which it developed.

fungus (plural: fungi) Any of a group of unicellular or multicellular, spore-producing organisms that feed on organic matter, both living and decaying. Molds, yeast and mushrooms are all types of fungi.

gene A segment of DNA that codes, or holds instructions, for producing a protein. Offspring inherit genes from their parents. Genes influence how an organism looks and behaves.

germ Any one-celled microorganism, such as a bacterium, fungal species or virus particle. Some germs cause disease. Others can promote the health of higher-order organisms, including birds and mammals. The health effects of most germs, however, remain unknown.

gonorrhea A serious disease that can infect the genitals, rectum and throat. This sexually transmitted disease is very common, especially among people between the ages of 15 and 24. Untreated, it can cause infertility or death. "Untreated gonorrhea may also increase your chances of getting or giving HIV - the virus that causes AIDS," according to the U.S. Centers for Disease Control and Prevention.

growth promoter (in livestock agriculture) A medicine, usually an antibiotic, added in small doses to the feed given to animals raised for meat. Used as a preventive medicine, it can reduce the risk that animals will become sick, which would slow their growth. And that would decrease a farmer's profits.

immune system The collection of cells and their responses that help the body fight off infection.

infection A disease that can be transmitted between organisms.

influenza (or flu) A highly contagious viral infection of the respiratory passages causing fever and severe aching. It often occurs as an epidemic.

livestock Animals raised for meat or dairy products, including cattle, sheep, goats, pigs, chickens and geese.

microbe Short formicroorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

microbiology The study of microorganisms, principally bacteria, fungi and viruses. Scientists who study microbes and the infections they can cause or ways that they can interact with their environment are known as microbiologists.

mutation Some change that occurs to a gene in an organism's DNA. Some mutations occur naturally. Others can be triggered by outside factors, such as pollution, radiation, medicines or something in the diet. A gene with this change is referred to as a mutant.

plasmid A small circular loop of DNA that is separate from the main chromosomal DNA of bacteria.

pneumonia A lung disease in which infection by a virus or bacterium causes inflammation and tissue damage. Sometimes the lungs fill with fluid or mucus. Symptoms include fever, chills, cough and trouble breathing.

resistance (as in drug resistance) The reduction in the effectiveness of a drug to cure a disease, usually a microbial infection. (as in disease resistance) The ability of an organism to fight off disease.

superbug A popular term for a disease-causing germ that can withstand medicines.

toxic shock syndrome A rare and potentially deadly bacterial infection caused by Staphylococcus aureus. This bacterium release toxins - natural poisons - into the body of its host. Symptoms include a sudden high fever, muscle aches, vomiting, diarrhea, a rash and sometimes seizures.

toxin A poison produced by living organisms, such as germs, bees, spiders, poison ivy and snakes.

tuberculosis A bacterial disease that causes unusual growths in the lungs or other tissues. Untreated, it can kill. The infection usually spreads when a sick individual coughs (or talks, sings or sneezes), spewing germs into the air.

virus Tiny infectious particles consisting of RNA or DNA surrounded by protein. Viruses can reproduce only by injecting their genetic material into the cells of living creatures. Although scientists frequently refer to viruses as live or dead, in fact no virus is truly alive. It doesn't eat like animals do, or make its own food the way plants do. It must hijack the cellular machinery of a living cell in order to survive.

World Health Organization An agency of the United Nations, established in 1948, to promote health and to control communicable diseases. It is based in Geneva, Switzerland. The United Nations relies on the WHO for providing international leadership on global health matters. This organization also helps shape the research agenda for health issues and sets standards for pollutants and other things that could pose a risk to health. WHO also regularly reviews data to set policies for maintaining health and a healthy environment.

Citations

E. Landhuis. " The war on superbugs." Science News for Students. July 16, 2014.

B. Harder. " Joining the Resistance: Drug-immune microbes waft over hogs." Science News. Jan. 1, 2005.

A.L. Mascarelli. " Infectious animals." Science News for Students. April 17, 2013.

J. Raloff. " Antibiotics afield." Science News. Nov. 26, 2005.

J. Raloff. " Growth-promoting antibiotics: On the way out?" Science News. March 23, 2012.

J. Raloff. " Retail meats host drug-resistant bacteria." Science News. Oct. 20, 2001.

N. Seppa. " Danes keeping drugs out of livestock." Science News. April 8, 2003.

Original Journal Source: M. Barnett and J. Linder. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. Journal of the American Medical Association (JAMA). Published May 21, 2014. doi: 10.1001/jama.2013.286141.

Original Journal Source: J. Nesme et al. Large-scale metagenomic-based study of antibiotic resistance in the environment. Current Biology. Published May 8, 2014. doi: 10.1016/j.cub.2014.03.036.

Original Journal Source: S. Peacock. Health care: Bring microbial sequencing to hospitals. Nature. Published May 29, 2014. doi:10.1038/509557a.

Original Journal Source: B. Spellberg, J. Bartlett and D. Gilbert. The future of antibiotics and resistance. New England Journal of Medicine. Published Jan. 24, 2013. doi: 10.1056/NEJMp1215093.

Original Journal Source: S. Cole. Who will develop new antibacterial agents? Philosophical Transactions of the Royal Society B. Published May 12, 2014. doi: 10.1098/rstb.2013.0430.

Original Journal Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Antibiotic-resistant threats in the United States, 2013.

Original Report Source: World Health Organization. Antimicrobial resistance global report on surveillance, 2014.

Teachers' questions: Superbugs: A silent health emergency

Esther Landhuis is a freelance journalist in the San Francisco Bay Area. She worked on her high school newspaper and spent a decade studying biology before discovering a career that combines writing and science.

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Have antibiotics become too popular? Overusing these medicines fuels resistant germs that pose a global health threat.

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There are many illnesses. Major or minor, they affect the immune system and the cells and antibiotics help. But what are the illnesses disturbing the flow of the body?

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There are many illnesses. Major or minor, they affect the immune system and the cells and antibiotics help. But what are the illnesses disturbing the flow of the body?

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Bacteria and other microbes can make us sick. But there's a lurking danger with some germs that's far more frightening than a bout of food poisoning or an infected wound. Today, drugs exist to fight most of these germs. They're called antibiotics. Before these medicines came along, common infections frequently killed people. And that's where the danger lies: What will happen if antibiotics no longer kill germs?

Already some antibiotics have lost their superpowers. Many others are beginning to lose theirs. Biologists describe this problem as resistance. Across the globe, germs are becoming resistant to antibiotic medicines. In a sense, these "superbugs" have begun to laugh at those former wonder drugs.

But resistance is no laughing matter. As germs toughen up against drugs that are supposed to slay them, treatable conditions such as TB - tuberculosis - can spread. And surgeries that rely on antibiotics could turn from life-saving to life-threatening.

The threat is huge

"Alarming levels" of drug-resistant bacteria already exist in many parts of the world. That's the conclusion of a 257-page report published in April. It was issued by the World Health Organization (WHO).

This United Nations agency, based in Geneva, Switzerland, recently reviewed how well these germ slayers perform in 114 countries. In some places, it found, antibiotics no longer work for half of all people being treated against common diseases. Those diseases include pneumonia and gonorrhea.

The Centers for Disease Control and Prevention (CDC), based in Atlanta, Ga., also has been investigating the problem . It estimates that in the United States alone, antibiotic-resistant infections now sicken some two million people each year. At least 23,000 of them die.

But even antibiotic-resistant germs that don't kill can be a problem. Their infections become harder to treat - and more expensive. Consider one estimate - $233 million - published May 20 in the journal Antimicrobial Resistance and Infection Control. That's how much researchers calculated that it costs the United States each year to deal with just one resistant superbug. That germ causes a lung disease known as pneumonia.

Drug-immune bugs that flourish in the human gut can enter the environment with every flush of the toilet. Researchers discovered how big this problem is when they analyzed wastewater from 11 sites in one French city. Antibiotic-resistant bacteria tainted 96 percent of their samples. A May 1 paper in Clinical Infectious Diseases describes the disturbing details.

Some scientists have scouted for such germs in the environment. They collected superbugs at hospitals. Then they probed the germs, identifying parts of their genes that appear to make them resistant to antibiotics. Next, the researchers looked in the outdoor environment for that same genetic fingerprint of superbugs. And they turned up that superbug DNA in 71 places - from the soil and sea water to human wastes. The researchers reported their findings May 8 in Current Biology.

Why it's happening

Drug designers have created antibiotics to kill bacteria, as well as some fungi and other germs. But sometimes, a few treated germs survive. They survive because they're stronger. Or they may have certain genetic mutations that allow them to break down the drug. They might even have evolved a way to keep the drugs from harming their operational machinery. Over time, all germs susceptible to a drug will die off. That will leave behind only superbugs - those microbes that medicines can't kill.

This is not surprising. In fact, it's quite natural. Part of evolution, it's known as survival of the fittest.

Scientists stumbled onto the first antibiotic, penicillin, around 1930. Since then, research has produced a medicine cabinet full of additional ones. It appeared that these would make many of the worst bacterial infections ever more manageable. So, during the 1970s, drug developers began focusing on noninfectious health problems, such as cancer and heart disease. As a result, in the past 30 years, no new types of antibiotics have been developed.

Right now, bacteria are outsmarting antibiotics faster than developers can make new ones. And there are no signs things will change, says Stewart Cole. He directs the Global Health Institute at the Ecole Polytechnique Fédérale de Lausanne in Switzerland.

Writing in the May 12 Philosophical Transactions of the Royal Society B, he argues that the "golden age" of antibiotic development "is a distant memory, and the likelihood of there being another seems slim." This lack of new types of germ killers, he says, has been allowing superbugs to morph and thrive.

One of the most famous of them is known as MRSA (pronounced MER-sah). The letters stand for methicillin-resistant Staphylococcus aureus . Methicillin is a widely used antibiotic. And Staph aureus is a germ that can cause boils, food poisoning, toxic-shock syndrome and more. These bacteria sicken (and sometimes kill) by releasing potent natural poisons - called toxins - into the body.

Despite its name, MRSA is resistant to far more antibiotics than just methicillin. That makes this superbug particularly nasty in hospitals and prisons. These are places where people often have open wounds or weak immune systems. Both increase a person's chance of picking up an infection.

Too much of a good thing

Drug resistance can develop at any time. But its likelihood climbs as the use of an antibiotic increases. And this is especially true when an antibiotic is overused. That's when a doctor prescribes it for infections it has no hope of curing.

For instance, doctors sometimes prescribe antibiotics to treat an infection before they learn if the disease is caused by bacteria. If viruses are responsible, then antibiotics will be useless. The reason: Antibiotic medicines do not kill viruses. Yet by giving an antibiotic to someone with a viral infection, that drug will reach good bacteria living in our bodies. And over time, some of these bacteria will become resistant to the drug.

Last year, the CDC reported that up to half of the antibiotics that U.S. doctors prescribed went to people who didn't actually need them.

Take, for example, someone who visits a doctor for a lingering cough. Viral infections cause most coughs. So a viral cough won't be helped by drugs and will tend to go away on its own. Yet 71 percent of the time, doctors will still prescribe antibiotics for patients coming in with a common cough, a May 21 study finds.

"I think there's this perception among both doctors and patients that coughs don't go away without antibiotic treatment," Jeffrey Linder told Science News for Students . Linder, who coauthored the new report, is a doctor at Brigham & Women's Hospital in Boston, Mass. He and Michael Barnett, also from the hospital, tracked the drugs that doctors prescribed during more than 3,000 U.S. clinic visits between 1996 and 2010. They reported their findings in the Journal of the American Medical Association .

A small number of people who visit a doctor with a cough turn out to have bacterial pneumonia. These cases do require antibiotic treatment. But Linder says doctors should easily be able to recognize these few from the hordes of people coming in with a routine, viral cough.

Perilous profit

Antibiotic overuse also has become a problem on farms. In the United States, animals - not people - receive about 80 percent of all antibiotics. Sometimes the drugs are used to save an infected animal or prevent disease from spreading through a herd. More often, though, feed suppliers put small amounts of these drugs into the food that will be given to healthy animals. These antibiotics help speed the animals' growth. And this has boosted farmers' profits.

But using antibiotics just to beef up livestock is "a direct threat to human health," argues Kellogg Schwab. He's an environmental microbiologist at Johns Hopkins University in Baltimore, Md. Earlier, he and his coworkers detected bacteria that are resistant to antibiotics in the exhaust air blowing out of farm buildings. That suggests these superbugs can spread through the air from animals to people.

SteveOehlenschlager / iStockphoto

Germs that are immune to antibiotics also can hitch a ride into your body through ground beef or the chicken breast on your cutting board. Biologists have found that much of the fresh beef, pork and poultry sold in grocery stores contains bacteria resistant to antibiotics.

Even if those germs don't sicken us or cause other immediate harm, they can offload their resistance genes into other bacteria that normally live inside our bodies. Sometimes, like with the MRSA superbug, resistance is carried on circular pieces of DNA called plasmids. These plasmids can slip easily from one bacterial cell into another.

In this way, our gut microbes can become "a reservoir of resistance," says Sharon Peacock. She's a microbiologist at the University of Cambridge in England. Later, "when we actually get sick and need an antibiotic, we may already carry a resistance gene" that may keep that drug from working, she says.

In the United States, farmers have fought against banning antibiotics as growth promoters. They say it will reduce their profits because more animals will get sick, slowing their growth. But that's not been the experience in other countries.

The U.S. Food and Drug Administration, or FDA, has proposed banning antibiotic use in healthy animals. But for more than 30 years, the livestock industry and Congress have fought such action. Recently, the FDA stepped up its efforts to end this practice.

In December 2013, FDA laid out a plan to phase out within three years the use of antibiotics on farms to boost livestock growth. Its stated reason: concern that farm use of these drugs has made more germs immune to the antibiotics needed to fight life-threatening infections in people. And that's a worry because the same germs that sicken animals often sicken people.

Antibiotic resistance is a complex and growing problem. Many microbiologists worry that the time when antibacterial medicines no longer work could be coming. Thankfully, doctors and many patients are becoming more aware of the problem. Researchers also are hard at work creating new tools to keep superbugs from taking over.
Next: How scientists are trying to tackle the problem
Power Words

antibiotic A germ-killing substance prescribed as a medicine (or sometimes as a feed additive to promote the growth of livestock). It does not work against viruses.

bacterium (plural bacteria) A single-celled organism forming one of the three domains of life. These dwell nearly everywhere on Earth, from the bottom of the sea to inside animals.

boils (in medicine) A skin infection that starts as a hard, red, painful lump. Eventually, it gets bigger, softens and fills with pus. A common source of these is a bacterium known as Staphylococcus aureus.

bioengineer A researcher who applies technology for the beneficial manipulation of living things. Bioengineers use the principles of biology and the techniques of engineering to design organisms or products that can mimic, replace or augment the chemical or physical processes present in existing organisms. This field includes researchers who genetically modify organisms, including microbes. It also includes researchers who design medical devices such as artificial hearts and artificial limbs.

Centers for Disease Control and Prevention, or CDC An agency of the U.S. Department of Health and Human Services, CDC is charged with protecting public health and safety by working to control and prevent disease, injury and disabilities. It does this by investigating disease outbreaks, tracking exposures by Americans to infections and toxic chemicals, and regularly surveying diet and other habits among a representative cross-section of all Americans.

cholera A bacterial disease that infects the small intestine, causing sever diarrhea, vomiting and dehydration. It is spread by germs from feces that contaminate water or food.

DNA (short for deoxyribonucleic acid) A long, spiral-shaped molecule inside most living cells that carries genetic instructions. In all living things, from plants and animals to microbes, these instructions tell cells which molecules to make.

evolution A process by which species undergo changes over time, usually through genetic variation and natural selection, that leave a new type of organism better suited for its environment than the earlier type. The newer type is not necessarily more "advanced," just better adapted to the conditions in which it developed.

fungus (plural: fungi) Any of a group of unicellular or multicellular, spore-producing organisms that feed on organic matter, both living and decaying. Molds, yeast and mushrooms are all types of fungi.

gene A segment of DNA that codes, or holds instructions, for producing a protein. Offspring inherit genes from their parents. Genes influence how an organism looks and behaves.

germ Any one-celled microorganism, such as a bacterium, fungal species or virus particle. Some germs cause disease. Others can promote the health of higher-order organisms, including birds and mammals. The health effects of most germs, however, remain unknown.

gonorrhea A serious disease that can infect the genitals, rectum and throat. This sexually transmitted disease is very common, especially among people between the ages of 15 and 24. Untreated, it can cause infertility or death. "Untreated gonorrhea may also increase your chances of getting or giving HIV - the virus that causes AIDS," according to the U.S. Centers for Disease Control and Prevention.

growth promoter (in livestock agriculture) A medicine, usually an antibiotic, added in small doses to the feed given to animals raised for meat. Used as a preventive medicine, it can reduce the risk that animals will become sick, which would slow their growth. And that would decrease a farmer's profits.

immune system The collection of cells and their responses that help the body fight off infection.

infection A disease that can be transmitted between organisms.

influenza (or flu) A highly contagious viral infection of the respiratory passages causing fever and severe aching. It often occurs as an epidemic.

livestock Animals raised for meat or dairy products, including cattle, sheep, goats, pigs, chickens and geese.

microbe Short formicroorganism. A living thing that is too small to see with the unaided eye, including bacteria, some fungi and many other organisms such as amoebas. Most consist of a single cell.

microbiology The study of microorganisms, principally bacteria, fungi and viruses. Scientists who study microbes and the infections they can cause or ways that they can interact with their environment are known as microbiologists.

mutation Some change that occurs to a gene in an organism's DNA. Some mutations occur naturally. Others can be triggered by outside factors, such as pollution, radiation, medicines or something in the diet. A gene with this change is referred to as a mutant.

plasmid A small circular loop of DNA that is separate from the main chromosomal DNA of bacteria.

pneumonia A lung disease in which infection by a virus or bacterium causes inflammation and tissue damage. Sometimes the lungs fill with fluid or mucus. Symptoms include fever, chills, cough and trouble breathing.

resistance (as in drug resistance) The reduction in the effectiveness of a drug to cure a disease, usually a microbial infection. (as in disease resistance) The ability of an organism to fight off disease.

superbug A popular term for a disease-causing germ that can withstand medicines.

toxic shock syndrome A rare and potentially deadly bacterial infection caused by Staphylococcus aureus. This bacterium release toxins - natural poisons - into the body of its host. Symptoms include a sudden high fever, muscle aches, vomiting, diarrhea, a rash and sometimes seizures.

toxin A poison produced by living organisms, such as germs, bees, spiders, poison ivy and snakes.

tuberculosis A bacterial disease that causes unusual growths in the lungs or other tissues. Untreated, it can kill. The infection usually spreads when a sick individual coughs (or talks, sings or sneezes), spewing germs into the air.

virus Tiny infectious particles consisting of RNA or DNA surrounded by protein. Viruses can reproduce only by injecting their genetic material into the cells of living creatures. Although scientists frequently refer to viruses as live or dead, in fact no virus is truly alive. It doesn't eat like animals do, or make its own food the way plants do. It must hijack the cellular machinery of a living cell in order to survive.

World Health Organization An agency of the United Nations, established in 1948, to promote health and to control communicable diseases. It is based in Geneva, Switzerland. The United Nations relies on the WHO for providing international leadership on global health matters. This organization also helps shape the research agenda for health issues and sets standards for pollutants and other things that could pose a risk to health. WHO also regularly reviews data to set policies for maintaining health and a healthy environment.

Citations

E. Landhuis. " The war on superbugs." Science News for Students. July 16, 2014.

B. Harder. " Joining the Resistance: Drug-immune microbes waft over hogs." Science News. Jan. 1, 2005.

A.L. Mascarelli. " Infectious animals." Science News for Students. April 17, 2013.

J. Raloff. " Antibiotics afield." Science News. Nov. 26, 2005.

J. Raloff. " Growth-promoting antibiotics: On the way out?" Science News. March 23, 2012.

J. Raloff. " Retail meats host drug-resistant bacteria." Science News. Oct. 20, 2001.

N. Seppa. " Danes keeping drugs out of livestock." Science News. April 8, 2003.

Original Journal Source: M. Barnett and J. Linder. Antibiotic prescribing for adults with acute bronchitis in the United States, 1996-2010. Journal of the American Medical Association (JAMA). Published May 21, 2014. doi: 10.1001/jama.2013.286141.

Original Journal Source: J. Nesme et al. Large-scale metagenomic-based study of antibiotic resistance in the environment. Current Biology. Published May 8, 2014. doi: 10.1016/j.cub.2014.03.036.

Original Journal Source: S. Peacock. Health care: Bring microbial sequencing to hospitals. Nature. Published May 29, 2014. doi:10.1038/509557a.

Original Journal Source: B. Spellberg, J. Bartlett and D. Gilbert. The future of antibiotics and resistance. New England Journal of Medicine. Published Jan. 24, 2013. doi: 10.1056/NEJMp1215093.

Original Journal Source: S. Cole. Who will develop new antibacterial agents? Philosophical Transactions of the Royal Society B. Published May 12, 2014. doi: 10.1098/rstb.2013.0430.

Original Journal Source: U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. Antibiotic-resistant threats in the United States, 2013.

Original Report Source: World Health Organization. Antimicrobial resistance global report on surveillance, 2014.

Teachers' questions: Superbugs: A silent health emergency

Esther Landhuis is a freelance journalist in the San Francisco Bay Area. She worked on her high school newspaper and spent a decade studying biology before discovering a career that combines writing and science.

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Have antibiotics become too popular? Overusing these medicines fuels resistant germs that pose a global health threat.

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History for kids - Free history network for kids

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The Black Death

The Black Death : Bubonic Plague

In late 1347, the Black Death killed approximately 30 to 45 percent of the European population (although some people put this rate even higher at around 60 percent). No one knew what caused the plague so people in the Middle Ages tried a number of methods to combat the disease but they didn't help. The only thing people could do was to simply run away from any place that was infected.

What Is It?

The Black Death is a bacterial disease. This simply means it is caused by bacteria. The official name of the bacteria is Yersina pestis. It was named after the French scientist, Alexandre Yersin, who discovered this germ. This bacteria actually causes three different types of plague: bubonic plague, pneumonic plague, and septicemic plague.

Bubonic Plague: This was the most common form of the plague and got its name from the swollen areas (called buboes) that develop when a person is infected. These buboes appear in the groin, armpit, and neck. They can be the size of a golf ball or as big as an apple. The bubonic plague would typically kill its victim within a week but some people were able to recover from the disease (although not very many).

A flea that was infected with the disease would bite a person .Around six days after being bitten, a black blister would appear around the bite. Shortly after this, the buboes would appear followed by purple blotches on the skin. These blotches were caused by bleeding under the skin of the infected person. Bubonic plague killed around 50 to 60 percent of people who have been infected.

Pneumonic plague: This plague was much more deadly than bubonic plague but didn't happen as often. It entered a victim's lungs and caused pneumonia. The infected person would come down with a fever and begin coughing up blood. This coughing would help pass the disease on to other people. About 95 to 100 percent of people infected with pulmonary plague would die within three days.

Septicemic Plague: Septicemic plague occurs when the bacteria enters the victim's bloodstream. The victim will develop a rash and die within the day. Septicemic plague was always fatal but was very rare. The victim died so quickly that there wasn't time for the disease to be passed on to another person.

How Was It Spread?

The bacteria that causes the plague lives in the stomachs of fleas. These fleas are responsible for the spread of the disease. The fleas live on rats which were numerous throughout the Middle Ages. For some reason (people don't really know why) the bacteria builds up in the flea's stomach. As a result, there is so much bacteria, that the flea "throws up" while feeding. Unfortunately, what the flea is feeding on is a person. The flea bites a person and begins drinking the person's blood. At the same time, the flea throws up and the bacteria enters the blood of the person the flea is biting resulting in the person being infected with the plague.

When Did It Start and Where Did It Come From?

The plague first arrived in Europe in 1347 and came from the steppes area of Central Asia. The disease had been in the area for a while but did not cause a big problem because the people who lived in the area were the Mongols. The Mongols lived closely with their horses and fleas don't like the smell of horses so they did not cause a big problem.

Later trade and trading ports in Central Asia were created to help develop trade. The trading posts were areas where rats could gather. The rats brought the infected fleas with them. Any area that had a lot of rats was in danger of having the plague as well.

The plague probably made it into Europe as the result of an attack on the trading port of Kaffa by the Mongols. As the Mongols laid siege to the city, the army was destroyed by the plague. The Mongol leader, Yannibeg, wanted the people who lived in Kaffa to get the plague as well so he used a catapult to throw infected bodies over the city walls and into the city.

The people who lived in the city tried to stop the plague by quickly throwing the dead bodies into the sea, but the plague quickly spread through the city. In fact, these dead bodies were not responsible for the spread of the plague. A dead body isn't going to breath on anyone and the infected fleas that carry the plague would have almost immediately left the dead body for a living person.

A more likely answer for the spread of the plague into Kaffa is, once again, rats. Rats probably made their way into the city and carried the infected fleas with them. The plague took hold in the city and when the people fled the city in their ships, they took the plague with them. When these ships docked at the town of Messina, most of the crew were infected or already dead. The city government quickly had the ships towed out of the harbour but it was too late. The plague had arrived and began its spread throughout Europe.

Was There A Cure?

During the Middle Ages, there was no cure for the Black Death although a number of things were tried. In fact, doctors had no idea how the disease was spread. To combat the disease, doctors (when they were willing to actually see patients infected with the plague) would use bloodletting and boil lancing. Bloodletting simply means a doctor would cut a person and let some blood drain out. Boil lancing occurred when a doctors would cut open the swollen areas of a person (the buboes) and let them drain.

In addition, people would use burning herbs and bath in vinegar to fight the disease. Another method people would use was to simply run away. People would leave the area as soon as any plague cases were reported (and sometimes even before cases were reported).

Many people believed that the plague was visited upon them by God to punish society for being sinful. To atone for these sins, some people would beat themselves with leather straps or pieces of metal in an effort to lift God's curse.

When Did It End?

This outbreak of the plague ended in the early 1350s (around 1353) although there were a number of outbreaks of the plague over the centuries. In fact, even today, there are plague outbreaks. In 2003, more than 2,100 cases of the plague were reported as well as 180 deaths. In 2006, an outbreak in the Democratic Republic of Congo resulted in the death of at least fifty people. In recent years, cases of the plague have been reported in China, India, Vietnam, and Mongolia as well as in the United States.

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The Black Death : Bubonic Plague In late 1347, the Black Death killed approximately 30 to 45 percent of the European population (although some people put this rate even higher at around 60 percent).

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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Plague is best known as the killer disease that wiped out nearly half of Europe during the 1300s. But the germ infected people up to 3,000 years earlier than that, DNA from ancient teeth now show.

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Newsela | Instructional Content Platform

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Newsela is an Instructional Content Platform that supercharges reading engagement and learning in every subject.

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It's not like anybody believes their shopping carts are clean. Most supermarkets place a dispenser of sanitizing wipes nearby, as if to hint at the exact opposite.

But in case you were on the fence, yes, they're gross.

A study of 85 random shopping carts conducted by Dr. Charles P. Gerba found that 50 percent carried E. coli, while 72 percent contained coliform bacteria. "The exceptionally high level of coliform bacteria suggests that fecal material may be involved in cart contamination," the report further stated.

In other words, your cart most likely harbors bathroom germs.

According to Donna Duberg, an assistant professor of clinical laboratory science at Saint Louis University, these pathogens find their way into our carriages through a number of avenues. "Certainly children can be a source of the germs," she explains, as toddlers often ride in carts when accompanying their parents, but Duberg doesn't downplay the role of the consumers either. "We may bring in germs with our hands," she adds.

Depending on our immune systems, many of these pathogens have the potential to make us sick, too. "Especially the fecal coliforms," notes Elizabeth Scott, an assistant professor of biology at Simmons University in Boston. "The concern is that we can pick up pathogens from the cart that can be transmitted directly to our mouths or to other foodstuffs."

Is this really that big of a concern, though? Germs are everywhere, from to They're always going to be present, so how bad could a shopping cart be?

Duberg cites Gerba's findings for the answer: "[There are] 138,00 total bacteria per square inch of a shopping cart - an amount which exceeds the number of bacteria in the average public restroom," she says. "These are fecal bacteria capable of causing illness."

Unfortunately, fecal germs aren't the only bacteria to be wary of. "There are bacteria capable of causing food-borne illnesses such as Salmonella, Shigella, Listeria, and, of course, E. coli O157H7 that may be hiding in the food we are purchasing, especially the fruits and vegetables and raw meats," says Duberg. "You can tell by doing a quick scan of food recalls," such as these online safety alerts posted by the FDA, she adds.

Taking both fecal and food-borne pathogens into account, it's no wonder there are disinfecting wipes in almost every supermarket. But as it turns out, they may not be as effective as we think.

"In theory, it's a good idea, but rather hard to achieve," explains Scott. "Where do you apply the disinfectant? How effective is the disinfectant? It's much better to practice careful hand hygiene and use alcohol hand sanitizer and hand washing."

Duberg adds that most of the wipes are utilizing benzalkonium chloride - and not bleach or alcohol - a disinfecting agent. This means that in order to sanitize, shoppers should be thoroughly wetting the surface areas (handles, grates, coffee cup holders) with the wipes. But if a shopper wanted to disinfect, Duberg says most brands of benzalkonium chloride recommend you leave the surfaces wet for up to four minutes.

The good news, she adds, is that if you thoroughly wet the surfaces with a benzalkonium chloride wipe, "you're going to get way over 99 percent" of the germs.

Or, if you'd rather skip that step, you can just grab a hand-held basket instead. Baskets might contain the same pathogenic bacteria as a cart, but as Scott says, "If it's baskets vs. carts, at least baskets aren't used to carry kids."

But just to be safe, you should probably make time to wipe down the basket, too.

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Maybe a bit grosser than you initially thought.

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After reading about Diseases and Illnesses, my opinion is that people still need to be safe when going out to prevent illness. Many people might think that they are immune when that is not the case. But really scientists say that antibiotics are losing to ‘superbugs’, evolved illnesses that are fighting back to antibiotics.  One theory I have is that maybe the current situation, the COVID-19 pandemic, would last 2 years. The virus is strong, maybe strong enough to resist medicine. Perhaps doctors would be able to come up with an antibiotic that might work. This makes me wonder if we would ever get out of quarantine and get an injection with ‘superbugs’ around.. 

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After reading about Diseases and Illnesses, my opinion is that people still need to be safe when going out to prevent illness. Many people might think that they are immune when that is not the case. But really scientists say that antibiotics are losing to ‘superbugs’, evolved illnesses that are fighting back to antibiotics.  One theory I have is that maybe the current situation, the COVID-19 pandemic, would last 2 years. The virus is strong, maybe strong enough to resist medicine. Perhaps doctors would be able to come up with an antibiotic that might work. This makes me wonder if we would ever get out of quarantine and get an injection with ‘superbugs’ around.. 