Members of my professional tribe – infectious diseases physicians – are celebrated for their politeness, patience and gentility. They are known to be approachable and conciliatory in the sometimes-hostile hospital environment. These positive qualities, I am afraid to say, may also be among our greatest weaknesses – and they could be putting our patients at risk.

In Gone Viral, the germs that share our lives I look at 15 micro-organisms that have shaped the face of humanity over the last 100 years. One of them, HIV, has been established in humans for just over 30 years, but has become one of the worst epidemic infections of modern times. Another, SARS, appeared suddenly in 2003, scared the pants off the general population (and the medical profession) by killing around 10% of those infected, but then unexpectedly disappeared from the face of the earth. Even though nearly 200 Australians died, the swine flu pandemic of 2009 was not as severe as people originally feared, but it gave us a chance to see how the health system would react to a global health crisis.

It is understandable (and indeed appropriate) that these infections attract popular attention, but I have also tried to highlight a number of relatively neglected infections that, despite their unglamorous names and lack of hype, nevertheless cause substantial pain, suffering and death throughout the world. Take the humble garden-variety Golden Staph – a.k.a. Staphylococcus aureus – for example.

If you have been unfortunate enough to spend time in an emergency department waiting room you may have observed that the pale, sweaty, middle-aged man with his hand pressed to the centre of his chest has been taken straight through the doors to the back of the department – ahead of you. Because the triage nurse has a high suspicion that the man is having a heart attack, she follows an internationally accepted protocol, based on the premise that ‘time means heart muscle’ – the sooner the diagnosis is confirmed and the patient is taken to the coronary catheter laboratory where the blocked artery is opened up, the more likely the patient is to survive and to be left with minimal damage to the heart. Had you been sitting in the waiting room with a temperature of 39 degrees, shivering uncontrollably and brewing a staphylococcal infection in your blood, you would be unlikely to receive such an urgent welcome to the resuscitation cubicle. In most hospitals it may be several hours before you receive the antibiotic treatment that you need – depending on the clinical acumen of the triage nurse and the doctor who first sees you. Yet, if you have Staphylococcus aureus growing in your blood, your chance of dying within a year is around 20%. The queue-jumper with a heart attack has just a 5% to 7% chance of dying within a year.

All medical staff want to do the best for their patients, so why does one set of symptoms (central crushing chest pain) evoke a rapid response, but another (high fever and uncontrollable shaking) does not? For some reason the mortality associated with bacterial bloodstream infections has not become part of the received wisdom of the medical profession. We haven’t been able to make it a ‘no-brainer’ for nurses and doctors that you are more likely to die if you have germs in the blood than you if you have had a heart attack.

Some part of the fault lies with me and with my tribal colleagues. Perhaps we haven’t shouted down the telephone when a patient has been misdiagnosed or when their treatment has been delayed; perhaps we haven’t muscled our way enough into medical school curricula; perhaps we act too much like ground crew in the presence of the cardiology Top Guns; perhaps our drugs are too cheap to attract the powerful marketing forces of the pharmaceutical industry that drives so much of current practice; perhaps we haven’t been able to convince some doctors that things so small can cause so much harm. Sometimes it is not just the nice guys who finish last – maybe our patients do too.

Gone Viral is an attempt to bring this and many other lesser-known infectious diseases issues to the lay reader’s (and their doctor's) attention. I hope that this knowledge will help people to make better decisions about their health care and increase their ability to advocate for themselves and their families within an increasingly complex and overstretched modern health system.  

Frank Bowden is the author of Gone Viral: The germs that share our lives, published by NewSouth.