When penicillin and other wonder drugs revolutionized Western medicine in the 1940s and '50s, it seemed as though every infectious illness could be cured with a few pills or injections. But half a century after it began, the golden age of antibiotics is ending with the alarming news that the drugs that were supposed to save the world have instead spawned an epidemic that may destroy it.

In 1988 in a New York City hospital, the first strains of vancomycin-resistant enterococci (VRE) appeared, and between September 1989 and October 1991, 38 New York hospitals reported VRE infections, 98 percent of which were contracted during the patient's hospital stay. Soon hospitals in New Jersey, Connecticut and other states began reporting VRE infections, and the problem quickly spread to other countries. VRE infections are now a worldwide problem.

Nearly all VRE infections are acquired in hospitals. The longer the hospital stay, the greater the risk. Although the risk is highest in intensive care units, VRE infections in hospitals have been traced to nearly every patient-occupied area. Individuals previously treated with vancomycin or combination antibiotic therapy have an increased risk of developing VRE. Those with a serious disease or suppressed immune system or who undergo abdominal surgery are at increased risk. Most VRE infections occur in patients 41 to 60 years old, but they can affect people of any age. VRE infections are virtually untreatable using conventional methods. Even if combination antibiotics appear to be effective, the patient soon has a relapse more virulent than the original infection. A 1995 study at Albert Einstein College of Medicine in New York found that when VRE infections spread to the blood (bacteriemia), the in-hospital death rate was 100 percent. VRE infections are now the second leading cause of infections acquired in hospitals.

But VRE infections are not the problem public health officials fear most. In the August 2, 1998, New York Times Magazine, reporter Sheryl Gay Stolberg described the world's first case of vancomycin intermediate-resistant staphylococcus, or VISA, which appeared in New York in March 1998. “In recent years,” wrote Stolberg, “it has become fashionable in the media to warn of the exotic new infectious diseases percolating in other lands. The gruesome Ebola virus, which swept through Zaire three years ago, has captured the public imagination in books and on film. But while Hollywood has been busy making scary movies, infectious-disease experts know that the bigger danger is in our own back yard: garden variety germs that for decades have been so easily felled by antibiotics that most people, including some scientists, naively assumed they were no longer a threat. For the past decade, however, scientists at the Federal Centers for Disease Control and Prevention in Atlanta and all over the world have been sounding alarm bells about the growth of antibiotic resistance, a problem that has been fueled by patients who demand antibiotics for every bout of the sniffles and by doctors who give in to such demands. The list of dangerously virulent drug-resistant microbes is growing all the time: streptococcus pneumoniae, which causes pneumonia, childhood ear infections and meningitis; mycobacterium tuberculosis, which causes TB; and neisseria gonorrhoea, which causes gonorrhea.” Hospitals favor the development of harmful pathogens, for they provide ideal conditions for mutation. In an effort to prevent the growth of germs, hospitals use chemical disinfectants on floors and other surfaces, and drugs such as antibiotics to kill bacteria in patients. Both practices give microbes the constant exposure to chemicals and drugs that they need to outsmart them, and no environment inhabited by human beings is 100 percent sterile. Inevitably, a few microbes survive, and some of them adapt and pass their adaptation to their next generation. Having killed off whatever natural enemies might keep these new microbes in check, the hospital provides ideal breeding conditions in the frail and fragile patients it houses, and it spreads the new microbes to their new hosts in various ways.

Hospitals are not the only breeding ground for new versions of old pathogens. As the New York Times explained on January 24, 1999, previously unknown bacteria and viruses are blooming in the earth's warming oceans, killing marine life and threatening human health. At that week's national meeting of the American Association for the Advancement of Science, researchers reported that dying coral, diseased shellfish and ocean waters infected with human viruses are symptoms of a rapidly growing global problem. According to the organization, new studies show that vast colonies of human viruses migrate regularly into Florida's coastal waters from the state's 1.6 million septic tanks, and many people are becoming infected with viruses picked up while swimming, windsurfing or boating in infected waters. One study found that almost 25 percent of the people using marine beaches developed ear infections, sore throats, sore eyes, respiratory infections or gastrointestinal disease. Some of the viruses detected in coastal waters are linked to heart disease, diabetes, meningitis and hepatitis. “Most people who come in contact with these viruses do not get ill,” said Joan B. Rose, a researcher at the University of South Florida, “but of the 20 to 24 percent who do, about 1 percent become chronically infected.” Rose's research team traced the migration of viruses from septic tanks and found that pathogens infect coastal waters within 24 hours of being flushed down toilets. Storms that churn ocean water speed the process. Many of the viruses that infect humans directly or through the eating of contaminated shellfish cannot be detected by the routine monitoring of water pollution. Other researchers at the meeting said that the increase in pathogens in the world's oceans may be linked to a 1.8-degree rise in ocean surface temperatures detected in many areas. Warmer water kills algae on coral, weakening the coral and making it more susceptible to infection.

Another factor in the development of new viruses and bacteria is America's drinking water. Municipal water contamination became a national concern when chemical pesticides, fertilizers, industrial solvents, road salt, bacteria, parasites and heavy metals found their way into kitchen faucets. Now pharmaceutical drugs, including antibiotics, hormones, pain killers, tranquilizers and chemotherapy chemicals, have been measured in surface water, ground water and drinking water. The first recorded study that detected drugs in sewage took place in Kansas City in 1976. In 1992, German researchers discovered clofibric acid, a drug that is related to the weed killer 2,4-D and is used to reduce blood cholesterol levels, in water supplies. One of the most common water pollutants in North America is the female sex hormone estradiol.

An estimated 30 percent of the drugs manufactured between 1992 and 1995 dissolve in fat but not in water. Once they are excreted into the environment, they move through the food chain. Because many drugs are designed to retain their chemical structure without breaking down, they remain unchanged in ground water for years or even decades. When a drug is ingested by a human patient or farm animal, between 50 to 90 percent of the drug is excreted unchanged. The remainder is excreted as metabolites, which are byproducts of the body's interaction with the drug. Some metabolites dissolve in fat but not water and, according to researchers, they can be more persistent than the original drugs from which they were derived. The routine use of antibiotics and other drugs on farm animals has made America's farms potential hotbeds of genetic mutation. Because of the drug residues that contaminate our food supply and water supply, most children, adults, and household pets ingest trace amounts of antibiotics and other prescription drugs on a daily basis. The quantities may be small, but researchers blame this constant exposure for the increasing drug resistance of common bacteria.

Of all the drug-resistant bacteria, none are so frightening to medical experts as vancomycin intermediate-resistant staphylococcus, or VISA. Until 1997 and 1998, when the first four cases of VISA were documented, this bacterium was theoretically possible but not yet a problem. Now it's real. Staphylococcus lives harmlessly on the skin and nostrils of healthy people, where it is held in check by other bacteria. If it gains access to the body through cuts, scrapes, surgical incisions, burns or other skin injuries, staph causes infections, some of which can be serious. Medical researchers are alarmed because if VISA strains of staph become common, every staph infection will be so potentially fatal that any scraped knee or minor cut could be fatal. As Sheryl Stolberg wrote, “The emergence of an untreatable strain of staph would put virtually any healthy person at risk and could turn a bad situation into a disastrous one.”

GRAPEFRUIT SEED EXTRACT

There are many herbs and essential oils that kill enterococcus, staphylococcus and other bacteria as well as viruses, which antibiotics are unable to treat. One of the most popular is grapefruit seed extract, or GSE, made from the seeds and connecting tissue of citrus fruit. In the October 1996 edition of his Alternatives newsletter (Mountain Home Publishing, 1201 Seven Locks Road, Rockville, MD 20854), David G. Williams, D.C., described an elderly woman with VRE who was successfully treated for five days with a product that contains 100 mg grapefruit seed extract, 200 mg Artemisia annua (annual wormwood or sweet Annie) and 200 mg Echinacea angustifolia, 1 capsule 3 times daily. After repeated cultures showed her to be free of the VRE infection, two other VRE patients received the same treatment. Because conventional medicine has nothing to offer VRE patients, this is exciting news—but, as Williams explained, it isn't news you're likely to read outside of his publication, for the physicians using this unapproved, unconventional therapy have no interest in creating a medical controversy by reporting their results. “If you have any upcoming surgery or hospital stays, or if you work in a hospital setting,” he wrote, “I would suggest keeping some of this [type of]product around. I would also consider pre-dosing 3 or 4 days prior to any surgery, as well as taking the product for a week or so following the procedure.”

Although pathogens have a more difficult time adapting to natural products, which have a more complex molecular structure than pharmaceutical chemicals, daily exposure might eventually allow some microbes to survive, mutate and become resistant to grapefruit seed extract, just as they are resistant to penicillin and other antibiotics. Although GSE is believed to be free of adverse side effects, large doses over time may disrupt the body's balance of beneficial bacteria. Two healthcare professionals of my acquaintance have mentioned seeing this disruption in people who have taken large doses of grapefruit seed extract for a month or more. Any herb that is used on a daily basis may become less effective when needed. Alternating grapefruit seed extract with other antiseptic herbs is an effective strategy. So is taking these herbs in “courses,” in which a product is taken for several days and then stopped for a day or two before being resumed (five days on and two days off is a popular regimen), for no more than a month or six weeks before being replaced by another herb.

NONI

Also known as the Indian mulberry, noni (Morinda citrifolia) is a small Polynesian evergreen that grows in tropical climates. Because of research in Japan showing that noni fruit inhibits the growth of cells known to be precursors of certain cancers, noni products have become popular supplements for human and animal cancer patients. Noni is reported to be an analgesic pain reliever and an antiseptic effective against harmful viruses, bacteria including E. coli, fungi and internal parasites, making it an appropriate “immunization” herb. It can be applied to cuts and other wounds to help them heal without scarring. Noni is available as a pasteurized juice diluted with other juices to improve its flavor, and in capsules containing powder made by drying noni juice at low temperature or freeze-drying.

Unfortunately, the multilevel marketing of any product may result in the widespread publication of unverifiable anecdotal stories, wildly enthusiastic claims, high-pressure sales tactics, and the denigration of competing products. It is difficult to separate fact from fiction in the early years of a supplement's widespread promotion, and these are the early years of noni's mass marketing. Because of its long history of medicinal use in tropical cultures and its lack of documented toxicity, noni is probably as safe as its promoters claim. Health food stores carry noni products from a number of national brands.

OLIVE LEAF EXTRACT

Derived from the leathery green leaves of the familiar olive tree Olea Europaea, olive leaf extract is a broad-spectrum infection fighter. The olive leaf has a long medical history, dating back to ancient Egypt and popular in folk medicine for centuries. In the 1850s, it was used to cure malaria with a strong decoction made by boiling a handful of leaves in a quart of water until half the water evaporated. Early in the twentieth century, the bitter compound oleuropein was isolated and determined to be a disease-resistant ingredient. In the early 1960s, Dutch researchers discovered elenolic acid, a chemical agent within oleuropein that has a powerful antibacterial effect and that may be its most potent chemical ingredient. American pharmaceutical researchers in the late 1960s showed that calcium elenolate, a salt of elenolic acid, inhibited the growth of every virus against which it was tested, without any harmful influence on host cell mechanisms. However, because the compound rapidly binds to proteins in the blood, which renders it ineffective, attempts to develop calcium elenolate as a pharmaceutical drug failed.

Olive leaves remained an interesting topic of research but of limited commercial value until the development by East Park Research of a manufacturing method that solved the problem of protein binding. In his book Olive Leaf Extract (New York: Kensington Books, 1997), medical journalist Morton Walker reports that olive leaf extract has been shown to be effective against over a hundred diseases caused by bacteria, viruses, fungi and parasites. In addition to fighting infection, it improves circulatory health and may help prevent heart attacks by improving the pumping action of the heart muscle, lowering high blood pressure, eliminating atrial fibrillation and preventing LDL cholesterol from oxidizing. The extract has been used to heal peptic ulcers, hiatal hernias, psoriasis, fibromyalgia, rheumatoid arthritis and a host of other illnesses.

Any herb that kills fungi and parasites can cause “die-off,” a side effect lasting a week to ten days during which fatigue, excessive perspiration, headache, diarrhea and other symptoms of detoxification overwhelm the patient. This reaction is caused by the sudden death of pathogens and resulting demands made on the body's organs of elimination as they remove dead yeast cells, parasites and other waste products. Reducing the dosage reduces the symptoms, although this gentler strategy lengthens treatment time.

TEA TREE OIL

The essential oil of the leaves and branches of the Australian tea tree, Melaleuca alternifolia, is advertised as “a medicine kit in a bottle,” and the description fits. Tea tree oil is used externally to treat skin lesions, insect bites, rashes, burns, abscesses, cuts, abrasions, infected wounds, and fungal infections. Like eucalyptus oil, tea tree oil is a specific for the respiratory system as well as an all-purpose disinfectant. Australian and British research conducted in the 1930s showed that a 15 percent tea tree oil solution is as effective as the full-strength oil in killing yeast cells, mold, bacteria and viruses. More recent laboratory tests have shown that concentrations as low as 1 percent are effective against streptococcus and other gram-positive bacteria, E. coli and other gram-negative bacteria as well as fungi.

Several brands of superior-quality tea tree oil are available. For best results, use a therapeutic-quality oil that is 100 percent Melaleuca alternifolia imported from Australia. Tea tree oil can be applied full-strength to the skin of most adults, but it should be diluted before use on children, pets, and those with sensitive skin. For most applications, a 10 percent solution works well. Dilute 1 tablespoon full-strength tea tree oil in 1/2 cup olive oil (or another carrier oil) and mix by shaking.

Because essential oils do not dissolve in water, an intermediate step is needed to prepare water-based disinfectant sprays and washes. Use this procedure to dilute any essential oil in water, tea, aloe vera gel or other nonfat liquids. To prepare a 7 percent tea tree oil solution, which many aromatherapists recommend for topical application and household use, add 1 tablespoon full-strength tea tree oil to 2 ounces (4 tablespoons) vodka, other grain alcohol, vegetable glycerine or sulfated castor oil. Shake or stir well and let stand for 10 seconds. If a film of oil floats to the top, add more liquid and shake again. When no oil floats to the surface, pour the solution into a measuring cup and add enough aloe vera juice or gel, herbal tea such as comfrey or calendula, pure water or any combination of aloe, tea and water to fill the cup to the 6-ounce or 3/4-cup mark. At that point, your solution will be approximately 7 percent tea tree oil. If the solution separates after standing, shake well just before using.

A 7 percent solution of tea tree oil in water can be sprayed on kitchen and bathroom surfaces, into air ducts or air-conditioning units, and on telephone receivers and mildewed shower walls. It can be added to laundry wash water or simply sprayed into the air. Tea tree oil should not be used every day on every surface, for immunologists report that regular exposure may cause bacteria, viruses and other agents of infection to become resistant to the oil's effects. Instead of relying on a single disinfecting agent, use several in rotation.

OIL OF OREGANO

Common oregano, the culinary herb Origanum vulgare, which is a member of the mint family, is the “true” oregano of the herb garden, and it enjoys an ancient medical reputation, having long been used as a remedy for digestive, respiratory and rheumatic problems and as a treatment for stings and bites. In The Complete Aromatherapy Handbook (New York: Sterling Publishing, Inc., 1990), Susanne Fischer-Rizzi writes, “Oregano is one of the most effective antiseptic essential oils for all kinds of infections. This antiviral remedy helps stimulate the stomach and the appetite and helps treat hiccups and dyspepsia. Oregano also loosens phlegm, calms coughing spells and helps treat chronic bronchitis. Topically oregano has been used to help treat cellulite, eczema, psoriasis, and chronic skin problems. Using oregano in a sitz bath or as a massage oil may help relieve menstrual problems. Dosage: Take orally 1 to 2 drops, diluted, one to two times daily. Caution: Do not use during pregnancy.” For external application, dilute oregano essential oil in a large quantity of carrier oil, such as 5 drops essential oil per teaspoon (15 drops per tablespoon, or 30 drops per fluid ounce) of olive oil. Caution: Stronger solutions can burn or irritate the skin.

Dr. Cass Ingram, a physician and surgeon, promotes this fragrant herb in his book The Cure Is in the Cupboard: How to Use Oregano for Better Health (Buffalo Grove, IL: Knowledge House, 1997), recommending both the dried herb and its well-diluted essential oil as a treatment for abscesses, allergies, arthritis, asthma, athlete's foot, back pain, bites, bronchitis, bruising, candidiasis, canker sores, colds, cold sores, colitis, congestion, diarrhea, earaches, eczema, fatigue, flu, fungal infections, gastritis, hearing loss, neuritis, parasites, poison ivy, prostatitis, psoriasis, ringworm, rosacea, shoulder pain, sinusitis, splinter wounds, scalp conditions, tooth and gum infections, traveler's diarrhea, ulcers, urinary infections, warts, wounds and several other conditions in adults and children.

Ingram's book and media appearances have caused a flurry of interest in Origanum vulgare. Few aromatherapy companies carry this essential oil; most sell Thymus capitatus (Spanish oregano) labeled as Oregano-Origanum. Be sure your oregano essential oil is correctly labeled, of therapeutic quality and from a reputable dealer. The essential oil of oregano can be diluted like tea tree oil, described above, to make a water-based antiseptic solution. In addition, you can grow Origanum vulgare and either dry the herb for use in capsules or make an alcohol or glycerine tincture. You can also find a commercially available alcohol tincture of organically grown Origanum vulgaris, which shares many of the properties of the essential oil.

CJ Puotinen is the author of eleven books about medicinal herbs for pets and people, including Herbs for the Heart, The Encyclopedia of Natural Pet Care, and Natural Remedies for Dogs and Cats, all published by Keats Publishing. She writes the Question and Answer column for the Northeast Herbal Association Journal (“Ask Goldie,” by Goldie Oatstraw). For information about the Northeast Herbal Association, which has members throughout the U.S. and Canada, write to NEHA, PO Box 10, Newport, NY 13416-0010.