In total, some 200,000 people would be infected if a strain of disease resistant to antibiotics took hold, according to official forecasts which reveal the potential casualty toll for the first time.
Within 20 years, outbreaks of common flu could become “serious” for patients as drugs become useless and routine surgery could be curtailed due to the risk of infection, it is warned.
Scientists are increasingly concerned about the impact of antimicrobial resistance (AMR), which makes routine antibiotics or antivirals drugs ineffective against diseases that have formerly been brought under control.
It would mean that the huge gains made since the discovery of penicillin in curbing conditions such as pneumonia and tuberculosis and rendering surgery and childbirth safe could be lost.
David Cameron has warned that such a scenario would see the world “cast back into the dark ages of medicine”.
The new figures are given in the National Risk Register of Civil Emergencies, a document compiled by the Cabinet Office that assesses the challenges posed by terrorism, disease, natural disasters and industrial strife.
For the first time, it contains an assessment of the dangers posed by AMR, which it describes as a “particularly serious” issue for the UK.
The document says: “Without effective antibiotics, even minor surgery and routine operations could become high-risk procedures, leading to increased duration of illness and ultimately premature mortality. Much of modern medicine, for example organ transplantation, bowel surgery and some cancer treatments may become unsafe due to the risk of infection. In addition, influenza pandemics would become more serious without effective treatments.”
It adds: “The number of infections complicated by AMR are expected to increase markedly over the next 20 years. If a widespread outbreak were to occur, we could expect around 200,000 people to be affected by a bacterial blood infection that could not be treated effectively with existing drugs, and around 80,000 of these might die.
“High numbers of deaths could also be expected from other forms of antimicrobial resistant infection.”
Already, there are no longer any effective drugs against one strain of E.coli, a bacterial infection that can prove lethal.
Analysts have also looked at the potential casualties from an increasing drug resistance in Klebsiella pneumonia, a form of bacterial pneumonia, and Staphylococcus aureus, a skin infection, as well as HIV, tuberculosis and malaria.
The assessment comes after a report by Jim O’Neill, a former Goldman Sachs economist, commissioned by the Prime Minister, which forecast a worldwide death toll of 10 million people a year by 2050 unless new drugs are developed.
Conditions such as MSRA, the hospital superbug, already kill 50,000 people a year in the US and Europe, the report said. In order to preserve the antibiotic armoury, medical experts want doctors to issue fewer prescriptions.
Dame Sally Davies, the Chief Medical Officer, who has been warning of the dangers in Britain’s response to AMR, is calling for a new diagnostics test that would allow GPs to instantly distinguish between viral and bacterial infections.
Improved diagnostics would also allow doctors to prescribe the mildest forms of antibiotics, decreasing the likelihood of microorganisms becoming immune.
NICE, the medicines watchdog, has proposed cash rewards for doctors who do not give out antibiotics unnecessarily, to help control the level of prescriptions.
In a significant development, growing numbers of bacteria are becoming resistant to “last resort antibiotics”, known as carbapenems, used in severe infections when less potent antibiotics have failed.
The enzyme NDM-1, which makes bacteria drug-resistant, was found in 600 bacteria in laboratory tests in 2013 according to Public Health England — up from five in 2006.
The ability of HIV to mutate in response to antiretroviral drugs is creating the need to develop new and expensive drugs in the worldwide fight against HIV.
Separately, the National Risk Register classifies pandemic influenza as the highest risk civil emergency facing Britain, outside of terrorist attacks.
A pandemic of a disease such as H1N1 swine flu, H5N1 avian flu, or SARS could infect half the UK population and result in 20,000 to 750,000 deaths, the Cabinet Office forecast.
A flu pandemic has a between 1 in 2 or 1 in 20 likelihood of occurring within the next five years, making it more likely than an outbreak of a major animal disease such as foot and mouth, coastal flooding or rioting, the Cabinet Office assessed.
The report warns that in the absence of early or effective interventions to deal with a pandemic, the consequences may include “significant social and economic disruption, significant threats to the continuity of essential services, lower production levels, and shortages and distribution difficulties”.
The fact that the 2009 H1N1 swine flu outbreak was far milder than feared “is not necessarily indicative of future pandemic influenzas”, the Cabinet Office said. “The consensus view among experts is that there is a high probability of another influenza pandemic occurring.”
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