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 Composer Wolfgang Amadeus Mozart’s death in 1791 has long been a mystery, but a new study published Tuesday in the Annals of Internal Medicine suggests that it was, of all things, a common strep infection that killed the maestro at the age of 35. 

Researchers speculate that Mozart contracted the strep infection—easily treatable today—from a fellow musician who had been hospitalized at a crowded military hospital in Vienna. It’s not difficult to imagine that strep would rage in a dirty hospital in the 18th century. But a 2008 report from Lancet Infectious Diseases says that crowded, understaffed hospitals worldwide remain breeding grounds for antibiotic resistant infections such as Methicillin Resistant Staphylococcus Aureus (MRSA). 

Jump to 9:32 in the Annals of Internal Medicine Podcast above for an interview with Richard Zegers, MD, PhD, of the University of Amsterdam, who published an epidemiologic investigation of Mozart's death. Below, a looser interpretation of Mozart's death, from Peter Shaffer's Amadeus.

The strep infection that killed Mozart is comparable to superbug infections like those caused by MRSA. Such infections are increasingly difficult to stop—even with a modern arsenal of antibiotics. There are even several pan-resistant infections for which we have no effective treatment—putting us in much the same situation as those in the pre-antibiotic era.

These bugs take hold in a hospital, are transfered from patient to patient, and spread out into the community. A recent study shows that nearly 13 percent of hospitalized patients go home with MRSA, and 20 percent of these patients pass the bug to friends and family members. 

Doctors today still have a range of powerful antibiotics they can use to combat bacterial infections like strep. But as time goes on, more and more microbes become resistant to these drugs, so even after experimenting with complex and often costly drug combinations, our medical system often fails to contain infections caused by superbugs. 

Mozart died on December 5, 1791. According to eyewitness accounts, he knew he was dying and had the forethought to leave the world with a legacy: instructions on how to complete the Requiem.

Hopefully, our new insight into the cause of the maestro’s death provides another sort of inspiration: We must act now to contain the spread of antibiotic resistant infections, which kill millions of people around the world. We must treat antibiotics as a valuable resource, one that can be depleted with over-use. And we must take steps to increase our supply of new drugs that can take over when an existing antibiotic fails to wipe out an infection.

If we do nothing, our future battles with bacterial infections are likely to look increasingly like frightening scenes from the past.   

 

 

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