Which would you click on: a story about a threatening bacteria called carbapenem-resistant Enterobacteriaceae (CRE) producing OXA-48-like carbapenemases or one about a scary germ headlined the Phantom Menace?
Unless you're a microbiologist, we're guessing you chose the Star Wars-inspired term. In fact, they refer to the same bacteria: a potentially devastating superbug that is resistant to antibiotics - and spreading in the United States.
The name of the germ plays a huge role in how the public perceives it (and that, in turn, can affect everything from how research gets funded to how successfully it is curtailed).
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"I think naming has a real function," said Lance Price, director of the Antibiotic Resistance Action Center at George Washington University's Milken Institute of Public Health. "People don't want us to use terms like carbapenem-resistant Enterobacteriaceae producing OXA-48-like carbapenemases, and we need people to pay attention."
He calls the news that a superbug gene recently found in China that has already infected someone in Denmark the worst he's heard in a long time.
The term "Phantom Menace" conveys the way "this bug and others of its ilk spread around the world unnoticed until they reach a critical mass," Price said.
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It's an ideal term by almost every measure: it's accurate, it's a reference almost everyone gets, and the timing couldn't be better, with Star Wars Episode VII opening next week. In other words, it's clickable.
"If you go with a very dry, dense, opaque scientific term, it turns into that Charlie Brown teacher voice or white noise, and it's really unlikely most readers will key into it," said Mike Bell, deputy director of the Center for Disease Control and Prevention's Division of Healthcare Quality Promotion.
"Having an easily acquired handle for topics like this can be helpful to shine a light on them among all the other things" in the 24-hour news cycle. "It's very clever; I wish I'd thought of it," he added.
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That credit goes to French scientists who coined it in a 2012 study and the Washington Post for reviving it last week when the CDC reported the rise of the bug in the U.S.
Compare it to nontuberculous mycobacterial infections: "That's a bad name," Bell said. "Whenever you're telling us what it's not," it's not a good choice.
Another way to tell if a name isn't working: it's followed by a colon and a short phrase. "Ebola is highly recognizable," Bell said. "You don't need to say ‘Ebola: the deadly virus.'"
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Of course, Phantom Menace is not the actual name of the bug, Price points out. And, the concept applies to more than one bacteria.
"My only reservation is that the same description really applies to all these bugs that spread asymptomatically, but when they get a hold of somebody, they kick you when you're down," Price said. "So when your immune system is down, or for people in the ICU or a group of elderly people - that's when they really do their thing."
Diseases are named with an eye to new guidelines from the World Health Organization, which discourages associations with places, groups of people and animal species (think Middle East Respiratory Syndrome, Spanish Flu, swine flu).
It also discourages "terms that incite undue fear," such as "fatal." But more subtle references to fear can be helpful in making people pay attention, Bell said. Anthrax, for example, invokes a sense of foreboding simply based on its sound.
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"The letter X is uncommon," Bell pointed out, although he's not sure "what it is that makes it a threatening name."
"X" is also used in XDR TB, for extensively drug-resistant TB.
When a name doesn't escape from the "white noise" of scientific speak, it's often dubbed something else. Remember the bovine spongiform encephalopathy scare of the 1990s? Hint: It's nickname is mad cow disease. How about E. coli O157:H7? It's better known as Jack-in-the-Box E. coli.
The color black, as in black plague, can also give a subtle indication of fear.
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At a minimum, a name should be pronounceable or have a pronounceable acronym, Price said. MRSA (shorthand for Methicillin-resistant Staphylococcus aureus), for example, may mean very little to most, but it helps to be able to say "mer-sah," rather than M.R.S.A. Same goes for SARS, short for severe acute respiratory syndrome, and MERS, despite its reference to a location.
Even H1N1 and E. coli are OK because they're easy to say, Bell said.
As a runner-up to Phantom Menace, Price likes H30-Rx, a train of antibiotic-resistant E. coli bacteria.
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"When we discovered a new strain of E. coli that kills a lot of people in the U.S. and is really resistant to antibiotics, we thought about the name quite a bit and coined the name H30-Rx," he said. "It's still a little wonky, but it has that T. Rex sound to it, plus the Rx for treatment. It didn't take off in the media but our scientists colleagues picked up on it."
The bottom line: The reason scientists need the public to recognize things like carbapenem-resistant Enterobacteriaceae (CRE) producing OXA-48-like carbapenemases is so they ask legislators to fund research, Price said. "I don't try to heighten these things to get funding, but we need to pay attention," he said. "This and global climate change are the two biggest things we face today."