December 21, 2011

Fight the Resistance

Sophia LeMaire

Sophia LeMaire

Science Translation Research Assistant

Center for a Livable Future

Kremer with piglet (The Missourian)

Drug-resistant infections are nothing to sneeze at. Margaret Chan, Director-General of the World Health Organization, this year said that “in the absence of urgent corrective and protective actions, the world is heading toward a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated.” Last year, a New York Times article addressed the increase in drug resistance and how it is outpacing the development of new antibiotics; in the article, Brad Spellberg, a doctor specializing in infectious disease at Harbor-UCLA Medical Center, said “For these infections, we’re back to dancing around a bubbling cauldron while rubbing two chicken bones together.”

Last week, I attended a Congressional briefing on the use of antimicrobials in food animal production sponsored by Representative Louise Slaughter (D–NY) and organized by the Institute for Agriculture and Trade Policy (IATP). The low doses of antibiotics that animals consume via medicated feeds have been linked to an increase in drug-resistant bacteria that can spread from the herds to the community via contaminated meat or dairy products or contact with farm personnel. Speaking were four business executives and farmers who’ve had personal and professional experiences with the issue. The CEO of Applegate Farms, the CEO of Chipotle, and the founder of Niman Ranch related their companies’ experiences transitioning to meat from animals raised without the use of antibiotics, and what motivated each of them to just say no to antimicrobial growth promoters for their meat.

Also speaking was Russ Kremer, founder of the Ozark Mountain Pork cooperative, who provided a welcome bit of perspective. A farmer all his life, Kremer spoke about how he began using antibiotics on his farm, wooed by integrators who promised increased efficiency and higher profits. Although he was unsatisfied raising increasingly sick and dying hogs, he continued the industrialized operation in the hopes that the higher yield would outweigh his dissatisfaction. Everything changed when he was gored in the leg by a boar. Having worked on a farm since he was a boy, he was accustomed to the occasional injury and thought little of it. He “poured the blood out of his boot,” cleaned himself up, and continued working without seeking medical attention. A few weeks later when his leg had swollen to twice its normal size, the gravity of the injury became apparent. His doctor quickly diagnosed a Streptococcus infection, and prescribed antibiotics. The first treatment, penicillin, didn’t work, so his doctor tried another class of antibiotic…and another…and another. Finally, the fourth antibiotic, cephalosporin, got the infection under control. Kremer said plainly that this drug saved his life.

You might be thinking that your best bet is to stay away from angry boars. But while farm workers are at an elevated risk of infection, you’d be mistaken if you thought that they were the only susceptible ones.

A quick Google search produces fearsome troubling statistics about drug resistant infections. For MRSA alone, which is a staph (not strep) infection, of the over 250,000 people infected with this bug, 19,000 of them will die from complications associated with their infection. And even though 19,000 is only about .006% of the current U.S. population, 19,000 people is about 4,000 more people than live in my hometown, almost five times the number of students attending my alma mater, and more than 450 times the number of people on my brother’s paper route. I, like many people, sometimes found it difficult to make such lofty figures personal. That is, until I put a name to one of those thousands of faces.

This past spring, my friend’s brother was in the hospital with a Strep infection. A junior high-schooler in otherwise good health, he is among a relatively low-risk group. What began as an unalarming cough and fever quickly turned into rapid heartbeat, fluid in his lungs, and dangerously low blood pressure. The doctors suggested at the onset that he may be experiencing Toxic Shock Syndrome, and over the next week added acute pancreatitis and possibly a staph infection—all apparently resulting from a days-old cut on his knee—to his list of maladies.  For ten days, his medical team pursued aggressive treatment with several different antibiotics and intravenous feeding, and still his vital signs remained unstable. He survived the infection, and eventually he was well enough to go home, although it would be a while before the exhaustion of the whole ordeal wore off.

Both these stories had happy endings: Russ Kremer is enjoying his work now that he is raising healthy hogs the way he wants to (that is, without antibiotics), and my friend’s brother is back to being a healthy 13-year-old. Both have recovered from their strep infections. It is sobering, though, to consider the little brothers, neighbors, parents, and friends that must be part of that 19,000-person tally with antibiotic-resistant staph infections.

The good news is that you don’t have to be a scientist or a farmer to have a say. By supporting companies like Applegate farms and Chipotle that have made a commitment to source their meats from farms that are not using antibiotics in their animals, you can eat well, protect society, and fight the resistance—and help build a food system that does not undermine our ability to treat disease.

 

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