Chickens at One Straw Farm, Hereford, Md.
Today, Environmental Health Perspectives published an important study showing that the removal of antibiotic use on poultry farms results, quickly and dramatically, in a reduction of antibiotic-resistant Enterococcus. The study, led by Amy Sapkota of the University of Maryland School of Public Health, investigated the impact of removing antibiotics from U.S. poultry farms by studying ten conventional and ten newly organic large-scale poultry houses in the mid-Atlantic region. They tested for the presence of enterococci bacteria in poultry litter, feed, and water, and tested its resistance to 17 common antimicrobials, most of them critically important in treating human infections.
Sapkota’s research was funded in part by the Johns Hopkins Center for a Livable Future (CLF), and it validates the trend underway among some poultry farms—converting from conventional to organic methods. Sapkota, who earned a doctorate in Environmental Health Sciences at the Johns Hopkins Bloomberg School of Public School and once served as the CLF research director, said, “We initially hypothesized that we would see some differences in on-farm levels of antibiotic-resistant enterococci when poultry farms transitioned to organic practices. But we were surprised to see that the differences were so significant across several different classes of antibiotics even in the very first flock that was produced after the transition to organic standards.” Read More >
Last week, Senators Diane Feinstein (D-CA) and Susan Collins (R-ME) took an important stand in support of America’s health by reintroducing the Preservation of Antibiotics for Medical Treatment Act (S. 1211). The bill aims to prevent the misuse of antibiotics in agriculture to ensure their continued effectiveness in the treatment of both human and animal diseases. Senators Jack Reed (D-RI) and Barbara Boxer (D-CA) are co-sponsoring, and the bill has been referred to the Senate Committee of Health, Education, Labor, and Pensions. Rep. Louise Slaughter (D-NY) has been the major champion for PAMTA in the House and has made several attempts to push the bill forward. She reintroduced it this year, and in March it entered the House Subcommittee on Health.
In her introduction, Sen. Feinstein explained the significance of the bill, particularly its role in protecting public health. Currently, about 80% of all antibiotics sold are for livestock, mostly for nontherapeutic purposes. Approximately 74% of these antibiotics are administered through feed containing low doses. This provides imprecise and inconsistent drug dosing that can result in drug resistance amongst surviving bacteria. Unfortunately, these resistant microbes can travel to humans and cause serious illnesses that are no longer treatable with standard antibiotics. Read More >
When moms talk you can bet lawmakers listen, not to mention food retailers. That is exactly what the Pew Campaign on Human Health and Industrial Farming is counting on following the release of a nationwide poll of 804 American moms, which found that 80 percent are concerned that food animals produced on industrial farms are being given large amounts of antibiotics. Each of these moms is a registered voter and has kids aged 16 or younger. Not only were most of the moms polled concerned about antibiotic use, more than three-quarters said they would support federal regulations to limit its use in food animals.
No doubt this news has the animal agriculture industry concerned. Despite the warnings from scientists and public health experts of the risks of the low-dose use of antibiotics in livestock and poultry, food animal producers have for years fought proposed federal regulations claiming there is little proof the practice poses a risk to humans. Top leaders of the U.S. Centers for Disease Control and Prevention and the Food and Drug Administration disagree with animal producers. Former FDA Deputy Commissioner Joshua Sharfstein testified in front of Congress stating the links are undeniable and in a letter to the Johns Hopkins Center for a Livable Future (CLF) the director of the CDC, Dr. Thomas R. Frieden, confirmed that the CDC, “feels there is strong scientific evidence of a link between antibiotic use in food animals and antibiotic resistance in humans.”
More and more research continues to pour in, almost on a daily basis, linking antibiotic-use in intensive food animal production facilities to the growing threat of antibiotic resistant infections in people. Earlier this month, a Pew funded nationwide study of grocery store meats revealed nearly 50 percent of the meat and poultry we buy carries antibiotic-resistant Staphylococcus aureus and that DNA tests indicate the animals themselves were the primary sources. Read More >
India is the most recent country to address the public health concerns associated with the use of non-therapeutic antimicrobials in food animal production, and in doing so, may just leap-frog the United States.
India’s Directorate General of Health Services recently released a policy document entitled “The National Policy for Containment of Antimicrobial Resistance (NPCAR)”, which outlines approaches for targeting both human and animal antimicrobial usage, infection prevention and control, education and training on administration of antimicrobials, antimicrobial resistance surveillance systems, and enforcement.
“It is a move that should be viewed as very positive, if significantly overdue” says Ed Broughton, Research and Evaluation Director of the USAID Health Care Improvement Project at University Research Company and former doctoral fellow at the Johns Hopkins Center for a Livable Future.
Among the proposed policies specific to food animal production, the NPCAR recommends banning non-therapeutic usage of antimicrobials in food animals, labeling requirements in food exposed to antimicrobials, and banning over-the-counter (OTC) sale of antimicrobials. It is not clear whether the OTC sales ban would also apply to purchases of antimicrobials in feed (i.e. medicated feed) for food animals. Read More >
The editors of Scientific American recently encouraged U.S. hog farmers to “follow Denmark and stop giving farm animals low-dose antibiotics.” Sixteen years ago, in order to reduce the threat of increased development of antibiotic resistant bacteria in their food system and the environment, Denmark phased in an antibiotic growth promotant ban in food animal production. Guess what? According to Denmark’s Ministry of Food, Agriculture and Fisheries the ban is working and the industry has continued to thrive. The government agency found that Danish livestock and poultry farmers used 37% less antibiotics in 2009 than in 1994, leading to overall reductions of antimicrobial resistance countrywide.
- Courtesy: Ministry of Food, Agriculture and Fisheries, Danish Veterinary and Food Administration, July, 2010
Except for a few early hiccups regarding the methods used in weaning piglets, production levels of livestock and poultry have either stayed the same or increased. So how did Danish producers make this transition, and why isn’t the U.S. jumping to follow suit? Like many things in industrial agriculture, the answer is not clear.
If any country knows how to intensively produce food animals, particularly pigs, it is Denmark. In 2008, farmers produced about 27 million hogs. In fact, the Scandinavian country claims to be the world’s largest exporter of pork. Thus Scientific American editors argue that the Danish pork production system should serve as a suitable model to compare to ours. U.S. agriculture economists from Iowa State University agree. In a 2003 report, Drs. Helen Jensen and Dermot Hayes stated that Denmark’s pork industry is “…at least as sophisticated as that of the United States… and is therefore a suitable market for evaluating a ban on antibiotic growth promotants (AGPs).” Read More >
One in six Americans contracts a foodborne illness each year (CDC). Such illness can mean an unpleasant day of vomiting, diarrhea, fever, and/or worse— hospitalization or death in rare cases. “There’s something that can be said about the problem of foodborne illness, that can’t be said of many other public health problems of the day” said Elisabeth Hagan, Under Secretary for Food Safety at USDA, who opened a January 25th foodborne hazards conference convened at the Pew Charitable Trusts offices in Washington DC, “and that is: Foodborne illness is preventable.”
The day-long conference “Managing the Risk of Foodborne Hazards: STECs and Antibiotic-Resistant Pathogens” was organized jointly by Pew and the Center for Science in the Public Interest (CSPI). Hagan and other conference speakers focused their attention on antibiotic-resistant pathogens and shiga toxin-producing Escherichia coli (E. coli). A key message that I heard from several speakers was that we know enough today to develop policies that can enable action in addressing the most pressing foodborne hazards.
Central to the development of smarter food policies is incorporating our understanding the ecology of foodborne microbes. For example, understanding the ecology of toxin-producing E. coli strains can improve our ability to detect the right types of E. coli in tainted foods. In another example, nontherapeutic use of antibiotics in food animal production creates a persistent collection of antibiotic-resistant bacterial genes or a ‘resistome’ on farms that is difficult to dismantle. Antibiotic-resistance genes transferred to pathogenic bacteria creates a health hazards for animal workers, slaughterhouse workers, farm neighbors, and to consumers who handle or prepare raw meat in their kitchens.
The Pew/CSPI conference focused on antibiotics in food animals because in 2009 nearly 80% by weight of all antimicrobials were sold for use in food animal, and the remaining 20% by weight were used in human medicine, as reported last year by Ralph Loglici on the Livable Future Blog.
Resistance is an inevitable result of using antibiotics on food animals or humans. In the words of Quijing Zhang of Iowa State University, “[it is] always going to happen.” Once gut bacteria become resistant to antibiotics, they can trade the blueprints for resistance to other beneficial bacteria or with pathogenic bacteria in a giant microbial swap meet called ‘the resistome.’
The microbial world’s resistome and our own human-centered biome collide more often than we think—just talk to a health care provider about hospital-acquired antibiotic resistant infections or read the latest 2008 report on the quality of retail meats from the U.S. National Antimicrobial Resistance Monitoring System.
When humans take antibiotics or animals are given antibiotics, these are individual decisions—and as Dr. Stuart Levy of Tufts University pointed out, “[these individual decisions have] societal effects when antibiotics are mismanaged, such that every dose of antibiotics has a consequence.” Levy underscores the severity of current practices, saying, “the fact that we are still practicing [the use of antibiotics in animal production] is an embarrassment and a mistake.”
Read More >
Antibiotics, one of the world’s greatest medical discoveries, are slowly losing their effectiveness in fighting bacterial infections and the massive use of the drugs in food animals may be the biggest culprit. The growing threat of antibiotic resistance is largely due to the misuse and overuse of antibiotics in both people and animals, which leads to an increase in “super-bacteria”. However, people use a much smaller portion of antibiotics sold in this country compared to the amount set aside for food animals. In fact, according to new data just released by the Food and Drug Administration (FDA), of the antibiotics sold in 2009 for both people and food animals almost 80% were reserved for livestock and poultry. A huge portion of those antibiotics were never intended to fight bacterial infections, rather producers most likely administered them in continuous low-dosages through feed or water to increase the speed at which their animals grew. And that has many public health experts and scientists troubled.
For years scientists concerned about the threat of antibiotic resistant bacteria in food animal production have been trying to figure out just how much antibiotics producers are using each year. The best they could do was come up with rough estimates. That is because the data was never publicly available, until now. Read More >
It is time for some straight talk about the risks of using massive amounts of antibiotics in livestock and poultry. I don’t know one infectious disease expert who would disagree that there are direct links between antibiotic use in food animals and antibiotic resistance in people. Period. If you don’t believe me just ask Rear Admiral Ali Kahn, Assistant Surgeon General and Acting Deputy Director for the CDC’s National Center for Emerging and Zoonotic Infectious Disease. Just this summer, during a hearing before the House Energy and Commerce Committee, Dr. Kahn testified that, “there is unequivocal evidence and relationship between [the] use of antibiotics in animals and [the] transmission of antibiotic-resistant bacteria causing adverse effects in humans.”
Knowing this, I continue to be frustrated with the fact that Agriculture Secretary Tom Vilsack does not publically recognize that the industrial food animal production system is a leading contributor to the increase of antibiotic resistance in pathogens that infect people and animals. Earlier this month at a National Cattlemen’s Beef Association meeting, Vilsack reportedly responded to a question about the Preservation of Antibiotics for Medical Treatment Act (PAMTA) by saying the, “USDA’s public position is, and always has been, that antibiotics need to be used judiciously, and we believe they already are.”
That quote had me scratching my head when I read it in a New York Times Op-Ed a couple of weeks ago. The Times’ editors interpreted the statement as saying Vilsack believes there is no need to change antibiotic use policy among food animal producers. That contradicts the positions of both the FDA and CDC. The Times pointed out that while neither regulatory agency is doing enough to address the problem both, at least, recognize that current antibiotic use should change. Read More >
Congressional testimony by two high-ranking government officials in April revealed some misconceptions about the mounting evidence over the use of antibiotics in industrial farm animal production and links to antibiotic resistance in humans.
To clarify the case, Keeve Nachman, PhD, MHS, and director of CLF’s Farming for the Future Program, and Robert Lawrence, MD, director of CLF, wrote to Thomas Frieden, MD, MPH, director, Centers for Disease Control and Prevention, and Anthony Fauci, MD, director, National Institute of Allergy and Infectious Diseases. Both Frieden and Fauci provided testimony before the Subcommittee on Health of the House Committee on Energy and Commerce, the second of three hearings examining antibiotic resistance. A third committee hearing on Antibiotic Resistance and the Use of Antibiotics in Animal Agriculture” was held July 14.
“We reviewed with great interest your testimony and Q&A session,” they wrote. “What we’ve found in our review of the transcript underscores the need for the public health community to ensure that findings of our research are effectively and accurately communicated with those responsible for legislative and regulatory policy.” Read More >
The CBS Evening News with Katie Couric aired yet another report last night detailing the risks associated with feeding antibiotics to farm animals. The report is a follow-up to a series aired in February and reported on here in the LivableFutureBlog. In last night’s report, Couric covers Wedneday’s Congressional hearing held to determine whether or not the feeding of antibiotics to healthy farm animals could pose a significant health risk to humans. This was the third, and final, Congressional hearing on antibiotic resistance. At the hearing of the House Energy and Commerce subcommittee, a representative of the United States Department of Agriculture (USDA) finally caught up with the rest of the world—and his peers at the Food and Drug Administration (FDA) and Center for Disease Control and Prevention (CDC)—and admitted that the use of antibiotics in farm animal feed is contributing to the growing problem of deadly antibiotic resistance in America.Dr. John Clifford, Deputy Administrator for Veterinary Services for the USDA’s Animal and Plant Health Inspection Service (APHIS) read from his previously submitted testimony that the USDA believes it is likely that U.S. use of antibiotics in animal agriculture does lead to some cases of resistance in humans and the animals.
The Center for a Livable Future submitted a written statement to the House Committee. “The Food & Drug Administration recently released a draft “guidance document” that reviewed the evidence linking antimicrobial resistance to food animal production,” Dr. Robert S. Lawrence, Director of the Johns Hopkins Center for a Livable Future wrote. ” FDA concludes, ‘Using medically important antimicrobial drugs for production purposes is not in the interest of protecting and promoting public health.’ FDA clearly supports the conclusions of public health researchers discussed here, and has begun taking action in response to antimicrobial resistance accelerated by animal agriculture. No scientific debate exists on these issues–only political questions remain.
“I commend members for their leadership on this topic, and urge further action to fully prohibit using antimicrobial drugs for growth promotion and prophylaxis. Preserving the efficacy of antimicrobials in human medicine require immediate action, and I urge Congress to move quickly in taking steps to protect the public’s health.”
As reported previously in the LivableFutureBlog, a bill to limit the use of antibiotics–H.R. 1549, Preservation of Antibiotics for Medical Treatment Act–is awaiting committee action.
Many other influential media outlets are giving the issue of antibiotics in animal feed significant coverage. A recent article in DesMoinesRegister.com, “Antibiotics in livestock affects humans, USDA testifies,” notes the “Agriculture Department, which livestock producers have traditionally relied on to advocated for their interests, backed the idea of a link between animal use of antibiotics and human health.”