Flu season has arrived, and it’s sure to be a nuisance—but will it be interesting? This year, the CDC is keeping a keen eye on three novel swine flus that have infected humans. This pig-to-human transmission is noteworthy in itself, but there’s more: two of the three swine flu viruses have taken on genetic material from the 2009 H1N1 virus, in a process known as reassortment.
Confirming the onset of flu season is a February 10 Flu Report by the CDC; the arrival of flu season is nothing remarkable. But since August, the CDC has reported three novel influenza A virus variants (H3N2v, H1N1v, H2N2v) that have infected humans in the U.S., for a total of 14 cases. (Twelve of the 14 cases are H3N2v.) All three viruses originated in swine herds, and CDC has labeled the infection of humans with these swine flus as “rare events.” On December 9, the CDC was “taking this situation very seriously.” 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.
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 >
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.”
The director of the Centers for Disease Control and Prevention, Dr. Thomas R. Frieden, confirms that the CDC “feels there is strong scientific evidence of a link between antibiotic use in food animals and antibiotic resistance in humans.” Frieden offered the CDC’s position in his response to a letter from Keeve Nachman, PhD, MHS, and director of CLF’s Farming for the Future Program, and Robert Lawrence, MD, director. Lawrence and Nachman sent the letter to Frieden and Anthony Fauci, MD, director, National Institute of Allergy and Infectious Diseases, last June seeking to clarify Congressional testimony concerning the evidence against the use of antibiotics in industrial farm animal production.
Frieden noted the multiple North American studies that show the links between antibiotic use and antibiotic resistance. “In addition,” he said, “a strong body of evidence from Europe demonstrates that antibiotic use in animals is linked with antibiotic resistance in humans. We have thoroughly reviewed these studies and have found them to be well-designed and rigorous, and to establish a clear link between antibiotic use in animals and antibiotic resistance in humans.”
Lawrence and Nachman commended the position officially stated by the CDC. “We are gratified that the CDC recognizes the scientific connections between the inappropriate and overuse of antibiotics in food animal production and antibiotic resistance in humans, and pledge to continue to work closely with the agency, regulators, and policymakers to address the problem. A number of studies supported by the CLF and by others clearly establish the direct causal link between use of low dose antibiotics in feed or water for growth promotion and the emergence of ever-more antibiotic resistant strains of bacteria that are important human pathogens.” Legislation on a bill to limit antibiotic use in food animal production, the Preservation of Antibiotics for Medical Treatment Act, is now pending in Congress.
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 >
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.”
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.”
There aren’t exactly celebrities in the field of public health, but a few of the biggest names are in Atlanta this week for the National Environmental Public Health Conference (NEPHC). For one, Thomas Frieden, the new director of the Centers for Disease Control, got a rock star reception when he addressed the 1,100 conference attendees primarily from academia, nonprofit organizations and government entities on Monday.
Frieden, formerly the commissioner of the New York City Department of Health, was recently appointed by the Obama administration to head the CDC, based on his successes in New York. Menu labeling laws, trans fat bans, increased cigarette taxes and smoke-free bars and restaurants all were enacted on his watch (with the support of his former boss Mayor Mike Bloomberg, himself a champion of public health). In Frieden, it’s clear we have not only an advocate for environmental health, but also a skillful leader who understands the policy process and the best strategies for achieving meaningful changes.
Other representatives from federal agencies spoke about their efforts to reduce potentially harmful chemical exposures in food, air and water. The deputy secretary of the U.S. Department of Agriculture, Kathleen Merrigan, spoke of her desire for a more regional food system and improved food safety and school nutrition standards. She even mentioned the agency’s commitment to organic produce, showcased at an organic garden at the USDA headquarters in Washington. Hmmm, I wonder if USDA got the same backlash from the pesticide industry that Michelle Obama received after planting her organic garden at the White House? Read More >
Timing could be better considering the latest warnings of sugar shortages and price spikes by U.S. food manufacturers, but at least one public health communications and marketing researcher believes a tax on high fructose corn syrup could help in the fight against America’s obesity epidemic. I caught up with Dr. R. Craig Lefebvre, a professor at George Washington University School of Public Health’s Department of Prevention and Community Health, in Atlanta this week after he took part in a panel discussion at the CDC’s National Conference on Health Communication, Marketing and Media. Dr. Lefebvre suggested that directly taxing consumers who buy sugary drinks or foods would be much more regressive than taxing manufacturers who use high fructose corn syrup. His argument: while producers may want to pass on the higher costs to their customers, market pressures may force them to come up with ways to reduce their dependence on high fructose corn syrup without raising prices. What do you think of Dr. Lefebvre’s proposal?
It was meant to be the kickoff of a national conversation, but the Centers for Disease Control (CDC) sponsored meeting on chemical exposures and public health, held in Washington last week, felt more like an argument at times.
The meeting started off predictably enough—with Howard Frumkin, the director of the CDC’s National Center for Environmental Health, Agency for Toxic Substances and Disease Registry,discussing the importance of strengthening scientific understanding of chemical exposures, urging better collaboration among public health agencies, local governments and non-governmental organizations, and outlined the goal of developing an action agenda for strengthening the public health approach to chemical exposures.This agenda, he said, should be based on values everyone can get behind—including prevention of morbidity and mortality, good science, the effective use of resources, care for vulnerable populations, and responsible stewardship for future generations.
Lisa Jackson, the new administrator of the Environmental Protection Agency, won the loudest applause of the day for her remarks.Jackson, who leads a staff of 18,000 at the EPA, said she aims to restore America’s faith in the EPA to protect them and preserve the environment.By refocusing on core issues such as chemical management, reporting requirements, environmental justice, land use management—Jackson hopes to bring increased accountability to the agency. Read More >