ANTIBIOTIC RESISTANCE & HUMAN DISEASE

The CAFO Connection

The Centers for Disease Control and Prevention (CDC) have officially confirmed what health advocates, independent scientists and common sense nutritionists have maintained, and CDC had alluded to, for years: uncontrolled use of antibiotics in food animals is dangerous to humans.

In its report, Antibiotic Resistance Threats in the United States, 2013, the CDC states:

Antibiotics are widely used in food-producing animals, and according to data published by FDA, there are more kilograms of antibiotics sold in the United States for food- producing animals than for people. This use contributes to the emergence 
of antibiotic-resistant bacteria in food-producing animals. Resistant bacteria in food- producing animals are of particular concern because these animals serve as carriers.

Resistant bacteria can contaminate the foods that come from those animals, and people who consume these foods can develop antibiotic-resistant infections. Antibiotics must be used judiciously in humans and animals because both uses contribute to not only the emergence, but also the persistence and spread of antibiotic-resistant bacteria.

Two million people acquire serious infections due to resistant bacteria, mostly patients in health related facilities. Of those made ill, 23,000 die.

Caroline Smith DeWaal, director of food safety at the Center for Science in the Public Interest(CSPI) said in a CSPI post: CDC found that 22% of the resistant illnesses are linked to foodborne hazards, so the overuse of antibiotics in the animal sector can no longer be ignored. The volume of antibiotics sold for use in animals dwarfs those used in human medicine. While attention to both sectors is vital, action is urgently needed to manage the food safety risks posed by the non-therapeutic use of antibiotics in food animals. At one time, the widespread use of antibiotics in the raising of food animals was driven by the propensity for disease at concentrated animal feeding operations.

CAFOs (confined animal feeding operations) raise mostly hogs, cows, sheep and chickens in conditions so cramped, unsanitary, and cruel, that daily doses of antibiotics are used to prevent the animals from acquiring infections and disease. But the later discovery that certain antibiotics also prompted fast growth in animals raised antibiotic use to even more abusive levels, prompting the CDC to conclude:
[T]he use of antibiotics for promoting growth is not necessary, and the practice should be phased out.

According to the Union of Concerned Scientists:
Resistant bacteria that develop in CAFOs (confined animal feeding operations) can be transferred to the general human population via food. The government, public health officials, and physicians are increasingly concerned about foodborne diseases caused by Campylobacter and Salmonella bacteria.
…As resistant strains of bacteria emerge, they have easy passage to humans—right though the grocery store. Campylobacter, for example, is carried into kitchens on poultry and can cause illness when people eat raw or undercooked poultry meat…In fact, the use in poultry of fluoroquinolones, a precious class of antibiotics, led to the development of resistant Campylobacter strains. Before fluoroquinolones were approved for use in agriculture in the United States, no fluoroquinolone resistance was reported in people unless they had previously taken the drugs for illness or traveled to a country that permitted their use in agriculture.

 

There are 1,300,000 Campylobacter infections each year resulting in 13,000 hospitalizations and 120 deaths, according to CDC.  The report points out regulatory responsibility lies not with CDC but:

[W]ith the U.S. Food and Drug Administration (FDA) which regulates antibiotics, many foods, animal feed, and other products; and with the U.S. Department of Agriculture (USDA), which regulates meat, poultry, and egg products. The best the CDC can say about FDA action to ban the use of antibiotics for growth purposes is: Recent guidance from the U.S. Food and Drug Administration (FDA) describes a pathway toward this goal.

Mae Wu at NRDC’s Switchboard parses the stilted phrase “describes a pathway”:

[F]rom all appearances, we can’t count on the Food and Drug Administration to make these necessary improvements. Despite recognizing this problem more than 35 years ago, the FDA’s only real action has been to propose guidelines on how antibiotics should be used in livestock that are not only voluntary, but also leave gaping loopholes that allow antibiotics to still be used on healthy animals under the guise of “disease prevention.”

On June 27, 2013, Senator Diane Feinstein (D,CA), Senator Kirsten Gillibrand (D,NY) and others introduced S.1256: Preventing Antibiotic Resistance Act of 2013., which would limit the use of antibiotics to actual disease control. The findings section of the bill is a primer on the shameful history of antibiotic abuse in agriculture, and regulatory failure at the Food and Drug Administration, and the U.S. Department of Agriculture (USDA).

Some excerpts:

  • In 1977, the Food and Drug Administration concluded that feeding livestock low doses of antibiotics used in human disease treatment could promote the development of antibiotic-resistance in bacteria. However, the Food and Drug Administration did not act in response to these findings, despite laws requiring the agency to do so. §(1)(A)
  • In 2012, the Food and Drug Administration was ordered by a Federal court to address the use of antibiotics in livestock, as the result of a lawsuit filed against the agency citing the agency’s failure to act.
  • In 2003, the Food and Drug Administration modified the drug approval process for antibiotics to recognize the development of resistant bacteria as an important aspect of safety, but most antibiotics currently used in animal production systems for nontherapeutic purposes were approved before the Food and Drug Administration began considering resistance during the drug-approval process. §(11)(A)
  • The Food and Drug Administration has not established a schedule for reviewing those existing approvals. §(11)(B)
  • In 2009, the Congressional Research Service concluded that, without restrictions on the use of antimicrobial drugs in the production of livestock, export markets for livestock and poultry could be negatively impacted due to restrictions on the use of antibiotics in other nations. §(13)

According to govtrack.us, a government transparency website, the chance that S.1256 will be reported out of the Senate Committee on Health, Education, Labor, and Pensions is 2%.  The chance it will pass on the floor of  the U.S. Senate is 0%.

CSPI’s senior staff attorney Sarah Klein said: CDC’s new findings underscore the price consumers pay for the continuing delay by the USDA to act on controlling antibiotic-resistant Salmonella in the nation’s meat supply. USDA should grant CSPI’s 2011 petition to declare these pathogens as adulterants to ensure that these superbugs are removed from the food supply whenever they are discovered.

Additionally, CSPI made the following recommendations:

  • FDA and the White House should immediately release new guidance for pharmaceutical companies, veterinarians and the food industry;
  • Food producers should use antibiotics on the advice of a veterinarian only to treat animal disease, and not as prophylactics or to promote growth;
  • To minimize exposure to antibiotic resistant pathogens in the meat supply, consumers should buy meats that bear a label saying “USDA Certified Organic” or “Raised Without Antibiotics: USDA Process Certified”.
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