Maryn McKenna

Journalist and Author

FDA Finally Imposes Some Controls on Agricultural Antibiotics. Sort Of.

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USDA Photos by Lance Cheung/Flickr

This morning, the US Food and Drug Administration dropped some long-awaited-but-still-big news regarding the use of antibiotics in meat production. Tl;dr: The FDA asked (but did not compel) the livestock industry to stop using the micro-dose “growth promoter” antibiotics that are widely believed to contribute to increase in antibiotic resistant bacteria in animals, food and humans.

With exquisite timing, they happen to have picked a day when I am traveling, in order to get to my end-of-semester evaluation tomorrow for my  MIT fellowship. So I’m going to do what curation I can on this, and point to some important reactions and analyses. I’ll come back for a deeper look, probably on the weekend.

So here are the basics.

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Shutdown Salmonella Outbreak Continues. CDC Food Safety Chief: 'We Have a Blind Spot.'

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Image: Ben Husmann, (CC), Flickr

We’re 11 days now into the federal shutdown and four days since the announcement of a major foodborne outbreak in chicken that is challenging the shutdown-limited abilities of the food-safety and disease-detective personnel at the Centers for Disease Control and Prevention, Food and Drug Administration and Department of Agriculture. Here’s an update.
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There's a Major Foodborne Illness Outbreak and the Government's Shut Down

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image: BokChoi-Snowpea (CC), Flickr

Late-breaking news, and I’ll update as I find out more: While the government is shut down, with food-safety personnel and disease detectives sent home and forbidden to work, a major foodborne-illness outbreak has begun. This evening, the Food Safety and Inspection Service of the US Department of Agriculture announced that “an estimated 278 illnesses … reported in 18 states” have been caused by chicken contaminated with Salmonella Heidelberg and possibly produced by the firm Foster Farms.

“FSIS is unable to link the illnesses to a specific product and a specific production period,” the agency said in an emailed alert. “The outbreak is continuing.”

(Updates to this post are at the bottom.)

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A Few Ways the Government Shutdown Could Harm Your Health (And the World's)

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image: BMills (CC), Flickr

There’s going to be a lot — a lot — of coverage today on the federal shutdown, what it means and how long it might go on. I thought it might be worth quickly highlighting how it affects the parts of the government that readers here care most about: public health, global health, food safety and the spread of scary diseases.

Most of those government functions are contained within the Cabinet-level Department of Health and Human Services, where 52 percent of the employees have been sent home. So the news is not good.

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CDC Threat Report: Yes, Agricultural Antibiotics Play a Role in Drug Resistance

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Campylobacter bacteria. Image: CDC

The grave assessment on the advance of drug resistance, released Monday by the US Centers for Disease Control and Prevention, contained some important observations about the relationship between antibiotic use in agriculture and resistant infections in humans. Those observations, combined with remarks made yesterday by the director of the CDC and also with testimony given in the past by other CDC personnel, ought to put to rest what seems like a persistent meme: that the CDC has never said, or doesn’t believe, that agricultural antibiotic use plays a role in the advance of resistance.

This is important because it puts the CDC in line with a substantial body of research pointing to agricultural use playing a role in the emergence of resistance outside farm properties. With the CDC agreeing — plus, to some degree, the Food and Drug Administration — surely it’s time to move on to whether there are things that could be done to curb the risks posed by some ag practices, while respecting the role that livestock-raising in particular plays as a substantial economic sector, and as an engine in feeding the world.

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USDA: Chicken Processed in China Can be Sold in the US Without Labels to Say So

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source: nugget photo and poor Photoshop skills by me.

Catching up to this news, which dropped quietly just before the holiday weekend: In a first, the US Department of Agriculture has given permission for chicken products processed in the People’s Republic of China to be sold in the United States without labeling that would indicate where the chicken products came from.

The news was broken by Politico, whose writers obtained USDA documents before the agency released them, and then followed up by the New York Times, with some no-holds-barred analysis by Bloomberg Businessweek.

If you’ve been reading for a while, you’ll know that food safety in China is well below US standards. (See this post for stories of toxic vinegar, glow-in-the-dark pork, and more.) So it may be a surprise to hear that birds grown and slaughtered outside that country, but cooked and made into products in it, would be acceptable for sale here. Especially since the plants that USDA has approved for sales into the US market will not have USDA inspectors on site.

Here is the USDA notice, in the form of an audit issued by the Food Safety and Inspection Service.

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Two Former FDA Commissioners Agree: Ag Antibiotic Policies Must Change

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source: Anselm (CC), Flickr

This is an ICYMI (“in case you missed it”) post, twice over. Last week, former Food and Drug Administration Commissioner Donald Kennedy, Ph.D., wrote a piece for the Washington Post in which he urged that the FDA change how it regulates antibiotics that are used in agriculture as part of meat production.

His prescription is notable, not just in itself, but because it marks the second time in a few months that a former commissioner of the FDA used a major paper’s op-ed page to criticize his former agency’s conduct on farm antibiotic use. David A. Kessler, M.D., did the same thing, hitting many of the same points, in the New York Times in March.

Kennedy was FDA Commissioner from 1977 to 1979, just as scrutiny of antibiotic use in livestock-raising was beginning. (There’s a timeline in this post.) Kessler was Commissioner from 1990 to 1997, during the time in which the FDA began to look for, and find, antibiotic-resistant bacteria on retail meat. There were almost 20 years between their tenures — and 16 years from Kessler to now — and yet almost nothing has changed.

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More on 'Nightmare Bacteria': Maybe Even Worse Than We Thought?

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Flickr: CelesteH, CC

In my last post I talked about the under-appreciated emergence of “nightmare bacteria” (those are the Centers for Disease Control and Prevention’s words, not mine) that are widely distributed in hospitals and nursing homes around the world and do not respond to a last-ditch small family of antibiotics called carbapenems. That seemed dire enough, but new research suggests the problem, bad as it looks, has been understated.

There’s an ahead-of-print article in Antimicrobial Agents and Chemotherapy whose authors include David Shlaes, a physician-researcher and former pharmaceutical executive, now consultant, and Brad Spellberg, an infectious disease physician on the UCLA medical faculty and author among other books of Rising Plague, about antibiotic resistance. In a commentary examining the Food and Drug Administration’s promised “reboot” of antibiotic development rules, they analyze privately gathered data on resistance in the United States and conclude the incidence of highly resistant bacteria is greater than the CDC has estimated.

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Summer Is Lyme Disease Season. The Price of the Drug to Treat It Just Exploded

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If you’ve been reading for a while, you might remember some posts about nationwide shortages of drugs. The Food and Drug Administration was concerned, and so were very senior physicians working in infectious disease, cancer, everyday emergency medicine and even veterinary care.

The crisis faded from view, as they do. So it wasn’t much noticed that back in March, the American Academy of Pediatrics warned of an FDA alert over an apparent shortage of doxycycline, an old and inexpensive drug that is used mostly for uncomplicated infections such as sexually transmitted diseases and acne. It is also used, though, as the first treatment for a new case of Lyme disease — and that, more than anything, has sparked alarm.
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Fecal Transplants: The FDA Steps In

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Hi constant readers: I am traveling again, and while I’m in a far time zone, news has broken that you might be interested in. So while I don’t have a full understanding myself yet of what’s going on, I’m going to throw up what I’ve got, because I know how many people are interested in this.

Briefly: The US Food and Drug Administration has decided to bring the semi-outlawed — but very safe and very effective — procedure called “fecal transplant” under its auspices, ruling that to perform it, physicians must have applied for an “investigational new drug application,” or IND. This requires a lot of advance paperwork, 30 days of consideration, and does not return not a guaranteed yes. For the transplants, which have been performed informally but carefully by a growing number of physicians as a treatment (and often cure) for devastating C. difficile infection, it may improve safety, but it can’t help but impose obstacles and delay. (My past posts on fecal transplants here and here.)

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