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Big news in the world of food policy, farming and antibiotic use: Perdue Farms, the third-largest chicken producer in the United States, announced today that during the past decade it has ceased using most of the antibiotics that formerly propped up its chicken production.
There are caveats to that “most,” and I’ll explain them. But it’s important to say up front that this is a nationally significant move and looks like an industry-leading step.
Image: Matsuyuki/ Flickr
Breaking news today from the Centers for Disease Control and Prevention, out of its open-access journal Emerging Infectious Diseases: Researchers in Canada have identified a very highly resistant bacterium in squid imported from South Korea and being sold in a Chinese grocery store.
The letter reporting the finding was supposed to go live at noon ET, but hasn’t yet. When it does, it will be linked from this page, under the subheading Letters. It is titled: “Carbapenamase-Producing Organism in Food, 2014.”
Image: ICStefanescu (CC), Flickr
A troubling and also kind of odd story came out of Denmark this weekend. In a court proceeding, a microbiologist has disclosed that three residents of the country who had no known connection to farming died of MRSA infections caused by ST398, the livestock-associated strain of drug-resistant staph that first appeared among pig farmers in the Netherlands in 2004 and has since moved through Europe, Canada and the United States.
If the report is correct — and sources have told me it is, but I’ve seen no data to confirm it — it reinforces the concern that bacteria which become resistant because of antibiotic use on farms can move off farms and affect the health of people who have no connection to farming.
Livestock MRSA has always one of the best cases for establishing that, because the drug to which it showed the greatest resistance, tetracycline, wasn’t used against human MRSA in the Netherlands, but was used routinely on farms — so the only place the strain could have picked up its unique resistance pattern was in pigs. (Here’s my long archive of posts on pig MRSA, dating back to my book Superbug where the story was told for the first time.)
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Image: Willem vdh/Flickr
In my last post, I talked about the unnerving increase in avian flu H7N9 in China. The novel flu strain, now in its second year, appears to be spreading more rapidly than it did in its first appearance, and also more rapidly than H5N1, the avian flu strain that has caused the most worry internationally.
You can’t have avian flu — or at least, not this avian flu — without birds; most of the people who have been diagnosed with H7N9 had contact with live chickens or visited a market that sold live poultry for slaughter. H7N9 is continuing to spread in China; and so it’s a lucky coincidence that a nonprofit with deep knowledge of Chinese agriculture has just published a series of reports exploring the vast expansion of Chinese production of meat animals, including chickens.
Image: gina pina/Flickr
A nonprofit group that has been using the courts to pressure the Food and Drug Administration into exerting more control over farm antibiotic overuse has done a deep review of FDA documents prised loose through Freedom of Information Act requests — and concludes that by allowing the drugs to remain on the market as formulated, the agency isn’t meeting its own internal safety standards.
Instead of only making that assertion, the Natural Resources Defense Council took the unusual step of showing its evidence in detail. NRDC published its analysis, Playing Chicken with Antibiotics, alongside a selection of the raw documents it received from the FDA. You’ll have to be a document-obsessive to take it on: The file (cached in a Dropbox and requiring download to view) is 306 mb and 971 pages. But even without considering its content, the file’s heft makes clear how much discussion there has been at the FDA over this issue, and suggests how much evidence has been accumulating over the problem of antibiotic resistance emerging from livestock production. Also telling: The FDA has been attempting to put some controls on livestock production since 1977; these documents cover only reviews of antibiotic feed additives that were conducted between 2001 and 2010.
NRDC’s conclusion, in its report:
FDA’s scientific reviewers’ findings show that none of these products would likely be approvable as new additives for nontherapeutic livestock use if submitted today, under current FDA guidelines. Eighteen of the 30 reviewed feed additives were deemed to pose a “high risk” of exposing humans to antibiotic-resistant bacteria through the food supply, based on the information available. The remainder lacked adequate data for the reviewers to make any determination and their safety remains unproven. In addition, FDA concluded in their review that at least 26 of the reviewed feed additives do not satisfy even the safety standards set by FDA in 1973.
USDA Photos by Lance Cheung/Flickr
In my first take on the news of the FDA finalizing its request to agriculture to stop using growth-promoter antibiotics, I promised to come back for a more thoughtful reaction. And then this happened, and this happened, and the holidays happened, and, well, it’s been a busy few weeks.
So, finally getting back to it: When the news broke, a number of people, including me, said that this was a long-awaited first step on the part of the FDA, but of uncertain ultimate impact because it asks for voluntary action and does not address whether the drugs simply can be relabeled. I still agree with both those points, but think the possibly most important issue — which I raised briefly in the first post — is that merely removing antibiotics, without changing the system in which those antibiotics have been administered, may cause significant animal-welfare problems, without having any real effect on human health.
(If you’d like the short version of this, listen to my chat with NPR’s Weekend All Things Considered.)
image: Thousand Robots (CC), Flickr
Two important, linked publications are out today, both carrying the same message: The way we raise poultry in this country is creating an under-appreciated health hazard, and the government structures we depend upon to detect that hazard and protect us from it are failing us.
The two pubs are:
Short version: Independent tests show that multi-drug resistant disease-causing bacteria are widely present on chicken, and the US Department of Agriculture’s Food Safety and Inspection Service (FSIS) has insufficient personnel, or legal authority, to change that.
Both these assertions are important, because foodborne illness, and especially drug-resistant foodborne illness, are also under-appreciated — for how serious the disease can be, and how long-lasting the after-effects are. (For more on those: Here’s a piece I wrote for The Atlantic about how drug-resistant bacteria on chicken are causing an epidemic of urinary tract infections, and one for Scientific American about the lifelong cost of foodborne illness.)
It’s worth emphasizing also that we are right now in the middle of an outbreak of Salmonella on chicken that has been going on for about a year. The Centers for Disease Control and Prevention posted an update just this morning: 416 people since since last February, in 23 states and Puerto Rico, 39 percent of them hospitalized, linked to a single producer’s brand of chicken.
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.
Two years ago, I celebrated Thanksgiving here on Superbug by announcing some new studies on resistant bacteria being found in turkey meat in the US. That did not go over well; so this year, I saved the bad-turkey news for the post-holiday week. And here you go:
Just in time for our Thanksgiving — and in the ramp-up to English Christmas, for which turkey is a traditional dish — the UK’s Animal Health and Veterinary Laboratories Agency announced that livestock-associated MRSA, drug-resistant staph, has been found in UK poultry for the first time. From their not-very-informative press release:
The Animal Health and Veterinary Laboratories Agency (AHVLA) has identified the presence of Livestock-Associated Meticillin Resistant Staphylococcus Aureus (LA-MRSA) in poultry on a farm in East Anglia… Once the poultry have been slaughtered and sold the owner will carry out cleansing and disinfection of their accommodation to ensure the next birds do not become colonised when they arrive on site. The AHVLA will revisit the farm after depopulation and thorough cleansing and disinfection to determine whether LA-MRSA is still present.
USDA Photos by Lance Cheung/Flickr
It’s been a busy few weeks here at Casa Superbug — including some conference appearances, more on them later — so the first thing I’d like to do is point out some things that appeared while I was offline. Notably: In editorials, three newspapers recently challenged the way antibiotics are used on farms and asked why we can’t do better.
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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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.
Flickr: Thousand Robots, CC
In the long back and forth between science and agriculture over the source of antibiotic resistance in humans — Due to antibiotic overuse on farms, or in human medicine? — one question has been stubbornly hard to answer. If antibiotic-resistant bacteria do arise on farms, do they leave the farm and circulate in the wider world? And if they do, how much damage do they do?
A multi-national team of researchers recently published their answers to both questions. Their answer: In Europe, 1,518 deaths and 67,236 days in the hospital, every year, which would not otherwise have occurred.
Photo: ROIrving/ Flickr
In my last post I promised to catch up on some of the other research that has been published on the flow of MRSA (and other resistant organisms) between farm animals and farm workers as a result of farm antibiotic use.
Before I do that, though, I want to nod toward two other great pieces published on this. First, Mark Bittman examined this issue closely at the New York Times. And Clare Leschin-Hoar also covered the new research at Take Part. (Bonus: Don’t miss her dissection of the news that a National Geographic photographer was arrested in Kansas after taking pictures of a feedlot — from the air.)
Pig farms from the air. Maryn McKenna, 
I saved this post until today to allow everyone to get their holiday hot dogs guilt-free. Now that’s over: An important study has just been published which makes a close connection between the emergence of antibiotic-resistant bacteria, and the use of antibiotics on large-scale conventional hog farms. Bonus: It involves the resistant bacterium MRSA ST398 (known in shorthand as “pig MRSA”), which is widespread in Europe but up to this point has been found mainly in only one state in the US, Iowa. With this paper, the count rises to two(see Update): The study subjects in this paper are hog-farm workers in eastern North Carolina.
A quick explanation of why this is important: “Pig MRSA” is a particular strain of drug-resistant staph that is slightly different from the hospital and community (sports, gym) varieties. It was first spotted in the Netherlands in 2004, in the toddler daughter of pig farmers and in the family’s pigs. Since then, it has spread widely across Europe, not just in agriculture, but in healthcare and in everyday life, and has also been found widely in retail meat.
The question of whether livestock production’s use of antibiotics causes antibiotic-resistant bacteria to move into the wider world is much argued-over, and pig MRSA, or ST398 to be polite, is crucial to that dispute. That’s because, unlike most resistant bacteria, it has a genetic signature that makes an inarguable link back to farm drug use. More on that below. (If you want more, here’s an archive of my posts on ST398; the story of its emergence in 2004 and what happened afterward is told in my 2010 book SUPERBUG.)
Now, the study. Quick summary, with more unpacking to follow: Researchers checked livestock-farm workers in North Carolina to see whether they were carrying staph, and also drug-resistant staph. The workers formed two groups: one group worked at conventional hog operations, which routinely use antibiotics, and the other group at antibiotic-free farms. Both groups carried staph and also drug-resistant staph, which would be expected; about 30 percent of the population carries sensitive staph and about 4 percent carries the drug-resistant form. But, the key difference: Workers from the conventional, antibiotic-using farms were many times more likely to carry staph with the specific signature of farm-drug use.
That illuminates a potential occupational risk to the workers — and it also suggests that the workers could be a channel for that farm-influenced bacterium to move off the farm.
A pretty extraordinary thing happened Thursday, here in Georgia: A district court in the middle part of the state unsealed a 76-count, 52-page indictment of former officials of the Peanut Corporation of America (PCA), charging them with fraud and conspiracy for knowingly distributing peanut products contaminated with Salmonella.
The 2009 outbreak caused by the contaminated peanuts reached, literally, nationwide. Hundreds of products were recalled; 714 people were known to have been made sick by it in 46 states, one-fourth of them were hospitalized, and nine died, according to the Centers for Disease Control and Prevention. (As with other foodborne outbreaks, in which only a fraction of cases are confirmed by lab analysis, the actual number of victims may be much larger.) While that is not the largest outbreak recorded in the United States — the Salmonella in eggs scandal of 2010 sickened almost 2,000 people — it is definitely large: Most of the multi-state foodborne outbreaks analyzed by the CDC involve fewer than 100 known victims.
The PCA outbreak’s size makes it unusual, but so does the decision to press for prosecution: That happens in very few foodborne-illness cases. But if you read the indictment (which I extracted from the federal PACER system and put up at my Scribd account), you’ll see why the Department of Justice decided to prosecute this time. It alleges a trail of not only negligence — unrepaired roof leaks, ignored rodent infestations — but also deliberate deception which ranged from faked origin labeling to falsified lab results.
I suspect we think of large-scale confinement agriculture as a uniquely American issue. Possibly that’s because growth-promoter antibiotic use, which makes meat-raising efficient, originated in the United States; more likely, it’s because some of the largest firms in that sector — Smithfield and Tyson, for example — are US-based. But public and private research efforts (including the US Department of Agriculture, the United Nations’ Food and Agriculture Organization and the Pew Charitable Trusts) have documented that intensive livestock-raising is increasing in emerging economies such as India and China; as incomes rise, demand for meat does too.
A paper published Monday in the Proceedings of the National Academy of Sciences demonstrates that the unintended consequences of confinement agriculture are occurring in those countries as well. A multi-national team of researchers from Michigan State University and two campuses of the Chinese Academy of Sciences found — well, I can’t put it better than their paper’s title does: “Diverse and abundant antibiotic resistance genes in Chinese swine farms.”
A few days ago, the Food and Drug Administration released two important documents related to antibiotic use in livestock raising, and what the results of that antibiotic use are. I’d say that they released them quietly, except, when it comes to this issue, every release seems to be quiet, never accompanied by the press releases or briefings that other divisions of the FDA use to publicize their news.
The two documents are the 2011 Retail Meat Report from the National Antimicrobial Resistance Monitoring System, or NARMS, and the 2011 Summary Report on Antimicrobials Sold or Distributed for Use in Food-Producing Animals, which is known for short as ADUFA, after the 2008 Animal Drug User Fee Act that mandated the data be collected.
These two reports capture almost all the data we receive from the federal government about antibiotic use in livestock production (which is not the same thing as “all the data the federal government possesses” — there is evidence they receive more than they release). So their annual release is an important indicator for whether antibiotic use in meat production, and antibiotic resistance in meat, are trending up or down.
The news does not appear to be good.
In the past months, there have been several troubling research reports, from different parts of the world, exploring aspects of the same problem: Multi-drug resistant bacteria are present in chicken, apparently because of the use of antibiotics in poultry production, and are passing to people who work with, prepare or eat chicken, at some risk to their health.
Here are a few of the publications:
There’s a very fast-moving story breaking in the United Kingdom this past 24 hours: Millions of pre-made burgers sold by supermarkets in the United Kingdom and Ireland have been taken off the market after the meat they contain was found to contain DNA from both horses and pigs. More than a third of the products tested contained some DNA not from cows, and in individual burgers, the amounts ranged from very small to one-third. (Here are overnight stories from The Guardian, The Independent, and The Telegraph.)
The adulteration was discovered by Irish food authorities; Ireland’s food-safety rules are so tight that they include DNA testing for meat (as highlighted on Twitter by Irish food journalist Suzanne Campbell). At this point, the adulteration has been traced to three beef-processing plants, two in Ireland called Liffey Meats and Silvercrest Foods, and one in the U.K. called Dalepak Hambleton. Silvercrest, a subsidiary of ABP Foods, has pointed to “two continental European third-party suppliers who are the suspected source of the product in question,” and the Daily Mail says the source may be processors in Spain and the Netherlands that supplied a powdered protein, used to bulk up the burgers, which was supposed to be beef.
The illegal horsemeat may well be of European origin. But if I were a European journalist following this story, I’d look further afield as well. I’d look at Canada, Mexico and the United States, and I’d ask whether it is possible that the horsemeat originated in North America — and whether its risks include not just the non-disclosure of its presence, but undisclosed drug residues as well. [Read more…]
