Maryn McKenna

Journalist and Author

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Get Your Shots, Wash Your Hands, Thanks, and Goodbye

March 27, 2015 By Maryn Leave a Comment

icenine-exit

IceNine (CC), on Flickr

A little less than 5 years ago, editor Betsy Mason of WIRED Science called to ask whether I’d be interested in joining a new thing. WIRED was thinking about starting a science blog platform; she wondered whether I’d want to be one of the bloggers.

I did very much want: WIRED is both a great magazine, with inspiring storytelling and innovative design, and a brand with international reach. I was a bit perplexed why they would want me — scary diseases didn’t seem like a core interest for WIRED readers — but Betsy (now one of the authors of WIRED’s Map Lab blog) was confident the audience was there.

She was right. Superbug debuted Sept. 14, 2010 with a report on the “Indian superbug,” the antibiotic resistance factor NDM that was then just starting to move across the world. My second post explored “livestock MRSA,” the bacterium that originates in antibiotic overuse in agriculture, and the third looked at the shivery subject of a rare and deadly parasite transmitted by organ transplants. Those three posts pretty much defined Superbug’s turf: public health, global health, and food policy, with a sprinkle of dread. Readers responded with fascination and good will, then and to the more than 300 posts afterward.

Of which, as you’ve probably guessed, this is the last. Superbug has had a fantastic run, but there was only one other place I wanted to work, and I’m headed there. Next week, I’ll be joining National Geographic’s Phenomena under a new blog name.

(Worth saying: This move is coincident with Wired.com’s redesign, but is not at all related. Phenomena happened to have a rare opening.)

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, Ebola, food policy, Lyme, Never Seconds, polio, Resistance, TB

Your McNuggets: Soon Without a Side of Antibiotics

March 4, 2015 By Maryn Leave a Comment

Fast-food giant McDonald’s announced today that it will cease buying chicken raised with the routine use of most antibiotics, a move that seems certain to reframe the contentious debate about agriculture’s use of the increasingly precious drugs. The company set a deadline of two years to make chicken in its 14,000 US locations substantially antibiotic-free.

The announcement instantly makes McDonald’s the largest company by far to use its buying power to change how livestock are raised. Its 25 million US customers a day dwarf those at Chipotle Mexican Grill, which pioneered fast food using antibiotic-free meat, and also at Chick-fil-A, which announced a year ago that it would move to antibiotic-free chicken in five years.

McDonald’s new policy doesn’t solve the farm-antibiotics problem. The company is making the move only for chicken, not for beef or pork (though chicken is already the meat Americans eat the most). And the policy has important caveats. But since McDonald’s is the largest food-service buyer of chicken in America, this can’t help but affect other restaurants, and production of other meats.

In a phone interview, Marion Gross, senior vice president of McDonald’s North America Supply Chain, said the company made the move because customers have been asking for it. “This about meaningful action that is important to our customers,” she said. “We’re happy to be able to achieve this. This is not something new; we had our first antibiotic policy in place back in 2003, so it’s the evolution of a journey we have been on for some time.”

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: animals, antibiotics, mcdonalds, Resistance

Resistance: The Movie That Will Make You Care About Antibiotic Misuse

February 24, 2015 By Maryn Leave a Comment

A few years ago I happened to get introduced to a pair of filmmakers, Michael Graziano and Ernie Park, who were starting to explore the topic of antibiotic resistance. They had the same questions about resistance that I obsess over, and the same shock about how enormous the problem is: according to a recent estimate, 700,000 deaths every year, likely to rise into the millions if nothing is done.

They recognized their disbelief as the creative spark for a project, and three years later, have brought out Resistance, a documentary now available on iTunes. LV Anderson just said about it, in Slate:

Regardless of your preexisting interest in public health or food politics, once you learn a little about antibiotic abuse, you won’t be able to stop caring about it. Without antibiotics, many of the medical treatments that we take for granted would be impossible, and the speed and carelessness with which we squander these important drugs — on people who don’t need them and on livestock that really don’t need them — is downright infuriating…  In talking-head interviews with well-chosen, highly articulate experts, Resistance explains the fundamental reason the incorrect use of antibiotics is so dangerous: Every time we use antibiotics, we give bacteria another chance to develop resistance to it.

I think Resistance is a fantastic exploration of the problem, but I am likely to be biased, because I am in it. But I realized as I watched it that there was a lot about the documentary that I didn’t know: how it came to be, why the stories within it were chosen, and whether making it changed the filmmakers’ life.

Here’s an edited chat with Michael Graziano about making the film.

Maryn McKenna: Your previous film, Lunch Line, was about school lunch and nutrition. Antibiotic resistance seems a long way from that. What got you interested?

Michael Graziano: I was hoping to get rich as quickly as possible. I calculated that if I spent three years making a film about science and public health the money would start pouring in.

Turns out my calculations were wrong.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, antibiotics, documentary, Resistance

How to Fight Superbugs: Start Spending Money

February 5, 2015 By Maryn Leave a Comment

Plates of Methicillin-Resistant Staphylococcus Aureus (MRSA) in CDC’s healthcare-associated infections laboratory.

Plates of Methicillin-Resistant Staphylococcus Aureus (MRSA) in CDC’s healthcare-associated infections laboratory. Center for Disease Control/AP


The government-chartered British project examining antibiotic resistance — which made such a splash in December with its prediction that untreatable resistance will kill 10 million people per year by 2050 — has produced its first set of recommendations for turning back the problem.

They come down to this: Start spending money.

The project — formally titled the Review on Antimicrobial Resistance — analyzes the funding spent directly on resistance research, and indirectly through training specialists and investing in innovation, and finds that the resources devoted by governments and the private sector are not up to the job. With the same bluntness that marked its first report, the project says: “There is a problem of chronic under-investment in both the financial and human capital needed to tackle antimicrobial resistance.”

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, Resistance

The White House 2016 Budget Includes Big Funding for Antibiotic Resistance

January 31, 2015 By Maryn Leave a Comment

Roman Boed (CC), Flickr

Roman Boed (CC), Flickr

Next week, President Barack Obama will unveil his full budget request for the coming fiscal year. When he does, he’ll also reveal details of how his administration plans to fund the national strategy for combating antibiotic resistance that the White House released last autumn.

Here’s what we know so far, based on a fact sheet that the White House released earlier this week:

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, budget, Resistance, White House

The Coming Cost of Superbugs: 10 Million Deaths Per Year

December 15, 2014 By Maryn Leave a Comment

Plates of Methicillin-Resistant Staphylococcus Aureus (MRSA) in CDC’s healthcare-associated infections laboratory.

Plates of Methicillin-Resistant Staphylococcus Aureus (MRSA) in CDC’s healthcare-associated infections laboratory. Center for Disease Control/AP

If you weren’t taking antibiotic resistance seriously before, now would be a good time to start.

A project commissioned by the British government has released estimates of the near-future global toll of antibiotic resistance that are jaw-dropping in their seriousness and scale: 10 millions deaths per year, more than cancer, and at least $100 trillion in sacrificed gross national product.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, Resistance

To Slow Down Drug Resistance in Health Care, Buy an Antibiotic-Free Turkey for Thanksgiving

November 19, 2014 By Maryn Leave a Comment

Organic turkey poults, Lance Cheung, USDA. CC on Flickr

Organic turkey poults, Lance Cheung, USDA. USDA/Flickr

I thought it might be time to switch away from Ebola and catch up with other disease problems that continue to occur in the world. (If you miss Ebolanoia, though, I’m still collecting instances at my Tumblr. The latest: Indian authorities have force-quarantined in an airport a man who returned from West Africa with a clean bill of health and negative blood tests. They say they will not allow him to leave until his semen tests negative for Ebolavirus. Yes, they are insisting on samples.)

So: How can healthcare workers contribute to slowing down antibiotic resistance? A healthcare nonprofit suggests they commit to buying an antibiotic-free turkey for Thanksgiving.

If it feels like the problem in one sphere, medicine, doesn’t have much to do with the other, agriculture, then you are the perfect target for this pledge. (Even if you don’t actually work in health care.)

Here’s the backdrop to the campaign, created by Health Care Without Harm,the Sharing Antimicrobial Reports for Pediatric Stewardship (SHARPS) collaborative, and the Pediatric Infectious Disease Society (PIDS):

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: CDC, ECDC, Resistance, Thanksgiving, Turkey

White House Actions on Antibiotic Resistance: Big Steps, Plus Disappointments

September 22, 2014 By Maryn Leave a Comment

Roman Boed (CC), Flickr

Roman Boed (CC), Flickr

The United States government proposed several important steps last week that, if accomplished, will significantly change how this country attempts to counter the advance of antibiotic resistance, bringing us within reach of the more complete programs which exist in Europe. But as significant as it is, the new program has some perplexing gaps that left experts attending to the issue disappointed.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, animals, antibiotics, Resistance, White House

Chicken Company Perdue Takes Big Steps to Reduce Antibiotic Use

September 3, 2014 By Maryn Leave a Comment

Karen Jackson (CC), Flickr

Karen Jackson (CC), Flickr

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.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, chicken, food policy, food safety, poultry, Resistance

How Agriculture's Growth Promoters Might Work: A Mouse Study Sheds Some Light

August 19, 2014 By Maryn Leave a Comment

Rama (CC), FLickr

Rama (CC), Flickr

The farm practice that underlies most agricultural use of antibiotics is known as “growth promotion”: It calls for giving very small doses of antibiotics routinely to meat animals because those doses cause them to gain fat and muscle more quickly than they would otherwise. Growth promotion dates back to the early days of the antibiotic era, and has always been somewhat mysterious. Though there were attempts to pick apart its mechanisms in the 1950s and 1960s (I’ve been reading some fascinating old accounts), for the most part, people simply accepted that it worked. It’s only in the past decade or so, as interest has increased in the microbes that reside everywhere in our and animals’ bodies (a vast community generally known as the microbiome), that researchers have begun trying to dissect what is going on.

The scientific team that has probably pursued this most intensely is the NYU Langone Medical Center lab led by Martin J. Blaser. Blaser published a popular account of their research into antibiotics’ effect on obesity, asthma, diabetes, and other disorders in Missing Microbes: How the Overuse of Antibiotics Is Fueling Our Modern Plagues, published in April. (Disclosure: I reviewed the book for Nature.) Two years ago, the team showed that giving small doses of antibiotics to very young mice affected genes controlling metabolism of nutrients, and caused the mice to gain weight. Now they have followed up that research with detailed work exploring how much the timing and length of antibiotics affects weight gain. Though the work is still in mice, it leads to provocative conclusions about how growth promoters work in livestock, and what early-life antibiotics might do to humans as well.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, growth promoters, microbiome, Resistance

What the Forthcoming White House Report on Antibiotic Resistance Will Ask For

July 11, 2014 By Maryn Leave a Comment

e-Magine Art (CC), Flickr

e-Magine Art (CC), Flickr

Among the groups that work on awareness of antibiotics resistance — which include major medical and public health organizations as well as nonprofits trying to direct attention to antibiotic misuse in medicine and agriculture — there has been a lot of anticipation of a forthcoming report by the President’s Council of Advisors on Science and Technology. The report, which has been in the works for months, will be published shortly, possibly as early as next week. Today, the council — known as PCAST for short — held a public meeting to discuss the report’s contents and vote as a group to accept or rejected. The meeting was webcast, and as far as I could tell, the vote was unanimous.

Though the report itself won’t be out for a bit, the meeting gave a good sense of what the report will say. For accessibility, PCAST runs live voice-recognition transcription of its meetings; so while the meeting was proceeding, I grabbed a transcript to review later. Here’s what seems to be coming.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, antibiotics, FDA, Resistance

"Individual Actions Are Doomed to Failure": Coalition Asks for Global Action on Antibiotics

June 24, 2014 By Maryn Leave a Comment

antibiotics-inline

Biology101.org/Flickr

A newly formed international organization — more than 700 members in 55 countries — has launched an urgent appeal to governments and healthcare, begging for attention to antibiotic resistance as a grave global threat, and asking that antibiotics be declared a cultural heritage deserving legal protection.

The group grew out of meetings by French and other European researchers, and all its materials are bilingual, to the point that it is going by two names and acronyms: the World Alliance Against Antibiotic Resistance (WAAAR) and L’alliance contre le développement des bactéries multi-résistantes (AC2BMR).

The group has been in formation a while but went public Monday, publishing its appeal and asking for 10 specific actions to keep antibiotic resistance from surging beyond the point at which it can be controlled.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, Resistance

Very Serious Superbugs in Imported Seafood

June 11, 2014 By Maryn Leave a Comment

Image: Matsuyuki, Flickr

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.”

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, CDC, food policy, food safety, NDM, NDM-1, Resistance

World Health Organization Drafting Global Plan on Drug Resistance. Is That Enough?

May 26, 2014 By Maryn Leave a Comment

NathanReading-staph

Image: Nathan Reading (CC), Flickr

The annual World Health Assembly — the meeting of representatives of the 194 countries that belong to the World Health Organization — ended Saturday. Each year, the Assembly defines policy and sets out goals for the coming 12 months in a series of voted-on resolutions. This year it zeroed in on antibiotic resistance, upping the ante on the WHO’s previous efforts to fight the emergence of resistance globally. The biggest initiative: A global action plan that the agency expects to have drafted by next January, in order to have it approved by all the levels of the organization so that it can be voted on next May.
[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: Resistance, Who

Denmark: Three Deaths from Drug-Resistant "Pig MRSA"

May 12, 2014 By Maryn Leave a Comment

ICStefanescu (CC), Flickr

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.)
[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: agriculture, antibiotics, Denmark, food policy, food safety, MRSA, netherlands, Resistance, ST398

World Health Organization: Antibiotic Resistance Grave Global Problem

May 5, 2014 By Maryn Leave a Comment

NathanReading-staph

Image: Nathan Reading (CC), Flickr

The World Health Organization has released a significant report marking what I think must be the first attempt to quantify antibiotic resistance globally. It’s a very sobering read — not just for what the data says about the advance of resistance worldwide, but also because of what the organization could not say, because the data doesn’t exist.

The numbers themselves are unsettling. Dr. Keiji Fukuda, the WHO’s assistant director general, told the press: “It’s clear that rates are very high of resistance among bacteria causing many of the most common serious infections – the ones that we see both occurring in the community as well as in hospitals … In all regions of the world, we now see that hospitals are reporting untreatable, or nearly untreatable, infections.”

But the gaps in the numbers are too: There are 194 member countries in the WHO, but only 114 had the data-gathering resources to contribute something to the report, and only 22 were able to send in data on the most important occurrences of resistance in very common bacteria. Thus it’s possible that the report could be an under-estimate, or an over-estimate. But I can’t think of a scenario in which it could be considered substantially inaccurate. Its portrait of a world in which antibiotic resistance is advancing to grave proportions ought to be taken seriously.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, CRE, E. coli, gonorrhea, NDM, Resistance, Who

NDM: "A Great Challenge for the Future of Healthcare"

April 29, 2014 By Maryn Leave a Comment

Jason Scragz (CC), Flickr

Jason Scragz (CC), Flickr

A paper published this week reminded me to take a fresh look at NDM, the “Indian superbug” — actually a gene and enzyme — that got so much attention, including from me, in 2011. (Most of the posts are here.) Quick reminder: NDM surfaced in 2008 in Sweden, then was found in the United Kingdom, then in the United States and then elsewhere in the world. It had several distinctive qualities. It appeared in gut bacteria such as Klebsiella and E. coli, and caused infections when those bacteria escaped the gut and got elsewhere in the body. It rendered those bacteria not-vulnerable to almost all antibiotics, leaving so few drugs to use against it that medical personnel found it truly alarming. And it had strong links to South Asia: The first known patient was an Indian man living in Sweden who had gone home for a visit and been hospitalized; victims found later either had family links to India and Pakistan or had gotten medical care there, as medical tourists or because they were injured while traveling.

NDM (which stands for New Delhi metallo-beta-lactamase; it was originally NDM-1, but there are now at least seven variants) generated a lot of alarm at the time, with good reason. Its unusual resistance pattern made useless the last category of broad-spectrum, last-resort antibiotics, called carbapenems, that were still working reliably. Physicians treating patients who had infections involving NDM had to hunt among just a few remaining drugs that were still on the shelf because they were toxic or did not work reliably. Plus, because bacteria carrying the NDM resistance factor colonize the gut, the infection could be transported across borders and into hospitals without anyone noticing. With no symptoms showing, few hospitals would bother to check a patient (or a family member), especially since testing for gut bacteria is more complicated and intimate than, for instance, testing someone’s nostrils for MRSA.

By last year, NDM had mostly dropped out of the headlines, even though it was still moving across the globe (this 2013 paper details countries where it has been identified), and had also begun causing hospital outbreaks (for instance, this one in Denver in 2012). So the new paper I mentioned, written by staff from Public Health England and analyzing the first 250 patients with NDM in the UK, is a useful reminder of how formidable a microbiologic foe this can be.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, carbapenems, CRE, NDM, NDM-1, Resistance

CDC: Some Hospitals Need Assistance Using Antibiotics Properly (And the New Federal Budget May Help)

March 4, 2014 By Maryn Leave a Comment

Image: Zach Bulick/Flickr

Image: Zach Bulick/Flickr

Double-barreled news today from the US Centers for Disease Control and Prevention. In an analysis of several sets of hospital data, gathered by the agency and also purchased from independent databases, the CDC said it found that more than 37 percent of prescriptions written in hospitals involved some sort of error or poor practice, increasing the risk of serious infections or antibiotic resistance. And in a surprise announcement timed to the release of the federal draft budget, the agency said it is in line to receive $30 million to enhance its work combating antibiotic resistance in the US.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, C.diff, CDC, Resistance, Science Blogs, stewardship

From Bird Flu to Big Farms: The Rise of China's Agriculture

February 21, 2014 By Maryn Leave a Comment

Image: Willem vdh/Flickr

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.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: antibiotics, chicken, China, food policy, food safety, pigs, Resistance, Science Blogs

Report: FDA Documents Show Decade of Unsuccessful Attempts to Control Farm Antibiotics

January 28, 2014 By Maryn Leave a Comment

Image: gina pina/Flickr

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.

[Read more…]

Filed Under: Science, Science Blogs, Superbug Tagged With: animals, antibiotics, FDA, food policy, food safety, growth promoters, NRDC, Resistance, Science Blogs

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