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Many of us who get the flu this winter will demand antibiotics from our doctors. And hopefully, your doctor will turn you down.
Antibiotics, which kill bacteria, don't cure the flu. That's because the flu is caused by a virus, not bacteria. So your doctor would be prescribing an unnecessary drug.
But in a broader sense, your doctor's refusal to prescribe you antibiotics for the flu would do us all a favor. That's because unnecessary antibiotic use renders the drug ineffective for when it's really needed.
This threat is growing. In a recent Medium article, Wired science blogger Maryn McKenna describes a disturbingly plausible picture of a world in which antibiotics have become markedly less effective. That future is the focus of McKenna's interview this week on the Inquiring Minds podcast:
"For 85 years," McKenna explains on the show, antibiotics "have been solving the problem of infectious disease in a way that's really unique in human history. And people assume those antibiotics are always going to be there. And unfortunately, they're wrong."
Here are some disturbing facts about the growing problem of antibiotic resistance, courtesy of Mother Jones:
1. In the U.S. alone, 2 million people each year contract serious antibiotic-resistant infections and 23,000 die from them.
These figures comes from a new report from the U.S. Centers for Disease Control and Prevention (CDC) on antibiotic resistance that, for the first time, uses a blunt classification scheme to identify "urgent," "serious," and "concerning" threats from drug-resistant bacteria. The CDC lists three urgent threats: drug-resistant gonorrhea, drug-resistant "enterobacteriaceae" such as E. Coli, and Clostridium difficile, which causes life-threatening diarrhea and often is acquired in hospitals. Clostridium difficile kills at least 14,000 people a year.
2. We've been warned about antibiotic resistance since at least 1945. We just haven't been listening.
3. Antibiotic-resistant strains of bacteria are on the rise.
Clearly, antibiotic resistance is not new. Nonetheless, the frequency of antibiotic resistance events is increasing. For example, from 1980 to 1987, cases of penicillin-resistant Streptococcus pneumoniae (the bacteria that causes pneumonia) remained steady at about 5 percent of all strains. By 1997, 44 percent of strains were showing resistance. Similarly, Enterococci bacteria can cause urinary tract infections and meningitis, among other diseases), and in 1989, fewer than 0.5 percent of strains found in hospitals were resistant to antibiotics. Four years later that number was at 7.9 percent, and by 1998, some hospitals reported levels as high as 30 percent to 50 percent. "The more antibiotics are used, the more quickly bacteria develop resistance," says the CDC.
4. There has been a steady decline in Food and Drug Administration (FDA) approvals for new antibiotics.
Even as more bacteria are becoming resistant and our treatments are becoming less effective, we're also producing fewer new drugs to combat infections.
Why has this happened? "There's a kind of curve to antibiotic development," says McKenna, noting there was a boom in the 1950s, when Eli Lilly collected samples of biological materials from all over the world to capture antibiotic properties in natural substances. By the 1980s, much of the low-hanging antibiotic fruit had been harvested. Now, the development of new treatments is becoming increasingly difficult and costly, even as pharmaceutical companies are cutting research and development budgets and outsourcing drug discovery more and more. "The faucet from which [antibiotics] come has been turned down and down and down and now it's just a drip," McKenna says.
5. Up to half of all antibiotic prescriptions either aren't needed or are not effective.
A huge part of our problem is that we're misusing and abusing antibiotics. "Resistance is a natural process," says McKenna, but "we made resistance worse by the cavalier way that we used antibiotics, and still use them." Sick patients pressure their doctors for drugs, and doctors too often yield and dash off a script. A recent study found that doctors prescribed antibiotics 73 percent of the time for acute bronchitis, even though, as Mother Jones' Kiera Butler reports, antibiotics are not recommended at all for this condition.
Almost one in five emergency room visits resulting from adverse drug events are caused by antibiotics, the CDC says. Children are the most likely victims. Although antibiotics are generally safe, they can cause allergic reactions and also can interact with other drugs, harming patients who are vulnerable because they already suffer from other medical conditions. So if we stop over-prescribing antibiotics we'd also lessen adverse drug effects.
6. It's not just human medical misuse—a large volume of antibiotics is inappropriately used in livestock.
Antibiotics are heavily used in the agricultural industry—more antibiotics are used to treat animals than to treat people. While livestock drugs are used to fight infections, they are often fed to animals in smaller doses to encourage weight gain and growth—a practice, the CDC says, that is "not necessary" and "should be phased out." A recent draft document from the FDA similarly states that "in light of the risk that antimicrobial resistance poses to public health, the use of medically important antimicrobial drugs in food-producing animals for production purposes does not represent a judicious use of these drugs." For now, though, the FDA's approach to curbing this threat has been limited to issuing voluntary guidelines.
7. Before antibiotics, death rates were much higher from very common occurrences like skin infections, pneumonia and giving birth.
In her Medium article, McKenna gives some disturbing stats. Before antibiotics, just giving birth could be deadly: Five out of every thousand women who had a baby died. Pneumonia killed 30 percent of its victims. And "one out of nine people who got a skin infection died, even from something as simple as a scrape or an insect bite." If we run out of antibiotics, our future looks rather bleak.
8. The next major global pandemic may involve an antibiotic-resistant superbug.
"Plagues still really have power and almost a hundred years later, we shouldn't think that we're immune to them because we're not," warns McKenna. For instance, tuberculosis kills more than a million people a year, and it is becoming increasingly drug-resistant, says the World Health Organization.
Bacteria poses a threat even with viral infections. Viruses can weaken our immune systems just enough to allow bacteria to take hold. Death results from secondary bacterial infections that, at least until recently, were largely curbed by effective antibiotics.
So are we doomed to recede back into a time when infections were the most significant health threat that our species faced?
According to McKenna, it is unclear whether we can fully curb antibiotic overuse. The better approach is to get the drug industry research engine firing again. "There's a really active discourse around what's the best way to get pharmaceutical companies back into manufacturing antibiotics," she says.
Our future, then, once again lies in the hands of scientists, whose quest to find new treatments for drug-resistant bacteria is now of the utmost importance.
Visit EcoWatch’s HEALTH page for more related news on this topic.
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A powerful volcano on Monday rocked an uninhabited island frequented by tourists about 30 miles off New Zealand's coast. Authorities have confirmed that five people died. They expect that number to rise as some are missing and police officials issued a statement that flights around the islands revealed "no signs of life had been seen at any point,", as The Guardian reported.
"Based on the information we have, we do not believe there are any survivors on the island," the police said in their official statement. "Police is working urgently to confirm the exact number of those who have died, further to the five confirmed deceased already."
The eruption happened on New Zealand's Whakaari/White Island, an islet jutting out of the Bay of Plenty, off the country's North Island. The island is privately owned and is typically visited for day-trips by thousands of tourists every year, according to The New York Times.
My god, White Island volcano in New Zealand erupted today for first time since 2001. My family and I had gotten off it 20 minutes before, were waiting at our boat about to leave when we saw it. Boat ride home tending to people our boat rescued was indescribable. #whiteisland pic.twitter.com/QJwWi12Tvt— Michael Schade (@sch) December 9, 2019
Michael Schade / Twitter
At the time of the eruption on Monday, about 50 passengers from the Ovation of Seas were on the island, including more than 30 who were part of a Royal Caribbean cruise trip, according to CNN. Twenty-three people, including the five dead, were evacuated from the island.
The eruption occurred at 2:11 pm local time on Monday, as footage from a crater camera owned and operated by GeoNet, New Zealand's geological hazards agency, shows. The camera also shows dozens of people walking near the rim as white smoke billows just before the eruption, according to Reuters.
Police were unable to reach the island because searing white ash posed imminent danger to rescue workers, said John Tims, New Zealand's deputy police commissioner, as he stood next to Prime Minister Jacinda Ardern in a press conference, as The New York Times reported. Tims said rescue workers would assess the safety of approaching the island on Tuesday morning. "We know the urgency to go back to the island," he told reporters.
"The physical environment is unsafe for us to return to the island," Tims added, as CNN reported. "It's important that we consider the health and safety of rescuers, so we're taking advice from experts going forward."
Authorities have had no communication with anyone on the island. They are frantically working to identify how many people remain and who they are, according to CNN.
Geologists said the eruption is not unexpected and some questioned why the island is open to tourism.
"The volcano has been restless for a few weeks, resulting in the raising of the alert level, so that this eruption is not really a surprise," said Bill McGuire, emeritus professor of geophysical and climate hazards at University College London, as The Guardian reported.
"White Island has been a disaster waiting to happen for many years," said Raymond Cas, emeritus professor at Monash University's school of earth, atmosphere and environment, as The Guardian reported. "Having visited it twice, I have always felt that it was too dangerous to allow the daily tour groups that visit the uninhabited island volcano by boat and helicopter."
The prime minister arrived Monday night in Whakatane, the town closest to the eruption, where day boats visiting the island are docked. Whakatane has a large Maori population.
Ardern met with local council leaders on Monday. She is scheduled to meet with search and rescue teams and will speak to the media at 7 a.m. local time (1 p.m. EST), after drones survey the island, as CNN reported.
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