Should You Be Concerned About the Overuse of Antibiotics in Farm Animals?
However, other experts suggest that antibiotic use in food-producing animals poses very little risk to human health.
This article explores how antibiotics are used in foods and their potential consequences for your health.
Antibiotic Use in Food-Producing Animals
Antibiotics are drugs used to treat bacterial infections. They work by killing or stopping the growth of harmful bacteria.
Since the 1940s, antibiotics have been given to farm animals like cows, pigs and poultry in order to treat infections or prevent an illness from spreading.
These low doses may also reduce animal death rates and improve reproduction.
For these reasons, antibiotic use has become widespread in agriculture. In 2011, 80 percent of all antibiotics sold in the U.S. were for use in food-producing animals (3).
Bottom Line: Antibiotics are drugs used to treat bacterial infections. They are widely used in animal agriculture to treat disease and promote growth.
The Amount of Antibiotics in Foods is Very Low
Contrary to what you may think, the chances of you actually consuming antibiotics through animal foods is extremely low.
Strict legislation is currently in place in the U.S. to ensure that no contaminated food products are able to enter the food supply.
Similar laws are in place in Canada, Australia and the European Union.
Additionally, vets and animal owners are required to ensure that any animal products they produce are drug-free before they can be used as food.
Drug withdrawal periods are enforced before treated animals, eggs or milk are used as food. This allows time for the drugs to completely leave the animal's system.
The U.S. Department of Agriculture (USDA) has a strict process of testing all meat, poultry, eggs and milk for unwanted compounds, including antibiotic residues (4).
Bottom Line: Due to strict government legislation, it is extremely rare that antibiotics given to an animal would enter your food supply.
There is No Evidence That Antibiotics in Foods Are Harming People Directly
No evidence suggests antibiotics in food products are directly harming people.
In fact, figures from the USDA showed that the amount of animal products found to have antibiotic residues were extremely low and those that did were disposed of.
In 2010, less than 0.8 percent of animal food products tested positive for some form of contamination, including antibiotic residue (5).
Products confirmed as positive do not enter the food chain. Producers with repeat violations are publicly exposed—a system that discourages any misconduct.
Bottom Line: There is no evidence to suggest that antibiotics are being consumed from animal food products, let alone causing harm to humans.
The Overuse of Antibiotics in Animals Can Increase Resistant Bacteria
Antibiotics are generally fine when used properly for treating or preventing infections.
However, excessive or inappropriate use is a problem. When antibiotics are overused, they end up becoming less effective for both humans and animals.
This is because bacteria that are frequently exposed to antibiotics develop a resistance to them. As a result, the antibiotics are no longer as effective at killing harmful bacteria. This is a great concern for public health (6).
The U.S. Food and Drug Administration (FDA) has recognized this concern, updating its regulations to reduce the unnecessary use of antibiotics in livestock.
Bottom Line: Excessive antibiotic use can increase resistant bacteria, making the antibiotics less effective for both animals and humans.
Resistant Bacteria Can Spread to Humans, with Serious Health Risks
Resistant bacteria can be passed from food-producing animals to humans in a number of ways.
If an animal is carrying resistant bacteria, it can be passed on through meat that is not handled or cooked properly.
You can also encounter these bacteria by consuming food crops that have been sprayed with fertilizers containing animal manure with resistant bacteria.
One study found that people living close to crop fields sprayed with pig manure fertilizer are at a higher risk of infection from the resistant bacteria MRSA (7).
Once spread to humans, resistant bacteria can stay in the human gut and spread between individuals. The consequences of consuming resistant bacteria include (8):
- Infections that would not have happened otherwise.
- Increased severity of infections, often including vomiting and diarrhea.
- Difficulty in treating infections and higher chances that treatments will fail.
In the U.S., every year around two million people get infected with bacteria resistant to one or more of the antibiotics normally used to treat the infections (9).
Of those people, at least 23,000 die each year. Many more die from other conditions made worse by the infection (9).
Bottom Line: Resistant bacteria can be transferred from animals to humans through contaminated food products, causing infections and even death.
Resistant Bacteria in Food Products
Resistant bacteria in supermarket foods is a lot more common than you might think.
Commonly reported harmful bacteria from foods include Salmonella, Campylobacterand E.coli.
One report found resistant bacteria in 81 percent of ground turkey meat, 69 percent of pork chops, 55 percent of ground beef and 39 percent of chicken breasts, wings and thighs found in U.S. supermarkets (11).
Another study tested 136 beef, poultry and pork samples from 36 U.S. supermarkets. Almost 25 percent tested positive for the resistant bacteria MRSA (12).
Many products claim to be “raised without antibiotics," including some that are labeled organic. This does not mean these products are free from resistant bacteria.
Evidence suggests that these products still contain resistant bacteria, although they are slightly less resistant than regular products grown using antibiotics.
A study found that organic chickens were more frequently contaminated with bacteria like Salmonella and Campylobacter than non-organic chickens. However, the bacteria in organic chickens were slightly less resistant to antibiotics (13).
Again, the prevalence of Enterococcus bacteria was 25 percent higher in organic chicken than non-organic chicken. However, the amount of resistant bacteria was almost 13 percent less in organic chicken (14).
Another study found that out of 213 samples, the frequency of antibiotic-resistant E. coli tended to be only slightly lower for chicken raised without antibiotics, compared to regular chicken (15).
Bottom Line: Resistant bacteria are frequently found in animal-based food products. Food labeled “organic" or “raised without antibiotics" may have slightly lower amounts of resistant bacteria.
Why You Probably Don't Need to Be Concerned
There is no clear-cut evidence directly linking antibiotic use in food-producing animals to increased illness due to resistant bacteria in humans.
One review concluded that the danger to health is very small because proper cooking destroys the harmful bacteria (16).
It may actually be the human use of antibiotics that causes the majority of bacterial resistance (16).
However, transmission to the general public is rare. A study from Denmark reported that the likelihood of transmission for the population was only 0.003 percent (18).
If the food products are cooked properly and good hygiene practices are followed, then the risk is extremely low.
Bottom Line: There is no clear-cut link between antibiotic use in animals and resistant bacteria infections in humans. The risk to human health is likely to be small, since adequate cooking destroys bacteria in food.
How To Minimize Your Risk of Illness
It may be impossible to completely avoid resistant bacteria in animal foods.
However, there are things you can do to significantly reduce your risk:
- Practice good food hygiene: Wash your hands, use separate cutting boards for different foods and wash utensils thoroughly.
- Ensure food is cooked properly: Cooking meat to the proper temperature should kill any harmful bacteria.
- Buy antibiotic-free foods: You can minimize your risk even further by looking for labels that read organic, raised without antibiotics or antibiotic-free.
Take Home Message
The debate on antibiotic use in animals still continues.
Although there is no evidence that antibiotics in foods harm people directly, most agree that the over-use of antibiotics in food-producing animals is a problem.
It can contribute to the development and spread of drug-resistant bacteria, which is a potential risk to public health.
This article was reposted from our media associate Authority Nutrition.
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By Sherry H-Y. Chou, Aarti Sarwal and Neha S. Dangayach
The patient in the case report (let's call him Tom) was 54 and in good health. For two days in May, he felt unwell and was too weak to get out of bed. When his family finally brought him to the hospital, doctors found that he had a fever and signs of a severe infection, or sepsis. He tested positive for SARS-CoV-2, the virus that causes COVID-19 infection. In addition to symptoms of COVID-19, he was also too weak to move his legs.
When a neurologist examined him, Tom was diagnosed with Guillain-Barre Syndrome, an autoimmune disease that causes abnormal sensation and weakness due to delays in sending signals through the nerves. Usually reversible, in severe cases it can cause prolonged paralysis involving breathing muscles, require ventilator support and sometimes leave permanent neurological deficits. Early recognition by expert neurologists is key to proper treatment.
We are neurologists specializing in intensive care and leading studies related to neurological complications from COVID-19. Given the occurrence of Guillain-Barre Syndrome in prior pandemics with other corona viruses like SARS and MERS, we are investigating a possible link between Guillain-Barre Syndrome and COVID-19 and tracking published reports to see if there is any link between Guillain-Barre Syndrome and COVID-19.
Some patients may not seek timely medical care for neurological symptoms like prolonged headache, vision loss and new muscle weakness due to fear of getting exposed to virus in the emergency setting. People need to know that medical facilities have taken full precautions to protect patients. Seeking timely medical evaluation for neurological symptoms can help treat many of these diseases.
What Is Guillain-Barre Syndrome?
Guillain-Barre syndrome occurs when the body's own immune system attacks and injures the nerves outside of the spinal cord or brain – the peripheral nervous system. Most commonly, the injury involves the protective sheath, or myelin, that wraps nerves and is essential to nerve function.
Without the myelin sheath, signals that go through a nerve are slowed or lost, which causes the nerve to malfunction.
To diagnose Guillain-Barre Syndrome, neurologists perform a detailed neurological exam. Due to the nerve injury, patients often may have loss of reflexes on examination. Doctors often need to perform a lumbar puncture, otherwise known as spinal tap, to sample spinal fluid and look for signs of inflammation and abnormal antibodies.
Studies have shown that giving patients an infusion of antibodies derived from donated blood or plasma exchange – a process that cleans patients' blood of harmful antibodies - can speed up recovery. A very small subset of patients may need these therapies long-term.
The majority of Guillain-Barre Syndrome patients improve within a few weeks and eventually can make a full recovery. However, some patients with Guillain-Barre Syndrome have lingering symptoms including weakness and abnormal sensations in arms and/or legs; rarely patients may be bedridden or disabled long-term.
Guillain-Barre Syndrome and Pandemics
As the COVID-19 pandemic sweeps across the globe, many neurologic specialists have been on the lookout for potentially serious nervous system complications such as Guillain-Barre Syndrome.
Though Guillain-Barre Syndrome is rare, it is well known to emerge following bacterial infections, such as Campylobacter jejuni, a common cause of food poisoning, and a multitude of viral infections including the flu virus, Zika virus and other coronaviruses.
Studies showed an increase in Guillain-Barre Syndrome cases following the 2009 H1N1 flu pandemic, suggesting a possible connection. The presumed cause for this link is that the body's own immune response to fight the infection turns on itself and attacks the peripheral nerves. This is called an "autoimmune" condition. When a pandemic affects as many people as our current COVID-19 crisis, even a rare complication can become a significant public health problem. That is especially true for one that causes neurological dysfunction where the recovery takes a long time and may be incomplete.
Though there is clear clinical suspicion that COVID-19 can lead to Guillain-Barre Syndrome, many important questions remain. What are the chances that someone gets Guillain-Barre Syndrome during or following a COVID-19 infection? Does Guillain-Barre Syndrome happen more often in those who have been infected with COVID-19 compared to other types of infections, such as the flu?
The only way to get answers is through a prospective study where doctors perform systematic surveillance and collect data on a large group of patients. There are ongoing large research consortia hard at work to figure out answers to these questions.
Understanding the Association Between COVID-19 and Guillain-Barre Syndrome
While large research studies are underway, overall it appears that Guillain-Barre Syndrome is a rare but serious phenomenon possibly linked to COVID-19. Given that more than 10.7 million cases have been reported for COVID-19, there have been 10 reported cases of COVID-19 patients with Guillain-Barre Syndrome so far – only two reported cases in the U.S., five in Italy, two cases in Iran and one from Wuhan, China.
It is certainly possible that there are other cases that have not been reported. The Global Consortium Study of Neurological Dysfunctions in COVID-19 is actively underway to find out how often neurological problems like Guillain-Barre Syndrome is seen in hospitalized COVID-19 patients. Also, just because Guillain-Barre Syndrome occurs in a patient diagnosed with COVID-19, that does not imply that it was caused by the virus; this still may be a coincident occurrence. More research is needed to understand how the two events are related.
Due to the pandemic and infection-containment considerations, diagnostic tests, such as a nerve conduction study that used to be routine for patients with suspected Guillain-Barre Syndrome, are more difficult to do. In both U.S. cases, the initial diagnosis and treatment were all based on clinical examination by a neurological experts rather than any tests. Both patients survived but with significant residual weakness at the time these case reports came out, but that is not uncommon for Guillain-Barre Syndrome patients. The road to recovery may sometimes be long, but many patients can make a full recovery with time.
Though the reported cases of Guillain-Barre Syndrome so far all have severe symptoms, this is not uncommon in a pandemic situation where the less sick patients may stay home and not present for medical care for fear of being exposed to the virus. This, plus the limited COVID-19 testing capability across the U.S., may skew our current detection of Guillain-Barre Syndrome cases toward the sicker patients who have to go to a hospital. In general, the majority of Guillain-Barre Syndrome patients do recover, given enough time. We do not yet know whether this is true for COVID-19-related cases at this stage of the pandemic. We and colleagues around the world are working around the clock to find answers to these critical questions.
Sherry H-Y. Chou is an Associate Professor of Critical Care Medicine, Neurology, and Neurosurgery, University of Pittsburgh.
Aarti Sarwal is an Associate Professor, Neurology, Wake Forest University.
Neha S. Dangayach is an Assistant Professor of Neurology and Neurosurgery, Icahn School of Medicine at Mount Sinai.
Disclosure statement: Sherry H-Y. Chou receives funding from The University of Pittsburgh Clinical Translational Science Institute (CTSI), the National Institute of Health, and the University of Pittsburgh School of Medicine Dean's Faculty Advancement Award. Sherry H-Y. Chou is a member of Board of Directors for the Neurocritical Care Society. Neha S. Dangayach receives funding from the Bee Foundation, the Friedman Brain Institute, the Neurocritical Care Society, InCHIP-UConn Center for mHealth and Social Media Seed Grant. She is faculty for emcrit.org and for AiSinai. Aarti Sarwal does not work for, consult, own shares in or receive funding from any company or organization that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.
Reposted with permission from The Conversation.
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Unity Task Forces formed by presumptive Democratic presidential nominee Joe Biden and Sen. Bernie Sanders unveiled sweeping party platform recommendations Wednesday that—while falling short of progressive ambitions in a number of areas, from climate to healthcare—were applauded as important steps toward a bold and just policy agenda that matches the severity of the moment.
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Sanders said that while the "end result isn't what I or my supporters would've written alone, the task forces have created a good policy blueprint that will move this country in a much-needed progressive direction and substantially improve the lives of working families throughout our country."
"I look forward to working with Vice President Biden to help him win this campaign," the Vermont senator added, "and to move this country forward toward economic, racial, social, and environmental justice."
Biden, for his part, applauded the task forces "for helping build a bold, transformative platform for our party and for our country."
"I am deeply grateful to Bernie Sanders for working with us to unite our party and deliver real, lasting change for generations to come," said the former vice president.
On the life-or-death matter of reforming America's dysfunctional private health insurance system—a subject on which Sanders and Biden clashed repeatedly throughout the Democratic primary process—the Unity Task Force affirmed healthcare as "a right" but did not embrace Medicare for All, the signature policy plank of the Vermont senator's presidential bid.
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"There is no going back," Franco added. "Not an inch, not a step. We must only move forward from here."
Reposted with permission from Common Dreams.
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