USDA NRCS Montana
By Dipika Kadaba
The emergence of multiple pandemics in the animal agriculture industry over the past few decades, coupled with COVID-19's suspected origins in wildlife meat markets, has prompted renewed calls from experts to transform the global food system to prevent diseases harmful to humans.
<p>Industrial agriculture puts humans in contact with scores of animals in cramped conditions, which is ideal for disease transfer.</p>
<p>But that's only one of the health dangers it causes. Antibiotics are used ubiquitously in all kinds of large-scale agriculture, causing antibiotic resistance and environmental toxicity that studies show <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC122845/" target="_blank">we're not prepared to combat</a>.</p>
<p>Watch our new video to learn more about issues arising from antibiotic use in agriculture.</p>
<span style="display:block;position:relative;padding-top:56.25%;" class="rm-shortcode" data-rm-shortcode-id="5363447ee3ad107f98d95612dcc37888"><iframe lazy-loadable="true" src="https://www.youtube.com/embed/G8Q07BHRUwc?rel=0" width="100%" height="auto" frameborder="0" scrolling="no" style="position:absolute;top:0;left:0;width:100%;height:100%;"></iframe></span>
<p><em><a href="https://therevelator.org/author/dipikakadaba/" target="_blank">Dipika Kadaba</a> is an ecologist who uses data visualization and design to communicate environmental issues in her role as The Revelator's visual storyteller. Her interdisciplinary work originates in her background in environmental health research as a veterinarian, a graduate degree in conservation science, and a lifetime spent creating webcomics and animations for fun.</em></p><p><em><em>Reposted with permission from <em><a href="https://therevelator.org/antibiotics-agriculture-environment/" target="_blank">The Revelator</a>.</em></em><em></em></em></p>From Your Site Articles
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A girl wears a face mask while walking past a building shrouded in severe air pollution on Nov. 7, 2017 in Harbin, China. Tao Zhang / Getty Images
By Gudrun Heise
With an unknown lung disease apparently spreading in China, could there be a new outbreak akin to SARS? Not necessarily. Authorities have yet to identify it. And many respiratory illnesses are caused by viruses.
<h3>SARS</h3><p>SARS stands for "Severe Acute Respiratory Syndrome." It is one of the most dangerous, recent diseases, which is often fatal. The first cases were diagnosed in 2002 in China and it spread from there. Experts say that was due in part to the rate of modern tourism and travel in general. More than 8,000 people contracted SARS across 30 countries, and about 1,000 people died. But until that outbreak SARS was an unknown illness. Studies showed that it was a Coronavirus. Researchers think the virus spread from animals to humans.</p>
<h3>MERS</h3><p>The Middle East Respiratory Syndrome (MERS) was discovered in 2012. As with SARS, MERS is a type of Coronavirus. A Coronavirus can infect animals and humans. In humans, MERS mainly affects the respiratory system. The initial symptoms are similar to those of influenza — coughing, fever and shortness of breath. Later, patients can develop a lung infection and even kidney failure. But the illness can present itself and develop in different ways, depending on the patient, and can sometimes be fatal, as in 2015 in South Korea and China.</p><p>MERS is most common on the Arabian Peninsula, from where it gets its name. Studies suggest that it's often been spread from camels to humans. There is no vaccine against MERS or any other form of treatment.</p>
<h3>Avian Influenza</h3><p>Commonly called "bird flu," avian influenza is caused by the H5N2 virus, but there are variations of it. The "H" stands for hemagglutinin, a protein which helps the virus dock onto cells in a respiratory system. The "N" stands for neuraminidase. The virus needs a form of neuraminidase to reproduce itself and spread in an infected body. Bird flu often spreads in wild geese, but it can also spread on common poultry farms. In those cases, most of the affected birds die from the virus. The infection is caused by a range of viruses, including the influenza A virus.</p><p>Most types of bird flu do not affect humans. The only types that have so far been shown to spread from birds to humans are H5N1 and H7N9. Those two types can cause serious infections in humans and can be spread by infected birds. It has not been shown to spread from human to human. Humans can become infected through close contact with infected birds.</p><p>But all these viruses change and mutate constantly and that makes them even more dangerous.</p>
<h3>Legionnaires' Disease</h3><p>Legionnaires' disease is a severe form of lung infection. Symptoms include coughing, shivering, headache and high fever. In very bad cases, it can cause a patient to become confused or disorientated.</p><p>It is said the disease is spread via air conditioning systems, which distribute the bacteria. It is not transmitted from human to human.</p><p>Legionellosis was first discovered at a meeting of war veterans, the "American Legion," hence its name. The meeting was held in Philadelphia, where a number of the attendees became sick with an unknown lung illness. Two weeks after the meeting, further cases were diagnosed. In total 221 men were infected and 34 of them died. It was later determined that a bacteria known as legionella pneumophila was found in the air conditioning of a hotel and is said to have caused the outbreak.</p><p>But unhygienic water systems, such as showers in bathrooms, can also transmit the disease. Legionnaires' disease is found around the world. It is especially dangerous for people with weak immune systems. It is treated with <a href="http://www.ecowatch.com/tag/antibiotics">antibiotics</a>.</p>
<p><em>Reposted with permission from <a href="https://www.dw.com/en/unknown-lung-disease-in-china/a-51902586?maca=en-VAM_volltext_ecowatch-28485-html-copypaste" target="_blank">DW</a>.</em></p>Related Articles Around the Web
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EcoWatch Daily Newsletter
Antibiotic Crisis Coming as Superbugs Gain Strength and Drug Companies Go Bankrupt
26 December 2019
Health + Wellness
A superbug resistant to all known antibiotics is spreading undetected through hospital wards across the world, scientists in Australia warned on Sept. 3, 2018. WILLIAM WEST / AFP via Getty Images
Countries around the world are seeing a mounting threat from antibiotic resistance. After decades of overprescribing antibiotics and overusing them in factory farming, rivers are polluted with antibiotics and complications from drug-resistant infections are projected to cost $100 trillion by 2050, according to Scientific American.
<p>The Centers for Disease Control released a <a href="https://www.cdc.gov/drugresistance/biggest-threats.html" target="_blank">report</a> last month that said more than 2.8 million people in the U.S. experience an infection from antibiotic resistant bacteria each year, leading to 35,000 deaths. The report also pointed out that this is a global crisis, not just a domestic problem.</p><p>In fact, this spring, the United Nations declared this problem an <a href="https://www.who.int/antimicrobial-resistance/interagency-coordination-group/IACG_final_report_EN.pdf?ua=1" target="_blank">urgent global crisis</a> in need of immediate action.</p><p>Just when the fight against <a href="http://www.ecowatch.com/tag/superbugs">superbugs</a> needs to ramp up, drug companies are either going bankrupt or refusing to invest in research, according to <a href="https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html" target="_blank">The New York Times</a>. <a href="http://www.cidrap.umn.edu/news-perspective/2019/04/achaogen-bankruptcy-raises-worry-over-antibiotic-pipeline" target="_blank">Achaogen</a> and <a href="http://www.aradigm.com/" target="_blank">Aradigm</a>, two antibiotic start-ups, both went bankrupt. Pharmaceutical giants like Novartis and Allergan have stopped investing in antibiotic research. And one of the largest developers of antibiotics, <a href="https://melinta.com/" target="_blank">Melinta Therapeutics</a>, recently said it was running out of money.</p><p>The prospect of losing money has investors fleeing the sector, just when more money is needed, according to <a href="https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html" target="_blank">The New York Times</a>.</p><p>"This is a crisis that should alarm everyone," said Dr. Helen Boucher, an infectious disease specialist at Tufts Medical Center and a member of the Presidential Advisory Council on Combating Antibiotic-Resistant Bacteria, to <a href="https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html" target="_blank">The New York Times</a>.</p><p>"Antibiotic resistance has long been a problem, but the threats we face are real, immediate, and demand immediate action. Antibiotic resistance threatens modern medicine — our ability to safely perform routine surgeries and complicated organ transplants, as well as <a href="https://www.medicalnewstoday.com/articles/158401.php" target="_blank">chemotherapy</a>, all rely on the ability to prevent and treat infections," said Dr. Jesse Jacob from the Emory Antibiotic Resistance Center at the Emory University School of Medicine in Atlanta to <a href="https://www.medicalnewstoday.com/articles/327050.php#4" target="_blank">Medical News Today</a>.</p><p>The <a href="http://www.ecowatch.com/trump-watch/">Trump</a> administration has worsened the problem by cutting the budges of nationwide, hospital-based programs researching the issue. It has also ignored the World Health Organization's suggestions on reducing antibiotic use in livestock, as <a href="https://www.nbcnews.com/think/opinion/deaths-antibiotic-drug-resistance-are-historic-highs-aided-trump-s-ncna1092766" target="_blank">NBC News</a> reported.</p><p>Companies that have spent billions to find a solution to the increasing strength of germs that have developed a resistance to common antibiotics have not found a market to recoup their investment into research. Most antibiotics are used for short durations, unlike profitable medicines for chronic conditions, and many hospitals are unwilling to pay the high price for new therapies, according to <a href="https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html" target="_blank">The New York Times</a>.</p><p>The story of Achaogen provides a cautionary tale. After spending 15 years and a billion dollars to win FDA approval for a drug that cures hard-to-treat urinary tract infections, the World Health Organization added the new drug to its <a href="https://www.who.int/medicines/publications/essentialmedicines/en/" target="_blank">list of essential new medicines</a>. But, by then, Achaogen was out of money. It fired all of its scientists and declared bankruptcy, as <a href="https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html" target="_blank">The New York Times</a> reported.</p><p>"If this doesn't get fixed in the next six to 12 months, the last of the Mohicans will go broke and investors won't return to the market for another decade or two," said Chen Yu, a health care venture capitalist who has invested in the field, to <a href="https://www.nytimes.com/2019/12/25/health/antibiotics-new-resistance.html" target="_blank">The New York Times</a>.</p><p>"We need research to find new drugs but can't rely on a pipeline of new drugs alone to solve this problem, since resistance eventually happens to all drugs," said Dr. Jacob to <a href="https://www.medicalnewstoday.com/articles/327050.php#8" target="_blank">Medical News Today</a>.</p>
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U.S. Sen. Cory Booker speaking with attendees at the 2019 California Democratic Party State Convention at the George R. Moscone Convention Center in San Francisco, California on June 1. Gage Skidmore / Flickr / CC BY-SA 2.0
New Jersey senator and presidential hopeful Cory Booker put forth the Farm System Reform Act of 2019, in recognition of the environmental impact of industrial agriculture, which would put a stop to any new factory farms, as The Hill reported.
<p>The bill will reform the agriculture system by breaking up monopolistic practices in the industry and holding large corporate farms accountable for the environmental impacts of their practices, according to <a href="https://thehill.com/homenews/senate/474685-booker-proposes-moratorium-on-expanding-large-factory-farms" target="_blank">The Hill</a>.</p>
<p>The proposal takes particular aim at <a href="https://www.ecowatch.com/tag/factory-farming" rel="noopener noreferrer">factory farms</a>, or concentrated animal feeding operations (CAFOs), which are notorious for their detrimental environmental impacts, as well as the inhumane treatment of animals. Not only would the bill ban any new CAFOs, but it requires phasing existing ones out by 2040, according to the <a href="https://whistleblower.org/blog/senate-bill-to-overhaul-concentrated-animal-feeding-operations/" target="_blank">Government Accountability Project</a>. The bill will allocate $100 billion over a decade to entice farmers who want to transition out of running CAFOs.</p>
<p>CAFOs are known to generate an enormous amount of manure and waste, which frequently contaminates nearby <a href="https://www.ecowatch.com/tag/groundwater" rel="noopener noreferrer">groundwater</a>. They are also known to give farmers little freedom to change since farmers are often handcuffed by binding contracts with large corporations. The Department of Agriculture defines a CAFO as having 1,000 cattle, 700 dairy cows, 2,500 pigs, 125,000 chickens or 82,000 laying hens, as <a href="https://modernfarmer.com/2019/12/cory-booker-announces-legislation-to-scale-back-factory-farms/" target="_blank">Modern Farmer</a> reported. </p>
<p>Sen. Cory Booker's proposal aims to hold corporations responsible for pollution and other harm caused by their factory farm suppliers, even though the factory farms are independently owned and in a contract with the large corporations, according to <a href="https://thehill.com/homenews/senate/474685-booker-proposes-moratorium-on-expanding-large-factory-farms" target="_blank">The Hill</a>.</p>
<p>"Our independent family farmers and ranchers are continuing to be squeezed by large, multinational corporations that, because of their buying power and size, run roughshod over the marketplace. We need to fix the broken system – that means protecting family farmers and ranchers and holding corporate integrators responsible for the harm they are causing," said Booker, in a <a href="https://www.booker.senate.gov/?p=press_release&id=1036" target="_blank">statement</a> put out by his office. "Large factory farms are harmful to rural communities, public health, and the environment and we must immediately begin to transition to a more sustainable and humane system."</p>
<p>Booker's <a href="https://www.booker.senate.gov/?p=press_release&id=1036" target="_blank">statement</a> cited data from the Center for Disease Control and Prevention that found large CAFOs produce as much as 1.4 billion tons of waste each year, but don't need to maintain a waste treatment facility. Their steady dramatic increase in numbers recently put rural communities at risk of severe environmental hazards and threatens the viability of family farms.</p>
<p>Furthermore, the crowded conditions of livestock means antibiotics have been overused, leading to the spread of <a href="https://www.ecowatch.com/tag/antibiotic-resistance" rel="noopener noreferrer">antibiotic resistant bacteria</a>. That phenomenon pushed the American Public Health Association to urge federal, state and local governments as well as <a href="https://www.ecowatch.com/tag/public-health" rel="noopener noreferrer">public health</a> agencies to impose a moratorium on all new and expanding CAFOs last month, according to Booker's <a href="https://www.booker.senate.gov/?p=press_release&id=1036" target="_blank">statement</a>.</p>
<p>"Senator Booker's Farm System Reform Act pushes back on the concentration of animal production and the devastating impact that has had on our rural communities," said Randy Dugger, Indiana Farmers Union Vice President, in a <a href="https://www.booker.senate.gov/?p=press_release&id=1036" target="_blank">statement</a>. "Independent family farmers deserve an opportunity to be prosperous again. By providing fairness and transparency in the market, along with a significant investment to help those trapped in a broken system to get out, this bill can make a huge difference."</p>
<p>The bill also calls for restoring country-of-origin labeling for <a href="https://www.ecowatch.com/tag/beef" rel="noopener noreferrer">beef</a> and pork and expand to <a href="https://www.ecowatch.com/tag/dairy" rel="noopener noreferrer">dairy</a> products. It would tighten labeling regulations so consumers know where meat was grown, slaughtered and processed, which would stop the Department of Agriculture from labeling imported meat as "Product of USA." Currently, meat grown, slaughtered and processed in Brazil, but packaged in the USA can be labeled as Product of USA, as <a href="https://modernfarmer.com/2019/12/cory-booker-announces-legislation-to-scale-back-factory-farms/" target="_blank">Modern Farmer</a> reported. </p>
<p>"I have seen first-hand how hard it is to challenge the multinational corporations who control the meat industry," said Mike Callicrate, a Kansas rancher in a <a href="https://www.booker.senate.gov/?p=press_release&id=1036" target="_blank">press release</a>. "Farmers and ranchers need a marketplace that compensates them fairly and Senator Booker's Farm System Reform Act is a big step in the right direction. Things like country of origin labeling on meat, updates to the Packers and Stockyards Act, and resources to get folks out of a system that is bankrupting them will make a big difference."</p>
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Phages: Bacterial Eaters From Georgia to Fight Antibiotic Resistance
22 November 2019
Health + Wellness
By Tim Ruben Weimer
Tanja Diederen lives near Maastricht in the Netherlands. She has been suffering from Hidradenitis suppurativa for 30 years. Its a chronic skin disease in which the hair roots are inflamed under pain — often around the armpits and on the chest.
<p>€3,900 ($4,302) for treatment in Georgia</p><p>In August 2019, the now 50-year-old made a radical decision: she discontinued the antibiotics, which were becoming less and less effective. And she traveled to Georgia for two weeks to undergo treatment with bacteriophages (or phages for short).</p>
<p><em>Reposted with permission from <a href="https://www.dw.com/en/phages-bacterial-eaters-from-georgia-to-fight-antibiotic-resistance/a-51350421" rel="noopener noreferrer" target="_blank">Deutsche Welle</a>.</em><br/></p>
<img lazy-loadable="true" src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjA5OTMyNy9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYxMzYwNzA1MH0.m_FzsjtCvLIXdT4VMqkLZheKW5lA4dG_IjcRXbyyAqw/img.jpg?width=980" id="54d3f" class="rm-shortcode" data-rm-shortcode-id="7531a0ed541a5083cf8cc0896ad2ce3d" data-rm-shortcode-name="rebelmouse-image" /><p>Such phage therapy is not yet approved in most Western European countries. She paid 3,900 euros out of her own pocket in the hope that the unconventional therapy would help her.</p><p>Bacteriophages are viruses that fight against the proliferation of their host bacteria. Therapy with bacteriophages involves the oral administration of a single, isolated type of phage. They attach themselves to their bacterial counterparts in the patient's body in order to survive. </p><p>The phages reverse the polarity of the bacterial cell in such a way that it produces further phages, filling up with more and more phages and finally bursts. Then, the released phages attach themselves to other bacteria until all of the bacteria has been destroyed.</p>
Journey Into the Unknown
<p>"It tastes a bit like mushrooms," Tanja Diederen remarked as she took her morning phage dose. "When I went to Georgia, I was at first very nervous and excited, but above all disappointed about the treatment here in Holland."</p><p>After antibiotics stopped working for her, her doctor suggested that she take biopharmaceuticals, i.e. genetically engineered drugs. He had never heard of bacteriophages.</p><p>Instead, Diederen decided to look for treatment options with bacteriophages on her own, which she had heard about in a television program. </p>The Doctor Never Heard of Phages
<img lazy-loadable="true" src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjA5OTMyOS9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYyMDkyNzg5Mn0.qRW81FnFddQeCHblPbinr-ITYYThWMzcTkmyJHkLYXU/img.jpg?width=980" id="50ae5" class="rm-shortcode" data-rm-shortcode-id="9ab12b7d5efd0f615a2c891f5341dd33" data-rm-shortcode-name="rebelmouse-image" />A phage model — phages are viruses, that multiply in bacteria and then destroy them.
<p>She came across the <a href="http://eliava-institute.org/research/" target="_blank">Georgi-Eliava Institute</a> in Georgia, which has been researching bacteriophages since 1923 — just a few years after their discovery. Georgia has since developed into the global center of phage therapy.</p><p>During the Cold War, antibiotics were difficult to get there or anywhere in the Soviet Union. Treatment with phages was the best way to cure infectious diseases. Today, the Eliava Institute has one of the largest therapeutic collections of bacteriophages in the world.</p><p>Tanja Diederen stayed in treatment for two weeks, after which she traveled back to the Netherlands with a large suitcase full of phage tins. Since she began taking two different phages a day and applying a cream, she feels better.</p><p>She has more energy again and the small inflammations on her chest and armpits have decreased. The large inflammations come and go, but not as severe as before.</p>"It Doesn't Feel Illegal to Me"
<img lazy-loadable="true" src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjA5OTMzMi9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTU5OTQ3MjkyN30.LIFoPvFlOUrWiygZYQIFHFuU0XnbYZvQVuYOzLh72JM/img.jpg?width=980" id="5e607" class="rm-shortcode" data-rm-shortcode-id="8800327639cc2ab041ea52667ce91e73" data-rm-shortcode-name="rebelmouse-image" />Communicating with the Georgian doctors was difficult for Tanja Diederen. She needed a translator.
<p>Every three months Diederen travels to Belgium — 15 kilometers away — to pick up a new ration of bacteriophages sent from Georgia for 500 euros. Her health insurance doesn't pay for this. Belgium is the only Western European country where phages are allowed. In the Netherlands, as in all other countries, they can only be used in individual cases to save lives or relieve severe pain. </p><p>Her physician is solely responsible for the application.</p><p>"It doesn't feel illegal to me," said Diederen. "I am one hundred percent sure that this medicine will help many people."</p><p>Like antibiotics, bacteriophages can also lead to bacterial resistance. Their big advantage, however, is that they are always one step ahead of the bacteria and can overcome the resistance. In addition, they are always directed against a specific type of bacteria and thus leave useful bacteria undamaged, like in the intestine, for example.</p><p>Before phage treatment, it is always necessary to determine which bacteria actually trigger the disease. The phages are then produced individually for each patient — often in Georgia.</p>Bacteriophages Permitted in Belgium
<img lazy-loadable="true" src="https://assets.rebelmouse.io/eyJhbGciOiJIUzI1NiIsInR5cCI6IkpXVCJ9.eyJpbWFnZSI6Imh0dHBzOi8vYXNzZXRzLnJibC5tcy8yMjA5OTMzNC9vcmlnaW4uanBnIiwiZXhwaXJlc19hdCI6MTYwNTI2NDYzOX0.9BVO3fcj0e1erjgqXALiH58zBE2LWyCbtw2RvBpIrvA/img.jpg?width=980" id="182fb" class="rm-shortcode" data-rm-shortcode-id="1b9e9c2603898ec71e4d05666f26454f" data-rm-shortcode-name="rebelmouse-image" />Professor Jean-Paul Pirnay from the Queen-Astrid Military Hospital in Brussels works with bacteriophages.
<p>Such an individual medication does not meet the applicable regulations for medicinal products in any Western European country. It would take too much effort to have each individual phage formulation approved by the authorities.</p><p>Not so in Belgium. Since last year, this process can be legally circumvented by the Scientific Health Institute, in cooperation with doctors, patients, manufacturers, pharmacists and the Belgian Federal Office for Medicinal Products, issuing a certificate for the required phage ingredients. Pharmacists will then be able to use them for the manufacture of bacteriophages, subject to certain guidelines.</p><p>"We have used the existing legal framework to insert the bacteriophages," said <a href="https://www.researchgate.net/lab/Laboratory-for-Molecular-and-Cellular-Technology-Jean-Paul-Pirnay" target="_blank">Dr Jean-Paul Pirnay,</a> who works at the Queen Astrid Military Hospital in Brussels on bacteriophages.</p><p>Around 30 patients have already been treated there. Currently, the military hospital is the only place in Belgium where bacteriophages are produced.</p>Useful Supplement to Antibiotics
<p>"We need pharmaceutical companies to make the phage," says Pirnay. "A hospital can't produce all phages for a growing number of patients."</p><p>But industrial production of phages would require a clearer legal framework, and research is not yet ready.</p><p>"I believe that phages will not replace antibiotics," he said. "Both will be used together to make antibiotics more effective."</p><p>Tanja Diederen wants to continue her treatment in Brussels in the future. Communication with the Georgian doctors was difficult for her, she always needed a translator.</p><p>"I really hope that phages will soon be allowed in Europe," she said. "Going to Georgia is quite difficult and expensive."</p><p>Germany and the Netherlands are currently conducting pilot studies to see whether an individual prescription of bacteriophages would be possible. France has already imported Belgian phages and agreed to their use.</p>From Your Site Articles
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Pexels
By Bijal Trivedi
The Centers for Disease Control and Prevention (CDC) released a report on Nov. 13 that describes a list of microorganisms that have become resistant to antibiotics and pose a serious threat to public health. Each year these so-called superbugs cause more than 2.8 million infections in the U.S. and kill more than 35,000 people.
<p>The CDC listed 18 species of bacteria and fungi that are of greatest concern. The fear is that these superbugs could spread resistance to other disease-causing organisms, rendering modern medicines' most powerful weapons useless.</p><p>At the same time, many scholars across the U.S. are addressing the problem and coming up with innovative solutions to fight these microscopic threats. Here we spotlight four examples from our 2018-2019 archives.</p>
<p> <em>Reposted with permission from </em><em><a href="https://theconversation.com/how-scientists-are-combating-superbugs-4-essential-reads-127080" target="_blank">The Conversation</a></em><em>.</em></p>
1. Consistent Rules for Hospitals With Superbugs
<p>Infectious disease physician-scientist David Pride explains why incremental improvements of current antibiotics are not effective, and how the rules for containing antibiotic resistant bacteria differ from hospital to hospital exacerbating the spread of these deadly microbes. He presents an <a href="https://theconversation.com/an-ambitious-plan-to-stop-the-rise-of-superbugs-119693" target="_blank">ambitious plan</a> for curbing the rise of superbugs. That includes adopting common protocols across hospitals for when, and which, antibiotics are prescribed to stop inappropriate and over use. He also underscores the need to administer fewer antibiotics in livestock.</p>2. Viruses to the Rescue
<p>It is well known that the enemy of your enemy is your friend. Andrew Camilli and Minmin Yen write about how they and other researchers are exploiting this idea to enlist bacteria-killing viruses, called bacteriophages, to wipe out superbugs that are resistant to antibiotics. These researchers are focusing on using <a href="https://theconversation.com/phage-therapy-to-prevent-cholera-infections-and-possibly-those-caused-by-other-deadly-bacteria-117058" target="_blank">bacteriophages to kill off the cholera bacterium </a>in the gut to prevent infection. But these viral cocktails are also proving effective against other infections.</p>3. Smart Antibiotics
<p>One problem with current antibiotics is that they don't discriminate between the disease causing microbes and the beneficial ones that make up our microbiome and are essential to good health. David B. Stewart and Arun K. Sharma describe how they are designing <a href="https://theconversation.com/a-novel-smart-antibiotic-may-target-most-common-bacterial-infection-contracted-in-us-hospitals-99260" target="_blank">nanotechnology to carry inexpensive targeted drugs</a> that only kill <em>Clostridioides difficile</em>, a microbe that the CDC has classified in this new report as an urgent threat.</p>4. Deadly Fungi?
<p>You might be under the impression that all of the microbes on the CDC's list of public health threats are bacteria. But three — 20 percent of those mentioned in the report — are fungi. The most worrisome new foe is called <em>Candida auris</em>. With limited drugs to fight fungal infections, Carol A. Kumamoto and Jesus A. Romo write about how they are <a href="https://theconversation.com/a-frenemy-fungus-provides-clues-about-a-new-deadly-one-115110" target="_blank">studying a less dangerous fungal relative, <em>C. albicans</em></a> to identify the vulnerabilities of this treacherous fungus.</p><p><em>Editor's note: This story is a roundup of articles from The Conversation's archives.</em></p>From Your Site Articles
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Common Medications, Including Antibiotics, Can Alter Your Gut Microbiome
28 October 2019
Health + Wellness
According to a new study, some commonly used drugs can extensively affect your gut microbiome. Jose Luis Pelaez Inc / DigitalVision / Getty Images
By Amy Jamieson
Indigestion, a bacterial infection, or constipation: Thanks to the marvels of modern medicine, there are widely available medications to combat all of these things.
But when you take these medications, you may be getting more than you bargained for.
<p>According to a new study, some commonly used drugs — over-the-counter medications for heartburn and doctor-prescribed antibiotics among them — can extensively affect your gut microbiome.</p><p>Researchers at the University Medical Center Groningen and the Maastricht University Medical Center in The Netherlands also found that different categories of drugs increased antimicrobial resistance mechanisms.</p><p>They presented their findings at the <a href="https://live.ueg.eu/week/" target="_blank">United European Gastroenterology Week 2019</a> this week. The study hasn't been published yet in a peer-reviewed journal.</p><p>Should any of this research give you pause? Given the attention <a href="https://www.healthline.com/health/gut-health" target="_blank">gut health</a> has received <a href="https://www.healthline.com/health/digestive-health/reducing-inflammation-gut-health" target="_blank">as of late</a>, the answer is probably "yes."</p><p>"In recent years we have learned that the gut microbiota is important in human health," <a href="https://www.researchgate.net/profile/Arnau_Vich_Vila" target="_blank">Arnau Vich Vila</a>, a Ph.D. student and professor of medical sciences at the University of Groningen and a lead researcher on the study, told Healthline. "Overall, our research suggests that the use of commonly used medication can have health consequences through modification of our gut microbial composition and function."</p>
<p>Researchers looked at 41 commonly used drug categories. The ones they found to have the biggest impact on the gut microbiome included drugs used to treat indigestion called proton pump inhibitors (PPIs), antibiotics, laxatives and <a href="https://www.healthline.com/health-news/why-so-many-people-with-diabetes-stop-taking-metformin" target="_blank">metformin</a>, the most commonly prescribed drug for diabetes treatment.</p><p>The researchers assessed 1,883 fecal samples from people with inflammatory bowel disease (IBD) as well as people with irritable bowel syndrome (IBS) and a control group of people without these conditions.</p><p>They said there was evidence some of the medications put people at increased risk of intestinal infections, obesity, and disorders linked to the gut microbiome.</p><p>The team's findings regarding PPIs were the most alarming, in Vich Vila's opinion.</p><p>"This is a group of medication which is sold over the counter with no need for prescription, rendering its use not controlled by physicians," he said. "We have seen that the use of proton pump inhibitors has the largest impact on the gut microbiota composition, not only increasing certain potentially pathogenic bacteria in the gut but also increasing antibiotic resistance mechanisms."</p><p>Vich Vila said their results have been validated by other research groups, "which also associated the use of these drugs to different conditions such as enteric [intestines-related] infections and cardiovascular events."</p><p>Given what they've found, the researchers advise people to not take proton pump inhibitors without a recommendation from their doctors.</p>
<h2>The Importance of the Gut</h2><p>Your gut contains tens of trillions of microorganisms, including bacteria, fungi and viruses, that are altered by different factors.</p><p>Medications are one factor. Diet and genetics are others.</p><p>"The gut microbiota plays an important role in our immune and metabolic functions, therefore alterations in its composition or structure can have an impact on these," Vich Vila explained. "Our results suggest some interesting mechanisms that need further attention. For example, the use of oral steroids is related to the increased abundance of <em>Methanobrevibacter smithii</em>. This microbe has been related to obesity and increased body mass index [BMI], and an increase in weight is one of the common side effects of steroids use."</p><p>Another example, Vich Vila said, is the use of PPIs.</p><p>"Epidemiological studies have identified that users have a higher risk of developing enteric infections. However, the mechanism by which this occurs is still not known," he said. "Our findings suggest that changes in the gut microbiota induced by the use of this drug could facilitate these infections."</p><p>Vich Vila noted there are other studies that report gut changes with obesity, diabetes, liver disease, cancer and neurodegenerative diseases such as Alzheimer's disease and multiple sclerosis.</p><p>"There is growing evidence of the role of microbiota in the neurological diseases, in what is called the 'gut-brain axis,'" Vich Vila said. "To better understand which are the exact mechanisms that explain this relation, it is important to discriminate the causes and consequences of the microbial changes associated with these disorders."</p>
<h2>What's Ahead</h2><p>Their study, Vich Vila said, is an important first step to identifying potential relations between the use of medication and the gut microbiota.</p><p>He said more research is needed.</p><p>"We still need to understand how and why these changes occur," he said. "For that, we need to combine in vitro experiments with longitudinal studies. Moreover, the study of the metabolism of these drugs will allow us to discriminate direct and indirect effects."</p><p>Officials at the Food and Drug Administration (FDA) described the study results as "interesting."</p><p>"It is encouraging to see studies on gut microbiota," noted an FDA statement to Healthline. "We continue to gain a better understanding of the risk of intestinal infections, obesity, and other serious conditions and disorders linked to the gut microbiome. Gut microbiota plays an important role in a healthy digestive system."</p><p>As a consumer of these drugs, what's your next move?</p><p>Vich Vila said it's still too early to draw conclusions about the health consequences of these changes to the microbiome.</p><p>But if you're concerned about what you're taking, talk with your doctor — and only take medications as needed.</p><p>"Drugs have been tested to be safe and are useful to treat multiple disorders," Vich Vila said. "However, as we have seen in the past with the use of <a href="http://www.ecowatch.com/tag/antibiotics">antibiotics</a>, the unnecessary use of these drugs has become a problem. In the end, we advise patients to follow the recommendations of their doctor and to not take medication unnecessarily."</p>
<p><em>Reposted with permission from our media associate <a href="https://www.healthline.com/health-news/antibiotics-laxativcommon-medications-alter-gut-microbiome" target="_blank">Healthline</a>.</em></p>From Your Site Articles
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Here’s How Bad Antibiotic Resistance Has Gotten Over the Past 20 Years
22 October 2019
Health + Wellness
By Julia Ries
- Antibiotic resistance has doubled in the last 20 years.
- Additionally a new study found one patient developed resistance to a last resort antibiotic in a matter of weeks.
- Health experts say antibiotic prescriptions should only be given when absolutely necessary in order to avoid growing resistance.
Over the past decade, antibiotic resistance has emerged as one of the greatest public health threats.
<p><a href="https://www.cdc.gov/antibiotic-use/community/about/antibiotic-resistance-faqs.html" target="_blank">Antibiotics</a> have been used to prevent and treat bacterial infections since the 1940s when doctors first discovered the powerful drugs could save people's lives.</p><p>But in recent decades overuse and misuse has resulted in <a href="https://www.ncbi.nlm.nih.gov/pubmed/25279369" target="_blank">infectious bacteria becoming resistant</a> to these common drugs. Today, researchers have more details on just how severe antibiotic resistance has become and found evidence that we've reached a frightening new milestone.</p><p>New research published in the journal <a href="http://%20https//aac.asm.org/content/aac/early/2019/10/01/AAC.01637-19.full.pdf?ijkey=.kQmOSUjlIfZA&keytype=ref&siteid=asmjournals&_ga=2.222823711.502867457.1571672876-268124401.1528995690" target="_blank">Antimicrobial Agents and Chemotherapy</a> today discovered that resistance to one of the last resort drugs used to treat extremely drug-resistant Pseudomonas aeruginosa can develop a lot more quickly than we originally thought.</p><p>A patient infected with <a href="https://www.ehagroup.com/resources/pathogens/pseudomonas-aeruginosa/" target="_blank">Pseudomonas aeruginosa</a><a href="https://www.ehagroup.com/resources/pathogens/pseudomonas-aeruginosa/" target="_blank"> (</a><a href="https://www.ehagroup.com/resources/pathogens/pseudomonas-aeruginosa/" target="_blank">P. aeruginosa</a><a href="https://www.ehagroup.com/resources/pathogens/pseudomonas-aeruginosa/" target="_blank">)</a> — a bacteria that can cause a range of infections, including urinary tract infections, bone and joint infections, and respiratory infections — developed resistance to the antibiotic ceftolozane-tazobactam in just 22 days.</p><p>This discovery follows another European study, which found that resistance to antibiotics commonly used to treat a range of stomach infections has nearly doubled in 20 years</p><p>In fact, resistance to commonly used antibiotics — such as clarithromycin — is increasing at 1 percent each year, according to <a href="https://www.ueg.eu/press/releases/ueg-press-release/article/ueg-week-resistance-to-antibiotics-used-to-treat-harmful-stomach-infection-doubles-in-20-years-new/" target="_blank">those findings</a>, which researchers presented Monday at UEG Week Barcelona 2019.</p>
<p><em>Reposted with permission from our media associate <a href="https://www.healthline.com/health-news/heres-how-bad-antibiotic-resistance-has-gotten" rel="noopener noreferrer" target="_blank">Healthline</a>.</em></p>
Resistance Has Soared
<p>Antibiotics can be extremely helpful and even lifesaving when used appropriately. But many health experts are concerned that if we continue to overuse and misuse them, they'll lose their abilities to treat infections.</p><p>"There is concern that continued antibiotic resistance could lead us to a 'post-antibiotic world' in which infections are no longer treatable. This problem has been likened to a global public health threat on the level of that presented by climate change," <a href="https://stanfordhealthcare.org/doctors/d/stanley-deresinski.html" target="_blank">Dr. Stanley Deresinski</a>, an infectious disease doctor with Stanford Health Care, told Healthline.</p><p>To measure just how resistant the population has become to antibiotics and identify which treatments can be used in the future, researchers conducted surveys on how effectively people responded to various antibiotics in 1998, 2008 and most recently, in 2018.</p><p>For the 2018 survey, the researchers studied 1,232 patients from 18 countries in Europe who had contracted a Helicobacter pylori (H. pylori) infection, a harmful bacterium associated with gastric ulcer, lymphoma and gastric cancer.</p><p>The researchers determined that resistance to the antimicrobial clarithromycin — which is commonly used to treat <em>H. pylori</em> — had grown from 9.9 percent in 1998 to 21.6 percent in 2018.</p><p>In addition, resistance to other powerful antibiotics has grown significantly as well. The resistance rate for levofloxacin has risen to 17 percent, and the rate for metronidazole to 42 percent.</p><p>Lastly, the researchers noticed that resistance to amoxicillin, tetracycline and rifampicin compounds increased as well.</p><p>According to the study, the rates of resistance were highest in Southern Italy (37 percent), Croatia (35 percent) and Greece (30 percent).</p><p>Meanwhile, resistance rates in the United States have also soared, according to health experts.</p><p>"To see some countries with over 1/3 of all H. pylori infections resistant to clarithromycin (one of a combination of antibiotics used to treat H. pylori) is shocking. Things have been moving this way in the U.S., with estimates of clarithromycin resistance bordering 19 percent," says <a href="https://www.northwell.edu/find-care/find-a-doctor/gastroenterology/dr-arun-swaminath-md-11361885" target="_blank">Dr. Arun Swaminath</a>, the director of the inflammatory bowel disease program at Lenox Hill Hospital in New York.</p><p>If the United States doesn't become more prudent with antibiotic use, what's happening in southern Italy and Croatia could soon be our own future, Swaminath said.</p>Here’s Why It Happens
<p>The more we use antibiotics, the higher the prevalence of antimicrobial resistance is, explains <a href="https://www.yalemedicine.org/doctors/richard_martinello/" target="_blank">Dr. Richard Martinello</a>, a Yale Medicine infectious diseases expert.</p><p>"The use of antibiotics forces the evolution of resistant bacteria, and growth of these resistant bacteria are favored when antibiotics are present," says Martinello.</p><p>Essentially, that bacteria mutates into a version that's developed resistance, allowing them to survive and multiply in the presence of antibiotics.</p><p>And, as microbes become more resistance to antibiotics, doctors encounter a higher number of patients with infections that cannot be treated with antibiotics, Martinello said, adding that this can frequently lead to death or other potentially permanent health complications.</p>What Can Be Done
<p>According to the health experts, we need to slow down the use of antibiotics and use them only when necessary.</p><p>"Physicians prescribing antibiotics need to exercise discretion and only prescribe antibiotics when they may help patients. It has been estimated that in the upwards of 50 percent of prescriptions for antibiotics are for health conditions, such as colds, which will not be helped by antibiotics," Martinello said.</p><p>Additionally, patients also need to recognize the limitations of antibiotics.</p><p>"There is a patient expectation that antibiotics are cure-alls for colds, sore throats, URIs, diarrhea to name a few," says <a href="https://www.northwell.edu/find-care/find-a-doctor/internal-medicine/dr-theodore-john-strange-md-11364314" target="_blank">Dr. Theodore Strange</a>, the associate chair of medicine at Staten Island University Hospital.</p><p>Patients must only use them as prescribed and should return any unused antibiotics to their pharmacy.</p><p>"Antibiotics are necessary only when indicated for specific bacterial diseases and should be of the appropriate type, in the appropriate dose, [for] the appropriate amount of time," Strange said. "They are not 'cure-alls' for all."</p>The Bottom Line
<p>Antibiotic resistance has emerged as one of the greatest threats to public health in recent years. Now, new research shows just how big of a threat it is.</p><p>A new study found that resistance to commonly used antibiotics has nearly doubled in 20 years. Another found that resistance to antibiotics is developing faster than ever, with one patient becoming resistant in just 22 days.</p><p>Health experts agree that in order to mitigate the issue, people need to use antibiotics only when necessary.</p>From Your Site Articles
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Drug-Resistant Salmonella Linked to Overuse of Antibiotics in Cattle Farming
23 August 2019
Health + Wellness
Salmonella bacteria, a common cause of foodborne disease, invade an immune cell.
National Institude of Allergy and Infectious Disease
The Centers for Disease Control and Prevention (CDC) warned Thursday of a drug-resistant strain of salmonella newport linked to the overuse of antibiotics in cattle farming.
<p>The strain sickened 255 people in 32 states between June 2018 and March 2019, leading to 60 hospitalizations and two deaths, the agency wrote in its <a href="https://www.cdc.gov/mmwr/volumes/68/wr/mm6833a1.htm?s_cid=mm6833a1_w" target="_blank">Morbidity and Mortality Weekly Report</a>. And the strain is still making people sick, lead report author and CDC epidemiologist Dr. Ian Plumb told <a href="https://edition.cnn.com/2019/08/22/health/drug-resistant-salmonella-cdc-warning/index.html" target="_blank">CNN</a>.</p>
<div id="19865" class="rm-shortcode" data-rm-shortcode-id="ZAG1KL1576661573"><blockquote class="twitter-tweet twitter-custom-tweet" data-twitter-tweet-id="1164591825346342914" data-partner="rebelmouse"><div style="margin:1em 0">New @CDCMMWR: Learn about #Salmonella Newport infections in the US that are resistant to some common #antibiotics a… https://t.co/nBYacDhQLO</div> — CDC (@CDC)<a href="https://twitter.com/CDCgov/statuses/1164591825346342914">1566495302.0</a></blockquote></div><p>"We are continuing to see cases occurring among patients," Plumb told CNN in an email. "The antibiotic resistance pattern of this strain is alarming because the primary oral antibiotics used to treat patients with this type of salmonella infection may not work."</p><p>Plumb told <a href="https://consumer.healthday.com/public-health-information-30/salmonella-news-775/cdc-warns-of-drug-resistant-salmonella-in-beef-cheese-749591.html" target="_blank">HealthDay Reporter</a> that the two patients who died had other illnesses as well, but that the drug-resistant salmonella did contribute to their deaths.</p><p>The strain has shown decreased susceptibility to azithromycin and does not respond at all to ciprofloxacin, the report said. Both are commonly used to treat the disease, and, before 2017, fewer than 0.5 percent of salmonella strains found in U.S. patients were resistant to azithromycin.</p><p>The outbreak has been linked to the consumption of U.S. <a href="https://www.ecowatch.com/tag/beef" target="_self">beef</a> and Mexican soft cheese, leading investigators to believe the strain is present in cows in both countries, CNN reported.</p><p>"The resistant strains developed in animals, and those strains can then be transmitted to humans," Plumb told HealthDay Reporter.</p>
<p>Dr. Marc Siegel, a professor of medicine at the New York University Langone Medical Center who was not involved with the study, told HealthDay Reporter that the best way to prevent drug-resistant infections like this is to change farming practices.</p><p>"Salmonella is a very common bacteria in livestock, and the problem is that we're overusing antibiotics to try to control this problem," Siegel said. He said that farmers also gave antibiotics to cattle to increase their size.</p><p>He said that better human treatments were not the solution, since most of the time the infection needs no treatment at all.</p><p>"It's really a change in farming practices that are needed—to stop giving these animals antibiotics," he said.</p><p>The CDC also stated that avoiding giving cattle unnecessary antibiotics, especially those also used to treat humans, would help prevent the spread of drug-resistant salmonella.</p><p>In the meantime, the CDC recommended that people protect themselves by avoiding soft cheese made with unpasteurized milk and using thermometers to make sure beef is cooked to the proper temperature: 145 degrees Fahrenheit for steaks and roasts and 160 degrees Fahrenheit for ground beef.</p>
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C. Diff Is Evolving Into Superbug in Response to Western Sugary Diets
16 August 2019
Health + Wellness
Clostridium difficile bacterium with peritrichous flagella, computer illustration. C. difficile is now becoming resistant to most antibiotics.
KATERYNA KON / SCIENCE PHOTO LIBRARY / Getty Images
KATERYNA KON / SCIENCE PHOTO LIBRARY / Getty Images
One of the most widespread bacteria known to cause serious gut infections is evolving to take advantage of high-sugar diets in the West and resist disinfecting methods used in healthcare settings.
<p>The diarrhea and colitis-causing bacteria <em>Clostridioides difficile, </em>or C. Diff<em>, </em>is common throughout our environment and results in nearly 500,000 infections in the U.S. each year, the <a href="https://www.cdc.gov/cdiff/what-is.html" target="_blank">Centers for Disease Control and Prevention</a> says, which can be fatal for elderly and very sick people who have been hospitalized or given <a href="http://www.ecowatch.com/tag/antibiotics" target="_self">antibiotics</a>.</p><p>According to <a href="https://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691" target="_blank">Mayo Clinic</a>, C. Diff spores are often spread orally by contact with feces, which makes its way to food and other surfaces when an infected person fails to wash their hands thoroughly. The spores damage the lining of your intestine, potentially leading to severely dehydrating diarrhea, inflammation of the intestines, toxic megacolon and sepsis.</p><p>C. Diff is <a href="https://www.health.harvard.edu/staying-healthy/clostridium-difficile-an-intestinal-infection-on-the-rise" target="_blank">so common</a> in our surroundings that even some <a href="https://www.studyfinds.org/study-diarrhea-inducing-bacteria-c-diff-evolves-into-new-strain-that-thrives-in-hospitals/" target="_blank">healthy adults will carry it</a> in their system but are protected from severe symptoms by their healthy gut bacteria, <a href="https://www.theatlantic.com/health/archive/2015/12/obesity-antibiotics-microbiome/421344/" target="_blank">The Atlantic </a>reported. But antibiotics used to treat other infections can unintentionally eliminate the healthy bacteria, allowing C. Diff to thrive, cause an infection and spread to the environment when passed in diarrhea, <a href="https://www.nbcnews.com/health/health-news/dangerous-bacteria-can-survive-disinfectant-putting-patients-risk-n1029231" target="_blank">NBC News</a> reported.</p><p>Recent <a href="https://aem.asm.org/" target="_blank">research</a> has shown that C. Diff can spread to and exist for months on disposable hospital gowns, stainless steel and vinyl surfaces often found in health facilities, even after being hit with concentrated chlorine disinfectant. A <a href="https://www.sciencedaily.com/releases/2019/08/190812130914.htm" target="_blank">new study</a> by the Wellcome Sanger Institute and the London School of Hygiene & Tropical Medicine might have revealed why.</p><p>The study found that C. Diff has been evolving into two species over thousands of years, one of which is adapting into a superbug primed to spread in hospitals.</p><p>"The study shows how the pathogen <em>C. Difficile</em> is evolving in response to the Western sugary diet and common hospital disinfectants," study author Nitin Kumar, a senior bioinformatician at the Wellcome Sanger Institute, told <a href="https://www.popsci.com/c-diff-superbug-diarrhea-hospital-sugar-species-evolve/" target="_blank">Popular Science</a>.</p><p>For the study, published this week in <a href="https://www.nature.com/articles/s41588-019-0478-8" target="_blank">Nature Genetics</a>, the researchers sequenced the DNA of 906 different C. Diff strains from humans, other mammals such as dogs and pigs, and the environment. Kumar told <a href="https://www.livescience.com/evolving-superbug-sugar-diet.html" target="_blank">Live Science</a> that groups of organisms must share 95 percent of their genomes to be considered the same species, and based on the sequenced genomes, C. Diff is "on the verge of speciation."</p><p>The researchers found that one of the emerging species, <em>C. Difficile </em>clade A, was found in 70 percent of samples taken from hospital patients. A common trait of the new species was a mutation developed over thousands of years to improve sugar metabolism. When exposed to mice, the new species was more likely to flourish if the mice were fed diets enriched with simple sugars, like glucose and fructose, commonly consumed as part of the typical Western diet.</p><p>The <a href="https://nypost.com/2019/08/13/a-new-carb-loving-superbug-is-primed-to-target-hospital-food/" target="_blank">New York Post</a> reported that common hospital foods, such as pudding cups and mashed potatoes, could become hotspots for this new C. Diff. species.</p><p>The new species also had genetic mutations that changed how it formed spores, making it more resistant to disinfectants used in hospitals.</p><p>"Our study provides genome and laboratory based evidence that human lifestyles can drive bacteria to form new species so they can spread more effectively," senior author Trevor Lawley of the Wellcome Sanger Institute said in a <a href="https://www.sanger.ac.uk/news/view/diarrhoea-causing-bacteria-adapted-spread-hospitals" target="_blank">press release</a>.</p><p>"We show that strains of <em>C. Difficile </em>bacteria have continued to evolve in response to modern diets and healthcare systems and reveal that focusing on diet and looking for new disinfectants could help in the fight against this bacteria."</p>
<blockquote class="twitter-tweet"><p lang="en" dir="ltr">Writing for <a href="https://twitter.com/EcoWatch?ref_src=twsrc%5Etfw">@EcoWatch</a>: An analysis looking for more than a dozen common antibiotics in 711 rivers in one-third of the world's countries found that concentrations in some rivers were more than 300 times higher than "safe" levels.<a href="https://t.co/gXaBeASQeQ">https://t.co/gXaBeASQeQ</a></p>— Madison Dapcevich (@madisondap) <a href="https://twitter.com/madisondap/status/1133772880183873537?ref_src=twsrc%5Etfw">May 29, 2019</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
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What’s the Scoop on Kids and Dirt? Get Enough to Help, but Not Enough to Hurt, a Doctor Advises
03 August 2019
Health + Wellness
3sbworld / iStock / Getty Images Plus
By Cosby Stone
Whenever I am asked what I do for a living, the phrase "I'm an allergist" is almost immediately followed by "So, where are all of these allergies coming from?"
<p>Maybe I'll get sick of that question some day, but I haven't yet. As a clinician and researcher on allergies and public health, I first explain that when a society begins to become aware of a disease, the <a href="https://jamanetwork.com/journals/jama/fullarticle/1734702" target="_blank">reported prevalence will go up</a>. This is understandable. People who have medically unexplained symptoms wonder "Could I have this allergy that's being talked about?" and try on the diagnosis. Sometimes an allergy really is at the root of their problems, and sometimes it's not.</p><p>For example, <a href="https://www.sciencedirect.com/science/article/pii/S0091674914006721" target="_blank">at least 50% of patient-reported</a> food allergies are only presumed. They have not been evaluated thoroughly enough to know for sure whether the patient is allergic. Research also demonstrates that, in many cases, we presume wrongly. The symptoms fit better with an intolerance than an allergy, or the events were coincidental. While 11 to 12% of patients currently report a food allergy, only about 5% of adults and 8% of children likely <a href="https://www.sciencedirect.com/science/article/pii/S0091674914006721" target="_blank">have true food allergy</a>. Around 8% of patients report a penicillin allergy, but fewer than <a href="https://jamanetwork.com/journals/jama/article-abstract/409362" target="_blank">five out of 100 patients</a> who report a penicillin allergy can be shown to be allergic when tested.</p><p>Many people next ask whether allergies are genetic, but allergies in one's family appear to explain only <a href="https://www.sciencedirect.com/science/article/abs/pii/S0749379702005895" target="_blank">10 to 40% of a person's</a> increased risk for allergies. Allergic diseases are also increasing at rates that are inconsistent with genetic diseases.</p><p>More interesting is that there appear to have been different waves in which <a href="https://www.sciencedirect.com/science/article/pii/S0091674915005849" target="_blank">allergies appeared in historical records</a>. Hay fever (environmental allergies) first appeared in the 1800s, followed by more recent increases in asthma and food allergy.</p>
<h2>What's Changed, and What's Dirt Got to Do With It?</h2><p>So if genetics don't fully explain the rise in allergy, what does? Some of the most consistent risk factors for allergic diseases include <a href="https://www.ncbi.nlm.nih.gov/pubmed/31149702" target="_blank">overuse of antibiotics</a>; <a href="https://www.ncbi.nlm.nih.gov/pubmed/29733679" target="_blank">acute viral respiratory infections</a> in childhood; birth by <a href="https://www.ncbi.nlm.nih.gov/pubmed/30322585" target="_blank">cesarean section</a>; nutritional disorders; second-hand smoke exposure; pollution; and the <a href="https://clintransmed.springeropen.com/articles/10.1186/s40169-018-0195-4" target="_blank">environment where you grew up</a>.<br></p><p>To organize these risks into categories, two conceptual hypotheses currently seem to be of value — the <a href="https://www.sciencedirect.com/science/article/pii/S0091674903023704" target="_blank">barrier hypothesis</a> and the <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1838109/" target="_blank">hygiene hypothesis</a>.</p><p>Imagine that your immune system is an army behind a castle wall. The castle wall is your skin, your respiratory tract and your gastrointestinal tract. The army is composed of your white blood cells in addition to other cells in the body that can activate these gung-ho Marines to defend you.</p><p>The central tenet of the barrier hypothesis is that when our skin, respiratory tract and gastrointestinal tract are chronically injured, your castle wall is broken down. The soldiers of the immune system are activated to aggressive defense, yet allergens can penetrate, and people can begin to experience allergic inflammation in those areas. This has been most clearly demonstrated with the allergic skin disease known as <a href="https://www.sciencedirect.com/science/article/pii/S0091674903023704" target="_blank">eczema</a>.</p><p>Research has also shown that activities in these barrier sites can <a href="https://www.sciencedirect.com/science/article/pii/S0091674916304985" target="_blank">flavor the immune response and profile</a> of a person, especially in childhood. Many risk factors for allergic disease, such as viral infections, nutritional disorders, smoke exposure and pollution, affect the health of our barriers. Studies have indicated that up to <a href="https://www.sciencedirect.com/science/article/pii/S0091674914011609" target="_blank">50% of childhood eczema,</a> a barrier disease, can be prevented simply by applying protective emollients like petroleum jelly to protect babies' skin when we bathe them.</p>
<h2>The Role of Hygiene in Allergy</h2><p>The central tenet of the hygiene hypothesis is that we have gone a bit too far and inadvertently killed off our good bacteria along with the bad. As our society progressed from one that was chronically burdened with infectious diseases caused by poor sanitation, the thinking goes, we reduced our exposures to the things that gave our immune system an appropriate training and tolerance. Historically, our totally rational fear of dying from a cholera epidemic led to <a href="https://www.sciencedirect.com/science/article/pii/S0091674915005849" target="_blank">sewage and water management</a>, but may have kicked off the allergy epidemic.<br></p><p>Our overuse of <a href="http://www.ecowatch.com/tag/antibiotics" rel="noopener noreferrer">antibiotics</a> and C-sections affects the set of organisms called the <a href="https://clintransmed.springeropen.com/articles/10.1186/s40169-018-0195-4" target="_blank">microbiome</a> that an infant is exposed to growing up. Both have been shown to increase the risk of childhood allergic diseases.</p><p>Growing up in a rural area exposed to farm animals appears to confer a <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/j.1398-9995.2010.02397.x" target="_blank">decreased risk of allergies and asthma</a> for your entire lifetime, even among <a href="https://www.nejm.org/doi/full/10.1056/NEJMoa1508749" target="_blank">genetically similar populations</a>. Studies in mice have shown that inhaling certain molecules from soil-dwelling bacteria can set off a beneficial cascade promoting an immune system which focuses more on threats rather than nonthreats, such as <a href="https://science.sciencemag.org/content/349/6252/1106.abstract" target="_blank">allergens</a>.</p><p>Vaccinations appear to be a crucial exception to the rule of the <a href="https://ajph.aphapublications.org/doi/full/10.2105/AJPH.94.6.985" target="_blank">hygiene hypothesis</a>. They confer protection against diseases without any associated increase in the risk of allergic disease, likely because they, unlike antibiotics, are very specifically targeting only the worst disease-causing organisms.</p>
<h2>Our Current Prescription</h2><p>The data currently paints a picture that we might prevent allergies in the future by protecting our barriers and introducing the right <a href="https://www.nejm.org/doi/full/10.1056/nejmoa1414850" target="_blank">tolerizing exposures at the right time</a>, such as early introduction of peanuts. However, I can't currently tell you how much dirt or what kinds of bacteria your child needs to safely experience while growing up. It's too soon for that, but many wonderful scientists around the world are working on these questions, thanks to support from a variety of governments and foundations.</p><p>Until then, I will share with you the broad-brush advice that I currently give my friends and patients.</p><ul><li>Let your kids play outside, get dirty, try new foods and be exposed to a variety of things. Advocate for them to have outside recess time in school as much as possible.</li><li>Use plain soap and water; you don't need to sanitize everything.</li><li>Talk to your doctor about watchful waiting to respond to an illness, rather than take antibiotics.</li><li>Be judicious about what you put on your body's barriers, and become an advocate for clean air, clean water and a clean environment for everyone.</li><li>Get all of your routine vaccinations. The healthiest children in the U.S. are the ones who are fully vaccinated.</li></ul>
<blockquote class="twitter-tweet"><p lang="en" dir="ltr">'The Dirt Cure': Why Human Health Depends on Soil Health <a href="https://t.co/5KewSKwfcy">https://t.co/5KewSKwfcy</a> <a href="https://twitter.com/OrganicConsumer?ref_src=twsrc%5Etfw">@OrganicConsumer</a> <a href="https://twitter.com/regeneration_in?ref_src=twsrc%5Etfw">@regeneration_in</a> <a href="https://twitter.com/kissthegroundCA?ref_src=twsrc%5Etfw">@kissthegroundCA</a> <a href="https://twitter.com/hashtag/SoilHealth?src=hash&ref_src=twsrc%5Etfw">#SoilHealth</a></p>— EcoWatch (@EcoWatch) <a href="https://twitter.com/EcoWatch/status/969258905451757568?ref_src=twsrc%5Etfw">March 1, 2018</a></blockquote> <script async src="https://platform.twitter.com/widgets.js" charset="utf-8"></script>
<p><em>Cosby Stone is an instructor in allergy/immunology at Vanderbilt University Medical Center, Vanderbilt University.<br/></em><em>Disclosure statement: </em><em>Cosby Stone, Jr. MD, MPH currently receives funding from K12HS026395-0 via the Agency for Healthcare Research and Quality and has previously received funding from the National Heart, Lung, and Blood Institute and the National Institute of General Medical Sciences for his research in allergy.</em></p><p>
<em>Reposted with permission from our media associate <a href="https://theconversation.com/whats-the-scoop-on-kids-and-dirt-get-enough-to-help-but-not-enough-to-hurt-a-doctor-advises-121029" target="_blank">The Conversation</a>.</em>
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