from “Compassion in World Farming”
“In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated’ and that ‘The responsibility for turning this situation around is entirely in our hands.”
WHO Director-General, Dr Margaret Chan
(World Health Day, 7th April 2011)
Antibotics in Farm Animal Production (Public Health & Animal Welfare)- revised November 2011
ACKNOWLEDGEMENTS Dr Jacky Turner for invaluable research, advice and editing on this report.
CONTENTS 1.0 EXECUTIVE SUMMARY: WHY NON-THERAPEUTIC USE OF ANTIBIOTICS IN FARM ANIMALS SHOULD END 4 1.1 Antibiotic resistance and human medicine 6 1.2 Antibiotic resistance and intensive animal farming
(Partial Transcript of 35 Pages including Executive Summary) http://www.fao.org/fileadmin/user_upload/animalwelfare/antibiotics_in_animal_farming.pdf
“Why non-therapeutic use of antibiotics in farm animals should end.
“1.0 EXECUTIVE SUMMARY Why non-therapeutic use of antibiotics in farm animals should end. The antibiotic resistance that is developing globally in disease-causing bacteria is one of the major threats to human medicine. It leads to additional burdens on health systems, to treatment failures and, in the worst cases, to untreatable infections or infections treated too late to save life. Although the over-use of antibiotics in human medicine is the major cause of the current crisis of antibiotic resistance, public-health experts are agreed that the over-use and mis-use of antibiotics in intensive animal production is also an important factor – around half of the world’s antibiotic production is used in farm animals.
Infectious disease is encouraged by the crowded and stressful conditions in which animals live in factory farms. It is common in the UK and the European Union for animals such as pigs and poultry to be fed antibiotics in their feed and water, not to cure disease (therapeutic use) but to suppress infections that are likely to arise in factory farm conditions (non-therapeutic or preventive use). When animals are administered an antibiotic that is closely related to an antibiotic used in human medicine, cross-resistance occurs and disease-causing bacteria become resistant to the drug used in human medicine. The consensus of the world’s veterinary and medical experts is that it is dangerous and unjustifiable to use antibiotics that are related to drugs of critical importance in human medicine for ‘preventive’ administration to groups of apparently healthy animals.
The impact on public health The world’s public-health experts, from the European Union, the United States and the World Health Organization, are agreed that drug-resistant bacteria are created in farm animals by antibiotic use and that these resistant bacteria are transmitted to people in food and then spread by person-to-person transmission. In addition, genes for antibiotic resistance are known to be transferable to other bacteria of the same or a different strain or species. Antibiotic resistance leads to foodborne infections in humans that would not otherwise occur, that are more severe, last longer, are more likely to lead to infections of the bloodstream and to hospitalization, and more likely to lead to death. Severe infections by food borne bacteria include life-threatening urinary infections and blood poisoning.
Children are particularly likely to be infected by drug-resistant foodborne bacteria that have developed in farm animals as a result of over-use of antibiotics. The use in farm animals of antibiotics that are critically important in human medicine is implicated in the emergence of new forms of multi-resistant bacteria that infect people.
These include new strains of multi-resistant foodborne bacteria such as Salmonella, Campylobacter and E. coli that produce the ESBL and/or AmpC enzymes that inactivate nearly all beta-lactam antibiotics (which include penicillins and the critically important 3rd and 4th generation cephalosporins). The over-use of antibiotics in intensive pig farming is implicated in the emergence of a new ‘pig’ strain of the superbug methicillin-resistant Staphylococcus aureus (MRSA), first identified in 2004-2005 in the Netherlands. This has spread rapidly among pigs in many European countries, to people who are in contact with the animals, and from these people to the community and to hospitals.
The livestock-associated MRSA strain has also colonised chickens, dairy cattle and veal calves and the people who handle them and may also be emerging as a food safety risk. Revised November 2011 The current use of antibiotics in EU livestock production There is as yet no effective centralised data collection of the antibiotic use in every European country and it is not possible for the EU’s public health and veterinary authorities to know exactly what doses of each antibiotic are given to farmed animals, for how long and for what reason. Usage has even increased over the last decade in some of the most intensive sectors such as pig and broiler (meat) chicken production. Antibiotics may be administered for a substantial proportion of an animal’s lifetime.
Of particular concern, farmers may be increasingly using modern and more potent drugs such as the 3rd and 4th generation cephalosporins and the fluoroquinolones whose use should be strictly limited because they are of critical importance for human medicine. Preventing disease without prophylactic use of antibiotics Disease can almost always be prevented by using good husbandry rather than prophylactic use of antibiotics. Positive measures that can reduce disease in farmed animals include: switching to extensive production systems (including high-quality free range and organic systems); reducing stress; avoiding mixing; good weaning practice; keeping stocking densities low and avoiding excessive herd or flock sizes; reducing journey times during live transport of animals; breeding for natural robustness and disease-resistance.
Ending factory farming. Reform of intensive farming is essential, as the most certain and permanent way to reduce and eliminate nontherapeutic uses of antibiotics in European food production. The objective should be to replace the crowded and stressful conditions of factory farms by extensive and free-range systems that respect the animals’ welfare and provide conditions in which their health can be maintained without the frequent use of drugs. Recommendations The European Commission and the Member States should develop a more effective strategy to reduce antibiotic use in agriculture in order to ensure that antibiotics remain effective in the fields of both human and animal health. This should include a transparent review into the state of antibiotic use in agriculture and its relationship with patterns of anti-microbial resistance. The European Commission should propose new regulations to: o Phase out prophylactic use of antibiotics in farm animals other than in very limited, clearly defined situations; o Ban all prophylactic and off-label use of 3rd and 4th generation cephalosporin antibiotics in farm animals with immediate effect; o Ban all prophylactic and off-label use in farm animals of new antibiotics licensed in the EU. Revised November 2011 ‘Antimicrobials are used in farm animals for growth promotion, prophylaxis, metaphylaxis and therapy. Their use is the principle contributing factor to the emergence and dissemination of antimicrobial resistance among bacterial pathogens and commensals that have food animal reservoirs.’
1 The Codex Alimentarius Commission’s Committee on Food Hygiene, 2001. i ‘The widespread use of antimicrobials not only for therapeutic purposes but also for prophylactic and growth promotion purposes in livestock production has intensified the risk for the emergence and spread of resistant microorganisms. This raises particular concern since the same classes of antimicrobials are used both in humans and animals. The emergence and spread of antimicrobial resistance in bacteria poses a threat to human health and presents a major financial burden.
Moreover, few new antibiotics are being developed to replace those becoming ineffective through resistance.’ World Health Organization, 2007.ii
‘Drug resistance is becoming more severe and many infections are no longer easily cured, leading to prolonged and expensive treatment and greater risk of death … WHO calls for urgent and concerted action by governments, health professionals, industry and civil society and patients to slow down the spread of drug resistance, limit its impact today and preserve medical advances for future generations.
’World Health Organization, on World Health Day, under the theme ‘Combat drug resistance’, 7 April, 2011.iii ‘[T]he use of antibiotics in food animal production contributes to increased drug resistance. Approximately half of current antibiotic production is used in agriculture, to promote growth and prevent disease as well as to treat sick animals. With such massive use, those drug resistant microbes generated in animals can be later transferred to humans.’
World Health Organization, on World Health Day, under the theme ‘Combat drug resistance’, 7 April, 2011.iii ‘In Europe as in the world as a whole, antimicrobial resistance is now a real threat to public health, resulting in longer, more complicated courses of treatment, a greater risk of death and extra costs for healthcare systems’. Eurobarometer report, Antimicrobial Resistance, April 2010.iv 1.1 Antibiotic resistance and human medicine
On World Health Day, 7th April 2011, the WHO Director-General, Dr Margaret Chan, warned that ‘In the absence of urgent corrective and protective actions, the world is heading towards a post-antibiotic era, in which many common infections will no longer have a cure and, once again, kill unabated’ and that ‘The responsibility for turning this situation around is entirely in our hands.’
v Antibiotics2 are a precious resource in both human and veterinary medicine. They have saved countless lives since the mid-20th century. All medical experts agree they should be used cautiously, in order to minimise the development of 1 ‘Commensals’ are bacteria in animals and people that are harmless within their normal host. ‘Metaphylaxis’ refers to treatment of a whole flock or herd of animals when only some of them are suffering from disease. 2 The term ‘antibiotic’ refers originally to a naturally occurring substance (eg derived from fungi or bacteria) that kills or inhibits the growth of bacteria or other microorganisms. Many antibiotics are now semi-synthetic (ie modifications of Revised November 2011 resistance and prolong the useful life of each drug.
Yet, in spite of this understanding, we continue to allow them to be used as a tool in the mass, intensive production of farm animals in ways that jeopardise their effectiveness for treating people.
One of the most important threats to modern medicine is the development of bacteria that are resistant to antibiotics, making bacterial infections more difficult or even impossible to treat. While it is recognised that the human use of antibiotics is the largest contributor to antibiotic resistance, the over-use in intensively-produced farm animals is now believed to have played a major role in this global problem.
iii The use of antibiotics to prevent or treat common production diseases in intensive farming has led to the emergence of antibiotic-resistant bacteria such as Salmonella, Campylobacter and Escherichia coli (E. coli) that colonise farm animals and can be transmitted to people in food or through the environment. When these bacteria cause illnesses in people they are more difficult to treat and the resistant bacteria spread further by being transmitted between people. In addition, the genes for resistance can be passed from resistant bacteria to other bacteria that are also potentially disease-causing in people. The over-use of antibiotics in farm animals has made some food less safe to eat and made resistant bacterial infections more common.
Antibiotic resistance has increased rapidly in food-poisoning bacteria, such as Salmonella and Campylobacter, with the drugs used in farming being the same as, or very similar to, those used as front-line treatments in human medicine.
This has contributed to the rise of serious new types of antibiotic resistance that affect humans. Genes for a type of resistance known as extended spectrum beta-lactamase (ESBL) and AmpC betalactamase (Section 3.4.2) have spread internationally over the last decade in strains of E. coli and Salmonella that can cause severe infections including septicaemia (blood poisoning). A new strain of the so-called ‘superbug’ MRSA has emerged on intensive farms in continental Europe (Section 3.5.2) and has spread from pigs to pig farmers and the community in the Netherlands, and also to other EU countries and to North America. In Dutch hospitals by 2007, about 30% of all MRSA cases were caused by the farm animal strainvi and it has been found on 16.0% of Dutch chickenmeat and 10.7% of pork.vii 1.2 Antibiotic resistance and intensive animal farming The fundamental cause of food animal-related antibiotic resistance is factory farming. In intensive pig and poultry production, animals are kept confined in overcrowded conditions, usually with no outdoor access, and they are bred and managed for maximum yield (to grow faster or to produce more meat, milk, eggs, or offspring). These conditions compromise their health and their immune responses and encourage infectious disease to develop and spread easily.viii,ix Without the aid of drugs for disease prevention, it would not be possible to keep the animals productive in the intensive conditions in which they are often kept and managed. Antibiotics should not be used as preventive action to avoid disease that is encouraged by factory-farming methods. The policy-makers of 60 years ago made a serious mistake when they permitted antibiotics to be used for nontherapeutic reasons in animal production, often in spite of scientific misgivings. Sixty years later, while the evidence continues to be disputed by some sections of the industry, the actual and potential damage to public health is acknowledged by scientists and policy-makers in Europe, the US and in most regions of the world. European publichealth authorities such as the European Medicines Agency and the European Food Safety Authority are aware that it is essential to curb antibiotic use in farming and that the time has come to take effective action. This report sets out the evidence that the current level of antibiotic use on Europe’s farms is bad for public health, bad for animal health and welfare and bad for the reputation of Europe’s farmers and their produce. An essential the original naturally-occurring substance) and some are fully synthetic. The term ‘antimicrobial’ refers to all substances that kill or inhibit the growth of microorganisms. Revised November 2011 step to end permanently the over-use of antibiotics is the reform of intensive animal farming, encouraging farmers to move to well-managed extensive and free-range production systems. These systems would enable Europe’s farmers to maintain their animals’ health with the minimum of drug use and would improve the lives of billions of farmed animals.”
(The rest of the Report is found in the above Link)