Bacteria that resist 'last antibiotic' found in UK
bbc.com
bbc.com
The Chinese already recognize the effects on nature, the EU too (and iirc they're already beginning to introduce measures), the biggest problem is and always will be the US because of the huge influence of the farming lobby on US politics (and even if that was not the case, then the grid-lock between D/R where everyone boycotts bills from the other side, just because. Brain-dead US politics.)
"The Chinese resistance cases were down to overuse of antibiotics in agriculture."
That's an interesting way to describe a dictatorship!
At one time in the US there were rivers you could set alight, but that was a long time ago.
Some of these articles are several years old, and from sources I'd classify as more internal than foreign. It is likely that these figures would be conservative.
If this data is approximately correct, I think we could say that 1) China has an outsized effect on the problem of antibiotic resistance (even considering it's large population). 2) The US problem of antibiotic use is mostly an agricultural one (which deserves a lot of attention), and the Chinese overuse of antibiotics is not confined to either human or agricultural use.
I'm sure the chinese leadership is aware of the issue, and given their ability to make changes when something is very important (ie, air pollution during high profile events), the fact that little has been done is telling. It is likely that this simply isn't a high priority issue and thus we are unlikely to see any movement on it anytime soon.
http://china.org.cn/china/2015-07/14/content_36057168.htm http://news.xinhuanet.com/english/2015-07/14/c_134411007.htm http://content.time.com/time/world/article/0,8599,2103733,00...
Did you see the chart from another poster above? Many European countries like Germany, Spain, Portugal, Italy have very high levels of antibiotic usage in agriculture
http://i.imgur.com/9ybmhwE.jpg
I live in Europe, and am well aware of the common belief among many Europeans that we have excellent and high animal welfare standards. But the reality is that animal welfare standards also vary greatly between countries.
That chart above clearly demolishes the view that overuse of antibiotics is a problem principally for non-European countries.
It's not like anyone in Europe or the US is actually suffering from a lack of meat is it?
[He's fine - but we were terrified he might lose the sight in one eye for a while].
Unless you hunt.
And then even if, you'd have a resurgence of people sick and dying from parasites and other stuff you catch from improperly handled meat.
If you can't afford real meat, then you can't afford meat.
Nobody says that people who can't afford a catalytic converter deserve an exemption allowing them to spew more carbon from their cars. This is the same dynamic, but far, far worse.
I think shaming people for buying cheap meat is a terrible strategy that will backfire.
What needs to change are the regulations. When antibiotics are banned from the food supply, the market will discover other ways to regain the efficiencies.
It seems to me that, in every thread, you find a way to dream that more "regulations" will solve all of the social ills of the US and beyond.
The agri-industrial complex is perhaps the clearest example that the powerful among the regulated will find a way to be the regulators. What more needs to happen to clarify this for you?
If the only regulations you can have are ones which benefit big businesses, then no regulations at all might be better. You can't have a political ideology based around the idea that the government is perfectly competent and incorruptible.
Instead another alternative might be to get rid of the FDA entirely so new antibiotics can be developed faster, and we can genetically modify animals to breed them to grow bigger without antibiotics.
Well that only might work, and only in this one specific case. In general regulations can definitely be necessary. But they've proven they can't solve this problem, or at least not until the last minute when it might be too late. And even if we were successful, you can't stop other countries from doing it.
Big-ag is the furthest thing from a free market this side of big pharma. Have you heard of ag-gag laws? Corn subsidies? How about events like this:
http://www.wnem.com/story/26116053/farmers-forced-to-dump-pr...
...which happen all the time all over the country?
Our nation's food supply is controlled by a tiny elite for the most part, and it has completely insulated itself from market effects.
Blaming the every-man for this stuff is a cop out. Corporations are to blame. Real change will only come about through government (semi-likely) or self-regulation within industries (very unlikely).
It's plain to see that eating a factory cheeseburger does indeed cause this ill. It's not some strange economic abstraction, but an easy-to-see, real world example.
I'm very confused by your plan of action... shame the general public until they stop eating meat saturated by antibiotics?
In your plan, how many people will you need to deter in order to make a difference? Will the agricultural industry suddenly stop using antibiotics because a hundered thousand people stop eating at McDonnalds? Two million people?
Will your plan be able to get enough people to stop eating meat so that the agricultural industry notices and stops deforestation or other unethical practices? If they do, will it happen before global warming (caused mostly by the agricultural industry) becomes irreversible?
My comment might read like an excuse to you, but to me your comments read like someone who is very naive to the ways of the world.
> Comparing a realistic solution with an idealized one, and dismissing or even discounting the realistic solution as a result of comparing to a “perfect world” or impossible standard. Ignoring the fact that improvements are often good enough reason.
Indeed, absolving oneself of personal responsibility, especially when direct harm is so apparent, is sad to see. I think it is a form of apathy and not conducive to an actually better world. How can you honestly, "blame the industry" yet the very same day, support it with your money? It's simply hypocrisy.
Now government regulations placed on the agricultural industry are idealistic?
> dismissing or even discounting the realistic solution
I am strongly encouraging the more realistic solution, not dismissing or discounting it. How is expecting an impactful number of people to discontinue antibiotic meat usage more realistic than expecting government to step in?
> absolving oneself of personal responsibility
As I stated above, I personally avoid antibiotic raised meat, but I simply don't think shaming or blaming low income families is the right move here.
I challenge your assertion you avoid antibiotic animal products altogether - an impractical and unverifiable way to discourage the use of antibiotics. If you are serious, consider how purchasing meat, etc. directly leads to "deforestation ... lack of fresh water" without bias. Shaming isn't necessary, just educate yourself and others.
No, it isn't. From wikipedia:
"A straw man is a common form of argument and is an informal fallacy based on giving the impression of refuting an opponent's argument, while actually refuting an argument which was not advanced by that opponent."
> I challenge your assertion you avoid antibiotic animal products altogether - an impractical and unverifiable way to discourage the use of antibiotics
I'm arguing for government regulation -- I agree that regulating yourself is an impractical and unverifiable way to discourage the use of anitbiotics, as is discontinuing the consumption of meat for the same purpose.
> Shaming isn't necessary
Again, the same thing I'm saying -- glad we could agree with each other.
I understand the general argument about taking a bit of personal responsibility, even if it's basically just symbolic. Rather, it's the absolutism that irritates me. In my opinion, eating less at McDonald's and shopping less at Walmart is about as good as never going to those places.
Besides, if you're really a loving, compassionate, open-minded citizen of the planet, wouldn't it be good to spend some time in these places next to the most downtrodden members of our society?
How about this quote from Ghandi instead:
“If we could change ourselves, the tendencies in the world would also change. As a man changes his own nature, so does the attitude of the world change towards him. ... We need not wait to see what others do.”
withdrawn original post:
----------
Your position transposed 50 years back in time:
"I'm actually tired of the "blame the general public" argument. Blame industry for this. I'm not going to take the blame for racism every time I discriminate against a person for being non-white, nor am I going to assume blame when I promote a man over a better qualified woman. Unless billions of people change within the next few years (which is so unrealistic that I feel comfortable saying it won't happen) then my individual do-gooder actions will only bring self-satisfaction, not real change. Blaming the every-man for this stuff is a cop out. Corporations are to blame. Real change will only come about through government (semi-likely) or self-regulation within industries (very unlikely)."
edit: replies below are furious that I equated racism with factory meat. This misses the point completely. They are not the same at all. The point is that industry and government follow popular sentiment and not the other way around. Corporations will sell you what you will buy. Stop buying it and they will offer you an alternative.
If you buy an disproportionately polluting product, you are polluting. You can't avoid that by saying 'everyone else is doing it, I have no choice'. When racism was institutionalized, you had a choice to go along with it or not. You had, and have, personal responsibility independent of everyone else.
As Bill Engval says: Evel Knievel couldn't have made that jump.
How about focus on your own ethics instead of SHAMING people for eating for christ's sake.
Even though this is a "hot button topic", I don't think eating meat that you can afford (IE antibiotic raised meat) can possibly be compared to race or gender inequalities.
Eating a factory cheeseburger is akin to racism? Seriously? This is a logic fallacy.
Racism comes from the individual. It stems from stupidity and hatred and is directed against people who don't have the same nationality or skin color as you. Eating an antibiotic laden slab of beef due to lack of finances cannot possibly be placed on the same level as this.
I'll also point out that the only way to real change in gender and race inequalities have come about is through government or self-regulation in industries... the same thing I'm arguing for when it comes to the agricultural industry.
Go ahead and switch to all natural blah blah blah... you can now sleep at night knowing you're no longer part of the problem. But when you wake up in the morning, the problem is still there. You have accomplished nothing. But hey, when the world burns at least you can say "I told you so".
Do you realize that there are several religions that hold this exact tenet? And that it's one of the central tenets of Rastafari?
Maybe these people all live their lives based on a logical fallacy, but I don't think it's so far wrong. Both racism and factory farming come down to disrespect for 'the other.'
> Racism comes from the individual.
Most people who study racism regard it as an institution, separate but related to bigotry, which is a quality of an individual.
> I'll also point out that the only way to real change in gender and race inequalities have come about is through government or self-regulation in industries... the same thing I'm arguing for when it comes to the agricultural industry.
Go propose a talk at any Black Studies department in the country with this as your thesis and let us know how it goes.
A central tenet of rastafari is to abstain from antibiotic raised meat? Can you cite a source on this?
Even if this is true, why do you think that the religious beliefs of this or other religions holds any sort of sway over people who are not in those religions? For example, you do realize that it is a core religious tenet of the Westboro Baptist Church and many other Christian religions that homosexuals will burn in hell, but this doesn't mean it is true... in fact most educated people would argue that hell doesn't even exist.
> Maybe these people all live their lives based on a logical fallacy, but I don't think it's so far wrong
We'll have to agree to disagree on this point then.
> Go propose a talk at any Black Studies department in the country with this as your thesis and let us know how it goes.
So the progress we've made in the United States through laws and regulations regarding race and gender is a lie then? Those laws exist because of special interest groups, protesters etc. sure -- but you do realize that laws surrounding these issues exist now that didn't exist before, don't you?
This is a very foolish argument and I have no more to say on the matter.
It's a very misleading sort of progress. It helps many people believe that we're post-racial and that sexism doesn't happen.
I think that many people have confused "changing minds and hearts" with "forcing the public to accept and integrate". The laws and regulations I'm referring to are about enforcing rights, often times basic human ones.
I actually agree with this statement, however the problem of cheap meat can't be solved with good societal behavior unless its enforced on a global scale starting with the united states and that's simply not going to happen unless it is enforced by regulations placed on the out of control agricultural industry.
shaming individuals (which is what the original parent thread was all about) isn't a good plan -- it won't work.
We are seeing right now a trend towards better farming practices, with large chains like Chipotle going antibiotic-free. They are doing that, in part, because enough individuals made the choice to look for antibiotic-free food. In other words, individuals drove corporations to act.
Individual actions also add up directly, even without influencing corporations. If you eat even a little less of a harm-causing food, that's an actual impact on the market. Less of the product is being bought, and less will (eventually) be produced. It's a small effect, hard to see, but it is definitely there - it has to be.
And even if you think "oh, it rounds off", then yes, maybe they can produce 1,000 or 2,000 but not 1,001, so most likely reducing 1 won't affect production. But that just means that a single individual going from 1,001 to 1,000 will reduce 1,000, and that averages out - the probabilistic effect of an individual remains the same, and again, it has to be, assuming reasonable rational production.
Finally, there are indirect effects: If you eat less of a harmful product, your coworkers, friends, and family might notice. It might lead them to make a similar positive change. Hard to measure, but we do know this is an important factor.
I do agree we shouldn't "blame the general public" in the sense of blame/shame/etc. But at the same time, we can't give up and say we can't do anything, because our individual actions definitely do have an effect. To some extent, we can make things better.
https://en.wikipedia.org/wiki/Zoonosis "Most human diseases originated in animals"
When used en masse in large, concentrated populations, you're statistically much more likely to bring these superbugs into existence, and have them survive. After all, an infected human is fairly isolated. But Stick an infected chicken in a hen and you've got some trouble on your hands.
From what I've read the evidence isn't all that strong between use of antibiotics in livestock and resistance in humans.
Remember a lot of the antibiotics used in livestocks aren't even approved for use in humans. Or they were used in humans a long time ago, but no longer are.
Politicians are attempting to remove EU regulations against this under the guise of "removal of barriers to trade" with TTIP -- international trade agreements are the tool by which democracies are bypassed in such matters.
http://www.fsis.usda.gov/wps/portal/fsis/topics/food-safety-...
Select "Can hormones and antibiotics be used in cattle raising?".
I don't think In the US, you can keep them in miserable conditions and then pump them full of antibiotics before slaughtering. reasonably captures that.
How do you explain this then? (posted below by legulere)
http://capreform.eu/food-safety-in-the-us-eu-ttip-negotiatio...
Do you think this is a lie or being misrepresented in some fashion?
I see where it says antibiotics in animal feed – significantly restricted in the EU in 1998 and banned for non-medical use in 2006., but that points to them being allowed for medical purposes (on sick animals, rather than as feed additives).
In Europe the rules are similar yet the antibiotics use varies drastically: http://i.imgur.com/9ybmhwE.jpg
In addition, drugs are given "label use" directions for particular species (ie. ovine, swine, equine) but only for major economical species. For example, the farmer might have a bottle of long acting penicillin that says give horse X mg/kg of body weight. However, this farmer might be giving these drugs to sheep and the maker of the antibiotic doesn't have label use instructions for sheep. This results in what's called "extra label drug use" and the farmer has to basically guess at what dose to give. Too high could be harmful to the animal (toxicity, clearance rate etc), too low and you promote resistance.
Edit: and even if we did it in the West, China obviously doesn't care about making the inhabitants of its major cities huff heavy metals and coal dust so why would they care about this?
[0] https://www.mja.com.au/insight/2015/5/stop-antibiotics-exper...
Unfortunately our mechanisms for determining best evidence are woefully slow, complex, and expensive. Systematic reviews, for instance. Either this process needs to be improved (an excellent candidate for AI) or a nearly-as-good surrogate needs to be supported by policy makers.
However....
The systematic review and meta-analyses processes involve reading screeds of text and data; organising it; analysing it; weighing it against measures of quality; and conducting (often counter-intuitive) statistical procedures.
This is the sort of thing that takes humans a loooooong time and is prone to error. A domain-specific AI would surely excel at tasks like this.
Do you have any evidence for that or is it just how you think adaptation transmission works; and do you have evidence that - if the former holds - these examples are representative of the general case?
Why is this being sold to farmers in the first place, the antibiotic of last resistance?
http://www.lancet.com/journals/laninf/article/PIIS1473-3099(...
(see cached version for the full text, standard link has full text behind paywall)
... China is the world's largest poultry and pig producer, and in 2014 produced 17·5 million tonnes and 56·7 million tonnes, respectively.25 Most of the production is for domestic consumption with about 10% for export.26 The global market value of veterinary drugs increased from US$8·7 billion in 1992 to $20·1 billion in 2010, and in 2018 is anticipated to reach $43 billion.27, 28, 29 China is also one of the world's highest users of colistin in agriculture.29 Driven largely by China, the global demand for colistin in agriculture is expected to reach 11 942 tonnes per annum by the end of 2015 (with associated revenues of $229·5 million), rising to 16 500 tonnes by the year 2021, at an average annual growth rate of 4·75%.29 Of the top ten largest producers of colistin for veterinary use, one is Indian, one is Danish, and eight are Chinese. Asia (including China) makes up 73·1% of colistin production with 28·7% for export including to Europe.29 In 2015, the European Union and North America imported 480 tonnes and 700 tonnes, respectively, of colistin from China.29
That said multiple comments have been made here on HN on how there are no incentives for the pharmaceutical industry to bring a new antibiotic to market. It would likely be prescribed as a last effort antibiotic, with a very low volume.
In general I'm a pretty free-market guy, but this is one area I'd like to see the government more involved, both in subsidizing new antibiotic development and in making sure we have a stock of antibiotics that still work.
I feel better?
Is my kid going to live in a post-apocalyptic world where a new Black Plague has wiped out 2/3 of the population because it is completely antibiotic resistant? Or will new solutions (maybe ones that attack at a molecular level) be available first?
I'm not asking rhetorically, any input would be awesome.
Yes, but briefly.
A lot of modern medicine suddenly becomes useless because the health benefits that it brings are nullified by the fact that an infection is sure to follow.
Organ transplants and chemotherapy are two big ones that become near impossible if antibiotics are useless.
Because the competition is so high, the bacteria can't afford the energy/resources to continue resistance to antibiotics that aren't in use--they are out-competed.
Therefore, currently ineffective antibiotics will become effective again in the future.
That said, I did not read if this is being practiced already.
An interesting first step might be to restrict some antibiotics to human use only. At least then we wouldn't be breeding resistance for cheaper meat.
This is being practiced, but not intentionally. Some drugs are just not used anymore because they have become somewhat ineffective against most organisms, so they are shelved due to the fact they are not economically wise to produce, not because we are saving them.
Additionally I read some time ago that the problem is not the difficulty of developing new antibiotics, but the collapse of antibiotics research in the 80ies. So once the field is back up, there should be new antibiotics.
So as far as I understand it, the lack of antibiotics is a big problem, but a big problem on the scale of thousands are gonna die, not millions are gonna die.
I mean, if you're right, it's better than millions, but it sounds relatively preventable. Or at least we could give it the old college try.
> "antibiotic of last resort - colistin"
> "The DNA that gives bacteria resistance to colistin - the mcr-1 gene - can spread rapidly between species.
The concern is that colistin-resistance will now find its way into other superbugs to create infections that doctors cannot treat. "
The fact that the gene is not already widespread suggests that in the absence of the selective pressure of the antibiotic it has other effects that decrease fitness in a typical environment.
But, the problem seems to be that they'll be acting more like a gang (where each gang member is a species of bacteria) by multiplying and transferring their weapons (in this case, antibiotic resistant MCR-1 gene) among different bacteria species by means of horizontal gene transfer[1].
Here, horizontal gene transfer means bacteria don't need to carry the "general pathogenicity" as parts of its genome and transfer to future generations (by sexual/asexual re-production)[2]. They only have to be good (and will be damn good by MCR-1 gene) at whatever pathogen they carry. "Horizontal gene transfer" will take care of the rest.
I think we'll get a better idea of the problem I'm trying to explain if we look at it from "Unix philosophy" perspective which "favors composability as opposed to monolithic design"[3]. I hope that I'm decidedly proven wrong in this regard. But, it's just a hope.
Note:
I don't have any formal education/background in medical sciences.
---
[1] http://www.thelancet.com/journals/laninf/article/PIIS1473-30...
The organisms identified can be killed by cooking your food properly and all the bacteria we identified with this gene were responsive to other antibiotics, called carbapenems
Example: http://www.ncbi.nlm.nih.gov/m/pubmed/25418572/
Immigrant hotspots in London now have tuberculosis rates higher than Iraq and Rwanda. 80% of cases are people born abroad, and some are antibiotic-resistant. This is a disease we thought we'd erradicated:
http://www.bbc.co.uk/news/uk-england-london-34637968
The U.K. has seen unprecedented inflows in the last year (640K immigrants), and since then the rate has risen further - to the point where the government has refused to publish official immigration figures because it would be "unhelpful" to our negotiation with the EU, and upcoming referendum on EU membership
http://www.telegraph.co.uk/news/newstopics/eureferendum/1205...
I know how alarmist this comment sounds, and I fully expect it to be downvoted because it contradicts the politically-correct utopian vision of immigration that we're all expected to hold.
But I hope lefties realise that it's their suppression of debate that frustrates people and leads them supporting reactionary leaders like Trump.
We need to start discussing immigration without the stifling constraints of political correctness.
An analogy is like complaining about one leaking faucet in a conversation about drought when everyone is watering their garden.
[NB I did read the abstract, skimmed the paper with aid of Google Translate and I am, at least by the standards of HN, a raging leftie].
And that is a fair point, imo.
We enforce strict border control to protect ourselves from Ebola, SARS and other infectious diseases we can't treat.
I would assume poster expects to see that actions to help refugees and other less lucky people of the world are thoroughly weighed against health risks. Again, fair point, even if the poster is a Trump supporter.
So have an upvote.
I thought Hacker News might be the kind of forum where an argument backed with facts and sources (including peer reviewed papers) might be enough to break through tribal leftwing suppression of politically incorrect opinions. Evidently not.
> I know how alarmist this comment sounds, and I fully expect it to be downvoted because it contradicts the politically-correct utopian vision of immigration that we're all expected to hold.
(Emphasis mine)
From the HN Guidelines[1]:
> Please don't bait other users by inviting them to downvote you or declare that you'll probably get downvoted.
Immigration cannot be stopped, and that supposing that stopping it is desirable (by the way, as a complete lockdown is probably crazy, which kind of immigration do we restrict? Only from the poor, letting other people from rich countries in? Or should we screen and only let in healthy people?). Any measure taken to "stop" immigration will lead to people being out of the system and thus not able to receive necessary health care and education that could stop infections.
PS: Your last three phrases are what you are getting downvoted for: you take for granted that not being anti-immigration is an hipocrisy, or that it just comes from political-correctness and is not a valid idea-theory-whatever.
Migration in the context of epidemiology has nothing to do with your political status in that country, and has everything to do with your physical presence, and contact with other people in that location.
Sure, shut the UK's boarders to all international travel. Perhaps you'll manage to stop sex tourists from bringing back super-gonorrhoea from the third world.
The rate of infection among UK-born Londoners has risen, while among the non-UK-born it has fallen - and the report said it would be wrong to assume TB was a disease of migrants.
It makes no claim with respects to how relevant any of this is with respect to the overall increase in the occurrence of resistant strains. I'm not a doctor, I don't know how relevant this is, if at all. Clearly, being able to claim that immigrants spread disease fits a certain political agenda.
The U.K. has seen unprecedented inflows in the last year (640K immigrants)
With approximately 310k leaving, in other words, net migration is 330k[0]. But it sure is fun to quote the higher number! Of the ~640k, ~300k are coming to work (2/3 of them with a job offer), and 180k are coming to study. Since EU citizens are free to move around, unsurprisingly most of the immigrants (and, I presume, the emigrants) are from other EU countries.
On the other hand, the UK is doing comparatively little in terms of letting asylum seekers enter the country, despite being one of the richest countries on the planet in the middle of one of a humanitarian crisis: With almost a million people having crossed the Mediterranean as refugees and migrants so far this year, and conflicts in Syria and elsewhere continuing to generate staggering levels of human suffering, 2015 is likely to exceed all previous records for global forced displacement, the UN Refugee Agency warned in a new report today.[1]
[0] The number is "unprecedented" in so far as that it's 10k or 3% higher than the one in 2005, which as we all know left Britain reeling in anarchy and destitution. http://www.theguardian.com/uk-news/2015/aug/27/net-migration...
[1] Staggering levels of human suffering. http://www.unhcr.org/5672c2576.html
This has to be the biggest pile of horseshit I've read on HN recently. It's cool if you're not a left-winger yourself, but don't make shit up and then subsequently complain that people aren't treating you fairly because you provide a link elsewhere in your comment and are therefore 'sourced'.
Similarly, the "this is going to be downvoted" is a very adolescent way of debating. If you're upvoted, you 'win', because you scored well, and if you're downvoted, you 'win', because 'I called it; you're all a bunch of reactionaries'.
If you actually want a proper discussion, don't pre-shame your opponents.
You can't eradicate tuberculosis, but you can prevent the active form rather easily by making sure the population is well fed.
http://www.who.int/mediacentre/factsheets/fs104/en/ :
> About one-third of the world's population has latent TB, which means people have been infected by TB bacteria but are not (yet) ill with the disease and cannot transmit the disease.