MRSA is just one small example of what the future holds if we don't manage this carefully, we're actually exerting evolutionary pressure on the one adversary that holds a serious trump card over us, an 8 hour reproductive cycle.
> Antibiotics are now so widespread in use that you can detect them in the ground water and in the oceans.
"Detectability" is a silly metric which tells you nothing about this issue. Molecules are really, really, ridiculously small. Most of the breaths you take contain atoms from Caesar's last gasp, but that doesn't tell you anything useful about the prevalence of Caesar.
The articles linked talk about antibiotic-resistant genes being passed from organisms in hog waste lagoons (and hospitals) to organisms in groundwater. DNA is a molecule, yes, but a molecule with the will to survive.
It's the same kind if silly metric that is sticky, resonant, and evocative. If you want people to care about what you have to say, it's a smart strategy, especially if you back it up with meaningful analysis.
This therapy pre-dates antibiotics but is harder to target to the pathogen. Russia has been using phages for decades.
Other options include natural antibiotics, like manuka honey, which is already being used (as "MediHoney") by hospitals in the U.S. when other antibiotics fail. My main question is: Why is this end-of-line therapy, when it has few to no side effects and it's more difficult for bacteria to develop resistance to it (since it's a multifaceted natural compound, instead of a single-strategy synthetic compound)?
Answer: profit. But it's time for us to evolve. And evolution in this case doesn't necessarily mean more high-tech -- we're low-tech organisms, it's quite possible that the solution is also low-tech.
Actually you're quite mistaken. The reason no one uses phage therapy is because for it to be effective it has to be given in a cocktail, i.e. you're given 20 different phages at a time. The FDA/CDC strongly discourage cocktail usage as it promotes the development of resistance more than antibiotic abuse.
MediHoney is used mainly as a wound dressing to prevent infection, not to treat current infections (maybe infections at the wound site). The answer is not profit as you may believe.
That's not the only reason no-one uses phage therapy - there's also a strong cultural resistance in the west. I've worked on phage targeting various Salmonella serovars, and while you do require cocktails for the most effective treatment, but phage evolve along with the pathogen. There's no inherent limit on the availability of phage like there is with our current suite of antibiotics.
With extensive sequencing-based environmental monitoring, as we're starting to see in many western countries, we can detect the evolution of new bacterial and phage strains in near real-time and isolate the phage to treat the pathogens. We can keep up with pathogen evolution. There's no equivalent system for generating new antibiotics. I reckon this kind of tech is only a few years away - all the pieces are coming into place.
No but it's the main reason. If I had a nickel every time someone told me we can do real-time sequencing I'd be rich. You're greatly overestimating our technical capabilities and underestimating the costs and challenges that would be involved. Theoretically we can identify a new phage a week after resistance is detected, factor in all of the other costs and time involved and it's even worse. The major downside of phage therapy is that there is no readily available phage if resistance develops as there is with antibiotics (the manufacturing process for a new phage is not that short). If you find a methicillin resistant infection you can give a tetracycline or cephalosporins.
Additionally, don't forget that phages are not all lytic and not all are effective (i.e. look at C. difficile) and that phages won't affect intracellular pathogens (i.e. Salmonella, to my knowledges phages don't work but please share as you say you have experience with this).
So while phages can be useful (I never said they weren't) their use is limited and has it's own drawbacks.
(Bacterio)phages target bacteria only by nature, there are several mechanisms that prevent them from targeting human cells. They recognize bacterial membranes and not human, their replication mechanisms don't work in human cells and our cells have defenses against them. In short it would take a great amount of evolution to make them target human cells in the order of thousands of years at least due to the several existing barriers.
Edit: Just in case someone calls me out on this 'thousands of years' is an educated guess on my part from studying evolution not something I've actually read.
How long did bacteria and penicillin coexist? Thousands of years? Then practically overnight the bacteria decided they needed to evolve...
I don't think evolution always works according to the popular "and then the next giraffe's neck was 1mm longer than its parents'" gradual change model.
In different places, not an issue. It's only when penicillin is directly applied to a bacterial colony is there any chance for bacterial evolution to take place.
> Then practically overnight the bacteria decided they needed to evolve
You mean, when humans applied penicillin to bacteria on a large scale for the first time? That changed the bacteria's environment, most died, except those naturally resistant. It's classic natural selection.
> I don't think evolution always works according to the popular "and then the next giraffe's neck was 1mm longer than its parents'" gradual change model.
But one can argue that evolution almost never works, on the ground that the vast majority of mutations aren't adaptive. But the argument misses the point that some tiny fraction of the mutations become the entire future species because of increased reproductive fitness.
Also, the "gradual change" you describe normally arises because of the odd beneficial mutation, which, apart from being very improbable, might require many thousands of years to manifest itself.
Fair enough, but I suspect "thousands of years" of evolution may come very quickly if phages were to be used half as widely as antibiotics are.
Besides that, not all of the cells bacteriophages could harmfully target are human cells. What about the billions of gut bacteria in our digestive tract?
You don't take phages back out of the person, so the source is not under evolutionary pressure to affect humans -- each batch is "seeing" humans for the first time.
The issue isn't just that antibiotics are used routinely for animals. The issue is that high volume (and low cost) animal rearing techniques require extensive antibiotic use to compensate for the awful conditions and diet of the animals. Legislating against antibiotic use in animals would definitely help though.
I grew up in a former East Block country. Back then we had medical centers. If you were sick, you went there and they gave you something.
Most of the time the solution was: Antibiotics.
Because I was sick quite often, I can say I grew up on Antibiotics. When we moved to West Europe my mother made the mistake of chosing a doctor from our country (so she could uderstand what she says).
So I continued to get antibiotics until I got an bronchitis. Two weeks had passed until the doctor decided it was a bronchitis and not "just" one of my usual sick-phases (that she also treated with antibiotics). I spend additional two weeks getting more of the same antibiotic. It got worse.
Finaly she decided that it may be useful to make an radiographic examination. Lucily the doctor there realised that I had pneumonia and changed my medication.
I have not been to a doctor for over 20 years since.
I did not take anything besides some aspirine when I hit my head skiing 8 years ago.
I don't know how this is possible after my very hard childhood but I just don't get sick anymore.
I am very sure that I'll not make the same mistake of letting the doctors solve everything with the hammer when my children get sick.
While I can appreciate your situation, those last two paragraphs read with the same kind of anecdotal logic that lead people to the conclusion that vaccinations do more harm than good.
It wasn't ment that way.
The vaccination conspiracy theorists are the opposite evil here. They are even worse.
I didn't want to say that I would not give my kid antibiotics. This is bullshit. But I will change the doctor if his only solution is antibiotics. I had that situation already with my girlfriend. She is ill pretty often. She works in a kindergarden and parents tent to get rid of their sick kids by sending them there. She had to change her doctor because it just did not work out and sometimes the solution is simply to stay home for a few days and drink some warm tea.
There is no easy solution here. You can't say that you refuse all kinds of medication but you have to find out which doctor is really trying to help you out here and this can be only done through experience.
I for myself am just lucky. I can't say how but it works.
If I ever get really sick and the 3 days on tea won't help, I will go to the doctor I trust and get some medication to cure it.
I'm Norwegian. Norwegian doctors at least used to be extremely careful about anti-biotics. I now live in the UK, and the doctors here often prescribe anti-biotics after telling us we most likely have a viral infection.
I think the main thing is to challenge them to explain why. If they can't give a coherent explanation, ask them to explain to you what they think the risks are of waiting.
Most of the time when doctors here want to prescribe anti-biotics their answer is pretty much "just in case I missed something and it's actually a bacterial infection", and usually they'll then concede that if I'm ok with it, I can wait it out a couple of days and only take antibiotics if things doesn't start to improve with minimal risk. A couple of times the explanation has been that they've often seen specific symptoms exacerbated by a simultaneous bacterial infection, but again their response has been the same: if I don't keep getting worse, I'm fine to wait.
The only time I've ended up taking the antibiotics on offer was when I came in once spitting blood and with massive white lumps at the back of my throat (from whence the blood came, as they were ripped open when I coughed). Yay. Even then the doctor assumed, probably correctly, that it most likely was a viral infection that was making the rounds - she had a steady stream of the same symptoms that week -, but pointed out that given that my throat was so swollen and painful that I could hardly even drink, and the coughing of blood, if she was wrong and it got worse without antibiotics, next stop might be the hospital.
But of course few people care - they don't question the reasons for prescriptions at all.
Part of the high level of prescription of antibiotics in the UK is because of the health system here - they're paid per roughly per patient (adjusted for patient age, morbidity levels in the area they operate in, and a number of other factors meant to adjust for the cost of providing service, but the point is they are not paid per patient visit). If they get me out the door quickly and I don't come back, that's a win for them, so they are incentivised to get me well, but there's no downside to them short term from doing so by prescribing me something there might only be a 5% change that will make a difference to me at all - that's five percent fewer repeat visits at no real risk to them.
Few patients will complain, as the prescription cost is low, and when they get better in a few days, many of them will assume it was the antibiotics and so assume the doctor was right.
It's hard to set rules that prevent these kind of incentives, other than monitoring of whether or not they are in line with guidelines and/or whether or not they prescribe grossly more than the baseline.
Yes! I think so many of the problems in the world are because people have become too specialized. Nobody really understands how to do basic maintenance on their car anymore, what's happening with their data on the Internet, why their politicians make the decisions they do, or what their doctors are prescribing them and why. Capitalism pushes us so much in the direction of specialization (with good reasons), but I think we need to step back often and make sure we still have some good general understanding of the world.
>> The only time I've ended up taking the antibiotics on offer was when I came in once spitting blood and with massive white lumps at the back of my throat (from whence the blood came, as they were ripped open when I coughed).
As a side note, it sounds like you were probably at pretty high risk for a secondary infection through the wounds, as well - possibly another reason they prescribed antibiotics.
Thank you for outlining the basics of how we can ask questions of our doctors without feeling (or sounding) like we are saying "I don't trust you to know what you're doing". As you point out, often the doctors DO have reasons, but sometimes they might do it because if they don't, other patients will complain that the doctor "didn't do anything".
When we're sick or worried, it's easy to forget to ask these questions. I don't even manage to ask them of my car mechanic.
I don't know how this is possible after my very hard childhood but I just don't get sick anymore.
Sounds like whatever your doctors did worked miracles. No serious illness for 20 years? If this experiment could be repeated at scale, and proved to apply to others, everyone should receive the same antibiotics treatment you had!
IHS (Indian Health Service) would give you anti-biotics when it suspected strep throat (or any other sickness) they would prescribe anti-biotics even though their tests would take 3 days[1]. If it wasn't strep, they wouldn't tell you to stop taking the anti-biotics. Glad to see we followed the practices of East Block countries.
1) send to government contracted lab, get sample test, send back result - gotta love government contracts. I'm told someone got an even bigger contract to speed up the testing or allow onsite tests.
If you start an antibiotic course, it's important to finish it. Otherwise you will have exerted some selective pressure on bacteria in your body without making sure you killed them all, leaving only the resistant bacteria to flourish.
If you read Dr. Art Ayers he says antibiotic usage is almost a catastrophe for a person's health. The gut biome never fully recovers and the consequence is all kinds of strange inflammatory diseases, which of course are now epidemic in the West.
Overuse of antibiotics has also been linked to some "slow development" abnormalities in children, it is suspected (or so a report mentioned in New Scientist says...) this is due to disruption the gut biome which in some cases can for a time disrupt how much energy the young'n' can extra from food which as some developmental stages could be quite a inconvenience. IIRC that report suggested that most of the affect kids seemed to catch up eventually, but it is probably something that warrants more detailed investigation.
People aren't the problem; it's the food industry that abuses antibiotics the most. When a pig gets ill, it's way cheaper to give her a dose of antibiotics instead of getting a vet.
Antibiotics are sometimes given to sick animals, but their main use is as growth promoters [1]. Animals that are regularly fed low doses of antibiotics grow faster, meaning that they can be slaughtered earlier and the overall cost of rearing the animal is therefore reduced.
"The effectiveness of synercid, a drug of last resort for the treatment of vancomycin-resistant infections, is threatened because of the use of virginiamycin as a growth promoter in chickens and pigs in the United States. Virginiamycin is chemically related to synercid, and bacteria resistant to the one drug also appear to be resistant to the other." [2]
Many people will point out that the antibiotics given to animals are mostly different from those used on humans. However, as your example points out there are actually only a small number of families of antibiotics each of which share a specific method of attack on bacteria. And bacteria that become resistant to a cheap antibiotic, like virginiamycin, will do so in a way that also renders them resistant to their more expensive cousins that have been reserved for human use.
You just (unintentionally) said that capitalism is the problem.
If people were willing to pay for antibiotic-free meat, then farmers would produce it. They would call the vet, and maybe destroy the pig rather than treat it with antibiotics.
By the way, you're naively presuming they're using antibiotics when the pig gets sick. Nope, they're using them prophylactically.
> You just (unintentionally) said that capitalism is the problem.
That's a strawman fallacy [1].
> If people were willing to pay for antibiotic-free meat, then farmers would produce it.
Seeing as most farming in the United States is done on megafarms owned by large corporations [2] that have historically shown to be (to put it mildly) lax on their focus on serving healthy and nutritious products to their customers [3], and that "farmers" in the traditional colloquial sense are now only 2% of the population [4], you'll hopefully understand if I say that your statement has little relevance in the United States in 2013.
> Norwegians are sanguine about their coughs and colds, toughing it out through low-grade infections.
> "We don't throw antibiotics at every person with a fever. We tell them to hang on, wait and see, and we give them a Tylenol to feel better," says Haug.
I wish more of us would follow this approach and learn to accept being 'sick' for a few days (or even a week) every now and then.
What I noticed in US is that people are very touchy about being uncomfortable. Doctors are supposed to "fix" problems and make things "comfortable". This usually means "give me antibiotics to kill this infections as fast as possible" and "give me more pain pills, I don't want to feel any slight discomfort". If doctor tells them to drink some hot tea and lay in bed instead they might just switch doctors who will give them antibiotics. Or say a doctor decides that well you can get opiates for your pain but you might become dependent so take some aspirin and tough it out -- that won't work with many.
I know I am painting with a broad brush and with a sample of 30 or so acquaintances from both sides of the "pond" here, but it was my impression so far.
Yeah, that's a pretty broad brush. I don't even like to take Aspirin or Ibuprofen unless I have to, and I'm not the only one like that.
Also, I've noticed that some of my fellow Generation Y'ers have arrived at similar opinions by observing the issues that come with the over-medication of their parents/grand parents into old age. Doctors love to prescribe stuff, and sometimes the interactions between drugs is so bad that it can be pretty scary. Observing this as a third party can be enough to make you wary about over-using medication. It's also expensive and our health insurance situation over here is awful.
tl;dr, Yes, that's a huge generalization. I think a lot of younger Americans are starting to bend back the other way towards only medicating when necessary after seeing how much a can of worms it can be when used as a crutch.
Alas it is an affliction that is spreading around the world. More and more people I meet are unwilling to tolerate any 'downtime' for minor illnesses like colds.
"Man up and walk it off" is not uniformly distributed around the country. I give good odds that the rdstc is not from one of those areas.
As usual, accusing huge groups of hypocrisy is not well-founded unless you can establish that the hypocritical attitudes really are held by the same people.
I think this is probably more of a TV/movie thing than much based in reality. We're no tougher than anyone else, but I could see how you may think we see ourselves as such if you just watch our movies/shows.
In addition to rtdsc's comment, I have also observed that people in the US are more touchy about just the fact of 'being sick' and treat minor colds like it was TB or something. My girlfriend from here after I got a cold, "Oh, are you okay? Why do you think you got sick? Stay in bed for a while and take some medicine." No, it's just a cold. Why do I think I got sick? People get them when it turns cold out. Doesn't matter much except you sound like you're talking though a cup of tea.
I'm Norwegian, and worked for a US company years and years ago. Three of us went to Santa Cruz to visit the rest of the team. First morning there the local news was all up in arms about a storm. We looked out: There was a light drizzle.
We walked to the office without umbrellas, in light clothes, and hardly got wet. It was well over 20 degrees celsius, and a pleasant enough 15 minute walk despite the light drizzle.
We got into the office to find people in what looked like full survival mode, with raincoats, and hairdryers to get dry and warm. These were people who had driven right up to the office door.
When they saw us they were horrified and worried we'd get pneumonia and wondered how we could have chosen to walk 15 minutes through the "storm". Of course it did rain slightly more some other places - causing mud slides that closed a couple of roads and cut off the gas supply for a couple of days. But for us it was all terribly amusing.
After we went swimming in "only" something like 22 degrees in the water the following weekend, they got equally shocked (some of them asked if we'd used wet suits). I pointed out the coldest water I've been swimming in was 12 degrees, but I'm not sure they believed me.
Eh, as an American who's visited several major US cities, I've observed a whole lot of variation in behavior during inclement weather, partly because the US is pretty big and hence pretty diverse in climate. The behavior you describe might be more common in southern California, where it doesn't rain all that often. When I was in Seattle (where it rains pretty much all the time), a lot of people didn't seem like they noticed it was raining.
I am not sure your anecdote illustrates anything interesting. Perhaps a very big rain storm had been expected but didn't materialize. Plenty of Americans that I have seen wear shorts when it's really cold out here in Chicago, I am not sure I would consider this a great idea or a badge of honor
I do that, I avoid medicine, I do not remember why I took that policy (it was some years ago), but I did.
I only take medicine (even supplements) if a medic convince me it is absolutely necessary, or if I have a issue that is unbearable (like so much pain that make me want to suicide)
Capitalism and herd management are competing forces.
We Westerners think we're individuals, and each of us are free to make our own decisions. We completely ignore the medical advice, and want the best treatment possible. We want to take the antibiotics. We want a biopsy of that lung nodule. We want an MRI for that persistent migraine. We want to decide whether our child receives "possibly dangerous" vaccines. Statistics be damned.
Unfortunately, with antibiotics on one end of the spectrum (we take too many), and vaccines on the other end (we don't take enough), herd management is the right answer (we should all be pretty much forced to do the medically-suggested thing), and we utterly reject that.
His case is/was extreme: He was prescribing extreme high doses for extended periods of time to a small number of patients because some believe it works against extreme cases of Lyme disease, despite total lack of evidence.
It's rather shocking that he's been allowed to keep practicing as long as he has.
Why is it that some apocalyptic scientific predictions are accepted, while others gain a culture of denial?
Strikes me that one could construct a counter argument against this prediction which is as strong as the arguments, for example, climate change deniers use. Yet, no one has done so.
I'm struggling to imagine why. Is there profit for the current big players in solving this issue, where as climate change solutions are not so good for current energy supplier? Or something like that?
If you speak to farmers or others in the meat industry you will find plenty of strong denial about antibiotics in farming being a risk. You will find all the usual arguments: it's impossible for bacteria in animals to ever affect humans, they use different kinds of antibiotics, we will find newer antibiotics to solve the problem Once And For All etc etc.
For the most part the lack of widespread public denial is because the public are not talking about this issue so there is little need to modify public opinion. There hasn't been any serious attempt to limit the use of antibiotics in industrial farming in the USA yet[1]. If governments do get serious about that then the denier dollars will start flowing and Heartland and Cato will find shills to write articles about how the economic cost of stopping antibiotic use (here is where they claim it is a total ban when it isn't) in farming outweighs the cost of global pandemics because the people that die will mostly be the economically unproductive old and poor or some similar FUD.
> it's impossible for bacteria in animals to ever affect humans
Those farmers should read the book 'spillover'. According to some papers 60% of all pathogens has in recent times jumped from some other species to humanity, and depending on how rigidly you define species you can add the other 40% too.
Their logic is that the meat will be cooked killing all bacteria and denaturing and DNA remnants. What spillover discusses is referred to as zoonosis, and that's when the animal is alive (or carries a vector that is).
Why? Because some things are testable. Antibiotics can be tested in a lab, while climate science cannot. Furthermore the climate is not behaving like early models predicted it would, so it makes it hard for people to accept (especially after sensationalist movies like An Inconvenient Truth). Also the politics involved are complex. Some countries (like my Canada) use way more oil per person and wouldn't be as affected by climate change.
There is quite a bit of pushback at times on this issue as well, especially when agricultural use of antibiotics is mentioned as a potential contributing factor. Suggestions to regulate that usage tend to provoke contrary claims that the risk is overblown and contrary studies showing no significant danger.
How much profit is there in current antibiotics? Only a few of the newer ones are still patented. Aren't the bulk of prescribed antibiotics generics?
I don't think it's because of a difference in the profit to be made by solutions (green energy vs antibiotic alternatives), but rather because of a difference in the profit to be made by the status quo (hydrocarbon-based energy companies stand to make huge profits if they can delay the development of green alternatives until there's a major energy crunch).
Antibiotic resistance is more obviously traceable to antibiotics use. The greenhouse gasses link to global warming exists, but the skeptics have leverage against it: Western countries contribute more to global warming per capita (right?), but China and India are contributing more overall; anything we try to do is going to be very expensive and cause a modest slow-down of warming at best; the Earth has been warmer than it is now; global warming models are incomplete; the Earth is a very complex dynamic system that might buffer global warming in unknown ways before we get to a crisis.
It's more difficult to argue against antibiotic resistance in bacteria being a problem when we can see resistance develop in a lab, and when we've seen the dire consequences of plagues in documented history.
Even the existence of direct and easy to understand causal links doesn't prevent corporate disinformation campaigns if there is money involved. Just look at the history of tobacco propaganda. Cato is still feeding the media articles and quotes denying that there are health risks from second hand smoke.
If you want to find an industry where antibiotics crate large profit then look at industrial farming.
What percentage of antibiotics used in industrial animal farms are still patented, and what's the profit margin and net profit from those antibiotics at biotech companies?
Altogether, the US meat industry uses 29 million pounds of antibiotics every year. To put that number in perspective, consider that we humans in the United States—in all of our prescription fill-ups and hospital stays combined—use just over 7 million pounds per year. Thus the vast bulk of antibiotics consumed in this country, some 80 percent, goes to factory animal farms.
Actually you're quite right. There aren't any significant profits in the development of new antibiotics (right now) but that is changing as more and more resistance is popping up.
Additionally there are new treatments being investigated such as phage therapy (albeit this more of a revival) heavy metals and bacteriocins (protein based).
Terrible, sensationalist title. The actual quote from the article is "If we are not careful, we will soon be in a post-antibiotic era," which paints a very different picture.
Given the fact that the "If we are careful" bit is not going to happen (Without some drastic societal changes around the globe) I think we can pretty much ignore that part of the sentence.
Yep. I'd like to see a detailed analysis of how the future will develop regarding this.
America and most European countries already exercise care with antibiotics. However, South American countries and India etc sell almost all of them OTC where they can be incorporated into folklore style medicine.
Will drug resistant diseases stay within the boarders of the countries that incubate them? Or will the cases that slip across borders be enough to negate any benefit more careful countries cultivate?
FWIW, my original title was: "If we are not careful, we will soon be in a post-antibiotic era" and then my title was changed to the sensationalist title.
Evolution is such an important concept for people in general to understand. Bacteria evolve based on environmental factors (like varying levels of antibiotics), and that's eventually a very bad thing.
Viruses evolve as well, and the nasty viruses that we could eradicate entirely if we had good global vaccination coverage instead -- for a host of often-silly reasons -- get to explode in numbers in various outbreaks.
Even if a measles outbreak kills no one, it is still a huge increase in the amount of virus in the wild, and that means faster evolution.
I hate to imagine a parent who has been against vaccines (due to being duped by the anti-vaxxers) finding that their own local outbreak was the source for the super-measles virus, which isn't reliably stopped by vaccines and spreads like wildfire, or is more deadly than current strains.
Careful though, antibiotics are not directed against viruses but bacteria. These in turn are not being "preempted" by vaccination, to use a threading term for a threat.
Has there been any research to indicate that antibiotics in livestock gets passed to humans (and if so, to what degree)?
I know that there was testimony by Dr. Lance B. Price to the House Committee for greater transparency on "why, how and in what animals these vital drugs are used."
From the abstract (freely translated): "... guessed is that a third to half of resistance encountered in germs within humans is of agricultural origin."
Important is that not the antibiotics are transferred from animals to humans but the already resistant bacteria.
After analyzing the mutations of the MRSA strains in the women and the animals, the researchers concluded that it had been circulating among the livestock before jumping to the people. The researchers' analysis is "so fine-grained," McKenna writes, that it "seems to me to be difficult to challenge."
The Danish study comes on the heels a 2012 paper by a consortium of US and European researchers, which used gene sequencing to show that another common strain of MRSA originated in humans as a common staph infection, jumped to livestock, where it evolved resistance to the common antibiotics tetracycline and methicillin, and then jumped back to humans. Of course, you can also contract antibiotic-resistant pathogens through contact with raw meat—as, for example, more than 100 people did when the agribusiness giant Cargill sent out tens of millions of pounds of ground turkey tainted with antibiotic-resistant salmonella in 2011.
It's more about bacteria getting antibiotic resistence in animals and those get eventually passed to humans.
Antibiotics are pretty much a non-renewable resource, the more they're used, the lesser their effectiveness. Using them on livestock, or even excessively on humans would leave humans with a dangerous lack of medical defence against harmful bacteria.
"It's more about bacteria getting antibiotic resistence in animals and those get eventually passed to humans."
This can happen, but most of the bacteria found in animals are species-specific and don't get "passed" to us in the sense that you could "catch" flu or TB from another human.
The real danger is "horizontal gene transfer" [1], where different kinds of bacteria exchange genes - including those for antibiotic resistance. This is the main mechanism for the spread of resistance to antibiotics.
Direct transmission of diseases (such as flu) from animals to humans certainly can happen: thats why I wrote "this can happen" in my comment. However, its not a significant vector in the spread of antibiotic resistance.
BTW, Chicken Pox affects only humans and some other primates. The virus that causes it, varicella zoster, doesn't infect chickens or other fowl. And, being a virus, it has nothing to do with antibiotic resistance either.
Is the problem really hospitals, or is it industrial animal farming? Because I suspect it is mostly the latter. It is of course more convenient to rant against sick people than to give up the daily junk food burger.
Here is a thought experiment: who can pay more for those 17 kilos of grain? An American who wants his steak dinner or a family of Ugandans? What are the implications of the answer?
Unless there is some kind of apocalypse (rinderpest making it to the USA due to global warming) then the decline in meat production might be (relatively) gradual. The main use of antibiotics in agriculture (AFAIK) is simply to aid fattening animals as they are sick for fewer days of the year and so can put on more weight. Reduce antibiotic use and the market weight of animals will decline and either prices will have to rise or demand will fall as people move to other sources of protein - assuming there are reasonable/viable alternatives.
I'm not sure there will be many political effects - unless of course people are going hungry, however the economic effects might be interesting. If intensive meat production stopped then perhaps there would be more free-range or extensive meat available (certainly at a higher price). Environmentally this might not be a bad thing, for example, the integrated olive/chestnut, goat/pig agriculture we have here in Portugal is pretty good for wildlife. More animals wandering over a wider area would be good for vultures as well (which are in rapid decline globally). Admittedly this is probably a limited scenario but it illustrates that there are desirable alternatives to highly intensive agriculture.
Aside: The economics of meat production seem pretty crazy to me. I can go to my local supermarket and purchase several meals worth of fatty pork for less than the price of a couple of heads of broccoli and and few carrots. Given it takes a lot more resources to produce the pork that suggests that the system we have is seriously out of whack.
Caveat: Off course, we might not be able to carpet the globe in goats to make this all work. It's just not going to be possible (or at least very difficult) to do this with a population well in excess of 10 billion.
Regarding your aside: Cattle are usually not fed broccoli and carrots, and I am fairly certain you can get loads of their food for the price of some fatty pork. Even one of the higher-quality cereals, wheat, is sufficiently cheap that the price you pay for bread is almost entirely in manufacturing the bread and the various ingredients with less mass.
Animals do not represent the only viable food source for humans.
The global implications are less meat in everyone's diet, which is hardly a dire outcome. The majority of humanity is likely capable of subsisting on a completely plant-based diet. (Please note I am not a Vegan or Vegetarian, I'm just pointing out what should be obvious.)
I'm reminded of Asimov's Sci-Fi books where he included the idea of "Yeast vats and algae farms [which] produced basic nutrients, which were then processed with artificial flavors into palatable food."
Currently, we'd be able to live if we can't raise cattle, pigs and sheep at all - there would be implications in culinary habits, food markets, and agricultural equipment changes caused by switching from livestock to food crops; but nothing that should cause a total economic crash or destroy food security.
Since new anti-biotic development is so critical, I don't get why the feds don't in-source it to the CDC or provide massive incentives already. This is an infuriating problem that should've been dealt with decades ago on the R&D-funding front.
As I understand it, the problem is more fundamental than that.
Antibiotics were originally discovered accidentally, and a lot of subsequent antibiotics were discovered/created by investigating and extending the mechanisms of the original discoveries.
We're now running out of those implications to chase down. To get the "next breakthrough" in antibiotics will require another surprise discovery, or some other fundamental breakthrough in basic biological understanding.
Last I heard, the next breakthrough is expected to be the exploitation of quorum sensing. Tricking the bacteria into thinking there are already more than enough of them so they at least stop reproducing.
Another use of interfering with quorum sensing is keeping bacteria docile, even when they've multiplied to levels where they could be threatening to the host.
At one point[1], I heard that there were 3 new anti-biotics in development at various drug companies. It was my understanding that, like the lyme disease vaccine, they would probably not bring them to production given the current regulatory environment. I would imagine if it all goes to heck, then they would probably move forward.
1) its been a number of years so this might not be accurate anymore if it once was
Yay. This is what our current healthcare system is giving us. And it is impossible to talk about alternatives. You morons are going to die of hubris. Basically.
http://sustainability.formas.se/en/Issues/Issue-3-November-2...
http://www.sciencedaily.com/releases/2007/08/070821153926.ht...
MRSA is just one small example of what the future holds if we don't manage this carefully, we're actually exerting evolutionary pressure on the one adversary that holds a serious trump card over us, an 8 hour reproductive cycle.