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Chicks on Drugs
Organically
grown meat and vegetarianism are sounding better all the time.
By
Janet Reynolds
You've given up red meat, cut your salt intake, vowed
to exercise at least three times a week and, if you're a woman, upped
your calcium intake. You're going to live to be 100. But before you
plan your centennial years, consider this. That poultry you've been
consuming may be as much a health problem as that steak you gave up.
Not in the clogging-your-arteries way -- although if you're going
to eat your chicken fried with the skin on you might as well have
a Philly cheese steak.
No, poultry's potential poison is more insidious and,
ultimately, more threatening in the long term. The problem with poultry
comes from the antibiotics these birds are fed in their meal, drugs
used primarily to make them more productive rather than to cure sickness.
These drugs in turn can help make doctor-prescribed
antibiotics less effective -- and in the most dire cases, completely
ineffective -- against disease in the humans eating the chicken.
Add to this a processing procedure that critics say is a health hazard
in and of itself, and you've got a health crisis in the making.
Before we go further, a couple of caveats. As with
all dietary discussions, moderation and common sense are of the essence.
If you eat a raw egg every day, never wash your chicken before cooking
it and use the same knife to cut up your poultry and your vegetables,
then it's your own damn fault if you eventually get salmonella or
campylobacter, the two most common forms of food-borne illnesses from
poultry.
"It's consumer education as much as the processor,"
says professor and poultry specialist Michael Darre. "If you don't
follow up at home, all that good work beforehand is useless."
The caveat continues with the antibiotic angle. Scientists
and researchers everywhere agree that the major culprit in the increasing
number of antibiotic resistant bacteria -- super bugs if you
will -- are doctors who prescribe an antibiotic at the least
sneeze. These people are closely followed by the patients who come
in and demand a drug for said sneeze, especially if the sneeze, runny
nose and sore throat belong to a child. All you working parents out
there know exactly who you are.
To make an increasingly bad situation worse, too many
people don't finish their prescriptions. They feel better a few days
later and figure they'll save the rest of their prescription to get
a jump on the next illness.
The problem is that although the drug may have killed
off 90 percent of the bacteria, that remaining 10 percent becomes
stronger and more resistant to the drug, rendering it increasingly
ineffective as this pattern continues.
These caveats aside, the health world is becoming
progressively worried about the increase in these antibiotic-resistant
strains and turning to the animal agricultural world to find part
of the solution.
Hogging the Drugs
Currently 70 percent of all antibiotics
produced go into our livestock. Although other food animals such as
cattle and pork are fed antibiotics for reasons other than to cure
an illness, neither group receives as much as poultry. The Union of
Concerned Scientists (UCS), a nonprofit partnership of citizens and
scientists working to preserve health, estimates in its January 2001
report, "Hogging It: Estimates of Antimicrobial Abuse in Livestock,"
that livestock producers in the U.S. use 24.6 million pounds of antimicrobials
for nontherapeutic use every year. Of this, about 3.5 million pounds
is given to cattle, 10.3 million pounds to hogs, and 10.5 million
pounds to poultry. That tonnage would be even higher if therapeutic
use was included.
 And
nonprofits like the UCS aren't the only ones paying attention. Government
agencies have also begun to tackle the problem, creating task forces
and programs to better monitor overall drug use. Concludes the Centers
for Disease Control and Prevention (CDC) after one study of salmonella
infections in humans, "There is an urgent need to emphasize non-antimicrobial
infection control strategies."
Driven primarily by increased use in poultry, overall
use of antimicrobials for nontherapeutic purposes has risen by about
50 percent since 1985, according to the report. In poultry, nontherapeutic
use since the 1980s has increased by over 8 million pounds, a dramatic
307 percent increase on a per-bird basis. (Growth in industry size
accounted for about two-fifths of the overall increase.) In contrast,
humans receive 3 million pounds annually.
"For sheer overprescription, no doctor can touch the
American farmer," notes a Newsweek article called "The End
of Antibiotics." "Farm animals receive 30 times more antibiotics (mostly
penicillins and tetracyclines) than people do. The drugs treat and
prevent infections. But the main reasons farmers like them is that
they also make cows, hogs and chickens grow faster from each pound
of feed. Resistant strains emerge just as they do in humans taking
antibiotics -- and remain in the animal's flesh even after it
winds up in the meat case."
The Human Equation
"We fully realize the human side is a good
part of the picture," says Dr. Deborah Huang, a science policy fellow
at the Center for Science in the Public Interest (CSPI), a nonprofit
education and advocacy organization that focuses on improving the
safety and nutritional quality of our food supply. "We feel there's
enough science out there to support the conclusion that antibiotic
use in animals can contribute to resistance in humans."
That poultry has the potential to have a huge impact
on our health is not surprising given its increasing popularity in
recent years. In 1960, eggs accounted for 61 percent of gross chicken
income in the U.S., with broilers at 34 percent, according to Karen
Davis of United Poultry Concerns, a nonprofit educational group focusing
on poultry. By 1975, broilers supplied 50 percent of the gross chicken
income with eggs coming in at 49 percent.
Negative news about cholesterol and increasingly frenetic
lifestyles helped bring an end to the big breakfast in America and
with it, a drop in egg consumption. Between 1960 and 1990, egg consumption
dropped from about 321 to 235 eggs per person annually.
At the same time, chicken and turkey began to be regarded
as an inexpensive and convenient low-fat protein source. In 1993 U.S.
hog producers killed in one week 1.7 million pigs, an average of 10,000
pigs an hour, that standing in single file, would stretch 1,200 miles
from New York City to Kansas City.
But in that same week U.S. broiler producers killed
135 million chickens, an average of 800,000 chickens an hour, enough
to stretch in single file 25,000 miles or completely around the middle
of the earth.
That demand has driven the market to new lengths to
fill consumer need. Although chicken farms existed for centuries,
the industry itself is still relatively young. Before the 1920s, most
chicken farms were second-income operations on the family farm. The
focus was on the eggs, with the meat just a by-product once a hen's
laying days were over. The first year-round broiler production operation
began in 1926 when Cecile Long Steele and her husband built a year-round
farm capable of producing 10,000 chickens. Today, that would be considered
small.
It would also be considered economically inadequate.
In the early days of the industry, the birds were slaughtered at 14
weeks of age, at which point they weighed about two pounds. Today's
broilers are slaughtered at 7 weeks and weigh between four and six
pounds.
A large part of that change can be traced to the increased
use of drugs, which in addition to treating sick birds are used nontherapeutically
to prevent disease and help promote growth. According to the UCS,
tetracycline, penicillin, erythromycin and other antimicrobials important
to human use are among those used extensively in livestock.
Of course, no one begrudges farmers keeping their
poultry healthy. It is the preventative and growth-promotion drug
use that has everyone from the World Health Organization and the CDC
to the UCS and the CSPI demanding government usage guidelines and
restrictions.
Food-borne Illnesses
A look at some recent reports and trends
illustrates why health professionals and others are increasingly concerned.
Each year an estimated 1.4 million human salmonella infections occur
in the U.S., causing an estimated 80,000 to 160,000 people to seek
medical attention, resulting in 16,000 hospitalizations and nearly
600 deaths. According to the CDC, in 1999, salmonella and campylobacter
comprised the lion's share -- almost 82 percent -- of the
total food-borne illness cases.
Both of these diseases are increasingly associated
with poultry. Studies show that campylobacter grows best at the body
temperature of a bird, which can carry it without becoming ill. More
than half the raw chicken in the U.S. has campylobacter in it, according
to www.factoryfarming.com, a website devoted to the agriculture industry.
The CDC notes that most human salmonella infections
come from the ingestion of contaminated food, especially those of
animal origin. An estimated 20 percent of retail poultry is contaminated
with salmonella.
As anyone who has suffered from food poisoning knows,
these diseases are not pleasant. People with campylobacteriosis typically
have diarrhea, cramping, abdominal pain and a fever within two to
five days of exposure. The diarrhea may be bloody and accompanied
by nausea and vomiting, with the symptoms typically lasting one week.
Salmonella is a bacterial infection of the intestinal tract causing
nausea, vomiting, abdominal cramps, diarrhea, fever, chills, weakness
and exhaustion.
To be fair, the incident rates themselves can make
the hype seem a tad shallow, especially when you consider the sheer
number of meals eaten daily by the U.S. population. But what can be
merely unpleasant in a relatively healthy person can become potentially
life-threatening in the young, whose immune systems are typically
less developed, and in the elderly or immuno-suppressed. It is these
people who typically seek medical attention for these diseases --
and who are more likely to die if the antibiotics to cure them don't
work. Critics also worry that these trends could be the beginning
of what might ultimately, when tied in with overuse in human medicine,
be a return to a pre-antibiotic world.
In 1990 and 1995 the CDC found that 40 percent of
people with salmonella infections who sought medical attention were
treated with antimicrobial agents. Ciprofloxacin, a fluoroquinolone,
was the most commonly prescribed antibiotic. Enrofloxacin, ciprofloxacin's
counterpart for animals, has been given to U.S. poultry since 1995.
In humans, fluoroquinolones are considered one of
the most valuable antimicrobial drug classes because they are effective
against a wide range of bacterial infections, in particular food-borne
infections often resistant to other microbials. People understandably
became worried when reports from scientific and public-health communities
began noting more occurrences of fluoroquinolone-resistant campylobacter
infections, especially since no resistant strains had been recorded
prior to the use of this class of antibiotic in poultry.
As a result of this new disturbing development, last
year the FDA's Center for Veterinary Medicine proposed to withdraw
approval of enrofloxacin in poultry. After Bayer, the company that
manufacturers it, complained, however, the FDA held off. The proposal
is still under review. Meanwhile, sarafloxacin, another fluoroquinolone
used in poultry since 1995, has been taken off the market.
But these are not the only problem drugs. In April,
the FDA's Center for Veterinary Medicine decided to conduct a quantitative
risk assessment on the human health impact of the development of the
streptogramin-resistant enterococcus in humans and its association
with the use of virginiamycin in food-producing animals. Enterococci
are bacteria in a normal intestinal tract that can cause infection
if they get out of their normal environment.
Virginiamycin has been used on livestock since 1974.
The use of Synercid, which is closely related, in humans was only
approved in 1999 but may already be running into trouble. Scientists
say the effectiveness of Synercid, an injectable drug of last resort
for the treatment of serious or life-threatening vancomycin-resistant
infections, is at risk because of the use of virginiamycin as a growth
promoter in chickens and pigs in the U.S. Virginiamycin is found in
as much as 50 percent of supermarket chicken, turkey and pork.
In Europe virginiamycin, as well as three other growth-promoting
antibiotics, has already been banned, following recommendations from
the World Health Organization.
Another area of concern is vancomycin-resistant enterococci
(VRE) infection. In Europe, VRE has been isolated from raw poultry
products associated with the use of avoparcin as a feed additive.
Avoparcin is not used in the U.S. nor has VRE been isolated from poultry
at this time. However, University of Maryland Prof. Glenn Morris recently
reported the isolation of VRE in commercial chicken feed, underscoring
the increasing wide environmental distribution of this organism.
The discovery is particularly disturbing given that
vancomycin is the antibiotic of last resort, the only remaining drug
effective against the most deadly of all hospital-acquired infections:
methicillin-resistant staphylococcus aureus, according to an article
in this month's Scientific American. Also, once a patient is colonized
with VRE -- and survives -- he is colonized for life. To
date, VRE has been identified in 33 states.
Disputing the Numbers
Those in the industry dismiss these trends
as so much hype. The Animal Health Institute, for instance, disputes
the figures put out by the Union of Concerned Scientists. The institute,
which is a U.S. trade association representing manufacturers of animal
health care products, pharmaceuticals, vaccines and feed additives,
estimates nontherapeutic use of antibiotics at 17.8 million pounds
total for all animals.
Besides, the preventative measures are well worth
it, says Richard Lobb, public relations director of the National Chicken
Council, a trade association to which over 90 percent of chicken producers
belong. "The birds coming into the processing plant today are the
healthiest they've ever been," he says.
"We believe our use is responsible and limited," Lobb
continues. "All this is approved by the FDA. Any trace of the drug
is gone by the time the bird is processed. We feel our industry, pork
and others are being blamed for antibiotic resistance problems (created
by human misuse). The route of transmission of antibiotic-resistant
pathogens is a rather long and tenuous one."
Others who are in the barnyards agree. "Our perception
of the risk is way off from the reality," UConn's Darre says. "Risk
assessment vs. risk perception have to get in line somehow.
"If it was half as bad as the critics said, we'd all
be dead years ago," he continues. Darre notes, for instance, that
the government has strict guidelines about antibiotic withdrawal.
Farmers must wean poultry and other animals from the antibiotics,
whether therapeutic or nontherapeutic, a certain time before they
can be slaughtered. "The sky is falling to a certain extent but not
to the extent they say it is. There are no proven facts that eating
antibiotics makes humans resistant. The number-one problem is overuse
and misuse by humans."
Calling for Change
In the meantime, critics are calling for
change -- or at least more review. In "Hogging It," the UCS suggests
that the FDA establish a system so that companies that sell antimicrobials
for food animals or that mix them in animal feed or water must provide
annual reports on the quantities sold. This information should be
broken out by species and antimicrobial, the scientists say, and the
USDA should improve completeness and accuracy of its periodic surveys
of antimicrobial use in livestock production.
Others would like the federal government to speed
up implementation of the Public Health Action Plan to Combat Antimicrobial
Resistance. Under this plan the government would create a monitoring
system, improve surveillance and coordinate national surveillance.
Meanwhile, there is another tactic already in effect
that might help. Called competitive exclusion, this procedure takes
the microflora from healthy adult chickens and gives it to baby chicks.
"It gives them all the microorganisms they need and excludes the bad
ones," says professor Darre, noting that the procedure helps give
chicks healthier starts without the drugs. "It will help alleviate
the fear."
Janet Reynolds writes for the Hartford Advocate
in Connecticut, and AlterNet.
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