We are going in the opposite direction. Currently the US has more lax regulations than the EU. In the EU animals have to be healthy all the way throughout their lives to be sold as food. In the US, you can keep them in miserable conditions and then pump them full of antibiotics before slaughtering.
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.
It's not only the living conditions that is promoting the use of antibiotics in agriculture. The use of antibiotics in agriculture is so high due to the idea of "growth promoters". Animals given long term antibiotics actually grow quicker, and therefore become profitable faster than animals not given background levels of antibiotics. The problem with this activity is that low levels of antibiotics selects for resistance as we have seen.
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.
People like to blame antibiotic resistance on farms, but human populations with high rates of infection and transmission who aren't good at taking the full course of (or any) drugs are a more immediate problem. Increasing rates of drug-resistant tuberculosis and STDs aren't due to farm animals.
Amen. Animal agriculture (innocuously referred to as "agriculture" in the article) has to be the single biggest contributor to the existence of these superbugs.
They don't even need as much antibiotics in today's extreme farms. It's just that you earn more money if you give the animals antibiotics: You don't have to monitor them and then give them antibiotics and they will even grow faster.
That would reduce the profits of companies with large numbers of lobbyists.
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?
Amen. Similar to climate change in the sense that the world's worst offenders need to be on-board to resolve the problem and as a result, all other countries will cop out by blaming and scapegoating those countries
(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
I'm hoping new antibiotics like Teixobactin get to market quickly.
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.
Correct, antibiotic stewardship is basically holding back prescribing rights for last line drugs like linezolid, daptomycin etc, and rightfully so. If you're a drug company producing the newest drug, and you know that for anyone to use it they are going to need an pharmacy or ID consult to get it approved, you can view this as a barrier to adoption.
The problem is this is kind of a catch-22 for drug companies. If they only release a new antibiotic in IV form, meaning it will only be administered at hospitals, they don't get enough volume to make money. So why research the next one?
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.
Officials say the threat to human health is low, but is under ongoing review.
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.
From what I've read, the antibiotics can be phased out, and then later, phased back in.
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.
I don't think the worry is that we will suffer a Black Plague again, but more than almost every instance of surgery or anything that leaves a person immunocompromised will lead directly to infection.
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.
> 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?
There's always phage therapy. It's harder to get FDA approval though. Every application is uniquely modified to target a specific bacteria. This means each treatment would need its own approval under the current rules.
(Take this as coming from someone who pays attention for some time, but is not really knowledgeable about medicine.) People are today a lot healthier than they were 50 years ago. This alone helps a lot. Additionally we have better disinfectants and better procedures and better non antibiotic drugs. So the other parts of our defense in depth are largely intact.
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.
Modern sanitation helps a lot more than antibiotics. We don't throw our shit in the streets, we don't spend time around animals, people wash their hands and take showers, and we understand that sick people are contagious and can avoid them. The black plague spread through fleas on rats.
What is not mentioned in the article is that the bacteria in question is treatable with a range of other antibiotics aside from Colistin ... make of that what you will.
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
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:
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
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.
Your comment sounds alarmist because it is narrow minded, as it implies that the solution is to stop immigration instead of fighting antibiotic-resistant diseases. If we just stop immigration, we are just delaying the arrival of the problem to our first-world countries (and that supposing we could stop illegal immigration, which is far from trivial). In the meanwhile, anti-immigration policies could mean that sick people don't get a treatment and thus diseases such as tuberculosis are left untreated and spread further.
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.
> But I hope lefties realise that it's their suppression of debate that frustrates people and leads them supporting reactionary leaders like Trump.
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.
That study -- which is merely a meta-study of 26 selected other studies -- just summarizes the incidence rates of resistant strains in migrant populations vs. local populations. It seems unsurprising to me that immigrants from countries with poor public health systems tend to be sicker than we are and we should probably intensify our efforts to aid them in that regard.
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]
The BBC article you linked contradicts your argument:
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.
The abstract of paper you shared was interesting, but the reason you are being down voted is probably because of the tabloid level of political spin you have forced on it, and the crank-like way that you have tried to make yourself out as a victim because of intolerance for the "controversial" synthesis you have presented.
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.
> 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.
The post went from 1, 2, then 3 votes, down to 1, zero and then -1. Interesting.
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.
This is so off-topic it's painful, and inflammatory to the point of absurd. Please don't create accounts on HN to conduct political/religious/ideological flamewars.
Yes, clearly it is 100% a corrupt conspiracy. Nothing to do with ideals or compassion or even historical evidence, it is entirely calculated self-interest on behalf of every liberal party member. And it's definitely not just a natural cycle where immigrants tend to support parties that aid immigration, it's clearly a grand "scheme".
[+] [-] mschuster91|10 years ago|reply
[+] [-] TelmoMenezes|10 years ago|reply
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.
[+] [-] giarc|10 years ago|reply
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.
[+] [-] fiatmoney|10 years ago|reply
[+] [-] Betelgeuse90|10 years ago|reply
[+] [-] legulere|10 years ago|reply
In Europe the rules are similar yet the antibiotics use varies drastically: http://i.imgur.com/9ybmhwE.jpg
[+] [-] placeybordeaux|10 years ago|reply
[+] [-] api|10 years ago|reply
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?
[+] [-] em0ney|10 years ago|reply
[+] [-] Angostura|10 years ago|reply
[+] [-] perlpimp|10 years ago|reply
Why is this being sold to farmers in the first place, the antibiotic of last resistance?
[+] [-] invaliddata|10 years ago|reply
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
[+] [-] geertj|10 years ago|reply
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.
[+] [-] giarc|10 years ago|reply
[+] [-] gozur88|10 years ago|reply
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.
[+] [-] themartorana|10 years ago|reply
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.
[+] [-] mod|10 years ago|reply
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.
[+] [-] placeybordeaux|10 years ago|reply
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.
[+] [-] Camillo|10 years ago|reply
Yes, but briefly.
[+] [-] MawNicker|10 years ago|reply
[+] [-] yk|10 years ago|reply
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.
[+] [-] Houshalter|10 years ago|reply
[+] [-] austinjp|10 years ago|reply
[+] [-] Wintamute|10 years ago|reply
[+] [-] _oej6|10 years ago|reply
> "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. "
[+] [-] tahssa|10 years ago|reply
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
[+] [-] cbeach|10 years ago|reply
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.
[+] [-] gjulianm|10 years ago|reply
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.
[+] [-] vacri|10 years ago|reply
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.
[+] [-] cup|10 years ago|reply
An analogy is like complaining about one leaking faucet in a conversation about drought when everyone is watering their garden.
[+] [-] morsch|10 years ago|reply
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
[+] [-] panic|10 years ago|reply
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.
[+] [-] leohutson|10 years ago|reply
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.
[+] [-] stefantalpalaru|10 years ago|reply
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.
[+] [-] cbeach|10 years ago|reply
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.
[+] [-] anon79b8ad22b|10 years ago|reply
[deleted]
[+] [-] dang|10 years ago|reply
We detached this subthread from https://news.ycombinator.com/item?id=10774226 and marked it off-topic.
[+] [-] e40|10 years ago|reply
BS. I know a lot of liberal people and I guarantee not one of them supports immigration on those grounds.
[+] [-] unknown|10 years ago|reply
[deleted]
[+] [-] BookmarkSaver|10 years ago|reply
[+] [-] unknown|10 years ago|reply
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