Bioterrorism is back in the news. The FBI just closed its investigation of the anthrax attack in 2001 that killed 15 people and sickened 17 others. More recently, we have concerns that the laboratory-created highly infectious and lethal H5N1virus might fall into the hands of terrorists. It is, thus, highly propitious the new director of the FDA, Margaret Hamburg, the former Health Commissioner of the State of New York is an expert on bioterrorism. In his remarks at the appointment ceremony President Obama noted that the FDA, as it is presently operating has failed to protect the quality of the American food supply from microbial contamination and is, therefore, a “hazard to the public health.” What the President did not say, or perhaps even know, is that there are bioterrorists operating inside the food system in the United States that pose a much greater threat than an occasional outbreak of food poisoning.
Bioterrorists work in laboratories where they turn dangerous organisms like plague, small pox, botulism, and anthrax, or actually produce lethal microbes like the new pneumonic version of H5N1, that can be easily introduced into the general population to produce wide-scale devastating effects. Centralized Animal Feeding Operations (CAFOs) meet this criterion perfectly.
CAFOs are often indicted for the air and water pollution they cause, and the unspeakable cruelty they inflict on the animals confined within their flesh factories. I would like to add one more stipulation to this general indictment. I propose the CAFO operators should be considered to be bioterrorists: they are changing what are normally fairly harmless bacteria into very dangerous bacteria and releasing them into the environment. CAFOs are using antibiotics on a massive scale and are thereby creating strains of bacteria that highly resistant to antibiotics and more deadly as a result.
At least 80 percent of the antibiotics used in America are fed to animals living on factory farms. Raising vast numbers of pigs or chickens or cattle in close confinement with their wastes simply would not be possible without the routine feeding of antibiotics to keep the animals from dying of infectious diseases. While there is the side benefit that the antibiotics promote weight gain, the crucial fact is that without the promiscuous use of these drugs at subtherapeutic doses, meat production at the industrial scale could not be sustained for very long. Under more sanitary and less crowded conditions these antibiotics would simply not be necessary, but under such conditions meat production would be less profitable.
CAFOs rely on scale economies to keep costs low. As a result large numbers of animals are crowded into CAFO facilities which are thus difficult, that is to say costly, to keep clean. Because it’s cheaper to keep the animals drugged than to keep them clean, antibiotics are administered to prevent disease from spreading in this highly congenial environment.
The CAFO bioterrorists are engaged in a dangerous process, solely for the purpose of a little more profit, which threatens to destroy one of the greatest developments in public health since sewers; and it is not a sin of omission. The industrial meat producers in the United States are part of an ongoing de facto conspiracy to destroy the efficacy of antibiotics by breeding bacteria that are resistant to them and then releasing these bacteria into the environment where they can infect the now defenseless people.
The death toll resulting from the decreased efficacy of antibiotics against resistant bacteria is already staggering. For example, the CDC reports that Methicillin-resistant Staphylococcus aureus alone led to nearly 95,000 invasive infections in 2005 resulting in 18,650 deaths. MRSA infections in the United States now kill more people than AIDS.
Health care costs are also impacted. Patients infected with MRSA cost about $65,000 more to treat than the typical hospital admission.
MRSA has been found on pigs and farm workers in Canada from which we import over 700 million pounds of pork. Scientists in the United States have found MRSA on pigs as well as farm workers. Yet, neither the USDA, which regulates imported meat, nor the FDA, which regulates domestic meat, has done a single test for MRSA in the United States. This fact makes a statement by the National Pork Producers Council to the effect that the “USDA and the CDC have given our pigs a clean bill of health” seem just a bit perplexing. Just how the USDA did so without testing any animals remains a mystery. As for the CDC, a spokesperson said the CDC “could find no indication we made that statement.” Why no testing? A pork industry lobbyist declared that the industry was opposed to testing as it was “unnecessary.”
MRSA are what one scientist called “evolutionary overachievers,” who, since they “reproduce every 20 minutes,” create ample opportunity for mutations that select for antibiotic resistance. More ominously, the new strains are not only resistant they are more virulent. Unlike the MRSA seen in hospitals, many of the strains being reported elsewhere can release a toxin, Panton-Valentine leukocidin, or P.V.L., that kills the white blood cells in the immune system making them a double threat. A child that is healthy and playing with toys in the morning gets this infection and is dead that night. Research indicates that in the last five to six years, the proportion of MRSA infections with the P.V.L. gene has increased, to 90 percent from 5 percent.
MRSA is spreading in the community, with mini-epidemics among athletes and gay men. No one is yet sure how or where these new community-acquired strain of MRSA evolved, but it is sufficiently different from the hospital-bred strains to have some researchers looking elsewhere for its origin. As 19,000 people, of the nearly 100,000 infected, died in the United States from MRSA infections in 2005, this is a matter of no little importance
It is easy to see why hospitals and nursing homes, where antibiotics are used intensively, would be a locus for the selection of MRSA. But, the community acquired MRSA are genetically different leading researchers to look for another locus of natural selection. Where else are antibiotics used promiscuously enough to select out of the population of Staphylococcus A some strains that are drug resistant and incredibly more virulent? The evidence is mounting that the origin of community-acquired MRSA is the concentrated animal feeding operations, or CAFOs. Public-health experts have been warning us for years that the “CAFOs are a public-health disaster waiting to happen”
Recent studies in Europe and Canada found that confinement pig operations have become reservoirs of MRSA. A European study found that 60 percent of pig farms that routinely used antibiotics had MRSA-positive pigs (compared with 5 percent of farms that did not feed pigs antibiotics). The Centers for Disease Control and Prevention published a study showing that a strain of “MRSA from an animal reservoir has recently entered the human population and is now responsible for more than 20 percent of all MRSA in the Netherlands.” Is this strictly a European problem? Evidently it is not. According to a study in Veterinary Microbiology, MRSA was found on 45 percent of the 20 pig farms sampled in Ontario, and in 20 percent of the pig farmers. (People can harbor the bacteria without being infected by it.) Thanks to NAFTA, pigs move freely between Canada and the United States.
As for the United States, an epidemiologist at the University of Iowa found that 45% of the pig farmers she sampled carried MRSA and 49% of the pigs also carried the bacteria. Similarly, a scientist at the University of Minnesota reports that somewhere between 25% and 39% of American hogs carry MRSA. MRSA is also showing up in pork tested at the retail level. In Louisiana, 5 out of 90 samples turned up positive for MRSA and in Washington D.C. one of 300 samples of pork turned up positive.
Yet, the truth is we know dangerously little of the prevalence of MRSA in the CAFO system because independent researchers can’t study the problem without the cooperation of the livestock industry. If these researchers should find proof that one of the hidden costs of cheap meat is an epidemic of drug-resistant infections, there would be calls to revolutionize the way we produce meat in this country. This is not something that the meat and the pharmaceutical industries or their respective fully-captured regulatory “watchdogs,” the Department of Agriculture and FDA, are likely to permit. But, in the United States, the FDA has tried without success for more than thirty years to ban such uses. Congress, under the thrall of agricultural interests has stopped the agency from acting.
A bill introduced in 2009 by Representative Louise Slaughter (a microbiologist) a democrat from New York, and Edward Kennedy, would have banned seven classes of antibiotics important to human health from being used in animals, and would have restricted other antibiotics to therapeutic and some preventive uses. While the legislation was supported by the American Medical Association, the Union for Concerned Scientists and other groups, it was opposed by farm organizations like the National Pork Producers Council. It never passed. As one observer put it, as one observer put it, “in the battle between public health and agriculture, the guys with the cowboy hats generally win.”
In June of 2010, the FDA, led by Margaret Hamburger, released a policy document stating that agricultural uses of antibiotics should be limited to caring for sick animals, but to date nothing has come from it. Indeed, on December 22, 2011, the FDA formally capitulated by announcing that it will not seek to regulate the use of antibiotics by CAFOs. Instead it will rely on voluntary reforms from the industry.
The combination of a highly drug-resistant microbe with a Republican House of Representatives which is highly resistant to business regulation may prove more deadly than anyone could imagine. Perhaps framing the problem in terms of “bioterrorism” may spoil the “tea party” and allow the nation to smash through this political roadblock.