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<p class="MsoNormal"><font size="3" color="#000099" face="Times New Roman"><span style="font-size:12.0pt"><a href="http://www.theatlantic.com/health/archive/2015/03/the-next-big-antibiotic-resistance-threat/388430/">http://www.theatlantic.com/health/archive/2015/03/the-next-big-antibiotic-resistance-threat/388430/</a></span><o:p></o:p></font></p>
<p class="MsoNormal"><font size="3" color="#000099" face="Times New Roman"><o:p> </o:p></font></p>
<p class="MsoNormal" style="line-height:21.0pt;vertical-align:top"><b><font size="5" color="#242b30" face="Georgia"><span style="font-size:18.0pt;font-family:"Georgia","serif";color:#242B30;font-weight:bold">The Antibiotics Problem in Meat<o:p></o:p></span></font></b></p>
<p class="MsoNormal" style="line-height:21.0pt;vertical-align:top"><b><font size="5" color="#242b30" face="Georgia"><span style="font-size:18.0pt;font-family:"Georgia","serif";color:#242B30;font-weight:bold"><o:p> </o:p></span></font></b></p>
<p class="MsoNormal" style="mso-line-height-alt:11.4pt;vertical-align:top"><font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">A new study suggests that a consumer demand for chicken and
pork in place like India, Russia, China, and Brazil will help drive a large increase in overuse of the drugs by 2030. Is there anything we can do about it?
<o:p></o:p></span></font></p>
<p class="MsoNormal" style="line-height:11.4pt;vertical-align:top"><font size="1" color="#5c5c5c" face="Arial"><span style="font-size:6.5pt;font-family:"Arial","sans-serif";color:#5C5C5C"><a href="http://www.theatlantic.com/olga-khazan/"><font color="#5c5c5c"><span style="color:#5C5C5C;text-transform:uppercase;text-decoration:none">Olga
Khazan</span></font></a></span></font><font size="1" color="#5c5c5c" face="Arial"><span style="font-size:8.0pt;font-family:"Arial","sans-serif";color:#5C5C5C;text-transform:uppercase">Mar 23 2015, 11:41 AM ET</span></font><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext"><o:p></o:p></span></font></p>
<ul type="disc">
<li class="MsoNormal" style="color:windowtext;mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;line-height:11.4pt;mso-list:l0 level1 lfo1;vertical-align:top">
<font size="1" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif""><o:p> </o:p></span></font></li></ul>
<p class="MsoNormal" style="line-height:11.4pt;vertical-align:top"><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext"><img border="0" width="314" height="174" id="Picture_x0020_1" src="cid:image001.jpg@01D06561.15483070" alt="http://cdn.theatlantic.com/static/newsroom/img/mt/2015/03/bacon/lead.jpg?nlo8ww"></span></font><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext">gemteck1/Flickr
<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<i><font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext;font-style:italic">The Rising Plague</span></font></i><font color="black" face="Georgia"><span style="font-family:"Georgia","serif";color:windowtext">,
<a href="http://www.amazon.com/Rising-Plague-Bacteria-Dwindling-Arsenal/dp/1591027500">
<font color="#00598c"><span style="color:#00598C;text-decoration:none">a book</span></font></a> by Brad Spellberg, chief medical officer of the Los Angeles County—University of Southern California Medical Center, opens with eight chilling words:<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">“I’m out of antibiotics. She’s going to die.”<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">The quote is from a real doctor at UCLA-Harbor Medical Center, who was treating a real patient—a 20-something Spellberg calls “B.” B had
leukemia, and she developed an infection that built up resistance to the hospital’s most powerful antibiotics even as she was being pumped full of them. She died the day after Spellberg told her husband the hospital had nothing left to try.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">In the book, Spellberg describes the case as happening “several years ago.” The book was published in 2009.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-line-height-alt:11.4pt;vertical-align:top"><font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">"By playing your part you do reduce your risk of infection.
Although not completely.”<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">Antibiotic resistance may make cases like B's much more common in the future. One of the biggest culprits is the widespread use of antibiotics
in livestock. Industrial farms feed animals low doses of the drugs in order to promote growth and ward off infections within densely packed herds. From there, natural selection does its job: The bacteria that can overpower the drugs survive and multiply, and
they make their way out into the environment through water, urine, and feces. In the U.S., 80 percent of antibiotics are used in animals, though the industry is
<a href="http://www.npr.org/blogs/thesalt/2014/02/14/276976353/americans-want-antibiotic-free-chicken-and-the-industry-is-listening">
<font color="#00598c"><span style="color:#00598C;text-decoration:none">moving away</span></font></a> from the practice.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">A new study published in the
<a href="http://www.pnas.org/content/early/2015/03/18/1503141112.abstract"><i><font color="#00598c"><span style="color:#00598C;font-style:italic;text-decoration:none">Proceedings of the National Academy of Sciences</span></font></i><font color="#00598c"><span style="color:#00598C;text-decoration:none">
</span></font></a>forecasts the geography of antibiotic overuse in the future. According to the study authors, the next big threat will come from middle-income countries like Brazil, Russia, India, and China, where a burgeoning consumer class is starting to
prefer more meat in their diets, and where large-scale farms will try to meet this demand as cheaply as they can.</span></font><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext"><o:p></o:p></span></font></p>
<div class="MsoNormal" align="center" style="text-align:center;line-height:11.4pt;vertical-align:top">
<font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext">
<hr size="3" width="100%" align="center">
</span></font></div>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;line-height:11.4pt;vertical-align:top">
<b><font size="2" color="black" face="Georgia"><span style="font-size:10.0pt;font-family:"Georgia","serif";color:windowtext;font-weight:bold">Antibiotic Consumption in Chicken and Pigs</span></font></b><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext"><o:p></o:p></span></font></p>
<p class="MsoNormal" style="line-height:11.4pt;vertical-align:top"><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext"><img border="0" width="508" height="727" id="Picture_x0020_3" src="cid:image002.png@01D06561.15483070" alt="http://cdn.theatlantic.com/assets/media/img/posts/2015/03/Screen_Shot_2015_03_23_at_11.04.58_AM/29fd89a64.png"></span></font><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext">Antibiotic
consumption in chickens (top) and pigs (bottom) in </span></font><font color="black" face="Georgia"><span style="font-family:"Georgia","serif";color:windowtext">2010. Purple indicates new areas where antimicrobial consumption will exceed 30 kg per 10 km2 by
2030. (PNAS)<o:p></o:p></span></font></p>
<div class="MsoNormal" align="center" style="text-align:center;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">
<hr size="3" width="100%" align="center">
</span></font></div>
<div class="MsoNormal" align="center" style="text-align:center;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">
<hr size="3" width="100%" align="center">
</span></font></div>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">The study authors estimate that between 2010 and 2030, the global consumption of antibiotics will increase by 67 percent, with about a
third of that increase coming from changing livestock practices in fast-developing countries. China, for instance, already leads the world in antibiotic use in livestock.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">The increase will largely be driven by chicken and pork, rather than cattle. Chicken and pigs are easier to raise quickly in tight spaces,
whereas cattle herds take a while to build up, explained Timothy Robinson, principal scientist at the International Livestock Research Institute and an author of the study.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">It’s particularly devastating that developing countries will use the most antibiotics in livestock because they also shoulder a disproportionate
disease burden. For example, the authors write, “India has no regulatory provisions for the use of antimicrobials in cattle, chicken, and pigs raised for domestic consumption,” but approximately 95 percent “of adults in India carry bacteria resistant to â-lactam
antimicrobials.”<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">These are also the nations where restrictions on antibiotic use might be hardest to implement.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">“In Europe, we have fairly strict legislation on antimicrobial use,” Robinson said. “In the States, things are a bit looser. In India and
China and Russia, it's one thing producing the legislation and it's another thing enforcing it.”<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">All of this made me wonder how much good it does to buy antibiotic-free meat in the U.S., which, unlike the EU, hasn’t outlawed the use
of antibiotics in livestock as a growth promoter.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">The answer is: It depends. Chicken raised without antibiotics might have a lower chance of harboring resistant pathogens like Campylobacter
and Salmonella, says Ramanan Laxminarayan, director of the Center for Disease Dynamics, Economics and Policy.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">Still, choosing antibiotic-free chicken is still a little bit like buying a Prius or recycling: It could help on a wide scale, but only
if most people do it. Even if some people are chowing down on Whole Foods poultry, superbugs from chicken farms that
<i><span style="font-style:italic">do</span></i> use antibiotics could still make their way to humans through the water supply and other means. According to Laxminarayan, this is how most resistance genes get to humans, rather than through the direct consumption
of animals raised on antibiotics.<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">“Antimicrobial resistance is a tragedy of the commons, but with more direct individual effect than climate change,” said Thomas Van Boeckel,
an ecologist at Princeton University and the study's lead author. “By playing your part you do reduce your risk of infection. Although not completely.”<o:p></o:p></span></font></p>
<p class="MsoNormal" style="mso-margin-top-alt:auto;mso-margin-bottom-alt:auto;mso-line-height-alt:11.4pt;vertical-align:top">
<font size="3" color="black" face="Georgia"><span style="font-size:12.0pt;font-family:"Georgia","serif";color:windowtext">In order to preserve antibiotic effectiveness entirely, he added, “we need to rethink how we raise livestock.”</span></font><font size="1" color="black" face="Georgia"><span style="font-size:8.0pt;font-family:"Georgia","serif";color:windowtext"><o:p></o:p></span></font></p>
<p class="MsoNormal"><font size="3" color="#000099" face="Times New Roman"><o:p> </o:p></font></p>
<p class="MsoNormal"><font size="3" color="#000099" face="Times New Roman"><o:p> </o:p></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Times New Roman"><span style="font-size:10.0pt;color:navy">Deborah L. DeBiasi</span></font><font size="2" color="navy"><span style="font-size:11.0pt;color:navy"><br>
</span></font><b><font size="2" color="navy"><span style="font-size:10.0pt;color:navy;font-weight:bold">Email: Deborah.DeBiasi@deq.virginia.gov</span></font></b><b><i><font size="2" color="red"><span style="font-size:10.0pt;color:red;font-weight:bold;font-style:italic"><br>
</span></font></i></b><font size="2" color="navy"><span style="font-size:10.0pt;color:navy">WEB site address:
<a href="http://www.deq.virginia.gov/">www.deq.virginia.gov</a></span></font><font size="2" color="navy"><span style="font-size:11.0pt;color:navy"><br>
</span></font><font size="2" color="navy"><span style="font-size:10.0pt;color:navy">Virginia Department of Environmental Quality</span></font><font size="2" color="navy"><span style="font-size:11.0pt;color:navy"><br>
</span></font><font size="2" color="navy"><span style="font-size:10.0pt;color:navy">Office of Water Permits
</span></font><font size="2" color="navy"><span style="font-size:11.0pt;color:navy"><br>
</span></font><font size="2" color="navy"><span style="font-size:10.0pt;color:navy">Industrial Pretreatment/Whole Effluent Toxicity (WET) Program</span></font><font size="2" color="navy"><span style="font-size:11.0pt;color:navy"><br>
</span></font><font size="2" color="navy"><span style="font-size:10.0pt;color:navy">PPCPs, EDCs, and Microconstituents<o:p></o:p></span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Times New Roman"><span style="font-size:11.0pt;color:navy"><a href="http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx">http://www.deq.virginia.gov/Programs/Water/PermittingCompliance/PollutionDischargeElimination/Microconstituents.aspx</a></span></font><font size="2" color="navy"><span style="font-size:10.0pt;color:navy"><o:p></o:p></span></font></p>
<p class="MsoNormal"><font size="2" color="navy" face="Times New Roman"><span style="font-size:10.0pt;color:navy">Mail: P.O. Box 1105, Richmond, VA 23218</span></font><font size="2" color="navy"><span style="font-size:11.0pt;color:navy"><br>
</span></font><font size="2" color="navy"><span style="font-size:10.0pt;color:navy">Location: 629 E. Main Street, Richmond, VA 23219</span></font><font size="2" color="navy"><span style="font-size:11.0pt;color:navy"><br>
</span></font><font size="2" color="navy"><span style="font-size:10.0pt;color:navy">PH: 804-698-4028 FAX: 804-698-4032<o:p></o:p></span></font></p>
<p class="MsoNormal"><font size="3" color="#000099" face="Times New Roman"><o:p> </o:p></font></p>
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