Consumer Perceptions-Superbugs In Our Food Supply - Ms. Susan Vaughn Grooters, Food Safety Research & Policy, Center for Science in the Public Interest (CSPI), from the 2013 NIAA Symposium Bridging the Gap Between Animal Health and Human Health, November 12-14, 2013, Kansas City, MO, USA.
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Ms. Susan Vaughn Grooters - Consumer Perceptions-Superbugs In Our Food Supply
1. Consumer PerceptionSuperbugs in the Food
Supply
National Institute for Animal
Agriculture
Susan Vaughn Grooters, MPH
Research and Policy Associate
Kansas City, MO
November 13th 2013
2. Center for Science in the
Public Interest - CSPI
CSPI is a bi-national consumer advocacy organization
founded in 1971 by Michael Jacobson, Ph.D.
Focuses on nutrition, health, and food safety
Publishes the award-winning Nutrition Action
Healthletter
Approaching 1 million subscribers in the United
States and Canada
Accepts no government or industry funding
6. ď‚– Study of 55 Outbreaks in the U. S. 1973-2011
Antibiotic
Resistance in
Foodborne
Outbreaks CSPI Report
ď‚– does not include the two Foster Farms assoc.
outbreaks
ď‚– Analyzes:
ď‚–
ď‚–
ď‚–
ď‚–
Food Vehicle
Etiology
WHO categories
Multi-drug resistance
 Outlier – 1985 Samonella Typhimurium outbreak in
pasteurized milk in which 16,659 were
sickened, 2,777 were hospitalized, and 18 died
7. ď‚– Aminoglycosides
ď‚– Streptomycin
ď‚– Carbapenems
ď‚– Cephalosporins (3rd and 4th generation
World Health
Organization’s
List of
Critically
Important
Antibiotics
ď‚– Ceftriaxone
ď‚– Macrolides
ď‚– Fluoro- and other Quinolones
ď‚– Ciprofloxacin
ď‚– Nalidixic acid
ď‚– Glycopeptides
ď‚– Vancomycin
ď‚– Penicillins (natural aminopenicillins and antipseudomonals)
ď‚–
ď‚–
ď‚–
ď‚–
Amocicillin/claulanic acid
Ampicillin
Carbenicillin
Penicillin
Source: http://apps.who.int
8. ď‚– Amphenicols
ď‚– Chloramphenicol
ď‚– Cephalosporins (1st and 2nd generation) and
Cephamycins
World Health
Organization’s
List of Highly
Important
Antibiotics
ď‚– Cephalothin
ď‚– Cefoxitin
ď‚– Lincosamides
ď‚– Streptogramins
ď‚– Sulfonamides, et al.
ď‚– Sulfamethoxazole
ď‚– Sulfisoxazole
ď‚– Tetracyclines
Source: http://apps.who.int
9. Drug Resistance Profiles by WHO categories
50
47
45
40
36
35
# of Outbreaks
Antibiotic
Resistant
Bacteria and
Foodborne
Outbreaks
39
30
25
25
20
19
15
15
17
14
10
10
5
15
2
1
3
4
1
10
5
3
0
Critically Important
Highly Important
Not classified on WHO's list
4
1
10. Year Location Bacteria
Food/Source
Cases Hosp Death Resistances
1973 ME
S. Typhimurium
Eggs
32
NR
NR
unknown
1975 MD, FL,
CO
S. Newport
Ground beef
27
NR
NR
1979 CA, OR
S. Dublin
Raw milk
39
NR
NR
NR
NR
critically important
sulfonamides
highly important
tetracycline
highly important
ampicillin
penicillin
critically important
penicillin
critically important
kanamycin
penicillin
streptomycin
tetracycline
3
aminoglycosides
carbenicillin
Raw milk
streptomycin
sulfamethoxazole
S. Typhimurium
WHO Status
tetracycline
1977 KY
Drug Family
aminoglycosides
penicillin
aminoglycosides
tetracycline
highly important
critically important
critically important
highly important
unknown
ABR Foodborne Outbreaks
1970s
11. Year
Location
Bacteria
Food/Source
1980
MT
S. Typhimurium
Raw milk
1983
AZ
S. Typhimurium
Raw milk
1987
GA
S. Havana
Chicken
16659
73
2777
36
18
1
tetracycline
highly important
tetracycline
tetracycline
highly important
aminoglycosides
critically important
ampicillin
penicillin
critically important
amphenicol
highly important
aminoglycosides
highly important
aminoglycosides
critically important
sulfonamides
highly important
tetracycline
highly important
ampicillin
penicillin
critically important
aminoglycosides
highly important
aminoglycosides
critically important
sulfonamides
highly important
tetracycline
Pasteurized milk
critically important
sulfamethoxazole
S. Typhimurium
penicillin
streptomycin
IL
2
critically important
kanamycin
1985
22
penicillin
tetracycline
298
highly important
ampicillin
sulfamethoxazole
Ground beef
highly important
tetracycline
streptomycin
S. Newport
unknown
1
0
sulfonamides
kanamycin
CA
NR
NR
45
critically important
chloramphenicol
1985
715
highly important
aminoglycosides
streptomycin
Salad bar
highly important
aminoglycosides
tetracycline
S. Typhimurium
amphenicol
carbenicillin
OR
Resistances
1
critically important
tetracycline
1984
Death
11
penicillin
sulfonamide*
18
ampicillin
streptomycin
Ground beef
WHO Status
kanamycin
MN, SD, NE, IA S. Newport
Hosp
NR
12
Drug Family
chloramphenicol
1983
Cases
tetracycline
highly important
tetracycline
tetracycline
highly important
ABR Foodborne Outbreaks
1980s
12. Year
Location Bacteria
1994
WI
ABR
Foodborne
Outbreaks
1990s
1997
sulfonamides
*
ampicillin
penicillin
critically
important
amphenicol
highly important
aminoglycosides critically
important
sulfonamides
highly important
tetracycline
highly important
NR
amoxicillin/clavulanat penicillin
e
critically
important
ampicillin
13
0
highly important
penicillin
critically
important
amphenicol
highly important
aminoglycosides critically
important
sulfonamides
highly important
tetracycline
Mexican-style 79
cheese (raw
milk)
5
tetracycline
sulfamethoxazole
S. Typhimurium
DT104
Mexican-style 89
soft cheese
(queso fresco)
(raw milk)
aminoglycosides highly important
streptomycin
CA
S. Typhimurium
DT104
0
kanamycin
chloramphenicol
0
aminoglycosides critically
important
chloramphenicol
1997
WA
Unknown,
19
chocolate milk
suspected
highly important
tetracycline
S. Typhimurium
DT104
NR
highly important
sulfonamides
sulfonamide*
NE
5
tetracycline
streptomycin
1996
Alfalfa sprouts 19
critically
important
trimethoprimsulfamethoxazole
S. Stanley
NR
penicillin
tetracycline
AZ
NR
ampicillin
streptomycin
205
WHO Status
sulfisoxazole
E. coli O153:H45 Unknown,
(ETEC)
banquet food
Drug Family
tetracycline
1995
Food/Source Cases Hosp Death Resistances
tetracycline
highly important
ampicillin
penicillin
critically
important
chloramphenicol
amphenicol
highly important
streptomycin
aminoglycosides critically
important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
13. 1997
ABR
Foodborne
Outbreaks
1990s cont.
1998
KS
S. I 4,[5],12:i-
Campylobacter
jejuni
Unknown,
86
dinner
reception
multiple foods
suspected
Unknown,
128
gravy, potato,
pineapple
suspected
2
0
0
tetracycline
highly important
ampicillin
penicillin
critically
important
amphenicol
highly important
aminoglycosides critically
important
sulfonamides
highly important
tetracycline
highly important
ampicillin
penicillin
critically
important
streptomycin
31
aminoglycosides critically
important
aminoglycosides critically
important
sulfonamides
highly important
tetracycline
NY
NR
highly important
aminoglycosides highly important
sulfonamide*
1998
1
tetracycline
kanamycin
tetracycline
9
highly important
sulfamethoxazole
Raw milk
sulfonamides
streptomycin
S. Typhimurium
2
highly important
aminoglycosides critically
important
chloramphenicol
VT
NR
amphenicol
tetracycline
1997
706
chloramphenicol
streptomycin
Pork
NR
critically
important
tetracycline
S. Heidelberg
14
penicillin
sulfonamide*
MD
S.Typhimurium var Mexican-style 31
Copenhagen
cheese (raw
DT104b
milk)
ampicillin
streptomycin
1997
CA
tetracycline
highly important
sulfonamides
*
fluoroquinolone
critically
important
tetracycline
highly Important
trimethoprimsulfamethoxazole
ciprofloxacin
tetracycline
14. Year
Location Bacteria
Food/Source
2000
TN
Staphylococcus
aureus (MRSA)
Pork, barbeque, 3
vegetable
salad, cole slaw
0
0
2000
PA, NJ
S. Typhimurium
Pasteurized
milk
6
0
12
0
*
ampicillin
penicillin
critically important
aminoglycosides
highly important
aminoglycosides
critically important
sulfonamides
highly important
tetracycline
highly important
amoxicillin/clavulanate penicillin
critically important
ampicillin
penicillin
critically important
cefoxitin
ABR
Foodborne
Outbreaks
2000s
Italian-style soft 27
cheese (raw
milk)
penicillin
tetracycline
S. Newport
methecillin
sulfamethoxazole
CT
WHO Status
streptomycin
93
Drug Family
kanamycin
2001
Cases Hosp Death Resistances
cephamycin
highly important
ceftiofur
cephalosporin (3G) *
cephalothin
cephalosporin (1G) highly important
chloramphenicol
amphenicol
highly important
streptomycin
aminoglycosides
critically important
sulfamethoxazole
sulfonamides
highly important
tetracycline
tetracycline
highly important
tetracycline
highly important
2001
WI
E. coli O169:H41/ST Quesadilla,
(ETEC)
fajitas, nacho
chips, beans
21
0
0
tetracycline
2002
NY, MI,
PA, OH,
CT
S. Newport
47
17
1
amoxicillin/clavulanate penicillin
critically important
ampicillin
penicillin
critically important
cefoxitin
cephamycin
highly important
ceftiofur
cephalosporin
*
cephalothin
cephalosporin (1G) highly important
chloramphenicol
amphenicol
highly important
streptomycin
aminoglycosides
critically important
sulfamethoxazole
sulfonamides
highly important
tetracycline
tetracycline
highly important
kanamycin (2/3
resistant)
ceftriaxone (2)
aminoglycosides
highly important
Ground beef
cephalosporin (3G) critically important
15. 2002
OR
E. coli O27:H7/ST Chicken
(ETEC)
lasagna
2003
sulfonamides
highly important
tetracycline
highly important
tetracycline
highly important
Ground beef
56
11
0
ampicillin
penicillin
critically
important
amphenicol
highly important
aminoglycosides critically
important
sulfonamides
highly important
tetracycline
highly important
ampicillin
penicillin
critically
important
amphenicol
highly important
nalidixic acid
quinolone
critically
important
streptomycin
aminoglycosides critically
important
sulfisoxazole
sulfonamides
highly important
trimethoprimsulfamethoxazole
S. Newport
tetracycline
chloramphenicol
CA
0
tetracycline
2004
2
sulfamethoxazole
E. coli O6:H16
(ETEC)
41
streptomycin
NV
Catfish,
coleslaw
chloramphenicol
ABR
Foodborne
Outbreaks
2000s cont.
9 states S. Typhimurium
DT104
2004
E. coli O169:H49
(ETEC)
0
aminoglycosides critically
important
tetracycline
TN
0
streptomycin
sulfamethoxazole
2003
49
sulfonamides
*
Shrimp
Pasteurized
milk
130
100
0
5
0
0
amoxicillin/clavulanat penicillin
e
critically
important
ampicillin
penicillin
critically
important
cefoxitin
cephamycin
highly important
ceftiofur
cephalosporin
(3G)
*
ceftriaxone
cephalosporin
highly important
chloramphenicol
amphenicol
highly important
streptomycin
aminoglycosides critically
important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
16. 2004
cephalosporin
highly important
amphenicol
highly important
aminoglycosides
highly important
aminoglycosides
critically important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
sulfonamide*
sulfonamides
highly important
tetracycline
0
*
streptomycin
6
highly important
cephalosporin
(3G)
kanamycin
24
NR
cephamycin
chloramphenicol
Sandwich,
turkey
NR
critically important
ceftriaxone
ABR
Foodborne
Outbreaks
2000s cont.
2
penicillin
ceftiofur
S. Agona
Unknown
critically important
cefoxitin
MN
S. Newport
amoxicillin/clavulanat penicillin
e
ampicillin
2004
IL
tetracycline
highly important
2004
NY
S. Istanbul
Chicken
42
14
0
tetracycline
tetracycline
highly important
2005
MN
S. Heidelberg
Chicken
4
1
0
gentamicin
streptomycin
sulfonamide*
aminoglycosides
aminoglycosides
sulfonamides
critically important
critically important
highly important
2005
TN
S. Heidelberg
Unknown
19
2
0
gentamicin
aminoglycosides
critically important
nalidixic acid
quinolone
critically important
streptomycin
aminoglycosides
critically important
tetracycline
tetracycline
highly important
ampicillin
penicillin
critically important
gentamicin
aminoglycosides
critically important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
2005
IN, MI,
S. Braenderup
MO, OH
Tomato
84
8
0
17. 2005
cephalosporin
highly important
amphenicol
highly important
aminoglycosides
critically important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
amoxicillin/clavulanate penicillin
critically important
ampicillin
penicillin
critically important
chloramphenicol
amphenicol
highly important
streptomycin
ABR
Foodborne
Outbreaks
2000s cont.
0
highly important
cephalosporin (3G) *
streptomycin
0
0
cephamycin
chloramphenicol
25
1
critically important
ceftriaxone
Sushi
100
penicillin
ceftiofur
S. Typhimurium
S. Unknown
critically important
cefoxitin
CO
S. Typhimurium
Newport
amoxicillin/clavulanate penicillin
ampicillin
2005
CO
aminoglycosides
critically important
sulfonamide*
sulfonamides
highly important
trimethoprimsulfamethoxazole
sulfonamides
*
tetracycline
tetracycline
highly important
2006
AR
S. I 4,[5],12:i-
Unknown
14
4
0
nalidixic acid
quinolone
critically important
2006
PA
S. Typhimurium
Queso fresco, 20
unpasteurized;
raw milk
2
0
amoxicillin/clavulanate penicillin
critically important
ampicillin
penicillin
critically important
cefoxitin
cephamycin
highly important
ceftiofur
cephalosporin (3G) *
ceftriaxone
cephalosporin
highly important
chloramphenicol
amphenicol
highly important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
2006
UT
S. Typhimurium
Root vegetable 3
NR
NR
amoxicillin/clavulanate penicillin
critically important
ampicillin
penicillin
critically important
chloramphenicol
amphenicol
highly important
streptomycin
aminoglycosides
critically important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
18. 2006
ABR
Foodborne
Outbreaks
2000s cont.
2006
2007
TN
S. Hadar
CA, AZ, ID, S. Newport
NV
Mexican-style
96
cheese (cotija), (raw
milk)
Unknown
Ground beef
9
43
1
15
highly important
highly important
amoxicillin/clavulanate
penicillin
critically important
penicillin
critically important
cephamycin
cephalosporin (3G)
highly important
*
cephalosporin
amphenicol
aminoglycosides
highly important
highly important
critically important
sulfonamides
highly important
tetracycline
highly important
amoxicillin/clavulanate
penicillin
critically important
ampicillin
36
sulfonamides
tetracycline
penicillin
critically important
cephamycin
cephalosporin (3G)
highly important
*
amphenicol
highly important
aminoglycosides
critically important
sulfamethoxazole
tetracycline
S.
highly important
highly important
critically important
streptomycin
S. Newport
Meleagridis
cephalosporin
amphenicol
aminoglycosides
chloramphenicol
IL
highly important
*
cefoxitin
ceftiofur
2006
cephamycin
cephalosporin (3G)
tetracycline
3
critically important
sulfonamide*
9
penicillin
ceftriaxone
chloramphenicol
streptomycin
Unknown
highly important
critically important
cefoxitin
ceftiofur
S. Newport
cephalosporin
penicillin
ampicillin
IL
*
ceftriaxone
amoxicillin/clavulanate
sulfonamide*
tetracycline
NR
highly important
cephalosporin (3G)
ceftriaxone
chloramphenicol
streptomycin
24
critically important
cephamycin
cefoxitin
ceftiofur
Multiple foods
0
critically important
ampicillin
S. Newport
6
penicillin
ceftiofur
2006
Unknown
penicillin
cefoxitin
CA
S. Schwarzengrund
amoxicillin/clavulanate
ampicillin
2006
PA
0
sulfonamides
tetracycline
highly important
highly important
0
streptomycin
aminoglycosides
critically important
0
tetracycline
amoxicillin/clavulanate
tetracycline
penicillin
highly important
critically important
ampicillin
penicillin
critically important
cefoxitin
cephamycin
highly important
ceftiofur
cephalosporin (3G)
*
ceftriaxone
cephalosporin
critically important
chloramphenicol
amphenicol
highly important
streptomycin
aminoglycosides
critically important
sulfonamide*
sulfonamides
highly important
tetracycline
tetracycline
highly important
NR
0
0
19. 2007
ABR
Foodborne
Outbreaks
2000s cont.
critically important
ampicillin
penicillin
critically important
amphenicol
highly important
aminoglycosides
critically important
sulfonamides
highly important
tetracycline
highly important
amphenicol
highly important
aminoglycosides
critically important
sulfamethoxazole
sulfonamides
highly important
tetracycline
NR
cephalosporin (1G) highly important
streptomycin
NR
highly important
cephalosporin (3G) *
chloramphenicol
2
critically important
cephamycin
cephalothin
Ground beef
penicillin
ceftiofur
S. Newport
critically important
cefoxitin
AZ
amoxicillin/clavulanate penicillin
ampicillin
2009
0
highly important
aminoglycosides
tetracycline
4
highly important
tetracycline
sulfamethoxazole
68
sulfonamides
streptomycin
Ground beef
critically important
chloramphenicol
14 states S. Newport
highly important
aminoglycosides
streptomycin
2009
amphenicol
tetracycline
0
highly important
cephalosporin (3G) *
sulfamethoxazole
6
0
cephamycin
streptomycin
14
0
critically important
chloramphenicol
Ground beef
11
penicillin
ceftiofur
S. Typhimurium
DT104
Unknown
critically important
cefoxitin
7 states
S. Newport
amoxicillin/clavulanate penicillin
ampicillin
2009
MN
tetracycline
highly important
amoxicillin/clavulanate penicillin
critically important
ampicillin
penicillin
critically important
cefoxitin
cephamycin
highly important
ceftiofur
cephalosporin (3G) *
cephalothin
cephalosporin (1G) highly important
chloramphenicol
amphenicol
highly important
streptomycin
aminoglycosides
critically important
sulfamethoxazole
sulfonamides
highly important
tetracycline
tetracycline
highly important
20. 2011 10 states S. Hadar
S. Typhimurium
Ground beef
20
0
37
1
8
0
penicillin penicillin
cephalosporin
penicillin
aminoglycosides
critically important
critically important
critically important
critically important
tetracycline
highly important
gentamicin
2011 7 states
3
ampicillin
amoxicillin/clavulanate
ampicillin
streptomycin
tetracycline
2011 34 states S. Heidelberg
Ground turkey 12
(Jennie-O
Ground turkey 136
(Cargill)
aminoglycosides
critically important
amoxicillin/clavulanate penicillin
ampicillin
penicillin
ABR Foodborne Outbreaks
2010s
critically important
critically important
24. Risk
Management
Concepts
ď‚– Hazard resonably likely to occur (foundation of
HACCP-based controls)
ď‚– Known safety risk of a particular food (FDA FSMA)
ď‚– Performance standards (contaminant specific and
science-based); appropriate to reduce the risk of
serious illness or death to humans or animals (FDA
FSMA)
25. Prevention /
Crisis
Communication
ď‚– What we are AIMING for :
“An ounce of prevention is worth a pound of cure”
ď‚– What we too often HIT
“Don’t let a good crisis go to waste”
26.  Anticipating BSE’s emergence in North America
started in 1996; emergence in the early 2000s
Planning a
response
ď‚– Result:
ď‚– Well researched risk communication strategy and a
clear statement of the risk in relation to other
hazards in consumers’ diets resulted in only short
term declines in consumer consumption of beef
28. ď‚– The interactive exchange of information and
opinions concerning risk and risk management
among risk assessors, risk
managers, consumers, and other interested
parties
Risk
Communication
ď‚– Transparency is a key objective and its importance
can not be overemphasized
ď‚– Involvement of stakeholders can contribute to issue
identification and characterization, provide data
and other inputs for risk assessment, provide
alternatives for options assessment, develop
consensus or provide an outlet for public concern
29. Relation of Data
Gathering to
Risk
Management &
Communication
ď‚– The data collection function of AGISAR will
generate information of interest to multiple
parties, including risk managers, the food
industry, retailers and consumers
ď‚– Producers may be concerned about disclosure of
information about practices that they are not
prepared to address
ď‚– Consumers may be concerned that the results
demonstrate that their food is highly contaminated
ď‚– Risk managers must be prepared to address
concerns of stakeholders at any point during the
data collection process
30. ď‚– World Health Day Focus with WHO/ FAO/OIE
Risk
Management:
WHO/OIE
even USDA
ď‚– Core actions for antimicrobial use in food producing
animals:
ď‚– Provide national leadership and collaboration
ď‚– Create and enforce regulatory framework
ď‚– Strengthen surveillance and monitoring
ď‚– Promote education and training on antimicrobial use in
food-producing animals
ď‚– Reduce the need for antimicrobials through better
animal husbandry
ď‚– U.S. Department of Agriculture
“Animals, when exposed to antimicrobial agents, may
serve as a significant reservoir of resistant bacteria
that can transmit to humans through the food
supply.”
“The economic impact of antimicrobial resistance is
significant. Insufficient or failed treatment … is a huge
human cost.”
June 10, 2011 Food Safety Research Information Office
31. Table 1. Antimicrobial Drugs Approved for Domestic Use in Humans and Food-Producing Animals*.
Sales and Distribution Data Reported to FDA by Drug Class.
2009 Animal Annual
Totals (LBS)
2010 Animal Annual
Totals (LBS)
2011 Animal Annual
Totals(LBS)
Aminoglycosides
748,862
442,675
473,762
Critically / highly
Cephalosporins
91,113
54,207
58,667
Critically / highly
8,246,671
8,424,167
9,090,230
Ionophores
Lincosamides
WHO Status
Not ranked
Antibiotic
Sales Data Animal and
Human by
WHO Status
255,377
340,952
419,101
Macrolides
1,900,352
1,219,661
1,284,933
Critically
Penicillins
1,345,953
1,920,112
1,940,427
Critically / highly
Sulfas
1,141,715
1,116,020
817,959
Highly
10,167,481
12,328,521
12,439,744
Highly
Tetracyclines
Other (Not Independently Reported (NIR))**
Total
4,910,501
3,345,398
3,330,241
28,808,024
29,191,712
29,855,066
2009 Human
Annual Total (LBS)
Aminoglycosides
Cephalosporins
Ionophores
Important
2010 Human
Annual Total (LBS)
2011 Human
Annual Total (LBS)
WHO Status
20,682
15,413
14,297
Critically / highly
1,101,465
1,107,957
1,095,499
Critically / highly
0
0
0
Lincosamides
153,744
152,637
157,531
Important
Macrolides
388,626
362,239
361,620
Critically
Penicillins
3,217,027
3,174,502
3,219,677
Critically / highly
Sulfas
1,039,352
1,057,081
1,061,887
Highly
289,108
284,800
250,957
Highly
1,102,567
1,074,121
1,089,921
7,312,570
7,228,750
7,251,390
Tetracyclines
Other (Not Independently Reported (NIR))**
Total
* For all classes except aminoglycosides and ionophores, data includes antimicrobial drug
products which are approved and labeled for use in both food- and non-food- producing animals.
** NIR is used for antimicrobial classes with fewer than three sponsors actively marketing
products. This category includes fluoroquinolones and streptogramins.
*** Human drug use data is based on data from the IMS Health, IMS National Sales Perspectives.
Not ranked
39. ď‚– On April 11, FDA issued new guidelines intended to
curb the non-therapeutic uses of antibiotics in food
animal production.
ď‚– This first step:
Guidance for
Industry 209 & 213
VFD
ď‚– Voluntarily seeks to ban the use of antibiotics to
grow animals faster.
ď‚– Moves all over the counter (OTC) uses under
veterinary supervision.
Concerns with the guidances:
ď‚– Do not outline how FDA will monitor the
effectiveness of the guidelines.
ď‚– Do not clearly outline what uses are considered
prevention
41. PAMTA (Preservation of Antibiotics for Medical Treatment Act)
HR 1150: Rep. Slaughter
PARA (Prevention of Antibiotic Resistance Act)
S. 1256:
Endorsed by:
• American Medical Association
• American Nurses Association
• American Academy of Pediatrics
• American Public Health Association
• More than 400 other organizations!
44. Consumer Logic
Consumer
advocates’
understanding
ď‚– People take antibiotics when they are sick.
ď‚– Antibiotics are only available with medical consult
from a clinician.
ď‚– Antibiotics only available with a prescription.
 Giving antibiotics to animals must mean they’re
sick, too.
ď‚– When consumers learn that antibiotics are given
preventatively, for animals that aren’t sick – lack of
understanding.
ď‚– Lack of consistent veterinary oversight different
from human medicine.
45. Consumer
advocates’
understanding
Giving antibiotics to healthy
animals in low doses, helps
speed along the emergence of
antibiotic resistant bacteria.
People can get sick with
antibiotic resistant infections
when food is contaminated.
50. The Alliance
for the
Prudent
Use of
Antibiotics
ď‚–Antibiotic Resistant
bacteria generate
ď‚–$16.6 billion - $26
billion annually in
extra costs to the US
Healthcare system
51. ď‚– Antibiotic Resistance
ď‚– Antibiotics are losing their effectiveness due in part
to overuse in food animal production
ď‚– Consumer Interest
Fighting
Antibiotic
Resistance
ď‚– Preserving effective medicines for fighting
infections
ď‚– Resistant bacteria associated with foodborne
diseases
ď‚– Residue issues (allergens, side effects)
ď‚– Recommendation
ď‚– Adopt EU policy banning non therapeutic use
ď‚– Remove critically important human drugs from
animal food chain
52. Susan Vaughn Grooters, MPH
Research and Policy Associate
Center for Science in the Public Interest
1220 L St. NW, Suite 300
Washington, DC 20005
THANK YOU!
Phone: 202.777.8377
Email: sgrooters@cspinet.org
On the Internet: www.cspinet.org
www.FoodDay.org