Just three little words, “global health security”, but they represent such depths of meaning. A hundred years of modern scientific enquiry into infectious diseases such as yellow fever, malaria, and now zika. The wake up call of SARS and swine flu, where viruses with dramatic results leapt the species barrier. The galvanising effect of West Africa’s Ebola epidemic on the WHO, the international NGO and donor community and on governments. The concern over emerging and re-emerging infectious diseases, so many of them zoonotic in origin.
Most antibiotics in livestock farming are used in aquaculture, but significant amounts are also used in terrestrial livestock species, particularly in poultry and pigs.
Approximately 70% of antibiotics are used for non- therapeutic purposes, i.e. many antibiotics are used in sub- therapeutic doses and over prolonged periods, which leads to the development of genes that confer antimicrobial resistance to animal pathogens. These genes can subsequently be transferred to human pathogens and it is estimated that 75% of recently emerging diseases in humans are of animal origin.
Antimicrobial resistance (AMR) problems are further exacerbated by the fact that antibiotic resistance genes were found in bacteria long before antibiotics were ever used on super-pathogens in farm animals.
AMR is a worldwide problem, which clearly affects both animal and human health, and hence it is truly One Health issue.
St. Catherine’s College, Manor Road, Oxford, UK, 4-7th April 2016
Attended by M Djuric, CAB International, Wallingford, UK, on 5th April 2016 (Day 2)
The aims of the workshop were to build long-term and sustainable links between scientists in the UK and Egypt working in the field of infectious diseases of poultry and livestock.
The second day of the workshop consisted of two sessions and included four invited expert and engaging presentations by Professor Mohamed Shakal, Professor Fiona Tomly, Professor Javier Guitian and Dr Roberto La Regione.
By Miroslav Djuric, DVM, CAB International, Wallingford, UK
The European Agriculture Council has formally approved a draft law on animal diseases that are transmissible among animals and potentially to humans (zoonoses).
The provisions in the law on farm animal health visits stipulate that professional animal owners are to receive regular animal health visits from a veterinarian for disease prevention, detection and biosecurity. This new piece of legislation aims to merge and update existing scattered directives and regulations into a single and coherent law.
It is announced as an important step forward, since visits by vets are the cornerstone of the ‘prevention is better than cure’ strategy and indispensable for the prevention and early detection of known and emerging transmissible diseases. The role of the veterinarian in achieving this is defined and highlighted. The veterinary profession also has an active part to play in raising awareness of animal health and of One Health, or the interaction between animal health, animal welfare and public health.
By M Djuric, DVM
The U.S. Food and Drug Administration (FDA) has recently issued a guidance document on the use of antibiotics in farm animals. The document notes that excessive use leads to the spread of antibiotic-resistant diseases in both animals and humans. In the document, the FDA proposes that pharmaceutical companies voluntarily change some of their labelling and marketing practices to help phase out the use of certain antibiotics for enhanced food production.
All the drugs affected by this plan are antibacterial products, which have long been approved for the treatment, control or prevention of animal diseases. However, the same antibiotics are often added to the animal feed or drinking water of cattle, pigs, and poultry to gain weight faster or use less feed to gain weight.
The agency is asking animal pharmaceutical companies to notify the FDA within the next three months of their intent to voluntarily make the changes recommended in the guidance document. Based on timeframes set out in the guidance document, companies would then have three years to fully implement these changes.
By Miroslav Djuric
European Antibiotic Awareness Day is an annual initiative that aims to raise awareness of the threat of antibiotic resistance to public health and animal health as well as the importance of prudent use of antibiotics.
On the occasion of the 5th European Antibiotic Awareness Day, which was marked on 18 November 2012, the European Centre for Disease Prevention and Control (ECDC) has released new data demonstrating that antibiotic resistance remains a major European and global public health problem. Imprudent use of antibiotics is one of the main factors responsible for the development and increase in antibiotic resistance.
The ECDC data show that during the last decade, there has been an increase in antibiotic consumption in the EU. Antibiotic consumption in hospitals is considered as the main source that leads to the development of antibiotic resistance in bacteria, although the vast majority of antibiotic consumption occurs in the community, i.e outside hospitals. National antibiotic consumption data are publicly available from ESAC-Net providing a basis for monitoring progress towards a more prudent use of antibiotics.
The 1940s saw the beginning of the era of effective drug therapy for TB with the discovery of streptomycin. At the beginning of the 21st century we are seeing its end. Last month doctors in India reported an outbreak of a strain of TB that was termed totally drug resistant. It could be a false alarm because as it turns out the strains were not tested against all known drugs for TB but they were resistant to all 12 of the most common first and second line drugs.
Unfortunately India wasn’t the first place to report totally drug resistance such strains were reported in Italy in 2007 and Iran in 2009. Its presence in India is a concern, say experts because of the large poor population living in crowded conditions and government funded treatment of only simple TB cases.
TB develops drug resistance readily, probably aided by the long treatment times needed. Drug resistant strains followed very soon after the development of the first anti TB drugs and multiple drug resistant (MDR) forms heralded the resurgence of TB globally in the 1980s.
In response the World Health Organization developed the DOTS strategy, where adherence to the drug regime is ensured by observing the patient each time they take a drug dose. But despite this half a million cases of MDR TB occur each year because of poor adherence, poor quality drugs or erratic supply of drugs.
In 2006 the next step on the slippery slope to an incurable TB was the appearance of extremely drug resistant TB in an outbreak in South Africa. This was resistant to first and some secondline drugs.
This increasing drug resistance puts recent progress in decreasing the number of worldwide TB cases in jeopardy.
What can be done? Early diagnosis and testing and a better vaccine would go a long way to getting cases early and giving the right drugs. Treating early and accurately will stop the spread of TB.
TB diagnosis is antiquated – requiring use of microscopy in low resource settings. Matters are complicated by unreliable blood tests on the market which are attractive, quick to do and cheap. WHO issued a warning about those last year.
Progress is being made towards a rapid test. The Xpert MTB/RIF assay is a real-time PCR assay that is fully automated, and that has demonstrated high performance and could be deployed in a range of low- and middle-income settings. The World Health Organization (WHO) has publicly backed it.
World TB day is on 24th March 2012. Join the campaign against this disease of poverty here.
CABI is publishing a book about tuberculosis this year: Tuberculosis diagnosis and treatment.
See Global Health Knowledge Base for access to Global Health abstracts on tuberculosis
Photo credit: Janice Haney Carr