Feedlots, MRSA, and H.R. 1549
By Miryam Ehrlich Williamson
So far this year, three friends have come down with a serious bacterial infection known as MRSA. The acronym stands for methicillin-resistant Staphylococcus aureus. It describes forms of the staph bacterium that have evolved to be immune to antibiotics of the penicillin family, which used to be the first line of defense against a staph infection. More accurately, the M in the term should be understood as standing for multidrug-resistant, because some staph can fight off other types of antibiotics as well.
Getting diagnosed with MRSA is really bad news. It starts with an infection that won’t go away. Often the first antibiotic the doctor prescribes seems to have worked, but a week or two after you finish the dose the infection is back, sometimes in a new place. Sometimes you just feel generally rotten and you (and your doctor) can’t figure out why. Often you’ll be given a different antibiotic, and the cycle repeats. Eventually, after enough antibiotics have failed to cure the infection and you’ve expressed enough dissatisfaction with the treatment you’ve been receiving, you’ll be sent to the lab. There a technician will take a sample from the infection site, put it in a petri dish, and see what bacterium grows out. Then they’ll try all sorts of antibiotics to see what kills it, and you get a new prescription, this time for something that will work.
But that’s not the end of it, because you’ve been spreading the resistant strain to everything you’ve touched. If anyone you live with has an open cut, they’re a sitting duck for infection. So you’re told to wash bed linens and towels with bleach and hot water, wipe doorknobs, faucet handles, and just about everything else with bleach, and so forth.
If you’re lucky, you’re cured and nobody around you picks it up. If you’re not – well, MRSA kills about 16,000 people each year. So it makes sense to learn how this common bacterium came to be so dangerous.
I was a child in the days before antibiotics existed, at least as far as prescription drugs were concerned. If you were born in the 50s or later, it must be hard to imagine a world in which a strep infection could kill you. A blister on my father’s foot in the late 1930s turned into a raging streptococcus infection and we almost lost him. I don’t know what saved him, but it wasn’t an antibiotic. A few years later, my best friend’s sister died of a strep throat. The drug sulfanilomide came on the market during World War II and reduced the fear and threat associated with strep infections.
Staphylococcus, a different family of germs, was common then, too, but the ailment it caused, known as impetigo, was a skin infection of minor importance, most common in small children and blamed on digging in the dirt. (Whether that was true or not I have no idea, but the common belief was that the mothers of children who got it didn’t keep them clean enough.) The treatment didn’t require a doctor and there was no hiding that you had it. The medicine of choice was a liquid called gentian violet, so called because of its bright purple color, like the gentian flower, although it is not made from gentians, nor does it come from violets. But if you had impetigo, you had patches of bright purple skin and there was no way to hide the infection. Typically, it wasn’t covered because it was believed that contact with the air helped it heal.
Let’s pause now, and reflect upon the fact that strep skin infections are almost unknown these days and a strep throat generally keeps a kid home from school for a few days – often less if the child isn’t dosed with a fever-reducing drug, because strep begins to die at 100 degrees Fahrenheit. (Average normal temperature taken by mouth is 98.6 F, so 100 is a slight fever. Most doctors will tell you it should be let alone.)
And staph, which used to be cured by painting it purple, has offspring that can thumb their metaphorical noses at the drugs designed to kill them. How did this come about?
The answer comes in two parts. First is the infatuation of the Western world, especially America, with antibiotics. For generations after they came on the market (penicillin appeared on drugstore shelves shortly after WW II) doctors prescribed antibiotics for anything that looked like an infection, including an upper respiratory tract infection – that is, the common cold, which is caused by a virus and not a bacterium and is therefore not susceptible to antibiotics. Millions of babies got antibiotics for ear infections, again not likely caused by bacteria.
Giving antibiotics to people who don’t need them gives bacteria the opportunity to figure out at their leisure how to develop the ability to resist them. It took a while, but eventually doctors learned to reserve antibiotics for the times when they were really needed. Early on, they faced resistance from their patients and, especially, the parents of their patients, who expected to go home with pills when they came in sick. If that sounds like you, think again. Insist enough and the doctor will probably pull out the prescription pad rather than lose you as a patient. Do you want to be treated as a spoiled child, or with good medical practice?
But there’s another source of antibiotics that you may never have thought of: the meat you eat. (No, this isn’t going to be a vegan manifesto. I’m a carnivore, I evolved from carnivores, and I’m not about to tell you to do something I wouldn’t do myself, such as give up eating meat.)
These days, however, much of the antibiotic resistance that makes strains of staphylococcus such a threat comes from the way beef cattle are raised – on crowded feedlots, fed corn and grains to fatten them up, in conditions of such filth that they often have to stand in their own excrement. That’s appetizing, isn’t it.
To keep these animals from getting sick, feedlot operators give them antibiotics, just as doctors used to do to people who didn’t need them. You know the rest of that story, only instead of taking the antibiotics yourself when you don’t need them, now you’re eating them along with the meat from beeves who didn’t need them.
There are two ways to protect yourself – one expensive but fast acting, the other the price of a phone call or three that will take longer to be effective, but will spread the benefit around even to those who know nothing about needless antibiotics and the ills they cause, or who deny the truth of it.
The first: either switch to bison for your red meat (expensive, but delicious) or stick to free-grazing cattle that never see a feedlot. This, too, will probably cost more than run-of-the-mill beef. But you might find another family willing to go in with you on a whole cow raised by a farmer near you and processed at a slaughterhouse close enough to the people it serves to have to keep its facilities clean and inspected.
The second: Put some telephone muscle behind H.R. 1549 and its senate companion S. 619. Originated in the House by Rep. Louise Slaughter (D-NY28) and in the Senate by the late Sen. Ted Kennedy, both were filed March 17, 2009 and sent to committees, where they remain. It’s time to get them unstuck and out for debate and vote. Concerted attention to the cosponsors might do it.
The two bills have the same title: The Presentation of Antibiotics for Medical Treatment Act of 2009. The purpose: To amend the Federal Food, Drug, and Cosmetic Act to preserve the effectiveness of medically important antibiotics used in the treatment of human and animal diseases.
Basically, what the bills do is instruct the Secretary of Agriculture to withdraw approval for the use of antibiotics in cattle being raised for food when used for purposes other than curing illness. The law would take effect two years after passage. Today operators can give antibiotics without a prescription. Two years after the bill becomes a law, antibiotics for cattle will be available only on the strength of a veterinarian’s prescription.
The House bill has 108 cosponsors. The Senate version has 17, and some are Republicans. You can click here for the senators and here for the representatives who should be called and asked to get this bill out of committee and onto the floor. If you want talking points, click here and read Section 2, which provides the rationale behind the bills in plain English.
Legislators can decline to receive messages from people who don’t vote in their state (for senators) or district (for representatives), but it won’t hurt the bill’s chances if you call out of state or district, and it just may help.
And it doesn’t even have to be a toll call. Here are some toll-free numbers that will get you to the Capitol switchboard, where you may ask to speak to your senator or representative by name: 1-866-220-0044; 1-877-851-6437; 1-800-839-5276.
If you’re too shy to phone, you can always send a fax. To find the right fax numbers, go to www.senate.gov and www.house.gov. Don’t bother sending paper mail; Homeland Security is still fumigating every blessed piece of paper that comes to the Capitol (and probably to the White House, too, although I don’t know that for a fact.) Even postcards get the treatment. The delay, I’m told, can be up to three months.