Popular media has been promising the world a pandemic for some time now. But here's a frightening thought: What if the real threat isn't a genetically engineered superbug or an ambitious avian virus that makes the jump to humans?
What if, instead, something neutralizes our most basic defenses so that, for example, strep throat becomes lethal? Or a scratch on the skin?
And here's a frightening truth to go along with that thought: it's happening. It's not propaganda. It's not hyperbole. People are dying because of the overuse and misuse of antibiotics — at least 23,000 people every year, according to the Centers for Disease Control and Prevention.
Much has been written about antibiotic resistance, with some experts saying that we risk entering a post-antibiotic word. But the problem hasn't reached critical mass with the public, yet.
"This is a catastrophe in the making," says Congress member Louise Slaughter, a microbiologist and leading voice on antibiotic resistance. "If we squander the antibiotics we have and make the bacteria resistant to them, we are really heading for a critical problem. And soon."
And you're wrong if you think the use of antibiotics in livestock is a problem for meat-lovers only. Vegans and vegetarians sometimes need antibiotics when they get sick, too. So if the drugs no longer work, that's a problem for everyone.
Most people have probably heard about antibiotic resistance in the context of doctors writing too many prescriptions to pacify demanding patients, or patients not finishing a whole course of their drugs. But that's only a small part of the problem, Slaughter says. The real danger, she says — and there is widespread agreement from public health experts on this — comes from the agricultural industry.
Farmers often use antibiotics to promote faster growth in livestock, Slaughter says, or to compensate for keeping animals in unsanitary conditions. Eighty percent of all antibiotics produced in the US are used on healthy food animals.
Government and the agencies responsible for protecting public health have been inexcusably slow to respond to this potent public health threat, Slaughter says. And she blames the inaction on lobbying by agribusiness. She has been trying since 1999 to get legislation passed to ban farmers from using the antibiotics deemed by the World Health Organization to be the most medically important to humans, so that the drugs retain their efficacy. But she has been unsuccessful.
"The European Union's taking this very seriously," Slaughter says. "They know that something's happening. The United States government is just ho-hum about it."
The Food and Drug Administration's announcement in December that it would take steps to curb antibiotic use in food animals was billed by some as a game-changer. But the announcement does not excuse the agency's long history of inaction on this issue, Slaughter says, and it doesn't go far enough, because the changes are voluntarily and won't take full effect for three years.
"We don't have three more years to mess around," Slaughter says.
New Jersey resident Denise Hewitt has studied antibiotic resistance extensively. She has master's degrees in nutrition and ecology, and is a registered dietician with a longstanding interest in antibiotic resistance, food production, and sustainability issues. Hewitt says a position paper she wrote on antibiotic resistance in the late 1990's was rejected by the American Dietetic Association, now known as the Academy of Nutrition and Dietetics, because, she was told, the problem hadn't been substantiated.
Understanding and acknowledgment of the problem have come a long way, Hewitt says, but regulation and public outcry — the latter being the thing that would really make a difference — have been slow to follow.
Antibiotic resistance is an intimidating topic, she says, and until recently, people haven't been very interested in the provenance of their food.
"It's not a sexy topic that's going to draw crowds," Hewitt says. "The public really doesn't understand."
Hewitt says the public can get involved by learning about their food. That could mean joining a local community-supported agriculture project, she says, or talking to the farmers at the farmers' markets they visit.
"Maybe if someone stops at a farm stand for eggs, they inquire about how the chickens are treated or what they're fed." Hewitt says. "Farmers are very happy to share information with their customers if they are doing the right thing."
Jim DeLuca, general manager of Abundance Cooperative Market on Marshall Street, says that the farmers who supply the co-op don't use antibiotics on their animals at all.
"We ask the farmers and they tell us they don't," he says.
Of course, the big player around here is Wegmans. For a number of years, the company has sold meat and poultry that have not been treated with antibiotics or hormones. Those products come under Wegmans' Food You Feel Good About label or are labeled organic. And customers are increasingly interested in the origin of their food, company officials say.
"Our job is to listen to the customers and put the products on the shelves that meet their needs," says Kelly Schoeneck, Wegmans' vice president for meat and seafood.
Wegmans' suppliers use antibiotics primarily for treating sick animals, says company spokesperson Jo Natale. But sometimes, she says, healthy animals are treated with antibiotics at "stressful times," such as at weaning or when they're moved to a different location.
Some species are treated with low doses of antibiotics later in life, Natale says, to aid in growth.
Congress member Slaughter is grateful, a spokesperson says, that companies such as Wegmans are increasingly offering antibiotic-free options. But any use of antibiotics on animals contributes to antibiotic resistance, he says.
"The FDA admitted in 2012 that treating animals with low doses later in life was injudicious," Slaughter's spokesperson says. "And the CDC said it was not necessary and should be phased out."
If the first line of antibiotics loses its effectiveness, there's not a lot to fall back on, Hewitt says. Antibiotics take a long time to develop, she says, and there's no big financial incentive for the pharmaceutical industry to develop them.
"There are not a lot of new antibiotics in the pharmaceutical industry's pipeline," Hewitt says. "There's more money in other areas."
The latest wake-up call is an outbreak of antibiotic-resistant salmonella linked to chickens harvested at Foster Farms in California that began late last year. About 430 people have been sickened so far, according to the CDC, and the rate of hospitalizations has been twice the norm.
"What we saw with this last outbreak, that should have frightened anybody," Slaughter says. "We have been told by scientists that if we can't save some of this, that within a decade, strep throat or a scratch on the skin might be fatal. It's that serious. This is a subject that's crying out for attention now. It was crying out for attention before now."