A report in The
Week (November 22, 2013, page 9) outlines problems we face in healthcare
because antibiotics are becoming ineffective. At least 23 thousand Americans
are dying annually from infections that no longer are curable. Viruses are
becoming immune to the antibiotics used over more than five decades.
In 1945, Nobel
Laureate Alexander Fleming, who discovered penicillin, warned, “There is a
danger that the ignorant man may easily underdose himself and by exposing his
microbes to nonlethal quantities of the drug make them resistant.”
Viruses are
infectious particles smaller than any bacteria. A virus can insert its genetic
material into its host, literally taking over the cell’s functions and may
remain dormant inside cells for long periods. Some of the diseases in humans
caused by viruses include smallpox, the common cold, chickenpox, influenza, gastroenteritis, shingles,
herpes, polio, rabies, Ebola, hanta fever, and AIDS. (www.ucmp.berkeley.edu/alllife/virus.html.)
Viruses have
evolved rapidly. Since the life-cycle of a single organism may be only hours or
days, thousands of generations live, infect, and die each year. Mutations cause
a few to be resistant to a particular medication. These changes are passed on
to future generations. Those with the modification continue to infect even when
the medication is given, while those without die. Soon, the resistant viruses
dominate.
Dr. Arjun Srinivasan,
an official at the Centers for Disease Control, warns that procedures such as organ
transplants, pre-mature-infant care, replacing a catheter, and chemotherapy may
be in jeopardy in a “post-antibiotic era.” Margaret Chan, director-general of
the World Health Organization worries that problems such as strep throat or a
scrapped knee could, once again, become deadly.
We are making the
situation worse. The CDC estimates that half of human antibiotics are misused.
Some patients stop using the medication as soon as they start to feel better,
leaving many microbes to multiply. Worse negligence comes from overuse for
treating diseases not caused by a virus, such as bacterial infection, or to
which the virus is immune, such as the common cold, influenza, and gastroenteritis.
I know about the latter from personal experience this summer. I received one
antibiotic, then another, and finally cefdinir, a medication to which the virus
was not immune.
The worst offense: 80%
of antibiotics sold in the US are fed to farm animals, to plump them up and
keep them alive in their overcrowded pens. The resulting resistant viruses are
in the final product and sold to the consumer. This occurs here in central
Michigan at the invasive cow and pig factories that are springing up too
frequently in our counties. Lansing refuses to implement any reform to this
unhealthy practice.
Unfortunately the
pharmaceutical industry is not interested in developing new antibiotics. There
have been no major innovations in the area since 1987. It can require billions
of dollars to develop a new drug, but the return can be small. The average new
antibiotic loses $50 million. In 2012, Congress passed the GAIN Act to
encourage new development. The law extends patents on new antibiotics and
fast-tracks those aimed at important new pathogens. The industry wants tax
credits to help cover research and development costs.
Unfortunately, viruses
will develop immunity to the new products over time, so the process must
continue. Livestock farmers must stop pumping their animals full of these
medications, and doctors and patients must use available products only as
required.
We live in a complex
world and must insure that the pharmaceutical, medical, and agricultural
communities do what is correct for the health and wellbeing of everyone. If
Lansing and Congress do not oversee the process properly, we could face a
pandemic of immense consequences and the deaths of millions. The Great Plague
was caused by Yersinia pestis, a micro bacillus carried by fleas on rats. The next
one could be caused by a virus caught from your sick neighbor.
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