The Catastrophe of Antibiotic Resistance

March 6, 2015

By Medical Discovery News

The Catastrophe of Antibiotic Resistance

The World Health Organization has categorized antibiotic resistance as “a major global threat” and multidisciplinary research teams estimate it could lead to 10 million deaths each year by 2050. Bacteria that cause disease in humans can become resistant to the drugs used to treat them, and this poses a growing problem to public health.

Antibiotics were first introduced in the 1940s with the discovery and development of penicillin and saved many people from otherwise life-threatening infections. This one class of drugs has had an incredible impact on decreasing the severity of infections and saving lives.

Lately antibiotics have become overused and misused, which has allowed bacteria to mutate in ways that render antibiotics relatively powerless. Bacteria were one of the earliest life forms on Earth and remain one of the most successful, present everywhere from Arctic glaciers to geothermal springs. Because they are masters of adaptation, exposure to antibiotics causes the bacteria to accumulate mutations that will allow them to ignore the action of the antibiotics. That’s why doctors should only prescribe an antibiotic in the likelihood of a bacterial infection, and why it’s important to take all of the prescribed doses of an antibiotic. Otherwise, you can give the bacteria enough contact with the antibiotic to mutate but not enough to kill them, and they can come back stronger.

Half the use of antibiotics does not come from a doctor’s office or hospital, but a farm. Chickens, pigs, cows, and other livestock raised for food production are fed antibiotics to prevent infections and for faster weight gain. Many countries now ban this practice, and in 2013 the U.S. Food and Drug Administration (FDA) asked pharmaceutical companies to voluntarily curtail the sale of antibiotics directly to famers. Today, 26 pharmaceutical companies will only issue antibiotics for animals with a veterinarian’s prescription.

Infections by drug-resistant bacteria can be twice as likely to result in hospitalization and death. And while some bacteria are resistant to a single antibiotic, others are resistant to many. Methicillin-resistant Staphylococcus aureus (MRSA), multi-drug-resistant Neisseria gonorrhea, and multi-drug-resistant Clostridium difficile are superbugs taking a devastating toll worldwide. Some bacteria have mutated against all forms of antibiotics normally used to treat them, leaving no effective treatment options. Such infections are occurring around the globe in both rich and developing countries.

Legislation in the U.S. Congress proposes to permanently ban antibiotics that are used in humans from being used in livestock as well.  However, some argue that there is not a clear link between the antibiotic-resistant bacterial strains generated in livestock practices and those seen in human disease, which requires more intense research to answer. Whatever the outcome, the emergence and spread of antibiotic-resistant bacteria must be stopped. We also desperately need to develop new antimicrobials human use.

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Why Is Polio Still Around?

Dec. 29, 2012

By Medical Discovery News

An Afghan health worker administers the polio vaccine to a child during a vaccination campaign in 2010 in Kabul, Afghanistan

After plaguing humans for thousands of years, polio is on the verge of being wiped out. In 1988, the virus was endemic in 125 countries, but today it exists in only three: Nigeria, Afghanistan, and Pakistan. With scientists so close to eradicating polio, their work exhibits a renewed sense of urgency.

Polio, also called poliomyelitis or infantile paralysis, is caused by a virus that can infect nerves and lead to partial or complete paralysis. Between the 1840s and 1950s, polio epidemics occurred worldwide, paralyzing or killing half a million people each year.

All that changed in the 1950s with the development of polio vaccines. Over twenty years ago, the World Health Assembly resolved to wipe polio from the Earth by 2000. They got pretty close. During that time, healthcare workers immunized over 2 billion children. 

Since humans are the only reservoirs for polio, there’s an opportunity to eliminate the disease yet that hasn’t happened. Why? Inadequate funding is a major barrier. For example, an 18-month action plan devised by the World Health Organization needs $945 million to be fulfilled.

Logistics and politics are even bigger obstacles. Getting the vaccines to children in remote areas is complicated or made impossible by geopolitics, many of which are anti-U.S. or anti-Western. The Taliban has banned vaccinations in northern Pakistan, an area it controls, to protest American drone strikes. In one of the safe havens inside Pakistan, a local community worker helping with the campaign against polio was shot and killed. Just days before, two gunmen shot a Ghanaian doctor working for the WHO and his Pakistani driver, who were also participating in a polio vaccination campaign. 

Some of the violence is driven by a distrust of humanitarian and healthcare workers. A polio vaccine program in Nigeria eight years ago was undermined by rumors that the vaccine was unsafe and part of a nefarious plan to sterilize Muslim children.  

The CIA exacerbated this distrust by using a fake vaccination campaign to locate Osama Bin Laden. It planned to use DNA obtained through administering a Hepatitis B vaccine to identify Bin Ladin’s children and therefore find the terrorist. The ruse enraged locals, along with critics who blame the CIA for damaging the fragile relationship healthcare workers built with local communities in the anti-polio campaign and other vaccine programs. Furthermore, community workers in these areas became even greater targets of terrorist organizations.

Such complications leave polio-free countries at risk for imported cases. Chad, a country bordering Nigeria, has documented a few cases from people crossing the shared border. An outbreak in China in early 2012 that paralyzed 17 children and killed two is believed to have come from Pakistan.

Already this year, over 100 cases of polio have been reported, although they could have been avoided with a 50-cent vaccine. A valiant effort by multiple nonprofit and governmental agencies is now underway to rid the last vestiges of this disease.

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