The Effects on Human Health of Subtherapeutic Use of Antimicrobials in Animal Feeds (1980) / Chapter Skim
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2. Measuring Effects on Human Health from the Subtherapeutic Use of Antimicrobials in Animal Feeds
2. Measuring Effects on Human Health from the Subtherapeutic Use of Antimicrobials in Animal Feeds
Pages 12-21
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From page 12... ...
3. Was the Salmonella resistant to drugs when the infection occurred or did it acquire resistance through transfer of an R factor from the patientts resident microbial flora?
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From page 13... ...
cold strain from another person or from ingestion of contaminated meat? If the resistant strain was acquired from another person, was that person infected via the food chain and did the food chain begin with an animal that had received subtherapeutic doses of antimicrobials?
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From page 14... ...
disease in farm workers handling feed containing antimicrobials, when compared to rates in nonfarm groups, may be due as much to differences in sanitation in the work and home environments as to the acquisition of resistant pathogens from animals. Surveys are conducted frequently because they are relatively inexpensive and generally quite rapid.
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From page 15... ...
Thus, if it were possible to select a large number of subjects and randomly assign them to groups that are or are not exposed to animals fed antimicrobials or to the products of those animals, useful information would undoubtedly accrue. The performance of experimental studies with humans may be questioned on ethical grounds if there is any known or theorized hazard of the exposure being investigated.
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From page 16... ...
Similar studies should be conducted of employees, their families, and a comparison group of neighbors employed in other occupations to determine whether their microflora follow patterns like those observed in animals. At the next several steps in the production chain -- the slaughterhouses and wholesale and retail butcher shops -- bacteriological studies of carcasses, the work environments, employees, their families, and their neighbors should be pursued over time to determine whether changes in the indices of drug resistance occurring in the production facilities can be traced through the processing plants.
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From page 17... ...
Attempts should be made to trace the spread of Salmonella infection in these communities, identifying wherever possible cases attributable to contact with or consumption of contaminated meat and those due to secondary spread from person to person. The nature of antimicrobial resistance in other pathogens causing illness in these communities should also be investigated to ascertain the extent to which R factors arising from therapeutic and subtherapeutic antimicrobial use in animals are transferred between microbial species and constitute a health problem.
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From page 18... ...
Study Groups Carcasses Meat handlers Family members Neighbors PHASE 3: COMMUNITIES Study Groups Households selected on the basis of probability sample Cases of salmonellosis Other cases of infectious diseases caused by bacteria Study Procedures Bacteriological indices (as above) Human illness caused by bacteria Study Procedures Bacteriological indices (as above)
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From page 19... ...
Overt diarrhea caused by Salmonella, acute urinary tract infections in young women, and other illnesses related to infections with enteric pathogens all have extremely low incidence rates. Thus, any study attempting to relate an increase (po+sibly a small increase)
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From page 20... ...
The foregoing discussion makes it clear that isolated studies on parts of the transmission chain cannot be used to quantitate the overall effects on human health resulting from the subtherapeutic use of antimicrobials in animal feeds.
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From page 21... ...
The studies are presented as an indication of what the committee believes to be the most fruitful approaches. They will not provide a direct assessment of the effects on human health resulting from subtherapeutic levels of antimicrobials.
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