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  1. Antibiotic use in swine production“The AASV Perspective and Direction” John T. Waddell, DVM, MBA

  2. The AASV Positions • Welfare and Pregnant Sow Housing • We have no formal position addressing antibiotics • If we had an antibiotic policy or position, it might look something like this:

  3. AASV’s Antibiotic Policy AASV: • Supports the responsible use of antibiotics in pork production to ensure public health, food safety, animal health and welfare. • Supports and promotes sound science as the basis for decision-making and policy development regarding antibiotics in pork production. • Will proactively educate and communicate to stakeholders the role, benefits, risks and most current information on antibiotic uses in pork production. • Will take an industry leadership role and partner with pork chain stakeholders from producers to consumers to develop sound antibiotic policy.

  4. Managing Antibiotic Policy Packers & Food Companies Swine Clients Veterinarians Nutritionists Regulatory

  5. Antibiotic use in food animalsPerception vs. reality • Are antibacterials necessary in pork production? • Does the use of antibacterials in pork production threaten food safety? • Does the use of antibacterials in pork production compromise human health? • What are the implications of removing antibacterials from pork production?

  6. Background: The European experiment July 1999 The EU disallows low-level growth promotion use of certain antibiotics Use of antibiotics, including feed additives, is still allowed • Disease treatment, control and prevention The EU does not restrict the import or export of meat • From animals that have received antibiotics when strict residue standards are met

  7. Efficient production/economics focus “Welfare” focus (anti intensive Ag) Low-dose antibiotic reduction focus Antibiotic use in pork productionPerception vs. reality Perception All of Europe opposes modern, “U.S.-style” livestock production Reality • Most of Europe has the same focus as U.S. producers: • Efficient production • Economics • Few European countries advocate other approaches

  8. Antibiotic use in pork productionPerception vs. reality Perception We don’t need antibacterials to produce pork Reality Responsible use of antibacterials enable pork producers to economically provide an abundant supply of safe, affordable food, while helping ensure animal comfort and welfare

  9. Antibiotic use in pork productionPerception vs. reality Perception Using antibacterials in food animals will lead to a significant increase in resistant bacteria in humans Reality Proper diagnosis allows use of an antibiotic targeted to a single bacterial category, which limits resistance concerns For antibiotic resistance to develop in humans (from animal use), a resistant bacteria must survive processing, handling, prep, colonization, infection Antibiotics overuse in humans poses greater concern

  10. Antibiotic use in pork productionPerception vs. reality Perception Antibacterial use in food animals can reduce effectiveness of human medicines Reality • Many animal medications are not used in humans • Disallowing certain uses of antibiotics in the EU didn’t reduce bacterial resistance to antibiotics in humans1 • In some cases, resistance increased1 • No scientific evidence linking use in food animals to reduced efficacy in human medicine2 1 DANMAP 1999-2002. Danish veterinary and food administration. 2 Heidelberg Appeal Nederland Foundation, 1999.

  11. People are nearly 100 times more likely to be struck by lightning than to experience treatment failure due to antibiotic use in swine.* Risk comparison1 Annual probability Being struck by lightning 1 in 550,000 Dying from a bee sting 1 in 6 million Dying from a dog bite 1 in 18 million Acquiring resistant campylobacter from macrolide-treated swine resulting in treatment failure* <1 in 53 million Acquiring resistant E. faecium from macrolide-treated swine resulting in treatment failure* <1 in 21 billion Antibiotic use in pork productionPerception vs. reality * Treatment failure is defined as longer duration of symptoms (i.e. diarrhea), progression to more severe disease or mortality. 1 Hurd, S. et al. Antibiotic Resistance semi-quantitative risk assessment. Sept. 2003 ICAAC.

  12. Antibiotic use in pork productionPerception vs. reality Perception Eliminating low-dose use of antibacterials reduces risk of resistance in humans Reality • Disallowing low-dose use may actually increase the risk of resistance1 • Without low-dose use veterinarians must use more broad-spectrum antibiotics to treat disease outbreaks • May include medicines used in humans 1 DANMAP 1999-2002. Danish veterinary and food administration.

  13. Some infections increased after removing antibiotic growth promoters in Denmark1 (1998) Human campylobacteriosis cases in Denmark 5000 4000 3000 2000 1000 0 Registered cases Year 80 82 84 86 88 90 92 94 96 98 00 1 Kilde. Statens Serum Institut (Denmark). Antibiotic use in pork productionPerception vs. reality Perception Reducing antibacterial use in animals protects human health Reality

  14. Antibiotic use in pork productionPerception vs. reality Perception On farm antibacterial use is not sufficiently regulated and may be unsafe Reality • Antibacterials are stringently regulated by the US-FDA • Agency that governs human medicine • Antibacterials have been safely used for 45+ years • All major industry associations have established responsible use of medicines guidelines, including • American Association of Swine Veterinarians • American Association of Bovine Practitioners • National Chicken Council • And many others

  15. Antibiotic use in swine productionPerception vs. reality Perception Antibacterial-free farming makes food safer Reality • Antibacterial use in animals contributes to food safety • Safe food starts with healthy animals • EU phase-out of certain antibiotic uses resulted in no discernable improvement in food safety1 • Chickens raised without antibiotics are 3 times more likely to carry bacteria that make people sick2 1 Beyond antibiotic growth promoters in food production. Int’l Invitational Symposium, Foulum, Denmark, Nov. 2002. 2 Heuer, O., Pedersen, K. et al. Prevalence and antimicrobial susceptibility of thermophilic campylobacter in organic and conventional broiler flocks. Letters in Appl. Microbiology, 33 (4), Oct. 2001.

  16. Antibiotic use in food animalsPerception vs. reality Perception Food handling impacts food safety more • In the U.S., food-borne pathogens decreased from 1996 to 2001 following new FSIS/HACCP regulations1 Medication use in animals greatly impacts food safety (negative impact) Reality • Salmonella (-15%) • Listeria (-35%) • Campylobacter (-27%) • E. coli 0157 (-21%) • Yersinia (-49%) • Shigella (-35%) 1 FoodNet. MMWR 2002; 51::352-329.

  17. Antibiotic use in pork productionPerception vs. reality Perception Disallowing low-dose antibacterials won’t affect overall animal health Reality • Withholding low-dose antibiotic use • Reveals these agents have important health benefits1 • Results in death, diarrhea and weight loss caused by E. coli and L. intracellularis increase1 1Casewell, M. et al. The European ban on growth-promoting antibiotics and emerging consequences for human and animal health. Journ. Antimicrobial Chemotherapy (52) 2003.

  18. Antibiotic use in pork productionPerception vs. reality Perception Disallowing low-dose use will reduce overall medication use Reality Withholding low-dose antibacterials resulted in an increase of veterinary oral antibiotic use in Denmark1 1 DANMAP 1999-2001. Danish veterinary and food administration.

  19. Oral antibiotic use in Denmark In Denmark, use of oral antibiotics increased significantly after the removal of low-dose antibacterials1 70,000 60,000 50,000 40,000 30,000 20,000 10,000 0 Others Aminoglycosides Macrolides Key active compound Sulfonamides + Trimethoprim Penicillins (ext.) Tetracyclines 1998 1999 2000 2001 1 DANMAP 1999-2001. Danish veterinary and food administration. Antibiotic use in swine productionPerception vs. reality Reality

  20. FA Therapeutic Antibiotic Use(Kg of active product) Danmap

  21. Antibiotic use in pork productionPerception vs. reality Perception Disallowing low-dose antibiotic use reduces overall antibiotic use Reality • After phase-out and removal of growth promotion usage, therapeutic use increased including medicines in humans1 •  62% in Denmark, 1999-20002 •  51% in France3 •  20% in Denmark, 2000-20012 •  13% in Germany4 •  7.9% in the U.K. the first year5 1 Casewell, M. et al. The European ban on growth-promoting antibiotics and emerging consequences for human and animal health. Journ. Antimicrobial Chemotherapy (52) 2003. 2 DANMAP 1999-2002. 3 Use in broiler chickens. National Statistics of Animal Health Products, 2001. 4 I & G Report, 2001. 5 Veterinary Medicines Directorate. January, 2002.

  22. Antibiotic use in pork productionPerception vs. reality Perception Raising animals without low-dose antibacterials is more humane Reality • In the EU, use of therapeutic antibiotics increased, indicating higher disease rates and compromised animal welfare • In Sweden, post-weaning mortality increased 20%1 • In Denmark, diarrhea in piglets increased significantly2 with reported increases in nursery mortality3 • Denmark’s w-f mortality is up 25% in 10 years 1 Robertson, J. and Lundeheim, N. Proc. 13th IPVS Congress, 1994. 2 Andreasen. The National Veterinary Serum Laboratory, Denmark, 2000. 3 Danish weaner producers struggle with loss of antibiotics as growth promoters. World Pork Expo Report 5, June 5, 2003.

  23. Antibiotic use in pork productionPerception vs. reality Perception Discontinuing low-dose antibacterials makes economic sense Reality • Producers and animals pay a price • Total production costs increase $5.39/pig1 • $1.47 higher health costs • $1.20 additional labor 1 Larson, B. and Kliebenstein, J. Cost of pork production with nonsubtherapeutic use of antibiotics. Iowa State University Swine Research Report ASL-R1820, 2002.

  24. Effects of removing low-dose use in Denmark Without low-dose antimicrobials1 • Mortality increases ADG • Average daily gain decreases Mortality 1995 1996 1997 1998 1999 2000 2001 1 Callesen. Effects of termination of AGP-use on pig welfare and productivity. International Invitational Symposium. Foulum, Denmark, 2002. Antibiotic use in pork productionPerception vs. reality Reality

  25. What do we really know? Reality Without low-dose antibacterials • Animal health and welfare decline • Food safety and public health will not improve • Production, medication and labor costs increase • Danish sources estimate: $76.5 million economic impact1 • Large amounts of additional natural resources will be required • Example: estimated 0.05 worse feed conversion in U.S. poultry industry • To produce the additional grain needed… • Would require plowing down a farm field 1 mile wide from New York City to Chicago 1 Frandsen, S. et al. Consequences of terminating the use of antimicrobial growth promoters in Denmark for prices of food in Denmark. Danish Vet. Inst. International Invitational Symposium. Foulum, Denmark, 2002.

  26. What next? Reality Sound science—as opposed to political decisions not based on science—makes sense for US policy on antibacterial use in food animals Veterinarians should continue working to protect their clients • Removing antibacterials results in negative consequences • Greater animal disease • Food safety risk • Increased use of therapeutics • Added cost of food production Producers should work to protect their industry • US production and trade depend on healthy, disease-free animals In all cases, responsible antibiotic use principles should be followed

  27. Sound Antibiotic Policy • Supports the responsible use of antibiotics in food animal production to ensure public health, food safety, animal health and welfare. • Supports and promotes sound science as the basis for decision-making and policy development regarding antibiotics in food animal production. • Will proactively educate and communicate to stakeholders the role, benefits, risks and most current information on antibiotic uses in food animal production. • Will take an industry leadership role and partner with food chain stakeholders from customers to consumers to develop sound antibiotic policy.