Recent FDA rulings prompt important questions

About a month ago, the Food and Drug Administration (FDA) ruled that antibiotics should not be used in livestock for the purpose of promoting growth. As with most FDA rulings, they do not garner a lot of weight as their decisions are non-binding. In a surprise however, many livestock farmers who were polled about the ruling have stated that they would comply with the ruling. For years, we have seen the outcome of use of antibiotics in livestock as the numbers of antibiotic resistant bacteria types and associated infections rise. Now that the FDA has taken this intervening step, we now have to consider finding a balance in this process. Antibiotics still have a place in the raising of livestock as a means to insure that one sick animal does not infect an entire herd. As a preemptive action, antibiotics should still be used and used judiciously to reduce the potentially devastating economic effects of the loss of livestock due to illness.

A few days after the antibiotics ruling, the FDA also asked manufacturers of antibacterial products to conduct additional research to prove that an active ingredient, triclosan is safe for long-term use. Triclosan has been shown in lab testing to have deleterious effects, especially on children. In lab rats, triclosan has been shown to decrease thyroid hormone, affect metabolism and reproduction. These companies have to prove that triclosan, in it’s current formulation will not have these long term effects or will, if not shown have to reformulate their products without triclosan. It is interesting to note, the FDA first ruled on the use of triclosan in 1978, when it was in limited use. As the use of this chemical has expanded. the FDA felt it was in the interest of consumers to call for this review in advance of a potential new ruling on triclosan’s use in 2016.

FDA rulings have very little teeth as far as compliance and enforcement are concerned. I have been saying for a few years now that the role of the FDA needs to be drastically changed in order to better serve the needs of consumers and to insure that rulings truly have the force of law behind them. Without any major changes on the horizon, it will appear that the only way that proper regulation is in place will be via the legislative branch through the passing of new laws that will reduce antibiotic use and if triclosan is shown to be problematic in long-term use, that the chemical be regulated more closely or outright banned for use. Before that, we need to have alternatives, safe alternatives to triclosan so that our antimicrobial products still have usefulness in this era of unprecedented antimicrobial resistance.

Additional reading: FDA antimicrobial resistance strategy
Press release on safety of antimicrobial soaps

Media Misfire on Bacteria in Water Fountains

Part of teaching microbiology to my students who look to become the health care practitioners of tomorrow is also educating the public at large about the risk of microbes. I take this very seriously and I read as much of the latest research as possible in order to do this. Even a short presentation to an academic audience requires a lot of preparation to provide as much useful and timely information as possible. I am a bit distressed however when I see news reports that distort or twist information in such a way that could cause panic among the general population. Case in point, I was watching the Fox DC morning news yesterday morning when a report came on about drinking fountains and bacteria. As I watched this report, there were some points discussed that I took major issue with. In summation, the research took place in Tampa, Fla along the Pinellas Trail where water fountains are placed for those that traverse the area. Of the ten tested water fountains, water from three contained bacteria commonly found on toilets, cell phones and purse bottoms.  First, the sample size of ten cannot be applied to the population of water fountains as a whole. This research (as first reported by the The Suncoast News) states that the Pinellas trail water fountains and others in various sites around the area were being tested for harmful bacteria and to alert county officials of any findings. At no point in this article were any of the researchers making any claims that these findings could be common nationwide. So why was this report delivered in such a way that these and other facts listed in the article were not discussed?

Watch the report:

Many factors were ignored in this report in addition to the small sample size. The environment where the water fountains are and the activities that occur at these water fountains. Researchers observed walkers allowing dogs to drink directly from the fountain, so that could account for this area but not all water fountains have this source of bacteria as a problem. Also, if the infrastructure providing the water is intact, how much of a role could the animals in this environment contribute to the increased bacterial numbers? Fox DC in my opinion could create a mini stir among the general population with this report by nit-picking out the major details and focusing on the pieces that made this a “story.” When talking to an audience that wants news and needs to hear as much as the facts as possible, this story does a disservice to all. Explaining scientific concepts or more importantly public health interest research requires that ALL of the facts be laid out and explained in a way that minimizes fear and panic and places emphasis on informing and offering common sense solutions as the research can support. This was a very disappointing job of presenting interesting information for the sake of ratings and sensationalism.

Water and Infectious Diseases

Hello all! It has been a while since I have written. I am trying to slowly work my way back into writing more regularly. I have been busy in a very good way and here is one of those good ways. Last semester, I did a talk for a colleague’s seminar and the link is below. I hope you enjoy and provide feedback.


I have not and will not go gentle into that good night…

My poor, poor blog! All lonely and unused.  Academia has been good to me once again but it has kept me very busy. I am surprised that this blog hadn’t turned against me! I briefly forgot my password but it serves me right. I have been away way too long but much has happened, many lessons have been learned and from these lessons new ideas and a new way of thinking about what I do not only as an educator but as a Public Health Practitioner.

The way I want to use this blog has changed but that is what blogging is about, using the tool for the current environment. Lecturing my students on microbiology has been a blast and I am slowly working my way back into a rhythym and yet I see the void that exists in the world on how we view our delicate balance (or inbalance, depends on who you ask) with the microbial world. What do I want to do now? Well not too much from what I am doing now, just  doing it more often and concentrating on critically analyzing how changes in the microbial world are and could affect us. It seems that we spend a lot of time talking about all of the bad that occurs, new emerging diseases, reemerging diseases and how the microbes are winning.

We have had some good things happen:
— Rinderpest is on the path to eradication
— There is a new vaccine for the African meningitis belt, 300 million people are being targeted for the vaccine
— A Rapid TB test device has been created and recommended for use by the WHO
— There is a new push in polio vaccination in Africa.

Those were off the top of my head, but there are other things that are happening good for us as we do the constant tango with the microbial world. Of course there have been some other events of a political nature such as the Pope and his adjusted stance on condom use, but I would not want to use this blog as a political box but a change in stance (albeit very minor) can make a huge difference in how we address HIV/AIDS from an educational standpoint.

But really, if we all make some changes wouldn’t that make a huge difference in how we take the fight to the microbes? Will the new Food Safety Bill passed in the Senate give us better tools to ensure the safety of our food? We love food so much in this country that we have to save ourselves from ourselves. But it is not all about our love of food, it is also about the producers who love our money yet they give us substandard food. Do they do it out of greed? Depends on who you ask. I say it’s probably about 50/50, many are working to do the right thing but lack resources (money, manpower etc) to ensure that they are prepared. When the inspector walks in, they do the best they can but know they are wrong. The other half banks on the fact that inspections are few and far between and work to see how long they can get away with producing food products in less than desirable conditions. Should there be heftier consequences for these producers?  There should be, I am all for it!

All of this and everything I discussed in this blog entry make for great conversation and make excellent teaching points not only to those who are studying to work as health care professionals but for the general public as well. How we address the problem of infectious disease can take on many facets from the scientific, economic and political. But one thing is clear, each element has a place in the discussion and we cannot be afraid to neglect one area for fear of being one-tracked in our thinking on the subject. As I have said many times, coming together and putting our heads together is what is needed in order to best solve our collective problems.

Academic Mysteries

Teaching Anatomy/Microbiology as well as General Biology to restart my academic career, this time around as a full-time professor. I am finding that when you have been out of the game for a while, there are some areas that aren’t as polished and there are some points of information that one is used to delivering have either changed or need to be reviewed. Never thought the Microbiology part of my brain would be lacking but it is a bit. I found myself stumped by a question from a student but I was stumped because I did not do my due diligence to prepare for what was a minor point of  the topic of bacterial shapes and arrangements.

In order to redeem myself for what I felt was a bad day (the Labor Day holiday must have had a bigger toll on me than what I thought) I did the research that I should have done when I taught this class several years ago. What is the difference between a tetrad and a sarcinae of bacterial growth? Originally, I thought I had the answer but what I thought made no sense so I had to relent and say I had to do my homework.  I did solve the “mystery” and I will share the solution at a later time as I get back to more of the new discovery, research and education based entries I do here.

My other major issue now with one of my courses is trying to find an interesting, interactive activity for the microbiology portion of my Health Science course. I really want to incorporate the Public Health portion into the lectures and add some practicality to the class. I think my students will get so much more out of it. I am following a Professor on Twitter who is using the site as an educational tool to discuss HIV in her class and have her students tweet in response or when they find a topic that is related (with the appropriate hash tag). I don’t know if I would require students to get a Twitter account for a course, but I would like to do something that is technologically advanced, holds my students interest and has little dependence on social networking. Not to say that social networking is not important, it can prove to be a powerful tool as each person can learn from each other. My concern  is thinking about the possible wide divide amongst my students in technological comfort as well as how much some students interact with technology. Both of those items are related but my goal is education and not to make anyone feel left out with increased use of technology. I am going to keep thinking about this, I still have some time before I start the microbiology portion but if anyone has any suggestions, feel free to let me know.

Medical Travel and Disease

The New York Times reports this week that a new mutation has emerged which makes bacteria resistant to all antibiotics. The mutation has been discovered in India and Pakistan and is reported to be found in patients from the UK and the US who travel to this region to receive medical treatment. The mutation labeled NDM-1 according to the article has microbiologists and physicians worried that this could be the mother of all mutations. However, it is too early to tell if this is the case. How does a mutation come about and why is this mutation of concern?

Bacterial cells reproduce via cell division. A single bacterial cell creates a carbon of itself in multiplicative fashion. If a bacteria has basic characteristics (whether it causes disease or not), it will pass on those characteristics to it’s carbon copy. Bacterial cells obtain additional characteristics, such as antibiotic resistance through the uptake of a plasmid. A plasmid is a smaller, circular form of DNA which can give bacterial cells a variety of new characteristics and codes for ways by which the new characteristics can be expressed. Antibacterial resistance can be coded in bacteria in ways such as giving the bacteria the ability to synthesize enzymes to affect the antibiotics action or the bacteria can create structures called porins which shuffle antibiotics out of the cell. Plasmids, like the DNA that is innately in the bacterial cell is constantly undergoing evolutionary change and new characteristics can be created.

In a previous post, I discussed factors which have increased the spread of disease globally. Travel across the globe is one of the major ways by which disease can be introduced into susceptible populations. Medical travel to obtain treatments for a variety of aliments has been ongoing for many years. In this day and age, more and more people have used medical travel in the wake of loss of insurance, being denied claims or lower cost for certain medical treatments. Travelers returning from the India/Pakistan region to their home countries potentially could harbor this resistant bacteria. Only then and with time will we know if this is the super resistant bacteria that we have been fearing it’s arrival.