Kitchen Karate: How to protect yourself from superbugs while cooking

Antibiotic use in our food animals fuels the growth of “superbugs” in those animals. Those bugs then contaminate the meat – beef, pork, chicken, turkey, and even fish – that we bring home. This puts us at risk for infection by those bacteria, infections that are harder to treat and sometimes untreatable.

Those are the words of Dr. Lance Price, Director of the Antibiotic Resistance Action Center at the George Washington University School of Public Health, and “chef” in the (live, not animated) video below.

Though we should bring home meats labelled “no antibiotics,” Price’s message is that the kitchen is the place to confront foodborne bugs. And the number one weapon at our disposal? The faucet.

The faucet is the most important tool in the kitchen because you should be washing a lot of things when handling meat – cutting boards, knives, counter top, and especially your hands.

 

Surprisingly, though, you shouldn’t be washing the meat because that just spreads bacteria all over the place, says Price.

And as far as the crucial hand washing factor is concerned, which seems so straightforward, it appears that most of us are way off the mark:

 

What Anita Hill Can Teach Us

 

If there isn’t a word or phrase for something, does that something exist?

According to the Washington Post, the Trump administration, without warning and without giving reasons, has ordered the Centers for Disease Control and Prevention (CDC) to stop using certain words in their budget documents and in communications with Congress. The words are “evidence-based,” “science-based,” “vulnerable,” “fetus,” “diversity,” “transgender” and “entitlement.”

The Post reports that CDC staffers were stunned by what they say is an unprecedented act of censorship. Swift condemnation followed from across the science community. For example, here’s part of a joint statement called Reports of Censorship in Federal Budget Document, issued by the Infectious Diseases Society of America (IDSA), the HIV Medicine Association, and the Pediatric Infectious Diseases Society:

We find this unacceptable and disturbing… When ideology, fear, and ignorance dominate discourse in the public health arena, consequences are deadly. More than three decades ago when HIV first appeared in the U.S., the federal government’s unwillingness to acknowledge the epidemic and to allocate resources allowed the HIV epidemic to expand further and faster…. Timely intervention could have saved many thousands of lives. (Emphasis added.)

 

The allocation of resources, i.e., government funding, is a crucial determinant of health. As Jack Halberstam, professor of gender studies at Columbia University told Democracy Now, when you prohibit these words in funding requests to Congress:

[I]t has the effect of suppressing the exact kinds of health projects that people might submit that are based [on] and are in relationship to, people of color, queer people, women. Those are the targeted groups in that list. And it’s a very—or not very subtle way of saying, ‘We don’t particularly care about delivering … healthcare to those people.’ (Emphasis added.)

 

The IDSA charge that the ban constitutes an “unwillingness to acknowledge” a problem or a category of people is a very serious one, especially given our history with AIDS. But there’s another equally serious problem that’s caused by stripping the CDC of critical language – a basic inability to even think about let alone publicly acknowledge, the health issues of vulnerable people.

To understand this induced inability to tackle an issue, take another look at the story that’s front page news across the country: the sexual harassment of women in the workplace. Historically, there was an unwillingness to tackle it. But in the very beginning the issue wasn’t so much unwillingness as it was an inability to tackle it, and that inability was also grounded on what’s happening at the CDC – the lack of critical language.

In 1974, professor Lin Farley ran a Woman and Work class at Cornell University where she unexpectedly discovered that every one of her female students had been forced out of a job or fired because they rejected the sexual advances of a male boss. My God, Farley thought, it can’t be just this group of kids; but sure enough, further study convinced her that across the country women labored in hostile work environments ruled by men.

But Farley had another problem – no one knew what to call this phenomenon. No word or phrase then existed to describe the pathology she was witnessing. So she invented one: “sexual harassment of women on the job,” thereby giving birth to (1) the ability to talk about the subject and raise the consciousness of men and women, and (2) the ability to hold transgressors accountable.

Accountability was the issue on October 11, 1991, when University of Oklahoma law professor Anita Hill, using the charged language of “sexual harassment,” sought redress not for herself, but for a nation. In a publicly televised senate confirmation hearing for U.S. Supreme Court nominee Clarence Thomas, professor Hill, sitting alone at a table, facing some of the most powerful men in the country, provided painful, detailed, credible testimony of the prolonged sexual harassment she suffered from Thomas, who had been her boss at – of all places – the Equal Employment Opportunity Commission (EEOC).

Though Thomas was eventually confirmed – narrowly, the vote was 52 to 48 – some things began to change. For example, women filed twice as many sexual harassment complaints to the EEOC over the next few years.

But the coming out moment for sexual aggression had to wait until October 5, 2017, when the New York Times, in a groundbreaking report, revealed multiple allegations of sexual harassment against powerful film producer Harvey Weinstein, which led to the resignation of four members of the Weinstein Company’s all-male board, and to Weinstein’s firing – and that was just the beginning.

Innumerable similar allegations have spread far and wide ever since. So much so that Wikipedia has a new entry called the “Weinstein effect,” defined as a global trend in which people come forward to accuse powerful people, mostly men, of sexual misconduct.

And that trend will be publicly adjudicated in the United States by non-other than Brandeis professor of law and social justice, Anita Hill. On December 16 this year professor Hill was appointed to head the Commission on Sexual Harassment and Advancing Equality in the Workplace. It was created by Lucasfilm and the Nike Foundation to tackle widespread sexual abuse and harassment in the media and entertainment industries.

And remember those senate confirmation hearings? They were chaired by then senator Joe Biden who last week, according to Time magazine, finally acknowledged how badly Hill was treated: “I wish I had been able to do more for Anita Hill. I owe her an apology,” Biden said. “My one regret is that I wasn’t able to tone down the attacks on her by some of my Republican friends. I mean, they really went after her.”

So far so good. But imagine something. What if an order came down stripping Hill of some of the critical language she will need to do her work. For example, what if Hill’s funding was conditioned on her not using the words “sexual harassment.” And she was further ordered not to refer to young actresses as “vulnerable,” or say that her findings were in any way “evidence-based.” That, of course, would be absurd, it would be cruel – it would never happen.

But that’s exactly what just happened at the CDC. Where the victims are once again women, plus some of our most vulnerable – transgender people, communities of color, and everyone living with and at higher risk of HIV – and their partners and families.

With the wisdom of being able to look back on it all, Anita Hill says:

People in power are actually the ones who often exhibit the worst behavior. And they’re setting the tone for others in their workplaces that women are not to be valued. That’s the real tragedy.

That’s the reason the CDC story is a tragedy – precisely because the Executive Branch has knowingly increased the number of people who are “not to be valued.”

 

MRSA goes to the beach

 

Dr. Tara Smith’s research group from Kent State’s College of Public Health spent two summers on a MRSA hunt at a place rarely checked for the bug – the beach.

From April to September in 2014 and 2015, Smith’s group collected a combined 280 sand and water samples from 10 freshwater beaches that lie on the shores of Lake Erie in Northeast Ohio. They were looking for Staphylococcus aureus and methicillin-resistant Staphylococcus aureus (MRSA) and found a higher-than-expected prevalence for both: Staph aureus was found in 64 sand and water samples (23 percent) and MRSA in 23 samples (8 percent). Most of the bugs were found in June and July when it’s the hottest and most humid.

Smith’s findings matter because with all that exposed skin minor cuts easily occur. And that’s all the opportunity Staph needs to turn a non-event into a severe or life-threatening illness such as sepsis or endocarditis. As Dr. Smith’s paper reminds us, “roughly 11,000 people every year in the United States die of staph and MRSA-related disease, while the bacteria cause another 80,000 invasive infections and millions of skin and soft-tissue infections.”

Here’s the good news: “Simply using the showers that many beaches provide to rinse off after being on the beach or in the water can help you avoid carrying that bacteria home with you,” Smith says.

And for those lucky enough to have a backyard pool: Although Staph and MRSA are able to survive for extended periods of time in freshwater (and seawater), “they are killed within 24 h in properly chlorinated pool water.”

How parents can introduce their children to the world of microbes and disease

How do you get kids to brush their teeth and wash their hands when your rather dodgy argument is that, if they don’t, millions of invisible creatures will invade and make them sick? To bring that world to life, here’s a clever story told from the perspective of Staphylococcus aureus – “but you can call me Staph” – that rounds the bases on important issues without using the fancy words. For example, why do bugs live in us – what’s in it for them? What has this “crazy evil thing called antibiotics” done to their lives – and to ours? And the big question: Will they get a happy ending – that day when our poisonous antibiotics will no longer threaten their lives?

All that and more in 4 minutes:

Bacteria are like opossums – they live stupid and have a lot of offspring

 

Bacteria are essentially DNA wrapped in a coat. No brain, no spinal cord, no ability to think. So why, then, do we say they “outsmart” us? Is it really, as we so often read, an “arms race” between us and “clever” bacteria who have begun to “outsmart” us and our drugs? Or is there something else going on that better explains things?

Mike Apley, a veterinarian, and professor of medicine and clinical pharmacology at Kansas State University’s College of Veterinary Medicine, offers us an alternative view of bacteria:

Bacteria are like opossums; they live stupid and have a lot of offspring. It’s not that the bacteria outsmart us, but it’s that there are so many offspring with so many different mutations that the ones that can survive multiply, and we have a new, adapted population.

 

Apley is nobody’s fool. Aside from the above credentials, he was also a member of President Obama’s prestigious Advisory Council on Combating Antibiotic-Resistant Bacteria.

To understand his seemingly silly statement, take a look at the standard diagram used to teach antibiotic resistance. The trick is in going from step 2 to step 3. Question: What did the two (antibiotic resistant) bacteria do in step 2 that was so “clever” that resulted in so many of them in step 3?

 

Answer: Not a thing. They survived – that’s all they did. And then they did what bacteria do all day – they had “a lot of offspring.” So now we have a ton of bacteria all of whom are resistant to our drugs – Apley’s “new, adapted population.”

So if it’s not a case of us being outsmarted by the bacteria, then what’s going on here? In Apley’s view, it’s just your basic case of evolution and natural selection – which isn’t what most people think it is.

Carefully thought through, the antibiotic resistance diagram – going from step 2 to 3 – corrects this common yet crucial misunderstanding: Bacteria under threat from antibiotics don’t change by acquiring the trait of antibiotic resistance, thereby “outsmarting” us. Instead, what happens is that those few bacteria that already possess the trait of resistance to antibiotics, survive the onslaught of the drug and go on to reproduce.

This Khan video smartly explains what evolution is and isn’t. To get the most out of it, keep in mind that the example they use of an advantageous trait selected to be passed on to future generations – longer legs – is analogous to the advantageous trait of antibiotic resistance in bacteria that they, too, pass on to future generations.

 

Oh Canada: Why so many antibiotics?

 

A report released this month from the non-profit Canadian Institute for Health Information (CIHI), says antibiotics are prescribed more frequently in Canada than in other Organisation for Economic Co-operation and Development countries. For example, in 2015, more than 25 million courses of antibiotics were prescribed in Canada – the equivalent of almost 1 prescription for every Canadian age 20 to 69.

A CIHI statement released with the report condemns these numbers:

 

Our data shows that there is overuse and misuse of antibiotics across the country. The unnecessary use of antibiotics can be harmful for vulnerable patients, decreases the effectiveness of antibiotics over time and puts us at larger risk of antibiotic resistance.

 

And why does it matter if, due to overuse, antibiotics are losing their effectiveness? Because hospital-acquired infections are “frighteningly common.… They are the fourth-leading cause of death, with 8,000 to 12,000 Canadians dying of them every year,” said Dick Zoutman, physician director of the Community and Hospital Infection Control Association of Canada, to The Globe and Mail. Simply put, if we lose more antibiotics we lose more people.

The CIHI report is timely because with the coming of cold, flu, and pneumonia season, we, the people, have a crucial role to play in preserving the effectiveness of antibiotics: stop demanding them for illnesses they don’t treat. As the Centers for Disease Control and Prevention reminds us:

 

Antibiotics do not fight infections caused by viruses like colds, flu, most sore throats, and bronchitis. Even many sinus and ear infections can get better without antibiotics. Instead, symptom relief might be the best treatment option for these infections.

 

Here’s a handy reference:

 

 

 

Here’s Two of the Best Reports Ever Done for the Public on Antibiotics and Antibiotic Resistance

Since the World Health Organization has declared November 13 – 19 to be Antibiotic Awareness Week, we thought we’d post two resources that remain some of the best stuff ever put out on the subject. So for that reason and because they were both made a few years ago, we’ll repost them here to help keep them in the public view.

The first is the PBS Frontline investigation, Hunting the Nightmare Bacteria. Infectious disease specialist Brad Spellberg, MD, who runs the Los Angeles County-University of Southern California Medical Center, calls this report a “phenomenal story.” (Spellberg’s book, Rising Plague, remains a timely, valuable resource.)

Frontline updates this webpage with recent developments in the field. For example, The Trouble with Chicken looks at poultry, pathogens, and factory farming, a subject making headlines again because of Maryn Mckenna’s new book, Big Chicken.

 

 

And the Harvard School of Public Health ran a public forum called Battling Drug-Resistant Superbugs: Can We Win? Don’t worry that it’s Hahvud – this discussion is utterly user friendly. As one of the panelists, a pioneer in the field of resistant disease, remarked, “If I had $800,000 to spend on fighting infectious disease I’d spend $700,000 of it on educating the community. They need to be a partner in using antibiotics properly.”

We reported our takeaway at the time under the title A Message From the Harvard School of Public Health: Please Stop Asking for Antibiotics.

 

After a disease outbreak is over does that mean the germs have gone?

Dr. Tara C Smith, Professor of Epidemiology, Kent State University College of Public Health

“Not usually,” says infectious disease researcher Tara C Smith, PhD, in her new essayThe Unforgiving Math That Stops Disease. Take, say, measles, mumps, or rubella. After a large outbreak, the viruses will linger, but the level of immunity in the population is high because most susceptible individuals have been infected and (if they survived) developed immunity. Consequently, the viruses spread slowly.

Meanwhile, Smith explains, new susceptible children are born into the population. Within a few years, the population of young children who have never been exposed to the disease dilutes the overall immunity in the population to a level below what’s needed to keep outbreaks from occurring. The virus can then spread more rapidly, resulting in another epidemic, often in 5 to 10-year intervals.

From the bugs point of view, they’re simply lying in wait until there’s a sufficient number of susceptible children around so they can have a breakout year. In the case of measles, each infected child will infect 12 to 18 others.

So is there some way to protect susceptible children? Yes: we can vaccinate them. Furthermore, with measles, if about 95% of the population had immunity to the virus – acquired either through vaccination or having survived the disease – we would also be able to protect those who can’t be vaccinated due to infancy, illness, or old age.

Important new study on the benefit of the pneumonia vaccine

For infants across Ontario, pneumonia hospitalizations and related costs were eventually cut almost in half – 45% & 46% respectively – after the province approved a vaccination program for that age group. In addition, pneumonia hospitalizations also declined “substantially” for vaccine-ineligible older children and people over age 65, due to herd immunity. This reduction for the elderly is quite significant because they have a higher risk of death from pneumonia hospitalization than for any other reason, according to the Harvard Medical School.

Ont vax2

 

 

The Spread

When antibiotic resistance develops anywhere, it is a threat to people everywhere. That’s the point so nicely illustrated in the graphic below. Using the antibiotic resistance conferring NDM-1 gene as an example, it shows its spread from India (ND = New Delhi) to over 80 countries over a 10-year period.

Genes confer traits in bacteria in much the same way they do in us. For instance, various genes confer in us traits such as height, hair color, and risk for disease. Similarly, in bacteria, genes confer traits for survival such as an increased resistance to antibiotics, increased virulence, and bugs that are more contagious. In fact, those are the very traits found in a deadly new strain of pneumonia in China that scientists say “is likely just a matter of time” before it too escapes its country of origin.

 

Borders 3

 

Another antibiotic resistant gene of interest is MCR-1, which we profiled last year. Like NDM-1, it’s also on the move. A report last month by the Center for Disease Research and Policy at the University of Minnesota noted that in China, “MCR-1-harboring bacteria, mainly E. coli, were detected in 71% of water samples, 51% of farm animal fecal samples, 36% of food products, and 28% of human subjects.”

The question, then, is what can we do to protect ourselves. One of the best reports ever done on antibiotic resistance remains the 2013 Frontline piece, Hunting the Nightmare Bacteria. One of its segments, Eight Ways to Protect Yourselves From Superbugs, offered some good news: “Everyone may be at risk, but the chances of catching a drug-resistant bug outside of the hospital are small for most. For the average healthy person walking down the street? Those organisms are not much of a threat.”

However, that was before the detection and spread of the MCR-1 gene, and the emergence of the new and deadly strain of pneumonia mentioned above which NPR reported on here. And so the preventive measures that Frontline offers – e.g., proper hand washing with soap and water, getting the annual flu shot, and taking antibiotics only if you absolutely have to – would seem to be even more important now than before.

 

 

 

 

 

Related Posts Plugin for WordPress, Blogger...

Staypressed theme by Themocracy