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U.S. Department of Health and Human Services

Animal & Veterinary

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The Poultry Industry by Timothy Cummings, DVM, M.S., B.S., Mississippi State University

DR. CUMMINGS: Howdy y’all. For our international guests, I am going to make this presentation in Southern dialect. I also want to thank you for this opportunity. You know, this meeting is long overdue and I appreciate the opportunity for us all just to get together from different approaches, different agencies, different organizations, different industries and bat this topic around.

I really appreciate some of the previous comments already made. I am going to have a little bit different approach. My background, yes, I am at a university, but I have had a job in production. I have been on technical service side, and now I am at a university. I really don’t have a research appointment. 

It is more of what we call a “field service diagnostic appointment.” I work a lot with the broiler companies in the state and I consult with turkey and broiler companies outside the state. So I have a good feel as to what is going on out in the field.

As a result of that, I have a network of contacts that when I was asked to consider this opportunity, I said let’s call up my colleagues and tell them what we are wanting to do. I am just going to kind of summarize, you know, the comments that were made.

(Slide)

I think we have seen the objectives of NARMS and so forth, but this kind of outlines some of the questions and input that we had. I am just going to report it.

(Slide)

What I am not going to do, I am like an earlier presenter. I am not going to inundate you with data. I mean, I am just going to make some general comments that are based on real time, real world experience.

(Slide)

So the good. NARMS in principle is a good program. Although it is not perfect, it is a good tool for monitoring antibiotic resistance. We all appreciate that. So there is support of this program, for continuation of this program if the data is allowed to stand alone. I will address that point in some later slides.

(Slide)

The bad. Not necessarily saying this is the bad. These are just opportunities I think for areas of improvement that from some of the comments. 

We would like to see the final reports in a more timely fashion. That has already been alluded to. But I appreciate there are reasons for that. 

From the poultry perspective, to be frank, a lot of comments were made that the data is misrepresented by some agencies or consumer groups, by some individuals at times. I mean, I know there are different ways of looking at this data and teasing it and so forth. We just feel like sometimes it has really been misreprentative and I know we all feel that way at one time or another.

There are just a lot of other issues pertaining to the NARMS data. For example, antibiotic usage information is not collected to make correlations possible. But that is not necessarily the answer either.

(Slide)

Then the ugly. The good, the bad, and the ugly. Okay. I will just be frank. We in the poultry industry felt like we got a bad rap about Baytril. It was removed from the market in 2005 and a lot of the comments just referred to some of these trends without true scientific justification. The NARMS data was part of that process. 

Now subsequently since that removal in 2005, the Campylobacter fluoroquinolones resistance trends have actually been pretty stable, actually increased a little bit. So the question I heard time and time again; now that the NARMS data was used to help remove the product, will the NARMS data be used to reinstate the product? That should be a legitimate question. A very legitimate question.

Also with regard to the fluoroquinolones, you just have to recognize and understand that you actually may have worsened the public health because when sick flocks are not treated with efficacious products, the pathogen load goes up. Therefore, you may have higher loads of these pathogens, these enteric pathogens that we are concerned with. So that is certainly an ugly situation.

(Slide)

But really, just to talk about this issue, this is not a new debate. This topic has been ongoing since the 1960s. Really, essentially ever since they were discovered and started to be used in animal production. The bottom line is, we are still talking about it.

Just stop and think about that for a minute. We are still debating it. There is no definitive answer as to whether antibiotic usage in food animal production is a major contributor to resistant problems in human medicine. There is still a lot of debate about that. We do not have a definitive answer. I don’t know, I think simple down here in Mississippi. That tells me something right there.

(Slide)

Here is just a very important fact. I realize I am preaching to the choir in this room. We have to understand the differences when we talk about antibiotics used for disease prevention and/or control or in the feed versus those that we use in the chicken industry for therapy in the water. These antibiotics vary widely in their modes of action, their target organisms. It is just a huge mistake to just lump them all into one bucket and talk about them all that way.

I know we have heard it in this session at some time or another. We have to take individual antibiotics and individual bacteria and discuss them separately. They cannot be all lumped or painted together. This is hugely important.

(Slide)

Now, you know, maybe this veers off a specific NARMS topic or one of my direct charges, but I do want to spend a little bit of time because I think you would be interested. How much antibiotics are actually being used by the poultry industry? 

It is difficult to get an exact figure from current distribution setup systems. I can appreciate that void. There have been attempts to fill in that void by other sources. Bless their hearts, they made good attempts but to be frank, a lot of them are flat wrong. You say how can you say they are wrong if you can’t refute it? That is a fair enough challenge.

Well, we are going to work to refute that. There is something in process that will -- there are some programs being developed. There are other ways of getting these numbers, so we are going to work to come up with these actual numbers.

(Slide)

But, even if we get those numbers, say we get the usage numbers, is that the real issue? We use antibiotics in the chicken industry, and I am specifically addressing more so the broiler industry, not the table egg laying industry, because they hardly use any antibiotics at all anyhow. They can’t. 

They work. Antibiotics in the feed work. Occasionally we get into disease situations that we have to treat for welfare concerns, to reduce mortality, for ethical concerns as a veterinarian. You know, I have sworn to relieve the suffering of animals as well as protect the public health. I have both things to consider.

The bottom line is we in the broiler industry do a great job of producing a high quality, safe and economical protein source. Don’t lose sight of that fact. We do an excellent job. I can tell you, I see it day by day, week by week. I am in it, I see it.

The antibiotic resistance issue is very complex. It is not simply a matter of matching up usage and all of a sudden resistance trends, and there is the answer. No, there are a lot of other factors and implications. Just like, what are we calling resistance, what about methodologies. I mean I could make a list a mile long.

Don’t forget just like as already been commented, there are beneficial aspects of using antibiotics. They have to weigh against the resistance. I could not agree more, we have got to look at this risk and say, “Hey, are we really trying to get to zero risk? Is that possible?” 

Also, just to make sure we are all on the same playing field because I have read comments from some individuals I thought should know better, that we deal with flocks similar to public health. We do not treat individual animals. It is population medicine.

I am just throwing this in for fun because I get this question all the time. We don’t use hormones in poultry production. How many of you knew that? 

(Show of hands)

DR. CUMMINGS: None, nada, zip, none. If you don’t get anything else, take that message with you. I travel and I start these conversations with people in airplanes. They find out I am a poultry veterinarian and the first thing they do is laugh because they do not think about chickens needing doctors. The first question I get is what about all these hormones you are using in poultry? 

(Slide)

Now, does the industry use NARMS? Yes we do follow the information. We do look at the information. As a matter of fact, we see some different trends in some things that look positive for antibiotic use, to be frank, in it. But we don’t use it diagnostically. I mean, all poultry companies, all chicken companies either have their own in-staff veterinarian or utilize consulting veterinarians, university veterinarians to help them oversee antibiotic usage decisions and therapeutic decisions. We take this very seriously as well.

We understand the product that we are putting out has to be safe. If we don’t we are out of business. We do adhere to judicious use principles. Now, are we perfect? No, there is always room for improvement, but we understand that this is a vital issue and almost always when there is a disease we are utilizing culture and sensitivity results from a local diagnostic laboratory or in-house to help with therapeutic decisions.

Now, I will just make a few comments about antibiotic uses in the poultry industry, in the chicken broiler industry.

(Slide)

To be frank, we are just not treating much anymore. We are just not. We process 95 to 96 percent of the birds we place. There are not a lot of therapeutic antibiotics being given in the water. Occasionally you get a condition pop up like dermatitis or something that there might be some treatment. Generally it is with the Gram-positive antibiotic. 

But the reasons why broiler health has been good relatively good over the last decade is -- the other issues to be frank, we don’t have many efficacious products to use since Baytril was removed from the market. We just don’t. Broilers have a short lifespan. It just depends on your market what is your market weight is selling for. It is just the reality of it. We just don’t have many efficacious products.

(Slide)

Injectable antibiotics. Now remember my earlier comment. We don’t handle individual birds in the field, but we do use injectable antibiotics in the egg when we are giving these vaccines. We utilize in-ovo vaccination technology to deliver vaccine and most companies, not all but most companies will inject eggs with either gentamicin or ceftiofur.

Gentamicin is the one most commonly used but they will rotate with ceftiofur sometimes. They do this because you do tend see an improvement in first week livability. There is a reason for it.

(Slide)

Feed additive usage. Now most companies do use some degree of feed additive antibiotics, not all again. I want you to be clear about that. I am separating ionophores from this category of feed additive antibiotics. I know ionophores are antibiotics but they are used primarily for coccidiosis control and the spectrum of activity does not have human use implications. So we separate the ionophores out from that.

But the reality is gang, the two that are really used to any appreciable degree are virginiamycin and bacitracin. Those are the two big boys. No antibiotic is also a big category anymore because the antibiotic usage trend has been over the last decade has been down in my experience and in my opinion.

If we are all concerned about bacitracin, well it doesn’t have a lot of human equivalency usage as an ointment. Virginiamycin if we are concerned about Entercoccus resistance concerns, we have a CVM risk assessment that says it was a minimal public health risk. We have another independent health risk assessment that concludes the same. So it doesn’t seem like virginiamycin is one to really focus on.

We don’t use penicillin in broilers much due to clearance restrictions and cost factors. We don’t use tetracycline in broiler production. Why? Because the Russians have export requirements that you can’t use it. So we are just really limited.

(Slide)

I appreciate someone touched base about growth promotion. I am bringing this up because of current activity in this arena. It is a term by FDA when approvals were originated decades ago. But in my opinion and in our industry’s opinion, it is frankly a term that has just lost favor with the public. 

I can tell you from a clinical perspective, from my perspective going in the field, opening up birds, looking at illness, mortality and so forth, from a clinical perspective, the growth promotion antibiotics work at least in part by controlling enteritis. So they are really preventing and controlling enteritis. You get the growth promotion as a result of that. 

So we are calling it growth promotion, getting hung up about this term. Like I have already alluded to, there is just a lot of activity surrounding what to do with these claims.

(Slide)

I am sorry to harp on this, but I had a couple who said just throw this up there. The European experiment, and I know I have some colleagues from Europe, it is just a great real world lesson. If we are talking about banning the growth promotant claims, or feed additive antibiotic classes or them because of precautionary principles, well it did lead to increased therapeutic use in Europe. Yeah, there is a period when it got stabilized, the disease, but the bottom line, the overall resistance trends on the human side did not seem to improve. I don’t think we should expect any different results. 

(Slide)

NARMS to the field. The question back to NARMS. NARMS to the field. That question has come up and I do appreciate that you can see a different picture if you go to the field versus if you are in the processing plant. But there are a lot of things we need to talk about. Will it be easier? Is it more cost effective?

There is one part of me that says we can go to the field and that will be good, but ultimately it is really the bacteria on the carcass going out the back of the plant that is really telling. That is where the focus ought to be. 

But I can tell you this, Dr. Cray, we are open to that but we will just need to discuss it further and just talk about a lot of these issues. So we are certainly open to it.

(Slide)

In conclusion, NARMS should be continued but the data should be allowed to stand for itself and not ignored. Don’t cherry pick some things. As a matter of fact, there is some data like I say that the way we look at it to suggest, for example in resistant Salmonella and some other pathogens of the last decade, resistance is either trended stable, even declined some indicating that it is not a problem. 

We will do, the chicken industry -- the poultry industry, the turkey industry, I will speak for Dr. Cervantes -- we will do the right thing. Make no mistake about that, but we don’t want to continue to have to lose products due to what we consider unsubstantiated fears. 

We want Science, we want proper risk assessment, quantitative, qualitative risk assessments that include beneficial components of it. But let’s work together. We can get something done. Let’s work together with that.

I think I have about wrapped up. I do want to leave this final comment. I mean this is a  Tim Cumming’s comment. This wasn’t -- I just get irritated when I keep hearing this term factory farms. That right there is a factory farm. That family right there is the owner of our factory farm. They are the ones who work in it. They are my friends, they are my neighbors, those are your factory farms. I hope that leaves an impression with you right there.

So thank you for your time and putting up with me.  Hopefully you understood my accent. So thank you very much.

(Applause)

DR. FRYE: Thank you Tim. Let’s bring up Dr. Hector Cervantes from the Turkey Federation.