Animal & Veterinary
Session VIII Questions and Answers
DR. FRYE: We are going to pause for a moment to take questions and comments. We have just heard from our colleagues in the industry. Many of you might not have the opportunity to hear these comments and talks that often, so Pat and I thought we would just take five or ten minutes, if people wanted to make some comments now. If not, I don’t see anyone jumping up to the microphone, then we will just continue with the other talk.
So is there anyone, please come to the center. It looks like no one right now. Steve wants to say something.
MR. ROACH: Actually, I have a question for Tim Cummings. I am just curious. Is Flavomycin effective against necrotic enteritis in broilers? I am just curious as another drug as opposed to option for bacitracin and virginiamycin. I am just curious because it is not one used in human medicine.
DR. CUMMINGS: I am not sure I understood the question. You asked me if Flavomycin used --
MR. ROACH: -- yes, or bambermycin. Is it effective against it?
DR. CUMMINGS: The activity to bambermycin is not strong against the Gram-positive organisms.
MR. ROACH: Okay. So it is obvious. So the two options you mainly use are the virginiamycin and --
DR. CUMMINGS: I am not saying those are the only two options. What I am saying is of the majority of that use in the feed -- they are not in all feeds by the way. They are only in just selected feeds during the growing process. Bambermycin is a very miniscule amount anymore.
DR. CERVANTES: The only other approved for a control of necrotic enteritis in broiler chickens is Lincomycin. Flavomycin has no activity what so ever, the MIC is over 800, whereas for virginiamycin it is 0.025 or something like that.
DR. BARZILAY: Ezra Barzilay from CDC. I guess -- this really odd. I wanted to direct a question to Tom, but I am facing backwards so I am going to switch this way. I am really glad for the presentation. I think this is really important information.
I would like to caution a little bit trend information. We have struggled with trends for several years as evidenced by the fact that we don’t actually publish trends until they -- some of them will be forthcoming and we are beginning to do so more so in the latest presentations. There are still on the top of my head, looking at the presentation -- there are still a lot of inconsistencies with data that we publish and I want to make sure that the data that is in the report is appropriately communicated label that it is not misinterpreted by folks reading it.
We really want our stakeholders to look into it, to use the data, but I want to make sure that we don’t disagree in what the data shows. I personally disagree with the interpretation of the trending. I think that we are not seeing everything declining in every which way. So I think that the time course that we look at trends has to be fixed for every one of the things that we look at.
But very specifically, there were -- some of the numbers and we can take it up after the presentation. It is not important to go over, but I just want to make sure that we are not making a misrepresentation in a report of what some of these numbers are showing.
One of the key things in the disconnection between the slides you showed and our report from 2007, we published as an appendix exec sum (sic) report, the new ceftiofur/ceftriaxone breakpoints which are now fully adopted and used in 2008 which pretty much bring up the human ceftriaxone results much higher, almost 4.5 percent as opposed to 0.3 and 0.2 percent which eliminates the discrepancy we have had in this inconsistencies.
There are several places that I don’t think we are in entire agreement with the numbers and I see some folks nodding from the team.
I would like to go over them with you afterwards if you don’t mind terribly. But I would like to again -- this is not specific to the data points presented -- I would like to throw a little bit of caution for everybody in terms of trends. The caption of NARMS changed in a couple of places very specifically and trends are a very, very complicated thing to look at. It is not as simple as saying, “Well the percentage was such in such year” “In such and such year ---we have been presenting it pretty much in every report so far.
In the 2008 reports and starting with the 2009, we are going to attempt to show something more meaningful in terms of trending and I hope that our stakeholders will find it useful.
Dr. Ng: I just want to raise a question when I observed one of the meetings, that whatever we do in foodborne infectious diseases in the farm-to-fork area, we also have to consider how we fit into patient care. It raises the point by the veterinarian that they also want to consider animal health.
So for antimicrobial resistance threat in human health, our focus very often is not on enteric diseases. They are, in fact, very few treatment failure and typhoid which is different and that would require treatment. I think that if we have a problem in funding in solving this problem, we have to bring some relevance on the genetics chance of these resistant genes moving into diseases that actually require antimicrobial treatment.
For Neisseria gonorrhea, it has demonstrated that it acquires very often of the resistant genes from enteric pathogens. As a result, they become resistant. I think that whether, in fact, we are to learn from the Korean program that we may have to have other stakeholders look at what we are protecting in human diseases and how do we make the relevance of antimicrobial use in human relevant to what is used in agriculture and food animal production.
I do not have a solution, but it is a complex issue and we use in humans, similar to animals in treating diseases. But how the two fields merge with a common goal of protection overall human health and overall animal health. I still do not know how it is going to happen if individual diseases go individual ways.
DR. McDERMOTT: I wanted to make -- maybe it is a question, maybe it is a challenge. But one thing I want to comment on is I was really glad to hear offers from industry to help address the sampling issue.
I think we all recognize that is a high priority challenge for us right now and spelled out by the Science Board. Tom, I couldn’t agree more with you and the Science Board that we want this data to be as sound as possible.
That is what NARMS is. NARMS is a data generating program and I appreciate the sensibility surrounding the regulatory actions that encumber those who are practicing. Our job is to make sure any of those decisions are really well informed.
I think it is time for this program to back up and really look at the sampling part because if you get it wrong there you then a lot goes wrong. If you go get it right then you go a long way to ensuring reliable data.
So I just want to say, you know, thanks to the poultry and swine producers who seem to have a willingness to work us and we are eager to work with you too to try to address the sampling issue.
I hope that, perhaps, the turkey and cattle industries will see a value in that too.
DR. FRYE: Okay. It looks like nothing further at this moment. We will hear our last two presenters. Ruth Lynfield from Minnesota but who is representing the Infectious Diseases Society of America will come up.