Microbes Getting Smarter, Eh?

Hi Deepak and Gauri! We’ve been hearing about this complex and scary thing, ‘Antimicrobial Resistance’ (AMR). Can you please unpack it for our kids?

AMR is indeed scary. It happens when bacteria, viruses, fungi, and parasites that cause infections in us, humans, become resistant to the medicines we use to kill them. Thus, these microbes can no longer be killed and it becomes very difficult to treat our infections.

The major problem pertains to the growing resistance among bacteria against antibiotic medicines. This is commonly known as antibiotic resistance. When bacteria is exposed to antibiotics, some weak bacteria may die. But there are many strong ones which survive the antibiotic action. Such resistant bacteria continue to grow and multiply into more antibiotic-resistant bacteria. This is how, more and more resistant bacteria make the antibiotics ineffective in treating our infections, especially the ones caused by bacteria in children, like, ear infections, diarrhoea, lung infections, etc.

Some bacteria also become multidrug resistant, which means that they become resistant to more than one antibiotic. These are called ‘superbugs’. It can also happen that they become resistant to all the antibiotics available such that no medicine is able to kill them. In such cases, our diseases become untreatable and even common bacterial infections can cause death.

The sound of ‘superbugs’ is alarming. How problematic is AMR really?

Just as COVID-19, AMR is also a pandemic. But the difference is that unlike COVID, AMR is invisible. While COVID prevailed for a limited duration, AMR continues for many years. It worsens over the time and is expected to remain active even in future, if we do not act upon it. AMR silently kills many across the world every day and is, therefore, known as a pandemic of ‘silent’ nature.

In 2019, about 5 million deaths worldwide were estimated to be linked with antibiotic resistance. About 1.3 million deaths were caused directly because of bacterial AMR. This statistics is just for one year. Can you imagine the impact it will cause silently over many years? The impact is huge. This means that unless it is addressed, AMR will keep adding to our deaths.

It is estimated that by 2050, about 10 million people could die each year as a result of AMR. This could mean that it will cause about 3 deaths in every 10 seconds. It can heavily impact our livelihood, food security, and development, mainly, in the low-and-middle income countries.

We’ve heard that AMR is a big issue in animal farms. Can you help us connect the dots between such farms and us?

Most of you don’t know but apart from us, humans, antibiotics are also used in the poultry, dairy, and fisheries sector. They are mixed with animal food and are fed to chicks to make them grow faster and fatter so that their meat can be sold quickly and at high prices. They are also given to help hens lay more eggs and, particularly, to avoid diseases among them. All this is done so that the animal farmers incur less losses.

But what is alarming is that these antibiotics are being indiscriminately used in the livestock sector in spite of them being critical for treating humans. This means that there are high chances that the bacteria present in animals—to which these antibiotics are given—will develop some resistance and when we happen to consume these animals or their products, we’ll gain this resistance too. For example, resistant bacteria and antibiotic residues can remain in the eggs, milk, and meat produced in such animal farms. If not cooked well, they can enter our body. Most importantly, if we use these antibiotics anytime later for curing our illness, they will be useless on us. If we catch any disease, then they may not work, which is really worrisome.

Moreover, both these things—resistant bacteria and antibiotic residues—can also be present in the animal waste produced in these farms and then they can enter our food chain. Thus, antibiotic-resistance can spread out from farms in multiple ways.

So, you suggest that we should minimise giving ‘antibiotics,’ to our livestock?

Yes. Particularly, the set of antibiotics which overlap with human use and are critical for saving our lives.

For example, we have seen that in India, 27 critically important antibiotics were used in rearing chickens, fish, and dairy cattle. Few among these are ‘highest priority critically important antibiotics’ because they are the last option for treating certain infections when even common antibiotics don't work. Therefore, if we minimise their use in our livestock, then we can keep these life-savers for us and our future generations.

So, which medicines should we give to our animals? How else can our farmers keep them fit and fine?

We should look for alternatives to antibiotics, like ethnoveterinary medicines. These are simple herbal preparations which can be made at home using some readily available ingredients.

There is a big project that is currently studying the effectiveness of these medicines in treating diseases in milch cows. The project is led by the National Dairy Development Board and is called the Mastitis Control Popularization Project. Based on its results so far, ethnoveterinary medicines are successful in curing several diseases amongst cattle, particularly, mastitis, fever, and diarrhoea with a cure rate of about 80 per cent. They have also been successful in curing indigestion among them. This is very interesting as such herbal preparations are not only helping us save the use of antibiotics but are also being low-cost, easy-to-prepare and, most importantly, providing us with safe and antibiotic-free milk! Hence, they are very farmer-friendly.

Also, regarding the fitness of their animals, farmers should ensure that they provide better rearing conditions to prevent any outbreak of diseases among their livestock. They should rear breeds which are naturally disease-resistant; and provide them with clean water, better sanitation, and waste management facilities. They should give a spacious environment for their animals to thrive, instead of cramping them in a small area, and avoid a mass-scale use of antibiotics for triggering their growth and preventing diseases. The antibiotic dosage should also be restricted to disease-treatment and that too when clinical symptoms are evident to a veterinarian.

General public should also minimise the use of antibiotics, especially for diseases which are otherwise preventable through herbal medicines. Use of chemicals or antibiotics is not going to help. Real prevention lies in preventing the occurrence of diseases at their source.

As experts, how will you suggest our kids to prevent the impact of AMR? I suppose, we should definitely stop using antibiotics frequently and go herbal.

First and foremost, we need to be aware and educated about AMR and also make others aware on this subject.

Our kids should note that antibiotics should not be purchased without a doctor’s prescription and we must always complete their course, even if we are feeling better. We should not share our antibiotics with anyone. Expired or any leftover/unused antibiotics must NOT be thrown in dustbins. Instead, we should dispose them separately to avoid their misuse. Lastly, you all must have heard that ‘prevention is better than cure.’ So, we should adopt better hygienic practices, like hand-washing, drinking clean water, and managing our waste properly. This way, we will remain healthy and not require any medicines or antibiotics. In fact, we should invest in alternatives of antibiotics as it is always best to avoid them.

(This was first published in the 1-30 November 2022 edition of the Gobar Times.)