Is ABF production supporting or contradicting bird welfare? Maarten De Gussem, DVM Poultry Vaccinology - Ceva Summit March 14th 2016, Barcelona

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1 Is ABF production supporting or contradicting bird welfare? Maarten De Gussem, DVM Poultry Vaccinology - Ceva Summit March 14th 2016, Barcelona

2 Overview 2 Scope and introduction Why do we use antitibiotics and can we reduce without affecting welfare? What antibiotics will we have in the future? How can we deal with less AMB, what are the alternatives? Conclusion

3 Quiz time? 3 Who is this? Because it is more efficient Because it makes the poultry industry more profitable More eco-friendly (lower FCR) More healthy????? More welfare????? Less antibiotcs per kg meat produced?

4 Scope In some areas, high income mainly, ABF production is gaining ground ABF? No growth promotors No growth promotors or preventive antimicrobials No growth promotors, preventive or metaphylactic use No growth promotors, preventive, metaphylactic or therapeutic use of (human) critical AMB except if documented no alternative No growth promotors, preventive, metaphylactic, therapeutic use of (human) critical AMB at all No AMB at all, except ionophores No AMB, including ionophores 4

5 5 Scope In some areas, high income mainly, ABF production is gaining ground We can grow any of the above.but what does society want and how can we influence that We should teach society, consumers and policy makers (including retail!), that for us all is possible, but ABF will/can affect welfare if not done in the right way

Scope ABF can be voluntary (marketing!) and obligatory (NW Europe Scandic and Netherlands) Usually the latter will affect welfare at least for a transition period Fighting ABF is. Pointless.

6 Scope ABF can be voluntary (marketing!) and obligatory (NW Europe Scandic and Netherlands) Usually the latter will affect welfare at least for a transition period Fighting ABF is. Pointless. It can be anything from a huge commercial opportunity to a welfare disaster. Stop wasting your time to question the authority of non professionals to debate on the subject! (been there done that ). It is no fun, and zero result. Use the opportunity! Know what you talk about, and don t waste the crisis! 6

7 7 Good veterinary practices Welfare

8 8 Good veterinary practices Use of medicinal products In some countries distribution is done by feed mills, integrations Field Veterinarian has limited to no power, or does not exist (technical advisors very often trained on experience mainly)

9 GVP and AB resistance issues 9 Conflict between welfare and therapeutic restrictions GVP : should follow the law For main indication BE: not a single product registered, if cascade, what about withdrawal times? Some countries: no more treatments because of public pressure! For sure on this moment flocks are not been treated because of blunt rules for restriction of AB Maybe good for HRI, but not for welfare!

10 GVP and AB resistance issues 10 If more diseases tomorrow, (for whatever reason) should the Dutch treat less and make the birds suffer?? No logic behind linear AB reductions Better to focus on Good Antibiotic Use: No more treatments than needed to safeguard health and welfare, product quality Treatments follow logic: always first assess low risk HRI to high risk HRI Broad spectrum: not logic if diagnosis is done, and one disease agent is present Only treatment after a flock-based documented diagnostic with high standards (peeping in the house is not enough)

11 Overview 11 Scope and introduction Why do we use antitibiotics and can we reduce without affecting welfare? What antibiotics will we have in the future? How can we deal with less AMB, what are the alternatives? Conclusion

12 12

13 What bacterial pathogens are important in poultry? Gram (e.g. Salmonella spp., Pasteurella spp., Bordetella spp., E. coli, ORT, ). Gram + (e.g. C. perfringens, Staphylococcus spp., Streptococcus spp., Enterococcus spp. Mycoplasma spp. (lack of cell wall) E.g. M. gallisepticum, M. synoviae,

15 Split of AB use in poultry EU (2016) 15 AB type (est.) Broad (G+/G-) Narrow (G-) Narrow (G+)

16 16 Split of AB use in poultry EU (2016) Indication (est., own data) Gut health (G+) Respiratory (G-) Systemic (G+/G-) Other (G+/G-)

17 Respiratory/systemic health in Poultry years ago, respiratory/systemic infections main indication for AB Today a lot less (vaccinations) When AB treatment is done, relatively easy to isolate bacteria and establish antibiogram Much less problems with bad use antibiotics

18 18 Gut Health in Poultry: 2016 Gut health most important!! Vaccination for gut health issues far behind The gut lumen is considered outside body, a similar protective level is needed as e.g. skin So fundamental problem in solving gut health issues No antibiogram possible: not one type of bacteria involved, not all are cultivable We need to use AMB based on general rules

19 Gut Health in Poultry in 2016 (EU) 19 Organisms compromising gut health Bacterial: mainly Clostridium perfringens (Necrotic Enteritis - rare), Clostridiaceae (Bacterial Enteritis, BE ubiquitous G+) Outside EU controlled by Growth Promotors Parasitological: mainly Eimeria spp. causing clinical but mainly subclinical damages use anticoccidials Viral: turkeys accepted. Chicken black box (adeno, reo, astro, ) Feed Quality and Management (!) +/-70 % of total AB use in poultry!

20 Vicious cycle of pathogenesis of BE High feed intake, high NSP levels, coccidiosis, viruses... 1 Presence of nutritional factors that favour some bacterial groups and disfavour others causing disbalance Bacterial Enteritis Vicious Circle 2 Less functional gut De Gussem, Copyright 2015 VETWORKS 20 Inflammation and oxidative stress caused by interference of microbiota with mucosa

21 Overview 21 Copyright 2016VETWORKS Scope and introduction Why do we use antitibiotics and can we reduce without affecting welfare? What antibiotics will we have in the future? How can we deal with less AMB, what are the alternatives? Conclusion

22 What do we have today?? 22 Antimicrobial class Antimicrobial Spectrum Veterinary Human Antimicrobial class Antimicrobial Spectrum Veterinary Human Macrolides Folate pathway inhibitors tylosin narrow G+ Y Y trimethoprim broad Y Y tylvalosin narrow G+ Y N sulfonamides broad Y Y erythromycin narrow G+ Y Y Lincosamides (50S) spiramycin narrow G+ Y Y lincomycin narrow G+ N N tilmicosin broad Y Y Amphenicols (50S) Beta-lactam - penicillins florfenicol broad N N penicillin narrow G+ Y Y Pleuromutulins (50S) Beta-lactam - extended spectrum penicillins tiamulin narrow G+ N N amoxicillin broad Y Y Tetracyclines (30S) ampicillin broad Y Y oxytetracycline broad Y Y Beta-lactam - third generation cephalosporins chlortetracycline broad Y Y ceftiofur broad Y Y doxycycline broad Y Y (Fluoro)quinolones Aminoglycosides (30S) flumequine narrow G- Y N spectinomycin broad G- Y N enrofloxacine broad Y Y gentamicin broad G- Y Y difloxacine broad Y Y neomycin broad G- Y Y Polypeptides paromomycin broad G- Y N colistin (polymyxin E) narrow G- N N Critically important for humans (WHO) bacitracin narrow G+ N N

23 Link AMR humans animals? Looks simple but.. What will be the impact of reduction of antibiotic use in food animals? Very difficult to measure but EU precautionary principle One World One Health. 23

24 Epidemiology of AMR is very complex 24

25 25 Where are the issues with AB today - poultry? Typical mistakes (same as in human medicine!) : Often AMB are used according to principle: if it doesn t work, it doesn t harm Often diagnosis is not done, broad spectrum is used to cover all Broad spectrum very often used while small spectrum would be enough AMB used sometimes to overcome management problems or to avoid vaccination costs AMB are to be used under GVP (Good Veterinary Practice) With proper diagnosis and monitoring of resistance But ethically AMB cannot be refused to birds that need treatment

26 Benefits Antimicrobials / Antibiotics 26 AMB safeguard welfare, reduce mortality and improve performance If used correctly, they are also economically interesting If not correctly used, economically they are not interesting They help to get short term solutions, when disease outbreak is occurring For long term solutions, management, vaccinations,. are a lot more suitable But sometimes the knowledge is not there to replace AMB, or there is a financial stimulus to use (old, generic, cheap) AMB, still used in human medicin!

27 Is reduction AB use possible?? Yes but be careful for reduction for the reduction! Today flocks are not treated although sick because of AMB reduction plans! This is against GVP! If new disease occurs that requires higher use of AB, will we allow this even when it means reduction targets can not be met? Focus should be on correct use, not on reduction (although the first will lead to the second) Real target should be to avoid resistance (such as ESBL) issues, not just AB use 27

28 28 Overview Scope and introduction Why do we use antitibiotics and can we reduce without affecting welfare? What antibiotics will we have in the future? How can we deal with less AMB, what are the alternatives? Conclusion

29 29 Diagnostics before treatment Example Flock visit Check management errors and feed quality Necropsy of dead/culled birds Necropsy of 5 living, normal birds Take proper state-of the art diagnostic samples (bacteriologic isolation, serology, parasitology or PCR) for MIC / antibiogram to make logic AB choice low HRI to high small to broad cheap to expensive only for E. coli, Enterococcus, Staphylococcus, ORT (slow) crucial Clostridium relevant?, Mycoplasma spp. slow growers Finding primary / secondary causes Find out if management changes needed Find out if vaccination programs of broilers/breeders should be adapted

30 30 Copyright 2016VETWORKS Role of other drugs/tools in AB resistance? Anticoccidials: Prophylactic as feed additive, no human resistance issues Help to improve gut health and if used correctly, reduce AB treatment need Antifungal: no human resistance issues Anthelmintic: no human resistance issues Vaccines. No human resistance issues mainly respiratory systemic Probiotics, prebiotics, acids, no human resistance issues Both an improved/increased use of vaccines, alternatives and anticoccidials can contribute to lower need for antibiotics

31 Solutions to Vicious circle of BE Reduce feed intake, limit NSP levels, avoid coccidiosis, avoid viral infections, mycotoxins 1 High feed intake, high NSP levels, coccidiosis 4 3 Suppress bacterial proliferation (AGP, antibiotics, acids, probiotics, EO,. ) Opportunity for poultry industry : Less functional gut Bacterial Enteritis Vicious Circle 2 Presence of nutritional factors that favour some bacterial groups and disfavour others causing disbalance we can do better than only using antimicrobial agents! Inflammation and oxidative stress caused by interference of microbiota with mucosa Use exogenous enzymes, use better digestible feed After De Gussem, 2010 Add B-glucan/MOS or other products for faster restoration gut morphology, reduce inflammation and oxidative stress, butyric acid, AGP,... Copyright 2015 VETWORKS 31

32 Diagnose better! 32 Very often, when wet litter occurs, Bacterial enteritis treatment is started without proper diagnosis No isolation possible, no antibiogram, only macroscopic possible in field conditions. Need for veterinarian = cost. Improve/standardise diagnostics through scoring system (0 low -10 high) Set thresholds for AB treatment - example no treatment needed only non-ab alternative treatments allowed 6-10 AB allowed, only narrow spectrum G+ Document scoring for each treatment!! Audit procedures : check threshold levels

33 BE Bacterial Enteritis 33

34 Scoring system bacterial enteritis 34 Cost of diagnostics is increased, but estimated 30-40% of AB treatments on house level can be avoided, so pay back is expected for producers. Problems Scoring system is new, training needed in the industry No uniform guidelines from authorities or stakeholders: more easy to ban Antibiotics. Some producers don t want to take the effort.believe it is cheaper to use AB Audits don t focus enough on this particular aspect of AB use for gut health

Conclusion 35 For respiratory/systemic treatments, isolation of bacteria and antibiograms should be the rule, should be checked and audited For gut health issues, more complicated Uniform

Attention in action plans (diagnosis implemented, thresholds set, choice of AMB) specifically to AMB use for gut health, can reduce ESBL-related AMB use with 99% and overall AMB use with

35 Conclusion 35 For respiratory/systemic treatments, isolation of bacteria and antibiograms should be the rule, should be checked and audited For gut health issues, more complicated Uniform scoring system needed to establish thresholds before AB treatment is allowed Narrow spectrum antibiotics do work, so no broad spectrum to be used, in order to reduce ESBL (and other) issues Attention in action plans (diagnosis implemented, thresholds set, choice of AMB) specifically to AMB use for gut health, can reduce ESBL-related AMB use with 99% and overall AMB use with estimated % Not sure if it will help to reduce ESBL issues as in humans as link human / poultry is not clear but no threat for poultry industry Alternatives can help to reduce the number of treatments needed!!

36 36 Conclusion There is a real threat of reducing welfare when ABF is applied blindly and bluntly Alternatives don t only work against bacteria, but mostly also have other features that support gut health ( as did AGP!) Alternatives, depending on the type, improve gut developmental physiology, modulate immune response of GALT, reduce oxidative stress, prevent initial damage, improve digestibility,... Reductions of antibiotic use has led to paradigm shift in thinking about gut health and its relation with performance in poultry industry Therefore antibiotic reduction is not a liability, but an opportunity Yesterdays alternatives are today standard chose the right ones and you are ready for Tomorrow!

37 Thank you for your attention Questions:

Global Overview on Antibiotic Use Policies in Veterinary Medicine

Global Overview on Antibiotic Use Policies in Veterinary Medicine Dr Shabbir Simjee Global Regulatory & Technical Advisor Microbiology & Antimicrobials Elanco Animal Health Basingstoke, England simjeess@elanco.com