The Responsible and Prudent use of Antimicrobials on Irish Pig Farms Denis Healy
Antimicrobials/ Antibiotics - history Developed from the 1940s Treat Bacterial infections human, animal Intensive farming practices growth through 1970s onwards Pig industry ---1970 to date concentrated development
Pig Industry Use of antibiotics (ABs) in feed In feed treatment and prevention of lung and gut infections. 1970/1980s ---was use widespread? Antibiotic growth promoters in feed Legal up to 2006
Misuse /overuse of ABs in Pigs in 80s/90s real or perceived! Dept of Agriculture concern with usage Concern re residues in pig meat National Sampling Plan for ABs in pig carcases enhanced through late 1990s 55,000 samples annual Too many AB positives
Action Positive herds flagged sampling of herd 2 months Cost herdowner Enforcement of medicines regulations Information /advice to herdowners Awareness withdrawal periods
Result Major improvement Drop in AB positives to very low levels Since 2009 - annual ABs positives in pig meat ranged from 0-3 pigs. Enhanced consumer safety Good news story
Misuse of ABs in pigs-is it History? New Problem!! OLD NEW Antibiotic residues Pig farmers have addressed this issue. Vigilance-continued Antimicrobial Resistance
Antimicrobial Resistance {AMR} Human health animal health issues Antibiotic families Tetracyclines, B- Lactams/Penicillins, Quinolones, Sulphonamides Some bacteria showing complete resistance to common ABs WHY??
Concerns re use in Animals Therapeutic crisis?? Usage under scrutiny - growth promotion ban - restriction of CIAs/ prophylaxis Transfer of resistant bacteria/genes via food (ESBL E. coli poultry) direct contact ( MRSA CC398 pigs) environment Human situation is the driver
Global - Public Health Priority WHO OIE (Animal Health -International) Food & Agric Org. of UN (FAO) Codex Alimentarius Eur. Comm.
Antimicrobial Resistance (AMR)
public health priority 25,000 deaths in EU annually WHO AMR EUR 1.5 BILLION (lost productivity, healthcare) 4 million patients/year acquiring a healthcare associated infection
Commission Action Plan
E.U. Commission Action Points awareness on appropriate use of ABs Strengthen EU laws vet meds and medicated feed Recommendations prudent use surveillance on AMR and on use of animal medicines
Pig Farmers Is AMR your concern? Medical profession over prescribing! Vets and Farmers Shared blame/responsibility. Why worry?
Zoonotic Bacteria Cause disease in pigs and in humans E. Coli, Salmonella, Staphylococci, Campylobacter. Resistant bacteria---e.g. Salmonella Typhimurium (DT104). Treatment failure-major public health issue
2013 Irish Pig Industry AB s Use Farmer attitude? reuse in feed, water, injectables Why worry No meat residues - complacency Resistant bugs - not visible, not tangible. No penalties on producer No effect on pork sales
Data on Irish AB s Use (food animals) None definitive IMB 90 tonnes AB s annually of which 40% + in pigs Compare to Denmark / Netherlands
Pig Population 1,700 active herds 1.35 million pigs 140,000 breeding pigs 1.2 million fats 18.50% of herd with >500 pigs 1.5% herds with >10,000 pigs 1.5% (26 herds) = 30% of total pig population
What does DAFM know re AB use in Pigs? DAFM licences (med feed) Compound feed mills (20) and Home mixers (40+farm mills) DAFM knows pattern of use Creep, Link, Weaner, fats, sows Cause for concern!
Research Results Highest level of resistance to older antibiotics Tetracyclines, sulphonamides, ampicillins Greater levels of resistant E.coli on farms using high levels of ABs in feed Highest in weaners most in feed use! Resistance to Macrolides (Tylan)!!
Factors influencing higher than acceptable use some farms Viral diseases PRRS, PMWS, Bacterial infection real or not Farmer unwilling to stop in feed medication Why change pigs doing ok! Full scientific investigation - costs money. Will I get an answer?
Feed mixing /delivery systems One wet mixer Sows and weaners Only 1 st weaners need treatment Residue carryover to non target groups Result risk of resistant bacteria in herd
General Mixer + Satellite tanks YES / No Problem solved? Tank feeds 1 st stage weaner - 4 week cycle Problem many AB s licensed to treat for 7-10 days - NOT 4 weeks = RESISTANCE? Problem if purchasing or home mixing -yes Problem for prescribing vet - yes Feed mix/delivery systems changetarget small group for short time
Lack Of Water Medication Why? Cost Medicines poor availability? Practical or not if wet feeding Dutch, Danes success Ireland - Must evaluate
Veterinary Services One farm: multiple vets - Why? One vet is main advisor but All ABs purchased from other vets / pharmacists Scripts for med feed who writes VWD Custom and practice Evidence of communication failure vet to vet, farmer to vets
Do pig farmers know the prescribing vets legal responsibility? Vet must visit farm (not once a year) but Use of ABs on pig farms is unavoidable but justify use science & diagnose Sufficiently often & recently enough to have accurate picture of the CURRENT health, welfare and disease status of the pigs Vet should not be asked to prescribe or supply if he/she has the full picture of the disease status
High Pig Density high usage of AB s? Not necessarily true but - all stages on same site difficulty in breaking cycle of infection Insufficient disinfection/ rest time at critical points of production
Bio-security Failure Have a documented bio-security programme Train /educate all employee Transport of pigs Slaughter Offal Enforce the plan - No exceptions
The way forward - Prudent use of ABs E.C ---Guidelines being drafted Ireland - working group - national policy developing Real targets ---over 5 years Focus to mass medication large groups pigs France-target by 25% --5 years Holland ---target 70% by 2015.
Prudent use cont. Denmark on way to 50% and falling Irish pig industry ---what can you do Failure to target a decrease - not an option Primary responsibility lies with End user pig farmer Prescribing vet (small number of specialists).
Farmer and Vets Farmer ---consider multiple changes to production practices Later weaning Diet Increased space for young pigs Adapt feed mixing/delivery systems Water medication Alternative treatments acids in feed
Farmer One Primary veterinary advisor---contracted Herd health programme a must have Roll over use of in feed medication not the future ---changing times Follow proper course of treatment; Any decision to change treatment MUST have veterinary input that is science based Record keeping National data base of use of ABs in pig herds---- think of the benefits to the industry
Veterinarians Antibiotics cannot be used on farm unless vet prescribes Custom and practice of in feed use of ABs for longer than acceptable periods needs to be tackled Herd health programme ---the full package + one vet practice primarily responsible for the herd s health. Pharmacovigilance: Prescribing vet needs to monitor that usage of ABs is correct
Veterinarians cont. Educate clients Dangers of misuse Limit supply of critically important drugs Preach husbandry Bio-security Advise attendance at Teagasc courses, etc
DAFM Data base ---considering the centralised collection of data re use of medicines from Vets Pharmacists and Farmer Data re antimicrobial resistance in pig herds - versus the use of medication
DAFM Medicated feed licences Collate usage data from feed mills &home mixers Prudent use in feed will be a condition of licence Sanctions Denmark operates a yellow card system for vet and farmer. Option! Incentives: Funding? Feed systems adapt/alter fit for purpose. Industry plan!
AMR - the Irish Pig Industry Think AMR Individual producer - have a plan/target Prevent diseases Reduce use of Abs - be proactive Dictat from Brussels!! - avoid Lead from the front Think reputation, markets; profits. Result - healthier industry.