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"Antibiotic Resistance in Louisiana"

fdabramo

I situate my research at the crossroads of history, philosophy, sociology and anthropology of science. In the past, I have focused on epigenetics, environmental research, empirical bioethics and environmental justice, within and outside the academia, as you can read here, or here. Now I am focusing on antibiotic resistance, and I use it as a lens to interpret the contradictions of the last century derived by industrial production, environmental degradation and biomedical cultures.

What interests me is the (at that time) new epistemic discourse that since the Forties has been produced to explain morphological changes of organisms produce when they experience new environmental conditions or perturbations. Through an important experiment at the base of the so-called concept of genetic assimilation, Conrad H. Waddington showed that a thermic shock can produce changes in wings’ veins of fruit flies, changes that can eventually be inherited across generations, without the environmental trigger that caused them.

This focus on production and (genetic) storage of biological differences elicited by the environment is nowadays coupled with the knowledge produced through microbiome research that explains the phenotypic patterns that recur across generations.

In a thought-provoking twist, with microbiome research, the focus shifts from production and inheritance of biological differences to production and inheritance of biological similarities. Microbiome research shows that some phenotypic patterns are allowed by ecological communities of microorganisms composing all animals. Bacteria allow the development and functioning of our bodies within an epistemic framework that is now key to understand biology. The network of vessels composing mammals’ stomach is formed through cellular differentiation and expression of genes coordinated by bacteria. The same is true for our immune system that is coordinated by gut bacteria. Food, which is an important aspect of our lives also impacts on this microecology and mediates between our biological functions and functioning of means of production whose parts dedicated to food production have immense importance for our biology and our internal and external ecologies. Antibiotic resistance is one of the crossroads where culture, biology, history and the Anthropocene meet. Indeed, Antibiotic resistance shows that means of production of our societies have an even more widespread, deep and allegedly unexpected impact on the biology of animals and plants. The microorganism can indeed adapt to resist the selective toxicity of antibiotics. Moreover, bacteria can transfer their genetic code horizontally, by touch, so that we can acquire antibiotic resistance by eating food that functions as a vector, by hosting lice on our heads and many other contacts. Bacteria that are resistant to antibiotics that have been used as growth factors in animal husbandry and to prevent diseases in livestock and aquaculture, spread in natural ecosystems and can be found in wild species. Rivers and estuarine waters are places hosting antibiotic resistance.

Searching on PubMed (the search engine for biomedical literature) titles of articles containing the terms ‘antimicrobial’ and ‘Louisiana’ I retrieved just one twelve-years-old article. No results with terms such as 'Mississippi' or 'New Orleans'. The authors collected and analysed Oysters from both waters of Louisiana Gulf and in restaurants and food retailers in Baton Rouge. In most of the samples gathered, scientists recognised the presence of bacteria (Vibrio parahaemolyticus and Vibrio vulnificus) resistant to specific antimicrobials. Food production is indeed the first factor in terms of the quantity of antibiotics used. This use and related antibiotic resistance impact all the living beings present in a specific area, and can easily travel around the globe through many channels. As Littman & Viens have highlighted, a sustainable future is a future without antibiotics as “there may be no truly sustainable way of using antibiotics in the long-run, as microorganisms have shown to be almost infinitely adaptable since the first introduction of antibiotics” (Littman & Viens 2015). But in the meanwhile, we need to use them and antibiotic resistance is a phenomenon that can be better studied through environmental research, by analysing wild species and emissions nearby livestock, for instance.

The study that I retrieved focuses on Oysters. But what about antibiotic resistance conveyed through food that is consumed by the most?

What about exposures of communities that are living in highly polluted areas?

And what is the additive value on antibiotic resistance for individuals who experience the presence of industrial pollutants and that live in areas where cancer epidemics are registered?

In this respect, there is a strategy to cope with the issue of antibiotic resistance promoted by the Center for Disease Control and Prevention. The document doesn’t mention any action to monitor and regulate the production and usage of antibiotics in livestock. Nevertheless, the CDC wants to scrutinise, through genome sequencing, “Listeria, Salmonella, Campylobacter, and E. coli and uploads sequence data into PulseNet for nationwide monitoring of outbreaks and trends.” Moreover, the document reports that “In Fiscal Year 2019, Louisiana will begin simultaneously monitoring these isolates for resistance genes. When outbreaks are detected, local CDC-supported epidemiologists investigate the cases to stop spread.”

The questions that I would like to ask (to local ppl, activists, researchers, practitioners..) are:

What could be the epidemiologic characteristics (socioeconomic status, gender, residence..) of the populations more vulnerable to antibiotic resistance?

What is the additive role of antibiotic resistance for people living in highly polluted areas?

What is the impact of antibiotic resistance for people and patients living in areas where cancer incidence is high?

 

And on the long run I am interested in imagining possible strategies to not only living with the problem but also to tackle the problem itself, which means to develop strategies to answer the questions:

Why antibiotic resistance, which is known since a century, it’s a problem on the rise?

What is the role and interest of capitalism, in terms of profit-making of corporations, knowledge production and environmental degradation, in not being able to resolve antibiotic resistance?

What can be strategies of local communities to tackle the problem and to promote environmental justice in terms of alliances with ecologists, doctors, epidemiologists and other activists?

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wolmad

“Studies of traumatic event experience have shown that most people who experience an event do not develop psychopathology”

"Persons who live in a community where a disaster has occured may differ in their degree of exposure in the event. They may be affected directly, being present at the disaster site, or indirectly, having loved ones present at the disaster site or seeing images of the disaster in the media."

“The key functions of pre-disaster preparation efforts are to prevent or minimize exposure to potentially traumatic disaster-related events and reduce likelihood of additional post-disaster stressors, which are both associated with post-disaster mental disorders. Local governments and communities can reduce the likelihood and severity of disaster exposure”

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wolmad

There are 2 major groups of stakeholders described in the film, the Marine Corps and the people effected by diseased linked to the marine corps camps. The marine corps needed to grapple with the problems of waste disposal and the aftermath of how to deal with the effected people, while the people effected needed to survive the diseases, rebuild their lives, and persue justice from the military.

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wolmad

I further researched present undertakings at the chernobyl site for mitigation of nuclear effects, the pathophysiology of radiation poisoning, and how scientific evidance gained from chernobyl has effected how treatment for radiation poisoning is completed.

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wolmad

Three ways the arguements made in this article are supported includes:

  1. The article provides background information on what the narrative of an illness is and gives an analisys of what effects how a patient will percieve and present their narrative.
  2. the article presents stories of epilepsy patients in Ankara, who describe their diagnosis and treatment
  3. statistics and analytics generated by studies of the region

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wolmad
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The American Red Cross was founded in 1881 with the experiances of the Civil War still fresh on people's minds. After touring Europe and seeing the swiss Red Cross in action, Civil War nurse Clara Barton founded the American Red Cross to provide disaster relief and first aid both on the homefront and the front line. Early on, the Red Cross served to educate the public about topics such as first aid and water safety, while starting nursing programs and providing assistance to the military and military families. As new needs, such as blood donation, made themselves apparent, the Red Cross met these needs, starting donation programs and doing labratory research on the blood dontation technology and techniques starting in the 1960's.

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wolmad

Emergency response in the context of "boots on the ground" aid is not directly discussed in this article, however the greater complexities of humanitarian aid, which often do include medical emerency response, is the primary focus of this article.  This article focuses more on humanitarian efforts and gender based violence which can be important when considering the methods and social reprecussions of giving emergency aid.

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wolmad

The corrective action suggested by the film is to strengthen public health networks and response capabilities in liberia by means such as constructing more hospitals and health facilities and training more doctors and nurses to take care of the large numbers of effected people in epidemic situations.

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wolmad
Annotation of

In recent years all over the country, there has been an increase in the targeting of EMS and fire professionals in violant crimes, a few of which this article goes into detail describing. More recently, buget cuts have reduced the number of available officers in the response area served by the Bethel Township Fire Department, preventing law enforcement to be able to respond to calls in a timely manner. This puts Fire/EMS providers at heightened risk.