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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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Jacob Nelson

This article shows how some communities that, in the opinion of the Disaster Accountability Project organization, are within an effective radius of a nuclear incident at Indian Point and have little or no emergency plan for this kind of event. This is primarily due to these communities not having the knowledge that they could be effected by an event of this nature if they are over 10 miles away from the plant. Also, many of the communities that said they had not undergone any studies in relation to the plant's effects on their own community or developed any emergency plans because they cannot without federal aid. These counties and towns are not well-enough informed and are lacking the funding from the government in order to provide for their own safety if a nuclear accident were to occur

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Jacob Nelson

Emergency response is addressed in a broad sense of the major risk factors associated with a natural disaster and epidemics. The main points they make are that preparedness, with a focus on availability of safe water and primary healthcare services, along with surveillance for the beginnings of an epidemic, are necessessay for a strong response to a disaster situation   

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Jacob Nelson

The National Regulatory Commission: Government agency responsible for public safety with regards to nuclear reactors and nuclear energy

Entergy: An integrated energy company that primarily deals with electric power production. Operators of the Indian Point Nuclear Power Plant

Disaster Accountability Project: Nonprofit organization that monitors disaster-response programs and acts as a watchdog for disaster response and preperation

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Jacob Nelson

The main point of the article is to report a conflict of opinions between the NRC and the Disaster Accountability Project on the safety of the communities surrounding the Indian Point Nuclear Power Plant. The NRC and the company running the plant, Entergy, state that those communities within a 10 mile radius are required to have emergency evacuation plans in place should a nuclear emergency occur; those outside this radius, however, are not at as large of risk. The nonprofit, however, cites the NRC's report on the Fukushima disaster, where it recommended the US citizens within 50 miles of the plant should evacuate the area, and suggests that communities within a 50 mile radius of Indian Point have specific nuclear emergency plans at hand and prepared for use. Entergy says that the radius "provides a robust safety margin", and the NRC replies to the Disaster Accountability Project's statement by saying that the incident at Fukushima is not comparable to any nuclear power cite in the US, due to the size and number of reactors in the Fukushima plant.

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Jacob Nelson

"The risk for commuicable disease transmission after disasters is associated primarily with the size and characteristics of the population displaced, specifically the proximity of safe water adn functioning latrines, the nutritional status of the displaced population, the level of immunuty to vaccine-preventable diseases..., and the access to healthcare services"

"...natural disasters (regardless of type) that do not result in population displacement are rarely associated with outbreaks"

"When death is directly due to the natural disaster, human remains do not pose a rise for outbreaks"

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Jacob Nelson

The author contacted both the NRC and the nonprofit Disaster Accountability Project for statements and information on the safety of the plant and if emergency plans were in place. The NRC gave statements and information on their discussions with the Disaster Accountability Project, and the nonprofit described their process of sending freedom-of-information requests to 20 jurisdictions in NY, NJ, and CT located up to 50 miles from Indian Point, in order to determine if they had emergency plans related to the power plant and what they might be

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Jacob Nelson

1: Crowding is shown to be common in displaced populations, and local overpopulation/crowding often facillitates the transmittion of disease

2: Natural disasters that do not cause a displacement of a population are rarely associated with disease outbreaks

3: There is little or no evidence that dead bodies, as some believe, pose a epidemic risk for a population of survivors after a disaster has struck

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Jacob Nelson

"The federal Nuclear Regulatory Commission requires communities located within 10 miles of nuclear power plants to develop emergency plans. In New York, the four counties within 10 miles of Indian Point—Westchester, Rockland, Putnam and Orange—have taken such measures. But the Disaster Accountability Project, a nonprofit organization that monitors disaster response programs and the author of the report, cited the commission’s response to the 2011 nuclear accident in Fukushima, Japan, in which it recommended that U.S. citizens within 50 miles evacuate."

"NRC spokesman Neil Sheehan said the Fukushima site isn’t comparable to any in the U.S. 'Quite frankly, we don’t have any nuclear plant complexes where you have so many reactors packed so closely together.'"

"Those communities are exempt from the NRC’s emergency planning zones, so most haven’t developed such plans or conducted studies. According to several of them, they couldn’t without help from the federal government."