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4. A question of balance

As the public debate about MRSA in pigs in the Danish media continues to cast a slur on the country’s pig farmers, DAFC felt it necessary to highlight all the steps already being taken to limit its spread and to renew its calls for a calmer and more balanced assessment of the issues at stake.

The Danish media have continued to focus on the MRSA strain CC398, which is present in pigs. Its presence primarily represents an ‘occupational hazard’ for those coming into regular contact with livestock, and new hygiene protocols have already been introduced on farms. There is no evidence that it presents a significant food-borne risk and, compared to other MRSA strains, it has only been responsible for a small number of MRSA-related infections in Denmark. 

 
A question of balance?

During May, the Chairman and Managing Director of the Danish Agriculture and Food Council wrote a letter to ‘Politiken’, one of Denmark’s leading ‘broadsheet’ titles calling for “better balance” in this vital public debate. Here’s an English translation of some of the key points made in their published letter.

“For many Danes these days, the initials ‘MRSA’ now conjure up thoughts of deadly, resistant staphylococci that are spreading from the country's pig farms into society at large. But the MRSA challenge is much broader than the strain associated with pigs. The harsh reality is that significant numbers of Danes die every year from staphylococcal infections - most from ordinary staphylococci.

“A very small proportion of this mortality is caused by the pig-related MRSA strain (CC398). New figures from the State Serum Institute show that in the first three months of 2015, resistant Staphylococcus (MRSA) caused 11 cases of blood poisoning. Three of these cases were caused by pig-related MRSA. MRSA infections have caused two deaths during 2015 to date and none was attributed to pig-related MRSA. It is time that we all take the debate beyond a narrow focus on a single aspect of the problem relating to pigs.

“In much recent public discussion, MRSA has become synonymous with pig production. In furthering this misconception, the media have also elevated their own ‘expert’ who continues to point the finger at modern pig production. Whatever the initiatives taken by farmers to curb the spread of pig-related MRSA, the Professor of Clinical Microbiology at Odense University, Hans Jørn Kolmos, simply states that these do not go far enough.

 

 
 High levels of MRSA coverage in Danish media



“Recently Professor Kolmos added insult to injury when, following the publication of an ambitious MRSA Action Plan by the Food Ministry, he argued that only a 90 per cent reduction in antibiotic usage would have any impact on the presence of antibiotic resistance on pig farms.

“Such a narrow focus on tackling the challenge posed by the presence of the MRSA bacteria on Danish pig farms is plainly naive. Professor Kolmos consistently fails to acknowledge the amount of antibiotics being used in other countries and how great a resistance challenge this creates.”

Lower usage of antibiotics

“At DAFC, we have ambitious targets to reduce our low antibiotic usage still further, and will invest millions of Danish Kroner in a research programme aimed at reducing the risk of the infection spreading.
We make this investment willingly, because there is no one who would rather get rid of MRSA CC398 from our farms than our very own farmers.

“We therefore call for a better sense of proportion so that all the important steps we are taking to limit the spread of MRSA CC398 can deliver best advantage. Both the debate and the actions taken should be broadened to allow our citizens to gain a more realistic and considered view of how large and complex a challenge resistant bacteria is, affecting not just pig production but medical treatments in hospitals and the rest of Danish society, as well as all its international dimensions.

“DAFC largely supports the Danish authorities’ interventions and the responsibilities laid on the country's pig farmers to prevent pig-related MRSA spreading beyond the farm environment.”

Action needed

“In short, we agree with the government that we should act and not remain passive in addressing the MRSA challenge. Three deaths from 2009 to 2013 from MRSA CC398 are three too many. Over the same period, according to the State Serum Institute, 24 Danes died from other types of MRSA, while 1,241 Danes died due to infection from common staphylococci.

“We do not wish to appear complacent, but we believe it is fair to say that, contrary to the impression given in our media, Denmark is fortunate in its experience of a comparatively limited impact of resistant staphylococci. According to the European Prevention Centre, 18 per cent of the cases of blood poisoning in Europe are MRSA linked infections. In Denmark, this level is just 1.5 per cent.

“Countries in southern Europe have a particularly high percentage of resistant staphylococci and the risk for those travelling in these countries is significant in relation to those choosing to reside in Denmark. We do not quarantine those Danes returning from two weeks holiday in Portugal and Italy just because they may bring resistant bacteria back with them to Denmark. But maybe we should, if the ‘witch-hunt’ of pig producers continues and press reports which talk about ‘dangers’ of living near a farmer and his family persist.

“Although Danish pig farmers are among the world’s lowest users of antibiotics in treating their animals, this certainly is not the end of the matter. For example, Germany’s livestock farmers use more than four times as much antibiotic medicine per animal as their Danish peers.

“We are witnessing an increase of MRSA CC398 on our farms and we must, through our own interventions and those of the authorities, do all we can to reduce its prevalence.

“In Denmark, we must continue reducing our usage of veterinary antibiotics, but at the same time we can reasonably call on others to follow our lead. In this way, we can jointly reduce the risk of severe antibiotic resistance challenges in the future. We must also acknowledge that MRSA is a far wider problem than that which is currently confined to pig production in Denmark.”

 

   
Martin Merrild, DAFC Chairman       Karen Hækkerup, DAFC Managing Director