Geography Reference
In-Depth Information
in 1996 and the WHO's Geneva hub (CDC
2013
). What is also needed is low-tech
advice, such as better education to reduce the spread of infections by thorough hand-
washing and sterilization on surfaces near infected patients. Also there is need for
more radical cleaning methods in hospitals, such as the vaporizing technique that
sterilizes everything in hospital wards (Zoutman et al.
2011
). There are some signs
of success in these efforts, for more careful procedures have reduced rates of a par-
ticularly troublesome bacterium called methicillin-resistant
Staphylococcus aureus
bacterium (MRSA) in Britain by 80 % since the 2008 peak, when increasing num-
bers were picking up infections in hospitals (Davies et al.
2013
).
It has also been argued that there are other reasons for AMR. Too many antibiot-
ics have been given out routinely, often for viral infections that they cannot solve,
while many people do not take the full dose, meaning bacteria are not properly erad-
icated and those that resist multiply. In addition, broad spectrum drugs are often pre-
scribed, designed to cover many diseases, making bacterial mutations more likely.
More specific drugs aimed at particular diseases would help, but this requires better
diagnostic tests. Also this broad spectrum approach and indiscriminate use of anti-
biotics are killing off some of the many millions of 'good' bacteria that exist in our
bodies and are helpful for our health. So the WHO and governments at many levels
are emphasizing the need to educate doctors and the public to reduce their routine
drug use, especially for minor infections that do not need them, which decreases the
opportunity for bacteria resistances to emerge. This over-use is especially a problem
in countries where antibiotic products can be bought in shops without a prescription.
It is not only a developing world issue, but one that exists in many Mediterranean
countries, where resistances to five basic bacterial strains have grown, whereas the
figure in the U.K. where the drugs need a doctor's prescription was only 0.4 %
(WHO
2014b
). The growth of illegally produced and often ineffective antibiotics
is another challenge that needs to be rapidly contained. An even greater problem
comes from the routine antibiotic doses given to farm animals, especially in the
high density farming of chickens, pigs and cattle, without waiting for infections to
emerge and isolating the infected cases. This greater exposure to the drugs again
makes it more likely that resistant bacteria will emerge. Such farming practices
are routine in North America but banned in Europe, resulting in Europe closing its
markets to meat products from North America. To drastically reduce this drug use
is going to be difficult, given the profits that pharmaceutical companies make from
such practices. We may see similar problems to those experienced by attempts by
governments to reduce tobacco advertising etc. which led to huge lawsuits by the to-
bacco firms. Action on AMR is occurring at last, but is long overdue, if what senior
medical people and authorities describe as an emerging crisis is going to be solved.
13426
Increased Dangers from Indoor Environments
Most people in the developed world now spend most of their lives in indoor envi-
ronments, for time-budget surveys have shown that the average American spends
only an hour a day outside. This has led to increased attention being paid to the
