Kiera Butler

Kiera Butler

Senior Editor

Kiera answers your green questions every week in her Econundrums column. She was a hypochondriac even before she started researching germ warfare.

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Kiera has written about the environment, arts and culture, and more for Columbia Journalism Review, Orion, Audubon, OnEarth, Plenty, and the Utne Reader. She lives in Berkeley and recently planted 30 onions in her backyard.

The Shutdown Could Make This Serious Salmonella Outbreak Even Worse

| Tue Oct. 8, 2013 12:07 PM EDT

Update: On Tuesday, the CDC recalled some of its furloughed employees to work on the salmonella outbreak. It also discovered that the strain of salmonella seems to be antibiotic resistant. Tom Philpott has the full story here.

Over at Wired, Maryn McKenna reports on a major outbreak of the foodborne illness salmonella. So far, 278 people in 18 states have been sickened with the pathogen, which causes fever, cramps, diarrhea, and in severe cases, even death. In a press release the USDA identified the source of the outbreak as contaminated raw chicken from a producer called Foster Farms and said that the products were sold at supermarkets in Washington State, Oregon, and California. As of 11:30 AM EDT Tuesday, Foster Farms had a note up saying, "No recall is in effect. Products are safe to consume if properly handled and fully cooked." Foster Farms' chicken was linked to another salmonella outbreak—134 illnesses in 13 states—in July, the CDC reported.

Usually when there's an outbreak of this scale, the CDC mobilizes to pinpoint the source of the contaminated food. However, McKenna explains that the shutdown "means that the lab work and molecular detection that can link far-apart cases and define the size and seriousness of outbreaks are not happening." Individual states can use their own resources to trace the outbreak, but so far it looks like they won't be able to use the federal government's databases.

Of course, this is hardly the first recent outbreak of salmonella linked to poultry; Tom Philpott writes about how crowded conditions and overuse of antibiotics on farms make for perfect bacteria breeding grounds here. This CDC graphic shows the growing number of salmonella cases over the past two decades:

Centers for Disease Control and Prevention

 

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The Scary Truth About Antibiotic Overprescription

| Fri Oct. 4, 2013 3:54 PM EDT

When a patient complains of a sore throat or bronchitis, doctors prescribe antibiotics much more often than is medically necessary. That's the main takeaway of a new study published in the peer-reviewed journal JAMA Internal Medicine. Findings from the National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey reveal that doctors prescribed antibiotics to 60 percent of sore throat patients—despite the fact that the drugs are only thought to be necessary in about 10 percent of cases. For acute bronchitis, antibiotics are not recommended at all, yet the researchers—a team from Harvard—found that doctors prescribed antibiotics to an astonishing 73 percent of patients diagnosed with the condition. 

"We use azithromycin for an awful lot of things, and we abuse it terribly," one doctor told the New York Times.

The number of doctor visits for acute bronchitis tripled between 1996 to 2010, from about 1.1 million visits to 3.4 million visits. The number of sore throat visits actually declined from 7.5 percent of all visits in 1997 to 4.3 percent in 2010—and yet the rate of antibiotic prescription remained consistent.

Another interesting finding: the growing popularity of expensive, broad-spectrum antibiotics such as azithromycin over tried-and-true strep-targeting drugs like penicillin. Last year, the New York Times noted that azithromycin "may increase the likelihood of sudden death" in adults who have or are at risk for heart disease. In that piece, Dr. John G. Bartlett, a professor of medicine at Johns Hopkins University School of Medicine, told the Times that he believed that overprescription of azithromycin could also contribute to antibiotc resistance. "We use azithromycin for an awful lot of things, and we abuse it terribly," he said. "It's very convenient. Patients love it. 'Give me the Z-Pak.' For most of where we use it, probably the best option is not to give an antibiotic, quite frankly."

If the looming threat of antibiotic resistance isn't reason enough for concern about doctors' free hand with antibiotics, there's also the considerable cost to our health care system—an estimated $500 million for antibiotics prescribed unnecessarily for sore throat alone between 1997 and 2010. If you include the cost of treating the side effects of unnecessary antibiotics such as diarrhea and yeast infections, the study's authors estimate that the cost would increase 40-fold.

OkCupid's Awkward Response to Boulder Floods

| Mon Sep. 16, 2013 2:28 PM EDT

A friend of mine in Boulder received this message from OkCupid the other day:

1,000 people are still stranded due to the flash floods in Colorado. Maybe not the best time for this spam, OKCupid.

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