“We risk being in a post-antibiotic world,” said Thomas Frieden, director of the U.S. Centers for Disease Control and Prevention, referring to the urinary tract infection of a 49-year-old Pennsylvania woman who had not travelled within the prior five months.

Frieden, speaking at a National Press Club luncheon in Washington, D.C., said the bacteria was resistant to colistin, an antibiotic that is reserved for use against “nightmare bacteria.”

The infection was reported Thursday in a study appearing in Antimicrobial Agents and Chemotherapy, a publication of the American Society for Microbiology. It said the superbug itself had first been infected with a tiny piece of DNA called a plasmid, which passed along a gene called mcr-1 that confers resistance to colistin.

“(This) heralds the emergence of truly pan-drug resistant bacteria,” said the study, which was conducted by the Walter Reed National Military Medical Center. “To the best of our knowledge, this is the first report of mcr-1 in the USA.”

The patient visited a clinic on April 26 with symptoms of a urinary tract infection, according to the study, which did not describe her current condition. Authors of the study could not immediately be reached for comment.

The study said continued surveillance to determine the true frequency of the gene in the U.S. is critical.

“It is dangerous and we would assume it can be spread quickly, even in a hospital environment if it is not well contained,” said Dr. Gail Cassell, a microbiologist and senior lecturer at Harvard Medical School.

But she said the potential speed of its spread will not be known until more is learned about how the Pennsylvania patient was infected, and how present the colistin-resistant superbug is in the U.S. and globally.

“Medicine cabinet is empty for some”

In the U.S., antibiotic resistance has been blamed for at least two million illnesses and 23,000 deaths annually.

The mcr-1 gene was found last year in people and pigs in China, raising alarm.

The potential for the superbug to spread from animals to people is a major concern, Cassell said.

For now, Cassell said people can best protect themselves from it and from other bacteria resistant to antibiotics by thoroughly washing their hands, washing fruits and vegetables thoroughly and preparing foods appropriately.

Experts have warned since the 1990s that especially bad superbugs could be on the horizon, but few drugmakers have attempted to develop drugs against them.

Frieden said the need for new antibiotics is one of the more urgent health problems, as bugs become more and more resistant to current treatments.

“The more we look at drug resistance, the more concerned we are,” Frieden added. “The medicine cabinet is empty for some patients. It is the end of the road for antibiotics unless we act urgently.”

Overprescribing of antibiotics by physicians and in hospitals and their extensive use in food livestock have contributed to the crisis.

More than half of all hospitalized patients will get an antibiotic at some point during their stay. But studies have shown that 30-50 per cent of antibiotics prescribed in hospitals are unnecessary or incorrect, contributing to antibiotic resistance.

Many drugmakers have been reluctant to spend the money needed to develop new antibiotics, preferring to use their resources on medicines for cancer and rare diseases that command very high prices and lead to much larger profits.

In January, dozens of drugmakers and diagnostic companies, including Pfizer, Merck, Johnson and Johnson and GlaxoSmithKline, signed a declaration calling for new incentives from governments to support investment in development of medicines to fight drug-resistant superbugs.

In Canada, the federal health department’s Veterinary Drugs Directorate places polymyxins such as colistin in Category I (“very high importance”) of its list of antimicrobials based on their importance in human medicine.

Polymyxin B, which is approved for veterinary use, was added to Canada’s Veterinary Prescription Drug List in April.

Certain uses of the drug thus require a veterinarian’s prescription, so as “to reinforce prudent use of this class of drugs.”

Veterinary drugs affected by the ruling included Special Formula 17900-Forte Suspension, a Zoetis product to treat mastitis in dairy cattle, and three ointment products sold for use on dogs and cats.

— Reporting for Reuters by Ransdell Pierson; additional reporting by Bill Berkrot.

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A spokeswoman for Archer Daniels Midland said that as egg supplies tighten and prices rise, the food processing and commodities company has received numerous inquiries from manufacturers about the plant-based egg substitutes it makes.

With a strong dollar bolstering the buying power of U.S. importers, some companies are scouting for egg supplies abroad.

“The U.S. has never imported any significant amount of eggs, because we’ve always been a very low-cost producer,” said Tom Elam of FarmEcon, an agricultural consulting company. “Now, that’s no longer the case.”

The U.S. is grappling with its biggest outbreak of avian flu on record, which has led to the culling of 40 million birds. The virus has been confirmed on commercial farms and backyard flocks in 16 U.S. states and in British Columbia and Ontario.

The highly infectious virus has not crossed over to humans in the U.S., as it did in Asia following a 2003 outbreak, but transmission to humans is possible, according to the Centers for Disease Control and Prevention.

An industry group representing U.S. bakers began pushing the U.S. Department of Agriculture and Congress this week to speed up approvals for egg imports.

“We have members whose egg suppliers are already cutting back how much they’ll receive in the next few weeks, while others are not getting any,” said Cory Martin, vice president of government relations for the American Bakers Association. “They’re looking for eggs everywhere. And the problem is, too, there’s not enough egg substitute available right now to make up for the demand.”

Still, companies wanting to import eggs may have to look far afield.

“Canada is short on eggs and has been buying heavily from the U.S. for the last several years,” said Rick Brown, a senior vice-president of Urner Barry, a commodity market analysis firm. “Mexico has been dealing with its own outbreaks of avian influenza, so they’re banned from importing into the U.S. The logical place people will be looking now would be Europe.”

Avril, a farmer-controlled agri-food group that owns France’s largest egg brand, Matines, said it has seen an increase recently in demand from the U.S. and elsewhere in the Americas and plans to start making shipments to the Americas in June.

A spokesman for Avril told Reuters on Friday most of its exports would be heading to Mexico, though he noted that shipments to the U.S. were a possibility.

Economic bite

Exporting eggs into the U.S. from Europe will not be easy. Regulatory differences mean EU egg producers must seek an individual license to export and sometimes change procedures to bring safety standards into line.

But it is still an attractive business opportunity.

The French embassy in Washington is helping one French egg company start the process to obtain an export certificate, a French farm ministry spokesman said.

The Dutch also are positioning themselves as an egg exporter to the U.S. too, French egg industry group SNIPO said.

“The bird flu epidemic developing in the U.S. means it is necessary to start discussions as quickly as possible to benefit from opportunities in this market,” SNIPO said in an emailed statement, adding that French authorities had not responded as swiftly as their Dutch counterparts.

Prices soar

Meanwhile, companies sticking with egg suppliers closer to home are facing sharply higher prices as a result of the outbreak. Nearly 30 per cent of U.S. breaker eggs — which includes liquid, dried or frozen eggs used by food manufacturers — has disappeared due to the outbreak, according to Martin and federal data.

The outbreak has led to a sharp uptick in the wholesale price of such eggs, from 63 cents a dozen in late April, when the first egg-laying flock was reported infected, to $1.83 a dozen this week, Brown said (all figures US$).

The wholesale price of shell eggs, typically sold in cartons at grocery stores, has also risen, from $1.19 a dozen in late April to $2.03 a dozen this week, Brown said.

Nevertheless, some food makers are turning to the more expensive shell eggs to supplement supplies, although that means an additional cost to send the eggs to a breaking facility that will crack the shells, Elam said.

Analysts at Goldman Sachs predict consumers will ultimately spend an additional $7.5 billion to $8 billion because of the egg supply squeeze.

Nestle SA — which uses eggs for some of its Dreyer’s, Edy’s and Häagen-Dazs ice cream products — said it is braced for shortages and working with suppliers to help protect hens.

Dunkin’ Brands Group told Reuters it will leave it up to franchisees to decide whether to swallow the cost hikes they’re seeing or pass them on to consumers.

A matter of life or death

For some companies, having an adequate supply of fertilized eggs can be a matter of life or death. Some vaccine makers, including Merck and Co., maintain their own hen flocks to produce eggs used for incubating vaccines that protect against diseases such as measles and mumps.

Merck said it is taking no chances with its chicken flocks as avian influenza continues to spread; security is tight around the birds, and the health of the hens is continuously monitored.

Sanofi Pasteur, the vaccines division of Sanofi, said it too is keeping close tabs on the outbreak — particularly with the state agriculture department in Pennsylvania, home to some of its suppliers and the fourth-largest U.S. egg-laying flock. So far, no avian influenza cases have been identified there.

“We continue to maintain preventive measures for our egg supply system, including biosecurity and physical security procedures, to provide our suppliers with protection from being affected by this or any avian outbreak,” the company told Reuters in a statement.

And GlaxoSmithKline told Reuters it is reinforcing biosafety standards at more than 30 Canadian egg-laying farms that are dedicated to producing eggs for the company’s human flu vaccines.

The company has more egg supplies than it needs for its flu vaccine production in Canada and Germany, a spokeswoman said.

But as the bird flu outbreak spreads in the U.S., she added, “we are monitoring the current situation closely and have alerted all of our supply farms.”

— P.J. Huffstutter and Bill Berkrot report for Reuters on the agriculture sector from Chicago and pharmaceutical and biotech sectors from New York respectively. Additional reporting for Reuters by Karl Plume in Chicago, Lisa Baertlein in Los Angeles, Anjali Athavaley in New York, Sybille de La Hamaide in Bazancourt, France and Gus Trompiz in Paris.

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