4TH MERIAL FORUM

HAVE WE GOT PCVD &

SWINE INFLUENZA UNDER

CONTROL?

The future of antibiotics use in Europe

Moderator: Dr Sophie Randoux

• The antibiotic hype and the consequences for pig production in Europe. Dr. D. Schillinger

• Limiting the use of antibiotics in the Pig industry: the Danish experience. Dr M. Andreasen

• PCVD control in 2012: how to design the best PCV2 vaccination programme? Dr R. Aerts

Limiting the use of Antibiotics in the Pig Industry: The Danish Experience Margit Andreasen

DVM, PhD, Chief Scientist

Merial Swine Forum 2012

Side 4

Denmark as a role model?

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Total sales, all animal species 9 European countries in 2009

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NO SE FI DK UK CH CZ FR NL

mg

/PC

U*

*PCU population correction unit (Grave et al 2010)

EMA, 2011

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Events over time in Denmark

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50

100

150

200

250

1990 1992 1994 1996 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

An

tib

ioti

cs i

n t

on

s

Theraputic Growth promoter (AGP)

Antibiotic use is for all livestock,

80 % are used in the pig production

Ban on AGPs

to finishers

Ban on

flouroquinolones

Ban on cephalosporins

+ Yellow card initiative Ban on AGPs

to weaners

Prescription

only

DANMAP Vetstat

Herd visit

agreements

Side

Vetstat Database Veterinary use of antimicrobials

7

Pharmacies Veterinarians Feedmills

Herd level

Agegroup

Indication

Active compound

Vetstat database

(Ministry Food and Agric.)

ADD

ADD pr. 100 animals pr. day

CHR-register;

no. animals

Side

ADD

• Average dose per day for a drug used for its main indication in a standard sized animal

• Used to measure the amounts of standard doses given

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Side

Herds consumption can be followed closely by farmer and consultants

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Example from www.vetstat.dk (code needed):

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Herds consumption can be followed closely on indication and active compound

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Side

Antimicrobial consumption (2004-2009)

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2009 vs. 2008:

11.5 % increase

DANMAP, 2010

Side

2010 Yellow card scheme We must decrease usage!

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Side

Yellow card scheme Threshold limits 2010-12

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9-month moving average by age-group

Sows Weaners Finishers

ADD pr. 100

animals pr. day

5,2 28 8

Appr. 10 % of farmers were above these limits

Side

Yellow card – course of events July 2010

”Information letters”

– 1249 farmers - close to or over permit limit

– Informed about herds 3 ADD- values

– Chance to correct mistakes in their registrations

November 2010

Goverment order

December 2010

”Warning letter” to

– Appr. 1100 farmers above permit limits

–Appr. 500 above limit; 600 data-mistakes

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Side

15

9 months

Yellow Card

Restrictions on

water/feed medication

Inspection (DVFA)

5 months

Tightened

supervision

2nd Opinion

vet

Action plan

Charged supervision

and charged enforcement

orders/bans

Until below threshold

Red card

Eg. reduced

stocking

rate

Action plan includes

Laboratory diagnostics

Treatments

Change layout barn

Purchasing of animals

Management

Yellow card – what then?

Side

Future …

Every 2nd month, letters to new herds exceeding permit limits

Yearly new lower permit limits

– However, no down-regulation in 2012

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2000

4000

6000

8000

10000

12000

jan-

09

mar

-09

may

-09

jul-0

9

sep-

09

nov-09

jan-

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mar

-10

may

-10

jul-1

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sep-

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nov-10

jan-

11

mar

-11

may

-11

jul-1

1

sep-

11

nov-11

Month

Consum

ptio

n (

kg)

The Yellow Card effect

25 % ↓

From 2010 to 2011: an increase in production of 810,000 pigs

Warning letter

Yellow Card Yellow Cards

Side

More prudent use of antimicrobials

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500,0

1.000,0

1.500,0

2.000,0

2.500,0

3.000,0

3.500,0

4.000,0

4.500,0

5.000,0

jul-0

9

aug-

09

sep-

09

okt-0

9

nov-

09

dec-

09

jan-

10

feb-

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mar

-10

apr-1

0

maj-1

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jun-

10

jul-1

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aug-

10

sep-

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okt-1

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nov-

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dec-

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feb-

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-11

apr-1

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maj-1

1

Month

kg

acti

ve c

om

po

un

d

Figur 3

Water

Injective

Feed

Side

Reduction in treatment of weaners, gastrointestinal disease

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Side

Use of vaccines has increased

20

+ 21 %

+ 31 %

+ 27 %

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Fluoroquinolones & cephalosporins • Fluoroquinolones banned since 2002

– Only allowed under certain conditions and only by the

veterinarian personally

– Challenge: no longer possible to eradicate A.

pleuropneumoniae

• Cephalosporins

– Voluntary ban from July 2010

– AIM: to reduce potential risk for resistance in human

pathogens

– Veterinarians have found alternative treatments

– Challenges:

• Sporadic cases where cephalosporins are the only

drug of choice (eg. some E. coli)

Side

0

20

40

60

80

100

120

140

2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011

Ac

tiv

e c

om

po

un

d (

kg

)

Fluoroquinolones Cephalosporins

DANMAP, Vetstat

Use of cephalosporins and fluoroquinolones for pigs

Side

Limiting the use of antibiotics Impact on health

Side

Ban on AGPs Impact on health • Report from WHO (2003);

Impacts of antimicrobial growth promoter termination in Denmark (WHO/CDS/CPE/ZFK/2003.1)

• Weaners – Significant increase in antimicrobial treatments for

diarrhoea – Toxigenic E. coli and Lawsonia

• Finishers – Transient increase (7 months) in antimicrobial

treatments for diarrhoea – Lawsonia

Side

Impact on health - Productivity

Combating antimicrobial resistance – Time for joint action, Copenhagen March 14-15, 2012

0,0

0,5

1,0

1,5

2,0

2,5

3,0

3,5

4,0

4,5

5,0

'90 '92 '94 '96 '98 '00 '02 '04 '06 '08 '10

Mo

rtali

ty i

n p

erc

en

t

Finisher mortality, % Weaner mortality, %

Ban on AGPs

PMWS

Outbreak

Side

Impact on health - Productivity

Combating antimicrobial resistance – Time for joint action, Copenhagen March 14-15, 2012

Ban on AGP’s

show responsability

show responsability

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600

700

800

900

1000

'90 '92 '94 '96 '98 '00 '02 '04 '06 '08 '10

Ga

in,

gra

ms p

er

da

y

2,70

2,75

2,80

2,85

2,90

2,95

3,00

3,05

3,10

Fe

ed

co

nv

ers

ion

ra

tio

kg

/kg

ga

in

Daily gain finishers Feed conversion ratio kg/kg

Ban on AGPs

Side

Ban on AGPs Impact on resistance

• Report from WHO (2003); Impacts of antimicrobial growth promoter termination in Denmark (WHO/CDS/CPE/ZFK/2003.1)

• AGP termination reduced the food animal reservoir of enterococci resistant to AGPs

• However, we do not know the effect on human health!

Examples from the WHO report

Side

Yellow Card Impact on resistance

• To early to say …

Side

Our success is due to several measures

• The unique Danish SPF health management system

• High level of management

• The co-operative system

• Immediate application of new production technology

• Vaccination strategies

• Use of other efficient antibiotics based on resistance patterns

Side

What’s in it for the farmer?

Better public accept

Side

Thank you for listening!