Though seen as part of a global trend — a 2010 study in Lancet Infectious Diseases termed it ‘a worldwide health problem’ — the risk of massive spread through poor sanitation calls for special attention in South Asia, says Timothy Walsh, a scientist at the University of Cardiff who is working on antibiotic resistance genes (ARG) in Bangladesh and Pakistan.
The latest study from South Asia, funded partly by Astra Zeneca, UK, and by The Engineering and Physical Sciences Research Council, UK, was reported last month (February) in Environmental Science and Technology by a team led by David Graham from Newcastle University, UK.
Scientists from India and the UK compared water samples along the river Ganges at the two pilgrimage centres of Haridwar and Rishikesh during the months of February and June in 2012. February is off-season for pilgrimages while June sees a heavy pilgrim influx.
Looking for the presence of 'New Delhi metallo-beta-lactamase-1' — an enzyme that confers resistance to multiple antibiotics that was first reported from India in 2011 — the scientists found a 20-fold increase in the levels of the ARG during the pilgrim season. On a parallel track, the scientists also found uniformly high levels of ARG in Delhi, across both months.
Graham's team had reported a similar increase in ARG in the Almendares river in Cuba during the wet season in a study published in Frontiers in Microbiology in November 2012.
“Our short-term solution is for local governments to make available much more local waste-handling facilities to accommodate visitors during the pilgrimage season, such as portable toilets,” Graham tells SciDev.Net.
A study in the Asian Pacific journal of Tropical Disease in 2014 from Nepal found high levels of resistance among patients to several antibiotics used to treat shigellosis, an infection caused by Shigella bacteria that spread through water.
Another report, published by scientists from Shanghai Jiao Tong University in China, in Diagnostic Microbiology and Infectious Diseases, December 2013, found resistance to several anti-microbial drugs in over 99 per cent of Shigella isolates taken from patients’ stool samples.
Link to abstract of paper in Environmental Science and Technology