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Scientists question blood safety
Canadian government sued for allowing use of tainted blood from U.S.
US visitors to Britain may not make acceptable blood donors
Add yourself to CDC and FDA petitions
Teenage CJD victim inquest: 43rd nvCJD victim announced
USDA says largest meat recall in U.S. history underway
Britain details the start of its 'mad cow' outbreak
Spain's bullfights threatened by BSE
Breeding out scrapie at home
Plough-to-plate food scrutiny will cost £120m
Brussels spin doctors told truth must often be hidden
Test yourself for early Alzheimer's

Scientists question blood safety

Selected Medline abstracts 1 Feb 99
See also special purpose  Blood Recall/Withdrawal - CJD website
[Was the recent policy reversal -- to use CJD-tainted blood after all -- science-based?  -- webmaster]

Creutzfeldt-Jakob disease (CJD) after blood product transfusion from a donor with CJD.

Neurology 1998 Jun;50(6):1872-3 
Patry D, Curry B, Easton D, Mastrianni JA, Hogan DB
We report a second case of an association between an albumin transfusion and Creutzfeldt-Jakob disease. On balance, we believe our case represents a chance and not a causal relation.

Pooled plasma derivatives and Creutzfeldt-Jakob disease.

Lancet. 1996 Apr 6;347(9006):967.
de Silva R. ›››››››››
An exchange of letters with the authors of a paper [Creange et al, Ann Neurol 1995 Aug;38(2):269-72 ] reporting CJD 2 years after a 57 year old liver transplant recipient received pooled albumin transfused during surgery from a presymptomatic case of CJD. The reply notes that the short incubation period might have resulted from a leaky blod-brain barrier associated with transient hepatic failure.

[Transmissible spongiform encephalopathies--illnesses in the human].

Wien Med Wochenschr 1998;148(4):86-95 
Budka H
Transmissible spongiform encephalopathies (TSEs) or prion diseases in man and animals are of utmost interest at present.... Handling of laboratory material from TSE patients requires specific measures of precaution and decontamination. Although blood and blood products have been shown to transmit disease, experimental and epidemiologic data for disease transmission via blood transfusion are lacking. New WHO regulations define exclusion criteria for blood donors. A special situation applies to the UK because the distribution of infectivity in the new CJD variant might differ from that of classical TSEs; therefore leukodepletion of blood donations was recommended.

Creutzfeldt-Jakob disease and blood transfusion.

Acta Neurol Belg 1998 Sep;98(3):247-51 
Fernandez Lopez MJ, Van Everbroeck B, Pals P, Martin JJ, Cras P
Experimental data suggest that blood components from patients with CJD may carry infectivity. However, most of the studies have been made on the classic form of CJD. Further studies are needed to discern whether infectivity levels in blood from patients with the nvCJD differ from those with the classic form. Possibility of transmission of CJD by blood or blood products can not be excluded and therefore adequate surveillance should be implemented. People who have been exposed to contaminated blood should be followed, while recommendations are being adapted according to new scientific data on infectivity.

Can Creutzfeldt-Jakob disease be transmitted by transfusion?

Curr Opin Hematol 1995 Nov;2(6):472-7 
Brown P
The transmissible agent of Creutzfeldt-Jakob disease, a dementing neurodegenerative disorder, is present in many tissues of the body, even though its pathologic consequences are confined to the brain. Experimental animal models of the disease have shown that blood (most probably the leukocyte component) can be infectious in both the clinical and preclinical incubation stages of the disease, and there are also a few reported isolations of the agent from whole blood, buffy coats, or serum from humans with Creutzfeldt-Jakob disease. Despite this potential for blood-borne iatrogenic infection, epidemiologic studies do not support the contention that the administration of blood, blood components, or blood derivatives transmits the disease; in particular, not one of nearly 2000 patients who have been studied during the past two decades has been shown to have acquired the disease from a blood donor who later died of Creutzfeldt-Jakob disease. [How many of the 2,000 have died of any cause to date? -- webmaster] This fact does not diminish our responsibility to preclude such an occurrence from happening in the future, and will require an unremitting effort to screen from the blood donor population all individuals with a higher than average risk of harboring the infectious agent; namely, donors with neurologic disease, a family history of neurologic disease, or a history of events that have been identified as leading to iatrogenic Creutzfeldt-Jakob disease, such as neurosurgical procedures involving dura mater homografts or treatment with native pituitary hormones.

The distribution of infectivity in blood components and plasma derivatives in experimental models of transmissible spongiform encephalopathy.

Brown P, Rohwer RG, Dunstan BC, MacAuley C, Gajdusek DC, Drohan WN
Transfusion 1998 Sep;38(9):810-6 
The administration of blood components from donors who subsequently develop Creutzfeldt-Jakob disease has raised the issue of blood as a possible vehicle for iatrogenic disease. We examined infectivity in blood components and Cohn plasma fractions in normal human blood that had been "spiked" with trypsinized cells from a scrapie-infected hamster brain, and in blood of clinically ill mice that had been inoculated with a mouse-adapted strain of human transmissible spongiform encephalopathy. Infectivity was assayed by intracerebral inoculation of the blood specimens into healthy animals. Most of the infectivity in spiked human blood was associated with cellular blood components; the smaller amount present in plasma, when fractionated, was found mainly in cryoprecipitate (the source of factor VIII) and fraction I+II+III (the source of fibrinogen and immunoglobulin); almost none was recovered in fraction IV (the source of vitamin-K-dependent proteins) and fraction V (the source of albumin). Mice infected with the human strain of spongiform encephalopathy had very low levels of endogenous infectivity in buffy coat, plasma, cryoprecipitate, and fraction I+II+III, and no detectable infectivity in fractions IV or V. CONCLUSION: Convergent results from exogenous spiking and endogenous infectivity experiments, in which decreasing levels of infectivity occurred in cellular blood components, plasma, and plasma fractions, suggest a potential but minimal risk of acquiring Creutzfeldt-Jakob disease from the administration of human plasma protein concentrates.

Is Creutzfeldt-Jakob disease transmitted in blood?

Emerg Infect Dis 1997 Apr-Jun;3(2):155-63 
Ricketts MN  , Cashman NR, Stratton EE, ElSaadany S
Creutzfeldt-Jakob disease (CJD) has been considered infectious since the mid-1960s, but its transmissibility through the transfusion of blood or blood products is controversial. The causative agent's novel undefined nature and resistance to standard decontamination, the absence of a screening test, and the recognition that even rare cases of transmission may be unacceptable have led to the revision of policies and procedures worldwide affecting all facets of blood product manufacturing from blood collection to transfusion. We reviewed current evidence that CJD is transmitted through blood.

Is Creutzfeldt-Jakob disease transmitted in blood? Is the absence of evidence of risk evidence of the absence of risk?

CMAJ 1997 Nov 15;157(10):1367-70 
Ricketts MN

New variant Creutzfeldt-Jakob disease and the blood supply: is it time to face the music?

CMAJ 1998 Sep 22;159(6):669-70 
Hoey J, Giulivi A, Todkill AM

Creutzfeldt-Jakob disease and the risk from blood or blood products.

Vox Sang 1998;75(3):178-80 
Will R, Kimberlin R
The occurrence of iatrogenic cases of Creutzfeldt-Jakob disease (CJD) and the isolation of infectivity in some laboratory transmission studies in transmissible spongiform encephalopathies raises the possibility that CJD might be accidentally transmissible through blood or blood products. Epidemiological evidence, although not conclusive, does not suggest that classical CJD is transmitted through this route. However, new variant CJD (nvCJD) might pose greater risks of accidental transmission of infection and mechanisms to reduce the theoretical risk are under consideration. The theoretical risks from CJD and nvCJD must be balanced against the established therapeutic benefits of blood and blood products.

New Blood for a new blood agency

CMAJ 1999;160:244-5
Charlotte Gray, a contributing editor at CMAJ.
Many challenges await Canadian Blood Services, the organization now responsible for Canada's blood supply. The main job? Restoring Canadians' confidence in the blood-collection system following the Red Cross's public-relations meltdown.

The conviction in Lynda Cranston's voice could not be more forceful. "The first month has been great," says the new head of Canadian Blood Services (CBS). "The new senior management team is on board and our donations are up substantially from the same period last year. Now our goal is to stabilize the system and make any necessary improvements."

Every ounce of confidence Cranston can muster is important to the country's new national blood agency, which faces an enormous challenge: restoring Canadians' faith in a system rocked by a tainted-blood crisis and allegations of mismanagement.

In November 1997 Justice Horace Krever reported that during the 1980s, questionable blood-safety practices used by the Canadian Red Cross Society may have led to more than 1000 Canadians being infected with HIV and at least 12›000 with the hepatitis C virus. After Krever tabled his report, the federal government decided to remove responsibility for blood donation and distribution from the Red Cross, which had administered the system for more than 50 years. Canadian Blood Services, which is supposed to operate at arm's-length from governments, took over those duties in late September.

Cranston's appointment to the $265›000-a-year job was a signal of the kind of leadership the government wanted at the new agency. Cranston, 51, is a nurse who has spent most of the past 18 years in senior administrative posts in hospitals in Western Canada, where she oversaw completion of a successful hospital merger. In 1987 she had a brief stint in the private sector at Rogers Cantel - a job she left under less-than-happy circumstances just 8 months after being hired. ...

During the tainted-blood crisis, Canadians watched the Red Cross squirm rather than admit culpability or apologize to people who had been infected. Durhane Wong-Rieger, past president of the Canadian Hemophilia Society and an outspoken advocate for victims of tainted blood, was a member of the committee that hired Cranston for the CBS job. She told reporters that Cranston's "openness, accountability and willingness to be thorough but also to personally accept the responsibility" reflected the kind of values the CBS was looking for....

Cranston and her team are already scrambling to prepare for looming technological changes. The most immediate is the improved screening offered by genome amplification testing (GAT), which narrows the "window" between exposure to a virus and the appearance of antibodies during testing. GAT reduces the window for hepatitis C from 65 to 25 days, and for HIV from 22 to 16 days. However, the new tests will cost around $25 million a year and raise some difficult ethical questions, because in some cases blood platelets may be used before test results are available.

Dr.›Graham Sher, medical director at the CBS, told CMAJ recently that "recipients will need to understand the concept of acceptable risk in transfusion medicine." The need for public discussion of "acceptable risk" becomes even more acute when Creutzfeldt-Jakob disease is considered - it has not yet been proven to be a blood-borne illness. "We may be looking at increasingly expensive tests for an increasingly small gain in safety," says Sher.

In his report, Krever argued that Canada's blood system lags far behind other countries in its research activities, with the Red Cross spending only $2.3 million a year on research and development. But hematologic research in Canadian universities and hospitals is about to get a huge boost. The federal government has committed $5 million per year to blood research beginning in 2000, and the CBS has promised to spend about $20 million annually. ...

According to Douglas Starr's authoritative new book on the world's blood industry, Blood, an Epic History of Medicine and Commerce, there is no single model for organizing a national blood system. "In examining the tainted-blood tragedies of the 1980s, it becomes clear that no system was immune from mistakes." However, countries that emerged from the crisis with relatively low rates of blood-related infection had a few, simple, common elements, writes Starr, codirector of the Graduate Program in Science Journalism at Boston University. These included "diligent people in charge who fostered rapid response, open communications and close control over the source of their supplies. Safety is a matter of practice, not ideology."

When Lynda Cranston considers this list, she feels confident that Canadian Blood Services is on the right track. "We are organized around those elements. We have identified safety as our basic principle - we're not just paying lip service to it. A safe blood supply is our only agenda: there are no other issues for us."

Potential threat to blood supply emerges

USA Today 2 Feb 99
Within months, some and possibly all Americans who have visited Britain since 1980 could learn they're not welcome to donate blood. Such a harsh restriction would constrict the blood supply. But it would be a sober precaution against the remote risk of transmitting a new variant of Creutzfeldt-Jakob disease, the human form of ''mad cow'' disease that has afflicted 34 young Britons since 1996.

Classic Creutzfeldt-Jakob runs in families and can be transmitted through human-tissue grafts. The new variant, meanwhile, is believed to come from eating contaminated beef. An epidemic of mad cow disease affected British cattle in the past decade, peaking with 37,381 cases in 1992 and triggering a mass slaughter of cows. Four years later, humans have the new variant. It's described as Alzheimer's on fast forward and kills in months.

A committee of experts assembled by the Food and Drug Administration in December recommended excluding blood from donors who may have been exposed. In June, it will suggest where to draw the line. That's the tricky part. The FDA has to balance the unknown risk of transmitting the rare, deadly disease through the population against the clear risk of cutting blood supply by a million donors, or about 11%. There's no evidence Creutzfeldt-Jakob is transmissible through blood. Moreover, the odds of having it are in the millions. There aren't any cases of the new variant in the U.S.

But committee chairman Dr. Paul Brown cautions that there's ''total ignorance of the magnitude of an outbreak.'' It could be 100 cases, ''but if it's 5,000 cases, we'll say we were smart to be cautious.'' There's no way to detect the new variant early, and Britain sees the risks as so serious that it is phasing out all blood donations from its own residents.

History, too, argues for caution. Failure in the 1980s to screen out donors at high risk of transmitting the AIDS virus caused about 4,800 Americans to contract HIV through blood transfusions. By contrast, the FDA blocked visitors to the Arabian Peninsula after 1990 from donating blood from 1991-93, for fear they'd transmit leishmaniasis. Yet there was almost no evidence the tropical disease, which infects internal organs, could pass through blood.

The Red Cross estimates screening out visitors to Britain from 1984-1990 would require recruiting about a million new donors, raising several concerns. New donors' blood isn't as safe because it has only been screened once for illnesses such as hepatitis. Also, an unprecedented 11% cut in donations could create shortages, postponing patients' surgeries. That's not to mention Britain's new need to buy blood, possibly from the U.S.

To balance the risk of transmitting the fatal disease and the risk of a blood deficit, the committee is weighing a compromise: Screen out only long-term visitors to Britain. Their minuscule odds of having new variant Creutzfeldt-Jakob are still higher than, say, people eating burgers in Heathrow Airport.

If that group, too, is hazardously large, another option might be to prepare to screen in the future. Donor clinics could record who visited Britain, but allow donations until the risks are proved. Both middle-ground options would reduce the risk of Creutzfeldt-Jakob, yet protect the blood supply from a deep cut.

New plan could hurt blood supply

By Susan Wilkinson, AABA  USA Today rebuttal 2 Feb 99
[Susan Wilkinson is  president of the AABB, whose members are responsible for virtually all of the blood collected and more than 80% of the blood transfused in the U.S.]
As stewards of the nation's blood supply, the American Association of Blood Banks' highest priority is to maintain and enhance the safety and adequacy of this precious life-saving resource. In December, a Food and Drug Administration advisory committee voted to recommend the deferral of blood donors who have traveled to or resided in the United Kingdom.

The assumption underlying this geographic exclusion is that travel to or residence in the United Kingdom may serve as a surrogate risk activity for theoretical food-borne exposure to new variant Creutzfeldt-Jakob disease (CJD) and therefore poses a theoretical risk of transmission through blood products. To date, no cases of nvCJD have occurred in the U.S., and none has been related to blood transfusions anywhere in the world. [Excuse me? See Neurology 1998 Jun;50(6):1872-3 -- webmaster]

In reviewing this proposed deferral, we must ask: How would this measure impact both the safety and the adequacy of our nation's blood supply? To answer the first part of this question: We don't know. After many months of study, the risk of transmission of CJD through blood products is still theoretical. Addressing the impact on the adequacy of the blood supply, on the other hand, has some concrete implications that deserve serious consideration.

It is conceivable that at least 11% of prospective blood donors would be deferred. That could amount to an estimated loss of 2.1 million units each year, representing the approximate number of red cell units required annually to support the needs of patients undergoing coronary artery bypass surgery or bone marrow transplantation. The blood banking community will conduct surveys to determine more precisely the true impact on our donor population.

Blood shortages are an everyday concern for every American. As we balance both safety and availability issues, we must also consider that a deferral may sacrifice a measure of protection from known infectious agents for protection from a theoretical risk, and will significantly decrease blood availability in the U.S.

Add yourself to the petitions

02 Feb 99 Actual sample letters used with permission
Ms Donna Shalala
Secretary of Health and Human Services
200 Independence Avenue, SW
Washington, DC 20201

RE:  Docket Number 99P-0033/CP 1

Dear Ms. Shalala:

I would like to be added as a petitioner to the petition of the Humane Farming Association v Donna Shalala and Gene Matthews, HHS Docket Number 99P-0033/CP 1.  I reside at 866 Bliss Road, Quechee, VT 05059.  My mother, Jean E. Trainor, housewife, died of Creutzfeldt-Jakob Disease (CJD) at the Life Care Center of the South Shore in Scituate, MA.

At the onset of what we now know to have been the symptoms of CJD, my mother was initially diagnosed with anxiety and depression by her primary care physician and neurologist.  Other physical complaints that my mother made at the onset of symptoms were dismissed as imagined.  These symptoms existed as best we can tell from 9/17/98 to 10/25/98, when she was admitted to a hospital as a possible stroke victim.  After a battery of tests that revealed nothing, she was almost sent to a mental institution.  A sequence of Ōlucky” events that included an EEG showing some damage and a neurologist who was somewhat familiar with CJD, were the only things that prevented the months of agony others have gone through before a diagnosis was reached.  Still, by the time an official diagnosis had been made in November 1998, there was no way we could communicate with her, and no way we could say good-bye.  Since, as the petition states, CJD is invariably fatal, she was sent off to a nursing home to die.

My family and I do not accept the term Ōsporadic” in regard to my motherŐs diagnosis of CJD.  We have a strong suspicion that she contracted this disease via dental work or surgery.  There is no way to be sure, however, because CJD and other Transmissible Spongiform Encephalopathies (TSEs) are not reportable diseases and therefore not tracked accurately.  If our family had not insisted that her death certificate specifically state that she died of CJD, it is very likely that it would have been recorded as Ōcongestive heart failure”.  This could have put the funeral home employees at risk when dealing with her body after autopsy.

Sheryl Trainor 
Date: Sat, 30 Jan 1999
Dockets Management Branch
Food and Drug Administration
Room 1-23
12420 Parklawn Drive
Rockville, MD  20857

RE: Docket Number 7774

Dear Sir/Madam:

I would like to be added as a petitioner to the petition of the Humane Farming Association v Jane Henney, FDA Docket Number 7774.  I reside at 866 Bliss Road, Quechee, VT 05059.  My mother, Jean E. Trainor, housewife, died of Creutzfeldt-Jakob Disease (CJD) at the Life Care Center of the South Shore in Scituate, MA.  

My mother was initially diagnosed with anxiety and depression by her primary care physician and was treated with medications for those conditions.  Other physical complaints that my mother made at the onset of symptoms were basically written off as imagined.  She was hospitalized on 10/25/98, as a possible stroke victim, and after a battery of tests was almost sent to a mental institution.  It was luck more than anything that a neurologist attached to the hospital had seen the symptoms of CJD before and suggested that as a possible diagnosis.  She was officially diagnosed in November 1998 and sent to a nursing home to die.  She died on December 11, 1998, only 47 days after first being admitted to a hospital.

The articles in this petition will help combat the spread of transmissible spongiform encephalopathies (TSEs) of which CJD is just one.  Because CJD is a horrible way to die and because a link between Bovine Spongiform Encephalopathy (BSE) and CJD has been documented in 34+ cases in the UK and France, the animal feed regulations in the United States have to be specific without exception to ensure that TSEs are not spread in this country as they have been in others.  Little is known about the agent that causes these diseases and nothing is known about how to kill that agent in humans or animals.  It has been suggested by some researchers that current rendering practices could promote the spread of TSEs in the food chain here in the United States.  This cannot be allowed to happen.

I have watched a woman I loved very much die in a horrible, undignified way from Creutzfeldt-Jakob Disease.  By the time she was diagnosed with CJD, it was too late to say good-bye.  I would not wish this disease on my worst enemy, and I believe the US government owes it to the citizens of this country to do everything in its power to prevent the spread of this and similar TSE diseases here in the United States.

Sincerely,

Sheryl Trainor
Quechee, VT  05059

Coroner `not seeking to blame' over teenage CJD victim

PA News Mon, Jan 25, 1999  By Allan Smith 
A coroner's inquest today began investigating the background to the death of Britain's first teenage victim of the human form of mad cow disease BSE. But Wiltshire Coroner David Masters told the hearing opening at Chippenham that his investigation into the death of Stephen Churchill, 19, would not apportion guilt or blame. It would be a fact-finding mission to establish how, when and where Stephen died and to explore the causes of his death, said the coroner who is sitting alone.

He was speaking before the teenager's family - parents Dot and Dave Churchill and his sister Helen - gave their accounts of how Stephen's life crumbled rapidly towards the end of 1994. The teenager, who had 12 GCSEs was asked to re-sit his exams, and his health plummeted so that he became depressed, confused and lacking in co-ordination. He was so unstable on his feet he had to be moved around in a wheelchair.

Stephen, from Devizes, Wilts, died in May 1995. Post mortem examination of brain samples later confirmed that his condition was new variant Creuztfeld-Jakob Disease. He was the first known young person to contract the disorder which is thought to be linked to eating food infected by the cow disease BSE.

Initially his death was registered as natural causes. But his parents, shocked by his rapid decline from a fit and healthy teenager, campaigned vigorously to have an inquest. It was later ordered by Home Secretary Jack Straw. And the Churchills later gave evidence at the Government's BSE inquiry which is due to report in June.

Since Stephen's death a number of inquests have been held concerning the new variant of the disorder and "misadventure" verdicts have been given. There have now been 35 confirmed cases of nvCJD and there are around eight others being nursed.

Mrs Churchill, from Bath Road, Devizes, told the coroner that her son had been a perfectly healthy schoolboy. He had two minor operations in the 80s but did not require blood transfusions. As a youngster he had had some asthma but it was controlled by drugs. He passed 12 GCSEs and his ambition was to join the RAF. She said that he had a healthy appetite but generally did not eat convenience foods. He had, however, eaten some beefburgers and other beef meals. "We ate the foods people normally ate in the 80s," she said.

In May 1994 he suffered a severe asthma attack and he realised he could not join the RAF because of that condition. In August he had a road accident in his mother's car and could not recollect why he had found himself on the wrong side of the road. His scholastic record began to suffer and he did badly in end of term exams and was asked to re-sit.

He became depressive and confused and by January 1995 it was thought he might have some neurological disorder. He went to hospital in Devizes and within days became unstable on his feet and was moved around the wards in a wheelchair. He later transferred to a London hospital where a biopsy was carried out. As she sat by his bedside she notices the bed chart gave the reason for his biopsy as "CJD?". She said: "It was the first time we had seen those initials." Her son was later transferred to a Bath hospital and died at a home in Calne, Wiltshire, in May. A neuropathological examination later gave the cause of his death as new variant CJD.

Mr Churchill and her husband later formed a support group for parents of affected victims. The group is now known as the Human BSE Foundation. Mrs Churchill believed that Stephen was not aware of the cause of his condition. She said that CJD was not much in the media at that time.

Teenager's CJD death blamed on random meal

Mon, Jan 25, 1999  By Allan Smith, PA News
Stephen Churchill, Britain's first known teenage victim of a new strain of the brain disorder CJD, may have contracted his deadly illness through a random isolated meal of contaminated meat, an inquest heard today. Something in the 19-year-old's diet was the most likely source of the disease which reduced him from a healthy active student to a tragic and confused wheelchair patient, Wiltshire coroner David Masters was told.

And Dr James Ironside, from the National CJD Surveillance Unit at Edinburgh, also said that a dietary source was the most likely cause of the deaths of 35 other British victims of the new variant of Creutzfeldt-Jakob Disease. The coroner recorded a verdict of death by misadventure on the youngster from Devizes, Wiltshire, whose ambition had been to join the RAF.

As the verdict came in a Chippenham courtroom, his mother Dot, from Bath Road, collapsed in tears. She was comforted by her husband David and daughter Helen. All three had given evidence about the degenerative brain disorder which in May 1995 claimed the life of the teenager, who had passed 12 GCSEs and was a keen member of the Air Training Corps.

The Churchills had campaigned for nearly four years to have an inquest investigate Stephen's death. He had died in an elderly people's home at Calne, Wiltshire, after months of deteriorating health and a quest to find the cause of his disorder. It was initially recorded as "natural causes", but his parents were determined it should be investigated. Their campaigning led to Home Secretary Jack Straw ordering an inquest.

The Churchills gave evidence in October as key witnesses to the Government's BSE inquiry, which is set to report in June. Today the family said they were "satisfied" with the verdict. Mr Churchill said: "This has been a very personal day for the Churchill family and we feel it has probably put into place the last piece of the jigsaw. We feel the verdict is appropriate."

Asked about the possibility that a random meal may have caused their son's death, he said: "It is quite a terrifying thought that one single meal could create such a dreadful disease in one person and randomly affect the rest of the population." His wife added: "When the coroner said `misadventure' it was like saying that Stephen should never have died. "It brings it home that this disease was man made. It should never have happened. There are so many young people dying from this and it is tragic."

The Churchills founded and now run the national Human BSE Foundation. They say they intend to step down from their executive positions. Declining to discuss possible compensation claims, they said they were awaiting the outcome of the BSE inquiry. The coroner said his role was not to apportion guilt or blame.

The inquest was a fact-finding investigation into how, when and where Stephen died and to explore the causes of how he became a CJD victim. He agreed with the earlier death certificate that Stephen died from bronchial pneumonia and a progressive brain disorder. However, he ruled that he had not died from natural causes. He accepted the evidence from Dr Ironside that the teenager died from new variant CJD which was not naturally occurring and which it was not possible to diagnose at that time.

On the balance of probabilities, Stephen was infected by an agent of BSE - the cow disease - due to a random consumption of an infected meat product. He said: "It could probably have been one random consumption." In evidence, Mrs Churchill said her son was born at Stockton-on-Tees and moved with the family to Wiltshire in 1988.

As a child he suffered from asthma, but it was controlled by drugs. In May 1994 he suffered a major asthma attack and appeared to become depressed. On one occasion he had an accident in his mother's car and could not recollect how he came to be on the other side of the road. His academic performance suffered and he did badly in end-of-term exams and was asked to re-sit. He became more confused, withdrawn and quiet, she said.

Previously he had enjoyed a healthy appetite, but avoided convenience foods. Occasionally, however, he ate beefburgers and had a liking for sausages, she added.

He went to Roundway Hospital in Devizes for treatment for depression. His walking became unstable and within days of admission to hospital he was being moved around the wards in a wheelchair, said Mrs Churchill. Later tests suggested he was suffering from a degenerative brain condition. He returned to hospital in Bath and later went to the home at Calne, where he died. When he was in a London hospital for tests, said Mrs Churchill, she read his bed chart which gave the reason for his brain biopsy as "CJD?". It was the first time she had seen the initials.

She said she believed that Stephen was not aware of the origin of his condition. CJD was not much in the media at that time. She said the family began campaigning as they never felt his death was through natural causes and should be investigated.

Dr Ironside said that he and his colleagues had examined 35 known cases of nvCJD - all in Britain. There was only one other case in France and none elsewhere. CJD was diagnosed by patterns of abnormal prion protein in brain tissue, he explained. The prion protein occurred naturally in animals and humans, but nvCJD was unique - the only example known where the abnormal animal protein became transmitted to humans.

There were three likely sources of infection in Stephen's case - environmental, medical and dietary. But researchers had ruled out the first two and a dietary source seemed the most likely, as it was for all 35 victims. The nvCJD was an "acquired" disorder and he was absolutely satisfied that Stephen Churchill had died from it.

He maintained that there was "a strong balance of probability" that he acquired the BSE agent from a dietary source. This was likely to have been random and only one occasion would have been sufficient, he said.

Spain's bullfights threatened by BSE

Jan. 24, 98 UPI
MADRID, Spain. Spanish officials say the European Union ban on Portuguese cattle exports, based on an upsurge in the number of cases of the so-called mad cow disease hurts bullfighting.

But EU Agriculture Commissioner Franz Fischler says today the ban is necessary to prevent the spread of Bovine Spongiform Encephalopathy (BSE) and he will not make an exception.

Portugal supplies nearly half the 1,500 bulls killed yearly in the Spanish corrida and last November Portugal was stopped from exporting the animals because of an EU export veto on its beef and cattle.

Spokesmen for several Spanish bullrings say they cannot open their gates when the season begins in April because they cannot afford the costly remaining bulls raised domestically. Fischler today tells French radio this morning, "We imposed a ban because they have BSE (in Portugal) and we were not satisfied that sufficient measures are being put in place." Spanish diplomats and bullring lobbyists have been pressing Fischler hard in Brussels to grant an exemption to save the national sport on the grounds that the bulls will never be eaten by humans.

But Fischler says there remains widespread fear the bull carcasses rendered after the fight could end up in the human food chain and he insists that no exceptions will be made.

Meanwhile, in Britain, the ban has been welcomed by animal welfare activists who have been repeatedly demanded an end to the Spanish sport. They want Spain to adopt Portuguese-style bullfights, in which the animals are not wounded or killed.

In Spain, bullfighting is a big tourist attraction and matadors are national celebrities. There are about 400 bull-rings in Spain, ranging from huge arenas in Madrid and Barcelona with seats for 20,000 people to small town rings which seat about 1,500.

David Bowles of the royal society for the Prevention of Cruelty to Animals told British radio this morning: "It's ironic but pleasing that this BSE ban could improve animal welfare in Spain by reducing the number of bullfights this year."

Breeding out scrapie at home

Monday, January 25, 1999 By Environment Correspondent Robert Pigott 
[This program is highly ill-informed and potentially very dangerous --webmaster]
Scrapie, the spongiform disease that has afflicted British flocks for hundreds of years, could soon be bred out of existence, if an experiment on one farm is adopted across the UK. Jonathan and Caroll Barber of Crogham Farm, near Wymondham in Norfolk, have 450 breeding ewes which produced about 700 lambs in December - each one of them is resistant to scrapie.

The breeding programme has been made possible by genetic tests which can identify those sheep which are not susceptible to scrapie. Sheep, like all other mammals, have in their bodies what is known as prion protein. When the prion protein takes on an abnormal form in sheep, the animals succumb to scrapie. It is the same in cattle, although we know the disease as BSE, and in humans it is called CJD.

Scientists know which genes govern the prion protein, and by examining those genes it is possible to tell whether individual sheep will be resistant or susceptible to scrapie. But the Barbers are not breeding from scrapie-resistant sheep one at a time. Once they have identified scrapie-resistant ewes, they give them a course of injections so that they produce more than the normal number of eggs.

These eggs are then fertilised with semen from rams whose genes are also resistant to the disease. "The embryos are tiny," says Jonathan Barber, "you could put the whole of the UK's national sheep flock, up to 40 million sheep, into a pint pot".

Thirty or 40 fertile embryos are flushed out onto a glass dish, examined under a microscope to check they are fertile, and placed in surrogate mothers which give birth to lambs five months later.

However, supplying farmers and breeders with more and more sheep which have this particular genetic characteristic, could carry a risk.

Dr Chris Bostock, Director of Research at the Institute for Animal Health, says the dangers lie in reducing the range of genes contained in the national flock.

"At the moment we know that there are many different strains of scrapie. Some of them produce disease in some breeds, some produce disease in other breeds. The danger is that we don't know what drives change in the infectious agent. If we create a population of sheep that are homogenous - at the moment homogeneously resistant to strains of scrapie - we don't know whether the scrapie agent can change in such a way that it can now infect this previously resistant population of sheep"

But, the Barbers say enough of their sheep are resistant to make sure they keep a wide variety of genes. "I don't think there is a worry," says Jonathan Barber. "We've done lots of blood tests in lots of different breeds, and certainly within our own breed we've found a high proportion of animals which are not genetically susceptible - so that means that we have plenty of genetics to work at. So I don't think we are going to narrow the gene pool to be any worry at all."

The veterinary costs, of getting ewes to produce more eggs, fertilising them, flushing out the embryos and reinserting them into surrogate mothers add up to about a hundred pounds per sheep.

Caroll Barber thinks it will become more profitable as consumers demand every conceivable protection from disease. "As the sheep industry we must be very aware and concerned that we are selling a meat product and it is beholden on us that we aren't putting at risk our consumers.

"Scrapie has been in the country for two or three hundred years and we have never seen a problem pass onto a consumer. But we mustn't be complacent. If we have the wherewithal to eradicate any slim chance of a problem, then it's something we must do."

So far humans have stayed free of scrapie, but those other prion diseases, BSE and CJD, have made consumers more wary of the unknown. The way the Barbers see it, the need to eradicate scrapie has never been more urgent, and the prospects of doing so never as great.

Britain details the start of its 'mad cow' outbreak

January 26, 1999 The New York Times EMILY GREEN
Despite years of increasing worry and worldwide headlines, the British government has, according to this story, only now gathered the information it needs to figure out how "mad cow disease" spread through the nation's dairy herds and apparently cost 35 people their lives.

Late last year, a public inquiry by the government concluded the yearlong fact-finding phase of a nationwide investigation into the handling of mad cow disease, more properly known as bovine spongiform encephalopathy, or BSE.

On the same day, an advisory committee of the U.S. Food and Drug Administration recommended that the agency consider banning blood donations from people who have visited Britain since 1980, just in case the disease could be spread through the donations.

Both the recommendation and the British inquiry have the same aim: prevention.

Colin Blakemore, a professor of physiology at Oxford, called for the investigation in 1997, when he assumed the presidency of the British Association for the Advancement of Science. The year before, Blakemore was quoted as saying, "We must reform the way in which scientific advice is given to and interpreted by government ministers. Time and time again, inappropriate assurances to do with human health were made by people with no qualification to make them."

The British panel will sort through the information it has gathered and issue conclusions and recommendations in June. In the process, it is producing a medical detective story of unusual proportions. Testimony by scientists, veterinarians and doctors who dealt with the disease has painted a detailed picture of what happened in the field and in the laboratory as the outbreak took its course.

The Phillips inquiry has established that the epidemic began 14 years ago. On Dec. 22, 1984, a veterinarian named David Bee was called to a farm in West Sussex, in southern England, where a dairy cow known simply as No. 133 was displaying what he described as "a variety of unusual clinical manifestations." By Feb. 11, 1985, No. 133 was dead, and more cows on the farm were showing symptoms, including aggression, panic and lack of coordination.

Bee ruled out several possible causes: lead and mercury poisoning, fungal contamination of the feed container, kidney parasites. After six more cows on the farm died, the farm owners agreed to allow another sick animal, No. 142, to be killed so that an autopsy could be performed by the government. The report came in on Sept. 19, 1985. The cow's brain was riddled with spongelike holes, a pathologist at the government's Central Veterinary Laboratory in Weybridge, Surrey, said. Cow 142 had a "spongiform encephalopathy."

But it took pathologists more than a year to realize that the spongy-brain disorder was a disease in itself, and not the result of something else, such as poisoning. [Wrong -- this web site carries a scan of the memo written by the veterinarian pathologist. It was recognized for exactly what it was. Her supervisors refused to investigate further. -- webmaster] By November 1986, the condition had a name: bovine spongiform encephalopathy, one of a school of diseases known as transmissible spongiform encephalopathies, including scrapie, a disorder of sheep, and kuru, a human disease linked to cannibalism.

By March 1988, the source of bovine spongiform encephalopathy had been tracked by a Central Veterinary Laboratory epidemiologist to what Daniel Carleton Gajdusek, a kuru researcher and Nobel laureate, now calls "high-tech cannibalism"the use of performance-enhancing dairy feeds whose protein came from meat and bone meal from slaughtered sheep and cows. (The practice of including these ingredients in animal feed is no longer allowed in the United States.)

The British government quickly announced the formation of a scientific consultative committee to be led by a professor of zoology at the University of Oxford, Sir Richard Southwood. This group recommended that ruminant protein be banned from cattle feed, and a crucial issue being examined by the inquiry is the efficiency with which that ban was put into effect.

By fall 1988, people were beginning to wonder if the condition could spread to people who ate meat from sick animals. As Southwood recalled for the inquiry, "From work on scrapie we considered that the central nervous system and, to a lesser extent, the lymphatic system were the tissues that would harbor the agent." As a result, a total ban on the use of certain bovine offals, including brain, thymus and spleen, was announced in June 1989.

British pet food manufacturers had removed these substances from their dog and cat food a year earlier, but in May 1990, a house cat came down with a BSE-like disease, followed by a several zoo animals.

This ominous "species jump" prompted another government action. The Southwood committee had predicted that, should bovine spongiform encephalopathy erupt in humans, it would "closely resemble Creutzfeldt-Jakob disease," a fatal neurodegenerative disease that usually strikes the elderly and, like kuru, scrapie and BSE, is a transmissible spongiform encephalopathy. Shortly after the first cat died, a unit was set up at Western General Hospital in Edinburgh to monitor humans for signs of Creutzfeldt-Jakob disease.

Four years later, in summer 1994, in Wiltshire, the disease first appeared in a human, when the parents of a Royal Air Force cadet, Stephen Churchill, noticed that he had slipped behind in school. Soon he had succumbed to hallucinations. By March 1995, he was undergoing comprehensive tests at the National Hospital for Neurology and Neurosurgery in London. There, his mother for the first time saw a possible diagnosis in a note on his chart: "CJD?"

Stephen Churchill died on May 23, 1995, and by that fall more young people were found to be stricken with the same illness. Could the disease be spreading from cows to people? The British government maintained that beef products were safe. But some scientists began to contradict this position publicly.

In December 1995, Sir Bernard Tomlinson, a neuropathologist from Gateshead in northeast England, announced on BBC Radio 4 that he would not eat beef organs, including calf's liver. The health secretary at the time, Stephen Dorrell, responded on BBC, saying, "We have removed from the human food chain the organs that could conceivably be linked to that," and "There is no conceivable risk from what is now in the food chain." [See recent paper on infectivity of hides -- webmaster.]

Nevertheless, only four months later, on March 20, 1996, Dorrell read a fateful statement before the House of Commons that 10 young people had died, and "the most likely explanation" was "exposure to BSE." That day the world learned the name of a new disease: new variant CJD, or human BSE.

The European Union banned the sale of British beef for three years, until November 1998. In the meantime, according to Britain's Ministry of Agriculture, Fisheries and Food, more than 4,347,380 cattle were destroyed, most merely because they were deemed old enough to conceivably harbor the disease agent. The Ministry of Agriculture has estimated that the total cost will reach $7.13 billion by 2002.

To date the human death toll stands at 35, with 34 cases in the United Kingdom and one in France. Scientists who tested tissue samples at the Neuropathogenesis Unit in Edinburgh and at Imperial College School of Medicine at St. Mary's Hospital in London said BSE and human BSE are caused by the same disease agent, possibly a novel form of protein called prions. Whether humans were infected by bovine products, or from an independent source entirely, remains unknown.

News last year that two of the British victims had been blood donors has led to the establishment of a $77.5 million program to strip donated blood of the white blood cells that might carry the BSE agent. Meanwhile, Britain is importing most of its blood for plasma, mainly from the United States.

Some scientists regard the small number of cases among humans as a reason for optimism. But estimates of how many cases may follow vary wildly, from tens to hundreds to hundreds of thousands [or a few millions -- webmaster].

More than 173,000 cows from all over Britain have been confirmed to be infected. Hundreds of thousands more might have entered the food supply undetected. Though the inquiry has yet to draw conclusions, its work has brought some comfort to the families of people affected by the disease. "What we want is the truth," said Stephen Churchill's mother, Dot Churchill. "We believe that's what we'll be told by the inquiry."

Plough-to-plate food scrutiny will cost £120m

January 28 1999 L Times
A FLAT-RATE levy of £90 a year on nearly 500,000 food retail and catering premises was proposed by the Government yesterday to help to pay for a new food safety watchdog.

The levy was the most controversial element of a draft Bill for the creation of a food standards agency, which will monitor the safety of what Britain eats from plough to plate.

Retailers and farmers welcomed the principle of the agency but said that its independence would be undermined from the outset if it depended on food industry funding. Butchers, corner shops and other small businesses said it was unfair that they should be charged the same rate as supermarket chains and hotels.

Nick Brown, the Agriculture Minister, said the levy proposals would be put out to consultation for two months and could be amended in the light of these discussions. "The food industry is being asked to fund the extra costs of setting up the agency but most of the cost of protecting food safety will continue to be met from public funds," he said.

Mr Brown described the levy as modest, working out at £1.73 a week, roughly the cost of one prepared sandwich. Local authorities would be given the task of collecting the levy and would be able to use some of the money to finance food safety enforcement through environmental health officers.

There are 515,000 registered restaurants, hotels, shops, caterers and other outlets selling food to the public. But 25,000 of these, including small businesses such as newsagents, will be exempt from the levy. It will raise an estimated £40 million a year for the agency's start-up costs and part of its £120 million annual budget, with the rest coming from general taxation. The levy will be reviewed after three years.

Mr Brown said that the agency would not involve extra public expenditure because the money would come out of the £250 million a year already spent on food safety through such bodies as the Ministry of Agriculture and the Department of Health. He hoped the Bill could become law by this autumn and the agency be working by early next year. It will be headed by a chairman and will have about 12 independent members. It will be accountable to Frank Dobson, the Health Secretary, and will have 500 staff transferred from Agriculture and Health.

The new body will have the power to advise ministers, recommend policy changes and draft some legislation. It will be free to make public its advice to ministers. The agency will share with the Health Department the task of advising the public on diet and nutrition and will be consulted on the health aspects of genetically modified crops. One of its main functions will be to monitor the work of local councils.

The British Retail Consortium said last night: "The retail sector should not have to pay for the Government's constitutional work of enforcing food safety. £90 is not a modest sum for many small retailers." Graham Bidston, of the National Federation of Meat and Food Traders, which represents 3,000 independent butchers, said: "We support the agency in principle but anything that is funded by the industry will not be credible in the eyes of the public."

Canadian government sued for allowing use of tainted blood from U.S.

January 28, 1999  By DAVID CRARY Associated Press
TORONTO - Canadian hemophiliacs launched a class-action lawsuit Thursday against the Canadian government and two companies for using tainted plasma from U.S. prisoners in Canadian blood products. The lawsuit, seeking $655 million, contends that the high-risk plasma collected at prisons in Louisiana and Arkansas was used in Canada even after U.S. blood-product companies stopped buying prison plasma in early 1983.

David Harvey, the lawyer representing the plaintiffs, estimated that 1,000 Canadian hemophiliacs contracted hepatitis C between 1980 and 1985 from tainted blood imported from the United States. "This was blood the Americans refused to use themselves, but which Canada somehow deemed acceptable," Harvey said. Experts were aware by the early 1980s that prisons were a risky source of donated blood because of the high level of intravenous drug use and unprotected sex among inmates.

Canada has been struggling for several years to settle compensation for the more than 11,000 Canadians infected with hepatitis C and AIDS during the 1980s because of tainted blood in the national blood supply. The bad blood came from many sources.

The government has accepted responsibility for infections that occurred between 1986 and 1990, but says it could have done nothing to prevent pre-1986 problems because effective blood-screening techniques were not available. The lawsuit challenges this position, saying the government and the two companies should have known prior to 1986 that blood collected from prison inmates was likely to be contaminated.

"If they refuse to admit responsibility in the court of public opinion, we will force them to admit it in the court of law," said Michael McCarthy, the lead plaintiff in the lawsuit.

The companies named in the lawsuit are Montreal-based Continental Pharma Cryosan, which imported the plasma, and Toronto-based Connaught Laboratories Ltd., which used the plasma in its blood products. An official Canadian inquiry into the tainted-blood scandal determined in 1995 that some of the questionable plasma came from a prison in Grady, Ark., where some donor inmates were found to have hepatitis.

Continental Pharma was informed of the problem, but did not immediately notify Connaught, the inquiry report said. Plasma collected from four prisons in Louisiana also reached Canada, according to the report. The Canadian Health Department had no immediate comment on the lawsuit.

McCarthy, a hemophiliac from Waterloo, Ontario, says he contracted hepatitis C from using Connaught products between 1980 and 1984.

Tainted-blood scandal haunts Canadian government

January 28, 1999 Reuters News Service By LAUREN MCNABB 
OTTAWA - A scandal in Canada over tainted blood that nearly paralyzed the federal government in the first half of last year is still alive as Parliament prepared to resume its winter session next week. The debate centers around a $.72 billion government compensation plan for many of those who have been infected with hepatitis C - a debilitating and sometimes fatal liver disease - through the federally regulated blood bank system.

The government had hoped its compensation offer would put the issue to rest, but the president of the Hepatitis C Society of Canada, representing some 3,000 members, has urged that they reject it.

"Our society is giving the thumbs down to this plan," the society's president, Jeremy Beaty, told a news conference Wednesday. "We are urging the lawyers who've been negotiating behind closed doors to come into the open, talk to the victims who they haven't been talking to and come up with a plan that is more acceptable than the one that we understand is on the table."

Beaty and his allies in the opposition benches of Parliament had painted the Liberals as uncaring technocrats, first for offering inadequate funds and second for limiting compensation solely to those infected from 1986-90. The Liberals argued that the government should be cautious about providing compensation for every medical mistake.

Federal and provincial health ministers chose 1986 as the cutoff date for compensation because it was then that testing of blood supplies for the disease started in the United States. The Canadian Red Cross, which used to be the main blood agency, introduced a hepatitis C screening test in 1990.

Health Minister Allan Rock, a potential contender for the job of prime minister, spent most of last year conducting damage control on the hepatitis C issue. He signaled Wednesday he would not budge on the latest proposal.

"We believe the package is fair and generous," his spokesman Derek Kent said. "It's now up to each individual to decide whether or not to accept the package." Under the current deal, each hepatitis C victims infected during 1986-1990 would receive a lump sum of C$10,000 to compensate for any pain and suffering and loss of enjoyment of life. Any additional funds would be provided only if the disease progresses and only under a 75 percent payout sum that depends on what the settlement fund could afford at the time.

But Beaty says the allotted funds cannot even begin to cover the psychosocial and socioeconomic aspects of the disease. "Once you're labeled with the disease, once the doctor calls you and says you have hep C, your whole life changes," said Beaty, who says he contracted the disease through no fault of his own prior to 1986.

"Your sexual habits with your partner change, you have out-of-pocket expenses for alternative therapies, there are travel costs to specialists, and there is all the family stress. There are a tremendous amount of breakups between husbands and wives and the impact on employment is severe."

Speaking on behalf of his 16-year-old son Joey, Joe Hache said the C$10,000 sum was blood money to the victims. His son contracted the disease over nine years ago and must take C$150 worth of vitamins a month to alleviate any pain. "This framework agreement is a slap in Joey's face and thousands of others ... is this agreement acceptable? No way," said Hache.

The Ottawa Citizen newspaper reported separately that 200 hemophiliacs would file a class-action lawsuit in Toronto Thursday against the federal government and two companies over the shipment to Canada of contaminated plasma from U.S. prisons in the early 1980s.

In the U.S military, a battle over vaccination

Christian Science Monitor Service By WARREN RICHEY  January 29, 1999
Tom Rempfer is ready at a moment's notice to pack a bag and head out to any part of the world to fly combat missions in his A-10 fighter aircraft. The Connecticut Air National Guard captain says he is prepared to put his life on the line anyplace, anytime to protect the interests of the Untied States.

But earlier this month, Rempfer's commanders gave him a direct order he says he cannot obey. They ordered him to roll up his sleeve and accept a vaccination against anthrax, a biological weapon believed to be in Saddam Hussein's arsenal. "We were given the choice, take the vaccine or be grounded from your flying duties as A-10 attack pilots," Rempfer says.

"This is the only order I've ever had to refuse," says Air National Guard Maj. Dom Possemato, who shares Rempfer's dilemma. "I'm willing to accept that an Iraqi or Iranian might shoot me and put me in a grave, but I'm not willing to let my country do it with an unproved vaccination." Of 35 pilots in Possemato and Rempfer's squadron, nine have refused the shots.

The vaccination issue has been percolating since December 1997 when Defense Secretary William Cohen ordered all of the nation's 2.4 million soldiers and sailors (active duty, reserves, and national guard) to receive the anthrax vaccination. Pentagon officials insist the shots, which began in August and will continue for the next five years, are safe and effective. But many of those facing anthrax vaccinations aren't so sure.

The issue is critical because vaccination is a cornerstone of U.S. policy to protect the nation's forces from biological warfare whether waged by Saddam Hussein or free-lance terrorists. Planners are seeking to develop a dozen or more vaccines to safeguard American troops from a wide variety of biological and chemical weapons threats. In short, it holds the promise in the minds of some military strategists of rendering American forces immune from a particularly deadly form of terror.

But to many on the sharp end of the needle, the real terror springs from a U.S. policy forcing fearful soldiers to be injected with a vaccine they believe is neither safe nor effective, and may result in long-term health problems.

"In some ways they are playing Russian roulette, except the bullet goes really, really slow. The bullet may not hit you for 20 years. We just don't know," says Mark Zaid, a Washington lawyer active in the vaccination issue. "When the government starts to abuse our children - that which is sacred to us - that is when the line in the sand gets drawn," says Tim Watson, a Vietnam veteran whose son is a Marine worried about the vaccination. "This is morally wrong. This is communism when they do things like this."

Not everyone is concerned about the anthrax vaccinations, however. More than 166,000 service members have already received the first of the set of six shots. Only 76 have refused, says Pentagon spokesman Jim Turner. "It is just a handful of people," Turner says of the refusers. "I think that is absolutely remarkable. It's been a highly successful program by anyone's measure."

Those opposed to the vaccination policy say the number is low because military leaders are threatening to court-martial anyone who declines the shots. So far no one has faced an actual court-martial, though that may change soon. A U.S. Air Force airman at Travis Air Force Base in California may become the first American to be tried in a military court for refusing the shots.

All other refusers have lost pay, been fined, restricted to base or ship, and lost rank before being tossed out of the military under a general discharge. The General Accounting Office, the investigative arm of Congress, is looking into the vaccination policy. And concerned parents and spouses of military personnel have called a town meeting for Feb. 22 in Ilion, N.Y., to discuss the issue.

The fears of many are fueled by mistrust of military leaders who seem to them unresponsive to their concerns. They point to soldiers being contaminated during early nuclear weapons testing in the 1940s and 1950s, and combat forces exposed to Agent Orange in Vietnam in the 1960s. They also cite the lingering mystery surrounding an array of illnesses suffered by many Gulf War veterans in the 1990s.

Critics say the Pentagon should suspend the anthrax vaccination program pending comprehensive and independent testing of the long-term effects. Some suggest the United States should adopt a voluntary vaccination program like Britain's. Roughly 30 percent of British military personnel opted for the anthrax vaccination, while 70 percent declined, says a spokesman for Britain's Defense Ministry.

"I don't have good advice for service members," says Meryl Nass, an emergency-room doctor at a Maine hospital, who has spent 10 years researching anthrax and the vaccine issue. "I wouldn't take the vaccine myself. But I'm not planning a career in the military either." Nass and other critics use the Internet to provide an information clearinghouse for anyone skeptical of the anthrax program.

The Defense Department has tried to counter with a Web site of its own, but the site doesn't directly address many pointed questions raised by critics. "How can I trust a government that admitted to conducting secret experiments on military personnel in the past?" asks a young female sailor in an e-mail message. "Had I known when I was a civilian that I could be injected with experimental chemicals and medicines without my consent, I would not have joined."

Turner says the vaccine program is not experimental. "We have a vaccine that is safe, effective, and FDA approved," he says. "It has been out there since 1970 with an excellent safety record. How much testing is enough?"

USDA says Bil Mar meat recall could be largest in U.S. history

January 28, 1999  Reuters News Service By BARBARA HAGENBAUGH 
WASHINGTON - U.S. Agriculture Department officials estimate that the meat recall by Bil Mar Foods, a division of Sara Lee Corp., could end up being the largest in U.S. history, aides said Thursday. Currently, estimates of Bil Mar's recall range as high as 35 million pounds. A Sara Lee spokeswoman denied that the recall would be as large as 35 million pounds and repeated that the company expects to retrieve 15 million pounds of meat.

Bil Mar announced in December that it was recalling hot dogs and luncheon meat produced at its Zeeland, Mich., plant over sixth months. The meat had been linked by the Centers for Disease Control and Prevention to an outbreak of listeriosis, a condition caused by deadly Listeria bacteria.

The CDC said Monday that since August, 12 people have died, three women have had miscarriages and at least 79 people in 17 states have been sickened by Listeria bacteria.

According to Agriculture Department figures, the Zeeland plant involved in the recall produced 700,000 pounds of hot dogs and packaged meat per day of operation, aides said. But the department is still trying to obtain more information to develop an exact figure for the amount of meat recalled. "We still do not have a good estimate," an Agriculture Department spokeswoman told Reuters. Listeria bacteria is found in soil and in water and causes a condition called listeriosis, which is not normally contracted by healthy people.

The most common symptoms are meningitis, which has symptoms including high fever, severe headaches, neck stiffness and nausea. Listeriosis can cause miscarriages and stillbirths, and can be fatal for those with weakened immune systems, including infants, the elderly and people with chronic diseases.

Three more companies have announced since Bil Mar that they are recalling meat after Listeria was found in their products. Last week, Thorn Apple Valley, a Michigan firm, recalled 30 million pounds of hot dogs as well as luncheon kits produced during a six-month period at its Forrest City, Ark., plant.

The Thorn Apple Valley recall is currently considered the biggest in history, surpassing the previous U.S. record of 25 million pounds of tainted ground beef recalled by Hudson Foods Inc. in 1997. No illnesses have been linked to the Thorn Apple Valley products. The products were sold nationwide, as well as in South Korea and Russia, by a variety of companies and packaged under different names.

The Agriculture Department on Thursday provided updated information about the brand names the Bil Mar and Thorn Apple Valley meat were sold under. Last week, Bosell Foods Inc. of Cleveland recalled 350 pounds of sliced ham. No illnesses were reported.

Earlier this month, Oscar Mayer Foods, a unit of Philip Morris Cos., voluntarily recalled two types of luncheon meat after an elderly man in Kansas City, Mo., became sick after eating the company's deli meat. Government officials said there was no evidence that the four cases are linked.

Chicken burritos latest product added to meat recall

February 6, 1999 Reuters News Service
CHICAGO - Thousands of chicken burritos made by a division of food conglomerate Tyson Foods Inc. have been recalled, the latest instance of contamination by the deadly bacteria listeria. The recall affects some 78,000 burritos supplied to American Airlines at the end of last year, according to a report in the Detroit Free Press.

Chicago-based Culinary Foods Inc., a unit of Tyson Foods, is a supplier to airlines and also makes foods for restaurants, totaling about 50 million meals per year, the paper reported. Listeria bacteria was found in burritos sampled in Detroit, the paper said. When ingested, the bacteria causes a disease called listeriosis that starts out resembling intestinal flu but can lead to death.

A number of food products have been recalled recently, most notably hot dogs and deli meats made by Sara Lee Corp.'s Bil Mar Foods in December. A nationwide outbreak of listeria linked to Bil-Mar's Zeeland, Mich., plant has caused 16 deaths, according to the U.S. Centers for Disease Control and Prevention.

On Friday, meat companies in Ontario, Canada, and the Pacific Northwest recalled hot dogs suspected of contamination with the potentially deadly bacteria. Listeriosis primarily affects unborn children, the very young, the elderly and people with weakened immune systems. Healthy people are not normally sickened by it. At least one wrongful death suit has been filed against Sara Lee by a man who's wife died of listeriosis.

Officials from Culinary Foods and Arizona-based Tyson could not be reached for comment. According to the Detroit paper, Culinary Foods is a major supplier to the airline industry, with its foods showing up on almost all major carriers and foreign airlines as well. Dallas-based American Airlines stopped serving all food from Culinary Foods about a month ago after concerns arose, the paper reported.

Altered cerebral blood flow may cause Alzheimer's

January 26, 1999 Associated Press By MALCOLM RITTER
NEW YORK - Bits of a natural protein may promote Alzheimer's disease by disrupting the flow of blood in tiny vessels of the brain, according to a study in the February issue of the journal Nature Neuroscience.

The study provides more evidence that vitamin E and other antioxidants may fight the disease, and suggests that finding treatments to restore normal blood flow may also pay off.

Scientists don't know what causes most Alzheimer's cases. Many point to overproduction of natural protein fragments called amyloid-beta, which form clumps in the brains of patients. Studies show these fragments can kill brain cells.

The new work by neurologist Constantino Iadecola of the University of Minnesota and others suggests amyloid-beta, or related fragments, can promote Alzheimer's in a second way: by boosting production of harmful substances called oxygen radicals, which in turn keep tiny blood vessels from delivering the right amounts of blood to brain cells.

In the brain, amyloid-beta fragments are clipped from long proteins called APP. The researchers studied a strain of mice that overproduce APP, which leads to an overproduction of amyloid-beta. Mice from this strain eventually develop mental problems resembling Alzheimer's.

In the latest study, the mice were studied long before any Alzheimer's-type symptoms appeared. Researchers found that microscopic blood vessels in the mice brains didn't respond to a chemical signal to dilate, which would increase blood flow. In normal life that might mean the vessels can't shunt more blood to brain cells when they need it, Iadecola said.

Eventually that could damage those starved cells, or at least make them more vulnerable to damage from other causes, he said. But because the mice produce other fragments of APP in excess, the study can't formally show that amyloid-beta is the cause of the brain troubles in the mice, Iadecola said.

The researchers found two bits of evidence that oxygen radicals were involved in the blood vessel problem.

Researchers were able to prevent the abnormality by bathing the brain with an antioxidant, which render oxygen radicals harmless. In addition, mice that were programmed genetically to overproduce an antioxidant in addition to APP didn't show the abnormality in the first place. Iadecola said a 1997 study of Alzheimer patients found that vitamin E, an antioxidant, modestly slowed the course of the disease.

Quick check for Alzheimer's

Fri, Jan 29, 1999 Mushie Bolgla  UPI Science News
NEW YORK, Jan. 29 -- Researchers at New York's Albert Einstein College of Medicine say they have developed a quick and accurate screening test to identify people with early Alzheimer's disease and other memory disorders of late life.

The test, named the Memory Impairment Screen (MIS), also will be used to reassure the millions of people with memory complaints who are worried about Alzheimer's but shouldn't be. This fear can start for people who are in their 20s, but most often comes in mid-middle age, when brains become so packed with data that forgetfulness is common. The researchers, led by Dr. Richard B. Lipton, a professor of neurology, report their findings in the current issue of the journal Neurology. The results were based on a study involving almost 500 older people.

While Alzheimer's can only be diagnosed definitively after death, symptoms that point to the disease can often be recognized by experts. The MIS test takes only four minutes and has shown to be effective so far in separating people with normal forgetfulness of aging from those who likely have Alzheimer's, Lipton told United Press International today. His goal is to persuade primary care doctors to give the test to patients who're worried they may have Alzheimer's.

"There is an absolute epidemic of middle-aged and older people who think they have it, and they need to be reassured they don't or referred to a specialist," he said. "We wanted to be able to screen and reassure the needlessly worried and, at the same time, identify the patients who required further diagnostic assessment and possible treatment," he said. "Follow-up studies are currently planned or under way to assess the utility of the MIS in a variety of health-care settings and to evaluate a telephone version of the tool, which will include a cross-section of Bronx residents."

Dr. Herman Buschke, a neurologist at the Albert Einstein College of Medicine of Yeshiva University, said the test "uses insights into the nature of memory decline in Alzheimer's disease to improve early detection of the disorder." Lipton stressed the MIS is a screen test, not a diagnostic one, and because it only takes 4 minutes, can easily be incorporated into a routine doctor's visit.

The test uses category cues in which people are shown a card with four words and then asked questions about what they saw that reflect what they were thinking when the words were read. For example, a card might contain the word "furniture," and a person would then be asked to cite an example, such as chair or desk. Or shown moments later pictures of desks or chairs and asked to recall the word that was read. Or the person might be told a word, like desk, and asked to recall the category, in this example, furniture, he or she read on a card.

"The test is based on an insight into the nature of memory decline," Lipton said. "It turns out if you use category cues you can dramatically improve memory. To know a desk is an item of furniture, the subject has to be engaged and thinking about an abstraction." Using category cues should enhance performance, Lipton said, but doctors will be given scoring methods that will enable them to know when to refer patients to specialists.

Screening is needed for a variety of reasons, he said. Alzheimer's can be treated, though not cured, and new drugs are being developed, he said. Also, there are other reasons for memory loss not related to dementia, such as B-12 deficiency and blood clots. "And the final reason screening is important is that although Alzheimer's is extraordinarily common, it is not epidemic," Lipton told UPI. "But the fear of Alzheimer's is truly epidemic. Just about everyone has some sort of memory problem. Giving primary care doctors tools for reassuring people they're OK is also very important."

One drug, aricept, seems to increase the amount of acetylcholine in the brain, which seems to slow down memory loss. "What we want to do is help primary care doctors separate normal memory decline from the sort of memory problem that is symptomatic of early Alzheimer's and other memory disorders," Lipton said. Alzheimer's can be diagnosed definitively now, but there's no way to prove a person had Alzheimer's until a brain autopsy is performed.

Brussels spin doctors told truth must often be hidden

January 28 1999 L. Times CHARLES BREMNER IN BRUSSELS
A TEAM of experts was appointed last night to investigate allegations of corruption against European Commissioners, but efforts to clean up the image of the Brussels executive were marred by an embarrassing blunder by its own spin doctors.

The Commission's media service accidentally released an internal memorandum that called for a measure of "hypocrisy" and evasion when dealing with the press.

The Commission should not get carried away by the idea of "transparency", it said. "It is necessary to learn how to conceal aspects of information . . . which could give rise to bad interpretation."

The note was drafted by the spokesman for Edith Cresson, the Commissioner most under fire over allegations of nepotism, according to officials. The spokeswoman for Jacques Santer, President of the Commission, tried to play down the memo as a personal contribution to the attempt to revamp media strategy.

The need for this became urgent after the crisis this month in which the European Parliament came close to censuring Mr Santer and his 19 fellow Commissioners over claims of incompetence and corruption. The blunder of the note's release spoke volumes for the disarray in the Commission as it faces charges of cover-up and a culture of secrecy from politicians and media.

Mme Cresson is one of the main targets of the five experts who were picked by the Parliament and Commission to investigate allegations of abuses. The creation of the group of former high officials was agreed in the deal two weeks ago which enabled Commissioners to escape a parliamentary vote that could have dismissed them.

The team comprises Juan Antonio Carrillo (Spain), a former judge of the European Court of Human Rights; Pierre Lelong (France), former president of the EU Court of Auditors; Andr» Middelhoek (Netherlands), former president of the Court of Auditors; Walter Van Gerven (Belgium), former advocate-general at the European Court of Justice; and Inga-Britt Ahlenius (Sweden), auditor-general of Sweden's National Audit Office.

The experts are due to report to the Parliament within a month. They will then start a broader inquiry into mismanagement of the Commission's spending programmes.

The executive, which has promised to give the investigators free access to documents and staff, yesterday agreed on a timetable for a new code of conduct for Commissioners and new staff rules that would outlaw cronyism and other questionable practices.

British Conservative MEPs last night denounced the investigation as insufficiently independent. Edward McMillan-Scott, leader of the Tory group, regretted that there would be no British influence and said the Commission was still seeking to control its work. He added: "This has been launched to get Commission officials off the hook, but if it confirms that there is a culture of cover-up it will have served a purpose."

Pauline Green, the Labour MEP who heads the dominant Socialist bloc in the Parliament, promised that the assembly would be merciless if wrongdoing was found.

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