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nvCJD cases reach 34
I believed BSE experts', says Bottomley
Two new CJD-related websites
EU vets reject stricter mad cow controls
18 Dec 98 meeting: Possible deferral of blood or plasma donors
Book review: The Trembling Mountain. A Personal Account of Kuru, Cannibals, and Mad Cow Disease
Gummer explains his advice on beef safety
Beef safety compromised, says former CMO
CJD epidemic won't happen, says electrical engineer
Nothing yet totally kills mad cow agent - expert

Introducting Two New CJD-Related Websites

7 Dec 98 by Deborah Oney
"I would like to tell you about two relatively new CJD-related websites whch I think you will find of interest:

1. The Many Faces of Creutzfeldt-Jakob Disease website is a collection of personal stories that put a face on CJD. People describe very early symptoms and the progression of the disease. There are currently 27 stories (25 about people who died of CJD, one about a person who currently has CJD and one by a blood recall notification recipient.) The website is continually being updated as new stories are submitted.

2. The CJD Watch website is an attempt to track CJD cases throughout the world by geographical area. The tracking unit varies by country. In the United States the cases are tracked by county.

Barbara Matthews is the web administrator for both these websites. Please let her know about cases for the CJD Watch website. Also, please let families of CJD victims know about these websites."

Marc BARBIER
INRA ESR
DOMAINE UNIVERSITAIRE - BP 47X
38 040 GRENOBLE cedex - FRANCE
Tel: (33).4.76.82.78.82
Fax: (33).4.76.82.54.55
"Another CJD web site is under development in France, called the BASES Project. Mainly, since it is a research project in social science and information system, we hope to be able to structure a retrospective common database about TSE (with a BSE orientation as a model) mixing a scientific sub database, a regulation sub database, a media sub database and an expertise sub datadbase for UK, Netherland, Portugal and France. The aim will be then to use this Common DataBase to develop sociological and political analysis of the BSE saga using weak-signal analysis with scientometrics tools and full text analysis softaware.

The perspective is to design the feasibility of an early listening system in such situation of collective risk management. This project will also be fully accessible to the public on the Web; our first aim is to deliver a public structured database and some teaching about how the relations between scientific productions and public decision-making have been shaping this 'saga' "

EU vets reject stricter mad cow controls

December 2, 1998 Reuters
BRUSSELS -- European Union veterinary chiefs were cited as rejecting tighter controls on cattle parts most at risk of carrying mad cow disease on Wednesday in what this story calls a move which threatens a transatlantic trade row by default.

The EU's Standing Veterinary Committee voted down a European Commission proposal to increase consumer protection by excluding from the food chain by law so-called Specified Risk Materials (SRMs) such as the spinal cords, brains and eyes of cattle.

The vote -- not one country supported it -- is another blow for the Commission, which has been trying to get EU legislation through on this matter for two years. Each time member states, worried over extra financial costs, have thwarted it.

The story notes that Wednesday's vote now leaves in place even wider-ranging rules due to come into force by default on January 1, under which an already proposed SRM ban would be extended to cosmetics and pharmaceuticals, many of which contain cattle derivatives such as tallow.

This legislation provoked an angry reaction from the United States, which said it threatened billions of dollars' worth of trade. Since then, the Commission has proposed various amendments to work round the problem -- the latest proposal gave a complete derrogation to pharmaceuticals and cosmetics.

Comment (Roland Heynkes)

"I talked with one of the few German governmental BSE experts this morning in order to verify this and indeed it is true. Even the new German government says that in Germany it is not necessary to exclude the central nervous system from human food, because there is no BSE in Germany. Of course I disagree with this position, because until now we have had no sensitive BSE tests and even if we would test every slaughtered animal, this could not exclude BSE infected animals from human food. Therefore I agree with the EU Commission that it would be a good idea to exclude the most infective materials from human consumption as a measurement of precaution."

Comment (J Ralph Blanchfield):

"This is a grossly misleading headline and first two paragraphs. A headline that properly reflected what had happened would have been:

EU VETS REJECT WATERING-DOWN OF SRM CONTROLS TO PLACATE USA

Actually this time the Commission was proposing watered-down compromise measures to satisfy US objections. As a result of the vets rejecting that, by default even wider-ranging SRM rules come into force by default on January 1, under which an already proposed SRM ban would be extended to cosmetics and pharmaceuticals, many of which contain cattle derivatives such as tallow."

18 Dec 98 meeting: Possible deferral of blood or plasma donors

 Transmissible Spongiform Encephalopathies Advisory Committee 4 Dec 98
Date and Time: The meeting will be held on December 18, 1998 from 8:00am to 5:30pm. Written comments must be submitted by 4:30pm EST Friday, December 4, 1998.

Location: Holiday Inn-Bethesda, Versailles I & II, 8120 Wisconsin Avenue, Bethesda, MD 20814.

Addresses: Submit written comments to docket number 98N-0966, Dockets Management Branch (HFA-305), Food and Drug Administration, 5630 Fishers Lane, Rm. 1061, Rockville, MD 20852. E-mail address: JBUTLER1@BANGATE.FDA.GOV.

Contact Person: William Freas or Sheila D. Langford, 301-827-0314, or FDA Advisory Committee Information Line, 1-800-741-8138 (301-443-0572 in the Washington, DC area), code 12392. Please call the Information Line for up-to- date information on this meeting.

Agenda: On December 18, 1998, the committee will discuss possible deferral of blood or plasma donors based on geographical criteria linked to possible foodborne exposure to the agent of Bovine Spongiform Encephalopathy as a measure to reduce the potential for transmission of new variant Creutzfeldt- Jakob Disease (nvCJD) through blood and blood products. The potential effects of such deferrals on the supply of blood and blood products will be considered as part of the committee's deliberations.

Procedure: Interested persons may present data, information, or views, orally or in writing on issues pending before the committee. Written submissions should be sent to Dockets Management by December 4, 1998 as described below. Oral presentations from the public will be scheduled between approximately 2:15 and 3:15pm. Those desiring to make formal oral presentations should notify the contact person before December 9, 1998.

Comments: Interested persons may by 4:30pm EST, December 4, 1998, submit to the Dockets Management Branch (address above) written comments regarding this subject. Comments received by close of business December 4, 1998 will be given to the committee for review and made available to the public. Two copies of any comments are to be submitted, except that individuals may submit one copy. Comments are to be identified with the docket number 98N-0966. The received comments may be seen in the Dockets Management Branch between 9:00am and 4:00pm, Monday through Friday.

The Trembling Mountain A Personal Account of Kuru, Cannibals, and Mad Cow Disease

by Robert Klitzman Plenum Press, 1998
Reviewed by Jeanine Barone November 27, 1998 Biomednet Issue 43
Jeanine Barone is a nutritionist and exercise physiologist who specializes in writing about travel, fitness, food, and health.
"There is a recurring theme in physician Robert Klitzman's book The Trembling Mountain: A Personal Account of Kuru, Cannibals, and Mad Cow Disease. When an epidemic strikes, whether in an industrialized society or in a Stone Age tribe, responses are the same: denial and a refusal to alter ingrained behaviors that are responsible for spreading the pathogen.

Klitzman gained experience with plagues after spending time in Papua New Guinea, where kuru (a rare form of encephalopathy that - like bovine spongiform encephalopathy, also known as mad cow disease - is believed to be caused by pathogenic proteins called prions) killed up to two-thirds of the population in some villages. He took a year off between college and medical school in 1981 to conduct epidemiological research for D. Carleton Gajdusek, who won a Nobel Prize for his work with kuru and a related dementia called Creutzfeldt-Jakob disease (CJD).

After his fieldwork ended, the author returned to the United States to study medicine around the time when the first cases of AIDS were reported. According to Klitzman,In all three [kuru, mad cow disease, and AIDS], people at risk feared the disease but had difficulty understanding the disease mechanisms, accepting long incubation periods, and changing deeply rooted behaviors. Among these behaviors were the eating of human flesh, the eating of beef, the practice of unsafe sex, and the use of dirty needles to inject narcotics and other drugs.

The Trembling Mountain reads like a scientific travelogue touching on the connection between kuru and mad cow disease. It also provides a slim description of a Stone Age people, the Fore. The book is not a detailed scientific treatise; rather, Klitzman aims to take readers on a journey - the same journey he took - to explore the ways in which culture molds a person's view of death and disease. This trip was Klitzman's rite of passage, during which he learned to see patients as an anthropologist sees them, rather than as a biologist might.

In the local language, the word kuru means to tremble, a reference to the disease-induced tremors that progress until the afflicted can neither walk nor eat. As their central nervous systems degenerated, patients lost the ability to speak, were said to erupt in fits of laughter (hence its nickname the laughing death), and eventually died. Klitzman describes how this fatal disease spread as a result of the Fore's cannibalistic feasts. When someone died, the body was cut up, wrapped in banana leaves or a bamboo tube, steamed, and eaten.

The brain - the most highly prized portion and the organ with the greatest concentration of infectious prions - was always given to the nearest female relative, who shared it with her children. Though some anthropologists claim this cannibalism never existed, Klitzman provides numerous anecdotes consistent with the practice. In one instance, an old woman approached him at a funeral to tell him that his arm would probably taste very good. In Papua New Guinea, Klitzman tracked the remaining kuru cases and observed that the infection was declining. He proceeded to determine the longest incubation period, the virulence of the infectious agent, and other factors that played a role in determining who became ill. These factors included age, genes, dose, and strain; for instance, anyone born after the practice of cannibalism ceased in 1959 did not develop kuru.

At the time, researchers believed that kuru was spread primarily not by eating contaminated tissue but by touching infected mucous membranes and thereby contaminating one's hands. This made sense considering that, with no soap or tap water, women often didn't wash for weeks after a feast. It was Klitzman's job to prove that the disease was in fact spread by cannibalism.

At first, Klitzman was awkward, frightened, and frustrated as he examined dying patients and realized that he could do little more than offer them and their families a bar of soap and a blanket. He was quite naive, romanticizing Papua New Guinea as a tropical paradise and believing that the Fore would support his scientific research. Instead, he encountered problems similar to those in the West. For one thing, the people were hardly innocent.Cultures differ in how they approach essential human needs, but the basic psychological types of individuals I encountered here [lying, materialistic, and conniving people] resembled those in New York, says Klitzman. His guides had no idea what it meant to be truthful. They had no interest in his research, working only for the money, and used him for countless favors. The people here had no inquisitiveness into anything beyond their hamlet or personal material gain, he laments. When Klitzman mentioned the ocean on the distant horizon or that men walked on the moon, his guides were hardly interested.

Klitzman also recounts the frustrations involved in researching this deadly disease. He struggled to understand the Pidgin dialect (a combination of English, French, German, Dutch, and Malay) and to deal with chronically late guides, heat, humidity, and muddy trails. He slept with biting fleas, suffered from intestinal parasites, conducted interviews in the rain, coped with landslides, and trekked until he was exhausted. Patients bolted their doors or ran away when Klitzman visited their hamlet. Superstitious relatives refused to let him see patients, take pictures, or write down their names because they believed it would prove unhealthy. Many times he became so disgusted - especially when he went to bed hungry or was forced to eat in the mud with pigs - that he wanted to quit. At other moments, he relished the beauty and solitude of the mountain hikes and the simplicity of his life.

Despite the deaths, cannibalism continued among the Fore because they believed that kuru was caused by sorcery. They only stopped under the threat of arrest by the government. In the end, Klitzman couldn't convince them that kuru was caused by an infectious agent; the Fore wanted to see the cause, but all he could tell them was that it was too small to see. The tribe's belief in sorcery was so entrenched that even his guides, who worked with Western scientists, and teachers in the local school held these views. One local man who claimed he could cure kuru blamed his failures on patients' not following his advice. Much later, Klitzman realized that this is no different from doctors in the United States blaming patients - rather than inappropriate treatment - for their failures.

The book begins and ends with warnings about mad cow disease. People deal with disease, Klitzman asserts, by rationalizing (believing that kuru is due to sorcery or that AIDS only occurs in gay men) so that they can continue practicing long-held behaviors. The British didn't want to stop eating beef, the Fore didn't want to stop cannibalism, and people wanted to continue practicing unsafe sex. As the AIDS pandemic spread, I saw how Western reactions resembled Stone Age responses to kuru, notes Klitzman. Some scientists believe kuru may have originated from a feast in which someone infected with CJD was eaten. CJD is now known as the disease that people contract by eating beef infected with mad cow disease. Throughout the book, Klitzman warns that although no human cases of mad cow disease have been proven in the U.S., a number of cases traced to Britain have been identified in continental Europe. Klitzman also asserts that eating beef in the U.S. may be dangerous and that the rise in the incidence of Alzheimer's disease may simply reflect a misdiagnosis of CJD.

It wasn't until mad cow disease struck that Klitzman's research was of any practical value in the West. The incredibly long incubation periods of these prion diseases struck Klitzman when he examined a patient who developed kuru 41 years after a feast.I was sad, not just for him, but for Britain and the world. People would still die in Britain of mad cow disease more than 40 years after they ate their last infected hamburger, warns Klitzman."

Excerpt

"I had thought the natives primitive. Yet in the worlds of medicine and psychiatry, I saw many similarities to how New Guineans had understood and dealt with disease and the world. New Guinea gave me bases of comparison for all else I thought and saw - not only in medicine and psychiatry, but more broadly as well. My experiences there freed me somewhat from the constraints of Western culture: I took less for granted, and accepted less as given (which proved both a benefit and a handicap)."

Gummer explains his advice on beef safety

Mon, Dec 7, 1998  By Eileen Murphy, Consumer Affairs Correspondent, PA News
Former Conservative agriculture minister John Gummer will tell an inquiry investigating BSE that if he had thought beef was not totally safe he would not have fed it to his four children. In 1990 Mr Gummer gave his six-year-old daughter Cordelia a burger in front of media cameras to demonstrate his belief. That was five years before the first known victim of the human form of BSE died.

Mr Gummer, who was minister of state for agriculture from September 1985 until July 1988 and then Agriculture Secretary from July 1989 until May 1993, will give evidence tomorrow to the south London inquiry examining the BSE crisis. Like previous ministers who have given evidence to the inquiry, Mr Gummer states in his written statement that he accepted the expert advice of scientists following the notification of BSE in British cattle in 1987. But he said his guiding principle was always whether or not he felt that British beef was safe for his own family.

The former Tory party chairman said: "Although I had the benefit of the advice of the leading experts in the field, I am not myself a scientist. In matters as important as these it is essential to have a personal benchmark to be applied to decisions wherever appropriate. "In such circumstances I applied the test, `Would I be entirely happy for my children to eat this?' "That seemed to me to be the proper question for a non-expert to ask when assessing the views of experts."

Mr Gummer has already faced criticism at the inquiry for his actions during the crisis for making blanket statements that beef was "perfectly safe" to eat despite evidence that species other than cattle could become infected. Earlier this year the former chief medical officer Sir Donald Acheson said that he had not been consulted about Mr Gummer's statement, made after the announcement that a cat had caught BSE, that beef was safe. Sir Donald also told the inquiry that he would never have used that phrase himself. But Mr Gummer will contend that his first priority was always consumer safety.

In his statement he says: "My first principle as minister at MAFF was that the customer and the consumer came first. I reorganised ministerial responsibilities so that I made a clear division between consumer interests and the food, farming and fishery industries." Mr Gummer will tell the inquiry that he believed that the key to handling the crisis was a policy of openness towards the public.

He added: "This was not in relation to BSE alone - this was in relation to food safety in general. With regards to BSE the Government had three objectives - to protect the public from any possible risks; to identify the nature and cause of the disease and to establish the scope of its transmissibility; to aim to eradicate the disease and to prevent its recurrence."

Mr Gummer goes on to explain how he was forced to reduce the financial estimates for dealing with the BSE crisis, despite stressing the possible public health implications to the Treasury. He recalled a meeting in 1989 and said: "The Chief Secretary questioned the realism of the bids on BSE and salmonella, suggesting that they assumed a higher incidence of reported cases than experience suggested. I replied that there were real fears of risks to public safety on these issues.

"Recent laboratory work had indicated that BSE might be transmitted from one animal to another which had raised public concern in spite of the fact that there was no evidence that BSE could be transmitted to humans. "MAFF did agree to reduce the bid for salmonella and BSE related funding. If I had thought that these concessions would have adversely affected MAFF's ability to deal with BSE, I would not have made them. "While I was always conscious of the public health position, I also considered it essential to keep a tight hold on rationality."

Mr Gummer came under criticism earlier in the inquiry for failing to set up a computerised cattle tracking system to trace possible BSE cases and their offspring. But in his statement he claims that although MAFF were willing to carry out a feasibility study after the idea was mooted by the Agriculture Select Committee he could not find a justification for the expense, feeling that BSE was in decline. However, the epidemic worsened with the worldwide ban on exports being introduced and the Government admitting a possible link between BSE and CJD.

In his statement Mr Gummer said: "MAFF accepted that a feasibility study on this was necessary. In its response MAFF said that data about the offspring of known BSE cases was in fact already maintained on computer. "To go further and maintain records of other cattle would have been a formidable task. "The call for such a system seemed to be based on an assumption that if BSE were to be transmissible from dam to calf it would be necessary to slaughter all offspring of BSE cattle in order to eradicate the disease. "Furthermore, based on the epidemiological forecasts then available the number of cases would be falling rapidly by the time such a system was up and running and data relating to the peak of the epidemic would by that time be gone forever.

"The study concluded that the recommendation was based on a wrong premise, that the factors which gave rise to the recommended action had diminished considerably, and that while technically feasible the system would be very expensive." Such a system, which will cost 35 million to set up and run for its first year, has now been introduced to reassure European export markets that British beef is BSE-free.

Gummer `unaware' of beef health worry

 Tue, Dec 8, 1998 By Eileen Murphy, PA News
Former Conservative Agriculture Minister John Gummer today told the BSE inquiry he was unaware of any public health implications from eating offal during the crisis despite his predecessor backing scientific opinion that there was cause for concern. The inquiry investigating the mad cow disease outbreak heard that the minister's predecessor John Macgregor had made it clear to ministerial colleagues that he backed the views of the Chief Veterinary Officer Keith Meldrum who believed that offal should be banned from human consumption to protect public health.

Giving evidence to the London inquiry today Mr Gummer, who in the midst of the crisis proclaimed that beef was safe and fed a burger to his daughter Cordelia, said that he became Secretary of State for Agriculture in July 1989. This was seven months after the Southwood Committee delivered the first government report on BSE and how to deal with the crisis. By this point, three years after BSE had been recognised in the UK, the number of confirmed cases in cattle was 5,000. The Southwood report suggested a ban on offal despite stating that it was unlikely humans could catch BSE.

Mr Gummer said today he was not aware of any scientific evidence at the time that showed such a ban was urgent or necessary. He said: "I'm quite sure that the advice we were given was based entirely on the Southwood report in which the professor had specifically examined the issue." The offal ban had already been announced by the previous ministerial team but Mr Gummer said that although it was his job to implement the legislation he did not feel a sense of urgency about it, despite the rising numbers of BSE cases.

He said: "The offal ban had, of course, not been asked for. On the other hand it was something we had determined to do." The former minister explained that one constraining factor to speeding up the introduction of the ban was the need for consultation. He said that he did not believe the ban was "essential for public health" and added that when he took over his ministerial position it was summertime when a lot of local authorities whom he must consult, were on holiday.

Asked if he might have moved quicker if he thought that there was a serious risk to public health he added: "All I can say is that was not put to me. In fact the opposite was put to me. I saw this as a two belt and braces procedure." But Mr Gummer agreed that if legislation was seen as urgent there was often room to "find a way through." In fact, the offal ban was not introduced until November 1989 -- 10 months after the Southwood report suggested it.

The inquiry heard that evidence given by the Chief Veterinary Officer Mr Meldrum had shown that he felt that an offal ban was necessary and supported by scientific evidence. But the former minister said he had been unaware of his senior officials' views on the ban and he believed that Mr Meldrum agreed with the Southwood report fully. Mr Gummer's former colleague at the Ministry of Agriculture, David McLean, added that his view at the time was that the Southwood report was "the Bible" on BSE.

Yet Mr Gummer's predecessor, David Macgregor, had told colleagues that he supported Mr Meldrum's opinion that the government needed to go further than the recommendations of Southwood to deal with BSE. Mr Gummer said that he had never seen any correspondence showing such opinions or received any briefings from either man where they had shared these views.

Beef safety compromised, says former CMO

BMJ 1998;317:1031 by John Warden, parliamentary correspondent BMJ 
For five years at the height of Britain's crisis over bovine spongiform encephalopathy (BSE), government assurances that beef was safe to eat were based on a false assumption that abattoir surveillance was being enforced, the official inquiry into BSE was told in London this week.

Sir Kenneth Calman, who was until recently England's chief medical officer and who since 1991 issued at least five public assurances that beef was safe, revealed to the inquiry his concern at being told for the first time in late 1995 that on four occasions spinal cord had been found still attached to bovine carcases at abattoirs, in contravention of the law. This meant that potentially contaminated bovine material may have entered the human food chain and could be a factor in the emergence of new variant Creutzfeldt-Jakob disease (CJD) especially in young people.

Sir Kenneth disclosed what he called "differences of opinion" between the Department of Health and the Ministry of Agriculture, Fisheries and Food over what precautions to take, though he said that the public health was not compromised as a consequence. He felt, however, that the importance of the abattoir lapses was "understated" by the government's chief veterinary officer, Keith Meldrum.

At a subsequent meeting of officials to prepare a brief for a cabinet committee, Sir Kenneth felt it important that the cabinet and public should be told about the lapses, but the ministry of agriculture would only agree if words were added to the effect that they knew of no incident in which contaminated material had entered the food chain. Inquiry member June Bridgeman asked: "Did you feel ministers were not being fully informed?" Sir Kenneth replied: "Yes."

In written evidence Sir Kenneth said that over the years the advice he issued on the safety of beef was primarily on the understanding that the ban on specified bovine offals was operating effectively at abattoirs. When he was made aware of serious breaches, he was astonished and sought meetings with ministers to say that he was no longer in a position to give assurances that BSE contamination had not entered into the food chain. Instant enforcement action was taken.

Five months later, in March 1996, new variant CJD was identified. A few days before, Sir Kenneth had to dissuade the ministry of agriculture from giving out a "reassuring message which did not concur with the new findings." Asked if the breaches of the offal ban might have led to people contracting new variant CJD, Sir Kenneth said that it was one possibility among others.

Sir Kenneth told the inquiry that weekend media reports of his evidence were unhelpful. They implied that if he had known of the abattoir breaches before 1995 he would not have issued safety assurances. He said that his evidence was in no sense meant to be accusatory of Mr Meldrum, with whom he had a close working relationship.

He also said that his use of the word safe in relation to beef did not mean zero risk but defined it as "free from unacceptable risk or harm." This brought criticism from the Consumers' Association and from relatives of nvCJD victims. They said that Sir Kenneth's assurances that eating beef was safe were now seen to have been misleading.

Written evidence submitted to the inquiry can be found at http://www.bse.org.uk.

CJD epidemic won't happen, says electrical engineer

December 7 1998 London Times BY MICHAEL HORNSBY 
FEWER than 100 people are likely to die from the human form of "mad cow" disease and an epidemic can be ruled out, it is claimed today.

Two scientists at City University in London say they reached this conclusion through tried and tested risk analysis methods. "What we are saying is that there is not an epidemic and that it has been obvious for the past 2 years that there is not going to be an epidemic," Philip Thomas, visiting Professor in the Department of Electrical, Electronic and Information Engineering, said.

Professor Thomas and Martin Newby, Professor of Statistical Science, believe government policy has been mistakenly based on "worst-case conjectures", at huge cost to the taxpayer. They calculate that as few as four, and no more than 15, lives will be saved by the billions of pounds spent since 1996 on such BSE counter-measures as slaughtering all cattle over 30 months old.

The scientists' findings have been submitted as evidence to the BSE inquiry. A more detailed report on their research will be published next month in the British Food Journal.

Their study is based on the 23 people who had died of new-variant Creutzfeldt-Jakob disease by the end of 1997. Since then the disease has claimed nine more victims, a death rate fully in line with their predictions, they say.

The most likely number of deaths over the whole course of the disease is 87, they estimate. The time between infection and death is likely to average 6 to eight years. The scientists expect the annual incidence of new cases of new-variant CJD to reach a peak of 16 next year and then to start falling, with no more occurring after 2006.

The forecast death toll of 87 assumes that the ban introduced in 1989 on brain, spinal cord and other potentially infected cattle parts has been 70 per cent effective in preventing such material from entering the human food chain. Had the ban been 100 per cent effective, they calculate, no more than 26 people would have died over the course of the disease. But even without any ban, the number of victims would probably not have exceeded 109.

Even if the average incubation period were to turn out to be nearer 20 years, the scientists say the number of deaths would not be more than 330.

Their prognosis is in striking contrast with the far more cautious view of the Spongiform Encephalopathy Advisory Committee, the panel of scientists advising the Government. Peter Smith, a Seac member and Professor of Tropical Epidemiology at the London School of Hygiene and Tropical Medicine, said: "I fear they are going much further than the data allows at this stage."

Australian butcher case reported

Mon, 07 Dec 1998 Rachel Shepherd
"There are three cases reported in Australia. Two are under 50 and 1 of these is reported to be a butcher. The two under 50 are reported to be familial CJD although it is not clear how this was determined as the butcher is reported to be the first person in the family with the familial disease. None of this is statistically significant, but it is interesting."

Livestock fed most antibiotics

December 7 1998  London Times BY MICHAEL HORNSBY
AT LEAST three fifths of all antibiotics are used to treat animals rather than human beings, it is claimed in a report out today.

More than a tenth of the drugs used on animals are administered to promote faster growth in farm stock rather than to cure disease, according to the Soil Association, the voice of the organic farming movement, which commissioned the report.

"Pigs, poultry and even cattle are getting antibiotics on a daily basis to make them grow faster and try to control the diseases caused by intensive production," Richard Young, the association's campaigns and policy co-ordinator, said.

The report comes as government scientific advisers are preparing to recommend that some widely used drugs are banned from animal feed. Their proposals are expected to be announced next month.

Many scientists are worried that the growing resistance of bacteria such as salmonella to antibiotics may be linked to the use of the same or similar drugs in animals.

Nothing yet totally kills mad cow agent - expert

Reuters North America By Maggie Fox, Health and Science Correspondent
WASHINGTON (Reuters) - Nothing has yet been found that completely kills off the agents that cause mad cow disease and related diseases in humans, a U.S. researcher said Wednesday. Speaking at a science meeting, Dr. David Asher urged more research to find some method that will make food processing, medical and other equipment safe from carrying infection by the agents that cause such diseases.

Mad cow disease, known officially as bovine spongiform encephalopathy (BSE), is caused by a mutated protein known as a prion. So are related diseases such as Creutzfeldt-Jakob disease (CJD), which affects people, and scrapie in sheep. Britain is at the tail end of an epidemic of BSE, believed to have been caused by feeding the remains of sheep infected with scrapie to cattle. A human version of the disease, known as new variant CJD or nvCJD, has killed 30 people so far. Scientists think BSE is only transmitted by eating infected products.

Europe only last month lifted a 32-month ban of British beef products. But CJD is known to have been transmitted by transplants of infected brain matter and it is possible infection could be passed by using contaminated instruments.

Asher said he set up a laboratory last year at the Food and Drug Administration (FDA) to look for ways to eliminate the infectious prions. But he told a science meeting organized by the FDA and the American Association of Pharmaceutical Scientists, it is hard to kill them. The standard disinfectants -- sodium hydroxide, sodium hypochloride and moist heat -- had all eliminated most of the infectivity but not all of it. "Our goal is to kill it all," he said.

Other scientists have found that heating infected material to high temperatures for long periods of time, pouring on strong disinfectants and leaving them to dry out all fail to kill off all the infectivity. Asher says efforts to find a way to destroy the agent have fizzled out somewhat. "This is a very undersubscribed field of effort," he said.

Maybe a cocktail of disinfectants will work, he said. "It just appears to me that attention should be paid to using a combination of treatments," he said. Luckily, Asher said, there is no evidence that any cattle in the United States have succumbed. He said tests of brains from 7,000 animals show no sign of BSE. Many of the cattle tested had fallen down for no explained reason -- one of the same symptoms of BSE. BSE and CJD both gradually destroy the brain. Victims lose the ability to walk or stand, become demented and die. There is no treatment or cure.

nvCJD cases reach 34

DEPARTMENT OF HEALTH
1998/0574 Monday 7th December 1998
[We are abruptly up to 33 cases of nvCJD + 1 in France. Even if the rate does appear to be picking up, nothing can be inferred yet about the ultimate scope of the epidemic, which will be a superpositioning of genotype-specific smaller epidemics; codon 129 will prove to be only part of the genetics story. It is important to move forward quickly with the appendix and tonsil program. --webmaster]

Latest Department of Health nvCJD statistics. The next table will be published on Monday 4 January 1999.

Year Referrals       Deaths of  definite and  probable  cases   in the UK
            Sporadic latrogenic   families      GSS     nvCJD   Total
 
1985    -      26        1           1           0        -       28
1986    -      26        0           0           0        -       26
1987    -      23        0           0           1        -       24
1988    -      22        1           1           0        -       24
1989    -      28        2           2           0        -       32
1990    53     28        5           0           0        -       33
1991    75     32        1           3           0        -       36
1992    96     43        2           5           1        -       51
1993    78     38        4           2           2        -       46
1994    116    51        1           4           3        -       59
1995    87     35        4           2           3        3       47
1996    134    41        4           2           4       10       61
1997    160    58        6           4           1       10       79
1998*   111    27        1           2           0       10       40
* To 31 October 1998. Total number of definite and probable cases of nvCJD = 33.

I believed BSE experts', says Bottomley

PA News Sun, Dec 13, 1998 By Eileen Murphy, Consumer Affairs Correspondent, PA News 
Former Tory health minister Virginia Bottomley says that she believed scientific experts who told her British beef was safe and that a "sporadic" case of CJD (Creutzfeldt-Jakob Disease) in a farmer was not linked to "mad cow" disease.

Mrs Bottomley, who was at the Department of Health between 1989 and 1995, will today tell the London inquiry investigating the outbreak of BSE that, because of the unknown nature of the disease at the time of the crisis, Government ministers relied on the advice of scientists.

In written evidence for today's hearing she says: "At all times ministers and officials saw BSE/CJD as a serious subject and it was treated accordingly, with a professional and scientific approach." She says her key adviser at the Department was Sir Kenneth Calman, the Chief Medical Officer, who was expected to produce independent scientific advice, irrespective of political considerations.

"My own view was that the Department would be failing if it did not base its response to public health fears first and foremost on a sound foundation of scientific advice. This was the guiding principle, not only with BSE, but also in dealing with other public health concerns," Mrs Bottomley says. "In the case of BSE the particularly difficult nature of the background science made the provision of specialist advice all the more important."

Referring to 1992 she says: "I was informed of the probable first case of CJD in a farmer. I understood that the case of CJD in a farmer was a potentially serious finding. I was informed that the provisional diagnosis of CJD in a farmer had been confirmed through pathology."

But Mrs Bottomley said that at that time she followed the advice of the Government's Spongiform Encephalopathy Advisory Committee which had come to the view that "all the indications suggested that it was a typical sporadic case of CJD", and not something linked to BSE.

Southwood concerns in 1989

December 14, 1998 PA News Andy Woodcock 
Professor Sir Richard Southwood whose 1989 report provided the U.K. Government with its first scientific guidance on so-called "mad cow disease"was cited as writing in a private letter to a fellow expert in 1989 that he had anxiety over the danger of injections "very much in mind".

At that time, the Government was assuring the public that the risk to humans from BSE was remote, and had not moved to ban the use of certain specified bovine offals (SBOs) in pharmaceuticals such as vaccines, many of which contain cattle products.

Former Conservative Health Secretary Virginia Bottomley was cited as telling the BSE inquiry today that she was not aware of Professor Southwood's concerns or of the existence of the letter and that she was not aware that the ban on the use of SBOs did not apply to medicines.

The decision to introduce the SBO ban was announced in June 1989, four months after the publication of the Southwood report and a month before Professor Southwood's letter to the head of the Tyrell Committee of research into BSE. In the letter, Professor Southwood, of Oxford University, was quoted as writing, "Personally, I would have thought the possibility of human infection was moderately high if some medicinal products were made from tissues of infected animals and injected into humans. That's an extreme case, but we certainly had such anxieties very much in mind."

It was not for some time that the SBO ban was extended to cover pharmaceuticals, and Mrs Bottomley told the inquiry that she could not recall whether she had known at the time that there were no proposals to remove medicines produced before the ban from the shelves. During her time as Secretary of State for Health, between 1992 and 1995, she said, her understanding was that the best scientific advice was that it was very unlikely, but not impossible, that humans might be in danger of infection from BSE.

Mrs Bottomley was cited as telling the inquiry that she relied on the recommendations of her scientific advisers in dealing with a series of health scares during her term in office, including BSE, cot death, the so-called "flesh-eating bug", meningitis outbreaks and the plague in India, adding, "I worked very closely with the Chief Medical Officer on alarming issue after alarming issue and in each case I was aware that this had the potential to be some horrific new development.

I would not characterise my position as dismissing scare stories, but knowing that we had to evaluate the evidence and then share that evidence as quickly as possible. Always, when an anxiety was raised, I would ask the CMO `is this an issue which has enormous potential on which we must act now, energetically, or one where we should take another course of action?'. I have no recollection of ever personally expressing a view. I would always have said that the CMO thinks that there is no evidence that BSE causes CJD. I don't think my opinion on this subject is worth a lot, I am not an expert."

France announces two more cases of mad cow disease

December 14, 1998
Reuters
PARIS -- The Agriculture Ministry was cited as saying on Monday that two new cases of mad cow disease havebeen discovered in France, bringing to 48 the number of cows found suffering from bovine spongiform encephalopathy (BSE) here since 1990. Both cows were born and raised in western France and their herds -- 183 in the Sarthe region and 108 in the Mayenne area were completely destroyed at the end of last week, it said.

France has, according to this story, discovered 17 BSE cases this year out of a national livestock total of 21 million.

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